| Brain Health Usa | |
|
1225 W 190th St Ste 280 Gardena CA 90248-4305 | |
| (310) 515-8113 | |
| (310) 538-2102 |
| Full Name | Brain Health Usa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1225 W 190th St Ste 280, Gardena, California |
| Authorized Official Name and Position | Ehab S Yacoub (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3105158113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Health Usa 1225 W 190th St Ste 280 Gardena CA 90248-4305 Ph: (310) 515-8113 | Brain Health Usa 1225 W 190th St Ste 280 Gardena CA 90248-4305 Ph: (310) 515-8113 |
| NPI Number | 1417373713 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 5092099523 |
|---|---|
| Medicare Enrollment ID | O20170301002071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417373713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | A76244 (California) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Davy Z Qian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972572188 PECOS PAC ID: 9436135357 Enrollment ID: I20040629001308 |
| Provider Name | Robert D Rosenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437110400 PECOS PAC ID: 0042283533 Enrollment ID: I20040813000409 |
| Provider Name | Daniel D Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033267166 PECOS PAC ID: 8022909860 Enrollment ID: I20040823000722 |
| Provider Name | Ehab Yacoub |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295884088 PECOS PAC ID: 8921073057 Enrollment ID: I20040831001521 |
| Provider Name | Purificacion-hency Marquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457303232 PECOS PAC ID: 0244149730 Enrollment ID: I20041014000687 |
| Provider Name | Paul E Hartman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942371901 PECOS PAC ID: 5092772772 Enrollment ID: I20041214000790 |
| Provider Name | Ronald S Blustein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023129335 PECOS PAC ID: 8729036280 Enrollment ID: I20050111000698 |
| Provider Name | Inder Bhanver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386696573 PECOS PAC ID: 0042258428 Enrollment ID: I20050418000973 |
| Provider Name | Anita Hirsch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619062486 PECOS PAC ID: 2769416577 Enrollment ID: I20050921000704 |
| Provider Name | Frances M Thom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730369356 PECOS PAC ID: 5698855765 Enrollment ID: I20071231000566 |
| Provider Name | Ian R Tofler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558466342 PECOS PAC ID: 4688733389 Enrollment ID: I20081111000055 |
| Provider Name | Harsimrat Sandhu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710089578 PECOS PAC ID: 6507862471 Enrollment ID: I20090928000130 |
| Provider Name | Gregory G Mcgowan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073706636 PECOS PAC ID: 9234278979 Enrollment ID: I20091209000362 |
| Provider Name | William Shannon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063668275 PECOS PAC ID: 9638204761 Enrollment ID: I20100315000885 |
| Provider Name | Ajmal Mohammad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700017712 PECOS PAC ID: 2365570504 Enrollment ID: I20100510000669 |
| Provider Name | Deborah K Lucas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376758128 PECOS PAC ID: 8820281488 Enrollment ID: I20101015000419 |
| Provider Name | Omar Farooqi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336311315 PECOS PAC ID: 2961696083 Enrollment ID: I20101103000302 |
| Provider Name | Lana Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194998575 PECOS PAC ID: 1052500287 Enrollment ID: I20110104000802 |
| Provider Name | James H Lake |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871794404 PECOS PAC ID: 7315119906 Enrollment ID: I20111003000693 |
| Provider Name | Elisa Antonieta Gottheil |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427117274 PECOS PAC ID: 2567622145 Enrollment ID: I20120320000547 |
| Provider Name | Rosaleen C Shelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356527055 PECOS PAC ID: 6800043902 Enrollment ID: I20120824000264 |
| Provider Name | Ashraf F Fanous |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083830350 PECOS PAC ID: 4284729872 Enrollment ID: I20121003000418 |
| Provider Name | Khadeer A Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588964456 PECOS PAC ID: 1658523279 Enrollment ID: I20121206000106 |
| Provider Name | Sabeena Acharya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144520651 PECOS PAC ID: 7315182441 Enrollment ID: I20130320000620 |
| Provider Name | Christopher A Ifekwunigwe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770701708 PECOS PAC ID: 7214178805 Enrollment ID: I20130724000442 |
| Provider Name | Mike Seliktar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578734125 PECOS PAC ID: 8820227796 Enrollment ID: I20140219000795 |
| Provider Name | Fiel D Gamad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114342805 PECOS PAC ID: 7012130396 Enrollment ID: I20140514002260 |
