Mental Health Care for Your Whole Self
Personalized therapy and psychiatric care in San Francisco — and telehealth throughout California
✓ Most patients seen within 3-5 days
✓ 60-minute initial evaluations
✓ In-network: Aetna, Cigna, UHC/Optum, Carelon, Medicare + more
We’re in-network with
What we offer
Choose the type of support that fits where you are right now. We offer psychiatry, therapy, and in-clinic Spravato (esketamine) in one coordinated practice, with progress check-ins so your care can adjust when needed.
In-person in San Francisco (999 Sutter St) + telehealth throughout California.
Care that adapts with you
Psychiatry
Thoughtful medication care, with close follow-up.
We take time to understand your symptoms and medical history, then build a medication plan around your goals. If something isn’t helping, we adjust early. When it’s clinically appropriate, we can also discuss optional genetic testing to guide medication selection.
Therapy
Practical, evidence-based therapy for real life.
Therapy should feel like it’s going somewhere. We work toward clear goals and skills you can use between sessions, drawing from CBT, DBT, and trauma-informed care based on what you’re facing.
Spravado (Esketamine)
An in-clinic option for depression that hasn’t improved with standard treatments.
Spravato is FDA-approved for treatment-resistant depression and is given in our San Francisco office with medical monitoring. We’ll evaluate fit, help with authorization when possible, and walk you through exactly what to expect.
Our Story
Defina started with a simple idea: mental health care should feel personal, not transactional. Too many people are forced to choose between convenience and continuity. That can mean quick visits, little context, and too much trial and error.
We built Defina to be the kind of place we would want our friends and family to receive care. Thoughtful appointments. A coordinated team. A calm, welcoming office in San Francisco.
If you are looking for a steady, collaborative approach, we are here.
Our San Francisco office at 999 Sutter St.
Why the name Defina?
The name Defina (deh-FEE-nuh) comes from the Spanish word for "define."
It reflects what we set out to do: define a standard for mental health care that feels personal, consistent, and grounded in real progress. Simple, thoughtful care that helps people get better.
Meet the Founders
Genesis Javaherian, PMHNP-BC
Co-Founder and Psychiatric Provider
Genesis is a UCSF-trained, board-certified psychiatric mental health nurse practitioner. She has built clinical quality and training programs for large psychiatric care networks and has served as a Behavioral Health Commissioner for the City and County of San Francisco. She has also published peer-reviewed research on suicide risk and suicidal ideation.
Her care style is collaborative and evidence-based, with an emphasis on helping patients feel understood and supported over time.
Kavon Javaherian, MD MBA
Co-Founder and Internal Medicine Physician
Kavon is a board-certified internal medicine physician and a professor at UCSF. He currently serves as Associate Chief of the Medical Service at the San Francisco VA and has led quality improvement initiatives adopted across health systems.
His research focuses on remote monitoring, digital health tools and quality improvement initiatives. He brings a practical, outcomes-focused perspective grounded in evidence and real-world implementation.
Why the name Defina?
The name Defina (deh-FEE-nuh) comes from the Spanish word for "define."
It reflects what we set out to do: define a standard for mental health care that feels personal, consistent, and grounded in real progress. Simple, thoughtful care that helps people get better.
Who We Help
Mental Health Conditions we Treat in California
For adults in San Francisco and via telehealth throughout California.
We support those dealing with conditions like depression, anxiety, OCD, PTSD and trauma, bipolar disorder, and postpartum depression and more. We also work well with more complex situations, including substance use disorder, schizophrenia and when symptoms have not fully improved with standard care. Our team coordinates psychiatry and therapy, and we track progress over time so care can adjust when needed.
In network with: Anthem (Carelon Network Partner), Magellan, Aetna, Cigna, United Healthcare, Medicare, and most California insurance plans.
Depression
Feeling numb, exhausted, or stuck, even when you’re trying.
We tailor therapy and medication management to your goals and track progress over time so you’re not left guessing what’s working.
Anxiety
Racing thoughts, constant worry, panic, or tension that won’t turn off.
We combine practical therapy skills with thoughtful medication support when helpful, and adjust care based on how you’re doing over time.
Bipolar
Highs and lows that disrupt sleep, energy, and daily life.
We focus on mood stability, early warning signs, and a plan that fits real routines, with steady follow-up to prevent setbacks.
OCD
Intrusive thoughts and compulsions that take over your day.
We provide psychiatric support for Obsessive compulsive disorder (OCD) and coordinate closely with ERP-focused therapy when appropriate, so treatment stays aligned.
PTSD & Trauma
Trauma can show up in sleep, relationships, and the body.
We offer trauma-informed psychiatric care and coordinate with your therapist when you have one, so treatment supports healing and daily functioning.
Postpartum Depression
When pregnancy or postpartum feels heavy, scary, or unlike you.
We support depression and anxiety during pregnancy and postpartum with coordinated therapy and evidence-based medication options, including breastfeeding-compatible choices when appropriate.
Who We Help
Mental Health Conditions we Treat in California
For adults in San Francisco and via telehealth throughout California.
We support those dealing with conditions like depression, anxiety, OCD, PTSD and trauma, bipolar disorder, and postpartum depression and more. We also work well with more complex situations, including substance use disorder, schizophrenia and when symptoms have not fully improved with standard care. Our team coordinates psychiatry and therapy, and we track progress over time so care can adjust when needed.
In network with: Anthem (Carelon Network Partner), Magellan, Aetna, Cigna, United Healthcare, Medicare, and most California insurance plans.
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Feeling numb, exhausted, or stuck, even when you’re trying.
We tailor therapy and medication management to your goals and track progress over time so you’re not left guessing what’s working.
Depression treatment in San Francisco
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Racing thoughts, constant worry, panic, or tension that won’t turn off.
We combine practical therapy skills with thoughtful medication support when helpful, and adjust care based on how you’re doing over time.
Anxiety treatment in San
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Trauma can show up in sleep, relationships, and the body.
We offer trauma-informed psychiatric care and coordinate with your therapist when you have one, so treatment supports healing and daily functioning.
PTSD & trauma in San Francisco
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Intrusive thoughts and compulsions that take over your day.
We provide psychiatric support for Obsessive compulsive disorder (OCD) and coordinate closely with ERP-focused therapy when appropriate, so treatment stays aligned.
OCD treatment in San Francisco
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Highs and lows that disrupt sleep, energy, and daily life.
We focus on mood stability, early warning signs, and a plan that fits real routines, with steady follow-up to prevent setbacks.
Bipolar treatment in San Francisco
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When pregnancy or postpartum feels heavy, scary, or unlike you.
We support depression and anxiety during pregnancy and postpartum with coordinated therapy and evidence-based medication options, including breastfeeding-compatible choices when appropriate.
Postpartum depression in San Francisco
Our Difference
Why Patients throughout California Choose Defina
You Lead, We Guide
You know your life best. We’ll bring clinical expertise, options, and support so decisions feel clear and collaborative, not rushed or one-size-fits-all.
Your Care Team Actually Talks
If you see us for therapy and psychiatry, your providers work from the same plan. No repeating your story. No mixed messages. Just coordinated care.
We Measure, Not Guess
We use brief check-ins to track symptoms over time. If things aren’t improving, we adjust sooner, and you can actually see what’s changing.
San Francisco Clinic + California Telehealth
See us in person at 999 Sutter St or meet by secure video anywhere in California. Same team, same approach, same follow-through.
How It Works
Care That Adapts with You
Step One
Reach Out
Whether you are looking for a therapist, psychiatric medication support, or both — you simply complete our 5-minute form, book an appointment, add your insurance info and complete a few other sections.
Take the first step by clicking “get started” and scheduling your first appointment.
Step Two
Comprehensive First Visit (60 minute)
Our provider reviews your information before we meet—so we can skip the basics and go deeper from day one. Together, we'll create a treatment plan with clear, measurable goals: better sleep, fewer panic attacks, improved focus—whatever matters most to you.
Step Three
Ongoing Care with Real Tracking
At every follow-up, we measure your symptoms with validated scales (PHQ-9, GAD-7, etc.). You'll see your own progress over time, not just hope things are getting better.
What Patients Say
Progress is personal. Here’s what care at Defina has felt like for patients.
We’re in-network with
We’ll verify your coverage before you start.
Get Started
Complete the form below to experience tailored mental healthcare designed just for you.
Your information is HIPAA-protected
Available Within 3-5 Days
Tiene preguntas? Se habla español (415) 417-1929
Your Questions, Answered
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We currently accept Aetna, Cigna, Carelon (Anthem) UnitedHealth Care, Medicare and Magellan for clinical services and are actively adding additional plans. During the onboarding process, we double check your eligibility and reach out with other options if we’re not in network.
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Most new patients are scheduled within 3-5 business days. We offer same-week appointments for urgent situations.
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We’re clinician‑founded and measurement‑based. That means your care is led by experienced psychiatric and medical providers, and we track your symptoms, functioning, and quality of life over time so treatment actually adapts to you.
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Collaborative and straightforward. We’ll be honest about what we recommend, explain options clearly, and adjust your plan based on how you’re actually doing—not just what should work on paper.
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Yes, we have in person appointments available at our Nob Hill location
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Pharmacogenomic testing analyzes how your genes affect medication metabolism, helping psychiatrists select and dose psychiatric medications more precisely—particularly valuable for patients who have failed multiple medication trials.
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Both psychiatrists (MDs/DOs) and psychiatric nurse practitioners (PMHNPs) can diagnose mental health conditions, prescribe medications, and provide therapy. The main differences are in their training paths:
Psychiatrists complete medical school (4 years) followed by a 4-year psychiatry residency, totaling 8+ years of post-college training. They're medical doctors who specialize in mental health.
Psychiatric Nurse Practitioners complete nursing school, gain clinical experience as registered nurses, then earn a master's or doctoral degree (2-4 years) specializing in psychiatric-mental health care. At Defina, they must pass a national board certification exam (PMHNP-BC).
In California, PMHNPs can practice independently and provide the same psychiatric services as psychiatrists—evaluations, diagnoses, medication management, and therapy. Multiple research studies show equivalent patient outcomes between psychiatrists and psychiatric nurse practitioners for medication management.
Bottom line: The quality of your care depends more on your provider's clinical approach, ongoing training, and attention to your individual needs than on their degree type.
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This is one of the most common questions we hear—and unfortunately, many patients wait months wondering if their medication is helping.
Timeline expectations:
Weeks 1-2: You may notice changes in sleep, appetite, or energy before mood improves
Weeks 2-4: Early mood improvements often begin
Weeks 4-6: Full antidepressant effect typically reached
Weeks 6-8: If no improvement, it's time to reassess
Common signs your antidepressant IS working:
More stable mood (fewer extreme lows or less anxiety)
Improved sleep quality
Increased energy and motivation
Reduced anxiety or worry
Ability to enjoy activities again
Better concentration and decision-making
Improved appetite regulation
Signs it may NOT be working (or needs adjustment):
No change in symptoms after 6-8 weeks at adequate dose
Initial improvement followed by return of symptoms
Intolerable side effects that don't improve
Feeling "flat" or emotionally numb
The Defina approach: We don't guess. At every appointment, we measure your depression symptoms using the PHQ-9 scale. A meaningful response typically shows a 50% or greater reduction in your score. If your numbers aren't moving after 6-8 weeks, we adjust your treatment—whether that's changing doses, switching medications, adding therapy, or exploring options like pharmacogenomic testing.
You deserve to know if your treatment is actually working, not just hope it is.
We are conveniently located in Nob Hill, near the financial district, on the corner of Hyde Street and Sutter Street.
999 Sutter Street
San Francisco, CA 94109
Hours
Monday–Friday
8am–6pm
Phone
(415) 417-1929
Not located near San Francisco? We also offer Telehealth throughout California, including the Bay Area, San Diego, Los Angeles, Sacramento and surrounding regions.