BREANNE BENEDICT (NPI# 1992104715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992104715 |
| Entity Type | Individual |
| Full Name | BREANNE BENEDICT |
| Practice Address |
2185 W Grant Line Rd Tracy CA 95377-7309 |
| Practice Telephone | 2098396299 |
| Mailing Telephone | 2098396233 |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2020-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 30435 | CA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2185 W GRANT LINE RD |
| City | TRACY |
| State | CA |
| Zip Code | 95377-7309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801870035 | Konrad Boyd Thomas | Obstetrics & Gynecology | 2185 W Grant Line Rd, 2nd Floor, Tracy, CA 95377-7309 | 2005-12-01 |
| 1972013597 | Diane Marie Kennedy | Nurse Practitioner | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-10-10 |
| 1124552419 | Stacy Quach | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-13 |
| 1528592748 | Terry K Chow | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-13 |
| 1114451564 | Ngoc Son Dang | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-12 |
| 1619409745 | Natalya Pohoryelova | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-03-29 |
| 1659824399 | Eric Grady | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2016-07-29 |
| 1235508656 | Nicole Leona Preiss | Psychologist | 2185 W Grant Line Rd, Psychiatry, Tracy, CA 95377-7309 | 2015-09-15 |
| 1477933760 | Jennifer Rae Hulin Segura | Social Worker | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2015-06-02 |
| 1821408519 | Chuanzhong Ye | Psychiatry & Neurology | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2014-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639787070 | Mehak Bhardwaj | Behavior Technician | 2434 Saffron Ct, Tracy, CA 95377 | 2020-07-22 |
| 1427510809 | Xiaorui Yang | Behavior Technician | 1951 W Middlefield Dr Apt 224, Tracy, CA 95377 | 2019-04-03 |
| 1962936328 | Duc Nguyen | Pharmacist | 2941 W. Lowell Ave, Apt# 21, Tracy, CA 95377 | 2017-04-12 |
| 1053735043 | Luke Rond | Emergency Medicine | 763 Quail Run Cir, Tracy, CA 95377 | 2014-02-11 |
| 1578862553 | Nhan Duong | Pharmacist | 3250 W. Grant Line Road, Tracy, CA 95377 | 2011-03-16 |
| 1952570582 | Tech Diamond Health Care | Home Health | 2098 Babcock Lane, Tracy, CA 95377 | 2008-02-28 |
| 1316058795 | Wandisan and Rosete Medical Group Professional Corporation | Internal Medicine | 4600 S Tracy Blvd #107, Tracy, CA 95377 | 2006-08-31 |
| 1801838610 | Rollie Duyao Rosete | Internal Medicine | 4600 S Tracy Blvd, #107, Tracy, CA 95377 | 2006-06-13 |
| 1649274663 | Wivina Talabis Urbano | Pediatrics | 4600 South Tracy Blvd, Suite 110, Tracy, CA 95377 | 2005-06-08 |
| 1770586448 | Mitchell Edward Blum | Otolaryngology | 2160 W. Grantline Rd, Suite 250, Tracy, CA 95377 | 2005-05-24 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699229005 | Chad Cryder | Psychologist | 793 S Tracy Blvd # 329, Tracy, CA 95376-4753 | 2016-08-15 |
| 1235508656 | Nicole Leona Preiss | Psychologist | 2185 W Grant Line Rd, Psychiatry, Tracy, CA 95377-7309 | 2015-09-15 |
| 1043373020 | Tracy Ann Gayeski | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2006-12-19 |
| 1982764874 | Sonja Terry Van Laar | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2006-12-11 |
| 1154491736 | Doreen Ann Samelson | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2006-11-09 |
| 1699869875 | Sanford Health Network | Psychologist | 249 5th St E, Tracy, MN 56175-1536 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306690 | Eileen Kay Laughman | Psychologist | 24545 Town Center Dr Apt 5406, Valencia, CA 91355-1397 | 2020-11-08 |
| 1194324954 | Rachel Charman | Psychologist | 1001 Dove St Ste 110, Newport Beach, CA 92660-2845 | 2020-10-22 |
| 1700485760 | Melissa Ernestine Munoz | Psychologist | 353 H St # 1517, Chula Vista, CA 91910-5501 | 2020-10-21 |
| 1235737669 | Maha Nasrallah-babenko | Psychologist | 33442 Valley View Ct, Dana Point, CA 92629-1515 | 2020-10-16 |
| 1689272544 | Kaleidoscope Solutions Family Therapy | Psychologist | 25876 The Old Road, #85, Stevenson Ranch, CA 91381 | 2020-10-13 |
| 1992302814 | Sheena Gill | Psychologist | 2501 E Chapman Ave Ste 265, Fullerton, CA 92831-3108 | 2020-10-04 |
| 1255948600 | Kesha Patrice | Psychologist | 939 Ellis St, San Francisco, CA 94109-7714 | 2020-09-29 |
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1376159541 | Jill Caryn Campbell | Psychologist | 342 Ocho Rios Way, Oak Park, CA 91377-5541 | 2020-09-22 |
| 1225644487 | Brock Louis Pistel | Psychologist | 939 Ellis St Fl 67, San Francisco, CA 94109-7714 | 2020-09-22 |
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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.