DR. MIKHAIL GUTKIN (NPI# 1679601041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679601041 |
| Entity Type | Individual |
| Full Name | DR. MIKHAIL GUTKIN |
| Other Name | DR. MISHA GUTKIN |
| Credential | PHD |
| Practice Address |
1761 Broadway St Vallejo CA 94589-2226 |
| Practice Telephone | 7076452700 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY24794 | CA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY24794 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1761 BROADWAY ST |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316901689 | Esker-d Ligon | Nurse Practitioner | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2006-04-13 |
| 1013452119 | Jamie Lutat | Occupational Therapist | 1761 Broadway St, Vallejo, CA 94589-2226 | 2016-12-27 |
| 1962864785 | The Permanente Medical Group | Health Maintenance Organization | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2016-03-22 |
| 1063824019 | Shasta Marie Ihorn | Psychologist | 1761 Broadway St, Ste 100, Vallejo, CA 94589-2226 | 2014-05-27 |
| 1851734495 | Jonah Raphael Paquette | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2013-04-13 |
| 1659616043 | Lisa Michelle Termansen | Audiologist | 1761 Broadway St, Suite 200, Vallejo, CA 94589-2226 | 2012-12-11 |
| 1609134824 | Carol Lynn Ferro | Psychiatry & Neurology | 1761 Broadway St, Ste 100, Vallejo, CA 94589-2226 | 2012-04-25 |
| 1902175763 | Tina Loan Kim Hua | Pharmacist | 1761 Broadway St, Vallejo, CA 94589-2226 | 2011-12-23 |
| 1164790432 | Kristin Lee Koperski | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2011-12-01 |
| 1174843429 | Tracie Lee Kepler Hoffman | Marriage & Family Therapist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2010-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
| Find all providers in zip 94589 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072302 | Imani Rivers | Counselor | 135 Gateway Ct, Vallejo, CA 94589-4339 | 2020-10-30 |
| 1942860267 | Enkindled Minds Counseling and Wellness | Counselor | 2507 Springs Rd, Vallejo, CA 94591-5612 | 2019-06-18 |
| 1689164311 | Karen Vanessa Alvarado | Counselor | 160 Glen Cove Marina Rd E, Vallejo, CA 94591-7290 | 2018-05-17 |
| 1154776052 | Robben Stallworth | Counselor | 312 Starboard Dr, Vallejo, CA 94590-4024 | 2016-04-28 |
| 1093176273 | Vincent Charles | Counselor | 236 Georgia St Ste 101, Vallejo, CA 94590-5962 | 2016-03-15 |
| 1528440096 | Soren Perry | Counselor | 236 Georgia St., Vallejo, CA 94590 | 2015-06-22 |
| 1497132427 | Sierra Voss | Counselor | 144 Harrier Ave, Vallejo, CA 94590-3710 | 2015-04-28 |
| 1376935452 | Diana Harvey | Counselor | 1827 Alabama St, Vallejo, CA 94590-4739 | 2015-02-25 |
| 1518366327 | Kimberly A Holland | Counselor | 631 Tennessee Street Suite 201, Vallejo, CA 94590 | 2014-08-18 |
| 1174959811 | Chris William Cook | Counselor | 1243 Florida St, Vallejo, CA 94590-5540 | 2013-09-25 |
| Find all providers in VALLEJO | ||||
Please comment or provide details below to improve the information on DR. MIKHAIL GUTKIN.
| 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.