| Aleph Center, P.l.l.c. | |
|
6408 E Tanque Verde Rd Tucson AZ 85715 | |
| (520) 885-5558 | |
| (520) 885-5559 |
| Full Name | Aleph Center, P.l.l.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6408 E Tanque Verde Rd, Tucson, Arizona |
| Authorized Official Name and Position | Kevin S Goeta-kreisler (OWNER) |
| Authorized Official Contact | 5208855558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aleph Center, P.l.l.c. 6408 E Tanque Verde Rd Tucson AZ 85715 Ph: (520) 885-5558 | Aleph Center, P.l.l.c. 6408 E Tanque Verde Rd Tucson AZ 85715 Ph: (520) 885-5558 |
| NPI Number | 1215022157 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 06/29/2011 |
| Medicare PECOS PAC ID | 0143209809 |
|---|---|
| Medicare Enrollment ID | O20040715001337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215022157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Patty P Kane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750471900 PECOS PAC ID: 6709879968 Enrollment ID: I20040405001320 |
| Provider Name | Shannon C Petrovich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104374255 PECOS PAC ID: 7719941293 Enrollment ID: I20041115000769 |
| Provider Name | Cecilia A Amanti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659303162 PECOS PAC ID: 5294748711 Enrollment ID: I20060728000060 |
| Provider Name | Judith A Raymond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629117957 PECOS PAC ID: 4880797117 Enrollment ID: I20070307000257 |
| Provider Name | Cynthia E Reardon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437266749 PECOS PAC ID: 1052463676 Enrollment ID: I20091023000707 |
| Provider Name | Christopher Wiegand |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780767137 PECOS PAC ID: 0840474953 Enrollment ID: I20110414000648 |
| Provider Name | Kevin S Goeta Kreisler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801969076 PECOS PAC ID: 2668497546 Enrollment ID: I20110628000785 |
| Provider Name | Lori N Popeski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518073790 PECOS PAC ID: 8527154046 Enrollment ID: I20120131000143 |
| Provider Name | Jodi Lynn Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073010468 PECOS PAC ID: 4789932344 Enrollment ID: I20180730003294 |
| Provider Name | Jennifer Andjelich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134683998 PECOS PAC ID: 0345583415 Enrollment ID: I20190514001089 |
| Provider Name | Marnie Arnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396039491 PECOS PAC ID: 2062747249 Enrollment ID: I20190710001665 |
| Provider Name | Tabitha Salzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699319939 PECOS PAC ID: 0143631234 Enrollment ID: I20201120001582 |
| Provider Name | Sandra K Antoniak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891992285 PECOS PAC ID: 2769709641 Enrollment ID: I20210514002221 |
| Provider Name | Allison Rebecca Optican |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629429865 PECOS PAC ID: 4688908551 Enrollment ID: I20210813001565 |
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