MICHAEL A FRAGA


Address: 1717 W 2nd St, Roswell, NM 88201-2000
Phone: 5756231220

MICHAEL A FRAGA (NPI# 1518938315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518938315
Entity Type Individual
Full Name MICHAEL A FRAGA
Other Name MICHAEL A FRAGA
Credential PSY.D.
Practice Address 1717 W 2nd St
Roswell
NM 88201-2000
Mailing Address 3015 Mission Arch Dr
Roswell
NM 88201-8304
Practice Telephone 5756231220
Mailing Telephone 7074941303
Enumeration Date 2006-01-30
Last Update Date 2020-09-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 1041 NM Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1260 N Dutton Ave, Suite 225, Santa Rosa, CA 954014659 7074941303

Office Location

Street Address 1717 W 2ND ST
City ROSWELL
State NM
Zip Code 88201-2000

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1871733659 Gretta Dickman Massage Therapist 1717 W 2nd St, Suite 115, Roswell, NM 88201-2000 2009-03-06
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1316135957 Sleep Diagnostic Centers of New Clinic/Center 1717 W 2nd St, Suite 172, Roswell, NM 88201-2000 2007-10-09
1982826079 Prn Medical Family Medicine 1717 W 2nd St, Suite 115, Roswell, NM 88201-2000 2007-05-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902310022 Corey A Carter Specialist/Technologist, Other 117 E 19th Street, Roswell, NM 88201 2017-11-28
1326598541 Dove Medical Corporation Family Medicine 110 East 3rd Street, Roswell, NM 88201 2016-10-12
1841748381 Anali Velez Registered Nurse 300 N Kentucky, Roswell, NM 88201 2016-09-13
1831647379 Rebecca Palomino Registered Nurse 800 Marion Richards Rd, Roswell, NM 88201 2016-09-13
1215300926 Heart Path Oriental Medicine Clinic/Center 810 N Union, Roswell, NM 88201 2015-11-03
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1962815852 Marium Khan Internal Medicine 400 Military Heights Place, Roswell, NM 88201 2014-06-09
1316288913 Anaya Counseling Community/Behavioral Health 613 W 2nd St Ste 4, Roswell, NM 88201 2013-03-06
1205185386 Rosarita Brady Occupational Therapist 300 N. Kentucky, Roswell, NM 88201 2012-09-05
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861998197 Daniel B Charek Clinical Neuropsychologist 11685 Alpharetta Hwy Ste 170, Roswell, GA 30076 2018-04-04
1174739155 Logsdon Conradsen, LLC Clinical Neuropsychologist 515 E Crossville Rd, Suite 410, Roswell, GA 30075-3087 2007-05-15
1457472359 Damond J Logsdon Clinical Neuropsychologist 515 E Crossville Rd, Suite 420, Roswell, GA 30075-3087 2007-04-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326677220 Owen James Gaasedelen Clinical Neuropsychologist 2527 Wyoming Blvd Ne Ste A, Albuquerque, NM 87112-1039 2020-04-03
1720521859 Inetmed Rx2 Inc. Clinical Neuropsychologist 3655 Research Drive, Building A, Las Cruces, NM 88003-1239 2016-11-21
1326446881 Lynette M Abrams-silva Clinical Neuropsychologist 320 Gold Avenue Sw, Suite 1001, Albuquerque, NM 87102 2014-12-16
1437550415 Robert Brock Frost Clinical Neuropsychologist 3400 Constitution Ave Ne, Suite C, Albuquerque, NM 87106-1242 2014-09-10
1205237344 Eric H. Zimak Clinical Neuropsychologist Center for Neuropsychological Services, Msc 09 5030, 1 University of New Mexico, Albuquerque, NM 87131-0001 2014-09-09
1861824898 Sandia Neuropsychology LLC Clinical Neuropsychologist 3400 Constitution Ne, Albuquerque, NM 87106 2013-08-01
1881033231 Clinical, Forensic Neruopsychologist Associates of New Mexico Clinical Neuropsychologist 3228 Los Arboles Ave Ne, Bldg. 1-230, Albuquerque, NM 87107-1962 2013-06-19
1639433527 Stephanie Ann Gorman Clinical Neuropsychologist Center for Neuropsychological, Msc09 5030-1 Unm, Albuquerque, NM 87131-0001 2012-06-26
1508142019 Sharon Janice Kernen Clinical Neuropsychologist 9001 Galaxia Way Ne, Albuquerque, NM 87111-1440 2011-10-27
1780916130 High Plains Neuropsychology Associates PC Clinical Neuropsychologist 1101 Douglas Ave, Las Vegas, NM 87701-3932 2010-02-10
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Competitor

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City ROSWELL
Zip Code 88201

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Dataset Information

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.

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