Twin Lakes Psychology, Pc | |
4713 Soquel Creek Rd Soquel CA 95073 | |
(561) 235-9016 | |
Not Available |
Full Name | Twin Lakes Psychology, Pc |
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Speciality | Clinic/Center |
Location | 4713 Soquel Creek Rd, Soquel, California |
Authorized Official Name and Position | Max Garlick (CEO) |
Authorized Official Contact | 5612359016 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Twin Lakes Psychology, Pc 4713 Soquel Creek Rd Soquel CA 95073 Ph: (561) 235-9016 | Twin Lakes Psychology, Pc 4713 Soquel Creek Rd Soquel CA 95073 Ph: (561) 235-9016 |
NPI Number | 1871315994 |
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Provider Enumeration Date | 10/29/2024 |
Last Update Date | 10/29/2024 |
Certification Date | 10/25/2024 |
Medicare PECOS PAC ID | 1759816556 |
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Medicare Enrollment ID | O20241202003415 |
Identifier | Type | State | Issuer |
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1871315994 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Max A Garlick |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790834661 PECOS PAC ID: 8921341249 Enrollment ID: I20190529002839 |
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