JENNIFER MITOLO (NPI# 1861664088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861664088 |
Entity Type | Individual |
Full Name | JENNIFER MITOLO |
Credential | PSY.D. |
Practice Address |
1526 Brookhollow Dr Suite 73 Santa Ana CA 92705-5421 |
Practice Telephone | 7145453390 |
Mailing Telephone | 7145453390 |
Enumeration Date | 2008-03-27 |
Last Update Date | 2014-02-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY25678 | CA | Behavioral Health & Social Service Providers |
Y | 103TC0700X |
Psychologist Specialization: Clinical |
35SI00448400 | NJ | Behavioral Health & Social Service Providers |
Street Address |
1526 BROOKHOLLOW DR SUITE 73 |
City | SANTA ANA |
State | CA |
Zip Code | 92705-5421 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669020913 | Jasmin Cruz | Social Worker | 1526 Brookhollow Dr, Santa Ana, CA 92705-5421 | 2019-08-29 |
1760833081 | Tiffany Wambua | Behavioral Analyst | 1526 Brookhollow Dr, #70, Santa Ana, CA 92705-5421 | 2016-06-28 |
1033560305 | Deniece Ibanez | Behavioral Analyst | 1526 Brookhollow Dr, #70, Santa Ana, CA 92705-5421 | 2016-06-28 |
1407225550 | Susan Wingate | Social Worker | 1526 Brookhollow Dr, Santa Ana, CA 92705-5421 | 2015-09-18 |
1932578275 | Marcia Wilson | Social Worker | 1526 Brookhollow Dr, 73, Santa Ana, CA 92705-5421 | 2015-09-16 |
1437583978 | Cognitive Care Solutions Inc | Psychologist | 1526 Brookhollow Dr, Suite 73, Santa Ana, CA 92705-5421 | 2013-08-31 |
1245670272 | Jasmina Destanovic | Behavioral Analyst | 1526 Brookhollow Dr, #70, Santa Ana, CA 92705-5421 | 2013-07-05 |
1669716866 | Angela Yakscoe | Behavioral Analyst | 1526 Brookhollow Dr, #70, Santa Ana, CA 92705-5421 | 2012-11-12 |
1780937441 | Jenna L Beik | Speech-Language Pathologist | 1526 Brookhollow Dr, #70, Santa Ana, CA 92705-5421 | 2012-10-18 |
1104192285 | Chrislyn Saxena | Behavioral Analyst | 1526 Brookhollow Dr, #70, Santa Ana, CA 92705-5421 | 2012-03-22 |
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1952919763 | John G. Alevizos, D.o., A Professional Medical Corporation | Preventive Medicine | 1530 East Edinger Avenue, Suite 1, Santa Ana, CA 92705 | 2020-07-17 |
1477186625 | Joyce Altman Interpreters, Inc. | Interpreter | 1971 East 4th Street, Ste 206, Santa Ana, CA 92705 | 2020-02-17 |
1588214688 | Cindy Mejia | Behavior Technician | 505 N. Tustin Ave., #152, Santa Ana, CA 92705 | 2019-09-19 |
1588210504 | Jennifer Ang Lim-quevedo | Nurse Practitioner | 18362 Whitney Dr, Santa Ana, CA 92705 | 2019-08-15 |
1962056820 | Melinda Acosta Black | Social Worker | 1526 Brookhollow Drive, Santa Ana, CA 92705 | 2019-07-30 |
1972069631 | Amy Marie Elit | Nurse Practitioner | 1751 E Harry Ave, Santa Ana, CA 92705 | 2019-02-18 |
1386118180 | Unified Behavioral Health, LLC | Substance Abuse Rehabilitation Facility | 1218 W Santa Ana Blvd, Santa Ana, CA 92705 | 2019-01-15 |
1952884736 | Javier Perales | Social Worker | 1652 Windsor Ln, Santa Ana, CA 92705 | 2018-09-08 |
1073009700 | Eva E Kuncewicki | Marriage & Family Therapist | 1001 S Grand Ave # B, Santa Ana, CA 92705 | 2018-07-05 |
1487149886 | Nimbus Medtransport Inc. | Non-emergency Medical Transport (VAN) | 2112 E 4th St Ste 235, Santa Ana, CA 92705 | 2018-06-27 |
Find all providers in zip 92705 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
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1487290094 | Holistic Mental Health | Psychologist | 1801 Park Court Pl Ste F201, Santa Ana, CA 92701-5031 | 2019-11-19 |
1780245241 | Nancy Bement | Psychologist | 1651 E 4th St Ste 140, Santa Ana, CA 92701-5173 | 2019-06-25 |
1144572009 | Annie Nguyen Bui | Psychologist | 1634 W 19th St # C, Santa Ana, CA 92706-2301 | 2012-10-02 |
1861767386 | Kelly Don Krueger | Psychologist | 3711 S Sea Clf, Santa Ana, CA 92704-7142 | 2012-03-16 |
1184930919 | Philip Stephen Pines | Psychologist | 1633 E 4th St Ste 156, Santa Ana, CA 92701-5170 | 2010-08-31 |
1801122486 | Ronald L. Scott | Psychologist | 2220 E. Fruit Street, Suite 109, Santa Ana, CA 92701-4459 | 2009-11-02 |
1710129374 | Geraldine Marie Olin | Psychologist | 2021 E 4th St, Suite 116, Santa Ana, CA 92705-3912 | 2009-03-28 |
1184871048 | Jennifer Ann Morey | Psychologist | 2100 N Broadway Ste 101, Santa Ana, CA 92706-2624 | 2008-08-22 |
1366606386 | Michelle Protes Roth | Psychologist | 405 West 5th Street, Cys, Santa Ana, CA 92701 | 2008-07-18 |
1982895421 | Psychological Assessment Services | Psychologist | 2107 N. Broadway #207, Santa Ana, CA 92706 | 2007-08-08 |
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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.