Provider Demographics
NPI:1689480394
Name:SARIKHANI, FARNOUSH (PA-S)
Entity type:Individual
Prefix:
First Name:FARNOUSH
Middle Name:
Last Name:SARIKHANI
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4388 E CAMPO BELLO DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2294
Mailing Address - Country:US
Mailing Address - Phone:602-875-9291
Mailing Address - Fax:
Practice Address - Street 1:4388 E CAMPO BELLO DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2294
Practice Address - Country:US
Practice Address - Phone:602-875-9291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant