DR. CAROL FENNER (NPI# 1063912061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063912061 |
| Entity Type | Individual |
| Full Name | DR. CAROL FENNER |
| Credential | PH.D. |
| Practice Address |
2000 Embarcadero Oakland CA 94606-5334 |
| Mailing Address |
5548 Fremont St Oakland CA 94608-2608 |
| Practice Telephone | 4156064961 |
| Practice Fax Number | 5302684641 |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-02-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
2000 EMBARCADERO |
| City | OAKLAND |
| State | CA |
| Zip Code | 94606-5334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621492 | Alice S Myong | Pharmacist | 2000 Embarcadero, Ste 400, Oakland, CA 94606-5334 | 2005-06-30 |
| 1881154540 | Natalie Ho | Student in an Organized Health Care Education/Training Program | 2000 Embarcadero, Oakland, CA 94606-5334 | 2019-03-20 |
| 1811429194 | Brandon Huey | Student in an Organized Health Care Education/Training Program | 2000 Embarcadero, 400, Oakland, CA 94606-5334 | 2017-03-28 |
| 1033586383 | Seth Gomez | Pharmacist | 2000 Embarcadero, Suite # 400, Oakland, CA 94606-5334 | 2015-08-21 |
| 1629369855 | Jane Tzudiker | Marriage & Family Therapist | 2000 Embarcadero, Oakland, CA 94606-5334 | 2011-04-21 |
| 1396055075 | Indriani Wang | Pharmacist | 2000 Embarcadero, Suite 400, Oakland, CA 94606-5334 | 2010-10-15 |
| 1124334693 | Dulce Lopez | Psychologist | 2000 Embarcadero, Oakland, CA 94606-5334 | 2010-08-23 |
| 1821328675 | Michelle Angela Burns | Nurse Practitioner | 2000 Embarcadero, Suite 400, Oakland, CA 94606-5334 | 2009-12-29 |
| 1578795712 | Laura L Garrett | Marriage & Family Therapist | 2000 Embarcadero, Oakland, CA 94606 | 2009-08-21 |
| 1720221682 | Gerald Solt | Marriage & Family Therapist | 2000 Embarcadero, Oakland, CA 94606-5334 | 2009-04-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366923369 | Rhummanee Hang | Case Manager/Care Coordinator | 544 International Blvd., Suite #9, Oakland, CA 94606 | 2018-08-27 |
| 1841746153 | First Aid Transportation LLC | Non-emergency Medical Transport (VAN) | 1709 International Blvd Ste 107, Oakland, CA 94606 | 2016-08-27 |
| 1609236686 | Erik D Grasso | Behavioral Analyst | 1340 East 28th St., Suite C, Oakland, CA 94606 | 2016-03-03 |
| 1457770935 | Jessica Robin Gar Ling Leung | Family Medicine | 250 E. 18th Street, 2nd Floor, Oakland, CA 94606 | 2014-04-10 |
| 1902230709 | Masja Van Der Hoog | Acupuncturist | 1511 23rd Ave, Apt 10, Oakland, CA 94606 | 2013-08-28 |
| 1063756997 | Christine Michelle Huffner | Nurse Practitioner | 1030 International Blvd. San Antonio Neighborhood Healt, Oakland, CA 94606 | 2012-11-15 |
| 1336418920 | Alexandra Elisabeth Brewster | Counselor | 907 Lake Street San Pablo Avenue, San Pablo, CA 94606 | 2011-12-28 |
| 1780964064 | Meagen Elizabeth Grundberg | Community Health Worker | 544 International Blvd Ste 9, Oakland, CA 94606 | 2011-08-18 |
| 1285764217 | Nguyen Tran Dang, Dds, Inc. | Dentist | 270 East 12th St., Oakland, CA 94606 | 2007-03-07 |
| 1689704017 | Nguyen Tran Dang | Dentist | 270 East 12th Street, Oakland, CA 94606 | 2007-03-06 |
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| 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 |
|---|---|---|---|---|
| 1619026739 | Shaliza Shorey | Clinical Neuropsychologist | 3900 Broadway Bldg 1, Oakland, CA 94611-5616 | 2007-01-09 |
| 1497829287 | F. Myron Hays, Ph.d. | Clinical Neuropsychologist | 2917 Mcclure St, Oakland, CA 94609-3504 | 2006-11-20 |
| 1528168366 | Gregory Seth Alter | Clinical Neuropsychologist | 5666 Telegraph Ave, Oakland, CA 94609-1708 | 2006-09-22 |
| 1376143123 | Thomas Vanvleet | Clinical Neuropsychologist | 3947 Opal St, Oakland, CA 94609-2626 | 2020-10-30 |
| 1619599974 | Savera Psychological Services PC | Clinical Neuropsychologist | 401 Grand Ave Ste 380, Oakland, CA 94610-5054 | 2020-05-09 |
| 1558994277 | Pranamind LLC | Clinical Neuropsychologist | 459 W Macarthur Blvd, Oakland, CA 94609-2808 | 2020-02-21 |
| 1568092617 | Meena Saleh | Clinical Neuropsychologist | 3756 Grand Ave, Ste 404, Oakland, CA 94610-1545 | 2020-01-16 |
| 1477073062 | Amrita Mehta | Clinical Neuropsychologist | 401 Grand Ave Ste 380, Oakland, CA 94610-5054 | 2017-06-23 |
| 1699902759 | Michael Alex Peterson | Clinical Neuropsychologist | 1425 Leimert Blvd, Suite 403, Oakland, CA 94602-1865 | 2009-06-16 |
| 1104087576 | Wendy Santos-modesitt | Clinical Neuropsychologist | 747 52nd St, Department of Neuro-oncology, Oakland, CA 94609-1809 | 2008-06-19 |
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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.