Individual
SOPHIA AYISHA MAWLAVIZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1692 EL CAMINO REAL, SAN CARLOS, CA 94070-5208
(650) 817-9070
(650) 817-9074
Mailing address
1692 EL CAMINO REAL, SAN CARLOS, CA 94070-5208
(650) 817-9070
(650) 817-9074
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95233010
CA
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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