TRAVIS GREEN (NPI# 1750710919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750710919 |
| Entity Type | Individual |
| Full Name | TRAVIS GREEN |
| Credential | PA-C |
| Practice Address |
30300 Camino Capistrano San Juan Capistrano CA 92675-1304 |
| Practice Telephone | 9492402272 |
| Practice Fax Number | 9492405869 |
| Mailing Telephone | 9492402272 |
| Mailing Fax Number | 9492405869 |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2018-03-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60489241 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
8818001-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE PTAN | G8931677 | 01 |
| WA | 1750710919 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689979445 | Travis Lamar Green | Counselor | 3718 Sutor Ct, Tallahassee, FL 32311-4050 | 2011-01-25 |
| 1922248095 | Travis Green | Dentist | 1101 Veterans Drive (160-cdd), Va Medical Center, Lexington, KY 40502 | 2009-03-02 |
| 1336280361 | Travis Green | Specialist/Technologist | 5595 Memorial Ave N, Oak Park Heights, MN 55082-1091 | 2007-02-11 |
| 1700429925 | Travis Green | Nurse Practitioner | 3701 Corriere Rd Ste 10, Easton, PA 18045-7991 | 2019-10-21 |
| 1285275925 | Travis Lee Green | Physician Assistant | 150 55th St, Brooklyn, NY 11220-2508 | 2019-10-03 |
| 1134693518 | Travis Ray Green | Physician Assistant | 200 Elm St N, Onamia, MN 56359-7901 | 2019-01-18 |
| 1740635119 | Travis Green | Student in an Organized Health Care Education/Training Program | 6410 Fannin St, Suite 420, Houston, TX 77030-3000 | 2016-05-04 |
| 1669460796 | Travis C Green | Pathology | 9600 Datapoint Dr, San Antonio, TX 78229-2028 | 2005-10-12 |
| Street Address |
30300 CAMINO CAPISTRANO |
| City | SAN JUAN CAPISTRANO |
| State | CA |
| Zip Code | 92675-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669407946 | Rajini Rajalingam | Dentist | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2006-07-12 |
| 1346708880 | Kelly Lindsay Hunt | Nurse Practitioner | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2019-03-04 |
| 1831672393 | Patricia Lucia Speier-torres | Social Worker | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2018-09-11 |
| 1992219331 | Lauren Marie Rodriguez | Physician Assistant | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2017-11-21 |
| 1740791649 | Tyldesley Anne Taylor Hepworth | Social Worker | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2017-10-18 |
| 1073044376 | Ishani Dhillon | Dentist | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2017-03-27 |
| 1124474994 | Melinda Perez | Nurse Practitioner | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2016-05-10 |
| 1639538440 | Maria Nin Swonk | Social Worker | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2016-02-22 |
| 1578940722 | Tessa Durbano | Social Worker | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2015-04-27 |
| 1558750976 | Rosa Serrano | Community Health Worker | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2015-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184268088 | Dana Caballero | Social Worker | 30240 Racho Viejo Rd, Suite C-1, San Juan Capistrano, CA 92675 | 2019-11-04 |
| 1801363858 | Hgrt Medical Group Inc | Internal Medicine | 31741 Rancho Hill Viejo Road, San Juan Capistrano, CA 92675 | 2018-10-29 |
| 1487132551 | Alex James Vanderschelden | Chiropractor | 36461 Rancho Viejo Rd. Suiete 103, Suite 103, San Juan Capistrano, CA 92675 | 2018-08-01 |
| 1295224780 | Gateway Healthcare, Inc. | Skilled Nursing Facility | 29222 Rancho Viejo Rd Ste 127, San Juan Capistrano, CA 92675 | 2018-05-09 |
| 1033606991 | Pelican Point Dental | Dentist | 31103 Rancho Viejo Road Ste D2444, San Juan Capistrano, CA 92675 | 2018-04-17 |
| 1639677511 | Ocean Hills Recovery Inc. | Substance Abuse Rehabilitation Facility | 27126b Paseo Espada, Suite 725, San Juan Capistrano, CA 92675 | 2018-01-25 |
| 1679091441 | D Dawn Maxwell | Counselor | 30950 Rancho Viejo Rd Suite 225, San Juan Capistrano, CA 92675 | 2017-08-31 |
| 1417491523 | Terry D'amico | Physical Therapy Assistant | 32961 Calle Miguel, San Juan Capistrano, CA 92675 | 2016-12-08 |
| 1235580556 | Marriage Made Better Relationship Counseling | Community/Behavioral Health | 30200 Rancho Viejo Road, Suite D, San Juan Capistrano, CA 92675 | 2016-06-28 |
| 1679923288 | Shanti Recovery Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 31211 Casa Grande Drive, San Juan Capistrano, CA 92675 | 2016-06-14 |
| Find all providers in zip 92675 | ||||
| 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 |
|---|---|---|---|---|
| 1912523978 | Hannah Lawrence | Physician Assistant | 33752 Via De Agua, San Juan Capistrano, CA 92675-5043 | 2020-06-24 |
| 1730703877 | Mckenzie Lee Walsh | Physician Assistant | 31271 Calle Bolero, San Juan Capistrano, CA 92675-5393 | 2020-06-04 |
| 1316297286 | Krista Fendrick | Physician Assistant | 31461 Rancho Viejo Rd Ste 103, San Juan Capistrano, CA 92675-1865 | 2012-09-18 |
| 1578656997 | Eugenia Toneva-merdjanova | Physician Assistant | 32312 Camino Capistrano, San Juan Capistrano, CA 92675-4518 | 2006-09-30 |
| 1760436968 | Hector G Camacho Perez-arce | Physician Assistant | 27512 Calle Arroyo, Suite A, San Juan Capistrano, CA 92675-2753 | 2006-05-20 |
| 1962028985 | Elena Novak | Physician Assistant | 30280 Rancho Viejo Rd, San Juan Capistrano, CA 92675-1561 | 2020-06-25 |
| 1871071761 | Christine Huong Thu Pham | Physician Assistant | 27512 Calle Arroyo Ste A, San Juan Capistrano, CA 92675-6783 | 2018-08-01 |
| 1992219331 | Lauren Marie Rodriguez | Physician Assistant | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2017-11-21 |
| 1154701399 | Monique Peternella | Physician Assistant | 27512 Calle Arroyo Ste A, San Juan Capistrano, CA 92675 | 2015-06-03 |
| 1679777346 | Elizabeth Zacarias | Physician Assistant | 30300 Camino Capistrano, San Juan Capistrano, CA 92675-1304 | 2007-06-14 |
| Find all providers in SAN JUAN CAPISTRANO | ||||
| City | SAN JUAN CAPISTRANO |
| Zip Code | 92675 |
Please comment or provide details below to improve the information on TRAVIS GREEN.
| 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.