| Ucsd Medical Group | |
|
200 W Arbor Dr San Diego CA 92103-9000 | |
| (800) 926-8273 | |
| (888) 539-8781 |
| Full Name | Ucsd Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 200 W Arbor Dr, San Diego, California |
| Authorized Official Name and Position | Michael Dennis Price (DIRECTOR REVENUE CYCLE & OPERATIONS) |
| Authorized Official Contact | 8582496752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ucsd Medical Group File 57326 Los Angeles CA 90074-2410 Ph: (800) 926-8273 | Ucsd Medical Group 200 W Arbor Dr San Diego CA 92103-9000 Ph: (800) 926-8273 |
| NPI Number | 1508968967 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/25/2024 |
| Medicare PECOS PAC ID | 3577476761 |
|---|---|
| Medicare Enrollment ID | O20031203000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508968967 | NPI | - | NPPES |
| CQ4024 | Other | RAILROAD MEDICARE | |
| 364823305 | Other | US DEPT OF LABOR | |
| ZZZP3711Z | Medicaid | CA | |
| 364823307 | Other | US DEPT OF LABOR | |
| 364823310 | Other | US DEPT OF LABOR | |
| 364823300 | Other | US DEPT OF LABOR | |
| 364823303 | Other | US DEPT OF LABOR | |
| 364823304 | Other | US DEPT OF LABOR | |
| GPS000030 | Medicaid | CA | |
| 364823301 | Other | US DEPT OF LABOR | |
| 364823306 | Other | US DEPT OF LABOR | |
| 364823308 | Other | US DEPT OF LABOR | |
| ZZZ73229Z | Other | CA | BLUE SHIELD |
| 364823302 | Other | US DEPT OF LABOR | |
| CGP016905 | Other | CA | GHPP |
| Provider Name | Michael W Fitzgerald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336393578 PECOS PAC ID: 9335038165 Enrollment ID: I20040311000487 |
| Provider Name | Ashraf Mohamed Elmashat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851322887 PECOS PAC ID: 6103810692 Enrollment ID: I20040408000800 |
| Provider Name | Ildiko K Kovacs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811946072 PECOS PAC ID: 3870580525 Enrollment ID: I20040426001935 |
| Provider Name | Tahir I Bhatti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518915487 PECOS PAC ID: 9537156823 Enrollment ID: I20040428001109 |
| Provider Name | David H Lehman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578589396 PECOS PAC ID: 4587641709 Enrollment ID: I20040706000523 |
| Provider Name | Olga Vasilyevna Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083644710 PECOS PAC ID: 0547249831 Enrollment ID: I20040719001632 |
| Provider Name | Carl Taswell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679799266 PECOS PAC ID: 5890769509 Enrollment ID: I20040819001146 |
| Provider Name | Scott A Irwin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225117716 PECOS PAC ID: 1355305426 Enrollment ID: I20041117001265 |
| Provider Name | John G Donnelly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760566160 PECOS PAC ID: 9234193137 Enrollment ID: I20041118001032 |
| Provider Name | Sanjaya Saxena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225054596 PECOS PAC ID: 0749214336 Enrollment ID: I20050922001034 |
| Provider Name | Arpi Minassian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003849613 PECOS PAC ID: 8921033358 Enrollment ID: I20051004000814 |
| Provider Name | Briana C Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497705495 PECOS PAC ID: 7113939992 Enrollment ID: I20060616000155 |
| Provider Name | Daniel S Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144394586 PECOS PAC ID: 9537160833 Enrollment ID: I20070130000367 |
| Provider Name | Sonia Ancoli Israel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437209707 PECOS PAC ID: 8325144553 Enrollment ID: I20070504000453 |
| Provider Name | William J Sieber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851413165 PECOS PAC ID: 1759476302 Enrollment ID: I20070927000739 |
| Provider Name | Saifullah Nizamani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972523389 PECOS PAC ID: 3476564477 Enrollment ID: I20071005000801 |
| Provider Name | Jeremy M Hirst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073563714 PECOS PAC ID: 2668568296 Enrollment ID: I20071012000302 |
| Provider Name | Gregory Floyd Bishop |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003855545 PECOS PAC ID: 9436246790 Enrollment ID: I20071102000243 |
| Provider Name | William Perry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801811195 PECOS PAC ID: 0941381040 Enrollment ID: I20080115000400 |
| Provider Name | Carrie R Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629267000 PECOS PAC ID: 4688755572 Enrollment ID: I20080116000855 |
| Provider Name | Mark W Bondi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922030253 PECOS PAC ID: 8820170335 Enrollment ID: I20080123000364 |
| Provider Name | Sandra J Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235197633 PECOS PAC ID: 6608958889 Enrollment ID: I20080126000120 |
| Provider Name | Marc A Norman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922169101 PECOS PAC ID: 7214019496 Enrollment ID: I20080126000140 |
| Provider Name | Wendy G Tayer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619925583 PECOS PAC ID: 6002998259 Enrollment ID: I20080128000550 |
| Provider Name | Willard W Connor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871772129 PECOS PAC ID: 5890865232 Enrollment ID: I20080528000479 |
| Provider Name | Julie L Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689701310 PECOS PAC ID: 8325106206 Enrollment ID: I20081021000784 |
| Provider Name | Babbi J Winegarden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508014317 PECOS PAC ID: 7012079544 Enrollment ID: I20081217000605 |
| Provider Name | Steve H Koh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467650473 PECOS PAC ID: 4385707827 Enrollment ID: I20090109000644 |
| Provider Name | Allison R Hadley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710027396 PECOS PAC ID: 2264580620 Enrollment ID: I20090423000556 |
| Provider Name | Charles Ashbrook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588703979 PECOS PAC ID: 4880748631 Enrollment ID: I20090813000568 |
| Provider Name | Rachel Bader |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164639662 PECOS PAC ID: 2668507831 Enrollment ID: I20100315000403 |
| Provider Name | Alison M Reminick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649439258 PECOS PAC ID: 9931396207 Enrollment ID: I20101213000540 |
| Provider Name | Kristin S Cadenhead |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194744839 PECOS PAC ID: 1557550142 Enrollment ID: I20110113000211 |
| Provider Name | John R Kelsoe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184672156 PECOS PAC ID: 1658560107 Enrollment ID: I20110113000984 |
| Provider Name | Ashley L Clark |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548468523 PECOS PAC ID: 8022297860 Enrollment ID: I20110125000891 |
| Provider Name | Daniel D Sewell |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1740206804 PECOS PAC ID: 9234319872 Enrollment ID: I20110214000780 |
| Provider Name | Yvette Milazzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093989394 PECOS PAC ID: 0143405431 Enrollment ID: I20110502000492 |
| Provider Name | Dawn M Schiehser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639331549 PECOS PAC ID: 9830362599 Enrollment ID: I20111026000131 |
| Provider Name | Jennifer C Nagode |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043358724 PECOS PAC ID: 0244403210 Enrollment ID: I20111108000395 |
| Provider Name | Hoang A Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720011620 PECOS PAC ID: 0749457810 Enrollment ID: I20120113000314 |
| Provider Name | Derek H Loewy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457635963 PECOS PAC ID: 0749226405 Enrollment ID: I20120522001262 |
| Provider Name | Lavinia Fiorentino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376800771 PECOS PAC ID: 6103089214 Enrollment ID: I20120529000268 |
| Provider Name | Mohamad H Khafaja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780867119 PECOS PAC ID: 3678720208 Enrollment ID: I20120904000293 |
| Provider Name | Veronica Cardenas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598024572 PECOS PAC ID: 4183876162 Enrollment ID: I20121221000196 |
| Provider Name | Vanessa L Lauzon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457507709 PECOS PAC ID: 2961655733 Enrollment ID: I20130102000295 |
| Provider Name | Tracy A Alderman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497820278 PECOS PAC ID: 8921136144 Enrollment ID: I20130214000249 |
| Provider Name | Heline Mirzakhanian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538402151 PECOS PAC ID: 1153562525 Enrollment ID: I20130726000652 |
| Provider Name | Lawrence T Malak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467773028 PECOS PAC ID: 2860635950 Enrollment ID: I20130820001075 |
| Provider Name | Laura A Wakil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619102399 PECOS PAC ID: 1759517212 Enrollment ID: I20131112000859 |
| Provider Name | Elizabeth W Twamley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700089141 PECOS PAC ID: 4688801475 Enrollment ID: I20131227000580 |
| Provider Name | Joseph H Atkinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467477653 PECOS PAC ID: 7012144793 Enrollment ID: I20131231000091 |
| Provider Name | Beverly A Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063716009 PECOS PAC ID: 9830327774 Enrollment ID: I20140122001161 |
