Provider Demographics
NPI:1659649994
Name:BAILEY, JOHARI M (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JOHARI
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 FLEMING AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2529
Mailing Address - Country:US
Mailing Address - Phone:408-607-6376
Mailing Address - Fax:
Practice Address - Street 1:4333 FLEMING AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-2529
Practice Address - Country:US
Practice Address - Phone:925-687-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68862106H00000X
CA133929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist