DR. DEREK S MONGOLD (NPI# 1700099264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700099264 |
| Entity Type | Individual |
| Full Name | DR. DEREK S MONGOLD |
| Credential | MD |
| Practice Address |
3400 Delta Fair Blvd Antioch CA 94509-4004 |
| Practice Telephone | 9257776399 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2015-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | A122589 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101251845 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 22903 | WV | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
A122589 | CA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0101251845 | VA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
22903 | WV | Allopathic & Osteopathic Physicians |
| Street Address |
3400 DELTA FAIR BLVD |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929914 | Barbara A Rhoades | Nurse Practitioner | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2005-08-18 |
| 1962936849 | Nardip Singh | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-17 |
| 1649704743 | Anh X Nguyen | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-14 |
| 1104359918 | Borey Som | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-07 |
| 1790005015 | Elizabeth Seidler | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2010-06-09 |
| 1699091793 | Allison Townsend Hampton | Pediatrics | 3400 Delta Fair Blvd, Department of Pediatrics, Antioch, CA 94509-4004 | 2010-04-14 |
| 1063746998 | Athena Panzar | Counselor | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2009-09-24 |
| 1083859888 | Philip Song | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2008-12-08 |
| 1033319215 | Sanaz Stacy Aboutalebi-simon | Optometrist | 3400 Delta Fair Blvd, The Permanente Medical Group, Inc., Antioch, CA 94509-4004 | 2007-07-24 |
| 1164647467 | Darcey A Thompson | Physical Therapist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2007-04-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760666853 | Edward Lau | Psychiatry & Neurology | 3501 Lone Tree Way, Suite 200, Antioch, CA 94509 | 2007-12-25 |
| 1518041144 | Beatrice St. Claire | Psychiatry & Neurology | 3454 Hillcrest Ave, Antioch, CA 94531-8238 | 2006-10-24 |
| 1497113724 | Ronald L Leon Md Inc | Psychiatry & Neurology | 3432 Hillcrest Ave Ste 175, Antioch, CA 94531-6343 | 2016-02-01 |
| 1568717510 | Ernest Ayodele Gbadebo-goyea | Psychiatry & Neurology | 5000 Mountain Springs Dr, Antioch, TN 37013-5699 | 2012-07-16 |
| 1366737652 | Nnennaya Ekwutosi Nwokeji | Psychiatry & Neurology | 3454 Hillcrest Ave, Antioch, CA 94531-8238 | 2011-06-14 |
| 1639321771 | Christine Lim | Psychiatry & Neurology | 3454 Hillcrest Ave, Kaiser Permanente, Antioch, CA 94531-8238 | 2008-10-21 |
| 1871645846 | Thomas R. Jones | Psychiatry & Neurology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2007-01-18 |
| 1346392578 | Kyle P. Owen | Psychiatry & Neurology | 2213 Buchanan Rd, Suite 203, Antioch, CA 94509-4265 | 2007-01-17 |
| 1568527240 | Kavitha Rao | Psychiatry & Neurology | 2213 Buchanan Rd, Kaiser Department of Mental Health Suite 203, Antioch, CA 94509 | 2006-12-24 |
| 1386723971 | Melanie G Akalal | Psychiatry & Neurology | 3454 Hillcrest Ave, Antioch, CA 94531-8238 | 2006-11-03 |
| Find all providers in ANTIOCH | ||||
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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.