SAMANTHA QUEEN (NPI# 1013547058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013547058 |
| Entity Type | Individual |
| Full Name | SAMANTHA QUEEN |
| Practice Address |
5500 Campanile Dr San Diego CA 92182-0001 |
| Mailing Address |
9902 Knollview Dr Spring Valley CA 91977-7034 |
| Practice Telephone | 6195945200 |
| Mailing Telephone | 6197133704 |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
5500 CAMPANILE DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92182-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649206269 | Denise Ann Wiksten | Specialist/Technologist | 5500 Campanile Dr, Dept. of Exercise & Nutritional Sciences, San Diego, CA 92182-0001 | 2006-06-24 |
| 1326663840 | Lisa Marie Contois | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2020-06-10 |
| 1134777246 | Sara Alyson Leighanne Self | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-1680 | 2019-09-01 |
| 1033767793 | Eric Estrada | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2019-08-27 |
| 1376009506 | Kyle Nicholas Llorens | Physical Therapist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2019-02-12 |
| 1336604990 | Alaina Katherine Nicholas | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2019-02-07 |
| 1518431972 | Nathaniel Burns Bechtel | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0003 | 2019-01-17 |
| 1205325065 | Queenie Soriano | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2018-05-08 |
| 1558850370 | Kristin Anne Manyak | Specialist/Technologist | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2018-05-07 |
| 1154839124 | Cristal Moreno | Student in an Organized Health Care Education/Training Program | 5500 Campanile Dr, San Diego, CA 92182-0001 | 2018-01-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184137861 | Megan Lawler | Specialist/Technologist | 5032 55th Street, San Diego, CA 92182 | 2017-11-16 |
| 1548501703 | Jon Eric Alexander | Counselor | 5500 Campanile Dr., San Diego, CA 92182 | 2013-03-12 |
| 1114575875 | Rand Al Urfali | Student in an Organized Health Care Education/Training Program | 5500 Campanile Drive, San Diego, CA 92182 | 2019-08-27 |
| 1326414988 | Rachel Mahoney | Counselor | 5500 Campanile Drive, San Diego, CA 92182 | 2015-08-18 |
| 1215551551 | Jacob Riley Callahan | Specialist/Technologist | 5302 55th St, San Diego, CA 92182-0001 | 2020-06-02 |
| 1164573234 | Amol Narendra Doshi | Preventive Medicine | Sdsu Calpulli Ctr Health Svcs 5500 Campanile Dr, San Diego, CA 92182-0001 | 2007-01-16 |
| 1710973953 | Cathy Ann Baughman-gross | Nurse Practitioner | 7500 Hardy Ave, San Diego, CA 92182-0001 | 2005-09-22 |
| 1972531994 | Donald Fredrick Kessler | Specialist/Technologist | 5500 Campanille Dr, San Diego, CA 92182-4313 | 2006-06-29 |
| 1033184064 | Carolyn Rae Peters | Specialist/Technologist | 5505 Campanile Dr., Aac 1402, San Diego, CA 92182-4313 | 2006-02-22 |
| 1902443518 | Sergio Miguel Ibarra | Specialist/Technologist | 5500 Campanile Drive, San Diego, CA 92182-4313 | 2019-12-02 |
| Find all providers in zip 92182 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716204 | Julianne A. Demery | Student in an Organized Health Care Education/Training Program | Naval Base San Diego 2450 Craven Street #3300, San Diego, CA 92136-0001 | 2020-10-01 |
| 1649885732 | Leanne Evalyn Morancie | Student in an Organized Health Care Education/Training Program | 4231 Balboa Ave # 1245, San Diego, CA 92117-5504 | 2020-09-15 |
| 1689288136 | Melissa Eileen Fitzgibbon | Student in an Organized Health Care Education/Training Program | 5114 63rd St, San Diego, CA 92115-1407 | 2020-09-02 |
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1861004392 | Mareena Biju | Student in an Organized Health Care Education/Training Program | 10995 Evening Creek Dr E, San Diego, CA 92128-4009 | 2020-08-17 |
| 1184235202 | Taylor G Wasko | Student in an Organized Health Care Education/Training Program | 4114 Swift Ave Apt 4, San Diego, CA 92104-2249 | 2020-08-12 |
| 1790394245 | Elisa Melo Da Silva Smerik | Student in an Organized Health Care Education/Training Program | 3235 Loma Riviera Dr, San Diego, CA 92110-5511 | 2020-07-29 |
| 1215554076 | Ana Mohammad-zadeh | Student in an Organized Health Care Education/Training Program | 17289 Russet St, San Diego, CA 92127-2135 | 2020-06-28 |
| 1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
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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.