Provider Demographics
NPI:1235944976
Name:AMAE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:AMAE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-407-0343
Mailing Address - Street 1:3061 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4009
Mailing Address - Country:US
Mailing Address - Phone:310-601-5099
Mailing Address - Fax:888-988-1786
Practice Address - Street 1:167 S SAN ANTONIO RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3046
Practice Address - Country:US
Practice Address - Phone:310-601-5099
Practice Address - Fax:888-988-1786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty