ALBERT MODAD (NPI# 1629453691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629453691 |
| Entity Type | Individual |
| Full Name | ALBERT MODAD |
| Practice Address |
1211 Puerta Del Sol San Clemente CA 92673-6306 |
| Mailing Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 9492765553 |
| Mailing Telephone | 6199064623 |
| Mailing Fax Number | 6199064564 |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2018-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
29697 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STUDENT IN A HEALTH CARE TRAINING PROGRAM | 39 | 01 |
| Street Address |
1211 PUERTA DEL SOL |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-6306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699003376 | William Frederick Gordon | Psychologist | 1211 Puerta Del Sol, San Clemente, CA 92673 | 2009-11-18 |
| 1619419181 | Malgorzata Inga Orcutt | Marriage & Family Therapist | 1211 Puerta Del Sol, Suite 280, San Clemente, CA 92673-6306 | 2016-11-15 |
| 1487196333 | Greta Meyerhof | Marriage & Family Therapist | 1211 Puerta Del Sol, 200, San Clemente, CA 92673-6306 | 2016-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679097851 | Alicia Marie Duzman | Psychologist | 616 S El Camino Real Ste G16, San Clemente, CA 92672-4294 | 2017-07-31 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1194003608 | Gina Atencio-maclean | Psychologist | 647 Camino De Los Mares Ste 221, San Clemente, CA 92673-2807 | 2011-08-01 |
| 1124235593 | Marijane Elizabeth Ward | Psychologist | 2801 Canto Nubiado, San Clemente, CA 92673-6420 | 2007-05-16 |
| 1023138831 | Linda Anne Wicks | Psychologist | 255 Vista Marina, San Clemente, CA 92672-5439 | 2007-03-29 |
| 1588741656 | Sylvia Mary Marnella | Psychologist | 33 Campanilla, San Clemente, CA 92673 | 2006-11-01 |
| 1376528703 | Douglas Kent Smith | Psychologist | 629 Camino De Los Mares, Ste 202a, San Clemente, CA 92673-2834 | 2005-12-08 |
| 1558597146 | Affiliated Psychiatric Medical Group | Psychologist | 647 Camino De Los Mares, #226, San Clemente, CA 92673-2807 | 2009-06-09 |
| 1790902211 | Janet M Seymour | Psychologist | 655 Camino De Los Mares, Suite 127, San Clemente, CA 92673-2809 | 2007-04-18 |
| 1740405893 | Piper Ann Walsh | Psychologist | 655 Camino De Los Mares, Suite 127, San Clemente, CA 92673-2809 | 2007-04-16 |
| Find all providers in SAN CLEMENTE | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
Please comment or provide details below to improve the information on ALBERT MODAD.
| 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.