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1633 Cypress Ln Paradise CA 95969-2823 | |
(800) 257-8715 | |
(800) 819-1655 |
Full Name | |
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Speciality | Psychologist - Clinical |
Location | 1633 Cypress Ln, Paradise, 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 |
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55 Hatchetts Hill Rd Old Lyme CT 06371-1534 Ph: (800) 370-3651 | 1633 Cypress Ln Paradise CA 95969-2823 Ph: (800) 257-8715 |
NPI Number | 1316992829 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 07/10/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316992829 | NPI | - | NPPES |
CC7816 | Other | CA | RAILROAD MEDICARE |
GPS000150 | Medicaid | CA |