| Meraki Management- Ca Llc | |
|
1605 The Alameda San Jose CA 95126-2202 | |
| (805) 728-9093 | |
| Not Available |
| Full Name | Meraki Management- Ca Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1605 The Alameda, San Jose, California |
| Authorized Official Name and Position | Tracy Marie Rogers (VP OF REVENUE) |
| Authorized Official Contact | 8057289093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meraki Management- Ca Llc Po Box 45973 San Francisco CA 94145-0973 Ph: () - | Meraki Management- Ca Llc 1605 The Alameda San Jose CA 95126-2202 Ph: (805) 728-9093 |
| NPI Number | 1659054211 |
|---|---|
| Provider Enumeration Date | 08/10/2023 |
| Last Update Date | 08/10/2023 |
| Certification Date | 08/10/2023 |
| Medicare PECOS PAC ID | 4183154735 |
|---|---|
| Medicare Enrollment ID | O20250211003566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659054211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn P Hirst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053452664 PECOS PAC ID: 3577600378 Enrollment ID: I20091028000088 |
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