Provider Demographics
NPI:1861735409
Name:ALZUBI, CHRISTIAN FATIMA
Entity type:Individual
Prefix:MS
First Name:CHRISTIAN
Middle Name:FATIMA
Last Name:ALZUBI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHRISTIAN
Other - Middle Name:FATIMA
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2210 HASTINGS DR
Mailing Address - Street 2:APT 203
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3373
Mailing Address - Country:US
Mailing Address - Phone:650-218-9460
Mailing Address - Fax:
Practice Address - Street 1:225 37TH AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4324
Practice Address - Country:US
Practice Address - Phone:650-573-2639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA80787106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106H00000XMedicare PIN