| Erik Sean Bidinger-boggess | |
|
772 S Mark St Tulare CA 93274-6031 | |
| (530) 864-9445 | |
| Not Available |
| Full Name | Erik Sean Bidinger-boggess |
|---|---|
| Speciality | Social Worker |
| Location | 772 S Mark St, Tulare, California |
| Authorized Official Name and Position | Erik Sean Bidinger-boggess (OWNER) |
| Authorized Official Contact | 5308649445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erik Sean Bidinger-boggess 772 S Mark St Tulare CA 93274-6031 Ph: () - | Erik Sean Bidinger-boggess 772 S Mark St Tulare CA 93274-6031 Ph: (530) 864-9445 |
| NPI Number | 1801540588 |
|---|---|
| Provider Enumeration Date | 02/10/2022 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Medicare PECOS PAC ID | 8123412152 |
|---|---|
| Medicare Enrollment ID | O20220308001382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801540588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Erik Sean Bidinger-boggess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801944426 PECOS PAC ID: 9032503065 Enrollment ID: I20220308001458 |
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