MICHELLE CHAN (NPI# 1114405784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114405784 |
| Entity Type | Individual |
| Full Name | MICHELLE CHAN |
| Credential | PH.D. |
| Practice Address |
4860 Y St Ste 3700 Sacramento CA 95817-2307 |
| Practice Telephone | 9167035019 |
| Mailing Telephone | 9167035019 |
| Enumeration Date | 2018-08-05 |
| Last Update Date | 2018-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 30237 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710503305 | Michelle Mong Chan | Specialist | 5250 S Rainbow Blvd Unit 1138, Las Vegas, NV 89118-0630 | 2020-06-19 |
| 1043326283 | Michelle L. Chan | Internal Medicine | 1726 New Ave, San Gabriel, CA 91776-3734 | 2006-08-21 |
| 1285113324 | Michelle Chan | Optometrist | 2400 N Druid Hills Rd Ne, Atlanta, GA 30329-3211 | 2018-08-09 |
| 1194241943 | Michelle Chan | Pharmacist | 1275 York Ave, New York, NY 10065-6007 | 2017-08-14 |
| 1679004907 | Michelle Chan | Student in an Organized Health Care Education/Training Program | 110 Francis St Ste Gb, Boston, MA 02215-5563 | 2017-03-27 |
| 1154795375 | Michelle Chan | Pharmacist | 2677 Clayton Rd, Concord, CA 94519-2724 | 2015-11-26 |
| 1154707727 | Michelle Chan | Dentist | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2015-08-06 |
| 1750784252 | Michelle Chan | Occupational Therapist | 3731 6th Ave, 103, San Diego, CA 92103-4383 | 2014-09-29 |
| 1154731222 | Michelle Chan | Emergency Medicine | 1504 Taub Loop, Emergency Center, Houston, TX 77030-1608 | 2014-04-29 |
| 1508152893 | Michelle Chan | Emergency Medicine | 5731 Bee Ridge Rd, Sarasota, FL 34233-5056 | 2011-06-24 |
| Street Address |
4860 Y ST STE 3700 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95817-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629052220 | Fredric Austin Gorin | Psychiatry & Neurology | 4860 Y St Ste 3700, Dept of Neurology Uc Davis Medical Center, Sacramento, CA 95817-2307 | 2005-12-06 |
| 1720583909 | Michael Miller Chang | Student in an Organized Health Care Education/Training Program | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2018-03-28 |
| 1205213063 | Yasmine Gharbaoui | Student in an Organized Health Care Education/Training Program | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2015-04-30 |
| 1558758755 | Kristina Hart | Psychiatry & Neurology | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2015-04-25 |
| 1346643145 | Lisa Marie Mooney | Social Worker | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2014-10-07 |
| 1225370059 | Kevin James Keenan | Psychiatry & Neurology | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2013-03-19 |
| 1629332671 | Shweta Teckchandani | Psychiatry & Neurology | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2012-06-25 |
| 1326307042 | Ajay Sampat | Psychiatry & Neurology | 4860 Y St Ste 3700, Sacramento, CA 95817 | 2012-05-15 |
| 1477840734 | Shannon Nicole Liang | Psychiatry & Neurology | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2011-07-06 |
| 1295909331 | Palak D Parikh | Psychiatry & Neurology | 4860 Y St Ste 3700, Sacramento, CA 95817-2307 | 2008-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855103 | Quintin Kuse | Student in an Organized Health Care Education/Training Program | 4610 X Street, Sacramento, Sacramento, CA 95817 | 2020-09-09 |
| 1285259283 | Uc Davis Health | Dietitian, Registered | 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 | 2020-06-15 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1467010728 | Jiunn Liang Jonathan Yap | Student in an Organized Health Care Education/Training Program | 4860 Y Str, Ste. 2820, Sacramento, CA 95817 | 2019-06-03 |
| 1083176614 | Kevin Lee | Student in an Organized Health Care Education/Training Program | 2315 Stockton Blvd, Op512, Sacramento, CA 95817 | 2019-04-02 |
| 1508326703 | Ritika Johal | Student in an Organized Health Care Education/Training Program | 4150 V Street, Pssb 1200, Sacramento, CA 95817 | 2019-03-22 |
| 1811468838 | Paige Palsgaard | Behavior Technician | 6730 4th Ave Apt 1731d, Sacramento, CA 95817 | 2018-12-17 |
| 1922503408 | Marie Rossi | Student in an Organized Health Care Education/Training Program | 4150 V Street #1100, Sacramento, CA 95817 | 2018-03-27 |
| 1639673791 | Sean Lam | Student in an Organized Health Care Education/Training Program | 4150 V Street #1200, Sacramento, CA 95817 | 2018-03-22 |
| 1124555388 | Tatyana Polyak | Surgery | 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 | 2017-05-18 |
| Find all providers in zip 95817 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1396058780 | Lenore A Tate | Clinical Neuropsychologist | 2030 W El Camino Ave Ste 200, Sacramento, CA 95833-1867 | 2010-07-14 |
| 1588816391 | Maria Moleski | Clinical Neuropsychologist | 2631 Phyllis Ave, Sacramento, CA 95820-4642 | 2008-10-13 |
| 1659530129 | Glenn Alan Hammel | Clinical Neuropsychologist | 1061 Sagamore Way, Sacramento, CA 95822-1714 | 2008-06-09 |
| 1710150685 | John J. Wicks | Clinical Neuropsychologist | 2128 V St, Sacramento, CA 95818-1732 | 2008-04-10 |
| 1003029471 | Lawrence Manley Wilcox | Clinical Neuropsychologist | 1421 P St., #16, Sacramento, CA 95814-5921 | 2007-05-08 |
| 1649326810 | Grant L. Hutchinson | Clinical Neuropsychologist | 730 Alhambra Blvd, Suite 205, Sacramento, CA 95816-3847 | 2007-01-28 |
| 1700934247 | Nancy Bell Mahaney | Clinical Neuropsychologist | 1555 River Park Dr, Suite 205, Sacramento, CA 95815-4612 | 2007-01-08 |
| 1093874133 | Catherine Elise Broomand | Clinical Neuropsychologist | 2345 Fair Oaks Blvd # 14, Sacramento, CA 95825-4708 | 2006-12-06 |
| 1962598284 | June Paltzer | Clinical Neuropsychologist | 1329 Howe Avenue, Suite 201, Sacramento, CA 95825-3363 | 2006-10-05 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95817 |
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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.