| Kcps | |
|
719 Jadwin Ave Unit 719-11 Richland WA 99352-4217 | |
| (509) 214-1894 | |
| Not Available |
| Full Name | Kcps |
|---|---|
| Speciality | Psychologist |
| Location | 719 Jadwin Ave Unit 719-11, Richland, Washington |
| Authorized Official Name and Position | Angela Klingensmith (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 5092141894 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kcps 719 Jadwin Ave Unit 719-11 Richland WA 99352-4217 Ph: () - | Kcps 719 Jadwin Ave Unit 719-11 Richland WA 99352-4217 Ph: (509) 214-1894 |
| NPI Number | 1720852429 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 3173962677 |
|---|---|
| Medicare Enrollment ID | O20240417000692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720852429 | NPI | - | NPPES |
| Provider Name | Angela R Klingensmith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962926485 PECOS PAC ID: 3072933654 Enrollment ID: I20210304002558 |
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