| Affiliated Psychiatric Medical Group | |
|
647 Camino De Los Mares #226 San Clemente CA 92673-2807 | |
| (949) 489-9898 | |
| (949) 489-2569 |
| Full Name | Affiliated Psychiatric Medical Group |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 647 Camino De Los Mares, San Clemente, California |
| Authorized Official Name and Position | Esther Edith Sellers (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9494899898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Affiliated Psychiatric Medical Group 647 Camino De Los Mares #226 San Clemente CA 92673-2807 Ph: (949) 489-9898 | Affiliated Psychiatric Medical Group 647 Camino De Los Mares #226 San Clemente CA 92673-2807 Ph: (949) 489-9898 |
| NPI Number | 1558597146 |
|---|---|
| Provider Enumeration Date | 06/09/2009 |
| Last Update Date | 06/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558597146 | NPI | - | NPPES |
| PSY140020 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY14002 (California) | Primary |
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