Healthcare Provider Details

I. General information

NPI: 1134916216
Provider Name (Legal Business Name): MRS. AMINA IQBAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E TULARE AVE
VISALIA CA
93292-3629
US

IV. Provider business mailing address

520 E TULARE AVE
VISALIA CA
93292-3629
US

V. Phone/Fax

Practice location:
  • Phone: 912-755-1670
  • Fax: 559-749-9823
Mailing address:
  • Phone: 559-623-0900
  • Fax: 559-749-9823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: