| Ggtg | |
|
1603 California Ave Ste 137 Bakersfield CA 93304-1346 | |
| (661) 404-4123 | |
| Not Available |
| Full Name | Ggtg |
|---|---|
| Speciality | Psychologist |
| Location | 1603 California Ave Ste 137, Bakersfield, California |
| Authorized Official Name and Position | Kimerly Ann Cobbs (PARTNER) |
| Authorized Official Contact | 6616193193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ggtg 10900 Artist Ct Bakersfield CA 93312-2879 Ph: (661) 619-3193 | Ggtg 1603 California Ave Ste 137 Bakersfield CA 93304-1346 Ph: (661) 404-4123 |
| NPI Number | 1912766841 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 9739521725 |
|---|---|
| Medicare Enrollment ID | O20240522001304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912766841 | NPI | - | NPPES |
| Provider Name | Tara Sue Garrett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093981524 PECOS PAC ID: 1052767555 Enrollment ID: I20231019000862 |
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