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2888 Loker Ave E Ste 110 Carlsbad CA 92010-6683 | |
| (888) 341-4449 | |
| (858) 529-9709 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2888 Loker Ave E Ste 110, Carlsbad, California |
| Authorized Official Name and Position | Candice Shamoon (CREDENTIALING DIRECTOR) |
| Authorized Official Contact | 8883414449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2888 Loker Ave E Carlsbad CA 92010-6682 Ph: (833) 378-4110 | 2888 Loker Ave E Ste 110 Carlsbad CA 92010-6683 Ph: (888) 341-4449 |
| NPI Number | 1912688656 |
|---|---|
| Provider Enumeration Date | 07/26/2023 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Medicare PECOS PAC ID | 0941731509 |
|---|---|
| Medicare Enrollment ID | O20241007002442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912688656 | NPI | - | NPPES |
| Provider Name | Jennifer Guerguis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1023236676 PECOS PAC ID: 1850822420 Enrollment ID: I20241009003575 |
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