| The New Mind Whole Person Psychological Care Inc | |
|
114 N Indian Hill Blvd Suite B Claremont CA 91711-4675 | |
| (909) 603-9300 | |
| (909) 603-9301 |
| Full Name | The New Mind Whole Person Psychological Care Inc |
|---|---|
| Speciality | Psychologist |
| Location | 114 N Indian Hill Blvd, Claremont, California |
| Authorized Official Name and Position | Dennis W. Wallstrom (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9096039300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The New Mind Whole Person Psychological Care Inc 114 N Indian Hill Blvd Suite B Claremont CA 91711-4675 Ph: (909) 603-9300 | The New Mind Whole Person Psychological Care Inc 114 N Indian Hill Blvd Suite B Claremont CA 91711-4675 Ph: (909) 603-9300 |
| NPI Number | 1538604699 |
|---|---|
| Provider Enumeration Date | 12/28/2016 |
| Last Update Date | 03/01/2018 |
| Medicare PECOS PAC ID | 1456620905 |
|---|---|
| Medicare Enrollment ID | O20170627001848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538604699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY13058 (California) | Primary |
| Provider Name | Dennis W Wallstrom |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932152600 PECOS PAC ID: 1153468038 Enrollment ID: I20091026000496 |
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