MR. RHETT CHANDLER LACEY (NPI# 1760978506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760978506 |
| Entity Type | Individual |
| Full Name | MR. RHETT CHANDLER LACEY |
| Credential | PA-C |
| Practice Address |
545 Caber Dr Santa Rosa CA 95409-4404 |
| Practice Telephone | 7073286724 |
| Mailing Telephone | 7073286724 |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 092325 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
545 CABER DR |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95409-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568005205 | Angela Tejeda | Counselor | 35555 Sonoma Hwy, Santa Rosa, CA 95409 | 2019-10-25 |
| 1609335314 | Heidi Diebel | Marriage & Family Therapist | 9291 Oak Trail Cir, Santa Rosa, CA 95409 | 2019-03-13 |
| 1427525328 | Christopher William Schouest | Behavioral Analyst | 5424 Sharon St., Santa Rosa, CA 95409 | 2018-10-29 |
| 1194178756 | Ana Ceniceros | Registered Nurse | 7425 Los Guilucos Rd, Santa Rosa, CA 95409 | 2016-07-19 |
| 1669842878 | Kimberly Harris | Counselor | 7425 Los Guilicos Rd., Dept. H, Santa Rosa, CA 95409 | 2015-09-30 |
| 1568884849 | Christopher Cincotta | Counselor | 540 Middle Rincon Road, Santa Rosa, CA 95409 | 2014-01-06 |
| 1104186626 | Gina Ruth Sarpy | Marriage & Family Therapist | 7425 Los Guilicos Rd, Dept. H, Santa Rosa, CA 95409 | 2012-05-17 |
| 1467745950 | Courtney King | Family Medicine | 4702 Starbuck Ave, Santa Rosa, CA 95409 | 2011-05-17 |
| 1427351162 | Robert E Richardson Md Professional Corp. | Surgery | 1812 Happy Valley Road, Santa Rosa, CA 95409 | 2010-12-20 |
| 1497063564 | Edmundo Simon Martinez IIi IIi | Occupational Therapist | 5555 Montgomery Dr., Santa Rosa, CA 95409 | 2010-09-22 |
| Find all providers in zip 95409 | ||||
| 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 |
|---|---|---|---|---|
| 1588139091 | Jenny Quan | Physician Assistant | 2300 Mendocino Ave Ste 4, Santa Rosa, CA 95403-3115 | 2018-10-11 |
| 1417079112 | James Thomas Williams | Physician Assistant | 728 Mendocino Ave, Santa Rosa, CA 95401-4804 | 2007-04-04 |
| 1356491112 | Jaremy Lowe Kwock | Physician Assistant | 525 Doyle Park Dr Ste 102, Santa Rosa, CA 95405-4562 | 2007-01-11 |
| 1235203274 | Ann S Bruner-welch | Physician Assistant | 401 Bicentennial Way # 120, Santa Rosa, CA 95403-2149 | 2006-11-20 |
| 1770672925 | Robert Evan Crenshaw | Physician Assistant | 401 Bicentennial Way Ste 120, Santa Rosa, CA 95403-2149 | 2006-10-12 |
| 1982640298 | Amy K Jones | Physician Assistant | 1221 N Dutton Ave, Concentra Medical Group, Santa Rosa, CA 95401-4607 | 2006-06-22 |
| 1821068669 | Christine J Perkowska | Physician Assistant | 583 Summerfield Rd, Santa Rosa, CA 95405-5239 | 2006-01-24 |
| 1649265976 | Heather Noel Silva | Physician Assistant | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2005-09-13 |
| 1538167226 | Wendy A Williams | Physician Assistant | 2455 Summerfield Rd, Santa Rosa, CA 95405-7815 | 2005-07-07 |
| 1891335766 | Erin Fisher | Physician Assistant | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2020-01-08 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95409 |
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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.