| Keystone Therapy And Training Services Inc | |
|
4415 Sonoma Hwy Ste A Santa Rosa CA 95409-4165 | |
| (707) 327-0909 | |
| Not Available |
| Full Name | Keystone Therapy And Training Services Inc |
|---|---|
| Speciality | Social Worker |
| Location | 4415 Sonoma Hwy Ste A, Santa Rosa, California |
| Authorized Official Name and Position | Erica Bosque (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7073270909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Therapy And Training Services Inc 4415 Sonoma Hwy Ste A Santa Rosa CA 95409-4165 Ph: (707) 327-0909 | Keystone Therapy And Training Services Inc 4415 Sonoma Hwy Ste A Santa Rosa CA 95409-4165 Ph: (707) 327-0909 |
| NPI Number | 1952057598 |
|---|---|
| Provider Enumeration Date | 02/22/2022 |
| Last Update Date | 02/24/2022 |
| Certification Date | 02/24/2022 |
| Medicare PECOS PAC ID | 3173910015 |
|---|---|
| Medicare Enrollment ID | O20220425001423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952057598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Erica Joeverley Bosque |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356824189 PECOS PAC ID: 9032506738 Enrollment ID: I20220427002823 |
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