| Clarity-james Medical Services Corp | |
|
4040 Civic Center Dr Ste 200 San Rafael CA 94903-4187 | |
| (111) 111-1111 | |
| Not Available |
| Full Name | Clarity-james Medical Services Corp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4040 Civic Center Dr Ste 200, San Rafael, California |
| Authorized Official Name and Position | Adam Wolf Widen (DIRECTOR) |
| Authorized Official Contact | 4157958050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarity-james Medical Services Corp 4040 Civic Center Dr Ste 200 San Rafael CA 94903-4187 Ph: () - | Clarity-james Medical Services Corp 4040 Civic Center Dr Ste 200 San Rafael CA 94903-4187 Ph: (111) 111-1111 |
| NPI Number | 1972192953 |
|---|---|
| Provider Enumeration Date | 01/13/2021 |
| Last Update Date | 02/04/2025 |
| Certification Date | 02/04/2025 |
| Medicare PECOS PAC ID | 2668886813 |
|---|---|
| Medicare Enrollment ID | O20210128002631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972192953 | NPI | - | NPPES |
| C4674875 | Other | CA | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Emily Katherine Ackerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861887945 PECOS PAC ID: 3274963046 Enrollment ID: I20210802002782 |
| Provider Name | Roderick Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861917882 PECOS PAC ID: 0941575484 Enrollment ID: I20211228002061 |
| Provider Name | Roberta Gordin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518458793 PECOS PAC ID: 4587056866 Enrollment ID: I20220118002247 |
| Provider Name | Erin Lindsey Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528695558 PECOS PAC ID: 3173918885 Enrollment ID: I20220316001050 |
| Provider Name | Morgan B Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134893365 PECOS PAC ID: 5597145276 Enrollment ID: I20220712002470 |
| Provider Name | Jaqueline Silva Muller Leite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205384765 PECOS PAC ID: 0143500991 Enrollment ID: I20231110002293 |
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