DIANE MARIE KENNEDY (NPI# 1972013597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972013597 |
| Entity Type | Individual |
| Full Name | DIANE MARIE KENNEDY |
| Credential | NP |
| Practice Address |
2185 W Grant Line Rd Tracy CA 95377-7309 |
| Practice Telephone | 2098396231 |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95006559 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 941105628 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2185 W Grant Line Rd, Tracy, CA 953777309 | 2098396231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588911176 | Diane Marie Kennedy | Pharmacist | 851 Ireland Ave, Pharmacy Department, Fort Knox, KY 40121-2722 | 2012-08-14 |
| 1588919393 | Diane M Kennedy | Case Manager/Care Coordinator | 2970 Kele St, Suite 203, Lihue, HI 96766-1823 | 2012-07-17 |
| 1467655092 | Diane Elizabeth Kennedy | Nurse Practitioner | 11180 Warner Ave, Suite 455, Fountain Valley, CA 92708 | 2007-06-10 |
| 1316939721 | Diane L Kennedy | Family Medicine | 1601 Sioux Valley Drive, Luverne, MN 56156 | 2005-08-22 |
| Street Address |
2185 W GRANT LINE RD |
| City | TRACY |
| State | CA |
| Zip Code | 95377-7309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801870035 | Konrad Boyd Thomas | Obstetrics & Gynecology | 2185 W Grant Line Rd, 2nd Floor, Tracy, CA 95377-7309 | 2005-12-01 |
| 1124552419 | Stacy Quach | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-13 |
| 1528592748 | Terry K Chow | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-13 |
| 1114451564 | Ngoc Son Dang | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-04-12 |
| 1619409745 | Natalya Pohoryelova | Pharmacist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2017-03-29 |
| 1659824399 | Eric Grady | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2016-07-29 |
| 1235508656 | Nicole Leona Preiss | Psychologist | 2185 W Grant Line Rd, Psychiatry, Tracy, CA 95377-7309 | 2015-09-15 |
| 1477933760 | Jennifer Rae Hulin Segura | Social Worker | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2015-06-02 |
| 1992104715 | Breanne Benedict | Psychologist | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2014-08-18 |
| 1821408519 | Chuanzhong Ye | Psychiatry & Neurology | 2185 W Grant Line Rd, Tracy, CA 95377-7309 | 2014-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639787070 | Mehak Bhardwaj | Behavior Technician | 2434 Saffron Ct, Tracy, CA 95377 | 2020-07-22 |
| 1427510809 | Xiaorui Yang | Behavior Technician | 1951 W Middlefield Dr Apt 224, Tracy, CA 95377 | 2019-04-03 |
| 1962936328 | Duc Nguyen | Pharmacist | 2941 W. Lowell Ave, Apt# 21, Tracy, CA 95377 | 2017-04-12 |
| 1053735043 | Luke Rond | Emergency Medicine | 763 Quail Run Cir, Tracy, CA 95377 | 2014-02-11 |
| 1578862553 | Nhan Duong | Pharmacist | 3250 W. Grant Line Road, Tracy, CA 95377 | 2011-03-16 |
| 1952570582 | Tech Diamond Health Care | Home Health | 2098 Babcock Lane, Tracy, CA 95377 | 2008-02-28 |
| 1316058795 | Wandisan and Rosete Medical Group Professional Corporation | Internal Medicine | 4600 S Tracy Blvd #107, Tracy, CA 95377 | 2006-08-31 |
| 1801838610 | Rollie Duyao Rosete | Internal Medicine | 4600 S Tracy Blvd, #107, Tracy, CA 95377 | 2006-06-13 |
| 1649274663 | Wivina Talabis Urbano | Pediatrics | 4600 South Tracy Blvd, Suite 110, Tracy, CA 95377 | 2005-06-08 |
| 1770586448 | Mitchell Edward Blum | Otolaryngology | 2160 W. Grantline Rd, Suite 250, Tracy, CA 95377 | 2005-05-24 |
| Find all providers in zip 95377 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750806378 | Bridget Nkiruka Dike | Nurse Practitioner | 1901 Columbia Ct, Tracy, CA 95376-9088 | 2017-08-04 |
| 1013368208 | Oke Umeugoji | Nurse Practitioner | 2172 Tennis Ln, Tracy, CA 95377-1166 | 2016-06-29 |
| 1063884625 | Anthony Ogbodo | Nurse Practitioner | 4180 Cherry Blossom Ln, Tracy, CA 95377-8825 | 2015-10-22 |
| 1821417718 | Ricardo Echon | Nurse Practitioner | 644 W 12th Street, Tracy, CA 95376 | 2014-04-08 |
| 1487888368 | Oloruntobi O Agbelusi | Nurse Practitioner | 767 Hemmingway Ct, Tracy, CA 95376-8700 | 2009-05-07 |
| 1912474768 | Jessica F Hoffman | Nurse Practitioner | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2018-10-30 |
| 1407339716 | Huma Helmand | Nurse Practitioner | 1441 N Tracy Blvd, Tracy, CA 95376-3445 | 2018-09-12 |
| 1528550928 | Ruby Khanal | Nurse Practitioner | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2018-05-31 |
| 1568973329 | Rene Gilberto Steinhauer IIi | Nurse Practitioner | 1420 N Tracy Blvd, Tracy, CA 95376-3451 | 2017-10-19 |
| 1881129369 | Lisa Marie King | Nurse Practitioner | 1441 N Tracy Blvd, Tracy, CA 95376-3445 | 2017-04-21 |
| Find all providers in TRACY | ||||
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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.