| Provider Name | Lisa M Delano-wood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902064561 PECOS PAC ID: 2163652892 Enrollment ID: I20140225002036 |
| Provider Name | My Hanh T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598950651 PECOS PAC ID: 9931339140 Enrollment ID: I20140310001612 |
| Provider Name | Emily A Meier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255530572 PECOS PAC ID: 1759514128 Enrollment ID: I20140509000911 |
| Provider Name | Sarah A Pai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255762167 PECOS PAC ID: 5193948081 Enrollment ID: I20140521002507 |
| Provider Name | Brent T Mausbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164847638 PECOS PAC ID: 5799901377 Enrollment ID: I20140717001856 |
| Provider Name | Jessica L Thackaberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134478910 PECOS PAC ID: 4082831110 Enrollment ID: I20140813000175 |
| Provider Name | Jessie S Park |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376953257 PECOS PAC ID: 1153540091 Enrollment ID: I20140909000004 |
| Provider Name | Nick C Mellos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255362893 PECOS PAC ID: 9032019765 Enrollment ID: I20140909002863 |
| Provider Name | Charles A Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790186708 PECOS PAC ID: 9537389200 Enrollment ID: I20140930002482 |
| Provider Name | Willough A Jenkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255730859 PECOS PAC ID: 5294058145 Enrollment ID: I20141229000855 |
| Provider Name | David J Grelotti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619003035 PECOS PAC ID: 6406090604 Enrollment ID: I20150212000007 |
| Provider Name | Alan J Hsu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861636763 PECOS PAC ID: 7315263167 Enrollment ID: I20150313001150 |
| Provider Name | Nancy S Downs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871735324 PECOS PAC ID: 2365769197 Enrollment ID: I20150316001596 |
| Provider Name | Barbara L Parry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720090962 PECOS PAC ID: 1658690391 Enrollment ID: I20150501000576 |
| Provider Name | Mirsad Serdarevic |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881913721 PECOS PAC ID: 1052632478 Enrollment ID: I20150610000619 |
| Provider Name | Ellen K Heyneman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598797847 PECOS PAC ID: 5890006936 Enrollment ID: I20150616002837 |
| Provider Name | Aaron A Meyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538505425 PECOS PAC ID: 9830401199 Enrollment ID: I20150630001359 |
| Provider Name | Savita G Bhakta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326284480 PECOS PAC ID: 4789997008 Enrollment ID: I20150715002621 |
| Provider Name | David P Folsom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710026612 PECOS PAC ID: 8628114865 Enrollment ID: I20150915003320 |
| Provider Name | Alexandra Sietsma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932522778 PECOS PAC ID: 1254632680 Enrollment ID: I20151209000710 |
| Provider Name | Maria L.a. Tiamson-kassab |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760425987 PECOS PAC ID: 3476854027 Enrollment ID: I20151223001857 |
| Provider Name | Jessica Bailis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760739049 PECOS PAC ID: 9537482161 Enrollment ID: I20160113001877 |
| Provider Name | Donna Christine Corbett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245557024 PECOS PAC ID: 0244533719 Enrollment ID: I20160118000914 |
| Provider Name | Alison M Trexler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003104704 PECOS PAC ID: 0042514713 Enrollment ID: I20160201002560 |
| Provider Name | Isabel Ribeiro Caldas Domingues |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023367216 PECOS PAC ID: 5799074795 Enrollment ID: I20160513002094 |
| Provider Name | Steven Huege |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598716367 PECOS PAC ID: 1557330206 Enrollment ID: I20160608000678 |
| Provider Name | Jonathon Howlett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952622557 PECOS PAC ID: 8820389828 Enrollment ID: I20160622001747 |
| Provider Name | Russell J Miller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619175528 PECOS PAC ID: 4284866567 Enrollment ID: I20160701001202 |
| Provider Name | Anne Bird |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659539658 PECOS PAC ID: 2365610581 Enrollment ID: I20160707002660 |
| Provider Name | Kalya Vardi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730474768 PECOS PAC ID: 1557680725 Enrollment ID: I20160728002503 |
| Provider Name | Ellen E Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174822639 PECOS PAC ID: 2466745237 Enrollment ID: I20160801002574 |
| Provider Name | Carla Beth Marienfeld |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104007657 PECOS PAC ID: 3577690205 Enrollment ID: I20160802001737 |
| Provider Name | Priti Ojha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760897284 PECOS PAC ID: 2769776376 Enrollment ID: I20160816002219 |
| Provider Name | Leslie Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467626432 PECOS PAC ID: 4789971441 Enrollment ID: I20160922002562 |
| Provider Name | Jennifer G. Roby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639584758 PECOS PAC ID: 5395023014 Enrollment ID: I20161101001705 |
| Provider Name | Katherine J Bangen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750758595 PECOS PAC ID: 5092094821 Enrollment ID: I20161117001977 |
| Provider Name | Neil Richtand |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063510824 PECOS PAC ID: 1153602560 Enrollment ID: I20161223000257 |
| Provider Name | Amanda Gooding |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265840755 PECOS PAC ID: 7810278264 Enrollment ID: I20161227001310 |
| Provider Name | Murray Stein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659390771 PECOS PAC ID: 7315228640 Enrollment ID: I20161228002480 |
| Provider Name | Katia Harle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629362298 PECOS PAC ID: 8921389107 Enrollment ID: I20161229002042 |
| Provider Name | Karen Hanson Bondi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073815072 PECOS PAC ID: 4688955487 Enrollment ID: I20170110003374 |
| Provider Name | Zvinka Z Zlatar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497139059 PECOS PAC ID: 0345521126 Enrollment ID: I20170111001603 |
| Provider Name | Molly Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275921264 PECOS PAC ID: 1355623430 Enrollment ID: I20170125001549 |
| Provider Name | Roxanne Rockwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942438791 PECOS PAC ID: 8527342062 Enrollment ID: I20170301002136 |
| Provider Name | Natacha A Akshoomoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740315043 PECOS PAC ID: 2860776804 Enrollment ID: I20170310001988 |
| Provider Name | Julie Tenbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164417606 PECOS PAC ID: 6709876279 Enrollment ID: I20170417002048 |
| Provider Name | Emily Edmonds |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780120287 PECOS PAC ID: 7911284351 Enrollment ID: I20170516001053 |
| Provider Name | Stephanie Peck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417106899 PECOS PAC ID: 9537436860 Enrollment ID: I20170517000662 |
| Provider Name | Sidney Zisook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477586790 PECOS PAC ID: 1456628148 Enrollment ID: I20170531001458 |
| Provider Name | Raisa Yagudayeva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942555990 PECOS PAC ID: 9032489612 Enrollment ID: I20170714002559 |
| Provider Name | Henry John Orff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144685215 PECOS PAC ID: 9234409194 Enrollment ID: I20170725004282 |
| Provider Name | Nora Bammidi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912103011 PECOS PAC ID: 5698904670 Enrollment ID: I20170824003735 |
| Provider Name | Tanya Thu Tam Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205213717 PECOS PAC ID: 9335412899 Enrollment ID: I20170905001162 |
| Provider Name | Katherine Laura Immerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023087939 PECOS PAC ID: 7618161076 Enrollment ID: I20170929001585 |
| Provider Name | Roxanne Rockwell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942438791 PECOS PAC ID: 8527342062 Enrollment ID: I20171006003064 |
| Provider Name | Jamie Michelle Deluca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881117489 PECOS PAC ID: 4587939954 Enrollment ID: I20171011001011 |
| Provider Name | Molly B. Berman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295273811 PECOS PAC ID: 3870868276 Enrollment ID: I20171011002194 |
| Provider Name | Maya S. D'eon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992232151 PECOS PAC ID: 2860767142 Enrollment ID: I20171012002056 |
| Provider Name | Karla Flores Lagunas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013238484 PECOS PAC ID: 3072884790 Enrollment ID: I20171016003405 |
| Provider Name | Yuliana Noniyeva |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437404647 PECOS PAC ID: 6002172764 Enrollment ID: I20171113002332 |
| Provider Name | Ian J. E. Q. Lowe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881949048 PECOS PAC ID: 5890055164 Enrollment ID: I20180206000067 |
| Provider Name | Elizabeth Sears-wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215394382 PECOS PAC ID: 0648530949 Enrollment ID: I20180206001454 |
| Provider Name | Terry A Schwartz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417003294 PECOS PAC ID: 1759676679 Enrollment ID: I20180416002203 |
| Provider Name | Sarah Elizabeth Carreira |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023307436 PECOS PAC ID: 3870732670 Enrollment ID: I20180504001906 |
| Provider Name | Karim Waguih Ghobrial-sedky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093746836 PECOS PAC ID: 3375575509 Enrollment ID: I20180518002397 |
| Provider Name | Hannah C Sweet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366581506 PECOS PAC ID: 8527314392 Enrollment ID: I20180709003281 |
| Provider Name | Stephanie Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699126367 PECOS PAC ID: 1759637457 Enrollment ID: I20180711001668 |
| Provider Name | Yash B Joshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598151433 PECOS PAC ID: 4688921174 Enrollment ID: I20180713002507 |
| Provider Name | Monique S Montigny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689797326 PECOS PAC ID: 0143306233 Enrollment ID: I20180726003578 |
| Provider Name | Douglas Vincent D Agati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396189254 PECOS PAC ID: 3375782071 Enrollment ID: I20180821001434 |
| Provider Name | Shavon C Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053682773 PECOS PAC ID: 2769733732 Enrollment ID: I20181002000383 |
| Provider Name | Sarah J Banks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164701132 PECOS PAC ID: 8527231612 Enrollment ID: I20181012002106 |
| Provider Name | Lama Muhammad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558701623 PECOS PAC ID: 2668692013 Enrollment ID: I20181016003186 |
| Provider Name | Jeremy S. Bass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194036095 PECOS PAC ID: 4082835558 Enrollment ID: I20181022002152 |
| Provider Name | Jessica Andrea Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215346887 PECOS PAC ID: 3577808849 Enrollment ID: I20181214002965 |
| Provider Name | Marla Richard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578720934 PECOS PAC ID: 0345528204 Enrollment ID: I20190318000872 |
| Provider Name | Katelyn Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952797540 PECOS PAC ID: 2062754054 Enrollment ID: I20190423000592 |
| Provider Name | Christopher R Booth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568893162 PECOS PAC ID: 4981837226 Enrollment ID: I20190423001610 |
| Provider Name | Irene Nevarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003166646 PECOS PAC ID: 5294077210 Enrollment ID: I20190423001663 |
| Provider Name | Eve Nancy Lasswell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013483635 PECOS PAC ID: 4587906144 Enrollment ID: I20190430002880 |
| Provider Name | Brandon Michael Niemeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255622338 PECOS PAC ID: 8921253584 Enrollment ID: I20190617000289 |
| Provider Name | Alejandro Daniel Meruelo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265847917 PECOS PAC ID: 1951695774 Enrollment ID: I20190628002134 |
| Provider Name | Guido Klaus Wilhelm Frank |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578608733 PECOS PAC ID: 5294827523 Enrollment ID: I20190715002867 |
| Provider Name | Kerri N. Boutelle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780620906 PECOS PAC ID: 3072841873 Enrollment ID: I20190816002703 |
| Provider Name | Kavita Barron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821418542 PECOS PAC ID: 6305175639 Enrollment ID: I20190911001195 |
| Provider Name | Lisa Danielle Adler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891115606 PECOS PAC ID: 9931438074 Enrollment ID: I20190916000224 |
| Provider Name | Elena M Burpee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356682306 PECOS PAC ID: 5799015582 Enrollment ID: I20190920001236 |
| Provider Name | Jon David Stiffler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023334869 PECOS PAC ID: 2264681378 Enrollment ID: I20191028001156 |
| Provider Name | Nora K Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245607043 PECOS PAC ID: 1951633510 Enrollment ID: I20191031000503 |
| Provider Name | Dawn Michelle Eichen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861043366 PECOS PAC ID: 2961835129 Enrollment ID: I20191203000829 |
| Provider Name | Robert A Benard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184027724 PECOS PAC ID: 5496181109 Enrollment ID: I20200128002260 |
| Provider Name | Elizabeth Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326570045 PECOS PAC ID: 4789954496 Enrollment ID: I20200212000417 |
| Provider Name | Mary Ellen Trunko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477690220 PECOS PAC ID: 8123454048 Enrollment ID: I20200212000751 |
| Provider Name | Kristen L Duarte |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093119364 PECOS PAC ID: 2264869601 Enrollment ID: I20200225002590 |
| Provider Name | Hilary M Gould |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104297696 PECOS PAC ID: 3870917669 Enrollment ID: I20200727002555 |
| Provider Name | Eve Butera Holwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922462167 PECOS PAC ID: 4587908066 Enrollment ID: I20200915001791 |
| Provider Name | Leslie Bishop Tarver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811300957 PECOS PAC ID: 4385862564 Enrollment ID: I20201001002762 |
| Provider Name | Nicholas John Chesher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124539697 PECOS PAC ID: 4880014828 Enrollment ID: I20201013003613 |
| Provider Name | Julianna Lynn Gorder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013522838 PECOS PAC ID: 1254741598 Enrollment ID: I20201028000296 |
| Provider Name | Jessica Lynette Montoya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003421256 PECOS PAC ID: 1951711019 Enrollment ID: I20201102001405 |
| Provider Name | Kristie Lynn Reed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679869556 PECOS PAC ID: 4688953383 Enrollment ID: I20210210003034 |
| Provider Name | Zafiris Jeffrey Daskalakis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114516945 PECOS PAC ID: 2466869292 Enrollment ID: I20210323002500 |
| Provider Name | Andres Gilberto Mendez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841482692 PECOS PAC ID: 3274942180 Enrollment ID: I20210505002399 |
| Provider Name | Rachael Rebecca Liebman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396130050 PECOS PAC ID: 8224438007 Enrollment ID: I20210618001496 |
| Provider Name | Xia Li |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336670413 PECOS PAC ID: 9436551504 Enrollment ID: I20210712003268 |
| Provider Name | Eric Christian Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881058105 PECOS PAC ID: 5395016125 Enrollment ID: I20210722002041 |
| Provider Name | Simerjeet Kaur Brar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417393307 PECOS PAC ID: 0840528485 Enrollment ID: I20210802001221 |
| Provider Name | Paven Kaur Aujla Lidstone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942662093 PECOS PAC ID: 8022412337 Enrollment ID: I20210809003583 |
| Provider Name | Robert Michael Anthenelli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225139306 PECOS PAC ID: 9335543594 Enrollment ID: I20210810002103 |
| Provider Name | Daphna Meirav Finn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639522725 PECOS PAC ID: 5193057768 Enrollment ID: I20210812000204 |
| Provider Name | Javad John Fatollahi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467987321 PECOS PAC ID: 2961773858 Enrollment ID: I20210818003008 |
| Provider Name | Julia Star Gleichman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386173805 PECOS PAC ID: 8921403395 Enrollment ID: I20210823002707 |
| Provider Name | Kimberly Bryce Claudat |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699200949 PECOS PAC ID: 1850798406 Enrollment ID: I20210923002287 |
| Provider Name | Jay Norman Giedd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417198847 PECOS PAC ID: 5799182309 Enrollment ID: I20210924001008 |
| Provider Name | Fred Xiang Peng Liu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396277364 PECOS PAC ID: 4284022997 Enrollment ID: I20211029001974 |
| Provider Name | Cory Ross Weissman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528720661 PECOS PAC ID: 3072902964 Enrollment ID: I20211115002653 |
| Provider Name | Crystal Hunter Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548683378 PECOS PAC ID: 2062801681 Enrollment ID: I20211119000179 |
| Provider Name | Beth Suzanne Pettis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326638958 PECOS PAC ID: 8921498080 Enrollment ID: I20211203000319 |
| Provider Name | Virginia N Meltzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821684390 PECOS PAC ID: 4082029772 Enrollment ID: I20211206001720 |
| Provider Name | Anna Regina Pasternak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508459496 PECOS PAC ID: 5890185706 Enrollment ID: I20211208003375 |
| Provider Name | Rachael A Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659912327 PECOS PAC ID: 2860883402 Enrollment ID: I20211215002343 |
| Provider Name | Sharon Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053887760 PECOS PAC ID: 8224429402 Enrollment ID: I20211222002531 |
| Provider Name | Saghi Jahanbaksh Tehran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134792245 PECOS PAC ID: 8325431224 Enrollment ID: I20220216001383 |
| Provider Name | Brent R. Crandal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588739452 PECOS PAC ID: 7113310012 Enrollment ID: I20220216001472 |
| Provider Name | Amelia Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508352717 PECOS PAC ID: 7214322163 Enrollment ID: I20220311001772 |
| Provider Name | Andres Ricardo Schneeberger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184867376 PECOS PAC ID: 9739205790 Enrollment ID: I20220317002702 |
| Provider Name | Joana Ruby Callanta Bueno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578057576 PECOS PAC ID: 0446655393 Enrollment ID: I20220325000871 |
| Provider Name | Anna Korogodski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326634890 PECOS PAC ID: 9133514235 Enrollment ID: I20220325001948 |
| Provider Name | Kaylee B Petersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003152364 PECOS PAC ID: 1658512843 Enrollment ID: I20220403000005 |
| Provider Name | Hannah Wishnek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578012043 PECOS PAC ID: 7315334521 Enrollment ID: I20220418001429 |
| Provider Name | Shane Paul Castro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467958413 PECOS PAC ID: 9830443316 Enrollment ID: I20220707000341 |
| Provider Name | Ralph Saintfort |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184617995 PECOS PAC ID: 6002843810 Enrollment ID: I20220711000579 |
| Provider Name | Omar Ghosn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669005567 PECOS PAC ID: 4587045745 Enrollment ID: I20220719002094 |
| Provider Name | Emily A Troyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326484437 PECOS PAC ID: 5092015065 Enrollment ID: I20220721003452 |
| Provider Name | Elizabeth Anne Hitchcock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427781137 PECOS PAC ID: 8022499920 Enrollment ID: I20220725001198 |
| Provider Name | Jenna Levinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962858209 PECOS PAC ID: 8921399908 Enrollment ID: I20220825001211 |
| Provider Name | Lindsay Elledge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619428828 PECOS PAC ID: 3375927239 Enrollment ID: I20220826002200 |
| Provider Name | Jaenai Rodriguez - Delgado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508241811 PECOS PAC ID: 4880079821 Enrollment ID: I20220912003613 |
| Provider Name | Andy Bon Barredo Woo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609450550 PECOS PAC ID: 0143620435 Enrollment ID: I20220914003559 |
| Provider Name | Julia Rose Mcmullen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992272843 PECOS PAC ID: 0042688392 Enrollment ID: I20221117003047 |
| Provider Name | Melissa Peet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154046548 PECOS PAC ID: 8224407770 Enrollment ID: I20221206001241 |
| Provider Name | Elena Toda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285141143 PECOS PAC ID: 4385013754 Enrollment ID: I20221206002672 |
| Provider Name | Cerah Yumi Nagata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427648435 PECOS PAC ID: 2163891425 Enrollment ID: I20221207002893 |
| Provider Name | Elaine Do |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215696307 PECOS PAC ID: 5395130173 Enrollment ID: I20221219001424 |
| Provider Name | Kirstin F Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740905447 PECOS PAC ID: 2264801703 Enrollment ID: I20221221001828 |
| Provider Name | Lisette Manriquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760058911 PECOS PAC ID: 3870963531 Enrollment ID: I20221221002721 |
| Provider Name | Shanee Regev |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477218121 PECOS PAC ID: 5395115935 Enrollment ID: I20221223000369 |
| Provider Name | Adrienne Owens Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184389934 PECOS PAC ID: 8022488519 Enrollment ID: I20221227001438 |
| Provider Name | Cassandra Vieten |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336716992 PECOS PAC ID: 0648640938 Enrollment ID: I20230103000102 |
| Provider Name | Amanda Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205540622 PECOS PAC ID: 7911370952 Enrollment ID: I20230222001957 |
| Provider Name | Deanna Hamm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174924328 PECOS PAC ID: 5597139030 Enrollment ID: I20230323000880 |
| Provider Name | John Lyle Esten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003327636 PECOS PAC ID: 5597139923 Enrollment ID: I20230324002226 |
| Provider Name | Leslie B Fijolek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598883167 PECOS PAC ID: 6709251747 Enrollment ID: I20230405001815 |
| Provider Name | Kanchan Kohli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235485343 PECOS PAC ID: 1456696160 Enrollment ID: I20230414001503 |
| Provider Name | Yueling Li |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588157853 PECOS PAC ID: 0042606329 Enrollment ID: I20230608003085 |
| Provider Name | Alex Ledbetter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073017315 PECOS PAC ID: 7416358205 Enrollment ID: I20230626002955 |
| Provider Name | Stephanie J Tarle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659920403 PECOS PAC ID: 5294196119 Enrollment ID: I20230725002076 |
| Provider Name | Anne-marie Nicole Giuca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780180166 PECOS PAC ID: 0345660361 Enrollment ID: I20230825000470 |
| Provider Name | William E Pelham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306629399 PECOS PAC ID: 6709249436 Enrollment ID: I20230829002781 |
| Provider Name | Anne Cusack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114414943 PECOS PAC ID: 6608221296 Enrollment ID: I20231017003366 |
| Provider Name | Matthew Seung Wietzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518613678 PECOS PAC ID: 0042668162 Enrollment ID: I20231130001621 |
| Provider Name | Maybelle Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437921459 PECOS PAC ID: 1153779194 Enrollment ID: I20231130002907 |
| Provider Name | Ashley Golden Giorgi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952174203 PECOS PAC ID: 3577912419 Enrollment ID: I20231218001271 |
| Provider Name | Rachelle Pace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588334973 PECOS PAC ID: 7911356860 Enrollment ID: I20231218001738 |
| Provider Name | Cara Therese Pozun |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1215659909 PECOS PAC ID: 1254781255 Enrollment ID: I20240102003798 |
| Provider Name | Apryl Lynn Cutler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467960120 PECOS PAC ID: 6608227491 Enrollment ID: I20240105001393 |
| Provider Name | Jean-philippe Miron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952178196 PECOS PAC ID: 1254782881 Enrollment ID: I20240109000902 |
| Provider Name | Lindsay Kathleen Lyman Lowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477608818 PECOS PAC ID: 7416308713 Enrollment ID: I20240111001337 |
| Provider Name | Kathleen E Huff |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316387285 PECOS PAC ID: 5698126837 Enrollment ID: I20240111003424 |
| Provider Name | Page Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871365312 PECOS PAC ID: 8820447774 Enrollment ID: I20240115001269 |
| Provider Name | Victoria Rose Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750033890 PECOS PAC ID: 8022460005 Enrollment ID: I20240115001772 |
| Provider Name | Unique Deshona Whitehurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124800214 PECOS PAC ID: 9133579311 Enrollment ID: I20240125001189 |
| Provider Name | Suemin Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598477093 PECOS PAC ID: 6901249614 Enrollment ID: I20240209002232 |
| Provider Name | Sydney Renee Roscoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992448864 PECOS PAC ID: 7810331147 Enrollment ID: I20240214003920 |
| Provider Name | Kelsey R Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700264264 PECOS PAC ID: 2365886520 Enrollment ID: I20240215004415 |
| Provider Name | Kaitlyn Nicole Egan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629653860 PECOS PAC ID: 2062853195 Enrollment ID: I20240507003405 |
| Provider Name | Glen F. Pastores |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609980234 PECOS PAC ID: 6002257532 Enrollment ID: I20240514004177 |
Aefct Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 Murphy Canyon Rd Ste 212, San Diego, CA 92123 Phone: 858-569-0056 Fax: 858-569-4233 | |
The Center For Behavior Change, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7676 Hazard Center Dr Ste 500, San Diego, CA 92108 Phone: 619-876-8261 | |
R D Dipp Do Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1350 Columbia St, Unit 800, San Diego, CA 92101 Phone: 619-255-1649 Fax: 619-255-1649 | |
Alba Community School Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4041 Oregon St, San Diego, CA 92104 Phone: 619-521-5720 | |
True Crew California Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8910 University Center Ln Ste 400, San Diego, CA 92122 Phone: 603-692-8173 | |
Adapt Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6070 Mission Gorge Rd, San Diego, CA 92120 Phone: 619-957-0888 | |
Wise Self Psychology, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2535 Kettner Blvd Ste 2b1, San Diego, CA 92101 Phone: 619-678-0020 |