DR. KENNETH R. PELLETIER (NPI# 1184748014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184748014 |
| Entity Type | Individual |
| Full Name | DR. KENNETH R. PELLETIER |
| Credential | PHD, MD(HC) |
| Practice Address |
5 Country Oak Ln Alamo CA 94507-2854 |
| Practice Telephone | 9259327074 |
| Practice Fax Number | 9258383007 |
| Mailing Telephone | 9259327074 |
| Mailing Fax Number | 9258383007 |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY4631 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265488662 | Kenneth Pelletier | Physician Assistant | 3404 Wake Forest Rd, Ste 201, Raleigh, NC 27609-7341 | 2006-05-26 |
| Street Address |
5 COUNTRY OAK LN |
| City | ALAMO |
| State | CA |
| Zip Code | 94507-2854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851778831 | Tilden Sokoloff | Podiatrist | 72 Mott Dr, Alamo, CA 94507 | 2015-04-29 |
| 1821411299 | Christopher David Cox | Pediatrics | 2400 Lunada Ln, Alamo, CA 94507 | 2014-01-21 |
| 1285947796 | Cecilia Mary Kohl | Speech-Language Pathologist | 2630 Royal Oaks Drive, Alamo, CA 94507 | 2010-07-26 |
| 1235362658 | Martha Christine Chilbert | Chiropractor | 1599 Alamo Way, Alamo, CA 94507 | 2009-09-02 |
| 1336200591 | Aminda Osorio-modrell | Dentist | 3176 Danville Blvd, Ste 2, Alamo, CA 94507 | 2006-12-12 |
| 1912071143 | Mary Cecilia Burchell | Surgery | 27 Hagen Oak Court #b, Alamo, CA 94507 | 2006-11-20 |
| 1194737148 | Kenneth Attix Soult | Dentist | 3150 Danville Blvd, Alamo, CA 94507 | 2006-08-11 |
| 1912920539 | John A Knowles Jr. | Family Medicine | 1505 St. Alphonsus Way, Alamo, CA 94507 | 2006-07-25 |
| 1477530988 | Sheila Louise Raumer | Family Medicine | 130 Bando Court, Alamo, CA 94507 | 2005-12-27 |
| 1467997742 | George Naaman | Specialist | 328 Crest Ave, Hawthorne Effact, Alamo, CA 94507 | 2016-12-22 |
| Find all providers in zip 94507 | ||||
| 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 |
|---|---|---|---|---|
| 1407455108 | Chelsea Vilinskas | Clinical Neuropsychologist | 2624 Larkey Ln, Walnut Creek, CA 94597-2439 | 2020-10-22 |
| 1417554049 | Andrea Alioto | Clinical Neuropsychologist | 247 San Carlos Ave, Redwood City, CA 94061-3518 | 2020-10-06 |
| 1265045975 | Well Psychology, Inc. | Clinical Neuropsychologist | 3525 Del Mar Heights Rd # 1881, San Diego, CA 92130-2199 | 2020-08-24 |
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1437767399 | Ni Sun-suslow | Clinical Neuropsychologist | 220 Dickinson St # B, San Diego, CA 92103-2071 | 2020-07-16 |
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1649807058 | Nicholas S. Thaler Phd A Psychological Corporation | Clinical Neuropsychologist | 1526 14th St Ste 109, Santa Monica, CA 90404-3320 | 2020-03-25 |
| 1447890116 | Hussah Alkharafi | Clinical Neuropsychologist | 2720 Neilson Way # 5701, Santa Monica, CA 90405-4060 | 2020-01-10 |
| 1609414788 | Linda Rice | Clinical Neuropsychologist | 617 Bluegrass St, Simi Valley, CA 93065-5460 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. KENNETH R. PELLETIER.
| 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.