Provider Demographics
NPI:1912775354
Name:ALBA, KIANI L (AMFT)
Entity Type:Individual
Prefix:
First Name:KIANI
Middle Name:L
Last Name:ALBA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 N CIVIC DR APT 309
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3912
Mailing Address - Country:US
Mailing Address - Phone:805-400-8973
Mailing Address - Fax:
Practice Address - Street 1:302 VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2506
Practice Address - Country:US
Practice Address - Phone:925-386-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141749101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health