Provider Demographics
NPI:1275741167
Name:BHIMJI, ALTAF A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ALTAF
Middle Name:A
Last Name:BHIMJI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27508
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-0508
Mailing Address - Country:US
Mailing Address - Phone:510-480-7671
Mailing Address - Fax:
Practice Address - Street 1:518 EL CERRITO PLZ
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-4006
Practice Address - Country:US
Practice Address - Phone:510-480-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW214861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical