Table: enrolled_medi_cal_fee_for_service_ffs_providers , legal_name like F*

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  *

objectid	provider_source	provider_number	npi	owner_number	service_location_number	legal_name	enroll_status_eff_dt	provider_taxonomy	nemt_nmt_provider_type	anc_provider_type	fi_provider_type_cd	fi_provider_type	provider_license	fi_provider_specialty_cd	fi_provider_specialty	out_of_state_indicator	in_out_state	address_attention	address	address2	city	state	zip	zip_4	dhcs_county_cd	fips_county_cd	latitude	longitude	countyname
14	Fee-for-Service	1124200126	1124200126	1	1	FAJARDO, MARTA	10/31/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	77143	01	General Practice	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
17	Fee-for-Service	1477058113	1477058113	1	1	FLETCHER, SAVANNAH E MD	4/14/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	163754	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
24	Fee-for-Service	1114330404	1114330404	1	1	FIORE, BENJAMIN MD	4/1/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	192499	None	None	0	In state provider	None	8860 CENTER DR STE 420	None	LA MESA	CA	91942	7001	37	06073	32.78189749	-117.0075062	San Diego County
31	Fee-for-Service	1477526846	1477526846	1	1	FUNG, ANTONY H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55475	41	Internal Medicine	0	In state provider	WALNUT PRIMEMED, AMC	17595 ALMAHURST ST	STE 102	ROWLAND HEIGHTS	CA	91748	1799	19	06037	33.99174345	-117.9215033	Los Angeles County
34	Fee-for-Service	1821289513	1821289513	1	1	FITZGERALD, BRUCE MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	37352	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
87	Fee-for-Service	1770339616	1770339616	1	1	FAJARDO, JUNELL RUEZO	5/29/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	218 CANTADA WAY	None	AMERICAN CANYON	CA	94503	3171	28	06055	38.17540756	-122.2464841	Napa County
153	Fee-for-Service	1851426688	1851426688	1	1	FRANZON, DEBORAH E MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63893	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3030 CHILDRENS WAY	STE 213	SAN DIEGO	CA	92123	4227	37	06073	32.798889	-117.150826	San Diego County
159	Fee-for-Service	1376809954	1376809954	1	1	FELTES, MICHELLE T MD	12/9/2016	207P00000X	NA	Other	026	PHYSICIANS	143167	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
194	Fee-for-Service	1760654883	1760654883	1	1	FLEISCHMAN, FERNANDO MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103228	33	Thoracic Surgery	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
319	Fee-for-Service	1477526846	1477526846	1	1	FUNG, ANTONY H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55475	08	Family Practice	0	In state provider	WALNUT PRIMEMED, AMC	17595 ALMAHURST ST	STE 102	ROWLAND HEIGHTS	CA	91748	1799	19	06037	33.99174345	-117.9215033	Los Angeles County
325	Fee-for-Service	1225546575	1225546575	1	7	FAMILY HEALTHCARE NETWORK	9/16/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	826 E MANNING AVE	None	REEDLEY	CA	93654	2232	10	06019	36.60418846	-119.4408009	Fresno County
371	Fee-for-Service	1326665415	1326665415	1	1	FACULTY PHYSICIANS AND SURGE	8/4/2020	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	4646 BROCKTON AVE	STE 103	RIVERSIDE	CA	92506	0103	33	06065	33.9760171	-117.3860626	Riverside County
375	Fee-for-Service	1770339616	1770339616	1	1	FAJARDO, JUNELL RUEZO	5/29/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	218 CANTADA WAY	None	AMERICAN CANYON	CA	94503	3171	28	06055	38.17540756	-122.2464841	Napa County
419	Fee-for-Service	1891869400	1891869400	1	1	FELDMAN, KELLY A MD	11/4/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82473	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
436	Fee-for-Service	1225546575	1225546575	1	3	FAMILY HEALTHCARE NETWORK	1/13/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3505 E SHIELDS AVE	None	FRESNO	CA	93726	6910	10	06019	36.77977313	-119.7661846	Fresno County
441	Fee-for-Service	1851426688	1851426688	1	1	FRANZON, DEBORAH E MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63893	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	STE 213	SAN DIEGO	CA	92123	4227	37	06073	32.798889	-117.150826	San Diego County
443	Fee-for-Service	1548920788	1548920788	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	507 OLLER STREET	None	MENDOTA	CA	93640	2360	10	06019	36.75690856	-120.382127	Fresno County
455	Fee-for-Service	1225546575	1225546575	1	6	FAMILY HEALTHCARE NETWORK	7/16/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1850 WHITSON ST	None	SELMA	CA	93662	3609	10	06019	36.56566086	-119.612893	Fresno County
505	Fee-for-Service	1427023100	1427023100	1	1	FONG, CARLETON S OD	9/22/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2771 S DIAMOND BAR BLVD	None	DIAMOND BAR	CA	91765	3513	19	06037	33.97449155	-117.8375299	Los Angeles County
579	Fee-for-Service	1033129127	1033129127	1	1	FUNG, FREDERICK Y MD	3/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	40644	08	Family Practice	0	In state provider	None	2180 W CRESCENT AVE	STE B	ANAHEIM	CA	92801	3842	30	06059	33.8397445	-117.9580995	Orange County
612	Fee-for-Service	1518940667	1518940667	1	1	FEATHER RIVER HOSPITAL	1/18/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	5974 PENTZ RD	None	PARADISE	CA	95969	5593	04	06007	39.75705992	-121.572292	Butte County
613	Fee-for-Service	1225546575	1225546575	1	7	FAMILY HEALTHCARE NETWORK	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	826 E MANNING AVE	None	REEDLEY	CA	93654	2232	10	06019	36.60418846	-119.4408009	Fresno County
624	Fee-for-Service	1225546575	1225546575	1	4	FAMILY HEALTHCARE NETWORK	9/23/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	30924 E KINGS CANYON RD	None	SQUAW VALLEY	CA	93675	9601	10	06019	36.7408714	-119.2455329	Fresno County
658	Fee-for-Service	1093236986	1093236986	1	1	FAMILY PLANNING ASSOCIATES M	6/21/2019	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4922 WHITTIER BLVD	None	LOS ANGELES	CA	90022	1111	19	06037	34.02163273	-118.1631725	Los Angeles County
725	Fee-for-Service	1225546575	1225546575	1	3	FAMILY HEALTHCARE NETWORK	1/13/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3505 E SHIELDS AVE	None	FRESNO	CA	93726	6910	10	06019	36.77977313	-119.7661846	Fresno County
733	Fee-for-Service	1548920788	1548920788	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	507 OLLER STREET	None	MENDOTA	CA	93640	2360	10	06019	36.75690856	-120.382127	Fresno County
741	Fee-for-Service	1871818138	1871818138	1	2	FRIENDS OF FAMILY	8/11/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1129 W 4TH ST	None	ONTARIO	CA	91762	1703	36	06071	34.077636	-117.6713055	San Bernardino County
748	Fee-for-Service	1225546575	1225546575	1	6	FAMILY HEALTHCARE NETWORK	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1850 WHITSON ST	None	SELMA	CA	93662	3609	10	06019	36.56566086	-119.612893	Fresno County
752	Fee-for-Service	1093734360	1093734360	1	1	FAGNANT, ROBERT J MD	9/12/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	161601	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
776	Fee-for-Service	1124481015	1124481015	1	1	FLEMING, MONTIDA C MD	6/18/2019	390200000X	NA	Other	026	PHYSICIANS	152800	None	None	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
796	Fee-for-Service	1295729242	1295729242	1	1	FRISMAN, DENNIS M MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54392	22	Pathology (M.D. only)	0	In state provider	None	1701 SANTA ANITA AVE	None	SOUTH EL MONTE	CA	91733	3411	19	06037	34.04810648	-118.0424794	Los Angeles County
902	Fee-for-Service	1720373871	1720373871	1	1	FEIN, ERIC H MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123457	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
916	Fee-for-Service	1225546575	1225546575	1	4	FAMILY HEALTHCARE NETWORK	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	30924 E KINGS CANYON RD	None	SQUAW VALLEY	CA	93675	9601	10	06019	36.7408714	-119.2455329	Fresno County
929	Fee-for-Service	1497079040	1497079040	1	1	FANTE, RYAN J MD	9/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128596	18	Ophthalmology	0	In state provider	None	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
991	Fee-for-Service	1710997366	1710997366	1	1	FEENEY, COLIN M MD	10/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35442	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
1005	Fee-for-Service	1417511767	1417511767	1	1	FISCHER, MICHAEL MD	7/19/2022	390200000X	NA	Other	026	PHYSICIANS	180053	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
1022	Fee-for-Service	1063460830	1063460830	1	1	FORREST D LANCHBURY, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	14 6TH AVE SW	None	BOWMAN	ND	58623	4518	00	None	46.18204217	-103.4038233	Bowman County
1026	Fee-for-Service	1962898692	1962898692	1	1	FULLER, DAVID L MD	5/21/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	162126	None	None	0	In state provider	None	8635 W 3RD ST	STE 485W	LOS ANGELES	CA	90048	6121	19	06037	34.07361928	-118.3803143	Los Angeles County
1028	Fee-for-Service	1932199304	1932199304	1	1	FU, AUDREY MD	12/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88205	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
1048	Fee-for-Service	1184783136	1184783136	1	1	FAMILY MEDICAL GROUP INC	1/1/1980	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1850 SULLIVAN AVE	STE 150	DALY CITY	CA	94015	2230	41	06081	37.68085904	-122.4728842	San Mateo County
1077	Fee-for-Service	1144294216	1144294216	1	1	FRANKS,T KEVIN DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 3RD AVE SW	None	MINOT	ND	58701	3880	00	None	48.23336909	-101.2951165	Ward County
1119	Fee-for-Service	1184669277	1184669277	1	1	FRIZELL, GARRY G CRNA	8/1/1995	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
1195	Fee-for-Service	1730313016	1730313016	1	1	FAUCETTE, LINDSEY B DO	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13029	None	None	0	In state provider	None	1400 E CHURCH ST	BLDG 8	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
1277	Fee-for-Service	1801802079	1801802079	1	1	FLORO, F JERRY MD	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	42959	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2220 CLARK AVE	None	LONG BEACH	CA	90815	2521	19	06037	33.79772674	-118.1338339	Los Angeles County
1365	Fee-for-Service	1891291423	1891291423	1	1	FAM, MARIAN MD	11/17/2022	193400000X	NA	Other	026	PHYSICIANS	174623	None	None	0	In state provider	None	25150 HANCOCK AVE	STE 206	MURRIETA	CA	92562	5989	33	06065	33.56635084	-117.1823956	Riverside County
1400	Fee-for-Service	1134550643	1134550643	1	1	FERGUSON, COLE MD	10/26/2020	207ZP0101X	NA	Other	026	PHYSICIANS	170171	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
1410	Fee-for-Service	1043277601	1043277601	1	1	FENG, WEI MD	4/12/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	51793	40	Pediatrics	0	In state provider	None	50 BELLEFONTAINE ST	STE 104	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
1447	Fee-for-Service	1134467392	1134467392	1	1	FOULADIAN, GEORGE MD INC	2/21/2013	193400000X	NA	Other	026	PHYSICIANS	41170	41	Internal Medicine	0	In state provider	A CALIFORNIA PC	1300 N. VERMONT AVE	704	LOS ANGELES	CA	90027	6089	19	06037	34.0956033	-118.2916918	Los Angeles County
1486	Fee-for-Service	1063557940	1063557940	1	1	FAREEDUDDIN, RIZWANA MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	93902	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1500-30 S OLIVE ST	None	LOS ANGELES	CA	90015	3023	19	06037	34.03568676	-118.2649769	Los Angeles County
1523	Fee-for-Service	1356518211	1356518211	1	1	FULLAR, HINA MD	4/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137784	36	Psychiatry	0	In state provider	None	710 S BROADWAY STREET	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
1594	Fee-for-Service	1639103138	1639103138	1	1	FERNANDEZ, GEOVER MD	9/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103070	07	Dermatology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
1662	Fee-for-Service	1164498457	1164498457	1	1	FINE, STEVEN N. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	475 FRANKLIN ST	STE 110	FRAMINGHAM	MA	01702	6265	00	None	42.289488	-71.4279015	Middlesex County
1685	Fee-for-Service	1992121479	1992121479	1	1	FRANCIS, TAMMY CNP	10/21/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
1706	Fee-for-Service	1528009396	1528009396	1	1	FREMONT MEDICAL GRP INC	4/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	734 MOWRY AVE	None	FREMONT	CA	94536	4115	01	06001	37.56635225	-121.9749284	Alameda County
1803	Fee-for-Service	1356959043	1356959043	1	1	FIEDLER, SARAH M NP	9/6/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
1822	Fee-for-Service	1538185533	1538185533	1	1	FONG, TIMOTHY WAYNE MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70984	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
1841	Fee-for-Service	1104273549	1104273549	1	1	FEINBERG, SEAN MD	4/23/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
1855	Fee-for-Service	1992187348	1992187348	1	1	FENDER, VERONICA A LCSW	2/21/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
1871	Fee-for-Service	1811091853	1811091853	1	1	FOK, RANDOLPH Y MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	41813	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2330 TRUXTON AVE	STE A	BAKERSFIELD	CA	93301	1829	15	06029	35.37346747	-119.0291175	Kern County
1882	Fee-for-Service	1326126483	1326126483	1	1	FANG, CHARLES C MD	8/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81071	08	Family Practice	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
1896	Fee-for-Service	1619302031	1619302031	1	1	FAMILY HEALTHCARE NETWORK	12/15/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 EAST OAK AVE	None	VISALIA	CA	93291	6331	54	06107	36.332253	-119.288691	Tulare County
1938	Fee-for-Service	1487073532	1487073532	1	2	FIROUZIAN, ATOOSA	8/28/2020	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	139496	40	Pediatrics	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
1939	Fee-for-Service	1740816230	1740816230	1	2	FIVE STAR ASSISTED LIVING CO	1/14/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5727 N HAZEL AVE	None	FRESNO	CA	93711	2139	10	06019	36.82156671	-119.8495175	Fresno County
2047	Fee-for-Service	1104087287	1104087287	1	1	FLORES, PATRICK DO	7/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
2060	Fee-for-Service	1952757296	1952757296	1	1	FU, ALEX DO	10/25/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
2108	Fee-for-Service	1891732194	1891732194	1	1	FREEMAN, STEPHANNY F N	9/30/2008	2084P0800X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
2168	Fee-for-Service	1326126483	1326126483	1	1	FANG, CHARLES C MD	8/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81071	41	Internal Medicine	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
2205	Fee-for-Service	1316925183	1316925183	1	1	FAN, LARRY K	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73816	89	Surgery-Traumatic	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
2327	Fee-for-Service	1497957641	1497957641	1	1	FARZIN-GOHAR, SHADI MD	1/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114124	78	Neoplastic Diseases/Oncology	0	In state provider	None	2653 ELM AVE	STE 200	LONG BEACH	CA	90806	1652	19	06037	33.805512	-118.188348	Los Angeles County
2330	Fee-for-Service	1427518596	1427518596	1	1	FREEMAN, JEANNINE A NP	9/26/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5900 STATE FARM DR	None	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
2367	Fee-for-Service	1528231362	1528231362	1	1	FAMILY FIRST MED GROUP	4/29/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	AMC	456 E ORANGE GROVE	SUITE 120	PASADENA	CA	91104	5235	19	06037	34.15773149	-118.141101	Los Angeles County
2390	Fee-for-Service	1821265448	1821265448	1	1	FAKIRI, ZARLASHT DO	6/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10065	41	Internal Medicine	0	In state provider	None	3466 MT DIABLO BLVD	STE C 100	LAFAYETTE	CA	94549	3952	07	06013	37.89256947	-122.1150289	Contra Costa County
2413	Fee-for-Service	1760639256	1760639256	1	1	FELTS, CASSY C MD	8/30/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	179836	None	None	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
2442	Fee-for-Service	1710027446	1710027446	2	1	FAIZ, ZAREEN MD	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	37287	None	None	0	In state provider	None	8301 FLORENCE AVE	STE 101	DOWNEY	CA	90240	3946	19	06037	33.95129816	-118.125377	Los Angeles County
2456	Fee-for-Service	1003342585	1003342585	1	1	FUENTES, ANDREA P MD	7/29/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	171442	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
2480	Fee-for-Service	1093398059	1093398059	1	1	FORWARD WELLNESS FAMILY THER	8/6/2021	101Y00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	APY, INC.	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
2507	Fee-for-Service	1497955249	1497955249	1	1	FITZPATRICK, KATHLEEN K	3/3/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
2575	Fee-for-Service	1770852659	1770852659	1	1	FLORES, TERESA MD	9/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119440	01	General Practice	0	In state provider	None	1206 E 17TH ST	STE 101	SANTA ANA	CA	92701	2641	30	06059	33.75983651	-117.8539425	Orange County
2615	Fee-for-Service	1497957641	1497957641	1	1	FARZIN-GOHAR, SHADI MD	1/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114124	40	Pediatrics	0	In state provider	None	2653 ELM AVE	STE 200	LONG BEACH	CA	90806	1652	19	06037	33.805512	-118.188348	Los Angeles County
2647	Fee-for-Service	1013947597	1013947597	1	1	FERREN, PETER MD	8/23/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	79672	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
2674	Fee-for-Service	1710709993	1710709993	1	1	FRESNO COLLECTIVE FOR INCLUS	2/26/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	3032 TULARE ST	None	FRESNO	CA	93721	1415	10	06019	36.74161978	-119.7791358	Fresno County
2724	Fee-for-Service	1649473679	1649473679	1	1	FOLLMAR, KEITH E MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124368	24	Plastic Surgery	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
2732	Fee-for-Service	1013401959	1013401959	1	1	FAITH & LIFE HOSPICE INC	4/22/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	356 W COLORADO ST	SUITE C	GLENDALE	CA	91204	1603	19	06037	34.14250251	-118.2603915	Los Angeles County
2765	Fee-for-Service	1194802991	1194802991	1	1	FERGUSON, DANIEL R MD	10/1/2017	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	151485	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	481 PLUMAS BLVD	SUITE 104	YUBA CITY	CA	95991	5075	51	06101	39.13306148	-121.6140103	Sutter County
2770	Fee-for-Service	1093398059	1093398059	1	1	FORWARD WELLNESS FAMILY THER	8/21/2024	101Y00000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	APY, INC.	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
2784	Fee-for-Service	1780684621	1780684621	1	1	FRANKLIN, JONATHAN T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2901 SQUALICUM PKWY	None	BELLINGHAM	WA	98225	1851	00	None	48.77211992	-122.473101	Whatcom County
2906	Fee-for-Service	1497957641	1497957641	1	1	FARZIN-GOHAR, SHADI MD	1/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114124	68	Hematology	0	In state provider	None	2653 ELM AVE	STE 200	LONG BEACH	CA	90806	1652	19	06037	33.805512	-118.188348	Los Angeles County
2926	Fee-for-Service	1316996903	1316996903	1	1	FAMILY PRACTICE ASSOCIATES	10/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	74550	41	Internal Medicine	0	In state provider	OF CARSON MED GROUP INC	824 E CARSON ST	STE 201	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
2963	Fee-for-Service	1255609418	1255609418	1	1	FORD, SHEILA E MD	3/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	79116	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
2964	Fee-for-Service	1710709993	1710709993	1	1	FRESNO COLLECTIVE FOR INCLUS	2/26/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3032 TULARE ST	None	FRESNO	CA	93721	1415	10	06019	36.74161978	-119.7791358	Fresno County
2996	Fee-for-Service	1255821070	1255821070	1	1	FORMEN & FORMEN HOME HEALTH	1/18/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	664 W BROADWAY	UNIT H	GLENDALE	CA	91204	1008	19	06037	34.14674052	-118.269936	Los Angeles County
3015	Fee-for-Service	1710055892	1710055892	1	1	FREED, RICHARD PHD	9/11/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVENUE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
3020	Fee-for-Service	1013401959	1013401959	1	1	FAITH & LIFE HOSPICE INC	4/22/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	356 W COLORADO ST	SUITE C	GLENDALE	CA	91204	1603	19	06037	34.14250251	-118.2603915	Los Angeles County
3056	Fee-for-Service	1093398059	1093398059	1	1	FORWARD WELLNESS FAMILY THER	8/6/2021	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	APY, INC.	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
3089	Fee-for-Service	1225123789	1225123789	1	1	FLEMING, LOIS R DPM	2/20/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1760 GOLD ST	STE 400	REDDING	CA	96001	1800	45	06089	40.57873165	-122.3934095	Shasta County
3107	Fee-for-Service	1942570833	1942570833	1	1	FAVELA-RODRIGUEZ, ROCIO LMF	3/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
3116	Fee-for-Service	1245605781	1245605781	1	1	FACULTY PHYSICIANS AND	12/2/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
3158	Fee-for-Service	1235238783	1235238783	1	1	FITTANTE, NICHOLAS J LMFT	11/13/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
3166	Fee-for-Service	1962451823	1962451823	1	1	FIELD, MELVIN, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1605 W FAIRBANKS AVE	None	WINTER PARK	FL	32789	4603	00	None	28.59319076	-81.3711494	Orange County
3169	Fee-for-Service	1184850273	1184850273	1	1	FORDWOOD, SAMANTHA R PHD	9/3/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
3250	Fee-for-Service	1710709993	1710709993	1	1	FRESNO COLLECTIVE FOR INCLUS	2/26/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	3032 TULARE ST	None	FRESNO	CA	93721	1415	10	06019	36.74161978	-119.7791358	Fresno County
3256	Fee-for-Service	1164499638	1164499638	1	1	FROHLICH, THOMAS G MD	4/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88326	41	Internal Medicine	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94607	1018	01	06001	37.79926205	-122.2314248	Alameda County
3257	Fee-for-Service	1801832894	1801832894	1	1	FONG, STACEY T	9/6/2006	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	25078 PEACHLAND AVE	STE F	NEWHALL	CA	91321	2554	19	06037	34.37865037	-118.5468731	Los Angeles County
3263	Fee-for-Service	1932394459	1932394459	1	1	FILLMORE, LONI L PHD	10/3/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
3266	Fee-for-Service	1265931760	1265931760	1	1	FILGAS, BERGEN A LMFT	3/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2101 GEER RD	STE 102A	TURLOCK	CA	95382	1142	50	06099	37.512324	-120.8489985	Stanislaus County
3324	Fee-for-Service	1316400245	1316400245	1	1	FLEMING, NATHANIEL H MD	6/17/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	177834	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
3371	Fee-for-Service	1619358199	1619358199	1	1	FRANCO, LISANDRA MD	8/13/2020	207R00000X	NA	Other	026	PHYSICIANS	158862	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
3419	Fee-for-Service	1912965773	1912965773	1	1	FARBMAN, ERIC S MD	9/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	1	Border provider	None	1707 W CHARLESTON BLVD	STE 230	LAS VEGAS	NV	89102	2353	00	None	36.15879353	-115.1643015	Clark County
3437	Fee-for-Service	1336363829	1336363829	1	1	FOCHT, PAUL C	11/29/1995	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2118 SHATTUCK AVE	None	BERKELEY	CA	94704	1209	01	06001	37.87067171	-122.2682682	Alameda County
3544	Fee-for-Service	1164499638	1164499638	1	1	FROHLICH, THOMAS G MD	4/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88326	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94607	1018	01	06001	37.79926205	-122.2314248	Alameda County
3572	Fee-for-Service	1447679790	1447679790	1	1	FAVILA, SUSANA NP	12/9/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2205 ROSS AVENUE	SUITE 101	EL CENTRO	CA	92243	3623	13	06025	32.78143643	-115.5804952	Imperial County
3579	Fee-for-Service	1013127554	1013127554	1	1	FATIMA, RUQAYA MD	3/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113642	08	Family Practice	0	In state provider	None	1450 TREAT BLVD	160	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
3591	Fee-for-Service	1699825042	1699825042	1	1	FOX DRUGS OF TORRANCE INC	11/3/1988	183500000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1327 EL PRADO AVE	None	TORRANCE	CA	90501	2716	19	06037	33.83457367	-118.3164895	Los Angeles County
3596	Fee-for-Service	1932192242	1932192242	1	1	FAER, MICHAEL J MD	6/30/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	35298	None	None	0	In state provider	SAN LEANDRO RADIOLOGICAL	1033 A ST	None	HAYWARD	CA	94541	4105	01	06001	37.67435393	-122.0830819	Alameda County
3605	Fee-for-Service	1962801795	1962801795	1	1	FUENTES, STEPHANIE	6/12/2023	106H00000X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11870 PIERCE ST	SUITE 150	RIVERSIDE	CA	92505	4402	33	06065	33.90095662	-117.4936969	Riverside County
3643	Fee-for-Service	1053368167	1053368167	1	1	FELDMAN, ROCHELLE C MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32408	01	General Practice	0	In state provider	None	18520 VIA PRINCESSA	STE C2	CANYON COUNTRY	CA	91387	8326	19	06037	34.40317439	-118.4585559	Los Angeles County
3741	Fee-for-Service	1407885403	1407885403	1	2	FRUTKIN, ANDREW D MD	1/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54394	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
3811	Fee-for-Service	1396033783	1396033783	1	1	FERENCZY, EDWARD D MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
3933	Fee-for-Service	1053368167	1053368167	1	1	FELDMAN, ROCHELLE C MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32408	40	Pediatrics	0	In state provider	None	18520 VIA PRINCESSA	STE C2	CANYON COUNTRY	CA	91387	8326	19	06037	34.40317439	-118.4585559	Los Angeles County
3944	Fee-for-Service	1609029750	1609029750	1	1	FAN, RANDALL K MD	8/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121024	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
3974	Fee-for-Service	1316123144	1316123144	1	1	FOSTERING EARLY LEARNING	2/8/2008	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	INSTITUTE	311 PROFESSIONAL DRIVE	STE 100	ROHNERT PARK	CA	94928	2152	49	06097	38.35501527	-122.7069494	Sonoma County
3980	Fee-for-Service	1245388198	1245388198	1	1	FALLON, JEROME D MD	11/30/2007	207ND0101X	NA	Dermatology	026	PHYSICIANS	87784	07	Dermatology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
4018	Fee-for-Service	1265596761	1265596761	1	1	FLOM, SHEILA G	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82964	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
4019	Fee-for-Service	1164497814	1164497814	1	1	FRIEDMAN, ARNOLD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL	None	TUCSON	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
4021	Fee-for-Service	1174009674	1174009674	1	1	FRANCISCO, PATRICIA LMFT	5/28/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
4099	Fee-for-Service	1396033783	1396033783	1	1	FERENCZY, EDWARD D MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
4115	Fee-for-Service	1861774507	1861774507	1	5	FELIX SIGAL DPM A PROFESSION	1/21/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	AL CORPORATION	3333 WILSHIRE BLVD	#500	LOS ANGELES	CA	90010	4101	19	06037	34.06178448	-118.295712	Los Angeles County
4158	Fee-for-Service	1255319802	1255319802	1	1	FOLLETT, HEATHER N MD	6/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86658	38	Geriatrics	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
4305	Fee-for-Service	1265596761	1265596761	1	1	FLOM, SHEILA G	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82964	08	Family Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
4379	Fee-for-Service	1598287567	1598287567	1	1	FAUNCE, NICHOLAS MD	7/27/2023	2086S0102X	NA	General Surgery	026	PHYSICIANS	158826	None	None	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
4431	Fee-for-Service	1043317563	1043317563	1	1	FILUK, ROBERT MD	9/30/1986	207R00000X	NA	Other	026	PHYSICIANS	59699	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
4447	Fee-for-Service	1255319802	1255319802	1	1	FOLLETT, HEATHER N MD	6/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86658	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
4451	Fee-for-Service	1528078359	1528078359	1	1	FRIEDMAN, JOEL P MD	8/18/1972	No Taxonomy Provided	NA	None	026	PHYSICIANS	16542	41	Internal Medicine	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
4455	Fee-for-Service	1013615723	1013615723	1	1	FUENTEZ, THOMAS CRNA	3/30/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
4456	Fee-for-Service	1245318302	1245318302	1	1	FORREST, CHRISTOPHER J	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78118	06	Cardiovascular Disease (M.D. only)	0	In state provider	MD	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
4552	Fee-for-Service	1922071596	1922071596	1	1	FORD, JOHN S MD	11/30/1992	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	76646	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
4560	Fee-for-Service	1831542158	1831542158	1	1	FAIDI, NADIN MD	9/14/2020	207R00000X	NA	Other	026	PHYSICIANS	161822	41	Internal Medicine	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
4672	Fee-for-Service	1932168051	1932168051	1	1	FERRERAS, RICHARD A MD	11/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	49019	41	Internal Medicine	0	In state provider	None	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
4721	Fee-for-Service	1861925745	1861925745	1	1	FRANKS, ZACHARY M DO	6/16/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	19591	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
4760	Fee-for-Service	1013107705	1013107705	1	1	FEW, LISA M PA	9/21/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	14576	-	NOT APPLICABLE	0	In state provider	None	8741 LAUREL CANYON BLVD	None	SUN VALLEY	CA	91352	2919	19	06037	34.2284836	-118.4000486	Los Angeles County
4762	Fee-for-Service	1497733265	1497733265	1	1	FILDES, JOHN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	89	Surgery-Traumatic	1	Border provider	FILDES, JOHN J MD	2040 W CHARLESTON BLVD	STE 601	LAS VEGAS	NV	89102	2245	00	None	36.1589735	-115.168095	Clark County
4780	Fee-for-Service	1144216888	1144216888	1	1	FLAMM, MELVIN D JR MD	2/28/1994	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	19838	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F ST	STE 207A	SACRAMENTO	CA	95819	3221	34	06067	38.571354	-121.4368695	Sacramento County
4833	Fee-for-Service	1952416711	1952416711	1	2	FLYNN, THOMAS A OD APC	8/15/2011	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	203 WALKER ST	SUITE 1	ORLAND	CA	95963	1457	11	06021	39.74734953	-122.1918345	Glenn County
4835	Fee-for-Service	1336766187	1336766187	1	1	FRIENDSHIP HOSPICE INC	5/3/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	20121 VENTURA BLVD	SUITE 314	WOODLAND HILLS	CA	91364	2559	19	06037	34.17068268	-118.5718406	Los Angeles County
5015	Fee-for-Service	1316034655	1316034655	1	1	FRIEDLAND, SHAI MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63022	10	Gastroenterology (M.D. only)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
5051	Fee-for-Service	1497733265	1497733265	1	1	FILDES, JOHN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	FILDES, JOHN J MD	2040 W CHARLESTON BLVD	STE 601	LAS VEGAS	NV	89102	2245	00	None	36.1589735	-115.168095	Clark County
5103	Fee-for-Service	1619434156	1619434156	1	1	FLORES, BIANCA V LMFT	8/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6276 N 1ST ST	103	FRESNO	CA	93710	5400	10	06019	36.82794977	-119.7721574	Fresno County
5122	Fee-for-Service	1336766187	1336766187	1	1	FRIENDSHIP HOSPICE INC	5/3/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	20121 VENTURA BLVD	SUITE 314	WOODLAND HILLS	CA	91364	2559	19	06037	34.17068268	-118.5718406	Los Angeles County
5142	Fee-for-Service	1922161918	1922161918	1	1	FRANCISCO, PAUL R MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82055	36	Psychiatry	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
5163	Fee-for-Service	1649583071	1649583071	1	1	FENTRESS, DANIEL M MD	8/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109455	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
5173	Fee-for-Service	1083146732	1083146732	1	1	FOULAD, DELILA P MD	6/17/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	156834	None	None	0	In state provider	None	2020 SANTA MONICA BLVD	510	SANTA MONICA	CA	90404	2000	19	06037	34.02901811	-118.4795396	Los Angeles County
5202	Fee-for-Service	1306181136	1306181136	1	1	FLORES, VITTORIA LCSW	9/25/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
5232	Fee-for-Service	1912927302	1912927302	1	1	FANOUS, YVONNE F MD	8/4/1980	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	35699	03	Allergy	0	In state provider	None	11441 HEACOCK ST	STE C	MORENO VALLEY	CA	92557	7907	33	06065	33.954858	-117.243978	Riverside County
5256	Fee-for-Service	1205030111	1205030111	1	1	FUKUSHIMA, DOREEN L MD	11/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124200	36	Psychiatry	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
5278	Fee-for-Service	1235281031	1235281031	1	1	FONG, TSZ MEI MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	56428	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
5281	Fee-for-Service	1164527495	1164527495	1	1	FINK III MD, JAMES R	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HARBORVIEW MED CTRE	325 9TH AVE	C/O UWP MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
5304	Fee-for-Service	1316034655	1316034655	1	1	FRIEDLAND, SHAI MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63022	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
5338	Fee-for-Service	1073586665	1073586665	1	1	FAZILAT, REBECCA E MD	5/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90661	40	Pediatrics	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
5340	Fee-for-Service	1962439505	1962439505	1	1	FREIWALD, SCOTT A MD	5/22/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79194	None	None	0	In state provider	None	3300 DOUGLAS BLVD	STE 200	ROSEVILLE	CA	95661	3845	31	06061	38.74393533	-121.2327358	Placer County
5377	Fee-for-Service	1376685974	1376685974	1	1	FORTUNE, JULIE M LMFT	3/6/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1835 SUNNYCREST DR	None	FULLERTON	CA	92835	3616	30	06059	33.89224326	-117.9312781	Orange County
5398	Fee-for-Service	1164708814	1164708814	1	1	FUJIKAMI, KEVIN T CPO	11/21/2011	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1524 21ST ST	#B	BAKERSFIELD	CA	93301	4002	15	06029	35.3781555	-119.0195505	Kern County
5500	Fee-for-Service	1609869510	1609869510	1	1	FALLAH-NAJMABADI, H MD	2/15/1995	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	53954	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	5609 J ST	STE A	SACRAMENTO	CA	95819	3948	34	06067	38.564829	-121.434228	Sacramento County
5503	Fee-for-Service	1902397789	1902397789	1	1	FRASER, KOLTON G DO	9/14/2020	390200000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	101 CIVIC CTR LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
5517	Fee-for-Service	1427027499	1427027499	1	1	FOX, JOHN B MD	3/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	28892	30	Radiology	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
5519	Fee-for-Service	1831181395	1831181395	1	1	FRANCHO, RAQUEL MD	6/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80615	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
5522	Fee-for-Service	1912927302	1912927302	1	1	FANOUS, YVONNE F MD	8/4/1980	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	35699	40	Pediatrics	0	In state provider	None	11441 HEACOCK ST	STE C	MORENO VALLEY	CA	92557	7907	33	06065	33.954858	-117.243978	Riverside County
5569	Fee-for-Service	1164581773	1164581773	1	1	FITTS, LINDA E MD	10/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69048	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
5688	Fee-for-Service	1326231952	1326231952	1	1	FRED BROWN'S RECOVERY SERVIC	10/21/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ES, INC.	270 276 278 W 14TH ST	None	SAN PEDRO	CA	90731	4315	19	06037	33.73153566	-118.2830099	Los Angeles County
5768	Fee-for-Service	1790704286	1790704286	1	1	FISHER, JOHN J MD	5/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	22375	41	Internal Medicine	0	In state provider	None	1 SCRIPPS DR	STE 103	SACRAMENTO	CA	95825	6206	34	06067	38.573181	-121.4118135	Sacramento County
5837	Fee-for-Service	1053523712	1053523712	1	1	FOXFOOT, CYNTHIA DOULA	3/17/2024	176B00000X	NA	Licensed Midwife	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	29	06057	0	0	None
5856	Fee-for-Service	1164581773	1164581773	1	1	FITTS, LINDA E MD	10/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69048	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
5873	Fee-for-Service	1275562597	1275562597	1	1	FLETCHER, LAURA M MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73569	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
5874	Fee-for-Service	1265641781	1265641781	1	1	FRENCH, RICHARD S MD	2/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	53120	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1250 EAST ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
5949	Fee-for-Service	1295789048	1295789048	2	1	FISHBOR INC	8/10/2009	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8704 SEPULVEDA BLVD	None	NORTH HILLS	CA	91343	5112	19	06037	34.22837871	-118.4675863	Los Angeles County
5957	Fee-for-Service	1275550154	1275550154	1	1	FAY, ROBERT M MD AMC	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	68720	20	Orthopedic Surgery	0	In state provider	None	720 NORTH NORMA STREET	SUITE A & B	RIDGECREST	CA	93555	3553	15	06029	35.63401053	-117.6787363	Kern County
6000	Fee-for-Service	1093902447	1093902447	1	1	FORWARD, EDWARD K CRNA	6/15/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
6093	Fee-for-Service	1376616250	1376616250	1	1	FAKINOS, LAURENCE M MD	2/28/1992	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67377	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	27800 MEDICAL CENTER RD	STE 260	MISSION VIEJO	CA	92691	6447	30	06059	33.55952733	-117.6645199	Orange County
6094	Fee-for-Service	1447876008	1447876008	1	1	FLAHERTY, CURTIS P MD	7/18/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
6144	Fee-for-Service	1417297847	1417297847	1	16	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	5500 E SANTA ANA CANYON	STE 255	ANAHEIM	CA	92807	3103	30	06059	33.8513765	-117.794124	Orange County
6164	Fee-for-Service	1720852783	1720852783	1	1	FEIN, MICAELA LCSW	4/8/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
6205	Fee-for-Service	1780115576	1780115576	1	1	FLAMER-CALDERA, ADAM B MD	5/6/2022	207P00000X	NA	Other	026	PHYSICIANS	165922	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
6240	Fee-for-Service	1093860058	1093860058	1	1	FITZGERALD, COREEN	2/8/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
6256	Fee-for-Service	1497847479	1497847479	1	1	FAMILY HOSPICE CARE LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	255 N EL CIELO RD	STE 300	PALM SPRINGS	CA	92262	6986	33	06065	33.82571219	-116.5106736	Riverside County
6258	Fee-for-Service	1558454256	1558454256	1	1	FAMILY HEALTHCARE NETWRK	12/1/2001	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	41651 SIERRA DR	STE A	THREE RIVERS	CA	93271	9678	54	06107	36.43810513	-118.9052901	Tulare County
6310	Fee-for-Service	1902028798	1902028798	1	1	FRANKLIN, CHARLES LMFT	12/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
6437	Fee-for-Service	1225433030	1225433030	1	1	FAVOR, KATHLEEN V	8/3/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1234 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3911	38	06075	37.781144	-122.4390035	San Francisco County
6496	Fee-for-Service	1336101567	1336101567	1	1	FISHER, TREVOR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2005 NW SAMMAMISH RD	None	ISSAQUAH	WA	98027	8940	00	None	47.55190239	-122.0641589	King County
6501	Fee-for-Service	1952600389	1952600389	1	1	FARAJZADEH DEROEE, ARMIN MD	11/4/2022	207LP2900X	NA	Other	026	PHYSICIANS	140831	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
6518	Fee-for-Service	1841747888	1841747888	1	1	FRANCK, MADI LCSW	6/28/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
6531	Fee-for-Service	1669512554	1669512554	1	1	FRANKOVSKI, MATTHEW J MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72239	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
6544	Fee-for-Service	1376510321	1376510321	1	2	FREINKEL, ROBERT L MD APC	11/8/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	25328	03	Allergy	0	In state provider	None	22 BATTERY STREET	SUITE 914	SAN FRANCISCO	CA	94111	5523	38	06075	37.79155742	-122.3996102	San Francisco County
6546	Fee-for-Service	1497847479	1497847479	1	1	FAMILY HOSPICE CARE LLC	11/1/2006	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	255 N EL CIELO RD	STE 300	PALM SPRINGS	CA	92262	6986	33	06065	33.82571219	-116.5106736	Riverside County
6547	Fee-for-Service	1558454256	1558454256	1	1	FAMILY HEALTHCARE NETWRK	12/1/2001	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	41651 SIERRA DR	STE A	THREE RIVERS	CA	93271	9678	54	06107	36.43810513	-118.9052901	Tulare County
6579	Fee-for-Service	1679863641	1679863641	1	1	FALK, RAPHAEL I MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124951	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
6626	Fee-for-Service	1194060905	1194060905	1	1	FOOTHILL VASCULAR CENTER	8/6/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	105 N HILL AVE	STE 200	PASADENA	CA	91106	1934	19	06037	34.147827	-118.121406	Los Angeles County
6712	Fee-for-Service	1235677832	1235677832	1	1	FRESENIUS MEDICAL CARE	4/29/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	FRESNO LLC	1899 N HELM AVE	SUITE 102	FRESNO	CA	93727	1612	10	06019	36.76764198	-119.7239157	Fresno County
6789	Fee-for-Service	1326055286	1326055286	1	1	FARRELL, THOMAS R MD	1/30/1997	207L00000X	NA	Other	026	PHYSICIANS	43564	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
6801	Fee-for-Service	1710140355	1710140355	1	1	FERNANDEZ, NANCY LCSW	5/13/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	204 EAST BEACH STREET	None	WATSONVILLE	CA	95076	4809	44	06087	36.91224802	-121.7541363	Santa Cruz County
6835	Fee-for-Service	1558454256	1558454256	1	1	FAMILY HEALTHCARE NETWRK	12/7/2001	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	41651 SIERRA DR	STE A	THREE RIVERS	CA	93271	9678	54	06107	36.43810513	-118.9052901	Tulare County
6892	Fee-for-Service	1770742009	1770742009	1	1	FERREIRO, SEAN M LMFT	9/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	224 W GRAHAM AVE	None	LAKE ELSINORE	CA	92530	3740	33	06065	33.66853666	-117.3296688	Riverside County
6917	Fee-for-Service	1194060905	1194060905	1	1	FOOTHILL VASCULAR CENTER	8/6/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	105 N HILL AVE	STE 200	PASADENA	CA	91106	1934	19	06037	34.147827	-118.121406	Los Angeles County
6918	Fee-for-Service	1750757480	1750757480	1	1	FLORES, COLLEEN S LMFT	11/3/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
6924	Fee-for-Service	1548435217	1548435217	1	1	FLORES, MONA G MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	87607	33	Thoracic Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
7002	Fee-for-Service	1588869465	1588869465	1	1	FISHER, SYNDIA S	4/4/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
7005	Fee-for-Service	1417297847	1417297847	1	28	FIRST CHOICE PHYSICIAN PARTN	11/24/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	380 W CENTRAL AVE	400	BREA	CA	92821	3066	30	06059	33.93197087	-117.901779	Orange County
7068	Fee-for-Service	1851430219	1851430219	1	1	FALLAT, DAVID MD	1/24/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
7102	Fee-for-Service	1982698262	1982698262	1	1	FRIEDMAN, MARC R MD	4/26/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	46963	41	Internal Medicine	0	In state provider	None	1325 COTTONWOOD ST	None	WOODLAND	CA	95695	5131	57	06113	38.664027	-121.7933505	Yolo County
7112	Fee-for-Service	1346381779	1346381779	1	1	FERRY, SONDRA M NP	12/9/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2531 CHESTER AVE	None	BAKERSFIELD	CA	92120	3606	15	06029	35.382582	-119.0188955	Kern County
7122	Fee-for-Service	1992768238	1992768238	1	1	FOGG, MAXWELL & LANIER,	2/1/1998	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	MD INC.	2401 W CLEVELAND AVE	None	MADERA	CA	93637	3608	20	06039	36.9746635	-120.087405	Madera County
7199	Fee-for-Service	1770126070	1770126070	1	1	FAMIGLIETTI, REGINA Y LMFT	2/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9033 BASELINE RD	STE. K	RANCHO CUCAMONGA	CA	91730	1214	36	06071	34.12151248	-117.6080805	San Bernardino County
7224	Fee-for-Service	1659550960	1659550960	1	1	FENG, CHRISTOPHER A	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
7241	Fee-for-Service	1063972503	1063972503	1	1	FLORES, JOCELYN LMFT	5/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14075 HESPERIA ROAD	SUITE 101	VICTORVILLE	CA	92395	4500	36	06071	34.50679185	-117.296399	San Bernardino County
7288	Fee-for-Service	1942221650	1942221650	2	1	FEMININE PHARMD INC	7/3/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	524 W 4TH STREET	STE A	PERRIS	CA	92570	2077	33	06065	33.78236446	-117.237456	Riverside County
7320	Fee-for-Service	1407911282	1407911282	1	1	FROUMIS, NICHOLAS A OD	8/14/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
7344	Fee-for-Service	1477948677	1477948677	1	1	FELIBERTI, JOSE R MD	5/11/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	150657	None	None	0	In state provider	None	536 CAMINO MERCADO	STE.306	ARROYO GRANDE	CA	93420	1418	40	06079	35.12986992	-120.6006027	San Luis Obispo County
7389	Fee-for-Service	1982698262	1982698262	1	1	FRIEDMAN, MARC R MD	4/26/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	46963	01	General Practice	0	In state provider	None	1325 COTTONWOOD ST	None	WOODLAND	CA	95695	5131	57	06113	38.664027	-121.7933505	Yolo County
7425	Fee-for-Service	1821081647	1821081647	2	1	FRIENDLY OB-GYN MEDICAL	2/28/2013	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	71778	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	GROUP INC	12810 HEACOCK ST	STE B105	MORENO VALLEY	CA	92553	3171	33	06065	33.934851	-117.2437635	Riverside County
7437	Fee-for-Service	1396812129	1396812129	1	1	FATEMI, SHIREEN MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	58689	67	Endocrinology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
7460	Fee-for-Service	1639218548	1639218548	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	2777 LONG BEACH BLVD	STE 200	LONG BEACH	CA	90806	1513	19	06037	33.80734327	-118.189472	Los Angeles County
7506	Fee-for-Service	1982796009	1982796009	1	1	FLETCHER, JACQUELINE MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60135	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1828 EL CAMINO REAL	STE 805	BURLINGAME	CA	94010	3124	41	06081	37.59552262	-122.3838771	San Mateo County
7524	Fee-for-Service	1962273128	1962273128	1	1	FLEETWOOD, MICHELLE R	3/28/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
7609	Fee-for-Service	1326344607	1326344607	1	1	FINKELSTEIN, ANN K MD	12/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115414	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
7628	Fee-for-Service	1336646173	1336646173	1	1	FRANCE, KALI J OT	1/28/2020	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W ARROW HWY	130	SAN DIMAS	CA	91773	2330	19	06037	34.10677054	-117.8331379	Los Angeles County
7700	Fee-for-Service	1962594309	1962594309	1	1	FEINER, JEFFREY MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	36977	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	24411 HEALTH CENTER DR	STE 350	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
7704	Fee-for-Service	1619932894	1619932894	1	1	FISHER, PAUL MD	4/16/2024	2085P0229X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
7712	Fee-for-Service	1285298059	1285298059	1	1	FARIAS, FRANCISCO MD	9/10/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	3200 BELL RD	None	AUBURN	CA	95603	9244	31	06061	38.94193574	-121.103139	Placer County
7725	Fee-for-Service	1396812129	1396812129	1	1	FATEMI, SHIREEN MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	58689	01	General Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
7794	Fee-for-Service	1053585141	1053585141	1	1	FERREL, NANCY L MD	6/1/2023	207P00000X	NA	Other	026	PHYSICIANS	46664	None	None	0	In state provider	None	473 W EATON AVE	None	TRACY	CA	95376	3420	39	06077	37.74337767	-121.4327182	San Joaquin County
7834	Fee-for-Service	1164596789	1164596789	1	1	FISHER, DEIDRE T MD	4/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	51829	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
7850	Fee-for-Service	1871697102	1871697102	1	1	FAMILY PRACTICE ASSOCS	8/2/2002	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1611 FEATHER RIVER BLVD	STE 10	OROVILLE	CA	95965	4548	04	06007	39.50613596	-121.5700804	Butte County
7905	Fee-for-Service	1316079767	1316079767	1	1	FUHRMANN, MAX E PHD	6/30/1991	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3625 E THOUSAND OAKS BLV	SUITE 119	THOUSAND OAKS	CA	91362	3553	56	06111	34.16480359	-118.8299997	Ventura County
7944	Fee-for-Service	1598773624	1598773624	1	1	FALCON CRITICAL CARE TRANSPO	7/13/2005	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	RT	3508 SAN PABLO DAM RD	None	EL SOBRANTE	CA	94803	2728	07	06013	37.96359992	-122.3212591	Contra Costa County
7987	Fee-for-Service	1588631568	1588631568	1	1	FEENEY, THOMAS P MD	5/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83196	41	Internal Medicine	0	In state provider	None	1850 SULLIVAN AVE	STE 310	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
8035	Fee-for-Service	1881761724	1881761724	1	1	FLAGG, MICHAEL E MD	11/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48448	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
8037	Fee-for-Service	1952778458	1952778458	1	1	FERNANDEZ, JOHANNA LMFT	1/14/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
8040	Fee-for-Service	1023342466	1023342466	1	1	FILHO, RUBENS C MD	7/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111073	68	Hematology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
8096	Fee-for-Service	1033741830	1033741830	1	1	FIGUEROA, MARIA CECILIA	12/8/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3650 E SOUTH ST	SUITE 310	LAKEWOOD	CA	90712	1519	19	06037	33.8601747	-118.1494013	Los Angeles County
8136	Fee-for-Service	1871697102	1871697102	1	1	FAMILY PRACTICE ASSOCS	8/2/2002	282N00000X	NA	Hospitals	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1611 FEATHER RIVER BLVD	STE 10	OROVILLE	CA	95965	4548	04	06007	39.50613596	-121.5700804	Butte County
8181	Fee-for-Service	1679814768	1679814768	1	1	FRESENIUS MEDICAL CARE EAST	3/28/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LAKES LLC	2391 BOSWELL ROAD	None	CHULA VISTA	CA	91914	3509	37	06073	32.65546753	-116.963172	San Diego County
8193	Fee-for-Service	1265859375	1265859375	1	1	FRANDSEN, ERIK L MD	8/16/2021	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	172923	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
8230	Fee-for-Service	1356684500	1356684500	1	1	FRIEDMAN, MEGAN E A DO	2/19/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	15262	05	Anesthesiology	0	In state provider	None	1509 WILSON TERRACE	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
8273	Fee-for-Service	1891219796	1891219796	1	1	FELTHOVEN, ROBERT	12/16/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	920 PARK ROW	None	SALINAS	CA	93901	2407	27	06053	36.66409481	-121.6592738	Monterey County
8275	Fee-for-Service	1588631568	1588631568	1	1	FEENEY, THOMAS P MD	5/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83196	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1850 SULLIVAN AVE	STE 310	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
8277	Fee-for-Service	1497847487	1497847487	1	1	FAMILY PLANNING ASSOC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	2500 H ST	None	BAKERSFIELD	CA	93301	2818	15	06029	35.38232703	-119.0211171	Kern County
8298	Fee-for-Service	1740250497	1740250497	1	1	FITZGERALD, CHERI R	12/1/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2051 STATHAM BLVD	None	OXNARD	CA	93033	3901	56	06111	34.17967669	-119.1655477	Ventura County
8321	Fee-for-Service	1922099530	1922099530	2	1	FRY, MICHAEL F MD	10/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	54589	20	Orthopedic Surgery	0	In state provider	None	1139 THIRD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
8326	Fee-for-Service	1215009428	1215009428	1	1	FRANCOIS TELLUS, M.D.	4/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8900 VAN WYCK EXPY	None	JAMAICA	NY	11418	2832	00	None	40.700268	-73.8157905	Queens County
8371	Fee-for-Service	1902187859	1902187859	1	1	FEIGENBAUM, ANNETTE S J MD	9/15/2011	207SG0202X	NA	Other	026	PHYSICIANS	54803	None	None	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
8416	Fee-for-Service	1144687047	1144687047	1	1	FLETCHER, TYISHA R NP	10/17/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5970 S CENTRAL AVENUE	None	LOS ANGELES	CA	90001	1150	19	06037	33.985584	-118.256433	Los Angeles County
8467	Fee-for-Service	1124607452	1124607452	1	1	FICA, ZACHARY MD	7/29/2024	261QU0200X	NA	Other	026	PHYSICIANS	191930	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
8484	Fee-for-Service	1174017214	1174017214	1	1	FAR NORTHERN ANESTHESIA CONS	7/19/2018	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ULTANTS	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
8529	Fee-for-Service	1992857239	1992857239	1	1	FLORES, EDGAR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78642	41	Internal Medicine	0	In state provider	None	501 S BROOKHURST RD	None	FULLERTON	CA	92833	3207	30	06059	33.865002	-117.959396	Orange County
8588	Fee-for-Service	1669827028	1669827028	1	1	FARNSWORTH, WILLIAM B MD	6/24/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	172324	None	None	0	In state provider	None	6010 HIDDEN VALLEY RD	SUITE 200	CARLSBAD	CA	92011	4219	37	06073	33.12288368	-117.3058276	San Diego County
8741	Fee-for-Service	1881700300	1881700300	1	1	FOX, WADE	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MERCY MEDICAID CENTER	2700 STEWART PARKWAY	None	ROSEBURG	OR	97471	1281	00	None	43.2399838	-123.3665048	Douglas County
8798	Fee-for-Service	1841325685	1841325685	1	1	FIVE ANGELS CO., INC.	10/5/1995	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3074 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5828	19	06037	33.97286564	-118.2129501	Los Angeles County
8811	Fee-for-Service	1992857239	1992857239	1	1	FLORES, EDGAR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78642	40	Pediatrics	0	In state provider	None	501 S BROOKHURST RD	None	FULLERTON	CA	92833	3207	30	06059	33.865002	-117.959396	Orange County
8914	Fee-for-Service	1124259015	1124259015	1	1	FACULTY MEDICAL GROUP OF	10/29/2009	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	LLUSM	900 E WASHINGTON ST	STE 150	COLTON	CA	92324	4119	36	06071	34.04820662	-117.3128102	San Bernardino County
8916	Fee-for-Service	1154880235	1154880235	1	1	FRANCOEUR, ALEX A MD	7/31/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	176899	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
8923	Fee-for-Service	1366619082	1366619082	1	1	FOUNDERS HOUSE OF HOPE, INC	10/3/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	18025 PIONEER AVENUE	None	ARTESIA	CA	90701	3904	19	06037	33.86679733	-118.0823134	Los Angeles County
8994	Fee-for-Service	1629502760	1629502760	1	1	FERNANDEZ, JUAN D MD	5/9/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	185789	None	None	0	In state provider	None	625 S FAIR OAKS AVE	227, 240, 280, 285	PASADENA	CA	91105	2613	19	06037	34.134894	-118.1504155	Los Angeles County
9045	Fee-for-Service	1003501941	1003501941	1	1	FRIES, JENNIFER R NP	4/10/2023	363LN0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
9096	Fee-for-Service	1720308356	1720308356	1	1	FIKHMAN, MICHAEL S MD	7/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130705	18	Ophthalmology	0	In state provider	None	10800 MAGNILIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
9109	Fee-for-Service	1366544595	1366544595	1	1	FERRARO, STEPHEN P MD	8/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	51269	20	Orthopedic Surgery	0	In state provider	None	2638 EDITH AVE	None	REDDING	CA	96001	3043	45	06089	40.57129583	-122.3975042	Shasta County
9129	Fee-for-Service	1134882277	1134882277	1	1	FVC LONG BEACH ASC LLC	11/4/2022	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	16506 LAKEWOOD BLVD	STE 200	BELLFLOWER	CA	90706	5165	19	06037	33.88470916	-118.1424401	Los Angeles County
9189	Fee-for-Service	1306396320	1306396320	1	1	FARHAN KHABAZ MD PROFESSIONA	10/31/2017	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	L CORP	875 N BREA BLVD	None	BREA	CA	92821	2606	30	06059	33.93434103	-117.8932895	Orange County
9219	Fee-for-Service	1316955172	1316955172	1	1	FLOREA, ANDREW S	1/10/2008	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	83181	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
9248	Fee-for-Service	1053314823	1053314823	1	1	FALASE, EKUNDAYO A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EASTSIDE PREMIER NEPHOLO	1612 MILSTEAD ROAD	SUITE A	CONYERS	GA	30012	0000	00	None	33.6828339	-83.9933004	Rockdale County
9285	Fee-for-Service	1952559247	1952559247	1	1	FISHFADER, FANNY P MD	10/21/2011	207L00000X	NA	Other	026	PHYSICIANS	109783	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
9352	Fee-for-Service	1144374091	1144374091	1	1	FOX, DAVID A MD	7/21/2020	2084P0804X	NA	Psychiatry	026	PHYSICIANS	34063	36	Psychiatry	0	In state provider	None	3443 W SHAW AVE	None	FRESNO	CA	93711	3249	10	06019	36.805356	-119.854413	Fresno County
9357	Fee-for-Service	1720789373	1720789373	1	1	FIRTH, MEGHAN NP	11/6/2023	363LN0005X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
9372	Fee-for-Service	1932388444	1932388444	1	1	FONG, KENTON D MD	1/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	91371	24	Plastic Surgery	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
9397	Fee-for-Service	1700951142	1700951142	1	1	FORD, MARY JO MD	12/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73858	09	Gynecology (D.O. only)	0	In state provider	None	250 N ROBERTSON BLVD	STE 512	BEVERLY HILLS	CA	90211	1795	19	06037	34.0696407	-118.3836988	Los Angeles County
9410	Fee-for-Service	1790840049	1790840049	1	1	FEINBERG, STEVEN D MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	25386	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
9445	Fee-for-Service	1225598238	1225598238	1	1	FEIN, ALEXANDER S MD	3/25/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	100 STEIN PLZ	None	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
9467	Fee-for-Service	1508472135	1508472135	1	1	FINLEY, SHANEE	7/25/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
9542	Fee-for-Service	1124634258	1124634258	1	1	FIRST PRIORITY HOSPICE INC	10/7/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 231	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
9549	Fee-for-Service	1043873557	1043873557	1	1	FOX, LEA S NP	6/25/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
9637	Fee-for-Service	1396751533	1396751533	1	2	FELDMAN, CLIFFORD R MD	7/6/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	78112	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
9697	Fee-for-Service	1790840049	1790840049	1	1	FEINBERG, STEVEN D MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	25386	25	Physical Medicine and Rehabilitation	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
9729	Fee-for-Service	1518951565	1518951565	1	1	FISHKIN, JAMES S MD	11/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	75472	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
9812	Fee-for-Service	1194000851	1194000851	1	1	FERNANDEZ, AMY L LCSW	8/4/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41593 WINCHESTER RD	STE 200	TEMECULA	CA	92590	4857	33	06065	33.52030169	-117.1659061	Riverside County
9831	Fee-for-Service	1124634258	1124634258	1	1	FIRST PRIORITY HOSPICE INC	10/7/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 231	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
9862	Fee-for-Service	1659626679	1659626679	1	1	FOX, ALEX C MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136190	None	None	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
9952	Fee-for-Service	1851358097	1851358097	1	1	FINLEY, ANNA K	9/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74361	13	Neurology (M.D. only)	0	In state provider	MD	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
10030	Fee-for-Service	1639470792	1639470792	1	1	FORTUNATO, FABIO	12/17/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	500 EAST ESPLANADE DR	SUITE 1225	OXNARD	CA	93036	0589	56	06111	34.22877446	-119.1713365	Ventura County
10065	Fee-for-Service	1508811191	1508811191	1	1	FARRIMOND, DONALD M MD	6/1/2003	207P00000X	NA	Other	026	PHYSICIANS	83180	66	Emergency Medicine (Urgent Care)	0	In state provider	None	199 WEBSTER ST	None	COLUSA	CA	95932	2826	06	06011	39.20852937	-122.0055755	Colusa County
10168	Fee-for-Service	1891322798	1891322798	1	1	FUJIWARA, WAKANA	9/12/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	185577	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
10181	Fee-for-Service	1912240912	1912240912	1	1	FACIO, RACHEL V LMFT	10/8/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19720 VENTURA BLVD	STE C	WOODLAND HILLS	CA	91364	2676	19	06037	34.17245599	-118.5633517	Los Angeles County
10213	Fee-for-Service	1306194337	1306194337	1	1	FARIVAR, BABAK MD	4/11/2024	207P00000X	NA	Other	026	PHYSICIANS	135228	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
10218	Fee-for-Service	1629142625	1629142625	1	1	FUONG, GRACE R MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	53649	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
10234	Fee-for-Service	1295785798	1295785798	1	1	FISHER, RICHARD W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33379	10	Gastroenterology (M.D. only)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
10264	Fee-for-Service	1669425740	1669425740	1	1	FISHER, ROBERT S MD	7/27/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	37260	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
10273	Fee-for-Service	1639690431	1639690431	1	1	FOLK, JOHANNA B PHD	5/25/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1001 POTRERO AVE	6E/6D37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
10303	Fee-for-Service	1164177341	1164177341	1	1	FIRST CHOICE HOME CARE, INC	12/4/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	11360 VENTURA BLVD	UNIT A	STUDIO CITY	CA	91604	3139	19	06037	34.14008157	-118.3779609	Los Angeles County
10348	Fee-for-Service	1194776351	1194776351	1	1	FREDERICK FERRIS THOMPSON	9/15/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 PARRISH ST	None	CANANDAIGUA	NY	14424	1731	00	None	42.87561813	-77.28832561	Ontario County
10428	Fee-for-Service	1417206830	1417206830	1	1	FELIX, DAVID LMFT	4/20/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1307 W 6TH ST	212C	CORONA	CA	92882	1642	33	06065	33.87790309	-117.589666	Riverside County
10454	Fee-for-Service	1609897552	1609897552	1	1	FLASKERUD,JEFFREY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	317 MARTIN LUTHER KING	JR WAY	SEATTLE	WA	98405	6132	00	None	47.60479219	-122.2968126	King County
10490	Fee-for-Service	1093850786	1093850786	1	1	FADOO, FARHAN MD	4/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93772	08	Family Practice	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
10491	Fee-for-Service	1023158128	1023158128	1	1	FREITAS, BONNIE C MD	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	61053	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
10497	Fee-for-Service	1609335520	1609335520	1	1	FREEMAN, ADAM N MD	2/10/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	19701	None	None	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
10502	Fee-for-Service	1144615576	1144615576	1	1	FETZER, DANIEL L MD	5/17/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	148256	None	None	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
10504	Fee-for-Service	1417297847	1417297847	1	12	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	16671 YORBA LINDA BLVD	SUITE 210	YORBA LINDA	CA	92886	2025	30	06059	33.8884134	-117.8435449	Orange County
10521	Fee-for-Service	1134156896	1134156896	1	1	FLORES, MAURICIO MD	11/22/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	71501	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
10534	Fee-for-Service	1225171986	1225171986	1	1	FRIEDMAN, STEVEN A MD	5/16/2020	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	65944	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
10539	Fee-for-Service	1295817476	1295817476	1	2	FUJIKAWA-BROOKS, SHARON	2/8/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	UNIVERISTY NEUROSCIENCES	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
10546	Fee-for-Service	1295381796	1295381796	1	2	FOOTHILLS EXTENDED CARE INC	3/12/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3280 WASHINGTON STREET	None	PLACERVILLE	CA	95667	5838	09	06017	38.72270909	-120.7893981	El Dorado County
10549	Fee-for-Service	1073347910	1073347910	1	1	FREEMAN, LAUREL LCSW	10/7/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
10559	Fee-for-Service	1194767871	1194767871	1	1	FOUNTAIN VIEW SUBACUTE &	1/1/1979	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	NURSING CENTER, LLC	5310 FOUNTAIN AVE	None	LOS ANGELES	CA	90029	1005	19	06037	34.09504581	-118.3050281	Los Angeles County
10568	Fee-for-Service	1891774311	1891774311	1	2	FLICKNER, JAMES L OD	5/31/2016	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	48 W ROMIE LN	None	SALINAS	CA	93901	2391	27	06053	36.66343104	-121.6600006	Monterey County
10581	Fee-for-Service	1811382559	1811382559	1	1	FU, POLLY B MD	8/3/2020	390200000X	NA	Other	026	PHYSICIANS	146789	67	Endocrinology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
10690	Fee-for-Service	1093712473	1093712473	1	1	FAIRCHOK, GREGORY P MD	8/18/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	87986	30	Radiology	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
10785	Fee-for-Service	1962690115	1962690115	1	1	FAWZI, YVETTE V	4/21/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
10815	Fee-for-Service	1316901101	1316901101	1	1	FUNG, MAPLE M MD	7/9/2008	207RN0300X	NA	Nephrology	026	PHYSICIANS	76595	45	Nephrology (Renal-Kidney)	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
10844	Fee-for-Service	1306893110	1306893110	1	1	FERN LITMAN-MAZO M.D.	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2730 PROSPERITY AVE	STE B	FAIRFAX	VA	22031	4324	00	None	38.877561	-77.23836	City of Fairfax
10875	Fee-for-Service	1629501770	1629501770	1	1	FREITAS, AMANDA S DO	8/16/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	18663	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
10904	Fee-for-Service	1679660013	1679660013	1	1	FAHMIE, DARLENE J DPM	3/5/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7524 FAIRMOUNT AVE	None	EL CERRITO	CA	94530	3746	07	06013	37.90405432	-122.2914004	Contra Costa County
10962	Fee-for-Service	1285646497	1285646497	1	1	FENSTER, PAUL E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
11036	Fee-for-Service	1639360845	1639360845	1	1	FUJITO, DIANE S	2/27/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
11137	Fee-for-Service	1548619869	1548619869	1	1	FUNG, ALBERT PSYD	5/14/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
11164	Fee-for-Service	1801207923	1801207923	1	1	FILIP, IRINA MD	12/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143999	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
11171	Fee-for-Service	1245758028	1245758028	1	1	FRANKS, ZECHARIAH G MD	6/27/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	184650	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
11175	Fee-for-Service	1326302027	1326302027	1	1	FOOTHILL HEALTH CENTER	4/2/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1650 S WHITE ROAD	None	SAN JOSE	CA	95127	4758	43	06085	37.3464142	-121.8102261	Santa Clara County
11177	Fee-for-Service	1598862849	1598862849	1	1	FLINCHBAUGH, CORTLANDT P	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	55200	None	None	0	In state provider	MD	3033 W ORANGE AVE	None	ANAHEIM	CA	92804	3156	30	06059	33.82476552	-117.994914	Orange County
11180	Fee-for-Service	1548331580	1548331580	1	1	FIROUZBAKHSH, SIMA MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	66572	05	Anesthesiology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
11251	Fee-for-Service	1871547927	1871547927	1	1	FUNG,FRANK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4033 TALBOT RD S #430	None	RENTON	WA	98055	0000	00	None	47.444238	-122.214555	King County
11264	Fee-for-Service	1063802148	1063802148	1	1	FALLAHZADEH ABARGHOUEI, MOHA	6/5/2020	207R00000X	NA	Other	026	PHYSICIANS	153643	45	Nephrology (Renal-Kidney)	0	In state provider	MMAD KAZEM MD	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
11347	Fee-for-Service	1134160609	1134160609	1	1	FAKOORY, JACOB J MD	5/31/1990	207P00000X	NA	Other	026	PHYSICIANS	39375	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
11407	Fee-for-Service	1447249040	1447249040	1	1	FARHOOMAND, KAVEH S DO	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8295	41	Internal Medicine	0	In state provider	None	3231 WARING CT	STE G	OCEANSIDE	CA	92056	4510	37	06073	33.18776771	-117.2893136	San Diego County
11432	Fee-for-Service	1588158026	1588158026	1	1	FOOT HEEL ANKLE PODIATRY COR	3/11/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	PORATION	1520 N MOUNTAIN AVE	#E122	ONTARIO	CA	91762	1128	36	06071	34.085925	-117.669564	San Bernardino County
11437	Fee-for-Service	1003196049	1003196049	1	1	FONG, CHRISTOPHER J OD	9/2/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
11457	Fee-for-Service	1326302027	1326302027	1	1	FOOTHILL HEALTH CENTER	4/2/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1650 S WHITE ROAD	None	SAN JOSE	CA	95127	4758	43	06085	37.3464142	-121.8102261	Santa Clara County
11531	Fee-for-Service	1043231814	1043231814	1	1	FANG, WEI MD	4/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82842	22	Pathology (M.D. only)	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
11548	Fee-for-Service	1720584345	1720584345	1	1	FRANK, ETHAN D MD	7/31/2024	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	163956	04	Otology, Laryngology, Rhinology	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
11667	Fee-for-Service	1801435516	1801435516	1	1	FLORES, LAUREN K CNP	8/14/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1720 S BASCOM AVE	None	CAMPBELL	CA	95008	0608	43	06085	37.292472	-121.9315815	Santa Clara County
11696	Fee-for-Service	1447249040	1447249040	1	1	FARHOOMAND, KAVEH S DO	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8295	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3231 WARING CT	STE G	OCEANSIDE	CA	92056	4510	37	06073	33.18776771	-117.2893136	San Diego County
11699	Fee-for-Service	1639117930	1639117930	1	1	FORSYTHE, JAMES C MD	12/30/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	39081	30	Radiology	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
11707	Fee-for-Service	1538396411	1538396411	1	1	FLANNERY, CHRISTOPHER M MD	2/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120210	41	Internal Medicine	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
11746	Fee-for-Service	1326302027	1326302027	1	1	FOOTHILL HEALTH CENTER	10/25/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1650 S WHITE ROAD	None	SAN JOSE	CA	95127	4758	43	06085	37.3464142	-121.8102261	Santa Clara County
11812	Fee-for-Service	1467847095	1467847095	1	1	FIROOZAN, SHEILA MD	4/16/2025	390200000X	NA	Other	026	PHYSICIANS	None	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
11909	Fee-for-Service	1669422507	1669422507	1	1	FRANKLIN, SHAWN P W MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	64585	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3883 AIRWAY DR	STE 165	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
11978	Fee-for-Service	1205878956	1205878956	1	1	FOROUSHANI, FARIBA MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	49938	None	None	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
11991	Fee-for-Service	1770647273	1770647273	1	1	FLOSI, TODD J MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72889	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
12034	Fee-for-Service	1326302027	1326302027	1	1	FOOTHILL HEALTH CENTER	12/20/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 S WHITE ROAD	None	SAN JOSE	CA	95127	4758	43	06085	37.3464142	-121.8102261	Santa Clara County
12116	Fee-for-Service	1003196551	1003196551	1	1	FARNELL, ABBY R LCSW	8/24/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5349 COLLEGE AVE	None	OAKLAND	CA	94618	1416	01	06001	37.83903459	-122.2513435	Alameda County
12145	Fee-for-Service	1992752653	1992752653	2	1	FIRST CARE MEDICAL SUPPLY	3/10/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	7907 MELROSE AVE	None	LOS ANGELES	CA	90046	7109	19	06037	34.08383059	-118.361684	Los Angeles County
12209	Fee-for-Service	1407923394	1407923394	1	1	FRENCH, TERREL L MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	55345	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
12306	Fee-for-Service	1215001094	1215001094	1	1	FRANKE, CLAIRE J LMFT	4/14/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
12310	Fee-for-Service	1558667170	1558667170	1	1	FAGHANI, MANDANA MD	11/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151452	41	Internal Medicine	0	In state provider	None	4650 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6306	19	06037	33.98160766	-118.4400667	Los Angeles County
12315	Fee-for-Service	1760983258	1760983258	1	1	FIORI, CAMILLE	1/25/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
12335	Fee-for-Service	1376506618	1376506618	1	1	FOGG, MAXWELL, & LANIER,	6/30/1996	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	M.D., INC	1817 SHAW AVE	STE 104	CLOVIS	CA	93611	4069	10	06019	36.8086995	-119.681613	Fresno County
12342	Fee-for-Service	1588740229	1588740229	1	1	FREEDOM PROPERTIES - HEMET	10/1/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2400 W ACACIA AVE	None	HEMET	CA	92545	3755	33	06065	33.74378594	-116.9968233	Riverside County
12378	Fee-for-Service	1902942949	1902942949	1	1	FARNER, CYNTHIA A MD	6/30/1991	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	44581	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	525 SPRUCE ST	None	SAN FRANCISCO	CA	94118	2681	38	06075	37.78565234	-122.4536626	San Francisco County
12422	Fee-for-Service	1043848807	1043848807	1	1	FLORES, ERNEST MD	12/1/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	188743	None	None	0	In state provider	None	865 3RD AVE	STE 101	CHULA VISTA	CA	91911	1349	37	06073	32.62189562	-117.0722453	San Diego County
12451	Fee-for-Service	1912905928	1912905928	1	1	FROST, PHILIP H MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	11230	01	General Practice	0	In state provider	None	505 PARNASSUS AVE	# 997M	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
12460	Fee-for-Service	1720063902	1720063902	1	1	FECHNER, PATRICIA Y MD	1/31/1996	2080P0205X	NA	Endocrinology	026	PHYSICIANS	63045	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
12468	Fee-for-Service	1023214467	1023214467	1	1	FINNEMORE, REBECCA K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	105589	08	Family Practice	0	In state provider	None	141 LYNCH CREEK WAY	SUITE C	PETALUMA	CA	94954	2390	49	06097	38.25192092	-122.6341929	Sonoma County
12660	Fee-for-Service	1770970329	1770970329	1	1	FOULAD, DAVID S MD	7/8/2022	208600000X	NA	General Surgery	026	PHYSICIANS	143786	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
12722	Fee-for-Service	1366520868	1366520868	1	1	FANG-YEN, MICHAEL C MD	4/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85593	18	Ophthalmology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
12728	Fee-for-Service	1841665866	1841665866	1	1	FRIHART, JAYME M LCSW	6/6/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
12748	Fee-for-Service	1720063902	1720063902	1	1	FECHNER, PATRICIA Y MD	1/31/1996	2080P0205X	NA	Endocrinology	026	PHYSICIANS	63045	67	Endocrinology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
12779	Fee-for-Service	1417594078	1417594078	1	1	FAYE JENSEN M.D., INC.	2/19/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	105 MARGARET LN	STE A	GRASS VALLEY	CA	95945	5289	29	06057	39.22948777	-121.0465057	Nevada County
12809	Fee-for-Service	1205998382	1205998382	1	1	FINER, WARD B PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	611 S MILPITAS BLVD	None	MILPITAS	CA	95035	5473	43	06085	37.4246225	-121.8944566	Santa Clara County
12820	Fee-for-Service	1669680757	1669680757	1	1	FERNANDES, TIMOTHY M MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112514	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
12878	Fee-for-Service	1518333251	1518333251	1	1	FUERST, SUSAN L CNP	12/10/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	638 CAMINO DE LOS MARES	None	SAN CLEMENTE	CA	92673	2848	30	06059	33.45932277	-117.6517315	Orange County
12879	Fee-for-Service	1265686273	1265686273	1	1	FRANCIS, SHAMITHA L MD	1/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127966	41	Internal Medicine	0	In state provider	None	2335 E KASHIAN LANE	SUITE 450	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
12914	Fee-for-Service	1740208081	1740208081	1	1	FIRST HEALTH OF THE	11/22/2010	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CAROLINAS INC	155 MEMORIAL DRIVE	None	PINEHURST	NC	28374	8710	00	None	35.205552	-79.4564505	Moore County
12941	Fee-for-Service	1720319908	1720319908	1	1	FOY, ROSA I LMFT	10/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	325	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
12991	Fee-for-Service	1679639686	1679639686	1	1	FRANKLIN, JOHN E JR MD	6/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137486	41	Internal Medicine	0	In state provider	None	152 PIONEER LANE	SUITE D	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
12994	Fee-for-Service	1821037938	1821037938	1	1	FREMONT AREA MEDICAL CENTER	7/26/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	450 EAST 23RD ST	None	FREMONT	NE	68025	2303	00	None	41.454306	-96.491349	Dodge County
13009	Fee-for-Service	1114346509	1114346509	1	1	FISHER, JESSICA PSYD	7/29/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	30700 RUSSELL RANCH RD	SUITE 250	WESTLAKE VILLAGE	CA	91362	9507	56	06111	34.14987261	-118.7943115	Los Angeles County
13129	Fee-for-Service	1972559441	1972559441	1	1	FORBES, ATHOLL R MD	8/21/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	30104	05	Anesthesiology	0	In state provider	PO BOX 297	25 ORINDA WAY	STE 308	ORINDA	CA	94563	4402	07	06013	37.88274993	-122.1883893	Contra Costa County
13160	Fee-for-Service	1801898622	1801898622	1	1	FURLONG,JOSEPH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	336 WILD WILLOW DRIVE	None	EL PASO	TX	79922	0000	00	None	31.82033191	-106.5794534	El Paso County
13178	Fee-for-Service	1609840479	1609840479	1	1	FAIDI, ADAD ADNAN MD	11/30/1991	207RE0101X	NA	Endocrinology	026	PHYSICIANS	48562	67	Endocrinology	0	In state provider	None	930 N CENTER ST	None	STOCKTON	CA	95202	1312	39	06077	37.96196905	-121.2936562	San Joaquin County
13202	Fee-for-Service	1740208081	1740208081	1	1	FIRST HEALTH OF THE	11/22/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CAROLINAS INC	155 MEMORIAL DRIVE	None	PINEHURST	NC	28374	8710	00	None	35.205552	-79.4564505	Moore County
13205	Fee-for-Service	1740816230	1740816230	1	1	FIVE STAR ASSISTED LIVING CO	7/11/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2573 W BARSTOW AVE	None	FRESNO	CA	93711	2567	10	06019	36.81546253	-119.8392706	Fresno County
13208	Fee-for-Service	1770973158	1770973158	1	1	FILSON, STEPHANIE L NP	1/2/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
13214	Fee-for-Service	1821527524	1821527524	1	1	FERREL, BENJAMIN T DO	8/1/2022	208600000X	NA	General Surgery	026	PHYSICIANS	19589	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
13221	Fee-for-Service	1235304833	1235304833	1	1	FARIN, AZADEH MD	3/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88731	14	Neurological Surgery	0	In state provider	None	2888 LONG BEACH BLVD	STE 240	LONG BEACH	CA	90806	1570	19	06037	33.809706	-118.189343	Los Angeles County
13281	Fee-for-Service	1821037938	1821037938	1	1	FREMONT AREA MEDICAL CENTER	7/26/2009	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	450 EAST 23RD ST	None	FREMONT	NE	68025	2303	00	None	41.454306	-96.491349	Dodge County
13294	Fee-for-Service	1952473464	1952473464	1	1	FENSTER, EMILY LCSW	10/31/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
13330	Fee-for-Service	1003475815	1003475815	1	1	FERLIC, CAROLYN MD	3/4/2024	390200000X	NA	Other	026	PHYSICIANS	188931	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
13425	Fee-for-Service	1952740177	1952740177	1	1	FRIESEN, TZYYNONG L MD	8/1/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	152327	04	Otology, Laryngology, Rhinology	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
13468	Fee-for-Service	1609840479	1609840479	1	1	FAIDI, ADAD ADNAN MD	11/30/1991	207RE0101X	NA	Endocrinology	026	PHYSICIANS	48562	41	Internal Medicine	0	In state provider	None	930 N CENTER ST	None	STOCKTON	CA	95202	1312	39	06077	37.96196905	-121.2936562	San Joaquin County
13567	Fee-for-Service	1801051792	1801051792	1	1	FRAGA, LINDA A MD	1/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98993	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
13598	Fee-for-Service	1033116918	1033116918	1	1	FOSTER, SCOTT A MD	6/20/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	83889	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
13694	Fee-for-Service	1326126400	1326126400	1	1	FOSTER, GEOFFREY E DPM	11/5/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
13713	Fee-for-Service	1952740177	1952740177	1	1	FRIESEN, TZYYNONG L MD	8/1/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	152327	40	Pediatrics	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
13743	Fee-for-Service	1881783223	1881783223	1	1	FOROUZESH, SOLOMON N M D INC	9/5/2017	207RR0500X	NA	Other	026	PHYSICIANS	30592	41	Internal Medicine	0	In state provider	None	9808 VENICE BLVD	STE 604	CULVER CITY	CA	90232	6820	19	06037	34.0236396	-118.3980847	Los Angeles County
13837	Fee-for-Service	1982796389	1982796389	1	2	FEIBLEMAN, CARY E MD INC	3/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	40658	07	Dermatology	0	In state provider	SUITE B EAST BLDG	1360 W 6TH ST	None	SAN PEDRO	CA	90732	3514	19	06037	33.73886546	-118.3075065	Los Angeles County
13887	Fee-for-Service	1598085425	1598085425	1	1	FINE, GABRIEL C MD	11/7/2024	2085N0904X	NA	Other	026	PHYSICIANS	163114	30	Radiology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
13920	Fee-for-Service	1457587073	1457587073	1	1	FURUBAYASHI, JILL K MD	4/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113720	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
13985	Fee-for-Service	1073631271	1073631271	1	1	FORTUNA ELEMENTARY SCHOOL	6/4/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	2089 NEWBURG RD	None	FORTUNA	CA	95540	2706	12	06023	40.5886443	-124.1447518	Humboldt County
14008	Fee-for-Service	1942548565	1942548565	1	1	FARROKH RAVAN	9/8/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1003 WILLOW CREEK RD	None	PRESCOTT	AZ	86301	1641	00	None	34.558992	-112.481901	Yavapai County
14010	Fee-for-Service	1639110067	1639110067	1	1	FALCK, ALISON J MD	12/8/2020	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	170418	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
14016	Fee-for-Service	1881910511	1881910511	1	1	FARUQUE, TANIA MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128513	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	SUITE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
14027	Fee-for-Service	1902829765	1902829765	1	1	FISGUS, JAMES MD	12/31/1982	207P00000X	NA	Other	026	PHYSICIANS	43073	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5000 SAN BERNARDINO ST	None	MONTCLAIR	CA	91763	2326	36	06071	34.07768647	-117.6957498	San Bernardino County
14082	Fee-for-Service	1568113744	1568113744	1	1	FOREMAN, MORGAN LMFT	9/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
14110	Fee-for-Service	1306921911	1306921911	1	1	FRANCISCAN ALLIANCE, INC	5/18/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5454 HOHMAN AVE	None	HAMMOND	IN	46320	1931	00	None	41.614704	-87.522984	Lake County
14135	Fee-for-Service	1801842943	1801842943	1	1	FISCHER, SEAN A MD	10/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95048	68	Hematology	0	In state provider	None	2021 SANTA MONICA BLVD	STE 400E	SANTA MONICA	CA	90404	2109	19	06037	34.02922048	-118.4793681	Los Angeles County
14347	Fee-for-Service	1033578968	1033578968	1	1	FLORES, HECTOR D	3/9/2016	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3495 LAKEVIEW DR	None	IONE	CA	95640	9613	03	06005	38.24099119	-120.9615072	Amador County
14397	Fee-for-Service	1306921911	1306921911	1	1	FRANCISCAN ALLIANCE, INC	5/18/2011	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5454 HOHMAN AVE	None	HAMMOND	IN	46320	1931	00	None	41.614704	-87.522984	Lake County
14419	Fee-for-Service	1386819944	1386819944	1	1	FANG, YUAN L	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	222 E VALLEY BLVD	None	SAN GABRIEL	CA	91776	3596	19	06037	34.07979597	-118.0973304	Los Angeles County
14422	Fee-for-Service	1801842943	1801842943	1	1	FISCHER, SEAN A MD	10/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95048	78	Neoplastic Diseases/Oncology	0	In state provider	None	2021 SANTA MONICA BLVD	STE 400E	SANTA MONICA	CA	90404	2109	19	06037	34.02922048	-118.4793681	Los Angeles County
14443	Fee-for-Service	1225520398	1225520398	1	1	FROST, GRANT	3/20/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2115 MONTIEL RD	STE 103	SAN MARCOS	CA	92069	3587	37	06073	33.1322413	-117.1176172	San Diego County
14546	Fee-for-Service	1225105125	1225105125	1	1	FITHIAN, DONALD C. MD.	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68319	20	Orthopedic Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
14605	Fee-for-Service	1760832125	1760832125	1	1	FRANCA MAGALHAES, ISABELA P	3/14/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SYD	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
14675	Fee-for-Service	1275191926	1275191926	1	1	FACULTY PHYSICIANS AND SURGE	6/17/2020	207ZC0006X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
14724	Fee-for-Service	1457329716	1457329716	1	1	FANOUS, VADIM V MD	5/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76985	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
14741	Fee-for-Service	1801241260	1801241260	1	1	FIGURELLE, MORGAN DO	8/27/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	18075	None	None	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
14826	Fee-for-Service	1699732917	1699732917	1	1	FORAGE, JAMES S MD	4/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	14	Neurological Surgery	1	Border provider	None	3061 S MARYLAND PKWY	STE 200	LAS VEGAS	NV	89109	6227	00	None	36.134172	-115.1369265	Clark County
14861	Fee-for-Service	1083611362	1083611362	1	1	FAYLONA, EDGARDO A MD	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	78	Neoplastic Diseases/Oncology	1	Border provider	None	58 N PECOS RD	None	HENDERSON	NV	89074	7319	00	None	36.03160397	-115.1002424	Clark County
14885	Fee-for-Service	1962452714	1962452714	1	1	FACULTY PHYSICIANS AND	12/22/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS 0F LLUSM	2195 CLUB CENTER DR	STE L	SAN BERNARDINO	CA	92408	4162	36	06071	34.06055692	-117.2814193	San Bernardino County
14912	Fee-for-Service	1275020984	1275020984	1	1	FIGHTMASTER, RYAN MD	1/14/2021	390200000X	NA	Other	026	PHYSICIANS	165054	None	None	0	In state provider	None	520 N MAIN ST	SUITE 120	SANTA ANA	CA	92701	4623	30	06059	33.749316	-117.868123	Orange County
14925	Fee-for-Service	1801218243	1801218243	1	1	FUHRMAN, JASON G MD	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127062	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
14930	Fee-for-Service	1669598157	1669598157	1	1	FOGEL, MICHAEL R MD	1/1/1982	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	10608	10	Gastroenterology (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
14954	Fee-for-Service	1457794752	1457794752	1	3	FOLCH-HAYEK, BEATRIZ M MD FA	12/20/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	148014	09	Gynecology (D.O. only)	0	In state provider	K MD FACOG	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	37	06073	32.750523	-117.100927	San Diego County
15063	Fee-for-Service	1144869223	1144869223	1	1	FOSTER, CLAIRE H PSYD	6/15/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
15151	Fee-for-Service	1083611362	1083611362	1	1	FAYLONA, EDGARDO A MD	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	68	Hematology	1	Border provider	None	58 N PECOS RD	None	HENDERSON	NV	89074	7319	00	None	36.03160397	-115.1002424	Clark County
15171	Fee-for-Service	1366000226	1366000226	1	1	FUENTES, EUNICE D LPCC	6/28/2022	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8421 AUBURN BLVD	SUITE 110	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
15173	Fee-for-Service	1962452714	1962452714	1	1	FACULTY PHYSICIANS AND	1/18/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS 0F LLUSM	2195 CLUB CENTER DR	STE L	SAN BERNARDINO	CA	92408	4162	36	06071	34.06055692	-117.2814193	San Bernardino County
15182	Fee-for-Service	1790777506	1790777506	1	1	FALLON, JULIE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	49268	01	General Practice	0	In state provider	None	295 POSADA LN	STE C	TEMPLETON	CA	93465	4055	40	06079	35.55315971	-120.7214435	San Luis Obispo County
15202	Fee-for-Service	1376856880	1376856880	1	1	FENNEWALD, JESSICA NP	8/11/2020	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	50 ALESSANDRO PLACE	SUITE 440	PASADENA	CA	91105	0000	19	06037	34.13101049	-118.151532	Los Angeles County
15214	Fee-for-Service	1326537044	1326537044	1	1	FAN, JUSTON DO	4/16/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	17612	20	Orthopedic Surgery	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
15224	Fee-for-Service	1538431150	1538431150	1	1	FORREST, WILLIAM H	12/24/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1555 RIVER PARK DR	STE 206	SACRAMENTO	CA	95815	4604	34	06067	38.600019	-121.434687	Sacramento County
15239	Fee-for-Service	1457794752	1457794752	1	3	FOLCH-HAYEK, BEATRIZ M MD FA	12/20/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	148014	15	Obstetrics (D.O. only)	0	In state provider	K MD FACOG	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	37	06073	32.750523	-117.100927	San Diego County
15351	Fee-for-Service	1962585125	1962585125	1	1	FRUSH, DONALD P MD	9/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	158388	30	Radiology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
15366	Fee-for-Service	1942255625	1942255625	1	1	FLETCHER, STEVEN F MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71273	66	Emergency Medicine (Urgent Care)	0	In state provider	MONO GENERAL HOSPITAL	536	None	BRIDGEPORT	CA	93517	0536	26	06051	38.256516	-119.2242555	Mono County
15379	Fee-for-Service	1598197840	1598197840	1	1	FONG, DANIEL J MD	11/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134067	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
15436	Fee-for-Service	1447509377	1447509377	1	1	FONG, TIFFANY L PSYD	4/27/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1900 S MCDOWELL BLVD	12	PETALUMA	CA	94954	5473	49	06097	38.230006	-122.5958952	Sonoma County
15444	Fee-for-Service	1154796522	1154796522	1	1	FRESENIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY LLC	290 HOSPITAL CIRCLE	None	WESTMINSTER	CA	92683	3950	30	06059	33.76234687	-117.9956535	Orange County
15449	Fee-for-Service	1619072600	1619072600	1	1	FANOUS, BASEM MD	5/21/1995	207R00000X	NA	Other	026	PHYSICIANS	53406	41	Internal Medicine	0	In state provider	None	13851 FOOTHILL BLVD	STE 4	SYLMAR	CA	91342	3042	19	06037	34.31119451	-118.4351004	Los Angeles County
15463	Fee-for-Service	1962452714	1962452714	1	1	FACULTY PHYSICIANS AND	8/31/2017	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	SURGEONS 0F LLUSM	2195 CLUB CENTER DR	STE L	SAN BERNARDINO	CA	92408	4162	36	06071	34.06055692	-117.2814193	San Bernardino County
15497	Fee-for-Service	1821617135	1821617135	1	1	FISCHER-COLBRIE, MEGAN	11/1/2023	390200000X	NA	Other	026	PHYSICIANS	183457	None	None	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
15510	Fee-for-Service	1942241476	1942241476	1	1	FISHER, STEVEN D MD	5/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	25508	02	General Surgery	0	In state provider	None	23451 MADISON ST	STE 340	TORRANCE	CA	90505	4762	19	06037	33.81197627	-118.3478154	Los Angeles County
15522	Fee-for-Service	1861073033	1861073033	1	2	FLEXEN, BRIANNE J NP	12/18/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95025938	-	NOT APPLICABLE	0	In state provider	None	13001 RAMONA BLVD	SUITE E & J	IRWINDALE	CA	91706	3752	19	06037	34.07969659	-117.9895641	Los Angeles County
15607	Fee-for-Service	1689640658	1689640658	1	1	FITZPATRICK, JILL E MD	1/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63523	08	Family Practice	0	In state provider	None	700 ZION ST	None	NEVADA CITY	CA	95959	2921	29	06057	39.25501228	-121.0253266	Nevada County
15620	Fee-for-Service	1730248196	1730248196	1	1	FINCH, MARK J MD	2/8/2015	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	52408	77	Infectious Disease	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4383	01	06001	37.63347961	-122.0897735	Alameda County
15649	Fee-for-Service	1063765733	1063765733	1	1	FITTS, ERICA L LMFT	3/15/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
15653	Fee-for-Service	1942255625	1942255625	1	1	FLETCHER, STEVEN F MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71273	08	Family Practice	0	In state provider	MONO GENERAL HOSPITAL	536	None	BRIDGEPORT	CA	93517	0536	26	06051	38.256516	-119.2242555	Mono County
15731	Fee-for-Service	1205588159	1205588159	1	1	FORUM HEALTH SERVICES, INC	5/1/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12722 RIVERSIDE DR	STE 207A	VALLEY VILLAGE	CA	91607	3326	19	06037	34.15758454	-118.410318	Los Angeles County
15734	Fee-for-Service	1508448069	1508448069	1	1	FERNANDEZ, JHAIMY C MD	11/26/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184788	08	Family Practice	0	In state provider	None	6000 SEPULVEDA BLVD	E10	CULVER CITY	CA	90230	6421	19	06037	33.985512	-118.393524	Los Angeles County
15752	Fee-for-Service	1639388994	1639388994	1	1	FAYAZI, AZADEH MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115936	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
15817	Fee-for-Service	1588649602	1588649602	1	1	FARRISH, SUSAN C MD	11/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	157397	01	General Practice	0	In state provider	None	488 E VALLEY PKWY	STE 211	ESCONDIDO	CA	92025	3370	37	06073	33.12523814	-117.0769715	San Diego County
15837	Fee-for-Service	1700272721	1700272721	1	1	FIVE POINT CARE	5/10/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	7913 SATSUMA AVE	None	SUN VALLEY	CA	91352	4617	19	06037	34.214337	-118.3670975	Los Angeles County
15842	Fee-for-Service	1265530570	1265530570	1	1	FERDOWSIAN, MEHRAD M MD	9/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
15863	Fee-for-Service	1427174176	1427174176	1	1	FERGERSON, BYRON D MD	7/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116623	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
15915	Fee-for-Service	1316289309	1316289309	1	1	FEUCHT, ALLISYN OD INC	6/10/2013	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9372 DESCHUTES ROAD	None	PALO CEDRO	CA	96073	8799	45	06089	40.55985415	-122.2386636	Shasta County
15936	Fee-for-Service	1952865388	1952865388	1	1	FERRARI-RAMIREZ, ANN OT	1/28/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
15970	Fee-for-Service	1659539856	1659539856	1	1	FRANCIS, DAMON E MD	7/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103611	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94120	7464	38	06075	37.75548534	-122.4065362	San Francisco County
16017	Fee-for-Service	1619956976	1619956976	1	1	FOSBINDER, JOHN J DO	6/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	9214	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3001 SILLECT AVE	None	BAKERSFIELD	CA	93308	6337	15	06029	35.38601911	-119.0400416	Kern County
16090	Fee-for-Service	1700021409	1700021409	1	1	FIELDS, NAKEYA T LCSW	10/16/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	848 MARCHETA ST	STE 1	ALTADENA	CA	91001	2580	19	06037	34.18759978	-118.132523	Los Angeles County
16138	Fee-for-Service	1184718769	1184718769	1	1	FISHER, DARRYL J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45490	66	Emergency Medicine (Urgent Care)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
16158	Fee-for-Service	1760588420	1760588420	1	1	FIELDS, CARRIE S DO	7/22/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	6449	08	Family Practice	0	In state provider	None	450 E SPRING ST	STE 1	LONG BEACH	CA	90806	1625	19	06037	33.8099218	-118.1872346	Los Angeles County
16167	Fee-for-Service	1194797258	1194797258	1	1	FREDERICK D WILLIAMS,	2/8/2015	207W00000X	NA	Ophthalmology	026	PHYSICIANS	41755	02	General Surgery	0	In state provider	M.D. INC.	1506 CENTINELA AVE	None	INGLEWOOD	CA	90302	1144	19	06037	33.97692895	-118.3654246	Los Angeles County
16168	Fee-for-Service	1619991908	1619991908	1	1	FLOWERS, CHARLES W MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	70691	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	655 EUCLID AVE	#302	NATIONAL CITY	CA	91950	2953	37	06073	32.68353398	-117.082625	San Diego County
16187	Fee-for-Service	1356804975	1356804975	1	1	FRANSEN, SAMUEL DO	7/16/2023	2279E0002X	NA	Other	026	PHYSICIANS	20903	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
16205	Fee-for-Service	1023648623	1023648623	1	1	FAMILIES TOGETHER OF ORANGE	12/18/2020	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	MOBILE	621 W 1ST STREET	None	TUSTIN	CA	92780	2939	30	06059	33.74577853	-117.8305245	Orange County
16268	Fee-for-Service	1407941719	1407941719	1	2	FAMILY PLANNING ASSOCIATES M	4/16/2020	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP, INC	1625 E MAIN STREET	SUITE 202	EL CAJON	CA	92021	9101	37	06073	32.80969963	-116.9203429	San Diego County
16320	Fee-for-Service	1356417471	1356417471	1	1	FARBER-DEZUBIRIA, ANDREA L	6/20/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2071 EAST HERNDON	None	CLOVIS	CA	93611	6101	10	06019	36.8375685	-119.6781105	Fresno County
16386	Fee-for-Service	1649740556	1649740556	1	1	FOOT AND ANKLE CARE TEAM INC	3/12/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5365 WALNUT AVE	STE M	CHINO	CA	91710	2622	36	06071	34.02626051	-117.6883155	San Bernardino County
16420	Fee-for-Service	1548898091	1548898091	1	1	FRIEDMAN, ALEXANDRA MD	7/29/2024	207P00000X	NA	Other	026	PHYSICIANS	185204	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
16425	Fee-for-Service	1184718769	1184718769	1	1	FISHER, DARRYL J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45490	02	General Surgery	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
16446	Fee-for-Service	1063518868	1063518868	1	1	FISHER, MASARU J MD	7/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	80499	None	None	0	In state provider	None	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	38	06075	37.72851602	-122.4296638	San Francisco County
16455	Fee-for-Service	1194797258	1194797258	1	1	FREDERICK D WILLIAMS,	2/8/2015	207W00000X	NA	Ophthalmology	026	PHYSICIANS	41755	18	Ophthalmology	0	In state provider	M.D. INC.	1506 CENTINELA AVE	None	INGLEWOOD	CA	90302	1144	19	06037	33.97692895	-118.3654246	Los Angeles County
16503	Fee-for-Service	1811105117	1811105117	1	1	FRAUSTO, STEPHEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	604 W WARNER RD	STE E201	CHANDLER	AZ	85225	2911	00	None	33.335388	-111.8512305	Maricopa County
16514	Fee-for-Service	1386749893	1386749893	1	1	FRANCISCAN ALLIANCE INC	8/15/2012	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	8111 S EMERSON AVE	None	INDIANAPOLIS	IN	46237	8601	00	None	39.648528	-86.0796855	Marion County
16599	Fee-for-Service	1912953936	1912953936	1	10	FAIRBANKS & POWER PHYSICAL T	9/4/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	9660 HAVEN AVE	130	RANCHO CUCAMONGA	CA	91730	5896	36	06071	34.08001728	-117.5758578	San Bernardino County
16606	Fee-for-Service	1962482893	1962482893	1	1	FERRARO, FRANCIS A MD	5/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	65018	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
16678	Fee-for-Service	1851920904	1851920904	1	1	FECK, JEREMY J DO	8/21/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20269	None	None	0	In state provider	None	845 LA VETA	STE 108	ORANGE	CA	92868	3930	30	06059	33.78064548	-117.8611107	Orange County
16755	Fee-for-Service	1033566005	1033566005	1	1	FIRST TOUCH HOME HEALTH	12/6/2017	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	12062 VALLEY VIEW STREET	STE 224A	GARDEN GROVE	CA	92845	1737	30	06059	33.78720885	-118.028413	Orange County
16763	Fee-for-Service	1457428328	1457428328	1	1	FUNAHASHI, TADASHI T MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	61301	20	Orthopedic Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
16777	Fee-for-Service	1538222732	1538222732	1	1	FLORES BACKSTROM, TERESA	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYD	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
16795	Fee-for-Service	1760937411	1760937411	1	1	FIDDES, NICOLA T PSYD	7/26/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
16801	Fee-for-Service	1386749893	1386749893	1	1	FRANCISCAN ALLIANCE INC	8/15/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	8111 S EMERSON AVE	None	INDIANAPOLIS	IN	46237	8601	00	None	39.648528	-86.0796855	Marion County
16845	Fee-for-Service	1902090350	1902090350	1	1	FERRARO, RACHAEL M DO	5/14/2009	207R00000X	NA	Other	026	PHYSICIANS	10497	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	None	LOS ANGELES	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles
16855	Fee-for-Service	1760100267	1760100267	1	1	FU, EDWARD PT	4/5/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
16872	Fee-for-Service	1467984625	1467984625	1	1	FONG, JEANETTE M MD	6/30/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	157078	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
16934	Fee-for-Service	1619101490	1619101490	1	1	FORTUNATO, CANDICE MD	5/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
16988	Fee-for-Service	1053471490	1053471490	1	1	FUJII, DOUGLAS T MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	7069	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	414 G ST	STE 220	MARYSVILLE	CA	95901	5670	58	06115	39.13913942	-121.5934649	Yuba County
17029	Fee-for-Service	1508840570	1508840570	1	1	FONTANA, GREGORY P MD	9/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76374	33	Thoracic Surgery	0	In state provider	None	215 W JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
17030	Fee-for-Service	1689641482	1689641482	1	1	FEROUZ, FAZEELA MD	12/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	86533	05	Anesthesiology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
17087	Fee-for-Service	1134582265	1134582265	1	1	FAUSTINO-WONG, JESSAMINE MD	11/9/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	150475	40	Pediatrics	0	In state provider	None	1301 PINOLE VALLEY RD	None	PINOLE	CA	94564	1384	07	06013	37.9991883	-122.2867117	Contra Costa County
17158	Fee-for-Service	1972781565	1972781565	1	1	FRIDEN OPTOMETRY INC A	5/19/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	68 CENTRAL AVE	STE C	QUINCY	CA	95971	9718	32	06063	39.93638081	-120.9358748	Plumas County
17172	Fee-for-Service	1205862489	1205862489	1	1	FOOTHILL PULMONARY AND	1/1/1979	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	CRITICAL CARE CONSULTANT	959 E WALNUT ST	STE 120	PASADENA	CA	91106	5364	19	06037	34.14962102	-118.1305187	Los Angeles County
17181	Fee-for-Service	1740203363	1740203363	1	1	FISHMAN, DEBORAH L	8/30/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2428 DWIGHT WAY	STE 2	BERKELEY	CA	94704	3503	01	06001	37.86496482	-122.259389	Alameda County
17202	Fee-for-Service	1124204938	1124204938	1	1	FAMILY HEALTH CTRS OF SD INC	2/22/2005	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	5454 EL CAJON BLVD	None	SAN DIEGO	CA	92115	3621	37	06073	32.75809043	-117.0778038	San Diego County
17239	Fee-for-Service	1801464581	1801464581	1	1	FINCHE, VIVIENNE G CCC-SLP	10/19/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1261 TRAVIS BLVD	120	FAIRFIELD	CA	94533	4897	48	06095	38.25812361	-122.0495417	Solano County
17266	Fee-for-Service	1326656505	1326656505	1	1	FIRST RESPONSE HOSPICE CARE	7/9/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5530 CORBIN AVE	STE 221	TARZANA	CA	91356	6095	19	06037	34.171812	-118.5621935	Los Angeles County
17276	Fee-for-Service	1053471490	1053471490	1	1	FUJII, DOUGLAS T MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	7069	41	Internal Medicine	0	In state provider	None	414 G ST	STE 220	MARYSVILLE	CA	95901	5670	58	06115	39.13913942	-121.5934649	Yuba County
17316	Fee-for-Service	1073599726	1073599726	1	1	FONG, RONALD L MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	72453	08	Family Practice	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
17361	Fee-for-Service	1568562395	1568562395	1	1	FRANCO, ARIE MD	4/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128285	42	Nuclear Medicine	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
17386	Fee-for-Service	1124175740	1124175740	1	1	FAR WEST PODIATRIC MEDICAL G	12/13/2005	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	ROUP	13624 HAWTHORNE BLVD	STE 206	HAWTHORNE	CA	90250	5818	19	06037	33.9083784	-118.3523983	Los Angeles County
17406	Fee-for-Service	1336227248	1336227248	1	1	FERNANDEZ, VICTOR R MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68288	41	Internal Medicine	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
17456	Fee-for-Service	1225455405	1225455405	1	1	FITZWATER, SEAN P MD	11/17/2020	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	142416	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
17462	Fee-for-Service	1205862489	1205862489	1	1	FOOTHILL PULMONARY AND	1/1/1979	207RP1001X	NA	Pulmonology	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	CRITICAL CARE CONSULTANT	959 E WALNUT ST	STE 120	PASADENA	CA	91106	5364	19	06037	34.14962102	-118.1305187	Los Angeles County
17479	Fee-for-Service	1114940947	1114940947	1	1	FORD, MICHAEL J MD	2/1/1999	207L00000X	NA	Other	026	PHYSICIANS	72698	05	Anesthesiology	0	In state provider	None	3857 BIRCH ST	STE 709	NEWPORT BEACH	CA	92660	2616	30	06059	33.66332364	-117.8712141	Orange County
17487	Fee-for-Service	1033493424	1033493424	1	1	FRANKLIN, KAHESHA MD	3/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133311	01	General Practice	0	In state provider	None	1006 W LA PALMA AVENUE	None	ANAHEIM	CA	92801	4122	30	06059	33.84713552	-117.9305145	Orange County
17531	Fee-for-Service	1740750371	1740750371	1	1	FAVILA-REYES, RUBY ANNE B RC	5/2/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	P	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
17557	Fee-for-Service	1326656505	1326656505	1	1	FIRST RESPONSE HOSPICE CARE	7/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5530 CORBIN AVE	STE 221	TARZANA	CA	91356	6095	19	06037	34.171812	-118.5621935	Los Angeles County
17610	Fee-for-Service	1558416313	1558416313	1	1	FAWZI, AMANI A MD	8/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80549	18	Ophthalmology	0	In state provider	None	10 CONGRESS ST	STE 300	PASADENA	CA	91105	3023	19	06037	34.13396893	-118.1528162	Los Angeles County
17632	Fee-for-Service	1629103247	1629103247	1	1	FONG, DENNIS W OD	8/6/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	230 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
17650	Fee-for-Service	1568562395	1568562395	1	1	FRANCO, ARIE MD	4/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128285	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
17681	Fee-for-Service	1669608170	1669608170	1	1	FLORES, SARAH MD	9/5/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	119659	10	Gastroenterology (M.D. only)	0	In state provider	None	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	34	06067	38.571084	-121.471074	Sacramento County
17692	Fee-for-Service	1285624940	1285624940	2	1	FUSCALDO, FRANCISCO B MD	4/24/1987	174400000X	NA	Other	026	PHYSICIANS	25805	None	None	0	In state provider	None	2813 N BROADWAY	None	LOS ANGELES	CA	90031	2611	19	06037	34.07370346	-118.2125385	Los Angeles County
17772	Fee-for-Service	1336101690	1336101690	1	1	FENNELL, MICHAEL S MD	4/1/1999	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7134	00	None	42.32787853	-122.863311	Jackson County
17845	Fee-for-Service	1770746646	1770746646	1	1	FISCHL, PETER MD INC	4/10/2009	193400000X	NA	Other	026	PHYSICIANS	33580	02	General Surgery	0	In state provider	None	16130 KOKANEE RD	STE 104	APPLE VALLEY	CA	92307	1353	36	06071	34.54434148	-117.2679094	San Bernardino County
17877	Fee-for-Service	1871818138	1871818138	1	1	FRIENDS OF FAMILY	6/1/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	501 S IDAHO ST	SUITE 100 & 190	LA HABRA	CA	90631	6047	30	06059	33.927525	-117.959216	Orange County
17928	Fee-for-Service	1689722548	1689722548	1	1	FELDMAN, REVITAL K MD	6/11/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83113	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
17969	Fee-for-Service	1700254117	1700254117	1	1	FORSYTH, KATIE M CNP	10/19/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25880 MCBEAN PKWY	None	SANTA CLARITA	CA	91355	2004	19	06037	34.40360638	-118.5522028	Los Angeles County
18011	Fee-for-Service	1326752841	1326752841	1	1	FISHER, KATHRYN J BIRTH DOUL	6/19/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
18133	Fee-for-Service	1770746646	1770746646	1	1	FISCHL, PETER MD INC	4/10/2009	193400000X	NA	Other	026	PHYSICIANS	33580	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	16130 KOKANEE RD	STE 104	APPLE VALLEY	CA	92307	1353	36	06071	34.54434148	-117.2679094	San Bernardino County
18162	Fee-for-Service	1871818138	1871818138	1	1	FRIENDS OF FAMILY	6/1/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	501 S IDAHO ST	SUITE 100 & 190	LA HABRA	CA	90631	6047	30	06059	33.927525	-117.959216	Orange County
18164	Fee-for-Service	1740496322	1740496322	1	1	FARZANEH, BABAK MD	5/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97278	02	General Surgery	0	In state provider	None	255 E BONITA AVE	None	POMONA	CA	91767	1923	19	06037	34.097913	-117.7474635	Los Angeles County
18213	Fee-for-Service	1629165394	1629165394	1	1	FIUTOWSKI, LESZEK MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1001 BELMONT AVE	None	YOUNGSTOWN	OH	44504	1003	00	None	41.11287755	-80.6554141	Mahoning County
18236	Fee-for-Service	1588692289	1588692289	1	1	FUCHS, MICHAEL	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	520 S EAGLE	None	MERIDIAN	ID	83642	6794	00	None	43.600527	-116.3518425	Ada County
18266	Fee-for-Service	1457323446	1457323446	1	1	FAHEY, GORDON T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78020	02	General Surgery	0	In state provider	None	2407 W VINE ST	STE B	LODI	CA	95242	3730	39	06077	38.12285348	-121.3044345	San Joaquin County
18305	Fee-for-Service	1588082036	1588082036	1	1	FALTAOUS, MARK MD	7/3/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
18326	Fee-for-Service	1265424394	1265424394	1	1	FUNK, DEBORAH L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	47 NEW SCOTLAND AVE	None	ALBANY	NY	12208	3412	00	None	42.65281106	-73.77466567	Albany County
18342	Fee-for-Service	1952318404	1952318404	1	1	FRIEDLANDER, MARTIN MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	59701	18	Ophthalmology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
18351	Fee-for-Service	1336345552	1336345552	1	1	FORSTER, AMANDA A	1/30/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
18374	Fee-for-Service	1508580705	1508580705	1	1	FORTUNA FAMILY MEDICINE INC	9/12/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	FREE STANDING RHC	2404 NEWBURG ROAD	None	FORTUNA	CA	95540	2818	12	06023	40.59065211	-124.1410568	Humboldt County
18382	Fee-for-Service	1477972388	1477972388	1	1	FISCHER, KATRINA A MD	8/13/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	139123	41	Internal Medicine	0	In state provider	None	100 S. SAN MATEO DR.	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
18385	Fee-for-Service	1649558800	1649558800	1	1	FINNEGAN-PATTERSON, KERRY L	1/30/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
18419	Fee-for-Service	1770746646	1770746646	1	1	FISCHL, PETER MD INC	4/10/2009	193400000X	NA	Other	026	PHYSICIANS	33580	33	Thoracic Surgery	0	In state provider	None	16130 KOKANEE RD	STE 104	APPLE VALLEY	CA	92307	1353	36	06071	34.54434148	-117.2679094	San Bernardino County
18433	Fee-for-Service	1790982775	1790982775	1	1	FRIEDEBERG, LAURA R LMFT	8/7/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	310 8TH ST	STE 201	OAKLAND	CA	94607	4210	01	06001	37.79894269	-122.2704172	Alameda County
18451	Fee-for-Service	1871818138	1871818138	1	1	FRIENDS OF FAMILY	6/1/2012	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	501 S IDAHO ST	SUITE 100 & 190	LA HABRA	CA	90631	6047	30	06059	33.927525	-117.959216	Orange County
18529	Fee-for-Service	1568540136	1568540136	1	1	FELDMAN, JONATHAN D MD	7/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	55955	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
18545	Fee-for-Service	1790759397	1790759397	1	1	FLORENCIO E YUZON, M.D.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3600 KOLBE RD	STE 205	LORAIN	OH	44053	1677	00	None	41.43729188	-82.23529263	Lorain County
18569	Fee-for-Service	1538288998	1538288998	1	1	FERNANDEZ, JORGE L LCSW	3/26/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1510 FLORIDA AVENUE	SUITE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
18605	Fee-for-Service	1417297847	1417297847	1	22	FIRST CHOICE PHYSICIAN PARTN	3/30/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	680 LANGSDORF DR	SUITE 103	FULLERTON	CA	92831	3702	30	06059	33.87673088	-117.8824577	Orange County
18641	Fee-for-Service	1548657992	1548657992	1	1	FREDERICK, ALIYA L MD	7/1/2021	2084N0402X	NA	Neurology	026	PHYSICIANS	148160	None	None	0	In state provider	None	8001 FROST STREET	None	SAN DIEGO	CA	92123	2746	37	06073	32.802147	-117.151371	San Diego County
18647	Fee-for-Service	1275598443	1275598443	1	1	FRASER, ELLEN J MD	2/28/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80097	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
18660	Fee-for-Service	1508580705	1508580705	1	1	FORTUNA FAMILY MEDICINE INC	9/12/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	FREE STANDING RHC	2404 NEWBURG ROAD	None	FORTUNA	CA	95540	2818	12	06023	40.59065211	-124.1410568	Humboldt County
18662	Fee-for-Service	1013913755	1013913755	1	1	FONTAINE, JAMES D MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72697	20	Orthopedic Surgery	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
18669	Fee-for-Service	1477972388	1477972388	1	1	FISCHER, KATRINA A MD	8/13/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	139123	68	Hematology	0	In state provider	None	100 S. SAN MATEO DR.	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
18674	Fee-for-Service	1326184896	1326184896	1	1	FREEMAN, DARREN K DO	9/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	None	555 TACHEVAH DR	STE 3W105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
18677	Fee-for-Service	1871948372	1871948372	1	1	FRISCHKNECHT, JONATHAN DO	1/2/2025	2080P0204X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
18697	Fee-for-Service	1841403805	1841403805	1	1	FURTADO, CLAUDIA D MD	7/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93607	30	Radiology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
18743	Fee-for-Service	1659329456	1659329456	1	1	FITZPATRICK, MARIAN C PT	6/12/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1252 BROADWAY	SUITE B	PLACERVILLE	CA	95667	5806	09	06017	38.73128098	-120.7852781	El Dorado County
18815	Fee-for-Service	1568540136	1568540136	1	1	FELDMAN, JONATHAN D MD	7/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	55955	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
18837	Fee-for-Service	1245541580	1245541580	1	1	FIELDS, BRIAN W DO	9/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14659	41	Internal Medicine	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
18869	Fee-for-Service	1366513301	1366513301	1	1	FARACH, LAURA	4/8/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76236	40	Pediatrics	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
18909	Fee-for-Service	1134705023	1134705023	1	1	FEI, XIANHAN M MD	5/9/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
18954	Fee-for-Service	1013913755	1013913755	1	1	FONTAINE, JAMES D MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72697	25	Physical Medicine and Rehabilitation	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
18999	Fee-for-Service	1750408571	1750408571	1	1	FREDERICKS, BRETT OD	2/14/2019	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	21 UPPER RAGSDALE DR	201	MONTEREY	CA	93940	2860	27	06053	36.57578382	-121.810169	Monterey County
19114	Fee-for-Service	1538605241	1538605241	1	1	FUJII, TATSUHIRO MD	7/17/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	154394	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
19130	Fee-for-Service	1134652894	1134652894	1	1	FRANKEL, REVA MD	10/6/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	172445	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
19179	Fee-for-Service	1568494151	1568494151	1	1	FRANCO, DANIEL MD	12/6/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51653	08	Family Practice	0	In state provider	None	1800 WESTERN AVE	STE 401	SAN BERNARDINO	CA	92411	1355	36	06071	34.1315778	-117.3182453	San Bernardino County
19190	Fee-for-Service	1033668900	1033668900	1	1	FAHEY, REBECCA LCSW	1/12/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	104463	-	NOT APPLICABLE	0	In state provider	None	1891 EFFIE ST	None	LOS ANGELES	CA	90026	1711	19	06037	34.08461594	-118.2570874	Los Angeles County
19291	Fee-for-Service	1679508923	1679508923	1	1	FARMER, DOUGLAS G MD	6/30/1991	204F00000X	NA	General Surgery	026	PHYSICIANS	49584	02	General Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
19378	Fee-for-Service	1134755630	1134755630	1	1	FLIGELMAN, SARA J PSYD	4/27/2020	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
19403	Fee-for-Service	1104960624	1104960624	1	1	FRATINI, ADRIENNE A MD	12/21/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	67629	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
19497	Fee-for-Service	1326016379	1326016379	1	1	FIELDS, JACK M MD	3/2/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	106599	30	Radiology	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
19512	Fee-for-Service	1740291434	1740291434	1	1	FRANK, SIDNEY A MD	10/26/1973	No Taxonomy Provided	NA	None	026	PHYSICIANS	23569	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1215 CLAY ST	None	OAKLAND	CA	94612	0000	01	06001	37.80403182	-122.274455	Alameda County
19568	Fee-for-Service	1891313250	1891313250	1	1	FRAGOSO, ERIK J LMFT	9/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
19601	Fee-for-Service	1003235540	1003235540	1	1	FAZELI, SASAN MD	8/17/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	168030	41	Internal Medicine	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
19647	Fee-for-Service	1275610503	1275610503	1	1	FAROOQI, MUFTISAADAT A	8/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	69294	10	Gastroenterology (M.D. only)	0	In state provider	GASTROENTER & HEPATOLOGY	1332 W HERNDON AVE	STE 100	FRESNO	CA	93711	7118	10	06019	36.83737137	-119.8148304	Fresno County
19652	Fee-for-Service	1992028724	1992028724	1	1	FATTORINI-OCAMPO, GIOVANNA	4/17/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
19664	Fee-for-Service	1972583755	1972583755	1	1	FERNANDEZ, DON M MD	7/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54858	None	None	0	In state provider	None	77 CADILLAC DR	STE 210	SACRAMENTO	CA	95825	5480	34	06067	38.572551	-121.4181585	Sacramento County
19695	Fee-for-Service	1265422604	1265422604	1	1	FLAMM, SCOTT D MD	10/6/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	68151	None	None	0	In state provider	None	74785 US HIGHWAY 111	STE 101	INDIAN WELLS	CA	92210	7129	33	06065	33.72131925	-116.360116	Riverside County
19709	Fee-for-Service	1992872808	1992872808	1	1	FULLMAN, HOWARD J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	44278	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
19797	Fee-for-Service	1881341212	1881341212	1	1	FINDING HOPE COUNSELING SERV	3/20/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ICES A PSYCHOLOGICAL COR	3200 E GUASTI RD STE 100	None	ONTARIO	CA	91761	8661	36	06071	34.06518	-117.5822055	San Bernardino County
19802	Fee-for-Service	1740291434	1740291434	1	1	FRANK, SIDNEY A MD	10/26/1973	No Taxonomy Provided	NA	None	026	PHYSICIANS	23569	40	Pediatrics	0	In state provider	None	1215 CLAY ST	None	OAKLAND	CA	94612	0000	01	06001	37.80403182	-122.274455	Alameda County
19887	Fee-for-Service	1003235540	1003235540	1	1	FAZELI, SASAN MD	8/17/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	168030	67	Endocrinology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
19947	Fee-for-Service	1710518642	1710518642	1	1	FARLOW, TONA R LMFT	7/5/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
19948	Fee-for-Service	1548349681	1548349681	1	1	FURY, RICHARD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39943	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
19954	Fee-for-Service	1306944947	1306944947	1	1	FUENTES, JOSE R MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	78988	01	General Practice	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
19958	Fee-for-Service	1942528468	1942528468	1	1	FELKER, ELY R MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118683	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3076	19	06037	34.06373445	-118.443537	Los Angeles County
19963	Fee-for-Service	1790771616	1790771616	1	1	FABRICANT, MICHAEL S MD	6/27/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	13441	41	Internal Medicine	0	In state provider	None	333 W BASTANCHURY RD	None	FULLERTON	CA	92835	3420	30	06059	33.89358012	-117.9327635	Orange County
19985	Fee-for-Service	1982292827	1982292827	1	1	FRESENIUS MEDICAL CARE	5/3/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA, LLC	3939 RUFFIN RD	STE 100	SAN DIEGO	CA	92123	1804	37	06073	32.8139371	-117.121269	San Diego County
20001	Fee-for-Service	1336674571	1336674571	1	1	FUENTES, WENDY NP	11/27/2019	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2559 W ROSAMOND BLVD	STE D	ROSAMOND	CA	93560	6267	15	06029	34.86420508	-118.1771868	Kern County
20005	Fee-for-Service	1063645778	1063645778	1	1	FERNANDES, NEYCHELLE MD	3/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
20081	Fee-for-Service	1255335154	1255335154	1	1	FAGAN, PHILIP J JR MD	2/8/2015	207P00000X	NA	Other	026	PHYSICIANS	32505	None	None	0	In state provider	None	1133 WEST SYCAMORE ST	None	WILLOWS	CA	95988	2601	11	06021	39.5205105	-122.2082775	Glenn County
20111	Fee-for-Service	1346517489	1346517489	1	1	FINKS, KATEE R CNM	11/9/2021	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
20155	Fee-for-Service	1356690549	1356690549	1	1	FILTZKOWSKI, JAIME CNP	2/1/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1100 TRANCAS ST	STE 350	NAPA	CA	94558	2959	28	06055	38.32316569	-122.2981938	Napa County
20182	Fee-for-Service	1497745194	1497745194	1	1	FINE, STEPHEN A MD	1/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147121	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
20242	Fee-for-Service	1306944947	1306944947	1	1	FUENTES, JOSE R MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	78988	41	Internal Medicine	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
20267	Fee-for-Service	1043715733	1043715733	1	1	FAWIBE, OLUWATOSIN S MD	8/21/2023	208600000X	NA	General Surgery	026	PHYSICIANS	174644	None	None	0	In state provider	None	3838 SAN DIMAS ST	B 231	BAKERSFIELD	CA	93301	2284	15	06029	35.3946385	-119.008203	Kern County
20320	Fee-for-Service	1740471044	1740471044	1	1	FRIEDENBERG, ALLISON S MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113474	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
20331	Fee-for-Service	1740233022	1740233022	1	1	FERRARI, MARCANTONIO MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76373	05	Anesthesiology	0	In state provider	None	725 E SANTA CLARA ST	STE 101	SAN JOSE	CA	95112	1936	43	06085	37.34328626	-121.8756374	Santa Clara County
20380	Fee-for-Service	1851989024	1851989024	1	1	FRIENDLY HOSPICE BEST CARE	12/22/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC.	14545 VICTORY BLVD	STE 602A	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
20396	Fee-for-Service	1538186465	1538186465	1	1	FRIENDLY PHARMACY INC	8/2/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	FRIENDLY #1 PHARMACY	485 LEWIS RD	STE D	SAN JOSE	CA	95111	2196	43	06085	37.29663318	-121.8392205	Santa Clara County
20470	Fee-for-Service	1215134267	1215134267	1	1	FRIEDLANDER, TERENCE W MD	6/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88888	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
20475	Fee-for-Service	1982796389	1982796389	1	1	FEIBLEMAN, CARY E MD INC	3/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	40658	07	Dermatology	0	In state provider	None	701 E 28TH ST	STE 311	LONG BEACH	CA	90806	2780	19	06037	33.80803441	-118.1847137	Los Angeles County
20501	Fee-for-Service	1194872812	1194872812	1	1	FONG, ABRAHAM P MD	1/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92154	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
20572	Fee-for-Service	1174011928	1174011928	1	1	FIGUERO, TIFFANY NP	2/11/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	480 TESCONI CIR	STE B	SANTA ROSA	CA	95401	4691	49	06097	38.449557	-122.7357315	Sonoma County
20609	Fee-for-Service	1740471044	1740471044	1	1	FRIEDENBERG, ALLISON S MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113474	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
20619	Fee-for-Service	1508842303	1508842303	1	1	FARRELL, MAUREEN E MD	1/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	82843	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
20668	Fee-for-Service	1851989024	1851989024	1	1	FRIENDLY HOSPICE BEST CARE	12/22/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC.	14545 VICTORY BLVD	STE 602A	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
20677	Fee-for-Service	1326231713	1326231713	1	1	FAMILY HEALTH CENTER OF	6/17/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	SAN DIEGO	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
20709	Fee-for-Service	1427234111	1427234111	1	1	FLAGSTAFF MEDICAL CENTER	11/1/1995	3416A0800X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	1464	00	None	35.208594	-111.645099	Coconino County
20718	Fee-for-Service	1427266691	1427266691	1	1	FAKHOURY, RAMON F MD	3/24/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	98772	08	Family Practice	0	In state provider	None	25455 BARTON ROAD	STE 204B	LOMA LINDA	CA	92354	3450	36	06071	34.04805253	-117.249534	San Bernardino County
20757	Fee-for-Service	1215134267	1215134267	1	1	FRIEDLANDER, TERENCE W MD	6/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88888	68	Hematology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
20847	Fee-for-Service	1801832464	1801832464	1	1	FIG HOLDINGS, LLC	3/1/2002	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GARDEN CITY HEALTHCARE	1310 W GRANGER AVE	None	MODESTO	CA	95350	3911	50	06099	37.66758923	-121.012878	Stanislaus County
20876	Fee-for-Service	1831166560	1831166560	1	1	FUNDINGSLAND, BRENT W MD	6/7/2021	207L00000X	NA	Other	026	PHYSICIANS	76891	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
20881	Fee-for-Service	1265677538	1265677538	1	1	FANG, DEANNA MD	3/23/2021	207ZP0105X	NA	Other	026	PHYSICIANS	140477	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
20886	Fee-for-Service	1770025330	1770025330	1	1	FRANCIS, ELISE S OT	1/28/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
20898	Fee-for-Service	1740471044	1740471044	1	1	FRIEDENBERG, ALLISON S MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113474	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
20935	Fee-for-Service	1629626007	1629626007	1	1	FREEDOM CARE TRANSPORTATION	5/5/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	INC	3200 E GUASTI RD	100	ONTARIO	CA	91761	8661	36	06071	34.06518	-117.5822055	San Bernardino County
20955	Fee-for-Service	1760555361	1760555361	1	1	FORGEY, RICHARD L OD	3/4/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	210 S GRAND AVE	STE 115	GLENDORA	CA	91741	4263	19	06037	34.133859	-117.872523	Los Angeles County
20965	Fee-for-Service	1326231713	1326231713	1	1	FAMILY HEALTH CENTER OF	8/9/2024	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	SAN DIEGO	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
20972	Fee-for-Service	1194747196	1194747196	1	1	FEINBERG, HOWARD L DO	10/15/2021	207RR0500X	NA	Other	026	PHYSICIANS	15007	None	None	0	In state provider	None	1805 N CALIFORNIA ST	201	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
20973	Fee-for-Service	1972685659	1972685659	1	1	FISHER, DAVID A LMFT	8/23/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1806 MARTIN LUTHER KING	#4	BERKELEY	CA	94709	2227	01	06001	37.87393991	-122.2733008	Alameda County
21000	Fee-for-Service	1497808711	1497808711	1	1	FIRSTMED AMBULANCE SERVICES,	8/13/2007	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	13915 SATICOY ST	None	PANORAMA CITY	CA	91402	6521	19	06037	34.21036264	-118.4360357	Los Angeles County
21013	Fee-for-Service	1972204253	1972204253	1	1	FAMILY MEDICAL TRANSPORTATIO	11/14/2023	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N LLC	16888 NISQUALLI RD	#200	VICTORVILLE	CA	92395	9703	36	06071	34.48549065	-117.2953211	San Bernardino County
21053	Fee-for-Service	1861923724	1861923724	1	1	FIREMAN, EMILY A MD	8/3/2020	207R00000X	NA	Other	026	PHYSICIANS	159532	41	Internal Medicine	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
21244	Fee-for-Service	1548729122	1548729122	1	1	FULL POTENTIAL SPEECH THERAP	9/13/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	Y CENTER, INC	27393 YNEZ RD STE 153	None	TEMECULA	CA	92591	4605	33	06065	33.50698549	-117.1502918	Riverside County
21247	Fee-for-Service	1538429998	1538429998	1	1	FARSHCHI, ANNAHITA MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121162	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
21254	Fee-for-Service	1326231713	1326231713	1	1	FAMILY HEALTH CENTER OF	6/22/2022	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
21300	Fee-for-Service	1003199357	1003199357	1	1	FOUNDING FATHERS HEALTH CARE	10/22/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1307 WEST SIXTH ST	SUITE 205	CORONA	CA	92882	8247	33	06065	33.87790309	-117.589666	Riverside County
21301	Fee-for-Service	1669069878	1669069878	1	1	FEENSTRA, JESSICA LMFT	1/31/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
21336	Fee-for-Service	1578572145	1578572145	1	1	FELAHY-AL AZAWI A MEDICAL	5/9/2011	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	40702	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	16660 PARAMOUNT BLVD	STE 105	PARAMOUNT	CA	90723	5457	19	06037	33.882723	-118.1599535	Los Angeles County
21351	Fee-for-Service	1881772598	1881772598	1	1	FRINK, RAYMOND J MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65671	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
21370	Fee-for-Service	1881358331	1881358331	1	1	FELIX, ALFONSO PT	11/10/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	15095 AMARGOSA RD	SUITE 104	VICTORVILLE	CA	92394	1875	36	06071	34.52479785	-117.3303132	San Bernardino County
21384	Fee-for-Service	1255342945	1255342945	1	1	FLEMING, CAROLYN M MD	2/2/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	21471	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
21386	Fee-for-Service	1164477428	1164477428	1	1	FOX, DAN E MD	10/31/1984	207P00000X	NA	Other	026	PHYSICIANS	54824	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
21396	Fee-for-Service	1720104615	1720104615	1	1	FANNON, LAURA E PHD	11/13/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	49	06097	38.26876442	-122.6598332	Sonoma County
21434	Fee-for-Service	1295778090	1295778090	1	1	FERNANDEZ, JORGE A MD	5/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83383	66	Emergency Medicine (Urgent Care)	0	In state provider	EMERGENCY DEPT.	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
21471	Fee-for-Service	1619350485	1619350485	1	1	FOX, BRUCE D MD	8/28/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	150463	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
21496	Fee-for-Service	1609431998	1609431998	1	1	FOUNTAIN VALLEY SENIOR HOMES	11/18/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	17690 SAN VICENTE	None	FOUNTAIN VALLEY	CA	92708	5261	30	06059	33.70608	-117.950692	Orange County
21511	Fee-for-Service	1396703435	1396703435	1	1	FRIEDEN, ILONA J MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	38622	07	Dermatology	0	In state provider	None	400 PARNASSUS AVE	# 316	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
21541	Fee-for-Service	1326231713	1326231713	1	1	FAMILY HEALTH CENTER OF	2/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SAN DIEGO	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
21574	Fee-for-Service	1922453133	1922453133	1	1	FOONG, SENG YUE JOSHUA DO	6/25/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22659	08	Family Practice	0	In state provider	None	11030 BOLLINGER CANYON R	SUITE 250	SAN RAMON	CA	94582	4874	07	06013	37.77383963	-121.9239786	Contra Costa County
21589	Fee-for-Service	1710058789	1710058789	1	1	FLEISCHMAN, JOSHUA T MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	64805	08	Family Practice	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
21594	Fee-for-Service	1396594347	1396594347	1	1	FREEMAN-ROSS, JAMIE G BIRTH	6/14/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	56	06111	0	0	None
21639	Fee-for-Service	1013161843	1013161843	1	1	FLEISHER, CARL A MD	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	112794	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.07067	-118.4432445	Los Angeles County
21667	Fee-for-Service	1891456596	1891456596	1	1	FIRST SIGNATURE HOME HEALTH	1/23/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	225 E BROADWAY	SUITE 211C	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
21670	Fee-for-Service	1255342945	1255342945	1	1	FLEMING, CAROLYN M MD	2/2/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	21471	01	General Practice	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
21691	Fee-for-Service	1528565868	1528565868	1	1	FINE, KERRY E DO	7/21/2023	208600000X	NA	General Surgery	026	PHYSICIANS	18114	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
21776	Fee-for-Service	1942239041	1942239041	1	1	FAVREAU,JOYA T MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63726	41	Internal Medicine	0	In state provider	None	444 S SAN VICENTE BLVD	None	LOS ANGELES	CA	90048	4165	19	06037	34.06999878	-118.3755119	Los Angeles County
21794	Fee-for-Service	1922768159	1922768159	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	992 O STREET	None	FIREBAUGH	CA	93622	2221	10	06019	36.8600251	-120.4577148	Fresno County
21798	Fee-for-Service	1396703435	1396703435	1	1	FRIEDEN, ILONA J MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	38622	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	# 316	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
21808	Fee-for-Service	1518120625	1518120625	1	1	FIGUEROA, HEATHER R MD	5/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129315	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	STE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
21823	Fee-for-Service	1396875712	1396875712	1	1	FOOTHILL EMERGENCY PHYS.	2/28/1986	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP	1812 VERDUGO BLVD	None	GLENDALE	CA	91208	1407	19	06037	34.20560177	-118.216054	Los Angeles County
21931	Fee-for-Service	1679018873	1679018873	1	1	FLAGSTAFF INTENSIVE CARE SPE	1/16/2021	363LA2100X	NA	Nurse Practitioner	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	2	Out of state provider	CIALISTS, PLLC	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
21947	Fee-for-Service	1346272424	1346272424	1	1	FRANZ RISCHARD DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
21983	Fee-for-Service	1851127484	1851127484	1	1	FARRALES, JACQUELINE NP	3/13/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
22005	Fee-for-Service	1538137575	1538137575	1	1	FIDDLER, DANIEL S MD	5/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	842 E MAIN STREET	None	MEDFORD	OR	97504	7155	00	None	42.32787853	-122.863311	Jackson County
22040	Fee-for-Service	1376550913	1376550913	1	1	FRIEDLANDER, MICHAEL P MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	58604	41	Internal Medicine	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
22082	Fee-for-Service	1922768159	1922768159	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	992 O STREET	None	FIREBAUGH	CA	93622	2221	10	06019	36.8600251	-120.4577148	Fresno County
22092	Fee-for-Service	1295878221	1295878221	1	1	FOROUZANNIA, ARMAN MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108639	30	Radiology	0	In state provider	None	101 E VALENCIA DR	None	FULLERTON	CA	92835	3809	30	06059	33.8662563	-117.9241995	Orange County
22093	Fee-for-Service	1609824127	1609824127	1	1	FOSTER, LAURA M MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73962	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	4000	01	06001	37.69212528	-121.8803442	Alameda County
22127	Fee-for-Service	1427034602	1427034602	1	1	FIELD, RONALD J MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	23915	40	Pediatrics	0	In state provider	None	1108 VINE ST	None	PASO ROBLES	CA	93446	2597	40	06079	35.62589234	-120.6938603	San Luis Obispo County
22139	Fee-for-Service	1891252912	1891252912	1	1	FONTELA, RAMONA S CNP	8/20/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2760 FLETCHER PKWY	None	EL CAJON	CA	92020	2110	37	06073	32.80015674	-117.0036982	San Diego County
22176	Fee-for-Service	1790369577	1790369577	1	1	FORD, RACHELLE G MD	5/3/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184464	08	Family Practice	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
22199	Fee-for-Service	1730725268	1730725268	1	1	FRENCH, WENDY D NP	6/1/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
22230	Fee-for-Service	1164429015	1164429015	1	1	FUJITANI, ROY M MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	54101	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
22288	Fee-for-Service	1538259197	1538259197	1	1	FOSTER, DONALD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1 CHILDRENS WAY	None	LITTLE ROCK	AR	72202	3500	00	None	34.742745	-92.2927905	Pulaski County
22317	Fee-for-Service	1568882512	1568882512	1	1	FOREVER HOSPICE INC	7/18/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14550 ARCHWOOD ST	SUITE 101	VAN NUYS	CA	91405	4604	19	06037	34.19290331	-118.4504678	Los Angeles County
22344	Fee-for-Service	1053870303	1053870303	1	1	FOLEY, MEGAN A MD	6/30/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	179026	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
22350	Fee-for-Service	1841071925	1841071925	1	1	FILIPPI, TIFFANY C RCP	11/16/2023	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
22453	Fee-for-Service	1134155229	1134155229	1	1	FISHER, MICHAEL	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
22499	Fee-for-Service	1609888767	1609888767	1	1	FU, XING CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5300 GEARY BLVD	STE 315	SAN FRANCISCO	CA	94121	2355	38	06075	37.78055056	-122.4764152	San Francisco County
22591	Fee-for-Service	1730267535	1730267535	1	1	FOOKS, TREVOR GRAEME MD	1/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63964	36	Psychiatry	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
22606	Fee-for-Service	1841626116	1841626116	1	1	FREE AT LAST COMMUNITY	5/3/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	RECOVERY AND REHAB SVS	1095 WEEKS STREET	1085 SUITES A, B	EAST PALO ALTO	CA	94303	1341	41	06081	37.47026995	-122.1310875	San Mateo County
22607	Fee-for-Service	1568882512	1568882512	1	1	FOREVER HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14550 ARCHWOOD ST	SUITE 101	VAN NUYS	CA	91405	4604	19	06037	34.19290331	-118.4504678	Los Angeles County
22662	Fee-for-Service	1326686197	1326686197	1	1	FRANKLIN HOSPICE INC	12/14/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7630 VINELAND AVE	STE 203	SUN VALLEY	CA	91352	4535	19	06037	34.209189	-118.3703025	Los Angeles County
22737	Fee-for-Service	1760516140	1760516140	1	1	FORD, LUCY K LCSW	12/3/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	15728	-	NOT APPLICABLE	0	In state provider	None	24 EAST MAIN STREET	None	VENTURA	CA	93001	2660	56	06111	34.28096357	-119.3003485	Ventura County
22784	Fee-for-Service	1225020845	1225020845	1	1	FONTAINE, ARTHUR B MD	7/20/2004	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	59286	30	Radiology	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
22843	Fee-for-Service	1275897647	1275897647	1	1	FARAHMAND, FARHOOD MD	5/3/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169073	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
22902	Fee-for-Service	1609384940	1609384940	1	1	FAMILY HEALTHCARE NETWORK	6/26/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	255 N HERWALDT DRIVE	None	FRESNO	CA	93701	2186	10	06019	36.745794	-119.7834345	Fresno County
22934	Fee-for-Service	1669917118	1669917118	1	1	FERGUSON, LAKEINA S LMFT	12/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
22936	Fee-for-Service	1447284732	1447284732	1	1	FISCHER, CARMEN I MD	3/11/2021	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	85164	None	None	0	In state provider	None	9802 STOCKDALE HWY	SUITE 105	BAKERSFIELD	CA	93311	3653	15	06029	35.3544067	-119.1113372	Kern County
22950	Fee-for-Service	1326686197	1326686197	1	1	FRANKLIN HOSPICE INC	12/14/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7630 VINELAND AVE	STE 203	SUN VALLEY	CA	91352	4535	19	06037	34.209189	-118.3703025	Los Angeles County
22993	Fee-for-Service	1043394653	1043394653	1	1	FARINHA, JOSE B MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	24184	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
23017	Fee-for-Service	1609431998	1609431998	1	2	FOUNTAIN VALLEY SENIOR HOMES	10/5/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	18561 SANTA ISADORA	None	FOUNTAIN VALLEY	CA	92708	5621	30	06059	33.69313076	-117.9785233	Orange County
23104	Fee-for-Service	1710464854	1710464854	1	1	FISCHER, SIMONE PT	12/13/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
23153	Fee-for-Service	1073713657	1073713657	1	2	FRIEDLICH, DANIEL L MD	11/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99737	14	Neurological Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
23190	Fee-for-Service	1609384940	1609384940	1	1	FAMILY HEALTHCARE NETWORK	7/21/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	255 N HERWALDT DRIVE	None	FRESNO	CA	93701	2186	10	06019	36.745794	-119.7834345	Fresno County
23197	Fee-for-Service	1326482357	1326482357	1	1	FLANAGAN, REBECCA C DO	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13864	01	General Practice	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
23202	Fee-for-Service	1093276792	1093276792	1	1	FERNANDES, KAREN MD	10/19/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	185600	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
23222	Fee-for-Service	1427118744	1427118744	1	1	FLANAGAN, JANET A LCSW	3/23/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO ST	PLM 3	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
23281	Fee-for-Service	1528308053	1528308053	1	1	FOLMAR, JOHN L	8/6/2013	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	533 AIRPORT BLVD	STE 400	BURLINGAME	CA	94010	2013	41	06081	37.5900636	-122.3408061	San Mateo County
23345	Fee-for-Service	1922056134	1922056134	1	1	FITTS, JAMES M MD	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132359	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
23352	Fee-for-Service	1154354629	1154354629	1	1	FLAGEL, JEREMY D MD	4/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96061	36	Psychiatry	0	In state provider	None	5353 MISSION CENTER RD	STE 224	SAN DIEGO	CA	92108	1304	37	06073	32.77207362	-117.154699	San Diego County
23396	Fee-for-Service	1356632830	1356632830	1	1	FLAMENCO, SANDRA LMFT	3/7/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
23472	Fee-for-Service	1518159649	1518159649	1	1	FOKAS, PHILLIP LMFT	6/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
23477	Fee-for-Service	1821101577	1821101577	1	1	FORSTER, MICHAEL C	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	45060	08	Family Practice	0	In state provider	None	101 HOSPITAL RD	None	SONORA	CA	95370	5227	55	06109	37.9744944	-120.3778743	Tuolumne County
23478	Fee-for-Service	1609384940	1609384940	1	1	FAMILY HEALTHCARE NETWORK	6/26/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	255 N HERWALDT DRIVE	None	FRESNO	CA	93701	2186	10	06019	36.745794	-119.7834345	Fresno County
23479	Fee-for-Service	1982043212	1982043212	1	1	FISHMAN, DANIEL O MD	8/11/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	169228	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
23493	Fee-for-Service	1356436380	1356436380	1	1	FAMILY PLANNING ASSOCIATES M	5/1/1988	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	EDICAL GROUP INC	24241 HAWTHORNE BLVD	SUITE 201	TORRANCE	CA	90505	6504	19	06037	33.802578	-118.351229	Los Angeles County
23507	Fee-for-Service	1417297847	1417297847	1	18	FIRST CHOICE PHYSICIAN PARTN	9/11/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	16611 YORBA LINDA	None	YORBA LINDA	CA	92886	2046	30	06059	33.88840251	-117.8442157	Orange County
23520	Fee-for-Service	1053532366	1053532366	1	1	FIELD, SARAH S MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121800	03	Allergy	0	In state provider	None	455 S MAIN ST	ALLERGY DEPT	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
23594	Fee-for-Service	1306180518	1306180518	1	1	FRANZA, KATELYN M LCSW	11/1/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	72139	-	NOT APPLICABLE	0	In state provider	None	726 POLK STREET	4TH FLOOR	SAN FRANCISCO	CA	94109	7813	38	06075	37.78379532	-122.4192766	San Francisco County
23616	Fee-for-Service	1770528390	1770528390	1	1	FISHBEIN, MICHAEL C MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22677	22	Pathology (M.D. only)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
23694	Fee-for-Service	1710194121	1710194121	1	1	FISHER, STEPHEN A MD	10/1/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	9997	-	NOT APPLICABLE	0	In state provider	None	925 BROCKHURST ST	None	OAKLAND	CA	94608	4222	01	06001	37.82348261	-122.2769038	Alameda County
23702	Fee-for-Service	1962732487	1962732487	1	1	FRY, SHEILA M	8/26/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
23721	Fee-for-Service	1164721726	1164721726	1	1	FOX, CASEY A DO	11/27/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12877	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
23726	Fee-for-Service	1205831161	1205831161	1	1	FIERER, ADAM S MD	1/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69685	02	General Surgery	0	In state provider	None	2385 S MELROSE DR	None	VISTA	CA	92081	8788	37	06073	33.14409946	-117.2417711	San Diego County
23770	Fee-for-Service	1821101577	1821101577	1	1	FORSTER, MICHAEL C	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	45060	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 HOSPITAL RD	None	SONORA	CA	95370	5227	55	06109	37.9744944	-120.3778743	Tuolumne County
23806	Fee-for-Service	1891105565	1891105565	1	1	FARSHIDPOUR, MAHAM MD	7/1/2021	208M00000X	NA	Other	026	PHYSICIANS	172105	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
23810	Fee-for-Service	1497829238	1497829238	1	1	FRANCOIS, LISSA N MD	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138465	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
23906	Fee-for-Service	1699260265	1699260265	1	1	FATEHI, NIMA MD	12/22/2021	207R00000X	NA	Other	026	PHYSICIANS	174174	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
23959	Fee-for-Service	1063437879	1063437879	1	1	FLIPPEN II, CHARLES C MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85434	13	Neurology (M.D. only)	0	In state provider	None	300 UCLA PLAZA DR STE B2	None	LOS ANGELES	CA	90095	0001	19	06037	34.06465655	-118.4461	Los Angeles County
24081	Fee-for-Service	1336189042	1336189042	1	1	FOSTER, MARK S MD	7/31/1995	207P00000X	NA	Other	026	PHYSICIANS	61041	01	General Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
24097	Fee-for-Service	1255042966	1255042966	1	1	FOSTER, TONI	2/23/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	33	06065	0	0	None
24154	Fee-for-Service	1740249432	1740249432	1	1	FISHMAN, ELENA MD	8/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78221	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
24179	Fee-for-Service	1669730909	1669730909	1	1	FAROOQI, SARA M MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136969	None	None	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
24213	Fee-for-Service	1063874303	1063874303	1	1	FRANCOIS, GINA MD	6/29/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
24262	Fee-for-Service	1922187657	1922187657	1	1	FU, LINLIN MD	9/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87170	30	Radiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
24275	Fee-for-Service	1770898108	1770898108	1	1	FOLBRECHT, JEANELLE PHD	11/30/2000	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
24346	Fee-for-Service	1962580605	1962580605	1	1	FERNANDO, CHRISTINE E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33155	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
24359	Fee-for-Service	1417297847	1417297847	1	26	FIRST CHOICE PHYSICIAN PARTN	7/17/2019	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	3650 E SOUTH ST	STE 404	LAKEWOOD	CA	90712	1508	19	06037	33.8601747	-118.1494013	Los Angeles County
24368	Fee-for-Service	1609057041	1609057041	1	1	FONG, DEAN DO	12/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9526	90	Pathology-Forensic	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
24472	Fee-for-Service	1003271149	1003271149	1	1	FUENTES, LORENA L CNP	4/8/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	415 W ROUTE 66	STE 202	GLENDORA	CA	91740	4335	19	06037	34.12883848	-117.869958	Los Angeles County
24476	Fee-for-Service	1033458153	1033458153	1	1	FLORES TINDALL, KAYLA J MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144934	01	General Practice	0	In state provider	None	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	49	06097	38.26876442	-122.6598332	Sonoma County
24512	Fee-for-Service	1558840215	1558840215	1	1	FITCH, SARAH R LMFT	2/10/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1041 E YORBA LINDA BLVD	202	PLACENTIA	CA	92870	3760	30	06059	33.88848865	-117.8451029	Orange County
24591	Fee-for-Service	1528327327	1528327327	1	1	FREEDMAN, JARYD T MD	8/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140335	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
24607	Fee-for-Service	1932486172	1932486172	1	2	FAN, WEN H LMFT	7/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
24633	Fee-for-Service	1801945357	1801945357	1	1	FELDMAN, SANFORD G MD	12/11/2007	207W00000X	NA	Ophthalmology	026	PHYSICIANS	45627	18	Ophthalmology	0	In state provider	None	3737 MORAGA AVE	STE A105	SAN DIEGO	CA	92117	5458	37	06073	32.8086683	-117.2109991	San Diego County
24672	Fee-for-Service	1245938463	1245938463	1	1	FABELLA, ARMAND CITO NP	8/16/2023	2251P0200X	NA	Physical Therapist	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
24696	Fee-for-Service	1699071753	1699071753	1	1	FACULTY MEDICAL GROUP	9/26/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	47	Miscellaneous	0	In state provider	OF LLUSM	28078 BAXTER RD	None	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
24697	Fee-for-Service	1629415120	1629415120	1	1	FRANCO, ARMANDO L MD INC	9/19/1996	193400000X	NA	Other	026	PHYSICIANS	48696	None	None	0	In state provider	None	12810 HEACOCK ST	SUITE B206	MORENO VALLEY	CA	92553	3170	33	06065	33.934851	-117.2437635	Riverside County
24718	Fee-for-Service	1366481384	1366481384	1	1	FERRERA, PETER P MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	56381	41	Internal Medicine	0	In state provider	None	1045 ATLANTIC AVE	STE 505	LONG BEACH	CA	90813	3422	19	06037	33.780267	-118.1850795	Los Angeles County
24820	Fee-for-Service	1164524229	1164524229	1	1	FISCHER, DAVID J MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73898	22	Pathology (M.D. only)	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
24861	Fee-for-Service	1770594798	1770594798	1	1	FUSTER, JOAQUIN MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	23213	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	STE 38159	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
24879	Fee-for-Service	1972921641	1972921641	1	1	FERNANDEZ, CARLOS R MD	8/1/2018	207L00000X	NA	Other	026	PHYSICIANS	152780	05	Anesthesiology	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
24899	Fee-for-Service	1306372073	1306372073	1	1	FACULTY PHYSICIANS	6/30/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	& SURGEONS OF LLUSM	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
24910	Fee-for-Service	1396125134	1396125134	1	1	FLAMMIA, JEAN M MD	10/7/2020	207P00000X	NA	Other	026	PHYSICIANS	170037	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
24957	Fee-for-Service	1710998422	1710998422	1	1	FERGUSON, THOMAS J MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63228	66	Emergency Medicine (Urgent Care)	0	In state provider	UCD PROFESS GROUP	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
24965	Fee-for-Service	1053499764	1053499764	1	1	FRANCIS, LYNETTE C MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	53084	01	General Practice	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
24985	Fee-for-Service	1699071753	1699071753	1	1	FACULTY MEDICAL GROUP	9/26/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	OF LLUSM	28078 BAXTER RD	None	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
25015	Fee-for-Service	1831166461	1831166461	1	1	FRYDMAN, HOWARD C MD	10/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	33958	34	Urology and Urological Surgery	0	In state provider	None	2625 W ALAMEDA AVE	STE 404	BURBANK	CA	91505	4817	19	06037	34.1577056	-118.329779	Los Angeles County
25075	Fee-for-Service	1962433458	1962433458	1	1	FAMILY HEALTH CTRS OF SD	5/1/2003	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
25108	Fee-for-Service	1942449772	1942449772	1	1	FISHMAN, DEBRA PHD	6/22/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4900 BROADWAY	None	SACRAMENTO	CA	95820	1532	34	06067	38.546091	-121.447305	Sacramento County
25109	Fee-for-Service	1457693848	1457693848	1	1	FAST, ANGELA M MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131936	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
25114	Fee-for-Service	1003922691	1003922691	1	1	FURLONG, MICHAEL T MD	5/31/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	84894	18	Ophthalmology	0	In state provider	None	2107 N 1ST ST	STE 101	SAN JOSE	CA	95131	2019	43	06085	37.37486601	-121.9196266	Santa Clara County
25151	Fee-for-Service	1255446308	1255446308	1	1	FISHER, GEORGE A MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	65330	41	Internal Medicine	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
25187	Fee-for-Service	1306372073	1306372073	1	1	FACULTY PHYSICIANS	10/29/2019	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	& SURGEONS OF LLUSM	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
25247	Fee-for-Service	1699749911	1699749911	1	1	FARRIS, REUBEN M MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	39917	08	Family Practice	0	In state provider	PROVIDERS MEDICAL GROUP	340 4TH AVE	STE 2	CHULA VISTA	CA	91910	3883	37	06073	32.63831293	-117.0833536	San Diego County
25274	Fee-for-Service	1699071753	1699071753	1	1	FACULTY MEDICAL GROUP	9/26/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	OF LLUSM	28078 BAXTER RD	None	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
25280	Fee-for-Service	1104128198	1104128198	1	1	FISHER, REBECCA A LCSW	5/3/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	748 N MARKET ST	None	REDDING	CA	96003	3606	45	06089	40.5960907	-122.38781	Shasta County
25325	Fee-for-Service	1154589810	1154589810	1	1	FISHER, JERRON L MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106850	30	Radiology	0	In state provider	None	1700 S COURT ST	SUITE F	VISALIA	CA	93277	4931	54	06107	36.315108	-119.2916925	Tulare County
25356	Fee-for-Service	1962433458	1962433458	1	1	FAMILY HEALTH CTRS OF SD	5/1/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
25439	Fee-for-Service	1255446308	1255446308	1	1	FISHER, GEORGE A MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	65330	78	Neoplastic Diseases/Oncology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
25461	Fee-for-Service	1205886645	1205886645	1	1	FLINN, ANNA M L DO	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	9033	15	Obstetrics (D.O. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
25463	Fee-for-Service	1487885372	1487885372	1	3	FOOTHILLS PAIN MANAGEMENT CL	8/1/2024	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	INIC	1828 CESAR E CHAVEZ AVE	STE 4500	LOS ANGELES	CA	90033	2577	19	06037	34.05023174	-118.2154927	Los Angeles County
25475	Fee-for-Service	1306372073	1306372073	1	1	FACULTY PHYSICIANS	12/16/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	& SURGEONS OF LLUSM	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
25501	Fee-for-Service	1851301964	1851301964	1	1	FUNK, GARY R OD	3/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
25502	Fee-for-Service	1578653259	1578653259	1	1	FORMAN, LISA M MD	4/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
25581	Fee-for-Service	1124133574	1124133574	1	1	FONG, EDWARD C W MD	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87813	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
25584	Fee-for-Service	1285742528	1285742528	1	1	FU, KETIH S MD	1/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	35073	41	Internal Medicine	0	In state provider	None	1851 N RIVERSIDE AVE	None	RIALTO	CA	92376	8069	36	06071	34.133238	-117.3704145	San Bernardino County
25596	Fee-for-Service	1770631574	1770631574	1	1	FELDMAN, STEFANIE A MD	8/8/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66571	24	Plastic Surgery	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
25639	Fee-for-Service	1417297847	1417297847	1	24	FIRST CHOICE PHYSICIAN PARTN	9/14/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	3851 KATELLA AVE	SUITE 220	LOS ALAMITOS	CA	90720	3309	30	06059	33.80319053	-118.0657305	Orange County
25671	Fee-for-Service	1467437905	1467437905	1	1	FADUL, PAMELA MD	11/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86948	05	Anesthesiology	0	In state provider	None	332 S JUNIPER ST	STE 108	ESCONDIDO	CA	92025	4941	37	06073	33.12066536	-117.0770413	San Diego County
25689	Fee-for-Service	1215961073	1215961073	1	1	FLAHERTY, HEATHER L MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76925	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
25723	Fee-for-Service	1770946063	1770946063	1	1	FERGUSON, AUBREY Y MD	2/18/2019	207P00000X	NA	Other	026	PHYSICIANS	153025	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
25749	Fee-for-Service	1205886645	1205886645	1	1	FLINN, ANNA M L DO	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	9033	09	Gynecology (D.O. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
25791	Fee-for-Service	1578653259	1578653259	1	1	FORMAN, LISA M MD	4/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
25806	Fee-for-Service	1104993062	1104993062	1	1	FRIED, MARC W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35361	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
25842	Fee-for-Service	1699327692	1699327692	1	1	FAMILY SPRING PSYCHOLOGY, P.	12/20/2022	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	C.	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
25870	Fee-for-Service	1124133574	1124133574	1	1	FONG, EDWARD C W MD	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87813	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
25871	Fee-for-Service	1477663870	1477663870	1	1	FARYAN, MARK W DO	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5644	01	General Practice	0	In state provider	None	704 MOUNTAIN RANCH RD	STE 103	SAN ANDREAS	CA	95249	9707	05	06009	38.188881	-120.6695385	Calaveras County
25885	Fee-for-Service	1770631574	1770631574	1	1	FELDMAN, STEFANIE A MD	8/8/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66571	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
25926	Fee-for-Service	1750755732	1750755732	1	1	FAVORITE CARE HOME HEALTH	9/24/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1415 E COLORADO ST	STE 211	GLENDALE	CA	91205	1541	19	06037	34.14279663	-118.2333245	Los Angeles County
25932	Fee-for-Service	1417297847	1417297847	1	20	FIRST CHOICE PHYSICIAN PARTN	3/10/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	11180 WARNER AVE	SUITE 167	FOUNTAIN VALLEY	CA	92708	7515	30	06059	33.71632048	-117.9334575	Orange County
25936	Fee-for-Service	1396054235	1396054235	1	1	FUENTES, HERMINIA I LCSW	4/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	76295	-	NOT APPLICABLE	0	In state provider	None	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	19	06037	33.98965917	-118.287673	Los Angeles County
25938	Fee-for-Service	1124025051	1124025051	1	1	FREEDMAN PETER EM	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33020	36	Psychiatry	0	In state provider	None	3031 TELEGRAPH AVE	STE 103	BERKELEY	CA	94705	2052	01	06001	37.85506766	-122.259871	Alameda County
25984	Fee-for-Service	1396111886	1396111886	1	1	FRESENIUS MEDICAL CARE OF	5/23/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	GLENDALE, LLC	623 S CENTRAL AVE	None	GLENDALE	CA	91204	2008	19	06037	34.137864	-118.257886	Los Angeles County
26003	Fee-for-Service	1558312330	1558312330	1	1	FINKEL, MICHELLE A MD	12/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	71379	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
26062	Fee-for-Service	1417297847	1417297847	1	7	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	16671 YORBA LINDA BLVD	SUITE 200	YORBA LINDA	CA	92886	2025	30	06059	33.8884134	-117.8435449	Orange County
26107	Fee-for-Service	1063517506	1063517506	1	1	FISHER, HENRY K MD	4/9/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28508	-	NOT APPLICABLE	0	In state provider	None	4023 MARINE AVE.	None	LAWNDALE	CA	90260	1840	19	06037	33.89468047	-118.344636	Los Angeles County
26117	Fee-for-Service	1699327692	1699327692	1	2	FAMILY SPRING PSYCHOLOGY, P.	10/28/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C.	2400 LAS GALLINAS AVE	135	SAN RAFAEL	CA	94903	1447	21	06041	38.03313103	-122.5443973	Marin County
26130	Fee-for-Service	1699327692	1699327692	1	1	FAMILY SPRING PSYCHOLOGY, P.	12/20/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	C.	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
26135	Fee-for-Service	1649576752	1649576752	2	1	FRASER, HEATHER A LCSW	8/13/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	104 E OLIVE AVE	SUITE 201	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
26281	Fee-for-Service	1528446093	1528446093	1	1	FULLER, PETER C MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
26306	Fee-for-Service	1700473063	1700473063	1	1	FAVIA, HEIDI A LMFT	4/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
26375	Fee-for-Service	1083084594	1083084594	1	1	FONG, DANIEL J	5/18/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
26384	Fee-for-Service	1710130521	1710130521	1	1	FLOWE, CODY LEE CRNA	2/8/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2615	15	06029	35.38333823	-119.0188872	Kern County
26412	Fee-for-Service	1720647381	1720647381	1	1	FRANCILLON, LYDIE MD	12/19/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181815	None	None	0	In state provider	None	8110 LAGUNA BLVD	None	ELK GROVE	CA	95758	7904	34	06067	38.421306	-121.408173	Sacramento County
26419	Fee-for-Service	1699327692	1699327692	1	1	FAMILY SPRING PSYCHOLOGY, P.	12/20/2022	103TC0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	C.	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
26443	Fee-for-Service	1144205154	1144205154	1	1	FENTON, JOSHUA MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63697	08	Family Practice	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
26495	Fee-for-Service	1164611075	1164611075	1	1	FLORA, GURDIP S MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	43194	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1172 SWALLOW LANE	None	SIMI VALLEY	CA	93065	3154	56	06111	34.26008797	-118.7941068	Ventura County
26534	Fee-for-Service	1821291337	1821291337	1	1	FIFE, BENJAMIN E PSYD	10/8/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1700 PIERCE ST	STE 103	SAN FRANCISCO	CA	94115	6114	38	06075	37.78590598	-122.436579	San Francisco County
26599	Fee-for-Service	1609058064	1609058064	1	1	FORENO INC	3/10/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	MEDICINE SHOPPE	195 W SHAW AVE	STE 101	CLOVIS	CA	93612	3700	10	06019	36.80861152	-119.713212	Fresno County
26697	Fee-for-Service	1952617524	1952617524	1	1	FARRAR, MARIA L NP	5/22/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3349 G STREET	SUITE F	MERCED	CA	95340	0978	24	06047	37.32432497	-120.4693064	Merced County
26702	Fee-for-Service	1770789448	1770789448	1	1	FREEMAN, MICHAEL B MD	2/8/2015	208200000X	NA	General Surgery	026	PHYSICIANS	103459	24	Plastic Surgery	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
26707	Fee-for-Service	1699327692	1699327692	1	1	FAMILY SPRING PSYCHOLOGY, P.	12/20/2022	103TC0700X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	C.	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
26727	Fee-for-Service	1710326558	1710326558	1	1	FISCHMAN, MICHAEL A MD	10/18/2018	207RN0300X	NA	Nephrology	026	PHYSICIANS	155691	45	Nephrology (Renal-Kidney)	0	In state provider	None	3300 E SOUTH ST	STE 308	LONG BEACH	CA	90805	4598	19	06037	33.86018093	-118.1537163	Los Angeles County
26731	Fee-for-Service	1386886166	1386886166	1	1	FEJES, JOHN M MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106647	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
26783	Fee-for-Service	1164611075	1164611075	1	1	FLORA, GURDIP S MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	43194	41	Internal Medicine	0	In state provider	None	1172 SWALLOW LANE	None	SIMI VALLEY	CA	93065	3154	56	06111	34.26008797	-118.7941068	Ventura County
26878	Fee-for-Service	1396700704	1396700704	1	1	FRANKS, THERESA M MD	11/30/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80309	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	100 E VALENCIA MESA DR	STE 310	FULLERTON	CA	92835	3800	30	06059	33.89343304	-117.9279349	Orange County
26890	Fee-for-Service	1588694475	1588694475	1	1	FARRAG, YASSER E MD	7/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81307	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
26972	Fee-for-Service	1548813041	1548813041	1	1	FAMILIES TOGETHER OF ORANGE	10/6/2020	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	COUNTY	9918 W KATELLA AVE	SUITE A&C	ANAHEIM	CA	92804	6465	30	06059	33.80307047	-117.959688	Orange County
26994	Fee-for-Service	1699327692	1699327692	1	1	FAMILY SPRING PSYCHOLOGY, P.	5/7/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	C.	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
27035	Fee-for-Service	1992236756	1992236756	1	1	FRIEDMAN, NATHAN A MD	3/26/2021	207P00000X	NA	Other	026	PHYSICIANS	155699	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
27053	Fee-for-Service	1891140497	1891140497	1	1	FRANKS, ARIEL A MD	2/14/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	155039	08	Family Practice	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
27111	Fee-for-Service	1376602953	1376602953	1	1	FAJOLU, OLUWOLE MD	7/13/2012	208G00000X	NA	General Surgery	026	PHYSICIANS	39634	01	General Practice	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
27137	Fee-for-Service	1346297165	1346297165	1	1	FRISANCHO, JUAN C MD	3/25/2008	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	68291	20	Orthopedic Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
27197	Fee-for-Service	1194350793	1194350793	1	1	FOCKLER, JOSHUA P	2/11/2021	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1215 MONROE	None	RED BLUFF	CA	96080	3103	52	06103	40.17995806	-122.243023	Tehama County
27233	Fee-for-Service	1578832192	1578832192	1	1	FISCHER, SVETLANA MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127824	41	Internal Medicine	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
27268	Fee-for-Service	1225546575	1225546575	1	2	FAMILY HEALTHCARE NETWORK	10/2/2018	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2315 E ILLINOIS AVE	None	FRESNO	CA	93701	2219	10	06019	36.74505638	-119.783366	Fresno County
27282	Fee-for-Service	1699327692	1699327692	1	1	FAMILY SPRING PSYCHOLOGY, P.	4/4/2024	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	C.	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
27342	Fee-for-Service	1427402601	1427402601	1	1	FRYE, JOSEPH MD	10/19/2021	207ZP0102X	NA	Other	026	PHYSICIANS	154055	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
27383	Fee-for-Service	1417297847	1417297847	1	8	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	16671 YORBA LINDA BLVD	SUITE 100	YORBA LINDA	CA	92886	2025	30	06059	33.8884134	-117.8435449	Orange County
27414	Fee-for-Service	1730550534	1730550534	1	1	FERRERO, EDWARD PSYD	12/16/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3925 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
27416	Fee-for-Service	1780095026	1780095026	1	1	FREID, LAUREN MD	6/28/2019	207RR0500X	NA	Other	026	PHYSICIANS	161339	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
27453	Fee-for-Service	1154590768	1154590768	1	1	FUNG, EWINA M MD	8/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102484	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	99 N LA CIENEGA	None	BEVERLY HILLS	CA	90211	2222	19	06037	34.06736471	-118.3763201	Los Angeles County
27492	Fee-for-Service	1194194571	1194194571	1	1	FIRST ACUPUNCTURE & HERB	10/1/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	9400 CATTARAUGUS AVE	None	LOS ANGELES	CA	90034	2341	19	06037	34.03616148	-118.3942016	Los Angeles County
27548	Fee-for-Service	1689967309	1689967309	1	1	FRANCIS, WILLIAM O MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126820	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
27560	Fee-for-Service	1134354483	1134354483	1	1	FAN, WEI L MD	2/1/2019	282N00000X	NA	Hospitals	026	PHYSICIANS	153972	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
27577	Fee-for-Service	1750729976	1750729976	1	1	FRANKEL, JASON	10/6/2023	208800000X	NA	Other	026	PHYSICIANS	191419	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
27607	Fee-for-Service	1497789747	1497789747	1	1	FIELDS, KATHERINE S MD	2/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98484	07	Dermatology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
27705	Fee-for-Service	1780095026	1780095026	1	1	FREID, LAUREN MD	6/28/2019	207RR0500X	NA	Other	026	PHYSICIANS	161339	83	Rheumatology	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
27754	Fee-for-Service	1548348634	1548348634	1	1	FONG, BRYAN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36979	01	General Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
27884	Fee-for-Service	1750306932	1750306932	1	1	FLORES, EDITH MD	6/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77785	41	Internal Medicine	0	In state provider	None	100 MEDICAL PLAZA SUITE	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
27931	Fee-for-Service	1528604543	1528604543	1	1	FULLARD, KRISTY L NP	5/11/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3751 E SHIELDS AVE	None	FRESNO	CA	93726	0000	10	06019	36.7796958	-119.7618088	Fresno County
27934	Fee-for-Service	1083816284	1083816284	1	1	FARROHI, ALIREZA C MD	2/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100111	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
27964	Fee-for-Service	1568093045	1568093045	1	1	FEDORUK, KELLY ANNE MD	10/5/2020	207L00000X	NA	Other	026	PHYSICIANS	144015	05	Anesthesiology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
27980	Fee-for-Service	1255602470	1255602470	1	1	FOWLER, MARIE A LCSW	5/5/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
28008	Fee-for-Service	1982068201	1982068201	1	2	FIRSTCARE PHARMACY LLC	2/8/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18555 VENTURA BLVD	STE A	TARZANA	CA	91356	4192	19	06037	34.16958413	-118.5380552	Los Angeles County
28034	Fee-for-Service	1871600866	1871600866	1	1	FREEMAN, GREGORY L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4411 MEDICAL DR	STE 300O	SAN ANTONIO	TX	78229	3822	00	None	29.51000304	-98.57210273	Bexar County
28172	Fee-for-Service	1831523711	1831523711	1	1	FANNING, DORENE	4/16/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8421 AUBURN BLVD	SUITE 110	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
28228	Fee-for-Service	1467410019	1467410019	2	1	FARAVARDEH, ARMAN MD	7/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	94375	45	Nephrology (Renal-Kidney)	0	In state provider	None	8551 CENTER DR	STE 505	LA MESA	CA	91942	3032	37	06073	32.77902014	-117.0137093	San Diego County
28243	Fee-for-Service	1033572110	1033572110	1	1	FUNG, DEBORAH MD	12/27/2022	207R00000X	NA	Other	026	PHYSICIANS	181968	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
28310	Fee-for-Service	1831520048	1831520048	1	1	FAMILY HEALTHCARE NETWORK	1/16/2014	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	9416 ROAD 238	None	TERRA BELLA	CA	93270	9400	54	06107	35.96072962	-119.0399481	Tulare County
28311	Fee-for-Service	1225441058	1225441058	1	1	FRIEDMAN, ALEXANDER DO	7/28/2017	207R00000X	NA	Other	026	PHYSICIANS	14266	41	Internal Medicine	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
28336	Fee-for-Service	1720386956	1720386956	1	1	FLAX HOLDINGS LLC	6/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9000 LARKIN ROAD	None	LIVE OAK	CA	95953	9599	51	06101	39.26227064	-121.6599965	Sutter County
28350	Fee-for-Service	1932486172	1932486172	1	1	FAN, WEN H LMFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	93489	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
28394	Fee-for-Service	1376663740	1376663740	1	1	FEINSTEIN, BARRY DPM	12/1/2002	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	12840 RIVERSIDE DR	STE 204	NORTH HOLLYWOOD	CA	91607	3341	19	06037	34.15759054	-118.4129775	Los Angeles County
28526	Fee-for-Service	1023552528	1023552528	1	1	FELDMAN, NATALIA E	4/27/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
28599	Fee-for-Service	1831520048	1831520048	1	1	FAMILY HEALTHCARE NETWORK	1/16/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	9416 ROAD 238	None	TERRA BELLA	CA	93270	9400	54	06107	35.96072962	-119.0399481	Tulare County
28628	Fee-for-Service	1366156952	1366156952	1	1	FOR THE VILLAGE INC	2/24/2023	374J00000X	NA	Other	107	DOULA GROUP PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
28629	Fee-for-Service	1750525267	1750525267	1	1	FITZGERALD, KIMBERLY A MD	1/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132788	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
28701	Fee-for-Service	1912389578	1912389578	1	1	FOO, PATRICIA K MD	9/27/2019	207R00000X	NA	Other	026	PHYSICIANS	164632	41	Internal Medicine	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
28713	Fee-for-Service	1659885622	1659885622	1	1	FRAZIER, TALA L LCSW	9/29/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2000 W BRIGGSMORE AVE	STE I	MODESTO	CA	95350	3839	50	06099	37.67139252	-121.0281273	Stanislaus County
28723	Fee-for-Service	1033535216	1033535216	1	2	FIGG, JONATHAN A MD	11/5/2019	207R00000X	NA	Other	026	PHYSICIANS	164977	41	Internal Medicine	0	In state provider	None	2960 CAMINO DIABLO	105	WALNUT CREEK	CA	94597	3988	07	06013	37.89859467	-122.0843018	Contra Costa County
28763	Fee-for-Service	1992080618	1992080618	1	1	FARNAD, SHAHBAZ A MD	2/16/2023	163WG0000X	NA	Other	026	PHYSICIANS	149636	None	None	0	In state provider	None	5757 WILSHIRE BLVD	PROMENADE 2	LOS ANGELES	CA	90036	5810	19	06037	34.0624504	-118.3534253	Los Angeles County
28801	Fee-for-Service	1578306486	1578306486	1	1	FERGUSON, WENDY LMFT	6/28/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28465 OLD TOWN FRONT ST	STE 221	TEMECULA	CA	92590	1822	33	06065	33.49566437	-117.1516462	Riverside County
28842	Fee-for-Service	1205914066	1205914066	1	1	FORSTER, JILL D MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	56504	20	Orthopedic Surgery	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
28896	Fee-for-Service	1831520048	1831520048	1	1	FAMILY HEALTHCARE NETWORK	1/16/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	9416 ROAD 238	None	TERRA BELLA	CA	93270	9400	54	06107	35.96072962	-119.0399481	Tulare County
28897	Fee-for-Service	1912953993	1912953993	1	1	FOLLETT, FOREST W MD	10/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	39048	66	Emergency Medicine (Urgent Care)	0	In state provider	None	48677 VICTORIA LN	None	OAKHURST	CA	93644	9216	20	06039	37.32772782	-119.6601883	Madera County
28925	Fee-for-Service	1912264128	1912264128	1	1	FINNERAN, JOHN J IV MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128102	05	Anesthesiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
28928	Fee-for-Service	1053488957	1053488957	1	1	FARRIER, JEFFREY M MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74048	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
29001	Fee-for-Service	1578298451	1578298451	1	1	FRIGAULT, MELISSA LORENA M	7/12/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	8104 BODEGA AVE	None	SEBASTOPOL	CA	95472	3116	49	06097	38.39812953	-122.8412618	Sonoma County
29097	Fee-for-Service	1124681812	1124681812	1	1	FONTENOT, VIRGINIA E MD	8/8/2023	390200000X	NA	Other	026	PHYSICIANS	185787	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
29172	Fee-for-Service	1831520048	1831520048	1	1	FAMILY HEALTHCARE NETWORK	12/16/2014	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	9416 ROAD 238	None	TERRA BELLA	CA	93270	9400	54	06107	35.96072962	-119.0399481	Tulare County
29186	Fee-for-Service	1093855991	1093855991	1	1	FULWIDER, THOMAS MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	41774	66	Emergency Medicine (Urgent Care)	0	In state provider	None	768 MOUNTAIN RANCH RD	None	SAN ANDREAS	CA	95249	9707	05	06009	38.19058212	-120.6709481	Calaveras County
29216	Fee-for-Service	1700856713	1700856713	1	1	FAERBER, WADE DO	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	6291	20	Orthopedic Surgery	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
29219	Fee-for-Service	1902163694	1902163694	1	1	FENG, MALLORY W MD	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142958	36	Psychiatry	0	In state provider	None	565 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38903016	-122.0819046	Santa Clara County
29289	Fee-for-Service	1578298451	1578298451	1	1	FRIGAULT, MELISSA LORENA M	7/12/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	8104 BODEGA AVE	None	SEBASTOPOL	CA	95472	3116	49	06097	38.39812953	-122.8412618	Sonoma County
29297	Fee-for-Service	1992487680	1992487680	1	1	FAZLI, ZARGHONA AU	12/29/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
29360	Fee-for-Service	1427385475	1427385475	1	1	FIRETAG, BRANDIE L MD	5/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112721	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	3701 S HIGUERA STREET	None	SAN LUIS OBISPO	CA	93401	7462	40	06079	35.2507845	-120.6712168	San Luis Obispo County
29362	Fee-for-Service	1639381387	1639381387	1	1	FAJARDO, MICHELLE A DO	6/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9558	22	Pathology (M.D. only)	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
29387	Fee-for-Service	1568728939	1568728939	1	1	FOELLER, MEGAN E MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141690	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
29543	Fee-for-Service	1063675601	1063675601	1	1	FORD, JONATHAN B	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111458	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
29567	Fee-for-Service	1427234673	1427234673	1	1	FALLBROOK HOSPITAL	2/29/2008	193400000X	NA	Other	018	NURSE ANESTHETISTS	-	05	Anesthesiology	0	In state provider	CORPORATION	624 E ELDER ST	None	FALLBROOK	CA	92028	3099	37	06073	33.38020455	-117.2446307	San Diego County
29604	Fee-for-Service	1477710028	1477710028	1	1	FOSTER, CURTIS A MD	6/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	55593	08	Family Practice	0	In state provider	None	1627 E ANAHEIM STREET	None	LONG BEACH	CA	90813	3809	19	06037	33.78263549	-118.171296	Los Angeles County
29622	Fee-for-Service	1093015992	1093015992	1	1	FARAC, LAUREN N MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129635	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
29652	Fee-for-Service	1396289716	1396289716	1	1	FANDIALAN, JAMES L LPCC	5/25/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2150 N 1ST ST	650	SAN JOSE	CA	95131	2031	43	06085	37.37699728	-121.9208292	Santa Clara County
29656	Fee-for-Service	1730965971	1730965971	1	1	FAMILY HEALTHCARE NETWORK	3/8/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	939 SOUTH 12TH AVENUE	None	HANFORD	CA	93230	5705	16	06031	36.31855998	-119.673081	Kings County
29745	Fee-for-Service	1821450024	1821450024	1	1	FAKHRI, MOHAMMAD M MD	6/9/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165736	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
29769	Fee-for-Service	1144391046	1144391046	1	1	FEIZBAKHSH, FARZIN MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79543	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
29776	Fee-for-Service	1730212788	1730212788	1	1	FRIEDMAN, MARC L MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	50208	30	Radiology	0	In state provider	None	444 S SAN VICENTE BLVD	FL 1	LOS ANGELES	CA	90048	4165	19	06037	34.06999878	-118.3755119	Los Angeles County
29783	Fee-for-Service	1568749570	1568749570	1	1	FIRST CHOICE ANESTHESIA CONS	3/25/2021	207LP2900X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ULTANTS OF NORTHERN CALI	455 PLUMAS	None	YUBA CITY	CA	95991	5074	51	06101	39.13180779	-121.6136017	Sutter County
29839	Fee-for-Service	1821228669	1821228669	1	1	FOUNTAIN VALLEY ANESTHE	9/1/2009	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SIOLOGY MEDICAL ASSOCIAT	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
29840	Fee-for-Service	1730511999	1730511999	1	1	FLEENER, RICHARD D AU	12/10/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
29842	Fee-for-Service	1316919731	1316919731	1	1	FISHER, JOAN M MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	72808	68	Hematology	0	In state provider	None	3700 CALIFORNIA ST	#B 1/4 FL	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
29905	Fee-for-Service	1972923217	1972923217	1	1	FLYNN, SEAN MD	10/3/2022	390200000X	NA	Other	026	PHYSICIANS	139420	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
29915	Fee-for-Service	1619776168	1619776168	1	1	FREEMAN, KIMBERLY	3/11/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
29941	Fee-for-Service	1255659215	1255659215	1	1	FUJIMOTO, MICHELLE L DO	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11190	None	None	0	In state provider	None	2141 N HARBOR BLVD	STE 25000	FULLERTON	CA	92835	3830	30	06059	33.89443025	-117.9288328	Orange County
29944	Fee-for-Service	1730965971	1730965971	1	1	FAMILY HEALTHCARE NETWORK	3/8/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	939 SOUTH 12TH AVENUE	None	HANFORD	CA	93230	5705	16	06031	36.31855998	-119.673081	Kings County
29974	Fee-for-Service	1750796181	1750796181	1	1	FREEMAN, JENNIFER R LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
30020	Fee-for-Service	1144607466	1144607466	1	1	FLOWERS, AARRON DPM	7/9/2018	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2907 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	44	06087	36.98793933	-121.9782322	Santa Cruz County
30131	Fee-for-Service	1316919731	1316919731	1	1	FISHER, JOAN M MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	72808	40	Pediatrics	0	In state provider	None	3700 CALIFORNIA ST	#B 1/4 FL	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
30140	Fee-for-Service	1063948370	1063948370	1	1	FAUSETT, CAMERON L MD	9/9/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	172865	None	None	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
30158	Fee-for-Service	1487115317	1487115317	1	1	FARRAJI, HAMOUDI DO	6/15/2022	207R00000X	NA	Other	026	PHYSICIANS	19405	None	None	0	In state provider	None	555 WASHINGTON STREET	None	SAN DIEGO	CA	92103	2289	37	06073	32.74986289	-117.1599343	San Diego County
30202	Fee-for-Service	1194826594	1194826594	1	1	FERGUSON, DIANNA P MD	12/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	77697	41	Internal Medicine	0	In state provider	None	11539 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	2325	19	06037	33.929352	-118.352747	Los Angeles County
30209	Fee-for-Service	1033452834	1033452834	1	1	FORSYTHE, MICHELLE S	1/23/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12062 VALLEY VIEW ST	STE 137	GARDEN GROVE	CA	92845	1741	30	06059	33.78720885	-118.028413	Orange County
30337	Fee-for-Service	1750599684	1750599684	1	1	FAMILY HEALTH CENTERS OF SAN	7/1/2023	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CENTER	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
30360	Fee-for-Service	1356350805	1356350805	1	1	FARSAD, G REZA H MD	11/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37865	02	General Surgery	0	In state provider	SUITE 103	1401 N PALM CANYON DR	None	PALM SPRINGS	CA	92262	4434	33	06065	33.841269	-116.546807	Riverside County
30376	Fee-for-Service	1669588414	1669588414	1	1	FALK, ERIKA P PHD	6/16/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
30380	Fee-for-Service	1235153552	1235153552	1	1	FOX, KENNETH A MD	3/9/2020	208G00000X	NA	General Surgery	026	PHYSICIANS	154681	33	Thoracic Surgery	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
30406	Fee-for-Service	1568766483	1568766483	1	1	FENSTER, ALDA M LCSW	9/18/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1487 E CHEVY CHASE DR	None	GLENDALE	CA	91206	4008	19	06037	34.15195587	-118.2327541	Los Angeles County
30490	Fee-for-Service	1255454211	1255454211	1	1	FELIX,LINDA J	4/5/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
30518	Fee-for-Service	1043787583	1043787583	1	1	FORTITUDE HOME HEALTH INC	9/17/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	520 N BROOKHURST ST	SUITE 134	ANAHEIM	CA	92801	5235	30	06059	33.838974	-117.959013	Orange County
30549	Fee-for-Service	1811037831	1811037831	1	1	FEASTER, WILLIAM W MD	1/1/1990	207L00000X	NA	Other	026	PHYSICIANS	34947	05	Anesthesiology	0	In state provider	None	3001 COLBY ST	# AT	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
30559	Fee-for-Service	1952646960	1952646960	1	1	FROYD, JON D DO	3/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12531	08	Family Practice	0	In state provider	None	2500 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3156	07	06013	38.00658519	-122.1309063	Contra Costa County
30584	Fee-for-Service	1336191949	1336191949	1	1	FRIEDLAND, JEROME R MD	1/25/1999	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	30198	20	Orthopedic Surgery	0	In state provider	None	18039 SHERMAN WAY	None	RESEDA	CA	91335	4630	19	06037	34.2012275	-118.5266565	Los Angeles County
30615	Fee-for-Service	1114085669	1114085669	1	1	FITZGERALD, MARYSHEILA A	3/24/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	8915 TOWNE CENTRE	None	SAN DIEGO	CA	92122	5650	37	06073	32.86767898	-117.2071838	San Diego County
30664	Fee-for-Service	1427048321	1427048321	1	1	FLAIG, KEVIN MD	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	62226	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23700 IRIS AVE	None	MORENO VALLEY	CA	92388	0000	33	06065	33.888429	-117.2248788	Riverside County
30669	Fee-for-Service	1295781219	1295781219	1	1	FACULTY MEDICAL GROUP OF	3/1/1995	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	LLUSM	25865 BARTON ROAD	STE 101	LOMA LINDA	CA	92354	3896	36	06071	34.04824853	-117.2403225	San Bernardino County
30721	Fee-for-Service	1922217918	1922217918	1	1	FLORES, ROBERTO C MD	6/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107447	05	Anesthesiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
30755	Fee-for-Service	1215977335	1215977335	1	1	FENTON, ANDREW N MD	6/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89316	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
30837	Fee-for-Service	1598704926	1598704926	1	1	FORISTER, JULIE F OD	9/14/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 STEIN PLAZA	RM-1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
30915	Fee-for-Service	1982027546	1982027546	1	1	FOSTER, JACQUELINE D PHD	12/26/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
30930	Fee-for-Service	1629012323	1629012323	1	1	FARINACCI, JOHN F JR MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42826	66	Emergency Medicine (Urgent Care)	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
30959	Fee-for-Service	1295781219	1295781219	1	1	FACULTY MEDICAL GROUP OF	3/1/1995	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	LLUSM	25865 BARTON ROAD	STE 101	LOMA LINDA	CA	92354	3896	36	06071	34.04824853	-117.2403225	San Bernardino County
30962	Fee-for-Service	1225036627	1225036627	1	1	FRIPP, RAYMOND R MD	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50679	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
31001	Fee-for-Service	1861073033	1861073033	1	1	FLEXEN, BRIANNE NP	9/13/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25000 AVENUE STANFORD	167	VALENCIA	CA	91355	4553	19	06037	34.43847322	-118.5729968	Los Angeles County
31039	Fee-for-Service	1225677107	1225677107	1	1	FERNANDEZ, VHERNNA OT	1/23/2020	225XN1300X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1610 ARDEN WAY	SUITE 195	SACRAMENTO	CA	95815	4035	34	06067	38.598597	-121.42863	Sacramento County
31054	Fee-for-Service	1457596272	1457596272	1	1	FEARS, SCOTT C MD	7/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87169	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
31095	Fee-for-Service	1750578803	1750578803	1	1	FUJIWARA, MIKA MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	105060	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
31096	Fee-for-Service	1033246137	1033246137	1	1	FORDE, HEATHER PSYD	10/30/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
31194	Fee-for-Service	1700859352	1700859352	1	1	FORREST, MICHAEL R MD	11/30/1982	2085R0001X	NA	Other	026	PHYSICIANS	38437	30	Radiology	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
31196	Fee-for-Service	1326714775	1326714775	1	1	FOREVER YOUNG CBAS	8/24/2023	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	8265 FOOTHILL BLVD	None	SUNLAND	CA	91040	2807	19	06037	34.25971751	-118.31346	Los Angeles County
31212	Fee-for-Service	1659785962	1659785962	1	1	FE, ALEXANDER Z MD	8/19/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	172925	None	None	0	In state provider	None	9850 GENESEE AVE	STE 780	LA JOLLA	CA	92037	1232	37	06073	32.882913	-117.226341	San Diego County
31236	Fee-for-Service	1437546546	1437546546	1	1	FLANNERY, KATE L LMFT	8/7/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
31250	Fee-for-Service	1225036627	1225036627	1	1	FRIPP, RAYMOND R MD	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50679	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
31338	Fee-for-Service	1578124863	1578124863	1	1	FISHER, JONATHAN M MD	4/12/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	179884	None	None	0	In state provider	None	26585 W AGOURA ROAD	330	CALABASAS	CA	91302	1958	19	06037	34.14240621	-118.7027109	Los Angeles County
31369	Fee-for-Service	1437471455	1437471455	1	1	FLOREA, ANDREW S MD INC	9/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	83181	None	None	0	In state provider	None	1174 NEVADA ST	STE 100	REDLANDS	CA	92374	2893	36	06071	34.068636	-117.217434	San Bernardino County
31470	Fee-for-Service	1144626649	1144626649	1	1	FOOTHILL HEALTH CENTER	11/15/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	9460 NO NAME UNO	STE 110	GILROY	CA	95020	3536	43	06085	37.037781	-121.570965	Santa Clara County
31482	Fee-for-Service	1942837604	1942837604	1	1	FRIEND, LAUREN MD	8/9/2023	207P00000X	NA	Other	026	PHYSICIANS	185485	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
31526	Fee-for-Service	1598776452	1598776452	1	1	FANALE, CHRISTOPHER V. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	499 E HAMPDEN AVE	STE 360	ENGLEWOOD	CO	80113	3877	00	None	39.65319046	-104.982129	Arapahoe County
31560	Fee-for-Service	1720453475	1720453475	1	1	FORT, CARLA M LPCC	11/17/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
31622	Fee-for-Service	1245338102	1245338102	1	1	FAJARDO, GINELLE V	3/23/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	215 N STATE COLLEGE BLVD	STE G	ANAHEIM	CA	92806	2932	30	06059	33.84270255	-117.8893257	Orange County
31637	Fee-for-Service	1396751533	1396751533	1	1	FELDMAN, CLIFFORD R MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	78112	36	Psychiatry	0	In state provider	None	4911 VAN NUYS BLVD	# 102	SHERMAN OAKS	CA	91403	1716	19	06037	34.1596563	-118.4487403	Los Angeles County
31658	Fee-for-Service	1790890341	1790890341	1	1	FULLER, CLARK B MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76647	33	Thoracic Surgery	0	In state provider	None	8635 W 3RD ST	# 975-W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
31695	Fee-for-Service	1164741906	1164741906	1	1	FIERO, MARIE L MD	6/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156179	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
31727	Fee-for-Service	1043289317	1043289317	1	1	FELDMAN, MARTIN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	24107	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1310 W STEWART DR	STE 606	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
31758	Fee-for-Service	1144626649	1144626649	1	1	FOOTHILL HEALTH CENTER	10/25/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	9460 NO NAME UNO	STE 110	GILROY	CA	95020	3536	43	06085	37.037781	-121.570965	Santa Clara County
31821	Fee-for-Service	1457308868	1457308868	1	1	FEALY, MIKE P MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	63961	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6412 LAUREL AVE	None	LAKE ISABELLA	CA	93240	9529	15	06029	35.63564004	-118.407037	Kern County
31822	Fee-for-Service	1205938727	1205938727	1	1	FIVE STAR MEDICAL TRANS	12/23/2003	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	MAGDALENO, MIGUEL A	895 PALOMAR ST	STE E	CHULA VISTA	CA	91911	2627	37	06073	32.60451466	-117.0919661	San Diego County
31938	Fee-for-Service	1659725562	1659725562	1	1	FINK, REBECCA MD	9/18/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	159345	40	Pediatrics	0	In state provider	None	9600 CUYAMACA ST	STE 101-104	SANTEE	CA	92071	2692	37	06073	32.85158542	-116.9835131	San Diego County
31953	Fee-for-Service	1306393269	1306393269	1	1	FORSYTHE, SHAUNA J LMFT	6/15/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
31955	Fee-for-Service	1821071283	1821071283	1	1	FERGUSON, AMY L	3/9/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
31958	Fee-for-Service	1740435502	1740435502	1	1	FAMILY MEDICINE CENTER OF	12/7/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	TORRANCE	2841 LOMITA BLVD	SUITE 220	TORRANCE	CA	90505	5111	19	06037	33.80997064	-118.3374754	Los Angeles County
31970	Fee-for-Service	1225116320	1225116320	1	1	FORTH, DAVID S MD	7/9/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	25568	01	General Practice	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
31972	Fee-for-Service	1407342918	1407342918	1	1	FRIEDMAN, JEREMY A MD	8/13/2024	207L00000X	NA	Other	026	PHYSICIANS	173904	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
32016	Fee-for-Service	1558724435	1558724435	1	1	FAMILY CARE HOME HEALTH	6/20/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY INC	15643 SHERMAN WAY	SUITE 210	VAN NUYS	CA	91406	8202	19	06037	34.20128049	-118.474155	Los Angeles County
32046	Fee-for-Service	1144626649	1144626649	1	1	FOOTHILL HEALTH CENTER	3/30/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	9460 NO NAME UNO	STE 110	GILROY	CA	95020	3536	43	06085	37.037781	-121.570965	Santa Clara County
32153	Fee-for-Service	1336274885	1336274885	1	1	FRANCISCO, RICA M PHD	11/3/2008	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	SUITE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
32214	Fee-for-Service	1801042015	1801042015	1	1	FLEMING, JAKE E DO	1/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11169	08	Family Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
32259	Fee-for-Service	1992026876	1992026876	1	1	FAZZONE, MARIE I LMFT	12/8/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	120045	-	NOT APPLICABLE	0	In state provider	None	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	12	06023	40.89808837	-124.0923819	Humboldt County
32264	Fee-for-Service	1154446771	1154446771	1	1	FULTZ, ANNE M	2/24/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	609 E ORANGEBURG AVE	STE 201	MODESTO	CA	95350	5512	50	06099	37.66364947	-120.9857985	Stanislaus County
32334	Fee-for-Service	1144626649	1144626649	1	1	FOOTHILL HEALTH CENTER	3/30/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	9460 NO NAME UNO	STE 110	GILROY	CA	95020	3536	43	06085	37.037781	-121.570965	Santa Clara County
32340	Fee-for-Service	1508333154	1508333154	1	1	FOREMAN-BOGGUS, MICHELE C LC	5/19/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
32412	Fee-for-Service	1124181102	1124181102	1	1	FOURNARAKIS,BILL M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	747 BROADWAY	None	SEATTLE	WA	98122	4307	00	None	47.608326	-122.3207985	King County
32480	Fee-for-Service	1922033034	1922033034	1	1	FOPPIANO, LINDA E MD	12/31/1989	207L00000X	NA	Other	026	PHYSICIANS	55839	05	Anesthesiology	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
32499	Fee-for-Service	1821144478	1821144478	1	1	FRIEDMAN, JENNIFER RL MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87128	13	Neurology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
32543	Fee-for-Service	1871662304	1871662304	1	1	FLANNERY, TIMOTHY K MD	10/29/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72809	09	Gynecology (D.O. only)	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
32720	Fee-for-Service	1912953936	1912953936	1	4	FAIRBANKS & POWER PHYSICAL T	1/9/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	29992 HUNTER RD	SUITE 106	MURRIETA	CA	92563	4765	33	06065	33.56887078	-117.1376697	Riverside County
32803	Fee-for-Service	1003520065	1003520065	1	1	FMC 26, PC	1/31/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	14547 VICTORY BLVD	None	VAN NUYS	CA	91411	1619	19	06037	34.18668853	-118.450395	Los Angeles County
32840	Fee-for-Service	1043605652	1043605652	1	1	FANG, CHARLES X MD	6/23/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	145290	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
32843	Fee-for-Service	1699899872	1699899872	1	2	FERRER, RIZALDY R PHD	2/14/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	317 E FOOTHILL BLVD	STE 208	ARCADIA	CA	91006	2600	19	06037	34.15112348	-118.0221697	Los Angeles County
32851	Fee-for-Service	1447579917	1447579917	1	1	FELDMAN, LISA A MD	5/11/2018	207T00000X	NA	General Surgery	026	PHYSICIANS	154662	14	Neurological Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
32884	Fee-for-Service	1861569873	1861569873	1	1	FEINSTEIN, RONALD F MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40965	24	Plastic Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
32986	Fee-for-Service	1265556344	1265556344	1	1	FISHER, ORNA MD	1/1/2023	208200000X	NA	General Surgery	026	PHYSICIANS	132303	None	None	0	In state provider	None	327 SAN MATEO DR,	SUITE 4	SAN MATEO	CA	94401	2585	41	06081	37.57156972	-122.3318678	San Mateo County
