| Ephraim Behavioral Inc | |
|
38345 30th St E Ste E5 Palmdale CA 93550-4984 | |
| (310) 200-6573 | |
| Not Available |
| Full Name | Ephraim Behavioral Inc |
|---|---|
| Speciality | Social Worker |
| Location | 38345 30th St E Ste E5, Palmdale, California |
| Authorized Official Name and Position | Vajezatha Z Payne (OWNER) |
| Authorized Official Contact | 3102006573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ephraim Behavioral Inc 38345 30th St E Ste E5 Palmdale CA 93550-4984 Ph: (310) 200-6573 | Ephraim Behavioral Inc 38345 30th St E Ste E5 Palmdale CA 93550-4984 Ph: (310) 200-6573 |
| NPI Number | 1508712837 |
|---|---|
| Provider Enumeration Date | 03/09/2026 |
| Last Update Date | 03/09/2026 |
| Certification Date | 03/09/2026 |
| Medicare PECOS PAC ID | 7719455872 |
|---|---|
| Medicare Enrollment ID | O20260506003266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508712837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 102L00000X | Psychoanalyst | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Vajezatha Payne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558651372 PECOS PAC ID: 4880003698 Enrollment ID: I20210518002584 |
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