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191 Lighthouse Ave Ste A5 Monterey CA 93940-1704 | |
| (831) 737-8295 | |
| (831) 740-6769 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 191 Lighthouse Ave Ste A5, Monterey, California |
| Authorized Official Name and Position | Liana Shapiro-lee (PRESIDENT) |
| Authorized Official Contact | 8317378295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
191 Lighthouse Ave Ste A5 Monterey CA 93940-1704 Ph: (831) 737-8295 | 191 Lighthouse Ave Ste A5 Monterey CA 93940-1704 Ph: (831) 737-8295 |
| NPI Number | 1730659103 |
|---|---|
| Provider Enumeration Date | 11/28/2018 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 4789110008 |
|---|---|
| Medicare Enrollment ID | O20241210004201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730659103 | NPI | - | NPPES |
| 1679838866 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Liana S Shapiro-lee |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679838866 PECOS PAC ID: 5698201911 Enrollment ID: I20241210004237 |
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