JERICK TAN (NPI# 1356842843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356842843 |
| Entity Type | Individual |
| Full Name | JERICK TAN |
| Credential | NP |
| Practice Address |
1500 E Duarte Road Duarte CA 91010 |
| Mailing Address |
17952 E Edna Pl Covina CA 91722-3201 |
| Practice Telephone | 6262564673 |
| Mailing Telephone | 6266732210 |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2018-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
95008276 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1500 E DUARTE ROAD |
| City | DUARTE |
| State | CA |
| Zip Code | 91010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437190915 | Shana M Landau | Radiology | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2006-06-08 |
| 1437512944 | Vincent Chan | Pediatrics | 1500 E Duarte Road, Duarte, CA 91010 | 2016-04-01 |
| 1750764320 | Suresh B Selvaraju | Specialist | 1500 E Duarte Road, Nw # 2238, Duarte, CA 91741 | 2015-07-01 |
| 1770971418 | Brian Christopher Bowman | Nurse Practitioner | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2015-01-05 |
| 1235545542 | Elizabeth A Perrone | Physician Assistant | 1500 E Duarte Road, Duarte, CA 91010 | 2014-07-08 |
| 1730592346 | Mona Mojtahedzadeh | Psychiatry & Neurology | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2014-06-11 |
| 1922426543 | Duveen Sturgeon | Nurse Practitioner | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2014-04-01 |
| 1821419342 | Lauren Seipel | Nurse Practitioner | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2013-12-31 |
| 1205257920 | Idoroenyi Amanam | Internal Medicine | 1500 E Duarte Road, Duarte, CA 91010-3012 | 2013-12-23 |
| 1053752253 | Shaila Merchant | Surgery | 1500 E Duarte Road, Mob L001, Duarte, CA 91010 | 2013-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386266849 | Cheyenne King | Student in an Organized Health Care Education/Training Program | 1801 Huntington Drive, Duarte, Ca 91010, Duarte, CA 91010 | 2020-05-07 |
| 1114578028 | Cristian Gonzalez | Case Manager/Care Coordinator | 2250 E Foothill Ave, Pasadena, CA 91010 | 2019-09-23 |
| 1366932378 | Maisie Madrid | Marriage & Family Therapist | 1801 Huntington Drive, Duarte, CA 91010 | 2018-05-15 |
| 1598289571 | Bertha Maria Torres | Social Worker | 938 E. Huntington Drive, Unit A, Duarte, CA 91010 | 2017-08-01 |
| 1598292286 | Sheila Ramirez | Occupational Therapy Assistant | 2302 Citrus View Ave, Duarte, CA 91010 | 2017-05-12 |
| 1982059556 | Patricia Mendoza | Case Manager/Care Coordinator | 2502 E.huntington Dr., Duarte, CA 91010 | 2016-05-02 |
| 1770966178 | Sinziana Dumitra | Surgery | 1500 Durate Road California, Mob L001, Duarte, CA 91010 | 2015-07-02 |
| 1477940161 | Jin Sun L Bitar | Internal Medicine | 1500 Duarte Rd # Wing4, Duarte, CA 91010 | 2015-04-20 |
| 1659625622 | Jeanette Marie Petermann | Nurse Practitioner | 1036 East Huntington Drive, Duarte, CA 91010 | 2012-10-30 |
| 1649534397 | Nathaniel J Khoe Dds. Inc | Dentist | 1016 Huntington Drive, Duarte, CA 91010 | 2012-06-27 |
| Find all providers in zip 91010 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871136929 | Raymond Tran Nguyen | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2019-10-22 |
| 1639636426 | Dianne Fernandez | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2019-02-27 |
| 1659887024 | Anne Marie Dejoya Reeve | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2017-12-21 |
| 1942729389 | Edyssa Ann Uy | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2017-09-18 |
| 1558675330 | Cecilio V. Cay | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2010-08-04 |
| 1215252010 | Leana Chien | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2010-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139109 | Lena Kazanchyan | Nurse Practitioner | 11834 Archwood St, North Hollywood, CA 91606-1603 | 2020-09-16 |
| 1740898386 | Victor De Guzman | Nurse Practitioner | 24808 Sand Wedge Ln, Valencia, CA 91355-2315 | 2020-07-20 |
| 1114535937 | Ashley Elizabeth Rosso | Nurse Practitioner | 3111 Camino Del Rio N Ste 625, San Diego, CA 92108-5718 | 2020-07-17 |
| 1518586452 | Zaruhi Harutyunyan | Nurse Practitioner | 7901 Santa Monica Blvd Ste 206, West Hollywood, CA 90046-5180 | 2020-04-10 |
| 1457986168 | Maritza J Lira | Nurse Practitioner | 23141 Verdugo Dr Ste 201, Laguna Hills, CA 92653-1341 | 2020-03-03 |
| 1225677198 | Shannon Ha Duyen Sicat | Nurse Practitioner | 2617 E Chapman Ave Ste 109, Orange, CA 92869-3245 | 2019-12-24 |
| 1528605961 | Elsa L Pineda-flores | Nurse Practitioner | 1513 S Grand Ave Ste 306, Los Angeles, CA 90015-3075 | 2019-12-04 |
| 1447895073 | Kemi Osilesi | Nurse Practitioner | 1943 Seasons St, Simi Valley, CA 93065-0580 | 2019-11-07 |
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1255993531 | May Therese Ronci | Nurse Practitioner | 38504 Cougar Pass, Palmdale, CA 93551-5019 | 2019-07-08 |
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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.