| Provider Name | Hani M Atallah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104169655 PECOS PAC ID: 2062736127 Enrollment ID: I20150120000786 |
| Provider Name | Thomas M Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639136534 PECOS PAC ID: 0648464792 Enrollment ID: I20150527000927 |
| Provider Name | Iris M Rayo De Seliktar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275896995 PECOS PAC ID: 4880902386 Enrollment ID: I20151002001248 |
| Provider Name | Rodney Paul Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801902077 PECOS PAC ID: 9436377843 Enrollment ID: I20151221001761 |
| Provider Name | Mary Edem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760787030 PECOS PAC ID: 9830491737 Enrollment ID: I20160108002574 |
| Provider Name | Armin Farajzadeh Deroee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952600389 PECOS PAC ID: 8527352996 Enrollment ID: I20160808001289 |
| Provider Name | Rivy Oseni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306140637 PECOS PAC ID: 5698060044 Enrollment ID: I20160926002052 |
| Provider Name | Gloria Sudeta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083070064 PECOS PAC ID: 7810285210 Enrollment ID: I20161130001840 |
| Provider Name | Pedro Morante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689038507 PECOS PAC ID: 4385937861 Enrollment ID: I20161205002451 |
| Provider Name | Andrea Lynn Sczesny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801245121 PECOS PAC ID: 2961783634 Enrollment ID: I20170111003407 |
| Provider Name | Susan Y Shen |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1730422502 PECOS PAC ID: 2264700038 Enrollment ID: I20170620001203 |
| Provider Name | Ifeoma Nweke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881053593 PECOS PAC ID: 2264701853 Enrollment ID: I20170713002563 |
| Provider Name | Arlene Taylor Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174993604 PECOS PAC ID: 0042580623 Enrollment ID: I20170714002511 |
| Provider Name | Opeyemi A Bello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023497351 PECOS PAC ID: 8123384724 Enrollment ID: I20171115001475 |
| Provider Name | Richard P Heidenfelder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700984911 PECOS PAC ID: 1658630058 Enrollment ID: I20180110001037 |
| Provider Name | Andrea Carasquero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912455122 PECOS PAC ID: 4082991583 Enrollment ID: I20180125001183 |
| Provider Name | Anissa Ellen Spada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114469111 PECOS PAC ID: 1557622867 Enrollment ID: I20180301001874 |
| Provider Name | Jennifer L Eastman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962854034 PECOS PAC ID: 2961757315 Enrollment ID: I20180626002419 |
| Provider Name | Linda Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073096053 PECOS PAC ID: 9739432709 Enrollment ID: I20181022003262 |
| Provider Name | Michael They |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134699218 PECOS PAC ID: 0143568014 Enrollment ID: I20190424002183 |
| Provider Name | Regina W Speights |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982055430 PECOS PAC ID: 2163716077 Enrollment ID: I20190502002739 |
| Provider Name | Tehila Tanya Abrekov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295248110 PECOS PAC ID: 1557467222 Enrollment ID: I20190606000568 |
| Provider Name | Mark Anthony Knight |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851573554 PECOS PAC ID: 7810222999 Enrollment ID: I20190711001321 |
| Provider Name | Vanessa Naval |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669819702 PECOS PAC ID: 8426290933 Enrollment ID: I20190805001825 |
| Provider Name | Eric J. Gardner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861688269 PECOS PAC ID: 4385819929 Enrollment ID: I20190906002896 |
| Provider Name | Marianne Guevarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801338793 PECOS PAC ID: 5799016861 Enrollment ID: I20191004000575 |
| Provider Name | Adaobi Judith Afonta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295385581 PECOS PAC ID: 3971936766 Enrollment ID: I20191210000220 |
| Provider Name | Lawrence F Peskin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477004794 PECOS PAC ID: 9931532546 Enrollment ID: I20191211002378 |
| Provider Name | Naga Venkata Satish Babu Bodapati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164839528 PECOS PAC ID: 7911205141 Enrollment ID: I20200115000928 |
| Provider Name | Rosekate C Ugorji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043481922 PECOS PAC ID: 7911332804 Enrollment ID: I20200123000926 |
| Provider Name | Thad Matthew Makowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508945031 PECOS PAC ID: 6204922560 Enrollment ID: I20200123001971 |
| Provider Name | Amelle Joseph Baptiste Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952946956 PECOS PAC ID: 9032545439 Enrollment ID: I20200203002389 |
| Provider Name | Jennifer Knisely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992276679 PECOS PAC ID: 9830525674 Enrollment ID: I20200214000322 |
| Provider Name | Nnamdi Ofoeze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073151916 PECOS PAC ID: 8224465174 Enrollment ID: I20200305001909 |
| Provider Name | Christine Taheran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144642109 PECOS PAC ID: 4486084084 Enrollment ID: I20200422002771 |
| Provider Name | Paula Leticia Cedillo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275168536 PECOS PAC ID: 3274964192 Enrollment ID: I20200509000280 |
| Provider Name | Sarah Fese Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023413556 PECOS PAC ID: 6901128453 Enrollment ID: I20200617002055 |
| Provider Name | Monica Keo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083244016 PECOS PAC ID: 0648692509 Enrollment ID: I20200622003113 |
| Provider Name | Inderpreet Singh Virk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720531726 PECOS PAC ID: 6002230620 Enrollment ID: I20200715002863 |
| Provider Name | Scott Bruce Gladstone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427389691 PECOS PAC ID: 7911321914 Enrollment ID: I20200723001666 |
| Provider Name | Sandra Mary Abraham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427467851 PECOS PAC ID: 4688098551 Enrollment ID: I20200724000805 |
| Provider Name | Farooque Azam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689203093 PECOS PAC ID: 0941627988 Enrollment ID: I20200904001152 |
| Provider Name | Hye Young Yoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821606716 PECOS PAC ID: 3072932607 Enrollment ID: I20201001001260 |
| Provider Name | Kyle Jeng-heng Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154930774 PECOS PAC ID: 1850710385 Enrollment ID: I20201001001785 |
| Provider Name | Leslie A Langley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255779120 PECOS PAC ID: 9638487952 Enrollment ID: I20201005002033 |
| Provider Name | Surendra Chaganti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932213725 PECOS PAC ID: 6608969878 Enrollment ID: I20201014002081 |
| Provider Name | Albert Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194339382 PECOS PAC ID: 7315367950 Enrollment ID: I20201020001257 |
| Provider Name | Valerie L Thorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982887659 PECOS PAC ID: 0143302364 Enrollment ID: I20201104002860 |
| Provider Name | Patrick Jordan Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639775166 PECOS PAC ID: 6901218593 Enrollment ID: I20201228000510 |
| Provider Name | Loneze Dumas Laurent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700485901 PECOS PAC ID: 9032522297 Enrollment ID: I20210106003211 |
| Provider Name | Richard Pessagno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043301377 PECOS PAC ID: 0941239131 Enrollment ID: I20210119002523 |
| Provider Name | Kishore J. Thampy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659367951 PECOS PAC ID: 0143268904 Enrollment ID: I20210223000684 |
| Provider Name | Adalijiza Tavera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043825193 PECOS PAC ID: 9537575337 Enrollment ID: I20210302002174 |
| Provider Name | Trisha L Contarino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689935959 PECOS PAC ID: 0143636522 Enrollment ID: I20210309003328 |
| Provider Name | Ugochi Okonko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871059873 PECOS PAC ID: 8022428044 Enrollment ID: I20210316002241 |
| Provider Name | Francis Mbella Manga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154561439 PECOS PAC ID: 6204173479 Enrollment ID: I20210324000746 |
| Provider Name | Mahmoud Aborabeh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720439672 PECOS PAC ID: 2567879711 Enrollment ID: I20210406000355 |
| Provider Name | Patrick Harry Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124538764 PECOS PAC ID: 3577829613 Enrollment ID: I20210426002268 |
| Provider Name | Stephany Manurung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669065660 PECOS PAC ID: 7012326200 Enrollment ID: I20210428002767 |
| Provider Name | Noja A Nash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386965986 PECOS PAC ID: 8325457401 Enrollment ID: I20210430000447 |
| Provider Name | Angela Ofoegbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457828097 PECOS PAC ID: 0042619207 Enrollment ID: I20210520002462 |
| Provider Name | Oluwole O Jegede |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063717775 PECOS PAC ID: 1759527542 Enrollment ID: I20210614002349 |
| Provider Name | Oluwatoyin Oladimeji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396345245 PECOS PAC ID: 1456751130 Enrollment ID: I20210617000933 |
| Provider Name | Cynthia Canul |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598156606 PECOS PAC ID: 9537560784 Enrollment ID: I20210625001921 |
| Provider Name | Bariasa Kanabolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578093050 PECOS PAC ID: 0941601751 Enrollment ID: I20210630004044 |
