Healthcare Provider Details

I. General information

NPI: 1649116096
Provider Name (Legal Business Name): MONTEREY BAY PSYCHIATRY, ADVANCED PRACTICE NURSING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 DEL FINO PL STE 201
CARMEL VALLEY CA
93924-9567
US

IV. Provider business mailing address

126 CLOCK TOWER PL STE 104C
CARMEL CA
93923-8791
US

V. Phone/Fax

Practice location:
  • Phone: 831-200-3758
  • Fax: 831-480-1840
Mailing address:
  • Phone: 831-200-3758
  • Fax: 831-480-1840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HALLEH ENTEKHABI
Title or Position: OWNER
Credential: DNP, PNP, PMHNP
Phone: 831-200-3758