Healthcare Provider Details
I. General information
NPI: 1073439840
Provider Name (Legal Business Name): ATLAS PSYCHIATRY, MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
298 BERNAL RD STE B
SAN JOSE CA
95119-1809
US
IV. Provider business mailing address
298 BERNAL RD STE B
SAN JOSE CA
95119-1809
US
V. Phone/Fax
- Phone: 408-638-4744
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HEIDI
STAHL
Title or Position: PRESIDENT
Credential: MD
Phone: 408-638-4744