TLC BEHAVIORAL HEALTH AND PSYCHOLOGY CORPORATION (NPI# 1538556865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538556865 |
| Entity Type | Organization |
| Organization Name | TLC BEHAVIORAL HEALTH AND PSYCHOLOGY CORPORATION |
| Practice Address |
1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 |
| Practice Telephone | 5103377950 |
| Practice Fax Number | 5103377969 |
| Mailing Telephone | 5103377950 |
| Mailing Fax Number | 5103377969 |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2016-05-10 |
| Authorized Official Name | MICHAEL WIEDERSTEIN (CEO, CFO) |
| Authorized Official Telephone | 5103377950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
| Street Address |
1080 MARINA VILLAGE PARKWAY SUITE 100 |
| City | ALAMEDA |
| State | CA |
| Zip Code | 94501-1078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528444114 | Mallynda Fernando | Licensed Vocational Nurse | 1080 Marina Village Parkway, Telecare Corporation, Alameda, CA 94501 | 2015-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386259158 | Hailee Ann Heiselbetz | Behavior Technician | 1025 Atlantic Ave. Ste 101, Alameda, CA 94501 | 2020-09-09 |
| 1134745961 | Linda Nykin | Naturopath | 2002 Monterey Cir, Alameda, CA 94501 | 2020-06-17 |
| 1801427570 | Mirna Rodriguez Lopez | Behavior Technician | 1025 Atlantic Ave. Ste. 101, Alameda, CA 94501 | 2020-01-30 |
| 1356987010 | Guadalupe H Hernandez | Technician | 3650 Mount Diablo Blvd, Layayette, CA 94501 | 2019-11-18 |
| 1952951832 | Lily T Nguyen | Behavior Technician | 1025 Atlantic Ave, Suite 101, Alameda, CA 94501 | 2019-09-12 |
| 1326503004 | Mary Macpherson | Speech-Language Pathologist | 2308 Central Ave., Alameda, CA 94501 | 2019-02-06 |
| 1285103838 | Stephanie Owens | Behavioral Analyst | 2213 Clinton Ave #a, Alameda, CA 94501 | 2018-11-13 |
| 1508349390 | Cindy Cabrera | Behavioral Analyst | 1025 Atlantic Ave Suite 101, Alameda, CA 94501 | 2018-09-08 |
| 1629554928 | Anita Elizabeth Bower | Behavioral Analyst | 125 Atlantic Ave Suite 101, Alameda, CA 94501 | 2018-07-19 |
| 1659862571 | Mariana Rocio Pacas Mexicano | Behavioral Analyst | 1025 Atlantic Ave. Suite 101, Alameda, CA 94501 | 2018-05-26 |
| Find all providers in zip 94501 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497607 | Michael J Hurtado | Psychologist | 5597 W Vartikian Ave, Fresno, CA 93722-3145 | 2020-11-06 |
| 1396374054 | Mark A Amparo | Psychologist | 5222 Balboa Ave Ste 33, San Diego, CA 92117-6953 | 2020-04-05 |
| 1043844459 | Nickolas Sloan Huston | Psychologist | 2371 W Main St Spc 57, Barstow, CA 92311-3614 | 2020-02-24 |
| 1366080418 | Denise Cherelle Rollins | Psychologist | 8619 Culpepper Dr, Sacramento, CA 95823-7658 | 2019-12-18 |
| 1124671136 | Ivan Butrus | Psychologist | 1516 Granite Hills Dr # Drb, El Cajon, CA 92019-5300 | 2019-07-18 |
| 1821659517 | Teresa Malyka Cheam | Psychologist | 301 The City Drive, Orange, CA 92868-3205 | 2019-06-24 |
| 1629633755 | Rans Shaaya | Psychologist | 520 Ballard St, El Cajon, CA 92019-2124 | 2019-05-03 |
| 1356823637 | Tin Joshua Pham | Psychologist | 1860 Walnut St. Suite A, Red Bluff, CA 96080-3611 | 2018-09-03 |
| 1184102238 | Ashley Jean Parker | Psychologist | 3575 Ridgewood Rd, Willits, CA 95490-9787 | 2018-08-01 |
| 1376039438 | Azia Brown | Psychologist | 365 Talbot Ave Apt M15, Pacifica, CA 94044-2667 | 2018-07-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on TLC BEHAVIORAL HEALTH AND PSYCHOLOGY CORPORATION.
| 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.