Provider Demographics
NPI:1215626049
Name:ALIGN REMEDY
Entity type:Organization
Organization Name:ALIGN REMEDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JALALI BIDGOLI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-849-0801
Mailing Address - Street 1:260 NEWPORT CENTER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7520
Mailing Address - Country:US
Mailing Address - Phone:310-849-0801
Mailing Address - Fax:
Practice Address - Street 1:260 NEWPORT CENTER DR STE 206
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7520
Practice Address - Country:US
Practice Address - Phone:310-849-0801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty