| Redwood Psychology Center, Inc | |
|
19375 Hwy. 116 Monte Rio CA 95462 | |
| (707) 865-1200 | |
| Not Available |
| Full Name | Redwood Psychology Center, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 19375 Hwy. 116, Monte Rio, California |
| Authorized Official Name and Position | Denise Horner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7078651200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redwood Psychology Center, Inc Po Box 519 Monte Rio CA 95462 Ph: (707) 865-1200 | Redwood Psychology Center, Inc 19375 Hwy. 116 Monte Rio CA 95462 Ph: (707) 865-1200 |
| NPI Number | 1629196290 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 10/06/2022 |
| Certification Date | 10/06/2022 |
| Medicare PECOS PAC ID | 2062880487 |
|---|---|
| Medicare Enrollment ID | O20221116001129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629196290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | 110000330 (California) | Primary |
| Provider Name | Antonio Madrid |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881818292 PECOS PAC ID: 4688834633 Enrollment ID: I20120328000677 |
| Provider Name | Kathleen Kunster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063740736 PECOS PAC ID: 2365732740 Enrollment ID: I20160526002140 |
| Provider Name | Nicholas Keith Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508325903 PECOS PAC ID: 6507243094 Enrollment ID: I20220523002276 |
| Provider Name | David Peter Westwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164787354 PECOS PAC ID: 5294103461 Enrollment ID: I20221118001017 |
| Provider Name | Carl Ernest Combs |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528225786 PECOS PAC ID: 9032560180 Enrollment ID: I20240112002303 |
| Provider Name | Diana B Holloway |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659521847 PECOS PAC ID: 7810349909 Enrollment ID: I20240112004200 |
| Provider Name | Denise Emily Horner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457571978 PECOS PAC ID: 5496123812 Enrollment ID: I20240123004265 |
| Provider Name | Barbara Elizabeth Prosniewski |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1346626744 PECOS PAC ID: 9830613165 Enrollment ID: I20250408003456 |
Redwood Psychology Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19375 Hwy 116, Monte Rio, CA 95462 Phone: 707-865-1200 |