ELLERY BOUWKAMP (NPI# 1558826719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558826719 |
| Entity Type | Individual |
| Full Name | ELLERY BOUWKAMP |
| Credential | PA-C |
| Practice Address |
855 E Madison Ave El Cajon CA 92020-3819 |
| Mailing Address |
300 14th St Apt 706 San Diego CA 92101-7843 |
| Practice Telephone | 6194402751 |
| Mailing Telephone | 6164031375 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA56519 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
855 E MADISON AVE |
| City | EL CAJON |
| State | CA |
| Zip Code | 92020-3819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659301547 | Katherine Francis | Pediatrics | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2006-07-04 |
| 1437768017 | Alisia Alyas | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2020-07-29 |
| 1265966006 | Hannah Green | Family Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2017-04-19 |
| 1255726154 | Benison Lau | Internal Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2015-03-30 |
| 1477951523 | Lindsay Summers | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2014-12-05 |
| 1457769333 | Wegdan Hanna-haddad | Psychologist | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2014-07-24 |
| 1972929404 | Katherine Rose Lais | Registered Nurse | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2014-03-07 |
| 1043655004 | Arim Jayne Lee | Family Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2013-05-05 |
| 1083059265 | Judith Anne Tessema | Family Medicine | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2013-05-01 |
| 1801141163 | Justin Eli Mallit | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2012-07-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447877840 | Margarito Alejandro Torres | Behavior Technician | 1005 S. Sunshine Ave, El Cajon, CA 92020 | 2020-07-01 |
| 1619503166 | Stella Zeicu Varagic | Dentist | 2526 Fletcher Pkwy, El Cajon, CA 92020 | 2020-03-17 |
| 1548827819 | Unexpected Possibilities, Inc | Non-emergency Medical Transport (VAN) | 1015 El Cajon Blvd # A, El Cajon, CA 92020 | 2019-05-22 |
| 1083175707 | Maricela Uriarte D.d.s | Dentist | 164 W Park Ave, El Cajon, CA 92020 | 2019-03-26 |
| 1881153963 | Rubeleta Medina | Nurse Practitioner | 1908 Friendship Drive, El Cajon, CA 92020 | 2019-03-18 |
| 1235619800 | Melissa Gomez | Counselor | 1600 Cuyamaca St, El Cajo, CA 92020 | 2018-08-14 |
| 1013407790 | Erin Metcalf | Family Medicine | 133 W Main St., 240, El Cajon, CA 92020 | 2018-05-17 |
| 1326535220 | Diana Orozco | Counselor | 1870cordell Court, Suite 101, El Cajon, CA 92020 | 2018-04-16 |
| 1104330646 | Mercy Air Service, Inc. | Ambulance | 545 Kenney St Ste G1a, El Cajon, CA 92020 | 2017-11-20 |
| 1790296184 | Way Cool Homecare, Inc | In Home Supportive Care | 900 N. Cuyamaca Street, Ste 201, El Cajon, CA 92020 | 2017-10-12 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1205302403 | Amy Marie Foster | Physician Assistant | 1625 E Main St Ste 100, El Cajon, CA 92021-5240 | 2018-10-16 |
| 1104836659 | George M Zambrana | Physician Assistant | 133 W Main St Ste 100, El Cajon, CA 92020-3325 | 2006-08-08 |
| 1275543068 | Jose Martin Nuno | Physician Assistant | 133 West Main Street, Ste. 100, El Cajon, CA 92020 | 2006-08-08 |
| 1417922873 | Brenda Joy Baker | Physician Assistant | 2815 Steele Canyon Rd, Sovereign Health, El Cajon, CA 92019-4619 | 2006-02-21 |
| 1437768017 | Alisia Alyas | Physician Assistant | 855 E Madison Ave, El Cajon, CA 92020-3819 | 2020-07-29 |
| 1679039093 | Monica Kamantigue Munoz | Physician Assistant | 1625 E Main St, Ste 100, El Cajon, CA 92021-5240 | 2019-02-11 |
| 1144733544 | Matthew John Anderson | Physician Assistant | 278 Avocado Ave, El Cajon, CA 92020-4604 | 2017-11-08 |
| 1699201616 | Laura Allen | Physician Assistant | 278 Avocado Ave, El Cajon, CA 92020-4604 | 2017-05-11 |
| 1629457403 | Jennifer Hamblin | Physician Assistant | 300 S Pierce St, El Cajon, CA 92020-4124 | 2015-05-26 |
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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.