| Vivian Insua-lopez Psy D Psychologist Inc | |
|
15455 San Fernando Misson Blvd. #308 Mission Hills CA 91345 | |
| (818) 408-9284 | |
| (818) 847-7830 |
| Full Name | Vivian Insua-lopez Psy D Psychologist Inc |
|---|---|
| Speciality | Psychologist |
| Location | 15455 San Fernando Misson Blvd., Mission Hills, California |
| Authorized Official Name and Position | Vivian Barbara Insua-lopez (PSYCHOLOGISTS) |
| Authorized Official Contact | 8184089284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivian Insua-lopez Psy D Psychologist Inc 15455 San Fernando Mission Blvd Ste 300 Mission Hills CA 91345-1353 Ph: (818) 408-9284 | Vivian Insua-lopez Psy D Psychologist Inc 15455 San Fernando Misson Blvd. #308 Mission Hills CA 91345 Ph: (818) 408-9284 |
| NPI Number | 1740725639 |
|---|---|
| Provider Enumeration Date | 12/30/2016 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/04/2022 |
| Medicare PECOS PAC ID | 0840558284 |
|---|---|
| Medicare Enrollment ID | O20171213000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740725639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY26404 (California) | Primary |
| Provider Name | Vivian B Insua Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629261862 PECOS PAC ID: 3173845104 Enrollment ID: I20141203000006 |
| Provider Name | Kellie E Muller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073074514 PECOS PAC ID: 3779907274 Enrollment ID: I20200710002693 |
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