| La Mer Psychiatric Medical Group, Inc. | |
|
1901 Outlet Center Dr Suite 220 Oxnard CA 93036-0663 | |
| (805) 388-8330 | |
| (805) 388-8030 |
| Full Name | La Mer Psychiatric Medical Group, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1901 Outlet Center Dr, Oxnard, California |
| Authorized Official Name and Position | Jerry Bruns (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8053888330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Mer Psychiatric Medical Group, Inc. Po Box 201 Camarillo CA 93011-0201 Ph: (805) 388-8330 | La Mer Psychiatric Medical Group, Inc. 1901 Outlet Center Dr Suite 220 Oxnard CA 93036-0663 Ph: (805) 388-8330 |
| NPI Number | 1346327517 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/05/2014 |
| Medicare PECOS PAC ID | 4981504818 |
|---|---|
| Medicare Enrollment ID | O20040126000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346327517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
| 171100000X | Acupuncturist | (* (Not Available)) | Secondary |
| Provider Name | Jerry Bruns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851402184 PECOS PAC ID: 4385546787 Enrollment ID: I20040505001778 |
| Provider Name | Debra S Herrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154470094 PECOS PAC ID: 1951409325 Enrollment ID: I20070607000753 |
| Provider Name | Michael Huff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538153242 PECOS PAC ID: 3678463981 Enrollment ID: I20161014001488 |
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