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Organization

VERICARE OF CALIFORNIA MEDICAL GROUP

Active
Other names
Vericare
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT)
(800) 370-3652
Entity
Organization

Contact information

Practice address
3293 N DRINKWATER BLVD, SCOTTSDALE, AZ 85251-6405
(480) 947-7443
Mailing address
55 HATCHETTS HILL RD, OLD LTME, CT 06371-1534
(800) 370-3651
(877) 515-7147

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

Enumeration date
08/05/2007
Last updated
07/11/2017
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