MARIE KATHERINE MULCOCK (NPI# 1558897413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558897413 |
| Entity Type | Individual |
| Full Name | MARIE KATHERINE MULCOCK |
| Other Name | MASHA KATHERINE PREOBRAZHENSKY |
| Credential | PA-S |
| Practice Address |
801 E Chapman Ave Ste 203 Fullerton CA 92831-3846 |
| Mailing Address |
Po Box 919 Fullerton CA 92836-0919 |
| Practice Telephone | 7146809000 |
| Practice Fax Number | 7146808233 |
| Mailing Telephone | 7146809000 |
| Mailing Fax Number | 7146808233 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10618366-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
801 E CHAPMAN AVE STE 203 |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-3846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376630665 | Jesus Sanchez Ocana | Counselor | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2006-10-06 |
| 1366058489 | Juan Islas | Rehabilitation Practitioner | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-09-23 |
| 1285247965 | Jennifer Solorzano | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-24 |
| 1427660646 | Jennifer Soto | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-19 |
| 1982216289 | Michelle Garcia | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-18 |
| 1013528736 | Rafaela Vargas | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-14 |
| 1841801057 | Coral Bedolla | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-11 |
| 1902417330 | Yessenia Gonzalez | Student in an Organized Health Care Education/Training Program | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-10 |
| 1750991816 | Yvette Bautista Suarez | Rehabilitation Practitioner | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-08-04 |
| 1396354783 | Christopher Fry | Community Health Worker | 801 E Chapman Ave Ste 203, Fullerton, CA 92831-3846 | 2020-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861581563 | Roger William Skebelsky | Physician Assistant | 100 E Valencia Mesa Drive, 310, Fullerton, CA 92835 | 2006-10-12 |
| 1013487883 | Austin James Perkins | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2018-12-04 |
| 1346716842 | Charles Alexandre Greener | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2018-10-23 |
| 1952589459 | May Majied Ali | Physician Assistant | 100 E Valencia Mesa Dr, Suite 311, Fullerton, CA 92835-3813 | 2008-02-06 |
| 1275742462 | Carrie-anne Clark | Physician Assistant | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813 | 2007-05-22 |
| 1174731640 | Dennis Wayne Briley | Physician Assistant | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813 | 2007-05-18 |
| 1588872089 | Carrie M Carrillo | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2007-05-18 |
| 1205889326 | William Charles Andrew Hall | Physician Assistant | 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835 | 2006-05-18 |
| 1912961038 | Grace Jin Lee | Physician Assistant | 1950 Sunnycrest Dr, Suite 2600, Fullerton, CA 92835-3638 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
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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.