Healthcare Provider Details

I. General information

NPI: 1932603115
Provider Name (Legal Business Name): ALPHA BEHAVIORAL HEALTH CONSULTING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44349 LOWTREE AVE STE 117
LANCASTER CA
93534-4104
US

IV. Provider business mailing address

2432 CAROLYN DR
PALMDALE CA
93551-5444
US

V. Phone/Fax

Practice location:
  • Phone: 310-567-9389
  • Fax:
Mailing address:
  • Phone: 310-567-9389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MUHAMMAD REZA EMAMI
Title or Position: PRESIDENT
Credential: M.S
Phone: 310-567-9389