| Psychshield Behavioral Healthcare | |
|
4000 Long Beach Blvd Ste 212 Long Beach CA 90807-2617 | |
| (562) 595-7102 | |
| (562) 595-9112 |
| Full Name | Psychshield Behavioral Healthcare |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4000 Long Beach Blvd Ste 212, Long Beach, California |
| Authorized Official Name and Position | Wiley D Sutton (CEO/PSYCHOTHERAPY PROVIDER) |
| Authorized Official Contact | 5625957102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychshield Behavioral Healthcare Po Box 250 Lakewood CA 90714-0250 Ph: (562) 595-7102 | Psychshield Behavioral Healthcare 4000 Long Beach Blvd Ste 212 Long Beach CA 90807-2617 Ph: (562) 595-7102 |
| NPI Number | 1437358520 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 01/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437358520 | NPI | - | NPPES |
| PHD 019 00 N | Other | CA | BLUE SHIELD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PSY 4467 (California) | Primary |
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