| Eric Houston | |
|
3906 Hathaway Ave Long Beach CA 90815-5125 | |
| (347) 200-7227 | |
| Not Available |
| Full Name | Eric Houston |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3906 Hathaway Ave, Long Beach, California |
| Authorized Official Name and Position | Eric Houston (OWNER) |
| Authorized Official Contact | 3472007227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Houston 3906 Hathaway Ave Long Beach CA 90815-5125 Ph: () - | Eric Houston 3906 Hathaway Ave Long Beach CA 90815-5125 Ph: (347) 200-7227 |
| NPI Number | 1043833445 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Medicare PECOS PAC ID | 4789098914 |
|---|---|
| Medicare Enrollment ID | O20210130000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043833445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Eric Houston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275154791 PECOS PAC ID: 8325462856 Enrollment ID: I20200716003485 |
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