Provider Demographics
NPI:1629270376
Name:MILANI, ANYA JADE (MA)
Entity Type:Individual
Prefix:
First Name:ANYA
Middle Name:JADE
Last Name:MILANI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5428 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1530
Mailing Address - Country:US
Mailing Address - Phone:925-372-7984
Mailing Address - Fax:
Practice Address - Street 1:1738 JEANNE CIR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6618
Practice Address - Country:US
Practice Address - Phone:925-372-7984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE4575235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPE004575OtherMEDI-CAL RENDERING PROVID