| Drlullaby Llc | |
|
4533 Macarthur Blvd Newport Beach CA 92660-2059 | |
| (844) 475-3379 | |
| Not Available |
| Full Name | Drlullaby Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4533 Macarthur Blvd, Newport Beach, California |
| Authorized Official Name and Position | Lisa Ann Medalie (CEO) |
| Authorized Official Contact | 8444753379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drlullaby Llc 1101 Davis St Ste 5767 Evanston IL 60201-5945 Ph: (844) 475-3379 | Drlullaby Llc 4533 Macarthur Blvd Newport Beach CA 92660-2059 Ph: (844) 475-3379 |
| NPI Number | 1174239636 |
|---|---|
| Provider Enumeration Date | 01/27/2023 |
| Last Update Date | 09/12/2023 |
| Certification Date | 09/12/2023 |
| Medicare PECOS PAC ID | 9931507290 |
|---|---|
| Medicare Enrollment ID | O20230321001746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174239636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Guylene Velez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730216672 PECOS PAC ID: 0143308593 Enrollment ID: I20080424000762 |
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