RYAN BACON (NPI# 1528510682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528510682 |
| Entity Type | Individual |
| Full Name | RYAN BACON |
| Practice Address |
434 Coe Ave San Jose CA 95125-1621 |
| Mailing Address |
232 E Gish Rd San Jose CA 95112-4706 |
| Practice Telephone | 4084648694 |
| Mailing Telephone | 4084537616 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114425378 | Ryan Bacon | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-01-23 |
| Street Address |
434 COE AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95125-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1376197848 | Mariam Samir Abadir | Dentist | 1670 Westwood Dr. Suite K, San Jose, CA 95125 | 2019-08-01 |
| 1750870747 | Gertrud Stojancic | Massage Therapist | 3315 Almaden Expressway, # 27/29, San Jose, CA 95125 | 2018-05-04 |
| 1659809259 | Edward Escoto | Assistant Behavior Analyst | 2075 Lincoln Ave Ste D, San Jose, CA 95125 | 2017-05-25 |
| 1104288422 | Kristin Ann Dessau | Counselor | 1261 Lincoln Avenue, Suite 202, San Jose, CA 95125 | 2016-03-25 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1598042905 | Walgreens | Exclusive Provider Organization | 2585 Almaden Road, San Jose, CA 95125 | 2011-11-14 |
| 1881981488 | Kevin Jia-chian Yen | Dentist | 1660 Willow St Ste 5, San Jose, CA 95125 | 2011-07-02 |
| 1699093724 | Lokahi Acupuncture, Inc. | Acupuncturist | 1688 Willow Street, Suite B, San Jose, CA 95125 | 2010-05-13 |
| 1538482468 | Mark Lucius Yoslow | Psychologist | 970 Minnesota Avenue, San Jose, CA 95125 | 2010-03-06 |
| Find all providers in zip 95125 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619592292 | Feng Zheng | Case Manager/Care Coordinator | 298a Bernal Road, San Jose, CA 95119-1809 | 2020-06-10 |
| 1881234375 | Harpreet Kaur | Case Manager/Care Coordinator | 1691 Bagpipe Way, San Jose, CA 95121-1506 | 2020-01-13 |
| 1790321214 | Jesse Schulte | Case Manager/Care Coordinator | 2 N Market St, San Jose, CA 95113-1211 | 2019-11-19 |
| 1386288017 | Path (people Assisting The Homeless) | Case Manager/Care Coordinator | 290 N. 2nd Street San Jose Ca, San Jose, CA 95112 | 2019-11-06 |
| 1154964252 | Darra Lea Velasco | Case Manager/Care Coordinator | 171 N Capitol Ave Apt 4, San Jose, CA 95127-2333 | 2019-10-21 |
| 1851948038 | Xinia Maria Muniz | Case Manager/Care Coordinator | 5066 New Trier Ave, San Jose, CA 95136-2720 | 2019-08-22 |
| 1790246577 | Gary Anduin Garrick | Case Manager/Care Coordinator | 1356 Ridder Park Dr, San Jose, CA 95131-2313 | 2019-03-26 |
| 1972076347 | William Ray Brice | Case Manager/Care Coordinator | 834 Opal Dr Apt 2, San Jose, CA 95117-2662 | 2019-01-08 |
| 1285103697 | Connie Bustillo | Case Manager/Care Coordinator | 1356 Ridder Park Drive, San Jose, CA 95131 | 2018-11-14 |
| 1235605528 | Melissa Ann Morgan | Case Manager/Care Coordinator | 428 N. White Rd., San Jose, CA 95127 | 2018-10-15 |
| Find all providers in SAN JOSE | ||||
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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.