MISS JENNIFER ANNE EHTESHAMI (NPI# 1255492666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255492666 |
| Entity Type | Individual |
| Full Name | MISS JENNIFER ANNE EHTESHAMI |
| Other Name | JENNIFER ANNE WHITLOCK |
| Credential | PA-C |
| Practice Address |
24255 Pacific Coast Hwy Malibu CA 90263-3999 |
| Practice Telephone | 3105064316 |
| Practice Fax Number | 3105064588 |
| Mailing Telephone | 3105064316 |
| Mailing Fax Number | 3105064588 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2010-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA-1929 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | PA-17488 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
24255 PACIFIC COAST HWY |
| City | MALIBU |
| State | CA |
| Zip Code | 90263-3999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386686277 | Kevin Allen Wright | Specialist/Technologist | 24255 Pacific Coast Hwy, Pepperdine University Athletics, Malibu, CA 90263-3999 | 2006-06-12 |
| 1104431451 | Alex Jason Vander Vorste | Specialist/Technologist | 24255 Pacific Coast Hwy, Pepperdine Athletics - Sports Medicine, Malibu, CA 90263 | 2020-09-14 |
| 1043867971 | Pepperdine University | Clinic/Center | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2019-08-26 |
| 1275186025 | Karissa Ann Scherer | Specialist/Technologist | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2019-07-22 |
| 1861917577 | Nicole Mariko Elby | Physical Therapist | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2017-08-03 |
| 1063967016 | Katherine Sniffen | Specialist/Technologist | 24255 Pacific Coast Hwy, Athletic Department, Malibu, CA 90263-3999 | 2016-08-19 |
| 1649661661 | Pepperdine University | Chiropractor | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2015-02-12 |
| 1255547667 | Kathleen Eldridge | Psychologist | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-05-15 |
| 1518082544 | Geliann Kitsigianis | Internal Medicine | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-03-20 |
| 1073647640 | Nancy Safinick | Physician Assistant | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-03-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619198355 | Amber Clemmons-trigueros | Counselor | 24255 Pacific Coast Hwy # 3707, Malibu, CA 90263-3999 | 2007-05-01 |
| 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 |
|---|---|---|---|---|
| 1073647640 | Nancy Safinick | Physician Assistant | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-03-15 |
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|---|---|---|---|---|
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| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
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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.