MR. KENRICK ANTHONY LICORISH (NPI# 1003947755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003947755 |
| Entity Type | Individual |
| Full Name | MR. KENRICK ANTHONY LICORISH |
| Credential | M.D. |
| Practice Address |
520 N Main St Ste 111 Santa Ana CA 92701 |
| Mailing Address |
Po Box 1261 Santa Ana CA 92702 |
| Practice Telephone | 7149732378 |
| Mailing Telephone | 7144602948 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | A37875 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
A37875 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144759085 | Kenrick Brian Licorish | Psychiatry & Neurology | 2351 Clay St Ste 380, San Francisco, CA 94115-1931 | 2017-06-05 |
| Street Address |
520 N MAIN ST STE 111 |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811149677 | Brush Advisories Medical | Allergy & Immunology | 520 N Main St Ste 111, Santa Ana, CA 92701 | 2008-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1952915456 | Alexandria Bekele | Counselor | Address: 405 W. 5th Street, Santa Ana, CA 92701 | 2020-09-02 |
| 1508479239 | Candice Bjorkman | Counselor | 1201 E Fruit St, Santa Ana, CA 92701 | 2020-08-24 |
| 1013527365 | Maryiam Elizabeth Barkho | Dentist | 809 South Main Street Suite B, Santa Ana, CA 92701 | 2020-08-02 |
| 1447803788 | Emmett Eugene Cook II | Counselor | 1207 E Fruit Street, Santa Ana, CA 92701 | 2019-07-16 |
| 1619538741 | Emily H Sanders | Marriage & Family Therapist | 1800-f Parkcourt Place, Suite 205, Santa Ana, CA 92701 | 2019-06-28 |
| 1184191769 | Peace of Mind Wellness & Family Counseling, Inc. | Counselor | 1651 E. Fourth St Ste 240, Santa Ana, CA 92701 | 2018-10-31 |
| 1841765815 | Kelly Marie Contreras | Clinical Medical Laboratory | 902 N. Grand Avenue, Suite 204, Santa Ana, CA 92701 | 2018-10-05 |
| 1780176537 | Diane Carol Navarro-prescott | Counselor | 1633 East 4th Street, Santa Ana, CA 92701 | 2018-06-06 |
| 1750873758 | Eileen Fernandez | Counselor | 615 W Civic Center Dr Fl 2, Santa Ana, CA 92701 | 2018-06-05 |
| Find all providers in zip 92701 | ||||
| Taxonomy Code | 207RA0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Allergy & Immunology |
| An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309341 | Kianoush Shakib Md Inc | Internal Medicine | 11661 San Vicente Blvd Ste 101, Los Angeles, CA 90049-5150 | 2019-01-10 |
| 1629510235 | Lawrence Awai | Internal Medicine | 4776 Stetson Rd, Clovis, CA 93619-9555 | 2016-11-14 |
| 1619363314 | Aminaa Siddiqi | Internal Medicine | 2440 W Covell Blvd Ste 104, Davis, CA 95616-5671 | 2015-04-09 |
| 1881082683 | Ricardo Antonio Tan Md Inc. | Internal Medicine | 5219 Cedros Ave, Sherman Oaks, CA 91411-4016 | 2014-12-31 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| 1609202274 | George Richard Barr | Internal Medicine | 225 Crossroads Blvd # 381, Carmel, CA 93923-8674 | 2013-09-16 |
| 1184069692 | Tyler Basen | Internal Medicine | 26691 Plaza Ste 170, Mission Viejo, CA 92691-6396 | 2013-05-10 |
| 1528403797 | Warner C. Greene | Internal Medicine | 1650 Owens St, San Francisco, CA 94158-2261 | 2013-05-01 |
| 1407153000 | Howard Eric Strom | Internal Medicine | 3411 La Falda Pl, Los Angeles, CA 90068-1509 | 2011-02-16 |
| 1598893794 | Rakesh Jindal M.d. Inc | Internal Medicine | 462 W Putnam Ave, Porterville, CA 93257-3321 | 2007-03-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.