Mr Jose Ricardo Iraheta Jr, MFTI | |
435 Edgemar Ave, Pacifica, CA 94044-1961 | |
(650) 355-3900 | |
Not Available |
Full Name | Mr Jose Ricardo Iraheta Jr |
---|---|
Gender | Male |
Speciality | Marriage & Family Therapist |
Location | 435 Edgemar Ave, Pacifica, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407108160 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Entity Name | Permanente Medical Group Inc |
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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 |
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Mr Jose Ricardo Iraheta Jr, MFTI 6558 Mary Ellen Ave, Van Nuys, CA 91401-1327 Ph: (818) 421-0417 | Mr Jose Ricardo Iraheta Jr, MFTI 435 Edgemar Ave, Pacifica, CA 94044-1961 Ph: (650) 355-3900 |
Ms. Julia Eleanor Sherman, MFTI Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 435 Edgemar Ave, Pacifica, CA 94044 Phone: 650-355-3900 Fax: 650-355-2850 | |
Diane Custer, DIANE CUSTER Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 80 Eureka Sq, Suite 151, Pacifica, CA 94044 Phone: 650-245-1877 | |
Sandra Carson, MFTI 65138 Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 480 Manor Plz, Pacifica, CA 94044 Phone: 650-355-8787 | |
Ms. Emily Schwartz, MS Couples Therapy Medicare: Medicare Enrolled Practice Location: 480 Manor Plz, Pacifica, CA 94044 Phone: 650-355-8787 | |
Leah Judith Chalofsky, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 480 Manor Plz, Pacifica, CA 94044 Phone: 650-355-8787 | |
Mrs. Kathryn Denise Patt, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 435 Edgemar Ave, Pacifica, CA 94044 Phone: 650-877-8542 | |
Elizabeth Fahrney Bashore, MA, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 80 Eureka Sq Ste 151, Pacifica, CA 94044 Phone: 415-680-5939 |