Provider Demographics
NPI:1659925840
Name:MILLER, DAAIYAH NZINGA
Entity Type:Individual
Prefix:
First Name:DAAIYAH
Middle Name:NZINGA
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAAIYAH
Other - Middle Name:NZINGA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40015 SIERRA HWY
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2101
Mailing Address - Country:US
Mailing Address - Phone:424-222-3071
Mailing Address - Fax:661-526-4931
Practice Address - Street 1:40015 SIERRA HWY STE B280
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2143
Practice Address - Country:US
Practice Address - Phone:661-526-5061
Practice Address - Fax:661-526-4931
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator