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Organization
VERICARE OF CALIFORNIA MEDICAL GROUP
Active
Organization
VERICARE OF CALIFORNIA MEDICAL GROUP
Active
Other names
Vericare
Organization subpart
No
Provider details
NPI number
Authorized official
BENNETT O VOIT (ASSISTANT SECRETARY)
(800) 257-8715
Entity
Organization
Contact information
Practice address
430 WILLOW ST, ALAMEDA, CA 94501-6130
(800) 257-8715
(800) 819-1655
Mailing address
4715 VIEWRIDGE AVE, STE 230, SAN DIEGO, CA 92123-1680
(800) 257-8715
(800) 819-1655
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC7816
RAILROAD MEDICARE
CA
05
—
GP5000150
—
CA
Enumeration date
05/19/2006
Last updated
02/26/2016
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