HOLLY VANDERHYDE (NPI# 1033773379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033773379 |
| Entity Type | Individual |
| Full Name | HOLLY VANDERHYDE |
| Credential | NP |
| Practice Address |
12364 Perris Blvd Moreno Valley CA 92557-7423 |
| Practice Telephone | 6052096421 |
| Mailing Telephone | 9512438871 |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2020-04-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 95011532 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 58471 Twenty Nine Palms Hwy, Ste 103, Yucca Valley, CA 92284 | 7608951525 | 7608326124 |
| Street Address |
12364 PERRIS BLVD |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92557-7423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194027672 | Destiny Hospice Care, Inc | Hospice Care, Community Based | 12364 Perris Blvd, Moreno Valley, CA 92557-7423 | 2010-12-03 |
| 1427558949 | Folley Felix Igbinosun | Nurse Practitioner | 12364 Perris Blvd, Moreno Valley, CA 92557-7423 | 2018-02-21 |
| 1659726206 | Kaishauna Guidry | General Practice | 12364 Perris Blvd, Moreno Valley, CA 92557-7423 | 2016-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598314577 | Knight Rider Transport Inc | Private Vehicle | 21334 Ocasey Ct, Moreno Valley, CA 92557 | 2019-09-11 |
| 1679041495 | Shaping Pathways | Community/Behavioral Health | 11627 Mccully Court, Moreno Valley, CA 92557 | 2018-11-09 |
| 1710485644 | Torie Curiel | Behavior Technician | 12125 Day St E301, Moreno Valley, CA 92557 | 2018-01-25 |
| 1164949921 | Phyllis Yvonne Miller | Behavioral Analyst | 15450 Casa Grande St, Moreno Valley, CA 92557 | 2017-08-23 |
| 1255855912 | Natalie Maria-vega Cortinas | Specialist/Technologist | 12348 Kasota Ct., Moreno Valley, CA 92557 | 2017-08-03 |
| 1942720263 | Shenna Pontier Brown | Licensed Vocational Nurse | 12031 Poutous Ct, Moreno Valley, CA 92557 | 2017-06-27 |
| 1104209733 | Saira Medrano | Counselor | 11966 Villa Hermosa, Moreno Valley, CA 92557 | 2015-07-01 |
| 1295071405 | Maura Sauls | Counselor | 9963 Paseo Corralito, Moreno Valley, CA 92557 | 2012-12-14 |
| 1992919583 | Jody Willetts | Technician, Other | 11480 Tiffany Lane, Moreno Valley, CA 92557 | 2007-05-10 |
| 1457564841 | Derrick Trigenza Smith | Dental Hygienist | 23569 Sunnymead Ranch Parkway, Moreno Valley, CA 92557 | 2007-05-08 |
| Find all providers in zip 92557 | ||||
| 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 |
|---|---|---|---|---|
| 1902417124 | Fely Embrado | Nurse Practitioner | 12632 Magnolia Dr, Moreno Valley, CA 92555-3513 | 2020-08-11 |
| 1528695558 | Erin Sullivan | Nurse Practitioner | 25620 Cactus Ave, Moreno Valley, CA 92555-9255 | 2020-03-27 |
| 1255872719 | Sibonisiwe Moyo Johnson | Nurse Practitioner | 22555 Alessandro Blvd Ste B, Moreno Valley, CA 92553 | 2017-03-16 |
| 1730571209 | Cecelia Patrician Cartman Seals | Nurse Practitioner | 26590 Kalmia Ave, Moreno Valley, CA 92555-1760 | 2015-02-20 |
| 1457770836 | Uchenna G Orji | Nurse Practitioner | 24853 Alessandro Blvd, #4, Moreno Valley, CA 92553-6102 | 2014-04-14 |
| 1699842435 | Betty A Stevens | Nurse Practitioner | 12416 Prairie Wind Trl, Moreno Valley, CA 92555-5405 | 2006-11-29 |
| 1457969032 | Heain Aung | Nurse Practitioner | 26520 Cactus Ave Ste A2006, Moreno Valley, CA 92555-3927 | 2020-07-20 |
| 1346706561 | Courtney Renee Moore | Nurse Practitioner | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2019-02-12 |
| 1639633084 | Ian William Kirby | Nurse Practitioner | 22675 Alessandro Blvd, Moreno Valley, CA 92553-8551 | 2019-01-29 |
| 1932671567 | Sherri Grace Myung | Nurse Practitioner | 14114 Business Center Dr Ste D, Moreno Valley, CA 92553-9113 | 2018-12-20 |
| Find all providers in MORENO VALLEY | ||||
| City | MORENO VALLEY |
| Zip Code | 92557 |
Please comment or provide details below to improve the information on HOLLY VANDERHYDE.
| 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.