Theracare Wellness | |
265 S Randolph Ave Ste 120 Brea CA 92821-5798 | |
(562) 448-5907 | |
Not Available |
Full Name | Theracare Wellness |
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Speciality | Psychologist |
Location | 265 S Randolph Ave Ste 120, Brea, California |
Authorized Official Name and Position | Dustin Arnold (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6572463075 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Theracare Wellness 265 S Randolph Ave. Ste 120 Brea CA 92821-5798 Ph: () - | Theracare Wellness 265 S Randolph Ave Ste 120 Brea CA 92821-5798 Ph: (562) 448-5907 |
NPI Number | 1487200515 |
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Provider Enumeration Date | 08/14/2019 |
Last Update Date | 09/07/2022 |
Certification Date | 09/07/2022 |
Medicare PECOS PAC ID | 9537593371 |
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Medicare Enrollment ID | O20200102001478 |
Identifier | Type | State | Issuer |
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1487200515 | NPI | - | NPPES |
215E40TL | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Ashley D Prueitt |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1548598220 PECOS PAC ID: 6608187190 Enrollment ID: I20150624003293 |
Provider Name | Veronica Regueiro |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1003319104 PECOS PAC ID: 3375808454 Enrollment ID: I20180518001567 |
Provider Name | Alicia Erika Dominguez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1306241435 PECOS PAC ID: 1456601772 Enrollment ID: I20180907001715 |
Provider Name | Dustin M Arnold |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1366921900 PECOS PAC ID: 1153674239 Enrollment ID: I20181019002315 |
Provider Name | Catherine Jameson Kelly |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1225463409 PECOS PAC ID: 4284966615 Enrollment ID: I20191104001979 |
Provider Name | Jehan Helmi |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1497986285 PECOS PAC ID: 7719210517 Enrollment ID: I20191126002893 |
Provider Name | Elizabeth C Cazares |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1275199903 PECOS PAC ID: 6608209283 Enrollment ID: I20191212002165 |
Provider Name | Ayat O Madi |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003399874 PECOS PAC ID: 9032516752 Enrollment ID: I20210923000575 |
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