| Beachside Adult And Family Therapy Inc | |
|
3160 Telegraph Rd Ste 200 Ventura CA 93003-3250 | |
| (805) 642-4611 | |
| (805) 585-3241 |
| Full Name | Beachside Adult And Family Therapy Inc |
|---|---|
| Speciality | Counselor |
| Location | 3160 Telegraph Rd Ste 200, Ventura, California |
| Authorized Official Name and Position | Kerry O'reilly (CEO) |
| Authorized Official Contact | 3104635656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beachside Adult And Family Therapy Inc 3160 Telegraph Rd Ste 200 Ventura CA 93003-3250 Ph: (805) 642-4611 | Beachside Adult And Family Therapy Inc 3160 Telegraph Rd Ste 200 Ventura CA 93003-3250 Ph: (805) 642-4611 |
| NPI Number | 1992018469 |
|---|---|
| Provider Enumeration Date | 07/26/2010 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 3870930035 |
|---|---|
| Medicare Enrollment ID | O20240322003143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992018469 | NPI | - | NPPES |
| 1241840 | Other | BEACON | |
| 700687251 | Medicaid | CA |
| Provider Name | Aimee Shapiro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083899314 PECOS PAC ID: 3577907211 Enrollment ID: I20240221001143 |
| Provider Name | Marion Hedges-domenicucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801186036 PECOS PAC ID: 7618315482 Enrollment ID: I20240329002601 |
| Provider Name | Patricia P Correa |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013948207 PECOS PAC ID: 7315385077 Enrollment ID: I20240401002918 |
| Provider Name | Lisa Tomei |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649721838 PECOS PAC ID: 3678910833 Enrollment ID: I20240516000563 |
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