Orange Blossom Psychological Services Professional Corporation | |
1255 W Colton Ave # 534 Redlands CA 92374-2861 | |
(909) 830-1946 | |
Not Available |
Full Name | Orange Blossom Psychological Services Professional Corporation |
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Speciality | Psychologist |
Location | 1255 W Colton Ave # 534, Redlands, California |
Authorized Official Name and Position | Amie Lemos-miller (CLINICAL PSYCHOLOGIST/OWNER) |
Authorized Official Contact | 9098301946 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Orange Blossom Psychological Services Professional Corporation 7745 Boulder Avenue Unit 1205 Highland CA 92346 Ph: (909) 830-1946 | Orange Blossom Psychological Services Professional Corporation 1255 W Colton Ave # 534 Redlands CA 92374-2861 Ph: (909) 830-1946 |
NPI Number | 1104670835 |
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Provider Enumeration Date | 04/17/2024 |
Last Update Date | 04/17/2024 |
Certification Date | 04/17/2024 |
Medicare PECOS PAC ID | 9335673045 |
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Medicare Enrollment ID | O20241115004259 |
Identifier | Type | State | Issuer |
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1104670835 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Amie Marie Lemos-miller |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1639377609 PECOS PAC ID: 2163811852 Enrollment ID: I20211118002024 |
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