| Psych Lab | |
|
3950 Long Beach Blvd Ste 101 Long Beach CA 90807-5410 | |
| (562) 684-1300 | |
| (562) 684-1301 |
| Full Name | Psych Lab |
|---|---|
| Speciality | Psychologist |
| Location | 3950 Long Beach Blvd Ste 101, Long Beach, California |
| Authorized Official Name and Position | David Godot (CEO) |
| Authorized Official Contact | 5626841305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych Lab 5150 E Pacific Coast Hwy Ste 200 Long Beach CA 90804-3399 Ph: (323) 942-9668 | Psych Lab 3950 Long Beach Blvd Ste 101 Long Beach CA 90807-5410 Ph: (562) 684-1300 |
| NPI Number | 1811452196 |
|---|---|
| Provider Enumeration Date | 01/31/2019 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 4880015791 |
|---|---|
| Medicare Enrollment ID | O20200602000696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811452196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | David Godot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679941256 PECOS PAC ID: 1254630551 Enrollment ID: I20200603001240 |
| Provider Name | Nicolette Karina Robbins Zangari |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144092099 PECOS PAC ID: 1052764792 Enrollment ID: I20240129003364 |
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