| Tucker Peck Phd | |
|
2258 Santa Clara Ave Ste 5 Alameda CA 94501-4473 | |
| (415) 802-2860 | |
| (844) 227-8699 |
| Full Name | Tucker Peck Phd |
|---|---|
| Speciality | Psychologist |
| Location | 2258 Santa Clara Ave Ste 5, Alameda, California |
| Authorized Official Name and Position | Tucker Peck (CEO) |
| Authorized Official Contact | 5204859411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tucker Peck Phd 2103 San Jose Ave Alameda CA 94501-4994 Ph: (520) 485-9411 | Tucker Peck Phd 2258 Santa Clara Ave Ste 5 Alameda CA 94501-4473 Ph: (415) 802-2860 |
| NPI Number | 1841951399 |
|---|---|
| Provider Enumeration Date | 01/06/2022 |
| Last Update Date | 08/18/2023 |
| Certification Date | 08/18/2023 |
| Medicare PECOS PAC ID | 9739573619 |
|---|---|
| Medicare Enrollment ID | O20220221000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841951399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Tucker Peck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205291440 PECOS PAC ID: 0446544019 Enrollment ID: I20220221000310 |
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