Provider Demographics
NPI:1518444058
Name:ALI, MIR KARAMAT
Entity type:Individual
Prefix:MR
First Name:MIR
Middle Name:KARAMAT
Last Name:ALI
Suffix:
Gender:M
Credentials:
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 2418
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-6418
Mailing Address - Country:US
Mailing Address - Phone:626-533-7168
Mailing Address - Fax:
Practice Address - Street 1:2403 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3007
Practice Address - Country:US
Practice Address - Phone:707-544-3295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18973101YP2500X
CAAPCC5010101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional