DR. MARILYN LORETTA TIDWELL -SHOEMAKER (NPI# 1144867409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144867409 |
| Entity Type | Individual |
| Full Name | DR. MARILYN LORETTA TIDWELL -SHOEMAKER |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1809 W Redlands Blvd Redlands CA 92373-8054 |
| Mailing Address |
22542 Powhatan Rd Apple Valley CA 92308-6646 |
| Practice Telephone | 9092894075 |
| Mailing Telephone | 9515059676 |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2020-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95013184 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1809 W REDLANDS BLVD |
| City | REDLANDS |
| State | CA |
| Zip Code | 92373-8054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578525499 | Syam P Kunam | Psychiatry & Neurology | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2006-04-05 |
| 1710544242 | Kelechi Ugonna Olukaikpe Ogom | Nurse Practitioner | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2019-05-21 |
| 1700382512 | Cajon Medical Group PC | Internal Medicine | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2018-04-02 |
| 1326547183 | Cajon Medical Group PC | Internal Medicine | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2018-02-07 |
| 1639696412 | Archis Desai Md, Inc. | Internal Medicine | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2017-08-23 |
| 1093185035 | Victoria Dubois | Social Worker | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2015-10-02 |
| 1396141230 | Archis Desai | Internal Medicine | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2014-11-04 |
| 1871994970 | Kristina Marie Mitchell | Marriage & Family Therapist | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2014-09-08 |
| 1780098772 | Vanessa Ramsdell | Counselor | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2014-06-17 |
| 1336493071 | Cornerstone Family Counseling and Behavioral Health Group, Inc | Psychologist | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2012-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473422 | Mindfulness Counseling Services | Marriage & Family Therapist | 101 E. Redlands, Suite 170a, Redlands, CA 92373 | 2020-09-24 |
| 1710596721 | Vandna Mittal | Counselor | 26967 Beamount Avenue, 1020 Coronado Drive, Redlands, CA 92373 | 2020-07-26 |
| 1164062345 | Sara Bencoe | Nurse Practitioner | 101 E. Redlands Blvd. Ste. 106, Redlands, CA 92373 | 2020-01-15 |
| 1033604103 | John Duane Wuchenich | Anesthesiology | 451 Summit Avenue, Redlands, CA 92373 | 2018-06-29 |
| 1013401074 | Adept Hospice Care | Hospice Care, Community Based | 515 New Jersey St., Suite G, Redlands, CA 92373 | 2018-06-21 |
| 1134616121 | Rodrigo Robles | Student in an Organized Health Care Education/Training Program | 26001 Redlands Blvd ., 2nd Floor, 2d 301, Redlands, CA 92373 | 2018-04-16 |
| 1760987614 | Redlands Endodontics | Dentist | 245 Terracina Blvd Suite 207 B, Redlands, CA 92373 | 2018-03-23 |
| 1487164166 | Tyler Stafford | Behavioral Analyst | 1467 Ford St. Suite 104, Redlands, CA 92373 | 2017-10-06 |
| 1083131486 | Shannon Palmowski | Behavioral Analyst | Institute for Behavioral Health, 1041 Alabama Ave, Redlands, CA 92373 | 2017-08-25 |
| 1275062622 | Erim Sarbuland | Marriage & Family Therapist | 101 East Redlands Boulevard, Suites #215, Redlands, CA 92373 | 2017-06-08 |
| Find all providers in zip 92373 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220588 | Elma M Slough | Nurse Practitioner | 461 Tennessee St, Redlands, CA 92373-8167 | 2020-06-19 |
| 1972139020 | Gaea Jamine Umali | Nurse Practitioner | 461 Tennessee St, Redlands, CA 92373-8167 | 2020-03-20 |
| 1295365955 | Michelle Buckman | Nurse Practitioner | 312 Brookside Ave, Redlands, CA 92373-4608 | 2020-01-22 |
| 1356985113 | Janae Michelle Cox | Nurse Practitioner | 1902 Orange Tree Ln Ste 200, Redlands, CA 92374-2800 | 2019-11-04 |
| 1710544242 | Kelechi Ugonna Olukaikpe Ogom | Nurse Practitioner | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2019-05-21 |
| 1992280531 | Louis Lennart Kho Qui | Nurse Practitioner | 1971 Essex Ct, Redlands, CA 92373-8057 | 2018-09-29 |
| 1679071153 | Shou Wang | Nurse Practitioner | 26001 Redlands Blvd, Redlands, CA 92373-7762 | 2018-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 1033718580 | John Sylvanus Allieu Sr. | Nurse Practitioner | 2672 Merganser Ct, Los Banos, CA 93635-9473 | 2020-10-25 |
| 1316546930 | Chika U Oguagha | Nurse Practitioner | 16240 Carmine St, Fontana, CA 92336-1481 | 2020-10-23 |
| 1215534888 | Rosa Maria Aguero | Nurse Practitioner | 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 | 2020-10-06 |
| 1134726995 | Margarita Maghtesyan | Nurse Practitioner | 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 | 2020-10-05 |
| 1043827140 | April Lopez Ortiz | Nurse Practitioner | 500 W Ashland Ct, Visalia, CA 93277-6609 | 2020-09-23 |
| 1477167666 | David Joseph Russell | Nurse Practitioner | 17846 Glenwood Rd, Manteca, CA 95336-9521 | 2020-09-03 |
| 1194339382 | Albert Liu | Nurse Practitioner | 43559 Southerland Way, Fremont, CA 94539-5931 | 2020-09-03 |
| 1407469554 | Andre Alexandrian | Nurse Practitioner | 1606 Winona Ave, Burbank, CA 91504-2823 | 2020-08-28 |
| 1790398238 | Heather Richardson | Nurse Practitioner | 112 S Park St Ste 1, San Francisco, CA 94107-1809 | 2020-08-25 |
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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.