LUCY M DOUGLASS (NPI# 1912940594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912940594 |
| Entity Type | Individual |
| Full Name | LUCY M DOUGLASS |
| Credential | MD |
| Practice Address |
2081 Bronze Star Dr Woodland CA 95776 |
| Mailing Address |
3400 Data Dr Quality Dept, 2nd Fl Rancho Cordova CA 95670-7956 |
| Practice Telephone | 5306682600 |
| Practice Fax Number | 5306611081 |
| Mailing Telephone | 9163792861 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2018-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A90595 | CA | Other Service Providers |
| N | 207P00000X | Emergency Medicine | A90595 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2081 BRONZE STAR DR |
| City | WOODLAND |
| State | CA |
| Zip Code | 95776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285629428 | Kristin Diane Rickelman | Nurse Practitioner | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2005-09-14 |
| 1821574625 | Editha C Setiawan | Family Medicine | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2018-07-14 |
| 1801380803 | Gurpreet Kaur Malhi | Nurse Practitioner | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2018-06-21 |
| 1497283212 | Hillary Williams | Nurse Practitioner | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2017-05-24 |
| 1073046124 | Adriana Santana | Family Medicine | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2017-04-05 |
| 1033661897 | Ofili Okolonwamu | Physician Assistant | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2016-10-27 |
| 1639550122 | My Dungthi Pham | Family Medicine | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2015-06-10 |
| 1376958173 | Janet A Hill | Physician Assistant | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2014-07-01 |
| 1144632951 | Behnam Vahdati Nia | Family Medicine | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2014-05-28 |
| 1750792149 | Iris M Villanueva | Physician Assistant | 2081 Bronze Star Dr, Woodland, CA 95776-5423 | 2014-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265736102 | Kristin Mae Davey | Physical Therapist | 1423 Roosevelt Drive, Woodland, CA 95776 | 2011-01-07 |
| 1669784484 | Suzan Jane Motooka | Licensed Vocational Nurse | 991 Hoppin Ct, Woodland, CA 95776 | 2010-07-09 |
| 1104157478 | Gill and Ghazal Dental Corporation | Dentist | 2041 Bronze Star Drive Suite 100, Woodland, CA 95776 | 2010-01-26 |
| 1962640284 | Amber Christine Mitchell | Behavioral Analyst | 2100 5th St., Davis, CA 95776 | 2009-01-23 |
| 1730348764 | Woodland Residential Services | Nursing Facility/Intermediate Care Facility | 40145 Best Ranch Road, Woodland, CA 95776 | 2008-06-05 |
| 1376716845 | Steven William Thomson | Dentist | 825 East St #121, Woodland, CA 95776 | 2008-04-07 |
| 1902081714 | Costco Wholesale Corporation | Pharmacy | 2299 Bronze Star Dr, Woodland, CA 95776 | 2007-12-31 |
| 1609095322 | Woodland Hearing Aid Services Inc | Specialist | 1837 E Gibson Rd Suite K, Woodland, CA 95776 | 2007-04-24 |
| 1114099157 | Kali Javon Leonard | Optometrist | 421 B Pioneer Ave, Woodland, CA 95776 | 2006-11-14 |
| 1609271485 | Victoria Leigh Aphailee | Registered Nurse | 1975 Maxwell Ave, Apt# C114, Woodland, CA 95776 | 2014-10-23 |
| Find all providers in zip 95776 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801345475 | Jennifer Ray Rosenbaum | Specialist | 321 Forest Park Rd, Woodland, WA 98674-7204 | 2016-09-23 |
| 1275921090 | Mia Nicole Treasure | Specialist | 2418 Nw Hayes Rd, Woodland, WA 98674-2218 | 2014-12-31 |
| 1841550845 | Lori Gonder | Specialist | 566 Goerig St, Woodland, WA 98674-9442 | 2012-05-23 |
| 1235350836 | Matthew Jon Gargulinski | Specialist | 632 West Gibson Rd, Woodland, CA 95695 | 2007-05-01 |
| 1609095322 | Woodland Hearing Aid Services Inc | Specialist | 1837 E Gibson Rd Suite K, Woodland, CA 95776 | 2007-04-24 |
| 1568680684 | Teresa Kasiarz | Specialist | 1264 E Gibson Rd Ste F600, Woodland, CA 95776-6319 | 2007-04-23 |
| 1699808378 | Tennille Renee Roberts | Specialist | 15450 County Road 99, Woodland, CA 95695-9339 | 2007-03-13 |
| 1417361916 | Gabriela Garcia | Specialist | 15450 County Road 99, Woodland, CA 95695-9339 | 2014-06-12 |
| 1609062397 | Aaron Miguel | Specialist | 124 Walnut St, Woodland, CA 95695-3137 | 2007-09-17 |
| 1366654238 | Woodland Nephrology Med Grp | Specialist | 520 Cottonwood St, Suite 2, Woodland, CA 95695-3603 | 2007-05-04 |
| Find all providers in WOODLAND | ||||
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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.