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General NPI Number Information
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NPI Number | 1083088652
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Entity Type | Organization
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Legal Business Name | VORTEX PSYCHIATRY, INC.
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 02/26/2023
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Provider Practice Location Address
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Address Line | 4155 BLACKHAWK PLAZA CIR STE 240
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City | DANVILLE
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State | CA
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Zip | 94506-4613
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Country | US
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Telephone | 925-648-2650
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Fax | 925-648-2530
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Provider Business Mailing Address
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Address Line | 3860 BLACKHAWK RD STE 170
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City | DANVILLE
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State | CA
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Zip | 94506-4668
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Country | US
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Telephone | 925-648-2650
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Fax | 925-648-2530
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAID ALI IBRAHIMI
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Credential | MD
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Telephone | 925-648-2650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | A129171
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | A129171
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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