Johanna D Gladieux, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY4858 Issued in CA

Practice address

954 Risa Rd Ste a
Lafayette, CA 94549-3418

Phone

(510) 332-0329

NPI assigned

Jul 6, 2006

Last updated

Nov 10, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1285665117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 TOPPER LN",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945495119",
            "telephone_number": "925-283-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 RISA RD STE A",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493418",
            "telephone_number": "510-332-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADIEUX",
        "first_name": "JOHANNA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY4858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CE059A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayvaan Ghovanloo
• Arthur Vito Giacalone, PH.D.
• Virginia T Gillanders, OTR/L
• Bert N. Gilling, M.D.
• Joseph Giove, C.C.HT.
• Theodore Alan Glattke, P.T.
• Erika Beth Goldstein, PH.D.
• Jamie Goldstein, PSY.D
• Anthony Javier Gonzalez
• Leslie Gonzalez, DC

• Psychologist in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.