DR. LINA JACKLYN KENNEDY (NPI# 1467719260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467719260 |
| Entity Type | Individual |
| Full Name | DR. LINA JACKLYN KENNEDY |
| Credential | M.D. |
| Practice Address |
3828 Schaufele Ave Suite 300 Long Beach CA 90808-1793 |
| Mailing Address |
3828 Schaufele Ave Ste 300 Long Beach CA 90808-1793 |
| Practice Telephone | 5629971144 |
| Practice Fax Number | 5629893612 |
| Mailing Telephone | 5629971144 |
| Mailing Fax Number | 5629893612 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2018-05-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
A141381 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3828 SCHAUFELE AVE SUITE 300 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90808-1793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306830211 | Martin W. Muth | Obstetrics & Gynecology | 3828 Schaufele Ave, Suite 200, Long Beach, CA 90808-1791 | 2005-09-07 |
| 1598148942 | Waltzman Plastic and Reconstructive Surgery | Plastic Surgery | 3828 Schaufele Ave, Suite 360, Long Beach, CA 90808-1791 | 2015-07-02 |
| 1073946943 | Wave Imaging, LLC | Clinic/Center | 3828 Schaufele Ave, Ste 250, Long Beach, CA 90808-1793 | 2013-08-15 |
| 1912254749 | Elizabeth Horvitz West | Obstetrics & Gynecology | 3828 Schaufele Ave, Suite 200, Long Beach, CA 90808-1791 | 2012-08-10 |
| 1346524691 | Veronica Wong Chang | Physician Assistant | 3828 Schaufele Ave, Suite 300, Long Beach, CA 90808-1793 | 2011-10-05 |
| 1255621694 | Makell Charles Murphy | Physician Assistant | 3828 Schaufele Ave, Suite 340, Long Beach, CA 90808-1791 | 2011-04-18 |
| 1720389919 | Yvonne Elise Rodriguez | Family Medicine | 3828 Schaufele Ave, Suite 200, Long Beach, CA 90808-1791 | 2010-11-04 |
| 1194967240 | Joshua Waltzman | Plastic Surgery | 3828 Schaufele Ave, Suite 360, Long Beach, CA 90808-1782 | 2009-04-02 |
| 1235304833 | Azadeh Farin | Neurological Surgery | 3828 Schaufele Ave, Suite 340, Long Beach, CA 90808 | 2008-04-24 |
| 1083789085 | Raafat N. Mattar | Anesthesiology | 3828 Schaufele Ave, Ste 320, Long Beach, CA 90808-1793 | 2006-11-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629558713 | Long Beach-lakewood Orthopedic Institute | Orthopaedic Surgery | 3828 Schaufele Ave Ste 320, Long Beach, CA 90808 | 2018-08-17 |
| 1376072710 | Premiere Cottages Inc. | Assisted Living Facility | 4815 Premiere Ave, Long Beach, CA 90808 | 2017-06-08 |
| 1760911184 | Collaborative Partners for Success, LLC | Speech-Language Pathologist | 3472 Tulane Avenue, Long Beach, CA 90808 | 2017-06-08 |
| 1942658604 | Susan S Orr | Physical Therapist | 3833 Worsham Ave #301, Long Beach, CA 90808 | 2016-06-02 |
| 1447611298 | Rac Brittany House | Alzheimer Center (Dementia Center) | 5641 Centralia Avenue, Long Beach, CA 90808 | 2016-03-08 |
| 1003234261 | Ray Ira Apter | Social Worker | 4333 N. Greenbrier Road, Long Beach, CA 90808 | 2014-04-03 |
| 1043590649 | Fonda Jiang | Allergy & Immunology | 3816 Woodruff Ave Ste 209, Long Beach, CA 90808 | 2011-08-26 |
| 1457640757 | Alexander Cristian Gavrila | Dentist | 4200 Lakewood Blvd, Long Beach, CA 90808 | 2011-04-07 |
| 1851629034 | Reyana Ewing | Dietitian, Registered | 4195 N Viking Way Ste D, Long Beach, CA 90808 | 2009-11-25 |
| 1548497597 | Veronika Lee Hoover | Social Worker | 4195 N. Viking Way, Suite F, Long Beach, CA 90808 | 2009-06-17 |
| Find all providers in zip 90808 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861643611 | William David Tutrone | Dermatology | 604 E Park Ave, Long Beach, NY 11561-2505 | 2008-10-09 |
| 1467659904 | Glass and Pomerantz, Md's, Pllc | Dermatology | 265 W Park Ave, Long Beach, NY 11561-3222 | 2007-06-28 |
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| 1578175006 | Lms Medical Services | Dermatology | 1118 N Mccadden Pl, Los Angeles, CA 90038-1213 | 2020-08-17 |
| 1932687241 | Silhouette Medical Group | Dermatology | 101 E Vineyard Ave Ste 107, Livermore, CA 94550-6877 | 2018-07-31 |
| 1780188482 | California Dermatology Physicians | Dermatology | 1902 Fullerton Ave # 102, Corona, CA 92881-3112 | 2018-03-19 |
| 1942709738 | Azadeh Shirazi Md Inc | Dermatology | 7301 Girard Ave Ste 202, La Jolla, CA 92037-5151 | 2018-02-07 |
| 1205342920 | Solano Dermatology Associates Inc | Dermatology | 1700 2nd St Ste 220, Napa, CA 94559-2455 | 2017-12-18 |
| 1831603901 | Laser Medspa, Inc. | Dermatology | 73655 El Paseo Ste N, Palm Desert, CA 92260-4304 | 2017-11-27 |
| 1326427204 | Jennifer Herrmann Md Inc | Dermatology | 421 N Rodeo Dr Ste 7, Beverly Hills, CA 90210-4514 | 2015-05-25 |
| 1235540196 | Microsurgery Goup | Dermatology | 21039 S Figueroa Ave Suite 201, Carson, CA 90745-7042 | 2014-05-14 |
| 1811261183 | Robert Ray Nettles | Dermatology | 8500 Wilshire Blvd Ste 630, Beverly Hills, CA 90211-3139 | 2012-03-02 |
| 1164748737 | Jane Chung | Dermatology | 895 E Fremont Ave Ste 201, Sunnyvale, CA 94087-2973 | 2010-04-08 |
| Find all providers with the same taxonomy | ||||
| City | LONG BEACH |
| Zip Code | 90808 |
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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.