| Reconnect Relationship, A Professional Psychology Corporation | |
|
499 N Canon Dr Ste 216 Beverly Hills CA 90210-4887 | |
| (310) 500-8442 | |
| (855) 881-3484 |
| Full Name | Reconnect Relationship, A Professional Psychology Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 499 N Canon Dr Ste 216, Beverly Hills, California |
| Authorized Official Name and Position | Gilbert Chalepas (PRESIDENT) |
| Authorized Official Contact | 3105008442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reconnect Relationship, A Professional Psychology Corporation 499 N Canon Dr Ste 216 Beverly Hills CA 90210-4887 Ph: (310) 500-8442 | Reconnect Relationship, A Professional Psychology Corporation 499 N Canon Dr Ste 216 Beverly Hills CA 90210-4887 Ph: (310) 500-8442 |
| NPI Number | 1386266021 |
|---|---|
| Provider Enumeration Date | 05/15/2020 |
| Last Update Date | 05/15/2020 |
| Certification Date | 05/15/2020 |
| Medicare PECOS PAC ID | 4486076775 |
|---|---|
| Medicare Enrollment ID | O20200615001028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386266021 | NPI | - | NPPES |
| PSY23708 | Other | CA | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gilbert Chalepas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306152905 PECOS PAC ID: 8527254507 Enrollment ID: I20101202000696 |
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