DR. ROBERT PHIL PARK (NPI# 1053472605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053472605 |
| Entity Type | Individual |
| Full Name | DR. ROBERT PHIL PARK |
| Credential | PSY.D. |
| Practice Address |
1305 Tommydon St Stockton CA 95210-3364 |
| Practice Telephone | 2094765211 |
| Mailing Telephone | 2094765211 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY20153 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477639375 | Robert K Park | Dentist | 12374 Carmel Country Rd, #209, San Diego, CA 92130-4523 | 2006-10-31 |
| 1497701353 | Robert Park | Optometrist | 3385 Woodward Crossing Blvd, Suite 350, Buford, GA 30519-4947 | 2006-05-25 |
| 1083617633 | Robert Park | Obstetrics & Gynecology | 2177 Marylwood Ct, West Linn, OR 97068-1434 | 2005-05-27 |
| 1326525866 | Robert W Park | Counselor | 5757 Woodway Dr Ste 110, Houston, TX 77057-1506 | 2018-07-27 |
| 1871957597 | Robert Y. Park | Student in an Organized Health Care Education/Training Program | 833 Chestnut St, Suite 220, Philadelphia, PA 19107-4414 | 2016-04-08 |
| 1457680407 | Robert Eoin Park | Internal Medicine | 3400 Spruce St, 210 White, Philadelphia, PA 19104-4206 | 2009-12-21 |
| 1578749610 | Robert Park | Dentist | 4220 W 3rd St, Ste 202, Los Angeles, CA 90020-3450 | 2008-01-19 |
| 1063611747 | Robert D Park | Dentist | 9727 Greenside Dr, Cockeysville, MD 21030-5030 | 2007-07-13 |
| 1255471579 | Robert E Park | Chiropractor | 174 W Parrish Ln, Centerville, UT 84014-1821 | 2007-02-07 |
| 1942371851 | Robert J. Park | Internal Medicine | 441 N Lakeview Ave, Anaheim, CA 92807-3028 | 2006-11-13 |
| Street Address |
1305 TOMMYDON ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891795076 | Alice Park | Psychiatry & Neurology | 1305 Tommydon St, Stockton, CA 95210-3364 | 2005-07-28 |
| 1699108076 | Brooke G Vierra | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2013-08-20 |
| 1780956136 | Amanda Lyn Ashworth | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2012-02-01 |
| 1225315401 | Colleen A Weyrens | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2011-11-15 |
| 1639359318 | Natalie Nacole Vides-boelke | Social Worker | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-11-09 |
| 1679763510 | Mitsuaki Kayne Ohata | Psychologist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-07-26 |
| 1679770895 | Uzma Nazir | Social Worker | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-06-29 |
| 1114131737 | Thu Dan Thi Pham | Psychologist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-05-10 |
| 1265552095 | Ceferina Rose Garcia | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-03-29 |
| 1114068731 | Linda Liem | Social Worker | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811352628 | Stephen Gutknecht | Psychologist | 3755 W Benjamin Holt Dr Apt 163, Stockton, CA 95219-3313 | 2015-12-21 |
| 1518277433 | Maria Elisabet Revilla | Psychologist | 1350 W Robinhood Dr Ste 18, Stockton, CA 95207-5519 | 2010-10-13 |
| 1184869356 | Frederick Arthur Martin | Psychologist | 1232 Mill Way, Stockton, CA 95209-4368 | 2008-12-02 |
| 1720108335 | Crystal Rose Krull | Psychologist | 1117 S Grant St, Stockton, CA 95206-1626 | 2007-03-29 |
| 1316003759 | Cheryl Thornton | Psychologist | 808 South St, Stockton, MO 65785 | 2006-12-29 |
| 1851493639 | Victor Manuel Zapien | Psychologist | 1743 Grand Canal Blvd Suite #16, Stockton, CA 95207 | 2006-09-02 |
| 1720021975 | Floyd Joseph O'brien | Psychologist | 33 W Alder St, Stockton, CA 95204-5701 | 2006-06-14 |
| 1306336888 | Debra Ann Robertson | Psychologist | 7707 Austin Rd, Stockton, CA 95215-8312 | 2018-05-10 |
| 1992175863 | Ronnie Doss | Psychologist | 7707 Austin Rd, Stockton, CA 95215-8312 | 2015-10-04 |
| 1528450459 | Jennifer Crews Thom | Psychologist | 7373 West Ln, Stockton, CA 95210-3377 | 2015-03-02 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.