LOMA LINDA UNIVERSITY MEDICAL CENTER (NPI# 1912033846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912033846 |
| Entity Type | Organization |
| Organization Name | LOMA LINDA UNIVERSITY MEDICAL CENTER |
| Practice Address |
11234 Anderson St Loma Linda CA 92354-2804 |
| Mailing Address |
25123 Daisy Ave Loma Linda CA 92354-3510 |
| Practice Telephone | 9095588514 |
| Mailing Telephone | 9092660962 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MARY JO VOLLMER-SANDHOLM (PEDIATRIC NURSE PRACTITIONER) |
| Authorized Official Telephone | 9095588514 |
| Authorized Official Credential | MSN, RN, CPNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
533452 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831414432 | Loma Linda University Medical Center | Exclusive Provider Organization | 11234 Anderson St Gme Office Cp 21005, Loma Linda, CA 92350-0001 | 2010-04-07 |
| 1568630622 | Loma Linda University Medical Center | General Acute Care Hospital | 8265 E Blackwillow Cir, Apt. 112, Anaheim, CA 92808-1958 | 2008-02-12 |
| 1285837468 | Loma Linda University Medical Center | General Acute Care Hospital | 11750 Mount Vernon Ave # N251, Grand Terrace, CA 92313-8202 | 2007-06-06 |
| 1215140389 | Loma Linda University Medical Center | General Acute Care Hospital | 26630 Barton Rd Apt 113, Redlands, CA 92373-4324 | 2007-05-07 |
| 1700298437 | Loma Linda University Medical Center | General Acute Care Hospital | 11175 Campus St, Loma Linda, CA 92350-1700 | 2014-05-29 |
| 1295903268 | Loma Linda University Medical Center | General Acute Care Hospital | 11234 Anderson St, Llumc House Staff Office, Loma Linda, CA 92354-2804 | 2008-02-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LOMA LINDA UNIVERSITY MEDICAL CENTER - MURRIETA | 28062 Baxter Rd, Murrieta, CA 92563-1401 |
| Street Address |
11234 ANDERSON ST |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794657 | Leigh Ann Ballou | Physician Assistant | 11234 Anderson St, Rm 2562b, Loma Linda, CA 92354-2804 | 2005-07-14 |
| 1285233759 | Daemian Alexander Martin Sr. | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-10-25 |
| 1922610450 | Samantha Zepeda Merchant | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-08-17 |
| 1609493451 | Romina Mcgalliard | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-27 |
| 1811514854 | Christopher Jihoon Kim | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-25 |
| 1912523135 | Shelly Marie Bogue | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-23 |
| 1962028613 | Sikai Song | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-18 |
| 1720604515 | Nelson Horsley | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-17 |
| 1134744055 | Teddy Matthew Mumu | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-16 |
| 1124643135 | Kristofer John Vance | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659506368 | Julie Lynn Hill | Nurse Practitioner | 11234 Anderson St Ste 6700h, Loma Linda, CA 92354-2804 | 2009-05-26 |
| 1659575157 | Mary Joanne Vollmer-sandholm | Nurse Practitioner | Loma Linda University School of Nursing, 11262 Campus St., Loma Linda, CA 92350-0001 | 2007-06-11 |
| 1871005884 | Katie Michelle Thompson | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2017-10-31 |
| 1588180236 | Brianna Nicole Stewart | Nurse Practitioner | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2017-08-15 |
| 1619419066 | Diana Can | Nurse Practitioner | 11370 Anderson St, Suite 2050, Loma Linda, CA 92354-3450 | 2016-11-15 |
| 1578986840 | Dorothy Dokko | Nurse Practitioner | 11234 Anderson St Rm 6700h, Loma Linda, CA 92354-2804 | 2014-01-22 |
| 1932412525 | Tracey S. Pae | Nurse Practitioner | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2010-07-23 |
| 1821324765 | Samantha Jo Johnson | Nurse Practitioner | 11370 Anderson St, Suite 2050, Loma Linda, CA 92354-3450 | 2009-10-28 |
| 1538321500 | Cynthia Jeanne Guerra | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354 | 2008-06-30 |
| 1891992137 | Erin Leslie Moorcones | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2007-06-29 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
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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.