| Provider Name | Alison Mitchell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306387626 PECOS PAC ID: 6800168709 Enrollment ID: I20210714003598 |
| Provider Name | Faith Ogala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184264277 PECOS PAC ID: 2264852136 Enrollment ID: I20210722001694 |
| Provider Name | Eric Steckler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972503514 PECOS PAC ID: 5698933794 Enrollment ID: I20210805002110 |
| Provider Name | Kizzyann Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235516352 PECOS PAC ID: 0042525818 Enrollment ID: I20210811004192 |
| Provider Name | Tony A Akpengbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437441524 PECOS PAC ID: 8729483797 Enrollment ID: I20210830001541 |
| Provider Name | Oluwatoyin Olubukola Oladejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144794108 PECOS PAC ID: 0143645481 Enrollment ID: I20210924001313 |
| Provider Name | Davina G Uchegbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841846342 PECOS PAC ID: 0749688901 Enrollment ID: I20211001003038 |
| Provider Name | Dhanashree T Mahesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912081589 PECOS PAC ID: 7719914092 Enrollment ID: I20211008002086 |
| Provider Name | Maryam H Lateef |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477533610 PECOS PAC ID: 3577475888 Enrollment ID: I20211028002987 |
| Provider Name | Ellie Mehrdel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679141477 PECOS PAC ID: 2264821305 Enrollment ID: I20211111001856 |
| Provider Name | Joy Egungwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194300459 PECOS PAC ID: 4587053566 Enrollment ID: I20211112000906 |
| Provider Name | Rosa Maria Aguero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215534888 PECOS PAC ID: 7517356207 Enrollment ID: I20211118002049 |
| Provider Name | Ugochi Azubuike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447746938 PECOS PAC ID: 8224438932 Enrollment ID: I20211201000199 |
| Provider Name | Joshua P Werblin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629089677 PECOS PAC ID: 2062516016 Enrollment ID: I20211220002626 |
| Provider Name | Sunni Erika Gessel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184388332 PECOS PAC ID: 0840681045 Enrollment ID: I20211223000364 |
| Provider Name | Samaneh Fanaeian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417621434 PECOS PAC ID: 5193117885 Enrollment ID: I20220107001781 |
| Provider Name | Roberta Gordin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518458793 PECOS PAC ID: 4587056866 Enrollment ID: I20220118002247 |
| Provider Name | Shanna Darling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114474350 PECOS PAC ID: 8527450675 Enrollment ID: I20220121001244 |
| Provider Name | Ernest Takang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467738963 PECOS PAC ID: 9537553417 Enrollment ID: I20220221000364 |
| Provider Name | Nathalie Anyakpor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699319103 PECOS PAC ID: 6305231069 Enrollment ID: I20220315002060 |
| Provider Name | Christine Nancy Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811272206 PECOS PAC ID: 3173918794 Enrollment ID: I20220317002624 |
| Provider Name | Juan C Rondeau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003312232 PECOS PAC ID: 1355736414 Enrollment ID: I20220328001798 |
| Provider Name | Porsha Marie Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992387088 PECOS PAC ID: 1951788579 Enrollment ID: I20220519000892 |
| Provider Name | Chika Agulanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942957113 PECOS PAC ID: 1052799384 Enrollment ID: I20220527001242 |
| Provider Name | Arlin A Bhattacharjee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134688047 PECOS PAC ID: 9234522806 Enrollment ID: I20220602000891 |
| Provider Name | Jason Lasala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821744178 PECOS PAC ID: 3375921323 Enrollment ID: I20220602001742 |
| Provider Name | Oluwafunmilola Olusola Sulaimon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992330492 PECOS PAC ID: 7911336599 Enrollment ID: I20220602001918 |
| Provider Name | Charlene N Azonwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184375859 PECOS PAC ID: 6406234467 Enrollment ID: I20220602002004 |
| Provider Name | Brittany G Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558011296 PECOS PAC ID: 6608254685 Enrollment ID: I20220602002833 |
| Provider Name | Chidiebere Osondu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487228532 PECOS PAC ID: 7719365725 Enrollment ID: I20220603000780 |
| Provider Name | Ebere A Nwosu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518540053 PECOS PAC ID: 5597143529 Enrollment ID: I20220603001420 |
| Provider Name | Trish Williams-forde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710468590 PECOS PAC ID: 7315326899 Enrollment ID: I20220614002730 |
