JENNA TIDWELL (NPI# 1285187435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285187435 |
| Entity Type | Individual |
| Full Name | JENNA TIDWELL |
| Practice Address |
3505 Broadway Oakland CA 94611-5714 |
| Practice Telephone | 5107526298 |
| Enumeration Date | 2016-07-24 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170300000X | Genetic Counselor, MS | GC000665 | CA | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 W La Veta Ave, Orange, CA 928684304 | 7147346200 | 7147346218 |
| Street Address |
3505 BROADWAY |
| City | OAKLAND |
| State | CA |
| Zip Code | 94611-5714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376199836 | Furyal Mahmood | Genetic Counselor, MS | 3505 Broadway, Oakland, CA 94611-5798 | 2019-08-12 |
| 1902334766 | Lakshmi Vijanderan | Speech-Language Pathologist | 3505 Broadway, Oakland, CA 94611-5714 | 2017-05-24 |
| 1700248267 | Emily Rettner | Genetic Counselor, MS | 3505 Broadway, Oakland, CA 94611-5714 | 2016-03-24 |
| 1639555238 | Shandra Jeffries | Genetic Counselor, MS | 3505 Broadway, Oakland, CA 94611-5714 | 2015-08-05 |
| 1366825754 | Kaiser Permanente | Genetic Counselor, MS | 3505 Broadway, Mosswood Building, 10th Floor, Oakland, CA 94611-5714 | 2015-07-02 |
| 1699187971 | Victoria Chu | Student in an Organized Health Care Education/Training Program | 3505 Broadway, Oakland, CA 94611-5714 | 2014-05-21 |
| 1467871970 | Michelle Louie | Pediatrics | 3505 Broadway, Oakland, CA 94611-5714 | 2014-04-11 |
| 1477890325 | Erin B Poma | Speech-Language Pathologist | 3505 Broadway, 7th Floor, Oakland, CA 94611-5714 | 2013-01-12 |
| 1568742500 | Patricia Gail Le | Dietitian, Registered | 3505 Broadway, 12th Floor, Oakland, CA 94611-5714 | 2011-08-22 |
| 1497071963 | Bryce Abram Mendelsohn | Medical Genetics | 3505 Broadway, Oakland, CA 94611-5714 | 2010-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063028454 | Abduljabbar Alhammoud | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Oakland Medical Center 275 W. Macarth, Oakland, CA 94611 | 2020-09-21 |
| 1184287435 | Unfold Psychology: A. Heafey Practice | Psychologist | 1955 Mountain Blvd., Suite 101, Oakland, CA 94611 | 2019-04-22 |
| 1700389699 | Katie Herron | Student in an Organized Health Care Education/Training Program | 2535 Harrison St., Oakland, CA 94611 | 2018-03-16 |
| 1861923351 | Hoiwan Cheung | Student in an Organized Health Care Education/Training Program | 3600 Broadway, 4th Fl., Suite 43, Kaiser Oakland, Oakland, CA 94611 | 2017-03-25 |
| 1104377126 | Collin Chan | Pharmacist | 3801 Howe Street, Fabiola G-25, Oakland, CA 94611 | 2016-10-14 |
| 1912457276 | Madeline Marie Perket | Registered Nurse | 933 Kingston Ave, Piedmont, CA 94611 | 2016-10-11 |
| 1962959460 | Healing Arts Chiropractic | Chiropractor | 187 40th Street Way, Oakland, CA 94611 | 2016-09-01 |
| 1033573829 | Diana Murphy | Counselor | 629 Oakland, Oakland, CA 94611 | 2016-04-08 |
| 1437515483 | Laura Northrup II | Marriage & Family Therapist | 3873 Piedmont Ave, Suite 5, Oakland, CA 94611 | 2016-01-06 |
| 1558736835 | Michael Joseph Scollard | Dentist | 42 Linda Ave., Oakland, CA 94611 | 2015-12-11 |
| Find all providers in zip 94611 | ||||
| Taxonomy Code | 170300000X |
| Grouping | Other Service Providers |
| Classification | Genetic Counselor, MS |
| A masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; identifies interventions to manage or ameliorate disease risk; educates about inheritance, testing, management, prevention, ethical issues, resources, and research; and counsels to promote informed choices and adaptation. Certification was established in 1993 by the American Board of Genetic Counseling and prior to that by the American Board of Medical Genetics. Requirements for experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: National Society of Genetic Counselors [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316433246 | Monica B Datta | Genetic Counselor, MS | 3505 Broadway Fl 10, Oakland, CA 94611-5798 | 2018-07-03 |
| 1801929484 | Joan Alice Emery | Genetic Counselor, MS | 5730 Telegraph Ave, Oakland, CA 94609-1710 | 2007-03-13 |
| 1689652828 | Phyllis R Pearle | Genetic Counselor, MS | 5730 Telegraph Ave Ste 117, Oakland, CA 94609-1710 | 2006-01-06 |
| 1437137700 | Ann Stembridge Kung | Genetic Counselor, MS | 275 W Macarthur Blvd, Kaiser Oakland/genetics Dept, Oakland, CA 94611-5641 | 2006-01-05 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
| 1376199836 | Furyal Mahmood | Genetic Counselor, MS | 3505 Broadway, Oakland, CA 94611-5798 | 2019-08-12 |
| 1467981985 | Holly Ann-marie Mueller | Genetic Counselor, MS | 5730 Telegraph Ave Ste 117, Oakland, CA 94609-1710 | 2017-06-08 |
| 1700248267 | Emily Rettner | Genetic Counselor, MS | 3505 Broadway, Oakland, CA 94611-5714 | 2016-03-24 |
| 1639555238 | Shandra Jeffries | Genetic Counselor, MS | 3505 Broadway, Oakland, CA 94611-5714 | 2015-08-05 |
| 1366825754 | Kaiser Permanente | Genetic Counselor, MS | 3505 Broadway, Mosswood Building, 10th Floor, Oakland, CA 94611-5714 | 2015-07-02 |
| Find all providers in OAKLAND | ||||
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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.