DR. GLENN E FORTINI (NPI# 1205966041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205966041 |
| Entity Type | Individual |
| Full Name | DR. GLENN E FORTINI |
| Credential | M.D. |
| Practice Address |
1 Shields Ave Davis CA 95616-5270 |
| Mailing Address |
417 Mace Blvd. Suite J, #341 Davis CA 95618 |
| Practice Telephone | 5307522300 |
| Practice Fax Number | 5307522306 |
| Mailing Telephone | 5307565539 |
| Mailing Fax Number | 5307562022 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
A19839 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1 SHIELDS AVE |
| City | DAVIS |
| State | CA |
| Zip Code | 95616-5270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356322903 | Aimee Sisson | Student in an Organized Health Care Education/Training Program | 1 Shields Ave, Uc Davis Master of Public Health Program, Davis, CA 95616-5270 | 2005-11-10 |
| 1811597941 | Anna Pavlov | Registered Nurse | 1 Shields Ave, Davis, CA 95616-5270 | 2020-10-28 |
| 1811548779 | Sarah Schmitt | Dietitian, Registered | 1 Shields Ave, Davis, CA 95616-5270 | 2019-09-23 |
| 1619526373 | Vida Khaliki | Physician Assistant | 1 Shields Ave, Davis, CA 95616-5200 | 2019-09-05 |
| 1912496563 | Lisa Kay Varnum | Specialist/Technologist | 1 Shields Ave, Davis, CA 95616-5200 | 2018-05-08 |
| 1730682022 | Sean Carrington | Specialist/Technologist | 1 Shields Ave, Davis, CA 95616 | 2018-03-13 |
| 1720502701 | Torie Johnson | Specialist/Technologist | 1 Shields Ave, Davis, CA 95616-5270 | 2017-08-01 |
| 1073044350 | Uc Davis Student Health and Counseling Services | Clinic/Center | 1 Shields Ave, Shcs, Davis, CA 95616-5270 | 2017-03-27 |
| 1992247092 | Lauren Eichstadt | Pharmacist | 1 Shields Ave, Davis, CA 95616-5270 | 2016-11-07 |
| 1467906222 | Duane Robinson | Specialist | 1 Shields Ave, School of Vet Med, Uc Davis, Davis, CA 95616-5270 | 2016-08-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1366908618 | Capitol Periodontal Group | Dentist | 750 F Street #5, Davis, CA 95616 | 2019-02-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| Find all providers in zip 95616 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528026861 | Institute for Restorative Health | Psychiatry & Neurology | 1460 Drew Ave, Suite 300, Davis, CA 95616-4889 | 2006-05-03 |
| 1619585080 | Cep America - Neurology PC | Psychiatry & Neurology | 2000 Sutter Pl, Davis, CA 95616-6201 | 2020-07-21 |
| 1467771402 | Neerali Bernard | Psychiatry & Neurology | 2030 Sutter Pl, Suite 1000, Davis, CA 95616-6212 | 2010-05-28 |
| 1548587926 | Myra Qi-hua Hu | Psychiatry & Neurology | 2030 Sutter Pl, Suite 1000, Davis, CA 95616-6212 | 2010-04-26 |
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| 1710592431 | Muhammad Amin | Psychiatry & Neurology | 33433 Pony Loop, Fremont, CA 94555-3511 | 2020-09-10 |
| 1558973792 | Catalyst Neuromedical Center PC | Psychiatry & Neurology | 3305 Placer St Ste B, Redding, CA 96001-2378 | 2020-08-19 |
| 1134730906 | West Coast Valley Medical Inc | Psychiatry & Neurology | 3357 Cahuenga Blvd W # 18, Los Angeles, CA 90068-1327 | 2020-08-13 |
| 1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1427689256 | Alejandro F Centurion Md Inc | Psychiatry & Neurology | 100 Clock Tower Pl Ste 225, Carmel, CA 93923-8778 | 2020-01-30 |
| 1659901254 | Kern County Neurological Medical Group, Inc | Psychiatry & Neurology | 18645 Gale Ave Ste 228b, City of Industry, CA 91748-1363 | 2020-01-22 |
| 1609415314 | Aspire Holdings, Inc | Psychiatry & Neurology | 28212 Kelly Johnson Pkwy Ste 215, Valencia, CA 91355-5090 | 2019-12-27 |
| 1336785187 | Tp-health Ca PC | Psychiatry & Neurology | 201 E Center St Ste 112, Anaheim, CA 92805-7212 | 2019-11-26 |
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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.