| Mindful Healing Licensed Clinical Social Worker Pc | |
|
1394 Park Ave Emeryville CA 94608-3537 | |
| (510) 384-3373 | |
| Not Available |
| Full Name | Mindful Healing Licensed Clinical Social Worker Pc |
|---|---|
| Speciality | Social Worker |
| Location | 1394 Park Ave, Emeryville, California |
| Authorized Official Name and Position | Rebecca M Olsen (OWNER) |
| Authorized Official Contact | 5103843373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Healing Licensed Clinical Social Worker Pc 1394 Park Ave Emeryville CA 94608-3537 Ph: (510) 384-3373 | Mindful Healing Licensed Clinical Social Worker Pc 1394 Park Ave Emeryville CA 94608-3537 Ph: (510) 384-3373 |
| NPI Number | 1245067321 |
|---|---|
| Provider Enumeration Date | 09/13/2024 |
| Last Update Date | 07/29/2025 |
| Certification Date | 07/29/2025 |
| Medicare PECOS PAC ID | 1254862188 |
|---|---|
| Medicare Enrollment ID | O20241003000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245067321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Rebecca Marie Olsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740565621 PECOS PAC ID: 7719426865 Enrollment ID: I20240903003140 |
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