| Telecare Santa Maria Adult/older Adult Fsp | |
|
124 W. Carmen Lane Suite A Santa Maria CA 93458-7768 | |
| (805) 348-1850 | |
| Not Available |
| Full Name | Telecare Santa Maria Adult/older Adult Fsp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 124 W. Carmen Lane, Santa Maria, California |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare Santa Maria Adult/older Adult Fsp 1080 Marina Village Pkwy Suite 100 Alameda CA 94501-6427 Ph: (510) 337-7950 | Telecare Santa Maria Adult/older Adult Fsp 124 W. Carmen Lane Suite A Santa Maria CA 93458-7768 Ph: (805) 348-1850 |
| NPI Number | 1316192149 |
|---|---|
| Provider Enumeration Date | 11/20/2008 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316192149 | NPI | - | NPPES |
| 000009177 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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