| Heal Psychiatric Services, Inc | |
|
1710 S Amphlett Blvd Suite 301 San Mateo CA 94402-2703 | |
| (650) 273-4082 | |
| (650) 275-7559 |
| Full Name | Heal Psychiatric Services, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1710 S Amphlett Blvd, San Mateo, California |
| Authorized Official Name and Position | Farzana Amin (C.E.O.) |
| Authorized Official Contact | 6502734082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heal Psychiatric Services, Inc 1710 S Amphlett Blvd Suite 301 San Mateo CA 94402-2703 Ph: (650) 273-4082 | Heal Psychiatric Services, Inc 1710 S Amphlett Blvd Suite 301 San Mateo CA 94402-2703 Ph: (650) 273-4082 |
| NPI Number | 1174987119 |
|---|---|
| Provider Enumeration Date | 04/06/2016 |
| Last Update Date | 06/04/2016 |
| Medicare PECOS PAC ID | 6901105873 |
|---|---|
| Medicare Enrollment ID | O20160427000624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174987119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A95033 (California) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | A95033 (California) | Primary |
| Provider Name | Farzana Amin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669525911 PECOS PAC ID: 3476656661 Enrollment ID: I20070308000237 |
| Provider Name | Ryuko Ishikawa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053629634 PECOS PAC ID: 8921326729 Enrollment ID: I20150407001429 |
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