33007	Fee-for-Service	1912953936	1912953936	1	4	FAIRBANKS & POWER PHYSICAL T	7/25/2024	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	& SPORTS MEDICINE	29992 HUNTER RD	SUITE 106	MURRIETA	CA	92563	4765	33	06065	33.56887078	-117.1376697	Riverside County
33010	Fee-for-Service	1356061527	1356061527	1	1	FOUNTAIN, JUNE K NP	3/15/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
33024	Fee-for-Service	1487327813	1487327813	1	1	FOX OPS LLC	5/26/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	16 COLEMAN PLACE	None	MENLO PARK	CA	94025	2406	41	06081	37.46266839	-122.16127	San Mateo County
33180	Fee-for-Service	1164654604	1164654604	1	1	FAYAD, VICTOR MD	3/1/2019	207R00000X	NA	Other	026	PHYSICIANS	136874	41	Internal Medicine	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
33199	Fee-for-Service	1164650487	1164650487	1	1	FRANKO, ORRIN I MD	12/4/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	113473	20	Orthopedic Surgery	0	In state provider	None	13690 E 14TH ST STE 200	None	SAN LEANDRO	CA	94578	2584	01	06001	37.71615361	-122.1438999	Alameda County
33229	Fee-for-Service	1467985705	1467985705	1	1	FARCHADI, DAVID MD	6/30/2020	207R00000X	NA	Other	026	PHYSICIANS	162131	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
33235	Fee-for-Service	1841398542	1841398542	1	1	FRATINO, CHRISTINE V DO	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	8629	01	General Practice	0	In state provider	None	2200 O'FARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
33244	Fee-for-Service	1790851442	1790851442	1	1	FRID, ALEXANDER B DO	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6891	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
33310	Fee-for-Service	1801361944	1801361944	1	1	FISK, CYLA G LMFT	5/13/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	107 S FAIR OAKS AVENUE	310	PASADENA	CA	91105	2010	19	06037	34.14383611	-118.1504823	Los Angeles County
33334	Fee-for-Service	1457322885	1457322885	1	1	FORT BEND COUNTY AMBULANCE	7/16/2008	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4336 HIGHWAY 36 S	None	ROSENBERG	TX	77471	9108	00	None	29.51821742	-95.80793684	Fort Bend County
33464	Fee-for-Service	1629239744	1629239744	1	1	FOX, PAIGE M MD	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109837	24	Plastic Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
33486	Fee-for-Service	1164650487	1164650487	1	1	FRANKO, ORRIN I MD	12/4/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	113473	46	Hand Surgery	0	In state provider	None	13690 E 14TH ST STE 200	None	SAN LEANDRO	CA	94578	2584	01	06001	37.71615361	-122.1438999	Alameda County
33491	Fee-for-Service	1952884884	1952884884	1	1	FRIEDMAN, DEBBI J LCSW	10/4/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
33512	Fee-for-Service	1679153704	1679153704	1	1	FULTON, MELODY R DO	4/10/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20336	08	Family Practice	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
33552	Fee-for-Service	1770598534	1770598534	1	1	FAZILAT, BAHAREH	6/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90071	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
33556	Fee-for-Service	1154854230	1154854230	1	1	FARZAM, DAVID M MD	7/1/2021	207L00000X	NA	Other	026	PHYSICIANS	156927	None	None	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
33630	Fee-for-Service	1720115033	1720115033	1	1	FAMILY HEALTH CARE CENTERS	8/15/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	GREATER LOS ANGELES INC	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	19	06037	33.97292523	-118.1475473	Los Angeles County
33650	Fee-for-Service	1841237153	1841237153	1	1	FORRESTER, CHERI J MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	47860	08	Family Practice	0	In state provider	None	655 REDWOOD HWY	STE 375	MILL VALLEY	CA	94941	3041	21	06041	37.8918372	-122.5169699	Marin County
33652	Fee-for-Service	1750899175	1750899175	1	1	FIRST AID HEALTH CARE INC	1/21/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	19231 VICTORY BLVD	STE 555	RESEDA	CA	91335	1923	19	06037	34.18659852	-118.552221	Los Angeles County
33696	Fee-for-Service	1447633383	1447633383	1	1	FOLSOM CARDIOLOGY INC	8/1/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	100423	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1600 CREEKSIDE DRIVE	SUITE 3300	FOLSOM	CA	95630	3444	34	06067	38.669994	-121.147488	Sacramento County
33839	Fee-for-Service	1205316437	1205316437	1	1	FREIGE, CAITLIN LCSW	9/24/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
33918	Fee-for-Service	1720115033	1720115033	1	1	FAMILY HEALTH CARE CENTERS	8/15/2003	261QC1500X	NA	Other	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	GREATER LOS ANGELES INC	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	19	06037	33.97292523	-118.1475473	Los Angeles County
33924	Fee-for-Service	1417297847	1417297847	1	3	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1325 N ROSE DR	SUITE 100	PLACENTIA	CA	92870	3800	30	06059	33.8868003	-117.8420447	Orange County
33925	Fee-for-Service	1417297847	1417297847	1	27	FIRST CHOICE PHYSICIAN PARTN	10/15/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	1325 N ROSE DR	SUITE 210	PLACENTIA	CA	92870	3840	30	06059	33.8868003	-117.8420447	Orange County
33931	Fee-for-Service	1023350303	1023350303	1	2	FLORY, MARTA N MD	5/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133948	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
34026	Fee-for-Service	1417319757	1417319757	1	1	FREEMAN, JENNIFER S MD	1/9/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	None	07	Dermatology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
34059	Fee-for-Service	1053461459	1053461459	1	1	FELDMAN, MAURICE	1/31/1990	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1420 E LOS ANGELES AVE	STE B	SIMI VALLEY	CA	93065	7805	56	06111	34.27162848	-118.7715555	Ventura County
34235	Fee-for-Service	1952481004	1952481004	1	1	FITZPATRICK, MICHAEL MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86507	20	Orthopedic Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
34277	Fee-for-Service	1447222955	1447222955	1	1	FRITOCK, MARIA D MD	7/1/2018	207LP3000X	NA	Other	026	PHYSICIANS	155002	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
34290	Fee-for-Service	1225698590	1225698590	1	1	FAGUNDES, NICOLE M LMFT	6/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
34321	Fee-for-Service	1710474887	1710474887	1	1	FILLINGER, BROOKLYN R MD	8/17/2023	207L00000X	NA	Other	026	PHYSICIANS	176164	None	None	0	In state provider	None	1328 22ND ST	None	SANTA MONICA	CA	90404	2032	19	06037	34.03122319	-118.4797185	Los Angeles County
34354	Fee-for-Service	1295975951	1295975951	1	1	FAVAZZA, MICHAEL R MD	10/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	106010	40	Pediatrics	0	In state provider	None	9333 IMPERIAL HIGHWAY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
34394	Fee-for-Service	1134284995	1134284995	1	1	FELLOWS, SHEILA A	8/3/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1441 ALAMO STREET	None	MONTARA	CA	94037	0995	41	06081	37.5354877	-122.4939126	San Mateo County
34456	Fee-for-Service	1912953936	1912953936	1	3	FAIRBANKS & POWER PHYSICAL T	7/31/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	949 S STATE ST	None	HEMET	CA	92543	7182	33	06065	33.73230496	-116.9716029	Riverside County
34492	Fee-for-Service	1962475541	1962475541	1	1	FRENCH, WILLIAM J MD	9/30/1986	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	24524	01	General Practice	0	In state provider	None	1124 W CARSON ST	BLDG A1	TORRANCE	CA	90502	2006	19	06037	33.83154152	-118.2954105	Los Angeles County
34633	Fee-for-Service	1427344522	1427344522	1	1	FONG, BRIAN M	6/11/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17100 NORWALK BLVD	STE 107	CERRITOS	CA	90703	2750	19	06037	33.87557796	-118.0725386	Los Angeles County
34644	Fee-for-Service	1285851337	1285851337	1	1	FREDERICK M COSTELLO	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	ST LUKE'S REGIONAL MD	3525 E LOUISE DR	STE 400	MERIDIAN	ID	83642	0000	00	None	43.601931	-116.349894	Ada County
34655	Fee-for-Service	1932783107	1932783107	1	1	FANG, MELODY MD	10/14/2024	390200000X	NA	Other	026	PHYSICIANS	186410	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
34687	Fee-for-Service	1467981340	1467981340	1	1	FOURIE, KAREN Y MD	3/22/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165344	None	None	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
34769	Fee-for-Service	1447680301	1447680301	1	1	FLETSCHER, WALTER L MD INC	5/5/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	48644	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2510 AIRPARK DR	STE 302	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
34815	Fee-for-Service	1376997668	1376997668	1	1	FASCIANO, DANIELLE DO	7/15/2023	207ZP0102X	NA	Other	026	PHYSICIANS	21112	None	None	0	In state provider	None	6605 NANCY RIDGE DR	None	SAN DIEGO	CA	92121	2253	37	06073	32.88682438	-117.1796133	San Diego County
34829	Fee-for-Service	1730434119	1730434119	1	1	FAKIH, HAFIZ ABDUL MOIZ MD	1/9/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	-	None	None	2	Out of state provider	ENTER, INC	1910 SOUTH AVE	None	LA CROSSE	WI	54601	5467	00	None	43.79473653	-91.24623835	La Crosse County
34861	Fee-for-Service	1356342638	1356342638	1	1	FERNANDES, INGRID W MD	7/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130373	None	None	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
34874	Fee-for-Service	1891730461	1891730461	1	1	FRYE, RICHARD E MD	9/18/2019	2084N0402X	NA	Neurology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
34897	Fee-for-Service	1124561741	1124561741	1	1	FAMILY PLANNING ASSOCIATES M	6/21/2019	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1700 LOMBARD ST	STE 110	OXNARD	CA	93030	8211	56	06111	34.21699272	-119.149297	Ventura County
35079	Fee-for-Service	1003106584	1003106584	1	1	FUJITA, MARK M MD	5/6/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	154352	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
35119	Fee-for-Service	1780682617	1780682617	1	1	FREY-GITLIN, KARLA S DO	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	6450	08	Family Practice	0	In state provider	None	8501 WEST RD	None	REDWOOD VALLEY	CA	95470	9583	23	06045	39.26542262	-123.2199077	Mendocino County
35183	Fee-for-Service	1285810762	1285810762	1	1	FERRO, JODI C MD	10/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92974	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1250 LA VENTA DR	STE 105	WESTLAKE VILLAGE	CA	91361	3758	56	06111	34.14827603	-118.8227637	Ventura County
35238	Fee-for-Service	1790951606	1790951606	1	1	FONTES, JOAO DANIEL T MD	9/4/2020	207R00000X	NA	Other	026	PHYSICIANS	169557	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11180 WARNER AVE	STE 269	FOUNTAIN VALLEY	CA	92708	7516	30	06059	33.71632048	-117.9334575	Orange County
35263	Fee-for-Service	1801285960	1801285960	1	1	FRESENIUS MEDICAL CARE NORTH	2/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	COAST LLC	3300 VISTA WAY	SUITE A	OCEANSIDE	CA	92056	3632	37	06073	33.18081595	-117.3156434	San Diego County
35317	Fee-for-Service	1790700813	1790700813	1	1	FOGDALL, RICHARD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22386	05	Anesthesiology	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
35322	Fee-for-Service	1871788943	1871788943	1	1	FURLONG VISION CORRECTION	7/16/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	84894	18	Ophthalmology	0	In state provider	MEDICAL CENTER INC	2107 N 1ST STREET	STE 101	SAN JOSE	CA	95131	2019	43	06085	37.37486601	-121.9196266	Santa Clara County
35335	Fee-for-Service	1972563781	1972563781	1	1	FAY, MARK T MD	1/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	18	Ophthalmology	1	Border provider	KLAMATH OPTHALMOLOGY	2640 BIEHN ST	None	KLAMATH FALLS	OR	97601	1181	00	None	42.2454811	-121.7916325	Klamath County
35380	Fee-for-Service	1881143782	1881143782	1	1	FENESY, MICHELLE C PHD	8/4/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
35382	Fee-for-Service	1376617977	1376617977	1	1	FRIED, ROBERT A MD	4/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	53210	41	Internal Medicine	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
35440	Fee-for-Service	1386726347	1386726347	1	1	FONE, KATHRYN ELAINE	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2750 N TEXAS ST	STE 230	FAIRFIELD	CA	94533	1290	48	06095	38.277576	-122.0334705	Solano County
35502	Fee-for-Service	1609130616	1609130616	1	1	FLEISCHMANN, CHRISTINE E MD	5/17/2022	207P00000X	NA	Other	026	PHYSICIANS	156801	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
35508	Fee-for-Service	1568729424	1568729424	1	1	FAKHRI, BITA MD	8/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152281	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
35575	Fee-for-Service	1255912671	1255912671	1	1	FLETCHER, GEOFFREY M LMFT	3/14/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
35631	Fee-for-Service	1538809033	1538809033	1	1	FUTURE HEALTH CENTER INC	6/13/2022	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1000	36	06071	34.073505	-117.3505995	San Bernardino County
35707	Fee-for-Service	1174854772	1174854772	1	1	FAITH & HOPE HOME HEALTH INC	7/21/2011	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	5435 BALBOA BLVD	SUITE 110	ENCINO	CA	91316	1566	19	06037	34.16995337	-118.5011287	Los Angeles County
35809	Fee-for-Service	1437218575	1437218575	1	1	FEINBERG, BARRY J MD	3/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	24225	04	Otology, Laryngology, Rhinology	0	In state provider	None	1913 EAST 5TH ST	None	LONG BEACH	CA	90802	2024	19	06037	33.77295768	-118.1682236	Los Angeles County
35833	Fee-for-Service	1528128535	1528128535	1	1	FRANCO, AL ROBERT MD	12/1/2003	207RR0500X	NA	Other	026	PHYSICIANS	35128	83	Rheumatology	0	In state provider	ARTHRITIS CTR OF RIVERSD	4000 14TH ST	STE 511	RIVERSIDE	CA	92501	4019	33	06065	33.97771007	-117.3818381	Riverside County
35868	Fee-for-Service	1174690028	1174690028	1	1	FRANT, DAVID MD	10/24/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64416	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
35874	Fee-for-Service	1184829848	1184829848	1	1	FAROKHPAY, REZA MD	5/4/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	108097	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
35972	Fee-for-Service	1891286274	1891286274	1	1	FELDER, JENNIFER N PHD	8/27/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
35977	Fee-for-Service	1225546575	1225546575	1	5	FAMILY HEALTHCARE NETWORK	7/29/2022	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7060 N RECREATION AVE	None	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
35986	Fee-for-Service	1952849671	1952849671	1	1	FALAHATI, VEESTA MD	9/15/2023	111NI0900X	NA	Other	026	PHYSICIANS	178230	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
36017	Fee-for-Service	1043305485	1043305485	1	1	FAMILY PLANNING ASSOCIATES M	1/1/1983	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP INC	1060 N. 13TH AVE	None	UPLAND	CA	91786	3402	36	06071	34.10782111	-117.6335087	San Bernardino County
36044	Fee-for-Service	1376510321	1376510321	1	1	FREINKEL, ROBERT L MD APC	10/12/1976	207K00000X	NA	Other	026	PHYSICIANS	25328	03	Allergy	0	In state provider	None	1460 N CAMINO ALTO	SUITE 109	VALLEJO	CA	94589	2567	48	06095	38.13262019	-122.2386804	Solano County
36098	Fee-for-Service	1316018294	1316018294	1	1	FRIEDLER, ELI MD	8/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	41058	36	Psychiatry	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
36099	Fee-for-Service	1982282562	1982282562	1	1	FELIX, CHRISTIAN MD	10/28/2024	208M00000X	NA	Other	026	PHYSICIANS	191449	41	Internal Medicine	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
36124	Fee-for-Service	1528128535	1528128535	1	1	FRANCO, AL ROBERT MD	12/1/2003	207RR0500X	NA	Other	026	PHYSICIANS	35128	41	Internal Medicine	0	In state provider	ARTHRITIS CTR OF RIVERSD	4000 14TH ST	STE 511	RIVERSIDE	CA	92501	4019	33	06065	33.97771007	-117.3818381	Riverside County
36155	Fee-for-Service	1174690028	1174690028	1	1	FRANT, DAVID MD	10/24/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64416	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
36169	Fee-for-Service	1023059763	1023059763	1	1	FORMAN, STEVEN M MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85344	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3801 KATELLA AVE	STE 301	LOS ALAMITOS	CA	90720	3373	30	06059	33.80318951	-118.066068	Orange County
36174	Fee-for-Service	1992020754	1992020754	1	1	FEENEY, BENJAMIN T MD	3/1/2020	208600000X	NA	General Surgery	026	PHYSICIANS	158678	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
36210	Fee-for-Service	1124150800	1124150800	1	1	FLECK, KIMBERLY N MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	53824	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
36226	Fee-for-Service	1447222831	1447222831	1	1	FRANCISCO, GREGORY M MD	6/14/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	55149	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
36236	Fee-for-Service	1427474634	1427474634	1	1	FIAMENGO, JAIME L	6/29/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
36243	Fee-for-Service	1922325315	1922325315	1	1	FARRELLY, EWA B MD	8/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114221	08	Family Practice	0	In state provider	None	450 E SPRING STREET	SUITE 1	LONG BEACH	CA	90806	1625	19	06037	33.8099218	-118.1872346	Los Angeles County
36260	Fee-for-Service	1225079205	1225079205	1	1	FUNG, BARRY Y MD	4/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70770	18	Ophthalmology	0	In state provider	None	1816 TULLY RD	STE 288	SAN JOSE	CA	95122	4406	43	06085	37.32297177	-121.8247897	Santa Clara County
36266	Fee-for-Service	1225546575	1225546575	1	5	FAMILY HEALTHCARE NETWORK	3/23/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7060 N RECREATION AVE	None	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
36282	Fee-for-Service	1710027404	1710027404	1	1	FREEMON, RACHEL	5/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
36415	Fee-for-Service	1518322676	1518322676	1	1	FORD, MEGAN L LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
36416	Fee-for-Service	1952497943	1952497943	1	1	FISH, JEREMY M MD	2/28/1991	207R00000X	NA	Other	026	PHYSICIANS	74674	08	Family Practice	0	In state provider	None	2700 GRANT ST	#200	CONCORD	CA	94520	2270	07	06013	37.98417931	-122.0361585	Contra Costa County
36421	Fee-for-Service	1396734125	1396734125	1	1	FELKER, RICHARD MD	5/23/2023	174400000X	NA	Other	026	PHYSICIANS	163073	None	None	0	In state provider	None	1524 MCHENRY AVE	STE 100	MODESTO	CA	95350	4566	50	06099	37.666233	-120.993933	Stanislaus County
36553	Fee-for-Service	1225546575	1225546575	1	5	FAMILY HEALTHCARE NETWORK	3/23/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7060 N RECREATION AVE	None	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
36634	Fee-for-Service	1952674251	1952674251	1	1	FISHBEIN, GREGORY A MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123458	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B-186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
36696	Fee-for-Service	1407619695	1407619695	1	1	FIRST CHOICE PSYCHIATRY, A N	4/1/2024	363LP0808X	NA	Nurse Practitioner	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	URSING CORPORATION	43825 46TH ST	None	LANCASTER	CA	93536	2365	19	06037	34.67916803	-118.2127337	Los Angeles County
36702	Fee-for-Service	1093856122	1093856122	2	1	FIRST CHOICE MEDICAL	1/17/2007	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TRANSPORTATION LLC	4805 CYPRESS AVE	None	CARMICHAEL	CA	95608	1618	34	06067	38.639943	-121.352535	Sacramento County
36778	Fee-for-Service	1780695890	1780695890	1	1	FIGUERED, BRUCE V PHD	2/13/2003	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7200 PARKWAY DR	STE 113	LA MESA	CA	91942	1534	37	06073	32.77297454	-117.0419524	San Diego County
36866	Fee-for-Service	1770596330	1770596330	1	1	FRIEDLANDER, MELANIE MD	7/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85208	02	General Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 514	LOS ANGELES	CA	90033	5324	19	06037	34.06287152	-118.2029433	Los Angeles County
36877	Fee-for-Service	1972965242	1972965242	1	1	FLEMING, TARA M MD	8/6/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	152462	40	Pediatrics	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
36895	Fee-for-Service	1891296976	1891296976	1	1	FRANCISCO, JOSEPH A NP	3/11/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	801 SANTA FE WAY	None	SHAFTER	CA	93263	3158	15	06029	35.49142021	-119.260004	Kern County
36931	Fee-for-Service	1659337749	1659337749	1	1	FRESNO COUNTY E O C	12/1/1977	261QF0050X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	HEALTH CLINIC	1047 R ST	STE 1047	FRESNO	CA	93721	1312	10	06019	36.7403869	-119.7827521	Fresno County
36952	Fee-for-Service	1457794752	1457794752	1	1	FOLCH-HAYEK, BEATRIZ M MD FA	10/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148014	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	COG	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
36959	Fee-for-Service	1700810140	1700810140	1	1	FOSTER, TAMMY MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60832	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
37046	Fee-for-Service	1669550323	1669550323	1	1	FRANK, ROCHELLE I MD	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83783	13	Neurology (M.D. only)	0	In state provider	None	2315 STOCKTON BLVD	STE 5308	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
37070	Fee-for-Service	1518044908	1518044908	1	1	FISCHKES, ROSE M LCSW	7/30/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21201 VICTORY BLVD	STE 200	CANOGA PARK	CA	91303	2866	19	06037	34.18839235	-118.5945668	Los Angeles County
37095	Fee-for-Service	1790757706	1790757706	1	1	FINKEL, LAWRENCE I DO	7/1/1997	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	MEDICAL DIAGNOSTIC IM	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
37165	Fee-for-Service	1053726802	1053726802	1	1	FRIESEN, JEFFREY B MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153079	41	Internal Medicine	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
37209	Fee-for-Service	1982865044	1982865044	1	1	FITZMAURICE, LAURA E MD	2/7/2011	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	104082	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
37252	Fee-for-Service	1962106229	1962106229	1	1	FERNANDO, JAMES P NP	7/13/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
37262	Fee-for-Service	1699448100	1699448100	1	1	FRONT PORCH COMMUNITIES AND	4/1/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SERVICES	437 WEBSTER ST	None	PALO ALTO	CA	94301	1242	43	06085	37.449819	-122.1584436	Santa Clara County
37305	Fee-for-Service	1265531016	1265531016	1	1	FAN, NANCY H DO	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	10053	31	Roentgenology, Radiology (M.D. only)	0	In state provider	None	1720 ESPLANADE	None	CHICO	CA	95926	3315	04	06007	39.74490068	-121.8505328	Butte County
37330	Fee-for-Service	1528191699	1528191699	1	1	FREECE, KRISTA L PHD	6/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1630 E MAIN ST	None	EL CAJON	CA	92021	5204	37	06073	32.80766827	-116.9222044	San Diego County
37424	Fee-for-Service	1760792733	1760792733	1	1	FOJAS, OLIVIA D LCSW	3/10/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD ROAD	None	SANTA CLARA	CA	95051	5173	43	06085	37.33774954	-122.002065	Santa Clara County
37446	Fee-for-Service	1699899872	1699899872	1	1	FERRER, RIZALDY R PHD	7/18/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1495 N LAKE AVE	None	PASADENA	CA	91104	2303	19	06037	34.17164095	-118.1321599	Los Angeles County
37472	Fee-for-Service	1891711339	1891711339	1	1	FLORY, TERESA C MD	2/26/2020	207L00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1128 W EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2518	43	06085	37.38761858	-122.0874556	Santa Clara County
37529	Fee-for-Service	1740600972	1740600972	1	1	FEIDI, RANA A MD	3/31/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	167850	77	Infectious Disease	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
37637	Fee-for-Service	1578508545	1578508545	1	1	FOREHAND, LYLE B MD	6/2/2022	2084P0805X	NA	Psychiatry	026	PHYSICIANS	79117	None	None	0	In state provider	None	10251 VISTA SORRENTO PAR	SUITE 280	SAN DIEGO	CA	92121	3776	37	06073	32.89524013	-117.2142063	San Diego County
37697	Fee-for-Service	1619031564	1619031564	1	1	FREE, OCEANA LMFT	1/30/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
37743	Fee-for-Service	1770684896	1770684896	1	1	FARRAG, HASSAN S MD	11/30/1986	2084P0800X	NA	Psychiatry	026	PHYSICIANS	43178	None	None	0	In state provider	None	17075 DEVONSHIRE ST	204	NORTHRIDGE	CA	91325	5408	19	06037	34.25755945	-118.50471	Los Angeles County
37748	Fee-for-Service	1649774290	1649774290	1	1	FRANK, ANNABEL K MD	1/25/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	166504	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
37776	Fee-for-Service	1275533499	1275533499	1	1	FINKEL, PAUL N MD	12/28/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	25112	41	Internal Medicine	0	In state provider	None	32144 AGOURA RD	STE 102	WESTLAKE VILLAGE	CA	91361	4038	19	06037	34.14848408	-118.8208595	Los Angeles County
37855	Fee-for-Service	1669576294	1669576294	1	1	FERRAZARES, DAVID MD	6/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	60620	40	Pediatrics	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
37915	Fee-for-Service	1457596272	1457596272	1	2	FEARS, SCOTT C MD	12/2/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	87169	-	NOT APPLICABLE	0	In state provider	None	5220 W WASHINGTON BLVD	SUITE 101	LOS ANGELES	CA	90016	1331	19	06037	34.04141393	-118.3546504	Los Angeles County
37929	Fee-for-Service	1144617184	1144617184	1	1	FELTHOVEN, MEGAN	12/9/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	920 PARK ROW	None	SALINAS	CA	93901	2407	27	06053	36.66409481	-121.6592738	Monterey County
37992	Fee-for-Service	1104168756	1104168756	1	1	FREEMAN, ALEXANDRA H MD	9/14/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	133612	09	Gynecology (D.O. only)	0	In state provider	None	782 MEDICAL CENTER DR E	STE 212	CLOVIS	CA	93611	6889	10	06019	36.84379626	-119.6609117	Fresno County
38011	Fee-for-Service	1760644686	1760644686	1	1	FIALLO, LUIS A MD PC	7/11/2008	207RP1001X	NA	Pulmonology	026	PHYSICIANS	51309	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	754 MEDICAL CENTER CT	STE 100	CHULA VISTA	CA	91911	6655	37	06073	32.61778462	-117.0228924	San Diego County
38093	Fee-for-Service	1083682546	1083682546	1	1	FORNACIARI, WILLIAM K MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69338	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
38097	Fee-for-Service	1336173137	1336173137	1	1	FRACISCO, SUSAN D MD	12/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	72637	36	Psychiatry	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
38103	Fee-for-Service	1093727943	1093727943	1	1	FISHKIND, AVRIM B MD	7/17/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	54128	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
38128	Fee-for-Service	1558695189	1558695189	1	1	FINNEGAN, DANIEL J	10/9/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	12791 NEWPORT AVE	SUITE 101	TUSTIN	CA	92780	2785	30	06059	33.75168784	-117.808677	Orange County
38190	Fee-for-Service	1528122025	1528122025	1	1	FUJIMOTO, GARY MD	8/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	43075	01	General Practice	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
38283	Fee-for-Service	1104168756	1104168756	1	1	FREEMAN, ALEXANDRA H MD	9/14/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	133612	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	782 MEDICAL CENTER DR E	STE 212	CLOVIS	CA	93611	6889	10	06019	36.84379626	-119.6609117	Fresno County
38293	Fee-for-Service	1497857460	1497857460	1	1	FELLOW, JOHN E MD	1/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	60559	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
38366	Fee-for-Service	1275806853	1275806853	1	1	FREDERICK, STEPHANIE A CCC-S	1/16/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	LP	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
38394	Fee-for-Service	1134632987	1134632987	1	1	FROST, ALEXANDER PT	8/12/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
38397	Fee-for-Service	1922401215	1922401215	1	1	FARHADIAN, ELAHEH MD INC	3/11/2015	207R00000X	NA	Other	026	PHYSICIANS	100453	41	Internal Medicine	0	In state provider	None	17447 CHATSWORTH ST	None	GRANADA HILLS	CA	91344	5718	19	06037	34.2648835	-118.514745	Los Angeles County
38402	Fee-for-Service	1003948803	1003948803	1	1	FORTADES, MARITA A MD	10/31/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	52557	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
38428	Fee-for-Service	1386669190	1386669190	1	1	FISK, HARRIS R MD	3/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	20300	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA # B200	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
38435	Fee-for-Service	1912905035	1912905035	1	1	FARRELL,JAMES A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1580 W ANTELOPE DR	None	LAYTON	UT	84041	0000	00	None	41.08922695	-111.9943717	Davis County
38472	Fee-for-Service	1376510321	1376510321	1	3	FREINKEL, ROBERT L MD APC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	25328	03	Allergy	0	In state provider	None	1615 HILL ROAD	SUITE I	NOVATO	CA	94947	4338	21	06041	38.09764686	-122.5787662	Marin County
38538	Fee-for-Service	1003230509	1003230509	1	1	FILDEY, JENNIFER K CRNA	5/11/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	8019	39	06077	37.97026329	-121.2890849	San Joaquin County
38542	Fee-for-Service	1922185875	1922185875	1	1	FONG, NEPHENTHE I MD	6/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76264	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
38572	Fee-for-Service	1104168756	1104168756	1	1	FREEMAN, ALEXANDRA H MD	9/14/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	133612	15	Obstetrics (D.O. only)	0	In state provider	None	782 MEDICAL CENTER DR E	STE 212	CLOVIS	CA	93611	6889	10	06019	36.84379626	-119.6609117	Fresno County
38585	Fee-for-Service	1477907905	1477907905	1	1	FERNANDES, CARLO R DO	11/23/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17851	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
38692	Fee-for-Service	1689630147	1689630147	1	1	FROHMNA, ELLIOT M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
38753	Fee-for-Service	1912953936	1912953936	1	2	FAIRBANKS & POWER PHYSICAL T	7/31/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	2 PETERS CANYON RD.	100	IRVINE	CA	92606	1799	30	06059	33.71183218	-117.7978776	Orange County
38766	Fee-for-Service	1285614750	1285614750	1	1	FERRA, RAMON U	4/13/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	48006	None	None	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
38828	Fee-for-Service	1881867125	1881867125	1	1	FOSTER, ZEKE W MD	7/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109883	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	STE A108	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
38843	Fee-for-Service	1679060107	1679060107	1	1	FRITZMANN, EMILY A MD	9/25/2024	207R00000X	NA	Other	026	PHYSICIANS	174928	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
38857	Fee-for-Service	1245328889	1245328889	2	1	FARAZ-ESLAMI, PARASTOO P MD	10/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84163	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	600 CORPORATE DR	SUITE 100	LADERA RANCH	CA	92694	1153	30	06059	33.55834891	-117.6292039	Orange County
38868	Fee-for-Service	1104956408	1104956408	1	1	FRICK, ANNA C MD	9/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	94545	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	350 30TH ST	STE 300	OAKLAND	CA	94609	3422	01	06001	37.81892183	-122.2640154	Alameda County
38897	Fee-for-Service	1366438814	1366438814	1	1	FALK,ALEX MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	305 S STATE ST	None	ABERDEEN	SD	57401	0000	00	None	45.461403	-98.47929349	Brown County
38902	Fee-for-Service	1114245800	1114245800	1	1	FAM, ANTHONY F MD	10/31/2019	207R00000X	NA	Other	026	PHYSICIANS	162296	41	Internal Medicine	0	In state provider	None	5555 GROSSMONT CENTER	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
38957	Fee-for-Service	1639941065	1639941065	1	1	FLOR-VERA, CLARA LCSW	6/7/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3438 MENDOCINO AVE	STE B	SANTA ROSA	CA	95403	2275	49	06097	38.472282	-122.723991	Sonoma County
38976	Fee-for-Service	1114035235	1114035235	1	2	FATULA, MICHAEL LMFT	11/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	519 N LA CIENEGA BLVD	#16	WEST HOLLYWOOD	CA	90048	2007	19	06037	34.0807556	-118.3766237	Los Angeles County
38993	Fee-for-Service	1730573692	1730573692	1	1	FERGUSON, JESSICA D MD	6/30/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	145044	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
39048	Fee-for-Service	1972227791	1972227791	1	1	FARBER, MAX D CNP	6/6/2023	363LX0001X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
39137	Fee-for-Service	1558080044	1558080044	1	1	FIDES ASSISTED LIVING INC	5/16/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2526 NEW AVENUE	None	ROSEMEAD	CA	91770	2939	19	06037	34.05888514	-118.1080728	Los Angeles County
39189	Fee-for-Service	1194983494	1194983494	1	1	FLETCHER, SARAH MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110002	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
39231	Fee-for-Service	1184772006	1184772006	1	1	FRIEND, DIANA J MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71704	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
39245	Fee-for-Service	1265619043	1265619043	1	1	FRANKEL, AARON J MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101629	05	Anesthesiology	0	In state provider	None	2420 CAMINO RAMON	None	SAN RAMON	CA	94583	4319	07	06013	37.77229042	-121.9634581	Contra Costa County
39257	Fee-for-Service	1104146570	1104146570	1	1	FAMOUS, KATIE R MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125258	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
39303	Fee-for-Service	1861892705	1861892705	1	1	FACULTY PHYSICIANS AND	4/16/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM	901 SAN BERNARDINO RD	STE 104 AND 302	UPLAND	CA	91786	4912	36	06071	34.10050176	-117.6382066	San Bernardino County
39370	Fee-for-Service	1326098534	1326098534	1	1	FIDEL, MANOLITO B MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	81909	36	Psychiatry	0	In state provider	None	10802 COLLEGE PL	None	CERRITOS	CA	90703	1505	19	06037	33.88484554	-118.102932	Los Angeles County
39431	Fee-for-Service	1396157467	1396157467	1	1	FREEMAN, MATTHEW D	6/27/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
39535	Fee-for-Service	1588864821	1588864821	1	1	FLORES, JOSE T MD	10/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	50533	36	Psychiatry	0	In state provider	None	100 FALLS CANYON RD	None	AVALON	CA	90704	1563	19	06037	33.33904622	-118.3307237	Los Angeles County
39545	Fee-for-Service	1104146570	1104146570	1	1	FAMOUS, KATIE R MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125258	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
39564	Fee-for-Service	1649457474	1649457474	1	2	FEMINIST WOMENS HEALTH	10/11/2016	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2110 FERRY ST	None	ANDERSON	CA	96007	3459	45	06089	40.45112301	-122.298562	Shasta County
39588	Fee-for-Service	1861892705	1861892705	1	1	FACULTY PHYSICIANS AND	11/6/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	SURGEONS OF LLUSM	901 SAN BERNARDINO RD	STE 104 AND 302	UPLAND	CA	91786	4912	36	06071	34.10050176	-117.6382066	San Bernardino County
39610	Fee-for-Service	1144899253	1144899253	1	1	FIELDS, RACHEL MD	1/30/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186830	70	Clinic (mixed specialty)	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
39687	Fee-for-Service	1215182746	1215182746	1	1	FANG, PEIR YU DO	9/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14430	01	General Practice	0	In state provider	None	1420 S CENTRAL AVENUE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
39689	Fee-for-Service	1346446747	1346446747	1	1	FIROUZTALE, PEJMAN A MD	7/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104115	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
39899	Fee-for-Service	1144899253	1144899253	1	1	FIELDS, RACHEL MD	1/30/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186830	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
39977	Fee-for-Service	1134205214	1134205214	1	1	FIGUEROA, BRENDA L MD	6/24/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	114674	None	None	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
40203	Fee-for-Service	1871144329	1871144329	1	1	FAMILY HEALTHCARE NETWORK	4/10/2020	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	65 N. HOCKETT ST.	None	PORTERVILLE	CA	93257	4700	54	06107	36.0663928	-119.01714	Tulare County
40211	Fee-for-Service	1306235171	1306235171	1	1	FELIPE, LAUREN OD	3/1/2025	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14709 PRAIRIE AVE	None	LAWNDALE	CA	90260	1831	19	06037	33.89785517	-118.3439175	Los Angeles County
40213	Fee-for-Service	1467411157	1467411157	1	1	FREDERICK J. REED, M.D.	4/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 3RD ST	STE 1	DAVENPORT	WA	99122	5008	00	None	47.656755	-118.1447295	Lincoln County
40352	Fee-for-Service	1700993623	1700993623	1	1	FREIMER, NELSON B MD	5/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	53766	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90074	0001	19	06037	34.07067	-118.4432445	Los Angeles County
40376	Fee-for-Service	1134762677	1134762677	1	1	FUJINO, LINDA E LMFT	4/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4401 SEPULVEDA BLVD	210	SHERMAN OAKS	CA	91403	3934	19	06037	34.150356	-118.467397	Los Angeles County
40389	Fee-for-Service	1740741917	1740741917	1	1	FROUTAN, NAVID N MD	3/31/2022	207R00000X	NA	Other	026	PHYSICIANS	176518	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
40422	Fee-for-Service	1275928830	1275928830	1	1	FISCHETTI, CHANEL E MD	5/7/2018	390200000X	NA	Other	026	PHYSICIANS	154859	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
40423	Fee-for-Service	1891894739	1891894739	1	1	FEMINO, J DOMINIC MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	52097	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
40438	Fee-for-Service	1780978858	1780978858	1	1	FOOTPRINTS BEHAVIORAL INTERV	3/26/2020	103K00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ENTIONS, INC.	1901 CARNEGIE AVE	SUITE 1-C	SANTA ANA	CA	92705	5504	30	06059	33.711615	-117.8416035	Orange County
40453	Fee-for-Service	1235173972	1235173972	1	1	FINBERG, KURT R	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	27064	None	None	0	In state provider	None	2200 18TH ST	None	BAKERSFIELD	CA	93301	3607	15	06029	35.37533149	-119.0275155	Kern County
40475	Fee-for-Service	1427162304	1427162304	1	1	FERRER, MARIA L MD	10/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63748	40	Pediatrics	0	In state provider	None	1508 GARCES HWY	STE 1	DELANO	CA	93215	3687	15	06029	35.76141641	-119.2369096	Kern County
40510	Fee-for-Service	1518045418	1518045418	1	1	FRIESEN, BRIAN MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	55842	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
40612	Fee-for-Service	1275582918	1275582918	1	1	FACULTY PHYSICIANS AND	1/1/2000	193400000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	SURGEONS OF LLUSM	25455 BARTON RD	101B 102B 104B 106B 108B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
40625	Fee-for-Service	1013189646	1013189646	1	1	FREEBY, MATTHEW J MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	86659	67	Endocrinology	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
40636	Fee-for-Service	1225106628	1225106628	1	1	FREITAG, MILAM K PHD	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	55 NEW MONTGOMERY ST	STE 420	SAN FRANCISCO	CA	94105	3429	38	06075	37.78805944	-122.4011798	San Francisco County
40658	Fee-for-Service	1720648710	1720648710	1	1	FRELINGER, JESSICA M MD	6/21/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	177464	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
40687	Fee-for-Service	1841561594	1841561594	1	1	FREEHAUF, ANAMAE M	11/7/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
40791	Fee-for-Service	1609259068	1609259068	1	1	FANAIEYAN, AMELIA A OD	4/27/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE ST	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
40809	Fee-for-Service	1649719055	1649719055	1	1	FORSTING, SHANE G DO	7/28/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	19956	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
40829	Fee-for-Service	1366544751	1366544751	1	1	FUQUA CUEN, DEBORAH OT	11/7/2018	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
40845	Fee-for-Service	1528059276	1528059276	1	1	FLORES, JILL M MD	4/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	77198	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
40850	Fee-for-Service	1700856598	1700856598	1	1	FOLEY, WILLIAM J MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	57594	02	General Surgery	0	In state provider	None	1211 W LA PALMA AVE	STE 505	ANAHEIM	CA	92801	2812	30	06059	33.84718298	-117.933758	Orange County
40898	Fee-for-Service	1477685055	1477685055	1	1	FOK, CAROL H NP	12/21/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
40913	Fee-for-Service	1871524363	1871524363	1	1	FAMILY HEALTH CTRS OF SD	3/1/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
41073	Fee-for-Service	1598117996	1598117996	1	1	FARRELL-ANDERSON, JOANNE LM	9/16/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
41081	Fee-for-Service	1710483961	1710483961	1	1	FROELICH, SOPHIA MD	8/31/2022	207P00000X	NA	Other	026	PHYSICIANS	167800	None	None	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
41126	Fee-for-Service	1386295350	1386295350	1	1	FAMILY HEALTHCARE NETWORK	4/10/2020	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2333 S MOONEY BLVD	None	VISALIA	CA	93277	6228	54	06107	36.308682	-119.3154255	Tulare County
41198	Fee-for-Service	1871524363	1871524363	1	1	FAMILY HEALTH CTRS OF SD	3/1/2003	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
41215	Fee-for-Service	1801823349	1801823349	1	1	FRYE REG MED CTR INC	1/11/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	420 N CENTER ST	None	HICKORY	NC	28601	5046	00	None	35.737659	-81.337131	Catawba County
41241	Fee-for-Service	1548369648	1548369648	1	1	FEDERMAN, EDWARD C	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	60283	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	6699 ALVARADO RD	STE 2308	SAN DIEGO	CA	92120	5241	37	06073	32.77665383	-117.0540279	San Diego County
41281	Fee-for-Service	1568799989	1568799989	1	1	FELDSTEIN, MICHAEL J MD	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114702	20	Orthopedic Surgery	0	In state provider	None	450 6TH AVENUE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
41286	Fee-for-Service	1063675601	1063675601	1	2	FORD, JONATHAN MD	1/5/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	111458	-	NOT APPLICABLE	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
41288	Fee-for-Service	1174629232	1174629232	1	1	FUKAMI, SUMINA MD	4/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80905	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	FLOOR 2	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
41450	Fee-for-Service	1336297167	1336297167	1	1	FARUS, SUE A MD	10/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	41593	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	310 SANTA FE DR	None	ENCINITAS	CA	92024	5110	37	06073	33.038406	-117.285354	San Diego County
41451	Fee-for-Service	1225546575	1225546575	1	1	FAMILY HEALTHCARE NETWORK	6/26/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	290 NORTH WAYTE LANE	STE 1200-1300, 1600-1800	STE 2100-2300, 2500-2600	FRESNO	CA	93701	2124	10	06019	0	0	None
41487	Fee-for-Service	1508104712	1508104712	1	1	FUSION SPECIALTY PHARMACY IN	8/4/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	1100 CANYON VIEW DR	SUITE C	SANTA CLARA	UT	84765	5671	00	None	37.1270309	-113.6382848	Washington County
41502	Fee-for-Service	1801823349	1801823349	1	1	FRYE REG MED CTR INC	1/11/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	420 N CENTER ST	None	HICKORY	NC	28601	5046	00	None	35.737659	-81.337131	Catawba County
41514	Fee-for-Service	1013901644	1013901644	1	1	FRANKLE, DAVID M MD	7/31/1983	146D00000X	NA	Other	026	PHYSICIANS	32031	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
41529	Fee-for-Service	1184621385	1184621385	1	1	FOBI COMPREHENSIVE	7/12/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY, INC	7922 ROSECRANS AVE	#P-2	PARAMOUNT	CA	90723	6028	19	06037	33.90361647	-118.161198	Los Angeles County
41546	Fee-for-Service	1801072996	1801072996	1	1	FONTES, AGUEDA LCSW	6/25/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8247 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	34	06067	38.459187	-121.4080245	Sacramento County
41549	Fee-for-Service	1538297072	1538297072	1	1	FIORE, DARREN M MD	4/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93431	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
41560	Fee-for-Service	1902998966	1902998966	1	1	FUERST, RANDALL F OD	12/8/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2200 SUNRISE BLVD	STE 120	RANCHO CORDOVA	CA	95670	4378	34	06067	38.62287	-121.2672825	Sacramento County
41570	Fee-for-Service	1740233725	1740233725	1	1	FCS MEDICAL CORPORATION	2/28/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FAMILY CARE SPECIALISTS	815 W WASHINGTON BLVD	None	MONTEBELLO	CA	90640	6123	19	06037	33.99411697	-118.1169341	Los Angeles County
41614	Fee-for-Service	1619371861	1619371861	1	1	FRANKENSTEIN, BRENDA W LCSW	12/24/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	10022	-	NOT APPLICABLE	0	In state provider	None	303 E 52ND STREET	None	LOS ANGELES	CA	90011	4513	19	06037	33.99526806	-118.2699516	Los Angeles County
41714	Fee-for-Service	1508916107	1508916107	1	1	FULLERTON, HEATHER J MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67954	79	Neurology-Child	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
41737	Fee-for-Service	1225546575	1225546575	1	1	FAMILY HEALTHCARE NETWORK	6/26/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	290 NORTH WAYTE LANE	STE 1200-1300, 1600-1800	STE 2100-2300, 2500-2600	FRESNO	CA	93701	2124	10	06019	0	0	None
41868	Fee-for-Service	1396130522	1396130522	1	1	FEDER, RACHEL E MD	7/14/2021	163WG0100X	NA	Other	026	PHYSICIANS	171660	None	None	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
41887	Fee-for-Service	1497044200	1497044200	1	1	FUNG, CHRISTOPHER MD	4/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140898	05	Anesthesiology	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
42005	Fee-for-Service	1922291822	1922291822	1	1	FENG, PEGGY P MD	9/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99126	40	Pediatrics	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
42025	Fee-for-Service	1225546575	1225546575	1	1	FAMILY HEALTHCARE NETWORK	5/7/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	290 NORTH WAYTE LANE	STE 1200-1300, 1600-1800	STE 2100-2300, 2500-2600	FRESNO	CA	93701	2124	10	06019	0	0	None
42066	Fee-for-Service	1326203837	1326203837	1	1	FRUZZA, ABIGAIL C MD	7/6/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	102008	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
42091	Fee-for-Service	1639126618	1639126618	1	1	FLASHMAN, ROBERT MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	48643	None	None	0	In state provider	None	1145 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3511	19	06037	33.89242734	-118.2947128	Los Angeles County
42154	Fee-for-Service	1457797961	1457797961	1	1	FREED, AMANDA S MD	7/21/2021	207SG0201X	NA	Other	026	PHYSICIANS	169275	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
42198	Fee-for-Service	1225245723	1225245723	1	1	FRESNO ENDOSCOPY CENTER	8/4/1998	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7405 N FRESNO ST	None	FRESNO	CA	93720	2457	10	06019	36.8450311	-119.7839039	Fresno County
42223	Fee-for-Service	1982782769	1982782769	1	1	FAN, GRACE MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78442	30	Radiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
42253	Fee-for-Service	1215990494	1215990494	1	1	FELL, KEVIN C MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65757	08	Family Practice	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
42263	Fee-for-Service	1053383075	1053383075	1	1	FISKE, SHIRLEY A DO	7/1/1997	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	MEDICAL DIAGNOSTIC IM	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
42282	Fee-for-Service	1609940766	1609940766	1	1	FERGASON, KRISTINE D OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
42312	Fee-for-Service	1225546575	1225546575	1	1	FAMILY HEALTHCARE NETWORK	2/20/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	290 NORTH WAYTE LANE	STE 1200-1300, 1600-1800	STE 2100-2300, 2500-2600	FRESNO	CA	93701	2124	10	06019	0	0	None
42323	Fee-for-Service	1891534624	1891534624	1	1	FONG, SARAH E PT	8/29/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39650 LIBERTY ST	SUITE 140	FREMONT	CA	94538	2225	01	06001	37.54662058	-121.9736002	Alameda County
42353	Fee-for-Service	1124235791	1124235791	1	1	FELEKE, BELETE T MD	10/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99542	66	Emergency Medicine (Urgent Care)	0	In state provider	None	301 E 13TH ST	None	MERCED	CA	95341	6211	24	06047	37.29248035	-120.4730619	Merced County
42363	Fee-for-Service	1104086149	1104086149	1	1	FOWLER, EILEEN RPT	6/1/1996	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 MEDICAL PLAZA RM 140	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
42372	Fee-for-Service	1952535577	1952535577	1	1	FOOT AND ANKLE INSTITUTE OF	2/15/2013	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	SAN FRANCISCO INC	450 SUTTER ST	STE 1404	SAN FRANCISCO	CA	94108	4206	38	06075	37.78934929	-122.4077786	San Francisco County
42385	Fee-for-Service	1871981472	1871981472	1	2	FLINT, CLARA LCSW	8/21/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4135 GRIFFITH AVE	None	CLOVIS	CA	93619	7279	10	06019	36.78980353	-119.6296155	Fresno County
42410	Fee-for-Service	1245718865	1245718865	1	1	FAKHRO, SAMEEH A MD	2/4/2022	207R00000X	NA	Other	026	PHYSICIANS	175008	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
42421	Fee-for-Service	1295245009	1295245009	1	1	FLAKE, KENT V CRNA	3/22/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
42488	Fee-for-Service	1669767752	1669767752	1	1	FIASEU, KAYCEE MD	4/24/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	183345	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
42512	Fee-for-Service	1134147457	1134147457	1	1	FLORES, MARYLUPE LCSW	7/21/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
42529	Fee-for-Service	1265471734	1265471734	1	1	FILLY, ANTHONY L MD	2/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	8900 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	1958	19	06037	34.06703955	-118.3859235	Los Angeles County
42545	Fee-for-Service	1629592795	1629592795	1	1	FEICKERT, CASEY J PT	1/10/2022	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5617 SCOTTS VALLEY	None	SCOTTS VALLEY	CA	95066	3482	44	06087	37.06204883	-122.0069319	Santa Cruz County
42578	Fee-for-Service	1083959142	1083959142	1	1	FERNANDEZ, JAMES R MD	3/18/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	121623	30	Radiology	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
42622	Fee-for-Service	1427081835	1427081835	1	1	FOHRMAN, EDWARD B MD	2/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	65434	05	Anesthesiology	0	In state provider	None	1600 WEST AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
42649	Fee-for-Service	1356602965	1356602965	1	1	FLORES, RACHEL R R MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136764	01	General Practice	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
42682	Fee-for-Service	1912134453	1912134453	1	1	FIEDLER, AMY G MD	6/14/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	178750	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
42718	Fee-for-Service	1215267471	1215267471	1	1	FELICIANO SERRANO M.D., INC.	9/10/2024	207RN0300X	NA	Nephrology	026	PHYSICIANS	None	45	Nephrology (Renal-Kidney)	0	In state provider	None	7305 PACIFIC BLVD FL 1 A	None	HUNTINGTON PARK	CA	90255	5736	19	06037	33.97310678	-118.2252721	Los Angeles County
42720	Fee-for-Service	1952498081	1952498081	1	1	FISHER, ALEXANDER N MD	6/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103072	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
42812	Fee-for-Service	1952472938	1952472938	1	1	FENG, MARK I MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	62297	34	Urology and Urological Surgery	0	In state provider	ATTN MGA OFFICE	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
42817	Fee-for-Service	1942225693	1942225693	1	1	FELIX, TERRI MD	6/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78220	40	Pediatrics	0	In state provider	None	7551 MADISON AVE	None	CITRUS HEIGHTS	CA	95610	7449	34	06067	38.664333	-121.2879735	Sacramento County
42841	Fee-for-Service	1053705566	1053705566	1	1	FIGURASIN, RICK O DO	12/18/2023	207P00000X	NA	Other	026	PHYSICIANS	22250	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
42870	Fee-for-Service	1699861765	1699861765	1	1	FLETCHER, LEAH LCSW	1/28/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
42968	Fee-for-Service	1508124413	1508124413	1	1	FUJIMOTO, MICHELE A MD	12/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114644	02	General Surgery	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
42974	Fee-for-Service	1093784951	1093784951	1	1	FISCHBERG, GLENN M MD	1/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
42976	Fee-for-Service	1417297847	1417297847	1	21	FIRST CHOICE PHYSICIAN PARTN	9/26/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	3851 KATELLA AVE	STE 300	LOS ALAMITOS	CA	90720	3566	30	06059	33.80319053	-118.0657305	Orange County
42986	Fee-for-Service	1225588510	1225588510	1	1	FARZANEH, TED MD	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145309	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	RM B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
43005	Fee-for-Service	1215267471	1215267471	1	1	FELICIANO SERRANO M.D., INC.	9/10/2024	207RN0300X	NA	Nephrology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	7305 PACIFIC BLVD FL 1 A	None	HUNTINGTON PARK	CA	90255	5736	19	06037	33.97310678	-118.2252721	Los Angeles County
43009	Fee-for-Service	1952498081	1952498081	1	1	FISHER, ALEXANDER N MD	6/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103072	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
43111	Fee-for-Service	1912531377	1912531377	1	1	FRESENIUS MEDICAL CARE LONG	4/22/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BEACH LLC	2789 LONG BEACH BLVD	None	LONG BEACH	CA	90806	1519	19	06037	33.80780403	-118.1894826	Los Angeles County
43124	Fee-for-Service	1598775256	1598775256	1	1	FISHER, STEVEN G PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3368 2ND AVE	STE C1	SAN DIEGO	CA	92103	5666	37	06073	32.74059458	-117.1631479	San Diego County
43153	Fee-for-Service	1629060108	1629060108	1	1	FU, ERIC J MD	9/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	83890	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
43212	Fee-for-Service	1659410561	1659410561	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	372 ARDEN AVE	STE 200	GLENDALE	CA	91203	4002	19	06037	34.1584394	-118.261212	Los Angeles County
43252	Fee-for-Service	1861131971	1861131971	1	1	FOX, HILARY NP	4/11/2023	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16955 VANOWEN	None	VAN NUYS	CA	91406	4542	19	06037	34.19389751	-118.503342	Los Angeles County
43344	Fee-for-Service	1801907308	1801907308	1	1	FIELDS, DANIEL J MD	3/16/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	42280	08	Family Practice	0	In state provider	SACTO SIERRA MED GRP INC	8170 LAGUNA BLVD	STE 210	ELK GROVE	CA	95758	7902	34	06067	38.421054	-121.405365	Sacramento County
43369	Fee-for-Service	1821354937	1821354937	1	1	FENG, WENDY MD	8/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127191	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
43421	Fee-for-Service	1801104179	1801104179	1	1	FATHI, ROYA MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124602	41	Internal Medicine	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
43489	Fee-for-Service	1417918715	1417918715	1	1	FARNUM, MARK F MD INC	1/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42109	05	Anesthesiology	0	In state provider	None	20750 VENTURA BLVD	STE 210	WOODLAND HILLS	CA	91364	6235	19	06037	34.16652116	-118.5855291	Los Angeles County
43503	Fee-for-Service	1417627944	1417627944	1	1	FOURTH OPTOMETRIC CARE OF CA	10/28/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	130 S MAIN ST	STE F	ORANGE	CA	92868	2869	30	06059	33.787512	-117.8673275	Orange County
43538	Fee-for-Service	1538542303	1538542303	1	1	FINK, SAYDA L MD DO	10/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	155079	08	Family Practice	0	In state provider	None	47647 CALEO BAY DR	STE 210	LA QUINTA	CA	92253	8858	33	06065	33.70305235	-116.2936509	Riverside County
43584	Fee-for-Service	1205993995	1205993995	1	1	FISCHER, DAVID J MD	5/1/1995	207L00000X	NA	Other	026	PHYSICIANS	67233	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
43594	Fee-for-Service	1558896878	1558896878	1	1	FOK, ERIC D MD	7/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	136638	05	Anesthesiology	0	In state provider	None	1650 CREEKSIDE DRIVE	None	FOLSOM	CA	95630	3400	34	06067	38.67021	-121.145382	Sacramento County
43597	Fee-for-Service	1043669229	1043669229	1	1	FAGEL, CHRISTIAN B MD	9/15/2022	208M00000X	NA	Other	026	PHYSICIANS	180566	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
43648	Fee-for-Service	1528010964	1528010964	1	1	FRANCO, ROSINA MD	11/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	54793	08	Family Practice	0	In state provider	None	1701 E CESAR E CHAVEZ AV	STE 402	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
43683	Fee-for-Service	1477984375	1477984375	1	1	FIRST PRIORITY HOME HEALTH	10/2/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	12540 HEACOCK ST	STE 1	MORENO VALLEY	CA	92553	3052	33	06065	33.938253	-117.2437645	Riverside County
43692	Fee-for-Service	1164495370	1164495370	1	1	FISHER, DARCEE MD	1/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11600 W 2ND AVE	None	LAKEWOOD	CO	80228	0000	00	None	39.71791454	-105.1292205	Jefferson County
43699	Fee-for-Service	1578688073	1578688073	1	1	FEIER, CHRIS C MD	4/28/2008	207P00000X	NA	Other	026	PHYSICIANS	94254	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
43705	Fee-for-Service	1366070013	1366070013	1	1	FLAUTERO ARCOS, JORGE D MD	5/31/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186482	None	None	0	In state provider	None	1245 16TH STREET	SUITE 125, 204, 307	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
43753	Fee-for-Service	1033535216	1033535216	1	1	FIGG, JONATHAN A MD	11/5/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	164977	-	NOT APPLICABLE	0	In state provider	None	2960 CAMINO DIABLO	105	WALNUT CREEK	CA	94597	3988	07	06013	37.89859467	-122.0843018	Contra Costa County
43815	Fee-for-Service	1760433148	1760433148	1	1	FRIEDLAND, DAVID MD	12/12/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	04	Otology, Laryngology, Rhinology	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
43842	Fee-for-Service	1245412774	1245412774	1	1	FRANKENBERG, MERRILI M	5/20/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
43928	Fee-for-Service	1548220874	1548220874	1	1	FAITH YOUNG PETERSON, NP	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	211 FOREST ST	None	MCCALL	ID	83638	5256	00	None	44.90892985	-116.1118421	Valley County
44137	Fee-for-Service	1851839336	1851839336	1	1	FULLER, TRACEY LPCC	2/23/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11331 LAKE BLVD	None	FELTON	CA	95018	8907	44	06087	37.10078265	-122.0500017	Santa Cruz County
44153	Fee-for-Service	1407849284	1407849284	1	1	FONG, MINCH K MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	78910	01	General Practice	0	In state provider	None	24953 PASEO DE VALENCIA	STE 25B	LAGUNA HILLS	CA	92653	4341	30	06059	33.60028568	-117.7010887	Orange County
44175	Fee-for-Service	1770792822	1770792822	1	1	FLORES,LISA B PHD	9/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
44212	Fee-for-Service	1962474619	1962474619	1	1	FANSELAU, ANNEMARIE E MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64663	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
44229	Fee-for-Service	1619098365	1619098365	1	2	FUENTES, MARIBEL PALOMA M	9/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FUENTES	3756 FLORENCE ST	None	REDWOOD CITY	CA	94063	4418	41	06081	37.4786932	-122.1867827	San Mateo County
44251	Fee-for-Service	1215035415	1215035415	1	1	FARID, HANY MD	1/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80565	02	General Surgery	0	In state provider	None	11600 INDIAN HILLS RD	None	MISSION HILLS	CA	91345	1225	19	06037	34.2811228	-118.4588429	Los Angeles County
44277	Fee-for-Service	1780059030	1780059030	1	1	FOSSA, MALLORY N NP	9/14/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
44367	Fee-for-Service	1922578608	1922578608	1	1	FREE YOUR MIND MARRIAGE & FA	1/16/2024	104100000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	MILY THERAPY, PROFESSION	23121 VERDUGO DRIVE	SUITE 105	LAGUNA HILLS	CA	92653	1003	30	06059	33.62655523	-117.7292097	Orange County
44400	Fee-for-Service	1356685028	1356685028	1	1	FRIDMAN DOUGHERTY, VICTORIA	2/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
44409	Fee-for-Service	1760516314	1760516314	1	1	FLORES, GILBERT E MD	7/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99308	02	General Surgery	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
44501	Fee-for-Service	1962474619	1962474619	1	1	FANSELAU, ANNEMARIE E MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64663	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
44517	Fee-for-Service	1487760351	1487760351	1	1	FAN, IAIN DO	7/9/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	12427	None	None	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
44534	Fee-for-Service	1508931601	1508931601	1	1	FAIN, MICHAEL D OD	4/2/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	323 N MATHILDA AVE	None	SUNNYVALE	CA	94085	4207	43	06085	37.38565917	-122.0317807	Santa Clara County
44554	Fee-for-Service	1417297847	1417297847	1	4	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	751 S WEIR CANYON RD	SUITE 167	ANAHEIM	CA	92808	1692	30	06059	33.86181251	-117.7376332	Orange County
44612	Fee-for-Service	1740305671	1740305671	1	1	FRIEDMAN, JOHN D MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35644	None	None	0	In state provider	None	8635 W 3RD ST	STE 170W	LOS ANGELES	CA	90048	6103	19	06037	34.07361928	-118.3803143	Los Angeles County
44654	Fee-for-Service	1922578608	1922578608	1	1	FREE YOUR MIND MARRIAGE & FA	1/16/2024	104100000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MILY THERAPY, PROFESSION	23121 VERDUGO DRIVE	SUITE 105	LAGUNA HILLS	CA	92653	1003	30	06059	33.62655523	-117.7292097	Orange County
44666	Fee-for-Service	1669896502	1669896502	1	1	FRANCIS, CAMERON MD	12/3/2020	208200000X	NA	General Surgery	026	PHYSICIANS	128597	None	None	0	In state provider	None	9888 GENESEE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
44777	Fee-for-Service	1285741090	1285741090	1	1	FRISHBERG, DAVID P MD	12/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	61364	22	Pathology (M.D. only)	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
44782	Fee-for-Service	1972250165	1972250165	1	1	FORER-DEHREY, SUSAN I LCSW	12/14/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
44833	Fee-for-Service	1548349681	1548349681	1	2	FURY, RICHARD MD	8/15/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	39943	-	NOT APPLICABLE	0	In state provider	None	201 D STREET	STE G	MARYSVILLE	CA	95901	5957	58	06115	39.13753087	-121.5885645	Yuba County
44891	Fee-for-Service	1851334833	1851334833	1	1	FANG, ZHUANG-TING MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64027	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
44927	Fee-for-Service	1114037033	1114037033	1	1	FRANZINO, STEPHEN J	12/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	76023	20	Orthopedic Surgery	0	In state provider	None	38690 STIVERS STREET	STE A	FREMONT	CA	94536	5276	01	06001	37.55724607	-121.9830866	Alameda County
45058	Fee-for-Service	1588736508	1588736508	1	1	FILLMORE, KIMBERLEY E MD	6/1/2016	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	74184	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	999 S FAIRMONT AVENUE	SUITE 230	LODI	CA	95240	5142	39	06077	38.1206163	-121.2858323	San Joaquin County
45062	Fee-for-Service	1639596489	1639596489	1	1	FUTTERMAN, SUSAN N LMFT	6/22/2023	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
45107	Fee-for-Service	1487819819	1487819819	1	1	FERNANDEZ, DIANE R MD	4/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114125	22	Pathology (M.D. only)	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
45111	Fee-for-Service	1336677186	1336677186	1	1	FANTAYE, SAMUEL H MD	7/19/2022	207R00000X	NA	Other	026	PHYSICIANS	169452	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
45119	Fee-for-Service	1982031241	1982031241	1	1	FRANZEN, ANNETTE G PSYD	5/31/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1660 E ROSEVILLE	BUILDING C	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
45134	Fee-for-Service	1053477638	1053477638	1	1	FRENCHMAN, MEGHANA MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95348	41	Internal Medicine	0	In state provider	None	375 HUNTINGTON DRIVE	STE G	SAN MARINO	CA	91108	2357	19	06037	34.1067704	-118.1349621	Los Angeles County
45142	Fee-for-Service	1609537919	1609537919	1	1	FREDEKING, ROBIN T NP	7/26/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5555 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	4000	01	06001	37.69212528	-121.8803442	Alameda County
45157	Fee-for-Service	1912348194	1912348194	1	1	FRESNO COUNTY HISPANIC	8/8/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	COMMISSION ON ALCOHOL AN	1414 W KEARNEY BLVD	None	FRESNO	CA	93706	2702	10	06019	36.72868305	-119.8279548	Fresno County
45199	Fee-for-Service	1083181317	1083181317	1	1	FIGUEROA, VIVIAN M	11/6/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
45230	Fee-for-Service	1417035999	1417035999	1	1	FARAHABADI, ELLIE MD	12/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70665	41	Internal Medicine	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
45235	Fee-for-Service	1023051588	1023051588	1	1	FRAZER, GREGORY J	8/4/2003	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	11645 WILSHIRE BLVD	STE 600	LOS ANGELES	CA	90025	6807	19	06037	34.05005135	-118.4602303	Los Angeles County
45281	Fee-for-Service	1366755209	1366755209	1	1	FLEMING, KAREN L MD	3/10/2023	207LP3000X	NA	Other	026	PHYSICIANS	118593	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
45288	Fee-for-Service	1528209236	1528209236	1	1	FAHIMI, JAHAN MD	8/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102483	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
45303	Fee-for-Service	1417953043	1417953043	1	1	FISHMAN, SIDNEY H MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	30590	04	Otology, Laryngology, Rhinology	0	In state provider	None	3801 KATELLA AVE	STE 425	LOS ALAMITOS	CA	90720	6901	30	06059	33.80318951	-118.066068	Orange County
45346	Fee-for-Service	1033508874	1033508874	1	1	FILSOOF, AMY R MD	9/3/2020	207R00000X	NA	Other	026	PHYSICIANS	150946	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
45367	Fee-for-Service	1720100506	1720100506	1	1	FRYE, ADAMA M MD	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111415	13	Neurology (M.D. only)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
45400	Fee-for-Service	1649255498	1649255498	1	1	FLAMING, DANIEL T	1/28/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	142335	01	General Practice	0	In state provider	None	2 WEST FERN	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
45413	Fee-for-Service	1346301769	1346301769	1	1	FORKINS, STEPHEN M LCSW	4/27/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
45455	Fee-for-Service	1255324042	1255324042	1	2	FAGAN, JOHN OD	10/28/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	20231 W VALLEY BLVD	STE G	TEHACHAPI	CA	93561	6865	15	06029	35.12450852	-118.4900355	Kern County
45521	Fee-for-Service	1144424144	1144424144	1	1	FIDLER, RICHARD L CRNA	9/9/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
45529	Fee-for-Service	1912998220	1912998220	1	1	FEBRES, PEDRO R MD	2/22/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	29593	66	Emergency Medicine (Urgent Care)	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
45556	Fee-for-Service	1154409746	1154409746	1	1	FONG, JULIA MD	10/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81403	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
45650	Fee-for-Service	1437241932	1437241932	1	1	FUNK, KENT J MD	11/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	69465	None	None	0	In state provider	None	525 E MICHELTORENA ST	STE 110	SANTA BARBARA	CA	93103	4208	42	06083	34.4320636	-119.7020672	Santa Barbara County
45680	Fee-for-Service	1932272630	1932272630	1	1	FREEMAN, NATHAN P MD	4/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104678	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
45703	Fee-for-Service	1265499412	1265499412	1	1	FELTMAN, RICHARD I	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3511 CAMINO DEL RIO S	STE 302	SAN DIEGO	CA	92108	4020	37	06073	32.77772762	-117.1180597	San Diego County
45707	Fee-for-Service	1447473921	1447473921	1	1	FARMER, CRAIG M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66504	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
45780	Fee-for-Service	1629070008	1629070008	1	1	FREEMAN, HEIDI M MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	87867	None	None	0	In state provider	None	1035 PEACH ST	STE 301	SAN LUIS OBISPO	CA	93401	2700	40	06079	35.28478505	-120.6627228	San Luis Obispo County
45818	Fee-for-Service	1912998220	1912998220	1	1	FEBRES, PEDRO R MD	2/22/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	29593	01	General Practice	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
45844	Fee-for-Service	1467461574	1467461574	1	1	FANG, JOHN P MD	10/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54802	18	Ophthalmology	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
45897	Fee-for-Service	1104166297	1104166297	1	1	FLOWERS-GUERRERO, JESSICA M	6/10/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
45948	Fee-for-Service	1245686195	1245686195	1	1	FUNG, NATHANIEL S MD	9/16/2022	208600000X	NA	General Surgery	026	PHYSICIANS	179922	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
46011	Fee-for-Service	1043304611	1043304611	1	1	FULLER, TONYA F MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140674	13	Neurology (M.D. only)	0	In state provider	None	782 E HARDING WY	None	STOCKTON	CA	95204	6101	39	06077	37.96910043	-121.284224	San Joaquin County
46025	Fee-for-Service	1912964842	1912964842	1	1	FAULKNER, MARY E NP	3/14/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	350 30TH STREET	SUITE 208	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
46102	Fee-for-Service	1235239088	1235239088	1	1	FORSCHER, CHARLES A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73332	78	Neoplastic Diseases/Oncology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
46143	Fee-for-Service	1114998861	1114998861	1	1	FEENAGHTY, MARTHA DO	12/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	7827	None	None	0	In state provider	None	1117 E DEVONSHIRE AVENUE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
46146	Fee-for-Service	1609054139	1609054139	1	1	FURMAN, ANCHEL MD	1/23/2008	207R00000X	NA	Other	026	PHYSICIANS	49247	41	Internal Medicine	0	In state provider	None	630 S RAYMOND AVENUE	#240	PASADENA	CA	91105	3283	19	06037	34.13505223	-118.1487761	Los Angeles County
46222	Fee-for-Service	1477581056	1477581056	1	1	FELDSTEIN, VICKIE A MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	62159	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
46242	Fee-for-Service	1730137126	1730137126	1	1	FERRELL, LINDA D MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	41978	90	Pathology-Forensic	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
46259	Fee-for-Service	1063037067	1063037067	1	1	FOWLER, JAMIE LCSW	8/30/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
46290	Fee-for-Service	1184796997	1184796997	1	1	FENTZKE, KATHLEEN M MD	8/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51753	40	Pediatrics	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
46305	Fee-for-Service	1518592021	1518592021	1	1	FIRST SURGERY CENTER, INC.	9/7/2021	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	31625 DE PORTOLA RD	102	TEMECULA	CA	92592	2770	33	06065	33.48359715	-117.1048345	Riverside County
46324	Fee-for-Service	1770328635	1770328635	1	1	FIRST 5 MENDOCINO	2/12/2025	172V00000X	NA	Other	109	LOCAL HEALTH JURISDICTIONS	-	-	NOT APPLICABLE	0	In state provider	None	419 TALMAGE ROAD	J	UKIAH	CA	95482	0000	23	06045	39.1361207	-123.2000593	Mendocino County
46325	Fee-for-Service	1063987329	1063987329	1	1	FULLER, TOCCARA LAJANDA	7/20/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2716 E MICHIGAN AVENUE	None	FRESNO	CA	93703	1134	10	06019	36.77678307	-119.77894	Fresno County
46339	Fee-for-Service	1114160892	1114160892	1	1	FIRST BRISTOL OPTOMETRY	5/5/2009	302F00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1601 W 1ST ST	STE C	SANTA ANA	CA	92703	3670	30	06059	33.7454853	-117.8902193	Orange County
46347	Fee-for-Service	1174697486	1174697486	1	1	FONG, GEORGE H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38311	01	General Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
46374	Fee-for-Service	1578646626	1578646626	1	1	FL & CO	1/30/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	NEWPORT COAST PHARMACY	400 NEWPORT CENTER DR	STE 106	NEWPORT BEACH	CA	92660	8600	30	06059	33.6142606	-117.8726808	Orange County
46389	Fee-for-Service	1235239088	1235239088	1	1	FORSCHER, CHARLES A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73332	68	Hematology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
46408	Fee-for-Service	1700144946	1700144946	1	1	FOTIOU, HELENA MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128464	41	Internal Medicine	0	In state provider	None	8700 BEVELRY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
46477	Fee-for-Service	1790136372	1790136372	1	1	FAZAL, ARSALAN MD	11/1/2020	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
46526	Fee-for-Service	1053378802	1053378802	1	1	FREMONT ARTIFICIAL LIMB &	7/1/1996	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	BRACE INC	1999 MOWRY AVE	STE J	FREMONT	CA	94538	1723	01	06001	37.55783419	-121.9808484	Alameda County
46531	Fee-for-Service	1730137126	1730137126	1	1	FERRELL, LINDA D MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	41978	22	Pathology (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
46568	Fee-for-Service	1366764763	1366764763	1	1	FISHMAN, MICHAEL P DPM	1/4/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3851 KATELLA AVE	SUITE # 255	LOS ALAMITOS	CA	90720	3377	30	06059	33.80319053	-118.0657305	Orange County
46573	Fee-for-Service	1114027125	1114027125	1	1	FELOBOUS, SYLVIA M G MD	10/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	75000	40	Pediatrics	0	In state provider	None	8204 LONG BEACH BLVD	STE B	SOUTH GATE	CA	90280	2011	19	06037	33.96384526	-118.2251089	Los Angeles County
46612	Fee-for-Service	1063987329	1063987329	1	1	FULLER, TOCCARA LAJANDA	7/20/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2716 E MICHIGAN AVENUE	None	FRESNO	CA	93703	1134	10	06019	36.77678307	-119.77894	Fresno County
46634	Fee-for-Service	1134984826	1134984826	1	1	FAMILY CARE TRANSPORTATION I	7/6/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	NC	66 FRANKLIN ST	300	OAKLAND	CA	94607	3728	01	06001	37.79455987	-122.2757573	Alameda County
46641	Fee-for-Service	1225489305	1225489305	1	1	FOX, ELIZABETH A MD	8/27/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	172443	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
46671	Fee-for-Service	1407241581	1407241581	1	1	FABERSUNNE, CAMILA S MD	6/21/2018	390200000X	NA	Other	026	PHYSICIANS	146835	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	6E/6D37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
46677	Fee-for-Service	1235239088	1235239088	1	1	FORSCHER, CHARLES A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73332	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
46681	Fee-for-Service	1104296433	1104296433	1	1	FREEDOM MEDICAL GROUP INC	2/20/2018	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	555 W PUTNAM AVENUE	None	PORTERVILLE	CA	93257	3286	54	06107	36.06956396	-119.0291153	Tulare County
46686	Fee-for-Service	1528005154	1528005154	1	1	FAYE DOERHOFF MD	1/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1465 S GRAND BLVD	None	SAINT LOUIS	MO	63104	1003	00	None	38.62142784	-90.23848205	St. Louis city
46696	Fee-for-Service	1861965410	1861965410	1	1	FAMILIA FARMACIA INC	2/12/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1757 CROWS LANDING RD	None	MODESTO	CA	95358	5608	50	06099	37.603611	-120.9935675	Stanislaus County
46697	Fee-for-Service	1073689832	1073689832	1	1	FULMER, HUGH P MD	1/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	41467	None	None	0	In state provider	None	3628 E IMPERIAL HWY	STE 408	LYNWOOD	CA	90262	2646	19	06037	33.93070837	-118.2044557	Los Angeles County
46706	Fee-for-Service	1255497897	1255497897	1	1	FUNG, MARTIN A MD FAAP	6/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78439	40	Pediatrics	0	In state provider	None	595 BUCKINGHAM WY	STE 430	SAN FRANCISCO	CA	94132	1912	38	06075	37.73012679	-122.4767395	San Francisco County
46715	Fee-for-Service	1871571786	1871571786	1	1	FOUSS, CLINTON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMERGENCY MED SPCLST PC	3033 S PARKER RD, #800	None	AURORA	CO	80014	0000	00	None	39.6612	-104.8603095	Arapahoe County
46746	Fee-for-Service	1912953936	1912953936	1	8	FAIRBANKS & POWER PHYSICAL T	1/25/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	25381 RAILROAD CANYON RD	1101 AND 1102	LAKE ELSINORE	CA	92532	2705	33	06065	33.66885662	-117.2636558	Riverside County
46772	Fee-for-Service	1023874302	1023874302	1	1	FOSTER, KRYSTAL M	3/21/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
46831	Fee-for-Service	1801440276	1801440276	1	1	FAMILY PLANNING ASSOCAITES M	12/19/2019	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	EDICAL GROUP INC	301 N PRAIRIE AVENUE	SUITE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
46897	Fee-for-Service	1710094024	1710094024	1	1	FREYALDENHOVEN, STEPHEN	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69296	06	Cardiovascular Disease (M.D. only)	0	In state provider	MD	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	40	06079	35.27804785	-120.649711	San Luis Obispo County
46903	Fee-for-Service	1396321758	1396321758	1	1	FUNEZ CASTRO, ESTHER DO	11/13/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20906	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
46919	Fee-for-Service	1790769479	1790769479	2	1	FLORES, RICARDO R MD	9/13/2017	2080P0214X	NA	Pulmonology	026	PHYSICIANS	58554	01	General Practice	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
46939	Fee-for-Service	1275589756	1275589756	1	1	FARID, MARJAN MD	6/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85936	18	Ophthalmology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
46949	Fee-for-Service	1043301344	1043301344	1	1	FISHER, LYNDA K MD	1/1/1982	2080P0205X	NA	Endocrinology	026	PHYSICIANS	23566	67	Endocrinology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
46963	Fee-for-Service	1770011348	1770011348	1	1	FREDRICKSON, MATILDE DO	9/20/2021	207QA0401X	NA	Adult Primary Care	026	PHYSICIANS	16704	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
46978	Fee-for-Service	1821299660	1821299660	1	1	FERRER, JENNIFER A MD	2/8/2015	390200000X	NA	Other	026	PHYSICIANS	105820	36	Psychiatry	0	In state provider	None	4619 N ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	1478	19	06037	34.08871316	-118.073569	Los Angeles County
46992	Fee-for-Service	1497702492	1497702492	1	1	FRANKLIN, WILLIAM E DO	7/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10997	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 OLD RIVER ROAD	None	BAKERSFIELD	CA	93311	9781	15	06029	35.351487	-119.1143025	Kern County
46999	Fee-for-Service	1346690138	1346690138	1	1	FARHANGIAN, MICHAEL E MD	7/2/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	167882	07	Dermatology	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
47018	Fee-for-Service	1245304542	1245304542	1	1	FONG, CHRISTINE W MD	12/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	80361	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
47023	Fee-for-Service	1679652713	1679652713	1	1	FONG, RONALD L MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	30899	08	Family Practice	0	In state provider	None	1604 UNION ST	None	SAN FRANCISCO	CA	94123	4507	38	06075	37.79834855	-122.4258054	San Francisco County
47046	Fee-for-Service	1942418348	1942418348	1	1	FOOT SPECIALISTS NORTHRI	4/22/1980	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	PODIATRY GROUP	9335 RESEDA BLVD	STE 500	NORTHRIDGE	CA	91324	2979	19	06037	34.24019062	-118.5361007	Los Angeles County
47058	Fee-for-Service	1235583287	1235583287	1	1	FARNOOSH, SOROUSH MD	10/27/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	171997	None	None	0	In state provider	None	1700 E CESAR E CHAVEZ AV	SUITE 2500	LOS ANGELES	CA	90033	2434	19	06037	34.05101259	-118.217259	Los Angeles County
47062	Fee-for-Service	1326454463	1326454463	1	1	FRIED, EVA M	11/3/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	161821	None	None	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
47081	Fee-for-Service	1902093610	1902093610	1	1	FRED P GUARCELLO & PETER	9/5/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	S KLEM PTR	1263 PLEASANT GROVE BLVD	STE 100	ROSEVILLE	CA	95747	5858	31	06061	38.77233838	-121.3143437	Placer County
47118	Fee-for-Service	1881806610	1881806610	1	1	FORTUNA PHARMACY INC	10/7/1991	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1058 MAIN ST	None	FORTUNA	CA	95540	2009	12	06023	40.59800746	-124.1558685	Humboldt County
47126	Fee-for-Service	1962842823	1962842823	1	1	FLETCHALL, LEAH MD	10/30/2018	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1775 THOMPSON ROAD	None	COOS BAY	OR	97420	2125	00	None	43.383456	-124.2330435	Coos County
47135	Fee-for-Service	1699326132	1699326132	1	1	FINCALERO, FRANCISCO NP	2/10/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3656 W SHAW AVE	None	FRESNO	CA	93711	3231	10	06019	36.80840238	-119.8594473	Fresno County
47161	Fee-for-Service	1336528215	1336528215	1	1	FLEWELLING, CAITLIN LCSW	10/10/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 N PALM CANYON DR	215	PALM SPRINGS	CA	92262	5658	33	06065	33.827652	-116.5468485	Riverside County
47186	Fee-for-Service	1710094024	1710094024	1	1	FREYALDENHOVEN, STEPHEN	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69296	33	Thoracic Surgery	0	In state provider	MD	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	40	06079	35.27804785	-120.649711	San Luis Obispo County
47212	Fee-for-Service	1487848966	1487848966	1	1	FERNANDES, TIMOTHY J PT	12/22/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4318 SPYRES WAY	None	MODESTO	CA	95356	9259	50	06099	37.70194177	-120.9988293	Stanislaus County
47226	Fee-for-Service	1134280233	1134280233	1	1	FLEISCHMANN, LAURA J LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
47230	Fee-for-Service	1962579847	1962579847	1	1	FEINSTEIN, CHARLES I MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36116	40	Pediatrics	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
47239	Fee-for-Service	1043301344	1043301344	1	1	FISHER, LYNDA K MD	1/1/1982	2080P0205X	NA	Endocrinology	026	PHYSICIANS	23566	40	Pediatrics	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
47278	Fee-for-Service	1700051729	1700051729	1	1	FINALLE, CHERI L MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111800	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
47311	Fee-for-Service	1679652713	1679652713	1	1	FONG, RONALD L MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	30899	41	Internal Medicine	0	In state provider	None	1604 UNION ST	None	SAN FRANCISCO	CA	94123	4507	38	06075	37.79834855	-122.4258054	San Francisco County
47358	Fee-for-Service	1508248535	1508248535	1	1	FIUTKO, AMBER N MD	10/13/2019	207P00000X	NA	Other	026	PHYSICIANS	160320	None	None	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4304	37	06073	32.63282707	-117.0829101	San Diego County
47391	Fee-for-Service	1447811104	1447811104	1	1	FAN, XIYING MD	8/13/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	176538	07	Dermatology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
47549	Fee-for-Service	1336206754	1336206754	1	1	FREEBERG, GILA LCSW	4/30/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
47557	Fee-for-Service	1932594017	1932594017	1	1	FENG, TAOYUAN R MD	7/28/2020	207L00000X	NA	Other	026	PHYSICIANS	168436	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
47588	Fee-for-Service	1396220067	1396220067	1	1	FLANNIGAN, KRISTIN CCC-SLP	12/26/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2505 W SHAW AVE	STE. 101	FRESNO	CA	93711	3334	10	06019	36.80619423	-119.8359004	Fresno County
47647	Fee-for-Service	1134275373	1134275373	1	1	FINAMORE, JENNIFER A MFT	9/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3172 WALFORD AVE	STE 1	EUREKA	CA	95503	4898	12	06023	40.77960999	-124.1378813	Humboldt County
47660	Fee-for-Service	1366492399	1366492399	1	1	FACULTY PHYS & SURGEONS	6/1/1999	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	OF LLUSM-INTERNAL MED	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
47671	Fee-for-Service	1033563879	1033563879	1	1	FRENCH, MEGAN C CRNA	2/28/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
47676	Fee-for-Service	1205877172	1205877172	1	1	FAXTON-ST LUKES HEALTHCARE	5/24/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1676 SUNSET AVENUE	None	UTICA	NY	13502	5416	00	None	43.09083945	-75.25756844	Oneida County
47696	Fee-for-Service	1043501943	1043501943	1	1	FARZAD, ASHKAN MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126165	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
47738	Fee-for-Service	1730821141	1730821141	1	1	FUNG, CORY NP	7/31/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
47747	Fee-for-Service	1528260122	1528260122	1	1	FRANKLIN-MCKINLEY SD	6/24/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	645 WOOL CREEK DR	None	SAN JOSE	CA	95112	2617	43	06085	37.31593216	-121.8501245	Santa Clara County
47753	Fee-for-Service	1295967388	1295967388	1	1	FATIMA JAFFER	6/20/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	345 SMITH AVE N	None	SAINT PAUL	MN	55102	2346	00	None	44.94251219	-93.1074995	Ramsey County
47768	Fee-for-Service	1053488932	1053488932	1	1	FONG, ALISON A MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62678	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
47812	Fee-for-Service	1043823511	1043823511	1	1	FENDER, ELYSE	8/17/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
47841	Fee-for-Service	1275538241	1275538241	1	1	FRASCHETTI, DANIEL J DO	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8445	40	Pediatrics	0	In state provider	None	57445 29 PALMS HWY	STE 302	YUCCA VALLEY	CA	92284	2947	36	06071	34.12434696	-116.4111216	San Bernardino County
47852	Fee-for-Service	1942937321	1942937321	1	1	FREEDMAN, GALEN OT	1/20/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	300 STEIN PLZ	420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
47898	Fee-for-Service	1215193149	1215193149	1	1	FAMILY SERVICE AGENCY TEHAMA	8/28/2018	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	COUNTY	1347 GRANT ST	None	RED BLUFF	CA	96080	2366	52	06103	40.18355103	-122.2401731	Tehama County
47925	Fee-for-Service	1093441875	1093441875	1	1	FERNANDEZ, ANTHONY NP	2/24/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1161 E COVINA BLVD	None	COVINA	CA	91724	1523	19	06037	34.09946746	-117.8671905	Los Angeles County
47965	Fee-for-Service	1205877172	1205877172	1	1	FAXTON-ST LUKES HEALTHCARE	5/24/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1676 SUNSET AVENUE	None	UTICA	NY	13502	5416	00	None	43.09083945	-75.25756844	Oneida County
48223	Fee-for-Service	1275858177	1275858177	1	1	FRANCO, BEDELCIA Z MFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
48224	Fee-for-Service	1699326272	1699326272	1	1	FREEDOM LIFE HOSPICE LLC	2/23/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8904 RESEDA BLVD	STE 205	NORTHRIDGE	CA	91324	3930	19	06037	34.232058	-118.536062	Los Angeles County
48279	Fee-for-Service	1225004435	1225004435	1	1	FELFOLDI, JAMES DPM INC	11/1/1999	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3340 KEMPER ST	STE 102	SAN DIEGO	CA	92110	4907	37	06073	32.7529355	-117.2146751	San Diego County
48383	Fee-for-Service	1558651406	1558651406	1	1	FISCHETTE, WILLIAM S MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125498	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
48409	Fee-for-Service	1033556196	1033556196	1	1	FLANNERY, ELIZABETH A	8/1/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
48420	Fee-for-Service	1023038262	1023038262	1	1	FIELD, CAROLE H MFT	5/21/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4789 VINELAND AVENUE	SUITE 208	TOLUCA LAKE	CA	91602	3578	19	06037	34.15727541	-118.3706703	Los Angeles County
48431	Fee-for-Service	1720319908	1720319908	1	2	FOY, ROSA I LMFT	2/8/2020	261QM0850X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	301 9TH ST	SUITE 213	REDLANDS	CA	92374	4412	36	06071	34.05825	-117.177229	San Bernardino County
48436	Fee-for-Service	1982666871	1982666871	1	1	FOGG, STEVEN G MD	3/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	74705	18	Ophthalmology	0	In state provider	None	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
48445	Fee-for-Service	1154772705	1154772705	1	1	FAMILY HEALTHCARE NETWORK	8/20/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12586 AVENUE 408	None	OROSI	CA	93647	9454	54	06107	36.53030229	-119.2915122	Tulare County
48511	Fee-for-Service	1699326272	1699326272	1	1	FREEDOM LIFE HOSPICE LLC	2/23/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8904 RESEDA BLVD	STE 205	NORTHRIDGE	CA	91324	3930	19	06037	34.232058	-118.536062	Los Angeles County
48530	Fee-for-Service	1801073960	1801073960	1	1	FLANS, ROBIN PHD	6/5/2008	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	#230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
48534	Fee-for-Service	1598858813	1598858813	1	1	FITZPATRICK, MOIRA P PHD	5/10/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
48569	Fee-for-Service	1295381796	1295381796	1	1	FOOTHILLS EXTENDED CARE INC	3/12/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1040 MARSHALL WAY	None	PLACERVILLE	CA	95667	5706	09	06017	38.72616862	-120.7928905	El Dorado County
48611	Fee-for-Service	1780822171	1780822171	1	1	FU, KATHERINE J MD	9/25/2019	2086S0122X	NA	General Surgery	026	PHYSICIANS	112103	None	None	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
48622	Fee-for-Service	1891048203	1891048203	1	1	FOUST, CASSANDRA J	9/17/2013	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
48641	Fee-for-Service	1811246457	1811246457	1	1	FAERSTEIN, IAN D PHD	2/2/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
48647	Fee-for-Service	1750366720	1750366720	1	1	FLOYD, LISA JO. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
48653	Fee-for-Service	1306876131	1306876131	1	1	FROMER, ERIC B DC	7/25/2023	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	5123 W. SUNSET BLVD.	#202	LOS ANGELES	CA	90027	5779	19	06037	34.0981773	-118.3013882	Los Angeles County
48682	Fee-for-Service	1982698478	1982698478	1	1	FELSON, SUZANNE C DPM	6/19/2019	213ES0131X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
48684	Fee-for-Service	1104190891	1104190891	1	1	FLORES, JESSICA LCSW	10/26/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
48701	Fee-for-Service	1629599261	1629599261	1	1	FICINSKI, MATTHEW MD	12/10/2020	390200000X	NA	Other	026	PHYSICIANS	166178	None	None	0	In state provider	None	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
48743	Fee-for-Service	1326863200	1326863200	1	1	FRANCE, HANNAH	1/17/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
48753	Fee-for-Service	1407863756	1407863756	1	1	FONG, MICHAEL W MD	12/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114374	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	STE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
48757	Fee-for-Service	1992729313	1992729313	1	1	FERRARI, ALBERT A MD INC	2/28/1991	207RR0500X	NA	Other	026	PHYSICIANS	12909	41	Internal Medicine	0	In state provider	None	5904 N EL DORADO ST	STE E	STOCKTON	CA	95207	4467	39	06077	38.00704727	-121.3084478	San Joaquin County
48822	Fee-for-Service	1053595207	1053595207	1	1	FOOS, AMELIA G	2/26/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
48901	Fee-for-Service	1912953936	1912953936	1	1	FAIRBANKS & POWER PHYSICAL T	7/31/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	25251 PASEO DE ALICIA	SUITE 201	LAGUNA HILLS	CA	92653	4616	30	06059	33.60148289	-117.6894952	Orange County
48906	Fee-for-Service	1538625850	1538625850	1	1	FIRST AID HOSPICE INC	9/1/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	401 N BRAND BLVD	STE 262	GLENDALE	CA	91203	4444	19	06037	34.151958	-118.255149	Los Angeles County
48915	Fee-for-Service	1881772978	1881772978	1	1	FERRER, WALDO L MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89359	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
48975	Fee-for-Service	1427221944	1427221944	1	1	FRIENDLY PHARMACY INCORP	4/28/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	FRIENDLY #2 PHARMACY	639 TULLY RD	#A	SAN JOSE	CA	95111	1000	43	06085	37.30925506	-121.8458869	Santa Clara County
49023	Fee-for-Service	1508129859	1508129859	1	1	FREEMAN, ANDREA LCSW	9/27/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	250 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26846327	-121.9547306	Santa Clara County
49107	Fee-for-Service	1164741690	1164741690	1	1	FUNG, LAWRENCE K MD	12/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113519	36	Psychiatry	0	In state provider	None	725 WELCH RD	MC 5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
49111	Fee-for-Service	1992866701	1992866701	1	1	FIDLER, SUZANNE A MD	9/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	56291	41	Internal Medicine	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
49132	Fee-for-Service	1962160994	1962160994	1	1	FAVOR TRANSIT	3/15/2023	342000000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	5179 LONE TREE WAY	543	ANTIOCH	CA	94531	8689	07	06013	37.96178982	-121.7554986	Contra Costa County
49133	Fee-for-Service	1861102568	1861102568	1	1	FEER, KAHLER M PT	12/6/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1950 S SUNWEST LN	108	SAN BERNARDINO	CA	92408	3263	36	06071	34.06493336	-117.2907254	San Bernardino County
49151	Fee-for-Service	1558866418	1558866418	1	1	FANG, KEXIN MD	9/15/2022	207R00000X	NA	Other	026	PHYSICIANS	178121	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
49153	Fee-for-Service	1366448466	1366448466	1	1	FRAZIER, JOEL L MD	10/11/2018	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	85911	20	Orthopedic Surgery	0	In state provider	None	609 E ORANGEBURG AVE	STE 201	MODESTO	CA	95350	5512	50	06099	37.66364947	-120.9857985	Stanislaus County
49193	Fee-for-Service	1538625850	1538625850	1	1	FIRST AID HOSPICE INC	9/1/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	401 N BRAND BLVD	STE 262	GLENDALE	CA	91203	4444	19	06037	34.151958	-118.255149	Los Angeles County
49203	Fee-for-Service	1881772978	1881772978	1	1	FERRER, WALDO L MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89359	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
49256	Fee-for-Service	1790358265	1790358265	1	1	FERNANDEZ, DANICA MAE	10/16/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	423 IMPERIAL HWY	None	FULLERTON	CA	92835	1146	30	06059	33.91749052	-117.925452	Orange County
49320	Fee-for-Service	1891806477	1891806477	1	1	FACTOR, ANDREW D MD	8/27/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69626	41	Internal Medicine	0	In state provider	None	1201 ALHAMBRA BLVD	STE 230	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
49364	Fee-for-Service	1265056709	1265056709	1	1	FERNANDEZ, JENNIFER NP	3/24/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
49402	Fee-for-Service	1437387081	1437387081	1	1	FRIEBELE, JILL C MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131970	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
49420	Fee-for-Service	1942255195	1942255195	1	1	FCS MEDICAL CORPORATION	8/1/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FAMILY CARE SPECIALISTS	1701 E CESAR E CHAVEZ AV	STE 230	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
49455	Fee-for-Service	1902011026	1902011026	1	1	FORGHANI, NIKTA MD	8/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	82286	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
49512	Fee-for-Service	1770978918	1770978918	1	1	FERRARO, REGAN MD	4/27/2020	111NR0200X	NA	Other	026	PHYSICIANS	146343	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
49518	Fee-for-Service	1679516157	1679516157	1	1	FERRER, NOEL A M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54527	05	Anesthesiology	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
49583	Fee-for-Service	1417297847	1417297847	1	11	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	2240 N HARBOR BLVD	SUITE 200	FULLERTON	CA	92835	2635	30	06059	33.89764434	-117.929218	Orange County
49606	Fee-for-Service	1740368323	1740368323	1	1	FONG, KATHERINE J MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63100	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
49612	Fee-for-Service	1407310360	1407310360	1	1	FORONDA, LAUREN A A	2/19/2019	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4541 PHILADELPHIA ST	STE C-103	CHINO	CA	91710	2250	36	06071	34.0334157	-117.7057109	San Bernardino County
49636	Fee-for-Service	1831235936	1831235936	1	1	FRANKEL, LORRY R MD	4/1/1981	2080P0203X	NA	Other	026	PHYSICIANS	33884	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	750 WELCH ROAD	SUITE 315	PALO ALTO	CA	94304	1510	43	06085	37.43749692	-122.175445	Santa Clara County
49672	Fee-for-Service	1568476505	1568476505	1	1	FOSTER, STEVEN A DO	6/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8530	40	Pediatrics	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
49693	Fee-for-Service	1043461148	1043461148	1	1	FIRST CHOICE HEARING AID	4/8/2016	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	22622 LAMBERT ST	SUITE 301B	LAKE FOREST	CA	92630	1669	30	06059	33.63396854	-117.7143897	Orange County
49718	Fee-for-Service	1720061534	1720061534	1	1	FRANKLIN, STEPHEN D MD	1/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85446	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
49883	Fee-for-Service	1972985208	1972985208	1	1	FURST, KATHERINE	1/8/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
50000	Fee-for-Service	1669886891	1669886891	2	1	FADIAL, TOM	11/15/2023	207P00000X	NA	Other	026	PHYSICIANS	138385	None	None	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
50044	Fee-for-Service	1790017218	1790017218	1	1	FAKHERI, SAMAN MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107753	41	Internal Medicine	0	In state provider	None	14411 HAMLIN ST	None	VAN NUYS	CA	91401	1467	19	06037	34.18869553	-118.447074	Los Angeles County
50082	Fee-for-Service	1073637286	1073637286	1	1	FARIDMOHAJER, MEHRDAD MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77485	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
50128	Fee-for-Service	1255838488	1255838488	1	1	FRANCIS, LETHA	2/14/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
50161	Fee-for-Service	1780635078	1780635078	1	1	FLAGSTAFF MEDICAL CENTER	2/16/2016	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
50198	Fee-for-Service	1407814486	1407814486	1	1	FAGAN, ROYCE M JR MD	9/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55132	41	Internal Medicine	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
50259	Fee-for-Service	1952747628	1952747628	1	1	FREDERICKS, CHARLES MD	6/30/2020	208600000X	NA	General Surgery	026	PHYSICIANS	161492	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
50288	Fee-for-Service	1790967453	1790967453	1	1	FRESNO STATE UNIVERSITY	1/7/2008	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	None	5044 N BARTON AVE	M/S HC81	FRESNO	CA	93740	8012	10	06019	36.80942142	-119.7496436	Fresno County
50447	Fee-for-Service	1780635078	1780635078	1	1	FLAGSTAFF MEDICAL CENTER	2/16/2016	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
50461	Fee-for-Service	1902579402	1902579402	1	1	FAST RESPONSE HOME HEALTH	5/24/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	6410 VAN NUYS BLVD	UNIT E101	VAN NUYS	CA	91401	1449	19	06037	34.187085	-118.4487115	Los Angeles County
50471	Fee-for-Service	1912296799	1912296799	1	1	FERNANDEZ, LAURA P MD	8/28/2017	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	150677	41	Internal Medicine	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
50486	Fee-for-Service	1871835355	1871835355	1	1	FUERST, NICOLE M MD	6/23/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	161508	18	Ophthalmology	0	In state provider	None	150 S GRAND AVE	STE I	GLENDORA	CA	91741	4717	19	06037	34.13462554	-117.8725267	Los Angeles County
50489	Fee-for-Service	1649478918	1649478918	1	1	FAJARDO, GREGORIO G	6/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
50555	Fee-for-Service	1952513475	1952513475	1	1	FERSCHL, MARLA B MD	6/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95737	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVENUE	BOX 0648	SAN FRANCISCO	CA	94122	0648	38	06075	37.76332993	-122.4582988	San Francisco County
50577	Fee-for-Service	1538221288	1538221288	1	1	FATHERS OF ST CHARLES	3/13/1989	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	10631 VINEDALE ST	None	SUN VALLEY	CA	91352	2899	19	06037	34.22867707	-118.3631806	Los Angeles County
50579	Fee-for-Service	1245240092	1245240092	1	1	FRITZZAVACKI, SUSAN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36102	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
50618	Fee-for-Service	1114424595	1114424595	1	1	FELDMAN, HOPE A MD	4/11/2025	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
50651	Fee-for-Service	1790733871	1790733871	1	1	FORTUNA, LISA MD	12/8/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	167748	None	None	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
50677	Fee-for-Service	1942294814	1942294814	1	1	FORT SANDERS REG MED CTR	5/3/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1901 W CLINCH AVE	None	KNOXVILLE	TN	37916	2307	00	None	35.95719519	-83.93632673	Knox County
50710	Fee-for-Service	1750669834	1750669834	1	1	FORBES, ANGELA S DO	7/19/2021	207L00000X	NA	Other	026	PHYSICIANS	18888	None	None	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
50724	Fee-for-Service	1871981472	1871981472	1	1	FLINT, CLARA LCSW	4/4/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
50758	Fee-for-Service	1912296799	1912296799	1	1	FERNANDEZ, LAURA P MD	8/28/2017	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	150677	38	Geriatrics	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
50768	Fee-for-Service	1023258969	1023258969	1	1	FLORES, RANDY N DO	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
50775	Fee-for-Service	1386910388	1386910388	1	1	FULLER, TOVA F MD	12/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	158475	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
50789	Fee-for-Service	1073882130	1073882130	1	1	FAHMY, ERICA R	11/3/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
50817	Fee-for-Service	1831363423	1831363423	1	1	FITZPATRICK, APRIL J CRNA	8/25/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9850 GENESEE AVE	SUITE 440	SAN DIEGO	CA	92037	1212	37	06073	32.882913	-117.226341	San Diego County
50832	Fee-for-Service	1093778698	1093778698	1	1	FUJINO, KATHLEEN M MD	6/30/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80719	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
50863	Fee-for-Service	1700226933	1700226933	1	1	FOCUS MEDICAL IMAGING	11/18/2013	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A PROFESSIONAL MEDICAL	267 S SAN PEDRO STREET	SUITE 261	LOS ANGELES	CA	90012	3874	19	06037	34.04784371	-118.2423418	Los Angeles County
51003	Fee-for-Service	1275697211	1275697211	1	1	FAMILY HOMES, INC	4/1/2004	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	BYRON ICF/DDH HOME	853 NEWMAN DRIVE	None	S SAN FRANCISCO	CA	94080	2124	41	06081	37.66139008	-122.4560938	San Mateo County
51097	Fee-for-Service	1871710160	1871710160	1	1	FEDDERSEN, MICHAEL H DO	9/22/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	9585	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
51134	Fee-for-Service	1275673790	1275673790	1	1	FUNG, GREGORY MD INC	2/27/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	41709	41	Internal Medicine	0	In state provider	None	789 VALLEJO STREET	None	SAN FRANCISCO	CA	94133	3834	38	06075	37.79837302	-122.4102043	San Francisco County
51168	Fee-for-Service	1144268517	1144268517	1	1	FRANCE, YUNGHI K PHD	2/25/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
51200	Fee-for-Service	1578921151	1578921151	1	1	FRESENIUS MEDICAL CARE	5/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	SOLANO COUNTY LLC	125 N LINCOLN STREET	SUITE B	DIXON	CA	95620	3259	48	06095	38.44614779	-121.8364229	Solano County
51264	Fee-for-Service	1346635299	1346635299	1	1	FARR, CHAD B DO	8/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 MARYLAND PKWY	None	LAS VEGAS	NV	89109	2306	00	None	36.132948	-115.136874	Clark County
51291	Fee-for-Service	1922392877	1922392877	1	1	FENIX, JB MD	10/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
51324	Fee-for-Service	1013568526	1013568526	1	1	FRAZIER, KRYSTLE A NP	6/18/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
51341	Fee-for-Service	1417593286	1417593286	1	1	FOCUS HOME HEALTH INC	6/7/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12550 BROOKHURST ST	UNIT F	GARDEN GROVE	CA	92840	4834	30	06059	33.780591	-117.9584435	Orange County
51353	Fee-for-Service	1336371285	1336371285	1	1	FLEMING, KRISTY FAYE MD	6/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120835	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	STE 465	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
51372	Fee-for-Service	1346582053	1346582053	1	1	FOWLER, AARON B MD	5/1/2020	390200000X	NA	Other	026	PHYSICIANS	136191	33	Thoracic Surgery	0	In state provider	None	1310 W STEWART DR	STE 503	ORANGE	CA	92868	3856	30	06059	33.78236048	-117.8664975	Orange County
51410	Fee-for-Service	1750449666	1750449666	1	1	FORD, HEATHER	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
51432	Fee-for-Service	1770653180	1770653180	1	1	FARBEROW, L DAVID OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1537 PACIFIC AVE	None	SANTA CRUZ	CA	95060	3942	44	06087	36.97596432	-122.0267851	Santa Cruz County
51445	Fee-for-Service	1700145562	1700145562	1	1	FORGHANI, DENISSE R MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133073	40	Pediatrics	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
51620	Fee-for-Service	1982657029	1982657029	1	1	FCS MEDICAL CORPORATION	8/31/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FAMILY CARE SPECIALISTS	5823 YORK BLVD	STE 1	LOS ANGELES	CA	90042	2634	19	06037	34.11850913	-118.1915335	Los Angeles County
51681	Fee-for-Service	1093787004	1093787004	1	2	FENZL, GREGORY J DO	11/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	2400 SOUTH AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
51700	Fee-for-Service	1528260577	1528260577	1	1	FERRANTE, MICHELLE L MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	48391	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
51731	Fee-for-Service	1609000405	1609000405	1	1	FAMILY HEALTH CENTERS OF	2/4/2009	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	251 LANDIS	None	CHULA VISTA	CA	91910	2628	37	06073	32.6425313	-117.0814859	San Diego County
51823	Fee-for-Service	1942879390	1942879390	1	1	FLAG HOME HEALTH CARE, INC.	9/12/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3213 DE WITT DR.	SUITE A	LOS ANGELES	CA	90068	1421	19	06037	34.13199027	-118.3449299	Los Angeles County
51845	Fee-for-Service	1093067860	1093067860	1	1	FARR, STEVEN L MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133089	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
51873	Fee-for-Service	1164459434	1164459434	1	1	FREEMAN, MITCH M MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVENUE	# A	YUMA	AZ	85364	0000	00	None	32.683167	-114.633459	Yuma County
51898	Fee-for-Service	1164484572	1164484572	1	1	FORT SUTTER SURGERY CTR	10/2/2007	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SURGICAL CARE AFFILIATES	2801 K ST	STE 525	SACRAMENTO	CA	95816	5191	34	06067	38.572947	-121.46904	Sacramento County
51961	Fee-for-Service	1790306074	1790306074	1	1	FHMC GROUP INC	11/25/2020	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	822 E AVENUE K	None	LANCASTER	CA	93535	4766	19	06037	34.67493856	-118.1138795	Los Angeles County
52021	Fee-for-Service	1114381035	1114381035	1	1	FLORES, ESTHER LCSW	2/19/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	964 5TH AVENUE	SUITE 535	SAN DIEGO	CA	92101	6102	37	06073	32.71539477	-117.1601872	San Diego County
52071	Fee-for-Service	1871688739	1871688739	1	1	FERNANDEZ, MARINO MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	51029	None	None	0	In state provider	None	3152 N MILLBROOK AVE	STE D	FRESNO	CA	93703	1459	10	06019	36.779166	-119.7634925	Fresno County
52087	Fee-for-Service	1225546575	1225546575	1	8	FAMILY HEALTHCARE NETWORK	10/27/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1344 WEST CLINTON AVE	None	FRESNO	CA	93704	3805	10	06019	36.77199051	-119.8275525	Fresno County
52144	Fee-for-Service	1942363882	1942363882	1	1	FANKHAUSER, JOHN E MD	12/1/2003	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	74837	08	Family Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
52189	Fee-for-Service	1699784124	1699784124	1	1	FRANCE, DONALD G. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2811 TIETON DR	None	YAKIMA	WA	98902	3761	00	None	46.59274567	-120.54785	Yakima County
52198	Fee-for-Service	1417297847	1417297847	1	2	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	11160 WARNER AVE	SUITE 117	FOUNTAIN VALLEY	CA	92708	4010	30	06059	33.71630854	-117.934317	Orange County
52207	Fee-for-Service	1396276648	1396276648	1	1	FRIEDMAN, JONATHAN M MD	6/9/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175582	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
52262	Fee-for-Service	1396054235	1396054235	1	2	FUENTES, HERMINIA I LCSW	8/10/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1875 W REDONDO BEACH BLV	STE 303	GARDENA	CA	90247	3644	19	06037	33.8879044	-118.3111113	Los Angeles County
52270	Fee-for-Service	1962408989	1962408989	1	1	FAN, KARL T MD	2/24/2011	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	84274	None	None	0	In state provider	None	2800 L ST	STE 260	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
52316	Fee-for-Service	1760560379	1760560379	1	1	FELIX-FRETES, CARLOS MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	62897	36	Psychiatry	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
52323	Fee-for-Service	1740675347	1740675347	1	1	FEIGENBAUM, DANA MD	7/9/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	146836	07	Dermatology	0	In state provider	None	1001 POTRERO AVE BLDG 90	WARD 92, RM 224	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
52331	Fee-for-Service	1285712190	1285712190	1	1	FERNANDEZ, TONY C MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78382	41	Internal Medicine	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
52371	Fee-for-Service	1396775474	1396775474	1	1	FILART, MARCEL MD	3/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76022	41	Internal Medicine	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
52374	Fee-for-Service	1225546575	1225546575	1	8	FAMILY HEALTHCARE NETWORK	10/27/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1344 WEST CLINTON AVE	None	FRESNO	CA	93704	3805	10	06019	36.77199051	-119.8275525	Fresno County
52425	Fee-for-Service	1881988749	1881988749	1	1	FARNAES, LAUGE MD	9/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	124601	68	Hematology	0	In state provider	None	3030 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
52497	Fee-for-Service	1366953226	1366953226	1	1	FANELLI, STACIE L LCSW	12/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9135 ARCHIBALD AVE	STE B	RANCHO CUCAMONGA	CA	91730	5227	36	06071	34.08763562	-117.5934458	San Bernardino County
52502	Fee-for-Service	1942437819	1942437819	1	1	FAYED, MOHAMED A MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128863	41	Internal Medicine	0	In state provider	None	1000 GREENLEY ROAD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
52554	Fee-for-Service	1275827941	1275827941	1	1	FLEISIG, SARAH B MD	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152713	68	Hematology	0	In state provider	None	1100 TRANCAS ST	STE 256	NAPA	CA	94558	2921	28	06055	38.32316569	-122.2981938	Napa County
52589	Fee-for-Service	1780762369	1780762369	1	1	FRENCH, PERRIN L MD	3/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	23857	36	Psychiatry	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
52637	Fee-for-Service	1578794194	1578794194	1	1	FERRACO, INC.	5/12/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1541 PARKWAY LOOP	C	TUSTIN	CA	92780	6526	30	06059	33.7195786	-117.8282194	Orange County
52649	Fee-for-Service	1346397072	1346397072	1	1	FRIEDMAN-BENDER, AMY E PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
52695	Fee-for-Service	1124056494	1124056494	1	1	FAWCETT, RICHRD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2500 NE NEFF RD	None	BEND	OR	97701	6015	00	None	44.067735	-121.268187	Deschutes County
52711	Fee-for-Service	1881988749	1881988749	1	1	FARNAES, LAUGE MD	9/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	124601	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
52736	Fee-for-Service	1295887065	1295887065	1	1	FOSTER, MARC R INC	2/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ORLAND PHYSICAL THERAPY	1351 CORTINA DR	STE 110	ORLAND	CA	95963	2402	11	06021	39.73939326	-122.2015299	Glenn County
52774	Fee-for-Service	1558478446	1558478446	1	1	FARRELL, ANGELA B LCSW	10/10/2007	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
52798	Fee-for-Service	1952386476	1952386476	1	1	FARRELL, ROBERT MD	10/29/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	164406	30	Radiology	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
52823	Fee-for-Service	1982966883	1982966883	1	1	FARUKHI, SALMA A MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130994	01	General Practice	0	In state provider	None	2680 N SANTIAGO BLVD	STE 100	ORANGE	CA	92867	1859	30	06059	33.83323111	-117.8339429	Orange County
52844	Fee-for-Service	1275827941	1275827941	1	1	FLEISIG, SARAH B MD	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152713	41	Internal Medicine	0	In state provider	None	1100 TRANCAS ST	STE 256	NAPA	CA	94558	2921	28	06055	38.32316569	-122.2981938	Napa County
52858	Fee-for-Service	1710985817	1710985817	1	1	FORTE, MARIO D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1615 DELAWARE ST	None	LONGVIEW	WA	98632	2367	00	None	46.1309207	-122.9408931	Cowlitz County
52915	Fee-for-Service	1073608675	1073608675	1	1	FAMILY PLANNING ASSOC	4/7/1980	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	2030 COFFEE RD	STE A1	MODESTO	CA	95355	2498	50	06099	37.672569	-120.9757125	Stanislaus County
52923	Fee-for-Service	1124170998	1124170998	1	1	FERNANDEZ, ISAIAH PT	2/12/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
52955	Fee-for-Service	1497371850	1497371850	1	1	FIELDS FERRIS, JENNIFER A LM	7/31/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
52974	Fee-for-Service	1265518872	1265518872	1	1	FRONT PORCH COMMUNITIES	3/18/1999	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	& SERVICES	2855 CARLSBAD BLVD	None	CARLSBAD	CA	92008	2902	37	06073	33.15950084	-117.352152	San Diego County
53020	Fee-for-Service	1407112741	1407112741	1	1	FLUKE, LAURA M DO	12/1/2023	208600000X	NA	General Surgery	026	PHYSICIANS	19446	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
53091	Fee-for-Service	1538556394	1538556394	1	1	FENG, ALBERT W MD	4/11/2020	207L00000X	NA	Other	026	PHYSICIANS	147304	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
53130	Fee-for-Service	1275827941	1275827941	1	1	FLEISIG, SARAH B MD	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152713	78	Neoplastic Diseases/Oncology	0	In state provider	None	1100 TRANCAS ST	STE 256	NAPA	CA	94558	2921	28	06055	38.32316569	-122.2981938	Napa County
53150	Fee-for-Service	1417355801	1417355801	1	1	FLORES, YASMIN LMFT	11/10/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 MOBIL AVE	D29	CAMARILLO	CA	93010	6338	56	06111	34.22111093	-119.0429505	Ventura County
53153	Fee-for-Service	1073536157	1073536157	1	1	FABEROWSKI, NICHOLAS MD	6/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55099	18	Ophthalmology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
53175	Fee-for-Service	1619111556	1619111556	1	1	FISH, JENNIFER C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113164	01	General Practice	0	In state provider	None	6 TARMAN DR	None	CLOVERDALE	CA	95425	3932	49	06097	38.79822374	-123.0176641	Sonoma County
53220	Fee-for-Service	1912953936	1912953936	1	5	FAIRBANKS & POWER PHYSICAL T	12/31/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	25285 MADISON AVE	SUITE 103	MURRIETA	CA	92562	8981	33	06065	33.55369902	-117.1965543	Riverside County
53262	Fee-for-Service	1326577305	1326577305	1	1	FALLON, CHELSEA R	3/5/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	840 S FAIRMONT AVE	STE 5	LODI	CA	95240	5105	39	06077	38.122992	-121.2858225	San Joaquin County
53305	Fee-for-Service	1932177839	1932177839	1	1	FIELDS, DONALD DO	3/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	6702	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
53312	Fee-for-Service	1497798839	1497798839	1	1	FENNELL, VINCENT R MD	5/13/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	22155	None	None	0	In state provider	None	18250 ROSCOE BLVD	STE 320	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
53435	Fee-for-Service	1720593981	1720593981	1	1	FAWEHINMI, KEMI E NP	10/16/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
53443	Fee-for-Service	1992468409	1992468409	1	1	FEDDERSEN, CHARITO NP	1/1/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
53488	Fee-for-Service	1831266683	1831266683	1	1	FENWICK, JANET E CRNA	8/24/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
53506	Fee-for-Service	1578964508	1578964508	1	1	FARRELL III, GERALD J MD	4/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132132	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	30	06059	33.93500365	-118.1321119	Los Angeles County
53584	Fee-for-Service	1437378536	1437378536	1	1	FOSS, RICHARD W PHD	1/3/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	150 E MEDA AVE	STE 110	GLENDORA	CA	91741	2607	19	06037	34.13845555	-117.8643588	Los Angeles County
53590	Fee-for-Service	1932177839	1932177839	1	1	FIELDS, DONALD DO	3/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	6702	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
53607	Fee-for-Service	1750575916	1750575916	1	1	FARFALLA INC	7/29/2011	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	6809	40	Pediatrics	0	In state provider	None	3655 LOMITA BLVD	STE 211	TORRANCE	CA	90505	1924	19	06037	33.81497113	-118.3489779	Los Angeles County
53610	Fee-for-Service	1649457474	1649457474	1	1	FEMINIST WOMENS HEALTH	2/19/1993	261QC1500X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER-REDDING	1901 VICTOR AVE	None	REDDING	CA	96002	0412	45	06089	40.578561	-122.338664	Shasta County
53611	Fee-for-Service	1699761684	1699761684	1	2	FOGG, ANDREW W	10/24/2018	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1775 HARRISON AVE	None	EUREKA	CA	95501	1338	12	06023	40.79191911	-124.1395817	Humboldt County
53742	Fee-for-Service	1740489798	1740489798	1	1	FABI, MARY R MD	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	84008	41	Internal Medicine	0	In state provider	None	1341 S ELISEO DR	STE 200	GREENBRAE	CA	94904	2000	21	06041	37.9449045	-122.537105	Marin County
53846	Fee-for-Service	1841398187	1841398187	1	1	FILOTEO, JULIAN V PHD	5/1/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
53861	Fee-for-Service	1720431018	1720431018	1	1	FARAMARZ TEHRANI, M.D., INC.	1/25/2017	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	None	None	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
53870	Fee-for-Service	1205289410	1205289410	1	1	FOROUHI, SOUREN MD	1/28/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	157501	01	General Practice	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
53942	Fee-for-Service	1487810131	1487810131	1	1	FLETCHER, JASON M DO	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	12163	41	Internal Medicine	0	In state provider	None	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
53969	Fee-for-Service	1558361873	1558361873	1	1	FITZPATRICK, DANIEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	55 COBURG RD	None	EUGENE	OR	97401	2433	00	None	44.06095991	-123.0812169	Lane County
54063	Fee-for-Service	1669520656	1669520656	1	1	FELITTI, VINCENT J MD	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	30132	49	Unknown	0	In state provider	None	8010 PARKWAY DR	None	LA MESA	CA	91942	2104	37	06073	32.7749024	-117.0246371	San Diego County
54065	Fee-for-Service	1982604906	1982604906	1	1	FOLEY, ALLISON KLEIN MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71345	41	Internal Medicine	0	In state provider	None	1041 E YORBA LINDA BLVD	STE 5	PLACENTIA	CA	92870	3736	30	06059	33.88848865	-117.8451029	Orange County
54088	Fee-for-Service	1629388590	1629388590	1	1	FINNEMORE, TODD M PSY	7/5/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	23869	-	NOT APPLICABLE	0	In state provider	None	5900 STATE FARM DRIVE	SUITE 200	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
54124	Fee-for-Service	1831462118	1831462118	1	1	FIKERT, STACY A MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126201	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
54202	Fee-for-Service	1417297847	1417297847	1	23	FIRST CHOICE PHYSICIAN PARTN	2/27/2018	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	1275 N ROSE DR	STE 118	PLACENTIA	CA	92870	3919	30	06059	33.8868003	-117.8420447	Orange County
54285	Fee-for-Service	1982829941	1982829941	1	1	FORCADA-LOWRIE, RAYMUNDO MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113070	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
54290	Fee-for-Service	1588041669	1588041669	1	1	FLINN, DANIEL C DO	4/18/2022	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	18879	None	None	0	In state provider	None	40949 WINCHESTER RD	None	TEMECULA	CA	92591	6031	33	06065	33.52574268	-117.1589811	Riverside County
54295	Fee-for-Service	1255386942	1255386942	1	1	FIELD, JAMES C. MD	12/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 ARLINGTON AVE	None	CALDWEL	ID	83605	0000	00	None	43.654374	-116.694738	Canyon County
54301	Fee-for-Service	1578903977	1578903977	1	1	FARAG, SARAH MD	12/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141589	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54313	Fee-for-Service	1881662021	1881662021	1	1	FARADAY, RICHARD M MD	2/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	70794	41	Internal Medicine	0	In state provider	None	705 W LA VETA AVE	STE 114	ORANGE	CA	92868	4447	30	06059	33.78062272	-117.8600738	Orange County
54358	Fee-for-Service	1548387764	1548387764	1	1	FIDELMAN, NICHOLAS MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84789	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
54396	Fee-for-Service	1073057154	1073057154	1	1	FLANIGAN, KATHLEEN LPCC	5/29/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39159 PASEO PADRE PKWY	STE 121	FREMONT	CA	94538	1600	01	06001	37.5531875	-121.9805141	Alameda County
54432	Fee-for-Service	1548318439	1548318439	1	1	FOLEY, DIANE MD	8/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	48226	05	Anesthesiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54524	Fee-for-Service	1578842829	1578842829	1	1	FALANGA, DANIEL T	9/1/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
54698	Fee-for-Service	1679015135	1679015135	1	1	FRESCHL, MARIE L LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3333 SKY PARK DR	STE 220	TORRANCE	CA	90505	5023	19	06037	33.81036565	-118.3466218	Los Angeles County
54718	Fee-for-Service	1548318439	1548318439	1	1	FOLEY, DIANE MD	8/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	48226	01	General Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54784	Fee-for-Service	1437655800	1437655800	1	1	FONG, STEPHANIE DO	10/22/2021	207R00000X	NA	Other	026	PHYSICIANS	18022	None	None	0	In state provider	None	17762 BEACH BLVD.	220	HUNTINGTON BEACH	CA	92647	6860	30	06059	33.70404013	-117.9890603	Orange County
54799	Fee-for-Service	1801334941	1801334941	1	1	FLORES, KATIE E	12/1/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
54831	Fee-for-Service	1356641013	1356641013	1	1	FONG, JANELLE A MD	12/28/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	117515	40	Pediatrics	0	In state provider	None	5088 N FRESNO ST	SUITE B	FRESNO	CA	93710	7611	10	06019	36.810081	-119.781342	Fresno County
54898	Fee-for-Service	1558554519	1558554519	1	1	FAMILY HEALTHCARE NETWRK	5/10/2007	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1133 S POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05124618	-119.0425626	Tulare County
54918	Fee-for-Service	1548368749	1548368749	1	1	FOWLER, VINCENT R III MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30049	07	Dermatology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
54929	Fee-for-Service	1518264175	1518264175	1	1	FRAUENPREIS, KURT E MD	8/1/2011	193400000X	NA	Other	026	PHYSICIANS	53836	38	Geriatrics	0	In state provider	A MEDICAL CORPORATION	1600 E FLORIDA AVE	SUITE 103	HEMET	CA	92544	8637	33	06065	33.74768747	-116.9557425	Riverside County
54999	Fee-for-Service	1508862871	1508862871	1	1	FRITZLER, MARK D MD	8/12/1990	208800000X	NA	Other	026	PHYSICIANS	60227	34	Urology and Urological Surgery	0	In state provider	None	645 W EAST AVE	STE 1	CHICO	CA	95926	7201	04	06007	39.75005307	-121.8725246	Butte County
55023	Fee-for-Service	1942572359	1942572359	1	1	FRANKS, BRENDA C LMFT	10/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	500 OLIVE ST # 28	None	MARYSVILLE	CA	95901	5637	58	06115	39.1397517	-121.5989699	Yuba County
55047	Fee-for-Service	1023247178	1023247178	1	1	FULLWOOD-FLECK, CYNTHIA LMF	9/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
55058	Fee-for-Service	1730457177	1730457177	2	1	FRASIER, JOY B LCSW	8/16/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	220 WILSON LN	None	FORTUNA	CA	95540	8544	12	06023	40.54885418	-124.1176782	Humboldt County
55153	Fee-for-Service	1124190103	1124190103	1	1	FISCHER, BRIAN A MD	5/6/2021	207LC0200X	NA	Other	026	PHYSICIANS	172322	None	None	0	In state provider	None	1625 PINE STREET	SUITE 102	REDDING	CA	96001	1018	45	06089	40.58321511	-122.388937	Shasta County
55185	Fee-for-Service	1558554519	1558554519	1	1	FAMILY HEALTHCARE NETWRK	5/10/2007	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1133 S POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05124618	-119.0425626	Tulare County
55217	Fee-for-Service	1518264175	1518264175	1	1	FRAUENPREIS, KURT E MD	8/1/2011	193400000X	NA	Other	026	PHYSICIANS	53836	08	Family Practice	0	In state provider	A MEDICAL CORPORATION	1600 E FLORIDA AVE	SUITE 103	HEMET	CA	92544	8637	33	06065	33.74768747	-116.9557425	Riverside County
55270	Fee-for-Service	1083381776	1083381776	1	1	FOUR CORNERS HEALTH LLC	10/13/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1310 E. OLIVE AVE	None	FRESNO	CA	93728	3610	10	06019	36.75765565	-119.7954457	Fresno County
55346	Fee-for-Service	1205216512	1205216512	1	1	FARHAN, HASSAN N MD	7/28/2020	207L00000X	NA	Other	026	PHYSICIANS	162149	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
55349	Fee-for-Service	1437699212	1437699212	1	1	FLETES, ZEIDA M NP	12/12/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
55411	Fee-for-Service	1326552092	1326552092	1	1	FUNK, COURTNEY M LCSW	8/7/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
55435	Fee-for-Service	1700409810	1700409810	1	2	FRIEDMAN OPTOMETRY, INC.	3/1/2020	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10724 WASHINGTON BLVD	None	CULVER CITY	CA	90232	3314	19	06037	34.0162352	-118.4061254	Los Angeles County
55539	Fee-for-Service	1710156807	1710156807	1	1	FISHER, JENNIFER M MD	6/1/2000	207RH0003X	NA	Oncology	026	PHYSICIANS	65170	40	Pediatrics	0	In state provider	None	15025 INNOVATION DR	None	SAN DIEGO	CA	92128	3409	37	06073	32.98956795	-117.0767228	San Diego County
55551	Fee-for-Service	1144281635	1144281635	1	1	FURNESS, GARY N MD	3/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	42216	08	Family Practice	0	In state provider	None	2455 SUMMERFIELD ROAD	None	SANTA ROSA	CA	95405	7815	49	06097	38.441511	-122.6624535	Sonoma County
55559	Fee-for-Service	1124161955	1124161955	1	1	FRISHBERG, KATHLEEN D LCSW	7/27/2011	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	718 SPRING ST	None	SANTA ROSA	CA	95404	3902	49	06097	38.446911	-122.70249	Sonoma County
55561	Fee-for-Service	1750487773	1750487773	1	1	FLORES-DAHMS, KATHLEEN M MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54880	30	Radiology	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
55588	Fee-for-Service	1053543165	1053543165	1	1	FTEEH, GAMIL MD	9/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130028	40	Pediatrics	0	In state provider	None	25845 BARTON RD	SUITE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
55631	Fee-for-Service	1154498798	1154498798	1	1	FAJARDO, ANA C MD INC	4/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73895	08	Family Practice	0	In state provider	None	845 E CHAPMAN AVE	None	ORANGE	CA	92866	1622	30	06059	33.78788013	-117.8446884	Orange County
55635	Fee-for-Service	1417297847	1417297847	1	25	FIRST CHOICE PHYSICIAN PARTN	4/23/2019	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	1275 N ROSE DR	106	PLACENTIA	CA	92870	3941	30	06059	33.8868003	-117.8420447	Orange County
55666	Fee-for-Service	1508228891	1508228891	1	1	FORMAN, NELL A MD	9/14/2021	207L00000X	NA	Other	026	PHYSICIANS	155231	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
55697	Fee-for-Service	1831134873	1831134873	1	1	FUJII, MARK K MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	76538	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
55717	Fee-for-Service	1417375098	1417375098	1	1	FARAG, MARK C MD	2/13/2024	2084V0102X	NA	Neurology	026	PHYSICIANS	141024	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
55723	Fee-for-Service	1972576270	1972576270	1	1	FIROZ, HADI A MD	1/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	56218	41	Internal Medicine	0	In state provider	None	6555 COYLE AVENUE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
55824	Fee-for-Service	1699781955	1699781955	1	1	FOSTER, JAMES MD	6/1/1998	207P00000X	NA	Other	026	PHYSICIANS	63021	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
55826	Fee-for-Service	1194247593	1194247593	1	1	FICHTNER, MARIEJOSE B LMFT	4/8/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
55860	Fee-for-Service	1053875484	1053875484	1	1	FAMILY HEALTHCARE NETWORK	4/28/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	3619	54	06107	36.0663928	-119.01714	Tulare County
55880	Fee-for-Service	1720074990	1720074990	1	1	FOSTER,SHERWIN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 LINCOLN WAY	None	COEUR D ALENE	ID	83814	2611	00	None	47.69465937	-116.7917936	Kootenai County
55924	Fee-for-Service	1841428802	1841428802	1	1	FROUSH, ARMAN G DO	1/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13940	30	Radiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
55937	Fee-for-Service	1861417636	1861417636	1	1	FISHER, ANN C MD	12/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95738	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
56004	Fee-for-Service	1063560902	1063560902	1	1	FOUAD, BEN-ISAAC E MD	12/31/1988	207RP1001X	NA	Pulmonology	026	PHYSICIANS	25252	29	Pulmonary Diseases (M.D. only)	0	In state provider	CALIF PULMONARY DISEASE	1200 SHADOW HILL WAY	None	BEVERLY HILLS	CA	90210	2234	19	06037	34.09295543	-118.4157921	Los Angeles County
56042	Fee-for-Service	1588923619	1588923619	1	1	FRATER, FRANCINE E MD	5/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130374	01	General Practice	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
56048	Fee-for-Service	1104995059	1104995059	2	1	FAIRFAX DISCOUNT PHARMACY,	11/23/2010	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	7771 BEVERLY BOULEVARD	None	LOS ANGELES	CA	90036	2151	19	06037	34.07614712	-118.3592487	Los Angeles County
56066	Fee-for-Service	1619098365	1619098365	1	1	FUENTES, MARIBEL PALOMA M	8/14/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	98491	-	NOT APPLICABLE	0	In state provider	None	2560 PULGAS AVENUE	None	EAST PALO ALTO	CA	94303	1323	41	06081	37.47530197	-122.1318685	San Mateo County
56091	Fee-for-Service	1750122800	1750122800	1	1	FORD, HARRY CRNA	12/12/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
56109	Fee-for-Service	1104905256	1104905256	1	1	FISCHHOFF, ARLENE MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65939	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
56147	Fee-for-Service	1053875484	1053875484	1	1	FAMILY HEALTHCARE NETWORK	9/6/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	3619	54	06107	36.0663928	-119.01714	Tulare County
56222	Fee-for-Service	1104845775	1104845775	1	1	FARACI, JOHN P MD	9/6/2019	207K00000X	NA	Other	026	PHYSICIANS	162574	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
56237	Fee-for-Service	1134377765	1134377765	1	1	FOROOHAR, ABTIN MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117048	20	Orthopedic Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
56273	Fee-for-Service	1073137212	1073137212	1	1	FALLS, LAKEISHA	1/7/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	30	06059	33.746805	-117.834147	Orange County
56381	Fee-for-Service	1316990849	1316990849	1	1	FIESER, CARL MD	11/27/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	178003	None	None	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
56404	Fee-for-Service	1003112871	1003112871	1	1	FANNIN, LISA CCC-SLP	3/7/2025	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5205 SILVERSTONE CIR	None	SALIDA	CA	95368	8110	50	06099	37.71495049	-121.0949055	Stanislaus County
56412	Fee-for-Service	1477624427	1477624427	1	1	FRANCESCHINI, RALPH E MD	10/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	44023	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
56434	Fee-for-Service	1053875484	1053875484	1	1	FAMILY HEALTHCARE NETWORK	9/6/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	3619	54	06107	36.0663928	-119.01714	Tulare County
56473	Fee-for-Service	1891770905	1891770905	1	1	FARRELL, FRANK J MD	11/28/2008	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	68482	10	Gastroenterology (M.D. only)	0	In state provider	None	2186 GEARY BLVD	STE 320	SAN FRANCISCO	CA	94115	3457	38	06075	37.78343395	-122.4392245	San Francisco County
56500	Fee-for-Service	1790219186	1790219186	1	1	FRASER, JAMES A MD	7/31/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	101 CITY DR S	# B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
56510	Fee-for-Service	1104845775	1104845775	1	1	FARACI, JOHN P MD	9/6/2019	207K00000X	NA	Other	026	PHYSICIANS	162574	03	Allergy	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
56543	Fee-for-Service	1619990710	1619990710	1	1	FINKEMEIER, CHRISTOPHER G MD	9/20/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	83703	20	Orthopedic Surgery	0	In state provider	None	6620 COYLE AVENUE	STE 212	CARMICHAEL	CA	95608	6337	34	06067	38.66751	-121.310028	Sacramento County
56665	Fee-for-Service	1851626568	1851626568	1	1	FOX, MELANIE D DO	3/5/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	1	Border provider	None	77 PRINGLE	None	RENO	NV	89502	1907	00	None	39.52484706	-119.7951825	Washoe County
56678	Fee-for-Service	1083751382	1083751382	1	1	FREY, CAROL C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45808	01	General Practice	0	In state provider	None	1200 ROSECRANS AVE	STE 208	MANHATTAN BEACH	CA	90266	2470	19	06037	33.90178953	-118.3931775	Los Angeles County
56698	Fee-for-Service	1801877949	1801877949	1	1	FOUHY, SHAWN A MD	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83083	05	Anesthesiology	0	In state provider	None	616 E CHAPEL ST	None	SANTA MARIA	CA	93454	4522	42	06083	34.95426953	-120.427596	Santa Barbara County
56723	Fee-for-Service	1053875484	1053875484	1	1	FAMILY HEALTHCARE NETWORK	5/22/2020	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	3619	54	06107	36.0663928	-119.01714	Tulare County
56732	Fee-for-Service	1013442342	1013442342	1	1	FAROOQ, SAAD DO	7/16/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	16977	None	None	0	In state provider	None	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
56759	Fee-for-Service	1073524492	1073524492	1	1	FREDRICKS, ROBERT E MD	1/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86902	40	Pediatrics	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
56797	Fee-for-Service	1104845775	1104845775	1	1	FARACI, JOHN P MD	9/6/2019	207K00000X	NA	Other	026	PHYSICIANS	162574	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
56812	Fee-for-Service	1538403670	1538403670	1	1	FRESNO CA MULTI ASC LP	10/28/2013	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1843 E FIR AVE	STE 104	FRESNO	CA	93720	3863	10	06019	36.83911653	-119.7492705	Fresno County
56867	Fee-for-Service	1114274388	1114274388	1	1	FELLORES, JAYME M AU	3/13/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1701 4TH ST	STE 120	SANTA ROSA	CA	95404	3661	49	06097	38.448801	-122.699439	Sonoma County
56910	Fee-for-Service	1992140115	1992140115	1	1	FERDMAN, ROBERT DO	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13776	01	General Practice	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
57093	Fee-for-Service	1336271055	1336271055	1	1	FERIDOUNI, SYRUS MD	10/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97912	08	Family Practice	0	In state provider	None	1100-06 1/2 W GLEN OAKS	None	GLENDALE	CA	91201	0000	19	06037	34.15926579	-118.2562523	Los Angeles County
57099	Fee-for-Service	1720115660	1720115660	1	1	FEVILLE, WONG, MAZMANIAN	2/28/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	GLENDALE PEDIATRICS	1530 E CHEVY CHASE DR	STE 101	GLENDALE	CA	91206	4139	19	06037	34.150689	-118.2303855	Los Angeles County
57102	Fee-for-Service	1235195157	1235195157	1	2	FUNKHOUSER, MARTHA E MD	10/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	71787	07	Dermatology	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
57116	Fee-for-Service	1366044307	1366044307	1	1	FINEST HOSPICE INC	6/13/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7200 VINELAND AVE	STE 210A	SUN VALLEY	CA	91352	5088	19	06037	34.2016328	-118.3703012	Los Angeles County
57131	Fee-for-Service	1891020657	1891020657	1	1	FREGOSO, ARIANA M LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
57178	Fee-for-Service	1700997210	1700997210	1	1	FONE, PATRICIA D MD	7/1/1996	208600000X	NA	General Surgery	026	PHYSICIANS	74706	34	Urology and Urological Surgery	0	In state provider	None	305 OAK RIDGE DR	None	ROSEVILLE	CA	95661	3419	31	06061	38.74274671	-121.2701665	Placer County
57187	Fee-for-Service	1508093188	1508093188	1	1	FOROUZANDEH, SHABNAM MD	11/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120836	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
57194	Fee-for-Service	1568872851	1568872851	1	1	FIDELIA HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	19112 GRIDLEY RD	SUITE 200	CERRITOS	CA	90703	6614	19	06037	33.8571	-118.0908315	Los Angeles County
57271	Fee-for-Service	1265435739	1265435739	1	1	FAJARDO, ERIC T MD	3/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77784	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
57275	Fee-for-Service	1235367582	1235367582	1	1	FORTES, SUSANA CNP	8/31/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1900 19TH AVE	None	SAN FRANCISCO	CA	94116	1250	38	06075	37.75211157	-122.4762664	San Francisco County
57348	Fee-for-Service	1902245616	1902245616	1	1	FARANAZ-KABIR, SABA MD FAAP	9/14/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	147500	None	None	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
57362	Fee-for-Service	1619129921	1619129921	1	1	FAGAN, JOHN E JR OD INC	10/28/2008	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	20231 W VALLEY BLVD	STE G	TEHACHAPI	CA	93561	6865	15	06029	35.12450852	-118.4900355	Kern County
57404	Fee-for-Service	1366044307	1366044307	1	1	FINEST HOSPICE INC	6/13/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7200 VINELAND AVE	STE 210A	SUN VALLEY	CA	91352	5088	19	06037	34.2016328	-118.3703012	Los Angeles County
57417	Fee-for-Service	1386624377	1386624377	2	1	FEENEY, JAMES MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45181	41	Internal Medicine	0	In state provider	None	455 GRAND AVE	None	S SAN FRANCISCO	CA	94080	3635	41	06081	37.65618476	-122.4148475	San Mateo County
57423	Fee-for-Service	1376592105	1376592105	1	1	FAZEL, NASIM MD	12/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83700	07	Dermatology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
57482	Fee-for-Service	1568872851	1568872851	1	1	FIDELIA HOSPICE INC	8/18/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	19112 GRIDLEY RD	SUITE 200	CERRITOS	CA	90703	6614	19	06037	33.8571	-118.0908315	Los Angeles County
57506	Fee-for-Service	1124176359	1124176359	1	1	FAMILY HOME MEDICAL INC	5/8/2000	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	3991 N FREEWAY BLVD	STE 110	SACRAMENTO	CA	95834	1269	34	06067	38.641419	-121.480092	Sacramento County
57532	Fee-for-Service	1538244298	1538244298	1	1	FLANAGAN, TRACY MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	52297	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	# M1490	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
57611	Fee-for-Service	1306002894	1306002894	1	1	FAIR OAKS MEDICAL SUPPLY INC	10/21/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	5933 FAIR OAKS BLVD	None	CARMICHAEL	CA	95608	5221	34	06067	38.608785	-121.3292475	Sacramento County
57675	Fee-for-Service	1023514965	1023514965	1	1	FANG, SALLY NP	6/27/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
57708	Fee-for-Service	1386624377	1386624377	2	1	FEENEY, JAMES MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45181	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	455 GRAND AVE	None	S SAN FRANCISCO	CA	94080	3635	41	06081	37.65618476	-122.4148475	San Mateo County
57743	Fee-for-Service	1881633329	1881633329	1	1	FORGEY, RONALD	9/30/1990	207P00000X	NA	Other	026	PHYSICIANS	4770	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
57771	Fee-for-Service	1578090189	1578090189	1	1	FAYANJU, OLUSEYI A MD	7/8/2022	207R00000X	NA	Other	026	PHYSICIANS	169863	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
57798	Fee-for-Service	1255846796	1255846796	1	1	FOLLENS-JONES, JALEESA K PT	8/26/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	17095 MAIN ST	None	HESPERIA	CA	92345	6004	36	06071	34.41984761	-117.2904344	San Bernardino County
57839	Fee-for-Service	1255533550	1255533550	1	1	FROST, MEGAN M MD	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	537 SW UNION AVE	None	GRANTS PASS	OR	97527	5543	00	None	42.42237366	-123.3423317	Josephine County
57886	Fee-for-Service	1265529515	1265529515	1	1	FICHTNER, CHRISTOPHER G MD	11/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88223	13	Neurology (M.D. only)	0	In state provider	None	555 TACHEVAH DRIVE	SUITE 2E107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
57893	Fee-for-Service	1962840587	1962840587	1	1	FARAJIAN, VIKEN A MD	11/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137393	05	Anesthesiology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
57900	Fee-for-Service	1811125842	1811125842	1	1	FARAJZADEH, FARZIN MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118269	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
57911	Fee-for-Service	1871509471	1871509471	1	1	FERNANDEZ, ALFREDO F MD	10/19/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	33550	20	Orthopedic Surgery	0	In state provider	None	1800 SULLIVAN AVE	RM 410	DALY CITY	CA	94015	2224	41	06081	37.68077723	-122.4728941	San Mateo County
57932	Fee-for-Service	1275657256	1275657256	1	1	FUENTES-NGUYEN, LESLIE A	9/17/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
57992	Fee-for-Service	1316266042	1316266042	1	1	FLIS, DANIEL W MD	6/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134236	04	Otology, Laryngology, Rhinology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
57994	Fee-for-Service	1386624377	1386624377	2	1	FEENEY, JAMES MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45181	08	Family Practice	0	In state provider	None	455 GRAND AVE	None	S SAN FRANCISCO	CA	94080	3635	41	06081	37.65618476	-122.4148475	San Mateo County
58035	Fee-for-Service	1649206806	1649206806	1	1	FRENCH, ERICK S MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	78570	08	Family Practice	0	In state provider	None	347 ANDRIEUX ST	None	SONOMA	CA	95476	6811	49	06097	38.28843573	-122.4651035	Sonoma County
58070	Fee-for-Service	1962160556	1962160556	1	1	FRACTOR, LAUREN LMFT	12/14/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23822 VALENCIA BLVD	207	VALENCIA	CA	91355	5302	19	06037	34.41372708	-118.5513626	Los Angeles County
58100	Fee-for-Service	1215274014	1215274014	1	1	FAYE, ADRIENNE LMFT	7/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 S BARRINGTON AVE	None	LOS ANGELES	CA	90025	5385	19	06037	34.03672191	-118.4500156	Los Angeles County
58103	Fee-for-Service	1689051807	1689051807	1	1	FREEMAN, AMBER L LMFT	10/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41700 IVY ST	STE B	MURRIETA	CA	92562	9439	33	06065	33.55413845	-117.2070961	Riverside County
58111	Fee-for-Service	1972019552	1972019552	1	1	FARRELL, MATTHEW J MD	4/9/2024	2085R0001X	NA	Other	026	PHYSICIANS	179779	30	Radiology	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
58176	Fee-for-Service	1265529515	1265529515	1	1	FICHTNER, CHRISTOPHER G MD	11/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88223	36	Psychiatry	0	In state provider	None	555 TACHEVAH DRIVE	SUITE 2E107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
58179	Fee-for-Service	1518006543	1518006543	1	1	FEKRAZAD, MOHAMMAD H MD	4/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55261	68	Hematology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
58253	Fee-for-Service	1598701211	1598701211	1	1	FERRETTI, ROBERT S MD	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	18512	20	Orthopedic Surgery	0	In state provider	None	599 SIR FRANCIS DRAKE BL	STE 302	GREENBRAE	CA	94904	1732	21	06041	37.95026531	-122.5332546	Marin County
58254	Fee-for-Service	1124141379	1124141379	1	1	FUDGE, MELINDA T MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142484	36	Psychiatry	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
58277	Fee-for-Service	1316208911	1316208911	1	1	FITZPATRICK, DANIEL C MD	6/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155978	05	Anesthesiology	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
58332	Fee-for-Service	1316909161	1316909161	1	1	FRIGON, KIM FRANCES MD	3/8/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	183315	None	None	0	In state provider	None	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
58379	Fee-for-Service	1316978596	1316978596	1	1	FOSTER-BARBER, AUDREY E	5/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86477	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
58411	Fee-for-Service	1275933087	1275933087	1	1	FRANCO, SUSANA LMFT	11/5/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA CT	STE A-311	PALMDALE	CA	93550	7607	19	06037	34.64013337	-118.1280539	Los Angeles County
58415	Fee-for-Service	1194212357	1194212357	1	1	FRIEDRICH, JOSEPH M MD	7/12/2022	207P00000X	NA	Other	026	PHYSICIANS	163996	None	None	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
58466	Fee-for-Service	1750679247	1750679247	1	1	FEUCHT, ALLISYN S OD	10/14/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9221 SIERRA COLLEGE BLVD	STE 130	ROSEVILLE	CA	95661	5919	31	06061	38.735028	-121.225764	Placer County
58467	Fee-for-Service	1518006543	1518006543	1	1	FEKRAZAD, MOHAMMAD H MD	4/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55261	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
58618	Fee-for-Service	1720180680	1720180680	1	1	FRIEDLICH, PHILIPPE MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77787	78	Neoplastic Diseases/Oncology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
58631	Fee-for-Service	1689049371	1689049371	1	1	FRESENIUS MEDICAL CARE LONG	12/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BEACH LLC	20710 LEAPWOOD AVE	SUITE E	CARSON	CA	90746	3642	19	06037	33.84272925	-118.2584222	Los Angeles County
58651	Fee-for-Service	1841960374	1841960374	1	1	FOURTH OPTOMETRIC CARE OF CA	10/16/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4505 SEPULVEDA BLVD	None	TORRANCE	CA	90505	2207	19	06037	33.82629455	-118.3603387	Los Angeles County
58681	Fee-for-Service	1437632189	1437632189	1	1	FOSTER, JORDAN A	1/30/2025	261QM0801X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2715 PORTER ST	204	SOQUEL	CA	95073	2437	44	06087	36.986121	-121.9574065	Santa Cruz County
58687	Fee-for-Service	1861531691	1861531691	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	3655 LOMITA BLVD	STE 400	TORRANCE	CA	90505	1928	19	06037	33.81497113	-118.3489779	Los Angeles County
58802	Fee-for-Service	1881341212	1881341212	1	2	FINDING HOPE COUNSELING SERV	11/18/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ICES A PSYCHOLOGICAL COR	23046 AVENIDA DE LA CARL	STE 600	LAGUNA HILLS	CA	92653	1537	30	06059	33.62729647	-117.7222879	Orange County
58896	Fee-for-Service	1477565372	1477565372	1	1	FRIEDMAN, STEVEN B PHD	8/10/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3333 SKYPARK DR	SUITE 220	TORRANCE	CA	90505	5023	19	06037	33.81036565	-118.3466218	Los Angeles County
58898	Fee-for-Service	1104156629	1104156629	1	1	FAHIM, NATALY M OD	3/18/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	318 E COMPTON BLVD	None	COMPTON	CA	90221	3206	19	06037	33.89597324	-118.2191747	Los Angeles County
58906	Fee-for-Service	1437287380	1437287380	1	1	FLYER, BRIAN L MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	48952	41	Internal Medicine	0	In state provider	None	1125 S BEVERLY DR	STE 700	LOS ANGELES	CA	90035	1148	19	06037	34.05696658	-118.3966613	Los Angeles County
58907	Fee-for-Service	1720180680	1720180680	1	1	FRIEDLICH, PHILIPPE MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77787	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
58921	Fee-for-Service	1972898799	1972898799	1	1	FASSETT, MARLYS S S MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124742	07	Dermatology	0	In state provider	None	801 TRAEGER AVE	STE 310	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
58922	Fee-for-Service	1487869376	1487869376	2	1	FOX DRUG STORE INC	4/4/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13660 E. MANNING AVE	STE 102	PARLIER	CA	93648	9802	10	06019	36.6050283	-119.5444823	Fresno County
58992	Fee-for-Service	1639177892	1639177892	1	1	FRUGONI, CORINNE ELVIRA	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	70478	08	Family Practice	0	In state provider	INDIAN HEALTH SERVS.	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	12	06023	40.89808837	-124.0923819	Humboldt County
59034	Fee-for-Service	1730550112	1730550112	1	1	FLORES, JUAN NP	9/16/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
59048	Fee-for-Service	1356802250	1356802250	1	1	FLORES, ERICA L DO	5/16/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	20417	15	Obstetrics (D.O. only)	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
59151	Fee-for-Service	1760562011	1760562011	1	1	FERNANDES, CARACIOLO J MD	11/1/2020	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
59166	Fee-for-Service	1760673446	1760673446	1	1	FAHOURI, GINA LMFT	10/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1664 SOLANO AVE	None	ALBANY	CA	94707	2118	01	06001	37.89114582	-122.2828697	Alameda County
59183	Fee-for-Service	1578222998	1578222998	1	1	FINCH, KENDALL CCC-SLP	10/12/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1849 WILLOW PASS RD.	SUITE 420	CONCORD	CA	94520	2524	07	06013	37.97486759	-122.0377305	Contra Costa County
59260	Fee-for-Service	1891794319	1891794319	1	1	FORINO, MICHAEL T MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	76890	30	Radiology	0	In state provider	None	1100 W STEWART DRIVE	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
59336	Fee-for-Service	1356802250	1356802250	1	1	FLORES, ERICA L DO	5/16/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	20417	09	Gynecology (D.O. only)	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
59370	Fee-for-Service	1689865529	1689865529	1	1	FRIEND, JOHANNA PHD	1/16/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
59406	Fee-for-Service	1982820981	1982820981	1	1	FURPHY, MELISSA MD	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.25477	-122.63175	Sonoma County
59433	Fee-for-Service	1104890326	1104890326	1	1	FAKHRI, FARIBORZ D DO	2/13/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	8959	None	None	0	In state provider	None	4250 AUBURN BLVD	None	SACRAMENTO	CA	95841	4100	34	06067	38.642832	-121.3649325	Sacramento County
59441	Fee-for-Service	1588699151	1588699151	1	1	FAMILY HEALTHCARE NETWRK	9/15/2001	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
59599	Fee-for-Service	1366451080	1366451080	1	1	FRONT LINE EMERGENCY	2/28/1984	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	CARE SPECIALISTS AMC	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
59605	Fee-for-Service	1427193390	1427193390	1	1	FROEHLICH, NICOLETTE RN	11/6/2006	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	25902 N FUHRMAN RD	None	ACAMPO	CA	95220	9132	39	06077	38.22397103	-121.1388307	San Joaquin County
59615	Fee-for-Service	1730196288	1730196288	1	1	FOWLER, CHARLES MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 E 3RD ST	None	DELTA	CO	81416	2815	00	None	38.74319827	-108.0470522	Delta County
59633	Fee-for-Service	1346440146	1346440146	1	1	FATHY, TAMER M MD	10/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112366	08	Family Practice	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
59662	Fee-for-Service	1114286408	1114286408	1	1	FAJARDO, CECILE T DO MD	8/6/2018	2080P0210X	NA	Nephrology	026	PHYSICIANS	13143	45	Nephrology (Renal-Kidney)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
59728	Fee-for-Service	1588699151	1588699151	1	1	FAMILY HEALTHCARE NETWRK	10/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
59768	Fee-for-Service	1144265752	1144265752	1	1	FERNANDO, LEONOR P MD	7/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	29463	68	Hematology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
59790	Fee-for-Service	1497806988	1497806988	1	1	FENG, YONGQING	9/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100454	None	None	0	In state provider	None	2 WEST FERN ST	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
59950	Fee-for-Service	1124167812	1124167812	1	1	FORNALSKI, STEFAN MD	1/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	77952	20	Orthopedic Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
59952	Fee-for-Service	1427728955	1427728955	1	1	FOURTH OPTOMETRIC CARE OF CA	10/28/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15068 GOLDENWEST STREET	None	WESTMINSTER	CA	92683	6152	30	06059	33.743178	-118.0069006	Orange County
60005	Fee-for-Service	1396037859	1396037859	1	1	FOX, STEPHANIE MD	9/17/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	156699	40	Pediatrics	0	In state provider	None	1840 SIERRA GARDENS	None	ROSEVILLE	CA	95678	2912	31	06061	38.74730831	-121.2613758	Placer County
60015	Fee-for-Service	1588699151	1588699151	1	1	FAMILY HEALTHCARE NETWRK	10/1/1995	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
60095	Fee-for-Service	1053488874	1053488874	1	1	FUJIMOTO, ANDY N MD	1/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68567	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
60192	Fee-for-Service	1114510724	1114510724	1	1	FISHER, ADDY PT	11/4/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
60278	Fee-for-Service	1124034749	1124034749	1	1	FREDERICKS, JOHN C MD	6/1/1994	207P00000X	NA	Other	026	PHYSICIANS	32763	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15615 POMERADO RD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
60304	Fee-for-Service	1588699151	1588699151	1	1	FAMILY HEALTHCARE NETWRK	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
60325	Fee-for-Service	1235445511	1235445511	1	1	FLORES, YVETTE M PHD	8/8/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
60328	Fee-for-Service	1437253705	1437253705	1	1	FIMREITE, JEFFREY S OD	5/2/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2414 S FAIRVIEW ST	STE 103	SANTA ANA	CA	92704	5318	30	06059	33.71437705	-117.9079237	Orange County
60380	Fee-for-Service	1346230398	1346230398	1	1	FARRUKH, NAGHMANA MD	4/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55582	40	Pediatrics	0	In state provider	None	1647 E HOLT BLVD	None	ONTARIO	CA	91764	2107	36	06071	34.06464	-117.615204	San Bernardino County
60401	Fee-for-Service	1609859974	1609859974	1	1	FERRIES, JASON MD	8/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88862	41	Internal Medicine	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
60437	Fee-for-Service	1083768063	1083768063	1	1	FURLONG, DAVID M DO	1/8/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	8877	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
60441	Fee-for-Service	1831963867	1831963867	1	1	FARRIS, RYAN PT	12/5/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3400 CALLOWAY DR	600	BAKERSFIELD	CA	93312	2513	15	06029	35.39110123	-119.1097878	Kern County
60453	Fee-for-Service	1619974144	1619974144	1	1	FOLSOM CITY	1/1/1979	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	50 NATOMA ST	None	FOLSOM	CA	95630	2614	34	06067	38.6814866	-121.1635593	Sacramento County
60493	Fee-for-Service	1184005258	1184005258	1	1	FONTANILLA, ROBERT PA	11/18/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52552	-	NOT APPLICABLE	0	In state provider	None	44-374 PALM STREET	None	INDIO	CA	92201	3117	33	06065	33.72380849	-116.227381	Riverside County
60550	Fee-for-Service	1912953936	1912953936	1	7	FAIRBANKS & POWER PHYSICAL T	1/18/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	& SPORTS MEDICINE	1561 ONTARIO	SUITE 101	CORONA	CA	92881	6662	33	06065	33.84257433	-117.5332788	Riverside County
60559	Fee-for-Service	1770005027	1770005027	1	1	FRIEDMAN, DANIEL J PSYD	6/18/2021	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
60565	Fee-for-Service	1124034749	1124034749	1	1	FREDERICKS, JOHN C MD	6/1/1994	207P00000X	NA	Other	026	PHYSICIANS	32763	41	Internal Medicine	0	In state provider	None	15615 POMERADO RD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
60592	Fee-for-Service	1891050522	1891050522	1	1	FIELDS, ASHLEY B MD	6/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143885	01	General Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
60619	Fee-for-Service	1215995246	1215995246	1	1	FREY, CLAUDE S MD	7/19/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	55627	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
60649	Fee-for-Service	1568404572	1568404572	1	1	FEINGOLD, MITCHELL L DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	928 FORT STOCKTON DR	STE 103	SAN DIEGO	CA	92103	1856	37	06073	32.75090149	-117.171945	San Diego County
60725	Fee-for-Service	1710662192	1710662192	1	1	FORSTER, MERCEDES MD	8/2/2024	390200000X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
60738	Fee-for-Service	1306913504	1306913504	1	1	FISHMAN, ARNOLD MD	1/1/1982	208600000X	NA	General Surgery	026	PHYSICIANS	32947	02	General Surgery	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
60806	Fee-for-Service	1437186467	1437186467	1	1	FRANCINI, ALEXANDER O MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71850	25	Physical Medicine and Rehabilitation	0	In state provider	None	361 HOSPITAL RD	STE 223	NEWPORT BEACH	CA	92663	3511	30	06059	33.62579141	-117.9299554	Orange County
60838	Fee-for-Service	1912953936	1912953936	1	7	FAIRBANKS & POWER PHYSICAL T	4/28/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	1561 ONTARIO	SUITE 101	CORONA	CA	92881	6662	33	06065	33.84257433	-117.5332788	Riverside County
60853	Fee-for-Service	1518045103	1518045103	1	1	FIRTCH, WILLIAM L MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	61851	01	General Practice	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
60925	Fee-for-Service	1134687783	1134687783	1	1	FICE, MICHAEL P MD	3/18/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	1225 15TH ST	2100	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
60952	Fee-for-Service	1619674504	1619674504	1	1	FAVEL, KRISTEN MD	2/17/2023	2080P0210X	NA	Nephrology	026	PHYSICIANS	184179	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
60955	Fee-for-Service	1023133584	1023133584	1	1	FRANCIS, CARLA L LCSW	7/31/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	67038	-	NOT APPLICABLE	0	In state provider	None	5715 SOUTH BROADWAY AVE	None	LOS ANGELES	CA	90037	4131	19	06037	33.990273	-118.2783255	Los Angeles County
61021	Fee-for-Service	1659779312	1659779312	1	1	FOX, MARA J CNM	7/21/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
61149	Fee-for-Service	1952311797	1952311797	1	1	FENTON, PETER C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	6360 S 3000 E	STE 300	SALT LAKE CTY	UT	84121	6926	00	None	40.63386928	-111.8062036	Salt Lake County
61188	Fee-for-Service	1154693281	1154693281	1	1	FIHMAN, LEONORA DPM	9/22/2022	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	15225 VANOWEN ST	STE 108	VAN NUYS	CA	91405	3603	19	06037	34.19394549	-118.464777	Los Angeles County
61221	Fee-for-Service	1487688842	1487688842	1	1	FURMAN, YURY MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72162	13	Neurology (M.D. only)	0	In state provider	None	6333 WILSHIRE BLVD	STE 402	LOS ANGELES	CA	90048	5722	19	06037	34.06355697	-118.366413	Los Angeles County
61222	Fee-for-Service	1134273188	1134273188	1	1	FOK, DAVID Y OD	7/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR ROAD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
61228	Fee-for-Service	1962800086	1962800086	1	1	FINN, KATHERINE R	6/1/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
61262	Fee-for-Service	1437971116	1437971116	1	1	FAMILY FIRST MATERNITY CENTE	11/8/2024	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	R	4056 ALTA MESA DR	None	REDDING	CA	96002	3732	45	06089	40.54821409	-122.3303114	Shasta County
61375	Fee-for-Service	1760121222	1760121222	1	1	FOSTER, JESSICA NP	4/17/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	720 E CARNEGIE DR.	STE 140	SAN BERNARDINO	CA	92408	3516	36	06071	34.06914052	-117.2695442	San Bernardino County
61401	Fee-for-Service	1588893374	1588893374	1	1	FOSTER-GOLDMAN, ALISON R MD	9/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126859	None	None	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91773	3219	19	06037	34.20289797	-118.6294006	Los Angeles County
61432	Fee-for-Service	1558556696	1558556696	1	1	FAKHERI, AZITA MD INC	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	69052	41	Internal Medicine	0	In state provider	None	19100 VENTURA BOULEVARD	SUITE A	TARZANA	CA	91356	3239	19	06037	34.17250811	-118.5488682	Los Angeles County
61541	Fee-for-Service	1902499056	1902499056	1	1	FLOWERS, JOHN T NP	1/9/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15107 VANOWEN STREET	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
61599	Fee-for-Service	1568882298	1568882298	1	1	FAN, ASHLEY H DO	11/27/2017	207R00000X	NA	Other	026	PHYSICIANS	14285	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
61630	Fee-for-Service	1639653181	1639653181	1	1	FRENCH, HELEN F LCSW	6/1/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	686 W LINE ST	None	BISHOP	CA	93514	3302	14	06027	37.36133867	-118.4014701	Inyo County
61643	Fee-for-Service	1861659534	1861659534	1	1	FIRST VISION, INC	3/23/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SURECHOICE MEDICAL	9100 S SEPULVEDA BLVD	STE 112	LOS ANGELES	CA	90045	4849	19	06037	33.954147	-118.396111	Los Angeles County
61675	Fee-for-Service	1376642140	1376642140	1	1	FOX, DALE A MD	8/1/1984	207P00000X	NA	Other	026	PHYSICIANS	37023	66	Emergency Medicine (Urgent Care)	0	In state provider	None	446 26TH ST	None	SAN DIEGO	CA	92102	3026	37	06073	32.70981972	-117.1381594	San Diego County
61711	Fee-for-Service	1730160714	1730160714	1	1	FOX, ARTHUR H MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80873	02	General Surgery	0	In state provider	None	1141 W REDONDO BEACH BLV	STE 202	GARDENA	CA	90247	3584	19	06037	33.89247036	-118.2941482	Los Angeles County
61712	Fee-for-Service	1508084658	1508084658	1	1	FOX, ROBERT C MD INC	7/30/2003	207W00000X	NA	Ophthalmology	026	PHYSICIANS	50857	18	Ophthalmology	0	In state provider	None	2216 BUENAVENTURA BLVD	None	REDDING	CA	96001	3838	45	06089	40.55453352	-122.3904825	Shasta County
61757	Fee-for-Service	1104188176	1104188176	1	1	FARJOODI, PAYAM MD INC	11/18/2013	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	112479	None	None	0	In state provider	None	11160 WARNER AVENUE	SUITE 311	FOUNTAIN VALLEY	CA	92708	4055	30	06059	33.71630854	-117.934317	Orange County
61774	Fee-for-Service	1801268719	1801268719	1	1	FRANCISQUE, ESTEPHA A LCSW	1/23/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3550 WATT AVE	SUITE 140	SACRAMENTO	CA	95821	2667	34	06067	38.630115	-121.3819245	Sacramento County
61780	Fee-for-Service	1295079531	1295079531	1	1	FINNEY, JANE M NP	9/28/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
61868	Fee-for-Service	1629033030	1629033030	1	1	FUSION DIAGNOSTIC	3/1/2003	2085R0202X	NA	Mammography/MRI Provider	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	GROUP LLC	1700 CALIFORNIA ST	STE 260	SAN FRANCISCO	CA	94109	4588	38	06075	37.79030099	-122.4230289	San Francisco County
61908	Fee-for-Service	1245592625	1245592625	1	1	FAY, JONATHAN D MD	12/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	2640 BIEHN ST	STE 3	KLAMATH FALLS	OR	97601	1181	00	None	42.2454811	-121.7916325	Klamath County
61915	Fee-for-Service	1407878911	1407878911	1	1	FISCH, BRUCE J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
61949	Fee-for-Service	1962429571	1962429571	1	1	FATIMA, FAZILATH MD	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133691	41	Internal Medicine	0	In state provider	None	17360 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	3720	30	06059	33.71141952	-117.9542482	Orange County
61974	Fee-for-Service	1114276664	1114276664	1	1	FRIEDMAN, MARK A MD INC	9/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55315	20	Orthopedic Surgery	0	In state provider	None	555 PETALUMA AVE	SUITE B	SEBASTOPOL	CA	95472	4225	49	06097	38.39744712	-122.8206197	Sonoma County
62055	Fee-for-Service	1922090919	1922090919	1	1	FEUERMAN, NEAL MD INC	4/12/1993	207L00000X	NA	Other	026	PHYSICIANS	76284	05	Anesthesiology	0	In state provider	None	3300 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
62066	Fee-for-Service	1689002024	1689002024	1	1	FACULTY PHYSICIANS AND	4/10/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	SURGEONS OF LLUSM	69844 HWY 111	STE A AND B	RANCHO MIRAGE	CA	92270	2849	33	06065	33.76988393	-116.4463473	Riverside County
62175	Fee-for-Service	1245279389	1245279389	1	1	FRANK, LEONARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12040 NE 128TH ST	None	KIRKLAND	WA	98034	3013	00	None	47.71493427	-122.1792761	King County
62221	Fee-for-Service	1396751285	1396751285	1	1	FREY, JOHN R MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	50392	02	General Surgery	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
62227	Fee-for-Service	1861540437	1861540437	1	1	FERRIS, ANN K MD	2/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68318	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
62252	Fee-for-Service	1720162464	1720162464	1	1	FERGUSON, CAROL G NP	11/22/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	371256	-	NOT APPLICABLE	0	In state provider	None	101 GOUGH ST	None	SAN FRANCISCO	CA	94102	5903	38	06075	37.77425761	-122.4224731	San Francisco County
62291	Fee-for-Service	1851829642	1851829642	1	1	FARAH, TARA MD	4/30/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169405	None	None	0	In state provider	None	1011 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72827776	-121.2904066	Placer County
62351	Fee-for-Service	1629239140	1629239140	1	1	FLINT, JAMES H MD	9/18/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	156864	20	Orthopedic Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
62383	Fee-for-Service	1558385641	1558385641	1	1	FREITAS, PAUL MICHAEL	8/31/1995	207P00000X	NA	Other	026	PHYSICIANS	27100	01	General Practice	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
62492	Fee-for-Service	1104038462	1104038462	1	1	FAZELI, BAHAR D MD	7/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105819	05	Anesthesiology	0	In state provider	None	2975 N SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
62550	Fee-for-Service	1720049620	1720049620	2	1	FOLEY, JOHN V MD	12/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	76285	20	Orthopedic Surgery	0	In state provider	None	10051 LAKE AVENUE	SUITE 3	TRUCKEE	CA	96161	4870	29	06057	39.32550268	-120.2025066	Nevada County
62575	Fee-for-Service	1841231834	1841231834	1	1	FITZGERALD, THOMAS M DPM	8/31/1986	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1350 MEDICAL CENTER DR	None	ROHNERT PARK	CA	94928	2932	49	06097	38.34760949	-122.6835315	Sonoma County
62672	Fee-for-Service	1407927460	1407927460	1	1	FORD, WILLIAM R MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	65381	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
62687	Fee-for-Service	1952733032	1952733032	1	1	FOX, CHRISTOPHER B NP	1/17/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
62716	Fee-for-Service	1740308550	1740308550	1	1	FAGAN, BRIAN T MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82153	40	Pediatrics	0	In state provider	None	50 W BELLEFONTAINE	STE 405	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
62770	Fee-for-Service	1538259304	1538259304	1	1	FORD, LLOYD C MD	4/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65009	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3194	07	06013	37.9141514	-122.0422089	Contra Costa County
62831	Fee-for-Service	1912953936	1912953936	1	9	FAIRBANKS & POWER PHYSICAL T	6/25/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	& SPORTS MEDICINE	9900 INDIANA AVE	8	RIVERSIDE	CA	92503	5498	33	06065	33.90939848	-117.4496843	Riverside County
62909	Fee-for-Service	1508255175	1508255175	1	1	FACULTY PHYSICIANS AND	9/15/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM	1505 WILSON TERRACE	STE 155	GLENDALE	CA	91206	4032	19	06037	34.14960934	-118.2313491	Los Angeles County
62915	Fee-for-Service	1659380657	1659380657	1	2	FARRER, TODD A MD	2/6/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	60156	-	NOT APPLICABLE	0	In state provider	None	1100 UNION AVE	None	BAKERSFIELD	CA	93307	1050	15	06029	35.36762397	-119.0028315	Kern County
62946	Fee-for-Service	1538192588	1538192588	1	1	FELDMAN, RANDY BRIAN MD	10/16/2007	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	67543	77	Infectious Disease	0	In state provider	None	8635 W 3RD STREET	SUITE 1185W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
62964	Fee-for-Service	1407927460	1407927460	1	1	FORD, WILLIAM R MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	65381	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
62994	Fee-for-Service	1982781548	1982781548	1	1	FEIERABEND, SUSAN B MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	60059	08	Family Practice	0	In state provider	None	2500 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3156	07	06013	38.00658519	-122.1309063	Contra Costa County
63006	Fee-for-Service	1740308550	1740308550	1	1	FAGAN, BRIAN T MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82153	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	50 W BELLEFONTAINE	STE 405	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
63070	Fee-for-Service	1992710552	1992710552	1	2	FRESNO WOMENS MEDICAL	8/28/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1125 T ST	None	FRESNO	CA	93721	1430	10	06019	36.74255831	-119.781447	Fresno County
63087	Fee-for-Service	1386835585	1386835585	1	1	FOWLER, JUSTIN MD	6/19/2024	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	189271	02	General Surgery	0	In state provider	None	6555 COYLE	SUITE 220	CARMICHAEL	CA	95608	0303	34	06067	38.66859	-121.3118055	Sacramento County
63098	Fee-for-Service	1619137064	1619137064	1	1	FRONK, JOSHUA C DO	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11771	08	Family Practice	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
63119	Fee-for-Service	1912953936	1912953936	1	9	FAIRBANKS & POWER PHYSICAL T	1/16/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	9900 INDIANA AVE	8	RIVERSIDE	CA	92503	5498	33	06065	33.90939848	-117.4496843	Riverside County
63185	Fee-for-Service	1760499511	1760499511	1	1	FIGUEROA, CARLOS M	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44673	None	None	0	In state provider	None	625 S FAIR OAKS AVE	STE 245	PASADENA	CA	91105	2613	19	06037	34.134894	-118.1504155	Los Angeles County
63211	Fee-for-Service	1457412322	1457412322	1	1	FARBER, LOREN MFT	8/13/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3172 WALFORD AVE	STE 3	EUREKA	CA	95503	4898	12	06023	40.77960999	-124.1378813	Humboldt County
63213	Fee-for-Service	1376678524	1376678524	1	1	FONG-CHANG, MAY LCSW	8/14/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25 S RAYMOND AVE	STE 201	ALHAMBRA	CA	91801	7146	19	06037	34.09042452	-118.1450725	Los Angeles County
63236	Fee-for-Service	1538192588	1538192588	1	1	FELDMAN, RANDY BRIAN MD	10/16/2007	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	67543	41	Internal Medicine	0	In state provider	None	8635 W 3RD STREET	SUITE 1185W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
63248	Fee-for-Service	1972950368	1972950368	1	1	FATIMA, AELIA MD	8/28/2020	207R00000X	NA	Other	026	PHYSICIANS	168118	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
63254	Fee-for-Service	1609046077	1609046077	1	1	FERADOUNI, ARMIN DPM	11/28/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2601 W ALAMEDA AVE	SUITE 208	BURBANK	CA	91505	4800	19	06037	34.15783817	-118.3293969	Los Angeles County
63303	Fee-for-Service	1194369777	1194369777	1	1	FRESH RX LLC	5/19/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	18417 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2898	19	06037	33.98841262	-117.9032198	Los Angeles County
63364	Fee-for-Service	1316100415	1316100415	1	1	FRANKWICH, KAREN A MD	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109808	67	Endocrinology	0	In state provider	None	27871 MEDICAL CENTER DR	SUITE 200	MISSION VIEJO	CA	92691	6406	30	06059	33.558534	-117.6641255	Orange County
63562	Fee-for-Service	1225027709	1225027709	1	1	FOX, MICHAEL	10/31/1986	207P00000X	NA	Other	026	PHYSICIANS	31552	66	Emergency Medicine (Urgent Care)	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
63577	Fee-for-Service	1487885372	1487885372	1	1	FOOTHILLS PAIN MANAGEMENT CL	4/21/2011	193400000X	NA	Other	026	PHYSICIANS	52522	02	General Surgery	0	In state provider	CLINIC PC	906 S SUNSET AVE	STE 105	WEST COVINA	CA	91790	3400	19	06037	34.06466364	-117.9424724	Los Angeles County
63578	Fee-for-Service	1447782032	1447782032	1	1	FLANNERY, MICHAEL P DO	7/27/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	18792	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
63587	Fee-for-Service	1023270881	1023270881	1	1	FLIGIEL, HELENE M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 E MEDICAL CENTER DR	None	ANN ARBOR	MI	48109	5000	00	None	42.28391347	-83.72716554	Washtenaw County
63649	Fee-for-Service	1578608733	1578608733	1	1	FRANK, GUIDO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
63741	Fee-for-Service	1134784812	1134784812	1	1	FAN, JOSHUA MD	10/25/2023	207P00000X	NA	Other	026	PHYSICIANS	190632	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
63784	Fee-for-Service	1396351987	1396351987	1	1	FIELDS, CEDRIC LMFT	4/12/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
63788	Fee-for-Service	1962423574	1962423574	2	1	FULLERTON SURGICAL CENTER LP	10/5/2011	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2240 N HARBOR BLVD	STE 100	FULLERTON	CA	92835	2634	30	06059	33.89764434	-117.929218	Orange County
63798	Fee-for-Service	1619048527	1619048527	1	1	FALK, PETER M MD	4/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	24762	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
63805	Fee-for-Service	1841371127	1841371127	1	1	FRED, CAROL A LCSW	9/6/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	95 N MARENGO AVE	STE 200	PASADENA	CA	91101	1746	19	06037	34.14788105	-118.1459721	Los Angeles County
63824	Fee-for-Service	1275910705	1275910705	1	1	FISCHER, ADINA S MD	10/25/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	143771	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
63928	Fee-for-Service	1336320407	1336320407	1	1	FAYSMAN, KAROLINA NP	12/26/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
63943	Fee-for-Service	1891091682	1891091682	1	1	FREY, ERIC D MD	10/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116953	10	Gastroenterology (M.D. only)	0	In state provider	None	1111 N CHINA LAKE BLVD	STE B	RIDGECREST	CA	93555	3130	15	06029	35.64171	-117.669847	Kern County
63998	Fee-for-Service	1457345225	1457345225	1	1	FRIEDMAN, BRUCE F MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53565	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
64025	Fee-for-Service	1033356936	1033356936	1	1	FINCHER, ROBERT W DO	6/22/2022	2086S0129X	NA	General Surgery	026	PHYSICIANS	18958	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
64062	Fee-for-Service	1871509034	1871509034	1	1	FLETTNER, JULIANE G OD	10/24/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2500 MILVIA ST	STE 208	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
64160	Fee-for-Service	1700825312	1700825312	1	1	FAN, TERRY MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90300	40	Pediatrics	0	In state provider	None	3811 VALLEY CENTRE DR	None	SAN DIEGO	CA	92130	3318	37	06073	32.93760492	-117.2320932	San Diego County
64176	Fee-for-Service	1679550032	1679550032	1	1	FRITZ, RUSSELL C MD	5/31/1991	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60870	30	Radiology	0	In state provider	None	3301 EL CAMINO REAL	STE 100	ATHERTON	CA	94027	3803	41	06081	37.46631066	-122.2076453	San Mateo County
64207	Fee-for-Service	1124882477	1124882477	1	1	FATE PHARMACY INC	4/26/2024	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10200 SEPULVEDA BLVD STE	None	MISSION HILLS	CA	91345	2690	19	06037	34.25572562	-118.4673156	Los Angeles County
64224	Fee-for-Service	1780331439	1780331439	1	1	FRUZZA, DIANA L CNP	9/27/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	638 CAMINO DE LOS MARES	None	SAN CLEMENTE	CA	92673	2848	30	06059	33.45932277	-117.6517315	Orange County
64232	Fee-for-Service	1891091682	1891091682	1	1	FREY, ERIC D MD	10/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116953	41	Internal Medicine	0	In state provider	None	1111 N CHINA LAKE BLVD	STE B	RIDGECREST	CA	93555	3130	15	06029	35.64171	-117.669847	Kern County
64260	Fee-for-Service	1033298740	1033298740	1	1	FLORES, JOSEPH MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27099	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
64262	Fee-for-Service	1396893129	1396893129	1	1	FASSIHI, KATHERINE S MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68023	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
64282	Fee-for-Service	1912953936	1912953936	1	6	FAIRBANKS & POWER PHYSICAL T	6/30/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	28780 SINGLE OAK	295	TEMECULA	CA	92590	3625	33	06065	33.49890392	-117.1612965	Riverside County
64291	Fee-for-Service	1457345225	1457345225	1	1	FRIEDMAN, BRUCE F MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53565	03	Allergy	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
64307	Fee-for-Service	1356705149	1356705149	1	1	FARAH, NAZIA DO	5/25/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17206	08	Family Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
64342	Fee-for-Service	1710482278	1710482278	1	1	FALSGRAF, ERIKA MD	9/30/2021	207P00000X	NA	Other	026	PHYSICIANS	165435	None	None	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
64352	Fee-for-Service	1104983873	1104983873	1	2	FARAG, JOHN S MD	12/26/2024	207R00000X	NA	Other	026	PHYSICIANS	83293	41	Internal Medicine	0	In state provider	None	4240 LATHAM ST	STE A	RIVERSIDE	CA	92501	1741	33	06065	34.00198519	-117.3739252	Riverside County
64447	Fee-for-Service	1417345323	1417345323	1	1	FOOTHILL MEDICAL CLINIC INC	5/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42629	41	Internal Medicine	0	In state provider	None	10011 N FOOTHILL BLVD	STE 105	CUPERTINO	CA	95014	5649	43	06085	37.32285289	-122.0687405	Santa Clara County
64491	Fee-for-Service	1386009645	1386009645	1	1	FRESENIUS MEDICAL CARE	12/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	NORWALK LLC	13063 ROSENCRANS AVE	BUILDING 1	SANTA FE SPRINGS	CA	90670	4930	19	06037	33.90246268	-118.0532666	Los Angeles County
64493	Fee-for-Service	1639367774	1639367774	1	1	FREESTONE, GARY M OD APC	1/31/1989	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 N RIVERSIDE AVE	STE 220	RIALTO	CA	92376	8082	36	06071	34.132905	-117.3704675	San Bernardino County
64516	Fee-for-Service	1669918660	1669918660	1	1	FEIGE, MICHELLE M	4/5/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	43112 15TH STREET W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
64649	Fee-for-Service	1437100245	1437100245	1	1	FLORIAN A WEILKE MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 BROADWAY N	None	FARGO	ND	58102	3641	00	None	46.885068	-96.7872375	Cass County
64783	Fee-for-Service	1508323635	1508323635	1	1	FORNERON, JUSTIN CRNA	1/23/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3555 CESAR CHAVEZ ST	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.7479947	-122.4209132	San Francisco County
64923	Fee-for-Service	1811243132	1811243132	1	1	FORELO, JANET A MSW LCSW	7/18/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	45 E SANTA ANA	101	FRESNO	CA	93704	2927	10	06019	36.80476673	-119.8122625	Fresno County
64952	Fee-for-Service	1669550745	1669550745	1	1	FRANKLIN, NANCY E MD	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	68943	07	Dermatology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
64961	Fee-for-Service	1376784389	1376784389	1	1	FRESENIUS MEDICAL CARE	5/1/2009	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA LLC	7927 OSTROW ST	STE A	SAN DIEGO	CA	92111	3604	37	06073	32.8132947	-117.1548122	San Diego County
64981	Fee-for-Service	1447700034	1447700034	1	1	F. JIMENEZ MEDICAL CORPORATI	7/19/2022	163WG0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	360 E 7TH ST	SUITE D	UPLAND	CA	91786	6701	36	06071	34.08880374	-117.6465151	San Bernardino County
65068	Fee-for-Service	1427348382	1427348382	1	1	FIRESTEIN, CATHERINE E MD	6/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143013	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
65074	Fee-for-Service	1508954884	1508954884	1	1	FUNG, NANCY Q H MD	11/2/2015	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	108831	25	Physical Medicine and Rehabilitation	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
65083	Fee-for-Service	1669410270	1669410270	1	2	FAKHERI, AZITA MD	9/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	69052	41	Internal Medicine	0	In state provider	None	19100 VENTURA BOULEVARD	SUITE A	TARZANA	CA	91356	3239	19	06037	34.17250811	-118.5488682	Los Angeles County
65151	Fee-for-Service	1164500930	1164500930	1	1	FRANZGROTE, MERULA D MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65227	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
65215	Fee-for-Service	1487996161	1487996161	1	1	FIRESTONE, BRANDON M MD	10/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132592	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
65255	Fee-for-Service	1710760442	1710760442	1	1	FDL SYNERGY INC	3/21/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8831 DORSETT DR	None	HUNTINGTON BEACH	CA	92646	7150	30	06059	33.65586121	-117.9735872	Orange County
65271	Fee-for-Service	1912999525	1912999525	1	1	FALCO, DANIEL A MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	60912	40	Pediatrics	0	In state provider	None	650 UNIVERSITY AVE	STE 200	SACRAMENTO	CA	95825	6726	34	06067	38.567115	-121.4188065	Sacramento County
65330	Fee-for-Service	1790841799	1790841799	1	1	FARAHMAND, NAVID MD	4/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103609	05	Anesthesiology	0	In state provider	None	819 AUTO CENTER DRIVE	None	PALMDALE	CA	93551	4599	19	06037	34.59142164	-118.14665	Los Angeles County
65444	Fee-for-Service	1114168747	1114168747	1	1	FURSE, ROBERT L LMFT	10/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	409 N CAMDEN DR	STE 103	BEVERLY HILLS	CA	90210	4422	19	06037	34.06871362	-118.4042218	Los Angeles County
65467	Fee-for-Service	1245868298	1245868298	1	1	FERGUSON, FREDERICK I MD	9/5/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	188679	None	None	0	In state provider	None	1920 COLORADO AVENUE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
65526	Fee-for-Service	1265094767	1265094767	1	1	FAST, LEAH M MD	8/14/2023	207L00000X	NA	Other	026	PHYSICIANS	182153	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
65629	Fee-for-Service	1215020854	1215020854	1	1	FARRELL, ERIC D MD	8/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54683	20	Orthopedic Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
65712	Fee-for-Service	1598952582	1598952582	1	1	FITZGERALD, CURTIS CP	1/21/2022	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3125 COFFEE RD	SUITE 2	MODESTO	CA	95355	1768	50	06099	37.68354805	-120.9760392	Stanislaus County
65770	Fee-for-Service	1396249728	1396249728	1	1	FELD, ZOE M MD	9/16/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	164398	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
65837	Fee-for-Service	1265611768	1265611768	1	1	FICHTENKORT, JOHN D	8/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	57591	01	General Practice	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
65880	Fee-for-Service	1982101234	1982101234	1	1	FAIQ, NADIA MD	5/20/2022	207P00000X	NA	Other	026	PHYSICIANS	164228	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
66009	Fee-for-Service	1225397979	1225397979	1	1	FERRER-KAW, MONA C MD	8/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152234	01	General Practice	0	In state provider	None	111 SMITH RANCH RD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
66071	Fee-for-Service	1699498121	1699498121	1	1	FAULDING, CHRISTINA M NP	7/3/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
66159	Fee-for-Service	1356875496	1356875496	1	1	FERNANDEZ, VINDIA G PHD	11/5/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
66213	Fee-for-Service	1487679361	1487679361	1	1	FAISAL, FAWAZ MD	3/31/1994	2084N0400X	NA	Neurology	026	PHYSICIANS	50545	None	None	0	In state provider	None	300 UCLA PLAZA DR	STE B200	LOS ANGELES	CA	90024	0000	19	06037	34.06465655	-118.4461	Los Angeles County
66278	Fee-for-Service	1235292616	1235292616	1	1	FRENCH, AMY C MD	9/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100272	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	655 EUCLID AVE	STE 409	NATIONAL CITY	CA	91950	2981	37	06073	32.68353398	-117.082625	San Diego County
66296	Fee-for-Service	1225397979	1225397979	1	1	FERRER-KAW, MONA C MD	8/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152234	36	Psychiatry	0	In state provider	None	111 SMITH RANCH RD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
66323	Fee-for-Service	1447544044	1447544044	1	1	FONTES, KRISTIN E MD	8/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122479	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
66337	Fee-for-Service	1104163443	1104163443	1	1	FLORES, KARLA I LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
66354	Fee-for-Service	1598192098	1598192098	1	1	FARIBA SHARIFI PSYCHOLOGICAL	12/5/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CORP.	17337 VENTURA BLVD	STE 222	ENCINO	CA	91316	3903	19	06037	34.16102943	-118.5108514	Los Angeles County
66424	Fee-for-Service	1063433563	1063433563	1	1	FELDMANN, WILLIAM MD	5/9/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	49486	30	Radiology	0	In state provider	None	15031 RINALDI ST	None	MISSION HILLS	CA	91345	1207	19	06037	34.27904453	-118.459944	Los Angeles County
66517	Fee-for-Service	1922010073	1922010073	1	1	FENG, CHU-PEI MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66204	None	None	0	In state provider	None	16300 SAND CANYON AVE	STE 102	IRVINE	CA	92618	3704	30	06059	33.66115075	-117.7742405	Orange County
66568	Fee-for-Service	1891743571	1891743571	1	1	FIRST RESPONDER EMS INC	7/21/1988	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	FIRST RESPONDER EMS INC	333 HUSS DR	STE 100	CHICO	CA	95928	8242	04	06007	39.70538544	-121.8201138	Butte County
66613	Fee-for-Service	1164469201	1164469201	1	1	FLORES, JACOB N MD	12/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	60865	01	General Practice	0	In state provider	None	5520 SANTA MONICA BLVD	SUITE 112	LOS ANGELES	CA	90038	2932	19	06037	34.09074149	-118.310229	Los Angeles County
66631	Fee-for-Service	1013189448	1013189448	1	1	FLORES, MICHELLE LMFT	8/2/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2141 N HARBOR BLVD	STE 25000	FULLERTON	CA	92835	3830	30	06059	33.89443025	-117.9288328	Orange County
66645	Fee-for-Service	1053450908	1053450908	1	1	FUSE, YOSHIO	1/22/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6888 LINCOLN AVE	STE J	BUENA PARK	CA	90620	4107	30	06059	33.83179254	-118.013031	Orange County
66708	Fee-for-Service	1487172805	1487172805	1	1	FARZIN BENJAMIN PEDOUIM MD I	10/4/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	None	None	None	0	In state provider	NC	18377 BEACH BLVD	SUITE 330	HUNTINGTON BEACH	CA	92648	1350	30	06059	33.69580652	-117.9895815	Orange County
66719	Fee-for-Service	1942628987	1942628987	1	1	FAN, WEI MD	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147168	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
66764	Fee-for-Service	1427031335	1427031335	1	1	FUA, DENNIS C MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90073	05	Anesthesiology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
66818	Fee-for-Service	1033181391	1033181391	1	1	FRANCESCHI, JEFFREY P	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
66823	Fee-for-Service	1457329096	1457329096	1	1	FROMM, LOLIE L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39116	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 HOSPITAL CIR	None	WESTMINSTER	CA	92683	3910	30	06059	33.76352239	-117.9958997	Orange County
66842	Fee-for-Service	1992417539	1992417539	1	1	FLORES, JAMES	2/15/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95022013	-	NOT APPLICABLE	0	In state provider	None	2045 AND 2055 SAVIERS RD	9, 10, 11 & 12	OXNARD	CA	93033	3651	56	06111	34.179219	-119.1776065	Ventura County
66894	Fee-for-Service	1427118348	1427118348	1	1	FRANCIS, BRIAN A MD	1/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60102	18	Ophthalmology	0	In state provider	None	622 W DUARTE RD	STE 101	ARCADIA	CA	91007	9266	19	06037	34.12645266	-118.0521552	Los Angeles County
66957	Fee-for-Service	1750364816	1750364816	1	1	FOSTER, CAMERON MD	6/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88267	42	Nuclear Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
66986	Fee-for-Service	1598738270	1598738270	1	1	FERRATE,RODOLFO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 S PIONEER PARKWAY	None	WEST VALLEY CITY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
67058	Fee-for-Service	1952391542	1952391542	1	1	FAR, AZITA MD	2/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83699	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
67083	Fee-for-Service	1255423356	1255423356	1	1	FLOYD, JOYCELLEN MD	9/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	42296	08	Family Practice	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
67099	Fee-for-Service	1053482588	1053482588	1	2	FITZGERALD, LAURIE LMFT	2/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11882 TAMMY WAY	STE 3	GRASS VALLEY	CA	95949	6621	29	06057	39.13570474	-121.050495	Nevada County
67115	Fee-for-Service	1225372238	1225372238	1	1	FERRO, ANTONIA M LMFT	1/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
67164	Fee-for-Service	1962732974	1962732974	1	1	FONTE, NANETTE C MD	7/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111173	41	Internal Medicine	0	In state provider	None	1759 W AVENUE J	SUITE 101	LANCASTER	CA	93534	2703	19	06037	34.68944351	-118.163124	Los Angeles County
67188	Fee-for-Service	1174110597	1174110597	1	1	FEDORCHAK, LAUREN CRNA	9/12/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
67272	Fee-for-Service	1295816569	1295816569	1	1	FRESNO COMMUNITY HOSP &	7/29/1992	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CENTER	3003 N MARIPOSA ST	None	FRESNO	CA	93703	1127	10	06019	36.777735	-119.779307	Fresno County
67305	Fee-for-Service	1699077594	1699077594	1	1	FRENKEL, ORON MD	7/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113321	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
67313	Fee-for-Service	1235313123	1235313123	1	1	FOOT AND ANKLE WELLNESS CLIN	4/13/2020	213ES0131X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	IC	6310 SAN VICENTE BLVD	STE 220	LOS ANGELES	CA	90048	5816	19	06037	34.06093425	-118.3673115	Los Angeles County
67318	Fee-for-Service	1699785857	1699785857	1	1	FISCHER, KEITH R MD	1/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	82030	08	Family Practice	0	In state provider	None	525 3RD AVE	None	CHULA VISTA	CA	91910	5616	37	06073	32.63367609	-117.0769202	San Diego County
67331	Fee-for-Service	1154388205	1154388205	1	1	FROST, TIMOTHY R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2929 5TH ST	STE 100	RAPID CITY	SD	57701	7355	00	None	44.05598594	-103.2274757	Pennington County
67349	Fee-for-Service	1851779052	1851779052	1	1	FENLON, MICHAEL MD	2/8/2018	208600000X	NA	General Surgery	026	PHYSICIANS	135974	02	General Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
67369	Fee-for-Service	1275625832	1275625832	1	1	FENG, JOHN JIH-JONG	9/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79786	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
67394	Fee-for-Service	1003687468	1003687468	1	1	FERNANDEZ, MAYRA CHRISTINA	7/10/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3250 W AVENUE L	None	LANCASTER	CA	93536	4127	19	06037	34.66021411	-118.1898096	Los Angeles County
67409	Fee-for-Service	1861565392	1861565392	1	1	FACTOR, PHILLIP H DO MD	1/31/2018	207RC0200X	NA	Other	026	PHYSICIANS	12426	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
67465	Fee-for-Service	1275762338	1275762338	1	1	FISCHER, JUSTIN L	4/22/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5720 STONERIDGE MALL RD	STE 390	PLEASANTON	CA	94588	2831	01	06001	37.69247085	-121.9301884	Alameda County
67629	Fee-for-Service	1427069913	1427069913	2	1	FIFTEEN SIXTY PHARMACY LLC	8/11/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1560 E CHEVY CHASE DR	#110	GLENDALE	CA	91206	4197	19	06037	34.15290734	-118.2302295	Los Angeles County
67680	Fee-for-Service	1003687468	1003687468	1	1	FERNANDEZ, MAYRA CHRISTINA	7/10/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3250 W AVENUE L	None	LANCASTER	CA	93536	4127	19	06037	34.66021411	-118.1898096	Los Angeles County
67769	Fee-for-Service	1417400573	1417400573	1	1	FACULTY PHYSICIANS & SURGEON	5/12/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	OF LLUSM	16305 SAND CANYON AVE	STE 220	IRVINE	CA	92618	3782	30	06059	33.66201662	-117.7737316	Orange County
67816	Fee-for-Service	1326107079	1326107079	1	1	FELDMAN, KENNETH A MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55657	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
67886	Fee-for-Service	1265404289	1265404289	1	1	FEHRENBACHER, GEORGE MD	9/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50702	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2 MEDICAL PLAZA DR	STE 175	ROSEVILLE	CA	95661	3049	31	06061	38.76507948	-121.2477476	Placer County
67906	Fee-for-Service	1699860999	1699860999	1	1	FAMILY PLANNING ASSOCIATES M	1/1/1979	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP INC	703 MAGNOLIA AVE	None	CORONA	CA	92879	3118	33	06065	33.85828352	-117.5557208	Riverside County
67941	Fee-for-Service	1164804605	1164804605	1	1	FLETCHER, BRYAN DO	1/16/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	23204	36	Psychiatry	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
67948	Fee-for-Service	1295958577	1295958577	1	1	FIREBAUGH-LAS DELTAS JOINT	1/9/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	UNIFIED SCHOOL DISTRICT	1976 MORRIS KYLE DR	None	FIREBAUGH	CA	93622	9711	10	06019	36.84447	-120.4446915	Fresno County
68034	Fee-for-Service	1063551893	1063551893	1	1	FAMILY PLANNING ASSOCIATES	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1135 S SUNSET AVE	SUITE 302	WEST COVINA	CA	91790	3964	19	06037	34.06215064	-117.9453997	Los Angeles County
68108	Fee-for-Service	1346448651	1346448651	1	2	FARLEY-BATES, NINA DIANA LC	3/1/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	49063 ROAD 426	SUITE A	OAKHURST	CA	93644	9487	20	06039	37.33186891	-119.6510247	Madera County
68113	Fee-for-Service	1265088694	1265088694	1	1	FRIEDECK, JOHN	9/25/2024	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2373 COLORADO BLVD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
68118	Fee-for-Service	1174880835	1174880835	1	1	FERRO, DIEGO F M D INC	5/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106012	None	None	0	In state provider	None	420 W ACACIA ST	SUITE 1	STOCKTON	CA	95203	2441	39	06077	37.96135715	-121.2996632	San Joaquin County
68126	Fee-for-Service	1376802744	1376802744	1	1	FRANKEN, CARA L MD	12/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121685	02	General Surgery	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
68129	Fee-for-Service	1255770632	1255770632	1	1	FLAGG, SHANIA K MD	9/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151117	01	General Practice	0	In state provider	None	290 N WAYTE LANE	None	FRESNO	CA	93701	2124	10	06019	36.74643429	-119.7837416	Fresno County
68145	Fee-for-Service	1770698698	1770698698	1	2	FOLEY, EDITH M MD	8/12/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	70410	-	NOT APPLICABLE	0	In state provider	None	113 SOUTH M STREET	None	LOMPOC	CA	93436	5226	42	06083	34.63843246	-120.4643325	Santa Barbara County
68152	Fee-for-Service	1376144477	1376144477	1	1	FACULTY PHYSICIANS AND SURGE	5/3/2021	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	35400 BOB HOPE DR	STE 110	RANCHO MIRAGE	CA	92270	1772	33	06065	33.7914	-116.4058625	Riverside County
68158	Fee-for-Service	1467837377	1467837377	1	1	FARRELL, DEACON E MD	4/6/2021	207L00000X	NA	Other	026	PHYSICIANS	163151	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
68173	Fee-for-Service	1265404289	1265404289	1	1	FEHRENBACHER, GEORGE MD	9/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50702	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2 MEDICAL PLAZA DR	STE 175	ROSEVILLE	CA	95661	3049	31	06061	38.76507948	-121.2477476	Placer County
68205	Fee-for-Service	1386735918	1386735918	1	1	FREETO, DAVID M MD	2/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	25327	10	Gastroenterology (M.D. only)	0	In state provider	None	3443 VILLA LN	STE 4	NAPA	CA	94558	6417	28	06055	38.3259594	-122.2945735	Napa County
68229	Fee-for-Service	1265689335	1265689335	1	2	FRANK NASTANSKI MD A PROFESS	6/13/2020	208600000X	NA	General Surgery	026	PHYSICIANS	None	89	Surgery-Traumatic	0	In state provider	IONAL CORPORATION	999 N TUSTIN AVE	SUITE 109	SANTA ANA	CA	92705	3528	30	06059	33.754167	-117.834191	Orange County
68242	Fee-for-Service	1467715177	1467715177	1	1	FISHER, PATRICK B MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	130767	34	Urology and Urological Surgery	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
68425	Fee-for-Service	1043398936	1043398936	1	1	FAKHOURI,ISSA M MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70359	41	Internal Medicine	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
68434	Fee-for-Service	1558400861	1558400861	1	1	FUNG, LENORA V MD	8/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	31254	None	None	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
68493	Fee-for-Service	1386735918	1386735918	1	1	FREETO, DAVID M MD	2/9/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	25327	41	Internal Medicine	0	In state provider	None	3443 VILLA LN	STE 4	NAPA	CA	94558	6417	28	06055	38.3259594	-122.2945735	Napa County
68515	Fee-for-Service	1720549884	1720549884	1	1	FRIEDMAN, ERIC D MD	6/19/2024	207L00000X	NA	Other	026	PHYSICIANS	185895	05	Anesthesiology	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
68534	Fee-for-Service	1083029839	1083029839	1	1	FENIG, YANIV M MD	3/1/2024	204F00000X	NA	General Surgery	026	PHYSICIANS	191859	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
68585	Fee-for-Service	1063594612	1063594612	1	1	FULFORD, KEVIN L MD	9/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	66474	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	ONE HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
68611	Fee-for-Service	1104892199	1104892199	1	1	FLEMING, NICHOLAS F MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55445	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
68674	Fee-for-Service	1669453841	1669453841	1	1	FUENTES, ARMANDO MD	6/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88707	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
68686	Fee-for-Service	1679591663	1679591663	1	1	FAUROT, SUSAN P LMFT	2/4/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9829 BLUE LARKSPUR LN	SUITE 2	MONTEREY	CA	93940	6535	27	06053	36.57109892	-121.8021077	Monterey County
68708	Fee-for-Service	1134544471	1134544471	1	1	FURAAT INC	8/27/2018	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3443 CAMINO DEL RIO S	STE 207	SAN DIEGO	CA	92108	3914	37	06073	32.77709054	-117.1196521	San Diego County
68782	Fee-for-Service	1770673832	1770673832	1	1	FARNITANO, CHRISTOPHER	8/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51083	08	Family Practice	0	In state provider	None	2500 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3156	07	06013	38.00658519	-122.1309063	Contra Costa County
68836	Fee-for-Service	1013430982	1013430982	1	1	FAMILY WELLNESS CLINIC, INC	1/2/2018	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1817 SHAW AVE	SUITE 101	CLOVIS	CA	93611	4069	10	06019	36.8086995	-119.681613	Fresno County
68859	Fee-for-Service	1033746276	1033746276	1	1	FEENY, ALBERT K MD	6/30/2023	208M00000X	NA	Other	026	PHYSICIANS	186513	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
68921	Fee-for-Service	1952478786	1952478786	1	1	FABE, BRENDA L MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40751	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
68943	Fee-for-Service	1710935150	1710935150	1	1	FRANKLIN,JULIE R MD	2/13/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	49706	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
68973	Fee-for-Service	1619902087	1619902087	1	1	FLETCHER, HOWARD V MD	4/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	34948	07	Dermatology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
68985	Fee-for-Service	1548447378	1548447378	1	1	FEMINIST WOMENS HEALTH	7/1/1987	261QC1500X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	1442 ETHAN WAY	STE 100	SACRAMENTO	CA	95825	2232	34	06067	38.592126	-121.4190765	Sacramento County
68997	Fee-for-Service	1154697100	1154697100	1	1	FARBER, BENJAMIN A MD	11/1/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	None	85	Surgery-Pediatric	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
69013	Fee-for-Service	1881761310	1881761310	1	1	FORRESTER, MICHAEL G MD	8/1/1982	193200000X	NA	Other	026	PHYSICIANS	46300	47	Miscellaneous	0	In state provider	None	521 E ELDER ST	STE 202	FALLBROOK	CA	92028	3083	37	06073	33.38015149	-117.246267	San Diego County
69022	Fee-for-Service	1013479807	1013479807	1	1	FRANCZAK, MICHAEL MD	8/9/2023	207L00000X	NA	Other	026	PHYSICIANS	177602	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
69054	Fee-for-Service	1871896498	1871896498	1	1	FOX, BRITTANY R PT	1/13/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25150 HANCOCK AVE	STE 100	MURRIETA	CA	92562	5987	33	06065	33.56635084	-117.1823956	Riverside County
69075	Fee-for-Service	1407880040	1407880040	1	2	FLORES, CARLOS A MD	10/1/2002	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	41653	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	14673 PARTHENIA ST	STE 101	PANORAMA CITY	CA	91402	2991	19	06037	34.22819333	-118.4523118	Los Angeles County
69127	Fee-for-Service	1649253329	1649253329	1	1	FARAH, RAMEZ MD	1/24/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	45707	30	Radiology	0	In state provider	None	6939 PALM CT	None	RIVERSIDE	CA	92506	2815	33	06065	33.947325	-117.4011395	Riverside County
69129	Fee-for-Service	1184673568	1184673568	1	1	FLUKE, MATTHEW M MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85606	30	Radiology	0	In state provider	None	2426 BUHNE ST	None	EUREKA	CA	95501	3207	12	06023	40.78592355	-124.1405936	Humboldt County
69225	Fee-for-Service	1184607970	1184607970	1	1	FONG, HANLON J MD	9/30/1980	207R00000X	NA	Other	026	PHYSICIANS	32167	41	Internal Medicine	0	In state provider	None	2000 VAN NESS AVE	STE 605	SAN FRANCISCO	CA	94109	3016	38	06075	37.79415339	-122.422986	San Francisco County
69232	Fee-for-Service	1487232070	1487232070	1	1	FITZPATRICK, JUDITH A MD	12/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	192202	70	Clinic (mixed specialty)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
69282	Fee-for-Service	1154697100	1154697100	1	1	FARBER, BENJAMIN A MD	11/1/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
69289	Fee-for-Service	1467080291	1467080291	1	1	FLORES, MARIO	8/2/2023	208M00000X	NA	Other	026	PHYSICIANS	20554	None	None	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
69341	Fee-for-Service	1083655963	1083655963	1	1	FLUHARTY, COLLEEN MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73711	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
69409	Fee-for-Service	1740488543	1740488543	1	1	FAGAN, MATTHEW J DO	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13007	01	General Practice	0	In state provider	None	2200 O'FARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
69416	Fee-for-Service	1487025458	1487025458	1	1	FAITHFUL HOSPICE CARE, INC	8/9/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5924 E LOS ANGELES AVE	UNIT F	SIMI VALLEY	CA	93063	5526	56	06111	34.27171481	-118.6755673	Ventura County
69419	Fee-for-Service	1205870474	1205870474	1	1	FRAMBACK, DONALD MD	6/30/1987	207W00000X	NA	Ophthalmology	026	PHYSICIANS	60402	18	Ophthalmology	0	In state provider	None	1355 SAN PABLO ST	None	LOS ANGELES	CA	90033	1035	19	06037	34.06080447	-118.203734	Los Angeles County
69441	Fee-for-Service	1457799660	1457799660	1	1	FRENCH MEDICAL CORP	2/18/2014	261QM2500X	NA	Other	026	PHYSICIANS	104679	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	7177 BROCKTON AVE	SUITE 337	RIVERSIDE	CA	92506	2634	33	06065	33.94289496	-117.3943941	Riverside County
69480	Fee-for-Service	1902911647	1902911647	1	1	FREIER, MARY CATHERINI	3/1/2002	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
69481	Fee-for-Service	1457606238	1457606238	1	1	FRUCHT, COREY S MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129127	07	Dermatology	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
69491	Fee-for-Service	1104465566	1104465566	1	1	FREEMAN, NECHELLE CNP	4/5/2024	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
69502	Fee-for-Service	1427073683	1427073683	1	1	FEDULLO, PETER MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41977	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	225 DICKINSON ST	# H207	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
69503	Fee-for-Service	1174951800	1174951800	1	1	FAIZA DOSSA VIPUL, O.D., OPT	4/18/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1799 FOURTH ST	E	BERKELEY	CA	94710	1741	01	06001	37.87050809	-122.3007764	Alameda County
69513	Fee-for-Service	1184607970	1184607970	1	1	FONG, HANLON J MD	9/30/1980	207R00000X	NA	Other	026	PHYSICIANS	32167	45	Nephrology (Renal-Kidney)	0	In state provider	None	2000 VAN NESS AVE	STE 605	SAN FRANCISCO	CA	94109	3016	38	06075	37.79415339	-122.422986	San Francisco County
69523	Fee-for-Service	1487232070	1487232070	1	1	FITZPATRICK, JUDITH A MD	12/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	192202	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
69618	Fee-for-Service	1568657153	1568657153	1	1	FU, SHARON L LMFT	2/15/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
69694	Fee-for-Service	1003266438	1003266438	1	1	FIAMENGO, ALIDA A DO	2/14/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	17168	None	None	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
69704	Fee-for-Service	1487025458	1487025458	1	1	FAITHFUL HOSPICE CARE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5924 E LOS ANGELES AVE	UNIT F	SIMI VALLEY	CA	93063	5526	56	06111	34.27171481	-118.6755673	Ventura County
69758	Fee-for-Service	1689624850	1689624850	1	1	FRANK JUNG	5/4/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 S PARK ST	None	MADISON	WI	53715	1830	00	None	43.05939824	-89.40081047	Dane County
69776	Fee-for-Service	1538508015	1538508015	1	2	FOOTHILL HEALTH CENTER	5/3/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1066 S WHITE RD	None	SAN JOSE	CA	95127	3812	43	06085	37.35676387	-121.8196933	Santa Clara County
69808	Fee-for-Service	1639569247	1639569247	1	1	FUNCHES, EBONY N NP	11/4/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15272 SUMMIT AVE	None	FONTANA	CA	92336	0231	36	06071	34.152624	-117.4724415	San Bernardino County
69822	Fee-for-Service	1013943620	1013943620	1	1	FURBER, LEWIS E JR NP	8/4/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	36977 PARK AVE	None	BURNEY	CA	96013	4067	45	06089	40.87640189	-121.6730441	Shasta County
69835	Fee-for-Service	1083777007	1083777007	1	1	FIEDLER, MARTIN P DC	3/28/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	9667 HIGHWAY 29	STE 101	LOWER LAKE	CA	95457	9438	17	06033	38.91012553	-122.612985	Lake County
69851	Fee-for-Service	1629174149	1629174149	1	1	FENG, HELEN MD	7/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85995	83	Rheumatology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
69866	Fee-for-Service	1962693895	1962693895	1	1	FORD, ROBERT CRNA	3/15/2010	193400000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	PROFESSIONAL NURSING COR	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
69868	Fee-for-Service	1164620795	1164620795	1	1	FRIEDMAN, DAVID B MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	57885	07	Dermatology	0	In state provider	None	1165 N EUCLID ST	None	ANAHEIM	CA	92801	1938	30	06059	33.849792	-117.941806	Orange County
69918	Fee-for-Service	1881615664	1881615664	1	1	FRIEDLY, LAUREN M MD	1/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80912	41	Internal Medicine	0	In state provider	None	2340 CLAY ST	None	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
69920	Fee-for-Service	1326132366	1326132366	1	1	FTF PHARMACY CORPORATION	11/1/2001	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17577 ARROW BLVD	STE 101	FONTANA	CA	92335	4011	36	06071	34.09938951	-117.421272	San Bernardino County
69942	Fee-for-Service	1114377983	1114377983	1	1	FERGUSON, NICHOLAS T MD	7/2/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	154617	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
69945	Fee-for-Service	1871880427	1871880427	1	1	FRANTZ, MEGAN A MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142489	25	Physical Medicine and Rehabilitation	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
69993	Fee-for-Service	1356874523	1356874523	1	1	FU, AURELIA B MD	8/20/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	161359	None	None	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
69995	Fee-for-Service	1073546032	1073546032	1	1	FAMILY CARE PROVIDERS	11/1/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP, INC	1300 N FRESNO ST	None	FRESNO	CA	93703	3845	10	06019	36.75998613	-119.7814674	Fresno County
69998	Fee-for-Service	1164418893	1164418893	1	1	FRAIPONT, MICHAEL J MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81716	89	Surgery-Traumatic	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3229	19	06037	34.133598	-118.1534895	Los Angeles County
70049	Fee-for-Service	1982664884	1982664884	1	1	FELIX CERNA M.D.	8/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 WALTER ST NE	STE 104	ALBUQUERQUE	NM	87102	2541	00	None	35.08716551	-106.6401923	Bernalillo County
70072	Fee-for-Service	1225116981	1225116981	1	1	FENTON, WAYNE H MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	48220	04	Otology, Laryngology, Rhinology	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
70084	Fee-for-Service	1013212430	1013212430	1	1	FAYAD, HOUSSAM MD	6/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133149	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
70089	Fee-for-Service	1184849929	1184849929	2	1	FINKELSTEIN, ADRIAN	5/3/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	38147	36	Psychiatry	0	In state provider	None	5760 LAS VIRGINES ROAD,	333	CALABASAS	CA	91302	9026	19	06037	34.1622763	-118.702633	Los Angeles County
70112	Fee-for-Service	1235189275	1235189275	1	1	FACULTY PHYSICIANS AND	1/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	SURGEONS OF LLUSM	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
70128	Fee-for-Service	1245307107	1245307107	1	1	FREDERICKS, GARY L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26038	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
70138	Fee-for-Service	1629174149	1629174149	1	1	FENG, HELEN MD	7/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85995	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
70151	Fee-for-Service	1770698698	1770698698	1	1	FOLEY, EDITH M MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70410	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
70177	Fee-for-Service	1326756081	1326756081	1	1	FLUKER, ARMESHA	4/27/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	16200 LASSELLE ST	APT 132	MORENO VALLEY	CA	92555	3049	33	06065	33.87120513	-117.2109625	Riverside County
70189	Fee-for-Service	1386403392	1386403392	1	1	FLANAGAN, CHRISTOPHER M MD	7/30/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
70263	Fee-for-Service	1912142373	1912142373	1	1	FRIDOLFSSON, DANIEL	6/6/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4510 VIEWRIDGE AVE	None	SAN DIEGO	CA	92123	1637	37	06073	32.82283469	-117.1248707	San Diego County
70275	Fee-for-Service	1902854854	1902854854	1	1	FEMA PHYSICAL THERAPY CENTER	2/22/2019	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	1751 W ROMNEYA DR	SUITE M	ANAHEIM	CA	92801	1815	30	06059	33.85068001	-117.9438835	Orange County
70337	Fee-for-Service	1922172915	1922172915	1	1	FARLEY, PAUL S MD	7/1/1983	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	50092	08	Family Practice	0	In state provider	None	5685 MAIN STREET	None	KELSEYVILLE	CA	95451	8945	17	06033	38.97222647	-122.8301393	Lake County
70399	Fee-for-Service	1235189275	1235189275	1	1	FACULTY PHYSICIANS AND	1/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	SURGEONS OF LLUSM	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
70445	Fee-for-Service	1134742604	1134742604	1	1	FARRAHI, LAYLA N DO	7/10/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20529	None	None	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
70463	Fee-for-Service	1326756081	1326756081	1	1	FLUKER, ARMESHA	4/27/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	16200 LASSELLE ST	APT 132	MORENO VALLEY	CA	92555	3049	33	06065	33.87120513	-117.2109625	Riverside County
70509	Fee-for-Service	1881073864	1881073864	1	1	FOK, KIMBERLY DO	9/22/2020	207R00000X	NA	Other	026	PHYSICIANS	18115	41	Internal Medicine	0	In state provider	None	1020 29TH ST	STE 120	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
70542	Fee-for-Service	1518979996	1518979996	1	1	FRIEDMAN, ALAN	7/7/1980	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2109 MACARTHUR BLVD	None	OAKLAND	CA	94602	2228	01	06001	37.80053735	-122.2169097	Alameda County
70573	Fee-for-Service	1902317043	1902317043	1	1	FERGUSON, SARA M	4/2/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
70595	Fee-for-Service	1124106208	1124106208	1	1	FISCHER, ALLEN MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	49761	40	Pediatrics	0	In state provider	None	1950 FRANKLIN STREET	4TH FLOOR	OAKLAND	CA	94612	5190	01	06001	37.80791495	-122.2673747	Alameda County
70694	Fee-for-Service	1861451858	1861451858	1	8	FULLERTON RADIOLOGY MEDICAL	4/3/2023	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP, INC	1350 W COVINA BLVD	None	SAN DIMAS	CA	91773	3245	19	06037	34.09906108	-117.8343639	Los Angeles County
70707	Fee-for-Service	1598766743	1598766743	1	1	FREEDMAN, ANDREW R MD	1/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	89321	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1 MADRONE STREET	None	WILLITS	CA	95490	4425	23	06045	39.40088064	-123.3510718	Mendocino County
70708	Fee-for-Service	1881817971	1881817971	1	1	FRANCO, MICHELE A	3/29/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
70749	Fee-for-Service	1871671552	1871671552	1	1	FERRON, PAMALA A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32021	30	Radiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
70759	Fee-for-Service	1831460468	1831460468	1	1	FRAZIER, LINDA R PSYD	12/28/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41911 5TH ST	STE 103	TEMECULA	CA	92590	2730	33	06065	33.49563559	-117.1495713	Riverside County
70795	Fee-for-Service	1134271380	1134271380	1	2	FAWWAZ, AMIN R MD INC	8/12/2003	174400000X	NA	Other	026	PHYSICIANS	39280	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1110 W LA PALMA AVE	STE 7	ANAHEIM	CA	92801	2826	30	06059	33.84712953	-117.9320355	Orange County
70841	Fee-for-Service	1194907618	1194907618	1	1	FELCE, ROONGGAN K OD	4/11/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
70885	Fee-for-Service	1124106208	1124106208	1	1	FISCHER, ALLEN MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	49761	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1950 FRANKLIN STREET	4TH FLOOR	OAKLAND	CA	94612	5190	01	06001	37.80791495	-122.2673747	Alameda County
70906	Fee-for-Service	1043636293	1043636293	1	1	FREEDOM HOME HEALTH AND	10/21/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE SERVICES IN	519 D ST	SUITE B	MARYSVILLE	CA	95901	5525	58	06115	39.14100286	-121.5890324	Yuba County
70930	Fee-for-Service	1295418259	1295418259	1	1	FADY A YOUSSEF MD INC	8/25/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	None	None	0	In state provider	None	1050 LINDEN AVENUE, 2ND	None	LONG BEACH	CA	91006	6154	19	06037	33.78003775	-118.1866604	Los Angeles County
70944	Fee-for-Service	1245310929	1245310929	1	1	FANG, YUEMIAO CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	FANGS ACUPUNCTURE CLINIC	1091 INDUSTRIAL RD	STE 120	SAN CARLOS	CA	94070	4118	41	06081	37.50414091	-122.2487517	San Mateo County
70959	Fee-for-Service	1497971535	1497971535	1	1	FINTELMANN, ROBERT E MD	5/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107688	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
70991	Fee-for-Service	1417553389	1417553389	1	2	FREEDOM MEDICAL TRANSPORTATI	5/24/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON, INC	8977 FOOTHILL BLVD	UNIT D	RANCHO CUCAMONGA	CA	91730	3498	36	06071	34.10653001	-117.6091175	San Bernardino County
71005	Fee-for-Service	1609172436	1609172436	1	1	FLORES, MYRNA A	5/2/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 E GUASTI RD	STE 178B	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
71035	Fee-for-Service	1871671552	1871671552	1	1	FERRON, PAMALA A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32021	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
71036	Fee-for-Service	1285860130	1285860130	1	1	FRIENDS AND FAMILY HOME INC	5/31/2009	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	225 ALMADEN WAY	None	SAN MATEO	CA	94403	2926	41	06081	37.53954517	-122.2889433	San Mateo County
71057	Fee-for-Service	1689710105	1689710105	1	1	FARNSWORTH, ELISABETH	12/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
71138	Fee-for-Service	1891990560	1891990560	1	1	FRANCIS, KEN M LMFT	8/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
71164	Fee-for-Service	1124576822	1124576822	1	1	FURMAN, MARY	10/27/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
71190	Fee-for-Service	1700822244	1700822244	2	1	FIELD, JOSEPH S DO	2/13/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	7228	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
71196	Fee-for-Service	1043636293	1043636293	1	1	FREEDOM HOME HEALTH AND	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE SERVICES IN	519 D ST	SUITE B	MARYSVILLE	CA	95901	5525	58	06115	39.14100286	-121.5890324	Yuba County
71273	Fee-for-Service	1710965009	1710965009	1	1	FEDOR, MARK MD	7/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87864	14	Neurological Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
71274	Fee-for-Service	1679928394	1679928394	1	1	FONG, ANDREW T MD	8/26/2021	207ZP0102X	NA	Other	026	PHYSICIANS	149653	None	None	0	In state provider	None	5555 W LAS POSITAS BLVD	None	PLEASANTON	CA	94588	4000	01	06001	37.69212528	-121.8803442	Alameda County
71283	Fee-for-Service	1225560139	1225560139	1	1	FOX, JENNIFER NP	7/8/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3100 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70453535	-121.8586496	Alameda County
71322	Fee-for-Service	1003852351	1003852351	1	1	FITZGERALD, DAVID C MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	55079	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	# A200	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
71324	Fee-for-Service	1700984127	1700984127	1	1	FREDMAN, DANIEL J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2800 E AJO WAY	None	TUCSON	AZ	85713	6204	00	None	32.175801	-110.9306925	Pima County
71432	Fee-for-Service	1942320288	1942320288	1	1	FEHMI, SYED-MUHAMMAD A	7/1/2009	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	107838	10	Gastroenterology (M.D. only)	0	In state provider	MD	200 W ARBOR DRIVE	8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
71444	Fee-for-Service	1326614850	1326614850	1	1	FAITH W NDEGWA	9/16/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6525 COWBOY WAY	None	CITRUS HEIGHTS	CA	95621	3325	34	06067	38.689767	-121.312035	Sacramento County
71460	Fee-for-Service	1902821168	1902821168	1	1	FARID, FARID F MD	12/30/1998	207R00000X	NA	Other	026	PHYSICIANS	33167	08	Family Practice	0	In state provider	None	8420 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3201	19	06037	34.06472266	-118.3745094	Los Angeles County
71463	Fee-for-Service	1134201866	1134201866	1	1	FOOTHILL FAMILY PRACTICE	11/15/1985	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP	440 W FOOTHILL BLVD	None	GLENDORA	CA	91741	3361	19	06037	34.13599629	-117.8714999	Los Angeles County
71578	Fee-for-Service	1801356589	1801356589	1	1	FOK, MARY MD	4/25/2022	207R00000X	NA	Other	026	PHYSICIANS	177190	None	None	0	In state provider	None	2336 SANTA MONICA BLVD	301, 304	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
71579	Fee-for-Service	1053408542	1053408542	1	1	FANN, PATRICK C MD	11/30/1990	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	65619	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
71583	Fee-for-Service	1982800751	1982800751	1	1	FARHAT, MOUHAMED A MD	8/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97622	None	None	0	In state provider	None	3605 LONG BEACH BLVD	STE 405	LONG BEACH	CA	90807	4026	19	06037	33.822693	-118.1893765	Los Angeles County
71589	Fee-for-Service	1427184480	1427184480	1	1	FLORCZYK, DENA L MD	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112444	41	Internal Medicine	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
71611	Fee-for-Service	1134767437	1134767437	1	1	FILLIPON, MICHAEL LCSW	12/9/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
71620	Fee-for-Service	1497706113	1497706113	1	1	FOREMAN, TANYA J MD	4/30/2020	207NS0135X	NA	Dermatology	026	PHYSICIANS	60419	07	Dermatology	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
71649	Fee-for-Service	1295279289	1295279289	1	1	FLORENTINO, CHRISTOPHER G	12/22/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
71661	Fee-for-Service	1811921851	1811921851	1	1	FOR FEET SAKE PODIATRY GROUP	12/20/2018	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	, INC.	1521 BESSIE AVE	None	TRACY	CA	95376	3004	39	06077	37.74540705	-121.4331189	San Joaquin County
71714	Fee-for-Service	1952868119	1952868119	1	1	FRANQUI, MARITZA CNM	10/8/2024	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
71718	Fee-for-Service	1144720665	1144720665	1	1	FOOTSTEPS, A LICENSED CLINIC	1/22/2022	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICES	55 SHAW AVE	STE 115	CLOVIS	CA	93612	3819	10	06019	36.80859553	-119.708505	Fresno County
71733	Fee-for-Service	1326614850	1326614850	1	1	FAITH W NDEGWA	9/16/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6525 COWBOY WAY	None	CITRUS HEIGHTS	CA	95621	3325	34	06067	38.689767	-121.312035	Sacramento County
71734	Fee-for-Service	1881378974	1881378974	1	1	FRANCISCO, VANESSA OD	1/1/2025	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
71745	Fee-for-Service	1396050365	1396050365	1	1	FITZGIBBONS, MARIKO M MD	5/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118061	30	Radiology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
71747	Fee-for-Service	1902821168	1902821168	1	1	FARID, FARID F MD	12/30/1998	207R00000X	NA	Other	026	PHYSICIANS	33167	41	Internal Medicine	0	In state provider	None	8420 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3201	19	06037	34.06472266	-118.3745094	Los Angeles County
71877	Fee-for-Service	1427184480	1427184480	1	1	FLORCZYK, DENA L MD	5/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112444	40	Pediatrics	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
71889	Fee-for-Service	1245051218	1245051218	1	1	FRUIT OF THE WOMB	12/23/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
71895	Fee-for-Service	1942488267	1942488267	1	1	FOLGELSON, STEPHANIE K	9/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92164	07	Dermatology	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	2348	36	06071	34.12632952	-117.1956652	San Bernardino County
71908	Fee-for-Service	1821316555	1821316555	1	1	FLYNN, TORREY B. NP	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTIVEW BLVD	None	AURORA	CO	80042	1719	00	None	39.748041	-104.834673	Adams County
71919	Fee-for-Service	1548328636	1548328636	1	1	FLYNN, WILLIAM M MD	4/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	57010	02	General Surgery	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6002	19	06037	34.28200485	-118.4030797	Los Angeles County
71920	Fee-for-Service	1144683491	1144683491	1	1	FLORES-CUEVA, YOLANDA MD	12/11/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158296	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
71960	Fee-for-Service	1013088905	1013088905	1	1	FRANCIA, EDGARDO Y MD	12/10/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70414	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
72006	Fee-for-Service	1477564631	1477564631	1	1	FAYLONA, GOLLARD, KAUSHA	6/27/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	1	Border provider	CANCER AND BLOOD SPECIAL	58 N PECOS RD	None	HENDERSON	NV	89074	7319	00	None	36.03160397	-115.1002424	Clark County
72007	Fee-for-Service	1144720665	1144720665	1	1	FOOTSTEPS, A LICENSED CLINIC	1/22/2022	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICES	55 SHAW AVE	STE 115	CLOVIS	CA	93612	3819	10	06019	36.80859553	-119.708505	Fresno County
72040	Fee-for-Service	1619082328	1619082328	1	1	FOX, MATTHEW R LCSW	5/25/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
72053	Fee-for-Service	1154819209	1154819209	1	1	FARZANEH, ADAM MD	3/29/2022	207R00000X	NA	Other	026	PHYSICIANS	173690	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
72058	Fee-for-Service	1427113489	1427113489	1	1	FAIRFAX ELEMENTARY SD	10/16/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1500 S FAIRFAX RD	None	BAKERSFIELD	CA	93307	3151	15	06029	35.341254	-118.932066	Kern County
72128	Fee-for-Service	1982059135	1982059135	1	1	FINNEGAN, DANIELA LMFT	6/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
72145	Fee-for-Service	1518306257	1518306257	1	1	FISCHMAN, TIFFANY J MD	9/3/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	154009	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
72167	Fee-for-Service	1104923978	1104923978	1	1	FALKINSTEIN, YURI MD	3/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85756	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
72168	Fee-for-Service	1790326825	1790326825	1	1	FACULTY PHYSICIANS AND SURGE	11/15/2019	208800000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	11360 MT VIEW AVE	STE B	LOMA LINDA	CA	92354	3834	36	06071	34.04666844	-117.2436991	San Bernardino County
72243	Fee-for-Service	1184694598	1184694598	1	1	FLINN, SCOTT D MD	3/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68423	01	General Practice	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
72295	Fee-for-Service	1477564631	1477564631	1	1	FAYLONA, GOLLARD, KAUSHA	6/27/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	1	Border provider	CANCER AND BLOOD SPECIAL	58 N PECOS RD	None	HENDERSON	NV	89074	7319	00	None	36.03160397	-115.1002424	Clark County
72318	Fee-for-Service	1609812684	1609812684	1	1	FORSBERG, LARRY C CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	FORSBERG ACUPUNCTURE INC	337 W PORTAL AVE	None	SAN FRANCISCO	CA	94127	1411	38	06075	37.73743525	-122.4696205	San Francisco County
72342	Fee-for-Service	1518250521	1518250521	1	1	FLORES, AMY E MD	4/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145094	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
72366	Fee-for-Service	1689107435	1689107435	1	1	FITHIAN, ANDREW T MD	8/16/2022	390200000X	NA	Other	026	PHYSICIANS	158897	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
72383	Fee-for-Service	1992289243	1992289243	1	1	FOGARTY-HARRIS, DEIRDRE LMF	7/12/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
72387	Fee-for-Service	1114143385	1114143385	1	1	FERNANDEZ-ROCHA, MARISOL LC	3/6/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
72418	Fee-for-Service	1225535636	1225535636	1	1	FRELINGER, CATHERINE	8/19/2024	390200000X	NA	Other	026	PHYSICIANS	165215	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
72421	Fee-for-Service	1821525254	1821525254	1	1	FREED, MARY M CCC-SLP	6/19/2019	251E00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1857 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.2558809	-119.2202677	Ventura County
72659	Fee-for-Service	1851376511	1851376511	1	1	FUERST, DAVID J MD	9/25/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	47430	18	Ophthalmology	0	In state provider	None	607 N CENTRAL AVE	STE 105	GLENDALE	CA	91203	1804	19	06037	34.153974	-118.2579675	Los Angeles County
72850	Fee-for-Service	1770828196	1770828196	1	1	FRIEDMAN, CLAIRE K LMFT	10/17/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	50468	-	NOT APPLICABLE	0	In state provider	None	8030 SOQUEL AVE	SUITE 103	SANTA CRUZ	CA	95062	2096	44	06087	36.98236333	-121.9670379	Santa Cruz County
72851	Fee-for-Service	1609672435	1609672435	1	1	FONSECA, BRIAN PT	4/2/2025	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2335 VISTA WAY	None	OCEANSIDE	CA	92054	5663	37	06073	33.18316476	-117.3365251	San Diego County
72856	Fee-for-Service	1841450731	1841450731	1	1	FAVREAU, JESSICA B MD	2/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139150	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
72877	Fee-for-Service	1407909971	1407909971	1	1	FARHAT, MOHAMAD A MD	11/14/2016	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	87863	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
72882	Fee-for-Service	1578735163	1578735163	1	1	FORD, JOSEPH MD INC	7/1/1976	193400000X	NA	Other	026	PHYSICIANS	30251	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3475 TORRANCE BLVD	STE H	TORRANCE	CA	90503	5800	19	06037	33.83762089	-118.3467904	Los Angeles County
72917	Fee-for-Service	1083101893	1083101893	1	1	FLORES MONCKEBERG, CRISTINA	2/4/2025	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	A MD	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
72967	Fee-for-Service	1962897645	1962897645	1	1	FOOROHAR, AFSOON DO	2/6/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	46900 OCEAN DR	None	GUALALA	CA	95445	9999	23	06045	38.80460137	-123.5780677	Mendocino County
72978	Fee-for-Service	1902996747	1902996747	1	1	FRANKLIN, DAVID L PHD	11/8/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
73013	Fee-for-Service	1942397260	1942397260	1	1	FERRICK, DANIEL P MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	58549	08	Family Practice	0	In state provider	None	1234 EMPIRE ST	None	FAIRFIELD	CA	94533	5711	48	06095	38.25037548	-122.049045	Solano County
73163	Fee-for-Service	1487885372	1487885372	1	2	FOOTHILLS PAIN MANAGEMENT CL	6/25/2020	163WP0000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	INIC	236 W COLLEGE ST	None	COVINA	CA	91723	1902	19	06037	34.08746822	-117.8933488	Los Angeles County
73169	Fee-for-Service	1578735163	1578735163	1	1	FORD, JOSEPH MD INC	7/1/1976	193400000X	NA	Other	026	PHYSICIANS	30251	41	Internal Medicine	0	In state provider	None	3475 TORRANCE BLVD	STE H	TORRANCE	CA	90503	5800	19	06037	33.83762089	-118.3467904	Los Angeles County
73181	Fee-for-Service	1578637369	1578637369	1	1	FIRST CHCE MOBILE RADLGY	8/6/2007	No Taxonomy Provided	NA	None	028	PORTABLE X-RAY	-	-	NOT APPLICABLE	0	In state provider	None	4425 N SUNFLOWER AVE	None	COVINA	CA	91724	2328	19	06037	34.09372026	-117.8464311	Los Angeles County
73228	Fee-for-Service	1235215310	1235215310	1	1	FROCHTZWAJG, STANLEY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33339	08	Family Practice	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
73282	Fee-for-Service	1558305417	1558305417	1	1	FRIEDLANDER, STEVEN R MD	9/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48579	05	Anesthesiology	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
73376	Fee-for-Service	1902018294	1902018294	1	1	FERGUSON, JON E MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11757	13	Neurology (M.D. only)	0	In state provider	None	3011 CERES AVE	STE 100	CHICO	CA	95973	9803	04	06007	39.77592447	-121.8384651	Butte County
73400	Fee-for-Service	1164724563	1164724563	1	1	FAINMAN, DINA R MD	8/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117388	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25470 MEDICAL CENTER DR	STE 205	MURRIETA	CA	92562	4901	33	06065	33.55723646	-117.1859554	Riverside County
73451	Fee-for-Service	1487885372	1487885372	1	2	FOOTHILLS PAIN MANAGEMENT CL	7/5/2024	163WP0000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INIC	236 W COLLEGE ST	None	COVINA	CA	91723	1902	19	06037	34.08746822	-117.8933488	Los Angeles County
73515	Fee-for-Service	1235215310	1235215310	1	1	FROCHTZWAJG, STANLEY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33339	01	General Practice	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
73564	Fee-for-Service	1114157203	1114157203	1	1	FRUZZA, MATHEW L DO	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	10879	40	Pediatrics	0	In state provider	None	632 W GIBSON RD	None	WOODLAND	CA	95695	5143	57	06113	38.66314048	-121.794696	Yolo County
73584	Fee-for-Service	1619479284	1619479284	1	1	FERRER, MIRON N	9/19/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
73619	Fee-for-Service	1508627183	1508627183	1	1	FERNANDEZ-CARVAJAL, YAN NP	8/22/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11030 BOLLINGER CANYON R	SUITE 250	SAN RAMON	CA	94582	4874	07	06013	37.77383963	-121.9239786	Contra Costa County
73630	Fee-for-Service	1891280475	1891280475	1	1	FIDELIA HOME HEALTH SERVICES	11/21/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12509 OXNARD ST	SUITE 211	NORTH HOLLYWOOD	CA	91606	4440	19	06037	34.17943548	-118.405683	Los Angeles County
73697	Fee-for-Service	1851361000	1851361000	1	1	FAYNSOD, MOSHE MD INC	4/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	65167	None	None	0	In state provider	None	1360 W 6TH ST	STE 315	SAN PEDRO	CA	90732	3581	19	06037	33.73886546	-118.3075065	Los Angeles County
73707	Fee-for-Service	1134271380	1134271380	1	1	FAWWAZ, AMIN R MD INC	8/11/2003	174400000X	NA	Other	026	PHYSICIANS	39280	None	None	0	In state provider	None	3010 W ORANGE AVE	STE 408	ANAHEIM	CA	92804	3173	30	06059	33.82472315	-117.994133	Orange County
73723	Fee-for-Service	1104848274	1104848274	1	1	FOWLER, GLENN W MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	27260	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
73786	Fee-for-Service	1174907604	1174907604	1	1	FROUSIAKIS, STARLEEN E MD	8/26/2019	208M00000X	NA	Other	026	PHYSICIANS	148279	41	Internal Medicine	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
73821	Fee-for-Service	1952739237	1952739237	1	1	FRIEDMAN, KARRY S LMFT	7/6/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	83795	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
73828	Fee-for-Service	1861498271	1861498271	1	1	FAKIH, MARWAN G MD	11/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55385	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
73872	Fee-for-Service	1225426992	1225426992	1	1	FEENSTRA, LEANDRA M CRNA	3/6/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	2ND FLOOR	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
73906	Fee-for-Service	1598144685	1598144685	1	2	FORD, TENISHA LPCC	8/29/2024	106H00000X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
73954	Fee-for-Service	1306812250	1306812250	1	1	FEHR, GREGORY B MD	4/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
73995	Fee-for-Service	1548910334	1548910334	1	1	FERNBERG, TAYLOR MD	7/9/2024	390200000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
74014	Fee-for-Service	1104848274	1104848274	1	1	FOWLER, GLENN W MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	27260	13	Neurology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
74066	Fee-for-Service	1962643585	1962643585	1	1	FLORES, KATHIA R LMFT	2/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3500 W OLIVE AVE	#300	BURBANK	CA	91502	1442	19	06037	34.15273659	-118.3383429	Los Angeles County
74094	Fee-for-Service	1164149902	1164149902	1	1	FONVILLE, ADAM L CRNA	3/27/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
74128	Fee-for-Service	1437249380	1437249380	1	1	FIELD, MARSHALL L OD	1/31/1986	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	18429 SHERMAN WAY	None	RESEDA	CA	91335	4217	19	06037	34.20120553	-118.5349545	Los Angeles County
74247	Fee-for-Service	1467910380	1467910380	1	1	FRENCH, JILLIAN K PT	1/28/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
74248	Fee-for-Service	1336366806	1336366806	1	1	FRANKE, ETHAN I MD	4/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90973	14	Neurological Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
74301	Fee-for-Service	1164449955	1164449955	1	1	FLISZAR, EVELYNE A MD	7/31/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60712	30	Radiology	0	In state provider	None	330 LEWIS STREET	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
74378	Fee-for-Service	1932502820	1932502820	1	1	FLOOD, JENNIFER L LMFT	4/7/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	98661	-	NOT APPLICABLE	0	In state provider	None	401 S. STREET	None	SACRAMENTO	CA	95811	6919	34	06067	38.572677	-121.5050805	Sacramento County
74382	Fee-for-Service	1699950063	1699950063	1	1	FAGBULE, OLASUNKANMI MD	3/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100735	41	Internal Medicine	0	In state provider	None	48677 VICTORIA LN	None	OAKHURST	CA	93644	9216	20	06039	37.32772782	-119.6601883	Madera County
74400	Fee-for-Service	1023646650	1023646650	1	1	FRUIN, KAITLYN M MD	5/6/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	188059	41	Internal Medicine	0	In state provider	None	1304 15TH ST	102	SANTA MONICA	CA	90404	1809	19	06037	34.02600773	-118.486172	Los Angeles County
74446	Fee-for-Service	1437239530	1437239530	1	1	FATTOHI, FATIH A	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	41122	None	None	0	In state provider	None	9850 GENESEE AVE	STE 700	LA JOLLA	CA	92037	1218	37	06073	32.882913	-117.226341	San Diego County
74506	Fee-for-Service	1669509089	1669509089	1	1	FINCH, LISA MD	4/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115015	30	Radiology	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
74590	Fee-for-Service	1922401751	1922401751	1	1	FARAH, JENNIFER L MD	10/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132787	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
74621	Fee-for-Service	1558854570	1558854570	1	1	FAST AID HOME CARE INC	7/3/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14542 VENTURA BLVD	STE 210	SHERMAN OAKS	CA	91403	5512	19	06037	34.15111125	-118.4500521	Los Angeles County
74626	Fee-for-Service	1720003924	1720003924	1	1	FELD, GREGORY MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	37258	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
74667	Fee-for-Service	1922185859	1922185859	1	1	FISCH, BENJAMIN M MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68808	78	Neoplastic Diseases/Oncology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
74679	Fee-for-Service	1639131436	1639131436	1	1	FALCK MOBILE HEALTH CORP	6/17/1988	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1517 W BRADEN CT	None	ORANGE	CA	92868	1125	30	06059	33.79697148	-117.8686343	Orange County
74689	Fee-for-Service	1316094923	1316094923	1	1	FLEMING, KENDRA L MD	9/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94754	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
74737	Fee-for-Service	1275298887	1275298887	1	1	FARAH, CODY D PT	2/8/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2335 VISTA WAY	None	OCEANSIDE	CA	92054	5663	37	06073	33.18316476	-117.3365251	San Diego County
74739	Fee-for-Service	1093459984	1093459984	1	1	FERRER, DAVID CRNA	6/27/2022	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
74760	Fee-for-Service	1497961015	1497961015	1	1	FEIGIN, KATHRYN LCSW	12/17/2024	101YA0400X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
74770	Fee-for-Service	1609182021	1609182021	1	1	FERRARI, NICOLE M LMFT	4/25/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
74772	Fee-for-Service	1720697196	1720697196	1	1	FOUNTAIN HOSPICE INC	10/13/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	13523 VENTURA BLVD	None	SHERMAN OAKS	CA	91423	3801	19	06037	34.14748205	-118.4278548	Los Angeles County
74809	Fee-for-Service	1770361875	1770361875	1	1	FOREFRONT DERMATOLOGY - PACI	12/4/2023	207ND0101X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	AL GROUP, A FOREFRONT DE	1661 SOQUEL DR STE E	None	SANTA CRUZ	CA	95065	1709	44	06087	36.98906386	-121.981629	Santa Cruz County
74857	Fee-for-Service	1770559171	1770559171	1	1	FRONEK, JAN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42375	20	Orthopedic Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
74890	Fee-for-Service	1932267978	1932267978	1	1	FLORES, ADAM R	10/1/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
74893	Fee-for-Service	1922104751	1922104751	1	1	FONTANA ARTIFICIAL LIMB	7/1/1996	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	AND BRACE CO INC	8576 NUEVO AVE	None	FONTANA	CA	92335	3826	36	06071	34.0979973	-117.4370192	San Bernardino County
74955	Fee-for-Service	1922185859	1922185859	1	1	FISCH, BENJAMIN M MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68808	30	Radiology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
74998	Fee-for-Service	1386162949	1386162949	1	1	FACULTY PHYSICIANS AND SURGE	4/20/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	ONS OF LLUSM	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
75006	Fee-for-Service	1639498348	1639498348	1	1	FRY, KATHERINE J MD	5/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138735	40	Pediatrics	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
75060	Fee-for-Service	1720697196	1720697196	1	1	FOUNTAIN HOSPICE INC	10/13/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	13523 VENTURA BLVD	None	SHERMAN OAKS	CA	91423	3801	19	06037	34.14748205	-118.4278548	Los Angeles County
75091	Fee-for-Service	1548218936	1548218936	1	1	FUJIMOTO, PATRICK M MD	5/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87608	05	Anesthesiology	0	In state provider	None	CLAY & BUCHANNAN ST	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.791126	-122.4309105	San Francisco County
75151	Fee-for-Service	1396437042	1396437042	1	1	FUENTES, MELISSA S LCSW	11/30/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
75184	Fee-for-Service	1790896009	1790896009	1	1	FARLEY, BRETT C MD	10/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78902	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
75284	Fee-for-Service	1437757879	1437757879	1	1	FEDERAL HOME HEALTH AGENCY	8/3/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	18340 VENTURA BLVD	STE 206	TARZANA	CA	91356	4294	19	06037	34.16710415	-118.5320031	Los Angeles County
75285	Fee-for-Service	1881821791	1881821791	1	1	FREERKSEN, SUZANNA L MD	4/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132676	36	Psychiatry	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
75288	Fee-for-Service	1386162949	1386162949	1	1	FACULTY PHYSICIANS AND SURGE	4/20/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	ONS OF LLUSM	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
75289	Fee-for-Service	1598303182	1598303182	1	1	FRISCO, ASHLEY N NP	11/15/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6160 CORNERSTONE CT	100	SAN DIEGO	CA	92121	3720	37	06073	32.89631284	-117.1881857	San Diego County
75315	Fee-for-Service	1942259700	1942259700	1	1	FRIEDMAN, HOWARD MD	5/10/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	39819	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
75367	Fee-for-Service	1417115635	1417115635	1	1	FERNANDO, CHRISTALINE J MD	3/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110264	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
75380	Fee-for-Service	1649286519	1649286519	1	1	FELIX, JUAN C MD	2/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	73369	22	Pathology (M.D. only)	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
75469	Fee-for-Service	1659459451	1659459451	1	1	FREEDMAN, STEVEN M MD	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	50391	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
75489	Fee-for-Service	1811209679	1811209679	1	1	FARRELL, MARY C	12/16/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	780 SHADOWRIDGE DRIVE	None	VISTA	CA	92083	7986	37	06073	33.16632768	-117.2212175	San Diego County
75504	Fee-for-Service	1720519382	1720519382	1	1	FONG, CAROL OD	11/27/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	477 E COLORADO BLVD	None	PASADENA	CA	91107	2024	19	06037	34.14587948	-118.140561	Los Angeles County
75566	Fee-for-Service	1255861852	1255861852	1	1	FAROOK, NAUREEN MD	8/15/2023	207R00000X	NA	Other	026	PHYSICIANS	187842	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
75574	Fee-for-Service	1386162949	1386162949	1	1	FACULTY PHYSICIANS AND SURGE	7/23/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
75595	Fee-for-Service	1831429513	1831429513	1	1	FERNANDO, DAYANTHA M MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112515	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
75650	Fee-for-Service	1245339159	1245339159	1	1	FARAGALLAH, SAMIR B DC	8/12/2020	111NS0005X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3505 CAMINO DEL RIO S.	120	SAN DIEGO	CA	92108	4002	37	06073	32.77756386	-117.1185135	San Diego County
75661	Fee-for-Service	1396056305	1396056305	1	1	FARAG, MIKE J DO	1/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	11157	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
75671	Fee-for-Service	1811993298	1811993298	1	1	FUNK, CATRINA M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1717 S J ST	None	TACOMA	WA	98405	4933	00	None	47.24538397	-122.4487283	Pierce County
75756	Fee-for-Service	1477647212	1477647212	1	1	FRIEDMAN, GEORGE Z JR MD	2/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	41990	08	Family Practice	0	In state provider	None	1100 TRANCAS ST	SUITE 350	NAPA	CA	94558	2959	28	06055	38.32316569	-122.2981938	Napa County
75838	Fee-for-Service	1801842232	1801842232	1	1	FRITZ, RONALD M. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 KOOTENAI HEALTH WAY	None	COEUR D ALENE	ID	83814	6051	00	None	47.695635	-116.792906	Kootenai County
75864	Fee-for-Service	1740335025	1740335025	1	1	FIORENTINO, DAVID F MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69579	07	Dermatology	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
75865	Fee-for-Service	1386162949	1386162949	1	1	FACULTY PHYSICIANS AND SURGE	1/23/2020	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
75895	Fee-for-Service	1720094147	1720094147	1	1	FLECK, ROBERT J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 BURNET AVE	None	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
75913	Fee-for-Service	1770953937	1770953937	1	1	FIFER, NATALIE D LMFT	8/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	224 W GRAHAM AVE	None	LAKE ELSINORE	CA	92530	3740	33	06065	33.66853666	-117.3296688	Riverside County
76039	Fee-for-Service	1609011212	1609011212	1	1	FAUCETT, JILLIAN E LMFT	7/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
76094	Fee-for-Service	1487008421	1487008421	1	1	FORD STREET PROJECT	9/27/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	139 FORD ST	None	UKIAH	CA	95482	4011	23	06045	39.15678542	-123.2059231	Mendocino County
76111	Fee-for-Service	1891299657	1891299657	1	1	FAUST, ADRIENE P LCSW	6/12/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	16527	-	NOT APPLICABLE	0	In state provider	None	1023-1031 PICO BLVD	None	SANTA MONICA	CA	90405	1415	19	06037	34.01396222	-118.4798724	Los Angeles County
76116	Fee-for-Service	1730337775	1730337775	1	1	FONTES, VANESSA C PSYD	7/17/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
76151	Fee-for-Service	1386162949	1386162949	1	1	FACULTY PHYSICIANS AND SURGE	4/20/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ONS OF LLUSM	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
76206	Fee-for-Service	1881289189	1881289189	1	1	FORD, BETTYE PHD	9/30/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	107 W FAIRVIEW BLVD	None	INGLEWOOD	CA	90302	1202	19	06037	33.97924422	-118.3583448	Los Angeles County
76237	Fee-for-Service	1477534832	1477534832	1	1	FURST, EWARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3705 MEDICAL PKWY	STE 570	AUSTIN	TX	78705	1024	00	None	30.30500791	-97.74430984	Travis County
76296	Fee-for-Service	1083605042	1083605042	1	1	FRIEDMAN, MICHAEL R MD	9/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92327	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
76307	Fee-for-Service	1982704813	1982704813	1	1	FOX, JOHN W MD AND	4/20/1987	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOX, CARLA MD INC	501 WASHINGTON ST	STE 508	SAN DIEGO	CA	92103	2231	37	06073	32.74986289	-117.1599343	San Diego County
76441	Fee-for-Service	1386162949	1386162949	1	1	FACULTY PHYSICIANS AND SURGE	10/9/2019	193200000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
76514	Fee-for-Service	1679539415	1679539415	1	1	FAHLEN, MARK T	9/9/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81212	45	Nephrology (Renal-Kidney)	0	In state provider	None	305 E GRANGER AVE	STE 202	MODESTO	CA	95350	4344	50	06099	37.66729751	-120.9891555	Stanislaus County
76574	Fee-for-Service	1639467137	1639467137	1	1	FERGUSON, ERIN	4/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
76589	Fee-for-Service	1275721896	1275721896	1	1	FLAIR PARK MEDICAL CLINI	6/20/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1730 S SAN GABRIEL BLVD	None	SAN GABRIEL	CA	91776	3928	19	06037	34.077654	-118.0907045	Los Angeles County
76595	Fee-for-Service	1023087277	1023087277	1	1	FIELDS, JAMES T MD	1/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142682	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
76657	Fee-for-Service	1427012228	1427012228	1	1	FAKHRAI, MEHDI MD	8/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	39658	33	Thoracic Surgery	0	In state provider	None	10605 BALBOA BLVD	SUITE 225	GRANADA HILLS	CA	91344	6376	19	06037	34.263378	-118.5022965	Los Angeles County
76681	Fee-for-Service	1144752825	1144752825	1	1	FLORES, BRIAN	5/1/2017	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
76689	Fee-for-Service	1629423264	1629423264	1	1	FARIAS, MELISA L DO	11/18/2019	207R00000X	NA	Other	026	PHYSICIANS	17119	41	Internal Medicine	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
76692	Fee-for-Service	1932160587	1932160587	1	1	FRASER, THOMAS B MD	6/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
76873	Fee-for-Service	1558763250	1558763250	1	1	FANG, STACY MD	9/17/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	140045	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3838 CALIFORNIA ST .	SUITE 805	SAN FRANCISCO	CA	94118	1510	38	06075	37.78591809	-122.4575439	San Francisco County
76875	Fee-for-Service	1265945885	1265945885	1	1	FIRST CARE INC	11/19/2018	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2441 W ORANGETHORPE AVE	None	FULLERTON	CA	92833	4201	30	06059	33.85916571	-117.9710549	Orange County
76877	Fee-for-Service	1275721896	1275721896	1	1	FLAIR PARK MEDICAL CLINI	6/20/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1730 S SAN GABRIEL BLVD	None	SAN GABRIEL	CA	91776	3928	19	06037	34.077654	-118.0907045	Los Angeles County
76887	Fee-for-Service	1366593733	1366593733	1	1	FRONT, ADAM L PHD	11/22/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
76947	Fee-for-Service	1427012228	1427012228	1	1	FAKHRAI, MEHDI MD	8/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	39658	02	General Surgery	0	In state provider	None	10605 BALBOA BLVD	SUITE 225	GRANADA HILLS	CA	91344	6376	19	06037	34.263378	-118.5022965	Los Angeles County
77108	Fee-for-Service	1932224953	1932224953	1	1	FONSECA, MANUEL LMFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
77167	Fee-for-Service	1275721896	1275721896	1	1	FLAIR PARK MEDICAL CLINI	6/20/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	1730 S SAN GABRIEL BLVD	None	SAN GABRIEL	CA	91776	3928	19	06037	34.077654	-118.0907045	Los Angeles County
77185	Fee-for-Service	1639661408	1639661408	1	1	FAST RECOVERY HOME HEALTH	4/17/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE	4221 WILSHIRE BLVD	SUITE 170-8	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
77216	Fee-for-Service	1417901406	1417901406	1	1	FAWCETT MEMORIAL HOSPITAL, I	11/1/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	21298 OLEAN BLVD	None	PORT CHARLOTTE	FL	33952	6705	00	None	26.98786646	-82.0981751	Charlotte County
77233	Fee-for-Service	1427012228	1427012228	1	1	FAKHRAI, MEHDI MD	8/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	39658	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	10605 BALBOA BLVD	SUITE 225	GRANADA HILLS	CA	91344	6376	19	06037	34.263378	-118.5022965	Los Angeles County
77281	Fee-for-Service	1255710687	1255710687	1	1	FULLER, RYAN M MD	7/1/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	146731	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
77380	Fee-for-Service	1447406699	1447406699	1	1	FRANCISCAN HEALTH SYSTEMS	3/18/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	11567 CANTERWOOD BLVD	None	GIG HARBOR	WA	98332	5812	00	None	47.364275	-122.6148067	Pierce County
77469	Fee-for-Service	1124118724	1124118724	1	1	FOSNOCHT, DAVID E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N. MEDICAL DRIVE	None	SALT LAKE CITY	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
77492	Fee-for-Service	1598754939	1598754939	1	1	FISHER, BENA MD	8/31/1986	2084N0400X	NA	Neurology	026	PHYSICIANS	50532	13	Neurology (M.D. only)	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
77502	Fee-for-Service	1417901406	1417901406	1	1	FAWCETT MEMORIAL HOSPITAL, I	11/1/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	21298 OLEAN BLVD	None	PORT CHARLOTTE	FL	33952	6705	00	None	26.98786646	-82.0981751	Charlotte County
77589	Fee-for-Service	1457311797	1457311797	1	1	FRANKEL, HEIDI L MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89180	89	Surgery-Traumatic	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
77669	Fee-for-Service	1447406699	1447406699	1	1	FRANCISCAN HEALTH SYSTEMS	3/18/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	11567 CANTERWOOD BLVD	None	GIG HARBOR	WA	98332	5812	00	None	47.364275	-122.6148067	Pierce County
77695	Fee-for-Service	1619049509	1619049509	1	1	FEIL, FRED OD	9/14/1990	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	262 MAIN ST #1	PO BOX 1880	None	CHESTER	CA	96020	1880	32	06063	0	0	None
77868	Fee-for-Service	1093924714	1093924714	1	1	FLETCHER, SOPHIE A MD	11/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56168	34	Urology and Urological Surgery	0	In state provider	None	34 MARK WEST SPRINGS RD	2ND FLOOR	SANTA ROSA	CA	95403	1436	49	06097	38.49639719	-122.7501553	Sonoma County
77874	Fee-for-Service	1790719847	1790719847	1	1	FITZGERALD, LINDA M	4/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24258 EL TORO RD	None	LAGUNA WOODS	CA	92637	3488	30	06059	33.61088364	-117.7236433	Orange County
77875	Fee-for-Service	1912953936	1912953936	1	11	FAIRBANKS & POWER PHYSICAL T	9/4/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	& SPORTS MEDICINE	27701 SCOTT RD BUILDING	108	MENIFEE	CA	92584	9417	33	06065	33.64152653	-117.174582	Riverside County
77876	Fee-for-Service	1457311797	1457311797	1	1	FRANKEL, HEIDI L MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89180	02	General Surgery	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
77895	Fee-for-Service	1467453837	1467453837	1	1	FRISHMAN, JORDAN I. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1300 E CENTRAL RD	None	ARLINGTON HTS	IL	60005	2857	00	None	42.06647051	-87.966846	Cook County
77898	Fee-for-Service	1366600082	1366600082	1	1	FRED P GUARCELLO & PETER	12/23/2008	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	S KLEM PTR	1101 STANDIFORD AVE	STE A-2	MODESTO	CA	95350	0981	50	06099	37.68934851	-121.009653	Stanislaus County
77934	Fee-for-Service	1316022080	1316022080	1	1	FERNANDEZ-MELONE, JOHN H	5/1/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	63887	02	General Surgery	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
77982	Fee-for-Service	1891840591	1891840591	1	1	F W CARTER & ERIC I	7/21/2014	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	RICHMAN PTR OPTOMTRY	293 WILLOW STREET	None	BISHOP	CA	93514	2720	14	06027	37.36287548	-118.3915755	Inyo County
78005	Fee-for-Service	1841389814	1841389814	1	1	FAHIM, ASHRAF G	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69708	None	None	0	In state provider	None	31762 MISSION TRL	None	LAKE ELSINORE	CA	92530	4545	33	06065	33.65782233	-117.2986219	Riverside County
78020	Fee-for-Service	1619974409	1619974409	1	1	FREITAG, MARK C.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45860	08	Family Practice	0	In state provider	None	68555 RAMON RD	STE D103	CATHEDRAL CITY	CA	92234	3310	33	06065	33.8158285	-116.4648113	Riverside County
78022	Fee-for-Service	1053199067	1053199067	1	1	FAJARDO, JENNIFER RUEZO	2/16/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1091 AMBER RIDGE LN	None	VACAVILLE	CA	95687	5828	28	06055	38.34592711	-121.9607206	Solano County
78153	Fee-for-Service	1770938904	1770938904	1	1	FINE, LIAT MD	9/9/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	155756	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
78163	Fee-for-Service	1568790137	1568790137	1	1	FLORES, ADRIAN H MD	12/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115311	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
78172	Fee-for-Service	1356538920	1356538920	1	1	FISTNER, SHANNON R LMFT	2/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
78311	Fee-for-Service	1053199067	1053199067	1	1	FAJARDO, JENNIFER RUEZO	2/16/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1091 AMBER RIDGE LN	None	VACAVILLE	CA	95687	5828	28	06055	38.34592711	-121.9607206	Solano County
78391	Fee-for-Service	1104952902	1104952902	1	1	FLETCHER, LETTERIA	5/20/2024	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	380 W MACARTHUR BLVD	None	OAKLAND	CA	94609	2819	01	06001	37.82519027	-122.2609525	Alameda County
78393	Fee-for-Service	1447405170	1447405170	1	1	FRESENIUS MED CARE	12/1/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIABLO NEPHROLOGY CLINIC	1800 N PARK BLVD	None	PITTSBURG	CA	94565	4152	07	06013	38.01131923	-121.8632615	Contra Costa County
78397	Fee-for-Service	1104879899	1104879899	2	1	FOGARTY, SHANA D MD	4/7/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	184460	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
78438	Fee-for-Service	1740818772	1740818772	1	1	FLANAGAN, COLLEEN MD	10/3/2023	208600000X	NA	General Surgery	026	PHYSICIANS	178384	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
78475	Fee-for-Service	1861451858	1861451858	1	7	FULLERTON RADIOLOGY MEDICAL	1/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP, INC	5000 SAN BERNARDINO ST.	None	MONTCLAIR	CA	91763	5000	36	06071	34.07768647	-117.6957498	San Bernardino County
78531	Fee-for-Service	1629426630	1629426630	1	1	FUJIMURA, KEN MD	5/14/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	154050	None	None	0	In state provider	None	630 S RAYMOND AVE	STE 310	PASADENA	CA	91105	3278	19	06037	34.13505223	-118.1487761	Los Angeles County
78628	Fee-for-Service	1043381965	1043381965	1	1	FEROZUDDIN, MOHAMMED MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70844	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
78651	Fee-for-Service	1831687581	1831687581	1	1	FEKRI, MEISAM MD	5/16/2022	207R00000X	NA	Other	026	PHYSICIANS	174199	None	None	0	In state provider	None	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
78677	Fee-for-Service	1801405014	1801405014	1	1	FIND YOUR BALANCE, CENTER FO	7/2/2021	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	R GROWTH & CHANGE INC.	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
78934	Fee-for-Service	1841443868	1841443868	1	1	FAN, STEPHANIE W CRNA	6/26/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
78964	Fee-for-Service	1801405014	1801405014	1	1	FIND YOUR BALANCE, CENTER FO	7/2/2021	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	R GROWTH & CHANGE INC.	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
79041	Fee-for-Service	1730270331	1730270331	1	1	FEFFER, MYRA L MD	2/8/2015	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	12306	10	Gastroenterology (M.D. only)	0	In state provider	None	6363 WILSHIRE BLVD	STE 516	LOS ANGELES	CA	90048	5700	19	06037	34.06367823	-118.3675294	Los Angeles County
79042	Fee-for-Service	1477625200	1477625200	1	1	FINN, ROBERT MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	50387	04	Otology, Laryngology, Rhinology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
79112	Fee-for-Service	1356406789	1356406789	1	1	FATMI, MOUNIR E MD	11/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99792	41	Internal Medicine	0	In state provider	None	1600 NORTH ROSE AVENUE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
79128	Fee-for-Service	1467661496	1467661496	1	1	FANTA, PAUL MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81637	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
79222	Fee-for-Service	1497986228	1497986228	1	1	FACULTY MEDICAL GROUP OF LLU	11/5/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	11370 ANDERSON ST	STE 1700	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
79253	Fee-for-Service	1801405014	1801405014	1	1	FIND YOUR BALANCE, CENTER FO	6/12/2023	106H00000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	R GROWTH & CHANGE INC.	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
79300	Fee-for-Service	1013241637	1013241637	1	1	FOLK, DARREN T LCSW	11/17/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
79310	Fee-for-Service	1962935973	1962935973	1	1	FREEDMAN, MICHAEL MD	2/14/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169425	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
79330	Fee-for-Service	1730270331	1730270331	1	1	FEFFER, MYRA L MD	2/8/2015	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	12306	41	Internal Medicine	0	In state provider	None	6363 WILSHIRE BLVD	STE 516	LOS ANGELES	CA	90048	5700	19	06037	34.06367823	-118.3675294	Los Angeles County
79341	Fee-for-Service	1821249871	1821249871	1	1	FRAGUELA, MIGUEL PSYD	9/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8247 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	34	06067	38.459187	-121.4080245	Sacramento County
79348	Fee-for-Service	1588982508	1588982508	1	1	FERKEL, ERIC I MD	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	112036	20	Orthopedic Surgery	0	In state provider	None	6815 NOBLE AVE	None	VAN NUYS	CA	91405	3730	19	06037	34.19440435	-118.461871	Los Angeles County
79359	Fee-for-Service	1922406776	1922406776	1	1	FLORES, ALEXANDRA E LMFT	9/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24325 MAIN ST	STE 102	NEWHALL	CA	91321	2932	19	06037	34.37920492	-118.5283244	Los Angeles County
79412	Fee-for-Service	1467661496	1467661496	1	1	FANTA, PAUL MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81637	68	Hematology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
79414	Fee-for-Service	1518964998	1518964998	1	1	FREDRICK, MARK J MD	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67380	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
79478	Fee-for-Service	1346272812	1346272812	1	1	FORSYTHE, KEVIN C MD	11/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96098	20	Orthopedic Surgery	0	In state provider	None	1901 N CALIFORNIA ST	None	STOCKTON	CA	95204	6005	39	06077	37.97165921	-121.2895813	San Joaquin County
79540	Fee-for-Service	1801405014	1801405014	1	1	FIND YOUR BALANCE, CENTER FO	10/26/2022	106H00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	R GROWTH & CHANGE INC.	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
79597	Fee-for-Service	1538267752	1538267752	1	1	FLOOD, GEORGE K MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	49407	36	Psychiatry	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
79603	Fee-for-Service	1518378546	1518378546	1	1	FONG BALART, JOSUE MD	5/11/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	145030	None	None	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
79703	Fee-for-Service	1518964998	1518964998	1	1	FREDRICK, MARK J MD	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67380	41	Internal Medicine	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
79713	Fee-for-Service	1457368649	1457368649	1	1	FEILER, LEWIS S MD	5/31/1979	174400000X	NA	Other	026	PHYSICIANS	32622	18	Ophthalmology	0	In state provider	None	162 CLINTON ST	None	REDWOOD CITY	CA	94062	1552	41	06081	37.48582242	-122.2390745	San Mateo County
79714	Fee-for-Service	1568457703	1568457703	1	1	FRANCO, RICARDA D MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81673	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
79717	Fee-for-Service	1538900154	1538900154	1	1	FARRIS, AMANDA R	7/17/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
79728	Fee-for-Service	1689891301	1689891301	1	1	FELICES DIAS ADULT DAY	2/4/2009	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	2309 S FLOWER ST	None	LOS ANGELES	CA	90007	2619	19	06037	34.02988251	-118.2732025	Los Angeles County
79768	Fee-for-Service	1588695472	1588695472	1	1	FRASSETTO, LYNDA A MD	9/30/1987	207RN0300X	NA	Nephrology	026	PHYSICIANS	61802	41	Internal Medicine	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
79806	Fee-for-Service	1629244371	1629244371	1	1	FERNANDEZ, HANNIA LMFT	5/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
79894	Fee-for-Service	1962867663	1962867663	1	1	FRESENIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY LLC	1401 S BROOKHURST RD	SUITE 108 & 109	FULLERTON	CA	92833	4492	30	06059	33.85761255	-117.9593114	Orange County
79901	Fee-for-Service	1427434174	1427434174	1	1	FAIRBAIRN, KELLY M DO	10/18/2023	390200000X	NA	Other	026	PHYSICIANS	15189	None	None	0	In state provider	None	101 CITY DR S	# B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
79932	Fee-for-Service	1518466952	1518466952	1	1	FUJIWARA, AMY M PT	5/26/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
79984	Fee-for-Service	1851476477	1851476477	1	1	FEDERIO, PHILIP J MD	2/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	52405	41	Internal Medicine	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
80004	Fee-for-Service	1265638399	1265638399	1	1	FALK, KRISTA L LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
80110	Fee-for-Service	1336569862	1336569862	1	1	FEIZABADI, NARGES NP	8/28/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3460 E LA PALMA AVENUE	None	ANAHEIM	CA	92806	2020	30	06059	33.85429451	-117.8446551	Orange County
80137	Fee-for-Service	1639536576	1639536576	1	1	FONTANA, APRIL CCC-SLP	5/17/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
80163	Fee-for-Service	1932274057	1932274057	1	1	FRANCIS, CHERISE M NP	7/1/2010	193400000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3415 WEST BALL ROAD	None	ANAHEIM	CA	92804	3708	30	06059	33.81728546	-118.0089495	Orange County
80196	Fee-for-Service	1831327030	1831327030	1	1	FLORES LAZCANO, NALLELY MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119063	None	None	0	In state provider	None	790 E BONITA AVE	2ND FLOOR	POMONA	CA	91767	1906	19	06037	34.09621447	-117.737406	Los Angeles County
80231	Fee-for-Service	1861491516	1861491516	1	1	FRIEND, CHRISTOPHER J MD	1/18/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	141231	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
80240	Fee-for-Service	1831927441	1831927441	1	1	FREDRICKSON, SABRINA M AU	7/31/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1135 E ROUTE 66	STE 111	GLENDORA	CA	91740	3778	19	06037	34.12888853	-117.845127	Los Angeles County
80272	Fee-for-Service	1851476477	1851476477	1	1	FEDERIO, PHILIP J MD	2/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	52405	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
80274	Fee-for-Service	1164685632	1164685632	1	1	FAN, MARK S MD	9/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	112478	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
80275	Fee-for-Service	1023536000	1023536000	1	1	FIGUEROA, MARIA LCSW	1/20/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10642 SANTA MONICA BLVD	209	LOS ANGELES	CA	90025	4525	19	06037	34.05272707	-118.4306058	Los Angeles County
80287	Fee-for-Service	1780888784	1780888784	1	1	FRENCH, MEGAN E CNP	6/24/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
80398	Fee-for-Service	1679550149	1679550149	2	1	FREMONT EMERGENCY SERVICES	2/24/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	MANDAVIA LTD	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
80477	Fee-for-Service	1073868006	1073868006	1	1	FLORES, JORGE MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140780	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
80479	Fee-for-Service	1356408314	1356408314	1	1	FAMILY HOMES, INC	3/17/2004	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	830 NEWMAN DR	None	S SAN FRANCISCO	CA	94080	2123	41	06081	37.6606805	-122.4556153	San Mateo County
80527	Fee-for-Service	1801033634	1801033634	1	1	FEDARAU, MAKSIM	5/11/2020	207L00000X	NA	Other	026	PHYSICIANS	138002	05	Anesthesiology	0	In state provider	None	975 SOUTH FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
80561	Fee-for-Service	1851476477	1851476477	1	1	FEDERIO, PHILIP J MD	2/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	52405	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
80574	Fee-for-Service	1982807657	1982807657	1	2	FAR, HAMID K MD	1/23/2009	207R00000X	NA	Other	026	PHYSICIANS	102393	41	Internal Medicine	0	In state provider	None	3610 ATLANTIC AVE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
80597	Fee-for-Service	1104247402	1104247402	1	1	FENNELL, LILLIE RUTH	1/10/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1554 N IDYLLWILD AVE	None	RIALTO	CA	92376	3159	36	06071	34.127748	-117.3859565	San Bernardino County
80609	Fee-for-Service	1063421311	1063421311	1	1	FAN, GARY G MD	7/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87120	05	Anesthesiology	0	In state provider	None	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
80696	Fee-for-Service	1770584534	1770584534	1	1	FLANIGAN, DANIEL P MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63532	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1310 W STEWART DR	STE 407	ORANGE	CA	92868	3855	30	06059	33.78236048	-117.8664975	Orange County
80786	Fee-for-Service	1518143205	1518143205	1	1	FLAGSTAFF MEDICAL CENTER	11/1/1995	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
80808	Fee-for-Service	1639409006	1639409006	1	1	FORSTER, BRYNNEN N MD	1/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	107198	40	Pediatrics	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
80816	Fee-for-Service	1861795965	1861795965	1	1	FITZGIBBONS, TJ MD INC	9/23/2013	193400000X	NA	Other	026	PHYSICIANS	32025	None	None	0	In state provider	None	1245 WILSHIRE BLVD	SUITE 905	LOS ANGELES	CA	90017	4809	19	06037	34.05362775	-118.2661889	Los Angeles County
80849	Fee-for-Service	1861693749	1861693749	1	1	FOLAND, JENNIFER A CRNA	9/15/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
80863	Fee-for-Service	1891113296	1891113296	1	1	FORMAN, ARIEL M PT	3/23/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7090 MIRATECH DR	None	SAN DIEGO	CA	92121	3109	37	06073	32.89821825	-117.1711874	San Diego County
80868	Fee-for-Service	1194717066	1194717066	1	1	FADDOUL, ABDO J MD	2/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	41062	34	Urology and Urological Surgery	0	In state provider	None	2 MEDICAL PLAZA DR	STE 125	ROSEVILLE	CA	95661	3038	31	06061	38.76507948	-121.2477476	Placer County
80879	Fee-for-Service	1043275183	1043275183	1	1	FOREST AMBULATORY SURGICAL A	1/25/2022	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2110 FOREST AVE	STE F	SAN JOSE	CA	95128	1469	43	06085	37.32701954	-121.9374675	Santa Clara County
80887	Fee-for-Service	1104247402	1104247402	1	1	FENNELL, LILLIE RUTH	1/10/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1554 N IDYLLWILD AVE	None	RIALTO	CA	92376	3159	36	06071	34.127748	-117.3859565	San Bernardino County
80901	Fee-for-Service	1871973677	1871973677	1	1	FERGUSON, BENJAMIN G DO	11/14/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	17132	None	None	0	In state provider	None	TWO MEDICAL PLAZA	STE 200	ROSEVILLE	CA	95661	3042	31	06061	38.76507948	-121.2477476	Placer County
80986	Fee-for-Service	1770584534	1770584534	1	1	FLANIGAN, DANIEL P MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63532	02	General Surgery	0	In state provider	None	1310 W STEWART DR	STE 407	ORANGE	CA	92868	3855	30	06059	33.78236048	-117.8664975	Orange County
81070	Fee-for-Service	1326185554	1326185554	1	1	FLORES, BETTY M NP	5/28/2019	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
81128	Fee-for-Service	1841347002	1841347002	1	1	FUTA, KRISTINE T PHD	11/18/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
81153	Fee-for-Service	1649746272	1649746272	1	1	FARD, YASHAR Y MD	4/16/2025	2084P0804X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
81163	Fee-for-Service	1659757474	1659757474	1	1	FENG, YONGQING MD PC	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	100454	41	Internal Medicine	0	In state provider	None	18391 COLIMA RD	STE 208	ROWLAND HEIGHTS	CA	91748	2730	19	06037	33.98844297	-117.9041666	Los Angeles County
81172	Fee-for-Service	1043405822	1043405822	1	1	FELIX, THERESA M LMFT	8/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
81242	Fee-for-Service	1376568808	1376568808	1	1	FORDHAM, KIMBERLY J MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78858	08	Family Practice	0	In state provider	None	1400 S GRAND AVE	STE 101	LOS ANGELES	CA	90015	3048	19	06037	34.03692236	-118.2655238	Los Angeles County
81265	Fee-for-Service	1003347972	1003347972	1	1	FOUGHTY, ZACHARY C MD	12/4/2024	2080P0204X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
81296	Fee-for-Service	1982793907	1982793907	1	1	FU, CECILIA H MD	7/3/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	79138	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
81346	Fee-for-Service	1689451981	1689451981	1	1	FOR YOUR GLORY LLC	9/20/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
81347	Fee-for-Service	1790721850	1790721850	1	1	FEDONENKO, ELEONORA MD	9/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	65259	41	Internal Medicine	0	In state provider	None	6221 WILSHIRE BLVD	STE 312	LOS ANGELES	CA	90048	5225	19	06037	34.06329534	-118.3640031	Los Angeles County
81435	Fee-for-Service	1104966787	1104966787	1	1	FRANTZ, KIMBERLI R MD	8/31/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	69966	40	Pediatrics	0	In state provider	None	2450 ST MARY COLUMBA DR	None	RED BLUFF	CA	96080	0000	52	06103	40.14921426	-122.2216794	Tehama County
81447	Fee-for-Service	1407382815	1407382815	1	1	FARAHMAND, SHIDEH NP	6/25/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
81521	Fee-for-Service	1851647168	1851647168	1	1	FOWLER, KYMRY H CCC-SLP	6/10/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2700 EAST FOOTHILL BLVD.	SUITE #100	PASADENA	CA	91107	0000	19	06037	34.14985464	-118.0947535	Los Angeles County
81551	Fee-for-Service	1003347972	1003347972	1	1	FOUGHTY, ZACHARY C MD	12/4/2024	2080P0204X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
81628	Fee-for-Service	1770613853	1770613853	1	1	FICKAS, TESS	2/8/2015	231HA2400X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	326 WEST 3RD AVENUE	None	ESCONDIDO	CA	92025	4111	37	06073	33.11827719	-117.0835621	San Diego County
81691	Fee-for-Service	1265582076	1265582076	1	1	FAIRBORN, JAY F MD	7/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	67589	08	Family Practice	0	In state provider	None	1033 THIRD STREET	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
81699	Fee-for-Service	1548532948	1548532948	1	1	FAULKENDER, SAMANTHA	8/20/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1648 DRUMMOND LN	None	LINCOLN	CA	95648	2935	31	06061	38.87900946	-121.312215	Placer County
81769	Fee-for-Service	1376570341	1376570341	1	1	FIERO, THOMAS P MD	4/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54391	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
81813	Fee-for-Service	1386866838	1386866838	1	1	FRENCH, BROOKE M MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
81838	Fee-for-Service	1841215027	1841215027	1	1	FITZGERALD, JOHN D MD	11/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	80802	None	None	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
81868	Fee-for-Service	1881818755	1881818755	1	1	FINE, STACEY S MD	11/29/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	75365	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
81890	Fee-for-Service	1790724383	1790724383	1	1	FELD, LAWRENCE H MD	5/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	45437	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
81893	Fee-for-Service	1952382756	1952382756	1	1	FERZANDI, TANAZ R MD	1/28/2020	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166730	09	Gynecology (D.O. only)	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
81909	Fee-for-Service	1811037013	1811037013	1	1	FRIED, ANGELA	12/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56210	None	None	0	In state provider	None	455 HICKEY BLVD	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
81936	Fee-for-Service	1457501629	1457501629	1	1	FOWLER, LISA K PHD	10/7/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5655 COLLEGE AVENUE	STE 315B	OAKLAND	CA	94618	1583	01	06001	37.84469363	-122.2518144	Alameda County
81943	Fee-for-Service	1316135569	1316135569	2	2	FIDELIS HEALTH GROUP LLC	12/3/2018	3336S0011X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1002 S BALDWIN AVE.	None	ARCADIA	CA	91007	7234	19	06037	34.12881621	-118.0546004	Los Angeles County
81978	Fee-for-Service	1083326623	1083326623	1	1	FOX, KHADIJA DOULA	1/20/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	39	06077	0	0	None
81979	Fee-for-Service	1265582076	1265582076	1	1	FAIRBORN, JAY F MD	7/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	67589	01	General Practice	0	In state provider	None	1033 THIRD STREET	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
82037	Fee-for-Service	1538165527	1538165527	1	1	FREDERICK MEMORIAL HOSPITAL	4/28/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	400 WEST SEVENTH STREET	None	FREDERICK	MD	21701	4593	00	None	39.423818	-77.41427532	Frederick County
82072	Fee-for-Service	1477647121	1477647121	1	1	FRIEDMAN, MARNI J	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65852	08	Family Practice	0	In state provider	None	901 SUNSET DR	STE. 6	HOLLISTER	CA	95023	5613	35	06069	36.83511073	-121.3873227	San Benito County
82105	Fee-for-Service	1487900890	1487900890	1	1	FESTA, JOY CCC-SLP	10/14/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	556 N 1ST ST	SUITE 201	SAN JOSE	CA	95112	5300	43	06085	37.34591974	-121.8977166	Santa Clara County
82136	Fee-for-Service	1790855146	1790855146	1	1	FITTEN, LUIS J MD	6/2/2010	2084P0805X	NA	Psychiatry	026	PHYSICIANS	29609	36	Psychiatry	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	6975	19	06037	34.06473399	-118.445865	Los Angeles County
82153	Fee-for-Service	1407352396	1407352396	1	1	FROST, SPENCER W MD	3/7/2025	163WG0100X	NA	Other	026	PHYSICIANS	163772	41	Internal Medicine	0	In state provider	None	2068 JOHN JONES RD	None	DAVIS	CA	95616	9711	57	06113	38.56390812	-121.7690112	Yolo County
82154	Fee-for-Service	1912404864	1912404864	1	1	FROEHLICH CHILDRESS, TANDRA	10/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	676 CHENERY ST	None	SAN FRANCISCO	CA	94131	3034	38	06075	37.7345429	-122.4335969	San Francisco County
82183	Fee-for-Service	1952382756	1952382756	1	1	FERZANDI, TANAZ R MD	1/28/2020	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166730	15	Obstetrics (D.O. only)	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
82246	Fee-for-Service	1588651855	1588651855	1	1	FUKES, DIANNE M PT	3/24/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2001 SOLAR DR	STE 150	OXNARD	CA	93036	0680	56	06111	34.22025454	-119.1449192	Ventura County
82250	Fee-for-Service	1063002590	1063002590	1	1	FIRST RELIABLE HOSPICE CARE	8/23/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	16501 SHERMAN WAY	STE 105A	VAN NUYS	CA	91406	3757	19	06037	34.20125005	-118.4927785	Los Angeles County
82322	Fee-for-Service	1538165527	1538165527	1	1	FREDERICK MEMORIAL HOSPITAL	4/28/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	400 WEST SEVENTH STREET	None	FREDERICK	MD	21701	4593	00	None	39.423818	-77.41427532	Frederick County
82439	Fee-for-Service	1407352396	1407352396	1	1	FROST, SPENCER W MD	3/7/2025	163WG0100X	NA	Other	026	PHYSICIANS	163772	70	Clinic (mixed specialty)	0	In state provider	None	2068 JOHN JONES RD	None	DAVIS	CA	95616	9711	57	06113	38.56390812	-121.7690112	Yolo County
82443	Fee-for-Service	1770538217	1770538217	1	1	FAGAN, CHRISTOPHER H	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42774	01	General Practice	0	In state provider	BEAR MOUNTAIN FAMILY PRA	41933 BIG BEAR BLVD	None	BIG BEAR LAKE	CA	92315	0000	36	06071	34.24334115	-116.8869688	San Bernardino County
82472	Fee-for-Service	1548390271	1548390271	1	1	FANG, BEVERLY J MD	1/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113011	41	Internal Medicine	0	In state provider	None	2825 J STREET	None	SACRAMENTO	CA	95817	2308	34	06067	38.573757	-121.468248	Sacramento County
82510	Fee-for-Service	1144717653	1144717653	1	1	FAKHOURY, AYED A MD	4/1/2022	208M00000X	NA	Other	026	PHYSICIANS	173470	None	None	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
82540	Fee-for-Service	1063002590	1063002590	1	1	FIRST RELIABLE HOSPICE CARE	8/23/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	16501 SHERMAN WAY	STE 105A	VAN NUYS	CA	91406	3757	19	06037	34.20125005	-118.4927785	Los Angeles County
82555	Fee-for-Service	1841518685	1841518685	1	1	FLAHERTY, HEATHER L MD INC	10/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	76925	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10833 LECONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
82726	Fee-for-Service	1407352396	1407352396	1	1	FROST, SPENCER W MD	3/7/2025	163WG0100X	NA	Other	026	PHYSICIANS	163772	10	Gastroenterology (M.D. only)	0	In state provider	None	2068 JOHN JONES RD	None	DAVIS	CA	95616	9711	57	06113	38.56390812	-121.7690112	Yolo County
82732	Fee-for-Service	1770538217	1770538217	1	1	FAGAN, CHRISTOPHER H	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42774	66	Emergency Medicine (Urgent Care)	0	In state provider	BEAR MOUNTAIN FAMILY PRA	41933 BIG BEAR BLVD	None	BIG BEAR LAKE	CA	92315	0000	36	06071	34.24334115	-116.8869688	San Bernardino County
82751	Fee-for-Service	1235659699	1235659699	1	1	FOROTAN, EMILY LMFT	3/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
82812	Fee-for-Service	1114953890	1114953890	1	1	FALK, JEREMY A MD	6/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90299	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
82814	Fee-for-Service	1477589935	1477589935	1	1	FEDERICO G DOLDEN MD	8/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	549 4TH ST	None	NIAGARA FALLS	NY	14301	1530	00	None	43.092297	-79.057989	Niagara County
82856	Fee-for-Service	1639109507	1639109507	1	1	FARAONI, JAMES D JR MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	842 E MAIN ST	None	MEDFORD	OR	97504	7155	00	None	42.32787853	-122.863311	Jackson County
82903	Fee-for-Service	1922060086	1922060086	1	1	FADEEL, OMAR O MD	10/1/1998	207R00000X	NA	Other	026	PHYSICIANS	44522	41	Internal Medicine	0	In state provider	None	3356 W BALL RD	STE 100	ANAHEIM	CA	92804	3727	30	06059	33.81726453	-118.007451	Orange County
82994	Fee-for-Service	1134172869	1134172869	1	1	FREYNE, SEAN MD	1/1/2001	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	73351	30	Radiology	0	In state provider	None	1700 N ROSE AVE	STE 110	OXNARD	CA	93030	7630	56	06111	34.21746	-119.155545	Ventura County
83102	Fee-for-Service	1114953890	1114953890	1	1	FALK, JEREMY A MD	6/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90299	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
83124	Fee-for-Service	1710695754	1710695754	1	1	FLANAGAN, JAMES M PT	5/28/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	291 EAST MAIN ST.	D, E	LOS GATOS	CA	95030	6137	43	06085	37.22109751	-121.9747502	Santa Clara County
83142	Fee-for-Service	1609285204	1609285204	1	1	FRESENIUS MEDICAL CARE	6/6/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ANAHEIM LLC	3150 W LINCOLN AVE	SUITE 100	ANAHEIM	CA	92801	6022	30	06059	33.83190949	-118.000332	Orange County
83231	Fee-for-Service	1144384066	1144384066	1	1	FONTAINE, RUTH S MD	2/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	41199	02	General Surgery	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6002	19	06037	34.28200485	-118.4030797	Los Angeles County
83234	Fee-for-Service	1912078825	1912078825	1	1	FLEURY, WILLIAM E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38039	41	Internal Medicine	0	In state provider	None	1100 PACIFIC COAST HWY	None	HARBOR CITY	CA	90710	3511	19	06037	33.7899001	-118.2974971	Los Angeles County
83243	Fee-for-Service	1104077726	1104077726	1	1	FARHADI, PANTEA MD	5/28/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	105057	None	None	0	In state provider	None	9005 ELEVADO	None	LOS ANGELES	CA	90069	4120	19	06037	34.08492712	-118.3875786	Los Angeles County
83262	Fee-for-Service	1912249574	1912249574	1	1	FU, PETER J MD	8/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148506	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
83317	Fee-for-Service	1285735431	1285735431	1	1	FAIRLEY, JEFFREY PT	3/25/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	224 INDIAN HILL BLVD	None	CLAREMONT	CA	91711	4609	19	06037	34.09607063	-117.7192866	Los Angeles County
83343	Fee-for-Service	1801272109	1801272109	1	1	FRAGUELA RIOS, CATHLYN LCSW	12/1/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2280 HARRISON AVE	SUITE B	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
83371	Fee-for-Service	1720150477	1720150477	1	1	FINLEY, ALLEN J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	21927	40	Pediatrics	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
83436	Fee-for-Service	1477622587	1477622587	2	2	FESTUS B DADA MD JD	9/11/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	25495 MEDICAL CENTER DR	302	MURRIETA	CA	92562	4904	33	06065	33.55804188	-117.1834064	Riverside County
83447	Fee-for-Service	1821174467	1821174467	2	1	FRONT PORCH COMMUNITIES AND	12/31/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SERVICES	621 W BONITA AVE	None	CLAREMONT	CA	91711	4513	19	06037	34.0965303	-117.7239465	Los Angeles County
83453	Fee-for-Service	1770361875	1770361875	1	3	FOREFRONT DERMATOLOGY - PACI	12/7/2023	207ND0101X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	AL GROUP, A FOREFRONT DE	1661 SOQUEL DR	STE C	SANTA CRUZ	CA	95065	1709	44	06087	36.98895429	-121.9821088	Santa Cruz County
83465	Fee-for-Service	1104906569	1104906569	1	3	FRESNO COMMUNITY HOSPITAL	1/1/1995	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CENTER	7171 NORTH CEDAR AVE	None	FRESNO	CA	93720	3311	10	06019	36.84077453	-119.7567239	Fresno County
83566	Fee-for-Service	1437147063	1437147063	1	1	FILLER, MOREY MD	11/15/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	17096	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	350 PARNASSUS AVE	STE 810	SAN FRANCISCO	CA	94117	3600	38	06075	37.76403932	-122.4561371	San Francisco County
83591	Fee-for-Service	1407014160	1407014160	1	1	FODOR, ALEXANDER M MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106851	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
83594	Fee-for-Service	1487695789	1487695789	1	1	FILPI, ROBERT G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12209	30	Radiology	0	In state provider	None	123 DI SALVO AVE	STE A	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
83618	Fee-for-Service	1578520409	1578520409	2	1	FLEISCHER, BARRY R	2/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	13740	04	Otology, Laryngology, Rhinology	0	In state provider	None	117 W BUNNY AVE	None	SANTA MARIA	CA	93458	2805	42	06083	34.96327701	-120.4368111	Santa Barbara County
83621	Fee-for-Service	1396240917	1396240917	1	1	FARAO, LOREN M NP	5/10/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
83724	Fee-for-Service	1306118336	1306118336	1	1	FOSCO, DOUGLAS G OT	6/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
83761	Fee-for-Service	1760680045	1760680045	1	1	FRANKE, NADJA R LMFT	1/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
83778	Fee-for-Service	1508022260	1508022260	1	1	FORD, EMILEY F MD	6/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110187	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
83782	Fee-for-Service	1972746220	1972746220	1	1	FAB MEDICAL SUPPLY INC	3/14/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FAB MEDICAL SUPPLY INC	5250 W. CENTURY BLVD	SUITE 504	LOS ANGELES	CA	90045	5972	19	06037	33.9451882	-118.371997	Los Angeles County
83783	Fee-for-Service	1548370521	1548370521	1	1	FELDMAN, CLAYTON A MD	7/31/1971	No Taxonomy Provided	NA	None	026	PHYSICIANS	7115	41	Internal Medicine	0	In state provider	SAN JOSE MED CLINIC	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
83789	Fee-for-Service	1942278692	1942278692	1	1	FOLSOM OUTPATIENT	6/1/2005	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SURGERY CENTER LP	1651 CREEKSIDE DR	STE 100	FOLSOM	CA	95630	3833	34	06067	38.672136	-121.14648	Sacramento County
83843	Fee-for-Service	1922577097	1922577097	1	1	FINO, ADRIENNE LMFT	6/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4091 RIVERSIDE DR	STE 103	CHINO	CA	91710	3195	36	06071	34.01888049	-117.715779	San Bernardino County
83940	Fee-for-Service	1225109275	1225109275	1	1	FIGUEROA, ARSENIO J MD	8/1/1998	208800000X	NA	Other	026	PHYSICIANS	77221	34	Urology and Urological Surgery	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
83947	Fee-for-Service	1265574669	1265574669	1	1	FOYGELMAN, ALEKSANDR DPM	12/26/2007	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	8121 VAN NUYS BLVD	STE 500	PANORAMA CITY	CA	91402	5100	19	06037	34.21865688	-118.4487896	Los Angeles County
83966	Fee-for-Service	1376800771	1376800771	1	1	FIORENTINO, LAVINIA PHD	5/11/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
83969	Fee-for-Service	1386148542	1386148542	1	1	FERRELL, JEFFREY E MD	10/8/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	164263	None	None	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6919	38	06075	37.78610439	-122.421569	San Francisco County
84190	Fee-for-Service	1023318045	1023318045	1	2	FARIDNIA, REGINA G LCSW	4/29/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26712	-	NOT APPLICABLE	0	In state provider	None	2100 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	5721	34	06067	38.572722	-121.479849	Sacramento County
84318	Fee-for-Service	1013900976	1013900976	1	1	FOSTER,TERRENCE D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	150 EAGLE SPRING COURT	STE A	STOCKBRIDGE	GA	30281	0000	00	None	33.50999761	-84.2281355	Henry County
84371	Fee-for-Service	1861655748	1861655748	1	1	FLORES, LORENA Z PSYD	1/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVENUE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
84379	Fee-for-Service	1598144685	1598144685	1	1	FORD, TENISHA LPCC	8/29/2024	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
84438	Fee-for-Service	1275503542	1275503542	1	1	FRIEDMAN, SHARON L MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	22120	01	General Practice	0	In state provider	None	25800 CARLOS BEE BLVD	None	HAYWARD	CA	94542	3000	01	06001	37.657395	-122.0576265	Alameda County
84441	Fee-for-Service	1184763880	1184763880	1	1	FARID, AMANY MD	12/1/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	76961	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 UCLA MEDICAL PLZ	STE 430	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
84520	Fee-for-Service	1144500018	1144500018	1	1	FULKERSON, JUSTIN S CRNA	8/11/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
84563	Fee-for-Service	1427327345	1427327345	1	1	FORBES, JHENELLE T CRNA	11/30/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
84677	Fee-for-Service	1760572937	1760572937	1	1	FREEDLAND, STEPHEN J MD	4/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68566	34	Urology and Urological Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
84794	Fee-for-Service	1932608965	1932608965	1	1	FITZGERALD, AREZOO	3/20/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	14335 BURBANK BLVD	# 10	VAN NUYS	CA	91401	4819	19	06037	34.1721395	-118.445607	Los Angeles County
84882	Fee-for-Service	1154857456	1154857456	1	1	FREEDMAN, AARON G LMFT	1/10/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1263 MISSION ST	None	SAN FRANCISCO	CA	94103	2705	38	06075	37.77664083	-122.414177	San Francisco County
84906	Fee-for-Service	1194139634	1194139634	1	1	FALWELL, LAKEISHA N NP	12/21/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
84948	Fee-for-Service	1093894594	1093894594	1	1	FULLER, LA CRYSTAL L RN	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1539 W GARVEY AVE	None	WEST COVINA	CA	91790	2138	19	06037	34.07276147	-117.9396	Los Angeles County
84980	Fee-for-Service	1871024141	1871024141	1	1	FRANCO, DIANA LMFT	4/26/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2741 HAMNER AVENUE	202	NORCO	CA	92860	3628	33	06065	33.92216844	-117.5591658	Riverside County
85039	Fee-for-Service	1750717450	1750717450	1	1	FLOWERS, KRISTIN LMFT	7/9/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 N IRWIN ST	STE 201E	HANFORD	CA	93230	4579	16	06031	36.32556401	-119.6470509	Kings County
85083	Fee-for-Service	1932608965	1932608965	1	1	FITZGERALD, AREZOO	3/20/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	14335 BURBANK BLVD	# 10	VAN NUYS	CA	91401	4819	19	06037	34.1721395	-118.445607	Los Angeles County
85126	Fee-for-Service	1184481574	1184481574	1	1	FLAGSTONE MEDICAL PC	4/25/2024	261QP2300X	NA	Other	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	2801 EAST SPRING STREET	SUITE 120	LONG BEACH	CA	90806	6840	19	06037	33.81174824	-118.1588809	Los Angeles County
85280	Fee-for-Service	1548603186	1548603186	1	1	FERREY, DOMINIC A MD	1/30/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	134061	13	Neurology (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
85295	Fee-for-Service	1144488248	1144488248	1	1	FOLEK, JESSICA M MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103976	02	General Surgery	0	In state provider	None	200 MEDICAL PLAZA	#214	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
85324	Fee-for-Service	1518960251	1518960251	1	1	FAN, XUEMO MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79042	22	Pathology (M.D. only)	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
85346	Fee-for-Service	1295750255	1295750255	1	1	FRISCIA, DAVID A MD	3/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	55078	20	Orthopedic Surgery	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
85384	Fee-for-Service	1851577605	1851577605	1	1	FIORENZA, JEFFREY P MD	8/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140177	10	Gastroenterology (M.D. only)	0	In state provider	None	23 UPPER RAGSDALE DR	STE 200	MONTEREY	CA	93940	7849	27	06053	36.57529358	-121.8101334	Monterey County
85395	Fee-for-Service	1871526533	1871526533	1	1	FREEMAN, MICHELE Y MD IN	7/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	56650	41	Internal Medicine	0	In state provider	None	575 E HARDY ST	STE 104	INGLEWOOD	CA	90301	4038	19	06037	33.94909392	-118.3477665	Los Angeles County
85443	Fee-for-Service	1306869177	1306869177	1	1	FETZ, ROBERT C MD	6/30/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	33114	30	Radiology	0	In state provider	None	1213 COFFEE RD	STE B	MODESTO	CA	95355	4229	50	06099	37.660401	-120.975669	Stanislaus County
85471	Fee-for-Service	1659365526	1659365526	1	1	FELLOWS, HOWARD W MD	9/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	88376	78	Neoplastic Diseases/Oncology	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
85491	Fee-for-Service	1750777579	1750777579	1	1	FAHRTASH, SINA MD	12/29/2024	2085R0204X	NA	Other	026	PHYSICIANS	192024	30	Radiology	0	In state provider	None	150 W. WASHINGTON STREET	None	SAN DIEGO	CA	92103	2005	37	06073	32.74999225	-117.1647027	San Diego County
85681	Fee-for-Service	1871526533	1871526533	1	1	FREEMAN, MICHELE Y MD IN	7/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	56650	45	Nephrology (Renal-Kidney)	0	In state provider	None	575 E HARDY ST	STE 104	INGLEWOOD	CA	90301	4038	19	06037	33.94909392	-118.3477665	Los Angeles County
85776	Fee-for-Service	1649373622	1649373622	1	1	FAISAL, F AL MD INC	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	50545	None	None	0	In state provider	None	1220 W OLIVE AVE	None	BURBANK	CA	91506	2216	19	06037	34.17057716	-118.3196429	Los Angeles County
85848	Fee-for-Service	1609134824	1609134824	1	1	FERRO, CAROL L MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120990	26	Psychiatry (child)	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
85865	Fee-for-Service	1164716619	1164716619	1	1	FU, TERESA MD	11/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122147	07	Dermatology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
85898	Fee-for-Service	1639671977	1639671977	1	1	FALCOCCHIA, DAVID DO	9/20/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20127	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
85905	Fee-for-Service	1275681082	1275681082	1	1	FATTAL,OVED MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64894	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	# 12430	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
85948	Fee-for-Service	1144417312	1144417312	1	1	FELARDO, SALVATORE J JR	4/1/1995	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2930 SUMMIT ST	None	OAKLAND	CA	94609	3405	01	06001	37.81828429	-122.2648347	Alameda County
85950	Fee-for-Service	1982660007	1982660007	1	1	FELD, JOY S	9/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80766	41	Internal Medicine	0	In state provider	None	8631 W 3RD ST	STE 1135E	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
86030	Fee-for-Service	1912983529	1912983529	1	1	FOONDOS, THEODORE MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	83972	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
86120	Fee-for-Service	1093212987	1093212987	1	1	FIELD, KRISTINA A MD	8/1/2021	207P00000X	NA	Other	026	PHYSICIANS	173935	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
86151	Fee-for-Service	1447456769	1447456769	1	1	FERTAL, JAMIE C DO	5/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11250	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
86181	Fee-for-Service	1992790661	1992790661	1	1	FORMAN, MICHAEL H MD	7/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	46089	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2182 S EL CAMINO REAL	STE 203	OCEANSIDE	CA	92054	6207	37	06073	33.18739807	-117.3282389	San Diego County
86183	Fee-for-Service	1437275385	1437275385	1	2	FILSON, CHRISTOPHER P MD	10/18/2023	208800000X	NA	Other	026	PHYSICIANS	124743	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
86187	Fee-for-Service	1083602304	1083602304	1	1	FRANCISCAN HOSPITALLER	6/15/2000	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SISTERS OF THE I C	1441 BERKELEY DR	None	LOS BANOS	CA	93635	9599	24	06047	37.04768911	-120.8345285	Merced County
86234	Fee-for-Service	1881623866	1881623866	1	1	FOWBLE, BARBARA L MD	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86793	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
86237	Fee-for-Service	1194892059	1194892059	1	1	FISCHBACH, GERALD O MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	57593	36	Psychiatry	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
86239	Fee-for-Service	1700055274	1700055274	1	2	FERAS AND HISHAM A MEDICAL C	2/21/2024	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2112 GAREY AVE	STE C	POMONA	CA	91766	5600	19	06037	34.03249701	-117.7491554	Los Angeles County
86381	Fee-for-Service	1750697991	1750697991	1	1	FRIEDMAN, MALKA G PSYD	7/21/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
86476	Fee-for-Service	1669786877	1669786877	1	1	FULLER, EVE R	5/24/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3105 E FREMONT AVE	None	FRESNO	CA	93710	4905	10	06019	36.83423093	-119.734202	Fresno County
86483	Fee-for-Service	1740318864	1740318864	1	1	FATIMA IMARA	9/22/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	221 MAHALANI ST	None	WAILUKU	HI	96793	2526	00	None	20.88554026	-156.4902142	Maui County
86750	Fee-for-Service	1376568808	1376568808	1	2	FORDHAM, KIMBERLY J MD	12/10/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	78858	-	NOT APPLICABLE	0	In state provider	None	16170 MAIN STREET	SUITE F	LOWER LAKE	CA	95457	7603	17	06033	38.91035811	-122.6100842	Lake County
86754	Fee-for-Service	1497833297	1497833297	1	1	FOSTER, TODD A MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78987	05	Anesthesiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
86769	Fee-for-Service	1154562270	1154562270	1	1	FREEMAN, ALISON PSYD	11/19/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
86820	Fee-for-Service	1780005710	1780005710	1	1	FISCHER, LINDSAY CNP	7/11/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10455 S DE ANZA BLVD	None	CUPERTINO	CA	95014	3011	43	06085	37.316601	-122.032407	Santa Clara County
86859	Fee-for-Service	1336208529	1336208529	1	1	FORBES, JILL D LCSW	1/4/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	132 S THOMPSON STREET	None	HEMET	CA	92543	4351	33	06065	33.74675899	-116.9651207	Riverside County
86923	Fee-for-Service	1902902828	1902902828	1	1	F&B HEALTHCARE, INC	2/1/1993	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	RIVERSIDE	8171 MAGNOLIA AVE	None	RIVERSIDE	CA	92504	3409	33	06065	33.93450499	-117.4218429	Riverside County
86951	Fee-for-Service	1932146461	1932146461	1	1	FORT WASHINGTON MEDICAL	1/3/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	11711 LIVINGSTON RD	None	FT WASHINGTON	MD	20744	5151	00	None	38.728683	-76.992606	Prince George's County
86983	Fee-for-Service	1447791744	1447791744	1	1	FANUCCI, LOUIS A DO	5/15/2024	390200000X	NA	Other	026	PHYSICIANS	16914	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
87035	Fee-for-Service	1154347862	1154347862	1	1	FILIPPI, DAVID S MD	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91801	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
87067	Fee-for-Service	1699361857	1699361857	1	1	FIRST CHOICE HOSPICE CARE,	10/15/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	18340 VENTURA BLVD	STE 228	TARZANA	CA	91356	7001	19	06037	34.16710415	-118.5320031	Los Angeles County
87133	Fee-for-Service	1104980549	1104980549	1	1	FERNALD, SARAH J LCSW	6/4/2024	101YA0400X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1100 TRANCAS ST	206	NAPA	CA	94558	2900	28	06055	38.32316569	-122.2981938	Napa County
87177	Fee-for-Service	1194169508	1194169508	1	1	FULLER, MELANIE LAC	6/12/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	45066 UKIAH ST	None	MENDOCINO	CA	95460	0000	23	06045	39.30603169	-123.8005994	Mendocino County
87207	Fee-for-Service	1730371816	1730371816	1	1	FANG, ALICE HAI-PING MD	8/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	657 TOWN CENTER DRIVE	None	LAS VEGAS	NV	89134	6367	00	None	36.180999	-115.3174815	Clark County
87240	Fee-for-Service	1932146461	1932146461	1	1	FORT WASHINGTON MEDICAL	1/3/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	11711 LIVINGSTON RD	None	FT WASHINGTON	MD	20744	5151	00	None	38.728683	-76.992606	Prince George's County
87352	Fee-for-Service	1740239060	1740239060	1	1	FISCHER, MICHAEL E MD	9/1/2002	174400000X	NA	Other	026	PHYSICIANS	49619	30	Radiology	0	In state provider	INC	900 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4716	19	06037	34.049623	-118.1388014	Los Angeles County
87356	Fee-for-Service	1699361857	1699361857	1	1	FIRST CHOICE HOSPICE CARE,	10/15/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	18340 VENTURA BLVD	STE 228	TARZANA	CA	91356	7001	19	06037	34.16710415	-118.5320031	Los Angeles County
87361	Fee-for-Service	1720222664	1720222664	1	1	FLINK, LAURA B MD	11/24/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	141599	41	Internal Medicine	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
87368	Fee-for-Service	1104906569	1104906569	1	26	FRESNO COMMUNITY HOSPITAL	7/13/2023	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2315 E ILLINOIS AVE	None	FRESNO	CA	93721	1324	10	06019	36.74505638	-119.783366	Fresno County
87399	Fee-for-Service	1669404737	1669404737	1	1	FAYARD, CARLOS R PHD	2/1/1996	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11320 MOUNTAIN VIEW AVE	STE B	LOMA LINDA	CA	92354	3860	36	06071	34.0472495	-117.2436911	San Bernardino County
87428	Fee-for-Service	1235298159	1235298159	1	1	FOOT SOLUTIONS	2/13/2018	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	5759 PACIFIC AVE	SUITE B120	STOCKTON	CA	95207	5164	39	06077	38.00251418	-121.3172922	San Joaquin County
87477	Fee-for-Service	1952459810	1952459810	1	1	FRICHTEL, CHRISTINA M DO	1/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8373	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
87482	Fee-for-Service	1174705446	1174705446	1	1	FONTAINE, ARTHUR B MD INC	12/27/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	2215 TRUXTUN AVENUE	None	BAKERSFIELD	CA	93301	3601	15	06029	35.37327448	-119.0278665	Kern County
87491	Fee-for-Service	1174501845	1174501845	1	1	FAMULARO, MICHAEL A MD	3/6/1996	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	29696	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	77 CASA ST	STE 105	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
87558	Fee-for-Service	1912610775	1912610775	1	1	FIRSTCHOICE CLINIC INC.	9/10/2024	207R00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7018 OWENSMOUTH AVE	SUIT 102	CANOGA PARK	CA	91303	2073	19	06037	34.1979459	-118.6015228	Los Angeles County
87700	Fee-for-Service	1811039555	1811039555	1	1	FULLERTON, PATRICK J DO	3/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11853	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 GARCES HWY	None	DELANO	CA	93215	3690	15	06029	35.76144847	-119.238912	Kern County
87743	Fee-for-Service	1457719783	1457719783	1	1	FOOTHILL HEIGHTS CARE CENTER	1/1/2016	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	1515 N FAIR OAKS AVE	None	PASADENA	CA	90803	1808	19	06037	34.17206003	-118.1507387	Los Angeles County
87766	Fee-for-Service	1427106053	1427106053	1	1	FISCHBEIN, NANCY J MD	11/30/1994	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	70753	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
87784	Fee-for-Service	1043664964	1043664964	1	1	FINN, JOANNA M MD	12/9/2019	207R00000X	NA	Other	026	PHYSICIANS	150965	41	Internal Medicine	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
87791	Fee-for-Service	1235322694	1235322694	1	1	FAMILY PRACTICE PHYS	6/21/1985	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	A MEDICAL GROUP	20932 BROOKHURST ST	STE 101	HUNTINGTON BEACH	CA	92646	6678	30	06059	33.65834344	-117.9535794	Orange County
87817	Fee-for-Service	1336210608	1336210608	1	1	FU, JR PAUL C MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79666	40	Pediatrics	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
87845	Fee-for-Service	1912610775	1912610775	1	1	FIRSTCHOICE CLINIC INC.	9/10/2024	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	7018 OWENSMOUTH AVE	SUIT 102	CANOGA PARK	CA	91303	2073	19	06037	34.1979459	-118.6015228	Los Angeles County
87896	Fee-for-Service	1073373734	1073373734	1	1	FABE LLC	3/20/2024	2278P4000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	24 OKEEFE CT	None	SACRAMENTO	CA	95835	2333	34	06067	38.683296	-121.5290025	Sacramento County
87915	Fee-for-Service	1578549788	1578549788	1	1	FERNANDEZ, JANICE L MD	4/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	85028	05	Anesthesiology	0	In state provider	None	3626 RUFFIN ROAD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
88032	Fee-for-Service	1548583594	1548583594	1	1	FIORE, GENEVIEVE H	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
88119	Fee-for-Service	1992932388	1992932388	1	1	FEAZELL, DAVID W MD	6/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115519	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
88170	Fee-for-Service	1306474127	1306474127	1	1	FUNG, CHRISTINE E MD	7/3/2023	390200000X	NA	Other	026	PHYSICIANS	182661	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
88262	Fee-for-Service	1720688054	1720688054	1	1	FOUNDATION MEDICINE, INC.	9/7/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	7010 KIT CREEK RD	None	MORRISVILLE	NC	27560	9761	00	None	35.8569	-78.869889	Wake County
88295	Fee-for-Service	1477729291	1477729291	1	1	FAIRMONT DERMATOLOGY MEDICAL	12/29/2017	207N00000X	NA	Dermatology	026	PHYSICIANS	None	07	Dermatology	0	In state provider	ASSOCIATES INC	801 S HAM LANE	STE A	LODI	CA	95242	7502	39	06077	38.124495	-121.2882875	San Joaquin County
88309	Fee-for-Service	1306077045	1306077045	1	1	FEE, GINGER E PT	7/6/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2835 S BRISTOL ST	SUITE B	SANTA ANA	CA	92704	6238	30	06059	33.70905039	-117.885413	Orange County
88331	Fee-for-Service	1528138583	1528138583	1	1	FINDLAY, RICHARD D MD	6/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	45782	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5073	19	06037	33.81253631	-118.3435557	Los Angeles County
88349	Fee-for-Service	1881729341	1881729341	1	1	FREEMAN, LIONEL IAN	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	665 WINTER ST SE	None	SALEM	OR	97301	0000	00	None	44.933211	-123.0355125	Marion County
88365	Fee-for-Service	1386668275	1386668275	1	1	FORAN, WILLIAM F MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79386	05	Anesthesiology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
88443	Fee-for-Service	1598255325	1598255325	1	1	FINCH, CHRISTINA MD	10/17/2019	390200000X	NA	Other	026	PHYSICIANS	164835	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
88497	Fee-for-Service	1235570060	1235570060	1	1	FORCINA, ANDREA V LMFT	6/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3401 GLENDALE BLVD	2ND FLOOR	LOS ANGELES	CA	90039	1814	19	06037	34.12026367	-118.2585836	Los Angeles County
88498	Fee-for-Service	1881089423	1881089423	1	1	FOWLER, CEDAR J MD	5/14/2019	207L00000X	NA	Other	026	PHYSICIANS	148398	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
88592	Fee-for-Service	1386084945	1386084945	1	1	FITTIPALDI, KARLA	11/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	103 MORRIS ST	L	SEBASTOPOL	CA	95472	3864	49	06097	38.40347434	-122.819185	Sonoma County
88660	Fee-for-Service	1104906569	1104906569	1	18	FRESNO COMMUNITY HOSPITAL	9/1/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	205 E RIVERPARK CIRCLE	SUITE 160	FRESNO	CA	93720	1572	10	06019	36.85456375	-119.7863981	Fresno County
88695	Fee-for-Service	1285684605	1285684605	1	1	FACULTY PHYSICIANS AND	12/31/1996	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	SURGEONS OF LLUSM	11401 HEACOCK ST	STE 330	MORENO VALLEY	CA	92557	7908	33	06065	33.954858	-117.243978	Riverside County
88711	Fee-for-Service	1881275402	1881275402	1	1	FLIETSTRA, JAQUELYNN LMFT	8/14/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41880 KALMIA ST	STE 115	MURRIETA	CA	92562	8835	33	06065	33.55740114	-117.2157733	Riverside County
88793	Fee-for-Service	1124222831	1124222831	1	1	FRENCH, EUGENIE E PHD	9/24/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9777 WILSHIRE BLVD	STE 907	BEVERLY HILLS	CA	90212	1910	19	06037	34.06710745	-118.4084145	Los Angeles County
88826	Fee-for-Service	1316197296	1316197296	1	2	FARUKHI, SHAHZAD R MD	6/27/2017	208M00000X	NA	Other	026	PHYSICIANS	126991	None	None	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
88924	Fee-for-Service	1972681609	1972681609	1	1	FINEGOLD, DON J MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	53206	41	Internal Medicine	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
88948	Fee-for-Service	1194089813	1194089813	1	1	FELIX, ABHILASH L MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149314	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 STANYAN STREET	None	SAN FRANCISCO	CA	94117	1019	38	06075	37.7738933	-122.4544685	San Francisco County
88950	Fee-for-Service	1942393996	1942393996	1	2	FERRER, FARAH G MD	10/21/2020	2084P0804X	NA	Psychiatry	026	PHYSICIANS	55258	36	Psychiatry	0	In state provider	None	5406 E BEVERLY BLVD	None	LOS ANGELES	CA	90022	2208	19	06037	34.0294449	-118.1492635	Los Angeles County
88983	Fee-for-Service	1285684605	1285684605	1	1	FACULTY PHYSICIANS AND	4/16/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM	11401 HEACOCK ST	STE 330	MORENO VALLEY	CA	92557	7908	33	06065	33.954858	-117.243978	Riverside County
89025	Fee-for-Service	1831199769	1831199769	1	1	FREND, JEREMY M MD	10/13/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61534	40	Pediatrics	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
89076	Fee-for-Service	1629118518	1629118518	1	2	FISHER, JAY D MD	10/25/2022	2080P0204X	NA	Other	026	PHYSICIANS	88903	None	None	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
89137	Fee-for-Service	1942576657	1942576657	1	1	FALIK, REBECCA C MD	9/27/2017	390200000X	NA	Other	026	PHYSICIANS	126750	None	None	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
89208	Fee-for-Service	1992525463	1992525463	1	1	FAUSTINO, MAY CHRISTINE NP	12/26/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1720 W BALL RD	STE 4C	ANAHEIM	CA	92804	5500	30	06059	33.8178465	-117.9425115	Orange County
89266	Fee-for-Service	1063697233	1063697233	1	1	FANG, DAVID M MD	11/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115652	20	Orthopedic Surgery	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
89307	Fee-for-Service	1275652232	1275652232	1	1	FARBOODY, NASEEM LMFT	10/29/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
89349	Fee-for-Service	1255580544	1255580544	1	1	FLOWERS-NED, TRACI LMFT	10/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
89414	Fee-for-Service	1700984218	1700984218	2	2	FREMONT UNIFORM AND MEDICAL	5/4/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SUPPLY INC.	644 MOWRY AVENUE	None	FREMONT	CA	94536	4113	01	06001	37.56683221	-121.9739694	Alameda County
89505	Fee-for-Service	1871519561	1871519561	1	1	FUNG, PETER K MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53944	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	330 S GARFIELD AVE	STE 208	ALHAMBRA	CA	91801	3893	19	06037	34.09137167	-118.1241735	Los Angeles County
89647	Fee-for-Service	1205911427	1205911427	1	1	FARRELL, ROBERT B OD	9/14/2015	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	119 S L ST	None	DINUBA	CA	93618	2324	54	06107	36.54055651	-119.3899159	Tulare County
89649	Fee-for-Service	1639205248	1639205248	1	1	FOOTHILL PHARMACY, INC	6/8/2004	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 E ANTELOPE AVE	STE B	WOODLAKE	CA	93286	1565	54	06107	36.41561341	-119.0969743	Tulare County
89718	Fee-for-Service	1851401020	1851401020	1	1	FUNNELL, THOMAS R OD	9/17/1980	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1445 DONLON ST	STE 12	VENTURA	CA	93003	8390	56	06111	34.25875688	-119.2366863	Ventura County
89793	Fee-for-Service	1659726123	1659726123	1	1	FITTER, JAYSON MD	9/24/2020	390200000X	NA	Other	026	PHYSICIANS	152408	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
89854	Fee-for-Service	1518323831	1518323831	1	1	FERRELL, SHILOH	5/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
89882	Fee-for-Service	1205100740	1205100740	1	1	FAMILY PLANNING ASSOCIATES M	12/9/2013	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	EDICAL GROUP INC	29645 RANCHO CALIFORNIA	SUITE 237	TEMECULA	CA	92591	5285	33	06065	33.50627123	-117.1431728	Riverside County
89914	Fee-for-Service	1700834496	1700834496	1	1	FLANNIGAN, BONNIE MD	4/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	34520	None	None	0	In state provider	None	14435 HAMLIN ST	STE B	VAN NUYS	CA	91401	6205	19	06037	34.18869947	-118.447731	Los Angeles County
89925	Fee-for-Service	1619969524	1619969524	1	1	FOGEL, THOMAS D MD	8/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	54921	30	Radiology	0	In state provider	None	2985 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28953746	-118.7439291	Ventura County
89941	Fee-for-Service	1205911427	1205911427	1	1	FARRELL, ROBERT B OD	9/14/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	119 S L ST	None	DINUBA	CA	93618	2324	54	06107	36.54055651	-119.3899159	Tulare County
90066	Fee-for-Service	1992880116	1992880116	1	1	FARRELL, ALLYSON T OD	9/14/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	119 S L ST	None	DINUBA	CA	93618	2324	54	06107	36.54055651	-119.3899159	Tulare County
90101	Fee-for-Service	1104906569	1104906569	1	21	FRESNO COMMUNITY HOSPITAL	2/22/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	215 N FRESNO ST	SUITE 250	FRESNO	CA	93701	2304	10	06019	36.74538	-119.781566	Fresno County
90116	Fee-for-Service	1316421340	1316421340	1	1	FERNANDEZ, MARYROSE F	5/17/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	8248 GRAPEMAN COURT	None	SACRAMENTO	CA	95829	8133	34	06067	38.457909	-121.31919	Sacramento County
90161	Fee-for-Service	1053418640	1053418640	1	1	FELTMAN, JOAN K MD	2/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	23409	41	Internal Medicine	0	In state provider	None	1301 20TH ST	STE 230	SANTA MONICA	CA	90404	2080	19	06037	34.02976782	-118.4812493	Los Angeles County
90170	Fee-for-Service	1386663540	1386663540	1	1	FARLO, JOSEPH N MD	5/27/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	77918	05	Anesthesiology	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
90177	Fee-for-Service	1134102882	1134102882	1	1	FIRESTONE, LISA B MD	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111077	25	Physical Medicine and Rehabilitation	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
90185	Fee-for-Service	1588756266	1588756266	1	1	FULLERTON, JOHN H MD	2/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	59000	41	Internal Medicine	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
90213	Fee-for-Service	1316987977	1316987977	1	1	FAN, ROBERT MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65166	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
90214	Fee-for-Service	1811283427	1811283427	1	1	FIDALGO, GARRETT M MD	7/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	235 WEST 6TH STREET	None	RENO	NV	89503	4548	00	None	39.53165987	-119.8181899	Washoe County
90240	Fee-for-Service	1942309489	1942309489	1	1	FUNG, PATRICIA P MD	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84261	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
90305	Fee-for-Service	1508275249	1508275249	1	1	FINKMOORE, BROOKE C NP	4/16/2020	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
90404	Fee-for-Service	1386839157	1386839157	1	1	FIJMAN, LUISA B MD	7/6/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50394	None	None	0	In state provider	None	15431 ANACAPA RD	STE D	VICTORVILLE	CA	92392	2458	36	06071	34.50544107	-117.3250832	San Bernardino County
90405	Fee-for-Service	1316421340	1316421340	1	1	FERNANDEZ, MARYROSE F	5/17/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	8248 GRAPEMAN COURT	None	SACRAMENTO	CA	95829	8133	34	06067	38.457909	-121.31919	Sacramento County
90411	Fee-for-Service	1720440837	1720440837	1	1	FREEMAN, HILLARY A MD	10/16/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	151953	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
90457	Fee-for-Service	1386663540	1386663540	1	1	FARLO, JOSEPH N MD	5/27/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	77918	40	Pediatrics	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
90467	Fee-for-Service	1376572602	1376572602	1	1	FRENCH, SAMUEL W MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70666	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
90480	Fee-for-Service	1396736245	1396736245	1	1	FARAJ, WALID A DO	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	8205	01	General Practice	0	In state provider	None	2075 SAN JOAQUIN HILLS	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
90533	Fee-for-Service	1770724098	1770724098	1	1	FLEURAT, MICHELLE R MD	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106648	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
90593	Fee-for-Service	1699732305	1699732305	1	1	FOGELFELD, LEON MD	1/5/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	175830	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
90624	Fee-for-Service	1952306466	1952306466	1	1	FLETES, RAFAEL MD	7/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77014	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2301 CIRCADIAN WAY	None	SANTA ROSA	CA	95407	5457	49	06097	38.421936	-122.7533895	Sonoma County
90648	Fee-for-Service	1942907274	1942907274	1	1	FLOWTANICA LLC	2/7/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
90738	Fee-for-Service	1093199424	1093199424	1	1	FARUKHI, MOHAMMED A MD	11/10/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	145744	None	None	0	In state provider	None	4316 E SLAUSON AVE	None	MAYWOOD	CA	90270	2838	19	06037	33.98746055	-118.1892788	Los Angeles County
90739	Fee-for-Service	1679610919	1679610919	1	1	FOSTER, STEVEN D	3/20/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5313 COLLEGE AVE	None	OAKLAND	CA	94618	1416	01	06001	37.83825407	-122.2513805	Alameda County
90748	Fee-for-Service	1508807108	1508807108	1	1	FINN, JAMES C III MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	59567	05	Anesthesiology	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
90751	Fee-for-Service	1700059615	1700059615	1	1	FIELD, ROBERT R MD	6/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121646	05	Anesthesiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
90764	Fee-for-Service	1841365541	1841365541	1	1	FRESNO CO OFC OF EDU	11/1/2018	No Taxonomy Provided	NA	None	101	UNIFIED SCHOOL DISTRICT	-	-	NOT APPLICABLE	0	In state provider	None	1111 VAN NESS AVE	None	FRESNO	CA	93721	2002	10	06019	36.73622928	-119.7909185	Fresno County
90782	Fee-for-Service	1285706267	1285706267	1	1	FAJARDO, EMMANUEL T JR	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
90798	Fee-for-Service	1982787057	1982787057	1	1	FEGHALI, NABIL S MD	6/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	34704	41	Internal Medicine	0	In state provider	None	8111 CANOGA AVE	None	CANOGA PARK	CA	91304	4103	19	06037	34.217262	-118.5975465	Los Angeles County
90825	Fee-for-Service	1639138779	1639138779	1	1	FOWLER, RAYMOND MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
90864	Fee-for-Service	1205984192	1205984192	1	1	FLIPPIN, MICHAEL A MD	6/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89977	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
90907	Fee-for-Service	1952306466	1952306466	1	1	FLETES, RAFAEL MD	7/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77014	45	Nephrology (Renal-Kidney)	0	In state provider	None	2301 CIRCADIAN WAY	None	SANTA ROSA	CA	95407	5457	49	06097	38.421936	-122.7533895	Sonoma County
90917	Fee-for-Service	1811201056	1811201056	1	1	FERMIN, PATRICIA D MD	11/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118502	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
90936	Fee-for-Service	1215921135	1215921135	1	1	FLICK,RICHARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5750 W THUNDERBIRD RD	STE G700	GLENDALE	AZ	85306	0000	00	None	33.612507	-112.1822145	Maricopa County
90960	Fee-for-Service	1245362458	1245362458	1	1	FLORES, MONICA E LMFT	9/21/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1672 W AVE J	SUITE 202	LANCASTER	CA	93534	5901	19	06037	34.68938947	-118.1609775	Los Angeles County
91030	Fee-for-Service	1245217520	1245217520	1	1	FAIRVIEW HEALTH SERVICES	6/9/2004	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	201 E NICOLLET BLVD	None	BURNSVILLE	MN	55337	5714	00	None	44.749107	-93.2733135	Dakota County
91053	Fee-for-Service	1841365541	1841365541	1	1	FRESNO CO OFC OF EDU	1/1/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1111 VAN NESS AVE	None	FRESNO	CA	93721	2002	10	06019	36.73622928	-119.7909185	Fresno County
91089	Fee-for-Service	1104415116	1104415116	1	1	FOK, ALICE MD	10/8/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	181789	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
91103	Fee-for-Service	1437199973	1437199973	1	1	FISHER JOHNATHAN	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
91113	Fee-for-Service	1528031705	1528031705	2	1	FEIST, FREDRIC W MD	11/30/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	88387	None	None	0	In state provider	MD	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
91118	Fee-for-Service	1346655420	1346655420	1	1	FOX, CHRISTOPHER L MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
91129	Fee-for-Service	1063427425	1063427425	1	1	FIERRO, NANCY L MD	7/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77146	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
91150	Fee-for-Service	1205984192	1205984192	1	1	FLIPPIN, MICHAEL A MD	6/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89977	20	Orthopedic Surgery	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
91186	Fee-for-Service	1063250637	1063250637	1	1	FLORES, GLORIA BIRTH DOULA	9/5/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	41	06081	0	0	None
91196	Fee-for-Service	1952306466	1952306466	1	1	FLETES, RAFAEL MD	7/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77014	41	Internal Medicine	0	In state provider	None	2301 CIRCADIAN WAY	None	SANTA ROSA	CA	95407	5457	49	06097	38.421936	-122.7533895	Sonoma County
91207	Fee-for-Service	1518246941	1518246941	1	1	FOLAUOO, PATSY J LCSW	3/8/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5850 EL CAMINO REAL	None	ATASCADERO	CA	93422	3318	40	06079	35.48962035	-120.670989	San Luis Obispo County
91223	Fee-for-Service	1427317981	1427317981	1	1	FRESNO AMERICAN INDIAN HEALT	11/27/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	H PROJECT	1551 E SHAW AVE	SUITE 128 & 139	FRESNO	CA	93710	8025	10	06019	36.80828196	-119.7589292	Fresno County
91265	Fee-for-Service	1538724893	1538724893	1	1	FORBES, DOMANIQUE C OT	8/20/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
91280	Fee-for-Service	1154044436	1154044436	1	1	FOLEY, ERIN M	2/6/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41769 ENTERPRISE CIR N	STE 104	TEMECULA	CA	92590	5626	33	06065	33.51823541	-117.1701538	Riverside County
91294	Fee-for-Service	1477028645	1477028645	1	1	FECK, THOMAS PT	2/14/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	26700 TOWNE CENTER DRIVE	SUITE 110	FOOTHILL RANCH	CA	92610	2844	30	06059	33.67455886	-117.6639195	Orange County
91313	Fee-for-Service	1497727440	1497727440	2	1	FRANK, DONALD T DO	6/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	8628	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
91316	Fee-for-Service	1245217520	1245217520	1	1	FAIRVIEW HEALTH SERVICES	1/12/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	201 E NICOLLET BLVD	None	BURNSVILLE	MN	55337	5714	00	None	44.749107	-93.2733135	Dakota County
91441	Fee-for-Service	1588001838	1588001838	1	1	FLAGG, ERIC R MD	6/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147130	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
91446	Fee-for-Service	1992761324	1992761324	1	1	FRIEDMAN, DAVID A. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10250 N 92ND ST	STE 203	SCOTTSDALE	AZ	85258	4518	00	None	33.580593	-111.8830365	Maricopa County
91511	Fee-for-Service	1427317981	1427317981	1	1	FRESNO AMERICAN INDIAN HEALT	11/27/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	H PROJECT	1551 E SHAW AVE	SUITE 128 & 139	FRESNO	CA	93710	8025	10	06019	36.80828196	-119.7589292	Fresno County
91554	Fee-for-Service	1992836027	1992836027	1	1	FOX, CHRISTINE K MD	6/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94755	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.76344756	-122.4581992	San Francisco County
91594	Fee-for-Service	1477953933	1477953933	1	1	FAMILY HEALTH CENTERS	6/15/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4874 POLK AVENUE	None	SAN DIEGO	CA	92105	2026	37	06073	32.75139818	-117.0895121	San Diego County
91599	Fee-for-Service	1487949038	1487949038	1	1	FLORES, SAMUEL B MD	4/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS ROAD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
91606	Fee-for-Service	1104473016	1104473016	1	1	FORCHE, MAURINE B NP	8/12/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
91643	Fee-for-Service	1528014636	1528014636	1	1	FOSTER-OLSON, CLAUDIA J MD	7/1/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45496	08	Family Practice	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
91660	Fee-for-Service	1831421742	1831421742	1	1	FOLSOM MEDICAL SUPPLY LLC	3/16/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FOLSOM MEDICAL SUPPLY	422 EAST BIDWELL ST	None	FOLSOM	CA	95630	3117	34	06067	38.67377623	-121.1662494	Sacramento County
91679	Fee-for-Service	1861791105	1861791105	1	1	FRIEDMAN, GERALD S MD INC	3/18/2010	207RN0300X	NA	Nephrology	026	PHYSICIANS	19835	45	Nephrology (Renal-Kidney)	0	In state provider	None	600 N 13TH AVENUE	STE 100	UPLAND	CA	91786	4905	36	06071	34.10113004	-117.6336234	San Bernardino County
91762	Fee-for-Service	1952560245	1952560245	1	1	FRANCIS, CATHERINE	2/20/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SYCHOLOGIST	4215 COLONY PLZ	None	NEWPORT BEACH	CA	92660	6343	30	06059	33.62079598	-117.8793913	Orange County
91768	Fee-for-Service	1801970504	1801970504	1	1	FRANKLIN A HANAUER MD INC	9/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	12740	41	Internal Medicine	0	In state provider	None	515 BEACH BLVD	STE G	ANAHEIM	CA	92804	1812	30	06059	33.82559703	-117.9934832	Orange County
91775	Fee-for-Service	1114277761	1114277761	1	1	FAHRENBACH, VICTORIA S MD	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127267	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
91793	Fee-for-Service	1881772408	1881772408	1	1	FUNG-YEUNG, SHELLEY S MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73818	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
91798	Fee-for-Service	1427317981	1427317981	1	1	FRESNO AMERICAN INDIAN HEALT	10/17/2022	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	H PROJECT	1551 E SHAW AVE	SUITE 128 & 139	FRESNO	CA	93710	8025	10	06019	36.80828196	-119.7589292	Fresno County
91825	Fee-for-Service	1902977895	1902977895	1	1	FLATAUER, FRANK E MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	36521	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
91864	Fee-for-Service	1730947441	1730947441	1	1	FORTITUDE MARRIAGE AND FAMIL	3/18/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11549 LOS OSOS VALLEY RD	STE 103	SAN LUIS OBISPO	CA	93405	6457	40	06079	35.25774909	-120.6917339	San Luis Obispo County
91882	Fee-for-Service	1477953933	1477953933	1	1	FAMILY HEALTH CENTERS	8/7/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4874 POLK AVENUE	None	SAN DIEGO	CA	92105	2026	37	06073	32.75139818	-117.0895121	San Diego County
91965	Fee-for-Service	1861791105	1861791105	1	1	FRIEDMAN, GERALD S MD INC	3/18/2010	207RN0300X	NA	Nephrology	026	PHYSICIANS	19835	41	Internal Medicine	0	In state provider	None	600 N 13TH AVENUE	STE 100	UPLAND	CA	91786	4905	36	06071	34.10113004	-117.6336234	San Bernardino County
92024	Fee-for-Service	1740227701	1740227701	1	1	FURMAN, GILBERT I MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36440	40	Pediatrics	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
92050	Fee-for-Service	1790785301	1790785301	1	1	FUCHS, MARY A MD	6/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55670	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
92109	Fee-for-Service	1730376179	1730376179	1	1	FRENCH, AIMEE N MD	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	104679	None	None	0	In state provider	None	161 N MCKINLEY AVE	SUITE 105	CORONA	CA	92879	6530	33	06065	33.88515306	-117.5167674	Riverside County
92120	Fee-for-Service	1902977895	1902977895	1	1	FLATAUER, FRANK E MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	36521	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
92130	Fee-for-Service	1841237005	1841237005	1	1	FOSTER, CARLA S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	214 W 1500 S	None	BOUNTIFUL	UT	84010	7408	00	None	40.87477748	-111.8859705	Davis County
92148	Fee-for-Service	1093944134	1093944134	1	1	FIRER, DANIEL J MD	5/14/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	143295	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	1651	56	06111	34.27771547	-119.2540344	Ventura County
92170	Fee-for-Service	1477953933	1477953933	1	1	FAMILY HEALTH CENTERS	9/25/2015	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4874 POLK AVENUE	None	SAN DIEGO	CA	92105	2026	37	06073	32.75139818	-117.0895121	San Diego County
92175	Fee-for-Service	1548587546	1548587546	1	1	FERNG, TIMOTHY T MD	7/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136491	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
92185	Fee-for-Service	1770789380	1770789380	1	1	FOWLER, STEVEN J MD	8/30/2022	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	81705	None	None	0	In state provider	None	1850 EL CAMINO REAL	SUITE 200	BURLINGAME	CA	94010	3102	41	06081	37.59600871	-122.384453	San Mateo County
92186	Fee-for-Service	1699160325	1699160325	1	1	FLANNERY, KAITLIN M MD	5/21/2019	207L00000X	NA	Other	026	PHYSICIANS	143718	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
92212	Fee-for-Service	1316901630	1316901630	1	1	FONG, LAWRENCE H MD	8/20/1995	207R00000X	NA	Other	026	PHYSICIANS	78909	78	Neoplastic Diseases/Oncology	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
92287	Fee-for-Service	1750453403	1750453403	1	1	FERNANDEZ Y GARCIA,	5/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86775	40	Pediatrics	0	In state provider	BIANCA C MD	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
92317	Fee-for-Service	1740227701	1740227701	1	1	FURMAN, GILBERT I MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36440	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
92332	Fee-for-Service	1417613233	1417613233	1	1	FOLGAR, GISELLE LMFT	7/3/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
92356	Fee-for-Service	1922485952	1922485952	1	1	FOOTHILL HEALTH CENTER	9/28/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	5504 MONTEREY HWY	None	SAN JOSE	CA	95138	1529	43	06085	37.2546727	-121.8004013	Santa Clara County
92447	Fee-for-Service	1730218801	1730218801	1	1	FAIR, NAOMI A LMFT	10/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 29TH STREET	SUITE 401	OAKLAND	CA	94609	3549	01	06001	37.81784861	-122.2652263	Alameda County
92453	Fee-for-Service	1174635353	1174635353	1	1	FRANK BROWN	11/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2400 N WASHINGTON BLVD	None	NORTH OGDEN	UT	84414	7233	00	None	41.30169729	-111.9687457	Weber County
92460	Fee-for-Service	1477953933	1477953933	1	1	FAMILY HEALTH CENTERS	6/15/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4874 POLK AVENUE	None	SAN DIEGO	CA	92105	2026	37	06073	32.75139818	-117.0895121	San Diego County
92480	Fee-for-Service	1265846505	1265846505	1	1	FLORES, ERIKA A LMFT	2/13/2024	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
92492	Fee-for-Service	1356387187	1356387187	1	1	FULLER, NEEMA MD	4/22/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	54745	08	Family Practice	0	In state provider	None	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
92517	Fee-for-Service	1184702979	1184702979	1	1	FONG, EMORY N MD	8/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	55761	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
92519	Fee-for-Service	1285198192	1285198192	1	1	FULLERTON HEALTHCARE, INC	5/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2800 N HARBOR BLVD	None	FULLERTON	CA	92835	1727	30	06059	33.90262026	-117.9292716	Orange County
92556	Fee-for-Service	1255955670	1255955670	1	1	FRANK, DALIA D LMFT	8/9/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12522 MOORPARK ST	106	STUDIO CITY	CA	91604	1355	19	06037	34.15033253	-118.406061	Los Angeles County
92643	Fee-for-Service	1922485952	1922485952	1	1	FOOTHILL HEALTH CENTER	10/25/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	5504 MONTEREY HWY	None	SAN JOSE	CA	95138	1529	43	06085	37.2546727	-121.8004013	Santa Clara County
92694	Fee-for-Service	1336853126	1336853126	1	1	FEARN, ROBERT I MD	2/3/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
92848	Fee-for-Service	1194727859	1194727859	1	1	FITZGIBBON, MICHAEL W MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	34615	77	Infectious Disease	0	In state provider	None	1913 E 17TH ST	STE 102	SANTA ANA	CA	92705	8627	30	06059	33.76000545	-117.8399925	Orange County
92849	Fee-for-Service	1780258913	1780258913	1	1	FRIENDLY HOSPICE CARE INC	7/29/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1700 E LINCOLN AVE	SUITE 202	ANAHEIM	CA	92805	4347	30	06059	33.84008418	-117.8937053	Orange County
92889	Fee-for-Service	1952412793	1952412793	1	1	FLEMING, BRIAN J	1/1/1999	213EP1101X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	131 N EL MOLINO AVE	None	PASADENA	CA	91101	1873	19	06037	34.14834	-118.1369375	Los Angeles County
92917	Fee-for-Service	1881615466	1881615466	1	1	FABRICANT, ROBERT N MD	5/1/1993	207W00000X	NA	Ophthalmology	026	PHYSICIANS	30028	18	Ophthalmology	0	In state provider	None	555 N 13TH AVE	None	UPLAND	CA	91786	4904	36	06071	34.10042233	-117.6335451	San Bernardino County
92930	Fee-for-Service	1922485952	1922485952	1	1	FOOTHILL HEALTH CENTER	10/14/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	5504 MONTEREY HWY	None	SAN JOSE	CA	95138	1529	43	06085	37.2546727	-121.8004013	Santa Clara County
92990	Fee-for-Service	1871055574	1871055574	1	1	FORT, VICTORIA K MD	8/22/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178115	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
93029	Fee-for-Service	1972681690	1972681690	1	1	FELIX, MICHAEL S MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	62483	25	Physical Medicine and Rehabilitation	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
93069	Fee-for-Service	1407807316	1407807316	1	1	FEINGOLD, DAVID L MD	6/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	78522	20	Orthopedic Surgery	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
93084	Fee-for-Service	1467618454	1467618454	1	1	FARROKHI, FARNOOSH MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125827	67	Endocrinology	0	In state provider	None	20101 LAKE CHABOT ROAD	3RD FLOOR	CASTRO VALLEY	CA	94546	3746	01	06001	37.69819004	-122.0873124	Alameda County
93137	Fee-for-Service	1780258913	1780258913	1	1	FRIENDLY HOSPICE CARE INC	7/29/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1700 E LINCOLN AVE	SUITE 202	ANAHEIM	CA	92805	4347	30	06059	33.84008418	-117.8937053	Orange County
93147	Fee-for-Service	1023150141	1023150141	1	1	FROM THE HEART PHYSICAL	11/21/2011	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	THERAPY, INC	7854 TAMPA AVE	None	RESEDA	CA	91335	1701	19	06037	34.213608	-118.553503	Los Angeles County
93156	Fee-for-Service	1588912919	1588912919	1	2	FUNES, GUADALUPE LCSW	7/26/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1875 W REDONDO BEACH BLV	STE 303	GARDENA	CA	90247	3644	19	06037	33.8879044	-118.3111113	Los Angeles County
93163	Fee-for-Service	1255314126	1255314126	1	1	FOLAN, LUIS A MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88732	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
93209	Fee-for-Service	1093141640	1093141640	1	1	FARHAT, BOBBY LMFT	5/23/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5149 MOORPARK AVE	107A	SAN JOSE	CA	95129	2156	43	06085	37.30955411	-121.9929659	Santa Clara County
93220	Fee-for-Service	1922485952	1922485952	1	1	FOOTHILL HEALTH CENTER	9/28/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	5504 MONTEREY HWY	None	SAN JOSE	CA	95138	1529	43	06085	37.2546727	-121.8004013	Santa Clara County
93297	Fee-for-Service	1235576042	1235576042	1	1	FARMAND, FARNUSH PSYD	8/13/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
93360	Fee-for-Service	1578553905	1578553905	1	1	FEINSTEIN, EBEN I MD	12/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	35786	45	Nephrology (Renal-Kidney)	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
93401	Fee-for-Service	1467730788	1467730788	1	1	FONG, FLORENCE L	6/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116094	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
93422	Fee-for-Service	1235663675	1235663675	1	1	FORE, MATTHEW S MD	9/14/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171910	None	None	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
93452	Fee-for-Service	1144300237	1144300237	1	1	FALCONE, RICHARD A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3333 BURNET AVE	None	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
93553	Fee-for-Service	1427744366	1427744366	1	1	FLORES, DEBBIE	3/14/2025	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1231 ROBINHOOD DR	A2	STOCKTON	CA	95207	5506	39	06077	37.9992686	-121.3219878	San Joaquin County
93593	Fee-for-Service	1467433763	1467433763	1	1	FAIRFIELD MEDICAL CENTER	10/7/2010	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	401 N EWING ST	None	LANCASTER	OH	43130	3372	00	None	39.71756213	-82.57660192	Fairfield County
93638	Fee-for-Service	1225008568	1225008568	1	1	FEIYU XUE	11/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	125 N 18TH ST	STE C	MOUNT VERNON	WA	98273	3902	00	None	48.422061	-122.318878	Skagit County
93707	Fee-for-Service	1205973898	1205973898	1	1	FREEHILL, MICHAEL T MD	4/1/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	112639	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
93752	Fee-for-Service	1316561384	1316561384	1	1	FRANCISCO, ALLAIN G MD	10/4/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178113	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
93812	Fee-for-Service	1376615781	1376615781	1	1	FAHIM, MARIAM W DO	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9032	40	Pediatrics	0	In state provider	None	400 N PEPPER AVE	6TH FLOOR SOUTH	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
93821	Fee-for-Service	1942372933	1942372933	1	1	FIFTY-O-ONE PARKHURST	12/11/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5001 PARKHURST DR	None	SANTA ROSA	CA	95409	3221	49	06097	38.476089	-122.6612835	Sonoma County
93839	Fee-for-Service	1346361813	1346361813	1	1	FRANK DEPIETRO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3811 OHARA STREET	None	PITTSBURGH	PA	15213	0000	00	None	40.44350017	-79.95952606	Allegheny County
93847	Fee-for-Service	1184857773	1184857773	1	1	FOXWELL, CHARLES E LCSW	4/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
93882	Fee-for-Service	1467433763	1467433763	1	1	FAIRFIELD MEDICAL CENTER	10/7/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	401 N EWING ST	None	LANCASTER	OH	43130	3372	00	None	39.71756213	-82.57660192	Fairfield County
93955	Fee-for-Service	1528055472	1528055472	1	1	FREEMAN, IRA N	7/17/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12660 RIVERSIDE DR	STE 100	VALLEY VILLAGE	CA	91607	3430	19	06037	34.1575795	-118.409499	Los Angeles County
93959	Fee-for-Service	1396834412	1396834412	1	1	FULLER, BRIAN G MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	65795	30	Radiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
94001	Fee-for-Service	1548210578	1548210578	1	1	FACULTY PHYSICIANS &	8/1/1996	208VP0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM-PAIN M	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
94006	Fee-for-Service	1750440376	1750440376	1	1	FLORES, FRANK H MD	3/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63342	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
94112	Fee-for-Service	1174130934	1174130934	2	1	FOSTER, SAMANTHA E LMFT	7/15/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	86 N. CRAIG AVE	APT 6	PASADENA	CA	91107	3574	19	06037	34.14765466	-118.1061781	Los Angeles County
94143	Fee-for-Service	1124023494	1124023494	2	1	FIVE STAR HOME HEALTH INC	7/28/2010	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8616 LA TIJERA BLVD	SUITE 408	LOS ANGELES	CA	90045	3944	19	06037	33.95943215	-118.3918599	Los Angeles County
94185	Fee-for-Service	1801823067	1801823067	1	1	FERGUSON, KEVIN L MD	10/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71757	22	Pathology (M.D. only)	0	In state provider	None	3701 S HIGUERA ST	STE 200	SAN LUIS OBISPO	CA	93401	7462	40	06079	35.2507845	-120.6712168	San Luis Obispo County
94191	Fee-for-Service	1790056380	1790056380	1	1	FIELDS, EMMACULATE M NP	7/19/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
94217	Fee-for-Service	1427384221	1427384221	1	1	FANARI, ZAHER MD	12/2/2022	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	183146	None	None	0	In state provider	None	2335 E KASHIAN LANE	STE 240	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
94241	Fee-for-Service	1366761751	1366761751	1	1	FERREIRA, ALEKSANDRA V DO	8/3/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	-	None	None	1	Border provider	None	2020 WELLNESS WAY	#300	LAS VEGAS	NV	89106	4145	00	None	36.16163146	-115.1686755	Clark County
94372	Fee-for-Service	1942392600	1942392600	1	1	FINLEY HOSPTIAL	12/5/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 N GRANDVIEW AVE	None	DUBUQUE	IA	52001	6388	00	None	42.49589131	-90.68759467	Dubuque County
94479	Fee-for-Service	1801823067	1801823067	1	1	FERGUSON, KEVIN L MD	10/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71757	68	Hematology	0	In state provider	None	3701 S HIGUERA ST	STE 200	SAN LUIS OBISPO	CA	93401	7462	40	06079	35.2507845	-120.6712168	San Luis Obispo County
94486	Fee-for-Service	1043664766	1043664766	1	1	FAMILY HEALTHCARE NETWORK	1/9/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1008 N CHERRY STREET	None	TULARE	CA	93274	2212	54	06107	36.22217583	-119.3376171	Tulare County
94501	Fee-for-Service	1346231735	1346231735	1	1	FONG, YUMAN MD	6/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130488	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
94559	Fee-for-Service	1306546577	1306546577	1	1	FRAPPAOLO, WILLIAM T CRNA	7/21/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
94644	Fee-for-Service	1639304199	1639304199	1	1	FORAN, JENNIFER M MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129027	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
94655	Fee-for-Service	1679282438	1679282438	1	1	FACTOR, REINA S PHD	12/13/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
94775	Fee-for-Service	1043664766	1043664766	1	1	FAMILY HEALTHCARE NETWORK	7/2/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1008 N CHERRY STREET	None	TULARE	CA	93274	2212	54	06107	36.22217583	-119.3376171	Tulare County
94781	Fee-for-Service	1205884566	1205884566	1	1	FROMM, CHRISTOPHER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1440 N MAIN ST	None	SPEARFISH	SD	57783	1505	00	None	44.4981735	-103.8611443	Lawrence County
94845	Fee-for-Service	1295823680	1295823680	1	1	FRICKS, CARL ELLISON	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	69384	41	Internal Medicine	0	In state provider	None	9850 GENESEE AVE	STE 780	LA JOLLA	CA	92037	1232	37	06073	32.882913	-117.226341	San Diego County
94884	Fee-for-Service	1437410925	1437410925	1	1	FRUHAN, SCOTT A MD	6/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136193	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
94923	Fee-for-Service	1679688014	1679688014	1	1	FERNYAK, SUSAN E MD	1/29/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	52402	41	Internal Medicine	0	In state provider	None	SFIA, INT'L TERM.AIRPORT	None	SAN FRANCISCO	CA	94128	0000	38	06075	37.633327	-122.3979544	San Mateo County
94958	Fee-for-Service	1790812642	1790812642	1	1	FONG, THOMAS H MD	8/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104522	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
94994	Fee-for-Service	1790855161	1790855161	1	2	FIDERE ANESTHESIA CONSULTANT	2/25/2021	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	S, INC.	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
94996	Fee-for-Service	1083886741	1083886741	1	1	FAN, AMELIA M MD	6/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103199	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
95016	Fee-for-Service	1750602397	1750602397	1	1	FORREST, ADAM J DO	7/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	11890	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
95020	Fee-for-Service	1033434071	1033434071	1	1	FOLTZ, CAINAN H MD	8/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116914	38	Geriatrics	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
95028	Fee-for-Service	1962441675	1962441675	1	1	FODA, RUSSELL P. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5151 REED RD	STE 105B	COLUMBUS	OH	43220	2595	00	None	40.06279476	-83.06661134	Franklin County
95051	Fee-for-Service	1487040366	1487040366	1	1	FULLIN, DANIEL C MD	8/7/2021	207L00000X	NA	Other	026	PHYSICIANS	171818	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
95055	Fee-for-Service	1770679102	1770679102	1	1	FIGUEROA, MANUEL I MD	12/1/1993	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	21870	08	Family Practice	0	In state provider	None	816 S INDIANA ST	None	LOS ANGELES	CA	90023	1820	19	06037	34.024896	-118.192291	Los Angeles County
95060	Fee-for-Service	1043664766	1043664766	1	1	FAMILY HEALTHCARE NETWORK	3/30/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1008 N CHERRY STREET	None	TULARE	CA	93274	2212	54	06107	36.22217583	-119.3376171	Tulare County
95090	Fee-for-Service	1477525608	1477525608	1	1	FLEISCHMANN, THOMAS OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3704 MARCONI AVE	STE 2	SACRAMENTO	CA	95821	5338	34	06067	38.61747	-121.378446	Sacramento County
95093	Fee-for-Service	1568553022	1568553022	1	1	FELDKAMP IV, IRVING M MD	5/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94750	01	General Practice	0	In state provider	None	2777 LONG BEACH BLVD	None	LONG BEACH	CA	90806	1571	19	06037	33.80734327	-118.189472	Los Angeles County
95098	Fee-for-Service	1124549878	1124549878	1	1	FORD, ARIEL R NP	7/6/2020	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
95099	Fee-for-Service	1376251645	1376251645	1	1	FRESNO OPERATIONS, LP	10/5/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7442 N MILLBROOK AVE	None	FRESNO	CA	93720	3241	10	06019	36.84422063	-119.7657382	Fresno County
95119	Fee-for-Service	1558440131	1558440131	1	1	FIORENTINO, RANDY P MD	7/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83405	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	DR R P FIORENTINO CO	805 W LA VETA AVE	STE 101	ORANGE	CA	92868	3928	30	06059	33.78064152	-117.8606475	Orange County
95162	Fee-for-Service	1851398218	1851398218	1	1	FIDAI, GULZAR MD	2/21/2023	207R00000X	NA	Other	026	PHYSICIANS	156740	None	None	0	In state provider	None	275 HOSPITAL DRIVE	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
95226	Fee-for-Service	1518399138	1518399138	1	1	FARHADI LANGROUDI, KHASHAYAR	9/25/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYD	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
95273	Fee-for-Service	1144308057	1144308057	1	1	FIGUEROA, NORMA E MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71062	40	Pediatrics	0	In state provider	None	1500 S CENTRAL AVE	STE 310	GLENDALE	CA	91204	2581	19	06037	34.12736888	-118.257777	Los Angeles County
95291	Fee-for-Service	1528616117	1528616117	1	3	FRED BROWN'S RECOVERY SERVIC	5/15/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ES, INC.	505 S PACIFIC AVE	103, 104, 105, 106, 203,	SAN PEDRO	CA	90731	2656	19	06037	33.739479	-118.2879355	Los Angeles County
95339	Fee-for-Service	1033195888	1033195888	2	1	FRIEDMAN, ARTHUR OD	5/6/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7890 HAVEN AVE	STE 17	RANCHO CUCAMONGA	CA	91730	3051	36	06071	34.110342	-117.5759955	San Bernardino County
95348	Fee-for-Service	1043664766	1043664766	1	1	FAMILY HEALTHCARE NETWORK	1/9/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1008 N CHERRY STREET	None	TULARE	CA	93274	2212	54	06107	36.22217583	-119.3376171	Tulare County
95358	Fee-for-Service	1932280450	1932280450	1	1	FERMELIA, DAVID E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	57874	02	General Surgery	0	In state provider	None	8631 W 3RD ST	STE 710E	LOS ANGELES	CA	90048	5911	19	06037	34.07361928	-118.3803143	Los Angeles County
95444	Fee-for-Service	1659825404	1659825404	1	1	FERREYRA, MONICA R LCSW	11/22/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2829 WATT AVENUE	None	SACRAMENTO	CA	95821	6237	34	06067	38.615247	-121.383558	Sacramento County
95471	Fee-for-Service	1033435995	1033435995	1	1	FU, OLIVIA S MD	9/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124319	41	Internal Medicine	0	In state provider	None	2200 O'FARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
95496	Fee-for-Service	1912930165	1912930165	1	1	FE B ADVINCULA MD INC	4/21/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	DOCTORS MEDICAL GROUP	1300 S SUNSET AVE	None	WEST COVINA	CA	91790	3342	19	06037	34.0601054	-117.9474205	Los Angeles County
95518	Fee-for-Service	1104013192	1104013192	1	1	FOSTER, ROCHAUNDA M	6/28/2011	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	11861 TIFFANY ST	None	VICTORVILLE	CA	92392	0470	36	06071	34.48435096	-117.4050517	San Bernardino County
95532	Fee-for-Service	1841957297	1841957297	1	1	FLASH MEDICAL, P.C.	1/11/2023	207NS0135X	NA	Dermatology	026	PHYSICIANS	None	None	None	0	In state provider	None	421 N RODEO DR	STE A-1	BEVERLY HILLS	CA	90210	4500	19	06037	34.06967423	-118.4034633	Los Angeles County
95537	Fee-for-Service	1033429519	1033429519	1	1	FEIT, ERIC M DPM INC	3/26/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3655 LOMITA BLVD	STE 120	TORRANCE	CA	90505	1907	19	06037	33.81497113	-118.3489779	Los Angeles County
95546	Fee-for-Service	1205880366	1205880366	1	1	FAMILY PRACTICE MEDICAL	12/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	ASSOCIATES	455 OCONNOR DR	STE 200	SAN JOSE	CA	95128	1632	43	06085	37.326654	-121.939897	Santa Clara County
95721	Fee-for-Service	1326022989	1326022989	1	1	FLYNN, THOMAS F. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10123 SE MARKET ST	None	PORTLAND	OR	97216	2532	00	None	45.51158947	-122.5586205	Multnomah County
95724	Fee-for-Service	1780676957	1780676957	1	1	FLORENCE DIALYSIS CENTER	5/23/2001	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	351 W FLORENCE AVE	None	LOS ANGELES	CA	90003	1808	19	06037	33.97468349	-118.279962	Los Angeles County
95740	Fee-for-Service	1386687929	1386687929	1	1	FANG, MEILING L MD	10/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	54068	07	Dermatology	0	In state provider	None	21840 S NORMANDIE AVE	STE 100	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
95785	Fee-for-Service	1912930165	1912930165	1	1	FE B ADVINCULA MD INC	4/21/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	DOCTORS MEDICAL GROUP	1300 S SUNSET AVE	None	WEST COVINA	CA	91790	3342	19	06037	34.0601054	-117.9474205	Los Angeles County
95800	Fee-for-Service	1710065370	1710065370	1	1	FOX, KENNETH ARON MD	8/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91853	13	Neurology (M.D. only)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
95835	Fee-for-Service	1720688054	1720688054	1	2	FOUNDATION MEDICINE, INC.	3/4/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	150 2ND ST	None	CAMBRIDGE	MA	02141	2115	00	None	42.367014	-71.0788635	Middlesex County
95874	Fee-for-Service	1568772820	1568772820	1	1	FAIRMOUNT PODIATRY GROUP	8/6/2012	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	7524 FAIRMOUNT AVENUE	None	EL CERRITO	CA	94530	3746	07	06013	37.90405432	-122.2914004	Contra Costa County
95892	Fee-for-Service	1982358057	1982358057	1	1	FLINT, KIRSTYN CNP	7/31/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3999 SANTA RITA RD	None	PLEASANTON	CA	94588	3462	01	06001	37.69668269	-121.8754031	Alameda County
95993	Fee-for-Service	1508339862	1508339862	1	1	FRENCH, CODY J	11/2/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
95994	Fee-for-Service	1326467432	1326467432	1	1	FARGUSSON, JOSEPH E MD	7/1/2017	390200000X	NA	Other	026	PHYSICIANS	139039	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
96010	Fee-for-Service	1265547210	1265547210	1	1	FISHER, A JAMES III DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	817 HARRIS ST	None	EUREKA	CA	95503	4541	12	06023	40.78039596	-124.1596783	Humboldt County
96055	Fee-for-Service	1821109190	1821109190	1	1	FELDMAN, DAVID P MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92326	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
96068	Fee-for-Service	1184995334	1184995334	1	1	FRECCERO, ALLISON D OT	4/6/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
96070	Fee-for-Service	1912930165	1912930165	1	1	FE B ADVINCULA MD INC	4/21/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	DOCTORS MEDICAL GROUP	1300 S SUNSET AVE	None	WEST COVINA	CA	91790	3342	19	06037	34.0601054	-117.9474205	Los Angeles County
96114	Fee-for-Service	1427875467	1427875467	1	1	FREY, KENDALL	9/24/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	29	06057	0	0	None
96170	Fee-for-Service	1205009917	1205009917	1	1	FACULTY PHYSICIANS AND SURGE	4/15/2008	208G00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	ONS OF LLUSM	18182 US HIGHWAY 18	SUITE 104	APPLE VALLEY	CA	92307	2200	36	06071	34.54087945	-117.267147	San Bernardino County
96285	Fee-for-Service	1396124293	1396124293	1	1	FOAD ELAHI MD CALIFORNIA CEN	11/5/2019	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	TER OF PAIN MEDICINE AND	1144 NORMAN DR	104	MANTECA	CA	95336	5925	39	06077	37.79425166	-121.1998524	San Joaquin County
96294	Fee-for-Service	1871273979	1871273979	1	1	FUENTES, ELISA D OT	7/25/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W HOSPITALITY LN	103	SAN BERNARDINO	CA	92408	3249	36	06071	34.0659135	-117.289215	San Bernardino County
96340	Fee-for-Service	1861835563	1861835563	1	1	FUREY, LAUREN CCC-SLP	6/26/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
96349	Fee-for-Service	1508022385	1508022385	1	1	FOWLER, PAUL D MD	4/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112575	40	Pediatrics	0	In state provider	None	610 E ROMIE LANE	SUITE 2	SALINAS	CA	93901	4209	27	06053	36.65952777	-121.6444287	Monterey County
96353	Fee-for-Service	1932364759	1932364759	1	1	FINCH, JULI D LCSW	3/11/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
96370	Fee-for-Service	1497216543	1497216543	1	1	FLORES, JAN F PT	11/8/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
96454	Fee-for-Service	1942205240	1942205240	1	1	FEIL, STAN H MD	11/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84602	18	Ophthalmology	0	In state provider	None	112 N AKERS ST	STE A	VISALIA	CA	93291	5121	54	06107	36.330156	-119.3483475	Tulare County
96458	Fee-for-Service	1205009917	1205009917	1	1	FACULTY PHYSICIANS AND SURGE	4/15/2008	208G00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ONS OF LLUSM	18182 US HIGHWAY 18	SUITE 104	APPLE VALLEY	CA	92307	2200	36	06071	34.54087945	-117.267147	San Bernardino County
96475	Fee-for-Service	1780625988	1780625988	1	1	FRANCO, JUDITH A CRNA	3/18/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 N STATE ST	STE 14-901	LOS ANGELES	CA	90089	0287	19	06037	34.05855992	-118.209755	Los Angeles County
96562	Fee-for-Service	1447655055	1447655055	1	1	FARBER, ADAM L CRNA	10/29/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
96643	Fee-for-Service	1225815954	1225815954	1	1	FIVE EIGHTEEN INC	11/1/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	12823 COLLINS ST	None	VALLEY VILLAGE	CA	91607	1406	19	06037	34.17371699	-118.4126944	Los Angeles County
96689	Fee-for-Service	1104383801	1104383801	1	1	FUJITA, HOLLY OT	3/15/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
96744	Fee-for-Service	1205009917	1205009917	1	1	FACULTY PHYSICIANS AND SURGE	4/15/2008	208G00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	ONS OF LLUSM	18182 US HIGHWAY 18	SUITE 104	APPLE VALLEY	CA	92307	2200	36	06071	34.54087945	-117.267147	San Bernardino County
96765	Fee-for-Service	1659864205	1659864205	1	1	FONG, AMY W MD	11/9/2021	207R00000X	NA	Other	026	PHYSICIANS	173498	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
96780	Fee-for-Service	1982051058	1982051058	1	1	FRANGOS, STEPHANIE N MD	10/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140083	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
96860	Fee-for-Service	1275511396	1275511396	1	1	FREEMAN, L WAYNE MD INC	7/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	31899	18	Ophthalmology	0	In state provider	None	5220 CLARK AVE	STE 420	LAKEWOOD	CA	90712	2631	19	06037	33.8527092	-118.1337623	Los Angeles County
96906	Fee-for-Service	1376621276	1376621276	1	1	FARRELL, STEPHEN M MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	49492	01	General Practice	0	In state provider	PALO ALTO MED CLINIC	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
96962	Fee-for-Service	1386694313	1386694313	1	1	FACULTY PHYSICIANS AND	1/30/2004	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	SURGEONS OF LLUSM	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
96963	Fee-for-Service	1588665657	1588665657	1	1	FAN, BUNCHEN R MD	5/29/1995	174400000X	NA	Other	026	PHYSICIANS	43151	40	Pediatrics	0	In state provider	None	4124 ROSEMEAD BLVD	STE A	ROSEMEAD	CA	91770	4400	19	06037	34.08249645	-118.0731651	Los Angeles County
96970	Fee-for-Service	1952332827	1952332827	1	1	FRANCO, RUBEN G MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73741	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
97008	Fee-for-Service	1265192512	1265192512	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2057 HIGH STREET	None	SELMA	CA	93662	3512	10	06019	36.5696877	-119.6130418	Fresno County
97054	Fee-for-Service	1831260470	1831260470	1	1	FOLSOM, DOUGLAS L MD	7/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	20961	08	Family Practice	0	In state provider	None	22101 REDWOOD RD	None	CASTRO VALLEY	CA	94546	7107	01	06001	37.68666803	-122.0735922	Alameda County
97066	Fee-for-Service	1679864912	1679864912	1	1	FLEMING, NATHAN MD	1/23/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	191507	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
97077	Fee-for-Service	1033291331	1033291331	1	1	FRESNO UNIF SCHOOL DIST	3/8/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1301 M STREET	None	FRESNO	CA	93721	1807	10	06019	36.73931877	-119.790654	Fresno County
97139	Fee-for-Service	1639459654	1639459654	1	1	FARHAD SIGARI MD FACS PC	10/21/2021	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4640 ADMIRALTY WAY	718	MARINA DEL REY	CA	90292	6621	19	06037	33.98120707	-118.4409729	Los Angeles County
97187	Fee-for-Service	1033847397	1033847397	1	1	FRANDO, CHARLENE R NP	7/1/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3033 W ORANGE AVE	None	ANAHEIM	CA	92804	3156	30	06059	33.82476552	-117.994914	Orange County
97197	Fee-for-Service	1194807289	1194807289	1	1	FARLEY, JOY L MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82611	08	Family Practice	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
97212	Fee-for-Service	1528019239	1528019239	1	1	FUTERNICK, MARC A MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64094	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
97218	Fee-for-Service	1093799967	1093799967	1	1	FLAHARTY, GINA E NP	5/28/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
97227	Fee-for-Service	1285959106	1285959106	1	1	FALAKASSA, JONATHAN J MD	9/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135025	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
97242	Fee-for-Service	1770015315	1770015315	1	1	FELDMAN, MAJA A MD	5/26/2020	207P00000X	NA	Other	026	PHYSICIANS	160135	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
97247	Fee-for-Service	1750313268	1750313268	1	1	FANN, JAMES I-LIN MD	5/31/1995	208G00000X	NA	General Surgery	026	PHYSICIANS	57873	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
97263	Fee-for-Service	1174545677	1174545677	1	1	FISCHER, EDGAR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
97291	Fee-for-Service	1407199797	1407199797	1	1	FRANKO, DENISE M MD	8/10/2021	207L00000X	NA	Other	026	PHYSICIANS	170805	None	None	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
97297	Fee-for-Service	1265192512	1265192512	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2057 HIGH STREET	None	SELMA	CA	93662	3512	10	06019	36.5696877	-119.6130418	Fresno County
97299	Fee-for-Service	1861576845	1861576845	1	1	FISHER, SCOTT W	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	41278	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
97365	Fee-for-Service	1033291331	1033291331	1	1	FRESNO UNIF SCHOOL DIST	11/1/2018	No Taxonomy Provided	NA	None	101	UNIFIED SCHOOL DISTRICT	-	-	NOT APPLICABLE	0	In state provider	None	1301 M STREET	None	FRESNO	CA	93721	1807	10	06019	36.73931877	-119.790654	Fresno County
97406	Fee-for-Service	1700964558	1700964558	1	1	FA, EMELINA M MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	71540	30	Radiology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
97495	Fee-for-Service	1316145956	1316145956	1	1	FARHADIAN, ELAHEH MD	9/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100453	41	Internal Medicine	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
97515	Fee-for-Service	1619055373	1619055373	1	1	FENTON, WILLIAM M MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42184	20	Orthopedic Surgery	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
97556	Fee-for-Service	1710341458	1710341458	1	1	FAIN, AUSTIN DO	5/25/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17554	08	Family Practice	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
97560	Fee-for-Service	1225464993	1225464993	1	1	FORDHAM, JOHN A DO	2/9/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	14863	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
97610	Fee-for-Service	1033575246	1033575246	1	1	FRESENIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY LLC	17197 NEWHOPE STREET	SUITE E	FOUNTAIN VALLEY	CA	92708	4228	30	06059	33.713802	-117.9284504	Orange County
97742	Fee-for-Service	1114125143	1114125143	1	1	FLORIDA HOME MEDICAL SUPPLY	10/4/2013	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	INC	1113 N CENTRAL AVE	None	KISSIMMEE	FL	34741	4405	00	None	28.30198638	-81.40773777	Osceola County
97792	Fee-for-Service	1033512132	1033512132	1	1	FRICKE, KATHERINE R LCSW	5/12/2020	225400000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	624 W 9TH ST	103	SAN PEDRO	CA	90731	3158	19	06037	33.73607853	-118.290789	Los Angeles County
97803	Fee-for-Service	1619055373	1619055373	1	1	FENTON, WILLIAM M MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42184	05	Anesthesiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
97804	Fee-for-Service	1811137052	1811137052	1	1	FUNG, LESLIE H MD	10/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107849	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
97909	Fee-for-Service	1306827787	1306827787	1	1	FEROUZ-COLBORN, ALIYA S MD	10/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	84256	04	Otology, Laryngology, Rhinology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
97938	Fee-for-Service	1518371798	1518371798	1	1	FENG, ERIC C MD	10/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15096	41	Internal Medicine	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
97993	Fee-for-Service	1295031862	1295031862	1	1	FARMANI, MARYAM T LMFT	12/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20300 VENTURA BLVD	315	WOODLAND HILLS	CA	91364	0903	19	06037	34.16931134	-118.5754465	Los Angeles County
98061	Fee-for-Service	1871593095	1871593095	1	1	FLORES, ROSEMARY MD	10/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63292	01	General Practice	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
98064	Fee-for-Service	1427637339	1427637339	1	1	FAIRE, MEHLIKA DO	8/8/2024	208M00000X	NA	Other	026	PHYSICIANS	21416	08	Family Practice	0	In state provider	None	1020 29TH STREET	SUITE 570	SACRAMENTO	CA	95816	5125	34	06067	38.572803	-121.4685	Sacramento County
98074	Fee-for-Service	1841746153	1841746153	1	1	FIRST AID TRANSPORTATION LLC	6/23/2019	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1709 INTERNATIONAL BLVD	107	OAKLAND	CA	94606	5035	01	06001	37.7875271	-122.242933	Alameda County
98078	Fee-for-Service	1861570962	1861570962	1	1	FREDMAN, STEVEN M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27167	01	General Practice	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
98108	Fee-for-Service	1114211182	1114211182	1	1	FERGUSON, JENNIFER A	7/22/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1340 LAKE BLVD	None	DAVIS	CA	95616	5673	57	06113	38.55491538	-121.7876886	Yolo County
98162	Fee-for-Service	1558672220	1558672220	1	1	FRIEDMAN, LUCAS MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148282	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	33	06065	33.9760587	-117.3800672	Riverside County
98224	Fee-for-Service	1366496945	1366496945	1	1	FLORES-BYRNE, LIZBETH C NP	11/8/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
98248	Fee-for-Service	1740242445	1740242445	1	1	FOGG, MAXWELL AND LANIER	11/1/2001	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MD INC	40232 JUNCTION DR	None	OAKHURST	CA	93644	8719	20	06039	37.3331485	-119.6588089	Madera County
98356	Fee-for-Service	1336368190	1336368190	1	1	FORTALEZA, PAUL DO	1/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	6703	08	Family Practice	0	In state provider	None	1450 N LAKE AVE	STE A	PASADENA	CA	91104	2301	19	06037	34.17087521	-118.132138	Los Angeles County
98363	Fee-for-Service	1861451858	1861451858	1	5	FULLERTON RADIOLOGY MEDICAL	2/24/1993	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP, INC	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
98378	Fee-for-Service	1295345320	1295345320	1	1	FAHL, ANA-ALICIA M CNP	6/7/2023	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
98404	Fee-for-Service	1326270422	1326270422	1	1	FAMINI, POUYAN MD	12/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114529	67	Endocrinology	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
98469	Fee-for-Service	1578687745	1578687745	1	1	FALLON, DAVID P LMFT	5/12/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
98486	Fee-for-Service	1124381645	1124381645	1	1	FAVINI, NATHAN MD	11/30/2023	207R00000X	NA	Other	026	PHYSICIANS	135758	None	None	0	In state provider	None	95 THIRD ST	None	SAN FRANCISCO	CA	94103	3103	38	06075	37.78653271	-122.402286	San Francisco County
98494	Fee-for-Service	1700244738	1700244738	1	1	FLORES, JAVIER LMFT	11/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	44709 NORTH DATE AVENUE	None	LANCASTER	CA	93536	3101	19	06037	34.69471258	-118.1403055	Los Angeles County
98505	Fee-for-Service	1467101964	1467101964	1	1	FAM CARE HOMES LLC	7/14/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1502 PEPPERTREE PLACE	None	PITTSBURG	CA	94565	5620	07	06013	38.00064802	-121.8668043	Contra Costa County
98526	Fee-for-Service	1942411343	1942411343	1	1	FLEISHMAN, SCOTT PHD	9/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
98539	Fee-for-Service	1104273010	1104273010	1	1	FAY, LILIANA V LMFT	9/27/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1111 MARKET STREET	1ST AND 2ND FLOORS	SAN FRANCISCO	CA	94103	1513	38	06075	37.78018987	-122.4128297	San Francisco County
98560	Fee-for-Service	1063454841	1063454841	1	1	FARAHMAND, MAHNAZ MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63290	10	Gastroenterology (M.D. only)	0	In state provider	None	41715 WINCHESTER RD	None	TEMECULA	CA	92590	4808	33	06065	33.51843041	-117.1680022	Riverside County
98624	Fee-for-Service	1194755660	1194755660	1	1	FLOUM, STEVEN A MD	9/1/2001	207R00000X	NA	Other	026	PHYSICIANS	71104	41	Internal Medicine	0	In state provider	None	1866 N ORANGE GROVE AVE	STE 202	POMONA	CA	91767	3031	19	06037	34.07771682	-117.7485431	Los Angeles County
98688	Fee-for-Service	1326270422	1326270422	1	1	FAMINI, POUYAN MD	12/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114529	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
98700	Fee-for-Service	1174910707	1174910707	1	1	FINKELSHTEYN, ILYA	9/6/2022	208M00000X	NA	Other	026	PHYSICIANS	176673	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
98714	Fee-for-Service	1689943946	1689943946	1	1	FARHADI, PANTEA MD A MEDICAL	9/28/2012	283Q00000X	NA	Hospitals	026	PHYSICIANS	105057	36	Psychiatry	0	In state provider	CORPORATION	9005 ELEVADO	None	LOS ANGELES	CA	90069	4120	19	06037	34.08492712	-118.3875786	Los Angeles County
98736	Fee-for-Service	1528312741	1528312741	1	1	FALLAH, MICHELLE N PSYD	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
98774	Fee-for-Service	1881647642	1881647642	1	1	FANG, YU-HUA MD	6/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	74701	41	Internal Medicine	0	In state provider	None	30250 RANCHO VIEJO RD	STE G	SAN JUAN CAPISTRA	CA	92675	1555	30	06059	33.52319034	-117.6657717	Orange County
98851	Fee-for-Service	1245318997	1245318997	1	1	FALCK, TROY M MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	61558	02	General Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
98912	Fee-for-Service	1881678852	1881678852	1	1	FREEDMAN, ANDREW L MD	12/15/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	67938	34	Urology and Urological Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
98944	Fee-for-Service	1487945077	1487945077	1	1	FRIEDMAN, JOEL L DO	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	12613	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	215 WEST JANSS ROAD	DEPT OF PATHOLOGY	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
98995	Fee-for-Service	1194215665	1194215665	1	1	FUNG, SIMON S M MD	6/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	200 MED PLAZA	STE 1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
98996	Fee-for-Service	1396498804	1396498804	1	1	FITT, ANDREW CRNA	3/30/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1000 GREENLEY ROAD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
99048	Fee-for-Service	1265691281	1265691281	1	1	FEDA, ANDREW M MD	2/16/2023	207R00000X	NA	Other	026	PHYSICIANS	123901	None	None	0	In state provider	None	1922 HILLHURST	STE 200	LOS ANGELES	CA	90027	2712	19	06037	34.106166	-118.2873815	Los Angeles County
99050	Fee-for-Service	1962906859	1962906859	1	1	FALK, SARAH N MD	7/31/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	187052	None	None	0	In state provider	None	4323 W RIVERSIDE DRIVE	None	BURBANK	CA	91505	4044	19	06037	34.15223748	-118.347426	Los Angeles County
99100	Fee-for-Service	1649692351	1649692351	1	1	FAMILY FIRST HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15317 PARAMOUNT BLVD	STE 205	PARAMOUNT	CA	90723	4338	19	06037	33.89423811	-118.1602067	Los Angeles County
99144	Fee-for-Service	1629289178	1629289178	1	1	FOGEL, BRENT L MD	7/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90493	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	# B200	LOS ANGELES	CA	90095	0000	19	06037	34.06473399	-118.445865	Los Angeles County
99146	Fee-for-Service	1902330905	1902330905	1	1	FRANCO, CURTIS J NP	7/10/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	2	Out of state provider	None	500 W THOMAS RD	STE 500	PHOENIX	AZ	85013	4220	00	None	33.481485	-112.080816	Maricopa County
99147	Fee-for-Service	1275814550	1275814550	1	1	FUNDENBERGER, REBECCA K LMFT	8/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1833 W MARCH LN	SUITE 6	STOCKTON	CA	95207	6415	39	06077	37.9875446	-121.3283031	San Joaquin County
99154	Fee-for-Service	1427162783	1427162783	1	1	FEINSTEIN & ROE MDS INC	10/24/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MDS INC	1245 WILSHIRE BLVD	STE 514	LOS ANGELES	CA	90017	4805	19	06037	34.05362775	-118.2661889	Los Angeles County
99160	Fee-for-Service	1831732296	1831732296	1	1	FAMILY PLANNING ASSOCIATES M	7/27/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	EDICAL GROUP INC	4922 WHITTIER BLVD	None	LOS ANGELES	CA	90022	1111	19	06037	34.02163273	-118.1631725	Los Angeles County
99199	Fee-for-Service	1477584126	1477584126	2	1	FINE HOME HEALTH INC	9/21/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2250 OBISPO AVE	STE 101	SIGNAL HILL	CA	90755	4027	19	06037	33.797493	-118.154554	Los Angeles County
99224	Fee-for-Service	1669504700	1669504700	1	1	FINE, STEPHEN LMFT	11/22/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	34932	-	NOT APPLICABLE	0	In state provider	None	11301 WILSHIRE BLVD	BUILDING 212	LOS ANGELES	CA	90073	9998	19	06037	34.055937	-118.458153	Los Angeles County
99292	Fee-for-Service	1063630614	1063630614	1	6	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	40485 MURRIETA HOT SPRIN	STE B2	MURRIETA	CA	92563	6436	33	06065	33.55646034	-117.1785658	Riverside County
99387	Fee-for-Service	1649692351	1649692351	1	1	FAMILY FIRST HOSPICE INC	6/15/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15317 PARAMOUNT BLVD	STE 205	PARAMOUNT	CA	90723	4338	19	06037	33.89423811	-118.1602067	Los Angeles County
99395	Fee-for-Service	1083856355	1083856355	1	1	FISHER, SCOTT T LMFT	4/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
99435	Fee-for-Service	1073921359	1073921359	1	1	FARDGHASSEMI, MARJAN PHD	9/10/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
99456	Fee-for-Service	1922305705	1922305705	1	1	FALKINSTEIN, LINA	1/11/2024	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3413 W PACIFIC AVE	100, 200	BURBANK	CA	91505	1555	19	06037	34.18839272	-118.3485967	Los Angeles County
99487	Fee-for-Service	1477584126	1477584126	2	1	FINE HOME HEALTH INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2250 OBISPO AVE	STE 101	SIGNAL HILL	CA	90755	4027	19	06037	33.797493	-118.154554	Los Angeles County
99535	Fee-for-Service	1720094741	1720094741	1	1	FOX, CYDNEY M	6/5/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	403 W ADAMS BLVD	None	LOS ANGELES	CA	90007	2664	19	06037	34.02741539	-118.2743622	Los Angeles County
99585	Fee-for-Service	1750844304	1750844304	1	1	FYDA, HOLLY D CNP	10/31/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
99670	Fee-for-Service	1932162013	1932162013	2	1	FLORES, ROBERT O MD	9/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	40429	08	Family Practice	0	In state provider	None	11273 LAUREL CANYON BLVD	SUITE 1	SAN FERNANDO	CA	91340	4300	19	06037	34.27498293	-118.4494282	Los Angeles County
99704	Fee-for-Service	1285088328	1285088328	1	1	FOLICK, ANDREW K MD	6/12/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	153782	67	Endocrinology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
99714	Fee-for-Service	1831258425	1831258425	1	1	FUSTER, CARLOS D MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45497	40	Pediatrics	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
99836	Fee-for-Service	1407010234	1407010234	1	1	FU, CATHERINA C MD	6/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94546	30	Radiology	0	In state provider	None	330 LEWIS STREET	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
99895	Fee-for-Service	1780796763	1780796763	1	1	FLORENTINO, ANDREW I MD	11/27/2007	174400000X	NA	Other	026	PHYSICIANS	50125	40	Pediatrics	0	In state provider	MD INC	3585 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2654	19	06037	33.93049543	-118.2057312	Los Angeles County
99920	Fee-for-Service	1154875961	1154875961	1	1	FENTON, DANIEL PHD	5/26/2023	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
99928	Fee-for-Service	1639412091	1639412091	1	1	FONSWORTH, PEOLIA K III MD	5/30/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	132680	-	NOT APPLICABLE	0	In state provider	None	514 W PACIFIC COAST HWY	None	LONG BEACH	CA	90806	5237	19	06037	33.78983955	-118.1985075	Los Angeles County
99930	Fee-for-Service	1164750170	1164750170	1	1	FARROKH, ALI-REZA MD FCCP	8/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117693	None	None	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
100012	Fee-for-Service	1952842171	1952842171	1	1	FUELL WYSONG, ELENA	11/12/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	181967	None	None	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
100063	Fee-for-Service	1609420355	1609420355	1	1	FERGUSON, TRACI NP	10/19/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3148 MIDWAY DRIVE	SUITE 113	SAN DIEGO	CA	92110	5439	37	06073	32.75039352	-117.208269	San Diego County
100234	Fee-for-Service	1083046759	1083046759	1	1	FISCHER, ROBIN B NP	7/18/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
100306	Fee-for-Service	1972072643	1972072643	1	1	FERRO, JESSICA RCP	10/16/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
100384	Fee-for-Service	1124108279	1124108279	1	1	FOSTER, CLARENCE E MD	8/3/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51540	02	General Surgery	0	In state provider	None	101 THE CITY DR S	STE B10	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
100421	Fee-for-Service	1033580402	1033580402	1	1	FAZIOLANDRUM, ANGELA K LCSW	12/7/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
100438	Fee-for-Service	1407963002	1407963002	1	1	FAYNER, SHELDON R MD INC	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	34800	01	General Practice	0	In state provider	None	3356 W BALL RD	STE 206	ANAHEIM	CA	92804	3728	30	06059	33.81726453	-118.007451	Orange County
100452	Fee-for-Service	1790255131	1790255131	1	1	FARAZ, KRYSTAL	4/2/2025	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
100462	Fee-for-Service	1396823019	1396823019	1	1	FLAMM, JASON A MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81870	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
100486	Fee-for-Service	1588021620	1588021620	1	1	FARNHAM, MONICA LMFT	5/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2829 WATT AVENUE	None	SACRAMENTO	CA	95821	6237	34	06067	38.615247	-121.383558	Sacramento County
100521	Fee-for-Service	1750861852	1750861852	1	1	FLORO, MARISSA C PHD	12/18/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
100590	Fee-for-Service	1285729558	1285729558	1	1	FESTEKJIAN, ARA MD	6/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90663	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
100624	Fee-for-Service	1437338951	1437338951	1	1	FUNG, ENRICA M MD	5/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114390	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
100639	Fee-for-Service	1265647119	1265647119	1	1	FRANCES, ESTHER M NP	10/21/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4700 SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
100649	Fee-for-Service	1154384337	1154384337	1	1	FAY, PETER M MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70138	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
100661	Fee-for-Service	1356402747	1356402747	1	1	FOELSCHOW, JAMES L MD	5/1/1985	207L00000X	NA	Other	026	PHYSICIANS	54781	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
100715	Fee-for-Service	1932298593	1932298593	1	1	FAJARDO, ERIC T MD INC	3/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77784	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
100721	Fee-for-Service	1831590371	1831590371	1	1	FRANCO, JOSE L LMFT	9/14/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
100741	Fee-for-Service	1396823019	1396823019	1	1	FLAMM, JASON A MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81870	68	Hematology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
100781	Fee-for-Service	1083959464	1083959464	1	1	FAMILY HEALTH CENTERS OF	6/20/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	352 L STREET	None	CHULA VISTA	CA	91911	1208	37	06073	32.61997526	-117.0739163	San Diego County
100872	Fee-for-Service	1023094737	1023094737	2	1	FOX, STEPHEN G MD	8/18/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	52492	30	Radiology	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
100913	Fee-for-Service	1437338951	1437338951	1	1	FUNG, ENRICA M MD	5/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114390	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
100948	Fee-for-Service	1780740902	1780740902	1	1	FULLERTON JOINT UHSD	7/10/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1051 W BASTANCHURY RD	None	FULLERTON	CA	92833	2247	30	06059	33.88807266	-117.9440874	Orange County
101041	Fee-for-Service	1366537854	1366537854	1	1	FALQUIER, SABRINA A MD	7/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82327	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
101070	Fee-for-Service	1083959464	1083959464	1	1	FAMILY HEALTH CENTERS OF	6/20/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	352 L STREET	None	CHULA VISTA	CA	91911	1208	37	06073	32.61997526	-117.0739163	San Diego County
101113	Fee-for-Service	1215947379	1215947379	1	1	FRONEK, ZDENKA MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46265	83	Rheumatology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
101179	Fee-for-Service	1801842414	1801842414	1	1	FRENCH, TRACI MD	4/8/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180565	08	Family Practice	0	In state provider	None	3415 S SEPULVEDA BLVD	STE 1122	LOS ANGELES	CA	90034	6060	19	06037	34.02086527	-118.4235306	Los Angeles County
101186	Fee-for-Service	1386883114	1386883114	1	1	FIERRO, MIRANDA LCSW	1/16/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
101237	Fee-for-Service	1427702281	1427702281	1	1	FORSHEE, GARRET M CSW	5/24/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
101245	Fee-for-Service	1255628426	1255628426	1	1	FORREST, ASHLEY M	6/15/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
101307	Fee-for-Service	1568680395	1568680395	1	1	FU, MAO-JIN MD	1/1/2009	207R00000X	NA	Other	026	PHYSICIANS	33783	41	Internal Medicine	0	In state provider	None	5450 JEFFERSON AVE	STE 6	CHINO	CA	91710	3522	36	06071	34.0247326	-117.6862355	San Bernardino County
101347	Fee-for-Service	1508881715	1508881715	1	1	FAN, JOSEPH T	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82302	None	None	0	In state provider	None	210 N GARFIELD AVE	STE 212	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
101357	Fee-for-Service	1083959464	1083959464	1	1	FAMILY HEALTH CENTERS OF	3/27/2014	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	352 L STREET	None	CHULA VISTA	CA	91911	1208	37	06073	32.61997526	-117.0739163	San Diego County
101402	Fee-for-Service	1215947379	1215947379	1	1	FRONEK, ZDENKA MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46265	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
101569	Fee-for-Service	1992710552	1992710552	1	1	FRESNO WOMENS MEDICAL	2/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	7050 N RECREATION AVE	STE 102	FRESNO	CA	93720	8001	10	06019	36.83835219	-119.7404373	Fresno County
101574	Fee-for-Service	1578959573	1578959573	1	1	FAMENINI, SHANNON MD	11/1/2019	207R00000X	NA	Other	026	PHYSICIANS	147808	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
101599	Fee-for-Service	1588754006	1588754006	1	1	FONTE-ORDONEZ, TIFFANY M MD	9/16/2022	207R00000X	NA	Other	026	PHYSICIANS	176004	None	None	0	In state provider	None	1375 UNIVERSITY AVE	None	HEALDSBURG	CA	95448	3382	49	06097	38.6272407	-122.8638253	Sonoma County
101613	Fee-for-Service	1528033370	1528033370	1	1	FINE, CLIFFORD L MD	3/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	46702	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	SUITE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
101646	Fee-for-Service	1083959464	1083959464	1	1	FAMILY HEALTH CENTERS OF	8/7/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	352 L STREET	None	CHULA VISTA	CA	91911	1208	37	06073	32.61997526	-117.0739163	San Diego County
101665	Fee-for-Service	1265503155	1265503155	1	1	FANG, HENRY H MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64534	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
101674	Fee-for-Service	1255457487	1255457487	1	1	FAYDO, LINDA M CNM	12/2/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	365 E HILLCREST DR	None	THOUSAND OAKS	CA	91360	5802	56	06111	34.18122452	-118.8704974	Ventura County
101694	Fee-for-Service	1053784215	1053784215	1	1	FRENCH, JOZELLA M LMFT	5/26/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
101712	Fee-for-Service	1124104815	1124104815	1	1	FLORES, MARIBEL C MD	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	95959	08	Family Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2099	37	06073	32.55831005	-117.0475102	San Diego County
101760	Fee-for-Service	1457443798	1457443798	1	1	FREY, MARIETTA I MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61198	40	Pediatrics	0	In state provider	None	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
101766	Fee-for-Service	1316474380	1316474380	1	1	FALATOONZADEH, PAYAM MD	10/5/2022	390200000X	NA	Other	026	PHYSICIANS	162507	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
101850	Fee-for-Service	1730489980	1730489980	1	1	FRENCH, HILLARY A PSYD	2/3/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	565 CASTRO STREET	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38903016	-122.0819046	Santa Clara County
101878	Fee-for-Service	1609501733	1609501733	1	1	FLIKER, AVIVA MD	9/19/2022	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	180643	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
101898	Fee-for-Service	1104064575	1104064575	1	1	FRESNO SKILLED NURSING	1/1/2009	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTRE LLC	1665 M STREET	None	FRESNO	CA	93721	1121	10	06019	36.74258317	-119.7942345	Fresno County
101912	Fee-for-Service	1801821095	1801821095	1	1	FANG, MEIKA A MD	1/1/1995	207RR0500X	NA	Other	026	PHYSICIANS	53684	83	Rheumatology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
101929	Fee-for-Service	1134598014	1134598014	1	1	FREDERICKSON, CYNTHIA L AU	8/21/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	197 E CAROLINE ST	None	SAN BERNARDINO	CA	92408	3731	36	06071	34.06143353	-117.2822085	San Bernardino County
102008	Fee-for-Service	1497829972	1497829972	1	1	FARAHANCHI, ARASH DO	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9462	41	Internal Medicine	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
102165	Fee-for-Service	1528821956	1528821956	1	1	FENIX LUMI CORP	11/20/2024	193200000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	22500 TOWN CIR	STE 2108	MORENO VALLEY	CA	92553	7517	33	06065	33.94084671	-117.2722299	Riverside County
102209	Fee-for-Service	1366885410	1366885410	1	1	FOOTFIX APC	7/3/2013	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	724 SANTA MONICA BLVD	None	SANTA MONICA	CA	90401	2602	19	06037	34.01924558	-118.4916504	Los Angeles County
102323	Fee-for-Service	1326573734	1326573734	1	1	FURMAN, KARA E MD	8/21/2023	207L00000X	NA	Other	026	PHYSICIANS	162127	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
102380	Fee-for-Service	1093009169	1093009169	1	1	FISCHER, MATTHEW A MD	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133152	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
102446	Fee-for-Service	1629307665	1629307665	1	1	FONG, MINCH K MD INC	9/22/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	78910	78	Neoplastic Diseases/Oncology	0	In state provider	None	26691 PLAZA DRIVE	SUITE 200	MISSION VIEJO	CA	92691	8582	30	06059	33.56533763	-117.6645538	Orange County
102544	Fee-for-Service	1245214105	1245214105	1	1	FINNEY, LYNNE A H	11/12/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	480 PLUMAS BOULEVARD	SUITE 204	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
102597	Fee-for-Service	1548541121	1548541121	1	1	FREED, ELIZABETH A BATES PSY	6/17/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2400 BATH STREET	STE 202	SANTA BARBARA	CA	93105	4351	42	06083	34.43168847	-119.7234694	Santa Barbara County
102618	Fee-for-Service	1598883167	1598883167	1	1	FIJOLEK, LESLIE B LCSW	3/6/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
102708	Fee-for-Service	1437880721	1437880721	1	1	FEITOSA, VINCENT NP	8/16/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
102732	Fee-for-Service	1629307665	1629307665	1	1	FONG, MINCH K MD INC	9/22/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	78910	68	Hematology	0	In state provider	None	26691 PLAZA DRIVE	SUITE 200	MISSION VIEJO	CA	92691	8582	30	06059	33.56533763	-117.6645538	Orange County
102787	Fee-for-Service	1871504498	1871504498	1	1	FERNANDEZ, GENARO C MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	45754	66	Emergency Medicine (Urgent Care)	0	In state provider	None	610 EUCLID AVE	STE 201	NATIONAL CITY	CA	91950	2952	37	06073	32.68419388	-117.0829524	San Diego County
102819	Fee-for-Service	1336393578	1336393578	1	1	FITZGERALD, MICHAEL W MD	5/19/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	73710	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
102894	Fee-for-Service	1497876247	1497876247	1	1	FONG, DEREK G MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77880	41	Internal Medicine	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
102907	Fee-for-Service	1720406101	1720406101	1	1	FENIK, YELENA MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145447	40	Pediatrics	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
102915	Fee-for-Service	1306231998	1306231998	1	1	FARKAS-SKILES, CRISTINA M MD	11/10/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	147776	None	None	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
102947	Fee-for-Service	1861456980	1861456980	1	1	FERNANDEZ, EDGAR J MD	5/1/1984	208600000X	NA	General Surgery	026	PHYSICIANS	31698	02	General Surgery	0	In state provider	None	11100 WARNER AVENUE	#320A	FOUNTAIN VALLEY	CA	92708	5713	30	06059	33.716291	-117.9355051	Orange County
102987	Fee-for-Service	1316051204	1316051204	1	1	FIELDS, SCOTT A MD	4/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85759	02	General Surgery	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
103011	Fee-for-Service	1548847437	1548847437	1	1	FEUVRIER, ARIANA S	10/22/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
103014	Fee-for-Service	1285277624	1285277624	1	1	FUTRITSKI, VIKTORIA NP	4/28/2023	363LG0600X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
103075	Fee-for-Service	1871504498	1871504498	1	1	FERNANDEZ, GENARO C MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	45754	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	610 EUCLID AVE	STE 201	NATIONAL CITY	CA	91950	2952	37	06073	32.68419388	-117.0829524	San Diego County
103083	Fee-for-Service	1437319399	1437319399	1	1	FORMAN, DANA L DO	9/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9772	02	General Surgery	0	In state provider	None	2800 L ST	STE 200	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
103105	Fee-for-Service	1497987978	1497987978	1	1	FARMER, PATRICK E MD	9/30/2022	207L00000X	NA	Other	026	PHYSICIANS	117240	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
103119	Fee-for-Service	1811906175	1811906175	1	1	FARNESI, DARREN A MD	4/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	72585	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
103176	Fee-for-Service	1497172506	1497172506	1	1	FERREIRA, ALLISON C MD	9/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138943	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
103207	Fee-for-Service	1417020918	1417020918	1	1	FLETT, LAURA A S	4/30/1989	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	YREKA PHYSICAL THERAPY	205 EXECUTIVE CT	None	YREKA	CA	96097	2629	47	06093	41.72979295	-122.6306996	Siskiyou County
103221	Fee-for-Service	1447200233	1447200233	1	1	FORSYTH MEM HOSP INC	11/4/2005	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3333 SILAS CREEK PKWY	None	WINSTON SALEM	NC	27103	3090	00	None	36.075654	-80.298	Forsyth County
103292	Fee-for-Service	1629383161	1629383161	1	1	FITZGERALD, KRISTI J CRNA	10/11/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
103333	Fee-for-Service	1417016163	1417016163	1	1	FAROOQUI, ADIL MD	4/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70262	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
103360	Fee-for-Service	1821108655	1821108655	1	1	FEREN, MICHAEL H MD	6/7/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79402	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
103365	Fee-for-Service	1649767781	1649767781	1	1	FARSHCHIAN, MEHDI MD	6/13/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	176648	None	None	0	In state provider	None	2020 SANTA MONICA BLVD	510	SANTA MONICA	CA	90404	2000	19	06037	34.02901811	-118.4795396	Los Angeles County
103396	Fee-for-Service	1598148876	1598148876	1	1	FOX, CONNIE S LMFT	11/20/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 HOTEL CIRCLE S	SUITE 208	SAN DIEGO	CA	92108	3318	37	06073	32.75901493	-117.1790451	San Diego County
103410	Fee-for-Service	1619954450	1619954450	1	1	FREI,DONALD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	501 E HAMPDEN	None	ENGLEWOOD	CO	80113	0000	00	None	39.6531952	-104.9810967	Arapahoe County
103424	Fee-for-Service	1164020780	1164020780	1	1	FIRST RELIABLE HOME CARE INC	11/18/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16501 SHERMAN WAY	STE 105	VAN NUYS	CA	91406	3757	19	06037	34.20125005	-118.4927785	Los Angeles County
103433	Fee-for-Service	1639126626	1639126626	1	1	FERRAGAMO, TRACY C DPM	2/8/2015	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2925 SPAFFORD STREET	SUITE A	DAVIS	CA	95618	6808	57	06113	38.55217149	-121.713617	Yolo County
