Inner Expansions Therapy Services | |
9700 El Camino Real Ste 200 Atascadero CA 93422-5579 | |
(805) 460-7300 | |
(805) 468-4290 |
Full Name | Inner Expansions Therapy Services |
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Speciality | Social Worker |
Location | 9700 El Camino Real Ste 200, Atascadero, California |
Authorized Official Name and Position | Shannon Cantillano (CEO/CLINICAL DIRECTOR) |
Authorized Official Contact | 8054607300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Expansions Therapy Services 7343 El Camino Real # 226 Atascadero CA 93422-4697 Ph: (805) 460-7300 | Inner Expansions Therapy Services 9700 El Camino Real Ste 200 Atascadero CA 93422-5579 Ph: (805) 460-7300 |
NPI Number | 1205543535 |
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Provider Enumeration Date | 11/07/2022 |
Last Update Date | 07/05/2024 |
Certification Date | 07/05/2024 |
Medicare PECOS PAC ID | 0143692822 |
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Medicare Enrollment ID | O20230206001731 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205543535 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Shannon J Cantillano |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1780811364 PECOS PAC ID: 8729215470 Enrollment ID: I20131230000795 |
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Masood Moghaddam Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5975 Entrada Ave, Atascadero, CA 93422 Phone: 805-703-3540 Fax: 805-466-9765 | |
Community Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3500 El Camino Real, Atascadero, CA 93422 Phone: 805-781-4700 | |
Drug And Alcohol Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3556 El Camino Real, Atascadero, CA 93422 Phone: 805-461-6080 |