Healthcare Provider Details

I. General information

NPI: 1154231645
Provider Name (Legal Business Name): MOHAMMAD FAWAD ZAKARIYA AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

725 PRICE ST
DALY CITY CA
94014-2163
US

IV. Provider business mailing address

4193 CHERRY OAKS PL
PALO ALTO CA
94306-3842
US

V. Phone/Fax

Practice location:
  • Phone: 650-301-3300
  • Fax:
Mailing address:
  • Phone: 650-283-3346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: