ANGELA WYBLE (NPI# 1871588715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871588715 |
| Entity Type | Individual |
| Full Name | ANGELA WYBLE |
| Credential | PAC |
| Practice Address |
2725 Mendocino Ave Santa Rosa CA 95403-2805 |
| Practice Telephone | 7075454537 |
| Practice Fax Number | 7075456726 |
| Mailing Telephone | 7075454537 |
| Mailing Fax Number | 7075456726 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2017-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA17243 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | P01795158 | 01 |
| CA | 1871588715 | 05 |
| Street Address |
2725 MENDOCINO AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95403-2805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649265976 | Heather Noel Silva | Physician Assistant | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2005-09-13 |
| 1558812875 | Northern California Medical Assoc Inc | Dermatology | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2016-10-21 |
| 1114399334 | Angela Abboud | Physician Assistant | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2015-10-27 |
| 1760725394 | Brianne Zechlinski Dickey | Dermatology | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2013-04-02 |
| 1649599648 | Jennifer Hayes | Dermatology | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2010-06-01 |
| 1083949853 | Judith Hong | Dermatology | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2009-10-12 |
| 1083849012 | Ligaya Park | Dermatology | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2009-05-20 |
| 1942483755 | Pisenti Chiropractic, Inc | Chiropractor | 2725 Mendocino Ave, Suite C, Santa Rosa, CA 95403-2805 | 2007-12-14 |
| 1588879373 | Redwood Dermatopathology Laboratory | Clinical Medical Laboratory | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2007-05-14 |
| 1710913231 | Redwood Family Dermatology Medical Associates | Dermatology | 2725 Mendocino Ave, Santa Rosa, CA 95403-2805 | 2006-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549841 | Abundance Acupuncture Healing Clinic | Acupuncturist | 3410 Mendocino Avenue, Santa Rosa, CA 95403 | 2019-10-11 |
| 1982161337 | Crystal J Ward | Registered Nurse | 2350 Mendocino Ave, Ste A4, Santa Rosa, CA 95403 | 2019-02-21 |
| 1033674379 | George Edward Griese | Respiratory Therapist, Registered | 501 Bicentennial Way, Santa Rosa, CA 95403 | 2019-01-31 |
| 1508320672 | East-west Natural Medicine Inc. | Acupuncturist | 2200 Range Ave #207, Santa Rosa, CA 95403 | 2019-01-23 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1326519182 | Jkb Solutions Inc. | In Home Supportive Care | 3554 Round Barn Boulevard, Suite 311, Santa Rosa, CA 95403 | 2018-12-05 |
| 1487121265 | Catholic Charities of The Diocese of Santa Rosa | Clinic/Center | 987 Airway Ct, Santa Rosa, CA 95403 | 2018-10-30 |
| 1447746524 | Lisa Jean Quang | Optometrist | 3925 Old Redwood, Medical Office Building 4, Suite 141, Santa Rosa, CA 95403 | 2018-07-02 |
| 1598253353 | Jennifer Renee Lummus | Community Health Worker | 3614 Condo Court, Santa Rosa, CA 95403 | 2018-04-27 |
| 1871042366 | Sadie Thuet | Marriage & Family Therapist | 3434 A Mendocino Ave, Santa Rosa, CA 95403 | 2016-09-26 |
| Find all providers in zip 95403 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467096149 | Brittany Griffin | Physician Assistant | 208 Concourse Blvd # 1, Santa Rosa, CA 95403-8210 | 2019-11-05 |
| 1922301522 | Alexandra Maya Mcspadden | Physician Assistant | 3333 Mendocino Avenue Suite 130, Kaiser Permanente Cosmetic Services, Santa Rosa, CA 95403 | 2010-12-21 |
| 1821058140 | Patty Lynn Tucker | Physician Assistant | 585 W College Ave, Santa Rosa, CA 95401-5000 | 2006-03-23 |
| 1760089635 | Christopher Andrew Rhule | Physician Assistant | 1551 Pacific Ave, Santa Rosa, CA 95404-3568 | 2020-10-05 |
| 1538662937 | Paul Viscogliosi | Physician Assistant | 3883 Airway Dr Ste 165, Santa Rosa, CA 95403-1675 | 2018-03-12 |
| 1619404431 | Atoosa Molanazadeh | Physician Assistant | 1165 Montgomery Dr, Santa Rosa, CA 95405-4801 | 2017-05-11 |
| 1467889451 | Angela Merrisa Wetmore | Physician Assistant | 585 W College Ave Ste A, Santa Rosa, CA 95401-5060 | 2013-10-04 |
| 1255696910 | Jody Lynn Pennycook | Physician Assistant | 4740 Hoen Ave, Santa Rosa, CA 95405-7824 | 2012-07-09 |
| 1104101401 | Luis E Garcia | Physician Assistant | 208 Concourse Blvd, Santa Rosa, CA 95403-8210 | 2011-10-18 |
| 1316176712 | Lesley M Field | Physician Assistant | 121 Sotoyome St, Santa Rosa, CA 95405-4823 | 2009-07-07 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95403 |
Please comment or provide details below to improve the information on ANGELA WYBLE.
| 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.