Healthcare Provider Details

I. General information

NPI: 1215451935
Provider Name (Legal Business Name): VCAT TREATMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 AIRWAY AVE STE C3
COSTA MESA CA
92626-4622
US

IV. Provider business mailing address

3151 AIRWAY AVE STE C3
COSTA MESA CA
92626-4622
US

V. Phone/Fax

Practice location:
  • Phone: 949-769-1372
  • Fax:
Mailing address:
  • Phone: 949-769-1372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberPSY28098
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NADER BABAI SIAHDOHONI
Title or Position: CEO/OWNER
Credential: PHD
Phone: 949-769-1372