| Northern California Neurohealth | |
|
673 Merchant St Ste A Vacaville CA 95688-6952 | |
| (707) 415-7473 | |
| Not Available |
| Full Name | Northern California Neurohealth |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 673 Merchant St Ste A, Vacaville, California |
| Authorized Official Name and Position | Katheryn Conde (OWNER) |
| Authorized Official Contact | 7074157473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern California Neurohealth 673 Merchant St Ste A Vacaville CA 95688-6952 Ph: (707) 415-7473 | Northern California Neurohealth 673 Merchant St Ste A Vacaville CA 95688-6952 Ph: (707) 415-7473 |
| NPI Number | 1770170334 |
|---|---|
| Provider Enumeration Date | 12/29/2020 |
| Last Update Date | 02/07/2022 |
| Certification Date | 02/03/2022 |
| Medicare PECOS PAC ID | 9931512746 |
|---|---|
| Medicare Enrollment ID | O20210114002445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770170334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Katheryn Conde |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992110639 PECOS PAC ID: 0840603650 Enrollment ID: I20210205000933 |
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