| La Vie Psychology Group, Inc. | |
|
650 Sierra Madre Villa Ave Suite 110 Pasadena CA 91107-2013 | |
| (626) 351-9616 | |
| (626) 351-9493 |
| Full Name | La Vie Psychology Group, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 650 Sierra Madre Villa Ave, Pasadena, California |
| Authorized Official Name and Position | Mark W Baker (PRESIDENT) |
| Authorized Official Contact | 6263519616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Vie Psychology Group, Inc. 650 Sierra Madre Villa Ave Suite 110 Pasadena CA 91107-2013 Ph: (626) 351-9616 | La Vie Psychology Group, Inc. 650 Sierra Madre Villa Ave Suite 110 Pasadena CA 91107-2013 Ph: (626) 351-9616 |
| NPI Number | 1174775134 |
|---|---|
| Provider Enumeration Date | 10/21/2008 |
| Last Update Date | 10/21/2008 |
| Medicare PECOS PAC ID | 6002970233 |
|---|---|
| Medicare Enrollment ID | O20090202000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174775134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY9219 (California) | Primary |
| Provider Name | Mark Baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528239506 PECOS PAC ID: 4284798414 Enrollment ID: I20090202000632 |
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