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2460 Park Blvd Ste 1 Palo Alto CA 94306-1917 | |
| (650) 727-5147 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2460 Park Blvd Ste 1, Palo Alto, California |
| Authorized Official Name and Position | Jaimi Taylor (DIRECTOR) |
| Authorized Official Contact | 6506223541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2460 Park Blvd Ste 1 Palo Alto CA 94306-1917 Ph: (650) 727-5147 | 2460 Park Blvd Ste 1 Palo Alto CA 94306-1917 Ph: (650) 727-5147 |
| NPI Number | 1538986872 |
|---|---|
| Provider Enumeration Date | 09/25/2024 |
| Last Update Date | 01/17/2025 |
| Certification Date | 01/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538986872 | NPI | - | NPPES |
| 1568910107 | Other | CA | CMS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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