NICOLE FERNANDES (NPI# 1558997569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558997569 |
| Entity Type | Individual |
| Full Name | NICOLE FERNANDES |
| Practice Address |
1300 N Dutton Ave Santa Rosa CA 95401-7112 |
| Mailing Address |
4789 Seneca Park Ave Fremont CA 94538-4074 |
| Practice Telephone | 7073969191 |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2020-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95012649 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NURSE PRACTITIONER LICENSE NUMBER | 95012649 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447567300 | Nicole E Fernandes | Psychologist | 700 Ashford Avenue, Ardsley Middle School, Ardsley, NY 10502 | 2010-09-13 |
| 1760842108 | Nicole I Fernandes | Counselor | 2535 Kettner Blvd, San Diego, CA 92101-1250 | 2016-02-27 |
| Street Address |
1300 N DUTTON AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-7112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487649711 | Patricia Whooley Kulawiak | Family Medicine | 1300 N Dutton Ave, Santa Rosa, CA 95401 | 2005-09-13 |
| 1245830223 | Alexy Francisco Andrade | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2020-10-28 |
| 1588207351 | Megan Culligan | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-10-23 |
| 1376185272 | Ryan Duval | Acupuncturist | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-10-11 |
| 1386295160 | Jordan Michele Petersen | Dental Hygienist | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-09-24 |
| 1871153734 | Priscilla Lujan Rodriguez | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-06-13 |
| 1770148108 | Jennifer Nicole Francis | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-05-01 |
| 1770059750 | Brittany English | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-10-17 |
| 1386129294 | Claire Maureen Kugler | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-09-26 |
| 1689159535 | Jessica Leavitt | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780160234 | Susan English Knowles | Nurse Practitioner | 3383 Airway Dr, Santa Rosa, CA 95403-2005 | 2018-07-18 |
| 1912498726 | Lydia Ann Smith | Nurse Practitioner | 2375 Range Ave Unit 1, Santa Rosa, CA 95403-9419 | 2018-05-29 |
| 1659870186 | Shannon Cross Todd | Nurse Practitioner | 4729a Hoen Ave, Santa Rosa, CA 95405-7862 | 2018-02-11 |
| 1093222408 | Mary Esther Andich | Nurse Practitioner | 2800 Cleveland Ave Ste A, Santa Rosa, CA 95403-2784 | 2018-01-08 |
| 1316473697 | Renee Novakovich | Nurse Practitioner | 704 Adobe Dr, Santa Rosa, CA 95404-2706 | 2017-05-05 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1437549235 | Jennifer Takagi | Nurse Practitioner | 1803 Aspen Leaf Ln, Santa Rosa, CA 95401-4295 | 2015-01-31 |
| 1164828828 | Danielle J Daye | Nurse Practitioner | 50 Montgomery Dr, Santa Rosa, CA 95404-6615 | 2014-11-07 |
| 1609208354 | Derrick Pelton | Nurse Practitioner | 2360 Mendocino Ave Ste A4, Santa Rosa, CA 95403-3154 | 2013-08-05 |
| 1225313869 | Kristine Monson Brown | Nurse Practitioner | 1501 Mendocino Ave, Santa Rosa, CA 95401-4332 | 2011-10-14 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
Please comment or provide details below to improve the information on NICOLE FERNANDES.
| 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.