NPIMap

Organization Active NPI

Center for Diagnostic and Interventional Psychiatry

  • Psychiatry Physician
  • Santa Rosa, CA
National Provider Identifier
1164842316
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A112632 Issued in CA
Legal business name
CENTER FOR DIAGNOSTIC AND INTERVENTIONAL PSYCHIATRY
Practice address
1287 Fulton Rd
Santa Rosa, CA 95401-4923
Phone
(707) 800-7716
Fax
(707) 800-7799
NPI assigned
Apr 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Authorized official

Name
Anas Elsaid, M.D.
Title
Owner
Phone
(707) 800-7716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A112632 CA Primary

Addresses

Primary practice location

1287 Fulton Rd
Santa Rosa, CA 95401-4923

Mailing address

PO Box 1770
La Mesa, CA 91944-1770
Phone (619) 464-1165

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1164842316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-464-1165",
            "fax_number": "619-567-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 FULTON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014923",
            "telephone_number": "707-800-7716",
            "fax_number": "707-800-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DIAGNOSTIC AND INTERVENTIONAL PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "ELSAID",
        "authorized_official_first_name": "ANAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-800-7716",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A112632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.