MRS. AISSA LEA GARIN X (NPI# 1700357662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700357662 |
| Entity Type | Individual |
| Full Name | MRS. AISSA LEA GARIN X |
| Other Name | MISS AISSA LEA PEREZ |
| Practice Address |
441 S Ham Ln Ste A Lodi CA 95242-3525 |
| Mailing Address |
2418 Christina Ave Stockton CA 95204-1506 |
| Practice Telephone | 2092248940 |
| Mailing Telephone | 2099696546 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2019-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CA | Behavioral Health & Social Service Providers | |
| Y | 106H00000X | Marriage & Family Therapist | 110482 | CA | Behavioral Health & Social Service Providers |
| Street Address |
441 S HAM LN STE A |
| City | LODI |
| State | CA |
| Zip Code | 95242-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740631985 | Alexis Cortez-bautista | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2016-06-29 |
| 1083260780 | Marci Deanna Patrick | Licensed Vocational Nurse | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2019-08-18 |
| 1306492822 | Abigail Gillett | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2019-08-12 |
| 1043866627 | Jennifer Preap | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2019-08-10 |
| 1740834753 | Jaleese Denee Bryant | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2019-07-29 |
| 1821560129 | Angeles Alfaro | Licensed Vocational Nurse | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2018-12-26 |
| 1205305968 | Michael James Latorraca | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2018-11-24 |
| 1285103200 | Ashadieeyah Latifa Karima Barakat | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2018-11-20 |
| 1619444700 | Ginger Vaughn | Counselor | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2018-10-27 |
| 1114407368 | Meenal Mandeeta Prasad-mangal | Licensed Vocational Nurse | 441 S Ham Ln Ste A, Lodi, CA 95242-3525 | 2018-08-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
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| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437639713 | Kristen Elaine Holmes | Marriage & Family Therapist | 13451 N Extension Rd, Lodi, CA 95242-9249 | 2018-08-16 |
| 1720461403 | Edward L Krager | Marriage & Family Therapist | 510 S Fairmont Ave Ste 1, Lodi, CA 95240-3800 | 2015-06-30 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1629418678 | Katelyn Elizabeth Zodikoff | Marriage & Family Therapist | 1120 W Oak St, Lodi, CA 95240-2825 | 2013-07-04 |
| 1760782460 | Malcolm Andrew Berean | Marriage & Family Therapist | 1338 S School St Ste A, Lodi, CA 95240-5700 | 2010-10-27 |
| 1245560648 | Gene Evans Napier | Marriage & Family Therapist | 801 S Lower Sacramento Rd, Lodi, CA 95242-3636 | 2010-01-06 |
| 1437300423 | Lise Helen Bachman-karnes | Marriage & Family Therapist | 330 S Fairmont Ave Ste 7, Lodi, CA 95240-3843 | 2008-10-08 |
| 1376794479 | Sheila Layah Mulvihill | Marriage & Family Therapist | 5 1/2 W Pine St, Suite 8, Lodi, CA 95240-2158 | 2008-10-07 |
| 1790900819 | Becky Jane Dalporto | Marriage & Family Therapist | 12755 North Hwy 88, Lodi, CA 95240 | 2007-04-16 |
| 1336267996 | Tammy Andra Souza | Marriage & Family Therapist | 404 W. Pine Street, Suite 1, Lodi, CA 95240 | 2007-03-26 |
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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.