| High Desert Psychological Services | |
|
15497 W Sand St Victorville CA 92392-2910 | |
| (442) 327-9311 | |
| (442) 327-9315 |
| Full Name | High Desert Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 15497 W Sand St, Victorville, California |
| Authorized Official Name and Position | Eric Bahra (OWNER) |
| Authorized Official Contact | 7142903009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Psychological Services 15497 W Sand St Victorville CA 92392-2910 Ph: (442) 327-9311 | High Desert Psychological Services 15497 W Sand St Victorville CA 92392-2910 Ph: (442) 327-9311 |
| NPI Number | 1104463371 |
|---|---|
| Provider Enumeration Date | 12/05/2019 |
| Last Update Date | 10/27/2020 |
| Certification Date | 10/27/2020 |
| Medicare PECOS PAC ID | 2860819125 |
|---|---|
| Medicare Enrollment ID | O20200901001503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104463371 | NPI | - | NPPES |
| Provider Name | Sean K Sterling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285885699 PECOS PAC ID: 0446222376 Enrollment ID: I20040810001393 |
| Provider Name | Gerald R Duprez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760462105 PECOS PAC ID: 6406886118 Enrollment ID: I20050812000536 |
| Provider Name | Ravita Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225122039 PECOS PAC ID: 1951598945 Enrollment ID: I20101202000913 |
| Provider Name | Norberto M Carlos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275622672 PECOS PAC ID: 2860670726 Enrollment ID: I20110623000127 |
| Provider Name | Jamie E Garcia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760638712 PECOS PAC ID: 3870742612 Enrollment ID: I20121011000165 |
| Provider Name | Gloria Sudeta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083070064 PECOS PAC ID: 7810285210 Enrollment ID: I20161130001840 |
| Provider Name | Stephanie Kleppe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669511002 PECOS PAC ID: 8123302684 Enrollment ID: I20170228001782 |
| Provider Name | Cheryl Joy Babb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114247137 PECOS PAC ID: 8123302304 Enrollment ID: I20170307002369 |
| Provider Name | Leslie Scarrott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578093282 PECOS PAC ID: 7113299744 Enrollment ID: I20170816004653 |
| Provider Name | Michael E Geraghty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114491545 PECOS PAC ID: 9739421611 Enrollment ID: I20190424001806 |
| Provider Name | Eric M Bahra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053887117 PECOS PAC ID: 9638402522 Enrollment ID: I20190607001665 |
| Provider Name | Javier Eduardo Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518357821 PECOS PAC ID: 5496087439 Enrollment ID: I20191024001853 |
| Provider Name | Yuliana A Medina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558751891 PECOS PAC ID: 7911239686 Enrollment ID: I20191029003519 |
| Provider Name | Michael Christian Solano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609094945 PECOS PAC ID: 5991138877 Enrollment ID: I20191206001433 |
| Provider Name | Eric B Zywicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851801443 PECOS PAC ID: 4981967817 Enrollment ID: I20191206002302 |
| Provider Name | Veronica C Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801216833 PECOS PAC ID: 1254768328 Enrollment ID: I20200302001732 |
| Provider Name | Mark A Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497019558 PECOS PAC ID: 5799115408 Enrollment ID: I20200421001693 |
| Provider Name | Michael F Josiah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184264517 PECOS PAC ID: 2769892082 Enrollment ID: I20201027003020 |
| Provider Name | Aizzel R Trieu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689214074 PECOS PAC ID: 9133539224 Enrollment ID: I20201030001028 |
| Provider Name | Meliza Q Kinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316564594 PECOS PAC ID: 7214348416 Enrollment ID: I20201119000512 |
| Provider Name | Amanda Bertoldo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114367687 PECOS PAC ID: 6406264068 Enrollment ID: I20210420001199 |
| Provider Name | Francisca A Buenrostro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568862472 PECOS PAC ID: 6103229737 Enrollment ID: I20210720003112 |
| Provider Name | Tami Stokes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740895325 PECOS PAC ID: 5294139226 Enrollment ID: I20210812001270 |
| Provider Name | John Pascua |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376046912 PECOS PAC ID: 7810388964 Enrollment ID: I20211227001141 |
| Provider Name | Stephanie Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043589351 PECOS PAC ID: 6305238098 Enrollment ID: I20220107001663 |
| Provider Name | Lynn M Givens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063601383 PECOS PAC ID: 1951794320 Enrollment ID: I20220207001983 |
| Provider Name | Roxie L Hiett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447624226 PECOS PAC ID: 0941693329 Enrollment ID: I20220207002398 |
| Provider Name | Susan Y Vanallen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659791234 PECOS PAC ID: 0648663062 Enrollment ID: I20220208001406 |
| Provider Name | Yalina Palomino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235687245 PECOS PAC ID: 2769876218 Enrollment ID: I20220225000923 |
| Provider Name | Jassiel E Barrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306505383 PECOS PAC ID: 2961896436 Enrollment ID: I20220225001773 |
| Provider Name | Sachelly A Ramos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992104921 PECOS PAC ID: 0840684312 Enrollment ID: I20220225001883 |
| Provider Name | Flora Diamreyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477626521 PECOS PAC ID: 2860544202 Enrollment ID: I20220303002511 |
| Provider Name | Priscilla F Vado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053507467 PECOS PAC ID: 6901290964 Enrollment ID: I20220308002508 |
| Provider Name | Jacquelyn Williams-brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033731518 PECOS PAC ID: 5991190928 Enrollment ID: I20220309002702 |
| Provider Name | Teri M Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174835409 PECOS PAC ID: 0244625135 Enrollment ID: I20220310002123 |
| Provider Name | Tristan H Randall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043693369 PECOS PAC ID: 9830584721 Enrollment ID: I20220310002359 |
| Provider Name | Eric C Murillo-angelo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235261876 PECOS PAC ID: 5496140287 Enrollment ID: I20220314001248 |
| Provider Name | Amber King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538744404 PECOS PAC ID: 7618362419 Enrollment ID: I20220314001565 |
| Provider Name | Amair Jaber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972137149 PECOS PAC ID: 3173919107 Enrollment ID: I20220331000436 |
| Provider Name | Kristen Ulmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639532591 PECOS PAC ID: 3779979554 Enrollment ID: I20220404001161 |
| Provider Name | Anisbel Hornia Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740763036 PECOS PAC ID: 3678969052 Enrollment ID: I20220412001352 |
| Provider Name | Kim Strong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720308646 PECOS PAC ID: 9638566706 Enrollment ID: I20220420002665 |
| Provider Name | Adriana M Ocampo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760080709 PECOS PAC ID: 2769879253 Enrollment ID: I20220502001975 |
| Provider Name | Karie G Peel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093865834 PECOS PAC ID: 3577552918 Enrollment ID: I20220608000618 |
| Provider Name | Janice J Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073127841 PECOS PAC ID: 9830570027 Enrollment ID: I20220719003091 |
| Provider Name | Valoria Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790933398 PECOS PAC ID: 2961885439 Enrollment ID: I20220816001638 |
| Provider Name | Jennifer L Greeno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558918680 PECOS PAC ID: 4284019761 Enrollment ID: I20220920001037 |
| Provider Name | Nalini Persaud |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750570909 PECOS PAC ID: 5092190249 Enrollment ID: I20220923002024 |
| Provider Name | Ashley E Mccort |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518334812 PECOS PAC ID: 9133505134 Enrollment ID: I20220928002361 |
| Provider Name | Vasundhara K Benson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134519622 PECOS PAC ID: 0840667762 Enrollment ID: I20221107002056 |
| Provider Name | Anthony M Paez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629608229 PECOS PAC ID: 5496125635 Enrollment ID: I20230103002869 |
| Provider Name | Jason Colby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831804756 PECOS PAC ID: 1951308303 Enrollment ID: I20230308003195 |
| Provider Name | Kathleen Baca Leanos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386043370 PECOS PAC ID: 3072987890 Enrollment ID: I20230317002375 |
| Provider Name | Kristie Bott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205151024 PECOS PAC ID: 5890169445 Enrollment ID: I20230321002675 |
| Provider Name | Anthony Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730633694 PECOS PAC ID: 4688049471 Enrollment ID: I20230410000796 |
| Provider Name | Toni Mae Angeli Ouano Delmonte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851098750 PECOS PAC ID: 5092170175 Enrollment ID: I20230424002798 |
| Provider Name | Jennifer Lee Tapia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285224097 PECOS PAC ID: 8628433562 Enrollment ID: I20230525001904 |
| Provider Name | Dulce D Quezada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861822736 PECOS PAC ID: 7911364955 Enrollment ID: I20230606002182 |
| Provider Name | Cindy R Salbino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457048787 PECOS PAC ID: 6608235379 Enrollment ID: I20230629000701 |
| Provider Name | Emelyn Laszkiewicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386252120 PECOS PAC ID: 0143689927 Enrollment ID: I20230711004250 |
| Provider Name | Richard Jumba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245941301 PECOS PAC ID: 1153795976 Enrollment ID: I20230817002881 |
| Provider Name | Hue Dang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346774171 PECOS PAC ID: 8022471093 Enrollment ID: I20230824001911 |
| Provider Name | Ruben Cabrera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356865273 PECOS PAC ID: 8325402902 Enrollment ID: I20230914004006 |
| Provider Name | Graham Mitchell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346419736 PECOS PAC ID: 3274989652 Enrollment ID: I20231020001135 |
| Provider Name | Alexander Np Adu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598213985 PECOS PAC ID: 1951751437 Enrollment ID: I20231226000120 |
| Provider Name | Manuel Paschinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679286611 PECOS PAC ID: 2668824012 Enrollment ID: I20240122001592 |
| Provider Name | Deidra R Wells |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639696610 PECOS PAC ID: 3577916667 Enrollment ID: I20240124004638 |
| Provider Name | Tammy M Makela |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386766640 PECOS PAC ID: 3274986377 Enrollment ID: I20240124004812 |
| Provider Name | Shimeka D Arnold |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710483078 PECOS PAC ID: 0840643748 Enrollment ID: I20240126002616 |
| Provider Name | Kanwal Hassan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528716875 PECOS PAC ID: 3375996127 Enrollment ID: I20240128000277 |
| Provider Name | Rochelle Ashton-beasley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1831345099 PECOS PAC ID: 8325491079 Enrollment ID: I20240129003805 |
| Provider Name | Adriana Hermosillo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053701573 PECOS PAC ID: 2466805114 Enrollment ID: I20240129004022 |
| Provider Name | Teresa Alvarado |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1336454065 PECOS PAC ID: 0941653604 Enrollment ID: I20240129004289 |
| Provider Name | Smita Kapoor |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801270244 PECOS PAC ID: 5294188967 Enrollment ID: I20240129004409 |
| Provider Name | Noha Metry |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902282437 PECOS PAC ID: 3870946486 Enrollment ID: I20240131000989 |
| Provider Name | Michelle Leary |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558717991 PECOS PAC ID: 8729431242 Enrollment ID: I20240131001924 |
| Provider Name | Nester Sanchez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114151727 PECOS PAC ID: 0143673616 Enrollment ID: I20240131003687 |
| Provider Name | Arianna M Reyna |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881150530 PECOS PAC ID: 8527411008 Enrollment ID: I20240131003998 |
| Provider Name | Erica Khamvongsa |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942705363 PECOS PAC ID: 8224481718 Enrollment ID: I20240131004115 |
| Provider Name | Karence L Belton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386037372 PECOS PAC ID: 4789027004 Enrollment ID: I20240202003662 |
| Provider Name | Tiffanay Perry |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1366928525 PECOS PAC ID: 9032552161 Enrollment ID: I20240206002285 |
| Provider Name | Gabriela T Gomez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1891018180 PECOS PAC ID: 0840633822 Enrollment ID: I20240206004746 |
| Provider Name | Sarah D Riley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114281961 PECOS PAC ID: 7911340906 Enrollment ID: I20240206004855 |
| Provider Name | Christiane S Diaz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316301849 PECOS PAC ID: 5193168136 Enrollment ID: I20240207001502 |
| Provider Name | Jeanne M Mckellar |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1841321965 PECOS PAC ID: 5597108373 Enrollment ID: I20240208002400 |
| Provider Name | Elisa M Braggins |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376041400 PECOS PAC ID: 5799128211 Enrollment ID: I20240212001701 |
| Provider Name | Candyce R Flemister |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437639515 PECOS PAC ID: 2062855596 Enrollment ID: I20240212001925 |
| Provider Name | Teah L Barrow |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053448472 PECOS PAC ID: 5991148496 Enrollment ID: I20240212004423 |
| Provider Name | Pamela Burney |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1205360575 PECOS PAC ID: 5799129029 Enrollment ID: I20240214004127 |
| Provider Name | Jenifer L Carpenter Buckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457128217 PECOS PAC ID: 0840634028 Enrollment ID: I20240215001586 |
| Provider Name | Chad E Kiedrowski |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457533630 PECOS PAC ID: 3274977467 Enrollment ID: I20240215001731 |
| Provider Name | Joanne L Farrell-anderson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598117996 PECOS PAC ID: 0648614842 Enrollment ID: I20240215002098 |
| Provider Name | David Fallon |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578687745 PECOS PAC ID: 9133563372 Enrollment ID: I20240215003473 |
| Provider Name | Jonathan P Wilson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497176903 PECOS PAC ID: 2668816232 Enrollment ID: I20240222001269 |
| Provider Name | Cindy Avelar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871073510 PECOS PAC ID: 9436593936 Enrollment ID: I20240222002573 |
| Provider Name | Elizabeth A Myers |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154792596 PECOS PAC ID: 4183068687 Enrollment ID: I20240222002802 |
| Provider Name | Daiya H Mikhail |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164605028 PECOS PAC ID: 0042654568 Enrollment ID: I20240222003371 |
| Provider Name | Jessica Martinez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1275863318 PECOS PAC ID: 3072958438 Enrollment ID: I20240226002862 |
| Provider Name | Lavina A Ellison |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1689103814 PECOS PAC ID: 2466897723 Enrollment ID: I20240227002490 |
| Provider Name | Ofelia Johnson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902373038 PECOS PAC ID: 0648615559 Enrollment ID: I20240301002018 |
| Provider Name | Allison K Reza |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1841316874 PECOS PAC ID: 5395181770 Enrollment ID: I20240307002037 |
| Provider Name | Jennifer Macias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386068229 PECOS PAC ID: 9537505722 Enrollment ID: I20240311001225 |
| Provider Name | Brandi Stevens |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1790263614 PECOS PAC ID: 8729424932 Enrollment ID: I20240311002026 |
| Provider Name | Caroline A Reyna |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1215389564 PECOS PAC ID: 6608212840 Enrollment ID: I20240311002944 |
| Provider Name | Alejandro Ornelas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093849762 PECOS PAC ID: 6305282302 Enrollment ID: I20240313001131 |
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Phillip Tardanico, Licensed Clinical Social Worker & Associates, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15000 7th St Ste 209, Victorville, CA 92395 Phone: 760-217-9527 Fax: 442-267-5623 | |
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