JACK WAYLAND DAVIS II (NPI# 1447817127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447817127 |
| Entity Type | Individual |
| Full Name | JACK WAYLAND DAVIS II |
| Practice Address |
1109 Flagship Dr Vallejo CA 94592-1114 |
| Practice Telephone | 5303333770 |
| Mailing Telephone | 5303333770 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225104250 | Jack M Davis | Podiatrist | 2251 W 900 N, Farr West, UT 84404-9586 | 2006-11-28 |
| 1235242652 | Jack Justin Davis | Dentist | 543 West Ave, Rifle, CO 81650-3553 | 2006-08-17 |
| 1396297966 | Jack Davis | Peer Specialist | 665 136th Ave, Suite 50, Holland, MI 49424-1897 | 2016-10-31 |
| 1063529162 | Jack Mathew Davis | Nurse Practitioner | 18th Medcom, Attn: Dccs-qm (credentials), Apo, AP 96205-0054 | 2006-08-24 |
| Street Address |
1109 FLAGSHIP DR |
| City | VALLEJO |
| State | CA |
| Zip Code | 94592-1114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671811 | Amy Ngoc Anh Tran | Student in an Organized Health Care Education/Training Program | Touro University California, 1310 Club Drive, Vallejo, CA 94592 | 2019-10-25 |
| 1780168666 | Bill Darrel Danyeur | Health Educator | Touro University California Dpp, 1310 Club Drive, Vallejo, CA 94592 | 2018-09-18 |
| 1194034710 | Paul Robert Hansen | Pharmacist | 1310 Johnson Lane, Mare Island, Vallejo, CA 94592 | 2010-09-30 |
| 1548298607 | Touro University California | Family Medicine | 1310 Club Drive, Vallejo, CA 94592 | 2006-06-29 |
| 1093785362 | Ronald W. Eng | Dentist | Vanchcs Outpatient Clinic. Dental Service (160/mi), Bldg. 201, Walnut Ave., Mare Island, CA 94592 | 2006-01-26 |
| 1952386625 | Renu Yadav Sharma | Dentist | Va Nchcs- Dental Service, Bldg 201 Walnut Ave, Mare Island, CA 94592 | 2005-12-14 |
| 1689659518 | Linda Chie | Dentist | Va Northern California Health Care Systen Dental Clinic, Bldg. 201, Walnut Ave., Mare Island, CA 94592 | 2005-12-14 |
| 1922082403 | Linda Ann Aragon | Internal Medicine | 201 Walnut Ave, Mare Isle, CA 94592 | 2005-11-30 |
| 1114404712 | Keith Isamu Yoshizuka | Pharmacist | 1310 Club Drive, Touro University California College of Pharmacy, Vallejo, CA 94592 | 2018-07-26 |
| 1669996518 | Daniel Jaemoon Kang | Dentist | 201 Walnut Avenue, 612 Ge/mi Dental, Vallejo, CA 94592 | 2017-08-02 |
| Find all providers in zip 94592 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730703281 | Rachel Brodhead | Student in an Organized Health Care Education/Training Program | 437 N Regatta Dr, Vallejo, CA 94591-7702 | 2020-06-01 |
| 1952924631 | Shanice Renee Watts | Student in an Organized Health Care Education/Training Program | 144 Columbia Way, Vallejo, CA 94589-1421 | 2020-05-28 |
| 1215556766 | Huong Tran | Student in an Organized Health Care Education/Training Program | 816 Jack London Dr, Vallejo, CA 94589-1407 | 2020-04-15 |
| 1144859158 | Yasaman Ashley Lajevardi | Student in an Organized Health Care Education/Training Program | 721 Oscar St, Vallejo, CA 94592-1180 | 2020-04-02 |
| 1124654082 | Sean Wang | Student in an Organized Health Care Education/Training Program | 911 Madrone Ave, Vallejo, CA 94592-1165 | 2020-03-22 |
| 1447895735 | Marcus Justin Chen | Student in an Organized Health Care Education/Training Program | 610 Poplar Ave, Vallejo, CA 94592-1147 | 2019-11-11 |
| 1134762792 | Alexander John Mckean | Student in an Organized Health Care Education/Training Program | 827 Kentucky St, Vallejo, CA 94590-5215 | 2019-10-25 |
| 1225671811 | Amy Ngoc Anh Tran | Student in an Organized Health Care Education/Training Program | Touro University California, 1310 Club Drive, Vallejo, CA 94592 | 2019-10-25 |
| 1700449030 | Desire Ingabire | Student in an Organized Health Care Education/Training Program | 436 Waterview Ter, Vallejo, CA 94591-7159 | 2019-04-22 |
| 1821558495 | Christian Joaquin | Student in an Organized Health Care Education/Training Program | 101 Pinto Dr, Vallejo, CA 94591-8451 | 2019-03-21 |
| Find all providers in VALLEJO | ||||
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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.