| Innervations Therapy | |
|
858 Maryland Dr Vista CA 92083-3361 | |
| (760) 500-3740 | |
| Not Available |
| Full Name | Innervations Therapy |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 858 Maryland Dr, Vista, California |
| Authorized Official Name and Position | Liza M Castro (OWNER) |
| Authorized Official Contact | 7605003740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innervations Therapy 858 Maryland Dr Vista CA 92083-3361 Ph: (760) 500-3740 | Innervations Therapy 858 Maryland Dr Vista CA 92083-3361 Ph: (760) 500-3740 |
| NPI Number | 1629813845 |
|---|---|
| Provider Enumeration Date | 06/28/2024 |
| Last Update Date | 06/28/2024 |
| Certification Date | 06/28/2024 |
| Medicare PECOS PAC ID | 7416497961 |
|---|---|
| Medicare Enrollment ID | O20240911000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629813845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Liza Castro |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1720572654 PECOS PAC ID: 8628514288 Enrollment ID: I20240719001867 |
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