CORY DEVIN MACKINNON (NPI# 1386123370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386123370 |
| Entity Type | Individual |
| Full Name | CORY DEVIN MACKINNON |
| Practice Address |
490 N Grape St Escondido CA 92025-3079 |
| Practice Telephone | 7609759939 |
| Mailing Telephone | 7609759939 |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
490 N GRAPE ST |
| City | ESCONDIDO |
| State | CA |
| Zip Code | 92025-3079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487811345 | Annie Marie Merkel | Student in an Organized Health Care Education/Training Program | 490 N Grape St, Escondido, CA 92025-3079 | 2008-05-19 |
| 1780285882 | Sierra Francis | Licensed Vocational Nurse | 490 N Grape St, Escondido, CA 92025-3079 | 2020-11-04 |
| 1023615705 | Tierra Renea Brown | Registered Nurse | 490 N Grape St, Escondido, CA 92025-3079 | 2020-10-05 |
| 1346854429 | Kirshjah Martin | Student in an Organized Health Care Education/Training Program | 490 N Grape St, Escondido, CA 92025-3079 | 2020-09-04 |
| 1124631791 | Roxanna Llamas | Student in an Organized Health Care Education/Training Program | 490 N Grape St, Escondido, CA 92025-3079 | 2020-08-24 |
| 1588275408 | Aine Emanuelle Smith-jackson | Counselor | 490 N Grape St, Escondido, CA 92025-3079 | 2020-08-13 |
| 1255941027 | Soledad Gonzalezsevilla | Student in an Organized Health Care Education/Training Program | 490 N Grape St, Escondido, CA 92025-3079 | 2020-08-05 |
| 1396355178 | Nathan Feder | Counselor | 490 N Grape St, Escondido, CA 92025-3079 | 2020-08-05 |
| 1194335000 | Jessica Alcaraz-bigelow | Student in an Organized Health Care Education/Training Program | 490 N Grape St, Escondido, CA 92025-3079 | 2020-08-05 |
| 1932718632 | Midory Ibanez | Student in an Organized Health Care Education/Training Program | 490 N Grape St, Escondido, CA 92025-3079 | 2020-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
| 1801449640 | Jennifer Marsh | Marriage & Family Therapist | 403 N Escondido Blvd #533, Escondido, CA 92025 | 2019-07-21 |
| 1093281644 | Lucy Breen | Peer Specialist | 474 Weest Vermont Ave #104, Escondido, CA 92025 | 2018-10-22 |
| 1457834665 | Daniel & Max | Optometrist | 730 N Center City Parkway, Building A-1, Suite 101, Escondido, CA 92025 | 2018-09-13 |
| 1477033272 | Hyoshin Kwak | Acupuncturist | 106 S. Grape St, Suite 10, Escondido, CA 92025 | 2018-08-21 |
| 1467948877 | Irma P Garcia | Counselor | 337 West Mission Ave, Escondido, CA 92025 | 2018-07-09 |
| 1295235380 | Anna M. Rainville | Marriage & Family Therapist | 11701 San Pasqual Valley Rd, Escondido, CA 92025 | 2018-02-15 |
| 1689187049 | Monica Pino | Occupational Therapist | 469 E Grand Avenue, Escondido, CA 92025 | 2017-11-08 |
| 1427569581 | Mtk Primary Care Medical Group | Specialist | 1835a S Centre City Pkwy Ste 459, Escondido, CA 92025 | 2017-10-17 |
| 1619490349 | Elizabeth Sanchez Arvizu | Student in an Organized Health Care Education/Training Program | 490 N. Grape Stret, Escondido, CA 92025 | 2017-07-25 |
| Find all providers in zip 92025 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
| 1093281644 | Lucy Breen | Peer Specialist | 474 Weest Vermont Ave #104, Escondido, CA 92025 | 2018-10-22 |
| 1487108700 | Orlando Barahona | Peer Specialist | 490 N. Grape Street, Escondido, CA 92025 | 2016-08-04 |
| 1730701566 | Renee Isabelle Hirschfeld | Peer Specialist | 1050 N Broadway, Escondido, CA 92026-3044 | 2020-05-14 |
| 1548817364 | Melissa J Greenberg | Peer Specialist | 474 W Vermont Ave Ste 104, Escondido, CA 92025-6584 | 2019-08-26 |
| 1366094542 | Michael Terrance Hall | Peer Specialist | 490 N Grape St, Escondido, CA 92025-3079 | 2019-07-09 |
| 1699333997 | Arielle Abigail Goan | Peer Specialist | 1050 N Broadway, Escondido, CA 92026-3044 | 2019-05-31 |
| 1760040158 | Alvar Roy | Peer Specialist | 1050 N Broadway, Escondido, CA 92026-3044 | 2019-05-31 |
| 1053881508 | Efrain Eliseo Quintero | Peer Specialist | 474 W Vermont Ave Ste 104, Escondido, CA 92025-6584 | 2018-11-27 |
| 1235632829 | Kiloren Lorraine Woolley | Peer Specialist | 474 W Vermont Ave Ste 104, Escondido, CA 92025-6584 | 2018-03-09 |
| Find all providers in ESCONDIDO | ||||
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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.