Provider Demographics
NPI:1093543100
Name:IRSHAD, RUMISA
Entity type:Individual
Prefix:
First Name:RUMISA
Middle Name:
Last Name:IRSHAD
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 1:185 EL RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-2171
Mailing Address - Country:US
Mailing Address - Phone:650-636-3560
Mailing Address - Fax:
Practice Address - Street 1:185 EL RANCHO DR
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-2171
Practice Address - Country:US
Practice Address - Phone:650-636-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician