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General NPI Number Information
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NPI Number | 1174987119
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Entity Type | Organization
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Legal Business Name | HEAL PSYCHIATRIC SERVICES, INC
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 06/04/2016
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Provider Practice Location Address
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Address Line | 1710 S AMPHLETT BLVD SUITE 301
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City | SAN MATEO
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State | CA
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Zip | 94402-2703
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Country | US
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Telephone | 650-273-4082
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Fax | 650-275-7559
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Provider Business Mailing Address
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Address Line | 1710 S AMPHLETT BLVD SUITE 301
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City | SAN MATEO
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State | CA
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Zip | 94402-2703
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Country | US
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Telephone | 650-273-4082
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Fax | 650-275-7559
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. FARZANA AMIN
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Credential | M.D.
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Telephone | 650-273-4082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A95033
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License Number State | CA
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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 | A95033
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License Number State | CA
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