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600 Newport Center Dr Newport Beach CA 92660-6412 | |
| (808) 354-0544 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 600 Newport Center Dr, Newport Beach, California |
| Authorized Official Name and Position | Shannon Curry (PRESIDENT) |
| Authorized Official Contact | 8083540544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 46b Newport Beach CA 92662-0646 Ph: () - | 600 Newport Center Dr Newport Beach CA 92660-6412 Ph: (808) 354-0544 |
| NPI Number | 1548693930 |
|---|---|
| Provider Enumeration Date | 08/21/2013 |
| Last Update Date | 01/20/2023 |
| Certification Date | 01/20/2023 |
| Medicare PECOS PAC ID | 3971731761 |
|---|---|
| Medicare Enrollment ID | O20140125000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548693930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY-1404 (Hawaii) | Primary |
| Provider Name | Shannon Jeanne Curry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972947406 PECOS PAC ID: 4880822675 Enrollment ID: I20140125000181 |
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