Provider Demographics
NPI:1619839917
Name:ALMANSOOB, MALICKA EMELDA
Entity type:Individual
Prefix:
First Name:MALICKA
Middle Name:EMELDA
Last Name:ALMANSOOB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 CALIFORINA AVENUE
Mailing Address - Street 2:APT #24
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304
Mailing Address - Country:US
Mailing Address - Phone:202-600-6623
Mailing Address - Fax:
Practice Address - Street 1:609 E 18TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5616
Practice Address - Country:US
Practice Address - Phone:661-321-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20896101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)