BRIDGET KELLEHER (NPI# 1245695006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245695006 |
| Entity Type | Individual |
| Full Name | BRIDGET KELLEHER |
| Credential | NP |
| Practice Address |
604 Rose Ave Venice CA 90291-2767 |
| Practice Telephone | 3103928636 |
| Mailing Telephone | 3103928636 |
| Mailing Fax Number | 3103926642 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2018-11-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95003447 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
604 ROSE AVE |
| City | VENICE |
| State | CA |
| Zip Code | 90291-2767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588655047 | Samantha Andrien Stewart | Psychiatry & Neurology | 604 Rose Ave, Venice, CA 90291-2767 | 2005-11-03 |
| 1740730050 | Kayla Sunhee Pang | Pharmacist | 604 Rose Ave, Venice, CA 90291-2767 | 2016-10-11 |
| 1851741896 | Victor Luis Mleczko | Family Medicine | 604 Rose Ave, Venice, CA 90291 | 2016-06-21 |
| 1568818227 | Meagan Wong | Family Medicine | 604 Rose Ave, Venice, CA 90291-2767 | 2016-05-11 |
| 1588027932 | Janet Chaidez | Nurse Practitioner | 604 Rose Ave, Venice, CA 90291 | 2016-04-03 |
| 1578926986 | Mimie Hoang Anh Tran | Family Medicine | 604 Rose Ave, Venice, CA 90291-2767 | 2016-04-02 |
| 1619341773 | Kristin Grannis | Marriage & Family Therapist | 604 Rose Ave, Venice, CA 90291-2767 | 2015-11-30 |
| 1730558842 | Ivy Doris Chang | Social Worker | 604 Rose Ave, Venice, CA 90291-2767 | 2015-09-18 |
| 1265808547 | Danielle Sinkford | Registered Nurse | 604 Rose Ave, Venice, CA 90291-2767 | 2015-08-20 |
| 1033596143 | Alexander Pappas | Family Medicine | 604 Rose Ave, Venice, CA 90291-2767 | 2015-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629837 | Dylan Booth | Dentist | 601 Vernon Ave, Venice, CA 90291 | 2017-10-05 |
| 1467979500 | Linda Sittler | Registered Nurse | 1025 Palms Ave, Venice, CA 90291 | 2017-08-29 |
| 1003218660 | Patricia Guadalupe Rivas | Counselor | 717 Lincoln Blvd., Venice, CA 90291 | 2014-09-25 |
| 1497016877 | Carrie Lynn Kowalski | Physician Assistant | 604 Rose Avenue, Venice, CA 90291 | 2012-06-02 |
| 1821364761 | Cheryl Lynn Perkins | Nutritionist | 215 Culver Boulevard, # 5203, Playa Del Rey, CA 90291 | 2012-03-26 |
| 1629391875 | James L. Hoff | Optometrist | 1636 Abbot Kinney Blvd., Venice, CA 90291 | 2010-03-02 |
| 1720315096 | Kristen Nicol Leishman | Counselor | 911 Coeur D'alene Ave, Venice, CA 90291 | 2009-11-06 |
| 1922237882 | David Anthony Garcia | Physician Assistant | 15031 Rinaldi St., Providence Holy Cross Medical Center Ed, Mission Hills, CA 90291 | 2009-07-13 |
| 1548411010 | David Watts | Acupuncturist | 307 S. Robertson Blvd, Beverly Hills, CA 90291 | 2008-10-02 |
| 1184891699 | Judy Alexander | Voluntary or Charitable | 204 Hampton Drive, St Joseph Center, Venice, CA 90291 | 2008-05-14 |
| Find all providers in zip 90291 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841847720 | Joseph Matthew Adkins | Nurse Practitioner | 417 Lake of The Woods Dr, Venice, FL 34293 | 2019-08-24 |
| 1558824292 | John Huffaker | Nurse Practitioner | 333 Tamiami Trl S Ste 307, Venice, FL 34285-2428 | 2019-04-10 |
| 1609324201 | Kelly Gonzalez | Nurse Practitioner | 11814 Tempest Harbor Loop, Venice, FL 34292-3821 | 2016-09-13 |
| 1134598238 | Katie A Spada | Nurse Practitioner | 1531 Tamiami Trl S Ste 703, Venice, FL 34285-5569 | 2015-09-18 |
| 1992171755 | Rachel Martinez Franzen | Nurse Practitioner | 901 Venetia Bay Blvd Ste 110, Venice, FL 34285-8042 | 2015-08-17 |
| 1841599701 | Dawn Carole Carry | Nurse Practitioner | Venetian Hospitalist Services, 540 The Rialto, Venice, FL 34285-2900 | 2011-03-17 |
| 1821045352 | Elina S Belilovskiy | Nurse Practitioner | 425 Commercial Ct, Suite 112, Venice, FL 34292 | 2006-05-30 |
| 1376141986 | Emily Cunningham | Nurse Practitioner | 540 The Rialto, Venice, FL 34285-2900 | 2020-10-15 |
| 1437765179 | Nicole Marie Clark | Nurse Practitioner | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285-3209 | 2020-09-18 |
| 1205451366 | Jessica Wyckoff | Nurse Practitioner | 1415 E Venice Ave, Venice, FL 34292-3064 | 2020-06-14 |
| Find all providers in VENICE | ||||
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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.