NICOLE KANG (NPI# 1124560552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124560552 |
| Entity Type | Individual |
| Full Name | NICOLE KANG |
| Credential | PH.D. |
| Practice Address |
1145 Sturgis Road Twentynine Palms CA 92278 |
| Mailing Address |
11507 Rabbit Run Ter Silver Spring MD 20904-4212 |
| Practice Telephone | 7608302724 |
| Mailing Telephone | 7144027583 |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1145 STURGIS ROAD |
| City | TWENTYNINE PALMS |
| State | CA |
| Zip Code | 92278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699726570 | Naval Hospital Twentynine Palms | Military Hospital | 1145 Sturgis Road, Twentynine Palms, CA 92278 | 2006-05-15 |
| 1659927788 | Tyler Pharr Hamby | Optometrist | 1145 Sturgis Road, Twentynine Palms, CA 92278 | 2019-08-14 |
| 1366854663 | Phyllis Jo Ann Dykes | Registered Nurse | 1145 Sturgis Road, Twentynine Palms, CA 92278 | 2014-05-21 |
| 1750644142 | John James Nevin | Pediatrics | 1145 Sturgis Road, Twentynine Palms, CA 92277 | 2012-06-20 |
| 1013281765 | Amanda Faye Boudreaux | Audiologist | 1145 Sturgis Road, Twentynine Palms, CA 92278 | 2012-02-28 |
| 1386946853 | Kara Michele Wortley | Physician Assistant | 1145 Sturgis Road, Naval Hospital Twentynine Palms, Twentynine Palms, CA 92278-1831 | 2010-12-03 |
| 1003070467 | Janelle Marie Marra | Family Medicine | 1145 Sturgis Road, Magtftc Mcagcc, Twentynine Palms, CA 92278-8250 | 2008-07-15 |
| 1114124682 | Rodrigo Fernando Lopez | Nurse Anesthetist, Certified Registered | 1145 Sturgis Road, Naval Hospital Twentynine Palms, Twentynine Palms, CA 92278 | 2007-06-28 |
| 1821295585 | Arika L Johnson | Clinical Neuropsychologist | 1145 Sturgis Road, Naval Hospital 29 Palms, Twentynine Palms, CA 92278-8250 | 2007-06-27 |
| 1457555161 | Anatoly Kristiann Hernandez | Anesthesiology | 1145 Sturgis Road, Twentynine Palms, CA 92278 | 2007-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770143711 | Michelle Alexandra Engel | Student in an Organized Health Care Education/Training Program | Twentynine Palms Marine Base, 1591, Apo, AA 92278 | 2019-06-20 |
| 1427544659 | Matthew John Thacker | Dentist | 1591 Griffin Rd., Twentynine Palms, CA 92278 | 2018-07-11 |
| 1922541986 | Joshua Gumpert | Physician Assistant | 1560 6th St, 2nd Deck, Twentynine Palms, CA 92278 | 2016-11-23 |
| 1427441112 | Joshua Bellavia | Military Health Care Provider | Commanding Officer Naval Hospital Twentynine Palms, Attn: Joshua Bellavia Box 788250, Twentynine Palms, CA 92278 | 2015-03-05 |
| 1730583063 | Erric Leif Apeland | Military Health Care Provider | 1436 Third Street, Mcagcc, Twentynine Palms, CA 92278 | 2014-10-15 |
| 1609286137 | Jason Ulaner | Chiropractor | 1145 Sturgis St, Twentynine Palms, CA 92278 | 2014-05-06 |
| 1497184188 | Blake Lyman | Physician Assistant | 1552 6th Street, Adult Medical Care Clinic, Twentynine Palms, CA 92278 | 2013-11-04 |
| 1013267996 | Alonzo Jamelle Shields | Military Health Care Provider | Regimental Aid Station, 7th Marine Hq Ras, Twentynine Palms, CA 92278 | 2012-09-18 |
| 1184996134 | William John Becker | Physician Assistant | Mcagcc, Building 1538, Twnetynine Palms, CA 92278 | 2012-02-07 |
| 1962666776 | Michael D Vanmanen | Orthopaedic Surgery | Bldg 1145 Sturgis Rd, Twentynine Palms, CA 92278 | 2008-07-11 |
| Find all providers in zip 92278 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679741 | Krista Lapidario | Student in an Organized Health Care Education/Training Program | 18602 Kings Row Ave, Cerritos, CA 90703-8048 | 2020-11-04 |
| 1548861818 | Masara Issa | Student in an Organized Health Care Education/Training Program | 2261 Runabout Pl, El Cajon, CA 92019-4250 | 2020-11-03 |
| 1245830736 | Khalid Bey | Student in an Organized Health Care Education/Training Program | 1st Dnbn Attn: Credentials 555221, Camp Pendleton, CA 92055-5221 | 2020-10-26 |
| 1538768221 | Judith Guarneros | Student in an Organized Health Care Education/Training Program | 47 Rogers Rd, Kernville, CA 93238-6021 | 2020-10-22 |
| 1174122048 | Vivian M. Arredondo | Student in an Organized Health Care Education/Training Program | 22656 Lark St, Grand Terrace, CA 92313-5714 | 2020-10-22 |
| 1861091621 | Kristen N Brauchler | Student in an Organized Health Care Education/Training Program | 2098 Cabot Ave, Merced, CA 95348-4023 | 2020-10-22 |
| 1215536206 | Marissa Burton | Student in an Organized Health Care Education/Training Program | 1759 Queenstown Dr, San Jose, CA 95132-1755 | 2020-10-21 |
| 1447859533 | Brooke Edelson | Student in an Organized Health Care Education/Training Program | 21 Waverley Ct Apt 4, Menlo Park, CA 94025-3551 | 2020-10-20 |
| 1891394987 | Shannon Shen | Student in an Organized Health Care Education/Training Program | 190 Ryland St Apt 3422, San Jose, CA 95110-2295 | 2020-10-20 |
| 1164020657 | Corinne Elizabeth Zachry | Student in an Organized Health Care Education/Training Program | 1149 S Hill St # H375, Los Angeles, CA 90015-2212 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | TWENTYNINE PALMS |
| Zip Code | 92278 |
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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.