| Alexis Smith Psyd Clinical Ps Inc | |
|
1855 San Miguel Dr Ste 23 Walnut Creek CA 94596-5290 | |
| (925) 324-1593 | |
| Not Available |
| Full Name | Alexis Smith Psyd Clinical Ps Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1855 San Miguel Dr Ste 23, Walnut Creek, California |
| Authorized Official Name and Position | Alexis Smith (CEO) |
| Authorized Official Contact | 9253241593 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexis Smith Psyd Clinical Ps Inc 1855 San Miguel Dr Ste 23 Walnut Creek CA 94596-5290 Ph: (925) 324-1593 | Alexis Smith Psyd Clinical Ps Inc 1855 San Miguel Dr Ste 23 Walnut Creek CA 94596-5290 Ph: (925) 324-1593 |
| NPI Number | 1164920278 |
|---|---|
| Provider Enumeration Date | 01/24/2018 |
| Last Update Date | 08/29/2024 |
| Certification Date | 08/29/2024 |
| Medicare PECOS PAC ID | 8426312422 |
|---|---|
| Medicare Enrollment ID | O20180427000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164920278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 28050 (California) | Primary |
| Provider Name | Alexis Smith-baumann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063741601 PECOS PAC ID: 8224318217 Enrollment ID: I20161208002174 |
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