| Emmada Psychology Center, Inc. | |
|
8939 S Sepulveda Blvd Suite #200 Los Angeles CA 90045-3631 | |
| (310) 903-0840 | |
| Not Available |
| Full Name | Emmada Psychology Center, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 8939 S Sepulveda Blvd, Los Angeles, California |
| Authorized Official Name and Position | Rickey Williamson (PRESIDENT) |
| Authorized Official Contact | 8668634645 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emmada Psychology Center, Inc. 595 E Colorado Blvd Ste 211 Pasadena CA 91101-2028 Ph: (866) 863-4645 | Emmada Psychology Center, Inc. 8939 S Sepulveda Blvd Suite #200 Los Angeles CA 90045-3631 Ph: (310) 903-0840 |
| NPI Number | 1891032652 |
|---|---|
| Provider Enumeration Date | 01/12/2013 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 0244479970 |
|---|---|
| Medicare Enrollment ID | O20130610000526 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891032652 | NPI | - | NPPES |
| Provider Name | Rickey L Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578619417 PECOS PAC ID: 9537204201 Enrollment ID: I20100305000144 |
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