| Phillips Medstone A Psychological Corporation | |
|
5333 Mission Center Rd Suite 100 San Diego CA 92108-1302 | |
| (619) 543-0983 | |
| (619) 810-0383 |
| Full Name | Phillips Medstone A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 5333 Mission Center Rd, San Diego, California |
| Authorized Official Name and Position | Autumn R Phillips (PRESIDENT) |
| Authorized Official Contact | 6195430983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillips Medstone A Psychological Corporation 5333 Mission Center Rd Suite 100 San Diego CA 92108-1302 Ph: (619) 543-0983 | Phillips Medstone A Psychological Corporation 5333 Mission Center Rd Suite 100 San Diego CA 92108-1302 Ph: (619) 543-0983 |
| NPI Number | 1801222120 |
|---|---|
| Provider Enumeration Date | 09/18/2013 |
| Last Update Date | 04/28/2014 |
| Medicare PECOS PAC ID | 6507099603 |
|---|---|
| Medicare Enrollment ID | O20140424002258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801222120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Autumn R Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598083909 PECOS PAC ID: 0143478297 Enrollment ID: I20120913000651 |
| Provider Name | Pooja Amatya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649631011 PECOS PAC ID: 6103178124 Enrollment ID: I20181002002638 |
| Provider Name | A-lisa Shay Miles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326468471 PECOS PAC ID: 7618215468 Enrollment ID: I20190220003039 |
| Provider Name | Sandy Cullins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417672684 PECOS PAC ID: 6103295829 Enrollment ID: I20221219002584 |
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