Etas is a
Clinic/center - Developmental Disabilities based in Yucaipa, California. Etas is licensed to practice in * (Not Available) (license number ) and their current practice location is
34590 County Line Rd, Suite 7, Yucaipa, California. It can be reached at their office (for appointments etc.) via phone at
(909) 795-4255.
NPI number for Etas is 1790029312 and their current mailing address is 34590 County Line Rd, Suite 7, Yucaipa, California. Etas
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1790029312.
Healthcare Provider's Profile
| Full Name | Etas |
|---|
| Type | Facility |
|---|
| Speciality | Clinic/center - Developmental Disabilities |
|---|
| Location | 34590 County Line Rd, Yucaipa, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1790029312
- Provider Enumeration Date: 11/20/2012
- Last Update Date: 11/20/2012
Medical Identifiers
Medical identifiers for Etas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790029312 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2251P0200X | Physical Therapist - Pediatrics | (* (Not Available)) | Secondary |
| 225XF0002X | Occupational Therapist - Feeding, Eating & Swallowing | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 261QD1600X | Clinic/center - Developmental Disabilities | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | PT10699 (California) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Etas is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Etas
34590 County Line Rd, Suite 7,
Yucaipa, CA 92399-5303
Ph: (909) 795-4255 | Etas
34590 County Line Rd, Suite 7,
Yucaipa, CA 92399-5303
Ph: (909) 795-4255 |
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