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General NPI Number Information
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NPI Number | 1033620455
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Entity Type | Individual
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Provider Name | GHAZALA A KHAN LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 115 TOWN AND COUNTRY
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City | DANVILLE
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State | CA
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Zip | 94568-9456
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Country | US
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Telephone | 151-036-4140
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 10482
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City | PLEASANTON
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State | CA
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Zip | 94588-0482
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Country | US
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Telephone | 15103641402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 138678
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT100117
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License Number State | CA
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