TRACEY S. PAE (NPI# 1932412525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932412525 |
| Entity Type | Individual |
| Full Name | TRACEY S. PAE |
| Credential | C.P.N.P. |
| Practice Address |
11370 Anderson St Ste 2100 Loma Linda CA 92354-3450 |
| Mailing Address |
File # 54701 Los Angeles CA 90074-4701 |
| Practice Telephone | 9095582822 |
| Mailing Telephone | 9095583111 |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2010-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
NP 19497 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11370 ANDERSON ST STE 2100 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821084070 | Gregory Elton Saunders | Surgery | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2005-09-23 |
| 1164088787 | Andrea Kottlowski | Audiologist | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2019-05-20 |
| 1881161511 | Garrett Newman | Nurse Practitioner | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2018-10-31 |
| 1902355589 | Fabrizio Luca | Surgery | 11370 Anderson St Ste 2100, Loma Linda, CA 92354 | 2016-09-23 |
| 1346642840 | Ashley Page | Audiologist | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2014-09-16 |
| 1235546847 | Amanda Nicole Lane | Audiologist | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2014-07-15 |
| 1144667023 | Whitney Alyssa Mast | Audiologist | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2013-05-31 |
| 1316174733 | Baishakhi Choudhury | Otolaryngology | 11370 Anderson St Ste 2100, Loma Linda, CA 92354 | 2009-06-11 |
| 1194950196 | Aarthy Kannappan | Surgery | 11370 Anderson St Ste 2100, Loma Linda, CA 92354-3450 | 2009-05-19 |
| 1952542169 | Faraz Ali Khan | Surgery | 11370 Anderson St Ste 2100, Loma Linda, CA 92354 | 2009-03-18 |
| 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 |
| 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 |
| 1205957412 | Barry G. Nieman | Nurse Practitioner | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2007-04-03 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on TRACEY S. PAE.
| 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.