MEGHAN LICCIARDELLO (NPI# 1689212482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689212482 |
| Entity Type | Individual |
| Full Name | MEGHAN LICCIARDELLO |
| Credential | PA |
| Practice Address |
300 Harding Blvd Ste 213 Roseville CA 95678-2474 |
| Practice Telephone | 9163901347 |
| Mailing Telephone | 9163901347 |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 427 Grove St, Roseville, CA 956781508 | 9163901347 |
| Street Address |
300 HARDING BLVD STE 213 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95678-2474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225676778 | Alexandra Dee Petersen | Physician Assistant | 300 Harding Blvd Ste 213, Roseville, CA 95678-2474 | 2019-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
| 1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
| 1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
| 1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
| 1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
| 1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
| Find all providers in zip 95678 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538781372 | Jacob Adam Novick | Physician Assistant | 1346 Stonebridge Way, Roseville, CA 95661-5457 | 2020-05-14 |
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1710541016 | Khine Mira Tian | Physician Assistant | 2780 Snelling Ave N Ste 304, Roseville, MN 55113-7125 | 2019-04-23 |
| 1093287161 | Michael Eugeniuscz Froniewski | Physician Assistant | 1544 Eureka Rd Ste 160, Roseville, CA 95661-3092 | 2018-12-29 |
| 1528547106 | Steven Charles Frank | Physician Assistant | 11801 Go for Broke Rd, Roseville, CA 95678-7055 | 2018-08-14 |
| 1710392196 | Linda Ly Luong | Physician Assistant | 781 Pleasant Grove Blvd Ste 170, Roseville, CA 95678 | 2014-06-24 |
| 1487995924 | Judy Garcia Tumber | Physician Assistant | 8727 Wentworth Ct, Roseville, CA 95747-6370 | 2013-03-07 |
| 1598049249 | Ann Barbeiro | Physician Assistant | 8207 Sierra College Blvd Ste 500, Roseville, CA 95661-9407 | 2011-09-29 |
| 1164686937 | Julie Hunn | Physician Assistant | 729 Sunrise Ave Ste 900, Roseville, CA 95661-4525 | 2008-07-10 |
| 1891975199 | Mayra L Bobadilla | Physician Assistant | 729 Sunrise Ave Ste 619, Roseville, CA 95661-4548 | 2007-11-05 |
| Find all providers in ROSEVILLE | ||||
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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.