| Southern California Psychiatric Associates Inc. | |
|
28 Monarch Bay Plz Suite N Dana Point CA 92629-3460 | |
| (949) 489-5564 | |
| (949) 493-9350 |
| Full Name | Southern California Psychiatric Associates Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 28 Monarch Bay Plz, Dana Point, California |
| Authorized Official Name and Position | Richard Granese (OWNER) |
| Authorized Official Contact | 9494895564 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Psychiatric Associates Inc. 28 Monarch Bay Plz Suite N Dana Point CA 92629-3460 Ph: (949) 489-5564 | Southern California Psychiatric Associates Inc. 28 Monarch Bay Plz Suite N Dana Point CA 92629-3460 Ph: (949) 489-5564 |
| NPI Number | 1962641811 |
|---|---|
| Provider Enumeration Date | 02/17/2009 |
| Last Update Date | 02/17/2009 |
| Medicare PECOS PAC ID | 3678733508 |
|---|---|
| Medicare Enrollment ID | O20120329000548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962641811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A83535 (California) | Primary |
| Provider Name | Richard Granese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437175189 PECOS PAC ID: 6002704384 Enrollment ID: I20050627001109 |
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