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General NPI Number Information
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NPI Number | 1508409970
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Entity Type | Organization
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Legal Business Name | MINDSET COUNSELING GROUP
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Dates
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Enumeration Date | 10/17/2019
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Last Update Date | 10/17/2019
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Provider Practice Location Address
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Address Line | 39845 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538-2974
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Country | US
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Telephone | 510-273-9126
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Fax |
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Provider Business Mailing Address
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Address Line | 39845 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538-2974
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Country | US
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Telephone | 510-273-9126
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIMI MARKAR
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Credential |
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Telephone | 858-382-4422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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