Provider Demographics
NPI:1831854447
Name:SHAMYNDS HEALING CENTER PC
Entity type:Organization
Organization Name:SHAMYNDS HEALING CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYA
Authorized Official - Middle Name:ZIA
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-623-7858
Mailing Address - Street 1:2012 19TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1668
Mailing Address - Country:US
Mailing Address - Phone:916-538-6498
Mailing Address - Fax:916-898-2457
Practice Address - Street 1:2012 19TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-1668
Practice Address - Country:US
Practice Address - Phone:916-538-6498
Practice Address - Fax:916-498-2457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)