Psychiatric Care Medical Corporation | |
3455 Westridge Dr Kelseyville CA 95451-8227 | |
(707) 279-2932 | |
Not Available |
Full Name | Psychiatric Care Medical Corporation |
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Speciality | Counselor - Professional |
Location | 3455 Westridge Dr, Kelseyville, California |
Authorized Official Name and Position | Olga Segal (PRESIDENT) |
Authorized Official Contact | 7072792932 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Psychiatric Care Medical Corporation 3455 Westridge Dr Kelseyville CA 95451-8227 Ph: () - | Psychiatric Care Medical Corporation 3455 Westridge Dr Kelseyville CA 95451-8227 Ph: (707) 279-2932 |
NPI Number | 1437175619 |
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Provider Enumeration Date | 07/14/2006 |
Last Update Date | 10/20/2009 |
Identifier | Type | State | Issuer |
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1437175619 | NPI | - | NPPES |
00A857740 | Other | CA | PIN NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | A85774 (California) | Primary |