| Trauma Recovery, Inc | |
|
18917 Nordhoff St Ste 18 Northridge CA 91324 | |
| (818) 397-1260 | |
| (818) 341-3806 |
| Full Name | Trauma Recovery, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 18917 Nordhoff St Ste 18, Northridge, California |
| Authorized Official Name and Position | Beverly Carol Rivera (CLINICAL PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 8183413805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma Recovery, Inc 18917 Nordhoff St Ste 18 Northridge CA 91324-4823 Ph: (818) 397-1260 | Trauma Recovery, Inc 18917 Nordhoff St Ste 18 Northridge CA 91324 Ph: (818) 397-1260 |
| NPI Number | 1336383850 |
|---|---|
| Provider Enumeration Date | 04/28/2009 |
| Last Update Date | 06/05/2018 |
| Medicare PECOS PAC ID | 5193876332 |
|---|---|
| Medicare Enrollment ID | O20090629000118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336383850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Beverly C Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639382815 PECOS PAC ID: 8921108036 Enrollment ID: I20070702000615 |
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