Healthcare Provider Details

I. General information

NPI: 1639731375
Provider Name (Legal Business Name): MERU HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 1/2 PANORAMIC WAY
BERKELEY CA
94704-1834
US

IV. Provider business mailing address

470 RAMONA ST
PALO ALTO CA
94301-1707
US

V. Phone/Fax

Practice location:
  • Phone: 714-595-9993
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PRIYANKA WALI
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 714-595-9993