1063530400 NPI number — MRS. SHEREEN A KHAN-AMRIKANI LMFT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063530400 NPI number — MRS. SHEREEN A KHAN-AMRIKANI LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHAN-AMRIKANI
Provider First Name:
SHEREEN
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KHAN
Provider Other First Name:
SHEREEN
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063530400
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 508
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VALLEJO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94590-0050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-654-4101
Provider Business Mailing Address Fax Number:
707-666-6632

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PO BOX 508
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALLEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94590-0050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-654-4101
Provider Business Practice Location Address Fax Number:
707-666-6632
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  90678 , 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)





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