KATHRYN WICKARD (NPI# 1538783212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538783212 |
| Entity Type | Individual |
| Full Name | KATHRYN WICKARD |
| Practice Address |
14715 East Highway 20 Clearlake Oaks CA 95423 |
| Mailing Address |
Po Box 366 Clearlake Oaks CA 95423-0366 |
| Practice Telephone | 7076681800 |
| Mailing Telephone | 7079981800 |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
271931 | CA | Nursing Service Providers |
| Street Address |
14715 EAST HIGHWAY 20 |
| City | CLEARLAKE OAKS |
| State | CA |
| Zip Code | 95423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235762402 | Lyndsey Irene Cook | Counselor | 14715 East Highway 20, Clearlake Oaks, CA 95423 | 2020-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851851182 | Shawn Paul Paonessa | Counselor | 14715 East Hwy 20, Clearlake Oaks, CA 95423 | 2019-03-22 |
| 1063859494 | Celia M Drill | Behavioral Analyst | 12594 Acorn St., Clearlake Oaks, CA 95423 | 2013-05-24 |
| 1932431012 | Marie Mostin Crail | Internal Medicine | 12842 3rd Street, Clearlake Oaks, CA 95423 | 2010-02-01 |
| 1285727586 | Arthur Colyn Rehe | Chiropractor | 12600 Foothill Blvd, Clearlake Oaks, CA 95423 | 2006-10-02 |
| 1992134100 | East Lake Elementary | Local Education Agency (LEA) | 13050 High Valley Road, Clearlake Oaks, CA 95423 | 2013-11-07 |
| 1578866323 | Hilltop Recovery Services | Substance Abuse Rehabilitation Facility | 14715 Highway 20, Clearlake Oaks, CA 95423-0366 | 2010-12-17 |
| 1578995072 | East Lake Elementary School | Local Education Agency (LEA) | 13050 High Valley Road, Clearlake Oaks, CA 95423-0577 | 2013-08-07 |
| 1528108453 | Darcy Towner Skarada | Marriage & Family Therapist | 12454 The Plaza, Clearlake Oaks, CA 95423-0773 | 2007-02-08 |
| 1194945022 | Kim Marie Baughan Young | Marriage & Family Therapist | 12454 The Plaza, Clearlake Oaks, CA 95423-0773 | 2007-04-25 |
| 1871593343 | Clearlake Oaks Fire Protection District | Ambulance | 12655 E Highway 20, Clearlake Oaks, CA 95423-8312 | 2005-07-27 |
| Find all providers in zip 95423 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467075549 | Tracy Eileen Erickson | Registered Nurse | 8950 Cal Center Dr Ste 160, Sacramento, CA 95826-3225 | 2020-05-22 |
| 1942837232 | Joe Charles Filipi | Registered Nurse | 29 Rowan Dr, Aliso Viejo, CA 92656-4280 | 2020-03-25 |
| 1932739141 | Wallace T. Wiggam | Registered Nurse | 2403 Professional Dr # Ca, Santa Rosa, CA 95403-3007 | 2020-01-16 |
| 1144785254 | Vincent Falcone | Registered Nurse | 6715 W Wren Ave, Visalia, CA 93291-8344 | 2019-02-02 |
| 1427544642 | Tamekia Latesica Brown | Registered Nurse | 9418 Wareham Dr, Bakersfield, CA 93313-5816 | 2018-07-11 |
| 1942701313 | Beatrix Dozier | Registered Nurse | 293 N State College Blvd Apt 2061, Orange, CA 92868-5715 | 2018-02-21 |
| 1326564147 | Continued Care Nursing Services Inc. | Registered Nurse | 45741 Shadow Mountain Dr, Palm Desert, CA 92260-4624 | 2017-08-15 |
| 1265989727 | Nurses for Safe Access | Registered Nurse | 27209 Highway 189, Blue Jay, CA 92317 | 2016-09-01 |
| 1265883250 | Kelley Hoffman | Registered Nurse | 148 W Avenida San Antonio, San Clemente, CA 92672-4354 | 2016-06-30 |
| 1215396114 | Richard Perlstein | Registered Nurse | 23524 Daisetta Dr, Newhall, CA 91321-3721 | 2016-02-19 |
| Find all providers with the same taxonomy | ||||
| City | CLEARLAKE OAKS |
| Zip Code | 95423 |
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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.