DR. JEAN A GUSTAFSON (NPI# 1578802054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578802054 |
| Entity Type | Individual |
| Full Name | DR. JEAN A GUSTAFSON |
| Credential | M.D. |
| Practice Address |
17 Thalia St Mill Valley CA 94941-2020 |
| Practice Telephone | 4153887144 |
| Mailing Telephone | 4153887144 |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A042354 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528369675 | Jean M. Gustafson | Physical Therapist | 80 North Main Street, Mayfield Elementary School, Mayfield, NY 12117 | 2010-11-05 |
| 1437445442 | Jean M. Gustafson | Family Medicine | 401 N 9th St, Bismarck, ND 58501-4530 | 2011-06-28 |
| 1841378148 | Jean Gustafson | Social Worker | 111 Infirmary Way, 127 Hills North, Amherst, MA 01003-9287 | 2006-11-02 |
| Street Address |
17 THALIA ST |
| City | MILL VALLEY |
| State | CA |
| Zip Code | 94941-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730707464 | Onward Cares, Inc. | Private Vehicle | 201 Morning Sun Ave, Mill Valley, CA 94941 | 2020-07-09 |
| 1255973848 | Cara Nicole Christie | Dietitian, Registered | 35 Miller Avenue Suite #273, Mill Valley, CA 94941 | 2019-10-15 |
| 1538698774 | Shari Lyn Coskey | Psychologist | 311 Miller Ave Ste A-1, Mill Valley, CA 94941 | 2017-06-10 |
| 1225572662 | Katelynn Allen | Physical Therapist | 421 Miller Ave, Mill Valley, CA 94941 | 2016-12-05 |
| 1134591340 | Sheree Lyn Reed | Pharmacist | 800 Redwood Hwy, Frontage Rd #10, Mill Valley, CA 94941 | 2015-10-27 |
| 1235527904 | Sheila Francis Lynch | Social Worker | 33 Millwood Street, Suite #3, Mill Valley, CA 94941 | 2015-01-05 |
| 1790197580 | Linden Farrar Berry | Marriage & Family Therapist | 275 Miller Avenue, Mill Valley, CA 94941 | 2014-05-28 |
| 1073930343 | Eman Elmi | Podiatrist | 7 North Knoll Road Suite 3, Mill Valley, CA 94941 | 2014-03-25 |
| 1053657726 | Susan Pauly-o'neill | Nurse Practitioner | 750 Redwood Hwy Frontage Rd, Mill Valley, CA 94941 | 2012-12-27 |
| 1598049652 | John Deri | Psychiatry & Neurology | 10 Millwood Street, Suite #4, Mill Valley, CA 94941 | 2011-10-06 |
| Find all providers in zip 94941 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689230732 | Sandra Lee Strauss | General Practice | 6 Underhill Rd, Mill Valley, CA 94941-1424 | 2019-05-14 |
| 1639457773 | Bruce A Gordon | General Practice | 8 Upland Ave, Mill Valley, CA 94941-1130 | 2011-07-22 |
| 1417054941 | Arnold G. Werschky II | General Practice | 279 Miller Avenue, Mill Valley, CA 94941-2832 | 2006-09-19 |
| 1386710218 | Beth C Mcdougall | General Practice | 125 Throckmorton Ave, Mill Valley, CA 94941-1909 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992986 | Lindsay Fry | General Practice | 375 Bonair St Apt 1, La Jolla, CA 92037-5911 | 2020-11-04 |
| 1255939674 | Kiira Health Practice Ca PC | General Practice | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 |
| 1851999627 | Golden State Medical Center PC | General Practice | 2551 San Ramon Valley Blvd Ste 108, San Ramon, CA 94583-1661 | 2020-10-14 |
| 1598362709 | Afua Takyi | General Practice | 1555 River Park Dr Ste 211, Sacramento, CA 95815-4604 | 2020-10-01 |
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | MILL VALLEY |
| Zip Code | 94941 |
Please comment or provide details below to improve the information on DR. JEAN A GUSTAFSON.
| 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.