TRAVIS FOGEL (NPI# 1790718518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790718518 |
| Entity Type | Individual |
| Full Name | TRAVIS FOGEL |
| Credential | PHD |
| Practice Address |
11406 Loma Linda Dr Loma Linda CA 92354-3711 |
| Mailing Address |
54701 File Number Los Angeles CA 90074-4701 |
| Practice Telephone | 9095586144 |
| Practice Fax Number | 9095583905 |
| Mailing Telephone | 9095583111 |
| Mailing Fax Number | 9095583905 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY17746 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PSY177460 | 05 |
| Street Address |
11406 LOMA LINDA DR |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932168655 | Dave Lynaeus Tan | Physical Therapist | 11406 Loma Linda Dr, West Entrance, Loma Linda, CA 92354-3711 | 2006-03-21 |
| 1396342960 | Jeffrey Ryan Murray | Clinical Neuropsychologist | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2020-10-06 |
| 1942775929 | Edna Sonya Barrett | Physical Therapist | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2018-10-05 |
| 1205364106 | Caitlin Linas Medes | Occupational Therapist | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2017-05-23 |
| 1164876918 | Joshua Nelson Speirs | Student in an Organized Health Care Education/Training Program | 11406 Loma Linda Dr, Suite 213, Loma Linda, CA 92354-3711 | 2016-04-18 |
| 1427465327 | Shawn Michael Teran | Student in an Organized Health Care Education/Training Program | 11406 Loma Linda Dr, Room 516, Loma Linda, CA 92354-3711 | 2014-07-13 |
| 1992065940 | Joseph Johnson | Orthopaedic Surgery | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2012-05-24 |
| 1144589839 | Davin Yah-ming Chu | Physical Medicine & Rehabilitation | 11406 Loma Linda Dr, Suite 516, Loma Linda, CA 92354-3711 | 2012-05-15 |
| 1154689248 | Joseph Liu | Orthopaedic Surgery | 11406 Loma Linda Dr, Loma Linda, CA 92354 | 2012-04-26 |
| 1245531367 | Summer San Lucas | Physical Therapist | 11406 Loma Linda Dr, West Entrance, Loma Linda, CA 92354-3711 | 2010-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| 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 |
|---|---|---|---|---|
| 1316124969 | Jose L Fuentes | Clinical Neuropsychologist | 24230 Barton Rd, Loma Linda, CA 92354-3232 | 2008-01-25 |
| 1275583007 | Faculty Physicians and Surgeons of Llusm | Clinical Neuropsychologist | 25845 Barton Road, Ste. F, Loma Linda, CA 92354-3857 | 2006-05-11 |
| 1811993389 | Michael J Gilewski | Clinical Neuropsychologist | 11406 Loma Linda Dr Rm 105, Loma Linda, CA 92354-3711 | 2005-06-21 |
| 1396342960 | Jeffrey Ryan Murray | Clinical Neuropsychologist | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2020-10-06 |
| 1710249313 | Suzanne Michelle Hilleary | Clinical Neuropsychologist | Va Loma Linda Healthcare System, 11201 Benton Street, Loma Linda, CA 92357-0001 | 2012-06-11 |
| 1689988362 | Kyrstle Barrera | Clinical Neuropsychologist | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2010-08-04 |
| 1992026702 | Samantha Lyn French | Clinical Neuropsychologist | 11201 Benton St, Loma Linda, CA 92357-4801 | 2010-06-15 |
| 1619296829 | Christine Kang | Clinical Neuropsychologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2010-05-27 |
| 1659559136 | Fuentes Family Counseling, Inc. | Clinical Neuropsychologist | 24230 Barton Rd, Loma Linda, CA 92354-3232 | 2008-02-06 |
| 1619927647 | Faculty Physicians and Surgeons of Llusm | Clinical Neuropsychologist | 11406 Loma Linda Dr, Suite 300, Loma Linda, CA 92354-3711 | 2006-05-11 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on TRAVIS FOGEL.
| 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.