AUTUMN SKYE IVY (NPI# 1659638666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659638666 |
Entity Type | Individual |
Full Name | AUTUMN SKYE IVY |
Practice Address |
1201 W La Veta Ave Orange CA 92868-4203 |
Practice Telephone | 8887702462 |
Enumeration Date | 2012-04-13 |
Last Update Date | 2017-09-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208000000X | Pediatrics | A126865 | CA | Allopathic & Osteopathic Physicians |
Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
A126865 | CA | Allopathic & Osteopathic Physicians |
Street Address |
1201 W LA VETA AVE |
City | ORANGE |
State | CA |
Zip Code | 92868-4203 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477552941 | Roberto Limgenco Barretto | Otolaryngology | 1201 W La Veta Ave, Ste. 311, Orange, CA 92868-4213 | 2005-07-18 |
1083212054 | Mercy Air Service, Inc. | Ambulance | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-10-13 |
1225641418 | Jonathan Chodosh Strok | Nurse Practitioner | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-08-26 |
1881206779 | Emma Lind | Nurse Practitioner | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-08-20 |
1750993622 | Natalie Michelle Adame | Nurse Practitioner | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-08-20 |
1578172946 | Olivia Armour Tiffany | Psychologist | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-07-30 |
1376161323 | Tina Halabian | Student in an Organized Health Care Education/Training Program | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-07-07 |
1538786041 | Alyssa Marie Ramos-chavez | Psychologist | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-06-30 |
1588281265 | Tiffany Thao Vo | Student in an Organized Health Care Education/Training Program | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-06-29 |
1801423769 | Jonathan Thorpe | Student in an Organized Health Care Education/Training Program | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2020-03-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346859386 | Sadaf Abrishami | Pharmacist | 101 The City Dr S., Orange, CA 92868 | 2020-07-27 |
1245869825 | Helena Yijia Hong | Student in an Organized Health Care Education/Training Program | Uci Medical Center, 101 The City Drive, Orange, CA 92868 | 2020-04-06 |
1932736527 | Joshua Kristopher Livingston | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, Rte. 128-01, Orange, CA 92868 | 2020-03-24 |
1831725894 | Michelle Brown | Student in an Organized Health Care Education/Training Program | 101 The City Dr S. Rte 128-01, Orange, CA 92868 | 2020-03-20 |
1093363491 | Kristin Lee | Pharmacist | 132 S. Anita Dr., Orange, CA 92868 | 2019-08-28 |
1740834217 | Matthew Brian Mecheal | Dentist | 725 W. La Veta Suite 260, Orange, CA 92868 | 2019-08-01 |
1245897990 | Brent Tyler Louie | Student in an Organized Health Care Education/Training Program | 101 The City Drive South Building 3, Route 88, Neuropsychiatric Center Uc Irvine Medical Center, Orange, CA 92868 | 2019-05-28 |
1093277972 | Danielle Amato | Student in an Organized Health Care Education/Training Program | Uc Irvine Health 101 The City Drive, City Tower, Ste 40, Orange, CA 92868 | 2019-04-01 |
1851852206 | Julia Ting Bu | Student in an Organized Health Care Education/Training Program | Uc Irvine Health, 101 The City Drive, City Tower, Ste 400, Orange, CA 92868 | 2019-03-28 |
1326507344 | Harrison Beene Lowder | Student in an Organized Health Care Education/Training Program | 505 S. Main St, Suite 525, Orange, CA 92868 | 2019-03-19 |
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Taxonomy Code | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649513573 | Children's Hospital of Orange County | Psychiatry & Neurology | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2013-03-28 |
1518129162 | Daniel Shrey | Psychiatry & Neurology | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2008-06-25 |
1427216316 | Psf Neurology 2 | Psychiatry & Neurology | 455 S Main St, Orange, CA 92868-3835 | 2008-05-28 |
1487865523 | Lily Hoang Tran | Psychiatry & Neurology | 455 S Main St, Orange, CA 92868-3835 | 2007-05-24 |
1043233026 | Andrew Richard Mcintosh | Psychiatry & Neurology | 101 The City Dr S, Pediatric Neurology Zot 4482, Orange, CA 92868-3201 | 2006-07-25 |
1770551350 | Amanda Naguiat Fernandez | Psychiatry & Neurology | 455 S Main St, Orange, CA 92868-3835 | 2006-03-09 |
1497723498 | Jane F. Donat | Psychiatry & Neurology | 455 S Main St, Orange, CA 92868-3835 | 2006-03-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144797937 | A Fine Balance | Psychiatry & Neurology | 4200 Scotts Valley Dr Ste E, Scotts Valley, CA 95066-4539 | 2018-10-30 |
1619321791 | Prohealth Partners A Medical Group Inc | Psychiatry & Neurology | 16300 Sand Canyon Ave Ste 488, Irvine, CA 92618-3711 | 2016-04-14 |
1811381882 | Sinifunanya Nwaobi | Psychiatry & Neurology | 100 Ucla Medical Plaza Suite 245, Los Angeles, CA 90095-7419 | 2015-03-26 |
1366857260 | Prohealth Partners A Medical Group Inc | Psychiatry & Neurology | 26800 Crown Valley Pkwy Ste 510, Mission Viejo, CA 92691-8028 | 2014-06-30 |
1316387830 | Melissa Przeklasa Auth Md Professional Corporation | Psychiatry & Neurology | 30131 Town Center Dr Ste 195, Laguna Niguel, CA 92677-2040 | 2013-06-28 |
1538432463 | Joao Siffert | Psychiatry & Neurology | 18277 Via Ascenso, Rancho Santa Fe, CA 92067-2802 | 2012-02-23 |
1396043006 | Peter Himber | Psychiatry & Neurology | 1525 North Tustin Avenue, Santa Ana, CA 92705 | 2011-03-03 |
1902123060 | Danilo Reyes Bernardo Jr. | Psychiatry & Neurology | 10833 Le Conte Ave Ste 22-474, Los Angeles, CA 90095-4221 | 2010-04-29 |
1497071799 | Jennifer Lynn Martelle Tu | Psychiatry & Neurology | 744 52nd St Fl 5, Oakland, CA 94609-1810 | 2010-04-12 |
1912231705 | Audrey Christine Brumback | Psychiatry & Neurology | Ucsf Dept of Neurology 505 Parnassus Ave, Room M798, Box 0114, San Francisco, CA 94143-0001 | 2009-09-25 |
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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.