Provider Demographics
NPI:1649758277
Name:IDRISS, SARIYA
Entity type:Individual
Prefix:
First Name:SARIYA
Middle Name:
Last Name:IDRISS
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 1:1197 COMMONWEALTH AVE APT 23
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2918
Mailing Address - Country:US
Mailing Address - Phone:617-794-3242
Mailing Address - Fax:
Practice Address - Street 1:CAMBRIDGE HEALTH ALLIANCE, 1493 CAMBRIDGE ST.
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-665-1185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical