ASTA IAH BAISA (NPI# 1295210953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295210953 |
| Entity Type | Individual |
| Full Name | ASTA IAH BAISA |
| Other Name | ASTA IAH HAMAN-DICKO |
| Credential | RN, PHN, FNP-C |
| Practice Address |
2455 San Ramon Valley Blvd San Ramon CA 94583-1601 |
| Mailing Address |
2806 Marina Blvd Apt 4 San Leandro CA 94577-4048 |
| Practice Telephone | 8663892727 |
| Mailing Telephone | 5109676703 |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 95086184 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95008367 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9925 International Blvd Ste 5, Oakland, CA 946032558 | 5107771177 |
| Street Address |
2455 SAN RAMON VALLEY BLVD |
| City | SAN RAMON |
| State | CA |
| Zip Code | 94583-1601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336182674 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 2455 San Ramon Valley Blvd, San Ramon, CA 94583-1601 | 2006-06-14 |
| 1245888247 | Deepa Reddy Annavaram | Pharmacist | 2455 San Ramon Valley Blvd, San Ramon, CA 94583-1601 | 2019-09-03 |
| 1154978039 | Diane Rose Urrutia-gailey | Pharmacist | 2455 San Ramon Valley Blvd, San Ramon, CA 94583-1601 | 2019-08-24 |
| 1447708094 | Amy Eady | Allergy & Immunology | 2455 San Ramon Valley Blvd, San Ramon, CA 94583-1601 | 2016-09-12 |
| 1730514340 | Supneet Kaur | Nurse Practitioner | 2455 San Ramon Valley Blvd, Cvs Minute Clinic # 9868, San Ramon, CA 94583-1601 | 2013-09-13 |
| 1770820706 | Ruby Nicholle Harrison | Nurse Practitioner | 2455 San Ramon Valley Blvd, San Ramon, CA 94583-1601 | 2013-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295375475 | Angel Beatrice Mckneely | Behavior Technician | 3150 Crow Canyon Place, Suite 110, San Ramon, CA 94583 | 2020-01-15 |
| 1205302247 | Asma Parisa Rezaye | Behavior Technician | 4708 Norris Canyon Rd, Unit 201, San Ramon, CA 94583 | 2018-10-17 |
| 1679055461 | Mary Martineau | Speech-Language Pathologist | 210 Porter Dr Ste 120, San Ramon, CA 94583 | 2018-08-29 |
| 1336631332 | Alison Jean Barnes | Behavior Technician | Goals for Autism, 1 Crow Canyon Court, San Ramon, CA 94583 | 2018-06-05 |
| 1730671975 | Michael Federico | Pharmacist | 2735 Ascot Drive, San Ramon, CA 94583 | 2018-06-04 |
| 1508384843 | Donor Network West | Organ Procurement Organization | 12667 Alcosta Blvd., Suite 500, San Ramon, CA 94583 | 2017-09-07 |
| 1265950141 | Danielle Lustig Fitch | Marriage & Family Therapist | 3180 Crown Canyon Pl. Ste 140, San Ramon, CA 94583 | 2017-08-31 |
| 1386166205 | Park Place Ambulatory Surgery Center | Orthopaedic Surgery | 100 Park Place, Suite 100, San Ramon, CA 94583 | 2017-07-12 |
| 1952822991 | Virginia Rutledge Mosby | Marriage & Family Therapist | 3180 Crow Canyon Place #140, San Ramon, CA 94583 | 2017-06-29 |
| 1437684784 | Nakhla Dental Group | Dentist | Crow Canyon Dental, 2821 Crow Canyon Road #200, San Ramon, CA 94583 | 2017-04-25 |
| Find all providers in zip 94583 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245415 | Mondana Alavi-vahid | Nurse Practitioner | 4159 Greenwich Dr, San Ramon, CA 94582-2810 | 2020-08-12 |
| 1700349313 | Marianne Superio | Nurse Practitioner | 9085 Alcosta Blvd Apt 317, San Ramon, CA 94583-4112 | 2019-04-10 |
| 1225560139 | Jennifer Fox | Nurse Practitioner | 200 Porter Dr Ste 200, San Ramon, CA 94583 | 2017-03-30 |
| 1699194183 | Carrie Stavropoulos | Nurse Practitioner | 460 Market Pl, San Ramon, CA 94583-4745 | 2014-04-10 |
| 1063833663 | Joanne Vogel Md Inc | Nurse Practitioner | 11030 Bollinger Canyon Rd Ste 250, San Ramon, CA 94582-4874 | 2013-12-27 |
| 1407297781 | Armine Tayag | Nurse Practitioner | 2101 N Donovan Way, San Ramon, CA 94582-3275 | 2013-07-15 |
| 1770118101 | Jayasiry Perera | Nurse Practitioner | 460 Market Pl, San Ramon, CA 94583-4745 | 2020-03-05 |
| 1417447756 | Cinthia Vanessa Rojas | Nurse Practitioner | 460 Market Pl, San Ramon, CA 94583-4745 | 2018-05-11 |
| 1487102794 | Sandy Ly | Nurse Practitioner | 5601 Norris Canyon Rd, Suite 340, San Ramon, CA 94583-5407 | 2016-09-15 |
| 1730514340 | Supneet Kaur | Nurse Practitioner | 2455 San Ramon Valley Blvd, Cvs Minute Clinic # 9868, San Ramon, CA 94583-1601 | 2013-09-13 |
| Find all providers in SAN RAMON | ||||
Please comment or provide details below to improve the information on ASTA IAH BAISA.
| 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.