Provider Demographics
NPI:1689167611
Name:ALLAH, ARIFAH FATINE
Entity Type:Individual
Prefix:
First Name:ARIFAH
Middle Name:FATINE
Last Name:ALLAH
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 1:3301 N PARK DR UNIT 2013
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1883
Mailing Address - Country:US
Mailing Address - Phone:916-335-9556
Mailing Address - Fax:
Practice Address - Street 1:3301 N PARK DR UNIT 2013
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-1883
Practice Address - Country:US
Practice Address - Phone:916-335-9556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB5853539172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver