Basic Information
Provider Information
NPI: 1811190119
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHMAD-BEY
FirstName: NAFEESA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 42
Address2:  
City: EL CERRITO
State: CA
PostalCode: 945300042
CountryCode: US
TelephoneNumber: 9259572709
FaxNumber: 9259572746
Practice Location
Address1: 202 GLACIER DR
Address2: 2ND FLOOR
City: MARTINEZ
State: CA
PostalCode: 945534826
CountryCode: US
TelephoneNumber: 9259572709
FaxNumber: 9259572746
Other Information
ProviderEnumerationDate: 06/06/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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