DR. TRACEY LYNNE SHEPHERD (NPI# 1255313805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255313805 |
| Entity Type | Individual |
| Full Name | DR. TRACEY LYNNE SHEPHERD |
| Credential | PHD |
| Practice Address |
13193 Central Avenue Suite 200 Chino CA 91710 |
| Practice Telephone | 9099029111 |
| Practice Fax Number | 9099029199 |
| Mailing Telephone | 9099029111 |
| Mailing Fax Number | 9099029199 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY 16524 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PSY165240 | 05 |
| Street Address |
13193 CENTRAL AVENUE SUITE 200 |
| City | CHINO |
| State | CA |
| Zip Code | 91710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477562809 | Daniel Dominic Lopez | Marriage & Family Therapist | 13193 Central Avenue, Suite 200, Chino, CA 91710 | 2006-08-05 |
| 1174506828 | Kenneth Charles Alexander | Physician Assistant | 13193 Central Avenue, Suite 200, Chino, CA 91710 | 2005-11-28 |
| 1780666339 | Mei Han Tang-pieri | Social Worker | 13193 Central Avenue, Suite 200, Chino, CA 91710 | 2005-11-18 |
| 1831171388 | Travis Dauntia Fultz | Psychologist | 13193 Central Avenue, Suite 200, Chino, CA 91710 | 2005-11-18 |
| 1336121888 | Foothills Psychological Services, Inc. | Psychiatry & Neurology | 13193 Central Avenue, Suite 200, Chino, CA 91710 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962037887 | Corrections and Rehabilitation | Pharmacy | 14901 So Central Avenue, Chino, CA 91710 | 2020-03-11 |
| 1053968289 | California Institute for Men Phcy | Pharmacy | 14901 So Central Ave, Chino, CA 91710 | 2019-08-22 |
| 1982170510 | Kind Care Connections, LLC | In Home Supportive Care | 14726 Ramona Ave # E10, Chino, CA 91710 | 2018-10-22 |
| 1922593789 | Christopher Armando Camarena | Assistant Behavior Analyst | 6062 Eucalyptus Ave, Chino, CA 91710 | 2018-06-25 |
| 1730696519 | Barsoum Dental Corp | Dentist | 14613 Ramona Ave, Chino, CA 91710 | 2018-01-03 |
| 1326569864 | Christina La | Optometrist | 5250 Philadelphia St Ste D, Chino, CA 91710 | 2017-07-06 |
| 1629502554 | Jk Pharmacy Inc | Pharmacy | 5562 Philadelphia St, #110, Chino, CA 91710 | 2017-04-18 |
| 1801336680 | Altek Drugs Inc. | Pharmacy | 13085 Central Ave Ste 2, Chino, CA 91710 | 2017-02-28 |
| 1518405893 | Audrey Ronquillo | Behavior Technician | 800 Ferrari Ln, Suite 100, Ontario, CA 91710 | 2017-02-07 |
| 1952849556 | Jennifer Huynh | Behavior Technician | 800 Ferrari Ln Suite 100, Ontario, CA 91710 | 2017-02-03 |
| Find all providers in zip 91710 | ||||
| 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 |
|---|---|---|---|---|
| 1710257084 | Jeffrey Craig Scott | Psychologist | Correctional Institute for Men Chino Ave, Chino, CA 91710 | 2012-01-04 |
| 1396812913 | David Morris Steinberger | Psychologist | 12530 10th Street, Suite C, Chino, CA 91710-3520 | 2006-11-29 |
| 1063445716 | Theresa Marie Darrington | Psychologist | 4091 Riverside Dr, Ste 117, Chino, CA 91710-6502 | 2006-07-08 |
| 1801307368 | Health Service Alliance | Psychologist | 13193 Central Ave, Chino, CA 91710-4179 | 2017-10-23 |
| 1437604667 | Brandon Yip | Psychologist | 14901 Central Ave, Chino, CA 91710-9500 | 2016-08-17 |
| 1932500295 | Debra Cacianti | Psychologist | 14901 Central Ave, Chino, CA 91710-9500 | 2014-09-05 |
| 1801297122 | David Kondo | Psychologist | 14901 Central Ave, Chino, CA 91710-9500 | 2014-09-05 |
| 1619387313 | Christina Maria Fetcho | Psychologist | 14901 Central Ave, Chino, CA 91710-9500 | 2014-05-02 |
| 1205251923 | Patricia Fernandez | Psychologist | 14901 Central Ave, Chino, CA 91710-9500 | 2014-03-04 |
| 1902240005 | Rosemary Meyers | Psychologist | 14901 Central Ave, Chino, CA 91710-9500 | 2013-04-19 |
| Find all providers in CHINO | ||||
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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.