Provider Demographics
NPI:1942806740
Name:SHAH-ALLIBHOY, SHAZIA (LMFT, NCSP, CAMS)
Entity Type:Individual
Prefix:
First Name:SHAZIA
Middle Name:
Last Name:SHAH-ALLIBHOY
Suffix:
Gender:F
Credentials:LMFT, NCSP, CAMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19935 EAGLE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4000
Mailing Address - Country:US
Mailing Address - Phone:818-924-3617
Mailing Address - Fax:
Practice Address - Street 1:19935 EAGLE RIDGE LN
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326-4000
Practice Address - Country:US
Practice Address - Phone:818-924-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060183364103TS0200X
CALMFT53738106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool