JACQUELINE SURRENCY (NPI# 1568693398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568693398 |
| Entity Type | Individual |
| Full Name | JACQUELINE SURRENCY |
| Credential | P.A-C |
| Practice Address |
1414 East Florence Ave Los Angeles CA 90001-2010 |
| Mailing Address |
9145 Rosecrans Ave Bellflower CA 90706-2137 |
| Practice Telephone | 3235881383 |
| Mailing Telephone | 5623059222 |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2013-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA20403 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1414 EAST FLORENCE AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90001-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730722539 | Lisa Crockom | Technician | 1838 E. Badillo Street Apt 1, Los Angeles, CA 90001 | 2019-10-24 |
| 1679047229 | Rosario Montes | Behavior Technician | 6907 Hooper Ave, Los Angeles, CA 90001 | 2019-01-16 |
| 1467902031 | Fun Dental 4 Kids 2 | Dentist | 1014 E Manchester Ave, Suite I, Los Angeles, CA 90001 | 2016-10-07 |
| 1295100709 | Central City Community Health Center | Clinic/Center | 1236 E Florence Ave, Los Angeles, CA 90001 | 2015-12-09 |
| 1437596327 | Natasha Nasha Andrews | Clinic/Center | 1620 E. 83rd Street, Los Angeles, CA 90001 | 2013-05-31 |
| 1679827943 | Denise Michelle Betters | Counselor | 8019 S Compton Ave., Los Angeles, CA 90001 | 2012-11-07 |
| 1790050763 | Animo Locke Tech Charter High School | Community/Behavioral Health | 810 E. 111th Street, Room # 113 & 114, Los Angeles, CA 90001 | 2012-03-09 |
| 1093021602 | Larthia Renard Dunham | Social Worker | 8019 S. Compton Blvd., Los Angeles, CA 90001 | 2010-08-20 |
| 1114258761 | Central City Comm Hlt Ctr Mobile Unit | General Practice | 5986 Central Avenue, Los Angeles, CA 90001 | 2010-01-21 |
| 1457688517 | Yesenia Cruz | Dental Assistant | 1119 E 64th St., Los Angeles, CA 90001 | 2009-11-11 |
| Find all providers in zip 90001 | ||||
| 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 |
|---|---|---|---|---|
| 1154929644 | Tatum Little | Physician Assistant | 3307 W 79th St, Los Angeles, CA 90043-5249 | 2020-10-15 |
| 1144828963 | Chan Ho Park | Physician Assistant | 4721 Oakwood Ave, Los Angeles, CA 90004-3112 | 2020-10-14 |
| 1235737172 | Jennifer Rae Levitt Physician Assistant, Inc | Physician Assistant | 1439 N Highland Ave Ste 1059, Los Angeles, CA 90028-7622 | 2020-10-13 |
| 1174120943 | Melody Fatehi | Physician Assistant | 6228 Orange St Apt 9, Los Angeles, CA 90048-4836 | 2020-10-05 |
| 1467063826 | Hannah Shannon Rihani | Physician Assistant | 1737 Midvale Ave, Los Angeles, CA 90024-5512 | 2020-08-11 |
| 1356969901 | Emily Rachel Lavi | Physician Assistant | 1132 S Holt Ave Apt 7, Los Angeles, CA 90035-2424 | 2020-07-09 |
| 1083242952 | Julia Andrea Hurtado | Physician Assistant | 3783 Cimarron St, Los Angeles, CA 90018-4463 | 2020-03-27 |
| 1174150130 | Susan C. Williams | Physician Assistant | 2215 Alcazar St, Los Angeles, CA 90033-1003 | 2020-03-26 |
| 1720615776 | Shannon Hakakeyan | Physician Assistant | 1580 Manning Ave Apt 303, Los Angeles, CA 90024-6086 | 2020-03-26 |
| 1952938243 | Jayanti Sharma | Physician Assistant | 1515 Amherst Ave Apt 303, Los Angeles, CA 90025-3677 | 2020-03-25 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90001 |
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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.