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General NPI Number Information
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NPI Number | 1720895311
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Entity Type | Organization
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Legal Business Name | MINDFUL MENTAL WELLNESS, P.A.
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 112 S PARK ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-1809
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Country | US
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Telephone | 408-703-7926
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Fax |
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Provider Business Mailing Address
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Address Line | 548 MARKET ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-5401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RISHEET PATEL
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Credential | MD
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Telephone | 855-294-3663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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