MS. KELLIE D BOUGARD (NPI# 1245672500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245672500 |
| Entity Type | Individual |
| Full Name | MS. KELLIE D BOUGARD |
| Practice Address |
4920 South Avalon Blvd Los Angeles CA 90011 |
| Practice Telephone | 3232355035 |
| Mailing Telephone | 3232355035 |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2013-07-26 |
| 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 | Student, Health Care |
| Street Address |
4920 SOUTH AVALON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| 1073863445 | Ronald Armado | Pharmacist | 4211 S. Avalon, Los Angeles, CA 90011 | 2012-09-13 |
| Find all providers in zip 90011 | ||||
| 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 |
|---|---|---|---|---|
| 1164020657 | Corinne Elizabeth Zachry | Student in an Organized Health Care Education/Training Program | 1149 S Hill St # H375, Los Angeles, CA 90015-2212 | 2020-10-15 |
| 1750989588 | Jasmine Carpenter | Student in an Organized Health Care Education/Training Program | 4920 S Avalon Blvd, Los Angeles, CA 90011-4004 | 2020-10-14 |
| 1801401062 | Rachel Brenner | Student in an Organized Health Care Education/Training Program | 3787 S Vermont Ave Apt 2, Los Angeles, CA 90007-4203 | 2020-09-14 |
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1154936565 | Samrah Shaheer Abbasi | Student in an Organized Health Care Education/Training Program | 3022 Oakhurst Ave, Los Angeles, CA 90034-2856 | 2020-09-11 |
| 1568077071 | Amber Mottola | Student in an Organized Health Care Education/Training Program | 550 N Figueroa St Apt 4084, Los Angeles, CA 90012-3389 | 2020-09-11 |
| 1760096937 | Elizabeth Idema | Student in an Organized Health Care Education/Training Program | 1559 N Commonwealth Ave, Los Angeles, CA 90027-5513 | 2020-09-03 |
| 1053924225 | Deanna Sharon Lin | Student in an Organized Health Care Education/Training Program | 520 So Lafayette Park Place, 3rd Floor, Los Angeles, CA 90057-5400 | 2020-08-28 |
| 1003429762 | Kendra Knudsen | Student in an Organized Health Care Education/Training Program | 611 Levering Ave Apt 3, Los Angeles, CA 90024-2325 | 2020-08-24 |
| 1750993515 | Deena Basilious | Student in an Organized Health Care Education/Training Program | 1403 S Union Ave, Los Angeles, CA 90015-3205 | 2020-08-21 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
Please comment or provide details below to improve the information on MS. KELLIE D BOUGARD.
| 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.