MEDICARE: MIRZA NAJAF ALIKHAN

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
1	106H00000X	Marriage & Family Therapist	98653	CA

General Provider Information

NPI Number	:	1518474774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRZA NAJAF ALIKHAN

Provider Business Mailing Address
First Line	:	230 W ALAMAR AVE APT 6
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-3747
Country	:	US
Telephone Number	:	805-402-6841
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 E CARRILLO ST STE A
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-1410
Country	:	US
Telephone Number	:	805-626-8906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	01/09/2018

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