RANDY STEVEN YERGENSON (NPI# 1235510504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235510504 |
| Entity Type | Individual |
| Full Name | RANDY STEVEN YERGENSON |
| Practice Address |
222 Drake Ave Beaumont CA 92223-7512 |
| Practice Telephone | 9512046511 |
| Mailing Telephone | 9512046511 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2019-11-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 52594 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PA-C | 52594 | 01 |
| Street Address |
222 DRAKE AVE |
| City | BEAUMONT |
| State | CA |
| Zip Code | 92223-7512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972115376 | National Vision Inc | Optometrist | 1561 East 2nd Street, Suite 300, Beaumont, CA 92223 | 2020-08-18 |
| 1417566985 | Krystle Santana | Marriage & Family Therapist | 14700 Manzanita Park Rd, Beaumont, Ca 9223, Beaumont, CA 92223 | 2020-07-30 |
| 1063045656 | Beaver Medical Group, L.p. | Durable Medical Equipment & Medical Supplies | 839 Highland Springs Parkway, Building C, Beaumont, CA 92223 | 2020-02-21 |
| 1730745969 | Paola Correa | Counselor | 24700 Manzanita Park Rd, Beaumont, CA 92223 | 2019-05-13 |
| 1639662802 | Jeremy Ball | Optometrist | 1659 E 6th St Ste A, Beaumont, CA 92223 | 2018-06-12 |
| 1659894368 | Jennifer Vargas | Counselor | 136 E. 6th St., Beaumont, CA 92223 | 2017-07-25 |
| 1770931487 | Amy Appleby | Student in an Organized Health Care Education/Training Program | 1360 Coriander Ct, Beaumont, CA 92223 | 2016-06-03 |
| 1427410364 | Jacob Garcia | Licensed Vocational Nurse | 38686 Florence Ave, Beaumont, CA 92223 | 2016-03-21 |
| 1396121588 | Anastasia B Flores | Counselor | 14700 Manzanita Park Rd., Beaumont, CA 92223 | 2015-08-11 |
| 1326424227 | Cindy Quyen Huynh | Dentist | 1620 E 2nd St Ste A, Beaumont, CA 92223 | 2015-08-03 |
| Find all providers in zip 92223 | ||||
| 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 |
|---|---|---|---|---|
| 1699239145 | Michael Delauney Dukate | Physician Assistant | 2965 Harrison St Ste 220, Beaumont, TX 77702-1149 | 2019-01-29 |
| 1427561786 | Colette Lavoy | Physician Assistant | 81 Highland Springs Ave Ste 100, Beaumont, CA 92223-3170 | 2017-11-08 |
| 1639621758 | Jason Allen Fondrick | Physician Assistant | 3030 North St Ste 430, Beaumont, TX 77702-1434 | 2016-10-25 |
| 1457806424 | Adriana Barrier | Physician Assistant | 1361 Mandrake Way, Beaumont, CA 92223-8467 | 2016-08-19 |
| 1376937003 | Winnie Community Hospital LLC | Physician Assistant | 85 Ih 10 N Ste 112, Beaumont, TX 77707 | 2015-03-19 |
| 1134540560 | Tommy Kent Sims | Physician Assistant | 5030 Highway 69 S, Beaumont, TX 77705-1258 | 2014-01-03 |
| 1396084992 | Courtney Marie Guidry | Physician Assistant | 755 N 11th St Ste P5200, Beaumont, TX 77702 | 2013-02-04 |
| 1285911412 | Nicholas Rene Alonzo | Physician Assistant | 81 Highland Springs Ave Ste 103, Beaumont, CA 92223-3170 | 2011-11-16 |
| 1770673782 | Stephen Livain Richard | Physician Assistant | 2890 N St, Christus Minor Care Clinic, Beaumont, TX 77702 | 2006-10-13 |
| 1578659124 | William Sperling | Physician Assistant | 3282 College St, Beaumont, TX 77701-4610 | 2006-10-04 |
| Find all providers in BEAUMONT | ||||
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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.