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NPI Code Detail

MEDICARE: PRISCILLA JOY MIYACHI

MEDICARE: PRISCILLA JOY MIYACHI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianY3207995CA

General Provider Information

NPI Number : 1568966422
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILLA JOY MIYACHI
Provider Business Mailing Address
First Line : 6030 W OAKS BLVD STE 170
Second Line :
City : ROCKLIN
State : CA
Zip : 95765-4437
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6030 W OAKS BLVD STE 170
Second Line :
City : ROCKLIN
State : CA
Zip : 95765-4437
Country : US
Telephone Number : 916-824-3220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2018
Last Update Date : 03/23/2018

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Directions to “ PRISCILLA JOY MIYACHI ” Practice Location

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