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Mariam Princess Ikharo-matlock
Student in an Organized Health Care Education/Training Program in Antioch, California
NPI 1730845249

Mariam Princess Ikharo-matlock is a Student in an Organized Health Care Education/Training Program based in Antioch, CA. Mariam Princess Ikharo-matlock practices in Antioch, CA. The NPI Number for Mariam Princess Ikharo-matlock is 1730845249 and holds a License No. (California).

The current practice location address for Mariam Princess Ikharo-matlock is 1879 Mount Goethe Way, Antioch, CA and can be reached out via phone at 510-904-8656.

Location: 1879 Mount Goethe Way, Antioch, CA, 94531-9077
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730845249
Provider Name
Mariam Princess Ikharo-matlock
Credential
Provider Entity Type
Individual
Gender
Female
Address
1879 Mount Goethe Way, Antioch, CA, 94531-9077
Phone Number
510-904-8656
Fax Number
Provider Enumeration Date
11/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1879 Mount Goethe Way
City
Antioch
State
California
Zip
94531-9077
Phone Number
510-904-8656
Fax Number
person
Provider Business Mailing Address Details
Address
1879 Mount Goethe Way
City
Antioch
State
California
Zip
94531-9077
Phone Number
510-904-8656
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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