SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO (NPI# 1427362680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427362680 |
| Entity Type | Organization |
| Organization Name | SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO |
| Practice Address |
1111 Sonoma Ave Ste 322 Santa Rosa CA 95405-4819 |
| Practice Telephone | 7075463300 |
| Practice Fax Number | 4154573819 |
| Mailing Telephone | 7075463300 |
| Mailing Fax Number | 4154573819 |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2011-03-16 |
| Authorized Official Name | DR. EDGAR O ANGELONE (PRESIDENT) |
| Authorized Official Telephone | 7075463300 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY13957 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1111 SONOMA AVE STE 322 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558360479 | Patrick Devlin | Internal Medicine | 1111 Sonoma Ave, Suite 302, Santa Rosa, CA 95405-4819 | 2005-07-21 |
| 1700312493 | Tina Page Afifi | Hearing Instrument Specialist | 1111 Sonoma Ave, Ste 316, Santa Rosa, CA 95405-4819 | 2017-05-02 |
| 1770995748 | Northern California Medical Assoc Inc | Dermatology | 1111 Sonoma Ave, Ste 202, Santa Rosa, CA 95405-4819 | 2014-05-27 |
| 1508164948 | Bryan M. Pereira, M.d., P.C. | Neurological Surgery | 1111 Sonoma Ave, Suite # 320, Santa Rosa, CA 95405 | 2011-03-09 |
| 1952603284 | Barry Neil Silberg, M.d., Inc. | Plastic Surgery | 1111 Sonoma Ave, Suite 210, Santa Rosa, CA 95405-4819 | 2010-11-18 |
| 1609056878 | Jiries Peter Mogannam | Dentist | 1111 Sonoma Ave, Suite #220, Santa Rosa, CA 95405-4819 | 2007-11-05 |
| 1023205713 | Northern California Medical Assoc | Orthopaedic Surgery | 1111 Sonoma Ave, Ste 202, Santa Rosa, CA 95405-4813 | 2007-09-27 |
| 1154523447 | Santa Rosa Cardiac Imaging | Nuclear Medicine | 1111 Sonoma Ave, Suite 108, Santa Rosa, CA 95405-4819 | 2007-05-31 |
| 1225158884 | Patrick G Devlin Md A Medical Corporation | Specialist | 1111 Sonoma Ave, Suite 302, Santa Rosa, CA 95405-4819 | 2007-03-29 |
| 1083766331 | Drew Hittenberger and Associates | Orthotic Fitter | 1111 Sonoma Ave, Suite 106, Santa Rosa, CA 95405-4819 | 2007-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| 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 |
|---|---|---|---|---|
| 1134149289 | Richard P. Olcese | Clinical Neuropsychologist | 1260 N Dutton Ave, Suite 245, Santa Rosa, CA 95401-4659 | 2006-07-20 |
| 1568854727 | North Bay Neuropsychology A Psychology Corporation | Clinical Neuropsychologist | 1101 College Ave, Suite 250, Santa Rosa, CA 95404-3956 | 2015-02-25 |
| 1689093726 | Vergil Hobbs | Clinical Neuropsychologist | 1260 N Dutton Ave, Suite 225, Santa Rosa, CA 95401-4659 | 2014-04-15 |
| 1225349145 | Katie Jo Keridan | Clinical Neuropsychologist | 825 College Ave Ste 4, Santa Rosa, CA 95404-4108 | 2010-06-24 |
| 1215260591 | Jeremy Blank | Clinical Neuropsychologist | 2455 Bennett Valley Rd, Ste B208, Santa Rosa, CA 95404-5667 | 2009-09-17 |
| 1962652883 | Ellen O'toole | Clinical Neuropsychologist | 1101 College Ave, Suite 250, Santa Rosa, CA 95404-3956 | 2008-09-27 |
| 1487846069 | Sonoma Memory Clinic | Clinical Neuropsychologist | 401 S A St, Santa Rosa, CA 95401-8518 | 2007-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455108 | Chelsea Vilinskas | Clinical Neuropsychologist | 2624 Larkey Ln, Walnut Creek, CA 94597-2439 | 2020-10-22 |
| 1417554049 | Andrea Alioto | Clinical Neuropsychologist | 247 San Carlos Ave, Redwood City, CA 94061-3518 | 2020-10-06 |
| 1265045975 | Well Psychology, Inc. | Clinical Neuropsychologist | 3525 Del Mar Heights Rd # 1881, San Diego, CA 92130-2199 | 2020-08-24 |
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1437767399 | Ni Sun-suslow | Clinical Neuropsychologist | 220 Dickinson St # B, San Diego, CA 92103-2071 | 2020-07-16 |
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1649807058 | Nicholas S. Thaler Phd A Psychological Corporation | Clinical Neuropsychologist | 1526 14th St Ste 109, Santa Monica, CA 90404-3320 | 2020-03-25 |
| 1447890116 | Hussah Alkharafi | Clinical Neuropsychologist | 2720 Neilson Way # 5701, Santa Monica, CA 90405-4060 | 2020-01-10 |
| 1609414788 | Linda Rice | Clinical Neuropsychologist | 617 Bluegrass St, Simi Valley, CA 93065-5460 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO.
| 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.