Provider Demographics
NPI:1801234968
Name:ALI, AREEZA JEHAN
Entity type:Individual
Prefix:MS
First Name:AREEZA
Middle Name:JEHAN
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 1:5627 TELEGRAPH AVE STE 121
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1707
Mailing Address - Country:US
Mailing Address - Phone:510-467-0244
Mailing Address - Fax:
Practice Address - Street 1:5627 TELEGRAPH AVE STE 121
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1707
Practice Address - Country:US
Practice Address - Phone:510-467-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA970831041C0700X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical