KELLEY HUMPHREY (NPI# 1295218097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295218097 |
| Entity Type | Individual |
| Full Name | KELLEY HUMPHREY |
| Credential | PA |
| Practice Address |
398 S Green Valley Rd Watsonville CA 95076-3099 |
| Mailing Address |
1691 The Alameda San Jose CA 95126-2203 |
| Practice Telephone | 8317247525 |
| Practice Fax Number | 8317247438 |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2018-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 55838 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
398 S GREEN VALLEY RD |
| City | WATSONVILLE |
| State | CA |
| Zip Code | 95076-3099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083667323 | Planned Parenthood Mar Monte, Inc | Clinic/Center | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2006-05-18 |
| 1821651175 | Sarah Elizabeth Gold | Nurse Practitioner | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2019-04-22 |
| 1972913952 | Kelly Denise Zwiers | Nurse Practitioner | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2014-04-30 |
| 1124465133 | Victoria Chew | Family Medicine | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2013-05-30 |
| 1225198542 | Shana Portnoy Sisti | Counselor | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2006-12-08 |
| 1326138488 | Susan Lasko | Physician Assistant | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2006-10-12 |
| 1285722942 | Jessica Rose Dieseldorff | Registered Nurse | 398 S Green Valley Rd, Watsonville, CA 95076-3099 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757515 | Vicky E Gonzalez | Case Manager/Care Coordinator | 2714 Freedom Blvrd, Watsonville, CA 95076 | 2019-02-28 |
| 1861987059 | Encompass Community Services | Community/Behavioral Health | 2714 Freedom Blvd., Freedom, CA 95076 | 2018-06-29 |
| 1134617798 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076 | 2018-04-28 |
| 1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
| 1811403603 | Hieu Thi Thanh Nguyen Boulom | Pharmacist | 2810 Freedom Blvd, Watsonview, CA 95076 | 2017-12-16 |
| 1649798398 | Jonathon Rank | Counselor | 335 East Lake Ave, Watsonville, CA 95076 | 2017-09-01 |
| 1841653318 | Cristina Guzman | Registered Nurse | 195 Aviation Way, Ste 200, Watsonville, CA 95076 | 2016-04-01 |
| 1013388974 | Salud Para La Gente | Clinic/Center | 195 Aviation Way, Suite 200, Watsonville, CA 95076 | 2015-10-16 |
| 1386025757 | Yaseer Yousuf Parupia | Podiatrist | 47 Penny Lane, Suite 1, Watsonville, CA 95076 | 2015-06-11 |
| 1093100935 | Diana Perezchica | Counselor | 20716 Freedom Blv, Watsonville, CA 95076 | 2015-03-30 |
| Find all providers in zip 95076 | ||||
| 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 |
|---|---|---|---|---|
| 1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
| 1215187794 | Ricardo Plata | Physician Assistant | 1150 Main St Ste 3, Watsonville, CA 95076-3760 | 2008-09-22 |
| 1629634829 | Brenda D De La Torre | Physician Assistant | 1066 S Green Valley Rd, Watsonville, CA 95076-4163 | 2019-05-13 |
| 1164985644 | Kellee English | Physician Assistant | 1066 S Green Valley Rd, Watsonville, CA 95076-4163 | 2019-04-10 |
| 1477072775 | Stephanie Garcia Torres | Physician Assistant | 30 Brennan St, Watsonville, CA 95076-4303 | 2017-09-18 |
| 1720436470 | Caitlin Maureen Casey | Physician Assistant | 204 E Beach St, Watsonville, CA 95076-4809 | 2016-06-02 |
| 1033505987 | Zerlina Sramek | Physician Assistant | 1150 Main St Ste 3, Watsonville, CA 95076-3760 | 2015-04-07 |
| 1306243506 | Christopher Mills | Physician Assistant | 30 Brennan St, Watsonville, CA 95076-4303 | 2014-12-03 |
| 1861689911 | Alicia Catherine Potes | Physician Assistant | 204 E Beach St, Watsonville, CA 95076-4809 | 2007-10-02 |
| 1639291867 | Anna Deraco | Physician Assistant | 204 E Beach St, Watsonville, CA 95076-4809 | 2007-04-06 |
| Find all providers in WATSONVILLE | ||||
| City | WATSONVILLE |
| Zip Code | 95076 |
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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.