| Cloverfield Mental Health Services | |
|
1751 Cloverfield Blvd Santa Monica CA 90404-4007 | |
| (310) 450-0650 | |
| (310) 833-1221 |
| Full Name | Cloverfield Mental Health Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1751 Cloverfield Blvd, Santa Monica, California |
| Authorized Official Name and Position | Angeline Loch (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 3233349000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cloverfield Mental Health Services 1453 16th St Santa Monica CA 90404-2715 Ph: (310) 264-6646 | Cloverfield Mental Health Services 1751 Cloverfield Blvd Santa Monica CA 90404-4007 Ph: (310) 450-0650 |
| NPI Number | 1306977459 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 12/18/2019 |
| Certification Date | 12/18/2019 |
| Medicare PECOS PAC ID | 7214150382 |
|---|---|
| Medicare Enrollment ID | O20210108002442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306977459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Aaron Siani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831535053 PECOS PAC ID: 6103124581 Enrollment ID: I20160419000703 |
| Provider Name | Amelia Mcconnell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720110414 PECOS PAC ID: 3779821061 Enrollment ID: I20190212001698 |
| Provider Name | Shannon Ordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881125755 PECOS PAC ID: 8527399153 Enrollment ID: I20200424002091 |
| Provider Name | Jordan S Barlam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649781501 PECOS PAC ID: 6406269703 Enrollment ID: I20210105003220 |
| Provider Name | Sara C Hyoun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942643655 PECOS PAC ID: 8123431327 Enrollment ID: I20210107001267 |
| Provider Name | Nicholas S Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407344542 PECOS PAC ID: 1759795537 Enrollment ID: I20210208001067 |
| Provider Name | Erika Hsu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801390810 PECOS PAC ID: 6406287226 Enrollment ID: I20210208002093 |
| Provider Name | David J Han |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134633845 PECOS PAC ID: 6608281316 Enrollment ID: I20210210001615 |
| Provider Name | Kimberly L Krieger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093144743 PECOS PAC ID: 0941615546 Enrollment ID: I20210211003229 |
| Provider Name | Brittney J Buchanan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790034726 PECOS PAC ID: 2668887266 Enrollment ID: I20210212001209 |
| Provider Name | Jennifer E Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063813673 PECOS PAC ID: 7810304821 Enrollment ID: I20210318000320 |
| Provider Name | Jennifer E Manegold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790280451 PECOS PAC ID: 3173954757 Enrollment ID: I20210329001793 |
| Provider Name | Justin C Key |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093246647 PECOS PAC ID: 0244560480 Enrollment ID: I20210415002842 |
| Provider Name | Jennifer N Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285097402 PECOS PAC ID: 8820492879 Enrollment ID: I20210812001784 |
| Provider Name | Brian S. Benjamin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518354661 PECOS PAC ID: 4486943172 Enrollment ID: I20210901003800 |
| Provider Name | Amy M Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164829651 PECOS PAC ID: 5193105187 Enrollment ID: I20220708000364 |
| Provider Name | Alyson M Fortner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235769894 PECOS PAC ID: 3678954955 Enrollment ID: I20220718002534 |
| Provider Name | Collin Mathew Price |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134680010 PECOS PAC ID: 1759780042 Enrollment ID: I20220726002334 |
| Provider Name | Marylou E Mcleod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386060762 PECOS PAC ID: 0648652180 Enrollment ID: I20220801001693 |
| Provider Name | Hilary Morgan Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548897614 PECOS PAC ID: 0042692683 Enrollment ID: I20220802003478 |
| Provider Name | Amber Nicole Baysinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194351189 PECOS PAC ID: 7416354824 Enrollment ID: I20220808002241 |
| Provider Name | Aaron J Watson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386273027 PECOS PAC ID: 6800284365 Enrollment ID: I20220825003871 |
| Provider Name | Shawna T Chan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326676321 PECOS PAC ID: 8022498096 Enrollment ID: I20220917000372 |
| Provider Name | Dennis Dacarett-galeano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871121418 PECOS PAC ID: 7113308313 Enrollment ID: I20230208001461 |
| Provider Name | Sloane E Fowkes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265154868 PECOS PAC ID: 5496120297 Enrollment ID: I20230410000903 |
| Provider Name | Daniel Patrick Morberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811525611 PECOS PAC ID: 0840671947 Enrollment ID: I20230727003244 |
| Provider Name | Joseph E Kaizer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932786902 PECOS PAC ID: 4880053388 Enrollment ID: I20230801003884 |
| Provider Name | Alex M Mirman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164009874 PECOS PAC ID: 8628436557 Enrollment ID: I20231020002401 |
| Provider Name | Meagan Wills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558911594 PECOS PAC ID: 7214384189 Enrollment ID: I20231114003252 |
| Provider Name | Rebecca F Tesfai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164010989 PECOS PAC ID: 1456700632 Enrollment ID: I20231213001953 |
| Provider Name | Seong Yeop Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598230583 PECOS PAC ID: 1951784339 Enrollment ID: I20240521000218 |
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