MEDICARE: MS. AMAL BADR HARAKA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	174400000X	Specialist
3	261QR1100X	Research Clinic/Center

General Provider Information

NPI Number	:	1992577910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMAL BADR HARAKA

Provider Business Mailing Address
First Line	:	7160 SHORELINE DR UNIT 4206
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-4918
Country	:	US
Telephone Number	:	202-656-5556
Fax Number	:

Provider Business Practice Location Address
First Line	:	7160 SHORELINE DR UNIT 4206
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-4918
Country	:	US
Telephone Number	:	202-656-5556
Fax Number	:

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

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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