=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225846751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THRIVE MENTAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2024
-----------------------------------------------------
Last Update Date | 12/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 580 EXECUTIVE CENTER 11501 DUBLIN BLVD. STE 105
-----------------------------------------------------
City | DUBLIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-340-4551
-----------------------------------------------------
Fax | 510-275-1135
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 580 EXECUTIVE CENTER 11501 DUBLIN BLVD. STE 105
-----------------------------------------------------
City | DUBLIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-305-7175
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RIHAN JAVID
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 415-305-7175
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------