AUDREYANDRA LUCIA IMANSJAH (NPI# 1710481858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710481858 |
| Entity Type | Individual |
| Full Name | AUDREYANDRA LUCIA IMANSJAH |
| Credential | DO |
| Practice Address |
800 N Main St Santa Ana CA 92701-3576 |
| Mailing Address |
23216 Ernest Ct Hayward CA 94541-3554 |
| Practice Telephone | 6572826355 |
| Mailing Telephone | 6505806466 |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
800 N MAIN ST |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92701-3576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787151 | Anna Ng | Nurse Practitioner | 800 N Main St, Santa Ana, CA 92701-3576 | 2020-10-16 |
| 1679102875 | Andrew Phan | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2020-04-08 |
| 1194285965 | So La Lee | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2019-03-20 |
| 1730648510 | Olivia Hayostek | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2019-03-19 |
| 1770042541 | Ariel Murtagh | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2019-03-19 |
| 1366902199 | Antigone Gonis | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2019-03-19 |
| 1184183170 | Heidy Amarilis Sasvin | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2019-03-18 |
| 1760976047 | Namita Kamath Patel | Dietitian, Registered | 800 N Main St, Santa Ana, CA 92701-3576 | 2018-06-19 |
| 1871098988 | Vincente Philip Lam | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2018-03-29 |
| 1336644129 | Danny Ngo | Student in an Organized Health Care Education/Training Program | 800 N Main St, Santa Ana, CA 92701-3576 | 2018-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807401 | Midori K Dirig | Psychologist | 405 W. 3rd Street, Santa Ana, CA 92701 | 2020-09-28 |
| 1952915456 | Alexandria Bekele | Counselor | Address: 405 W. 5th Street, Santa Ana, CA 92701 | 2020-09-02 |
| 1508479239 | Candice Bjorkman | Counselor | 1201 E Fruit St, Santa Ana, CA 92701 | 2020-08-24 |
| 1013527365 | Maryiam Elizabeth Barkho | Dentist | 809 South Main Street Suite B, Santa Ana, CA 92701 | 2020-08-02 |
| 1447803788 | Emmett Eugene Cook II | Counselor | 1207 E Fruit Street, Santa Ana, CA 92701 | 2019-07-16 |
| 1619538741 | Emily H Sanders | Marriage & Family Therapist | 1800-f Parkcourt Place, Suite 205, Santa Ana, CA 92701 | 2019-06-28 |
| 1184191769 | Peace of Mind Wellness & Family Counseling, Inc. | Counselor | 1651 E. Fourth St Ste 240, Santa Ana, CA 92701 | 2018-10-31 |
| 1841765815 | Kelly Marie Contreras | Clinical Medical Laboratory | 902 N. Grand Avenue, Suite 204, Santa Ana, CA 92701 | 2018-10-05 |
| 1780176537 | Diane Carol Navarro-prescott | Counselor | 1633 East 4th Street, Santa Ana, CA 92701 | 2018-06-06 |
| 1750873758 | Eileen Fernandez | Counselor | 615 W Civic Center Dr Fl 2, Santa Ana, CA 92701 | 2018-06-05 |
| Find all providers in zip 92701 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151805 | Alisa Pham | Student in an Organized Health Care Education/Training Program | 120 Kenton Dr, Santa Ana, CA 92704-1400 | 2020-07-09 |
| 1528685054 | Torrence Puck | Student in an Organized Health Care Education/Training Program | 2302 Strawberry Ln, Santa Ana, CA 92706-2241 | 2020-06-30 |
| 1932725231 | Tho Ho Nguyen | Student in an Organized Health Care Education/Training Program | 711 S Euclid St Apt 8, Santa Ana, CA 92704-1867 | 2020-06-23 |
| 1790300267 | Quang Minh Ngo | Student in an Organized Health Care Education/Training Program | 5515 Silver Dr, Santa Ana, CA 92703-2439 | 2020-06-10 |
| 1992320444 | Chuck Truc Nguyen | Student in an Organized Health Care Education/Training Program | 427 S Starboard St, Santa Ana, CA 92704-1064 | 2020-06-10 |
| 1427697911 | Ramiro Castelan | Student in an Organized Health Care Education/Training Program | 2005 Kilson Dr, Santa Ana, CA 92707-2915 | 2019-12-31 |
| 1134777972 | Mario Alberto Avalos Rebollar | Student in an Organized Health Care Education/Training Program | 2718 W Anahurst Pl, Santa Ana, CA 92704-4506 | 2019-08-26 |
| 1205490521 | Thuy-vy Nguyen | Student in an Organized Health Care Education/Training Program | 2230 W Adams St, Santa Ana, CA 92704-5532 | 2019-04-23 |
| 1942798145 | Michael Clenshaw | Student in an Organized Health Care Education/Training Program | 11211 Vista Del Lago, Santa Ana, CA 92705-5903 | 2018-04-24 |
| 1992237895 | Katherine Huynh | Student in an Organized Health Care Education/Training Program | 3200 W 5th St Apt 205, Santa Ana, CA 92703-1833 | 2017-03-30 |
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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.