Ghaderifard, Azita

Ghaderifard, Azita is an sole proprietor health care provider with primary practice located at 23101 Lake Center Dr 130, Lake Forest CA 92630-2801. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ghaderifard, Azita can be contacted via phone (949) 716-9021.

Contact Information

Primary practice address
23101 Lake Center Dr 130 Lake Forest CA 92630-2801
Phone: (949) 716-9021
Fax: (949) 861-6810
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 14410 California
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 577516 Texas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 577516 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 577516 Texas

Profile Details

NPI number 1467753129
LBN Legal business name Ghaderifard, Azita
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2010
Last updated Nov 4th, 2013 - about 11 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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