Provider Demographics
NPI:1003805458
Name:VAFAIE, HELEN (DO)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:VAFAIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BENTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1717
Mailing Address - Country:US
Mailing Address - Phone:216-849-1330
Mailing Address - Fax:
Practice Address - Street 1:75 BENTON WAY
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1717
Practice Address - Country:US
Practice Address - Phone:440-732-1089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A101212084P0800X
OH340074622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2259336Medicaid
OH4088986Medicare PIN
OH4088985Medicare PIN
OH7289821Medicare PIN
OH2259336Medicaid