TRACY D MANDRYK (NPI# 1356667059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356667059 |
| Entity Type | Individual |
| Full Name | TRACY D MANDRYK |
| Credential | NP |
| Practice Address |
1901 Outlet Center Dr Suite 230 Oxnard CA 93036-0663 |
| Mailing Address |
1011 Waterbury Ln Ventura CA 93001-3841 |
| Practice Telephone | 8059836233 |
| Mailing Telephone | 8057662750 |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2012-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 388425 | CA | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
388425 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1901 OUTLET CENTER DR SUITE 230 |
| City | OXNARD |
| State | CA |
| Zip Code | 93036-0663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245263664 | Vinod K. Valiveti M.d. Inc. | Internal Medicine | 1901 Outlet Center Dr, Suite 250, Oxnard, CA 93036-0663 | 2006-07-09 |
| 1801282116 | Kimberly Ann Mccowan | Nurse Practitioner | 1901 Outlet Center Dr, Oxnard, CA 93036-0663 | 2015-04-13 |
| 1659792752 | Jennifer Nichol Neira | Nurse Practitioner | 1901 Outlet Center Dr, Oxnard, CA 93036-0663 | 2013-12-17 |
| 1801108568 | Sean Chang | Radiology | 1901 Outlet Center Dr, Suite 120, Oxnard, CA 93036-0663 | 2010-07-10 |
| 1609105238 | Courtney Meredith Lillich | Physical Therapist | 1901 Outlet Center Dr, Oxnard, CA 93036-0663 | 2009-12-10 |
| 1902134257 | Gillian Alexandra Lillich | Physical Therapist | 1901 Outlet Center Dr, Ste 110, Oxnard, CA 93036-0663 | 2009-11-25 |
| 1346464054 | Rona Lee Beck | Contractor | 1901 Outlet Center Dr, Suite 110, Oxnard, CA 93036-0663 | 2007-04-12 |
| 1922131291 | Terry Patrick Dillon | Preventive Medicine | 1901 Outlet Center Dr, Suite 100, Oxnard, CA 93036-0663 | 2007-03-14 |
| 1588708218 | Paul V Koscheski | Radiology | 1901 Outlet Center Dr, Oxnard, CA 93036-0663 | 2007-02-16 |
| 1033259635 | David M Cortina | Physical Therapist | 1901 Outlet Center Dr, Suite 110, Oxnard, CA 93036-0663 | 2007-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689508 | Cebrina Dieli | Massage Therapist | 470 Forest Park Blvd., C-212, Oxnard, CA 93036 | 2020-11-06 |
| 1760021810 | Tiffany Anne Eyestonhe | Counselor | 1911 Wiiliams Drive, Star Program, Oxnard, CA 93036 | 2020-01-06 |
| 1356903579 | Usman Khan | Student in an Organized Health Care Education/Training Program | 1911 Williams Drive Suite 200, Oxnard, CA 93036 | 2019-07-08 |
| 1689236937 | Benjamin Jonathan Ponce | Student in an Organized Health Care Education/Training Program | 1911 Williams Drive, Suite 200, Oxnard, CA 93036 | 2019-07-07 |
| 1194296806 | Ezequiel Armando Sanchez | Counselor | 1911 Williams Drive Star Program, Oxnard, CA 93036 | 2018-12-07 |
| 1710457809 | Shadi Heydari Bateni | Counselor | 2150 N. Victoria Avenue, Oxnard, CA 93036 | 2018-11-30 |
| 1023586443 | Reylene Carmen Sanchez | Counselor | 2755 Yearling Place, Oxnard, CA 93036 | 2018-11-02 |
| 1689157117 | For Eyes Optical Co. of California | Eyewear Supplier (Equipment, not the service) | 2820 Portico Way, Suite 1110, Oxnard, CA 93036 | 2018-09-11 |
| 1518445113 | Heather Christian Byhoffer | Marriage & Family Therapist | 1261 W. Gonzales Rd., Oxnard, CA 93036 | 2018-08-06 |
| 1477045110 | Dr. Jeffrey A. Saladin, Dental Corp | Dentist | 2100 Solar Drive, Suite 200, Oxnard, CA 93036 | 2018-05-30 |
| Find all providers in zip 93036 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760780654 | Kathy Won Park | Nurse Practitioner | 1901 Solar Dr Ste 165, Oxnard, CA 93036-2644 | 2011-03-02 |
| 1265087290 | Daniel Laurence Shaw | Nurse Practitioner | 1600 N Rose Ave, Oxnard, CA 93030-3722 | 2019-08-06 |
| 1710177209 | Marie Lazare Kearns | Nurse Practitioner | 1600 N Rose Ave, Oxnard, CA 93030-3722 | 2007-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619442 | Dolores Josephine Meehan | Nurse Practitioner | South Bay Vascular Center, 2255 South Bascom Avenue Suite 200, Campbell, CA 95008-7800 | 2020-11-03 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1851990550 | Fernanda Monteon Ibarra | Nurse Practitioner | 30222 Belmont Ct, Agoura Hills, CA 91301-4611 | 2020-10-22 |
| 1780283168 | Brenda Rienru Rhima | Nurse Practitioner | 24657 Rockston Dr, Corona, CA 92883-1614 | 2020-10-18 |
| 1215535034 | Shiji John | Nurse Practitioner | 3765 Gunnison Cir, Corona, CA 92881-8486 | 2020-10-14 |
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1063028298 | Kanokwan Kultan | Nurse Practitioner | 15850 Babcock St, San Diego, CA 92127-3680 | 2020-09-22 |
| 1538775093 | David Lee | Nurse Practitioner | 5710 S Glennie Ln Apt A, Los Angeles, CA 90016-1063 | 2020-09-21 |
| 1124634886 | Catherine Kestenian | Nurse Practitioner | 351 E Foothill Blvd Ste 250, Arcadia, CA 91006-7426 | 2020-09-18 |
| 1285249565 | Anu Tharoor | Nurse Practitioner | 505 Parnassus Ave Fl 9, San Francisco, CA 94143-2204 | 2020-09-13 |
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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.