TANEAKA KOSHKO-BRADLEY (NPI# 1568009629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568009629 |
| Entity Type | Individual |
| Full Name | TANEAKA KOSHKO-BRADLEY |
| Practice Address |
1540 Florida Ave Modesto CA 95350-4430 |
| Practice Telephone | 2096618840 |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2019-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1540 FLORIDA AVE |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-4430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487608477 | Richard Warren Gratian | Pediatrics | 1540 Florida Ave, Ste 205, Modesto, CA 95350-4430 | 2006-05-22 |
| 1255957221 | Nathan Chalk | Counselor | 1540 Florida Ave, Modesto, CA 95350-4430 | 2020-06-24 |
| 1720630197 | James Dean Stalians | Registered Nurse | 1540 Florida Ave, Modesto, CA 95350-4430 | 2019-07-15 |
| 1144746140 | Kristen E. Flack | Registered Nurse | 1540 Florida Ave, Modesto, CA 95350-4430 | 2017-08-21 |
| 1225552284 | Dheera Tamvada | Internal Medicine | 1540 Florida Ave, Modesto, CA 95350-4430 | 2017-08-01 |
| 1952602708 | Wendy Zolczynski | Registered Nurse | 1540 Florida Ave, Ste 100, Modesto, CA 95350 | 2010-11-10 |
| 1366760027 | Talwinderdeep Singh Kahlon | Internal Medicine | 1540 Florida Ave, Suite 100, Modesto, CA 95350-4430 | 2010-05-05 |
| 1265767669 | Melissa Ann Sorensen | Registered Nurse | 1540 Florida Ave, Suite 100, Modesto, CA 95350-4430 | 2009-10-02 |
| 1235361536 | Allyson M Van Horn | Registered Nurse | 1540 Florida Ave, Suite 100, Modesto, CA 95350-4430 | 2009-08-20 |
| 1851532261 | Jayshri Mahesh Nimbargi | Internal Medicine | 1540 Florida Ave, Modesto, CA 95350-4430 | 2009-03-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
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| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1154948149 | Lauren N Zampieri | Case Manager/Care Coordinator | 1706 Sandalwood Dr, Modesto, CA 95350-3819 | 2020-06-25 |
| 1487271474 | Jonathan Reinke | Case Manager/Care Coordinator | 605 E Coolidge Ave Apt 21, Modesto, CA 95350-4591 | 2020-06-25 |
| 1699395871 | Andrea Valencia | Case Manager/Care Coordinator | 1095 Carver Rd Unit 213, Modesto, CA 95350-7705 | 2020-04-17 |
| 1649806373 | Harshil Girn | Case Manager/Care Coordinator | 2628 Medinah Ct, Modesto, CA 95355-9666 | 2020-03-13 |
| 1932740693 | Jennifer Rogers | Case Manager/Care Coordinator | 525 S Jefferson St, Modesto, CA 95351-2708 | 2019-10-03 |
| 1710543152 | Nina Lajeen | Case Manager/Care Coordinator | 2109 Norik Dr, Modesto, CA 95355-9155 | 2019-05-10 |
| 1629631106 | Jayne Sharon Nunes | Case Manager/Care Coordinator | 800 Scenic Dr Bldg B, Modesto, CA 95350-6131 | 2019-04-19 |
| 1467937789 | Danica Freitas | Case Manager/Care Coordinator | 4008 Nugget Dr, Modesto, CA 95355-9526 | 2018-10-02 |
| 1538664321 | Melonie Johnson | Case Manager/Care Coordinator | 4417 Crestmont Way, Modesto, CA 95356-9343 | 2018-03-26 |
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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.