Provider Demographics
NPI:1831894724
Name:AHMED, FAWZIYYAH (FNP)
Entity type:Individual
Prefix:
First Name:FAWZIYYAH
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W 220TH ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2868
Mailing Address - Country:US
Mailing Address - Phone:310-293-4158
Mailing Address - Fax:
Practice Address - Street 1:410 W 220TH ST UNIT 5
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2868
Practice Address - Country:US
Practice Address - Phone:310-293-4158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily