Provider Demographics
NPI:1699579631
Name:PREOCANIN, MIRJANA
Entity type:Individual
Prefix:MS
First Name:MIRJANA
Middle Name:
Last Name:PREOCANIN
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:MIRA
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3001 E TAHQUITZ CANYON WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6900
Mailing Address - Country:US
Mailing Address - Phone:442-371-3342
Mailing Address - Fax:
Practice Address - Street 1:3001 E TAHQUITZ CANYON WAY STE 103
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6900
Practice Address - Country:US
Practice Address - Phone:442-371-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker