Healthcare Provider Details

I. General information

NPI: 1841055258
Provider Name (Legal Business Name): SALEEMA NATHIFA ALI AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S FAIRMONT AVE # 9
LODI CA
95240-3800
US

IV. Provider business mailing address

2701 DEL PASO RD # 130-213
SACRAMENTO CA
95835-2305
US

V. Phone/Fax

Practice location:
  • Phone: 279-782-9537
  • Fax:
Mailing address:
  • Phone: 916-639-8879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13649
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: