LARISA GUMEROVA (NPI# 1699061986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699061986 |
| Entity Type | Individual |
| Full Name | LARISA GUMEROVA |
| Credential | PA-C |
| Practice Address |
1742 Oregon St Redding CA 96001 |
| Mailing Address |
1742 Oregon St Redding CA 96001-1717 |
| Practice Telephone | 5306467269 |
| Practice Fax Number | 5302752201 |
| Mailing Telephone | 5306467269 |
| Mailing Fax Number | 5302752201 |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2019-03-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 21544 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9745 Prospect Ave Ste 100, Santee, CA 920714273 | 6194484841 | |
| 7625 Mesa College Drive, 315a, San Diego, CA 921115343 | 8585761011 | 8585761025 |
| Street Address |
1742 OREGON ST |
| City | REDDING |
| State | CA |
| Zip Code | 96001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298598 | Kellie Sperduto | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2020-06-05 |
| 1992324321 | Ibrahim Mulic | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2020-04-15 |
| 1790304715 | Katie Erin Ghelfi-dunbar | Psychologist | 1742 Oregon St, Redding, CA 96001-1717 | 2020-04-09 |
| 1821627746 | Brock Haskell | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2020-04-02 |
| 1780140137 | Emily Anne Caveza | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2019-02-11 |
| 1861960213 | Carri Ann Decarlo | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2018-11-04 |
| 1649762634 | Tamar Boswell | Marriage & Family Therapist | 1742 Oregon St, Redding, CA 96001-1717 | 2018-06-05 |
| 1952811051 | Rickey Lee Southwell Jr. | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2017-10-04 |
| 1912357922 | Tessa Rose Sale | Marriage & Family Therapist | 1742 Oregon St, Redding, CA 96001-1717 | 2016-06-21 |
| 1598047565 | Michael Sam Dang | Counselor | 1742 Oregon St, Redding, CA 96001-1717 | 2011-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| 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 |
|---|---|---|---|---|
| 1073123915 | Kendra Owen | Physician Assistant | 1555 East St Ste 100, Redding, CA 96001-1153 | 2020-08-05 |
| 1316578818 | Kaylin Rae Sanders | Physician Assistant | 375 Smile Pl Ste B, Redding, CA 96001-3653 | 2020-02-03 |
| 1922550292 | Nicole Combs | Physician Assistant | 2216 Buenaventura Blvd Ste B, Redding, CA 96001-3838 | 2016-11-02 |
| 1326482068 | Terry Lee Pelayo | Physician Assistant | 2022 Jewell Ln, Redding, CA 96001-4823 | 2013-04-24 |
| 1578842100 | Lacey Monique Townsend | Physician Assistant | 2891 Churn Creek Rd Ste A, Redding, CA 96002-1148 | 2011-08-13 |
| 1396994430 | Robyn Lynn Carpenter | Physician Assistant | 2750 Eureka Way Ste 101, Redding, CA 96001-0251 | 2008-09-12 |
| 1528144912 | Kathleen B. Chesney | Physician Assistant | 1388 Court Street, Suite H, Redding, CA 96001-1650 | 2006-10-27 |
| 1073122412 | Christopher Wills | Physician Assistant | 100 E Cypress Ave, Redding, CA 96002-0162 | 2020-07-30 |
| 1689298598 | Kellie Sperduto | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2020-06-05 |
| 1992324321 | Ibrahim Mulic | Physician Assistant | 1742 Oregon St, Redding, CA 96001-1717 | 2020-04-15 |
| Find all providers in REDDING | ||||
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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.