Individual
AVA LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4001 HIGHWAY 104, IONE, CA 95640
(209) 274-4911
Mailing address
4001 HIGHWAY 104, IONE, CA 95640
(209) 274-4911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32161
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32161
PSYCHOLOGIST LICENSE
CA
Enumeration date
11/02/2020
Last updated
11/02/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us