Provider Demographics
NPI:1730657099
Name:MISCIA, DANA LEIGH
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LEIGH
Last Name:MISCIA
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 1:5926 BIXBY VILLAGE DR # 109
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2066
Mailing Address - Country:US
Mailing Address - Phone:973-641-2561
Mailing Address - Fax:
Practice Address - Street 1:16052 BEACH BLVD STE 218
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3809
Practice Address - Country:US
Practice Address - Phone:714-655-5235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ$$$$$$$$$OtherSOCIAL SECURITY