| Lagasse Yates, Inc | |
|
12625 High Bluff Dr Suite 206 San Diego CA 92130-2052 | |
| (858) 793-8768 | |
| Not Available |
| Full Name | Lagasse Yates, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 12625 High Bluff Dr, San Diego, California |
| Authorized Official Name and Position | Susan Lagasse (OWNER) |
| Authorized Official Contact | 8587938768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lagasse Yates, Inc 12625 High Bluff Dr Suite 206 San Diego CA 92130-2052 Ph: (858) 793-8768 | Lagasse Yates, Inc 12625 High Bluff Dr Suite 206 San Diego CA 92130-2052 Ph: (858) 793-8768 |
| NPI Number | 1902851900 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 11/18/2011 |
| Medicare PECOS PAC ID | 2668476086 |
|---|---|
| Medicare Enrollment ID | O20060826000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902851900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan Lagasse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164461836 PECOS PAC ID: 4688677743 Enrollment ID: I20060810000522 |
| Provider Name | Ronald Bradfield Yates |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881633618 PECOS PAC ID: 3577567908 Enrollment ID: I20120202000559 |
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