| Nakisha Lavon Grant, | |
|
31772 Casino Dr Ste A&b, Lake Elsinore, CA 92530-4502 | |
| (951) 674-9400 | |
| (951) 674-9486 |
| Full Name | Nakisha Lavon Grant |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 31772 Casino Dr Ste A&b, Lake Elsinore, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538711049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 98955 (California) | Primary |
| Entity Name | Psych Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811455306 PECOS PAC ID: 0840639746 Enrollment ID: O20240411001868 |
| Mailing Address | Practice Location Address |
|---|---|
| Nakisha Lavon Grant, 31772 Casino Dr Ste A&b, Lake Elsinore, CA 92530-4502 Ph: (951) 674-9400 | Nakisha Lavon Grant, 31772 Casino Dr Ste A&b, Lake Elsinore, CA 92530-4502 Ph: (951) 674-9400 |
Marixa Aguirre, Counselor Medicare: Not Enrolled in Medicare Practice Location: 265 San Jacinto River Rd, Suite 107, Lake Elsinore, CA 92530 Phone: 951-674-9243 Fax: 951-674-9635 | |
Mrs. Nicole Elemento Tatunay, Counselor Medicare: Not Enrolled in Medicare Practice Location: 600 Central Avenue, E1, Lake Elsinore, CA 92530 Phone: 951-471-1426 Fax: 951-471-1453 | |
Pamela Catherine Paslay, Counselor Medicare: Not Enrolled in Medicare Practice Location: 600 Central Ave Ste E1, Lake Elsinore, CA 92530 Phone: 951-471-1426 Fax: 951-471-1453 | |
Stephanie Rojas Cordon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 265 San Jacinto River Rd, Suite 107, Lake Elsinore, CA 92530 Phone: 951-674-9243 Fax: 951-674-9635 | |
Mr. Misael Castillo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 600 Central Ave Ste E1, Lake Elsinore, CA 92530 Phone: 951-471-1426 Fax: 951-471-1453 | |
Jasmine J Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 265 San Jacinto River Rd, Lake Elsinore, CA 92530 Phone: 951-674-9243 Fax: 951-674-9635 | |
Shalin Kent, Counselor Medicare: Not Enrolled in Medicare Practice Location: 600 3rd St, Lake Elsinore, CA 92530 Phone: 951-216-7300 Fax: 951-216-7333 |