Provider Demographics
NPI:1720599921
Name:BIBI, UMAIRA
Entity Type:Individual
Prefix:
First Name:UMAIRA
Middle Name:
Last Name:BIBI
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 1:815 BRYTE AVE # ATP30
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95605-1801
Mailing Address - Country:US
Mailing Address - Phone:916-997-5901
Mailing Address - Fax:
Practice Address - Street 1:815 BRYTE AVE APT 30
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95605-1860
Practice Address - Country:US
Practice Address - Phone:916-997-5901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician