Provider Demographics
NPI:1134148802
Name:STEIN, ALIYAH (MFT)
Entity type:Individual
Prefix:MS
First Name:ALIYAH
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:ALIYAH
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:1014 CRAGMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1412
Mailing Address - Country:US
Mailing Address - Phone:510-848-5167
Mailing Address - Fax:510-558-3235
Practice Address - Street 1:1014 CRAGMONT AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94708-1412
Practice Address - Country:US
Practice Address - Phone:510-848-5167
Practice Address - Fax:510-558-3235
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM15659106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist