Individual provider · Type 1 NPI

Mariam Princess Ikharo-Matlock

Student in an Organized Health Care Education/Training Program · Antioch, CA

NPI number 1730845249 Active

Practice location

1879 Mount Goethe Way
Antioch, CA 94531-9077

Call (510) 904-8656 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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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About NPI 1730845249

Mariam Princess Ikharo-Matlock's National Provider Identifier is 1730845249, issued on Nov 10, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Antioch, CA. The record was last updated on Nov 10, 2021.