| Good Shepherd Counseling Clinic | |
|
17461 Irvine Blvd Suite D Tustin CA 92780-3034 | |
| (714) 402-0131 | |
| Not Available |
| Full Name | Good Shepherd Counseling Clinic |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 17461 Irvine Blvd, Tustin, California |
| Authorized Official Name and Position | Susan Marie Kell (OWNER) |
| Authorized Official Contact | 7144020131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Counseling Clinic 30713 Riverside Dr Suite 203 Lake Elsinore CA 92530-4714 Ph: (951) 678-1642 | Good Shepherd Counseling Clinic 17461 Irvine Blvd Suite D Tustin CA 92780-3034 Ph: (714) 402-0131 |
| NPI Number | 1467763466 |
|---|---|
| Provider Enumeration Date | 06/24/2010 |
| Last Update Date | 06/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467763466 | NPI | - | NPPES |
| ZZZ55205Y | Other | CA | BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MFC39965 (California) | Primary |
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