Provider Information for 1376950055
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CALLIE MCKENZIE LMFT
Sex: Female
NPI: 1376950055
Last Updated: 2020-05-08
Certification Date: 2020-05-08
Certification Date: 2020-05-08
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376950055 | ||||||||
| Enumeration Date | 2014-07-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 311 FOREST AVE PACIFIC GROVE, CA 93950-3367 United States Phone: 707-684-9900 | Fax: | ||||||||
| Primary Practice Address | 311 FOREST AVE PACIFIC GROVE, CA 93950-3367 United States Phone: 707-684-9900 | Fax: | ||||||||
| Secondary Practice Address(es) | 130 W GABILAN ST | ||||||||
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