Healthcare Provider Details

I. General information

NPI: 1972120368
Provider Name (Legal Business Name): ALICIA SHANTI JAMES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 ROCKET WAY
GARDENDALE AL
35071-4654
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-631-3452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2433
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: