Provider Demographics
NPI:1649520545
Name:ALI, AMANI EMAN
Entity type:Individual
Prefix:
First Name:AMANI
Middle Name:EMAN
Last Name:ALI
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 1:1941 E 30TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-3489
Mailing Address - Country:US
Mailing Address - Phone:949-689-4808
Mailing Address - Fax:
Practice Address - Street 1:1941 E 30TH ST APT 7
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-3489
Practice Address - Country:US
Practice Address - Phone:949-689-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker