JACQUELINE MERYL EVANS (NPI# 1588755441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588755441 |
| Entity Type | Individual |
| Full Name | JACQUELINE MERYL EVANS |
| Credential | MD |
| Practice Address |
2818 Audubon Cir Davis CA 95618-7600 |
| Practice Telephone | 9163975585 |
| Mailing Telephone | 9163975585 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
G87264 | CA | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
MD-44596 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G872640 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4650 W Sunset Blvd, Ms# 12, Los Angeles, CA 900276062 | 3236692557 | 3236640728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954333 | Jacqueline Evans | Technician | 501 E Lake Mead Pkwy Apt 2313, Henderson, NV 89015-6425 | 2020-08-28 |
| 1154733582 | Jacqueline Celeste Evans | Emergency Medicine | 3551 Roger Brooke Dr # 3600, Fort Sam Houston, TX 78234 | 2014-05-20 |
| 1619268034 | Jacqueline Marie Evans | Massage Therapist | 3604 Laredo Dr, A, Lexington, KY 40517-2173 | 2011-04-20 |
| 1851378871 | Jacqueline Ann Evans | Obstetrics & Gynecology | 2150 Noll Dr, Lancaster, PA 17603 | 2005-12-30 |
| 1235775438 | Jacqueline M Evans | Physician Assistant | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2019-11-22 |
| 1821579335 | Jacqueline Hae Yun Evans | Physician Assistant | 2 W Fern Ave, Redlands, CA 92373-5916 | 2018-08-22 |
| 1245788488 | Jacqueline Evans | Student in an Organized Health Care Education/Training Program | 105 Garfield Ave, Eau Claire, WI 54701-4811 | 2016-09-16 |
| 1194272914 | Jacqueline Michelle Evans | Counselor | 711 Sw Ramsey Ave, Grants Pass, OR 97527-5500 | 2016-09-09 |
| 1053726315 | Jacqueline Carmen Elizabeth Evans | Optometrist | 10705 W Colfax Ave, Lakewood, CO 80215-3813 | 2014-06-25 |
| 1639410525 | Jacqueline Rose Evans | Counselor | 3211 W Charleston Blvd, Las Vegas, NV 89102-1953 | 2013-03-03 |
| Street Address |
2818 AUDUBON CIR |
| City | DAVIS |
| State | CA |
| Zip Code | 95618-7600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568013332 | Maria Pilar Alonso Nunez | Social Worker | 2707 Henri Ct, Davis, CA 95618 | 2019-09-24 |
| 1437616349 | Dagon Jones Dds Inc. | Dentist | 2800 5th Street, Suite 100, Davis, CA 95618 | 2019-02-27 |
| 1265938484 | Martel Elizabeth Costa | Nurse Practitioner | 1909 Galileo Ct Ste A, Davis, CA 95618 | 2018-04-05 |
| 1952785644 | Avineet Boparai | Dentist | 4515 Fermi Pl Ste 106, Davis, CA 95618 | 2015-07-13 |
| 1063841096 | Sergio Vicuna Dental Corporation | Dentist | 4515 Fermi Place Suite 106, Davis, CA 95618 | 2013-11-12 |
| 1700103314 | Daren Allen Casagrande | Counselor | 315 Mace Blvd, Davis, CA 95618 | 2010-04-23 |
| 1689802803 | Rocky P.j. Jedick | Emergency Medicine | 2206 Halsey Cir, Davis, CA 95618 | 2009-06-25 |
| 1356463004 | Vincent & Associates | Speech-Language Pathologist | 3560 J Street, Suite 1, Sacramento, CA 95618 | 2007-04-04 |
| 1316075138 | New Life Clinic | Acupuncturist | 1736 Picasso Ave., Suite B, Davis, CA 95618 | 2007-03-01 |
| 1558419622 | Baoping Li | Acupuncturist | 1736 Picasso Ave, Suite B, Davis, CA 95618 | 2007-01-08 |
| Find all providers in zip 95618 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417368804 | Sara Aghamohammadi | Pediatrics | 4650 W Sunset Blvd # Ms 3, Los Angeles, CA 90027-6062 | 2014-05-19 |
| 1023367422 | Batool Alsheikh | Pediatrics | 6235 N Fresno St Ste 103, Fresno, CA 93710 | 2012-08-31 |
| 1699093880 | Richard P Lion | Pediatrics | 11234 Anderson St Rm 5763, Loma Linda, CA 92354-2804 | 2010-05-12 |
| 1558505719 | Ryan Richard Taylor | Pediatrics | Mattel Childrens Hospital At Ucla, 10833 Le Conte Ave., 12-494, Mdcc, Los Angeles, CA 90095-0001 | 2009-04-30 |
| 1871737270 | Shan Lyn Ward | Pediatrics | 3333 California St # S110, San Francisco, CA 94118-1981 | 2009-04-29 |
| 1932341641 | Anas Al Kawass | Pediatrics | 17100 Euclid Street, Picu, Fountain Valley, CA 92708 | 2009-03-26 |
| 1497996649 | Andreas Schwingshackl | Pediatrics | Rrmc 400 Westwood Blvd, Los Angeles, CA 90095-2113 | 2009-03-18 |
| 1588804801 | Carol Elizabeth Nicholson | Pediatrics | 6461 Zuma View Pl, #149, Malibu, CA 90265-4495 | 2009-02-26 |
| 1831355320 | Niveditha Vilasagar | Pediatrics | 4867 W Sunset Blvd Fl 5, Los Angeles, CA 90027-5969 | 2008-08-04 |
| 1154519072 | Eloa S. Adams | Pediatrics | 275 W Macarthu, Oakland, CA 94611-5641 | 2007-10-04 |
| Find all providers with the same taxonomy | ||||
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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.