MR. JOHN LEE KITCHELL (NPI# 1366419731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366419731 |
| Entity Type | Individual |
| Full Name | MR. JOHN LEE KITCHELL |
| Credential | P.A. |
| Practice Address |
1209 Woodrow Ave Suite B-10 Modesto CA 95350-1288 |
| Practice Telephone | 2095587331 |
| Mailing Telephone | 2095587331 |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10078 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA | MK0571198 | 01 |
| CA | CALIFORNIA STATE PA LIC | PA10078 | 01 |
| Street Address |
1209 WOODROW AVE SUITE B-10 |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-1288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508832965 | Hilda A Villarreal | Clinical Nurse Specialist | 1209 Woodrow Ave, Modesto, CA 95350-1288 | 2006-02-27 |
| 1114300209 | Karen Ann P Rayos | Family Medicine | 1209 Woodrow Ave, Modesto, CA 95350-1288 | 2015-07-07 |
| 1093910275 | County of Stanislaus | Clinic/Center | 1209 Woodrow Ave, Ste. B-10, Modesto, CA 95350-1288 | 2007-06-18 |
| 1295747152 | Juan Lopez Solorza | Family Medicine | 1209 Woodrow Ave, Suite B10, Modesto, CA 95350-1288 | 2006-08-12 |
| 1447268966 | Thomas Raymond Wenstrup | Family Medicine | 1209 Woodrow Ave, Suite B10, Modesto, CA 95350-1288 | 2006-08-03 |
| 1346258555 | Seang Meng Seng | Family Medicine | 1209 Woodrow Ave, Suite B10, Modesto, CA 95350-1288 | 2006-08-03 |
| 1134137680 | Suzanne Louise Meyer | Internal Medicine | 1209 Woodrow Ave, Suite B10, Modesto, CA 95350-1288 | 2006-08-03 |
| 1629095567 | Kay Zagaris | Nurse Practitioner | 1209 Woodrow Ave, Suite B-10, Modesto, CA 95350-1288 | 2006-07-16 |
| 1760445589 | Leslie Ann Halseth | Physician Assistant | 1209 Woodrow Ave, Modesto, CA 95350-1273 | 2006-04-11 |
| 1326001074 | Barbara Ruddy | Nurse Practitioner | 1209 Woodrow Ave, Ste B-10, Modesto, CA 95350 | 2006-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
| Find all providers in zip 95350 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992987259 | Kristine Ann Rebiero | Physician Assistant | 1030 Scenic Dr, Modesto, CA 95350-6133 | 2007-11-28 |
| 1174606800 | Delia Yanira Hernandez | Physician Assistant | 1317 Oakdale Rd Ste 440, Modesto, CA 95355 | 2006-10-24 |
| 1194821223 | Linda Sue Phillips | Physician Assistant | 3400 Finch Rd, Parker-racor Healthstat Clinic, Modesto, CA 95354-4125 | 2006-09-16 |
| 1265415525 | Natalie Angele Mattos | Physician Assistant | 1114 6th St, Modesto, CA 95354-2203 | 2005-11-21 |
| 1598264103 | Corey Tremblay | Physician Assistant | 817 Coffee Rd Ste B, Modesto, CA 95355-4241 | 2018-02-09 |
| 1720592033 | Jennifer Ann O'connor | Physician Assistant | 1114 6th St, Modesto, CA 95354-2203 | 2017-11-22 |
| 1275938748 | Cleiban Hernan Vega | Physician Assistant | 1234 Mchenry Ave, Modesto, CA 95350-5373 | 2014-10-27 |
| 1861895278 | David Ronald Boone | Physician Assistant | 1409 E Briggsmore Ave, Modesto, CA 95355-2707 | 2014-09-30 |
| 1730594078 | Joshua Clements | Physician Assistant | 2101 Tenaya Dr, Modesto, CA 95354-3930 | 2014-06-25 |
| 1134473564 | Sheena Latrac Allen | Physician Assistant | 1441 Florida Ave, Modesto, CA 95350-4404 | 2012-11-07 |
| Find all providers in MODESTO | ||||
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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.