DR. VICTORIA PEZZULLO TATE (NPI# 1427124825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427124825 |
| Entity Type | Individual |
| Full Name | DR. VICTORIA PEZZULLO TATE |
| Credential | PSYD, LCP |
| Practice Address |
420 Third St Ne Charlottesville VA 22901 |
| Mailing Address |
17 Muirfield Green Ln Midlothian VA 23112-4517 |
| Practice Telephone | 8045197191 |
| Practice Fax Number | 8047442101 |
| Mailing Telephone | 8045197191 |
| Mailing Fax Number | 8047442101 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2012-07-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 0810003679 | VA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 269349 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942680426 | Victoria Vanessa Tate | Surgery | 701 Grove Rd, 3rd Floor Support Tower, Greenville, SC 29605-4210 | 2015-06-01 |
| 1174878318 | Victoria Tate | Counselor | 6160 Mission Gorge Rd, San Diego, CA 92120-3410 | 2012-07-13 |
| 1801998539 | Victoria Tate | Counselor | 124 Mallard Street, Gmhc, Greenville, SC 29601-4046 | 2006-09-02 |
| Street Address |
420 THIRD ST NE |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641501 | John Mccord | Speech-Language Pathologist | English Meadows, 1220 Crozet Ave, Crozet, VA 22901 | 2020-05-20 |
| 1922566017 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 27 Discovery Dr, Bluffton, SC 22901 | 2019-03-07 |
| 1477011872 | Courtney Dyan Bonilla | Counselor | 633 Berkmar Circle, Charlottesville, VA 22901 | 2019-03-05 |
| 1558855346 | Dana Scott | Counselor | 696 Berkmar Cir Ste 3b, Charlottesville, VA 22901 | 2018-06-15 |
| 1043725336 | M Clinic, LLC | Internal Medicine | 406 Albemarle Square, Charlottesville, VA 22901 | 2017-12-08 |
| 1033620380 | Cheryl K Cottrell | Counselor | 875 East Rio Court, Charlottesville, VA 22901 | 2017-10-13 |
| 1114389640 | Heather Lorin Broach | Physical Therapist | 2331 Seminole Ln Ste 103, Charlottesville, VA 22901 | 2016-03-23 |
| 1649669904 | Costco Wholesale Corporation | Pharmacy | 3171 District Ave, Charlottesville, VA 22901 | 2015-01-09 |
| 1083988778 | Melissa Stanley | Nurse Practitioner | 1356 River Rd, Charlottesville, VA 22901 | 2012-02-28 |
| 1982977633 | Jea Catherine Brickwedde | Specialist | 716 Rio Rd W, Fa, Charlottesville, VA 22901 | 2012-02-10 |
| Find all providers in zip 22901 | ||||
| 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 |
|---|---|---|---|---|
| 1821396920 | James Forrest Sanders | Clinical Neuropsychologist | 1960 Lewis Mountain Rd, Unit 1, Charlottesville, VA 22903-2463 | 2011-03-14 |
| 1700825239 | Matthew Williams Bowen | Clinical Neuropsychologist | 6 Old Farm Rd, Charlottesville, VA 22903-4722 | 2006-06-06 |
| 1326009242 | Katherine L Willis | Clinical Neuropsychologist | 313 Steephill St, Charlottesville, VA 22902-5853 | 2006-03-30 |
| 1063918530 | Stephanie L Lenox | Clinical Neuropsychologist | 1215 Lee St, Charlottesville, VA 22908-0816 | 2018-04-03 |
| 1285000315 | Joyce Suh | Clinical Neuropsychologist | 1221 Lee St, Charlottesville, VA 22908-1534 | 2015-08-12 |
| 1063811487 | Laurie Brenner | Clinical Neuropsychologist | 1221 Lee St, Charlottesville, VA 22908-0001 | 2014-08-21 |
| 1962794685 | Lauren Ashley Chandler | Clinical Neuropsychologist | 1215 Lee St, Box 800394, Charlottesville, VA 22908-0816 | 2011-05-13 |
| 1790819910 | Donna K. Broshek | Clinical Neuropsychologist | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2007-03-16 |
| 1992839534 | Jeffrey T. Barth | Clinical Neuropsychologist | Uva Hospital W, Hospital Drive, 3rd Floor, Charlottesville, VA 22908-0001 | 2007-03-15 |
| 1174692792 | Kathleen L. Fuchs | Clinical Neuropsychologist | 1221 Lee St, Charlottesville, VA 22908-0001 | 2006-11-07 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22901 |
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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.