Healthcare Provider Details

I. General information

NPI: 1578484192
Provider Name (Legal Business Name): ALLIAH'S BEAUTY AND WELLNESS SALON, INC. OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1263 E LYNWOOD DR
SAN BERNARDINO CA
92404-2752
US

IV. Provider business mailing address

2527 S GARFIELD PL
ONTARIO CA
91761-6115
US

V. Phone/Fax

Practice location:
  • Phone: 909-749-5327
  • Fax:
Mailing address:
  • Phone: 909-749-5327
  • Fax: 909-749-5327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DESHEILA MURPHY
Title or Position: SERVICE PROVIDER
Credential: PROFESSIONAL HEALER
Phone: 909-749-5327