Healthcare Provider Details

I. General information

NPI: 1083943427
Provider Name (Legal Business Name): ASHLEY ALEEM LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 CAMINO DEL RIO S SUITE 205
SAN DIEGO CA
92108-4006
US

IV. Provider business mailing address

3737 CAMINO DEL RIO S SUITE 205
SAN DIEGO CA
92108-4006
US

V. Phone/Fax

Practice location:
  • Phone: 619-917-1844
  • Fax: 619-563-4559
Mailing address:
  • Phone: 619-917-1844
  • Fax: 619-563-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPCI 94
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC 2743
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: