| Mindsmith | |
|
2330 Main St Ste D Ramona CA 92065-2539 | |
| (619) 376-7076 | |
| (619) 303-4270 |
| Full Name | Mindsmith |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2330 Main St Ste D, Ramona, California |
| Authorized Official Name and Position | Jennifer Ane Miller (OWNER/PRESIDENT) |
| Authorized Official Contact | 6193787076 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindsmith 5575 Lake Park Way Ste 100 La Mesa CA 91942-1669 Ph: (619) 378-7076 | Mindsmith 2330 Main St Ste D Ramona CA 92065-2539 Ph: (619) 376-7076 |
| NPI Number | 1346720562 |
|---|---|
| Provider Enumeration Date | 08/16/2018 |
| Last Update Date | 08/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346720562 | NPI | - | NPPES |
| 586347 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY17908 (California) | Primary |
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