MR. LOREN GLEN OTT (NPI# 1316904428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316904428 |
| Entity Type | Individual |
| Full Name | MR. LOREN GLEN OTT |
| Credential | PA |
| Practice Address |
1600 Esplanade Suite C Chico CA 95926-3369 |
| Practice Telephone | 5308974500 |
| Practice Fax Number | 5308974544 |
| Mailing Telephone | 5308974500 |
| Mailing Fax Number | 5308974544 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA16797 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00PA16797 | 05 | |
| CA | BLUE SHIELD | ZZZ52846Z | 01 |
| CA | MEDICARE PTAN | ZZZ13431Z | 01 |
| Street Address |
1600 ESPLANADE SUITE C |
| City | CHICO |
| State | CA |
| Zip Code | 95926-3369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477975613 | Enloe Medical Center | Surgery | 1600 Esplanade, Suite C, Chico, CA 95926-3369 | 2014-01-07 |
| 1770905994 | Enloe Medical Center | Orthopaedic Surgery | 1600 Esplanade, Suite C, Chico, CA 95926-3369 | 2014-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104332576 | Asheley Dawn Kimble | Registered Nurse | 592 Lindo Ave, Chico, CA 95926 | 2017-12-21 |
| 1275050635 | Wa Meng Vang | Counselor | 560 Cohasset Rd #180, Chico, CA 95926 | 2017-08-26 |
| 1922538677 | Lisa Ann Milardovich | Physical Medicine & Rehabilitation | 1576 Hawthorne Ave, Chico, CA 95926 | 2017-06-15 |
| 1205364700 | Andrew Vercellino | Chiropractor | 1281 East Ave #100, Chico, CA 95926 | 2017-05-26 |
| 1205389095 | Michele Lando | Social Worker | 572 Rio Lindo Ave Ste 108, Chico, CA 95926 | 2016-07-27 |
| 1215397864 | Joseph Boone Wills IIi | Marriage & Family Therapist | 6 Governors Ln Ste C, Chico, CA 95926 | 2016-02-24 |
| 1356723001 | Erica White | Counselor | 109 Parmac Road, Suite 1, Chico, CA 95926 | 2015-06-18 |
| 1902285208 | Genuine Dbt Licensed Clinical Social Worker Inc | Psychologist | 1140 Mangrove Ave Ste D, Chico, CA 95926 | 2015-05-20 |
| 1255724324 | Linda K Zimbelman | Nurse Practitioner | 1645 Esplanade #1, Chico, CA 95926 | 2015-03-12 |
| 1366851040 | Jose Mendoza | Counselor | 590 Rio Lindo Avenue, Chico, CA 95926 | 2014-08-07 |
| Find all providers in zip 95926 | ||||
| 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 |
|---|---|---|---|---|
| 1275046526 | Ryan Elizabeth Prendergast | Physician Assistant | 1720 Esplanade Fl 2, Chico, CA 95926-3315 | 2017-11-08 |
| 1356643621 | Joshua Ismael Calderon | Physician Assistant | 1531 Esplanade # 72, Chico, CA 95926-3310 | 2010-11-18 |
| 1902092786 | Cynthia Maureen Hale | Physician Assistant | 145 Mission Ranch Blvd., Suite 110, Chico, CA 95926 | 2007-09-14 |
| 1851470868 | Christopher John Buckley | Physician Assistant | 2581 California Park Dr, Apt. 284, Chico, CA 95928-4012 | 2006-11-02 |
| 1255430658 | Francis Anthony Croal | Physician Assistant | 1354 East Ave Ste R, Chico, CA 95926-7383 | 2006-09-22 |
| 1578514493 | Renee G Christenson | Physician Assistant | 251 Cohasset Rd Ste 240, Chico, CA 95926-2235 | 2006-05-15 |
| 1023006715 | William A Sprotte | Physician Assistant | 277 Cohasset Dr., Chico, CA 95926 | 2005-10-07 |
| 1134731268 | Imelda Miranda Mata | Physician Assistant | 80 Declaration Dr, Chico, CA 95973-4900 | 2020-08-19 |
| 1396381463 | Caitlin Collins | Physician Assistant | 2 Governors Ln, Chico, CA 95926-6300 | 2019-11-22 |
| 1336785096 | Jeannette Marian Mutch Teesdale | Physician Assistant | 1531 Esplanade, Chico, CA 95926-3310 | 2019-11-18 |
| Find all providers in CHICO | ||||
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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.