Provider Demographics
NPI:1851634414
Name:FATHIMA, SABA (BS)
Entity type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:FATHIMA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9090 MOODY ST APT 170
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2942
Mailing Address - Country:US
Mailing Address - Phone:714-473-7892
Mailing Address - Fax:
Practice Address - Street 1:9090 MOODY ST APT 170
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2942
Practice Address - Country:US
Practice Address - Phone:714-473-7892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19132355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant