Rafael Caro Portuges, | |
1021 Navellier St, El Cerrito, CA 94530-2626 | |
(510) 524-0405 | |
Not Available |
Full Name | Rafael Caro Portuges |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 1021 Navellier St, El Cerrito, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487803334 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Permanente Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Rafael Caro Portuges, 2275 Arlington Dr, San Leandro, CA 94578-1132 Ph: (310) 621-9636 | Rafael Caro Portuges, 1021 Navellier St, El Cerrito, CA 94530-2626 Ph: (510) 524-0405 |
Cassie Kellogg, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11175 San Pablo Ave, El Cerrito, CA 94530 Phone: 510-334-5386 | |
Joanna Marie Illing, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11175 San Pablo Ave, El Cerrito, CA 94530 Phone: 510-559-5550 | |
Ms. Kathleen Price Hazard, PPS, AMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 7125 Donal Ave, El Cerrito, CA 94530 Phone: 510-231-1449 | |
Carly Lukas, MFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 11175 San Pablo Ave, El Cerrito, CA 94530 Phone: 510-559-5550 | |
Julia Bernard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 6727 Snowdon Ave, El Cerrito, CA 94530 Phone: 510-232-3440 | |
Colleen Fox West, MFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1811 Elm St, El Cerrito, CA 94530 Phone: 510-412-2155 | |
Ken Hirano, Counselor Medicare: Not Enrolled in Medicare Practice Location: 752 Richmond St, El Cerrito, CA 94530 Phone: 510-875-0140 |