Provider Demographics
NPI:1083505382
Name:YOUSSEF, MARIAM
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:YOUSSEF
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S FLOWER ST UNIT 175
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3402
Mailing Address - Country:US
Mailing Address - Phone:909-671-9444
Mailing Address - Fax:
Practice Address - Street 1:400 S FLOWER ST UNIT 175
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3402
Practice Address - Country:US
Practice Address - Phone:909-671-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program