Healthcare Provider Details

I. General information

NPI: 1235045428
Provider Name (Legal Business Name): KAAMILAH BERNICE SAAFIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14162 GOPHER CANYON RD
VICTORVILLE CA
92394-7419
US

IV. Provider business mailing address

14162 GOPHER CANYON RD
VICTORVILLE CA
92394-7419
US

V. Phone/Fax

Practice location:
  • Phone: 562-291-7272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberW9917257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: