DR. JACQUELINE RANDA (NPI# 1013919349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013919349 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE RANDA |
| Credential | PT |
| Practice Address |
874 American Pacific Dr Henderson NV 89014-8800 |
| Practice Telephone | 7027773122 |
| Practice Fax Number | 7027773055 |
| Mailing Telephone | 7027773122 |
| Mailing Fax Number | 7027773055 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2013-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
2845 | NV | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT28176 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD PIN | 54220ZZZ07464Z | 01 |
| CA | RAILROAD MEDICARE | P00066377 | 01 |
| Street Address |
874 AMERICAN PACIFIC DR |
| City | HENDERSON |
| State | NV |
| Zip Code | 89014-8800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926297 | Dana Shepherd | Physician Assistant | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2020-06-12 |
| 1558999888 | Jino Soriano | Student in an Organized Health Care Education/Training Program | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2020-03-31 |
| 1083279442 | Sarah Peralta | Behavior Technician | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2019-05-01 |
| 1871082511 | Robert Wimmer | Physician Assistant | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-05-08 |
| 1093217507 | Tiffany Ann Finnegan | Behavior Technician | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-03-01 |
| 1801303326 | Adam Volker | Behavioral Analyst | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-01-05 |
| 1497268791 | Patrick Allen Leytham | Technician, Other | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2017-11-08 |
| 1316475072 | Cynthia Lau | Occupational Therapist | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2017-05-25 |
| 1497209134 | Teresa Renee Edwards | Behavioral Analyst | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2016-08-11 |
| 1275906521 | Touro University | Psychologist | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2015-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857024 | Sudheer J. Surpure, Md, Dds, Inc. | Oral & Maxillofacial Surgery | Grand Canyon Oral and Facial Surgery, 1600 W. Sunset Road, Suite B, Henderson, NV 89014 | 2020-10-06 |
| 1386271740 | Fibonacci Services LLC | Counselor | 2920 N. Green Valley Pkwy, Bulding 8 & Suite 812, Henderson, NV 89014 | 2020-03-25 |
| 1508409145 | Facial Expressions Presented By K. Thomas | Home Infusion | 1520 W. Sunset Rd. Ste 130, #205, Henderson, NV 89014 | 2019-10-27 |
| 1235794595 | Marquise D Dennis | Prosthetist | 1520 W. Sunset Rd, Henderson, NV 89014 | 2019-05-02 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1841716727 | Logan Bretney | Physical Therapist | 400 S Stephanie St, Suite 310, Building 1, Henderson, NV 89014 | 2017-08-22 |
| 1912421280 | Alan Joseph Sevy | Dentist | 1485 W Warm Springs Rd Ste 101, Henderson, NV 89014 | 2017-07-28 |
| 1659805307 | Ann Marie Echevarria | Behavior Technician | 2551 N Green Valley Parkway, 410a, Henderson, NV 89014 | 2017-04-19 |
| 1366838997 | Ladwana Retic, Lcsw LLC | Case Management | 1514 Tree Top Ct, Henderson, NV 89014 | 2015-04-10 |
| 1073958393 | Ashlyn Call | Physician Assistant | 1397 Galleria Dr Ste 100, Henderson, NV 89014 | 2013-04-30 |
| Find all providers in zip 89014 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154946309 | Lauren Liebert | Physical Therapist | 8975 S Pecos Rd Ste 7a, Henderson, NV 89074-7161 | 2020-06-13 |
| 1124506282 | Jesus Enrique Garcia-camacho | Physical Therapist | 400 N Stephanie St., Suite 310, Henderson, NV 89014-6608 | 2018-08-01 |
| 1992875330 | Christina M Mulloy-groh | Physical Therapist | 2629 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052 | 2006-11-09 |
| 1437160397 | Michelle Jennifer Campbell | Physical Therapist | 2790 W Horizon Ridge Pkwy, Suite #110, Henderson, NV 89052-3997 | 2006-08-10 |
| 1295786531 | Adam Lee Mast | Physical Therapist | 870 Seven Hills Dr Ste 201, Henderson, NV 89052-4379 | 2006-05-12 |
| 1689671661 | Amy M Herr | Physical Therapist | 471 Klutey Park Plaza Dr, Henderson, KY 42420-3347 | 2005-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956058 | Mollet Physical Therapy Pllc | Physical Therapist | 4100 Caughlin Pkwy, Reno, NV 89519-0608 | 2020-06-08 |
| 1912544800 | Diana Christine Adamson | Physical Therapist | 8224 Chimney Bluffs St, North Las Vegas, NV 89085-4412 | 2019-12-10 |
| 1972140150 | Nina Routon | Physical Therapist | 3521 Smoketree Ave, Carson City, NV 89705-8011 | 2019-12-05 |
| 1538638911 | Jacquelyn Nemedez | Physical Therapist | 1898 College Pkwy Ste 102, Carson City, NV 89706-7926 | 2018-11-15 |
| 1790252120 | Reno Orthopaedic Clinic Inc. | Physical Therapist | 1365 Medical Parkway, Carson City, NV 89703 | 2018-10-24 |
| 1427543081 | Physiospine Reno, LLC | Physical Therapist | 6880 S Mccarran Blvd Ste 13, Reno, NV 89509-6129 | 2018-06-26 |
| 1689184319 | Laura Lentz | Physical Therapist | 14430 Rancheros Dr, Reno, NV 89521-7319 | 2017-10-09 |
| 1770821100 | Erin Shaw | Physical Therapist | 6300 Mccarran St Unit 1027, North Las Vegas, NV 89081-8134 | 2013-01-18 |
| 1518261668 | Chad L Loberg | Physical Therapist | 2213 N 5th St, Suite B, Elko, NV 89801-2484 | 2011-01-04 |
| 1669613402 | Carrie K Cameron | Physical Therapist | 100 W Liberty St, Suite 170, Reno, NV 89501-1962 | 2009-03-06 |
| 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.