| Fathom Psychology, Pc | |
|
260 Maple Ct Ste 223 Ventura CA 93003-3567 | |
| (805) 628-2546 | |
| Not Available |
| Full Name | Fathom Psychology, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 260 Maple Ct Ste 223, Ventura, California |
| Authorized Official Name and Position | Susan D Sharma (PRESIDENT) |
| Authorized Official Contact | 8056282546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fathom Psychology, Pc 260 Maple Ct Ste 223 Ventura CA 93003-3567 Ph: (805) 628-2546 | Fathom Psychology, Pc 260 Maple Ct Ste 223 Ventura CA 93003-3567 Ph: (805) 628-2546 |
| NPI Number | 1558069864 |
|---|---|
| Provider Enumeration Date | 02/16/2023 |
| Last Update Date | 02/16/2023 |
| Certification Date | 02/16/2023 |
| Medicare PECOS PAC ID | 3476918616 |
|---|---|
| Medicare Enrollment ID | O20230424000669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558069864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan Davies Sharma |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457577280 PECOS PAC ID: 4385009521 Enrollment ID: I20230518001206 |
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