Provider Demographics
NPI:1093366114
Name:MIRANDA, CLAUDIA (MA)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13031 LAMIA PT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6928
Mailing Address - Country:US
Mailing Address - Phone:510-825-9711
Mailing Address - Fax:
Practice Address - Street 1:411 CAMINO DEL RIO S STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3550
Practice Address - Country:US
Practice Address - Phone:619-307-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program