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1505 Colby Dr Glendale CA 91205-3307 | |
| (800) 257-8715 | |
| (800) 819-1655 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1505 Colby Dr, Glendale, California |
| Authorized Official Name and Position | Melissa King (DIRECTOR, CREDENTIALING ENROLLMENT) |
| Authorized Official Contact | 8003703651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
55 Hatchetts Hill Rd Old Lyme CT 06371-1534 Ph: (800) 370-3651 | 1505 Colby Dr Glendale CA 91205-3307 Ph: (800) 257-8715 |
| NPI Number | 1760437271 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 07/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760437271 | NPI | - | NPPES |
| GPS000150 | Medicaid | CA | |
| CH5753 | Other | CA | RAILROAD MEDICARE |
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