KEITH DAVID ROULEAU (NPI# 1215130562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215130562 |
| Entity Type | Individual |
| Full Name | KEITH DAVID ROULEAU |
| Credential | PA-C |
| Practice Address |
29605 Solana Way #n6 Temecula CA 92591-3758 |
| Practice Telephone | 5106911267 |
| Mailing Telephone | 5106911267 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2015-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA19013 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA NUMBER | MR3132569 | 01 |
| Street Address |
29605 SOLANA WAY #N6 |
| City | TEMECULA |
| State | CA |
| Zip Code | 92591-3758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255978961 | Kendall Leeanne Mattix | Behavior Technician | 26720 Ynez Court, Temecula, CA 92591 | 2019-12-02 |
| 1457915167 | Janice Marie Vevoda-aguero | Registered Nurse | 31233 Skyline Drive, Temecula, CA 92591 | 2019-04-29 |
| 1689151698 | David W Schwartz Md A Medical Corporation | Preferred Provider Organization | 29645 Rancho California Rd Ste 105, Temecula, CA 92591 | 2018-07-23 |
| 1356830426 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 40780 Winchester Rd, Temecula, CA 92591 | 2018-05-04 |
| 1780196428 | Shirley K Wade | Case Manager/Care Coordinator | 40925 County Circle Drive, Temecula, CA 92591 | 2017-11-03 |
| 1639691405 | Angela Parry | Counselor | 29645 Rancho California Rd # 133c, Temecula, CA 92591 | 2017-07-12 |
| 1386166395 | Jonathan James Creech | Optometrist | 41257 Magarita Road, Suite B 103, Temecula, CA 92591 | 2017-07-11 |
| 1730600743 | Rachel Michele Brannigan | Specialist/Technologist | 39522 Seraphina Rd, Temecula, CA 92591 | 2017-06-29 |
| 1457890303 | Kala Chrisilis Earley | Specialist/Technologist | 29004 Bridgehampton Rd, Temecula, CA 92591 | 2017-02-13 |
| 1114464823 | Danielle Sasha Gonzalez | Counselor | 41002 County Circle Dr., Temecula, CA 92591 | 2017-01-20 |
| Find all providers in zip 92591 | ||||
| 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 |
|---|---|---|---|---|
| 1134572662 | Natalie Anastasia Nealeigh | Physician Assistant | 40469 Calle Katerine, Temecula, CA 92591-6981 | 2016-07-20 |
| 1760837314 | Francis Ezpeleta Galura | Physician Assistant | 30197 Corte Plata, Temecula, CA 92591-1900 | 2016-05-02 |
| 1053778274 | Dermatology Specialists, Inc | Physician Assistant | 31469 Rancho Pueblo Rd # 101, Temecula, CA 92592-4834 | 2016-01-19 |
| 1902298565 | Shannon Miller | Physician Assistant | 40674 Calle Cancion, Temecula, CA 92592-9472 | 2015-02-19 |
| 1245669340 | James Brinkman | Physician Assistant | 32032 Cala Gerona, Temecula, CA 92592-3657 | 2013-11-08 |
| 1932494499 | Jacqueline Rose Weir | Physician Assistant | 41715 Winchester Rd Ste 101, Temecula, CA 92590-4853 | 2011-06-13 |
| 1326340225 | John Denton Olson | Physician Assistant | 31675 Calle Barcaldo, Temecula, CA 92592-3611 | 2010-11-28 |
| 1487834644 | Ryan Daniel Rowan | Physician Assistant | 44054 Margarita Rd, Suite 1, Temecula, CA 92592-2773 | 2007-11-05 |
| 1114117470 | Clyde James Burgess Jr. | Physician Assistant | 31616 Loma Linda Rd, Temecula, CA 92592-1639 | 2007-08-01 |
| 1669693156 | Deanna Carlsberg | Physician Assistant | 32505 Galatina St, Temecula, CA 92592-3880 | 2007-05-01 |
| Find all providers in TEMECULA | ||||
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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.