KELLY FRUTH (NPI# 1730701285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730701285 |
| Entity Type | Individual |
| Full Name | KELLY FRUTH |
| Practice Address |
13690 E 14th St Ste 230 San Leandro CA 94578-2584 |
| Mailing Address |
301 Old County Rd Apt 203 Belmont CA 94002-2502 |
| Practice Telephone | 3102944278 |
| Mailing Telephone | 3102944278 |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 57800 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13690 E 14TH ST STE 230 |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94578-2584 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285116020 | Paige Elizabeth Anderson | Physician Assistant | 13690 E 14th St Ste 230, San Leandro, CA 94578-2584 | 2018-08-29 |
| 1982171377 | Brianne Kathleen Cassidy | Physician Assistant | 13690 E 14th St Ste 230, San Leandro, CA 94578-2584 | 2018-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952886327 | Keyla Itzel Monroy Rodriguez | Behavioral Analyst | 900 143rd Ave, Apt 269, San Leandro, CA 94578 | 2018-10-01 |
| 1962938340 | Shaylah Rigmaiden | Counselor | 3847 E14th St, #215, San Leandro, CA 94578 | 2017-05-04 |
| 1861864449 | Laurence Tang | Pharmacist | 13847 E. 14th Street, San Leandro, CA 94578 | 2015-10-22 |
| 1902227481 | Marissa Phan | Pharmacist | 15555 E. 14th Street #400, San Leandro, CA 94578 | 2013-12-30 |
| 1629403993 | Carly Renee Lucas | Counselor | 2257 Arlington Dr., San Leandro, CA 94578 | 2013-09-05 |
| 1871933317 | Javier Huerta | Counselor | 16335 E. 14th St, San Leandro, CA 94578 | 2013-06-28 |
| 1710231717 | Farida M Ismail | Non-emergency Medical Transport (VAN) | 1601 165th Ave, 107, San Leandro, CA 94578 | 2012-10-30 |
| 1487901989 | Amanda Dupuis | Counselor | 15942 Footlhill Blvd, San Leandro, CA 94578 | 2012-08-14 |
| 1629323506 | Mei Xiu Chua | Counselor | 13666 East 14th Street, San Leandro, CA 94578 | 2012-07-17 |
| 1730445644 | Nisreen Mesiwala Kothari | Ophthalmology | 15051 Hesperian Blvd Ste A, San Leandro, CA 94578 | 2012-04-04 |
| Find all providers in zip 94578 | ||||
| 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 |
|---|---|---|---|---|
| 1568001204 | Maisa Morrar | Physician Assistant | 1596 Jean Way, San Leandro, CA 94577-1311 | 2019-12-28 |
| 1023668290 | Maria Fernanda Leyva | Physician Assistant | 1566 140th Ave, San Leandro, CA 94578-1614 | 2019-09-18 |
| 1487189791 | Felicity Alexis Vanessa Harris | Physician Assistant | 2600 San Leandro Blvd Apt 1702, San Leandro, CA 94578-5060 | 2017-04-24 |
| 1790073682 | Natalia M Cortez | Physician Assistant | 13939 E 14th St Ste 150, San Leandro, CA 94578 | 2011-07-13 |
| 1720225766 | Adrienne Dorothy Kane | Physician Assistant | 2500 Merced St Bldg A4th, San Leandro, CA 94577-4201 | 2009-01-13 |
| 1134100563 | David G Ross | Physician Assistant | 13939 E 14th St, Suite 150, San Leandro, CA 94578-2601 | 2005-11-11 |
| 1912519299 | Aria Alokozai | Physician Assistant | 13690 E 14th St Ste 100, San Leandro, CA 94578-2584 | 2020-08-18 |
| 1063991511 | Jennifer Kam | Physician Assistant | 13851 E 14th St Ste 202, San Leandro, CA 94578-2627 | 2018-08-07 |
| 1881124220 | Genevieve Marie Terry | Physician Assistant | 13855 E 14th St, San Leandro, CA 94578-2611 | 2017-06-18 |
| 1073044582 | Norma Adriana Monroy | Physician Assistant | 16110 E 14th St, San Leandro, CA 94578-3002 | 2017-03-26 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94578 |
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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.