Address: 1976 W Rose Street, Stockton, CA 95203

ELIZABETH ZDRADZINSKI (NPI# 1760737241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760737241
Entity Type Individual
Gender Female
Credential PSY.D.
Practice Address 1976 W Rose Street
CA 95203
Practice Telephone 2094251645
Mailing Address 1976 W Rose Street
CA 95203
Mailing Telephone 2094251645
Certification Date 2021-04-02
Enumeration Date 2012-07-19
Last Update Date 2021-04-02
Is Sole Proprietor Y


Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 103T00000X Psychologist PSY25566 CA Behavioral Health & Social Service Providers
N 103T00000X Psychologist PY8520 FL Behavioral Health & Social Service Providers

Physician Overview

PECOS Associate Control (PAC) ID 5991074718
by Medicare Provider Enrollment and Chain/Ownership System (PECOS)
Professional Enrollment ID I20170710001892
Location 1317 Oakdale Rd, Suite 440, Modesto, CA 95355-3364
Phone Number 2095223362
Graduation Year 2009
Group Practice PAC ID 8022338854
Number of Group Practice Members 6

Office Location

Street Address 1976 W ROSE STREET
State CA
Zip Code 95203

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1487019568 Evelyn Marie Cabral Registered Nurse 1966 W Rose St, Stockton, CA 95203-1327 2015-12-16
1639292675 Angelina Julia Manzo I · Angelina Julia Manzo I Counselor - Addiction (Substance Use Disorder) 1444 N Baker St, Stockton, CA 95203-1713 2007-04-06
1285011064 Brian Andrew Reuter Emergency Medicine Dameron Hospital, 525 Acacia St, Stockton, CA 95203 2015-04-30
1245782622 Christine Bolthouse Specialist/Technologist - Athletic Trainer 1858 Lucerne Ave, Stockton, CA 95203-1440 2016-11-01
1447899349 Sagrario Alva Chavez Technician - Attendant Care Provider Sagrario Chavez, 1248 West Park St., Stockton, CA 95203 2019-12-26
1144899600 Elizabeth S Rehme Massage Therapist 1724 Monte Diablo Ave, Stockton, CA 95203-1554 2021-06-20
1619350634 Sudha Vani Saduvala Internal Medicine 525 W Acacia St, Stockton, CA 95203 2015-07-08
1538682810 Kumars Transport Non-emergency Medical Transport (VAN) 1112 W Fremont St, Stockton, CA 95203 2017-07-19
1417021726 Sahir Naseer Emergency Medicine 525 W Acacia St, Stockton, CA 95203 2006-11-20
1104312800 Melissa Delossantos Behavioral Analyst 2180 Lucerne Ave, Stockton, CA 95203-1257 2018-07-05
Find all in zip 95203

Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811352628 Stephen Gutknecht Psychologist 3755 W Benjamin Holt Dr Apt 163, Stockton, CA 95219-3313 2015-12-21
1518277433 Maria Elisabet Revilla Psychologist 1350 W Robinhood Dr Ste 18, Stockton, CA 95207-5519 2010-10-13
1184869356 Frederick Arthur Martin Psychologist 1232 Mill Way, Stockton, CA 95209-4368 2008-12-02
1144344136 Austin Abbott Carpenter Jr. Psychologist 645 W Harding Way, Sutie 2, Stockton, CA 95204-5688 2007-03-17
1053472605 Robert Phil Park Psychologist 1305 Tommydon St, Stockton, CA 95210-3364 2006-12-13
1851493639 Victor Manuel Zapien Psychologist 1743 Grand Canal Blvd Suite #16, Stockton, CA 95207 2006-09-02
1720021975 Floyd Joseph O'Brien Psychologist 33 W Alder St, Stockton, CA 95204-5701 2006-06-14
1871196865 Yoe M Moon · Paul Moon Psychologist 7707 Austin Rd, Stockton, CA 95215-8312 2020-11-20
1801445929 Juliet Acolatse · Jda Psychology Assessment & Services Psychologist 1201 N Sutter St, Stockton, CA 95202-1506 2019-09-11
1306336888 Debra Ann Robertson · Debra Ann Lanham Psychologist 7707 Austin Rd, Stockton, CA 95215-8312 2018-05-10
Find all providers in STOCKTON


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Dataset Information

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.