Provider Demographics
NPI:1962529552
Name:ALQARWANI, LATIKA (MFT)
Entity type:Individual
Prefix:MRS
First Name:LATIKA
Middle Name:
Last Name:ALQARWANI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 PLUMERIA AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-6024
Mailing Address - Country:US
Mailing Address - Phone:916-541-4910
Mailing Address - Fax:916-967-7536
Practice Address - Street 1:650 HOWE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4731
Practice Address - Country:US
Practice Address - Phone:916-541-4910
Practice Address - Fax:916-967-1572
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42640106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9957Medicaid