MICHAEL G DESTEFANO (NPI# 1295912988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295912988 |
| Entity Type | Individual |
| Full Name | MICHAEL G DESTEFANO |
| Credential | PHD |
| Practice Address |
10333 El Camino Real Atascadero CA 93422-5808 |
| Mailing Address |
1600 9th St Room 205 Mailstop 2-3 Sacramento CA 95814-6414 |
| Practice Telephone | 8054682000 |
| Practice Fax Number | 8054666011 |
| Mailing Telephone | 9166542431 |
| Mailing Fax Number | 9166543186 |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2008-01-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY 4853 | CA | Behavioral Health & Social Service Providers |
| N | 103TE1100X |
Psychologist Specialization: Exercise & Sports |
PSY 4853 | CA | Behavioral Health & Social Service Providers |
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
PSY 4853 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447873369 | Michael Destefano | Physical Therapy Assistant | 6010 Bay Pkwy Fl 1, Brooklyn, NY 11204-6079 | 2020-05-27 |
| 1407200116 | Michael Destefano | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2016-04-19 |
| 1982972378 | Michael A Destefano | Psychologist | 14 S Bryn Mawr Ave, Suite 205, Bryn Mawr, PA 19010-3216 | 2011-12-13 |
| 1326369943 | Michael William Destefano | Radiology | 1 Cooper Plz, Camden, NJ 08103 | 2010-06-17 |
| 1588796320 | Michael Don Destefano | Pediatrics | 7000 W 111th St, Worth, IL 60482-1851 | 2007-03-09 |
| 1972536712 | Michael J Destefano | Social Worker | 110 Lincoln Street, Ridgway, PA 15853 | 2006-07-07 |
| 1609864040 | Michael Joseph Destefano | Obstetrics & Gynecology | 100 Navarre Pl, Ste. 4470, South Bend, IN 46601-1156 | 2005-10-10 |
| Street Address |
10333 EL CAMINO REAL |
| City | ATASCADERO |
| State | CA |
| Zip Code | 93422-5808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578565628 | Olga A Yahontova | Psychiatry & Neurology | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2005-06-01 |
| 1699385294 | Kathleen Trotta | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2020-08-07 |
| 1346875960 | Elizabeth Ann Schmidt | Nurse Practitioner | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2020-03-04 |
| 1811521578 | Maria Lourdes Maningding Martinez | Nurse Practitioner | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2020-03-02 |
| 1154968907 | Kacee M Stagg | Dietitian, Registered | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2019-11-27 |
| 1306482344 | Lester James Willis | Nurse Practitioner | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2019-11-25 |
| 1053968552 | Michael Bormacoff Jr. | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2019-08-20 |
| 1649826264 | Jacek Cieply | Nurse Practitioner | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2019-08-11 |
| 1164991220 | David Pyo | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2018-11-19 |
| 1407324387 | Travis Mcgee | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2018-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356903645 | Michael E Nevin | Licensed Psychiatric Technician | 6550 Morro Rd, Unit D, Atascadero, CA 93422 | 2019-07-08 |
| 1225495583 | Kelly Michelle Morrow | Counselor | 7130 Sombrilla Ave., Atascadero, CA 93422 | 2016-01-18 |
| 1609242817 | Cheyenne M Britton | Counselor | 9366 Ribereng Circle, Atascadero, CA 93422 | 2015-08-12 |
| 1033590856 | Debra Marie Califia | Counselor | 6500 Morro Rd., Aegis Treatment Centers, Atascadero, CA 93422 | 2015-06-17 |
| 1134548498 | Allison Muller | Counselor | 8000 Santa Rosa Road, Atascadero, CA 93422 | 2014-04-15 |
| 1376973875 | Jana Slezakova | Psychologist | 10333 El Camino Real Dept Of, Atascadero, CA 93422 | 2013-11-19 |
| 1013341189 | Kimberly L Schwab | Counselor | 5575 Hospital Dr., Atascadero, CA 93422 | 2013-08-26 |
| 1982941274 | Krisitana Lynn Hatcher Miller | Counselor | 6312 Atascadero Ave, Atascadero, CA 93422 | 2013-01-07 |
| 1588939995 | Else Mai Thi Curry | Counselor | 4000 Santa Cruz Rd, Atascadero, CA 93422 | 2012-03-19 |
| 1083987523 | Kathryn Gaoiran Bartlett | Pharmacist | 8200 El Camino Real, Atascadero, CA 93422 | 2012-02-14 |
| Find all providers in zip 93422 | ||||
| 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 |
|---|---|---|---|---|
| 1417188822 | Killorin Maureen Riddell | Psychologist | 11305 Eliano Street, Atascadero, CA 93422 | 2009-08-03 |
| 1205062270 | Scott Matthew Smith | Psychologist | 5755 Violeta Ave, Atascadero, CA 93422-3125 | 2009-06-04 |
| 1598918799 | Deborah Steese Hewitt | Psychologist | 11700 Viejo Camino Blvd, C.a.l.l., Atascadero, CA 93422-5709 | 2008-10-31 |
| 1801930078 | Cindy Mitchell | Psychologist | 3528 El Camino Real, Atascadero, CA 93422 | 2007-02-19 |
| 1669530622 | Jennifer Berg | Psychologist | 10801 El Camino Real, Atascadero, CA 93422-8867 | 2006-12-04 |
| 1699385294 | Kathleen Trotta | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2020-08-07 |
| 1225564685 | Caroline Goldsmith | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2017-05-04 |
| 1902156664 | Jaynann Barcklay | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2012-09-10 |
| 1902153604 | Roxanne Marie Rassti | Psychologist | 10333 El Camino Real, Department of State Hospitals - Atascadero, Atascadero, CA 93422-5808 | 2012-08-13 |
| 1972867984 | David Rosenblatt | Psychologist | 10333 El Camino Real, Atascadero State Hospital, Atascadero, CA 93422-5808 | 2012-06-25 |
| Find all providers in ATASCADERO | ||||
| City | ATASCADERO |
| Zip Code | 93422 |
Please comment or provide details below to improve the information on MICHAEL G DESTEFANO.
| 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.