| Sequoia Psychotherapy Center, Inc | |
|
1960 N. Gateway Blvd Fresno CA 93727 | |
| (559) 266-5200 | |
| Not Available |
| Full Name | Sequoia Psychotherapy Center, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1960 N. Gateway Blvd, Fresno, California |
| Authorized Official Name and Position | Mark David Popper (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 5592665200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sequoia Psychotherapy Center, Inc 1960 N. Gateway Blvd Fresno CA 93727 Ph: (559) 266-5200 | Sequoia Psychotherapy Center, Inc 1960 N. Gateway Blvd Fresno CA 93727 Ph: (559) 266-5200 |
| NPI Number | 1427085349 |
|---|---|
| Provider Enumeration Date | 06/27/2006 |
| Last Update Date | 03/29/2019 |
| Medicare PECOS PAC ID | 1355380783 |
|---|---|
| Medicare Enrollment ID | O20050426000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427085349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | PSY 13574 (California) | Primary |
| Provider Name | Mark D Popper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306878020 PECOS PAC ID: 3870547391 Enrollment ID: I20050308000875 |
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