| |
2330 Main St Ste D Ramona CA 92065-2539 | |
(619) 376-7076 | |
(619) 303-4270 |
Full Name | |
---|---|
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 |
---|---|
5575 Lake Park Way Ste 100 La Mesa CA 91942-1669 Ph: (619) 378-7076 | 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 |
Mindful Living Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24340 Ca-78, Ramona, CA 95065 Phone: 619-341-9007 Fax: 619-354-2157 | |