MR. JESSE INGRAM JR. (NPI# 1851512560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851512560 |
| Entity Type | Individual |
| Full Name | MR. JESSE INGRAM JR. |
| Credential | PA-C |
| Practice Address |
9985 Sierra Ave Fontana CA 92335-6720 |
| Mailing Address |
1033 La Marillo Cir Corona CA 92879-8234 |
| Practice Telephone | 9094275525 |
| Practice Fax Number | 9094277602 |
| Mailing Telephone | 9094275525 |
| Mailing Fax Number | 9094277602 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA13419 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669987996 | Jesse Howard Ingram | Occupational Therapist | 625 Walnut St, Mckeesport, PA 15132-2806 | 2017-12-08 |
| 1407837024 | Jesse C Ingram | Psychologist | 5201 S Westmoreland Rd, Dallas, TX 75237-1622 | 2005-11-10 |
| Street Address |
9985 SIERRA AVE |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-6720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144212929 | Nathan David Carlson | Family Medicine | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2005-08-18 |
| 1467060723 | Carly Turner Constance Kloack | Speech-Language Pathologist | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2020-07-22 |
| 1518406669 | Eugene Corcoran | Pharmacist | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2017-02-21 |
| 1689113029 | Tiffany Pattynama | Pharmacist | 9985 Sierra Ave, Link Pharmacy 2 Floor, Fontana, CA 92335-6720 | 2017-02-17 |
| 1134668692 | Li Ming Fong | Pharmacist | 9985 Sierra Ave, Mob1, 3rd Flr, Ob/gyn Pharmacy, Fontana, CA 92335-6720 | 2017-02-16 |
| 1275072738 | Jayshree Patel | Pharmacist | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2017-02-16 |
| 1578002127 | Lianne Garcia-mao | Pharmacist | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2017-02-15 |
| 1154860880 | Dean Pak | Pharmacist | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2017-02-14 |
| 1659728368 | Victoria Lowe | Physician Assistant | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2016-05-23 |
| 1518321157 | Brian Patterson | Student in an Organized Health Care Education/Training Program | 9985 Sierra Ave, Mob 3, Floor 3, Attn: Carol Farrell, Fontana, CA 92335-6720 | 2016-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356548069 | Lisa Bodzio | Physician Assistant | 9985 Sierra Ave, Fontana, CA 92335-6720 | 2007-06-27 |
| 1760594733 | Carlette Spengler Kolesnik | Physician Assistant | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
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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.