DR. KELLEY LYNN HAGERICH (NPI# 1013109792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013109792 |
| Entity Type | Individual |
| Full Name | DR. KELLEY LYNN HAGERICH |
| Credential | M.D., MPH |
| Practice Address |
Va San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161-0001 |
| Practice Telephone | 8585528585 |
| Mailing Telephone | 8585528585 |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2012-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | A113020 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
VA SAN DIEGO HEALTHCARE SYSTEM 3350 LA JOLLA VILLAGE DRIVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92161-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154379949 | Mary Alice Lacy | Nurse Practitioner | Va San Diego Healthcare System, 3350 La Jolla Village Drive, Mc-118, San Diego, CA 92161-0001 | 2006-05-04 |
| 1972012268 | Jessica Lynne Lontayo | Student in an Organized Health Care Education/Training Program | Va San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161-0002 | 2017-09-29 |
| 1457705915 | Victoria Lee Clark | Dietitian, Registered | Va San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA 92161-0001 | 2016-04-20 |
| 1336458124 | Tatiana Anastasia Chircop-rollick | Psychologist | Va San Diego Healthcare System, 3350 La Jolla Village Drive (116a), San Diego, CA 92161-0001 | 2010-09-28 |
| 1437464492 | Megan Ann Paulk | Audiologist | Va San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161-0001 | 2010-08-15 |
| 1013231067 | Kathleen Ann Mcchesney | Psychologist | Va San Diego Healthcare System, 3350 La Jolla Village Drive, (116b), San Diego, CA 92161-0001 | 2010-03-19 |
| 1508098815 | Shannon Marie Matsko | Pharmacist | Va San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA 92161-0001 | 2009-08-20 |
| 1891926515 | Natalie Nicole Castriotta | Psychologist | Va San Diego Healthcare System, 33, San Diego, CA 92161-0001 | 2009-07-29 |
| 1346474848 | Carl Stepnowsky | Psychologist | Va San Diego Healthcare System, 3350 La Jolla Village Drive (111n-1), San Diego, CA 92161-0001 | 2009-05-12 |
| 1245470871 | Christie A. Cole | Nurse Anesthetist, Certified Registered | Va San Diego Healthcare System, (mc 125) 3350 La Jolla Village Drive, San Diego, CA 92161-0001 | 2009-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902315807 | Laura Crocker | Psychologist | 3350 La Jolla Village Dr Mc 151b, San Diego, CA 92161 | 2017-09-22 |
| 1568849545 | Deborah Falch | Internal Medicine | Office of Primary Care Room 3322, 3350 La Jolla Village Drive, San Diego, CA 92161 | 2015-04-29 |
| 1649566001 | Alyan Ali | Student in an Organized Health Care Education/Training Program | 350 La Jolla Village Dr, Unit 118, San Diego, CA 92161 | 2011-06-23 |
| 1992840144 | I-wei Shu | Psychiatry & Neurology | 3350 La Jolla Village Drive Mc 116a, San Diego, CA 92161 | 2007-02-21 |
| 1639252216 | R Shabetai | General Acute Care Hospital | Vahcs 3350 La Jolla Village Dr, Cardiolgy 111a, La Jolla, CA 92161 | 2006-10-24 |
| 1437233624 | Lee Michael Williams | Marriage & Family Therapist | Department of Veteran Affairs, 3350 La Jolla Village Dr, Psychology Department, San Diego, CA 92161 | 2006-10-24 |
| 1295824340 | Pamela Anne Broder | Pharmacist | San Diego Va Medical Center (119), 3350 La Jolla Village Drive, San Diego, CA 92161 | 2006-10-12 |
| 1750484259 | Michael Neil Oxman | Internal Medicine | Shingles Prevention Study (111f-1), Va Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161 | 2006-09-07 |
| 1295847358 | Patricia Ellen Fornes | Physical Therapist | Dept. Veterens Affairs San Diego Healthcare Services, 3350 La Jolla Village Dr. Dept. Pm&r Mb 117, San Diego, CA 92161 | 2006-08-31 |
| 1477667087 | Kathryn Victoria Frederick Louv | Nurse Practitioner | 3350 La Jolla Village Dr., La Jolla, CA 92161 | 2006-08-19 |
| Find all providers in zip 92161 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
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| 1023639176 | Arthur Wong | Internal Medicine | 4222 Kansas St Unit 2, San Diego, CA 92104-1802 | 2020-04-29 |
| 1679102461 | Santosh Vetticaden | Internal Medicine | 6420 Mesa Norte Dr, San Diego, CA 92130-6852 | 2020-04-03 |
| 1225664964 | Andres Smith M.d. A Professional Medical Corporation | Internal Medicine | 6244 El Cajon Blvd Ste 29, San Diego, CA 92115-3918 | 2020-03-13 |
| 1154972388 | Kimberly Hall Fernandez | Internal Medicine | 700 W E St Unit 2101, San Diego, CA 92101-5993 | 2019-09-29 |
| 1992289300 | Sd Healthcare Solutions | Internal Medicine | 5943 Thorn St, San Diego, CA 92105-3916 | 2018-09-21 |
| 1992295331 | Alera Inc | Internal Medicine | 2667 Camino Del Rio S Ste 307-6, San Diego, CA 92108 | 2018-05-11 |
| 1275020844 | Lf Capital Inc | Internal Medicine | 438 Camino Del Rio S Ste 203, San Diego, CA 92108-3546 | 2018-04-18 |
| 1710401302 | Ca Post Acute Specialists PC | Internal Medicine | 3525 Del Mar Heights Rd # 966, San Diego, CA 92130-2199 | 2017-07-26 |
| 1063933604 | John Jackson Howard | Internal Medicine | 4616 Patricia Pl, San Diego, CA 92115-1934 | 2017-07-05 |
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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.