JACARANDA RADIOLOGY (NPI# 1356620512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356620512 |
| Entity Type | Organization |
| Organization Name | JACARANDA RADIOLOGY |
| Other Organization Name | JACARANDA IMAGING CENTER |
| Practice Address |
12021 Jacaranda Ave Ste 104 Hesperia CA 92345-4978 |
| Practice Telephone | 7609565561 |
| Mailing Telephone | 7609565561 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |
| Authorized Official Name | MISS LAKESHA SCOTT (ADMINISTRATIVE MANAGER) |
| Authorized Official Telephone | 7609562636 |
| Authorized Official Credential | VN |
| Is Organization Subpart | Y |
| Parent Organization Name | ABRAHAM WILSON INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Jacaranda Imaging Center | Other Name - Individual/Organization |
| Street Address |
12021 JACARANDA AVE STE 104 |
| City | HESPERIA |
| State | CA |
| Zip Code | 92345-4978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881467 | Leslie Guzman | Behavioral Analyst | 6700 Newhall Ave, Hesperia, CA 92345 | 2020-08-14 |
| 1134769896 | Nu Wave Medical Group Inc | Family Medicine | 9390 Hesperia Rd Suite 7, Hesperia, CA 92345 | 2020-01-10 |
| 1760901383 | Lindsey Kathleen Dunnagan | Counselor | 16501 Walnut Street, Suite 12, Hesperia, CA 92345 | 2017-09-14 |
| 1356869374 | Deborah Irene Freeman | Nurse Practitioner | 15398 Main Street Suite A, Hesperia, CA 92345 | 2017-08-30 |
| 1902260151 | Serge Bronstein | Counselor | 16808 Main St., D-154, Hesperia, CA 92345 | 2016-04-13 |
| 1366815805 | Caremore Health Plan | Nurse Practitioner | 17085 Main Street, Hesperia, CA 92345 | 2015-11-05 |
| 1174928402 | Jennifer Cathrin Bayle | Counselor | 17130 Sequoia St, Suite 106, Hesperia, CA 92345 | 2014-10-29 |
| 1447654256 | Diana Grace Chilstrom | Marriage & Family Therapist | 11776 Mariposa Road, Hesperia, CA 92345 | 2014-10-22 |
| 1639597545 | Adrianna Ebony Williams | Physical Therapy Assistant | 8939 11th Ave, Hesperia, CA 92345 | 2014-03-29 |
| 1477974426 | Aja Stoll | Case Manager/Care Coordinator | 9655 Ninth Ave, Hesperia, CA 92345 | 2013-12-18 |
| Find all providers in zip 92345 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
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| 1164049508 | Ohni Imaging Inc | Clinic/Center | 8631 W 3rd St # 945e, Los Angeles, CA 90048-5901 | 2020-07-01 |
| 1952924599 | Oracle Imaging Inc. | Clinic/Center | 6941 Brockton Ave, Riverside, CA 92506-3803 | 2020-05-18 |
| 1720625742 | F&m Radiology Medical Center Inc | Clinic/Center | 17779 Ventura Blvd # 100, Encino, CA 91316-3717 | 2019-12-09 |
| 1982240321 | United Care Foundation | Clinic/Center | 2233 Watt Ave Ste 120, Sacramento, CA 95825-0569 | 2019-11-20 |
| 1932744893 | Westcoast Radiology Associates Pllc | Clinic/Center | 4193 Flat Rock Dr Ste 200, Riverside, CA 92505-7113 | 2019-11-14 |
| 1518502087 | Ishraf Corporation | Clinic/Center | 5720 Stoneridge Mall Rd Ste 288, Pleasanton, CA 94588-2830 | 2019-11-08 |
| 1780227769 | Drs Concepts, Incorporated | Clinic/Center | 9335 Reseda Blvd. Suite 102, Northridge, CA 91324 | 2019-10-23 |
| 1538700588 | Central Valley Medical Imaging, LLC | Clinic/Center | 1125 E Spruce Ave Ste 103, Fresno, CA 93720-3385 | 2019-10-01 |
| 1700447497 | Ester A Hanna | Clinic/Center | 72650 Fred Waring Dr Ste 107, Palm Desert, CA 92260-5007 | 2019-06-24 |
| 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.