Provider Demographics
NPI:1518320894
Name:SYNAPSE ASSOCIATION
Entity Type:Organization
Organization Name:SYNAPSE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-450-3239
Mailing Address - Street 1:1326 MARINA CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2623
Mailing Address - Country:US
Mailing Address - Phone:650-450-3239
Mailing Address - Fax:
Practice Address - Street 1:1326 MARINA CIR
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2623
Practice Address - Country:US
Practice Address - Phone:650-450-3239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-03
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82972251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health