| Susan L Holley Phd, A Psychological Corporation | |
|
798 Tucker Rd Ste 1 Tehachapi CA 93561-2503 | |
| (661) 206-8108 | |
| (661) 821-9752 |
| Full Name | Susan L Holley Phd, A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 798 Tucker Rd Ste 1, Tehachapi, California |
| Authorized Official Name and Position | Susan Louise Holley (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6612068108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan L Holley Phd, A Psychological Corporation 798 Tucker Rd Ste 1 Tehachapi CA 93561-2503 Ph: (661) 206-8108 | Susan L Holley Phd, A Psychological Corporation 798 Tucker Rd Ste 1 Tehachapi CA 93561-2503 Ph: (661) 206-8108 |
| NPI Number | 1598955239 |
|---|---|
| Provider Enumeration Date | 07/30/2007 |
| Last Update Date | 05/01/2024 |
| Certification Date | 05/01/2024 |
| Medicare PECOS PAC ID | 4688752462 |
|---|---|
| Medicare Enrollment ID | O20080418000342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598955239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan L Holley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124056270 PECOS PAC ID: 8325126105 Enrollment ID: I20080418000335 |
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