| Lydia S Glass Phd Psychological & Mediation Services Inc | |
|
200 E Del Mar Blvd Ste 210 Pasadena CA 91105-2551 | |
| (626) 792-4153 | |
| (626) 930-0626 |
| Full Name | Lydia S Glass Phd Psychological & Mediation Services Inc |
|---|---|
| Speciality | Counselor |
| Location | 200 E Del Mar Blvd Ste 210, Pasadena, California |
| Authorized Official Name and Position | Lydia S Glass (PRESIDENT) |
| Authorized Official Contact | 6267924153 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lydia S Glass Phd Psychological & Mediation Services Inc 200 E Del Mar Blvd Ste 210 Pasadena CA 91105-2551 Ph: (626) 792-4153 | Lydia S Glass Phd Psychological & Mediation Services Inc 200 E Del Mar Blvd Ste 210 Pasadena CA 91105-2551 Ph: (626) 792-4153 |
| NPI Number | 1861635013 |
|---|---|
| Provider Enumeration Date | 04/16/2009 |
| Last Update Date | 04/16/2009 |
| Medicare PECOS PAC ID | 5799834115 |
|---|---|
| Medicare Enrollment ID | O20090514000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861635013 | NPI | - | NPPES |
| CP13464 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PSY13464 (California) | Primary |
| Provider Name | Lydia Glass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518179035 PECOS PAC ID: 8921156506 Enrollment ID: I20090514000167 |
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