Healthcare Provider Details

I. General information

NPI: 1528081585
Provider Name (Legal Business Name): MITESH ARVIN PAREKH PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 S CATALINA AVE SUITE 204
PASADENA CA
91106-2426
US

IV. Provider business mailing address

33 S CATALINA AVE SUITE 204
PASADENA CA
91106-2426
US

V. Phone/Fax

Practice location:
  • Phone: 626-744-9055
  • Fax: 626-744-9055
Mailing address:
  • Phone: 626-744-9055
  • Fax: 626-744-9055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY20519
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20519
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: