ELAINE THERESE VAN GUNDY (NPI# 1174565485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174565485 |
| Entity Type | Individual |
| Full Name | ELAINE THERESE VAN GUNDY |
| Credential | M.D., F.A.A.P. |
| Practice Address |
1451 Secret Ravine Pkwy Suite 150 Roseville CA 95661-4051 |
| Practice Telephone | 9165802420 |
| Practice Fax Number | 9165802402 |
| Mailing Telephone | 9165802420 |
| Mailing Fax Number | 9165802402 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | C43153 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C431530 | 05 |
| Street Address |
1451 SECRET RAVINE PKWY SUITE 150 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-4051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053565283 | Donna R. Chipps | Nurse Practitioner | 1451 Secret Ravine Pkwy, Suite 150, Roseville, CA 95661-6052 | 2008-11-14 |
| 1508930801 | Rai Care Centers of Northern California I, LLC | Clinic/Center | 1451 Secret Ravine Pkwy, Building D, Suite 130, Roseville, CA 95661-4051 | 2006-11-20 |
| 1912919689 | Myrza R Perez | Allergy & Immunology | 1451 Secret Ravine Pkwy, Suite 150, Roseville, CA 95661-4051 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245715192 | Shannon Thornton | Specialist | 564 N Sunrise Ave, Roseville, CA 95661-3035 | 2018-09-26 |
| 1437688991 | Maria Cloris Kian | Specialist | 106n Sunrise Ave, B-8, Rooms #1-2, Roseville, CA 95661 | 2017-06-08 |
| 1760923874 | Richard Wurster | Specialist | 1640 Ainsdale Dr, Roseville, CA 95747-5838 | 2017-03-09 |
| 1871908277 | Scott B Hearth, Md | Specialist | 8735 Sierra College Blvd Ste 200, Roseville, CA 95661-5992 | 2014-06-24 |
| 1386957892 | Nancy E Neibarger | Specialist | 6073 Big Bend Dr, Roseville, CA 95678-1978 | 2010-07-26 |
| 1972749737 | Victor M Nava M D Inc | Specialist | 100 S. Harding Blvd. #2, Roseville, CA 95678-3360 | 2008-12-29 |
| 1780841015 | Melvin Stahl | Specialist | 640 Pear Blossom Ct, Roseville, CA 95747-8606 | 2008-05-22 |
| 1700097409 | Lynn Marie Bjornnes | Specialist | 2960 Snelling Ave N, Roseville, MN 55113-2458 | 2007-05-24 |
| 1871637488 | Parker Hughes Clinics | Specialist | 2665 Long Lake Rd, Roseville, MN 55113-2538 | 2007-02-16 |
| 1649322033 | Richard N Sauer | Specialist | 729 Sunrise Ave Ste 616, Roseville, CA 95661-4548 | 2007-01-17 |
| Find all providers in ROSEVILLE | ||||
Please comment or provide details below to improve the information on ELAINE THERESE VAN GUNDY.
| 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.