| Detra Ford, | |
|
415 Cornell Ave, Coalinga, CA 93210-1220 | |
| (559) 341-3293 | |
| Not Available |
| Full Name | Detra Ford |
|---|---|
| Gender | Female |
| Speciality | Marriage & Family Therapist |
| Location | 415 Cornell Ave, Coalinga, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245706498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 106209 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Detra Ford, 415 Cornell Ave, Coalinga, CA 93210-1220 Ph: (559) 341-3293 | Detra Ford, 415 Cornell Ave, Coalinga, CA 93210-1220 Ph: (559) 341-3293 |
Frank J Walker, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 424 Jefferson St, Coalinga, CA 93210 Phone: 559-935-1221 | |
Elida M. Ledesma, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 380 & 386 Coalinga Plaza, Coalinga, CA 93210 Phone: 855-343-1057 | |
Karen Leeann Nelson, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 194 E Elm Ave Ste 101, Coalinga, CA 93210 Phone: 559-362-8585 Fax: 559-362-8585 | |
Mrs. Heide M Hassenteufel, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 311 N 5th St, Coalinga, CA 93210 Phone: 559-593-5634 Fax: 559-934-0697 | |
Mrs. Cristina Norma Mendoza, Couples Therapy Medicare: Medicare Enrolled Practice Location: 380 Coalinga Plz, Coalinga, CA 93210 Phone: 559-935-7191 |