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3132 Jefferson St San Diego CA 92110-4421 | |
| (619) 683-3100 | |
| (619) 683-3842 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 3132 Jefferson St, San Diego, California |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1080 Marina Village Pkwy Suite 100 Alameda CA 94501-6427 Ph: (510) 337-7950 | 3132 Jefferson St San Diego CA 92110-4421 Ph: (619) 683-3100 |
| NPI Number | 1720164882 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 03/08/2023 |
| Certification Date | 03/08/2023 |
| Medicare PECOS PAC ID | 6901820380 |
|---|---|
| Medicare Enrollment ID | O20070614000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720164882 | NPI | - | NPPES |
| 37EQ | Other | CA | COUNTY MENTAL HEALTH CERTIFICATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Edward Lim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386660447 PECOS PAC ID: 1850297664 Enrollment ID: I20031211000649 |
| Provider Name | Arkady Oreper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346320710 PECOS PAC ID: 7911800628 Enrollment ID: I20040129001182 |
| Provider Name | Serge Abdishoo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336162759 PECOS PAC ID: 9537152129 Enrollment ID: I20040407001641 |
| Provider Name | Michael M Quach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255542577 PECOS PAC ID: 1254320336 Enrollment ID: I20040512000782 |
| Provider Name | Ricque Brister |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932320389 PECOS PAC ID: 0143211375 Enrollment ID: I20040518001213 |
| Provider Name | Lovella P Caluya Diaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497956320 PECOS PAC ID: 8729061403 Enrollment ID: I20040611001473 |
| Provider Name | Rick L Jenkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275502825 PECOS PAC ID: 8022093376 Enrollment ID: I20040621001431 |
| Provider Name | Christopher Wood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538121272 PECOS PAC ID: 8022096635 Enrollment ID: I20040709001413 |
| Provider Name | Lianjie Du |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255331385 PECOS PAC ID: 6002888203 Enrollment ID: I20040810000541 |
| Provider Name | William R Mains |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477751741 PECOS PAC ID: 2264409630 Enrollment ID: I20040914001391 |
| Provider Name | Svetlana Troitskaia-williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922145671 PECOS PAC ID: 7911988803 Enrollment ID: I20040929001285 |
| Provider Name | Miguel C Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134200272 PECOS PAC ID: 8123088341 Enrollment ID: I20041012001612 |
| Provider Name | Peter Edwards Newsom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093746166 PECOS PAC ID: 7315996196 Enrollment ID: I20050119000559 |
| Provider Name | Yun S Chong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376586933 PECOS PAC ID: 6204889561 Enrollment ID: I20050225000825 |
| Provider Name | Ronald L Seff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891792925 PECOS PAC ID: 7113961988 Enrollment ID: I20050613000878 |
| Provider Name | Richard Granese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437175189 PECOS PAC ID: 6002704384 Enrollment ID: I20050627001109 |
| Provider Name | Miryam Weber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750496774 PECOS PAC ID: 4688610694 Enrollment ID: I20050629001276 |
| Provider Name | Leanne M Stoneking |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336320449 PECOS PAC ID: 1850320417 Enrollment ID: I20050804000681 |
| Provider Name | Louai A Bilal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881623932 PECOS PAC ID: 7214834936 Enrollment ID: I20050809000725 |
| Provider Name | Carey M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992760714 PECOS PAC ID: 3971538489 Enrollment ID: I20051004000511 |
| Provider Name | Soo Christine Chun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538278205 PECOS PAC ID: 5092732941 Enrollment ID: I20051029000166 |
| Provider Name | Donald L Sharps |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366412256 PECOS PAC ID: 9931120953 Enrollment ID: I20051216000795 |
| Provider Name | Ronnie R Cummings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255537940 PECOS PAC ID: 1355363938 Enrollment ID: I20051222000722 |
| Provider Name | Bryan E Bruns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437184975 PECOS PAC ID: 7719992841 Enrollment ID: I20060210000539 |
| Provider Name | Visant A. Sanathara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760417661 PECOS PAC ID: 1951305010 Enrollment ID: I20060831000447 |
| Provider Name | Shona Quest Baum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851339501 PECOS PAC ID: 1052315090 Enrollment ID: I20060906000486 |
| Provider Name | Marc A Capobianco |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750394656 PECOS PAC ID: 5496752198 Enrollment ID: I20061020000557 |
| Provider Name | Caitlin C Pickart |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275657157 PECOS PAC ID: 3678673936 Enrollment ID: I20070716000408 |
| Provider Name | Cristina M Aamot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356563167 PECOS PAC ID: 2567554942 Enrollment ID: I20070815000905 |
| Provider Name | Sridhar Prathikanti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306920640 PECOS PAC ID: 1658474721 Enrollment ID: I20070920000869 |
