Provider Demographics
NPI:1609627009
Name:WILSHIRE INSTITUTE FOR INTERVENTIONAL PSYCHIATRY INC
Entity Type:Organization
Organization Name:WILSHIRE INSTITUTE FOR INTERVENTIONAL PSYCHIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ATEFEH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-671-5010
Mailing Address - Street 1:PO BOX 1429
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0969
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9350 WILSHIRE BLVD STE 203-I34
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3214
Practice Address - Country:US
Practice Address - Phone:650-671-5015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty