| Del Valle Clinic, Inc | |
|
1797 4th St Livermore CA 94550-4347 | |
| (925) 443-2500 | |
| (925) 443-0771 |
| Full Name | Del Valle Clinic, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1797 4th St, Livermore, California |
| Authorized Official Name and Position | Nancy Oehrly (OWNER) |
| Authorized Official Contact | 9254432500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Del Valle Clinic, Inc 1797 4th St Livermore CA 94550-4347 Ph: (925) 443-2500 | Del Valle Clinic, Inc 1797 4th St Livermore CA 94550-4347 Ph: (925) 443-2500 |
| NPI Number | 1023028248 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 09/20/2007 |
| Medicare PECOS PAC ID | 2961539846 |
|---|---|
| Medicare Enrollment ID | O20100428000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023028248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tina Glueck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265761159 PECOS PAC ID: 0042355018 Enrollment ID: I20100302000220 |
| Provider Name | Jeannette D Lobao |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285644492 PECOS PAC ID: 6305012741 Enrollment ID: I20120105000789 |
| Provider Name | Jordan Boehler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316280332 PECOS PAC ID: 4385971852 Enrollment ID: I20190806002590 |
| Provider Name | Shawna V Welton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104029552 PECOS PAC ID: 1456766351 Enrollment ID: I20210225002940 |
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