CORTNEY KECKLEY (NPI# 1194363770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194363770 |
| Entity Type | Individual |
| Full Name | CORTNEY KECKLEY |
| Credential | FNP-BC |
| Practice Address |
8831 Villa La Jolla Dr La Jolla CA 92037-1949 |
| Practice Telephone | 8584574480 |
| Mailing Telephone | 8584574480 |
| Enumeration Date | 2019-12-14 |
| Last Update Date | 2019-12-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95013356 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8831 VILLA LA JOLLA DR |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194760199 | Garfield Beach Cvs LLC | Pharmacy | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2006-06-17 |
| 1720694235 | Anh Phuong Ta | Pharmacist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2020-09-20 |
| 1932722758 | Caroline Toledo Zimmet | Nurse Practitioner | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2020-05-27 |
| 1437784352 | Kaylene Noelle De Vries | Pharmacist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2020-03-11 |
| 1699324954 | Cameron Gonzalez | Technician/Technologist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2019-09-10 |
| 1851940027 | Michael Ferrino | Technician/Technologist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2019-09-10 |
| 1881254126 | Anh Long Lam | Pharmacist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2019-06-18 |
| 1487219820 | Lisa Stoddart | Technician/Technologist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2019-05-01 |
| 1790349124 | Angela Jimenez | Technician/Technologist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2019-05-01 |
| 1033774468 | Felix Lopez | Technician/Technologist | 8831 Villa La Jolla Dr, La Jolla, CA 92037-1949 | 2019-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679136832 | Meghan Elizabeth Jones | Nurse Practitioner | 9300 Campus Point Dr # Mc7892, La Jolla, CA 92037-1300 | 2019-04-15 |
| 1033677190 | Deedra Elizabeth Roberts | Nurse Practitioner | 5655 Caminito Danzarin, La Jolla, CA 92037-7161 | 2019-03-07 |
| 1942788773 | Melanie Trusz | Nurse Practitioner | 9898 Genesee Ave Fl 4, La Jolla, CA 92037-1205 | 2018-08-02 |
| 1528570116 | Spencer Elizabeth Berman | Nurse Practitioner | 9293 Regents Rd Unit C306, La Jolla, CA 92037-9173 | 2017-11-03 |
| 1942729710 | Jessica Lynne Funk | Nurse Practitioner | 9898 Genesee Ave # Amp200, La Jolla, CA 92037-1205 | 2017-09-13 |
| 1144677592 | Johnnie Gayle Javidan | Nurse Practitioner | 7720 Fay Ave., La Jolla, CA 92037 | 2016-05-16 |
| 1194972950 | Judith Ann Gaspar | Nurse Practitioner | 9500 Gilman Dr Dept 39, La Jolla, CA 92093-0039 | 2008-08-24 |
| 1457530180 | Monsita Josefa Faley | Nurse Practitioner | Scripps Clinic Medical Group, 9898 Genesee Ave, La Jolla, CA 92037 | 2007-10-30 |
| 1477667087 | Kathryn Victoria Frederick Louv | Nurse Practitioner | 3350 La Jolla Village Dr., La Jolla, CA 92161 | 2006-08-19 |
| 1811978992 | Bonnie L Eklund | Nurse Practitioner | 9300 Campus Point Dr, Mail Code 7381, La Jolla, CA 92037-1300 | 2005-11-07 |
| Find all providers in LA JOLLA | ||||
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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.