ANNA JADWIGA HADILAKSONO (NPI# 1922582832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922582832 |
Entity Type | Individual |
Full Name | ANNA JADWIGA HADILAKSONO |
Credential | NP |
Practice Address |
135 Carmen Ln Santa Maria CA 93458-7729 |
Mailing Address |
128 La Colima Pismo Beach CA 93449-2841 |
Practice Telephone | 8059287361 |
Mailing Telephone | 7327543197 |
Enumeration Date | 2018-09-18 |
Last Update Date | 2018-09-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
95010045 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
135 CARMEN LN |
City | SANTA MARIA |
State | CA |
Zip Code | 93458-7729 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992799704 | Francis P Lagattuta | Physical Medicine & Rehabilitation | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2005-09-07 |
1205225174 | Matthew Hadilaksono | Physical Medicine & Rehabilitation | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2015-01-15 |
1508299942 | Leoncio Paciente Yap | Nurse Practitioner | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2013-08-20 |
1609172030 | Sam (none) Safaee | Physician Assistant | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2011-02-02 |
1659691897 | Kendra Brown-walker | Physical Medicine & Rehabilitation | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2010-06-10 |
1184958837 | Beth A Brown | Physician Assistant | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2009-09-29 |
1982846770 | Jody Michelle Jensen | Physician Assistant | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2009-03-25 |
1851550404 | Winston F Montero | Physical Medicine & Rehabilitation | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2008-06-08 |
1669640827 | Leah Ann Clarke | Physician Assistant | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2008-02-11 |
1346376183 | Julie Leanore Bruns | Physical Therapist | 135 Carmen Ln, Santa Maria, CA 93458-7729 | 2007-02-26 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790206761 | Recovery Point Acute Care | Family Medicine | 104b W Morrison Ave, Santa Maria, CA 93458 | 2017-06-29 |
1669912986 | Terry Jauregui | Behavior Technician | 1908 Vallet Vista, Santa Maria, CA 93458 | 2017-03-06 |
1770960692 | Anka Behavioral Health Incorporated | Community Based Residential Treatment Facility, Mental Illness | 212 West Carmen Lane, Santa Maria, CA 93458 | 2015-04-29 |
1447663299 | Dan Reynolds | Case Manager/Care Coordinator | 117 W. Tunnel Street, Santa Maria, CA 93458 | 2014-06-10 |
1043640824 | Good Samaritan Shelter | Counselor | 403 W Morrison Ave, Santa Maria, CA 93458 | 2013-11-15 |
1114281003 | Angelica Guadalupe Enriquez | Counselor | 1908 N. Western Ave, Santa Maria, CA 93458 | 2012-06-26 |
1225307036 | Krista Nicole Delia | Counselor | 2443 Ebony St., Santa Maria, CA 93458 | 2011-12-22 |
1528374774 | Jeff Robert Jeffery | Counselor | 117 S. Benwiley Avenue, Santa Maria, CA 93458 | 2010-08-25 |
1528295367 | Dena Marshelle Reed | Counselor | 401-b W. Morrison Ave., Santa Maria, CA 93458 | 2009-06-19 |
1114177326 | Suzanne Brooke Vierling | Counselor | 7321 S. Lincoln, Santa Maria, CA 93458 | 2008-09-24 |
Find all providers in zip 93458 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417009671 | Connie J Galvez | Nurse Practitioner | 116 S Palisade Dr, Suite 104, Santa Maria, CA 93454-8904 | 2007-01-17 |
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1245849645 | Shannon Pereira | Nurse Practitioner | 2368 Honeysuckle Way, Hemet, CA 92545-4796 | 2020-07-31 |
Find all providers with the same taxonomy |
City | SANTA MARIA |
Zip Code | 93458 |
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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.