| Yofi Ketamine Clinic Inc | |
|
16661 Ventura Blvd Ste 707 Encino CA 91436-4825 | |
| (818) 851-0302 | |
| (818) 855-9621 |
| Full Name | Yofi Ketamine Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16661 Ventura Blvd Ste 707, Encino, California |
| Authorized Official Name and Position | Anoosh Javaherian (OWNER) |
| Authorized Official Contact | 8184815318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yofi Ketamine Clinic Inc 30200 Agoura Rd Ste 150 Agoura Hills CA 91301-5427 Ph: (818) 851-0302 | Yofi Ketamine Clinic Inc 16661 Ventura Blvd Ste 707 Encino CA 91436-4825 Ph: (818) 851-0302 |
| NPI Number | 1679236996 |
|---|---|
| Provider Enumeration Date | 10/14/2021 |
| Last Update Date | 10/14/2021 |
| Certification Date | 10/14/2021 |
| Medicare PECOS PAC ID | 4880084433 |
|---|---|
| Medicare Enrollment ID | O20211214001525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679236996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Aaron Siani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831535053 PECOS PAC ID: 6103124581 Enrollment ID: I20160419000703 |
| Provider Name | Anoosh Daniel Javaherian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922467752 PECOS PAC ID: 8628326022 Enrollment ID: I20180801001407 |
| Provider Name | Amir Elijah Rad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871911909 PECOS PAC ID: 0446509186 Enrollment ID: I20190114000182 |
| Provider Name | Dorna Rowshanrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417510504 PECOS PAC ID: 5991179822 Enrollment ID: I20230316000866 |
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