Organization Active NPI

Pathwave Psychiatry PC

  • Psychiatry Physician
  • Berkeley, CA
National Provider Identifier
1124809793
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PATHWAVE PSYCHIATRY PC
Practice address
2999 Regent St Ste 512
Berkeley, CA 94705-2120
Phone
(510) 925-2351
Fax
(510) 903-5083
NPI assigned
Oct 10, 2023
Last updated
Apr 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sahab Yaqubi, MDNPI 1437597739
Title
Ceo
Phone
(510) 925-1230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2999 Regent St Ste 512
Berkeley, CA 94705-2120

Mailing address

2999 Regent St Ste 512
Berkeley, CA 94705-2120
Phone (510) 925-2351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240808002318 CA Part B Supplier - Clinic/Group Practice 8729525621 Receives reassigned benefits from 1 practitioner
Practice locations: Berkeley, CA

National Provider Directory

National Provider Directory

Locations

2999 Regent St
Ste 512
Berkeley, CA 94705
Phone (510) 549-0734

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1124809793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST STE 512",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052120",
            "telephone_number": "510-925-2351",
            "fax_number": "510-903-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST STE 512",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052120",
            "telephone_number": "510-925-2351",
            "fax_number": "510-903-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAVE PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "YAQUBI",
        "authorized_official_first_name": "SAHAB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-925-1230",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.