| Therapeutic Alliance Professionals Llc | |
|
12631 Imperial Hwy Ste B117-10 Santa Fe Springs CA 90670-6727 | |
| (562) 287-8804 | |
| Not Available |
| Full Name | Therapeutic Alliance Professionals Llc |
|---|---|
| Speciality | Social Worker |
| Location | 12631 Imperial Hwy Ste B117-10, Santa Fe Springs, California |
| Authorized Official Name and Position | Isabella Vidriales (OWNER/ AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5624187299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Alliance Professionals Llc 12631 Imperial Hwy Ste B117-10 Santa Fe Springs CA 90670-6727 Ph: (562) 287-8804 | Therapeutic Alliance Professionals Llc 12631 Imperial Hwy Ste B117-10 Santa Fe Springs CA 90670-6727 Ph: (562) 287-8804 |
| NPI Number | 1528785615 |
|---|---|
| Provider Enumeration Date | 10/20/2022 |
| Last Update Date | 02/14/2023 |
| Certification Date | 02/14/2023 |
| Medicare PECOS PAC ID | 3274905120 |
|---|---|
| Medicare Enrollment ID | O20230202002021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528785615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Isabella Vidriales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750613782 PECOS PAC ID: 1052607272 Enrollment ID: I20230202002334 |
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