Provider Demographics
NPI:1467086256
Name:MIYA, ZUHURA
Entity Type:Individual
Prefix:
First Name:ZUHURA
Middle Name:
Last Name:MIYA
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 1:19803 ROSEMARY ST
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-3323
Mailing Address - Country:US
Mailing Address - Phone:909-642-5263
Mailing Address - Fax:
Practice Address - Street 1:19803 ROSEMARY ST
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-3323
Practice Address - Country:US
Practice Address - Phone:909-642-5263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst