| Sage Psychological Services, Pc | |
|
2835 Camino Del Rio S Suite 120 San Diego CA 92108-3825 | |
| (858) 228-7701 | |
| Not Available |
| Full Name | Sage Psychological Services, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2835 Camino Del Rio S, San Diego, California |
| Authorized Official Name and Position | Sage Schuitevoerder (OWNER) |
| Authorized Official Contact | 8582287701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Psychological Services, Pc 2835 Camino Del Rio S Suite 120 San Diego CA 92108-3825 Ph: (858) 228-7701 | Sage Psychological Services, Pc 2835 Camino Del Rio S Suite 120 San Diego CA 92108-3825 Ph: (858) 228-7701 |
| NPI Number | 1558719492 |
|---|---|
| Provider Enumeration Date | 06/01/2016 |
| Last Update Date | 06/01/2016 |
| Medicare PECOS PAC ID | 9133405004 |
|---|---|
| Medicare Enrollment ID | O20170406002219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558719492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 25395 (California) | Primary |
| Provider Name | Sage Schuitevoerder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962562892 PECOS PAC ID: 8921238239 Enrollment ID: I20140306001964 |
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