MYRN LISA MEDLOCK (NPI# 1427230630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427230630 |
| Entity Type | Individual |
| Full Name | MYRN LISA MEDLOCK |
| Credential | RN, PHN |
| Practice Address |
660 E Los Angeles Ave Ste B2 Simi Valley CA 93065-1884 |
| Practice Telephone | 8055781111 |
| Practice Fax Number | 8055781104 |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | 410535 | CA | Other Service Providers |
| Street Address |
660 E LOS ANGELES AVE STE B2 |
| City | SIMI VALLEY |
| State | CA |
| Zip Code | 93065-1884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992861553 | Aegis Treatment Centers, LLC | Clinic/Center | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2006-12-28 |
| 1366052656 | John Charles Laux | Counselor | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2020-08-03 |
| 1568081305 | Jacqueline Villasenor | Licensed Vocational Nurse | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2020-04-12 |
| 1336773233 | Chiemeziem Ikonte | Counselor | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2020-02-28 |
| 1942856646 | Gabriela Maria Diaz | Counselor | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2019-08-18 |
| 1902452717 | Ashley Stavrinou | Licensed Vocational Nurse | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2019-08-16 |
| 1831745637 | Hector Alejandro Diaz | Licensed Vocational Nurse | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2019-08-16 |
| 1932668225 | Heidi Ida Higgins | Counselor | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2019-03-15 |
| 1083194864 | Emma Pallone | Marriage & Family Therapist | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2018-08-21 |
| 1851807093 | Kristen Michelle Bergo | Counselor | 660 E Los Angeles Ave Ste B2, Simi Valley, CA 93065-1884 | 2017-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312243 | Healing Hands Health Care Corp | Hospice Care, Community Based | 585 E. Los Angeles Ave, Suite H-b, Simi Valley, CA 93065 | 2020-09-29 |
| 1487261731 | Healing Love Health Care Services, Inc. | Hospice Care, Community Based | 585 E. Los Angeles Ave., Suite H - A, Simi Valley, CA 93065 | 2020-09-29 |
| 1528682499 | Nicole G. Nalbandian | Dentist | First Street Dental Group and Orthodontics, 1197 E Los Angeles Ave Ste E, Simi Valley, CA 93065 | 2020-06-05 |
| 1316597230 | K-clear Nursing Inc | Family Medicine | 1822 Springgate Ln Unit G., Simi Valley, CA 93065 | 2019-09-12 |
| 1780242313 | Valencia Medical Inc | Family Medicine | 1526 Patricia Ave, Unit 159, Simi Valley, CA 93065 | 2019-05-29 |
| 1962920553 | Taylor Pediatrics | Pediatrics | 2755 Alamo Street Ste: 201, Simi Valley, CA 93065 | 2017-09-02 |
| 1487181301 | Renee Brooks | Marriage & Family Therapist | Ventura County Behavioral Health, 1227 E. Los Angeles Ave., Simi Valley, CA 93065 | 2017-05-23 |
| 1225577208 | Amanda Blake | Dietitian, Registered | 2592 Victoria St, Simi Valley, CA 93065 | 2017-02-23 |
| 1245778364 | Tyler James Arauza | Behavior Technician | 2856 Thicket Pl., Simi Valley, CA 93065 | 2017-02-09 |
| 1992169007 | Sahar Yaftaly | Dentist | 2045 Royal Ave Ste 109, Simi Valley, CA 93065 | 2016-04-06 |
| Find all providers in zip 93065 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114104940 | Laura L Riley | Case Manager/Care Coordinator | 1881 Morley St, Simi Valley, CA 93065-3529 | 2008-01-23 |
| 1366628851 | Reyna Chang | Case Manager/Care Coordinator | 234 Winton Ct, Simi Valley, CA 93065-6296 | 2008-01-14 |
| 1093372138 | Healthy Senior Care Partners | Case Manager/Care Coordinator | 1965 Yosemite Ave Ste 120, Simi Valley, CA 93063-5220 | 2019-05-23 |
| 1033232715 | Jeanne M Colon | Case Manager/Care Coordinator | 3150 E Los Angeles Ave, Simi Valley, CA 93065-3940 | 2007-04-09 |
| 1750404208 | Lenier Sean Baxter | Case Manager/Care Coordinator | 3150 E Los Angeles Ave, Simi Valley, CA 93065-3940 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275935 | Grecia Leticia Garcia | Case Manager/Care Coordinator | 1830 Rodgers Rd Apt F, Hanford, CA 93230-1930 | 2020-11-03 |
| 1679173835 | Cristina Palacios-gomez | Case Manager/Care Coordinator | 1834 E Lester Ave, Fresno, CA 93720-1963 | 2020-10-27 |
| 1417557653 | Jeannine Arnetta Nash | Case Manager/Care Coordinator | 7614 Lemon Ave Ste C, Lemon Grove, CA 91945-1619 | 2020-10-27 |
| 1932709359 | Vue Moua | Case Manager/Care Coordinator | 4812 Conzelman Way, Elk Grove, CA 95757-2508 | 2020-10-26 |
| 1932709458 | Andre Howard | Case Manager/Care Coordinator | 2281 Hurley Way Apt 10, Sacramento, CA 95825-2337 | 2020-10-26 |
| 1194324020 | Project Raised | Case Manager/Care Coordinator | 3839 Amanda St, Unit 133, West Covina, CA 91792-2759 | 2020-10-21 |
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1750989240 | David John Schmidt-cook | Case Manager/Care Coordinator | 5580 Foothill Rd, Rocklin, CA 95677-3316 | 2020-10-15 |
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1841897675 | Madeline Hannah Starkenburg | Case Manager/Care Coordinator | 11559 Claridge Dr, Rch Cucamonga, CA 91730-7246 | 2020-10-05 |
| Find all providers with the same taxonomy | ||||
| City | SIMI VALLEY |
| Zip Code | 93065 |
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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.