KRISTINE SUPPLE (NPI# 1720157233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720157233 |
| Entity Type | Individual |
| Full Name | KRISTINE SUPPLE |
| Credential | PA |
| Practice Address |
2921 Saviers Rd Oxnard CA 93033-5314 |
| Mailing Address |
2705 Loma Vista Rd Suite 205 Ventura CA 93003-1581 |
| Practice Telephone | 8054875588 |
| Practice Fax Number | 8054875589 |
| Mailing Telephone | 8056672801 |
| Mailing Fax Number | 8056411706 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 15019 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM18553H | 05 | |
| CA | OTHER INSURANCE | 95-1683892 | 01 |
| CA | ZZT40394F | 05 | |
| CA | RHM08609F | 05 | |
| CA | RHM08608F | 05 |
| Street Address |
2921 SAVIERS RD |
| City | OXNARD |
| State | CA |
| Zip Code | 93033-5314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407847734 | Steve Kent Jones | Emergency Medicine | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2005-11-04 |
| 1134548605 | Danilo Cinco Bernal | Nurse Practitioner | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2014-04-14 |
| 1912320433 | Chelsea L. Tiedemann | Nurse Practitioner | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2014-02-04 |
| 1730404450 | Emely Rose Leal-fernandez | Registered Nurse | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2010-04-06 |
| 1871782953 | Mario Alberto Saucedo | Emergency Medicine | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2007-10-15 |
| 1477744480 | Alison W Shuman | Pediatrics | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2007-08-05 |
| 1790989630 | Loquintha Danielle Rex-vital | Nurse Practitioner | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2007-06-13 |
| 1154333052 | Christine Camara | Physician Assistant | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2006-08-12 |
| 1740228345 | Community Memorial Health System | Clinic/Center | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2006-06-04 |
| 1760420053 | Joseph Louie Rodriguez | Family Medicine | 2921 Saviers Rd, Oxnard, CA 93033-5314 | 2006-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462332 | Andy Luu | Physical Therapist | Two Trees 2051 Statham Blvd, Oxnard, CA 93033 | 2019-11-22 |
| 1568004661 | Martha Hughes | Technician | 615 East Juniper St, Oxnard, CA 93033 | 2019-10-10 |
| 1093232985 | Elena Martinez | Student in an Organized Health Care Education/Training Program | 226 E Fir Ave, Oxnard, CA 93033 | 2017-08-23 |
| 1083140248 | Mara Andrea Sibucao | Licensed Vocational Nurse | 4201 Justin Way, Oxnard, CA 93033 | 2017-05-10 |
| 1477915023 | Maria Guadalupe Castro | Counselor | 1710 San Marino St., Oxnard, CA 93033 | 2016-03-23 |
| 1356709760 | Guadalupe Cervantes-ortiz | Marriage & Family Therapist | 401 Mary Herrera Ln. Apt. B, Oxnard, CA 93033 | 2016-02-01 |
| 1457718850 | Jeff Segovia | Community Health Worker | 4651 Telephone Rd, Suite 300, Ventura, CA 93033 | 2016-01-15 |
| 1083079867 | Reynaldo Concepcion | Registered Nurse | 200 Hillmont Avenue, Ventura, CA 93033 | 2015-12-22 |
| 1235548892 | Daisy V Kerr | Counselor | 135 Lark St, Oxnard, CA 93033 | 2014-08-07 |
| 1508187329 | County of Ventura | Clinic/Center | 325 W. Channel Islands Blvd., Oxnard, CA 93033 | 2010-06-16 |
| Find all providers in zip 93033 | ||||
| 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 |
|---|---|---|---|---|
| 1730712134 | Javier Estefan Valencia Cervantes | Physician Assistant | 1266 Rubio Cir, Oxnard, CA 93030-0102 | 2020-02-13 |
| 1811460769 | Lace Granatelli | Physician Assistant | 1801 Solar Dr Ste 150, Oxnard, CA 93030-0147 | 2019-01-03 |
| 1487147013 | Ryan Masaru Kennedy | Physician Assistant | 4421 E Hueneme Rd, Oxnard, CA 93033-8232 | 2018-06-08 |
| 1093221020 | Scott Thomas Welch | Physician Assistant | 2750 Park View Ct Ste 250, Oxnard, CA 93036-5458 | 2017-12-28 |
| 1396296844 | Stephanie Anne Smith | Physician Assistant | 345 S A St, Oxnard, CA 93030-5804 | 2016-10-19 |
| 1881064988 | Tim Ho | Physician Assistant | 4621 Frost Dr, Oxnard, CA 93033-7247 | 2015-10-01 |
| 1407161698 | Jessica Hope Harvey | Physician Assistant | St. John's Regional Medical Center - 1600 N Rose Avenue, Oxnard, CA 93030 | 2010-08-11 |
| 1023114709 | Joseph Michael Diaz | Physician Assistant | 2240 E Gonzales Rd Ste 100, Oxnard, CA 93036-8212 | 2006-09-16 |
| 1043223704 | Areli Torres | Physician Assistant | 450 West Clara Street, Clinicas Del Camino Real Inc, Oxnard, CA 93033 | 2006-08-14 |
| 1659932606 | Eeman Hasan | Physician Assistant | 4400 Olds Rd, Oxnard, CA 93033-8061 | 2019-06-20 |
| Find all providers in OXNARD | ||||
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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.