| City Psychology, Inc. | |
|
909 15th St Ste 8 Modesto CA 95354-1130 | |
| (209) 529-7807 | |
| (209) 529-7919 |
| Full Name | City Psychology, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 909 15th St Ste 8, Modesto, California |
| Authorized Official Name and Position | Cynthia Vincent (OWNER) |
| Authorized Official Contact | 2095297807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| City Psychology, Inc. Po Box 721 Modesto CA 95353-0721 Ph: (209) 529-7807 | City Psychology, Inc. 909 15th St Ste 8 Modesto CA 95354-1130 Ph: (209) 529-7807 |
| NPI Number | 1972993509 |
|---|---|
| Provider Enumeration Date | 02/03/2015 |
| Last Update Date | 01/06/2023 |
| Certification Date | 01/06/2023 |
| Medicare PECOS PAC ID | 8123322328 |
|---|---|
| Medicare Enrollment ID | O20160209001311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972993509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY17076 (California) | Primary |
| Provider Name | Cynthia Vincent |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770696478 PECOS PAC ID: 9032413232 Enrollment ID: I20160209001398 |
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