GARY HAVLICEK (NPI# 1568553436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568553436 |
| Entity Type | Individual |
| Full Name | GARY HAVLICEK |
| Credential | CRNA |
| Practice Address |
165 N Clark St Fresno CA 93701-2108 |
| Mailing Address |
3050 E Airport Way Long Beach CA 90806-2404 |
| Practice Telephone | 5592338657 |
| Practice Fax Number | 5592330990 |
| Mailing Telephone | 5624269661 |
| Mailing Fax Number | 5624264227 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 74 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | RN2565630 | 01 |
| Street Address |
165 N CLARK ST |
| City | FRESNO |
| State | CA |
| Zip Code | 93701-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427673748 | Caroline Ford | Nurse Practitioner | 165 N Clark St, Fresno, CA 93701-2108 | 2020-06-11 |
| 1740329655 | Family Planning Associates Medical Group, Inc. | Clinical Medical Laboratory | 165 N Clark St, Fresno, CA 93701-2108 | 2007-02-06 |
| 1487742581 | Nina Capers | Nurse Practitioner | 165 N Clark St, Fresno, CA 93701-2108 | 2006-10-11 |
| 1992899769 | Family Planning Associates Medical Group, Inc. | Clinic/Center | 165 N Clark St, Fresno, CA 93701-2108 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740244 | Tamara Sue Stanic | Registered Nurse | 215 N. Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-29 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1003445693 | Michelle Edwardson | Registered Nurse | 215 North Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-06 |
| 1184253924 | Patricia Calderon | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-03 |
| 1922637032 | Leticia Lopez | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-02 |
| 1275026585 | Yesenia Gonzalez | Nurse Practitioner | 311 Abby Street, Fresno, CA 93701 | 2018-06-11 |
| 1710474606 | Amanda Juarez | Dietitian, Registered | 215 N Fresno, Suite 370, Fresno, CA 93701 | 2018-04-17 |
| 1235650391 | Plastic Surgery Partners of Fresno Inc | Plastic Surgery | 215 N Fresno St, Ste 490, Fresno, CA 93701 | 2017-06-29 |
| 1205369790 | Amy Alagh | Student in an Organized Health Care Education/Training Program | 155 N Fresno Street, Fresno, CA 93701 | 2017-04-11 |
| 1922462159 | Henry Matthew Dunn | Student in an Organized Health Care Education/Training Program | Ucsf Fresno, 155 N. Fresno St., Department of Orthopaedic Surgery, Fresno, CA 93701 | 2016-04-13 |
| Find all providers in zip 93701 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720687395 | Anesthesia First, Inc | Nurse Anesthetist, Certified Registered | 1332 W Herndon Ave Ste 102, Fresno, CA 93711-7118 | 2020-10-23 |
| 1447868013 | Matthew Shirts | Nurse Anesthetist, Certified Registered | 6713 E Princeton Ave, Fresno, CA 93727-1441 | 2020-07-20 |
| 1144858028 | Dennis Casanova Colon | Nurse Anesthetist, Certified Registered | 547 E Weldon Ave, Fresno, CA 93704-6031 | 2020-03-27 |
| 1720543762 | Advanced Anesthesia Incorporated | Nurse Anesthetist, Certified Registered | 568 E Herndon Ave Ste 103, Fresno, CA 93720-2989 | 2019-02-04 |
| 1790230886 | Jonathan Gardner | Nurse Anesthetist, Certified Registered | 2823 Fresno & R St, Fresno, CA 93721-1324 | 2016-08-18 |
| 1396872164 | Gwendolyn K Mckinney | Nurse Anesthetist, Certified Registered | 5859 E Midwick Ln, Fresno, CA 93727-5528 | 2007-02-27 |
| 1437223088 | Terry Kyrm Bavin | Nurse Anesthetist, Certified Registered | 7300 N. Fresno St., Fresno, CA 93720-2942 | 2006-11-17 |
| 1114090230 | Robert Howard Ford II | Nurse Anesthetist, Certified Registered | 2823 Fresno & R Street, Fresno, CA 93721-1365 | 2006-11-16 |
| 1972689537 | Sherry K Wiggins | Nurse Anesthetist, Certified Registered | Fresno and R Street, Fresno, CA 93721 | 2006-10-27 |
| 1538271374 | Bridget Nester Petrillo | Nurse Anesthetist, Certified Registered | 2823 Fresno Street, Fresno, CA 93721-1365 | 2006-08-31 |
| Find all providers in FRESNO | ||||
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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.