MS. BLANCA OLIVIA PENA (NPI# 1346675170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346675170 |
| Entity Type | Individual |
| Full Name | MS. BLANCA OLIVIA PENA |
| Credential | PA-C |
| Practice Address |
2700 N 140th Ave Ste 107 Goodyear AZ 85395-2439 |
| Practice Telephone | 6235358770 |
| Practice Fax Number | 6235358771 |
| Mailing Telephone | 6235358770 |
| Mailing Fax Number | 6235358771 |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2013-0061 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 080389 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14506 W Granite Valley Dr Ste 124, Sun City West, AZ 853756012 | 6235358770 | 6235358771 |
| 2700 N 140th Ave Ste 107, Goodyear, AZ 853952439 | 6235358770 | 6235358771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801308747 | Blanca Estela Pena | Student in an Organized Health Care Education/Training Program | 40 Boardman Pl, San Francisco, CA 94103 | 2017-11-01 |
| 1740433242 | Blanca Erika Pena | Dentist | 8515 Greenville Ave Ste N108, Dallas, TX 75243-7035 | 2008-10-28 |
| Street Address |
2700 N 140TH AVE STE 107 |
| City | GOODYEAR |
| State | AZ |
| Zip Code | 85395-2439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255426870 | Kelli Ann Mercado | Physician Assistant | 2700 N 140th Ave Ste 107, Goodyear, AZ 85395-2439 | 2006-10-03 |
| 1295280949 | Tania Edwards | Audiologist | 2700 N 140th Ave Ste 107, Goodyear, AZ 85395-2439 | 2016-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154962439 | Amber Dawn Gutierrez | Registered Nurse | 15430 W. Turney Avenue, Goodyear, AZ 85395 | 2019-10-08 |
| 1851947865 | Az Care Partners Home Care, LLC | Chore Provider | 14122 W. Mcdowell Rd., Suite 102a, Goodyear, AZ 85395 | 2019-08-15 |
| 1407334329 | Hana M Eichele | Occupational Therapist | 13385 W Mcdowell Road, Goodyear, AZ 85395 | 2018-08-02 |
| 1639662406 | Kristen Henderson | Occupational Therapist | 14577 W Indian School Road, Goodyear, AZ 85395 | 2018-06-07 |
| 1114419389 | Eric Seabaugh | Specialist/Technologist | 13385 W. Mcdowell Rd., Goodyear, AZ 85395 | 2018-06-04 |
| 1912497504 | Goodyear Modern Dentistry, LLP | Dentist | 15260 West Mcdowell Rd, Goodyear, AZ 85395 | 2018-05-18 |
| 1225531551 | Erik Jason Martinez | Registered Nurse | 4565 N 153rd Ln, Goodyear, AZ 85395 | 2018-03-13 |
| 1538677042 | Kacie Bartlett | Speech-Language Pathologist | 14557 W Mcdowel Rd, Suiet 500, Goodyear, AZ 85395 | 2018-01-18 |
| 1942717277 | Deeann Guymon | Specialist/Technologist | 13385 W. Mcdowell Road, Goodyear, AZ 85395 | 2018-01-09 |
| 1023520228 | Kathy Lynn Gorchesky | Registered Nurse | 15430 West Turney Avenue, Goodyear, AZ 85395 | 2017-10-27 |
| Find all providers in zip 85395 | ||||
| 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 |
|---|---|---|---|---|
| 1639667405 | Craig M Tambatamba | Physician Assistant | 16064 W Williams St, Goodyear, AZ 85338-3494 | 2018-04-27 |
| 1871827220 | Timothy Ralph Johnson | Physician Assistant | 2014 N Citrus Rd, Goodyear, AZ 85338 | 2009-10-01 |
| 1366695470 | Trent Wilson Knight | Physician Assistant | 700 N Estrella Pkwy Ste 145, Goodyear, AZ 85338-9329 | 2008-11-03 |
| 1013187301 | Nakia Lashawn Brooks | Physician Assistant | 14200 Celebrate Life Way, Goodyear, AZ 85338-2539 | 2008-03-03 |
| 1255426870 | Kelli Ann Mercado | Physician Assistant | 2700 N 140th Ave Ste 107, Goodyear, AZ 85395-2439 | 2006-10-03 |
| 1962059279 | Wv Medical Group LLC | Physician Assistant | 3301 N Litchfield Rd Ste 200, Goodyear, AZ 85395-3197 | 2019-08-21 |
| 1235691155 | Cassie Woods | Physician Assistant | 13677 W Mcdowell Rd, Goodyear, AZ 85395-2635 | 2019-04-01 |
| 1346729696 | Brooklynne Frederick Goss | Physician Assistant | 13677 W Mcdowell Rd, Goodyear, AZ 85395-2635 | 2018-08-08 |
| 1831676980 | Lisa Jacqueline Kovacevic | Physician Assistant | 13677 W Mcdowell Rd, Goodyear, AZ 85395-2635 | 2018-07-22 |
| 1073039947 | Katrina Carbonell Aquino | Physician Assistant | 13677 W Mcdowell Rd, Goodyear, AZ 85395-2635 | 2017-08-22 |
| Find all providers in GOODYEAR | ||||
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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.