MRS. WANETTA KING (NPI# 1366494924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366494924 |
| Entity Type | Individual |
| Full Name | MRS. WANETTA KING |
| Credential | LCSW |
| Practice Address |
15301 Warren Shingle Rd Beale Afb CA 95903-1907 |
| Practice Telephone | 5306343423 |
| Practice Fax Number | 5306340670 |
| Mailing Telephone | 5306343423 |
| Mailing Fax Number | 5306340670 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 2552-C | NV | Other Service Providers |
| Street Address |
15301 WARREN SHINGLE RD |
| City | BEALE AFB |
| State | CA |
| Zip Code | 95903-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831182047 | Sadina Lynn Brecheisen-beach | Nurse Practitioner | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2005-08-24 |
| 1407472111 | Shalaleh Khoei | Dietitian, Registered | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2020-06-18 |
| 1902443476 | Thuy-trang Thu Lam | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-12-04 |
| 1558920819 | Madison Lee Kernick | Dentist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-06-11 |
| 1669039525 | Dustin Lansing Bennett | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-05-24 |
| 1760944607 | David Chou | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2019-04-01 |
| 1548721244 | Nicolas Lara | Internal Medicine | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2019-03-26 |
| 1265901920 | Brianna Lee Holmes | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2018-11-24 |
| 1861973513 | Ryan Joel Banci Mintalar | Physician Assistant | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2018-08-21 |
| 1336634823 | Erika Jennifer Reid | Social Worker | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2018-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962575969 | Linda Lee Currier | Physical Therapist | 9 Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-11-16 |
| 1700984853 | Kimberly D Kumer | Psychiatry & Neurology | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-09-20 |
| 1780637124 | Lillie M Mells | Social Worker | 9mdos/sgoh, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-05-18 |
| 1003109844 | Jerrica Marie Wild | Military Health Care Provider | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2011-05-26 |
| 1962413773 | William F Nakashima | Internal Medicine | 414 G St, Suite 106, Marysville, CA 95903 | 2006-08-10 |
| 1417999228 | Frank Peter Baccelli | Dentist | 15337 Warren Shingle Rd, Beale Afb, CA 95903-1905 | 2006-06-13 |
| 1245389071 | Kelly Neil West | Family Medicine | 9th Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903-1907 | 2007-01-10 |
| 1912456369 | Martha Lawder | Dietitian, Registered | 15301 Warren Shingle Road, Beale, CA 95903-1907 | 2016-09-27 |
| 1487799755 | Dianna M. Garbett | Counselor | 15301 Warren Shingle Road, 9 Mdos Sgohf, Beale Afb, CA 95903-1907 | 2007-02-21 |
| 1770027807 | Maura Scolese | Physical Therapist | 3386 Loma Dr, Beale Afb, CA 95903-2122 | 2016-12-08 |
| Find all providers in zip 95903 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821087719 | Leonid M. Katkovsky | Military Health Care Provider | 15301 Warren Shingle Rd, 9th Mdg, Beale Afb, CA 95903-1907 | 2005-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1629692389 | Christopher Matey | Military Health Care Provider | 34800 Bob Wilson Dr Ste 110, San Diego, CA 92134-1110 | 2020-05-29 |
| 1982225769 | Jin Ah Kim | Military Health Care Provider | Naval Medical Center San Diego 38400 Bon Wilson Drive, San Diego, CA 92134-5000 | 2020-05-03 |
| 1124647680 | Katherine Koliadko | Military Health Care Provider | 11023 Evans St, Loma Linda, CA 92354-2708 | 2020-04-14 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1588292858 | Korina Erin Sandoval | Military Health Care Provider | Naval Medical Center Drive 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2020-03-31 |
| 1033746508 | Hannah Johnson | Military Health Care Provider | 34800 Bob Wilson Dr Ste 403, San Diego, CA 92134-1403 | 2020-03-25 |
| 1891336541 | Prana Hands Nonprofit | Military Health Care Provider | 2180 Garnet Ave Ste 3l, San Diego, CA 92109-3676 | 2019-10-03 |
| 1578124194 | David M Allen | Military Health Care Provider | 1st Mlg, Bldg 150121, Camp Pendleton, CA 92055 | 2019-06-25 |
| 1992366587 | Darion Pegues | Military Health Care Provider | 3530 Kelsey St, San Diego, CA 92124-3516 | 2019-06-24 |
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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.