Provider Demographics
NPI:1821985300
Name:RIZVI, MARIAM
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:RIZVI
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 1:3411 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7204
Mailing Address - Country:US
Mailing Address - Phone:650-815-1672
Mailing Address - Fax:
Practice Address - Street 1:7901 STONERIDGE DR STE 150
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3502
Practice Address - Country:US
Practice Address - Phone:925-417-8733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty