MRS. LARISSA JEAN POLES (NPI# 1366687709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366687709 |
| Entity Type | Individual |
| Full Name | MRS. LARISSA JEAN POLES |
| Credential | PA-C |
| Practice Address |
3930 4th Ave San Diego CA 92103-3119 |
| Mailing Address |
579 Via Del Caballo San Marcos CA 92078-8911 |
| Practice Telephone | 6192979610 |
| Mailing Telephone | 7602122792 |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2010-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 20111 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3930 4TH AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-3119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134136948 | Nicki Christine Karlo | Physical Therapy Assistant | 3930 4th Ave, San Diego, CA 92103-3119 | 2006-08-02 |
| 1639624299 | U.S. Healthworks Medical Group, PC | Preventive Medicine | 3930 4th Ave, Suite 200, San Diego, CA 92103-3119 | 2016-08-23 |
| 1609232727 | Christopher Lee | Physical Therapy Assistant | 3930 4th Ave, San Diego, CA 92103-3119 | 2016-01-05 |
| 1104219377 | Frn San Diego LLC | Clinic/Center | 3930 4th Ave, Suite 300, San Diego, CA 92103-3119 | 2015-03-12 |
| 1871864116 | Jessica Hurd | Counselor | 3930 4th Ave, 300, San Diego, CA 92103-3119 | 2012-01-18 |
| 1851682785 | Chai Seo Saelee | Social Worker | 3930 4th Ave, Suite 300, San Diego, CA 92103-3119 | 2011-04-26 |
| 1205131414 | Vivienne R Schroeder | Counselor | 3930 4th Ave, #300, San Diego, CA 92103-3119 | 2011-01-19 |
| 1386965333 | Grace Schutze | Social Worker | 3930 4th Ave, Suite# 300, San Diego, CA 92103-3119 | 2010-06-14 |
| 1689905226 | Franco Joseph Korpics | Counselor | 3930 4th Ave, San Diego, CA 92103-3119 | 2010-01-21 |
| 1518298108 | Bonnie Russell | Counselor | 3930 4th Ave, 300, San Diego, CA 92103-3119 | 2010-01-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| 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 |
|---|---|---|---|---|
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| 1639776503 | Nathan Tuan Dinh | Physician Assistant | 8296 Via Escalada, San Diego, CA 92129-2223 | 2020-10-05 |
| 1750988671 | Denise Aquino | Physician Assistant | 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 | 2020-10-04 |
| 1962009183 | Courtney Krysl | Physician Assistant | 14434 Corte Lampara, San Diego, CA 92129-3818 | 2020-10-01 |
| 1497369284 | Brian Carroll | Physician Assistant | 7242 Melotte St, San Diego, CA 92119-1613 | 2020-08-31 |
| 1871104067 | Satoshi Ikeda | Physician Assistant | 16198 Paseo Del Sur, San Diego, CA 92127-6155 | 2020-08-12 |
| 1760009989 | Lili Tran | Physician Assistant | 8865 Calle Tragar, San Diego, CA 92129-2156 | 2020-07-03 |
| 1245857259 | Kendra Roberta Witt | Physician Assistant | 11396 Poblado Rd, San Diego, CA 92127-1351 | 2020-06-25 |
| 1336766344 | Brandon Scott Johnson | Physician Assistant | 1540 Oliver Ave Apt C, San Diego, CA 92109-5595 | 2020-06-25 |
| 1104441021 | Kira Ann Tellache | Physician Assistant | 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 | 2020-06-16 |
| Find all providers in SAN DIEGO | ||||
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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.