JACY LYNN RESENDEZ (NPI# 1275014771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275014771 |
| Entity Type | Individual |
| Full Name | JACY LYNN RESENDEZ |
| Practice Address |
2225 Challenger Way Santa Rosa CA 95407-5441 |
| Mailing Address |
1556 Heather Dr Santa Rosa CA 95401-6003 |
| Practice Telephone | 7075656900 |
| Mailing Telephone | 7577497898 |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2225 CHALLENGER WAY |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95407-5441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154399723 | Lisa Ann Moran | Psychiatry & Neurology | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2006-03-09 |
| 1851904510 | Jessica Lopez | Technician/Technologist | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2020-08-24 |
| 1730798273 | Jenny Phung | Counselor | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2020-07-30 |
| 1891319455 | Maria S Baron | Registered Nurse | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2020-05-29 |
| 1639790439 | Beatrice Muthoni Nganga | Registered Nurse | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2020-05-03 |
| 1528693363 | Erica Adele Hartman | Registered Nurse | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2020-03-11 |
| 1336772540 | Jillian Leach | Registered Nurse | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2020-02-16 |
| 1932763596 | Monica Kidd | Registered Nurse | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2019-04-29 |
| 1255898524 | Carol Lynn Galipo | Registered Nurse | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2019-02-22 |
| 1063977460 | Gardner Carlson | Licensed Psychiatric Technician | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2019-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100477 | Charrise Reece | Case Management | 935 S Davis, Santa Rosa, CA 95407 | 2020-10-07 |
| 1629687256 | Suzel Anne-marie Deer | Registered Nurse | 1017 Stony Point Rd, Santa Rosa, CA 95407 | 2020-07-29 |
| 1285152884 | Mercedes Zipperle | Specialist/Technologist | 638 Athena Pl, Santa Rosa, CA 95407 | 2017-09-03 |
| 1235664988 | Priceless Transport Care LLC | Non-emergency Medical Transport (VAN) | 661 Powderhorn Ave, Santa Rosa, CA 95407 | 2017-05-01 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1205207321 | Flaman Craig Mccloud Jr. | Counselor | 440 Arrowood Dr., Santa Rosa, CA 95407 | 2015-10-15 |
| 1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1508159955 | Luis Angel Gonzalez | Counselor | 1202 Apollo Way, Santa Rosa, CA 95407 | 2011-05-18 |
| 1326286295 | Kelly Alexis Rathmann | Social Worker | 3650 Standish Avenue, Santa Rosa, CA 95407 | 2009-01-29 |
| Find all providers in zip 95407 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758931 | Allison Noesekabel | Student in an Organized Health Care Education/Training Program | 401 Bicentennial Way Rm 1201, Santa Rosa, CA 95403-2149 | 2020-04-03 |
| 1467083733 | Jessica Hetherington | Student in an Organized Health Care Education/Training Program | 2255 Challenger Way Ste 107, Santa Rosa, CA 95407-5423 | 2020-01-27 |
| 1184282121 | Isabella Maile Beal | Student in an Organized Health Care Education/Training Program | 2275 Warwick Dr, Santa Rosa, CA 95405-8677 | 2019-06-04 |
| 1366904963 | Nathaniel Parker | Student in an Organized Health Care Education/Training Program | 1002 Jennings Ave Apt 207, Santa Rosa, CA 95401-4347 | 2019-04-02 |
| 1265991509 | Ishika Arora | Student in an Organized Health Care Education/Training Program | 401 Bicentennial Way # 110, Santa Rosa, CA 95403-2149 | 2019-03-17 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1881198745 | Elia R. Cole | Student in an Organized Health Care Education/Training Program | 401 Bicentennial Way Ste 110, Santa Rosa, CA 95403-2149 | 2018-03-23 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1073049623 | Shyam Sunder Indrakanti | Student in an Organized Health Care Education/Training Program | 2824 Elk Ln, Santa Rosa, CA 95407-5029 | 2017-05-02 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95407 |
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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.