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General NPI Number Information
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NPI Number | 1225475593
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Entity Type | Individual
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Provider Name | JAMAAL E KIZZIEE LMFT
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Gender | Male
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 1700 NORBRIDGE AVE STE H
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5700
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Country | US
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Telephone | 510-545-6632
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 SAN LEANDRO BLVD STE 300
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City | SAN LEANDRO
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State | CA
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Zip | 94577-1675
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Country | US
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Telephone | 510-667-3176
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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 |
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License Number State |
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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 | LMFT127254
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License Number State | CA
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