DR. MICHAEL WALSH GANNON


Address: 109 Cloud Touch Ct, Roseville, CA 95747-7116
Phone: 9163185317

DR. MICHAEL WALSH GANNON (NPI# 1962809699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962809699
Entity Type Individual
Full Name DR. MICHAEL WALSH GANNON
Credential PH.D., L.C.A.D.C.
Practice Address 109 Cloud Touch Ct
Roseville
CA 95747-7116
Practice Telephone 9163185317
Mailing Telephone 9163185317
Enumeration Date 2014-11-24
Last Update Date 2016-11-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
167168 KY Behavioral Health & Social Service Providers
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
1340 KY Behavioral Health & Social Service Providers

Other Providers MICHAEL GANNON

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1194086041 Michael Patrick Gannon Internal Medicine 3509 N Broad St, Philadelphia, PA 19140-4105 2012-06-06
1366582710 Michael J Gannon Internal Medicine 2741 Wheaton Way, Bremerton, WA 98310-3344 2007-02-07
1316096480 Michael Lawrence Gannon Dentist 138 Church St Ne, Vienna, VA 22180-4543 2007-01-09
1790704856 Michael Kevin Gannon Orthopaedic Surgery 2979 Squalicum Pkwy, Suite #203, Bellingham, WA 98225-1811 2006-07-19
1528060654 Michael James Gannon Family Medicine 11452 Space Center Blvd, Houston, TX 77059 2005-08-10

Office Location

Street Address 109 CLOUD TOUCH CT
City ROSEVILLE
State CA
Zip Code 95747-7116

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215407051 Clifford Leo Faubert Nurse Practitioner 1937 Ellesmere Loop, Roseville, CA 95747 2018-12-04
1821577172 Adam Botwinik Psychologist 8849 Cook Riolo Road, Roseville, CA 95747 2018-08-08
1093231201 Heather Mairi Ybarra Behavior Technician 4216 Wyman Way, Roseville, CA 95747 2017-08-18
1881114650 Bridget Bell Behavior Technician 8202 Tail Race Dr, Roseville, CA 95747 2017-06-22
1760911192 Laura Marie Hummel Massage Therapist 9077 Foothills Blvd. Suite 200, Roseville, CA 95747 2017-06-08
1184975625 Whitney Anne Wright Marriage & Family Therapist 7517 Locomotive Ln, Roseville, CA 95747 2012-09-24
1962764290 Panumas Soukaroon Physical Medicine & Rehabilitation Glenwood Springs Way, Roseville, CA 95747 2012-06-12
1134487366 Tatyana Serikov Dental Hygienist 616 Treviso Ct, Roseville, CA 95747 2012-04-25
1720352099 Peggy Holcomb Clinical Neuropsychologist 4010 Foothills Bvld., Ste. 103-3, Roseville, CA 95747 2012-03-02
1740577220 Laina Marie Haider Occupational Therapist 7950 Footthills Blvd, The Bridges At Woodcreek Oaks, Roseville, CA 95747 2011-07-05
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013575364 William Henry Hoffman IIi Counselor 2467 Sheldon St, Roseville, MN 55113-3138 2019-06-02
1962987560 Bradley Thomas Conley Counselor 2233 Hamline Ave N Ste 110, Roseville, MN 55113-5002 2018-09-28
1386156065 Gina M Nunez Counselor 730 Sunrise Ave Ste 200-201, Roseville, CA 95661-4567 2017-11-02
1023540515 Dawn New Awakening LLC Counselor 26316 Ronald St, Roseville, MI 48066-4458 2017-04-03
1700210218 Ozlem Tekelioglu Counselor 1133 Coloma Way Suite C, Roseville, CA 95661 2013-09-03
1114369816 Amanda Macmillan Counselor 101 Cirby Hills Drive, Roseville, CA 95678 2013-07-23
1316295082 Pes-ebs.inc. Counselor 340 Lincoln St, Roseville, CA 95678-2230 2012-08-28
1871860890 Raymond Richard Evans Counselor 2499 Rice Street, Roseville, MN 55113 2011-11-18
1023308079 Jennica Rachel Jenkins Counselor 1899 E Roseville Pkwy Ste 140, Roseville, CA 95661-7980 2011-04-12
1154628857 Kelly Elizabeth Steinbach Counselor 1050 Opportunity Dr Ste 160b, Roseville, CA 95678-3030 2011-02-16
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Competitor

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City ROSEVILLE
Zip Code 95747

Improve Information

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Dataset Information

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.

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