Provider Demographics
NPI:1194214239
Name:MIND STUDY CENTER
Entity Type:Organization
Organization Name:MIND STUDY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-765-4045
Mailing Address - Street 1:595 E COLORADO BLVD STE 810
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2001
Mailing Address - Country:US
Mailing Address - Phone:626-765-4045
Mailing Address - Fax:888-398-9743
Practice Address - Street 1:595 E COLORADO BLVD STE 810
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2001
Practice Address - Country:US
Practice Address - Phone:626-765-4045
Practice Address - Fax:888-398-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103TC0700X
CA106H00000X
CAA1236232084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427345222OtherNPI
CA1154778371OtherMARRIAGE & FAMILY THERAPIST