JESSICA TAN (NPI# 1568001071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568001071 |
| Entity Type | Individual |
| Full Name | JESSICA TAN |
| Practice Address |
99 Montecillo Rd San Rafael CA 94903-3308 |
| Mailing Address |
2681 Driftwood St Hayward CA 94545-1304 |
| Practice Telephone | 4154444838 |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 81156 | CA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598245755 | Jessica Tan | Physical Therapist | 11335 Ssg Sims St., El Paso, TX 79918 | 2018-08-17 |
| 1598327967 | Jessica Tan | Physician Assistant | 50 Acacia Ave, San Rafael, CA 94901-2230 | 2019-07-05 |
| 1417480310 | Jessica Tan | Nurse Practitioner | 861 Coronado Center Dr Ste 220, Henderson, NV 89052 | 2017-04-07 |
| 1760842181 | Jessica Tan | Case Manager/Care Coordinator | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2016-02-26 |
| 1578713707 | Jessica Suhui Tan | Allergy & Immunology | 1000 Franklin Pkwy, San Mateo, CA 94403-1922 | 2008-09-24 |
| 1417156811 | Jessica Chi-min Tan | Radiology | 505 Parnassus Ave, L-371, San Francisco, CA 94143-2204 | 2007-07-16 |
| Street Address |
99 MONTECILLO RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528889 | Jeffry D Cardneau | Surgery | 99 Montecillo Rd, Mob 1, 2nd Floor, Department of Surgery, San Rafael, CA 94903-3308 | 2005-06-17 |
| 1225645468 | Lauren Freudman | Occupational Therapist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-09-30 |
| 1285254037 | Omar Ahmed | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-04-22 |
| 1447887229 | Meka Angela Parks | Registered Nurse | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-03-24 |
| 1710519202 | Mahsa Khorramdin | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-02-12 |
| 1720626211 | Ava May Mahan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-15 |
| 1437797271 | Alicia Pontecorvo | Dietitian, Registered | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-11 |
| 1437795499 | Shirley Liu | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-11-25 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| 1881168771 | Mary Vertinski | Psychologist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386112951 | Jessica Robinson | Pharmacist | 350 Northgate One, San Rafael, CA 94903-3415 | 2018-11-12 |
| 1225554470 | I-kuan Hsu | Pharmacist | 100 Smith Ranch Rd Fl 2, San Rafael, CA 94903-5552 | 2017-08-19 |
| 1558725168 | Tashi Gonpo | Pharmacist | 1500 Northgate Dr, San Rafael, CA 94903-3671 | 2016-04-09 |
| 1851718498 | Mayra Guzman | Pharmacist | 950 Las Gallinas Av, San Rafael, CA 94903 | 2014-03-20 |
| 1093144594 | Tiffany Deering | Pharmacist | 9 Diego Dr, San Rafael, CA 94903-2367 | 2013-11-05 |
| 1285063172 | Elham Barkhordari-bafoghi | Pharmacist | 1030 Cresta Way, Apt # 3, San Rafael, CA 94903-4842 | 2013-11-01 |
| 1194093351 | Jessica Anne Clubb | Pharmacist | 950 Las Gallinas Ave, Safeway Pharmacy, San Rafael, CA 94903 | 2011-12-02 |
| 1922308345 | Frank Peter Tarantino | Pharmacist | 485 Pinewood Dr, San Rafael, CA 94903-1331 | 2010-11-02 |
| 1740592492 | Dennis Philip Schafer | Pharmacist | 471 3rd St, San Rafael, CA 94901-3576 | 2010-07-10 |
| 1669606984 | Nicole Marie Clausen | Pharmacist | 1525 Francisco Blvd E Ste 2, San Rafael, CA 94901-5560 | 2009-05-14 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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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.