Calzadilla Psychological Inc | |
1530 E Chevy Chase Dr Suite 204 Glendale CA 91206-4163 | |
(310) 325-4415 | |
(310) 326-3744 |
Full Name | Calzadilla Psychological Inc |
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Speciality | Psychologist |
Location | 1530 E Chevy Chase Dr, Glendale, California |
Authorized Official Name and Position | Marylin Calzadilla (OWNER) |
Authorized Official Contact | 8189685564 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Calzadilla Psychological Inc Po Box 251377 Glendale CA 91225-1377 Ph: (310) 325-4415 | Calzadilla Psychological Inc 1530 E Chevy Chase Dr Suite 204 Glendale CA 91206-4163 Ph: (310) 325-4415 |
NPI Number | 1083914162 |
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Provider Enumeration Date | 10/23/2010 |
Last Update Date | 07/01/2014 |
Medicare PECOS PAC ID | 8426210501 |
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Medicare Enrollment ID | O20120507000763 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083914162 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PSY17154 (California) | Primary |
Provider Name | Marylin Calzadilla |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1700893336 PECOS PAC ID: 2062409956 Enrollment ID: I20040430000951 |
Provider Name | Hannah N Krueger |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1104432004 PECOS PAC ID: 3072924190 Enrollment ID: I20201122000053 |
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