BERNADETTE GERONIMO (NPI# 1023544673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023544673 |
| Entity Type | Individual |
| Full Name | BERNADETTE GERONIMO |
| Practice Address |
4301 N Star Way Modesto CA 95356-9262 |
| Practice Telephone | 2095771200 |
| Mailing Telephone | 2095771200 |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QH0600X |
Spec/Tech, Pathology Specialization: Histology |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4301 N STAR WAY |
| City | MODESTO |
| State | CA |
| Zip Code | 95356-9262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629074810 | Harvey Chung-der Chang | Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2005-06-22 |
| 1295356814 | Roger Goorley | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2020-05-05 |
| 1962049239 | Cortney J Allen | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2019-12-05 |
| 1740763135 | Abdul Samad | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2018-09-11 |
| 1063900108 | Tyler Ewing | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2018-04-24 |
| 1366736977 | Ashley J Tarasen | Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2011-06-01 |
| 1487958815 | Alireza Torabi | Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2010-12-28 |
| 1598079717 | Rana Tawil | Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2010-07-29 |
| 1861704058 | Richard Danialan | Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2010-07-05 |
| 1225264724 | Xiangrong Zhao | Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2009-06-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649809021 | Amelia E Delgadillo | Licensed Vocational Nurse | 501 Triangle Rd, Modesto, CA 95356 | 2020-04-07 |
| 1689220279 | Meagan Veneman | Physical Medicine & Rehabilitation | 125 Hogue Rd, Modesto, CA 95356 | 2019-08-10 |
| 1497131213 | Hermes Guardian Transport | Non-emergency Medical Transport (VAN) | 4221 Erin Way, Modesto, CA 95356 | 2015-08-04 |
| 1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
| 1922242866 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 500 Glass Ln Ste H, Modesto, CA 95356 | 2009-04-22 |
| 1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
| 1265636013 | Margaret Kathleen Grisell | Orthopaedic Surgery | 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 | 2007-06-14 |
| 1841412111 | Bobby Gene Boswell | Specialist/Technologist | 3908 Vintage Cove, Modesto, CA 95356 | 2007-05-03 |
| 1598892861 | Merritt Radiological Medical Group Inc | Radiology | 526 Charity Way, Modesto, CA 95356 | 2007-02-27 |
| 1396871091 | Michael Steven Beck | Social Worker | 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 | 2007-02-26 |
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| Taxonomy Code | 246QH0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Histology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932581824 | Kendra Garchow | Spec/Tech, Pathology | 2625 Coffee Rd Ste S, Modesto, CA 95355-2050 | 2015-06-26 |
| 1407813777 | Histo-path Technical Specialties, Inc | Spec/Tech, Pathology | 961 N Emerald Ave, Ste D, Modesto, CA 95351-1556 | 2006-04-28 |
| 1295356814 | Roger Goorley | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2020-05-05 |
| 1962049239 | Cortney J Allen | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2019-12-05 |
| 1740763135 | Abdul Samad | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2018-09-11 |
| 1063900108 | Tyler Ewing | Spec/Tech, Pathology | 4301 N Star Way, Modesto, CA 95356-9262 | 2018-04-24 |
| 1245699396 | Eva Glover | Spec/Tech, Pathology | 2625 Coffee Rd, Suite S, Modesto, CA 95355-2050 | 2016-02-17 |
| 1508249764 | Ermias Gebregziabher | Spec/Tech, Pathology | 2625 Coffee Rd, Suite S, Modesto, CA 95355-2050 | 2015-07-07 |
| 1821470717 | Christopher Weston | Spec/Tech, Pathology | 2625 Coffee Rd Ste S, Modesto, CA 95355-2050 | 2015-06-26 |
| 1942694047 | John Mbeo | Spec/Tech, Pathology | 2625 Coffee Rd, Suite S, Modesto, CA 95355-2050 | 2015-03-26 |
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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.