| Premium Mental Health Services | |
|
1130 Coffee Rd Ste 10 Modesto CA 95355-4228 | |
| (559) 495-8659 | |
| Not Available |
| Full Name | Premium Mental Health Services |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1130 Coffee Rd Ste 10, Modesto, California |
| Authorized Official Name and Position | Mariela Gutierrez (CLINIC SUPERVISOR) |
| Authorized Official Contact | 2095229054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Mental Health Services 1130 Coffee Rd Ste 10 Modesto CA 95355-4228 Ph: (209) 522-9054 | Premium Mental Health Services 1130 Coffee Rd Ste 10 Modesto CA 95355-4228 Ph: (559) 495-8659 |
| NPI Number | 1689458051 |
|---|---|
| Provider Enumeration Date | 08/24/2023 |
| Last Update Date | 08/09/2024 |
| Certification Date | 08/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689458051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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