IVAN BUTRUS (NPI# 1124671136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124671136 |
| Entity Type | Individual |
| Full Name | IVAN BUTRUS |
| Practice Address |
1516 Granite Hills Dr # Drb El Cajon CA 92019-5300 |
| Practice Telephone | 6192778382 |
| Mailing Telephone | 6192778382 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 842365357 | 05 |
| Street Address |
1516 GRANITE HILLS DR # DRB |
| City | EL CAJON |
| State | CA |
| Zip Code | 92019-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497299747 | Vanessa Salem | Occupational Therapy Assistant | 11368 Via Rancho San Diego Unit F, El Cajon, CA 92019 | 2016-12-06 |
| 1497103865 | Jocelyn De Jesus Tuason | Assisted Living Facility | 11945 Via Hacienda, El Cajon, CA 92019 | 2016-05-26 |
| 1508241340 | Dalia Jamma | Dentist | 2990 Jamacha Rd # 140, El Cajon, CA 92019 | 2015-07-22 |
| 1720477060 | Angela Marie Robertson | Registered Nurse | 208 Almyra Rd, El Cajon, CA 92019 | 2015-01-09 |
| 1730483785 | Christina Lynn Winter | Dentist | 183 S. First Street, El Cajon, CA 92019 | 2011-01-05 |
| 1649588005 | Anna Liza Celso Baston | Nurse Practitioner | 1465 E Lexington, Unit 10-c, El Cajon, CA 92019 | 2010-09-20 |
| 1194050997 | Cokey Powell | Psychologist | 2815 Steele Cajon Rd., El Cajon, CA 92019 | 2009-10-12 |
| 1871738039 | Volunteers In Medicine - San Diego, Inc. | Voluntary or Charitable | 1465 E Madison Avenue, El Cajon, CA 92019 | 2008-12-02 |
| 1568507168 | Dianna Lee Norman | Family Medicine | 165 S First Street, El Cajan, CA 92019 | 2007-02-21 |
| 1780746263 | Ebtissam H Korkis | Family Medicine | 1530 Jamacha Road, Unit E Unit F, El Cajon, CA 92019 | 2006-12-14 |
| Find all providers in zip 92019 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629633755 | Rans Shaaya | Psychologist | 520 Ballard St, El Cajon, CA 92019-2124 | 2019-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497607 | Michael J Hurtado | Psychologist | 5597 W Vartikian Ave, Fresno, CA 93722-3145 | 2020-11-06 |
| 1396374054 | Mark A Amparo | Psychologist | 5222 Balboa Ave Ste 33, San Diego, CA 92117-6953 | 2020-04-05 |
| 1043844459 | Nickolas Sloan Huston | Psychologist | 2371 W Main St Spc 57, Barstow, CA 92311-3614 | 2020-02-24 |
| 1366080418 | Denise Cherelle Rollins | Psychologist | 8619 Culpepper Dr, Sacramento, CA 95823-7658 | 2019-12-18 |
| 1821659517 | Teresa Malyka Cheam | Psychologist | 301 The City Drive, Orange, CA 92868-3205 | 2019-06-24 |
| 1356823637 | Tin Joshua Pham | Psychologist | 1860 Walnut St. Suite A, Red Bluff, CA 96080-3611 | 2018-09-03 |
| 1184102238 | Ashley Jean Parker | Psychologist | 3575 Ridgewood Rd, Willits, CA 95490-9787 | 2018-08-01 |
| 1376039438 | Azia Brown | Psychologist | 365 Talbot Ave Apt M15, Pacifica, CA 94044-2667 | 2018-07-02 |
| 1639566953 | John Gutierrez | Psychologist | 3281 Ledgewood Circle, Riverside, CA 92503 | 2015-04-24 |
| 1538556865 | Tlc Behavioral Health and Psychology Corporation | Psychologist | 1080 Marina Village Parkway, Suite 100, Alameda, CA 94501-1078 | 2015-04-24 |
| Find all providers with the same taxonomy | ||||
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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.