| Xan C Devaney | |
|
922 E St Ste 202 Eureka CA 95501-1873 | |
| (707) 616-9649 | |
| Not Available |
| Full Name | Xan C Devaney |
|---|---|
| Speciality | Clinic/Center |
| Location | 922 E St Ste 202, Eureka, California |
| Authorized Official Name and Position | Xan Devaney (OWNER/OPERATOR) |
| Authorized Official Contact | 7076169649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Xan C Devaney Po Box 6691 Eureka CA 95502-6691 Ph: () - | Xan C Devaney 922 E St Ste 202 Eureka CA 95501-1873 Ph: (707) 616-9649 |
| NPI Number | 1841973294 |
|---|---|
| Provider Enumeration Date | 08/11/2023 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 5294178687 |
|---|---|
| Medicare Enrollment ID | O20240213003386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841973294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Xan C Devaney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730542846 PECOS PAC ID: 2365783495 Enrollment ID: I20190417002564 |
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