Provider Demographics
NPI:1225752199
Name:HUSSAIN, NAZIHA BATOOL
Entity Type:Individual
Prefix:
First Name:NAZIHA
Middle Name:BATOOL
Last Name:HUSSAIN
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 1:131 SARATOGA AVE APT 3206
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7354
Mailing Address - Country:US
Mailing Address - Phone:949-922-0048
Mailing Address - Fax:
Practice Address - Street 1:100 SMITH RANCH RD FL 2
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-5552
Practice Address - Country:US
Practice Address - Phone:949-922-0048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty