MARYPAT KELLY (NPI# 1043289523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043289523 |
| Entity Type | Individual |
| Full Name | MARYPAT KELLY |
| Credential | GNP |
| Practice Address |
80 Great Oaks Blvd San Jose CA 95119-1310 |
| Mailing Address |
1150 Pine St Menlo Park CA 94025-3455 |
| Practice Telephone | 4083633000 |
| Practice Fax Number | 4083633082 |
| Mailing Telephone | 6504730529 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
15112 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
80 GREAT OAKS BLVD |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95119-1310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609844729 | Marion Jean Hogan | Nurse Practitioner | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2006-03-14 |
| 1033631205 | Nichole E Imamura-sperling | Social Worker | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2017-07-10 |
| 1326570706 | Joanna Michaels | Social Worker | 80 Great Oaks Blvd, B-209, San Jose, CA 95119-1310 | 2017-04-03 |
| 1184176752 | Linda Woodsmall | Social Worker | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2016-10-31 |
| 1053786780 | Patricia Ann Ash Moore | Social Worker | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2015-12-07 |
| 1457721128 | Russell Schnurr | Social Worker | 80 Great Oaks Blvd, 180d, San Jose, CA 95119-1310 | 2015-10-06 |
| 1003206244 | Va Palo Alto Healthcare System | Clinic/Center | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2015-01-26 |
| 1700284932 | Thanh Nga Thi Do | Social Worker | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2014-12-22 |
| 1417387002 | Va | Psychiatric Unit | 80 Great Oaks Blvd, San Jose, CA 95119 | 2013-11-18 |
| 1295099331 | Angel Yu | Pharmacist | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2012-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922623594 | Julia Angelina Rojas | Rehabilitation Counselor | 298 A Bernal Rd, San Jose, CA 95119 | 2020-06-10 |
| 1609496215 | Kaiser Foundation Hospitals | Pharmacy | 274 International Cir Fl 1 Rm 104, San Jose, CA 95119 | 2020-04-23 |
| 1104451194 | Arthur Warren Hall | Counselor | 298 A Bernal Road, San Jose, CA 95119 | 2020-03-10 |
| 1992264774 | Jennifer Luu | Student in an Organized Health Care Education/Training Program | 276 International Circle Building, 1 - 2nd Floor - Family Medicine Residency Unit G, San Jose, CA 95119 | 2019-03-19 |
| 1194209510 | Victoria Marques | Pharmacist | 275 Hospital Parkway, Suite 625, San Jose, CA 95119 | 2018-09-21 |
| 1780123497 | Costco Wholesale Corporation | Hearing Aid Equipment | 6898 Raleigh Road, San Jose, CA 95119 | 2017-02-14 |
| 1437563855 | Mark Douglas Zukunft | Emergency Medicine | 250 Hospital Pkwy Dept Of, San Jose, CA 95119 | 2014-06-13 |
| 1669896338 | Paul J. Zuchowski Chiropractic, A Professional Corporation | Chiropractor | 6950 Santa Teresa Blvd., Ste.a, San Jose, CA 95119 | 2014-02-14 |
| 1700227873 | Yu-chien Cheng | Internal Medicine | 275 Hospital Pkwy Ste 600, San Jose, CA 95119 | 2013-07-17 |
| 1730432014 | Tami Otomo | Pharmacist | 6201 San Ignacio Ave, San Jose, CA 95119 | 2012-10-24 |
| Find all providers in zip 95119 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487921656 | Pratima Gupta | Nurse Practitioner | 255 N White Rd, Suite 200, San Jose, CA 95127-1964 | 2011-11-16 |
| 1013136423 | Julie Dutton | Nurse Practitioner | 4855 Atherton Ave Ste 101, San Jose, CA 95130-1026 | 2007-04-24 |
| 1609844729 | Marion Jean Hogan | Nurse Practitioner | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2006-03-14 |
| 1003213679 | Jodie Sugiyama | Nurse Practitioner | 4850 Union Ave, San Jose, CA 95124-5156 | 2014-11-26 |
| 1780017632 | Elisha Bonny Eng Jang | Nurse Practitioner | 299 Stockton Ave, San Jose, CA 95126-2763 | 2013-08-14 |
| 1871548701 | Deena Marie Bunzel | Nurse Practitioner | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139109 | Lena Kazanchyan | Nurse Practitioner | 11834 Archwood St, North Hollywood, CA 91606-1603 | 2020-09-16 |
| 1740898386 | Victor De Guzman | Nurse Practitioner | 24808 Sand Wedge Ln, Valencia, CA 91355-2315 | 2020-07-20 |
| 1114535937 | Ashley Elizabeth Rosso | Nurse Practitioner | 3111 Camino Del Rio N Ste 625, San Diego, CA 92108-5718 | 2020-07-17 |
| 1518586452 | Zaruhi Harutyunyan | Nurse Practitioner | 7901 Santa Monica Blvd Ste 206, West Hollywood, CA 90046-5180 | 2020-04-10 |
| 1457986168 | Maritza J Lira | Nurse Practitioner | 23141 Verdugo Dr Ste 201, Laguna Hills, CA 92653-1341 | 2020-03-03 |
| 1225677198 | Shannon Ha Duyen Sicat | Nurse Practitioner | 2617 E Chapman Ave Ste 109, Orange, CA 92869-3245 | 2019-12-24 |
| 1528605961 | Elsa L Pineda-flores | Nurse Practitioner | 1513 S Grand Ave Ste 306, Los Angeles, CA 90015-3075 | 2019-12-04 |
| 1447895073 | Kemi Osilesi | Nurse Practitioner | 1943 Seasons St, Simi Valley, CA 93065-0580 | 2019-11-07 |
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1255993531 | May Therese Ronci | Nurse Practitioner | 38504 Cougar Pass, Palmdale, CA 93551-5019 | 2019-07-08 |
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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.