Healthcare Provider Details

I. General information

NPI: 1164106456
Provider Name (Legal Business Name): VAYU HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 10/13/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 TYDD ST
EUREKA CA
95501-1284
US

IV. Provider business mailing address

19 ALISO WAY
PORTOLA VALLEY CA
94028-7526
US

V. Phone/Fax

Practice location:
  • Phone: 650-444-1569
  • Fax:
Mailing address:
  • Phone: 650-444-1569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AVNI SHAH
Title or Position: PRESIDENT
Credential: MD
Phone: 650-444-1569