| Support For Your Life | |
|
701 High St Ste 227 Auburn CA 95603-4727 | |
| (530) 500-5885 | |
| (530) 500-4748 |
| Full Name | Support For Your Life |
|---|---|
| Speciality | Psychologist |
| Location | 701 High St Ste 227, Auburn, California |
| Authorized Official Name and Position | Kristin Lyn Kaminski-wadle (DIRECTOR) |
| Authorized Official Contact | 5305005885 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Support For Your Life 701 High St Ste 227 Auburn CA 95603-4727 Ph: (530) 500-5885 | Support For Your Life 701 High St Ste 227 Auburn CA 95603-4727 Ph: (530) 500-5885 |
| NPI Number | 1255034203 |
|---|---|
| Provider Enumeration Date | 03/27/2023 |
| Last Update Date | 03/27/2023 |
| Certification Date | 03/26/2023 |
| Medicare PECOS PAC ID | 9638518467 |
|---|---|
| Medicare Enrollment ID | O20240412002792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255034203 | NPI | - | NPPES |
| 1245779552 | Other | NPI |
| Provider Name | Kristin Lyn Kaminski-wadle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245779552 PECOS PAC ID: 2961736244 Enrollment ID: I20190619002788 |
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