Healthcare Provider Details

I. General information

NPI: 1346836756
Provider Name (Legal Business Name): UZMA KHURRAM LMFT, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: UZMA KHURRAM LMFT, LPCC

II. Dates (important events)

Enumeration Date: 12/19/2020
Last Update Date: 12/19/2020
Certification Date: 12/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 GLEN ALPINE ST
MORAGA CA
94556-1928
US

IV. Provider business mailing address

PO BOX 6934
MORAGA CA
94570-6934
US

V. Phone/Fax

Practice location:
  • Phone: 760-500-3285
  • Fax:
Mailing address:
  • Phone: 925-310-5723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC7962
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT116362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: