DR. MICHAEL R VILLANUEVA (NPI# 1063522860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063522860 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL R VILLANUEVA |
| Credential | PSYD |
| Practice Address |
837 Alder Creek Dr Medford OR 97504-8911 |
| Practice Telephone | 5416083878 |
| Practice Fax Number | 5416083880 |
| Mailing Telephone | 5416083878 |
| Mailing Fax Number | 5416083880 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 0974 | OR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
0974 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 042601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316909757 | Michael Villaverde Villanueva | Physician Assistant | 13050 Heacock St, Moreno Valley, CA 92553-3122 | 2006-04-03 |
| 1205337151 | Michael Agcaoili Villanueva | Chore Provider | 2001 S Jones Blvd Ste E-3, Las Vegas, NV 89146-3182 | 2018-02-26 |
| 1508145988 | Michael Villanueva | Registered Nurse | 7701 Burholme Ave, Philadelphia, PA 19111-2437 | 2011-08-16 |
| 1679786941 | Michael Villanueva | Psychologist | 11230 Sorrento Valley Rd, Suite 210, San Diego, CA 92121-1332 | 2007-05-07 |
| 1083768527 | Michael Anthony Villanueva | Chiropractor | 6050 Sterling Creek Rd, Portage, IN 46368-7752 | 2007-01-22 |
| Street Address |
837 ALDER CREEK DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700189099 | Tricia Leannie Smith | Psychologist | 837 Alder Creek Dr, Medford, OR 97504-8911 | 2010-12-08 |
| 1255650800 | Mercedes Dickinson | Clinical Neuropsychologist | 837 Alder Creek Dr, Medford, OR 97504-8911 | 2010-05-21 |
| 1588726939 | Southern Oregon Neuropsychological Clinic LLC | Psychologist | 837 Alder Creek Dr, Medford, OR 97504 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639398779 | Nancy E Roosa | Clinical Neuropsychologist | 124 Sagamore Ave, Medford, MA 02155-2145 | 2007-04-25 |
| 1538227806 | Edwin Eric Pearson | Clinical Neuropsychologist | 843 E Main St Ste A101, Medford, OR 97504-7137 | 2006-12-05 |
| 1992874275 | Jerome J Schultz | Clinical Neuropsychologist | 101 Presidents Landing, Ccad 1st Floor, Medford, MA 02155 | 2006-11-08 |
| 1730283375 | Melinda Warner | Clinical Neuropsychologist | 10 Presidents Landing, Medford, MA 02155 | 2006-09-12 |
| 1477569598 | John Louks | Clinical Neuropsychologist | 2830 Payne Rd, Medford, OR 97504 | 2006-07-31 |
| 1225309339 | North Fork Neuropsychology | Clinical Neuropsychologist | 12 Platinum Ct, Medford, NY 11763-2247 | 2012-01-20 |
| 1154691533 | Katherine Warner Licensed Psychologist | Clinical Neuropsychologist | 1016 Court St, Medford, OR 97501-5728 | 2012-01-03 |
| 1255650800 | Mercedes Dickinson | Clinical Neuropsychologist | 837 Alder Creek Dr, Medford, OR 97504-8911 | 2010-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093278111 | Viva Wheaton Psyd LLC | Clinical Neuropsychologist | 603 E. Hancock St, Newberg, OR 97132 | 2019-04-08 |
| 1528532884 | Viva Wheaton | Clinical Neuropsychologist | 603 E. Hancock St., Newberg, OR 97132-3806 | 2019-01-18 |
| 1710334099 | Robyn Ashley Migliorini | Clinical Neuropsychologist | 497 Sw Century Dr Ste 104, Bend, OR 97702-1167 | 2016-05-17 |
| 1649640335 | Northwest Neurohealth LLC | Clinical Neuropsychologist | 501 N. Villa Road, Newberg, OR 97140 | 2015-10-07 |
| 1609265123 | Albany General Hospital | Clinical Neuropsychologist | 534 Pleasant View Way Nw, Suite 200, Albany, OR 97321-1700 | 2015-01-21 |
| 1902208846 | 360 Pediatric Psychology, PC | Clinical Neuropsychologist | 201 B Ave., Suite #285, Lake Oswego, OR 97034 | 2014-09-23 |
| 1497010706 | Leah B. Schock Phd, LLC | Clinical Neuropsychologist | 975 Sw Colorado Ave Ste 100, Bend, OR 97702-3155 | 2012-07-12 |
| 1639472319 | Opal Institute LLC | Clinical Neuropsychologist | 14780 Sw Osprey Dr. #285, Beaverton, OR 97007 | 2010-12-17 |
| 1275790461 | Audrina Alexis Mullane | Clinical Neuropsychologist | 534 Pleasant View Way Nw Ste 200, Albany, OR 97321-1789 | 2008-05-16 |
| 1801098090 | Nancy Loss | Clinical Neuropsychologist | 2223 Ne 47th Avenue, Portland, OR 97213 | 2007-06-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. MICHAEL R VILLANUEVA.
| 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.