Theresa Gannon in Sacramento - Clinical Neuropsychologist
Theresa Gannon - NPI 1548243413
Theresa Gannon is a Clinical Neuropsychologist in Sacramento, California. Theresa Gannon practices all healthcare services and medical treatments related to Clinical Neuropsychologist. The NPI Number for Theresa Gannon is 1548243413. The last update date is 2011-02-22.
Theresa Gannon's current location address is 2825 50th St, Sacramento, California. You can contact this provider via phone number 9167030290. The mailing address for Theresa Gannon is 2825 50th St, Sacramento, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Theresa Gannon |
|---|---|
| Address | 2825 50th St, Sacramento, California |
| Phone Number | 9167030290 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1548243413 |
|---|---|
| Provider Enumeration Date | 2005-11-23 |
| Last Updated Date | 2011-02-22 |
Provider Mailing Address Detail
| Address | 2825 50th St |
|---|---|
| City | Sacramento |
| State | California (CA) |
| Post Code | 958172308 |
| Phone Number | 9167030290 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Neuropsychologist |
|---|---|
| Taxonomy | 103G00000X |
| Licence No | PSY16008 |
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Definition: A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing th |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PSY16008 | CA | PSYCHOLOGIST LICENSE # | |
| GR002104M | CA | MEDI-CAL GROUP NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Theresa Gannon by the Centers for Medicare & Medicaid Services?
The Theresa Gannon has been issued the NPI (National Provider Identifier) 1548243413, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Theresa Gannon is geographically located?
The Theresa Gannon is physically situated at the following location: 2825 50Th St, Sacramento, CA, 958172308.
What is Theresa Gannon's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Theresa Gannon's specialized field of practice is Clinical Neuropsychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103G00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1548243413 to Theresa Gannon?
The Theresa Gannon received its 1548243413 assignment from the Centers for Medicare & Medicaid Services on 2005-11-23.
When was the Theresa Gannon's information last updated?
The Theresa Gannon's information was last updated on 2011-02-22.
NPI Number: 1699778829
Address: 1200 Oakleaf Way, Altoona, WI