LYNNE R. MIELKE (NPI# 1700985413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700985413 |
| Entity Type | Individual |
| Full Name | LYNNE R. MIELKE |
| Credential | M.D. |
| Practice Address |
4463 Stoneridge Dr Ste A Pleasanton CA 94588-8402 |
| Practice Telephone | 9258466300 |
| Practice Fax Number | 9258466323 |
| Mailing Telephone | 9258466300 |
| Mailing Fax Number | 9258466323 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0005X |
Psychiatry & Neurology Specialization: Neurodevelopmental Disabilities |
G59017 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4463 STONERIDGE DR STE A |
| City | PLEASANTON |
| State | CA |
| Zip Code | 94588-8402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538409669 | Sandra Ann Kreizenbeck | Nurse Practitioner | 4463 Stoneridge Dr Ste A, Pleasanton, CA 94588-8402 | 2013-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932786 | Kabafusion, LLC | Durable Medical Equipment & Medical Supplies | 5860 W. Las Positas Blvd, Suite 19, Pleasanton, CA 94588 | 2020-11-02 |
| 1619519691 | Vanessa Baldwin | Behavior Technician | 5828 Stoneridge Mall Road, Suit 205, Pleasanton, CA 94588 | 2019-10-11 |
| 1184187783 | Amanda Singh | Behavior Technician | 1811 Stoneridge Mall Rd Suite 205, Pleasanton, CA 94588 | 2019-04-10 |
| 1891262192 | Virginia Zamora | Behavior Technician | 5820 Stoneridgemall Rd, Suite 205, Pleasanton, CA 94588 | 2018-10-25 |
| 1891275368 | Ixchel N Baltazar | Behavioral Analyst | 520 Stoneridge Mall Rd, Ste. 205, Pleasanton, CA 94588 | 2018-08-15 |
| 1386149409 | Monique Imanii Brown | Behavioral Analyst | 511 Johnson Drive, Pleasanton, CA 94588 | 2018-03-29 |
| 1922509710 | Cierra Marie Barton | Behavioral Analyst | 5820 Stoneridge Mall Road, Suite 205, Pleasanton, CA 94588 | 2018-02-27 |
| 1851800056 | Delisa Simon | Nurse Practitioner | 4439 Stoneridge Dr Ste 110, Pleasanton, CA 94588 | 2017-09-20 |
| 1831611409 | One Health Hospice, Inc. | Hospice Care, Community Based | 7059 Commerce Cir, Suite G, Pleasanton, CA 94588 | 2017-07-14 |
| 1114478641 | Carlos Gavino | Behavior Technician | 5820 Stoneridge Mall Dr, Suite 205, Pleasanton, CA 94588 | 2016-10-19 |
| Find all providers in zip 94588 | ||||
| Taxonomy Code | 2084P0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation and chronic behavioral syndromes, or neurologic conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology. A subspecialty certificate for NDN was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811155161 | Joshua Daniel Feder | Psychiatry & Neurology | 415 N Highway 101, Solana Beach, CA 92075-1172 | 2008-05-22 |
| 1760587141 | Mark Kaplan | Psychiatry & Neurology | 3575 Cahuenga Blvd W, 243, Los Angeles, CA 90068-1366 | 2006-09-13 |
| 1649208638 | Diane W Kecskes | Psychiatry & Neurology | 3796 N Fresno St, Suite # 104, Fresno, CA 93726-5500 | 2006-06-29 |
| 1811949399 | Richard Joseph Chadwin | Psychiatry & Neurology | 690 Hudson Ct, Sonoma, CA 95476 | 2006-05-16 |
| 1619188315 | Ange J Lobue | Psychiatry & Neurology | 525 2nd St, Suite 300, Eureka, CA 95501-0437 | 2007-05-24 |
| 1932233996 | Sabira Saifuddin | Psychiatry & Neurology | 2660 Townsgate Rd, Suite 780, Westlake Village, CA 91361-2714 | 2007-03-14 |
| 1528100021 | Michael Sean Marcin | Psychiatry & Neurology | 401 Parnassus Ave, Box-0984 Hos, San Francisco, CA 94143-2211 | 2007-02-12 |
| 1093807000 | Victoria Lynn Dunckley | Psychiatry & Neurology | 909 Electric Ave, Ste 302b, Seal Beach, CA 90740-6336 | 2006-09-28 |
| 1881796811 | Regents of The University of California - Ucsd Medical Group | Psychiatry & Neurology | 200 West Arbor Drive, Mc-8201 Attn: Provider Enrollment Department, San Diego, CA 92103-8201 | 2006-09-01 |
| City | PLEASANTON |
| Zip Code | 94588 |
Please comment or provide details below to improve the information on LYNNE R. MIELKE.
| 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.