MEDICARE: MIA ALEXA QUBADI HIGH SCHOOL DIPLOMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1336984509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIA ALEXA QUBADI HIGH SCHOOL DIPLOMA

Provider Business Mailing Address
First Line	:	5850 GRANITE PKWY STE 600
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12660 RIVERSIDE DR STE 305
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3431
Country	:	US
Telephone Number	:	818-614-3365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/28/2024

Similar Medicare Providers

1912852229 — CAYLA ARLENA ARNOLD
Practice Location Address:

12660 RIVERSIDE DR STE 305
NORTH HOLLYWOOD, CA
91607-3431

Practice Phone: 818-614-3365
Practice Fax:

1154403921 — DAVID C PARRIS MD
Practice Location Address:

12660 RIVERSIDE DR STE 310
NORTH HOLLYWOOD, CA
91607-3431

Practice Phone: 818-755-0391
Practice Fax: 818-753-8165

1720580103 — DR. SEVAK MINASSIAN MD
Practice Location Address:

12660 RIVERSIDE DR STE 310
NORTH HOLLYWOOD, CA
91607-3431

Practice Phone: 818-755-0391
Practice Fax: 818-753-8165

1588254536 — SIMONA BENEDETTA SERIO
Practice Location Address:

12660 RIVERSIDE DR STE 310
NORTH HOLLYWOOD, CA
91607-3431

Practice Phone: 747-206-9161
Practice Fax:

1538870167 — SAHITI S ANNADATA
Practice Location Address:

12660 RIVERSIDE DR STE 305
NORTH HOLLYWOOD, CA
91607-3431

Practice Phone: 747-254-1154
Practice Fax:

1235131343 — DR. ERIC J PINDERSKI M.D.
Practice Location Address:

12660 RIVERSIDE DR , STE 310
N HOLLYWOOD, CA
91607-3431

Practice Phone: 818-755-0391
Practice Fax: 818-753-8165

Directions to “ MIA ALEXA QUBADI HIGH SCHOOL DIPLOMA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.