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5955 Lake Vista Dr Bonsall CA 92003-6104 | |
(760) 472-3950 | |
(760) 472-3949 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 5955 Lake Vista Dr, Bonsall, California |
Authorized Official Name and Position | Michele Linden (LICENSED PSYCHOLOGIST) |
Authorized Official Contact | 7604723950 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5256 S Mission Rd Suite 703-807 Bonsall CA 92003-3614 Ph: (760) 472-3950 | 5955 Lake Vista Dr Bonsall CA 92003-6104 Ph: (760) 472-3950 |
NPI Number | 1629434311 |
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Provider Enumeration Date | 01/11/2016 |
Last Update Date | 01/11/2016 |
Identifier | Type | State | Issuer |
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1629434311 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | PSY 10658 (California) | Primary |