Provider Demographics
NPI:1689440018
Name:RIMSA, MIKAYLA KAY
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:KAY
Last Name:RIMSA
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 1:985 PARKVIEW DR UNIT 20
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-4100
Mailing Address - Country:US
Mailing Address - Phone:650-387-2053
Mailing Address - Fax:
Practice Address - Street 1:1790 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-2822
Practice Address - Country:US
Practice Address - Phone:650-387-2053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer