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General NPI Number Information
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NPI Number | 1457126427
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Entity Type | Organization
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Legal Business Name | TEEN CENTER LLC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1002 LIVE OAK BLVD
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City | YUBA CITY
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State | CA
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Zip | 95991-4028
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Country | US
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Telephone | 949-677-8734
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 LIVE OAK BLVD STE A-100
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City | YUBA CITY
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State | CA
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Zip | 95991-4028
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Country | US
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Telephone | 714-716-5044
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Fax | 714-551-4238
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SAYEH BEHESHTI
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Credential |
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Telephone | 714-716-5044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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