Provider Demographics
NPI:1265328108
Name:EPPS, MIYANA
Entity type:Individual
Prefix:
First Name:MIYANA
Middle Name:
Last Name:EPPS
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 1:1010 ALLEN ST UNIT 229
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-5881
Mailing Address - Country:US
Mailing Address - Phone:510-813-9700
Mailing Address - Fax:
Practice Address - Street 1:3034 HICKORYNUT ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4907
Practice Address - Country:US
Practice Address - Phone:510-813-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging