MR. BRYAN ROBERT MILONJA (NPI# 1104283167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104283167 |
| Entity Type | Individual |
| Full Name | MR. BRYAN ROBERT MILONJA |
| Credential | M.A. |
| Practice Address |
1108 S El Camino Real San Mateo CA 94402-2804 |
| Practice Telephone | 6504580026 |
| Mailing Telephone | 6504580026 |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1108 S EL CAMINO REAL |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720204506 | David Dean Johnson | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2007-04-18 |
| 1548876337 | Jenae Aesha Richardson | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2020-09-17 |
| 1982148557 | Michael Krechevsky | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-12-15 |
| 1992248884 | Cheng Hsu | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-11-23 |
| 1215485487 | Philip Hershon | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-09-16 |
| 1669855730 | Patrick Kerwin | Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2015-07-07 |
| 1740673441 | Shannon Diaz | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2015-03-05 |
| 1063831337 | Sarah Schaafsma | Marriage & Family Therapist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2014-04-15 |
| 1174952378 | Mary Brennan | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2013-11-07 |
| 1093142309 | Nga Ly | Nurse Practitioner | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2013-10-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
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| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366004855 | Doaa Mohamed Abdelrahman | Counselor | 126 W 25th Ave # 200, San Mateo, CA 94403-2208 | 2019-07-03 |
| 1629555644 | Dorcas Gaines | Counselor | 226 De Anza Blvd, San Mateo, CA 94402-3913 | 2018-07-23 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1104321165 | Maria Del Rosario Martinez | Counselor | 225 37th Ave Fl 3er, San Mateo, CA 94403-4324 | 2018-03-29 |
| 1407308539 | Rob Mcilvoy | Counselor | 526 S Eldorado St, San Mateo, CA 94402-1328 | 2016-10-24 |
| 1831644624 | Rodney Wg Roddewig | Counselor | 205 S Ellsworth Ave Apt 106, San Mateo, CA 94401-4076 | 2016-08-22 |
| 1427409507 | Callie Deeann Palmer | Counselor | 1650 S Amphlett Blvd Ste 113, San Mateo, CA 94402-2514 | 2016-06-29 |
| 1033566252 | Vivian Koroluk | Counselor | 803 S Grant St, San Mateo, CA 94402-1413 | 2016-05-17 |
| 1720442452 | Jamie Holden | Counselor | 1510 Fashion Island Blvd #110, San Mateo, CA 94404-1596 | 2016-04-08 |
| 1386000701 | Geraldine Punzalan | Counselor | 1670 S Amphlett Blvd Ste 15, San Mateo, CA 94402-2510 | 2016-01-14 |
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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.