Individual
SHANAZ HATIFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 SUTTON WAY APT 220, GRASS VALLEY, CA 95945-4188
(510) 393-5796
Mailing address
210 SUTTON WAY APT 220, GRASS VALLEY, CA 95945-4188
(510) 393-5796
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
D2101371
CA
101YM0800X
Mental Health Counselor
D2101371
CA
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
CA
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/21/2016
Last updated
04/22/2025
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