| Matthew Weisskopf, Ph.d.,a Psychological Corporation | |
|
2423 Camino Del Rio S Ste 102 San Diego CA 92108-3734 | |
| (858) 232-6136 | |
| (888) 753-7206 |
| Full Name | Matthew Weisskopf, Ph.d.,a Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 2423 Camino Del Rio S Ste 102, San Diego, California |
| Authorized Official Name and Position | Matthew Weisskopf (OWNER) |
| Authorized Official Contact | 8582326136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Weisskopf, Ph.d.,a Psychological Corporation 5339 Outlook Pt San Diego CA 92124-1819 Ph: (858) 232-6136 | Matthew Weisskopf, Ph.d.,a Psychological Corporation 2423 Camino Del Rio S Ste 102 San Diego CA 92108-3734 Ph: (858) 232-6136 |
| NPI Number | 1184062655 |
|---|---|
| Provider Enumeration Date | 06/06/2013 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Medicare PECOS PAC ID | 0143458232 |
|---|---|
| Medicare Enrollment ID | O20140117000936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184062655 | NPI | - | NPPES |
| 133650 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY21048 (California) | Primary |
| Provider Name | Matthew D Weisskopf |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710055785 PECOS PAC ID: 2567565294 Enrollment ID: I20070316000308 |
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