Provider Demographics
NPI:1528081585
Name:PAREKH, MITESH ARVIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MITESH
Middle Name:ARVIN
Last Name:PAREKH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33 S CATALINA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2426
Mailing Address - Country:US
Mailing Address - Phone:626-744-9055
Mailing Address - Fax:626-744-9055
Practice Address - Street 1:33 S CATALINA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2426
Practice Address - Country:US
Practice Address - Phone:626-744-9055
Practice Address - Fax:626-744-9055
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20519103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA#95-2633765OtherMEDI-CAL