KELLI SMITH (NPI# 1841771664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841771664 |
| Entity Type | Individual |
| Full Name | KELLI SMITH |
| Practice Address |
30420 Haun Rd Menifee CA 92584-6810 |
| Mailing Address |
28780 Single Oak Dr Ste 160 Temecula CA 92590-5528 |
| Practice Telephone | 9516764193 |
| Mailing Telephone | 9516764193 |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2020-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 28780 Single Oak Dr Ste 160, Temecula, CA 925905528 | 9516764193 | |
| 30420 Haun Rd, Menifee, CA 925846810 | 9516764193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710537253 | Kelli Marie Smith | Nurse Practitioner | 401 S Fifth St, Lynch, NE 68746-3013 | 2019-09-17 |
| 1972028215 | Kelli Smith | Counselor | 2001 W Plano Pkwy Ste 1400, Plano, TX 75075-8607 | 2017-08-08 |
| 1891157400 | Kelli Marie Smith | Student in an Organized Health Care Education/Training Program | 401 Quarry Rd # Mc5723, Palo Alto, CA 94304-1419 | 2016-03-23 |
| 1760881809 | Kelli Ann Smith | Pharmacist | 4122 Autumn Crest Dr, Hamilton, MI 49419-9119 | 2014-08-14 |
| 1154580983 | Kelli S. Smith | Physical Therapist | 1116 Halsell St, Bridgeport, TX 76426-3000 | 2008-06-06 |
| 1932382637 | Kelli Smith | Clinical Nurse Specialist | 43 Brookfield Cir, Framingham, MA 01701-4036 | 2007-12-17 |
| 1235119843 | Kelli L Smith | Physical Therapist | 259 Melbourne Ave, Akron, OH 44313-6574 | 2006-01-19 |
| 1326035148 | Kelli Pugh Smith | Audiologist | 901 Enterprise Pkwy Ste 300, Hampton, VA 23666-6249 | 2005-10-06 |
| 1831196203 | Kelli Gay Smith | Audiologist | 11685 Alpharetta Hwy, Ste 360, Roswell, GA 30076-4982 | 2005-06-30 |
| 1144868506 | Kelli Marie Smith | Case Manager/Care Coordinator | 6100 S Walker Ave, Oklahoma City, OK 73139-7026 | 2019-12-17 |
| Street Address |
30420 HAUN RD |
| City | MENIFEE |
| State | CA |
| Zip Code | 92584-6810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194774158 | Richard Eric James Madrid | Family Medicine | 30420 Haun Rd, Menifee, CA 92584-6810 | 2006-05-08 |
| 1740756279 | Rebekah Marie Tolopilo | Physician Assistant | 30420 Haun Rd, Menifee, CA 92584 | 2018-10-23 |
| 1073693552 | Daniel Camarillo Jr. | Family Medicine | 30420 Haun Rd, Menifee, CA 92584-6810 | 2006-10-17 |
| 1083720718 | Katharine M O'brien | Family Medicine | 30420 Haun Rd, Menifee, CA 92584-6810 | 2006-08-23 |
| 1104841212 | Rolando Gutierrez | Family Medicine | 30420 Haun Rd, Menifee, CA 92584-6810 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467091249 | Christopher Aron Sanders | Family Medicine | 30243 Westlake Dr, Menifee, CA 92584 | 2019-12-27 |
| 1336619451 | Tricia Rose Fontanilla Alegado | Nurse Practitioner | 29740 Mesa Verde Cir, Menifee, CA 92584 | 2018-12-01 |
| 1548776446 | Nicole O'neil | Nurse Practitioner | 29826 Haun Rd Suite 300, Menifee, CA 92584 | 2017-12-14 |
| 1518485150 | Harvinder Singh | Driver | 31972 Ruxton St, Menifee, CA 92584 | 2017-09-04 |
| 1558884239 | Poulsen Dental Corporation | Dentist | 29121 Newport Road, Ste 1, Menifee, CA 92584 | 2017-07-25 |
| 1598200040 | Thay Kieu | Dental Hygienist | 30035 Haun Rd, Menifee, CA 92584 | 2016-12-19 |
| 1033668652 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 28995 Newport Road, Menifee, CA 92584 | 2016-09-23 |
| 1295187474 | Cohen Sedgh, Manavi & Pakravan Dental Corp | Dentist | 30035 Haun Road, Menifee, CA 92584 | 2016-07-12 |
| 1871965640 | Sharon D. Benjamin | Licensed Vocational Nurse | 29120 Bridgeport Lane, Menifee, CA 92584 | 2015-10-20 |
| 1538573175 | Edwin Haroldo Alvarez | Physician Assistant | 31216 Silver Moon Court, Menifee, CA 92584 | 2014-06-11 |
| Find all providers in zip 92584 | ||||
| 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 |
|---|---|---|---|---|
| 1538573175 | Edwin Haroldo Alvarez | Physician Assistant | 31216 Silver Moon Court, Menifee, CA 92584 | 2014-06-11 |
| 1821242991 | Ana Rios | Physician Assistant | 29821 Antelope Rd Ste 102, Menifee, CA 92584-8860 | 2008-11-15 |
| 1982226205 | Madison Kawehelani Holtz | Physician Assistant | 27188 Sun City Blvd, Menifee, CA 92586-5505 | 2020-05-08 |
| 1346755337 | Lauren Elizabeth Nguyen | Physician Assistant | 29821 Antelope Rd Ste 102, Menifee, CA 92584-8860 | 2017-12-12 |
| 1013314442 | Stephanie Kirk | Physician Assistant | 29826 Haun Rd, Suite 302, Menifee, CA 92586-6546 | 2014-12-01 |
| 1588922058 | Erin Elizabeth Nash-fairfax | Physician Assistant | 29798 Haun Rd, Suite 207, Menifee, CA 92586-6541 | 2012-05-02 |
| 1619299633 | Laura Michelle Oltmanns | Physician Assistant | 29798 Haun Road, Ste #106, Menifee, CA 92586 | 2010-02-17 |
| 1396900965 | Darryl Lamont Davenport | Physician Assistant | 27168 Newport Rd Ste 1, Menifee, CA 92584-7383 | 2008-07-23 |
| 1356547137 | Erin Starr Romero | Physician Assistant | 29798 Haun Rd, Suite 108, Menifee, CA 92586-6541 | 2007-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1134720972 | Alessandra Porfido | Physician Assistant | 733 Filbert St Apt 1, San Francisco, CA 94133-2767 | 2020-11-06 |
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1609477504 | Julia Claire Stiefel | Physician Assistant | 369 Orange St Apt A, Oakland, CA 94610-2979 | 2020-11-05 |
| 1164023347 | Wendy P Lewis | Physician Assistant | 10447 Highdale St, Bellflower, CA 90706-4122 | 2020-11-04 |
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
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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.