MS. STEPHANIE AGONCILLO (NPI# 1427425172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427425172 |
Entity Type | Individual |
Full Name | MS. STEPHANIE AGONCILLO |
Credential | PA-C |
Practice Address |
2911 Chanticleer Ave Santa Cruz CA 95065-1815 |
Practice Telephone | 8314772350 |
Mailing Telephone | 8314772350 |
Enumeration Date | 2015-08-28 |
Last Update Date | 2019-11-19 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 53464 | CA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363A00000X | Physician Assistant | NC | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
460 Waterstone Dr, Hillsborough, NC 272789078 | 9195955900 |
Street Address |
2911 CHANTICLEER AVE |
City | SANTA CRUZ |
State | CA |
Zip Code | 95065-1815 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447230511 | Noel Fishman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2006-01-17 |
1942620067 | Christopher Desimone | Surgery | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2014-04-17 |
1518304013 | Kayla Cushner | Advanced Practice Midwife | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2013-05-24 |
1730321993 | Kaly Chang-chien Kao | Physical Medicine & Rehabilitation | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2009-04-01 |
1063603108 | Damien L Smith | Urology | 2911 Chanticleer Ave, Santa Cruz, CA 95065 | 2007-08-05 |
1982808234 | Patrick James Tomafsky | Physician Assistant | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2007-06-12 |
1124199344 | Joseph Franks | Urology | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2006-11-10 |
1497843098 | Donald E Schepps | Surgery | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2006-10-10 |
1558318758 | Rami Dakkuri | Specialist | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2006-05-31 |
1467422071 | Camille Washowich | Nurse Practitioner | 2911 Chanticleer Ave, Santa Cruz, CA 95065-1815 | 2006-01-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295335743 | Mindful Living Psychotherapy | Clinic/Center | 24340 Ca-78, Ramona, CA 95065 | 2020-10-26 |
1265084297 | Care From The Heart In Home Services, Inc. | In Home Supportive Care | 3141 Paul Sweet Road, Santa Cruz, CA 95065 | 2019-07-10 |
1215410188 | Barry Lynn Keeler | Pharmacist | Dominican Plaza Pharmacy, 1595 Soquel Dr Suite 120, Santa Cruz, CA 95065 | 2018-09-07 |
1407212582 | Naikan Counseling Center | Community/Behavioral Health | 3319b Mission Drive, Santa Cruz, CA 95065 | 2016-01-05 |
1124461587 | Lindsay Mooney | Obstetrics & Gynecology | 2907 Chanticleer Ave Fl 2, Santa Cruz, CA 95065 | 2013-04-16 |
1689911398 | Gabriela Alejandra Torres De Fernandez | Dentist | 1588 Soquel Dr Suite 3, Santa Cruz, CA 95065 | 2013-01-15 |
1184999211 | Shannon Leigh Purpuri | Midwife | 401 Happy Valley Rd, Santa Cruz, CA 95065 | 2012-03-22 |
1619119997 | Himabindu Pitta | Hospitalist | 1555 Soquel Dr., Santa Cruz, CA 95065 | 2009-04-01 |
1780834614 | Rym C Partridge | Dentist | 3337 Mission Dr., Santa Cruz, CA 95065 | 2008-09-29 |
1710177159 | Jill Bewley | Acupuncturist | 100 Burton Dr, Santa Cruz, CA 95065 | 2007-08-01 |
Find all providers in zip 95065 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730709049 | Maria Veronica Serratos Valdivia | Physician Assistant | 1255 38th Ave Spc 114, Santa Cruz, CA 95062-3240 | 2020-04-16 |
1346618071 | Ellen Hucal O'halloran | Physician Assistant | 620b Sumner St, Santa Cruz, CA 95062-2535 | 2015-09-11 |
1831412659 | Kimberlee Kay Walsh | Physician Assistant | 1667 Dominican Way Ste 234, Santa Cruz, CA 95065-1560 | 2010-03-08 |
1518106533 | Leila Ann Kramer | Physician Assistant | 2025 Soquel Ave., Santa Cruz, CA 95065-1794 | 2009-02-13 |
1124244215 | Melinda Carol Padgett | Physician Assistant | University of California, Santa Cruz, Student Health, 1156 High Street, Santa Cruz, CA 95064 | 2007-04-17 |
1063581668 | Sharon Lipschutz Kluger | Physician Assistant | 1661 Soquel Dr Ste E, Santa Cruz, CA 95065-1709 | 2006-11-07 |
1639182843 | Brian Christopher Martin | Physician Assistant | 1505 Soquel Drive, Suite 12, Santa Cruz, CA 95065-1716 | 2006-08-15 |
1932179892 | Pamela Wagner | Physician Assistant | 2900 Chanticleer Ave., Santa Cruz, CA 95065-1816 | 2006-01-24 |
1730188608 | Marion Joanna Jordan | Physician Assistant | 1080 Emeline Ave, Santa Cruz, CA 95060-1966 | 2005-07-21 |
1164051314 | Alec Steven Rogness | Physician Assistant | 2018 Mission St, Santa Cruz, CA 95060-5218 | 2020-04-08 |
Find all providers in SANTA CRUZ |
City | SANTA CRUZ |
Zip Code | 95065 |
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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.