KIMBERLY LYNN HAUNER (NPI# 1295791432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295791432 |
| Entity Type | Individual |
| Full Name | KIMBERLY LYNN HAUNER |
| Other Name | KIMBERLY WESTERGOM |
| Credential | NP |
| Practice Address |
1300 W Lodi Ave Suite P Lodi CA 95242-3000 |
| Mailing Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2093697493 |
| Mailing Telephone | 2095241211 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN488842 | CA | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
NP11149 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RN88842 | 05 |
| Street Address |
1300 W LODI AVE SUITE P |
| City | LODI |
| State | CA |
| Zip Code | 95242-3000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104829431 | Kevin Irving Stroh | Podiatrist | 1300 W Lodi Ave, Ste W, Lodi, CA 95242-3037 | 2005-05-31 |
| 1316483803 | Anisha Ranchhod Dds, Inc. | Clinic/Center | 1300 W Lodi Ave, Suite M, Lodi, CA 95242-3000 | 2017-01-09 |
| 1336526045 | Michelle Otts | Counselor | 1300 W Lodi Ave, Suite G-2, Lodi, CA 95242-3000 | 2015-05-01 |
| 1962743906 | Alexander Scott Malm | Counselor | 1300 W Lodi Ave, G-2, Lodi, CA 95242-3000 | 2013-03-14 |
| 1619243763 | Preferred Prosthetics Inc | Prosthetic/Orthotic Supplier | 1300 W Lodi Ave, Suite H, Lodi, CA 95242-3000 | 2012-03-22 |
| 1275837742 | Marshall E. Gomes | Dentist | 1300 W Lodi Ave, Suite N, Lodi, CA 95242-3000 | 2010-12-27 |
| 1881820751 | Karen Marie Rangel | Counselor | 1300 W Lodi Ave, Ste-g-2, Lodi, CA 95242-3000 | 2009-06-05 |
| 1417183385 | Alex R Anderson | Counselor | 1300 W Lodi Ave, Suite G-2, Lodi, CA 95242-3000 | 2009-06-05 |
| 1942445440 | David R. Vera Sr. | Orthotist | 1300 W Lodi Ave, Suite H, Lodi, CA 95242-3000 | 2008-12-11 |
| 1053535062 | Valley Community Counseling Services, Inc | Community/Behavioral Health | 1300 W Lodi Ave, Ste G-2, Lodi, CA 95242-3000 | 2007-04-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
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| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952414013 | Terri Vaccarezza | Nurse Practitioner | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-15 |
| 1194738765 | Lisa Oneal | Nurse Practitioner | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528668167 | Amber Briana Curry | Nurse Practitioner | 1336 6th Ave, San Francisco, CA 94122-2504 | 2020-10-30 |
| 1194325092 | Caitlin Pirruccello | Nurse Practitioner | 5400 Balboa Blvd Ste 210, Encino, CA 91316-5208 | 2020-10-29 |
| 1851990832 | Casey Domine | Nurse Practitioner | 1750 10th St., Apt. A, Oakland, CA 94607 | 2020-10-21 |
| 1184221798 | Larae Jean Hansen | Nurse Practitioner | 7805 Redondo St, Ventura, CA 93004-3814 | 2020-10-06 |
| 1497361612 | Brandon Philip Obero Vinzon | Nurse Practitioner | 155 E 4th St Apt 206, Long Beach, CA 90802-2498 | 2020-09-22 |
| 1538774070 | Emily Ruth Schoen | Nurse Practitioner | 110 Calle Balboa, San Clemente, CA 92672-3132 | 2020-09-11 |
| 1831715770 | Veronica Munoz-rivera I | Nurse Practitioner | 1327 Leopard Ct, Palmdale, CA 93551-4360 | 2020-06-16 |
| 1770102295 | Roxanna Arely Caballero | Nurse Practitioner | 185 N Douglas Ave, Fresno, CA 93727-3637 | 2020-04-14 |
| 1053949214 | Gina Louise James | Nurse Practitioner | 124 Stoney Hill Dr, Folsom, CA 95630-4614 | 2020-03-31 |
| 1831723519 | Patrinella Gonzales | Nurse Practitioner | 81833 Dr Carreon Blvd Ste 6, Indio, CA 92201-5590 | 2020-03-03 |
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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.