MEDICARE: MISHA HUSSAIN

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	103K00000X	Behavior Analyst		CA

General Provider Information

NPI Number	:	1386332427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISHA HUSSAIN

Provider Business Mailing Address
First Line	:	1892 S WESTSIDE DR UNIT 64
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805-7486
Country	:	US
Telephone Number	:	949-656-6537
Fax Number	:

Provider Business Practice Location Address
First Line	:	1892 S WESTSIDE DR UNIT 64
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805-7486
Country	:	US
Telephone Number	:	949-656-6537
Fax Number	:

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

Provider Enumeration Date	:	04/26/2023
Last Update Date	:	04/26/2023

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Directions to “ MISHA HUSSAIN ” Practice Location

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