| Bhrs Odyssey Program | |
|
1682 Novato Blvd Ste 105 Novato CA 94947-7021 | |
| (415) 473-2721 | |
| Not Available |
| Full Name | Bhrs Odyssey Program |
|---|---|
| Speciality | Clinic/Center |
| Location | 1682 Novato Blvd Ste 105, Novato, California |
| Authorized Official Name and Position | Rosanna Lallana (COMPLIANCE PRIVACY SECURITY OFCR) |
| Authorized Official Contact | 4154732531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhrs Odyssey Program 20 N San Pedro Rd Ste 2021 San Rafael CA 94903-4158 Ph: (415) 473-2721 | Bhrs Odyssey Program 1682 Novato Blvd Ste 105 Novato CA 94947-7021 Ph: (415) 473-2721 |
| NPI Number | 1679081335 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 12/02/2022 |
| Certification Date | 12/02/2022 |
| Medicare PECOS PAC ID | 1153225065 |
|---|---|
| Medicare Enrollment ID | O20031121000810 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679081335 | NPI | - | NPPES |
| 2177 | Medicaid | CA |
| Provider Name | Timothy R Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720208424 PECOS PAC ID: 8224010467 Enrollment ID: I20041015000649 |
| Provider Name | Katharine A Ballinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437123312 PECOS PAC ID: 0345265153 Enrollment ID: I20051011000733 |
| Provider Name | Janet R Farhie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871680223 PECOS PAC ID: 5092803544 Enrollment ID: I20071115000700 |
| Provider Name | Rebeca L Quezada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477641033 PECOS PAC ID: 5597802488 Enrollment ID: I20091026000619 |
| Provider Name | Michael A Ciranni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760680722 PECOS PAC ID: 9133266919 Enrollment ID: I20091027000863 |
| Provider Name | Ann Murray A Shortall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508999541 PECOS PAC ID: 9739228990 Enrollment ID: I20091201000181 |
| Provider Name | Ryan D Mckim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407180656 PECOS PAC ID: 6103968508 Enrollment ID: I20100122000776 |
| Provider Name | Marne A Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033223755 PECOS PAC ID: 9537204839 Enrollment ID: I20100310000608 |
| Provider Name | Alexander Evens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114144649 PECOS PAC ID: 8628100096 Enrollment ID: I20100720001031 |
| Provider Name | Kerry Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285762609 PECOS PAC ID: 1759568959 Enrollment ID: I20110615000172 |
| Provider Name | Tara C Collins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801039839 PECOS PAC ID: 7810135423 Enrollment ID: I20130521000121 |
| Provider Name | Sukhi Johal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417158981 PECOS PAC ID: 9436140498 Enrollment ID: I20130805000773 |
| Provider Name | Sarah R Sevi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760828453 PECOS PAC ID: 6204060809 Enrollment ID: I20131015001329 |
| Provider Name | Jennifer R Echo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134402514 PECOS PAC ID: 6002043114 Enrollment ID: I20131217001652 |
| Provider Name | Margaret J Grimley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558461095 PECOS PAC ID: 9931351046 Enrollment ID: I20140520002508 |
| Provider Name | Ngoc Loi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790802445 PECOS PAC ID: 8022331107 Enrollment ID: I20141222000559 |
| Provider Name | Margaret Dann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891028213 PECOS PAC ID: 3173846094 Enrollment ID: I20141230001325 |
| Provider Name | Violet Lakeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417261066 PECOS PAC ID: 1153575402 Enrollment ID: I20150220000265 |
| Provider Name | Russell Ronald Monroe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932237450 PECOS PAC ID: 8820314396 Enrollment ID: I20150226002072 |
| Provider Name | Deepak Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548403827 PECOS PAC ID: 7911022959 Enrollment ID: I20150617001562 |
| Provider Name | Charles Edwin Saldanha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295881456 PECOS PAC ID: 3375858558 Enrollment ID: I20150817002811 |
| Provider Name | Laurentiu Dumitrescu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033421573 PECOS PAC ID: 7810112778 Enrollment ID: I20150914002145 |
| Provider Name | Neil Khanna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538101381 PECOS PAC ID: 5294778379 Enrollment ID: I20151104001854 |
