MARTHA Y BRANTLEY-JACKSON (NPI# 1396302261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396302261 |
| Entity Type | Individual |
| Full Name | MARTHA Y BRANTLEY-JACKSON |
| Practice Address |
25400 Alessandro Blvd Ste 101 Moreno Valley CA 92553-4319 |
| Practice Telephone | 9515700043 |
| Mailing Telephone | 9515700043 |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-05-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | CA | Managed Care Organizations |
| Street Address |
25400 ALESSANDRO BLVD STE 101 |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92553-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447815659 | Quinn Community Outreach Corporation | Health Maintenance Organization | 25400 Alessandro Blvd Ste 101, Moreno Valley, CA 92553-4319 | 2019-05-02 |
| 1750900023 | Eudora Mitchell | Health Educator | 25400 Alessandro Blvd Ste 101, Moreno Valley, CA 92553-4319 | 2020-04-15 |
| 1497313662 | Yvonne Roberson Choyce | Health Maintenance Organization | 25400 Alessandro Blvd Ste 101, Moreno Valley, CA 92553-4319 | 2019-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104441559 | Tanya Gentle | Marriage & Family Therapist | 2319 Cottonwood Avenue, Building A Suite 110, Moreno Valley, CA 92553 | 2020-06-11 |
| 1275194227 | Antonio Pearce | Psychologist | 12968 Frederick Street, Suite D, Moreno Valley, CA 92553 | 2019-06-20 |
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1952813420 | Shanaya Frederick | Driver | 14929 Spinnaker Lane, Moreno Valley, CA 92553 | 2017-10-24 |
| 1457879413 | R & C Logistic Services, LLC | Private Vehicle | 14768 Briana St, Moreno Valley, CA 92553 | 2017-08-30 |
| 1720505084 | Elda Pricila Hernandez | Behavioral Analyst | 24596 Atwood Ave.apt1, Moreno Valley, CA 92553 | 2017-08-28 |
| 1174044101 | Ps Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 24594 Sunnymead Blvd, Suite M, Moreno Valley, CA 92553 | 2017-06-29 |
| 1942736327 | Richard Pantoja Reyna | Licensed Vocational Nurse | 23119 Cottonwood Ave Bld A Suite 110, Moreno Valley, CA 92553 | 2017-05-04 |
| 1255872719 | Sibonisiwe Moyo Johnson | Nurse Practitioner | 22555 Alessandro Blvd Ste B, Moreno Valley, CA 92553 | 2017-03-16 |
| 1518311190 | Ryan Macavinta | Nurse Practitioner | 22765 Alessandro Blvd., Moreno Valley, CA 92553 | 2016-04-20 |
| Find all providers in zip 92553 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326498601 | A Tender Love and Care Inc | Preferred Provider Organization | 12968 Frederick St Ste Abc&d, Moreno Valley, CA 92553-5229 | 2016-06-16 |
| 1346392040 | Humanistic Ffa, Inc. | Preferred Provider Organization | 13800 Heacock St Ste D117, Moreno Valley, CA 92553-3340 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154961142 | Hoag Physcian Partners | Preferred Provider Organization | 16148 Sand Canyon Ave Fl 2, Irvine, CA 92618-3700 | 2020-01-08 |
| 1356806525 | Premierone Plus Aco | Preferred Provider Organization | 1210 N Jefferson St Ste D, Anaheim, CA 92807-1630 | 2019-02-01 |
| 1548730450 | Mastour & Fard Dental Corp | Preferred Provider Organization | 587 N. Ventu Park Road., Suite C, Newberry Park, CA 91320 | 2018-12-04 |
| 1689151698 | David W Schwartz Md A Medical Corporation | Preferred Provider Organization | 29645 Rancho California Rd Ste 105, Temecula, CA 92591 | 2018-07-23 |
| 1184100471 | Care Allies Ipa, Inc | Preferred Provider Organization | 1211 W La Palma Ave Ste 309, Anaheim, CA 92801-2811 | 2018-07-19 |
| 1245723071 | Pacific Associates Medical Group, Inc. | Preferred Provider Organization | 9900 Lakewood Blvd Ste 103, Downey, CA 90240-4039 | 2018-06-06 |
| 1821585266 | Anthony Nguyen Dds Inc | Preferred Provider Organization | 1125 E 17th St Ste N156, Santa Ana, CA 92701-2215 | 2018-04-20 |
| 1275038051 | Ryan Lange D.m.d. Inc. | Preferred Provider Organization | 17897 Macarthur Blvd Ste 100, Irvine, CA 92614-0532 | 2018-03-26 |
| 1649798190 | Freedom Physicians Corporation | Preferred Provider Organization | 2295 Huntington Dr., Ste. D, San Marino, CA 91108 | 2017-09-05 |
| 1952835282 | Dr. Jose Flores D.d.s Inc. | Preferred Provider Organization | 11510 Downey Ave, Downey, CA 90241 | 2017-04-13 |
| Find all providers with the same taxonomy | ||||
| City | MORENO VALLEY |
| Zip Code | 92553 |
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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.