KRISTI JO DIEHL (NPI# 1417080052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417080052 |
| Entity Type | Individual |
| Full Name | KRISTI JO DIEHL |
| Other Name | KRISTI JO GOUGH |
| Credential | PA-C |
| Practice Address |
15361 Central Ave Chino CA 91710-7608 |
| Mailing Address |
16441 Cyan Ct Chino Hills CA 91709-4601 |
| Practice Telephone | 9093937171 |
| Practice Fax Number | 9093937676 |
| Mailing Telephone | 9093938082 |
| Mailing Fax Number | 9096069599 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA18019 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15361 CENTRAL AVE |
| City | CHINO |
| State | CA |
| Zip Code | 91710-7608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053394817 | Cynthia Diane Moreno | Family Medicine | 15361 Central Ave, Chino, CA 91710-7608 | 2005-11-25 |
| 1205311842 | Nicole Renee Basle | Physician Assistant | 15361 Central Ave, Chino, CA 91710-7608 | 2018-09-29 |
| 1043615610 | Moreno Family Medical and Associates Inc | Family Medicine | 15361 Central Ave, Chino, CA 91710-7608 | 2014-10-24 |
| 1720411275 | Sarah Detorres | Physician Assistant | 15361 Central Ave, Chino, CA 91710-7608 | 2013-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962037887 | Corrections and Rehabilitation | Pharmacy | 14901 So Central Avenue, Chino, CA 91710 | 2020-03-11 |
| 1053968289 | California Institute for Men Phcy | Pharmacy | 14901 So Central Ave, Chino, CA 91710 | 2019-08-22 |
| 1982170510 | Kind Care Connections, LLC | In Home Supportive Care | 14726 Ramona Ave # E10, Chino, CA 91710 | 2018-10-22 |
| 1922593789 | Christopher Armando Camarena | Assistant Behavior Analyst | 6062 Eucalyptus Ave, Chino, CA 91710 | 2018-06-25 |
| 1730696519 | Barsoum Dental Corp | Dentist | 14613 Ramona Ave, Chino, CA 91710 | 2018-01-03 |
| 1326569864 | Christina La | Optometrist | 5250 Philadelphia St Ste D, Chino, CA 91710 | 2017-07-06 |
| 1629502554 | Jk Pharmacy Inc | Pharmacy | 5562 Philadelphia St, #110, Chino, CA 91710 | 2017-04-18 |
| 1801336680 | Altek Drugs Inc. | Pharmacy | 13085 Central Ave Ste 2, Chino, CA 91710 | 2017-02-28 |
| 1518405893 | Audrey Ronquillo | Behavior Technician | 800 Ferrari Ln, Suite 100, Ontario, CA 91710 | 2017-02-07 |
| 1952849556 | Jennifer Huynh | Behavior Technician | 800 Ferrari Ln Suite 100, Ontario, CA 91710 | 2017-02-03 |
| Find all providers in zip 91710 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679024426 | Danielle Elisa Martinez | Physician Assistant | 13768 Roswell Ave Ste 115, Chino, CA 91710-1402 | 2016-10-17 |
| 1689860082 | Sean Fitzgerald Coleman | Physician Assistant | 14726 Ramona Ave Ste And107, Chino, CA 91710-5730 | 2007-09-19 |
| 1659563369 | Michael Don Cordia | Physician Assistant | 14726 Ramona Ave Ste 107, Chino, CA 91710-5730 | 2007-08-16 |
| 1356884639 | Adam Elevario | Physician Assistant | 13768 Roswell Ave, Suite 118, Chino, CA 91710-1401 | 2016-11-18 |
| 1952730061 | Heather Michelle Sykes | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2013-11-08 |
| 1003154428 | Neeru Kaur Gaetano | Physician Assistant | 13768 Roswell Ave, Suite 216, Chino, CA 91710-1401 | 2013-01-18 |
| 1649419482 | Andrew Alfred Harris | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2009-02-18 |
| 1609808468 | Jose Domingo Garcia | Physician Assistant | 11760 Central Ave, Suite 100, Chino, CA 91710-1900 | 2006-07-06 |
| 1700815958 | Caryn Joy Axtell-kelly | Physician Assistant | 13193 Central Ave, Suite 220, Chino, CA 91710 | 2006-07-01 |
| 1194753426 | Stephen Anthony Harvey | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2006-06-28 |
| Find all providers in CHINO | ||||
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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.