DR. DODY J. REUSTLE (NPI# 1306147350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306147350 |
| Entity Type | Individual |
| Full Name | DR. DODY J. REUSTLE |
| Credential | PSYD |
| Practice Address |
711 Jefferson Street Suite 202 Fairfield CA 94533-5556 |
| Practice Telephone | 7073423639 |
| Practice Fax Number | 7074272262 |
| Mailing Telephone | 7073423639 |
| Mailing Fax Number | 7074272262 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2019-07-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY 23886 | CA | Behavioral Health & Social Service Providers |
| Street Address |
711 JEFFERSON STREET SUITE 202 |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-5556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407404684 | Siobhan O'leary Evarts | Psychologist | 1275 Post Rd Ste A18, Fairfield, CT 06824-6060 | 2019-08-30 |
| 1164887949 | Kara Emery | Psychologist | 520 Chadbourne Rd, Fairfield, CA 94534-9453 | 2015-12-22 |
| 1619220563 | April Justine Young | Psychologist | 712 Texas St, Fairfield, CA 94533-5519 | 2012-10-16 |
| 1033438015 | Dr. Katherine Bothos, LLC | Psychologist | 170 Post Rd Ste 208, Fairfield, CT 06824-6242 | 2010-05-29 |
| 1740506054 | Agila Rangarajan | Psychologist | 2812 Mack Rd, Fairfield, OH 45014-5130 | 2010-04-12 |
| 1114254836 | Katherine Bothos | Psychologist | 170 Post Rd, Suite 208, Fairfield, CT 06824-6242 | 2009-11-17 |
| 1871764076 | Norma Jean Van Volkinburg | Psychologist | 694 A Street, Travis Air Force Base To, Fairfield, CA 94535 | 2008-03-14 |
| 1033388327 | Erin R Frick | Psychologist | 728 Texas St, Suite 3, Fairfield, CA 94533-5560 | 2008-02-21 |
| 1679768329 | Pioli Psychological Services | Psychologist | 1495 Black Rock Turnpike, Fairfield, CT 06825 | 2007-09-06 |
| 1992838247 | Nancy E Killian | Psychologist | 1241 Post Rd, Fairfield, CT 06824-6025 | 2007-03-14 |
| Find all providers in FAIRFIELD | ||||
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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.