CARLY JENNA O'CONNOR (NPI# 1821525270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821525270 |
| Entity Type | Individual |
| Full Name | CARLY JENNA O'CONNOR |
| Credential | PA |
| Practice Address |
9898 Genesee Ave # Amp410 La Jolla CA 92037-1205 |
| Mailing Address |
2159 Burgener Blvd San Diego CA 92110-1103 |
| Practice Telephone | 8588245383 |
| Practice Fax Number | 8589643125 |
| Mailing Telephone | (408) 515-4036 |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146L00000X | Emergency Medical Technician, Paramedic | P31438 | Emergency Medical Service Providers | |
| Y | 363A00000X | Physician Assistant | 54426 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2159 Burgener Blvd, San Diego, CA 921101103 | (408) 515-4036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326528571 | Carly Noelle O'connor | Student in an Organized Health Care Education/Training Program | 444 Center St, Manchester, CT 06040-3926 | 2018-08-17 |
| Street Address |
9898 GENESEE AVE # AMP410 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| 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 |
|---|---|---|---|---|
| 1356981807 | Stephanie Katharine Turk | Physician Assistant | 10710 N Torrey Pines Rd # Ms 213, La Jolla, CA 92037-1035 | 2020-01-13 |
| 1962043331 | Shea Shovlin | Physician Assistant | 9898 Genesee Ave # Amp130, La Jolla, CA 92037-1205 | 2019-10-07 |
| 1265960256 | Audrey Elizabeth Zanzucchi | Physician Assistant | 6830 Paseo Laredo, La Jolla, CA 92037-6422 | 2017-06-02 |
| 1528424330 | Samantha K Estes | Physician Assistant | 9850 Genesee Ave Suite 330, La Jolla, CA 92037 | 2016-01-08 |
| 1467838425 | Victoria Christison | Physician Assistant | 10666 N Torrey Pines Rd # Ms 221, La Jolla, CA 92037-1027 | 2015-07-31 |
| 1407254071 | Jaclyn Ann Dempsey | Physician Assistant | 8910 Villa La Jolla Dr Ste 100, La Jolla, CA 92037 | 2014-12-15 |
| 1316355605 | Sarah Akiki Tebsherani | Physician Assistant | 10666 N Torrey Pines Rd # 2w, La Jolla, CA 92037 | 2014-07-30 |
| 1487744009 | Yuki K. Rosenkoetter | Physician Assistant | 10666 N Torrey Pines Rd # N203, La Jolla, CA 92037-1027 | 2006-10-13 |
| 1235122961 | Jose Luis Ruiz | Physician Assistant | 9400 Campus Point Dr, La Jolla, CA 92093 | 2005-08-29 |
| 1548867864 | Caitlin Hopkins | Physician Assistant | 9888 Genesee Ave, La Jolla, CA 92037-1205 | 2020-10-08 |
| Find all providers in LA JOLLA | ||||
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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.