JACQUELINE GENTRY (NPI# 1780215335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780215335 |
| Entity Type | Individual |
| Full Name | JACQUELINE GENTRY |
| Practice Address |
11776 Mariposa Rd Hesperia CA 92345-1622 |
| Mailing Address |
16065 Andover Dr Victorville CA 92394-1432 |
| Practice Telephone | 7609567542 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750709192 | Jacqueline Carol Gentry | Family Medicine | 1720 Gunbarrel Road, Suite 206, Chattanooga, TN 37421 | 2014-04-02 |
| Street Address |
11776 MARIPOSA RD |
| City | HESPERIA |
| State | CA |
| Zip Code | 92345-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740346386 | Aegis Treatment Centers, LLC | Clinic/Center | 11776 Mariposa Rd, Suite 101, 103, & 104, Hesperia, CA 92345-1622 | 2006-12-28 |
| 1073114658 | Edward Allen Palmer | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2020-11-02 |
| 1790302859 | Briel La Nae Garcia Cupp | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2020-07-06 |
| 1740820083 | Taya Berry | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2020-01-15 |
| 1225691132 | Angela Renee Welsh | Licensed Vocational Nurse | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2019-04-16 |
| 1902469992 | Karen Elizabeth Gavidia | Licensed Vocational Nurse | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2019-04-16 |
| 1679036354 | Janet Vanessa Gomez | Licensed Vocational Nurse | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2019-04-10 |
| 1124595053 | Abigail Reyes | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2018-10-29 |
| 1467948869 | Alphonso Lancelot Spears IIi | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2018-07-09 |
| 1861995532 | Angelica Godinez | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345 | 2018-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881467 | Leslie Guzman | Behavioral Analyst | 6700 Newhall Ave, Hesperia, CA 92345 | 2020-08-14 |
| 1134769896 | Nu Wave Medical Group Inc | Family Medicine | 9390 Hesperia Rd Suite 7, Hesperia, CA 92345 | 2020-01-10 |
| 1760901383 | Lindsey Kathleen Dunnagan | Counselor | 16501 Walnut Street, Suite 12, Hesperia, CA 92345 | 2017-09-14 |
| 1356869374 | Deborah Irene Freeman | Nurse Practitioner | 15398 Main Street Suite A, Hesperia, CA 92345 | 2017-08-30 |
| 1902260151 | Serge Bronstein | Counselor | 16808 Main St., D-154, Hesperia, CA 92345 | 2016-04-13 |
| 1366815805 | Caremore Health Plan | Nurse Practitioner | 17085 Main Street, Hesperia, CA 92345 | 2015-11-05 |
| 1174928402 | Jennifer Cathrin Bayle | Counselor | 17130 Sequoia St, Suite 106, Hesperia, CA 92345 | 2014-10-29 |
| 1447654256 | Diana Grace Chilstrom | Marriage & Family Therapist | 11776 Mariposa Road, Hesperia, CA 92345 | 2014-10-22 |
| 1639597545 | Adrianna Ebony Williams | Physical Therapy Assistant | 8939 11th Ave, Hesperia, CA 92345 | 2014-03-29 |
| 1477974426 | Aja Stoll | Case Manager/Care Coordinator | 9655 Ninth Ave, Hesperia, CA 92345 | 2013-12-18 |
| Find all providers in zip 92345 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851925788 | Kevin Buchanan | Counselor | 16621 Mesa St, Hesperia, CA 92345-2138 | 2020-03-01 |
| 1104310424 | Richard J Morrell | Counselor | 11776 Mariposa Rd Ste 101, Hesperia, CA 92345-1622 | 2018-06-20 |
| 1104274422 | Ian Seabolt | Counselor | 7939 Oxford Ave, Hesperia, CA 92345-7037 | 2016-05-26 |
| 1407118110 | Tarence R Mann | Counselor | 11776 Mariposa Rd # 103, Hesperia, CA 92345-1622 | 2012-06-10 |
| 1184886756 | Randall Leo Burden | Counselor | 10662 Maple Ave, Hesperia, CA 92345-2436 | 2008-06-25 |
| 1962554634 | Norman Lani Roberts | Counselor | 11959 Mariposa Rd, Hesperia, CA 92345-1637 | 2007-01-16 |
| 1740331776 | Sabrina Marie Vigil | Counselor | 11959 Mariposa Rd., Hesperia, CA 92345 | 2007-01-16 |
| 1073114658 | Edward Allen Palmer | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2020-11-02 |
| 1790302859 | Briel La Nae Garcia Cupp | Counselor | 11776 Mariposa Rd, Hesperia, CA 92345-1622 | 2020-07-06 |
| 1932723442 | Marissa Lynn Paz | Counselor | 11776 Mariposa Rd # 103, Hesperia, CA 92345-1622 | 2020-05-31 |
| Find all providers in HESPERIA | ||||
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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.