NICOLE LYNN IWAN (NPI# 1982210092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982210092 |
| Entity Type | Individual |
| Full Name | NICOLE LYNN IWAN |
| Practice Address |
3491 Kurtz St Ste 150 San Diego CA 92110-4430 |
| Practice Telephone | 6193202404 |
| Mailing Telephone | 6193202404 |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2020-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
3491 KURTZ ST STE 150 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92110-4430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932699659 | Reem Aranki | Counselor | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2018-05-17 |
| 1578176103 | Jade Marie Walker | Student in an Organized Health Care Education/Training Program | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-08-24 |
| 1447869532 | Michelle Leeann Ojeda | Case Manager/Care Coordinator | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-07-24 |
| 1083247779 | Fernando Ebeo Serrano Jr. | Nurse Practitioner | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-02-20 |
| 1134779705 | Telecare Corporation | Clinic/Center | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2019-09-16 |
| 1528618196 | Telecare Corporation | Clinic/Center | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2019-09-16 |
| 1982252441 | Telecare Corporation | Clinic/Center | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2019-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
| 1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
| 1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
| 1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
| 1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
| 1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
| 1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
| 1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
| Find all providers in zip 92110 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
| 1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
| 1487298840 | Garrett Ives | Peer Specialist | 2909 Keats St Apt 7, San Diego, CA 92106-2345 | 2019-10-29 |
| 1144882622 | Melissa Ratsamy | Peer Specialist | 286 Euclid Ave Project Enable, #102, San Diego, CA 92114 | 2019-07-03 |
| 1699258459 | Talya Donahue | Peer Specialist | 1045 Ninth Ave, San Diego, CA 92101 | 2018-09-07 |
| 1811434467 | Deborah Sue Lynn | Peer Specialist | 140 W. Arbor Dr., Ucsd Gifford Outpatient Clinic, San Diego, CA 92103-2421 | 2017-01-20 |
| 1023463163 | Miguel Pablo Surposa | Peer Specialist | 5711 Bolivar St, San Diego, CA 92139-1617 | 2016-04-26 |
| 1376140590 | Leon Samuel Mancilla | Peer Specialist | 5555 Reservoir Dr, San Diego, CA 92120-5134 | 2020-10-01 |
| 1962014001 | Paulina Alvarado | Peer Specialist | 6160 Mission Gorge Rd, San Diego, CA 92120-3410 | 2020-08-19 |
| 1194333773 | Paulina Vazquez | Peer Specialist | 4283 El Cajon Blvd Ste 115, San Diego, CA 92105-1289 | 2020-07-20 |
| Find all providers in SAN DIEGO | ||||
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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.