Dr. June Roseann Hannon, Ph.D.
Clinical Neuropsychologist in Stockton, CA. Individual provider (NPI-1).
NPI number1790798247
StatusActive
Last updated in NPPESSep 22, 2020
Details
- NPI
- 1790798247
- Entity type
- Individual (NPI-1)
- Name
- Dr. June Roseann Hannon
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 15, 2006
- Certification date
- Sep 22, 2020
- Last updated
- Sep 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL PSYCHOLOGIST
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY5871 | CA | Yes |
Practice location
2111 Lido CirStockton, CA 95207-6014
Phone 209-565-1365 · Fax 209-474-7421
Mailing address
2111 Lido CirStockton, CA 95207-6014
Phone 209-565-1365 · Fax 209-474-7421
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