CANDRA CARR (NPI# 1477742823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477742823 |
| Entity Type | Individual |
| Full Name | CANDRA CARR |
| Credential | PA-C |
| Practice Address |
1718 Sylvan Way 1202 Lodi CA 95242-4318 |
| Practice Telephone | 2035000893 |
| Mailing Telephone | 2035000893 |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 19365 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1718 SYLVAN WAY 1202 |
| City | LODI |
| State | CA |
| Zip Code | 95242-4318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124169271 | Jacqueline Bonanno | Dietitian, Registered | 1718 Sylvan Way, #912, Lodi, CA 95242-4318 | 2007-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
| Find all providers in zip 95242 | ||||
| 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 |
|---|---|---|---|---|
| 1770952210 | Viktor Gashi | Physician Assistant | 184 Paterson Ave, Lodi, NJ 07644-3121 | 2015-09-15 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1710500848 | Sara Ghohestani-bojd | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-05-23 |
| 1245864297 | Kristin Jean Gedda | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-02-28 |
| 1215587266 | Stanton Welsh | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242-4321 | 2019-09-11 |
| 1295390672 | Armeghan Bagherpour | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-05-01 |
| 1730643768 | Hannah Esther Keller | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-01-23 |
| 1669970778 | Jason Rogers | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2018-01-24 |
| 1922510171 | Janel Ojeda | Physician Assistant | 1901 W Kettleman Ln Ste 200, Lodi, CA 95242-4337 | 2017-10-27 |
| 1346269412 | Misti Blandford | Physician Assistant | 1901 W Kettleman Ln, Suite 200, Lodi, CA 95242-4337 | 2006-07-19 |
| Find all providers in LODI | ||||
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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.