Provider Demographics
NPI:1780729236
Name:RAHMANY, KHALIL R (PHD)
Entity type:Individual
Prefix:
First Name:KHALIL
Middle Name:R
Last Name:RAHMANY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94522
Mailing Address - Country:US
Mailing Address - Phone:510-445-1015
Mailing Address - Fax:510-445-1035
Practice Address - Street 1:39676 CEDAR BLVD
Practice Address - Street 2:SUITE 240A
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560
Practice Address - Country:US
Practice Address - Phone:510-445-1015
Practice Address - Fax:510-445-1035
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15853103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPLS158530Medicare ID - Type Unspecified