| Adal Heart2heart Psychotherapy Services, Inc. | |
|
16654 Soledad Canyon Rd Ste 204 Canyon Country CA 91387-3217 | |
| (661) 270-6644 | |
| Not Available |
| Full Name | Adal Heart2heart Psychotherapy Services, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 16654 Soledad Canyon Rd Ste 204, Canyon Country, California |
| Authorized Official Name and Position | Jacob Adal (PRESIDENT) |
| Authorized Official Contact | 6612706644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adal Heart2heart Psychotherapy Services, Inc. 16654 Soledad Canyon Rd Suite 204 Canyon Country CA 91387-3217 Ph: () - | Adal Heart2heart Psychotherapy Services, Inc. 16654 Soledad Canyon Rd Ste 204 Canyon Country CA 91387-3217 Ph: (661) 270-6644 |
| NPI Number | 1215485305 |
|---|---|
| Provider Enumeration Date | 09/16/2016 |
| Last Update Date | 11/19/2020 |
| Certification Date | 11/17/2020 |
| Medicare PECOS PAC ID | 9032475819 |
|---|---|
| Medicare Enrollment ID | O20171110001435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215485305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY28617 (California) | Primary |
| Provider Name | Jacob Adal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801117072 PECOS PAC ID: 2769748557 Enrollment ID: I20171117001840 |
| Provider Name | Nicole Michelle Adal |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1689015133 PECOS PAC ID: 2567804834 Enrollment ID: I20240604000132 |
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