SHASTA MARIE IHORN (NPI# 1063824019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063824019 |
| Entity Type | Individual |
| Full Name | SHASTA MARIE IHORN |
| Credential | PHD |
| Practice Address |
1761 Broadway St Ste 100 Vallejo CA 94589-2226 |
| Practice Telephone | 7076452700 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
1761 BROADWAY ST STE 100 |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316901689 | Esker-d Ligon | Nurse Practitioner | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2006-04-13 |
| 1013452119 | Jamie Lutat | Occupational Therapist | 1761 Broadway St, Vallejo, CA 94589-2226 | 2016-12-27 |
| 1962864785 | The Permanente Medical Group | Health Maintenance Organization | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2016-03-22 |
| 1851734495 | Jonah Raphael Paquette | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2013-04-13 |
| 1659616043 | Lisa Michelle Termansen | Audiologist | 1761 Broadway St, Suite 200, Vallejo, CA 94589-2226 | 2012-12-11 |
| 1609134824 | Carol Lynn Ferro | Psychiatry & Neurology | 1761 Broadway St, Ste 100, Vallejo, CA 94589-2226 | 2012-04-25 |
| 1902175763 | Tina Loan Kim Hua | Pharmacist | 1761 Broadway St, Vallejo, CA 94589-2226 | 2011-12-23 |
| 1164790432 | Kristin Lee Koperski | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2011-12-01 |
| 1174843429 | Tracie Lee Kepler Hoffman | Marriage & Family Therapist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2010-06-09 |
| 1760713713 | Jorge Belloso-curiel | Social Worker | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2010-01-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285103622 | Elena Friio | Psychologist | 150 Glen Cove Marina Rd E # 21, Vallejo, CA 94591-7292 | 2018-11-15 |
| 1952861445 | Neda Soussanbari | Psychologist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2019-03-21 |
| 1013250323 | Richard Henry Von Feldt | Psychologist | 800 Sereno Dr, Vallejo, CA 94589-2411 | 2013-04-04 |
| 1417296211 | Andrinee Wilson | Psychologist | 800 Sereno Dr, Vallejo, CA 94589-2411 | 2013-02-14 |
| 1164790432 | Kristin Lee Koperski | Psychologist | 1761 Broadway St, Suite 100, Vallejo, CA 94589-2226 | 2011-12-01 |
| 1871804856 | Maria Ortiz-baker | Psychologist | 1761 Broadway St Ste 100, Vallejo, CA 94589-2227 | 2010-06-24 |
| 1013143262 | Ian Joseph Wallace | Psychologist | 200 Maritime Academy Dr, The California Maritime Academy, Student Health Service, Vallejo, CA 94590-8181 | 2009-06-02 |
| 1447305396 | Kathryn Wetzler | Psychologist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2007-01-23 |
| 1073663936 | Patricia J Dwyer | Psychologist | 975 Sereno Dr, Bay View South, Vallejo, CA 94589-2441 | 2007-01-11 |
| 1942378716 | Stephanie Ann Zone | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2006-12-01 |
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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.