Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | 108481 | CA |
NPI | 1003344995 |
---|---|
Provider Name | Jaazar Shalabi |
First Address | Pinole, CA 94564-2014 |
Second Address | Pinole, CA 94564-2014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2017 |
Last Update Date | 18/06/2021 |