DEBORA LYNN PARK (NPI# 1538179619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538179619 |
| Entity Type | Individual |
| Full Name | DEBORA LYNN PARK |
| Practice Address |
6135 King Road Suite A Loomis CA 95650-8877 |
| Practice Telephone | 9166520427 |
| Practice Fax Number | 9166524197 |
| Mailing Telephone | 9166520427 |
| Mailing Fax Number | 9166524197 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | RHP72501 | CA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
6135 KING ROAD SUITE A |
| City | LOOMIS |
| State | CA |
| Zip Code | 95650-8877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902820319 | Heidi Mary Harvey | Nurse Practitioner | 6135 King Road, Suite A, Loomis, CA 95650-8877 | 2006-07-27 |
| 1235143736 | Gary Alan Gramm | Family Medicine | 6135 King Road, Suite A, Loomis, CA 95650-8877 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629252622 | Kevin Fleming Chiropractic, Inc | Chiropractor | 3621 Taylor Road, Suite A, Loomis, CA 95650 | 2007-12-27 |
| 1316133754 | Leslie Ann Hirschaut | Psychiatry & Neurology | 2499 Humphrey Rd, Loomis, CA 95650 | 2007-09-19 |
| 1356545693 | William J Ryland | Counselor | 5980 Webb Street, Loomis, CA 95650 | 2007-06-12 |
| 1316163462 | Michael Ratliff | Non-emergency Medical Transport (VAN) | 5900 King Rd Ste 209, Loomis, CA 95650 | 2007-04-17 |
| 1366573289 | Peter S. Klem, Od | Optometrist | 3493 Taylor Rd, Loomis, CA 95650 | 2007-03-09 |
| 1649260217 | Takemoto Drug Co | Pharmacy | 3685 Taylor Rd, Loomis, CA 95650 | 2005-10-25 |
| 1245725464 | Koinonia Foster Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3725 Taylor Rd, Loomis, CA 95650 | 2018-06-29 |
| 1538511852 | Allison Lensing | Community Health Worker | 3725 Taylor Rd, Loomis, CA 95650 | 2016-07-11 |
| 1851595938 | Donald Richmond | Counselor | 5980 Webb Street, Loomis, CA 95650 | 2007-06-13 |
| 1770787020 | Koinonia Foster Homes, Inc | Clinic/Center | 5980 Webb Street, Loomis, CA 95650 | 2007-06-12 |
| Find all providers in zip 95650 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891303665 | Jeffrey Chan | Radiologic Technologist | 2735 Ulloa St, San Francisco, CA 94116-2321 | 2020-07-17 |
| 1275098675 | California Mobile Imaging LLC | Radiologic Technologist | 3649 W Beechwood Ave Ste 106, Fresno, CA 93711-0693 | 2019-02-10 |
| 1669960068 | Tracey Saucier | Radiologic Technologist | 6342 Fallbrook Ave Ste 102, Woodland Hills, CA 91367-1613 | 2018-05-01 |
| 1972090652 | Souk Luangsrinhotha | Radiologic Technologist | 5021 Rosso Ct, Salida, CA 95368-9066 | 2018-04-18 |
| 1013454123 | Thanhtrang Dinh | Radiologic Technologist | 1725 W 17th St Rm 101e, Santa Ana, CA 92706-2316 | 2017-01-26 |
| 1427401512 | Ashim Haydar Ali | Radiologic Technologist | 8900 Thornton Rd Ste 24, Stockton, CA 95209-1820 | 2016-07-13 |
| 1952758963 | Kevin Schuman | Radiologic Technologist | 8042 Tuscany St, Fontana, CA 92336-3800 | 2016-05-19 |
| 1154782373 | Damian Dejesus | Radiologic Technologist | 2204 Auberry Ave, Bakersfield, CA 93304-7268 | 2016-03-15 |
| 1487023149 | Yasuhide Mikami | Radiologic Technologist | 710 E Keats Ave, Fresno, CA 93710-7022 | 2015-09-23 |
| 1518334630 | Hun Choe | Radiologic Technologist | 41 Muirfield, Trabuco Canyon, CA 92679-3421 | 2015-08-24 |
| Find all providers with the same taxonomy | ||||
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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.