103509	Fee-for-Service	1447200233	1447200233	1	1	FORSYTH MEM HOSP INC	11/4/2005	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	3333 SILAS CREEK PKWY	None	WINSTON SALEM	NC	27103	3090	00	None	36.075654	-80.298	Forsyth County
103524	Fee-for-Service	1104030196	1104030196	1	1	FREEZE-RAMSEY, RACHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4301 W. MARKHAM ST	SLOT # 521	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
103538	Fee-for-Service	1528324829	1528324829	1	1	FAN, EUGENE H MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128537	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
103560	Fee-for-Service	1629049655	1629049655	1	1	FERRARA, STEPHEN L MD	10/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	60947	30	Radiology	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
103563	Fee-for-Service	1902937774	1902937774	1	1	FREIRE, GABRIELLE M LMFT	9/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	501 S FAIRFAX AVE	STE 214	LOS ANGELES	CA	90036	3198	19	06037	34.06725156	-118.3614386	Los Angeles County
103611	Fee-for-Service	1912095662	1912095662	1	1	FLETE, LINETTE E CRNA	4/20/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
103634	Fee-for-Service	1982410999	1982410999	1	1	FERNANDEZ, CLAUDIA NP	12/27/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
103698	Fee-for-Service	1346668472	1346668472	1	1	FLEISCHMANN, JOEL D MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149925	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EURKEA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
103706	Fee-for-Service	1821169012	1821169012	1	1	FONG, DERMET N MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	42188	41	Internal Medicine	0	In state provider	None	1955 COWELL BLVD	None	DAVIS	CA	95618	6325	57	06113	38.5399459	-121.7284328	Yolo County
103709	Fee-for-Service	1518356203	1518356203	1	1	FRANCO GARCIA, ALEXANDRA MD	9/29/2023	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	149078	None	None	0	In state provider	None	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
103723	Fee-for-Service	1477622587	1477622587	2	1	FESTUS B DADA MD JD	8/28/2019	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	25470 MEDICAL CENTER DR	SUITE 203	MURRIETA	CA	92562	4901	33	06065	33.55723646	-117.1859554	Riverside County
103732	Fee-for-Service	1871031542	1871031542	1	1	FORTE, KADREA LMFT	5/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
103736	Fee-for-Service	1154768406	1154768406	1	1	FLORES, STEFAN K MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134070	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
103737	Fee-for-Service	1902917909	1902917909	1	1	FINK TOZER KATHLEEN R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 9TH AVE	MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
103829	Fee-for-Service	1710331707	1710331707	1	1	FAMBRO, CYNTHIA MD	9/27/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	153223	08	Family Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
103844	Fee-for-Service	1346418217	1346418217	1	1	FODDRILL, JUDITH E LMFT	6/29/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	507 NATOMA ST	None	FOLSOM	CA	95630	2523	34	06067	38.676294	-121.1718825	Sacramento County
103845	Fee-for-Service	1033135678	1033135678	1	1	FELDMAN, DAVID E MD INC	2/1/2000	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60969	01	General Practice	0	In state provider	None	4500 W 116TH ST	None	HAWTHORNE	CA	90250	2209	19	06037	33.92906042	-118.3548882	Los Angeles County
104029	Fee-for-Service	1255892188	1255892188	1	1	FEINTUCH, JOSHUA D MD	2/2/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	None	None	0	In state provider	None	200 MEDICAL PLAZA	565	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
104133	Fee-for-Service	1033135678	1033135678	1	1	FELDMAN, DAVID E MD INC	2/1/2000	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60969	30	Radiology	0	In state provider	None	4500 W 116TH ST	None	HAWTHORNE	CA	90250	2209	19	06037	33.92906042	-118.3548882	Los Angeles County
104139	Fee-for-Service	1932204161	1932204161	2	1	FOULADIAN, GEORGE MD	6/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	41170	41	Internal Medicine	0	In state provider	None	5901 W OLYMPIC BLVD	SUITE 307	LOS ANGELES	CA	90036	4667	19	06037	34.05764121	-118.3603115	Los Angeles County
104171	Fee-for-Service	1437190139	1437190139	1	1	FUKUMURA, GLEN T MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	43686	40	Pediatrics	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
104172	Fee-for-Service	1255794442	1255794442	1	1	FRIEDMAN, LILY E MD	10/15/2019	390200000X	NA	Other	026	PHYSICIANS	153441	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
104197	Fee-for-Service	1629145644	1629145644	1	1	FINCK, DIANA M MD	8/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91753	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
104202	Fee-for-Service	1689674251	1689674251	1	1	FRIESEN, CLIFFORD M MD	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	6130 ELTON AVE	None	LAS VEGAS	NV	89107	2538	00	None	36.17198653	-115.225452	Clark County
104263	Fee-for-Service	1568422558	1568422558	1	1	FEDERHART, JAY B MD	6/1/1998	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	84686	None	None	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
104289	Fee-for-Service	1164943767	1164943767	1	1	FRIESEN, SUSAN C	9/12/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8953 N CHESTNUT AVE	None	FRESNO	CA	93720	5366	10	06019	36.86634375	-119.7388705	Fresno County
104350	Fee-for-Service	1922389683	1922389683	1	1	FEICHTMANN, RACHEL C	6/5/2012	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
104378	Fee-for-Service	1538259551	1538259551	1	1	FRESNO COUNTY CCS	8/13/1993	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	GINSBURG MTU	67 E ASHLAN AVE	None	FRESNO	CA	93704	3518	10	06019	36.7939172	-119.8122805	Fresno County
104430	Fee-for-Service	1053584631	1053584631	1	1	FANG, TOM C MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	1	Border provider	None	10619 PROFESSIONAL CIRCL	None	RENO	NV	89521	5831	00	None	39.42779657	-119.7542429	Washoe County
104449	Fee-for-Service	1235235458	1235235458	1	1	FOX, JASON MD	11/5/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	168930	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
104563	Fee-for-Service	1679836647	1679836647	1	1	FRANCIS, ANDREW W MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141866	18	Ophthalmology	0	In state provider	None	1001 PORTERO AVE	ROOM 4M31	SAN FRANCISCO	CA	94411	3518	38	06075	37.75548534	-122.4065362	San Francisco County
104579	Fee-for-Service	1962881730	1962881730	1	1	FEIST, MEGAN L CNRA	11/3/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
104596	Fee-for-Service	1932520012	1932520012	1	1	FLORES, JOSE L MD	8/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127965	01	General Practice	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
104619	Fee-for-Service	1730296963	1730296963	1	1	FU, SELENA Y MD	2/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109292	18	Ophthalmology	0	In state provider	None	160 E ARTESIA STREET	# 325	POMONA	CA	91767	2900	19	06037	34.07556833	-117.7507835	Los Angeles County
104630	Fee-for-Service	1659884302	1659884302	1	1	FLORES, LILLY C LMFT	10/26/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18672 FLORIDA ST	#100	HUNTINGTON BEACH	CA	92648	1917	30	06059	33.691185	-117.9910425	Orange County
104644	Fee-for-Service	1285040105	1285040105	1	1	FRESENIUS MEDICAL CARE	7/1/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ALHAMBRA LLC	11204 RUSH ST	None	SOUTH EL MONTE	CA	91733	3551	19	06037	34.04824183	-118.0328791	Los Angeles County
104712	Fee-for-Service	1275714545	1275714545	1	1	FURUKAWA, BETSY J MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140309	07	Dermatology	0	In state provider	None	11370 ANDERSON ST	STE 2600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
104719	Fee-for-Service	1376655217	1376655217	1	1	FORTUNA FAMILY MEDICAL GROUP	3/23/1992	207Q00000X	NA	Adult Primary Care	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	874 MAIN ST	None	FORTUNA	CA	95540	1926	12	06023	40.59801851	-124.158231	Humboldt County
104742	Fee-for-Service	1134625874	1134625874	1	1	FAKUNLE, MARY O MD	2/22/2024	208800000X	NA	Other	026	PHYSICIANS	163588	None	None	0	In state provider	None	1260 15TH STREET	1024	SANTA MONICA	CA	90404	1145	19	06037	34.02648965	-118.4867439	Los Angeles County
104778	Fee-for-Service	1669510848	1669510848	1	2	FATTAH, HALA M MD	1/9/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	74049	-	NOT APPLICABLE	0	In state provider	None	2311 LOVERIDGE RD	2ND FLOOR	PITTSBURG	CA	94565	5117	07	06013	38.00694767	-121.8712439	Contra Costa County
104782	Fee-for-Service	1225229008	1225229008	1	1	FARZIN, SAHAR MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	98125	30	Radiology	0	In state provider	None	2800 L ST	STE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
104813	Fee-for-Service	1255737854	1255737854	1	1	FRANCIS, JENNIFER	9/29/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1192 N LYMAN AVENUE	None	COVINA	CA	91724	1805	19	06037	34.100496	-117.849591	Los Angeles County
104903	Fee-for-Service	1508171570	1508171570	1	1	FOROUTAN, SHAHIN MD	10/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118403	02	General Surgery	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9989	39	06077	37.88652418	-121.2820956	San Joaquin County
105007	Fee-for-Service	1376655217	1376655217	1	1	FORTUNA FAMILY MEDICAL GROUP	3/23/1992	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	874 MAIN ST	None	FORTUNA	CA	95540	1926	12	06023	40.59801851	-124.158231	Humboldt County
105013	Fee-for-Service	1376888024	1376888024	1	1	FLORENCE WESTERN MEDICAL	5/10/2013	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	13500 VAN NUYS BLVD	None	PACOIMA	CA	91331	3028	19	06037	34.26224593	-118.4273324	Los Angeles County
105077	Fee-for-Service	1689013161	1689013161	2	3	FREMONT EMERGENCY SERVICES	2/24/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	SCHERR) LTD	102 E LAKE MEAD PARKWAY	None	HENDERSON	NV	89015	5575	00	None	36.03815706	-114.9842287	Clark County
105101	Fee-for-Service	1255737854	1255737854	1	1	FRANCIS, JENNIFER	9/29/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1192 N LYMAN AVENUE	None	COVINA	CA	91724	1805	19	06037	34.100496	-117.849591	Los Angeles County
105120	Fee-for-Service	1487860896	1487860896	1	1	FOMENKO, OLHA MD	6/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105788	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
105153	Fee-for-Service	1063886323	1063886323	1	1	FAKHERI, SAMAN MD INC	6/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	107753	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	17075 DEVONSHIRE ST	STE 201	NORTHRIDGE	CA	91325	1600	19	06037	34.25755945	-118.50471	Los Angeles County
105163	Fee-for-Service	1306034822	1306034822	1	1	FORCIER, KATHLEEN B MD	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105459	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
105179	Fee-for-Service	1215371547	1215371547	1	1	FESSEHA, ASSAF K MD	3/6/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	152288	01	General Practice	0	In state provider	None	200 MEDICAL PLAZA	STE 530	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
105200	Fee-for-Service	1366967028	1366967028	1	1	FORTINI, HANNAH L CNM	9/6/2018	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
105261	Fee-for-Service	1295885325	1295885325	1	1	FRANKENSTEIN, RICHARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37787	41	Internal Medicine	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 502	GARDEN GROVE	CA	92843	1901	30	06059	33.77450141	-117.9123364	Orange County
105279	Fee-for-Service	1528625811	1528625811	1	1	FRESNO NURSING AND REHAB	6/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	3672 N 1ST ST	None	FRESNO	CA	93726	6810	10	06019	36.78457103	-119.7723721	Fresno County
105312	Fee-for-Service	1558515254	1558515254	1	1	FOSTER, KELLY H MD	6/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107689	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
105353	Fee-for-Service	1992822803	1992822803	1	1	FEDER, SUSANNAH R PHD	5/1/2000	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4713 1ST STREET	STE 254	PLEASANTON	CA	94566	7381	01	06001	37.65761159	-121.8760415	Alameda County
105354	Fee-for-Service	1033512595	1033512595	1	1	FALARDEAU, DENISE L NP	4/5/2022	363LG0600X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
105376	Fee-for-Service	1437439379	1437439379	1	1	FERNANDES, PRIYANKA MD	2/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	139373	40	Pediatrics	0	In state provider	None	200 MED PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
105398	Fee-for-Service	1366401176	1366401176	1	1	FERGUSON, MARY T MD	5/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
105439	Fee-for-Service	1922028554	1922028554	1	1	FRANKLIN,JOACHIM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	190 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.6124738	-116.1926844	Ada County
105443	Fee-for-Service	1184845349	1184845349	1	1	FLETCHER, JO-AN M	10/3/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
105518	Fee-for-Service	1396799052	1396799052	1	1	FOUAD, HANY C MD	5/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	85094	08	Family Practice	0	In state provider	None	5051 VERDUGO WAY	SUITE 110	CAMARILLO	CA	93012	8679	56	06111	34.21524684	-119.0033176	Ventura County
105536	Fee-for-Service	1760080881	1760080881	1	1	FAMILY HEALTH CARE RESOURCES	6/24/2022	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3444 WHITTIER BLVD	SUITE A	LOS ANGELES	CA	90023	1708	19	06037	34.02715078	-118.199595	Los Angeles County
105544	Fee-for-Service	1295885325	1295885325	1	1	FRANKENSTEIN, RICHARD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37787	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 502	GARDEN GROVE	CA	92843	1901	30	06059	33.77450141	-117.9123364	Orange County
105646	Fee-for-Service	1477644334	1477644334	1	1	FRIEDMAN, NEIL J MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84315	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
105674	Fee-for-Service	1558359885	1558359885	1	1	FICHMAN, DAVID MD	5/31/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	56079	08	Family Practice	0	In state provider	None	6800 PALM AVE	STE H	SEBASTOPOL	CA	95472	4236	49	06097	38.39602719	-122.8185446	Sonoma County
105697	Fee-for-Service	1255696407	1255696407	1	1	FARASAT, SADAF MD	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147939	41	Internal Medicine	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
105736	Fee-for-Service	1548573769	1548573769	1	1	FREEMAN, JOHN A MD	6/12/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	54241	36	Psychiatry	0	In state provider	None	8830 HIGHWAY 20E	140	GLENHAVEN	CA	95443	0140	17	06033	39.036654	-122.7321855	Lake County
105752	Fee-for-Service	1639705692	1639705692	1	1	FROUD, JULIA MD	9/20/2023	390200000X	NA	Other	026	PHYSICIANS	185981	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
105781	Fee-for-Service	1699886275	1699886275	1	1	FARRELL, ROBERT E MD INC	3/16/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35929	40	Pediatrics	0	In state provider	None	77 CADILLAC DR	None	SACRAMENTO	CA	95825	5453	34	06067	38.572551	-121.4181585	Sacramento County
105785	Fee-for-Service	1942470893	1942470893	1	1	FINLAYSON, ERIK I MD	4/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101340	41	Internal Medicine	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	8589	30	06059	33.62421676	-117.9309656	Orange County
105799	Fee-for-Service	1427715176	1427715176	1	1	FLYNN, THOMAS J NP	9/30/2022	363LP0222X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
105826	Fee-for-Service	1780027359	1780027359	1	1	FROSSO ADAMAKOS	2/26/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1901 1ST AVE	None	NEW YORK	NY	10029	7494	00	None	40.784778	-73.9439055	New York County
105867	Fee-for-Service	1760560510	1760560510	1	1	FRANCO, MAURICIO MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36017	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
105899	Fee-for-Service	1629168091	1629168091	1	1	FINCH, JACK WAYNE	7/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	68377	08	Family Practice	0	In state provider	SHASTA FAMILY PRACTICE	2701 OLD EUREKA WAY	STE 1-E	REDDING	CA	96001	0210	45	06089	40.58555878	-122.4101367	Shasta County
105964	Fee-for-Service	1114314648	1114314648	1	1	FAIZ, ARFA MD	11/19/2020	207RA0201X	NA	Other	026	PHYSICIANS	156574	None	None	0	In state provider	None	5765 GREENBACK LN	None	SACRAMENTO	CA	95841	2013	34	06067	38.681622	-121.327848	Sacramento County
106019	Fee-for-Service	1174560585	1174560585	1	1	FAMILY HEALTH CENTERS OF	9/2/2005	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
106022	Fee-for-Service	1548573769	1548573769	1	1	FREEMAN, JOHN A MD	6/12/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	54241	91	Pharmacology-Clinical	0	In state provider	None	8830 HIGHWAY 20E	140	GLENHAVEN	CA	95443	0140	17	06033	39.036654	-122.7321855	Lake County
106038	Fee-for-Service	1215172655	1215172655	1	1	FERRELL, JED MD	8/15/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	152864	None	None	0	In state provider	None	7700 FOLSOM BLVD	None	SACRAMENTO	CA	95826	2608	34	06067	38.549871	-121.4145045	Sacramento County
106093	Fee-for-Service	1407110109	1407110109	1	1	FADHIL, ALI A MD	2/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145663	41	Internal Medicine	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
106140	Fee-for-Service	1679591861	1679591861	1	1	FORMOSO, VICTORIA G MD	2/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	39645	41	Internal Medicine	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
106184	Fee-for-Service	1063630614	1063630614	1	3	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1408 INDUSTRIAL PARK AVE	None	REDLANDS	CA	92374	4517	36	06071	34.0645025	-117.2039387	San Bernardino County
106203	Fee-for-Service	1811079528	1811079528	1	1	FOWLER, JOSEPH L CRNA	9/26/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	500 SW RAMSEY AVE	None	GRANTS PASS	OR	97527	5554	00	None	42.4198785	-123.3432318	Josephine County
106219	Fee-for-Service	1063933869	1063933869	1	1	FERNANDEZ RAMOS, MARIA C MD	5/1/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
106224	Fee-for-Service	1538508445	1538508445	1	1	FORGHANI-ARANI, ERSHAD DO	10/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13741	01	General Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
106232	Fee-for-Service	1598865594	1598865594	1	1	FLORA, ROMEO G JR LCSW	4/18/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
106233	Fee-for-Service	1811183304	1811183304	1	1	FAYEK, MOHAMED H MD	2/2/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72282	None	None	0	In state provider	None	3801 KATELLA AVE	STE 330	LOS ALAMITOS	CA	90720	6900	30	06059	33.80318951	-118.066068	Orange County
106241	Fee-for-Service	1619055704	1619055704	1	1	FERRY, JAMES A MD	8/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72157	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5601 DEER VALLEY RD	None	ANTIOCH	CA	94531	8577	07	06013	37.9518204	-121.7780768	Contra Costa County
106248	Fee-for-Service	1740332964	1740332964	1	1	FITZGERALD, SUSAN M MD	4/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78708	66	Emergency Medicine (Urgent Care)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
106275	Fee-for-Service	1477563666	1477563666	1	1	FOWLER, ELIZABETH W MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	72932	40	Pediatrics	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
106293	Fee-for-Service	1255511630	1255511630	1	1	FAMILY HEALTH CENTER OF	4/29/2009	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	JOSHUA TREE	63532 29 PALMS HWY	SUITE C	JOSHUA TREE	CA	92252	0000	36	06071	34.13510347	-116.277102	San Bernardino County
106307	Fee-for-Service	1174560585	1174560585	1	1	FAMILY HEALTH CENTERS OF	9/2/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
106354	Fee-for-Service	1154578565	1154578565	1	1	FURST, SHAWN R DO	11/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12926	25	Physical Medicine and Rehabilitation	0	In state provider	None	1702 ESPLANDE	None	CHICO	CA	95926	3315	04	06007	39.74458257	-121.8503103	Butte County
106399	Fee-for-Service	1154380962	1154380962	1	1	FREY, BRET W MD	6/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
106443	Fee-for-Service	1801986823	1801986823	1	1	FRESNO COUNTY CCS	10/4/2005	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	CLOVIS MTU	1345 N PEACH AVE	None	CLOVIS	CA	93619	8342	10	06019	36.854289	-119.715669	Fresno County
106467	Fee-for-Service	1629358411	1629358411	1	1	FAIRBANKS, MICHAEL K DPM APC	12/21/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	7750 EASTRIDGE DR	None	LA MESA	CA	91941	7882	37	06073	32.75081848	-117.0306305	San Diego County
106490	Fee-for-Service	1265994297	1265994297	1	1	FOX, ALEXANDER J MD	7/25/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	180160	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
106509	Fee-for-Service	1164442497	1164442497	1	1	FISHER, MONTE P MD	8/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69053	30	Radiology	0	In state provider	None	1138 NORMAN DRIVE	None	MANTECA	CA	95336	5965	39	06077	37.79443266	-121.1991696	San Joaquin County
106580	Fee-for-Service	1255511630	1255511630	1	1	FAMILY HEALTH CENTER OF	4/29/2009	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	JOSHUA TREE	63532 29 PALMS HWY	SUITE C	JOSHUA TREE	CA	92252	0000	36	06071	34.13510347	-116.277102	San Bernardino County
106628	Fee-for-Service	1366426363	1366426363	1	1	FUCHS, GERHARD J MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	45861	34	Urology and Urological Surgery	0	In state provider	None	8635 W 3RD ST	STE 1070	LOS ANGELES	CA	90048	6105	19	06037	34.07361928	-118.3803143	Los Angeles County
106635	Fee-for-Service	1023138245	1023138245	1	1	FERGUSON, SCOTT R MD	8/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
106738	Fee-for-Service	1497122410	1497122410	1	1	FUTERNICK, SARAH B CNM	4/5/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
106758	Fee-for-Service	1083848519	1083848519	1	1	FELL, ANDREA H LCSW	3/31/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	680 LANGSDORF DR STE	219	FULLERTON	CA	92831	3702	30	06059	33.87673088	-117.8824577	Orange County
106839	Fee-for-Service	1174982516	1174982516	1	1	FUN N GO MEDICAL TRANSPORT	5/16/2016	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1900 CAMDEN AVE	STE 201	SAN JOSE	CA	95124	2942	43	06085	37.26166552	-121.9236804	Santa Clara County
106869	Fee-for-Service	1255511630	1255511630	1	1	FAMILY HEALTH CENTER OF	4/29/2009	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	JOSHUA TREE	63532 29 PALMS HWY	SUITE C	JOSHUA TREE	CA	92252	0000	36	06071	34.13510347	-116.277102	San Bernardino County
106871	Fee-for-Service	1326126913	1326126913	1	1	FELDMAN, CHARLES A MD	3/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	28847	45	Nephrology (Renal-Kidney)	0	In state provider	None	770 WELCH RD	STE 250	PALO ALTO	CA	94304	1513	43	06085	37.43748087	-122.1759625	Santa Clara County
106908	Fee-for-Service	1497915805	1497915805	1	1	FAKE, LINDA D	12/27/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
106914	Fee-for-Service	1790738953	1790738953	1	1	FOX, LINDY P MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91253	07	Dermatology	0	In state provider	None	1701 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3011	38	06075	37.78553106	-122.4399475	San Francisco County
106918	Fee-for-Service	1831260470	1831260470	1	2	FOLSOM, DOUGLAS L MD	12/1/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	20961	-	NOT APPLICABLE	0	In state provider	None	22646 2ND STREET	None	HAYWARD	CA	94541	4210	01	06001	37.67461096	-122.0787149	Alameda County
106925	Fee-for-Service	1316921000	1316921000	1	1	FLORES, NOEL L MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	54949	41	Internal Medicine	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
107053	Fee-for-Service	1417315391	1417315391	1	1	FISK, SUZANNE M NP	11/24/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
107081	Fee-for-Service	1598704140	1598704140	1	1	FUJIMOTO, VICTOR Y MD	7/31/1989	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67964	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
107229	Fee-for-Service	1134154453	1134154453	1	1	FRELINGER, RICHARD E	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	5944	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
107240	Fee-for-Service	1174842041	1174842041	1	1	FINE, ERIC M PHD	12/13/2010	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
107253	Fee-for-Service	1053837534	1053837534	1	1	FLORES, ANA-MERCEDES PHD	10/30/2023	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
107331	Fee-for-Service	1689804460	1689804460	1	1	FERSHTMAN, CAROLYN S PHD	3/29/2011	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	621 CHERRY STREET	STE 2	SANTA ROSA	CA	95404	4202	49	06097	38.444877	-122.7163005	Sonoma County
107489	Fee-for-Service	1053523142	1053523142	1	1	FIVE ACES HEALTH CARE	10/5/2001	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CHRIST THE KING ADHC CTR	18800 AMAR RD	SUITE D4-08	WALNUT	CA	91789	4166	19	06037	34.02857448	-117.8910187	Los Angeles County
107499	Fee-for-Service	1437776390	1437776390	1	1	FLAWLESS CARE HOME HEALTH	11/11/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	18711 SHERMAN WAY	STE 106A	RESEDA	CA	91335	4086	19	06037	34.20120092	-118.5408066	Los Angeles County
107516	Fee-for-Service	1134154453	1134154453	1	1	FRELINGER, RICHARD E	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	5944	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
107529	Fee-for-Service	1285690321	1285690321	1	1	FITZGERALD, REBECCA L MD	3/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	49000	07	Dermatology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
107607	Fee-for-Service	1255415006	1255415006	1	1	FELIZ HEALTH CARE CTR	8/16/1994	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	17741 CORTNER AVE	None	CERRITOS	CA	90703	8119	19	06037	33.86937332	-118.0699549	Los Angeles County
107633	Fee-for-Service	1124341086	1124341086	1	1	FRENCHER, STANLEY K MD	1/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109025	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
107660	Fee-for-Service	1932631256	1932631256	1	1	FRACKMAN, ANNA E MD	6/3/2021	207L00000X	NA	Other	026	PHYSICIANS	157680	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
107662	Fee-for-Service	1053357467	1053357467	1	1	FINNEGAN, MARY MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64432	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 CANAL ST	None	KING CITY	CA	93930	3431	27	06053	36.20653258	-121.1319345	Monterey County
107719	Fee-for-Service	1205064268	1205064268	1	1	FONG, SARAH DO	9/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11798	08	Family Practice	0	In state provider	None	1057 PINE AVENUE	None	LONG BEACH	CA	90813	3118	19	06037	33.7801197	-118.1924041	Los Angeles County
107730	Fee-for-Service	1588912919	1588912919	1	1	FUNES, GUADALUPE LCSW	4/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	68669	-	NOT APPLICABLE	0	In state provider	None	326 W 23RD ST	None	LOS ANGELES	CA	90007	2612	19	06037	34.02952562	-118.2716815	Los Angeles County
107734	Fee-for-Service	1174553424	1174553424	1	1	FARDIN, BABAK MD	9/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84646	18	Ophthalmology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
107741	Fee-for-Service	1497076053	1497076053	1	1	FOELLER, TIMOTHY M MD	12/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141573	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
107744	Fee-for-Service	1366543597	1366543597	1	1	FITZGERALD,JUDITH DO	8/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	407 ULUNIU STREET	None	KAILUA	HI	96734	0000	00	None	21.39646318	-157.7434882	Honolulu County
107754	Fee-for-Service	1669671319	1669671319	1	1	FUROY, DANIEL J MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108041	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1145 W REDONDO BEACH BLV	None	GARDENA	CA	90247	3528	19	06037	33.89242734	-118.2947128	Los Angeles County
107797	Fee-for-Service	1184786337	1184786337	1	1	FISHMAN, ELLEN	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5720 STONERIDGE MALL RD	SUITE 390	PLEASANTON	CA	94588	2831	01	06001	37.69247085	-121.9301884	Alameda County
107807	Fee-for-Service	1124199344	1124199344	1	1	FRANKS, JOSEPH H MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64092	34	Urology and Urological Surgery	0	In state provider	None	1595 SOQUEL DR	STE 110	SANTA CRUZ	CA	95065	1717	44	06087	36.98879599	-121.9826354	Santa Cruz County
107916	Fee-for-Service	1538590781	1538590781	1	1	FAMILY HEALTH CENTERS OF SAN	12/15/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	DIEGO, INC	1750 5TH AVENUE	None	SAN DIEGO	CA	92101	2754	37	06073	32.72358991	-117.1602657	San Diego County
107917	Fee-for-Service	1073946547	1073946547	1	1	FORD STREET PROJECT	9/26/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	201 BRUSH ST	BLDGS 201A, 201B, 201C	UKIAH	CA	95482	3424	23	06045	39.1592217	-123.2057318	Mendocino County
107920	Fee-for-Service	1316027709	1316027709	1	5	FRESNO COMMUNITY HOSPITAL	7/12/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	785 N MEDICAL CTR DR W	SUITE 305	CLOVIS	CA	93611	6800	10	06019	36.84377271	-119.6609536	Fresno County
107951	Fee-for-Service	1306039995	1306039995	1	1	FARWELL, NICOLE J CCC-SLP	9/19/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	27192 NEWPORT ROAD	SUITE 1	MENIFEE	CA	92584	7387	33	06065	33.68506045	-117.1855215	Riverside County
107983	Fee-for-Service	1891041612	1891041612	1	1	FRANZEL, BERNADETTE A MFT	6/23/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	92448	-	NOT APPLICABLE	0	In state provider	None	716 OCEAN STREET	SUITE 200	SANTA CRUZ	CA	95060	4034	44	06087	36.97862665	-122.0208242	Santa Cruz County
107987	Fee-for-Service	1720476690	1720476690	1	1	FIGUEROA, AVERY N M LCSW	11/8/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
108029	Fee-for-Service	1306931266	1306931266	1	1	FAMILY PLANNING ASSOC	10/29/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
108050	Fee-for-Service	1093190498	1093190498	1	1	FIGUEROA, VIVIAN LCSW	4/14/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5850 EL CAMINO REAL	None	ATASCADERO	CA	93422	3318	40	06079	35.48962035	-120.670989	San Luis Obispo County
108052	Fee-for-Service	1457588782	1457588782	1	1	FARAHAT, PARHAM MD	4/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119091	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12401 E WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
108154	Fee-for-Service	1356481964	1356481964	1	1	FURUKAWA, LOUISE K MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	82185	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
108164	Fee-for-Service	1639469737	1639469737	1	1	FONSECA, SANDRA LMFT	12/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	132 S THOMPSON ST	None	HEMET	CA	92543	4351	33	06065	33.74675899	-116.9651207	Riverside County
108190	Fee-for-Service	1770361875	1770361875	1	2	FOREFRONT DERMATOLOGY - PACI	12/6/2023	207ND0101X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	AL GROUP, A FOREFRONT DE	1661 SOQUEL DR	STE B	SANTA CRUZ	CA	95065	1709	44	06087	36.98895429	-121.9821088	Santa Cruz County
108200	Fee-for-Service	1558087791	1558087791	1	1	FEBUARY, TESS PT	3/7/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1392 E PALOMAR ST	503	CHULA VISTA	CA	91913	1892	37	06073	32.62360793	-116.9969964	San Diego County
108236	Fee-for-Service	1265686109	1265686109	1	3	FACULTY PHYSICIANS AND SURGE	11/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	SUITE 6200	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
108260	Fee-for-Service	1508869819	1508869819	1	1	FOX, ROBERT C MD INC	6/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50857	18	Ophthalmology	0	In state provider	None	1441 LIBERTY ST	STE 205	REDDING	CA	96001	0848	45	06089	40.5857177	-122.3870781	Shasta County
108303	Fee-for-Service	1215667894	1215667894	1	1	FINDLEY, JONI M	6/16/2022	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON	16912 MARTIN ROAD	None	RACKERBY	CA	95972	0000	58	06115	39.4467522	-121.338227	Yuba County
108316	Fee-for-Service	1306931266	1306931266	1	1	FAMILY PLANNING ASSOC	11/17/1977	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
108321	Fee-for-Service	1629196969	1629196969	1	1	FORSHAN, COLLETTE L	2/20/2008	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	330 W FELICITA AVE	STE A4	ESCONDIDO	CA	92025	6531	37	06073	33.10430078	-117.0738922	San Diego County
108327	Fee-for-Service	1346310950	1346310950	1	1	FARSAR, NADER DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	9335 RESEDA BLVD	STE 200	NORTHRIDGE	CA	91324	2977	19	06037	34.24019062	-118.5361007	Los Angeles County
108364	Fee-for-Service	1194966887	1194966887	1	1	FOLEY, RHONDA LCSW	3/9/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	3001	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
108394	Fee-for-Service	1104906569	1104906569	1	1	FRESNO COMMUNITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	AND MEDICAL CENTER	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
108425	Fee-for-Service	1720390107	1720390107	1	1	FAIN, MATTHEW D DO	9/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	1	Border provider	None	1707 W CHARLESTON BLVD	STE 230	LAS VEGAS	NV	89102	2353	00	None	36.15879353	-115.1643015	Clark County
108437	Fee-for-Service	1730192303	1730192303	1	1	FREDERIC J ARSHAM, MD	1/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	A PROFESSIONAL CORP	1834 MAIN ST	None	RAMONA	CA	92065	2522	37	06073	33.03447536	-116.8814758	San Diego County
108440	Fee-for-Service	1356481964	1356481964	1	1	FURUKAWA, LOUISE K MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	82185	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
108447	Fee-for-Service	1184712085	1184712085	1	1	FRANKLIN SQUARE HOSPITAL	10/3/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER, INC	9000 FRANKLIN SQUARE DR	None	BALTIMORE	MD	21237	3901	00	None	39.35020918	-76.47973835	Baltimore County
108508	Fee-for-Service	1588859235	1588859235	1	1	FOND, ANDREW T MD	7/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103284	05	Anesthesiology	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
108514	Fee-for-Service	1528067170	1528067170	1	1	FOLDVARY, PETER MD DBA	4/30/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	32026	30	Radiology	0	In state provider	IMAGING MED CORP OF PARA	3715 E SOUTH ST	None	LONG BEACH	CA	90805	4521	19	06037	33.86026343	-118.1478013	Los Angeles County
108600	Fee-for-Service	1760541338	1760541338	1	1	FALKENBACH, MARK MD	9/22/1986	207R00000X	NA	Other	026	PHYSICIANS	43121	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
108605	Fee-for-Service	1306931266	1306931266	1	1	FAMILY PLANNING ASSOC	12/15/2020	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
108609	Fee-for-Service	1770531816	1770531816	1	1	FIRST, BRIAN P MD	7/23/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	33952	67	Endocrinology	0	In state provider	None	4282 GENESEE AVE	STE 102	SAN DIEGO	CA	92117	4986	37	06073	32.82092667	-117.1828683	San Diego County
108637	Fee-for-Service	1427417518	1427417518	1	1	FIELDER, KAY L	3/21/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5851 NEWMAN STREET	None	CYPRESS	CA	90630	3322	30	06059	33.82804648	-118.0315215	Orange County
108668	Fee-for-Service	1871112656	1871112656	1	1	FEDER, SCOTT M MD	6/29/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	185479	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
108683	Fee-for-Service	1104906569	1104906569	1	1	FRESNO COMMUNITY HOSPITAL	12/1/1979	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	AND MEDICAL CENTER	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
108725	Fee-for-Service	1730192303	1730192303	1	1	FREDERIC J ARSHAM, MD	8/10/1998	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL CORP	1834 MAIN ST	None	RAMONA	CA	92065	2522	37	06073	33.03447536	-116.8814758	San Diego County
108737	Fee-for-Service	1184712085	1184712085	1	1	FRANKLIN SQUARE HOSPITAL	10/3/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER, INC	9000 FRANKLIN SQUARE DR	None	BALTIMORE	MD	21237	3901	00	None	39.35020918	-76.47973835	Baltimore County
108798	Fee-for-Service	1104068030	1104068030	1	1	FAMILY CARE CENTER	7/3/2003	261QR1300X	NA	Rural Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	284 SPRUCE ST	None	GRIDLEY	CA	95948	2216	04	06007	39.36699345	-121.6910745	Butte County
108812	Fee-for-Service	1124037874	1124037874	1	1	FISHER, MINA K MD	1/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92240	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
108824	Fee-for-Service	1427064070	1427064070	1	1	FERNANDEZ, STEPHEN M MD	8/1/2002	207L00000X	NA	Other	026	PHYSICIANS	48005	05	Anesthesiology	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
108826	Fee-for-Service	1841587920	1841587920	2	1	FOX, JOHN W MD	11/16/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183270	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
108893	Fee-for-Service	1306931266	1306931266	1	1	FAMILY PLANNING ASSOC	11/5/2019	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	MEDICAL GROUP INC	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
108894	Fee-for-Service	1821355033	1821355033	1	1	FISCHEL, DAVID DO	12/15/2023	207R00000X	NA	Other	026	PHYSICIANS	13263	None	None	0	In state provider	None	10 CONGRESS ST	STE 208	PASADENA	CA	91105	3027	19	06037	34.13396893	-118.1528162	Los Angeles County
108897	Fee-for-Service	1770531816	1770531816	1	1	FIRST, BRIAN P MD	7/23/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	33952	41	Internal Medicine	0	In state provider	None	4282 GENESEE AVE	STE 102	SAN DIEGO	CA	92117	4986	37	06073	32.82092667	-117.1828683	San Diego County
108905	Fee-for-Service	1528127149	1528127149	1	1	FREEDMAN, CHARLES MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	31851	40	Pediatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
108935	Fee-for-Service	1508892738	1508892738	1	1	FRATKIN, MICHAEL D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83364	41	Internal Medicine	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
109001	Fee-for-Service	1770622508	1770622508	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	12304 SANTA MONICA BLVD	SUITE 116	LOS ANGELES	CA	90025	2586	19	06037	34.03948285	-118.4656304	Los Angeles County
109009	Fee-for-Service	1770626806	1770626806	1	1	FUSCO, JOHN A	1/31/1993	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3700 VAN BUREN BLVD	STE 102	RIVERSIDE	CA	92503	4299	33	06065	33.9187599	-117.4453051	Riverside County
109013	Fee-for-Service	1285868539	1285868539	1	2	FITZGIBBONS, LYNN N MD	4/13/2017	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	99152	77	Infectious Disease	0	In state provider	None	400 W PEUBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
109109	Fee-for-Service	1427064070	1427064070	1	1	FERNANDEZ, STEPHEN M MD	8/1/2002	207L00000X	NA	Other	026	PHYSICIANS	48005	01	General Practice	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
109158	Fee-for-Service	1114035235	1114035235	1	1	FATULA, MICHAEL LMFT	11/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12402 VENTURA BLVD.	2ND FLOO	STUDIO CITY	CA	91604	2457	19	06037	34.14282922	-118.4031927	Los Angeles County
109232	Fee-for-Service	1922297944	1922297944	1	1	FAIRBANKS, KRISTIN E MD	8/2/2010	207L00000X	NA	Other	026	PHYSICIANS	90297	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
109256	Fee-for-Service	1700868783	1700868783	1	1	FEUER,JONATHAN A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	VALLEY ANESTHES CONSULT	2901 NORTH CENTRAL AVE	STE#500	PHOENIX	AZ	85012	2738	00	None	33.480666	-112.0729905	Maricopa County
109265	Fee-for-Service	1245211135	1245211135	1	1	FRAIX, MARCEL P DO	12/9/2009	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	9008	25	Physical Medicine and Rehabilitation	0	In state provider	None	887 E SECOND STREET	STE C	POMONA	CA	91766	2009	19	06037	34.05810644	-117.7395016	Los Angeles County
109288	Fee-for-Service	1407945017	1407945017	1	1	FEDELE, ADRIAN MD	11/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87820	02	General Surgery	0	In state provider	None	411 W 20TH ST	None	MERCED	CA	95340	3713	24	06047	37.30404265	-120.4804769	Merced County
109353	Fee-for-Service	1134949944	1134949944	1	1	FARRAR, AFI-SARAN	12/5/2024	171M00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	34	06067	0	0	None
109358	Fee-for-Service	1518040690	1518040690	1	1	FAITH, STEVEN E OD FAAO	10/2/1986	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1278 CONCANNON BLVD	None	LIVERMORE	CA	94550	6002	01	06001	37.6609605	-121.7789055	Alameda County
109401	Fee-for-Service	1396738696	1396738696	1	1	FOOE, B CHARLES	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2003 LINCOLN WAY	None	COEUR D ALENE	ID	83814	2611	00	None	47.69465937	-116.7917936	Kootenai County
109472	Fee-for-Service	1649358128	1649358128	1	1	FARGHALLI, NAHLA MD	11/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78380	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
109498	Fee-for-Service	1740237155	1740237155	1	1	FREUND, EDMUND MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34171	08	Family Practice	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
109503	Fee-for-Service	1205240959	1205240959	1	1	FEJLEH, MOHAMMAD PHILLIP C	7/30/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	149205	10	Gastroenterology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
109516	Fee-for-Service	1336121888	1336121888	1	1	FOOTHILLS PSYCHOLOGICAL SERV	11/28/2018	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
109536	Fee-for-Service	1861608788	1861608788	1	1	FELCH, JOYCE L LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1430 EAST AVE	STE 4C	CHICO	CA	95926	1629	04	06007	39.76116577	-121.8188568	Butte County
109622	Fee-for-Service	1417193194	1417193194	1	1	FAKOORY, NADIA J MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112443	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1701 SANTA ANITA AVENUE	None	SOUTH EL MONTE	CA	91733	3411	19	06037	34.04810648	-118.0424794	Los Angeles County
109657	Fee-for-Service	1467497008	1467497008	1	1	FLAHERMAN, VALERIE J MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80953	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
109659	Fee-for-Service	1225472202	1225472202	1	1	FINCH, WILLIAM MD	4/23/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	133465	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
109714	Fee-for-Service	1275640591	1275640591	1	1	FREY, JAMES L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 W THOMAS RD	None	PHOENIX	AZ	85013	4224	00	None	33.481485	-112.080816	Maricopa County
109741	Fee-for-Service	1184043283	1184043283	1	1	FILLMORE, RYAN D MD	6/9/2018	390200000X	NA	Other	026	PHYSICIANS	155465	13	Neurology (M.D. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
109800	Fee-for-Service	1306874599	1306874599	1	1	FOWLER, THOMAS M MD	6/30/1990	207P00000X	NA	Other	026	PHYSICIANS	66814	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16453 COLORADO AVE	None	PARAMOUNT	CA	90723	5011	19	06037	33.8848803	-118.1614216	Los Angeles County
109802	Fee-for-Service	1619438488	1619438488	1	1	FOFANA, MARIAME MD	11/2/2022	390200000X	NA	Other	026	PHYSICIANS	176939	None	None	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5695	35	06069	36.83504962	-121.3858245	San Benito County
109805	Fee-for-Service	1336121888	1336121888	1	1	FOOTHILLS PSYCHOLOGICAL SERV	1/24/2024	103T00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
109812	Fee-for-Service	1104906569	1104906569	1	25	FRESNO COMMUNITY HOSPITAL	9/20/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	2335 E KASHIAN LN	SUITE 301	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
109830	Fee-for-Service	1962538132	1962538132	1	1	FELSHER, DEAN W MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	79300	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
109832	Fee-for-Service	1558428052	1558428052	1	1	FESMIRE, RUTH L LMFT	8/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 VIA CABRILLO MARINA	STE 200C	SAN PEDRO	CA	90731	7724	19	06037	33.719931	-118.2828535	Los Angeles County
109899	Fee-for-Service	1306864665	1306864665	1	1	FREDERICK K NESS	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	TRINITY MEDICAL GROUP	1 BURDICK EXPY W	None	MINOT	ND	58701	0000	00	None	48.2325845	-101.2938165	Ward County
109938	Fee-for-Service	1235287103	1235287103	1	1	FRANKLIN, KYMBERLY M MD	2/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75238	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
110005	Fee-for-Service	1447540505	1447540505	1	1	FREDIANI, JAIME N MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131342	68	Hematology	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
110035	Fee-for-Service	1609317304	1609317304	1	1	FERNANDEZ, VIOLETTA M LCSW	9/25/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
110069	Fee-for-Service	1023465549	1023465549	1	1	FADDOUL, CHRISTINA M LMFT	9/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	802	SAN DIEGO	CA	92108	3102	37	06073	32.76632791	-117.1616245	San Diego County
110076	Fee-for-Service	1609982313	1609982313	1	1	FUHRMAN, LINDA M NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
110081	Fee-for-Service	1306333026	1306333026	1	1	FENSKA, JAMES E MD	11/3/2023	207L00000X	NA	Other	026	PHYSICIANS	179291	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
110092	Fee-for-Service	1336121888	1336121888	1	1	FOOTHILLS PSYCHOLOGICAL SERV	2/15/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
110117	Fee-for-Service	1962538132	1962538132	1	1	FELSHER, DEAN W MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	79300	68	Hematology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
110120	Fee-for-Service	1821657982	1821657982	1	1	FARIS, JESSICA L MD	9/15/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	187982	None	None	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
110137	Fee-for-Service	1154724383	1154724383	1	1	FAGERSTROM, KAREN M PHD	4/10/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
110202	Fee-for-Service	1073976478	1073976478	1	1	FENG, KENT Y MD	7/1/2019	207R00000X	NA	Other	026	PHYSICIANS	160534	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
110229	Fee-for-Service	1023368503	1023368503	1	1	FENG, ZIPEI MD	6/13/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	185473	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
110291	Fee-for-Service	1063571677	1063571677	1	1	FOGARTY, KATHRYN A MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	57881	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
110295	Fee-for-Service	1447540505	1447540505	1	1	FREDIANI, JAIME N MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131342	78	Neoplastic Diseases/Oncology	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
110375	Fee-for-Service	1356316426	1356316426	1	1	FARROKHI, FARZAD MD	3/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	61039	05	Anesthesiology	0	In state provider	None	600 N HIGHLAND SPRINGS A	None	BANNING	CA	92220	3046	33	06065	33.9316595	-116.9468639	Riverside County
110378	Fee-for-Service	1336121888	1336121888	1	1	FOOTHILLS PSYCHOLOGICAL SERV	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ICES, INC.	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
110379	Fee-for-Service	1780350595	1780350595	1	1	FRANCHI, DYLAN OD	9/10/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	114 MISSION RANCH BLVD.	SUITE 50	CHICO	CA	95926	5137	04	06007	39.75356438	-121.8600403	Butte County
110432	Fee-for-Service	1164503868	1164503868	1	1	FORD, JOSEPH MD	12/10/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30251	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3475 TORRANCE BLVD	STE H	TORRANCE	CA	90503	5800	19	06037	33.83762089	-118.3467904	Los Angeles County
110440	Fee-for-Service	1619288115	1619288115	1	1	FRIEDMAN, BRANDON J OD	7/19/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2150 NORTH WATERMAN AVE	#210	SAN BERNARDINO	CA	92404	4811	36	06071	34.134705	-117.2787865	San Bernardino County
110481	Fee-for-Service	1043271943	1043271943	1	1	FLIEGEL, JONATHAN E	12/1/2020	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	600 HIGHLAND AVE	None	MADISON	WI	53792	0001	00	None	43.07868393	-89.4316606	Dane County
110518	Fee-for-Service	1861446015	1861446015	1	1	FARBAKHSH, KAMBIZ MD	12/6/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	55570	41	Internal Medicine	0	In state provider	None	6601 WHITE FEATHER ROAD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
110540	Fee-for-Service	1679754634	1679754634	1	1	FACULTY PHYSICIANS AND	1/16/2008	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	SURGEONS OF LLUSM	833 AUTO CENTER DR	STE C	PALMDALE	CA	93551	4488	19	06037	34.59142577	-118.1466519	Los Angeles County
110581	Fee-for-Service	1063571677	1063571677	1	1	FOGARTY, KATHRYN A MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	57881	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
110585	Fee-for-Service	1447540505	1447540505	1	1	FREDIANI, JAIME N MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131342	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
110668	Fee-for-Service	1689681181	1689681181	1	1	FEIWELL, ROBERT J MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	73595	None	None	0	In state provider	None	652 PETALUMA AVE	STE I	SEBASTOPOL	CA	95472	4266	49	06097	38.39662494	-122.8201368	Sonoma County
110669	Fee-for-Service	1336121888	1336121888	1	1	FOOTHILLS PSYCHOLOGICAL SERV	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ICES, INC.	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
110682	Fee-for-Service	1154492189	1154492189	1	1	FU, GRACE J MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74000	08	Family Practice	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
110700	Fee-for-Service	1073621157	1073621157	1	1	FELT, JAMES V MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	36813	None	None	0	In state provider	None	350 30TH ST	STE 311	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
110721	Fee-for-Service	1164503868	1164503868	1	1	FORD, JOSEPH MD	12/10/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30251	41	Internal Medicine	0	In state provider	None	3475 TORRANCE BLVD	STE H	TORRANCE	CA	90503	5800	19	06037	33.83762089	-118.3467904	Los Angeles County
110779	Fee-for-Service	1194941799	1194941799	1	1	FRANKEL, JENNIFER H MD	6/13/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	182694	None	None	0	In state provider	None	200 TAMAL PLAZA	200	CORTE MADERA	CA	94925	1128	21	06041	37.93574053	-122.5199024	Marin County
110791	Fee-for-Service	1508927625	1508927625	1	1	FONG, CHERYL L MD	2/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77919	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
110840	Fee-for-Service	1992151757	1992151757	1	1	FAZLINEJAD, ARIA DO	11/21/2019	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
110876	Fee-for-Service	1427211507	1427211507	1	1	FRUGONI, BRIAN J MD	4/3/2017	207L00000X	NA	Other	026	PHYSICIANS	101255	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92109	9001	37	06073	32.7537975	-117.1658298	San Diego County
110908	Fee-for-Service	1780120220	1780120220	1	1	FAMILY HEALTH MEDICAL CENTER	7/25/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	444 SANTA RITA AVE	None	LOS BANOS	CA	93635	3838	24	06047	37.06272659	-120.837364	Merced County
110919	Fee-for-Service	1700855269	1700855269	1	1	FAUCONIER, IAN N MD	11/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	87817	None	None	0	In state provider	None	1541 FLORIDA AVE	SUITE 100	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
110924	Fee-for-Service	1295255073	1295255073	1	1	FISHER, MOLLY LCSW	2/12/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
111084	Fee-for-Service	1912018276	1912018276	1	1	FARMER, PAMELA L MD	4/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51888	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
111107	Fee-for-Service	1811289200	1811289200	1	1	FOULAD, ALLEN MD	4/27/2018	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	123903	84	Surgery-Head and Neck	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
111118	Fee-for-Service	1679558175	1679558175	1	1	F.C.H., INC	11/1/1994	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	947 3RD ST	None	SANTA MONICA	CA	90403	2508	19	06037	34.0213209	-118.5027155	Los Angeles County
111160	Fee-for-Service	1427211507	1427211507	1	1	FRUGONI, BRIAN J MD	4/3/2017	207L00000X	NA	Other	026	PHYSICIANS	101255	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92109	9001	37	06073	32.7537975	-117.1658298	San Diego County
111195	Fee-for-Service	1780120220	1780120220	1	1	FAMILY HEALTH MEDICAL CENTER	7/25/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	444 SANTA RITA AVE	None	LOS BANOS	CA	93635	3838	24	06047	37.06272659	-120.837364	Merced County
111212	Fee-for-Service	1508869645	1508869645	1	1	FRESNO CA ENDSCOPY ASC LP	2/20/2002	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ENDOSCOPY CENTER	7055 N FRESNO ST	SUITE 100	FRESNO	CA	93720	2957	10	06019	36.83880319	-119.7813727	Fresno County
111236	Fee-for-Service	1659403988	1659403988	1	1	FELDMAN, EDWARD J MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32700	41	Internal Medicine	0	In state provider	None	8635 W 3RD ST	STE 960W	LOS ANGELES	CA	90048	6106	19	06037	34.07361928	-118.3803143	Los Angeles County
111270	Fee-for-Service	1205986015	1205986015	1	1	FUNG, MITCHELL F MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71321	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
111275	Fee-for-Service	1265696298	1265696298	1	1	FANNING, LAUREN E MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126066	34	Urology and Urological Surgery	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
111354	Fee-for-Service	1093962847	1093962847	1	1	FALOR, ANN E MD	8/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112637	02	General Surgery	0	In state provider	None	863 N DOUGLAS ST	STE 100	EL SEGUNDO	CA	90245	2801	19	06037	33.92830583	-118.3831669	Los Angeles County
111371	Fee-for-Service	1518401546	1518401546	1	1	FACULTY PHYSICIANS AND	1/24/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	SURGEONS OF LLUSM	4500 BROCKTON AVE	STE 201	RIVERSIDE	CA	92501	4006	33	06065	33.97785263	-117.3836152	Riverside County
111446	Fee-for-Service	1427211507	1427211507	1	1	FRUGONI, BRIAN J MD	4/3/2017	207L00000X	NA	Other	026	PHYSICIANS	101255	40	Pediatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92109	9001	37	06073	32.7537975	-117.1658298	San Diego County
111452	Fee-for-Service	1649682097	1649682097	1	1	FREIHEIT, DEREK R MD	9/20/2021	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
111495	Fee-for-Service	1154688091	1154688091	1	1	FLORES, SARA C MD	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130315	25	Physical Medicine and Rehabilitation	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
111498	Fee-for-Service	1558780106	1558780106	1	1	FERNANDEZ MONTERO, YULSI L	2/12/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	141510	-	NOT APPLICABLE	0	In state provider	MD	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
111601	Fee-for-Service	1992235402	1992235402	2	1	FRAZIER HEALTHCARE INC	9/12/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3544 MT PINOS WAY	None	FRAZIER PARK	CA	93225	9998	15	06029	34.82244872	-118.944968	Kern County
111644	Fee-for-Service	1285997668	1285997668	1	1	FOCUS MEDICAL GROUP INC	1/22/2014	193200000X	NA	Other	026	PHYSICIANS	84479	41	Internal Medicine	0	In state provider	None	2079 COMPTON AVE	SUITE 102	CORONA	CA	92881	7284	33	06065	33.848496	-117.5361745	Riverside County
111646	Fee-for-Service	1144531369	1144531369	1	1	FELDMAN, ELLIOT PT	1/13/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
111664	Fee-for-Service	1356567929	1356567929	1	1	FRANCISCO, BENJAMIN G JR	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106282	41	Internal Medicine	0	In state provider	MD	11370 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
111692	Fee-for-Service	1689950248	1689950248	1	1	FOOTHILL HEALTH CENTER	8/14/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2380 MONTPELIER DRIVE	STE 200	SAN JOSE	CA	95116	1620	43	06085	37.36522881	-121.8474637	Santa Clara County
111704	Fee-for-Service	1447290994	1447290994	1	1	FONG, RALPH MD	3/16/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	73942	08	Family Practice	0	In state provider	None	8170 LAGUNA BLVD	STE 101	ELK GROVE	CA	95758	7902	34	06067	38.421054	-121.405365	Sacramento County
111739	Fee-for-Service	1033151378	1033151378	1	1	FICKES, JANE E CRNA	3/17/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3828 DELMAS TER	None	CULVER CITY	CA	90232	2713	19	06037	34.02308948	-118.3972101	Los Angeles County
111784	Fee-for-Service	1558780106	1558780106	1	1	FERNANDEZ MONTERO, YULSI L	8/1/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	141510	08	Family Practice	0	In state provider	MD	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
111841	Fee-for-Service	1295842300	1295842300	1	1	FRANCIOSA, STEFAN DO	3/12/2025	2085R0204X	NA	Other	026	PHYSICIANS	12883	30	Radiology	0	In state provider	None	1310 LAS TABLAS RD	STE 103	TEMPLETON	CA	93465	9746	40	06079	35.55442349	-120.722643	San Luis Obispo County
111857	Fee-for-Service	1497147805	1497147805	1	1	FULLERTON, MORGAN E MD	2/14/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	134545	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
111879	Fee-for-Service	1306882618	1306882618	1	1	FISHER, STUART MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	30650	34	Urology and Urological Surgery	0	In state provider	None	1304 15TH ST	STE 200	SANTA MONICA	CA	90404	1811	19	06037	34.02600773	-118.486172	Los Angeles County
111912	Fee-for-Service	1689071573	1689071573	1	1	FITZPATRICK, LINDSAY A PSYD	6/11/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23461 S POINTE DR	STE 100	LAGUNA HILLS	CA	92653	1547	30	06059	33.62535142	-117.7206568	Orange County
111922	Fee-for-Service	1326647835	1326647835	1	1	FLORES, JAZMIN	2/23/2021	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1038 E BASTANCHURY RD	#211	FULLERTON	CA	92835	2786	30	06059	33.89934717	-117.9114748	Orange County
111943	Fee-for-Service	1467418038	1467418038	1	1	FRIENDLY MEDICAL CENTER	5/12/1992	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	15462 MAIN ST	None	HESPERIA	CA	92345	3318	36	06071	34.42553716	-117.3261813	San Bernardino County
111944	Fee-for-Service	1699111807	1699111807	1	1	FONG, KRISTEN Y NP	5/9/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
111947	Fee-for-Service	1033108071	1033108071	1	1	FLEMING, TIMOTHY N. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1959 NE PACIFIC ST	None	SEATTLE	WA	98195	0001	00	None	47.65080692	-122.3081828	King County
111983	Fee-for-Service	1689950248	1689950248	1	1	FOOTHILL HEALTH CENTER	8/14/2014	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	2380 MONTPELIER DRIVE	STE 200	SAN JOSE	CA	95116	1620	43	06085	37.36522881	-121.8474637	Santa Clara County
112057	Fee-for-Service	1346267309	1346267309	1	1	FOROUTANI, ARASH MD	10/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80655	41	Internal Medicine	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
112058	Fee-for-Service	1356728687	1356728687	1	1	FISHER, EMILY J MD	7/30/2021	207R00000X	NA	Other	026	PHYSICIANS	171148	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
112080	Fee-for-Service	1376750885	1376750885	1	1	FURNER, ROBIN B MFT	8/13/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4000 BROADWAY	STE 1	OAKLAND	CA	94611	5670	01	06001	37.82771857	-122.2565587	Alameda County
112111	Fee-for-Service	1659349686	1659349686	1	1	FLEISCHMANN, WILLIAM A	1/31/1987	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6716 RIO LINDA BLVD	None	RIO LINDA	CA	95673	3347	34	06067	38.690064	-121.4565165	Sacramento County
112159	Fee-for-Service	1386722072	1386722072	1	1	FONTAINE, FRANK M MD	5/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72890	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
112209	Fee-for-Service	1326647835	1326647835	1	1	FLORES, JAZMIN	2/23/2021	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1038 E BASTANCHURY RD	#211	FULLERTON	CA	92835	2786	30	06059	33.89934717	-117.9114748	Orange County
112258	Fee-for-Service	1598224875	1598224875	1	1	FULLER, KYLIE MD	9/5/2023	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	187008	None	None	0	In state provider	None	250 BONITA AVE	None	POMONA	CA	91767	1863	19	06037	34.09664881	-117.751261	Los Angeles County
112266	Fee-for-Service	1437109329	1437109329	1	1	FROE, FELECIA MD	2/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88834	34	Urology and Urological Surgery	0	In state provider	None	1789 W YOSEMITE AVE	None	MANTECA	CA	95337	5160	39	06077	37.79964	-121.246425	San Joaquin County
112270	Fee-for-Service	1689950248	1689950248	1	1	FOOTHILL HEALTH CENTER	8/14/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2380 MONTPELIER DRIVE	STE 200	SAN JOSE	CA	95116	1620	43	06085	37.36522881	-121.8474637	Santa Clara County
112291	Fee-for-Service	1285261990	1285261990	1	1	FRYE, WILLIAM	8/1/2023	207P00000X	NA	Other	026	PHYSICIANS	187547	None	None	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
112317	Fee-for-Service	1972982239	1972982239	1	1	FEGALE, BENJAMIN MD	3/25/2023	2086S0129X	NA	General Surgery	026	PHYSICIANS	149742	None	None	0	In state provider	None	3660 PARK SIERRA DRIVE	SUITE 105	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
112390	Fee-for-Service	1700964426	1700964426	1	1	FOX, GARY M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41744	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
112444	Fee-for-Service	1295971158	1295971158	1	1	FARR, SAMANTHA G NP	3/24/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
112485	Fee-for-Service	1902985039	1902985039	1	1	FLANIGAN, JAMES A MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71318	05	Anesthesiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
112582	Fee-for-Service	1235130832	1235130832	2	1	FOX HILLS PHARMACY INC	12/1/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4455 W 117TH ST	STE 101	HAWTHORNE	CA	90250	2240	19	06037	33.92825048	-118.3539285	Los Angeles County
112591	Fee-for-Service	1619407707	1619407707	1	1	FAN, JESSICA H MD	7/29/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	171710	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
112594	Fee-for-Service	1073598793	1073598793	1	1	FURUKAWA, KENNETH T MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50409	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
112600	Fee-for-Service	1588196232	1588196232	1	1	FALAHA, MOHAMED S MD	10/7/2022	207R00000X	NA	Other	026	PHYSICIANS	169451	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
112777	Fee-for-Service	1629653001	1629653001	1	1	FOWLER POST ACUTE LLC	4/9/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1306 E SUMNER AVE	None	FOWLER	CA	93625	2627	10	06019	36.62727693	-119.6729936	Fresno County
112780	Fee-for-Service	1174955645	1174955645	1	1	FATOORECHI, SARAH PSYD	2/10/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	STE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
112818	Fee-for-Service	1740669282	1740669282	1	1	FANG, HONGFEI MD	7/12/2021	208M00000X	NA	Other	026	PHYSICIANS	154616	None	None	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
112821	Fee-for-Service	1790280469	1790280469	1	1	FIELDS, DAVID W MD	5/9/2022	390200000X	NA	Other	026	PHYSICIANS	165156	None	None	0	In state provider	None	22419 KENT AVE	None	TORRANCE	CA	90505	2303	19	06037	33.824448	-118.3564765	Los Angeles County
112852	Fee-for-Service	1275847360	1275847360	1	1	FILLO, JEREMIAH D MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117793	08	Family Practice	0	In state provider	None	830 SCENIC DRIVE	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
112854	Fee-for-Service	1417047432	1417047432	1	1	FRESNO COUNTY CCS	1/1/2003	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	STOREY MTU	5250 E CHURCH AVE	None	FRESNO	CA	93725	0900	10	06019	36.71486814	-119.7173212	Fresno County
112870	Fee-for-Service	1447765409	1447765409	1	1	FOMOTAR, MARCEL CNP	9/15/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1085 SANDERS AVE	None	CLOVIS	CA	93619	3935	10	06019	36.81692816	-119.6418339	Fresno County
112893	Fee-for-Service	1235864927	1235864927	1	1	FRANCIS, GLORIA A	7/26/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1192 N LYMAN AVE	None	COVINA	CA	91724	1805	19	06037	34.100496	-117.849591	Los Angeles County
112908	Fee-for-Service	1912013087	1912013087	1	1	FRIEDMAN, RORY J	12/15/1989	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1045 ATLANTIC AVE	STE 807	LONG BEACH	CA	90813	3414	19	06037	33.780267	-118.1850795	Los Angeles County
112910	Fee-for-Service	1609963156	1609963156	1	1	FERNANDEZ, RODRIGO J MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44441	66	Emergency Medicine (Urgent Care)	0	In state provider	INC	480 FOURTH AVE	STE 516	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
112952	Fee-for-Service	1528421781	1528421781	1	1	FERBER, CHRISTOPHER J MD	4/7/2023	2080P0205X	NA	Endocrinology	026	PHYSICIANS	154645	None	None	0	In state provider	None	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
113001	Fee-for-Service	1013932045	1013932045	1	1	FRASIER, BRADLEY MD	9/30/1987	174400000X	NA	Other	026	PHYSICIANS	56768	34	Urology and Urological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
113018	Fee-for-Service	1982327698	1982327698	1	1	FAIZA, FAHMIDA PT	4/17/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
113142	Fee-for-Service	1275847360	1275847360	1	1	FILLO, JEREMIAH D MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117793	01	General Practice	0	In state provider	None	830 SCENIC DRIVE	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
113156	Fee-for-Service	1407010556	1407010556	1	1	FAIRBANKS, TIMOTHY J MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	80244	02	General Surgery	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
113182	Fee-for-Service	1235864927	1235864927	1	1	FRANCIS, GLORIA A	7/26/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1192 N LYMAN AVE	None	COVINA	CA	91724	1805	19	06037	34.100496	-117.849591	Los Angeles County
113198	Fee-for-Service	1609963156	1609963156	1	1	FERNANDEZ, RODRIGO J MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44441	45	Nephrology (Renal-Kidney)	0	In state provider	INC	480 FOURTH AVE	STE 516	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
113207	Fee-for-Service	1437892593	1437892593	1	1	FARAGUNA, CINDY C NP	11/5/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
113247	Fee-for-Service	1659514990	1659514990	1	1	FAKHRAEI, PIROUZ MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119144	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
113254	Fee-for-Service	1447295746	1447295746	1	1	FUJITA, MIHOKO MD	2/6/2023	2085R0001X	NA	Other	026	PHYSICIANS	53485	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
113288	Fee-for-Service	1316053192	1316053192	1	1	FERRONE, CRISTINA R MD	8/9/2023	2086X0206X	NA	General Surgery	026	PHYSICIANS	187495	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
113332	Fee-for-Service	1912403239	1912403239	1	1	FANG, ROZANNA MD	1/15/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177680	08	Family Practice	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
113374	Fee-for-Service	1790721678	1790721678	1	1	FALLIERAS, GEORGE N MD	1/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98124	None	None	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
113484	Fee-for-Service	1326293143	1326293143	1	1	FATEMI, OMID MD	9/8/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	136468	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
113485	Fee-for-Service	1609963156	1609963156	1	1	FERNANDEZ, RODRIGO J MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44441	41	Internal Medicine	0	In state provider	INC	480 FOURTH AVE	STE 516	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
113495	Fee-for-Service	1275907909	1275907909	1	1	FAVELA CASTRO, MARIA L LMFT	11/21/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
113517	Fee-for-Service	1538224241	1538224241	1	1	FAMILY HOMES, INC	3/17/2004	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SHANNON ICF/DDH HOME	2 ARLINGTON DR	None	S SAN FRANCISCO	CA	94080	1123	41	06081	37.67032404	-122.4534427	San Mateo County
113532	Fee-for-Service	1225207012	1225207012	1	1	FLAVIN, KARA E MD	3/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	101180	25	Physical Medicine and Rehabilitation	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
113638	Fee-for-Service	1013257674	1013257674	1	1	FERGUSON, JON DO CORP	1/29/2014	193400000X	NA	Other	026	PHYSICIANS	11757	45	Nephrology (Renal-Kidney)	0	In state provider	None	3011 CERES AVE	STE 100	CHICO	CA	95973	5637	04	06007	39.77592447	-121.8384651	Butte County
113654	Fee-for-Service	1134684582	1134684582	1	1	FRANZ, DANIELLE C LMFT	5/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
113658	Fee-for-Service	1366111312	1366111312	1	1	FORD, TOBY S LMFT	9/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
113706	Fee-for-Service	1770145807	1770145807	1	1	FAUST, SAMUEL L PT	12/14/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	35023 MISSION HILLS DR	BLDG A	RANCHO MIRAGE	CA	92270	1317	33	06065	33.79890054	-116.4319423	Riverside County
113735	Fee-for-Service	1316022692	1316022692	1	1	FREELAND, MICHAEL B OD	3/2/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	FAMILY OPT GRP CAMARILLO	4976 VERDUGO WAY	None	CAMARILLO	CA	93012	8632	56	06111	34.21547303	-119.0040356	Ventura County
113740	Fee-for-Service	1922639301	1922639301	1	1	FERRARI, GINA NP	10/4/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	355 ABBOTT STREET	200	SALINAS	CA	93901	4483	27	06053	36.66552031	-121.6439174	Monterey County
113770	Fee-for-Service	1407639826	1407639826	1	1	FOX, CATHERINE E	11/9/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
113784	Fee-for-Service	1043994486	1043994486	1	1	FRANCIS-EDWARDS, FELICIA M	7/17/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
113804	Fee-for-Service	1619083615	1619083615	1	1	FLEISCHMAN, HORACIO S MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	41069	01	General Practice	0	In state provider	INC	4036 WHITTIER BLVD	STE 200	LOS ANGELES	CA	90023	2561	19	06037	34.02390455	-118.1847825	Los Angeles County
113831	Fee-for-Service	1871600031	1871600031	1	1	FENG, ZHEN ZHOU MD	11/16/2007	207R00000X	NA	Other	026	PHYSICIANS	100208	10	Gastroenterology (M.D. only)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	94503	2149	49	06097	38.471625	-122.7259935	Sonoma County
113854	Fee-for-Service	1659473734	1659473734	1	1	FARAHANCHI, ALI DC	8/1/1999	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	HEALTH VIBES	803 WASHINGTON ST	None	SAN DIEGO	CA	92103	2206	37	06073	32.75005077	-117.157164	San Diego County
113875	Fee-for-Service	1316409865	1316409865	1	1	FRESENIUS MEDICAL CARE	3/1/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA V LLC	5961 UNIVERSITY AVE	STE 317	SAN DIEGO	CA	92115	6300	37	06073	32.75130695	-117.0683913	San Diego County
113886	Fee-for-Service	1487644613	1487644613	1	1	FUKUNAGA, KARL K MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72161	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
113890	Fee-for-Service	1649839655	1649839655	1	1	FLORES, MICHAEL A DPM	6/1/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	110 NEW STINE RD	None	BAKERSFIELD	CA	93309	2605	15	06029	35.35333762	-119.0610348	Kern County
113930	Fee-for-Service	1609825256	1609825256	1	1	FRIEND, PETER S MD	1/1/1982	207RN0300X	NA	Nephrology	026	PHYSICIANS	22253	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6480 DWANE AVE	None	SAN DIEGO	CA	92120	3925	37	06073	32.78648325	-117.0555488	San Diego County
113974	Fee-for-Service	1881628204	1881628204	1	1	FELDMAN, DOREE L MD	10/26/2010	207L00000X	NA	Other	026	PHYSICIANS	88251	05	Anesthesiology	0	In state provider	None	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
114001	Fee-for-Service	1376297143	1376297143	1	1	FEATHER RIVER CARE CENTER	3/1/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1 GILMORE LANE	None	OROVILLE	CA	95966	5147	04	06007	39.50782179	-121.5406657	Butte County
114010	Fee-for-Service	1063083723	1063083723	1	1	FUNCTIONAL REHABILITATION PH	8/9/2023	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	YSICAL THERAPY PC	3300 E SOUTH ST	STE 203	LAKEWOOD	CA	90805	4589	19	06037	33.86018093	-118.1537163	Los Angeles County
114025	Fee-for-Service	1386761153	1386761153	1	1	FRYE, REBECCA A DO	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9884	08	Family Practice	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
114092	Fee-for-Service	1619083615	1619083615	1	1	FLEISCHMAN, HORACIO S MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	41069	08	Family Practice	0	In state provider	INC	4036 WHITTIER BLVD	STE 200	LOS ANGELES	CA	90023	2561	19	06037	34.02390455	-118.1847825	Los Angeles County
114134	Fee-for-Service	1487733689	1487733689	1	1	FALL RIVER JOINT USD	9/30/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	20375 TAMARACK AVE	None	BURNEY	CA	96013	4054	45	06089	40.87997081	-121.6720505	Shasta County
114174	Fee-for-Service	1487644613	1487644613	1	1	FUKUNAGA, KARL K MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72161	10	Gastroenterology (M.D. only)	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
114218	Fee-for-Service	1609825256	1609825256	1	1	FRIEND, PETER S MD	1/1/1982	207RN0300X	NA	Nephrology	026	PHYSICIANS	22253	41	Internal Medicine	0	In state provider	None	6480 DWANE AVE	None	SAN DIEGO	CA	92120	3925	37	06073	32.78648325	-117.0555488	San Diego County
114244	Fee-for-Service	1982797684	1982797684	1	1	FRIENDS MEDICAL GROUP IN	2/15/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	5742 BEACH BLVD	SUITE A	BUENA PARK	CA	90621	2043	30	06059	33.876423	-117.9981635	Orange County
114271	Fee-for-Service	1396203006	1396203006	1	1	FRIENDLY NURSES HOME HEALTH	4/14/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	1707 EYE ST	STE 206	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
114359	Fee-for-Service	1164759155	1164759155	1	1	FINN, JESSICA A MD	7/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117304	22	Pathology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
114423	Fee-for-Service	1225034358	1225034358	1	1	FARAHI, JACK J MD	7/31/1993	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	67763	41	Internal Medicine	0	In state provider	APEX CARDIOLOGY CONSULT.	301 N PRAIRIE AVE	STE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
114435	Fee-for-Service	1982138665	1982138665	1	1	FORSLUND, JOHAN M MD	8/29/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	160765	None	None	0	In state provider	None	2141 N HARBOR BLVD	SUITE 35000	FULLERTON	CA	92835	3616	30	06059	33.89443025	-117.9288328	Orange County
114448	Fee-for-Service	1184659617	1184659617	1	1	FISHBACH, RONALD S MD	11/10/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	16649	41	Internal Medicine	0	In state provider	A MED CORP	8635 W 3RD ST	STE 1185W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
114462	Fee-for-Service	1003965641	1003965641	2	1	FELDMAN, SANFORD G MD	12/11/2007	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	INC	3737 MORAGA AVE	STE A 105	SAN DIEGO	CA	92117	5458	37	06073	32.8086683	-117.2109991	San Diego County
114532	Fee-for-Service	1982797684	1982797684	1	1	FRIENDS MEDICAL GROUP IN	2/15/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	5742 BEACH BLVD	SUITE A	BUENA PARK	CA	90621	2043	30	06059	33.876423	-117.9981635	Orange County
114566	Fee-for-Service	1174512636	1174512636	1	1	FESSLER, SUE MD	11/5/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	350 HERITAGE WAY	2100	KALISPELL	MT	59901	3167	00	None	48.216645	-114.324948	Flathead County
114569	Fee-for-Service	1255412300	1255412300	1	1	FRAZEE, JOHN G MD INC	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	33185	14	Neurological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
114585	Fee-for-Service	1942696125	1942696125	1	1	FLECK, ANDREW MD	3/4/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	173127	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
114589	Fee-for-Service	1871524454	1871524454	1	1	FAN, ALICE C MD	8/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74466	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
114641	Fee-for-Service	1063422178	1063422178	1	1	FISHER, MICHAEL B MD INC	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	22239	41	Internal Medicine	0	In state provider	None	221 W PUEBLO ST	None	SANTA BARBARA	CA	93105	6814	42	06083	34.431101	-119.7212764	Santa Barbara County
114703	Fee-for-Service	1043745938	1043745938	1	1	FAGUET, JOSH I MD	6/12/2023	208M00000X	NA	Other	026	PHYSICIANS	157679	None	None	0	In state provider	None	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	19	06037	33.8375955	-118.358748	Los Angeles County
114705	Fee-for-Service	1487847513	1487847513	1	1	FRAZIER, ALANA C LCSW	5/17/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
114711	Fee-for-Service	1225034358	1225034358	1	1	FARAHI, JACK J MD	7/31/1993	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	67763	06	Cardiovascular Disease (M.D. only)	0	In state provider	APEX CARDIOLOGY CONSULT.	301 N PRAIRIE AVE	STE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
114769	Fee-for-Service	1538508015	1538508015	1	1	FOOTHILL HEALTH CENTER	1/29/2014	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1066 S WHITE RD	None	SAN JOSE	CA	95127	3812	43	06085	37.35676387	-121.8196933	Santa Clara County
114780	Fee-for-Service	1477628006	1477628006	1	1	FOWLER, PATRICK T MD	3/1/1999	208800000X	NA	Other	026	PHYSICIANS	78482	None	None	0	In state provider	None	2624 EDITH AVE	None	REDDING	CA	96001	3043	45	06089	40.57136027	-122.397513	Shasta County
114810	Fee-for-Service	1851546584	1851546584	1	1	FRESENIUS MEDICAL CARE	12/1/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIABLO NEPHROLOGY CLINIC	365 LENNON LN	STE 160	WALNUT CREEK	CA	94598	5910	07	06013	37.92784983	-122.0301444	Contra Costa County
114871	Fee-for-Service	1861436602	1861436602	1	1	FLEMING, CHRISTOPHER H	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	46264	20	Orthopedic Surgery	0	In state provider	None	4444 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4136	33	06065	33.97614344	-117.3797664	Riverside County
114912	Fee-for-Service	1184661027	1184661027	1	1	FUTORAN, ROBERT M MD	1/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	70323	22	Pathology (M.D. only)	0	In state provider	None	FRESNO & R STREETS	None	FRESNO	CA	93721	0000	10	06019	36.741663	-119.7841005	Fresno County
114921	Fee-for-Service	1629037841	1629037841	1	1	FOGATA, MARIA L MD	1/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81691	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
114927	Fee-for-Service	1063422178	1063422178	1	1	FISHER, MICHAEL B MD INC	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	22239	45	Nephrology (Renal-Kidney)	0	In state provider	None	221 W PUEBLO ST	None	SANTA BARBARA	CA	93105	6814	42	06083	34.431101	-119.7212764	Santa Barbara County
114993	Fee-for-Service	1639412091	1639412091	1	2	FONSWORTH, PEOLIA K MD	7/6/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	132680	36	Psychiatry	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
115042	Fee-for-Service	1285940411	1285940411	1	1	FUH, CHENN-YOW MD INC	8/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	38829	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	382 W OLIVE AVE	None	MERCED	CA	95348	3137	24	06047	37.31918345	-120.4755181	Merced County
115062	Fee-for-Service	1538508015	1538508015	1	1	FOOTHILL HEALTH CENTER	11/1/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1066 S WHITE RD	None	SAN JOSE	CA	95127	3812	43	06085	37.35676387	-121.8196933	Santa Clara County
115110	Fee-for-Service	1881617017	1881617017	1	1	FITZGIBBONS, LESLIE J MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81312	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
115127	Fee-for-Service	1215279708	1215279708	1	1	FU, JONATHAN MD	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134422	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
115130	Fee-for-Service	1740980358	1740980358	1	1	FESENIUS MEDICAL CARE	5/13/2024	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	VENTURA COAST LLC	2200 OUTLET CENTER DR	STE 420	OXNARD	CA	93036	0613	56	06111	34.22164581	-119.1483723	Ventura County
115225	Fee-for-Service	1245709187	1245709187	1	1	FOUNTAIN HOMECARE SERVICES	12/31/2019	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	LLC	18305 SHERMAN WAY #13	None	RESEDA	CA	91335	4425	19	06037	34.20121152	-118.5319665	Los Angeles County
115247	Fee-for-Service	1487736328	1487736328	1	1	FRANKEL, ROBERT MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	44461	40	Pediatrics	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
115282	Fee-for-Service	1760592216	1760592216	1	1	FULLER, PHILIP S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
115331	Fee-for-Service	1285940411	1285940411	1	1	FUH, CHENN-YOW MD INC	8/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	38829	41	Internal Medicine	0	In state provider	None	382 W OLIVE AVE	None	MERCED	CA	95348	3137	24	06047	37.31918345	-120.4755181	Merced County
115351	Fee-for-Service	1538508015	1538508015	1	1	FOOTHILL HEALTH CENTER	11/1/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1066 S WHITE RD	None	SAN JOSE	CA	95127	3812	43	06085	37.35676387	-121.8196933	Santa Clara County
115526	Fee-for-Service	1477631125	1477631125	1	1	FERRONATO, STEVEN R MD	12/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	42110	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
115529	Fee-for-Service	1790831436	1790831436	1	1	FRIEDLAND, SUSAN JANE	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	54666	36	Psychiatry	0	In state provider	None	2340 CLAY ST	None	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
115613	Fee-for-Service	1194346171	1194346171	1	1	FORBES, EVAN J NP	10/28/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
115675	Fee-for-Service	1558486415	1558486415	1	1	FREEMAN, JOHN A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51125	05	Anesthesiology	0	In state provider	None	616 E CHAPEL ST	None	SANTA MARIA	CA	93454	4522	42	06083	34.95426953	-120.427596	Santa Barbara County
115703	Fee-for-Service	1700124849	1700124849	1	1	FRESNO SLEEP WAKE CENTER INC	12/13/2018	173F00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	,	7455 N FRESNO ST	304	FRESNO	CA	93720	2480	10	06019	36.84569956	-119.7839	Fresno County
115724	Fee-for-Service	1336224005	1336224005	1	1	FOGELBERG, RENEE B MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60635	05	Anesthesiology	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
115743	Fee-for-Service	1437109469	1437109469	1	1	FACULTY PHYS AND SURG OF	8/23/2004	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	LLUSM - OPHTHOMOLOGY	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
115855	Fee-for-Service	1851369284	1851369284	1	1	FREMONT AMBULATORY SURGERY	5/28/2004	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	39350 CIVIC CENTER	# 100	FREMONT	CA	94538	2384	01	06001	37.55399458	-121.9756047	Alameda County
115878	Fee-for-Service	1447230511	1447230511	1	1	FISHMAN, NOEL H MD	8/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	19763	02	General Surgery	0	In state provider	None	1850 SULLIVAN AVE	STE 210	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
115880	Fee-for-Service	1861451858	1861451858	1	1	FULLERTON RADIOLOGY MEDICAL	1/1/1979	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SPLIT RADIOLOGY	1301 N ROSE DR	None	PLACENTIA	CA	92870	3802	30	06059	33.8868003	-117.8420447	Orange County
115909	Fee-for-Service	1235525213	1235525213	1	1	FAWLEY, NICHOLAS DO	7/8/2021	207LP3000X	NA	Other	026	PHYSICIANS	18242	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
115913	Fee-for-Service	1104906569	1104906569	1	23	FRESNO COMMUNITY HOSPITAL	2/22/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	215 N FRESNO ST	SUITE 310	FRESNO	CA	93721	1324	10	06019	36.74538	-119.781566	Fresno County
115961	Fee-for-Service	1619636305	1619636305	1	1	FRESENIUS MEDICAL CARE	6/13/2023	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	REEDLEY HOME	790 E MANNING AVE	None	REEDLEY	CA	93654	2232	10	06019	36.6042183	-119.4410408	Fresno County
115970	Fee-for-Service	1588988646	1588988646	1	1	FRESENIUS MEDICAL CARE	5/10/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA LLC	340 4TH AVE	SUITE 18	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
115987	Fee-for-Service	1144369059	1144369059	1	1	FAMILY PLANNING ASSOCIATES	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	8635 FIRESTONE BLVD	None	DOWNEY	CA	90241	5242	19	06037	33.93691837	-118.1265474	Los Angeles County
116015	Fee-for-Service	1578565198	1578565198	1	1	FREDERICKSON, SARI NP	3/5/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
116030	Fee-for-Service	1437109469	1437109469	1	1	FACULTY PHYS AND SURG OF	12/1/1998	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	LLUSM - OPHTHOMOLOGY	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
116041	Fee-for-Service	1104906569	1104906569	1	22	FRESNO COMMUNITY HOSPITAL	2/22/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	215 N FRESNO ST	SUITE 230	FRESNO	CA	93721	1324	10	06019	36.74538	-119.781566	Fresno County
116060	Fee-for-Service	1235105073	1235105073	1	1	FISHER, ZACHARY E MD	6/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107981	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
116102	Fee-for-Service	1689846388	1689846388	1	1	FLECK, TERRY R MD	10/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108955	04	Otology, Laryngology, Rhinology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
116106	Fee-for-Service	1063630614	1063630614	1	1	F J S HEARING PROFESSIONALS	4/5/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	19083 BEAR VALLEY RD	STE 3	APPLE VALLEY	CA	92308	2719	36	06071	34.47095584	-117.2472361	San Bernardino County
116140	Fee-for-Service	1134151194	1134151194	1	1	FENNAR, TAD DPM	12/1/1997	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1300 W 6TH ST	STE 2	SAN PEDRO	CA	90732	3531	19	06037	33.7388555	-118.3059045	Los Angeles County
116152	Fee-for-Service	1558305847	1558305847	1	1	FRANKLIN MEMORIAL HOSP	7/20/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	111 FRANKLIN HEALTH	COMMONS	FARMINGTON	ME	04938	6144	00	None	44.626509	-70.1629335	Franklin County
116166	Fee-for-Service	1447230511	1447230511	1	1	FISHMAN, NOEL H MD	8/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	19763	33	Thoracic Surgery	0	In state provider	None	1850 SULLIVAN AVE	STE 210	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
116184	Fee-for-Service	1407920705	1407920705	1	1	FERRARI, MICHELLE MARIE	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64300	36	Psychiatry	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
116227	Fee-for-Service	1851570360	1851570360	1	1	FISHER, BREA E MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129360	01	General Practice	0	In state provider	None	1633 SOUTH COURT ST	None	VISALIA	CA	93277	4945	54	06107	36.315972	-119.292237	Tulare County
116240	Fee-for-Service	1609960731	1609960731	1	1	F & N PHARMA INC	1/24/1997	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WEST PHARMACY	18061 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	1304	30	06059	33.70077	-117.989257	Orange County
116419	Fee-for-Service	1679628069	1679628069	1	1	FRIEDMAN, ARTHUR OD APOC	9/1/1999	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL OPTOMETRI	2150 N WATERMAN AVE	STE 201	SAN BERNARDINO	CA	92404	4811	36	06071	34.134705	-117.2787865	San Bernardino County
116437	Fee-for-Service	1558305847	1558305847	1	1	FRANKLIN MEMORIAL HOSP	7/20/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	111 FRANKLIN HEALTH	COMMONS	FARMINGTON	ME	04938	6144	00	None	44.626509	-70.1629335	Franklin County
116453	Fee-for-Service	1447230511	1447230511	1	1	FISHMAN, NOEL H MD	8/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	19763	49	Unknown	0	In state provider	None	1850 SULLIVAN AVE	STE 210	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
116467	Fee-for-Service	1497779656	1497779656	1	1	FIELDS, KAREN L MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	45315	41	Internal Medicine	0	In state provider	None	5750 DOWNEY AVE	STE 100	LAKEWOOD	CA	90712	1411	19	06037	33.859611	-118.1511435	Los Angeles County
116470	Fee-for-Service	1407920705	1407920705	1	1	FERRARI, MICHELLE MARIE	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64300	26	Psychiatry (child)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
116532	Fee-for-Service	1821056706	1821056706	1	1	FAULKNER, WILLIAM J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1945 CEI DR	None	CINCINNATI	OH	45242	5664	00	None	39.2428671	-84.3841781	Hamilton County
116606	Fee-for-Service	1619955804	1619955804	1	1	FADARE, OLUWOLE MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131462	01	General Practice	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
116640	Fee-for-Service	1568025302	1568025302	1	1	FUMUSO, PERRY W MD	7/3/2023	390200000X	NA	Other	026	PHYSICIANS	184877	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
116689	Fee-for-Service	1306902507	1306902507	1	1	FAMILY HOMES, INC	1/25/2000	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	503 CREST VIEW AVE	None	BELMONT	CA	94002	2456	41	06081	37.52861947	-122.2832979	San Mateo County
116710	Fee-for-Service	1558788331	1558788331	1	1	FACULTY PHYSICIANS	6/10/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	& SURGEONS OF LLUSM	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
116730	Fee-for-Service	1790855161	1790855161	1	3	FIDERE ANESTHESIA CONSULTANT	2/25/2021	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	S, INC.	815 POLLARD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
116743	Fee-for-Service	1184622433	1184622433	1	1	FANG, LEE-HSIN BILLY MD	12/15/2014	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	305 SOUTH DRIVE	SUITE 6	MOUNTAIN VIEW	CA	94040	4207	43	06085	37.36724311	-122.0815284	Santa Clara County
116831	Fee-for-Service	1154416808	1154416808	1	1	FARAH, DANNY F	6/13/2008	207RN0300X	NA	Nephrology	026	PHYSICIANS	72189	None	None	0	In state provider	None	16133 VENTURA BLVD	STE 360	ENCINO	CA	91436	2424	19	06037	34.15656164	-118.4849569	Los Angeles County
116842	Fee-for-Service	1053991711	1053991711	1	1	FONG, NICHOLAS DO	9/9/2024	207R00000X	NA	Other	026	PHYSICIANS	22670	41	Internal Medicine	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
116989	Fee-for-Service	1881667012	1881667012	1	1	FARMER, JANE K MD	3/7/2011	207RE0101X	NA	Endocrinology	026	PHYSICIANS	63304	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
116995	Fee-for-Service	1740219062	1740219062	1	1	FELDMAN, ROBERT C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38903	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3300 WEBSTER ST	STE 710	OAKLAND	CA	94609	3122	01	06001	37.82132826	-122.2621843	Alameda County
117000	Fee-for-Service	1730158957	1730158957	1	1	FLAMMER,MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 S. POINEER PARKWAY	None	WEST VALLEY CITY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
117011	Fee-for-Service	1811959315	1811959315	1	1	FRANKENFELD, ERIC MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2901 SQUALICUM PKWY	None	BELLINGHAM	WA	98225	1851	00	None	48.77211992	-122.473101	Whatcom County
117033	Fee-for-Service	1114008653	1114008653	1	1	FISHER, MARK	5/24/2012	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1321 COLLEGE ST	STE D	WOODLAND	CA	95695	4706	57	06113	38.66508	-121.774824	Yolo County
117048	Fee-for-Service	1841649936	1841649936	1	1	FRANKLIN, KEVIN LCSW	3/12/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
117058	Fee-for-Service	1326569195	1326569195	1	1	FELIX, JO E	10/24/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
117113	Fee-for-Service	1831404896	1831404896	1	1	FITZPATRICK, MICHAEL J PSYD	5/21/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3825 HOPYARD ROAD	SUITE 140	PLEASANTON	CA	94566	8528	01	06001	37.683009	-121.9036935	Alameda County
117129	Fee-for-Service	1003857129	1003857129	1	1	FRENCH, WILLIAM M MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50686	30	Radiology	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
117146	Fee-for-Service	1811361892	1811361892	1	1	FIELD, HEATHER A	1/15/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
117168	Fee-for-Service	1831404375	1831404375	1	1	FARHAR, REGINA NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6 WILLARD	None	IRVINE	CA	92604	4694	30	06059	33.67534801	-117.7900415	Orange County
117203	Fee-for-Service	1477700938	1477700938	1	1	FORMAN, JUSTIN D PHD	2/12/2019	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	320 10TH ST	STE 200	SANTA ROSA	CA	95401	5291	49	06097	38.443572	-122.719698	Sonoma County
117222	Fee-for-Service	1891876447	1891876447	1	1	FREIMER, GREGORY L. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 E DAWSON ST	None	TYLER	TX	75701	2036	00	None	32.3420585	-95.29174939	Smith County
117226	Fee-for-Service	1518315282	1518315282	1	1	FARALA, JOHN P MD	7/12/2021	208M00000X	NA	Other	026	PHYSICIANS	152594	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
117254	Fee-for-Service	1780725556	1780725556	1	1	FERRITER, STACY K CRNA	12/12/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
117265	Fee-for-Service	1508202144	1508202144	1	1	FERNANDO, TASHA J MD	1/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132861	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
117311	Fee-for-Service	1417388943	1417388943	1	1	FLORENCE HOSPICE LLC	5/17/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	20847 SHERMAN WAY	STE 310	WINNETKA	CA	91306	2706	19	06037	34.2011495	-118.587888	Los Angeles County
117316	Fee-for-Service	1164820197	1164820197	1	1	FONSECA PHARMACY SERVICES	5/7/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1045 G STREET	None	REEDLEY	CA	93654	2935	10	06019	36.59667098	-119.4512335	Fresno County
117338	Fee-for-Service	1366474322	1366474322	1	1	FRIEDMAN, GERALD S MD	10/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	19835	45	Nephrology (Renal-Kidney)	0	In state provider	A PROFESSIONAL CORP	800 N PARK AVE	None	POMONA	CA	91768	3001	19	06037	34.06607586	-117.7547223	Los Angeles County
117342	Fee-for-Service	1033254040	1033254040	1	1	FIRST, PAUL D MD AMC	7/31/1985	207W00000X	NA	Ophthalmology	026	PHYSICIANS	37229	18	Ophthalmology	0	In state provider	None	7080 HOLLYWOOD BLVD	STE 902	LOS ANGELES	CA	90028	6959	19	06037	34.10143074	-118.3445888	Los Angeles County
117354	Fee-for-Service	1184690984	1184690984	1	1	FARID-MOAYER, MEHRAN MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66203	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1515 TROUSDALE DR	STE 115	BURLINGAME	CA	94010	4524	41	06081	37.59358295	-122.3841295	San Mateo County
117369	Fee-for-Service	1336309616	1336309616	1	1	FELDT, BRENT A MD	12/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130651	04	Otology, Laryngology, Rhinology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	2552	48	06095	38.26109552	-122.0470245	Solano County
117540	Fee-for-Service	1215270533	1215270533	1	1	FATEH, ROUZBEH MD	9/1/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	174833	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
117558	Fee-for-Service	1649806696	1649806696	1	1	FONG, ANNA M MD	8/7/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178957	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
117574	Fee-for-Service	1144697988	1144697988	1	1	FISHER, KATRINA R LCSW	2/23/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
117581	Fee-for-Service	1972115095	1972115095	1	1	FEUER, HAYLEY LCSW	3/25/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	130 N BRAND BLVD	202	GLENDALE	CA	91203	2644	19	06037	34.147521	-118.2549325	Los Angeles County
117599	Fee-for-Service	1417388943	1417388943	1	1	FLORENCE HOSPICE LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	20847 SHERMAN WAY	STE 310	WINNETKA	CA	91306	2706	19	06037	34.2011495	-118.587888	Los Angeles County
117625	Fee-for-Service	1366474322	1366474322	1	1	FRIEDMAN, GERALD S MD	10/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	19835	41	Internal Medicine	0	In state provider	A PROFESSIONAL CORP	800 N PARK AVE	None	POMONA	CA	91768	3001	19	06037	34.06607586	-117.7547223	Los Angeles County
117642	Fee-for-Service	1184690984	1184690984	1	1	FARID-MOAYER, MEHRAN MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66203	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1515 TROUSDALE DR	STE 115	BURLINGAME	CA	94010	4524	41	06081	37.59358295	-122.3841295	San Mateo County
117647	Fee-for-Service	1760645725	1760645725	1	1	FREDRICKSON, RHIANA R MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112171	36	Psychiatry	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
117695	Fee-for-Service	1609181155	1609181155	1	1	FARIAS, JANELLE B LMFT	9/7/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
117711	Fee-for-Service	1023318045	1023318045	1	1	FARIDNIA, REGINA G	3/23/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
117717	Fee-for-Service	1124758883	1124758883	1	1	FRIENDS OF FAMILY HEALTH	6/21/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	565 S AZUSA WAY	None	LA PUENTE	CA	91744	5113	19	06037	34.01163314	-117.9241766	Los Angeles County
117771	Fee-for-Service	1285772780	1285772780	1	1	FORESTHILL FIRE PROTECTN	3/12/2007	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	24320 MAIN ST	None	FORESTHILL	CA	95631	9318	31	06061	39.01934692	-120.8214432	Placer County
117914	Fee-for-Service	1366474322	1366474322	1	1	FRIEDMAN, GERALD S MD	10/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	19835	39	Preventive (M.D. only)	0	In state provider	A PROFESSIONAL CORP	800 N PARK AVE	None	POMONA	CA	91768	3001	19	06037	34.06607586	-117.7547223	Los Angeles County
117964	Fee-for-Service	1174159669	1174159669	1	1	FRANCONI, COLLEEN MD	11/21/2022	171000000X	NA	Other	026	PHYSICIANS	181785	None	None	0	In state provider	None	5575 RUFFIN RD	STE 100	SAN DIEGO	CA	92123	1380	37	06073	32.83605627	-117.1266464	San Diego County
117967	Fee-for-Service	1619983590	1619983590	1	1	FEIT, THEODORE S MD INC	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	32804	None	None	0	In state provider	None	2031 W ALAMEDA AVE	STE 330	BURBANK	CA	91506	2960	19	06037	34.15972797	-118.3237055	Los Angeles County
117996	Fee-for-Service	1558504902	1558504902	1	1	FITZGERALD, CHRISTOPHER R MD	8/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124041	40	Pediatrics	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
118004	Fee-for-Service	1124758883	1124758883	1	1	FRIENDS OF FAMILY HEALTH	10/16/2023	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	565 S AZUSA WAY	None	LA PUENTE	CA	91744	5113	19	06037	34.01163314	-117.9241766	Los Angeles County
118024	Fee-for-Service	1659790046	1659790046	1	1	FAGLIANO, STEPHANIE M	4/5/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	123 W PADRE ST	SUITE A	SANTA BARBARA	CA	93105	3960	42	06083	34.43007785	-119.7177802	Santa Barbara County
118046	Fee-for-Service	1275502700	1275502700	1	1	FUNG, DAVID M MD	6/30/1985	207L00000X	NA	Other	026	PHYSICIANS	46964	05	Anesthesiology	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
118083	Fee-for-Service	1629842828	1629842828	1	1	FOOTHILL URGENT CARE	1/9/2025	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	8027 FOOTHILL BLVD	None	SUNLAND	CA	91040	2957	19	06037	34.25968851	-118.3080465	Los Angeles County
118114	Fee-for-Service	1598073397	1598073397	1	1	FRUCHTENICHT, MEREDITH L E	4/24/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94958	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
118179	Fee-for-Service	1881789196	1881789196	1	1	FRIEDMAN, RICHARD G MD	7/16/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	32430	41	Internal Medicine	0	In state provider	SUITE 300	4033 3RD AVE	None	SAN DIEGO	CA	92103	2117	37	06073	32.75053781	-117.1627168	San Diego County
118205	Fee-for-Service	1811007255	1811007255	1	1	FUJIOKA, KEN MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	59288	41	Internal Medicine	0	In state provider	SHARP REES STEALY CORP	9834 GENESEE AVE	STE 400	LA JOLLA	CA	92037	1216	37	06073	32.884074	-117.225855	San Diego County
118212	Fee-for-Service	1598792897	1598792897	1	1	FARROW, LINDA C	3/12/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1501 SUPERIOR AVE	STE 313	NEWPORT BEACH	CA	92663	3641	30	06059	33.62918676	-117.9305675	Orange County
118250	Fee-for-Service	1841406899	1841406899	1	1	FARRER-OBRYANT, ROSA MD	7/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101339	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
118251	Fee-for-Service	1821115825	1821115825	1	1	FUNK, KRISTI M MD	11/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73916	78	Neoplastic Diseases/Oncology	0	In state provider	None	120 S SPALDING DRIVE	STE 205	BEVERLY HILLS	CA	90212	1800	19	06037	34.06625419	-118.4088854	Los Angeles County
118260	Fee-for-Service	1669510848	1669510848	1	1	FATTAH, HALA M MD	4/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74049	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
118285	Fee-for-Service	1558504902	1558504902	1	1	FITZGERALD, CHRISTOPHER R MD	8/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124041	41	Internal Medicine	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
118287	Fee-for-Service	1588847354	1588847354	1	1	FERREIRA, CATHERINE L	2/24/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
118293	Fee-for-Service	1124758883	1124758883	1	1	FRIENDS OF FAMILY HEALTH	6/21/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	565 S AZUSA WAY	None	LA PUENTE	CA	91744	5113	19	06037	34.01163314	-117.9241766	Los Angeles County
118341	Fee-for-Service	1487636296	1487636296	1	1	FIELD, NANCY T MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77698	01	General Practice	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
118346	Fee-for-Service	1851571905	1851571905	1	1	FUJII, PATRICIA L LCSW	8/16/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2652 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3041	43	06085	37.35228637	-121.9754073	Santa Clara County
118382	Fee-for-Service	1841717782	1841717782	1	1	FOX, BENJAMIN PT	3/5/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
118398	Fee-for-Service	1578999611	1578999611	1	1	FINN, MEGHAN E NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118445	Fee-for-Service	1710052832	1710052832	1	1	FRANCKE, UTA MD	4/27/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	25346	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	# A200	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
118467	Fee-for-Service	1881789196	1881789196	1	1	FRIEDMAN, RICHARD G MD	7/16/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	32430	66	Emergency Medicine (Urgent Care)	0	In state provider	SUITE 300	4033 3RD AVE	None	SAN DIEGO	CA	92103	2117	37	06073	32.75053781	-117.1627168	San Diego County
118535	Fee-for-Service	1366977258	1366977258	1	1	FAVIS, ROXANNE DO	7/1/2022	207L00000X	NA	Other	026	PHYSICIANS	16891	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
118538	Fee-for-Service	1821115825	1821115825	1	1	FUNK, KRISTI M MD	11/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73916	02	General Surgery	0	In state provider	None	120 S SPALDING DRIVE	STE 205	BEVERLY HILLS	CA	90212	1800	19	06037	34.06625419	-118.4088854	Los Angeles County
118607	Fee-for-Service	1821058934	1821058934	1	1	FOLSOM ORTHOPAEDIC	10/13/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	SURGERY & MEDICAL CLINIC	2575 E BIDWELL ST	STE 250	FOLSOM	CA	95630	6447	34	06067	38.658888	-121.1303835	Sacramento County
118608	Fee-for-Service	1316148653	1316148653	1	1	FIRAS MARAYATI, MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 NORTH CAMPBELL	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
118616	Fee-for-Service	1164671178	1164671178	1	1	FREDERICKS, ANNE E NP	9/11/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
118623	Fee-for-Service	1568765915	1568765915	1	1	FOOT & ANKLE PHYSICIANS &	5/13/2014	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	SURGEONS PC	17777 VENTURA BLVD	STE 252	ENCINO	CA	91316	3736	19	06037	34.16286556	-118.5200521	Los Angeles County
118639	Fee-for-Service	1457882052	1457882052	1	1	FRANCOIS, RONY A MD	6/14/2022	207ZD0900X	NA	Other	026	PHYSICIANS	172444	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
118648	Fee-for-Service	1326234477	1326234477	1	1	FINK, STEPHEN A MD	6/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101253	05	Anesthesiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
118734	Fee-for-Service	1710052832	1710052832	1	1	FRANCKE, UTA MD	4/27/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	25346	01	General Practice	0	In state provider	None	300 PASTEUR DR	# A200	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
118757	Fee-for-Service	1881789196	1881789196	1	1	FRIEDMAN, RICHARD G MD	7/16/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	32430	06	Cardiovascular Disease (M.D. only)	0	In state provider	SUITE 300	4033 3RD AVE	None	SAN DIEGO	CA	92103	2117	37	06073	32.75053781	-117.1627168	San Diego County
118774	Fee-for-Service	1740579440	1740579440	1	1	FATTAH, HADI MD	10/29/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	141450	45	Nephrology (Renal-Kidney)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
118777	Fee-for-Service	1316493257	1316493257	1	1	FLEWELLING, LYNN B LMFT	10/1/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 E REDLANDS BLVD	STE 234F	REDLANDS	CA	92373	4775	36	06071	34.05731952	-117.181197	San Bernardino County
118847	Fee-for-Service	1871957712	1871957712	1	1	FERNANDEZ, DIEGO R MD	9/23/2021	207R00000X	NA	Other	026	PHYSICIANS	172321	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
118943	Fee-for-Service	1396169090	1396169090	1	1	FRIEND, EARL C	6/27/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
118956	Fee-for-Service	1861451858	1861451858	1	6	FULLERTON RADIOLOGY MEDICAL	1/4/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP, INC	5451 WALNUT AVE	None	CHINO	CA	91708	9998	36	06071	34.02626886	-117.6858645	San Bernardino County
119007	Fee-for-Service	1609912666	1609912666	1	1	FICKS, LAUREN G MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72034	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
119186	Fee-for-Service	1477600856	1477600856	1	1	FORGHANI, NIKI OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
119208	Fee-for-Service	1366101685	1366101685	1	1	FUTUREGENERATION LABORATORIE	5/31/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	S LLC	10211 PACIFIC MESA BLVD	STE 408	SAN DIEGO	CA	92121	4327	37	06073	32.90356075	-117.1910233	San Diego County
119254	Fee-for-Service	1730129651	1730129651	1	2	FROST, NICHOLAS R MD	9/5/2017	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	22304	-	NOT APPLICABLE	0	In state provider	None	2600 STANWELL DR	STE 100	CONCORD	CA	94520	4862	07	06013	37.98689836	-122.047993	Contra Costa County
119296	Fee-for-Service	1609912666	1609912666	1	1	FICKS, LAUREN G MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72034	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
119326	Fee-for-Service	1992150015	1992150015	1	1	FARAG, AMYE M MD	7/24/2020	390200000X	NA	Other	026	PHYSICIANS	167807	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
119407	Fee-for-Service	1104906569	1104906569	1	19	FRESNO COMMUNITY HOSPITAL	9/1/2015	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	15 E AUDUBON DRIVE	None	FRESNO	CA	93720	1542	10	06019	36.86091856	-119.7886861	Fresno County
119476	Fee-for-Service	1013931211	1013931211	1	1	FREEMER, MICHELLE M MD	10/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67545	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1001 POTRERO AVE	RM 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
119485	Fee-for-Service	1659822583	1659822583	1	1	FRIEDEMAN, ELISABETH PT	12/9/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
119603	Fee-for-Service	1063630614	1063630614	1	8	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	10351 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	1809	33	06065	33.9113564	-117.4626292	Riverside County
119680	Fee-for-Service	1356400089	1356400089	1	1	FLORES-GUINTU, LUTCHIE J NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11001 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1413	19	06037	34.26991066	-118.4671653	Los Angeles County
119693	Fee-for-Service	1104906569	1104906569	1	19	FRESNO COMMUNITY HOSPITAL	9/1/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	15 E AUDUBON DRIVE	None	FRESNO	CA	93720	1542	10	06019	36.86091856	-119.7886861	Fresno County
119706	Fee-for-Service	1952346348	1952346348	1	1	FRISHBERG, BENJAMIN M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43493	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
119708	Fee-for-Service	1477025450	1477025450	1	1	FLORES, AURORA E NP	10/20/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
119742	Fee-for-Service	1821257395	1821257395	1	1	FERRARA, JAMMIE T MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120185	05	Anesthesiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
119809	Fee-for-Service	1922186923	1922186923	1	1	FERRER, RAMON M MD	8/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54269	36	Psychiatry	0	In state provider	None	6600 MERCY CT	STE 290	FAIR OAKS	CA	95628	3190	34	06067	38.666565	-121.309857	Sacramento County
119817	Fee-for-Service	1659380657	1659380657	1	1	FARRER, TODD A MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	60156	08	Family Practice	0	In state provider	None	2631 FASHION PL	STE A	BAKERSFIELD	CA	93306	3068	15	06029	35.392302	-118.958049	Kern County
119884	Fee-for-Service	1063630614	1063630614	1	4	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3603 W FLORIDA AVE	None	HEMET	CA	92545	3514	33	06065	33.74699274	-117.0099935	Riverside County
119920	Fee-for-Service	1912050055	1912050055	1	1	FALLEJO, SAMUEL N OD	10/16/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
119935	Fee-for-Service	1891255907	1891255907	1	1	FERIANTE, JOSHUA DO	7/19/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	19705	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
119947	Fee-for-Service	1053482943	1053482943	1	1	FEFFERMAN, RICHARD A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	16335	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
119973	Fee-for-Service	1245680990	1245680990	1	1	FALCONE, JOSEPH A MD	6/5/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	153706	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
119989	Fee-for-Service	1417156118	1417156118	1	2	FELDMAN, DANIELE S	9/18/2017	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	106571	01	General Practice	0	In state provider	None	116 S PALISADE DR	STE 104	SANTA MARIA	CA	93454	8905	42	06083	34.9523869	-120.4120717	Santa Barbara County
119995	Fee-for-Service	1952346348	1952346348	1	1	FRISHBERG, BENJAMIN M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43493	01	General Practice	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
120021	Fee-for-Service	1871987784	1871987784	1	1	FITZPATRICK, JESSE K MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146260	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
120030	Fee-for-Service	1821257395	1821257395	1	1	FERRARA, JAMMIE T MD	6/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120185	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
120066	Fee-for-Service	1346240264	1346240264	1	1	FUNG, LIT K MD	11/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	59878	33	Thoracic Surgery	0	In state provider	None	1501 OAKDALE ROAD	SUITE 218	MODESTO	CA	95355	3381	50	06099	37.665279	-120.957607	Stanislaus County
120114	Fee-for-Service	1659382323	1659382323	1	1	FELIX, VANESSA MD	3/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83878	41	Internal Medicine	0	In state provider	None	2000 O ST	None	SACRAMENTO	CA	95814	5224	34	06067	38.57106572	-121.4822412	Sacramento County
120125	Fee-for-Service	1275583007	1275583007	1	1	FACULTY PHYSICIANS	12/10/2007	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	84	Surgery-Head and Neck	0	In state provider	AND SURGEONS OF LLUSM	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
120145	Fee-for-Service	1164584918	1164584918	1	1	FRIEDLAND, KATHLEEN PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
120159	Fee-for-Service	1013018514	1013018514	1	1	FERMIN, ESTHER A MD	1/1/1979	207RH0000X	NA	Hematology	026	PHYSICIANS	25858	01	General Practice	0	In state provider	None	15203 11TH ST	STE A	VICTORVILLE	CA	92395	3737	36	06071	34.52758919	-117.2925085	San Bernardino County
120167	Fee-for-Service	1336432947	1336432947	1	1	FAMILY PLANNING ASSOCIATES M	6/2/2011	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP INC	2915 TELEGRAPH AVENUE	SUITE 101	BERKELEY	CA	94705	2069	01	06001	37.85719633	-122.2595246	Alameda County
120219	Fee-for-Service	1104906569	1104906569	1	17	FRESNO COMMUNITY HOSPITAL	10/1/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	729 MEDICAL CENTER DRIVE	SUITE 215	CLOVIS	CA	93611	6885	10	06019	36.84152435	-119.6624818	Fresno County
120235	Fee-for-Service	1659328797	1659328797	1	1	FRISCHER MEDICAL GROUP	5/2/2005	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC	11480 BROOKSHIRE AVE	STE 200	DOWNEY	CA	90241	5021	19	06037	33.93622932	-118.1311752	Los Angeles County
120241	Fee-for-Service	1477736734	1477736734	1	1	FU, HELEN I MD	9/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93904	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	27400 HESPERIAN BVLD	None	LIVERMORE	CA	94545	9235	01	06001	37.63011596	-122.0960694	Alameda County
120284	Fee-for-Service	1952346348	1952346348	1	1	FRISHBERG, BENJAMIN M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43493	13	Neurology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
120410	Fee-for-Service	1477783983	1477783983	1	1	FOLEY, JESSICA M PHD	4/5/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
120412	Fee-for-Service	1275583007	1275583007	1	1	FACULTY PHYSICIANS	12/10/2007	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	AND SURGEONS OF LLUSM	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
120450	Fee-for-Service	1013018514	1013018514	1	1	FERMIN, ESTHER A MD	1/1/1979	207RH0000X	NA	Hematology	026	PHYSICIANS	25858	41	Internal Medicine	0	In state provider	None	15203 11TH ST	STE A	VICTORVILLE	CA	92395	3737	36	06071	34.52758919	-117.2925085	San Bernardino County
120467	Fee-for-Service	1649279902	1649279902	1	1	FRIEDMAN, MARK J MD	9/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
120489	Fee-for-Service	1326292012	1326292012	1	1	FREMONT NEPHROLOGY	2/23/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	PROF CORP	39233 LIBERTY ST	None	FREMONT	CA	94538	1501	01	06001	37.55061601	-121.9816447	Alameda County
120524	Fee-for-Service	1659328797	1659328797	1	1	FRISCHER MEDICAL GROUP	5/2/2005	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	INC	11480 BROOKSHIRE AVE	STE 200	DOWNEY	CA	90241	5021	19	06037	33.93622932	-118.1311752	Los Angeles County
120527	Fee-for-Service	1295338903	1295338903	1	1	FISHER, SARA PT	2/23/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2051 STATHAM BLVD	None	OXNARD	CA	93033	3901	56	06111	34.17967669	-119.1655477	Ventura County
120540	Fee-for-Service	1851545404	1851545404	1	1	FUJIMOTO, DEBORAH LCSW	10/17/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7825 FAY AVE	200	LA JOLLA	CA	92037	4252	37	06073	32.84527369	-117.275383	San Diego County
120620	Fee-for-Service	1740329655	1740329655	1	1	FAMILY PLANNING ASSOC	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GRP INC	165 N CLARK ST	None	FRESNO	CA	93701	2108	10	06019	36.74454278	-119.786043	Fresno County
120629	Fee-for-Service	1073768891	1073768891	2	1	FERNANDEZ, GENARO MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	122302	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
120651	Fee-for-Service	1477631265	1477631265	1	1	FAN, PELLY MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61460	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
120700	Fee-for-Service	1275583007	1275583007	1	1	FACULTY PHYSICIANS	12/10/2007	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	AND SURGEONS OF LLUSM	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
120702	Fee-for-Service	1275918849	1275918849	1	1	FLORENCE MEDICAL SUPPLY INC	5/2/2016	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2060 CHICAGO AVE	UNIT C4	RIVERSIDE	CA	92507	2206	33	06065	33.992568	-117.3483325	Riverside County
120709	Fee-for-Service	1447463088	1447463088	1	1	FRANCISCO, ANDREA M PSYD	7/17/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
120758	Fee-for-Service	1104605328	1104605328	1	1	F & F HELPING HANDS INC	12/13/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2270 EAST PALMDALE BLVD	SUITE K/L	PALMDALE	CA	93550	4933	19	06037	34.58009827	-118.0881861	Los Angeles County
120779	Fee-for-Service	1326292012	1326292012	1	1	FREMONT NEPHROLOGY	2/23/2009	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PROF CORP	39233 LIBERTY ST	None	FREMONT	CA	94538	1501	01	06001	37.55061601	-121.9816447	Alameda County
120928	Fee-for-Service	1750509006	1750509006	1	1	FOOSE, TRACY E MD	7/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103132	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
120975	Fee-for-Service	1639322415	1639322415	1	2	FORT HELP MISSION, INC	11/6/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1101 CAPP STREET	None	SAN FRANCISCO	CA	94110	4697	38	06075	37.748871	-122.4170205	San Francisco County
120986	Fee-for-Service	1275583007	1275583007	1	1	FACULTY PHYSICIANS	4/16/2024	208000000X	NA	Pediatric Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AND SURGEONS OF LLUSM	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
121004	Fee-for-Service	1609942861	1609942861	2	1	FALK, WILLIAM B NP	1/17/2007	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	678 2ND ST W	None	SONOMA	CA	95476	6901	49	06097	38.28914695	-122.4617525	Sonoma County
121009	Fee-for-Service	1023599891	1023599891	1	1	FLORES, JOANA LMFT	10/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 N BRAND BLVD	STE 223	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
121038	Fee-for-Service	1578787859	1578787859	1	1	FEINSTEIN, JOEL M MD	6/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108039	05	Anesthesiology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
121063	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	6/19/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
121093	Fee-for-Service	1104917285	1104917285	1	1	FERRARA, SUSAN T NP	12/4/2006	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	678 2ND ST W	None	SONOMA	CA	95476	6901	49	06097	38.28914695	-122.4617525	Sonoma County
121167	Fee-for-Service	1477604684	1477604684	1	1	FORWAND, JODI M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	75 BEEKMAN ST	None	PLATTSBURGH	NY	12901	1438	00	None	44.701011	-73.4692635	Clinton County
121181	Fee-for-Service	1760679344	1760679344	1	1	FRIEDBERG, GENEVIEVE E	7/3/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 SOQUEL AVE	STE 320	SANTA CRUZ	CA	95062	2336	44	06087	36.97623386	-122.0170137	Santa Cruz County
121270	Fee-for-Service	1730404112	1730404112	1	1	FRESH BEGINNING INC	12/3/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	FRESH BEGINNING INC	72 W 11TH STREET	SUITE A	TRACY	CA	95376	3906	39	06077	37.7396427	-121.427681	San Joaquin County
121273	Fee-for-Service	1275583007	1275583007	1	1	FACULTY PHYSICIANS	3/1/2002	208000000X	NA	Pediatric Primary Care	031	PSYCHOLOGISTS	-	None	None	0	In state provider	AND SURGEONS OF LLUSM	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
121317	Fee-for-Service	1679787360	1679787360	1	1	FAMILY BRIDGES	5/8/2000	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HONG FOOK-HARRISON ST	1388 HARRISON ST	None	OAKLAND	CA	94612	0000	01	06001	37.80277715	-122.2676048	Alameda County
121354	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	6/19/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
121376	Fee-for-Service	1083816136	1083816136	1	1	FLETCHER, CRAIG H MD	6/9/2022	207ZC0006X	NA	Other	026	PHYSICIANS	177791	None	None	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
121378	Fee-for-Service	1699729178	1699729178	1	1	FENERTY, JOSEPH P	6/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	75953	None	None	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
121406	Fee-for-Service	1528135464	1528135464	1	1	FASS, BENJAMIN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	21395	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
121454	Fee-for-Service	1205907276	1205907276	1	1	FANG, ERVIN N MD	11/30/1993	207W00000X	NA	Ophthalmology	026	PHYSICIANS	78501	18	Ophthalmology	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
121476	Fee-for-Service	1356424741	1356424741	1	1	FISH, DAVID ELI MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77878	20	Orthopedic Surgery	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
121551	Fee-for-Service	1922569748	1922569748	1	1	FENNIMORE, NICOLE J MD	4/29/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	None	10123 SE MARKET STREET	None	PORTLAND	OR	97216	2532	00	None	45.51158947	-122.5586205	Multnomah County
121560	Fee-for-Service	1366520199	1366520199	1	1	FANG, MING MD	1/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83531	10	Gastroenterology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
121574	Fee-for-Service	1689013161	1689013161	2	2	FREMONT EMERGENCY SERVICES	2/24/2016	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	8280 W WARM SPRINGS RD	None	LAS VEGAS	NV	89113	3612	00	None	36.057384	-115.2721395	Clark County
121640	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	7/20/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
121699	Fee-for-Service	1427395094	1427395094	1	1	FOOTHILL RETIREMENT OPERATOR	8/31/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	OPERATOR, LLC	6720 SAINT ESTABAN STREE	None	TUJUNGA	CA	91042	3335	19	06037	34.24549046	-118.2788572	Los Angeles County
121816	Fee-for-Service	1649348061	1649348061	1	1	FLETCHER, ARIEL M LMFT	2/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
121928	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	11/20/2023	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
122085	Fee-for-Service	1093891897	1093891897	1	1	FOOTE, LESLIE ARDEN MD	4/25/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60560	66	Emergency Medicine (Urgent Care)	0	In state provider	None	AIRPORT ROAD	None	HOOPA	CA	95546	0000	12	06023	41.04526615	-123.6661741	Humboldt County
122098	Fee-for-Service	1013354190	1013354190	1	1	FAUSTIN, MARCIA I MD	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132562	01	General Practice	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
122119	Fee-for-Service	1336208933	1336208933	1	1	FRIEDMAN, NOAH J MD	10/3/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71320	03	Allergy	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
122170	Fee-for-Service	1669677217	1669677217	1	1	FAITH & HOPE HOSPICE CARE	10/27/2009	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	1575 N LAKE AVE	SUITE 208	PASADENA	CA	91104	2340	19	06037	34.17298885	-118.1321076	Los Angeles County
122176	Fee-for-Service	1487116000	1487116000	1	1	FERGUSON, RYAN	7/12/2024	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	22376	25	Physical Medicine and Rehabilitation	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
122216	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	4/16/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
122283	Fee-for-Service	1306506530	1306506530	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	12572 AVENUE 416	None	OROSI	CA	93647	2191	54	06107	36.54486145	-119.2919862	Tulare County
122327	Fee-for-Service	1891725347	1891725347	1	1	FRANK, STEVEN A LMFT	12/18/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	260 MAPLE COURT	SUITE 103	VENTURA	CA	93003	3553	56	06111	34.27027545	-119.24562	Ventura County
122372	Fee-for-Service	1093891897	1093891897	1	1	FOOTE, LESLIE ARDEN MD	4/25/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60560	01	General Practice	0	In state provider	None	AIRPORT ROAD	None	HOOPA	CA	95546	0000	12	06023	41.04526615	-123.6661741	Humboldt County
122381	Fee-for-Service	1578900726	1578900726	1	1	FRIEDLANDER, JOSHUA A MD	6/15/2018	207R00000X	NA	Other	026	PHYSICIANS	153278	30	Radiology	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
122382	Fee-for-Service	1548569601	1548569601	1	1	FOX, LAUREL A LMFT	4/27/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	53573	-	NOT APPLICABLE	0	In state provider	None	2620 INDUSTRY WAY	SUITE A	LYNWOOD	CA	90262	4024	19	06037	33.92360701	-118.2254995	Los Angeles County
122442	Fee-for-Service	1548439524	1548439524	1	1	FADDOUL, DIALA A MD	12/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113851	40	Pediatrics	0	In state provider	None	1346 E FOOTHILL BLVD	STE 201	LA CANADA	CA	91011	2143	19	06037	34.20780552	-118.2076252	Los Angeles County
122452	Fee-for-Service	1801127360	1801127360	1	1	FURLONG, AMY E LCSW	6/10/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
122462	Fee-for-Service	1669677217	1669677217	1	1	FAITH & HOPE HOSPICE CARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	1575 N LAKE AVE	SUITE 208	PASADENA	CA	91104	2340	19	06037	34.17298885	-118.1321076	Los Angeles County
122496	Fee-for-Service	1831100429	1831100429	2	1	FOUNTAIN VALLEY CENTRAL	2/1/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY INC	11055 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	4007	30	06059	33.7165233	-117.9365153	Orange County
122503	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	6/19/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
122516	Fee-for-Service	1710995717	1710995717	1	1	FONG, DAVID DPM	6/19/1986	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	357 15TH ST	None	OAKLAND	CA	94612	3303	01	06001	37.80442482	-122.2683293	Alameda County
122520	Fee-for-Service	1245413160	1245413160	1	1	FIGUEROA, CLAUDIA M LMFT	3/13/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7840 IMPERIAL HWY	B	DOWNEY	CA	90242	3457	19	06037	33.92542657	-118.1549366	Los Angeles County
122565	Fee-for-Service	1568591550	1568591550	1	1	FUENTES, PAULA R LMFT	8/2/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 N BRAND BLVD	STE 223	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
122573	Fee-for-Service	1306506530	1306506530	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	12572 AVENUE 416	None	OROSI	CA	93647	2191	54	06107	36.54486145	-119.2919862	Tulare County
122611	Fee-for-Service	1225297567	1225297567	1	1	FERREIRO, SHARON R LMFT	9/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	224 W GRAHAM AVE	None	LAKE ELSINORE	CA	92530	3740	33	06065	33.66853666	-117.3296688	Riverside County
122644	Fee-for-Service	1912261405	1912261405	1	1	FORD, JOSEPH DO	8/14/2018	208800000X	NA	Other	026	PHYSICIANS	16006	34	Urology and Urological Surgery	0	In state provider	None	938 N CHERRY ST	None	VISALIA	CA	93274	2210	54	06107	36.221211	-119.337643	Tulare County
122661	Fee-for-Service	1730129651	1730129651	1	1	FROST, NICHOLAS R MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	22304	36	Psychiatry	0	In state provider	None	5131 GARFIELD ST	None	LA MESA	CA	91941	5103	37	06073	32.77204948	-117.0059214	San Diego County
122700	Fee-for-Service	1295783900	1295783900	1	3	FITZPATRICK PHYSICAL THERAPY	8/1/2020	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC.	12150 INDUSTRY BLVD	42	JACKSON	CA	95642	9375	03	06005	38.36994515	-120.7997294	Amador County
122725	Fee-for-Service	1437173358	1437173358	1	1	FERGUSON, KEVIN MD	1/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	58273	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 WEST MINERAL KING AV	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
122734	Fee-for-Service	1083692941	1083692941	1	1	FAIRVIEW HEALTH SERVICES	1/27/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5200 FAIRVIEW BLVD	None	WYOMING	MN	55092	8013	00	None	45.32172586	-92.99989785	Chisago County
122766	Fee-for-Service	1467995746	1467995746	1	1	FRESENIUS MEDICAL CARE SAN	3/25/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	JUAN CAPISTRANO LLC	31001 RANCHO VIEJO RD	STE 100	SAN JUAN CAPISTRA	CA	92675	8704	30	06059	33.50974262	-117.6596065	Orange County
122783	Fee-for-Service	1962800292	1962800292	1	1	FORGHANY, REIHANEH MD	5/28/2020	390200000X	NA	Other	026	PHYSICIANS	151788	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
122791	Fee-for-Service	1477503407	1477503407	1	1	FACULTY PHYSICIANS AND	6/10/2019	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	SURGEONS OF LLUSM-PEDS	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
122803	Fee-for-Service	1093978314	1093978314	1	1	FONTECHA, CATHERINE A MD	7/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116272	None	None	0	In state provider	None	500 W HOSPITALITY RD	None	FRENCH CAMP	CA	95231	9693	39	06077	0	0	None
122873	Fee-for-Service	1457946931	1457946931	1	1	FIRST OPTOMETRIC CARE OF NOR	11/20/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	TRIC GROUP	5777 GREENBACK LANE	SUITE 100	SACRAMENTO	CA	95841	2013	34	06067	38.682756	-121.327839	Sacramento County
122882	Fee-for-Service	1760495485	1760495485	1	1	FEATHER RIVER TRIBAL	8/4/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	2145 5TH AVE	None	OROVILLE	CA	95965	5870	04	06007	39.50368243	-121.5646958	Butte County
122913	Fee-for-Service	1043685969	1043685969	1	1	FLINDERS, ABRAHAM D MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139335	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
122950	Fee-for-Service	1730129651	1730129651	1	1	FROST, NICHOLAS R MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	22304	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5131 GARFIELD ST	None	LA MESA	CA	91941	5103	37	06073	32.77204948	-117.0059214	San Diego County
122958	Fee-for-Service	1336134345	1336134345	1	1	FARRAR, MICHAEL K OD	9/15/1981	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3650 MAIN ST	STE C	COTTONWOOD	CA	96022	9746	45	06089	40.39377848	-122.2808091	Shasta County
122963	Fee-for-Service	1376109439	1376109439	1	1	FARYABI, NASIM DO	10/14/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19734	None	None	0	In state provider	None	1600 OWENS ST	None	SAN FRANCISCO	CA	94158	2261	38	06075	37.76850146	-122.3949365	San Francisco County
122996	Fee-for-Service	1295783900	1295783900	1	2	FITZPATRICK PHYSICAL THERAPY	6/12/2018	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC.	1252 BROADWAY	SUITE B	PLACERVILLE	CA	95667	5806	09	06017	38.73128098	-120.7852781	El Dorado County
123021	Fee-for-Service	1083692941	1083692941	1	1	FAIRVIEW HEALTH SERVICES	1/27/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5200 FAIRVIEW BLVD	None	WYOMING	MN	55092	8013	00	None	45.32172586	-92.99989785	Chisago County
123038	Fee-for-Service	1114374824	1114374824	1	1	FALLBROOK PEDIATRICS INC	11/14/2016	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	56278	40	Pediatrics	0	In state provider	None	321 E ALVARADO ST	None	FALLBROOK	CA	92028	2912	37	06073	33.38200789	-117.2493602	San Diego County
123146	Fee-for-Service	1932549219	1932549219	1	1	FROUSIAKIS, PETROS K DO	10/23/2019	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	13803	20	Orthopedic Surgery	0	In state provider	DO	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
123228	Fee-for-Service	1023075108	1023075108	1	1	FALK, MATTHEW S MD	8/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86044	42	Nuclear Medicine	0	In state provider	None	1001 POTRERO AVE	RM G100	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
123300	Fee-for-Service	1104944727	1104944727	1	1	FROCH, LARRY MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75550	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
123320	Fee-for-Service	1407387202	1407387202	1	1	FITTER, SAMANTHA MD	5/26/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160040	40	Pediatrics	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
123386	Fee-for-Service	1184833501	1184833501	1	1	FAMILY HLTH CTRS OF LA	8/15/2003	261QC1500X	NA	Other	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	19	06037	33.97292523	-118.1475473	Los Angeles County
123418	Fee-for-Service	1538228192	1538228192	1	1	FLAMM, BRUCE L MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42432	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
123423	Fee-for-Service	1326434614	1326434614	1	1	FURUKAWA, DAISUKE MD	6/22/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	148399	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
123450	Fee-for-Service	1871125385	1871125385	1	1	FREAD, AMELIA B LAC	4/1/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	2801 K ST	STE 110	SACRAMENTO	CA	95630	3489	34	06067	38.572947	-121.46904	Sacramento County
123474	Fee-for-Service	1144913526	1144913526	1	1	FREEMAN, KEVIN PT	11/13/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1504 CHAMPLAIN DR	None	FRESNO	CA	93720	5624	10	06019	36.86845445	-119.7572681	Fresno County
123476	Fee-for-Service	1588635684	1588635684	1	1	FUGITT, JONATHAN B MD	9/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85990	30	Radiology	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
123492	Fee-for-Service	1730215229	1730215229	1	1	FISCHER, STEPHEN P MD	5/1/2001	207L00000X	NA	Other	026	PHYSICIANS	45045	01	General Practice	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
123517	Fee-for-Service	1083373435	1083373435	1	1	FALCONE, EMILY M PT	5/28/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1251 E DYER RD	SUITE 150	SANTA ANA	CA	92705	5662	30	06059	33.70870351	-117.8551005	Orange County
123538	Fee-for-Service	1962799312	1962799312	1	1	FLORES, LORENA R LMFT	1/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
123569	Fee-for-Service	1891000741	1891000741	1	1	FLANAGAN, MELODY A OD	11/10/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
123589	Fee-for-Service	1902508708	1902508708	1	1	FAN, EMILY N NP	12/15/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	925 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4442	19	06037	34.08499473	-118.1230937	Los Angeles County
123591	Fee-for-Service	1598806606	1598806606	1	1	FOSTER, PAMELA E MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85778	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
123703	Fee-for-Service	1336230960	1336230960	1	1	FARBER, GARY M MD	2/18/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	46359	None	None	0	In state provider	None	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
123716	Fee-for-Service	1164499968	1164499968	1	1	FARHOOMAND, LADAN MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	83382	05	Anesthesiology	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
123729	Fee-for-Service	1851418545	1851418545	1	1	FISHER, JANELLE PSYD	5/25/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4931 ARNOLD AVENUE	SUITE 10	MCCLELLAN	CA	95652	2524	34	06067	38.65734	-121.3861185	Sacramento County
123737	Fee-for-Service	1518165919	1518165919	1	1	FAROOQ, AAMER MD	6/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124741	68	Hematology	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
123780	Fee-for-Service	1578780334	1578780334	1	1	FIERRO, MARTIN A LMFT	9/23/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PARKWAY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
123781	Fee-for-Service	1730215229	1730215229	1	1	FISCHER, STEPHEN P MD	5/1/2001	207L00000X	NA	Other	026	PHYSICIANS	45045	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
123790	Fee-for-Service	1871294447	1871294447	1	1	FREDERIC, MARJORY NP	2/10/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
123907	Fee-for-Service	1518116102	1518116102	1	1	FRESNO COMMUNITY HOSP &	5/31/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CENTER	3003 N MARIPOSA ST	None	FRESNO	CA	93703	1127	10	06019	36.777735	-119.779307	Fresno County
123926	Fee-for-Service	1902979131	1902979131	1	1	FRESCO, JENNIFER M MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102333	01	General Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
124012	Fee-for-Service	1932392396	1932392396	1	1	FOSSEE, CRAIG T MD	10/20/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	172702	None	None	0	In state provider	None	19950 RINALDI ST	SUITES 100 103 200	PORTER RANCH	CA	91326	4141	19	06037	34.27560199	-118.5696701	Los Angeles County
124025	Fee-for-Service	1518165919	1518165919	1	1	FAROOQ, AAMER MD	6/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124741	78	Neoplastic Diseases/Oncology	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
124029	Fee-for-Service	1881889806	1881889806	1	1	FACER, JULIE CRNA	10/18/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
124183	Fee-for-Service	1295891265	1295891265	1	1	FEICHTMANN, CHARLOTTE A	6/10/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
124195	Fee-for-Service	1508191065	1508191065	1	1	FREEMAN, JOSEPH D MD	7/27/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113248	None	None	0	In state provider	None	PUEBLO AT BATH	None	SANTA BARBARA	CA	93105	4311	42	06083	34.430526	-119.72196	Santa Barbara County
124208	Fee-for-Service	1457680530	1457680530	1	1	FACULTY PHYSICIANS & SURGEON	1/4/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	S OF LUM	12021 JACARANDA AVE	None	HESPERIA	CA	92345	4956	36	06071	34.46963618	-117.263267	San Bernardino County
124253	Fee-for-Service	1710995717	1710995717	1	2	FONG, DAVID DPM	5/31/1992	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	950 STOCKTON ST	STE 300	SAN FRANCISCO	CA	94108	1676	38	06075	37.79469747	-122.4079497	San Francisco County
124266	Fee-for-Service	1912217787	1912217787	1	1	FITZGERALD, JENNIFER K NP	1/23/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
124281	Fee-for-Service	1891867610	1891867610	1	1	FINKEL, ANNETTE MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26121	40	Pediatrics	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
124283	Fee-for-Service	1306389671	1306389671	1	1	FISHER, DANIELLE M	2/2/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
124312	Fee-for-Service	1356416713	1356416713	1	1	FISHER, SVETLANA OD	10/1/2001	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	AN OPTOMETRY CORP	7976 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90046	5008	19	06037	34.0907785	-118.3641255	Los Angeles County
124314	Fee-for-Service	1518165919	1518165919	1	1	FAROOQ, AAMER MD	6/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124741	41	Internal Medicine	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
124334	Fee-for-Service	1497822340	1497822340	1	1	FLORES, RAMIRO C MD	7/11/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66290	01	General Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
124348	Fee-for-Service	1134157704	1134157704	1	1	FEEZELL, SEAN A DO	5/4/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	8372	10	Gastroenterology (M.D. only)	0	In state provider	None	915 SAN RAMON VALLEY BLV	STE 100	DANVILLE	CA	94526	4062	07	06013	37.80740959	-121.9917956	Contra Costa County
124361	Fee-for-Service	1154343663	1154343663	1	1	FARIN, HEIKE D MD	1/1/2001	207PE0004X	NA	Other	026	PHYSICIANS	62220	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
124453	Fee-for-Service	1336415801	1336415801	1	1	FACQUE, ALEXANDER R MD	3/2/2020	208200000X	NA	General Surgery	026	PHYSICIANS	161637	24	Plastic Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
124496	Fee-for-Service	1457680530	1457680530	1	1	FACULTY PHYSICIANS & SURGEON	9/20/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	S OF LUM	12021 JACARANDA AVE	None	HESPERIA	CA	92345	4956	36	06071	34.46963618	-117.263267	San Bernardino County
124499	Fee-for-Service	1558316042	1558316042	1	1	FIGUEROA, MICHAEL	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61485	None	None	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
124579	Fee-for-Service	1912311440	1912311440	1	1	FOOTHILL HEALTH CENTER	4/8/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	242 LA PALA DRIVE	SUITE A & B	SAN JOSE	CA	95127	2130	43	06085	37.37740177	-121.8284956	Santa Clara County
124620	Fee-for-Service	1497822340	1497822340	1	1	FLORES, RAMIRO C MD	7/11/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66290	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
124637	Fee-for-Service	1396268868	1396268868	1	1	FLANAGAN, SARA	8/9/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
124653	Fee-for-Service	1881380590	1881380590	1	1	FALLBROOK ASSISTED LIVING	3/20/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	INC	5504 FALLBROOK AVE	None	WOODLAND HILLS	CA	91367	4326	19	06037	34.17026655	-118.6232955	Los Angeles County
124691	Fee-for-Service	1518445592	1518445592	1	1	FINE, JULIE A RCP	8/27/2018	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
124759	Fee-for-Service	1821306879	1821306879	1	1	FLAVELL, ROBERT R MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118685	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
124807	Fee-for-Service	1699791335	1699791335	1	1	FLOYD, BESSIE B MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29973	18	Ophthalmology	0	In state provider	None	317 N EL CAMINO REAL	STE 206	ENCINITAS	CA	92024	2813	37	06073	33.05428107	-117.2615637	San Diego County
124865	Fee-for-Service	1912311440	1912311440	1	1	FOOTHILL HEALTH CENTER	4/8/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	242 LA PALA DRIVE	SUITE A & B	SAN JOSE	CA	95127	2130	43	06085	37.37740177	-121.8284956	Santa Clara County
124875	Fee-for-Service	1083000822	1083000822	1	1	FIGURA, MYROSLAV MD	8/6/2019	207L00000X	NA	Other	026	PHYSICIANS	145514	05	Anesthesiology	0	In state provider	None	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
124880	Fee-for-Service	1144230996	1144230996	1	1	FONG, TSE-LING MD	2/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	50388	41	Internal Medicine	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
124918	Fee-for-Service	1295137040	1295137040	1	1	FAVELA, TRICIA LCSW	5/15/2024	390200000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16195 SISKIYOU RD.	120B	APPLE VALLEY	CA	92307	1346	36	06071	34.54549098	-117.2671509	San Bernardino County
124927	Fee-for-Service	1518045426	1518045426	1	1	FLORES, ALAIN G MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74467	08	Family Practice	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
124965	Fee-for-Service	1710026612	1710026612	1	1	FOLSOM, DAVID P MD	9/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65435	36	Psychiatry	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
125004	Fee-for-Service	1124325717	1124325717	1	1	FRIDAY, JAMILAH MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115653	40	Pediatrics	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
125042	Fee-for-Service	1285632711	1285632711	1	1	FULLER, DONALD B MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62532	30	Radiology	0	In state provider	None	2466 1ST AVE	None	SAN DIEGO	CA	92101	1408	37	06073	32.731137	-117.1639695	San Diego County
125054	Fee-for-Service	1326548496	1326548496	1	1	FENTON, SARAH M CRNA	5/22/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
125066	Fee-for-Service	1245267103	1245267103	1	1	FEENEY, KAREN L MD	6/28/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83195	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
125068	Fee-for-Service	1245729342	1245729342	1	1	FOFANA, CHEICKNA MD	4/3/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184649	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
125073	Fee-for-Service	1457446411	1457446411	1	1	FAMILY PLANNING ASSOC	1/9/2012	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP INC	12304 SANTA MONICA BLVD	STE 116	LOS ANGELES	CA	90025	2586	19	06037	34.03948285	-118.4656304	Los Angeles County
125201	Fee-for-Service	1306599428	1306599428	1	1	FRANCIS, CHARTAVIA CNP	7/6/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
125297	Fee-for-Service	1710063243	1710063243	1	1	FEIGENBAUM, PAUL A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33646	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
125324	Fee-for-Service	1285857086	1285857086	1	1	FONG, COLLEEN LMFT	10/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1648 DRUMMOND LN	None	LINCOLN	CA	95648	2935	31	06061	38.87900946	-121.312215	Placer County
125330	Fee-for-Service	1174626469	1174626469	1	1	FROELICHER, VICTOR F MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	35133	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
125343	Fee-for-Service	1164002333	1164002333	1	1	FOLEY, GILLIAN M MD	3/13/2025	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
125422	Fee-for-Service	1043327596	1043327596	1	1	FERFALD, NATHAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PHYSICIAN OFFICE CTR	1 MEDICAL CENTER DRIVE	None	MORGANTOWN	WV	26506	7911	00	None	39.65333742	-79.95924145	Monongalia County
125444	Fee-for-Service	1417263500	1417263500	1	1	FARTASH, ARIAN OD	12/2/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	734 N MAIN ST	None	CORONA	CA	92880	1439	33	06065	33.89171973	-117.5640251	Riverside County
125506	Fee-for-Service	1093726788	1093726788	1	1	FRIED, ITZHAK MD	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	72173	14	Neurological Surgery	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
125541	Fee-for-Service	1235581232	1235581232	1	1	FREEMAN, ELKIE LMFT	5/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
125580	Fee-for-Service	1619990322	1619990322	1	1	FARGO, WISE MD	2/27/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	39502	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
125669	Fee-for-Service	1477531481	1477531481	1	1	FORDYCE, KELLY E MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	73294	41	Internal Medicine	0	In state provider	None	26800 CROWN VALLEY PKWY	#305	MISSION VIEJO	CA	92691	6389	30	06059	33.56286021	-117.6673449	Orange County
125675	Fee-for-Service	1962573576	1962573576	1	1	FREETO, BRIAN D MD	7/17/2014	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	107982	None	None	0	In state provider	None	3273 CLAREMONT WY	#100	NAPA	CA	94558	0572	28	06055	38.32062499	-122.3012501	Napa County
125681	Fee-for-Service	1477544070	1477544070	1	1	FINE, NATASHA W MD	9/18/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80535	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
125753	Fee-for-Service	1962561621	1962561621	1	1	FARFAN, FAUSTO MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60831	66	Emergency Medicine (Urgent Care)	0	In state provider	ATTN MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
125782	Fee-for-Service	1447241765	1447241765	1	1	FRAZEE, BRADLEY W MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	73123	66	Emergency Medicine (Urgent Care)	0	In state provider	PERMANENTE MEDICAL GROUP	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
125796	Fee-for-Service	1285650283	1285650283	1	1	FISHER, KENDRA L MD	12/12/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	53070	30	Radiology	0	In state provider	None	25455 BARTON RD	STE 107B	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
125866	Fee-for-Service	1619990322	1619990322	1	1	FARGO, WISE MD	2/27/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	39502	40	Pediatrics	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
125872	Fee-for-Service	1164439873	1164439873	1	1	FOX, KENNETH H MD	1/15/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	152696	30	Radiology	0	In state provider	None	21840 S NORMANDIE AVE	STE 100	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
125884	Fee-for-Service	1184976292	1184976292	1	1	FOLORUNSO, OLUWATOSIN E MD	11/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137163	40	Pediatrics	0	In state provider	None	31180 ROAD 72	None	GOSHEN	CA	93227	9997	54	06107	36.35594779	-119.4124242	Tulare County
125952	Fee-for-Service	1053637694	1053637694	1	2	FULLER, COREY B MD	2/1/2022	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
125988	Fee-for-Service	1326191578	1326191578	1	1	FOX, MARSHA	2/27/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
126000	Fee-for-Service	1407318017	1407318017	1	1	FARFEL, ALLISON O MD	6/28/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178390	None	None	0	In state provider	None	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
126016	Fee-for-Service	1376621003	1376621003	1	1	FENG, YIYU MD	1/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81678	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
126019	Fee-for-Service	1609196419	1609196419	1	1	FU, SHAWN S MD	10/27/2017	208600000X	NA	General Surgery	026	PHYSICIANS	120639	02	General Surgery	0	In state provider	None	1901 N CALIFORNIA ST	None	STOCKTON	CA	95204	6005	39	06077	37.97165921	-121.2895813	San Joaquin County
126040	Fee-for-Service	1316955925	1316955925	1	1	FEDERICO, AMY M DO	6/30/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	17020	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
126082	Fee-for-Service	1487696134	1487696134	1	1	FISCHER, CHERYCE P MD	12/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52415	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
126099	Fee-for-Service	1922260033	1922260033	1	1	FREDERIKSEN, RYAN A MD	2/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108502	01	General Practice	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4310	42	06083	34.42967671	-119.7228362	Santa Barbara County
126131	Fee-for-Service	1639495658	1639495658	1	1	FLORES, ALICIA G MD	6/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119610	41	Internal Medicine	0	In state provider	None	4600 BROADWAY	STE 1100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
126150	Fee-for-Service	1831392158	1831392158	1	1	FAIZ, SHAZIA MD	12/5/2008	207RE0101X	NA	Endocrinology	026	PHYSICIANS	105787	41	Internal Medicine	0	In state provider	None	1207 FAIRCHILD COURT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
126243	Fee-for-Service	1770819054	1770819054	1	1	FARAHANI, CATHERINE E MD	10/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105900	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
126365	Fee-for-Service	1104921378	1104921378	1	1	FALK, LARRY C MD	11/30/1984	208600000X	NA	General Surgery	026	PHYSICIANS	45179	02	General Surgery	0	In state provider	None	244 HOSPITAL DR	STE A	UKIAH	CA	95482	4557	23	06045	39.15258592	-123.2037217	Mendocino County
126378	Fee-for-Service	1447437967	1447437967	1	1	FIROOZ, NAZANIN MD	10/9/2008	207R00000X	NA	Other	026	PHYSICIANS	96204	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
126420	Fee-for-Service	1578665253	1578665253	1	1	FORBES, ROBERT OD	5/1/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	1	Border provider	None	2615 ALMOND ST	None	KLAMATH FALLS	OR	97601	1176	00	None	42.25205113	-121.7885136	Klamath County
126421	Fee-for-Service	1487724902	1487724902	1	1	FM REHAB EXPRESS INC	3/11/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6888 LINCOLN AVE	SUITE J2	BUENA PARK	CA	90620	4107	30	06059	33.83179254	-118.013031	Orange County
126436	Fee-for-Service	1831392158	1831392158	1	1	FAIZ, SHAZIA MD	12/5/2008	207RE0101X	NA	Endocrinology	026	PHYSICIANS	105787	67	Endocrinology	0	In state provider	None	1207 FAIRCHILD COURT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
126486	Fee-for-Service	1841745544	1841745544	1	1	FRADKIN, KAREN PT	6/21/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
126495	Fee-for-Service	1114392933	1114392933	1	1	FLEXOGENIX INC	5/3/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	21250 HAWTHORNE BLVD	SUITE 110	TORRANCE	CA	90503	5508	19	06037	33.83566432	-118.3531683	Los Angeles County
126501	Fee-for-Service	1831444918	1831444918	1	1	FUTCH, CELIA A OD	5/1/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	895 TRANCAS ST	None	NAPA	CA	94558	3040	28	06055	38.32406807	-122.2928218	Napa County
126543	Fee-for-Service	1205030624	1205030624	1	1	FIRST VENTURE ENTERPRISE	5/31/2000	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	RAMONA ADULT DAY HEALTH	13310 RAMONA BLVD	STE K	BALDWIN PARK	CA	91706	3862	19	06037	34.08103919	-117.9829014	Los Angeles County
126568	Fee-for-Service	1164570115	1164570115	1	1	FILSINGER, PETER M MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77098	30	Radiology	0	In state provider	ATTN MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
126590	Fee-for-Service	1497426233	1497426233	1	1	FUNG, ALVIN NP	5/26/2023	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
126648	Fee-for-Service	1124014725	1124014725	1	1	FARRICIELLI LAURIE ANN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	40 E INDIANOLA	None	PHOENIX	AZ	85012	0000	00	None	33.492537	-112.071843	Maricopa County
126748	Fee-for-Service	1376650168	1376650168	1	1	FERNANDEZ, ALICIA MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81672	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
126790	Fee-for-Service	1932443744	1932443744	1	1	FINN, HOLLY LMFT	5/29/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	381 BAYSIDE RD	STE: D	ARCATA	CA	95521	7102	12	06023	40.86293406	-124.0739007	Humboldt County
126809	Fee-for-Service	1457814808	1457814808	1	1	FARMAH, PREETI K MD	5/22/2024	2086X0206X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
126858	Fee-for-Service	1265967756	1265967756	1	1	FANG, JENNIFER Y MD	8/3/2021	207P00000X	NA	Other	026	PHYSICIANS	158180	None	None	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
126878	Fee-for-Service	1710030747	1710030747	1	1	FALCONIO, LINDA S MD	3/31/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	37851	01	General Practice	0	In state provider	None	499 N EL CAMINO REAL	None	ENCINITAS	CA	92024	1366	37	06073	33.05803268	-117.262602	San Diego County
126881	Fee-for-Service	1780634022	1780634022	1	1	FORD, GARY E MD	7/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	36302	01	General Practice	0	In state provider	None	1141 W REDONDO BEACH BLV	STE 402	GARDENA	CA	90247	3582	19	06037	33.89247036	-118.2941482	Los Angeles County
126918	Fee-for-Service	1073861076	1073861076	1	1	FLORES-MARTINEZ, CARMEN LCS	12/3/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	4110 EDISON AVE	206A	CHINO	CA	91710	8417	36	06071	33.99723746	-117.7140555	San Bernardino County
126924	Fee-for-Service	1457498735	1457498735	1	1	FURFARI, KRISTIN A MD	6/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	2	Out of state provider	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
126935	Fee-for-Service	1760626618	1760626618	1	1	FOULKE, KARI R MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114537	08	Family Practice	0	In state provider	None	5900 STATE FARM DR	None	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
126960	Fee-for-Service	1982639563	1982639563	1	1	FELICIANO, ZENAIDA MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	53278	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MED PLAZA	STE. 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
127111	Fee-for-Service	1346262615	1346262615	1	1	FATEMI, MARK H MD	1/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	22624	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5471 LA PALMA AVE	STE 203	LA PALMA	CA	90623	1798	30	06059	33.84643649	-118.0377675	Orange County
127123	Fee-for-Service	1972664795	1972664795	1	1	FUENTEBELLA, JUDY T MD	10/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99709	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
127197	Fee-for-Service	1376569376	1376569376	1	1	FEINBERG, DAVID MD	3/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	69173	36	Psychiatry	0	In state provider	NEUROPSHCHIATRIC HOSP	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
127258	Fee-for-Service	1891960415	1891960415	1	1	FACULTY PHYSICIANS &	8/22/2008	2086S0129X	NA	General Surgery	022	PHYSICIANS GROUP	-	23	Peripheral Vascular Disease or Surgery (D.O. only)	0	In state provider	None	44274 GEORGE CUSHMAN CT	STE 208	TEMECULA	CA	92592	5945	33	06065	33.48313254	-117.0888293	Riverside County
127342	Fee-for-Service	1497840664	1497840664	1	1	FUETTE, STEPHEN P MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82910	66	Emergency Medicine (Urgent Care)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
127371	Fee-for-Service	1942784541	1942784541	1	1	FRESENIUS MEDICAL CARE	8/11/2020	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	FRESNO NORTH HOME LLC	6733 N WILLOW AVE	STE 101	FRESNO	CA	93710	5953	10	06019	36.83464076	-119.7311553	Fresno County
127490	Fee-for-Service	1528049905	1528049905	1	1	FRANSON, JOHN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 S 3RD W	None	SODA SPRINGS	ID	83276	1559	00	None	42.6517178	-111.6133425	Caribou County
127516	Fee-for-Service	1508270075	1508270075	1	1	FRIEDELL, RICHARD T PT	7/23/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3900 FREEDOM CIRCLE	None	SANTA CLARA	CA	95054	1222	43	06085	37.38769057	-121.9700955	Santa Clara County
127638	Fee-for-Service	1558377424	1558377424	1	1	FEDENKO, ALEXANDER N MD	11/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	56427	22	Pathology (M.D. only)	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5315	19	06037	34.06269295	-118.2030006	Los Angeles County
127672	Fee-for-Service	1225367071	1225367071	1	1	FOUNTAIN VALLEY PEDIATRICS	3/8/2010	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	11100 WARNER AVE	STE 262	FOUNTAIN VALLEY	CA	92708	7512	30	06059	33.716291	-117.9355051	Orange County
127687	Fee-for-Service	1023413903	1023413903	1	1	FAKHRAI, MARYAM S MD	8/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133448	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1310 SAN BERNARDINO RD	STE 205	UPLAND	CA	91786	4985	36	06071	34.10260261	-117.6332582	San Bernardino County
127738	Fee-for-Service	1598993263	1598993263	1	1	FUENTES, CHARLENE J PHD	4/8/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
127751	Fee-for-Service	1033620109	1033620109	1	1	FRESENIUS MEDICAL CARE	2/15/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CLOVIS LLC	2585 ALLUVIAL AVE	None	CLOVIS	CA	93611	9505	10	06019	36.84521771	-119.666097	Fresno County
127832	Fee-for-Service	1356800171	1356800171	1	1	FLATOW-TRUJILLO, LAINEY M MD	3/21/2023	207R00000X	NA	Other	026	PHYSICIANS	177297	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
127862	Fee-for-Service	1194018838	1194018838	1	1	FOY, STEVEN T MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122053	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
127883	Fee-for-Service	1659822914	1659822914	1	1	FRESNO AMBULATORY SURGERY	1/14/2019	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	568 E HERNDON AVE	STE 103	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
127905	Fee-for-Service	1275609000	1275609000	1	1	FERRIS, FRANK D MD	5/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50802	41	Internal Medicine	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
127943	Fee-for-Service	1417156118	1417156118	1	1	FELDMAN, DANIELE S H MD	1/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	106571	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	116 SOUTH PALISADE DRIVE	SUITE 104	SANTA MARIA	CA	93454	8905	42	06083	34.9523869	-120.4120717	Santa Barbara County
127998	Fee-for-Service	1336213230	1336213230	1	1	FISCHBEIN, STUART J MD	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	52027	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	THE WOMAN'S PLACE	3901 LAS POSAS RD	STE 207	CAMARILLO	CA	93010	1506	56	06111	34.2415821	-119.0183756	Ventura County
128033	Fee-for-Service	1831501741	1831501741	1	1	FELDMAN, BENJAMIN A MD	5/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140383	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
128061	Fee-for-Service	1144505272	1144505272	1	1	FIBER-TECH MANUFACTURING	2/14/2012	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	INC	4150 CONVOY STREET	None	SAN DIEGO	CA	92111	3705	37	06073	32.8182558	-117.154913	San Diego County
128085	Fee-for-Service	1396815056	1396815056	1	1	FLETCHER, JOHN C MD	4/27/2006	170100000X	NA	Other	026	PHYSICIANS	18219	41	Internal Medicine	0	In state provider	None	3838 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1522	38	06075	37.78591809	-122.4575439	San Francisco County
128090	Fee-for-Service	1154470011	1154470011	1	1	FRANCES, MATTHEW H MD	2/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97732	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
128159	Fee-for-Service	1134757586	1134757586	1	1	FERMI, DANIEL MD	11/3/2023	207R00000X	NA	Other	026	PHYSICIANS	191089	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
128212	Fee-for-Service	1407394265	1407394265	1	1	FEIL, SUSAN D NP	6/5/2019	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
128254	Fee-for-Service	1336121888	1336121888	1	2	FOOTHILLS PSYCHOLOGICAL SERV	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ICES, INC.	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
128268	Fee-for-Service	1417299298	1417299298	1	1	FULLENWIDER, CHARLES O MD	4/29/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	191439	05	Anesthesiology	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
128300	Fee-for-Service	1073096152	1073096152	1	1	FLORES ISAAC, MERCY LMFT	6/4/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1320 STANDIFORD AVE	STE 5	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
128321	Fee-for-Service	1376389288	1376389288	1	1	FELICITAS, CATHERINE NP	10/15/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
128331	Fee-for-Service	1467461004	1467461004	1	1	FARLEY, MICHAEL L DO	9/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9624	08	Family Practice	0	In state provider	A MEDICAL CORPORATION	2401 HARTNELL AVE	None	REDDING	CA	96002	2321	45	06089	40.56373452	-122.326209	Shasta County
128338	Fee-for-Service	1326736042	1326736042	1	1	FREEMAN, MIRANDA R OT	5/3/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3687 MT DIABLO	SUITE 100	LAFAYETTE	CA	94549	3717	07	06013	37.8898926	-122.1304235	Contra Costa County
128377	Fee-for-Service	1811201734	1811201734	1	1	FINDLAY, HEATHER A LMFT	1/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	870 MARKET ST.	SUITE 980	SAN FRANCISCO	CA	94102	5998	38	06075	37.7848184	-122.4070488	San Francisco County
128392	Fee-for-Service	1841429552	1841429552	1	1	FLORES, JOSE A LCSW	11/1/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	24848	-	NOT APPLICABLE	0	In state provider	None	151 W MISSION STREET	SUITE C1 01	SAN JOSE	CA	95110	1713	43	06085	37.3498901	-121.9035777	Santa Clara County
128421	Fee-for-Service	1508816315	1508816315	1	1	FARAH, NAZIH N MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60863	30	Radiology	0	In state provider	None	7901 FROST STREET	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
128467	Fee-for-Service	1316027709	1316027709	1	1	FRESNO COMMUNITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	AND MEDICAL CENTER	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
128477	Fee-for-Service	1548409113	1548409113	1	1	FARHADIAN, BITA MD	8/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106646	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4226 W BEVERLY BLVD	None	LOS ANGELES	CA	90004	1802	19	06037	34.0762665	-118.3010445	Los Angeles County
128542	Fee-for-Service	1336121888	1336121888	1	2	FOOTHILLS PSYCHOLOGICAL SERV	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	47	Miscellaneous	0	In state provider	ICES, INC.	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
128572	Fee-for-Service	1710048483	1710048483	1	1	FUNG, JASON F MD	4/16/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	86935	07	Dermatology	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
128584	Fee-for-Service	1932461043	1932461043	1	1	FUNG, KELLY A MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127771	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
128648	Fee-for-Service	1033157235	1033157235	1	1	FERNANDEZ, EDGAR A DO	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	6550	08	Family Practice	0	In state provider	None	9930 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166152	-117.955521	Orange County
128673	Fee-for-Service	1265823264	1265823264	1	1	FALLBROOK HEALTHCARE CENTER	7/20/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	OPERATING COMPANY LLC	325 POTTER STREET	None	FALLBROOK	CA	92028	3068	37	06073	33.37939451	-117.2428003	San Diego County
128700	Fee-for-Service	1013952597	1013952597	1	3	FAMILY HEALTH CENTERS OF	1/19/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2136 EL CAJON BLVD	None	SAN DIEGO	CA	92104	1102	37	06073	32.75537928	-117.1416551	San Diego County
128751	Fee-for-Service	1417952797	1417952797	1	1	FREEDMAN, ERIC L MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50712	20	Orthopedic Surgery	0	In state provider	None	81812 DR CARREON BLVD	STE D	INDIO	CA	92201	5594	33	06065	33.70742848	-116.236728	Riverside County
128754	Fee-for-Service	1316027709	1316027709	1	1	FRESNO COMMUNITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	AND MEDICAL CENTER	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
128762	Fee-for-Service	1770006009	1770006009	1	1	FLORIAN, LINETH F MD	10/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	158691	01	General Practice	0	In state provider	None	2333 FOOTHILL BLVD	None	LA VERNE	CA	91750	3027	19	06037	34.11220804	-117.7613999	Los Angeles County
128795	Fee-for-Service	1861679979	1861679979	1	1	FUNG, WESLEY L	6/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93327	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
128822	Fee-for-Service	1497715023	1497715023	2	1	FLETCHER, LORIANNA MD	11/9/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54052	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	40	06079	35.27804785	-120.649711	San Luis Obispo County
128830	Fee-for-Service	1336121888	1336121888	1	2	FOOTHILLS PSYCHOLOGICAL SERV	2/15/2019	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
128835	Fee-for-Service	1588126148	1588126148	1	1	FAQIHI, SABREEN	5/9/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	184674	None	None	0	In state provider	None	18433 ROSCOE BLVD	SUITE 104	NORTHRIDGE	CA	91325	4108	19	06037	34.22076747	-118.534725	Los Angeles County
128843	Fee-for-Service	1982827341	1982827341	1	1	FARESE, ROBERT V MD	10/31/1992	207R00000X	NA	Other	026	PHYSICIANS	65728	67	Endocrinology	0	In state provider	None	1001 POTRERO AVE	RM 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
128875	Fee-for-Service	1215310008	1215310008	1	1	FAMILY HEALTH CARE CENTERS	1/23/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6119 AGRA STREET	None	BELL GARDENS	CA	90201	1705	19	06037	33.97562016	-118.1541987	Los Angeles County
128893	Fee-for-Service	1831224724	1831224724	1	1	FELDMAN, BARRY S MD INC	10/25/2005	207RP1001X	NA	Pulmonology	026	PHYSICIANS	85669	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
128898	Fee-for-Service	1154461622	1154461622	1	1	FLUSHING HOSPITAL MEDICAL	10/13/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER	4500 PARSONS BLVD	None	FLUSHING	NY	11355	2205	00	None	40.755627	-73.816047	Queens County
128918	Fee-for-Service	1366461626	1366461626	1	1	FRIEND, ANDREW K LMFT	12/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
128965	Fee-for-Service	1922192673	1922192673	1	1	FRENCH, MELISSA C CNM	10/23/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
128972	Fee-for-Service	1013952597	1013952597	1	6	FAMILY HEALTH CENTERS OF	6/9/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	157 E VALLEY PARKWAY	SUITE 200	ESCONDIDO	CA	92025	2762	37	06073	33.12315955	-117.0809067	San Diego County
128989	Fee-for-Service	1013952597	1013952597	1	3	FAMILY HEALTH CENTERS OF	1/19/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2136 EL CAJON BLVD	None	SAN DIEGO	CA	92104	1102	37	06073	32.75537928	-117.1416551	San Diego County
129085	Fee-for-Service	1689629487	1689629487	1	1	FISHBEIN, HOWARD A MD	2/1/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	31254	None	None	0	In state provider	None	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	30	06059	33.67620851	-117.7948348	Orange County
129105	Fee-for-Service	1467941658	1467941658	1	1	FAMILY ASTHMA AND ALLERGY	10/18/2018	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	03	Allergy	0	In state provider	CENTER PC	730 WOODSIDE ROAD	None	REDWOOD CITY	CA	94061	3749	41	06081	37.46743742	-122.2240658	San Mateo County
129117	Fee-for-Service	1336121888	1336121888	1	2	FOOTHILLS PSYCHOLOGICAL SERV	1/2/2024	103T00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
129134	Fee-for-Service	1851740591	1851740591	1	1	FOX, AUSTIN R MD	6/7/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	170928	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
129147	Fee-for-Service	1184708174	1184708174	1	1	FAHEY, MARK R MD	10/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	38339	05	Anesthesiology	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
129161	Fee-for-Service	1215310008	1215310008	1	1	FAMILY HEALTH CARE CENTERS	1/23/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6119 AGRA STREET	None	BELL GARDENS	CA	90201	1705	19	06037	33.97562016	-118.1541987	Los Angeles County
129182	Fee-for-Service	1831224724	1831224724	1	1	FELDMAN, BARRY S MD INC	10/25/2005	207RP1001X	NA	Pulmonology	026	PHYSICIANS	85669	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
129185	Fee-for-Service	1154461622	1154461622	1	1	FLUSHING HOSPITAL MEDICAL	10/13/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER	4500 PARSONS BLVD	None	FLUSHING	NY	11355	2205	00	None	40.755627	-73.816047	Queens County
129203	Fee-for-Service	1104906569	1104906569	1	24	FRESNO COMMUNITY HOSPITAL	2/9/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	4460 E HUNTINGTON BLVD	None	FRESNO	CA	93702	2962	10	06019	36.73924594	-119.752227	Fresno County
129210	Fee-for-Service	1205895562	1205895562	1	1	FAVOUR, SUSAN E. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
129258	Fee-for-Service	1013952597	1013952597	1	6	FAMILY HEALTH CENTERS OF	6/9/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	157 E VALLEY PARKWAY	SUITE 200	ESCONDIDO	CA	92025	2762	37	06073	33.12315955	-117.0809067	San Diego County
129291	Fee-for-Service	1679952758	1679952758	1	1	FORS, DARRON MD	10/18/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	162317	18	Ophthalmology	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
129295	Fee-for-Service	1134322399	1134322399	1	1	FELLERS, CAROL E	3/9/2004	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 BURTON MESA BLVD	STE B	LOMPOC	CA	93436	1400	42	06083	34.70401649	-120.4647615	Santa Barbara County
129318	Fee-for-Service	1689013161	1689013161	2	1	FREMONT EMERGENCY SERVICES	2/24/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	MANDAVIA LTD	3001 ST ROSE PARKWAY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
129331	Fee-for-Service	1609350396	1609350396	1	1	FRANKLIN, CYRUS L NP	11/2/2020	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
129344	Fee-for-Service	1811167588	1811167588	1	1	FERGUSON, APRIL M MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109417	41	Internal Medicine	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
129393	Fee-for-Service	1467941658	1467941658	1	1	FAMILY ASTHMA AND ALLERGY	10/18/2018	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CENTER PC	730 WOODSIDE ROAD	None	REDWOOD CITY	CA	94061	3749	41	06081	37.46743742	-122.2240658	San Mateo County
129403	Fee-for-Service	1336121888	1336121888	1	2	FOOTHILLS PSYCHOLOGICAL SERV	11/28/2018	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
129416	Fee-for-Service	1578678926	1578678926	1	1	FAIRBANKS, MICHAEL K DPM	4/7/2013	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	425 W BONITA AVE	STE 110	SAN DIMAS	CA	91773	2543	19	06037	34.10669347	-117.814932	Los Angeles County
129437	Fee-for-Service	1174621585	1174621585	2	2	FONTANA PHYSICIANS ASSOCIATE	12/16/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	IAR MEDICAL CORP	17695 ARROW BLVD	None	FONTANA	CA	92335	4041	36	06071	34.09939175	-117.4184788	San Bernardino County
129447	Fee-for-Service	1215310008	1215310008	1	1	FAMILY HEALTH CARE CENTERS	11/13/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6119 AGRA STREET	None	BELL GARDENS	CA	90201	1705	19	06037	33.97562016	-118.1541987	Los Angeles County
129467	Fee-for-Service	1932125382	1932125382	1	1	FARAJI, JAMSHID MD INC	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50024	41	Internal Medicine	0	In state provider	None	6620 COYLE AVE	STE 102	CARMICHAEL	CA	95608	6336	34	06067	38.66751	-121.310028	Sacramento County
129476	Fee-for-Service	1982630901	1982630901	1	1	FRANCIS, AREN MD	8/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95347	04	Otology, Laryngology, Rhinology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
129488	Fee-for-Service	1942312996	1942312996	1	1	FLORES, CRISTINA S MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54112	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
129552	Fee-for-Service	1184622433	1184622433	1	2	FANG, LEE-HSIN BILLY MD	7/21/2014	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2500 HOSPTIAL DRIVE	SUITE 12B	MOUNTAIN VIEW	CA	94040	4120	43	06085	37.36908	-122.081819	Santa Clara County
129638	Fee-for-Service	1588042436	1588042436	1	1	FORSYTH, EDWARD B MD	10/18/2021	208800000X	NA	Other	026	PHYSICIANS	171149	None	None	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
129640	Fee-for-Service	1881300671	1881300671	1	1	FRATIANNI, JOHN CRNA	4/30/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	465 PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
129670	Fee-for-Service	1578060547	1578060547	1	1	FINCH, NATHAN MD	9/9/2022	207P00000X	NA	Other	026	PHYSICIANS	164700	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
129708	Fee-for-Service	1922379940	1922379940	1	1	FEVALEAKI, BRONWYN R	1/27/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
129710	Fee-for-Service	1497987150	1497987150	1	1	FIELDER, JOHN PHD	6/4/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
129726	Fee-for-Service	1174621585	1174621585	2	2	FONTANA PHYSICIANS ASSOCIATE	12/16/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	IAR MEDICAL CORP	17695 ARROW BLVD	None	FONTANA	CA	92335	4041	36	06071	34.09939175	-117.4184788	San Bernardino County
129738	Fee-for-Service	1215310008	1215310008	1	1	FAMILY HEALTH CARE CENTERS	2/14/2022	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6119 AGRA STREET	None	BELL GARDENS	CA	90201	1705	19	06037	33.97562016	-118.1541987	Los Angeles County
129777	Fee-for-Service	1942312996	1942312996	1	1	FLORES, CRISTINA S MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54112	01	General Practice	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
129795	Fee-for-Service	1447453048	1447453048	1	1	FURZE, ALEXIS D MD	4/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110385	04	Otology, Laryngology, Rhinology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
129847	Fee-for-Service	1972034825	1972034825	1	1	FERO, KATHERINE MD	10/4/2023	208800000X	NA	Other	026	PHYSICIANS	161430	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
129855	Fee-for-Service	1851479455	1851479455	1	1	FRIES, GERALD R MD	1/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	69626	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
129864	Fee-for-Service	1669639092	1669639092	1	1	FRASER, DOUGLAS R MD	6/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	1707 W CHARLESTON BLVD	160	LAS VEGAS	NV	89102	2354	00	None	36.15879353	-115.1643015	Clark County
129916	Fee-for-Service	1255726519	1255726519	1	1	FERREROSA, LAUREN M MD	7/6/2018	2080P0207X	NA	Hematology	026	PHYSICIANS	154105	68	Hematology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
129935	Fee-for-Service	1881777233	1881777233	1	1	FAN, DIANA R MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64583	40	Pediatrics	0	In state provider	None	3585 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84863912	-118.3491615	Los Angeles County
129938	Fee-for-Service	1881840023	1881840023	1	1	FORMANTES, SIGRID M MD	9/24/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	118898	36	Psychiatry	0	In state provider	None	1809 W. REDLANDS BLVD	None	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
129980	Fee-for-Service	1841408127	1841408127	1	1	FOWLER, BROCK L PSYD	7/29/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
130014	Fee-for-Service	1225146566	1225146566	1	1	FREEDMAN, ARTHUR M MD	8/5/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	16570	01	General Practice	0	In state provider	None	1000 TRANCAS ST	None	NAPA	CA	94558	2906	28	06055	38.32349768	-122.2963137	Napa County
130037	Fee-for-Service	1871529297	1871529297	1	1	FARROKH ALEMZADEH, MD., INC.	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	55448	08	Family Practice	0	In state provider	None	4950 BARRANCA PKWY	STE 107	IRVINE	CA	92604	8650	30	06059	33.67620851	-117.7948348	Orange County
130065	Fee-for-Service	1942312996	1942312996	1	1	FLORES, CRISTINA S MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54112	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
130066	Fee-for-Service	1306861158	1306861158	1	1	FONG, HENRY	6/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	69103	None	None	0	In state provider	None	400 N MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	49	06097	38.25477	-122.63175	Sonoma County
130073	Fee-for-Service	1629626494	1629626494	1	1	FERNANDES, CHRISTIAN OT	11/14/2024	106S00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
130149	Fee-for-Service	1629144092	1629144092	1	1	FINGER, JOCELYN E CNM	11/7/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
130214	Fee-for-Service	1326500158	1326500158	1	1	FAYAD, MONA MD	6/27/2023	207WX0110X	NA	Ophthalmology	026	PHYSICIANS	187226	None	None	0	In state provider	None	100 STEIN PLZ	None	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
130223	Fee-for-Service	1437555612	1437555612	1	1	FACULTY PHYSICIANS AND	6/25/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	SURGEONS OF LLUSM	23000 ATLANTIC CIRCLE	None	MORENO VALLEY	CA	92553	5990	33	06065	33.93307833	-117.2610923	Riverside County
130224	Fee-for-Service	1881777233	1881777233	1	1	FAN, DIANA R MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64583	78	Neoplastic Diseases/Oncology	0	In state provider	None	3585 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84863912	-118.3491615	Los Angeles County
130231	Fee-for-Service	1194122457	1194122457	1	1	FAMILIES TOGETHER OF ORANGE	12/1/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	COUNTY	661 W FIRST ST	STE G	TUSTIN	CA	92780	2939	30	06059	33.74578153	-117.831231	Orange County
130315	Fee-for-Service	1972545184	1972545184	1	1	FRY, MICHAEL A MD	5/31/2001	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	86080	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1X55	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
130324	Fee-for-Service	1871529297	1871529297	1	1	FARROKH ALEMZADEH, MD., INC.	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	55448	01	General Practice	0	In state provider	None	4950 BARRANCA PKWY	STE 107	IRVINE	CA	92604	8650	30	06059	33.67620851	-117.7948348	Orange County
130434	Fee-for-Service	1598025116	1598025116	1	2	FEUDALE, BRENT A MD	7/7/2021	2080P0204X	NA	Other	026	PHYSICIANS	135002	None	None	0	In state provider	None	9300 VALLEY CHILRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
130463	Fee-for-Service	1215085659	1215085659	1	1	FRIEDMAN, DAVID L MD	10/2/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	32221	-	NOT APPLICABLE	0	In state provider	None	8831 VENICE BLVD	None	LOS ANGELES	CA	90034	3223	19	06037	34.03056062	-118.3863512	Los Angeles County
130489	Fee-for-Service	1346250073	1346250073	1	1	FINEMAN, IGOR MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55380	None	None	0	In state provider	None	50 ALESSANDRO PL	STE 300	PASADENA	CA	91105	4001	19	06037	34.13101049	-118.151532	Los Angeles County
130511	Fee-for-Service	1881777233	1881777233	1	1	FAN, DIANA R MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64583	68	Hematology	0	In state provider	None	3585 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84863912	-118.3491615	Los Angeles County
130515	Fee-for-Service	1194122457	1194122457	1	1	FAMILIES TOGETHER OF ORANGE	12/1/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	COUNTY	661 W FIRST ST	STE G	TUSTIN	CA	92780	2939	30	06059	33.74578153	-117.831231	Orange County
130528	Fee-for-Service	1558399584	1558399584	1	1	FONG, ANNA OD	1/31/1985	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6700 N 1ST ST	STE 102	FRESNO	CA	93710	3947	10	06019	36.83586697	-119.7721176	Fresno County
130545	Fee-for-Service	1679923742	1679923742	1	1	FROCHTZWAJG, DANIEL DO	12/17/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19174	None	None	0	In state provider	None	4560 ADMIRALTY WAY	STE 100	MARINA DEL REY	CA	90292	5424	19	06037	33.98364904	-118.4449069	Los Angeles County
130550	Fee-for-Service	1598543498	1598543498	1	1	FIRST CARE MEDICAL TRANSPORT	3/29/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ATION INC.	1720 S SAN GABRIEL BLVD	STE 216	SAN GABRIEL	CA	91776	3937	19	06037	34.07799198	-118.0907096	Los Angeles County
130569	Fee-for-Service	1205327897	1205327897	1	1	FIORE, ANDREW M DO	9/21/2023	207R00000X	NA	Other	026	PHYSICIANS	20887	None	None	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
130634	Fee-for-Service	1891810305	1891810305	1	1	FOWLER, SYLVIA K MD	1/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79706	78	Neoplastic Diseases/Oncology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
130758	Fee-for-Service	1093117962	1093117962	1	1	FACULTY PHYSICIANS AND	1/21/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	359 SAN MIGUEL DR	STE 105	NEWPORT BEACH	CA	92660	7807	30	06059	33.61273425	-117.8720129	Orange County
130803	Fee-for-Service	1194122457	1194122457	1	1	FAMILIES TOGETHER OF ORANGE	12/1/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	COUNTY	661 W FIRST ST	STE G	TUSTIN	CA	92780	2939	30	06059	33.74578153	-117.831231	Orange County
130922	Fee-for-Service	1891810305	1891810305	1	1	FOWLER, SYLVIA K MD	1/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79706	68	Hematology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
130949	Fee-for-Service	1629000724	1629000724	1	1	FONTAINE, LUC O MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	36515	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1490 SIXTH STREET	None	COACHELLA	CA	92236	1712	33	06065	33.67863924	-116.1766654	Riverside County
131013	Fee-for-Service	1164589644	1164589644	1	1	FUTSCHER, JEANNE T	1/24/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
131019	Fee-for-Service	1134231053	1134231053	1	1	FAIR OAKS PLAZA PHARMACY	2/26/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1526 MISSION ST	None	SOUTH PASADENA	CA	91030	3216	19	06037	34.11589236	-118.1508723	Los Angeles County
131055	Fee-for-Service	1740757996	1740757996	1	1	FAMILY MEDICINE HEADQUARTERS	8/8/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	521 N AZUSA AVE	None	AZUSA	CA	91702	2936	19	06037	34.1306038	-117.9075906	Los Angeles County
131086	Fee-for-Service	1467982819	1467982819	1	1	FRANK C LEE, MD, INC	10/1/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	12550 HESPERIA RD	220	VICTORVILLE	CA	92395	5873	36	06071	34.47928534	-117.2909553	San Bernardino County
131091	Fee-for-Service	1194122457	1194122457	1	1	FAMILIES TOGETHER OF ORANGE	12/1/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	COUNTY	661 W FIRST ST	STE G	TUSTIN	CA	92780	2939	30	06059	33.74578153	-117.831231	Orange County
131135	Fee-for-Service	1063561926	1063561926	1	1	FOX, JONATHAN J MD	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83743	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
131153	Fee-for-Service	1316027709	1316027709	1	7	FRESNO COMMUNITY HOSPITAL	8/15/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	785 N MEDICAL CTR DR W	SUITE 201	CLOVIS	CA	93611	6800	10	06019	36.84377271	-119.6609536	Fresno County
131157	Fee-for-Service	1619057684	1619057684	2	1	FARID, SAMY F MD	12/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	45390	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1729 W AVENUE J	SUITE 101	LANCASTER	CA	93534	4014	19	06037	34.68944953	-118.162287	Los Angeles County
131211	Fee-for-Service	1891810305	1891810305	1	1	FOWLER, SYLVIA K MD	1/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79706	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
131227	Fee-for-Service	1245700954	1245700954	1	2	FUTURE MEDICAL TRANSPORTATIO	8/9/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N INC.	8363 RESEDA BLVD	204	NORTHRIDGE	CA	91324	4623	19	06037	34.22255941	-118.5361155	Los Angeles County
131244	Fee-for-Service	1285720201	1285720201	1	1	FONG, LINDSEY	6/28/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	15446 S WESTERN AVENUE	None	GARDENA	CA	90249	4319	19	06037	33.89042107	-118.3091303	Los Angeles County
131249	Fee-for-Service	1568047306	1568047306	1	1	FIGUEROA, JONATHAN I LMFT	2/13/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
131251	Fee-for-Service	1689772816	1689772816	1	1	FENNER, JAMES E MD	2/8/2015	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	SOUTHWEST EMERGENCY SVCS	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
131258	Fee-for-Service	1992923650	1992923650	1	1	FISHER, SHARON	6/16/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
131323	Fee-for-Service	1619054533	1619054533	1	1	FINN, JOHN P MD	5/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94753	None	None	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
131345	Fee-for-Service	1255581773	1255581773	1	1	FINLAYSON, RYAN T MD	1/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119439	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2540 EAST ST	None	CONCORD	CA	94520	1906	07	06013	37.98292379	-122.0341876	Contra Costa County
131403	Fee-for-Service	1932668878	1932668878	1	1	FLORENDO, EDMUND R	1/26/2024	207L00000X	NA	Other	026	PHYSICIANS	180465	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
131420	Fee-for-Service	1437600194	1437600194	1	1	FEINSTEIN, SHERA B MD	8/17/2024	390200000X	NA	Other	026	PHYSICIANS	180560	30	Radiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
131442	Fee-for-Service	1316027709	1316027709	1	3	FRESNO COMMUNITY HOSPITAL	7/27/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	785 N MEDICAL CTR DR W	SUITE 304	CLOVIS	CA	93611	6800	10	06019	36.84377271	-119.6609536	Fresno County
131467	Fee-for-Service	1215200159	1215200159	1	1	FUKUNAGA, BRYCE K MD	5/21/2017	207P00000X	NA	Other	026	PHYSICIANS	148355	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
131494	Fee-for-Service	1467741397	1467741397	1	1	FERRELL, BARBARA G NP	10/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	480B TESCONI CIR	None	SANTA ROSA	CA	95401	4691	49	06097	38.44950583	-122.7351601	Sonoma County
131537	Fee-for-Service	1811193857	1811193857	1	1	FERNANDO CASTRO-SILVA	11/23/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 SUNNYVIEW LN	None	KALISPELL	MT	59901	3129	00	None	48.214773	-114.3236925	Flathead County
131581	Fee-for-Service	1548087463	1548087463	1	1	FAMILY PLANNING ASSOCIATES M	1/24/2025	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	EDICAL GROUP INC	415 W BENJAMIN HOLT DR	STE D6	STOCKTON	CA	95207	3958	39	06077	38.01194847	-121.3161933	San Joaquin County
131583	Fee-for-Service	1396754925	1396754925	1	1	FARLEY, MICHAEL L DO	3/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9624	None	None	0	In state provider	None	1441 LIBERTY ST	STE 200	REDDING	CA	96001	0848	45	06089	40.5857177	-122.3870781	Shasta County
131585	Fee-for-Service	1194406199	1194406199	1	1	FINNEGAN, ANGELICA CCC-SLP	12/3/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
131609	Fee-for-Service	1427282466	1427282466	1	1	FAMILY HLTH CTR OF SAN DIEGO	12/22/2010	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
131627	Fee-for-Service	1992232268	1992232268	1	1	FREDERICK, ROSS P MD	6/2/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176005	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
131630	Fee-for-Service	1033297163	1033297163	1	1	FONG, BRYAN P MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81504	84	Surgery-Head and Neck	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
131672	Fee-for-Service	1841220373	1841220373	1	1	FELDMAN, GARY MD APC	11/2/2004	207RR0500X	NA	Other	026	PHYSICIANS	43953	41	Internal Medicine	0	In state provider	A PROFESSIONAL CORP	5230 PACIFIC CONCOURSE D	None	LOS ANGELES	CA	90045	6200	19	06037	33.92774198	-118.3727493	Los Angeles County
131712	Fee-for-Service	1831477249	1831477249	1	1	FANG, CHUNHUI MD	1/14/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	148751	78	Neoplastic Diseases/Oncology	0	In state provider	None	2626 N CALIFORNIA ST	STE B	STOCKTON	CA	95204	5500	39	06077	37.97724966	-121.2917368	San Joaquin County
131726	Fee-for-Service	1518917772	1518917772	1	1	FACULTY PHYSICIAN AND	12/12/2017	208600000X	NA	General Surgery	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	SURGEON OF LLUSM	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
131759	Fee-for-Service	1124189014	1124189014	1	1	FINEGAN, TRACY L NP	5/10/2018	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
131828	Fee-for-Service	1841382439	1841382439	1	1	FABIE, RAYMOND A MD	12/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	42773	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
131867	Fee-for-Service	1548087463	1548087463	1	1	FAMILY PLANNING ASSOCIATES M	1/24/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	EDICAL GROUP INC	415 W BENJAMIN HOLT DR	STE D6	STOCKTON	CA	95207	3958	39	06077	38.01194847	-121.3161933	San Joaquin County
131899	Fee-for-Service	1427282466	1427282466	1	1	FAMILY HLTH CTR OF SAN DIEGO	4/29/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
131914	Fee-for-Service	1033297163	1033297163	1	1	FONG, BRYAN P MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81504	04	Otology, Laryngology, Rhinology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
132002	Fee-for-Service	1669487435	1669487435	1	1	FARROHI, FAREADEH MD	7/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	36865	40	Pediatrics	0	In state provider	None	18546 ROSCOE BLVD	STE 211	NORTHRIDGE	CA	91324	5451	19	06037	34.22069869	-118.537684	Los Angeles County
132003	Fee-for-Service	1831477249	1831477249	1	1	FANG, CHUNHUI MD	1/14/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	148751	68	Hematology	0	In state provider	None	2626 N CALIFORNIA ST	STE B	STOCKTON	CA	95204	5500	39	06077	37.97724966	-121.2917368	San Joaquin County
132013	Fee-for-Service	1518917772	1518917772	1	1	FACULTY PHYSICIAN AND	6/19/1996	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	SURGEON OF LLUSM	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
132080	Fee-for-Service	1396768842	1396768842	1	1	FOXE, JAMES W MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	40643	08	Family Practice	0	In state provider	None	1860 S CENTRAL ST	STE D	VISALIA	CA	93277	4418	54	06107	36.314469	-119.3106195	Tulare County
132089	Fee-for-Service	1962581090	1962581090	1	1	FLEISHER, MARC S MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79584	04	Otology, Laryngology, Rhinology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
132157	Fee-for-Service	1548087463	1548087463	1	1	FAMILY PLANNING ASSOCIATES M	1/24/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	EDICAL GROUP INC	415 W BENJAMIN HOLT DR	STE D6	STOCKTON	CA	95207	3958	39	06077	38.01194847	-121.3161933	San Joaquin County
132169	Fee-for-Service	1295364024	1295364024	1	1	FURTH, WILLIAM MD	9/5/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	187328	None	None	0	In state provider	None	2970 HILLTOP MALL ROAD	305	RICHMOND	CA	94806	1947	07	06013	37.97819764	-122.329244	Contra Costa County
132185	Fee-for-Service	1427282466	1427282466	1	1	FAMILY HLTH CTR OF SAN DIEGO	4/29/2010	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
132266	Fee-for-Service	1174789572	1174789572	1	1	FRIEDRICH, MARTINA C LMFT	5/15/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	26250 INDUSTRIAL BLVD	STE 45	HAYWARD	CA	94545	2922	01	06001	37.63381267	-122.1111642	Alameda County
132290	Fee-for-Service	1669487435	1669487435	1	1	FARROHI, FAREADEH MD	7/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	36865	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18546 ROSCOE BLVD	STE 211	NORTHRIDGE	CA	91324	5451	19	06037	34.22069869	-118.537684	Los Angeles County
132299	Fee-for-Service	1881435337	1881435337	1	1	FRAIS, IVANA M LMFT	6/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
132304	Fee-for-Service	1518917772	1518917772	1	1	FACULTY PHYSICIAN AND	5/2/2017	208600000X	NA	General Surgery	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	SURGEON OF LLUSM	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
132329	Fee-for-Service	1306026422	1306026422	1	1	FOSTER, HILARY S PHD	4/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3772 HOWE STREET	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
132341	Fee-for-Service	1285691121	1285691121	1	1	FERNANDES, DIONISIO A MD	3/5/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	29416	40	Pediatrics	0	In state provider	None	7471 N FRESNO ST	None	FRESNO	CA	93720	2457	10	06019	36.84632065	-119.783885	Fresno County
132443	Fee-for-Service	1548087463	1548087463	1	1	FAMILY PLANNING ASSOCIATES M	1/24/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	EDICAL GROUP INC	415 W BENJAMIN HOLT DR	STE D6	STOCKTON	CA	95207	3958	39	06077	38.01194847	-121.3161933	San Joaquin County
132453	Fee-for-Service	1073944450	1073944450	1	1	FULLERTON HEALTHCARE &	12/20/2013	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTRE LP	2222 N HARBOR BLVD	None	FULLERTON	CA	92835	2605	30	06059	33.89696088	-117.9291275	Orange County
132473	Fee-for-Service	1427282466	1427282466	1	1	FAMILY HLTH CTR OF SAN DIEGO	12/17/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
132480	Fee-for-Service	1649290552	1649290552	3	1	FOOTHILL HOME CARE INC	12/30/2014	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	12921 RAMONA BLVD	STE C	IRWINDALE	CA	91706	3752	19	06037	34.07954734	-117.9902374	Los Angeles County
132590	Fee-for-Service	1518917772	1518917772	1	1	FACULTY PHYSICIAN AND	10/31/2017	208600000X	NA	General Surgery	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	SURGEON OF LLUSM	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
132622	Fee-for-Service	1487713574	1487713574	1	1	FAIRCHILD, JUDITH	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
132631	Fee-for-Service	1285691121	1285691121	1	1	FERNANDES, DIONISIO A MD	3/5/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	29416	03	Allergy	0	In state provider	None	7471 N FRESNO ST	None	FRESNO	CA	93720	2457	10	06019	36.84632065	-119.783885	Fresno County
132671	Fee-for-Service	1043504418	1043504418	1	1	FROLEK, HOLLY L OT	3/23/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	21515 HAWTHORNE BLVD	STE G100	TORRANCE	CA	90503	6503	19	06037	33.83306687	-118.3530111	Los Angeles County
132678	Fee-for-Service	1174568703	1174568703	1	1	FURUKAWA, IZUMI AUD	10/12/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5831 COTTLE ROAD	None	SAN JOSE	CA	95123	3734	43	06085	37.245213	-121.804079	Santa Clara County
132695	Fee-for-Service	1013900331	1013900331	1	1	FISKE, CHARLES E MD	3/31/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	35057	None	None	0	In state provider	None	450 30TH ST	None	OAKLAND	CA	94609	3302	01	06001	37.81935255	-122.2664506	Alameda County
132738	Fee-for-Service	1922184431	1922184431	1	1	FRAMBACH, BRUCE H MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	51408	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
132762	Fee-for-Service	1427282466	1427282466	1	1	FAMILY HLTH CTR OF SAN DIEGO	4/29/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
132915	Fee-for-Service	1285691121	1285691121	1	1	FERNANDES, DIONISIO A MD	3/5/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	29416	01	General Practice	0	In state provider	None	7471 N FRESNO ST	None	FRESNO	CA	93720	2457	10	06019	36.84632065	-119.783885	Fresno County
133014	Fee-for-Service	1316027709	1316027709	1	2	FRESNO COMMUNITY HOSPITAL	8/22/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	729 N MEDICAL CTR DR W	STE 121	CLOVIS	CA	93611	6880	10	06019	36.84152435	-119.6624818	Fresno County
133028	Fee-for-Service	1265514210	1265514210	1	1	FRESNO CO DEPT OF PUBLIC	9/12/1995	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	HEALTH LAB #A	1221 FULTON MALL	None	FRESNO	CA	93721	1915	10	06019	36.73615912	-119.7927065	Fresno County
133065	Fee-for-Service	1215905591	1215905591	1	1	FERRI, JOHN A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1401 W LOCUST ST	None	STILWELL	OK	74960	3217	00	None	35.80856644	-94.64321622	Adair County
133069	Fee-for-Service	1952487464	1952487464	1	1	FALCONER, ROBERT I DPM	6/22/2006	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
133082	Fee-for-Service	1942355086	1942355086	1	1	FRONCZAK, DANIEL B PHD	3/30/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	969 BROADWAY	None	OAKLAND	CA	94607	4017	01	06001	37.80134725	-122.273069	Alameda County
133145	Fee-for-Service	1225608334	1225608334	1	1	FUNG, ANITA CRNA	1/23/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 CHESTER AVE.	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
133151	Fee-for-Service	1548447378	1548447378	1	2	FEMINIST WOMENS HEALTH	10/11/2016	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	10665 COLOMA RD	SUITE C AND D	RANCHO CORDOVA	CA	95670	4086	34	06067	38.612484	-121.2912495	Sacramento County
133179	Fee-for-Service	1245318807	1245318807	1	1	FISHER, ALAN V MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36021	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
133203	Fee-for-Service	1316027709	1316027709	1	4	FRESNO COMMUNITY HOSPITAL	7/12/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	785 N MEDICAL CTR DR W	SUITE 106	CLOVIS	CA	93611	6800	10	06019	36.84377271	-119.6609536	Fresno County
133204	Fee-for-Service	1558703637	1558703637	1	1	FLORES, MARI L LCSW	11/5/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
133312	Fee-for-Service	1346398237	1346398237	1	1	FORWARD, CATHY L CRNA	3/25/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	RMC MOB2	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
133370	Fee-for-Service	1669504700	1669504700	1	2	FINE, STEPHEN LMFT	7/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
133425	Fee-for-Service	1558437236	1558437236	1	1	FITZPATRICK, SARA A CRNA	4/7/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
133470	Fee-for-Service	1821169509	1821169509	1	1	FERNANDO AZARCON	4/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
133473	Fee-for-Service	1376670141	1376670141	1	1	FRYMOYER, ADAM R MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96651	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
133500	Fee-for-Service	1770578411	1770578411	1	1	FRENCH, TONIANNE MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74840	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
133527	Fee-for-Service	1609986397	1609986397	1	1	FARRIS, STEVEN L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	SERVICES,LLC	2852 S CARRIAGE LANE	None	MESA	AZ	85202	7801	00	None	33.362811	-111.892833	Maricopa County
133553	Fee-for-Service	1386640746	1386640746	1	1	FIGHTLIN, STEFANIE J MD	11/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7879	08	Family Practice	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
133593	Fee-for-Service	1558445544	1558445544	1	1	FREEDMAN, JOHN MD	6/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	44746	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1580 VALENCIA ST	None	SAN FRANCISCO	CA	94110	4423	38	06075	37.74746923	-122.4202583	San Francisco County
133642	Fee-for-Service	1265622542	1265622542	1	1	FEGHALI, NABIL S MD INC	12/17/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	8111 CANOGA AVENUE	None	CANOGA PARK	CA	91304	4103	19	06037	34.217262	-118.5975465	Los Angeles County
133648	Fee-for-Service	1982172151	1982172151	1	1	FIRST AND HEALTH CARE INC	11/29/2018	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	719 E 1ST ST STE C	None	SANTA ANA	CA	92701	5330	30	06059	33.74559963	-117.8610857	Orange County
133716	Fee-for-Service	1912094434	1912094434	1	1	FRAME, ELIZABETH W MD	9/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156427	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
133851	Fee-for-Service	1316941859	1316941859	1	1	FAROOKI, AAMER Z MD	5/28/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	55218	30	Radiology	0	In state provider	None	1504 N WISHON AVE	None	FRESNO	CA	93728	1827	10	06019	36.763497	-119.8010405	Fresno County
