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8767 Carmel Valley Rd Carmel CA 93923-7958 | |
| (831) 582-1017 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 8767 Carmel Valley Rd, Carmel, California |
| Authorized Official Name and Position | Jennifer Fenton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8315821017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1087 Monterey CA 93942-1087 Ph: (831) 582-1017 | 8767 Carmel Valley Rd Carmel CA 93923-7958 Ph: (831) 582-1017 |
| NPI Number | 1669934261 |
|---|---|
| Provider Enumeration Date | 04/02/2019 |
| Last Update Date | 10/09/2024 |
| Certification Date | 10/09/2024 |
| Medicare PECOS PAC ID | 5698201200 |
|---|---|
| Medicare Enrollment ID | O20241205004005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669934261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Jennifer Irene Fenton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083891485 PECOS PAC ID: 4587190194 Enrollment ID: I20241210003104 |
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