CAPITOLA PEDIATRICS (NPI# 1811012545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811012545 |
| Entity Type | Organization |
| Organization Name | CAPITOLA PEDIATRICS |
| Other Organization Name | CAPITOLA PEDIATRICS |
| Practice Address |
4145 Clares Street Suite A Capitola CA 95010 |
| Practice Telephone | 8314761933 |
| Practice Fax Number | 8314762677 |
| Mailing Telephone | 8314761933 |
| Mailing Fax Number | 8314762677 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2014-08-04 |
| Authorized Official Name | DR. ELIZABETH BASKERVILLE (OWNER/PEDIATRICIAN) |
| Authorized Official Telephone | 8314751883 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD ID#-CAP OFFIC | ZZZ08020Z | 01 |
| CA | GR0099151 | 05 |
| Other Name | Type Code |
|---|---|
| Capitola Pediatrics | Doing Business As Name - Organization |
| Street Address |
4145 CLARES STREET SUITE A |
| City | CAPITOLA |
| State | CA |
| Zip Code | 95010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609436641 | Suzanne Lerner | Psychologist | 720a Capitola Ave, Capitola, CA 95010 | 2019-06-20 |
| 1801351317 | Michael Stephen Quinn | Chiropractor | 720 A- Capitola Ave, Capitola, CA 95010 | 2019-02-08 |
| 1053885194 | Health In Mind P.C. | Psychiatry & Neurology | 610 Capitola Ave, Capitola, CA 95010 | 2019-01-11 |
| 1427547355 | Jerry Wallace Fulford | Massage Therapist | 4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010 | 2018-05-07 |
| 1457730293 | Cpap Experts LLC | Durable Medical Equipment & Medical Supplies | 820 Bay Ave #203a, Capitola, CA 95010 | 2015-05-26 |
| 1972904241 | Molly Chaudoir | Acupuncturist | 4170 Gross Rd. Ext., Suite 6, Santa Cruz, CA 95010 | 2014-09-05 |
| 1245598374 | Stan C Wolken | Dentist | 4770 Capitola Rd, Capitola, CA 95010 | 2012-04-26 |
| 1104103399 | Jacinda Ann Maurer | Registered Nurse | 4725 Grace Street, Apt. 1, Capitola, CA 95010 | 2011-11-16 |
| 1508043225 | Brian J. Schabel, Dds, Ms & Vivian H. Chan, Dds, Ms, Inc. | Dentist | 1830 41st Ave., Capitola, CA 95010 | 2008-01-24 |
| 1609066679 | Sandra Polakoff | Marriage & Family Therapist | 519 Capitola Avenue, Suite B, Capitola, CA 95010 | 2007-07-26 |
| Find all providers in zip 95010 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447390752 | Kent Thompson | Pediatrics | 1820 41st Ave. Ste D, Capitola, CA 95065 | 2007-02-07 |
| 1598850174 | Leigh Alison Mueller | Pediatrics | 4145 Clares St, Suite A, Capitola, CA 95010-2053 | 2006-10-03 |
| 1679560197 | Carla Collins Gorum | Pediatrics | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2005-09-29 |
| 1558366021 | Hong-nhung Tran | Pediatrics | 1820 41st Ave Ste D, Capitola, CA 95010-2516 | 2005-06-20 |
| 1588026082 | Sara Saman Faheem | Pediatrics | 1820 41st Ave Ste D, Capitola, CA 95010-2516 | 2016-03-23 |
| 1457738965 | Stephanie Melton Graziani | Pediatrics | 1820 41st Ave Ste D, Capitola, CA 95010 | 2015-05-05 |
| 1669811733 | Komal Afzal | Pediatrics | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2013-06-21 |
| 1134406135 | Shailinder Jeet Singh | Pediatrics | 1820 41st Ave, # 640, Capitola, CA 95010-2516 | 2011-11-04 |
| 1861796989 | Jedediah Larsen Wheeler | Pediatrics | 1820 41st Ave Ste D, Capitola, CA 95010-2516 | 2011-01-04 |
| 1669798229 | Edward H Lipson | Pediatrics | 4145 Clares St, Suite A, Capitola, CA 95010-2053 | 2010-04-07 |
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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.