Provider Demographics
NPI:1447011036
Name:AMLANI, ALZAK (PHD)
Entity type:Individual
Prefix:DR
First Name:ALZAK
Middle Name:
Last Name:AMLANI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CALIFORNIA AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1627
Mailing Address - Country:US
Mailing Address - Phone:650-325-8393
Mailing Address - Fax:
Practice Address - Street 1:220 CALIFORNIA AVE STE 120
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1627
Practice Address - Country:US
Practice Address - Phone:650-325-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15231103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty