| Pathwave Psychiatry Pc | |
|
2999 Regent St Ste 512 Berkeley CA 94705-2120 | |
| (510) 925-2351 | |
| (510) 903-5083 |
| Full Name | Pathwave Psychiatry Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2999 Regent St Ste 512, Berkeley, California |
| Authorized Official Name and Position | Sahab Yaqubi (CEO) |
| Authorized Official Contact | 5109251230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathwave Psychiatry Pc 2999 Regent St Ste 512 Berkeley CA 94705-2120 Ph: (510) 925-2351 | Pathwave Psychiatry Pc 2999 Regent St Ste 512 Berkeley CA 94705-2120 Ph: (510) 925-2351 |
| NPI Number | 1124809793 |
|---|---|
| Provider Enumeration Date | 10/10/2023 |
| Last Update Date | 04/29/2026 |
| Certification Date | 04/29/2026 |
| Medicare PECOS PAC ID | 8729525621 |
|---|---|
| Medicare Enrollment ID | O20240808002318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124809793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sahab Yaqubi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437597739 PECOS PAC ID: 1557646619 Enrollment ID: I20210127002266 |
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