Healthcare Provider Details

I. General information

NPI: 1174403000
Provider Name (Legal Business Name): SACRED CEDAR PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 BERKELEY WAY STE 3
BERKELEY CA
94704-1007
US

IV. Provider business mailing address

1903 BERKELEY WAY STE 3
BERKELEY CA
94704-1007
US

V. Phone/Fax

Practice location:
  • Phone: 510-463-4699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SETARE ESLAMI
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 510-463-4699