| The Lotus Collaborative, Inc., A Psychology Clinic | |
|
2500 Market St San Francisco CA 94114-1915 | |
| (415) 931-3731 | |
| (415) 931-3739 |
| Full Name | The Lotus Collaborative, Inc., A Psychology Clinic |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2500 Market St, San Francisco, California |
| Authorized Official Name and Position | Elizabeth Porter (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8316007103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lotus Collaborative, Inc., A Psychology Clinic 603 Mission St Santa Cruz CA 95060-3612 Ph: (831) 600-7103 | The Lotus Collaborative, Inc., A Psychology Clinic 2500 Market St San Francisco CA 94114-1915 Ph: (415) 931-3731 |
| NPI Number | 1720566128 |
|---|---|
| Provider Enumeration Date | 07/30/2018 |
| Last Update Date | 02/01/2021 |
| Certification Date | 02/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720566128 | NPI | - | NPPES |
| 1407120579 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY24204 (California) | Primary |
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