| Adrianne Ahern-grundland, Ph.d. | |
|
11622 El Camino Real Suite 100 San Diego CA 92130-2049 | |
| (858) 764-2422 | |
| Not Available |
| Full Name | Adrianne Ahern-grundland, Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 11622 El Camino Real, San Diego, California |
| Authorized Official Name and Position | Adrianne Ahern Grundland (PRESIDENT/OWNER) |
| Authorized Official Contact | 8587642422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adrianne Ahern-grundland, Ph.d. 11622 El Camino Real Suite 100 San Diego CA 92130-2049 Ph: (858) 764-2422 | Adrianne Ahern-grundland, Ph.d. 11622 El Camino Real Suite 100 San Diego CA 92130-2049 Ph: (858) 764-2422 |
| NPI Number | 1902349731 |
|---|---|
| Provider Enumeration Date | 11/28/2016 |
| Last Update Date | 05/24/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 0042596108 |
|---|---|
| Medicare Enrollment ID | O20170404002374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902349731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY14473 (California) | Primary |
| Provider Name | Adrianne Ahern-grundland |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861627325 PECOS PAC ID: 3274719489 Enrollment ID: I20110523000621 |
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