Provider Demographics
NPI:1912794389
Name:NURIEVA, MALIKA
Entity type:Individual
Prefix:
First Name:MALIKA
Middle Name:
Last Name:NURIEVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CREEKSIDE RIDGE CT STE 215
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-3595
Mailing Address - Country:US
Mailing Address - Phone:916-834-7291
Mailing Address - Fax:
Practice Address - Street 1:1100 ROSEVILLE PKWY APT 427
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-4103
Practice Address - Country:US
Practice Address - Phone:916-834-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker