| Mind Body Medicine Inc | |
|
1811 Grand Canal Blvd Ste 3 Stockton CA 95207-8107 | |
| (209) 800-1718 | |
| Not Available |
| Full Name | Mind Body Medicine Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1811 Grand Canal Blvd Ste 3, Stockton, California |
| Authorized Official Name and Position | Sapna Purawat (OWNER/MD) |
| Authorized Official Contact | 2098001718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Body Medicine Inc 1811 Grand Canal Blvd Ste 3 Stockton CA 95207-8107 Ph: (209) 800-1718 | Mind Body Medicine Inc 1811 Grand Canal Blvd Ste 3 Stockton CA 95207-8107 Ph: (209) 800-1718 |
| NPI Number | 1871278754 |
|---|---|
| Provider Enumeration Date | 06/19/2023 |
| Last Update Date | 06/19/2023 |
| Certification Date | 06/19/2023 |
| Medicare PECOS PAC ID | 2264893197 |
|---|---|
| Medicare Enrollment ID | O20230725002706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871278754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sapna Purawat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437316668 PECOS PAC ID: 3375793045 Enrollment ID: I20191127002539 |
| Provider Name | Joy Amoge Nnebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205601507 PECOS PAC ID: 3072953033 Enrollment ID: I20240425000002 |
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