| Boodah, Inc | |
|
27281 Las Ramblas Ste 200 Mission Viejo CA 92691-8303 | |
| (800) 593-2560 | |
| (800) 593-2560 |
| Full Name | Boodah, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 27281 Las Ramblas Ste 200, Mission Viejo, California |
| Authorized Official Name and Position | Colleen Long Gallicchio (OWNER/PROVIDER) |
| Authorized Official Contact | 8005932560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boodah, Inc 2 Bushwood Cir Ladera Ranch CA 92694-0513 Ph: (800) 593-2560 | Boodah, Inc 27281 Las Ramblas Ste 200 Mission Viejo CA 92691-8303 Ph: (800) 593-2560 |
| NPI Number | 1700427432 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 10/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700427432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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