Provider Demographics
NPI:1578728556
Name:ELBGAL, MUHAMMAD NASSER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MUHAMMAD
Middle Name:NASSER
Last Name:ELBGAL
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 1:350 90TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1879
Mailing Address - Country:US
Mailing Address - Phone:650-877-5430
Mailing Address - Fax:
Practice Address - Street 1:350 90TH ST FL 2
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1879
Practice Address - Country:US
Practice Address - Phone:650-877-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-19
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA75771101YM0800X, 104100000X
CA818391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker