| Darrell Broaddus Psychological Services Pc | |
|
6128 Via Presidio Orangevale CA 95662-4460 | |
| (916) 412-4270 | |
| Not Available |
| Full Name | Darrell Broaddus Psychological Services Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6128 Via Presidio, Orangevale, California |
| Authorized Official Name and Position | Darrell Broaddus (OWNER/OPERATOR) |
| Authorized Official Contact | 9164124270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Darrell Broaddus Psychological Services Pc Po Box 750834 Forest Hills NY 11375-0834 Ph: (718) 268-6600 | Darrell Broaddus Psychological Services Pc 6128 Via Presidio Orangevale CA 95662-4460 Ph: (916) 412-4270 |
| NPI Number | 1215339650 |
|---|---|
| Provider Enumeration Date | 09/17/2014 |
| Last Update Date | 09/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215339650 | NPI | - | NPPES |
| PSY 20101 | Other | CA | CALIFORNIA LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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