| Alisa Gardner, | |
|
3151 Airway Ave, T2, Costa Mesa, CA 92626-4607 | |
| (949) 438-2342 | |
| Not Available |
| Full Name | Alisa Gardner |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 39 Years |
| Location | 3151 Airway Ave, Costa Mesa, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518319946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW18615 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Integrative Behavioral Health And Medicine Inc | 4385021393 | 13 |
| Entity Name | Integrative Behavioral Health & Medicine Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548910151 PECOS PAC ID: 4385021393 Enrollment ID: O20220512002322 |
| Mailing Address | Practice Location Address |
|---|---|
| Alisa Gardner, 4546 El Camino Real Ste B7, Los Altos, CA 94022-1069 Ph: (866) 362-4246 | Alisa Gardner, 3151 Airway Ave, T2, Costa Mesa, CA 92626-4607 Ph: (949) 438-2342 |
Michelle Elaine Glinski, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2801 Bristol St, Costa Mesa, CA 92626 Phone: 714-850-8410 | |
Joseph Madrid, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 252 16th Pl Apt C, Costa Mesa, CA 92627 Phone: 949-566-5222 | |
Shelley Beckham, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 271 Mesa Dr, Costa Mesa, CA 92627 Phone: 949-422-1882 Fax: 949-548-2303 | |
Brian Jacobo, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Jeremy Quang Le, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 301 Victoria St, Costa Mesa, CA 92627 Phone: 949-642-2734 | |
Lizeth Dimas Sebastian, Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 2801 Bristol St, Costa Mesa, CA 92626 Phone: 714-850-8408 | |
Kelleen Carrie Stainer, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 555 Anton Blvd Ste 150, Costa Mesa, CA 92626 Phone: 949-204-0011 |