Provider Demographics
NPI:1366095176
Name:BENALI, SABRINA NICOLE (MT,HHE,LC,)
Entity type:Individual
Prefix:PROF
First Name:SABRINA
Middle Name:NICOLE
Last Name:BENALI
Suffix:
Gender:F
Credentials:MT,HHE,LC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-4134
Mailing Address - Country:US
Mailing Address - Phone:510-282-7136
Mailing Address - Fax:
Practice Address - Street 1:6120 HAYES ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-4134
Practice Address - Country:US
Practice Address - Phone:510-282-7137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist