| Susan J. Novak, Phd | |
|
23832 Rockfield Blvd Ste 130 Lake Forest CA 92630-2860 | |
| (949) 297-6680 | |
| (949) 861-6321 |
| Full Name | Susan J. Novak, Phd |
|---|---|
| Speciality | Clinic/Center |
| Location | 23832 Rockfield Blvd Ste 130, Lake Forest, California |
| Authorized Official Name and Position | Susan Joy Novak (PRESIDENT/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9492976680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan J. Novak, Phd 23832 Rockfield Blvd Ste 130 Lake Forest CA 92630-2860 Ph: (949) 297-6680 | Susan J. Novak, Phd 23832 Rockfield Blvd Ste 130 Lake Forest CA 92630-2860 Ph: (949) 297-6680 |
| NPI Number | 1346585908 |
|---|---|
| Provider Enumeration Date | 12/06/2012 |
| Last Update Date | 03/03/2020 |
| Certification Date | 03/03/2020 |
| Medicare PECOS PAC ID | 6305061243 |
|---|---|
| Medicare Enrollment ID | O20140708002399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346585908 | NPI | - | NPPES |
| Provider Name | Susan Novak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093084162 PECOS PAC ID: 4486879327 Enrollment ID: I20140708002452 |
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