Provider Demographics
NPI:1811782493
Name:ISLAM, MEENA Z
Entity type:Individual
Prefix:
First Name:MEENA
Middle Name:Z
Last Name:ISLAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37196 TALBERT TER APT 285
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-1916
Mailing Address - Country:US
Mailing Address - Phone:951-837-6259
Mailing Address - Fax:
Practice Address - Street 1:37196 TALBERT TER APT 285
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-1916
Practice Address - Country:US
Practice Address - Phone:951-837-6259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty