Provider Demographics
NPI:1942645197
Name:ALI, JAHAR
Entity Type:Individual
Prefix:
First Name:JAHAR
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 W 167TH ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-5160
Mailing Address - Country:US
Mailing Address - Phone:424-221-6377
Mailing Address - Fax:
Practice Address - Street 1:839 W 167TH ST
Practice Address - Street 2:APT. 2
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-5160
Practice Address - Country:US
Practice Address - Phone:424-221-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor