DR. Fatemeh Ahdi Bani-Taba, PSYD

NPI #1144413725 in Santa Rosa, California

Provider Information

NPI Number: 1144413725
Entity Type: Individual
Name: DR. Fatemeh Ahdi Bani-Taba, PSYD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PSYD
Enumeration Date: Aug 27, 2007
Last Updated: Aug 27, 2007

Practice Location

Address: 401 BICENTENNIAL WAY
Address 2: MOB EAST
City: Santa Rosa
State: California
ZIP Code: 95403-2149
Phone: (707) 571-5181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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