| Shashita Inamdar Md Professional Corporation | |
|
4510 Executive Dr Ste 115 San Diego CA 92121-3021 | |
| (858) 427-5060 | |
| (619) 383-6701 |
| Full Name | Shashita Inamdar Md Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4510 Executive Dr, San Diego, California |
| Authorized Official Name and Position | Trina Robin Weatherford (OFFICER) |
| Authorized Official Contact | 6193836700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shashita Inamdar Md Professional Corporation Po Box 601422 San Diego CA 92160-1422 Ph: (619) 383-6700 | Shashita Inamdar Md Professional Corporation 4510 Executive Dr Ste 115 San Diego CA 92121-3021 Ph: (858) 427-5060 |
| NPI Number | 1902220809 |
|---|---|
| Provider Enumeration Date | 02/12/2014 |
| Last Update Date | 01/10/2020 |
| Certification Date | 01/10/2020 |
| Medicare PECOS PAC ID | 4082839774 |
|---|---|
| Medicare Enrollment ID | O20140714002326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902220809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sandra M Firth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487862470 PECOS PAC ID: 0244222057 Enrollment ID: I20040401000504 |
| Provider Name | Manish V Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225083272 PECOS PAC ID: 8527971951 Enrollment ID: I20100107000542 |
| Provider Name | Amanda Saxe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528159126 PECOS PAC ID: 3971790965 Enrollment ID: I20101202000892 |
| Provider Name | Veronica Deatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316371180 PECOS PAC ID: 0840426284 Enrollment ID: I20131113001612 |
| Provider Name | Michelle M Brilee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114342417 PECOS PAC ID: 8628291689 Enrollment ID: I20140519002287 |
| Provider Name | Toni A Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356752786 PECOS PAC ID: 0941429286 Enrollment ID: I20140918000250 |
| Provider Name | Brittany L Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629525340 PECOS PAC ID: 7416235957 Enrollment ID: I20161103000878 |
| Provider Name | Lindsay A Howard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497140438 PECOS PAC ID: 6709192362 Enrollment ID: I20190904002915 |
| Provider Name | Monique Frisby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598396848 PECOS PAC ID: 3375959125 Enrollment ID: I20210602003117 |
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