Pathwave Psychiatry Pc | |
1270 Campus Dr Berkeley CA 94708-2045 | |
(617) 299-9383 | |
Not Available |
Full Name | Pathwave Psychiatry Pc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 1270 Campus Dr, Berkeley, California |
Authorized Official Name and Position | Sahab Yaqubi (CEO) |
Authorized Official Contact | 5109251230 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pathwave Psychiatry Pc 1270 Campus Dr Berkeley CA 94708-2045 Ph: () - | Pathwave Psychiatry Pc 1270 Campus Dr Berkeley CA 94708-2045 Ph: (617) 299-9383 |
NPI Number | 1124809793 |
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Provider Enumeration Date | 10/10/2023 |
Last Update Date | 10/12/2023 |
Certification Date | 10/12/2023 |
Medicare PECOS PAC ID | 8729525621 |
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Medicare Enrollment ID | O20240808002318 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124809793 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Sahab Yaqubi |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1437597739 PECOS PAC ID: 1557646619 Enrollment ID: I20210127002266 |
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