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419 Georgia St Ste 11 Vallejo CA 94590-6046 | |
(707) 652-5442 | |
(707) 651-9426 |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 419 Georgia St Ste 11, Vallejo, California |
Authorized Official Name and Position | Amanda Summers (OWNER) |
Authorized Official Contact | 7076888859 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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419 Georgia St Ste 11 Vallejo CA 94590-6046 Ph: (707) 652-5442 | 419 Georgia St Ste 11 Vallejo CA 94590-6046 Ph: (707) 652-5442 |
NPI Number | 1881318012 |
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Provider Enumeration Date | 09/30/2022 |
Last Update Date | 10/26/2022 |
Certification Date | 10/26/2022 |
Identifier | Type | State | Issuer |
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1881318012 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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