Provider Demographics
NPI:1508737669
Name:SARAEIAN, SAMANEH
Entity type:Individual
Prefix:
First Name:SAMANEH
Middle Name:
Last Name:SARAEIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 CLUB MERIDIAN DR APT 6B
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-4522
Mailing Address - Country:US
Mailing Address - Phone:517-281-8201
Mailing Address - Fax:
Practice Address - Street 1:315 MERCY AVE STE 301
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8367
Practice Address - Country:US
Practice Address - Phone:209-564-3513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program