NAOMI DETABLAN (NPI# 1679986970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679986970 |
| Entity Type | Individual |
| Full Name | NAOMI DETABLAN |
| Credential | D.P.M. |
| Practice Address |
108 Lynch Creek Way Suite 3 Petaluma CA 94954-2357 |
| Practice Telephone | 7077632253 |
| Practice Fax Number | 7077890996 |
| Mailing Telephone | 7077632253 |
| Mailing Fax Number | 7077890996 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2017-04-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
E5341 | CA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
108 LYNCH CREEK WAY SUITE 3 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-2357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275533887 | Thomas Owen Maloney | Internal Medicine | 108 Lynch Creek Way, #5, Petaluma, CA 94954-2357 | 2005-07-26 |
| 1831587955 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954-2357 | 2014-12-23 |
| 1366670747 | Nikola Lozanov, M. D., Inc. | Family Medicine | 108 Lynch Creek Way, Suite #4, Petaluma, CA 94954-2357 | 2009-06-24 |
| 1982893582 | Adamane S Lalith Mohan | Internal Medicine | 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954-2357 | 2007-10-18 |
| 1952418220 | Edward Frank Loker Jr. | Internal Medicine | 108 Lynch Creek Way, #5, Petaluma, CA 94954-2357 | 2006-08-24 |
| 1366559486 | A.s.lalith Mohan M.d. Prof. Inc | Internal Medicine | 108 Lynch Creek Way, #3, Petaluma, CA 94954 | 2006-08-24 |
| 1417968512 | Nikola Yuliev Lozanov | Family Medicine | 108 Lynch Creek Way, Suite 4, Petaluma, CA 94954-2357 | 2006-08-11 |
| 1205847209 | Michael Alan Johnson | Podiatrist | 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954 | 2006-08-11 |
| 1962423103 | Farid Osman | Internal Medicine | 108 Lynch Creek Way, Suite, Petaluma, CA 94954-2357 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528726 | Millennium Foot and Ankle Institute PC | Podiatrist | 26235 Ravenhill Rd, Santa Clarita, CA 91387-4046 | 2020-11-02 |
| 1861008054 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 5471 La Palma Ave Ste 106, La Palma, CA 90623-1792 | 2020-09-22 |
| 1174139356 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 4911 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1746 | 2020-09-22 |
| 1093327231 | Upperline Healthcare California PC | Podiatrist | 2131 San Joaquin Hills Rd, Newport Beach, CA 92660-6507 | 2020-08-19 |
| 1841815545 | Kenny Au Quach | Podiatrist | 17100 Euclid St # 4004, Fountain Valley, CA 92708-4004 | 2020-06-09 |
| 1417579129 | Central California Leg, Foot, and Ankle Center, Inc. | Podiatrist | 11325 Park Square Dr Apt D204, Bakersfield, CA 93311-8854 | 2020-05-15 |
| 1487282109 | Laura Y Lee, Dpm Inc | Podiatrist | 5525 Forestwood Dr, Sacramento, CA 95842-2128 | 2020-03-29 |
| 1780211458 | Dupontdpm Inc. | Podiatrist | 651 1st St W Ste C, Sonoma, CA 95476-7046 | 2020-03-24 |
| 1659903722 | Bay Area Foot Care, Inc | Podiatrist | 5924 Stoneridge Dr Ste 102, Pleasanton, CA 94588-2750 | 2020-02-06 |
| 1780215210 | Albert Elhiani Dpm Inc | Podiatrist | 9340 W Pico Blvd Ste 2, Los Angeles, CA 90035-1255 | 2020-02-03 |
| 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.