CHELSEA VANDERWOUDE (NPI# 1255999736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255999736 |
| Entity Type | Individual |
| Full Name | CHELSEA VANDERWOUDE |
| Practice Address |
4510 Executive Dr San Diego CA 92121-3021 |
| Mailing Address |
1356 Via Terrassa Encinitas CA 92024-5348 |
| Practice Telephone | 8585348019 |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1356 Via Terrassa, Encinitas, CA 920245348 | 2693523818 |
| Street Address |
4510 EXECUTIVE DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-3021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538153747 | James Raymond Moitoza | Orthopaedic Surgery | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2005-09-01 |
| 1164959433 | Keri Anne O'connor | Registered Nurse | 4510 Executive Dr, San Diego, CA 92121-3021 | 2017-05-17 |
| 1891230868 | Kaizen Brain Center | Psychiatry & Neurology | 4510 Executive Dr, Suite 107, San Diego, CA 92121-3021 | 2016-12-30 |
| 1285179614 | Hatem Abou-sayed Md Mba Facs - A Professional Medical Corporation | Plastic Surgery | 4510 Executive Dr, Suite 105, San Diego, CA 92121-3021 | 2016-12-20 |
| 1508310319 | Ana Ramirez | Psychologist | 4510 Executive Dr, Suite 315, San Diego, CA 92121-3021 | 2016-08-09 |
| 1457711657 | Achieve Tms Centers, LLC | Psychiatry & Neurology | 4510 Executive Dr, 115, San Diego, CA 92121-3021 | 2016-03-01 |
| 1932501640 | K Kohani D D S A Professional Corporation | Dentist | 4510 Executive Dr, Suite 205, San Diego, CA 92121-3021 | 2014-09-24 |
| 1306263470 | Eric Lamarca | Radiologic Technologist | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2014-03-26 |
| 1902220809 | Shashita Inamdar Md Professional Corporation | Psychiatry & Neurology | 4510 Executive Dr, Ste 115, San Diego, CA 92121-3021 | 2014-02-12 |
| 1457773699 | R.p. Dunnum, M.d. Inc. | Preventive Medicine | 4510 Executive Dr, Suite 107, San Diego, CA 92121-3021 | 2014-01-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
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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 |
|---|---|---|---|---|
| 1033716204 | Julianne A. Demery | Student in an Organized Health Care Education/Training Program | Naval Base San Diego 2450 Craven Street #3300, San Diego, CA 92136-0001 | 2020-10-01 |
| 1649885732 | Leanne Evalyn Morancie | Student in an Organized Health Care Education/Training Program | 4231 Balboa Ave # 1245, San Diego, CA 92117-5504 | 2020-09-15 |
| 1689288136 | Melissa Eileen Fitzgibbon | Student in an Organized Health Care Education/Training Program | 5114 63rd St, San Diego, CA 92115-1407 | 2020-09-02 |
| 1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
| 1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
| 1861004392 | Mareena Biju | Student in an Organized Health Care Education/Training Program | 10995 Evening Creek Dr E, San Diego, CA 92128-4009 | 2020-08-17 |
| 1184235202 | Taylor G Wasko | Student in an Organized Health Care Education/Training Program | 4114 Swift Ave Apt 4, San Diego, CA 92104-2249 | 2020-08-12 |
| 1790394245 | Elisa Melo Da Silva Smerik | Student in an Organized Health Care Education/Training Program | 3235 Loma Riviera Dr, San Diego, CA 92110-5511 | 2020-07-29 |
| 1215554076 | Ana Mohammad-zadeh | Student in an Organized Health Care Education/Training Program | 17289 Russet St, San Diego, CA 92127-2135 | 2020-06-28 |
| 1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
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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.