Provider Demographics
NPI:1588421309
Name:RASOUL, JALEN SAMER
Entity type:Individual
Prefix:MR
First Name:JALEN
Middle Name:SAMER
Last Name:RASOUL
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 1:734 NIANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1912
Mailing Address - Country:US
Mailing Address - Phone:858-761-1211
Mailing Address - Fax:
Practice Address - Street 1:734 NIANTIC AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1912
Practice Address - Country:US
Practice Address - Phone:858-761-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor