| Wave Professional Clinical Counselors, Inc. | |
|
3150 Pio Pico Dr Ste. 105 Carlsbad CA 92008-1951 | |
| (760) 500-3325 | |
| (714) 739-4008 |
| Full Name | Wave Professional Clinical Counselors, Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3150 Pio Pico Dr, Carlsbad, California |
| Authorized Official Name and Position | Mark C Brewer (OWNER) |
| Authorized Official Contact | 7605003325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wave Professional Clinical Counselors, Inc. 3150 Pio Pico Dr Ste. 105 Carlsbad CA 92008-1951 Ph: (760) 500-3325 | Wave Professional Clinical Counselors, Inc. 3150 Pio Pico Dr Ste. 105 Carlsbad CA 92008-1951 Ph: (760) 500-3325 |
| NPI Number | 1700288768 |
|---|---|
| Provider Enumeration Date | 09/22/2014 |
| Last Update Date | 10/12/2017 |
| Medicare PECOS PAC ID | 6305153123 |
|---|---|
| Medicare Enrollment ID | O20150911000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700288768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC46057 (California) | Primary |
| Provider Name | Nikki A Kanemaru Klein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780751248 PECOS PAC ID: 6608917570 Enrollment ID: I20100114000373 |
| Provider Name | Randi Frances Beckman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386848679 PECOS PAC ID: 7618203555 Enrollment ID: I20190730002147 |
| Provider Name | Julia Kusian Armbruster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760541536 PECOS PAC ID: 0648608364 Enrollment ID: I20200311002525 |
| Provider Name | Molly Mae Wildfeuer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053777268 PECOS PAC ID: 6800293705 Enrollment ID: I20210920002362 |
| Provider Name | Alfia M Dunbar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1083336309 PECOS PAC ID: 9931544830 Enrollment ID: I20240301001571 |
| Provider Name | Sonja Taghavi |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1508536434 PECOS PAC ID: 8628414646 Enrollment ID: I20240313002065 |
| Provider Name | Mariz Bebawy |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1588332456 PECOS PAC ID: 2264878081 Enrollment ID: I20240314001761 |
| Provider Name | Mark C. Brewer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1023154358 PECOS PAC ID: 2769799592 Enrollment ID: I20240314002709 |
| Provider Name | George Tyler Duarte |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245855717 PECOS PAC ID: 3678919446 Enrollment ID: I20240314003641 |
| Provider Name | Emily Eyerly |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205285145 PECOS PAC ID: 1355788738 Enrollment ID: I20240320003627 |
| Provider Name | Mary D Roberts |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801149299 PECOS PAC ID: 8921447780 Enrollment ID: I20240412004308 |
| Provider Name | Paula M Ratter |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1467529818 PECOS PAC ID: 9133568397 Enrollment ID: I20240419003295 |
| Provider Name | Eric A Herrera |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568106359 PECOS PAC ID: 1052753746 Enrollment ID: I20240528000232 |
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