| La Clinica Del Pueblo, Inc. | |
|
2831 15th Street Nw Washington DC 20009-4607 | |
| (202) 462-4788 | |
| (202) 332-0085 |
| Full Name | La Clinica Del Pueblo, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2831 15th Street Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Joanie Clement Rodrick (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2024640141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Clinica Del Pueblo, Inc. 2831 15th Street Nw Washington DC 20009-4607 Ph: (202) 462-4788 | La Clinica Del Pueblo, Inc. 2831 15th Street Nw Washington DC 20009-4607 Ph: (202) 462-4788 |
| NPI Number | 1124227590 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 09/23/2021 |
| Certification Date | 03/16/2021 |
| Medicare PECOS PAC ID | 3971490558 |
|---|---|
| Medicare Enrollment ID | O20040228000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124227590 | NPI | - | NPPES |
| Provider Name | Ricardo Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609913532 PECOS PAC ID: 7214916832 Enrollment ID: I20040716001062 |
| Provider Name | Madeline F Wilks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205819943 PECOS PAC ID: 1052380706 Enrollment ID: I20040929000423 |
| Provider Name | Ricardo G Caldera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053420646 PECOS PAC ID: 0648341149 Enrollment ID: I20080611000106 |
| Provider Name | Joshua H. Kolko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477614998 PECOS PAC ID: 8921164211 Enrollment ID: I20090312000122 |
| Provider Name | Robin E Berlin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265628465 PECOS PAC ID: 1951575992 Enrollment ID: I20111201000108 |
| Provider Name | Leah C Lujan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740549195 PECOS PAC ID: 0244482073 Enrollment ID: I20121130000358 |
| Provider Name | Jose Antonio Segura |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265699169 PECOS PAC ID: 9931428935 Enrollment ID: I20150424000415 |
| Provider Name | Marianne Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407107782 PECOS PAC ID: 4789980715 Enrollment ID: I20160316002569 |
| Provider Name | Albertina Munoz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982095295 PECOS PAC ID: 8820371461 Enrollment ID: I20170206002587 |
| Provider Name | Victoria Amber White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225355183 PECOS PAC ID: 9133358021 Enrollment ID: I20170313000663 |
| Provider Name | Susana Bosques |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710338793 PECOS PAC ID: 4688941917 Enrollment ID: I20170517000858 |
| Provider Name | Claudia Marcela Husni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003016643 PECOS PAC ID: 2769567890 Enrollment ID: I20170712001529 |
| Provider Name | Leah Harford Braun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851687586 PECOS PAC ID: 1254572365 Enrollment ID: I20171016003363 |
| Provider Name | Oscar Anibel Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982098968 PECOS PAC ID: 4789950940 Enrollment ID: I20171017000300 |
| Provider Name | Angie J Castro Moreno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467827113 PECOS PAC ID: 3678821154 Enrollment ID: I20180731000840 |
| Provider Name | Sabrina Valdez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912306325 PECOS PAC ID: 5294124582 Enrollment ID: I20211108000403 |
| Provider Name | Paul Loeser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902301583 PECOS PAC ID: 1456600071 Enrollment ID: I20221013000941 |
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