Provider Demographics
NPI:1982458402
Name:MASEKA, ANITHA SIFA
Entity Type:Individual
Prefix:
First Name:ANITHA
Middle Name:SIFA
Last Name:MASEKA
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 1:6828 W PLEASANT LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2659
Mailing Address - Country:US
Mailing Address - Phone:623-200-2148
Mailing Address - Fax:
Practice Address - Street 1:10320 W MCDOWELL RD BLDG G
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4863
Practice Address - Country:US
Practice Address - Phone:623-215-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health