| Redwood Psychological, Inc | |
|
1080 Mason Mall Ste 6c Crescent City CA 95531-4335 | |
| (707) 951-7620 | |
| Not Available |
| Full Name | Redwood Psychological, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1080 Mason Mall Ste 6c, Crescent City, California |
| Authorized Official Name and Position | Jeff Kelly (PRESIDENT) |
| Authorized Official Contact | 7079517620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redwood Psychological, Inc 1080 Mason Mall Ste 6c Crescent City CA 95531-4335 Ph: (707) 951-7620 | Redwood Psychological, Inc 1080 Mason Mall Ste 6c Crescent City CA 95531-4335 Ph: (707) 951-7620 |
| NPI Number | 1265096838 |
|---|---|
| Provider Enumeration Date | 04/29/2019 |
| Last Update Date | 02/07/2020 |
| Certification Date | 02/07/2020 |
| Medicare PECOS PAC ID | 7517384803 |
|---|---|
| Medicare Enrollment ID | O20200901002551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265096838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jeff Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669631065 PECOS PAC ID: 8426475716 Enrollment ID: I20200901002800 |
Dhhs Mental Health Branch Family Resource Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 494 Pacific Ave, Crescent City, CA 95531 Phone: 707-464-5500 | |
Remi Vista, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 E St Rm 26, Crescent City, CA 95531 Phone: 707-464-4349 Fax: 707-464-4572 | |
Remi Vista Services For Probation Youth Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Williams Dr # 2, Crescent City, CA 95531 Phone: 707-464-4349 Fax: 707-464-4572 | |
Dhhs Behavioral Health Branch Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 405 & 455 K Street, Crescent City, CA 95531 Phone: 707-464-7224 Fax: 707-465-0855 | |
Department Of Health And Human Services Alcohol And Other Drug Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1279 2nd St Ste C, Crescent City, CA 95531 Phone: 707-464-0860 Fax: 707-465-0855 | |
Dhhs Behavioral Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1125 Burtschell, Crescent City, CA 95531 Phone: 707-464-7224 |