Provider Demographics
NPI:1982256038
Name:MOMI, PRIYA
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:MOMI
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 1:1215 PLUMAS ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3490
Mailing Address - Country:US
Mailing Address - Phone:530-763-2176
Mailing Address - Fax:
Practice Address - Street 1:1215 PLUMAS ST STE 1200
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3490
Practice Address - Country:US
Practice Address - Phone:530-763-2176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19341235Z00000X
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist