JESSICA KETTERER (NPI# 1457717639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457717639 |
| Entity Type | Individual |
| Full Name | JESSICA KETTERER |
| Credential | PH.D. |
| Practice Address |
603 N Flamingo Rd Suite 151 Pembroke Pines FL 33028-1023 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542654325 |
| Practice Fax Number | 9544434747 |
| Mailing Telephone | 9542765603 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2016-08-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY9462 | FL | Behavioral Health & Social Service Providers |
| Street Address |
603 N FLAMINGO RD SUITE 151 |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33028-1023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376535484 | Fausto A De La Cruz | Internal Medicine | 603 N Flamingo Rd, #357, Pembroke Pines, FL 33028-1023 | 2005-08-16 |
| 1922470814 | Adriana Abuchar | Physician Assistant | 603 N Flamingo Rd, Suite 350, Pembroke Pines, FL 33028 | 2015-10-30 |
| 1760853030 | Lauren F Hodges | Physician Assistant | 603 N Flamingo Rd, Suite 358, Pembroke Pines, FL 33028-1023 | 2015-10-13 |
| 1578932687 | South Broward Hospital District | Internal Medicine | 603 N Flamingo Rd, Suite 159, Pembroke Pines, FL 33028-1023 | 2015-09-18 |
| 1720454879 | Sheyla Galban | Physician Assistant | 603 N Flamingo Rd, Suite 260, Pembroke Pines, FL 33028-1023 | 2015-08-12 |
| 1568877843 | Limor Oz | General Acute Care Hospital | 603 N Flamingo Rd, Pembroke Pines, FL 33028-1023 | 2014-06-25 |
| 1417384983 | Carmen Daniela Connolly | Physician Assistant | 603 N Flamingo Rd, Suite 357, Pembroke Pines, FL 33028-1023 | 2013-09-30 |
| 1316208291 | Adiene Caridad Murillo | Clinical Nurse Specialist | 603 N Flamingo Rd, Suite 157, Pembroke Pines, FL 33028-1023 | 2012-06-06 |
| 1457619207 | Ximena Guimet | Physician Assistant | 603 N Flamingo Rd, 357, Pembroke Pines, FL 33028-1023 | 2012-04-30 |
| 1700157021 | Sear-enity Natural Medicine, Inc. | Acupuncturist | 603 N Flamingo Rd, Ste 159, Pembroke Pines, FL 33028-1023 | 2012-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821570276 | Grace Olivine Lue | Nurse Practitioner | 2291 Nw 171 Terrace, Pembroke Pines, FL 33028 | 2018-09-02 |
| 1336658194 | Edna Daniel | Registered Nurse | 16213 Nw 18th Street, Pembroke Pines, FL 33028 | 2017-09-25 |
| 1093257032 | Carlos Eduardo Florian Jr. | Physical Therapist | 701 North Flamingo Road, Pembroke Pines, FL 33028 | 2016-11-08 |
| 1760868574 | Clara Elisa Delgado | Nurse Practitioner | 601 N Flamingo Road Suite 105, Pembroke Pines, FL 33028 | 2015-08-04 |
| 1942614375 | Emmanuel Magboo | Physical Therapist | 1563 Nw 159 Lane, Pembroke Pines, FL 33028 | 2014-06-13 |
| 1134546302 | Tahnie Danastor | Obstetrics & Gynecology | 601 N Flamingo Rd Ste 307, Pembroke Pines, FL 33028 | 2014-03-25 |
| 1316388200 | Mirella Silva-bass | Counselor | 2250 Nw 136 Ave # 100f, Pembroke Pines, FL 33028 | 2013-07-09 |
| 1932447364 | Grazia Oropesa | Nurse Practitioner | 12824 Nw 21st St, Pembroke Pines, FL 33028 | 2013-01-18 |
| 1548545320 | Rita Galliano | Speech-Language Pathologist | 1261 Nw 141st Ave, Pembroke Pines, FL 33028 | 2011-10-12 |
| 1033429949 | Paulette Paul | Registered Nurse | 15575 N.w. 12th Court, Pembroke Pines, FL 33028 | 2010-10-13 |
| Find all providers in zip 33028 | ||||
| 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 |
|---|---|---|---|---|
| 1811515745 | Sarah Amelia Sanon | Psychologist | 10381 Sw 9th Ln, Pembroke Pines, FL 33025-3585 | 2020-07-07 |
| 1699323139 | Shakera Ann Marie Bucknor Ingram | Psychologist | 1561 Sw 190th Ave, Pembroke Pines, FL 33029-6148 | 2019-08-28 |
| 1609423581 | Barton Jones | Psychologist | 10031 Pines Blvd Ste 212, Pembroke Pines, FL 33024-6169 | 2019-08-24 |
| 1376052233 | Natalie Valentine | Psychologist | 11749 Nw 12th St, Pembroke Pines, FL 33026 | 2017-09-23 |
| 1902348113 | Cary Acosta | Psychologist | 14719 Sw 11th Ct, Pembroke Pines, FL 33027-6198 | 2016-11-06 |
| 1063762714 | Venessa Margaret Fegley-villalba | Psychologist | 20540 Nw 8th St, Pembroke Pines, FL 33029-3471 | 2012-09-10 |
| 1407122021 | Gretchen Michelle Moy | Psychologist | 18830 Nw 10th St, Pembroke Pines, FL 33029-2925 | 2012-03-28 |
| 1972839439 | Jeannie Chandler Nunez | Psychologist | 1941 Nw 150th Ave, Suite 104, Pembroke Pines, FL 33028-2874 | 2009-10-19 |
| 1386775617 | Robert J. Cipriano Jr. | Psychologist | 10031 Pines Boulevard, (suite 240), Pembroke Pines, FL 33024-6180 | 2007-03-08 |
| 1255493961 | Noel John Shami | Psychologist | 11411 Nw 22nd St, Pembroke Pines, FL 33026-2003 | 2006-12-16 |
| Find all providers in PEMBROKE PINES | ||||
| City | PEMBROKE PINES |
| Zip Code | 33028 |
Please comment or provide details below to improve the information on JESSICA KETTERER.
| 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.