MARY MORENO (NPI# 1033420252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033420252 |
| Entity Type | Individual |
| Full Name | MARY MORENO |
| Credential | M.D. |
| Practice Address |
1200 B Gale Wilson Blvd Fairfield CA 94533-3552 |
| Mailing Address |
2642 Harrison St Oakland CA 94612-3814 |
| Practice Telephone | 7076465000 |
| Mailing Telephone | 3233132842 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2018-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A126876 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | RT-2119 | NH | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 Alhambra Ave, Contra Costa Regional Medical Center, Martinez, CA 945533156 | 9253705110 | 9253705142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760037147 | Mary Moreno | Technician | 225 Redwood St Apt 23, San Diego, CA 92103-5668 | 2019-08-02 |
| 1013520394 | Mary Ann Moreno | Chore Provider | 1325 Airmotive Way, Reno, NV 89502-3201 | 2020-08-26 |
| 1053806992 | Mary Moreno | Technician | 1701 N Green Valley Pkwy Ste 9a, Henderson, NV 89074-5991 | 2018-06-23 |
| 1073665709 | Mary Moreno | Speech-Language Pathologist | 606 N Michigan St, Elmhurst, IL 60126-1934 | 2007-01-16 |
| 1548359946 | Mary Donovan Moreno | Psychiatry & Neurology | 1465 N 4th St, Suite 119, Laramie, WY 82072-2066 | 2006-10-12 |
| Street Address |
1200 B GALE WILSON BLVD |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-3552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649263526 | Ronald T Stafford | Anesthesiology | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2005-08-25 |
| 1295334753 | Manpreet Kaur | Pharmacist | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2020-10-25 |
| 1861004533 | Rokzanne Dosier | Nurse Practitioner | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2020-08-23 |
| 1457984882 | Neeta Bhasin | Pharmacist | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2020-02-13 |
| 1083246003 | Carol Ritzinger | Pharmacist | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2020-02-07 |
| 1659901239 | Elayne Faucett Maples | Nurse Practitioner | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2020-01-22 |
| 1760024384 | Gina Cristina Copak | Pharmacist | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2019-10-15 |
| 1952880437 | Hospitalist Medicine Physicians of California-tcg, PC | Internal Medicine | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2018-08-07 |
| 1487132007 | Hospitalist Medicine Physicians of California - Fairfield, PC | Internal Medicine | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2018-08-06 |
| 1548747686 | Sandra Manzato Barboza Tinoco | Dietitian, Registered | 1200 B Gale Wilson Blvd, Fairfield, CA 94533-3552 | 2018-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275147647 | Rebecca Diane Yeater | Family Medicine | Wellspan Family Medicine - Fairfield, 4910 Fairfield Rd, Fairfield, PA 17320 | 2020-09-03 |
| 1366822199 | House Calls and Virtual Visits, LLC | Family Medicine | 36 Sanford St, Fairfield, CT 06824-5917 | 2015-06-06 |
| 1093133746 | Simone Alicia Douge | Family Medicine | 700 Route 46 E Ste 450, Fairfield, NJ 07004 | 2014-03-31 |
| 1629499801 | Joseph John Sciarrillo | Family Medicine | 20 Paisley Ln, Fairfield, CT 06825-1158 | 2013-12-14 |
| 1568894731 | Mary Helen Gartin | Family Medicine | 2000c South Main, Fairfield, IA 52556 | 2013-07-30 |
| 1689013195 | Marikit B Parker | Family Medicine | 1101 B Gale Wilson Blvd Ste 101c, Fairfield, CA 94533-3771 | 2013-06-18 |
| 1538459821 | Samuel C. Docena, Md.,inc | Family Medicine | 1244 Nilles Rd Ste 10, Fairfield, OH 45014-2788 | 2011-04-08 |
| 1467759746 | Richard Marie Valeriote | Family Medicine | 3350 Blackhawk Place, Fairfield, CA 94534 | 2011-02-22 |
| 1861655466 | Antonela Barbu | Family Medicine | 2238 Black Rock Tpke, Fairfield, CT 06825-3219 | 2008-07-03 |
| 1477744290 | Ahmad Shariff Vonschlegell | Family Medicine | 541 Cement Hill Rd, Fairfield, CA 94533-1329 | 2007-08-06 |
| Find all providers in FAIRFIELD | ||||
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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.