| Over Sixty Health Center | |
|
3260 Sacramento St Berkeley CA 94702-2739 | |
| (510) 428-4500 | |
| Not Available |
| Full Name | Over Sixty Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 3260 Sacramento St, Berkeley, California |
| Authorized Official Name and Position | Marty Lynch (CEO) |
| Authorized Official Contact | 5109814100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Over Sixty Health Center Po Box 11247 Berkeley CA 94712-2247 Ph: (510) 981-4100 | Over Sixty Health Center 3260 Sacramento St Berkeley CA 94702-2739 Ph: (510) 428-4500 |
| NPI Number | 1689670002 |
|---|---|
| Provider Enumeration Date | 06/21/2005 |
| Last Update Date | 10/23/2009 |
| Medicare PECOS PAC ID | 2062304538 |
|---|---|
| Medicare Enrollment ID | O20050713000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689670002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 140000191 (California) | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | 140000191 (California) | Primary |
| Provider Name | Levis Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104045426 PECOS PAC ID: 0648169219 Enrollment ID: I20040311001422 |
| Provider Name | Richard K Turner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568485092 PECOS PAC ID: 7012904352 Enrollment ID: I20040428000746 |
| Provider Name | Robert Golomb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831148048 PECOS PAC ID: 5698677334 Enrollment ID: I20040428000889 |
| Provider Name | Sekai Chideya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174816409 PECOS PAC ID: 4385634492 Enrollment ID: I20040512001081 |
| Provider Name | Karen N Carothers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619935830 PECOS PAC ID: 8820990567 Enrollment ID: I20040525000924 |
| Provider Name | Desmond E Carson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912934464 PECOS PAC ID: 1254312259 Enrollment ID: I20040526000586 |
| Provider Name | Sara Woolf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083746010 PECOS PAC ID: 0840276721 Enrollment ID: I20040629001703 |
| Provider Name | Susan Callaway Ferguson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093756678 PECOS PAC ID: 6709855679 Enrollment ID: I20040928000343 |
| Provider Name | Steven Chui Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902976434 PECOS PAC ID: 0840252102 Enrollment ID: I20041028001061 |
| Provider Name | Kendra L Jacobson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982644167 PECOS PAC ID: 5496717647 Enrollment ID: I20041029000671 |
| Provider Name | Sarah J Oven |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487618740 PECOS PAC ID: 4880664630 Enrollment ID: I20050125000455 |
| Provider Name | Arthur Edward Bakal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114005980 PECOS PAC ID: 8921050394 Enrollment ID: I20050214000609 |
| Provider Name | Sarah a Briand |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1548351117 PECOS PAC ID: 0042263253 Enrollment ID: I20050228001062 |
| Provider Name | Edwin Seth Munich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770556805 PECOS PAC ID: 6507811700 Enrollment ID: I20050321000976 |
| Provider Name | Melissa Barbara Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225009319 PECOS PAC ID: 2062469844 Enrollment ID: I20050404000915 |
| Provider Name | Emily K Birenbaum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467619122 PECOS PAC ID: 1153369384 Enrollment ID: I20050419001029 |
| Provider Name | Andrea L Green |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477620359 PECOS PAC ID: 6305887274 Enrollment ID: I20050520000475 |
| Provider Name | Ivana a Pereira-ambrose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356444848 PECOS PAC ID: 6800838921 Enrollment ID: I20050527000518 |
| Provider Name | Ji Jill Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386685444 PECOS PAC ID: 1850329608 Enrollment ID: I20050802000710 |
| Provider Name | David Lane Pakter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174638076 PECOS PAC ID: 8325063647 Enrollment ID: I20051005001326 |
| Provider Name | Merry Beth Gong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265540462 PECOS PAC ID: 8123048931 Enrollment ID: I20051122000822 |
| Provider Name | Daphne Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538260054 PECOS PAC ID: 3577584069 Enrollment ID: I20051212000884 |
| Provider Name | George Jackson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770517666 PECOS PAC ID: 6709891054 Enrollment ID: I20060501000770 |
| Provider Name | Deborah Kathryn Simon-weisberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285640417 PECOS PAC ID: 8527062397 Enrollment ID: I20060908000506 |
| Provider Name | Katherine W Roller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093755563 PECOS PAC ID: 2860497708 Enrollment ID: I20060927000155 |
| Provider Name | Gurinder S Wadhwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437161346 PECOS PAC ID: 9436259728 Enrollment ID: I20070716000660 |
| Provider Name | Rachel J Fogel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205039013 PECOS PAC ID: 5799873097 Enrollment ID: I20071120000651 |
| Provider Name | Brazell H Carter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578736328 PECOS PAC ID: 4284712449 Enrollment ID: I20080429000329 |
| Provider Name | Helen Kao |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1184657330 PECOS PAC ID: 7810076296 Enrollment ID: I20080509000624 |
| Provider Name | Sarah M Kelmenson Chau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689796674 PECOS PAC ID: 1951471077 Enrollment ID: I20080602000424 |
| Provider Name | Douglas J Spurr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205881257 PECOS PAC ID: 6002701612 Enrollment ID: I20080619000790 |
| Provider Name | Steven Mark Sornsin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821056185 PECOS PAC ID: 4385546027 Enrollment ID: I20080709000650 |
| Provider Name | Rebecca Lyn Mcentee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528105707 PECOS PAC ID: 7113095209 Enrollment ID: I20081002000196 |
| Provider Name | Laura M Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487608774 PECOS PAC ID: 0345308557 Enrollment ID: I20081016000343 |
| Provider Name | Laurie Trombla |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245253871 PECOS PAC ID: 9739241415 Enrollment ID: I20081215000782 |
| Provider Name | Meredith M Whiteside |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437205085 PECOS PAC ID: 4981767647 Enrollment ID: I20090107000443 |
| Provider Name | Kimberly J Duir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578646998 PECOS PAC ID: 8426115387 Enrollment ID: I20090319000378 |
| Provider Name | Amy R Kane |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922137611 PECOS PAC ID: 6406906353 Enrollment ID: I20090615000513 |
| Provider Name | Ana Rosa Chang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548292675 PECOS PAC ID: 6507917465 Enrollment ID: I20090706000617 |
| Provider Name | Christina Kwok-oleksy |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659698447 PECOS PAC ID: 8325162217 Enrollment ID: I20100830000474 |
| Provider Name | Carla Perissinotto |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1790963502 PECOS PAC ID: 0941324677 Enrollment ID: I20100901000297 |
| Provider Name | Diane Yvonne Chowwoods |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790726511 PECOS PAC ID: 2567658081 Enrollment ID: I20101123000909 |
| Provider Name | Shahida P Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386729051 PECOS PAC ID: 9032306857 Enrollment ID: I20101206001119 |
| Provider Name | Carol Darwish |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093893828 PECOS PAC ID: 4183811326 Enrollment ID: I20101214000348 |
| Provider Name | Patricia Conolly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821177965 PECOS PAC ID: 9133273311 Enrollment ID: I20110211000983 |
| Provider Name | Norman L Banks |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396884888 PECOS PAC ID: 5395761597 Enrollment ID: I20110224000151 |
| Provider Name | Kimberly a Reynosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588742365 PECOS PAC ID: 1850574179 Enrollment ID: I20110324000278 |
| Provider Name | Robert S Debare |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124106901 PECOS PAC ID: 1951585967 Enrollment ID: I20110414000758 |
| Provider Name | David H Levinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992880652 PECOS PAC ID: 2769667567 Enrollment ID: I20110420000660 |
| Provider Name | Joan L King-angell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578641346 PECOS PAC ID: 4789869991 Enrollment ID: I20110504000259 |
| Provider Name | Mark D Robinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508051251 PECOS PAC ID: 6002093077 Enrollment ID: I20110601000223 |
| Provider Name | Claudell Stephens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437240850 PECOS PAC ID: 2668659178 Enrollment ID: I20110610000076 |
| Provider Name | Eric a Fuller |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1346234457 PECOS PAC ID: 6002087699 Enrollment ID: I20110912000034 |
| Provider Name | Victoria a Behrman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700925484 PECOS PAC ID: 4284893728 Enrollment ID: I20120302000117 |
| Provider Name | Kari Petersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356478978 PECOS PAC ID: 6204095938 Enrollment ID: I20120315000350 |
| Provider Name | Genica Leane Robbins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821183153 PECOS PAC ID: 2163681735 Enrollment ID: I20120319000157 |
| Provider Name | Lee Ann Marie Cuny |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1528221223 PECOS PAC ID: 3476702911 Enrollment ID: I20120927000364 |
| Provider Name | Judy L Lock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235354945 PECOS PAC ID: 5496907826 Enrollment ID: I20121212000191 |
| Provider Name | Danielle L Marchman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982851366 PECOS PAC ID: 5698953701 Enrollment ID: I20121217000351 |
| Provider Name | Jennifer H Weise |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477608511 PECOS PAC ID: 4183862162 Enrollment ID: I20130603000635 |
| Provider Name | Nicole L Bores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043512742 PECOS PAC ID: 9335374776 Enrollment ID: I20131021001023 |
| Provider Name | Xaviera Ortiz Soto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760707756 PECOS PAC ID: 9830324219 Enrollment ID: I20131022000285 |
| Provider Name | Joan a Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891000188 PECOS PAC ID: 4284828187 Enrollment ID: I20131113000233 |
| Provider Name | Brent K Sugimoto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013296953 PECOS PAC ID: 1052547254 Enrollment ID: I20131118001041 |
| Provider Name | Amy Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528123692 PECOS PAC ID: 7416171582 Enrollment ID: I20140610002343 |
| Provider Name | Kimberly Ann Ceci |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114186657 PECOS PAC ID: 7113141847 Enrollment ID: I20140618002338 |
| Provider Name | Gretchen M Duran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255663613 PECOS PAC ID: 6002032844 Enrollment ID: I20140730002720 |
| Provider Name | Gwynne L Searls |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023154234 PECOS PAC ID: 5193942803 Enrollment ID: I20140804000821 |
| Provider Name | Gabriel R Aguilar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396089397 PECOS PAC ID: 2062639784 Enrollment ID: I20140804001306 |
| Provider Name | Napoleon a Nazareno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427466465 PECOS PAC ID: 0840411963 Enrollment ID: I20141014002257 |
| Provider Name | Katherine Winter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356631121 PECOS PAC ID: 4385966639 Enrollment ID: I20141124000848 |
| Provider Name | Kirsten Flagg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134537244 PECOS PAC ID: 0244552206 Enrollment ID: I20141201002217 |
| Provider Name | Tev Monnin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790107670 PECOS PAC ID: 7113240292 Enrollment ID: I20141222000549 |
| Provider Name | Kimberly Cardoso |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760652820 PECOS PAC ID: 0143270942 Enrollment ID: I20150204001743 |
| Provider Name | Douglas Frey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467711572 PECOS PAC ID: 5395060149 Enrollment ID: I20150219000385 |
| Provider Name | Jennifer Tsang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114340130 PECOS PAC ID: 3678890829 Enrollment ID: I20150326001863 |
| Provider Name | Faith Crumpler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154584829 PECOS PAC ID: 0446578991 Enrollment ID: I20150413000778 |
| Provider Name | Tiffany Lundeen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1942257324 PECOS PAC ID: 0749255503 Enrollment ID: I20150422001662 |
| Provider Name | Layla R Welborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053711994 PECOS PAC ID: 7416271440 Enrollment ID: I20150526002237 |
| Provider Name | Samali Kasozilubega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295081180 PECOS PAC ID: 7517288756 Enrollment ID: I20150601000380 |
| Provider Name | Linda K Frankel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730211368 PECOS PAC ID: 6709064710 Enrollment ID: I20150604002320 |
| Provider Name | Journey Meadows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891195806 PECOS PAC ID: 9638482318 Enrollment ID: I20150723009595 |
| Provider Name | Stephanie a Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629143813 PECOS PAC ID: 6002078813 Enrollment ID: I20150805006873 |
| Provider Name | Brett London |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730474933 PECOS PAC ID: 4486969854 Enrollment ID: I20150813010868 |
| Provider Name | Margaret C Ford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356604524 PECOS PAC ID: 2860638988 Enrollment ID: I20150925001092 |
| Provider Name | Suzanne L Saunders |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1326195660 PECOS PAC ID: 3779891841 Enrollment ID: I20151009001237 |
| Provider Name | Jason W Reinking |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568701738 PECOS PAC ID: 7416190293 Enrollment ID: I20151015001837 |
| Provider Name | Aislinn Bird |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013084607 PECOS PAC ID: 0840509618 Enrollment ID: I20151016001817 |
| Provider Name | Rory B Caygill-walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871979062 PECOS PAC ID: 1254641905 Enrollment ID: I20151109000641 |
| Provider Name | Damon E Francis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659539856 PECOS PAC ID: 6800941725 Enrollment ID: I20151202001228 |
| Provider Name | Magdalen M Edmunds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619203668 PECOS PAC ID: 5799959359 Enrollment ID: I20160203002546 |
| Provider Name | Bronwyn Sing |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962797886 PECOS PAC ID: 0749412138 Enrollment ID: I20160331001376 |
| Provider Name | Nicole Atme-bahrani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609264886 PECOS PAC ID: 6204133457 Enrollment ID: I20160401001494 |
| Provider Name | Lauren Enteen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801224217 PECOS PAC ID: 4082912498 Enrollment ID: I20160419001885 |
| Provider Name | Ekta Thakor Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336301019 PECOS PAC ID: 1456511815 Enrollment ID: I20160526000511 |
| Provider Name | Meghan Woods |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184061376 PECOS PAC ID: 6406147438 Enrollment ID: I20160622002679 |
| Provider Name | Tanya M Lagrimas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922446533 PECOS PAC ID: 1052609294 Enrollment ID: I20161004001613 |
| Provider Name | Sarah Bottomley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003369471 PECOS PAC ID: 8527346675 Enrollment ID: I20161025002222 |
| Provider Name | Melanie Marusczak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679944169 PECOS PAC ID: 4981984119 Enrollment ID: I20161206000873 |
| Provider Name | Sandeep Lehil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710242995 PECOS PAC ID: 1850529249 Enrollment ID: I20161209001479 |
| Provider Name | Manton S Hurd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427372101 PECOS PAC ID: 9335420215 Enrollment ID: I20170109001372 |
| Provider Name | Jenny Parma |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1285055210 PECOS PAC ID: 2163703885 Enrollment ID: I20170111001116 |
| Provider Name | Denise Scholz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043760705 PECOS PAC ID: 0143504894 Enrollment ID: I20170224002188 |
| Provider Name | Megan O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750784559 PECOS PAC ID: 2668758160 Enrollment ID: I20170418001552 |
| Provider Name | Olivia Debree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083081608 PECOS PAC ID: 6608143888 Enrollment ID: I20170517003056 |
| Provider Name | Martha Alicia Rea |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710408430 PECOS PAC ID: 0446521686 Enrollment ID: I20170804003243 |
| Provider Name | Nancy Saldivar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407112311 PECOS PAC ID: 2769628155 Enrollment ID: I20170807003279 |
| Provider Name | Britta C Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831167360 PECOS PAC ID: 1254598758 Enrollment ID: I20170814002994 |
| Provider Name | Damara Kathleen Luce |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790210540 PECOS PAC ID: 6406128982 Enrollment ID: I20170817002742 |
| Provider Name | Aisha Bettina Wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598102394 PECOS PAC ID: 3971890385 Enrollment ID: I20170825003496 |
| Provider Name | Tom Mcbride |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851702534 PECOS PAC ID: 0941581409 Enrollment ID: I20170919001657 |
| Provider Name | Mimi Ogawa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497189658 PECOS PAC ID: 3476828195 Enrollment ID: I20171005003224 |
| Provider Name | Sumaira a Cheema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437677655 PECOS PAC ID: 5092080556 Enrollment ID: I20171009003161 |
| Provider Name | Valorie Kolovos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962767780 PECOS PAC ID: 0941438378 Enrollment ID: I20171106003189 |
| Provider Name | Jeffrey B Ritterman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871667170 PECOS PAC ID: 8820354418 Enrollment ID: I20171115001079 |
| Provider Name | Rebecca Spence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265854558 PECOS PAC ID: 6204192743 Enrollment ID: I20171115003851 |
| Provider Name | Margaret Hsu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902315799 PECOS PAC ID: 1759649858 Enrollment ID: I20171219001471 |
| Provider Name | Thanh Trung Tran Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831501345 PECOS PAC ID: 7911211461 Enrollment ID: I20171229002341 |
| Provider Name | Michael Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790296556 PECOS PAC ID: 7214296383 Enrollment ID: I20180117002655 |
| Provider Name | Catherine M Flanagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790204212 PECOS PAC ID: 8729348438 Enrollment ID: I20180126002187 |
| Provider Name | Kelley Suzanne Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376947622 PECOS PAC ID: 2961763347 Enrollment ID: I20180227002000 |
| Provider Name | Serena Wu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427213123 PECOS PAC ID: 7810138492 Enrollment ID: I20180418002327 |
| Provider Name | Laila Rania Tannura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942710140 PECOS PAC ID: 4587928015 Enrollment ID: I20180508002167 |
| Provider Name | Angelique V Von Halle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639394745 PECOS PAC ID: 4981904216 Enrollment ID: I20180515001223 |
| Provider Name | Kevin Lagor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205297033 PECOS PAC ID: 9931464120 Enrollment ID: I20180516003043 |
| Provider Name | Rose Ochieng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750721551 PECOS PAC ID: 6709141351 Enrollment ID: I20180531001285 |
| Provider Name | Yui Nishiike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760751457 PECOS PAC ID: 9234391871 Enrollment ID: I20180821002418 |
| Provider Name | Maisha a Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598150666 PECOS PAC ID: 3072827633 Enrollment ID: I20180911002668 |
| Provider Name | Tracy L White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245674340 PECOS PAC ID: 8123320124 Enrollment ID: I20181003001378 |
| Provider Name | Lynmarie Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942728118 PECOS PAC ID: 1759633530 Enrollment ID: I20181004003090 |
| Provider Name | Heather Ayers-cluff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366951568 PECOS PAC ID: 9032461496 Enrollment ID: I20181012000479 |
| Provider Name | Danielle Gordon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306353297 PECOS PAC ID: 5991058844 Enrollment ID: I20181023003732 |
| Provider Name | Lisa G Netherland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730524026 PECOS PAC ID: 4880991223 Enrollment ID: I20181026001376 |
| Provider Name | Mously Diakhate |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811407265 PECOS PAC ID: 7810240298 Enrollment ID: I20181101001148 |
| Provider Name | Stephanie Phung |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760966410 PECOS PAC ID: 2062766934 Enrollment ID: I20181112001786 |
| Provider Name | Audrey I Schaps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154896215 PECOS PAC ID: 7517211873 Enrollment ID: I20181126003908 |
| Provider Name | Christine Marie Salera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366999088 PECOS PAC ID: 2163766098 Enrollment ID: I20181204003072 |
| Provider Name | Nicole Sata |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1336528249 PECOS PAC ID: 4082950506 Enrollment ID: I20190103002979 |
| Provider Name | Danielle Petta-flores Dexter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437518602 PECOS PAC ID: 4284970237 Enrollment ID: I20190111000826 |
| Provider Name | Vanessa Marie Mayen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023462694 PECOS PAC ID: 7517203144 Enrollment ID: I20190117003440 |
| Provider Name | Kalamaoka Aina KS Niheu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487756235 PECOS PAC ID: 5294827085 Enrollment ID: I20190125001430 |
| Provider Name | Edward Tilghman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265917173 PECOS PAC ID: 3173860376 Enrollment ID: I20190125002024 |
| Provider Name | Dana S Gersten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033536404 PECOS PAC ID: 1557655107 Enrollment ID: I20190211001859 |
| Provider Name | Scott Loeliger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205926367 PECOS PAC ID: 0840476214 Enrollment ID: I20190227000236 |
| Provider Name | Jessica Tinwai Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922442383 PECOS PAC ID: 7315286606 Enrollment ID: I20190304002864 |
| Provider Name | Darcy E Stanley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083062640 PECOS PAC ID: 6800135799 Enrollment ID: I20190312001745 |
| Provider Name | Kenshata Mignon Watkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245573393 PECOS PAC ID: 4082996335 Enrollment ID: I20190402001169 |
| Provider Name | Virginia Jean Hens-piazza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003121260 PECOS PAC ID: 8426291170 Enrollment ID: I20190423002012 |
| Provider Name | Lucia Tanaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922414085 PECOS PAC ID: 6103132808 Enrollment ID: I20190501001700 |
| Provider Name | Sirina Reddy Keesara |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720469984 PECOS PAC ID: 9638473143 Enrollment ID: I20190613001988 |
| Provider Name | Michael Lee Goldrich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851786792 PECOS PAC ID: 1951636083 Enrollment ID: I20190711002991 |
| Provider Name | Fiona Camille Lundy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598198350 PECOS PAC ID: 8123353844 Enrollment ID: I20190717001168 |
| Provider Name | Ashley Yuran Ro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801306667 PECOS PAC ID: 6103152657 Enrollment ID: I20190723000197 |
| Provider Name | Bethany Nourse Golden |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104042712 PECOS PAC ID: 8628304466 Enrollment ID: I20190731002234 |
| Provider Name | Marilisa Mancao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912982455 PECOS PAC ID: 8921171539 Enrollment ID: I20190808002442 |
| Provider Name | Aimee Leigh Rowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255769857 PECOS PAC ID: 6002196086 Enrollment ID: I20190821003916 |
| Provider Name | Skylar Althea Loeb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821344003 PECOS PAC ID: 6507194891 Enrollment ID: I20190823003309 |
| Provider Name | Jean Anne Marsters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265837439 PECOS PAC ID: 5597095026 Enrollment ID: I20190926001948 |
| Provider Name | Evelyn Duenas Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356690259 PECOS PAC ID: 4880925361 Enrollment ID: I20191015000797 |
| Provider Name | Zena Estelle Herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023668498 PECOS PAC ID: 2567794365 Enrollment ID: I20191028003319 |
| Provider Name | Aarentino Maximillian Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952964959 PECOS PAC ID: 9335471994 Enrollment ID: I20191031000417 |
| Provider Name | Maya Protter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629628037 PECOS PAC ID: 6507298353 Enrollment ID: I20191115001102 |
| Provider Name | Sara Evangeline Delaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548697733 PECOS PAC ID: 1759713415 Enrollment ID: I20191118002966 |
