VIRIDIANA PENALOZA (NPI# 1699247403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699247403 |
| Entity Type | Individual |
| Full Name | VIRIDIANA PENALOZA |
| Practice Address |
29413 Russell St Gold Beach OR 97444-7748 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5412476566 |
| Practice Fax Number | 5412476549 |
| Mailing Telephone | 5418588170 |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2020-04-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
29413 RUSSELL ST |
| City | GOLD BEACH |
| State | OR |
| Zip Code | 97444-7748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609963842 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 29413 Russell St, Gold Beach, OR 97444-7748 | 2006-10-09 |
| 1609496553 | Veronica A Hester | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2020-04-21 |
| 1568023232 | Callie A Preston | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2019-06-24 |
| 1376007013 | Ahmad R El Masri | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2019-01-28 |
| 1437628559 | Evelyn N Keitel | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2018-11-19 |
| 1609351196 | Chastity S Kolmorgan | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2018-10-01 |
| 1306324801 | Sarah B Stewart | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2018-08-06 |
| 1235643404 | Kristina Munoz | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2017-11-27 |
| 1841717196 | Tamera Somers | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2017-08-28 |
| 1619494317 | Tara Modugno | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619460227 | Curry Health District | Clinic/Center | 94125 Fourth Street, Gold Beach, OR 97444 | 2018-06-08 |
| 1427553692 | Columbiacare Services | Clinic/Center | 29415 Russell St, Gold Beach, OR 97444 | 2018-03-28 |
| 1972951630 | Kay Minkler | Case Manager/Care Coordinator | 29836 Mary Street, Gold Beach, OR 97444 | 2016-06-02 |
| 1811305717 | Mary Chambers | Counselor | 29821 Colvin St., Gold Beach, OR 97444 | 2014-07-24 |
| 1750703575 | Oregon Retina, LLP | Ophthalmology | 94225 E. 4th St., Gold Beach, OR 97444 | 2014-01-14 |
| 1548600208 | Stephanie Ann Laudert | Family Medicine | Curry Medical Practice, 94220 4th Street, Gold Beach, OR 97444 | 2013-06-26 |
| 1982944047 | Marta Maya Druzdzel | Massage Therapist | 29740 Ellensburg Ave, Gold Beach, OR 97444 | 2013-02-26 |
| 1598035347 | Curry County Health Department | Public Health or Welfare | 94235 Moore St., Gold Beach, OR 97444 | 2012-01-11 |
| 1013296920 | Merna Peterson | Counselor | 29821 Colvin, Gold Beach, OR 97444 | 2011-08-09 |
| 1609050129 | County of Curry | Home Health | 29984 Ellensburg Ave, Gold Beach, OR 97444 | 2007-12-19 |
| Find all providers in zip 97444 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720337959 | Rebecca Stichter | Counselor | 94235 Moore St Ste 421, Gold Beach, OR 97444-9699 | 2012-09-04 |
| 1013296920 | Merna Peterson | Counselor | 29821 Colvin, Gold Beach, OR 97444 | 2011-08-09 |
| 1609496553 | Veronica A Hester | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2020-04-21 |
| 1568023232 | Callie A Preston | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2019-06-24 |
| 1063972289 | Keqing Sun | Counselor | 29692 Ellensburg Ave, Gold Beach, OR 97444-8701 | 2019-03-22 |
| 1376007013 | Ahmad R El Masri | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2019-01-28 |
| 1437628559 | Evelyn N Keitel | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2018-11-19 |
| 1609351196 | Chastity S Kolmorgan | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2018-10-01 |
| 1306324801 | Sarah B Stewart | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2018-08-06 |
| 1235643404 | Kristina Munoz | Counselor | 29413 Russell St, Gold Beach, OR 97444-7748 | 2017-11-27 |
| Find all providers in GOLD BEACH | ||||
| City | GOLD BEACH |
| Zip Code | 97444 |
Please comment or provide details below to improve the information on VIRIDIANA PENALOZA.
| 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.