Av Behavioral Medicine, Inc | |
1672 W Avenue J Ste 110 Lancaster CA 93534-2859 | |
(661) 723-9557 | |
(661) 347-3320 |
Full Name | Av Behavioral Medicine, Inc |
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Speciality | Psychiatry & Neurology |
Location | 1672 W Avenue J Ste 110, Lancaster, California |
Authorized Official Name and Position | Marites P Del Rosario (MEDICAL DIRECTOR/ OWNER) |
Authorized Official Contact | 6617262949 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Av Behavioral Medicine, Inc 1672 W Avenue J 110 Lancaster CA 93534-2827 Ph: (661) 723-9557 | Av Behavioral Medicine, Inc 1672 W Avenue J Ste 110 Lancaster CA 93534-2859 Ph: (661) 723-9557 |
NPI Number | 1881070100 |
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Provider Enumeration Date | 08/10/2015 |
Last Update Date | 11/09/2023 |
Certification Date | 11/09/2023 |
Medicare PECOS PAC ID | 5193011740 |
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Medicare Enrollment ID | O20160907002005 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881070100 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | A53570 (California) | Primary |
Provider Name | Roy B Del Rosario |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1740381870 PECOS PAC ID: 2567451040 Enrollment ID: I20040510000998 |
Provider Name | Marites P Del Rosario |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1205937349 PECOS PAC ID: 6103061411 Enrollment ID: I20130314000153 |
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