| Evolving Pathways Inc. | |
|
16801 Bollinger Dr Pacific Palisades CA 90272-3220 | |
| (424) 212-3212 | |
| Not Available |
| Full Name | Evolving Pathways Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 16801 Bollinger Dr, Pacific Palisades, California |
| Authorized Official Name and Position | Jessie Caldera (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 4242123212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolving Pathways Inc. 16801 Bollinger Dr Pacific Palisades CA 90272-3220 Ph: (424) 212-3212 | Evolving Pathways Inc. 16801 Bollinger Dr Pacific Palisades CA 90272-3220 Ph: (424) 212-3212 |
| NPI Number | 1760090609 |
|---|---|
| Provider Enumeration Date | 07/16/2020 |
| Last Update Date | 07/17/2020 |
| Certification Date | 07/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760090609 | NPI | - | NPPES |
| CB297075 | Medicaid | CA | |
| CB297075 | Other | CA | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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