| Provider Name | Heather A Colbert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518000546 PECOS PAC ID: 2961598057 Enrollment ID: I20071020000198 |
| Provider Name | Sara L Bassler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255522785 PECOS PAC ID: 7315035219 Enrollment ID: I20071109000466 |
| Provider Name | Janet R Farhie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871680223 PECOS PAC ID: 5092803544 Enrollment ID: I20071115000700 |
| Provider Name | Arshia Shirzadi |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1689786550 PECOS PAC ID: 7810922564 Enrollment ID: I20080212000730 |
| Provider Name | Shellie M Kahane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336231729 PECOS PAC ID: 4082799333 Enrollment ID: I20080311000196 |
| Provider Name | Freddie S Weinstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205980729 PECOS PAC ID: 8820161649 Enrollment ID: I20080725000628 |
| Provider Name | Marita G Dailo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326053174 PECOS PAC ID: 7719055953 Enrollment ID: I20081001000466 |
| Provider Name | Vanessa Vianey Hernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891836425 PECOS PAC ID: 8921160656 Enrollment ID: I20081215000301 |
| Provider Name | Harpreet M Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124003835 PECOS PAC ID: 6002978095 Enrollment ID: I20081230000140 |
| Provider Name | Tapeesh Kansal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841291408 PECOS PAC ID: 7113816455 Enrollment ID: I20090130000534 |
| Provider Name | Jyotila Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215096920 PECOS PAC ID: 7810917846 Enrollment ID: I20090211000750 |
| Provider Name | Kamaljeet Boora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356587711 PECOS PAC ID: 6709939317 Enrollment ID: I20090729000806 |
| Provider Name | Linda A Horgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467687954 PECOS PAC ID: 5193879070 Enrollment ID: I20090811000620 |
| Provider Name | Edward J Maxwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710119425 PECOS PAC ID: 3870649205 Enrollment ID: I20090925000371 |
| Provider Name | Nitin Kulkarni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487698304 PECOS PAC ID: 4385783968 Enrollment ID: I20091120000680 |
| Provider Name | Frederick J Falvo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275685653 PECOS PAC ID: 7618017039 Enrollment ID: I20091216000230 |
| Provider Name | Christopher M Sue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639225444 PECOS PAC ID: 0042353583 Enrollment ID: I20100204000906 |
| Provider Name | Emma Magana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154591758 PECOS PAC ID: 0941343339 Enrollment ID: I20100208000267 |
| Provider Name | Holli M Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144380940 PECOS PAC ID: 8325181746 Enrollment ID: I20100208000531 |
| Provider Name | Leslie M Kaplan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649466160 PECOS PAC ID: 2062555378 Enrollment ID: I20100209000616 |
| Provider Name | Gillian S Friedman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336282052 PECOS PAC ID: 8224173026 Enrollment ID: I20100304000497 |
| Provider Name | Aaron M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477880151 PECOS PAC ID: 9638205958 Enrollment ID: I20100812001043 |
| Provider Name | Alice Kollmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144220831 PECOS PAC ID: 9739213216 Enrollment ID: I20100819000444 |
| Provider Name | Jullyn C Chargualaf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831308691 PECOS PAC ID: 9335334598 Enrollment ID: I20101112000892 |
| Provider Name | Vincent Steven Perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194803007 PECOS PAC ID: 6608059613 Enrollment ID: I20110329000927 |
| Provider Name | Kaney Fedovskiy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114091469 PECOS PAC ID: 6406956333 Enrollment ID: I20110510000746 |
| Provider Name | Elmer P Ignacio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578507604 PECOS PAC ID: 9638344351 Enrollment ID: I20111208000251 |
| Provider Name | Mary Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386662484 PECOS PAC ID: 8729094131 Enrollment ID: I20120320000963 |
| Provider Name | Joshua Hyong-jin Cho |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003043969 PECOS PAC ID: 7214199934 Enrollment ID: I20120425000644 |
| Provider Name | Ali R Dia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912031030 PECOS PAC ID: 0547416802 Enrollment ID: I20120802000331 |
| Provider Name | Danielle L Marchman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982851366 PECOS PAC ID: 5698953701 Enrollment ID: I20121217000351 |
| Provider Name | Nataliya Giagou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285854216 PECOS PAC ID: 4284888975 Enrollment ID: I20130205000232 |
| Provider Name | Louisa R Steiger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417106204 PECOS PAC ID: 3274788211 Enrollment ID: I20130225000185 |
| Provider Name | Sabeena Acharya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144520651 PECOS PAC ID: 7315182441 Enrollment ID: I20130320000620 |
| Provider Name | Priyamvada Narayanan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346466067 PECOS PAC ID: 2264324995 Enrollment ID: I20130724000284 |
| Provider Name | Yuliya M Perch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043475569 PECOS PAC ID: 3173719150 Enrollment ID: I20130820001041 |
| Provider Name | Izzet Yazgan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982734109 PECOS PAC ID: 5597850081 Enrollment ID: I20130821000376 |
| Provider Name | Stefani A Lafrenierre |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750645743 PECOS PAC ID: 8527296755 Enrollment ID: I20140116000279 |
| Provider Name | Michelle J Ahn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295902930 PECOS PAC ID: 9335301589 Enrollment ID: I20140214001431 |
| Provider Name | Robert J Enriquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649590175 PECOS PAC ID: 8426271867 Enrollment ID: I20140603001776 |
| Provider Name | Bridget Kathleen Cleary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053691790 PECOS PAC ID: 4082832753 Enrollment ID: I20140822000761 |
| Provider Name | Elizabeth A Dewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407027618 PECOS PAC ID: 9830331818 Enrollment ID: I20140915002188 |
| Provider Name | Gurmanjot Kaur Samra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083843619 PECOS PAC ID: 4284958653 Enrollment ID: I20150114000732 |
| Provider Name | Sunpreet Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326464462 PECOS PAC ID: 1850616749 Enrollment ID: I20150218000289 |
| Provider Name | Preneet Dhillon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487975041 PECOS PAC ID: 3375860927 Enrollment ID: I20150319002642 |
| Provider Name | Yucui Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699036582 PECOS PAC ID: 6002133493 Enrollment ID: I20150324000633 |
| Provider Name | Jennifer A Morey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184871048 PECOS PAC ID: 9638496532 Enrollment ID: I20150401002305 |
| Provider Name | Paul P Araullo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053744870 PECOS PAC ID: 4789905282 Enrollment ID: I20150609002749 |
| Provider Name | Shaista Y Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770626327 PECOS PAC ID: 7911147269 Enrollment ID: I20150611003453 |
| Provider Name | Diane Crayton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184748956 PECOS PAC ID: 0941510085 Enrollment ID: I20151102002336 |
| Provider Name | Robin L Weintraub |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982075180 PECOS PAC ID: 0840591673 Enrollment ID: I20151219000179 |
| Provider Name | Kenneth R Wulff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124105085 PECOS PAC ID: 5395048813 Enrollment ID: I20160115001887 |
| Provider Name | Victor Manuel Salazar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619263993 PECOS PAC ID: 1153624895 Enrollment ID: I20160129001025 |
| Provider Name | Darren A Lucas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053548784 PECOS PAC ID: 4082838107 Enrollment ID: I20160204002431 |
| Provider Name | Tyisha Renee Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144687047 PECOS PAC ID: 4981909827 Enrollment ID: I20160301002131 |
| Provider Name | Kapil Chopra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912169137 PECOS PAC ID: 0941451298 Enrollment ID: I20160427000592 |
| Provider Name | Carolyn D Harris-muchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619155280 PECOS PAC ID: 2567751878 Enrollment ID: I20160510000661 |
| Provider Name | Ebele O Mbeledogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689071169 PECOS PAC ID: 5597054585 Enrollment ID: I20160513001837 |
| Provider Name | Catalina Flick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174696033 PECOS PAC ID: 0749573624 Enrollment ID: I20160729001790 |
| Provider Name | Sharon A Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144376070 PECOS PAC ID: 5991014581 Enrollment ID: I20160825001206 |
| Provider Name | Jasmin Suayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316307739 PECOS PAC ID: 7618263930 Enrollment ID: I20160912002118 |
| Provider Name | Arkadiy Yaretskiy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558604751 PECOS PAC ID: 5698055911 Enrollment ID: I20161202001439 |
| Provider Name | Jessie Carado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912399585 PECOS PAC ID: 1456631456 Enrollment ID: I20161208002451 |
| Provider Name | Maral Vahe Derkhorenian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336693019 PECOS PAC ID: 2860772878 Enrollment ID: I20161209000123 |
| Provider Name | Raeellen K Keeney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265779318 PECOS PAC ID: 6406139245 Enrollment ID: I20170202000008 |
| Provider Name | Sreekumar Nair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104848191 PECOS PAC ID: 8921002734 Enrollment ID: I20170316001351 |
| Provider Name | Kaitlin J Smallwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407066335 PECOS PAC ID: 3971888389 Enrollment ID: I20170328000471 |
| Provider Name | Basant K Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447299680 PECOS PAC ID: 3870558588 Enrollment ID: I20170331000757 |
| Provider Name | Nicole Dupree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891187456 PECOS PAC ID: 6204112014 Enrollment ID: I20170410002476 |
| Provider Name | Maria J Kellner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609840826 PECOS PAC ID: 3375820335 Enrollment ID: I20170501002113 |
| Provider Name | Rashida Michelle Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740698430 PECOS PAC ID: 1355633322 Enrollment ID: I20170522000289 |
| Provider Name | Hadi Estakhri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003161522 PECOS PAC ID: 5294030367 Enrollment ID: I20170818002114 |
| Provider Name | Ruth Mondolfi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568704641 PECOS PAC ID: 1456626266 Enrollment ID: I20171004002275 |
| Provider Name | Bridget B Kiefaber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922388172 PECOS PAC ID: 2961777636 Enrollment ID: I20171005001122 |
| Provider Name | Rupinder Randhawa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407128275 PECOS PAC ID: 9931339827 Enrollment ID: I20171026001315 |
| Provider Name | Opeyemi A Bello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023497351 PECOS PAC ID: 8123384724 Enrollment ID: I20171115001475 |
| Provider Name | Shebet U Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942617493 PECOS PAC ID: 7113283631 Enrollment ID: I20171115002917 |
| Provider Name | Naser Ahmadi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497019806 PECOS PAC ID: 7214176114 Enrollment ID: I20171229002414 |
| Provider Name | Heather V Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407246812 PECOS PAC ID: 8628337458 Enrollment ID: I20180123003448 |
| Provider Name | Shemiah M Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497274625 PECOS PAC ID: 7214297290 Enrollment ID: I20180213000564 |
| Provider Name | Tony T.n. Tran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053750265 PECOS PAC ID: 5597084459 Enrollment ID: I20180425002160 |
| Provider Name | Jessica Jazmin Gonzalez-rangel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720276884 PECOS PAC ID: 2769738665 Enrollment ID: I20180707000093 |
| Provider Name | Shelly Lyn Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093239436 PECOS PAC ID: 9133476500 Enrollment ID: I20180717003407 |
| Provider Name | Deva C Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023566825 PECOS PAC ID: 8325397060 Enrollment ID: I20180814002116 |
| Provider Name | Rachel Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275010241 PECOS PAC ID: 9537403241 Enrollment ID: I20181206003632 |
| Provider Name | George S Forgeng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760859508 PECOS PAC ID: 0345505095 Enrollment ID: I20181211002528 |
| Provider Name | Nicholas Bowen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730535899 PECOS PAC ID: 7719228899 Enrollment ID: I20190418001800 |
| Provider Name | Katelyn Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952797540 PECOS PAC ID: 2062754054 Enrollment ID: I20190423000592 |
| Provider Name | Kenneth Edwin Richter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174605067 PECOS PAC ID: 5193079101 Enrollment ID: I20190519000015 |
| Provider Name | Rhaelynne Scherr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972684769 PECOS PAC ID: 0547594103 Enrollment ID: I20190702000623 |
| Provider Name | Ifeatu B Enemmuo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952969008 PECOS PAC ID: 9335476779 Enrollment ID: I20190808001015 |
| Provider Name | Keley Heckman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801948187 PECOS PAC ID: 9739416009 Enrollment ID: I20190808002539 |
| Provider Name | David Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871942243 PECOS PAC ID: 5597002717 Enrollment ID: I20190926000994 |
| Provider Name | Edward Kaftarian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245376615 PECOS PAC ID: 3870824964 Enrollment ID: I20191003001038 |
| Provider Name | Joyce Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073014353 PECOS PAC ID: 9335475714 Enrollment ID: I20191008001669 |
| Provider Name | Asim A Rizvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043521487 PECOS PAC ID: 9032469978 Enrollment ID: I20191108000415 |
| Provider Name | Neal Ryan Christopher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750735650 PECOS PAC ID: 0749614733 Enrollment ID: I20191227002277 |
| Provider Name | Jennifer T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306489778 PECOS PAC ID: 4183059363 Enrollment ID: I20200116000165 |
| Provider Name | Yujing Guo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508411588 PECOS PAC ID: 2860826179 Enrollment ID: I20200116000731 |
| Provider Name | Robert A Benard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184027724 PECOS PAC ID: 5496181109 Enrollment ID: I20200128002260 |
| Provider Name | Jennifer L Amos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043761000 PECOS PAC ID: 4183052764 Enrollment ID: I20200331002822 |
| Provider Name | Charlotte Maria Primo Mizuta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437791381 PECOS PAC ID: 9335579267 Enrollment ID: I20200416003971 |
| Provider Name | Kisani B Ogwaro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518128883 PECOS PAC ID: 7810145208 Enrollment ID: I20200422002842 |
| Provider Name | Luis Julian Vallejo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457735060 PECOS PAC ID: 5890076111 Enrollment ID: I20200514001188 |
| Provider Name | Troy Kurz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154862357 PECOS PAC ID: 9739503822 Enrollment ID: I20200722001726 |
| Provider Name | Ethan Glenn Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609473735 PECOS PAC ID: 6204256100 Enrollment ID: I20201014002933 |
| Provider Name | Sridevi Banka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477199420 PECOS PAC ID: 6608296231 Enrollment ID: I20201020000791 |
| Provider Name | Sharon Stetz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659630507 PECOS PAC ID: 7113172024 Enrollment ID: I20201103001760 |
| Provider Name | Eric Tubat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336536960 PECOS PAC ID: 3678835956 Enrollment ID: I20201130001667 |
