KEELY REED TIETJEN (NPI# 1639738040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639738040 |
| Entity Type | Individual |
| Full Name | KEELY REED TIETJEN |
| Credential | PA-C |
| Practice Address |
2070 Clinton Ave Alameda CA 94501-4399 |
| Mailing Address |
6 Diablo Cir Lafayette CA 94549-3316 |
| Practice Telephone | 5108641800 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA56700 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2070 CLINTON AVE |
| City | ALAMEDA |
| State | CA |
| Zip Code | 94501-4399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427039288 | Edward D Lee | Emergency Medicine | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2005-11-09 |
| 1790265973 | Angelimarie Mangahas | Nurse Practitioner | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2018-08-17 |
| 1528415908 | Rikki Jacqueline Rodriguez | Nurse Practitioner | 2070 Clinton Ave, Suite #400, Alameda, CA 94501-4399 | 2016-05-16 |
| 1558769224 | California Hospital Medicine Physicians Medical Group Inc | Physician Assistant | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2014-12-12 |
| 1891112082 | Samra Rashid | Internal Medicine | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2014-03-25 |
| 1962824532 | Nerissa Barreto | Nurse Practitioner | 2070 Clinton Ave, Alameda, CA 94501 | 2014-01-15 |
| 1396176160 | Alameda Health System | Skilled Nursing Facility | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2013-12-04 |
| 1831529049 | Alameda Health System | General Acute Care Hospital | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2013-11-25 |
| 1629410584 | Jillian E Cipa-tatum | Internal Medicine | 2070 Clinton Ave, Alameda Inpatient Medicine- Alameda Hospital, Alameda, CA 94501-4399 | 2013-07-20 |
| 1740622679 | Luke Lin | Internal Medicine | 2070 Clinton Ave, Alameda, CA 94501 | 2013-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386259158 | Hailee Ann Heiselbetz | Behavior Technician | 1025 Atlantic Ave. Ste 101, Alameda, CA 94501 | 2020-09-09 |
| 1134745961 | Linda Nykin | Naturopath | 2002 Monterey Cir, Alameda, CA 94501 | 2020-06-17 |
| 1801427570 | Mirna Rodriguez Lopez | Behavior Technician | 1025 Atlantic Ave. Ste. 101, Alameda, CA 94501 | 2020-01-30 |
| 1356987010 | Guadalupe H Hernandez | Technician | 3650 Mount Diablo Blvd, Layayette, CA 94501 | 2019-11-18 |
| 1952951832 | Lily T Nguyen | Behavior Technician | 1025 Atlantic Ave, Suite 101, Alameda, CA 94501 | 2019-09-12 |
| 1326503004 | Mary Macpherson | Speech-Language Pathologist | 2308 Central Ave., Alameda, CA 94501 | 2019-02-06 |
| 1285103838 | Stephanie Owens | Behavioral Analyst | 2213 Clinton Ave #a, Alameda, CA 94501 | 2018-11-13 |
| 1508349390 | Cindy Cabrera | Behavioral Analyst | 1025 Atlantic Ave Suite 101, Alameda, CA 94501 | 2018-09-08 |
| 1629554928 | Anita Elizabeth Bower | Behavioral Analyst | 125 Atlantic Ave Suite 101, Alameda, CA 94501 | 2018-07-19 |
| 1659862571 | Mariana Rocio Pacas Mexicano | Behavioral Analyst | 1025 Atlantic Ave. Suite 101, Alameda, CA 94501 | 2018-05-26 |
| Find all providers in zip 94501 | ||||
| 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 |
|---|---|---|---|---|
| 1467926477 | Stephanie Hwanying Yeh | Physician Assistant | 1241 Otis Dr, Alameda, CA 94501-5664 | 2019-01-14 |
| 1124489877 | Veronica Dieuhien Vo | Physician Assistant | 2167 San Antonio Ave, Alameda, CA 94501-4326 | 2016-03-09 |
| 1194811919 | Catherine B. Egelhoff | Physician Assistant | 2433 Central Ave., Alameda, CA 94501 | 2006-10-05 |
| 1720010226 | Lori Glassie | Physician Assistant | 2325 Clement Ave, Suite B, Alameda, CA 94501-7063 | 2006-07-07 |
| 1407835820 | David Hines | Physician Assistant | Building 1 Medical Clinic, Us Coast Guard Island, Alameda, CA 94501 | 2006-01-13 |
| 1023653672 | Maxwell Kaczmarek | Physician Assistant | 1 Eagle Rd, Alameda, CA 94501-5100 | 2019-11-07 |
| 1144883240 | Christine Harper Moscati | Physician Assistant | 2421 Encinal Ave Ste A, Alameda, CA 94501-5670 | 2019-04-15 |
| 1588168330 | Jane Yuri Lee | Physician Assistant | 2433 Central Ave, Alameda, CA 94501 | 2018-03-19 |
| 1033625272 | Meridith A Palo | Physician Assistant | 1 Eagle Rd, Alameda, CA 94501-5100 | 2017-12-26 |
| 1558769224 | California Hospital Medicine Physicians Medical Group Inc | Physician Assistant | 2070 Clinton Ave, Alameda, CA 94501-4399 | 2014-12-12 |
| Find all providers in ALAMEDA | ||||
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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.