BIG DOG COUNSELING, INC. (NPI# 1629451703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629451703 |
| Entity Type | Organization |
| Organization Name | BIG DOG COUNSELING, INC. |
| Practice Address |
1683 Novato Blvd Suite 1b Novato CA 94947-3200 |
| Mailing Address |
815 Creed Rd Oakland CA 94610-1826 |
| Practice Telephone | 5104277785 |
| Practice Fax Number | 5106250662 |
| Mailing Telephone | 5104277785 |
| Mailing Fax Number | 5106250662 |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-08-25 |
| Authorized Official Name | DR. LOUISA PARKS (PRESIDENT) |
| Authorized Official Telephone | 5104277785 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY24459 | CA | Behavioral Health & Social Service Providers |
| Y | 103G00000X | Clinical Neuropsychologist | PSY24459 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | FX694A | 01 |
| CA | CA BOARD OF PSYCHOLOGY LICENSE NUMBER | PSY24459 | 01 |
| CA | MEDICARE UIN | 816671 | 01 |
| Street Address |
1683 NOVATO BLVD SUITE 1B |
| City | NOVATO |
| State | CA |
| Zip Code | 94947-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407135882 | Rainey Sealey Temkin | Psychologist | 1682 Novato Blvd Ste 105, Novato, CA 94947 | 2011-08-16 |
| 1801192786 | Barbara Jean Gosselin | Marriage & Family Therapist | 1748 Novato Blvd Suite 210, Novato, CA 94947 | 2011-02-10 |
| 1659681377 | Karen Ann Murphy | Occupational Therapist | 27 Stasia Dr., Novato, CA 94947 | 2010-10-15 |
| 1154659415 | Christopher Michael Hackett | Chiropractor | 1559 South Novato Blvd., Suite E, Novato, CA 94947 | 2009-11-25 |
| 1003068305 | Suttinee Saguandeekul | Pharmacist | 910 Diablo Ave, Novato, CA 94947 | 2008-10-17 |
| 1891983581 | Shital Gandhi | Radiology | 500 Redwood Blvd Ste 300, Novato, CA 94947 | 2007-10-09 |
| 1356544126 | Victoria Elizabeth Herzog | Marriage & Family Therapist | 1682 Novato Blvd, Suite 250a, Novato, CA 94947 | 2007-06-07 |
| 1912047655 | Michael Craig Corder | Chiropractor | 1553 S Novato Blvd, A2 Corder Chiropractic Office, Novato, CA 94947 | 2007-02-08 |
| 1427106905 | Jacob Kyle Leone | Naturopath | 1748 Novato Blvd, Suite 100, Novato, CA 94947 | 2007-01-08 |
| 1881756401 | Mental Health Management I, Inc. | Psychiatric Residential Treatment Facility | 655 Canyon Road, Novato, CA 94947 | 2006-12-14 |
| Find all providers in zip 94947 | ||||
| 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 |
|---|---|---|---|---|
| 1598124893 | Bridget Johnson | Clinical Neuropsychologist | 1 Montego Ky, Novato, CA 94949-5322 | 2016-02-15 |
| 1912924440 | Mark Douglas Kamena | Clinical Neuropsychologist | 1683 Novato Blvd Ste 1b, Novato, CA 94947-3204 | 2006-07-17 |
| 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 | ||||
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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.