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220 Newport Center Dr Suite 1 Newport Beach CA 92660-7506 | |
| (714) 497-3519 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 220 Newport Center Dr, Newport Beach, California |
| Authorized Official Name and Position | Alina Gram (DIRECTOR) |
| Authorized Official Contact | 7144973519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
220 Newport Center Dr Suite 1 Newport Beach CA 92660-7506 Ph: () - | 220 Newport Center Dr Suite 1 Newport Beach CA 92660-7506 Ph: (714) 497-3519 |
| NPI Number | 1952771735 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 04/06/2022 |
| Certification Date | 03/02/2022 |
| Medicare PECOS PAC ID | 3072907757 |
|---|---|
| Medicare Enrollment ID | O20220222002218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952771735 | NPI | - | NPPES |
| Provider Name | Alina M Gram |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700256914 PECOS PAC ID: 1254631294 Enrollment ID: I20160311001365 |
| Provider Name | Iamee Renae Kling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225645096 PECOS PAC ID: 6103221890 Enrollment ID: I20210818002073 |
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