Dr Siamak Ehteshamzadeh, PSYD is a
Counselor - Addiction (substance Use Disorder) based in Moreno Valley, California. Dr Siamak Ehteshamzadeh is licensed to practice in * (Not Available) (license number ) and his current practice location is
25320 Lurin Ave, Moreno Valley, California. He can be reached at his office (for appointments etc.) via phone at
(951) 217-9363.
NPI number for Dr Siamak Ehteshamzadeh is 1508116518 and his current mailing address is Po Box 8461, Moreno Valley, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508116518.
Healthcare Provider's Profile
| Full Name | Dr Siamak Ehteshamzadeh |
|---|
| Gender | Male |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 25320 Lurin Ave, Moreno Valley, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1508116518
- Provider Enumeration Date: 09/17/2012
- Last Update Date: 04/12/2025
Medical Identifiers
Medical identifiers for Dr Siamak Ehteshamzadeh such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508116518 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | PSB37425 (California) | Secondary |
| 103TF0000X | Psychologist - Family | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Siamak Ehteshamzadeh is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Siamak Ehteshamzadeh, PSYD
Po Box 8461,
Moreno Valley, CA 92552-8461
Ph: (951) 217-9363 | Dr Siamak Ehteshamzadeh, PSYD
25320 Lurin Ave,
Moreno Valley, CA 92551-2405
Ph: (951) 217-9363 |
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