DR. TOMMY GLEN MILLADGE (NPI# 1699111575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699111575 |
| Entity Type | Individual |
| Full Name | DR. TOMMY GLEN MILLADGE |
| Credential | PHD |
| Practice Address |
5456 Highbury Way Eastvale CA 91752-3690 |
| Practice Telephone | 9097208646 |
| Mailing Telephone | 9097208646 |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2013-05-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY9852 | CA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY9852 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PL0098520 | 05 |
| Street Address |
5456 HIGHBURY WAY |
| City | EASTVALE |
| State | CA |
| Zip Code | 91752-3690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124673462 | National Vision Inc | Optometrist | 12585 Cantu Galleano Ranch Road, Suite 120, Eastvale, CA 91752 | 2019-08-05 |
| 1720645328 | Creative Child and Family Services, Inc. | Family Medicine | 7049 Ohio River Dr, Eastvale, CA 91752 | 2019-05-20 |
| 1124681150 | Sleep Dme Management, Inc. | Home Health Aide | 12523 Limonite Avenie, #440-341, Mira Loma, CA 91752 | 2019-04-16 |
| 1255835179 | Costco Wholesale Corporation | Hearing Aid Equipment | 5030 Hamner Ave., Eastvale, CA 91752 | 2018-03-23 |
| 1487171963 | Devin Davis | Behavioral Analyst | 6632 Leanne St., Mira Loma, CA 91752 | 2017-08-25 |
| 1063946226 | Help Me Rhonda | Point of Service | 5919 Sunny Circle, Mira Loma, CA 91752 | 2017-04-14 |
| 1477930949 | Avinash Mirle Chandrashekar | Speech-Language Pathologist | 5725 Darbreak Dr, Apt C, Eastvale, CA 91752 | 2015-05-04 |
| 1336371061 | Prior Board & Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6121 Jupiter Dr., Mira Loma, CA 91752 | 2009-08-13 |
| 1245497288 | Elizabeth E Williamson | Dentist | 12571 Limonite Avenue, Suite 230, Mira Loma, CA 91752 | 2008-05-19 |
| 1003099425 | Dhama and Rodgers Dental Corporation | Dentist | 6445 Pat's Ranch Road, Ste G, Mira Loma, CA 91752 | 2007-12-07 |
| Find all providers in zip 91752 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023867 | Watson, Sanchez, & Navarro Psychological Group | Psychologist | 270 E 7th St Ste 1c, Upland, CA 91786-6602 | 2020-11-08 |
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1982203568 | Gautami Polepally Ashok | Psychologist | 1234 W Chapman Ave Ste 203, Orange, CA 92868-2863 | 2020-10-23 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1588261580 | Pamela J Newman | Psychologist | 3737 Elderberry Gln, Escondido, CA 92025-7910 | 2020-10-04 |
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
| 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.