PRANAMIND LLC (NPI# 1558994277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558994277 |
| Entity Type | Organization |
| Organization Name | PRANAMIND LLC |
| Other Organization Name | PRANA MIND CENTER |
| Practice Address |
459 W Macarthur Blvd Oakland CA 94609-2808 |
| Practice Telephone | 8774596463 |
| Practice Fax Number | 8774596463 |
| Mailing Telephone | 8774596463 |
| Mailing Fax Number | 8774596463 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | DR. PAUL JACKSON (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 8774596463 |
| Authorized Official Credential | PH. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Prana Mind Center | Doing Business As Name - Organization |
| Street Address |
459 W MACARTHUR BLVD |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-2808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477112522 | Paul A Jackson | Psychologist | 459 W Macarthur Blvd, Oakland, CA 94609-2808 | 2019-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619026739 | Shaliza Shorey | Clinical Neuropsychologist | 3900 Broadway Bldg 1, Oakland, CA 94611-5616 | 2007-01-09 |
| 1497829287 | F. Myron Hays, Ph.d. | Clinical Neuropsychologist | 2917 Mcclure St, Oakland, CA 94609-3504 | 2006-11-20 |
| 1528168366 | Gregory Seth Alter | Clinical Neuropsychologist | 5666 Telegraph Ave, Oakland, CA 94609-1708 | 2006-09-22 |
| 1376143123 | Thomas Vanvleet | Clinical Neuropsychologist | 3947 Opal St, Oakland, CA 94609-2626 | 2020-10-30 |
| 1619599974 | Savera Psychological Services PC | Clinical Neuropsychologist | 401 Grand Ave Ste 380, Oakland, CA 94610-5054 | 2020-05-09 |
| 1568092617 | Meena Saleh | Clinical Neuropsychologist | 3756 Grand Ave, Ste 404, Oakland, CA 94610-1545 | 2020-01-16 |
| 1063912061 | Carol Fenner | Clinical Neuropsychologist | 2000 Embarcadero, Oakland, CA 94606-5334 | 2018-02-15 |
| 1477073062 | Amrita Mehta | Clinical Neuropsychologist | 401 Grand Ave Ste 380, Oakland, CA 94610-5054 | 2017-06-23 |
| 1699902759 | Michael Alex Peterson | Clinical Neuropsychologist | 1425 Leimert Blvd, Suite 403, Oakland, CA 94602-1865 | 2009-06-16 |
| 1104087576 | Wendy Santos-modesitt | Clinical Neuropsychologist | 747 52nd St, Department of Neuro-oncology, Oakland, CA 94609-1809 | 2008-06-19 |
| Find all providers in OAKLAND | ||||
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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.