MEDICARE: ASHRAF KHATER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1366067753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHRAF KHATER LCSW

Provider Business Mailing Address
First Line	:	1511 JEFFERSON ST UNIT TH10
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-1952
Country	:	US
Telephone Number	:	315-382-9966
Fax Number	:

Provider Business Practice Location Address
First Line	:	3316 LAGUNA WAY STE B
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-2818
Country	:	US
Telephone Number	:	415-326-3707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	10/25/2025

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