| Provider Name | Ndubuisi Chimezie Obioha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699410746 PECOS PAC ID: 3375923915 Enrollment ID: I20220629001582 |
| Provider Name | Angela Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770224859 PECOS PAC ID: 2466833660 Enrollment ID: I20220719003578 |
| Provider Name | Vanessa Marmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891442778 PECOS PAC ID: 0345621496 Enrollment ID: I20220720001818 |
| Provider Name | Karine Setyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194464693 PECOS PAC ID: 2365823119 Enrollment ID: I20220725003563 |
| Provider Name | Joel Dey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053815167 PECOS PAC ID: 3375899305 Enrollment ID: I20220728001583 |
| Provider Name | Dana J Mcgaffee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770631145 PECOS PAC ID: 6901995786 Enrollment ID: I20220822001818 |
| Provider Name | Rita Onwenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003463100 PECOS PAC ID: 6608250485 Enrollment ID: I20220827000310 |
| Provider Name | Len Umayam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710594916 PECOS PAC ID: 5890179170 Enrollment ID: I20220906001901 |
| Provider Name | Lauren Grawert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508093543 PECOS PAC ID: 9436331139 Enrollment ID: I20221006001368 |
| Provider Name | Fereydoon Daniel Radfar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154435758 PECOS PAC ID: 7719160654 Enrollment ID: I20221028002107 |
| Provider Name | Chika Q Ugwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760113195 PECOS PAC ID: 9537536842 Enrollment ID: I20221028002499 |
| Provider Name | Diana H Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528648284 PECOS PAC ID: 9537536362 Enrollment ID: I20221107002756 |
| Provider Name | Diana Bleyan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316444037 PECOS PAC ID: 8224411962 Enrollment ID: I20221111000775 |
| Provider Name | Uzoma Uwakah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275131765 PECOS PAC ID: 3274900873 Enrollment ID: I20221111000880 |
| Provider Name | Marlon R Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134861123 PECOS PAC ID: 2264809862 Enrollment ID: I20221111000919 |
| Provider Name | Evelyn Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053840660 PECOS PAC ID: 3779950282 Enrollment ID: I20221111001622 |
| Provider Name | Philip Creps |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649284688 PECOS PAC ID: 8820084544 Enrollment ID: I20221114001992 |
| Provider Name | Kosi Obialor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336861632 PECOS PAC ID: 3779951421 Enrollment ID: I20221130001720 |
| Provider Name | Tanisha Ragland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154679462 PECOS PAC ID: 9638548076 Enrollment ID: I20221207001812 |
| Provider Name | Olajumoke Adeyemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114323755 PECOS PAC ID: 9931578275 Enrollment ID: I20221208002683 |
| Provider Name | Wendy A Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730801218 PECOS PAC ID: 6800265000 Enrollment ID: I20221209002574 |
| Provider Name | Jonathan Snipes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821250077 PECOS PAC ID: 8123298254 Enrollment ID: I20221212001272 |
| Provider Name | Future Ogbebor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245961663 PECOS PAC ID: 3072982172 Enrollment ID: I20221213000531 |
| Provider Name | Sima Aman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689396293 PECOS PAC ID: 0547639676 Enrollment ID: I20221213001864 |
| Provider Name | Ngozi C Onyenuforo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306562335 PECOS PAC ID: 9638548670 Enrollment ID: I20221213002320 |
| Provider Name | Hany M Mohamed El Sabban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336893320 PECOS PAC ID: 5496136582 Enrollment ID: I20221213003001 |
| Provider Name | Porsha K Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346981750 PECOS PAC ID: 4880064518 Enrollment ID: I20221221001617 |
| Provider Name | Amara J Ezumah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427770940 PECOS PAC ID: 2961872601 Enrollment ID: I20221221002149 |
| Provider Name | Nkiruka C Anakor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215662101 PECOS PAC ID: 5799155461 Enrollment ID: I20221221003149 |
| Provider Name | Nats J Babel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316371479 PECOS PAC ID: 4587034137 Enrollment ID: I20221223000775 |
| Provider Name | Sima Dinari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346965704 PECOS PAC ID: 8628448586 Enrollment ID: I20230110002821 |
| Provider Name | Armen Saribegian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750962676 PECOS PAC ID: 6406227248 Enrollment ID: I20230113002124 |
| Provider Name | Aisha Y Shaikh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710604491 PECOS PAC ID: 6204207434 Enrollment ID: I20230125002065 |
| Provider Name | Amy Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295272318 PECOS PAC ID: 5991177404 Enrollment ID: I20230209002559 |
| Provider Name | Sara L Olson-wiencek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790400786 PECOS PAC ID: 2567836430 Enrollment ID: I20230315001937 |
| Provider Name | Stephen Eshun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417679465 PECOS PAC ID: 3678948908 Enrollment ID: I20230418002680 |
| Provider Name | Sergio Almanzar-ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588003727 PECOS PAC ID: 2668847906 Enrollment ID: I20230418002769 |
| Provider Name | Leroy Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780395244 PECOS PAC ID: 5395110639 Enrollment ID: I20230418002798 |
| Provider Name | Agata Sitek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376277814 PECOS PAC ID: 0648645986 Enrollment ID: I20230418002880 |
| Provider Name | Chinedu Nwadike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255051371 PECOS PAC ID: 1254796543 Enrollment ID: I20230419002365 |
| Provider Name | Edith Amadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801509328 PECOS PAC ID: 3375908635 Enrollment ID: I20230420002801 |
| Provider Name | Lydia Njie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194440107 PECOS PAC ID: 1951779834 Enrollment ID: I20230421001806 |
| Provider Name | Ijeoma Akanno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750953014 PECOS PAC ID: 9638534555 Enrollment ID: I20230428001142 |
| Provider Name | Paula Ann Butcon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124769534 PECOS PAC ID: 3678938347 Enrollment ID: I20230502002249 |
| Provider Name | Ismail Kalokoh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912959073 PECOS PAC ID: 3779626809 Enrollment ID: I20230502002491 |
| Provider Name | Chioma Onodugo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528521499 PECOS PAC ID: 9739544420 Enrollment ID: I20230502002976 |
| Provider Name | Tochi Nwachukwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285399949 PECOS PAC ID: 2264897958 Enrollment ID: I20230502003077 |
| Provider Name | Kristine Mbamalu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831812676 PECOS PAC ID: 0042675746 Enrollment ID: I20230502003309 |
| Provider Name | Tony Truong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609580935 PECOS PAC ID: 3072978634 Enrollment ID: I20230503003126 |
| Provider Name | Apneet Kaur Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669972311 PECOS PAC ID: 6204291669 Enrollment ID: I20230508002576 |
| Provider Name | Felix Na Ahmedov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083372361 PECOS PAC ID: 6204292329 Enrollment ID: I20230516001812 |
| Provider Name | Brejon Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548623937 PECOS PAC ID: 1355707480 Enrollment ID: I20230516002453 |
| Provider Name | Hyunjib Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659097459 PECOS PAC ID: 0042676025 Enrollment ID: I20230517001415 |
| Provider Name | Lili Buzsaki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255710083 PECOS PAC ID: 7113280447 Enrollment ID: I20230517001686 |
| Provider Name | Tameka Terryann Dyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851019640 PECOS PAC ID: 6608232228 Enrollment ID: I20230523002774 |
| Provider Name | Christy Zeegen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639784291 PECOS PAC ID: 5698131225 Enrollment ID: I20230523003290 |
| Provider Name | Sharon Atwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538356670 PECOS PAC ID: 5698842276 Enrollment ID: I20230524002021 |
| Provider Name | Denise Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568162055 PECOS PAC ID: 1153788658 Enrollment ID: I20230526000897 |
| Provider Name | Toimbie Sih Amaazee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144929647 PECOS PAC ID: 0648637041 Enrollment ID: I20230530002340 |
| Provider Name | Samuel Uchechukwu Chilaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679140644 PECOS PAC ID: 8527425891 Enrollment ID: I20230531002448 |
| Provider Name | Cynthia Key |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679271191 PECOS PAC ID: 3375900517 Enrollment ID: I20230605000498 |
| Provider Name | Barbara Anne Schaetzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972102788 PECOS PAC ID: 6204209117 Enrollment ID: I20230612002802 |
| Provider Name | Ruben Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205289337 PECOS PAC ID: 4385001932 Enrollment ID: I20230613001679 |
| Provider Name | J. Paul Gatdula |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225727258 PECOS PAC ID: 4587021142 Enrollment ID: I20230613001978 |
| Provider Name | Joan C Njoku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265140222 PECOS PAC ID: 3173981610 Enrollment ID: I20230615001805 |
| Provider Name | Rabab Fatima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417648304 PECOS PAC ID: 1153789698 Enrollment ID: I20230615001843 |
| Provider Name | Stanley Fernando Mesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851084727 PECOS PAC ID: 2163880329 Enrollment ID: I20230620002100 |
