Healthcare Provider Details
I. General information
NPI: 1457179442
Provider Name (Legal Business Name): PSYCHPLUS ASSOCIATES OF CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2024
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3095 TELEGRAPH AVE
BERKELEY CA
94705-2035
US
IV. Provider business mailing address
7877 WILLOW CHASE BLVD
HOUSTON TX
77070-5934
US
V. Phone/Fax
- Phone: 832-869-4818
- Fax: 832-241-2902
- Phone: 832-869-4818
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FAISAL
TAI
Title or Position: CEO
Credential: MD
Phone: 832-869-4818