Provider Demographics
NPI:1174924484
Name:STRICKLEN, HARRIET
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:STRICKLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3847
Mailing Address - Country:US
Mailing Address - Phone:510-774-9570
Mailing Address - Fax:
Practice Address - Street 1:1031 IVES DAIRY RD STE 228
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:510-774-9570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-07
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies