JACQUELINE RENEE COGHILL


Address: Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501
Phone: 7072699590

JACQUELINE RENEE COGHILL (NPI# 1740831767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740831767
Entity Type Individual
Full Name JACQUELINE RENEE COGHILL
Practice Address Waterfront Recovery Services
2413 2nd St
Eureka
CA 95501
Mailing Address 3126 J St
Eureka
CA 95503-5416
Practice Telephone 7072699590
Practice Fax Number 7074452599
Mailing Telephone 7075996736
Enumeration Date 2019-09-20
Last Update Date 2019-09-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
95012163 CA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA MEDICAL DOCTOR 1417307125 01

Office Location

Street Address WATERFRONT RECOVERY SERVICES
2413 2ND ST
City EUREKA
State CA
Zip Code 95501

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538795919 Eric Meyer Goldsmith Physical Therapist 2306 Dean Street, Eureka, CA 95501 2020-03-18
1609406404 Humboldt County Behavioral Health Community/Behavioral Health 638 W Clark St., Bldg. E, Eureka, CA 95501 2020-01-21
1982177275 Jenny Bugnacki Case Manager/Care Coordinator 721 Wood St, Eureka, CA 95501 2019-01-09
1073023107 Humboldt Recovery Center Inc. Substance Abuse Rehabilitation Facility 1303 11th St, Eureka, CA 95501 2017-10-03
1730698283 Gabriel Holtski Naturopath 1632 Broadway, Suite #252, Eureka, CA 95501 2017-09-27
1164951851 Redwood Community Services, Inc. Foster Care Agency 2426 6th St, Eureka, CA 95501 2017-06-07
1033651922 Narum Clinical Services Social Worker 930 3rd St, Suite 201, Eureka, CA 95501 2016-11-09
1750839510 Sierra Marie Evers-hellmich Physical Medicine & Rehabilitation 2103 Myrtle Avenue, Eureka, CA 95501 2016-09-21
1558720623 Jennifer Vu Behavioral Analyst 730 7th St Ste A, Eureka, CA 95501 2016-02-18
1205233186 Katie Woerner Counselor 427 F St Ste 229, Eureka, CA 95501 2014-11-20
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447817184 Marresa Chinwe Ozokwere Nurse Practitioner 2200 Tydd St, Eureka, CA 95501-1284 2019-05-28
1144728924 Iver Lien Nurse Practitioner 826 4th St, Eureka, CA 95501-0516 2018-01-26
1417129222 Mary Ann Meyers Nurse Practitioner 2350 Buhne St, A, Eureka, CA 95501-3238 2008-04-01
1629266382 Carla A Hilton Nurse Practitioner 1602 N Elm St, Eureka, KS 67045-1090 2007-10-09

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NPI Name Taxonomy Address Enumeration
1235738782 Peninsula Healthcare Center Nurse Practitioner 22330 Hawthorne Blvd Ste 208, Torrance, CA 90505-2536 2020-10-25
1710584008 Venessa Beck Nurse Practitioner 903 Cardiff St, San Diego, CA 92114-5019 2020-10-08
1053918094 Janel Nicole Sanglerat Nurse Practitioner 416 Aviation Blvd, Santa Rosa, CA 95403-1032 2020-10-02
1790382760 Christopher Tran Nurse Practitioner 11441 Heacock St Ste F, Moreno Valley, CA 92557-7907 2020-10-02
1487266292 Mollie Shira Hudson Nurse Practitioner 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 2020-08-21
1962014381 Mario Javier Herrera Nurse Practitioner 2130 High Pointe Dr, Apt 108, Corona, CA 92879 2020-08-18
1952912131 Norman Ivan Kier Nurse Practitioner 3834 Edison Ave, Sacramento, CA 95821-2728 2020-08-12
1942811377 Thanhan Mathews Nurse Practitioner 114 W Cameron St Apt B, Hanford, CA 93230-2965 2020-08-10
1972113355 Marine Mary Kademyan Nurse Practitioner 6528 Babcock Ave, North Hollywood, CA 91606 2020-07-31
1245849645 Shannon Pereira Nurse Practitioner 2368 Honeysuckle Way, Hemet, CA 92545-4796 2020-07-31
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Competitor

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City EUREKA
Zip Code 95501

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Dataset Information

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.

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