| El Camino Psychology Services. Pc | |
|
2181 S El Camino Real Ste 307 Oceanside CA 92054-6288 | |
| (760) 722-4233 | |
| (760) 722-4232 |
| Full Name | El Camino Psychology Services. Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2181 S El Camino Real Ste 307, Oceanside, California |
| Authorized Official Name and Position | Brock Kenneth Kilbourne (DIRECTOR) |
| Authorized Official Contact | 7607224233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Camino Psychology Services. Pc 2181 S El Camino Real Ste 307 Oceanside CA 92054-6288 Ph: (760) 722-4233 | El Camino Psychology Services. Pc 2181 S El Camino Real Ste 307 Oceanside CA 92054-6288 Ph: (760) 722-4233 |
| NPI Number | 1932233178 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 10/20/2008 |
| Medicare PECOS PAC ID | 7214903475 |
|---|---|
| Medicare Enrollment ID | O20040908001455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932233178 | NPI | - | NPPES |
| PSY10467 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY10467 (California) | Primary |
| Provider Name | Brock K Kilbourne |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467586701 PECOS PAC ID: 6204802473 Enrollment ID: I20040909000546 |
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