DR. J. TIMOTHY GREEN (NPI# 1790871267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790871267 |
| Entity Type | Individual |
| Full Name | DR. J. TIMOTHY GREEN |
| Other Name | DR. JOE GREEN |
| Credential | PH.D. |
| Practice Address |
25255 Cabot Road Suite 210 Laguna Hills CA 92653 |
| Practice Telephone | 9494722353 |
| Practice Fax Number | 9497702440 |
| Mailing Telephone | 9494722353 |
| Mailing Fax Number | 9497702440 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PYS11187 | CA | Behavioral Health & Social Service Providers |
| Street Address |
25255 CABOT ROAD SUITE 210 |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992827307 | Kelly V. Karjoo | Psychologist | 25255 Cabot Rd, Ste 217, Laguna Hills, CA 92653-5519 | 2007-04-05 |
| 1407978950 | Lois Beverly Yeh | Psychologist | 25255 Cabot Rd Ste 102, Laguna Hills, CA 92653-5507 | 2007-04-04 |
| 1548396112 | Parvin Salkeld | Psychologist | 24953 Paseo De Valencia Ste 30a, Laguna Hills, CA 92653-4343 | 2007-02-26 |
| 1508953100 | Kathleen Dumain | Psychologist | 23121 Verdugo Dr, Ste. 200, Laguna Hills, CA 92653-1339 | 2006-10-06 |
| 1235165028 | Iris Newbury | Psychologist | 23276 S Pointe Dr, Suite 217, Laguna Hills, CA 92653-1432 | 2006-06-23 |
| 1790724235 | Stephen Edward Berger | Psychologist | 23461 S Pointe Dr, Laguna Hills, CA 92653-1538 | 2006-06-06 |
| 1730716564 | Nina Tilka | Psychologist | 23461 S Pointe Dr Ste 100, Laguna Hills, CA 92653-1523 | 2020-03-23 |
| 1629610423 | Christine Lillja | Psychologist | 23173 La Cadena Dr, Laguna Hills, CA 92653-1404 | 2019-10-13 |
| 1568010858 | Amanda Hart | Psychologist | 23461 S Pointe Dr Ste 100, Laguna Hills, CA 92653-1523 | 2019-08-29 |
| 1659839801 | Pratik U Patel | Psychologist | 25283 Cabot Rd Ste 107, Laguna Hills, CA 92653-5509 | 2019-03-06 |
| Find all providers in LAGUNA HILLS | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
Please comment or provide details below to improve the information on DR. J. TIMOTHY GREEN.
| 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.