Individual
MS. AUDIAH LATIFAH FEAGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
431 SHADOW TREE DR, OCEANSIDE, CA 92058-7022
(760) 362-3966
Mailing address
311 N SANTA FE AVE APT 107, VISTA, CA 92084-5431
(619) 765-8125
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y2907937
DRIVER LICENSE
CA
Enumeration date
09/23/2019
Last updated
09/23/2019
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