ANNA JADWIGA HADILAKSONO


Address: 135 Carmen Ln, Santa Maria, CA 93458-7729
Phone: 8059287361

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 135 CARMEN LN
City SANTA MARIA
State CA
Zip Code 93458-7729

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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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1487266292 Mollie Shira Hudson Nurse Practitioner 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 2020-08-21
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Competitor

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City SANTA MARIA
Zip Code 93458

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Dataset Information

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.

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