| |
825 Pollard Rd Ste 100 Los Gatos CA 95032-1435 | |
(650) 484-0440 | |
(650) 484-0668 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 825 Pollard Rd Ste 100, Los Gatos, California |
Authorized Official Name and Position | Kristin Andruska (PRESIDENT) |
Authorized Official Contact | 6504840440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 391344 Mountain View CA 94039-1344 Ph: (650) 484-0440 | 825 Pollard Rd Ste 100 Los Gatos CA 95032-1435 Ph: (650) 484-0440 |
NPI Number | 1740868926 |
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Provider Enumeration Date | 03/30/2021 |
Last Update Date | 04/19/2021 |
Certification Date | 04/19/2021 |
Medicare PECOS PAC ID | 9436567716 |
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Medicare Enrollment ID | O20210427000769 |
Identifier | Type | State | Issuer |
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1740868926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Kristin M Andruska |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1619263431 PECOS PAC ID: 3375772882 Enrollment ID: I20180116000905 |
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