1801269287 NPI number — TALAL H. ALSALEEM, LMFT

Table of content: (NPI 1801269287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801269287 NPI number — TALAL H. ALSALEEM, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TALAL H. ALSALEEM, LMFT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HAPPILY EVER AFTER RETREATS--COUPLES COUNSELING AND COACHING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801269287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1315 HAZEL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRIDLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95948-2409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-779-9939
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
915 HIGHLAND POINTE DR
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95678-5419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-779-9939
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALSALEEM
Authorized Official First Name:
TALAL
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
916-779-9939

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  49918 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)