| Dfas | |
|
2323 Julian Ln Fairfield CA 94534-3131 | |
| (301) 633-9503 | |
| Not Available |
| Full Name | Dfas |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2323 Julian Ln, Fairfield, California |
| Authorized Official Name and Position | Rachel Anne Broussard (PMHNP) |
| Authorized Official Contact | 3016339503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfas 2323 Julian Ln Fairfield CA 94534-3131 Ph: (301) 633-9503 | Dfas 2323 Julian Ln Fairfield CA 94534-3131 Ph: (301) 633-9503 |
| NPI Number | 1871036194 |
|---|---|
| Provider Enumeration Date | 11/19/2016 |
| Last Update Date | 11/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871036194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | R190890 (Maryland) | Primary |
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