PROF. AMJAD AL-KHAWALDEH (NPI# 1477091445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477091445 |
| Entity Type | Individual |
| Full Name | PROF. AMJAD AL-KHAWALDEH |
| Credential | PHD, CNS, NP |
| Practice Address |
3390 University Ave Ste 100 Riverside CA 92501-3315 |
| Mailing Address |
2012 Fallen Leaf Pl Tustin CA 92780-6713 |
| Practice Telephone | 9518277793 |
| Mailing Telephone | 7148753755 |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2020-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 539548 | CA | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 95006131 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NP LICENSE AND FURNISHING NUMBER | 95006131 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2801 Atlantic Ave, Palliative Care Team, Long Beach, CA 908061701 | 5629332000 | 5629336010 |
| Street Address |
3390 UNIVERSITY AVE STE 100 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501-3315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770524290 | Ramdas G. Pai | Internal Medicine | 3390 University Ave Ste 100, Riverside, CA 92501-3315 | 2006-06-08 |
| 1699152819 | Jin Seon Kim Paglingayen | Family Medicine | 3390 University Ave Ste 100, Riverside, CA 92501 | 2015-04-27 |
| 1811255060 | Regents of The University of California | Family Medicine | 3390 University Ave Ste 100, Riverside, CA 92501-3315 | 2012-04-25 |
| 1326184896 | Darren Freeman | Physical Medicine & Rehabilitation | 3390 University Ave Ste 100, Riverside, CA 92501-3315 | 2007-01-30 |
| 1265522569 | Nandini Netkal Gowda | Internal Medicine | 3390 University Ave Ste 100, Riverside, CA 92501-3315 | 2006-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689214074 | Aizzel Ramas Trieu | Nurse Practitioner | 3524 Jackfrost Ct, Riverside, CA 92503-4500 | 2020-01-13 |
| 1518504059 | Ragi Sadek | Nurse Practitioner | 12378 Jacaranda Way, Riverside, CA 92503-7048 | 2019-12-03 |
| 1710522255 | Patricia Denise Dupree | Nurse Practitioner | 14200 Meridian Pkwy # 101, Riverside, CA 92518-3044 | 2019-11-07 |
| 1750932141 | Huynh Ngoc Tu Nguyen | Nurse Practitioner | 9041 Magnolia Ave Ste 302, Riverside, CA 92503-3957 | 2019-09-26 |
| 1174030506 | Sible Rebello | Nurse Practitioner | 3660 Park Sierra Dr Ste 208, Riverside, CA 92505-3071 | 2018-01-08 |
| 1922519651 | Veronica Ann Pablo Miller | Nurse Practitioner | 8990 Garfield St Ste 8, Riverside, CA 92503-3922 | 2017-10-20 |
| 1497041453 | Bethany Marie Goldberg | Nurse Practitioner | 38 Amaral Street, Riverside, RI 02915 | 2011-06-28 |
| 1770884462 | Kristin F. Cadieux | Nurse Practitioner | 375 Wampanoag Trl Ste 102, Riverside, RI 02915 | 2010-11-11 |
| 1336463652 | Emily Angelica Agito Dela Rosa | Nurse Practitioner | 4361 Latham St Ste 270, Riverside, CA 92501-4332 | 2010-03-15 |
| 1497969562 | Candy Nordahl | Nurse Practitioner | 4440 Brockton Ave Ste 200, Riverside, CA 92501-4026 | 2007-05-09 |
| Find all providers in RIVERSIDE | ||||
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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.