Healthcare Provider Details

I. General information

NPI: 1669143145
Provider Name (Legal Business Name): SALEH BAHATI PMHNP-BC, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 E BASELINE RD STE C8
TEMPE AZ
85283-1521
US

IV. Provider business mailing address

625 N PLAZA DR
APACHE JUNCTION AZ
85120-5502
US

V. Phone/Fax

Practice location:
  • Phone: 480-809-1765
  • Fax: 480-602-4406
Mailing address:
  • Phone: 833-431-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number264088
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: