MARYPAT KELLY


Address: 80 Great Oaks Blvd, San Jose, CA 95119-1310
Phone: 4083633000

MARYPAT KELLY (NPI# 1043289523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043289523
Entity Type Individual
Full Name MARYPAT KELLY
Credential GNP
Practice Address 80 Great Oaks Blvd
San Jose
CA 95119-1310
Mailing Address 1150 Pine St
Menlo Park
CA 94025-3455
Practice Telephone 4083633000
Practice Fax Number 4083633082
Mailing Telephone 6504730529
Enumeration Date 2006-03-16
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
15112 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 80 GREAT OAKS BLVD
City SAN JOSE
State CA
Zip Code 95119-1310

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609844729 Marion Jean Hogan Nurse Practitioner 80 Great Oaks Blvd, San Jose, CA 95119-1310 2006-03-14
1033631205 Nichole E Imamura-sperling Social Worker 80 Great Oaks Blvd, San Jose, CA 95119-1310 2017-07-10
1326570706 Joanna Michaels Social Worker 80 Great Oaks Blvd, B-209, San Jose, CA 95119-1310 2017-04-03
1184176752 Linda Woodsmall Social Worker 80 Great Oaks Blvd, San Jose, CA 95119-1310 2016-10-31
1053786780 Patricia Ann Ash Moore Social Worker 80 Great Oaks Blvd, San Jose, CA 95119-1310 2015-12-07
1457721128 Russell Schnurr Social Worker 80 Great Oaks Blvd, 180d, San Jose, CA 95119-1310 2015-10-06
1003206244 Va Palo Alto Healthcare System Clinic/Center 80 Great Oaks Blvd, San Jose, CA 95119-1310 2015-01-26
1700284932 Thanh Nga Thi Do Social Worker 80 Great Oaks Blvd, San Jose, CA 95119-1310 2014-12-22
1417387002 Va Psychiatric Unit 80 Great Oaks Blvd, San Jose, CA 95119 2013-11-18
1295099331 Angel Yu Pharmacist 80 Great Oaks Blvd, San Jose, CA 95119-1310 2012-07-03
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NPI Name Taxonomy Address Enumeration
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1992264774 Jennifer Luu Student in an Organized Health Care Education/Training Program 276 International Circle Building, 1 - 2nd Floor - Family Medicine Residency Unit G, San Jose, CA 95119 2019-03-19
1194209510 Victoria Marques Pharmacist 275 Hospital Parkway, Suite 625, San Jose, CA 95119 2018-09-21
1780123497 Costco Wholesale Corporation Hearing Aid Equipment 6898 Raleigh Road, San Jose, CA 95119 2017-02-14
1437563855 Mark Douglas Zukunft Emergency Medicine 250 Hospital Pkwy Dept Of, San Jose, CA 95119 2014-06-13
1669896338 Paul J. Zuchowski Chiropractic, A Professional Corporation Chiropractor 6950 Santa Teresa Blvd., Ste.a, San Jose, CA 95119 2014-02-14
1700227873 Yu-chien Cheng Internal Medicine 275 Hospital Pkwy Ste 600, San Jose, CA 95119 2013-07-17
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487921656 Pratima Gupta Nurse Practitioner 255 N White Rd, Suite 200, San Jose, CA 95127-1964 2011-11-16
1013136423 Julie Dutton Nurse Practitioner 4855 Atherton Ave Ste 101, San Jose, CA 95130-1026 2007-04-24
1609844729 Marion Jean Hogan Nurse Practitioner 80 Great Oaks Blvd, San Jose, CA 95119-1310 2006-03-14
1003213679 Jodie Sugiyama Nurse Practitioner 4850 Union Ave, San Jose, CA 95124-5156 2014-11-26
1780017632 Elisha Bonny Eng Jang Nurse Practitioner 299 Stockton Ave, San Jose, CA 95126-2763 2013-08-14
1871548701 Deena Marie Bunzel Nurse Practitioner 80 Great Oaks Blvd, San Jose, CA 95119-1310 2006-05-22

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1114535937 Ashley Elizabeth Rosso Nurse Practitioner 3111 Camino Del Rio N Ste 625, San Diego, CA 92108-5718 2020-07-17
1518586452 Zaruhi Harutyunyan Nurse Practitioner 7901 Santa Monica Blvd Ste 206, West Hollywood, CA 90046-5180 2020-04-10
1457986168 Maritza J Lira Nurse Practitioner 23141 Verdugo Dr Ste 201, Laguna Hills, CA 92653-1341 2020-03-03
1225677198 Shannon Ha Duyen Sicat Nurse Practitioner 2617 E Chapman Ave Ste 109, Orange, CA 92869-3245 2019-12-24
1528605961 Elsa L Pineda-flores Nurse Practitioner 1513 S Grand Ave Ste 306, Los Angeles, CA 90015-3075 2019-12-04
1447895073 Kemi Osilesi Nurse Practitioner 1943 Seasons St, Simi Valley, CA 93065-0580 2019-11-07
1487297107 Fareeha Sipra Nurse Practitioner Fresno County Jail, 1225 M Street, Fresno, CA 93721 2019-10-25
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Competitor

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City SAN JOSE
Zip Code 95119

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Dataset Information

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.

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