Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariam Princess Ikharo-Matlock

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1730845249

Mariam Princess Ikharo-Matlock is a Student in an Organized Health Care Education/Training Program in Antioch, California. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

1879 Mount Goethe Way
Antioch, CA 94531-9077
Phone: (510) 904-8656
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1730845249
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 10, 2021
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021

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