Provider Demographics
NPI:1962731554
Name:DAMIS-SALAAM, NAEEMAH
Entity type:Individual
Prefix:MS
First Name:NAEEMAH
Middle Name:
Last Name:DAMIS-SALAAM
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 1:17632 PARTHENIA
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91236
Mailing Address - Country:US
Mailing Address - Phone:909-568-1241
Mailing Address - Fax:818-812-9018
Practice Address - Street 1:17632 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3159
Practice Address - Country:US
Practice Address - Phone:909-568-1241
Practice Address - Fax:818-812-9018
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)