Shafa Psychiatric and Consulting Center

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SHAFA PSYCHIATRIC AND CONSULTING CENTER

Practice address

265 S Randolph Ave Ste 290
Brea, CA 92821-5702

Phone

(657) 341-4422

NPI assigned

Mar 6, 2023

Organization subpart

No

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

Authorized official

Name

Khosravi Gohar, M.D

Title

Ceo President

Phone

(657) 341-4422

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Shafa Psychiatric and Consulting Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shafa Psychiatric & Consulting Center Apc

  • Clinic/Center
  • Yorba Linda, CA
  • NPI 1376239384
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gohar Khosravi, M.D

  • Psychiatry Physician
  • Norwalk, CA
  • NPI 1912384611
  NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1689374027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N KRAEMER BLVD UNIT 171",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928711408",
            "telephone_number": "657-341-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 S RANDOLPH AVE STE 290",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215702",
            "telephone_number": "657-341-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFA PSYCHIATRIC AND CONSULTING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-05",
        "status": "A",
        "authorized_official_last_name": "GOHAR",
        "authorized_official_first_name": "KHOSRAVI",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "657-341-4422",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912384611",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joselyn Sepulveda
• Vincent Sermeno
• Joey Chan Serrano, OT
• Sinthia Lizethe Serrato, LMFT
• SG Homecare, Inc
• Biren Shah, M.D.
• Mahika Shah
• Rina Shah, PHARMD
• Sahil Shah, DO
• Samha Shah, REGISTERED NURSE

• Adult Mental Health Clinic/Center in Brea, CA
• Providers in Brea, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.