Mindloft | |
240 W Chapman Ave Ste 200 Orange CA 92866-1316 | |
(949) 569-9226 | |
Not Available |
Full Name | Mindloft |
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Speciality | Psychologist |
Location | 240 W Chapman Ave Ste 200, Orange, California |
Authorized Official Name and Position | Dale Werner (MANAGING PRINCIPAL) |
Authorized Official Contact | 9495699226 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mindloft Po Box 3340 Tustin CA 92781-3340 Ph: (949) 569-9226 | Mindloft 240 W Chapman Ave Ste 200 Orange CA 92866-1316 Ph: (949) 569-9226 |
NPI Number | 1972258796 |
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Provider Enumeration Date | 02/21/2022 |
Last Update Date | 09/09/2024 |
Certification Date | 09/09/2024 |
Medicare PECOS PAC ID | 2567830730 |
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Medicare Enrollment ID | O20221118001001 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972258796 | NPI | - | NPPES |
Provider Name | Stephany Agudelo |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467825331 PECOS PAC ID: 6800203217 Enrollment ID: I20210401000448 |
Provider Name | Perla Barragan |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1972267714 PECOS PAC ID: 1951755727 Enrollment ID: I20230927002711 |
Provider Name | Claudia Garcia |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1790462588 PECOS PAC ID: 8527406677 Enrollment ID: I20240409001263 |
Provider Name | Kelly Rauch |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1336607688 PECOS PAC ID: 4385081033 Enrollment ID: I20240416000957 |
Provider Name | Alexander Petro |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1891455390 PECOS PAC ID: 8820467806 Enrollment ID: I20240517002591 |
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