| Provider Name | Megan Catherine-romain Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174177679 PECOS PAC ID: 9830521459 Enrollment ID: I20191119002387 |
| Provider Name | Shevaun Mariam Lewallen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679123616 PECOS PAC ID: 9032542451 Enrollment ID: I20191125002716 |
| Provider Name | Jennifer Espinoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609425461 PECOS PAC ID: 8123452422 Enrollment ID: I20191219000920 |
| Provider Name | Carol Ngo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245532076 PECOS PAC ID: 6709212848 Enrollment ID: I20200207001330 |
| Provider Name | Shante R Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295384030 PECOS PAC ID: 6800220021 Enrollment ID: I20200227001284 |
| Provider Name | Yiyi Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194379917 PECOS PAC ID: 5698102861 Enrollment ID: I20200227002455 |
| Provider Name | Madeline Reed Furst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205489085 PECOS PAC ID: 1658707203 Enrollment ID: I20200309001196 |
| Provider Name | Anya Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578095113 PECOS PAC ID: 8325469216 Enrollment ID: I20200601002967 |
| Provider Name | Maisa Morrar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568001204 PECOS PAC ID: 3173945375 Enrollment ID: I20200616003205 |
| Provider Name | Cris Bissonnette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619216009 PECOS PAC ID: 1759526627 Enrollment ID: I20200721002523 |
| Provider Name | Mariam Attawia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275156853 PECOS PAC ID: 8820415359 Enrollment ID: I20200831000024 |
| Provider Name | Rebecca Liu Citron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730613142 PECOS PAC ID: 8325371123 Enrollment ID: I20200910001905 |
| Provider Name | Erica Bass |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275065732 PECOS PAC ID: 9335568641 Enrollment ID: I20201005002691 |
| Provider Name | Jessica Xcarlet Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285987974 PECOS PAC ID: 2365862372 Enrollment ID: I20201013001984 |
| Provider Name | Adia Z Scrubb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225561079 PECOS PAC ID: 3577983832 Enrollment ID: I20201026003127 |
| Provider Name | Angelina Maria Molina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346853520 PECOS PAC ID: 5092125781 Enrollment ID: I20201109002011 |
| Provider Name | Jessica Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104190891 PECOS PAC ID: 0941598908 Enrollment ID: I20201111002126 |
| Provider Name | Carmen Yung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003475450 PECOS PAC ID: 0345673729 Enrollment ID: I20201209001471 |
| Provider Name | Christine Tarrant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992340830 PECOS PAC ID: 5092127464 Enrollment ID: I20201209002868 |
| Provider Name | Lila Samady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033211610 PECOS PAC ID: 8729490925 Enrollment ID: I20201211001667 |
| Provider Name | Lauren Winokur Plate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184236861 PECOS PAC ID: 8426476623 Enrollment ID: I20210106000348 |
| Provider Name | Ann Sussman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720292956 PECOS PAC ID: 2668650771 Enrollment ID: I20210107002803 |
| Provider Name | Ashli Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942815998 PECOS PAC ID: 0143633941 Enrollment ID: I20210118000302 |
| Provider Name | Caroline Ruth Cangelosi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275659161 PECOS PAC ID: 8123434784 Enrollment ID: I20210304002508 |
| Provider Name | Taylor Cuffaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972104875 PECOS PAC ID: 6507273158 Enrollment ID: I20210325002192 |
| Provider Name | Adebowale Adeniji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821405283 PECOS PAC ID: 5991113920 Enrollment ID: I20210412002767 |
| Provider Name | Briauna J Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700490729 PECOS PAC ID: 7012325822 Enrollment ID: I20210415002230 |
| Provider Name | Kevin S Critchlow |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912380346 PECOS PAC ID: 5092059816 Enrollment ID: I20210427003162 |
| Provider Name | Jenny Anne Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063091619 PECOS PAC ID: 5597164889 Enrollment ID: I20210518001766 |
| Provider Name | Alayna Liptak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023622115 PECOS PAC ID: 9032518097 Enrollment ID: I20210524001532 |
| Provider Name | Maria Culcasi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023060662 PECOS PAC ID: 1052598588 Enrollment ID: I20210601001029 |
| Provider Name | Brittany Janee Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316557341 PECOS PAC ID: 4688077480 Enrollment ID: I20210729003885 |
| Provider Name | Amanda Jewell Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023259843 PECOS PAC ID: 1456754290 Enrollment ID: I20210730001300 |
| Provider Name | Fredalyne Benitez Tolentino |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295308674 PECOS PAC ID: 7113321969 Enrollment ID: I20210802002044 |
