Organization
SUPPORTIVE PSYCHOLOGICAL CARE
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYRUS MOAZAM PHD (OWNER)
(916) 505-9151
Entity
Organization
Contact information
Practice address
9267 GREENBACK LN, B98, ORANGEVALE, CA 95662-4863
(916) 505-9151
(916) 988-7864
Mailing address
9267 GREENBACK LN, B-98, ORANGEVALE, CA 95662-4863
(916) 505-9151
(916) 988-7864
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY13748
CA
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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