Healthcare Provider Details

I. General information

NPI: 1588483119
Provider Name (Legal Business Name): SABA ALJUMHOOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1618 ORANGE AVE APT 202
REDLANDS CA
92373-5381
US

IV. Provider business mailing address

1618 ORANGE AVE APT 202
REDLANDS CA
92373-5381
US

V. Phone/Fax

Practice location:
  • Phone: 909-602-9514
  • Fax:
Mailing address:
  • Phone: 909-602-9514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number95369695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: