Provider Demographics
NPI:1013630573
Name:AWAD, ANALIBYA JASER
Entity Type:Individual
Prefix:
First Name:ANALIBYA
Middle Name:JASER
Last Name:AWAD
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 1:8962 OAKRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-3095
Mailing Address - Country:US
Mailing Address - Phone:951-455-7661
Mailing Address - Fax:
Practice Address - Street 1:12125 DAY ST STE E301
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-6704
Practice Address - Country:US
Practice Address - Phone:951-344-2166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst