| Kr Psychological Services, Inc | |
|
30011 Ivy Glenn Dr Ste 120 Laguna Niguel CA 92677-5041 | |
| (714) 812-1916 | |
| (949) 305-8286 |
| Full Name | Kr Psychological Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 30011 Ivy Glenn Dr Ste 120, Laguna Niguel, California |
| Authorized Official Name and Position | Kristina Brosius-rodriguez (CEO) |
| Authorized Official Contact | 7148121916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kr Psychological Services, Inc 90 Vantis Dr Unit 6021 Aliso Viejo CA 92656-2547 Ph: (714) 812-1916 | Kr Psychological Services, Inc 30011 Ivy Glenn Dr Ste 120 Laguna Niguel CA 92677-5041 Ph: (714) 812-1916 |
| NPI Number | 1538531900 |
|---|---|
| Provider Enumeration Date | 10/26/2015 |
| Last Update Date | 04/14/2024 |
| Certification Date | 04/14/2024 |
| Medicare PECOS PAC ID | 7315287539 |
|---|---|
| Medicare Enrollment ID | O20190325001935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538531900 | NPI | - | NPPES |
| Provider Name | Kristina Kay Brosius-rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902960446 PECOS PAC ID: 1153416581 Enrollment ID: I20190325002025 |
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