| Cal Psychiatric Services | |
|
4530 S Eastern Ave Ste 1 Las Vegas NV 89119-6181 | |
| (702) 629-7490 | |
| (702) 629-7685 |
| Full Name | Cal Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4530 S Eastern Ave Ste 1, Las Vegas, Nevada |
| Authorized Official Name and Position | Akindele Emmanuel Kolade (OWNER) |
| Authorized Official Contact | 7026297490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cal Psychiatric Services 4530 S Eastern Ave Ste 1 Las Vegas NV 89119-6181 Ph: (702) 629-7490 | Cal Psychiatric Services 4530 S Eastern Ave Ste 1 Las Vegas NV 89119-6181 Ph: (702) 629-7490 |
| NPI Number | 1619255122 |
|---|---|
| Provider Enumeration Date | 08/01/2011 |
| Last Update Date | 03/30/2022 |
| Certification Date | 03/30/2022 |
| Medicare PECOS PAC ID | 3870808744 |
|---|---|
| Medicare Enrollment ID | O20150821012601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619255122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A84300 (California) | Primary |
| Provider Name | Beverly Driskill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689762122 PECOS PAC ID: 0042303075 Enrollment ID: I20070907000392 |
| Provider Name | Akindele E Kolade |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922051846 PECOS PAC ID: 9335198183 Enrollment ID: I20140521000480 |
| Provider Name | Marguarette J Suprien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881051415 PECOS PAC ID: 4082913751 Enrollment ID: I20160502000505 |
| Provider Name | Leesha R Bitto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124410105 PECOS PAC ID: 8022308295 Enrollment ID: I20160531000700 |
| Provider Name | Anna Marie Grace Maniebo Kastner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801485347 PECOS PAC ID: 6002215043 Enrollment ID: I20210525002014 |
| Provider Name | Bryan Michael Bender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669143517 PECOS PAC ID: 4789076126 Enrollment ID: I20220117000648 |
| Provider Name | Brittany Lynn Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568187219 PECOS PAC ID: 1456795558 Enrollment ID: I20240216001520 |
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