NEPHROLOGY MED ASSOCS CHO (NPI# 1639205917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639205917 |
| Entity Type | Organization |
| Organization Name | NEPHROLOGY MED ASSOCS CHO |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Mailing Address |
3116 W March Ln Ste 200 Stockton CA 95219-2369 |
| Practice Telephone | 5104283335 |
| Practice Fax Number | 5104505850 |
| Mailing Telephone | 2094736555 |
| Mailing Fax Number | 2094736543 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROSE ELLEN MORRELL (HEAD OF DEPT) |
| Authorized Official Telephone | 5104283335 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
G31927 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DR MORRELL'S CA MD LICENS | G31927 | 01 |
| CA | MEDI-CAL | GR0095810 | 01 |
| Street Address |
747 52ND ST |
| 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 | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790050193 | Aalia Akber | Pediatrics | 275 W Macarthur, Oakland, CA 94611-5641 | 2012-03-19 |
| 1083810113 | Christina Lo | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2007-06-25 |
| 1841378619 | Sheldon Orloff | Pediatrics | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2006-11-01 |
| 1932121902 | Anju Lashkari | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730653080 | Nihar Bhakta | Pediatrics | 3430 Sitio Sandia, Carlsbad, CA 92009-8483 | 2019-01-18 |
| 1821304403 | Pediatric Kidney Center Inc | Pediatrics | 5309 Aurora Way, Bakersfield, CA 93306-7808 | 2010-08-20 |
| 1659504959 | Nianzhou Xiao | Pediatrics | 9300 Valley Childrens Pl Dept Of, Madera, CA 93636-8761 | 2009-09-02 |
| 1104066877 | Lyndon & Belinda Senar Mds Inc | Pediatrics | 9840 Brimhall Rd, Bakersfield, CA 93312-2791 | 2009-02-20 |
| 1306052667 | James En-cheh Tong | Pediatrics | 533 Parnassus Ave # U-585, San Francisco, CA 94143-2208 | 2007-05-15 |
| 1487874954 | Elizabeth Michelle Talley | Pediatrics | 300 Pasteur Dr Rm G306, Stanford, CA 94305-2200 | 2007-04-26 |
| 1831266048 | Paul Scott Kurtin | Pediatrics | 1157 Solana Dr, Del Mar, CA 92014-3907 | 2006-11-30 |
| 1780773721 | Hma Mahdavi | Pediatrics | 1760 Termino Ave Ste 214, Long Beach, CA 90804-2169 | 2006-10-11 |
| 1801982301 | Gary Robert Lerner | Pediatrics | 4650sunset Blvd, Los Angeles, CA 90027-6062 | 2006-10-04 |
| 1841214376 | Cynthia Wong | Pediatrics | 300 Pasteur Drive, G306, Stanford, CA 94305-5208 | 2006-07-27 |
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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.