CARRIE L BRECKER (NPI# 1063598894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063598894 |
| Entity Type | Individual |
| Full Name | CARRIE L BRECKER |
| Credential | PSYD |
| Practice Address |
100 Prison Rd Represa CA 95671-3000 |
| Practice Telephone | 9169858610 |
| Mailing Telephone | 9169858610 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY22050 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA PSYCHOLOGY LICENSE | PSY22050 | 01 |
| Street Address |
100 PRISON RD |
| City | REPRESA |
| State | CA |
| Zip Code | 95671-3000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730269929 | Kathryn Eilene Peters | Pharmacist | 100 Prison Rd, Represa, CA 95671-3000 | 2006-10-16 |
| 1043795875 | Marsha Evans | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2018-09-27 |
| 1528545738 | Abby Molinet | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2018-07-20 |
| 1053847665 | Jacqueline Daasch Caoile | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2017-05-03 |
| 1427509314 | Kathryn Manness | Social Worker | 100 Prison Rd, Represa, CA 95671-3000 | 2016-10-17 |
| 1124575717 | Juzelie Gomez | Student in an Organized Health Care Education/Training Program | 100 Prison Rd, Represa, CA 95671-3000 | 2016-09-01 |
| 1336500412 | Alyssa Aguilar | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2016-03-16 |
| 1841674579 | Pembe Ethem | Student in an Organized Health Care Education/Training Program | 100 Prison Rd, Represa, CA 95671-3000 | 2015-07-13 |
| 1326441627 | Suzanne Ladson | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2014-09-30 |
| 1740682228 | Nicole Thompson | Student in an Organized Health Care Education/Training Program | 100 Prison Rd, Represa, CA 95671-3000 | 2014-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811207426 | Nicole Calma | Counselor | 100 Prison Road Sacramento State Prison, Represa, CA 95671 | 2010-10-15 |
| 1578737359 | Laura Beebe | Registered Nurse | 1 Prison Road, Csp Sacramento, Folsom, CA 95671 | 2008-04-14 |
| 1588661730 | Gregory Carl Tinloy | Dentist | 100 Prison Rd., Represa, CA 95671 | 2005-07-01 |
| 1174768972 | Timothea Greer Mcginley | Psychologist | 100 Prison Road, Csp Sacramento, Represa, CA 95671 | 2008-12-08 |
| 1275717340 | Harry Moran Singh Dhesi | Dentist | 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 | 2007-12-24 |
| 1235312463 | John Maciel Jr. | Dentist | 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 | 2007-12-11 |
| 1730362930 | Dennis Rulon Fairbourn | Dentist | 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 | 2007-12-11 |
| 1194070219 | Regina White | Social Worker | Csp Sacramento Mhsds Regina White, 100 Prison Road, Represa, CA 95671-0001 | 2012-07-14 |
| 1306174933 | Dudley Atkinson | Social Worker | Csp Sacramento, 100 Prison Road P.o., Represa, CA 95671-0001 | 2009-11-19 |
| 1932344280 | Amy Louise Holliday | Case Manager/Care Coordinator | California State Prison At Sacramento, 100 Prison Rd, Represa, CA 95671-0001 | 2008-12-15 |
| Find all providers in zip 95671 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619147444 | R. David Wheeler | Psychologist | California State Prison - Sacramento, 100 Prison Road, Represa, CA 95671-3000 | 2008-03-07 |
| 1053847665 | Jacqueline Daasch Caoile | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2017-05-03 |
| 1053749556 | Ruben Valencia | Psychologist | 100 Prison Rd, Csp-sac, Eop-b, Represa, CA 95671-3000 | 2013-10-18 |
| 1972843142 | Robert Charles Mcmahon | Psychologist | 300 Prison Rd, Folsom State Prison, Represa, CA 95671-3001 | 2013-02-25 |
| 1710246616 | Adielle Carrington | Psychologist | 100 Prison Rd, Represa, CA 95671-0012 | 2012-05-11 |
| 1023388774 | James Dennis Scott | Psychologist | 300 Prison Rd, Attn: Mental Health, Represa, CA 95671-3001 | 2012-01-11 |
| 1598087967 | Ellie I Johnson | Psychologist | 300 Prison Rd, Represa, CA 95671-0002 | 2010-02-25 |
| 1821320839 | Parker Douglas Houston | Psychologist | Prison Rd, Represa, CA 95671-0001 | 2010-02-02 |
| 1619111226 | Alvin Benjamin Ardales Gaerlan | Psychologist | 100 Prison Rd, Represa, CA 95671-3000 | 2009-04-27 |
| 1174768972 | Timothea Greer Mcginley | Psychologist | 100 Prison Road, Csp Sacramento, Represa, CA 95671 | 2008-12-08 |
| Find all providers in REPRESA | ||||
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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.