| Therapy Based Psychiatry Pc | |
|
30101 Agoura Ct Ste 204 Agoura Hills CA 91301-4341 | |
| (805) 889-0709 | |
| (562) 261-1098 |
| Full Name | Therapy Based Psychiatry Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 30101 Agoura Ct Ste 204, Agoura Hills, California |
| Authorized Official Name and Position | Ali Najafian Jazi (CEO) |
| Authorized Official Contact | 8058890709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Based Psychiatry Pc 30101 Agoura Ct Ste 204 Agoura Hills CA 91301-4341 Ph: (805) 889-0709 | Therapy Based Psychiatry Pc 30101 Agoura Ct Ste 204 Agoura Hills CA 91301-4341 Ph: (805) 889-0709 |
| NPI Number | 1477323954 |
|---|---|
| Provider Enumeration Date | 01/04/2024 |
| Last Update Date | 01/04/2024 |
| Certification Date | 01/04/2024 |
| Medicare PECOS PAC ID | 8022456318 |
|---|---|
| Medicare Enrollment ID | O20240405000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477323954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Ali Najafian Jazi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790105955 PECOS PAC ID: 8325268857 Enrollment ID: I20190321000687 |
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