GLENN T ROYES (NPI# 1376671743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376671743 |
| Entity Type | Individual |
| Full Name | GLENN T ROYES |
| Credential | HSC |
| Practice Address |
599 Tomales Rd Petaluma CA 94952-5002 |
| Mailing Address |
599 Tomales Rd Petaluma CA 94952 |
| Practice Telephone | 7077657491 |
| Practice Fax Number | 7077657773 |
| Mailing Telephone | 7077657491 |
| Mailing Fax Number | 7077657773 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Street Address |
599 TOMALES RD |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-5002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831167717 | Randall Carl Lucas | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2006-03-08 |
| 1164069480 | Eliza Zetino | Dental Assistant | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2019-12-05 |
| 1467698662 | Jami Rene Moore | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-18 |
| 1740426931 | Maureen Huber | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-18 |
| 1831334168 | Yamil N Vazquez | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952 | 2008-12-16 |
| 1740425073 | Ryan Richard Jablonowski | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-16 |
| 1417192840 | Ashton L. Atkins | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| 1053556480 | Rachel Elaine Burton | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| 1962647396 | Nichole Danielle Mccarthy | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| 1407091838 | William Matthew Hilt | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669689568 | United States Coast Guard | Clinic/Center | 410 Pennsylvania Ave # A, Petaluma, CA 94952-9103 | 2007-05-17 |
| 1710041058 | Coast Guard Training Center Petaluma | Clinic/Center | 599 Tomales Rd, Health Services Division, Petaluma, CA 94952-5002 | 2006-12-21 |
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| 1891109799 | Weed Army Community Hospital | Clinic/Center | Ave B Bldg R190, Warrior Care Center, Fort Irwin, CA 92310 | 2014-06-18 |
| 1871832394 | Branch Medical Clinic Area 62 | Clinic/Center | Bldg 620306 8th Street, Camp Pendleton, CA 92055 | 2013-02-04 |
| 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.