PAULA ANN PARK (NPI# 1801494398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801494398 |
| Entity Type | Individual |
| Full Name | PAULA ANN PARK |
| Credential | FNP, MSN, BSN, RN |
| Practice Address |
29300 Portola Pkwy Ste B Lake Forest CA 92630-8741 |
| Mailing Address |
12270 Haven Cir Riverside CA 92503-5982 |
| Practice Telephone | 7147732141 |
| Mailing Telephone | 7147732141 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95012155 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396199030 | Paula Park | Pharmacist | 453 13th St Apt 219, San Diego, CA 92101-7561 | 2016-04-19 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| Street Address |
29300 PORTOLA PKWY STE B |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-8741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780224873 | Richard R Moy, D.p.m., Inc | Podiatrist | 29300 Portola Pkwy Ste B, Lake Forest, CA 92630-8741 | 2020-01-07 |
| 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 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 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 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578060786 | Johnne Leoncio | Nurse Practitioner | 21022 Larchmont Dr, Lake Forest, CA 92630-5815 | 2018-04-12 |
| 1013453406 | Katie L Konopacz | Nurse Practitioner | 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 | 2017-01-10 |
| 1760931448 | Ruth Figueira Herdy | Nurse Practitioner | 22855 Lake Forest Drive, Suite A, Lake Forest, CA 92630-1656 | 2016-09-23 |
| 1609060441 | Varsha Shere | Nurse Practitioner | 24972 Crystal Cir, Lake Forest, CA 92630-2507 | 2007-09-05 |
| 1750859310 | Lauren Jill Birkinshaw | Nurse Practitioner | 23653 El Toro Rd, Lake Forest, CA 92630-8614 | 2018-11-12 |
| 1477038347 | Jennifer Nicole Nelson | Nurse Practitioner | 1000 N Westmoreland Rd, Lake Forest, IL 60045-1658 | 2018-09-26 |
| 1083193635 | Jae Woo | Nurse Practitioner | 23823 El Toro Rd, Lake Forest, CA 92630-4743 | 2018-08-13 |
| 1689150963 | Colleen Marie Mcnichols | Nurse Practitioner | 1000 N Westmoreland Rd Fl 3, Lake Forest, IL 60045 | 2018-07-19 |
| 1053805895 | Andrea C Komsri | Nurse Practitioner | 1000 N Westmoreland Rd, Pavilion B, Level 1, Lake Forest, IL 60045 | 2018-06-15 |
| 1235627712 | Jazmine T. Rios | Nurse Practitioner | 1000 N Westmoreland Rd, Lake Forest, IL 60045 | 2018-04-30 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on PAULA ANN PARK.
| 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.