DR. JAKE KELLY (NPI# 1386094993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386094993 |
| Entity Type | Individual |
| Full Name | DR. JAKE KELLY |
| Practice Address |
701 Scofield Ave Wasco CA 93280-7515 |
| Mailing Address |
425 Estancia Irvine CA 92602-1108 |
| Practice Telephone | 6617588400 |
| Mailing Telephone | 4085050654 |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
Behavioral Health & Social Service Providers |
| Street Address |
701 SCOFIELD AVE |
| City | WASCO |
| State | CA |
| Zip Code | 93280-7515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225059827 | Soe Htay | Internal Medicine | 701 Scofield Ave, Wasco, CA 93280-7515 | 2006-07-21 |
| 1487281549 | Ryan Christopher Pritchard | Psychologist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2020-03-26 |
| 1215583695 | Barbara Ann Tongate | Social Worker | 701 Scofield Ave, Wasco, CA 93280-7515 | 2019-08-12 |
| 1396269544 | Charles Matthew Ching | Psychologist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2017-07-31 |
| 1447774534 | Farshid Yadegar | Psychologist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2017-07-31 |
| 1790144483 | Cathleen Jane Paderes Solano | Social Worker | 701 Scofield Ave, Wasco, CA 93280-7515 | 2016-02-23 |
| 1508232000 | Samantha Hill | Social Worker | 701 Scofield Ave, Wasco, CA 93280 | 2015-08-19 |
| 1225431299 | Tereza Maya | Registered Nurse | 701 Scofield Ave, Wasco, CA 93280-7515 | 2014-10-03 |
| 1467861021 | Ann Nicholas | Psychologist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2014-08-07 |
| 1861806754 | Nima Patel | Psychologist | 701 Scofield Ave, Wasco State Prison, Wasco, CA 93280 | 2014-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609411461 | Juan Louis Castillo Jr. | Case Manager/Care Coordinator | 29341 Kimberlina Road Suite 102, Wasco, CA 93280 | 2019-11-15 |
| 1346768108 | Crystal Magana | Case Manager/Care Coordinator | 930 F St., Wasco, CA 93280 | 2017-08-31 |
| 1669914099 | Noemi Elizondo | Marriage & Family Therapist | 29341 Suite 102 Kimberlina Road, Wasco, CA 93280 | 2016-11-16 |
| 1437431376 | Javier Barba | Counselor | 29325 Kimberlina Rd., Wasco, CA 93280 | 2011-09-16 |
| 1235381724 | Maribel Pelayo | Counselor | 1217 7th Street, Wasco, CA 93280 | 2008-10-16 |
| 1194909218 | Lourdes Garza I | Counselor | 29325 Kimberlina Rd, Wasco, CA 93280 | 2007-12-26 |
| 1396876397 | Mike Mais Sagarian | Dentist | 1229 7-th St., Wasco, CA 93280 | 2007-03-08 |
| 1588791495 | Walter Patton II | Counselor | 29325 Kimberlina Road, Wasco, CA 93280 | 2007-02-27 |
| 1982739298 | Donna Antoinette Rede | Social Worker | 29325 Kimberling Rd., Wasco, CA 93280 | 2007-02-23 |
| 1568949576 | Raymond Antonio Martinez Guzman | Counselor | 930 F St, Wasco, CA 93280 | 2018-07-23 |
| Find all providers in zip 93280 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639448103 | Camellia Mohadjer | Psychologist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2011-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962049130 | Ashley Cohen | Psychologist | 320 Linda Dr, Hollister, CA 95023-6646 | 2019-12-05 |
| 1174185540 | Daisy Covarrubias | Psychologist | 9727 Diana Ave, Riverside, CA 92503-4281 | 2019-07-05 |
| 1538620786 | San Diego Forensic Psychology Corporation | Psychologist | 4640 Cass Street, # 90422, San Diego, CA 92109 | 2019-03-29 |
| 1982169587 | Jocelyn Roland | Psychologist | 2937 Veneman Ave Ste B125, Modesto, CA 95356-0690 | 2019-02-07 |
| 1265997936 | Shanda Angioli | Psychologist | 4640 Cass St # 90422, San Diego, CA 92109-2804 | 2019-02-06 |
| 1841755626 | Brianna Marie Alcantar | Psychologist | 855 E Laurel Dr Bldg H, Salinas, CA 93905-1300 | 2019-02-05 |
| 1316423692 | Millie Georganna Herrera | Psychologist | 4001 State Higheay 104, Ione, CA 95640 | 2018-07-19 |
| 1003308446 | Kiara Dixon | Psychologist | 15501 San Pablo Ave # G-317, Richmond, CA 94806-5848 | 2018-06-01 |
| 1700322633 | Lindsay Heber | Psychologist | 28204 Picadilly Pl, Castaic, CA 91384-3830 | 2017-01-17 |
| 1295193738 | Schuyler Weifu Liao | Psychologist | 2576 W San Ramon Ave, Fresno, CA 93711-2749 | 2016-01-28 |
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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.