MRS. KATHLENE MARIE EVERHART (NPI# 1124229612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124229612 |
| Entity Type | Individual |
| Full Name | MRS. KATHLENE MARIE EVERHART |
| Credential | P.A. |
| Practice Address |
9415 Mission Blvd Riverside CA 92509-2600 |
| Mailing Address |
Po Box 7849 Riverside CA 92513-7849 |
| Practice Telephone | 9513608795 |
| Practice Fax Number | 9513608798 |
| Mailing Telephone | 9513585222 |
| Mailing Fax Number | 9513585235 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
CA18713 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA | ME1525154 | 01 |
| Street Address |
9415 MISSION BLVD |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92509-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493288 | County of Riverside-community Health Agency | Pediatrics | 9415 Mission Blvd, Riverside, CA 92509-2600 | 2005-11-04 |
| 1639637895 | Cheng Yi Teng Yen | Marriage & Family Therapist | 9415 Mission Blvd, Riverside, CA 92509-2661 | 2019-03-06 |
| 1073088225 | Walter Ernesto Hernandez | Nurse Practitioner | 9415 Mission Blvd, Riverside, CA 92509-2661 | 2018-10-03 |
| 1831261155 | Geoffrey Won-chen Leung | Family Medicine | 9415 Mission Blvd, Riverside, CA 92509-2600 | 2006-11-14 |
| 1457422644 | Pratik Shah Dds Inc. | Dentist | 9415 Mission Blvd, Ste# L, Riverside, CA 92509-2600 | 2006-11-11 |
| 1396859237 | County of Riverside- Community Health Agency | Family Medicine | 9415 Mission Blvd, Riverside, CA 92509-2600 | 2006-08-18 |
| 1437162005 | Yukuen Chung | Family Medicine | 9415 Mission Blvd, Riverside, CA 92509-2600 | 2006-08-14 |
| 1245243815 | Martha A Chong | Pediatrics | 9415 Mission Blvd, Riverside, CA 92509-2600 | 2006-08-14 |
| 1053321182 | County of Riverside- Community Health Agency | Family Medicine | 9415 Mission Blvd, Riverside, CA 92509-2600 | 2006-08-09 |
| 1396751939 | Pratik M Shah | Dentist | 9415 Mission Blvd, Ste# L, Riverside, CA 92509-2600 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720530744 | Leesette De Santiago | Dental Assistant | 6130 Camino Real #12, Riverside, CA 92509 | 2016-10-25 |
| 1043646383 | Andy R Moreno | Counselor | 7790 Big Rock Dr., Riverside, CA 92509 | 2013-09-18 |
| 1275845018 | Myra Agnes Harrison | Pharmacist | 8015 Limonete, Rite Aid, Riverside, CA 92509 | 2010-07-09 |
| 1740424415 | Lin Chew Ota | Obstetrics & Gynecology | 6250 Clay Street, Riverside, CA 92509 | 2009-04-27 |
| 1164660106 | Ramona Jean Carver | Marriage & Family Therapist | 5790 Magnolia Ave., Ste 202, Riverside, CA 92509 | 2009-01-29 |
| 1568627925 | Lisa Anne Razo | Marriage & Family Therapist | 6580 45th St, Riverside, CA 92509 | 2008-07-25 |
| 1215106810 | Xia L. Liu Professional Dentl Corp | Dentist | 8880 Limonite Ave, Pedley, CA 92509 | 2008-02-27 |
| 1467658385 | Riverside County Rubidoux Pharmacy | Pharmacy | 5256 Mission Ave, Rubidoux, CA 92509 | 2007-06-26 |
| 1366644429 | Cynthia Stover | Physician Assistant | 5256 Mission Boulevard, Riverside, CA 92509 | 2007-06-01 |
| 1942327499 | Sober Living By The Sea, Inc | Substance Abuse Rehabilitation Facility | 6690 Limonite Frontage Rd, Riverside, CA 92509 | 2007-03-22 |
| Find all providers in zip 92509 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487136123 | Amy Cortez | Physician Assistant | 3838 Sherman Dr Ste 203, Riverside, CA 92503-4060 | 2018-08-29 |
| 1003265117 | Travis William Cruz | Physician Assistant | 9525 Los Amigos Court, Riverside, CA 92508 | 2016-06-09 |
| 1619325875 | Johnny Morales | Physician Assistant | 9065 Limecrest Dr, Riverside, CA 92508-6418 | 2016-05-28 |
| 1003273707 | Kevin Morris | Physician Assistant | 7101 Magnolia Ave Ste A, Riverside, CA 92504-3843 | 2016-01-26 |
| 1386014132 | Tariq Parwani | Physician Assistant | 7450 Northrop Dr, #261, Riverside, CA 92508-5002 | 2015-10-05 |
| 1962808477 | Erika Lee Amthor | Physician Assistant | 7095 Indiana Ave Ste 210, Riverside, CA 92506-4159 | 2014-11-11 |
| 1821493230 | Jean Huynh | Physician Assistant | 11725 State Ave., Suite 100, Riverside, CA 92505 | 2014-10-28 |
| 1831505080 | Samantha Miller | Physician Assistant | 4646 Brockton Ave Ste 101, Riverside, CA 92506-0103 | 2014-07-09 |
| 1679870695 | Maria E. Lopez | Physician Assistant | 6200 Van Buren Blvd, Riverside, CA 92503-2098 | 2011-02-28 |
| 1811207632 | Bekele T Haimanot | Physician Assistant | 9528 Los Coches Court, Riverside, CA 92508 | 2010-10-14 |
| Find all providers in RIVERSIDE | ||||
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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.