| Patient Centered Psychiatry, Inc | |
|
801 Seneca St Ventura CA 93001-1411 | |
| (805) 504-6814 | |
| Not Available |
| Full Name | Patient Centered Psychiatry, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 801 Seneca St, Ventura, California |
| Authorized Official Name and Position | Timothy Park (CEO) |
| Authorized Official Contact | 8055046814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patient Centered Psychiatry, Inc 3010 Beard Rd Napa CA 94558-3442 Ph: (805) 504-6814 | Patient Centered Psychiatry, Inc 801 Seneca St Ventura CA 93001-1411 Ph: (805) 504-6814 |
| NPI Number | 1457992430 |
|---|---|
| Provider Enumeration Date | 10/01/2019 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/02/2021 |
| Medicare PECOS PAC ID | 7315376027 |
|---|---|
| Medicare Enrollment ID | O20200401000877 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457992430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
| Provider Name | Timothy Daniel Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841602315 PECOS PAC ID: 2062639586 Enrollment ID: I20200401001034 |
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