DR. MICHAEL ALEX PETERSON (NPI# 1699902759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699902759 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL ALEX PETERSON |
| Other Name | DR. ALEX PETERSON |
| Credential | PH.D. |
| Practice Address |
1425 Leimert Blvd Suite 403 Oakland CA 94602-1865 |
| Practice Telephone | 5105310500 |
| Practice Fax Number | 5103360902 |
| Mailing Telephone | 5105310500 |
| Mailing Fax Number | 5103360902 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 18593 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1548715634 | Michael Latrae Peterson | Social Worker | 6767 W Windmill Ln, Las Vegas, NV 89139-6501 | 2016-08-18 |
| 1033544119 | Michael Robert Peterson | Counselor | 522 4th St S, Stillwater, MN 55082-4966 | 2013-09-09 |
| 1750651113 | Michael Peterson | Social Worker | 1400 N Hayworth Ave Apt 9, West Hollywood, CA 90046-3836 | 2012-01-03 |
| 1578848131 | Michael Dean Peterson | Dentist | 4710 Amber Valley Pkwy S, Ste A, Fargo, ND 58104 | 2011-10-14 |
| 1467693119 | Michael Lamont Peterson | Registered Nurse | 13 Hollister St, Rochester, NY 14605-1401 | 2009-03-10 |
| 1003062001 | Michael Carl Peterson | Physical Therapist | 2850 Mitchell Rd, Jamestown, NY 14701-8906 | 2008-08-11 |
| 1942472691 | Michael E Peterson | Dentist | 5355 W State St, Boise, ID 83703-3333 | 2008-04-01 |
| 1134325145 | Michael W Peterson | Dentist | 1319 Tennessee St, Vallejo, CA 94590 | 2007-06-26 |
| 1609079094 | Michael Gene Peterson | Emergency Medicine | 201 E. Nicollet Blvd., Burnsville, MN 55337 | 2007-06-06 |
| Street Address |
1425 LEIMERT BLVD SUITE 403 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94602-1865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487733267 | Dan Quinn | Psychologist | 1425 Leimert Blvd, Suite 204, Oakland, CA 94602-1865 | 2006-11-03 |
| 1720480130 | Rosemary Wood Lmft | Community/Behavioral Health | 1425 Leimert Blvd, Suite 202, Oakland, CA 94602-1865 | 2014-09-17 |
| 1437580248 | Sari Ann Leivent Sanghvi | Psychologist | 1425 Leimert Blvd, Suite 302-a, Oakland, CA 94602-1865 | 2013-12-04 |
| 1972941342 | Nicholas Don Hack | Student in an Organized Health Care Education/Training Program | 1425 Leimert Blvd, Ste 202, Oakland, CA 94602-1852 | 2013-06-07 |
| 1952610172 | Bonnie Sue Ho | Psychologist | 1425 Leimert Blvd, Suite #202, Oakland, CA 94602-1865 | 2010-10-05 |
| 1740408806 | Deborah L. Blackburn | Marriage & Family Therapist | 1425 Leimert Blvd, Suite 200, Oakland, CA 94602-1808 | 2007-04-23 |
| 1316002025 | Susan L. Love | Counselor | 1425 Leimert Blvd, #302, Oakland, CA 94602-1808 | 2006-12-22 |
| 1891855979 | Virginia Ann Keeler-wolf | Marriage & Family Therapist | 1425 Leimert Blvd, Ste. 302, Oakland, CA 94602-1808 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376151845 | Nicholas Collins Pac Lac Inc | Acupuncturist | 3433 Brunell Dr, Oakland, CA 94602 | 2020-07-21 |
| 1225667850 | Elaine Dellinger | Student in an Organized Health Care Education/Training Program | Highland Hospital 1411 East 31st Street, Qic 22123, Oakland, CA 94602 | 2020-04-06 |
| 1356804033 | Jayakala Lakireddy | Student in an Organized Health Care Education/Training Program | Dept of Surgery, 1411 East 31st Street, Oakland, CA 94602 | 2019-04-10 |
| 1750844585 | Kirea J Mazzolini | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, 1411 East 31st Street, Oakland, CA 94602 | 2019-04-09 |
| 1912478587 | Joie Mazor | Chiropractor | 3201 Macarthur Blvd., Oakland, CA 94602 | 2018-12-07 |
| 1114424884 | Jesse Santos | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, 1411 East 31st Street, Oakland, CA 94602 | 2018-04-10 |
| 1679078646 | Tia Vang | Student in an Organized Health Care Education/Training Program | 1411 E. 31st Street 2nd Flr A2, Oakland, CA 94602 | 2018-03-29 |
| 1942704101 | Michael Mian | Student in an Organized Health Care Education/Training Program | 1411 E 31st St, Qic 22123, Oakland, CA 94602 | 2018-03-22 |
| 1063916575 | Charisma Kaushik | Student in an Organized Health Care Education/Training Program | 1411 East 31st Street, Qic 22123, Oakland, CA 94602 | 2018-03-20 |
| 1841711363 | David Christopher Carroll | Pharmacist | 1411 E. 31st Street, Oakland, CA 94602 | 2017-07-06 |
| Find all providers in zip 94602 | ||||
| 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 |
| 1558994277 | Pranamind LLC | Clinical Neuropsychologist | 459 W Macarthur Blvd, Oakland, CA 94609-2808 | 2020-02-21 |
| 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 |
| 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.