Provider Demographics
NPI:1932331113
Name:HARARAH, AMANY ISSA
Entity Type:Individual
Prefix:MRS
First Name:AMANY
Middle Name:ISSA
Last Name:HARARAH
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 1:3694 HILBORN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-7988
Mailing Address - Country:US
Mailing Address - Phone:165-024-5292
Mailing Address - Fax:
Practice Address - Street 1:3694 HILBORN RD STE 150
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-7993
Practice Address - Country:US
Practice Address - Phone:650-245-2928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26740103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist