Provider Demographics
NPI:1346069861
Name:JARRAH, SEIF
Entity type:Individual
Prefix:
First Name:SEIF
Middle Name:
Last Name:JARRAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DOVE ST STE 335
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1433
Mailing Address - Country:US
Mailing Address - Phone:949-395-8246
Mailing Address - Fax:
Practice Address - Street 1:1600 DOVE ST STE 335
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1433
Practice Address - Country:US
Practice Address - Phone:949-395-8246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT149010390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program