Guillermo Enrique Gallegos, PH. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

SIOO2556 Issued in NJ

Practice address

5 Fir CT Ste 2
Oakland, NJ 07436-1821

Phone

(908) 239-2338

Fax

(201) 933-1326

NPI assigned

Nov 10, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vericare Behavioral Health of New Jersey, P.a.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1669408274
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1003117821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 MOUNTAIN WAY",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702817",
            "telephone_number": "908-239-2338",
            "fax_number": "201-933-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIR CT STE 2",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074361821",
            "telephone_number": "908-239-2338",
            "fax_number": "201-933-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "GUILLERMO",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "SIOO2556",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "16943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flow Home Care Physical Therapy LLC
• Jo-Ann Freund
• Robert Anthony Freund, DPT
• Lauryn Gadomski, BCBA
• Kristine Marie Gaffney, CCC-SLP
• Jessica Garcia, PT
• Kelly Annete Garcia, PT, DPT
• Garden State Orthopaedic Center, Inc.
• Anita Gardner, MS, RDN
• Karen A Garrett, DPT

• Clinical Psychologist in Oakland, NJ
• Providers in Oakland, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.