Doctor Name: | SHIMA TAGHAVI |
NPI Number: | 1235588955 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 545 Laurel St San Diego, CA - 921011634 |
Business Phone Number: | 6192330453 |
Business Fax Number: | |
Mailing Address: | 2509 Old Quarry Rd, Apartment 1427 SAN DIEGO |
State: | CA |
Postal Code: | 921082762 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/03/2016 |
NPI Last Update Date: | 06/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |