Provider Demographics
NPI:1295404192
Name:DESERT SPIRIT PSYCHOLOGY
Entity Type:Organization
Organization Name:DESERT SPIRIT PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBHANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-679-6565
Mailing Address - Street 1:10115 E MOUNTAIN VIEW RD UNIT 1084
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-6315
Mailing Address - Country:US
Mailing Address - Phone:714-679-6565
Mailing Address - Fax:
Practice Address - Street 1:10401 E MCDOWELL MOUNTAIN RANCH RD STE 130
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7525
Practice Address - Country:US
Practice Address - Phone:714-679-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty