Provider Demographics
NPI:1750063640
Name:AZIZ, WIDAD ZUHAR
Entity type:Individual
Prefix:
First Name:WIDAD
Middle Name:ZUHAR
Last Name:AZIZ
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 1:176 S PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4144
Mailing Address - Country:US
Mailing Address - Phone:858-314-0125
Mailing Address - Fax:
Practice Address - Street 1:176 S PIERCE ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4144
Practice Address - Country:US
Practice Address - Phone:858-314-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician