Healthcare Provider Details

I. General information

NPI: 1487597357
Provider Name (Legal Business Name): HEARTFELT PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 N SAN DIMAS CANYON RD
SAN DIMAS CA
91773-1223
US

IV. Provider business mailing address

1236 N SAN DIMAS CANYON RD
SAN DIMAS CA
91773-1223
US

V. Phone/Fax

Practice location:
  • Phone: 978-578-9104
  • Fax:
Mailing address:
  • Phone: 978-578-9104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SADEED JAWAD
Title or Position: CEO
Credential:
Phone: 978-578-9104