MRS. JERRICA MARIE WILD


Address: 15301 Warren Shingle Road, Beale Afb, CA 95903
Phone: 5306344738

MRS. JERRICA MARIE WILD (NPI# 1003109844) 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) 1003109844
Entity Type Individual
Full Name MRS. JERRICA MARIE WILD
Practice Address 15301 Warren Shingle Road
Beale Afb
CA 95903
Mailing Address 15301 Warren Shingle Rd
Beale Afb
CA 95903-1907
Practice Telephone 5306344738
Mailing Telephone 5306344738
Enumeration Date 2011-05-26
Last Update Date 2011-11-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 15301 WARREN SHINGLE ROAD
City BEALE AFB
State CA
Zip Code 95903

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700984853 Kimberly D Kumer Psychiatry & Neurology 15301 Warren Shingle Road, Beale Afb, CA 95903 2006-09-20
1487799755 Dianna M. Garbett Counselor 15301 Warren Shingle Road, 9 Mdos Sgohf, Beale Afb, CA 95903-1907 2007-02-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1962575969 Linda Lee Currier Physical Therapist 9 Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903 2006-11-16
1780637124 Lillie M Mells Social Worker 9mdos/sgoh, 15301 Warren Shingle Road, Beale Afb, CA 95903 2006-05-18
1962926907 James Perman Dentist 15301 Warren Shingle Rd, Beale Afb, CA 95903 2017-08-01
1487990768 Amy Abroms Social Worker 15301 Warren Shingle Rd, Beale Afb, CA 95903 2012-12-14
1568751378 Sarah Elizabeth Avila Family Medicine 15301 Warren Shingle Rd, Beale Afb, CA 95903 2011-04-01
1396064218 Thomas Michael Skinner Family Medicine 15301 Warren Shingle Rd, Beale Afb, CA 95903 2010-05-18
1306178900 Kourtni Starkey Preventive Medicine 15301 Warren Shingle Rd, Beale Afb, CA 95903 2010-02-05
1972740728 Enrilyn Robles Thronson Pediatrics 15301 Warren Shingle Rd, Beale Afb, CA 95903 2009-01-15
1205059508 Sarah J Stringer Psychiatry & Neurology 15301 Warren Shingle Rd, Beale Afb, CA 95903 2007-04-11
1841372810 Tony Joseph Eid Pharmacist 15301 Warren Shingle Rd, Beale Afb, CA 95903 2006-10-19
Find all providers in zip 95903

Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558700104 Tadd Olin Knox Ragsdale Military Health Care Provider 3062 Troutman Dr, Beale Afb, CA 95903-2329 2013-06-17
1851634026 Stephen Michael Wheeler Military Health Care Provider 3828 Tyburn Dr, Beale Afb, CA 95903-2254 2013-04-05
1750516530 Tanisha E Harrison Military Health Care Provider 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 2009-05-21
1851526057 Michell Marian Girton Military Health Care Provider 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 2009-05-18
1396988408 Brian M Ritchie Military Health Care Provider 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 2009-04-20
1538302823 James Thomas Feldhausen Military Health Care Provider 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 2009-04-16
1699918979 Jenna Danielle Gasper Military Health Care Provider 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 2009-04-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1366051294 Ryan Allan Arriaga Military Health Care Provider 1000 Allison Dr, Vacaville, CA 95687-4975 2020-07-27
1851917165 Katelyn Renee Watson Military Health Care Provider 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 2020-06-23
1558911024 Christopher Andersen Military Health Care Provider 1000 Allison Dr Apt 183, Vacaville, CA 95687-4988 2019-09-17
1558873968 Giovanni Oddo Military Health Care Provider 25051 Mawson Dr, Laguna Hills, CA 92653-5263 2017-10-26
1730606658 Jeffrey Rodriguez Military Health Care Provider 975 Carl Cir, Edwards, CA 93523-1906 2017-08-23
1154847960 James Edward Schafer Military Health Care Provider 883 Covey Ct, Hollister, CA 95023-8906 2017-08-15
1437551702 Jonathan Saplan Military Health Care Provider 1411 Pelican Way, Suisun City, CA 94585-2330 2014-09-18
1093124398 Benjamin Ryan Foy Military Health Care Provider 2784 Hornet Way, San Diego, CA 92106-6421 2014-08-12
1598182214 Matthew Wheaton Burns Military Health Care Provider 105 Colorado St, Travis Afb, CA 94535-1255 2014-03-19
1508282658 April Summers Military Health Care Provider 2205 Farrell Ave Apt 204, Redondo Beach, CA 90278-1846 2014-03-13
Find all providers with the same taxonomy

Competitor

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City BEALE AFB
Zip Code 95903

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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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