| Prudent Telepsychiatry Care | |
|
8880 Benson Ave Ste 125 Montclair CA 91763-1661 | |
| (323) 632-5868 | |
| (866) 214-8786 |
| Full Name | Prudent Telepsychiatry Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 8880 Benson Ave Ste 125, Montclair, California |
| Authorized Official Name and Position | Felista Anugom (PRESIDENT) |
| Authorized Official Contact | 8662147214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prudent Telepsychiatry Care 8880 Benson Ave Ste 125 Montclair CA 91763-1661 Ph: (866) 214-7214 | Prudent Telepsychiatry Care 8880 Benson Ave Ste 125 Montclair CA 91763-1661 Ph: (323) 632-5868 |
| NPI Number | 1619544988 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 05/10/2024 |
| Certification Date | 04/20/2023 |
| Medicare PECOS PAC ID | 4789080235 |
|---|---|
| Medicare Enrollment ID | O20210908002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619544988 | NPI | - | NPPES |
| Provider Name | Felista A Anugom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891070686 PECOS PAC ID: 5991928285 Enrollment ID: I20140513001246 |
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