KATHLEEN GAVIGAN WAFFNER (NPI# 1205968377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205968377 |
| Entity Type | Individual |
| Full Name | KATHLEEN GAVIGAN WAFFNER |
| Credential | PA |
| Practice Address |
2915 Telegraph Ave Suite 101 Berkeley CA 94705-2060 |
| Mailing Address |
11875 Dublin Blvd Suite B 125 Dublin CA 94568-2843 |
| Practice Telephone | 5108434544 |
| Practice Fax Number | 5108433871 |
| Mailing Telephone | 9255872505 |
| Mailing Fax Number | 9255872511 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA19079 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2915 TELEGRAPH AVE SUITE 101 |
| City | BERKELEY |
| State | CA |
| Zip Code | 94705-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770542326 | Katya Tova Gerwein | Pediatrics | 2915 Telegraph Ave, Suite 101, Berkeley, CA 94705-2060 | 2006-03-22 |
| 1801192315 | Sarah Pontell | Physician Assistant | 2915 Telegraph Ave, Suite 101, Berkeley, CA 94705-2060 | 2011-01-31 |
| 1831240399 | Nancy Rutley Fenstermacher | Dentist | 2915 Telegraph Ave, Suite 303, Berkeley, CA 94705-2060 | 2007-01-12 |
| 1720180995 | Juliet Patricia Granberg | Pediatrics | 2915 Telegraph Ave, Suite 304, Berkeley, CA 94705 | 2006-09-01 |
| 1083722615 | Beth Matlock | Obstetrics & Gynecology | 2915 Telegraph Ave, Berkeley, CA 94705-2060 | 2006-08-25 |
| 1801902622 | Katarina Lanner-cusin | Obstetrics & Gynecology | 2915 Telegraph Ave, Suite 200, Berkeley, CA 94705-2060 | 2006-08-22 |
| 1053427328 | Elizabeth Kanwit | Obstetrics & Gynecology | 2915 Telegraph Ave, #200, Berkeley, CA 94705-2060 | 2006-08-21 |
| 1154437432 | Arzou D Ahsan | Obstetrics & Gynecology | 2915 Telegraph Ave, Suite 200, Berkeley, CA 94705-2060 | 2006-08-21 |
| 1881655074 | Paula Lasky Price | Physician Assistant | 2915 Telegraph Ave, Suite 101, Berkeley, CA 94705-2060 | 2006-03-29 |
| 1043271448 | Sabra Daly | Physician Assistant | 2915 Telegraph Ave, Suite 101, Berkeley, CA 94705-2060 | 2006-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882956 | Diane Lomas Wyatt | Marriage & Family Therapist | 2340 Ward St. Ste 104, Berkeley, CA 94705 | 2020-02-12 |
| 1700371275 | Icecreamwala Dermatology Inc | Dermatology | 2435 Webster St Ste 101, Berkeley, CA 94705 | 2018-06-27 |
| 1396253803 | David R Shaddock | Marriage & Family Therapist | 3030 Ashby Avenue, # 105, Berkeley, CA 94705 | 2018-01-18 |
| 1821504432 | Allegra Tringali | Physical Therapist | 2450 Ashby Ave Fl 6, Berkeley, CA 94705 | 2017-12-19 |
| 1659898740 | Hunter Brown | Student in an Organized Health Care Education/Training Program | Wright Institute Clinical Services 1918 University Ave, Suite 2b, Berkeley, CA 94705 | 2017-08-29 |
| 1588014534 | Heather Valdez | Social Worker | 2185 Ashby Ave, Berkeley, CA 94705 | 2016-06-20 |
| 1215350145 | S.e.e.d.s. (social and Emotional Education Development and Support) | Community/Behavioral Health | 3120 Telegraph Avenue Ste 9, Berkeley, CA 94705 | 2014-01-29 |
| 1144580960 | Benjamin Tucker | Counselor | 2625 Alcatraz Ave Ste 609, Berkeley, CA 94705 | 2012-05-26 |
| 1881966141 | Jennifer Cowherd | Behavioral Analyst | 2201 Woolsey St, Berkeley, CA 94705 | 2012-02-02 |
| 1518255892 | Erika D Huguenard | Counselor | 2811a College Avenue, Berkeley, CA 94705 | 2011-07-20 |
| Find all providers in zip 94705 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1154882835 | Isabella Maria Killion | Physician Assistant | 1100 The Alameda, Berkeley, CA 94707-2502 | 2019-03-26 |
| 1033676622 | Lucas Fogarty | Physician Assistant | 2222 Prince St, Berkeley, CA 94705-1819 | 2019-03-01 |
| 1720592009 | Tinebeta Daniel Mekonnen | Physician Assistant | 2762 Mathews St, Berkeley, CA 94702-2245 | 2017-11-25 |
| 1356878136 | Albert Ahoy | Physician Assistant | 2770 Acton St, Berkeley, CA 94702-2334 | 2017-05-11 |
| 1790210540 | Damara Kathleen Luce | Physician Assistant | 1515 Fairview St, Apt. C, Berkeley, CA 94703-2317 | 2017-04-28 |
| 1528396868 | Stacey Phelps | Physician Assistant | 2500 Milvia St Ste 218, Berkeley, CA 94704-2636 | 2009-11-24 |
| 1124222153 | Luz Munoz | Physician Assistant | 2031 Sixth St, Berkeley, CA 94710 | 2007-06-13 |
| 1538241260 | Annette Delilah Pizano | Physician Assistant | 2920 Telegraph Ave, Berkeley, CA 94705-2031 | 2006-10-20 |
| 1336158328 | Terri D Pagano | Physician Assistant | 2510 Webster St, Suite 300, Berkeley, CA 94705-2557 | 2006-08-07 |
| Find all providers in BERKELEY | ||||
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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.