COLIN GLYNN CUSICK (NPI# 1780107169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780107169 |
| Entity Type | Individual |
| Full Name | COLIN GLYNN CUSICK |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
3901 Lone Tree Way Antioch CA 94509-6200 |
| Mailing Address |
8238 Golf Links Rd Oakland CA 94605-3537 |
| Practice Telephone | 9257797200 |
| Mailing Telephone | 3132684906 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 54485 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3901 LONE TREE WAY |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205820420 | Muhammad Raees | Internal Medicine | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2005-09-02 |
| 1194343715 | Kizzy Kinte' Houston | Nurse Practitioner | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2020-07-09 |
| 1124668223 | Sharon D Fernekees-jeans | Social Worker | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2020-01-07 |
| 1780248161 | Veronica Padilla | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2019-04-30 |
| 1386123255 | Alicia Ramsey | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509 | 2018-08-10 |
| 1770098915 | Vincent Rimando Largo | Pharmacist | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2017-12-11 |
| 1285157818 | Jason Thompson | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2017-07-25 |
| 1972043396 | Darrell Joseph Creekmore | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2017-03-03 |
| 1699213835 | Christina Nardi | Nurse Practitioner | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2017-02-08 |
| 1861944571 | Emily Choi | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2016-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| 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 |
|---|---|---|---|---|
| 1922631886 | Amanda Kristine Barbanica | Physician Assistant | 3565 Markley Creek Dr, Antioch, CA 94509-6288 | 2020-02-19 |
| 1437667334 | Miguel Angel Coria | Physician Assistant | 1817 Terrace Dr, Antioch, CA 94509-2804 | 2018-01-14 |
| 1376079731 | Bola Gabriel | Physician Assistant | 5100 Brookstone Ct, Antioch, TN 37013-5687 | 2017-05-04 |
| 1558733451 | Anthony Ambrosino | Physician Assistant | 2904 Carolyn Ct, Antioch, CA 94509-4952 | 2015-10-30 |
| 1922406297 | Myrlande Dixon | Physician Assistant | 5380 Hickory Hollow Pkwy, Ste 201, Antioch, TN 37013-3117 | 2014-12-18 |
| 1013356757 | Kevin Eugene Groh | Physician Assistant | 5380 Hickory Hollow Pkwy Ste 201, Antioch, TN 37013 | 2013-06-16 |
| 1558642934 | George Edward Marcus IIi | Physician Assistant | 2125 Aileen Dr, Antioch, TN 37013-1702 | 2011-08-30 |
| 1407157886 | Mike Romain | Physician Assistant | 2788 Murfreesboro Pike, Antioch, TN 37013-2004 | 2010-11-16 |
| 1023644507 | Jeffrey Robert Chavez | Physician Assistant | 4501 Sand Creek Rd, Antioch, CA 94531-8687 | 2020-03-17 |
| 1780248161 | Veronica Padilla | Physician Assistant | 3901 Lone Tree Way, Antioch, CA 94509-6200 | 2019-04-30 |
| Find all providers in ANTIOCH | ||||
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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.