JOHN J CRUZ (NPI# 1104332170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104332170 |
| Entity Type | Individual |
| Full Name | JOHN J CRUZ |
| Practice Address |
65 N Keller Republic WA 99166-8804 |
| Mailing Address |
165 E Hawthorne Ave Colville WA 99114-2629 |
| Practice Telephone | 5097753364 |
| Practice Fax Number | 5097758906 |
| Mailing Telephone | 5096844597 |
| Mailing Fax Number | 5096845286 |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | CG60806753 | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235583220 | John Cruz | Counselor | 22 Myona St, Methuen, MA 01844-5506 | 2016-04-16 |
| 1528165131 | John Norbert Cruz | Internal Medicine | 24 Conkey Ave, Norwich, NY 13815-1774 | 2006-09-19 |
| 1619528254 | John Paul Cruz | Student in an Organized Health Care Education/Training Program | 2008 N Garey Ave, Pomona, CA 91767-2722 | 2019-09-25 |
| 1881086668 | John William Cruz | Emergency Medicine | 1120 15th St, Augusta, GA 30912-1000 | 2015-03-03 |
| 1427457092 | John Cruz | Counselor | 386 W Main St, Bergenfield, NJ 07621-1569 | 2014-08-19 |
| 1922326495 | John Michael Cruz | Psychiatry & Neurology | 2001 Dwight Way, Suite 4190, Berkeley, CA 94704-2608 | 2010-05-09 |
| 1760616015 | John La Cruz | Military Health Care Provider | 22 Mdg, Mcconnell Afb, KS 67221-3712 | 2009-05-14 |
| 1609047091 | John Junior Cruz | Physician Assistant | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2008-03-13 |
| Street Address |
65 N KELLER |
| City | REPUBLIC |
| State | WA |
| Zip Code | 99166-8804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275045536 | Mailyn S Fleck | Peer Specialist | 65 N Keller, Republic, WA 99166-8804 | 2017-10-26 |
| 1679049258 | Sarah Kw Spark | Counselor | 65 N Keller, Republic, WA 99166 | 2018-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073976593 | Rachel S Flesher | Doula | 143 N Kauffman St, Republic, WA 99166 | 2016-04-01 |
| 1144534959 | Ferry County Sheriff | Non-emergency Medical Transport (VAN) | 175 North Jefferson, Republic, WA 99166 | 2010-08-04 |
| 1558539734 | Barnaby David Denison | Adult Companion | 42 Klondike Road, Republic, WA 99166 | 2008-02-11 |
| 1205057387 | Robert Walter Hardwick Jr. | Dentist | 194 North Portland St., Republic, WA 99166 | 2007-05-02 |
| 1952438665 | Clara Denise Wisener | Massage Therapist | 720 S Clark Ave, Republic, WA 99166 | 2007-02-28 |
| 1356476477 | Ferry County Emergency Medical Service District 1 | Ambulance | 979 South Clark Ave, 205, Republic, WA 99166 | 2007-02-22 |
| 1457496184 | Ronald L Casebeer | Counselor | 65 North Keller Street, Republic, WA 99166 | 2007-02-20 |
| 1669562047 | Ferry County Counseling Services | Community/Behavioral Health | 147 N. Clark Ave #12, Republic, WA 99166 | 2006-10-13 |
| 1952766503 | Angie Tietsort | Massage Therapist | 28 North Keller Street, Republic, WA 99166 | 2015-12-28 |
| 1174693089 | Robert Mark Slagle | Pharmacist | North 6 Clark St., Republic, WA 99166-0497 | 2006-11-08 |
| Find all providers in zip 99166 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275045536 | Mailyn S Fleck | Peer Specialist | 65 N Keller, Republic, WA 99166-8804 | 2017-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992304703 | Corina Thornton | Peer Specialist | Arrow Lakes Street, Nespelem, WA 99155-0304 | 2020-10-22 |
| 1578161402 | Yavonnie Leslie Griggs | Peer Specialist | 3285 Ferguson Ln Sw, Tumwater, Wa 98512, Tumwater, WA 98512 | 2020-10-13 |
| 1306454061 | Ashley D Vinson-harris | Peer Specialist | 116 S 339th Cir, Federal Way, WA 98003-4537 | 2020-07-20 |
| 1184240301 | Aleric Hughes | Peer Specialist | 1200 Sw Holden St, Seattle, WA 98106-2054 | 2020-06-23 |
| 1013533876 | Alyssa Camille Meaker | Peer Specialist | 4350 Cordata Pkwy Ste 220, Bellingham, WA 98226-8278 | 2020-06-17 |
| 1134741424 | Tara Lin Garcia | Peer Specialist | 4256 Federal Avenue, Everett, WA 98203 | 2020-05-11 |
| 1558982058 | Edward Thomas Gollihugh | Peer Specialist | 721 Fawcett Ave Ste 204, Tacoma, WA 98402-5502 | 2020-05-06 |
| 1295356483 | Yvette Marie Sampson | Peer Specialist | Josephinum C/o Crew, 1902 2nd Ave., Seattle, WA 98101 | 2020-04-29 |
| 1043856123 | Jayde Wailani Albright | Peer Specialist | 5920 N Calispel St, Spokane, WA 99205-6214 | 2019-11-23 |
| 1033755244 | Willapa Behavioral Health | Peer Specialist | 2204 Pacific Ave. N., Long Beach, WA 98631 | 2019-11-22 |
| Find all providers with the same taxonomy | ||||
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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.