| None | |
|
35 E 10th St Suite E3 Tracy CA 95376-4058 | |
| (510) 258-1163 | |
| (209) 830-1156 |
| Full Name | None |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 35 E 10th St, Tracy, California |
| Authorized Official Name and Position | Michael V. Cubie (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 5102581163 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None Po Box 306 Tracy CA 95378-0306 Ph: (510) 258-1163 | None 35 E 10th St Suite E3 Tracy CA 95376-4058 Ph: (510) 258-1163 |
| NPI Number | 1316298755 |
|---|---|
| Provider Enumeration Date | 09/25/2012 |
| Last Update Date | 09/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316298755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PSY20021 (California) | Primary |
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