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790 Mason St Ste 102 Vacaville CA 95688-4661 | |
| (707) 874-8463 | |
| (707) 455-6026 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 790 Mason St Ste 102, Vacaville, California |
| Authorized Official Name and Position | Phillip James Atkinson (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7078748463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
790 Mason St Ste 102 Vacaville CA 95688-4661 Ph: (707) 874-8463 | 790 Mason St Ste 102 Vacaville CA 95688-4661 Ph: (707) 874-8463 |
| NPI Number | 1629410022 |
|---|---|
| Provider Enumeration Date | 07/25/2013 |
| Last Update Date | 02/06/2024 |
| Certification Date | 02/06/2024 |
| Medicare PECOS PAC ID | 3870984925 |
|---|---|
| Medicare Enrollment ID | O20211227001329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629410022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY21927 (California) | Primary |
| Provider Name | Maria Ortiz-baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871804856 PECOS PAC ID: 9032361571 Enrollment ID: I20121210000311 |
| Provider Name | Teresa Lynn Hood |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1861036691 PECOS PAC ID: 8426409780 Enrollment ID: I20240111000044 |
| Provider Name | Julianne Elizabeth Hicks |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346755717 PECOS PAC ID: 9335582014 Enrollment ID: I20240209001156 |
| Provider Name | Zelina Silber |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578187811 PECOS PAC ID: 6608308960 Enrollment ID: I20241011002684 |
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