Emily Broadhurst, is a
Psychologist - Clinical based in Antioch, California. Emily Broadhurst is licensed to practice in California (license number PSY34627) and her current practice location is
509 W 10th St, Antioch, California. She can be reached at her office (for appointments etc.) via phone at
(925) 777-9540.
NPI number for Emily Broadhurst is 1669919064 and her current mailing address is 427 E Century Blvd, Lodi, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669919064.
Healthcare Provider's Profile
| Full Name | Emily Broadhurst |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 509 W 10th St, Antioch, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1669919064
- Provider Enumeration Date: 01/23/2017
- Last Update Date: 11/22/2023
Medical Identifiers
Medical identifiers for Emily Broadhurst such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669919064 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | PSY34627 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY34627 (California) | Primary |
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. Emily Broadhurst 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 |
|---|
Emily Broadhurst,
427 E Century Blvd,
Lodi, CA 95240-8810
Ph: () - | Emily Broadhurst,
509 W 10th St,
Antioch, CA 94509-1653
Ph: (925) 777-9540 |
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