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General NPI Number Information
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NPI Number | 1477323954
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Entity Type | Organization
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Legal Business Name | THERAPY BASED PSYCHIATRY PC
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 30101 AGOURA CT STE 204
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4341
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Country | US
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Telephone | 805-889-0709
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Fax | 562-261-1098
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Provider Business Mailing Address
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Address Line | 30101 AGOURA CT STE 204
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4341
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Country | US
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Telephone | 805-889-0709
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Fax | 562-261-1098
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Authorized Official
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Title or Position | CEO
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Name | DR. ALI NAJAFIAN JAZI
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Credential | MD
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Telephone | 805-889-0709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric 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 | 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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