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18818 Hwy 18 Apple Valley CA 92307-0009 | |
| (760) 995-8813 | |
| (760) 995-8929 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 18818 Hwy 18, Apple Valley, California |
| Authorized Official Name and Position | Mark Edward Thomas (MENTAL HEALTH CLINIC SUPERVISOR) |
| Authorized Official Contact | 9516623730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
18818 Hwy 18 Apple Valley CA 92307-0009 Ph: (760) 995-8813 | 18818 Hwy 18 Apple Valley CA 92307-0009 Ph: (760) 995-8813 |
| NPI Number | 1902010887 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902010887 | NPI | - | NPPES |
| 36DM | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | ZZZ74743Z (California) | Primary |
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Victor Valley Neurology, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 15995 Tuscola Rd, Suite 203, Apple Valley, CA 92307 Phone: 760-946-4004 Fax: 760-946-4944 |