Jaclyn M De Groot (NPI# 1306186259, PAC ID# 6800116369) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1306186259 |
| PAC ID by PECOS | 6800116369 |
| Professional Enrollment ID | I20150522001879 |
| Full Name | Jaclyn M De Groot |
| Organization Legal Name | ST JOSEPH HERITAGE HEALTHCARE |
| Address |
100 E Valencia Mesa Dr Suite 105 Fullerton CA 92835-3816 |
| Phone Number | 7144465200 |
| Gender | F |
| Graduation Year | 2012 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8921993205 |
| Number of Group Practice Members | 982 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050224 | HOAG MEMORIAL HOSPITAL PRESBYTERIAN |
| Address | Phone | Organization |
|---|---|---|
| 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 | 7144465200 | ST JOSEPH HERITAGE HEALTHCARE |
| 100 E Valencia Mesa Dr, Fullerton, CA 92835-3816 | 7144465200 | ST JOSEPH HERITAGE HEALTHCARE |
| Organization Legal Name | ST JOSEPH HERITAGE HEALTHCARE |
| Physicians | 1022 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tarah N Nelson | Nurse Practitioner | St Joseph Heritage Healthcare | 2460 Buhne St, Eureka, CA 95501-3207 |
| Kristen Shay Rasnick | Nurse Practitioner | St Joseph Heritage Healthcare | 6580 Hembree Ln, Suite 270, Windsor, CA 95492-6885 |
| Basit Rahim | Neurology | St Joseph Heritage Healthcare | 26800 Crown Valley Pkwy, Suite 385, Mission Viejo, CA 92691-7320 |
| Elizabeth Wachtel O'brien | Certified Nurse Midwife (cnm) | St Joseph Heritage Healthcare | 3307 Renner Dr, Fortuna, CA 95540-3119 |
| Michael James Glamore | Urology | St Joseph Heritage Healthcare | 1701 4th St, Suite 200, Santa Rosa, CA 95404-3661 |
| Teresa E Shields-szabo | Family Medicine | St Joseph Heritage Healthcare | 26795 Portola Pkwy, Foothill Ranch, CA 92610-1713 |
| Austin James Perkins | Physician Assistant | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Sherin Ann Chakkalakel | Nurse Practitioner | St Joseph Heritage Healthcare | 905 E Washington St, St Joseph Heritage Healthcare, Petaluma, CA 94952-3389 |
| Jamie Lea Meyer | Nurse Practitioner | St Joseph Heritage Healthcare | 2332 23rd St, Eureka, CA 95501-3231 |
| Laura Elizabeth Hall | Nurse Practitioner | St Joseph Heritage Healthcare | 2280 Harrison Ave, Suite K, Eureka, CA 95501-3200 |
| Street Address |
100 E VALENCIA MESA DR SUITE 105 |
| City | FULLERTON |
| State | CA |
| Zip | 92835-3816 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Austin James Perkins | Physician Assistant | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Kenneth K Tan | Family Medicine | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Erene M Nawar | Internal Medicine | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| James L Hardeman | Pulmonary Disease | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Jerry L Fralick | Pain Management | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 310, Fullerton, CA 92835-3800 |
| Richard E Lloyd | Hematology/oncology | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Monica K Martyn | Registered Dietitian Or Nutrition Professional | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Neha B Savalia | Internal Medicine | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Doreen M Rioux | Family Medicine | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Renee M Soderquist | Registered Dietitian Or Nutrition Professional | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Howard Dedes | Interventional Pain Management | 295 Imperial Hwy, Suite 100, Fullerton, CA 92835-1020 | |
| Alvaro O Liceaga | Interventional Pain Management | 295 Imperial Hwy 100, Fullerton, CA 92835-1020 | |
| Sara Said | Psychologist, Clinical | The Neurobehavioral Group, A Psychological Corporation | 385 Imperial Hwy, Fullerton, CA 92835-1040 |
| Stella R Vargas | Physical Therapy | 373 Imperial Hwy, Fullerton, CA 92835-1040 | |
| Johnson L Moon | Neurology | Neurology Center of North Orange County A Medical Corp | 381 Imperial Hwy, Fullerton, CA 92835-1040 |
| Priscilla P Armstrong | Psychologist, Clinical | The Neurobehavioral Group, A Psychological Corporation | 385 Imperial Hwy, Fullerton, CA 92835-1040 |
| Margaret M Slaven | Psychologist, Clinical | The Neurobehavioral Group, A Psychological Corporation | 385 Imperial Hwy, Fullerton, CA 92835-1040 |
| Manpreet Kaur Multani | Neurology | Neurology Center of North Orange County A Medical Corp | 381 Imperial Hwy, Fullerton, CA 92835-1040 |
| Eileen S Kang | Psychologist, Clinical | The Neurobehavioral Group, A Psychological Corporation | 385 Imperial Hwy, Fullerton, CA 92835-1040 |
| Kiran Bath | Neurology | Neurology Center of North Orange County A Medical Corp | 381 Imperial Hwy, Fullerton, CA 92835-1040 |
| Find all physicians in zip 92835 | |||
| City | FULLERTON |
| Zip Code | 92835 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FULLERTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jaclyn M De Groot.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.