Provider Demographics
NPI:1821877879
Name:RAJI, SAMIRA (MA)
Entity Type:Individual
Prefix:
First Name:SAMIRA
Middle Name:
Last Name:RAJI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14013 CAPTAINS ROW APT 316
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-7386
Mailing Address - Country:US
Mailing Address - Phone:310-804-4129
Mailing Address - Fax:
Practice Address - Street 1:14013 CAPTAINS ROW APT 316
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-7386
Practice Address - Country:US
Practice Address - Phone:310-804-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities