| T. Adelstein, Ph.d., Psychologist, P.c. | |
|
45 Windstone Dr San Rafael CA 94903-1438 | |
| (415) 381-2209 | |
| (415) 593-7789 |
| Full Name | T. Adelstein, Ph.d., Psychologist, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 45 Windstone Dr, San Rafael, California |
| Authorized Official Name and Position | Teddy Adelstein (PRESIDENT) |
| Authorized Official Contact | 4153812209 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| T. Adelstein, Ph.d., Psychologist, P.c. 823 Peregrine Ave Davis CA 95616-0170 Ph: (415) 381-2209 | T. Adelstein, Ph.d., Psychologist, P.c. 45 Windstone Dr San Rafael CA 94903-1438 Ph: (415) 381-2209 |
| NPI Number | 1669864302 |
|---|---|
| Provider Enumeration Date | 03/03/2015 |
| Last Update Date | 06/01/2022 |
| Certification Date | 06/01/2022 |
| Medicare PECOS PAC ID | 0244550721 |
|---|---|
| Medicare Enrollment ID | O20150523000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669864302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 12543 (California) | Primary |
| 103TA0700X | Psychologist - Adult Development & Aging | 12543 (California) | Secondary |
| Provider Name | Teddy Adelstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144276874 PECOS PAC ID: 7416115639 Enrollment ID: I20120220000716 |
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