KERRY A. HANNIFIN, PSY.D., INC. (NPI# 1114439890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114439890 |
| Entity Type | Organization |
| Organization Name | KERRY A. HANNIFIN, PSY.D., INC. |
| Practice Address |
1850 E Washington St Colton CA 92324-4621 |
| Mailing Address |
8780 19th St Ste 411 Alta Loma CA 91701-4608 |
| Practice Telephone | 8443746336 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |
| Authorized Official Name | DR. KERRY A HANNIFIN (PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Telephone | 3107103027 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY24515 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1850 E WASHINGTON ST |
| City | COLTON |
| State | CA |
| Zip Code | 92324-4621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467438036 | Andrew Warren Hesseltine | Anesthesiology | 1850 E Washington St, Colton, CA 92324-4621 | 2005-12-15 |
| 1750824058 | Mareena Miller | Nurse Practitioner | 1850 E Washington St, Colton, CA 92324-4621 | 2016-11-18 |
| 1881098101 | A&m Surgery Center, Inc. | Clinic/Center | 1850 E Washington St, Colton, CA 92324-4621 | 2014-10-15 |
| 1710241179 | Jared Newman | Chiropractor | 1850 E Washington St, Colton, CA 92324-4621 | 2012-06-30 |
| 1396038105 | Andrew W. Hesseltine M.d., Inc | Non-Pharmacy Dispensing Site | 1850 E Washington St, Colton, CA 92324-4621 | 2011-05-26 |
| 1083918403 | Eric Song | Physician Assistant | 1850 E Washington St, Colton, CA 92324-4621 | 2010-12-28 |
| 1841527942 | Tim Patrick Hoang | Physician Assistant | 1850 E Washington St, Colton, CA 92324-4621 | 2009-11-10 |
| 1801039292 | Abdul Sadat Kanu | Anesthesiology | 1850 E Washington St, Colton, CA 92324-4621 | 2009-04-14 |
| 1902060361 | Alexandria I Arias | Physician Assistant | 1850 E Washington St, Colton, CA 92324-4621 | 2008-07-15 |
| 1184766685 | Andrew W Hesseltine, M.d., Inc | Physician Assistant | 1850 E Washington St, Colton, CA 92324-4621 | 2007-02-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1063042851 | Making A Difference Association, Inc. | Psychologist | 1430 E Cooley Drive, Ste 111, Colton, CA 92324 | 2020-01-21 |
| 1326685488 | Allstar Medical Respite and Recuperative Care | Case Management | 450 N Sperry Drive, Colton, CA 92324 | 2019-12-06 |
| 1558916379 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1010 North Pepper Ave, Colton, CA 92324 | 2019-08-08 |
| 1326692633 | Kadi Lyn Pearce | Licensed Practical Nurse | 970 N. Latham St, Colton, CA 92324 | 2019-07-25 |
| 1184281966 | Steven Andrew Cardoza | Physician Assistant | Armc, 400 N. Pepper Ave, Colton, CA 92324 | 2019-05-28 |
| 1528540952 | Daniel Tochukwu Umah-mgborogwu | Physician Assistant | 400 N Pepper Ave, Ste 107, Coton, CA 92324 | 2018-09-01 |
| 1255826038 | Cal Med Vascular Center LLC | Clinic/Center | 1281 W C St, Colton, CA 92324 | 2018-06-25 |
| 1891288072 | A. Arroyo Lourenco Dds, Inc | Dentist | 827 W Valley Blvd., Colton, CA 92324 | 2018-06-12 |
| 1700396165 | Emily Covington | Registered Nurse | 1550 E. Washington St., Ste 101, Colton, CA 92324 | 2017-10-11 |
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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 |
|---|---|---|---|---|
| 1558795682 | Laura A Negin | Psychologist | 1461 E Cooley Dr Ste 100, Colton, CA 92324-3921 | 2013-08-26 |
| 1295047389 | Errinn Ann Bixby | Psychologist | 900 E Washington St Ste 300, Colton, CA 92324 | 2010-07-06 |
| 1336395987 | Vanessa Francis | Psychologist | 400 N Pepper Ave, Colton, CA 92324-1801 | 2008-08-14 |
| 1598936213 | Michael Tennies | Psychologist | 400 N Pepper Ave, Colton, CA 92324-1801 | 2008-03-20 |
| 1750552576 | Tish Crawford | Psychologist | 400 N Pepper Ave, Colton, CA 92324-1801 | 2008-03-19 |
| 1962544486 | Timothy Keith Dechenne | Psychologist | 1330 E Cooley Dr, Colton, CA 92324-3905 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306690 | Eileen Kay Laughman | Psychologist | 24545 Town Center Dr Apt 5406, Valencia, CA 91355-1397 | 2020-11-08 |
| 1194324954 | Rachel Charman | Psychologist | 1001 Dove St Ste 110, Newport Beach, CA 92660-2845 | 2020-10-22 |
| 1700485760 | Melissa Ernestine Munoz | Psychologist | 353 H St # 1517, Chula Vista, CA 91910-5501 | 2020-10-21 |
| 1235737669 | Maha Nasrallah-babenko | Psychologist | 33442 Valley View Ct, Dana Point, CA 92629-1515 | 2020-10-16 |
| 1689272544 | Kaleidoscope Solutions Family Therapy | Psychologist | 25876 The Old Road, #85, Stevenson Ranch, CA 91381 | 2020-10-13 |
| 1992302814 | Sheena Gill | Psychologist | 2501 E Chapman Ave Ste 265, Fullerton, CA 92831-3108 | 2020-10-04 |
| 1255948600 | Kesha Patrice | Psychologist | 939 Ellis St, San Francisco, CA 94109-7714 | 2020-09-29 |
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1376159541 | Jill Caryn Campbell | Psychologist | 342 Ocho Rios Way, Oak Park, CA 91377-5541 | 2020-09-22 |
| 1225644487 | Brock Louis Pistel | Psychologist | 939 Ellis St Fl 67, San Francisco, CA 94109-7714 | 2020-09-22 |
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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.