MRS. SUSAN LYNNE EAGLE-MULDER (NPI# 1467886101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467886101 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN LYNNE EAGLE-MULDER |
| Practice Address |
55475 Sante Fe Trail Suite 100 Yucca Valley CA 92284 |
| Practice Telephone | 8553656558 |
| Mailing Telephone | 8553656558 |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 37089 | CA | Nursing Service Providers |
| Street Address |
55475 SANTE FE TRAIL SUITE 100 |
| City | YUCCA VALLEY |
| State | CA |
| Zip Code | 92284 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821646746 | Dawn Irene Blue | Registered Nurse | 55887 Yucca Valley Trail, Yucca Valley, CA 92284 | 2019-09-04 |
| 1659838415 | Lifeline Marketing Group, LLC Kenneth M Folwell Sole Mbr | Genetic Counselor, MS | 57675 Twentynine Palms Hwy, Suite 102, Yucca Valley, CA 92284 | 2019-02-27 |
| 1790240026 | Rosenda Marie Quintero | Case Manager/Care Coordinator | 7281 Dumosa Avneue, Ste 4, Yucca Valley, CA 92284 | 2019-01-31 |
| 1740790617 | Robert Farrer | Pharmacist | 57701 Twentynine Palms Highway, Yucca Valley, CA 92284 | 2017-10-05 |
| 1881128981 | Louis James Medina | Case Manager/Care Coordinator | 58471 Twentynine Palms Hwy #102, Yucca Valley, CA 92284 | 2017-04-14 |
| 1003369620 | Hi -desert Memorial Health Care District | Clinic/Center | 57019 Yucca Trail Ste C, Yucca Valley, CA 92284 | 2016-08-01 |
| 1346639002 | Virginia Susan Mccann | Marriage & Family Therapist | 58945 Business Cernter Drive, Suite D, Yucca Valley, CA 92284 | 2015-01-20 |
| 1578964375 | Desert Oasis Healthcare | Clinic/Center | 57-840 29 Palms Hwy, Yucca Valley, CA 92284 | 2014-09-11 |
| 1306245113 | Katie Z Topper | Nurse Practitioner | 57402 Twentynine Palm Highway, Ste 1, Yucca Valley, CA 92284 | 2014-08-18 |
| 1215347307 | Sandip Patel | Pharmacist | 57701 Twentynine Palms Hwy, Yucca Valley, CA 92284 | 2014-04-29 |
| Find all providers in zip 92284 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326162033 | Edward George Elsasser | Licensed Psychiatric Technician | 56869 El Dorado Dr, Yucca Valley, CA 92284-4335 | 2007-03-19 |
| 1235672353 | Kimberly Meier | Licensed Psychiatric Technician | 58471 29 Palms Hwy Ste 102, Yucca Valley, CA 92284-5818 | 2016-11-21 |
| 1497151054 | Dawn Stockhausen | Licensed Psychiatric Technician | 58945 Business Center Dr, Yucca Valley, CA 92284-7307 | 2014-11-10 |
| 1083022016 | Bruce Baughman | Licensed Psychiatric Technician | 55475 Santa Fe Trl, Ste 100, Yucca Valley, CA 92284-3117 | 2014-07-22 |
| 1083046395 | Jeremy Scott Bard | Licensed Psychiatric Technician | 58945 Business Center Dr, Suite D, Yucca Valley, CA 92284-7307 | 2013-08-08 |
| 1467792283 | Sandy Moua | Licensed Psychiatric Technician | 58945 Business Center Dr, Suite D, Yucca Valley, CA 92284-7307 | 2013-02-15 |
| 1285958025 | Jeri Nicole Jones I | Licensed Psychiatric Technician | 58945 Business Center Dr Ste D, Yucca Valley, CA 92284-7310 | 2010-03-23 |
| 1083866024 | Gerald Gamache Jr. | Licensed Psychiatric Technician | 55475 Santa Fe Trl, Yucca Valley, CA 92284-3117 | 2008-10-22 |
| 1649441536 | Pamela Baguley | Licensed Psychiatric Technician | 55475 Santa Fe Trl, Yucca Valley, CA 92284-3117 | 2008-03-18 |
| 1386828044 | Constance Jensen | Licensed Psychiatric Technician | 55475 Santa Fe Trl, Yucca Valley, CA 92284-3117 | 2007-12-18 |
| Find all providers in YUCCA VALLEY | ||||
| City | YUCCA VALLEY |
| Zip Code | 92284 |
Please comment or provide details below to improve the information on MRS. SUSAN LYNNE EAGLE-MULDER.
| 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.