| Blue Sky Psychology Group, Inc. | |
|
9700 El Camino Real Ste 300 Atascadero CA 93422-5581 | |
| (805) 975-5013 | |
| Not Available |
| Full Name | Blue Sky Psychology Group, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 9700 El Camino Real Ste 300, Atascadero, California |
| Authorized Official Name and Position | Jody E Debruin (PRESIDENT) |
| Authorized Official Contact | 8059755013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Sky Psychology Group, Inc. 9700 El Camino Real Ste 300 Atascadero CA 93422-5581 Ph: (805) 975-5013 | Blue Sky Psychology Group, Inc. 9700 El Camino Real Ste 300 Atascadero CA 93422-5581 Ph: (805) 975-5013 |
| NPI Number | 1710782842 |
|---|---|
| Provider Enumeration Date | 02/13/2025 |
| Last Update Date | 02/13/2025 |
| Certification Date | 02/13/2025 |
| Medicare PECOS PAC ID | 4284155342 |
|---|---|
| Medicare Enrollment ID | O20250305001434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710782842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jody Debruin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760633523 PECOS PAC ID: 7416095005 Enrollment ID: I20091119000421 |
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