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General NPI Number Information
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NPI Number | 1124673173
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Entity Type | Individual
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Provider Name | MR. SHAREEF NASHID SALAAM
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Gender | Male
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3885
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Fax | 510-601-3913
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Provider Business Mailing Address
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Address Line | 854 COASTAL ST
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City | RICHMOND
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State | CA
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Zip | 94804-4502
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Country | US
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Telephone | 510-710-8128
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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