Provider Demographics
NPI:1922874197
Name:MUHAMMAD, KHALILAH J
Entity Type:Individual
Prefix:
First Name:KHALILAH
Middle Name:J
Last Name:MUHAMMAD
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 1:3499 10TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3617
Mailing Address - Country:US
Mailing Address - Phone:951-955-1560
Mailing Address - Fax:
Practice Address - Street 1:3499 10TH ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3617
Practice Address - Country:US
Practice Address - Phone:951-955-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical