DR. SUPRABHA N JAIN (NPI# 1841228384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841228384 |
| Entity Type | Individual |
| Full Name | DR. SUPRABHA N JAIN |
| Credential | MD |
| Practice Address |
325 N Wiget Ln Ste 130 Walnut Creek Walnut Creek CA 94598-2435 |
| Practice Telephone | 9259355425 |
| Practice Fax Number | 9259472671 |
| Mailing Telephone | 9259355425 |
| Mailing Fax Number | 9259472671 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2017-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
A67699 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
325 N WIGET LN STE 130 WALNUT CREEK |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-2435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326552902 | Gregory Lee Willis | Acupuncturist | 325 N Wiget Ln Ste 130, Walnut Creek, CA 94598-2435 | 2017-11-19 |
| 1447707922 | Marie Guptill | Acupuncturist | 325 N Wiget Ln Ste 130, Walnut Creek, CA 94598-2435 | 2016-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356342638 | Ingrid Wendy Fernandes | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2005-08-09 |
| 1770659559 | Edgar Y Kwan | Internal Medicine | 1210 Rossmoor Pkwy, Walnut Creek, CA 94595-2501 | 2006-11-25 |
| 1225118599 | Lucia C Kim | Internal Medicine | 320 Lennon Ln, Walnut Creek, CA 94598-2419 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421480 | Healthier Lifestyle Medical Group | Internal Medicine | 1412 W Glenoaks Blvd Ste B, Glendale, CA 91201-1990 | 2020-06-10 |
| 1972065704 | Joseph A Habis Md | Internal Medicine | 359 Bel Marin Keys Blvd Ste 22, Novato, CA 94949-5637 | 2019-04-01 |
| 1801363858 | Hgrt Medical Group Inc | Internal Medicine | 31741 Rancho Hill Viejo Road, San Juan Capistrano, CA 92675 | 2018-10-29 |
| 1972081412 | Ahra Cho, M.d., Inc | Internal Medicine | 2727 W Olympic Blvd Ste 205, Los Angeles, CA 90006-2640 | 2018-08-06 |
| 1013401975 | Robert H Moon Md, Inc | Internal Medicine | 181 Rea Ave, El Cajon, CA 92020-3985 | 2018-06-14 |
| 1821587585 | Aost Healthcare Services | Internal Medicine | 10990 Lower Azusa Rd Ste 4, El Monte, CA 91731-1353 | 2018-05-08 |
| 1396233185 | Caroline Petrossian | Internal Medicine | 1880 Century Park East Suite 711, Century City, CA 90067 | 2018-04-26 |
| 1558868927 | Gps Physician Group of California PC | Internal Medicine | American River Center, 3900 Garfield Ave, Carmichael, CA 95608 | 2018-04-11 |
| 1427588417 | Vivacitas Medical Group PC | Internal Medicine | 1383 N Mcdowell Blvd Ste 110, Petaluma, CA 94954-1190 | 2017-06-13 |
| 1144616590 | Lindsey Merrihew Haddock | Internal Medicine | 4150 Clement St Bldg 1306b, San Francisco, CA 94121 | 2015-04-13 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
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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.