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74040 Highway 111 Stej4 Palm Desert CA 92260-4134 | |
(760) 340-2476 | |
(760) 340-2476 |
Full Name | |
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Speciality | Psychologist - Clinical |
Location | 74040 Highway 111, Palm Desert, California |
Authorized Official Name and Position | Sabine K Gaedt (PRESIDENT) |
Authorized Official Contact | 7603402476 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1108 Rancho Mirage CA 92270 Ph: (760) 340-2476 | 74040 Highway 111 Stej4 Palm Desert CA 92260-4134 Ph: (760) 340-2476 |
NPI Number | 1235350570 |
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Provider Enumeration Date | 05/02/2007 |
Last Update Date | 09/28/2007 |
Identifier | Type | State | Issuer |
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1235350570 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | PSY13454 (California) | Primary |
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