JAQUES NGAKAM (NPI# 1194254995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194254995 |
| Entity Type | Individual |
| Full Name | JAQUES NGAKAM |
| Credential | PA |
| Practice Address |
801 11th St Lakeport CA 95453-8107 |
| Mailing Address |
19790 Oak Flat Rd Apt D Hidden Valley Lake CA 95467-8588 |
| Practice Telephone | 7072633746 |
| Practice Fax Number | 7072633749 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2019-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
54323 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1225 Wilshire Blvd, Los Angeles, CA 900171901 | 2139772121 |
| Street Address |
801 11TH ST |
| City | LAKEPORT |
| State | CA |
| Zip Code | 95453-8107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932107828 | John Regis Minotti | Internal Medicine | 801 11th St, Lakeport, CA 95453-4100 | 2005-07-13 |
| 1174183784 | Adventist Health Physicians Network | Internal Medicine | 801 11th St, Lakeport, CA 95453-4100 | 2019-06-17 |
| 1871063040 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 801 11th St, Lakeport, CA 95453-4100 | 2018-11-30 |
| 1871640060 | Daniel Ayers | Chiropractor | 801 11th St, Lakeport, CA 95453 | 2007-01-03 |
| 1275630196 | Kraivit Angsupanich | Surgery | 801 11th St, Suite 1, Lakeport, CA 95453-4100 | 2006-09-20 |
| 1659387512 | David Betat | Family Medicine | 801 11th St, Lakeport, CA 95453-4100 | 2006-07-31 |
| 1912957242 | John Patrick Robertson | Internal Medicine | 801 11th St, Lakeport, CA 95453-4100 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1285000810 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 14678 Lakeshore Boulevard, Clearlake, CA 95453 | 2015-08-18 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
| Find all providers in zip 95453 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053503144 | Erin E Thurman | Physician Assistant | 5150 Hill Rd E Ste E, Lakeport, CA 95453-5100 | 2007-08-14 |
| 1033321963 | Nichol Ann Kriz | Physician Assistant | 5176 Hill Road East, Lakeport, CA 95453-6111 | 2007-05-04 |
| 1184052003 | Amanda L Smithers | Physician Assistant | 5196 Hill Rd E Ste 300, Lakeport, CA 95453-6374 | 2013-10-31 |
| 1740615558 | Mark Brien Kane | Physician Assistant | 5176 Hill Road East, Sutter-lakeside Hospital, Attn: Emergency Department, Lakeport, CA 95453 | 2013-09-11 |
| 1326118365 | Karen J Kennedy | Physician Assistant | 5335 Lakeshore Blvd, Lakeport, CA 95453-6123 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JAQUES NGAKAM.
| 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.