MRS. JENNIFER REBECCA MALLOY (NPI# 1114008554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114008554 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER REBECCA MALLOY |
| Credential | PA-C |
| Practice Address |
2255 S Bascom Ave Suite 200 Campbell CA 95008-7800 |
| Practice Telephone | 4083763626 |
| Practice Fax Number | 4088712377 |
| Mailing Telephone | 4083763626 |
| Mailing Fax Number | 4088712377 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2010-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA17849 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609392612 | Jennifer Aide Malloy | Acupuncturist | 2401 Pga Blvd Ste 248, Palm Beach Gardens, FL 33410-3515 | 2017-08-21 |
| 1144714833 | Jennifer L Malloy | Chiropractor | 418 Chestnut St, Union, NJ 07083-9306 | 2018-06-18 |
| 1265983563 | Jennifer A Malloy | Physician Assistant | 1700 Peach St, Suite 200, Erie, PA 16501-2134 | 2016-10-21 |
| 1275906059 | Jennifer Malloy | Dentist | 86th Medical Group, Ramstein Ab, Germany, Apo, AE 09012 | 2015-11-03 |
| 1962749853 | Jennifer Brown Malloy | Pharmacist | 2015 Edgewater Dr, Orlando, FL 32804-5311 | 2013-01-11 |
| 1770871055 | Jennifer Nora Malloy | Counselor | 1620 Cummins Dr, Modesto, CA 95358-6400 | 2011-07-20 |
| 1972620227 | Jennifer Malloy | Social Worker | 3322 N Broad St, Philadelphia, PA 19140-5185 | 2007-03-23 |
| Street Address |
2255 S BASCOM AVE SUITE 200 |
| City | CAMPBELL |
| State | CA |
| Zip Code | 95008-7800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679671259 | Polyxene G. Kokinos | Specialist | 2255 S Bascom Ave, Ste 200, Campbell, CA 95008-7800 | 2006-09-20 |
| 1124561303 | South Bay Angiography and Interventional Center | Radiology | 2255 S Bascom Ave, Suite 200, Campbell, CA 95008-7800 | 2016-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298380 | Kerry Lynn Osteen | Massage Therapist | 3579 S Bascom Ave, Apt 5, Campbell, CA 95008 | 2020-09-02 |
| 1164057550 | Francesca Dalangin | Physical Therapist | 163 E. Hamilton Avenue, Campbell, CA 95008 | 2020-03-06 |
| 1144790767 | Haley Brucato | Behavior Technician | 131 Rose Court Apt. 21, Campbell, CA 95008 | 2018-11-27 |
| 1740765809 | Crystal-xuanthao Nguyen Curammeng | Licensed Vocational Nurse | 251 Llwelyn Ave, Campbell, CA 95008 | 2018-09-25 |
| 1841799236 | Gabrielle Suzanne Buma | Physician Assistant | Uplift Family Services 251 Llewellyn Ave, Campbell, CA 95008 | 2018-02-12 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1184132573 | My Hanh Thi Nguyen | Behavioral Analyst | 1440 Theresa Avenue, Campbell, CA 95008 | 2018-01-19 |
| 1346770948 | Stephanie Michele Klahold | Pharmacist | 100 North San Tomas Aquino Road, Campbell, CA 95008 | 2017-06-15 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1912448408 | Suzane Mitchualmacauley | Licensed Vocational Nurse | 251 Llewelyn Ave, Uplift Family Services, Campbell, CA 95008 | 2017-03-16 |
| Find all providers in zip 95008 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366405383 | Robert Charles Witcosky | Physician Assistant | 3803 S Bascom Ave, Suite 102, Campbell, CA 95008-7317 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
| 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.