| Prairie Medical Associates | |
|
860 Green Island Rd American Canyon CA 94503-9657 | |
| (415) 735-6453 | |
| (415) 548-2181 |
| Full Name | Prairie Medical Associates |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 860 Green Island Rd, American Canyon, California |
| Authorized Official Name and Position | Gianna Papa (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5104390441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Medical Associates 400 Concar Dr Ste 4-147 San Mateo CA 94402-2681 Ph: () - | Prairie Medical Associates 860 Green Island Rd American Canyon CA 94503-9657 Ph: (415) 735-6453 |
| NPI Number | 1942973730 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 07/05/2022 |
| Certification Date | 07/05/2022 |
| Medicare PECOS PAC ID | 5395142665 |
|---|---|
| Medicare Enrollment ID | O20210929001750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942973730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mark Zink |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205916731 PECOS PAC ID: 3072406099 Enrollment ID: I20040204000508 |
| Provider Name | Guylene Velez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730216672 PECOS PAC ID: 0143308593 Enrollment ID: I20080424000762 |
| Provider Name | Lindsey Law |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861853715 PECOS PAC ID: 7719240605 Enrollment ID: I20180405001376 |
| Provider Name | Sarah Borish |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508411497 PECOS PAC ID: 6507198678 Enrollment ID: I20191023002034 |
| Provider Name | Dave P Ravi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043501364 PECOS PAC ID: 5890032601 Enrollment ID: I20211117001577 |
| Provider Name | Karen Park Lim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922298496 PECOS PAC ID: 0143511063 Enrollment ID: I20211118001859 |
| Provider Name | Jennifer Layne Latimer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902057565 PECOS PAC ID: 5698165132 Enrollment ID: I20211124000842 |
| Provider Name | Georges Jean-pierre |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255537551 PECOS PAC ID: 9436220225 Enrollment ID: I20220323001082 |
| Provider Name | Heather Marie Cotsenmoyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548690449 PECOS PAC ID: 2567848062 Enrollment ID: I20221006003143 |
| Provider Name | Anna Kathleen Livak Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366931503 PECOS PAC ID: 2668848987 Enrollment ID: I20221011002946 |
| Provider Name | Glenn Sample |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881915270 PECOS PAC ID: 4284993973 Enrollment ID: I20221012003125 |
| Provider Name | Brittany Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215572110 PECOS PAC ID: 3375918691 Enrollment ID: I20230418001994 |
Health & Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4381 Broadway St, Suite 101, American Canyon, CA 94503 Phone: 707-259-8139 | |
Mcgrew Behavioral Health Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Theresa Ave, American Canyon, CA 94503 Phone: 707-246-7920 Fax: 707-649-0393 | |
Mcgrew Behavior Intervention Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 Newbury Way, American Canyon, CA 94503 Phone: 707-246-7920 Fax: 707-648-0393 | |
Solano Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 W American Canyon Rd Ste 508-291, American Canyon, CA 94503 Phone: 707-334-1544 |