KEVIN MARTIN WALSH (NPI# 1508200429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508200429 |
| Entity Type | Individual |
| Full Name | KEVIN MARTIN WALSH |
| Credential | M.D. |
| Practice Address |
747 52nd St Room 245 Oakland CA 94609-1809 |
| Practice Telephone | 5104283800 |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A125366 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356419345 | Kevin Michael Walsh | Social Worker | 41-51 East 11th Street, 4th Floor, New York, NY 10003 | 2006-11-30 |
| 1346336302 | Kevin Patrick Walsh | Counselor | 2414 Park Ave, Minneapolis, MN 55404-3713 | 2006-10-05 |
| 1649214438 | Kevin Walsh | Physician Assistant | Saint Barnabas Medical Center, Old Short Hills Road, Livingston, NJ 07039 | 2006-06-15 |
| 1922561075 | Kevin Cunningham Walsh | Student in an Organized Health Care Education/Training Program | 750 E Adams St, Syracuse, NY 13210-2306 | 2019-04-06 |
| 1679035414 | Kevin Patrick Walsh | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-04-02 |
| 1326508656 | Kevin William Walsh | Student in an Organized Health Care Education/Training Program | 501 W 14th St, Wilmington, DE 19801-1013 | 2019-03-22 |
| 1750773339 | Kevin Walsh | Registered Nurse | 625 W Washington Ave, Madison, WI 53703-2637 | 2015-02-19 |
| 1285058883 | Kevin Walsh | Pharmacist | 901 S State Rd, Davison, MI 48423-1721 | 2014-02-18 |
| 1982042073 | Kevin Michael Walsh | Nurse Practitioner | 11100 Euclid Ave, Lt 9001, Cleveland, OH 44106-1716 | 2013-06-11 |
| 1689966939 | Kevin Walsh | Anesthesiology | 525 E 68th St, Box 124, New York, NY 10065-4870 | 2011-05-04 |
| Street Address |
747 52ND ST ROOM 245 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1053921064 | Jessica Stankiewicz Lightcap | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-04 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063831386 | Ron Yalon | Pediatrics | 469 51st St, Oakland, CA 94609-2143 | 2014-04-15 |
| 1801136262 | Anthony S Raimo | Pediatrics | 645 Ramapo Valley Rd, Oakland, NJ 07436-2813 | 2013-02-21 |
| 1326314816 | Darrow Debs Deluca | Pediatrics | 747 52nd Street, Room 201, Pediatric Multispecialty Medical Group, Oakland, CA 94609-1809 | 2012-03-28 |
| 1366760175 | Lynne N Rosen | Pediatrics | 3451 East 12th St., Oakland, CA 94601-3425 | 2010-05-04 |
| 1568698090 | Juan Raul Gutierrez | Pediatrics | 1030 International Ave., Oakland, CA 94606-3730 | 2009-06-10 |
| 1265691190 | Donna J Lombardi-goldfus | Pediatrics | 50 Overlook Ridge, Oakland, NJ 07436 | 2008-06-05 |
| 1578721551 | Josephine A Roen | Pediatrics | 125 2nd St Apt 411, Oakland, CA 94607-4565 | 2008-05-27 |
| 1124294665 | Omid Gheysar | Pediatrics | 1800 Harrison Street 7th Street, Oakland, CA 94612-3429 | 2008-05-05 |
| 1336312891 | Lisa Meredith Siskind | Pediatrics | 3505 Broadway Fl 6, Oakland, CA 94611-5714 | 2008-04-04 |
| 1205027760 | Lisa Ann B Michaels | Pediatrics | 11 E Oak St, Oakland, NJ 07436-2721 | 2007-08-08 |
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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.