| Ipsychological Pc | |
|
6518 Lonetree Blvd Ste 152 Rocklin CA 95765-5874 | |
| (916) 975-4358 | |
| Not Available |
| Full Name | Ipsychological Pc |
|---|---|
| Speciality | Psychologist |
| Location | 6518 Lonetree Blvd Ste 152, Rocklin, California |
| Authorized Official Name and Position | Elijah Meeker (OWNER) |
| Authorized Official Contact | 9169754358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ipsychological Pc 1298 Antelope Creek Dr Unit 422 Roseville CA 95678-2282 Ph: (916) 975-4358 | Ipsychological Pc 6518 Lonetree Blvd Ste 152 Rocklin CA 95765-5874 Ph: (916) 975-4358 |
| NPI Number | 1043860661 |
|---|---|
| Provider Enumeration Date | 09/16/2019 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Medicare PECOS PAC ID | 0143652032 |
|---|---|
| Medicare Enrollment ID | O20191114001638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043860661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elijah Meeker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225568306 PECOS PAC ID: 5799020574 Enrollment ID: I20181226000549 |
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