JEREMY DANIEL BLAKESPEAR (NPI# 1750474177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750474177 |
| Entity Type | Individual |
| Full Name | JEREMY DANIEL BLAKESPEAR |
| Other Name | JEREMY DANIEL SPEARMAN |
| Credential | P.A.-C. |
| Practice Address |
3220 Mission Ave Ste 1 Oceanside CA 92058-1354 |
| Mailing Address |
150 Valpreda Rd San Marcos CA 92069-2973 |
| Practice Telephone | 7604333155 |
| Mailing Telephone | 7607366767 |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2015-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA 19825 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 51942131206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
51942131206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3220 MISSION AVE STE 1 |
| City | OCEANSIDE |
| State | CA |
| Zip Code | 92058-1354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750386330 | Laurie Ann Brebrick | Registered Nurse | 3220 Mission Ave Ste 1, Oceanside, CA 92058-1354 | 2005-06-20 |
| 1114298130 | Lisa Maria Abresch | Physician Assistant | 3220 Mission Ave Ste 1, Oceanside, CA 92058 | 2012-01-23 |
| 1649370164 | Phillip W Poth | Internal Medicine | 3220 Mission Ave Ste 1, Oceanside, CA 92058-1354 | 2006-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508463555 | Michael William Baker | Dental Hygienist | 14th St., Oceanside, CA 92058 | 2020-10-02 |
| 1548877004 | Juliaisa Gisselle Caldero | Dental Assistant | Bldg 13128, Oceanside, CA 92058 | 2020-09-29 |
| 1932715836 | Leilani Viveros | Behavior Technician | 251 Airprort Road, Oceanside, CA 92058 | 2020-09-17 |
| 1043835952 | Emma Caitlin Johnson | Dentist | 92055 14th St, Bldg 13128, Oceanside, CA 92058 | 2020-06-16 |
| 1073135836 | Roxana Ivette Rodriguez | Military Health Care Provider | 22190 Marine Dr, Oceanside, CA 92058 | 2020-05-14 |
| 1699307744 | Rachael Bousman | Specialist/Technologist | 13129 14th St, Area 13, Camp Pendleton, CA 92058 | 2020-02-06 |
| 1811528359 | Misaael Valdes | Military Health Care Provider | Building, B St, Oceanside, CA 92058 | 2020-02-03 |
| 1497385736 | Phong Thanh Tran | Dental Hygienist | 599 A Ave #501, Oceanside, CA 92058 | 2020-01-24 |
| 1245796366 | Christian Thompson | Physician Assistant | 1st Med Bn, Camp Pendleton, Oceanside, CA 92058 | 2019-02-13 |
| 1104308568 | Caila Martin | Behavior Technician | 293 Douglas Dr Apt. 272, Oceanside, CA 92058 | 2018-09-02 |
| Find all providers in zip 92058 | ||||
| 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 |
|---|---|---|---|---|
| 1902448475 | Long Tran | Physician Assistant | 4926 Bella Collina St, Oceanside, CA 92056-1911 | 2019-10-16 |
| 1134761679 | Amanda Lee Vecchio | Physician Assistant | 4171 Oceanside Blvd Ste 109, Oceanside, CA 92056-6008 | 2019-10-16 |
| 1245796366 | Christian Thompson | Physician Assistant | 1st Med Bn, Camp Pendleton, Oceanside, CA 92058 | 2019-02-13 |
| 1801368881 | Yitzchok Tzvi Rosenbaum | Physician Assistant | 3397 Park Ave, Oceanside, NY 11572-4357 | 2019-01-01 |
| 1760971626 | Frank J Saviano | Physician Assistant | 3571 Long Beach Rd, Oceanside, NY 11572-5702 | 2018-05-07 |
| 1790021186 | Lindsey Armatis-rivera | Physician Assistant | 616 S Coast Hwy, Oceanside, CA 92054-4121 | 2012-12-12 |
| 1861725202 | Matthew J Spencer | Physician Assistant | 3231 Waring Court Ste. O, Oceanside, CA 92056 | 2009-09-17 |
| 1538492319 | Carolyn Michele Thomas | Physician Assistant | 3998 Vista Way Ste 102, Oceanside, CA 92056-4515 | 2009-09-11 |
| 1770761702 | Renee J. Reinertsen | Physician Assistant | 2710 Long Beach Rd, Oceanside, NY 11572-2255 | 2008-02-01 |
| 1063448074 | Danielle Mantini-reinoso | Physician Assistant | 3142 Vista Way Suite 207, Oceanside, CA 92056-3619 | 2006-06-23 |
| Find all providers in OCEANSIDE | ||||
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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.