KELSI MUNDELL (NPI# 1164977500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164977500 |
Entity Type | Individual |
Full Name | KELSI MUNDELL |
Practice Address |
1385 N Hamilton Pkwy Novato CA 94949-8276 |
Mailing Address |
7596 Commerce Blvd Apt 19 Cotati CA 94931-3714 |
Practice Telephone | 4153823363 |
Mailing Telephone | 7077613408 |
Enumeration Date | 2016-08-15 |
Last Update Date | 2016-08-15 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
1385 N HAMILTON PKWY |
City | NOVATO |
State | CA |
Zip Code | 94949-8276 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962649772 | Kelley Smith | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2009-01-15 |
1568079887 | Laurel Te Velde | Specialist | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-09-30 |
1669087474 | Corina Dorothy Vitale | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-09-09 |
1356951826 | Martin Uche | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2020-08-08 |
1003466103 | Deshaun Lamar Mootry | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-09-19 |
1578118709 | Sarah Jasmine Bailey | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-08-05 |
1023577152 | Megan Latrice Bagby | Counselor | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2019-03-18 |
1639683733 | Robert Turner Johnson | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2017-11-28 |
1952845034 | Deonna Donnyell Jennings | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-12-08 |
1982159323 | Bailey Tiura | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-08-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295365427 | Rebecca Pia Ashkenazy | Counselor | 201 Alameda Del Prado Suite 201, Novato, CA 94949 | 2020-01-15 |
1063073583 | Minding Your Body | Clinic/Center | 250 Bel Marin Keys Boulevard, Suite D1, Nevato, CA 94949 | 2019-06-25 |
1750743555 | Shivani Vasishta | Physician Assistant | 5800 Nave Dr, Novato, CA 94949 | 2016-03-22 |
1780065516 | Sikander Isshak | Pharmacist | 437 Via Del Plano, Novato, CA 94949 | 2015-06-17 |
1619224763 | Kerby Ann Gleeson | Social Worker | 1385 North Hamilton Parkway, Novato, CA 94949 | 2012-08-08 |
1295094241 | Stacy Anne Rosenblatt | Social Worker | 1385 North Hamilton Prkway, Novato, CA 94949 | 2012-05-11 |
1487913505 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 394 Bel Marin Keys Blvd, Suite 4, Novato, CA 94949 | 2012-05-09 |
1609181213 | Vincent Gregory Pons | Internal Medicine | 448 Ignacio Blvd, No. 403, Novato, CA 94949 | 2010-08-09 |
1811217946 | Prima Medical Foundation | Clinic/Center | 4 Hamilton Landing, Suite 100, Novato, CA 94949 | 2010-06-11 |
1770776957 | Lisa Marutani | Registered Nurse | 21 Tamal Vista, 100, Corte Madera, CA 94949 | 2007-08-22 |
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Taxonomy Code | 225400000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Rehabilitation Practitioner |
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962649772 | Kelley Smith | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2009-01-15 |
1154520872 | Orlando Victor Avila | Rehabilitation Practitioner | 1385 N Hamilton Aparkway, Novato, CA 94949-6119 | 2007-07-12 |
1366916116 | Maria Cristina Frias | Rehabilitation Practitioner | 1682 Novato Blvd, Novato, CA 94947-7000 | 2019-01-15 |
1639683733 | Robert Turner Johnson | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2017-11-28 |
1952845034 | Deonna Donnyell Jennings | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-12-08 |
1982159323 | Bailey Tiura | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2016-08-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861092447 | Isaiah Daniel Clark | Rehabilitation Practitioner | 33600 Mapleton Ave # D2018, Murrieta, CA 92563-4434 | 2020-10-31 |
1760089122 | Leslie Ann Showalter | Rehabilitation Practitioner | 6720 Tampa Ave, Reseda, CA 91335-5014 | 2020-10-07 |
1508477019 | Brenda Cabrera | Rehabilitation Practitioner | 127 W Hillcrest Blvd, Inglewood, CA 90301-2623 | 2020-08-10 |
1669082202 | Brenda Vargas | Rehabilitation Practitioner | 16650 Sherman Way # 201, Van Nuys, CA 91406-3782 | 2020-08-07 |
1629696042 | Ashlie Renee Javier | Rehabilitation Practitioner | 1266 Calle Estrella, San Dimas, CA 91773-4080 | 2020-07-13 |
1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
1780212852 | Isaiah Sanchez | Rehabilitation Practitioner | 10535 Zelzah Ave, Granada Hills, CA 91344-5902 | 2020-04-01 |
1235766015 | Theresa Matheson | Rehabilitation Practitioner | 15533 Ryon Ave, Bellflower, CA 90706-3624 | 2020-03-24 |
1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
1356976864 | Millea Jewel Betts | Rehabilitation Practitioner | 801 E Chapman Ave # Sut203, Fullerton, CA 92831-3839 | 2020-03-04 |
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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.