IVAN ROBERT GOSSAGE (NPI# 1386807030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386807030 |
| Entity Type | Individual |
| Full Name | IVAN ROBERT GOSSAGE |
| Credential | NP |
| Practice Address |
1660 Humboldt Rd Ste 3 Chico CA 95928-9199 |
| Mailing Address |
1082 Via Verona Dr Chico CA 95973-1031 |
| Practice Telephone | 5305303370 |
| Mailing Telephone | 5305664307 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2020-08-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
808252 | CA | Nursing Service Providers |
| N | 164X00000X | Licensed Vocational Nurse | 231037 | CA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95014269 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 592 Rio Lindo Ave, Chico, CA 959261817 | 5308912775 | |
| 560 Cohasset Rd, Chico, CA 959262281 | 5303324250 | 5308936843 |
| Street Address |
1660 HUMBOLDT RD STE 3 |
| City | CHICO |
| State | CA |
| Zip Code | 95928-9199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497783013 | Susan Dayle Matthiessen | Social Worker | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2006-06-30 |
| 1972132983 | Francis Mcdermott Md Inc | Psychiatry & Neurology | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2020-04-02 |
| 1528381696 | Kelly S. Hernandez | Marriage & Family Therapist | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2010-03-03 |
| 1548440258 | Frederick Schlaff, Md, Inc. | Psychologist | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2007-11-09 |
| 1831124122 | Ladd Dee Mcdonald | Psychologist | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2006-07-12 |
| 1821013954 | Jeaneese Hawkley | Counselor | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2006-07-12 |
| 1255356382 | Marvin Megibow | Psychologist | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2006-07-12 |
| 1548295447 | Jennifer Shepard Kirkham | Social Worker | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2006-07-11 |
| 1336171842 | Bonnie Megibow | Counselor | 1660 Humboldt Rd Ste 3, Chico, CA 95928-9199 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083232672 | Mary Ester Potts | Behavior Technician | 1611 Chico River Road, Chico, CA 95928 | 2020-07-09 |
| 1679105605 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1910 E. 20th Street, Chico, CA 95928 | 2020-02-07 |
| 1790250306 | Amy Groven | Counselor | 7 Williamsburg Lane, Chico, CA 95928 | 2018-10-10 |
| 1093217424 | Bonnie Jo Nelson | Registered Nurse | 91 Elderberry Court, Chico, CA 95928 | 2018-03-01 |
| 1174039036 | Deer Creek Surgery Center LLC | Clinic/Center | 127 Raley Blvd., Chico, CA 95928 | 2017-12-14 |
| 1174063606 | Erika Beteran | Counselor | 344 W 8th St, Chico, CA 95928 | 2017-03-02 |
| 1356723266 | Arjun S Sandhu | Podiatrist | 1806 Foundation Lane, Chico, CA 95928 | 2015-06-26 |
| 1912394735 | Kirk Bjella | Pediatrics | 1515 Springfield Dr, Children's Health Center, Chico, CA 95928 | 2015-04-20 |
| 1215346309 | Kathleen Renee Dahlstrom | Marriage & Family Therapist | 315 Wall St Ste 5, Chico, CA 95928 | 2014-08-04 |
| 1740696574 | Northern Valley Catholic Social Service, Inc. | Case Management | 1297 Park Avenue, Chico, CA 95928 | 2014-07-01 |
| Find all providers in zip 95928 | ||||
| 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 |
|---|---|---|---|---|
| 1659465417 | Julie K Lafreniere | Nurse Practitioner | 2561 California Park Dr Ste 300, Chico, CA 95928-4208 | 2006-10-03 |
| 1023490125 | Danielle Farris | Nurse Practitioner | 1660 Humboldt Rd, Suite 3, Chico, CA 95928-9199 | 2015-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.