SAMUEL PARK (NPI# 1578738522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578738522 |
| Entity Type | Individual |
| Full Name | SAMUEL PARK |
| Credential | PHD |
| Practice Address |
9500 Gilman Drive Mc 0304 La Jolla CA 92093-0304 |
| Practice Telephone | 8585343755 |
| Practice Fax Number | 8585342628 |
| Mailing Telephone | 8585343755 |
| Mailing Fax Number | 8585342628 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY16648 | CA | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
PSY16648 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922363183 | Samuel Park | Preventive Medicine | 2448 Historic Decatur Rd Ste 130, San Diego, CA 92106-6127 | 2012-07-12 |
| 1053607952 | Samuel Joon Park | Internal Medicine | 160 1st St Unit 551, Mineola, NY 11501-5025 | 2011-06-20 |
| 1851504377 | Samuel Sanghong Park | Orthopaedic Surgery | 12 Salt Creek Ln Ste 350, Hinsdale, IL 60521-8612 | 2007-05-08 |
| 1023174752 | Samuel Ryan Park | Anesthesiology | 22 Odyssey Ste 155, Irvine, CA 92618-3194 | 2006-12-28 |
| 1497832661 | Samuel K. Park | Family Medicine | 20072 Sw Birch St Ste 100, Newport Beach, CA 92660-0794 | 2006-11-01 |
| 1740285907 | Samuel Mo Park | Physical Medicine & Rehabilitation | 340 W East Ave, Chico, CA 95926-7238 | 2005-06-15 |
| 1124551239 | Samuel Park | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific St, Bb-1469, Seattle, WA 98195-0001 | 2017-04-05 |
| 1154853836 | Samuel Park | Physical Therapist | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2017-03-31 |
| 1790237899 | Samuel Park | Student in an Organized Health Care Education/Training Program | 3580 Wilshire Blvd Fl 8, Los Angeles, CA 90010-2505 | 2016-10-25 |
| 1295187136 | Samuel Park IIi | Physical Medicine & Rehabilitation | 1240 Mckee Rd, Dover, DE 19904-1381 | 2016-07-03 |
| Street Address |
9500 GILMAN DRIVE MC 0304 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92093-0304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154312775 | Ucsd Med-cytogenetics | Clinical Medical Laboratory | 9500 Gilman Drive, Mail Code 0639, La Jolla, CA 92093-0639 | 2005-11-02 |
| 1487179248 | Christopher Migdal | Student in an Organized Health Care Education/Training Program | 9500 Gilman Drive, #0851, La Jolla, CA 92093 | 2017-08-13 |
| 1114459252 | Tiffany Alexis Castillo | Psychiatry & Neurology | 9500 Gilman Drive, Mc #9116a, La Jolla, CA 92093 | 2017-03-29 |
| 1285097188 | Allison Marie Pastor | Specialist/Technologist | 9500 Gilman Drive, La Jolla, CA 92093 | 2016-03-30 |
| 1346522141 | Monica Guma | Internal Medicine | 9500 Gilman Drive, La Jolla, CA 92093 | 2011-09-16 |
| 1174778500 | Theodore Friedmann | General Acute Care Hospital | 9500 Gilman Drive, La Jolla, CA 92093-0634 | 2008-11-26 |
| 1104073782 | Kenneth Quinto | Internal Medicine | 9500 Gilman Drive, La Jolla, CA 92093-0635 | 2008-08-26 |
| 1598931552 | Rina Schul | Psychologist | 9500 Gilman Drive, Ucsd Psychological and Counseling Services, La Jolla, CA 92093-0304 | 2008-04-30 |
| 1467627570 | Christina Danielle Lambert | Psychologist | 9500 Gilman Drive, #0304, La Jolla, CA 92093-0304 | 2008-04-29 |
| 1629243670 | Tiffany Omeara | Psychologist | 9500 Gilman Drive, #0304, La Jolla, CA 92093-0304 | 2008-04-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902442908 | Forrest N Ridgway | Pharmacist | 3855 Health Sciences Drive #0845, La Jolla, CA 92093 | 2019-11-25 |
| 1578060067 | Michelle Sloan | Student in an Organized Health Care Education/Training Program | 9500 Gilman Dr #0851, La Jolla, CA 92093 | 2018-04-10 |
| 1114372471 | Kevin Ting | Internal Medicine | 9500 Gilman Dr # Mc7411, La Jolla, CA 92093 | 2016-04-24 |
| 1225490147 | Karen Tye | Student in an Organized Health Care Education/Training Program | 3960 Health Sciences Drive, La Jolla, CA 92093 | 2016-03-22 |
| 1457716615 | Christine Pulido | Student in an Organized Health Care Education/Training Program | 9500 Gilman Drive #0851, La Jolla, CA 92093 | 2015-12-15 |
| 1467830489 | Justin Arshed Shaya | Internal Medicine | 3855 Health Sciences Dr #0829, La Jolla, CA 92093 | 2015-05-11 |
| 1225425606 | Brad Hiroshi Kimura | Internal Medicine | 9500 Gilman Dr # Mc9111g, La Jolla, CA 92093 | 2015-04-23 |
| 1407241169 | Courtney Holmes Mckee | Emergency Medicine | 3855 Health Sciences Drive Mc0987, La Jolla, CA 92093 | 2015-03-31 |
| 1528488350 | Arlene Bravo | General Practice | 9500 Gilman Dr # Mc0656, La Jolla, CA 92093 | 2014-04-19 |
| 1710237391 | Chaitanya Pabbati | Psychiatry & Neurology | 9500 Gillman Drive #9116a, La Jolla, CA 92093 | 2012-09-11 |
| Find all providers in zip 92093 | ||||
| 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 |
|---|---|---|---|---|
| 1700496080 | Jeffry Clary Warren | Psychologist | 1224 Prospect St Ste 100, La Jolla, CA 92037-3609 | 2020-08-03 |
| 1730711433 | Maria Alejandra Infante | Psychologist | Ucsd 9500 Gilman Drive Mc 0405, La Jolla, CA 92093-0001 | 2020-02-10 |
| 1669015855 | Jodi Tompkins | Psychologist | 836 Prospect St Ste 101, La Jolla, CA 92037-4213 | 2019-10-21 |
| 1831547496 | Angela Petersen | Psychologist | 8950 Villa La Jolla Dr Ste B109, La Jolla, CA 92037-1704 | 2016-05-24 |
| 1093161648 | Barbara Rosen | Psychologist | 654 Bonair St, La Jolla, CA 92037-6114 | 2016-05-12 |
| 1023474434 | Morton Shaevitz | Psychologist | 2671 Greentree Ln, La Jolla, CA 92037-1148 | 2016-01-14 |
| 1194083972 | Reina Juarez | Psychologist | University of California San Diego 0304, 9500 Gilman Dr., La Jolla, CA 92093-0304 | 2012-04-30 |
| 1932486529 | Felise Beth Levine | Psychologist | 3252 Holiday Ct Ste 205, La Jolla, CA 92037-1808 | 2011-11-09 |
| 1578878641 | Edith Eva Eger | Psychologist | 7231 Rue Michael, La Jolla, CA 92037-3913 | 2010-08-13 |
| 1477883585 | Michael Milad | Psychologist | 935 Genter St Unit 408, La Jolla, CA 92037-5520 | 2010-01-12 |
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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.