| Soulh Kiki S Corner Corp | |
|
22801 Ventura Blvd Ste 301 Woodland Hills CA 91364-1222 | |
| (805) 222-6371 | |
| Not Available |
| Full Name | Soulh Kiki S Corner Corp |
|---|---|
| Speciality | Social Worker |
| Location | 22801 Ventura Blvd Ste 301, Woodland Hills, California |
| Authorized Official Name and Position | Kiana Naimi (OWNER) |
| Authorized Official Contact | 3108549987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulh Kiki S Corner Corp 17809 Halsted St Unit 316 Northridge CA 91325-2069 Ph: (805) 222-6371 | Soulh Kiki S Corner Corp 22801 Ventura Blvd Ste 301 Woodland Hills CA 91364-1222 Ph: (805) 222-6371 |
| NPI Number | 1205680113 |
|---|---|
| Provider Enumeration Date | 04/16/2024 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 6507308863 |
|---|---|
| Medicare Enrollment ID | O20240603001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205680113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Kiana Naimi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417474610 PECOS PAC ID: 7315489671 Enrollment ID: I20240603001739 |
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