MR. JUAN CASILLAS JR. (NPI# 1003165135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003165135 |
| Entity Type | Individual |
| Full Name | MR. JUAN CASILLAS JR. |
| Credential | NP |
| Practice Address |
222 W 39th Ave San Mateo CA 94403-4364 |
| Practice Telephone | 6505732669 |
| Practice Fax Number | 6505732214 |
| Mailing Telephone | 6505732669 |
| Mailing Fax Number | 6505732214 |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2014-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 593398 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
22074 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL PROVIDER | 1679642326 | 01 |
| Street Address |
222 W 39TH AVE |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94403-4364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683789 | Diana V Jao | Internal Medicine | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2005-07-20 |
| 1306465125 | Rennie Burke | Student in an Organized Health Care Education/Training Program | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-04-11 |
| 1447887856 | Michelle Wong | Physical Therapist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-03-25 |
| 1508406398 | Alexandria Vanessa Perez | Counselor | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-01-09 |
| 1275197899 | Connie Chen | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2019-04-29 |
| 1063075596 | Jiaochen Ke | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2019-04-19 |
| 1952877524 | Asmi Mehta | Physical Therapist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-10-22 |
| 1649753427 | Ariane Beck | Emergency Medicine | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-09-08 |
| 1114408176 | Matthew Tyler Sachs | Registered Nurse | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-08-27 |
| 1679066047 | Niloofar Zabihi | Pharmacist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520903 | Happy Enerqi LLC | Acupuncturist | 5 43rd Ave, San Mateo, CA 94403 | 2019-10-21 |
| 1740840396 | Vincent Wing Ching Fong | Marriage & Family Therapist | 2600 S. El Camino Real Suite 200, San Mateo, CA 94403 | 2019-06-17 |
| 1861056426 | Denise Gaytan | Licensed Vocational Nurse | 2600 El Camino, San Mateo, CA 94403 | 2019-04-29 |
| 1134686991 | Connie Markoff | Counselor | 3827 Fernwood St, San Mateo, CA 94403 | 2019-02-27 |
| 1467965392 | Happyqi Inc | Acupuncturist | 5 43rd Ave., San Mateo, CA 94403 | 2017-11-14 |
| 1710403092 | John Luu | Chiropractor | 3153 Campus Dr, San Mateo, CA 94403 | 2017-08-17 |
| 1477009033 | Latifunisa Lilani | Community Health Worker | 2600 El Camino Real, San Mateo, CA 94403 | 2016-09-01 |
| 1881029874 | Juan Carlos Friesen | Licensed Vocational Nurse | 2600 S. El Camino, Suite #200, San Mateo, CA 94403 | 2013-09-09 |
| 1619300423 | Emily Rodda | Nurse Practitioner | 222 W. 39th Avenue, San Mateo Medical Center - Pediatric Clinic, San Mateo, CA 94403 | 2013-08-15 |
| 1619309549 | Maria Lucila Echeverria-bustios | Counselor | 1911 Ivy St., San Mateo, CA 94403 | 2013-08-02 |
| Find all providers in zip 94403 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851936892 | Zahiyah Hasan | Nurse Practitioner | 1518 Cobb St, San Mateo, CA 94401-3622 | 2019-11-13 |
| 1639692445 | Amy Fong | Nurse Practitioner | 117 N San Mateo Dr Ste 1, San Mateo, CA 94401-2708 | 2017-07-24 |
| 1164896411 | Jennifer Morales | Nurse Practitioner | 411 Borel Ave Ste 100, San Mateo, CA 94402-3516 | 2015-11-24 |
| 1124495247 | Michele Cronin | Nurse Practitioner | 1670 S Amphlett Blvd Ste 300, San Mateo, CA 94402-2534 | 2015-08-24 |
| 1013231422 | Marty Gail Rosier | Nurse Practitioner | 2000 Alameda De Las Pulgas Ste 210, San Mateo, CA 94403-1293 | 2010-03-15 |
| 1871661207 | Allison Virginia Bunch | Nurse Practitioner | 50 S San Mateo Dr Ste 360, San Mateo, CA 94401 | 2006-12-01 |
| 1942833066 | Heather Paul | Nurse Practitioner | 66 Bovet Rd Ste 105, San Mateo, CA 94402-3126 | 2020-02-17 |
| 1609416593 | Rachel Brinitzer | Nurse Practitioner | 1900 Ofarrell St Ste 190, San Mateo, CA 94403-1372 | 2020-01-08 |
| 1518507409 | Joseph Krezanoski | Nurse Practitioner | 1900 Ofarrell St Ste 190, San Mateo, CA 94403-1372 | 2020-01-08 |
| 1417509167 | Alison L. Sloan | Nurse Practitioner | 101 S San Mateo Dr Ste 311, San Mateo, CA 94401-3844 | 2019-07-12 |
| Find all providers in SAN MATEO | ||||
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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.