DR. GARY JAMES REZOWALLI (NPI# 1770645939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770645939 |
| Entity Type | Individual |
| Full Name | DR. GARY JAMES REZOWALLI |
| Credential | PH.D. |
| Practice Address |
175 Bernal Rd Ste 140 San Jose CA 95119-1343 |
| Practice Telephone | 4089726454 |
| Practice Fax Number | 4089726494 |
| Mailing Telephone | 4089726454 |
| Mailing Fax Number | 4089726494 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY 13273 | CA | Behavioral Health & Social Service Providers |
| Street Address |
175 BERNAL RD STE 140 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95119-1343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215096052 | Andrew Charles Berger | Psychologist | 175 Bernal Rd Ste 140, San Jose, CA 95119-1343 | 2006-12-07 |
| 1033266796 | Jackie Ann Ebbert | Social Worker | 175 Bernal Rd Ste 140, San Jose, CA 95119-1343 | 2007-01-04 |
| 1407913759 | Michael Anthony Curry | Social Worker | 175 Bernal Rd Ste 140, San Jose, CA 95119-1343 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922623594 | Julia Angelina Rojas | Rehabilitation Counselor | 298 A Bernal Rd, San Jose, CA 95119 | 2020-06-10 |
| 1609496215 | Kaiser Foundation Hospitals | Pharmacy | 274 International Cir Fl 1 Rm 104, San Jose, CA 95119 | 2020-04-23 |
| 1104451194 | Arthur Warren Hall | Counselor | 298 A Bernal Road, San Jose, CA 95119 | 2020-03-10 |
| 1992264774 | Jennifer Luu | Student in an Organized Health Care Education/Training Program | 276 International Circle Building, 1 - 2nd Floor - Family Medicine Residency Unit G, San Jose, CA 95119 | 2019-03-19 |
| 1194209510 | Victoria Marques | Pharmacist | 275 Hospital Parkway, Suite 625, San Jose, CA 95119 | 2018-09-21 |
| 1780123497 | Costco Wholesale Corporation | Hearing Aid Equipment | 6898 Raleigh Road, San Jose, CA 95119 | 2017-02-14 |
| 1437563855 | Mark Douglas Zukunft | Emergency Medicine | 250 Hospital Pkwy Dept Of, San Jose, CA 95119 | 2014-06-13 |
| 1669896338 | Paul J. Zuchowski Chiropractic, A Professional Corporation | Chiropractor | 6950 Santa Teresa Blvd., Ste.a, San Jose, CA 95119 | 2014-02-14 |
| 1700227873 | Yu-chien Cheng | Internal Medicine | 275 Hospital Pkwy Ste 600, San Jose, CA 95119 | 2013-07-17 |
| 1730432014 | Tami Otomo | Pharmacist | 6201 San Ignacio Ave, San Jose, CA 95119 | 2012-10-24 |
| Find all providers in zip 95119 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861023020 | Widyasita Sawyer | Psychologist | 1189 Curtner Ave, San Jose, CA 95125-3618 | 2020-01-27 |
| 1861030033 | Maria-christina Stewart | Psychologist | 3141 Stevens Creek Blvd # 40167, San Jose, CA 95117-1141 | 2019-12-18 |
| 1306404504 | Palak Dipak Kothari | Psychologist | 20 S 2nd St Unit 425, San Jose, CA 95113-2532 | 2019-06-03 |
| 1942762299 | Dr. Danessa Mayo, Phd | Psychologist | 1190 Lincoln Ave Ste 7, San Jose, CA 95125-3036 | 2019-04-04 |
| 1104362433 | Samantha Kountz-edwards | Psychologist | 1588 Hallbrook Dr, San Jose, CA 95118-1611 | 2017-01-10 |
| 1306243530 | Kell Fujimoto | Psychologist | 2845 Moorpark Ave, Suite 203, San Jose, CA 95128-3158 | 2014-12-03 |
| 1174964092 | Brandi Marche Brooks | Psychologist | 1866 Half Pence Way, San Jose, CA 95132 | 2013-07-08 |
| 1306181284 | Marion Marsha Wadley | Psychologist | 1443 Lupton Ave, San Jose, CA 95125-3847 | 2012-12-04 |
| 1639433709 | Janice Jaishika Raj | Psychologist | 2400 Moorpark Ave., #300, San Jose, CA 95128 | 2012-07-03 |
| 1114296803 | Amanda M Walters | Psychologist | 1101 S Winchester Blvd Ste P297, San Jose, CA 95128 | 2011-12-24 |
| Find all providers in SAN JOSE | ||||
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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.