| Neurotree | |
|
3707 E Southern Ave Floors 1 And 2 Mesa AZ 85206-2569 | |
| (424) 387-6806 | |
| Not Available |
| Full Name | Neurotree |
|---|---|
| Speciality | Counselor |
| Location | 3707 E Southern Ave, Mesa, Arizona |
| Authorized Official Name and Position | David Esraelian (CEO/CO-FOUNDER) |
| Authorized Official Contact | 4243876806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurotree 530 S Lake Ave # 149 Pasadena CA 91101-3515 Ph: (424) 387-6806 | Neurotree 3707 E Southern Ave Floors 1 And 2 Mesa AZ 85206-2569 Ph: (424) 387-6806 |
| NPI Number | 1386366755 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 09/13/2022 |
| Certification Date | 09/13/2022 |
| Medicare PECOS PAC ID | 5294106373 |
|---|---|
| Medicare Enrollment ID | O20230127002106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386366755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | Frederick Calvin Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083676977 PECOS PAC ID: 1052335189 Enrollment ID: I20211220001482 |
| Provider Name | Jennifer Renae Kljajic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346645413 PECOS PAC ID: 1456629484 Enrollment ID: I20220914003457 |
| Provider Name | Oluwatoyin Aluko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659952984 PECOS PAC ID: 2769859610 Enrollment ID: I20221104002118 |
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