Provider Demographics
NPI:1114703816
Name:AFRIADE, SOPHIA MAGHNIA
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MAGHNIA
Last Name:AFRIADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11107 SILVER SUN CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-9126
Mailing Address - Country:US
Mailing Address - Phone:909-241-9880
Mailing Address - Fax:
Practice Address - Street 1:11107 SILVER SUN CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-9126
Practice Address - Country:US
Practice Address - Phone:909-241-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician