| Jsp Corporation Inc | |
|
36330 Hidden Springs Rd Ste E Wildomar CA 92595-5804 | |
| (442) 224-3320 | |
| Not Available |
| Full Name | Jsp Corporation Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 36330 Hidden Springs Rd Ste E, Wildomar, California |
| Authorized Official Name and Position | Jacquelyn Hamed (CEO) |
| Authorized Official Contact | 4422243320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jsp Corporation Inc 36330 Hidden Springs Rd Ste E Wildomar CA 92595-5804 Ph: (442) 224-3320 | Jsp Corporation Inc 36330 Hidden Springs Rd Ste E Wildomar CA 92595-5804 Ph: (442) 224-3320 |
| NPI Number | 1629824354 |
|---|---|
| Provider Enumeration Date | 04/24/2024 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 8325570617 |
|---|---|
| Medicare Enrollment ID | O20241010004082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629824354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Samir Hamed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568166965 PECOS PAC ID: 8628427200 Enrollment ID: I20231207002072 |
| Provider Name | Jacquelyn Hamed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578260758 PECOS PAC ID: 9234661521 Enrollment ID: I20250512001248 |
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