| Emotional & Behavioral Health Psychology Swistun Phd Inc | |
|
9850 Genesee Ave Ste 130 La Jolla CA 92037-1206 | |
| (312) 375-1827 | |
| Not Available |
| Full Name | Emotional & Behavioral Health Psychology Swistun Phd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 9850 Genesee Ave Ste 130, La Jolla, California |
| Authorized Official Name and Position | Dominika J Swistun (CEO) |
| Authorized Official Contact | 3123751827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional & Behavioral Health Psychology Swistun Phd Inc 9850 Genesee Ave Ste 130 La Jolla CA 92037-1206 Ph: (312) 375-1827 | Emotional & Behavioral Health Psychology Swistun Phd Inc 9850 Genesee Ave Ste 130 La Jolla CA 92037-1206 Ph: (312) 375-1827 |
| NPI Number | 1750098737 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/31/2022 |
| Medicare PECOS PAC ID | 1850760554 |
|---|---|
| Medicare Enrollment ID | O20221219001693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750098737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dominika Swistun |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669875373 PECOS PAC ID: 6709116908 Enrollment ID: I20191002000622 |
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