MIGUEL PABLO SURPOSA (NPI# 1023463163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023463163 |
| Entity Type | Individual |
| Full Name | MIGUEL PABLO SURPOSA |
| Practice Address |
5711 Bolivar St San Diego CA 92139-1617 |
| Practice Telephone | 6192451766 |
| Mailing Telephone | 6192451766 |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
5711 BOLIVAR ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92139-1617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831621689 | Paige Tetreau | Prevention Professional | 2367 Morningside St, San Diego, CA 92139 | 2017-03-31 |
| 1881030310 | Brandon Christopher Jackson | Military Health Care Provider | 6810 Camphor Ln, San Diego, CA 92139 | 2013-05-10 |
| 1720316532 | Jacobi Medical Center | General Acute Care Hospital | 6861 Potomac Street, 57, San Diego, CA 92139 | 2009-12-07 |
| 1083862296 | Jennie C Bilbes | Registered Nurse | 6860 Bear Rier Row, Unit #1, San Diego, CA 92139 | 2008-08-29 |
| 1104033018 | Shanon Star Murillo | Internal Medicine | 2401 Reo Drive, San Diego, CA 92139 | 2007-05-17 |
| 1851378236 | Iyabo O Daramola | Internal Medicine | 2401 Reo Dr, San Diego, CA 92139 | 2005-12-28 |
| 1770180648 | Darius Lee Sean Woods | Military Health Care Provider | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 |
| 1134580913 | Emilio Casenave | Military Health Care Provider | 6031 Sandy Shore Ct, San Diego, CA 92139-1014 | 2016-03-08 |
| 1689934879 | Neil Allen Regero Nucup | Military Health Care Provider | 1802 Rocky Shore Rd, San Diego, CA 92139-1017 | 2012-05-21 |
| 1568855880 | Jameson Basa | Military Health Care Provider | 1976 Sky Harbor Rd, San Diego, CA 92139-1023 | 2015-03-11 |
| Find all providers in zip 92139 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
| 1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
| 1487298840 | Garrett Ives | Peer Specialist | 2909 Keats St Apt 7, San Diego, CA 92106-2345 | 2019-10-29 |
| 1144882622 | Melissa Ratsamy | Peer Specialist | 286 Euclid Ave Project Enable, #102, San Diego, CA 92114 | 2019-07-03 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1811434467 | Deborah Sue Lynn | Peer Specialist | 140 W. Arbor Dr., Ucsd Gifford Outpatient Clinic, San Diego, CA 92103-2421 | 2017-01-20 |
| 1376140590 | Leon Samuel Mancilla | Peer Specialist | 5555 Reservoir Dr, San Diego, CA 92120-5134 | 2020-10-01 |
| 1982210092 | Nicole Lynn Iwan | Peer Specialist | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-09-23 |
| 1962014001 | Paulina Alvarado | Peer Specialist | 6160 Mission Gorge Rd, San Diego, CA 92120-3410 | 2020-08-19 |
| 1194333773 | Paulina Vazquez | Peer Specialist | 4283 El Cajon Blvd Ste 115, San Diego, CA 92105-1289 | 2020-07-20 |
| Find all providers in SAN DIEGO | ||||
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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.