| Provider Name | Nima Deldan Lal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144812181 PECOS PAC ID: 8820458169 Enrollment ID: I20230718001711 |
| Provider Name | Matthew D Carpinello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790059194 PECOS PAC ID: 2466888904 Enrollment ID: I20230725001865 |
| Provider Name | Yaifeh Chafeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508558099 PECOS PAC ID: 5496116212 Enrollment ID: I20230726002791 |
| Provider Name | Vinessa Gaerlan-finch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275729329 PECOS PAC ID: 4880784826 Enrollment ID: I20230727000502 |
| Provider Name | Luis Enrique Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093219909 PECOS PAC ID: 1052772746 Enrollment ID: I20230727001934 |
| Provider Name | Lydia Owuor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700080744 PECOS PAC ID: 2769844752 Enrollment ID: I20230808001001 |
| Provider Name | Quincy Jade Cornell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457037558 PECOS PAC ID: 6204298961 Enrollment ID: I20230811000875 |
| Provider Name | Heather Marie Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700561511 PECOS PAC ID: 4789046269 Enrollment ID: I20230815003829 |
| Provider Name | Ravinder Kaur Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194400598 PECOS PAC ID: 1557723079 Enrollment ID: I20230816000940 |
| Provider Name | Lilian Onyinye Ikpeamaeze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902169196 PECOS PAC ID: 0042672479 Enrollment ID: I20230816001833 |
| Provider Name | Jacqueline J Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740988120 PECOS PAC ID: 1658730585 Enrollment ID: I20230821003857 |
| Provider Name | Fahim Rasul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821550245 PECOS PAC ID: 8921428558 Enrollment ID: I20230825002370 |
| Provider Name | Ronald St Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316032147 PECOS PAC ID: 0648201822 Enrollment ID: I20230829000906 |
| Provider Name | Marina Bassili |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619319100 PECOS PAC ID: 2062876204 Enrollment ID: I20230907000034 |
| Provider Name | Christopher Go |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083221568 PECOS PAC ID: 1052775095 Enrollment ID: I20230911000484 |
| Provider Name | Manuel Mota Castillo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003867698 PECOS PAC ID: 9133179567 Enrollment ID: I20230925003150 |
| Provider Name | Dawn Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740481118 PECOS PAC ID: 0941473599 Enrollment ID: I20231002002209 |
| Provider Name | Daron Watts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841275591 PECOS PAC ID: 8628206885 Enrollment ID: I20231012000784 |
| Provider Name | Shanshan Lin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841998242 PECOS PAC ID: 6608221114 Enrollment ID: I20231018000700 |
| Provider Name | Paola Paquini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245920669 PECOS PAC ID: 0941660740 Enrollment ID: I20231019001250 |
| Provider Name | Emmanuel Ifemazi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558052159 PECOS PAC ID: 0143677682 Enrollment ID: I20231106002130 |
| Provider Name | Kimberly Daugherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508641705 PECOS PAC ID: 1355799628 Enrollment ID: I20231127002354 |
| Provider Name | Diep Le Dinh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124802137 PECOS PAC ID: 5597113530 Enrollment ID: I20231130002968 |
| Provider Name | Anthony Ilogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609656909 PECOS PAC ID: 7214387059 Enrollment ID: I20231220001511 |
| Provider Name | Danielle Nicole Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265678528 PECOS PAC ID: 0749630077 Enrollment ID: I20231228001047 |
| Provider Name | Diego Centeno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114608825 PECOS PAC ID: 8325498447 Enrollment ID: I20240102000825 |
| Provider Name | Donald Mclawhorn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457841595 PECOS PAC ID: 0244577856 Enrollment ID: I20240108005683 |
| Provider Name | Erin Felicia Emanuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225713894 PECOS PAC ID: 8123479441 Enrollment ID: I20240110003857 |
| Provider Name | Travis Zachary Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255950291 PECOS PAC ID: 5092167973 Enrollment ID: I20240116003024 |
| Provider Name | Menberemedhin Abera Tegegne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407141609 PECOS PAC ID: 1951753748 Enrollment ID: I20240117002478 |
| Provider Name | Gerald S Stein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336324011 PECOS PAC ID: 2961531496 Enrollment ID: I20240201001015 |
| Provider Name | John Iwuanyanwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689364911 PECOS PAC ID: 6608229976 Enrollment ID: I20240202001483 |
| Provider Name | Omotola T'sarumi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710369376 PECOS PAC ID: 6507290012 Enrollment ID: I20240205000146 |
| Provider Name | David Fallat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851430219 PECOS PAC ID: 3274582457 Enrollment ID: I20240205002977 |
| Provider Name | Marie Antoinette Magana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376235929 PECOS PAC ID: 4789028630 Enrollment ID: I20240219002161 |
| Provider Name | Chinyere Iwuagwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023755006 PECOS PAC ID: 2466896113 Enrollment ID: I20240221001242 |
| Provider Name | Sathi Datta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932726114 PECOS PAC ID: 9133563802 Enrollment ID: I20240221002119 |
| Provider Name | Andrea Michelle Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104576271 PECOS PAC ID: 4385089598 Enrollment ID: I20240227004632 |
| Provider Name | Eri Minagawa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346025210 PECOS PAC ID: 9739524869 Enrollment ID: I20240228004439 |
| Provider Name | Chloe Margaret Strycker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225776461 PECOS PAC ID: 7113362138 Enrollment ID: I20240229003055 |
| Provider Name | Emily Coreas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598541062 PECOS PAC ID: 9537505102 Enrollment ID: I20240306002496 |
| Provider Name | Adeshewa Adekunbi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083134829 PECOS PAC ID: 7911276019 Enrollment ID: I20240307004282 |
| Provider Name | Kelly Virs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518390533 PECOS PAC ID: 8820434533 Enrollment ID: I20240315001432 |
| Provider Name | Uliana A Zavyalova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518739481 PECOS PAC ID: 3577900208 Enrollment ID: I20240318001571 |
| Provider Name | Alvin Parker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184151151 PECOS PAC ID: 0547530966 Enrollment ID: I20240325000655 |
| Provider Name | Alyssa Grace Legaspi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821688003 PECOS PAC ID: 4981041993 Enrollment ID: I20240326004012 |
| Provider Name | Monique Rochelle Acosta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487425872 PECOS PAC ID: 5597104406 Enrollment ID: I20240411002406 |
| Provider Name | Nechelle Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104465566 PECOS PAC ID: 8628417466 Enrollment ID: I20240412003358 |
| Provider Name | Joel Quitugua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821740945 PECOS PAC ID: 9335588995 Enrollment ID: I20240415003648 |
| Provider Name | Harrison Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649833872 PECOS PAC ID: 4981947710 Enrollment ID: I20240424002124 |
| Provider Name | Thomas Earwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588629414 PECOS PAC ID: 7214937945 Enrollment ID: I20240507003813 |
| Provider Name | Ali Mohmmed Jablawi |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487236477 PECOS PAC ID: 9931540556 Enrollment ID: I20240514003248 |
| Provider Name | Jeerire Pierre Manokian |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437998705 PECOS PAC ID: 0345682621 Enrollment ID: I20240531003243 |
| Provider Name | Vadim Sarkisyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063286714 PECOS PAC ID: 3577005776 Enrollment ID: I20240603003858 |
| Provider Name | Kamron Fariba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407315864 PECOS PAC ID: 2567825979 Enrollment ID: I20240605003220 |
| Provider Name | Kyle Tretter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780440065 PECOS PAC ID: 2860934817 Enrollment ID: I20240606000884 |
| Provider Name | John Esplana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669227690 PECOS PAC ID: 1456893916 Enrollment ID: I20240612000738 |
| Provider Name | Elizabeth Davis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679321848 PECOS PAC ID: 1153864590 Enrollment ID: I20240613003668 |
Sunshine Community Resource Organization Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 W 135th Street, Gardena, CA 90247 Phone: 626-600-9392 | |
City2village International Initiative Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18726 S Western Ave Ste 403, Gardena, CA 90248 Phone: 310-769-5710 Fax: 844-850-5892 | |
Los Angeles County Department Of Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14112 S Kingsley Dr, Gardena, CA 90249 Phone: 213-217-7312 Fax: 310-496-2757 | |
Drew Child Development Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1411 W. 190th Street Suite 300, Gardena, CA 90248 Phone: 310-609-3890 Fax: 310-609-0301 | |
Alafia Mental Health Institute Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 W Redondo Beach Blvd # 215, Gardena, CA 90248 Phone: 310-352-6422 | |
Mendrix Medical Associates Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18726 S Western Ave Ste 320, Gardena, CA 90248 Phone: 516-729-8606 | |
Aadap Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13931 Van Ness Ave, Gardena, CA 90249 Phone: 310-768-8018 Fax: 310-768-4170 |