133917	Fee-for-Service	1780925719	1780925719	1	1	FLORES, SALLY LMFT	10/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	112 E CHAPMAN AVE	A-5	ORANGE	CA	92866	1454	30	06059	33.78785148	-117.852237	Orange County
133954	Fee-for-Service	1962475897	1962475897	1	1	FIORELLO, ALBERT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
133982	Fee-for-Service	1194743427	1194743427	1	1	FAHMY, MICHAEL H MD	6/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69627	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
133983	Fee-for-Service	1659371367	1659371367	1	1	FICINSKI, MARIOLA L MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	50558	67	Endocrinology	0	In state provider	None	1245 WILSHIRE BLVD	STE 804	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
133989	Fee-for-Service	1043249105	1043249105	2	1	FAIRMONT PHARMACY LLC	9/21/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	50 BELLEFONTAINE ST	STE 103	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
134005	Fee-for-Service	1912094434	1912094434	1	1	FRAME, ELIZABETH W MD	9/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156427	83	Rheumatology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
134082	Fee-for-Service	1508262411	1508262411	1	1	FITZPATRICK, ERIN C LMFT	11/8/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
134084	Fee-for-Service	1376621094	1376621094	1	1	FITCH, BRIAN PAUL MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	51412	36	Psychiatry	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
134152	Fee-for-Service	1013955657	1013955657	1	1	FILBRANDT, PHILLIP R MD	9/5/2007	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	85910	25	Physical Medicine and Rehabilitation	0	In state provider	None	578 RIO LINDO AVE	STE 1	CHICO	CA	95926	1800	04	06007	39.75476878	-121.8485796	Butte County
134197	Fee-for-Service	1508580895	1508580895	1	1	FRIEDE, NAOMI NP	10/31/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
134219	Fee-for-Service	1518911809	1518911809	1	1	FINK, KURT A MD	2/14/2011	207L00000X	NA	Other	026	PHYSICIANS	103974	05	Anesthesiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
134269	Fee-for-Service	1659371367	1659371367	1	1	FICINSKI, MARIOLA L MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	50558	41	Internal Medicine	0	In state provider	None	1245 WILSHIRE BLVD	STE 804	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
134400	Fee-for-Service	1043579303	1043579303	1	1	FEINSTEIN, AARON J MD	6/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131167	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 MEDICAL PLAZA	STE 500	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
134416	Fee-for-Service	1700981016	1700981016	1	1	FINE, FRANK E MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66472	01	General Practice	0	In state provider	None	803 COFFEE RD	STE 4	MODESTO	CA	95355	4238	50	06099	37.65474897	-120.9756157	Stanislaus County
134421	Fee-for-Service	1497012199	1497012199	1	1	FUNG, DANIEL T MD	12/5/2019	2085R0204X	NA	Other	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	6410 FANNIN STREET	SUITE 1500	HOUSTON	TX	77030	5306	00	None	29.71419639	-95.39755562	Harris County
134430	Fee-for-Service	1679738504	1679738504	1	1	FRY, ROBERT W E MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115889	20	Orthopedic Surgery	0	In state provider	None	6719 ALVARADO RD	STE 200	SAN DIEGO	CA	92120	5256	37	06073	32.77684978	-117.055137	San Diego County
134474	Fee-for-Service	1740734441	1740734441	1	1	FOROUZAN, SARA LMFT	7/14/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
134542	Fee-for-Service	1487862470	1487862470	1	1	FIRTH, SANDRA M PHD	3/15/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	44-530 SAN PABLO AVE	SUITE 201	PALM DESERT	CA	92260	3596	33	06065	33.72807112	-116.3825504	Riverside County
134544	Fee-for-Service	1538138276	1538138276	1	1	FORD, SEKOU C MD	10/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88204	08	Family Practice	0	In state provider	None	1600 HOLLOWAY AVE	None	SAN FRANCISCO	CA	94132	1722	38	06075	37.72087043	-122.4782195	San Francisco County
134565	Fee-for-Service	1669520573	1669520573	1	1	FLYNN, VINCENT J MD	6/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82370	34	Urology and Urological Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
134569	Fee-for-Service	1639237043	1639237043	1	1	FELDMAN, DAVID MD INC	11/24/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
134634	Fee-for-Service	1932375037	1932375037	1	1	FALK, CHRISTINA C CRNA	9/8/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
134658	Fee-for-Service	1518962802	1518962802	1	1	FIELD, SUE A MD	4/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127692	05	Anesthesiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.049547	-117.264078	San Bernardino County
134660	Fee-for-Service	1619486727	1619486727	1	1	FAZLEABAS, QURAISH G MD	8/14/2020	207P00000X	NA	Other	026	PHYSICIANS	16965	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
134663	Fee-for-Service	1417066291	1417066291	1	1	FAKHRE, ELHAM MD	9/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106917	41	Internal Medicine	0	In state provider	None	215 WEST JANSS	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
134730	Fee-for-Service	1689687386	1689687386	1	1	FULAN, JOHN LMFT	9/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
134740	Fee-for-Service	1669658373	1669658373	1	1	FAMILY HEALTHY CTRS OF SD	9/27/2000	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTER	1111 W CHASE AVE	None	EL CAJON	CA	92020	5710	37	06073	32.78161035	-116.9764603	San Diego County
134742	Fee-for-Service	1528018553	1528018553	1	1	FACULTY PHYSICIANS AND	8/30/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM-NEUROS	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
134829	Fee-for-Service	1235908989	1235908989	1	1	FAMILY RESOURCE NAVIGATORS	12/23/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	101 CALLAN AVE	STE 200	SAN LEANDRO	CA	94577	4558	01	06001	37.72594042	-122.1562404	Alameda County
134859	Fee-for-Service	1568547859	1568547859	1	1	FISHBEYN HOLDINGS INC	11/1/2002	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	POST & DIVISADERO MEDICA	2299 POST ST	STE 109	SAN FRANCISCO	CA	94115	3443	38	06075	37.78434298	-122.4392033	San Francisco County
134892	Fee-for-Service	1871532630	1871532630	1	1	FOURNIER, ROBERT SCOTT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 OSTRUM ST	None	BETHLEHEM	PA	18015	1000	00	None	40.60853156	-75.39270674	Lehigh County
134929	Fee-for-Service	1427459460	1427459460	1	1	FRIED, KIMBERLY A LMFT	2/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 PIO PICO DR	STE 105	CARLSBAD	CA	92008	1951	37	06073	33.16162799	-117.3408476	San Diego County
134948	Fee-for-Service	1982782504	1982782504	1	1	FRACCHIA, CARLA A MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85524	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
134954	Fee-for-Service	1720134646	1720134646	1	1	FAMILY THERAPY INSTITUTE	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	OF SANTA BARBARA	23 W MISSION ST	None	SANTA BARBARA	CA	93101	8460	42	06083	34.43022721	-119.7153091	Santa Barbara County
135034	Fee-for-Service	1528018553	1528018553	1	1	FACULTY PHYSICIANS AND	4/10/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM-NEUROS	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
135038	Fee-for-Service	1457619132	1457619132	1	1	FLORES, MARLENE LMFT	10/25/2017	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	127 NORTH MADISON AVE	SUITE 213	PASADENA	CA	91101	9001	19	06037	34.148223	-118.1384475	Los Angeles County
135046	Fee-for-Service	1104974062	1104974062	1	1	FOK, SHIU-KWAN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29328	36	Psychiatry	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
135060	Fee-for-Service	1437495462	1437495462	1	1	FLORENCE WESTERN MEDICAL	5/10/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	20440 SHERMAN WAY	None	CANOGA PARK	CA	91306	3110	19	06037	34.20098249	-118.578753	Los Angeles County
135111	Fee-for-Service	1891715009	1891715009	1	1	FELDMAN, GARY S MD	1/3/2009	2080P0006X	NA	Psychiatry	026	PHYSICIANS	86656	40	Pediatrics	0	In state provider	None	2880 ATLANTIC AVE	STE 255	LONG BEACH	CA	90806	1734	19	06037	33.809382	-118.185001	Los Angeles County
135115	Fee-for-Service	1710103528	1710103528	1	1	FOREVER YOUNG ADULT DAY	1/21/2003	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	9820 TOPANGA CANYON BLVD	STE F	CHATSWORTH	CA	91311	4025	19	06037	34.24900343	-118.6059431	Los Angeles County
135151	Fee-for-Service	1811417231	1811417231	1	1	FRANCO, ELIZABETH M NP	8/10/2020	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
135266	Fee-for-Service	1346249067	1346249067	1	1	FARREN, GEORGIANNA MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	59600	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
135320	Fee-for-Service	1528018553	1528018553	1	1	FACULTY PHYSICIANS AND	10/21/2019	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	SURGEONS OF LLUSM-NEUROS	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
135332	Fee-for-Service	1104974062	1104974062	1	1	FOK, SHIU-KWAN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29328	25	Physical Medicine and Rehabilitation	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
135367	Fee-for-Service	1588695167	1588695167	1	1	FROSS, ROBIN D MD	3/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	60158	07	Dermatology	0	In state provider	None	2444 MOORPARK AVE	STE 316	SAN JOSE	CA	95128	2621	43	06085	37.3160487	-121.9373196	Santa Clara County
135442	Fee-for-Service	1144282831	1144282831	1	1	FOGG, MAXWELL AND LANIER	12/21/2005	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MD INC	3830 N 1ST ST	None	FRESNO	CA	93726	4301	10	06019	36.78754262	-119.7723305	Fresno County
135453	Fee-for-Service	1457857914	1457857914	1	1	FOOTT, ALEXANDER J MD	8/26/2021	207P00000X	NA	Other	026	PHYSICIANS	174477	None	None	0	In state provider	None	800 E WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
135513	Fee-for-Service	1699784959	1699784959	1	1	FERNANDEZ, STEPHEN M MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	48005	05	Anesthesiology	0	In state provider	A PROF CORP	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
135517	Fee-for-Service	1477688281	1477688281	1	1	FARRELL, JULIA R	8/19/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
135528	Fee-for-Service	1235345711	1235345711	1	1	FRANCIS, STACEY H MD	8/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113014	24	Plastic Surgery	0	In state provider	None	4650 SUNSET BLVD.	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
135643	Fee-for-Service	1588695167	1588695167	1	1	FROSS, ROBIN D MD	3/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	60158	13	Neurology (M.D. only)	0	In state provider	None	2444 MOORPARK AVE	STE 316	SAN JOSE	CA	95128	2621	43	06085	37.3160487	-121.9373196	Santa Clara County
135742	Fee-for-Service	1801975933	1801975933	1	1	FRANKLIN, ROBERT M	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72701	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3555 ARMY ST	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.7479947	-122.4209132	San Francisco County
135755	Fee-for-Service	1841637360	1841637360	1	1	FAJILAN, ADRIEL A MD	10/11/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	135537	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
135796	Fee-for-Service	1609935261	1609935261	1	1	FLOWERS, FRANK M JR MD	3/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51152	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
135797	Fee-for-Service	1366871287	1366871287	1	2	FRONT PORCH COMM & SERVICES	12/31/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	111 3RD AVE	None	CHULA VISTA	CA	91910	1822	37	06073	32.64811177	-117.0824374	San Diego County
135799	Fee-for-Service	1699784959	1699784959	1	1	FERNANDEZ, STEPHEN M MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	48005	01	General Practice	0	In state provider	A PROF CORP	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
135817	Fee-for-Service	1841366804	1841366804	1	1	FAN, JENNIFER LMFT	9/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
135842	Fee-for-Service	1629364419	1629364419	1	1	FRISCHMANN, LINDSEY K DO	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13930	13	Neurology (M.D. only)	0	In state provider	None	275 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
135858	Fee-for-Service	1952406605	1952406605	1	2	FU, JULIUS H MD	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52315	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	None	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
135895	Fee-for-Service	1225493836	1225493836	1	1	FACUNDO, LETICIA M	5/23/2022	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8421 AUBURN BLVD	SUITE 110	CITRUS HEIGHTS	CA	95610	0359	34	06067	38.719026	-121.291335	Sacramento County
135946	Fee-for-Service	1306812821	1306812821	1	1	FOX, MICHAEL A MD	12/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86313	30	Radiology	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
135952	Fee-for-Service	1154397628	1154397628	1	1	FULLERTON CARDIOVASCULAR	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	MEDICAL GROUP INC	2720 N HARBOR BLVD	STE 130	FULLERTON	CA	92835	2625	30	06059	33.90126238	-117.9292154	Orange County
136031	Fee-for-Service	1801975933	1801975933	1	1	FRANKLIN, ROBERT M	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72701	40	Pediatrics	0	In state provider	None	3555 ARMY ST	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.7479947	-122.4209132	San Francisco County
136183	Fee-for-Service	1235333162	1235333162	1	1	FARFIELD-SUISUN UNIFIED	6/6/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOL DISTRICT	2490 HILBORN RD	None	FAIRFIELD	CA	94534	1072	48	06095	38.27592693	-122.0522739	Solano County
136222	Fee-for-Service	1073623906	1073623906	1	1	FUJIMOTO, MICHAEL K. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1560 N 115TH ST	None	SEATTLE	WA	98133	8414	00	None	47.7123252	-122.3357195	King County
136241	Fee-for-Service	1154397628	1154397628	1	1	FULLERTON CARDIOVASCULAR	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL GROUP INC	2720 N HARBOR BLVD	STE 130	FULLERTON	CA	92835	2625	30	06059	33.90126238	-117.9292154	Orange County
136266	Fee-for-Service	1154783371	1154783371	1	1	FRENKEL, SAM MD	7/1/2019	390200000X	NA	Other	026	PHYSICIANS	150821	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
136273	Fee-for-Service	1407915739	1407915739	1	1	FUNAMURA, JACK L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35134	30	Radiology	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
136331	Fee-for-Service	1780734343	1780734343	1	1	FONTANA, LOUIS A MD	3/16/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	49072	None	None	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
136337	Fee-for-Service	1356351936	1356351936	1	1	FLEMMING, BONNIE L MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	34524	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	26 LOCKE LN	None	MILL VALLEY	CA	94941	2154	21	06041	37.89961399	-122.5337889	Marin County
136367	Fee-for-Service	1801905773	1801905773	1	1	FOSTER, ELISA M DO	10/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9979	30	Radiology	0	In state provider	None	FRESNO & R STREETS	None	FRESNO	CA	93721	1324	10	06019	36.741663	-119.7841005	Fresno County
136423	Fee-for-Service	1083792998	1083792998	1	1	FESSLER, JERRY D MD	2/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	31007	08	Family Practice	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
136484	Fee-for-Service	1477155141	1477155141	1	1	FEDERAL HOSPICE CARE INC	10/11/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	18340 VENTURA BLVD	STE 204	TARZANA	CA	91356	4291	19	06037	34.16710415	-118.5320031	Los Angeles County
136489	Fee-for-Service	1831167113	1831167113	1	1	FANTELLI,FLOYD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3100 CHANNING WAY	None	IDAHO FALLS	ID	83404	0000	00	None	43.470198	-111.9901955	Bonneville County
136502	Fee-for-Service	1730652082	1730652082	1	1	FARNSWORTH, MARISA LMFT	4/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5079 HIGHWAY 140	None	MARIPOSA	CA	95338	2434	22	06043	37.48746975	-119.9681179	Mariposa County
136526	Fee-for-Service	1790960896	1790960896	1	1	FRANCIS, DEVON R MD	11/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	103163	40	Pediatrics	0	In state provider	None	45 NIELSON STREET	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7925859	Santa Cruz County
136543	Fee-for-Service	1245289545	1245289545	1	1	FAN, DALI MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53856	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
136572	Fee-for-Service	1629156468	1629156468	1	1	FOOMAN, ALI P MD	6/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93312	05	Anesthesiology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
136628	Fee-for-Service	1144511437	1144511437	1	1	FAHMI SHENODA, SHERRY R MD	10/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153272	40	Pediatrics	0	In state provider	None	701 E 28TH STREET	SUITE 200	LONG BEACH	CA	90806	2759	19	06037	33.80803441	-118.1847137	Los Angeles County
136723	Fee-for-Service	1205833035	1205833035	1	1	FIRPO, ROBERT S MD	1/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	31123	02	General Surgery	0	In state provider	None	12291 WASHINGTON BLVD	STE 105	WHITTIER	CA	90606	2500	19	06037	33.96734104	-118.0508773	Los Angeles County
136772	Fee-for-Service	1477155141	1477155141	1	1	FEDERAL HOSPICE CARE INC	10/11/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	18340 VENTURA BLVD	STE 204	TARZANA	CA	91356	4291	19	06037	34.16710415	-118.5320031	Los Angeles County
136824	Fee-for-Service	1851875389	1851875389	1	1	FAGHIRI, ATUSA PSYD	10/4/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
136888	Fee-for-Service	1013952597	1013952597	1	7	FAMILY HEALTH CENTERS OF	6/22/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	338 W LEXINGTON AVE	STE 104	EL CAJON	CA	92020	4443	37	06073	32.79272653	-116.965152	San Diego County
136894	Fee-for-Service	1487636932	1487636932	1	1	FUNKE, ELIZABETH A NP	3/2/2005	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
136937	Fee-for-Service	1801242367	1801242367	1	1	FREEMAN, ELIZABETH W MD	1/15/2025	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	None	36.072729	-115.295094	Clark County
136964	Fee-for-Service	1720184898	1720184898	1	1	FAROOQ, MUHAMMAD A MD	7/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	56230	08	Family Practice	0	In state provider	None	8426 CALIFORNIA AVE	None	SOUTH GATE	CA	90280	2414	19	06037	33.9592432	-118.2052109	Los Angeles County
136984	Fee-for-Service	1467804930	1467804930	1	1	FRANCO, EGINIA MD	9/30/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169409	08	Family Practice	0	In state provider	None	12746 W JEFFERSON BLVD	FL 2-4	LOS ANGELES	CA	90094	2885	19	06037	33.97751255	-118.417598	Los Angeles County
137012	Fee-for-Service	1205833035	1205833035	1	1	FIRPO, ROBERT S MD	1/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	31123	33	Thoracic Surgery	0	In state provider	None	12291 WASHINGTON BLVD	STE 105	WHITTIER	CA	90606	2500	19	06037	33.96734104	-118.0508773	Los Angeles County
137135	Fee-for-Service	1114030467	1114030467	1	1	FERNANDEZ, DANILO MD	3/10/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	80133	None	None	0	In state provider	None	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
137138	Fee-for-Service	1255470167	1255470167	1	1	FAMILY PLANNING ASSOCIATES	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	5050 PALO VERDE	STE 203	MONTCLAIR	CA	91763	2334	36	06071	34.08145549	-117.69516	San Bernardino County
137155	Fee-for-Service	1922447895	1922447895	1	1	FARRELL, CRYSTAL R MD	9/25/2019	2085P0229X	NA	Other	026	PHYSICIANS	156125	30	Radiology	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
137177	Fee-for-Service	1013952597	1013952597	1	7	FAMILY HEALTH CENTERS OF	6/22/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	338 W LEXINGTON AVE	STE 104	EL CAJON	CA	92020	4443	37	06073	32.79272653	-116.965152	San Diego County
137327	Fee-for-Service	1063696839	1063696839	1	1	FRANKEL, DAVID A MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	82056	23	Peripheral Vascular Disease or Surgery (D.O. only)	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
137330	Fee-for-Service	1467684928	1467684928	1	1	FOX, DANIEL N MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114643	05	Anesthesiology	0	In state provider	None	2175 ROSALINE AVENUE	None	REDDING	CA	96001	6690	45	06089	40.57278686	-122.3958519	Shasta County
137482	Fee-for-Service	1851929830	1851929830	1	1	FREISE, JONATHAN E MD	8/2/2023	208600000X	NA	General Surgery	026	PHYSICIANS	177429	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
137515	Fee-for-Service	1447327382	1447327382	1	1	FRIED, STANLEY M MD	2/22/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	29705	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
137573	Fee-for-Service	1457439192	1457439192	1	1	FUCHS, EDWARD S MD	7/16/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40264	01	General Practice	0	In state provider	None	201 CLINTON RD	STE 106	JACKSON	CA	95642	2678	03	06005	38.34202831	-120.7638813	Amador County
137750	Fee-for-Service	1346480837	1346480837	1	1	FAMILY HEALTH CENTERS OF	2/4/2009	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	251 LANDIS AVE	None	CHULA VISTA	CA	91910	2628	37	06073	32.6425313	-117.0814859	San Diego County
137762	Fee-for-Service	1265581102	1265581102	1	1	FRANKEL, SUZANNE H PHD	3/1/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
137804	Fee-for-Service	1447327382	1447327382	1	1	FRIED, STANLEY M MD	2/22/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	29705	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
137892	Fee-for-Service	1093728503	1093728503	2	1	FRISCH, DONNA J MD	10/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	76025	01	General Practice	0	In state provider	None	500 S ANAHEIM HILLS RD	STE 206	ANAHEIM	CA	92807	4759	30	06059	33.8427954	-117.7772895	Orange County
137947	Fee-for-Service	1750793279	1750793279	1	1	FIELDS, MATTHEW P M MD	9/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15348	08	Family Practice	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
138001	Fee-for-Service	1447429642	1447429642	1	1	FREEDOM MOBILITY CTR	7/31/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FREEDOM MOBILITY CTR	586 PARKER AVE	None	RODEO	CA	94572	1450	07	06013	38.02985884	-122.2664112	Contra Costa County
138005	Fee-for-Service	1447837885	1447837885	1	1	FORTUNA HOSPICE INC	9/8/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	735 W DUARTE RD	STE 203	ARCADIA	CA	91007	9511	19	06037	34.1258867	-118.0562874	Los Angeles County
138044	Fee-for-Service	1346480837	1346480837	1	1	FAMILY HEALTH CENTERS OF	2/4/2009	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	251 LANDIS AVE	None	CHULA VISTA	CA	91910	2628	37	06073	32.6425313	-117.0814859	San Diego County
138056	Fee-for-Service	1497832455	1497832455	1	1	FARRALES-NGUYEN, SUSAN D NP	9/1/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
138062	Fee-for-Service	1952963878	1952963878	1	1	FISHEL, DANIEL M DO	8/30/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17753	None	None	0	In state provider	None	1525 W FLORIDA AVE	D	HEMET	CA	92543	3825	33	06065	33.7473507	-116.9878543	Riverside County
138075	Fee-for-Service	1861908451	1861908451	1	1	FLORES, TEO TODD L PT	2/10/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
138096	Fee-for-Service	1558783878	1558783878	1	1	FULTON ENTERPRISES	6/1/2014	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4180 TREAT BLVD	SUITE 102	CONCORD	CA	94518	4509	07	06013	37.95467253	-122.0024802	Contra Costa County
138148	Fee-for-Service	1497867600	1497867600	1	1	FORBES, LEONARD H OD	5/31/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12737 GLENOAKS BLVD	STE 3	SYLMAR	CA	91342	4724	19	06037	34.30181336	-118.4422626	Los Angeles County
138190	Fee-for-Service	1588815138	1588815138	1	1	FOWLER, DORIAN E CRNA	9/24/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	500 SW RAMSEY AVE	None	GRANTS PASS	OR	97527	5554	00	None	42.4198785	-123.3432318	Josephine County
138217	Fee-for-Service	1992404388	1992404388	1	1	FONTENOT, MORGAN OT	7/23/2024	390200000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	5730	27	06053	36.57482436	-121.8101797	Monterey County
138255	Fee-for-Service	1134307283	1134307283	1	1	FENTON, NAI BRITTANY LMFT	5/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
138263	Fee-for-Service	1336785286	1336785286	1	1	FRIEDLAND, JENNY Y MD	3/21/2025	207R00000X	NA	Other	026	PHYSICIANS	188380	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
138290	Fee-for-Service	1447837885	1447837885	1	1	FORTUNA HOSPICE INC	9/8/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	735 W DUARTE RD	STE 203	ARCADIA	CA	91007	9511	19	06037	34.1258867	-118.0562874	Los Angeles County
138293	Fee-for-Service	1700316866	1700316866	1	1	FRIELING, OLIVIA A	4/24/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
138339	Fee-for-Service	1811002082	1811002082	1	1	FARID, WAFAA M MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	51882	01	General Practice	0	In state provider	None	1729 W AVENUE J	SUITE 101	LANCASTER	CA	93534	2708	19	06037	34.68944953	-118.162287	Los Angeles County
138417	Fee-for-Service	1316027709	1316027709	1	6	FRESNO COMMUNITY HOSPITAL	7/12/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	785 N MEDICAL CTR DR W	SUITE 102	CLOVIS	CA	93611	6800	10	06019	36.84377271	-119.6609536	Fresno County
138418	Fee-for-Service	1235166430	1235166430	1	1	FERNANDEZ, OSCAR A MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71880	05	Anesthesiology	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
138421	Fee-for-Service	1811912074	1811912074	1	1	FINN, RICHARD SAMUEL MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67544	68	Hematology	0	In state provider	None	100 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
138516	Fee-for-Service	1316099443	1316099443	1	1	FISHER, MARY E MD	2/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	93275	08	Family Practice	0	In state provider	None	2433 CENTRAL AVE	STE A	ALAMEDA	CA	94501	4564	01	06001	37.76358675	-122.2413153	Alameda County
138520	Fee-for-Service	1568510808	1568510808	1	1	FERREYRA, ALEJANDRO J	11/3/2008	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	4715 VIEWRIDGE AVE	SUITE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
138525	Fee-for-Service	1053637694	1053637694	1	1	FULLER, COREY B MD	7/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118405	20	Orthopedic Surgery	0	In state provider	None	25455 BARTON RD	None	LOMA LINDA	CA	92354	3312	36	06071	34.04805253	-117.249534	San Bernardino County
138580	Fee-for-Service	1013952597	1013952597	1	2	FAMILY HEALTH CENTERS OF	10/26/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	742 10TH ST	None	IMPERIAL BEACH	CA	91932	2216	37	06073	32.58294554	-117.111886	San Diego County
138581	Fee-for-Service	1538231972	1538231972	1	1	FONG, PAU K MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33418	41	Internal Medicine	0	In state provider	None	3939 J ST	STE 108	SACRAMENTO	CA	95819	3671	34	06067	38.570211	-121.45374	Sacramento County
138605	Fee-for-Service	1487300778	1487300778	1	1	FOUR SEASONS HEALTH	9/27/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	239 E ALAMEDA AVE	STE 201	BURBANK	CA	91502	1557	19	06037	34.17541398	-118.2988703	Los Angeles County
138623	Fee-for-Service	1548225667	1548225667	1	1	FITZPATRICK, JAMES E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4200 EAST AVENUE	None	DENVER	CO	80262	0001	00	None	39.61666868	-105.0726924	City and County of Denver
138626	Fee-for-Service	1811002082	1811002082	1	1	FARID, WAFAA M MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	51882	08	Family Practice	0	In state provider	None	1729 W AVENUE J	SUITE 101	LANCASTER	CA	93534	2708	19	06037	34.68944953	-118.162287	Los Angeles County
138679	Fee-for-Service	1306823695	1306823695	1	1	FREYHOF,J MATTHEW MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2222 PHILADELPHIA DR	None	DAYTON	OH	45406	1813	00	None	39.78749248	-84.23490647	Montgomery County
138708	Fee-for-Service	1811912074	1811912074	1	1	FINN, RICHARD SAMUEL MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67544	78	Neoplastic Diseases/Oncology	0	In state provider	None	100 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
138724	Fee-for-Service	1124159892	1124159892	1	1	FLORES, GABRIELA LCSW	9/6/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	65560	-	NOT APPLICABLE	0	In state provider	None	2115 N WILMINGTON AVE	None	COMPTON	CA	90222	2030	19	06037	33.91197848	-118.2391821	Los Angeles County
138734	Fee-for-Service	1033678081	1033678081	1	1	FULLER, NATHANAEL MD	10/18/2023	207L00000X	NA	Other	026	PHYSICIANS	178996	None	None	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
138738	Fee-for-Service	1831241637	1831241637	1	1	FAILANO-AGOO, LORNA C MD	1/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46483	01	General Practice	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
138772	Fee-for-Service	1306357686	1306357686	1	1	FITZGERALD, KATHLEEN W CNP	11/20/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3327 ROSECRANS ST	None	SAN DIEGO	CA	92110	4223	37	06073	32.74779742	-117.2076448	San Diego County
138816	Fee-for-Service	1265457444	1265457444	1	1	FRIEDMAN, JODI L MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	67097	41	Internal Medicine	0	In state provider	None	100 MEDICAL PLAZA STE 29	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
138829	Fee-for-Service	1548601933	1548601933	1	1	FUENTES, MARK B MD	8/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149089	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
138831	Fee-for-Service	1417991183	1417991183	1	1	FRANCHETT, ANDREA MD	10/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80246	08	Family Practice	0	In state provider	None	3000 COLBY ST	STE 304	BERKELEY	CA	94705	2058	01	06001	37.85473248	-122.2575793	Alameda County
138861	Fee-for-Service	1063545804	1063545804	1	1	FARVID, ALI R MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91109	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
138864	Fee-for-Service	1013952597	1013952597	1	2	FAMILY HEALTH CENTERS OF	10/26/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	742 10TH ST	None	IMPERIAL BEACH	CA	91932	2216	37	06073	32.58294554	-117.111886	San Diego County
138907	Fee-for-Service	1649371022	1649371022	1	1	FULLER, KATHRYN A	7/21/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	30495 CANWOOD	101	AGOURA HILLS	CA	91301	4331	19	06037	34.14698794	-118.7853623	Los Angeles County
138973	Fee-for-Service	1841288107	1841288107	1	1	FANNING, CARA F MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	77	Infectious Disease	1	Border provider	None	5701 W CHARLESTON BLVD	STE 100	LAS VEGAS	NV	89146	1256	00	None	36.15908651	-115.219719	Clark County
139029	Fee-for-Service	1265686109	1265686109	1	2	FACULTY PHYSICIANS AND SURGE	11/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	11234 ANDERSON ST	STE 6100,6300,7200,7300	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
139031	Fee-for-Service	1710335948	1710335948	1	1	FUENTES, JULIE LMFT	5/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
139102	Fee-for-Service	1275714917	1275714917	1	1	FUSSELL, SUZANNE L MD	3/1/1999	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55383	08	Family Practice	0	In state provider	ST NAZARENE MED CLIN INC	1100 N VENTURA RD	STE 109	OXNARD	CA	93030	3841	56	06111	34.212771	-119.1944035	Ventura County
139116	Fee-for-Service	1932276763	1932276763	1	1	FALKOFF, REUBEN J MD	8/31/1983	207KA0200X	NA	Other	026	PHYSICIANS	35919	03	Allergy	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
139149	Fee-for-Service	1740695493	1740695493	1	1	FAZEL, ZOHA LPCC	11/8/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE	130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
139158	Fee-for-Service	1164692745	1164692745	2	1	FULLERTON MEDICAL PHARMACY I	2/28/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1401 S. BROOKHURST RD	101	FULLERTON	CA	92833	4492	30	06059	33.85761255	-117.9593114	Orange County
139169	Fee-for-Service	1063480275	1063480275	1	1	FLATEN,ERIC L CRNA	11/1/2000	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
139171	Fee-for-Service	1164631081	1164631081	1	1	FAMILY RADIOLOGY INC	10/24/2011	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	3440 LOMITA BLVD	# 151	TORRANCE	CA	90505	4865	19	06037	33.81328127	-118.3452927	Los Angeles County
139193	Fee-for-Service	1104493980	1104493980	1	1	FARMER, PHILLIP P CNP	8/20/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	491 E ALESSANDRO BLVD	None	RIVERSIDE	CA	92508	6071	33	06065	33.91628714	-117.3230954	Riverside County
139196	Fee-for-Service	1588601678	1588601678	1	1	FRANCESCHINI, NICHOLAS MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	77 W. FOREST AVE #207	None	PHOENIX	AZ	86001	0000	00	None	35.20971	-111.6438255	Coconino County
139208	Fee-for-Service	1629631312	1629631312	1	1	FULTON GARDENS POST ACUTE	5/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	537 E FULTON STREET	None	STOCKTON	CA	95204	2227	39	06077	37.98493477	-121.2934666	San Joaquin County
139247	Fee-for-Service	1760560494	1760560494	1	1	FEINBERG, BENNETT MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63579	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
139252	Fee-for-Service	1972595700	1972595700	1	1	FLOWERS, CHIQUITA R MD	5/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	67337	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
139258	Fee-for-Service	1841288107	1841288107	1	1	FANNING, CARA F MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	5701 W CHARLESTON BLVD	STE 100	LAS VEGAS	NV	89146	1256	00	None	36.15908651	-115.219719	Clark County
139302	Fee-for-Service	1679587091	1679587091	1	1	FERDOWS, DEAN MD	11/9/2011	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	46360	01	General Practice	0	In state provider	None	4316 SLAUSON AVE	UNIT A	MAYWOOD	CA	90270	2838	19	06037	33.98746055	-118.1892788	Los Angeles County
139316	Fee-for-Service	1265686109	1265686109	1	2	FACULTY PHYSICIANS AND SURGE	7/19/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11234 ANDERSON ST	STE 6100,6300,7200,7300	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
139317	Fee-for-Service	1700660560	1700660560	1	1	FAJOTA, TRACY-JANE NP	9/28/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14901 RINALDI STREET	SUITE 200-201	MISSION HILLS	CA	91345	1254	19	06037	34.27903452	-118.457433	Los Angeles County
139361	Fee-for-Service	1891322129	1891322129	1	1	FUCHS, JOSHUA DO	8/28/2024	207P00000X	NA	Other	026	PHYSICIANS	20793	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
139448	Fee-for-Service	1922625466	1922625466	1	1	FEDDER, DOUGLAS F MD	9/27/2023	207R00000X	NA	Other	026	PHYSICIANS	184903	None	None	0	In state provider	None	6001 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5400	07	06013	37.7755858	-121.958923	Contra Costa County
139461	Fee-for-Service	1447443841	1447443841	1	1	FONG, DANIEL C LMFT	4/15/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
139470	Fee-for-Service	1699703801	1699703801	1	1	FIELDS, WILLIAM W III MD	10/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45043	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	# 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
139603	Fee-for-Service	1265686109	1265686109	1	2	FACULTY PHYSICIANS AND SURGE	11/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11234 ANDERSON ST	STE 6100,6300,7200,7300	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
139636	Fee-for-Service	1013310309	1013310309	1	1	FOUNTAIN VALLEY GROUP	2/9/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	SERVICES PC	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
139650	Fee-for-Service	1356493738	1356493738	1	1	FYNEWEVER, TRICIA L MD	4/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85070	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
139668	Fee-for-Service	1568939015	1568939015	1	1	FORTITUDE HOSPICE INC	12/4/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3700 WILSHIRE BLVD	STE 610	LOS ANGELES	CA	90010	2867	19	06037	34.06168851	-118.3068315	Los Angeles County
139679	Fee-for-Service	1801965835	1801965835	1	1	FIRESTONE, DANIEL N MD	11/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92664	66	Emergency Medicine (Urgent Care)	0	In state provider	None	600 CITY PARKWAY WEST	None	ORANGE	CA	92868	2900	30	06059	33.78299646	-117.89694	Orange County
139794	Fee-for-Service	1598752909	1598752909	1	1	FAMILY EYE ASSOCIATES	7/1/2001	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC GROUP	2201 BOYNTON AVE	None	FAIRFIELD	CA	94533	4319	48	06095	38.24981148	-122.06655	Solano County
139802	Fee-for-Service	1972547511	1972547511	1	1	FERRANTE, FRANCIS M MD	6/29/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86121	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
139842	Fee-for-Service	1063630614	1063630614	1	5	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3559 W RAMSEY AVE	STE C2	BANNING	CA	92220	3505	33	06065	33.9263001	-116.9160867	Riverside County
139860	Fee-for-Service	1275038325	1275038325	1	1	FINCH, ROBERT C MD	1/18/2022	1835P0200X	NA	Other	026	PHYSICIANS	174513	None	None	0	In state provider	None	6555 COYLE AVE	STE 310	CARMICHAEL	CA	95608	0303	34	06067	38.66859	-121.3118055	Sacramento County
139863	Fee-for-Service	1508473257	1508473257	1	1	FLINTALL, HOLLY PT	12/22/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2895 LOMA VISTA ROAD	SUITE H	VENTURA	CA	93003	1542	56	06111	34.27543868	-119.2574459	Ventura County
139891	Fee-for-Service	1265686109	1265686109	1	2	FACULTY PHYSICIANS AND SURGE	11/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	STE 6100,6300,7200,7300	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
139937	Fee-for-Service	1679973309	1679973309	1	1	FLORES, JEANETTE LCSW	7/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
139955	Fee-for-Service	1568939015	1568939015	1	1	FORTITUDE HOSPICE INC	12/4/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3700 WILSHIRE BLVD	STE 610	LOS ANGELES	CA	90010	2867	19	06037	34.06168851	-118.3068315	Los Angeles County
140003	Fee-for-Service	1851682090	1851682090	1	1	FISSENDEN, THOMAS M MD	8/23/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	164275	04	Otology, Laryngology, Rhinology	0	In state provider	None	500 DOYLE PARK DR	STE 106A	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
140112	Fee-for-Service	1811139637	1811139637	1	1	FONG, BRYAN J MD	7/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110784	05	Anesthesiology	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3651	30	06059	33.60848903	-117.7079742	Orange County
140143	Fee-for-Service	1689015695	1689015695	1	1	FITZGERALD, SHEA M	12/16/2013	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	SUITE 120	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
140192	Fee-for-Service	1467530147	1467530147	1	1	FU, ANTHONY M MD	9/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80424	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
140216	Fee-for-Service	1043236953	1043236953	1	1	FARREAU, MIREILLE MD	11/30/1989	207P00000X	NA	Other	026	PHYSICIANS	48697	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
140225	Fee-for-Service	1912918913	1912918913	1	1	FEUSNER, JAMIE D MD	7/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75093	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
140238	Fee-for-Service	1225022098	1225022098	1	1	FRIEDMAN, LAURENCE J MD	10/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	80718	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91773	3219	19	06037	34.20289797	-118.6294006	Los Angeles County
140251	Fee-for-Service	1063924843	1063924843	1	1	FOLAND, AMY K CRNA	3/5/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
140307	Fee-for-Service	1225563612	1225563612	1	1	FRYLING, LAUREN R MD	5/16/2021	207P00000X	NA	Other	026	PHYSICIANS	158341	None	None	0	In state provider	None	13100 STUDEBAKER ROAD	None	NORWALK	CA	90650	2531	19	06037	33.912594	-118.099152	Los Angeles County
140326	Fee-for-Service	1285785055	1285785055	1	1	FARTHING, PATRICIA B MFT	1/4/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	44866	-	NOT APPLICABLE	0	In state provider	None	890 HAYES STREET	None	SAN FRANCISCO	CA	94117	2615	38	06075	37.77587721	-122.4309963	San Francisco County
140375	Fee-for-Service	1043557796	1043557796	1	1	FACCHINO, JANELLE B NP	5/11/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
140452	Fee-for-Service	1689163370	1689163370	1	1	FRANKMAN, JONATHAN	7/14/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18409	None	None	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
140506	Fee-for-Service	1063630614	1063630614	1	7	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	528 N PALM AVE	None	ONTARIO	CA	91762	3218	36	06071	34.069212	-117.6534855	San Bernardino County
140566	Fee-for-Service	1437683877	1437683877	1	1	FRESENIUS MEDICAL CARE	3/25/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	NEPHROLOGY CLINICS	2731 SYSTRON DRIVE	None	CONCORD	CA	94518	1035	07	06013	37.96498906	-122.0288061	Contra Costa County
140571	Fee-for-Service	1982667473	1982667473	2	1	FRANK M DE MAYO MD PC	2/14/2020	111NX0800X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	MEDICAL CENTER	530 WEST EATON AVENUE	SUITE E	TRACY	CA	95376	3400	39	06077	37.74328351	-121.433886	San Joaquin County
140602	Fee-for-Service	1417000522	1417000522	1	1	FRAGOSO-CORONA, ALMA OD	12/5/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4137 MAINE AVE	None	BALDWIN PARK	CA	91706	3309	19	06037	34.0879081	-117.9604554	Los Angeles County
140624	Fee-for-Service	1205863909	1205863909	1	1	FRYKMAN, ERIC K MD	9/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	62970	01	General Practice	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
140690	Fee-for-Service	1356427595	1356427595	1	1	FURMAN, GEOFFREY D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	36482	66	Emergency Medicine (Urgent Care)	0	In state provider	None	801 N TUSTIN AVE	None	SANTA ANA	CA	92705	3612	30	06059	33.752286	-117.8341735	Orange County
140692	Fee-for-Service	1285665810	1285665810	1	1	FISHER, LISA A MD	5/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56081	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
140743	Fee-for-Service	1245865492	1245865492	1	1	FERRON, BRIANA M LMFT	1/5/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	959 E COLORADO BLVD	SUITE 220	PASADENA	CA	91106	5900	19	06037	34.14594353	-118.1306205	Los Angeles County
140806	Fee-for-Service	1063630614	1063630614	1	2	F J S HEARING PROFESSIONALS	10/23/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2012 N RIVERSIDE AVE	STE J	RIALTO	CA	92377	4603	36	06071	34.13892569	-117.3719933	San Bernardino County
140853	Fee-for-Service	1811175821	1811175821	1	1	FRANCO, DIANA MD	3/18/2008	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	61850	01	General Practice	0	In state provider	None	6006 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4402	19	06037	34.01701018	-118.1415056	Los Angeles County
140859	Fee-for-Service	1982667473	1982667473	2	1	FRANK M DE MAYO MD PC	2/14/2020	111NX0800X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CENTER	530 WEST EATON AVENUE	SUITE E	TRACY	CA	95376	3400	39	06077	37.74328351	-121.433886	San Joaquin County
140869	Fee-for-Service	1316110281	1316110281	1	1	FERNANDEZ-RANVIER, GUSTAVO G	2/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113246	02	General Surgery	0	In state provider	MD	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
140879	Fee-for-Service	1912213968	1912213968	1	1	FLORES, SALLY LMFT	7/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	56970 YUCCA TRAIL	STE 104	YUCCA VALLEY	CA	92284	3148	36	06071	34.12059645	-116.420985	San Bernardino County
141019	Fee-for-Service	1073568648	1073568648	1	1	FOX, DANIEL T MD	10/16/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62883	30	Radiology	0	In state provider	None	345 S A ST	None	OXNARD	CA	93030	5804	56	06111	34.19938431	-119.1786013	Ventura County
141032	Fee-for-Service	1255384905	1255384905	1	1	FARAHMAND, SHIRIN M MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48578	22	Pathology (M.D. only)	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
141042	Fee-for-Service	1437632742	1437632742	1	2	FAMILY PLANNING ASSOCIATES M	6/21/2019	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	43845 W 10TH ST	STE 1E	LANCASTER	CA	93534	1111	19	06037	34.68012017	-118.1479449	Los Angeles County
141143	Fee-for-Service	1942393996	1942393996	1	1	FERRER, FARAH G MD	11/23/2010	2084P0804X	NA	Psychiatry	026	PHYSICIANS	55258	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
141150	Fee-for-Service	1760811251	1760811251	1	1	FRIEDBERG, DAVID MD INC	1/28/2016	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	112102	20	Orthopedic Surgery	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2643	19	06037	33.93112671	-118.2035532	Los Angeles County
141218	Fee-for-Service	1487149621	1487149621	1	1	FIRST CARE HOME HEALTH INC	12/20/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3800 LA CRESCENTA AVE	STE 203	LA CRESCENTA	CA	91214	3948	19	06037	34.2115128	-118.2399309	Los Angeles County
141299	Fee-for-Service	1700878428	1700878428	2	1	FAGEN, NEIL MD	1/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	29304	10	Gastroenterology (M.D. only)	0	In state provider	None	18411 CLARK ST	STE 204	TARZANA	CA	91356	3539	19	06037	34.16981538	-118.5337442	Los Angeles County
141388	Fee-for-Service	1275913758	1275913758	1	1	FIRSTCARE HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5500 BOLSA AVE	SUITE 222	HUNTINGTON BEACH	CA	92649	5705	30	06059	33.7443258	-118.0324152	Orange County
141390	Fee-for-Service	1417964867	1417964867	1	1	FREEMAN, ROGER A MD	10/10/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	29093	20	Orthopedic Surgery	0	In state provider	None	306 LAUREL MOUNTAIN RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64244416	-118.9680348	Mono County
141400	Fee-for-Service	1306819586	1306819586	1	1	FLORES, DEBORAH L MD	8/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70890	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
141422	Fee-for-Service	1891940078	1891940078	1	1	FIRESTONE, SUSAN MD	12/18/2008	207LP3000X	NA	Other	026	PHYSICIANS	87851	05	Anesthesiology	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
141466	Fee-for-Service	1538420104	1538420104	1	7	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	35 CASA ST	SUITE 320	SAN LUIS OBISPO	CA	93405	1894	40	06079	35.29359615	-120.6654304	San Luis Obispo County
141574	Fee-for-Service	1619960903	1619960903	1	1	FEARER, TODD A MD	5/31/1985	207R00000X	NA	Other	026	PHYSICIANS	54961	01	General Practice	0	In state provider	None	1214 COAST VILLAGE RD	STE 5	SANTA BARBARA	CA	93108	3783	42	06083	34.42111957	-119.643935	Santa Barbara County
141608	Fee-for-Service	1366969248	1366969248	1	1	FIELD, ALEXANDRA LMFT	9/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24325 MAIN ST	STE 102	NEWHALL	CA	91321	2932	19	06037	34.37920492	-118.5283244	Los Angeles County
141616	Fee-for-Service	1124758727	1124758727	1	1	FRIENDS OF THE FAMILY	6/21/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5062 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	2402	19	06037	34.00044931	-118.0838937	Los Angeles County
141676	Fee-for-Service	1275913758	1275913758	1	1	FIRSTCARE HOSPICE, INC	8/29/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5500 BOLSA AVE	SUITE 222	HUNTINGTON BEACH	CA	92649	5705	30	06059	33.7443258	-118.0324152	Orange County
141696	Fee-for-Service	1720050321	1720050321	1	1	FITZGERALD, BRIAN T MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55760	20	Orthopedic Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
141712	Fee-for-Service	1407616816	1407616816	1	1	FINLEY, JACQUELINE NP	1/21/2025	163WP0808X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
141746	Fee-for-Service	1801097852	1801097852	1	1	FURUTA, MICHELLE L MD	8/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99491	36	Psychiatry	0	In state provider	None	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
141792	Fee-for-Service	1447447818	1447447818	1	1	FU, JUSTIN A MD	8/5/2008	207R00000X	NA	Other	026	PHYSICIANS	96100	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
141836	Fee-for-Service	1245207489	1245207489	2	1	FREINKEL, ROBERT L MD	1/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	25328	03	Allergy	0	In state provider	None	1460 N CAMINO ALTO	SUITE 109	VALLEJO	CA	94589	2567	48	06095	38.13262019	-122.2386804	Solano County
141840	Fee-for-Service	1417247552	1417247552	1	1	FORRESTER, JOSEPH D MD	9/1/2019	208600000X	NA	General Surgery	026	PHYSICIANS	122002	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
141868	Fee-for-Service	1417306101	1417306101	1	1	FU, CHEN MD	9/27/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	158717	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
141903	Fee-for-Service	1124758727	1124758727	1	1	FRIENDS OF THE FAMILY	2/22/2024	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5062 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	2402	19	06037	34.00044931	-118.0838937	Los Angeles County
141940	Fee-for-Service	1881811404	1881811404	1	1	FOOTHILL COMMUN MED CORP	10/23/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	SAN RAFAEL COMM MED CLIN	647 E ARROW HWY	None	AZUSA	CA	91702	5802	19	06037	34.1068263	-117.8982008	Los Angeles County
142006	Fee-for-Service	1245597962	1245597962	1	1	FOLTZ, CHRISTOPHER M MD	12/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126905	02	General Surgery	0	In state provider	None	8635 W 3RD STREET	1190W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
142068	Fee-for-Service	1316417769	1316417769	1	1	FERNANDEZ, DANYELLE AU	7/25/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3816 WOODRUFF AVE	STE 305	LONG BEACH	CA	90808	2146	19	06037	33.828102	-118.1165525	Los Angeles County
142074	Fee-for-Service	1396743241	1396743241	1	1	FONG, VERNON K MD	4/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	43492	20	Orthopedic Surgery	0	In state provider	None	728 PACIFIC AVE	STE 501	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
142121	Fee-for-Service	1689666265	1689666265	1	1	FURDIK, VILIAM M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	53336	05	Anesthesiology	0	In state provider	None	3530 WILSHIRE BLVD	STE 350	LOS ANGELES	CA	90010	2335	19	06037	34.06171652	-118.301427	Los Angeles County
142192	Fee-for-Service	1124758727	1124758727	1	1	FRIENDS OF THE FAMILY	6/21/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5062 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	2402	19	06037	34.00044931	-118.0838937	Los Angeles County
142222	Fee-for-Service	1982743761	1982743761	1	1	FAMILY PLANNING ASSOC	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GRP INC	3893 MISSION INN AVE	None	RIVERSIDE	CA	92501	3217	33	06065	33.98400727	-117.3759957	Riverside County
142256	Fee-for-Service	1982783015	1982783015	1	1	FRANK, SUZANNE M MD	12/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53349	40	Pediatrics	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
142294	Fee-for-Service	1245597962	1245597962	1	1	FOLTZ, CHRISTOPHER M MD	12/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126905	77	Infectious Disease	0	In state provider	None	8635 W 3RD STREET	1190W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
142327	Fee-for-Service	1932413796	1932413796	1	1	FELICANO, AGNES NP	12/2/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	180 SIERRA COLLEGE DRIVE	None	GRASS VALLEY	CA	95945	5768	29	06057	39.23235449	-121.0475561	Nevada County
142390	Fee-for-Service	1114989803	1114989803	1	1	FOGG, MAXWELL AND LANIER	11/1/2001	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MD INC	1817 SHAW AVE	STE 104	CLOVIS	CA	93611	4069	10	06019	36.8086995	-119.681613	Fresno County
142398	Fee-for-Service	1083852628	1083852628	1	1	FREVERT, EMILY L PT	10/20/2009	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	980 ROOSEVELT	STE 100	IRVINE	CA	92620	3670	30	06059	33.69380208	-117.7653165	Orange County
142415	Fee-for-Service	1750593349	1750593349	1	1	FERNANDO, ELIZA M MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61717	40	Pediatrics	0	In state provider	None	6601 RUGBY AVE	STE 104	HUNTINGTON PARK	CA	90255	4046	19	06037	33.979113	-118.2265595	Los Angeles County
142441	Fee-for-Service	1649575077	1649575077	1	1	FIERRO, LIZVETH L MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133405	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26520 CACTUS AVENUE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
142462	Fee-for-Service	1215026760	1215026760	1	1	FRASER, COSMO L MD	1/1/2000	193400000X	NA	Other	026	PHYSICIANS	40203	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2115 E ONSTOTT RD	None	YUBA CITY	CA	95991	1556	51	06101	39.16145541	-121.6346977	Sutter County
142480	Fee-for-Service	1780718858	1780718858	1	1	FIELDEN, CHAD LMFT	6/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4944 SUNRISE BLVD	SUITE J3	FAIR OAKS	CA	95628	4941	34	06067	38.656107	-121.271931	Sacramento County
142493	Fee-for-Service	1710432265	1710432265	1	1	FRANCO, MIA LCSW	3/25/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
142564	Fee-for-Service	1093243438	1093243438	1	1	FAZAKERLY, AMANDA J	6/12/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
142581	Fee-for-Service	1346314044	1346314044	1	1	FRAILEY, MARIA I PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	625 3RD AVE	None	CHULA VISTA	CA	91910	5703	37	06073	32.62998356	-117.0754419	San Diego County
142658	Fee-for-Service	1689624025	1689624025	1	1	FLANZBAUM, JONATHAN M MD	9/2/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64414	40	Pediatrics	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
142670	Fee-for-Service	1730206038	1730206038	1	1	FIVE STAR HOME HOSPICE INC	2/9/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1028 N LAKE AVE	#106	PASADENA	CA	91104	4570	19	06037	34.16368395	-118.1324447	Los Angeles County
142703	Fee-for-Service	1750593349	1750593349	1	1	FERNANDO, ELIZA M MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61717	08	Family Practice	0	In state provider	None	6601 RUGBY AVE	STE 104	HUNTINGTON PARK	CA	90255	4046	19	06037	33.979113	-118.2265595	Los Angeles County
142725	Fee-for-Service	1205126117	1205126117	1	1	FALOLA, OLORUNTOYIN O MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122001	07	Dermatology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	41	06081	37.313433	-121.9318385	Santa Clara County
142750	Fee-for-Service	1215026760	1215026760	1	1	FRASER, COSMO L MD	1/1/2000	193400000X	NA	Other	026	PHYSICIANS	40203	41	Internal Medicine	0	In state provider	None	2115 E ONSTOTT RD	None	YUBA CITY	CA	95991	1556	51	06101	39.16145541	-121.6346977	Sutter County
142775	Fee-for-Service	1023897618	1023897618	1	1	FULLER, MARCUS LCSW	2/12/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
142789	Fee-for-Service	1669005500	1669005500	1	1	FAMILY CHOICE PEDIATRICS INC	6/18/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	3801 KATELLA AVE	STE 221	LOS ALAMITOS	CA	90720	3380	30	06059	33.80318951	-118.066068	Orange County
142826	Fee-for-Service	1275875015	1275875015	1	1	FRIES, JOYCE M	9/12/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2295 S VINEYARD AVE	None	ONTARIO	CA	91761	7925	36	06071	34.031889	-117.608112	San Bernardino County
142879	Fee-for-Service	1659077378	1659077378	2	1	FORD TRANSPORTATION SERVICE	8/17/2023	347C00000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	1901 DAHLIA CT	None	PALMDALE	CA	93550	7371	19	06037	34.5526211	-118.0954059	Los Angeles County
142900	Fee-for-Service	1750427753	1750427753	1	1	FARROW, TERRY MD	5/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120247	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
142913	Fee-for-Service	1104114206	1104114206	1	1	FAWCETT, KEVIN PHD	8/8/2011	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
142923	Fee-for-Service	1891830121	1891830121	1	1	FRANK, CLARE	4/5/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
142948	Fee-for-Service	1912935826	1912935826	1	1	FONG, SHIRLEY A MD	9/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90666	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	STE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
142959	Fee-for-Service	1730206038	1730206038	1	1	FIVE STAR HOME HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1028 N LAKE AVE	#106	PASADENA	CA	91104	4570	19	06037	34.16368395	-118.1324447	Los Angeles County
142969	Fee-for-Service	1639405004	1639405004	1	1	FAMILY HEALTH CENTER	12/28/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF JOSHUA TREE INC	7350 CHURCH ST	None	YUCCA VALLEY	CA	92284	3246	36	06071	34.11914526	-116.4365977	San Bernardino County
142978	Fee-for-Service	1538227608	1538227608	1	1	FRIENDLY CARE MEDICAL	1/23/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP, INC	3610 ATLANTIC AVE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
142981	Fee-for-Service	1245937598	1245937598	1	1	FAIRFAX GARDENS OPERATIONS	10/25/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	1025 N FAIRFAX AVE	None	LOS ANGELES	CA	90046	6102	19	06037	34.08935608	-118.3616297	Los Angeles County
143022	Fee-for-Service	1407863764	1407863764	1	1	FUNG, KAIHI F MD	10/31/1988	208600000X	NA	General Surgery	026	PHYSICIANS	50706	02	General Surgery	0	In state provider	None	711 W COLLEGE ST	STE 300	LOS ANGELES	CA	90012	1093	19	06037	34.06541412	-118.2414102	Los Angeles County
143062	Fee-for-Service	1699235515	1699235515	1	1	FOLEY, JOHN MD	11/4/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	29472 AVE DE LAS BANDERA	None	RANCHO SANTA MARG	CA	92688	2651	30	06059	33.620238	-117.610578	Orange County
143105	Fee-for-Service	1003985599	1003985599	1	1	FARHAT, HORMOZ MD	9/30/1982	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	38193	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5900 PACIFIC BLVD	STE 102	HUNTINGTON PARK	CA	90255	2914	19	06037	33.988968	-118.225184	Los Angeles County
143187	Fee-for-Service	1942656533	1942656533	1	1	FORRETT, RAFAEL LMFT	8/1/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
143216	Fee-for-Service	1669594735	1669594735	1	1	FRAUSTO, JULIE LCSW	1/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
143252	Fee-for-Service	1639257348	1639257348	1	1	FITZPATRICK, THOMAS A MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75498	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
143253	Fee-for-Service	1639405004	1639405004	1	1	FAMILY HEALTH CENTER	7/28/2011	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF JOSHUA TREE INC	7350 CHURCH ST	None	YUCCA VALLEY	CA	92284	3246	36	06071	34.11914526	-116.4365977	San Bernardino County
143262	Fee-for-Service	1871944025	1871944025	1	1	FIMREITE, MICHAEL H OD	7/12/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2414 S FAIRVIEW STREET	STE 103	SANTA ANA	CA	92704	5318	30	06059	33.71437705	-117.9079237	Orange County
143265	Fee-for-Service	MSS00021F	None	1	1	FRESNO-MADERA AREA	7/1/1998	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	AGENCY ON AGING	2520 W SHAW AVE	STE 101A	FRESNO	CA	93711	2768	10	06019	36.80843351	-119.8385246	Fresno County
143300	Fee-for-Service	1962839183	1962839183	1	1	FRESENIUS MEDICAL CARE	10/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA II LLC	570 N 2ND STREET	None	EL CAJON	CA	92021	6448	37	06073	32.801328	-116.935897	San Diego County
143327	Fee-for-Service	1720179799	1720179799	1	1	FOSTER CITY PEDIATRIC	12/31/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP, INC	1295 E HILLSDALE BLVD	None	FOSTER CITY	CA	94404	1214	41	06081	37.56929845	-122.26533	San Mateo County
143483	Fee-for-Service	1295961795	1295961795	1	1	FITZPATRICK, ELLEN P MD	9/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138322	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
143489	Fee-for-Service	1124025937	1124025937	1	1	FRANCOIS LUKS	9/21/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2 DUDLEY ST	STE 190	PROVIDENCE	RI	02905	3248	00	None	41.81068615	-71.40798057	Providence County
143503	Fee-for-Service	1336100478	1336100478	1	1	FARAZ ALAM, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4530 E MUIRWOOD DR	STE 105	PHOENIX	AZ	85048	7693	00	None	33.303006	-111.9855375	Maricopa County
143558	Fee-for-Service	1639405004	1639405004	1	1	FAMILY HEALTH CENTER	12/28/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF JOSHUA TREE INC	7350 CHURCH ST	None	YUCCA VALLEY	CA	92284	3246	36	06071	34.11914526	-116.4365977	San Bernardino County
143580	Fee-for-Service	1255378840	1255378840	1	1	FRIEDMAN, SERENA M MD	2/8/2015	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	32511	01	General Practice	0	In state provider	None	7345 MEDICAL CENTER DR	STE 310	WEST HILLS	CA	91307	1961	19	06037	34.20369349	-118.629837	Los Angeles County
143678	Fee-for-Service	1588273833	1588273833	1	1	FARTASH OD INC	9/3/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	RY	734 N MAIN ST	None	CORONA	CA	92880	1439	33	06065	33.89171973	-117.5640251	Riverside County
143760	Fee-for-Service	1760758106	1760758106	1	1	FERNANDEZ, DAMIAN O MD	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141808	None	None	0	In state provider	None	1020 29TH ST	STE 270	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
143796	Fee-for-Service	1366492191	1366492191	1	1	FACULTY PHYSICIANS AND	4/24/2006	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	SURGEONS OF LLUSM	12571 HESPERIA ROAD	None	VICTORVILLE	CA	92395	5847	36	06071	34.479497	-117.2908745	San Bernardino County
143833	Fee-for-Service	1205984275	1205984275	1	1	FINKELSTEIN, SOLOMON MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39004	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
143933	Fee-for-Service	1215311295	1215311295	1	1	FELD, SARA LCSW	9/14/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2200 PACIFIC COAST HWY	STE 102	HERMOSA BEACH	CA	90254	2700	19	06037	33.87079831	-118.3947051	Los Angeles County
143942	Fee-for-Service	1881753481	1881753481	1	1	FULLER, CLAIRE V MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	68827	40	Pediatrics	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
144035	Fee-for-Service	1801399621	1801399621	1	1	FELDMAN, KELLY A MD	5/6/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	164645	None	None	0	In state provider	None	101 THE CITY DR S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
144055	Fee-for-Service	1255633517	1255633517	1	1	FARD, JENNIFER LMFT	6/10/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
144139	Fee-for-Service	1760606123	1760606123	1	1	FLORES, LOUIS B	11/3/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	32929	08	Family Practice	0	In state provider	None	9128 WOODMAN AVE	None	ARLETA	CA	91331	6405	19	06037	34.23612313	-118.4409578	Los Angeles County
144211	Fee-for-Service	1053366633	1053366633	1	1	FREDRICK, DOUGLAS R MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	43821	18	Ophthalmology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
144232	Fee-for-Service	1295291193	1295291193	1	2	FAKHIMI, AMITA F PSYD	8/18/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	18700 OXNARD STREET	None	TARZANA	CA	91356	1413	19	06037	34.18014349	-118.5410025	Los Angeles County
144270	Fee-for-Service	1073032389	1073032389	1	1	FRAZIER-PHILO, KRYSTLE R PSY	7/16/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	D	461 TENNESSEE ST	SUITE C	REDLANDS	CA	92373	8161	36	06071	34.058745	-117.2000975	San Bernardino County
144296	Fee-for-Service	1629456900	1629456900	1	1	FAMILY HEALTH CENTERS	6/10/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4094 4TH AVENUE	None	SAN DIEGO	CA	92103	2143	37	06073	32.75153771	-117.161688	San Diego County
144393	Fee-for-Service	1770938839	1770938839	1	1	FIRST HAND HOME HEALTH INC	10/11/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3455 OCEAN VIEW BLVD	SUITE 101A	GLENDALE	CA	91208	1554	19	06037	34.20197542	-118.2282667	Los Angeles County
144433	Fee-for-Service	1255406468	1255406468	1	1	FREDERICK, BUCHWALD R	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	28000 MEADOW DR UNIT 210	None	EVERGREEN	CO	80439	2116	00	None	39.63780045	-105.3183616	Jefferson County
144466	Fee-for-Service	1740496629	1740496629	1	1	FLORES, RHAPSODY O LCSW	10/24/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
144514	Fee-for-Service	1760616908	1760616908	1	1	FERRARA, RACHEL A MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113630	01	General Practice	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
144525	Fee-for-Service	1922286657	1922286657	1	1	FRATERS, MICHAEL G DO	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10091	66	Emergency Medicine (Urgent Care)	0	In state provider	None	726 FOURTH STREET	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
144540	Fee-for-Service	1538282595	1538282595	1	1	FITZGIBBONS, GREGORY A	12/13/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2305 CAMINO RAMON	STE 200	SAN RAMON	CA	94583	1316	07	06013	37.77544224	-121.9657563	Contra Costa County
144573	Fee-for-Service	1972918217	1972918217	1	1	FRUGOLI, AMANDA J DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14831	41	Internal Medicine	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
144584	Fee-for-Service	1629456900	1629456900	1	1	FAMILY HEALTH CENTERS	9/1/2015	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4094 4TH AVENUE	None	SAN DIEGO	CA	92103	2143	37	06073	32.75153771	-117.161688	San Diego County
144681	Fee-for-Service	1285728717	1285728717	1	1	FAMILY HOME HEALTH	4/1/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY, LLC	1200 EAST ROUTE 66	SUITE 206A	GLENDORA	CA	91740	6377	19	06037	34.12873149	-117.8422695	Los Angeles County
144709	Fee-for-Service	1992801443	1992801443	1	1	FRIDEY, JOY L MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	60285	22	Pathology (M.D. only)	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
144722	Fee-for-Service	1275287161	1275287161	1	1	FEDOROVA, VALERIYA	3/9/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
144723	Fee-for-Service	1588665939	1588665939	1	1	FUNG, ANNE E MD	9/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72953	18	Ophthalmology	0	In state provider	None	2100 WEBSTER ST	STE 214	SAN FRANCISCO	CA	94115	2375	38	06075	37.7904826	-122.4324477	San Francisco County
144725	Fee-for-Service	1831371020	1831371020	1	1	FUH, ERIC MD	9/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	105059	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
144801	Fee-for-Service	1841346608	1841346608	1	1	FONG, JUSTIN P MD	6/30/1990	207R00000X	NA	Other	026	PHYSICIANS	57883	41	Internal Medicine	0	In state provider	None	2636 OCEAN AVE	None	SAN FRANCISCO	CA	94132	1616	38	06075	37.73197943	-122.4738275	San Francisco County
144821	Fee-for-Service	1104904606	1104904606	1	1	FEEBACK-LEE, ANDREA H MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83895	40	Pediatrics	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
144854	Fee-for-Service	1538420104	1538420104	1	3	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1220 LAS TABLAS RD	SUITE 1418	TEMPLETON	CA	93465	9756	40	06079	35.55442452	-120.7211175	San Luis Obispo County
144871	Fee-for-Service	1629456900	1629456900	1	1	FAMILY HEALTH CENTERS	12/2/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4094 4TH AVENUE	None	SAN DIEGO	CA	92103	2143	37	06073	32.75153771	-117.161688	San Diego County
145032	Fee-for-Service	1942377700	1942377700	1	1	FISHER, CHRISTINA M CRNA	4/5/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
145042	Fee-for-Service	1538696042	1538696042	1	1	FERNANDEZ, ALFRED MD	7/8/2021	207P00000X	NA	Other	026	PHYSICIANS	171328	None	None	0	In state provider	None	1350 W COVINA BLVD	None	SAN DIMAS	CA	91773	3219	19	06037	34.09906108	-117.8343639	Los Angeles County
145046	Fee-for-Service	1033260195	1033260195	1	1	FOWLER, MICHAEL B MD	5/31/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	42497	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
145066	Fee-for-Service	1700017175	1700017175	1	1	FARAHMAND, GUITY MD	4/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116388	None	None	0	In state provider	None	3300 WEBSTER ST	SUITE 804	OAKLAND	CA	94609	3118	01	06001	37.82132826	-122.2621843	Alameda County
145161	Fee-for-Service	1629456900	1629456900	1	1	FAMILY HEALTH CENTERS	6/10/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4094 4TH AVENUE	None	SAN DIEGO	CA	92103	2143	37	06073	32.75153771	-117.161688	San Diego County
145217	Fee-for-Service	1609816636	1609816636	1	1	FORTUNATA, BLAISE PHD	1/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	800 SERENO DRIVE	None	VALLEJO	CA	94589	2411	48	06095	38.12792924	-122.2506587	Solano County
145258	Fee-for-Service	1558418186	1558418186	1	1	FIELD, ROBERT B PHD	12/12/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	907 SAN RAMON VALLEY BLV	STE 202	DANVILLE	CA	94526	4036	07	06013	37.80813695	-121.9922024	Contra Costa County
145380	Fee-for-Service	1780794735	1780794735	1	1	FIGUEROA, DAVY L MD	7/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	46362	41	Internal Medicine	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
145419	Fee-for-Service	1952478836	1952478836	1	1	FERNANDEZ, MANUEL P MD	2/8/2015	207RE0101X	NA	Endocrinology	026	PHYSICIANS	38862	41	Internal Medicine	0	In state provider	None	23961 CALLE DE LA MAGDAL	None	LAGUNA HILLS	CA	92653	3616	30	06059	33.60999658	-117.7126577	Orange County
145421	Fee-for-Service	1285299628	1285299628	1	1	FRANCO, ERIKA NP	6/26/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9464 9TH AVE	SUITE A	HESPERIA	CA	92345	3483	36	06071	34.42240692	-117.3208348	San Bernardino County
145471	Fee-for-Service	1346412244	1346412244	1	1	FONG, MATTHEW MD	8/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	13013	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
145496	Fee-for-Service	1023131869	1023131869	1	1	FAXON, JON M LCSW	3/10/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD ROAD	None	SANTA CLARA	CA	95131	5173	43	06085	37.33774954	-122.002065	Santa Clara County
145566	Fee-for-Service	1881891166	1881891166	1	1	FEDORKA, PETER N MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81068	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
145567	Fee-for-Service	1972537025	1972537025	1	1	FUSTER, MARK M MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	80544	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
145620	Fee-for-Service	1588741433	1588741433	1	1	FLAPAN, WENDY DO	2/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8080	25	Physical Medicine and Rehabilitation	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
145658	Fee-for-Service	1104432566	1104432566	1	1	FIRST UNLIMITED HOSPICE CARE	8/18/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	1533 LOMITA BLVD	None	HARBOR CITY	CA	90710	2024	19	06037	33.79784346	-118.3038885	Los Angeles County
145679	Fee-for-Service	1669457834	1669457834	1	1	FERNANDEZ, ERIK MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77325	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
145704	Fee-for-Service	1952478836	1952478836	1	1	FERNANDEZ, MANUEL P MD	2/8/2015	207RE0101X	NA	Endocrinology	026	PHYSICIANS	38862	67	Endocrinology	0	In state provider	None	23961 CALLE DE LA MAGDAL	None	LAGUNA HILLS	CA	92653	3616	30	06059	33.60999658	-117.7126577	Orange County
145708	Fee-for-Service	1649672437	1649672437	1	1	FRANK, PAUL N MD	5/28/2020	207L00000X	NA	Other	026	PHYSICIANS	139489	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
145717	Fee-for-Service	1316026784	1316026784	1	1	FREED, ROBERT L MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	32247	83	Rheumatology	0	In state provider	None	16300 SAND CANYON AVE	STE 708	IRVINE	CA	92618	3707	30	06059	33.66115075	-117.7742405	Orange County
145747	Fee-for-Service	1417051558	1417051558	1	1	FRANK, STEWART L MD INC	8/19/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	26854	41	Internal Medicine	0	In state provider	None	4033 3RD AVE	STE 204	SAN DIEGO	CA	92103	2130	37	06073	32.75053781	-117.1627168	San Diego County
145768	Fee-for-Service	1922499714	1922499714	1	1	FANG, KEVIN J MD	10/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134401	40	Pediatrics	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
145847	Fee-for-Service	1629130240	1629130240	1	1	FEATHER RIVER TRIBAL	9/1/2002	261QR1300X	NA	Rural Health Center	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	HEALTH	2145 5TH AVE	None	OROVILLE	CA	95965	5870	04	06007	39.50368243	-121.5646958	Butte County
145885	Fee-for-Service	1568540250	1568540250	1	1	FITZGIBBON, JOHN MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	62703	47	Miscellaneous	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
145945	Fee-for-Service	1588026082	1588026082	1	1	FAHEEM, SARA S MD	7/10/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	158536	40	Pediatrics	0	In state provider	None	1820 41ST AVE	STE D	CAPITOLA	CA	95010	2516	44	06087	36.975573	-121.964832	Santa Cruz County
145946	Fee-for-Service	1104432566	1104432566	1	1	FIRST UNLIMITED HOSPICE CARE	8/18/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	1533 LOMITA BLVD	None	HARBOR CITY	CA	90710	2024	19	06037	33.79784346	-118.3038885	Los Angeles County
145957	Fee-for-Service	1699418384	1699418384	1	1	FLORES, HOPE LMFT	11/21/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	33	06065	33.994269	-117.3485375	Riverside County
145995	Fee-for-Service	1295858967	1295858967	1	1	FENDLEY, GARNEY H MD	7/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111457	30	Radiology	0	In state provider	None	1001 POTRERO VF	ROOM 1X	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
146008	Fee-for-Service	1700999844	1700999844	1	1	FREDIAN, APRIL L MD	3/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108550	08	Family Practice	0	In state provider	None	450 PARK STREET	SUITE 100B	ALAMEDA	CA	94501	6257	01	06001	37.75569711	-122.2492336	Alameda County
146052	Fee-for-Service	1639529910	1639529910	1	1	FISICARO, RYAN A	2/19/2023	111NR0200X	NA	Other	026	PHYSICIANS	176936	None	None	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
146103	Fee-for-Service	1588744635	1588744635	1	1	FRUEHAUF, JOHN P MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	58826	78	Neoplastic Diseases/Oncology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
146128	Fee-for-Service	1801925250	1801925250	1	1	FENSON, BRETT J MD	9/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98991	05	Anesthesiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
146139	Fee-for-Service	1629130240	1629130240	1	1	FEATHER RIVER TRIBAL	7/1/1994	261QR1300X	NA	Rural Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH	2145 5TH AVE	None	OROVILLE	CA	95965	5870	04	06007	39.50368243	-121.5646958	Butte County
146173	Fee-for-Service	1417084583	1417084583	1	1	FISK, SHELA B PHD	6/30/1993	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	STANFORD UNIV CLINIC	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
146236	Fee-for-Service	1467615807	1467615807	1	1	FOROUHAR, ELENA MD	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141923	None	None	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
146257	Fee-for-Service	1659386274	1659386274	1	1	FAITH PHARMACY, INC	6/8/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	26357 MCBEAN PARKWAY	SUITE 140	VALENCIA	CA	91355	4488	19	06037	34.41257644	-118.5597683	Los Angeles County
146288	Fee-for-Service	1891837852	1891837852	1	2	FISHBERG, GARY M OD	2/2/1997	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5225 CANYON CREST DR	STE 201	RIVERSIDE	CA	92507	6323	33	06065	33.95618617	-117.3293404	Riverside County
146290	Fee-for-Service	1386738177	1386738177	1	1	FAMILY HEALTHCARE NETWRK	4/15/2001	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	35800 HIGHWAY 190	None	SPRINGVILLE	CA	93265	9116	54	06107	36.13335918	-118.8145066	Tulare County
146301	Fee-for-Service	1194029413	1194029413	1	2	FIRST RESPONSE HOME CARE INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	459 W BROADWAY	SUITE 8	GLENDALE	CA	91204	1228	19	06037	34.14684351	-118.2638205	Los Angeles County
146321	Fee-for-Service	1346420445	1346420445	1	1	FORATI, ANAHITA LAC	12/8/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
146323	Fee-for-Service	1174507180	1174507180	1	1	FULLER, SCOTT C MD	6/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94603	04	Otology, Laryngology, Rhinology	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
146354	Fee-for-Service	1790314961	1790314961	1	1	FANONI, MICHELLE DO	8/22/2023	208M00000X	NA	Other	026	PHYSICIANS	21368	None	None	0	In state provider	None	11795 EDUCATION ST	STE 201	AUBURN	CA	95602	2469	31	06061	38.94433757	-121.098912	Placer County
146362	Fee-for-Service	1154433217	1154433217	1	1	FOSTER, LINDA L OD	5/21/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4921 EAGLE ROCK BLVD	None	LOS ANGELES	CA	90041	1906	19	06037	34.13566493	-118.2151948	Los Angeles County
146368	Fee-for-Service	1871529297	1871529297	1	3	FARROKH ALEMZADEH, MD., INC.	10/19/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	655 CAMINO DE LOS MARES	207	SAN CLEMENTE	CA	92673	2809	30	06059	33.4574489	-117.6489043	Orange County
146405	Fee-for-Service	1124447313	1124447313	1	1	FRAGOSO-NINO, ANNA O NP	5/16/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
146425	Fee-for-Service	1629130240	1629130240	1	1	FEATHER RIVER TRIBAL	9/1/2002	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH	2145 5TH AVE	None	OROVILLE	CA	95965	5870	04	06007	39.50368243	-121.5646958	Butte County
146449	Fee-for-Service	1326329350	1326329350	1	1	FLORES, SARA E CNM	2/8/2017	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	583 SUMMERFIELD RD	None	SANTA ROSA	CA	95405	5239	49	06097	38.45268	-122.672088	Sonoma County
146459	Fee-for-Service	1295105500	1295105500	1	1	FARIS, ALLISON N	6/5/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
146504	Fee-for-Service	1669559506	1669559506	1	1	FUNG, SPENCER T MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54635	10	Gastroenterology (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
146545	Fee-for-Service	1366000721	1366000721	1	1	FINNEGAN, LEIGH M MD	7/28/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178748	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
146572	Fee-for-Service	1336121888	1336121888	1	6	FOOTHILLS PSYCHOLOGICAL SERV	8/20/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ICES, INC.	9089 BASELINE RD	SUITE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
146579	Fee-for-Service	1386738177	1386738177	1	1	FAMILY HEALTHCARE NETWRK	4/15/2001	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	35800 HIGHWAY 190	None	SPRINGVILLE	CA	93265	9116	54	06107	36.13335918	-118.8145066	Tulare County
146581	Fee-for-Service	1164713061	1164713061	1	1	FARROW, JACKSON M MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141747	30	Radiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
146620	Fee-for-Service	1437136298	1437136298	1	1	FISHER, ANDREW M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RADIOLOGY IMAGING ASSOCI	501 E HAMPDEN	None	ENGLEWOOD	CO	80113	2702	00	None	39.6531952	-104.9810967	Arapahoe County
146625	Fee-for-Service	1528299989	1528299989	1	1	FOCUS MEDICAL IMAGING	1/26/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	A PROFESSIONAL MEDICAL	4640 ADMIRALTY WAY	STE 102	MARINA DEL REY	CA	90292	6629	19	06037	33.98120707	-118.4409729	Los Angeles County
146704	Fee-for-Service	1144676065	1144676065	1	1	FAN, HEI M LMFT	7/2/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	320 GARFEILD AVE	STE 202	ALHAMBRA	CA	91801	3887	19	06037	34.09184212	-118.1245127	Los Angeles County
146709	Fee-for-Service	1356491567	1356491567	1	1	FIELD, ALEXANDER L OD	11/23/2004	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	24400 JACKSON AVE	STE A	MURRIETA	CA	92562	1987	33	06065	33.57240222	-117.2050098	Riverside County
146715	Fee-for-Service	1750305868	1750305868	1	1	FLORES, CHRISTINA DPM	3/12/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
146725	Fee-for-Service	1912199779	1912199779	1	1	FARGIANO, ANTONIO A MD	10/27/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	174753	None	None	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
146726	Fee-for-Service	1780935940	1780935940	1	1	FLETCHER, EMILY E MD	7/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122247	40	Pediatrics	0	In state provider	None	769 MEDICAL CENTER CT	SUITE 300	CHULA VISTA	CA	91911	6600	37	06073	32.619186	-117.0200925	San Diego County
146786	Fee-for-Service	1891821633	1891821633	1	1	FUST, JOHN LLOYD MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	47866	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
146792	Fee-for-Service	1669559506	1669559506	1	1	FUNG, SPENCER T MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54635	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
146794	Fee-for-Service	1457490369	1457490369	1	1	FAMILY PLANNING ASSOC	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GRP INC	2030 COFFEE RD	STE A1	MODESTO	CA	95355	2498	50	06099	37.672569	-120.9757125	Stanislaus County
146859	Fee-for-Service	1336121888	1336121888	1	6	FOOTHILLS PSYCHOLOGICAL SERV	11/19/2024	103T00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	9089 BASELINE RD	SUITE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
146862	Fee-for-Service	1487941282	1487941282	1	1	FODOREANU, ANDREI MD	7/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122579	40	Pediatrics	0	In state provider	None	769 MEDICAL CENTER CT	SUITE 300	CHULA VISTA	CA	91911	6600	37	06073	32.619186	-117.0200925	San Diego County
146865	Fee-for-Service	1386738177	1386738177	1	1	FAMILY HEALTHCARE NETWRK	8/28/2001	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	35800 HIGHWAY 190	None	SPRINGVILLE	CA	93265	9116	54	06107	36.13335918	-118.8145066	Tulare County
146887	Fee-for-Service	1427098789	1427098789	1	1	FRANCISCO MERCADO JR	1/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	347 N KUAKINI ST	None	HONOLULU	HI	96817	2336	00	None	21.32247447	-157.8564644	Honolulu County
146911	Fee-for-Service	1255877577	1255877577	1	1	FORSYTHE, SHARON D LMFT	8/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11025 PIONEER TRAIL	110	TRUCKEE	CA	96161	0250	29	06057	39.33584965	-120.1819445	Nevada County
147006	Fee-for-Service	1063052207	1063052207	1	1	FERREIRA, LEAH LMFT	7/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1815 S WESTSIDE DR	UNIT 5023	ANAHEIM	CA	92805	8661	30	06059	33.80184302	-117.8948078	Orange County
147105	Fee-for-Service	1831659887	1831659887	1	1	FLORES, JEREMY A MD	5/8/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178229	36	Psychiatry	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
147148	Fee-for-Service	1336121888	1336121888	1	6	FOOTHILLS PSYCHOLOGICAL SERV	8/20/2024	103T00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ICES, INC.	9089 BASELINE RD	SUITE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
147248	Fee-for-Service	1306513064	1306513064	1	1	FALKENBERG, SAMUEL PT	5/24/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
147253	Fee-for-Service	1912029901	1912029901	1	1	FOUNTAIN VALLEY CARD MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CLINIC	11100 WARNER AVE	STE 268	FOUNTAIN VALLEY	CA	92708	7512	30	06059	33.716291	-117.9355051	Orange County
147262	Fee-for-Service	1538420104	1538420104	1	13	FIRST CHOICE PHYSICIAN PARTN	8/29/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	6955 EL CAMINO REAL	STE 101	ATASCADERO	CA	93422	4216	40	06079	35.48656009	-120.6652493	San Luis Obispo County
147275	Fee-for-Service	1639522725	1639522725	1	1	FINN, DAPHNA M MD	8/9/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	152291	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
147394	Fee-for-Service	1083824858	1083824858	1	1	FRANCIS, KIRENZA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2799 W GRAND BLVD	None	DETROIT	MI	48202	2608	00	None	42.36645079	-83.08385497	Wayne County
147424	Fee-for-Service	1407209430	1407209430	1	2	FRASOULI CARE HOME	3/20/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	27561 ALMENDRA DRIVE	None	MISSION VIEJO	CA	92691	1703	30	06059	33.63433881	-117.6495662	Orange County
147434	Fee-for-Service	1336121888	1336121888	1	6	FOOTHILLS PSYCHOLOGICAL SERV	8/20/2024	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	47	Miscellaneous	0	In state provider	ICES, INC.	9089 BASELINE RD	SUITE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
147488	Fee-for-Service	1073997201	1073997201	1	1	FAMILY HEALTHCARE NETWORK	9/17/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	263 S WEST STREET	None	TULARE	CA	93274	3411	54	06107	36.20460711	-119.3668926	Tulare County
147540	Fee-for-Service	1912029901	1912029901	1	1	FOUNTAIN VALLEY CARD MED	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	CLINIC	11100 WARNER AVE	STE 268	FOUNTAIN VALLEY	CA	92708	7512	30	06059	33.716291	-117.9355051	Orange County
147620	Fee-for-Service	1760057780	1760057780	1	1	FAMILY FIRST CONGREGATED	12/2/2021	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	LIVING FACILITY INC	329 YOSEMITE AVE	None	PERRIS	CA	92570	8674	33	06065	33.74356369	-117.2362126	Riverside County
147640	Fee-for-Service	1699062216	1699062216	1	1	FOK, SARA MD	5/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138159	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
147666	Fee-for-Service	1902913809	1902913809	1	2	FELMAN, IRA E MD	2/18/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	37852	78	Neoplastic Diseases/Oncology	0	In state provider	None	715 TANK FARM RD	STE C	SAN LUIS OBISPO	CA	93401	7068	40	06079	35.24853234	-120.642458	San Luis Obispo County
147723	Fee-for-Service	1124008537	1124008537	1	1	FEE, MARTIN J MD	5/1/1996	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	72509	41	Internal Medicine	0	In state provider	None	320 SUPERIOR AVE	STE 280	NEWPORT BEACH	CA	92663	6140	30	06059	33.62657138	-117.9330754	Orange County
147782	Fee-for-Service	1073997201	1073997201	1	1	FAMILY HEALTHCARE NETWORK	2/4/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	263 S WEST STREET	None	TULARE	CA	93274	3411	54	06107	36.20460711	-119.3668926	Tulare County
147890	Fee-for-Service	1871931584	1871931584	1	1	FUNG, MONICA MD	6/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142212	77	Infectious Disease	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
147954	Fee-for-Service	1902913809	1902913809	1	2	FELMAN, IRA E MD	2/18/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	37852	68	Hematology	0	In state provider	None	715 TANK FARM RD	STE C	SAN LUIS OBISPO	CA	93401	7068	40	06079	35.24853234	-120.642458	San Luis Obispo County
147975	Fee-for-Service	1982798831	1982798831	1	1	FAMILY PLANNING ASSOC	6/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP INC	8635 FIRESTONE BLVD	STE 100	DOWNEY	CA	90241	5242	19	06037	33.93691837	-118.1265474	Los Angeles County
148005	Fee-for-Service	1538420104	1538420104	1	10	FIRST CHOICE PHYSICIAN PARTN	12/22/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	1035 PEACH STREET	STE 301	SAN LUIS OBISPO	CA	93401	2700	40	06079	35.28478505	-120.6627228	San Luis Obispo County
148011	Fee-for-Service	1124008537	1124008537	1	1	FEE, MARTIN J MD	5/1/1996	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	72509	77	Infectious Disease	0	In state provider	None	320 SUPERIOR AVE	STE 280	NEWPORT BEACH	CA	92663	6140	30	06059	33.62657138	-117.9330754	Orange County
148066	Fee-for-Service	1073997201	1073997201	1	1	FAMILY HEALTHCARE NETWORK	1/5/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	263 S WEST STREET	None	TULARE	CA	93274	3411	54	06107	36.20460711	-119.3668926	Tulare County
148108	Fee-for-Service	1841374055	1841374055	1	1	FISCHL, PETER MD	12/31/1984	208600000X	NA	General Surgery	026	PHYSICIANS	33580	02	General Surgery	0	In state provider	None	12550 HESPERIA RD	None	VICTORVILLE	CA	92395	5873	36	06071	34.47928534	-117.2909553	San Bernardino County
148118	Fee-for-Service	1336311315	1336311315	1	1	FAROOQI, OMAR MD	9/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112480	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
148185	Fee-for-Service	1205169687	1205169687	1	1	FELICIANO, CARLOS I JR LCSW	5/19/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
148191	Fee-for-Service	1356873111	1356873111	1	1	FISHER, SARAH S LMFT	6/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2275 S. MAIN ST.	SUITE 201	CORONA	CA	92882	5303	33	06065	33.85511663	-117.5694892	Riverside County
148208	Fee-for-Service	1003975426	1003975426	1	1	FALKENBERG, KURT M	2/14/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
148235	Fee-for-Service	1699200105	1699200105	1	1	FAIZ, ABIDA DO	12/8/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15231	08	Family Practice	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
148292	Fee-for-Service	1669666889	1669666889	1	1	FABRIS, NICOLE A MD	9/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94252	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
148300	Fee-for-Service	1275952566	1275952566	1	1	FRANKLIN, AISHA D MD	4/27/2018	207R00000X	NA	Other	026	PHYSICIANS	143064	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
148306	Fee-for-Service	1881614030	1881614030	1	2	FARROW, CHARLES PHD	4/26/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	610 EUCLID AVE	200	NATIONAL CITY	CA	91950	2951	37	06073	32.68419388	-117.0829524	San Diego County
148321	Fee-for-Service	1750963666	1750963666	1	1	FOUR LIFE HOSPICE CARE INC	7/18/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10718 1/2 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91602	2313	19	06037	34.1522265	-118.3643685	Los Angeles County
148340	Fee-for-Service	1528684131	1528684131	1	1	FRASER, KEVIN J MD	10/31/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191678	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
148346	Fee-for-Service	1568542405	1568542405	1	1	FRANKEL, MATTHEW B MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65171	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
148350	Fee-for-Service	1073997201	1073997201	1	1	FAMILY HEALTHCARE NETWORK	9/17/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	263 S WEST STREET	None	TULARE	CA	93274	3411	54	06107	36.20460711	-119.3668926	Tulare County
148354	Fee-for-Service	1245201912	1245201912	1	1	FIELD, CHRISTIN A MD	4/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	77097	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11303 WASHINGTON BLVD	STE 100	LOS ANGELES	CA	90095	6003	19	06037	34.00408212	-118.4147433	Los Angeles County
148417	Fee-for-Service	1710172382	1710172382	1	1	FLORES, ROBERT O MD INC	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	40429	08	Family Practice	0	In state provider	None	11273 LAUREL CANYON BLVD	SUITE 1	SAN FERNANDO	CA	91340	4300	19	06037	34.27498293	-118.4494282	Los Angeles County
148424	Fee-for-Service	1841505518	1841505518	1	1	FERMOILE, MARIA J PT	10/30/2022	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1504 CHAMPLAIN DR	None	FRESNO	CA	93720	5624	10	06019	36.86845445	-119.7572681	Fresno County
148451	Fee-for-Service	1437593746	1437593746	1	1	FERNANDEZ-POL, CLARISSA W MD	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131883	40	Pediatrics	0	In state provider	None	555 CASTRO ST	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
148512	Fee-for-Service	1134680465	1134680465	1	1	FARAJI, MEHDI MD	9/12/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
148528	Fee-for-Service	1326097056	1326097056	1	1	FACULTY PHYSICIANS AND	1/1/2000	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	SURGEONS OF LLUSM	11370 ANDERSON ST	# 1500	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
148531	Fee-for-Service	1144270794	1144270794	1	1	FU, KARIN L MD	4/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62299	None	None	0	In state provider	None	10833 LECONTE AVE	None	LOS ANGELES	CA	90024	0000	19	06037	34.0637703	-118.4428198	Los Angeles County
148541	Fee-for-Service	1598044752	1598044752	1	1	FINAU, JASON LCSW	9/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
148580	Fee-for-Service	1114005782	1114005782	1	1	FENG, ANGELA S MD	10/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90908	05	Anesthesiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
148607	Fee-for-Service	1750963666	1750963666	1	1	FOUR LIFE HOSPICE CARE INC	7/18/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10718 1/2 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91602	2313	19	06037	34.1522265	-118.3643685	Los Angeles County
148640	Fee-for-Service	1073997201	1073997201	1	1	FAMILY HEALTHCARE NETWORK	9/17/2015	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	263 S WEST STREET	None	TULARE	CA	93274	3411	54	06107	36.20460711	-119.3668926	Tulare County
148750	Fee-for-Service	1073073847	1073073847	1	1	FOLEY, LINDSAY MD	10/7/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
148817	Fee-for-Service	1881870285	1881870285	1	1	FRIEDMAN, JASON T CPO	10/24/2005	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	15644 POMERADO RD	STE 103	POWAY	CA	92064	2428	37	06073	32.99717879	-117.0579379	San Diego County
148868	Fee-for-Service	1538420104	1538420104	1	15	FIRST CHOICE PHYSICIAN PARTN	9/2/2020	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	1154 E GRAND AVE	None	ARROYO GRANDE	CA	93420	2583	40	06079	35.12006347	-120.598114	San Luis Obispo County
148910	Fee-for-Service	1891756276	1891756276	1	1	FULLERTON DIALYSIS CTR	7/29/2005	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	CROSSROADS DIALYSIS	3214 YORBA LINDA BLVD	None	FULLERTON	CA	92831	1707	30	06059	33.8885987	-117.8689829	Orange County
148911	Fee-for-Service	1093986507	1093986507	1	1	FLAGGS, PAMELA J OT	7/25/2003	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8050 SOQUEL DR	STE A	APTOS	CA	95003	3981	44	06087	36.97694316	-121.900446	Santa Cruz County
148913	Fee-for-Service	1487749495	1487749495	1	1	FAMILY PLANNING ASSOCIATES	1/1/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	855 E HOSPITALITY LANE	None	SAN BERNARDINO	CA	92408	3596	36	06071	34.06878193	-117.2675193	San Bernardino County
148985	Fee-for-Service	1821160672	1821160672	1	1	FIELD, DAVID R MD	5/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	37545	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	#1490M	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
148995	Fee-for-Service	1376626044	1376626044	1	1	FAREY, KRISTA C MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	59698	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
148996	Fee-for-Service	1417154436	1417154436	1	1	FRAGOSO, RUBEN C MD	8/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109259	30	Radiology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
149039	Fee-for-Service	1255525937	1255525937	1	1	FORCE, SANDRA K MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66813	08	Family Practice	0	In state provider	None	7777 MILLIKEN AVE	STE 350	RANCHO CUCAMONGA	CA	91730	6782	36	06071	34.10843256	-117.5570865	San Bernardino County
149043	Fee-for-Service	1356504716	1356504716	1	1	FAN, GUINEA S MD	12/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106539	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
149126	Fee-for-Service	1255991873	1255991873	1	1	FOSTER, MADELINE LMFT	9/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	307 S. B ST.	None	SAN MATEO	CA	94401	4053	41	06081	37.56539871	-122.3222584	San Mateo County
149150	Fee-for-Service	1720412943	1720412943	1	1	FISHER, JASON MD	11/4/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	174633	None	None	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
149192	Fee-for-Service	1821459553	1821459553	1	1	FORMUZAL, TATYANA N PT	10/14/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
149202	Fee-for-Service	1073672689	1073672689	1	1	FELDER, ROBERT R MD	1/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54121	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
149232	Fee-for-Service	1659344927	1659344927	1	1	FAIR, RICHARD H MD	11/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	30180	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1062 S K ST	None	TULARE	CA	93274	6421	54	06107	36.19548226	-119.3433058	Tulare County
149310	Fee-for-Service	1881697688	1881697688	1	1	FULLER, DANA A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1780 N PLANO RD	None	RICHARDSON	TX	75081	1914	00	None	32.97183294	-96.6996712	Dallas County
149315	Fee-for-Service	1881746733	1881746733	1	1	FAMILY PSYCHOLOGICAL SERVICE	4/8/2020	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	S INC	30495 CANWOOD	101	AGOURA HILLS	CA	91301	4331	19	06037	34.14698794	-118.7853623	Los Angeles County
149334	Fee-for-Service	1386959666	1386959666	1	1	FERNANDO, ROSHINIE M MD	1/2/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	122145	36	Psychiatry	0	In state provider	None	1860 HAMNER AVE	None	NORCO	CA	92860	2945	33	06065	33.9090675	-117.5612393	Riverside County
149341	Fee-for-Service	1417647058	1417647058	1	1	FAMILY COUNSELING PARTNERS	10/6/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	594 N GLASSELL ST	None	ORANGE	CA	92867	6748	30	06059	33.796782	-117.853129	Orange County
149355	Fee-for-Service	1538420104	1538420104	1	17	FIRST CHOICE PHYSICIAN PARTN	10/24/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SANTA MARIA	1510 E MAIN ST	None	SANTA MARIA	CA	93454	4825	42	06083	34.95282793	-120.4100798	Santa Barbara County
149387	Fee-for-Service	1669826970	1669826970	1	1	FEDUSKA, COLLIN MD	7/20/2020	207L00000X	NA	Other	026	PHYSICIANS	168581	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
149454	Fee-for-Service	1316560428	1316560428	1	1	FLANNERY, RYAN LPCC	8/13/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
149482	Fee-for-Service	1497120182	1497120182	1	1	FRESENIUS MEDICAL CARE	12/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	LONG BEACH LLC	1525 LONG BEACH BLVD	None	LONG BEACH	CA	90802	4518	19	06037	33.78597314	-118.189513	Los Angeles County
149487	Fee-for-Service	1326307810	1326307810	1	1	FAIR, MARIYA I CRNA	8/13/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9449 IMPERIAL HWY	STE ABCD	DOWNEY	CA	90242	2814	19	06037	33.91714048	-118.1262915	Los Angeles County
149512	Fee-for-Service	1073672689	1073672689	1	1	FELDER, ROBERT R MD	1/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54121	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
149515	Fee-for-Service	1336549401	1336549401	1	1	FLANAGAN, YVETTE V LPCC	4/24/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
149570	Fee-for-Service	1689679961	1689679961	1	1	FINKEL, NAT OD	11/26/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
149599	Fee-for-Service	1881746733	1881746733	1	1	FAMILY PSYCHOLOGICAL SERVICE	4/8/2020	103T00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	S INC	30495 CANWOOD	101	AGOURA HILLS	CA	91301	4331	19	06037	34.14698794	-118.7853623	Los Angeles County
149628	Fee-for-Service	1417647058	1417647058	1	1	FAMILY COUNSELING PARTNERS	10/6/2023	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	594 N GLASSELL ST	None	ORANGE	CA	92867	6748	30	06059	33.796782	-117.853129	Orange County
149658	Fee-for-Service	1487613147	1487613147	1	1	FMM HOME CARE CORP	7/20/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	11481 HEACOCK STREET	STE 130	MORENO VALLEY	CA	92557	7906	33	06065	33.954858	-117.243978	Riverside County
149676	Fee-for-Service	1770567745	1770567745	1	1	FLYNN, PATRICK R MD	10/28/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	80566	08	Family Practice	0	In state provider	None	3900 LAKEVILLE HIGHWAY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
149754	Fee-for-Service	1215017363	1215017363	1	1	FORTHAL, DONALD MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44065	77	Infectious Disease	0	In state provider	None	101 CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
149808	Fee-for-Service	1144420357	1144420357	1	1	FREDRICKSON, SCOTT H MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106215	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
149817	Fee-for-Service	1336256965	1336256965	1	1	FELBER, ROD J DO	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	5026	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
149891	Fee-for-Service	1881746733	1881746733	1	1	FAMILY PSYCHOLOGICAL SERVICE	4/8/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	S INC	30495 CANWOOD	101	AGOURA HILLS	CA	91301	4331	19	06037	34.14698794	-118.7853623	Los Angeles County
149917	Fee-for-Service	1720142854	1720142854	1	1	FEUSNER, JAMES H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40752	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
149927	Fee-for-Service	1487767893	1487767893	1	1	FRANK, JERRI L LMFT	10/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	141 DUESENBERG DR	STE 2	WESTLAKE VILLAGE	CA	91362	3467	56	06111	34.17061344	-118.8324323	Ventura County
149965	Fee-for-Service	1205239258	1205239258	1	1	FLACH, THOMAS C JR	10/29/2014	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	251 N STATE HWY	173	LAKE ARROWHEAD	CA	92352	0716	36	06071	0	0	None
149995	Fee-for-Service	1639243017	1639243017	1	1	FERRERO, MAURO LMFT	7/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7831 STEWART AVE	None	LOS ANGELES	CA	90045	1055	19	06037	33.96882049	-118.4111449	Los Angeles County
150094	Fee-for-Service	1619068574	1619068574	1	1	FEDOR, GEORGE P MD APC	5/1/2003	207L00000X	NA	Other	026	PHYSICIANS	52838	05	Anesthesiology	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
150146	Fee-for-Service	1689066029	1689066029	1	2	FAMILY FIRST MEDICAL CARE	6/22/2017	261QM1300X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1317 OAKDALE ROAD	SUITE 100	MODESTO	CA	95355	3362	50	06099	37.662489	-120.957588	Stanislaus County
150171	Fee-for-Service	1306897962	1306897962	1	1	FORT MOJAVE INDIAN TRIBE	8/23/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	1	Border provider	None	1607 PLANTATION RD	None	MOHAVE VALLEY	AZ	86440	8420	00	None	34.851987	-114.5952675	Mohave County
150176	Fee-for-Service	1881746733	1881746733	1	1	FAMILY PSYCHOLOGICAL SERVICE	7/21/2021	103T00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	S INC	30495 CANWOOD	101	AGOURA HILLS	CA	91301	4331	19	06037	34.14698794	-118.7853623	Los Angeles County
150187	Fee-for-Service	1528735198	1528735198	1	1	FANG, NANCY CNP	10/4/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
150198	Fee-for-Service	1083773642	1083773642	1	1	FIEDLER CHIROPRACTIC INC	10/1/2000	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	9667 HWY 29 STE 101	PO BOX 298	None	LOWER LAKE	CA	95457	0298	17	06033	38.90951776	-122.6779955	Lake County
150206	Fee-for-Service	1720142854	1720142854	1	1	FEUSNER, JAMES H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40752	78	Neoplastic Diseases/Oncology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
150229	Fee-for-Service	1982042040	1982042040	1	1	FILLAK, LESLI LMFT	9/21/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
150269	Fee-for-Service	1396875258	1396875258	1	1	FABITO, MICHELLE V	2/29/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
150278	Fee-for-Service	1477731792	1477731792	1	1	FOREVER CARING HOME HEALTH	3/21/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	120 W EL SEGUNDO BLVD	SUITE B	LOS ANGELES	CA	90061	1628	19	06037	33.91638952	-118.2746565	Los Angeles County
150280	Fee-for-Service	1598813545	1598813545	1	1	FAGHIEH, ARASH MD	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76263	41	Internal Medicine	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
150311	Fee-for-Service	1477958304	1477958304	1	1	FOCUS EDUCATIONAL	1/2/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PROGRAMMING SPECIALISTS	1427 N LA BREA AVE	None	LOS ANGELES	CA	90028	7505	19	06037	34.096968	-118.3441575	Los Angeles County
150365	Fee-for-Service	1285728055	1285728055	1	1	FRANK J SLOAN, MD	7/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
150432	Fee-for-Service	1689066029	1689066029	1	2	FAMILY FIRST MEDICAL CARE	1/9/2020	261QM1300X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	1317 OAKDALE ROAD	SUITE 100	MODESTO	CA	95355	3362	50	06099	37.662489	-120.957588	Stanislaus County
150462	Fee-for-Service	1558303271	1558303271	1	1	FAUSTINA, GILBERT E MD	1/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	26359	01	General Practice	0	In state provider	None	1543 E PALMDALE BLVD	SUITE F	PALMDALE	CA	93550	2000	19	06037	34.57966352	-118.101582	Los Angeles County
150463	Fee-for-Service	1801235080	1801235080	1	1	FLEDDERMANN, ADAM MD	1/16/2025	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
150464	Fee-for-Service	1881746733	1881746733	1	1	FAMILY PSYCHOLOGICAL SERVICE	9/28/2020	103T00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	S INC	30495 CANWOOD	101	AGOURA HILLS	CA	91301	4331	19	06037	34.14698794	-118.7853623	Los Angeles County
150470	Fee-for-Service	1306897962	1306897962	1	1	FORT MOJAVE INDIAN TRIBE	8/23/2010	No Taxonomy Provided	NA	None	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	1	Border provider	None	1607 PLANTATION RD	None	MOHAVE VALLEY	AZ	86440	8420	00	None	34.851987	-114.5952675	Mohave County
150492	Fee-for-Service	1720142854	1720142854	1	1	FEUSNER, JAMES H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40752	68	Hematology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
150576	Fee-for-Service	1134164189	1134164189	1	1	FIRMAN, JAMES W MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	32024	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9601 S SEPULVEDA BLVD	None	LOS ANGELES	CA	90045	5203	19	06037	33.948297	-118.3963665	Los Angeles County
150615	Fee-for-Service	1528225687	1528225687	1	1	FOX, CHRISTOPHER C MD	12/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106040	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
150647	Fee-for-Service	1346742384	1346742384	1	1	FLOYD, ISABELLE CNM	10/7/2022	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	905 MAPLE ST	None	REDWOOD CITY	CA	94063	0000	41	06081	37.48767797	-122.223049	San Mateo County
150723	Fee-for-Service	1689066029	1689066029	1	2	FAMILY FIRST MEDICAL CARE	6/22/2017	261QM1300X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1317 OAKDALE ROAD	SUITE 100	MODESTO	CA	95355	3362	50	06099	37.662489	-120.957588	Stanislaus County
150752	Fee-for-Service	1801235080	1801235080	1	1	FLEDDERMANN, ADAM MD	1/16/2025	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
150784	Fee-for-Service	1306209010	1306209010	1	1	FUNGHI, CRISTINA MD	3/8/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	160783	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
150791	Fee-for-Service	1952728826	1952728826	1	1	FUENTES, CYNTHIA V MD	12/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145351	01	General Practice	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
150799	Fee-for-Service	1013195213	1013195213	1	1	FRESENIUS MEDICAL CARE	2/9/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	EUCALYPTUS LLC	610 N EUCALYPTUS AVE	None	INGLEWOOD	CA	90302	2202	19	06037	33.97026685	-118.3587964	Los Angeles County
150877	Fee-for-Service	1750437505	1750437505	1	1	FEINBERG, ALEXANDRA Y	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	SPEAK WITH STRENGTH A S	3033 EL CAMINO AVE	None	SACRAMENTO	CA	95821	6014	34	06067	38.610828	-121.3926255	Sacramento County
150974	Fee-for-Service	1538420104	1538420104	1	5	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	901 OAK PARK BLVD	SUITE 101	PISMO BEACH	CA	93449	3408	40	06079	35.13460775	-120.6050814	San Luis Obispo County
150982	Fee-for-Service	1629522438	1629522438	1	1	FLORES, MICHELLE C CNP	7/8/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
150986	Fee-for-Service	1033577614	1033577614	1	1	FRESENIUS MEDICAL CARE	5/1/2016	251G00000X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	WOODLAND CALIFORNIA LLC	35 W MAIN STREET	None	WOODLAND	CA	95695	3015	57	06113	38.67750552	-121.7850905	Yolo County
151003	Fee-for-Service	1538420104	1538420104	1	12	FIRST CHOICE PHYSICIAN PARTN	9/8/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ARTNERS	35 CASA ST	STE 220	SAN LUIS OBISPO	CA	93405	1890	40	06079	35.29359615	-120.6654304	San Luis Obispo County
151014	Fee-for-Service	1689066029	1689066029	1	2	FAMILY FIRST MEDICAL CARE	3/3/2021	261QM1300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1317 OAKDALE ROAD	SUITE 100	MODESTO	CA	95355	3362	50	06099	37.662489	-120.957588	Stanislaus County
151020	Fee-for-Service	1124722301	1124722301	1	1	FREEDOM CHOICE TRANSPORTATIO	8/25/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N	4425 E CAMINO PAROCELA	None	PALM SPRINGS	CA	92264	1443	33	06065	33.81398248	-116.4980025	Riverside County
151049	Fee-for-Service	1225597321	1225597321	1	1	FAHY, JOHN F MD	7/8/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
151060	Fee-for-Service	1922199694	1922199694	1	2	FRIENDS & FAMILY MEDICAL CLI	5/16/2023	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	501 E HARDY ST	205	INGLEWOOD	CA	90301	4021	19	06037	33.9491005	-118.348857	Los Angeles County
151086	Fee-for-Service	1467575449	1467575449	1	1	FOY, MICHELLE	6/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
151094	Fee-for-Service	1649341405	1649341405	1	1	FATAYERJI,NABIL I MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63224	40	Pediatrics	0	In state provider	None	3030 CHILDRENS WAY	STE 216	SAN DIEGO	CA	92123	4227	37	06073	32.798889	-117.150826	San Diego County
151160	Fee-for-Service	1891131298	1891131298	1	1	FIRST PEDIATRICS MEDICAL	10/14/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	GROUP INC	6255 N FRESNO STREET	SUITE 106	FRESNO	CA	93710	5271	10	06019	36.82763799	-119.7814169	Fresno County
151181	Fee-for-Service	1427479278	1427479278	1	1	FAIRLEY, SHERRELL LMFT	12/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
151196	Fee-for-Service	1437387248	1437387248	1	1	FRENCH, VALERIE A MD	6/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124836	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 POTRERO AVE	RM 6D	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
151212	Fee-for-Service	1578095493	1578095493	1	1	FARRIMOND, FRANCES MD	10/19/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	157193	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
151228	Fee-for-Service	1629809421	1629809421	1	1	FUTURE VISION OPTOMETRY CARE	9/18/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	25834 THE OLD RD	None	STEVENSON RANCH	CA	91381	1710	19	06037	34.39045108	-118.5733191	Los Angeles County
151234	Fee-for-Service	1174652622	1174652622	1	1	FOREST, CATHERINE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75171	08	Family Practice	0	In state provider	None	816 WESTERN DR	None	SANTA CRUZ	CA	95060	6823	44	06087	36.97180331	-122.0584375	Santa Cruz County
151238	Fee-for-Service	1295291193	1295291193	1	1	FAKHIMI, AMITA F PSYD	6/4/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1101 N PACIFIC AVE	SUITE 204	GLENDALE	CA	91202	3250	19	06037	34.16078708	-118.2644824	Los Angeles County
151240	Fee-for-Service	1417927161	1417927161	1	1	FRONK, STEVEN J OD	11/16/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	817 COURT ST	STE 10	JACKSON	CA	95642	2156	03	06005	38.35288237	-120.7662416	Amador County
151249	Fee-for-Service	1164996351	1164996351	1	1	FLORES, NICHOLAS J CRNA	1/1/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	869 CHERRY STREET	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
151266	Fee-for-Service	1538420104	1538420104	1	5	FIRST CHOICE PHYSICIAN PARTN	10/10/2017	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PARTNERS	901 OAK PARK BLVD	SUITE 101	PISMO BEACH	CA	93449	3408	40	06079	35.13460775	-120.6050814	San Luis Obispo County
151289	Fee-for-Service	1538420104	1538420104	1	12	FIRST CHOICE PHYSICIAN PARTN	9/8/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	ARTNERS	35 CASA ST	STE 220	SAN LUIS OBISPO	CA	93405	1890	40	06079	35.29359615	-120.6654304	San Luis Obispo County
151298	Fee-for-Service	1689066029	1689066029	1	2	FAMILY FIRST MEDICAL CARE	6/22/2017	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1317 OAKDALE ROAD	SUITE 100	MODESTO	CA	95355	3362	50	06099	37.662489	-120.957588	Stanislaus County
151382	Fee-for-Service	1649341405	1649341405	1	1	FATAYERJI,NABIL I MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63224	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3030 CHILDRENS WAY	STE 216	SAN DIEGO	CA	92123	4227	37	06073	32.798889	-117.150826	San Diego County
151441	Fee-for-Service	1164072799	1164072799	1	1	FARRUGIA, PATRICIA LPCC	10/2/2024	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	19	06037	34.15682212	-118.4871886	Los Angeles County
151490	Fee-for-Service	1205984226	1205984226	1	1	FERNANDEZ JR, JOSE L MD	12/31/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	92853	08	Family Practice	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
151509	Fee-for-Service	1033303268	1033303268	1	1	FERNANDEZ-MARTORELL,	11/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53455	40	Pediatrics	0	In state provider	PATRICIO MD	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
151582	Fee-for-Service	1184256869	1184256869	1	1	FORRISTEL, TERRA M LCSW	8/23/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ERVICES	1430 EAST AVE	4A	CHICO	CA	95926	1629	04	06007	39.76116577	-121.8188568	Butte County
151598	Fee-for-Service	1346370590	1346370590	1	1	FREIHEIT, DAVID MD	10/1/1995	207P00000X	NA	Other	026	PHYSICIANS	69856	66	Emergency Medicine (Urgent Care)	0	In state provider	None	170 ALAMEDA	# DE	REDWOOD CITY	CA	94062	2751	41	06081	37.48095011	-122.2532536	San Mateo County
151662	Fee-for-Service	1588820765	1588820765	1	1	FORAN, JESSICA L NP	11/8/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
151728	Fee-for-Service	1922216175	1922216175	1	1	FLEISCHMAN, ANGELA G MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125078	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
151738	Fee-for-Service	1841261054	1841261054	1	1	FONG, JOHN SIU WON	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	49494	36	Psychiatry	0	In state provider	None	1130 MONACO CT	None	STOCKTON	CA	95207	6704	39	06077	37.98847129	-121.3197954	San Joaquin County
151744	Fee-for-Service	1871793026	1871793026	1	1	FISHER, PAUL W DC	9/25/2007	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	112 EL VISTA AVE	None	MODESTO	CA	95354	3006	50	06099	37.638765	-120.957182	Stanislaus County
151771	Fee-for-Service	1891734828	1891734828	1	1	FIROOZI, BABAK MD	7/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	54247	41	Internal Medicine	0	In state provider	None	1236 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	2607	30	06059	33.8508897	-117.9761562	Orange County
151796	Fee-for-Service	1033303268	1033303268	1	1	FERNANDEZ-MARTORELL,	11/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53455	35	Pediatric Cardiology (M.D. only)	0	In state provider	PATRICIO MD	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
151812	Fee-for-Service	1184632101	1184632101	1	1	FRIEDRICHSDORF, STEFAN J MD	5/27/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
151821	Fee-for-Service	1346317195	1346317195	1	1	FAROL, LEONARDO MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88785	68	Hematology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
151954	Fee-for-Service	1679809826	1679809826	1	1	FLEMING, SARAH E MD	3/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	89838	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
151956	Fee-for-Service	1174364202	1174364202	1	1	FECSKE, PAIGE LMFT	7/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2677 N MAIN ST	STE 110	SANTA ANA	CA	92705	6663	30	06059	33.77224313	-117.8672259	Orange County
151971	Fee-for-Service	1942665138	1942665138	1	1	FROME, DAVID MD	9/25/2023	207L00000X	NA	Other	026	PHYSICIANS	184920	None	None	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
152003	Fee-for-Service	1801096300	1801096300	1	1	FERRONI, ANDREA C LM	10/1/2016	No Taxonomy Provided	NA	None	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	171 N WASHINGTON ST	STE E	SONORA	CA	95370	5651	55	06109	37.98764782	-120.3845579	Tuolumne County
152014	Fee-for-Service	1922216175	1922216175	1	1	FLEISCHMAN, ANGELA G MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125078	78	Neoplastic Diseases/Oncology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
152082	Fee-for-Service	1619973393	1619973393	2	1	FALDU, SANJIV G MD	3/20/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	166929	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2526 SISTER MARY COLUMBA	1ST FLOOR	RED BLUFF	CA	96080	4327	52	06103	40.14934389	-122.2195713	Tehama County
152142	Fee-for-Service	1669016499	1669016499	1	1	FACULTY PHYSICIANS AND SURGE	2/4/2021	207XS0106X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	ONS OF LLUSM	900 E WASHINGTON ST	STE 200	COLTON	CA	92324	4192	36	06071	34.04820662	-117.3128102	San Bernardino County
152244	Fee-for-Service	1679809826	1679809826	1	1	FLEMING, SARAH E MD	3/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	89838	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
152277	Fee-for-Service	1295875680	1295875680	1	1	FILBECK, KENNETH J MD	8/1/2018	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	156828	66	Emergency Medicine (Urgent Care)	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
152302	Fee-for-Service	1922216175	1922216175	1	1	FLEISCHMAN, ANGELA G MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125078	68	Hematology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
152307	Fee-for-Service	1316192040	1316192040	1	1	FRESENIUS MEDICAL CARE	12/1/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIABLO NEPHROLOGY CLINIC	508 CONTRA COSTA BLVD	STE D	PLEASANT HILL	CA	94523	1285	07	06013	37.98037164	-122.0670605	Contra Costa County
152392	Fee-for-Service	1255304242	1255304242	1	1	FALCHETTI, DANIEL A PT	6/20/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2492 WALNUT AVE STE 140	None	TUSTIN	CA	92780	6953	30	06059	33.71776535	-117.808989	Orange County
152411	Fee-for-Service	1538420104	1538420104	1	16	FIRST CHOICE PHYSICIAN PARTN	12/3/2020	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	6955 EL CAMINO REAL	STE 200	ATASCADERO	CA	93422	4216	40	06079	35.48656009	-120.6652493	San Luis Obispo County
152424	Fee-for-Service	1033174180	1033174180	1	1	FELTON, PATRICIA KAY MD	8/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87447	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7050 N RECREATION AVE	STE 102	FRESNO	CA	93720	8001	10	06019	36.83835219	-119.7404373	Fresno County
152432	Fee-for-Service	1669016499	1669016499	1	1	FACULTY PHYSICIANS AND SURGE	2/25/2020	207XS0106X	NA	Orthopedic Surgery	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	ONS OF LLUSM	900 E WASHINGTON ST	STE 200	COLTON	CA	92324	4192	36	06071	34.04820662	-117.3128102	San Bernardino County
152456	Fee-for-Service	1154580017	1154580017	1	1	FISCHER, TREVAN D MD	6/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135300	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
152500	Fee-for-Service	1538485099	1538485099	1	1	FEBLES, TAYNET T MD INC	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109536	41	Internal Medicine	0	In state provider	None	916 I STREET	None	MERCED	CA	95340	8039	24	06047	37.30254728	-120.4772496	Merced County
152568	Fee-for-Service	1528262177	1528262177	1	1	FOREMAN, RESA LCSW	6/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
152586	Fee-for-Service	1982631016	1982631016	1	1	FROST, MICHAEL MD	10/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72558	68	Hematology	0	In state provider	None	3701 S HIGUERA ST	STE 200	SAN LUIS OBISPO	CA	93401	7462	40	06079	35.2507845	-120.6712168	San Luis Obispo County
152617	Fee-for-Service	1841525862	1841525862	1	1	FAMILY HEALTH MEDICAL CENTER	12/2/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1045 5TH STREET	None	LOS BANOS	CA	93635	4204	24	06047	37.05986807	-120.8505485	Merced County
152771	Fee-for-Service	1427111269	1427111269	1	1	FARSON, MATTHEW C MD	9/30/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	84074	08	Family Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
152825	Fee-for-Service	1376011528	1376011528	1	1	FOX, CHELSEA PT	5/4/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	137 S LAS POSAS RD	STE 254	SAN MARCOS	CA	92078	2475	37	06073	33.14138594	-117.1924065	San Diego County
152827	Fee-for-Service	1891773917	1891773917	1	1	FREUDENBERG MEDICAL LLC	3/29/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1110 MARK AVENUE	None	CARPINTERIA	CA	93013	9301	42	06083	34.38685156	-119.4862299	Santa Barbara County
152847	Fee-for-Service	1558717520	1558717520	1	1	FABARA, SABRINA DO	5/17/2021	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
152865	Fee-for-Service	1942285655	1942285655	1	1	FRANK, KENNETH A MD	5/5/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	45739	40	Pediatrics	0	In state provider	None	251 TURNPIKE DR	None	FOLSOM	CA	95630	0000	34	06067	38.654946	-121.170537	Sacramento County
152878	Fee-for-Service	1982631016	1982631016	1	1	FROST, MICHAEL MD	10/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72558	22	Pathology (M.D. only)	0	In state provider	None	3701 S HIGUERA ST	STE 200	SAN LUIS OBISPO	CA	93401	7462	40	06079	35.2507845	-120.6712168	San Luis Obispo County
152880	Fee-for-Service	1477648079	1477648079	1	1	FEROUZ, FAZEELA MD INC	3/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85633	05	Anesthesiology	0	In state provider	None	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	30	06059	33.746805	-117.834147	Orange County
152906	Fee-for-Service	1841525862	1841525862	1	1	FAMILY HEALTH MEDICAL CENTER	12/2/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1045 5TH STREET	None	LOS BANOS	CA	93635	4204	24	06047	37.05986807	-120.8505485	Merced County
152916	Fee-for-Service	1609309764	1609309764	1	1	FONG, CALVIN C MD	5/20/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	160624	01	General Practice	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
152971	Fee-for-Service	1639640956	1639640956	1	1	FLORES, JEFFREY PT	5/3/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
153000	Fee-for-Service	1568581429	1568581429	1	1	FULKERSON, ERIC W MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103677	20	Orthopedic Surgery	0	In state provider	None	1601 YGNACIO VELLEY ROAD	None	WALNUT CREEK	CA	94598	3194	07	06013	37.9141514	-122.0422089	Contra Costa County
153005	Fee-for-Service	1205210051	1205210051	1	1	FLEMING, KELLE LCSW	10/30/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
153008	Fee-for-Service	1851365803	1851365803	1	1	FLYNN, ROBERT P MD	11/30/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	65380	30	Radiology	0	In state provider	None	340 4TH AVE	STE 15	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
153105	Fee-for-Service	1841373321	1841373321	1	1	FREED, ROBERT P MD	5/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	11141	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
153138	Fee-for-Service	1295758431	1295758431	1	1	FRIEDBERG, BRUCE H MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70209	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
153163	Fee-for-Service	1265664940	1265664940	1	1	FERJANI-HICHRI, NARJES MD	12/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133421	01	General Practice	0	In state provider	None	107 N MCKINLEY ST	None	CORONA	CA	92879	6561	33	06065	33.88230027	-117.5145319	Riverside County
153192	Fee-for-Service	1841525862	1841525862	1	1	FAMILY HEALTH MEDICAL CENTER	7/29/2011	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1045 5TH STREET	None	LOS BANOS	CA	93635	4204	24	06047	37.05986807	-120.8505485	Merced County
153195	Fee-for-Service	1609309764	1609309764	1	1	FONG, CALVIN C MD	5/20/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	160624	08	Family Practice	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
153215	Fee-for-Service	1366768418	1366768418	1	1	FORESTER, NICOLE LPCC	8/9/2023	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	220 SANSOME	400	SAN FRANCISCO	CA	94104	2321	38	06075	37.79250132	-122.4009823	San Francisco County
153227	Fee-for-Service	1952764680	1952764680	1	1	FOYABO, JUDITH M CNP	3/30/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1803 S HARBOR BLVD	None	ANAHEIM	CA	92802	3509	30	06059	33.80296924	-117.9154254	Orange County
153268	Fee-for-Service	1992059893	1992059893	1	1	FRANCISCO, CARLA M MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	96872	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
153281	Fee-for-Service	1750645024	1750645024	1	1	FERNANDO, GERARD I MD	10/5/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	145394	None	None	0	In state provider	None	8329 BRIMHALL RD	804	BAKERSFIELD	CA	93312	2243	15	06029	35.366706	-119.0959425	Kern County
153297	Fee-for-Service	1821417726	1821417726	1	1	FEINSTEIN, IGOR MD	5/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137728	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
153352	Fee-for-Service	1861830366	1861830366	1	1	FORAN, IAN M MD	9/22/2020	207XX0004X	NA	Orthopedic Surgery	026	PHYSICIANS	131875	20	Orthopedic Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
153361	Fee-for-Service	1033655345	1033655345	1	1	FRYER, JONATHAN D LCSW	1/21/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
153370	Fee-for-Service	1407837164	1407837164	1	1	FUNG, LAWRENCE HM MD	7/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89433	13	Neurology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
153394	Fee-for-Service	1841373321	1841373321	1	1	FREED, ROBERT P MD	5/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	11141	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
153482	Fee-for-Service	1891837852	1891837852	1	1	FISHBERG, GARY M OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	NORWALK VISION CENTER	12413 NORWALK BLVD	None	NORWALK	CA	90650	2040	19	06037	33.91842154	-118.072751	Los Angeles County
153491	Fee-for-Service	1407059181	1407059181	1	1	FERNANDEZ-MIRANDA, JUAN C MD	6/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
153510	Fee-for-Service	1053381228	1053381228	1	1	FALCON, MICHELLE L MD	3/31/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49446	41	Internal Medicine	0	In state provider	None	3275 SKYPARK DR	None	TORRANCE	CA	90505	5027	19	06037	33.80825394	-118.343391	Los Angeles County
153512	Fee-for-Service	1366507352	1366507352	1	1	FUJIKAWA, MARK A OD	6/7/1991	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2414 SHATTUCK AVE	None	BERKELEY	CA	94704	2023	01	06001	37.86536739	-122.2677305	Alameda County
153576	Fee-for-Service	1942371984	1942371984	1	1	FAYSAL, MOHAMMAD H MD	12/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	37652	34	Urology and Urological Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
153636	Fee-for-Service	1205051687	1205051687	1	1	FOLIART, DONNA E MD	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	39816	01	General Practice	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
153681	Fee-for-Service	1093764532	1093764532	1	1	FANUCCHI, MARGARET A MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74546	05	Anesthesiology	0	In state provider	None	501 PETALUMA AVE	None	SEBASTOPOL	CA	95472	4215	49	06097	38.39674221	-122.8201502	Sonoma County
153690	Fee-for-Service	1366671083	1366671083	1	1	FERRELL, LARNELL M MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109456	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2636	19	06037	33.93112671	-118.2035532	Los Angeles County
153767	Fee-for-Service	1952835498	1952835498	1	1	FIGARSKY, IAN MD	12/3/2019	390200000X	NA	Other	026	PHYSICIANS	166009	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
153779	Fee-for-Service	1982747671	1982747671	1	4	FAMILY HEALTH CENTERS	7/18/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
153784	Fee-for-Service	1598187080	1598187080	1	1	FERNANDEZ, NATALIA M LMFT	9/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
153910	Fee-for-Service	1124186085	1124186085	1	2	FARNHAM, THOS R MD	12/31/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	42378	-	NOT APPLICABLE	0	In state provider	None	1701 ZONAL AVE	None	LOS ANGELES	CA	90053	1065	19	06037	34.06219051	-118.2106555	Los Angeles County
153924	Fee-for-Service	1477677359	1477677359	1	1	FERNANDEZ, MARGARITA L NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5225 CANYON CREST DR	STE 13	RIVERSIDE	CA	92507	6320	33	06065	33.95618617	-117.3293404	Riverside County
153980	Fee-for-Service	1285009704	1285009704	1	1	FRESENIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY, LLC	535 E FIRST ST	None	TUSTIN	CA	92780	3312	30	06059	33.74582649	-117.8184105	Orange County
154017	Fee-for-Service	1821540717	1821540717	1	1	FEY, HEIDI LCSW	5/2/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	505 NORTH TUSTIN AVENUE	SUITE 265	SANTA ANA	CA	78611	3112	30	06059	33.74962094	-117.8341227	Orange County
154019	Fee-for-Service	1033442611	1033442611	1	1	FAUSNAUGHT, HELENA PT	11/2/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7202 MILLBROOK	105	FRESNO	CA	93720	3341	10	06019	36.83958089	-119.7645538	Fresno County
154051	Fee-for-Service	1073204509	1073204509	1	1	FELIX, MONICA LCSW	5/18/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
154060	Fee-for-Service	1205834694	1205834694	1	3	FRESNO SURGICAL HOSP	4/6/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	6125 N FRESNO ST	None	FRESNO	CA	93710	5207	10	06019	36.825057	-119.7814395	Fresno County
154069	Fee-for-Service	1982747671	1982747671	1	4	FAMILY HEALTH CENTERS	7/18/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
154095	Fee-for-Service	1366737264	1366737264	1	1	FRANKIE, REBEKAH	11/8/2024	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	4056 ALTA MESA DR	None	REDDING	CA	96002	3732	45	06089	40.54821409	-122.3303114	Shasta County
154152	Fee-for-Service	1043304769	1043304769	1	1	FAMILY PLANNING ASSOC	11/1/1980	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP INC	2777 LONG BEACH BLVD	STE 200	LONG BEACH	CA	90806	1513	19	06037	33.80734327	-118.189472	Los Angeles County
154185	Fee-for-Service	1770369878	1770369878	1	1	FELL, LUKAS M	10/18/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	18643 BROOKHURST ST	SUITE 1-D	FOUNTAIN VALLEY	CA	92708	6709	30	06059	33.69222046	-117.9543117	Orange County
154188	Fee-for-Service	1457789190	1457789190	1	1	FOOT & ANKLE DOCTORS OF	9/8/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	BEVERLY	240 S LA CIENEGA BLVD	STE 300	BEVERLY HILLS	CA	90211	3315	19	06037	34.06392928	-118.3761548	Los Angeles County
154240	Fee-for-Service	1063590644	1063590644	1	1	FREY, AMY E MD	2/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	60213	05	Anesthesiology	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
154285	Fee-for-Service	1407066095	1407066095	1	1	FLAHERTY, PATRICK M DO	9/8/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	4855 BLUE DIAMOND RD	None	LAS VEGAS	NV	89139	7602	00	None	36.03258913	-115.2074608	Clark County
154302	Fee-for-Service	1770668717	1770668717	1	1	FUCHS, MIRIAM B OD	5/31/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 UNIVERSITY DR	None	VISTA	CA	92083	7700	37	06073	33.172614	-117.2166885	San Diego County
154322	Fee-for-Service	1851853683	1851853683	1	1	FIDALGO, CHRISTOPHER CCC-SL	3/23/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	P	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
154378	Fee-for-Service	1003005109	1003005109	1	1	FETTMAN, NICHOLAS A MD	2/27/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	116624	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
154430	Fee-for-Service	1619216595	1619216595	1	1	FRIEDLANDER, LOIS H LMFT	8/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 MILLER AVE	STE D	MILL VALLEY	CA	94941	2897	21	06041	37.89916279	-122.5387998	Marin County
154435	Fee-for-Service	1124186085	1124186085	1	3	FARNHAM, THOS R MD	1/19/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	42378	-	NOT APPLICABLE	0	In state provider	None	1926 W. BEVERLY BLVD.	None	LOS ANGELES	CA	90057	2402	19	06037	34.06588198	-118.2686209	Los Angeles County
154477	Fee-for-Service	1457789190	1457789190	1	1	FOOT & ANKLE DOCTORS OF	9/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	BEVERLY	240 S LA CIENEGA BLVD	STE 300	BEVERLY HILLS	CA	90211	3315	19	06037	34.06392928	-118.3761548	Los Angeles County
154512	Fee-for-Service	1881691004	1881691004	1	1	FABIO, ALMEIDA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N. CAMPBELL	None	TUCSON	AZ	85724	0000	00	None	32.240493	-110.9460825	Pima County
154612	Fee-for-Service	1831628403	1831628403	1	1	FAGUNDES, HELEN Z NP	11/11/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
154716	Fee-for-Service	1568028645	1568028645	1	1	FINEST HOME HEALTH CARE	11/15/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7200 VINELAND AVE	SUITE 225	SUN VALLEY	CA	91352	5077	19	06037	34.2016328	-118.3703012	Los Angeles County
154733	Fee-for-Service	1851403109	1851403109	1	1	FAHEY, MICHAEL J MD	3/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	58383	02	General Surgery	0	In state provider	None	481 PLUMAS BLVD	STE 103	YUBA CITY	CA	95991	5075	51	06101	39.13306148	-121.6140103	Sutter County
154822	Fee-for-Service	1902985476	1902985476	1	1	FASSL, BERNHARD A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 N MEDICAL DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77069459	-111.8370155	Salt Lake County
154835	Fee-for-Service	1255457941	1255457941	1	1	FOWLER, KATHRYN J MD	8/10/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	154877	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
154871	Fee-for-Service	1255774881	1255774881	1	1	FUQUA, BRANDON L MD	8/13/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
154896	Fee-for-Service	1598807448	1598807448	1	1	FAIG, JEFFREY C MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	46962	67	Endocrinology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
154916	Fee-for-Service	1316951296	1316951296	1	1	FORRESTER, JOSEPH	5/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S POTOMAC ST	STE 110	AURORA	CO	80012	4514	00	None	39.691242	-104.829948	Arapahoe County
154938	Fee-for-Service	1174770630	1174770630	1	1	FORM PHYSICAL THERAPY, APC	2/16/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2358 PINE ST	None	SAN FRANCISCO	CA	94115	2715	38	06075	37.78787734	-122.4345417	San Francisco County
154957	Fee-for-Service	1164414652	1164414652	1	1	FINK, RAYMOND I MD	9/7/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	49984	67	Endocrinology	0	In state provider	None	8851 CENTER DR	STE 603	LA MESA	CA	91942	3063	37	06073	32.78189749	-117.0075062	San Diego County
154971	Fee-for-Service	1386875110	1386875110	1	1	FACULTY MEDICAL GRP OF LLUSM	11/3/2009	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	25455 BARTON ROAD	SUITE 107B	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
155008	Fee-for-Service	1144225897	1144225897	1	1	FORRED, WALTER A JR MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	34967	38	Geriatrics	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
155021	Fee-for-Service	1811213564	1811213564	1	1	FERZOCO, RAINA M MD	2/1/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	159773	68	Hematology	0	In state provider	None	1595 SOQUEL DR	STE 350	SANTA CRUZ	CA	95065	1723	44	06087	36.98879599	-121.9826354	Santa Cruz County
155125	Fee-for-Service	1235181967	1235181967	1	1	FISHER, PAUL G MD	6/30/1996	2084N0400X	NA	Neurology	026	PHYSICIANS	84211	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
155136	Fee-for-Service	1366413486	1366413486	2	1	FIFE, WILLIAM MD	4/18/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	64029	30	Radiology	0	In state provider	None	9320 BASELINE RD	STE C	RANCHO CUCAMONGA	CA	91701	5829	36	06071	34.12156453	-117.6018255	San Bernardino County
155168	Fee-for-Service	1164578449	1164578449	1	1	FOSTER, ALVIN JR PT	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	700 EAST CALAVERAS BLVD	None	MILPITAS	CA	95035	5439	43	06085	37.43308793	-121.8951311	Santa Clara County
155186	Fee-for-Service	1598807448	1598807448	1	1	FAIG, JEFFREY C MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	46962	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
155248	Fee-for-Service	1316146632	1316146632	1	1	FERNANDO, THILAN P J MD	5/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	97365	01	General Practice	0	In state provider	None	11480 BROOKSHIRE AVE	204	DOWNEY	CA	90241	5026	19	06037	33.93622932	-118.1311752	Los Angeles County
155348	Fee-for-Service	1518639723	1518639723	1	1	FRONT PORCH COMMUNITIES AND	6/22/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1055 NORTH KINGSLEY DR	None	LOS ANGELES	CA	90029	1207	19	06037	34.09006931	-118.303292	Los Angeles County
155366	Fee-for-Service	1699854737	1699854737	1	1	FRITSCH, CHRISTINA H MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54387	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
155390	Fee-for-Service	1124183843	1124183843	1	1	FERNANDO, ANNALISA C OD	2/8/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2414 S FAIRVIEW STREET	#103	SANTA ANA	CA	92704	5318	30	06059	33.71437705	-117.9079237	Orange County
155410	Fee-for-Service	1235181967	1235181967	1	1	FISHER, PAUL G MD	6/30/1996	2084N0400X	NA	Neurology	026	PHYSICIANS	84211	40	Pediatrics	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
155510	Fee-for-Service	1295878098	1295878098	1	1	FLORESCIO, PEDRO M JR MD	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	44757	-	NOT APPLICABLE	0	In state provider	None	11721 TELEGRAPH RD	SUITE A	SANTA FE SPRINGS	CA	90670	3674	19	06037	33.94629336	-118.0832752	Los Angeles County
155519	Fee-for-Service	1013952597	1013952597	1	1	FAMILY HEALTH CENTERS OF	5/9/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	2204 NATIONAL AVE	STE 201	SAN DIEGO	CA	92113	3615	37	06073	32.69715769	-117.1399272	San Diego County
155523	Fee-for-Service	1043269970	1043269970	1	1	FUSIA, TOD MD	3/7/2024	208800000X	NA	Other	026	PHYSICIANS	186881	None	None	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
155555	Fee-for-Service	1134553050	1134553050	1	1	FATOV, JULIA	6/5/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
155632	Fee-for-Service	1659428969	1659428969	1	1	FARIES, MARK B MD	5/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	80132	02	General Surgery	0	In state provider	None	2001 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2185	19	06037	34.02891163	-118.4797466	Los Angeles County
155677	Fee-for-Service	1881317451	1881317451	1	1	FONG, NATALIE NP	9/20/2022	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
155727	Fee-for-Service	1538420104	1538420104	1	1	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	77 CASA ST	SUITE 104	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
155738	Fee-for-Service	1790721728	1790721728	1	1	FERNANDEZ,RAMIRO MD	7/5/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69369	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
155805	Fee-for-Service	1013952597	1013952597	1	1	FAMILY HEALTH CENTERS OF	5/9/2005	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	2204 NATIONAL AVE	STE 201	SAN DIEGO	CA	92113	3615	37	06073	32.69715769	-117.1399272	San Diego County
155837	Fee-for-Service	1396754743	1396754743	1	1	FENN, HOWARD H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23934	36	Psychiatry	0	In state provider	None	282 STANFORD AVE	None	MENLO PARK	CA	94025	6328	41	06081	37.42902826	-122.1947038	San Mateo County
155902	Fee-for-Service	1063080083	1063080083	1	2	FAST AID NEMT	2/2/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3232 4TH AVE	5	SAN DIEGO	CA	92103	5702	37	06073	32.739165	-117.1612965	San Diego County
155904	Fee-for-Service	1669049581	1669049581	1	1	FREE AT HEART ONLINE THERAPY	8/9/2022	104100000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	LICENSED CLINICAL SOCIA	140 COMMONWEALTH AVE	SUITE 208	FULLERTON	CA	92832	1905	30	06059	33.87034048	-117.922437	Orange County
155939	Fee-for-Service	1639371180	1639371180	1	1	FIORELLA, MELANIE R MD	8/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95675	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
156029	Fee-for-Service	1902316755	1902316755	1	1	FUENTES, DAGOBERTO LCSW	6/9/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 FALLS CANYON ROAD	None	AVALON	CA	90704	1563	19	06037	33.33904622	-118.3307237	Los Angeles County
156072	Fee-for-Service	1891830907	1891830907	1	1	FEDERMAN, MYKE D MD	3/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82326	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
156125	Fee-for-Service	1396754743	1396754743	1	1	FENN, HOWARD H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23934	01	General Practice	0	In state provider	None	282 STANFORD AVE	None	MENLO PARK	CA	94025	6328	41	06081	37.42902826	-122.1947038	San Mateo County
156192	Fee-for-Service	1669049581	1669049581	1	1	FREE AT HEART ONLINE THERAPY	2/14/2025	104100000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	LICENSED CLINICAL SOCIA	140 COMMONWEALTH AVE	SUITE 208	FULLERTON	CA	92832	1905	30	06059	33.87034048	-117.922437	Orange County
156205	Fee-for-Service	1497741722	1497741722	1	1	FAULKNER, JOHN R MD	12/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	70567	34	Urology and Urological Surgery	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
156209	Fee-for-Service	1093330987	1093330987	2	1	FENECH, KATE F LMFT	6/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	80 EUREKA SQ	SUITE 132	PACIFICA	CA	94044	2654	41	06081	37.6325943	-122.488748	San Mateo County
156242	Fee-for-Service	1093117392	1093117392	1	1	FATE, ALASIA A AU	10/15/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 EXPOSITION BLVD	BLDG 700	SACRAMENTO	CA	95815	4300	34	06067	38.598876	-121.4502885	Sacramento County
156262	Fee-for-Service	1245379270	1245379270	1	1	FINK, CHRISTOPHER A MD	7/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108701	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
156274	Fee-for-Service	1023045283	1023045283	1	1	FORD, APRIL M MD	8/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90668	08	Family Practice	0	In state provider	None	790 E BONITA AVE	FL 2	POMONA	CA	91767	1906	19	06037	34.09621447	-117.737406	Los Angeles County
156318	Fee-for-Service	1508840802	1508840802	1	1	FREIMANIS, RITA I MD	6/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135810	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
156352	Fee-for-Service	1134171358	1134171358	1	1	FRIEDMAN, RONALD D MD	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	33638	05	Anesthesiology	0	In state provider	ST LUKES HOSPITAL	3555 ARMY ST	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.7479947	-122.4209132	San Francisco County
156364	Fee-for-Service	1376095653	1376095653	1	1	FARHAN, SAIF MD	8/24/2017	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
156413	Fee-for-Service	1396754743	1396754743	1	1	FENN, HOWARD H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23934	02	General Surgery	0	In state provider	None	282 STANFORD AVE	None	MENLO PARK	CA	94025	6328	41	06081	37.42902826	-122.1947038	San Mateo County
156434	Fee-for-Service	1174721856	1174721856	1	1	FANKUSHEN, DAVID S MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	10777	41	Internal Medicine	0	In state provider	None	12 RITTER ST	None	SAN RAFAEL	CA	94901	3323	21	06041	37.97154858	-122.5251877	Marin County
156457	Fee-for-Service	1356562789	1356562789	1	1	FARR, SARA MD	10/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99707	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
156462	Fee-for-Service	1275957359	1275957359	1	1	FAIRGOOD-TRAMMELL, TANISHA	12/16/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
156480	Fee-for-Service	1669049581	1669049581	1	1	FREE AT HEART ONLINE THERAPY	8/9/2022	104100000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	LICENSED CLINICAL SOCIA	140 COMMONWEALTH AVE	SUITE 208	FULLERTON	CA	92832	1905	30	06059	33.87034048	-117.922437	Orange County
156488	Fee-for-Service	1548216674	1548216674	1	2	FLAGG, GWENERVERE L MD	8/16/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	42472	-	NOT APPLICABLE	0	In state provider	None	152 W WALNUT ST	SUITE 150	GARDENA	CA	90248	3146	19	06037	33.87540307	-118.2773813	Los Angeles County
156494	Fee-for-Service	1871366740	1871366740	1	1	FLORES CARBAJAL, LEONEL NP	2/1/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	869 N CHERRY ST	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
156599	Fee-for-Service	1720242399	1720242399	1	1	FAHR, ALICIA LPCC	7/3/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
156659	Fee-for-Service	1033258942	1033258942	1	1	FAMILY PLANNING ASSOC	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GRP INC	2500 H ST	None	BAKERSFIELD	CA	93301	2818	15	06029	35.38232703	-119.0211171	Kern County
156672	Fee-for-Service	1407396328	1407396328	1	1	FORSTER, BRIAN MD	9/16/2020	207PP0204X	NA	Other	026	PHYSICIANS	169750	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
156693	Fee-for-Service	1407965882	1407965882	1	1	FREY, LAUREN C MD	10/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
156746	Fee-for-Service	1922187079	1922187079	1	1	FONG, STANLEY T MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	51154	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
156823	Fee-for-Service	1174595144	1174595144	1	1	FRAKES, LAURIE A MD	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52663	None	None	0	In state provider	None	9850 GENESEE AVE	STE 830	LA JOLLA	CA	92037	1219	37	06073	32.882913	-117.226341	San Diego County
156978	Fee-for-Service	1811255862	1811255862	1	1	FLANERY, ANDREW S MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127517	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
156997	Fee-for-Service	1336214998	1336214998	2	1	FREESTONE, GARY M OD	12/22/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 N RIVERSIDE AVE	STE 220	RIALTO	CA	92376	8082	36	06071	34.132905	-117.3704675	San Bernardino County
157008	Fee-for-Service	1861745713	1861745713	1	1	FILIPPOVA, ELINA LCSW	2/19/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9667 HWY 29	SUITE 102	LOWER LAKE	CA	95457	0001	17	06033	38.91012553	-122.612985	Lake County
157011	Fee-for-Service	1003301110	1003301110	1	1	FOLEY, NICOLE C MD	8/5/2024	207R00000X	NA	Other	026	PHYSICIANS	None	68	Hematology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
157033	Fee-for-Service	1922187079	1922187079	1	1	FONG, STANLEY T MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	51154	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
157093	Fee-for-Service	1538420104	1538420104	1	14	FIRST CHOICE PHYSICIAN PARTN	1/25/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	892 AEROVISTA PL	SUITE 130	SAN LUIS OBISPO	CA	93401	8054	40	06079	35.24277125	-120.6405941	San Luis Obispo County
157096	Fee-for-Service	1619904273	1619904273	1	1	FORESTER, ROBERT A MD	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	60869	08	Family Practice	0	In state provider	None	1320 CELESTE DR	None	MODESTO	CA	95355	2402	50	06099	37.67209617	-120.9733006	Stanislaus County
157101	Fee-for-Service	1598068512	1598068512	2	2	FUNDAMENTAL MEDICAL SUPPLY I	12/11/2020	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	NC	7114 RESEDA BLVD	None	RESEDA	CA	91335	4210	19	06037	34.199829	-118.5360145	Los Angeles County
157114	Fee-for-Service	1609855436	1609855436	1	1	FOUNTAIN, HELEN MD	2/25/2025	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	171470	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
157140	Fee-for-Service	1689063331	1689063331	1	1	FAIRMONT PHARMACY	5/4/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1121 W. VINE STREET	SUITE 13	LODI	CA	95240	5137	39	06077	38.12278448	-121.287132	San Joaquin County
157149	Fee-for-Service	1245292358	1245292358	1	1	F.C.M.S. CORP	10/1/1994	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1751 N LOMBARD ST	STE C	OXNARD	CA	93030	8288	56	06111	34.21774887	-119.1493306	Ventura County
157191	Fee-for-Service	1538420104	1538420104	1	6	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	959 LAS TABLAS RD	SUITE B3	TEMPLETON	CA	93465	9703	40	06079	35.55436153	-120.7148265	San Luis Obispo County
157243	Fee-for-Service	1952535874	1952535874	1	1	FAMILY HEALTH CENTERS OF	10/28/2009	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	251 LANDIS AVE	None	CHULA VISTA	CA	91910	2628	37	06073	32.6425313	-117.0814859	San Diego County
157365	Fee-for-Service	1396833497	1396833497	1	1	FONG, VICTOR J MD	7/1/1998	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60577	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
157368	Fee-for-Service	1659804557	1659804557	1	1	FITZGERALD, KELLY N MD	8/7/2023	261QX0200X	NA	Other	026	PHYSICIANS	161510	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
157378	Fee-for-Service	1902851025	1902851025	1	1	FARQUHAR, THOMAS H MD	8/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77289	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
157381	Fee-for-Service	1932605193	1932605193	1	1	FENSTER, ANDREW	7/19/2023	111NR0200X	NA	Other	026	PHYSICIANS	164775	None	None	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
157396	Fee-for-Service	1912645250	1912645250	1	1	FOOT ANKLE & LOWER LEG SPECI	12/23/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	ALISTS	660 E SANTA CLARA STREET	None	SAN JOSE	CA	95112	1931	43	06085	37.34260528	-121.8769383	Santa Clara County
157426	Fee-for-Service	1871529297	1871529297	1	2	FARROKH ALEMZADEH, MD., INC.	10/19/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	4950 BARRANCA PKWY	107	IRVINE	CA	92604	8650	30	06059	33.67620851	-117.7948348	Orange County
157485	Fee-for-Service	1477654457	1477654457	1	1	FOLTZ, MARY L PT	5/8/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1060 CAMERADO DRIVE	None	CAMERON PARK	CA	95682	7600	09	06017	38.6856171	-120.9860614	El Dorado County
157519	Fee-for-Service	1073084653	1073084653	1	1	FASCHING, JENNIFER N PT	10/13/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
157532	Fee-for-Service	1982635470	1982635470	1	1	FAMILY HEALTH CENTERS OF SAN	10/1/2000	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	1643 LOGAN AVE	None	SAN DIEGO	CA	92113	1004	37	06073	32.70433646	-117.1484538	San Diego County
157533	Fee-for-Service	1083644801	1083644801	1	1	FRESNO CHILDRENS MED GRP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	7720 N FRESNO ST	STE 104	FRESNO	CA	93720	2407	10	06019	36.85068226	-119.7836282	Fresno County
157568	Fee-for-Service	1720710064	1720710064	1	1	FOURTH OPTOMETRIC CARE OF CA	10/28/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY OPTOMETRY	5385 WALNUT AVE	SUITE 2	CHINO	CA	91710	2605	36	06071	34.02627451	-117.6872175	San Bernardino County
157713	Fee-for-Service	1871529297	1871529297	1	2	FARROKH ALEMZADEH, MD., INC.	10/19/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	4950 BARRANCA PKWY	107	IRVINE	CA	92604	8650	30	06059	33.67620851	-117.7948348	Orange County
157743	Fee-for-Service	1043501067	1043501067	1	1	FOGLIA, AMANDA CCC-SLP	7/10/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
157792	Fee-for-Service	1649498080	1649498080	1	1	FACELLO, DAVID W OD	8/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11410	01	General Practice	0	In state provider	None	25500 MEDICAL CENTER	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
157818	Fee-for-Service	1982635470	1982635470	1	1	FAMILY HEALTH CENTERS OF SAN	10/1/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	1643 LOGAN AVE	None	SAN DIEGO	CA	92113	1004	37	06073	32.70433646	-117.1484538	San Diego County
157854	Fee-for-Service	1073056974	1073056974	1	1	FREED, ABBEY J DO	7/2/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	16162	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
157877	Fee-for-Service	1184662405	1184662405	1	1	FACULTY MEDICAL GROUP OF	1/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	LLUSM-EMERGENCY MED.	11234 ANDERSON ST	# A108	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
157991	Fee-for-Service	1841796356	1841796356	1	1	FERREIRA, ELIZABETH T MD	11/17/2022	207P00000X	NA	Other	026	PHYSICIANS	174316	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
158012	Fee-for-Service	1679070692	1679070692	1	1	FRANK, STEPHANIE MD	1/17/2023	207L00000X	NA	Other	026	PHYSICIANS	163596	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
158043	Fee-for-Service	1740427038	1740427038	1	1	FISHER-CARRINGTON, SONJA M L	9/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
158046	Fee-for-Service	1790159820	1790159820	1	1	FREY SIERRA EMERGENCY	9/8/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	PHYSICIANS, PLLC	2375 E PRATER WAY	None	SPARKS	NV	89434	9641	00	None	39.54247495	-119.6975356	Washoe County
158124	Fee-for-Service	1609910256	1609910256	1	1	FILANOSKY, CHARLES A PHD	1/9/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
158151	Fee-for-Service	1700058476	1700058476	1	1	FAUSTINO, MARIVIC A PT	6/24/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
158190	Fee-for-Service	1124077516	1124077516	1	1	FACULTY PHYS & SURG OF	4/16/2018	208000000X	NA	Pediatric Primary Care	031	PSYCHOLOGISTS	-	None	None	0	In state provider	LLUSM PEDIATRICS CARDIOL	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
158239	Fee-for-Service	1437261351	1437261351	1	1	FARMACIA RAMIREZ INC	9/19/2005	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	RAMIREZ PHARMACY	2403 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	3001	19	06037	34.0466819	-118.2074474	Los Angeles County
158247	Fee-for-Service	1861923112	1861923112	1	1	FERGUSON, AMANDA J MD	7/1/2022	390200000X	NA	Other	026	PHYSICIANS	159250	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
158278	Fee-for-Service	1598216624	1598216624	1	1	FAGHANI, SETAREH NP	1/30/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8250 WOODMAN AVENUE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
158283	Fee-for-Service	1710382031	1710382031	1	1	FOXX, DOROTHY LCSW	2/7/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
158324	Fee-for-Service	1538420104	1538420104	1	4	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	35 CASA ST	SUITE 130	SAN LUIS OBISPO	CA	93405	1887	40	06079	35.29359615	-120.6654304	San Luis Obispo County
158333	Fee-for-Service	1265577001	1265577001	1	1	FASHEH, RAMI G MD	11/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115812	08	Family Practice	0	In state provider	None	1220 ROSSMOOR PARKWAY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
158334	Fee-for-Service	1356586549	1356586549	1	1	FAN, VINCENT C MD	5/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121231	18	Ophthalmology	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
158360	Fee-for-Service	1518108000	1518108000	1	1	FEIBUSCH, KATE C MD	2/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	63847	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
158376	Fee-for-Service	1700071578	1700071578	1	1	FISHMAN, SIDNEY M MD INC	4/1/2001	193400000X	NA	Other	026	PHYSICIANS	30590	04	Otology, Laryngology, Rhinology	0	In state provider	None	3801 KATELLA AVE	STE 425	LOS ALAMITOS	CA	90720	6901	30	06059	33.80318951	-118.066068	Orange County
158382	Fee-for-Service	1982747671	1982747671	1	2	FAMILY HEALTH CENTERS	8/3/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1000 EUCLID AVENUE	None	NATIONAL CITY	CA	91950	3856	37	06073	32.68067201	-117.0804893	San Diego County
158387	Fee-for-Service	1699792523	1699792523	2	1	FOW, JONATHAN E	2/23/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	78523	20	Orthopedic Surgery	0	In state provider	None	117 W BUNNY AVE	None	SANTA MARIA	CA	93458	2805	42	06083	34.96327701	-120.4368111	Santa Barbara County
158401	Fee-for-Service	1295875185	1295875185	1	1	FISHER, ROBIN D MD	2/1/1993	207P00000X	NA	Other	026	PHYSICIANS	5371	08	Family Practice	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
158406	Fee-for-Service	1457428336	1457428336	1	1	FIELDS, DONALD B MD	2/28/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41037	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
158410	Fee-for-Service	1922109511	1922109511	1	1	FAMILY PHYSICIANS A	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL CORPORATION	1233 PLUMAS ST	STE A	YUBA CITY	CA	95991	3410	51	06101	39.14818027	-121.6175196	Sutter County
158411	Fee-for-Service	1609926062	1609926062	1	1	FRIEFELD, SANDRA K PHD	10/6/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
158441	Fee-for-Service	1972065787	1972065787	1	1	FINNEGAN, MICAELA MD	6/30/2023	207P00000X	NA	Other	026	PHYSICIANS	178956	None	None	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
158463	Fee-for-Service	1952496697	1952496697	1	1	FAMILY CLINIC OF MERCED	8/6/2003	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL OFFICE INC	450 E YOSEMITE AVE	STE B	MERCED	CA	95340	8429	24	06047	37.33211352	-120.4620165	Merced County
158477	Fee-for-Service	1124077516	1124077516	1	1	FACULTY PHYS & SURG OF	1/1/1998	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LLUSM PEDIATRICS CARDIOL	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
158505	Fee-for-Service	1063866291	1063866291	1	1	FONG, RICHARD W DO	9/23/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	18992	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
158550	Fee-for-Service	1316058415	1316058415	1	1	FAN, FANG MD	1/18/2021	207ZP0102X	NA	Other	026	PHYSICIANS	170975	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
158562	Fee-for-Service	1528007390	1528007390	1	1	FECHNER, KLAUS P MD	8/3/1994	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53335	30	Radiology	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
158619	Fee-for-Service	1285706093	1285706093	1	1	FOSTER, SAMIA G MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65969	02	General Surgery	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
158627	Fee-for-Service	1699705509	1699705509	1	1	FARGO, RAMIZ A MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63522	41	Internal Medicine	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
158670	Fee-for-Service	1982747671	1982747671	1	2	FAMILY HEALTH CENTERS	8/3/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1000 EUCLID AVENUE	None	NATIONAL CITY	CA	91950	3856	37	06073	32.68067201	-117.0804893	San Diego County
158689	Fee-for-Service	1295875185	1295875185	1	1	FISHER, ROBIN D MD	2/1/1993	207P00000X	NA	Other	026	PHYSICIANS	5371	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
158746	Fee-for-Service	1083830350	1083830350	1	1	FANOUS, ASHRAF F MD	9/2/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	89046	36	Psychiatry	0	In state provider	None	8775 AERO DRIVE	STE 238	SAN DIEGO	CA	92123	1756	37	06073	32.80965551	-117.1391563	San Diego County
158764	Fee-for-Service	1124077516	1124077516	1	1	FACULTY PHYS & SURG OF	10/22/2020	208000000X	NA	Pediatric Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	LLUSM PEDIATRICS CARDIOL	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
158886	Fee-for-Service	1619384864	1619384864	1	1	FOSAH, ARNOLD CNP	3/26/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
158892	Fee-for-Service	1376117994	1376117994	1	1	FOK, LORDESA E PT	11/25/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	50	06099	37.666053	-120.996222	Stanislaus County
158979	Fee-for-Service	1487283685	1487283685	1	1	FAGAN, MIRIAM R PSYD	4/26/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
159009	Fee-for-Service	1023452018	1023452018	1	1	FREMONT VASCULAR AND VEIN	11/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	51977	02	General Surgery	0	In state provider	INC	1900 MOWRY AVE	STE 404	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
159032	Fee-for-Service	1609330257	1609330257	1	1	FOUNTAIN, DAVID RCP	10/25/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
159049	Fee-for-Service	1417910092	1417910092	1	1	FRAGEN, ANDREW J MD	3/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83291	None	None	0	In state provider	None	555 E TACHEVAH DR	STE 2E-101	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
159082	Fee-for-Service	1447486972	1447486972	1	1	FAMILY HOSPICE CARE INC	12/28/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	255 E RINCON STREET	SUITE 315-A	CORONA	CA	92879	1375	33	06065	33.88639376	-117.5620641	Riverside County
159084	Fee-for-Service	1740355106	1740355106	1	1	FOX, MARK S	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
159149	Fee-for-Service	1346464286	1346464286	1	1	FORD, AUDRA E MD	8/16/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	149537	None	None	0	In state provider	None	1313 W 8TH ST	STE 100	LOS ANGELES	CA	90017	4420	19	06037	34.05048998	-118.269586	Los Angeles County
159160	Fee-for-Service	1780724211	1780724211	1	1	FRONTIERO, LAURA J NP	11/4/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3609 OCEAN RANCH BLVD	None	OCEANSIDE	CA	92056	2698	37	06073	33.210836	-117.3107856	San Diego County
159185	Fee-for-Service	1467912212	1467912212	1	1	FRENCH, CIERRA DO	3/26/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22314	08	Family Practice	0	In state provider	None	500 UNIVERSITY AVE	STE 220	SACRAMENTO	CA	95825	6525	34	06067	38.568402	-121.418019	Sacramento County
159198	Fee-for-Service	1629150552	1629150552	1	1	FARIAS, ELENA LCSW	11/5/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
159199	Fee-for-Service	1457658502	1457658502	1	1	FAN, APRIL K NP	4/17/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	9413	34	06067	38.467854	-121.4188155	Sacramento County
159231	Fee-for-Service	1467112607	1467112607	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	420 E EL MONTE WAY	None	DINUBA	CA	93618	1611	54	06107	36.545743	-119.3906959	Tulare County
159247	Fee-for-Service	1184945180	1184945180	1	1	FELAHY, ISAM MD INC	2/6/2012	193400000X	NA	Other	026	PHYSICIANS	25226	33	Thoracic Surgery	0	In state provider	None	2800 N CALIFORNIA STREET	STE 15	STOCKTON	CA	95204	3759	39	06077	37.97782434	-121.2919633	San Joaquin County
159253	Fee-for-Service	1700970795	1700970795	2	1	FUNG, GREGORY MD	5/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	41709	01	General Practice	0	In state provider	None	789 VALLEJO STREET	None	SAN FRANCISCO	CA	94133	3834	38	06075	37.79837302	-122.4102043	San Francisco County
159289	Fee-for-Service	1053948604	1053948604	1	1	FORNBACHER, SOPHIA MD	12/18/2023	207P00000X	NA	Other	026	PHYSICIANS	183438	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
159306	Fee-for-Service	1053657122	1053657122	1	1	FISHER, JORDAN M MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123902	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
159337	Fee-for-Service	1336137082	1336137082	1	1	FREEZE, CLAUDE G CRNA	3/11/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	408 SIERRA COLLEGE DRIVE	None	GRASS VALLEY	CA	95945	5089	29	06057	39.23652577	-121.0572556	Nevada County
159369	Fee-for-Service	1447486972	1447486972	1	1	FAMILY HOSPICE CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	255 E RINCON STREET	SUITE 315-A	CORONA	CA	92879	1375	33	06065	33.88639376	-117.5620641	Riverside County
159451	Fee-for-Service	1164073755	1164073755	1	1	FIFE, MIRANDA W NP	8/3/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	22419 KENT AVE	None	TORRANCE	CA	90505	2303	19	06037	33.824448	-118.3564765	Los Angeles County
159511	Fee-for-Service	1639440977	1639440977	1	1	FERNANDEZ, LUIS A	7/1/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	184052	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
159519	Fee-for-Service	1467112607	1467112607	1	1	FAMILY HEALTH CENTERS, INC.	1/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	420 E EL MONTE WAY	None	DINUBA	CA	93618	1611	54	06107	36.545743	-119.3906959	Tulare County
159534	Fee-for-Service	1184945180	1184945180	1	1	FELAHY, ISAM MD INC	2/6/2012	193400000X	NA	Other	026	PHYSICIANS	25226	02	General Surgery	0	In state provider	None	2800 N CALIFORNIA STREET	STE 15	STOCKTON	CA	95204	3759	39	06077	37.97782434	-121.2919633	San Joaquin County
159550	Fee-for-Service	1598334138	1598334138	1	1	FOREVER YOUNG HOME HEALTH	5/23/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1055 E COLORADO BLVD	STE 5120	PASADENA	CA	91106	2327	19	06037	34.14595648	-118.1287575	Los Angeles County
159569	Fee-for-Service	1649255480	1649255480	2	1	FLORES-COOPER, MARIA MD	11/1/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	69350	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1551 BISHOP ST	SUITE B240	SAN LUIS OBISPO	CA	93401	4140	40	06079	35.27475609	-120.6454494	San Luis Obispo County
159572	Fee-for-Service	1568929891	1568929891	1	1	FAMILY CARE CLHF, INC	10/21/2019	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1412 CLEVELAND RD	None	GLENDALE	CA	91202	1415	19	06037	34.17008678	-118.2776657	Los Angeles County
159602	Fee-for-Service	1144378852	1144378852	1	1	FRAZER, JEFFREY R MD	8/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	88078	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
159625	Fee-for-Service	1184720112	1184720112	1	1	FIRME, STEVE RANDAL E MD	3/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	56129	40	Pediatrics	0	In state provider	RAINBOW PEDIATRICS STEVE	980 E FOOTHILL BLVD	STE 102	UPLAND	CA	91786	4068	36	06071	34.10679351	-117.6379419	San Bernardino County
159637	Fee-for-Service	1972674885	1972674885	1	1	FEITELBERG, STEVEN P MD	10/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	43744	01	General Practice	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
159676	Fee-for-Service	1568415743	1568415743	1	1	FITZGIBBONS, PATRICK MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	48387	22	Pathology (M.D. only)	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
159678	Fee-for-Service	1629039599	1629039599	1	1	FISH, JONATHAN W MD	12/29/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176083	01	General Practice	0	In state provider	None	914 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
159743	Fee-for-Service	1659399244	1659399244	1	1	FULARA, INDIRA B MD	8/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80715	08	Family Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
159746	Fee-for-Service	1750499497	1750499497	1	1	FREYE, CHRISTOPHER J MD	3/7/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44546	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
159751	Fee-for-Service	1821154030	1821154030	1	1	FLEMING, JILL C LMFT	7/21/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
159781	Fee-for-Service	1104157601	1104157601	1	1	FELDSHER, ZHANNA MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	110463	40	Pediatrics	0	In state provider	None	12134 VICTORY BLVD	STE B	NORTH HOLLYWOOD	CA	91606	3205	19	06037	34.18664618	-118.3978356	Los Angeles County
159887	Fee-for-Service	1598068512	1598068512	2	1	FUNDAMENTAL MEDICAL SUPPLY I	4/14/2020	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	7114 RESEDA BLVD	None	RESEDA	CA	91335	4210	19	06037	34.199829	-118.5360145	Los Angeles County
159913	Fee-for-Service	1205834694	1205834694	1	1	FRESNO SURGICAL HOSP	4/9/1993	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	6125 N FRESNO ST	None	FRESNO	CA	93710	5207	10	06019	36.825057	-119.7814395	Fresno County
159914	Fee-for-Service	1184720112	1184720112	1	1	FIRME, STEVE RANDAL E MD	3/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	56129	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	RAINBOW PEDIATRICS STEVE	980 E FOOTHILL BLVD	STE 102	UPLAND	CA	91786	4068	36	06071	34.10679351	-117.6379419	San Bernardino County
159966	Fee-for-Service	1821589573	1821589573	1	1	FRANZONE, MICHAEL A OD	3/11/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2801 PARK MARINA DR	None	REDDING	CA	96001	2822	45	06089	40.5736108	-122.3737048	Shasta County
159977	Fee-for-Service	1730575895	1730575895	1	1	FLEXSER, JENNIFER S	7/20/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1526 N EDGEMONT STREET	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
159995	Fee-for-Service	1417992561	1417992561	1	1	FALCON, EDGARDO A MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31579	41	Internal Medicine	0	In state provider	None	1050 N VENTURA RD	None	OXNARD	CA	93030	3855	56	06111	34.212285	-119.1944015	Ventura County
159998	Fee-for-Service	1750648606	1750648606	1	1	FIRST CHOICE PHYSICIAN	6/22/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	PARTNERS	1000 DELBON AVE	STE 2	TURLOCK	CA	95382	2008	50	06099	37.51054507	-120.8367636	Stanislaus County
160035	Fee-for-Service	1750499497	1750499497	1	1	FREYE, CHRISTOPHER J MD	3/7/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44546	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
160062	Fee-for-Service	1790257954	1790257954	1	1	FISCELLA, PHUONG RCP	3/20/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
160107	Fee-for-Service	1770169518	1770169518	1	1	FOX-LEE, RYAN MD	5/31/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	182866	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
160149	Fee-for-Service	1891823340	1891823340	1	1	FAZIO, DANIEL MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94253	05	Anesthesiology	0	In state provider	None	350 HAWTHORN AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
160225	Fee-for-Service	1700821303	1700821303	1	1	FAMILY HEALTH CENTERS OF SAN	1/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	3544 30TH ST	None	SAN DIEGO	CA	92104	4120	37	06073	32.742936	-117.130118	San Diego County
160287	Fee-for-Service	1750648606	1750648606	1	1	FIRST CHOICE PHYSICIAN	6/22/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PARTNERS	1000 DELBON AVE	STE 2	TURLOCK	CA	95382	2008	50	06099	37.51054507	-120.8367636	Stanislaus County
160300	Fee-for-Service	1023490216	1023490216	1	1	FANNIES DAUGHTERS MEDICAL PC	6/12/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3650 W MARTIN LUTHER KIN	SUITE 185	LOS ANGELES	CA	90008	1799	19	06037	34.01122437	-118.3358788	Los Angeles County
160303	Fee-for-Service	1871673921	1871673921	1	1	FERNANDEZ, GAIL E MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83214	26	Psychiatry (child)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
160337	Fee-for-Service	1528413861	1528413861	1	1	FOLEY, BRIDGET A DO	6/8/2023	208M00000X	NA	Other	026	PHYSICIANS	21033	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
160381	Fee-for-Service	1619735776	1619735776	1	1	FUENTES, FELICITY	1/21/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	15	06029	0	0	None
160448	Fee-for-Service	1528331287	1528331287	1	3	FAMILY HEALTH CENTERS OF	4/17/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	248 LANDIS AVENUE	None	CHULA VISTA	CA	91910	2609	37	06073	32.6430374	-117.0817455	San Diego County
160473	Fee-for-Service	1487721296	1487721296	1	1	FERRALL, STEPHEN J MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60913	66	Emergency Medicine (Urgent Care)	0	In state provider	ATTN MGA OFFICE	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
160475	Fee-for-Service	1831583236	1831583236	1	1	FARANGIS SABETI-KOLAHI CHIRO	11/16/2023	193400000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	TER	22762 ASPAN ST	205	LAKE FOREST	CA	92630	1604	30	06059	33.63189765	-117.7151111	Orange County
160489	Fee-for-Service	1679564215	1679564215	1	1	FOSTER, MARILYN W FNP	8/22/2006	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2460 SAMARITAN DR	None	SAN JOSE	CA	95124	3907	43	06085	37.25105952	-121.948542	Santa Clara County
160492	Fee-for-Service	1801930599	1801930599	1	1	FRESNO LONG-TERM CARE	1/17/2001	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP INC	5150 N 6TH STREET	SUITE 149	FRESNO	CA	93710	7505	10	06019	36.81127498	-119.7632093	Fresno County
160508	Fee-for-Service	1972997526	1972997526	1	1	FLORES-FENLON, NICOLE I MD	6/20/2019	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	134731	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
160512	Fee-for-Service	1700821303	1700821303	1	1	FAMILY HEALTH CENTERS OF SAN	1/1/1995	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	3544 30TH ST	None	SAN DIEGO	CA	92104	4120	37	06073	32.742936	-117.130118	San Diego County
160516	Fee-for-Service	1265546048	1265546048	1	1	FREEMAN OAK HILL HEALTH SYST	8/17/2011	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1102 W 32ND ST	None	JOPLIN	MO	64804	3503	00	None	37.05416859	-94.52742582	Newton County
160538	Fee-for-Service	1043294507	1043294507	1	1	FALK, RANDOLPH J MD	6/30/1985	207W00000X	NA	Ophthalmology	026	PHYSICIANS	41643	18	Ophthalmology	0	In state provider	None	11030 VALLEY MALL	None	EL MONTE	CA	91731	2617	19	06037	34.07445984	-118.0342764	Los Angeles County
160572	Fee-for-Service	1235624768	1235624768	1	1	FRESNO COUNTY SUPERINTENDENT	3/12/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	OF SCHOOLS	1111 VAN NESS AVENUE	None	FRESNO	CA	93721	0000	10	06019	36.73622928	-119.7909185	Fresno County
160591	Fee-for-Service	1023490216	1023490216	1	1	FANNIES DAUGHTERS MEDICAL PC	6/12/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3650 W MARTIN LUTHER KIN	SUITE 185	LOS ANGELES	CA	90008	1799	19	06037	34.01122437	-118.3358788	Los Angeles County
160664	Fee-for-Service	1023374873	1023374873	1	1	FELDMAN, ANNALYSE A DO	4/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13262	01	General Practice	0	In state provider	None	2322 BUTANO DRIVE	SUITE 205	SACRAMENTO	CA	95825	0657	34	06067	38.606373	-121.3814655	Sacramento County
160701	Fee-for-Service	1205923638	1205923638	1	1	FLEMING, KENNETH MD	9/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	45337	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
160729	Fee-for-Service	1235437575	1235437575	1	1	FOLLMAR, KENNETH E III MD	4/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103360	40	Pediatrics	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
160740	Fee-for-Service	1528331287	1528331287	1	3	FAMILY HEALTH CENTERS OF	4/17/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	248 LANDIS AVENUE	None	CHULA VISTA	CA	91910	2609	37	06073	32.6430374	-117.0817455	San Diego County
160785	Fee-for-Service	1821186727	1821186727	1	1	FAMILY HEALTHCARE	7/1/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	NETWORK	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
160791	Fee-for-Service	1588976393	1588976393	1	1	FLOOD, JEFFREY D MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118546	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
160807	Fee-for-Service	1083724165	1083724165	1	1	FABA, ALSON S. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1319 PUNAHOU ST	None	HONOLULU	HI	96826	1001	00	None	21.30030321	-157.8342762	Honolulu County
160815	Fee-for-Service	1144635814	1144635814	1	1	FUQUA, CAITLIN MD	12/30/2018	207P00000X	NA	Other	026	PHYSICIANS	155180	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
160922	Fee-for-Service	1275731655	1275731655	1	1	FRIDEN, JONATHAN C OD	10/3/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	68 E CENTRAL AVE	STE C	QUINCY	CA	95971	9718	32	06063	39.93638081	-120.9358748	Plumas County
160956	Fee-for-Service	1144421355	1144421355	1	1	FAISAL BAHADUR	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3011 S LINDSAY RD	STE 105	GILBERT	AZ	85295	4333	00	None	33.295194	-111.773142	Maricopa County
160961	Fee-for-Service	1457642803	1457642803	1	1	FERTIG, PATRICIA A DO	12/12/2022	163WP0807X	NA	Other	026	PHYSICIANS	14928	None	None	0	In state provider	None	1551 BISHOP ST	A 150	SAN LUIS OBISPO	CA	93401	4635	40	06079	35.27475609	-120.6454494	San Luis Obispo County
160975	Fee-for-Service	1184718272	1184718272	1	1	FIORE, MARISSA A MD	7/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	88342	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
161050	Fee-for-Service	1275587511	1275587511	1	1	FORBES,MARION M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1601 RIO GRANDE ST	None	AUSTIN	TX	78701	1137	00	None	30.28011967	-97.74568692	Travis County
161074	Fee-for-Service	1821186727	1821186727	1	1	FAMILY HEALTHCARE	1/10/2005	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	NETWORK	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
161096	Fee-for-Service	1578596920	1578596920	1	1	FU, MAO-JIN MD A MEDICAL	10/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	33783	41	Internal Medicine	0	In state provider	CORPORATION	5450 JEFFERSON AVE	STE 6	CHINO	CA	91710	3522	36	06071	34.0247326	-117.6862355	San Bernardino County
161118	Fee-for-Service	1053587881	1053587881	1	1	FARRELL, ISAAC J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	THE UNIV OF AZ MED CTR	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
161144	Fee-for-Service	1851855779	1851855779	1	1	FRIDAY, ELIZABETH NP	4/7/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	4920 AVALON BLVD	None	LOS ANGELES	CA	90011	4004	19	06037	33.998157	-118.265212	Los Angeles County
161193	Fee-for-Service	1770788978	1770788978	1	1	FONES, MORGAN L	12/18/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
161241	Fee-for-Service	1639174576	1639174576	1	1	FISHER, ALAN J MD	1/31/1985	174400000X	NA	Other	026	PHYSICIANS	44121	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	612 W DUARTE RD	STE 705	ARCADIA	CA	91007	7685	19	06037	34.12647805	-118.051994	Los Angeles County
161255	Fee-for-Service	1033141676	1033141676	1	1	FONG, BRIAN D MD	10/1/1999	207P00000X	NA	Other	026	PHYSICIANS	68152	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1050 LINDEN AVE	None	LONG BEACH	CA	90813	3321	19	06037	33.78003775	-118.1866604	Los Angeles County
161267	Fee-for-Service	1942241310	1942241310	1	1	FIRST RESPONDER EMS	5/1/1998	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SACRAMENTO INC	10161 CROYDON WAY	SUITE 1	SACRAMENTO	CA	95827	2107	34	06067	38.581839	-121.31532	Sacramento County
161295	Fee-for-Service	1619011731	1619011731	1	1	FANAEE, SOHEILA LMFT	3/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 HILLTOP MALL ROAD	SUITE 9	RICHMOND	CA	94806	1921	07	06013	37.9802423	-122.3244075	Contra Costa County
161361	Fee-for-Service	1821186727	1821186727	1	1	FAMILY HEALTHCARE	6/6/2005	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	NETWORK	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
161448	Fee-for-Service	1740290865	1740290865	1	1	FOOTHILL PODIATRY CLINIC	11/2/2007	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	OF GRASS VALLEY, INC	123 MARGARET LN	STE A-1	GRASS VALLEY	CA	95945	5268	29	06057	39.22839146	-121.0455763	Nevada County
161507	Fee-for-Service	1245881051	1245881051	1	1	FIRST CHOICE ADHC INC	4/9/2025	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	607 S GLENOAKS BLVD	None	BURBANK	CA	91502	1845	19	06037	34.17950025	-118.3013539	Los Angeles County
161510	Fee-for-Service	1568540169	1568540169	1	1	FANG, ANDREW S MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65946	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
161525	Fee-for-Service	1164618278	1164618278	1	1	FALLAHIAN, AMIR H MD	12/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110683	30	Radiology	0	In state provider	None	1817 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	5008	15	06029	35.37326659	-119.0227581	Kern County
161566	Fee-for-Service	1275644643	1275644643	1	1	FALCK, DARILYN E MD	12/1/1997	207P00000X	NA	Other	026	PHYSICIANS	60584	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
161567	Fee-for-Service	1417967951	1417967951	1	1	FRANKLIN, GEORGE L JR	10/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	2	Out of state provider	None	2400 S AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
161578	Fee-for-Service	1134756844	1134756844	1	1	FLORES, NICKOLAS D	8/7/2023	207R00000X	NA	Other	026	PHYSICIANS	187559	None	None	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	9411	38	06075	37.78610439	-122.421569	San Francisco County
161612	Fee-for-Service	1770504839	1770504839	1	1	FREISEN, JANICE LCSW	7/14/2003	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	27212 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63229023	-122.0896425	Alameda County
161618	Fee-for-Service	1336664333	1336664333	1	1	FROMER CHIROPRACTIC, INC.	7/25/2023	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	5123 W. SUNSET BLVD.	#202	LOS ANGELES	CA	90027	5779	19	06037	34.0981773	-118.3013882	Los Angeles County
161649	Fee-for-Service	1821186727	1821186727	1	1	FAMILY HEALTHCARE	7/1/2003	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	NETWORK	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
161702	Fee-for-Service	1538243308	1538243308	1	1	FOLMAR, RAYMOND H MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	23113	20	Orthopedic Surgery	0	In state provider	None	710 N EUCLID	SUITE 208	ANAHEIM	CA	92801	4115	30	06059	33.8420837	-117.9415765	Orange County
161704	Fee-for-Service	1376066548	1376066548	1	1	FAHIMI, GOLSHAN MD	8/19/2024	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	175507	13	Neurology (M.D. only)	0	In state provider	None	23512 MADERO ROAD	None	MISSION VIEJO	CA	92691	2743	30	06059	33.62192373	-117.6765103	Orange County
161747	Fee-for-Service	1578673620	1578673620	1	1	FU, QINGQUAN MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	53780	41	Internal Medicine	0	In state provider	None	818 JACKSON ST	STE 202	SAN FRANCISCO	CA	94133	4849	38	06075	37.79580797	-122.4086365	San Francisco County
161757	Fee-for-Service	1144223397	1144223397	1	1	FELD, STELLA M	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69174	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
161814	Fee-for-Service	1619495751	1619495751	1	1	FARHAT, KELLI OT	2/7/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9850 GENESEE AVE	510	LA JOLLA	CA	92037	1224	37	06073	32.882913	-117.226341	San Diego County
161821	Fee-for-Service	1184731135	1184731135	1	1	FORMAN, STEPHEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29700	68	Hematology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
161917	Fee-for-Service	1326004284	1326004284	1	1	FREITAS, ALEX DANIEL MD	8/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	63146	None	None	0	In state provider	None	44105 15TH ST W	None	LANCASTER	CA	93534	4088	19	06037	34.684218	-118.1568465	Los Angeles County
161958	Fee-for-Service	1346660081	1346660081	1	1	FENG, JOHN C MD	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139812	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
162021	Fee-for-Service	1801323084	1801323084	1	1	FLORES, AUSTIN MD	6/17/2022	207LP3000X	NA	Other	026	PHYSICIANS	174356	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
162026	Fee-for-Service	1922621101	1922621101	1	1	FOWLER, BENJAMIN MD	11/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	185110	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
162040	Fee-for-Service	1922199694	1922199694	1	1	FRIENDS & FAMILY MEDICAL CLI	9/6/2006	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	92310	None	None	0	In state provider	CLINIC INC	501 E HARDY ST	STE 205	INGLEWOOD	CA	90301	4021	19	06037	33.9491005	-118.348857	Los Angeles County
162055	Fee-for-Service	1851391593	1851391593	1	1	FARACI, PHILIP A MD	6/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	23163	33	Thoracic Surgery	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
162116	Fee-for-Service	1124087671	1124087671	1	1	FLORES, ALAN G MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66855	08	Family Practice	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
162243	Fee-for-Service	1548309453	1548309453	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	10200 SEPULVEDA BLVD	STE 200	MISSION HILLS	CA	91345	2657	19	06037	34.25572562	-118.4673156	Los Angeles County
162244	Fee-for-Service	1720866809	1720866809	1	1	FLORINDA G. MALLORCA, M.D. I	9/28/2023	261QP2300X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	NC	1191 E YOSEMITE AVE	B	MANTECA	CA	95336	5071	39	06077	37.79751749	-121.1988375	San Joaquin County
162325	Fee-for-Service	1700495363	1700495363	1	1	FACULTY PHYSICIANS AND SURGE	1/29/2021	2085B0100X	NA	MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	1850 N RIVERSIDE AVE	STE 160	RIALTO	CA	92376	8056	36	06071	34.132905	-117.3704675	San Bernardino County
162480	Fee-for-Service	1316032113	1316032113	1	1	FELTHOUSE, RAE D MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	41414	68	Hematology	0	In state provider	None	627 ENCINITAS BLVD	None	ENCINITAS	CA	92024	3734	37	06073	33.04774032	-117.2787559	San Diego County
162522	Fee-for-Service	1609927102	1609927102	1	1	FONG, JUON-KIN K MD INC	10/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	28848	20	Orthopedic Surgery	0	In state provider	None	425 28TH ST	None	OAKLAND	CA	94609	3602	01	06001	37.81654892	-122.2659829	Alameda County
162647	Fee-for-Service	1437291168	1437291168	1	1	FREITAG, ERIC J PSYD	1/25/2023	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1910 OLYMPIC BLVD	STE 220	WALNUT CREEK	CA	94596	5071	07	06013	37.89453628	-122.0662326	Contra Costa County
162674	Fee-for-Service	1629130240	1629130240	1	5	FEATHER RIVER TRIBAL	8/23/2024	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	2145 5TH AVE	None	OROVILLE	CA	95965	5870	04	06007	39.50368243	-121.5646958	Butte County
162695	Fee-for-Service	1649223777	1649223777	1	1	FCS MEDICAL CORPORTION	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FAMILY CARE SPECIALISTS	1701 CESAR CHAVEZ	# 402	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
162718	Fee-for-Service	1851816300	1851816300	1	1	FLETCHER, KRISTY	9/2/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD	STE 230	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
162729	Fee-for-Service	1881654846	1881654846	1	1	FENTON, MICHAEL F PHD	8/1/1994	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1101 DOVE ST	STE 225	NEWPORT BEACH	CA	92660	2828	30	06059	33.6602824	-117.8647147	Orange County
162731	Fee-for-Service	1356869002	1356869002	1	1	FURNESS, MAURA C LCSW	12/6/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
162765	Fee-for-Service	1316032113	1316032113	1	1	FELTHOUSE, RAE D MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	41414	78	Neoplastic Diseases/Oncology	0	In state provider	None	627 ENCINITAS BLVD	None	ENCINITAS	CA	92024	3734	37	06073	33.04774032	-117.2787559	San Diego County
162792	Fee-for-Service	1669520623	1669520623	1	1	FEHL, FREDERICK C MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65562	07	Dermatology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
162796	Fee-for-Service	1154347797	1154347797	1	1	FLORENCE WESTERN	10/17/2005	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	7301 S WESTERN AVE	None	LOS ANGELES	CA	90047	2254	19	06037	33.973479	-118.309018	Los Angeles County
162856	Fee-for-Service	1013952597	1013952597	1	5	FAMILY HEALTH CENTERS OF	12/9/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7290 EL CAJON BLVD	None	SAN DIEGO	CA	92115	1829	37	06073	32.76884635	-117.0406752	San Diego County
162863	Fee-for-Service	1235575648	1235575648	1	1	FORD, CAITLIN DO	1/7/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22971	08	Family Practice	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
162886	Fee-for-Service	1184769879	1184769879	1	1	FOBBS, DENARD M MD	6/30/1981	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	38922	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7455 N FRESNO ST	STE 202	FRESNO	CA	93720	2481	10	06019	36.84569956	-119.7839	Fresno County
162902	Fee-for-Service	1124186085	1124186085	1	1	FARNHAM, THOS R MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	42378	None	None	0	In state provider	None	14418 PACIFIC AVE	None	BALDWIN PARK	CA	91706	4225	19	06037	34.08504094	-117.9602716	Los Angeles County
162914	Fee-for-Service	1538420104	1538420104	1	8	FIRST CHOICE PHYSICIAN PARTN	9/8/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARTNERS	2130 HERITAGE LOOP RD	BLDG 5	PASO ROBLES	CA	93446	7800	40	06079	35.74251645	-120.8773689	San Luis Obispo County
162921	Fee-for-Service	1265495345	1265495345	1	1	FERGUSON, IAN G D0	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	6890	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
162984	Fee-for-Service	1649223777	1649223777	1	1	FCS MEDICAL CORPORTION	12/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	FAMILY CARE SPECIALISTS	1701 CESAR CHAVEZ	# 402	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
163014	Fee-for-Service	1639303118	1639303118	1	2	FALKENSTEIN, IRYNA A MD	3/15/2021	207WX0009X	NA	Ophthalmology	026	PHYSICIANS	145657	None	None	0	In state provider	None	491 30TH ST	STE 103	OAKLAND	CA	94609	3235	01	06001	37.81935528	-122.2667902	Alameda County
163058	Fee-for-Service	1154463032	1154463032	1	1	FRANKOVICH, JENNIFER	6/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80443	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
163082	Fee-for-Service	1154347797	1154347797	1	1	FLORENCE WESTERN	10/17/2005	193200000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	7301 S WESTERN AVE	None	LOS ANGELES	CA	90047	2254	19	06037	33.973479	-118.309018	Los Angeles County
163092	Fee-for-Service	1427026855	1427026855	1	1	FINK, EZEKIEL MD	11/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98155	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	#B200	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
163101	Fee-for-Service	1649610601	1649610601	1	1	FIRST STEP FAMILY COUNSELING	5/12/2020	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC.	624 W 9TH ST	103	SAN PEDRO	CA	90731	3158	19	06037	33.73607853	-118.290789	Los Angeles County
163108	Fee-for-Service	1487165544	1487165544	1	1	FOOTHILL HEALTH CENTER INC	3/3/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2060 ABORN ROAD	SUITE 125	SAN JOSE	CA	95121	1586	43	06085	37.3114718	-121.8072775	Santa Clara County
163134	Fee-for-Service	1194745067	1194745067	1	1	FRECKER, DAVID G MD	4/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	57049	01	General Practice	0	In state provider	None	219 NOGALES AVE	STE F	SANTA BARBARA	CA	93105	3848	42	06083	34.43171016	-119.7220176	Santa Barbara County
163146	Fee-for-Service	1013952597	1013952597	1	5	FAMILY HEALTH CENTERS OF	12/9/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7290 EL CAJON BLVD	None	SAN DIEGO	CA	92115	1829	37	06073	32.76884635	-117.0406752	San Diego County
163167	Fee-for-Service	1366429821	1366429821	2	1	FREMONT EMERGENCY SERVICES	2/24/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
163213	Fee-for-Service	1114317781	1114317781	1	1	FREMONT UNION HIGH SCHOOL	7/1/2014	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	589 W FREMONT AVE	None	SUNNYVALE	CA	94087	2556	43	06085	37.35222904	-122.0350225	Santa Clara County
163236	Fee-for-Service	1669584827	1669584827	1	1	FORNO, KARIN I MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	58049	08	Family Practice	0	In state provider	None	1900 MEMORIAL DR	None	CERES	CA	95307	1827	50	06099	37.600146	-120.961042	Stanislaus County
163389	Fee-for-Service	1649610601	1649610601	1	1	FIRST STEP FAMILY COUNSELING	5/12/2020	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	, INC.	624 W 9TH ST	103	SAN PEDRO	CA	90731	3158	19	06037	33.73607853	-118.290789	Los Angeles County
163396	Fee-for-Service	1487165544	1487165544	1	1	FOOTHILL HEALTH CENTER INC	3/3/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2060 ABORN ROAD	SUITE 125	SAN JOSE	CA	95121	1586	43	06085	37.3114718	-121.8072775	Santa Clara County
163413	Fee-for-Service	1225390529	1225390529	1	1	FLORA, BJORN K MD	11/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
163422	Fee-for-Service	1538420104	1538420104	1	2	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1064 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1806	40	06079	35.29096261	-120.6649484	San Luis Obispo County
163445	Fee-for-Service	1518083153	1518083153	1	1	FOLSOM CORDOVA USD	5/19/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1965 BIRKMONT DR	None	RANCHO CORDOVA	CA	95742	6407	34	06067	38.633634	-121.1991885	Sacramento County
163459	Fee-for-Service	1184871659	1184871659	1	1	FOUR RIVERS MANAGEMENT CORP	11/1/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	415 S UNION AVE	None	LOS ANGELES	CA	90017	1007	19	06037	34.0593819	-118.2685889	Los Angeles County
163523	Fee-for-Service	1164521605	1164521605	1	1	FRIEDENTHAL, ROGER P MD	8/1/2001	208600000X	NA	General Surgery	026	PHYSICIANS	9257	02	General Surgery	0	In state provider	None	2043 19TH AVE	None	SAN FRANCISCO	CA	94116	1253	38	06075	37.74965673	-122.4761431	San Francisco County
163553	Fee-for-Service	1831277433	1831277433	1	1	FAUX, CHRISTOPHER J MD	3/1/1999	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	84758	08	Family Practice	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
163590	Fee-for-Service	1023512456	1023512456	1	1	FOMENKO, VIRA MD	9/24/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164062	None	None	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
163607	Fee-for-Service	1255400313	1255400313	1	1	FADEFF, CHRIS M MD	3/1/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	65257	08	Family Practice	0	In state provider	None	9500 STOCKDALE HWY	SUITE 201	BAKERSFIELD	CA	93311	3621	15	06029	35.35452448	-119.1074625	Kern County
163668	Fee-for-Service	1992762207	1992762207	1	1	FEE, CHRISTOPHER MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71154	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
163679	Fee-for-Service	1649610601	1649610601	1	1	FIRST STEP FAMILY COUNSELING	5/12/2020	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC.	624 W 9TH ST	103	SAN PEDRO	CA	90731	3158	19	06037	33.73607853	-118.290789	Los Angeles County
163685	Fee-for-Service	1619163441	1619163441	1	1	FACULTY PHYSICIANS AND	1/22/2008	207T00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	SURGEONS OF LLUSM-NEUROS	341 MAGNOLIA AVE	STE 201	RIVERSIDE	CA	92879	3322	33	06065	33.85291987	-117.5664344	Riverside
163696	Fee-for-Service	1184063265	1184063265	1	1	FRIEDMAN, JAMES MD	7/15/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	160382	20	Orthopedic Surgery	0	In state provider	None	2488 N CALIFORNIA ST	None	STOCKTON	CA	95204	3494	39	06077	37.97587328	-121.2911856	San Joaquin County
163709	Fee-for-Service	1790741197	1790741197	1	1	FORD, LEIGH A NP	10/5/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	384318	-	NOT APPLICABLE	0	In state provider	None	1111 N EL DORADO ST	None	STOCKTON	CA	95202	1305	39	06077	37.96379262	-121.2929073	San Joaquin County
163730	Fee-for-Service	1669730230	1669730230	1	1	FRIESCH, CATHERINE C NP	8/24/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
163753	Fee-for-Service	1104454529	1104454529	1	1	FLOUNDERS, ERIC A MD	6/8/2023	207P00000X	NA	Other	026	PHYSICIANS	185438	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
163762	Fee-for-Service	1609896661	1609896661	1	1	FRANKS, ANNEMARY MD	6/1/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	71882	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
163798	Fee-for-Service	1740410083	1740410083	1	1	FRIDLAND, JULIA MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114048	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
163812	Fee-for-Service	1164521605	1164521605	1	1	FRIEDENTHAL, ROGER P MD	8/1/2001	208600000X	NA	General Surgery	026	PHYSICIANS	9257	24	Plastic Surgery	0	In state provider	None	2043 19TH AVE	None	SAN FRANCISCO	CA	94116	1253	38	06075	37.74965673	-122.4761431	San Francisco County
163824	Fee-for-Service	1982007357	1982007357	1	1	FAMILY CARE FOR ELDERLY INC	4/8/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	26741 PEPITA DR	None	MISSION VIEJO	CA	92691	5442	30	06059	33.59289311	-117.6633493	Orange County
163841	Fee-for-Service	1831518877	1831518877	1	1	FLURY, JACOB D MD	7/22/2021	207L00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1093 ROYAL COURT	None	MEDFORD	OR	97504	8383	00	None	42.34017467	-122.8666022	Jackson County
163888	Fee-for-Service	1346612686	1346612686	1	1	FRENCH, PALOMA OT	2/12/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
163949	Fee-for-Service	1538672795	1538672795	1	1	FLORES, JON H CRNA	12/8/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
163957	Fee-for-Service	1902372345	1902372345	1	1	FIGUEROA, JORGE LCSW	6/30/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
163963	Fee-for-Service	1649610601	1649610601	1	1	FIRST STEP FAMILY COUNSELING	5/12/2020	106H00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	, INC.	624 W 9TH ST	103	SAN PEDRO	CA	90731	3158	19	06037	33.73607853	-118.290789	Los Angeles County
163971	Fee-for-Service	1770584989	1770584989	1	1	FOWLER, TERRY K DO	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7881	08	Family Practice	0	In state provider	None	6189 LA PALMA AVE	None	BUENA PARK	CA	90620	2858	30	06059	33.84662776	-118.0247919	Orange County
164091	Fee-for-Service	1447281936	1447281936	1	1	FAMILY HEALTH CTRS OF SD	4/1/1991	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
164148	Fee-for-Service	1487836052	1487836052	1	1	FRIEDMAN, BROOKE E MD	7/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101757	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
164163	Fee-for-Service	1659833549	1659833549	1	1	FATCH, SHIREE S DO	10/20/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	20222	None	None	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
164166	Fee-for-Service	1528331287	1528331287	1	1	FAMILY HEALTH CENTERS OF	11/28/2013	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	1000 EUCLID AVENUE	None	NATIONAL CITY	CA	91950	7252	37	06073	32.68067201	-117.0804893	San Diego County
164172	Fee-for-Service	1609963164	1609963164	1	1	FINLEY, LYNNE K MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	43444	22	Pathology (M.D. only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
164253	Fee-for-Service	1497837603	1497837603	1	1	FLORYAN JOHN AO	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2895 LOMA VISTA RD	STE A	VENTURA	CA	93003	1522	56	06111	34.27543868	-119.2574459	Ventura County
164260	Fee-for-Service	1770584989	1770584989	1	1	FOWLER, TERRY K DO	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7881	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6189 LA PALMA AVE	None	BUENA PARK	CA	90620	2858	30	06059	33.84662776	-118.0247919	Orange County
164373	Fee-for-Service	1831332386	1831332386	1	1	FUKAYA, ERI MD	8/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135165	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
164378	Fee-for-Service	1104862895	1104862895	1	1	FOREST, ERIN E MD	3/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84217	46	Hand Surgery	0	In state provider	None	1201 ALHAMBRA BLVD	STE 410	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
164382	Fee-for-Service	1447281936	1447281936	1	1	FAMILY HEALTH CTRS OF SD	4/1/1991	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
164389	Fee-for-Service	1063408425	1063408425	1	1	FRALICK, JERRY L MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	42751	25	Physical Medicine and Rehabilitation	0	In state provider	None	10155 COLIMA RD	None	WHITTIER	CA	90603	2063	19	06037	33.94349601	-118.0106968	Los Angeles County
164443	Fee-for-Service	1790927895	1790927895	1	1	FATEHI, PEDRAM MD	11/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103283	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVENUE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
164455	Fee-for-Service	1528331287	1528331287	1	1	FAMILY HEALTH CENTERS OF	9/21/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	1000 EUCLID AVENUE	None	NATIONAL CITY	CA	91950	7252	37	06073	32.68067201	-117.0804893	San Diego County
164561	Fee-for-Service	1083862791	1083862791	1	1	FLORESISLAS, MERCEDES LCSW	3/25/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92563	7906	30	06059	33.62516256	-117.7353393	Orange County
164590	Fee-for-Service	1558725127	1558725127	1	1	FIDAI, MOHSIN S MD	8/2/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	172039	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
164621	Fee-for-Service	1023070869	1023070869	1	1	FOGG, MAXWELL, & LANIER,	6/30/1996	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	M.D., INC	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
164725	Fee-for-Service	1699704684	1699704684	1	1	FERNANDEZ, ANGEL MD	10/24/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
164732	Fee-for-Service	1790927895	1790927895	1	1	FATEHI, PEDRAM MD	11/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103283	41	Internal Medicine	0	In state provider	None	2450 ASHBY AVENUE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
164745	Fee-for-Service	1528331287	1528331287	1	1	FAMILY HEALTH CENTERS OF	9/21/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	1000 EUCLID AVENUE	None	NATIONAL CITY	CA	91950	7252	37	06073	32.68067201	-117.0804893	San Diego County
164766	Fee-for-Service	1851479927	1851479927	1	1	FOSTER, STEPHEN H MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32028	41	Internal Medicine	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
164815	Fee-for-Service	1760566020	1760566020	1	1	FANG, KENNETH C MD	6/30/1992	207R00000X	NA	Other	026	PHYSICIANS	67935	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
164850	Fee-for-Service	1558335687	1558335687	1	1	FELIPE DE ALBA, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2160 S 1ST AVE	None	MAYWOOD	IL	60153	3328	00	None	41.86025379	-87.83381752	Cook County
164871	Fee-for-Service	1629100656	1629100656	1	1	FARLEY, THOMAS L NP	6/19/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
164908	Fee-for-Service	1023070869	1023070869	1	1	FOGG, MAXWELL, & LANIER,	7/10/2023	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	M.D., INC	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
164959	Fee-for-Service	1841414992	1841414992	1	1	FITZGERALD, DAUGHN C OT	10/18/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	91188	0001	36	06071	34.072245	-117.4319685	San Bernardino County
164986	Fee-for-Service	1265686109	1265686109	1	4	FACULTY PHYSICIANS AND SURGE	7/19/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11234 ANDERSON ST	SUITE 7100	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
165004	Fee-for-Service	1619919586	1619919586	1	1	FLYNN, ARTHUR E MD	12/31/1985	208200000X	NA	General Surgery	026	PHYSICIANS	57770	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2648 E 14TH ST	None	OAKLAND	CA	94601	1506	01	06001	37.78093089	-122.2316571	Alameda County
165058	Fee-for-Service	1235699323	1235699323	1	1	FORTES, BLAKE H MD	5/1/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	185112	None	None	0	In state provider	None	100 STEIN PLZ	None	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
165101	Fee-for-Service	1760566020	1760566020	1	1	FANG, KENNETH C MD	6/30/1992	207R00000X	NA	Other	026	PHYSICIANS	67935	66	Emergency Medicine (Urgent Care)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
165202	Fee-for-Service	1104106814	1104106814	1	1	FAUCETT, ERYNNE A MD	1/2/2023	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	182697	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
165212	Fee-for-Service	1962574780	1962574780	1	1	FAN, YVETTE C MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	77220	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
165273	Fee-for-Service	1265686109	1265686109	1	4	FACULTY PHYSICIANS AND SURGE	10/31/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	SUITE 7100	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
165318	Fee-for-Service	1265876890	1265876890	1	1	FARKHONDEHPOUR, MOHAMMAD A	5/12/2017	208M00000X	NA	Other	026	PHYSICIANS	134730	41	Internal Medicine	0	In state provider	MD	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
165363	Fee-for-Service	1649801739	1649801739	1	1	FISHER, LESLEY L LMFT	12/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4221 WILSHIRE BLVD STE 1	None	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
165377	Fee-for-Service	1518581917	1518581917	1	1	FUNG, LESLEY M CNP	8/11/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4829 CLAIREMONT DR	None	SAN DIEGO	CA	92117	2706	37	06073	32.83175462	-117.2052088	San Diego County
165475	Fee-for-Service	1518910645	1518910645	1	1	FOREMAN, BRANDT A MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	73899	05	Anesthesiology	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
165499	Fee-for-Service	1962574780	1962574780	1	1	FAN, YVETTE C MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	77220	67	Endocrinology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
165561	Fee-for-Service	1265686109	1265686109	1	4	FACULTY PHYSICIANS AND SURGE	10/31/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11234 ANDERSON ST	SUITE 7100	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
165629	Fee-for-Service	1093711806	1093711806	1	1	FANGMAN, MICHAEL P MD	2/19/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	27775	41	Internal Medicine	0	In state provider	None	1375 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3382	49	06097	38.627145	-122.863779	Sonoma County
165665	Fee-for-Service	1801830070	1801830070	1	1	FREEMAN, KIMBERLY D MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81141	66	Emergency Medicine (Urgent Care)	0	In state provider	None	869 CHERRY AVE	None	TULARE	CA	93274	0000	54	06107	36.220932	-119.337698	Tulare County
165717	Fee-for-Service	1437174240	1437174240	1	1	FALLBROOK-RANCHO SURGERY AMC	12/1/1997	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	521 E ELDER ST	STE 205	FALLBROOK	CA	92028	3083	37	06073	33.38015149	-117.246267	San Diego County
165811	Fee-for-Service	1194773523	1194773523	1	1	FRALICK, RANDY A MD	2/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87066	34	Urology and Urological Surgery	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
165850	Fee-for-Service	1265686109	1265686109	1	4	FACULTY PHYSICIANS AND SURGE	10/31/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	11234 ANDERSON ST	SUITE 7100	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
165853	Fee-for-Service	1023296720	1023296720	1	1	FAMILY HEALTH CENTERS OF	11/29/2007	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	220 EUCLID AVE	STE 40	SAN DIEGO	CA	92114	3644	37	06073	32.706387	-117.085098	San Diego County
165918	Fee-for-Service	1093711806	1093711806	1	1	FANGMAN, MICHAEL P MD	2/19/2014	207RH0003X	NA	Oncology	026	PHYSICIANS	27775	78	Neoplastic Diseases/Oncology	0	In state provider	None	1375 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3382	49	06097	38.627145	-122.863779	Sonoma County
166022	Fee-for-Service	1184088841	1184088841	1	1	FLORES, MARIO DO	10/15/2021	207LP2900X	NA	Other	026	PHYSICIANS	18516	None	None	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
166073	Fee-for-Service	1316095268	1316095268	1	1	FOLKS, NANCY A MD	10/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77238	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
166108	Fee-for-Service	1366590325	1366590325	1	1	FRISTOE, ANN P MD	4/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81058	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
166318	Fee-for-Service	1790192839	1790192839	1	1	FENG, YUAN MD	7/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156665	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
166348	Fee-for-Service	1407904394	1407904394	1	1	FEINSTEIN, DOUGLAS S MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72382	05	Anesthesiology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
166366	Fee-for-Service	1861668469	1861668469	1	1	FRIEDMAN, JEFFREY PHD	7/10/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10 SANTA ROSA ST	STE 201	SAN LUIS OBISPO	CA	93405	5825	40	06079	35.29325417	-120.667547	San Luis Obispo County
166395	Fee-for-Service	1043295363	1043295363	1	1	FARBER, NEIL J MD	11/1/2007	207R00000X	NA	Other	026	PHYSICIANS	88003	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
166456	Fee-for-Service	1528116407	1528116407	1	1	FOGAN, LANCE MD	1/1/1982	2084N0400X	NA	Neurology	026	PHYSICIANS	14086	13	Neurology (M.D. only)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
166541	Fee-for-Service	1528331287	1528331287	1	2	FAMILY HEALTH CENTERS OF	10/22/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1550 BROADWAY	SUITE P002	SAN DIEGO	CA	92101	5713	37	06073	32.71579987	-117.1499238	San Diego County
166631	Fee-for-Service	1245493246	1245493246	1	1	FARIS KHAN	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MEDICAL	None	OMAHA	NE	68198	7400	00	None	0	0	None
166700	Fee-for-Service	1922619923	1922619923	1	1	FORTUNE HEALTH CARE SERVICES	11/29/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	225 E BROADWAY	STE 104	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
166783	Fee-for-Service	1821404740	1821404740	1	1	FRESENIUS MEDICAL CARE	7/1/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ALHAMBRA LLC	2300 W VALLEY BLVD	None	ALHAMBRA	CA	91803	1930	19	06037	34.07702781	-118.1490248	Los Angeles County
166847	Fee-for-Service	1861507832	1861507832	3	1	FRANK, ROBERTA L CNM	2/1/2015	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	3343 4TH AVE	None	SAN DIEGO	CA	92103	5703	37	06073	32.740353	-117.1612435	San Diego County
166859	Fee-for-Service	1578094447	1578094447	1	1	FAIZ, JESSICA MD	9/23/2021	207P00000X	NA	Other	026	PHYSICIANS	171548	None	None	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
166883	Fee-for-Service	1093912024	1093912024	1	1	FLOOD, JENNIFER M MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	62384	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
166932	Fee-for-Service	1497844401	1497844401	1	1	FELICIANO, EVA J MD	11/1/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	68287	40	Pediatrics	0	In state provider	None	1505 W 17TH ST	None	SAN BERNARDINO	CA	92411	1202	36	06071	34.13045153	-117.31869	San Bernardino County
166943	Fee-for-Service	1336609445	1336609445	1	1	FREGOSO, GABRIEL MD	9/4/2024	207LC0200X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
166961	Fee-for-Service	1881988814	1881988814	1	1	FALLBROOK MEDICAL CENTER, IN	6/19/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	593 E ELDER ST	SUITE B	FALLBROOK	CA	92028	5000	37	06073	33.3801147	-117.2453962	San Diego County
166963	Fee-for-Service	1508838251	1508838251	1	1	FUTENMA, CLAIRE E DPM	6/2/2009	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	133 N ALTADENA DR	FL 2	PASADENA	CA	91107	7325	19	06037	34.14843	-118.0986385	Los Angeles County
166986	Fee-for-Service	1205442654	1205442654	1	1	FAST CARE HOSPICE, INC	2/15/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7940 E GARVEY AVE	STE 206A	ROSEMEAD	CA	91770	2454	19	06037	34.06260948	-118.095489	Los Angeles County
167001	Fee-for-Service	1215139167	1215139167	1	1	FINCH, MICHAEL R MD	8/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91110	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
167040	Fee-for-Service	1669549424	1669549424	1	1	FUKUZAWA, MASAYUKI NP	8/7/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
167055	Fee-for-Service	1306189717	1306189717	1	1	FOSTER, ASHLEY A MD	8/23/2022	2080P0204X	NA	Other	026	PHYSICIANS	134012	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
167060	Fee-for-Service	1679589139	1679589139	1	1	FARZANEGAN, FARHAD MD	4/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102887	30	Radiology	0	In state provider	None	6600 BRUCEVILE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
167176	Fee-for-Service	1295048486	1295048486	1	1	FELMAN, IRA E MD	12/7/2010	207RH0003X	NA	Oncology	026	PHYSICIANS	37852	68	Hematology	0	In state provider	None	416 W LAS TUNAS DRIVE	#205	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
167184	Fee-for-Service	1215094941	1215094941	1	1	FINN, HOWARD S MD	5/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69175	05	Anesthesiology	0	In state provider	None	1711 W TEMPLE STREET	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
167273	Fee-for-Service	1205442654	1205442654	1	1	FAST CARE HOSPICE, INC	2/15/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7940 E GARVEY AVE	STE 206A	ROSEMEAD	CA	91770	2454	19	06037	34.06260948	-118.095489	Los Angeles County
167318	Fee-for-Service	1861462640	1861462640	1	1	FIREK, ANTHONY MD	12/31/1988	207RE0101X	NA	Endocrinology	026	PHYSICIANS	55956	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	# 3500	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
167331	Fee-for-Service	1427542828	1427542828	1	1	FLAMM, GABRIELLE K MD	12/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191515	None	None	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
167416	Fee-for-Service	1275529729	1275529729	1	1	FRELING, CLIFFORD MD	3/26/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
167421	Fee-for-Service	1639185838	1639185838	1	1	FARBER, LEONARD A MD	2/7/2018	2085R0001X	NA	Other	026	PHYSICIANS	153081	30	Radiology	0	In state provider	None	2151 N HARBOR BLVD	STE 1500	FULLERTON	CA	92835	3823	30	06059	33.89443025	-117.9288328	Orange County
167439	Fee-for-Service	1104288125	1104288125	1	1	FERNANDEZ HERNANDEZ, EDUARDO	7/29/2023	207RH0000X	NA	Hematology	026	PHYSICIANS	168560	None	None	0	In state provider	MD	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
167465	Fee-for-Service	1295048486	1295048486	1	1	FELMAN, IRA E MD	12/7/2010	207RH0003X	NA	Oncology	026	PHYSICIANS	37852	41	Internal Medicine	0	In state provider	None	416 W LAS TUNAS DRIVE	#205	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
167542	Fee-for-Service	1316051782	1316051782	1	1	FAGNER, JOSEPH STARR MD	8/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4400 LONG PRAIRIE RD	None	FLOWER MOUND	TX	75028	1892	00	None	33.04555568	-97.06928561	Denton County
167556	Fee-for-Service	1174789705	1174789705	1	1	FORTUNE, ATRI LMFT	8/24/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
167578	Fee-for-Service	1639601842	1639601842	1	1	FLORESCU, COSMIN	3/21/2024	207P00000X	NA	Other	026	PHYSICIANS	169408	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
167655	Fee-for-Service	1043410871	1043410871	1	1	FERAMISCO, JAMISON D	5/11/2011	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	105161	None	None	0	In state provider	None	1125 SIR FRANCIS DRAKE	None	KENTFIELD	CA	94904	1418	21	06041	37.95899686	-122.5520873	Marin County
167677	Fee-for-Service	1073505244	1073505244	1	1	FISHER, KEVIN A MD	8/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	49070	32	Radiation Therapy (D.O. only)	0	In state provider	None	1069 LOS PALOS DR	None	SALINAS	CA	93901	3916	27	06053	36.65855557	-121.6450018	Monterey County
167722	Fee-for-Service	1073904462	1073904462	1	1	FILLMORE AREA TRANSIT CORP	6/24/2021	347B00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	359 CENTRAL AVENUE	None	FILLMORE	CA	93015	1758	56	06111	34.4003887	-118.913724	Ventura County
167753	Fee-for-Service	1295048486	1295048486	1	1	FELMAN, IRA E MD	12/7/2010	207RH0003X	NA	Oncology	026	PHYSICIANS	37852	78	Neoplastic Diseases/Oncology	0	In state provider	None	416 W LAS TUNAS DRIVE	#205	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
167759	Fee-for-Service	1316997737	1316997737	1	1	FAUSONE, GARY W MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	64237	None	None	0	In state provider	None	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
167782	Fee-for-Service	1073670246	1073670246	1	1	FENNIMORE, JULIE F PHD	10/3/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
167804	Fee-for-Service	1437174240	1437174240	1	2	FALLBROOK-RANCHO SURGERY AMC	12/1/1997	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	25405 HANCOCK AVE	STE 202	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
167826	Fee-for-Service	1164871513	1164871513	1	1	FLUELLEN, SUNETRIS MD	8/11/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168430	None	None	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
167847	Fee-for-Service	1538246483	1538246483	1	1	FRAGER, NEAL B MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	50390	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
167898	Fee-for-Service	1124106976	1124106976	1	1	FRANK, GERALD W MD	6/1/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	19214	41	Internal Medicine	0	In state provider	None	4281 24TH ST	None	SAN FRANCISCO	CA	94114	3616	38	06075	37.751021	-122.4380665	San Francisco County
167910	Fee-for-Service	1942531983	1942531983	1	2	FIRST STEPS PRENATAL CARE	4/5/2012	193400000X	NA	Other	026	PHYSICIANS	36515	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	AMC	49281 GRAPEFRUIT BLVD	STE 1	COACHELLA	CA	92236	1712	33	06065	33.68999567	-116.1828461	Riverside County
167924	Fee-for-Service	1720495047	1720495047	1	1	FRANCIS, AMBER LCSW	2/29/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
167955	Fee-for-Service	1588003305	1588003305	1	1	FERRARI, TERRI L MD	4/26/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	134458	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
167982	Fee-for-Service	1144368333	1144368333	1	1	FORD, PAUL M MD	2/28/1990	207R00000X	NA	Other	026	PHYSICIANS	68699	01	General Practice	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
167989	Fee-for-Service	1306045976	1306045976	1	1	FU, EMERY J MD	5/11/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	91981	-	NOT APPLICABLE	0	In state provider	None	2050 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1001	01	06001	37.710738	-122.1146415	Alameda County
167994	Fee-for-Service	1427505759	1427505759	1	1	FREIE, BARBARA LMFT	10/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	484 MOBIL AVE STE 13	None	CAMARILLO	CA	93010	6361	56	06111	34.221672	-119.042953	Ventura County
168021	Fee-for-Service	1861980088	1861980088	1	1	FERARU, LUCIAN M DPM	3/11/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1701 E CESAR E CHAVEZ AV	STE 100	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
168026	Fee-for-Service	1629535083	1629535083	1	1	FRANCKE, EMILY K CRNA	10/21/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
168078	Fee-for-Service	1952929069	1952929069	1	1	FRIEDEN HOSPICE CARE	2/25/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6308 WOODMAN AVE	STE 207	VAN NUYS	CA	91401	2388	19	06037	34.185123	-118.4312405	Los Angeles County
168084	Fee-for-Service	1255595195	1255595195	1	1	FRITZ, ERIN P. MD	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 CHICAGO AVE	None	MINNEAPOLIS	MN	55404	4518	00	None	44.95666589	-93.26255996	Hennepin County
168167	Fee-for-Service	1861127219	1861127219	1	1	FOX, DELANIE PT	9/9/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25136 HANCOCK AVE	STE A	MURRIETA	CA	92562	5944	33	06065	33.56788654	-117.1824198	Riverside County
168189	Fee-for-Service	1245258433	1245258433	1	1	FOX, BRYAN J MD	7/23/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	73471	01	General Practice	0	In state provider	None	10225 AUSTIN DR	STE 101	SPRING VALLEY	CA	91978	1521	37	06073	32.73081646	-116.9707735	San Diego County
168249	Fee-for-Service	1043263775	1043263775	1	1	FULTON, RICHARD E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12324	30	Radiology	0	In state provider	None	345 S A ST	None	OXNARD	CA	93030	5804	56	06111	34.19938431	-119.1786013	Ventura County
168365	Fee-for-Service	1952929069	1952929069	1	1	FRIEDEN HOSPICE CARE	2/25/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6308 WOODMAN AVE	STE 207	VAN NUYS	CA	91401	2388	19	06037	34.185123	-118.4312405	Los Angeles County
168385	Fee-for-Service	1376009969	1376009969	1	1	FAMILY HORIZONS INC.	4/18/2022	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	10737 LAUREL ST	220	RANCHO CUCAMONGA	CA	91730	3837	36	06071	34.10515337	-117.570867	San Bernardino County
168433	Fee-for-Service	1457410177	1457410177	1	1	FERRARA, ANDREA M CNM	10/21/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
168457	Fee-for-Service	1568615607	1568615607	1	1	FIEDLER, FARANAK S MD	7/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117514	08	Family Practice	0	In state provider	None	1199 BUSH ST	STE 400	SAN FRANCISCO	CA	94109	5999	38	06075	37.7891291	-122.4167087	San Francisco County
168459	Fee-for-Service	1033593892	1033593892	1	1	FERNBERG, LAUREN M NP	8/25/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1335 N WATERMAN AVENUE	None	SAN BERNARDINO	CA	92404	5385	36	06071	34.124274	-117.2787625	San Bernardino County
168465	Fee-for-Service	1447324934	1447324934	1	1	FONG, SCOTT C OD	9/30/1991	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	NATOMAS EYEWORKS OPT	2735 DEL PASO RD	STE 120	SACRAMENTO	CA	95835	2311	34	06067	38.657385	-121.523877	Sacramento County
168475	Fee-for-Service	1376886150	1376886150	1	1	FAN, JENNIFER J Y MD	6/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133391	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
168498	Fee-for-Service	1225477557	1225477557	1	1	FENG, ALEXANDER MD	6/7/2018	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	25	Physical Medicine and Rehabilitation	0	In state provider	None	2625 W ALAMEDA AVE	STE 116	BURBANK	CA	91505	4815	19	06037	34.1577056	-118.329779	Los Angeles County
168619	Fee-for-Service	1528010204	1528010204	1	1	FERNANDO, IRENE R NP	1/24/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	399 E HIGHLAND AVE	STE 401	SAN BERNARDINO	CA	92402	3862	36	06071	34.1358627	-117.2757898	San Bernardino County
168669	Fee-for-Service	1821023862	1821023862	1	1	FORDE, NICHOLAS H MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	79972	02	General Surgery	0	In state provider	None	4730 47TH AVE	None	SACRAMENTO	CA	95824	3946	34	06067	38.509983	-121.451157	Sacramento County
168670	Fee-for-Service	1376639682	1376639682	1	1	FUNG, MAISIE M MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71105	08	Family Practice	0	In state provider	None	502 TORRANCE BLVD	None	REDONDO BEACH	CA	90277	3413	19	06037	33.83783749	-118.3832414	Los Angeles County
168675	Fee-for-Service	1376009969	1376009969	1	1	FAMILY HORIZONS INC.	4/18/2022	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	10737 LAUREL ST	220	RANCHO CUCAMONGA	CA	91730	3837	36	06071	34.10515337	-117.570867	San Bernardino County
168694	Fee-for-Service	1710551296	1710551296	1	1	FITTANTE, RAECHEL A LMFT	3/23/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
168696	Fee-for-Service	1043424971	1043424971	1	1	FIRME, STEVE RANDAL E MD	9/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	56129	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	RAINBOW PEDIATRICS STEVE	980 E FOOTHILL BLVD	STE 102	UPLAND	CA	91786	4068	36	06071	34.10679351	-117.6379419	San Bernardino County
168708	Fee-for-Service	1689698102	1689698102	1	1	FREEMAN, WILLIAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3223 8TH STREET	None	METAIRIE	LA	70002	1623	00	None	30.01636823	-90.15581839	Jefferson Parish
168743	Fee-for-Service	1598097982	1598097982	1	1	FRESENIUS MEDICAL CARE	6/18/2010	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA LLC	2205 WEST ROSS AVE	SUITE 3 & 4	EL CENTRO	CA	92243	3623	13	06025	32.78140945	-115.5804242	Imperial County
168777	Fee-for-Service	1831465897	1831465897	1	1	FERRER, HAIDEE S LMFT	10/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12530 10TH ST	STE C	CHINO	CA	91710	3520	36	06071	34.0258983	-117.6869086	San Bernardino County
168803	Fee-for-Service	1659877454	1659877454	1	1	FRELING, ALEC B MD	10/1/2021	207P00000X	NA	Other	026	PHYSICIANS	174047	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
168831	Fee-for-Service	1184893513	1184893513	1	1	FARROHI, PARISA J LCSW	3/25/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
168925	Fee-for-Service	1326177296	1326177296	1	1	FRANCO, DENNIS P MD	5/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	61849	01	General Practice	0	In state provider	None	1414 S GRAND AVE	STE 123	LOS ANGELES	CA	90015	3010	19	06037	34.03661142	-118.2657227	Los Angeles County
168958	Fee-for-Service	1376639682	1376639682	1	1	FUNG, MAISIE M MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71105	01	General Practice	0	In state provider	None	502 TORRANCE BLVD	None	REDONDO BEACH	CA	90277	3413	19	06037	33.83783749	-118.3832414	Los Angeles County
168988	Fee-for-Service	1043424971	1043424971	1	1	FIRME, STEVE RANDAL E MD	9/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	56129	40	Pediatrics	0	In state provider	RAINBOW PEDIATRICS STEVE	980 E FOOTHILL BLVD	STE 102	UPLAND	CA	91786	4068	36	06071	34.10679351	-117.6379419	San Bernardino County
169129	Fee-for-Service	1275111601	1275111601	1	1	FLORES-MENDEZ, FERNANDO	12/11/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
169137	Fee-for-Service	1689655045	1689655045	1	1	FOOTHILL CARE CENTER INC	12/2/1991	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1758 N BIG DALTON AVE	None	BALDWIN PARK	CA	91706	5910	19	06037	34.06902724	-117.9674883	Los Angeles County
169274	Fee-for-Service	1982919007	1982919007	1	1	FELIX, MELISSA E LMFT	11/27/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2545 S EUCLID AVE	None	ONTARIO	CA	91762	6620	36	06071	34.02683603	-117.6505972	San Bernardino County
169326	Fee-for-Service	1538496419	1538496419	1	1	FARHADIAN, PARASTOU MD	4/28/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	109662	None	None	0	In state provider	None	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	19	06037	34.2214515	-118.4573205	Los Angeles County
169390	Fee-for-Service	1609097229	1609097229	1	1	FAMILY CARE ADHC, INC	2/25/2009	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	6434-6440 COLDWATER CNYN	None	NORTH HOLLYWOOD	CA	91606	1113	19	06037	34.18786084	-118.4137767	Los Angeles County
169406	Fee-for-Service	1215063862	1215063862	1	1	FEINSTAT, THEODOR MD	10/31/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	42319	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2 MEDICAL PLAZA DR	STE 270	ROSEVILLE	CA	95661	3044	31	06061	38.76507948	-121.2477476	Placer County
169484	Fee-for-Service	1992899769	1992899769	1	1	FAMILY PLANNING ASSOC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	165 N CLARK ST	None	FRESNO	CA	93701	2108	10	06019	36.74454278	-119.786043	Fresno County
169519	Fee-for-Service	1861437816	1861437816	1	1	FOWER, FRANK MD	8/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	50063	None	None	0	In state provider	None	3350 W BALL RD	None	ANAHEIM	CA	92804	3710	30	06059	33.8172623	-118.0071207	Orange County
169540	Fee-for-Service	1992962765	1992962765	1	1	FARINHOLT, GINA N MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106135	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
169689	Fee-for-Service	1689136640	1689136640	1	1	FAMILY FIRST HOME HEALTHCARE	5/30/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	15317 PARAMOUNT BLVD	STE 201	PARAMOUNT	CA	90723	4358	19	06037	33.89423811	-118.1602067	Los Angeles County
169691	Fee-for-Service	1841377793	1841377793	1	1	FABISIAK, KEITH A MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	71010	40	Pediatrics	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
169694	Fee-for-Service	1215063862	1215063862	1	1	FEINSTAT, THEODOR MD	10/31/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	42319	10	Gastroenterology (M.D. only)	0	In state provider	None	2 MEDICAL PLAZA DR	STE 270	ROSEVILLE	CA	95661	3044	31	06061	38.76507948	-121.2477476	Placer County
169868	Fee-for-Service	1487811535	1487811535	1	1	FUX-WARNER, SUSANNE K LMFT	3/13/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1908 SWEETWATER RD	None	NATIONAL CITY	CA	91950	7628	37	06073	32.66119079	-117.0786584	San Diego County
169873	Fee-for-Service	1730267071	1730267071	1	1	FUQUA, CHARLES S PT	1/28/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 E BIDWELL ST	#101	FOLSOM	CA	95630	3452	34	06067	38.66841	-121.151025	Sacramento County
169909	Fee-for-Service	1871322974	1871322974	1	1	FLORES, RITA AU	10/18/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	550 W RANCH VIEW DR	2005	ROCKLIN	CA	95765	5396	31	06061	38.83760761	-121.2972372	Placer County
170027	Fee-for-Service	1578533865	1578533865	1	1	FREYER, DAVID R MD	11/27/2007	2080P0207X	NA	Hematology	026	PHYSICIANS	10181	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	MS #54	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
170147	Fee-for-Service	1538212329	1538212329	1	1	FERNANDEZ-FRACKELTON, M	4/1/1999	207P00000X	NA	Other	026	PHYSICIANS	63892	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
170348	Fee-for-Service	1538420104	1538420104	1	11	FIRST CHOICE PHYSICIAN PARTN	6/26/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ARTNERS	2727 BUENA VISTA DR	STE. 210	PASO ROBLES	CA	93446	8580	40	06079	35.6484081	-120.6722826	San Luis Obispo County
170393	Fee-for-Service	1114164449	1114164449	1	1	FONG, ALEX MD	3/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107315	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
170442	Fee-for-Service	1306140884	1306140884	1	1	FRANCIS, HEATHER M PT	7/5/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
170514	Fee-for-Service	1306084173	1306084173	1	1	FORNWALT, HARRY C III MD	6/1/2009	207R00000X	NA	Other	026	PHYSICIANS	103430	41	Internal Medicine	0	In state provider	None	15725 WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
170526	Fee-for-Service	1245262963	1245262963	1	1	FEINSTEIN, JOEL D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	32018	10	Gastroenterology (M.D. only)	0	In state provider	None	8631 W 3RD ST	STE 825E	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
170558	Fee-for-Service	1326142795	1326142795	1	1	FISHER, DANIEL C MD	6/30/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54920	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	6401 COYLE AVE	STE 416	CARMICHAEL	CA	95608	0310	34	06067	38.668698	-121.3148745	Sacramento County
170566	Fee-for-Service	1760877120	1760877120	1	1	FISH, STEVEN MD	10/25/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	164497	18	Ophthalmology	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
170653	Fee-for-Service	1851913115	1851913115	1	1	FONG, LILLY NP	4/28/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
170672	Fee-for-Service	1073545125	1073545125	1	1	FLORIDIA, ROSARIO JR MD	7/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83295	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
170747	Fee-for-Service	1841449154	1841449154	1	1	FLOURNOY, STEPHANIE E LCSW	4/21/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	738 E MAIN ST	None	VENTURA	CA	93001	2906	56	06111	34.28080954	-119.2894245	Ventura County
170814	Fee-for-Service	1427043280	1427043280	1	1	FACEMIRE, ANABEL S MD	6/12/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	135547	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 SIERRA COLLEGE DR	STE 105	GRASS VALLEY	CA	95945	5763	29	06057	39.23410746	-121.0515391	Nevada County
170837	Fee-for-Service	1083635411	1083635411	1	1	FERNANDEZ, MARIA I MD	2/20/2004	103T00000X	NA	Mental Health Outpatient Services	026	PHYSICIANS	62676	36	Psychiatry	0	In state provider	None	2323 SACRAMENTO ST	FL 2	SAN FRANCISCO	CA	94115	2328	38	06075	37.790109	-122.431555	San Francisco County
170877	Fee-for-Service	1689610388	1689610388	1	1	FISHER, TODD M MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	60711	66	Emergency Medicine (Urgent Care)	0	In state provider	SUN RIVER MEDICAL CORP	7501 HOSPITAL DR	STE 305	SACRAMENTO	CA	95823	5405	34	06067	38.464776	-121.416912	Sacramento County
170878	Fee-for-Service	1144085812	1144085812	1	1	FBN LOGISTICS, INC	8/2/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1101 MARINA VILLAGE PKWY	201	ALAMEDA	CA	94501	3579	01	06001	37.78594823	-122.2729465	Alameda County
170881	Fee-for-Service	1639699226	1639699226	1	1	FURNISS, CHRISTIANE K LCSW	12/8/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1062 G ST STE D	None	ARCATA	CA	95521	5800	12	06023	40.87008261	-124.0852546	Humboldt County
170955	Fee-for-Service	1780649848	1780649848	1	1	FIELD, ADAM G MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87461	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
170975	Fee-for-Service	1699133454	1699133454	1	1	FRANK, MEREDITH E LMFT	2/19/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
171048	Fee-for-Service	1346354750	1346354750	1	1	FISCH, JEFFREY D MD	10/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	82303	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
171165	Fee-for-Service	1689610388	1689610388	1	1	FISHER, TODD M MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	60711	41	Internal Medicine	0	In state provider	SUN RIVER MEDICAL CORP	7501 HOSPITAL DR	STE 305	SACRAMENTO	CA	95823	5405	34	06067	38.464776	-121.416912	Sacramento County
171207	Fee-for-Service	1265540405	1265540405	1	1	FRANKLIN LIU MD	11/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4801 W 81ST ST	STE 108	MINNEAPOLIS	MN	55437	1111	00	None	44.85623947	-93.34035	Hennepin County
171262	Fee-for-Service	1568523751	1568523751	1	1	FANG, CHI-HUA M MD	9/22/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	67095	18	Ophthalmology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3194	07	06013	37.9141514	-122.0422089	Contra Costa County
171273	Fee-for-Service	1518599299	1518599299	1	1	FAITH, HOPE & LOVE HOSPICE	6/8/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	4959 PALO VERDE STREET	STE 201B-1	MONTCLAIR	CA	91763	2341	36	06071	34.08129954	-117.6966135	San Bernardino County
171293	Fee-for-Service	1477504355	1477504355	1	1	FELDMAN, ERIC D MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36713	25	Physical Medicine and Rehabilitation	0	In state provider	None	2865 ATLANTIC AVE	STE 106	LONG BEACH	CA	90806	7414	19	06037	33.809418	-118.185058	Los Angeles County
171329	Fee-for-Service	1598775140	1598775140	1	1	FEDORKO, TRUDY DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3500 W WHEATLAND RD	None	DALLAS	TX	75237	3460	00	None	32.64745255	-96.8764365	Dallas County
171361	Fee-for-Service	1396062311	1396062311	1	1	FANG, GWENDOLINE MD	9/9/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163159	09	Gynecology (D.O. only)	0	In state provider	None	1600 WEST AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
171450	Fee-for-Service	1164948063	1164948063	1	1	FONNEGRA, LOUANNA B LMFT	8/27/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15455 SAN FERNANDO MISSO	#300	MISSION HILLS	CA	91345	1353	19	06037	34.27194157	-118.469079	Los Angeles County
171547	Fee-for-Service	1962460188	1962460188	1	1	FALK, RENA ELLEN MD	12/11/2002	174400000X	NA	Other	026	PHYSICIANS	24763	40	Pediatrics	0	In state provider	None	444 S SAN VICENTE BLVD	STE 1001	LOS ANGELES	CA	90048	4170	19	06037	34.06999878	-118.3755119	Los Angeles County
171559	Fee-for-Service	1518599299	1518599299	1	1	FAITH, HOPE & LOVE HOSPICE	6/8/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	4959 PALO VERDE STREET	STE 201B-1	MONTCLAIR	CA	91763	2341	36	06071	34.08129954	-117.6966135	San Bernardino County
171598	Fee-for-Service	1780244319	1780244319	1	1	FRAZIER, SHERI L LCSW	4/4/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
171674	Fee-for-Service	1003876418	1003876418	1	1	FELDMAN, LEON A MD	7/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75326	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
171689	Fee-for-Service	1932917838	1932917838	1	1	FAROKHZAD, ELAINA LMFT	1/9/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	500 CAPITOL MALL	SUITE 2350	SACRAMENTO	CA	95814	4737	34	06067	38.578059	-121.501422	Sacramento County
171812	Fee-for-Service	1558577403	1558577403	1	1	FARRELL, JENNIFER L MD	8/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104521	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
171827	Fee-for-Service	1174601892	1174601892	1	1	FRIEND, JEFFREY M MD	7/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85989	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
171844	Fee-for-Service	1699737403	1699737403	1	1	FISHMAN, ALAN MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	63789	47	Miscellaneous	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
171864	Fee-for-Service	1659016665	1659016665	1	1	FISCUS, TIMOTHY M DO	1/1/2025	207P00000X	NA	Other	026	PHYSICIANS	21774	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1303 EAST HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
171910	Fee-for-Service	1730256611	1730256611	1	1	FOK, HURBERT H DO	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7067	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
171944	Fee-for-Service	1952917528	1952917528	2	1	FULLERTON PHARMACY, INC.	3/26/2024	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1820 FULLERTON AVE	STE 105	CORONA	CA	92881	3160	33	06065	33.858756	-117.5503465	Riverside County
171961	Fee-for-Service	1003876418	1003876418	1	1	FELDMAN, LEON A MD	7/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75326	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
171992	Fee-for-Service	1720034960	1720034960	1	1	FARLESS, CAROLINE L NP	8/30/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
172015	Fee-for-Service	1144472010	1144472010	1	1	FOUNTAIN, STEVEN S MD	5/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	33261	20	Orthopedic Surgery	0	In state provider	None	74-990 COUNTRY CLUB DR	# 310	PALM DESERT	CA	92260	1991	33	06065	33.68690379	-116.4073666	Riverside County
172127	Fee-for-Service	1033360060	1033360060	1	1	FEINSTEIN, ANAT PHD	11/26/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
172134	Fee-for-Service	1699737403	1699737403	1	1	FISHMAN, ALAN MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	63789	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
172150	Fee-for-Service	1053576801	1053576801	1	1	FELIX, SUMI T MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115520	01	General Practice	0	In state provider	None	1818 N ORANGE GROVE AVE	#204	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
172151	Fee-for-Service	1679929525	1679929525	1	1	FONG, MARC W CRNA	6/29/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVENUE	2ND FLOOR ANESTHESIA	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
172158	Fee-for-Service	1548798291	1548798291	1	1	FINCH, SHEA A MD	7/28/2023	208M00000X	NA	Other	026	PHYSICIANS	185114	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
172191	Fee-for-Service	1619173028	1619173028	1	1	FAHS, RENEE L PHD	8/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
172241	Fee-for-Service	1730827023	1730827023	1	1	FAMILY LEGACY THERAPY PROFES	6/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SIONAL CORPORATION	1350 W ROBINHOOD DR	STE 7	STOCKTON	CA	95207	5519	39	06077	37.9983704	-121.3242298	San Joaquin County
172273	Fee-for-Service	1720052459	1720052459	1	1	FAN, RYAN A MD	12/22/2017	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	90660	None	None	0	In state provider	None	11190 WARNER AVE	SUITE 300	FOUNTAIN VALLEY	CA	92708	4019	30	06059	33.714	-117.9333585	Orange County
172289	Fee-for-Service	1386905016	1386905016	1	1	FALCK NORTHERN CALIFORNIA CO	10/23/2015	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	28333 INDUSTRIAL	None	HAYWARD	CA	94545	4428	01	06001	37.61713633	-122.0939135	Alameda County
172342	Fee-for-Service	1033180492	1033180492	1	1	FINDLEY, JOHN R MD INC	7/26/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	49637	05	Anesthesiology	0	In state provider	None	841 MOHAWK ST	STE 270	BAKERSFIELD	CA	93309	1547	15	06029	35.36193277	-119.0628694	Kern County
172349	Fee-for-Service	1528445392	1528445392	1	1	FAN, JOLINE MD	6/22/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	147125	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
172454	Fee-for-Service	1457386724	1457386724	1	1	FEENEY, CRAIG M MD	10/20/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	36976	None	None	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
172459	Fee-for-Service	1902185085	1902185085	1	1	FEWLASS, DARIUS C MD	1/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121543	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
172470	Fee-for-Service	1700214780	1700214780	1	1	FACULTY PHYSICIANS AND	4/10/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM	25865 BARTON RD	D101, D102, D103, D104	LOMA LINDA	CA	92354	3895	36	06071	34.04824853	-117.2403225	San Bernardino County
172474	Fee-for-Service	1851478705	1851478705	1	1	FISK, STEPHEN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30360	05	Anesthesiology	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
172530	Fee-for-Service	1942978820	1942978820	1	1	FONG, THASANEE NP	10/15/2021	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	854 MAGNOLIA AVE	STE 201	CORONA	CA	92879	3109	33	06065	33.8605591	-117.5513844	Riverside County
172576	Fee-for-Service	1225147101	1225147101	1	2	FAUCHER, KIMBERLY R MD	6/13/2022	207VG0400X	NA	Obstetrics & Gynecology	086	MEDICAL DIRECTORS	74987	-	NOT APPLICABLE	0	In state provider	None	810 N STATE ST	None	UKIAH	CA	95482	3410	23	06045	39.1579762	-123.2085995	Mendocino County
172624	Fee-for-Service	1265640775	1265640775	1	1	FARZIN, AZADEH MD	8/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100388	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
172814	Fee-for-Service	1730371832	1730371832	1	1	FUNCHAIN, PAULINE MD	12/5/2023	207RX0202X	NA	Oncology	026	PHYSICIANS	101032	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
172911	Fee-for-Service	1265640775	1265640775	1	1	FARZIN, AZADEH MD	8/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100388	40	Pediatrics	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
172920	Fee-for-Service	1871715193	1871715193	1	1	FOOTHILL CARE CENTER II LLC	10/14/1999	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	332 N MORRIS AVE	None	WEST COVINA	CA	91790	1411	19	06037	34.07787366	-117.9455143	Los Angeles County
172934	Fee-for-Service	1215003090	1215003090	1	1	FRANK, JONATHAN D MD	12/7/2019	207R00000X	NA	Other	026	PHYSICIANS	30274	41	Internal Medicine	0	In state provider	None	1210 ROSSMOOR PARKWAY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87774537	-122.0710148	Contra Costa County
172936	Fee-for-Service	1831277946	1831277946	1	1	FARHIDVASH, FARIBA	5/16/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	176343	None	None	0	In state provider	None	44045 MARGARITA RD	STE 106	TEMECULA	CA	92592	2729	33	06065	33.48351542	-117.1027964	Riverside County
172959	Fee-for-Service	1609948454	1609948454	1	1	FLORES, DIVINA G MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75782	36	Psychiatry	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
173016	Fee-for-Service	1427076066	1427076066	1	1	FUENTES-ALMEDA, GLENDA J PT	5/1/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1135 S SUNSET AVE	SUITE 101	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
173034	Fee-for-Service	1265686109	1265686109	1	3	FACULTY PHYSICIANS AND SURGE	11/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11234 ANDERSON ST	SUITE 6200	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
173119	Fee-for-Service	1639208804	1639208804	1	1	FLORES, DAVID CHARLES DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	10412 MAIN ST	None	LAMONT	CA	93241	1727	15	06029	35.2605183	-118.9145592	Kern County
173125	Fee-for-Service	1508933466	1508933466	1	1	FISCH, JOSEPH R MD	1/1/1993	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	49954	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
173170	Fee-for-Service	1083060180	1083060180	1	1	FARZAL, ZAINAB MD MPH	6/13/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	185484	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
173220	Fee-for-Service	1649324625	1649324625	1	1	FICK, DARYL MD	12/27/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	172965	None	None	0	In state provider	None	8860 CENTER DR STE 420	None	LA MESA	CA	91942	7001	37	06073	32.78189749	-117.0075062	San Diego County
173247	Fee-for-Service	1609948454	1609948454	1	1	FLORES, DIVINA G MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75782	26	Psychiatry (child)	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
173323	Fee-for-Service	1265686109	1265686109	1	3	FACULTY PHYSICIANS AND SURGE	11/2/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	11234 ANDERSON ST	SUITE 6200	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
173329	Fee-for-Service	1851349641	1851349641	2	1	FEE, HENRY J MD INC	8/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	28628	33	Thoracic Surgery	0	In state provider	None	14911 NATIONAL AVE	STE 6	LOS GATOS	CA	95032	2632	43	06085	37.25172742	-121.951483	Santa Clara County
173338	Fee-for-Service	1548044852	1548044852	1	1	FRANKLIN, LYVESHA	3/14/2025	172V00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	27	06053	0	0	None
173355	Fee-for-Service	1780841445	1780841445	1	1	FERDINAND-GANT, VICTORIA V	1/8/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	23201 MILL CREEK DR	STE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
173393	Fee-for-Service	1417443045	1417443045	1	1	FELDMAN, SAMUEL R MD	6/29/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	176582	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
173450	Fee-for-Service	1023299203	1023299203	1	1	FUNN, NASHIRA Y LCSW	3/18/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ING	8782 VANGUARD ST	None	CHINO	CA	91708	9467	36	06071	33.95612183	-117.6128159	San Bernardino County
173479	Fee-for-Service	1265068225	1265068225	1	1	FLORES, TAMMERA MD	11/7/2023	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
173545	Fee-for-Service	1588654875	1588654875	1	1	FEIT, ERIC I	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53686	41	Internal Medicine	0	In state provider	None	2625 W ALAMEDA AVE	STE 300	BURBANK	CA	91505	4819	19	06037	34.1577056	-118.329779	Los Angeles County
173588	Fee-for-Service	1922042076	1922042076	1	1	FINLEY, JOHN M DO	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	5583	89	Surgery-Traumatic	0	In state provider	None	3300 E SOUTH ST	STE 308	LONG BEACH	CA	90805	4549	19	06037	33.86018093	-118.1537163	Los Angeles County
173591	Fee-for-Service	1063828697	1063828697	1	1	FERRER, MELODI A CCC-SLP	10/15/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	556 N 1ST ST	SUITE 201	SAN JOSE	CA	95112	5300	43	06085	37.34591974	-121.8977166	Santa Clara County
173609	Fee-for-Service	1265686109	1265686109	1	3	FACULTY PHYSICIANS AND SURGE	7/19/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11234 ANDERSON ST	SUITE 6200	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
173615	Fee-for-Service	1851349641	1851349641	2	1	FEE, HENRY J MD INC	8/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	28628	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	14911 NATIONAL AVE	STE 6	LOS GATOS	CA	95032	2632	43	06085	37.25172742	-121.951483	Santa Clara County
173681	Fee-for-Service	1508989468	1508989468	1	1	FOWLER, WILEY L MD	8/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100547	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
173836	Fee-for-Service	1356847024	1356847024	1	1	FLORANTE, ROSARIO CORAZON C	3/25/2022	207R00000X	NA	Other	026	PHYSICIANS	173829	None	None	0	In state provider	None	1011 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72827776	-121.2904066	Placer County
173850	Fee-for-Service	1871599852	1871599852	1	1	FINNIGAN, DAVID P MD	3/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89076	40	Pediatrics	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
173874	Fee-for-Service	1902018385	1902018385	1	1	FRIDMAN, ALEX JR MD	10/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103675	41	Internal Medicine	0	In state provider	None	18460 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
173882	Fee-for-Service	1922042076	1922042076	1	1	FINLEY, JOHN M DO	8/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	5583	41	Internal Medicine	0	In state provider	None	3300 E SOUTH ST	STE 308	LONG BEACH	CA	90805	4549	19	06037	33.86018093	-118.1537163	Los Angeles County
173899	Fee-for-Service	1801868013	1801868013	1	1	FOOT SPECIALISTS OF	6/4/1984	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	THE CONEJO VALLEY	32144 AGOURA RD	SUITE 105	WESTLAKE VILLAGE	CA	91361	4052	19	06037	34.14848408	-118.8208595	Los Angeles County
173916	Fee-for-Service	1821313198	1821313198	1	1	FUERCH, JANENE H MD	5/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117694	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
173932	Fee-for-Service	1245389238	1245389238	1	1	FELAHY, BASIL	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	36908	None	None	0	In state provider	None	21520 PIONEER BLVD	STE 204	HAWAIIAN GARDENS	CA	90716	2601	19	06037	33.83331082	-118.0817764	Los Angeles County
173984	Fee-for-Service	1568421329	1568421329	1	1	FREIJ, BISHARA MD	6/20/2024	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	77	Infectious Disease	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
174030	Fee-for-Service	1861487233	1861487233	1	1	FLORES, KATHERINE A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43074	01	General Practice	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
174031	Fee-for-Service	1144297961	1144297961	1	1	FRIEDMAN, JAIME B MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79195	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
174053	Fee-for-Service	1114155405	1114155405	1	1	FATTAHI, RANA MD	6/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154209	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
174115	Fee-for-Service	1942531983	1942531983	1	1	FIRST STEPS PRENATAL CARE	4/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	36515	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	AMC	34151 DATE PALM DR	STE E	CATHEDRAL CITY	CA	92234	6831	33	06065	33.801111	-116.458167	Riverside County
174131	Fee-for-Service	1558617001	1558617001	1	2	FOX DRUG STORE INC	4/24/2020	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3020 SAN ANTONIO DR	None	FOWLER	CA	93625	9507	10	06019	36.6028569	-119.6570051	Fresno County
174147	Fee-for-Service	1023737343	1023737343	1	1	FERRER, LORENA M	9/1/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2549 SOUTH SEPULVEDA BLV	#2	LOS ANGELES	CA	90064	3169	19	06037	34.03400196	-118.4332908	Los Angeles County
174272	Fee-for-Service	1912386293	1912386293	1	1	FIERRO, SARA E LMFT	11/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
174273	Fee-for-Service	1568421329	1568421329	1	1	FREIJ, BISHARA MD	6/20/2024	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
174324	Fee-for-Service	1215229877	1215229877	1	1	FIX, JANA L MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132304	01	General Practice	0	In state provider	None	141 LYNCH CREEK WAY	SUITE C	PETALUMA	CA	94954	2390	49	06097	38.25192092	-122.6341929	Sonoma County
174422	Fee-for-Service	1255547220	1255547220	1	1	FARRAG, AHMED S A MD	2/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131614	01	General Practice	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
174430	Fee-for-Service	1255068987	1255068987	1	1	FAITH IN ACTION OF THE SAN G	3/26/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	ORGONIO PASS	66 SAN S GORGONIO AVE	SUITE #6	BANNING	CA	92220	6030	33	06065	33.92491282	-116.8767217	Riverside County
174432	Fee-for-Service	1023737343	1023737343	1	1	FERRER, LORENA M	9/1/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2549 SOUTH SEPULVEDA BLV	#2	LOS ANGELES	CA	90064	3169	19	06037	34.03400196	-118.4332908	Los Angeles County
174587	Fee-for-Service	1538125364	1538125364	1	1	FALABELLA, ANDRES A MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66952	05	Anesthesiology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
174640	Fee-for-Service	1770267841	1770267841	1	1	FIRST 5 YOLO CHILDREN AND FA	12/9/2024	172V00000X	NA	Other	109	LOCAL HEALTH JURISDICTIONS	-	-	NOT APPLICABLE	0	In state provider	MILIES COMMISSION	2779 DEL RIO PL UNIT A	None	DAVIS	CA	95618	6821	57	06113	38.55176998	-121.7159781	Yolo County
174655	Fee-for-Service	1275619116	1275619116	1	2	FOCUS VISION CLINIC OPTOMETR	7/16/2021	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1668 E 2ND ST	STE B	BEAUMONT	CA	92223	3168	33	06065	33.92359885	-116.9480354	Riverside County
174662	Fee-for-Service	1235639188	1235639188	1	2	FARNADY, KRISTA A	5/8/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
174770	Fee-for-Service	1831207976	1831207976	1	1	FLETCHER, CHANTAL C MD	9/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80448	41	Internal Medicine	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
174773	Fee-for-Service	1487692208	1487692208	1	1	FRANKLIN, SARAH E NP	11/15/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
174776	Fee-for-Service	1790824720	1790824720	1	1	FAIR, JOANNA MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
174833	Fee-for-Service	1154307767	1154307767	1	2	FRIEDMAN, RONALD A MD	1/20/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	49442	None	None	0	In state provider	None	80 GARDEN COURT	SUITE 103	MONTEREY	CA	93940	5389	27	06053	36.58531605	-121.8549252	Monterey County
174838	Fee-for-Service	1154460988	1154460988	1	1	FAMILY PLANNING ASSOC	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	1901 N TUSTIN AVE	None	SANTA ANA	CA	92705	7817	30	06059	33.76245307	-117.8350708	Orange County
174846	Fee-for-Service	1588273148	1588273148	1	1	FACULTY PHYSICIANS AND SURGE	1/29/2021	2085R0001X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	399 E 21ST ST	None	SAN BERNARDINO	CA	92404	4815	36	06071	34.13403047	-117.2767275	San Bernardino County
174873	Fee-for-Service	1063133692	1063133692	1	1	FRYE, MAGGIE NP	12/11/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	37	06073	32.8384953	-116.9677746	San Diego County
174876	Fee-for-Service	1740381383	1740381383	1	1	FAINSZTEIN, EVELYN G MD	8/1/2000	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	70304	41	Internal Medicine	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
174877	Fee-for-Service	1386296713	1386296713	1	1	FENG, STEPHANIE G CNP	4/28/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
174886	Fee-for-Service	1982770228	1982770228	1	1	FRESHMAN, JANELLE G PT	4/13/2021	2251H1200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24331 EL TORO ROAD	SUITE 200	LAGUNA WOODS	CA	92637	3116	30	06059	33.60928782	-117.7295058	Orange County
174890	Fee-for-Service	1134499759	1134499759	1	1	FELS, HEATHER R MD	8/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119608	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
174949	Fee-for-Service	1033270012	1033270012	1	1	FRIEDMAN,RICHARD MD	6/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 SUNNYVIEW LANE	None	KALISPELL	MT	59901	0000	00	None	48.214773	-114.3236925	Flathead County
174980	Fee-for-Service	1518057314	1518057314	1	1	FREDERIKSEN, KIRSTEN E MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1476	00	None	39.52483792	-119.7968314	Washoe County
175072	Fee-for-Service	1255894200	1255894200	1	1	FUJII, QUINN T DO	9/21/2022	207P00000X	NA	Other	026	PHYSICIANS	19567	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
175081	Fee-for-Service	1548216674	1548216674	1	1	FLAGG, GWENERVERE L MD	7/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	42472	08	Family Practice	0	In state provider	None	617 W MANCHESTER AVENUE	None	LOS ANGELES	CA	90044	5718	19	06037	33.96008547	-118.2846105	Los Angeles County
175082	Fee-for-Service	1801897764	1801897764	1	1	FOGELBERG, KENNETH W MD	3/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	27939	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1430 E MAIN ST	STE 102	SANTA MARIA	CA	93454	4831	42	06083	34.9528467	-120.4127301	Santa Barbara County
175114	Fee-for-Service	1013036888	1013036888	1	1	FISCHER, KAREN A MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46699	-	NOT APPLICABLE	0	In state provider	None	43520 DIVISION STREET	None	LANCASTER	CA	93535	4089	19	06037	34.673445	-118.130143	Los Angeles County
175218	Fee-for-Service	1811912009	1811912009	1	1	FORREST CITY ARKANSAS	12/2/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL COMPANY LLC	1601 NEW CASTLE RD	None	FORREST CITY	AR	72335	2218	00	None	35.03944565	-90.77194379	St. Francis County
175314	Fee-for-Service	1033293105	1033293105	1	1	FONG, RICHARD T K MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47429	20	Orthopedic Surgery	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
175341	Fee-for-Service	1417488933	1417488933	1	1	FERENCZI, BASIL MD	5/1/2022	208800000X	NA	Other	026	PHYSICIANS	176313	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
175428	Fee-for-Service	1225305956	1225305956	1	1	FELDMAN, IRINA	1/13/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18376 CLARK STREET	None	TARZANA	CA	91356	3502	19	06037	34.16975482	-118.5331876	Los Angeles County
175505	Fee-for-Service	1811912009	1811912009	1	1	FORREST CITY ARKANSAS	12/2/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL COMPANY LLC	1601 NEW CASTLE RD	None	FORREST CITY	AR	72335	2218	00	None	35.03944565	-90.77194379	St. Francis County
175510	Fee-for-Service	1215075213	1215075213	1	1	FITZPATRICK, THOMAS K	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	65144	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
175580	Fee-for-Service	1326077736	1326077736	1	1	FUNG, YING MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67630	30	Radiology	0	In state provider	None	106 LA CASA VIA	STE 140	WALNUT CREEK	CA	94598	3084	07	06013	37.91255783	-122.0428047	Contra Costa County
175599	Fee-for-Service	1477631299	1477631299	1	1	FILARSKY, BRUCE W MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	62350	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
175630	Fee-for-Service	1679704563	1679704563	1	1	FACULTY MEDICAL GROUP OF	10/29/2009	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	LLUSM	26870 BARTON RD	None	REDLANDS	CA	92374	4308	36	06071	34.04831949	-117.2178684	San Bernardino County
175649	Fee-for-Service	1336344167	1336344167	1	1	FLORES, ANGELA THERESE C MD	5/15/2018	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	134941	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
175674	Fee-for-Service	1144680463	1144680463	1	1	FUNKE, ERICH N PT	3/4/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1031 VILLAGE LN	None	CHICO	CA	95926	2812	04	06007	39.74903547	-121.8249236	Butte County
175711	Fee-for-Service	1265594923	1265594923	1	1	FLINN, DAVID	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
175771	Fee-for-Service	1841074978	1841074978	1	1	FLOWERS FAMILY CARE LLC	5/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1009 W 20TH STREET	None	SANTA ANA	CA	92706	3523	30	06059	33.76246577	-117.8789747	Orange County
175782	Fee-for-Service	1437745619	1437745619	1	1	FIRSTHAND HOSPICE INC	8/1/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	23361 EL TORO RD	SUITE 116	LAKE FOREST	CA	92630	4810	30	06059	33.62369544	-117.6967856	Orange County
175867	Fee-for-Service	1891205936	1891205936	1	1	FERONA, JOSHUA D PT	1/22/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
175945	Fee-for-Service	1619993532	1619993532	1	1	FONG, REMINGTON M MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	60713	40	Pediatrics	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
175947	Fee-for-Service	1760889190	1760889190	1	2	FIRST AID URGENT CARE INC	8/5/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	7204 FOOTHILL BLVD	None	TUJUNGA	CA	91042	2719	19	06037	34.24862229	-118.2886742	Los Angeles County
175987	Fee-for-Service	1962569616	1962569616	1	1	FEYGIN, POLINA T MD	8/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	67378	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
175995	Fee-for-Service	1326380155	1326380155	1	1	FU, ALEXANDER Y MD	8/23/2021	207L00000X	NA	Other	026	PHYSICIANS	147957	None	None	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
175997	Fee-for-Service	1407913981	1407913981	1	1	FOW, JONATHAN E MD INC	11/17/2008	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	78523	20	Orthopedic Surgery	0	In state provider	None	691 MORRO AVE	None	MORRO BAY	CA	93442	2233	40	06079	35.364654	-120.8511775	San Luis Obispo County
176070	Fee-for-Service	1437745619	1437745619	1	1	FIRSTHAND HOSPICE INC	8/1/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	23361 EL TORO RD	SUITE 116	LAKE FOREST	CA	92630	4810	30	06059	33.62369544	-117.6967856	Orange County
176094	Fee-for-Service	1316761877	1316761877	1	1	FRANCO, ADRIENNE CAMILLE PT	11/13/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5350 OLIVE ST	None	MONTCLAIR	CA	91763	1639	36	06071	34.09054746	-117.6886395	San Bernardino County
176147	Fee-for-Service	1528287661	1528287661	1	1	FEINBERG, STEVEN M MD	10/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86655	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
176211	Fee-for-Service	1689010910	1689010910	1	1	FLORES, SARA K MD	11/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150639	07	Dermatology	0	In state provider	None	2120 PROFESSIONAL DRIVE	None	ROSEVILLE	CA	95661	4063	31	06061	38.74247397	-121.2508672	Placer County
176213	Fee-for-Service	1215131743	1215131743	1	1	FELIX MEDICAL GROUP INC	12/17/2010	193400000X	NA	Other	026	PHYSICIANS	75952	08	Family Practice	0	In state provider	None	4343 MARKET ST	STE C	RIVERSIDE	CA	92501	3567	33	06065	33.97734857	-117.3791849	Riverside County
176237	Fee-for-Service	1760889190	1760889190	1	2	FIRST AID URGENT CARE INC	8/5/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	7204 FOOTHILL BLVD	None	TUJUNGA	CA	91042	2719	19	06037	34.24862229	-118.2886742	Los Angeles County
176274	Fee-for-Service	1932566338	1932566338	2	1	FUIMAONO, CANDICE M LMFT	3/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6828 RYCROFT DR	None	RIVERSIDE	CA	92506	5317	33	06065	33.92754581	-117.3413201	Riverside County
176443	Fee-for-Service	1356301675	1356301675	1	1	FERRARO, PATRICIA L DPM	7/22/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2074 LAKE TAHOE BLVD	STE 8	SOUTH LAKE TAHOE	CA	96150	6417	09	06017	38.91488542	-120.0019087	El Dorado County
176495	Fee-for-Service	1740621101	1740621101	1	1	FIRDOOS, SAIMA	5/20/2024	207R00000X	NA	Other	026	PHYSICIANS	171938	41	Internal Medicine	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
176522	Fee-for-Service	1538477823	1538477823	1	1	FORD, EMMA NP	11/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
176547	Fee-for-Service	1730147604	1730147604	1	1	FROMUTH, ROBERT D MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	64011	40	Pediatrics	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
176577	Fee-for-Service	1245706498	1245706498	1	1	FORD, DETRA LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
176590	Fee-for-Service	1487996302	1487996302	1	1	FLATOW, JOSHUA M MD	8/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131756	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
176614	Fee-for-Service	1467848903	1467848903	1	2	FISHER, EMILY MD	6/11/2022	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	148350	-	NOT APPLICABLE	0	In state provider	None	927 AMADOR STREET	None	VALLEJO	CA	94590	4606	48	06095	38.10854507	-122.243376	Solano County
176628	Fee-for-Service	1730175688	1730175688	1	1	FUENZALIDA, CHARLES	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10101 RIDGEGATE PKWY	None	LONETREE	CO	80124	5522	00	None	39.529305	-104.870799	Douglas County
176785	Fee-for-Service	1477588374	1477588374	1	1	FREY, JEFFREY M MD	2/8/2015	207W00000X	NA	Ophthalmology	026	PHYSICIANS	32808	18	Ophthalmology	0	In state provider	None	376 W BADILLO ST	None	COVINA	CA	91723	1827	19	06037	34.0862457	-117.8963259	Los Angeles County
176815	Fee-for-Service	1912952771	1912952771	1	1	FURUTAN, LAILAE MD	9/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76474	None	None	0	In state provider	None	7223 CHURCH ST	STE C	HIGHLAND	CA	92346	5816	36	06071	34.122888	-117.1737945	San Bernardino County
176863	Fee-for-Service	1770671455	1770671455	1	1	FEARON, WILLIAM F MD	9/1/1995	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54553	01	General Practice	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
176967	Fee-for-Service	1700303500	1700303500	1	1	FULLER, CHELSEA LMFT	3/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
177008	Fee-for-Service	1790718518	1790718518	1	1	FOGEL, TRAVIS PHD	10/1/2002	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11406 LOMA LINDA DR	# 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
177011	Fee-for-Service	1326522566	1326522566	1	1	FORTRA MEDICAL GROUP OF CALI	8/11/2021	207KA0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2303 CAMINO RAMON	SUITE 150	SAN RAMON	CA	94583	1392	07	06013	37.77552084	-121.9658366	Contra Costa County
177027	Fee-for-Service	1942361274	1942361274	1	1	FUJIOKA, DARCY U PHD	11/7/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
177060	Fee-for-Service	1336390566	1336390566	1	1	FLEMING, BETHANY S MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103537	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
177067	Fee-for-Service	1831201169	1831201169	1	1	FLYNN, DARRAGH J MD	1/31/2001	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	46268	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 DOYLE PARK DR	STE 103	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
177141	Fee-for-Service	1972751972	1972751972	1	1	FUERTEZ, RULA R MD	10/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102210	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
177258	Fee-for-Service	1922022656	1922022656	1	1	FEINSTEIN, JEFFREY A MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84759	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
177425	Fee-for-Service	1326378738	1326378738	1	1	FARHAD, YASAMIN LMFT	6/11/2018	103T00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	451 LAMBERT RD	SUITE 212	BREA	CA	92821	3922	30	06059	33.92478245	-117.9016438	Orange County
177429	Fee-for-Service	1861686354	1861686354	1	1	FILSOOF, DAVID M MD	4/1/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	120099	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2251 W ROSECRANS AVE	UNIT 21	COMPTON	CA	90222	3860	19	06037	33.90273823	-118.2557598	Los Angeles County
177547	Fee-for-Service	1922022656	1922022656	1	1	FEINSTEIN, JEFFREY A MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84759	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
177694	Fee-for-Service	1336135888	1336135888	1	1	FUKUSHIMA, CLIFFORD OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5501 W HILLSDALE AVE	STE D	VISALIA	CA	93291	5159	54	06107	36.329247	-119.3518845	Tulare County
177727	Fee-for-Service	1861468134	1861468134	1	1	FAUSETT, HILARY J MD INC	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	1530 E CHEVY CHASE DR	STE 205A	GLENDALE	CA	91206	4168	19	06037	34.150689	-118.2303855	Los Angeles County
177818	Fee-for-Service	1780378539	1780378539	1	1	FAMILY CARE CLINIC INC	12/18/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	3550 Q ST	STE 301	BAKERSFIELD	CA	93301	1645	15	06029	35.391978	-119.0105025	Kern County
177944	Fee-for-Service	1831662048	1831662048	1	1	FORCHA, CYRIL A NP	4/4/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
178021	Fee-for-Service	1730651662	1730651662	1	1	FIRST MILE CARE, INC.	11/15/2022	174H00000X	NA	Other	102	DIABETES PREVENTION PROGRAM SUPPLIER	-	-	NOT APPLICABLE	0	In state provider	None	3000 SAND HILL RD	STE 3-210	MENLO PARK	CA	94025	7119	41	06081	37.42353053	-122.2209093	San Mateo County
178026	Fee-for-Service	1063529881	1063529881	1	1	FREDIRICK W ENDORF	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	GROUP HEALTH PLAN	640 JACKSON ST	None	ST PAUL	MN	55101	0000	00	None	44.95496967	-93.09587426	Ramsey County
178071	Fee-for-Service	1699423814	1699423814	1	1	FAMILY HEALTHCARE NETWORK	2/2/2023	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1062 S K ST	STE 100	TULARE	CA	93274	6422	54	06107	36.19548226	-119.3433058	Tulare County
178099	Fee-for-Service	1881726354	1881726354	1	1	FOO, EDMUND B MD	8/31/1995	193400000X	NA	Other	026	PHYSICIANS	40019	41	Internal Medicine	0	In state provider	None	1850 S AZUSA AVE	STE 201	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
178113	Fee-for-Service	1356389274	1356389274	1	1	FEIZI, SAEED MD	8/2/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81831	45	Nephrology (Renal-Kidney)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
178201	Fee-for-Service	1780271130	1780271130	1	1	FREEDOM LABS & DIAGNOSTICS L	4/11/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	1	Border provider	LC	2965 S JONES BLVD	STE D-2	LAS VEGAS	NV	89146	5629	00	None	36.13573571	-115.2252295	Clark County
178208	Fee-for-Service	1265457170	1265457170	1	1	FRIAS-SAVALA, GLADYS MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55218	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
178233	Fee-for-Service	1609220011	1609220011	1	1	FOLSE, MICHAEL MD	11/2/2020	207P00000X	NA	Other	026	PHYSICIANS	170004	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
178375	Fee-for-Service	1487702353	1487702353	1	1	FAIT, JAMES M MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65850	20	Orthopedic Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
178393	Fee-for-Service	1386607976	1386607976	1	1	FINELLI, MARIA L CNP	2/14/2019	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
178502	Fee-for-Service	1952322877	1952322877	1	1	FOX, ANDREW MD	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81897	14	Neurological Surgery	0	In state provider	None	2800 L ST	STE 340	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
178528	Fee-for-Service	1326240805	1326240805	1	1	FABI, DAVID W MD	7/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112916	None	None	0	In state provider	None	4060 4TH AVE	STE 700	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
178543	Fee-for-Service	1144278433	1144278433	1	1	FULLERTON ANESTHESIA	11/5/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	ASSOCIATES INC	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
178551	Fee-for-Service	1649416850	1649416850	1	1	FLORES, ANTHONY S MD INC	12/6/1995	193400000X	NA	Other	026	PHYSICIANS	55336	08	Family Practice	0	In state provider	None	760 W ACACIA AVE	110	HEMET	CA	92543	4080	33	06065	33.74388166	-116.9784688	Riverside County
178589	Fee-for-Service	1003236845	1003236845	1	1	FAJARDO, JESUS MD	5/14/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	138953	20	Orthopedic Surgery	0	In state provider	None	747 WAREHOUSE ST	None	LOS ANGELES	CA	90021	1106	19	06037	34.03450435	-118.2393996	Los Angeles County
178612	Fee-for-Service	1083974422	1083974422	1	1	FORNOFF, LINDEN E MD	7/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154370	14	Neurological Surgery	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
178624	Fee-for-Service	1629343215	1629343215	1	1	FORREST, ALFRED E MD	7/26/2022	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	37501	None	None	0	In state provider	None	988 WALSH AVE	None	SANTA CLARA	CA	95050	2649	43	06085	37.36976352	-121.951071	Santa Clara County
178703	Fee-for-Service	1689066029	1689066029	1	1	FAMILY FIRST MEDICAL CARE	3/3/2021	261QM1300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	APC	1317 OAKDALE RD	SUITE 440	MODESTO	CA	95355	3364	50	06099	37.662489	-120.957588	Stanislaus County
178824	Fee-for-Service	1356498042	1356498042	1	1	FONG, CRAIG A OD	7/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
178918	Fee-for-Service	1154501120	1154501120	1	1	FORQUER, BRIAN D	12/31/1985	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	14435 SHERMAN WAY	STE 207	VAN NUYS	CA	91405	6233	19	06037	34.20123151	-118.4475285	Los Angeles County
178943	Fee-for-Service	1346663069	1346663069	1	1	FOX, ROSALYN J NP	5/17/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
178967	Fee-for-Service	1508393257	1508393257	1	1	FOWLER, MARK R MD	1/19/2023	207ZP0102X	NA	Other	026	PHYSICIANS	180313	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
178976	Fee-for-Service	1518120971	1518120971	2	1	FREMONT EMERGENCY SERVICES	2/24/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
178988	Fee-for-Service	1689066029	1689066029	1	1	FAMILY FIRST MEDICAL CARE	4/8/2015	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	APC	1317 OAKDALE RD	SUITE 440	MODESTO	CA	95355	3364	50	06099	37.662489	-120.957588	Stanislaus County
179028	Fee-for-Service	1730708322	1730708322	1	1	FULLERTON, ZOE MD	11/14/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	189336	84	Surgery-Head and Neck	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
179039	Fee-for-Service	1497034805	1497034805	1	1	FRIEDMAN, THEODORE E LCSW	6/8/2016	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5575 LAKE PARK WY	STE 100-1	LA MESA	CA	91942	1664	37	06073	32.78201664	-117.0342615	San Diego County
179266	Fee-for-Service	1689232449	1689232449	1	1	FOREFRONT RADIOLOGY MEDICAL	5/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP PC	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
179275	Fee-for-Service	1275619116	1275619116	1	1	FOCUS VISION CLINIC OPTOMETR	8/8/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1668 E 2ND ST	STE B	BEAUMONT	CA	92223	3168	33	06065	33.92359885	-116.9480354	Riverside County
179276	Fee-for-Service	1902394893	1902394893	1	1	FREDRICKSON, JARED S MD	8/30/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	177453	None	None	0	In state provider	None	2524 WESTSIDE RD	None	YREKA	CA	96097	9129	47	06093	41.69301114	-122.6403046	Siskiyou County
179277	Fee-for-Service	1689066029	1689066029	1	1	FAMILY FIRST MEDICAL CARE	1/9/2020	261QM1300X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	APC	1317 OAKDALE RD	SUITE 440	MODESTO	CA	95355	3364	50	06099	37.662489	-120.957588	Stanislaus County
179297	Fee-for-Service	1982747671	1982747671	1	3	FAMILY HEALTH CENTERS	7/18/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
179354	Fee-for-Service	1528528569	1528528569	1	1	FANOUS, ELIAS J MD	6/13/2024	207R00000X	NA	Other	026	PHYSICIANS	179829	41	Internal Medicine	0	In state provider	None	1010 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1806	40	06079	35.292168	-120.6658665	San Luis Obispo County
179360	Fee-for-Service	1518045954	1518045954	1	1	FRANCISCO, ROWENA R MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	49802	36	Psychiatry	0	In state provider	None	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
179430	Fee-for-Service	1043509987	1043509987	1	1	FROST, NESREEN PHD	4/14/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
179566	Fee-for-Service	1689066029	1689066029	1	1	FAMILY FIRST MEDICAL CARE	1/9/2020	261QM1300X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	APC	1317 OAKDALE RD	SUITE 440	MODESTO	CA	95355	3364	50	06099	37.662489	-120.957588	Stanislaus County
179583	Fee-for-Service	1982747671	1982747671	1	3	FAMILY HEALTH CENTERS	7/18/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	37	06073	32.71503452	-117.1134945	San Diego County
179684	Fee-for-Service	1336402163	1336402163	1	1	FLORES, VANESSA MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130420	01	General Practice	0	In state provider	None	7520 ARROYO CIRCLE	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
179842	Fee-for-Service	1457455602	1457455602	1	1	FARAC, RANDALL A MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97053	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
179852	Fee-for-Service	1689066029	1689066029	1	1	FAMILY FIRST MEDICAL CARE	1/9/2020	261QM1300X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	APC	1317 OAKDALE RD	SUITE 440	MODESTO	CA	95355	3364	50	06099	37.662489	-120.957588	Stanislaus County
179876	Fee-for-Service	1023052933	1023052933	1	1	FLEMING, WILLIAM R MD	1/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
179877	Fee-for-Service	1952406605	1952406605	1	1	FU, JULIUS H MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52315	36	Psychiatry	0	In state provider	DR. A BANUELOS JR CMO	751 S BASCOM	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
179883	Fee-for-Service	1689016867	1689016867	1	1	FAGAN, LAUREN B CRNA	7/29/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
179906	Fee-for-Service	1083226245	1083226245	1	1	FLOYD, ALLISON M NP	4/26/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	37	06073	32.99706	-117.05544	San Diego County
180128	Fee-for-Service	1013962422	1013962422	1	1	FRIAS, CARLOS A MD	11/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	845 N 10TH ST	None	SANTA PAULA	CA	93060	1300	56	06111	34.36592531	-119.0656897	Ventura County
180133	Fee-for-Service	1477589091	1477589091	1	1	FELLMETH, BRIAN D MD	1/26/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	59486	01	General Practice	0	In state provider	None	2110 PROFESSIONAL DR	STE 100	ROSEVILLE	CA	95661	3752	31	06061	38.74234873	-121.2521259	Placer County
180147	Fee-for-Service	1699848713	1699848713	1	1	FREMONT-RIDEOUT MANAGEMENT	12/1/1984	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SERVICES	939 LIVE OAK BLVD	None	YUBA CITY	CA	95991	4002	51	06101	39.142107	-121.6208315	Sutter County
180192	Fee-for-Service	1578094199	1578094199	1	1	FLATH, CRAIG S MD	8/4/2022	207L00000X	NA	Other	026	PHYSICIANS	160164	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
180211	Fee-for-Service	1962151258	1962151258	1	1	FAN, TIFFANY MD	11/20/2024	207P00000X	NA	Other	026	PHYSICIANS	189411	66	Emergency Medicine (Urgent Care)	0	In state provider	None	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
180256	Fee-for-Service	1861904328	1861904328	1	1	FORGE, JENNIFER R PT	5/7/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
180288	Fee-for-Service	1447563549	1447563549	1	1	FANG, ANDREA C MD	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118192	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
180313	Fee-for-Service	1881389948	1881389948	1	1	FINDING LOVE FOR TODAY COUNS	4/14/2023	261QM0850X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ELING INC.	11801 PIERCE ST	STE 200	RIVERSIDE	CA	92505	4400	33	06065	33.90100297	-117.49363	Riverside County
180330	Fee-for-Service	1447658216	1447658216	1	1	FADAKAR, GOLSHID T LMFT	4/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
180337	Fee-for-Service	1013071497	1013071497	1	1	FRITZ, JENNIFER K PSYD	6/9/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
180356	Fee-for-Service	1396108999	1396108999	1	1	FLORESCA, JON MD	8/1/2022	111NR0200X	NA	Other	026	PHYSICIANS	153707	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
180406	Fee-for-Service	1366587677	1366587677	1	1	FEINSTEIN, CARL B MD	3/20/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84411	None	None	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
180420	Fee-for-Service	1053467738	1053467738	1	1	FEIFEL, DAVID MD	10/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51236	36	Psychiatry	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
180436	Fee-for-Service	1538754007	1538754007	1	1	FIRST OPTOMETRIC CARE OF NOR	11/20/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	31573 RANCHO PUEBLO RD	STE 101	TEMECULA	CA	92592	4835	33	06065	33.4795997	-117.1092187	Riverside County
180440	Fee-for-Service	1972923704	1972923704	1	1	FENNESSY, JACOB H MD	8/15/2019	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	141175	20	Orthopedic Surgery	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
180517	Fee-for-Service	1720074313	1720074313	1	1	FAREED, GEORGE C MD	8/31/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	31850	None	None	0	In state provider	None	751 W LEGION ROAD	STE 105	BRAWLEY	CA	92227	7754	13	06025	32.95996012	-115.5538196	Imperial County
180531	Fee-for-Service	1114904307	1114904307	1	1	FLORES, SYLVIA J MD	9/24/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	75624	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1240 S ELISEO DR	None	GREENBRAE	CA	94904	2028	21	06041	37.94422763	-122.5361926	Marin County
180533	Fee-for-Service	1144856535	1144856535	1	1	FRUITVALE OPERATING COMPANY	8/1/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LP	3020 EAST 15TH ST	None	OAKLAND	CA	94601	2305	01	06001	37.77933151	-122.2270138	Alameda County
180576	Fee-for-Service	1417035163	1417035163	1	1	FENTZKE, RICHARD C MD	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88995	18	Ophthalmology	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
180584	Fee-for-Service	1902901762	1902901762	1	1	FIRST-SOTO MEDICAL GROUP	10/21/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2680 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	4708	19	06037	33.97394914	-118.2229166	Los Angeles County
180588	Fee-for-Service	1558468207	1558468207	1	1	FAUCETT, RODNEY DO	9/30/1989	207RN0300X	NA	Nephrology	026	PHYSICIANS	5369	45	Nephrology (Renal-Kidney)	0	In state provider	None	14020 SAN PABLO AVE	STE A	SAN PABLO	CA	94806	3604	07	06013	37.96124162	-122.3434731	Contra Costa County
180596	Fee-for-Service	1336598259	1336598259	1	1	FOUNDATION ENTERPRISES LLC	2/7/2017	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	395 WEST 17TH ST	None	SAN BERNARDINO	CA	92405	4409	36	06071	34.12998761	-117.2916972	San Bernardino County
180599	Fee-for-Service	1700811411	1700811411	1	1	FISCHBEIN, MICHAEL P MD	9/1/1998	208G00000X	NA	General Surgery	026	PHYSICIANS	63291	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
180635	Fee-for-Service	1528087335	1528087335	1	1	FROMMLET, MICHAEL MD	4/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89252	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 CANAL STREET	None	KING CITY	CA	93930	3431	27	06053	36.20653258	-121.1319345	Monterey County
180662	Fee-for-Service	1518988575	1518988575	1	1	FRESNO COMMUNITY HOSPITAL &	10/8/1996	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	ARMACY	290 N WAYTE LN FIRST FLO	None	FRESNO	CA	93701	2124	10	06019	36.74643429	-119.7837416	Fresno County
180668	Fee-for-Service	1871885368	1871885368	1	1	FLOYD, BARAKA D MD	9/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127405	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
180679	Fee-for-Service	1376644344	1376644344	1	1	FARIS, FRANK MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	1	Border provider	None	5915 S RAINBOW BLVD	STE 105	LAS VEGAS	NV	89118	2558	00	None	36.08119375	-115.2427495	Clark County
180747	Fee-for-Service	1649406125	1649406125	1	1	FOSTER, LORNA PSYD	7/26/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
180756	Fee-for-Service	1891800116	1891800116	1	1	FAGERLUND, LAURA N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72085	40	Pediatrics	0	In state provider	None	1050 B AVE	STE C	CORONADO	CA	92118	3430	37	06073	32.68408301	-117.1780847	San Diego County
180851	Fee-for-Service	1386179364	1386179364	1	1	FARINO, LIAN K MD	11/20/2020	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
180890	Fee-for-Service	1558468207	1558468207	1	1	FAUCETT, RODNEY DO	9/30/1989	207RN0300X	NA	Nephrology	026	PHYSICIANS	5369	41	Internal Medicine	0	In state provider	None	14020 SAN PABLO AVE	STE A	SAN PABLO	CA	94806	3604	07	06013	37.96124162	-122.3434731	Contra Costa County
180955	Fee-for-Service	1407209430	1407209430	1	1	FRASOULI CARE HOME	3/20/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	23800 HILLHURST DRIVE	None	LAGUNA NIGUEL	CA	92677	2237	30	06059	33.52057788	-117.713654	Orange County
181042	Fee-for-Service	1891800116	1891800116	1	1	FAGERLUND, LAURA N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72085	41	Internal Medicine	0	In state provider	None	1050 B AVE	STE C	CORONADO	CA	92118	3430	37	06073	32.68408301	-117.1780847	San Diego County
181046	Fee-for-Service	1134391287	1134391287	1	2	FIELD, STEPHEN DO	7/11/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	11017	-	NOT APPLICABLE	0	In state provider	None	5715 S BROADWAY AVENUE	None	LOS ANGELES	CA	90037	4131	19	06037	33.990273	-118.2783255	Los Angeles County
181098	Fee-for-Service	1942388046	1942388046	1	1	FEIN, MICHAEL A MD	5/20/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	23729	41	Internal Medicine	0	In state provider	None	3010 COLBY ST	STE 221	BERKELEY	CA	94705	2056	01	06001	37.85492078	-122.2576101	Alameda County
181102	Fee-for-Service	1316108616	1316108616	1	1	FISHER, MELISSA NP	6/25/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
181108	Fee-for-Service	1174565303	1174565303	1	1	FOREMAN, DANIEL S MD	2/1/2001	174400000X	NA	Other	026	PHYSICIANS	45204	18	Ophthalmology	0	In state provider	None	3126 PROFESSIONAL DR	STE 300	AUBURN	CA	95603	2407	31	06061	38.94088683	-121.1007646	Placer County
181183	Fee-for-Service	1396787420	1396787420	1	1	FISHER, LAWRENCE PHD	10/19/2011	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
181218	Fee-for-Service	1013341387	1013341387	1	1	FEIGENBUTZ, CHRISTY F NP	1/17/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
181276	Fee-for-Service	1356190961	1356190961	1	1	FAMILY RESOURCE & REFERRAL C	3/24/2025	251B00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	ENTER OF SAN JOAQUIN	3127 TRANSWORLD DR	100	STOCKTON	CA	95206	5003	39	06077	37.90766429	-121.2253027	San Joaquin County
181303	Fee-for-Service	1013989656	1013989656	2	1	FMSC INGLEWOOD OPERATING CO	8/1/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	100 S HILLCREST BLVD	None	INGLEWOOD	CA	90301	1313	19	06037	33.96249	-118.3486915	Los Angeles County
181322	Fee-for-Service	1750148953	1750148953	1	1	FORD, JANICE LMFT	3/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
181330	Fee-for-Service	1891800116	1891800116	1	1	FAGERLUND, LAURA N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	72085	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1050 B AVE	STE C	CORONADO	CA	92118	3430	37	06073	32.68408301	-117.1780847	San Diego County
181345	Fee-for-Service	1760889190	1760889190	1	1	FIRST AID URGENT CARE INC	8/5/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	None	9064 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	1813	19	06037	34.235073	-118.4502245	Los Angeles County
181394	Fee-for-Service	1174565303	1174565303	1	1	FOREMAN, DANIEL S MD	2/1/2001	174400000X	NA	Other	026	PHYSICIANS	45204	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3126 PROFESSIONAL DR	STE 300	AUBURN	CA	95603	2407	31	06061	38.94088683	-121.1007646	Placer County
181439	Fee-for-Service	1891724415	1891724415	1	1	FURUMIZO, STUART H MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62221	01	General Practice	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
181495	Fee-for-Service	1891351821	1891351821	1	1	FANTA, MESERET B	8/20/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1280 7TH AVENUE	None	SANTA CRUZ	CA	95062	2717	44	06087	36.97572049	-121.9938779	Santa Cruz County
181535	Fee-for-Service	1477535466	1477535466	1	1	FORACI, ANNA RITA	11/1/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7139	None	None	0	In state provider	None	306 W EL NORTE PKWY	STE S	ESCONDIDO	CA	92026	1960	37	06073	33.14056104	-117.0942385	San Diego County
181551	Fee-for-Service	1831149954	1831149954	1	1	FLYNN, LEO . MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2929 5TH ST	STE 100	RAPID CITY	SD	57701	7355	00	None	44.05598594	-103.2274757	Pennington County
181621	Fee-for-Service	1659575363	1659575363	1	1	FAUNCE, HELEN E LMFT	2/6/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24977 WASHINGTON AVENUE	SUITES K & L	MURRIETA	CA	92562	6149	33	06065	33.55150034	-117.2118708	Riverside County
181634	Fee-for-Service	1760889190	1760889190	1	1	FIRST AID URGENT CARE INC	8/5/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	9064 VAN NUYS BLVD	None	PANORAMA CITY	CA	91402	1813	19	06037	34.235073	-118.4502245	Los Angeles County
181637	Fee-for-Service	1871680223	1871680223	1	1	FARHIE, JANET R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	86827	36	Psychiatry	0	In state provider	None	1080 EMELINE AVE	None	SANTA CRUZ	CA	95060	1966	44	06087	36.99191102	-122.0176744	Santa Cruz County
181660	Fee-for-Service	1740667773	1740667773	1	1	FRY, JAMES DO MD	5/3/2018	390200000X	NA	Other	026	PHYSICIANS	15202	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
181719	Fee-for-Service	1255068789	1255068789	1	1	FORE, DAVID L LMFT	7/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3954 CANON AVENUE	None	OAKLAND	CA	94602	2224	01	06001	37.80393416	-122.2173635	Alameda County
181783	Fee-for-Service	1891351821	1891351821	1	1	FANTA, MESERET B	8/20/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1280 7TH AVENUE	None	SANTA CRUZ	CA	95062	2717	44	06087	36.97572049	-121.9938779	Santa Cruz County
181816	Fee-for-Service	1083041636	1083041636	1	1	FREE AT LAST COMMUNITY	11/13/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	RECOVERY AND REHABILITAT	819 & 823 JAMIE LN	None	EAST PALO ALTO	CA	94303	1694	43	06085	37.47060226	-122.136723	San Mateo County
181894	Fee-for-Service	1174606420	1174606420	1	1	FRESNO COUNTY HLTH DEPT	2/16/1984	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1221 FULTON MALL	None	FRESNO	CA	93721	1946	10	06019	36.73615912	-119.7927065	Fresno County
181906	Fee-for-Service	1780397570	1780397570	1	1	FAMILY HEALTH CENTERS OF SAN	4/3/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	FQHC CLINIC	8530 LA MESA BLVD	STE 306	LA MESA	CA	91942	0966	37	06073	32.76873337	-117.0134248	San Diego County
181912	Fee-for-Service	1588750988	1588750988	1	1	FLENTJE, CLINTON E CRNA	3/5/2009	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
181923	Fee-for-Service	1770620486	1770620486	1	1	FISHER, SARAH N OD	5/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
182024	Fee-for-Service	1982004164	1982004164	1	1	FLORES MIDENCE, ESTER S MD	8/24/2016	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	141967	40	Pediatrics	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
182027	Fee-for-Service	1366948143	1366948143	1	1	FUNK, LUCY H MD	9/21/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	165419	None	None	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
182092	Fee-for-Service	1821627514	1821627514	1	1	FONG, PETER DO	1/27/2025	208M00000X	NA	Other	026	PHYSICIANS	22516	41	Internal Medicine	0	In state provider	None	3 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
182129	Fee-for-Service	1891929691	1891929691	1	1	FAMLIY HLTH CTR OF SAN DIEGO	12/18/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
182158	Fee-for-Service	1275728347	1275728347	1	1	FORD, ANN R LMFT	6/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
182194	Fee-for-Service	1780397570	1780397570	1	1	FAMILY HEALTH CENTERS OF SAN	4/3/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	FQHC CLINIC	8530 LA MESA BLVD	STE 306	LA MESA	CA	91942	0966	37	06073	32.76873337	-117.0134248	San Diego County
182210	Fee-for-Service	1982981148	1982981148	1	1	FRANCIS, ASHLEY LCSW	2/24/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
182213	Fee-for-Service	1992258156	1992258156	1	1	FAR, MAHSHID MD	12/14/2021	390200000X	NA	Other	026	PHYSICIANS	161964	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
182215	Fee-for-Service	1710588181	1710588181	1	1	FAMILY THERAPY LA PROFESSION	4/19/2021	261QM1300X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	AL PSYCHOLOGY CORPORATIO	14540 VICTORY	STE 101	VAN NUYS	CA	91411	1697	19	06037	34.1866315	-118.4501385	Los Angeles County
182224	Fee-for-Service	1881610095	1881610095	1	1	FORD, SCOTT C MD	6/30/1986	207P00000X	NA	Other	026	PHYSICIANS	53348	66	Emergency Medicine (Urgent Care)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
182241	Fee-for-Service	1437357852	1437357852	1	1	FRANCO, JUAN CARLOS T MD	1/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106041	41	Internal Medicine	0	In state provider	None	225 EAST 2ND AVE	None	ESCONDIDO	CA	92025	4249	37	06073	33.12175817	-117.0787555	San Diego County
182244	Fee-for-Service	1720060999	1720060999	1	1	FLAHERTY,DAWN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	0000	00	None	41.659929	-91.548099	Johnson County
182247	Fee-for-Service	1265686109	1265686109	1	1	FACULTY PHYSICIANS AND SURGE	8/14/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	CARDIOLOGY	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
182370	Fee-for-Service	1386981983	1386981983	1	1	FLORES, OMAR R PT	2/17/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5432-34 CARPINTERIA AVE	None	CARPINTERIA	CA	93013	1423	42	06083	34.394733	-119.513288	Santa Barbara County
182372	Fee-for-Service	1326257940	1326257940	1	1	FUNK, NATHAN D MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	520 MEDICAL CENTER DRIVE	STE 200	MEDFORD	OR	97504	4314	00	None	42.318801	-122.831728	Jackson County
182432	Fee-for-Service	1982701454	1982701454	1	1	FRISCHER, ALAN A MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	57886	41	Internal Medicine	0	In state provider	None	10720 PARAMOUNT BLVD	None	DOWNEY	CA	90241	3346	19	06037	33.94732999	-118.1345312	Los Angeles County
182536	Fee-for-Service	1265686109	1265686109	1	1	FACULTY PHYSICIANS AND SURGE	12/12/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	CARDIOLOGY	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
182539	Fee-for-Service	1902149933	1902149933	1	1	FULLER, JENNIFER C MD	8/16/2019	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	160366	04	Otology, Laryngology, Rhinology	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
182612	Fee-for-Service	1710411939	1710411939	1	1	FAHDEN, NORA S MD	7/31/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157334	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
182614	Fee-for-Service	1982900684	1982900684	1	1	FAYAD, FREDERICA MD	2/25/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	133968	40	Pediatrics	0	In state provider	None	7101 MAGNOLIA AVE	A	RIVERSIDE	CA	92504	3843	33	06065	33.94582085	-117.4021968	Riverside County
182656	Fee-for-Service	1194833202	1194833202	1	1	FELDMAN, RICHARD J	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	51661	20	Orthopedic Surgery	0	In state provider	None	10749 RIVERSIDE DR	None	NORTH HOLLYWOOD	CA	91602	2324	19	06037	34.15228374	-118.365296	Los Angeles County
182695	Fee-for-Service	1922354422	1922354422	1	1	FARRELLY, ERIN E MD	5/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121731	20	Orthopedic Surgery	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
182710	Fee-for-Service	1548566813	1548566813	1	1	FIELDS, ALAINA N MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114862	08	Family Practice	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
182720	Fee-for-Service	1508016767	1508016767	1	1	FOOLADIAN, SIYAVASH MD	8/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107621	05	Anesthesiology	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
182733	Fee-for-Service	1710407481	1710407481	1	1	FOWLER, CHERIE LCSW	10/30/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	473 CARNEGIE DR	STE 200	SAN BERNARDINO	CA	92408	4201	36	06071	34.06796019	-117.2749922	San Bernardino County
182769	Fee-for-Service	1912648916	1912648916	1	1	FINK, EMILY MD	8/23/2024	207R00000X	NA	Other	026	PHYSICIANS	188988	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
182783	Fee-for-Service	1215012976	1215012976	1	1	FRIDUSS, STEPHANIE R MD	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	63703	07	Dermatology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
182825	Fee-for-Service	1265686109	1265686109	1	1	FACULTY PHYSICIANS AND SURGE	12/12/2008	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	CARDIOLOGY	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
182827	Fee-for-Service	1902149933	1902149933	1	1	FULLER, JENNIFER C MD	8/16/2019	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	160366	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
182878	Fee-for-Service	1285831172	1285831172	1	1	FRANCOIS, HOWARD MD	7/22/2008	2085U0001X	NA	Other	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	SUITE 100	LAS VEGAS	NV	89106	4812	00	None	36.16257648	-115.170696	Clark County
182909	Fee-for-Service	1811965791	1811965791	1	1	FELICIANO, LARRY R MD	9/25/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51153	08	Family Practice	0	In state provider	None	7601 HOSPITAL DR	STE 209	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
182912	Fee-for-Service	1851377329	1851377329	1	1	FLEISHER, STEPHAN J PHD	1/1/1994	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16031 CHASE ST	None	NORTH HILLS	CA	91343	6307	19	06037	34.22476949	-118.481958	Los Angeles County
183001	Fee-for-Service	1215207048	1215207048	1	1	FANOUS, RANDY MD	7/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118896	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
183031	Fee-for-Service	1124112750	1124112750	1	1	FARRELL-DILLON, BARBARA	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	DILLON CHIROPRACTIC	275 W LAUREL DR	STE A	SALINAS	CA	93906	3460	27	06053	36.69884331	-121.6556177	Monterey County
183092	Fee-for-Service	1255484069	1255484069	1	1	FLETCHER, STACY F MD	11/24/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
183114	Fee-for-Service	1265686109	1265686109	1	1	FACULTY PHYSICIANS AND SURGE	7/19/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CARDIOLOGY	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
183117	Fee-for-Service	1902149933	1902149933	1	1	FULLER, JENNIFER C MD	8/16/2019	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	160366	24	Plastic Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
183129	Fee-for-Service	1265293971	1265293971	1	1	FAMILY PLANNING ASSOCIATES M	7/17/2024	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	EDICAL GROUP INC	1068 N CHERRY ST	None	TULARE	CA	93274	2251	54	06107	36.22362991	-119.3373326	Tulare County
183157	Fee-for-Service	1346357043	1346357043	1	1	FISHER, WILLIAM B	11/13/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6591 COLLINS DR	STE E8	MOORPARK	CA	93021	1492	56	06111	34.2944564	-118.8424453	Ventura County
183254	Fee-for-Service	1871958975	1871958975	1	1	FENG, XIANG MD	8/2/2023	390200000X	NA	Other	026	PHYSICIANS	187337	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
183260	Fee-for-Service	1033188560	1033188560	1	1	FULWIDER, COLE M MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	37354	07	Dermatology	0	In state provider	None	8101 NEWMAN AVE	STE C	HUNTINGTON BEACH	CA	92647	7042	30	06059	33.70483151	-117.987264	Orange County
183302	Fee-for-Service	1740775832	1740775832	1	1	FOSTER-MACAULEY, SHANNON LM	2/1/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	7 W FIGUEROA ST	STE 300 PMB 3017	SANTA BARBARA	CA	93101	3189	42	06083	34.42212704	-119.703387	Santa Barbara County
183326	Fee-for-Service	1447281936	1447281936	1	3	FAMILY HEALTH CTRS OF SD	12/8/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2114 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	2209	37	06073	32.69816737	-117.1414342	San Diego County
183406	Fee-for-Service	1023303138	1023303138	1	1	FRAZIER, KENYATTA J MD	1/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	158054	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 E WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
183417	Fee-for-Service	1265293971	1265293971	1	1	FAMILY PLANNING ASSOCIATES M	7/17/2024	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	EDICAL GROUP INC	1068 N CHERRY ST	None	TULARE	CA	93274	2251	54	06107	36.22362991	-119.3373326	Tulare County
183431	Fee-for-Service	1497705842	1497705842	1	1	FRY, MARGARET W MD	2/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77159	40	Pediatrics	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
183438	Fee-for-Service	1013433002	1013433002	1	1	FEHRMAN, TAYLOR LCSW	3/27/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4401 SEPULVEDA BLVD	210	SHERMAN OAKS	CA	91403	3934	19	06037	34.150356	-118.467397	Los Angeles County
183448	Fee-for-Service	1992719165	1992719165	1	1	FORTUNA, ROBERT B MD	12/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95617	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
183461	Fee-for-Service	1386670610	1386670610	1	1	FAMILY HLTHCARE NETWORK	9/17/2001	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	33025 ROAD 159	None	IVANHOE	CA	93235	1234	54	06107	36.38892365	-119.2180107	Tulare County
183486	Fee-for-Service	1285626374	1285626374	1	1	FINBERG,STEPHEN DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2625 E. GREENWAY PKWY	STE 205	PHOENIX	AZ	85032	4372	00	None	33.627141	-112.024953	Maricopa County
183572	Fee-for-Service	1124570130	1124570130	1	1	FINCHAM, KELCIE MD	4/8/2022	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
183617	Fee-for-Service	1447281936	1447281936	1	3	FAMILY HEALTH CTRS OF SD	12/8/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2114 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	2209	37	06073	32.69816737	-117.1414342	San Diego County
183655	Fee-for-Service	1558410498	1558410498	1	1	FANTON, GARY S MD	9/30/1991	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	45737	20	Orthopedic Surgery	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
183676	Fee-for-Service	1043242423	1043242423	1	1	FIERSTIEN, STEPHEN B MD	11/1/1996	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21040	30	Radiology	0	In state provider	None	145 S DOHENY DR	None	BEVERLY HILLS	CA	90211	2509	19	06037	34.065855	-118.3897585	Los Angeles County
183703	Fee-for-Service	1265293971	1265293971	1	1	FAMILY PLANNING ASSOCIATES M	7/17/2024	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	EDICAL GROUP INC	1068 N CHERRY ST	None	TULARE	CA	93274	2251	54	06107	36.22362991	-119.3373326	Tulare County
183713	Fee-for-Service	1942537907	1942537907	1	1	FLOWER VILLA INCORPORATED	9/9/2009	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1480 S LA CIENEGA BLVD	None	LOS ANGELES	CA	90035	3715	19	06037	34.050996	-118.376133	Los Angeles County
183729	Fee-for-Service	1033529995	1033529995	1	1	FRENCH, SARAH D MD	5/21/2019	207RR0500X	NA	Other	026	PHYSICIANS	138865	41	Internal Medicine	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
183752	Fee-for-Service	1386670610	1386670610	1	1	FAMILY HLTHCARE NETWORK	9/1/1991	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	33025 ROAD 159	None	IVANHOE	CA	93235	1234	54	06107	36.38892365	-119.2180107	Tulare County
183764	Fee-for-Service	1881714152	1881714152	1	1	FARRELL, JENNIFER L	7/12/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	206 N JACKSON ST	STE 202	GLENDALE	CA	91206	4330	19	06037	34.14852285	-118.2501237	Los Angeles County
183767	Fee-for-Service	1689692576	1689692576	1	1	FLORELL, SCOTT R. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 CHIPETA WAY	None	SLC	UT	84108	1221	00	None	40.758707	-111.8239633	Salt Lake County
183789	Fee-for-Service	1053477646	1053477646	1	1	FRANCKE, WENDY MD	8/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69425	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
183980	Fee-for-Service	1629261870	1629261870	1	1	FIRST ODYSSEY GROUP INC.	9/12/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ODYSSEY MEDICAL SUPPLY	14623 HAWTHORNE BLVD	UNIT 106	LAWNDALE	CA	90260	1500	19	06037	33.898572	-118.3527775	Los Angeles County
183991	Fee-for-Service	1265293971	1265293971	1	1	FAMILY PLANNING ASSOCIATES M	7/17/2024	261QA0005X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	EDICAL GROUP INC	1068 N CHERRY ST	None	TULARE	CA	93274	2251	54	06107	36.22362991	-119.3373326	Tulare County
184017	Fee-for-Service	1033529995	1033529995	1	1	FRENCH, SARAH D MD	5/21/2019	207RR0500X	NA	Other	026	PHYSICIANS	138865	83	Rheumatology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
184040	Fee-for-Service	1386670610	1386670610	1	1	FAMILY HLTHCARE NETWORK	9/1/1991	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	33025 ROAD 159	None	IVANHOE	CA	93235	1234	54	06107	36.38892365	-119.2180107	Tulare County
184092	Fee-for-Service	1265443154	1265443154	1	1	FOOTHILL BEHAVIORAL HEALTH C	12/6/2023	1041C0700X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ONSULTANTS INC	15434 W SAGE ST	None	VICTORVILLE	CA	92395	3965	36	06071	34.51210263	-117.3272335	San Bernardino County
184134	Fee-for-Service	1053448415	1053448415	1	1	FOLKINS, ANN K MD	1/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106950	22	Pathology (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
184197	Fee-for-Service	1992088652	1992088652	1	1	FLEMING, JOHN MD	5/3/2024	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	124879	20	Orthopedic Surgery	0	In state provider	None	2200 E. MAPLE AVE	None	EL SEGUNDO	CA	90245	6507	19	06037	33.92690475	-118.3857342	Los Angeles County
184247	Fee-for-Service	1164769584	1164769584	1	1	FU, KARIN L MD INC	3/10/2014	261QR0208X	NA	Mammography Provider	026	PHYSICIANS	62299	30	Radiology	0	In state provider	None	1530 S OLIVE ST	2ND FLOOR	LOS ANGELES	CA	90015	3023	19	06037	34.03542552	-118.2652073	Los Angeles County
184281	Fee-for-Service	1497803654	1497803654	1	1	FAULK, ROBERT M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7920 HARRISON ST	None	LA VISTA	NE	68128	2912	00	None	41.19114159	-96.03664034	Douglas County
184326	Fee-for-Service	1386670610	1386670610	1	1	FAMILY HLTHCARE NETWORK	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	33025 ROAD 159	None	IVANHOE	CA	93235	1234	54	06107	36.38892365	-119.2180107	Tulare County
184360	Fee-for-Service	1801892799	1801892799	1	1	FISCHER, MARTIN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	6783	36	Psychiatry	0	In state provider	A MEDICAL CORP	8221 3RD ST	STE 305	DOWNEY	CA	90241	3732	19	06037	33.94241804	-118.1328946	Los Angeles County
184387	Fee-for-Service	1265443154	1265443154	1	1	FOOTHILL BEHAVIORAL HEALTH C	11/29/2018	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ONSULTANTS INC	15434 W SAGE ST	None	VICTORVILLE	CA	92395	3965	36	06071	34.51210263	-117.3272335	San Bernardino County
184426	Fee-for-Service	1275525693	1275525693	1	1	FULCHIERO, RANDALL M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MIAMI VALLEY HOSPITAL	1520 SOUTH MAIN ST	STE 2	DAYTON	OH	45409	2643	00	None	39.7376906	-84.18583354	Montgomery County
184583	Fee-for-Service	1023483328	1023483328	1	1	FRESENIUS MEDICAL CARE	12/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	IRVINE LLC	16255 LAGUNA CANYON ROAD	None	IRVINE	CA	92618	3603	30	06059	33.65873252	-117.7683929	Orange County
184670	Fee-for-Service	1265443154	1265443154	1	1	FOOTHILL BEHAVIORAL HEALTH C	3/7/2024	1041C0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	ONSULTANTS INC	15434 W SAGE ST	None	VICTORVILLE	CA	92395	3965	36	06071	34.51210263	-117.3272335	San Bernardino County
184689	Fee-for-Service	1659322469	1659322469	1	1	FILKINS, KAREN A MD	8/8/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	84052	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3325 PALO VERDE AVE	STE 105	LONG BEACH	CA	90808	4132	19	06037	33.81701249	-118.1078791	Los Angeles County
184693	Fee-for-Service	1568808772	1568808772	2	1	FLEXOGENIX INC	7/29/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1000 S HOPE STREET	STE 101	LOS ANGELES	CA	90015	4057	19	06037	34.04332181	-118.2620248	Los Angeles County
184712	Fee-for-Service	1225356264	1225356264	1	1	FLETCHER, LINDSEY K	3/5/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
184735	Fee-for-Service	1679568521	1679568521	1	1	FIELDS, WENDY J MD	9/15/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	78436	40	Pediatrics	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
184739	Fee-for-Service	1134391287	1134391287	1	1	FIELD, STEPHEN DO	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11017	36	Psychiatry	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
184745	Fee-for-Service	1225017767	1225017767	1	1	FLANAGAN, BRIAN F MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52943	05	Anesthesiology	0	In state provider	None	726 FOURTH STREET	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
184876	Fee-for-Service	1467535591	1467535591	1	1	FEILER, STACEE MSW LCSW	1/31/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
184893	Fee-for-Service	1154378305	1154378305	1	1	FUNG, JULI C MD	9/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86596	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
184906	Fee-for-Service	1992807523	1992807523	1	1	FATHI, ALIREZA MD	6/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79581	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
184958	Fee-for-Service	1265443154	1265443154	1	1	FOOTHILL BEHAVIORAL HEALTH C	12/8/2023	1041C0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ONSULTANTS INC	15434 W SAGE ST	None	VICTORVILLE	CA	92395	3965	36	06071	34.51210263	-117.3272335	San Bernardino County
184967	Fee-for-Service	1518332980	1518332980	1	1	FRESNIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY LLC	12555 GARDEN GROVE BLVD	SUITE 100	GARDEN GROVE	CA	92843	1904	30	06059	33.77450946	-117.913041	Orange County
184990	Fee-for-Service	1447922018	1447922018	1	1	FISHER, LENEA G NP	9/20/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1355 EAST ST	SUITE 200	REDDING	CA	96001	0801	45	06089	40.58628506	-122.3887911	Shasta County
184998	Fee-for-Service	1346225455	1346225455	1	1	FLEMING, NEAL W MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	66812	05	Anesthesiology	0	In state provider	None	2525 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
185015	Fee-for-Service	1851350466	1851350466	1	1	FICKLIN, VICKIE J LCSW	3/16/2010	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	615 E LEXINGTON AVE	None	EL CAJON	CA	92020	4617	37	06073	32.79268248	-116.9549159	San Diego County
185019	Fee-for-Service	1699870717	1699870717	1	1	FERNANDEZ, PATRICIA M MD	5/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54571	30	Radiology	0	In state provider	None	2800 L ST	STE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
185026	Fee-for-Service	1679568521	1679568521	1	1	FIELDS, WENDY J MD	9/15/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	78436	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
185041	Fee-for-Service	1629130240	1629130240	1	4	FEATHER RIVER TRIBAL	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2201 5TH AVE	None	OROVILLE	CA	95965	0000	04	06007	39.50254074	-121.5648218	Butte County
185127	Fee-for-Service	1386874949	1386874949	1	1	FURST ERLICH, JESSLYN E MD	1/17/2024	208M00000X	NA	Other	026	PHYSICIANS	119660	41	Internal Medicine	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
185128	Fee-for-Service	1588807390	1588807390	1	1	FONG, SUSAN A MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106819	40	Pediatrics	0	In state provider	None	2652 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3041	43	06085	37.35228637	-121.9754073	Santa Clara County
185132	Fee-for-Service	1336747153	1336747153	1	1	FLORES, PATRICIA LMFT	1/31/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	150948	-	NOT APPLICABLE	0	In state provider	None	5190 ATLANTIC AVE	None	LONG BEACH	CA	90805	6510	19	06037	33.850449	-118.1848215	Los Angeles County
185148	Fee-for-Service	1225128374	1225128374	1	1	FEENEY, JAMES M MD & VAUGHN	6/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	DAVID A MD	1800 SULLIVAN AVE	RM 207	DALY CITY	CA	94015	2222	41	06081	37.68077723	-122.4728941	San Mateo County
185179	Fee-for-Service	1497922587	1497922587	1	1	FRIEND, L K MD	10/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105460	20	Orthopedic Surgery	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
185194	Fee-for-Service	1992807523	1992807523	1	1	FATHI, ALIREZA MD	6/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79581	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
185199	Fee-for-Service	1134676042	1134676042	1	1	FLORES, ALEJANDRA LCSW	1/29/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RVICES	6202 FRANCIS LN	None	ORLAND	CA	95963	9303	11	06021	39.77410944	-122.2301792	Glenn County
185201	Fee-for-Service	1063496503	1063496503	1	1	FEFER, LOREN A MD	4/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	45094	10	Gastroenterology (M.D. only)	0	In state provider	None	3111 PROFESSIONAL DR	None	AUBURN	CA	95603	2456	31	06061	38.940327	-121.1007585	Placer County
185248	Fee-for-Service	1265443154	1265443154	1	1	FOOTHILL BEHAVIORAL HEALTH C	11/29/2018	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	ONSULTANTS INC	15434 W SAGE ST	None	VICTORVILLE	CA	92395	3965	36	06071	34.51210263	-117.3272335	San Bernardino County
185330	Fee-for-Service	1629130240	1629130240	1	4	FEATHER RIVER TRIBAL	4/19/2019	No Taxonomy Provided	NA	None	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	None	2201 5TH AVE	None	OROVILLE	CA	95965	0000	04	06007	39.50254074	-121.5648218	Butte County
185417	Fee-for-Service	1790743151	1790743151	1	1	FERNANDEZ, ROBERT G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	61142	08	Family Practice	0	In state provider	None	445 11TH ST	None	ORANGE COVE	CA	93646	2211	10	06019	36.62723052	-119.319103	Fresno County
185429	Fee-for-Service	1831168376	1831168376	1	1	FINLEY, RANDALL J MD	7/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96274	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
185435	Fee-for-Service	1225128374	1225128374	1	1	FEENEY, JAMES M MD & VAUGHN	6/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	DAVID A MD	1800 SULLIVAN AVE	RM 207	DALY CITY	CA	94015	2222	41	06081	37.68077723	-122.4728941	San Mateo County
185583	Fee-for-Service	1386746113	1386746113	1	1	FOGARTY, MATHEW A MD	12/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	52241	36	Psychiatry	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
185612	Fee-for-Service	1083689632	1083689632	2	1	FROST, JEFFREY B MD	1/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	29711	41	Internal Medicine	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
185647	Fee-for-Service	1558621904	1558621904	1	1	FEIGENBAUM, DANIELLE M MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123652	13	Neurology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5315	19	06037	34.06269295	-118.2030006	Los Angeles County
185661	Fee-for-Service	1750874442	1750874442	1	1	FRANKOVICH, JOURDAN M	8/8/2023	207RR0500X	NA	Other	026	PHYSICIANS	188359	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
185731	Fee-for-Service	1851362313	1851362313	1	1	FERRER, ADELARDO M MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50703	36	Psychiatry	0	In state provider	None	510 BROADWAY	STE 201	MILLBRAE	CA	94030	1966	41	06081	37.6027201	-122.393917	San Mateo County
185788	Fee-for-Service	1619070729	1619070729	1	1	FEATHER DOWN FAMILY	8/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	ASSOC, MEDICAL CORP	1590 POOLE BLVD	None	YUBA CITY	CA	95993	2607	51	06101	39.14468476	-121.6436714	Sutter County
185896	Fee-for-Service	1447303441	1447303441	1	1	FRANK RAY WILBUR	2/12/2018	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	175 CONCOURSE BLVD	None	SANTA ROSA	CA	95403	8217	49	06097	38.51157204	-122.7885509	Sonoma County
185982	Fee-for-Service	1033670104	1033670104	1	1	FREDRICKSON, JACOB PT	8/13/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
186009	Fee-for-Service	1689892895	1689892895	1	1	FULLERTON SCHOOL DIST	4/16/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1401 W VALENCIA DR	None	FULLERTON	CA	92833	3938	30	06059	33.86655147	-117.9512235	Orange County
186048	Fee-for-Service	1881985224	1881985224	1	1	FORCH, DENISHA V LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8247 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8200	34	06067	38.459187	-121.4080245	Sacramento County
186056	Fee-for-Service	1811936305	1811936305	1	1	FONG, CRAIG J MD	6/11/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64358	05	Anesthesiology	0	In state provider	None	CLAY AND BUCHANNAN	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.791126	-122.4309105	San Francisco County
186057	Fee-for-Service	1003117557	1003117557	1	1	FULCHER, JENNIFER A MD	5/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119112	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
186091	Fee-for-Service	1184077562	1184077562	1	1	FISH, SAMUEL E LAC	5/18/2017	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
186103	Fee-for-Service	1427363985	1427363985	1	1	FORD, NATHAN D MD	7/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	122580	01	General Practice	0	In state provider	None	7111 WINNETKA AVE	STE 14	CANOGA PARK	CA	91306	3674	19	06037	34.199739	-118.5710185	Los Angeles County
186124	Fee-for-Service	1063849735	1063849735	1	1	FREE AT LAST COMMUNITY	12/22/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	RECOVERY AND REHABILITAT	1796 BAY ROAD	None	EAST PALO ALTO	CA	94303	1611	41	06081	37.47165977	-122.1358311	San Mateo County
186178	Fee-for-Service	1700960879	1700960879	1	1	FUJII, KEN MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70963	20	Orthopedic Surgery	0	In state provider	None	1139 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
186246	Fee-for-Service	1760035489	1760035489	1	1	FRANCIS, JAKOB MD	8/25/2022	207R00000X	NA	Other	026	PHYSICIANS	20172	None	None	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
186320	Fee-for-Service	1033146758	1033146758	1	1	FISH, JONATHAN H MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	14910	30	Radiology	0	In state provider	None	3580 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1725	38	06075	37.78648975	-122.452943	San Francisco County
186395	Fee-for-Service	1033324447	1033324447	1	1	FAMILY BRIDGES	5/1/2000	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HONG FOOK CENTER	275 14TH ST	None	OAKLAND	CA	94612	4079	01	06001	37.80263214	-122.2670304	Alameda County
186414	Fee-for-Service	1215546270	1215546270	1	1	FRONTIER HOME HEALTH CARE	6/3/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	15720 VENTURA BLVD	STE 307	ENCINO	CA	91436	2914	19	06037	34.15524484	-118.4756687	Los Angeles County
186423	Fee-for-Service	1235521782	1235521782	1	2	FAMILY HEALTH CENTERS	9/18/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	2875 OCEAN VIEW BLVD	STE E128	SAN DIEGO	CA	92113	1334	37	06073	32.70113246	-117.1320823	San Diego County
186429	Fee-for-Service	1386122620	1386122620	1	1	FLORES, RAMONA RCP	9/24/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
186461	Fee-for-Service	1700960879	1700960879	1	1	FUJII, KEN MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70963	25	Physical Medicine and Rehabilitation	0	In state provider	None	1139 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
186529	Fee-for-Service	1275795965	1275795965	1	1	FUJIWARA, TADAO MD INC	6/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	25666	08	Family Practice	0	In state provider	None	5300 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4015	19	06037	34.02013512	-118.1561298	Los Angeles County
186530	Fee-for-Service	1700510898	1700510898	1	2	FAIRWAY CHILDREN'S MEDICAL G	8/13/2024	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	ROUP	888 S BREA CANYON RD	STE 330	DIAMOND BAR	CA	91789	3059	19	06037	34.00137763	-117.8453859	Los Angeles County
186540	Fee-for-Service	1750027033	1750027033	1	1	FIRST AID PHARMACY INC	7/29/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1113 N HOLLYWOOD WAY	None	BURBANK	CA	91505	2528	19	06037	34.17006439	-118.3481038	Los Angeles County
186549	Fee-for-Service	1386418069	1386418069	1	1	FLORES, JOSHUA PT	12/8/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
186552	Fee-for-Service	1003892167	1003892167	1	1	FULLER, JULIA D CRNA	4/27/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
186555	Fee-for-Service	1427548502	1427548502	1	1	FAMILY HEALTH CARE CENTERS	8/27/2018	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	GREATER LOS ANGELES INC	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	19	06037	33.97292523	-118.1475473	Los Angeles County
186651	Fee-for-Service	1346259611	1346259611	1	1	FERNANDO, JENNIFER NP	1/23/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
186711	Fee-for-Service	1235521782	1235521782	1	2	FAMILY HEALTH CENTERS	4/24/2024	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	2875 OCEAN VIEW BLVD	STE E128	SAN DIEGO	CA	92113	1334	37	06073	32.70113246	-117.1320823	San Diego County
186750	Fee-for-Service	1134167422	1134167422	1	1	FLORES, ANTHONY S MD	10/15/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55336	08	Family Practice	0	In state provider	None	1264 E LATHAM AVE	None	HEMET	CA	92543	4445	33	06065	33.7494633	-116.9590153	Riverside County
186801	Fee-for-Service	1164407789	1164407789	1	1	FEINBERG, RICHARD A MD	11/13/2006	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	29517	04	Otology, Laryngology, Rhinology	0	In state provider	None	2615 GRAND AVE	None	LONG BEACH	CA	90815	1708	19	06037	33.80527565	-118.1470853	Los Angeles County
186849	Fee-for-Service	1992379531	1992379531	1	1	FUNNAMARK, RANDALL DO	7/1/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
186850	Fee-for-Service	1356892731	1356892731	1	1	FRESENIUS MEDICAL CARE	3/18/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	MEMORIAL,LLC	17762 BEACH BLVD	SUITE 120	HUNTINGTON BEACH	CA	92647	6860	30	06059	33.70404013	-117.9890603	Orange County
186855	Fee-for-Service	1396881355	1396881355	1	1	FINGER, KENNETH	12/31/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	62059	08	Family Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
186888	Fee-for-Service	1972725505	1972725505	1	1	FENYOE, MEGAN R LCSW	12/7/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
186930	Fee-for-Service	1780135145	1780135145	1	1	FANSLER, KAM-LIN D CNM	4/5/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
186955	Fee-for-Service	1689843989	1689843989	1	1	FOYOUZI-YOUSEFI, NASTARAN MD	5/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107690	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
186999	Fee-for-Service	1235521782	1235521782	1	2	FAMILY HEALTH CENTERS	9/18/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	2875 OCEAN VIEW BLVD	STE E128	SAN DIEGO	CA	92113	1334	37	06073	32.70113246	-117.1320823	San Diego County
187005	Fee-for-Service	1023175916	1023175916	1	1	FASANO, SUSAN M LMFT	6/5/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
187036	Fee-for-Service	1063461333	1063461333	1	1	FIELDS, MARVIN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	16251	30	Radiology	0	In state provider	None	3325 PALO VERDE AVE	STE 103	LONG BEACH	CA	90808	4132	19	06037	33.81701249	-118.1078791	Los Angeles County
187054	Fee-for-Service	1972678639	1972678639	1	1	FERNANDEZ-BECKER, NIELSEN Q	11/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109586	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
187096	Fee-for-Service	1467849695	1467849695	1	1	FILIPPOU, PAULINE L MD	10/21/2022	208800000X	NA	Other	026	PHYSICIANS	177166	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
187104	Fee-for-Service	1558719047	1558719047	1	1	FARR, SAMAN DO	8/19/2024	390200000X	NA	Other	026	PHYSICIANS	16240	14	Neurological Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
187114	Fee-for-Service	1801922604	1801922604	1	1	FORD, JAMES M MD	11/30/1992	207RH0003X	NA	Oncology	026	PHYSICIANS	70477	41	Internal Medicine	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
187154	Fee-for-Service	1306686001	1306686001	1	1	FARRAJ, KRISTINA PT	1/16/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
187246	Fee-for-Service	1407056088	1407056088	1	1	FRANCO, TAMMY L	3/22/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
187273	Fee-for-Service	1558604256	1558604256	1	1	FEIGENBAUM, GARY S MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133392	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
187309	Fee-for-Service	1043394893	1043394893	1	1	FAZZOLARI, FRANK A MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75871	41	Internal Medicine	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
187327	Fee-for-Service	1013067040	1013067040	1	1	FOX, RENA K MD	6/29/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72286	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
187339	Fee-for-Service	1558569939	1558569939	1	1	FANG, DONGYU MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86468	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
187369	Fee-for-Service	1447543103	1447543103	1	1	FRANK, EVERARD CRNA	6/20/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
187396	Fee-for-Service	1972010684	1972010684	1	1	FAMILY HEALTHCARE NETWORK	4/9/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	22817 AVENUE 196	None	STRATHMORE	CA	93267	9404	54	06107	36.1454817	-119.0618595	Tulare County
187404	Fee-for-Service	1801922604	1801922604	1	1	FORD, JAMES M MD	11/30/1992	207RH0003X	NA	Oncology	026	PHYSICIANS	70477	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
187597	Fee-for-Service	1043394893	1043394893	1	1	FAZZOLARI, FRANK A MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75871	10	Gastroenterology (M.D. only)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
187616	Fee-for-Service	1053308510	1053308510	1	1	FRANTZ, ROBERT A MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	39818	05	Anesthesiology	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
187686	Fee-for-Service	1972010684	1972010684	1	1	FAMILY HEALTHCARE NETWORK	5/23/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	22817 AVENUE 196	None	STRATHMORE	CA	93267	9404	54	06107	36.1454817	-119.0618595	Tulare County
187726	Fee-for-Service	1710156203	1710156203	1	1	FISSEHA, SEBLE D MD	8/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85069	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
187758	Fee-for-Service	1730850561	1730850561	1	1	FIGUEROA, MATTHEW A LCSW	4/20/2022	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8300 UTICA AVE	STE 245	RANCHO CUCAMONGA	CA	91730	3852	36	06071	34.10227306	-117.5715643	San Bernardino County
187774	Fee-for-Service	1629497227	1629497227	1	1	FARIAS, ALEJANDRO MD	7/20/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	142176	None	None	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
187791	Fee-for-Service	1538184700	1538184700	1	1	FELDMAN, NANCY R MD	1/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	40260	41	Internal Medicine	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
187799	Fee-for-Service	1114157906	1114157906	1	1	FLORES, RAUDEL LMFT	5/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
187813	Fee-for-Service	1063430320	1063430320	1	1	FOSTER, JOY D MD	12/31/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	39082	None	None	0	In state provider	None	4200 E PACIFIC COAST HWY	None	LONG BEACH	CA	90804	2112	19	06037	33.78981346	-118.1439033	Los Angeles County
187837	Fee-for-Service	1205502044	1205502044	1	1	FAMILY FRIENDLY PSYCHOLOGICA	9/24/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	L GROUP, P.C.	500 COFFEE RD STE C	None	MODESTO	CA	95355	4926	50	06099	37.651032	-120.975531	Stanislaus County
187840	Fee-for-Service	1891781175	1891781175	1	1	FEE, JANIS D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73329	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 S ANAHEIM HILLS RD	STE 129	ANAHEIM	CA	92807	4762	30	06059	33.8427954	-117.7772895	Orange County
187857	Fee-for-Service	1366491292	1366491292	1	1	FEDALIZO, ELVIS M MD	2/18/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50432	08	Family Practice	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
187864	Fee-for-Service	1467485888	1467485888	1	1	FORSHPAN, REISHA	9/10/2018	103T00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4444 W RIVERSIDE DR	STE 305	BURBANK	CA	91505	4073	19	06037	34.15216892	-118.348791	Los Angeles County
187938	Fee-for-Service	1174598262	1174598262	1	1	FOY, RICHARD R MD	5/26/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	147512	None	None	0	In state provider	None	590 S INDIAN HILL BLVD	None	CLAREMONT	CA	91711	5212	19	06037	34.085313	-117.7191945	Los Angeles County
187974	Fee-for-Service	1972010684	1972010684	1	1	FAMILY HEALTHCARE NETWORK	4/9/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	22817 AVENUE 196	None	STRATHMORE	CA	93267	9404	54	06107	36.1454817	-119.0618595	Tulare County
188051	Fee-for-Service	1700913902	1700913902	1	2	FACES PLUS INC	3/21/2016	208200000X	NA	General Surgery	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	None	4510 EXECUTIVE DR	SUITE 200	SAN DIEGO	CA	92121	3021	37	06073	32.87570943	-117.2100834	San Diego County
188054	Fee-for-Service	1487018784	1487018784	1	1	FORTIN, KRISTEN L CNP	7/8/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
188127	Fee-for-Service	1528078516	1528078516	1	1	FIELDS, PETER A MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80579	66	Emergency Medicine (Urgent Care)	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
188137	Fee-for-Service	1154307767	1154307767	1	1	FRIEDMAN, RONALD A MD	4/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EYE CENTER	798 CASS ST	STE 204	MONTEREY	CA	93940	2920	27	06053	36.59428586	-121.8953825	Monterey County
188165	Fee-for-Service	1780692095	1780692095	1	1	FITCH, BRIAN D MD	6/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55198	05	Anesthesiology	0	In state provider	None	3555 CESAR CHAVEZ STREET	None	SAN FRANCISCO	CA	94110	4490	38	06075	37.7479947	-122.4209132	San Francisco County
188169	Fee-for-Service	1346733383	1346733383	1	1	FOSTER, KELLY E MD	6/20/2022	207L00000X	NA	Other	026	PHYSICIANS	163448	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
188202	Fee-for-Service	1275835332	1275835332	1	1	FELICITA PHARMACY INC	2/17/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	625 W CITRACADO PKWY	STE 106	ESCONDIDO	CA	92025	6428	37	06073	33.09166731	-117.0784699	San Diego County
188260	Fee-for-Service	1972010684	1972010684	1	1	FAMILY HEALTHCARE NETWORK	1/10/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	22817 AVENUE 196	None	STRATHMORE	CA	93267	9404	54	06107	36.1454817	-119.0618595	Tulare County
188272	Fee-for-Service	1376893669	1376893669	1	1	FIRMES, JOSHUA A LCSW	8/21/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1007 E COOLEY DR	STE 100	COLTON	CA	92324	3901	36	06071	34.05461152	-117.310599	San Bernardino County
188292	Fee-for-Service	1467848903	1467848903	1	1	FISHER, EMILY P MD	1/28/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	148350	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
188356	Fee-for-Service	1750602819	1750602819	1	1	FARSANI, TERRY T MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130247	07	Dermatology	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	43	06085	37.37715796	-122.0651926	Santa Clara County
188390	Fee-for-Service	1194780775	1194780775	1	1	FREISE, CHRIS MD	4/30/1989	208600000X	NA	General Surgery	026	PHYSICIANS	65942	08	Family Practice	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
188394	Fee-for-Service	1225158421	1225158421	1	1	FOX, HOWARD S DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1251 W GONZALES RD	None	OXNARD	CA	93036	3364	56	06111	34.21927951	-119.191878	Ventura County
188409	Fee-for-Service	1528078516	1528078516	1	1	FIELDS, PETER A MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80579	08	Family Practice	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
188420	Fee-for-Service	1740449149	1740449149	1	1	FUSSELL, DAVID A MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125979	30	Radiology	0	In state provider	None	2581 SAMARITAN DR	STE 100	SAN JOSE	CA	95124	4112	43	06085	37.25305684	-121.9507351	Santa Clara County
188496	Fee-for-Service	1750425146	1750425146	1	1	FUENTES,ANA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	20010 CENTURY BLVD	STE 200	GERMANTOWN	MD	20874	0000	00	None	39.18560725	-77.25950536	Montgomery County
188503	Fee-for-Service	1497705891	1497705891	1	1	FENNELL, ELTON G MD	9/8/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166234	None	None	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
188529	Fee-for-Service	1992179162	1992179162	1	1	FRIEBEN, CODY J NP	4/7/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
188538	Fee-for-Service	1962050724	1962050724	1	1	FLANDEZ, CRISTINE GERALDINE	1/25/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	M NP	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
188614	Fee-for-Service	1487085841	1487085841	1	1	FANI, PEJMAN DO MD	9/8/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	13052	08	Family Practice	0	In state provider	None	301 VICTORIA ST	None	COSTA MESA	CA	92627	1995	30	06059	33.65258952	-117.9121545	Orange County
188705	Fee-for-Service	1548847429	1548847429	1	1	FANSIWALA, KUSH M MD	4/1/2024	207R00000X	NA	Other	026	PHYSICIANS	191577	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
188717	Fee-for-Service	1578849287	1578849287	1	1	FINE-FOSTER, EMILY B PHD	8/20/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	SUITE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
188728	Fee-for-Service	1013447457	1013447457	1	1	FRAGOSO, KRISTEN RENE B LCSW	4/29/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	155 HOSPITALITY LN	245	SAN BERNARDINO	CA	92408	3305	36	06071	34.06580948	-117.2856915	San Bernardino County
188808	Fee-for-Service	1760525752	1760525752	1	1	FOOTHILL SURG SPEC MED	5/14/1984	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	GRP INC	1560 E CHEVY CHASE DR	STE 430	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
188820	Fee-for-Service	1871592063	1871592063	1	1	FEIGON, JUDITH T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7515 MAIN ST	STE 650	HOUSTON	TX	77030	4599	00	None	29.69896611	-95.41079561	Harris County
188855	Fee-for-Service	1508346388	1508346388	1	1	FATTAHI, NAHID LMFT	9/21/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
188897	Fee-for-Service	1144791062	1144791062	1	1	FUJIMURA, RERI	8/29/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
188898	Fee-for-Service	1639553613	1639553613	1	1	FAZELI, SOUDABEH MD	6/21/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161036	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
188899	Fee-for-Service	1700951423	1700951423	1	1	FREIMUTH, RITA S MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67525	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
188914	Fee-for-Service	1326052887	1326052887	1	1	FERNANDEZ, ERIC L MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60864	41	Internal Medicine	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1115	19	06037	34.27497644	-118.4679634	Los Angeles County
188917	Fee-for-Service	1457373342	1457373342	1	1	FORGHANI-ARANI, MEHRDAD	10/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8699	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	DO	12665 GARDEN GROVE BLVD	STE 601	GARDEN GROVE	CA	92843	1920	30	06059	33.77450141	-117.9123364	Orange County
188943	Fee-for-Service	1568984953	1568984953	1	1	FUSUNYAN, MARK A MD	9/14/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	172926	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
189122	Fee-for-Service	1063714970	1063714970	1	1	FAMILUA, OLUWAMAYOWA F MD FA	2/27/2023	208600000X	NA	General Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	CS	4655 COHEN AVE	None	EL PASO	TX	79924	4415	00	None	31.89285752	-106.4357823	El Paso County
189134	Fee-for-Service	1154601524	1154601524	1	1	FATEMI, GITA MD	7/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122706	83	Rheumatology	0	In state provider	None	64 E DAILY DR	None	CAMARILLO	CA	93010	5803	56	06111	34.22174543	-119.0683503	Ventura County
189163	Fee-for-Service	1871090001	1871090001	1	1	FLORES, JOSE RIZALDY R NP	7/22/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
189176	Fee-for-Service	1124505680	1124505680	1	1	FAMBROUGH, MARANDA PT	10/16/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25467 MEDICAL CENTER DR	100	MURRIETA	CA	92562	1501	33	06065	33.55711632	-117.1860368	Riverside County
189205	Fee-for-Service	1457373342	1457373342	1	1	FORGHANI-ARANI, MEHRDAD	10/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8699	15	Obstetrics (D.O. only)	0	In state provider	DO	12665 GARDEN GROVE BLVD	STE 601	GARDEN GROVE	CA	92843	1920	30	06059	33.77450141	-117.9123364	Orange County
189216	Fee-for-Service	1982747671	1982747671	1	1	FAMILY HEALTH CENTERS	4/27/2007	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4725 MARKET STREET	None	SAN DIEGO	CA	92102	4715	37	06073	32.71127386	-117.0929781	San Diego County
189295	Fee-for-Service	1609194216	1609194216	1	1	FEIN, RACHEL H PHD	9/6/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2131 ASHTON AVE	None	MENLO PARK	CA	94025	6501	41	06081	37.43205327	-122.2036961	San Mateo County
189473	Fee-for-Service	1386919595	1386919595	1	1	FEUERSTEIN, JOSHUA D MD	1/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151576	41	Internal Medicine	0	In state provider	None	1020 9TH ST	SUITE 120	SACRAMENTO	CA	95816	5173	34	06067	38.580048	-121.495275	Sacramento County
189480	Fee-for-Service	1063770121	1063770121	1	1	FRANKEL, JONATHAN A MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	128611	30	Radiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
189493	Fee-for-Service	1457373342	1457373342	1	1	FORGHANI-ARANI, MEHRDAD	10/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8699	09	Gynecology (D.O. only)	0	In state provider	DO	12665 GARDEN GROVE BLVD	STE 601	GARDEN GROVE	CA	92843	1920	30	06059	33.77450141	-117.9123364	Orange County
189502	Fee-for-Service	1740277995	1740277995	1	1	FERNANDEZ, MARY ANN S MD	8/24/2004	173000000X	NA	Other	026	PHYSICIANS	48115	40	Pediatrics	0	In state provider	None	595 BUCKINGHAM WAY	STE 430	SAN FRANCISCO	CA	94132	1912	38	06075	37.73012679	-122.4767395	San Francisco County
189505	Fee-for-Service	1982747671	1982747671	1	1	FAMILY HEALTH CENTERS	4/27/2007	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	4725 MARKET STREET	None	SAN DIEGO	CA	92102	4715	37	06073	32.71127386	-117.0929781	San Diego County
189619	Fee-for-Service	1639228059	1639228059	1	1	FRUT0S, PAUL W DO	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3269 STOCKTON HILL ROAD	None	KINGMAN	AZ	86404	1748	00	None	35.220006	-114.0380145	Mohave County
189639	Fee-for-Service	1376922708	1376922708	1	1	FLEMING, JAMIE MD	11/30/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
189658	Fee-for-Service	1952064222	1952064222	1	2	FACULTY PHYSICIANS AND SURGE	12/1/2021	204F00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	1695 N. SUNRISE WAY	None	PALM SPRINGS	CA	92262	3701	33	06065	33.844239	-116.5282075	Riverside County
189669	Fee-for-Service	1285641837	1285641837	1	1	FRIEDMAN, RICHARD MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	62351	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	880 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4700	19	06037	34.05038485	-118.1383456	Los Angeles County
189706	Fee-for-Service	1184815292	1184815292	1	1	FASSETT, RICHARD L MD IN	11/4/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	& ALLEN, JOSEPH E MD INC	4116 W POINT LOMA BLVD	None	SAN DIEGO	CA	92110	5605	37	06073	32.75335292	-117.2246698	San Diego County
189787	Fee-for-Service	1033750450	1033750450	1	1	FEDERMAN, LEEMORE LCSW	2/14/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	777 DAVIS ST	None	SAN LEANDRO	CA	94577	6923	01	06001	37.72317409	-122.162925	Alameda County
189794	Fee-for-Service	1255393955	1255393955	1	1	FOGG, MAXWELL AND LANIER	11/1/2001	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MD INC	2401 W CLEVELAND AVE	None	MADERA	CA	93637	3608	20	06039	36.9746635	-120.087405	Madera County
189798	Fee-for-Service	1962057034	1962057034	1	1	FREDRICKS, RYAN T CRNA	5/23/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
189828	Fee-for-Service	1346258787	1346258787	1	1	FRESNO, BLANCA I MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	45205	40	Pediatrics	0	In state provider	None	655 EUCLID AVE	STE 302	NATIONAL CITY	CA	91950	2973	37	06073	32.68353398	-117.082625	San Diego County
189831	Fee-for-Service	1164510236	1164510236	1	2	FERRIGNO, LISA MD	11/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
189833	Fee-for-Service	1447207626	1447207626	1	1	FUTCH, LISA S MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	65334	05	Anesthesiology	0	In state provider	None	460 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13140416	-121.6141951	Sutter County
189838	Fee-for-Service	1336630193	1336630193	1	1	FIGUEROA, APRIL M NP	11/11/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	27555 YNEZ RD	SUITE 370	TEMECULA	CA	92591	4678	33	06065	33.50370608	-117.1492569	Riverside County
189901	Fee-for-Service	1598051278	1598051278	1	1	FUJINAKA, MICHAEL K	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123278	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
189938	Fee-for-Service	1518295484	1518295484	1	1	FARMAND, FARBOD DO	1/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10966	None	None	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1819	36	06071	34.073505	-117.3505995	San Bernardino County
189952	Fee-for-Service	1285641837	1285641837	1	1	FRIEDMAN, RICHARD MD	5/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	62351	01	General Practice	0	In state provider	None	880 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4700	19	06037	34.05038485	-118.1383456	Los Angeles County
189974	Fee-for-Service	1679894372	1679894372	1	1	FELLOWS, MATTHEW I MD	7/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148995	01	General Practice	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
189996	Fee-for-Service	1568091494	1568091494	1	1	FELDMAN, DAVID MD	12/13/2024	2081H0002X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	183508	41	Internal Medicine	0	In state provider	None	5765 GREENBACK LN	None	SACRAMENTO	CA	95841	2013	34	06067	38.681622	-121.327848	Sacramento County
190010	Fee-for-Service	1811011679	1811011679	1	1	FRAZIER MOUNTAIN COMM	7/1/1994	261QM2500X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	704 LEBEC RD	None	LEBEC	CA	93225	0000	15	06029	34.82081411	-118.8844069	Kern County
190027	Fee-for-Service	1225645468	1225645468	1	1	FREUDMAN, LAUREN J OT	12/11/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
190032	Fee-for-Service	1205862612	1205862612	1	1	FAYAD, FADY MD	1/18/2024	207R00000X	NA	Other	026	PHYSICIANS	172881	01	General Practice	0	In state provider	None	9041 MAGNOLIA AVE	STE 6	RIVERSIDE	CA	92503	3941	33	06065	33.92541585	-117.4378266	Riverside County
190054	Fee-for-Service	1922636349	1922636349	1	1	FRIEDEN, MARSHALL J MD	9/20/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	190060	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
190060	Fee-for-Service	1295181857	1295181857	1	1	FUJIHARA, DAVID J DO MD	8/1/2018	207P00000X	NA	Other	026	PHYSICIANS	15955	66	Emergency Medicine (Urgent Care)	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
190062	Fee-for-Service	1194937011	1194937011	1	1	FERRANTE JOSEPH T DPM	12/29/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	PASADENA PODIATRY GROUP	65 N MADISON AVE	STE 512	PASADENA	CA	91101	5217	19	06037	34.14705803	-118.1384317	Los Angeles County
190090	Fee-for-Service	1306956362	1306956362	1	1	FALSAFI, SASSAN MD	1/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	85934	04	Otology, Laryngology, Rhinology	0	In state provider	None	3779 PIEDMONT AVE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
190151	Fee-for-Service	1942317268	1942317268	1	1	FABER, LUKE A MD	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49404	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	40	06079	35.27804785	-120.649711	San Luis Obispo County
190172	Fee-for-Service	1063456978	1063456978	1	1	FELIX, ALLEN C MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	75952	None	None	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
190197	Fee-for-Service	1588674022	1588674022	1	1	FLORES, SERGIO R MD	5/31/1993	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	69854	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1855 1ST AVE	STE 200B	SAN DIEGO	CA	92101	2650	37	06073	32.7247631	-117.1638834	San Diego County
190201	Fee-for-Service	1396036711	1396036711	1	1	FU, HE MD	10/8/2018	208200000X	NA	General Surgery	026	PHYSICIANS	155256	24	Plastic Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
190238	Fee-for-Service	1366439804	1366439804	1	1	FRANCIS, ROBERT L MD	6/27/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	17999	41	Internal Medicine	0	In state provider	None	333 W BASTANCHURY RD	None	FULLERTON	CA	92835	3420	30	06059	33.89358012	-117.9327635	Orange County
190255	Fee-for-Service	1205003142	1205003142	1	1	FEINZIMER, BENJAMIN A DO	9/4/2020	207P00000X	NA	Other	026	PHYSICIANS	17336	None	None	0	In state provider	None	9961 BALDWIN	None	EL MONTE	CA	91731	2203	19	06037	34.07142576	-118.0515933	Los Angeles County
190323	Fee-for-Service	1225731086	1225731086	1	1	FAMILY SERVICE AGENCY OF SAN	9/12/2024	171M00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	TA BARBARA COUNTY	123 W GUTIERREZ ST	None	SANTA BARBARA	CA	93101	3424	42	06083	34.41387023	-119.6962788	Santa Barbara County
190374	Fee-for-Service	1154365997	1154365997	1	1	FULLERTON ORTHOPAEDIC SU	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	MED GRP INC	101 LAGUNA RD	STE A	FULLERTON	CA	92835	3635	30	06059	33.89326085	-117.9300987	Orange County
190463	Fee-for-Service	1144631441	1144631441	1	1	FISCHBECK, TUCKER DO	2/25/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	14474	30	Radiology	0	In state provider	None	7301 MEDICAL CENTER DR	SUITE 103	WEST HILLS	CA	91307	1943	19	06037	34.20285756	-118.6294575	Los Angeles County
190484	Fee-for-Service	1588674022	1588674022	1	1	FLORES, SERGIO R MD	5/31/1993	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	69854	10	Gastroenterology (M.D. only)	0	In state provider	None	1855 1ST AVE	STE 200B	SAN DIEGO	CA	92101	2650	37	06073	32.7247631	-117.1638834	San Diego County
190504	Fee-for-Service	1831123421	1831123421	1	1	FELEKE, REHEMA A MD	8/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90972	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
190576	Fee-for-Service	1558752212	1558752212	1	1	FRESHMAN, RYAN MD	9/4/2024	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	166363	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
190583	Fee-for-Service	1497356760	1497356760	1	1	FLORES, CARLA Y BIRTH DOULA	9/26/2024	101Y00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	37	06073	0	0	None
190595	Fee-for-Service	1205897535	1205897535	1	1	FAHIM-GADALLAH, SAMEH MD	5/1/1995	207R00000X	NA	Other	026	PHYSICIANS	49405	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	41210 11TH ST W	STE C	PALMDALE	CA	93551	1447	19	06037	34.631649	-118.150154	Los Angeles County
190596	Fee-for-Service	1073547485	1073547485	1	1	FENG, ALEX LAC	5/2/2017	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
190638	Fee-for-Service	1902427404	1902427404	1	1	FERNANDEZ, CHRISTOPHER DO	7/25/2024	207QA0401X	NA	Adult Primary Care	026	PHYSICIANS	22770	08	Family Practice	0	In state provider	None	147 NORTH BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
190680	Fee-for-Service	1316359367	1316359367	1	1	FRESENIUS MEDICAL CARE	5/1/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	REEDLEY LLC	810 E MANNING AVE	None	REEDLEY	CA	93654	2102	10	06019	36.60418551	-119.4411015	Fresno County
190707	Fee-for-Service	1326067448	1326067448	1	1	FRIDAY, KAREN J MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68124	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
190730	Fee-for-Service	1790829349	1790829349	1	1	FRICKER, CAROLINE B LCSW	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27727	-	NOT APPLICABLE	0	In state provider	None	649 E ALBERTONI ST	SUITE 100	CARSON	CA	90746	1538	19	06037	33.87194399	-118.2643054	Los Angeles County
190740	Fee-for-Service	1407953300	1407953300	1	1	FERNANDEZ, ROGELIO G MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67336	01	General Practice	0	In state provider	None	4623 N 1ST ST	None	FRESNO	CA	93726	0904	10	06019	36.801657	-119.7724455	Fresno County
190771	Fee-for-Service	1588674022	1588674022	1	1	FLORES, SERGIO R MD	5/31/1993	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	69854	41	Internal Medicine	0	In state provider	None	1855 1ST AVE	STE 200B	SAN DIEGO	CA	92101	2650	37	06073	32.7247631	-117.1638834	San Diego County
190903	Fee-for-Service	1487128328	1487128328	1	1	FIRST AMERICAN NON EMERGENCY	11/22/2019	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	MEDICAL SERVICE, INC.	24907 SUNNYMEAD BLVD	E	MORENO VALLEY	CA	92553	9314	33	06065	33.93907052	-117.228861	Riverside County
190915	Fee-for-Service	1821102146	1821102146	1	1	FINNEY, CURTIS J MD	8/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88338	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
190996	Fee-for-Service	1326067448	1326067448	1	1	FRIDAY, KAREN J MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68124	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
191079	Fee-for-Service	1427327162	1427327162	1	1	FOREST, MATTHEW C	5/4/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	685 TWELVE BRIDGES DR	None	LINCOLN	CA	95648	8589	31	06061	38.85108687	-121.2886018	Placer County
191101	Fee-for-Service	1124301338	1124301338	1	1	FRANK, GILA E PSYD	1/15/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4700 SUNSET BLVD	None	LOS ANGELES	CA	90027	6082	19	06037	34.09812055	-118.2921165	Los Angeles County
191167	Fee-for-Service	1639352131	1639352131	1	1	FRASER-HULTHAGE, ANNA E	1/29/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	101439	08	Family Practice	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
191200	Fee-for-Service	1417503905	1417503905	1	1	FRESNO VALLEY SNF INC	9/17/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	4840 E TULARE AVE	None	FRESNO	CA	93727	3062	10	06019	36.74316146	-119.7346391	Fresno County
191267	Fee-for-Service	1699123927	1699123927	1	1	FIREIZEN, YARON MD	8/22/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	161419	None	None	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
191309	Fee-for-Service	1861429581	1861429581	1	1	FEINSTEIN, DONALD MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	5611	41	Internal Medicine	0	In state provider	None	1401 S HOPE ST	STE 323	LOS ANGELES	CA	90015	2903	19	06037	34.0376784	-118.2668845	Los Angeles County
191370	Fee-for-Service	1619972247	1619972247	1	1	FADDA, GEORGE Z MD	6/30/1988	207RN0300X	NA	Nephrology	026	PHYSICIANS	44918	45	Nephrology (Renal-Kidney)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
191565	Fee-for-Service	1205247061	1205247061	1	1	FUENTES, ODALYS J LMFT	2/20/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	250 W FIRST ST	SUITE 346	CLAREMONT	CA	91711	4742	19	06037	34.09450024	-117.7183344	Los Angeles County
191597	Fee-for-Service	1861429581	1861429581	1	1	FEINSTEIN, DONALD MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	5611	01	General Practice	0	In state provider	None	1401 S HOPE ST	STE 323	LOS ANGELES	CA	90015	2903	19	06037	34.0376784	-118.2668845	Los Angeles County
191688	Fee-for-Service	1215004130	1215004130	1	1	FAGIN, JOSEPH S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	15899	01	General Practice	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
191846	Fee-for-Service	1063688836	1063688836	1	1	FLAXMAN, GABRIEL MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110186	08	Family Practice	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
191855	Fee-for-Service	1407911258	1407911258	1	1	FAMILIES FIRST, INC	5/20/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	232 EAST GISH ROAD	None	SAN JOSE	CA	95122	4706	43	06085	37.36411044	-121.9052075	Santa Clara County
191867	Fee-for-Service	1063590347	1063590347	1	1	FINVER, GENA	1/31/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
191954	Fee-for-Service	1730364480	1730364480	1	1	FOLLETTE, JULIA L MD	3/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55187	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
191977	Fee-for-Service	1215004130	1215004130	1	1	FAGIN, JOSEPH S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	15899	08	Family Practice	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
192050	Fee-for-Service	1609072438	1609072438	1	1	FRANCIS, CARRIE L MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111716	04	Otology, Laryngology, Rhinology	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
192067	Fee-for-Service	1235521782	1235521782	1	1	FAMILY HEALTH CENTERS	6/19/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2325 COMMERCIAL ST	STE 1400	SAN DIEGO	CA	92113	1195	37	06073	32.70514724	-117.1429916	San Diego County
192124	Fee-for-Service	1588697254	1588697254	1	1	FOCUS HOME CARE INC	9/14/1996	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	4892 SCREECH OWL CREEK R	None	EL DORADO HILLS	CA	95762	8073	09	06017	38.64054638	-121.0445112	El Dorado County
192168	Fee-for-Service	1013930098	1013930098	1	1	FONG, CHRISTOPHER L OD	12/18/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
192287	Fee-for-Service	1295835072	1295835072	1	1	FARINAS, LEAH P MD	1/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88077	02	General Surgery	0	In state provider	None	1050 B AVE	STE C	CORONADO	CA	92118	3430	37	06073	32.68408301	-117.1780847	San Diego County
192334	Fee-for-Service	1083942148	1083942148	1	1	FLORENDO TAN, MARY ELLEN G	10/30/2009	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W SAN JOSE AVE	UNIT A	CLAREMONT	CA	91711	5204	19	06037	34.08314253	-117.7159185	Los Angeles County
192356	Fee-for-Service	1235521782	1235521782	1	1	FAMILY HEALTH CENTERS	9/25/2015	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2325 COMMERCIAL ST	STE 1400	SAN DIEGO	CA	92113	1195	37	06073	32.70514724	-117.1429916	San Diego County
192450	Fee-for-Service	1497784532	1497784532	1	1	FROMONT, SEBASTIEN C MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	79922	36	Psychiatry	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
192539	Fee-for-Service	1780896217	1780896217	1	1	FISHER, LYNNA G PT	2/26/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1110 CIVIC CENTER BLVD	STE 502	YUBA CITY	CA	95993	3013	51	06101	39.143016	-121.639237	Sutter County
192561	Fee-for-Service	1861406266	1861406266	1	1	FISHER, J RONALD MD	5/11/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	20619	30	Radiology	0	In state provider	None	865 PROSPECT HTS	None	SANTA CRUZ	CA	95065	1413	44	06087	36.990894	-121.9933851	Santa Cruz County
192575	Fee-for-Service	1295835072	1295835072	1	1	FARINAS, LEAH P MD	1/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88077	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1050 B AVE	STE C	CORONADO	CA	92118	3430	37	06073	32.68408301	-117.1780847	San Diego County
192584	Fee-for-Service	1689382327	1689382327	1	1	FORINASH, KAYCEE	2/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16955 VANOWEN	None	VAN NUYS	CA	91406	4542	19	06037	34.19389751	-118.503342	Los Angeles County
192632	Fee-for-Service	1396898623	1396898623	1	1	FUENTES, JOSEPH M MD	11/12/2010	390200000X	NA	Other	026	PHYSICIANS	111078	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
192646	Fee-for-Service	1235521782	1235521782	1	1	FAMILY HEALTH CENTERS	6/19/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2325 COMMERCIAL ST	STE 1400	SAN DIEGO	CA	92113	1195	37	06073	32.70514724	-117.1429916	San Diego County
192664	Fee-for-Service	1790058766	1790058766	1	1	FORREST, BARRY L LCSW	12/13/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
192671	Fee-for-Service	1972581098	1972581098	1	1	FLICKNER, CHRISTIAN J OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	48 W ROMIE LN	None	SALINAS	CA	93901	2317	27	06053	36.66343104	-121.6600006	Monterey County
192763	Fee-for-Service	1205391620	1205391620	1	1	FIEDLER, DEREK J CRNA	2/7/2023	207L00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
192799	Fee-for-Service	1972989408	1972989408	1	1	FOLK, CRYSTAL G LMFT	3/31/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5051 CANYON CREST DR	SUITE 204	RIVERSIDE	CA	92507	0000	33	06065	33.9589602	-117.3311519	Riverside County
192864	Fee-for-Service	1295835072	1295835072	1	1	FARINAS, LEAH P MD	1/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88077	01	General Practice	0	In state provider	None	1050 B AVE	STE C	CORONADO	CA	92118	3430	37	06073	32.68408301	-117.1780847	San Diego County
192873	Fee-for-Service	1417306200	1417306200	2	1	FAIRVIEW MTM PHARMA INC	4/6/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	EW	1002 N FAIRVIEW ST	None	SANTA ANA	CA	92703	1811	30	06059	33.75346151	-117.9023004	Orange County
192887	Fee-for-Service	1114936473	1114936473	1	1	FRIEDRICH, JEFFREY B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	325 9TH AVE	MS 359110 C/O UWP	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
192907	Fee-for-Service	1508180456	1508180456	1	1	FALLAH, HESHAAM M MD	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106484	84	Surgery-Head and Neck	0	In state provider	None	3779 PIEDMONT AVE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
192910	Fee-for-Service	1013924141	1013924141	1	1	FABRIS, CECILIA LMFT	9/14/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9033 BASELINE RD	STE A	RANCHO CUCAMONGA	CA	91730	1214	36	06071	34.12151248	-117.6080805	San Bernardino County
192932	Fee-for-Service	1235521782	1235521782	1	1	FAMILY HEALTH CENTERS	8/7/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2325 COMMERCIAL ST	STE 1400	SAN DIEGO	CA	92113	1195	37	06073	32.70514724	-117.1429916	San Diego County
192975	Fee-for-Service	1811274079	1811274079	1	1	FROHLICH, CHRISTINA C	1/18/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	RMC MOB2	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
192987	Fee-for-Service	1336741198	1336741198	1	1	FAMILY ONE HOSPICE &	4/4/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE	14545 FRIAR STREET	SUITE 261	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
193077	Fee-for-Service	1558493221	1558493221	1	1	FONSECA, NINOSKA R LMFT	3/2/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4625 MARWOOD DR	None	LOS ANGELES	CA	90065	5126	19	06037	34.13030788	-118.2245814	Los Angeles County
193135	Fee-for-Service	1104380088	1104380088	1	1	FOUNTAIN, DAWN S RCP	3/1/2019	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
193161	Fee-for-Service	1417562778	1417562778	1	1	FATE HOSPICE INC	3/31/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1461 E CHEVY CHASE DR	STE 100A	GLENDALE	CA	91206	4090	19	06037	34.15175609	-118.233918	Los Angeles County
193243	Fee-for-Service	1710048939	1710048939	1	1	FENNEMA, ERIC MATTHEW OD	8/30/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPT CNTR OF MENIFEE VLLY	29950 HAUN RD	STE 206	SUN CITY	CA	92586	6527	33	06065	33.68584881	-117.1754214	Riverside County
193274	Fee-for-Service	1336741198	1336741198	1	1	FAMILY ONE HOSPICE &	4/4/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE	14545 FRIAR STREET	SUITE 261	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
193288	Fee-for-Service	1164941753	1164941753	1	1	FLOWER HOME HEALTH, INC	9/20/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8560 VINEYARD AVE	STE 508	RANCHO CUCAMONGA	CA	91730	4350	36	06071	34.098435	-117.611127	San Bernardino County
193311	Fee-for-Service	1336264290	1336264290	1	1	FOOS, DAVID P DO	8/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10349	08	Family Practice	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
193451	Fee-for-Service	1417562778	1417562778	1	1	FATE HOSPICE INC	3/31/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1461 E CHEVY CHASE DR	STE 100A	GLENDALE	CA	91206	4090	19	06037	34.15175609	-118.233918	Los Angeles County
193478	Fee-for-Service	1164425294	1164425294	1	1	FAWAD TANVIR	1/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1060 E 100 S L-10	None	SALT LAKE CTY	UT	84102	1501	00	None	40.76715684	-111.8603066	Salt Lake County
193638	Fee-for-Service	1417066416	1417066416	1	1	FRUMIN, FREDERICK M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40662	40	Pediatrics	0	In state provider	None	317 N EL CAMINO #506	None	ENCINITAS	CA	92024	0000	37	06073	33.05428107	-117.2615637	San Diego County
193640	Fee-for-Service	1811123433	1811123433	1	1	FAZIO, MICHAEL G DO	5/13/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	22834	30	Radiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
193707	Fee-for-Service	1912185885	1912185885	1	1	FAUGHNAN, MEGAN E MD	11/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118153	40	Pediatrics	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
193724	Fee-for-Service	1861955627	1861955627	1	1	FIRST BELL HOME HEALTH CARE	2/9/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1923 WEST GLENOAKS BLVD	None	GLENDALE	CA	91201	1503	19	06037	34.17454928	-118.2941996	Los Angeles County
193763	Fee-for-Service	1659683720	1659683720	1	2	FOOTHILL EMERGENCY MEDICAL A	2/1/2022	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SSOCIATES, INC	600 MARINE BLVD	None	MOSS BEACH	CA	94038	9641	41	06081	37.52703039	-122.5075216	San Mateo County
193820	Fee-for-Service	1609835214	1609835214	1	1	FREDERIC JOSEPH	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1550 N 115TH ST	None	SEATTLE	WA	98133	8401	00	None	47.714643	-122.337108	King County
193888	Fee-for-Service	1487040200	1487040200	1	1	FU, BO MD	6/8/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	161312	36	Psychiatry	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
193925	Fee-for-Service	1679695050	1679695050	1	1	FISHER, BARBRA M MD FACOG	3/27/2023	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	184615	None	None	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
193940	Fee-for-Service	1033296991	1033296991	1	1	FARUQI, RISHAD M MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62675	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
193966	Fee-for-Service	1851928162	1851928162	1	1	FARHAT, AHMED M MD	2/13/2023	207P00000X	NA	Other	026	PHYSICIANS	180927	None	None	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
193971	Fee-for-Service	1033241617	1033241617	1	1	FORER, BONNIE J LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
194023	Fee-for-Service	1194995837	1194995837	1	1	FAGIN, ALICE M MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110727	84	Surgery-Head and Neck	0	In state provider	None	3301 C STREET	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
194038	Fee-for-Service	1346315090	1346315090	1	1	FERLATTE, NICHOLAS	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
194072	Fee-for-Service	1306047394	1306047394	1	1	FEIT-LEICHMAN, RACHEL A MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107019	None	None	0	In state provider	None	100 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06489065	-118.4443287	Los Angeles County
194119	Fee-for-Service	1700510898	1700510898	1	1	FAIRWAY CHILDREN'S MEDICAL G	10/31/2022	152WP0200X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	ROUP	2707 E VALLEY BLVD	215	WEST COVINA	CA	91792	3197	19	06037	34.00296323	-117.8868537	Los Angeles County
194156	Fee-for-Service	1528201779	1528201779	1	1	FOLEY, STEPHANIE J MD	8/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178283	None	None	0	In state provider	None	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	19	06037	34.06704253	-118.3835029	Los Angeles County
194173	Fee-for-Service	1326435447	1326435447	1	1	FLYNN, ANNE N MD	8/1/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	173088	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
194232	Fee-for-Service	1225147101	1225147101	1	1	FAUCHER, KIMBERLY R MD	2/8/2015	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	74987	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL CORP	1155 S MAIN ST	None	WILLITS	CA	95490	4336	23	06045	39.400402	-123.3496755	Mendocino County
194271	Fee-for-Service	1720155690	1720155690	1	1	FLETES, LUIS E MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66687	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
194350	Fee-for-Service	1508961491	1508961491	1	1	FAIZ, SAMIA MD	1/27/2020	207R00000X	NA	Other	026	PHYSICIANS	72188	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
194353	Fee-for-Service	1245778299	1245778299	1	1	FRED BROWN'S RECOVERY SERVIC	11/20/2019	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ES, INC.	852 & 856 W 19TH ST	None	SAN PEDRO	CA	90731	5314	19	06037	33.7270103	-118.295975	Los Angeles County
194498	Fee-for-Service	1669783122	1669783122	1	1	FAMILIA SANA MEDICAL GROUP	11/4/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC	15211 VANOWEN ST	#206	VAN NUYS	CA	91405	2290	19	06037	34.19395411	-118.4642527	Los Angeles County
194517	Fee-for-Service	1124551312	1124551312	1	1	FEI, FEI MD	7/25/2023	207ZP0102X	NA	Other	026	PHYSICIANS	164912	None	None	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
194522	Fee-for-Service	1154596336	1154596336	1	1	FORTENKO, OLGA M MD	11/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110003	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2351 CLAY ST	STE 501	SAN FRANCISCO	CA	94115	1931	38	06075	37.79101512	-122.4316059	San Francisco County
194530	Fee-for-Service	1831309616	1831309616	1	1	FLYNN, SARAH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	33155 ANNAPOLIS ST	None	WAYNE	MI	48184	2405	00	None	42.27425649	-83.36479079	Wayne County
194543	Fee-for-Service	1083904775	1083904775	1	1	FRIEDMAN, NICHOLAS L DO	2/1/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	20618	None	None	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
194548	Fee-for-Service	1235648080	1235648080	1	1	FLORES, JAMIE M LCSW	2/22/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	214 ESTATES DRIVE,	STE. E	ROSEVILLE	CA	95682	7652	31	06061	38.74766054	-121.273092	Placer County
194554	Fee-for-Service	1194109785	1194109785	1	1	FUSARO, MICHAEL E CRNA	4/7/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
194575	Fee-for-Service	1295749620	1295749620	1	1	FOLSOM ANESTHESIA MED	2/24/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	GROUP, INC	1650 CREEKSIDE DR	None	FOLSOM	CA	95630	3400	34	06067	38.67021	-121.145382	Sacramento County
194690	Fee-for-Service	1689746414	1689746414	1	1	FIRESTONE, JENNIFER R MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66206	08	Family Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
194784	Fee-for-Service	1477860641	1477860641	1	1	FDM ANESTHESIOLOGY INC	9/28/2010	207L00000X	NA	Other	026	PHYSICIANS	97383	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
194787	Fee-for-Service	1669783122	1669783122	1	1	FAMILIA SANA MEDICAL GROUP	11/4/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	INC	15211 VANOWEN ST	#206	VAN NUYS	CA	91405	2290	19	06037	34.19395411	-118.4642527	Los Angeles County
194809	Fee-for-Service	1528591369	1528591369	1	1	FARHAT, WAQAS MD	8/25/2020	207R00000X	NA	Other	026	PHYSICIANS	169453	41	Internal Medicine	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
194892	Fee-for-Service	1679509350	1679509350	1	1	FAIERMAN, ALVIN H MD	3/31/1986	207L00000X	NA	Other	026	PHYSICIANS	57589	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
194902	Fee-for-Service	1427196757	1427196757	1	1	FINLAY, JONATHAN L	11/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	35724	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
195028	Fee-for-Service	1568543627	1568543627	1	1	FUCHS, ANNA M MD	8/31/1990	208800000X	NA	Other	026	PHYSICIANS	54330	34	Urology and Urological Surgery	0	In state provider	KIDNEY STONE SERVICE	1681 BENEDICT CANYON DR	None	BEVERLY HILLS	CA	90210	2002	19	06037	34.10163615	-118.4363681	Los Angeles County
195047	Fee-for-Service	1871799734	1871799734	1	1	FEBRE, APRILLE D MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107117	40	Pediatrics	0	In state provider	None	25845 BARTON RD	None	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
195052	Fee-for-Service	1720014376	1720014376	1	1	FARFAN-GONZALEZ, OLIVIA	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75237	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8787 HALL RD	None	LAMONT	CA	93241	1953	15	06029	35.25969451	-118.908099	Kern County
195067	Fee-for-Service	1730281254	1730281254	1	1	FENG, FRANK DO	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7700	20	Orthopedic Surgery	0	In state provider	None	325 S WILLIS ST	None	VISALIA	CA	93291	6105	54	06107	36.327717	-119.2981005	Tulare County
195068	Fee-for-Service	1730282716	1730282716	1	1	FONG, LYNETTE J MD	8/3/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75170	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
195073	Fee-for-Service	1669783122	1669783122	1	1	FAMILIA SANA MEDICAL GROUP	11/4/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INC	15211 VANOWEN ST	#206	VAN NUYS	CA	91405	2290	19	06037	34.19395411	-118.4642527	Los Angeles County
195075	Fee-for-Service	1801160858	1801160858	1	1	FEIST, ALYSSA PT	6/5/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
195120	Fee-for-Service	1417175233	1417175233	1	1	FONG, CAROLINE L MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94172	30	Radiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
195159	Fee-for-Service	1205185337	1205185337	2	1	FESS, CHARLOTTE A LMFT	8/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	576 B STREET	SUITE 1A	SANTA ROSA	CA	95401	5269	49	06097	38.44377	-122.718393	Sonoma County
195166	Fee-for-Service	1598971616	1598971616	1	1	FILLMORE, SARA A LCSW	6/3/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
195286	Fee-for-Service	1528140621	1528140621	1	1	FOOTE, SHERI L CNM	4/7/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
195344	Fee-for-Service	1356529051	1356529051	1	1	FOSKEY, MATTHEW R DO	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10145	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
195368	Fee-for-Service	1740744788	1740744788	1	1	FARAHMAND, MIESHA MD	9/10/2024	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	186613	25	Physical Medicine and Rehabilitation	0	In state provider	None	1595 SOQUEL DR	STE 140	SANTA CRUZ	CA	95065	1717	44	06087	36.98879599	-121.9826354	Santa Cruz County
195421	Fee-for-Service	1083831549	1083831549	1	1	FARNG, EUGENE MD	9/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	95047	20	Orthopedic Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
195423	Fee-for-Service	1194779561	1194779561	1	1	FRANC, BENJAMIN L MD	11/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75921	42	Nuclear Medicine	0	In state provider	None	1001 POTRERO AVE	RM G100	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
195443	Fee-for-Service	1952064222	1952064222	1	1	FACULTY PHYSICIANS AND SURGE	10/18/2021	204F00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	1695 N SUNRISE WAY	None	PALM SPRINGS	CA	92262	3701	33	06065	33.844239	-116.5282075	Riverside County
195453	Fee-for-Service	1316059306	1316059306	1	1	FELAHY, ISAM MD	7/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	25226	33	Thoracic Surgery	0	In state provider	None	2800 N CALIFORNIA ST	STE 15	STOCKTON	CA	95204	3759	39	06077	37.97782434	-121.2919633	San Joaquin County
195469	Fee-for-Service	1346201878	1346201878	1	1	FABER, DAWN M MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102036	08	Family Practice	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
195498	Fee-for-Service	1003955147	1003955147	1	1	FITZGIBBONS, VALERIE A	12/13/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2305 CAMINO RAMON	STE 200	SAN RAMON	CA	94583	1316	07	06013	37.77544224	-121.9657563	Contra Costa County
195557	Fee-for-Service	1932673829	1932673829	1	1	FRALEY, SHANNEN L LMFT	7/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3558 ROUND BARN BLVD	None	SANTA ROSA	CA	95403	1780	49	06097	38.47617	-122.7235455	Sonoma County
195610	Fee-for-Service	1629306816	1629306816	1	1	FUNG-SAKITA, SHERRY MD	3/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109809	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
195683	Fee-for-Service	1922306802	1922306802	1	1	FULLER, KAITLIN	4/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
195707	Fee-for-Service	1902336480	1902336480	1	1	FITTS, ZANAEYA E	8/15/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
195733	Fee-for-Service	1952064222	1952064222	1	1	FACULTY PHYSICIANS AND SURGE	12/21/2021	204F00000X	NA	General Surgery	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	1695 N SUNRISE WAY	None	PALM SPRINGS	CA	92262	3701	33	06065	33.844239	-116.5282075	Riverside County
195787	Fee-for-Service	1952861676	1952861676	1	1	FRASER, JONATHAN MD	1/21/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179077	08	Family Practice	0	In state provider	None	2077 HARBOR BLVD	A	COSTA MESA	CA	92627	9384	30	06059	33.64990963	-117.9190918	Orange County
195801	Fee-for-Service	1255410395	1255410395	1	1	FUKUTOME, ANNE K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34952	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
195927	Fee-for-Service	1992259709	1992259709	1	1	FEENEY, JENNIFER E NP	1/27/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2660 W COVELL BLVD	None	DAVIS	CA	95616	5645	57	06113	38.56101005	-121.7821776	Yolo County
195941	Fee-for-Service	1578555736	1578555736	2	1	FORT SMITH HMA LLC	6/13/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1001 TOWSON AVENUE	None	FORT SMITH	AR	72902	4921	00	None	35.374455	-94.42107	Sebastian County
195956	Fee-for-Service	1932276896	1932276896	1	1	FLAGG, NANCY T MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36047	40	Pediatrics	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
196003	Fee-for-Service	1457674178	1457674178	1	1	FLORES, GINA C NP	11/29/2023	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
196028	Fee-for-Service	1346335809	1346335809	1	1	FRYE, SCOTT H MD	3/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	96710	41	Internal Medicine	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94858	2441	48	06095	38.12828446	-122.24821	Solano County
196170	Fee-for-Service	1699709964	1699709964	1	1	FRENCH, ALAN	10/31/1992	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 9TH ST	None	FORTUNA	CA	95540	2324	12	06023	40.59744847	-124.1576388	Humboldt County
196179	Fee-for-Service	1487671368	1487671368	1	1	FAREED, KHALED MD	11/6/2020	208800000X	NA	Other	026	PHYSICIANS	169178	34	Urology and Urological Surgery	0	In state provider	None	10840 WARNER AVE	STE 103	FOUNTAIN VALLEY	CA	92708	3847	30	06059	33.71625443	-117.9396853	Orange County
196230	Fee-for-Service	1578555736	1578555736	2	1	FORT SMITH HMA LLC	6/13/2016	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1001 TOWSON AVENUE	None	FORT SMITH	AR	72902	4921	00	None	35.374455	-94.42107	Sebastian County
196266	Fee-for-Service	1285151324	1285151324	1	1	FAMILY FIRST PHARMACY INC	12/15/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4859 E KINGS CANYON RD	None	FRESNO	CA	93727	3811	10	06019	36.7360305	-119.7332392	Fresno County
196329	Fee-for-Service	1467455774	1467455774	1	1	FAWCETT, CORY S MD	7/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	1600 NW 6TH ST	STE#N	GRANTS PASS	OR	97526	1094	00	None	42.45662001	-123.3226346	Josephine County
196363	Fee-for-Service	1225569726	1225569726	1	1	FARHANG, BEHNAZ MD	3/28/2025	207R00000X	NA	Other	026	PHYSICIANS	166906	41	Internal Medicine	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300 & 230	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
196370	Fee-for-Service	1255916896	1255916896	1	1	FERNANDEZ, BRIDGET A MD	8/5/2021	207SG0201X	NA	Other	026	PHYSICIANS	171909	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
196476	Fee-for-Service	1700047347	1700047347	1	1	FAN, HOWARD J MD	6/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116271	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	SUITE B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
196494	Fee-for-Service	1205130259	1205130259	1	1	FERNANDEZ, JENNIFER L PT	9/9/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3908 10 STREET	None	RIVERSIDE	CA	92501	3522	33	06065	33.98117228	-117.3785355	Riverside County
196573	Fee-for-Service	1831402742	1831402742	1	1	FLORES, KRISTOFFER LMFT	2/24/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
196615	Fee-for-Service	1467455774	1467455774	1	1	FAWCETT, CORY S MD	7/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	1600 NW 6TH ST	STE#N	GRANTS PASS	OR	97526	1094	00	None	42.45662001	-123.3226346	Josephine County
196650	Fee-for-Service	1225569726	1225569726	1	1	FARHANG, BEHNAZ MD	3/28/2025	207R00000X	NA	Other	026	PHYSICIANS	166906	70	Clinic (mixed specialty)	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300 & 230	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
196742	Fee-for-Service	1619050879	1619050879	1	1	FEBBO, PHILLIP G MD	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88730	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
196785	Fee-for-Service	1063806065	1063806065	1	1	FIRNBERG, MAYTAL T MD	6/16/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	171851	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
196876	Fee-for-Service	1255382545	1255382545	1	3	FOOTHILL CARDIOLOGY MEDICAL	2/8/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	GROUP	235 E BADILLO ST	None	COVINA	CA	91723	1917	19	06037	34.08632446	-117.88677	Los Angeles County
196946	Fee-for-Service	1023109956	1023109956	1	1	FIERSON,WALTER M MD PC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	29165	18	Ophthalmology	0	In state provider	None	1245 W HUNTINGTON DR	STE 109	ARCADIA	CA	91007	6393	19	06037	34.13083182	-118.0689111	Los Angeles County
196968	Fee-for-Service	1851971121	1851971121	1	1	FORMAN, STEVEN MD	7/11/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
196980	Fee-for-Service	1649556127	1649556127	1	1	FLOWERS, KRISTEEN M LCSW	1/11/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
197024	Fee-for-Service	1033238076	1033238076	1	1	FREDERICK, MELISSA A MD	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116626	41	Internal Medicine	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
197029	Fee-for-Service	1619050879	1619050879	1	1	FEBBO, PHILLIP G MD	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88730	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
197056	Fee-for-Service	1669629044	1669629044	1	1	FLORES, MARISOL MD	3/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119931	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
197163	Fee-for-Service	1851559975	1851559975	1	1	FLATTERY, DAVIDA N DO	3/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	9679	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
197280	Fee-for-Service	1417026329	1417026329	1	1	FRINTNER, MARY L AU	12/1/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2211 W. MAGNOLIA BLVD	SUITE 100	BURBANK	CA	91506	1755	19	06037	34.1728873	-118.3320905	Los Angeles County
197282	Fee-for-Service	1134116494	1134116494	1	1	FAGAN, THOMAS MD	10/28/2021	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	174751	None	None	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
197290	Fee-for-Service	1568538825	1568538825	1	1	FELLEGVARI, IREN PHD	2/3/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
197323	Fee-for-Service	1255542668	1255542668	1	1	FURUSHIRO, RANDY CPO	4/1/1995	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	535 E ROMIE LN	STE 3	SALINAS	CA	93901	4026	27	06053	36.65969283	-121.6449044	Monterey County
197431	Fee-for-Service	1154416287	1154416287	1	1	FLETMAN, DONNA MD	10/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88098	30	Radiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
197444	Fee-for-Service	1417987421	1417987421	1	1	FOTRE, TERRY V DO	7/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	4906	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
197509	Fee-for-Service	1275358442	1275358442	1	1	FLORES, AMY	12/19/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	07	06013	0	0	None
197512	Fee-for-Service	1841490810	1841490810	1	1	FAIRMAN, NATHAN P MD	9/15/2010	2080H0002X	NA	Pediatric Primary Care	026	PHYSICIANS	102421	36	Psychiatry	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
197637	Fee-for-Service	1609170208	1609170208	1	1	FELDMAN, SHELIA C	2/2/2022	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	25880 TOURNAMENT RD	SUITE 109	VALENCIA	CA	91355	2384	19	06037	34.39184204	-118.5626441	Los Angeles County
197658	Fee-for-Service	1952788952	1952788952	1	1	FENG, AVA Y MD	9/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147002	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
197732	Fee-for-Service	1144989807	1144989807	1	1	FUKUMOTO, KATHRYN D CRNA	6/22/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
197777	Fee-for-Service	1659683720	1659683720	1	1	FOOTHILL EMERGENCY MEDICAL A	8/1/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SSOCIATES, INC	438 W LAS TUNAS DRIVE	None	SAN GABRIEL	CA	91776	1216	19	06037	34.10243051	-118.105902	Los Angeles County
197796	Fee-for-Service	1841490810	1841490810	1	1	FAIRMAN, NATHAN P MD	9/15/2010	2080H0002X	NA	Pediatric Primary Care	026	PHYSICIANS	102421	01	General Practice	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
197912	Fee-for-Service	1184164030	1184164030	1	1	FAGGIONI, MICHELA MD	8/5/2024	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
197946	Fee-for-Service	1679644611	1679644611	1	1	FRIBOURG, DAVID M MD	4/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67953	02	General Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
197994	Fee-for-Service	1962624288	1962624288	1	1	FOOTHILL CARE CTR II LLC	1/4/1997	311ZA0620X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5420 OAKBANK DR	None	COVINA	CA	91722	1936	19	06037	34.11111793	-117.8836632	Los Angeles County
198005	Fee-for-Service	1740700574	1740700574	1	1	FIZA MEMON	3/1/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1001 TOWSON AVE	None	FORT SMITH	AR	72901	4921	00	None	35.374455	-94.42107	Sebastian County
198049	Fee-for-Service	1336261684	1336261684	1	1	FAYNER, YURY MD	9/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121645	30	Radiology	0	In state provider	None	1516 COTNER AVE	None	LOS ANGELES	CA	90025	3303	19	06037	34.04905416	-118.4477438	Los Angeles County
198101	Fee-for-Service	1003859513	1003859513	1	1	FILLY, ROY A MD	9/30/1988	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	33973	30	Radiology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
198167	Fee-for-Service	1881736478	1881736478	1	1	FABRIZIO, SUZANNE M OD	12/23/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8135 PAINTER AVE	SUITE 100	WHITTIER	CA	90602	3159	19	06037	33.965829	-118.032738	Los Angeles County
198179	Fee-for-Service	1316443849	1316443849	1	1	FOLLETT, MATTHEW MD	2/24/2025	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	163725	20	Orthopedic Surgery	0	In state provider	None	751 MEDICAL CENTER CT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
198268	Fee-for-Service	1871551093	1871551093	1	1	FISCHEL, NATHAN MD	10/8/1991	174400000X	NA	Other	026	PHYSICIANS	45572	68	Hematology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
198284	Fee-for-Service	1063548766	1063548766	1	1	FREEMAN, CYNTHIA B MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
198457	Fee-for-Service	1821285875	1821285875	1	1	FIELDING, KRISTA T MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92139	26	Psychiatry (child)	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
198490	Fee-for-Service	1578239638	1578239638	1	1	FRANCOIS, FELICIA A	10/4/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
198497	Fee-for-Service	1477726693	1477726693	1	1	FOLMAR, RAYMOND MD INC	1/15/2009	193400000X	NA	Other	026	PHYSICIANS	23113	20	Orthopedic Surgery	0	In state provider	None	21530 SOUTH PIONEER BLVD	None	LOS ANGELES	CA	90716	2608	19	06037	33.83358457	-118.0817796	Los Angeles
198552	Fee-for-Service	1871551093	1871551093	1	1	FISCHEL, NATHAN MD	10/8/1991	174400000X	NA	Other	026	PHYSICIANS	45572	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
198571	Fee-for-Service	1215068481	1215068481	1	1	FRIENDSHIP HOUSE ASSOCIATION	9/29/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	OF AMERICAN INDIANS, INC	56 JULIAN AVE	None	SAN FRANCISCO	CA	94103	3507	38	06075	37.76737561	-122.4211372	San Francisco County
198578	Fee-for-Service	1932762788	1932762788	1	1	FILLER, TAYLOR N MD	7/22/2022	207P00000X	NA	Other	026	PHYSICIANS	176341	None	None	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
198626	Fee-for-Service	1174102636	1174102636	1	1	FAMOUS HOSPICE CARE	10/24/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	STE 313C	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
198701	Fee-for-Service	1124668223	1124668223	1	1	FERNEKEES-JEANS, SHARON D	10/14/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
198719	Fee-for-Service	1508167545	1508167545	1	1	FLOYD, SHERROD W LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3840 HOMESTEAD ROAD	None	SANTA CLARA	CA	95051	5173	43	06085	37.33774954	-122.002065	Santa Clara County
198744	Fee-for-Service	1821285875	1821285875	1	1	FIELDING, KRISTA T MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92139	36	Psychiatry	0	In state provider	None	725 WELCH RD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
198895	Fee-for-Service	1629130240	1629130240	1	3	FEATHER RIVER TRIBAL	1/17/2019	No Taxonomy Provided	NA	None	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2102 5TH AVENUE	None	OROVILLE	CA	95965	0000	04	06007	39.50267276	-121.5649078	Butte County
198911	Fee-for-Service	1245674001	1245674001	1	1	FISHER, WILLIAM MD	7/1/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	137269	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
198913	Fee-for-Service	1174102636	1174102636	1	1	FAMOUS HOSPICE CARE	10/24/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	STE 313C	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
198936	Fee-for-Service	1922072230	1922072230	1	1	FARHAD ALRASHEDY	12/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	810 JASMINE ST	None	OMAK	WA	98841	9578	00	None	48.3963912	-119.5454377	Okanogan County
198946	Fee-for-Service	1881802148	1881802148	1	1	FOGG, MITZI C NP	9/9/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3900 LAKEVILLE HIGHWAY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
199022	Fee-for-Service	1245628502	1245628502	1	1	FRANCO, MALERIE L PT	3/26/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	24671 MONROE AVE	#101C	MURRIETA	CA	92562	2527	33	06065	33.56694181	-117.2021151	Riverside County
199032	Fee-for-Service	1467541367	1467541367	1	1	FEINBERG, DAVID A MD	4/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84233	30	Radiology	0	In state provider	None	652 PETALUMA AVE	STE I	SEBASTOPOL	CA	95472	4266	49	06097	38.39662494	-122.8201368	Sonoma County
199151	Fee-for-Service	1376635326	1376635326	1	1	FEHR, THEODORE W OT	1/10/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2700 N MAIN ST	STE 340	SANTA ANA	CA	92705	6634	30	06059	33.7737545	-117.8687284	Orange County
199162	Fee-for-Service	1578975561	1578975561	1	1	FARRELLY, ERIN E MD	6/19/2015	261QM2500X	NA	Other	026	PHYSICIANS	121731	20	Orthopedic Surgery	0	In state provider	A MEDICAL CORPORATION	999 N TUSTIN AVENUE	SUITE 109	SANTA ANA	CA	92705	6504	30	06059	33.754167	-117.834191	Orange County
199184	Fee-for-Service	1629130240	1629130240	1	3	FEATHER RIVER TRIBAL	1/17/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2102 5TH AVENUE	None	OROVILLE	CA	95965	0000	04	06007	39.50267276	-121.5649078	Butte County
199197	Fee-for-Service	1306456223	1306456223	1	1	FETALCO, KATE JEROMAE S NP	8/13/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
199207	Fee-for-Service	1558311373	1558311373	1	1	FACULTY PHYSICIANS AND	1/21/2025	2084P0800X	NA	Psychiatry	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	SURGEONS LLUSM/PSYCHIATR	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
199267	Fee-for-Service	1376120444	1376120444	1	1	FOZOUNI, LAILA MD	5/22/2024	207R00000X	NA	Other	026	PHYSICIANS	191580	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
199277	Fee-for-Service	1427075027	1427075027	1	1	FLETCHER HOSPITAL INC	8/18/2007	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	100 HOSPITAL DR.	None	HENDERSONVILLE	NC	28792	5272	00	None	35.390061	-82.488177	Henderson County
199331	Fee-for-Service	1790700797	1790700797	1	1	FRICK, STEVEN L MD	12/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	83434	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
199436	Fee-for-Service	1891783742	1891783742	1	1	FOX, JIM LMFT	2/8/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 HOTEL CIRCLE S	STE 208	SAN DIEGO	CA	92108	3318	37	06073	32.75901493	-117.1790451	San Diego County
199497	Fee-for-Service	1558311373	1558311373	1	1	FACULTY PHYSICIANS AND	1/1/1996	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	SURGEONS LLUSM/PSYCHIATR	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
199510	Fee-for-Service	1396994604	1396994604	1	1	FLORES, EDNA I MD	3/22/2015	207RH0003X	NA	Oncology	026	PHYSICIANS	114373	78	Neoplastic Diseases/Oncology	0	In state provider	None	207 WEST LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
199566	Fee-for-Service	1427075027	1427075027	1	1	FLETCHER HOSPITAL INC	8/18/2007	282NR1301X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	100 HOSPITAL DR.	None	HENDERSONVILLE	NC	28792	5272	00	None	35.390061	-82.488177	Henderson County
199604	Fee-for-Service	1972852721	1972852721	1	1	FRIAS, CHRISTOPHER R OT	8/2/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
199647	Fee-for-Service	1386826881	1386826881	1	1	FARSI, NAZEE MD	10/24/2018	207RR0500X	NA	Other	026	PHYSICIANS	114530	83	Rheumatology	0	In state provider	None	6180 BROCKTON AVE	SUITE 204	RIVERSIDE	CA	92506	2233	33	06065	33.958692	-117.3967415	Riverside County
199755	Fee-for-Service	1770880627	1770880627	1	1	FREDLUND, JOANNA LCSW	3/19/2025	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
199762	Fee-for-Service	1659686905	1659686905	1	1	FOWLER, TERRY A LMFT	12/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
199783	Fee-for-Service	1558311373	1558311373	1	1	FACULTY PHYSICIANS AND	7/1/2022	2084P0800X	NA	Psychiatry	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	SURGEONS LLUSM/PSYCHIATR	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
199797	Fee-for-Service	1396994604	1396994604	1	1	FLORES, EDNA I MD	3/22/2015	207RH0003X	NA	Oncology	026	PHYSICIANS	114373	68	Hematology	0	In state provider	None	207 WEST LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
199802	Fee-for-Service	1578647541	1578647541	1	1	FARLEY, ELLEN P MD	4/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	47047	08	Family Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
199824	Fee-for-Service	1922071398	1922071398	1	1	FANG, CHIEN MD	7/31/1992	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	69728	41	Internal Medicine	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
199827	Fee-for-Service	1699122770	1699122770	1	1	FINEGERSH, ANDREY MD	6/3/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	154093	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
199855	Fee-for-Service	1871514505	1871514505	1	1	FAROGHI,ARMAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2801 N GANTENBEIN	None	PORTLAND	OR	97227	0000	00	None	45.54387841	-122.6696022	Multnomah County
199869	Fee-for-Service	1972693547	1972693547	1	1	FITCH, SARAH J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CHILDRENS UNIV MED GRP	800 MARSHALL ST, STE 653	None	LITTLE ROCK	AR	72202	0000	00	None	34.74346583	-92.29154425	Pulaski County
199937	Fee-for-Service	1609131606	1609131606	1	1	FAHMIABDOU, ISLAM M MD	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147725	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	116 S PALISADE DR	STE 104	SANTA MARIA	CA	93454	8905	42	06083	34.9523869	-120.4120717	Santa Barbara County
199956	Fee-for-Service	1811662646	1811662646	1	1	FICON, SAMANTHA NP	9/19/2024	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
199958	Fee-for-Service	1851887384	1851887384	1	1	FISCHER, SEAN MD	2/7/2022	390200000X	NA	Other	026	PHYSICIANS	153516	None	None	0	In state provider	None	1131 W 6TH ST	250	ONTARIO	CA	91762	1108	36	06071	34.084404	-117.6717015	San Bernardino County
199982	Fee-for-Service	1578746004	1578746004	1	1	FINLEY, DAVID S MD	6/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93388	34	Urology and Urological Surgery	0	In state provider	None	200 MEDICAL PLAZA	#140	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
200071	Fee-for-Service	1558311373	1558311373	1	1	FACULTY PHYSICIANS AND	5/1/1998	2084P0800X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS LLUSM/PSYCHIATR	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
200087	Fee-for-Service	1083656086	1083656086	1	1	FISCHER, STUART MD	8/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	47229	41	Internal Medicine	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
200113	Fee-for-Service	1831375344	1831375344	1	1	FISHER, BRENT A PT	7/4/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
200207	Fee-for-Service	1760915706	1760915706	1	1	FEENEY, JAMES D	9/3/2020	390200000X	NA	Other	026	PHYSICIANS	160457	41	Internal Medicine	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
200215	Fee-for-Service	1639345416	1639345416	1	1	FRIEDMAN, RACHEL MD	1/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110110	08	Family Practice	0	In state provider	None	3883 AIR WAY DRIVE	202	SANTA ROSA	CA	95404	1707	49	06097	38.483226	-122.739705	Sonoma County
200257	Fee-for-Service	1831211259	1831211259	1	2	FLORO, CARMELA LMFT	9/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	848 DIABLO AVE	APT. 3	NOVATO	CA	94947	5317	21	06041	38.10178973	-122.5742722	Marin County
200316	Fee-for-Service	1942251020	1942251020	1	1	FALLTRICK, ROBERT T MD	5/1/1983	207L00000X	NA	Other	026	PHYSICIANS	28434	05	Anesthesiology	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
200352	Fee-for-Service	1942276886	1942276886	1	1	FINNERTY, SARAH K MD	4/26/2022	207P00000X	NA	Other	026	PHYSICIANS	169902	None	None	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
200358	Fee-for-Service	1558311373	1558311373	1	1	FACULTY PHYSICIANS AND	7/17/2024	2084P0800X	NA	Psychiatry	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SURGEONS LLUSM/PSYCHIATR	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
200407	Fee-for-Service	1184621542	1184621542	1	1	FOSTER,ZUZANA U MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65926	83	Rheumatology	0	In state provider	None	2500 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3156	07	06013	38.00658519	-122.1309063	Contra Costa County
200424	Fee-for-Service	1083782122	1083782122	1	1	FAMILY ASSOCIATED MED	12/16/1988	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GRP	767 S SUNSET AVE	STE 4	WEST COVINA	CA	91790	3546	19	06037	34.0672602	-117.9400049	Los Angeles County
200437	Fee-for-Service	1790703643	1790703643	1	1	FARSHIDI, ARDESHIR	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	40124	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1000 NEWBURY ROAD	SUITE 180	THOUSAND OAKS	CA	91320	6440	56	06111	34.18353384	-118.9044556	Ventura County
200504	Fee-for-Service	1326393166	1326393166	1	1	FOSTER, AMELIA PT	10/23/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7887 SOQUEL DR STE C&D&E	None	APTOS	CA	95003	3900	44	06087	36.97818934	-121.9069039	Santa Cruz County
200656	Fee-for-Service	1215989611	1215989611	1	1	FAIRVIEW GENERAL HOSP	11/27/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	18101 LORAIN AVE	None	CLEVELAND	OH	44111	5656	00	None	41.44936757	-81.82356311	Cuyahoga County
200664	Fee-for-Service	1588720205	1588720205	1	1	FEDDER, ANDREW A MD	7/12/2019	208600000X	NA	General Surgery	026	PHYSICIANS	160687	02	General Surgery	0	In state provider	None	782 MEDICAL CENTER DR E	SUITE 101	CLOVIS	CA	93611	6890	10	06019	36.84379626	-119.6609117	Fresno County
200710	Fee-for-Service	1750714358	1750714358	1	1	FRAZZITTA, AUBREY MD	9/12/2023	2085N0700X	NA	MRI Provider	026	PHYSICIANS	184948	None	None	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
200711	Fee-for-Service	1083782122	1083782122	1	1	FAMILY ASSOCIATED MED	12/16/1988	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	GRP	767 S SUNSET AVE	STE 4	WEST COVINA	CA	91790	3546	19	06037	34.0672602	-117.9400049	Los Angeles County
200713	Fee-for-Service	1154495810	1154495810	1	1	FALIK, SHELLEY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
200719	Fee-for-Service	1740591445	1740591445	1	1	FENG, ZHUANG MD	3/9/2023	207ZP0102X	NA	Other	026	PHYSICIANS	169220	None	None	0	In state provider	None	SANTA BARBARA COTTAGE	PUEBOL AT BATH STREET	SANTA BARBARA	CA	93102	0689	42	06083	34.42507224	-119.7015833	Santa Barbara County
200734	Fee-for-Service	1801892419	1801892419	1	1	FINK, MARSHA G MD	5/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	54315	41	Internal Medicine	0	In state provider	None	11190 WARNER AVE	STE 300	FOUNTAIN VALLEY	CA	92708	4045	30	06059	33.714	-117.9333585	Orange County
200740	Fee-for-Service	1891758298	1891758298	1	1	FISHER, TIMOTHY S MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69168	30	Radiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
200841	Fee-for-Service	1518140474	1518140474	1	1	FOX LEE, LAURA E MD	4/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9940	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
200877	Fee-for-Service	1538298310	1538298310	1	1	FERGUSON, KAREN R LMFT	2/19/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1652 WEST AVE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1602957	Los Angeles County
200943	Fee-for-Service	1215989611	1215989611	1	1	FAIRVIEW GENERAL HOSP	11/27/2001	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	18101 LORAIN AVE	None	CLEVELAND	OH	44111	5656	00	None	41.44936757	-81.82356311	Cuyahoga County
200945	Fee-for-Service	1053674606	1053674606	1	1	FRENCH, MICHAEL H DO	3/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13070	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
200980	Fee-for-Service	1255968764	1255968764	1	1	FORSHEE, JAMESON	10/15/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21446	None	None	0	In state provider	None	10058 WOLF RD	None	GRASS VALLEY	CA	95949	8194	29	06057	39.04265452	-121.0952182	Nevada County
200995	Fee-for-Service	1295889202	1295889202	1	1	FAYEK, SAMEH MD	8/18/2020	204F00000X	NA	General Surgery	026	PHYSICIANS	83958	02	General Surgery	0	In state provider	None	2040 E MARIPOSA AVE	None	EL SEGUNDO	CA	90245	5027	19	06037	33.92356852	-118.389987	Los Angeles County
201023	Fee-for-Service	1801892419	1801892419	1	1	FINK, MARSHA G MD	5/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	54315	78	Neoplastic Diseases/Oncology	0	In state provider	None	11190 WARNER AVE	STE 300	FOUNTAIN VALLEY	CA	92708	4045	30	06059	33.714	-117.9333585	Orange County
201060	Fee-for-Service	1649570292	1649570292	1	1	FRESENIUS MEDICAL CARE	6/27/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIABLO NEPHROLOGY CLINIC	2163 COUNTRY HILLS DR	STE 101	ANTIOCH	CA	94509	7345	07	06013	37.96976938	-121.7848343	Contra Costa County
201072	Fee-for-Service	1396399143	1396399143	1	1	FAMILY MEDICAL INC.	2/7/2020	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	592 LINCOLN AVE	None	NAPA	CA	94558	3611	28	06055	38.31026347	-122.2815735	Napa County
201084	Fee-for-Service	1992463251	1992463251	1	1	FACULTY PHYSICIANS AND SURGE	2/2/2022	103TF0200X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	11374 MT VIEW AVE	STE A	LOMA LINDA	CA	92354	3816	36	06071	34.0465275	-117.2436991	San Bernardino County
201095	Fee-for-Service	1023240561	1023240561	1	1	FRASER, EZRA T MD	8/30/2011	2085R0204X	NA	Other	026	PHYSICIANS	112170	None	None	0	In state provider	None	11411 BROOKSHIRE AVE	STE 301	DOWNEY	CA	90241	5009	19	06037	33.93667091	-118.1309273	Los Angeles County
201202	Fee-for-Service	1871525584	1871525584	1	1	FIERER, JOSHUA MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	14386	01	General Practice	0	In state provider	DEPT OF MEDICINE	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
201310	Fee-for-Service	1225014848	1225014848	1	1	FINNEN, NEIL P MD	11/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88321	18	Ophthalmology	0	In state provider	None	11370 ANDERSON STREET	SUITE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
201316	Fee-for-Service	1043416696	1043416696	1	1	FRANGOS, JENNIFER DO	4/1/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	17466	08	Family Practice	0	In state provider	None	135 SOUTH STATE COLLEGE	#228	BREA	CA	92821	5823	30	06059	33.92036053	-117.8829421	Orange County
201362	Fee-for-Service	1619000791	1619000791	1	1	FU, JENNIFER M MD	9/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	94758	07	Dermatology	0	In state provider	None	6431 FAIRMOUNT AVE	STE 3	EL CERRITO	CA	94530	3655	07	06013	37.90112527	-122.3010414	Contra Costa County
201369	Fee-for-Service	1992463251	1992463251	1	1	FACULTY PHYSICIANS AND SURGE	12/28/2021	103TF0200X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	ONS OF LLUSM	11374 MT VIEW AVE	STE A	LOMA LINDA	CA	92354	3816	36	06071	34.0465275	-117.2436991	San Bernardino County
201415	Fee-for-Service	1407272438	1407272438	1	1	FOX, MELANIE K PSYD	1/6/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
201465	Fee-for-Service	1841339678	1841339678	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
201548	Fee-for-Service	1942497938	1942497938	1	1	FILIPPELLI, DIANA PA	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1601 W SAINT MARYS RD	None	TUCSON	AZ	85745	2623	00	None	32.228199	-111.0000825	Pima County
201646	Fee-for-Service	1790189892	1790189892	1	1	FLORES, EDNA I MD APC	1/16/2015	207RH0003X	NA	Oncology	026	PHYSICIANS	114373	68	Hematology	0	In state provider	None	207 WEST LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
201658	Fee-for-Service	1992463251	1992463251	1	1	FACULTY PHYSICIANS AND SURGE	12/28/2021	103TF0200X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	26	Psychiatry (child)	0	In state provider	ONS OF LLUSM	11374 MT VIEW AVE	STE A	LOMA LINDA	CA	92354	3816	36	06071	34.0465275	-117.2436991	San Bernardino County
201666	Fee-for-Service	1457677981	1457677981	1	1	FELIX, GLADYS MD	8/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121109	40	Pediatrics	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
201686	Fee-for-Service	1164570008	1164570008	1	1	FOX, MARY A CNM	11/1/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
201691	Fee-for-Service	1508965286	1508965286	1	1	FASS, ARTHUR H DPM	2/8/2015	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	18250 ROSCOE BLVD	STE 125	NORTHRIDGE	CA	91325	4266	19	06037	34.22076142	-118.5313223	Los Angeles County
201818	Fee-for-Service	1770663825	1770663825	1	1	FLORIO, CECILIA A MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63099	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
201886	Fee-for-Service	1104902725	1104902725	1	1	FRONT PORCH COMMUNITIES	3/18/1999	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	AND SERVICES	842 E VILLA ST	None	PASADENA	CA	91101	1259	19	06037	34.15423989	-118.1338348	Los Angeles County
201893	Fee-for-Service	1548371008	1548371008	1	1	FOX, BARBARA J NP	2/13/2007	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
201935	Fee-for-Service	1790189892	1790189892	1	1	FLORES, EDNA I MD APC	1/16/2015	207RH0003X	NA	Oncology	026	PHYSICIANS	114373	78	Neoplastic Diseases/Oncology	0	In state provider	None	207 WEST LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
201936	Fee-for-Service	1720195266	1720195266	1	1	FILE, PAUL I MD	2/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	61291	None	None	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
201938	Fee-for-Service	1063402709	1063402709	1	1	FENTON, DOUGLAS K MD	8/10/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	50262	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2067 W VISTA WAY	STE 225	VISTA	CA	92083	6001	37	06073	33.18505594	-117.285958	San Diego County
201957	Fee-for-Service	1295972842	1295972842	1	1	FANG, XIAO-YING S MD	6/16/2009	207R00000X	NA	Other	026	PHYSICIANS	103069	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
201970	Fee-for-Service	1174056758	1174056758	1	1	FONTES, ANDREW D DO	8/31/2023	2080P0203X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
202004	Fee-for-Service	1346277100	1346277100	1	1	FERRIERO, DONNA M MD	1/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	49138	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
202008	Fee-for-Service	1285751255	1285751255	1	1	FOLEY, LINDSEY W CCC-SLP	9/10/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
202065	Fee-for-Service	1508812736	1508812736	1	1	FORNES, SABRINA M CRNA	4/5/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
202084	Fee-for-Service	1487997334	1487997334	1	1	FIGUEROA, DOMINICK E MD	5/10/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	162689	None	None	0	In state provider	None	2801 ATLANTIC AVE	3RD FL	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
202106	Fee-for-Service	1003911892	1003911892	1	1	FERNS, JAY A	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	6131	01	General Practice	0	In state provider	None	41715 WINCHESTER RD	STE 101	TEMECULA	CA	92590	4853	33	06065	33.51843041	-117.1680022	Riverside County
202180	Fee-for-Service	1588610703	1588610703	1	1	FU, YANGHENG MD	11/2/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67494	41	Internal Medicine	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
202203	Fee-for-Service	1659437838	1659437838	1	1	FARQUHARSON, HANNAH B MD	9/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91901	08	Family Practice	0	In state provider	None	550 WATER ST	STE A	SANTA CRUZ	CA	95060	4124	44	06087	36.98046158	-122.018718	Santa Cruz County
202291	Fee-for-Service	1346277100	1346277100	1	1	FERRIERO, DONNA M MD	1/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	49138	40	Pediatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
202321	Fee-for-Service	1003546342	1003546342	1	1	FRIENDS OF FAMILY HEALTH	11/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1129 W 4TH ST	None	ONTARIO	CA	91762	1703	36	06071	34.077636	-117.6713055	San Bernardino County
202371	Fee-for-Service	1912000811	1912000811	1	1	FARAJI, E ISAAC MD APC	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78778	10	Gastroenterology (M.D. only)	0	In state provider	None	1729 N OLIVE AVE	STE 11	TURLOCK	CA	95382	2501	50	06099	37.50874586	-120.8399103	Stanislaus County
202393	Fee-for-Service	1003911892	1003911892	1	1	FERNS, JAY A	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	6131	66	Emergency Medicine (Urgent Care)	0	In state provider	None	41715 WINCHESTER RD	STE 101	TEMECULA	CA	92590	4853	33	06065	33.51843041	-117.1680022	Riverside County
202406	Fee-for-Service	1518260306	1518260306	1	1	FENG, CHARLES H MD	5/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115080	41	Internal Medicine	0	In state provider	None	1000 FRANKLIN PKWY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
202412	Fee-for-Service	1528490430	1528490430	1	1	FREEMAN, MARIA LAURA G OD	4/27/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
202465	Fee-for-Service	1588610703	1588610703	1	1	FU, YANGHENG MD	11/2/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67494	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
202500	Fee-for-Service	1932287836	1932287836	1	1	FELIX, HELENA A MD	8/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73914	40	Pediatrics	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
202580	Fee-for-Service	1316018203	1316018203	1	1	FAROOQ, MICHAEL M MD	3/1/2000	2086S0129X	NA	General Surgery	026	PHYSICIANS	84935	02	General Surgery	0	In state provider	None	200 MEDICAL PLAZA	#526	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
202612	Fee-for-Service	1003546342	1003546342	1	1	FRIENDS OF FAMILY HEALTH	11/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1129 W 4TH ST	None	ONTARIO	CA	91762	1703	36	06071	34.077636	-117.6713055	San Bernardino County
202654	Fee-for-Service	1427409234	1427409234	1	1	FUH, JENNIFER C DO	7/27/2021	207RE0101X	NA	Endocrinology	026	PHYSICIANS	None	None	None	0	In state provider	None	200 MEDICAL PLAZA	SUITE 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
202657	Fee-for-Service	1598081028	1598081028	1	2	FAZEL, RAHIM DO	3/10/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	16521	30	Radiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
202658	Fee-for-Service	1912000811	1912000811	1	1	FARAJI, E ISAAC MD APC	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78778	41	Internal Medicine	0	In state provider	None	1729 N OLIVE AVE	STE 11	TURLOCK	CA	95382	2501	50	06099	37.50874586	-120.8399103	Stanislaus County
202675	Fee-for-Service	1720279763	1720279763	1	1	FERRARI, CATHERINE T LMFT	9/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4160 TEMESCAL CANYON RD	309	CORONA	CA	92883	4625	33	06065	33.81915655	-117.5075503	Riverside County
202738	Fee-for-Service	1174186142	1174186142	1	1	FIORAVANTI, MATTHEW MD	1/10/2024	390200000X	NA	Other	026	PHYSICIANS	185934	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
202753	Fee-for-Service	1760650857	1760650857	1	1	FOUNTAIN VALLEY REGIONAL	5/20/2011	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	SLEEP CENTER LLC	17150 EUCLID STREET	#300	FOUNTAIN VALLEY	CA	92708	4092	30	06059	33.714171	-117.9369905	Orange County
202778	Fee-for-Service	1760423123	1760423123	1	1	FARHADI, ASHKAN MD	6/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53536	10	Gastroenterology (M.D. only)	0	In state provider	None	722 BAKER STREET	None	COSTA MESA	CA	92626	4385	30	06059	33.68016047	-117.886563	Orange County
202794	Fee-for-Service	1538272000	1538272000	1	2	FUERST, DAVID J M D INC.	9/25/2001	207W00000X	NA	Ophthalmology	026	PHYSICIANS	47430	18	Ophthalmology	0	In state provider	None	1135 S SUNSET AVE	STE 312	WEST COVINA	CA	91790	0000	19	06037	34.06215064	-117.9453997	Los Angeles County
202902	Fee-for-Service	1003546342	1003546342	1	1	FRIENDS OF FAMILY HEALTH	11/1/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1129 W 4TH ST	None	ONTARIO	CA	91762	1703	36	06071	34.077636	-117.6713055	San Bernardino County
202907	Fee-for-Service	1962436303	1962436303	1	1	FELDMAN, DAVID B MD	4/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40706	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4005 N FRESNO ST	None	FRESNO	CA	93726	4040	10	06019	36.79072698	-119.7814525	Fresno County
202949	Fee-for-Service	1598081028	1598081028	1	2	FAZEL, RAHIM DO	3/10/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	16521	70	Clinic (mixed specialty)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
203112	Fee-for-Service	1437472164	1437472164	1	1	FAHER, DIANE J MD	8/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110300	40	Pediatrics	0	In state provider	None	8235 ROCHESTER AVE	SUITE 110	RANCHO CUCAMONGA	CA	91730	0719	36	06071	34.103952	-117.5456935	San Bernardino County
203223	Fee-for-Service	1780882910	1780882910	1	1	FAN, JOHN W MD	4/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108413	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
203245	Fee-for-Service	1487642757	1487642757	2	1	FHL PHARMACY, INC.	1/23/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	445 W BROADWAY	None	GLENDALE	CA	91204	1208	19	06037	34.14684551	-118.2633525	Los Angeles County
203250	Fee-for-Service	1154391522	1154391522	1	1	FERRARA, ELIZABETH MD	4/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73532	45	Nephrology (Renal-Kidney)	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
203291	Fee-for-Service	1841558103	1841558103	1	1	FONG, YI-JEN MD	8/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124113	01	General Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
203387	Fee-for-Service	1750650990	1750650990	1	1	FOUR SEASONS ASSISTED	8/27/2013	310400000X	NA	Other	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LIVING CENTER LLC	12120 CHANDLER BLVD.	None	NORTH HOLLYWOOD	CA	91607	2002	19	06037	34.1683242	-118.3971284	Los Angeles County
203416	Fee-for-Service	1598528481	1598528481	1	1	FATTIG, ASHLEY A PT	3/16/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
203532	Fee-for-Service	1215068481	1215068481	1	2	FRIENDSHIP HOUSE ASSOCIATION	9/29/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	OF AMERICAN INDIANS, INC	1815 39TH STREET	None	OAKLAND	CA	94601	4157	01	06001	37.77725628	-122.2169192	Alameda County
203537	Fee-for-Service	1154391522	1154391522	1	1	FERRARA, ELIZABETH MD	4/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73532	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
203575	Fee-for-Service	1942960745	1942960745	1	1	FARRIDAH SHAFIEE DO INC	2/15/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	135 MACAW LN	210	SIMI VALLEY	CA	93065	3153	56	06111	34.25962873	-118.7946585	Ventura County
203610	Fee-for-Service	1326624008	1326624008	1	1	FOX, SUTTON R	3/25/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
203614	Fee-for-Service	1336237072	1336237072	1	1	FAMILY HEALTHCARE NETWRK	2/1/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	31180 ROAD 72	None	GOSHEN	CA	93227	9997	54	06107	36.35594779	-119.4124242	Tulare County
203633	Fee-for-Service	1609975309	1609975309	1	1	FORSTER, PETER L MD	2/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	58999	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
203696	Fee-for-Service	1700957743	1700957743	1	1	FEALY, JANE C	10/27/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	43226	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
203712	Fee-for-Service	1316337421	1316337421	1	1	FAMILY CIRCLE CLHF	2/26/2016	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	8061 SAINT CLAIR AVENUE	None	NORTH HOLLYWOOD	CA	91605	1322	19	06037	34.21755	-118.399838	Los Angeles County
203727	Fee-for-Service	1205837697	1205837697	1	1	FELD, CARL J MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54655	41	Internal Medicine	0	In state provider	None	4314 W SLAUSON AVE	None	LOS ANGELES	CA	90043	2854	19	06037	33.98885257	-118.3509655	Los Angeles County
203754	Fee-for-Service	1467956342	1467956342	1	1	FLETCHER, WILL R MD	6/8/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165114	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
203759	Fee-for-Service	1629572011	1629572011	1	1	FISHER, JAKE MD	9/20/2023	207LP3000X	NA	Other	026	PHYSICIANS	163365	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
203763	Fee-for-Service	1932328671	1932328671	1	1	FIERRO, LAURA A LMFT	6/3/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10722 ARROW RTE	314-316	RANCHO CUCAMONGA	CA	91730	4811	36	06071	34.09917725	-117.5708877	San Bernardino County
203770	Fee-for-Service	1407844335	1407844335	1	1	FRANKLIN S CHOW MD	7/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	None	39.742182	-104.8408515	Adams County
203836	Fee-for-Service	1104233642	1104233642	1	1	FRY, ANNA C	12/27/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVENUE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
203905	Fee-for-Service	1336237072	1336237072	1	1	FAMILY HEALTHCARE NETWRK	2/1/2005	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	31180 ROAD 72	None	GOSHEN	CA	93227	9997	54	06107	36.35594779	-119.4124242	Tulare County
203907	Fee-for-Service	1558725663	1558725663	1	1	FIRST CHOICE HOME HEALTH	1/30/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY	1426 W 6TH STREET	STE 202	CORONA	CA	92882	3061	33	06065	33.87817542	-117.5926407	Riverside County
203944	Fee-for-Service	1942393517	1942393517	1	1	FORT MOJAVE MESA FIRE	1/1/1986	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	1	Border provider	DEPARTMENT	1260 HANCOCK ROAD	None	BULLHEAD CITY	AZ	86442	5906	00	None	35.107443	-114.603543	Mohave County
203959	Fee-for-Service	1598140048	1598140048	1	1	FRAUSTO, APOLLO LCSW	10/18/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
203984	Fee-for-Service	1700957743	1700957743	1	1	FEALY, JANE C	10/27/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	43226	41	Internal Medicine	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
204092	Fee-for-Service	1104289784	1104289784	1	1	FONG, FARRAH H DO	1/3/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17568	08	Family Practice	0	In state provider	None	7601 STONERIDGE	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
204115	Fee-for-Service	1770070336	1770070336	1	1	FOX, KEVIN E DO	7/20/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	20596	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
204131	Fee-for-Service	1821073198	1821073198	1	1	FARRALES, ROEL D MD	12/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96148	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 HYDE STREET	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
204191	Fee-for-Service	1336237072	1336237072	1	1	FAMILY HEALTHCARE NETWRK	2/20/2013	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	31180 ROAD 72	None	GOSHEN	CA	93227	9997	54	06107	36.35594779	-119.4124242	Tulare County
204259	Fee-for-Service	1588826374	1588826374	1	1	FEATHER RIVER TRIBAL	3/25/2025	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	555 W ONSTOTT RD	None	YUBA CITY	CA	95993	5654	51	06101	39.1298138	-121.6349029	Sutter County
204304	Fee-for-Service	1215941067	1215941067	1	1	FOXMAN, ERIC MD	1/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	52743	36	Psychiatry	0	In state provider	None	27924 SECO CANYON RD	None	SANTA CLARITA	CA	91350	3870	19	06037	34.4588501	-118.5343405	Los Angeles County
204333	Fee-for-Service	1316352990	1316352990	1	1	FREY, ADA LMFT	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	78370	-	NOT APPLICABLE	0	In state provider	None	1200 N MAIN ST	STE 100B, 301, 500	SANTA ANA	CA	92701	3630	30	06059	33.755175	-117.8676195	Orange County
204355	Fee-for-Service	1437224946	1437224946	1	1	FERNANDEZ-RENEDO, MARIA	4/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51936	67	Endocrinology	0	In state provider	D MD	750 W OLIVE AVE	STE 102	MERCED	CA	95348	2436	24	06047	37.31917248	-120.480657	Merced County
204451	Fee-for-Service	1982072542	1982072542	1	1	FERREIRA, KRISTINA N CRNA	1/29/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
204455	Fee-for-Service	1851426514	1851426514	1	1	FERRITO, JOSEPH R	1/1/1979	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	6140 CAMINO VERDE DR	STE I	SAN JOSE	CA	95119	1401	43	06085	37.2356403	-121.8010705	Santa Clara County
204488	Fee-for-Service	1518945005	1518945005	1	1	FOLZ, JAMES L MD	3/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	70906	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
204489	Fee-for-Service	1518243369	1518243369	1	1	FONTANARES, SYDNEY F PSYD	5/14/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
204511	Fee-for-Service	1609953959	1609953959	1	1	FAROOQI, MUFTISAADAT A	12/19/2006	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	69294	10	Gastroenterology (M.D. only)	0	In state provider	GASTROENTER & HEPATOLOGY	1332 W HERNDON AVE	STE 100	FRESNO	CA	93711	7118	10	06019	36.83737137	-119.8148304	Fresno County
204528	Fee-for-Service	1629084843	1629084843	1	1	FAMININI, MOUSSA MD	9/30/1988	207RE0101X	NA	Endocrinology	026	PHYSICIANS	31134	41	Internal Medicine	0	In state provider	None	16661 VENTURA BLVD	STE 818	ENCINO	CA	91436	1999	19	06037	34.15820737	-118.496492	Los Angeles County
204545	Fee-for-Service	1861544215	1861544215	1	1	FRIEDMAN, JOANNA G PHD	9/4/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
204546	Fee-for-Service	1588826374	1588826374	1	1	FEATHER RIVER TRIBAL	9/1/2002	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	555 W ONSTOTT RD	None	YUBA CITY	CA	95993	5654	51	06101	39.1298138	-121.6349029	Sutter County
204573	Fee-for-Service	1881811404	1881811404	1	2	FOOTHILL COMMUN MED CORP	10/17/2018	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1400 N HACIENDA BLVD	None	LA PUENTE	CA	91744	1187	19	06037	34.04599316	-117.9487791	Los Angeles County
204592	Fee-for-Service	1114140795	1114140795	1	1	FRAM, NICOLE R MD	3/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100271	18	Ophthalmology	0	In state provider	None	1001 POTRERO AVE	RM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
204601	Fee-for-Service	1386017614	1386017614	1	1	FRANCIS, FIONA LCSW	4/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
204602	Fee-for-Service	1750316402	1750316402	1	1	FONAROW, GREGG C MD	8/31/1991	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	64544	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MED PLAZA - #365	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
204619	Fee-for-Service	1164528469	1164528469	1	1	FONTANILLA, JOSE-MARIO C MD	3/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55552	41	Internal Medicine	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
204641	Fee-for-Service	1437224946	1437224946	1	1	FERNANDEZ-RENEDO, MARIA	4/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51936	41	Internal Medicine	0	In state provider	D MD	750 W OLIVE AVE	STE 102	MERCED	CA	95348	2436	24	06047	37.31917248	-120.480657	Merced County
204698	Fee-for-Service	1831327139	1831327139	1	1	FRANKLIN, ASHLEY LCSW	10/30/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
204746	Fee-for-Service	1639303118	1639303118	1	1	FALKENSTEIN, IRYNA A MD	3/9/2020	207WX0009X	NA	Ophthalmology	026	PHYSICIANS	145657	18	Ophthalmology	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
204766	Fee-for-Service	1114902285	1114902285	1	1	FENG, YUE MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53098	41	Internal Medicine	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
204786	Fee-for-Service	1588694061	1588694061	1	1	FLINT, ALEXANDER C MD	6/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89431	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
204815	Fee-for-Service	1629084843	1629084843	1	1	FAMININI, MOUSSA MD	9/30/1988	207RE0101X	NA	Endocrinology	026	PHYSICIANS	31134	67	Endocrinology	0	In state provider	None	16661 VENTURA BLVD	STE 818	ENCINO	CA	91436	1999	19	06037	34.15820737	-118.496492	Los Angeles County
204835	Fee-for-Service	1588826374	1588826374	1	1	FEATHER RIVER TRIBAL	9/1/2002	261QR1300X	NA	Rural Health Center	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	555 W ONSTOTT RD	None	YUBA CITY	CA	95993	5654	51	06101	39.1298138	-121.6349029	Sutter County
204857	Fee-for-Service	1124141759	1124141759	1	1	FITZSIMMONS, MARGARET M LMFT	5/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
204861	Fee-for-Service	1881811404	1881811404	1	2	FOOTHILL COMMUN MED CORP	10/17/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1400 N HACIENDA BLVD	None	LA PUENTE	CA	91744	1187	19	06037	34.04599316	-117.9487791	Los Angeles County
204891	Fee-for-Service	1750316402	1750316402	1	1	FONAROW, GREGG C MD	8/31/1991	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	64544	68	Hematology	0	In state provider	None	200 MED PLAZA - #365	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
205019	Fee-for-Service	1407208333	1407208333	1	1	FISHER, MYLES DO	10/14/2020	207P00000X	NA	Other	026	PHYSICIANS	18339	None	None	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4900	39	06077	37.80110374	-121.1974853	San Joaquin County
205087	Fee-for-Service	1790160513	1790160513	1	1	FAN, LINLIN LCSW	10/15/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
205123	Fee-for-Service	1588826374	1588826374	1	1	FEATHER RIVER TRIBAL	2/22/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH INC	555 W ONSTOTT RD	None	YUBA CITY	CA	95993	5654	51	06101	39.1298138	-121.6349029	Sutter County
205133	Fee-for-Service	1952137226	1952137226	1	1	FREE, YSABEL A	1/17/2025	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	12	06023	0	0	None
205153	Fee-for-Service	1083969935	1083969935	1	1	FARIAS-EISNER, GINA MD	1/28/2022	208200000X	NA	General Surgery	026	PHYSICIANS	141137	None	None	0	In state provider	None	5333 HOLLISTER AVE	195	SANTA BARBARA	CA	93111	2465	42	06083	34.43491982	-119.8105484	Santa Barbara County
205180	Fee-for-Service	1033297601	1033297601	1	1	FREYNE, PATRICK C MD	1/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89937	41	Internal Medicine	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
205303	Fee-for-Service	1679024178	1679024178	1	1	FOLLOSCO, ELIZABETH J LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23201 MILL CREEK DR	SUITE 220	LAGUNA HILLS	CA	92653	7906	30	06059	33.62516256	-117.7353393	Orange County
205323	Fee-for-Service	1841325834	1841325834	1	1	FEWTRELL, DEAN E OD A PROF	12/27/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ESSIONAL CORPORATION	311 PAJARO ST	None	SALINAS	CA	93901	3421	27	06053	36.67356122	-121.6524134	Monterey County
205376	Fee-for-Service	1396135455	1396135455	1	1	FRUHAUF, TIMOTHEE F MD	10/14/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	179715	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
205492	Fee-for-Service	1477101624	1477101624	1	1	FONTEJON, RALPH VINCENT A NP	2/25/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	19	06037	34.2395322	-118.3939944	Los Angeles County
205515	Fee-for-Service	1447080676	1447080676	1	1	FERNANDEZ, EDGAR PT	8/14/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	606 N MAGNOLIA AVE	None	CLOVIS	CA	93611	9206	10	06019	36.83952584	-119.666151	Fresno County
205536	Fee-for-Service	1245288273	1245288273	1	1	FARRAR, ROBERT MD	3/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55680	05	Anesthesiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
205634	Fee-for-Service	1881880896	1881880896	1	1	FAZILAT, GOLAREH MD	10/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	101403	18	Ophthalmology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
205690	Fee-for-Service	1215690938	1215690938	1	1	FAST DOC HOME HEALTH INC	1/25/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1314 W GLENOAKS BLVD	STE 101A	GLENDALE	CA	91201	1978	19	06037	34.16648918	-118.2835374	Los Angeles County
205735	Fee-for-Service	1164547675	1164547675	1	1	FLYNN, VINCENT J MD	8/24/2004	208800000X	NA	Other	026	PHYSICIANS	27358	34	Urology and Urological Surgery	0	In state provider	None	9834 GENESEE AVE	STE 411	LA JOLLA	CA	92037	1264	37	06073	32.884074	-117.225855	San Diego County
205771	Fee-for-Service	1619027414	1619027414	1	1	FOWLER, CHRISTOPHER M MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	61388	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
205871	Fee-for-Service	1497776934	1497776934	1	1	FLYNN, BRET W MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149330	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
205894	Fee-for-Service	1790246684	1790246684	1	1	FUENTES BALDARRAGO, ANA LUCI	2/29/2024	207R00000X	NA	Other	026	PHYSICIANS	177124	None	None	0	In state provider	A MD	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
205965	Fee-for-Service	1255334256	1255334256	1	1	FRANTA, JAMES T OD	5/25/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1414 E MAIN ST	None	SANTA MARIA	CA	93454	4806	42	06083	34.95286853	-120.4139295	Santa Barbara County
205973	Fee-for-Service	1073084224	1073084224	1	1	FAITH HOSPICE INC	3/27/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	13615 VICTORY BLVD	108	VAN NUYS	CA	91401	1767	19	06037	34.18671049	-118.429353	Los Angeles County
206026	Fee-for-Service	1114115417	1114115417	1	1	FERN LODGE, INC	9/13/2007	282J00000X	NA	Hospitals	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	18457 MADISON AVE	None	CASTRO VALLEY	CA	94546	1637	01	06001	37.71329669	-122.0637383	Alameda County
206028	Fee-for-Service	1295314433	1295314433	1	1	FLINTRIDGE HOSPICE CARE INC	10/17/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	SUITE 113	LA CRESCENTA	CA	91214	4578	19	06037	34.22121465	-118.2352382	Los Angeles County
206034	Fee-for-Service	1033117106	1033117106	2	2	FLORA, KIM D DPM	2/15/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1086 N CHERRY ST	None	TULARE	CA	93274	2251	54	06107	36.22388137	-119.3371979	Tulare County
206042	Fee-for-Service	1912264862	1912264862	1	27	FIRST CHOICE PHYSICIAN PARTN	9/26/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	ARTNERS	1801 COLORADO AVE	SUITE 240	TURLOCK	CA	95382	2704	50	06099	37.50941613	-120.8353105	Stanislaus County
206072	Fee-for-Service	1265886691	1265886691	1	1	FONG, ABIGAIL MD	8/6/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	158420	02	General Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
206076	Fee-for-Service	1528441219	1528441219	1	1	FREY, JOSEPH H MD	7/21/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146527	30	Radiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
206081	Fee-for-Service	1568805471	1568805471	1	1	FOX, TIMOTHY P MD	7/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148071	18	Ophthalmology	0	In state provider	None	1450 SAN PABLO ST	STE 4000	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
206111	Fee-for-Service	1801186796	1801186796	1	1	FOEPARKER, JENNIFER E MD	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125499	02	General Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
206123	Fee-for-Service	1093029316	1093029316	1	1	FISHER, PING W MD	12/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	126598	41	Internal Medicine	0	In state provider	None	1300 CRANE ST	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
206183	Fee-for-Service	1073540449	1073540449	1	1	FERNANDEZ, SAMUEL CNP	10/28/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1303 EAST HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
206227	Fee-for-Service	1235326489	1235326489	1	1	FRANCIS, PHILIP	7/1/1996	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2575 EAST BIDWELL ST	#100	FOLSOM	CA	95630	6444	34	06067	38.658888	-121.1303835	Sacramento County
206231	Fee-for-Service	1730267402	1730267402	1	1	FUJIOKA, SEAN K MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70769	08	Family Practice	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
206261	Fee-for-Service	1073084224	1073084224	1	1	FAITH HOSPICE INC	3/27/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	13615 VICTORY BLVD	108	VAN NUYS	CA	91401	1767	19	06037	34.18671049	-118.429353	Los Angeles County
206315	Fee-for-Service	1295314433	1295314433	1	1	FLINTRIDGE HOSPICE CARE INC	10/17/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	SUITE 113	LA CRESCENTA	CA	91214	4578	19	06037	34.22121465	-118.2352382	Los Angeles County
206330	Fee-for-Service	1912264862	1912264862	1	27	FIRST CHOICE PHYSICIAN PARTN	9/26/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ARTNERS	1801 COLORADO AVE	SUITE 240	TURLOCK	CA	95382	2704	50	06099	37.50941613	-120.8353105	Stanislaus County
206364	Fee-for-Service	1265886691	1265886691	1	1	FONG, ABIGAIL MD	8/6/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	158420	33	Thoracic Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
206379	Fee-for-Service	1285703413	1285703413	1	1	FINKENBERG, JOHN G MD	10/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	56283	20	Orthopedic Surgery	0	In state provider	None	5555 RESERVOIR DR	STE 104	SAN DIEGO	CA	92120	5198	37	06073	32.77628471	-117.0563688	San Diego County
206467	Fee-for-Service	1912093451	1912093451	1	1	FAMILY HEALTHCARE NETWRK	12/7/2001	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	12586 AVENUE 408	None	OROSI	CA	93647	9454	54	06107	36.53030229	-119.2915122	Tulare County
206521	Fee-for-Service	1710082912	1710082912	1	1	FUNAI, JOHN T. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3-3720 KUHIO HIGHWAY	None	LIHUE	HI	96766	1099	00	None	21.9917847	-159.3633216	Kauai County
206529	Fee-for-Service	1134539562	1134539562	1	1	FINK, SEAN MD	3/6/2018	207R00000X	NA	Other	026	PHYSICIANS	153986	41	Internal Medicine	0	In state provider	None	1100 N PALM CANYON DR	STE 109	PALM SPRINGS	CA	92262	4418	33	06065	33.838182	-116.546744	Riverside County
206541	Fee-for-Service	1134109119	1134109119	1	1	FRIDIE, KEVIN E MD	12/5/2019	207L00000X	NA	Other	026	PHYSICIANS	45276	05	Anesthesiology	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
206633	Fee-for-Service	1407818693	1407818693	1	1	FRANK M REMBERT	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	INTERCITY RADIOLOGY	925 HIGHLAND BLVD	STE1180	BOZEMAN	MT	59715	6905	00	None	45.669618	-111.020184	Gallatin County
206661	Fee-for-Service	1558818153	1558818153	1	1	FLEVIYA, SMITHA NP	1/12/2018	163W00000X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	325 S WILLIS ST	None	VISALIA	CA	93291	6105	54	06107	36.327717	-119.2981005	Tulare County
206668	Fee-for-Service	1285703413	1285703413	1	1	FINKENBERG, JOHN G MD	10/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	56283	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5555 RESERVOIR DR	STE 104	SAN DIEGO	CA	92120	5198	37	06073	32.77628471	-117.0563688	San Diego County
206735	Fee-for-Service	1104028406	1104028406	1	1	FAULKENBERRY-MIRANDA,	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95426	40	Pediatrics	0	In state provider	CHRISTIAN E MD	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
206747	Fee-for-Service	1285091124	1285091124	1	1	FLOWERS, ROSS PHD	1/22/2020	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5800 HANNUM AVE	105	CULVER CITY	CA	90230	6553	19	06037	33.98724995	-118.3858338	Los Angeles County
206751	Fee-for-Service	1265614838	1265614838	1	1	FOGH, SHANNON E MD	6/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112445	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
206753	Fee-for-Service	1912093451	1912093451	1	1	FAMILY HEALTHCARE NETWRK	12/1/2001	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	12586 AVENUE 408	None	OROSI	CA	93647	9454	54	06107	36.53030229	-119.2915122	Tulare County
206763	Fee-for-Service	1285153882	1285153882	1	1	FLINDERS PHYSICIANS GROUP IN	4/4/2018	261QP2300X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	C	5189 HOSPITAL RD	None	MARIPOSA	CA	95338	9524	22	06043	37.50033166	-119.9769163	Mariposa County
206780	Fee-for-Service	1437650074	1437650074	1	1	FAN, TING-WEI MD	8/31/2023	207L00000X	NA	Other	026	PHYSICIANS	178988	None	None	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
206837	Fee-for-Service	1285115857	1285115857	1	1	FULLER, ASHLEY LMFT	6/29/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE	130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
206873	Fee-for-Service	1730264250	1730264250	1	1	FLORES, ELEANOR A NP	2/9/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DRIVE	8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
206907	Fee-for-Service	1275989865	1275989865	1	1	FICK, ASHLEY D PSYD	4/19/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	28281 CROWN VALLEY PKWY,	STE. 225	LAGUNA NIGUEL	CA	92677	1483	30	06059	33.55219721	-117.6875387	Orange County
206922	Fee-for-Service	1720065931	1720065931	1	1	FREDERICK, HAROLD M MD	6/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	52182	None	None	0	In state provider	None	4334 CENTRAL AVE	None	RIVERSIDE	CA	92506	2918	33	06065	33.95346346	-117.3993495	Riverside County
207025	Fee-for-Service	1952322729	1952322729	1	1	FLUENCE, JOSEPH K MD	8/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42660	05	Anesthesiology	0	In state provider	None	817 COFFEE RD	STE C3	MODESTO	CA	95355	4241	50	06099	37.655235	-120.975616	Stanislaus County
207040	Fee-for-Service	1912093451	1912093451	1	1	FAMILY HEALTHCARE NETWRK	12/1/2001	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	12586 AVENUE 408	None	OROSI	CA	93647	9454	54	06107	36.53030229	-119.2915122	Tulare County
207119	Fee-for-Service	1366081895	1366081895	1	1	FRYMAN, MARSHALL	9/27/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
207163	Fee-for-Service	1801182407	1801182407	1	1	FORREY, REGINA M LMFT	5/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
207164	Fee-for-Service	1255322640	1255322640	1	1	FRY, PAUL J III	10/31/1990	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	54590	20	Orthopedic Surgery	0	In state provider	None	1139 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
207210	Fee-for-Service	1801851043	1801851043	1	1	FAMILY PRACTICE OF GLENDALE	10/24/1989	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	801 S CHEVY CHASE DR	STE 230	GLENDALE	CA	91205	4436	19	06037	34.136757	-118.2396195	Los Angeles County
207306	Fee-for-Service	1821409970	1821409970	1	1	FEERST, ANNETTE R LMFT	10/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7621 N DEL MAR AVE	SUITE 102	FRESNO	CA	93711	5802	10	06019	36.848772	-119.795887	Fresno County
207329	Fee-for-Service	1912093451	1912093451	1	1	FAMILY HEALTHCARE NETWRK	12/1/2001	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	12586 AVENUE 408	None	OROSI	CA	93647	9454	54	06107	36.53030229	-119.2915122	Tulare County
207416	Fee-for-Service	1396760708	1396760708	1	1	FAIR, SUSAN M PHD	8/13/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	445 BELLEVUE AVE	SUITE 203	OAKLAND	CA	94610	4923	01	06001	37.80910261	-122.2526914	Alameda County
207535	Fee-for-Service	1972752012	1972752012	1	1	FRANKOVITCH, MARK	10/20/2008	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3761 GEARY BLVD	None	SAN FRANCISCO	CA	94418	3405	38	06075	37.78112022	-122.4595496	San Francisco County
207545	Fee-for-Service	1235195173	1235195173	1	1	FEINER, JOHN R	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	65100	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
207564	Fee-for-Service	1104161579	1104161579	1	1	FACULTY PHYSICIANS AND	4/10/2014	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM	25805 BARTON RD	A-101,A102,A103	LOMA LINDA	CA	92354	3814	36	06071	34.04825223	-117.2408371	San Bernardino County
207599	Fee-for-Service	1659403277	1659403277	1	1	FINKELSTEIN, DAVID E PHD	12/23/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	316 NORTH KINGS RD	None	LOS ANGELES	CA	90048	2620	19	06037	34.07662691	-118.3721142	Los Angeles County
207601	Fee-for-Service	1003377706	1003377706	1	1	FARRAND, TED W MD	12/27/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176968	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
207687	Fee-for-Service	1144995382	1144995382	1	1	FIGUEROA, VERONICA R	3/1/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
207747	Fee-for-Service	1689681025	1689681025	1	1	FELDMAN,JEREMY MD	5/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3330 N 2ND ST	STE 300	PHOENIX	AZ	85012	2000	00	None	33.486606	-112.071654	Maricopa County
207800	Fee-for-Service	1770551350	1770551350	1	1	FERNANDEZ, AMANDA N MD	4/7/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	50398	79	Neurology-Child	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
207916	Fee-for-Service	1295920445	1295920445	1	1	FRIEDMAN, ROGER D MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31865	18	Ophthalmology	0	In state provider	None	5400 BALBOA BLVD	STE 131	ENCINO	CA	91316	5204	19	06037	34.169283	-118.501072	Los Angeles County
207924	Fee-for-Service	1568885788	1568885788	1	1	FIGUEROA, DOLORES MD APC	2/18/2014	193400000X	NA	Other	026	PHYSICIANS	72888	41	Internal Medicine	0	In state provider	None	4623 EAGLES ROCK BLVD	None	LOS ANGELES	CA	90041	3049	19	06037	34.12808902	-118.2176465	Los Angeles County
207926	Fee-for-Service	1972041671	1972041671	1	1	FENSTERWALD, MOLLY R MD	4/12/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	181894	None	None	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
208079	Fee-for-Service	1043304025	1043304025	1	1	FIRST FOUNTAINS MEDICAL	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	08	Family Practice	0	In state provider	CENTER INC	1480 S HARBOR BLVD	STE 1	LA HABRA	CA	90631	7506	30	06059	33.91276851	-117.931697	Orange County
208081	Fee-for-Service	1770551350	1770551350	1	1	FERNANDEZ, AMANDA N MD	4/7/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	50398	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
208096	Fee-for-Service	1821539172	1821539172	1	1	FEISTER, JOHN B MD	1/26/2022	208M00000X	NA	Other	026	PHYSICIANS	170247	None	None	0	In state provider	None	1101 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6919	38	06075	37.78610439	-122.421569	San Francisco County
208181	Fee-for-Service	1689742629	1689742629	1	1	FEGHALI, RITA J MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70305	40	Pediatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
208207	Fee-for-Service	1245469345	1245469345	1	1	FAKEH, AYMAN M MD	12/3/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173261	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
208217	Fee-for-Service	1053730168	1053730168	1	1	FARGUSSON, MICHAEL A MD	7/1/2017	207P00000X	NA	Other	026	PHYSICIANS	138769	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6501 COYLE AVENUE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
208232	Fee-for-Service	1134253594	1134253594	1	1	FRID, DINA MD	8/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97458	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
208234	Fee-for-Service	1548494164	1548494164	1	1	FLORES, GENE P	8/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3753 E THOUSAND OAKS BLV	None	WESTLAKE VILLAGE	CA	91362	3607	56	06111	34.16411108	-118.828654	Ventura County
208275	Fee-for-Service	1144425570	1144425570	1	1	FRIEND, KATHARINE	1/24/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2815 MITCHELL DR	STE 119	WALNUT CREEK	CA	94598	1622	07	06013	37.93129027	-122.0204585	Contra Costa County
208323	Fee-for-Service	1063642379	1063642379	1	1	FERRARA, CHRISTINE T MD	2/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139076	67	Endocrinology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
208327	Fee-for-Service	1154338580	1154338580	1	1	FANG, MICHAEL S MD	2/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88548	41	Internal Medicine	0	In state provider	None	933 S SUNSET AVE	STE 306	WEST COVINA	CA	91790	3410	19	06037	34.06428275	-117.9432037	Los Angeles County
208335	Fee-for-Service	1336227081	1336227081	1	1	FISCH, JEFFREY ROY MD	7/20/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75919	40	Pediatrics	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
208336	Fee-for-Service	1659404127	1659404127	1	1	FREEDMAN-HARVEY, GARY	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	909 ELECTRIC AVE	STE 202	SEAL BEACH	CA	90740	6336	30	06059	33.74242862	-118.1032856	Orange County
208349	Fee-for-Service	1710035068	1710035068	1	1	FONG, DON P OD	9/17/1980	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3956 J ST	# 4	SACRAMENTO	CA	95819	3625	34	06067	38.569338	-121.453146	Sacramento County
208409	Fee-for-Service	1063875821	1063875821	1	1	FUNK, JENNIFER MD	12/16/2019	207R00000X	NA	Other	026	PHYSICIANS	158008	41	Internal Medicine	0	In state provider	None	1501 TROUSDALE DRIVE	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
208444	Fee-for-Service	1174089411	1174089411	1	1	FAMILY TALK THERAPY CENTER,	10/18/2019	101YP2500X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
208564	Fee-for-Service	1104184191	1104184191	1	1	FULLER, CLINTON L MD	10/1/2020	207L00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	None	29.70724683	-95.4026169	Harris County
208601	Fee-for-Service	1093302598	1093302598	1	1	FULL HEARTS HOSPICE CARE INC	8/12/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	530 S GLENOAKS BLVD	STE 207	BURBANK	CA	91502	2753	19	06037	34.17993386	-118.301721	Los Angeles County
208606	Fee-for-Service	1194144758	1194144758	1	1	FIELDING-SINGH, VIKRAM MD	8/4/2020	207L00000X	NA	Other	026	PHYSICIANS	139270	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
208614	Fee-for-Service	1154338580	1154338580	1	1	FANG, MICHAEL S MD	2/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88548	45	Nephrology (Renal-Kidney)	0	In state provider	None	933 S SUNSET AVE	STE 306	WEST COVINA	CA	91790	3410	19	06037	34.06428275	-117.9432037	Los Angeles County
208622	Fee-for-Service	1356497523	1356497523	1	1	FAR EAST MED SUP & EQ IN	9/11/2003	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	LABADLABAD ROSENDO S	4426 BEVERLY BLVD	None	LOS ANGELES	CA	90004	1802	19	06037	34.07623269	-118.305185	Los Angeles County
208628	Fee-for-Service	1710067251	1710067251	1	1	FUNKHOUSER, LAURA MD	9/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	70416	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	# 100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
208651	Fee-for-Service	1700982493	1700982493	1	1	FLETCHER, ABIGAIL S MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67871	08	Family Practice	0	In state provider	None	450 E SPRING ST	STE 1	LONG BEACH	CA	90806	1625	19	06037	33.8099218	-118.1872346	Los Angeles County
208692	Fee-for-Service	1659537264	1659537264	1	1	FAHLEN, MARK T MD INC	8/1/2008	207RN0300X	NA	Nephrology	026	PHYSICIANS	81212	45	Nephrology (Renal-Kidney)	0	In state provider	None	1400 FLORIDA AVE	STE 109	MODESTO	CA	95350	4422	50	06099	37.66410995	-120.996159	Stanislaus County
208731	Fee-for-Service	1174089411	1174089411	1	1	FAMILY TALK THERAPY CENTER,	2/13/2025	101YP2500X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
208741	Fee-for-Service	1285624650	1285624650	1	1	FULMER, CHRISTIAN J DO	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	9099	01	General Practice	0	In state provider	None	50 E HALMITON AVENUE	STE 120	CAMPBELL	CA	95008	0204	43	06085	0	0	None
208809	Fee-for-Service	1114376597	1114376597	1	1	FINLEY, JESSICA MD	5/27/2020	208M00000X	NA	Other	026	PHYSICIANS	167711	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	#365,420,120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
208880	Fee-for-Service	1861824690	1861824690	1	1	FREEMAN, JESUSA CRISTINA LM	2/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
208881	Fee-for-Service	1104970250	1104970250	1	1	FURMAN, ANCHEL MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	49247	41	Internal Medicine	0	In state provider	None	50 BELLEFONTAINE ST	STE 201	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
208890	Fee-for-Service	1093302598	1093302598	1	1	FULL HEARTS HOSPICE CARE INC	8/12/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	530 S GLENOAKS BLVD	STE 207	BURBANK	CA	91502	2753	19	06037	34.17993386	-118.301721	Los Angeles County
208913	Fee-for-Service	1184250144	1184250144	1	1	FOOTS, VERNICA N CNP	7/7/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2505 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2011	19	06037	34.03287856	-118.4748782	Los Angeles County
208916	Fee-for-Service	1730355801	1730355801	1	1	FULLERTON CHEST & CRITICAL	3/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	69690	29	Pulmonary Diseases (M.D. only)	0	In state provider	CARE INC	875 N BREA BLVD	None	BREA	CA	92821	2606	30	06059	33.93434103	-117.8932895	Orange County
208980	Fee-for-Service	1659537264	1659537264	1	1	FAHLEN, MARK T MD INC	8/1/2008	207RN0300X	NA	Nephrology	026	PHYSICIANS	81212	41	Internal Medicine	0	In state provider	None	1400 FLORIDA AVE	STE 109	MODESTO	CA	95350	4422	50	06099	37.66410995	-120.996159	Stanislaus County
209018	Fee-for-Service	1174089411	1174089411	1	1	FAMILY TALK THERAPY CENTER,	9/25/2020	101YP2500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
209030	Fee-for-Service	1396908398	1396908398	1	1	FATHI, AMIR H MD	8/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136988	01	General Practice	0	In state provider	None	7415 NORTH CEDAR AVE	STE 102	FRESNO	CA	93720	3834	10	06019	36.8438171	-119.7568857	Fresno County
209054	Fee-for-Service	1386039758	1386039758	1	1	FRENCHER, JAMES MD	4/10/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	148992	30	Radiology	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
209158	Fee-for-Service	1215184551	1215184551	1	1	FEINTECH, LISA A M MD	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	62807	05	Anesthesiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	1778	19	06037	34.06373445	-118.443537	Los Angeles County
209204	Fee-for-Service	1710107693	1710107693	1	1	FREEMAN, CARLOTTA V MD	1/13/2011	2084P0015X	NA	Psychiatry	026	PHYSICIANS	84704	36	Psychiatry	0	In state provider	None	1414 S GRAND AVE	STE 410	LOS ANGELES	CA	90015	3078	19	06037	34.03661142	-118.2657227	Los Angeles County
209241	Fee-for-Service	1184658510	1184658510	1	1	FLYNN, MICHAEL MD	11/27/1985	207L00000X	NA	Other	026	PHYSICIANS	32657	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
209308	Fee-for-Service	1174089411	1174089411	1	1	FAMILY TALK THERAPY CENTER,	10/18/2019	101YP2500X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	19330 JESSE LN	STE 280	RIVERSIDE	CA	92508	5091	33	06065	33.90484164	-117.3254297	Riverside County
209438	Fee-for-Service	1669468872	1669468872	1	1	FEALY, MICHAEL J MD	11/16/2018	2082S0105X	NA	General Surgery	026	PHYSICIANS	69172	24	Plastic Surgery	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
209441	Fee-for-Service	1962408070	1962408070	1	1	FRANKEL, PHILLIP S MD	3/16/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	33330	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	301 N PRAIRIE AVE	STE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
209448	Fee-for-Service	1437345758	1437345758	1	1	FOREMAN, ANDREA G PHD	9/17/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
209468	Fee-for-Service	1154914695	1154914695	1	1	FIRST CLASS HOSPICE, INC.	11/18/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8932 RESEDA BLVD	STE 203	NORTHRIDGE	CA	91324	5829	19	06037	34.232877	-118.5360545	Los Angeles County
209502	Fee-for-Service	1528158912	1528158912	1	1	FARRAN, JAMAL M MD	11/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53373	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2215 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
209563	Fee-for-Service	1255621876	1255621876	1	1	FONG, ALAN G MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143713	18	Ophthalmology	0	In state provider	None	234 S FIRST AVE	STE 101	ARCADIA	CA	91006	3607	19	06037	34.13695131	-118.0282575	Los Angeles County
209639	Fee-for-Service	1891798195	1891798195	1	1	FAM, ALBERT A LCSW	2/2/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
209677	Fee-for-Service	1356635593	1356635593	1	1	FROST, LINDSAY MD	1/28/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	156311	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
209718	Fee-for-Service	1013115740	1013115740	1	1	FLOOD, TIFFANY M LCSW	6/12/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27330	-	NOT APPLICABLE	0	In state provider	None	323 N PRAIRIE AVE	STE 350	INGLEWOOD	CA	90301	4502	19	06037	33.966333	-118.3439975	Los Angeles County
209746	Fee-for-Service	1528488863	1528488863	1	1	FINKBEINER, BRANDON L MD	11/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153957	01	General Practice	0	In state provider	None	5176 HILL ROAD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
209757	Fee-for-Service	1154914695	1154914695	1	1	FIRST CLASS HOSPICE, INC.	11/18/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8932 RESEDA BLVD	STE 203	NORTHRIDGE	CA	91324	5829	19	06037	34.232877	-118.5360545	Los Angeles County
209807	Fee-for-Service	1154589273	1154589273	1	1	FRENETTE, ERIC MD	8/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101440	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
209893	Fee-for-Service	1225197163	1225197163	1	1	FARTASH, BECKY OD	10/24/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9418 FIRESTONE BLVD	None	DOWNEY	CA	90241	5504	19	06037	33.93147456	-118.1159463	Los Angeles County
209895	Fee-for-Service	1073769055	1073769055	1	1	FLINDERS, JESSICA NP	2/1/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
209922	Fee-for-Service	1245001502	1245001502	1	1	FISTA TRANSPORTATION LLC	7/16/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	901 W CIVIC CENTER DR.	UNIT 200	SANTA ANA	CA	92703	2352	30	06059	33.75155572	-117.8778014	Orange County
210012	Fee-for-Service	1245861350	1245861350	1	1	FAMILY HEALTH CENTERS OF SAN	7/6/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	DIEGO, INC	740 10TH STREET	None	IMPERIAL BEACH	CA	91932	2216	37	06073	32.58303062	-117.1118492	San Diego County
210014	Fee-for-Service	1073622080	1073622080	1	1	FLORINDA MAILOM PIANO, MD, A	3/27/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	MEDICAL CORPORATION	2121 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1706	19	06037	34.17309265	-118.3314784	Los Angeles County
210053	Fee-for-Service	1114256955	1114256955	1	1	FONG, JENNIFER K DPM	7/4/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
210080	Fee-for-Service	1033614920	1033614920	1	1	FUJIMOTO, JEFFREY T MD	3/29/2021	207R00000X	NA	Other	026	PHYSICIANS	164274	None	None	0	In state provider	None	2020 SANTA MONICA BLVD	210, 220, 230, 240	SANTA MONICA	CA	90404	2000	19	06037	34.02901811	-118.4795396	Los Angeles County
210090	Fee-for-Service	1558998195	1558998195	1	1	FLORENDO, MARIA NOELLE MD	7/1/2024	390200000X	NA	Other	026	PHYSICIANS	178277	13	Neurology (M.D. only)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
210143	Fee-for-Service	1861576209	1861576209	1	1	FRANCIS, MERRI B LCSW	12/26/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4120 CAMERON PARK DR	SUITE 205	CAMERON PARK	CA	95682	8480	09	06017	38.65534901	-120.9690081	El Dorado County
210151	Fee-for-Service	1457449910	1457449910	1	1	FENG LIU	7/28/2009	207R00000X	NA	Other	026	PHYSICIANS	107854	13	Neurology (M.D. only)	0	In state provider	None	7000 BOULDER AVENUE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
210175	Fee-for-Service	1164517744	1164517744	1	1	FAMILY HEALTHCARE NETWORK	6/5/2000	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	201 EAST LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	54	06107	36.4172997	-119.0975768	Tulare County
210199	Fee-for-Service	1407936198	1407936198	2	1	FISHMANN, ANDREW J MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	44744	41	Internal Medicine	0	In state provider	None	1245 WILSHIRE BLVD	SUITE 407	LOS ANGELES	CA	90017	1901	19	06037	34.05362775	-118.2661889	Los Angeles County
210233	Fee-for-Service	1659447027	1659447027	1	1	FISCHMAN, MICHAEL L MD	4/25/2022	2083P0500X	NA	Adult Primary Care	026	PHYSICIANS	43377	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
210237	Fee-for-Service	1063449759	1063449759	1	1	FUKUDA, KEVIN A MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81100	05	Anesthesiology	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
210250	Fee-for-Service	1508581869	1508581869	1	1	FUNES, JUSTIN PT	10/28/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
210254	Fee-for-Service	1770142663	1770142663	1	1	FERNANDEZ SANCHEZ, ANDREA C	3/28/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
210276	Fee-for-Service	1114015930	1114015930	1	1	FEUILLE, RICHARD H MD	1/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	39475	40	Pediatrics	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
210278	Fee-for-Service	1194912162	1194912162	1	1	FALCOCCHIA, MARIA A MD	11/14/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	98252	08	Family Practice	0	In state provider	None	275 W HERNDON AVE	None	CLOVIS	CA	93612	0204	10	06019	36.83766747	-119.715174	Fresno County
210281	Fee-for-Service	1174530612	1174530612	1	1	FRANCIS, DAVID J MD	10/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	27926	22	Pathology (M.D. only)	0	In state provider	None	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
210290	Fee-for-Service	1033199575	1033199575	1	1	FIMBRES, EDMUNDO C OD	1/1/1982	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6537 GREENLEAF AVE	None	WHITTIER	CA	90601	4108	19	06037	33.98157473	-118.0373941	Los Angeles County
210337	Fee-for-Service	1851143879	1851143879	1	1	FAMILY THERAPY CENTER CORP	7/11/2024	103TC1900X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3576 ARLINGTON AVE	SUITE 202	RIVERSIDE	CA	92506	3943	33	06065	33.94625192	-117.3913739	Riverside County
210348	Fee-for-Service	1629623509	1629623509	1	1	FIRST AMERICAN HOSPICE INC	5/8/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	436 W COLORADO ST	SUITE 209	GLENDALE	CA	91204	3074	19	06037	34.14249549	-118.2624705	Los Angeles County
210355	Fee-for-Service	1548540727	1548540727	1	1	FUNG, LILLY NP	11/3/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
210388	Fee-for-Service	1073747663	1073747663	1	1	FIFE, TIMOTHY A MD	10/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130563	04	Otology, Laryngology, Rhinology	0	In state provider	None	2 MEDICAL PLAZA DRIVE	SUITE 225	ROSEVILLE	CA	95661	3044	31	06061	38.76507948	-121.2477476	Placer County
210438	Fee-for-Service	1588084081	1588084081	1	1	FANG, SARAH MD	7/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14482	01	General Practice	0	In state provider	None	2110 BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
210439	Fee-for-Service	1407910615	1407910615	1	1	FRISBY, STEVEN M OD	12/12/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
210452	Fee-for-Service	1831637974	1831637974	1	1	FOSTER, MICHELE B NP	2/2/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
210457	Fee-for-Service	1164517744	1164517744	1	1	FAMILY HEALTHCARE NETWORK	6/5/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	201 EAST LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	54	06107	36.4172997	-119.0975768	Tulare County
210488	Fee-for-Service	1407936198	1407936198	2	1	FISHMANN, ANDREW J MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	44744	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1245 WILSHIRE BLVD	SUITE 407	LOS ANGELES	CA	90017	1901	19	06037	34.05362775	-118.2661889	Los Angeles County
210563	Fee-for-Service	1447401468	1447401468	1	1	FELDSTEIN, JAMIE L LMFT	2/11/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52265	-	NOT APPLICABLE	0	In state provider	None	1317 DEL NORTE RD	SUITE 200	CAMARILLO	CA	93010	8368	56	06111	34.22312217	-119.1046861	Ventura County
210624	Fee-for-Service	1851143879	1851143879	1	1	FAMILY THERAPY CENTER CORP	7/11/2024	103TC1900X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3576 ARLINGTON AVE	SUITE 202	RIVERSIDE	CA	92506	3943	33	06065	33.94625192	-117.3913739	Riverside County
210637	Fee-for-Service	1629623509	1629623509	1	1	FIRST AMERICAN HOSPICE INC	5/8/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	436 W COLORADO ST	SUITE 209	GLENDALE	CA	91204	3074	19	06037	34.14249549	-118.2624705	Los Angeles County
210669	Fee-for-Service	1053340133	1053340133	1	1	FOUNDATION FOR OSTEOPORO	2/14/2007	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	RESEARCH AND EDUCATION	1814 FRANKLIN ST	STE 620	OAKLAND	CA	94612	3426	01	06001	37.80706841	-122.2679	Alameda County
210742	Fee-for-Service	1417261405	1417261405	1	1	FOGEL, JONATHAN M PHD	2/21/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	525 W MAIN ST	SUITE 120	VISALIA	CA	93291	6116	54	06107	36.330003	-119.297439	Tulare County
210744	Fee-for-Service	1164517744	1164517744	1	1	FAMILY HEALTHCARE NETWORK	11/15/2001	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	201 EAST LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	54	06107	36.4172997	-119.0975768	Tulare County
210766	Fee-for-Service	1598790834	1598790834	1	1	FIELD, DAVID R MD	11/25/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	68988	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4100 TRUXTUN AVE	STE 306	BAKERSFIELD	CA	93309	0657	15	06029	35.37322685	-119.0458325	Kern County
210772	Fee-for-Service	1407387988	1407387988	1	1	FARIZANI, AMIR MD	3/15/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169679	None	None	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
210776	Fee-for-Service	1407936198	1407936198	2	1	FISHMANN, ANDREW J MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	44744	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1245 WILSHIRE BLVD	SUITE 407	LOS ANGELES	CA	90017	1901	19	06037	34.05362775	-118.2661889	Los Angeles County
210840	Fee-for-Service	1811552730	1811552730	1	1	FLORES, GABRIEL MD	9/7/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178300	None	None	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
210862	Fee-for-Service	1336525906	1336525906	1	2	FAMILY HEALTH CENTERS	6/22/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	5160 FEDERAL BLVD	None	SAN DIEGO	CA	92105	5429	37	06073	32.72151894	-117.0835519	San Diego County
210868	Fee-for-Service	1285765016	1285765016	2	1	FRANCISCO GIL PROFESSIONAL M	3/1/2021	163WG0000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	655 EUCLID AVE	STE 405	NATIONAL CITY	CA	91950	2979	37	06073	32.68353398	-117.082625	San Diego County
210883	Fee-for-Service	1073830899	1073830899	1	1	FONTANA, LYNN M NP	11/9/2018	364SA2200X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
210884	Fee-for-Service	1154594281	1154594281	1	1	FENSTERMACHER, KIRSTEN M	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	3840 HOMESTEAD ROAD	None	SANTA CLARA	CA	95051	4542	43	06085	37.33774954	-122.002065	Santa Clara County
210971	Fee-for-Service	1811660327	1811660327	1	1	FIRST RATE LAB LLC	6/14/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	3189 AIRWAY AVE	STE C	COSTA MESA	CA	92626	4612	30	06059	33.6829543	-117.8688753	Orange County
211001	Fee-for-Service	1992906465	1992906465	1	1	FUENTES, JENNIFER A CNP	3/9/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18080 IMPERIAL HWY	None	YORBA LINDA	CA	92886	3436	30	06059	33.89287302	-117.8194305	Orange County
211124	Fee-for-Service	1427125335	1427125335	1	1	FANNING, KATHLEEN M MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62940	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
211149	Fee-for-Service	1336525906	1336525906	1	2	FAMILY HEALTH CENTERS	9/23/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	5160 FEDERAL BLVD	None	SAN DIEGO	CA	92105	5429	37	06073	32.72151894	-117.0835519	San Diego County
211164	Fee-for-Service	1962593830	1962593830	1	1	FERRIS, ERNEST J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4301 W MARKHAM ST	SLOT #528	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
211179	Fee-for-Service	1417971151	1417971151	1	1	FUCHS, JULIE R. MD	2/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55022	02	General Surgery	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
211228	Fee-for-Service	1376795369	1376795369	1	1	FACULTY PHYS & SUR LLUSM	6/22/2016	207Y00000X	NA	ENT/Otolaryngology	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1895 ORANGE TREE LANE	STE 102	REDLANDS	CA	92374	0112	36	06071	34.06779452	-117.2169225	San Bernardino County
211274	Fee-for-Service	1699752915	1699752915	1	1	FAIRVIEW HEALTH SERVICES	6/8/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	6401 FRANCE AVE S	None	EDINA	MN	55435	2104	00	None	44.88704016	-93.32668847	Hennepin County
211350	Fee-for-Service	1124032248	1124032248	1	1	FISHER, JASON M MD	5/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81771	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
211364	Fee-for-Service	1285712968	1285712968	1	1	FERGERSON, SARAH S	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79115	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
211414	Fee-for-Service	1427125335	1427125335	1	1	FANNING, KATHLEEN M MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62940	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
211437	Fee-for-Service	1336525906	1336525906	1	2	FAMILY HEALTH CENTERS	9/20/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	5160 FEDERAL BLVD	None	SAN DIEGO	CA	92105	5429	37	06073	32.72151894	-117.0835519	San Diego County
211462	Fee-for-Service	1932561198	1932561198	1	1	FAMILY HEALTH CENTERS OF SAN	2/7/2017	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	525 E MAIN STREET	None	EL CAJON	CA	92020	4007	37	06073	32.79492347	-116.955981	San Diego County
211467	Fee-for-Service	1417971151	1417971151	1	1	FUCHS, JULIE R. MD	2/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55022	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
211475	Fee-for-Service	1114927050	1114927050	1	1	FELLER, JOHN MD	4/10/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65434	30	Radiology	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
211518	Fee-for-Service	1376795369	1376795369	1	1	FACULTY PHYS & SUR LLUSM	2/19/2020	207Y00000X	NA	ENT/Otolaryngology	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1895 ORANGE TREE LANE	STE 102	REDLANDS	CA	92374	0112	36	06071	34.06779452	-117.2169225	San Bernardino County
211523	Fee-for-Service	1851397277	1851397277	1	1	FARLEY A DEREK	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4040 N CENTRAL EXPWY	#600	DALLAS	TX	75204	0000	00	None	32.81262242	-96.79058739	Dallas County
211539	Fee-for-Service	1174791354	1174791354	1	1	FISHLEDER, MATTHEW E LMFT	2/25/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
211563	Fee-for-Service	1699752915	1699752915	1	1	FAIRVIEW HEALTH SERVICES	6/8/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	6401 FRANCE AVE S	None	EDINA	MN	55435	2104	00	None	44.88704016	-93.32668847	Hennepin County
211617	Fee-for-Service	1548646573	1548646573	1	1	FIERRO, PAUL R LMFT	8/15/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	111 N MARKET	STE 950	SAN JOSE	CA	95113	1112	43	06085	37.33791617	-121.8939388	Santa Clara County
211639	Fee-for-Service	1396748893	1396748893	1	1	FECHTNER, KENNETH B	1/31/1989	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	66085	None	None	0	In state provider	None	2200 HAYES ST	None	SAN FRANCISCO	CA	94117	1013	38	06075	37.77302042	-122.45342	San Francisco County
211649	Fee-for-Service	1295966026	1295966026	1	1	FACULTY MEDICAL GROUP OF	10/29/2009	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	LLUSM	25333 BARTON RD	None	LOMA LINDA	CA	92354	3123	36	06071	34.04801656	-117.251334	San Bernardino County
211657	Fee-for-Service	1922186428	1922186428	1	1	FLORES, PRISCILLA R DO	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9137	08	Family Practice	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
211724	Fee-for-Service	1336525906	1336525906	1	2	FAMILY HEALTH CENTERS	6/22/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	5160 FEDERAL BLVD	None	SAN DIEGO	CA	92105	5429	37	06073	32.72151894	-117.0835519	San Diego County
211744	Fee-for-Service	1164644100	1164644100	1	1	FORMAN, SCOTT A MD	2/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151568	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
211748	Fee-for-Service	1932561198	1932561198	1	1	FAMILY HEALTH CENTERS OF SAN	8/28/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	525 E MAIN STREET	None	EL CAJON	CA	92020	4007	37	06073	32.79492347	-116.955981	San Diego County
211800	Fee-for-Service	1508858465	1508858465	1	1	FISHBURN, ROBERT T MD	2/10/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	24395	30	Radiology	0	In state provider	None	274 HEATHER CT	None	TEMPLETON	CA	93465	9738	40	06079	35.55351	-120.717657	San Luis Obispo County
211804	Fee-for-Service	1376795369	1376795369	1	1	FACULTY PHYS & SUR LLUSM	12/10/2008	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1895 ORANGE TREE LANE	STE 102	REDLANDS	CA	92374	0112	36	06071	34.06779452	-117.2169225	San Bernardino County
211805	Fee-for-Service	1174964738	1174964738	1	1	FULGENT THERAPEUTICS LLC	7/14/2015	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	4978 SANTA ANITA AVE	STE 205	TEMPLE CITY	CA	91780	3600	19	06037	34.09611031	-118.0283098	Los Angeles County
211842	Fee-for-Service	1285785881	1285785881	1	1	FRANTZ, VICTORIA D LMFT	12/19/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14724 VENTURA BOULEVARD	SUITE 1100	SHERMAN OAKS	CA	91403	3511	19	06037	34.15179235	-118.4541787	Los Angeles County
211851	Fee-for-Service	1508245473	1508245473	1	1	FENG, BRIAN Y DO	6/20/2019	207P00000X	NA	Other	026	PHYSICIANS	17160	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
211983	Fee-for-Service	1447441357	1447441357	1	1	FITTER, JAY S LMFT	10/5/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1101 CALIFORNIA AVE	STE 100	CORONA	CA	92881	6472	33	06065	33.86171794	-117.5440764	Riverside County
212037	Fee-for-Service	1932561198	1932561198	1	1	FAMILY HEALTH CENTERS OF SAN	6/21/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	525 E MAIN STREET	None	EL CAJON	CA	92020	4007	37	06073	32.79492347	-116.955981	San Diego County
212098	Fee-for-Service	1215302096	1215302096	1	1	FITZGERALD, SEAN LPCC	9/1/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1902 ORANGE TREE LN	SUITE 200	REDLANDS	CA	92374	2888	36	06071	34.06785293	-117.2179967	San Bernardino County
212197	Fee-for-Service	1083637839	1083637839	2	1	FREIDENBERG, DAVID H MD	8/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	87581	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15630 18TH AVENUE	None	CLEARLAKE	CA	95422	9336	17	06033	38.93612361	-122.6201499	Lake County
212277	Fee-for-Service	1548790777	1548790777	1	1	FAHMY, KIROLOS OD	7/19/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1124 S MAIN ST	STE 101	CORONA	CA	92882	4449	33	06065	33.86931623	-117.5673487	Riverside County
212282	Fee-for-Service	1437602257	1437602257	1	1	FU, JASMINE Y MD	9/13/2021	207L00000X	NA	Other	026	PHYSICIANS	152123	None	None	0	In state provider	None	100 S SAN MATEO DR	None	SAN MATEO	CA	94401	3805	41	06081	37.5656736	-122.3254527	San Mateo County
212307	Fee-for-Service	1912996794	1912996794	1	1	FERGUSON, KENNETH H MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90492	34	Urology and Urological Surgery	0	In state provider	None	2020 SUTTER PLACE	None	DAVIS	CA	95616	6213	57	06113	38.56287659	-121.7715536	Yolo County
212326	Fee-for-Service	1932561198	1932561198	1	1	FAMILY HEALTH CENTERS OF SAN	6/21/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	525 E MAIN STREET	None	EL CAJON	CA	92020	4007	37	06073	32.79492347	-116.955981	San Diego County
212348	Fee-for-Service	1215121173	1215121173	1	1	FLOWERS, DANIELLE R MD	11/14/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	88202	40	Pediatrics	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
212412	Fee-for-Service	1790756799	1790756799	1	1	FU, IRENE S MD	9/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73533	40	Pediatrics	0	In state provider	None	765 MEDICAL CENTER CT	STE 205	CHULA VISTA	CA	91911	6600	37	06073	32.619069	-117.020835	San Diego County
212471	Fee-for-Service	1932375532	1932375532	1	1	FERRICK, FRIEDA L LMFT	6/17/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1023 4TH ST	F	SANTA ROSA	CA	95404	4329	49	06097	38.444004	-122.706648	Sonoma County
212511	Fee-for-Service	1952729303	1952729303	1	1	FAMILY HEALTH CENTERS	9/25/2015	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	1550 BROADWAY	STE 2	SAN DIEGO	CA	92101	5713	37	06073	32.71579987	-117.1499238	San Diego County
212516	Fee-for-Service	1942431762	1942431762	1	1	FACULTY MEDICAL GROUP OF	10/29/2009	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	LLUSM	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
212528	Fee-for-Service	1831558295	1831558295	1	1	FELLOWS, KERRY R NP	3/9/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
212646	Fee-for-Service	1790182947	1790182947	1	1	FRUDAKIS, SARAH L	4/29/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
212650	Fee-for-Service	1104976612	1104976612	1	1	FAMILY ADULT DAY HEALTH	1/15/2004	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	FAMILY ADHC-LOMITA	2280 LOMITA BLVD	None	LOMITA	CA	90717	1436	19	06037	33.80339264	-118.3223926	Los Angeles County
212680	Fee-for-Service	1992941066	1992941066	1	1	FASS, TARA M LMFT	8/13/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3831 HUGHES AVE	SUITE 708	CULVER CITY	CA	90232	6842	19	06037	34.02243278	-118.3981492	Los Angeles County
212770	Fee-for-Service	1922341502	1922341502	1	1	FU, EMILY MD	10/30/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	139176	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
212796	Fee-for-Service	1811674765	1811674765	1	1	FARMACIA SAN JOSE	11/14/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6012 E. FLORENCE AVE	D	BELL GARDENS	CA	90201	4737	19	06037	33.96694793	-118.1571599	Los Angeles County
212802	Fee-for-Service	1952729303	1952729303	1	1	FAMILY HEALTH CENTERS	10/22/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	1550 BROADWAY	STE 2	SAN DIEGO	CA	92101	5713	37	06073	32.71579987	-117.1499238	San Diego County
212820	Fee-for-Service	1891896841	1891896841	1	1	FARIVAR, SIRUS MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	36333	41	Internal Medicine	0	In state provider	None	17822 BEACH BLVD	STE 437	HUNTINGTON BEACH	CA	92647	7181	30	06059	33.70331388	-117.9890471	Orange County
212827	Fee-for-Service	1518164524	1518164524	1	1	FREEMAN, SHERRY M LMFT	9/14/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	310 3RD AVE	None	SAN FRANCISCO	CA	94118	2403	38	06075	37.78276788	-122.4611506	San Francisco County
212884	Fee-for-Service	1881849529	1881849529	1	1	FRESENIUS MEDICAL CARE	12/1/2008	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	DIABLO NEPHROLOGY CLINIC	4510 O'HARA AVE	STE B	BRENTWOOD	CA	94513	2293	07	06013	37.93856608	-121.7008388	Contra Costa County
212923	Fee-for-Service	1114119690	1114119690	1	1	FOSTER, CONCEPCION E LMFT	9/24/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27851 BRADLEY	107	MENIFEE	CA	92586	2286	33	06065	33.71630969	-117.1904696	Riverside County
212949	Fee-for-Service	1912264862	1912264862	1	26	FIRST CHOICE PHYSICIAN PARTN	12/6/2022	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	ARTNERS	1234 E NORTH ST	SUITE 102	MANTECA	CA	95336	4961	39	06077	37.80105524	-121.1968581	San Joaquin County
213055	Fee-for-Service	1124318472	1124318472	1	1	FRATTO, VICTORIA M MD	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136189	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
213089	Fee-for-Service	1952729303	1952729303	1	1	FAMILY HEALTH CENTERS	8/7/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	1550 BROADWAY	STE 2	SAN DIEGO	CA	92101	5713	37	06073	32.71579987	-117.1499238	San Diego County
213108	Fee-for-Service	1891896841	1891896841	1	1	FARIVAR, SIRUS MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	36333	10	Gastroenterology (M.D. only)	0	In state provider	None	17822 BEACH BLVD	STE 437	HUNTINGTON BEACH	CA	92647	7181	30	06059	33.70331388	-117.9890471	Orange County
213117	Fee-for-Service	1891785234	1891785234	1	1	FALLON, JULIE S MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78180	40	Pediatrics	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
213142	Fee-for-Service	1316901408	1316901408	1	1	FOX, JOHN W JR MD	1/20/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	43378	41	Internal Medicine	0	In state provider	None	4094 4TH AVE	# 301	SAN DIEGO	CA	92103	2143	37	06073	32.75153771	-117.161688	San Diego County
213199	Fee-for-Service	1033361886	1033361886	1	1	FACULTY PHYSICIANS & SUR	2/9/2009	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	OF LLUSM OPHTHALMOLOGY	4244 RIVERWALK PKWY	STE 100	RIVERSIDE	CA	92505	3372	33	06065	33.90336622	-117.49394	Riverside County
213211	Fee-for-Service	1588660369	1588660369	1	1	FAMILY HEALTH & HOUSING	3/22/2001	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	FOUNDATION	22617 S VERMONT AVE	None	TORRANCE	CA	90502	2550	19	06037	33.820281	-118.290368	Los Angeles County
213237	Fee-for-Service	1912264862	1912264862	1	26	FIRST CHOICE PHYSICIAN PARTN	12/6/2022	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	ARTNERS	1234 E NORTH ST	SUITE 102	MANTECA	CA	95336	4961	39	06077	37.80105524	-121.1968581	San Joaquin County
213306	Fee-for-Service	1184813339	1184813339	1	1	FOSTER, TERRANCE J MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	38904	08	Family Practice	0	In state provider	MEDICAL CORPORATION	274 COHASSET ROAD	SUITE 100	CHICO	CA	95926	2236	04	06007	39.75169866	-121.851622	Butte County
213340	Fee-for-Service	1518942804	1518942804	1	1	FURUTAN, NAVID P MD	10/19/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85917	40	Pediatrics	0	In state provider	None	9041 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3900	33	06065	33.92541585	-117.4378266	Riverside County
213352	Fee-for-Service	1144974791	1144974791	1	1	FANUCCHI, SHANNON K LMFT	2/22/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
213377	Fee-for-Service	1952729303	1952729303	1	1	FAMILY HEALTH CENTERS	10/22/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	1550 BROADWAY	STE 2	SAN DIEGO	CA	92101	5713	37	06073	32.71579987	-117.1499238	San Diego County
213388	Fee-for-Service	1104257369	1104257369	1	1	FRED BROWNS RECOVERY	9/13/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	270 W 14TH STREET	3	SAN PEDRO	CA	90731	4315	19	06037	33.73153278	-118.2828985	Los Angeles County
213414	Fee-for-Service	1720130180	1720130180	1	1	FLEISCHER, CHARLES A MD	6/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	6183	36	Psychiatry	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
213422	Fee-for-Service	1801957402	1801957402	1	1	FRANCUS, KENNETH E MD	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	59467	22	Pathology (M.D. only)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
213430	Fee-for-Service	1609231893	1609231893	1	1	FINE, NANETTE P LMFT	9/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1317 W FOOTHILL BLVD	SUITE 140	UPLAND	CA	91786	3686	36	06071	34.10715453	-117.6734115	San Bernardino County
213441	Fee-for-Service	1013252626	1013252626	1	1	FEMININE PHARMD INC	4/17/2013	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1270 UNIVERSITY AVE	None	SAN DIEGO	CA	92103	3312	37	06073	32.74861393	-117.1517063	San Diego County
213458	Fee-for-Service	1700664844	1700664844	1	1	FOSTER AND GARFF SURGICAL AS	6/27/2024	261QS0132X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	2124 S EL CAMINO REAL	STE 100	OCEANSIDE	CA	92054	6200	37	06073	33.18937621	-117.3280727	San Diego County
213461	Fee-for-Service	1932586344	1932586344	1	1	FAWIBE, FIYINFOLUWA MD	2/16/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	145359	None	None	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
213486	Fee-for-Service	1033361886	1033361886	1	1	FACULTY PHYSICIANS & SUR	8/31/2017	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OF LLUSM OPHTHALMOLOGY	4244 RIVERWALK PKWY	STE 100	RIVERSIDE	CA	92505	3372	33	06065	33.90336622	-117.49394	Riverside County
213505	Fee-for-Service	1306357454	1306357454	1	1	FLORES, MARIA ANGELICA M NP	6/1/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95007435	-	NOT APPLICABLE	0	In state provider	None	2460 MAIN ST	None	MORRO BAY	CA	93442	1552	40	06079	35.3868704	-120.8576894	San Luis Obispo County
213521	Fee-for-Service	1336297217	1336297217	1	1	FREEL, CYNTHIA L MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69862	08	Family Practice	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
213522	Fee-for-Service	1093807984	1093807984	1	1	FARZIN, ABDUL S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53334	08	Family Practice	0	In state provider	None	36243 INLAND VALLEY DR	STE 200	WILDOMAR	CA	92595	9548	33	06065	33.591528	-117.2393325	Riverside County
213530	Fee-for-Service	1912264862	1912264862	1	26	FIRST CHOICE PHYSICIAN PARTN	12/6/2022	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	ARTNERS	1234 E NORTH ST	SUITE 102	MANTECA	CA	95336	4961	39	06077	37.80105524	-121.1968581	San Joaquin County
213568	Fee-for-Service	1578641247	1578641247	1	1	FLORIO, RICHARD MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	81402	02	General Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
213576	Fee-for-Service	1760530703	1760530703	1	1	FARRELL, SUE ANN NP	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3420 KENYON ST	None	SAN DIEGO	CA	92110	5001	37	06073	32.74894593	-117.2139252	San Diego County
213605	Fee-for-Service	1386715043	1386715043	1	1	FRIEDLANDER, SHEILA F MD	2/28/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54225	07	Dermatology	0	In state provider	None	3030 CHILDRENS WAY	STE 408	SAN DIEGO	CA	92123	4228	37	06073	32.798889	-117.150826	San Diego County
213768	Fee-for-Service	1689624991	1689624991	1	1	FACULTY PHYSICIANS AND	4/16/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM	7223 CHURCH ST	STE C1	HIGHLAND	CA	92346	5869	36	06071	34.122888	-117.1737945	San Bernardino County
213773	Fee-for-Service	1033361886	1033361886	1	1	FACULTY PHYSICIANS & SUR	4/16/2018	207W00000X	NA	Ophthalmology	031	PSYCHOLOGISTS	-	None	None	0	In state provider	OF LLUSM OPHTHALMOLOGY	4244 RIVERWALK PKWY	STE 100	RIVERSIDE	CA	92505	3372	33	06065	33.90336622	-117.49394	Riverside County
213778	Fee-for-Service	1265713655	1265713655	1	1	FEINBERG, ELYSSA J MD	7/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119564	02	General Surgery	0	In state provider	None	725 WELCH ROAD	MC 5500	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
213810	Fee-for-Service	1093807984	1093807984	1	1	FARZIN, ABDUL S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53334	01	General Practice	0	In state provider	None	36243 INLAND VALLEY DR	STE 200	WILDOMAR	CA	92595	9548	33	06065	33.591528	-117.2393325	Riverside County
213831	Fee-for-Service	1194301119	1194301119	1	1	FRANCO, MAURICIO MD	6/24/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	184015	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	6E/6D37	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
213841	Fee-for-Service	1609074210	1609074210	1	1	FERDOWSALI, KAMERON MD	11/3/2008	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6490 S MCCARRAN BLVD	B13	RENO	NV	89509	6165	00	None	39.47672552	-119.796471	Washoe County
213910	Fee-for-Service	1881213510	1881213510	1	1	FREGOSO, BRYAN MD	8/1/2023	207P00000X	NA	Other	026	PHYSICIANS	186833	None	None	0	In state provider	None	1001 POTRERO AVE	RM 1E21	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
213915	Fee-for-Service	1336220854	1336220854	1	1	FELDMAN, GARY I MD	10/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65057	08	Family Practice	0	In state provider	None	2300 CALIFORNIA ST	STE 306	SAN FRANCISCO	CA	94115	2754	38	06075	37.78910083	-122.4323944	San Francisco County
213938	Fee-for-Service	1053330431	1053330431	1	1	FITZSIMONS, MARY MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	56339	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3001 COLBY ST	None	BERKELEY	CA	94705	2039	01	06001	37.85496934	-122.2575642	Alameda County
213974	Fee-for-Service	1629094339	1629094339	1	1	FOSTER, LAWRENCE G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34957	02	General Surgery	0	In state provider	None	230 HOSPITAL DR	None	UKIAH	CA	95482	4563	23	06045	39.15171639	-123.2035457	Mendocino County
214018	Fee-for-Service	1457801508	1457801508	1	1	FOWLER, CRISTINA NP	1/15/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
214021	Fee-for-Service	1902957491	1902957491	1	1	FOSTER, ANNE F MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81404	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
214055	Fee-for-Service	1689624991	1689624991	1	1	FACULTY PHYSICIANS AND	2/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	SURGEONS OF LLUSM	7223 CHURCH ST	STE C1	HIGHLAND	CA	92346	5869	36	06071	34.122888	-117.1737945	San Bernardino County
214069	Fee-for-Service	1740740810	1740740810	1	1	FLORA, REBECCA MD	5/17/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177341	08	Family Practice	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
214101	Fee-for-Service	1932537172	1932537172	1	1	FLATLEY, ERIN E NP	8/25/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
214110	Fee-for-Service	1215052576	1215052576	1	1	FOJAS, JOSE D PT	2/19/2019	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	22995 MILL CREEK DR	SUITE A	LAGUNA HILLS	CA	92653	1215	30	06059	33.62819651	-117.7351762	Orange County
214148	Fee-for-Service	1760625842	1760625842	1	1	FUGLEI, AMY L MD	10/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124701	36	Psychiatry	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
214199	Fee-for-Service	1437109345	1437109345	1	1	FISHER, JOHN TIMOTHY MD	8/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91319	66	Emergency Medicine (Urgent Care)	0	In state provider	None	43860 10TH ST W	None	LANCASTER	CA	93534	4848	19	06037	34.68010255	-118.1478903	Los Angeles County
214200	Fee-for-Service	1336220854	1336220854	1	1	FELDMAN, GARY I MD	10/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65057	41	Internal Medicine	0	In state provider	None	2300 CALIFORNIA ST	STE 306	SAN FRANCISCO	CA	94115	2754	38	06075	37.78910083	-122.4323944	San Francisco County
214217	Fee-for-Service	1457458929	1457458929	1	1	FAZZALARI, FRANCO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 E MEDICAL CENTER DR	None	ANN ARBOR	MI	48109	5000	00	None	42.28391347	-83.72716554	Washtenaw County
214242	Fee-for-Service	1215277108	1215277108	1	1	FOLEY, JENNIFER R MD	12/3/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
214262	Fee-for-Service	1518004076	1518004076	1	1	FINDEISS, LAURA K MD	4/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54064	30	Radiology	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
214263	Fee-for-Service	1629094339	1629094339	1	1	FOSTER, LAWRENCE G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34957	01	General Practice	0	In state provider	None	230 HOSPITAL DR	None	UKIAH	CA	95482	4563	23	06045	39.15171639	-123.2035457	Mendocino County
214308	Fee-for-Service	1700985363	1700985363	2	1	FLEIDERMAN, MARCOS MD	4/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	21519	41	Internal Medicine	0	In state provider	None	18356 CLARK ST	STE 101	TARZANA	CA	91356	3502	19	06037	34.16975482	-118.5331876	Los Angeles County
214357	Fee-for-Service	1740621119	1740621119	1	1	FRANKLIN, ROSANNA T PSYD	5/21/2024	251S00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
214393	Fee-for-Service	1790042554	1790042554	1	1	FAVILA, SARAH A MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136783	40	Pediatrics	0	In state provider	None	2020 SUTTER PLACE	None	DAVIS	CA	95616	6213	57	06113	38.56287659	-121.7715536	Yolo County
214394	Fee-for-Service	1780993790	1780993790	1	1	FITCH TORRES, LINDSEY	6/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
214397	Fee-for-Service	1629004957	1629004957	1	1	FELIZARTA, FRANCO A MD	6/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	63225	41	Internal Medicine	0	In state provider	None	3535 SAN DIMAS ST	STE 24	BAKERSFIELD	CA	93301	1688	15	06029	35.39123916	-119.008246	Kern County
214487	Fee-for-Service	1881655744	1881655744	2	1	FILICIOTTO, SAM MD	5/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65491	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	15708 POMERADO ROAD	SUITE N-207	POWAY	CA	92064	2036	37	06073	32.99948815	-117.0580342	San Diego County
214544	Fee-for-Service	1255482527	1255482527	1	1	FERDOWSMAKAN, ROBERT MD	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	94751	02	General Surgery	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
214548	Fee-for-Service	1629156286	1629156286	1	1	FLANIGAN ROGER E MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91653	36	Psychiatry	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
214563	Fee-for-Service	1437286796	1437286796	1	1	FAROOQUI, ASRA F MD	6/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98567	41	Internal Medicine	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
214633	Fee-for-Service	1689856270	1689856270	1	1	FIELDS, GLORIALEE LCSW	10/13/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 A STREET	306	HAYWARD	CA	94541	4151	01	06001	37.67233723	-122.0865795	Alameda County
214642	Fee-for-Service	1205039013	1205039013	1	1	FOGEL, RACHEL J MD	10/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95739	01	General Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
214687	Fee-for-Service	1629004957	1629004957	1	1	FELIZARTA, FRANCO A MD	6/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	63225	77	Infectious Disease	0	In state provider	None	3535 SAN DIMAS ST	STE 24	BAKERSFIELD	CA	93301	1688	15	06029	35.39123916	-119.008246	Kern County
214778	Fee-for-Service	1881655744	1881655744	2	1	FILICIOTTO, SAM MD	5/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65491	02	General Surgery	0	In state provider	None	15708 POMERADO ROAD	SUITE N-207	POWAY	CA	92064	2036	37	06073	32.99948815	-117.0580342	San Diego County
214899	Fee-for-Service	1740336981	1740336981	1	1	FABELLA, EMMANUEL T MD	2/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51956	41	Internal Medicine	0	In state provider	INC A PROFESSIONAL CORP	880 E MERRITT AVE	STE 102	TULARE	CA	93274	2247	54	06107	36.22202816	-119.3343473	Tulare County
214926	Fee-for-Service	1205039013	1205039013	1	1	FOGEL, RACHEL J MD	10/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95739	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
215054	Fee-for-Service	1508248493	1508248493	1	1	FRASER, JON M	9/11/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4141 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3109	38	06075	37.78096053	-122.4637512	San Francisco County
215073	Fee-for-Service	1952457202	1952457202	1	1	FREMONT UNIFIED SCH DIST	12/8/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4210 TECHNOLOGY DR	None	FREMONT	CA	94538	6337	01	06001	37.50883478	-121.9544927	Alameda County
215093	Fee-for-Service	1912264862	1912264862	1	8	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1541 FLORIDA AVE	STE 200	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
215188	Fee-for-Service	1306222062	1306222062	1	1	FILIPOVIC, MAYA MD	9/6/2022	207L00000X	NA	Other	026	PHYSICIANS	151304	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
215193	Fee-for-Service	1487702320	1487702320	1	1	FINCHEM, MERRI D MD	4/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81720	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
215225	Fee-for-Service	1790758506	1790758506	1	1	FOWLER, BLAINE A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36980	08	Family Practice	0	In state provider	None	7430 JACKSON DR	None	SAN DIEGO	CA	92119	2319	37	06073	32.80342449	-117.0457937	San Diego County
215236	Fee-for-Service	1528144037	1528144037	1	1	FLOWERS, KATHI MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	54823	40	Pediatrics	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
215244	Fee-for-Service	1972686632	1972686632	1	1	FU, ROY C MD	6/19/2009	207R00000X	NA	Other	026	PHYSICIANS	88997	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
215314	Fee-for-Service	1114243649	1114243649	1	1	FLAKES, ALISA L	10/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23945 SUNNYMEAD BLVD	5	MORENO VALLEY	CA	92553	3025	33	06065	33.93897472	-117.2450469	Riverside County
215358	Fee-for-Service	1952457202	1952457202	1	1	FREMONT UNIFIED SCH DIST	1/1/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	4210 TECHNOLOGY DR	None	FREMONT	CA	94538	6337	01	06001	37.50883478	-121.9544927	Alameda County
215382	Fee-for-Service	1912264862	1912264862	1	8	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	1541 FLORIDA AVE	STE 200	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
215403	Fee-for-Service	1588722672	1588722672	1	1	FUJINO, ROSS M	1/16/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
215407	Fee-for-Service	1932135266	1932135266	1	1	FARRUKH, ABDALLAH S MD	4/30/1982	207T00000X	NA	General Surgery	026	PHYSICIANS	40576	14	Neurological Surgery	0	In state provider	None	44902 10TH ST W	None	LANCASTER	CA	93534	2314	19	06037	34.699158	-118.148051	Los Angeles County
215458	Fee-for-Service	1538363684	1538363684	1	1	FIDLER-JOHNSON, CHRISTINA M	2/25/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3851 SHAW RIDGE RD	None	SAN DIEGO	CA	92130	2807	37	06073	32.93516088	-117.2297377	San Diego County
215479	Fee-for-Service	1285773085	1285773085	1	1	FRENCH, LYNN CCC-SLP	5/16/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3407 W SIXTH STREET	STE 716	LOS ANGELES	CA	90020	2764	19	06037	34.06363337	-118.295759	Los Angeles County
215482	Fee-for-Service	1326109315	1326109315	1	1	FLOYD VALLEY HOSPITAL	4/28/2024	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	714 LINCOLN ST NE	None	LE MARS	IA	51031	3341	00	None	42.79704846	-96.15637684	Plymouth County
215490	Fee-for-Service	1053817908	1053817908	1	1	FERNANDEZ-NEDVED, ELICIA MD	8/1/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	165315	None	None	0	In state provider	None	2230 STOCKTON BLVD	STE 2800	SACRAMENTO	CA	95817	1353	34	06067	38.555631	-121.459203	Sacramento County
215492	Fee-for-Service	1942733084	1942733084	1	1	FU, SUE J MD	5/12/2024	208600000X	NA	General Surgery	026	PHYSICIANS	156918	02	General Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
215574	Fee-for-Service	1629413687	1629413687	1	1	FAN, JASON M MD	8/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138157	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
215618	Fee-for-Service	1841533767	1841533767	1	1	FARASATPOUR, MISHEL MD	10/24/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	148258	13	Neurology (M.D. only)	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
215638	Fee-for-Service	1154559854	1154559854	1	1	FREILER, ANTHONY D MD	11/30/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176305	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
215670	Fee-for-Service	1912264862	1912264862	1	8	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	None	1541 FLORIDA AVE	STE 200	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
215743	Fee-for-Service	1922206143	1922206143	1	1	FOWLER, JEREMY R MD	1/7/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158759	None	None	0	In state provider	None	4663 SCOTTS VALLEY DR	None	SCOTTS VALLEY	CA	95066	3943	44	06087	37.04973619	-122.0157773	Santa Cruz County
215826	Fee-for-Service	1467889360	1467889360	1	1	FRESENIUS MEDICAL CARE	10/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BALBOA II LLC	5995 SEVERIN DR	None	LA MESA	CA	91942	3806	37	06073	32.7874768	-116.9992167	San Diego County
216065	Fee-for-Service	1700813359	1700813359	1	1	FONG, DELLA J MD	2/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	79210	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10720 PARAMOUNT BLVD	None	DOWNEY	CA	90241	3346	19	06037	33.94732999	-118.1345312	Los Angeles County
216084	Fee-for-Service	1730185695	1730185695	1	1	FAZIO, MICHAEL J MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	59079	07	Dermatology	0	In state provider	SKIN CANCER SURGERY CENT	2805 J ST	STE 100	SACRAMENTO	CA	95816	4307	34	06067	38.573982	-121.468419	Sacramento County
216103	Fee-for-Service	1912286915	1912286915	1	1	FIORENTINO, DIJANA LMFT	11/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	75100 MEDITERRANEAN	None	PALM DESERT	CA	92211	9069	33	06065	33.74397149	-116.3546505	Riverside County
216107	Fee-for-Service	1699722801	1699722801	1	1	FOY, JON F MD	9/30/1989	207L00000X	NA	Other	026	PHYSICIANS	48454	05	Anesthesiology	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
216135	Fee-for-Service	1609941798	1609941798	1	1	FAN, YUAN-DA MD	11/1/1996	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	43417	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	490 POST ST	STE 1112	SAN FRANCISCO	CA	94102	1302	38	06075	37.78812774	-122.4096884	San Francisco County
216260	Fee-for-Service	1346363025	1346363025	1	1	FOWLER USD	4/25/2000	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	658 E ADAMS AVE	None	FOWLER	CA	93625	2111	10	06019	36.63453084	-119.6736207	Fresno County
216281	Fee-for-Service	1912264862	1912264862	1	3	FIRST CHOICE PHYSICIAN PARTN	9/21/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	PARTNERS	3125 CONANT AVE	None	MODESTO	CA	95350	6527	50	06099	37.68548472	-121.0406676	Stanislaus County
216356	Fee-for-Service	1669494662	1669494662	1	1	FREIWALD, SANDRA L MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84531	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
216396	Fee-for-Service	1528075108	1528075108	1	1	FRANKLIN HOSPITAL	1/1/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	900 FRANKLIN AVE	None	VALLEY STREAM	NY	11580	2145	00	None	40.681296	-73.686483	Nassau County
216400	Fee-for-Service	1255382545	1255382545	1	4	FOOTHILL CARDIOLOGY MEDICAL	2/8/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	GROUP INC	289 W HUNTINGTON DR	SUITE 410	ARCADIA	CA	91007	3495	19	06037	34.13549119	-118.0419175	Los Angeles County
216449	Fee-for-Service	1487711966	1487711966	1	1	FULLAR, MICHAEL K MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139246	36	Psychiatry	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
216488	Fee-for-Service	1710900717	1710900717	1	1	FAIRBANKS, BRET S PT	7/31/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 PETERS CANYON RD	120	IRVINE	CA	92606	1799	30	06059	33.7113754	-117.7983703	Orange County
216501	Fee-for-Service	1841284304	1841284304	1	1	FU, YAO-SHI MD	3/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	30199	22	Pathology (M.D. only)	0	In state provider	None	4929 VAN NUYS BLVD	None	VAN NUYS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
216530	Fee-for-Service	1043742265	1043742265	1	1	FOO, KAREN MD	7/9/2021	2279E0002X	NA	Other	026	PHYSICIANS	172567	None	None	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
216606	Fee-for-Service	1902984552	1902984552	1	1	FANG, JUNMING MD	12/20/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65851	22	Pathology (M.D. only)	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
216687	Fee-for-Service	1528075108	1528075108	1	1	FRANKLIN HOSPITAL	4/10/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	900 FRANKLIN AVE	None	VALLEY STREAM	NY	11580	2145	00	None	40.681296	-73.686483	Nassau County
216722	Fee-for-Service	1760619712	1760619712	1	1	FISCHETTI, PETER N LMFT	9/15/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
216728	Fee-for-Service	1780756528	1780756528	1	1	FORGY, ANDREA MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	83161	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	555 CASTRO ST	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
216730	Fee-for-Service	1295845741	1295845741	1	1	FROID, CURTIS M OD	4/1/1984	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1015 MISSION ST	None	SANTA CRUZ	CA	95060	3524	44	06087	36.97080201	-122.036479	Santa Cruz County
216946	Fee-for-Service	1871536078	1871536078	1	1	FLAHERTY, JAMES G MD	1/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	53119	40	Pediatrics	0	In state provider	None	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
217016	Fee-for-Service	1427361096	1427361096	1	1	FUJINAKA, LINDSAY M	1/28/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1526 N EDGEMONT STREET	None	LOS ANGELES	CA	90027	5260	19	06037	34.098921	-118.2961105	Los Angeles County
217019	Fee-for-Service	1689329963	1689329963	1	1	FLORES, ERIKA P AU	3/7/2022	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
217066	Fee-for-Service	1962418483	1962418483	1	1	FLOWERS, MARY A MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	51005	45	Nephrology (Renal-Kidney)	0	In state provider	None	4161 REDONDO BEACH BLVD	STE 301	LAWNDALE	CA	90260	3306	19	06037	33.87608777	-118.3477232	Los Angeles County
217098	Fee-for-Service	1114037447	1114037447	1	1	FRANCIS, PAUL D MD	4/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87138	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
217105	Fee-for-Service	1699180430	1699180430	1	1	FUSHIMI, NAOKO NP	1/25/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
217125	Fee-for-Service	1831389733	1831389733	1	1	FRANCIS, JERMAINE LMFT	12/2/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51070	-	NOT APPLICABLE	0	In state provider	None	12021 S WILMINGTON AVE	LOT C	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
217129	Fee-for-Service	1215185038	1215185038	1	1	FOGELFELD, KEREN MD	5/2/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	108862	41	Internal Medicine	0	In state provider	None	17075 DEVONSHIRE ST	SUITE 205	NORTHRIDGE	CA	91325	1600	19	06037	34.25755945	-118.50471	Los Angeles County
217136	Fee-for-Service	1083611156	1083611156	1	1	FAMILY HEALTHCARE NETWRK	9/1/1991	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
217223	Fee-for-Service	1568812428	1568812428	1	1	FRANKS, JENNIFER M MD	10/13/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	182138	None	None	0	In state provider	None	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	19	06037	34.06348495	-118.28845	Los Angeles County
217233	Fee-for-Service	1871536078	1871536078	1	1	FLAHERTY, JAMES G MD	1/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	53119	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
217246	Fee-for-Service	1841722899	1841722899	1	1	FARSHIDI, FARNOOSH MD	7/23/2021	207R00000X	NA	Other	026	PHYSICIANS	164004	None	None	0	In state provider	None	800 SOUTH MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
217266	Fee-for-Service	1407837586	1407837586	1	1	FLORI, HEIDI R MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	77015	40	Pediatrics	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
217293	Fee-for-Service	1124087309	1124087309	1	1	FRANTZ, VINCENT P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13829	02	General Surgery	0	In state provider	None	1060 VALLEY VIEW DR	None	QUINCY	CA	95971	9510	32	06063	39.94051434	-120.9614275	Plumas County
217309	Fee-for-Service	1063683969	1063683969	1	2	FOORD, DYLAN DO	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	6900 N DURANGO DR	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
217317	Fee-for-Service	1336447531	1336447531	1	1	FAJARDO, MICHELLE B MD	1/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116012	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
217331	Fee-for-Service	1184010654	1184010654	1	1	FIRE DRAGON INVESTMENT, LLC	1/22/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	21515 SOUTH FIGUEROA ST	None	CARSON	CA	90745	1947	19	06037	33.83287522	-118.2861515	Los Angeles County
217335	Fee-for-Service	1942389515	1942389515	1	1	FILLOUX,FRANCIS M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
217355	Fee-for-Service	1962418483	1962418483	1	1	FLOWERS, MARY A MD	2/8/2015	207RN0300X	NA	Nephrology	026	PHYSICIANS	51005	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	4161 REDONDO BEACH BLVD	STE 301	LAWNDALE	CA	90260	3306	19	06037	33.87608777	-118.3477232	Los Angeles County
217404	Fee-for-Service	1386809846	1386809846	1	1	FOLEY, ANN L LCSW	12/11/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
217415	Fee-for-Service	1215185038	1215185038	1	1	FOGELFELD, KEREN MD	5/2/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	108862	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	17075 DEVONSHIRE ST	SUITE 205	NORTHRIDGE	CA	91325	1600	19	06037	34.25755945	-118.50471	Los Angeles County
217425	Fee-for-Service	1083611156	1083611156	1	1	FAMILY HEALTHCARE NETWRK	7/1/1994	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
217469	Fee-for-Service	1912264862	1912264862	1	14	FIRST CHOICE PHYSICIAN PARTN	7/7/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	ARTNERS	200 W COOLIDGE AVE	None	MODESTO	CA	95350	4447	50	06099	37.66550267	-120.9951522	Stanislaus County
217481	Fee-for-Service	1104801463	1104801463	1	1	FAN, PENG THIM MD	2/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	24800	83	Rheumatology	0	In state provider	None	12660 RIVERSIDE DR	STE 200	NORTH HOLLYWOOD	CA	91607	3430	19	06037	34.1575795	-118.409499	Los Angeles County
217496	Fee-for-Service	1346323086	1346323086	1	1	FLAGG, BRADFORD T MD	12/9/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69417	08	Family Practice	0	In state provider	None	4165 BLACKHAWK PLAZA CIR	STE 265	DANVILLE	CA	94506	4691	07	06013	37.79914917	-121.9171295	Contra Costa County
217560	Fee-for-Service	1174845085	1174845085	1	2	FERNANDEZ, LINDA	3/15/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2067 MARTER AVE	None	SIMI VALLEY	CA	93065	2431	56	06111	34.273809	-118.7599975	Ventura County
217641	Fee-for-Service	1497450530	1497450530	1	1	FOCUS ON HEALTH INC	6/27/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
217685	Fee-for-Service	1083699144	1083699144	1	1	FRANK G YANOWITZ MD	12/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 S COTTONWOOD ST	None	MURRAY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
217687	Fee-for-Service	1912537978	1912537978	1	1	FLOR Y SIENDO INDIVIDUAL AND	4/2/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LLNESS	220 INDIAN HILL BLVD	SUITE D	CLAREMONT	CA	91711	4929	19	06037	34.091658	-117.7192535	Los Angeles County
217711	Fee-for-Service	1083611156	1083611156	1	1	FAMILY HEALTHCARE NETWRK	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
217758	Fee-for-Service	1912264862	1912264862	1	14	FIRST CHOICE PHYSICIAN PARTN	7/7/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	ARTNERS	200 W COOLIDGE AVE	None	MODESTO	CA	95350	4447	50	06099	37.66550267	-120.9951522	Stanislaus County
217998	Fee-for-Service	1083611156	1083611156	1	1	FAMILY HEALTHCARE NETWRK	9/1/1991	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
218046	Fee-for-Service	1912264862	1912264862	1	14	FIRST CHOICE PHYSICIAN PARTN	7/7/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ARTNERS	200 W COOLIDGE AVE	None	MODESTO	CA	95350	4447	50	06099	37.66550267	-120.9951522	Stanislaus County
218133	Fee-for-Service	1306875190	1306875190	1	1	FENG, KARL H MD	6/15/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72088	None	None	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
218151	Fee-for-Service	1932312063	1932312063	1	1	FOULKES, RICHARD B MD	10/1/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	85290	None	None	0	In state provider	None	2446 W WHITTIER BLVD	None	MONTEBELLO	CA	90640	3041	19	06037	34.01449625	-118.1287912	Los Angeles County
218172	Fee-for-Service	1619927647	1619927647	1	1	FACULTY PHYSICIANS & SUR	8/5/1996	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	REHABILITATION PSYCHOLOG	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
218246	Fee-for-Service	1184696684	1184696684	1	1	FILLER, SCOTT G MD	6/30/1991	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	53347	41	Internal Medicine	0	In state provider	None	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	19	06037	33.83155851	-118.2920625	Los Angeles County
218266	Fee-for-Service	1164639688	1164639688	1	1	FELLOWS, JOANIE M LMFT	12/5/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1909 CAPITOL AVE	STE 100	SACRAMENTO	CA	95811	4243	34	06067	38.573937	-121.4820675	Sacramento County
218408	Fee-for-Service	1497831564	1497831564	1	1	FULTON, WILLIAM R DO	8/31/2010	208600000X	NA	General Surgery	026	PHYSICIANS	11312	02	General Surgery	0	In state provider	None	1200 PENNSYLVANIA AVE	STE 300-B	FAIRFIELD	CA	94533	3552	48	06095	38.2545748	-122.0497679	Solano County
218440	Fee-for-Service	1033174974	1033174974	1	1	FONG, HON MD	12/1/2003	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	42949	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	461 34TH ST	None	OAKLAND	CA	94609	2815	01	06001	37.82196319	-122.2637023	Alameda County
218457	Fee-for-Service	1831317338	1831317338	1	1	FROEHLICH-SANTINO, WENDY MD	9/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109260	40	Pediatrics	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
218486	Fee-for-Service	1174729958	1174729958	1	1	FAHMY, WAFIKA M MD	1/1/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	97277	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2011 19TH ST	None	BAKERSFIELD	CA	93301	4211	15	06029	35.37622947	-119.025045	Kern County
218517	Fee-for-Service	1083874218	1083874218	1	1	FAGOORA, PARAMJIT S MD INC	4/30/1990	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	5359 N FRESNO ST	STE 101	FRESNO	CA	93710	6831	10	06019	36.815031	-119.7813855	Fresno County
218590	Fee-for-Service	1689158941	1689158941	1	1	FAMILY HEALTHCARE NETWORK	4/11/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2333 S MOONEY BLVD	None	VISALIA	CA	93277	6228	54	06107	36.308682	-119.3154255	Tulare County
218733	Fee-for-Service	1952309494	1952309494	1	1	FALSONE, JOSEPH M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	WAKE HEART & VASCULAR	4325 LAKE BOONE TRL	STE 315	RALEIGH	NC	27607	7510	00	None	35.81505	-78.703101	Wake County
218745	Fee-for-Service	1831317338	1831317338	1	1	FROEHLICH-SANTINO, WENDY MD	9/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109260	36	Psychiatry	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
218770	Fee-for-Service	1922089507	1922089507	1	1	FULBECK, CHARLES L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50143	10	Gastroenterology (M.D. only)	0	In state provider	None	1551 BISHOP ST	STE 420	SAN LUIS OBISPO	CA	93401	4663	40	06079	35.27475609	-120.6454494	San Luis Obispo County
218873	Fee-for-Service	1689158941	1689158941	1	1	FAMILY HEALTHCARE NETWORK	10/29/2019	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	2333 S MOONEY BLVD	None	VISALIA	CA	93277	6228	54	06107	36.308682	-119.3154255	Tulare County
218899	Fee-for-Service	1588020432	1588020432	1	1	FACULTY PHYSICIANS AND	12/2/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	SURGEONS OF LLUSM	28062 BAXTER RD	None	MURRIETA	CA	92563	1401	33	06065	33.61350847	-117.1691225	Riverside County
218946	Fee-for-Service	1992407779	1992407779	1	1	FOUNTAIN VALLEY COMMUNITY	2/1/2024	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE, LLC	11680 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2513	30	06059	33.71618374	-117.9250847	Orange County
219032	Fee-for-Service	1831317338	1831317338	1	1	FROEHLICH-SANTINO, WENDY MD	9/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109260	26	Psychiatry (child)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
219037	Fee-for-Service	1093723637	1093723637	1	1	FRENCH, ROBERT N.E., MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0002	00	None	32.240493	-110.9460825	Pima County
219039	Fee-for-Service	1962401893	1962401893	1	1	FIORE, NICHOLAS F MD PC	2/8/2015	2086S0120X	NA	General Surgery	026	PHYSICIANS	-	85	Surgery-Pediatric	1	Border provider	None	653 N TOWN CENTER DR	STE 507	LAS VEGAS	NV	89144	0519	00	None	36.17975641	-115.3155995	Clark County
219056	Fee-for-Service	1922089507	1922089507	1	1	FULBECK, CHARLES L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50143	41	Internal Medicine	0	In state provider	None	1551 BISHOP ST	STE 420	SAN LUIS OBISPO	CA	93401	4663	40	06079	35.27475609	-120.6454494	San Luis Obispo County
219085	Fee-for-Service	1831194398	1831194398	1	1	FAZIO, DOREEN T MD	7/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	41260	18	Ophthalmology	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
219094	Fee-for-Service	1538212196	1538212196	1	1	FERNANDEZ, NATHANIAL MD	10/26/2022	208600000X	NA	General Surgery	026	PHYSICIANS	165627	None	None	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
219101	Fee-for-Service	1386920270	1386920270	1	1	FORSTER, CLAUDIA R LMFT	6/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	230 S SHEPHERD ST	SUITE E	SONORA	CA	95370	5076	55	06109	37.98264015	-120.3810653	Tuolumne County
219140	Fee-for-Service	1164500211	1164500211	1	1	FARSHIDI, HOOSHANG MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	43521	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	INC	1135 S SUNSET AVE	STE 303	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
219141	Fee-for-Service	1255382545	1255382545	1	2	FOOTHILL CARDIOLOGY MEDICAL	9/10/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	GROUP INC	625 S FAIR OAKS AVE	STE 215	PASADENA	CA	91105	2613	19	06037	34.134894	-118.1504155	Los Angeles County
219162	Fee-for-Service	1689158941	1689158941	1	1	FAMILY HEALTHCARE NETWORK	4/11/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2333 S MOONEY BLVD	None	VISALIA	CA	93277	6228	54	06107	36.308682	-119.3154255	Tulare County
219188	Fee-for-Service	1013913045	1013913045	1	1	FLOWERS, JEREMY R NP	11/14/2011	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2667 CAMINO DEL RIO S	STE 301-3	SAN DIEGO	CA	92108	3707	37	06073	32.76977026	-117.135564	San Diego County
219285	Fee-for-Service	1235698051	1235698051	1	1	FLAVIN, WILLIAM P MD	4/11/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	181510	None	None	0	In state provider	None	100 MED PLAZA	100, 755	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
219288	Fee-for-Service	1831171388	1831171388	1	1	FULTZ, TRAVIS D PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13193 CENTRAL AVE	STE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
219407	Fee-for-Service	1548332299	1548332299	1	1	FISHER, IVY MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37351	40	Pediatrics	0	In state provider	None	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	41	06081	37.66312028	-122.4631592	San Mateo County
219427	Fee-for-Service	1912264862	1912264862	1	21	FIRST CHOICE PHYSICIAN PARTN	1/15/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 103	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
219442	Fee-for-Service	1992000137	1992000137	1	1	FOWLER, BLAKE C MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118594	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
219449	Fee-for-Service	1689158941	1689158941	1	1	FAMILY HEALTHCARE NETWORK	9/9/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	2333 S MOONEY BLVD	None	VISALIA	CA	93277	6228	54	06107	36.308682	-119.3154255	Tulare County
219456	Fee-for-Service	1306874524	1306874524	1	1	FLEMING,JASON MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1319 PUNAHOU STREET	None	HONOLULU	HI	96826	1001	00	None	21.30030321	-157.8342762	Honolulu County
219474	Fee-for-Service	1689218208	1689218208	1	1	FUKUI, KOREY OD	4/13/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1001 TOWER WAY	STE 150	BAKERSFIELD	CA	93309	1586	15	06029	35.36363292	-119.0611362	Kern County
219479	Fee-for-Service	1619271947	1619271947	1	1	FLORES, CARLOS A MD	10/24/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	112638	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 E OLIVE AVE	STE 420	BURBANK	CA	91501	2171	19	06037	34.1845331	-118.3048131	Los Angeles County
219499	Fee-for-Service	1013042266	1013042266	1	1	FAKTOROVICH, ELLA G MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	79065	18	Ophthalmology	0	In state provider	None	ONE DANIEL DURNHAM CT	STE 170 C	SAN FRANCISCO	CA	94109	0000	38	06075	37.78693724	-122.4225429	San Francisco County
219511	Fee-for-Service	1366513269	1366513269	1	1	FLOEGEL, CHRISTINA MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	53629	05	Anesthesiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
219617	Fee-for-Service	1023129665	1023129665	2	1	FARAJIAN, ELHAM ELLE DPM PC	11/21/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	17822 BEACH BLVD	STE 301	HUNTINGTON BEACH	CA	92647	7197	30	06059	33.70331388	-117.9890471	Orange County
219685	Fee-for-Service	1043260334	1043260334	1	1	FACULTY PHYSICIANS AND	10/12/2009	2083X0100X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	SURGEONS OF LLUSM	25455 BARTON RD	STE 106B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
219715	Fee-for-Service	1285130328	1285130328	1	1	FISCHER, DAVID L MD	6/29/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	178695	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
219716	Fee-for-Service	1912264862	1912264862	1	21	FIRST CHOICE PHYSICIAN PARTN	1/15/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 103	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
219731	Fee-for-Service	1083792766	1083792766	1	1	FIELD, DAN MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	57150	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
219904	Fee-for-Service	1750667986	1750667986	2	1	FOUR SEASONS PHARMACY INC	4/15/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7872 WALKER ST	STE 106	LA PALMA	CA	90623	1748	30	06059	33.84787056	-118.0372511	Orange County
219927	Fee-for-Service	1104356039	1104356039	1	1	FRANCIS, MARK L MD	1/7/2022	207R00000X	NA	Other	026	PHYSICIANS	175252	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
219974	Fee-for-Service	1043260334	1043260334	1	1	FACULTY PHYSICIANS AND	10/12/2009	2083X0100X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	SURGEONS OF LLUSM	25455 BARTON RD	STE 106B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
220053	Fee-for-Service	1538247697	1538247697	1	1	FRESHMAN, STEVEN P MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61535	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
220078	Fee-for-Service	1184185142	1184185142	1	1	FIGLEWICZ, MATTHEW R DO	4/26/2023	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
220084	Fee-for-Service	1164842928	1164842928	1	1	FONG, RONALD X MD	11/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	158240	05	Anesthesiology	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
220116	Fee-for-Service	1225014731	1225014731	1	1	FOXMAN, ETHAN B MD	5/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	66612	30	Radiology	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
220120	Fee-for-Service	1639698475	1639698475	1	1	FOUNTAIN VALLEY EMERGENCY PH	4/7/2023	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	YSICIANS, P.C.	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
220127	Fee-for-Service	1033299185	1033299185	1	1	FOX, JOHN C MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68221	66	Emergency Medicine (Urgent Care)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
220144	Fee-for-Service	1275626202	1275626202	1	1	FERDMAN, RONALD MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	64356	40	Pediatrics	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
220145	Fee-for-Service	1194743237	1194743237	1	1	FRANK, LAWRENCE R MD	7/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	28452	None	None	0	In state provider	None	3627 FOURTEEN MILE DR	None	STOCKTON	CA	95219	3804	39	06077	37.99495877	-121.3587408	San Joaquin County
220251	Fee-for-Service	1700493871	1700493871	1	1	FIRPO, DANIEL C LCSW	8/27/2023	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3551 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.6057383	-122.0834562	Alameda County
220258	Fee-for-Service	1043260334	1043260334	1	1	FACULTY PHYSICIANS AND	10/12/2009	2083X0100X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	SURGEONS OF LLUSM	25455 BARTON RD	STE 106B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
220287	Fee-for-Service	1790867174	1790867174	1	1	FEENEY, MARGARET MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64895	40	Pediatrics	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
220346	Fee-for-Service	1528062304	1528062304	1	1	FRANKS,MARY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	504 ELM STREET NE	DEPT 1905	ALBUQUERUE	NM	87102	0000	00	None	35.08789405	-106.6375843	Bernalillo County
220366	Fee-for-Service	1558449579	1558449579	1	1	FEELEY, BRIAN T MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81676	20	Orthopedic Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
220390	Fee-for-Service	1194910422	1194910422	1	1	FOCIL, AUGUSTO E MD APC	8/13/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	FOCILMED INC	300 S A ST	STE 105	OXNARD	CA	93030	5841	56	06111	34.2000746	-119.1785373	Ventura County
220408	Fee-for-Service	1639698475	1639698475	1	1	FOUNTAIN VALLEY EMERGENCY PH	11/7/2017	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	YSICIANS, P.C.	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
220437	Fee-for-Service	1477691152	1477691152	1	1	FEIG, STEVEN A MD	7/1/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	25732	40	Pediatrics	0	In state provider	None	3701 STOCKER ST	STE 204	LOS ANGELES	CA	90008	5144	19	06037	34.00687315	-118.3375934	Los Angeles County
220457	Fee-for-Service	1700896396	1700896396	1	1	FREEDMAN, SHEIRA MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69340	08	Family Practice	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
220495	Fee-for-Service	1366885345	1366885345	1	1	FAHRADYAN, ARTUR MD	7/27/2022	208200000X	NA	General Surgery	026	PHYSICIANS	137921	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
220505	Fee-for-Service	1619112455	1619112455	1	1	FANG, QIN MD	5/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2425 N LAMB BLVD	SUITE 120	LAS VEGAS	NV	89115	5420	00	None	36.203436	-115.0801955	Clark County
220541	Fee-for-Service	1912264862	1912264862	1	17	FIRST CHOICE PHYSICIAN PARTN	4/29/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ARTNERS	2141 COLORADO AVE	None	TURLOCK	CA	95382	2011	50	06099	37.51231802	-120.8353115	Stanislaus County
220570	Fee-for-Service	1588975247	1588975247	1	2	FRESE, MICHAEL PHD	1/6/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
220590	Fee-for-Service	1629270939	1629270939	1	1	FRIEDLANDER, PAIGE M MD	7/31/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	98597	36	Psychiatry	0	In state provider	None	2340 CLAY STREET 7TH FLR	None	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
220595	Fee-for-Service	1467843441	1467843441	1	1	FERGUSON, JOLIE A LPCC	5/21/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
220609	Fee-for-Service	1710964481	1710964481	1	1	FENG, JACK C MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64319	10	Gastroenterology (M.D. only)	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
220630	Fee-for-Service	1114122876	1114122876	1	1	FARSHIDPANAH, SIAVASH MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111488	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
220632	Fee-for-Service	1669153656	1669153656	1	1	FLOWERS, LYNESSA	10/16/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	01	06001	0	0	None
220639	Fee-for-Service	1114155496	1114155496	1	1	FIERRO, MARK A MD	7/18/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	124997	None	None	0	In state provider	None	900 EAST HAMILTON AVE	220	CAMPBELL	CA	95008	0665	43	06085	37.29428651	-121.934403	Santa Clara County
220679	Fee-for-Service	1194910422	1194910422	1	1	FOCIL, AUGUSTO E MD APC	8/13/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	FOCILMED INC	300 S A ST	STE 105	OXNARD	CA	93030	5841	56	06111	34.2000746	-119.1785373	Ventura County
220692	Fee-for-Service	1730861709	1730861709	1	1	FLEECS, COLLIN PT	1/1/2024	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	426 N. IMPERIAL AVE.	None	EL CENTRO	CA	92243	2329	13	06025	32.79599732	-115.5700423	Imperial County
220793	Fee-for-Service	1619112455	1619112455	1	1	FANG, QIN MD	5/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	45	Nephrology (Renal-Kidney)	1	Border provider	None	2425 N LAMB BLVD	SUITE 120	LAS VEGAS	NV	89115	5420	00	None	36.203436	-115.0801955	Clark County
220798	Fee-for-Service	1083957997	1083957997	1	1	FONG, TODD C MD	1/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132563	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
220811	Fee-for-Service	1366401630	1366401630	1	1	FRICK, MATHIS P. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 STADIUM DR	None	MORGANTOWN	WV	26506	7911	00	None	39.65345878	-79.95562791	Monongalia County
220829	Fee-for-Service	1912264862	1912264862	1	17	FIRST CHOICE PHYSICIAN PARTN	4/29/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	ARTNERS	2141 COLORADO AVE	None	TURLOCK	CA	95382	2011	50	06099	37.51231802	-120.8353115	Stanislaus County
220918	Fee-for-Service	1114122876	1114122876	1	1	FARSHIDPANAH, SIAVASH MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111488	01	General Practice	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
220933	Fee-for-Service	1275685497	1275685497	1	1	FREEMAN, WAYNE E DO	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	7068	01	General Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
220942	Fee-for-Service	1437674884	1437674884	1	2	FAYEZIZADEH, MOJTABA MD	5/13/2021	207R00000X	NA	Other	026	PHYSICIANS	166222	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
220979	Fee-for-Service	1215413489	1215413489	1	1	FARAND, MASOUD	8/15/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1075 YORBA PL	SUITE 100	PLACENTIA	CA	92870	3152	30	06059	33.88941645	-117.844866	Orange County
221038	Fee-for-Service	1821082140	1821082140	1	1	FREDERICKSON, WILLARD L	1/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	79707	05	Anesthesiology	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
221045	Fee-for-Service	1871201384	1871201384	1	1	FORD, SHAWNA N CNM	4/15/2023	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
221110	Fee-for-Service	1447549654	1447549654	1	1	FONG, SUSIE X MD	3/3/2018	207R00000X	NA	Other	026	PHYSICIANS	129474	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
221118	Fee-for-Service	1982688685	1982688685	1	1	FRYKMAN, PHILIP K MD	11/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87814	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
221160	Fee-for-Service	1366402471	1366402471	1	1	FASTLE, REBECCA K MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
221161	Fee-for-Service	1952766693	1952766693	1	1	FRESNO POSTACUTE CARE LLC	1/16/2016	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1233 A STREET	None	FRESNO	CA	93706	3202	10	06019	36.72934448	-119.802878	Fresno County
221163	Fee-for-Service	1487930079	1487930079	1	1	FRAWLEY, ERIN M LCSW	6/30/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1200 CLAY ST	None	OAKLAND	CA	94612	1400	01	06001	37.80422981	-122.2742222	Alameda County
221251	Fee-for-Service	1215785589	1215785589	1	1	FASTRACKMED URGENT CARE INC	1/16/2025	193200000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	108 GREEN VALLEY RD	None	FREEDOM	CA	95019	3110	44	06087	36.93669269	-121.7720262	Santa Cruz County
221265	Fee-for-Service	1639163116	1639163116	1	1	FRANKEL, KENNETH A MD	10/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34335	22	Pathology (M.D. only)	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
221324	Fee-for-Service	1073684270	1073684270	1	1	FARRELL, LAWANNA G	5/29/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1176 N CITADEL AVE	None	FRESNO	CA	93611	6768	10	06019	36.85137658	-119.7258853	Fresno
221343	Fee-for-Service	1588809834	1588809834	1	1	FRITSCH, MATTHEW C MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112576	05	Anesthesiology	0	In state provider	None	23625 WR HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
221405	Fee-for-Service	1982688685	1982688685	1	1	FRYKMAN, PHILIP K MD	11/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87814	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
221426	Fee-for-Service	1912264862	1912264862	1	15	FIRST CHOICE PHYSICIAN PARTN	11/14/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	ARTNERS	1801 COLORADO AVE	STE 250	TURLOCK	CA	95382	2710	50	06099	37.50941613	-120.8353105	Stanislaus County
221506	Fee-for-Service	1477819316	1477819316	1	1	FREEMAN, ALLISON C MD	8/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126752	01	General Practice	0	In state provider	None	2210 DEL PASO RD	STE A	SACRAMENTO	CA	95834	9676	34	06067	38.655189	-121.5091575	Sacramento County
221513	Fee-for-Service	1093298879	1093298879	1	1	FAMILY HEALTH CENTERS OF SAN	11/15/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	3420 COLLEGE AVE	None	SAN DIEGO	CA	92115	7134	37	06073	32.74405281	-117.0538025	San Diego County
221539	Fee-for-Service	1215785589	1215785589	1	1	FASTRACKMED URGENT CARE INC	1/16/2025	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	108 GREEN VALLEY RD	None	FREEDOM	CA	95019	3110	44	06087	36.93669269	-121.7720262	Santa Cruz County
221561	Fee-for-Service	1184635104	1184635104	1	1	FOX, DONALD R MD	5/31/1987	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	50389	30	Radiology	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
221612	Fee-for-Service	1073684270	1073684270	1	1	FARRELL, LAWANNA G	5/29/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1176 N CITADEL AVE	None	FRESNO	CA	93611	6768	10	06019	36.85137658	-119.7258853	Fresno
221716	Fee-for-Service	1912264862	1912264862	1	15	FIRST CHOICE PHYSICIAN PARTN	11/14/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ARTNERS	1801 COLORADO AVE	STE 250	TURLOCK	CA	95382	2710	50	06099	37.50941613	-120.8353105	Stanislaus County
221769	Fee-for-Service	1497845325	1497845325	1	1	FOSTER, LORI JO	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	197 W TEFFT ST	None	NIPOMO	CA	93444	9281	40	06079	35.04121123	-120.4782213	San Luis Obispo County
221801	Fee-for-Service	1093298879	1093298879	1	1	FAMILY HEALTH CENTERS OF SAN	11/15/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DIEGO INC	3420 COLLEGE AVE	None	SAN DIEGO	CA	92115	7134	37	06073	32.74405281	-117.0538025	San Diego County
221876	Fee-for-Service	1457557910	1457557910	1	1	FRECHETTE, ERIC S MD	3/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117118	13	Neurology (M.D. only)	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
221945	Fee-for-Service	1487761235	1487761235	1	1	FONG, SUSAN K MD	9/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96871	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	350 30TH ST	STE 205	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
221966	Fee-for-Service	1548243884	1548243884	1	1	FREEMAN, ROBERT B MD	4/7/2022	208600000X	NA	General Surgery	026	PHYSICIANS	139284	None	None	0	In state provider	None	3800 JANES ROAD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
222001	Fee-for-Service	1912264862	1912264862	1	15	FIRST CHOICE PHYSICIAN PARTN	11/14/2017	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ARTNERS	1801 COLORADO AVE	STE 250	TURLOCK	CA	95382	2710	50	06099	37.50941613	-120.8353105	Stanislaus County
222003	Fee-for-Service	1073747119	1073747119	1	2	FREED, JOANNE E LMFT	12/19/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14724 VENTURA BOULEVARD	SUITE 1100	SHERMAN OAKS	CA	91403	3511	19	06037	34.15179235	-118.4541787	Los Angeles County
222045	Fee-for-Service	1730612581	1730612581	1	1	FERNANDES, NIKITA MD	11/15/2023	207R00000X	NA	Other	026	PHYSICIANS	165889	None	None	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
222082	Fee-for-Service	1790882728	1790882728	1	1	FITZGERALD, PATRICK J MD	2/8/2015	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	80210	84	Surgery-Head and Neck	0	In state provider	None	15644 POMERADO RD	STE DM	POWAY	CA	92064	2400	37	06073	32.99717879	-117.0579379	San Diego County
222087	Fee-for-Service	1649356296	1649356296	1	1	FRANK, JACQUELINE M CRNA	11/16/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
222156	Fee-for-Service	1912166737	1912166737	1	1	FAKSH, ARIJ DO	1/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14222	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
222165	Fee-for-Service	1295703023	1295703023	1	1	FONG, JENNIFER L OD	10/17/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1325 FLORIN RD	None	SACRAMENTO	CA	95831	3618	34	06067	38.496519	-121.508856	Sacramento County
222166	Fee-for-Service	1366472912	1366472912	1	1	FINCH, IRA J MD	4/30/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	42775	30	Radiology	0	In state provider	None	2577 SAMARITAN DR	STE 715	SAN JOSE	CA	95124	4103	43	06085	37.25246494	-121.9501879	Santa Clara County
222208	Fee-for-Service	1144357781	1144357781	1	1	FREEMAN, DEBRA A LMFT	7/17/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3020 OLD RANCH PKWY	300	SEAL BEACH	CA	90740	2765	30	06059	33.77604914	-118.0763313	Orange County
222226	Fee-for-Service	1013233212	1013233212	1	1	FLORIOLLI, DAVID R MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110728	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
222328	Fee-for-Service	1548958127	1548958127	1	1	FERRANTE, REBEKAH N CCC-SLP	5/4/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3687 MT DIABLO	SUITE 100	LAFAYETTE	CA	94549	3717	07	06013	37.8898926	-122.1304235	Contra Costa County
222345	Fee-for-Service	1891472494	1891472494	1	1	FACULTY PHYSICIANS AND SURGE	2/26/2024	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	1782 W PARK AVE	116	REDLANDS	CA	92373	3115	36	06071	34.05928849	-117.2143884	San Bernardino County
222406	Fee-for-Service	1629271143	1629271143	2	1	FELDMANN, SARAH C DO	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14100	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1555 SOQUEL DRIVE	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
222444	Fee-for-Service	1912166737	1912166737	1	1	FAKSH, ARIJ DO	1/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14222	01	General Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
222448	Fee-for-Service	1629129713	1629129713	1	1	FADDEN, JAN S LAC	10/26/2007	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	133 E HALEY ST	None	SANTA BARBARA	CA	93102	2330	42	06083	34.41883725	-119.6933889	Santa Barbara County
222613	Fee-for-Service	1093340366	1093340366	1	1	FLORA, ERIN R CNP	6/20/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14735 VENTURA BLVD	None	SHERMAN OAKS	CA	91403	3679	19	06037	34.15187275	-118.4543653	Los Angeles County
222633	Fee-for-Service	1861946568	1861946568	1	1	FLETCHER, AMANDA MSW LCSW	11/15/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	162 VIA MISSION DR	None	CHICO	CA	95928	4301	04	06007	39.7310612	-121.7858372	Butte County
222710	Fee-for-Service	1295093375	1295093375	1	1	FRANKE, RYAN G MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154372	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
222732	Fee-for-Service	1164093787	1164093787	1	1	FABULAE, JANEEN D LMFT	7/21/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	111 SMITH RANCH ROAD	None	SAN RAFAEL	CA	94903	1939	21	06041	38.01951576	-122.5315893	Marin County
222740	Fee-for-Service	1114129954	1114129954	1	1	FAN, JOHN C MD	2/8/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	96808	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
222895	Fee-for-Service	1932432929	1932432929	1	1	FRANK R. LUSHER, M.D., INC.	1/28/2019	174400000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	R CENTER	15336 DEVONSHIRE AVE.	SUITE 1	MISSION HILLS	CA	91345	2766	19	06037	34.25726849	-118.4664285	Los Angeles County
222927	Fee-for-Service	1003045485	1003045485	1	1	FONSECA, LIZETH C LMFT	4/26/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
222943	Fee-for-Service	1316390842	1316390842	1	1	FALLETTA, MILISSA M	8/1/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
223044	Fee-for-Service	1790154862	1790154862	1	1	FAMILY HEALTHCARE NETWORK	4/19/2017	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	4177 AVENUE 368	None	TRAVER	CA	93673	0000	54	06107	36.45902619	-119.480968	Tulare County
223124	Fee-for-Service	1720442601	1720442601	1	1	FRIMPONG-BOATENG, KRISTEN B	9/27/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157734	08	Family Practice	0	In state provider	MD	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
223296	Fee-for-Service	1477615623	1477615623	1	1	FIDEL, CONSTANCE M	1/30/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5720 STONERIDGE MALL RD	SUITE 390	PLEASANTON	CA	94588	2831	01	06001	37.69247085	-121.9301884	Alameda County
223321	Fee-for-Service	1033192133	1033192133	1	1	FLEMING, JOHN C OD	2/1/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9710 WINTER GARDENS BLVD	STE A	LAKESIDE	CA	92040	3866	37	06073	32.853978	-116.9311485	San Diego County
223331	Fee-for-Service	1790154862	1790154862	1	1	FAMILY HEALTHCARE NETWORK	1/22/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	4177 AVENUE 368	None	TRAVER	CA	93673	0000	54	06107	36.45902619	-119.480968	Tulare County
223413	Fee-for-Service	1598721003	1598721003	1	1	FRANCISCO, MARIE P MD	12/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91644	08	Family Practice	0	In state provider	None	800 DOUGLAS RD	None	STOCKTON	CA	95207	3607	39	06077	38.00786919	-121.3210892	San Joaquin County
223431	Fee-for-Service	1912264862	1912264862	1	10	FIRST CHOICE PHYSICIAN PARTN	3/16/2023	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1541 FLORIDA AVE	STE 103	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
223484	Fee-for-Service	1396483384	1396483384	1	1	FOUNDATION OF HOPE INC	5/23/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	250 NORTH M STREET	None	TULARE	CA	93274	4139	54	06107	36.21066008	-119.3439384	Tulare County
223503	Fee-for-Service	1306377080	1306377080	1	1	FAMILY SOLUTIONS COUNSELING	10/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	8050 FLORENCE AVE	32	DOWNEY	CA	90241	9993	19	06037	33.95259338	-118.1281629	Los Angeles County
223504	Fee-for-Service	1255718763	1255718763	1	1	FRENCH, JUDITH A CA	6/8/2018	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	24541 PACIFIC PARK	STE 205	ALISO VIEJO	CA	92656	3050	30	06059	33.57211592	-117.7018027	Orange County
223509	Fee-for-Service	1427181999	1427181999	2	1	FLORIDA AVENUE PRESCRIPTIONS	12/30/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1541 FLORIDA AVE	STE. P	MODESTO	CA	95350	4429	50	06099	37.666863	-120.9962775	Stanislaus County
223536	Fee-for-Service	1083707608	1083707608	1	1	FIROUZI, SINA MD	1/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89169	08	Family Practice	0	In state provider	None	1514 VALLEY VISTA DR	None	DIAMOND BAR	CA	91765	3929	19	06037	33.99491668	-117.8399137	Los Angeles County
223542	Fee-for-Service	1588689236	1588689236	1	1	FAGAN E R MEDICAL GROUP	2/28/1990	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
223576	Fee-for-Service	1205397916	1205397916	1	1	FIERRO, KYLE C MD	1/18/2023	207P00000X	NA	Other	026	PHYSICIANS	180390	None	None	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
223614	Fee-for-Service	1295169191	1295169191	1	1	F&T 900 INC	10/23/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1799 OLD BAYSHORE HWY	SUITE 128 D	BURLINGAME	CA	94010	1316	41	06081	37.60247143	-122.3720389	San Mateo County
223622	Fee-for-Service	1790154862	1790154862	1	1	FAMILY HEALTHCARE NETWORK	1/22/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	4177 AVENUE 368	None	TRAVER	CA	93673	0000	54	06107	36.45902619	-119.480968	Tulare County
223660	Fee-for-Service	1598549180	1598549180	1	1	FIRSTCARE SOLUTIONS INC.	10/3/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5410 STOCKDALE HWY	B	BAKERSFIELD	CA	93309	2502	15	06029	35.35431852	-119.0615535	Kern County
223714	Fee-for-Service	1891724886	1891724886	1	1	FARO T OWIESY MD INC	10/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	87796	None	None	0	In state provider	S	1820 FULLERTON AVE	120	CORONA	CA	92881	3100	33	06065	33.858756	-117.5503465	Riverside County
223718	Fee-for-Service	1912264862	1912264862	1	13	FIRST CHOICE PHYSICIAN PARTN	3/16/2023	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PARTNERS	4101 TULLY RD	STE 102	MODESTO	CA	95356	8981	50	06099	37.69867589	-121.0127412	Stanislaus County
223779	Fee-for-Service	1336530526	1336530526	1	1	FIRST TO SERVE, INC	8/26/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	8615 & 8617 W CRENSHAW	SUITES A & B	INGLEWOOD	CA	90304	0000	19	06037	33.95925303	-118.3265611	Los Angeles County
223854	Fee-for-Service	1790051423	1790051423	1	2	FAMILY HEALTH CARE CENTERS O	3/19/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	22310 WARDHAM AVE	None	HAWAIIAN GARDENS	CA	90716	1740	19	06037	33.82667708	-118.0650149	Los Angeles County
223897	Fee-for-Service	1255512729	1255512729	1	1	FRANK, STEWART L MD INC	8/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	4060 4TH AVE	STE 605	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
223963	Fee-for-Service	1477990612	1477990612	1	1	FORAN, CHRISTOPHER P MD	11/27/2017	390200000X	NA	Other	026	PHYSICIANS	133153	02	General Surgery	0	In state provider	None	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
224010	Fee-for-Service	1912264862	1912264862	1	13	FIRST CHOICE PHYSICIAN PARTN	2/21/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PARTNERS	4101 TULLY RD	STE 102	MODESTO	CA	95356	8981	50	06099	37.69867589	-121.0127412	Stanislaus County
224026	Fee-for-Service	1619084605	1619084605	1	1	FERNANDEZ, MIGUEL C MD	10/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	57875	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
224045	Fee-for-Service	1609353465	1609353465	1	1	FEJLEH, ASHLEY N DO	7/14/2020	207L00000X	NA	Other	026	PHYSICIANS	16340	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
224093	Fee-for-Service	1730502725	1730502725	1	1	FAMILY HEALTHCARE NETWORK	6/26/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
224102	Fee-for-Service	1992867360	1992867360	1	1	FRIEDMAN, LEE MD	12/19/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	144319	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
224143	Fee-for-Service	1790051423	1790051423	1	2	FAMILY HEALTH CARE CENTERS O	8/30/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	22310 WARDHAM AVE	None	HAWAIIAN GARDENS	CA	90716	1740	19	06037	33.82667708	-118.0650149	Los Angeles County
224185	Fee-for-Service	1255512729	1255512729	1	1	FRANK, STEWART L MD INC	8/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	4060 4TH AVE	STE 605	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
224197	Fee-for-Service	1801090956	1801090956	1	1	FLYNN, BRIAN A MFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
224241	Fee-for-Service	1093751950	1093751950	1	1	FORTUNE PHARMACY INC	12/22/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 S GARFIELD AVE	STE 104	ALHAMBRA	CA	91801	3893	19	06037	34.09137167	-118.1241735	Los Angeles County
224282	Fee-for-Service	1629431044	1629431044	1	1	FOSS, CHRISTOPHER R MD	1/30/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	155463	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
224295	Fee-for-Service	1912264862	1912264862	1	10	FIRST CHOICE PHYSICIAN PARTN	8/18/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1541 FLORIDA AVE	STE 103	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
224299	Fee-for-Service	1225365521	1225365521	1	1	FERREN, SUSAN R LMFT	8/27/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
224379	Fee-for-Service	1730502725	1730502725	1	1	FAMILY HEALTHCARE NETWORK	12/16/2014	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
224393	Fee-for-Service	1639115652	1639115652	1	1	FEIGENBAUM, BERNARD A MD	7/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69281	03	Allergy	0	In state provider	None	4077 5TH AVENUE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
224400	Fee-for-Service	1336538404	1336538404	1	1	FRESENIUS MEDICAL CARE	2/1/2015	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	NORTHCOAST LLC	950 HACIENDA DR	None	VISTA	CA	92081	6499	37	06073	33.19338467	-117.2621908	San Diego County
224430	Fee-for-Service	1790051423	1790051423	1	2	FAMILY HEALTH CARE CENTERS O	3/19/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	22310 WARDHAM AVE	None	HAWAIIAN GARDENS	CA	90716	1740	19	06037	33.82667708	-118.0650149	Los Angeles County
224432	Fee-for-Service	1962120097	1962120097	1	1	FIRST RIDE NON MEDICAL TRANS	12/19/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	PORTATION LLC	13800 HEACOCK ST	C230-F	MORENO VALLEY	CA	92553	6263	33	06065	33.91968997	-117.2437139	Riverside County
224524	Fee-for-Service	1710464706	1710464706	1	1	FEREIDOONI, ROYA PT	5/18/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
224584	Fee-for-Service	1912264862	1912264862	1	10	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	None	1541 FLORIDA AVE	STE 103	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
224641	Fee-for-Service	1679696678	1679696678	1	1	FURUICHI, SHERYL A	6/28/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2040 PACIFIC COAST HWY	None	LOMITA	CA	90717	2660	19	06037	33.78948351	-118.316493	Los Angeles County
224669	Fee-for-Service	1730502725	1730502725	1	1	FAMILY HEALTHCARE NETWORK	6/26/2014	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
224673	Fee-for-Service	1891885604	1891885604	1	1	FONTANA UNIF SCHOOL DIST	11/1/2018	No Taxonomy Provided	NA	None	101	UNIFIED SCHOOL DISTRICT	-	-	NOT APPLICABLE	0	In state provider	None	9680 CITRUS AVE	None	FONTANA	CA	92335	5571	36	06071	34.07795008	-117.4537765	San Bernardino County
224717	Fee-for-Service	1790051423	1790051423	1	2	FAMILY HEALTH CARE CENTERS O	3/19/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	22310 WARDHAM AVE	None	HAWAIIAN GARDENS	CA	90716	1740	19	06037	33.82667708	-118.0650149	Los Angeles County
224737	Fee-for-Service	1699777334	1699777334	1	1	FISHER, JOHN H M MD	3/12/1996	207RN0300X	NA	Nephrology	026	PHYSICIANS	41776	45	Nephrology (Renal-Kidney)	0	In state provider	None	1007 W AVENUE M14	STE B1	PALMDALE	CA	93551	1443	19	06037	34.63305153	-118.148193	Los Angeles County
224745	Fee-for-Service	1003987587	1003987587	1	1	FLANIGAN, KEVIN S MD	6/1/2021	207R00000X	NA	Other	026	PHYSICIANS	156347	None	None	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
224783	Fee-for-Service	1720106693	1720106693	1	1	FENG, MARY U MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143118	78	Neoplastic Diseases/Oncology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
224786	Fee-for-Service	1457745242	1457745242	1	1	FINNIN, DANIEL J MD	3/2/2023	207P00000X	NA	Other	026	PHYSICIANS	180204	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
224788	Fee-for-Service	1902922131	1902922131	1	1	FOSTER, JOHN E OD	3/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6640 ALTON PARKWAY	None	IRVINE	CA	92618	3734	30	06059	33.65911992	-117.7737909	Orange County
224808	Fee-for-Service	1558938431	1558938431	1	1	FLAGSHIP POST ACUTE LLC	8/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	466 FLAGSHIP RD	None	NEWPORT BEACH	CA	92663	3635	30	06059	33.62834163	-117.9286241	Orange County
224875	Fee-for-Service	1912264862	1912264862	1	13	FIRST CHOICE PHYSICIAN PARTN	2/21/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	PARTNERS	4101 TULLY RD	STE 102	MODESTO	CA	95356	8981	50	06099	37.69867589	-121.0127412	Stanislaus County
224917	Fee-for-Service	1932227659	1932227659	1	1	FRIEDMAN, CARY G LAC	9/27/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	545 OCEAN VIEW AVE	None	SANTA CRUZ	CA	95062	3363	44	06087	36.97603287	-122.0166335	Santa Cruz County
224947	Fee-for-Service	1295817880	1295817880	1	1	FOSSACECA, CHRISTOPHER R MD	10/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113247	05	Anesthesiology	0	In state provider	None	5176 HILL RD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
224959	Fee-for-Service	1730502725	1730502725	1	1	FAMILY HEALTHCARE NETWORK	6/26/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	54	06107	36.332757	-119.288682	Tulare County
224961	Fee-for-Service	1891885604	1891885604	1	1	FONTANA UNIF SCHOOL DIST	3/21/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	9680 CITRUS AVE	None	FONTANA	CA	92335	5571	36	06071	34.07795008	-117.4537765	San Bernardino County
224973	Fee-for-Service	1912365941	1912365941	1	1	FELICITY HOSPICE SERVICES	3/15/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	303 N GLENOAKS BLVD	STE 200	BURBANK	CA	91502	1118	19	06037	34.18486122	-118.308553	Los Angeles County
224980	Fee-for-Service	1487369310	1487369310	1	1	FUSTIN, AMY CCC-SLP	10/31/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5971 VENICE BLVD	None	LOS ANGELES	CA	90034	1713	19	06037	34.03833368	-118.3726622	Los Angeles County
225024	Fee-for-Service	1699777334	1699777334	1	1	FISHER, JOHN H M MD	3/12/1996	207RN0300X	NA	Nephrology	026	PHYSICIANS	41776	41	Internal Medicine	0	In state provider	None	1007 W AVENUE M14	STE B1	PALMDALE	CA	93551	1443	19	06037	34.63305153	-118.148193	Los Angeles County
225067	Fee-for-Service	1013201789	1013201789	1	1	FAROL, HANAKO Y DO	10/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11574	30	Radiology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
225135	Fee-for-Service	1982025292	1982025292	1	1	FELICITY PEDIATRICS APC	10/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102549	40	Pediatrics	0	In state provider	None	2400 BALFOUR RD	SUITE 302	BRENTWOOD	CA	94513	4955	07	06013	37.92519383	-121.734461	Contra Costa County
225152	Fee-for-Service	1164533329	1164533329	1	1	FRANKLIN, ROBERT C MD	8/18/2014	2084A0401X	NA	Psychiatry	026	PHYSICIANS	44663	36	Psychiatry	0	In state provider	None	1287 FULTON RD	None	SANTA ROSA	CA	95401	4923	49	06097	38.45043	-122.7715245	Sonoma County
225190	Fee-for-Service	1225132814	1225132814	1	1	FISHER, MARK MD	3/3/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34527	13	Neurology (M.D. only)	0	In state provider	None	2025 ZONAL AVE	None	LOS ANGELES	CA	90089	0264	19	06037	34.05998665	-118.2058023	Los Angeles County
225217	Fee-for-Service	1154766491	1154766491	1	1	FEINBERG, NICOLE N MD	10/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134268	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
225237	Fee-for-Service	1225021835	1225021835	1	1	FRIEND, JAMIE M PT	12/28/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
225245	Fee-for-Service	1851093066	1851093066	1	1	FED MED INC	6/4/2023	347C00000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	8350 MARTINELLI RD	A	FORESTVILLE	CA	95436	9713	49	06097	38.484585	-122.916294	Sonoma County
225249	Fee-for-Service	1891885604	1891885604	1	1	FONTANA UNIF SCHOOL DIST	4/1/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9680 CITRUS AVE	None	FONTANA	CA	92335	5571	36	06071	34.07795008	-117.4537765	San Bernardino County
225260	Fee-for-Service	1891565610	1891565610	1	1	FAMOS THERAPIES	8/29/2024	103K00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	815 THIRD AVE	SUITE 311	CHULA VISTA	CA	91911	1310	37	06073	32.62337313	-117.072841	San Diego County
225262	Fee-for-Service	1912365941	1912365941	1	1	FELICITY HOSPICE SERVICES	3/15/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	303 N GLENOAKS BLVD	STE 200	BURBANK	CA	91502	1118	19	06037	34.18486122	-118.308553	Los Angeles County
225268	Fee-for-Service	1598092330	1598092330	1	1	FARNAM, KEVIN S MD	6/28/2010	207K00000X	NA	Other	026	PHYSICIANS	110001	None	None	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
225303	Fee-for-Service	1033229836	1033229836	1	1	FARAHDEL, BEHNAM MD	11/14/2007	2084N0400X	NA	Neurology	026	PHYSICIANS	76764	13	Neurology (M.D. only)	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
225311	Fee-for-Service	1699777334	1699777334	1	1	FISHER, JOHN H M MD	3/12/1996	207RN0300X	NA	Nephrology	026	PHYSICIANS	41776	01	General Practice	0	In state provider	None	1007 W AVENUE M14	STE B1	PALMDALE	CA	93551	1443	19	06037	34.63305153	-118.148193	Los Angeles County
225388	Fee-for-Service	1700802998	1700802998	1	1	FALLAHTAFTI, MAHDIEH DO	12/7/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6766	41	Internal Medicine	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
225436	Fee-for-Service	1447439682	1447439682	1	1	FARAHANI, HOMAYOUN C	6/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	0837	00	None	39.52483792	-119.7968314	Washoe County
225587	Fee-for-Service	1205867660	1205867660	1	1	FLYNN, THOMAS A OD	7/11/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	715 JACKSON ST	None	RED BLUFF	CA	96080	3757	52	06103	40.17524703	-122.2405638	Tehama County
225594	Fee-for-Service	1760701544	1760701544	1	1	FATZLER, JENNIFER LMFT	1/18/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
225664	Fee-for-Service	1528213261	1528213261	1	1	FRESENIUS MED CARE DIABLO	12/1/2008	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	NEPHROLOGY CLINICS, LLC	2386 BUCHANAN RD	None	ANTIOCH	CA	94509	4411	07	06013	37.99845936	-121.8410042	Contra Costa County
225707	Fee-for-Service	1164517744	1164517744	1	2	FAMILY HEALTHCARE NETWORK	11/14/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	2210 E ILLINOIS AVE	None	FRESNO	CA	93701	2125	10	06019	36.74500687	-119.7846885	Fresno County
225778	Fee-for-Service	1669685715	1669685715	1	1	FARID, HAMED MD	2/10/2016	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	89976	30	Radiology	0	In state provider	None	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	30	06059	33.89356031	-117.9271656	Orange County
225827	Fee-for-Service	1164517744	1164517744	1	5	FAMILY HEALTHCARE NETWORK	7/27/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1062 S K STREET	None	TULARE	CA	93274	6422	54	06107	36.19548226	-119.3433058	Tulare County
225903	Fee-for-Service	1982708558	1982708558	1	1	FRIEDMAN, RICK A MD	11/27/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67571	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
225938	Fee-for-Service	1245307099	1245307099	1	1	FERRERI, MICHAEL V OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1717 E DATE PL	None	SAN BERNARDINO	CA	92404	4428	36	06071	34.14094893	-117.2500411	San Bernardino County
225992	Fee-for-Service	1003942830	1003942830	1	1	FITZGERALD, PETER J MD	6/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	66476	01	General Practice	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
225993	Fee-for-Service	1164517744	1164517744	1	2	FAMILY HEALTHCARE NETWORK	11/14/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	2210 E ILLINOIS AVE	None	FRESNO	CA	93701	2125	10	06019	36.74500687	-119.7846885	Fresno County
226100	Fee-for-Service	1801859145	1801859145	1	1	FOGG, MAXELL & LANIER,	2/1/1998	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	MD INC.	40232 JUNCTION DR	None	OAKHURST	CA	93644	8719	20	06039	37.3331485	-119.6588089	Madera County
226112	Fee-for-Service	1619981073	1619981073	1	1	FESTEKJIAN, JACO H MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	53799	24	Plastic Surgery	0	In state provider	None	200 MEDICAL PLAZA	STE 465	LOS ANGELES	CA	90095	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
226114	Fee-for-Service	1700322609	1700322609	1	1	FLORES, YVETTE M LMFT	8/26/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
226118	Fee-for-Service	1164517744	1164517744	1	5	FAMILY HEALTHCARE NETWORK	7/27/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1062 S K STREET	None	TULARE	CA	93274	6422	54	06107	36.19548226	-119.3433058	Tulare County
226175	Fee-for-Service	1700890043	1700890043	1	1	FRESNO MEDICAL	5/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CENTER, INC.	6069 N 1ST ST	STE 103	FRESNO	CA	93710	5467	10	06019	36.824463	-119.7723855	Fresno County
226198	Fee-for-Service	1316599640	1316599640	1	1	FACULTY PHYSICIANS AND SURGE	11/21/2019	204F00000X	NA	General Surgery	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ONS OF LLUSM	1801 N BROADWAY	None	SANTA ANA	CA	92706	2607	30	06059	33.76119885	-117.8695937	Orange County
226247	Fee-for-Service	1942381223	1942381223	1	1	FORTSON, WILBERT JR MD	5/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74703	None	None	0	In state provider	None	101 CITY DRIVE S	None	ORANGE	CA	92868	0000	30	06059	33.78674051	-117.8888713	Orange County
226249	Fee-for-Service	1144745084	1144745084	1	1	FOREST OF HOPE	2/11/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	540 N GOLDEN CIRCLE DR	SUITE 312	ORANGE	CA	92705	3926	30	06059	33.74924495	-117.8386722	Orange
226265	Fee-for-Service	1740608835	1740608835	1	1	FANG, STANLEY Y MD	12/19/2018	207R00000X	NA	Other	026	PHYSICIANS	140181	41	Internal Medicine	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
226282	Fee-for-Service	1164517744	1164517744	1	2	FAMILY HEALTHCARE NETWORK	5/7/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	2210 E ILLINOIS AVE	None	FRESNO	CA	93701	2125	10	06019	36.74500687	-119.7846885	Fresno County
226297	Fee-for-Service	1386916112	1386916112	1	1	FORTSON, MARY LCSW	3/7/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
226306	Fee-for-Service	1245336809	1245336809	1	1	FONG, DENNIS Y MD A	3/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	83720	None	None	0	In state provider	PROFESSIONAL	108 LA CASA VIA	STE 104	WALNUT CREEK	CA	94598	3013	07	06013	37.9124899	-122.0426939	Contra Costa County
226310	Fee-for-Service	1700998804	1700998804	1	1	FAJARDO, BLANCA S MD	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87234	None	None	0	In state provider	None	655 S MAIN ST	None	LOS ANGELES	CA	90014	2003	19	06037	34.0441643	-118.2511469	Los Angeles County
226367	Fee-for-Service	1811075641	1811075641	1	1	FARAG, GIHAN S MD	7/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66753	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
226381	Fee-for-Service	1124192620	1124192620	1	1	FOULADIAN, BEHNAM B OD	2/1/1993	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	EYE ON REDONDO OPTOMETRY	403 N PACIFIC COAST HWY	STE 108	REDONDO BEACH	CA	90277	2863	19	06037	33.84752126	-118.3880903	Los Angeles County
226392	Fee-for-Service	1639123581	1639123581	1	1	FENNELL, ROGER G MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	87648	05	Anesthesiology	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
226435	Fee-for-Service	1598022964	1598022964	1	1	FAN, GAVIN G MD	7/26/2022	207L00000X	NA	Other	026	PHYSICIANS	145829	None	None	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
226474	Fee-for-Service	1528103843	1528103843	1	1	FREDDERICKSEN, KIM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
226561	Fee-for-Service	1073536736	1073536736	1	1	FERNANDO,PENA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4242 MEDICAL DRIVE	STE 3100	SAN ANTONIO	TX	78229	0000	00	None	29.51345208	-98.56843947	Bexar County
226581	Fee-for-Service	1639676620	1639676620	1	1	FINDAKLY, DAWOOD B MD	8/15/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	183487	68	Hematology	0	In state provider	None	16918 DOVE CANYON RD	SUITE 103	SAN DIEGO	CA	92127	3455	37	06073	33.01707634	-117.1112373	San Diego County
226681	Fee-for-Service	1932552361	1932552361	1	1	FATAYERJI, AAYAH N DO	10/1/2020	208M00000X	NA	Other	026	PHYSICIANS	16979	None	None	0	In state provider	None	2185 CITRACADO PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
226689	Fee-for-Service	1528176989	1528176989	1	1	FERGUSON, MONICA O MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137803	41	Internal Medicine	0	In state provider	None	500 DOYLE PARK DR	SUITE 303	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
226694	Fee-for-Service	1376965186	1376965186	1	1	FIUMARA, MARY C LCSW	8/28/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2240 MERCURY WAY	None	SANTA ROSA	CA	95407	5413	49	06097	38.421135	-122.752008	Sonoma County
226864	Fee-for-Service	1730146903	1730146903	1	1	FIELDS, DARLENE M CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
226977	Fee-for-Service	1336210061	1336210061	1	1	FLETCHER, VANCE	8/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186960	08	Family Practice	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
227150	Fee-for-Service	1457380537	1457380537	1	1	FUNG, RANDOLPH MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81220	05	Anesthesiology	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
227182	Fee-for-Service	1972737716	1972737716	1	1	FIGUEROA, KIRSTIE L LCSW	9/11/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
227213	Fee-for-Service	1689780298	1689780298	1	1	FISH, LYNN A MSW	7/1/2004	1041C0700X	NA	Mental Health Outpatient Services	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	5900 CANTERBURY DR	APT L124	CULVER CITY	CA	90230	6714	19	06037	33.9861384	-118.3812213	Los Angeles County
227255	Fee-for-Service	1265755417	1265755417	1	1	FERNANDEZ, ROBERT A MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108328	None	None	0	In state provider	None	909 BLANCO CIRCLE	None	SALINAS	CA	93901	4401	27	06053	36.65354107	-121.6381985	Monterey County
227305	Fee-for-Service	1922083955	1922083955	1	1	FERRIS, SARAH MD	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93274	41	Internal Medicine	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
227359	Fee-for-Service	1487857488	1487857488	1	1	FOSTER, JOHN C MD	9/17/2021	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	66088	None	None	0	In state provider	None	1313 W 8TH ST	STE 100	LOS ANGELES	CA	90017	4420	19	06037	34.05048998	-118.269586	Los Angeles County
227427	Fee-for-Service	1295791648	1295791648	1	1	FOSTER, ROBERT D MD	7/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81405	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
227476	Fee-for-Service	1194750844	1194750844	1	1	FREESE, DENISE A MD MPH	6/1/1995	207R00000X	NA	Other	026	PHYSICIANS	77966	None	None	0	In state provider	None	2428 SANTA MONICA BLVD	STE 404	SANTA MONICA	CA	90404	2047	19	06037	34.0317559	-118.4762013	Los Angeles County
227500	Fee-for-Service	1093898744	1093898744	1	1	FARAMAZYAN, ALINA Y MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81273	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
227556	Fee-for-Service	1912072042	1912072042	1	1	FONG, RITA L OD	11/16/2007	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	3486	43	06085	37.36797679	-122.0297112	Santa Clara County
227694	Fee-for-Service	1417560194	1417560194	1	1	FULLER, VANESSA R NP	10/4/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
227709	Fee-for-Service	1568113827	1568113827	1	1	FACULTY PHYSICIANS AND SURGE	2/2/2022	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	ONS OF LLUSM	8599 HAVEN AVE	STE 102 & 210	RANCHO CUCAMONGA	CA	91730	4849	36	06071	34.097364	-117.575693	San Bernardino County
227738	Fee-for-Service	1144280660	1144280660	2	1	FREMONT NEUROLOGY MEDICAL AS	12/19/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	None	722 MOWRY AVE	None	FREMONT	CA	94536	4115	01	06001	37.56635225	-121.9749284	Alameda County
227783	Fee-for-Service	1134652357	1134652357	1	1	FERNANDEZ, JOHN D MD	12/1/2020	207R00000X	NA	Other	026	PHYSICIANS	169890	None	None	0	In state provider	None	9675 BRIGHTON WAY	SUITE 100	BEVERLY HILLS	CA	90210	5132	19	06037	34.06763711	-118.4052901	Los Angeles County
227850	Fee-for-Service	1801206750	1801206750	1	1	FAN, KENNETH DO	3/30/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	18095	None	None	0	In state provider	None	8077 FLORENCE AVE	STE 112	DOWNEY	CA	90240	3894	19	06037	33.95245028	-118.1277345	Los Angeles County
227863	Fee-for-Service	1750323416	1750323416	1	1	FORSETH, JAMES R. MD	6/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3330 N 2ND STREET	#300	PHOENIX	AZ	85012	2369	00	None	33.486606	-112.071654	Maricopa County
227879	Fee-for-Service	1912934779	1912934779	1	1	FREY, ROB MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85317	05	Anesthesiology	0	In state provider	None	261 MOBIL AVE	None	CAMARILLO	CA	93010	6337	56	06111	34.219026	-119.0430075	Ventura County
227912	Fee-for-Service	1124053871	1124053871	1	1	FITZSIMMONS, KARI D. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	500 17TH AVE	None	SEATTLE	WA	98122	5711	00	None	47.60689769	-122.3102467	King County
227992	Fee-for-Service	1790833754	1790833754	1	1	FEINERMAN, MARK E MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43884	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
227997	Fee-for-Service	1568113827	1568113827	1	1	FACULTY PHYSICIANS AND SURGE	5/4/2023	207K00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	8599 HAVEN AVE	STE 102 & 210	RANCHO CUCAMONGA	CA	91730	4849	36	06071	34.097364	-117.575693	San Bernardino County
228026	Fee-for-Service	1194296764	1194296764	1	1	FUENTES, SOCORRO LPCC	7/25/2024	106H00000X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
228113	Fee-for-Service	1538553565	1538553565	1	1	FLORES, MICHAEL DO	7/1/2019	207P00000X	NA	Other	026	PHYSICIANS	15079	66	Emergency Medicine (Urgent Care)	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
228136	Fee-for-Service	1467504530	1467504530	1	1	FAMILY HEALTHCARE NETWRK	8/4/2011	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	250 W 5TH ST	None	HANFORD	CA	93230	5033	16	06031	36.32439821	-119.6472235	Kings County
228157	Fee-for-Service	1649358599	1649358599	1	1	FAZILAT, SHAHIN MD	8/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90907	24	Plastic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
228194	Fee-for-Service	1386271229	1386271229	1	1	FARAJ, JESSICA M MD	7/3/2023	390200000X	NA	Other	026	PHYSICIANS	185783	None	None	0	In state provider	None	101 THE CITY DR S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
228200	Fee-for-Service	1053595694	1053595694	1	1	FIELD, SETH J MD	6/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87427	67	Endocrinology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
228212	Fee-for-Service	1174549232	1174549232	1	1	FAMILY HEALTH CENTERS	6/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2391 ISLAND AVE	None	SAN DIEGO	CA	92102	2941	37	06073	32.71044228	-117.1425241	San Diego County
228242	Fee-for-Service	1477897213	1477897213	1	1	FRENKEL, MELINDA D LMFT	8/28/2017	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	503 DOLORES ST	STE 205	SAN FRANCISCO	CA	94110	1580	38	06075	37.76131325	-122.4259408	San Francisco County
228255	Fee-for-Service	1588792683	1588792683	1	1	FORREST, LOUISE D MD	7/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88887	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2211	38	06075	37.76344756	-122.4581992	San Francisco County
228261	Fee-for-Service	1225053036	1225053036	1	1	FASSIHI, AMIR A MD	5/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73568	30	Radiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
228288	Fee-for-Service	1568113827	1568113827	1	1	FACULTY PHYSICIANS AND SURGE	6/17/2022	207K00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	8599 HAVEN AVE	STE 102 & 210	RANCHO CUCAMONGA	CA	91730	4849	36	06071	34.097364	-117.575693	San Bernardino County
228300	Fee-for-Service	1427044742	1427044742	1	1	FIEDLER,MARK D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9213 C UNIVERSITY BLVD	None	NORTH CHARLESTON	SC	29406	0000	00	None	32.976702	-80.0707725	Charleston County
228425	Fee-for-Service	1467504530	1467504530	1	1	FAMILY HEALTHCARE NETWRK	12/21/2006	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	250 W 5TH ST	None	HANFORD	CA	93230	5033	16	06031	36.32439821	-119.6472235	Kings County
228498	Fee-for-Service	1174549232	1174549232	1	1	FAMILY HEALTH CENTERS	6/1/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2391 ISLAND AVE	None	SAN DIEGO	CA	92102	2941	37	06073	32.71044228	-117.1425241	San Diego County
228501	Fee-for-Service	1275604480	1275604480	1	1	FAN, ROBERT S MD	5/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72087	41	Internal Medicine	0	In state provider	None	8110 AIRPORT BLVD	None	LOS ANGELES	CA	90045	3119	19	06037	33.96526302	-118.3852705	Los Angeles County
228504	Fee-for-Service	1700375250	1700375250	1	1	FORD, KAITLIN M MD	6/16/2023	390200000X	NA	Other	026	PHYSICIANS	166720	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
228548	Fee-for-Service	1841327269	1841327269	1	1	FEIKES, QUYNH N MD	10/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	1	Border provider	None	5320 S RAINBOW BLVD	STE 282	LAS VEGAS	NV	89118	1611	00	None	36.09179456	-115.2429031	Clark County
228573	Fee-for-Service	1568113827	1568113827	1	1	FACULTY PHYSICIANS AND SURGE	2/2/2022	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	ONS OF LLUSM	8599 HAVEN AVE	STE 102 & 210	RANCHO CUCAMONGA	CA	91730	4849	36	06071	34.097364	-117.575693	San Bernardino County
228599	Fee-for-Service	1376950477	1376950477	1	1	FALLAH, ARIA MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	139475	14	Neurological Surgery	0	In state provider	None	300 UCLA MEDICAL PLAZA	SUITE 200	LOS ANGELES	CA	90095	0001	19	06037	34.06465655	-118.4461	Los Angeles County
228607	Fee-for-Service	1083817704	1083817704	1	1	FELDMAR, DAVID A MD	7/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87326	02	General Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
228649	Fee-for-Service	1538663935	1538663935	1	1	FOO, ERIC T MD	6/1/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	163408	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
228689	Fee-for-Service	1376711697	1376711697	1	1	FARR, HASHEM M MD INC	5/24/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	38276	41	Internal Medicine	0	In state provider	None	2375 FOREST AVE	None	SAN JOSE	CA	95128	4610	43	06085	37.32698749	-121.945473	Santa Clara County
228712	Fee-for-Service	1467504530	1467504530	1	1	FAMILY HEALTHCARE NETWRK	12/21/2006	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	250 W 5TH ST	None	HANFORD	CA	93230	5033	16	06031	36.32439821	-119.6472235	Kings County
228719	Fee-for-Service	1134685365	1134685365	1	1	FRANCO, SHANNON E CNP	4/16/2019	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
228765	Fee-for-Service	1447346416	1447346416	1	1	FANT MARTIN, EMILY MD	4/24/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	751 DAILY DR	STE 110	CAMARILLO	CA	93010	6077	56	06111	34.21880533	-119.0593374	Ventura County
228767	Fee-for-Service	1669439311	1669439311	1	1	FISHER & ALLYN MDS INC	3/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1704 STATE ST	FL 2	SANTA BARBARA	CA	93101	2522	42	06083	34.42833132	-119.7112091	Santa Barbara County
228792	Fee-for-Service	1275604480	1275604480	1	1	FAN, ROBERT S MD	5/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72087	10	Gastroenterology (M.D. only)	0	In state provider	None	8110 AIRPORT BLVD	None	LOS ANGELES	CA	90045	3119	19	06037	33.96526302	-118.3852705	Los Angeles County
228828	Fee-for-Service	1922489665	1922489665	1	1	FRIENDS OF FAMILY HEALTH	5/4/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER	13152 NEWPORT AVE	STE B	TUSTIN	CA	92780	3469	30	06059	33.74737358	-117.812672	Orange County
228838	Fee-for-Service	1841327269	1841327269	1	1	FEIKES, QUYNH N MD	10/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	33	Thoracic Surgery	1	Border provider	None	5320 S RAINBOW BLVD	STE 282	LAS VEGAS	NV	89118	1611	00	None	36.09179456	-115.2429031	Clark County
228865	Fee-for-Service	1700664844	1700664844	1	2	FOSTER AND GARFF SURGICAL AS	9/3/2024	261QS0132X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	1102 MAIN AVE	None	FALLBROOK	CA	92028	3325	37	06073	33.37233494	-117.2513985	San Diego County
228868	Fee-for-Service	1568113827	1568113827	1	1	FACULTY PHYSICIANS AND SURGE	2/2/2022	207K00000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	ONS OF LLUSM	8599 HAVEN AVE	STE 102 & 210	RANCHO CUCAMONGA	CA	91730	4849	36	06071	34.097364	-117.575693	San Bernardino County
228931	Fee-for-Service	1356518096	1356518096	1	1	FAUSCETTE, NICOLE C LMFT	11/27/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
228981	Fee-for-Service	1164517744	1164517744	1	3	FAMILY HEALTHCARE NETWORK	9/16/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	330 E PINE ST	None	EXETER	CA	93221	1838	54	06107	36.29691064	-119.1391441	Tulare County
229032	Fee-for-Service	1356338750	1356338750	1	1	FAHNESTOCK, ROBERT LCSW	8/28/2007	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2020 COLUMBUS PKWY	STE 6	BENICIA	CA	94510	5400	48	06095	38.07967676	-122.1905996	Solano County
229117	Fee-for-Service	1922489665	1922489665	1	1	FRIENDS OF FAMILY HEALTH	5/4/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER	13152 NEWPORT AVE	STE B	TUSTIN	CA	92780	3469	30	06059	33.74737358	-117.812672	Orange County
229124	Fee-for-Service	1588901045	1588901045	1	1	FAMILY HEALTH CENTERS OF	4/24/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	1250 6TH AVE	STE 100	SAN DIEGO	CA	92101	4368	37	06073	32.71854144	-117.1593008	San Diego County
229150	Fee-for-Service	1568113827	1568113827	1	1	FACULTY PHYSICIANS AND SURGE	2/2/2022	207K00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ONS OF LLUSM	8599 HAVEN AVE	STE 102 & 210	RANCHO CUCAMONGA	CA	91730	4849	36	06071	34.097364	-117.575693	San Bernardino County
229194	Fee-for-Service	1528460060	1528460060	1	1	FORBES, AISLING	8/12/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
229212	Fee-for-Service	1689622177	1689622177	1	1	FABRIKANT, JERRY M DPM	10/11/2008	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5565 GROSSMONT CENTER DR	STE 3	LA MESA	CA	91942	3007	37	06073	32.77978322	-117.0094766	San Diego County
229217	Fee-for-Service	1609174176	1609174176	1	1	FIRST HEALTH MEDICAL GROUP	2/14/2014	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	78177	None	None	0	In state provider	None	5352 LAUREL CANYON BLVD	STE 110	NORTH HOLLYWOOD	CA	91607	4938	19	06037	34.168176	-118.3964725	Los Angeles County
229229	Fee-for-Service	1427467315	1427467315	1	1	FUNK, STERLING LMFT	7/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
229234	Fee-for-Service	1164535977	1164535977	1	1	FLEISCHHAUER,GREGORY G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9800 LEVIN RD NW	STE 204	SILVERDALE	WA	98383	7849	00	None	47.65252485	-122.6846948	Kitsap County
229275	Fee-for-Service	1164517744	1164517744	1	3	FAMILY HEALTHCARE NETWORK	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	330 E PINE ST	None	EXETER	CA	93221	1838	54	06107	36.29691064	-119.1391441	Tulare County
229294	Fee-for-Service	1043743362	1043743362	1	1	FU, KATHERINE A MD	2/17/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	158439	None	None	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
229325	Fee-for-Service	1588673578	1588673578	1	1	FRANCISCAN CARE SERVICES INC	6/28/2022	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	430 NORTH MONITOR STREET	None	WEST POINT	NE	68788	1595	00	None	41.843331	-96.70672354	Cuming County
229414	Fee-for-Service	1588901045	1588901045	1	1	FAMILY HEALTH CENTERS OF	6/16/2014	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	1250 6TH AVE	STE 100	SAN DIEGO	CA	92101	4368	37	06073	32.71854144	-117.1593008	San Diego County
229436	Fee-for-Service	1437187176	1437187176	1	1	FISCHMANN, GEORGE E MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49561	45	Nephrology (Renal-Kidney)	0	In state provider	INC	5525 ETIWANDA AVE	STE 305	TARZANA	CA	91356	6123	19	06037	34.17046451	-118.5308463	Los Angeles County
229439	Fee-for-Service	1649700832	1649700832	2	1	FIRST STOP RX INC	11/9/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1577 CHEVY CHASE	STE 130	GLENDALE	CA	91206	4740	19	06037	34.15313959	-118.2299467	Los Angeles County
229447	Fee-for-Service	1760437446	1760437446	1	1	FINE, MATTHEW N MD	7/1/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	36657	41	Internal Medicine	0	In state provider	None	2767 OLIVE HWY	STE 11	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
229453	Fee-for-Service	1730187881	1730187881	1	1	FEINBERG, GARY M MD	8/21/2018	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	58691	84	Surgery-Head and Neck	0	In state provider	None	4646 BROCKTON AVE	SUITE 201	RIVERSIDE	CA	92506	0104	33	06065	33.9760171	-117.3860626	Riverside County
229547	Fee-for-Service	1639251697	1639251697	1	1	FURMAN, JOHN C MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	69983	36	Psychiatry	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
229613	Fee-for-Service	1588673578	1588673578	1	1	FRANCISCAN CARE SERVICES INC	6/28/2022	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	430 NORTH MONITOR STREET	None	WEST POINT	NE	68788	1595	00	None	41.843331	-96.70672354	Cuming County
229629	Fee-for-Service	1750380671	1750380671	1	1	FRED ANDREW WILLIAMS,JR.MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2500 HOSPITAL DR	None	MARTINSBURG	WV	25401	3402	00	None	39.47628781	-77.98077516	Berkeley County
229639	Fee-for-Service	1235827429	1235827429	1	1	FAZIL, MARIAM NP	1/10/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1310 STEWART DR	STE 301	ORANGE	CA	92868	3854	30	06059	33.78236048	-117.8664975	Orange County
229673	Fee-for-Service	1609213297	1609213297	1	1	FIELDS, LAKESIA LMFT	9/17/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	RVICES	5150 E PACIFIC COAST HWY	200	LONG BEACH	CA	90804	3312	19	06037	33.7831762	-118.1333125	Los Angeles County
229701	Fee-for-Service	1588901045	1588901045	1	1	FAMILY HEALTH CENTERS OF	4/24/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	1250 6TH AVE	STE 100	SAN DIEGO	CA	92101	4368	37	06073	32.71854144	-117.1593008	San Diego County
229723	Fee-for-Service	1437187176	1437187176	1	1	FISCHMANN, GEORGE E MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49561	41	Internal Medicine	0	In state provider	INC	5525 ETIWANDA AVE	STE 305	TARZANA	CA	91356	6123	19	06037	34.17046451	-118.5308463	Los Angeles County
229747	Fee-for-Service	1245277789	1245277789	2	1	FARSHIDI, ELAHEH MD	8/21/2006	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49801	01	General Practice	0	In state provider	None	1801 W ROMNEYA DR	STE 305	ANAHEIM	CA	92801	1900	30	06059	33.8506615	-117.946413	Orange County
229841	Fee-for-Service	1255499166	1255499166	1	1	FLAHERTY, MARGARET	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
229848	Fee-for-Service	1265799522	1265799522	1	1	FORAT, SHAHRZAD CNP	6/16/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16300 ROSCOE BLVD	STE 1-A	VAN NUYS	CA	91406	1258	19	06037	34.22128033	-118.4884471	Los Angeles County
229920	Fee-for-Service	1255870598	1255870598	1	1	FERNANDEZ-SUTTON, CELIA LCS	3/30/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	7365 CARNELIAN ST	STE 202	RANCHO CUCAMONGA	CA	91730	1100	36	06071	34.12038413	-117.6160525	San Bernardino County
229931	Fee-for-Service	1073855904	1073855904	1	1	FRANTZ, STEPHEN J MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146179	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	W HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
229934	Fee-for-Service	1750724852	1750724852	1	1	FERRER, DAPHNE C MD	9/24/2018	2084P0804X	NA	Psychiatry	026	PHYSICIANS	155047	36	Psychiatry	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
230002	Fee-for-Service	1285929232	1285929232	1	1	FRANK, MATTHEW J MD	5/16/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	124604	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
230034	Fee-for-Service	1245277789	1245277789	2	1	FARSHIDI, ELAHEH MD	8/21/2006	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49801	38	Geriatrics	0	In state provider	None	1801 W ROMNEYA DR	STE 305	ANAHEIM	CA	92801	1900	30	06059	33.8506615	-117.946413	Orange County
230036	Fee-for-Service	1083691877	1083691877	1	1	FRIEDLAND, JEFFREY M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RADIOLOGY IMAGING ASSOCI	1501 S POTOMAC	None	DENVER	CO	80012	5411	00	None	39.689343	-104.832198	Arapahoe County
230162	Fee-for-Service	1881879443	1881879443	1	1	FORONDA, ALICIA M LMFT	1/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	555 SOQUEL AVE	260	SANTA CRUZ	CA	95062	2336	44	06087	36.97623386	-122.0170137	Santa Cruz County
230190	Fee-for-Service	1316257959	1316257959	1	1	FAMILY HEALTHCARE NETWORK	3/15/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1107 WEST POPLAR AVENUE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
230210	Fee-for-Service	1407832058	1407832058	1	1	FRANKEL, WARREN H MD	2/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21005	01	General Practice	0	In state provider	None	1050 LAS TABLAS RD	STE 15	TEMPLETON	CA	93465	9480	40	06079	35.55442352	-120.7183455	San Luis Obispo County
230313	Fee-for-Service	1598343287	1598343287	1	1	FRANCK, ELIZABETH PA	8/18/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	59386	-	NOT APPLICABLE	0	In state provider	None	541 S HAM LANE	SUITE A & B	LODI	CA	95242	3530	39	06077	38.12755919	-121.2882996	San Joaquin County
230324	Fee-for-Service	1245277789	1245277789	2	1	FARSHIDI, ELAHEH MD	8/21/2006	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	49801	08	Family Practice	0	In state provider	None	1801 W ROMNEYA DR	STE 305	ANAHEIM	CA	92801	1900	30	06059	33.8506615	-117.946413	Orange County
230381	Fee-for-Service	1518212737	1518212737	1	1	FAMILY DOCTORS INC	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	112720	01	General Practice	0	In state provider	None	477 N EL CAMINO REAL	SUITE A 300	ENCINITAS	CA	92024	1328	37	06073	33.05700866	-117.262449	San Diego County
230469	Fee-for-Service	1578738480	1578738480	1	1	FILLMORE UNIFIED SD	9/20/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	627 SESPE AVE	None	FILLMORE	CA	93015	1918	56	06111	34.40019884	-118.9174164	Ventura County
230499	Fee-for-Service	1407832058	1407832058	1	1	FRANKEL, WARREN H MD	2/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21005	08	Family Practice	0	In state provider	None	1050 LAS TABLAS RD	STE 15	TEMPLETON	CA	93465	9480	40	06079	35.55442352	-120.7183455	San Luis Obispo County
230539	Fee-for-Service	1467644997	1467644997	1	1	FAN, JOSEPH T MD INC	11/5/2009	207W00000X	NA	Ophthalmology	026	PHYSICIANS	83202	None	None	0	In state provider	None	500 N GARFIELD	STE 209	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
230591	Fee-for-Service	1831266725	1831266725	1	1	FULLER, PAUL N MD	8/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40778	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
230641	Fee-for-Service	1952612905	1952612905	1	1	FUNAMURA, JAMIE L MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118532	04	Otology, Laryngology, Rhinology	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
230653	Fee-for-Service	1801366588	1801366588	1	1	FRYMAN, ALEXANDRA LMFT	3/20/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21125 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91355	1356	19	06037	34.41164827	-118.5053439	Los Angeles County
230655	Fee-for-Service	1003860586	1003860586	1	1	FIFE, ROGER L MD INC	1/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	34105	08	Family Practice	0	In state provider	None	780 W OLIVE AVE	STE 104	MERCED	CA	95348	2437	24	06047	37.31916174	-120.4814268	Merced County
230762	Fee-for-Service	1861818718	1861818718	1	1	FELLOWSHIP HOSPICE SERVICES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	520 N BROOKHURST ST	SUITE 214	ANAHEIM	CA	92801	5238	30	06059	33.838974	-117.959013	Orange County
230811	Fee-for-Service	1114344173	1114344173	1	1	FRISCHER, LAURA M MD	3/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138727	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
230983	Fee-for-Service	1366490690	1366490690	1	1	FREDERICK, DEXTER MD	8/16/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	67590	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
231050	Fee-for-Service	1861818718	1861818718	1	1	FELLOWSHIP HOSPICE SERVICES	10/2/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	520 N BROOKHURST ST	SUITE 214	ANAHEIM	CA	92801	5238	30	06059	33.838974	-117.959013	Orange County
231095	Fee-for-Service	1215029251	1215029251	1	1	FERNANDO, NANCY DO	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	6343	None	None	0	In state provider	None	1505 W 17TH ST	None	SAN BERNARDINO	CA	92411	1202	36	06071	34.13045153	-117.31869	San Bernardino County
231101	Fee-for-Service	1659605632	1659605632	1	1	FELIX BUILES, JULIANNE JOYCE	6/28/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
231102	Fee-for-Service	1669554390	1669554390	1	1	FAUVRE, FRED M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	18788	41	Internal Medicine	0	In state provider	A PROF CORP	1320 MARICOPA HWY	STE I	OJAI	CA	93023	3154	56	06111	34.44248874	-119.2654707	Ventura County
231116	Fee-for-Service	1629202270	1629202270	1	1	FATHIAN, ASAL MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120098	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	350 30TH ST	STE 208	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
231125	Fee-for-Service	1477928901	1477928901	1	1	FRESENIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY LLC	17197 NEWHOPE STREET	SUITE A	FOUNTAIN VALLEY	CA	92708	4228	30	06059	33.713802	-117.9284504	Orange County
231139	Fee-for-Service	1962498030	1962498030	1	1	FRICK, GARY M OD	9/1/1981	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10225 TELEPHONE RD	STE E	VENTURA	CA	93004	2825	56	06111	34.27728925	-119.1621582	Ventura County
231215	Fee-for-Service	1568796605	1568796605	1	1	FORD, JOLENE R LCSW	5/20/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
231219	Fee-for-Service	1548373426	1548373426	1	1	FLYNN, CHRISTOPHER J MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72233	None	None	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
231272	Fee-for-Service	1508347840	1508347840	1	1	FRANQUI DOMINGUEZ, LAURA C M	9/20/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	D	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
231288	Fee-for-Service	1912492158	1912492158	1	1	FAZELIMANESH, SHIMA	7/9/2021	133V00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	346 HAUSER BLVD	APT 410	LOS ANGELES	CA	90036	5596	19	06037	34.06920056	-118.3509616	Los Angeles County
231293	Fee-for-Service	1922416411	1922416411	1	2	FAMILY HEALTH CARE CENTERS	8/9/2024	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	6001 E WASHINGTON BLVD	None	COMMERCE	CA	90040	2451	19	06037	33.99703164	-118.1499826	Los Angeles County
231310	Fee-for-Service	1194873141	1194873141	1	1	FENSTER, MARK S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41261	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
231313	Fee-for-Service	1366092892	1366092892	1	1	FRANKENBERGER, DIRK CPO	5/26/2020	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	19845 LAKE CHABOT	STE 302	CASTRO VALLEY	CA	94546	4055	01	06001	37.69995352	-122.087795	Alameda County
231321	Fee-for-Service	1861444986	1861444986	1	1	FAZEL, SHAWN MD	4/14/2022	207R00000X	NA	Other	026	PHYSICIANS	168857	None	None	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
231331	Fee-for-Service	1235421801	1235421801	1	1	FIALLO, ALFREDO A MD	11/13/2018	207L00000X	NA	Other	026	PHYSICIANS	154912	05	Anesthesiology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
231343	Fee-for-Service	1134178973	1134178973	1	1	FUNG, MAXWELL A MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80754	07	Dermatology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
231438	Fee-for-Service	1962432443	1962432443	1	1	FREIJE, WILLIAM A MD	3/1/1995	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	74602	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	115 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3606	19	06037	34.0309884	-118.2642142	Los Angeles County
231507	Fee-for-Service	1992025993	1992025993	1	1	FREE, KRISTIN B LCSW	5/7/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	48 HANOVER LN	STE 2	CHICO	CA	95973	7224	04	06007	39.75952037	-121.8654372	Butte County
231617	Fee-for-Service	1073597860	1073597860	1	1	FAN, ALEXANDER H MD	10/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77706	36	Psychiatry	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
231655	Fee-for-Service	1194104893	1194104893	1	1	FUTRELL, JULIE L PHD	11/8/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA ST	STE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
231676	Fee-for-Service	1104984327	1104984327	1	1	FAMILY MEDICINE ASSOC	7/1/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	18350 ROSCOE BLVD	STE 600	NORTHRIDGE	CA	91325	4187	19	06037	34.22071855	-118.5341175	Los Angeles County
231719	Fee-for-Service	1619278322	1619278322	1	1	FINKAS, LINDSAY K MD	1/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	120924	03	Allergy	0	In state provider	None	97 SAN MARIN DRIVE	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
231753	Fee-for-Service	1679833925	1679833925	1	1	FEE, COLIN D MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151447	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
231817	Fee-for-Service	1588246284	1588246284	1	1	FAME, CRYSTAL T DO	9/16/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22816	08	Family Practice	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
231897	Fee-for-Service	1538696232	1538696232	1	1	FELDMAN, LAUREN K LMFT	12/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14500 ROSCOE BLVD	STE 400	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
231910	Fee-for-Service	1205907102	1205907102	1	1	FONG, DONALD S MD	12/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72159	18	Ophthalmology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
232009	Fee-for-Service	1376840744	1376840744	1	1	FLORES, LUZ E LMFT	6/9/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 N BRAND BLVD	STE 212	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
232075	Fee-for-Service	1386081743	1386081743	1	1	FRUCHTBAUM, IRENE S PHD	7/6/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
232150	Fee-for-Service	1912225475	1912225475	1	1	FALL CONTROL SYSTEMS, LLC	12/8/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FALL CONTROL SYSTEMS LLC	1707 VIA EL PRADO	SUITE 202	REDONDO BEACH	CA	90277	5732	19	06037	33.81794294	-118.3870363	Los Angeles County
232176	Fee-for-Service	1467070094	1467070094	1	1	FRENCH, JENNIFER RCP	2/11/2022	2278G1100X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	450 6TH AVE	None	SAN FRANCISCO	CA	94118	3010	38	06075	37.7802547	-122.4642049	San Francisco County
232199	Fee-for-Service	1417452111	1417452111	1	1	FARMAND, STEFANIE DO	8/17/2022	2279E0002X	NA	Other	026	PHYSICIANS	19907	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
232248	Fee-for-Service	1689992133	1689992133	1	1	FERRER, WESTON S MD	5/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117937	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
232308	Fee-for-Service	1306297957	1306297957	1	1	FRYE, ANDREW J MD	2/1/2020	207P00000X	NA	Other	026	PHYSICIANS	166533	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 N JACKSON AVE	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
232319	Fee-for-Service	1750467874	1750467874	1	1	FUKUDA, DAVID K MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	77453	01	General Practice	0	In state provider	None	577 NORTH D STREET	SUITE 101	SAN BERNARDINO	CA	92401	1326	36	06071	34.109613	-117.291874	San Bernardino County
232338	Fee-for-Service	1366702391	1366702391	1	1	FARMER, KATHERINE A MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140403	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
232366	Fee-for-Service	1184640880	1184640880	1	1	FACIANA, DAVID M PT	3/12/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	865 PATRIOT DRIVE	202	MOORPARK	CA	93021	3405	56	06111	34.27758343	-118.8663357	Ventura County
232379	Fee-for-Service	1194152355	1194152355	1	1	FELTEN, CARLA M LCSW	11/15/2023	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	UNIT 203	UPLAND	CA	91786	4167	36	06071	34.10424442	-117.6701797	San Bernardino County
232406	Fee-for-Service	1285808089	1285808089	1	1	FINKELSTEIN, ANNA MD	8/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100643	30	Radiology	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
232437	Fee-for-Service	1215096409	1215096409	2	1	FRANCO, ARMANDO L MD	2/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	48696	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12810 HEACOCK ST	SUITE B206	MORENO VALLEY	CA	92553	3170	33	06065	33.934851	-117.2437635	Riverside County
232486	Fee-for-Service	1134887318	1134887318	1	1	FRONTLINE MEDICAL TRANSPORTA	10/17/2022	342000000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TION	8608 UTICA AVENUE,	SUITE 205	RANCHO CUCAMONGA	CA	91730	4877	36	06071	34.097247	-117.573008	San Bernardino County
232542	Fee-for-Service	1922496629	1922496629	1	1	FOX, ELIZABETH M NP	10/17/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232554	Fee-for-Service	1992060578	1992060578	1	1	FONG, CINDY	12/24/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	116 E WALNUT AVE	None	MONROVIA	CA	91016	3431	19	06037	34.14367921	-118.0000903	Los Angeles County
232565	Fee-for-Service	1295052710	1295052710	1	1	FUJIMOTO, SCOTT T DO	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11402	30	Radiology	0	In state provider	None	11370 ANDERSON ST	SUITE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
232607	Fee-for-Service	1487622361	1487622361	1	1	FORSLING, MICHAEL DPM	12/11/2002	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
232609	Fee-for-Service	1255354171	1255354171	1	1	FERNANDEZ, MARINA H MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37204	01	General Practice	0	In state provider	None	1135 S SUNSET AVE	STE 210	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
232652	Fee-for-Service	1952451007	1952451007	1	1	FONG, DARLENE T OD	5/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE STREET	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
232743	Fee-for-Service	1740245026	1740245026	2	1	FUH, CHENN-YOW MD	6/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	38829	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	382 W OLIVE AVE	None	MERCED	CA	95348	3137	24	06047	37.31918345	-120.4755181	Merced County
232841	Fee-for-Service	1528804176	1528804176	1	1	FORET, JACOB CRNA	11/26/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	207 W LEGION	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
232854	Fee-for-Service	1972668267	1972668267	2	1	FARMERSVILLE UNIFIED SCHOOL	7/1/2018	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	571 E CITRUS	None	FARMERSVILLE	CA	93223	1274	54	06107	36.3079474	-119.2019511	Tulare County
232855	Fee-for-Service	1023182599	1023182599	1	1	FLORES-MERRITT, ISABELLA MD	6/3/2010	207R00000X	NA	Other	026	PHYSICIANS	84790	02	General Surgery	0	In state provider	None	2800 L ST	STE 200	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
232889	Fee-for-Service	1023034873	1023034873	1	1	FORCE-OBROWSKI, SANDRA K MD	1/17/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66813	08	Family Practice	0	In state provider	None	7777 MILLIKEN AVE	STE 350	RANCHO CUCAMONGA	CA	91730	6782	36	06071	34.10843256	-117.5570865	San Bernardino County
232916	Fee-for-Service	1467984427	1467984427	1	1	FAIZY, RUBINA M LMFT	7/14/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164312	None	None	0	In state provider	None	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
232944	Fee-for-Service	1548324429	1548324429	1	1	FIRST SANTA ANA MED CLIN	8/5/1980	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	2337 W 1ST ST	None	SANTA ANA	CA	92703	3503	30	06059	33.7453593	-117.901017	Orange County
232962	Fee-for-Service	1235189911	1235189911	1	1	FACULTY PHYSICIANS & SURGEON	9/20/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	S OF LLUSM	25828 REDLANDS BLVD	101	REDLANDS	CA	92373	8450	36	06071	34.06306846	-117.240957	San Bernardino County
233032	Fee-for-Service	1740245026	1740245026	2	1	FUH, CHENN-YOW MD	6/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	38829	41	Internal Medicine	0	In state provider	None	382 W OLIVE AVE	None	MERCED	CA	95348	3137	24	06047	37.31918345	-120.4755181	Merced County
233091	Fee-for-Service	1225396591	1225396591	1	1	FRAZIER, MICHAEL G MD	9/28/2018	2084B0040X	NA	Neurology	026	PHYSICIANS	127381	None	None	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
233134	Fee-for-Service	1497111967	1497111967	1	1	FRESENIUS MEDICAL CARE	1/1/2016	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	PEGASUS LLC	3101 PEGASUS DRIVE	STE 100	BAKERSFIELD	CA	93308	6815	15	06029	35.43310529	-119.0649401	Kern County
233142	Fee-for-Service	1972668267	1972668267	2	1	FARMERSVILLE UNIFIED SCHOOL	4/23/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	571 E CITRUS	None	FARMERSVILLE	CA	93223	1274	54	06107	36.3079474	-119.2019511	Tulare County
233205	Fee-for-Service	1912264862	1912264862	1	9	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	PARTNERS	1541 FLORIDA AVE	STE 304	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
233207	Fee-for-Service	1871766121	1871766121	1	2	FACULTY PHYS & SURG OF	5/4/2023	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
233213	Fee-for-Service	1346238078	1346238078	1	1	FLEMMING, THERESA K NP	4/17/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
233230	Fee-for-Service	1548324429	1548324429	1	1	FIRST SANTA ANA MED CLIN	8/5/1980	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	2337 W 1ST ST	None	SANTA ANA	CA	92703	3503	30	06059	33.7453593	-117.901017	Orange County
233252	Fee-for-Service	1235189911	1235189911	1	1	FACULTY PHYSICIANS & SURGEON	9/1/1995	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	S OF LLUSM	25828 REDLANDS BLVD	101	REDLANDS	CA	92373	8450	36	06071	34.06306846	-117.240957	San Bernardino County
233276	Fee-for-Service	1619503828	1619503828	1	1	FOX, MADISON C CCC-SLP	7/5/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
233406	Fee-for-Service	1760974851	1760974851	1	1	FIGUEROA, ALYSSA K LMFT	9/1/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2000 W BRIGGSMORE AVE	STE I	MODESTO	CA	95350	3839	50	06099	37.67139252	-121.0281273	Stanislaus County
233495	Fee-for-Service	1871766121	1871766121	1	2	FACULTY PHYS & SURG OF	8/1/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
233603	Fee-for-Service	1730143066	1730143066	1	1	FIELDS, MARC T MD	3/24/2006	2085R0001X	NA	Other	026	PHYSICIANS	52087	None	None	0	In state provider	None	301 PROFESSIONAL CENTER	None	ROHNERT PARK	CA	94928	2152	49	06097	38.35471913	-122.7076253	Sonoma County
233634	Fee-for-Service	1992737068	1992737068	1	2	FRAUSTO, TERESA MD	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	75172	-	NOT APPLICABLE	0	In state provider	None	15480 RAMONA AVE	None	VICTORVILLE	CA	92392	2421	36	06071	34.50885704	-117.3259773	San Bernardino County
233717	Fee-for-Service	1215005756	1215005756	1	1	FARHA, AMJAD M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HENRY FORD HEALTH SYSTEM	2799 W GRAND BLVD	None	DETROIT	MI	48202	2608	00	None	42.36645079	-83.08385497	Wayne County
233723	Fee-for-Service	1477062412	1477062412	1	1	FOR SENIOR CARE, LLC	10/3/2019	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2333 YOSEMITE AVENUE	None	SIMI VALLEY	CA	93063	3540	56	06111	34.27782868	-118.6784931	Ventura County
233736	Fee-for-Service	1033177167	1033177167	1	1	FARMER, DIANA L MD	5/1/1998	2086S0120X	NA	General Surgery	026	PHYSICIANS	62158	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
233743	Fee-for-Service	1043259310	1043259310	1	1	FERKICH, ANTHONY R MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80871	None	None	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
233748	Fee-for-Service	1285900365	1285900365	1	1	FARAG, HEBA MD INC	11/27/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	84223	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	26691 PLAZA DR	STE 160	MISSION VIEJO	CA	92691	6375	30	06059	33.56533763	-117.6645538	Orange County
233839	Fee-for-Service	1801839675	1801839675	1	1	FLOWERS, FRANCESCA A MD	10/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	56060	41	Internal Medicine	0	In state provider	None	91275 66TH ST	None	MECCA	CA	92554	6515	33	06065	33.5692685	-116.0743905	Riverside County
233868	Fee-for-Service	1457658346	1457658346	1	1	FALCO, DARLENE K CRNA	10/11/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
233957	Fee-for-Service	1518987684	1518987684	1	1	FOSTER, ERINA N MD	10/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77486	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
234009	Fee-for-Service	1922325646	1922325646	1	1	FRUITVALE ELEM SD	1/22/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	7311 ROSEDALE HWY	None	BAKERSFIELD	CA	93308	5738	15	06029	35.38329551	-119.083689	Kern County
234056	Fee-for-Service	1336464270	1336464270	1	1	FITZPATRICK, MEGAN C MD	8/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142415	30	Radiology	0	In state provider	None	2301 BAHAMAS DRIVE	None	BAKERSFIELD	CA	93309	0663	15	06029	35.37447628	-119.0453594	Kern County
234088	Fee-for-Service	1215994827	1215994827	1	1	FUNG, GORDON L MD	8/24/2004	207RC0200X	NA	Other	026	PHYSICIANS	43076	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	789 VALLEJO ST	None	SAN FRANCISCO	CA	94133	3834	38	06075	37.79837302	-122.4102043	San Francisco County
234193	Fee-for-Service	1831256064	1831256064	1	1	FOUNTAIN VLY ELEM SD	5/1/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	10055 SLATER AVE	None	FOUNTAIN VALLEY	CA	92708	4712	30	06059	33.70909652	-117.953397	Orange County
234249	Fee-for-Service	1750634903	1750634903	1	1	FENTON VILLA INC	1/14/2016	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	13863 FENTON AVENUE	None	SYLMAR	CA	91342	1670	19	06037	34.32388284	-118.4386769	Los Angeles County
234253	Fee-for-Service	1174675854	1174675854	1	1	FLINT, LYNN A MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	100152	41	Internal Medicine	0	In state provider	None	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	38	06075	37.72851602	-122.4296638	San Francisco County
234254	Fee-for-Service	1962580035	1962580035	1	1	FORTENKO, ANATOLIY S MD	10/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79403	25	Physical Medicine and Rehabilitation	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
234287	Fee-for-Service	1225763337	1225763337	1	1	FUJIHARA, JEFFREY PT	10/20/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
234351	Fee-for-Service	1760064695	1760064695	1	1	FOSTER, TESS CNP	6/16/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1401 S BALDWIN AVE	None	ARCADIA	CA	91007	7922	19	06037	34.12357479	-118.0551359	Los Angeles County
234377	Fee-for-Service	1215994827	1215994827	1	1	FUNG, GORDON L MD	8/24/2004	207RC0200X	NA	Other	026	PHYSICIANS	43076	01	General Practice	0	In state provider	None	789 VALLEJO ST	None	SAN FRANCISCO	CA	94133	3834	38	06075	37.79837302	-122.4102043	San Francisco County
234389	Fee-for-Service	1194083824	1194083824	1	1	FACEY MEDICAL FOUNDATION	1/1/2014	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	11333 SEPULVEDA BLVD	SUITE 3200	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
234400	Fee-for-Service	1053806497	1053806497	1	1	FUKUDA, ANDREW	8/29/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
234417	Fee-for-Service	1699739912	1699739912	1	1	FIELD, BOB G MD INC	7/12/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	22056	40	Pediatrics	0	In state provider	None	1111 SONOMA AVE	STE 316	SANTA ROSA	CA	95405	4820	49	06097	38.442042	-122.700033	Sonoma County
234467	Fee-for-Service	1265708531	1265708531	1	1	FLORES RIOS, JOHANA E MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122420	08	Family Practice	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
234470	Fee-for-Service	1376561399	1376561399	1	1	FEDERICO, FRANCESCO MD	3/31/1984	207RH0003X	NA	Oncology	026	PHYSICIANS	35484	68	Hematology	0	In state provider	None	2601 W ALAMEDA AVE	STE 210	BURBANK	CA	91505	4810	19	06037	34.15783817	-118.3293969	Los Angeles County
234587	Fee-for-Service	1851718118	1851718118	1	1	FEUILLE, COLIN J MD	4/4/2022	208M00000X	NA	Other	026	PHYSICIANS	153815	None	None	0	In state provider	None	3975 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
234682	Fee-for-Service	1073028502	1073028502	1	1	FAWN, SHAINA LCSW	2/24/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11835 WEST OLYMPIC BLVD	SUITE 815E	LOS ANGELES	CA	90064	5056	19	06037	34.03273663	-118.4516927	Los Angeles County
234703	Fee-for-Service	1699739912	1699739912	1	1	FIELD, BOB G MD INC	7/12/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	22056	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1111 SONOMA AVE	STE 316	SANTA ROSA	CA	95405	4820	49	06097	38.442042	-122.700033	Sonoma County
234809	Fee-for-Service	1285743120	1285743120	1	1	FELDMAN, MITCHELL D MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66943	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
234840	Fee-for-Service	1811122799	1811122799	1	1	FRANKLIN RUTLAND, CEDRIC J	6/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135347	29	Pulmonary Diseases (M.D. only)	0	In state provider	MD	4234 RIVERWALK PARKWAY	SUITE 230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
234881	Fee-for-Service	1457647067	1457647067	1	1	FERENCE, ELISABETH D H MD	5/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139909	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 MEDICAL PLAZA	SUITE 550	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
234911	Fee-for-Service	1700913464	1700913464	1	1	FARHADY, PARASTOO MD	8/4/2014	282NW0100X	NA	Hospitals	026	PHYSICIANS	108700	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
234918	Fee-for-Service	1912264862	1912264862	1	7	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PARTNERS	1541 FLORIDA AVE	STE 101	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
234925	Fee-for-Service	1043398134	1043398134	1	1	FERNANDES, ELIZABETH MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30309	01	General Practice	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
234957	Fee-for-Service	1083865158	1083865158	1	1	FELIX-TRUNNELLE,ELIZABETH MD	10/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97330	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ELIZABETH MD	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
235088	Fee-for-Service	1154448876	1154448876	1	1	FRANCO, CARLO D MD	1/30/2024	207L00000X	NA	Other	026	PHYSICIANS	166556	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
235093	Fee-for-Service	1780689406	1780689406	1	1	FOGLAR, CHRISTIAN MD	8/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54508	20	Orthopedic Surgery	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
235122	Fee-for-Service	1811342926	1811342926	1	1	FIORINI, FRANCHESCA	4/8/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1635 LAKE SAN MARCOS DR	STE 108	SAN MARCOS	CA	92078	4680	37	06073	33.12584927	-117.211016	San Diego County
235198	Fee-for-Service	1689307902	1689307902	1	1	FENN, MATTHEW LMFT	12/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	302 W 5TH ST STE 308	None	SAN PEDRO	CA	90731	2750	19	06037	33.73971572	-118.284045	Los Angeles County
235208	Fee-for-Service	1912264862	1912264862	1	7	FIRST CHOICE PHYSICIAN PARTN	11/2/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PARTNERS	1541 FLORIDA AVE	STE 101	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
235231	Fee-for-Service	1285740464	1285740464	1	1	FITZGIBBONS, TERRENCE MD	9/30/1980	2086S0129X	NA	General Surgery	026	PHYSICIANS	32025	02	General Surgery	0	In state provider	None	1245 WILSHIRE BLVD	STE 905	LOS ANGELES	CA	90017	4809	19	06037	34.05362775	-118.2661889	Los Angeles County
235347	Fee-for-Service	1588616866	1588616866	1	1	FRANKS, JON B MD	5/9/1996	207L00000X	NA	Other	026	PHYSICIANS	54245	05	Anesthesiology	0	In state provider	None	1 DANIEL BURNHAM CT	STE 350-C	SAN FRANCISCO	CA	94109	5455	38	06075	37.78693724	-122.4225429	San Francisco County
235472	Fee-for-Service	1285709725	1285709725	1	1	FIROOZNAM,POPAK MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102037	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
235574	Fee-for-Service	1275242125	1275242125	1	1	FABER, JAKE A NP	1/13/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
235663	Fee-for-Service	1477964062	1477964062	1	1	FUNG, PO Y LPCC	3/7/2022	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
