Provider Demographics
NPI:1285141960
Name:RAHEEM, REHANA (PSY D)
Entity type:Individual
Prefix:
First Name:REHANA
Middle Name:
Last Name:RAHEEM
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 CHRISTIE AVE APT 2415
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1948
Mailing Address - Country:US
Mailing Address - Phone:510-520-0394
Mailing Address - Fax:
Practice Address - Street 1:1840 SAN MIGUEL DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8602
Practice Address - Country:US
Practice Address - Phone:510-520-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2023-10-20
Deactivation Date:2018-08-22
Deactivation Code:
Reactivation Date:2019-04-10
Provider Licenses
StateLicense IDTaxonomies
CAPSY35625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical