| Pci Westlake Centers | |
|
31194 La Baya Dr Ste 201 Westlake Village CA 91362-6431 | |
| (805) 797-7875 | |
| Not Available |
| Full Name | Pci Westlake Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 31194 La Baya Dr Ste 201, Westlake Village, California |
| Authorized Official Name and Position | Miriam Hamideh (CLINICAL PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 8057977875 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pci Westlake Centers 31194 La Baya Dr Ste 201 Westlake Village CA 91362-6431 Ph: (805) 338-2209 | Pci Westlake Centers 31194 La Baya Dr Ste 201 Westlake Village CA 91362-6431 Ph: (805) 797-7875 |
| NPI Number | 1508125998 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 07/01/2020 |
| Certification Date | 07/01/2020 |
| Medicare PECOS PAC ID | 6507029030 |
|---|---|
| Medicare Enrollment ID | O20120521000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508125998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PSY17320 (California) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
| Provider Name | Maria Hamideh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124183561 PECOS PAC ID: 0941463152 Enrollment ID: I20120529000155 |
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