TARA L ANDERSON (NPI# 1770058349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770058349 |
| Entity Type | Individual |
| Full Name | TARA L ANDERSON |
| Credential | MMSC, PA-C |
| Practice Address |
22365 El Toro Rd Unit 310 Lake Forest CA 92630 |
| Mailing Address |
22365 El Toro Rd Unit 310 Lake Forest CA 92630-5053 |
| Practice Telephone | 3105609720 |
| Mailing Telephone | 3105609720 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2019-12-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA57587 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225553944 | Tara Anderson | Respiratory Therapist, Registered | 7611 Parkridge Way, Savage, MN 55378-1747 | 2017-08-03 |
| 1649636788 | Tara Anderson | Acupuncturist | 1500 Graham Hill Rd Ste A, Santa Cruz, CA 95060-1349 | 2016-01-05 |
| 1144565169 | Tara Jo Anderson | Acupuncturist | 3118 Kimball Ave, Waterloo, IA 50702-5253 | 2012-12-03 |
| 1770736993 | Tara Letitia Anderson | Counselor | 3312 Surf Avenue, Jbfcs, Brooklyn, NY 11224 | 2008-10-31 |
| 1811165780 | Tara Anderson | Specialist | 7846 Golf Point Dr Se, Caledonia, MI 49316-7779 | 2008-02-13 |
| 1487878807 | Tara Ashlock Anderson | Pharmacist | 151 Mcarthur Avenue, Celina, TN 38551 | 2007-04-13 |
| 1831710599 | Tara Ann Anderson | Behavior Technician | 6190 Barnes Rd, Colorado Springs, CO 80922-2600 | 2020-05-04 |
| 1295355378 | Tara Anderson | Student in an Organized Health Care Education/Training Program | 1020 W Broadway Ave, Minneapolis, MN 55411-2504 | 2020-04-20 |
| 1215499413 | Tara L Anderson | Counselor | 130 Southern School Rd, Somerset, KY 42501-3223 | 2019-04-05 |
| 1083174866 | Tara Anderson | Prevention Professional | 611 Forest Ave, Maysville, KY 41056-1411 | 2019-03-20 |
| Street Address |
22365 EL TORO RD UNIT 310 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| 1316495112 | Elizabeth Ga Yeun Kim | Dentist | 22611 Lake Forest Dr Ste C5, Lake Forest, CA 92630 | 2016-09-21 |
| Find all providers in zip 92630 | ||||
| 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 |
|---|---|---|---|---|
| 1083133250 | Oana-diana Popescu | Physician Assistant | 24401 Muirlands Blvd Ste A, Lake Forest, CA 92630-3948 | 2017-09-19 |
| 1962939397 | Katherine Reynolds Armstrong | Physician Assistant | 1200 N Westmoreland Rd Ste 100, Lake Forest, IL 60045-1601 | 2017-05-16 |
| 1801106794 | Monica Alvarez | Physician Assistant | 23823 El Toro Rd, Suite E122, Lake Forest, CA 92630-4743 | 2010-10-14 |
| 1508881574 | Jay Pun Lee | Physician Assistant | 23785 El Toro Rd, Suite 609, Lake Forest, CA 92630-4762 | 2006-07-12 |
| 1114953155 | Stephanie Quilianna Fizzard | Physician Assistant | 25902 Tipperary Ln, Lake Forest, CA 92630-8059 | 2006-06-23 |
| 1104861384 | Scott Cummings Baron | Physician Assistant | 22855 Lake Forest Dr Ste A, Lake Forest, CA 92630-1656 | 2006-06-19 |
| 1598746521 | Karla E Stewart | Physician Assistant | 1000 N Westmoreland Rd Fl 3, Lake Forest, IL 60045-1658 | 2005-11-08 |
| 1194211888 | Patrick Tyler Murphy | Physician Assistant | 800 N Westmoreland Rd Ste 102, Lake Forest, IL 60045 | 2018-07-05 |
| 1548754153 | Kyle Cummisford | Physician Assistant | 1000 N Westmoreland Rd, Lake Forest, IL 60045-1658 | 2018-06-18 |
| 1396235792 | Amalia Maria Megally | Physician Assistant | 1000 N Westmoreland Rd, Lake Forest, IL 60045 | 2018-05-11 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on TARA L ANDERSON.
| 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.