Healthcare Provider Details

I. General information

NPI: 1114839818
Provider Name (Legal Business Name): FATIMA SAMAT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 FAIRMONT DR
CASTRO VALLEY CA
94578-1001
US

IV. Provider business mailing address

355 CARSON DR
HAYWARD CA
94544-4001
US

V. Phone/Fax

Practice location:
  • Phone: 510-227-0273
  • Fax:
Mailing address:
  • Phone: 510-944-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: