GINA ROSE GASTELUM (NPI# 1912946567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912946567 |
| Entity Type | Individual |
| Full Name | GINA ROSE GASTELUM |
| Credential | P.A.C. |
| Practice Address |
3307 Renner Dr Fortuna CA 95540-3119 |
| Mailing Address |
200 W Center Street Promenade Ste 300 Anaheim CA 92805-3960 |
| Practice Telephone | 7077259832 |
| Practice Fax Number | 7077257247 |
| Mailing Telephone | 7144494841 |
| Mailing Fax Number | 7149376233 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA15240 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PA15240 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3800 Janes Rd, Arcata, CA 955214742 | 7078268264 | 7078268292 |
| Street Address |
3307 RENNER DR |
| City | FORTUNA |
| State | CA |
| Zip Code | 95540-3119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407296064 | Brandon Eugene Bireley | Surgery | 3307 Renner Dr, Fortuna, CA 95540-3119 | 2013-06-27 |
| 1841429339 | Michael Grant Kent | Surgery | 3307 Renner Dr, Fortuna, CA 95540-3119 | 2009-07-07 |
| 1558421701 | Redwood Women's Health Center | Midwife | 3307 Renner Dr, Fortuna, CA 95540-3119 | 2006-12-11 |
| 1104910306 | David Scott Johnson | Surgery | 3307 Renner Dr, Fortuna, CA 95540-3119 | 2006-10-03 |
| 1538264544 | Stephanie Ivy Stone | Midwife | 3307 Renner Dr, Fortuna, CA 95540-3119 | 2006-09-14 |
| 1972548436 | Kristy M Wolff | Obstetrics & Gynecology | 3307 Renner Dr, Fortuna, CA 95540-3119 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234787 | Remi Vista, Inc. | Community/Behavioral Health | 3000 Newburg, Fortuna, CA 95540 | 2020-01-21 |
| 1144867474 | Paula-marie Schneider | Registered Nurse | 3750 Rohnerville Rd., Fortuna, CA 95540 | 2019-12-05 |
| 1609265537 | Nancy Stinson Lollich | Physical Therapy Assistant | 2321 Newburg Road, Fortuna Rehabilitation and Wellness, Fortuna, CA 95540 | 2015-01-15 |
| 1730438151 | Heber House Inc. Dba Dermatology Center | Dermatology | 2404 Newburg Rd., Fortuna, CA 95540 | 2012-08-30 |
| 1104173418 | Michelle Leigh Hoopes | Physician Assistant | 3304 Renner Dr Suite B, Fortuna, CA 95540 | 2012-08-07 |
| 1205181526 | Constance Mitchell | Registered Nurse | Redwood Pediatrics, 3305 Renner Dr, Fortuna, CA 95540 | 2012-07-24 |
| 1730457177 | Joy Nadine Frasier | Counselor | 220 Wilson Ln., Fortuna, CA 95540 | 2011-12-13 |
| 1063791713 | Gardenside Eldercare, LLC | Residential Treatment Facility, Physical Disabilities | 529 9th Street, Fortuna, CA 95540 | 2011-08-12 |
| 1093025173 | Sheri A Jewett | Massage Therapist | 2655 Virginia Court, Fortuna, CA 95540 | 2010-10-07 |
| 1134371339 | Mariana Van Der Merwe | Pharmacist | 725 South Boulevard, Rite Aid Pharmacy, Fortuna, CA 95540 | 2008-10-21 |
| Find all providers in zip 95540 | ||||
| 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 |
|---|---|---|---|---|
| 1104173418 | Michelle Leigh Hoopes | Physician Assistant | 3304 Renner Dr Suite B, Fortuna, CA 95540 | 2012-08-07 |
| 1790299048 | Caris Cassady | Physician Assistant | 3300 Renner Dr, Fortuna, CA 95540-3120 | 2017-11-23 |
| 1548566276 | Brent C Dawson | Physician Assistant | 3304 Renner Dr, Fortuna, CA 95540-7102 | 2011-01-27 |
| 1629011754 | Whitney M Werner | Physician Assistant | 3304 Renner Dr, Fortuna, CA 95540-7102 | 2006-06-14 |
| 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.