Provider Demographics
NPI:1275353690
Name:MUHAMMAD, ANISSA MICHELE
Entity type:Individual
Prefix:
First Name:ANISSA
Middle Name:MICHELE
Last Name:MUHAMMAD
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 1:4206 SANTO TOMAS DR APT A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3145
Mailing Address - Country:US
Mailing Address - Phone:323-921-5658
Mailing Address - Fax:
Practice Address - Street 1:4206 SANTO TOMAS DR APT A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3145
Practice Address - Country:US
Practice Address - Phone:323-921-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula