WELLHAVEN PRIMARY CARE (NPI# 1306463542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306463542 |
| Entity Type | Organization |
| Organization Name | WELLHAVEN PRIMARY CARE |
| Practice Address |
5555 Reservoir Dr Ste 303 San Diego CA 92120-5181 |
| Mailing Address |
5663 Balboa Ave # 517 San Diego CA 92111-2705 |
| Practice Telephone | 6197522280 |
| Enumeration Date | 2020-07-04 |
| Last Update Date | 2020-07-04 |
| Authorized Official Name | DR. JILLION T HARRIS (OWNER) |
| Authorized Official Telephone | 6197522280 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Wellhaven Primary Care LLC | Former Legal Business Name - Organization |
| Street Address |
5555 RESERVOIR DR STE 303 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92120-5181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1225593601 | Truself Training, Inc | Clinic/Center | 5125 Waring Road, San Diego, CA 92120 | 2019-02-09 |
| 1508381799 | Antin Sachs | In Home Supportive Care | 4420 Rainier Avenue, Suite 202, San Diego, CA 92120 | 2017-08-08 |
| 1588186415 | Matthew B Wilbat | Behavioral Analyst | 6851 Alvarado Rd., #17, San Diego, CA 92120 | 2017-07-12 |
| 1548782923 | Mori Khatibzadeh Dds Inc. | Clinic/Center | 6171 Mission Gorge Road, Suite #114, San Diego, CA 92120 | 2017-07-07 |
| 1306379359 | Ken Samith Oerding | Nurse Practitioner | 5422 Reservoir Drive, E7, San Diego Ca, CA 92120 | 2017-04-06 |
| 1396134409 | Debra Michele Stern-ellis | Social Worker | 4647 Zion Avenue Kaiser Permanente, 2nd Floor - Oncology, San Diego, CA 92120 | 2015-01-13 |
| 1821494717 | Shohreh Tourian | Dentist | 7451 Mission Gorge Road, San Diego, CA 92120 | 2014-11-05 |
| 1184049215 | Charles Yin | Counselor | 6153 Fairmount Ave Suite #260, San Diego, CA 92120 | 2014-02-26 |
| Find all providers in zip 92120 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205452349 | Klp Global | Clinic/Center | 3023 Bunker Hill St Ste 103, San Diego, CA 92109-5706 | 2020-06-24 |
| 1790247450 | Shawn Slayton, M.d. Inc. | Clinic/Center | 2700 Adams Ave Ste 209, San Diego, CA 92116-1367 | 2019-04-02 |
| 1073084729 | Bryan L Abramowitz Md Inc. | Clinic/Center | 4282 Genesee Ave Ste 302, San Diego, CA 92117-4985 | 2018-12-06 |
| 1699268458 | Monica Perlman Md Inc. | Clinic/Center | 555 W C St Ste 102, San Diego, CA 92101-8470 | 2018-06-07 |
| 1992200562 | Monica Perlman Md, Inc | Clinic/Center | 12925 El Camino Real Ste T25, San Diego, CA 92130-1891 | 2018-03-27 |
| 1396279113 | Dr Jaiswals Medical Center PC | Clinic/Center | 17424 Ashburton Rd, San Diego, CA 92128-3937 | 2017-04-18 |
| 1215381728 | Performance Sports and Family Medicine | Clinic/Center | 1277 Kettner Blvd Unit 311, San Diego, CA 92101-3381 | 2016-04-20 |
| 1093176331 | Stanford Employer Health Clinics | Clinic/Center | 10155 Pacific Heights Boulevard, San Diego, CA 92121 | 2016-03-15 |
| 1588024442 | Stanford Employer Health Clinics | Clinic/Center | 5535 Morehouse Dr Bldg S, Suite 270, San Diego, CA 92121-1710 | 2016-03-03 |
| 1417351073 | Alvarado Physicians Medical Group | Clinic/Center | 6719 Alvarado Road, Suite 108, San Diego, CA 92120-5270 | 2014-10-10 |
| Find all providers in SAN DIEGO | ||||
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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.