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Organization
REVIVE PSYCHIATRIC CENTER
Active
Organization
REVIVE PSYCHIATRIC CENTER
Active
Other names
Revive Psychiatric and Psychological Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEDIEH AZADMEHR PH.D (PRESIDENT)
(858) 877-1750
Entity
Organization
Contact information
Practice address
12636 HIGH BLUFF DR, SAN DIEGO, CA 92130-2022
(858) 877-1750
(855) 554-1110
Mailing address
12636 HIGH BLUFF DR, SAN DIEGO, CA 92130-2022
(858) 877-1750
(855) 554-1110
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/11/2021
Last updated
09/11/2021
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