| Samuel Psychotherapy, Inc | |
|
25255 Cabot Rd Suite 210 Laguna Hills CA 92653-5519 | |
| (951) 818-3038 | |
| Not Available |
| Full Name | Samuel Psychotherapy, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 25255 Cabot Rd, Laguna Hills, California |
| Authorized Official Name and Position | Maryann Samuel (OWNER) |
| Authorized Official Contact | 9518183038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Psychotherapy, Inc 25255 Cabot Rd Suite 210 Laguna Hills CA 92653-5519 Ph: () - | Samuel Psychotherapy, Inc 25255 Cabot Rd Suite 210 Laguna Hills CA 92653-5519 Ph: (951) 818-3038 |
| NPI Number | 1316333636 |
|---|---|
| Provider Enumeration Date | 04/14/2015 |
| Last Update Date | 11/21/2016 |
| Medicare PECOS PAC ID | 5698058808 |
|---|---|
| Medicare Enrollment ID | O20170214001888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316333636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY24440 (California) | Primary |
| Provider Name | Maryann F Samuel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033494703 PECOS PAC ID: 4688819980 Enrollment ID: I20130314000033 |
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