MIRACLE KENNON (NPI# 1417403163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417403163 |
| Entity Type | Individual |
| Full Name | MIRACLE KENNON |
| Practice Address |
711 W 54th St Los Angeles CA 90037-3723 |
| Mailing Address |
711 W 54th St Los Angeles CA 90037 |
| Practice Telephone | 3235931035 |
| Mailing Telephone | 3235931035 |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 374U00000X | Home Health Aide | D8116361 | CA | Nursing Service Related Providers |
| Street Address |
711 W 54TH ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90037-3723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871119701 | Carina Lizette Guerra | Nurse Practitioner | St. John's Well Child and Family Center, Inc., 808 W. 58th Street, Los Angeles, CA 90037 | 2020-06-16 |
| 1114556263 | Arm 4 Arm Foundation | Clinic/Center | 231 W Vernon Ave., Suite 101, 201, Los Angeles, CA 90037 | 2020-04-01 |
| 1407329766 | Lucidite Sleep Laboratory & Treatment Center Inc | Clinic/Center | 231 W Vernon Ave. Suite 108, Los Angeles, CA 90037 | 2019-01-09 |
| 1013491505 | Nancy Sandoval | Social Worker | 644 W 42nd Place, Los Angeles, CA 90037 | 2018-09-20 |
| 1932603081 | Adam Wiswell | Psychologist | 3982 S. Figueroa Street, Suite 203, Los Angeles, CA 90037 | 2018-03-22 |
| 1548764392 | St. John's Well Child and Family Center, Inc. | Clinic/Center | 1000 W. 50th St, Los Angeles, CA 90037 | 2018-03-19 |
| 1134637150 | Tamayo Inc & Lascoe Inc Dental Partnership | Dentist | 4400 S Broadway Ste #103, Los Angeles, CA 90037 | 2018-01-11 |
| 1295282283 | Catherine Azzopardi | Social Worker | 4601 S Broadway, Los Angeles, CA 90037 | 2016-09-07 |
| 1619423266 | Esmeralda Garcia | Dietitian, Registered | 808 W. 58th Street, 2nd Floor, Los Angeles, CA 90037 | 2016-09-01 |
| 1225405921 | Sophan Cheng | Nurse Practitioner | 808 W. 58th Street, Los Angeles, CA 90037 | 2015-08-28 |
| Find all providers in zip 90037 | ||||
| Taxonomy Code | 374U00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Home Health Aide |
| A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730719162 | Melissa B Gordon | Home Health Aide | 5518 S Manhattan Pl, Los Angeles, CA 90062-2621 | 2020-01-24 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1780239244 | Dorothy Bridges | Home Health Aide | 6755 6th Ave, Los Angeles, CA 90043-4407 | 2019-08-01 |
| 1083178370 | Micky K Ghirmay | Home Health Aide | 3730 W 27th St Apt 313, Los Angeles, CA 90018-5203 | 2019-01-31 |
| 1174034037 | Kelly Hadnott-brown | Home Health Aide | 4515 Mont Eagle Pl, Los Angeles, CA 90041-3418 | 2017-10-18 |
| 1760871784 | Walter L Brown | Home Health Aide | 1511 W 59th Pl, Los Angeles, CA 90047-1208 | 2015-01-14 |
| 1346413895 | Pauline Murray | Home Health Aide | 3321 W 54th St, Los Angeles, CA 90043-4821 | 2008-04-04 |
| 1639385255 | Sheila Renee Mitchell | Home Health Aide | 1060 E 53rd St Apt 204, Los Angeles, CA 90011-4662 | 2007-05-14 |
| 1205395399 | Jeffrey Lynn | Home Health Aide | 11257 National Blvd, Los Angeles, CA 90064-3921 | 2019-03-18 |
| 1629548441 | Darenesha Evette Peters | Home Health Aide | 8424 Hooper Ave, Los Angeles, CA 90001-3741 | 2018-12-05 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90037 |
Please comment or provide details below to improve the information on MIRACLE KENNON.
| 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.