DR. DIANNE YVONNE HARRIS (NPI# 1457379455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457379455 |
| Entity Type | Individual |
| Full Name | DR. DIANNE YVONNE HARRIS |
| Credential | M.D. |
| Practice Address |
101 Bodin Cir Sgcxe Travis Afb CA 94535-1809 |
| Mailing Address |
5164 Bass Ct Fairfield CA 94534-6621 |
| Practice Telephone | 7074237165 |
| Mailing Telephone | 7073446730 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | G064099 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962958314 | Dianne Harris | Licensed Practical Nurse | 1215 Colony Trl, Fairburn, GA 30213-1281 | 2016-08-26 |
| 1699005967 | Dianne Marie Harris | Registered Nurse | 4172 Antler Ln, Liverpool, NY 13090-6817 | 2010-01-08 |
| 1053713503 | Dianne Harris | Registered Nurse | 517 N Rampart St, New Orleans, LA 70112-3503 | 2014-09-16 |
| 1104102680 | Dianne Harris | Registered Nurse | 24 W Kingsbridge Rd, Mount Vernon, NY 10550-4945 | 2011-10-27 |
| 1336325869 | Dianne Harris | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2008-01-15 |
| 1154548956 | Dianne Harris | Counselor | 11457 Shoemaker, Detroit, MI 48213 | 2007-04-20 |
| 1992922678 | Dianne Harris | Pharmacist | 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462-1047 | 2007-04-20 |
| Street Address |
101 BODIN CIR SGCXE |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893276 | Charles A Tujo | Radiology | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-06-30 |
| 1538769351 | Chelsey Violet Pelkey | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-30 |
| 1538768114 | Jordan Rose | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-23 |
| 1821606591 | Madelyn Hale | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-20 |
| 1932727856 | Julie Thein | Audiologist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-07 |
| 1063039501 | Shae Daniel Bryant | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-01 |
| 1598381089 | Aaron J Surbaugh | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-06-19 |
| 1194348466 | Amanda Vance | Registered Nurse | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-05-21 |
| 1427681196 | Bradley Burkey | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-20 |
| 1821629288 | Gloria Calvillo | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295719334 | Michael Ross | Military Health Care Provider | 124 Bradley Blvd, Travis Afb, CA 94535-1340 | 2005-12-02 |
| 1932720927 | Jameson Reich | Military Health Care Provider | 101 Bodin Cir Bldg 777, Travis Afb, CA 94535-1809 | 2020-04-30 |
| 1225699903 | Willie Gene Mcclure IIi | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2019-06-24 |
| 1548208069 | Synya Kauhane Balanon | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1629692389 | Christopher Matey | Military Health Care Provider | 34800 Bob Wilson Dr Ste 110, San Diego, CA 92134-1110 | 2020-05-29 |
| 1982225769 | Jin Ah Kim | Military Health Care Provider | Naval Medical Center San Diego 38400 Bon Wilson Drive, San Diego, CA 92134-5000 | 2020-05-03 |
| 1124647680 | Katherine Koliadko | Military Health Care Provider | 11023 Evans St, Loma Linda, CA 92354-2708 | 2020-04-14 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1588292858 | Korina Erin Sandoval | Military Health Care Provider | Naval Medical Center Drive 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2020-03-31 |
| 1033746508 | Hannah Johnson | Military Health Care Provider | 34800 Bob Wilson Dr Ste 403, San Diego, CA 92134-1403 | 2020-03-25 |
| 1891336541 | Prana Hands Nonprofit | Military Health Care Provider | 2180 Garnet Ave Ste 3l, San Diego, CA 92109-3676 | 2019-10-03 |
| 1578124194 | David M Allen | Military Health Care Provider | 1st Mlg, Bldg 150121, Camp Pendleton, CA 92055 | 2019-06-25 |
| 1992366587 | Darion Pegues | Military Health Care Provider | 3530 Kelsey St, San Diego, CA 92124-3516 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
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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.