Healthcare Provider Details

I. General information

NPI: 1902491392
Provider Name (Legal Business Name): MALIKA KHADIJAT HOWARD SERIKI NA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MALIKA KHADIJA SERIKI CM

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 KENDALL ST
LAKEWOOD CO
80214-1412
US

IV. Provider business mailing address

1651 KENDALL ST
LAKEWOOD CO
80214-1412
US

V. Phone/Fax

Practice location:
  • Phone: 303-962-4304
  • Fax:
Mailing address:
  • Phone: 303-232-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: