| Ivy Glenn Wellness | |
|
30011 Ivy Glenn Dr Ste 216 Laguna Niguel CA 92677-5018 | |
| (949) 484-9161 | |
| Not Available |
| Full Name | Ivy Glenn Wellness |
|---|---|
| Speciality | Psychologist |
| Location | 30011 Ivy Glenn Dr Ste 216, Laguna Niguel, California |
| Authorized Official Name and Position | Kristin Bachman (OWNER) |
| Authorized Official Contact | 8586630651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Glenn Wellness 30011 Ivy Glenn Dr Ste 216 Laguna Niguel CA 92677-5018 Ph: (949) 484-9161 | Ivy Glenn Wellness 30011 Ivy Glenn Dr Ste 216 Laguna Niguel CA 92677-5018 Ph: (949) 484-9161 |
| NPI Number | 1417428665 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 12/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417428665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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