| Pacific Neurobehavioral Clinic, Pc | |
|
3636 4th Ave Ste 310 San Diego CA 92103-4294 | |
| (858) 964-0722 | |
| (866) 437-0375 |
| Full Name | Pacific Neurobehavioral Clinic, Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3636 4th Ave Ste 310, San Diego, California |
| Authorized Official Name and Position | Delia Silva (CEO) |
| Authorized Official Contact | 8589640722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Neurobehavioral Clinic, Pc 4080 Centre St Ste 104 San Diego CA 92103-2655 Ph: (858) 964-0722 | Pacific Neurobehavioral Clinic, Pc 3636 4th Ave Ste 310 San Diego CA 92103-4294 Ph: (858) 964-0722 |
| NPI Number | 1952724817 |
|---|---|
| Provider Enumeration Date | 01/29/2014 |
| Last Update Date | 03/19/2024 |
| Certification Date | 03/19/2024 |
| Medicare PECOS PAC ID | 9234454422 |
|---|---|
| Medicare Enrollment ID | O20150210002211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952724817 | NPI | - | NPPES |
| Provider Name | Delia Maria Silva |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295963288 PECOS PAC ID: 7810182219 Enrollment ID: I20101111000202 |
| Provider Name | Stacy Ann Aquipel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740733237 PECOS PAC ID: 4486940376 Enrollment ID: I20160831002771 |
| Provider Name | Takisha M Corbett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750631065 PECOS PAC ID: 9436589603 Enrollment ID: I20200501000522 |
| Provider Name | Angela Janet Estrada Patino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629339015 PECOS PAC ID: 4486085925 Enrollment ID: I20200515002310 |
| Provider Name | Sarah M Jurick Lefler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639604838 PECOS PAC ID: 8921426396 Enrollment ID: I20200916002554 |
| Provider Name | Van J Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063630770 PECOS PAC ID: 4789087156 Enrollment ID: I20210722001053 |
| Provider Name | Jose M Lafosse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306057260 PECOS PAC ID: 4789778879 Enrollment ID: I20220408001414 |
| Provider Name | Khushnoo Kersoo Indorewalla |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477089589 PECOS PAC ID: 0446629885 Enrollment ID: I20221207001836 |
| Provider Name | Beverly Sharifian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427699545 PECOS PAC ID: 6901258755 Enrollment ID: I20240117004530 |
| Provider Name | Margaret Ellenora Wiggins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033792270 PECOS PAC ID: 5395189591 Enrollment ID: I20240215002389 |
| Provider Name | Einat Karin Brenner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679351274 PECOS PAC ID: 1951743459 Enrollment ID: I20240529004095 |
Aefct Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 Murphy Canyon Rd Ste 212, San Diego, CA 92123 Phone: 858-569-0056 Fax: 858-569-4233 | |
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