Provider Demographics
NPI:1700628104
Name:CREST MIND LLC
Entity type:Organization
Organization Name:CREST MIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAFAIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:216-849-1330
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty