| Keshawan Sampath Inc. | |
|
12968 Frederick St Ste B Moreno Valley CA 92553-5229 | |
| (951) 208-0150 | |
| Not Available |
| Full Name | Keshawan Sampath Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 12968 Frederick St Ste B, Moreno Valley, California |
| Authorized Official Name and Position | Sharada Vegi (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 9512080150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keshawan Sampath Inc. 12968 Frederick St Ste B Moreno Valley CA 92553-5229 Ph: (951) 208-0150 | Keshawan Sampath Inc. 12968 Frederick St Ste B Moreno Valley CA 92553-5229 Ph: (951) 208-0150 |
| NPI Number | 1649067455 |
|---|---|
| Provider Enumeration Date | 04/23/2025 |
| Last Update Date | 04/23/2025 |
| Certification Date | 04/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649067455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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