| Michelle Fallah Psyd Clinical Psychologist Inc | |
|
113 Waterworks Way Ste 245 Irvine CA 92618-3175 | |
| (949) 299-9596 | |
| Not Available |
| Full Name | Michelle Fallah Psyd Clinical Psychologist Inc |
|---|---|
| Speciality | Psychologist |
| Location | 113 Waterworks Way Ste 245, Irvine, California |
| Authorized Official Name and Position | Michelle N. Fallah (OWNER, PRESIDENT) |
| Authorized Official Contact | 9492999596 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Fallah Psyd Clinical Psychologist Inc 113 Waterworks Way Ste 245 Irvine CA 92618-3175 Ph: (949) 299-9596 | Michelle Fallah Psyd Clinical Psychologist Inc 113 Waterworks Way Ste 245 Irvine CA 92618-3175 Ph: (949) 299-9596 |
| NPI Number | 1720633605 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 01/12/2023 |
| Certification Date | 01/12/2023 |
| Medicare PECOS PAC ID | 7911330733 |
|---|---|
| Medicare Enrollment ID | O20191210001362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720633605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle N Fallah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528312741 PECOS PAC ID: 2567717473 Enrollment ID: I20180618002363 |
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