| Blank Psychological Services, Inc. | |
|
27403 Ynez Rd Ste 205 Temecula CA 92591-4616 | |
| (951) 595-7386 | |
| (951) 414-3770 |
| Full Name | Blank Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 27403 Ynez Rd Ste 205, Temecula, California |
| Authorized Official Name and Position | Jeremy Blank (PRESIDENT) |
| Authorized Official Contact | 9515957386 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blank Psychological Services, Inc. 27403 Ynez Rd Ste 205 Temecula CA 92591-4616 Ph: (951) 595-7386 | Blank Psychological Services, Inc. 27403 Ynez Rd Ste 205 Temecula CA 92591-4616 Ph: (951) 595-7386 |
| NPI Number | 1487422747 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 01/04/2024 |
| Certification Date | 12/19/2023 |
| Medicare PECOS PAC ID | 9436501905 |
|---|---|
| Medicare Enrollment ID | O20240119002956 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487422747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jeremy Blank |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215260591 PECOS PAC ID: 5294056370 Enrollment ID: I20150730010948 |
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