DENA R PRUITT (NPI# 1497908750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497908750 |
| Entity Type | Individual |
| Full Name | DENA R PRUITT |
| Credential | PAC |
| Practice Address |
3035 N Main St Soquel CA 95073-2204 |
| Practice Telephone | 8314658680 |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2014-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA60053140 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA51240 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60053140 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3035 N MAIN ST |
| City | SOQUEL |
| State | CA |
| Zip Code | 95073-2204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861697328 | J. Talisman Pomeroy, Iv, M.d. | Specialist | 3035 N Main St, Soquel, CA 95073-2204 | 2007-06-15 |
| 1053794776 | Monica Gonzalez | Physician Assistant | 3035 N Main St, Soquel, CA 95073-2204 | 2015-06-30 |
| 1275797466 | Jennifer J Choate Md | Clinic/Center | 3035 N Main St, Soquel, CA 95073-2204 | 2008-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083963938 | Camille Ditter | Social Worker | 281 Paradise Lane, Soquel, CA 95073 | 2012-09-06 |
| 1811212640 | Rebecca C Hughes | Registered Nurse | 3622 Pringle Lane, Soquel, CA 95073 | 2010-04-05 |
| 1144450966 | Victoria Eagle | Counselor | 2425 Porter Street, #7, Soquel, CA 95073 | 2009-07-15 |
| 1184879405 | Mark Kevin Kalemos | Social Worker | 5905 Soquel Dr #300, Soquel, CA 95073 | 2008-12-01 |
| 1710144845 | Pauline Irene Fillion | Marriage & Family Therapist | 5905 Soquel Dr., Ste 200, Soquel, CA 95073 | 2008-05-16 |
| 1750508362 | Vickie Assunto | Marriage & Family Therapist | 2805 Porter St., Soquel, CA 95073 | 2007-04-18 |
| 1245356286 | Judy Gonzalez | Counselor | 2715 Porter Street, Soquel, CA 95073 | 2007-03-21 |
| 1942330550 | Jasmine Debra Berke | Acupuncturist | 2425 Porter Street, Soquel, CA 95073 | 2007-03-06 |
| 1275690802 | Andrea Beth Wachter | Marriage & Family Therapist | 5905 Soquel Dr 650, Soquel, CA 95073 | 2007-01-02 |
| 1194886606 | Shirley Laden Marcus | Marriage & Family Therapist | 5905 Soquel Drive, Suite 250, Soquel, CA 95073 | 2006-12-12 |
| Find all providers in zip 95073 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912568684 | Marian Padilla | Physician Assistant | 2950 Research Park Dr, Soquel, CA 95073-2000 | 2019-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
| Find all providers with the same taxonomy | ||||
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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.