| The Rebuilding Therapy Center | |
|
27001 La Paz Rd Suite 290 Mission Viejo CA 92691-5502 | |
| (949) 462-0102 | |
| (949) 462-0124 |
| Full Name | The Rebuilding Therapy Center |
|---|---|
| Speciality | Psychologist |
| Location | 27001 La Paz Rd, Mission Viejo, California |
| Authorized Official Name and Position | Julie Haynes (OFFICE MANAGER) |
| Authorized Official Contact | 9494620102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Rebuilding Therapy Center 27001 La Paz Rd Suite 290 Mission Viejo CA 92691-5502 Ph: (949) 462-0102 | The Rebuilding Therapy Center 27001 La Paz Rd Suite 290 Mission Viejo CA 92691-5502 Ph: (949) 462-0102 |
| NPI Number | 1467579813 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/19/2008 |
| Medicare PECOS PAC ID | 5991843591 |
|---|---|
| Medicare Enrollment ID | O20091118000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467579813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | #PSY5201 (California) | Primary |
| Provider Name | Michael Gass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700902285 PECOS PAC ID: 6608963269 Enrollment ID: I20071029000423 |
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