| Mind And Body Psychological Services, Pc | |
|
2409 19th Ave Ste B4 San Francisco CA 94116-2495 | |
| (415) 710-4879 | |
| (415) 564-3167 |
| Full Name | Mind And Body Psychological Services, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2409 19th Ave Ste B4, San Francisco, California |
| Authorized Official Name and Position | Tatiana Doubnova (PSYCHOLOGIST) |
| Authorized Official Contact | 4157104879 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind And Body Psychological Services, Pc 2409 19th Ave Ste B4 San Francisco CA 94116-2495 Ph: (415) 710-4879 | Mind And Body Psychological Services, Pc 2409 19th Ave Ste B4 San Francisco CA 94116-2495 Ph: (415) 710-4879 |
| NPI Number | 1134799786 |
|---|---|
| Provider Enumeration Date | 06/27/2021 |
| Last Update Date | 06/27/2021 |
| Certification Date | 08/07/2020 |
| Medicare PECOS PAC ID | 0648649426 |
|---|---|
| Medicare Enrollment ID | O20221219000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134799786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tatiana Doubnova |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790957280 PECOS PAC ID: 8628227154 Enrollment ID: I20120927000264 |
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