DR. JOHN ROBERT WATERSON (NPI# 1578505467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578505467 |
| Entity Type | Individual |
| Full Name | DR. JOHN ROBERT WATERSON |
| Credential | M.D., PH.D. |
| Practice Address |
747 52nd St Children's Hospital & Research Center At Oakland Oakland CA 94609-1809 |
| Practice Telephone | 5104283550 |
| Mailing Telephone | 5104283550 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2013-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
G85487 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G85487 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G85487 | 05 |
| Street Address |
747 52ND ST CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1053921064 | Jessica Stankiewicz Lightcap | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-04 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497071963 | Bryce Abram Mendelsohn | Medical Genetics | 3505 Broadway, Oakland, CA 94611-5714 | 2010-04-08 |
| 1508062910 | Leslie Manace Brenman | Medical Genetics | 275 W Macarthur, Oakland, CA 94611-5641 | 2007-06-22 |
| 1023197167 | Ronald Peter Bachman | Medical Genetics | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2006-11-02 |
| 1417035908 | Bruce D. Blumberg | Medical Genetics | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-01 |
| 1457439226 | Katherine G. Dawson | Medical Genetics | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588282263 | Sabrina Flores Cheng | Medical Genetics | 8 Hill St, Mill Valley, CA 94941-2007 | 2020-07-09 |
| 1972034841 | David Randall Blair | Medical Genetics | 550 16th St # 706, San Francisco, CA 94158-2545 | 2017-03-23 |
| 1841747052 | Risa Peoples | Medical Genetics | 743 Cereza Dr, Palo Alto, CA 94306-3145 | 2016-09-06 |
| 1659739472 | John David Stephens X | Medical Genetics | 220 S California Ave Ste 106, Palo Alto, CA 94306-1636 | 2016-02-08 |
| 1043576069 | Heather Marshall Byers | Medical Genetics | 300 Pasteur Dr Rm A097, Stanford, CA 94305-2200 | 2012-04-03 |
| 1275821555 | Cristel C Chapel Crespo | Medical Genetics | Choc Childrens, 1201 W La Veta Ave, Orange, CA 92868 | 2011-07-20 |
| 1437471810 | Jaime J Barea | Medical Genetics | 9300 Valley Childrens Pl # Ge21, Madera, CA 93636-8761 | 2010-02-25 |
| 1023218062 | Tom W Chu | Medical Genetics | 1025 Cascade Dr, Sunnyvale, CA 94087-4003 | 2007-07-18 |
| 1023224557 | Thomas Slavin Jr. | Medical Genetics | 2430 Cross St, La Crescenta, CA 91214-3103 | 2007-05-14 |
| 1861614299 | Eric Dec | Medical Genetics | 34145 Pacific Coast Hwy # 803, Dana Point, CA 92629-2808 | 2007-05-03 |
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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.