| Harley Vande Streek | |
|
5701 Lonetree Blvd Ste 223 Rocklin CA 95765-3796 | |
| (916) 259-1309 | |
| Not Available |
| Full Name | Harley Vande Streek |
|---|---|
| Speciality | Psychologist |
| Location | 5701 Lonetree Blvd Ste 223, Rocklin, California |
| Authorized Official Name and Position | Harley Vande Streek (OWNER) |
| Authorized Official Contact | 9162591309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harley Vande Streek 5701 Lonetree Blvd Ste 223 Rocklin CA 95765-3796 Ph: (916) 259-1309 | Harley Vande Streek 5701 Lonetree Blvd Ste 223 Rocklin CA 95765-3796 Ph: (916) 259-1309 |
| NPI Number | 1770261943 |
|---|---|
| Provider Enumeration Date | 07/07/2023 |
| Last Update Date | 07/07/2023 |
| Certification Date | 07/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770261943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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