INDYANA POLLEY (NPI# 1679036644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679036644 |
| Entity Type | Individual |
| Full Name | INDYANA POLLEY |
| Practice Address |
1341 Historical Plaza Way Manteca CA 95336-5064 |
| Practice Telephone | 2098241893 |
| Mailing Telephone | 2098241893 |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA57094 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1341 HISTORICAL PLAZA WAY |
| City | MANTECA |
| State | CA |
| Zip Code | 95336-5064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528575461 | Harpreet Dhaliwal | Nurse Practitioner | 1341 Historical Plaza Way, Manteca, CA 95336-5064 | 2017-12-31 |
| 1710510326 | Bryan Cabconce Coronel | Nurse Practitioner | 1341 Historical Plaza Way, Manteca, CA 95336-5064 | 2020-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687676 | Kasside Sahagun-escalante | Behavior Technician | 402 Victory Ave, Manteca, CA 95336 | 2019-09-09 |
| 1295253797 | Adriana Pena | Counselor | 129 E.center Street Ste.3, Manteca, CA 95336 | 2017-09-05 |
| 1104352277 | Native Directions Inc. | Substance Abuse Rehabilitation Facility | 13505 Union Rd, Manteca, CA 95336 | 2017-05-10 |
| 1437508389 | Anna Gavin | Contractor | 1256 W. Lathrop Rd #376, Manteca, CA 95336 | 2016-06-10 |
| 1164826137 | Michael M. Catz, M.d., Inc | Anesthesiology | 1205 E. North Street, Manteca, CA 95336 | 2014-10-20 |
| 1033518923 | Leanne Louis | Community Health Worker | 129 E Center Street, #3, Manteca, CA 95336 | 2014-08-18 |
| 1255684122 | Kenneth S. Ching, Md., Inc | Anesthesiology | 1205 East North Street, Manteca, CA 95336 | 2012-10-17 |
| 1629323043 | Harpradeep Ratia | Dentist | 1332 E Yosemite Ave, Manteca, CA 95336 | 2012-07-23 |
| 1750643664 | Shelley Marie Kohl | Specialist/Technologist, Other | 425 E. Center St Suite 1, Manteca, CA 95336 | 2012-06-15 |
| 1932488038 | Valerie Diane Segura | Behavioral Analyst | 1882 Cherrywood Pl, Manteca, CA 95336 | 2011-08-08 |
| Find all providers in zip 95336 | ||||
| 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 |
|---|---|---|---|---|
| 1457914772 | Gagan Takhar | Physician Assistant | 296 Cottage Ave, Manteca, CA 95336-4942 | 2019-04-22 |
| 1033580246 | Honeycomb Medical Services, A Med Corp | Physician Assistant | 1205 E North St, Manteca, CA 95336-4932 | 2015-10-14 |
| 1164824066 | Lam Q. Le | Physician Assistant | 296 Cottage Ave, Manteca, CA 95336-4942 | 2014-09-23 |
| 1285998690 | Marichu Nisperos | Physician Assistant | 330 Northgate Dr, Manteca, CA 95336-3139 | 2012-06-29 |
| 1952696957 | Janna Lynn Belletto | Physician Assistant | 1040 N Main St, Manteca, CA 95336-3745 | 2011-06-17 |
| 1720125339 | Hassan Assl | Physician Assistant | 1191 E Yosemite Ave Ste C, Manteca, CA 95336-5011 | 2007-01-31 |
| 1871648162 | Joan L. Sanchez | Physician Assistant | 1205 E North St, Manteca, CA 95336-4932 | 2007-01-24 |
| 1619048378 | Manteca Emergency Physicians, A Medical Corporation | Physician Assistant | 1205 E North St, Manteca, CA 95336-4932 | 2006-11-13 |
| 1689778227 | Dressia Newsom Hio | Physician Assistant | 1205 E North St, Manteca, CA 95336-4932 | 2006-09-12 |
| 1760494066 | Holly Noel Reece | Physician Assistant | 200 Cottage Ave, Ste 103, Manteca, CA 95336-4935 | 2006-08-13 |
| Find all providers in MANTECA | ||||
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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.