DR. JESSE RYAN WYATT (NPI# 1508205154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508205154 |
Entity Type | Individual |
Full Name | DR. JESSE RYAN WYATT |
Credential | M.D. |
Practice Address |
300 Hillmont Ave Ventura CA 93003 |
Mailing Address |
11234 Anderson St Gme Office Westerly Suite 'c' Loma Linda CA 92354-2804 |
Practice Telephone | 8056526000 |
Mailing Telephone | 9095584174 |
Enumeration Date | 2013-06-17 |
Last Update Date | 2018-07-31 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208000000X | Pediatrics | A126356 | CA | Allopathic & Osteopathic Physicians |
Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
A126356 | CA | Allopathic & Osteopathic Physicians |
Street Address |
300 HILLMONT AVE |
City | VENTURA |
State | CA |
Zip Code | 93003 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417999137 | Ventura County Medical Center | General Acute Care Hospital | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2006-06-11 |
1740899145 | Ruth Bannatz | Registered Nurse | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2020-07-31 |
1144847609 | Jody Jean Giacopuzzi | Social Worker | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2020-07-01 |
1356964167 | Christopher Zeman | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-27 |
1144843319 | Mariam Asper | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Ste 101&201, Ventura, CA 93003 | 2020-05-22 |
1154944379 | Katia Lee Margaret Cnop | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Ste 101&201, Ventura, CA 93003 | 2020-05-21 |
1225667421 | Katsiaryna Malykhina | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2020-04-08 |
1114560174 | Pejman Javaheri | Pharmacist | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2019-10-23 |
1124675483 | Ya-whey Wu | Pharmacist | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2019-08-21 |
1083260053 | Shanel Loren Alvarado Stadheim | Nurse Practitioner | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2019-08-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124645924 | Community Memorial Health System | Pharmacy | 2790 Loma Vista Road, Ventura, CA 93003 | 2020-06-29 |
1730702952 | Sarah Manon Begert | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave., Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-21 |
1033763677 | Ashley Danielle Aguilar | Counselor | 5740 Ralston Suite 100, Ventura, CA 93003 | 2019-08-01 |
1730747239 | Azadeh Ellsworth | Nurse Practitioner | 1752 S Victoria Ave Ste 250, Ventura, CA 93003 | 2019-05-31 |
1992275556 | Melissa Marie Cole | Social Worker | 4949 Market St, Ventura, CA 93003 | 2018-11-27 |
1851868400 | Weldon Acupuncture Professional Corporation | Acupuncturist | 3737 Telegraph Road, Suite F, Ventura, CA 93003 | 2018-10-31 |
1952876468 | Isabella Florencia Gallegos | Specialist/Technologist | 1857 Knoll Dr., Ventura, CA 93003 | 2018-10-11 |
1437645421 | Jill Huang Wong | Psychologist | 3585 Maple St Ste 248, Ventura, CA 93003 | 2018-07-02 |
1346735156 | Lisa Ngoc Thi Nguyen | Student in an Organized Health Care Education/Training Program | 147 N. Brent Street, Ventura, CA 93003 | 2018-06-25 |
1457845331 | Khloe Frank | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Suite 201, Ventura, CA 93003 | 2018-06-14 |
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Taxonomy Code | 2080P0203X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Critical Care Medicine |
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417368804 | Sara Aghamohammadi | Pediatrics | 4650 W Sunset Blvd # Ms 3, Los Angeles, CA 90027-6062 | 2014-05-19 |
1023367422 | Batool Alsheikh | Pediatrics | 6235 N Fresno St Ste 103, Fresno, CA 93710 | 2012-08-31 |
1699093880 | Richard P Lion | Pediatrics | 11234 Anderson St Rm 5763, Loma Linda, CA 92354-2804 | 2010-05-12 |
1558505719 | Ryan Richard Taylor | Pediatrics | Mattel Childrens Hospital At Ucla, 10833 Le Conte Ave., 12-494, Mdcc, Los Angeles, CA 90095-0001 | 2009-04-30 |
1871737270 | Shan Lyn Ward | Pediatrics | 3333 California St # S110, San Francisco, CA 94118-1981 | 2009-04-29 |
1932341641 | Anas Al Kawass | Pediatrics | 17100 Euclid Street, Picu, Fountain Valley, CA 92708 | 2009-03-26 |
1497996649 | Andreas Schwingshackl | Pediatrics | Rrmc 400 Westwood Blvd, Los Angeles, CA 90095-2113 | 2009-03-18 |
1588804801 | Carol Elizabeth Nicholson | Pediatrics | 6461 Zuma View Pl, #149, Malibu, CA 90265-4495 | 2009-02-26 |
1831355320 | Niveditha Vilasagar | Pediatrics | 4867 W Sunset Blvd Fl 5, Los Angeles, CA 90027-5969 | 2008-08-04 |
1154519072 | Eloa S. Adams | Pediatrics | 275 W Macarthu, Oakland, CA 94611-5641 | 2007-10-04 |
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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.