Healthcare Provider Details
I. General information
NPI: 1396112058
Provider Name (Legal Business Name): MOUNTAIN VIEW PSYCHIATRY AND TMS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2015
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 HOSPITAL DR STE 3A
MOUNTAIN VIEW CA
94040-4109
US
IV. Provider business mailing address
2500 HOSPITAL DR STE 3A
MOUNTAIN VIEW CA
94040-4109
US
V. Phone/Fax
- Phone: 650-696-6772
- Fax:
- Phone: 650-696-6772
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | C50631 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | C50631 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ZAHIDA
TAYYIB
Title or Position: CEO
Credential: M.D.
Phone: 650-468-1139