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17706 Hillside Way Santa Clarita CA 91350-5874 | |
| (812) 454-7472 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 17706 Hillside Way, Santa Clarita, California |
| Authorized Official Name and Position | Jordyn Sater Trockman (OWNER) |
| Authorized Official Contact | 3105265268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
17706 Hillside Way Santa Clarita CA 91350-5874 Ph: (812) 454-7472 | 17706 Hillside Way Santa Clarita CA 91350-5874 Ph: (812) 454-7472 |
| NPI Number | 1912670613 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 07/01/2023 |
| Certification Date | 07/01/2023 |
| Medicare PECOS PAC ID | 3375904659 |
|---|---|
| Medicare Enrollment ID | O20230802003795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912670613 | NPI | - | NPPES |
| Provider Name | Talia J Barach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740780592 PECOS PAC ID: 4082966700 Enrollment ID: I20181008003441 |
| Provider Name | Bahar Moheban |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700368479 PECOS PAC ID: 1658734777 Enrollment ID: I20230822003861 |
| Provider Name | Marina Marcus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639664048 PECOS PAC ID: 6103367917 Enrollment ID: I20240920000052 |
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