| Assessment And Development Center Of Sacramento | |
|
1555 River Park Dr Ste 103 Sacramento CA 95815-4603 | |
| (916) 692-8837 | |
| Not Available |
| Full Name | Assessment And Development Center Of Sacramento |
|---|---|
| Speciality | Psychologist |
| Location | 1555 River Park Dr Ste 103, Sacramento, California |
| Authorized Official Name and Position | Shiba Rahimi (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9169697588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Assessment And Development Center Of Sacramento 1555 River Park Dr Ste 103 Sacramento CA 95815-4603 Ph: (916) 692-8837 | Assessment And Development Center Of Sacramento 1555 River Park Dr Ste 103 Sacramento CA 95815-4603 Ph: (916) 692-8837 |
| NPI Number | 1750916177 |
|---|---|
| Provider Enumeration Date | 03/05/2020 |
| Last Update Date | 03/05/2020 |
| Certification Date | 03/05/2020 |
| Medicare PECOS PAC ID | 0840629036 |
|---|---|
| Medicare Enrollment ID | O20200409002309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750916177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Fariba Mansouri |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073995452 PECOS PAC ID: 8022304914 Enrollment ID: I20160831002745 |
| Provider Name | Shiba Rahimi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477801314 PECOS PAC ID: 6204269525 Enrollment ID: I20191127000629 |
| Provider Name | Douglas C Novotny |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962548800 PECOS PAC ID: 6002211919 Enrollment ID: I20210816001770 |
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