MOMENTUM FOR MENTAL HEALTH - A.S.S.I.S.T. SOLANO OUTPATIENT (NPI# 1336367010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336367010 |
| Entity Type | Organization |
| Organization Name | MOMENTUM FOR MENTAL HEALTH - A.S.S.I.S.T. SOLANO OUTPATIENT |
| Practice Address |
1935 Kidder Ave Fairfield CA 94533-3919 |
| Mailing Address |
2001 The Alameda San Jose CA 95126-1136 |
| Practice Telephone | 7074252741 |
| Practice Fax Number | 7074252862 |
| Mailing Telephone | 4082617777 |
| Mailing Fax Number | 4085549960 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2008-08-06 |
| Authorized Official Name | JOHN S. SMELSER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4082617777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 48AS | 05 |
| Street Address |
1935 KIDDER AVE |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-3919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| 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 |
|---|---|---|---|---|
| 1912543695 | Dr. Mae J. Balaban & Associates LLC | Psychologist | 333 A U.S. Highway 46 W Ste 260, Fairfield, NJ 07004 | 2019-11-18 |
| 1023579265 | Jennifer Rachel Pleasure | Psychologist | 1492 Unquowa Rd, Fairfield, CT 06824-4950 | 2019-03-29 |
| 1306296454 | Neeru Madan | Psychologist | 1125 Missouri St Ste 205, Fairfield, CA 94533-6000 | 2016-06-20 |
| 1063882025 | Matthew Love | Psychologist | 140 Sherman St Fl 5, Fairfield, CT 06824-5849 | 2015-10-03 |
| 1609266014 | Janet Walker | Psychologist | 35 S Benson Cmns, Fairfield, CT 06824-6239 | 2015-01-23 |
| 1013305788 | Cheryl Lykins | Psychologist | 255 Donald Dr, Fairfield, OH 45014-3006 | 2015-01-05 |
| 1922496694 | Molly Mcneil | Psychologist | 5058 Dixie Hwy, Fairfield, OH 45014-2934 | 2015-01-05 |
| 1255766861 | Grace Kiriakos | Psychologist | 604 Empire St Fl 1, Fairfield, CA 94533-5527 | 2013-09-13 |
| 1528366689 | Michael J. Weiss | Psychologist | 333 Bennett St, Fairfield, CT 06825-1375 | 2011-03-14 |
| 1740326586 | Joseph Plasner | Psychologist | 333 A V.s. Highway 46 W Ste 260, Fairfield, NJ 07004 | 2007-01-29 |
| Find all providers in FAIRFIELD | ||||
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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.