| Neuropsychological Associates Of Ca | |
|
1260 N Dutton Ave Ste 225 Santa Rosa CA 95401-4659 | |
| (707) 526-5424 | |
| (707) 526-5900 |
| Full Name | Neuropsychological Associates Of Ca |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1260 N Dutton Ave, Santa Rosa, California |
| Authorized Official Name and Position | Carolyn Frances Crimmins (PROVIDER) |
| Authorized Official Contact | 7075265424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuropsychological Associates Of Ca 1260 N Dutton Ave Ste 225 Santa Rosa CA 95401-4659 Ph: (707) 526-5424 | Neuropsychological Associates Of Ca 1260 N Dutton Ave Ste 225 Santa Rosa CA 95401-4659 Ph: (707) 526-5424 |
| NPI Number | 1508004540 |
|---|---|
| Provider Enumeration Date | 01/29/2009 |
| Last Update Date | 11/15/2019 |
| Medicare PECOS PAC ID | 5294882510 |
|---|---|
| Medicare Enrollment ID | O20090402000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508004540 | NPI | - | NPPES |
| PSY23205 | Other | CA | PSYCHOLOGIST LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 23205 (California) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Carolyn Frances Crimmins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902936321 PECOS PAC ID: 5294985453 Enrollment ID: I20121024000281 |
| Provider Name | Tari L Webber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205117876 PECOS PAC ID: 5193042950 Enrollment ID: I20150317000195 |
| Provider Name | Brian P King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942490230 PECOS PAC ID: 2961645619 Enrollment ID: I20180711002081 |
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