Fanaeian, Samaneh

Fanaeian, Samaneh is an individual health care provider with primary practice located at 2656 29Th St Ste 202 , Santa Monica CA 90405-2984. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Fanaeian, Samaneh can be contacted via phone (310) 503-0221.

Contact Information

Primary practice address
2656 29Th St Ste 202 Santa Monica CA 90405-2984
Phone: (310) 503-0221
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95017465 California

Profile Details

NPI number 1417621434
LBN Legal business name Fanaeian, Samaneh
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2021
Last updated Jan 2nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417621434 NPPES
California MEDICAID 1417621434

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