| Psychiatric Wellness Center Inc | |
|
30300 Agoura Road Suite 195 Agoura Hills CA 91301-5412 | |
| (818) 532-7950 | |
| (818) 532-7685 |
| Full Name | Psychiatric Wellness Center Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 30300 Agoura Road, Agoura Hills, California |
| Authorized Official Name and Position | Elsa Calumpit Cruz (OWNER) |
| Authorized Official Contact | 8187952515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Wellness Center Inc 30300 Agoura Road Suite 195 Agoura Hills CA 91301-5412 Ph: (818) 532-7950 | Psychiatric Wellness Center Inc 30300 Agoura Road Suite 195 Agoura Hills CA 91301-5412 Ph: (818) 532-7950 |
| NPI Number | 1962819789 |
|---|---|
| Provider Enumeration Date | 07/14/2014 |
| Last Update Date | 07/14/2014 |
| Medicare PECOS PAC ID | 4284851403 |
|---|---|
| Medicare Enrollment ID | O20140812002542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962819789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A75757 (California) | Primary |
| Provider Name | Elsa C Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861524159 PECOS PAC ID: 3476635236 Enrollment ID: I20080131000727 |
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