JASON DON ULLYOTT (NPI# 1083878532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083878532 |
| Entity Type | Individual |
| Full Name | JASON DON ULLYOTT |
| Credential | PA |
| Practice Address |
275 Hospital Dr Ukiah CA 95482-4531 |
| Practice Telephone | 7074627900 |
| Practice Fax Number | 7074627947 |
| Mailing Telephone | 7074627900 |
| Mailing Fax Number | 7074627947 |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2008-07-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA19754 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
275 HOSPITAL DR |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-4531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780678433 | H.w. Gordon, M.d., Medical Corporation | Pathology | 275 Hospital Dr, Dept of Pathology, Ukiah, CA 95482-4531 | 2005-09-08 |
| 1417560194 | Vanessa Renee Fuller | Nurse Practitioner | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2020-08-24 |
| 1134743644 | Hyun Jung Kye | Pharmacist | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2020-06-01 |
| 1003458704 | Anesthesia Management Services of California Inc | Nurse Anesthetist, Certified Registered | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2019-10-14 |
| 1275093197 | Caitlin Marie Raymond | Student in an Organized Health Care Education/Training Program | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2019-03-25 |
| 1265992168 | Joshua Levy | Student in an Organized Health Care Education/Training Program | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2019-03-25 |
| 1851856710 | Ashley Daw | Pharmacist | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2019-02-05 |
| 1184197048 | Ranna Shamiya | Pharmacist | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2019-01-03 |
| 1932671088 | Paulette Dancause | Pharmacist | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2018-12-28 |
| 1356813646 | Brandi Tacdol | Pharmacist | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2018-12-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093797250 | Kristin Marie Groessl | Physician Assistant | 260 Hospital Dr Ste 107, Ukiah, CA 95482 | 2005-11-15 |
| 1447668918 | Diana Garcia | Physician Assistant | 275 S Orchard Ave, Ukiah, CA 95482-5016 | 2014-07-29 |
| 1659578383 | Michael Van Dyke | Physician Assistant | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2007-06-27 |
| 1669687182 | Nancy Laybourn | Physician Assistant | 1050 N State St, Ukiah, CA 95482-3414 | 2007-05-10 |
| 1952469108 | Talitha L Marty | Physician Assistant | 333 Laws Ave, Ukiah, CA 95482-6540 | 2006-12-04 |
| 1972673895 | Renee Vinyard | Physician Assistant | 234 Hospital Dr, Ukiah, CA 95482-4560 | 2006-11-08 |
| 1174692545 | Sophia Grutsis Marquis | Physician Assistant | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2006-11-07 |
| 1164500690 | Susan Klimist-zingo | Physician Assistant | 260 Hospital Dr, Suite 209, Ukiah, CA 95482-4568 | 2006-11-01 |
| 1407885122 | Lynn Dress-meadows | Physician Assistant | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2006-07-03 |
| 1912943143 | Tonya Tiffany Selberg | Physician Assistant | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2006-06-22 |
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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.