Provider Demographics
NPI:1205726221
Name:MIRZA, SABREENA (NP)
Entity type:Individual
Prefix:
First Name:SABREENA
Middle Name:
Last Name:MIRZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1165 PHELPS AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-9665
Mailing Address - Country:US
Mailing Address - Phone:559-821-6151
Mailing Address - Fax:559-935-4162
Practice Address - Street 1:1165 PHELPS AVE STE 105
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9665
Practice Address - Country:US
Practice Address - Phone:559-821-6151
Practice Address - Fax:559-935-4162
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95031713363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner