SHELLY MARIE BOGUE (NPI# 1912523135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912523135 |
| Entity Type | Individual |
| Full Name | SHELLY MARIE BOGUE |
| Credential | STUDENT PHYSICIAN |
| Practice Address |
11234 Anderson St Loma Linda CA 92354-2804 |
| Practice Telephone | 9095584000 |
| Mailing Telephone | 9515584000 |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| Street Address |
11234 ANDERSON ST |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794657 | Leigh Ann Ballou | Physician Assistant | 11234 Anderson St, Rm 2562b, Loma Linda, CA 92354-2804 | 2005-07-14 |
| 1285233759 | Daemian Alexander Martin Sr. | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-10-25 |
| 1922610450 | Samantha Zepeda Merchant | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-08-17 |
| 1609493451 | Romina Mcgalliard | Registered Nurse | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-27 |
| 1811514854 | Christopher Jihoon Kim | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-25 |
| 1962028613 | Sikai Song | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-18 |
| 1720604515 | Nelson Horsley | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-17 |
| 1134744055 | Teddy Matthew Mumu | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-16 |
| 1124643135 | Kristofer John Vance | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-15 |
| 1841814993 | Jonathan Han | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2020-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544558 | Frida Keeru Bundi | Student in an Organized Health Care Education/Training Program | Loma Linda University 11262 Campus Street-west Hall, Loma Linda, CA 92350-0001 | 2020-07-01 |
| 1508482035 | Ella Wagner | Student in an Organized Health Care Education/Training Program | Loma Linda University 11262 Campus St- West Hall, Loma Linda, CA 92350-0001 | 2020-06-20 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1376167643 | Andrew J Park | Student in an Organized Health Care Education/Training Program | 26845 Barton Rd, Loma Linda, CA 92373-4309 | 2020-06-02 |
| 1689295263 | Carlie Alphanso Smith | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Primary Care -internal Med, 11234 Anderson St., Loma Linda, CA 92354-2804 | 2020-05-05 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1396365599 | Katielee Pallis | Student in an Organized Health Care Education/Training Program | Loma Linda University Evans Hall 201, Loma Linda, CA 92350-0001 | 2020-04-17 |
| 1639798879 | Brian Fardad Yadegari | Student in an Organized Health Care Education/Training Program | 11234 Anderson Street Gme Office Westerly Suite C, Loma Linda, CA 92354-2804 | 2020-04-08 |
| 1316576895 | Jason Elperin | Student in an Organized Health Care Education/Training Program | Loma Linda University Health-internal Medicine, 11234 Anderson Street, Loma Linda, CA 92354-2804 | 2020-04-06 |
| 1881223428 | Masuma Javed Syed | Student in an Organized Health Care Education/Training Program | Loma Linda University Health- Internal Medicine, 11234 Anderson Street, Loma Linda, CA 92354-2804 | 2020-04-06 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on SHELLY MARIE BOGUE.
| 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.