DR. BOBBY N HOLSTEAD (NPI# 1487735965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487735965 |
| Entity Type | Individual |
| Full Name | DR. BOBBY N HOLSTEAD |
| Credential | PH.D. |
| Practice Address |
27th Medical Group 224 W D.l. Ingram Ave Cannon Afb NM 88101-5103 |
| Mailing Address |
27th Medical Group/sghc 224 W D.l. Ingram Ave Cannon Afb NM 88101-5103 |
| Practice Telephone | 5759043917 |
| Practice Fax Number | 5757846028 |
| Mailing Telephone | 5759043917 |
| Mailing Fax Number | 5757846028 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2019-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 214 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | PRESBYTERIAN HEALTH PLAN | 201004465 | 01 |
| NM | N6176 | 05 | |
| NM | BC/BS OF NM | 00NM00N890 | 01 |
| Street Address |
27TH MEDICAL GROUP 224 W D.L. INGRAM AVE |
| City | CANNON AFB |
| State | NM |
| Zip Code | 88101-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821076829 | Neil M Horner | Optometrist | 27th Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88101-5103 | 2006-01-09 |
| 1235693151 | Marvin D Cox | Social Worker | 27th Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2019-01-24 |
| 1043693104 | Kimberly Baker | Family Medicine | 27th Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2015-07-07 |
| 1770998775 | Riyadh Zihraw Al-jammaly | Psychiatry & Neurology | 27th Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2014-06-27 |
| 1588938534 | Joshua M Hall | Pharmacist | 27th Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2012-03-07 |
| 1629045091 | Becky L Kaime | Pharmacist | 27th Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 1285274878 | Keishla Cota | Physical Therapist | 100 East Manana Blvd, Unit 1, Clovis, NM 88101 | 2020-01-10 |
| 1659927283 | Ndeye Ndour | Nurse Anesthetist, Certified Registered | 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 | 2019-08-09 |
| 1679132468 | Justine Nicole Nunez | Nurse Practitioner | 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 | 2019-06-06 |
| 1518453521 | Moore Psychological Services, Pllc | Social Worker | 1908 West 21st Street, Clovis, NM 88101 | 2018-07-03 |
| 1912494006 | Raesha Russell | Behavior Technician | 214 West 9th St, Clovis, NM 88101 | 2018-04-16 |
| 1013425800 | Vanessa Yardley | Registered Nurse | 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 | 2018-01-16 |
| 1699204230 | Olivia Garcia | Technician, Other | 1100 W 21st Street, Clovis, NM 88101 | 2017-06-07 |
| 1578006250 | Mary Ellen Gray | Technician, Other | 9408 B Vermont Court, Clovis, NM 88101 | 2016-11-29 |
| 1205296977 | Malaney Harmon | Behavioral Analyst | 2700 E 7th St., Clovis, NM 88101 | 2016-02-24 |
| Find all providers in zip 88101 | ||||
| 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 |
|---|---|---|---|---|
| 1477577641 | June Ellen Shepherd | Psychologist | Mental Health Clinic, 27 Th Special Operations Group, 208 Casablanca, Cannon Afb, NM 88103-5014 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366042814 | Barbara Gormley | Psychologist | 501 N Roadrunner Pkwy Apt 1901, Las Cruces, NM 88011-2023 | 2020-10-26 |
| 1124637541 | Behavioral Medicine and Assessment of New Mexico LLC | Psychologist | 3520 Calle Cuervo Nw, Albuquerque, NM 87114-9220 | 2020-07-31 |
| 1932732351 | Leslie Ann Becerra | Psychologist | 110 Sheep Springs Ways, Jemez Pueblo, NM 87024-0279 | 2020-02-13 |
| 1891341996 | Chelsea Spraberry | Psychologist | 2600 College Blvd, 2nd Floor, Rio Rancho, NM 87144 | 2019-08-14 |
| 1194287649 | Jennifer Nicole Crawford | Psychologist | Msc09 5030 1 Unm, Albuquerque, NM 87131 | 2019-04-03 |
| 1417425083 | Meredith Lynn Faith | Psychologist | 11109 Elvin Ave Ne, Albuquerque, NM 87112-3231 | 2018-11-12 |
| 1942777982 | Nesha Morse Psyd Inc | Psychologist | 1010 Marquez Pl Ste D2, Santa Fe, NM 87505-1724 | 2018-10-29 |
| 1003341975 | Corey J Vas | Psychologist | 741 N Alameda Blvd Ste 6, Las Cruces, NM 88005-2172 | 2017-04-27 |
| 1194190181 | Hugh J. Hammant | Psychologist | 1307 Arnold Palmer Ct, Las Cruces, NM 88011-3902 | 2015-12-02 |
| 1255703401 | Stacey Goldstein-dwyer | Psychologist | 661 Quantum Rd Ne Ste 8, Rio Rancho, NM 87124-4505 | 2015-10-28 |
| Find all providers with the same taxonomy | ||||
| City | CANNON AFB |
| Zip Code | 88101 |
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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.