DR. AMANDA MARLENE DESON (NPI# 1407203599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407203599 |
| Entity Type | Individual |
| Full Name | DR. AMANDA MARLENE DESON |
| Credential | D.O. |
| Practice Address |
100a Drakes Landing Rd Ste 225 Greenbrae CA 94904-3119 |
| Mailing Address |
1209 Kathileen Way Petaluma CA 94952-1816 |
| Practice Telephone | 4154617800 |
| Mailing Telephone | 9499330776 |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2020-06-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 20A18165 | CA | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | P32561 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | STATE LICENSE NUMBER | P32561 | 01 |
| Street Address |
100A DRAKES LANDING RD STE 225 |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904-3119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639353279 | Sujatha Pathi | Obstetrics & Gynecology | 100a Drakes Landing Rd Ste 225, Greenbrae, CA 94904-3119 | 2007-12-18 |
| 1922242858 | Alexis April Cardellini | Obstetrics & Gynecology | 100a Drakes Landing Rd Ste 225, Greenbrae, CA 94904-3119 | 2009-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382372 | Stacey Nicole Drew | Occupational Therapist | 4 Ash Ave, Unit 10, Kentfield, CA 94904 | 2019-08-22 |
| 1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
| 1396120481 | Tamena Potts | Counselor | 1109 Sir Francis Drake, Kentfield, CA 94904 | 2015-07-30 |
| 1598014763 | Rupali Ray Chaudhuri | Nurse Practitioner | 1341 S. Eliseo Dr, Suite 200, Greenbrae, CA 94904 | 2012-09-04 |
| 1326304809 | Lucy Yingxin Zhang | Ophthalmology | 900 S Eliseo Dr Ste 102, Greenbrae, CA 94904 | 2012-04-09 |
| 1396073185 | Bonnie Louise Hoag | Marriage & Family Therapist | 905 Sir Francis Drake Blvd., Ste. F., Kentfield, CA 94904 | 2009-12-07 |
| 1801043880 | Alexander Vogel Uihlein | Internal Medicine | 900 S Eliseo Dr Ste 201, Greenbrae, CA 94904 | 2008-08-21 |
| 1649426115 | Marilyn Thatcher | Psychologist | 1010 Sir Francis Drake Blve, Ste. 103, Kentfield, CA 94904 | 2008-08-14 |
| 1205007598 | Sir Francis Drake Dental | Dentist | 919 Sir Francis Drake Blvd, Kentfield, CA 94904 | 2008-03-14 |
| 1841401734 | Rishi K Wadhwa | Neurological Surgery | 1100 S Eliseo Dr Ste 1, Greenbrae, CA 94904 | 2007-05-24 |
| Find all providers in zip 94904 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639353279 | Sujatha Pathi | Obstetrics & Gynecology | 100a Drakes Landing Rd Ste 225, Greenbrae, CA 94904-3119 | 2007-12-18 |
| 1295807022 | Kristen M. Matsik | Obstetrics & Gynecology | 1260 S Eliseo Dr Fl 2, Greenbrae, CA 94904-2009 | 2006-11-15 |
| 1770560997 | Nona Cunningham | Obstetrics & Gynecology | 599 Sir Francis Drake Blvd Ste 202, Greenbrae, CA 94904-1731 | 2005-12-29 |
| 1194702431 | Stephen Ronald Bearg | Obstetrics & Gynecology | 1240 S Eliseo Dr, Suite 201, Greenbrae, CA 94904-2028 | 2005-12-28 |
| 1750627071 | Nona M Cunningham Md Inc | Obstetrics & Gynecology | 599 Sir Francis Drake Blvd, Suite 202, Greenbrae, CA 94904-1712 | 2012-12-13 |
| 1215281019 | Elizabeth Brown | Obstetrics & Gynecology | 100 Drakes Landing Rd # A, Suite 225, Greenbrae, CA 94904-2404 | 2012-10-31 |
| 1912276007 | Lizellen La Follette Md Inc | Obstetrics & Gynecology | 599 Sir Francis Drake Blvd, Suite 301, Greenbrae, CA 94904-1712 | 2011-12-20 |
| 1245536234 | Jacqueline Sue Dela Merced | Obstetrics & Gynecology | 599 Sir Francis Drake Blvd, Suite 301, Greenbrae, CA 94904-1712 | 2011-02-08 |
| 1922242858 | Alexis April Cardellini | Obstetrics & Gynecology | 100a Drakes Landing Rd Ste 225, Greenbrae, CA 94904-3119 | 2009-04-22 |
| 1326281023 | Amber Lynn Jaeger | Obstetrics & Gynecology | 100 Drakes Landing Rd # A, Suite 225, Greenbrae, CA 94904-2404 | 2009-04-09 |
| Find all providers in GREENBRAE | ||||
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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.