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General NPI Number Information
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NPI Number | 1497395396
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Entity Type | Individual
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Provider Name | ABBAS KHAN
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Gender | Male
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 19322 JESSE LN STE 200
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City | RIVERSIDE
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State | CA
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Zip | 92508-5072
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Country | US
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Telephone | 951-387-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 8732 PALOMAR AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-7202
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Country | US
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Telephone | 661-317-1018
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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 | 19509
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CMH0208951
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License Number State | NM
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