Provider Demographics
NPI:1396399226
Name:JIBRIL, ANILA ISMAIL
Entity Type:Individual
Prefix:
First Name:ANILA
Middle Name:ISMAIL
Last Name:JIBRIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANILA
Other - Middle Name:A
Other - Last Name:ISMAIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26922 FLO LN UNIT 436
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-5517
Mailing Address - Country:US
Mailing Address - Phone:818-297-6228
Mailing Address - Fax:
Practice Address - Street 1:26922 FLO LN UNIT 436
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-5517
Practice Address - Country:US
Practice Address - Phone:818-297-6228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist