MS. JACLYN MICHELLE BEATTY (NPI# 1417320235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417320235 |
| Entity Type | Individual |
| Full Name | MS. JACLYN MICHELLE BEATTY |
| Credential | N.P. |
| Practice Address |
445 Grand Oak Ct Walnut Creek CA 94598-3952 |
| Practice Telephone | 9257875388 |
| Mailing Telephone | 9257875388 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2017-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 26NR17665400 | NJ | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 95066000 | CA | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 192187 | TN | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
95004745 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
20625 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
445 GRAND OAK CT |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-3952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093100562 | Elizabeth Anne Chase | Nurse Practitioner | 2634 Grande Camino, Walnut Creek, CA 94598-3509 | 2015-04-01 |
| 1982097853 | Marianne Orton | Nurse Practitioner | 301 Lennon Ln, Suite 203, Walnut Creek, CA 94598-2483 | 2015-03-16 |
| 1538413117 | Carrie Toni Chan | Nurse Practitioner | 106 La Casa Via, Suite 240, Walnut Creek, CA 94598-3086 | 2012-11-02 |
| 1700084753 | Martha Jane Richards | Nurse Practitioner | 2123 Ygnacio Valley Rd, Ste K-100, Walnut Creek, CA 94598-3395 | 2007-07-10 |
| 1669509501 | Michelle L Minor | Nurse Practitioner | 1455 Montego, Walnut Creek, CA 94598-2990 | 2007-02-27 |
| 1932258308 | Faith Ellen Silvani | Nurse Practitioner | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2007-01-08 |
| 1942366349 | Elizabeth Ellen Willer | Nurse Practitioner | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-12-29 |
| 1326149626 | Margaret Cameron | Nurse Practitioner | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528668167 | Amber Briana Curry | Nurse Practitioner | 1336 6th Ave, San Francisco, CA 94122-2504 | 2020-10-30 |
| 1194325092 | Caitlin Pirruccello | Nurse Practitioner | 5400 Balboa Blvd Ste 210, Encino, CA 91316-5208 | 2020-10-29 |
| 1851990832 | Casey Domine | Nurse Practitioner | 1750 10th St., Apt. A, Oakland, CA 94607 | 2020-10-21 |
| 1184221798 | Larae Jean Hansen | Nurse Practitioner | 7805 Redondo St, Ventura, CA 93004-3814 | 2020-10-06 |
| 1497361612 | Brandon Philip Obero Vinzon | Nurse Practitioner | 155 E 4th St Apt 206, Long Beach, CA 90802-2498 | 2020-09-22 |
| 1538774070 | Emily Ruth Schoen | Nurse Practitioner | 110 Calle Balboa, San Clemente, CA 92672-3132 | 2020-09-11 |
| 1831715770 | Veronica Munoz-rivera I | Nurse Practitioner | 1327 Leopard Ct, Palmdale, CA 93551-4360 | 2020-06-16 |
| 1770102295 | Roxanna Arely Caballero | Nurse Practitioner | 185 N Douglas Ave, Fresno, CA 93727-3637 | 2020-04-14 |
| 1053949214 | Gina Louise James | Nurse Practitioner | 124 Stoney Hill Dr, Folsom, CA 95630-4614 | 2020-03-31 |
| 1831723519 | Patrinella Gonzales | Nurse Practitioner | 81833 Dr Carreon Blvd Ste 6, Indio, CA 92201-5590 | 2020-03-03 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
Please comment or provide details below to improve the information on MS. JACLYN MICHELLE BEATTY.
| 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.