Healthcare Provider Details

I. General information

NPI: 1295158764
Provider Name (Legal Business Name): JAWID ZAHEER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 GATEWAY CENTER WAY STE 300
SAN DIEGO CA
92102-4550
US

IV. Provider business mailing address

995 GATEWAY CENTER WAY STE 300
SAN DIEGO CA
92102-4550
US

V. Phone/Fax

Practice location:
  • Phone: 619-398-2156
  • Fax:
Mailing address:
  • Phone: 619-398-2156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: