| Adr Wellness A Professional Psychology Corporation | |
|
785 Grand Ave Ste 101 Carlsbad CA 92008-2370 | |
| (760) 793-8063 | |
| Not Available |
| Full Name | Adr Wellness A Professional Psychology Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 785 Grand Ave Ste 101, Carlsbad, California |
| Authorized Official Name and Position | Alisa Duclos-robinson (PRESIDENT/LEAD PSYCHOLOGIST) |
| Authorized Official Contact | 7607938063 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adr Wellness A Professional Psychology Corporation 785 Grand Ave Ste 101 Carlsbad CA 92008-2370 Ph: (760) 793-8063 | Adr Wellness A Professional Psychology Corporation 785 Grand Ave Ste 101 Carlsbad CA 92008-2370 Ph: (760) 793-8063 |
| NPI Number | 1073028742 |
|---|---|
| Provider Enumeration Date | 12/04/2017 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 1456764216 |
|---|---|
| Medicare Enrollment ID | O20210401000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073028742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY20363 (California) | Primary |
| Provider Name | Alisa Brady |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164649992 PECOS PAC ID: 4981830858 Enrollment ID: I20131125000118 |
| Provider Name | Carlos Xavier Montano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619055720 PECOS PAC ID: 6507909371 Enrollment ID: I20190323000080 |
| Provider Name | Jennifer Anne Vaughan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457936288 PECOS PAC ID: 3072911957 Enrollment ID: I20211006003060 |
| Provider Name | Meghan J Marcum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467773770 PECOS PAC ID: 3971977109 Enrollment ID: I20230329002477 |
| Provider Name | Samantha Dewitt Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881823045 PECOS PAC ID: 4284090887 Enrollment ID: I20230524003185 |
| Provider Name | Samantha Dewitt Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881823045 PECOS PAC ID: 4284090887 Enrollment ID: I20231116001119 |
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