JACOB WADLINGOTN (NPI# 1639520455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639520455 |
| Entity Type | Individual |
| Full Name | JACOB WADLINGOTN |
| Practice Address |
829 Kristi Ln Los Alamos NM 87544-2867 |
| Practice Telephone | 8062681517 |
| Mailing Telephone | 8062681517 |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| Street Address |
829 KRISTI LN |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544-2867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861849655 | Leonda Clendenen | Day Training/Habilitation Specialist | 2181 Loma Linda Dr, Los Alamos, NM 87544-2770 | 2016-05-21 |
| 1053732586 | Doris A Roberts | Day Training/Habilitation Specialist | 2101 Trinity Dr Ste T, Los Alamos, NM 87544-4103 | 2013-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186076 | Ohica-hadiya Ali | Day Training/Habilitation Specialist | 12700 Constitution Ave Ne Apt 9, Albuquerque, NM 87112-6067 | 2020-08-25 |
| 1720690092 | Kenneth Justin Schwartz | Day Training/Habilitation Specialist | 2319 Margarita Dr Se, Rio Rancho, NM 87124-2699 | 2020-08-18 |
| 1003424995 | Laetitia Marie Lucero | Day Training/Habilitation Specialist | 17c Lomas De La Cruz, Espanola, NM 87532-9048 | 2020-07-16 |
| 1265050256 | Aiyanna Amanda Woods-clark | Day Training/Habilitation Specialist | 440 Erbbe St Ne, Albuquerque, NM 87123-1138 | 2020-07-07 |
| 1821615923 | Ashlee Laughlin | Day Training/Habilitation Specialist | 420 Idalia Rd Sw, Rio Rancho, NM 87124-0845 | 2020-07-06 |
| 1982248068 | Shannon M Campbell | Day Training/Habilitation Specialist | 1126 Lafayette Dr Ne, Albuquerque, NM 87106-1904 | 2019-11-01 |
| 1053960757 | Rachael Lauren Corchine | Day Training/Habilitation Specialist | 6401 Santa Monica Ave Ne Apt 2086, Albuquerque, NM 87109-4166 | 2019-09-05 |
| 1457909095 | Naketta Jean Wiley | Day Training/Habilitation Specialist | 7709 Amy Marie Ct Nw, Albuquerque, NM 87120-6543 | 2019-08-27 |
| 1194371948 | Lorena Luevano | Day Training/Habilitation Specialist | 10600 Andalusian Ave Sw, Albuquerque, NM 87121-8949 | 2019-08-16 |
| 1609420223 | Ru'a Maadi | Day Training/Habilitation Specialist | 1200 Avenida Cesar Chavez Se Apt 423, Albuquerque, NM 87106-3902 | 2019-07-31 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
Please comment or provide details below to improve the information on JACOB WADLINGOTN.
| 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.