Provider Demographics
NPI:1760044697
Name:RAIF, GULHAN MUSTAFA
Entity Type:Individual
Prefix:
First Name:GULHAN
Middle Name:MUSTAFA
Last Name:RAIF
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 1:1225 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2101
Mailing Address - Country:US
Mailing Address - Phone:657-216-7752
Mailing Address - Fax:
Practice Address - Street 1:1225 W 6TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2101
Practice Address - Country:US
Practice Address - Phone:657-216-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW61253101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor