Organization
MINDWELL COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIN GHOLAMI (EXECUTIVE DIRECTOR)
(858) 877-1860
Entity
Organization
Contact information
Practice address
12625 HIGH BLUFF DR STE 103, SAN DIEGO, CA 92130-2053
(858) 877-1860
(855) 554-1110
Mailing address
12625 HIGH BLUFF DR STE 103, SAN DIEGO, CA 92130-2053
(858) 877-1860
(855) 554-1110
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2025
Last updated
12/15/2025
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