PACIFIC FORENSIC PSYCHOLOGY ASSOCIATES, INC (NPI# 1790325694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790325694 |
| Entity Type | Organization |
| Organization Name | PACIFIC FORENSIC PSYCHOLOGY ASSOCIATES, INC |
| Practice Address |
19230 Sonoma Highway Building 200 Sonoma CA 95476 |
| Practice Telephone | 9162240212 |
| Mailing Telephone | 9162240212 |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |
| Authorized Official Name | DR. TONY ANGELO (PRESIDENT / PRINCIPLE) |
| Authorized Official Telephone | 7073954500 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Elysian Health Partners | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396929022 | Pacific Forensic Psychology Associates, Inc | Counselor | 5200 San Gabriel Pl Ste G, Pico Rivera, CA 90660-2498 | 2007-12-17 |
| 1992997597 | Pacific Forensic Psychology Associates, Inc | Psychologist | 616 Shatto Pl, Los Angeles, CA 90005-1301 | 2007-08-16 |
| Street Address |
19230 SONOMA HIGHWAY BUILDING 200 |
| City | SONOMA |
| State | CA |
| Zip Code | 95476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003315169 | Kevin Mccarthy | Occupational Therapist | 19312 Sonoma Hwy, Ste B Sonoma, Sonoma, CA 95476 | 2018-02-05 |
| 1558895318 | Christy Murphy | Pharmacist | 19205 Sonoma Hwy, Sonoma, CA 95476 | 2017-04-18 |
| 1003355835 | Eric Wilson Garcia | Physical Therapist | 1331 Medical Center Dr, Rohnert Park, CA 95476 | 2017-02-13 |
| 1952759664 | Imgrx Sonoma Inc | Pharmacy | 19270 Sonoma Hwy, Suite A, Sonoma, CA 95476 | 2016-06-03 |
| 1790039121 | Joslyn Metzger | Social Worker | 10270 Sonoma Highway, Sonoma, CA 95476 | 2012-11-07 |
| 1477853182 | Marcy Swiatek Brandner | Counselor | 19343 Sonoma Highway, Sonoma, CA 95476 | 2010-10-27 |
| 1477784890 | Peter G. Meyerhof | Dentist | 684 W. Napa St., Sonoma, CA 95476 | 2009-08-03 |
| 1467692855 | Rebeca Fiske Bailey | Psychologist | 793 First St West, Sonoma, CA 95476 | 2009-02-25 |
| 1306099056 | Hubenette Dental Corporation | Dentist | 660 Third Street West, Sonoma, CA 95476 | 2008-10-28 |
| 1700041233 | Jeanne R Campbell | Marriage & Family Therapist | 771 Oregon St, Sonoma, CA 95476 | 2008-07-24 |
| Find all providers in zip 95476 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1184231508 | Rh Community Builders Lp. | Clinic/Center | 1040 N Pleasant Ave, Fresno, CA 93728-2434 | 2020-09-29 |
| 1730795337 | Full Circle Psychotherapy | Clinic/Center | 6741 Sebastopol Ave Ste 110, Sebastopol, CA 95472-3838 | 2020-09-18 |
| 1871108928 | Executive Recovery Group, Inc | Clinic/Center | 77725 Enfield Ln Ste 200, Palm Desert, CA 92211-0468 | 2020-09-14 |
| 1619581337 | Family Tree Psychology Group Inc. | Clinic/Center | 3655 Grand Ave, Oakland, CA 94610-2009 | 2020-09-01 |
| 1306459029 | Lisa Eaton Therapy and Coaching, A Licensed Clinical Social Worker Cor | Clinic/Center | 3014 Lupine, Lake Forest, CA 92630-8439 | 2020-08-24 |
| 1972112712 | County of Kern | Clinic/Center | 316 Kentucky, Bakersfield, CA 93305 | 2020-07-28 |
| 1417566605 | Freedom Family Counseling Group Corp. | Clinic/Center | 190 S Orchard Ave Ste C230, Vacaville, CA 95688-3657 | 2020-07-23 |
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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.