KATI BOOMGARDEN (NPI# 1326577552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326577552 |
| Entity Type | Individual |
| Full Name | KATI BOOMGARDEN |
| Credential | FNP |
| Practice Address |
2540 Sister Mary Columba Dr Red Bluff CA 96080-4327 |
| Practice Telephone | 5306902827 |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 845076 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95007884 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BOARD OF REGISTERED NURSING | 845076 | 01 |
| DEA | MB4618952 | 01 | |
| CA | BOARD OF REGISTERED NURSING | 9500784 | 01 |
| AANP: CERTIFICATION | F12170087 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6070 Meeks Way, Sacramento, CA 958351923 | 5309219021 |
| Street Address |
2540 SISTER MARY COLUMBA DR |
| City | RED BLUFF |
| State | CA |
| Zip Code | 96080-4327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720096449 | Russell Wayne Doyle | Physician Assistant | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | 2006-08-04 |
| 1679988950 | Rolling Hills Clinic | Clinic/Center | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | 2014-06-25 |
| 1457676280 | Adventist Health California Medical Group, Inc. | Orthopaedic Surgery | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | 2010-04-05 |
| 1811157373 | Andrew R. Wise | Dentist | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | 2008-06-09 |
| 1770781973 | John E. Kemp,m.d.,inc. | Orthopaedic Surgery | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | 2007-07-10 |
| 1871797860 | Orthopedic Surgical Institute, Inc | Orthopaedic Surgery | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080-4327 | 2007-06-13 |
| 1750498523 | James S Umber | Orthopaedic Surgery | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080 | 2006-08-25 |
| 1932214244 | Thomas M Coon | Orthopaedic Surgery | 2540 Sister Mary Columba Dr, Red Bluff, CA 96080 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578912408 | Gillian Lilo Prothro | Registered Nurse | 1425 Montgomery St., Red Bluff, CA 96080 | 2016-06-10 |
| 1154739373 | Gisela Vazquez Sandoval | Counselor | 818 Walnut St, Red Bluff, CA 96080 | 2014-07-31 |
| 1215348883 | Courtney Cathleen Coenen | Non-emergency Medical Transport (VAN) | 320 Michael Drive, Red Bluff, CA 96080 | 2014-05-16 |
| 1023451986 | Nhuha Thi Le | Registered Nurse | 1860 B Walnut St, Red Bluff, CA 96080 | 2013-04-10 |
| 1184991580 | Maria Arendina Los | Registered Nurse | 818 Main Street, Tehama County Health Services Agency, Red Bluff, CA 96080 | 2011-11-30 |
| 1558682195 | Metasebia Bekele | Physician Assistant | 1850 Walnut Street, Red Bluff, CA 96080 | 2010-06-17 |
| 1821314238 | Cynthia Louise Funderburk | Nurse's Aide | 1860 B Walnut Street, Red Bluff, CA 96080 | 2010-04-09 |
| 1285865485 | Phillip John Velador Jr. | Licensed Vocational Nurse | 1860b Walnut Street, Red Bluff, CA 96080 | 2009-08-05 |
| 1609010347 | Lori Kay Mccaughey | Registered Nurse | 1860b Walnut St, Red Bluff, CA 96080 | 2009-04-24 |
| 1467668616 | Tehama County Health Services Agency - Mental Health Division | Clinic/Center | 1860 Walnut Street, Suite A, B, D and J, Red Bluff, CA 96080 | 2007-05-15 |
| Find all providers in zip 96080 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083074306 | Ellen Musakwa | Nurse Practitioner | 108 Jefferson Ct, Unit A, Red Bluff, CA 96080-3865 | 2016-02-29 |
| 1497314793 | Holly Nicole Maples | Nurse Practitioner | 2490 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2019-06-10 |
| 1821567579 | Lacy Elaine Hook | Nurse Practitioner | 1850 Walnut St, Red Bluff, CA 96080-3611 | 2018-11-23 |
| 1083190441 | Cori Lynn Crow | Nurse Practitioner | 2490 Sister Mary Columba Dr, Red Bluff, CA 96080 | 2018-07-18 |
| 1689944274 | Christy Ewing | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2012-01-12 |
| 1780953273 | Julia Rae Charlesworth | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2011-12-29 |
| 1487849048 | Laura Jeanne Anjola | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2007-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003640 | Samira Kadri | Nurse Practitioner | 431 S Burnside Ave Apt 3g, Los Angeles, CA 90036-5343 | 2020-11-08 |
| 1801497706 | Ana Maria Cajigas De Jesus | Nurse Practitioner | 313 S Velva Pl, Anaheim, CA 92804-2647 | 2020-11-06 |
| 1609477421 | Taylor Mcknight | Nurse Practitioner | 5073 Oxford Dr, Cypress, CA 90630-3653 | 2020-11-06 |
| 1619578465 | Roslyn Dykes-barrow | Nurse Practitioner | 17631 Mulberry Dr, Carson, CA 90746-7403 | 2020-11-06 |
| 1861093601 | Philana P Mcdonald | Nurse Practitioner | 183 Stonebridge Ln, Paso Robles, CA 93446-1926 | 2020-11-06 |
| 1386245264 | Annie Parikh | Nurse Practitioner | 11675 Lambert Ave, El Monte, CA 91732-1955 | 2020-11-05 |
| 1073114096 | Blanca De Jesus Serrano | Nurse Practitioner | 18144 Outer Hwy 18 Ste 200, Apple Valley, CA 92307-2212 | 2020-11-05 |
| 1578164166 | Aimon Sangwanpanich | Nurse Practitioner | 8520 Shirley Ave, Northridge, CA 91324-4149 | 2020-11-02 |
| 1043810757 | Casie Lee Mcguire | Nurse Practitioner | 1826 Rainbow Terrace Ln, Montebello, CA 90640-1953 | 2020-10-30 |
| 1295335099 | Jail Lopez | Nurse Practitioner | 3171 Lynwood Rd, Lynwood, CA 90262-4118 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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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.