MEMORIALCARE HEALTH SYSTEM (NPI# 1467822411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467822411 |
| Entity Type | Organization |
| Organization Name | MEMORIALCARE HEALTH SYSTEM |
| Other Organization Name | CANCER RISK AND PREVENTION PROGRAM |
| Practice Address |
24302 Paseo De Valencia Laguna Hills CA 92653-3115 |
| Practice Telephone | 9494528854 |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2015-10-02 |
| Authorized Official Name | JENNA TIDWELL (GENETIC COUNSELOR) |
| Authorized Official Telephone | 9494528854 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170300000X | Genetic Counselor, MS | GC000665 | CA | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Cancer Risk and Prevention Program | Former Legal Business Name - Organization |
| Street Address |
24302 PASEO DE VALENCIA |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407969561 | Saddleback Outpatient Surgery Center Ltd | Clinic/Center | 24302 Paseo De Valencia, Laguna Hills, CA 92653-3115 | 2006-08-15 |
| 1376935155 | Alicia Scocchia | Genetic Counselor, MS | 24302 Paseo De Valencia, Laguna Hills, CA 92653-3115 | 2015-03-03 |
| 1306267380 | Memorial Radiation Oncology Medical Grouop | Radiology | 24302 Paseo De Valencia, Laguna Hills, CA 92653-3115 | 2013-12-18 |
| 1831436534 | Kavaljit K Chahal | Nurse Practitioner | 24302 Paseo De Valencia, Suite 200, Laguna Hills, CA 92653-3115 | 2013-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 170300000X |
| Grouping | Other Service Providers |
| Classification | Genetic Counselor, MS |
| A masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; identifies interventions to manage or ameliorate disease risk; educates about inheritance, testing, management, prevention, ethical issues, resources, and research; and counsels to promote informed choices and adaptation. Certification was established in 1993 by the American Board of Genetic Counseling and prior to that by the American Board of Medical Genetics. Requirements for experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: National Society of Genetic Counselors [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376935155 | Alicia Scocchia | Genetic Counselor, MS | 24302 Paseo De Valencia, Laguna Hills, CA 92653-3115 | 2015-03-03 |
| 1053650309 | Diana Kristine De Rosa | Genetic Counselor, MS | 24401 Calle De La Louisa, Suite 200, Laguna Hills, CA 92653-3623 | 2013-02-06 |
| 1972849933 | Nadine Rayes | Genetic Counselor, MS | 24401 Calle De La Louisa, Laguna Hills, CA 92653-3623 | 2012-12-19 |
| 1194925255 | Sandra Marie Brown | Genetic Counselor, MS | 24401 Calle De La Louisa, Suite 200, Laguna Hills, CA 92653-3623 | 2007-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366058950 | Daisy Hernandez | Genetic Counselor, MS | 2020 Zonal Ave # 410, Los Angeles, CA 90089-0121 | 2020-09-18 |
| 1114532769 | Jenna Stoltzfus | Genetic Counselor, MS | 725 Welch Rd # 5273, Palo Alto, CA 94304-1601 | 2020-09-10 |
| 1063026144 | Jacob Comeaux | Genetic Counselor, MS | 1450 Biggy St # 2517r, Los Angeles, CA 90033-1006 | 2020-09-04 |
| 1831700277 | Christina Kimiko Fujii | Genetic Counselor, MS | 5641 Delcliff Cir, Sacramento, CA 95822-2456 | 2020-08-10 |
| 1114535994 | Meghan Therese Blunt | Genetic Counselor, MS | 333 City Blvd W Ste 800, Orange, CA 92868-5901 | 2020-07-17 |
| 1639794076 | Joshua Ryan Barnhart | Genetic Counselor, MS | 133 La Casa Via Ste 140, Walnut Creek, CA 94598-3005 | 2020-06-11 |
| 1548883648 | Marian Joy Godinez Tsang | Genetic Counselor, MS | 4445 Thistle Dr, San Jose, CA 95136-2051 | 2020-05-22 |
| 1730702044 | Meghan Juliana Mckenna | Genetic Counselor, MS | 900 Blake Wilbur Dr Rm W3036, Palo Alto, CA 94304-2201 | 2020-05-20 |
| 1861014458 | Makenna Nicole Dubois | Genetic Counselor, MS | 9110 Blackbird Ave, Fountain Valley, CA 92708-6404 | 2020-05-18 |
| 1700426889 | Donna Lee Bernstein | Genetic Counselor, MS | 239 Reserve Ct, San Marcos, CA 92078-2054 | 2020-01-07 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
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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.