Provider Demographics
NPI:1164298923
Name:ARIZA, MIRNA LORENA
Entity Type:Individual
Prefix:
First Name:MIRNA
Middle Name:LORENA
Last Name:ARIZA
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 1:3914 MURPHY CANYON RD STE A224
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4423
Mailing Address - Country:US
Mailing Address - Phone:619-326-2222
Mailing Address - Fax:858-569-5970
Practice Address - Street 1:3914 MURPHY CANYON RD STE A224
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4423
Practice Address - Country:US
Practice Address - Phone:619-326-2222
Practice Address - Fax:858-569-5970
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator