DR. MALLORY JANE MITCHELL (NPI# 1235636440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235636440 |
| Entity Type | Individual |
| Full Name | DR. MALLORY JANE MITCHELL |
| Credential | DO |
| Practice Address |
1405 Rockhaven Dr Modesto CA 95356-9682 |
| Practice Telephone | 2093801574 |
| Mailing Telephone | 2093801574 |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2018-04-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467050591 | Mallory Nicole Mitchell | Registered Nurse | 1802 6th Ave S, Birmingham, AL 35233-1932 | 2020-10-12 |
| 1720514003 | Mallory Anne Mitchell | Student in an Organized Health Care Education/Training Program | University of Tennessee, 920 Madison Avenue Suite 447, Memphis, TN 38163-0001 | 2017-05-05 |
| Street Address |
1405 ROCKHAVEN DR |
| City | MODESTO |
| State | CA |
| Zip Code | 95356-9682 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508909292 | John Carl Mitchell | Spec/Tech, Cardiovascular | 1405 Rockhaven Dr, Modesto, CA 95356-9682 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649809021 | Amelia E Delgadillo | Licensed Vocational Nurse | 501 Triangle Rd, Modesto, CA 95356 | 2020-04-07 |
| 1689220279 | Meagan Veneman | Physical Medicine & Rehabilitation | 125 Hogue Rd, Modesto, CA 95356 | 2019-08-10 |
| 1497131213 | Hermes Guardian Transport | Non-emergency Medical Transport (VAN) | 4221 Erin Way, Modesto, CA 95356 | 2015-08-04 |
| 1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
| 1922242866 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 500 Glass Ln Ste H, Modesto, CA 95356 | 2009-04-22 |
| 1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
| 1265636013 | Margaret Kathleen Grisell | Orthopaedic Surgery | 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 | 2007-06-14 |
| 1841412111 | Bobby Gene Boswell | Specialist/Technologist | 3908 Vintage Cove, Modesto, CA 95356 | 2007-05-03 |
| 1598892861 | Merritt Radiological Medical Group Inc | Radiology | 526 Charity Way, Modesto, CA 95356 | 2007-02-27 |
| 1396871091 | Michael Steven Beck | Social Worker | 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 | 2007-02-26 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972168219 | Kourosh Mehrazar | Student in an Organized Health Care Education/Training Program | 1405 Villette Ct, Modesto, CA 95356-8904 | 2019-05-02 |
| 1609439793 | Sylvia Margarita Castro | Student in an Organized Health Care Education/Training Program | 1441 Florida Ave # 102, Modesto, CA 95350-4404 | 2019-04-15 |
| 1427518422 | Maham Rehman | Student in an Organized Health Care Education/Training Program | 2301 Powell Dr Apt 3, Modesto, CA 95350-1875 | 2019-03-25 |
| 1609334929 | Yaira Denis Aguilar | Student in an Organized Health Care Education/Training Program | 2000 W Briggsmore Ave # Stii, Modesto, CA 95350-3839 | 2019-03-05 |
| 1346727922 | Jorge Anguiano | Student in an Organized Health Care Education/Training Program | 821 Crippen Ave, Modesto, CA 95351-7700 | 2018-07-26 |
| 1740796648 | Paloma Angelica Parra | Student in an Organized Health Care Education/Training Program | 1400 K St Ste I, Modesto, CA 95354-1018 | 2017-12-15 |
| 1669987301 | Tristan Renee Bowman | Student in an Organized Health Care Education/Training Program | 1700 Mchenry Way, Modesto, CA 95354 | 2017-12-04 |
| 1326575002 | Rim Amare Gebremariam | Student in an Organized Health Care Education/Training Program | 1400 Florida Ave Ste 200, Modesto, CA 95350-4445 | 2017-05-12 |
| 1023557543 | Jasmine Dominique Brooks | Student in an Organized Health Care Education/Training Program | 2521 Pescadero Pl, Modesto, CA 95355-3439 | 2017-02-16 |
| 1225408412 | Raman Benjamin | Student in an Organized Health Care Education/Training Program | 2800 Wind River Ct, Modesto, CA 95356-9383 | 2015-09-30 |
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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.