Provider Demographics
NPI:1538574645
Name:KERMANI, ZOHREH (PSYD)
Entity type:Individual
Prefix:
First Name:ZOHREH
Middle Name:
Last Name:KERMANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 COLUMBIA ST UNIT 800
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3456
Mailing Address - Country:US
Mailing Address - Phone:858-771-4388
Mailing Address - Fax:619-942-5048
Practice Address - Street 1:1350 COLUMBIA ST UNIT 800
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3456
Practice Address - Country:US
Practice Address - Phone:619-259-3030
Practice Address - Fax:619-942-5048
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32653103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical