MIKA KAKEFUDA DERYNCK (NPI# 1477914307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477914307 |
| Entity Type | Individual |
| Full Name | MIKA KAKEFUDA DERYNCK |
| Credential | M.D. |
| Practice Address |
27 Hilltop Rd San Mateo CA 94402-1146 |
| Practice Telephone | 4159993933 |
| Mailing Telephone | 4159993933 |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2016-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | GO79889 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA MEDICAL LICENSE | GO79889 | 01 |
| Street Address |
27 HILLTOP RD |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-1146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
| Find all providers in zip 94402 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790349090 | Amy Melissa Hofmann | Specialist | 1720 S Amphlett Blvd # S110, San Mateo, CA 94402-2702 | 2019-04-23 |
| 1790256550 | Gemma Margaret Mary Roche | Specialist | 430 Peninsula Ave, San Mateo, CA 94401-1682 | 2018-12-05 |
| 1598236358 | Avalon Skin Care and Electrolysis Inc | Specialist | 430 Peninsula Ave Ste 8, San Mateo, CA 94401-1683 | 2018-12-05 |
| 1346605938 | Roderick Cooper | Specialist | 1108 S. El Camino Real, San Mateo, CA 94404 | 2015-12-23 |
| 1245475623 | Barbara Jean Neter | Specialist | 1900 Ofarrell St Ste 250, San Mateo, CA 94403-1387 | 2008-12-12 |
| 1265651780 | Marna M Skaar Md Inc | Specialist | 50 S San Mateo Dr Ste 280, San Mateo, CA 94401-3859 | 2007-04-24 |
| 1225252075 | Sharryn R Jones | Specialist | 1600 E 3rd Ave, #2807, San Mateo, CA 94401-2166 | 2007-04-12 |
| 1700900800 | Sharon Ann Clark | Specialist | 50 South San Mateo Drive, Ste. 105, San Mateo, CA 94401 | 2007-03-16 |
| 1689763781 | Maryam Arjomand | Specialist | 136 North San Mateo Dr, #1010, San Mateo, CA 94401 | 2006-10-12 |
| 1083667539 | Timothy Q Offensend | Specialist | 50 S San Mateo Dr Ste 120, San Mateo, CA 94401-3831 | 2006-05-18 |
| Find all providers in SAN MATEO | ||||
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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.