| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3335 M St, Merced, California |
| Authorized Official Name and Position | Dakota Pitsker (QAM) |
| Authorized Official Contact | 9168401148 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10850 Gold Center Dr Ste 325 Rancho Cordova CA 95670-6177 Ph: (916) 364-8395 | 3335 M St Merced CA 95348-2714 Ph: (209) 723-6559 |
| NPI Number | 1629844121 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629844121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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