| Provider Name | Nihal Desilva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003834789 PECOS PAC ID: 9436330560 Enrollment ID: I20160408001079 |
| Provider Name | Alec Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013259415 PECOS PAC ID: 0749596997 Enrollment ID: I20161129000590 |
| Provider Name | Gail E Burmeister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275698623 PECOS PAC ID: 1254691249 Enrollment ID: I20180213001359 |
| Provider Name | Sara Moschetto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083058192 PECOS PAC ID: 4880948199 Enrollment ID: I20181126000752 |
| Provider Name | Rupinder K Legha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578799680 PECOS PAC ID: 5597938381 Enrollment ID: I20181204000942 |
| Provider Name | Joshua Kane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033271747 PECOS PAC ID: 9638205875 Enrollment ID: I20181214001924 |
| Provider Name | Martin F Epson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801098967 PECOS PAC ID: 4587719950 Enrollment ID: I20181217002992 |
| Provider Name | Emma A Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447706528 PECOS PAC ID: 1456696277 Enrollment ID: I20181226002222 |
| Provider Name | Amit D Rajparia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477648681 PECOS PAC ID: 6800844986 Enrollment ID: I20190306000364 |
| Provider Name | Veronica B Searles Quick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790219863 PECOS PAC ID: 1254667041 Enrollment ID: I20190801000274 |
| Provider Name | Robert L Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982785507 PECOS PAC ID: 7618304775 Enrollment ID: I20200302001260 |
| Provider Name | Jessica O Diaz France |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285942862 PECOS PAC ID: 2961839147 Enrollment ID: I20200310000802 |
| Provider Name | Kimberly Monestime |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497200018 PECOS PAC ID: 1658708789 Enrollment ID: I20200427001898 |
| Provider Name | Kathleen R Chestnut |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063509560 PECOS PAC ID: 2163839366 Enrollment ID: I20210809000808 |
| Provider Name | Hallie J F Hogan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629507868 PECOS PAC ID: 8224433958 Enrollment ID: I20210818003456 |
| Provider Name | Jack Van Bezooyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346773504 PECOS PAC ID: 6406128347 Enrollment ID: I20211119001703 |
| Provider Name | Allison E Arsouzy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730690389 PECOS PAC ID: 8820476336 Enrollment ID: I20220610002227 |
| Provider Name | Thara M Nagarajan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184120289 PECOS PAC ID: 1658609110 Enrollment ID: I20221214002980 |
| Provider Name | Anne R O'connell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720189848 PECOS PAC ID: 1254348345 Enrollment ID: I20230331000982 |
| Provider Name | Laurel Melbin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295974541 PECOS PAC ID: 0749620516 Enrollment ID: I20240426000504 |
| Provider Name | Rachelle F Averbach |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407304306 PECOS PAC ID: 3274973003 Enrollment ID: I20240426002724 |
| Provider Name | Gretchen Forrey |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609322833 PECOS PAC ID: 6002256773 Enrollment ID: I20240429000686 |
| Provider Name | Nancy O'brien |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811163637 PECOS PAC ID: 8729428453 Enrollment ID: I20240429002886 |
| Provider Name | Alexander Dang |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609097385 PECOS PAC ID: 7911347596 Enrollment ID: I20240430001140 |
| Provider Name | Michelle Colleen Ogle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306919402 PECOS PAC ID: 6709235088 Enrollment ID: I20240507004288 |
| Provider Name | Hamaseh A Kianfar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245861772 PECOS PAC ID: 5799126686 Enrollment ID: I20240509001034 |
| Provider Name | Sadegh Nobari |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104848167 PECOS PAC ID: 6709228067 Enrollment ID: I20240531002322 |
| Provider Name | Alexandra B Siliezar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881746568 PECOS PAC ID: 3476095217 Enrollment ID: I20240607000711 |
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