MARIETTA BERMUDEZ GUAJARDO (NPI# 1033512868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033512868 |
| Entity Type | Individual |
| Full Name | MARIETTA BERMUDEZ GUAJARDO |
| Other Name | MARIETTA MENESES BERMUDEZ |
| Credential | FNP-BC |
| Practice Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2095216097 |
| Mailing Telephone | 2095216097 |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2019-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | NP95005262 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP126286 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
600 COFFEE RD |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073517751 | Kishore K. Kalluri | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2005-06-09 |
| 1508405622 | Erica Corral-ruiz | Registered Nurse | 600 Coffee Rd, Modesto, CA 95355-4201 | 2020-01-06 |
| 1598324519 | Cierra Coffman | Physician Assistant | 600 Coffee Rd, Modesto, CA 95355-4201 | 2019-06-12 |
| 1053879932 | Anitha Choorakulam George | Nurse Practitioner | 600 Coffee Rd, Modesto, CA 95355-4201 | 2019-03-09 |
| 1154852994 | Simran Kaur Bains | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2017-03-23 |
| 1891246153 | Pacific Infectious Diseases, Inc. | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-10-20 |
| 1497108062 | Palvasha Shah | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355 | 2016-07-19 |
| 1861845430 | Bharati Meesala | Hospitalist | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-07-19 |
| 1376999672 | David William Lowry | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-05-05 |
| 1245692250 | Swathi S.b. Kari | Hospitalist | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051391 | Careforyou LLC | Nurse Practitioner | 806 14th St, Modesto, CA 95354-1023 | 2020-10-21 |
| 1114561818 | Calmglow, Inc | Nurse Practitioner | 1120 13th St Ste B, Modesto, CA 95354-0950 | 2019-11-05 |
| 1851865158 | Christine Magidie Dumayas Roque | Nurse Practitioner | 1552 Coffee Road, Suite 200, Modesto, CA 95355-3122 | 2019-01-20 |
| 1043533417 | Dianne Michelle Hinton | Nurse Practitioner | 1724 G. Street, Modesto, CA 95354 | 2010-03-12 |
| 1003999137 | Lois Elaine Lewis | Nurse Practitioner | 205 W Granger Ave, Modesto, CA 95350 | 2006-10-23 |
| 1770690612 | Roxanne O. Garbez | Nurse Practitioner | 1700 Coffee Road, Modesto, CA 95355-2803 | 2006-08-24 |
| 1326001157 | Larry L. Kilgore | Nurse Practitioner | 401 E Paradise Road, Modesto, CA 95351 | 2006-04-11 |
| 1629031042 | Lisa Eppers | Nurse Practitioner | 700 17th St, Modesto, CA 95354-1209 | 2006-04-07 |
| 1578547725 | Maureen Elhard Freeman | Nurse Practitioner | 401 E Paradise Rd, Paradise Medical Office, Modesto, CA 95351 | 2005-12-01 |
| 1124639315 | Barbara Cummins | Nurse Practitioner | 3509 Coffee Rd, Modesto, CA 95355-1356 | 2020-08-12 |
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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.