|
| |
|
1622 4th St Santa Rosa CA 95404-4020 | |
| (707) 571-1714 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1622 4th St, Santa Rosa, California |
| Authorized Official Name and Position | Joy Lyn Kendall (PRESIDENT/OWNER) |
| Authorized Official Contact | 7075356615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1622 4th St Santa Rosa CA 95404-4020 Ph: (707) 535-6615 | 1622 4th St Santa Rosa CA 95404-4020 Ph: (707) 571-1714 |
| NPI Number | 1740830389 |
|---|---|
| Provider Enumeration Date | 09/16/2019 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Medicare PECOS PAC ID | 5890231872 |
|---|---|
| Medicare Enrollment ID | O20240725004831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740830389 | NPI | - | NPPES |
| Provider Name | Joy Lyn Kendall |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1891195525 PECOS PAC ID: 6709322787 Enrollment ID: I20240725004837 |
| Provider Name | Michael Warren Wilcox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619426046 PECOS PAC ID: 5294271011 Enrollment ID: I20240729001164 |
| Provider Name | Jeremiah Thompson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831866615 PECOS PAC ID: 6305379157 Enrollment ID: I20241031002465 |
| Provider Name | Mariam Opincar Merrin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295137412 PECOS PAC ID: 6103350426 Enrollment ID: I20241108003283 |
Clb Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 W 3rd St, D-250, Santa Rosa, CA 95401 Phone: 707-566-7571 | |
Sonoma County Indian Health Project Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 144 Stony Point Rd, Santa Rosa, CA 95401 Phone: 707-521-4545 | |
Cross Cultural Services And Evaluations, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1550 Airport Blvd Ste 206, Santa Rosa, CA 95403 Phone: 707-799-4274 | |
Mounir Belcadi, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3452 Mendocino Ave, Suite C, Santa Rosa, CA 95403 Phone: 707-579-8703 Fax: 707-579-8755 | |
Drug Abuse Alternatives Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2403 Professional Dr, Santa Rosa, CA 95403 Phone: 707-544-3295 | |
Surgical Neuromonitoring Service Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3005 Santa Margarita Ct, Santa Rosa, CA 95405 Phone: 707-573-2341 Fax: 707-539-2939 |