Provider Demographics
NPI:1841762135
Name:IKHARO-UMARU, RAUFAT HABIBA
Entity Type:Individual
Prefix:
First Name:RAUFAT
Middle Name:HABIBA
Last Name:IKHARO-UMARU
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 1:145 BEEDE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-1827
Mailing Address - Country:US
Mailing Address - Phone:925-303-2508
Mailing Address - Fax:
Practice Address - Street 1:145 BEEDE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1827
Practice Address - Country:US
Practice Address - Phone:925-303-2508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA684660163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse