VALLEY CHILDREN'S SPECIALTY MEDICAL GROUP - DEPT OF DERMATOLOGY (NPI# 1447620539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447620539 |
| Entity Type | Organization |
| Organization Name | VALLEY CHILDREN'S SPECIALTY MEDICAL GROUP - DEPT OF DERMATOLOGY |
| Practice Address |
9300 Valley Childrens Pl Madera CA 93636-8761 |
| Practice Telephone | 5593535700 |
| Practice Fax Number | 5593535708 |
| Mailing Telephone | 5593535700 |
| Mailing Fax Number | 5593535708 |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |
| Authorized Official Name | DEVONNA KAJI (PRESIDENT) |
| Authorized Official Telephone | 5593535700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | VALLEY CHILDREN'S SPECIALTY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
CA | Allopathic & Osteopathic Physicians |
| Street Address |
9300 VALLEY CHILDRENS PL |
| City | MADERA |
| State | CA |
| Zip Code | 93636-8761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405753 | Fred H Laningham | Radiology | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2005-05-24 |
| 1043811953 | Ashley Nicole Peton | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-11-06 |
| 1063013308 | Samantha Carballo Austin | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-11-03 |
| 1982205217 | Stefanie Marie Gibbons | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-11-03 |
| 1114525128 | Kristin Leann Lokey | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-10-12 |
| 1770190969 | Mallory King | Physician Assistant | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-09-30 |
| 1356957161 | Sabrina Star Tovar | Audiologist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-09-17 |
| 1790391621 | Alyssa Catherine Nakaguchi | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-09-16 |
| 1740894773 | Heather Goossen | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-09-08 |
| 1184236820 | Renzio Menico Bantayan Apostol | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043695257 | Kati Pitts | Social Worker | 9300 Valley Children's Pl., Madera, CA 93636 | 2015-07-29 |
| 1386903177 | Christina Lee-ann Badgett | Registered Nurse | 40617 Rd 406, Madera, CA 93636 | 2012-05-14 |
| 1205134897 | Gina West | Counselor | 10120 Lanes Bridge Dr, Madera, CA 93636 | 2011-03-04 |
| 1326342593 | Re Zaw | Pediatrics | 9300 Valley Children's Place, Residency Dept (ge20), Madera, CA 93636 | 2011-01-03 |
| 1013144179 | Cynthia Romer Fata | Pathology | 9300 Valley Childrens Pl # Sc12, Madera, CA 93636 | 2009-06-16 |
| 1689815888 | Nasser Moiduddin | Pediatrics | 9300 Valley Childrens Pl # PC14, Madera, CA 93636 | 2009-03-18 |
| 1174503338 | James Clifton Horspool | Pediatrics | 9300 Valley Children's Place, Mb01, Madera, CA 93636 | 2006-01-21 |
| 1205818465 | James Weston Hole | Obstetrics & Gynecology | 9300 Valley Children's Pl, Fe16, Madera, CA 93636 | 2005-11-15 |
| 1679056493 | Catherine K. Beaumier | Surgery | 9300 Valley Children's Pl., Madera, CA 93636 | 2018-09-07 |
| 1912492216 | Ji Yeon Kwon | Registered Nurse | 9300 Valley Childrens Pl # Ge07, Madera, CA 93636 | 2018-06-28 |
| Find all providers in zip 93636 | ||||
| Taxonomy Code | 207NP0225X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Pediatric Dermatology |
| A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: changed definition, added source] Additional Resources: American Board of Dermatology, 2007, http://www.abderm.org/ A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467811653 | Valley Children's Medical Group - Dept of Dermatology | Dermatology | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2016-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295290567 | Coastal Family Dermatology, PC | Dermatology | 892 Aerovista Pl Ste 120, San Luis Obispo, CA 93401-8054 | 2019-01-31 |
| 1700371275 | Icecreamwala Dermatology Inc | Dermatology | 2435 Webster St Ste 101, Berkeley, CA 94705 | 2018-06-27 |
| 1881989325 | Heather Irina Rishel | Dermatology | 345 W Portal Ave Ste 320, San Francisco, CA 94127-1429 | 2011-06-13 |
| 1396984423 | Marcia J Glenn Md & Associates Dermatology & Laser Med Ctr Inc | Dermatology | 4644 Lincoln Blvd Ste 500, Marina Del Rey, CA 90292-6391 | 2009-02-12 |
| 1528259744 | Phuong Khuu | Dermatology | 900 Blake Wilbur Dr Rm W0069, Stanford, CA 94305 | 2007-08-05 |
| 1932195567 | Neil Frank Gibbs | Dermatology | 34520 Bob Wilson Dr, Dermatology Department, Naval Medical Center, San Diego, CA 92134-2300 | 2005-09-20 |
| 1437594884 | Jessica Sprague | Dermatology | 8010 Frost St Ste 602, San Diego, CA 92123 | 2013-04-29 |
| 1366725590 | Pediatric Dermatology of Orange County PC | Dermatology | 3500 Barranca Pkwy, Ste 160, Irvine, CA 92606-8226 | 2011-09-23 |
| 1245479385 | Dong L Chang M D | Dermatology | 100 N Santa Anita Ave, Arcadia, CA 91006-3108 | 2009-02-12 |
| 1912107970 | Smita Awasthi | Dermatology | 3301 C St Ste 1300, Sacramento, CA 95816-3370 | 2007-07-18 |
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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.