| Jeannie Chang Psychologist Inc. | |
|
1401 21st St Ste R Sacramento CA 95811-5226 | |
| (415) 860-5914 | |
| Not Available |
| Full Name | Jeannie Chang Psychologist Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1401 21st St Ste R, Sacramento, California |
| Authorized Official Name and Position | Jeannie Chang (OWNER) |
| Authorized Official Contact | 4158605914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeannie Chang Psychologist Inc. 867 34th Ave San Francisco CA 94121-3433 Ph: () - | Jeannie Chang Psychologist Inc. 1401 21st St Ste R Sacramento CA 95811-5226 Ph: (415) 860-5914 |
| NPI Number | 1124899877 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 1759726730 |
|---|---|
| Medicare Enrollment ID | O20240229001441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124899877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jeannie Won Chang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104055029 PECOS PAC ID: 2466821608 Enrollment ID: I20221212000842 |
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