| North Bay Neuropsychology A Psychology Corporation | |
|
1221 Farmers Ln Ste C Santa Rosa CA 95405-6712 | |
| (707) 829-5057 | |
| (707) 829-5084 |
| Full Name | North Bay Neuropsychology A Psychology Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1221 Farmers Ln Ste C, Santa Rosa, California |
| Authorized Official Name and Position | Ellen O'toole (PRESIDENT) |
| Authorized Official Contact | 7078295057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Bay Neuropsychology A Psychology Corporation 122 Calistoga Rd # 355 Santa Rosa CA 95409-3702 Ph: (707) 829-5057 | North Bay Neuropsychology A Psychology Corporation 1221 Farmers Ln Ste C Santa Rosa CA 95405-6712 Ph: (707) 829-5057 |
| NPI Number | 1568854727 |
|---|---|
| Provider Enumeration Date | 02/25/2015 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 3678872322 |
|---|---|
| Medicare Enrollment ID | O20160502000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568854727 | NPI | - | NPPES |
| Provider Name | Ellen M O'toole |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962652883 PECOS PAC ID: 4789740879 Enrollment ID: I20090225000203 |
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