Basic Information
Provider Information
NPI: 1639590755
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AL-SHEIKH
FirstName: MAJID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ACSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 456 ELM AVE
Address2:  
City: LONG BEACH
State: CA
PostalCode: 908022426
CountryCode: US
TelephoneNumber: 5624376717
FaxNumber: 5624375072
Practice Location
Address1: 456 ELM AVE
Address2:  
City: LONG BEACH
State: CA
PostalCode: 908022426
CountryCode: US
TelephoneNumber: 5624376717
FaxNumber: 5624375072
Other Information
ProviderEnumerationDate: 12/16/2013
LastUpdateDate: 10/21/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X62260CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical
171M00000X  N Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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