Provider Demographics
NPI:1023441268
Name:HABIB, AMINA (MS MFTI)
Entity type:Individual
Prefix:MS
First Name:AMINA
Middle Name:
Last Name:HABIB
Suffix:
Gender:F
Credentials:MS MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 LOMITA AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1121
Mailing Address - Country:US
Mailing Address - Phone:702-406-8507
Mailing Address - Fax:
Practice Address - Street 1:603 LOMITA AVE
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1121
Practice Address - Country:US
Practice Address - Phone:702-406-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT136718106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist