| Pacific Psychiatry Inc. | |
|
3220 S Higuera St Suite 215 San Luis Obispo CA 93401-6987 | |
| (805) 541-5055 | |
| (805) 541-5075 |
| Full Name | Pacific Psychiatry Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3220 S Higuera St, San Luis Obispo, California |
| Authorized Official Name and Position | John Michael Rivard (PRESIDENT) |
| Authorized Official Contact | 8055415055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Psychiatry Inc. 3220 S Higuera St Suite 215 San Luis Obispo CA 93401-6987 Ph: (805) 541-5055 | Pacific Psychiatry Inc. 3220 S Higuera St Suite 215 San Luis Obispo CA 93401-6987 Ph: (805) 541-5055 |
| NPI Number | 1164615910 |
|---|---|
| Provider Enumeration Date | 08/24/2007 |
| Last Update Date | 08/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164615910 | NPI | - | NPPES |
| C2754748 | Other | CA | CORP RESGISTRATION # |
| FNP33987 | Other | CA | FICITITOUS NAME PERMIT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | C2754748 (California) | Primary |
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