| The Refinery Integrated Wellness Services Marriage And Family Thera | |
|
73255 El Paseo Ste 18 Palm Desert CA 92260-4249 | |
| (760) 385-3959 | |
| Not Available |
| Full Name | The Refinery Integrated Wellness Services Marriage And Family Thera |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 73255 El Paseo Ste 18, Palm Desert, California |
| Authorized Official Name and Position | Jessica Sanchez (OWNER) |
| Authorized Official Contact | 7603853959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Refinery Integrated Wellness Services Marriage And Family Thera Po Box 892861 Temecula CA 92589-2861 Ph: (760) 385-3959 | The Refinery Integrated Wellness Services Marriage And Family Thera 73255 El Paseo Ste 18 Palm Desert CA 92260-4249 Ph: (760) 385-3959 |
| NPI Number | 1326584731 |
|---|---|
| Provider Enumeration Date | 01/09/2017 |
| Last Update Date | 06/24/2024 |
| Certification Date | 04/04/2024 |
| Medicare PECOS PAC ID | 4981025145 |
|---|---|
| Medicare Enrollment ID | O20200527000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326584731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 84364 (California) | Primary |
| Provider Name | Raina Moosa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417102351 PECOS PAC ID: 5395023022 Enrollment ID: I20161031001225 |
| Provider Name | Courtney Rae Lingle Sippel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215187612 PECOS PAC ID: 3173923596 Enrollment ID: I20210607001533 |
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