| State University Of Iowa | |
|
500 Blank Honors Ctr Iowa City IA 52242-0454 | |
| (319) 467-4526 | |
| (319) 467-0431 |
| Full Name | State University Of Iowa |
|---|---|
| Speciality | Psychologist |
| Location | 500 Blank Honors Ctr, Iowa City, Iowa |
| Authorized Official Name and Position | Alissa Doobay (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 3193352894 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| State University Of Iowa 500 Blank Honors Ctr Iowa City IA 52242-0454 Ph: (319) 467-4526 | State University Of Iowa 500 Blank Honors Ctr Iowa City IA 52242-0454 Ph: (319) 467-4526 |
| NPI Number | 1073254181 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 08/27/2025 |
| Certification Date | 08/27/2025 |
| Medicare PECOS PAC ID | 7618884230 |
|---|---|
| Medicare Enrollment ID | O20250610001927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073254181 | NPI | - | NPPES |
| Provider Name | Jamie L Elizalde |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104171511 PECOS PAC ID: 3779701099 Enrollment ID: I20140828001777 |
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