DR. ROBERTO D DECANDIA (NPI# 1881699452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881699452 |
| Entity Type | Individual |
| Full Name | DR. ROBERTO D DECANDIA |
| Credential | PH.D. |
| Practice Address |
1000 S Fremont Ave Eastern Los Angeles Regional Center Alhambra CA 91802-7916 |
| Mailing Address |
Po Box 5163 Hacienda Heights CA 91745-0163 |
| Practice Telephone | 6262994700 |
| Mailing Telephone | 6262994700 |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2013-07-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PSY12012 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY12012 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | PSY120120 | 01 |
| Street Address |
1000 S FREMONT AVE EASTERN LOS ANGELES REGIONAL CENTER |
| City | ALHAMBRA |
| State | CA |
| Zip Code | 91802-7916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811513021 | Gabrielle Chasen Johnson | Registered Nurse | 1000 S Fremont Ave, Alhambra, CA 91803-8800 | 2020-06-23 |
| 1033730635 | Dru Elizabeth Lezina | Pharmacist | 1000 S Fremont Ave, Alhambra, CA 91803-8800 | 2020-05-05 |
| 1255801106 | Melanie Braund | Physical Therapist | 1000 S Fremont Ave, Alhambra, CA 91803-8800 | 2018-12-04 |
| 1265947352 | Katherine Tse | Occupational Therapist | 1000 S Fremont Ave, Alhambra, CA 91803-8800 | 2017-12-11 |
| 1487188041 | Fabian Castrellon | Behavioral Analyst | 1000 S Fremont Ave, Unit 60, Alhambra, CA 91803-8800 | 2017-04-20 |
| 1588198220 | Miriam Torres Hanson | Behavioral Analyst | 1000 S Fremont Ave, Suite 60, Alhambra, CA 91803-8800 | 2017-04-19 |
| 1104362896 | Jenna Stauffer | Assistant Behavior Analyst | 1000 S Fremont Ave, Building A-5, Suite 5128, Alhambra, CA 91803-8800 | 2017-01-18 |
| 1801339288 | Wai Yan Chow | Occupational Therapist | 1000 S Fremont Ave, Unit 27, Alhambra, CA 91803-8800 | 2016-12-02 |
| 1639629249 | Kira Bender | Occupational Therapist | 1000 S Fremont Ave, Alhambra, CA 91803-8800 | 2016-10-06 |
| 1336501469 | Johanne Zaporteza | Behavioral Analyst | 1000 S Fremont Ave, Unit 1, Bldg A5, Suite 5128, Alhambra, CA 91803 | 2016-03-28 |
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|---|---|---|---|---|
| 1548396898 | Margaret E Winter | Audiologist | Csula Hearing Clinic 1000 S Fremont St, Building B Suite B 10200, Alhambra, CA 91802 | 2007-02-23 |
| 1316313315 | Joseline Cubas | Marriage & Family Therapist | 10 W Bay State St Unit 6434, Alhambra, CA 91802-2880 | 2015-08-13 |
| 1114547072 | Shuhua Guo | Nurse Practitioner | 10 W Bay State St, Alhambra, CA 91802-3044 | 2020-04-21 |
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
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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.