| Kelly Kaitson Psychotherapy | |
|
100 E San Marcos Blvd Ste 400 San Marcos CA 92069-2988 | |
| (619) 955-2291 | |
| Not Available |
| Full Name | Kelly Kaitson Psychotherapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 E San Marcos Blvd Ste 400, San Marcos, California |
| Authorized Official Name and Position | Kelly Kaitson (PRESIDENT) |
| Authorized Official Contact | 7604150085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Kaitson Psychotherapy 1937 Twilight Gln Escondido CA 92026-5014 Ph: (760) 415-0085 | Kelly Kaitson Psychotherapy 100 E San Marcos Blvd Ste 400 San Marcos CA 92069-2988 Ph: (619) 955-2291 |
| NPI Number | 1245923853 |
|---|---|
| Provider Enumeration Date | 05/30/2023 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Medicare PECOS PAC ID | 8921468042 |
|---|---|
| Medicare Enrollment ID | O20230720000981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245923853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelly M Kaitson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447764147 PECOS PAC ID: 0840553202 Enrollment ID: I20180417002058 |
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