DR. CAROL LYNN GANDOLFO (NPI# 1578594313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578594313 |
| Entity Type | Individual |
| Full Name | DR. CAROL LYNN GANDOLFO |
| Credential | PSY D |
| Practice Address |
3530 West Pomona Blvd Pomona CA 91769-0100 |
| Mailing Address |
1600 9th Street Room 205 Mailstop 2-3 Sacramento CA 95814-6414 |
| Practice Telephone | 9095951221 |
| Mailing Telephone | 9166542431 |
| Mailing Fax Number | 9166543186 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
PSY16933 | CA | Behavioral Health & Social Service Providers |
| Street Address |
3530 WEST POMONA BLVD |
| City | POMONA |
| State | CA |
| Zip Code | 91769-0100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942256631 | Thach Cam Nguyen | Family Medicine | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-25 |
| 1104846427 | David A Smith | Psychologist | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-07-20 |
| 1952348104 | Thuan G Pham | Internal Medicine | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-31 |
| 1063469013 | Gregory Paul Stone | Dentist | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-27 |
| 1568419406 | Yien-nan Wang | Dentist | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-27 |
| 1386691228 | Aye A Cho | Physical Medicine & Rehabilitation | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-27 |
| 1194772038 | Elhamy Fawzy Khalil | Pediatrics | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-27 |
| 1215983580 | Joanne Ihm Koo | Internal Medicine | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-26 |
| 1306892864 | Cuong Huu Nghiem | Internal Medicine | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-26 |
| 1841246253 | Teri Marino Stiner | Podiatrist | 3530 West Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336661792 | Cathelyn Liwanag Timple | Physical Therapist | 255 E. Bonita Ave, Pomona, CA 91769 | 2017-07-07 |
| 1558574467 | Rohinder Kaur Sandhu Md Inc | Specialist | 255 E Bonita Ave, Pomona, CA 91769 | 2007-05-07 |
| 1720163728 | Joseph Hourany | Internal Medicine | 255 E Bonita Ave, Casa Colina Medical Center, Pomona, CA 91769 | 2006-10-26 |
| 1619068921 | Claremont Imaging Associates, A Medical Corporation | Radiology | 255 E Bonita Avenue, Pomona, CA 91769 | 2006-09-28 |
| 1801842810 | Rachel Elizabeth Firemark | Psychologist | 3530 W Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-25 |
| 1922028240 | Yash P Manchanda | Psychologist | 3530 W Pomona Blvd, Pomona, CA 91769-0100 | 2006-07-20 |
| 1831119155 | Joyce Jung Hong | Pediatrics | 3530 W Pomona Blvd, Pomona, CA 91769-0100 | 2006-07-20 |
| 1942247192 | Anh Cong Nguyen | Internal Medicine | 3530 W Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-31 |
| 1043257298 | Lotfy Ragheb Hanna | Internal Medicine | 3530 W Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-31 |
| 1326095266 | Charles Jeng | General Practice | 3530 W Pomona Blvd, Pomona, CA 91769-0100 | 2006-05-27 |
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| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033219928 | Stanley E Lunde | Psychologist | 3530 Pomona Blvd, Pomona, CA 91768-3238 | 2006-09-22 |
| 1619911120 | Brenda A Duffey-jepsen | Psychologist | 3530 Pomona Blvd, Pomona, CA 91768-3238 | 2006-06-15 |
| 1871549568 | Dean Darrell Engel Alexander | Psychologist | 3530 Pomona Blvd, Pomona, CA 91768-3238 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003476359 | Samuel Doong | Psychologist | 2514 Piedmont Ave Apt 105, Berkeley, CA 94704-3108 | 2019-06-18 |
| 1437634482 | New Horizons: Serving Individuals With Special Needs | Psychologist | 19031 Arminta Street, Reseda, CA 91335-1104 | 2018-09-26 |
| 1679086417 | B & D Assessment and Consulting Services, Inc. | Psychologist | 26565 West Agoura Rd Ste 200, Calabasas, CA 91302-1990 | 2017-11-15 |
| 1235593690 | Wayne Kilthau | Psychologist | 5301 Gerine Blossom Dr, San Jose, CA 95123-2118 | 2016-04-11 |
| 1588024103 | Kristin Bria | Psychologist | 150 Glen Cove Marina Rd E, Vallejo, CA 94591-7292 | 2016-02-24 |
| 1477921450 | Haleigh Scott | Psychologist | 3626 Fair Oaks Blvd Ste 100, Sacramento, CA 95864-7200 | 2015-09-09 |
| 1235543265 | Verbal Behavior Associates | Psychologist | 15373 Innovation Dr., Suite 200, San Diego, CA 92128 | 2014-06-18 |
| 1700290962 | New Directions for Young Adults - California | Psychologist | 100 Longbrook Way, Ste. 20, Pleasant Hill, CA 94523 | 2014-06-16 |
| 1518383520 | Tammy Brandt | Psychologist | 5016 North Parkway Calabasas, 215, Calabasas, CA 91302 | 2014-03-14 |
| 1548501323 | Independent Consulting Services | Psychologist | 124 Whispering Oaks Dr, Glendora, CA 91741-3988 | 2013-03-05 |
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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.