| Breakthrough Psychology Group Pc | |
|
432 S San Vicente Blvd Ste 200 Los Angeles CA 90048-4192 | |
| (909) 276-7720 | |
| Not Available |
| Full Name | Breakthrough Psychology Group Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 432 S San Vicente Blvd Ste 200, Los Angeles, California |
| Authorized Official Name and Position | Jared Abraham Doegey (OWNER) |
| Authorized Official Contact | 9092767720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Psychology Group Pc 432 S San Vicente Blvd Ste 200 Los Angeles CA 90048-4192 Ph: (909) 276-7720 | Breakthrough Psychology Group Pc 432 S San Vicente Blvd Ste 200 Los Angeles CA 90048-4192 Ph: (909) 276-7720 |
| NPI Number | 1457095986 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 05/06/2022 |
| Certification Date | 05/06/2022 |
| Medicare PECOS PAC ID | 3577940279 |
|---|---|
| Medicare Enrollment ID | O20220518002901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457095986 | NPI | - | NPPES |
| Provider Name | Jared Doegey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922634492 PECOS PAC ID: 7719308360 Enrollment ID: I20200605002346 |
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