Provider Demographics
NPI:1588029045
Name:ENHANCED PSYCHOLOGICAL HEALTH CARE, INC
Entity Type:Organization
Organization Name:ENHANCED PSYCHOLOGICAL HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:FARIDEH
Authorized Official - Middle Name:HASSANI
Authorized Official - Last Name:REZAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-265-8383
Mailing Address - Street 1:7183 NAVAJO RD STE G
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1650
Mailing Address - Country:US
Mailing Address - Phone:619-265-8383
Mailing Address - Fax:619-460-2100
Practice Address - Street 1:7183 NAVAJO RD STE G
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1650
Practice Address - Country:US
Practice Address - Phone:619-265-8383
Practice Address - Fax:619-460-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9899103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty