DR. JENNIFER ELIZONDO (NPI# 1740460658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740460658 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER ELIZONDO |
| Credential | M.D. |
| Practice Address |
1717 Las Vegas St Modesto CA 95358-5500 |
| Mailing Address |
737 W Childs Ave Merced CA 95341-6805 |
| Practice Telephone | 2095764200 |
| Practice Fax Number | 2095565064 |
| Mailing Telephone | 2093831848 |
| Mailing Fax Number | 2093831296 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2011-12-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A114425 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1717 LAS VEGAS ST |
| City | MODESTO |
| State | CA |
| Zip Code | 95358-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942283148 | Alfonso Hernandez | Marriage & Family Therapist | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2005-11-22 |
| 1932741139 | Virginia Inthavong | Nurse Practitioner | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2019-10-09 |
| 1245748805 | Yoojin Suh | Nurse Practitioner | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2018-01-17 |
| 1134570864 | Ravindar Kaur | Nurse Practitioner | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2016-06-23 |
| 1942612742 | Rozita Akhbari | Pediatrics | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2014-05-28 |
| 1578814216 | Gabriela Teresita Rodriguez | Social Worker | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2012-09-20 |
| 1023255841 | Mechelle Renee Perea-ryan | Registered Nurse | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2009-01-15 |
| 1033322870 | Golden Valley Health Centers | Social Worker | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2007-05-08 |
| 1942413786 | Golden Valley Health Centers | Family Medicine | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2007-05-08 |
| 1851504690 | Golden Valley Health Centers | Family Medicine | 1717 Las Vegas St, Modesto, CA 95358-5500 | 2007-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902321805 | Cecilia Yolanda Guajardo | Counselor | 2524 Finney Road, Ceres, CA 95358 | 2017-08-11 |
| 1205203049 | Olga Olivia Castillo | Case Manager/Care Coordinator | 1620 Cummings Rd, Modesto, CA 95358 | 2015-08-27 |
| 1174942270 | Rajneel Singh | Case Manager/Care Coordinator | 1524 Radcliffe Ave, Modesto, CA 95358 | 2014-04-16 |
| 1447486139 | Karl David Meabrod | Counselor | 190 E. Hackett Rd., Modesto, CA 95358 | 2009-06-08 |
| 1265634281 | County of Stanislaus | Community/Behavioral Health | 190 Hackett Road, Modesto, CA 95358 | 2007-06-01 |
| 1134250400 | Shelley Marie Southern | Marriage & Family Therapist | 1620 Cummins Drive, Modesto, CA 95358 | 2007-03-08 |
| 1538297973 | County of Stanislaus | Community/Behavioral Health | 251 East Hackett Road, Modesto, CA 95358 | 2007-02-28 |
| 1407347248 | Jamie Lauren Mcgillis | Counselor | 1620 Cummins Dr, Modesto, CA 95358 | 2018-05-29 |
| 1508250135 | Michelle Eldridge | Case Manager/Care Coordinator | 1620 Cummins Drive, Modesto, CA 95358 | 2015-03-20 |
| 1083747604 | Juan Carlos Teran Jr. | Case Manager/Care Coordinator | 1620 Cummins Dr, Modesto, CA 95358 | 2007-03-13 |
| Find all providers in zip 95358 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1104393362 | Binh T Dang Md Inc | Family Medicine | 2209 Coffee Rd Ste I, Modesto, CA 95355-2360 | 2018-10-25 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1164957486 | Progressive Urgent Care Inc | Family Medicine | 801 17th St, Modesto, CA 95354-1243 | 2017-04-24 |
| 1881039873 | Sabrina Arora-thissen | Family Medicine | 401 Paradise Rd. Ste, Modesto, CA 95351 | 2013-05-03 |
| 1467725473 | James L Stanton, Md Inc | Family Medicine | 200 B1 West Roseburg Avenue, Modesto, CA 95350 | 2012-02-22 |
| 1154698447 | Shashi .t Sood M.d., Inc | Family Medicine | 1401 Spanos Ct Ste 110, Modesto, CA 95355-2812 | 2011-11-30 |
| 1639408362 | Charlie Walker | Family Medicine | 1320 Celeste Drive, Modesto, CA 95355 | 2009-12-08 |
| 1871783142 | Jose Limon M.d. Inc. | Family Medicine | 1809 Bumgardner Ct, Modesto, CA 95355-9295 | 2007-08-01 |
| 1437375094 | Christianne Bishop | Family Medicine | 600 Coffee Road, Sutter Gould Medical Foundation, Modesto, CA 95355 | 2007-04-18 |
| Find all providers in MODESTO | ||||
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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.