MR. LOUIS E HERZOG (NPI# 1356830384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356830384 |
| Entity Type | Individual |
| Full Name | MR. LOUIS E HERZOG |
| Credential | NURSE PRACTITIONER |
| Practice Address |
7210 Murray Dr Stockton CA 95210 |
| Mailing Address |
525 E State St Baton Rouge LA 70802-6929 |
| Practice Telephone | 2093732800 |
| Practice Fax Number | 2093732878 |
| Mailing Telephone | 9852553776 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
RN140980 | LA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NP95009654 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP10024 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA STATE BOARD OF NURSING | NP95009654 | 01 |
| LA | LOUISIANA STATE BOARD OF NURSING | AP10024 | 01 |
| PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER | 2017037465 | 01 | |
| LA | WAITING ON LICENSE FOR NP | RN140980 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5000 Hennessy Blvd, Baton Rouge, LA 708084375 | 2257658964 |
| Street Address |
7210 MURRAY DR |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093872483 | Bindu Kanathezhath Sathi | Pediatrics | 7210 Murray Dr, Stockton, CA 95210-3339 | 2007-01-03 |
| 1023647021 | Torrie Alyn-hughes Piasecki | Social Worker | 7210 Murray Dr, Stockton, CA 95210-3339 | 2020-04-02 |
| 1972139079 | Karen Lee | Nurse Practitioner | 7210 Murray Dr, Stockton, CA 95210-3339 | 2020-03-20 |
| 1093365371 | Oanh T Nguyen | Counselor | 7210 Murray Dr, Stockton, CA 95210-3339 | 2019-09-18 |
| 1215496062 | Patricia Valencia | Social Worker | 7210 Murray Dr, Stockton, CA 95210-3339 | 2019-03-19 |
| 1467911685 | Savannah Grace Keller | Nurse Practitioner | 7210 Murray Dr, Stockton, CA 95210-3339 | 2019-03-18 |
| 1457816803 | Megan Lee Stevens | Social Worker | 7210 Murray Dr, Stockton, CA 95210-3339 | 2019-02-08 |
| 1881161479 | Amaninder Mann | Dental Hygienist | 7210 Murray Dr, Stockton, CA 95210-3339 | 2018-11-01 |
| 1851872378 | Jonathan O'brien | Physician Assistant | 7210 Murray Dr, Stockton, CA 95210-3339 | 2018-08-23 |
| 1811493075 | Alice Lau | Nurse Practitioner | 7210 Murray Dr, Stockton, CA 95210-3339 | 2018-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659981330 | Kamaljot Bajwa | Nurse Practitioner | 7707 Austin Rd, Stockton, CA 95215-8312 | 2020-08-06 |
| 1740460823 | Deborah M Jamieson | Nurse Practitioner | 1212 N California St, Stockton, CA 95202-1552 | 2007-11-06 |
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| 1033718580 | John Sylvanus Allieu Sr. | Nurse Practitioner | 2672 Merganser Ct, Los Banos, CA 93635-9473 | 2020-10-25 |
| 1316546930 | Chika U Oguagha | Nurse Practitioner | 16240 Carmine St, Fontana, CA 92336-1481 | 2020-10-23 |
| 1215534888 | Rosa Maria Aguero | Nurse Practitioner | 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 | 2020-10-06 |
| 1134726995 | Margarita Maghtesyan | Nurse Practitioner | 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 | 2020-10-05 |
| 1043827140 | April Lopez Ortiz | Nurse Practitioner | 500 W Ashland Ct, Visalia, CA 93277-6609 | 2020-09-23 |
| 1477167666 | David Joseph Russell | Nurse Practitioner | 17846 Glenwood Rd, Manteca, CA 95336-9521 | 2020-09-03 |
| 1194339382 | Albert Liu | Nurse Practitioner | 43559 Southerland Way, Fremont, CA 94539-5931 | 2020-09-03 |
| 1407469554 | Andre Alexandrian | Nurse Practitioner | 1606 Winona Ave, Burbank, CA 91504-2823 | 2020-08-28 |
| 1790398238 | Heather Richardson | Nurse Practitioner | 112 S Park St Ste 1, San Francisco, CA 94107-1809 | 2020-08-25 |
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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.