Provider Demographics
NPI:1437811353
Name:ALI, SHARIF (LMFT)
Entity type:Individual
Prefix:
First Name:SHARIF
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:SAUSALITO
Mailing Address - State:CA
Mailing Address - Zip Code:94966-0505
Mailing Address - Country:US
Mailing Address - Phone:415-972-9666
Mailing Address - Fax:
Practice Address - Street 1:1721 BRIDGEWAY APT B
Practice Address - Street 2:
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-1922
Practice Address - Country:US
Practice Address - Phone:415-972-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health