JESSICA STANKIEWICZ LIGHTCAP (NPI# 1053921064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053921064 |
| Entity Type | Individual |
| Full Name | JESSICA STANKIEWICZ LIGHTCAP |
| Credential | MSN, RN, ACCNS-P |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Practice Telephone | 5104283885 |
| Practice Fax Number | 5105977194 |
| Mailing Telephone | 5104283885 |
| Mailing Fax Number | 5105977194 |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN810614 | CA | Nursing Service Providers |
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
CNS4808 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
747 52ND ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
| 1497379317 | Sara Maria Markuson | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821457607 | Suyeon Lee | Clinical Nurse Specialist | 12112 Adrian St, #6-112, Garden Grove, CA 92840-4352 | 2016-02-22 |
| 1912387721 | Reia Theresa Zimmer | Clinical Nurse Specialist | 1855 4th St Fl 2, San Francisco, CA 94158-2350 | 2015-06-05 |
| 1144418815 | Janie Pansini Ronchelli | Clinical Nurse Specialist | 3659 Round Barn Circle, Santa Rosa, CA 95403 | 2007-10-09 |
| 1427655851 | Rachel Chapman | Clinical Nurse Specialist | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2020-10-08 |
| 1316570245 | Annette L. Rogers | Clinical Nurse Specialist | 1200 N State St, Los Angeles, CA 90033-1083 | 2020-02-19 |
| 1659721769 | Angelina Luper | Clinical Nurse Specialist | 2516 Stockton Blvd, Sacramento, CA 95817-2208 | 2016-06-20 |
| 1043676778 | Kristine Laguit | Clinical Nurse Specialist | 750 Welch Rd, Suite116, Palo Alto, CA 94304-1507 | 2016-01-11 |
| 1497140107 | Maura Elizabeth O'day | Clinical Nurse Specialist | 1855 4th St, 2nd Floor, Box 0570, San Francisco, CA 94158-2350 | 2015-03-31 |
| 1093123564 | Tomas Dante Smith | Clinical Nurse Specialist | 1543 E Palmdale Blvd, Suite C, Palmdale, CA 93550-2000 | 2014-07-29 |
| 1386061364 | Apex Pediatrics, Inc | Clinical Nurse Specialist | 399 E Highland Ave, Suite 329, San Bernardino, CA 92404-3808 | 2014-03-27 |
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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.