JOSHUA A. BROAD (NPI# 1134382013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134382013 |
| Entity Type | Individual |
| Full Name | JOSHUA A. BROAD |
| Credential | P.A. |
| Practice Address |
1314 N Norma St Ridgecrest CA 93555-2509 |
| Mailing Address |
12380 Hesperia Rd #2 Victorville CA 92395-5814 |
| Practice Telephone | 7604462935 |
| Practice Fax Number | 7604462937 |
| Mailing Telephone | 7602434188 |
| Mailing Fax Number | 7142436888 |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA19744 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE | PA19744 | 01 |
| CA | BOARD CERTIFICATION | 1082405 | 01 |
| Street Address |
1314 N NORMA ST |
| City | RIDGECREST |
| State | CA |
| Zip Code | 93555-2509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104094937 | Linda Marie Long | Nurse Practitioner | 1314 N Norma St, Ridgecrest, CA 93555 | 2008-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321776 | Patrick Joseph Mccammon | Case Manager/Care Coordinator | 1400 N Norma, Ste 127, Ridgecrest, CA 93555 | 2019-11-25 |
| 1780170704 | Krista Mae Sanchez Tizon | Behavior Technician | 123 Grande Way, Suite B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1245726348 | Shinta Desentia Fraya | Behavior Technician | 123 Grande Way Ste B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1780114397 | Darci Turner | Occupational Therapy Assistant | 4309 W Weiman, Ridgecrest, CA 93555 | 2017-06-15 |
| 1700319407 | Telecare Corporation | Clinic/Center | 1141 Chelsea Street, Ridgecrest, CA 93555 | 2017-04-10 |
| 1245776236 | Katherine Gerow | Prevention Professional | 1131 Inyokern Rd, Ridgecrest, CA 93555 | 2017-01-13 |
| 1639552151 | Max Scott Higa | Social Worker | 1400 North Norma Street, Suite 133, Ridgecrest, CA 93555 | 2015-07-01 |
| 1184044703 | Ridgecrest Charter School | Speech-Language Pathologist | 325 S. Downs St., Ridgecrest, CA 93555 | 2014-04-22 |
| 1023366838 | Andrew Whalley | Occupational Therapist | 901 N.heritage Dr., Suite 106, Ridgecrest, CA 93555 | 2012-08-28 |
| 1831453026 | Andrew S Peters | Family Medicine | 1 Administration Circle, Stop 1311, Branch Clinic China Lake, Bldg 1403, Ridgecrest, CA 93555 | 2012-07-02 |
| Find all providers in zip 93555 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831462068 | James Edward Antes | Physician Assistant | 1081 N China Lake Blve, Ridgecrest, CA 93555 | 2012-02-19 |
| 1316425846 | Alan Cosmo Haun | Physician Assistant | 900 N Heritage Dr, Ridgecrest, CA 93555-5536 | 2018-08-06 |
| 1427458223 | Beth Osweiler | Physician Assistant | 1081 N China Lake Blvd, Ridgecrest, CA 93555-3130 | 2014-08-28 |
| 1992062152 | Christian D Schwartz | Physician Assistant | 1111 N China Lake Blvd, Suite 190, Ridgecrest, CA 93555-3131 | 2012-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1134720972 | Alessandra Porfido | Physician Assistant | 733 Filbert St Apt 1, San Francisco, CA 94133-2767 | 2020-11-06 |
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1609477504 | Julia Claire Stiefel | Physician Assistant | 369 Orange St Apt A, Oakland, CA 94610-2979 | 2020-11-05 |
| 1164023347 | Wendy P Lewis | Physician Assistant | 10447 Highdale St, Bellflower, CA 90706-4122 | 2020-11-04 |
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
| City | RIDGECREST |
| Zip Code | 93555 |
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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.