| Evolving Pathways Psychology Corporation | |
|
2447 Pacific Coast Hwy Ste 210 Hermosa Beach CA 90254-2714 | |
| (310) 905-3151 | |
| (310) 756-1225 |
| Full Name | Evolving Pathways Psychology Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 2447 Pacific Coast Hwy Ste 210, Hermosa Beach, California |
| Authorized Official Name and Position | Jessie Caldera (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 4242123212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolving Pathways Psychology Corporation 2447 Pacific Coast Hwy Ste 210 Hermosa Beach CA 90254-2714 Ph: (310) 905-3151 | Evolving Pathways Psychology Corporation 2447 Pacific Coast Hwy Ste 210 Hermosa Beach CA 90254-2714 Ph: (310) 905-3151 |
| NPI Number | 1194303446 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 10/10/2023 |
| Certification Date | 10/06/2023 |
| Medicare PECOS PAC ID | 6002212115 |
|---|---|
| Medicare Enrollment ID | O20210914003366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194303446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Debbie Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851848337 PECOS PAC ID: 4385923077 Enrollment ID: I20161121002062 |
| Provider Name | Jessie Yesenia Caldera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497005706 PECOS PAC ID: 9234494246 Enrollment ID: I20180522002310 |
| Provider Name | Valerie Pintado Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851765192 PECOS PAC ID: 9638582885 Enrollment ID: I20210106002732 |
| Provider Name | Aisha Y Shaikh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710604491 PECOS PAC ID: 6204207434 Enrollment ID: I20230125002065 |
| Provider Name | Mliss Marie Doman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013698042 PECOS PAC ID: 6406200591 Enrollment ID: I20230922002183 |
| Provider Name | Chari Lanee Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932656162 PECOS PAC ID: 7618311945 Enrollment ID: I20240214004024 |
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