| Stepping Forward Group Professional | |
|
15375 Barranca Pkwy Ste D Irvine CA 92618-2206 | |
| (949) 333-1209 | |
| (949) 333-1209 |
| Full Name | Stepping Forward Group Professional |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 15375 Barranca Pkwy Ste D, Irvine, California |
| Authorized Official Name and Position | Gary Pedneault (MD) |
| Authorized Official Contact | 9493331209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stepping Forward Group Professional 15375 Barranca Pkwy Ste A201 Irvine CA 92618-2204 Ph: (949) 280-9254 | Stepping Forward Group Professional 15375 Barranca Pkwy Ste D Irvine CA 92618-2206 Ph: (949) 333-1209 |
| NPI Number | 1679389514 |
|---|---|
| Provider Enumeration Date | 12/05/2024 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679389514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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