| Beach Cities Psychological Clinic, Inc. | |
|
24681 La Plz Suite 370 Dana Point CA 92629-2526 | |
| (949) 899-5790 | |
| Not Available |
| Full Name | Beach Cities Psychological Clinic, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 24681 La Plz, Dana Point, California |
| Authorized Official Name and Position | Eileen M Kramer (CEO) |
| Authorized Official Contact | 9498138180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Cities Psychological Clinic, Inc. 24681 La Plz Suite 370 Dana Point CA 92629-2526 Ph: (949) 899-5790 | Beach Cities Psychological Clinic, Inc. 24681 La Plz Suite 370 Dana Point CA 92629-2526 Ph: (949) 899-5790 |
| NPI Number | 1366988610 |
|---|---|
| Provider Enumeration Date | 01/10/2017 |
| Last Update Date | 09/15/2017 |
| Medicare PECOS PAC ID | 0749514719 |
|---|---|
| Medicare Enrollment ID | O20190625001868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366988610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY25548 (California) | Primary |
| Provider Name | Eileen M Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184793119 PECOS PAC ID: 5092032680 Enrollment ID: I20150319000028 |
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