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General NPI Number Information
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NPI Number | 1962588921
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Entity Type | Individual
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Provider Name | MAHVASH ALAMI-RAD PHD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 16496 BERNARDO CENTER DR STE 307
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City | SAN DIEGO
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State | CA
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Zip | 92128-2524
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Country | US
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Telephone | 760-224-4422
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Fax | 858-649-6490
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Provider Business Mailing Address
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Address Line | 17892 CABELA DR
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City | SAN DIEGO
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State | CA
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Zip | 92127-1045
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Country | US
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Telephone | 760-224-4422
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Fax | 858-649-6490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 19728
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY19728
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License Number State | CA
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