DENNIS J STAKER (NPI# 1255352878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255352878 |
Entity Type | Individual |
Full Name | DENNIS J STAKER |
Credential | PHD |
Practice Address |
5030 Harrison Blvd Ogden UT 84403-4311 |
Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
Practice Telephone | 8013875620 |
Mailing Telephone | 8013875620 |
Enumeration Date | 2006-07-21 |
Last Update Date | 2012-12-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 49444202501 | UT | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | 49444202501 | UT | Behavioral Health & Social Service Providers |
Street Address |
5030 HARRISON BLVD |
City | OGDEN |
State | UT |
Zip Code | 84403-4311 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588660773 | Lee W Bradshaw | Clinical Nurse Specialist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2005-06-22 |
1437400447 | Jonathan Ahern | Psychologist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2012-10-01 |
1497039523 | Tyson John Miller | Social Worker | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2011-10-07 |
1598052375 | Sarah Hoffman | Nurse Practitioner | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2011-06-30 |
1760788160 | Bart Steven Sanders | Nurse Practitioner | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2011-02-01 |
1346568318 | Julie Goudie-nice | Psychologist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2010-05-14 |
1497990550 | Gary V Broadbent | Social Worker | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2008-12-03 |
1831346170 | Bryan B Bushman | Psychologist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2008-08-19 |
1720264369 | Marie Woodfield | Nurse Practitioner | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2008-01-14 |
1376731083 | Craig French | Social Worker | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2007-10-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
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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 |
---|---|---|---|---|
1730301474 | Beverly O'connor | Clinical Neuropsychologist | 533 26th St, Suite 100, Ogden, UT 84401-2465 | 2007-05-03 |
1063627388 | Brain Behavior Associates, P.C. | Clinical Neuropsychologist | 533 26th St, Suite 100, Ogden, UT 84401-2465 | 2007-05-11 |
1518048917 | Gregory L. Mayer | Clinical Neuropsychologist | 4699 Harrison Blvd, Suite 300, Ogden, UT 84403-4396 | 2006-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780215269 | Reboot Centers Hobble Creek | Clinical Neuropsychologist | 1154 Left Fork Hobble Creek Canyon Rd, Springville, UT 84663 | 2020-02-03 |
1497254304 | Ctr Supports | Clinical Neuropsychologist | 10182 S Campden Ct, South Jordan, UT 84009-7109 | 2018-02-06 |
1770954356 | Erin Elizabeth Krauskopf | Clinical Neuropsychologist | 231 E 400 S Ste 335, Salt Lake City, UT 84111-2806 | 2015-10-08 |
1528469947 | Jordan Harris Rigby | Clinical Neuropsychologist | 230 S 500 E Ste 100, Salt Lake City, UT 84102-2048 | 2014-09-05 |
1366719601 | Joann T. Tschanz | Clinical Neuropsychologist | 2810 Old Main Hill, Utah State University, Logan, UT 84322-2810 | 2011-11-30 |
1649567728 | Grace Macdowell | Clinical Neuropsychologist | 11762 S State St Ste 160, Draper, UT 84020-7174 | 2011-07-08 |
1215239348 | Jon Leroy Pertab | Clinical Neuropsychologist | 5171 South Cottonwood St Suite 810, Neurosciences Institute, Murray, UT 84107 | 2010-11-22 |
1619287208 | Lisa Michelle Sugerman | Clinical Neuropsychologist | 389 W 10000 S Ste A, South Jordan, UT 84095-4104 | 2010-10-15 |
1154565729 | Keith Mcgoldrick | Clinical Neuropsychologist | 1733 S 1100 E Ste 102, Salt Lake City, UT 84105-3482 | 2009-04-27 |
1356593297 | Dustin Bradshaw Hammers | Clinical Neuropsychologist | 650 Komas Dr Ste 106a, Salt Lake City, UT 84108-1225 | 2008-10-22 |
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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.