PHYLLIS JANE MOORE (NPI# 1528125747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528125747 |
| Entity Type | Individual |
| Full Name | PHYLLIS JANE MOORE |
| Credential | NP |
| Practice Address |
1200 El Camino Real South San Francisco CA 94080-3208 |
| Mailing Address |
901 El Camino Real San Bruno CA 94066-3009 |
| Practice Telephone | 6507422100 |
| Practice Fax Number | 6507421311 |
| Mailing Telephone | 6507422100 |
| Mailing Fax Number | 6507421311 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
193145 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134330483 | Phyllis C. Moore | Speech-Language Pathologist | 5111 Laird Ln, Jupiter, FL 33458-4095 | 2007-05-25 |
| 1497130017 | Phyllis Eugenia Moore | Nurse Practitioner | 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-4194 | 2015-07-24 |
| 1023374279 | Phyllis P Moore | Nurse Practitioner | 600 Main St, Friendship, TN 38034-1999 | 2012-04-02 |
| 1235407248 | Phyllis Ann Moore | Nurse Practitioner | 815 Pennsylvania Ave, Fort Worth, TX 76104-2224 | 2011-12-05 |
| 1467744979 | Phyllis S Moore | Clinical Nurse Specialist | 940 Belmont St, Mclean Hospital Southeast Location, Brockton, MA 02301-5596 | 2011-05-03 |
| 1164657706 | Phyllis Moore | Licensed Practical Nurse | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2009-05-27 |
| 1528136744 | Phyllis R Moore | Social Worker | 218 N Washington St, Phyllis R Moore Lcswr, Rome, NY 13440 | 2006-12-04 |
| 1407940604 | Phyllis Diane Moore I | Physical Therapy Assistant | 2710 Trotwood Ave, Columbia, TN 38401-4903 | 2006-10-03 |
| Street Address |
1200 EL CAMINO REAL |
| City | SOUTH SAN FRANCISCO |
| State | CA |
| Zip Code | 94080-3208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407858988 | Scot W. Russell | Psychologist | 1200 El Camino Real, South San Francisco, CA 94080 | 2005-08-15 |
| 1275131351 | Guerline Bornelus | Registered Nurse | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2020-10-12 |
| 1174134258 | Trista Yuen Ting Tam | Pharmacist | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2020-08-12 |
| 1831707686 | Kurt Herman Theumer | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2020-07-17 |
| 1538787346 | Maryfloriel Lozada | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2020-07-08 |
| 1881235109 | Sau Ming Lam | Dietitian, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2019-10-08 |
| 1073078606 | Vue Ngoy | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2019-02-07 |
| 1891269510 | Zachary Robert Cinti | Physician Assistant | 1200 El Camino Real, South San Francisco, CA 94080-3299 | 2019-01-15 |
| 1770056756 | Debora M Creighton-vaz | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2019-01-02 |
| 1508338088 | Melissa Anne Dayao | Respiratory Therapist, Registered | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2018-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245704303 | Patricia Sweeney | Nurse Practitioner | 435 Gran Ave, South San Francisco, CA 94080 | 2019-01-11 |
| 1518446988 | Yessenia Patricia Pena Ruiz | Counselor | 117 Pecks Ln, South San Francisco, CA 94080 | 2018-08-07 |
| 1982112579 | Breanna Mottau | Behavioral Analyst | 751a Camino Plaza, San Bruno, CA 94080 | 2018-01-17 |
| 1720594294 | Patricia Lynn Jasper | Nurse Practitioner | 395 Oyster Point Blvd., Suite 128, South San Francisco, CA 94080 | 2017-12-20 |
| 1184146755 | Breanne Ho | Student in an Organized Health Care Education/Training Program | 130 Nursery Way, South San Francisco, CA 94080 | 2017-07-14 |
| 1568843787 | Lita Wu | Optometrist | 119 Hickey Blvd, South San Francisco, CA 94080 | 2015-06-12 |
| 1720479553 | Naf Nasser Almadari | Physician Assistant | 717 Baden Ave, San Francisco, CA 94080 | 2015-02-16 |
| 1528459351 | Alexander M Gold | Internal Medicine | 270 East Grand Avenue, South San Francisco, CA 94080 | 2015-02-16 |
| 1548673411 | Elite Care Home Health Agency, Inc. | Home Health | 91 Westborough Blvd Ste 2020, South San Francisco, CA 94080 | 2014-06-08 |
| 1720415979 | Optometry Eyecareeyewear Com Inc | Optometrist | 601 Gateway Blvd., Suite 220, South San Francisco, CA 94080 | 2013-10-02 |
| Find all providers in zip 94080 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720594294 | Patricia Lynn Jasper | Nurse Practitioner | 395 Oyster Point Blvd., Suite 128, South San Francisco, CA 94080 | 2017-12-20 |
| 1265772669 | Katrina Surban Cruz | Nurse Practitioner | 35 Seville Way, South San Francisco, CA 94080-5544 | 2013-02-21 |
| 1275682056 | Elisabeth O'mara Sutter | Nurse Practitioner | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2007-01-09 |
| 1356407480 | Yong-qung Yang | Nurse Practitioner | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2007-01-01 |
| 1770651887 | John Kirk Phillips | Nurse Practitioner | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2006-11-30 |
| 1245318633 | Cherie Mignon Hawkins | Nurse Practitioner | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2006-11-01 |
| 1154431203 | Thomas Michael Grothe | Nurse Practitioner | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388504 | Daniel Ngo | Nurse Practitioner | 1180 S Hilda St, Anaheim, CA 92806-5007 | 2020-08-28 |
| 1407464522 | Laura Bradigan | Nurse Practitioner | 1744 Grand Ave Unit 2, Long Beach, CA 90804-2022 | 2020-07-15 |
| 1538787031 | Kelly Olcott | Nurse Practitioner | 4004 Via Lucero Apt 12, Santa Barbara, CA 93110-1692 | 2020-07-10 |
| 1629695440 | Kelley Ibarra | Nurse Practitioner | 1613 Celeste Dr, Modesto, CA 95355-5039 | 2020-06-26 |
| 1497379333 | Gloria Jean Campbell | Nurse Practitioner | 5055 E Garford St Apt 6, Long Beach, CA 90815-2861 | 2020-06-06 |
| 1851913115 | Lilly Fong | Nurse Practitioner | 15821 Square Top Ln, Fontana, CA 92336-4586 | 2020-05-09 |
| 1548880750 | Sharkeiya Terrell | Nurse Practitioner | 2752 Harrison Ave Ste A, Eureka, CA 95501-4738 | 2020-04-17 |
| 1730714007 | Julissa Leonides Caraballo | Nurse Practitioner | 4044 Promontory St, San Diego, CA 92109-5334 | 2020-03-07 |
| 1194355404 | Bethany Leda Donowho | Nurse Practitioner | 845 Via De La Paz Ste 16, Pacific Palisades, CA 90272-3627 | 2020-01-26 |
| 1518507078 | Rachel Saake Collar | Nurse Practitioner | 5100, 1000 Executive Pkwy, Oroville, CA 95966 | 2020-01-13 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH SAN FRANCISCO |
| Zip Code | 94080 |
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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.