| Soper Family Psychiatry Medical Group | |
|
1836 Central Ave Ste A Mckinleyville CA 95519-3667 | |
| (707) 445-4705 | |
| (707) 445-0581 |
| Full Name | Soper Family Psychiatry Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 1836 Central Ave Ste A, Mckinleyville, California |
| Authorized Official Name and Position | Niki Moore (OFFICE MANAGER) |
| Authorized Official Contact | 7074454705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soper Family Psychiatry Medical Group 1836 Central Ave Ste A Mckinleyville CA 95519-3667 Ph: (707) 445-4705 | Soper Family Psychiatry Medical Group 1836 Central Ave Ste A Mckinleyville CA 95519-3667 Ph: (707) 445-4705 |
| NPI Number | 1699158634 |
|---|---|
| Provider Enumeration Date | 07/08/2015 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/15/2024 |
| Medicare PECOS PAC ID | 2365850112 |
|---|---|
| Medicare Enrollment ID | O20210416001148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699158634 | NPI | - | NPPES |
| Provider Name | Wendy J Brandon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912004896 PECOS PAC ID: 4183708761 Enrollment ID: I20080220000518 |
| Provider Name | Steven J Roth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417971946 PECOS PAC ID: 3274658620 Enrollment ID: I20100909000230 |
| Provider Name | Robert E Soper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215065362 PECOS PAC ID: 8325203698 Enrollment ID: I20120712000171 |
| Provider Name | Anirudh Rai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679136865 PECOS PAC ID: 9931596095 Enrollment ID: I20220420002131 |
Aba Humboldt Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1622 Bartow Rd, Mckinleyville, CA 95519 Phone: 707-672-5527 Fax: 707-633-1755 | |
Agate Moon Ecotherapy Collective, Licensed Clinical Social Worker, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1776 Market Ave, Mckinleyville, CA 95519 Phone: 503-440-5924 | |
Humboldt County Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1615 Heartwood Drive, Mckinleyville, CA 95519 Phone: 707-268-2990 | |
Two Feathers Native American Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1560 Betty Ct Unit A, Mckinleyville, CA 95519 Phone: 707-839-1933 | |
North Coast Nurture Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 Central Ave Ste 2, Mckinleyville, CA 95519 Phone: 707-601-5622 Fax: 707-840-6036 | |
North Coast Psychotherapy Center For Anxiety And Ocd, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1660 Central Ave Ste F, Mckinleyville, CA 95519 Phone: 949-400-5069 |