DR. MARIANNE A MCKENNETT (NPI# 1376639666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376639666 |
| Entity Type | Individual |
| Full Name | DR. MARIANNE A MCKENNETT |
| Credential | MD |
| Practice Address |
865 3rd Ave Suite 133 Chula Vista CA 91911-1300 |
| Mailing Address |
4004 Beyer Blvd San Ysidro CA 92173-2007 |
| Practice Telephone | 6194986200 |
| Practice Fax Number | 6194270134 |
| Mailing Telephone | 6194284463 |
| Mailing Fax Number | 6194282625 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G57243 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | FHC70394F | 01 |
| Street Address |
865 3RD AVE SUITE 133 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91911-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609868181 | Advanced Eye Care | Ophthalmology | 865 3rd Ave, Suite 121, Chula Vista, CA 91911-1300 | 2005-08-19 |
| 1669947792 | Brenton Roman | Psychologist | 865 3rd Ave, Chula Vista, CA 91911-1300 | 2018-10-04 |
| 1588060214 | Vivencio B. Abante, Dds, Inc. | Clinic/Center | 865 3rd Ave, 120, Chula Vista, CA 91911-1300 | 2014-11-06 |
| 1033461801 | Roxane M. Santiago | Pediatrics | 865 3rd Ave, Suite 101, Chula Vista, CA 91911-1349 | 2012-10-03 |
| 1780909903 | Sean J Rodriguez | Family Medicine | 865 3rd Ave, #133, Chula Vista, CA 91910-1349 | 2010-03-31 |
| 1770718975 | Mary Ann Palomino | Family Medicine | 865 3rd Ave, Suite #133, Chula Vista, CA 91911-1300 | 2009-05-18 |
| 1942435144 | Ryan Rahee Yoon | Family Medicine | 865 3rd Ave, Suite 133, Chula Vista, CA 91911-1300 | 2009-05-18 |
| 1699900852 | Toni Jo Canton | Student in an Organized Health Care Education/Training Program | 865 3rd Ave, Suite# 133, Chula Vista, CA 91911-1300 | 2009-05-18 |
| 1760633028 | Myra Kurtz Ebeling | Dietitian, Registered | 865 3rd Ave, Chula Vista, Chula Vista, CA 91911-1300 | 2008-10-06 |
| 1063678720 | Briana Mejia | Student in an Organized Health Care Education/Training Program | 865 3rd Ave, Suite 133, Chula Vista, CA 91911-1300 | 2008-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011064 | Hfm Inc | Pharmacy | 750 Medical Center Court, Suite 8, Unit A, Chula Vista, CA 91911 | 2020-07-24 |
| 1659991198 | Cindy Way | Student in an Organized Health Care Education/Training Program | 1161 Bay Blvd. Ste. B Chula Vista,ca 91911, Chula Vista, CA 91911 | 2020-04-24 |
| 1083243455 | Uriel Angel Gonzalez | Student in an Organized Health Care Education/Training Program | 1161 Bay Boulevard B, Chula Vista, Chula Vista, CA 91911 | 2020-04-07 |
| 1083252464 | Denisse Patricia Macias | Dentist | 235 East Orange Avenue, Apartment E4, Chula Vista, CA 91911 | 2019-12-16 |
| 1952955494 | Jenifer Irene Wright | Counselor | 1180 Third Ave Suite C-3, Chula Vista, CA 91911 | 2019-08-01 |
| 1891357075 | Myriam Lourdes Scales | Counselor | 1172 3rd Ave Suite D1, Chula Vista, CA 91911 | 2019-07-08 |
| 1295228328 | Centro De Salud De La Comunidad De San Ysidro, Inc | Clinic/Center | 880 Third Ave Ste A, Chula Vista, CA 91911 | 2018-06-13 |
| 1902398589 | The Arc of San Diego | Day Training, Developmentally Disabled Services | 1280 Nolan Avenue, Chula Vista, CA 91911 | 2018-05-31 |
| 1003344292 | Jalitza Cardona | Peer Specialist | 853 3rd Ave, Suite C, Chula Vista, CA 91911 | 2017-06-01 |
| 1598138042 | Amy Nylund | Nurse Practitioner | 754 Medical Center Ct Ste 100, Chula Vista, CA 91911 | 2015-11-05 |
| Find all providers in zip 91911 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588197826 | Miguel Alvarez-estrada | Family Medicine | 480 Fourth Ave Ste 403, Chula Vista, CA 91910-4413 | 2017-04-04 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| 1285088013 | Yelennia Palacios | Family Medicine | 480 4th Ave Ste 403, Chula Vista, CA 91910-4413 | 2016-04-18 |
| 1437554979 | Martin Kabongo, M.d., Apc | Family Medicine | 1040 Tierra Del Rey Ste 107, Chula Vista, CA 91910-7865 | 2014-10-27 |
| 1396167813 | Mohammed K Elsayed A Proffesional Corporation | Family Medicine | 330 Oxford St Ste 106, Chula Vista, CA 91911-3118 | 2014-01-17 |
| 1760702237 | Jean Rizkallah, Md, Inc | Family Medicine | 450 Fourth Ave., Ste 408, Chula Vista, CA 91910-4430 | 2010-06-08 |
| 1174841936 | Jean Rizkallah, Md | Family Medicine | 450 Fouth Ave, Ste 407, Chula Vista, CA 91910-0000 | 2010-05-04 |
| 1033341409 | Andrew J Pasetti | Family Medicine | 644 Naples Street, Toc Chula Vista, Chula Vista, CA 91911 | 2009-08-18 |
| 1831328616 | Marina Udowenko | Family Medicine | 450 Fourth Ave Ste 408, Chula Vista, CA 91910-4430 | 2009-07-14 |
| 1982840518 | Rebecca Smith, Md, Medical Corporation | Family Medicine | 272 Salinas Dr Unit 165, Chula Vista, CA 91914-0444 | 2009-01-03 |
| Find all providers in CHULA VISTA | ||||
| City | CHULA VISTA |
| Zip Code | 91911 |
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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.