| Provider Name | Sreedharan Nair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972566909 PECOS PAC ID: 3779479589 Enrollment ID: I20201203000496 |
| Provider Name | Kartik Kailesh Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568786465 PECOS PAC ID: 2466693346 Enrollment ID: I20201209002096 |
| Provider Name | Michelle Del Rosario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467009084 PECOS PAC ID: 1759792377 Enrollment ID: I20201218001986 |
| Provider Name | Nagaraj Uddhandi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942456108 PECOS PAC ID: 9133384829 Enrollment ID: I20201221001346 |
| Provider Name | Kelly M Miskill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588901094 PECOS PAC ID: 6608194006 Enrollment ID: I20201223001699 |
| Provider Name | Hilda M Nguthu-bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689155442 PECOS PAC ID: 4385057728 Enrollment ID: I20210104001949 |
| Provider Name | Solomon Wolf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801801329 PECOS PAC ID: 8921160466 Enrollment ID: I20210112001840 |
| Provider Name | Omotayo Alamutu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689978652 PECOS PAC ID: 0840628426 Enrollment ID: I20210226001402 |
| Provider Name | Safiya Daley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801422258 PECOS PAC ID: 2163839861 Enrollment ID: I20210324003382 |
| Provider Name | Fernando E Serrano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083247779 PECOS PAC ID: 3375952302 Enrollment ID: I20210504001739 |
| Provider Name | Chidozie Ephrem Ibe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801493887 PECOS PAC ID: 5395144331 Enrollment ID: I20210525001929 |
| Provider Name | Marcus Jang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477154573 PECOS PAC ID: 8820497266 Enrollment ID: I20210604000780 |
| Provider Name | Michelle Buckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295365955 PECOS PAC ID: 1355740739 Enrollment ID: I20210604002789 |
| Provider Name | Karen Luu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215416102 PECOS PAC ID: 9739580283 Enrollment ID: I20210622002410 |
| Provider Name | Araceli Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144500067 PECOS PAC ID: 7719389907 Enrollment ID: I20210709002726 |
| Provider Name | Jennifer Ye Kong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427406198 PECOS PAC ID: 0840693123 Enrollment ID: I20210723002084 |
| Provider Name | Lauren Yvonne Azuela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487152054 PECOS PAC ID: 7113321811 Enrollment ID: I20210803001002 |
| Provider Name | Fernando Mendez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720472327 PECOS PAC ID: 2264710839 Enrollment ID: I20210816000456 |
| Provider Name | Amber Lee Mayfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679618086 PECOS PAC ID: 3971908773 Enrollment ID: I20210817001881 |
| Provider Name | Halima Lawal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164092656 PECOS PAC ID: 9032516174 Enrollment ID: I20210916001134 |
| Provider Name | Rashmi T Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942610902 PECOS PAC ID: 5597063776 Enrollment ID: I20211221002288 |
| Provider Name | Ronnie Alvarez Corona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982229571 PECOS PAC ID: 0941693550 Enrollment ID: I20220203000491 |
| Provider Name | Charlene Kc S Lacambra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326708207 PECOS PAC ID: 0244623411 Enrollment ID: I20220210002120 |
| Provider Name | Musaab Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437618725 PECOS PAC ID: 6901290865 Enrollment ID: I20220218002165 |
| Provider Name | Sarah Mohr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730324658 PECOS PAC ID: 3779978119 Enrollment ID: I20220321002436 |
| Provider Name | Christopher Chigbolu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841372463 PECOS PAC ID: 8628463791 Enrollment ID: I20220328002315 |
| Provider Name | Ashlyn L Hankey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023456746 PECOS PAC ID: 6608167895 Enrollment ID: I20220328002515 |
| Provider Name | Catherine Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730847070 PECOS PAC ID: 1355737388 Enrollment ID: I20220331000431 |
| Provider Name | Roger Timothy Alona Piedad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689344848 PECOS PAC ID: 4587051669 Enrollment ID: I20220419001822 |
| Provider Name | Thasanee Fong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942978820 PECOS PAC ID: 1850779935 Enrollment ID: I20220601002096 |
| Provider Name | Talia Ram Baruch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942817846 PECOS PAC ID: 9830577568 Enrollment ID: I20220608000777 |
| Provider Name | Marina Esperanza Belloso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467127332 PECOS PAC ID: 2769860352 Enrollment ID: I20220610000777 |
| Provider Name | Alan Duy Khiem Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891356671 PECOS PAC ID: 1355729880 Enrollment ID: I20220611000189 |
| Provider Name | Araz Abelian Barilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457006017 PECOS PAC ID: 2264811744 Enrollment ID: I20220614003005 |
| Provider Name | Erin Leianne Sneed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770138539 PECOS PAC ID: 7911386958 Enrollment ID: I20220621003101 |
| Provider Name | Denice Palacios |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497092993 PECOS PAC ID: 9931580651 Enrollment ID: I20220713000365 |
| Provider Name | Cristely Urena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063030526 PECOS PAC ID: 5496137267 Enrollment ID: I20220727001216 |
| Provider Name | Ana Chong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477943850 PECOS PAC ID: 8729460068 Enrollment ID: I20220802003547 |
| Provider Name | Skylar Scott Valles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033694237 PECOS PAC ID: 1456734185 Enrollment ID: I20220812003045 |
| Provider Name | Andy An Hoang Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710646021 PECOS PAC ID: 4880077858 Enrollment ID: I20220824001892 |
| Provider Name | Jenina Mesina Del Campo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053046953 PECOS PAC ID: 4385020262 Enrollment ID: I20220929002210 |
| Provider Name | Steven Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487204921 PECOS PAC ID: 0941632418 Enrollment ID: I20221102001836 |
| Provider Name | Anya Ithel Nevarez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629403803 PECOS PAC ID: 7012385768 Enrollment ID: I20221130001316 |
| Provider Name | Melissa Martelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972265668 PECOS PAC ID: 8729450531 Enrollment ID: I20230203001479 |
| Provider Name | Amy Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295272318 PECOS PAC ID: 5991177404 Enrollment ID: I20230209002559 |
| Provider Name | Ariel Joaquin Goitia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679044523 PECOS PAC ID: 1254539406 Enrollment ID: I20230214002228 |
| Provider Name | John Zaldua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306557970 PECOS PAC ID: 4284007113 Enrollment ID: I20230223002687 |
| Provider Name | Alexis Mackenzie Orens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073980033 PECOS PAC ID: 8921472788 Enrollment ID: I20230316002688 |
| Provider Name | Charlina Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902348584 PECOS PAC ID: 5496129736 Enrollment ID: I20230328001150 |
| Provider Name | Auriana Napier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720575244 PECOS PAC ID: 2567837719 Enrollment ID: I20230331001580 |
| Provider Name | Tony Thomas Abraham |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1609432061 PECOS PAC ID: 5193115830 Enrollment ID: I20230403002564 |
| Provider Name | Michael Scott Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144606963 PECOS PAC ID: 1355716002 Enrollment ID: I20230411000678 |
| Provider Name | Eli Kolp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669687612 PECOS PAC ID: 2062508419 Enrollment ID: I20230419002593 |
| Provider Name | Lydia Njie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194440107 PECOS PAC ID: 1951779834 Enrollment ID: I20230421001806 |
| Provider Name | Breanne L. Markowitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811561087 PECOS PAC ID: 3274998141 Enrollment ID: I20230427001941 |
| Provider Name | Porschea Laniece Pryor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558853721 PECOS PAC ID: 6901266949 Enrollment ID: I20230721001602 |
| Provider Name | Celeste Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376027912 PECOS PAC ID: 4789045626 Enrollment ID: I20230725003280 |
| Provider Name | Vy Thao Tran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841432895 PECOS PAC ID: 1658734058 Enrollment ID: I20230901001387 |
| Provider Name | Yesenia Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821509381 PECOS PAC ID: 1759738933 Enrollment ID: I20231109001083 |
| Provider Name | Jyoti Mallika Gustafson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700184124 PECOS PAC ID: 9830549724 Enrollment ID: I20231218004248 |
| Provider Name | Jesus De Dios |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851882633 PECOS PAC ID: 3476903493 Enrollment ID: I20240103000606 |
| Provider Name | Malaika Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497378921 PECOS PAC ID: 3173974052 Enrollment ID: I20240104001810 |
| Provider Name | Hilary Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497056907 PECOS PAC ID: 8921459728 Enrollment ID: I20240105001546 |
| Provider Name | Jonathan Edward Lucero |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407366495 PECOS PAC ID: 7012368707 Enrollment ID: I20240106000634 |
| Provider Name | Angelique Cassidy-borst |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982892998 PECOS PAC ID: 5890146583 Enrollment ID: I20240106000804 |
| Provider Name | Theresa Clark |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457688384 PECOS PAC ID: 4880045525 Enrollment ID: I20240108003310 |
| Provider Name | Paige Pabico |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1255697314 PECOS PAC ID: 6800247487 Enrollment ID: I20240108005116 |
| Provider Name | Phillip L Yee |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679831432 PECOS PAC ID: 4587015177 Enrollment ID: I20240108005674 |
| Provider Name | Amanda Montelongo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952713422 PECOS PAC ID: 5496106932 Enrollment ID: I20240109001467 |
| Provider Name | Bianca Lizette Lemus |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801255500 PECOS PAC ID: 7416308994 Enrollment ID: I20240109002870 |
| Provider Name | Jennifer Galindo Briscoe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669673570 PECOS PAC ID: 7214388735 Enrollment ID: I20240109004329 |
| Provider Name | Esther A Stanczak |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205176484 PECOS PAC ID: 0446601769 Enrollment ID: I20240110003676 |
| Provider Name | Bridgette Rose Herrmann |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497273650 PECOS PAC ID: 8022469352 Enrollment ID: I20240110004331 |
| Provider Name | Lane Mcgill |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1225054620 PECOS PAC ID: 7012368269 Enrollment ID: I20240111003571 |
| Provider Name | Lisa Marie Cresson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811018310 PECOS PAC ID: 1759732910 Enrollment ID: I20240111004014 |
| Provider Name | Lauren N Zampieri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154948149 PECOS PAC ID: 0446601603 Enrollment ID: I20240111004148 |
| Provider Name | Michelle Jeanette Munroe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154660470 PECOS PAC ID: 7517318777 Enrollment ID: I20240111004216 |
| Provider Name | Katelyn Jeane Wells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730669235 PECOS PAC ID: 8123479227 Enrollment ID: I20240112000850 |
| Provider Name | Jaqueline Diane Lara |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356791859 PECOS PAC ID: 8123479268 Enrollment ID: I20240112002277 |
| Provider Name | Arthur Dwain Tolbert |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265035406 PECOS PAC ID: 7113378290 Enrollment ID: I20240112003440 |
| Provider Name | Feroozan Gailani |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1689963548 PECOS PAC ID: 6204288327 Enrollment ID: I20240114000066 |
| Provider Name | Jessica Suzanne Aguirre |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851675789 PECOS PAC ID: 1254783236 Enrollment ID: I20240115001671 |
| Provider Name | Paige Cole |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1003373382 PECOS PAC ID: 4486006467 Enrollment ID: I20240115001792 |
| Provider Name | Bryan Sawlsville |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598895773 PECOS PAC ID: 9133571060 Enrollment ID: I20240116004671 |
| Provider Name | Alexandra S Hagnere |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245601970 PECOS PAC ID: 5395197123 Enrollment ID: I20240117003613 |
| Provider Name | Hessena P Langhans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801556618 PECOS PAC ID: 4486006137 Enrollment ID: I20240117004853 |
| Provider Name | Larry Boado Santiago |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1518149889 PECOS PAC ID: 1052763737 Enrollment ID: I20240118000884 |
| Provider Name | Lindsay Marilyn Barrientos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255014114 PECOS PAC ID: 9234581851 Enrollment ID: I20240119000925 |
| Provider Name | Antonio D Resendiz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1255908992 PECOS PAC ID: 7719330869 Enrollment ID: I20240125001719 |
| Provider Name | Kristina P Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033731112 PECOS PAC ID: 4486007986 Enrollment ID: I20240131004525 |
| Provider Name | Jennifer Barrios |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992157150 PECOS PAC ID: 4486007994 Enrollment ID: I20240131004934 |
| Provider Name | Glaiza Cecilia Canares Chambers |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174017313 PECOS PAC ID: 6002259744 Enrollment ID: I20240208004683 |
| Provider Name | Aleisha Lander |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730657073 PECOS PAC ID: 1850734336 Enrollment ID: I20240212003520 |
| Provider Name | Silvia Garber |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1033250477 PECOS PAC ID: 4981048154 Enrollment ID: I20240215001058 |
| Provider Name | Erica Iglesias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639598113 PECOS PAC ID: 0446694129 Enrollment ID: I20240221002362 |
| Provider Name | Sanie Joe Duldulao Andres |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568588093 PECOS PAC ID: 1052756509 Enrollment ID: I20240223003944 |
| Provider Name | Shannon Donlon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316441132 PECOS PAC ID: 4587009428 Enrollment ID: I20240229004291 |
| Provider Name | Jason Singh Roley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164913133 PECOS PAC ID: 7719322619 Enrollment ID: I20240301001704 |
| Provider Name | Kevin Scurich |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497101984 PECOS PAC ID: 5395164651 Enrollment ID: I20240314003130 |
| Provider Name | Robbie Kupono Kenobi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174077887 PECOS PAC ID: 7214373935 Enrollment ID: I20240315001766 |
| Provider Name | Caitlin Lombardo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356043632 PECOS PAC ID: 8325486038 Enrollment ID: I20240401001341 |
| Provider Name | Ilham Elmi Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043676281 PECOS PAC ID: 9133567860 Enrollment ID: I20240401002113 |
| Provider Name | Seung Jin Noh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467222380 PECOS PAC ID: 3779921820 Enrollment ID: I20240409001388 |
| Provider Name | Jessica Amber Dirks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245790120 PECOS PAC ID: 9436597515 Enrollment ID: I20240409002345 |
| Provider Name | Felicia Tara Taing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881189264 PECOS PAC ID: 9638517741 Enrollment ID: I20240409003390 |
| Provider Name | Justin Alvin Cheng |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366792442 PECOS PAC ID: 3971942863 Enrollment ID: I20240411001387 |
| Provider Name | Joslyne Elsa Aceves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982172904 PECOS PAC ID: 3971942889 Enrollment ID: I20240411002138 |
| Provider Name | Amanda Steele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437643111 PECOS PAC ID: 6608215058 Enrollment ID: I20240417003198 |
| Provider Name | Amanda Marie Martin Burdgick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245839893 PECOS PAC ID: 5395184634 Enrollment ID: I20240418003140 |
| Provider Name | Alexis E Rashdan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568941847 PECOS PAC ID: 9931554052 Enrollment ID: I20240422000763 |
| Provider Name | Amal Chakraburtty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053341362 PECOS PAC ID: 0840386876 Enrollment ID: I20240424001265 |
| Provider Name | Heather Joy Avila |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962867705 PECOS PAC ID: 9638519630 Enrollment ID: I20240424001439 |
| Provider Name | Denise Gabriela Smith |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316235195 PECOS PAC ID: 9234579921 Enrollment ID: I20240429001289 |
| Provider Name | Jesi Rose Chavez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568769438 PECOS PAC ID: 8628419280 Enrollment ID: I20240514000931 |
| Provider Name | Shannon Casey Yowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346555265 PECOS PAC ID: 8224470349 Enrollment ID: I20240521002995 |
| Provider Name | Christopher Woo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760189138 PECOS PAC ID: 2668814294 Enrollment ID: I20240528001701 |
| Provider Name | Christina Beth Farrington |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306189329 PECOS PAC ID: 4587106760 Enrollment ID: I20240603003102 |
| Provider Name | Dario Jose Puga |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245785609 PECOS PAC ID: 3577008069 Enrollment ID: I20240709001720 |
| Provider Name | Daniel A Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265293849 PECOS PAC ID: 9335684760 Enrollment ID: I20240710002627 |
| Provider Name | Lisa Carol Spars |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760544597 PECOS PAC ID: 5193260214 Enrollment ID: I20240712003989 |
| Provider Name | Pushpinder Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366109050 PECOS PAC ID: 7416495155 Enrollment ID: I20240813003187 |
| Provider Name | Diana Yvonne Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154028868 PECOS PAC ID: 0840738381 Enrollment ID: I20240815002481 |
| Provider Name | Lisa Ann Salazar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831582774 PECOS PAC ID: 2769921758 Enrollment ID: I20240821004889 |
| Provider Name | Tammy M Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114571999 PECOS PAC ID: 9436489366 Enrollment ID: I20240905001812 |
| Provider Name | Araly Abigail Fernandez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912228057 PECOS PAC ID: 1153861315 Enrollment ID: I20240913003399 |
| Provider Name | Christine Kieu Phan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487400917 PECOS PAC ID: 7315488988 Enrollment ID: I20240923002880 |
| Provider Name | Keisha Marie Owens |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780700492 PECOS PAC ID: 9335680859 Enrollment ID: I20240924000869 |
| Provider Name | Brian Joseph Rector |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770647158 PECOS PAC ID: 7911438015 Enrollment ID: I20240930003789 |
| Provider Name | Kimberly Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033430822 PECOS PAC ID: 5799216560 Enrollment ID: I20241003002358 |
| Provider Name | Riley Marie Hawblitzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215688908 PECOS PAC ID: 0648702266 Enrollment ID: I20241021000884 |
| Provider Name | Kelly Rochelle Tavenner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659003473 PECOS PAC ID: 3678005162 Enrollment ID: I20241022004125 |
| Provider Name | Roxanne Carney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417611591 PECOS PAC ID: 1456884907 Enrollment ID: I20241023001365 |
| Provider Name | Kamika Mason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073077277 PECOS PAC ID: 2769915495 Enrollment ID: I20241101001790 |
| Provider Name | Cecilia Izabal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043644172 PECOS PAC ID: 1557895158 Enrollment ID: I20241105001616 |
| Provider Name | Chad Wayne Beckman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396862710 PECOS PAC ID: 5294269056 Enrollment ID: I20241115001639 |
| Provider Name | Nicole Piquant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174341002 PECOS PAC ID: 1557896057 Enrollment ID: I20241120003418 |
| Provider Name | Stephen Rowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922710888 PECOS PAC ID: 9739614009 Enrollment ID: I20241122002209 |
| Provider Name | Michael C Ybarra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871788661 PECOS PAC ID: 5799211280 Enrollment ID: I20241206002587 |
Aefct Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 Murphy Canyon Rd Ste 212, San Diego, CA 92123 Phone: 858-569-0056 Fax: 858-569-4233 | |
R D Dipp Do Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1350 Columbia St, Unit 800, San Diego, CA 92101 Phone: 619-255-1649 Fax: 619-255-1649 | |
True Crew California Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8910 University Center Ln Ste 400, San Diego, CA 92122 Phone: 603-692-8173 | |
Wise Self Psychology, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2535 Kettner Blvd Ste 2b1, San Diego, CA 92101 Phone: 619-678-0020 |