| Provider Name | Rebecca Pfeifer-rosenblum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598379596 PECOS PAC ID: 4880098896 Enrollment ID: I20210812000172 |
| Provider Name | Teresa Elizabeth Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710651393 PECOS PAC ID: 7719383637 Enrollment ID: I20210901000950 |
| Provider Name | Angela Marie Rasmussen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861756074 PECOS PAC ID: 9032515879 Enrollment ID: I20210902002081 |
| Provider Name | Adrienne Coulter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447923073 PECOS PAC ID: 5890183594 Enrollment ID: I20211029001571 |
| Provider Name | Mauricio Lask Knizek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558501973 PECOS PAC ID: 2062703754 Enrollment ID: I20211111000726 |
| Provider Name | Emily Hunter-adamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821592759 PECOS PAC ID: 7416351234 Enrollment ID: I20211111002208 |
| Provider Name | Laura F Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568956712 PECOS PAC ID: 4587099890 Enrollment ID: I20211117002163 |
| Provider Name | Molly R Morrissey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770247504 PECOS PAC ID: 4789073479 Enrollment ID: I20211118001688 |
| Provider Name | Brian Beachler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043715816 PECOS PAC ID: 8729333000 Enrollment ID: I20211119000238 |
| Provider Name | Uyen Trinh Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447754908 PECOS PAC ID: 4284039835 Enrollment ID: I20211203002631 |
| Provider Name | Raelynne M Wiest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720756992 PECOS PAC ID: 3375933005 Enrollment ID: I20211210001977 |
| Provider Name | Janelle Abigail Silvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437820065 PECOS PAC ID: 2860882594 Enrollment ID: I20211210002154 |
| Provider Name | Luiyi Lin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144683269 PECOS PAC ID: 0648565655 Enrollment ID: I20220113002415 |
| Provider Name | Laura Robin Colebourn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679118186 PECOS PAC ID: 7618369034 Enrollment ID: I20220117000110 |
| Provider Name | Jessica D Bigler Uhl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912183864 PECOS PAC ID: 2769877695 Enrollment ID: I20220311000708 |
| Provider Name | Kara Percival |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598262701 PECOS PAC ID: 6507251196 Enrollment ID: I20220317001424 |
| Provider Name | Timothy Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235230384 PECOS PAC ID: 0244540136 Enrollment ID: I20220407001705 |
| Provider Name | Alana Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306587183 PECOS PAC ID: 9234526385 Enrollment ID: I20220420001539 |
| Provider Name | Caitryn Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366113508 PECOS PAC ID: 1658768726 Enrollment ID: I20220420002633 |
| Provider Name | Stacia Sloane |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1972090090 PECOS PAC ID: 1951798818 Enrollment ID: I20220422000867 |
| Provider Name | Chia-hua Chan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689337834 PECOS PAC ID: 3072900513 Enrollment ID: I20220502000075 |
| Provider Name | Talia Davidow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386003994 PECOS PAC ID: 2961889795 Enrollment ID: I20220517003134 |
| Provider Name | Nicole J Pena |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1811322274 PECOS PAC ID: 2668744806 Enrollment ID: I20220518000773 |
| Provider Name | Sharefi M Saleh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205223120 PECOS PAC ID: 5294035499 Enrollment ID: I20220804001305 |
| Provider Name | David Rafael Pichardo-gomez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407416738 PECOS PAC ID: 0446634513 Enrollment ID: I20220908003474 |
| Provider Name | Lisa Jensen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700159373 PECOS PAC ID: 9335525997 Enrollment ID: I20221005000564 |
| Provider Name | Bernice Aderintola Bamgbade |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609496637 PECOS PAC ID: 3779969100 Enrollment ID: I20221007001409 |
| Provider Name | Tafor Bonu Mochungong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356804884 PECOS PAC ID: 9335531441 Enrollment ID: I20221017000717 |
| Provider Name | Sonam Dolkar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184346538 PECOS PAC ID: 9537535398 Enrollment ID: I20221019000745 |
| Provider Name | Liesl Flora Piccolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912338450 PECOS PAC ID: 8527434299 Enrollment ID: I20221020001932 |
| Provider Name | Lakeyla Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396211645 PECOS PAC ID: 2264808609 Enrollment ID: I20221026001259 |
| Provider Name | Julia Marino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043735111 PECOS PAC ID: 7517335136 Enrollment ID: I20221201001276 |
| Provider Name | Tanay Maeve Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558961722 PECOS PAC ID: 2668841107 Enrollment ID: I20221206000896 |
| Provider Name | Ryan R Macphee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144822024 PECOS PAC ID: 5597134940 Enrollment ID: I20221207002122 |
