KELLY LAUREN PLATT (NPI# 1811551096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811551096 |
| Entity Type | Individual |
| Full Name | KELLY LAUREN PLATT |
| Credential | PA-C |
| Practice Address |
2920 Sonoma Blvd Ste C Vallejo CA 94590-3879 |
| Mailing Address |
801 Southampton Rd Apt 30 Benicia CA 94510-1916 |
| Practice Telephone | 7076430400 |
| Mailing Telephone | 5033482210 |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2020-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA56940 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PA LICENSE | PA56940 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689834590 | Kelly Jo Platt | Licensed Practical Nurse | 6216 Country Ln, Homer, NY 13077-9328 | 2008-06-13 |
| Street Address |
2920 SONOMA BLVD STE C |
| City | VALLEJO |
| State | CA |
| Zip Code | 94590-3879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982774345 | Jason Luu | Chiropractor | 2920 Sonoma Blvd Ste C, Vallejo, CA 94590-3879 | 2006-11-09 |
| 1578774253 | Luu Medical Group | Chiropractor | 2920 Sonoma Blvd Ste C, Vallejo, CA 94590-3879 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265051445 | Jaspreet Bains | Licensed Vocational Nurse | 508 Alabama Street, Vallejo, CA 94590 | 2020-04-08 |
| 1467097527 | Deneane Hannon | Behavioral Analyst | 238 Georgia St. Ste 102, Vallejo, CA 94590 | 2019-11-13 |
| 1780243196 | Abla Harara Almoraissi | Health Educator | John F. Kennedy Library, 505 Santa Clara St, Vallejo, CA 94590 | 2019-06-10 |
| 1891264461 | Brian Emory Kellogg | Marriage & Family Therapist | 525 Oregon St., Php/iop, Vallejo, CA 94590 | 2018-11-13 |
| 1952801862 | Carica Theresa Saraza Macariola | Specialist/Technologist | 1007 Solano Avenue, Vallejo, CA 94590 | 2018-02-16 |
| 1770007973 | Deborah A Johnson-white | Licensed Vocational Nurse | 908 Tuolumne, Vallejo, CA 94590 | 2017-07-29 |
| 1306378260 | Edgar Diaz | Counselor | 236 Georgia Street Suite 101, Vallejo, CA 94590 | 2017-03-30 |
| 1528440096 | Soren Perry | Counselor | 236 Georgia St., Vallejo, CA 94590 | 2015-06-22 |
| 1518366327 | Kimberly A Holland | Counselor | 631 Tennessee Street Suite 201, Vallejo, CA 94590 | 2014-08-18 |
| 1841605193 | Lawana Lofton | Psychologist | 88 Valle Vista Drive, Unit 6310, Vallejo, CA 94590 | 2014-06-25 |
| Find all providers in zip 94590 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467803965 | Megan Leigh Mccaleb | Physician Assistant | 107 Kentucky St, Vallejo, CA 94590-5035 | 2016-06-26 |
| 1104854728 | Mervyn Bertrand Nicholas | Physician Assistant | 5505 Bordeaux Ct, Vallejo, CA 94591-6308 | 2006-06-30 |
| 1184248650 | Hayden Leslie | Physician Assistant | 1310 Club Dr, Vallejo, CA 94592-1187 | 2020-06-01 |
| 1922648393 | Brittany Jordan Dingler | Physician Assistant | 100 Hospital Dr Ste 110, Vallejo, CA 94589-2577 | 2020-01-13 |
| 1285996611 | Joy Amanda Dugan | Physician Assistant | 365 Tuolumne St, Vallejo, CA 94590-5700 | 2012-06-12 |
| 1922105584 | Sally Kim Wong | Physician Assistant | 975 Sereno Drive, Vallejo, CA 94589 | 2006-09-17 |
| 1023056983 | John Howard Alexander | Physician Assistant | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2006-06-03 |
| 1013961572 | Margaret Malig Nonato | Physician Assistant | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
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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.