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NPI Code Detail

MEDICARE: KHADEJAH ABRAHAM

MEDICARE: KHADEJAH ABRAHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist121682CA

General Provider Information

NPI Number : 1124582150
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHADEJAH ABRAHAM
Provider Business Mailing Address
First Line : 444 W OCEAN BLVD STE 800
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-4529
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 444 W OCEAN BLVD STE 800
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-4529
Country : US
Telephone Number : 562-729-5803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2019
Last Update Date : 03/05/2026

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Directions to “ KHADEJAH ABRAHAM ” Practice Location

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