THERESA GANNON


Address: 2825 50th St, Ucdhs- Mind Institute, Sacramento, CA 95817-2308
Phone: 9167030290

THERESA GANNON (NPI# 1548243413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548243413
Entity Type Individual
Full Name THERESA GANNON
Credential PH.D.
Practice Address 2825 50th St
Ucdhs- Mind Institute
Sacramento
CA 95817-2308
Practice Telephone 9167030290
Mailing Telephone 9167030290
Enumeration Date 2005-11-23
Last Update Date 2011-02-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist PSY16008 CA Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA PSYCHOLOGIST LICENSE # PSY16008 01
CA MEDI-CAL GROUP NUMBER GR002104M 01

Other Providers THERESA GANNON

NPI Name Taxonomy Address Enumeration
1609923911 Theresa Gannon Social Worker 1967 Turnbull Ave, Suite 26, Bronx, NY 10473-2519 2007-01-05

Office Location

Street Address 2825 50TH ST
UCDHS- MIND INSTITUTE
City SACRAMENTO
State CA
Zip Code 95817-2308

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043293194 Lauren B. Plumer Pediatrics 2825 50th St, Sacramento, CA 95817-2308 2005-11-22
1316505886 Marie Louise Rocha Behavioral Analyst 2825 50th St, Sacramento, CA 95817-2310 2019-05-30
1982191870 Rachel Balitsky Behavioral Analyst 2825 50th St, Sacramento, CA 95817-2310 2018-04-17
1275051534 Ayaka Suzuki Genetic Counselor, MS 2825 50th St, Sacramento, CA 95817-2310 2017-09-06
1093239089 Megan E Tudor Psychologist 2825 50th St, Uc Davis Mind Institute, Sacramento, CA 95817 2017-08-01
1174053177 Meghan Rhys Miller Psychologist 2825 50th St, Sacramento, CA 95817-2310 2017-06-13
1134578099 Andrea Schneider Psychologist 2825 50th St, Sacramento, CA 95817-2310 2016-06-10
1144691635 Susan W Harris Social Worker 2825 50th St, Sacramento, CA 95817-2310 2015-10-09
1831575364 Colette Defilippo Genetic Counselor, MS 2825 50th St, Sacramento, CA 95817-2310 2015-08-06
1255736476 Rosa Denisse Rodriguez Pediatrics 2825 50th St, Sacramento, CA 95817-2310 2014-10-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346855103 Quintin Kuse Student in an Organized Health Care Education/Training Program 4610 X Street, Sacramento, Sacramento, CA 95817 2020-09-09
1285259283 Uc Davis Health Dietitian, Registered 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 2020-06-15
1942840558 Michael Marchand-gareau Ophthalmology Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 2020-01-11
1467010728 Jiunn Liang Jonathan Yap Student in an Organized Health Care Education/Training Program 4860 Y Str, Ste. 2820, Sacramento, CA 95817 2019-06-03
1083176614 Kevin Lee Student in an Organized Health Care Education/Training Program 2315 Stockton Blvd, Op512, Sacramento, CA 95817 2019-04-02
1508326703 Ritika Johal Student in an Organized Health Care Education/Training Program 4150 V Street, Pssb 1200, Sacramento, CA 95817 2019-03-22
1811468838 Paige Palsgaard Behavior Technician 6730 4th Ave Apt 1731d, Sacramento, CA 95817 2018-12-17
1922503408 Marie Rossi Student in an Organized Health Care Education/Training Program 4150 V Street #1100, Sacramento, CA 95817 2018-03-27
1639673791 Sean Lam Student in an Organized Health Care Education/Training Program 4150 V Street #1200, Sacramento, CA 95817 2018-03-22
1124555388 Tatyana Polyak Surgery 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 2017-05-18
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1922618917 Alyssa Weakley Clinical Neuropsychologist Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 2020-08-04
1396058780 Lenore A Tate Clinical Neuropsychologist 2030 W El Camino Ave Ste 200, Sacramento, CA 95833-1867 2010-07-14
1588816391 Maria Moleski Clinical Neuropsychologist 2631 Phyllis Ave, Sacramento, CA 95820-4642 2008-10-13
1659530129 Glenn Alan Hammel Clinical Neuropsychologist 1061 Sagamore Way, Sacramento, CA 95822-1714 2008-06-09
1710150685 John J. Wicks Clinical Neuropsychologist 2128 V St, Sacramento, CA 95818-1732 2008-04-10
1003029471 Lawrence Manley Wilcox Clinical Neuropsychologist 1421 P St., #16, Sacramento, CA 95814-5921 2007-05-08
1649326810 Grant L. Hutchinson Clinical Neuropsychologist 730 Alhambra Blvd, Suite 205, Sacramento, CA 95816-3847 2007-01-28
1700934247 Nancy Bell Mahaney Clinical Neuropsychologist 1555 River Park Dr, Suite 205, Sacramento, CA 95815-4612 2007-01-08
1093874133 Catherine Elise Broomand Clinical Neuropsychologist 2345 Fair Oaks Blvd # 14, Sacramento, CA 95825-4708 2006-12-06
1962598284 June Paltzer Clinical Neuropsychologist 1329 Howe Avenue, Suite 201, Sacramento, CA 95825-3363 2006-10-05
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Competitor

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City SACRAMENTO
Zip Code 95817

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Dataset Information

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.

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