| Provider Name | Amanda Maharaj |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144816851 PECOS PAC ID: 1153790407 Enrollment ID: I20221208002979 |
| Provider Name | Joscelyne Armenta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649991282 PECOS PAC ID: 8022487750 Enrollment ID: I20221219002998 |
| Provider Name | Elizabeth R Casey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295231314 PECOS PAC ID: 2567792419 Enrollment ID: I20230119001358 |
| Provider Name | Catherine Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669142865 PECOS PAC ID: 4385015262 Enrollment ID: I20230201001724 |
| Provider Name | Miriam L Paclibon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962123380 PECOS PAC ID: 7214309590 Enrollment ID: I20230214003444 |
| Provider Name | James P Keim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326176116 PECOS PAC ID: 6800072547 Enrollment ID: I20230220002560 |
| Provider Name | Alea Catherine Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801584966 PECOS PAC ID: 5991148918 Enrollment ID: I20240207000784 |
| Provider Name | Daisy Sajuan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912675810 PECOS PAC ID: 3870991037 Enrollment ID: I20240618004513 |
| Provider Name | Asheley Denis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952047292 PECOS PAC ID: 7810427937 Enrollment ID: I20250205000260 |
| Provider Name | Susan Lynn Cordero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952966004 PECOS PAC ID: 4880119643 Enrollment ID: I20250415001632 |
| Provider Name | Nathaniel Houston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114705464 PECOS PAC ID: 1355848441 Enrollment ID: I20251007000946 |
| Provider Name | Crystal Marie Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255944997 PECOS PAC ID: 8022507797 Enrollment ID: I20251031002159 |
| Provider Name | Jennifer Ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205357555 PECOS PAC ID: 4284124702 Enrollment ID: I20251104001966 |
| Provider Name | Laura Zelko |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1598588568 PECOS PAC ID: 9638604366 Enrollment ID: I20251104003414 |
| Provider Name | Samuel Kessel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467183202 PECOS PAC ID: 6901397215 Enrollment ID: I20251114001647 |
| Provider Name | Audrey Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992687545 PECOS PAC ID: 3971095845 Enrollment ID: I20251126004385 |
| Provider Name | Kalila a Kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548940430 PECOS PAC ID: 4486147923 Enrollment ID: I20251203002890 |
| Provider Name | Krista Farey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376626044 PECOS PAC ID: 1850578451 Enrollment ID: I20251203003968 |
| Provider Name | Silvia Avila-garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790369544 PECOS PAC ID: 1658864087 Enrollment ID: I20251204001032 |
| Provider Name | Erica Ma |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255012548 PECOS PAC ID: 2365937570 Enrollment ID: I20251224000782 |
| Provider Name | Scott David Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790442408 PECOS PAC ID: 5991281750 Enrollment ID: I20260112001034 |
| Provider Name | Judith Pierre |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932257490 PECOS PAC ID: 8527384924 Enrollment ID: I20260113002662 |
| Provider Name | Sophie Meade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306713110 PECOS PAC ID: 0345729588 Enrollment ID: I20260209002212 |
| Provider Name | Lara a Barth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023607397 PECOS PAC ID: 1951710763 Enrollment ID: I20260313000281 |
| Provider Name | John Watson Paul Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659259349 PECOS PAC ID: 7416422787 Enrollment ID: I20260406000860 |
| Provider Name | Zoe Ginsburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538664628 PECOS PAC ID: 1951715887 Enrollment ID: I20260417003150 |
| Provider Name | Nilson Enrique Mejia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265679104 PECOS PAC ID: 4284791476 Enrollment ID: I20260522001452 |
| Provider Name | Adrianne Khanolkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427638816 PECOS PAC ID: 9335675297 Enrollment ID: I20260527003511 |
| Provider Name | Amanda Mcinerney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447008008 PECOS PAC ID: 2769953181 Enrollment ID: I20260608000264 |
Uhs Pharmacy UC Berkeley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2222 Bancroft Way, Pharmacy; Room 1115, Berkeley, CA 94720 Phone: 510-642-3249 Fax: 510-642-5759 |
Lori Shore MD, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2905 Telegraph Ave, Berkeley, CA 94705 Phone: 510-224-8141 Fax: 510-848-9970 |
Berkeley General Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3017 Telegraph Ave Ste 210, Berkeley, CA 94705 Phone: 484-432-2177 Fax: 415-680-1717 |
Concentra Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2850 Seventh St Ste 100, Berkeley, CA 94710 Phone: 510-845-5170 Fax: 510-845-5173 |
Berkeley Trust Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 University Ave, Berkeley, CA 94710 Phone: 916-749-6192 |
Inpatient Consultants of California, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2450 Ashby Ave, Berkeley, CA 94705 Phone: 510-204-4444 |