Uc Telehealth Collaborative | |
6363 Greenwich Dr San Diego CA 92122-5947 | |
(918) 809-2411 | |
Not Available |
Full Name | Uc Telehealth Collaborative |
---|---|
Speciality | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry |
Location | 6363 Greenwich Dr, San Diego, California |
Authorized Official Name and Position | Tracy Van Slyke (MANAGER, PROVIDER ENROLLMENT) |
Authorized Official Contact | 9188092411 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Uc Telehealth Collaborative 6363 Greenwich Dr San Diego CA 92122-5947 Ph: () - | Uc Telehealth Collaborative 6363 Greenwich Dr San Diego CA 92122-5947 Ph: (918) 809-2411 |
NPI Number | 1982366605 |
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Provider Enumeration Date | 10/11/2021 |
Last Update Date | 10/11/2021 |
Certification Date | 10/05/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982366605 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
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