ALICE PARK (NPI# 1891795076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891795076 |
| Entity Type | Individual |
| Full Name | ALICE PARK |
| Credential | MD |
| Practice Address |
1305 Tommydon St Stockton CA 95210-3364 |
| Mailing Address |
3749 Whispering Creek Cir Stockton CA 95219-2329 |
| Practice Telephone | 2094765200 |
| Mailing Telephone | 2099525156 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
L8157 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747197 | Alice Jinyoung Park | Pharmacist | 9650 Baseline Rd, Rancho Cucamonga, CA 91701-5035 | 2020-07-16 |
| 1043860190 | Alice Marie Park | Registered Nurse | 9720 S Tacoma Way, Lakewood, WA 98499-4456 | 2019-09-19 |
| 1851693055 | Alice Soo Park | Registered Nurse | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2010-11-22 |
| 1386955771 | Alice Jeanne Park | Family Medicine | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2010-06-30 |
| 1841497591 | Alice Sunyoung Park | Physical Therapist | 5601 Desoto Avenue, Woodland Hills, CA 91365 | 2007-06-27 |
| 1649336298 | Alice J Park | Internal Medicine | 3780 Kilroy Airport Way Ste 115, Long Beach, CA 90806 | 2006-12-28 |
| 1902913361 | Alice Park | Nurse Anesthetist, Certified Registered | 150 N Eagle Creek Dr, Lexington, KY 40509-1805 | 2006-08-23 |
| 1093722290 | Alice S Park | Obstetrics & Gynecology | 9300 Campus Point Dr, Mail Code 0633, La Jolla, CA 92037-1300 | 2006-08-01 |
| Street Address |
1305 TOMMYDON ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699108076 | Brooke G Vierra | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2013-08-20 |
| 1780956136 | Amanda Lyn Ashworth | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2012-02-01 |
| 1225315401 | Colleen A Weyrens | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2011-11-15 |
| 1639359318 | Natalie Nacole Vides-boelke | Social Worker | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-11-09 |
| 1679763510 | Mitsuaki Kayne Ohata | Psychologist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-07-26 |
| 1679770895 | Uzma Nazir | Social Worker | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-06-29 |
| 1114131737 | Thu Dan Thi Pham | Psychologist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-05-10 |
| 1265552095 | Ceferina Rose Garcia | Marriage & Family Therapist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-03-29 |
| 1114068731 | Linda Liem | Social Worker | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-02-08 |
| 1326186024 | Genevieve Lenore Schaefer | Psychologist | 1305 Tommydon St, Stockton, CA 95210-3364 | 2007-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790139566 | Peter Alan Crist | Psychiatry & Neurology | 62 Wagner Rd, Stockton, NJ 08559-1412 | 2016-04-19 |
| 1982782892 | Arudra Bodepudi | Psychiatry & Neurology | 5250 Claremont Ave Ste 103, Stockton, CA 95207-5700 | 2006-11-01 |
| 1407932742 | John Matthew Yarbrough | Psychiatry & Neurology | 510 East Magnolia Street, Suite 100, Stockton, CA 95202 | 2006-10-30 |
| 1568567105 | Suryabanu Javeed | Psychiatry & Neurology | 1212 N California Street., Stockton, CA 95202 | 2006-09-14 |
| 1134230485 | Saul B Zelan | Psychiatry & Neurology | 7707 Austin Rd, Stockton, CA 95215-8312 | 2006-08-31 |
| 1144330572 | Jerry Travis Jones | Psychiatry & Neurology | 2522 Grand Canal Blvd, #1, Stockton, CA 95207-8213 | 2006-08-30 |
| 1194799395 | Jane Fernandez | Psychiatry & Neurology | 2522 Grand Canal Blvd Ste 1, Stockton, CA 95207-8213 | 2006-02-14 |
| 1841261054 | John Fong | Psychiatry & Neurology | 1130 Monaco Ct, Stockton, CA 95207 | 2006-01-27 |
| 1972592939 | Jin R. Soofi | Psychiatry & Neurology | 1212 N California St, Stockton, CA 95202-1552 | 2005-10-20 |
| 1033407986 | Vikram Malhotra | Psychiatry & Neurology | 7707 Austin Rd, Stockton, CA 95215-8312 | 2011-07-13 |
| Find all providers in STOCKTON | ||||
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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.