Provider Demographics
NPI:1902782576
Name:ROPACKI, MICHAEL THOMAS (PHD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:ROPACKI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25220 HANCOCK AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-0904
Mailing Address - Country:US
Mailing Address - Phone:951-417-4466
Mailing Address - Fax:951-380-8483
Practice Address - Street 1:25220 HANCOCK AVE STE 250
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-0904
Practice Address - Country:US
Practice Address - Phone:951-417-4466
Practice Address - Fax:951-380-8483
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18663103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist