Provider Demographics
NPI:1417089020
Name:ABDUL-MUMIN, SADIYYAH
Entity Type:Individual
Prefix:MISS
First Name:SADIYYAH
Middle Name:
Last Name:ABDUL-MUMIN
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 1:17434 BELLFLOWER BLVD STE 258
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6851
Mailing Address - Country:US
Mailing Address - Phone:310-800-2941
Mailing Address - Fax:
Practice Address - Street 1:17434 BELLFLOWER BLVD STE 258
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6851
Practice Address - Country:US
Practice Address - Phone:310-800-2941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86941106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty