MEDICARE: INCLUSIVE HEALTH PSYCHOLOGY, A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	103TA0700X	Adult Development & Aging Psychologist
3	103TF0000X	Family Psychologist
4	103TH0004X	Health Psychologist
5	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1740023274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCLUSIVE HEALTH PSYCHOLOGY, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	3790 EL CAMINO REAL # 1258
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-3314
Country	:	US
Telephone Number	:	650-468-0585
Fax Number	:

Provider Business Practice Location Address
First Line	:	3790 EL CAMINO REAL # 1258
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-3314
Country	:	US
Telephone Number	:	650-468-0585
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. NINA SINGH
Credential	:	PHD
Telephone Number	:	650-468-0585

Provider Enumeration Date	:	06/13/2024
Last Update Date	:	06/14/2024

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