ALICE PARK MD
NPI 1891795076
Psychiatry & Neurology - Psychiatry in Stockton, CA

Q: What is Alice Park's NPI number?

The NPI number for Alice Park is 1891795076. It was assigned to this individual provider in the NPPES registry on July 28, 2005.

Q: What is Alice Park's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Alice Park was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 28, 2005PECOS Enrolled

1305 TOMMYDON ST, STOCKTON, CA 95210(209) 476-5200 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Alice Park Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALICE PARK MD (NPI 1891795076) is an individual psychiatry provider in Stockton, California, licensed in Texas (L8157) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891795076

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameALICE PARKCredential: MD

Location Address1305 TOMMYDON STStockton, CA 95210-3364

Mailing Address3749 Whispering Creek CirStockton, CA 95219-2329 · (209) 952-5156

Phone(209) 476-5200

Sole ProprietorNo

Enumeration DateJuly 28, 2005

Last NPPES UpdateDecember 27, 2021

✔ NPI 1891795076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in TX · L8157

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

1305 TOMMYDON ST, Stockton, CA 95210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alice Park Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$176.60 typical visit price

range $58.87 – $176.60

Typical copayment $44.15 (range $14.71 – $44.15)

Most-billed visit code 99205

Established Patient

$73.16 typical visit price

range $19.28 – $144.60

Typical copayment $18.29 (range $4.82 – $36.15)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK ALLEN BOURASSA

Counselor (Professional)