| John B. Mansdorfer, Ph.d. | |
|
785 Grand Ave 219 Carlsbad CA 92008-2370 | |
| (760) 729-6009 | |
| (760) 729-6009 |
| Full Name | John B. Mansdorfer, Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 785 Grand Ave, Carlsbad, California |
| Authorized Official Name and Position | John B Mansdorfer (PSYCHOLOGIST) |
| Authorized Official Contact | 7607296009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John B. Mansdorfer, Ph.d. 785 Grand Ave 219 Carlsbad CA 92008-2370 Ph: (760) 729-6009 | John B. Mansdorfer, Ph.d. 785 Grand Ave 219 Carlsbad CA 92008-2370 Ph: (760) 729-6009 |
| NPI Number | 1669698908 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 03/11/2009 |
| Medicare PECOS PAC ID | 3870910458 |
|---|---|
| Medicare Enrollment ID | O20200827001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669698908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY13625 (California) | Primary |
| Provider Name | John B Mansdorfer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598900367 PECOS PAC ID: 7315008448 Enrollment ID: I20081209000096 |
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