JESSICA LYNN PEDEVILLE (NPI# 1609030501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609030501 |
| Entity Type | Individual |
| Full Name | JESSICA LYNN PEDEVILLE |
| Credential | PSY.D. |
| Practice Address |
1000 N 90th St Suite 200 Omaha NE 68114-2764 |
| Mailing Address |
1761 Griffith Park Blvd Los Angeles CA 90026-1055 |
| Practice Telephone | 4029553900 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2009-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
1000 N 90TH ST SUITE 200 |
| City | OMAHA |
| State | NE |
| Zip Code | 68114-2764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760477525 | Delmar Gardens of Omaha, LLC | Home Health | 1000 N 90th St, Omaha, NE 68114-2764 | 2005-09-16 |
| 1437513967 | Genevieve Maliszewski | Counselor | 1000 N 90th St, Suite 200, Omaha, NE 68114-2764 | 2016-04-11 |
| 1619225893 | Julie Ann Gentleman | Physical Therapist | 1000 N 90th St, Suite 203, Omaha, NE 68114-2764 | 2012-08-20 |
| 1629372032 | Lauren Beth Johnson | Psychologist | 1000 N 90th St, Ste 200, Omaha, NE 68114-2764 | 2010-12-28 |
| 1124284690 | Ashley C Harlow | Psychologist | 1000 N 90th St, Suite 200, Omaha, NE 68114-2764 | 2008-08-04 |
| 1639388440 | Jennifer K Mcwilliams | Psychiatry & Neurology | 1000 N 90th St, Ste 200, Omaha, NE 68114-2764 | 2007-05-21 |
| 1770637878 | Reo Wexner Newring | Counselor | 1000 N 90th St, Suite 200, Omaha, NE 68114 | 2007-01-23 |
| 1508913864 | Coleen K Cusick-brown | Social Worker | 1000 N 90th St, Ste 200, Omaha, NE 68114-2764 | 2007-01-05 |
| 1790771301 | Delmar Gardens of Omaha, LLC | Hospice Care, Community Based | 1000 N 90th St, Suite 203, Omaha, NE 68114-2764 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689237356 | Jared Nathan Holthaus | Optometrist | 625 N. 98th St, Omaha, NE 68114 | 2019-04-18 |
| 1346701869 | On Site Health and Wellness, LLC | Dietitian, Registered | 7905 Pacific Street, Omaha, NE 68114 | 2019-03-27 |
| 1801301205 | Logan Johnson | Specialist/Technologist | 8803 Webster Plz, Omaha, NE 68114 | 2017-12-06 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1023568540 | Active Spine Physical Therapy, LLC | Clinic/Center | 10110 Nicholas St Ste 100, Omaha, NE 68114 | 2016-10-07 |
| 1417400706 | Kayla Ann Leddy | Counselor | 7701 Pacific St Ste 100a, Omaha, NE 68114 | 2016-08-03 |
| 1134561103 | Julio Cesar Deleon Iv | Counselor | 9212 California Plaza #308, Omaha, NE 68114 | 2013-07-19 |
| 1477992261 | Nicole Janine Lecci | Dentist | 8910 Indian Hills Drive, Suite 200, Omaha, NE 68114 | 2013-06-14 |
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1558606665 | Nbd Solutions | Durable Medical Equipment & Medical Supplies | 327 N 78 Street, Omaha, NE 68114 | 2012-11-29 |
| Find all providers in zip 68114 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891120754 | Lynne F Clure | Psychologist | 444 S 44th St, Omaha, NE 68131-3727 | 2013-09-11 |
| 1124284690 | Ashley C Harlow | Psychologist | 1000 N 90th St, Suite 200, Omaha, NE 68114-2764 | 2008-08-04 |
| 1467621425 | Tiffany M Kodak | Psychologist | 985450 Nebraska Medical Ctr, Omaha, NE 68198-5450 | 2008-02-25 |
| 1326225228 | Children's Hospital | Psychologist | 8200 Dodge Street, Children's Hospital Edp Providers, Omaha, NE 68114-4113 | 2008-01-23 |
| 1679639884 | Peg M Miller-evans | Psychologist | Children's Family Support Center, 8200 Dodge Street, Omaha, NE 68114-4113 | 2006-12-29 |
| 1518023506 | Katie E Sewell | Psychologist | 8200 Dodge St, Children's Hospital & Medical Ctr - Behavioral Health, Omaha, NE 68114-4113 | 2006-12-28 |
| 1992735179 | Leaann Marie Lape-brinkman | Psychologist | 12001 Q St, Omaha, NE 68137-3542 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811515026 | James K Fruehling | Psychologist | 900 W Court St, Beatrice, NE 68310-3526 | 2020-07-14 |
| 1184188369 | Alexandria Fladhammer | Psychologist | 738 W 3rd St, Hastings, NE 68901-5134 | 2019-01-22 |
| 1710460670 | Brenda Glunz | Psychologist | 930 Eads Ave, Hebron, NE 68370-1420 | 2018-09-07 |
| 1033574819 | Amanda K. Schnee, Ph.d., LLC | Psychologist | 5539 S 27th St, Suite 101, Lincoln, NE 68512-1648 | 2015-12-22 |
| 1922463793 | Carrie Semke, LLC | Psychologist | 5539 S 27th St, Suite 101, Lincoln, NE 68512-1648 | 2015-12-22 |
| 1861834194 | Kimberly Marie Hill Grundman | Psychologist | 4800 Hospital Pkwy, Beatrice, NE 68310-6906 | 2013-07-29 |
| 1942439203 | Charles Muiu | Psychologist | 1103 Galvin Rd S, Area 'n', Bellevue, NE 68005-3002 | 2009-07-08 |
| 1407916521 | Ariadne Vigelius Schemm | Psychologist | 2300 S 16th St, Bryanlgh Medical Center West, Lincoln, NE 68502-3704 | 2006-12-11 |
| 1952488678 | Julie M Maikranz | Psychologist | 4501 S 70th St, Suite 120, Lincoln, NE 68516-4276 | 2006-11-01 |
| 1184706004 | Karen Ann Ellefsen | Psychologist | 2900 S 70th St, Ste 150, Lincoln, NE 68506-3688 | 2006-10-19 |
| 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.