| Siyan Clinical Corporation | |
|
480 Tesconi Cir Ste B Santa Rosa CA 95401-4691 | |
| (707) 206-7268 | |
| (707) 206-7254 |
| Full Name | Siyan Clinical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 480 Tesconi Cir Ste B, Santa Rosa, California |
| Authorized Official Name and Position | Anish S Shah (OWNER) |
| Authorized Official Contact | 7072067268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siyan Clinical Corporation 480 Tesconi Cir Ste B Santa Rosa CA 95401-4691 Ph: (707) 206-7268 | Siyan Clinical Corporation 480 Tesconi Cir Ste B Santa Rosa CA 95401-4691 Ph: (707) 206-7268 |
| NPI Number | 1568732972 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 09/11/2018 |
| Medicare PECOS PAC ID | 0042470122 |
|---|---|
| Medicare Enrollment ID | O20120327000847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568732972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Stephen C Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184778284 PECOS PAC ID: 2961440391 Enrollment ID: I20050418000622 |
| Provider Name | Anish Sunderrajan Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164615589 PECOS PAC ID: 7214074814 Enrollment ID: I20091031000006 |
| Provider Name | Christa A Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548406515 PECOS PAC ID: 0345415766 Enrollment ID: I20111214000369 |
| Provider Name | Warren Scott Bean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437180361 PECOS PAC ID: 1557538774 Enrollment ID: I20120111000435 |
| Provider Name | Barbara Ferrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467741397 PECOS PAC ID: 2860645249 Enrollment ID: I20130115000319 |
| Provider Name | Yvonne M Piper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447596432 PECOS PAC ID: 9234358433 Enrollment ID: I20140922000677 |
| Provider Name | Katherine E Whitley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801224043 PECOS PAC ID: 5597088450 Enrollment ID: I20141229001180 |
| Provider Name | Inna Zelikman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740585314 PECOS PAC ID: 8729309414 Enrollment ID: I20150605002603 |
| Provider Name | Terri J Drew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437588084 PECOS PAC ID: 8921227562 Enrollment ID: I20160615001341 |
| Provider Name | Brian A Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841368230 PECOS PAC ID: 0547546822 Enrollment ID: I20170421001231 |
| Provider Name | Naga Kothapalli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619301579 PECOS PAC ID: 4284934761 Enrollment ID: I20170628002707 |
| Provider Name | Prital Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801224092 PECOS PAC ID: 4688938020 Enrollment ID: I20180510001389 |
| Provider Name | Theresa Carla Negrido Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255600581 PECOS PAC ID: 7315202959 Enrollment ID: I20180531000775 |
| Provider Name | Christopher Solis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952839110 PECOS PAC ID: 5890042337 Enrollment ID: I20180716001538 |
| Provider Name | Tiffany Figuero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174011928 PECOS PAC ID: 8123367554 Enrollment ID: I20190302000039 |
| Provider Name | Aubree Nicole Vance |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255659298 PECOS PAC ID: 6103258918 Enrollment ID: I20191118000183 |
| Provider Name | Sunny Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548723422 PECOS PAC ID: 2769717396 Enrollment ID: I20200323001260 |
| Provider Name | Sherry Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346809316 PECOS PAC ID: 7618309089 Enrollment ID: I20200427001260 |
| Provider Name | Michelle Knosp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467826552 PECOS PAC ID: 2769730787 Enrollment ID: I20200512002352 |
| Provider Name | Dilrani Bhadare |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023321460 PECOS PAC ID: 0840611315 Enrollment ID: I20200609002032 |
| Provider Name | Bryan Gaddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689037285 PECOS PAC ID: 9133470768 Enrollment ID: I20200708003193 |
| Provider Name | Jessica Sickler Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205181005 PECOS PAC ID: 8628489523 Enrollment ID: I20201125001573 |
| Provider Name | Derek William Gilbert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457883605 PECOS PAC ID: 3577812767 Enrollment ID: I20210715004316 |
| Provider Name | Lemlem W Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639413297 PECOS PAC ID: 0042698607 Enrollment ID: I20220609003027 |
| Provider Name | Matthew Reel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568718930 PECOS PAC ID: 1153723358 Enrollment ID: I20220706001287 |
| Provider Name | Andrea Anne Kummer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588192389 PECOS PAC ID: 3577946003 Enrollment ID: I20220817000372 |
| Provider Name | Genevie Kneir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760922017 PECOS PAC ID: 1951660810 Enrollment ID: I20221227002433 |
| Provider Name | Robert V Arguelles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114394517 PECOS PAC ID: 7416314117 Enrollment ID: I20230612002909 |
| Provider Name | Krutika Chokhawala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740743988 PECOS PAC ID: 1951630193 Enrollment ID: I20230614000715 |
| Provider Name | Amruta Baburao Shanbhag |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295297083 PECOS PAC ID: 5597097063 Enrollment ID: I20231207003073 |
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