JOLYN FERGON (NPI# 1104934033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104934033 |
| Entity Type | Individual |
| Full Name | JOLYN FERGON |
| Credential | N.P., C.N.M |
| Practice Address |
1100 N Palm Canyon Dr Ste 212 Palm Springs CA 92262-4426 |
| Practice Telephone | 7603277900 |
| Practice Fax Number | 7603277905 |
| Mailing Telephone | 7603277900 |
| Mailing Fax Number | 7603277905 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2014-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
NP10593 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367A00000X | Advanced Practice Midwife | 1727 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE GROUP ID | ZZZ27958Z | 01 |
| CA | GR0101240 | 05 | |
| CA | GR0101241 | 05 | |
| CA | GR0101242 | 05 |
| Street Address |
1100 N PALM CANYON DR STE 212 |
| City | PALM SPRINGS |
| State | CA |
| Zip Code | 92262-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215464144 | Tatiana Shidaki | Nurse Practitioner | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2017-05-23 |
| 1548610439 | Gabriel Evaristo | Obstetrics & Gynecology | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2016-06-21 |
| 1467851147 | Eloisa Agatep | Nurse Practitioner | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2014-08-18 |
| 1255760443 | Kelli Nowak | Physician Assistant | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2013-11-07 |
| 1700097508 | Sandra M Moran | Nurse Practitioner | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2007-05-24 |
| 1609984442 | Jessica Reed-elam | Advanced Practice Midwife | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2006-08-29 |
| 1134237993 | Advanced Women's Healthcare, A Medical Corporation | Obstetrics & Gynecology | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841815610 | Dhara H Patel | Student in an Organized Health Care Education/Training Program | Gme Office, 1150 N. Palm Canyon Dr., Palm Springs, CA 92262 | 2020-06-08 |
| 1528683380 | Lizmar Cerezo Perez | Student in an Organized Health Care Education/Training Program | Gme Office 1150 N. Palm Canyon Dr. Palm Springs, Ca 922, Palm Springs, CA 92262 | 2020-06-08 |
| 1629637285 | Kimiko Tsuchiya | Family Medicine | 1150 North Palm Canyon Drive, Palm Springs, CA 92262 | 2019-06-07 |
| 1780240978 | Aly Sue Vancil | Counselor | 19531 Mclane St Suite B, Palm Springs, CA 92262 | 2019-05-14 |
| 1013477843 | Dennis Michael Woo | Student in an Organized Health Care Education/Training Program | 555 E. Tachevah Dr, Suite 2e - 204, Palm Springs, CA 92262 | 2019-03-19 |
| 1235609314 | Leslie Nohemi Vargas | Behavior Technician | 130 Golden Sands Dr, Palm Springs, CA 92262 | 2018-11-30 |
| 1346723194 | Eisenhower Medical Center | General Acute Care Hospital | 1401 North Palm Canyon Drive, Suite #202, Palm Springs, CA 92262 | 2018-09-07 |
| 1285123133 | Thuan Thi Nguyen | Social Worker | 1751 North Sunrise Way Suite G, Palm Springs, CA 92262 | 2018-05-07 |
| 1598268641 | Scotti Barnes Cassidy | Social Worker | 291 E Mel Ave Unit 261, Palm Springs, CA 92262 | 2018-03-15 |
| 1326577727 | William Alan Lee | Emergency Medicine | 1150 North Indian Canyon Drive, Palm Springs, CA 92262 | 2017-06-08 |
| Find all providers in zip 92262 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831204452 | Dana Jacobs | Nurse Practitioner | 4671 S Congress Ave Ste 100b, Palm Springs, FL 33461-4783 | 2006-08-21 |
| 1467851147 | Eloisa Agatep | Nurse Practitioner | 1100 N Palm Canyon Dr Ste 212, Palm Springs, CA 92262-4426 | 2014-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548819964 | Myra Sepulveda | Nurse Practitioner | 1700 Lombard St Ste 110, Oxnard, CA 93030-8288 | 2019-09-09 |
| 1639641699 | Zahra Jeylani Nur | Nurse Practitioner | 15101 Spectrum, Irvine, CA 92618-3426 | 2018-12-31 |
| 1518486125 | Patty Montoya | Nurse Practitioner | 1026 Felder St, Gardena, CA 90248-3348 | 2017-09-14 |
| 1902357817 | Alexandria Ludlow | Nurse Practitioner | 350 John Muir Pkwy Ste 205, Brentwood, CA 94513-5193 | 2016-10-17 |
| 1477922102 | Vanessa Domush | Nurse Practitioner | 845 E. Willow St, Signal Hill, CA 90755 | 2015-09-23 |
| 1174999015 | Kristina Hagopian | Nurse Practitioner | 8920 Wilshire Blvd Ste 525, Beverly Hills, CA 90211-1968 | 2015-08-14 |
| 1639553076 | Pacific Women's Healthcare Associates | Nurse Practitioner | 500 Superior Ave Ste 310, Newport Beach, CA 92663-3609 | 2015-07-15 |
| 1548655921 | Trudi J Petersen | Nurse Practitioner | 1700 Shattuck Ave # 75, Berkeley, CA 94709-3402 | 2015-04-01 |
| 1932590775 | Samah Shahzya Kureshi | Nurse Practitioner | 2619 Vanderbilt Ln Unit B, Redondo Beach, CA 90278-3318 | 2015-02-16 |
| 1346645801 | Norma Nix | Nurse Practitioner | 22423 Chase St, West Hills, CA 91304-3321 | 2014-10-27 |
| Find all providers with the same taxonomy | ||||
| City | PALM SPRINGS |
| Zip Code | 92262 |
Please comment or provide details below to improve the information on JOLYN FERGON.
| 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.