235679	Fee-for-Service	1114223989	1114223989	1	1	FERRIS WILLIAMS, SYDNEY E LC	12/28/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SW	2417 CENTRAL AVE	None	ALAMEDA	CA	94501	4515	01	06001	37.76389996	-122.2420612	Alameda County
235686	Fee-for-Service	1518566074	1518566074	1	1	FRONTLINE HOME HEALTH CARE	11/6/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	9198 GREENBACK LANE	SUITE 101	ORANGEVALE	CA	95662	4770	34	06067	38.677905	-121.2122655	Sacramento County
235761	Fee-for-Service	1629072392	1629072392	1	1	FISHER, JACK E DPM	6/26/2009	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	80 5TH ST	None	GILROY	CA	95020	5702	43	06085	37.0080574	-121.5703312	Santa Clara County
235823	Fee-for-Service	1487674461	1487674461	1	1	FORSYTH, JOHN C MD	11/13/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	69235	None	None	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
235836	Fee-for-Service	1720404288	1720404288	1	1	FREEDOM HOME HEALTH AND	10/21/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE SERVICES IN	519 D STREET	SUITE A	MARYSVILLE	CA	95901	5525	58	06115	39.14100286	-121.5890324	Yuba County
235849	Fee-for-Service	1104861681	1104861681	1	2	FAMILY HEALTH CTRS OF SD	12/8/2011	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1234 BROADWAY	None	EL CAJON	CA	92101	4901	37	06073	32.80773552	-116.9384985	San Diego County
235862	Fee-for-Service	1942388715	1942388715	1	1	FORD, LAWRENCE A DPM	5/10/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
235919	Fee-for-Service	1922189216	1922189216	1	1	FARID, MARY	1/31/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9007	10	Gastroenterology (M.D. only)	0	In state provider	None	2701 W ALAMEDA AVE	STE 206	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
235962	Fee-for-Service	1720296007	1720296007	1	1	FERGUSON, TERESA M MD	8/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106151	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
235978	Fee-for-Service	1912264862	1912264862	1	12	FIRST CHOICE PHYSICIAN PARTN	8/26/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	880 E TUOLOMNE RD	STE 103	TURLOCK	CA	95382	1550	50	06099	37.51459247	-120.837519	Stanislaus County
236007	Fee-for-Service	1104800747	1104800747	1	1	FOX, LAURA E MD INC	3/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	32893	18	Ophthalmology	0	In state provider	None	416 N BEDFORD DR	STE 300	BEVERLY HILLS	CA	90210	4309	19	06037	34.06819809	-118.4052828	Los Angeles County
236086	Fee-for-Service	1336141159	1336141159	1	1	FORNER, STEPHEN D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35751	01	General Practice	0	In state provider	None	1405 MAGNOLIA AVE	None	CHICO	CA	95926	3226	04	06007	39.74046859	-121.8497839	Butte County
236112	Fee-for-Service	1790051423	1790051423	1	1	FAMILY HEALTH CARE CENTERS O	3/1/2018	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LA INC	12113 WOODRUFF AVE	STE A	DOWNEY	CA	90241	5605	19	06037	33.9238587	-118.11678	Los Angeles County
236127	Fee-for-Service	1457441974	1457441974	1	1	FARAG, BASEM MD	12/19/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53207	None	None	0	In state provider	None	7828 HAVEN AVE	215	RANCHO CUCAMONGA	CA	91730	3049	36	06071	34.111854	-117.5759995	San Bernardino County
236138	Fee-for-Service	1104861681	1104861681	1	2	FAMILY HEALTH CTRS OF SD	12/8/2011	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1234 BROADWAY	None	EL CAJON	CA	92101	4901	37	06073	32.80773552	-116.9384985	San Diego County
236201	Fee-for-Service	1871670117	1871670117	1	1	FOOTHILL NURSING COMPANY	4/13/1990	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	PARTNERSHIP	401 W ADA AVE	None	GLENDORA	CA	91741	4241	19	06037	34.13242449	-117.869571	Los Angeles County
236208	Fee-for-Service	1235193665	1235193665	1	1	FOWLER, TIMOTHY P	12/23/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
236250	Fee-for-Service	1790154862	1790154862	1	3	FAMILY HEALTHCARE NETWORK	1/10/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	324 N VERMONT AVENUE	None	DINUBA	CA	93618	1631	54	06107	36.54780049	-119.3894155	Tulare County
236267	Fee-for-Service	1912264862	1912264862	1	12	FIRST CHOICE PHYSICIAN PARTN	8/26/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	880 E TUOLOMNE RD	STE 103	TURLOCK	CA	95382	1550	50	06099	37.51459247	-120.837519	Stanislaus County
236277	Fee-for-Service	1093360976	1093360976	1	1	FIRST AMERICAN HOME HEALTH	8/4/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	436 W COLORADO ST	SUITE 213	GLENDALE	CA	91204	1568	19	06037	34.14249549	-118.2624705	Los Angeles County
236348	Fee-for-Service	1104351006	1104351006	1	1	FOSSUM, CROIX MD	7/1/2022	2085R0001X	NA	Other	026	PHYSICIANS	159160	None	None	0	In state provider	None	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	37	06073	32.8002375	-117.1546269	San Diego County
236350	Fee-for-Service	1326488040	1326488040	1	1	FAN, DAVID S MD	10/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140367	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
236399	Fee-for-Service	1790051423	1790051423	1	1	FAMILY HEALTH CARE CENTERS O	6/6/2014	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LA INC	12113 WOODRUFF AVE	STE A	DOWNEY	CA	90241	5605	19	06037	33.9238587	-118.11678	Los Angeles County
236426	Fee-for-Service	1508925181	1508925181	1	1	FONG, PATRICK D MD	9/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77549	45	Nephrology (Renal-Kidney)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
236464	Fee-for-Service	1083750186	1083750186	1	1	FLOREZA, ARTHUR R MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	76400	36	Psychiatry	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
236482	Fee-for-Service	1043378409	1043378409	1	1	FENN, ARTHUR C MD	10/18/1972	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	13883	04	Otology, Laryngology, Rhinology	0	In state provider	None	1000 S ELISEO DR	STE 103	GREENBRAE	CA	94904	2150	21	06041	37.94348559	-122.5335273	Marin County
236537	Fee-for-Service	1790154862	1790154862	1	3	FAMILY HEALTHCARE NETWORK	6/18/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	324 N VERMONT AVENUE	None	DINUBA	CA	93618	1631	54	06107	36.54780049	-119.3894155	Tulare County
236639	Fee-for-Service	1114034055	1114034055	1	1	FODRAN, KIMBERLY A MD	8/29/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96275	None	None	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
236671	Fee-for-Service	1568668366	1568668366	1	1	FONG, MICHAEL K MD	7/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	61085	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
236687	Fee-for-Service	1790051423	1790051423	1	1	FAMILY HEALTH CARE CENTERS O	6/6/2014	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LA INC	12113 WOODRUFF AVE	STE A	DOWNEY	CA	90241	5605	19	06037	33.9238587	-118.11678	Los Angeles County
236708	Fee-for-Service	1437221876	1437221876	1	1	FOSS, JOHN D MD	8/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53795	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
236745	Fee-for-Service	1194353755	1194353755	1	1	FRANCIS, MUNIB J DO	11/13/2023	207R00000X	NA	Other	026	PHYSICIANS	20699	None	None	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
236771	Fee-for-Service	1104883149	1104883149	1	1	FUJII, JOHN K	9/4/1991	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3133 W MARCH LN	STE 2020	STOCKTON	CA	95219	2361	39	06077	37.98412533	-121.3519903	San Joaquin County
236825	Fee-for-Service	1790154862	1790154862	1	3	FAMILY HEALTHCARE NETWORK	6/18/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	324 N VERMONT AVENUE	None	DINUBA	CA	93618	1631	54	06107	36.54780049	-119.3894155	Tulare County
236855	Fee-for-Service	1831799824	1831799824	1	1	FULL CARE HOSPICE AND	10/23/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE INC	509 MARIN ST	STE 221	THOUSAND OAKS	CA	91360	4230	56	06111	34.18371146	-118.8824904	Ventura County
236886	Fee-for-Service	1811960966	1811960966	1	1	FREEMAN, MARLENE H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	87122	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1860 PENNSYLVANIA AVE	STE 300A	FAIRFIELD	CA	94533	3550	48	06095	38.261952	-122.0498745	Solano County
236898	Fee-for-Service	1942468830	1942468830	1	1	FERRANTE, KIMBERLY L MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120761	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
236959	Fee-for-Service	1649479767	1649479767	1	1	FAROOQI, NAGHMA A MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	93118	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
236963	Fee-for-Service	1912264862	1912264862	1	16	FIRST CHOICE PHYSICIAN PARTN	4/8/2019	207Q00000X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1262 E NORTH ST	None	MANTECA	CA	95336	4962	39	06077	37.80103784	-121.1964105	San Joaquin County
237042	Fee-for-Service	1801811013	1801811013	1	1	FERREIRA, ALEXANDER MD	12/14/2007	207RH0003X	NA	Oncology	026	PHYSICIANS	68641	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
237072	Fee-for-Service	1851331094	1851331094	1	1	FREUDMAN, JONATHAN M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42881	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
237092	Fee-for-Service	1194863811	1194863811	1	1	F & R MEDICAL SUPPLY	2/14/2008	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	F & R MEDICAL SUPPLY	14465 MAIN ST	SUITE 4	HESPERIA	CA	92345	4699	36	06071	34.42670736	-117.347273	San Bernardino County
237121	Fee-for-Service	1003642414	1003642414	1	1	FADER, TODD OT	1/29/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	13313 PALM DR.	B - C	DESERT HOT SPRING	CA	92240	5980	33	06065	33.951663	-116.501339	Riverside County
237133	Fee-for-Service	1902225089	1902225089	1	1	FELDMAN, ALINA K MD	9/28/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	141330	30	Radiology	0	In state provider	None	10101 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2517	19	06037	34.15223753	-118.3508865	Los Angeles County
237136	Fee-for-Service	1598767204	1598767204	1	1	FLETCHER, KIMBERLY MD	6/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	75956	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
237143	Fee-for-Service	1831799824	1831799824	1	1	FULL CARE HOSPICE AND	10/23/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE INC	509 MARIN ST	STE 221	THOUSAND OAKS	CA	91360	4230	56	06111	34.18371146	-118.8824904	Ventura County
237177	Fee-for-Service	1811960966	1811960966	1	1	FREEMAN, MARLENE H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	87122	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1860 PENNSYLVANIA AVE	STE 300A	FAIRFIELD	CA	94533	3550	48	06095	38.261952	-122.0498745	Solano County
237253	Fee-for-Service	1912264862	1912264862	1	16	FIRST CHOICE PHYSICIAN PARTN	4/8/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	1262 E NORTH ST	None	MANTECA	CA	95336	4962	39	06077	37.80103784	-121.1964105	San Joaquin County
237337	Fee-for-Service	1912292814	1912292814	1	1	FUNG, JULIA W MD	6/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139024	40	Pediatrics	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
237359	Fee-for-Service	1851331094	1851331094	1	1	FREUDMAN, JONATHAN M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42881	41	Internal Medicine	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
237368	Fee-for-Service	1902858194	1902858194	1	1	FAROOQI, MUBASHIR A MD	9/24/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	56486	36	Psychiatry	0	In state provider	None	1809 W. REDLANDS BLVD	None	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
237369	Fee-for-Service	1649435629	1649435629	1	1	FRIEDMAN, OREN A MD	5/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141852	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
237375	Fee-for-Service	1063700797	1063700797	1	1	FELKEY, ERIN R CRNA	2/23/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
237460	Fee-for-Service	1285715763	1285715763	1	1	FARR, ELIZABETH PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11500 W OLYMPIC BLVD	STE 400	LOS ANGELES	CA	90064	1525	19	06037	34.03617514	-118.4445122	Los Angeles County
237517	Fee-for-Service	1376540245	1376540245	1	1	FIRESTONE, MARVIN H	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	19295	36	Psychiatry	0	In state provider	ASSOCIATES IN NEUROPSYCH	520 S EL CAMINO REAL	STE 310	SAN MATEO	CA	94402	1716	41	06081	37.56127622	-122.3241196	San Mateo County
237616	Fee-for-Service	1669678405	1669678405	1	1	FORD, LINDA M LCSW	6/30/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
237630	Fee-for-Service	1265404123	1265404123	1	1	FISCHBACH, DAVID P MD	9/29/2008	207L00000X	NA	Other	026	PHYSICIANS	38037	05	Anesthesiology	0	In state provider	None	332 S JUNIPER ST	STE 108	ESCONDIDO	CA	92025	4941	37	06073	33.12066536	-117.0770413	San Diego County
237639	Fee-for-Service	1184619447	1184619447	1	1	FARUQUI, AAMIR A MD	12/4/2008	207RC0200X	NA	Other	026	PHYSICIANS	70207	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2121 YGNACIO VALLEY RD	#E104	WALNUT CREEK	CA	94598	3383	07	06013	37.92145513	-122.0324849	Contra Costa County
237655	Fee-for-Service	1649435629	1649435629	1	1	FRIEDMAN, OREN A MD	5/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141852	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
237657	Fee-for-Service	1578176301	1578176301	1	1	FARNAN, ASH LCSW	11/12/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5000 W SUNSET BLVD	FL 4	LOS ANGELES	CA	90027	5861	19	06037	34.0981066	-118.2986382	Los Angeles County
237681	Fee-for-Service	1073855342	1073855342	1	1	FISHER, TAMARA D	1/19/2016	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	2710 TELEGRAPH AVE	SUITE 230	OAKLAND	CA	94612	1771	01	06001	37.81647593	-122.2677965	Alameda County
237689	Fee-for-Service	1679988331	1679988331	1	1	FIGONI, ANDREW M MD	10/21/2022	207XS0114X	NA	Orthopedic Surgery	026	PHYSICIANS	151908	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
237716	Fee-for-Service	1790051423	1790051423	1	3	FAMILY HEALTH CARE CENTERS O	5/9/2024	261QC1500X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	EALTH CENTER	21409 ELAINE AVE	None	HAWAIIAN GARDENS	CA	90716	1025	19	06037	33.835293	-118.076536	Los Angeles County
237796	Fee-for-Service	1851368419	1851368419	1	1	FERRUCCI, VANESSA OD	9/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12661 GLENOAKS BLVD	None	SYLMAR	CA	91342	4748	19	06037	34.30062663	-118.4407393	Los Angeles County
237800	Fee-for-Service	1376540245	1376540245	1	1	FIRESTONE, MARVIN H	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	19295	27	Psychiatry Neurology (D.O. only)	0	In state provider	ASSOCIATES IN NEUROPSYCH	520 S EL CAMINO REAL	STE 310	SAN MATEO	CA	94402	1716	41	06081	37.56127622	-122.3241196	San Mateo County
237826	Fee-for-Service	1780609966	1780609966	1	1	FIGLIN, ROBERT MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35300	41	Internal Medicine	0	In state provider	U C L A	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
237835	Fee-for-Service	1093802498	1093802498	1	1	FERRARI, BERNARDO MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	51261	20	Orthopedic Surgery	0	In state provider	None	596 CARROLL ST	None	SUNNYVALE	CA	94086	6207	43	06085	37.36853041	-122.0305901	Santa Clara County
237842	Fee-for-Service	1912264862	1912264862	1	1	FIRST CHOICE PHYSICIAN PARTN	6/22/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1541 FLORIDA AVE	STE 100	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
237900	Fee-for-Service	1265484943	1265484943	1	1	FEIL, DENISE G MD	8/1/2022	2084P0805X	NA	Psychiatry	026	PHYSICIANS	61040	None	None	0	In state provider	None	924 WESTWOOD BLVD	515	LOS ANGELES	CA	90024	2926	19	06037	34.06309787	-118.4452763	Los Angeles County
237945	Fee-for-Service	1649435629	1649435629	1	1	FRIEDMAN, OREN A MD	5/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141852	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
238020	Fee-for-Service	1497393540	1497393540	1	1	FAMILY PHARMACY CENTER, INC.	3/6/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 W MAIN ST	STE. 102	EL CAJON	CA	92020	3461	37	06073	32.79498649	-116.964477	San Diego County
238129	Fee-for-Service	1912264862	1912264862	1	1	FIRST CHOICE PHYSICIAN PARTN	6/22/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	None	1541 FLORIDA AVE	STE 100	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
238160	Fee-for-Service	1912004920	1912004920	1	2	FACULTY PHYSICIANS AND SURGE	8/16/2019	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	ONS OF LLUSM	28062 BAXTER RD	None	MURRIETA	CA	92563	1401	33	06065	33.61350847	-117.1691225	Riverside County
238214	Fee-for-Service	1598382988	1598382988	1	1	FLOURISH FAMILY COUNSELING,	12/28/2022	106H00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41911 5TH ST	STE 103	TEMECULA	CA	92590	2730	33	06065	33.49563559	-117.1495713	Riverside County
238218	Fee-for-Service	1124577952	1124577952	1	1	FARRAR, COURTNEY PT	5/2/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	302	SAN DIEGO	CA	92108	1161	37	06073	32.77677653	-117.1592911	San Diego County
238261	Fee-for-Service	1073856654	1073856654	1	1	FULTON, SHANEE CCC-SLP	2/6/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 CAMERON AVE	108	WEST COVINA	CA	91790	2718	19	06037	34.06970547	-117.943734	Los Angeles County
238270	Fee-for-Service	1912004920	1912004920	1	1	FACULTY PHYSICIANS AND SURGE	6/22/2016	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	SURGEONS OF LLUSM	28078 BAXTER RD	510, 520	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
238285	Fee-for-Service	1871625426	1871625426	1	1	FERNANDEZ, TANYA D LCSW	2/2/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	308 W STATE ST	STE 3D	REDLANDS	CA	92373	4653	36	06071	34.05649746	-117.18603	San Bernardino County
238338	Fee-for-Service	1205151172	1205151172	1	1	FARID, NIKDOKHT MD	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94195	30	Radiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
238417	Fee-for-Service	1912264862	1912264862	1	1	FIRST CHOICE PHYSICIAN PARTN	6/22/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	None	1541 FLORIDA AVE	STE 100	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
238420	Fee-for-Service	1689639577	1689639577	1	1	FISHENFELD, JACO MD INC	1/1/1979	193400000X	NA	Other	026	PHYSICIANS	25575	41	Internal Medicine	0	In state provider	None	150 N JACKSON AVE	STE 1	SAN JOSE	CA	95116	1908	43	06085	37.36190683	-121.8468659	Santa Clara County
238422	Fee-for-Service	1679854657	1679854657	1	1	FRIXIONE, SUSAN T PSYD	3/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	39959 SIERRA HWY	STE A130	PALMDALE	CA	93550	3320	19	06037	34.60850218	-118.1223966	Los Angeles County
238445	Fee-for-Service	1912004920	1912004920	1	2	FACULTY PHYSICIANS AND SURGE	8/16/2019	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ONS OF LLUSM	28062 BAXTER RD	None	MURRIETA	CA	92563	1401	33	06065	33.61350847	-117.1691225	Riverside County
238464	Fee-for-Service	1689640856	1689640856	1	1	FREYNE, BRIGID M MD	12/4/2009	207R00000X	NA	Other	026	PHYSICIANS	64382	83	Rheumatology	0	In state provider	None	39755 MURRIETA HOT SPRIN	STE F110	MURRIETA	CA	92563	9119	33	06065	33.55575954	-117.1627899	Riverside County
238501	Fee-for-Service	1598382988	1598382988	1	1	FLOURISH FAMILY COUNSELING,	1/12/2022	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	41911 5TH ST	STE 103	TEMECULA	CA	92590	2730	33	06065	33.49563559	-117.1495713	Riverside County
238558	Fee-for-Service	1912004920	1912004920	1	1	FACULTY PHYSICIANS AND SURGE	10/31/2017	193200000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	SURGEONS OF LLUSM	28078 BAXTER RD	510, 520	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
238567	Fee-for-Service	1255803391	1255803391	1	1	FARIAS, CENNA F RCP	12/8/2023	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
238574	Fee-for-Service	1528661436	1528661436	1	1	FRAGA, ANA A CNP	4/20/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7915 FLORENCE AVE	None	LOS ANGELES	CA	90240	3801	19	06037	33.95424264	-118.1313464	Los Angeles
238593	Fee-for-Service	1013092758	1013092758	1	1	FEDERICO, MONICA J. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
238600	Fee-for-Service	1497154959	1497154959	1	1	FOGEL, RICHARD M JR NP	5/31/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
238706	Fee-for-Service	1689639577	1689639577	1	1	FISHENFELD, JACO MD INC	1/1/1979	193400000X	NA	Other	026	PHYSICIANS	25575	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	150 N JACKSON AVE	STE 1	SAN JOSE	CA	95116	1908	43	06085	37.36190683	-121.8468659	Santa Clara County
238708	Fee-for-Service	1437225273	1437225273	1	1	FOSTER, KIM M RN	12/1/2003	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	2	Out of state provider	None	1709 LAKE CLIFF HILLS LN	None	AUSTIN	TX	78732	2464	00	None	30.35148913	-97.88786727	Travis County
238747	Fee-for-Service	1689640856	1689640856	1	1	FREYNE, BRIGID M MD	12/4/2009	207R00000X	NA	Other	026	PHYSICIANS	64382	41	Internal Medicine	0	In state provider	None	39755 MURRIETA HOT SPRIN	STE F110	MURRIETA	CA	92563	9119	33	06065	33.55575954	-117.1627899	Riverside County
238757	Fee-for-Service	1710070859	1710070859	1	1	FRANK, ERIC C LCSW	12/15/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	22363	-	NOT APPLICABLE	0	In state provider	None	200 EAST WASHINGTON	SUITE 100	ESCONDIDO	CA	92025	1806	37	06073	33.12748922	-117.0822898	San Diego County
238762	Fee-for-Service	1114240371	1114240371	1	1	FAMILY MEDICAL CLINIC AND	7/28/2011	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	URGENT CARE INC	9723 SIERRA VISTA RD	UNIT A	PHELAN	CA	92371	8271	36	06071	34.42689	-117.5659235	San Bernardino County
238784	Fee-for-Service	1558797118	1558797118	1	16	FIRST CHOICE PHYSICIAN PARTN	9/1/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	ARTNERS	1180 N INDIAN CANYON DR	W214	PALM SPRINGS	CA	92262	4857	33	06065	33.839505	-116.5455735	Riverside County
238789	Fee-for-Service	1598382988	1598382988	1	1	FLOURISH FAMILY COUNSELING,	3/15/2022	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	41911 5TH ST	STE 103	TEMECULA	CA	92590	2730	33	06065	33.49563559	-117.1495713	Riverside County
238822	Fee-for-Service	1821179656	1821179656	1	2	FRESNO COMMUNITY	4/18/2002	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL & MEDICAL CTR	215 N FRESNO ST	SUITE 150	FRESNO	CA	93721	1324	10	06019	36.74538	-119.781566	Fresno County
238849	Fee-for-Service	1912004920	1912004920	1	1	FACULTY PHYSICIANS AND SURGE	9/29/2006	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM	28078 BAXTER RD	510, 520	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
238877	Fee-for-Service	1801144563	1801144563	1	1	FOREMAN, PATRICK C LMFT	11/6/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	102254	-	NOT APPLICABLE	0	In state provider	None	1885 LUNDY AVE	STE 223	SAN JOSE	CA	95131	1887	43	06085	37.39329538	-121.8907367	Santa Clara County
238902	Fee-for-Service	1285002733	1285002733	1	1	FANCHER, SEAN K	10/10/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
238994	Fee-for-Service	1437225273	1437225273	1	1	FOSTER, KIM M RN	9/20/2005	163WC0400X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1709 LAKE CLIFF HILLS LN	None	AUSTIN	TX	78732	2464	00	None	30.35148913	-97.88786727	Travis County
239011	Fee-for-Service	1669448205	1669448205	1	1	FINDLAY,COLIN L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3000 COLISEUM DR	None	HAMPTON	VA	23666	5963	00	None	37.05701869	-76.39237365	Hampton city
239073	Fee-for-Service	1558797118	1558797118	1	16	FIRST CHOICE PHYSICIAN PARTN	9/1/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ARTNERS	1180 N INDIAN CANYON DR	W214	PALM SPRINGS	CA	92262	4857	33	06065	33.839505	-116.5455735	Riverside County
239078	Fee-for-Service	1174845085	1174845085	1	1	FERNANDEZ, LINDA	3/15/2010	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2067 MARTER AVE	None	SIMI VALLEY	CA	93065	2431	56	06111	34.273809	-118.7599975	Ventura County
239095	Fee-for-Service	1144384678	1144384678	1	1	FENTON, ROSALIND NP	3/26/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	230 PROSPECT PLACE	SUITE 340B	CORONADO	CA	92118	1991	37	06073	32.69468235	-117.1677128	San Diego County
239100	Fee-for-Service	1477843720	1477843720	1	1	FREDRIKSEN, JASON R MD	2/4/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	3269 N STOCKTON HILL RD	None	KINGMAN	AZ	86409	3619	00	None	35.220006	-114.0380145	Mohave County
239116	Fee-for-Service	1710900584	1710900584	1	1	FRANDSEN, DAVID L NP	5/5/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
239146	Fee-for-Service	1245349851	1245349851	1	1	FISHER, HENRY A MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64535	10	Gastroenterology (M.D. only)	0	In state provider	None	2701 W ALAMEDA AVE	STE 206	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
239280	Fee-for-Service	1437559259	1437559259	1	1	FELDMAN, BONNIE J MFT	5/25/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45325	-	NOT APPLICABLE	0	In state provider	None	5675 WEST OLYMPIC BLVD	None	LOS ANGELES	CA	90036	4712	19	06037	34.05742688	-118.3532118	Los Angeles County
239321	Fee-for-Service	1720009160	1720009160	1	1	FREDERICK, RICHARD MD	5/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	71441	10	Gastroenterology (M.D. only)	0	In state provider	None	2340 CLAY ST	None	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
239353	Fee-for-Service	1730461930	1730461930	1	1	FORD, TERA G PHD	1/26/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	12501 IMPERIAL HIGHWAY	SUITE 400	NORWALK	CA	90650	1419	19	06037	33.91723852	-118.065834	Los Angeles County
239360	Fee-for-Service	1558797118	1558797118	1	16	FIRST CHOICE PHYSICIAN PARTN	9/1/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	ARTNERS	1180 N INDIAN CANYON DR	W214	PALM SPRINGS	CA	92262	4857	33	06065	33.839505	-116.5455735	Riverside County
239371	Fee-for-Service	1083714802	1083714802	1	1	FINLAYSON, EMILY V MD	10/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	68290	28	Proctology (colon and rectal)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
239434	Fee-for-Service	1245349851	1245349851	1	1	FISHER, HENRY A MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64535	41	Internal Medicine	0	In state provider	None	2701 W ALAMEDA AVE	STE 206	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
239462	Fee-for-Service	1801116249	1801116249	1	1	FRANK, PATRICK J DO	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3001 ST ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
239484	Fee-for-Service	1447367156	1447367156	1	1	FARRELL,JAMES P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	320 THOMAS MORE	PARKWAY	CRESTVIEW HILL	KY	41017	0000	00	None	39.02426239	-84.56780998	Kenton County
239488	Fee-for-Service	1962469460	1962469460	1	1	FRIDAY, JANET H MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85207	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
239542	Fee-for-Service	1881914075	1881914075	1	1	FLOOD, ADAM C DO	9/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	3001 ST ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
239580	Fee-for-Service	1316059751	1316059751	1	1	FERNANDEZ DE SOTO, MATEO	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40927	36	Psychiatry	0	In state provider	None	7108 N FRESNO ST	STE 270	FRESNO	CA	93720	2952	10	06019	36.83973143	-119.7814257	Fresno County
239617	Fee-for-Service	1477631661	1477631661	1	1	FAURIA, QUINN M DPM	9/27/2007	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	14400 BEAR VALLEY RD	STE 201	VICTORVILLE	CA	92392	5406	36	06071	34.473717	-117.347913	San Bernardino County
239652	Fee-for-Service	1730415605	1730415605	1	1	FUNK, BONNI R LPCC	11/22/2024	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
239663	Fee-for-Service	1801987722	1801987722	1	1	FEDOR, GEORGE P MD	4/27/2018	207L00000X	NA	Other	026	PHYSICIANS	52838	05	Anesthesiology	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91970	3940	19	06037	34.062852	-117.9446658	Los Angeles County
239671	Fee-for-Service	1265482368	1265482368	1	1	FAYAZ A SHAWL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7620 CARROLL AVE #200	None	TAKOMA PARK	MD	20912	0000	00	None	38.986182	-77.0004225	Montgomery County
239728	Fee-for-Service	1730147935	1730147935	1	1	FRIEDMAN, SIDNEY G MD	11/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	32331	None	None	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
239775	Fee-for-Service	1962469460	1962469460	1	1	FRIDAY, JANET H MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85207	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
239786	Fee-for-Service	1962521419	1962521419	1	1	FIROOZNIA, NILOFAR MD	12/22/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	109806	30	Radiology	0	In state provider	None	25395 HANCOCK AVE	STE 200	MURRIETA	CA	92562	9054	33	06065	33.5591482	-117.185187	Riverside County
239828	Fee-for-Service	1881420255	1881420255	1	1	FRANK, KRISTINE LCSW	9/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	71687 HIGHWAY 111	SUITE 205	RANCHO MIRAGE	CA	92270	4515	33	06065	33.74279697	-116.4137932	Riverside County
239853	Fee-for-Service	1255304432	1255304432	1	1	FELDMAN, HEIDI M MD	9/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	43373	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
239932	Fee-for-Service	1629120308	1629120308	1	1	FROHOCK, SARAH E LCSW	8/18/2014	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	572 RIO LINDO	STE 104E	CHICO	CA	95926	1851	04	06007	39.75508407	-121.8487933	Butte County
240045	Fee-for-Service	1972837029	1972837029	1	1	FORD, RAYSEAN S LCSW	3/18/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	675 18TH STREET	None	SAN FRANCISCO	CA	94143	0984	38	06075	37.76085391	-122.4356007	San Francisco County
240062	Fee-for-Service	1376566455	1376566455	1	1	FEIG, KEVIN P MD	7/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86632	02	General Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
240133	Fee-for-Service	1891971131	1891971131	1	1	FARID, SAMY F MD INC	2/19/2008	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1729 W AVENUE J	SUITE 101	LANCASTER	CA	93534	4014	19	06037	34.68944953	-118.162287	Los Angeles County
240144	Fee-for-Service	1255304432	1255304432	1	1	FELDMAN, HEIDI M MD	9/20/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	43373	49	Unknown	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
240150	Fee-for-Service	1679651384	1679651384	1	1	FANG, CHIH-CHEN MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	33931	05	Anesthesiology	0	In state provider	None	1820 TRIBUTE RD	STE J	SACRAMENTO	CA	95815	4307	34	06067	38.599578	-121.444326	Sacramento County
240217	Fee-for-Service	1912264862	1912264862	1	25	FIRST CHOICE PHYSICIAN PARTN	11/8/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	ARTNERS	1541 FLORIDA AVE	SUITE 305	MODESTO	CA	95350	4439	50	06099	37.666863	-120.9962775	Stanislaus County
240252	Fee-for-Service	1295864791	1295864791	1	1	FLEDDERJOHANN, MELISSA B PHD	11/7/2011	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
240254	Fee-for-Service	1033255948	1033255948	2	1	FRIZZELL, JILL A LCSW	9/15/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	632 9TH ST	A-4	ARCATA	CA	95521	6273	12	06023	40.86874075	-124.0852106	Humboldt County
240278	Fee-for-Service	1376897462	1376897462	1	1	FERRACO, INC.	6/27/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS	8734 CLETA ST	C	DOWNEY	CA	90241	5279	19	06037	33.93117166	-118.1284171	Los Angeles County
240285	Fee-for-Service	1437100278	1437100278	1	1	FAHIMIAN, NIMA A MD	8/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85986	36	Psychiatry	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
240295	Fee-for-Service	1538178355	1538178355	1	1	FISHER, TED Y MD	4/20/2020	207P00000X	NA	Other	026	PHYSICIANS	52523	66	Emergency Medicine (Urgent Care)	0	In state provider	None	628 G ST	None	BRAWLEY	CA	92227	2544	13	06025	32.97749348	-115.531407	Imperial County
240301	Fee-for-Service	1912264862	1912264862	1	5	FIRST CHOICE PHYSICIAN PARTN	10/14/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	PARTNERS	1144 NORMAN DRIVE	SUITE 203B	MANTECA	CA	95336	5960	39	06077	37.79425166	-121.1998524	San Joaquin County
240312	Fee-for-Service	1205154705	1205154705	1	1	FORREST, JEFFREY S MD	2/11/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	156743	-	NOT APPLICABLE	0	In state provider	None	14140 BEACH BLVD	STE 120, 155, 200	WESTMINSTER	CA	92683	4453	30	06059	33.756966	-117.9894915	Orange County
240348	Fee-for-Service	1225514755	1225514755	1	1	FRISCHTAK, HELENA L MD	10/7/2019	390200000X	NA	Other	026	PHYSICIANS	163486	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
240419	Fee-for-Service	1053637918	1053637918	1	1	FUENTES, JANICE R MD	11/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118821	13	Neurology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
240450	Fee-for-Service	1861680084	1861680084	1	1	FU, CASEY MD INC	7/23/2008	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	79788	10	Gastroenterology (M.D. only)	0	In state provider	None	630 S RAMOND AVE	#240	PASADENA	CA	91105	3283	19	06037	34.13505223	-118.1487761	Los Angeles County
240507	Fee-for-Service	1912264862	1912264862	1	25	FIRST CHOICE PHYSICIAN PARTN	11/8/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	ARTNERS	1541 FLORIDA AVE	SUITE 305	MODESTO	CA	95350	4439	50	06099	37.666863	-120.9962775	Stanislaus County
240629	Fee-for-Service	1952755407	1952755407	1	1	FARZANEH, CYRUS A MD	10/7/2019	208600000X	NA	General Surgery	026	PHYSICIANS	151160	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
240668	Fee-for-Service	1114094133	1114094133	1	1	FRIEDMAN, MITCHELL S MD	1/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	66479	05	Anesthesiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
240745	Fee-for-Service	1275583205	1275583205	1	1	FACULTY PHYS & SURGNS	12/16/2004	106H00000X	NA	Mental Health Outpatient Services	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	OF LLUSM-SURG AUDIOLOGY	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
240793	Fee-for-Service	1912264862	1912264862	1	25	FIRST CHOICE PHYSICIAN PARTN	11/8/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	ARTNERS	1541 FLORIDA AVE	SUITE 305	MODESTO	CA	95350	4439	50	06099	37.666863	-120.9962775	Stanislaus County
240839	Fee-for-Service	1114075033	1114075033	1	1	FONTELERA, CLIFF CRNA	3/25/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	RMC MOB2	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
240851	Fee-for-Service	1184799496	1184799496	1	1	FINEBERG, MARTIN MD	9/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	40066	40	Pediatrics	0	In state provider	None	504 S SIERRA MADRE BLVD	None	PASADENA	CA	91107	5240	19	06037	34.137603	-118.101464	Los Angeles County
240907	Fee-for-Service	1730267337	1730267337	1	1	FULTON, REGAN S MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65436	22	Pathology (M.D. only)	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
240916	Fee-for-Service	1922297993	1922297993	1	1	FORD, CINDY A LMFT	12/30/2016	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
240958	Fee-for-Service	1114094133	1114094133	1	1	FRIEDMAN, MITCHELL S MD	1/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	66479	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
240979	Fee-for-Service	1821348509	1821348509	1	1	FEHLBERG, HANNAH E	12/13/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2577 SAMARITAN DR	STE 845	SAN JOSE	CA	95124	4110	43	06085	37.25246494	-121.9501879	Santa Clara County
240985	Fee-for-Service	1033321211	1033321211	1	1	FAHMY, MARIANNE H MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	94894	10	Gastroenterology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
241034	Fee-for-Service	1275583205	1275583205	1	1	FACULTY PHYS & SURGNS	6/1/1997	106H00000X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	OF LLUSM-SURG AUDIOLOGY	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
241100	Fee-for-Service	1508503509	1508503509	1	1	FOSTER, JORDAN CRNA	12/22/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
241110	Fee-for-Service	1821380049	1821380049	1	1	FOOT DOCTORS OF SANTA CRUZ C	1/13/2021	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	OUNTY INC A PODIATRY GRO	47 PENNY LN STE 1	None	WATSONVILLE	CA	95076	6055	44	06087	36.92995246	-121.778301	Santa Cruz County
241111	Fee-for-Service	1306091087	1306091087	1	1	FORBES, CHELSEA R MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91252	40	Pediatrics	0	In state provider	None	4647 ZION AVENUE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
241151	Fee-for-Service	1700285244	1700285244	1	1	FISCHER, ANDREW C MD	11/2/2017	207P00000X	NA	Other	026	PHYSICIANS	139692	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
241179	Fee-for-Service	1346494044	1346494044	1	1	FOREMAN, KRISTOPHER L MD	10/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131754	30	Radiology	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
241267	Fee-for-Service	1205087079	1205087079	1	1	FARMANI, NILOOFAR L MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105243	41	Internal Medicine	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
241319	Fee-for-Service	1407824600	1407824600	1	1	FIALLO, LUIS A MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51309	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
241321	Fee-for-Service	1275583205	1275583205	1	1	FACULTY PHYS & SURGNS	6/22/2016	106H00000X	NA	Mental Health Outpatient Services	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	OF LLUSM-SURG AUDIOLOGY	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
241400	Fee-for-Service	1821380049	1821380049	1	1	FOOT DOCTORS OF SANTA CRUZ C	1/13/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	OUNTY INC A PODIATRY GRO	47 PENNY LN STE 1	None	WATSONVILLE	CA	95076	6055	44	06087	36.92995246	-121.778301	Santa Cruz County
241405	Fee-for-Service	1770721649	1770721649	1	1	FRANCISCO, MARIE PEARL	3/23/2009	261QP2300X	NA	Other	026	PHYSICIANS	91644	08	Family Practice	0	In state provider	C MD INC	1805 N CALIFORNIA ST	STE 206	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
241497	Fee-for-Service	1437359940	1437359940	1	1	FLETCHER, GLORILYN T OD	3/2/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	164 W. HOSPITALITY LANE	STE.7	SAN BERNARDINO	CA	92408	3329	36	06071	34.06586648	-117.2866005	San Bernardino County
241544	Fee-for-Service	1750544714	1750544714	1	1	FARLEY, STEVEN M MD	12/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87770	02	General Surgery	0	In state provider	MGA OFFICE	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
241551	Fee-for-Service	1841336385	1841336385	1	1	FARJOODI, PAYAM	7/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112479	None	None	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
241607	Fee-for-Service	1407824600	1407824600	1	1	FIALLO, LUIS A MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51309	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
241617	Fee-for-Service	1275583205	1275583205	1	1	FACULTY PHYS & SURGNS	6/10/2019	106H00000X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	OF LLUSM-SURG AUDIOLOGY	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
241619	Fee-for-Service	1285787663	1285787663	1	1	FIELDS, RACHEL H PHD	7/18/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY STREET	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
241637	Fee-for-Service	1538562269	1538562269	1	1	FORET, MEGAN M PHD	2/9/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY STREET	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
241672	Fee-for-Service	1689683906	1689683906	1	1	FRIEDMAN, BARBARA D MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84349	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
241684	Fee-for-Service	1295027555	1295027555	1	1	FARHAT, MEETRA MD	8/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125327	41	Internal Medicine	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
241714	Fee-for-Service	1023350113	1023350113	1	1	FAN, BENSEN B MD	8/1/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	154107	20	Orthopedic Surgery	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
241739	Fee-for-Service	1760794424	1760794424	1	1	FAY, ALEXANDER J MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142330	79	Neurology-Child	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
241821	Fee-for-Service	1710167994	1710167994	1	1	FUNG, TIK L D MD	1/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	98198	13	Neurology (M.D. only)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
241826	Fee-for-Service	1124189535	1124189535	1	1	FULTON, AMANDA J CRNA	5/17/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
241960	Fee-for-Service	1689683906	1689683906	1	1	FRIEDMAN, BARBARA D MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84349	01	General Practice	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
241972	Fee-for-Service	1821145426	1821145426	1	1	FARHANGFAR, KAMYAR MD	11/10/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	62478	41	Internal Medicine	0	In state provider	None	2020 J STREET	None	SACRAMENTO	CA	95811	3120	34	06067	38.576331	-121.4791155	Sacramento County
241986	Fee-for-Service	1285866384	1285866384	1	1	FARRELL, KATE	10/15/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	None	33.786909	-112.129047	Maricopa County
242009	Fee-for-Service	1255408175	1255408175	1	1	FORMICHELLA, DONNA J MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	52587	01	General Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
242153	Fee-for-Service	1811988777	1811988777	1	1	FIRST CALL AMBULANCE SERVICE	12/10/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1877 AIR LANE DR	None	NASHVILLE	TN	37210	3811	00	None	36.14551694	-86.69893163	Davidson County
242165	Fee-for-Service	1427080613	1427080613	1	1	FIELDSTON, EVAN SCOTT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	34TH CIVIC & CENTER BLVD	None	PHILADELPHIA	PA	19104	0000	00	None	39.94709074	-75.19535506	Philadelphia County
242311	Fee-for-Service	1417056193	1417056193	1	1	FEATHER RIVER HOSPITAL	6/30/2006	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FEATHER RIVER HOM MED	1295 BILLE RD	None	PARADISE	CA	95969	3443	04	06007	39.77043457	-121.5985055	Butte County
242325	Fee-for-Service	1528489341	1528489341	1	1	FREEHILL, JEFFERY P LMFT	8/6/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2900 BRISTOL ST	SUITE G-201	COSTA MESA	CA	92626	5981	30	06059	33.67689875	-117.8872016	Orange County
242377	Fee-for-Service	1053522433	1053522433	1	1	FLEMING, WILLIAM K MD	8/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97279	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
242494	Fee-for-Service	1649351198	1649351198	1	1	FITZMORRIS, STEVE MD	8/12/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	55688	41	Internal Medicine	0	In state provider	None	395 TERRACINA BLVD	None	REDLANDS	CA	92373	4849	36	06071	34.036782	-117.2039042	San Bernardino County
242517	Fee-for-Service	1992720015	1992720015	1	1	FELLOWS, JASON R MD	7/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80641	05	Anesthesiology	0	In state provider	None	7417 N CEDAR AVE	None	FRESNO	CA	93720	3637	10	06019	36.844227	-119.7568975	Fresno County
242522	Fee-for-Service	1215296819	1215296819	1	1	FURMAN, ARIANNE S DO	2/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13111	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
242546	Fee-for-Service	1437137544	1437137544	1	1	FIEDLER,BRAIN SCOTT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	640 JACKSON STREET	None	ST PAUL	MN	55101	0000	00	None	44.95496967	-93.09587426	Ramsey County
242646	Fee-for-Service	1326086307	1326086307	1	1	FIGUERED, BRUCE V PHD	2/13/2003	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7200 PARKWAY DRIVE	STE 113	LA MESA	CA	91942	1534	37	06073	32.77297454	-117.0419524	San Diego County
242696	Fee-for-Service	1851318406	1851318406	1	1	FLOME, ROBERT C LMFT	9/12/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16195 SISKIYOU ROAD	SUITE 120A	APPLE VALLEY	CA	92307	1346	36	06071	34.54549098	-117.2671509	San Bernardino County
242702	Fee-for-Service	1962660928	1962660928	1	1	FAGHIHNIA, NILOFAR DPM	8/22/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5893 COPLEY DR	None	SAN DIEGO	CA	92111	7906	37	06073	32.84332697	-117.1728709	San Diego County
242705	Fee-for-Service	1649358540	1649358540	1	1	FLORESCA, FERNANDINO MD	8/2/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80360	40	Pediatrics	0	In state provider	None	250 BLOSSOM HILL RD	None	LOS GATOS	CA	95032	4420	43	06085	37.23453236	-121.9743969	Santa Clara County
242784	Fee-for-Service	1649351198	1649351198	1	1	FITZMORRIS, STEVE MD	8/12/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	55688	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	395 TERRACINA BLVD	None	REDLANDS	CA	92373	4849	36	06071	34.036782	-117.2039042	San Bernardino County
242850	Fee-for-Service	1063614196	1063614196	1	1	FUNES, WILLIAM O LMFT	11/8/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
242858	Fee-for-Service	1952490492	1952490492	1	1	FAYAD-MATTAR, JOSE MD	6/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53247	04	Otology, Laryngology, Rhinology	0	In state provider	None	2100 W 3RD ST	None	LOS ANGELES	CA	90057	1922	19	06037	34.06308947	-118.2733326	Los Angeles County
242932	Fee-for-Service	1578769923	1578769923	1	1	FEALK, MICHAEL H DO	1/14/2016	208C00000X	NA	General Surgery	026	PHYSICIANS	12901	28	Proctology (colon and rectal)	0	In state provider	None	2 GOVERNORS LANE	SUITE A	CHICO	CA	95926	1988	04	06007	39.75567003	-121.8588553	Butte County
242937	Fee-for-Service	1215314125	1215314125	1	1	FONG, TRACY MD	9/24/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	147530	08	Family Practice	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
242943	Fee-for-Service	1043770852	1043770852	1	1	FISHMAN, ALISA LCSW	2/16/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10251 SORRENTO VISTA PAR	SUITE 280	SAN DIEGO	CA	92121	3776	37	06073	32.89524013	-117.2142063	San Diego County
242969	Fee-for-Service	1053945972	1053945972	1	1	FIRST EXPRESSIONS SPEECH-LAN	3/15/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	GUAGE PATHOLOGY SERVICES	7262 IDYLLWILD LANE	None	RIVERSIDE	CA	92505	7111	33	06065	33.9616642	-117.4769903	Riverside County
243017	Fee-for-Service	1588946750	1588946750	1	1	FIRST RESCUE AMBULANCE INC	10/12/2016	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	15705 ARROW HWY	STE 2	IRWINDALE	CA	91706	2901	19	06037	34.1070655	-117.9378495	Los Angeles County
243064	Fee-for-Service	1750551792	1750551792	1	1	FRENCH, ANDREA L MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89239	02	General Surgery	0	In state provider	None	625 LINCOLN AVENUE	None	SAN JOSE	CA	95126	3705	43	06085	37.31809479	-121.9082315	Santa Clara County
243073	Fee-for-Service	1043684475	1043684475	1	1	FRY, KATHY E	4/25/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
243115	Fee-for-Service	1073846762	1073846762	1	1	FANI, FARSHAD M MD	3/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109454	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
243128	Fee-for-Service	1861880726	1861880726	1	1	FERNANDES, SAMANTHA MD	10/9/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	139816	15	Obstetrics (D.O. only)	0	In state provider	None	555 CASTRO ST	None	MOUNTAIN VIEW	CA	94041	2009	43	06085	37.38946454	-122.0815711	Santa Clara County
243140	Fee-for-Service	1912264862	1912264862	1	22	FIRST CHOICE PHYSICIAN PARTN	3/3/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	ARTNERS	5601 NORRIS CANYON RD	SUITE 300	SAN RAMON	CA	94583	2180	07	06013	37.77772182	-121.9579459	Contra Costa County
243144	Fee-for-Service	1144688334	1144688334	1	1	FENG, MICHELLE C PHD	3/18/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10801 NATIONAL BLVD	SUITE 611	LOS ANGELES	CA	90064	4170	19	06037	34.03101398	-118.4202342	Los Angeles County
243362	Fee-for-Service	1952629735	1952629735	1	1	FRIEDBERG, DAVID A MD	6/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112102	20	Orthopedic Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A36	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
243381	Fee-for-Service	1184778276	1184778276	1	1	FOO, BEVERLY A LCSW	12/11/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1001 SNEATH LN	None	SAN BRUNO	CA	94066	2308	41	06081	37.63462925	-122.4259247	San Mateo County
243399	Fee-for-Service	1619322815	1619322815	1	1	FELL, ROBERT J MD	12/2/2019	207R00000X	NA	Other	026	PHYSICIANS	160533	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
243405	Fee-for-Service	1730449844	1730449844	1	1	FANG, ANNIE Y MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129142	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
243429	Fee-for-Service	1912264862	1912264862	1	22	FIRST CHOICE PHYSICIAN PARTN	3/3/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ARTNERS	5601 NORRIS CANYON RD	SUITE 300	SAN RAMON	CA	94583	2180	07	06013	37.77772182	-121.9579459	Contra Costa County
243433	Fee-for-Service	1356496913	1356496913	1	1	FLOOD, PAMELA D MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88909	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
243518	Fee-for-Service	1073939948	1073939948	1	1	FRIIS, LANCE D LMFT	11/17/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
243522	Fee-for-Service	1598723348	1598723348	1	1	FOLIENTE, ROY L MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81098	10	Gastroenterology (M.D. only)	0	In state provider	None	300 SIERRA COLLEGE DR	STE 105	GRASS VALLEY	CA	95945	5084	29	06057	39.23625806	-121.054471	Nevada County
243717	Fee-for-Service	1912264862	1912264862	1	22	FIRST CHOICE PHYSICIAN PARTN	3/3/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	ARTNERS	5601 NORRIS CANYON RD	SUITE 300	SAN RAMON	CA	94583	2180	07	06013	37.77772182	-121.9579459	Contra Costa County
243758	Fee-for-Service	1487141677	1487141677	1	1	FLORES, GESSELLE C	3/11/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	801 SANTA FE WAY	None	SHAFTER	CA	93263	3158	15	06029	35.49142021	-119.260004	Kern County
243804	Fee-for-Service	1659436392	1659436392	1	1	FEE, WILLARD E JR MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	19012	04	Otology, Laryngology, Rhinology	0	In state provider	DEPT OF SURGERY	STANFORD UNIV MED CTR	None	STANFORD	CA	94305	0000	43	06085	37.41407916	-122.1574664	Santa Clara County
243832	Fee-for-Service	1922043934	1922043934	1	1	FARAH, HUSAM H MD	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75987	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
243851	Fee-for-Service	1124303540	1124303540	1	1	FULLER, KISHI LMFT	9/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
243880	Fee-for-Service	1467987321	1467987321	1	1	FATOLLAHI, JAVAD J MD	10/4/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	171147	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
243938	Fee-for-Service	1184763633	1184763633	1	1	FINSTAD, GARY A MD	2/28/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	43717	02	General Surgery	0	In state provider	None	4308 BIRCH ST	None	LAKE ISABELLA	CA	93240	9535	15	06029	35.63462797	-118.4063951	Kern County
243952	Fee-for-Service	1114034485	1114034485	1	1	FURMAN-ALEX, NANCY A MD	3/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7883	41	Internal Medicine	0	In state provider	None	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
244030	Fee-for-Service	1447294384	1447294384	1	1	FERGUSON, DIANE M MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	79787	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
244074	Fee-for-Service	1447665831	1447665831	1	1	FOTROS, ARYANDOKHT	11/21/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	144359	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	4045 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2021	15	06029	35.3540847	-119.0536548	Kern County
244091	Fee-for-Service	1730540006	1730540006	1	1	FUNG, DOROTHY M	9/21/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
244093	Fee-for-Service	1962761460	1962761460	1	1	FORSYTHE, CHRISTOPHER S MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134446	66	Emergency Medicine (Urgent Care)	0	In state provider	None	726 FOURTH STREET	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
244122	Fee-for-Service	1922043934	1922043934	1	1	FARAH, HUSAM H MD	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75987	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
244123	Fee-for-Service	1295052199	1295052199	1	1	FULLER, THOMAS N CRNA	11/7/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	207 W LEGION	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
244131	Fee-for-Service	1174651483	1174651483	1	1	FAMILY VISION CARE	10/21/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY OF MODESTO	817 COFFEE RD	STE D	MODESTO	CA	95355	4241	50	06099	37.655235	-120.975616	Stanislaus County
244153	Fee-for-Service	1679745996	1679745996	1	1	FINE, ESTHER L MD	2/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96924	84	Surgery-Head and Neck	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
244275	Fee-for-Service	1417935081	1417935081	1	1	FRENETTE, CATHERINE MD	5/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80461	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
244280	Fee-for-Service	1497511919	1497511919	1	1	FAMILY HEALTH CENTERS OF SAN	5/16/2024	2083A0300X	NA	Adult Primary Care	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	RTH CENTRAL BEHAVIORAL H	4930 NAPLES ST	None	SAN DIEGO	CA	92110	3820	37	06073	32.77013831	-117.2030986	San Diego County
244293	Fee-for-Service	1326317819	1326317819	1	1	FAMILY HEALTHCARE NETWORK	8/14/2012	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	730 N FARMERSVILLE BLVD	None	FARMERSVILLE	CA	93223	1220	54	06107	36.30345652	-119.2070774	Tulare County
244360	Fee-for-Service	1164581989	1164581989	1	1	FETHERSTON, TODD G LCSW	4/17/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1840 SIERRA GARDENS	None	ROSEVILLE	CA	95661	2912	31	06061	38.74730831	-121.2613758	Placer County
244376	Fee-for-Service	1558589382	1558589382	1	1	FU, BARBARA Y MD	12/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55381	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
244418	Fee-for-Service	1104861681	1104861681	1	1	FAMILY HEALTH CTRS OF SD	6/1/2000	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER	1111 WEST CHASE AVE	None	EL CAJON	CA	92020	5710	37	06073	32.78161035	-116.9764603	San Diego County
244441	Fee-for-Service	1679745996	1679745996	1	1	FINE, ESTHER L MD	2/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96924	04	Otology, Laryngology, Rhinology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
244550	Fee-for-Service	1295885002	1295885002	1	1	FUCHSHUBER, PASCAL R MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66285	02	General Surgery	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
244559	Fee-for-Service	1912264862	1912264862	1	20	FIRST CHOICE PHYSICIAN PARTN	12/10/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 201	MODESTO	CA	95350	4404	50	06099	37.66487562	-120.9961927	Stanislaus County
244566	Fee-for-Service	1417935081	1417935081	1	1	FRENETTE, CATHERINE MD	5/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80461	38	Geriatrics	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
244579	Fee-for-Service	1326317819	1326317819	1	1	FAMILY HEALTHCARE NETWORK	2/3/2012	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	730 N FARMERSVILLE BLVD	None	FARMERSVILLE	CA	93223	1220	54	06107	36.30345652	-119.2070774	Tulare County
244590	Fee-for-Service	1154814929	1154814929	1	1	FLORES, COURTNEY A LMFT	9/2/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7170 N FINANCIAL DR.	STE 110	FRESNO	CA	93720	2939	10	06019	36.84000952	-119.7711439	Fresno County
244599	Fee-for-Service	1013994359	1013994359	1	1	FAIRVIEW HEALTH SERVICES	6/19/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FAIRVIEW HEALTH SERVICES	2450 RIVERSIDE AVE	None	MINNEAPOLIS	MN	55454	1450	00	None	44.96613258	-93.23756795	Hennepin County
244620	Fee-for-Service	1972274330	1972274330	1	1	FAST, CHRISTOPHER R PT	3/25/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
244665	Fee-for-Service	1851422927	1851422927	1	1	FUNEZ ARTEAGA, MICHELLE L LC	9/27/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	23452	-	NOT APPLICABLE	0	In state provider	LCSW	1525 E 17TH ST	STE B	SANTA ANA	CA	92705	8521	30	06059	33.75994151	-117.846612	Orange County
244700	Fee-for-Service	1891789004	1891789004	1	1	FLAM, MARSHALL S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	20870	68	Hematology	0	In state provider	None	145 N CLARK ST	None	FRESNO	CA	93701	2108	10	06019	36.744102	-119.7860465	Fresno County
244705	Fee-for-Service	1104861681	1104861681	1	1	FAMILY HEALTH CTRS OF SD	6/1/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER	1111 WEST CHASE AVE	None	EL CAJON	CA	92020	5710	37	06073	32.78161035	-116.9764603	San Diego County
244712	Fee-for-Service	1851578819	1851578819	1	1	FABRIKANT, JERRY M DPM	1/1/1979	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	INC	5565 GROSSMONT CENTER DR	BLDG 3 # 353	LA MESA	CA	91942	3021	37	06073	32.77978322	-117.0094766	San Diego County
244846	Fee-for-Service	1912264862	1912264862	1	20	FIRST CHOICE PHYSICIAN PARTN	12/10/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 201	MODESTO	CA	95350	4404	50	06099	37.66487562	-120.9961927	Stanislaus County
244868	Fee-for-Service	1093770638	1093770638	1	1	FISHER-OWENS, SUSAN A MD	2/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87235	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
244870	Fee-for-Service	1326317819	1326317819	1	1	FAMILY HEALTHCARE NETWORK	2/3/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	730 N FARMERSVILLE BLVD	None	FARMERSVILLE	CA	93223	1220	54	06107	36.30345652	-119.2070774	Tulare County
244886	Fee-for-Service	1013994359	1013994359	1	1	FAIRVIEW HEALTH SERVICES	3/1/1997	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FAIRVIEW HEALTH SERVICES	2450 RIVERSIDE AVE	None	MINNEAPOLIS	MN	55454	1450	00	None	44.96613258	-93.23756795	Hennepin County
244904	Fee-for-Service	1477649572	1477649572	1	1	FREIRE, MONICA E LCSW	2/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
244930	Fee-for-Service	1063578250	1063578250	1	1	FARRIS, EMILY M	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
244961	Fee-for-Service	1861430373	1861430373	1	1	FATEMI, NASTARAN MD	8/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87404	None	None	0	In state provider	None	3325 CHANATE RD	None	SANTA ROSA	CA	95404	1707	49	06097	38.469537	-122.707314	Sonoma County
244996	Fee-for-Service	1275534026	1275534026	1	1	FREEDOM MEDICAL SERVICES INC	6/27/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	4901 NW 17TH WAY	501	FORT LAUDERDALE	FL	33309	3774	00	None	26.18701085	-80.1648665	Broward County
245012	Fee-for-Service	1578658878	1578658878	1	1	FAMILY PLANNING ASSOC	1/1/1979	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	1901 NTUSTIN AVE	None	SANTA ANA	CA	92705	7817	30	06059	33.76245307	-117.8350708	Orange County
245063	Fee-for-Service	1396178448	1396178448	1	1	FEDIGAN, SHEA K PHD	1/28/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
245116	Fee-for-Service	1730157744	1730157744	1	1	FONG, BARBARA M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	14502 W MEEKER BLVD	None	SUN CITY WEST	AZ	85375	0000	00	None	33.660657	-112.3736175	Maricopa County
245131	Fee-for-Service	1770619926	1770619926	1	1	FATHMAN, CHARLES G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33057	01	General Practice	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
245135	Fee-for-Service	1912264862	1912264862	1	20	FIRST CHOICE PHYSICIAN PARTN	12/10/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 201	MODESTO	CA	95350	4404	50	06099	37.66487562	-120.9961927	Stanislaus County
245141	Fee-for-Service	1124070578	1124070578	1	1	FLORES, HECTOR	10/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	52360	08	Family Practice	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
245157	Fee-for-Service	1326317819	1326317819	1	1	FAMILY HEALTHCARE NETWORK	2/3/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	730 N FARMERSVILLE BLVD	None	FARMERSVILLE	CA	93223	1220	54	06107	36.30345652	-119.2070774	Tulare County
245199	Fee-for-Service	1972687945	1972687945	1	1	FOX, JEFFREY M MD	6/29/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72285	10	Gastroenterology (M.D. only)	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
245246	Fee-for-Service	1104856145	1104856145	1	1	FAYZ, FRANK M MD	10/8/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	127768	30	Radiology	0	In state provider	None	2820 N ONTARIO ST	None	BURBANK	CA	91504	2015	19	06037	34.20335077	-118.3443845	Los Angeles County
245331	Fee-for-Service	1205922945	1205922945	1	1	FLEMING, WESLEY E MD	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	70474	13	Neurology (M.D. only)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
245353	Fee-for-Service	1093893695	1093893695	1	1	FONG, JEFFREY S MD	8/28/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	49383	83	Rheumatology	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
245409	Fee-for-Service	1407848948	1407848948	1	1	FEAR, DANIEL R MD	7/11/2018	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	-	04	Otology, Laryngology, Rhinology	1	Border provider	None	520 MEDICAL CENTER DRIVE	SUITE 201	MEDFORD	OR	97504	4334	00	None	42.318801	-122.831728	Jackson County
245415	Fee-for-Service	1013967405	1013967405	1	1	FACULTY PHYS & SURGNS	12/17/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	OF LLUSM-SURGERY CT	3762 TIBBETTS ST	None	RIVERSIDE	CA	92506	2605	33	06065	33.94721583	-117.3989036	Riverside County
245459	Fee-for-Service	1205953791	1205953791	1	1	FLEMING-ARGUELLO, KAREN E	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
245462	Fee-for-Service	1972953537	1972953537	1	1	FUJIMOTO, JESSICA K MD	8/1/2019	207P00000X	NA	Other	026	PHYSICIANS	161754	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
245487	Fee-for-Service	1972687945	1972687945	1	1	FOX, JEFFREY M MD	6/29/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72285	41	Internal Medicine	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
245549	Fee-for-Service	1699705053	1699705053	1	1	FRY, MARK F PHD	1/15/2004	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	133 BRAEMER CT	None	BENICIA	CA	94510	2003	48	06095	38.06623588	-122.1613026	Solano County
245555	Fee-for-Service	1407343155	1407343155	1	1	FENG, HUI DO	4/25/2023	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
245568	Fee-for-Service	1093268310	1093268310	1	1	FULTON, AUBYN S PHD	5/18/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
245615	Fee-for-Service	1558380048	1558380048	1	1	FELDMAN, BERNARD M MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	26037	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
245619	Fee-for-Service	1205922945	1205922945	1	1	FLEMING, WESLEY E MD	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	70474	47	Miscellaneous	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
245623	Fee-for-Service	1740489350	1740489350	2	2	FADELL, MICHAEL F	2/28/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	166708	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
245683	Fee-for-Service	1376578609	1376578609	1	1	FARSAD, KHASHAYAR MD	6/2/2021	2085R0204X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	3181 SW SAM JACKSON PARK	RD	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
245695	Fee-for-Service	1083050207	1083050207	1	1	FRAGOSO, ROBERT LMFT	2/5/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA COURT	C-4	PALMDALE	CA	93550	7609	19	06037	34.64013337	-118.1280539	Los Angeles County
245731	Fee-for-Service	1902954704	1902954704	1	1	FLIPPIN, ARTHUR M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33763	13	Neurology (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
245817	Fee-for-Service	1174195481	1174195481	1	1	FIDELITE HOME HEALTH CARE IN	10/18/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	15053 VENTURA BLVD	SUITE 202A	SHERMAN OAKS	CA	91403	2498	19	06037	34.15306161	-118.4615488	Los Angeles County
245829	Fee-for-Service	1649302522	1649302522	1	1	FERRARI, LORENA LMFT	10/1/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93000	2801	56	06111	34.27443821	-119.2609368	Ventura County
245836	Fee-for-Service	1326431131	1326431131	1	1	FOX, LINDSAY J MEDICAL	4/29/2015	208600000X	NA	General Surgery	026	PHYSICIANS	104826	02	General Surgery	0	In state provider	CORPORATION	830 PINE STREET	None	MOUNT SHASTA	CA	96067	2137	47	06093	41.31730651	-122.3208659	Siskiyou County
245878	Fee-for-Service	1457428021	1457428021	1	1	FLOYD, JON W MD	4/30/1989	2088P0231X	NA	Other	026	PHYSICIANS	69687	34	Urology and Urological Surgery	0	In state provider	None	6633 TELEGRAPH AVE	None	OAKLAND	CA	94609	1115	01	06001	37.85249324	-122.2602468	Alameda County
246016	Fee-for-Service	1861611840	1861611840	1	1	FERGUSON, JENNIFER C NP	2/12/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
246025	Fee-for-Service	1568496735	1568496735	1	1	FARAG, HEBA MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84223	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18200 YORBA LINDA BLVD	STE 104	YORBA LINDA	CA	92886	4006	30	06059	33.88842824	-117.8154698	Orange County
246049	Fee-for-Service	1205821592	1205821592	1	1	FARR, CHARLES M MD	4/30/1989	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	45250	01	General Practice	0	In state provider	None	7202 N MILLBROOK AVE	STE 100	FRESNO	CA	93720	3341	10	06019	36.83958089	-119.7645538	Fresno County
246100	Fee-for-Service	1760975510	1760975510	1	1	FIGUEROA, STEPHANIE J LCSW	5/13/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
246181	Fee-for-Service	1679164271	1679164271	1	1	FICK, SUNDAS P	6/30/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
246198	Fee-for-Service	1447244157	1447244157	1	1	FREUND, MICHAEL MD	12/16/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	31958	41	Internal Medicine	0	In state provider	None	3650 SOUTH ST	STE 403	LAKEWOOD	CA	90712	1504	19	06037	33.86019847	-118.149255	Los Angeles County
246343	Fee-for-Service	1205821592	1205821592	1	1	FARR, CHARLES M MD	4/30/1989	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	45250	41	Internal Medicine	0	In state provider	None	7202 N MILLBROOK AVE	STE 100	FRESNO	CA	93720	3341	10	06019	36.83958089	-119.7645538	Fresno County
246467	Fee-for-Service	1760467831	1760467831	1	1	FURER, STEVEN A. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
246471	Fee-for-Service	1891297107	1891297107	1	1	FORSTER, SARA M PSYD	1/31/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
246475	Fee-for-Service	1710431044	1710431044	1	1	FARUQUE, OMAR	10/24/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21929	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
246478	Fee-for-Service	1487817706	1487817706	1	1	FEDERER, GREGORY E MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125076	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
246518	Fee-for-Service	1164461752	1164461752	1	1	FRIEND, DAVID I MD	7/17/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68378	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
246522	Fee-for-Service	1912960253	1912960253	1	1	FOGG, MAXWELL & LANIER	6/30/1996	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	M.D., INC	3830 N 1ST ST	None	FRESNO	CA	93726	4301	10	06019	36.78754262	-119.7723305	Fresno County
246579	Fee-for-Service	1295032522	1295032522	1	1	FORNI, FILIPPO M MFT	7/8/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	90940	-	NOT APPLICABLE	0	In state provider	None	3580 WILSHIRE BLVD	2000	LOS ANGELES	CA	90010	2521	19	06037	34.06170677	-118.302787	Los Angeles County
246602	Fee-for-Service	1659826857	1659826857	1	1	FUSHIMI, YURIKO LAC	1/28/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1131 E. MAIN STREET	SUITE 106	TUSTIN	CA	92780	4450	30	06059	33.74215582	-117.8150309	Orange County
246606	Fee-for-Service	1932603016	1932603016	1	1	FUREY, CAMERON MD	10/2/2024	207R00000X	NA	Other	026	PHYSICIANS	164262	41	Internal Medicine	0	In state provider	None	1420 S. CENTRAL AVENUE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
246623	Fee-for-Service	1205821592	1205821592	1	1	FARR, CHARLES M MD	4/30/1989	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	45250	10	Gastroenterology (M.D. only)	0	In state provider	None	7202 N MILLBROOK AVE	STE 100	FRESNO	CA	93720	3341	10	06019	36.83958089	-119.7645538	Fresno County
246631	Fee-for-Service	1417970831	1417970831	1	1	FRANEY, BRIDGETTE B MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94158	08	Family Practice	0	In state provider	None	17190 BERNARDO CENTER DR	None	SAN DIEGO	CA	92128	7030	37	06073	33.02473938	-117.0778645	San Diego County
246675	Fee-for-Service	1518086388	1518086388	1	1	FERMIL, YVONNE D CNP	4/8/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	318 W EL NORTE PKWY	None	ESCONDIDO	CA	92026	1925	37	06073	33.14269478	-117.0953874	San Diego County
246680	Fee-for-Service	1740733112	1740733112	1	1	FRENCH, SHANNON LCSW	8/14/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
246806	Fee-for-Service	1164461752	1164461752	1	1	FRIEND, DAVID I MD	7/17/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68378	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
246860	Fee-for-Service	1609260694	1609260694	1	1	FOLDVARY, DANIELLE M MD	6/10/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	148133	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
246882	Fee-for-Service	1497202113	1497202113	1	1	FAN, TRACY Y CRNA	1/12/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
246909	Fee-for-Service	1740236405	1740236405	1	1	FERRARO, ANGELO S MD	2/8/2015	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	2	Out of state provider	None	122 W 7TH AVE	STE 310	SPOKANE	WA	99204	2352	00	None	47.649717	-117.4138155	Spokane County
246912	Fee-for-Service	1689685323	1689685323	1	1	FRANCES MAHON DEACONESS	7/12/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	621 3RD ST S	None	GLASGOW	MT	59230	2604	00	None	48.189726	-106.6355415	Valley County
246917	Fee-for-Service	1699938225	1699938225	1	1	FIROUZ, SHAHROKH J MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	82285	24	Plastic Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
246927	Fee-for-Service	1659683720	1659683720	1	3	FOOTHILL EMERGENCY MEDICAL A	2/1/2022	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SSOCIATES, INC	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
246958	Fee-for-Service	1558797118	1558797118	1	2	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	PARTNERS	1180 N INDIAN CANYON DR	SUITE E218	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
246986	Fee-for-Service	1477747707	1477747707	1	1	FAGO, CLARISSA CNP	6/28/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	576 E EL CAMINO REAL	None	SUNNYVALE	CA	94087	1940	43	06085	37.36249974	-122.0260401	Santa Clara County
247008	Fee-for-Service	1275915225	1275915225	1	1	FRANKLIN, SARAH W MD	7/9/2021	207L00000X	NA	Other	026	PHYSICIANS	169891	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
247025	Fee-for-Service	1437237278	1437237278	1	1	FERGUSON, WENDELL D MD	9/12/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	59221	20	Orthopedic Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
247059	Fee-for-Service	1740621929	1740621929	1	1	FELLO, BELINDA LCSW	3/5/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	121 S PALM CANYON DR	SUITE 217	PALM SPRINGS	CA	92262	6378	33	06065	33.822774	-116.5468275	Riverside County
247080	Fee-for-Service	1518904556	1518904556	1	1	FARZANEH-FAR, RAMIN MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94059	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1001 POTRERO AVE	RM 5G1	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
247122	Fee-for-Service	1124384763	1124384763	1	1	FERNANDEZ, GLENN N MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135440	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
247137	Fee-for-Service	1598192528	1598192528	1	1	FUJII, MOTO PSYD	3/16/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1141 W SHAW AVE	STE 203	FRESNO	CA	93711	3713	10	06019	36.80826902	-119.8120449	Fresno County
247163	Fee-for-Service	1740462316	1740462316	1	2	FUH, KATHERINE C MD	8/25/2022	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	97217	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
247174	Fee-for-Service	1912264862	1912264862	1	28	FIRST CHOICE PHYSICIAN PARTN	9/20/2023	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	ARTNERS	680 GUZZI LN	STE 203	SONORA	CA	95370	5288	55	06109	37.97611058	-120.3719921	Tuolumne County
247200	Fee-for-Service	1689685323	1689685323	1	1	FRANCES MAHON DEACONESS	7/12/2009	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	621 3RD ST S	None	GLASGOW	MT	59230	2604	00	None	48.189726	-106.6355415	Valley County
247247	Fee-for-Service	1558797118	1558797118	1	2	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	PARTNERS	1180 N INDIAN CANYON DR	SUITE E218	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
247309	Fee-for-Service	1598157745	1598157745	1	1	FORT MOHAVE EMERGENCY	6/2/2016	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	1	Border provider	MEDICAL ASSOCIATES INC	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
247313	Fee-for-Service	1790941136	1790941136	1	1	FARRELL, FRANK J MD INC	10/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	68482	10	Gastroenterology (M.D. only)	0	In state provider	None	2186 GEARY BLVD	STE 320	SAN FRANCISCO	CA	94115	3457	38	06075	37.78343395	-122.4392245	San Francisco County
247407	Fee-for-Service	1639638695	1639638695	1	1	FLORIAN, JANA MD	7/6/2022	207P00000X	NA	Other	026	PHYSICIANS	176265	None	None	0	In state provider	None	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
247439	Fee-for-Service	1023310786	1023310786	1	1	FRANK, LINDA K LMFT	7/11/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	84062	-	NOT APPLICABLE	0	In state provider	None	2000 W BRIGGSMORE AVE	SUITE I	MODESTO	CA	95350	3839	50	06099	37.67139252	-121.0281273	Stanislaus County
247441	Fee-for-Service	1700883022	1700883022	1	1	FELSBERG, GARY J MD	6/7/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	89426	None	None	0	In state provider	None	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
247454	Fee-for-Service	1427032465	1427032465	1	1	FRIEDENSON, DAVID G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 S POTOMAC ST	None	AURORA	CO	80012	5411	00	None	39.689343	-104.832198	Arapahoe County
247457	Fee-for-Service	1720453269	1720453269	1	1	FRESENIUS MEDICAL CARE	2/1/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	ORANGE COUNTY LLC	12761 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5845	30	06059	33.77737896	-117.9151828	Orange County
247461	Fee-for-Service	1912264862	1912264862	1	28	FIRST CHOICE PHYSICIAN PARTN	9/20/2023	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ARTNERS	680 GUZZI LN	STE 203	SONORA	CA	95370	5288	55	06109	37.97611058	-120.3719921	Tuolumne County
247463	Fee-for-Service	1780246975	1780246975	1	1	FAUSTO, MERCY M LMFT	10/13/2023	101YP2500X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1545 ST MARKS PLAZA	SUITE 5	STOCKTON	CA	95207	6411	39	06077	37.98892524	-121.3254177	San Joaquin County
247476	Fee-for-Service	1255607214	1255607214	1	1	FAIRCHILD, ROBERT M MD	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126504	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
247536	Fee-for-Service	1558797118	1558797118	1	2	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PARTNERS	1180 N INDIAN CANYON DR	SUITE E218	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
247675	Fee-for-Service	1760978027	1760978027	1	1	FLORES, JAEL LMFT	3/22/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
247677	Fee-for-Service	1528180213	1528180213	1	1	FARRELL, CATHRYN A LMFT	7/9/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
247697	Fee-for-Service	1124178884	1124178884	1	1	FREY, TANJA S MD	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101404	05	Anesthesiology	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
247847	Fee-for-Service	1568622520	1568622520	1	1	FAR00QI, SHAHIDA A MD	9/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107980	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
247864	Fee-for-Service	1174822522	1174822522	1	1	FERGUSON, CATHERINE D MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132997	None	None	0	In state provider	None	1306 MARICOPA HIGHWAY	None	OJAI	CA	93023	3131	56	06111	34.44229705	-119.2645703	Ventura County
247885	Fee-for-Service	1538298575	1538298575	1	1	FAMILY MEDICAL GROUP	4/1/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	911 E TUOLUMNE RD	None	TURLOCK	CA	95382	1543	50	06099	37.51464851	-120.837933	Stanislaus County
247901	Fee-for-Service	1467986919	1467986919	1	1	FLATO, RUSSELL R MD	10/18/2023	2085R0204X	NA	Other	026	PHYSICIANS	157922	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
247975	Fee-for-Service	1588774764	1588774764	1	1	FRANKEL, CHARLES J MD INC	10/23/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	53688	01	General Practice	0	In state provider	None	2001 SANTA MONICA BLVD	SUITE 360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
248073	Fee-for-Service	1235170028	1235170028	1	2	FELIX, EDWARD L MD	9/26/2017	208600000X	NA	General Surgery	026	PHYSICIANS	43375	02	General Surgery	0	In state provider	None	316 S STRATFORD AVE	STE B	SANTA MARIA	CA	93454	5908	42	06083	34.95019447	-120.4147816	Santa Barbara County
248113	Fee-for-Service	1427375625	1427375625	1	1	FREEMAN, KALI L MD	9/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115833	22	Pathology (M.D. only)	0	In state provider	None	2625 COFFEE RD	STE S	MODESTO	CA	95355	2050	50	06099	37.67888506	-120.9759048	Stanislaus County
248236	Fee-for-Service	1508947730	1508947730	1	1	FAUGHT, WILLIAM E MD	3/1/1999	2086S0129X	NA	General Surgery	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	748 STATE ST	None	MEDFORD	OR	97504	8473	00	None	42.315624	-122.8303995	Jackson County
248261	Fee-for-Service	1588774764	1588774764	1	1	FRANKEL, CHARLES J MD INC	10/23/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	53688	10	Gastroenterology (M.D. only)	0	In state provider	None	2001 SANTA MONICA BLVD	SUITE 360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
248291	Fee-for-Service	1316171564	1316171564	1	1	FEDER, JESSICA D PHD	4/16/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19000 HOMESTEAD ROAD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
248303	Fee-for-Service	1023048501	1023048501	1	1	FRIEDEL, WILLIAM E MD	7/29/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	21974	34	Urology and Urological Surgery	0	In state provider	None	8851 CENTER DR	STE 501	LA MESA	CA	91942	3058	37	06073	32.78189749	-117.0075062	San Diego County
248357	Fee-for-Service	1235218488	1235218488	1	1	FLORIN, JACK H MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	26561	13	Neurology (M.D. only)	0	In state provider	FULLERTON NEUROLOGY	100 LAGUNA RD	STE 208	FULLERTON	CA	92835	3633	30	06059	33.89264089	-117.9298746	Orange County
248506	Fee-for-Service	1659596898	1659596898	1	1	FUJINAGA, KIM MIKA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	94-800 UKEE ST	STE 303	WAIPAHU	HI	96797	4044	00	None	21.41257872	-158.0008603	Honolulu County
248516	Fee-for-Service	1902036957	1902036957	1	1	FAW, DANA M MD	3/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111871	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
248552	Fee-for-Service	1801898929	1801898929	1	1	FREEMAN, MARK J MD	8/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	47688	08	Family Practice	0	In state provider	None	15322 LAKESHORE DR	STE 101	CLEARLAKE	CA	95422	9815	17	06033	38.95045805	-122.6255271	Lake County
248560	Fee-for-Service	1609890813	1609890813	1	1	FERBER, JEFFREY MD	8/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	52181	08	Family Practice	0	In state provider	None	130 CEDAR RD	None	VISTA	CA	92083	5102	37	06073	33.18682732	-117.2839184	San Diego County
248580	Fee-for-Service	1740262047	1740262047	1	1	FEATHERSTONE, BRYAN J DO	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7016	08	Family Practice	0	In state provider	None	3184 CHURN CREEK RD	None	REDDING	CA	96002	2122	45	06089	40.56138796	-122.3531253	Shasta County
248598	Fee-for-Service	1710999297	1710999297	1	1	FOX, JOYCE N MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	24879	07	Dermatology	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
248606	Fee-for-Service	1326104829	1326104829	1	1	FORTMANN, STEPHEN MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	29702	01	General Practice	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
248652	Fee-for-Service	1437383239	1437383239	1	1	FAMILY HLTH CTR OF SAN DIEGO	12/22/2010	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	7592 BROADWAY	None	LEMON GROVE	CA	91945	1604	37	06073	32.74274487	-117.0345359	San Diego County
248659	Fee-for-Service	1679794309	1679794309	1	1	FOOTHILL CARE CTR II LLC	11/15/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1304 W DURNESS ST	None	WEST COVINA	CA	91790	4766	19	06037	34.05800847	-117.9477256	Los Angeles County
248739	Fee-for-Service	1285211086	1285211086	1	1	FACE, CAROLYNE J MD	7/23/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
248767	Fee-for-Service	1104385954	1104385954	1	1	FIELD, CHARLES A	12/13/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	180158	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
248773	Fee-for-Service	1003364514	1003364514	1	1	FABIAN, MICHAEL T NP	2/24/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
248833	Fee-for-Service	1316157340	1316157340	1	1	FIORE, LYNNE M PHD	4/26/2011	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	979 MISSION DE ORO DR	STE G	REDDING	CA	96003	5321	45	06089	40.5937671	-122.3575636	Shasta County
248894	Fee-for-Service	1326104829	1326104829	1	1	FORTMANN, STEPHEN MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	29702	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
248901	Fee-for-Service	1295956712	1295956712	1	1	FLEMING, CYNTHIA A MD	10/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	52122	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
249012	Fee-for-Service	1023897451	1023897451	1	1	FENG, JIAO NP	3/13/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
249099	Fee-for-Service	1053518928	1053518928	1	1	FIRESTONE, PAULA B PHD	9/12/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	12501 IMPERIAL HWY	SUITE 400	NORWALK	CA	90650	1419	19	06037	33.91723852	-118.065834	Los Angeles County
249143	Fee-for-Service	1437671096	1437671096	1	1	FEINSTEIN, AMANDA B PHD	9/25/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
249149	Fee-for-Service	1801851043	1801851043	1	2	FAMILY PRACTICE OF GLENDALE	1/1/2001	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	A MEDICAL CORPORATION	1818 VERDUGO BLVD	STE 200	GLENDALE	CA	91208	1408	19	06037	34.20560177	-118.216054	Los Angeles County
249163	Fee-for-Service	1457360687	1457360687	1	1	FRIEDER, RICHARD P MD	12/1/2003	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	45278	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1245 16TH ST	STE 202	SANTA MONICA	CA	90404	1240	19	06037	34.02726451	-118.4857138	Los Angeles County
249314	Fee-for-Service	1386004851	1386004851	1	1	FOSKETT, AMY J PT	3/17/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1160 N VENTURA RD	None	OXNARD	CA	93030	3802	56	06111	34.2133887	-119.1943554	Ventura County
249395	Fee-for-Service	1093707358	1093707358	1	2	FRAWLEY, PATRICK J MD	2/27/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	34475	-	NOT APPLICABLE	0	In state provider	None	1020 PLACIDO AVE	None	SANTA BARBARA	CA	93101	3684	42	06083	34.41834626	-119.7065415	Santa Barbara County
249435	Fee-for-Service	1801851043	1801851043	1	2	FAMILY PRACTICE OF GLENDALE	1/1/2001	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A MEDICAL CORPORATION	1818 VERDUGO BLVD	STE 200	GLENDALE	CA	91208	1408	19	06037	34.20560177	-118.216054	Los Angeles County
249467	Fee-for-Service	1205843562	1205843562	1	1	FERNANDES, DEBORAH M MD	1/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	55487	40	Pediatrics	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
249570	Fee-for-Service	1144489998	1144489998	1	1	FEDER, ERICA C NP	11/13/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
249623	Fee-for-Service	1588486641	1588486641	1	1	FLAHIVE, FARAH L LMFT	11/6/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
249693	Fee-for-Service	1578594529	1578594529	1	1	FIEDLER, ELIZABETH I MD	10/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84570	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
249700	Fee-for-Service	1811092901	1811092901	1	1	FRESCO, LINDA H MD	5/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	53281	41	Internal Medicine	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
249727	Fee-for-Service	1790443109	1790443109	1	1	FENSTERMACHER RITCHIE, DIANA	9/7/2022	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	K DC	1775 HARRISON AVE	None	EUREKA	CA	95501	1338	12	06023	40.79191911	-124.1395817	Humboldt County
249765	Fee-for-Service	1922180843	1922180843	1	1	FRIENDLY EYE MED GRP INC	5/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	5451 LA PALMA AVE	STE 44	LA PALMA	CA	90623	1732	30	06059	33.84643146	-118.038843	Orange County
249777	Fee-for-Service	1386254613	1386254613	1	1	FRIENDLY, MADELEINE LMFT	2/22/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
249784	Fee-for-Service	1154462984	1154462984	1	1	F.I.T.T. MEDICAL	5/1/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	F.I.T.T. MEDICAL	821 PINE ST	STE B	PASO ROBLES	CA	93446	2862	40	06079	35.62301769	-120.6885811	San Luis Obispo County
249864	Fee-for-Service	1912264862	1912264862	1	24	FIRST CHOICE PHYSICIAN PARTN	8/9/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	ARTNERS	1444 FLORIDA AVE	SUITE 202	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
249869	Fee-for-Service	1689707101	1689707101	1	1	FERNANDEZ, MARSHA L LMFT	2/2/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29645 RANCHO CALIFORNIA	STE 209	TEMECULA	CA	92591	5285	33	06065	33.50627123	-117.1431728	Riverside County
249870	Fee-for-Service	1538664339	1538664339	1	1	FOLSOM ENDOSCOPY CENTER LLC	9/8/2018	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1671 CREEKSIDE DR	SUITE 100	FOLSOM	CA	95630	3890	34	06067	38.671632	-121.1452785	Sacramento County
249888	Fee-for-Service	1013932979	1013932979	1	1	FLORENCE MEDICAL CTR INC	10/20/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1557 E FLORENCE AVE	None	LOS ANGELES	CA	90001	2597	19	06037	33.97477752	-118.246176	Los Angeles County
249935	Fee-for-Service	1083698732	1083698732	1	1	FEIZ, VAHID MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	68094	18	Ophthalmology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
249937	Fee-for-Service	1558749382	1558749382	1	1	FEGALE, STEPHANIE L MD	9/6/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162999	09	Gynecology (D.O. only)	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
250041	Fee-for-Service	1548379225	1548379225	1	1	FIDALEO, RAYMOND A MD	12/12/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	11749	36	Psychiatry	0	In state provider	INC	3745 4TH AVE	None	SAN DIEGO	CA	92103	4202	37	06073	32.74599069	-117.1615742	San Diego County
250099	Fee-for-Service	1700481181	1700481181	1	1	FOSTER, MICHAELA PT	1/19/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	328 COMMERCIAL ROAD	SUITE 108	SAN BERNARDINO	CA	92408	3766	36	06071	34.05583518	-117.2779712	San Bernardino County
250151	Fee-for-Service	1912264862	1912264862	1	24	FIRST CHOICE PHYSICIAN PARTN	8/9/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ARTNERS	1444 FLORIDA AVE	SUITE 202	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
250172	Fee-for-Service	1982090775	1982090775	1	1	FURST-NICHOLS, NATHAN MD	10/22/2019	207P00000X	NA	Other	026	PHYSICIANS	164651	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
250197	Fee-for-Service	1760431837	1760431837	1	1	FOSTER, ELYSE MD	3/31/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	65941	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
250221	Fee-for-Service	1558749382	1558749382	1	1	FEGALE, STEPHANIE L MD	9/6/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162999	15	Obstetrics (D.O. only)	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
250398	Fee-for-Service	1700375110	1700375110	1	1	FALCK, BENJAMIN	8/12/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	None	07	Dermatology	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
250442	Fee-for-Service	1306002795	1306002795	1	1	FRIEDMAN, MIA MD	8/16/2022	207P00000X	NA	Other	026	PHYSICIANS	179140	None	None	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
250449	Fee-for-Service	1992085914	1992085914	1	1	FORBES, VERONICA J LCSW	2/2/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
250486	Fee-for-Service	1760431837	1760431837	1	1	FOSTER, ELYSE MD	3/31/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	65941	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
250513	Fee-for-Service	1922416411	1922416411	1	1	FAMILY HEALTH CARE CENTERS	9/18/2024	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6001 E WASHINGTON BLVD	None	COMMERCE	CA	90040	2451	19	06037	33.99703164	-118.1499826	Los Angeles County
250552	Fee-for-Service	1255472718	1255472718	1	1	FLOOD, DAVID L MD	5/20/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	52441	20	Orthopedic Surgery	0	In state provider	None	306 LAUREL MOUNTAIN RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.64244416	-118.9680348	Mono County
250633	Fee-for-Service	1154938512	1154938512	1	1	FURTICK, VICTOR LCSW	3/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	311 CALIFORNIA	#750	SAN FRANCISCO	CA	94104	2602	38	06075	37.79316768	-122.4002529	San Francisco County
250712	Fee-for-Service	1891000188	1891000188	1	1	FLORES, JOAN NP	4/20/2021	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
250735	Fee-for-Service	1649234865	1649234865	1	1	FAMILY PRACTICE MEDICAL	12/30/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP OF OAKLAND	350 30TH ST	STE 407	OAKLAND	CA	94609	3210	01	06001	37.81892183	-122.2640154	Alameda County
250750	Fee-for-Service	1558482083	1558482083	1	1	FALCONIO, LINDA S MD INC	3/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	499 N EL CAMINO REAL	STE C102	ENCINITAS	CA	92024	1347	37	06073	33.05803268	-117.262602	San Diego County
250780	Fee-for-Service	1417927070	1417927070	1	1	FREDERICK, JANE L MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	55594	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ACADEMIC OB/GYN	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
250800	Fee-for-Service	1922416411	1922416411	1	1	FAMILY HEALTH CARE CENTERS	8/20/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6001 E WASHINGTON BLVD	None	COMMERCE	CA	90040	2451	19	06037	33.99703164	-118.1499826	Los Angeles County
250825	Fee-for-Service	1831696160	1831696160	1	1	FONG GOMEZ, STEPHANIE Y MD	9/22/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163399	None	None	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
250830	Fee-for-Service	1528007861	1528007861	1	1	FU, KAREN H MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	69169	None	None	0	In state provider	None	30131 TOWN CENTER DR	STE 135	LAGUNA NIGUEL	CA	92677	2010	30	06059	33.52530096	-117.7148334	Orange County
250843	Fee-for-Service	1518595677	1518595677	1	1	FARIAS, EMILY MD	9/25/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	185126	None	None	0	In state provider	None	3634 ELIZABETH ST	None	RIVERSIDE	CA	92506	2506	33	06065	33.95782448	-117.3904065	Riverside County
250879	Fee-for-Service	1215047659	1215047659	1	1	FONG, LEO L MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	79576	01	General Practice	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
250924	Fee-for-Service	1902117732	1902117732	1	1	FRANZ, CLARE E R MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124647	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2175 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
250940	Fee-for-Service	1700083490	1700083490	1	1	FLYNN, TODD J LCSW	8/22/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3043	33	06065	33.904782	-117.469323	Riverside County
250987	Fee-for-Service	1407879901	1407879901	2	1	FLETSCHER, WALTER L MD	12/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	48644	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	198 COHASSET RD	None	CHICO	CA	95926	2202	04	06007	39.75140931	-121.8541188	Butte County
251037	Fee-for-Service	1407005283	1407005283	1	1	FROST, RYAN A LMFT	6/8/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1484 HARTNELL AVE	STE J	REDDING	CA	96002	2254	45	06089	40.56378551	-122.343849	Shasta County
251092	Fee-for-Service	1922416411	1922416411	1	1	FAMILY HEALTH CARE CENTERS	8/20/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF GREATER LOS ANGELES	6001 E WASHINGTON BLVD	None	COMMERCE	CA	90040	2451	19	06037	33.99703164	-118.1499826	Los Angeles County
251103	Fee-for-Service	1851450258	1851450258	1	1	FALKENBERG, STEPHANIE PT	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3900 LAKEVIEW HWY	None	PETALUMA	CA	94954	5698	49	06097	38.32168809	-122.6254468	Sonoma County
251111	Fee-for-Service	1144211020	1144211020	1	1	FLAGLER HOSPITAL, INC	1/4/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	400 HEALTH PARK BLVD	None	ST AUGUSTINE	FL	32086	5784	00	None	29.8627277	-81.31747884	St. Johns County
251189	Fee-for-Service	1003987918	1003987918	1	1	FAN, MICHAEL S MD	12/4/1995	207R00000X	NA	Other	026	PHYSICIANS	55420	41	Internal Medicine	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
251200	Fee-for-Service	1235737024	1235737024	1	1	FAMILY AID HOSPICE &	5/11/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	7345 TOPANGA CANYON BLVD	STE 120	CANOGA	CA	91303	1244	19	06037	34.20414	-118.6059855	Los Angeles County
251274	Fee-for-Service	1992528624	1992528624	1	1	FRIENDS OUTSIDE	11/5/2024	174H00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	1148 W FREMONT ST	None	STOCKTON	CA	95203	2622	39	06077	37.95487673	-121.3075373	San Joaquin County
251275	Fee-for-Service	1679542518	1679542518	1	1	FOTINAKES, PETER A MD	11/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	48227	13	Neurology (M.D. only)	0	In state provider	None	1310 W STEWART DR	STE 410	ORANGE	CA	92868	3855	30	06059	33.78236048	-117.8664975	Orange County
251304	Fee-for-Service	1316025208	1316025208	1	1	FONG, THEODORE T MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77016	01	General Practice	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
251399	Fee-for-Service	1144211020	1144211020	1	1	FLAGLER HOSPITAL, INC	1/4/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	400 HEALTH PARK BLVD	None	ST AUGUSTINE	FL	32086	5784	00	None	29.8627277	-81.31747884	St. Johns County
251466	Fee-for-Service	1376573956	1376573956	1	1	FISCHEL, ALAN J MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83137	05	Anesthesiology	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
251487	Fee-for-Service	1235737024	1235737024	1	1	FAMILY AID HOSPICE &	5/11/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	7345 TOPANGA CANYON BLVD	STE 120	CANOGA	CA	91303	1244	19	06037	34.20414	-118.6059855	Los Angeles County
251646	Fee-for-Service	1982814570	1982814570	1	1	FADIL, HALIM MD	4/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97731	13	Neurology (M.D. only)	0	In state provider	None	445 SOUTH CEDAR AVENUE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
251700	Fee-for-Service	1174549232	1174549232	1	2	FAMILY HEALTH CENTERS	2/8/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1625 NEWTON AVE	None	SAN DIEGO	CA	92113	1012	37	06073	32.70271971	-117.150066	San Diego County
251705	Fee-for-Service	1790745271	1790745271	1	1	FEIL,MATTHEW DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 S PIONEER PKWY	None	WEST VALLEY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
251757	Fee-for-Service	1073685814	1073685814	1	1	FORY, LINDA W MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73101	40	Pediatrics	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
251786	Fee-for-Service	1033276696	1033276696	1	2	FRANCK, LEELIA L MD	2/15/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	121957	-	NOT APPLICABLE	0	In state provider	None	380 ENCINAL STREET	200	SANTA CRUZ	CA	95060	2178	44	06087	36.98747083	-122.0380148	Santa Cruz County
251859	Fee-for-Service	1851812168	1851812168	1	1	FLESCHNER, KURT E DPM	9/19/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	635 ANDERSON RD STE 19	None	DAVIS	CA	95616	3505	57	06113	38.54876426	-121.7587542	Yolo County
251864	Fee-for-Service	1154382463	1154382463	1	1	FULLER, NICHOLAS S MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83197	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
251865	Fee-for-Service	1093007221	1093007221	1	1	FITZGERALD, DANIEL MD	8/1/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187840	None	None	0	In state provider	None	1680 E 120 ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
251932	Fee-for-Service	1588854426	1588854426	1	1	FRIEDMAN, BRUCE F MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53565	01	General Practice	0	In state provider	STE 255	11180 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	7501	30	06059	33.71632048	-117.9334575	Orange County
251941	Fee-for-Service	1548716962	1548716962	1	1	FOX, JACLYN M PHD	10/10/2022	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2248 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1474	34	06067	38.554983	-121.458555	Sacramento County
251996	Fee-for-Service	1174549232	1174549232	1	2	FAMILY HEALTH CENTERS	2/8/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1625 NEWTON AVE	None	SAN DIEGO	CA	92113	1012	37	06073	32.70271971	-117.150066	San Diego County
252031	Fee-for-Service	1033480165	1033480165	1	1	FENATI, GREGORY M DO	6/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12530	66	Emergency Medicine (Urgent Care)	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
252049	Fee-for-Service	1538272000	1538272000	1	1	FUERST, DAVID J M D INC.	9/25/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	47430	18	Ophthalmology	0	In state provider	None	1701 E CESAR CHAVEZ AVE	# 535	LOS ANGELES	CA	90033	2490	19	06037	34.05112725	-118.2173921	Los Angeles County
252135	Fee-for-Service	1467402289	1467402289	1	1	FACULTY PHYSICIANS AND	6/30/1995	208100000X	NA	Physical Medicine and Rehabilitation	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SURGEONS OF LLUSM	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
252153	Fee-for-Service	1558433193	1558433193	1	1	FRIEDMAN, CYNTHIA J LMFT	8/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	700 E ST	STE 206	SAN RAFAEL	CA	94901	2756	21	06041	37.97112293	-122.533553	Marin County
252199	Fee-for-Service	1861951642	1861951642	1	1	FRASER, NISA DO	10/21/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	19596	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
252210	Fee-for-Service	1932253861	1932253861	1	1	FATIMA, ANEES	4/19/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	51813	41	Internal Medicine	0	In state provider	None	8825 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2600	19	06037	34.00181371	-118.0847275	Los Angeles County
252221	Fee-for-Service	1588854426	1588854426	1	1	FRIEDMAN, BRUCE F MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53565	03	Allergy	0	In state provider	STE 255	11180 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	7501	30	06059	33.71632048	-117.9334575	Orange County
252227	Fee-for-Service	1215008255	1215008255	1	1	FRIEDENBERG, AMY L MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66815	36	Psychiatry	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
252252	Fee-for-Service	1467075937	1467075937	1	1	FELDMAN, JEREMY E PT	4/26/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1120 HUTCHINSON DRIVE	None	DAVIS	CA	95616	5270	57	06113	38.53834973	-121.7626055	Yolo County
252266	Fee-for-Service	1861772824	1861772824	1	1	FREED, ROBERT C MD	4/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111898	30	Radiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
252287	Fee-for-Service	1699886101	1699886101	1	1	FINEBERG, ANNETTE E MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86635	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
252331	Fee-for-Service	1902984842	1902984842	1	1	FAFINSKI, STEPHEN MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	87472	30	Radiology	0	In state provider	None	1025 N DOUTY STREET	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
252378	Fee-for-Service	1245382472	1245382472	1	1	FORMOLI, RABIA MD	8/24/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	49408	40	Pediatrics	0	In state provider	None	1190 W OLIVE AVE	STE L	MERCED	CA	95348	1960	24	06047	37.31910454	-120.4885665	Merced County
252403	Fee-for-Service	1013198993	1013198993	1	1	FELIX, ROBERTO MD	3/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101179	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
252405	Fee-for-Service	1750088605	1750088605	1	1	FAIRVIEW LIVING LLC	2/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1089 W HUFF ST	None	RIALTO	CA	92376	6826	36	06071	34.09170389	-117.3919288	San Bernardino County
252423	Fee-for-Service	1467402289	1467402289	1	1	FACULTY PHYSICIANS AND	8/6/2019	208100000X	NA	Physical Medicine and Rehabilitation	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
252450	Fee-for-Service	1881609337	1881609337	1	2	FERNANDEZ, ERIKA F MD	6/7/2021	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	131691	40	Pediatrics	0	In state provider	None	1400 E CHURCH ST	BLDG 8	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
252453	Fee-for-Service	1609338730	1609338730	1	1	FOGEL, ALEXIS H MD	9/16/2022	207PP0204X	NA	Other	026	PHYSICIANS	178248	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
252531	Fee-for-Service	1750061594	1750061594	1	1	FRANTZIAS, JOSEPH MD	12/11/2024	207T00000X	NA	General Surgery	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
252541	Fee-for-Service	1831110923	1831110923	1	1	FARBOODY, GHOLAM H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	42647	45	Nephrology (Renal-Kidney)	0	In state provider	INC	7111 WINNETKA AVE	None	CANOGA PARK	CA	91306	3646	19	06037	34.199739	-118.5710185	Los Angeles County
252576	Fee-for-Service	1679653927	1679653927	1	1	FERNANDEZ-KLINE, BLANCA MD	10/18/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	106885	None	None	0	In state provider	None	517 W JUNIPERO ST	None	SANTA BARBARA	CA	93105	4239	42	06083	34.42887266	-119.725938	Santa Barbara County
252579	Fee-for-Service	1104385202	1104385202	1	1	FELDMAN, ERICA B MD	11/21/2023	208M00000X	NA	Other	026	PHYSICIANS	176740	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
252652	Fee-for-Service	1538707476	1538707476	1	1	FIRST CHOICE HOME HEALTH INC	2/19/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	SUITE 250	VAN NUYS	CA	91411	1454	19	06037	34.18570347	-118.450386	Los Angeles County
252829	Fee-for-Service	1831110923	1831110923	1	1	FARBOODY, GHOLAM H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	42647	41	Internal Medicine	0	In state provider	INC	7111 WINNETKA AVE	None	CANOGA PARK	CA	91306	3646	19	06037	34.199739	-118.5710185	Los Angeles County
252866	Fee-for-Service	1275112732	1275112732	1	1	FARMAND, DONYA MD	3/26/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	27235 TOURNEY	2500	VALENCIA	CA	91355	5908	19	06037	34.41755702	-118.5772646	Los Angeles County
252874	Fee-for-Service	1740533785	1740533785	1	1	FUENTES, STEFANY D BIRTH DOU	8/21/2023	106H00000X	NA	Mental Health Outpatient Services	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
252927	Fee-for-Service	1215591201	1215591201	1	1	FARIS, ANNA MD	6/11/2024	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
252996	Fee-for-Service	1144428871	1144428871	1	1	FRAD, JENNIFER D LMFT	8/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
253025	Fee-for-Service	1558797118	1558797118	1	7	FIRST CHOICE PHYSICIAN PARTN	9/11/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1180 N INDIAN CANYON DR	SUITE E205	PALM SPRINGS	CA	92262	4402	33	06065	33.839505	-116.5455735	Riverside County
253042	Fee-for-Service	1801902077	1801902077	1	1	FOX, RODNEY P	4/10/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
253070	Fee-for-Service	1174587281	1174587281	1	1	FELDSTEIN, ARIEL E MD	12/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54991	10	Gastroenterology (M.D. only)	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
253088	Fee-for-Service	1184043085	1184043085	1	1	FILIPPA, ALYSON LCSW	7/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	29587	-	NOT APPLICABLE	0	In state provider	None	144 STONY POINT RD	None	SANTA ROSA	CA	95401	4122	49	06097	38.440494	-122.74353	Sonoma County
253089	Fee-for-Service	1689052052	1689052052	1	1	FARRAR, AMANDA B	2/8/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
253133	Fee-for-Service	1164489571	1164489571	1	1	FUNDERBURG, LINDA G MD	8/25/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	156477	None	None	0	In state provider	None	7111 N FRESNO ST	STE. 200	FRESNO	CA	93720	2965	10	06019	36.83951763	-119.7815709	Fresno County
253152	Fee-for-Service	1861508137	1861508137	1	1	FORSYTH, MARGARET M MD	1/1/1988	207R00000X	NA	Other	026	PHYSICIANS	60055	01	General Practice	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
253160	Fee-for-Service	1447510417	1447510417	1	1	FRANK, BENJAMIN S MD	10/3/2020	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	None	None	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
253212	Fee-for-Service	1265482772	1265482772	1	1	FRITZ, BENJAMIN A MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	66856	None	None	0	In state provider	None	1265 N DUTTON AVE	None	SANTA ROSA	CA	95401	7101	49	06097	38.448657	-122.7332025	Sonoma County
253321	Fee-for-Service	1245284686	1245284686	1	1	FATEMI, SHAHRAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	80377	08	Family Practice	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
253358	Fee-for-Service	1174587281	1174587281	1	1	FELDSTEIN, ARIEL E MD	12/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54991	40	Pediatrics	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
253377	Fee-for-Service	1215960091	1215960091	1	1	FULL CARE MEDICAL GROUP	7/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	48607	08	Family Practice	0	In state provider	INC	3903 LONE TREE WAY	STE 104	ANTIOCH	CA	94509	6251	07	06013	37.98216807	-121.8054744	Contra Costa County
253381	Fee-for-Service	1427152727	1427152727	1	1	FARHADIAN, HOUSHAND MD	2/8/2015	2080P0201X	NA	Neurology	026	PHYSICIANS	31355	03	Allergy	0	In state provider	None	23861 MCBEAN PKWY	STE E22	VALENCIA	CA	91355	4457	19	06037	34.39567343	-118.5542698	Los Angeles County
253384	Fee-for-Service	1730192378	1730192378	1	1	FOSTER, GARY P MD	1/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66662	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	BLDG 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
253411	Fee-for-Service	1427143734	1427143734	1	1	FAMILY PLANNING ASSOCIATES M	1/1/1979	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP INC	501 S VINCENT AVE	SUITE 205	WEST COVINA	CA	91790	6712	19	06037	34.0662144	-117.9274205	Los Angeles County
253502	Fee-for-Service	1780797704	1780797704	1	1	FLORES, JULIO H MD INC	1/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	58384	01	General Practice	0	In state provider	None	500 S MAIN ST	STE 1210	ORANGE	CA	92868	4556	30	06059	33.77991974	-117.8674745	Orange County
253531	Fee-for-Service	1760554893	1760554893	1	1	FELIX, WALKER D MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	77237	02	General Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
253534	Fee-for-Service	1770189284	1770189284	1	1	FULLERTON ROSEWOOD ASSISTED	6/29/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	411 E COMMONWEALTH AVE	None	FULLERTON	CA	92832	2018	30	06059	33.87044133	-117.9171774	Orange County
253545	Fee-for-Service	1518013978	1518013978	1	1	FLORES, ALONZO J MD	7/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	40484	08	Family Practice	0	In state provider	None	229 S GLASSELL ST	None	ORANGE	CA	92866	1945	30	06059	33.785478	-117.853083	Orange County
253555	Fee-for-Service	1356549992	1356549992	1	1	FONTENETTE, DOMINIQUE C MD	5/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119277	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2303	19	06037	34.02980528	-118.4786605	Los Angeles County
253557	Fee-for-Service	1235634940	1235634940	1	1	FAGAN, PHILIP R MD	11/16/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	163621	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2075 SAN JOAQUIN HILLS R	None	NEWPORT BEACH	CA	92660	6505	30	06059	33.61676129	-117.869325	Orange County
253559	Fee-for-Service	1922459577	1922459577	1	2	FIRMALAB INC	6/6/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	870 VINE ST	None	LOS ANGELES	CA	90038	3724	19	06037	34.086852	-118.3265915	Los Angeles County
253568	Fee-for-Service	1558797118	1558797118	1	15	FIRST CHOICE PHYSICIAN PARTN	10/3/2019	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	ARTNERS	1180 N INDIAN CANYON DR	E318	PALM SPRINGS	CA	92262	4809	33	06065	33.839505	-116.5455735	Riverside County
253604	Fee-for-Service	1073721304	1073721304	1	1	FRUTOS, LISA S NP	1/4/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4770 W HERNDON AVE	STE 111	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
253631	Fee-for-Service	1558558676	1558558676	1	1	FERNANDEZ, MANUEL E PSYD	6/19/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3454 HILLCREST AVENUE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
253641	Fee-for-Service	1386610665	1386610665	1	1	FLORES, RONALD R MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67630	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
253674	Fee-for-Service	1730192378	1730192378	1	1	FOSTER, GARY P MD	1/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66662	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	BLDG 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
253681	Fee-for-Service	1548816267	1548816267	1	1	FREDERICK R SAUTTER LICENSED	12/12/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	915 HIGHLAND POINTE DR	STE 250	ROSEVILLE	CA	95678	5421	31	06061	38.78338654	-121.2837779	Placer County
253697	Fee-for-Service	1538259981	1538259981	1	1	FONG, AMY L	9/30/2008	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
253736	Fee-for-Service	1033276696	1033276696	1	1	FRANCK, LEELIA L MD	3/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121957	08	Family Practice	0	In state provider	None	5196 HILL RD EAST	SUITE 300	LAKEPORT	CA	95453	6374	17	06033	39.10527946	-122.9080599	Lake County
253773	Fee-for-Service	1710487962	1710487962	1	1	FACULTY PHYSICIANS & SURGEON	3/14/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	OF LLUSM	82934 CIVIC CENTER DR	None	INDIO	CA	92201	4308	33	06065	33.71864703	-116.2178997	Riverside County
253791	Fee-for-Service	1780797704	1780797704	1	1	FLORES, JULIO H MD INC	1/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	58384	05	Anesthesiology	0	In state provider	None	500 S MAIN ST	STE 1210	ORANGE	CA	92868	4556	30	06059	33.77991974	-117.8674745	Orange County
253793	Fee-for-Service	1225660921	1225660921	1	1	FINLEY, MARY CCC-SLP	10/4/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	38	06075	37.78096053	-122.4637512	San Francisco County
253802	Fee-for-Service	1235603507	1235603507	1	1	FAST CARE HOME HEALTH INC	5/16/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	820 SAN FERNANDO RD	SUITE 205	SAN FERNANDO	CA	91340	3350	19	06037	34.28129873	-118.4400048	Los Angeles County
253803	Fee-for-Service	1306188727	1306188727	1	1	FRANCO, VANESSA S MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134068	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
253807	Fee-for-Service	1821465766	1821465766	1	1	FRIENDLY HAND FOUNDATION	10/15/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	347 S NORMANDIE AVE	None	LOS ANGELES	CA	90020	3167	19	06037	34.06760427	-118.3003795	Los Angeles County
253861	Fee-for-Service	1073869178	1073869178	1	1	FLORES, IRENE C OD	12/26/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
253885	Fee-for-Service	1316944721	1316944721	1	1	FARAN BASHIR MD	6/14/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9201 W THOMAS RD	None	PHOENIX	AZ	85037	3332	00	None	33.47892	-112.2579	Maricopa County
253905	Fee-for-Service	1386689701	1386689701	1	3	FAMILY HEALTH CENTERS OF	7/11/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	3690 MISSION BLVD	None	SAN DIEGO	CA	92109	7368	37	06073	32.78237635	-117.2525812	San Diego County
253930	Fee-for-Service	1386610665	1386610665	1	1	FLORES, RONALD R MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67630	08	Family Practice	0	In state provider	None	1100 MARSHALL WAY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
253975	Fee-for-Service	1174653026	1174653026	1	1	FORTUNOV, REGINE M MD	2/8/2015	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	None	300 W CLARENDON AVE	STE 375	PHOENIX	AZ	85013	3498	00	None	33.49179	-112.07844	Maricopa County
253977	Fee-for-Service	1619297751	1619297751	1	1	FAERSTAIN, STEVEN A MD	12/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111995	02	General Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
254046	Fee-for-Service	1447290192	1447290192	1	1	FAMILY PHARMACY SERVICES OF	5/17/1993	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	BEVERLY HILLS INC	8314 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	2397	19	06037	34.06426025	-118.3724385	Los Angeles County
254052	Fee-for-Service	1659100865	1659100865	1	1	FACIO-LEON, NATALIE LMFT	9/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
254096	Fee-for-Service	1265740260	1265740260	1	1	FOSTER, ANNA M LMFT	10/15/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
254102	Fee-for-Service	1285697870	1285697870	1	1	FOREMAN, JENNIFER MD	6/1/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	74547	40	Pediatrics	0	In state provider	None	3100 SUMMIT ST	None	OAKLAND	CA	94609	3410	01	06001	37.82018974	-122.2643221	Alameda County
254128	Fee-for-Service	1962582189	1962582189	1	1	FERGUSON, ROLLINGTON MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72372	41	Internal Medicine	0	In state provider	HEART MEDICINE & PAIN CL	368 28TH STREET	None	OAKLAND	CA	94609	3601	01	06001	37.81640758	-122.2647636	Alameda County
254176	Fee-for-Service	1619078953	1619078953	1	1	FLETCHER,DONALD D DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2700 STEWART PARKWAY	None	ROSEBURG	OR	97471	1281	00	None	43.2399838	-123.3665048	Douglas County
254178	Fee-for-Service	1912264862	1912264862	1	11	FIRST CHOICE PHYSICIAN PARTN	8/26/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	880 E TUOLOMNE RD	STE 201	TURLOCK	CA	95382	1550	50	06099	37.51459247	-120.837519	Stanislaus County
254196	Fee-for-Service	1386689701	1386689701	1	3	FAMILY HEALTH CENTERS OF	7/11/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	3690 MISSION BLVD	None	SAN DIEGO	CA	92109	7368	37	06073	32.78237635	-117.2525812	San Diego County
254201	Fee-for-Service	1356604524	1356604524	1	1	FORD, MARGARET C MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126936	41	Internal Medicine	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
254207	Fee-for-Service	1851807556	1851807556	1	1	FOSTER, DEVON U	3/21/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1301 W PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
254216	Fee-for-Service	1245809052	1245809052	1	1	FUENTES, HALEY I LMFT	7/13/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	550 W ALLUVIAL AVE	STE 108	FRESNO	CA	93711	5857	10	06019	36.84447289	-119.8025883	Fresno County
254220	Fee-for-Service	1407015936	1407015936	1	1	FRANKLIN, CORINNA C MD	10/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103873	08	Family Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
254262	Fee-for-Service	1174653026	1174653026	1	1	FORTUNOV, REGINE M MD	2/8/2015	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	300 W CLARENDON AVE	STE 375	PHOENIX	AZ	85013	3498	00	None	33.49179	-112.07844	Maricopa County
254316	Fee-for-Service	1710558465	1710558465	1	1	FUENTEBELLA, MIA ANICA K PT	12/9/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
254319	Fee-for-Service	1679663769	1679663769	1	1	FINE, SUSAN A	7/14/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
254329	Fee-for-Service	1225163504	1225163504	1	1	FACIANE, LANAE P LMFT	8/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
254345	Fee-for-Service	1033179882	1033179882	1	1	FAULK, ELIZABETH A MD	11/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54851	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5176 HILL ROAD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
254367	Fee-for-Service	1851459796	1851459796	1	1	FLAHERTY, ALICE	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
254410	Fee-for-Service	1629722897	1629722897	1	1	FLOWER HHA	10/10/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	103 W ALAMEDA AVE	STE 100	BURBANK	CA	91502	2253	19	06037	34.17123949	-118.3032671	Los Angeles County
254411	Fee-for-Service	1942215702	1942215702	2	1	FIG GARDEN OPTOMETRY INC	1/19/2016	193400000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5151 N PALM AVE	STE 150	FRESNO	CA	93704	2221	10	06019	36.81119879	-119.808555	Fresno County
254432	Fee-for-Service	1942557764	1942557764	1	1	FEUER, JULIE E LCSW	4/27/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
254451	Fee-for-Service	1164672499	1164672499	1	1	FONTENETTE, RODERICK W MD	4/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147303	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
254464	Fee-for-Service	1912264862	1912264862	1	18	FIRST CHOICE PHYSICIAN PARTN	9/1/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	850 WEST OLIVE AVE	STE A	MERCED	CA	95348	2427	24	06047	37.31843749	-120.4834376	Merced County
254555	Fee-for-Service	1528131166	1528131166	1	1	FISHER, MADELEINE R MD	4/22/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	51845	30	Radiology	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
254595	Fee-for-Service	1851492458	1851492458	1	1	FRANK H SCHMIDT, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	720 LINDSAY LN	STE C	CODY	WY	82414	4103	00	None	44.52017085	-109.0743422	Park County
254605	Fee-for-Service	1518068303	1518068303	1	1	FALLON, TROY T. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1046 6TH AVE SW	None	ALBANY	OR	97321	1916	00	None	44.63214872	-123.1157723	Linn County
254658	Fee-for-Service	1790963437	1790963437	1	1	FOLDVARY, SHERRY L	7/23/2009	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18111 NORDHOFF STREET	None	NORTHRIDGE	CA	91330	8288	19	06037	34.239213	-118.527768	Los Angeles County
254760	Fee-for-Service	1912264862	1912264862	1	18	FIRST CHOICE PHYSICIAN PARTN	9/1/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	850 WEST OLIVE AVE	STE A	MERCED	CA	95348	2427	24	06047	37.31843749	-120.4834376	Merced County
254790	Fee-for-Service	1659459436	1659459436	1	1	FONG, STEWART MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	51405	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
254875	Fee-for-Service	1912175944	1912175944	1	1	FUNG, REBECCA Y MD	4/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106529	40	Pediatrics	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
254893	Fee-for-Service	1982649331	1982649331	1	1	FALAKASSA, BAHMAN B MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	41461	10	Gastroenterology (M.D. only)	0	In state provider	None	16133 VENTURA BLVD	STE 415	ENCINO	CA	91436	2429	19	06037	34.15656164	-118.4849569	Los Angeles County
254926	Fee-for-Service	1356394969	1356394969	1	1	FANKUCHEN, ELLIOTT I MD	9/30/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	49524	30	Radiology	0	In state provider	None	30131 TOWN CENTER DR	STE 138	LAGUNA NIGUEL	CA	92677	2010	30	06059	33.52530096	-117.7148334	Orange County
254941	Fee-for-Service	1639358104	1639358104	1	1	FURY-GEISE, KAREN A CRNA	7/1/2003	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
254991	Fee-for-Service	1588688048	1588688048	1	1	FOLTZ, BRADLEY D MD	11/30/1985	207L00000X	NA	Other	026	PHYSICIANS	52586	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
255038	Fee-for-Service	1912264862	1912264862	1	18	FIRST CHOICE PHYSICIAN PARTN	9/1/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	850 WEST OLIVE AVE	STE A	MERCED	CA	95348	2427	24	06047	37.31843749	-120.4834376	Merced County
255097	Fee-for-Service	1336453950	1336453950	1	2	FRANCISCO J CUELLAR A PROFES	1/14/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	160 E ARTESIA ST	SUITE 345	POMONA	CA	91767	2994	19	06037	34.07556833	-117.7507835	Los Angeles County
255145	Fee-for-Service	1477010510	1477010510	1	1	FONDEVILLA, AFRIELLE C NP	10/27/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
255180	Fee-for-Service	1982649331	1982649331	1	1	FALAKASSA, BAHMAN B MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	41461	41	Internal Medicine	0	In state provider	None	16133 VENTURA BLVD	STE 415	ENCINO	CA	91436	2429	19	06037	34.15656164	-118.4849569	Los Angeles County
255198	Fee-for-Service	1366417503	1366417503	1	1	FREEDMAN, STEVEN MD	6/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	47294	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
255210	Fee-for-Service	1255980835	1255980835	1	1	FLETCHER COVE HOLDINGS, LLC	10/7/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1355 CLAYTON RD	None	SAN JOSE	CA	95127	4307	43	06085	37.35678477	-121.8068648	Santa Clara County
255291	Fee-for-Service	1003964172	1003964172	1	1	FALLBROOK UNION ESD	7/20/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	321 IOWA ST	None	FALLBROOK	CA	92028	2108	37	06073	33.3841598	-117.2480667	San Diego County
255332	Fee-for-Service	1205990447	1205990447	1	1	FERGUSON, CHRISTINE M LMFT	2/19/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
255383	Fee-for-Service	1336453950	1336453950	1	2	FRANCISCO J CUELLAR A PROFES	1/14/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	160 E ARTESIA ST	SUITE 345	POMONA	CA	91767	2994	19	06037	34.07556833	-117.7507835	Los Angeles County
255437	Fee-for-Service	1245352624	1245352624	1	1	FRANKE, HILLARY ANN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
255499	Fee-for-Service	1700931904	1700931904	1	1	FERRIS, MARY-LOUISE J MD	1/19/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	70081	None	None	0	In state provider	None	1720 EL CAMINO REAL	130	BURLINGAME	CA	94010	3224	41	06081	37.59341466	-122.381361	San Mateo County
255520	Fee-for-Service	1962963520	1962963520	1	1	FAN, AUSTIN G MD	9/19/2024	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	176863	77	Infectious Disease	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
255615	Fee-for-Service	1376898825	1376898825	1	1	FANG, JESSICA P OD	5/12/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1515 N VERMONT AVE	None	LOS ANGELES	CA	90027	5337	19	06037	34.09851639	-118.2918012	Los Angeles County
255691	Fee-for-Service	1497811194	1497811194	1	1	FIRESTONE, ROBERT S MD	12/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	39878	08	Family Practice	0	In state provider	P O BOX 240	261 W DANA ST	STE 200	NIPOMO	CA	93444	9151	40	06079	35.03939232	-120.4787566	San Luis Obispo County
255723	Fee-for-Service	1851453104	1851453104	1	1	FEREN, ROBERT A MD	4/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89317	41	Internal Medicine	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
255742	Fee-for-Service	1629485883	1629485883	1	1	FAMOYEGUN, AKINJIDE A	12/27/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
255753	Fee-for-Service	1518983352	1518983352	1	1	FREEMAN, WILLIAM R MD	8/31/1985	207W00000X	NA	Ophthalmology	026	PHYSICIANS	51579	18	Ophthalmology	0	In state provider	None	225 DICKINSON ST	# H201	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
255763	Fee-for-Service	1003843699	1003843699	1	1	FERNANDES, SYLVIA MD	1/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52749	25	Physical Medicine and Rehabilitation	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
255780	Fee-for-Service	1972570752	1972570752	1	1	FRAZIER, JOHN K MD	4/30/1992	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	33380	20	Orthopedic Surgery	0	In state provider	None	237 ESTUDILLO AVE	None	SAN LEANDRO	CA	94577	4725	01	06001	37.72538644	-122.1544221	Alameda County
255822	Fee-for-Service	1487124798	1487124798	1	1	FACULTY PHYSICIANS & SURGEON	6/14/2019	207PT0002X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	S OF LLUSM	328 COMMERCIAL RD	101	SAN BERNARDINO	CA	92408	3766	36	06071	34.05583518	-117.2779712	San Bernardino County
255823	Fee-for-Service	1831458827	1831458827	1	1	FERREY, ANTONEY J MD	3/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	129711	45	Nephrology (Renal-Kidney)	0	In state provider	None	1310 W STEWART DR	STE 607	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
255858	Fee-for-Service	1174584411	1174584411	1	1	FOX, ELIZABETH NP	2/28/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1300 E. SHAW AVE.	SUITE 171	FRESNO	CA	93710	7911	10	06019	36.80872147	-119.765979	Fresno County
255881	Fee-for-Service	1497716856	1497716856	1	1	FENG, TIMOTHY L MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84909	30	Radiology	0	In state provider	None	355 E GRAND AVE	STE 3	ESCONDIDO	CA	92025	3313	37	06073	33.12354429	-117.0775982	San Diego County
255910	Fee-for-Service	1164739389	1164739389	1	1	FREEMAN-JORDAN, BREANNA R MD	12/6/2010	207R00000X	NA	Other	026	PHYSICIANS	108235	41	Internal Medicine	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
255915	Fee-for-Service	1720508914	1720508914	1	1	FO, MELODY JOY S J PSYD	5/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
255925	Fee-for-Service	1174765432	1174765432	1	1	FREED CENTER FOR INDEPENDENT	9/22/2009	251X00000X	NA	Other	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	LIVING	435 SUTTON WAY	None	GRASS VALLEY	CA	95945	4102	29	06057	39.23227471	-121.03603	Nevada County
255964	Fee-for-Service	1215340047	1215340047	1	1	FOOTE, DINGLE MD	4/29/2019	390200000X	NA	Other	026	PHYSICIANS	136546	30	Radiology	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
256006	Fee-for-Service	1619739380	1619739380	1	1	FREUND, EMILY A PT	3/11/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
256015	Fee-for-Service	1528049475	1528049475	1	1	FEENEY, JOHN R DO	6/12/2018	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	6659	08	Family Practice	0	In state provider	None	25405 HANCOCK AVENUE	STE. 105	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
256023	Fee-for-Service	1194120600	1194120600	1	1	FREMONT HEALTHCARE OPERATING	1/1/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	COMPANY	39022 PRESIDIO WAY	None	FREMONT	CA	94538	1221	01	06001	37.54421269	-121.9910888	Alameda County
256043	Fee-for-Service	1588745137	1588745137	1	1	FRESNO COMMUNITY HOSPITAL	7/18/1980	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AND MEDICAL CENTER	1630 EAST SHAW AVENUE	SUITE 154	FRESNO	CA	93710	8105	10	06019	36.8088456	-119.7572815	Fresno County
256056	Fee-for-Service	1578062907	1578062907	1	1	FITZPATRICK, MIA M	6/25/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
256071	Fee-for-Service	1053382655	1053382655	1	1	FOLEY HOSPITAL COMPANY LLC	12/15/2023	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AL CENTER	1613 N MCKENZIE ST	None	FOLEY	AL	36535	2247	00	None	30.425967	-87.68323603	Baldwin County
256086	Fee-for-Service	1013228154	1013228154	1	1	FERNANDES, DANIELLE E MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124996	01	General Practice	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
256122	Fee-for-Service	1932613536	1932613536	1	1	FAMILY HEALTHCARE NETWORK	12/29/2017	3336C0002X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	250 W FIFTH ST	None	HANFORD	CA	93230	5034	16	06031	36.32439821	-119.6472235	Kings County
256173	Fee-for-Service	1134225352	1134225352	1	1	FINZEN, BARBARA D MD	3/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	44949	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
256177	Fee-for-Service	1376899245	1376899245	1	2	FOX, SHERILYN H LMFT	4/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13751 ROSWELL	SUITE A	CHINO	CA	91710	5464	36	06071	34.00289717	-117.7218115	San Bernardino County
256249	Fee-for-Service	1215952676	1215952676	1	1	FARAG, EMAD S MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66905	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA B200	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
256354	Fee-for-Service	1104648088	1104648088	1	1	FALATOONZADEH, SHAYAN PT	11/15/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5350 OLIVE ST	None	MONTCLAIR	CA	91763	1639	36	06071	34.09054746	-117.6886395	San Bernardino County
256359	Fee-for-Service	1174854863	1174854863	1	1	FANG, MING MD INC	7/28/2010	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	83531	10	Gastroenterology (M.D. only)	0	In state provider	None	3700 SUNSET LANE	STE 2	ANTIOCH	CA	94509	6123	07	06013	37.98481899	-121.8042927	Contra Costa County
256360	Fee-for-Service	1053382655	1053382655	1	1	FOLEY HOSPITAL COMPANY LLC	12/15/2023	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	AL CENTER	1613 N MCKENZIE ST	None	FOLEY	AL	36535	2247	00	None	30.425967	-87.68323603	Baldwin County
256367	Fee-for-Service	1275093353	1275093353	1	1	FUJIMURA, REBECCA MD	7/18/2022	390200000X	NA	Other	026	PHYSICIANS	180310	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
256373	Fee-for-Service	1013228154	1013228154	1	1	FERNANDES, DANIELLE E MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124996	68	Hematology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
256399	Fee-for-Service	1427354414	1427354414	1	1	FORMAN, MARK PSYD	1/7/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
256463	Fee-for-Service	1922688050	1922688050	1	1	FORMAL HOME HEALTH INC	8/19/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2060 HUNTINGTON DR	SUITE 10B	SAN MARINO	CA	91108	2044	19	06037	34.12068542	-118.108905	Los Angeles County
256475	Fee-for-Service	1861707994	1861707994	1	1	FERRER, EDWARD MD	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112720	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
256476	Fee-for-Service	1366412553	1366412553	1	1	FUJII, DAVID M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2901 N CENTRAL AVE,	SUITE 500	PHOENIX	AZ	85012	2738	00	None	33.480666	-112.0729905	Maricopa County
256531	Fee-for-Service	1417147174	1417147174	1	1	FERNANDEZ, KAREN S MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145224	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVENUE	SUITE 550 & 570	MODESTO	CA	95350	4574	50	06099	37.666233	-120.993933	Stanislaus County
256588	Fee-for-Service	1477917565	1477917565	1	1	FERRIS, MARGARET S MD	8/24/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	180872	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
256665	Fee-for-Service	1013228154	1013228154	1	1	FERNANDES, DANIELLE E MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124996	40	Pediatrics	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
256678	Fee-for-Service	1811070261	1811070261	1	1	FUENTES, MARIA G MD	10/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83896	41	Internal Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
256739	Fee-for-Service	1396344396	1396344396	1	1	FORTIS HOSPICE & PALLIATIVE	9/1/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	101 MOODY CT	SUITE 202	THOUSAND OAKS	CA	91360	6068	56	06111	34.17730935	-118.8654649	Ventura County
256844	Fee-for-Service	1962455535	1962455535	1	1	FERNANDO DIETSCH JR. M.D.	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	908 10TH AVE SW	None	QUINCY	WA	98848	1376	00	None	47.23094665	-119.8691639	Grant County
256913	Fee-for-Service	1366449563	1366449563	1	1	FAZZINO, DOLORES L NP	9/1/1999	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1622 PLEASANT PL	None	ENCINITAS	CA	92024	1975	37	06073	33.05407257	-117.2523503	San Diego County
256948	Fee-for-Service	1548571680	1548571680	1	1	FABER, KENNETH D MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	112884	34	Urology and Urological Surgery	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
256980	Fee-for-Service	1841385184	1841385184	1	1	FRALEY, ALEXANDER E MD	5/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	75500	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3443 VILLA LANE	STE 2	NAPA	CA	94558	6417	28	06055	38.3259594	-122.2945735	Napa County
256987	Fee-for-Service	1164451639	1164451639	1	1	FORD, PETER G MD	1/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	68809	07	Dermatology	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4310	42	06083	34.42967671	-119.7228362	Santa Barbara County
257025	Fee-for-Service	1619530094	1619530094	1	1	FARRUKH, OMAR A DO	2/23/2023	204D00000X	NA	Other	026	PHYSICIANS	20231	None	None	0	In state provider	None	42135 10TH STREET WEST	SUITE 301	LANCASTER	CA	93534	6093	19	06037	34.648533	-118.1477975	Los Angeles County
257027	Fee-for-Service	1396344396	1396344396	1	1	FORTIS HOSPICE & PALLIATIVE	9/1/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	101 MOODY CT	SUITE 202	THOUSAND OAKS	CA	91360	6068	56	06111	34.17730935	-118.8654649	Ventura County
257030	Fee-for-Service	1124604699	1124604699	1	1	FENNING, REECE MD MPH	10/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	30 MARK WEST SPRINGS RD	None	SANTA ROSA	CA	95403	1436	49	06097	38.4962723	-122.752117	Sonoma County
257035	Fee-for-Service	1629506514	1629506514	1	1	FOUST, TALISA J MD	7/1/2021	207R00000X	NA	Other	026	PHYSICIANS	159222	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
257069	Fee-for-Service	1902860406	1902860406	1	1	FERRELL, JENNIFER R DO	6/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1323 W 6TH AVE	None	STILLWATER	OK	74074	4306	00	None	36.11584141	-97.07504326	Payne County
257083	Fee-for-Service	1972131696	1972131696	1	1	FIDLER, HENRY CRNA	3/25/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
257134	Fee-for-Service	1265716765	1265716765	1	1	FONTES, CALEB	8/19/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	405 CRANE	None	TURLOCK	CA	95380	4525	50	06099	37.49533801	-120.8431733	Stanislaus County
257261	Fee-for-Service	1255316345	1255316345	1	1	FEIN, JORDAN D MD	8/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92368	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
257369	Fee-for-Service	1902868714	1902868714	1	1	FELIZ, BRADY J MD	3/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78704	22	Pathology (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
257509	Fee-for-Service	1033145909	1033145909	1	1	FRIEDLANDER, JOSIAH MD	7/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72088	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12291 WASHINGTON BLVD	STE 500	WHITTIER	CA	90606	2551	19	06037	33.96734104	-118.0508773	Los Angeles County
257524	Fee-for-Service	1376818039	1376818039	1	1	FODERA, VITO MD	7/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133379	None	None	0	In state provider	None	1600 AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
257543	Fee-for-Service	1508895004	1508895004	1	1	FANG, LICHUAN MD	10/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55474	01	General Practice	0	In state provider	None	2001 SANTA MONICA BLVD	SUITE 1090	SANTA MONICA	CA	90404	2211	19	06037	34.02891163	-118.4797466	Los Angeles County
257578	Fee-for-Service	1326354069	1326354069	1	1	FADUL, NISRIN A A MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149858	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
257606	Fee-for-Service	1861505158	1861505158	1	1	FERNANDEZ, THELMA T MD	12/8/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	36169	08	Family Practice	0	In state provider	None	1601 W AVENUE J	STE 101	LANCASTER	CA	93534	2824	19	06037	34.68946047	-118.158849	Los Angeles County
257622	Fee-for-Service	1174541882	1174541882	1	1	FONG, WAN KEI CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	7548 GARVEY AVE	None	ROSEMEAD	CA	91770	2960	19	06037	34.06258954	-118.1042325	Los Angeles County
257649	Fee-for-Service	1558797118	1558797118	1	5	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	555 TACHEVAH DR	SUITE 2E-107	PALM SPRINGS	CA	92262	5752	33	06065	33.83753681	-116.5424435	Riverside County
257687	Fee-for-Service	1972282622	1972282622	1	1	FERRY, DANA M LMFT	11/14/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
257739	Fee-for-Service	1194225482	1194225482	1	1	FIRMEZA, ALLISON T NP	6/5/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
257752	Fee-for-Service	1356435341	1356435341	1	1	FRANCISCAN ALLIANCE INC	8/9/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FRANCISCAN ST ELIZABETH	1701 S CREASY LANE	None	LAFAYETTE	IN	47905	4972	00	None	40.393953	-86.834511	Tippecanoe County
257939	Fee-for-Service	1235391798	1235391798	1	1	FUJII, SCOTT K MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116074	None	None	0	In state provider	None	6403 COYLE AVE	SUITE 170	CARMICHAEL	CA	95608	0363	34	06067	38.668347	-121.3148745	Sacramento County
258005	Fee-for-Service	1205831963	1205831963	1	1	FOUNDATION CARE LLC	3/17/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	4010 WEDGEWAY COURT	None	EARTH CITY	MO	63045	1213	00	None	38.7666545	-90.46161291	St. Louis County
258044	Fee-for-Service	1356435341	1356435341	1	1	FRANCISCAN ALLIANCE INC	8/9/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	FRANCISCAN ST ELIZABETH	1701 S CREASY LANE	None	LAFAYETTE	IN	47905	4972	00	None	40.393953	-86.834511	Tippecanoe County
258057	Fee-for-Service	1689746422	1689746422	1	1	FREEMAN, LAUREN MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54656	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
258068	Fee-for-Service	1093707358	1093707358	1	1	FRAWLEY, JOSEPH P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34475	41	Internal Medicine	0	In state provider	None	525 E MICHELTORENA ST	STE 107	SANTA BARBARA	CA	93103	4209	42	06083	34.4320636	-119.7020672	Santa Barbara County
258077	Fee-for-Service	1316532898	1316532898	1	1	FIRST OPTOMETRIC CARE OF NOR	11/20/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12138 FIRESTONE BLVD	None	NORWALK	CA	90650	4320	19	06037	33.90876295	-118.0747274	Los Angeles County
258104	Fee-for-Service	1417564006	1417564006	1	1	FRESH START HOSPICE CARE INC	12/1/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11131 VANOWEN ST	STE B	NORTH HOLLYWOOD	CA	91605	6315	19	06037	34.19401145	-118.373481	Los Angeles County
258113	Fee-for-Service	1821023599	1821023599	1	1	FURST, DANIEL E MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	26247	83	Rheumatology	0	In state provider	None	200 MEDICAL PLAZA #365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
258132	Fee-for-Service	1912264862	1912264862	1	2	FIRST CHOICE PHYSICIAN PARTN	6/22/2012	193200000X	NA	Other	022	PHYSICIANS GROUP	-	14	Neurological Surgery	0	In state provider	PARTNERS	205 W GRANGER AVE	STE D	MODESTO	CA	95350	4402	50	06099	37.6673525	-120.9954534	Stanislaus County
258185	Fee-for-Service	1801884655	1801884655	1	1	FIRELANDS REG MED CENTER	4/12/2006	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1111 HAYES AVE	None	SANDUSKY	OH	44870	3323	00	None	41.44536883	-82.70920544	Erie County
258239	Fee-for-Service	1003997156	1003997156	1	1	FARBER, SUSAN L LMFT	8/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	22 W MICHELTORENA	STE B	SANTA BARBARA	CA	93101	6525	42	06083	34.4255722	-119.7090178	Santa Barbara County
258248	Fee-for-Service	1932270105	1932270105	1	1	FERENCZI, GEORGE MD	7/14/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	35272	10	Gastroenterology (M.D. only)	0	In state provider	None	1330 W COVINA BLVD	STE 2	SAN DIMAS	CA	91773	3200	19	06037	34.09894509	-117.8340464	Los Angeles County
258313	Fee-for-Service	1740354299	1740354299	1	1	FLEMING, SUSAN E CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
258314	Fee-for-Service	1265754550	1265754550	1	1	FAJANS, DEBORAH L CRNA	3/30/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
258348	Fee-for-Service	1538721386	1538721386	1	1	FORD, MAGDELENA M CNP	9/13/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
258354	Fee-for-Service	1093707358	1093707358	1	1	FRAWLEY, JOSEPH P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34475	01	General Practice	0	In state provider	None	525 E MICHELTORENA ST	STE 107	SANTA BARBARA	CA	93103	4209	42	06083	34.4320636	-119.7020672	Santa Barbara County
258363	Fee-for-Service	1003969650	1003969650	1	1	FONG, TERESA A OD	1/1/1985	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	BLDG 1	1278 CONCANNON BLVD	None	LIVERMORE	CA	94550	6002	01	06001	37.6609605	-121.7789055	Alameda County
258390	Fee-for-Service	1417564006	1417564006	1	1	FRESH START HOSPICE CARE INC	12/1/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11131 VANOWEN ST	STE B	NORTH HOLLYWOOD	CA	91605	6315	19	06037	34.19401145	-118.373481	Los Angeles County
258402	Fee-for-Service	1356488217	1356488217	1	1	FLITTON, ALAN R PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2232 5TH AVE	None	SAN DIEGO	CA	92101	2104	37	06073	32.72872036	-117.1603101	San Diego County
258421	Fee-for-Service	1740340165	1740340165	1	1	FLEMING, CAROLE S NP	8/29/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
258434	Fee-for-Service	1881983724	1881983724	1	1	FLORES, MAHDY DO	9/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11663	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
258444	Fee-for-Service	1588975247	1588975247	1	1	FRESE, MICHAEL PHD	10/21/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7150 TAMPA AVE	None	LOS ANGELES	CA	91335	3700	19	06037	34.2001266	-118.5534932	Los Angeles County
258473	Fee-for-Service	1801884655	1801884655	1	1	FIRELANDS REG MED CENTER	4/12/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1111 HAYES AVE	None	SANDUSKY	OH	44870	3323	00	None	41.44536883	-82.70920544	Erie County
258504	Fee-for-Service	1285607986	1285607986	1	1	FORTUNA, RANDALL S MD	10/18/2021	208G00000X	NA	General Surgery	026	PHYSICIANS	68643	None	None	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
258592	Fee-for-Service	1043332968	1043332968	1	1	FOSTER, KATHRYN M OT	10/18/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
258602	Fee-for-Service	1275720484	1275720484	1	1	FAST, KATHARINE MD	11/4/2020	207RA0201X	NA	Other	026	PHYSICIANS	92138	03	Allergy	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
258656	Fee-for-Service	1609809649	1609809649	1	1	FLEISCHMANN, KIRSTEN MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84348	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
258672	Fee-for-Service	1801804794	1801804794	1	1	FONTECHA, ERNESTO L MD	2/28/1985	208600000X	NA	General Surgery	026	PHYSICIANS	36618	08	Family Practice	0	In state provider	None	157 1/2 S VERMONT AVE	None	LOS ANGELES	CA	90004	5904	19	06037	34.071165	-118.2916985	Los Angeles County
258680	Fee-for-Service	1396278537	1396278537	1	1	FAHIMUDDIN, FATIMAH Z MD	9/30/2024	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158846	09	Gynecology (D.O. only)	0	In state provider	None	2210 E ILLINOIS AVE	SUITE 301	FRESNO	CA	93701	2168	10	06019	36.74500687	-119.7846885	Fresno County
258691	Fee-for-Service	1184316515	1184316515	1	1	FLAHERTY, AUBREEANA W NP	8/31/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3600 W FLAGSTAFF AVE	None	VISALIA	CA	93277	0000	54	06107	36.359649	-119.331567	Tulare County
258858	Fee-for-Service	1023208667	1023208667	1	1	FREIGHTMAN, SHARIFA PHD	3/9/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
258862	Fee-for-Service	1538450762	1538450762	1	1	FERNANDEZ, MARISA M MD	3/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124112	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
258893	Fee-for-Service	1275720484	1275720484	1	1	FAST, KATHARINE MD	11/4/2020	207RA0201X	NA	Other	026	PHYSICIANS	92138	41	Internal Medicine	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
258968	Fee-for-Service	1396278537	1396278537	1	1	FAHIMUDDIN, FATIMAH Z MD	9/30/2024	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158846	15	Obstetrics (D.O. only)	0	In state provider	None	2210 E ILLINOIS AVE	SUITE 301	FRESNO	CA	93701	2168	10	06019	36.74500687	-119.7846885	Fresno County
259035	Fee-for-Service	1366520058	1366520058	1	1	FARIBA, MARJON M MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62773	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3941 J ST	STE 260	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
259077	Fee-for-Service	1295883692	1295883692	1	1	FERREIRA, KARA S	3/17/2006	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3031 W MARCH LN	STE 217	STOCKTON	CA	95219	6568	39	06077	37.9842796	-121.3494311	San Joaquin County
259129	Fee-for-Service	1386848802	1386848802	1	1	FILSINGER, DAREN B MD	6/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85937	None	None	0	In state provider	None	4650 W SUNSET BLVD	MS # 3	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
259161	Fee-for-Service	1336633221	1336633221	1	1	FLANNGAN, TAMEKIA L LCSW	6/6/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
259169	Fee-for-Service	1831277722	1831277722	1	1	FLEMING, RICHARD L MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	34616	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
259181	Fee-for-Service	1558797118	1558797118	1	14	FIRST CHOICE PHYSICIAN PARTN	12/12/2017	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	ARTNERS	81709 DOCTOR CARREON BLV	STE C1	INDIO	CA	92201	5577	33	06065	33.70733082	-116.2400326	Riverside County
259201	Fee-for-Service	1306108170	1306108170	1	1	FITZHUGH, MARY E	11/21/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
259223	Fee-for-Service	1669995346	1669995346	1	1	FRASER, LEANDRA A	9/17/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153160	15	Obstetrics (D.O. only)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
259247	Fee-for-Service	1982684569	1982684569	1	1	FABRY, JOSEPH M DO	12/29/2009	208600000X	NA	General Surgery	026	PHYSICIANS	7283	02	General Surgery	0	In state provider	None	2911 CHANTICLEER AVENUE	None	SANTA CRUZ	CA	95065	1816	44	06087	36.98821335	-121.978125	Santa Cruz County
259256	Fee-for-Service	1679582662	1679582662	1	2	FIVE PHARMS INC	11/17/2023	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	REET	2336 EYE ST	None	BAKERSFIELD	CA	93301	4012	15	06029	35.380809	-119.0199645	Kern County
259306	Fee-for-Service	1083259113	1083259113	1	1	FINNEY, JANIESE L	11/27/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	21814 AMBAR DR	None	WOODLAND HILLS	CA	91364	5202	19	06037	34.14267202	-118.6027463	Los Angeles County
259323	Fee-for-Service	1366520058	1366520058	1	1	FARIBA, MARJON M MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62773	01	General Practice	0	In state provider	None	3941 J ST	STE 260	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
259338	Fee-for-Service	1174393367	1174393367	1	1	FREGOSO RAMIREZ, VERONICA T	2/8/2024	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	38	06075	0	0	None
259352	Fee-for-Service	1952438525	1952438525	3	1	FOX DRUG STORE	6/10/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7355 N PALM AVE	SUITE 100	FRESNO	CA	93711	5770	10	06019	36.84318769	-119.8097047	Fresno County
259369	Fee-for-Service	1467652040	1467652040	1	1	FAUSTGEN, JOSEPH P MD	2/11/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73413	20	Orthopedic Surgery	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
259380	Fee-for-Service	1710108436	1710108436	1	1	FOOTHILL CARE CTR II LLC	3/23/1995	311ZA0620X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CALERA HOME	5311 N CALERA AVE	None	COVINA	CA	91722	1905	19	06037	34.1090005	-117.8845935	Los Angeles County
259466	Fee-for-Service	1558797118	1558797118	1	14	FIRST CHOICE PHYSICIAN PARTN	12/12/2017	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	ARTNERS	81709 DOCTOR CARREON BLV	STE C1	INDIO	CA	92201	5577	33	06065	33.70733082	-116.2400326	Riverside County
259470	Fee-for-Service	1801088422	1801088422	1	1	FORTUNE, ERIN L MD	5/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95577	40	Pediatrics	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
259482	Fee-for-Service	1245946938	1245946938	1	1	FREMONT SNF HEALTHCARE LLC	3/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2400 PARKSIDE DRIVE	None	FREMONT	CA	94536	5332	01	06001	37.55937235	-121.9818266	Alameda County
259507	Fee-for-Service	1538891379	1538891379	1	1	FRANCOIS, BERTHLYNE CCC-SLP	6/10/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
259594	Fee-for-Service	1083259113	1083259113	1	1	FINNEY, JANIESE L	11/27/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	21814 AMBAR DR	None	WOODLAND HILLS	CA	91364	5202	19	06037	34.14267202	-118.6027463	Los Angeles County
259635	Fee-for-Service	1962786335	1962786335	1	1	FAITH IN ANGELS HOSPICE INC	4/26/2023	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	120 S VICTORY BLVD	SUITE 203	BURBANK	CA	91502	2801	19	06037	34.17305012	-118.3162651	Los Angeles County
259706	Fee-for-Service	1871766121	1871766121	1	1	FACULTY PHYS & SURG OF	4/16/2018	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
259719	Fee-for-Service	1255592325	1255592325	1	1	FERRANDO, CECILE A	4/9/2024	2088F0040X	NA	Other	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
259804	Fee-for-Service	1649358136	1649358136	1	1	FRAS, IVAN ANDREW MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	76024	36	Psychiatry	0	In state provider	None	10850 MACARTHUR BLVD	STE 300	OAKLAND	CA	94605	5266	01	06001	37.7414325	-122.1498379	Alameda County
259812	Fee-for-Service	1558797118	1558797118	1	6	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	PARTNERS	47647 CALEO BAY DR	SUITE 101	LA QUINTA	CA	92253	8857	33	06065	33.70305235	-116.2936509	Riverside County
259817	Fee-for-Service	1487807392	1487807392	1	1	FRAIRE-CHEW, JENNY L DO	11/15/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	10566	08	Family Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
259839	Fee-for-Service	1902844046	1902844046	1	1	FITTINGHOFF, LESLIE A MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72571	40	Pediatrics	0	In state provider	None	1505 SAINT ALPHONSUS CT	None	ALAMO	CA	94507	1533	07	06013	37.85356704	-122.03496	Contra Costa County
259867	Fee-for-Service	1942394457	1942394457	1	1	FUSSELL, SUZANNE L MD	4/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55383	08	Family Practice	0	In state provider	None	2403 ATLANTIC AVE	None	LONG BEACH	CA	90806	3221	19	06037	33.800967	-118.1850555	Los Angeles County
259877	Fee-for-Service	1588827273	1588827273	1	1	FORDE, GARETH K MD	5/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120925	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
259920	Fee-for-Service	1962786335	1962786335	1	1	FAITH IN ANGELS HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	120 S VICTORY BLVD	SUITE 203	BURBANK	CA	91502	2801	19	06037	34.17305012	-118.3162651	Los Angeles County
259930	Fee-for-Service	1669521639	1669521639	1	1	FRITSCHEN, MARGARET R	11/15/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
259978	Fee-for-Service	1881663896	1881663896	1	1	FRANK LOVECCHIO D.O.	6/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4973	00	None	33.457203	-112.0262625	Maricopa County
259999	Fee-for-Service	1871766121	1871766121	1	1	FACULTY PHYS & SURG OF	12/12/2017	193200000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
260101	Fee-for-Service	1962955526	1962955526	1	1	FONG, JOHNNY MD	12/23/2020	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
260106	Fee-for-Service	1437639515	1437639515	1	1	FLEMISTER, CANDYCE LMFT	3/14/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
260131	Fee-for-Service	1912264862	1912264862	1	6	FIRST CHOICE PHYSICIAN PARTN	10/19/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	PARTNERS	1234 E NORTH STREET	SUITE 103	MANTECA	CA	95336	4961	39	06077	37.80105524	-121.1968581	San Joaquin County
260202	Fee-for-Service	1467593335	1467593335	1	1	FOERSTER, BRUCE V MD	6/30/1988	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	66154	70	Clinic (mixed specialty)	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
260208	Fee-for-Service	1962786335	1962786335	1	1	FAITH IN ANGELS HOSPICE INC	4/26/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	120 S VICTORY BLVD	SUITE 203	BURBANK	CA	91502	2801	19	06037	34.17305012	-118.3162651	Los Angeles County
260213	Fee-for-Service	1104200575	1104200575	1	1	FERNANDES, VINAY T MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137644	04	Otology, Laryngology, Rhinology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
260218	Fee-for-Service	1265519193	1265519193	1	1	FRIDUSS, MICHAEL E MD	4/23/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	53564	04	Otology, Laryngology, Rhinology	0	In state provider	None	762 ALTOS OAKS DR	None	LOS ALTOS	CA	94024	5434	43	06085	37.35925198	-122.0937034	Santa Clara County
260229	Fee-for-Service	1356501647	1356501647	1	1	FUENTES, ELOISA F MD	7/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88207	22	Pathology (M.D. only)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
260251	Fee-for-Service	1245264407	1245264407	1	1	FAHIMI ENTERPRISES INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84645	05	Anesthesiology	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
260291	Fee-for-Service	1871766121	1871766121	1	1	FACULTY PHYS & SURG OF	5/2/2017	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
260401	Fee-for-Service	1124290721	1124290721	1	1	FRED WM STELLHORN OPTOMETRIC	7/9/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	ENTER	140 N. FREMONT STREET	None	MANTECA	CA	95336	4729	39	06077	37.799019	-121.209612	San Joaquin County
260525	Fee-for-Service	1013065937	1013065937	1	1	FRANCO, ANA C MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77953	41	Internal Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
260569	Fee-for-Service	1558797118	1558797118	1	9	FIRST CHOICE PHYSICIAN PARTN	10/17/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1100 N PALM CANYON DR	STE 109	PALM SPRINGS	CA	92262	4418	33	06065	33.838182	-116.546744	Riverside County
260581	Fee-for-Service	1871766121	1871766121	1	1	FACULTY PHYS & SURG OF	5/30/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
260620	Fee-for-Service	1497709844	1497709844	1	2	FROMETA, KATE CNM	5/30/2017	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
260642	Fee-for-Service	1477914315	1477914315	1	1	FIORICA, SHANNON J LMFT	7/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5479 E ABBEYFIELD ST	SUITE 3	LONG BEACH	CA	90815	3050	19	06037	33.79388819	-118.1261825	Los Angeles County
260661	Fee-for-Service	1922134287	1922134287	1	1	FENNELL, DAN F MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	555 BLACK OAK DR	STE 300	MEDFORD	OR	97504	8947	00	None	42.318873	-122.835653	Jackson County
260700	Fee-for-Service	1528254240	1528254240	1	1	FERNANDEZ, PATRICIA S MD	5/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	67336	01	General Practice	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
260805	Fee-for-Service	1023066891	1023066891	1	1	FARR, MORTEZA M DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	8078	None	None	0	In state provider	None	1191 E YOSEMITE AVE	STE C	MANTECA	CA	95336	5011	39	06077	37.79751749	-121.1988375	San Joaquin County
260807	Fee-for-Service	1295458941	1295458941	1	1	FOOT & WOUND CARE OF INDIO	3/15/2023	213ES0131X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	82013 DOCTOR CARREON BLV	STE H	INDIO	CA	92201	5832	33	06065	33.70738152	-116.233002	Riverside County
260867	Fee-for-Service	1871766121	1871766121	1	1	FACULTY PHYS & SURG OF	2/3/2023	193200000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	81 S HIGHLAND SPRINGS AV	STE 103	BEAUMONT	CA	92223	2511	33	06065	33.919204	-116.9467869	Riverside County
260878	Fee-for-Service	1649582842	1649582842	1	1	FLORIDIA, MARCO P MD	9/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111801	30	Radiology	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
260894	Fee-for-Service	1669012100	1669012100	1	1	FAITH KAY HOSPICE LLC	11/5/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10586 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	1823	33	06065	33.90857142	-117.467003	Riverside County
260920	Fee-for-Service	1184965873	1184965873	1	1	FENG, ZEKUN MD	6/18/2020	208M00000X	NA	Other	026	PHYSICIANS	159614	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
260948	Fee-for-Service	1922134287	1922134287	1	1	FENNELL, DAN F MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	1	Border provider	None	555 BLACK OAK DR	STE 300	MEDFORD	OR	97504	8947	00	None	42.318873	-122.835653	Jackson County
260953	Fee-for-Service	1992737068	1992737068	1	1	FRAUSTO, TERESA MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75172	36	Psychiatry	0	In state provider	None	11374 MOUNTAIN VIEW AVE	STE A	LOMA LINDA	CA	92354	3830	36	06071	34.0465275	-117.2436991	San Bernardino County
261015	Fee-for-Service	1831708569	1831708569	1	1	FISHER, LINDSAY N CRNA	1/31/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
261078	Fee-for-Service	1750996625	1750996625	1	1	FOSTER, SHANNON C PT	6/11/2021	208100000X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	577 EAST ELDER STREET	SUITE I	FALLBROOK	CA	92028	3079	37	06073	33.3801147	-117.2456536	San Diego County
261103	Fee-for-Service	1174631709	1174631709	1	1	FOLEY, JILL D MD	2/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67448	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	12 CAMINO ENCINAS	STE 15	ORINDA	CA	94563	3309	07	06013	37.87679015	-122.1800856	Contra Costa County
261124	Fee-for-Service	1669869806	1669869806	1	1	FRETWELL, DEBORAH L MD	5/10/2019	207L00000X	NA	Other	026	PHYSICIANS	146561	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
261139	Fee-for-Service	1366083610	1366083610	1	1	FULINARA, VANESSA M NP	1/11/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7293 DUMOSA AVE	SUITE 5, 7 & 8	YUCCA VALLEY	CA	92284	3700	36	06071	34.12094334	-116.4177385	San Bernardino County
261168	Fee-for-Service	1881609337	1881609337	1	1	FERNANDEZ, ERIKA F MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131691	None	None	0	In state provider	None	3020 CHILDRENS WAY	MC 5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
261176	Fee-for-Service	1063892909	1063892909	1	1	FEREN, LAURA L PHD	6/29/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
261184	Fee-for-Service	1669012100	1669012100	1	1	FAITH KAY HOSPICE LLC	11/5/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10586 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	1823	33	06065	33.90857142	-117.467003	Riverside County
261264	Fee-for-Service	1518917244	1518917244	1	1	FUGIT, MICHAEL D MD	5/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76415	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
261265	Fee-for-Service	1730270737	1730270737	1	1	FIALA, MILAN	9/1/1974	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	23625	None	None	0	In state provider	None	100 UCLA MEDICAL PLZ	STE 220	LOS ANGELES	CA	90095	7022	19	06037	34.0651473	-118.4458393	Los Angeles County
261391	Fee-for-Service	1780266692	1780266692	1	1	F & F HELPING HANDS INC	6/9/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	& MEDICAL SUPPLIES	326 E AVENUE I	None	LANCASTER	CA	93535	1914	19	06037	34.7040153	-118.1250757	Los Angeles County
261401	Fee-for-Service	1275512337	1275512337	1	1	FEMCARE MEDICAL ASSOCIAT	11/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	160 E ARTESIA ST	STE 330	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
261412	Fee-for-Service	1275693590	1275693590	1	1	FREUDENBERGER, CURT L MD	8/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97575	20	Orthopedic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
261420	Fee-for-Service	1922075530	1922075530	1	1	FEICK, STEVEN W MD	6/14/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	74585	30	Radiology	0	In state provider	None	10101 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2517	19	06037	34.15223753	-118.3508865	Los Angeles County
261443	Fee-for-Service	1851671077	1851671077	1	1	FERGUSON, MELISSA S MD	4/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117792	08	Family Practice	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
261461	Fee-for-Service	1245783273	1245783273	1	1	FARLEY, SHAWANA	9/5/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
261509	Fee-for-Service	1841551132	1841551132	1	1	FITZPATRICK, MICHELLE INC	4/16/2012	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1947 FERN STREET	#3	SAN DIEGO	CA	92102	1137	37	06073	32.7262857	-117.1292533	San Diego County
261514	Fee-for-Service	1073563748	1073563748	1	1	FACULTY PHYSICIANS AND	10/1/1998	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	SURGEONS OF LLUSM PRIMAR	11441 HEACOCK ST	STE C	MORENO VALLEY	CA	92557	7907	33	06065	33.954858	-117.243978	Riverside County
261640	Fee-for-Service	1699115626	1699115626	1	1	FRIEDERICH, KATIE E MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123792	79	Neurology-Child	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
261674	Fee-for-Service	1366990095	1366990095	1	1	FRACALANZA, KATIE PHD	11/2/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
261675	Fee-for-Service	1760538110	1760538110	1	1	FREDERICSON, MICHAEL MD	1/28/1991	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	67096	01	General Practice	0	In state provider	None	1350 WILLOW RD	None	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
261686	Fee-for-Service	1497719504	1497719504	1	1	FRANCIS, KELLY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71155	02	General Surgery	0	In state provider	None	11160 WARNER AVE	STE 421	FOUNTAIN VALLEY	CA	92708	4056	30	06059	33.71630854	-117.934317	Orange County
261698	Fee-for-Service	1669840146	1669840146	1	1	FRESENIUS MEDICAL CARE OF	10/20/2017	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	FRESNO, LLC	1899 N HELM AVE	None	FRESNO	CA	93727	1612	10	06019	36.76764198	-119.7239157	Fresno County
261753	Fee-for-Service	1518967140	1518967140	1	1	FORD, ANNE E MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69212	01	General Practice	0	In state provider	None	2720 N HARBOR BLVD	STE 200	FULLERTON	CA	92835	2626	30	06059	33.90126238	-117.9292154	Orange County
261788	Fee-for-Service	1548742687	1548742687	1	1	FORGETTA, JANIS LMFT	1/10/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2810 EAST DEL MAR BL.	SUITE 9	PASADENA	CA	91107	4323	19	06037	34.14212984	-118.092328	Los Angeles County
261802	Fee-for-Service	1073563748	1073563748	1	1	FACULTY PHYSICIANS AND	4/16/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SURGEONS OF LLUSM PRIMAR	11441 HEACOCK ST	STE C	MORENO VALLEY	CA	92557	7907	33	06065	33.954858	-117.243978	Riverside County
261904	Fee-for-Service	1093756678	1093756678	1	1	FERGUSON, SUSAN C MD	9/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68471	41	Internal Medicine	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
261924	Fee-for-Service	1225486772	1225486772	1	1	FOLMSBEE, STEPHEN S MD	4/5/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	177976	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
261925	Fee-for-Service	1699115626	1699115626	1	1	FRIEDERICH, KATIE E MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123792	40	Pediatrics	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
262003	Fee-for-Service	1528453701	1528453701	1	1	FELDSTEIN, STEPHANIE I MD	3/12/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	146480	07	Dermatology	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
262051	Fee-for-Service	1215390844	1215390844	1	1	FAULK, MAYA LMFT	10/11/2022	1041C0700X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
262083	Fee-for-Service	1043721517	1043721517	1	1	FERRIS, THATCHER CRNA	4/3/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
262110	Fee-for-Service	1346264744	1346264744	1	1	FONG, DENG FA MD	11/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38973	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1215 34TH ST	None	BAKERSFIELD	CA	93301	2107	15	06029	35.39050249	-119.015775	Kern County
262113	Fee-for-Service	1972787604	1972787604	1	1	FASS, ARTHUR H DPM INC	5/16/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	18350 ROSCOE BLVD	STE 707	NORTHRIDGE	CA	91325	4280	19	06037	34.22071855	-118.5341175	Los Angeles County
262150	Fee-for-Service	1306680129	1306680129	1	1	FRISK, KRISTYN CNP	10/5/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8831 VILLA LA JOLLA DR	None	LA JOLLA	CA	92037	1949	37	06073	32.869242	-117.230535	San Diego County
262163	Fee-for-Service	1033407275	1033407275	1	1	FOSTER, ALEXANDER MD	6/27/2024	207WX0120X	NA	Ophthalmology	026	PHYSICIANS	124880	18	Ophthalmology	0	In state provider	None	2124 S EL CAMINO REAL	STE 100	OCEANSIDE	CA	92054	6200	37	06073	33.18937621	-117.3280727	San Diego County
262185	Fee-for-Service	1376899245	1376899245	1	1	FOX, SHERILYN H LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
262213	Fee-for-Service	1235272188	1235272188	1	1	FAJEWONYOMI, ADEWALE O	12/21/2007	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	A1 QUALITY MED SUPPLY	582 W VALLEY BLVD	SUITE 9	COLTON	CA	92324	2267	36	06071	34.06799483	-117.3319548	San Bernardino County
262308	Fee-for-Service	1194803700	1194803700	1	1	FOLLANSBEE, STEPHEN E MD	8/15/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	39318	41	Internal Medicine	0	In state provider	None	3620 ARMY ST	None	SAN FRANCISCO	CA	94110	4315	38	06075	37.74816319	-122.4218657	San Francisco County
262345	Fee-for-Service	1720537178	1720537178	1	1	FAIRBANKS MEMORIAL HOSPITAL,	7/28/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LLC	1650 COWLES ST	None	FAIRBANKS	AK	99701	5907	00	None	64.8310943	-147.7363579	Fairbanks North Star Borough
262370	Fee-for-Service	1275515520	1275515520	1	1	FOLLESTAD, BARBARA E MD	3/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	90072	02	General Surgery	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
262386	Fee-for-Service	1417499518	1417499518	1	2	FAMILY PLANNING ASSOCIATES M	7/30/2019	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7023 OWENSMOUTH AVE	None	CANOGA PARK	CA	91303	2006	19	06037	34.19809485	-118.6015764	Los Angeles County
262422	Fee-for-Service	1487748927	1487748927	1	1	FALKENBURG, JOANN MD	11/30/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63891	08	Family Practice	0	In state provider	None	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
262483	Fee-for-Service	1396052833	1396052833	1	1	FEWEL, REBECCA LCSW	12/26/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	65315	-	NOT APPLICABLE	0	In state provider	None	2400 MOORPARK AVE	SUITE 300	SAN JOSE	CA	95128	2680	43	06085	37.3160785	-121.937121	Santa Clara County
262526	Fee-for-Service	1871937946	1871937946	1	2	FOROUHAR, SARA MD	4/3/2017	390200000X	NA	Other	026	PHYSICIANS	145453	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
262587	Fee-for-Service	1588191621	1588191621	1	1	FARAMARZI, FARNAZ OD	3/7/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	555 N 13TH AVE	None	UPLAND	CA	91786	4904	36	06071	34.10042233	-117.6335451	San Bernardino County
262592	Fee-for-Service	1194803700	1194803700	1	1	FOLLANSBEE, STEPHEN E MD	8/15/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	39318	77	Infectious Disease	0	In state provider	None	3620 ARMY ST	None	SAN FRANCISCO	CA	94110	4315	38	06075	37.74816319	-122.4218657	San Francisco County
262604	Fee-for-Service	1447222674	1447222674	1	1	FALLBROOK HOSPITAL	12/1/1977	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	624 E ELDER ST	None	FALLBROOK	CA	92028	3099	37	06073	33.38020455	-117.2446307	San Diego County
262617	Fee-for-Service	1558310805	1558310805	2	1	FRANKEL, CHARLES J MD	2/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53688	01	General Practice	0	In state provider	None	2001 SANTA MONICA BLVD	SUITE 360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
262634	Fee-for-Service	1720537178	1720537178	1	1	FAIRBANKS MEMORIAL HOSPITAL,	7/28/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LLC	1650 COWLES ST	None	FAIRBANKS	AK	99701	5907	00	None	64.8310943	-147.7363579	Fairbanks North Star Borough
262703	Fee-for-Service	1750519385	1750519385	1	1	FORKOSH, GARRY	5/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123093	41	Internal Medicine	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
262763	Fee-for-Service	1336141365	1336141365	1	1	FOGELSON, MARC H MD	1/31/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	62479	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
262843	Fee-for-Service	1215184973	1215184973	1	1	FARRELL, NANCY PSYD	11/29/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	521 W CITRUS AVE	None	REDLANDS	CA	92373	4625	36	06071	34.0560682	-117.1887598	San Bernardino County
262847	Fee-for-Service	1710271143	1710271143	1	1	FARAH, DIBA MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129977	40	Pediatrics	0	In state provider	None	1040 ELM AVE	SUITE 304	LONG BEACH	CA	90813	3264	19	06037	33.779799	-118.1879535	Los Angeles County
262900	Fee-for-Service	1023395514	1023395514	1	1	FORMAN, MAUREEN H LCSW	2/11/2019	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	490 S FARRELL DR	STE C208	PALM SPRINGS	CA	92262	7944	33	06065	33.81651	-116.5180015	Riverside County
262904	Fee-for-Service	1558310805	1558310805	2	1	FRANKEL, CHARLES J MD	2/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53688	10	Gastroenterology (M.D. only)	0	In state provider	None	2001 SANTA MONICA BLVD	SUITE 360W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
262966	Fee-for-Service	1972785889	1972785889	1	1	FAERBER, WADE DO AMC	6/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	6291	20	Orthopedic Surgery	0	In state provider	None	40949 WINCHESTER RD	None	TEMECULA	CA	92591	6031	33	06065	33.52574268	-117.1589811	Riverside County
263025	Fee-for-Service	1306938071	1306938071	1	1	FLORIDA HOSP MED CTR	2/18/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	601 E ROLLINS ST	None	ORLANDO	FL	32803	1248	00	None	28.57581	-81.370035	Orange County
263030	Fee-for-Service	1760548572	1760548572	1	1	FIEDLER,RALPH A DC	3/28/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	9667 HIGHWAY 29	STE 101	LOWER LAKE	CA	95457	9438	17	06033	38.91012553	-122.612985	Lake County
263031	Fee-for-Service	1447681697	1447681697	1	1	FRESENIUS MEDICAL CARE RENAL	12/1/2013	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	THERAPEUTICS LLC	14812 OXNARD STREET	None	VAN NUYS	CA	91411	3143	19	06037	34.17935949	-118.4554935	Los Angeles County
263034	Fee-for-Service	1750117776	1750117776	1	1	FRUGE, SHAWN L PSYD	12/2/2024	2084P0800X	NA	Psychiatry	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1200 CLAY ST	None	OAKLAND	CA	94612	1400	01	06001	37.80422981	-122.2742222	Alameda County
263244	Fee-for-Service	1164195871	1164195871	1	1	FREITAS, NATASHA A LMFT	2/23/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1280 S VICTORIA AVE	SUITE 130	VENTURA	CA	93003	6550	56	06111	34.26344767	-119.2119344	Ventura County
263256	Fee-for-Service	1235542531	1235542531	1	1	FATIMA, SANNA MD	9/19/2018	207R00000X	NA	Other	026	PHYSICIANS	154332	41	Internal Medicine	0	In state provider	None	4053 LONE TREE WAY	100	ANTIOCH	CA	94531	6210	07	06013	37.97569499	-121.800733	Contra Costa County
263258	Fee-for-Service	1578068516	1578068516	1	1	FERREIRA, DORALICE N DO	1/27/2022	208M00000X	NA	Other	026	PHYSICIANS	18678	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
263263	Fee-for-Service	1174967178	1174967178	1	1	FAHEY, JACQUELINE MD	6/13/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	148664	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MED PLAZA STE 430	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
263275	Fee-for-Service	1588491849	1588491849	1	1	FAMILY RX PHARMACY INC	10/16/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17701 CHATSWORTH ST	None	GRANADA HILLS	CA	91344	5604	19	06037	34.26490093	-118.5200114	Los Angeles County
263309	Fee-for-Service	1790166338	1790166338	1	1	FELMLY, LLOYD M MD	7/11/2022	208G00000X	NA	General Surgery	026	PHYSICIANS	171662	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
263313	Fee-for-Service	1306938071	1306938071	1	1	FLORIDA HOSP MED CTR	2/18/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	601 E ROLLINS ST	None	ORLANDO	FL	32803	1248	00	None	28.57581	-81.370035	Orange County
263332	Fee-for-Service	1629248752	1629248752	1	1	FRY LEONARD, ELISA LCSW	6/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25000 AVENUE STANFORD	167	VALENCIA	CA	91355	4553	19	06037	34.43847322	-118.5729968	Los Angeles County
263342	Fee-for-Service	1356601793	1356601793	1	1	FAJARDO MARTINEZ, VIVIANA M	5/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136292	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MD	10833 LE CONTE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
263472	Fee-for-Service	1295885564	1295885564	1	1	FURIE, DAWN K L PHD	3/28/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1643 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.74688342	-121.2469903	Placer County
263498	Fee-for-Service	1508161035	1508161035	1	1	FAUSTINO, KEVIN B CRNA	3/24/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
263535	Fee-for-Service	1013946904	1013946904	1	1	FENN, MICHAEL H MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	17188	04	Otology, Laryngology, Rhinology	0	In state provider	None	1625 E MAIN ST	STE 103	EL CAJON	CA	92021	5223	37	06073	32.80969963	-116.9203429	San Diego County
263635	Fee-for-Service	1356601793	1356601793	1	1	FAJARDO MARTINEZ, VIVIANA M	5/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136292	40	Pediatrics	0	In state provider	MD	10833 LE CONTE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
263645	Fee-for-Service	1114090230	1114090230	2	1	FORD, ROBERT H CRNA	9/2/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
263708	Fee-for-Service	1174521520	1174521520	1	1	FRIEDMAN, ARNOLD S MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32350	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
263782	Fee-for-Service	1184255192	1184255192	1	1	FARRIER, DAWN LCSW	5/6/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3160 TELEGRAPH ROAD	STE 200	VENTURA	CA	93003	3250	56	06111	34.27228149	-119.2529119	Ventura County
263883	Fee-for-Service	1437226388	1437226388	1	1	FUNG, PETER J MD	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72811	25	Physical Medicine and Rehabilitation	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
263902	Fee-for-Service	1316347388	1316347388	1	1	FRASER, CHRISTINA LMFT	1/21/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3330 CLAYTON RD	SUITE E	CLAYTON	CA	94519	2838	07	06013	37.97200848	-122.0167188	Contra Costa County
263916	Fee-for-Service	1588760110	1588760110	1	1	FREEMAN, DOUGLAS J MD	11/15/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51473	08	Family Practice	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
263956	Fee-for-Service	1134159247	1134159247	1	2	FOWLER, MELINDA I CNM	8/12/2024	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
263979	Fee-for-Service	1235769894	1235769894	1	1	FORTNER, ALYSON M LCSW	12/23/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
263985	Fee-for-Service	1912074881	1912074881	1	1	FAN, FERNANDO MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73896	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
263989	Fee-for-Service	1548352354	1548352354	1	1	FIERRO, RICHARD A PHD	1/7/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1623 PARAMOUNT BLVD	None	MONTEBELLO	CA	90640	2133	19	06037	34.03718412	-118.0934942	Los Angeles County
263991	Fee-for-Service	1376772996	1376772996	1	1	FORD, GAVIN W MD	1/3/2022	207RC0200X	NA	Other	026	PHYSICIANS	174664	None	None	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
263998	Fee-for-Service	1174521520	1174521520	1	1	FRIEDMAN, ARNOLD S MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32350	05	Anesthesiology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
264016	Fee-for-Service	1255496105	1255496105	1	1	FAMILIESFIRST, INC	5/20/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	251 LLEWELLYN AVE	None	CAMPBELL	CA	95008	1940	43	06085	37.29173129	-121.9584335	Santa Clara County
264070	Fee-for-Service	1699851188	1699851188	1	1	FORD, JOHN R MD	12/31/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	43313	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
264076	Fee-for-Service	1205667235	1205667235	1	1	FREDERICKSEN, CYNTHIA LMFT	9/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	922 STATE STREET	STE A, OFFICE #2	SANTA BARBARA	CA	93101	6795	42	06083	34.42108289	-119.7013175	Santa Barbara County
264098	Fee-for-Service	1104833375	1104833375	1	1	FOSTER, LIONEL S MD	10/1/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	60284	34	Urology and Urological Surgery	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
264170	Fee-for-Service	1437226388	1437226388	1	1	FUNG, PETER J MD	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72811	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
264344	Fee-for-Service	1083698435	1083698435	2	1	FREZZA, ERMENEGILDO E MD	12/10/2018	208600000X	NA	General Surgery	026	PHYSICIANS	155108	02	General Surgery	0	In state provider	None	1133 W SYCAMORE ST	None	WILLOWS	CA	95988	2601	11	06021	39.5205105	-122.2082775	Glenn County
264437	Fee-for-Service	1528538857	1528538857	1	1	FOREVER ACTIVE CBAS	8/15/2019	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	1111 W GLENOAKS BLVD	None	GLENDALE	CA	91202	4205	19	06037	34.16456673	-118.2804831	Los Angeles County
264446	Fee-for-Service	1750678652	1750678652	1	1	FLOREK, DEREK DPM	2/25/2019	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	515 W MORTON AVE	None	PORTERVILLE	CA	93257	3303	54	06107	36.0732092	-119.0285315	Tulare County
264474	Fee-for-Service	1316331648	1316331648	1	1	FRAZIN, STEPHANIE R MD	9/4/2019	390200000X	NA	Other	026	PHYSICIANS	161378	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
264478	Fee-for-Service	1003659624	1003659624	1	1	FLORES SIMONS, CRISTINA D	8/13/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	8700 BEVERLY BLVD	TSB-290	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
264506	Fee-for-Service	1487602348	1487602348	1	1	FRYE, GREGORY J MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	69133	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
264516	Fee-for-Service	1831357367	1831357367	1	1	FULLMOTION PHYSICAL THERAPY	7/30/2018	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	PC	31461 RANCHO VIEJO RD	STE 101	SAN JAUN CAPISTRA	CA	92675	1893	30	06059	33.50531399	-117.6561561	Orange County
264555	Fee-for-Service	1477741825	1477741825	1	1	FERRETTI, DEBRA E	11/29/2007	172V00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11930 HERITAGE OAKS PL	#9	AUBURN	CA	95603	2458	31	06061	38.94059662	-121.0995593	Placer County
264595	Fee-for-Service	1043456809	1043456809	1	1	FOMBY ROSE CORP	6/25/1993	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MT MITCHELL HOME	522 E 157TH ST	None	GARDENA	CA	90248	2517	19	06037	33.8895165	-118.267551	Los Angeles County
264670	Fee-for-Service	1194852533	1194852533	1	1	FRANKEL, STEVEN D MD	8/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	56922	30	Radiology	0	In state provider	None	14850 ROSCOE BLVD	None	PANORAMA CITY	CA	91402	4618	19	06037	34.22145548	-118.4566005	Los Angeles County
264811	Fee-for-Service	1730250309	1730250309	1	1	FORMAN, STUART B MD	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71881	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
264868	Fee-for-Service	1598864050	1598864050	1	1	FRESENIUS MEDICAL CARE	3/22/2013	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	PHARMACY SERVICES INC	11001 DANKA WAY NORTH	SUITE 2	ST PETERSBURG	FL	33716	3724	00	None	27.87291262	-82.65444447	Pinellas County
264870	Fee-for-Service	1053499863	1053499863	1	1	FAN, WEI MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67123	41	Internal Medicine	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
264913	Fee-for-Service	1669695599	1669695599	1	1	FRANCO, GILBERT E JR MFT	10/5/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	50841	-	NOT APPLICABLE	0	In state provider	None	1180 THIRD AVE	SUITE C3 C4	CHULA VISTA	CA	91911	3139	37	06073	32.61076531	-117.0680161	San Diego County
264926	Fee-for-Service	1861589186	1861589186	1	1	FERRARI, OMAR DO	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12803	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4897	49	06097	38.443806	-122.701374	Sonoma County
264950	Fee-for-Service	1831234525	1831234525	1	1	FRIGO, ROSE R CRNA	3/16/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1860 PENNSYLVANIA AVE	STE 145	FAIRFIELD	CA	94533	3547	48	06095	38.261952	-122.0498745	Solano County
264965	Fee-for-Service	1659888360	1659888360	1	1	FIRTH, KILEY LMFT	9/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39 N WASHINGTON ST	F	SONORA	CA	95370	4758	55	06109	37.98582924	-120.3837287	Tuolumne County
265097	Fee-for-Service	1730250309	1730250309	1	1	FORMAN, STUART B MD	4/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71881	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
265156	Fee-for-Service	1861031296	1861031296	1	1	FRANCO, ERIN M	12/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11801 PIERCE ST	SUITE 200	RIVERSIDE	CA	92505	4408	33	06065	33.90100297	-117.49363	Riverside County
265188	Fee-for-Service	1508842451	1508842451	2	1	FENTON, LAURA Z MD	7/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
265234	Fee-for-Service	1528180569	1528180569	1	1	FONTEJON, EDWIN A	11/7/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
265298	Fee-for-Service	1366759235	1366759235	1	1	FERET, CELIA M LCSW	12/8/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	611 S MILPITAS BLVD	None	MILPITAS	CA	95035	5473	43	06085	37.4246225	-121.8944566	Santa Clara County
265366	Fee-for-Service	1538807003	1538807003	1	1	FISHER, SLOANE M NP	10/26/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8731 W PICO BLVD	None	LOS ANGELES	CA	90035	2205	19	06037	34.05456946	-118.3824636	Los Angeles County
265428	Fee-for-Service	1770948283	1770948283	1	1	FIVE OAKS SPEECH THERAPY SER	2/24/2020	261QH0700X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	VICES PC	22365 BARTON RD	None	GRAND TERRACE	CA	92313	5015	36	06071	34.03387854	-117.316818	San Bernardino County
265432	Fee-for-Service	1093756678	1093756678	1	2	FERGUSON, SUSAN C MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	68471	-	NOT APPLICABLE	0	In state provider	None	2545 SAN PABLO AVENUE	None	OAKLAND	CA	94612	1121	01	06001	37.81631446	-122.2752306	Alameda County
265455	Fee-for-Service	1982802716	1982802716	1	1	FEINBERG, DANIEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4300 ALTON ROAD	None	MIAMI BEACH	FL	33140	2800	00	None	25.81334191	-80.139276	Miami-Dade County
265468	Fee-for-Service	1558797118	1558797118	1	8	FIRST CHOICE PHYSICIAN PARTN	9/15/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	58457 29 PALMS HIGHWAY	STE 200	YUCCA VALLEY	CA	92284	5879	36	06071	34.13247642	-116.3885551	San Bernardino County
265477	Fee-for-Service	1659787943	1659787943	1	1	FERNANDEZ, CARLOS I MD	11/14/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	145018	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
265521	Fee-for-Service	1043368871	1043368871	1	1	FASSIHI, SARA MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	50123	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
265666	Fee-for-Service	1619514023	1619514023	1	1	FAMILIES CHOICE HOME CARE SV	8/13/2024	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	545 N MOUNTAIN AVE	STE 209	UPLAND	CA	91786	5055	36	06071	34.100631	-117.6702865	San Bernardino County
265695	Fee-for-Service	1558370072	1558370072	1	1	FORD, KEITH B MD	3/31/1983	2085N0904X	NA	Other	026	PHYSICIANS	42474	30	Radiology	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
265739	Fee-for-Service	1093710071	1093710071	1	1	FLORES, HENRY C MD	11/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	68721	02	General Surgery	0	In state provider	None	451 MARCH AVE	STE B	HEALDSBURG	CA	95448	3387	49	06097	38.62594212	-122.8645263	Sonoma County
265744	Fee-for-Service	1750967790	1750967790	1	1	FOK, MICHELLE	6/21/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
265764	Fee-for-Service	1326206459	1326206459	1	1	FAYSSOUX, REGINALD S MD	8/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111590	20	Orthopedic Surgery	0	In state provider	None	39000 BOB HOPE DRIVE	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
265884	Fee-for-Service	1760418263	1760418263	1	1	FUNKE, DONNA J CRNA	5/16/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
265895	Fee-for-Service	1194847350	1194847350	1	1	FORTIER, MICHELLE A PHD	8/10/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
265950	Fee-for-Service	1689931164	1689931164	1	1	FELL, GILLIAN L MD	10/21/2022	2086S0120X	NA	General Surgery	026	PHYSICIANS	166503	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
265973	Fee-for-Service	1427055714	1427055714	1	1	FELIX, CHARLES G MD	4/1/2020	207P00000X	NA	Other	026	PHYSICIANS	167574	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 GARCES HWY	None	DELANO	CA	93215	3660	15	06029	35.76144847	-119.238912	Kern County
265998	Fee-for-Service	1013974880	1013974880	1	1	FIALKOFF, HENIE MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	48416	40	Pediatrics	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
266127	Fee-for-Service	1982802831	1982802831	1	1	FONG, EDITH H LCSW	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
266146	Fee-for-Service	1811600679	1811600679	1	1	FRANKLIN, ELANA PT	1/18/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5120 MANZANITA AVE	SUITE 110	CARMICHAEL	CA	95608	0590	34	06067	38.659392	-121.327155	Sacramento County
266201	Fee-for-Service	1205970670	1205970670	1	1	FRANE, SARA L OD	8/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MINOR HALL	None	BERKELEY	CA	94720	0001	01	06001	37.87133398	-122.2545466	Alameda County
266260	Fee-for-Service	1790708097	1790708097	1	1	FISK, JOHN W MD	6/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154129	01	General Practice	0	In state provider	None	97 SAN MARIN DRIVE	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
266329	Fee-for-Service	1124226535	1124226535	1	1	FLOYD, ROBERT T MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	1155 MILL ST	MAIL CODE J10	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
266471	Fee-for-Service	1366532574	1366532574	1	1	FLORENCE,ANDREW MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3580 WEST 900 SOUTH	None	WEST JORDAN	UT	84088	8812	00	None	40.60046993	-111.9764205	Salt Lake County
266494	Fee-for-Service	1306930961	1306930961	1	1	FAMILY PLANNING ASSOCIAT	1/1/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP INC	10200 SEPULVEDA BLVD	STE 200	MISSION HILLS	CA	91345	2657	19	06037	34.25572562	-118.4673156	Los Angeles County
266613	Fee-for-Service	1124226535	1124226535	1	1	FLOYD, ROBERT T MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	1155 MILL ST	MAIL CODE J10	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
266635	Fee-for-Service	1124196506	1124196506	1	1	FRANKLIN, BRODERICK J MD	7/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	75473	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 VALLEY CHILDRENS P	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
266664	Fee-for-Service	1417996620	1417996620	1	1	FERGUSON, BRIAN DO	11/1/2023	207P00000X	NA	Other	026	PHYSICIANS	21907	None	None	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
266734	Fee-for-Service	1558797118	1558797118	1	10	FIRST CHOICE PHYSICIAN PARTN	12/22/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	None	1180 N INDIAN CANYON DR	STE E421	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
266856	Fee-for-Service	1780947200	1780947200	1	1	FAROOQI, SAMIA S MD	9/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141497	66	Emergency Medicine (Urgent Care)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
266895	Fee-for-Service	1952491821	1952491821	1	1	FERRICK,KEVIN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	111 E 210TH ST	None	BRONX	NY	10469	0000	00	None	40.879872	-73.8798975	Bronx County
266926	Fee-for-Service	1801852686	1801852686	1	1	FITZER, TIM A MD	1/6/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	75920	70	Clinic (mixed specialty)	0	In state provider	None	2500 MILVIA ST	None	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
267003	Fee-for-Service	1578530846	1578530846	1	1	FILIP, LAURA L LCSW	4/21/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21338	-	NOT APPLICABLE	0	In state provider	None	8140 SUNLAND BLVD	None	SUN VALLEY	CA	91352	3948	19	06037	34.21829866	-118.3696743	Los Angeles County
267018	Fee-for-Service	1306342118	1306342118	1	1	FLYNN, SARAH J MD	9/2/2022	208M00000X	NA	Other	026	PHYSICIANS	165170	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
267022	Fee-for-Service	1558797118	1558797118	1	10	FIRST CHOICE PHYSICIAN PARTN	12/22/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	1180 N INDIAN CANYON DR	STE E421	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
267052	Fee-for-Service	1124325493	1124325493	1	1	FOSTER, SELENA I LMFT	8/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5213 EL MERCADO	SUITE A	SANTA ROSA	CA	95403	1301	49	06097	38.5092599	-122.7569259	Sonoma County
267068	Fee-for-Service	1225041809	1225041809	1	1	FORREST GENERAL HOSP	10/27/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	6051 U S HIGHWAY 49	None	HATTIESBURG	MS	39401	7201	00	None	31.31792537	-89.32785717	Forrest County
267181	Fee-for-Service	1740742394	1740742394	1	1	FRETZ, ANNA E MD	6/7/2022	208M00000X	NA	Other	026	PHYSICIANS	177075	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
267271	Fee-for-Service	1346228707	1346228707	1	1	FONG BECK, MEI-LING E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63227	41	Internal Medicine	0	In state provider	None	21 TAMAL VISTA BLVD	None	CORTE MADERA	CA	94925	1130	21	06041	37.93173997	-122.5179353	Marin County
267306	Fee-for-Service	1558797118	1558797118	1	10	FIRST CHOICE PHYSICIAN PARTN	12/22/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	None	1180 N INDIAN CANYON DR	STE E421	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
267318	Fee-for-Service	1366698144	1366698144	1	1	FANANAPAZIR, GHANEH MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125826	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
267343	Fee-for-Service	1265813257	1265813257	1	1	FIELD, JUSTIN T MD	9/21/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	178246	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
267354	Fee-for-Service	1225041809	1225041809	1	1	FORREST GENERAL HOSP	10/27/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	6051 U S HIGHWAY 49	None	HATTIESBURG	MS	39401	7201	00	None	31.31792537	-89.32785717	Forrest County
267367	Fee-for-Service	1063855336	1063855336	1	1	FEINSTEIN, LAWRENCE G PHD	6/15/2016	103TH0004X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1690 WOODSIDE ROAD	STE 221	REDWOOD CITY	CA	94061	2119	41	06081	37.45503368	-122.2287967	San Mateo County
267403	Fee-for-Service	1932496767	1932496767	1	1	FOUR SEASONS HEALTHCARE &	7/1/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTER LP	5335 LAUREL CANYON BLVD	None	NORTH HOLLYWOOD	CA	91607	2796	19	06037	34.16789941	-118.3965279	Los Angeles County
267445	Fee-for-Service	1134312952	1134312952	1	2	FRIEZE, ERIKA A PSYD	7/30/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
267466	Fee-for-Service	1457983801	1457983801	1	1	FULTON, MEGAN CRNA	3/18/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	23 UPPER RAGSDALE DR	STE 200	MONTEREY	CA	93940	5771	27	06053	36.57529358	-121.8101334	Monterey County
267471	Fee-for-Service	1376532143	1376532143	1	1	FOREST, STEVEN J	1/1/1990	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	2232 SANTA CLARA AVE	None	ALAMEDA	CA	94501	4417	01	06001	37.76660996	-122.2448643	Alameda County
267667	Fee-for-Service	1801837000	1801837000	1	1	FISHER, ROBERT B MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	41940	05	Anesthesiology	0	In state provider	None	127 SYDNEY LN	None	REDWOOD CITY	CA	94063	5503	41	06081	37.49725747	-122.2242637	San Mateo County
267787	Fee-for-Service	1134501794	1134501794	1	1	F & B PHARMACY, INC.	4/1/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	NDING CENTER	1464 MADERA RD	# I-2	SIMI VALLEY	CA	93065	3077	56	06111	34.26580213	-118.7961902	Ventura County
267845	Fee-for-Service	1902066822	1902066822	1	1	FRANKENBERG, TAMARA I MD	10/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	114164	40	Pediatrics	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
267905	Fee-for-Service	1225268790	1225268790	1	1	FATHY, HASSAN M MD	10/1/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	140352	36	Psychiatry	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
267910	Fee-for-Service	1578543732	1578543732	1	1	FIGAZOLO, JOSEPH F OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1001 TOWER WAY	STE 150	BAKERSFIELD	CA	93309	1586	15	06029	35.36363292	-119.0611362	Kern County
267924	Fee-for-Service	1568769412	1568769412	1	1	FRED J VON STIEFF MD A PROFE	8/12/2020	207QA0401X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	SSIONAL CORPORATION	2481 PACHECO ST	None	CONCORD	CA	94520	2019	07	06013	37.98055897	-122.0307888	Contra Costa County
267964	Fee-for-Service	1801229281	1801229281	1	1	FU, JIM	12/9/2015	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	391 SUTTER STREET	STE 210	SAN FRANCISCO	CA	94108	4309	38	06075	37.78942325	-122.4066993	San Francisco County
267992	Fee-for-Service	1841592805	1841592805	1	1	FREDERICK, WILLIAM J III MD	1/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123614	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
268056	Fee-for-Service	1962711861	1962711861	1	1	FRIEL, NICOLE A MD	10/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151736	None	None	0	In state provider	None	2425 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2215	34	06067	38.553012	-121.45545	Sacramento County
268082	Fee-for-Service	1548295132	1548295132	1	1	FOGELMAN, ALAN M MD	1/1/1995	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	22560	41	Internal Medicine	0	In state provider	UCLA PROF SVCS OFF	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
268187	Fee-for-Service	1477013852	1477013852	1	1	FRATE, BRADLEY	3/7/2024	390200000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
268291	Fee-for-Service	1659459337	1659459337	1	1	FORRESTER, DONALD D MD	6/17/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	32027	08	Family Practice	0	In state provider	None	2163 COTTAGE WAY	None	SACRAMENTO	CA	95825	1064	34	06067	38.604681	-121.4175105	Sacramento County
268312	Fee-for-Service	1891980595	1891980595	1	1	FORELL, LESLIE PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	820 LAS GALLINAS	None	SAN RAFAEL	CA	94903	3410	21	06041	38.00702954	-122.5471567	Marin County
268339	Fee-for-Service	1174601769	1174601769	1	1	FAZIO,SAL MD	8/22/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76303	41	Internal Medicine	0	In state provider	None	2200 O FARRELL ST	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.78224789	-122.4412946	San Francisco County
268424	Fee-for-Service	1518520881	1518520881	1	1	FISCH, EVAN	11/4/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	520 MEDICAL CENTER DRIVE	SUITE 201	MEDFORD	OR	97504	4334	00	None	42.318801	-122.831728	Jackson County
268458	Fee-for-Service	1972516649	1972516649	1	1	FILOMENA S. PASCUAL, M.D., I	1/25/2024	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	8710 MONROE CT	STE. # 200	RANCHO CUCAMONGA	CA	91730	4883	36	06071	34.09544496	-117.5747968	San Bernardino County
268501	Fee-for-Service	1528176781	1528176781	1	1	FANG, EVELYN MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72557	41	Internal Medicine	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
268505	Fee-for-Service	1235219387	1235219387	1	1	FERNANDEZ,ELSA MD	12/1/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	24699	40	Pediatrics	0	In state provider	UC REGENTS PEDIATRICS	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
268530	Fee-for-Service	1417119389	1417119389	1	1	FAVRE-SMITH, ERIN K LCSW	10/4/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	302 W 5TH ST	308	SAN PEDRO	CA	90731	2750	19	06037	33.73971572	-118.284045	Los Angeles County
268568	Fee-for-Service	1851659296	1851659296	1	1	FAGGARD, MORGAN L DO	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13037	01	General Practice	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
268630	Fee-for-Service	1558797118	1558797118	1	4	FIRST CHOICE PHYSICIAN PARTN	5/1/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	PARTNERS	1100 N PALM CANYON DR	SUITE 203	PALM SPRINGS	CA	92262	4426	33	06065	33.838182	-116.546744	Riverside County
268646	Fee-for-Service	1144292897	1144292897	1	1	FELSER, BETSY MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84832	41	Internal Medicine	0	In state provider	None	1355 S SAN PEDRO ST	None	LOS ANGELES	CA	90015	3117	19	06037	34.03243628	-118.2543121	Los Angeles County
268739	Fee-for-Service	1730418971	1730418971	1	1	FOWLER, STEPHANIE L I LCSW	3/7/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2238 MONTE VISTA AVE	None	OROVILLE	CA	95966	6956	04	06007	39.474855	-121.5431325	Butte County
268784	Fee-for-Service	1528176781	1528176781	1	1	FANG, EVELYN MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72557	08	Family Practice	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
268798	Fee-for-Service	1053610410	1053610410	1	1	FARRELL, JESSICA M DO	1/14/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	12660	22	Pathology (M.D. only)	0	In state provider	None	305 PARK CREEK DR	None	CLOVIS	CA	92150	9015	10	06019	36.84077548	-119.7076545	Fresno County
268815	Fee-for-Service	1891913950	1891913950	1	1	FOREVER YOUNG ADULT DAY	6/30/2004	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	4265-73 MAINE AVE	None	BALDWIN PARK	CA	91706	3312	19	06037	34.08985365	-117.9605136	Los Angeles County
268856	Fee-for-Service	1306953021	1306953021	1	1	FREIMANN, JACK H MD JR	5/7/1991	174400000X	NA	Other	026	PHYSICIANS	58179	78	Neoplastic Diseases/Oncology	0	In state provider	None	2101 W BEVERLY BLVD	STE 300	MONTEBELLO	CA	90640	3951	19	06037	34.02044497	-118.1217168	Los Angeles County
268994	Fee-for-Service	1245313683	1245313683	1	1	FEDAK, MARIAN A MD INC	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	18624	01	General Practice	0	In state provider	None	1710 CESAR CHAVEZ	STE 220	LOS ANGELES	CA	90033	0000	19	06037	34.05101259	-118.217259	Los Angeles County
269242	Fee-for-Service	1275669038	1275669038	1	1	FREEMAN, JED L MD	10/15/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	73860	41	Internal Medicine	0	In state provider	None	2340 LIBERTY PKWY	200	RED BLUFF	CA	96080	4350	52	06103	40.15134646	-122.2220526	Tehama County
269273	Fee-for-Service	1245313683	1245313683	1	1	FEDAK, MARIAN A MD INC	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	18624	41	Internal Medicine	0	In state provider	None	1710 CESAR CHAVEZ	STE 220	LOS ANGELES	CA	90033	0000	19	06037	34.05101259	-118.217259	Los Angeles County
269316	Fee-for-Service	1215170147	1215170147	1	1	FARASH, LAUREN MD	9/16/2010	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	104587	40	Pediatrics	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
269455	Fee-for-Service	1346964616	1346964616	1	1	FLANNERY, RANDY D NP	5/1/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
269521	Fee-for-Service	1275669038	1275669038	1	1	FREEMAN, JED L MD	10/15/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	73860	70	Clinic (mixed specialty)	0	In state provider	None	2340 LIBERTY PKWY	200	RED BLUFF	CA	96080	4350	52	06103	40.15134646	-122.2220526	Tehama County
269763	Fee-for-Service	1558797118	1558797118	1	13	FIRST CHOICE PHYSICIAN PARTN	9/10/2017	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	ARTNERS	47647 CALEO BAY DR	STE 210	LA QUINTA	CA	92253	8858	33	06065	33.70305235	-116.2936509	Riverside County
269788	Fee-for-Service	1730639097	1730639097	1	1	F & B MEDICAL TRANSPORT, INC	11/27/2019	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	11751 SLAUSON AVE	#10	SANTA FE SPRINGS	CA	90670	0670	19	06037	33.96467264	-118.0645617	Los Angeles County
269800	Fee-for-Service	1275669038	1275669038	1	1	FREEMAN, JED L MD	10/15/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	73860	68	Hematology	0	In state provider	None	2340 LIBERTY PKWY	200	RED BLUFF	CA	96080	4350	52	06103	40.15134646	-122.2220526	Tehama County
269830	Fee-for-Service	1235217084	1235217084	1	1	FONG, MICHAEL L MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	64486	01	General Practice	0	In state provider	None	45 S 17TH ST	None	SAN JOSE	CA	95112	2032	43	06085	37.34311801	-121.8738218	Santa Clara County
269867	Fee-for-Service	1134953045	1134953045	1	1	FRIEND OF BOON	3/7/2025	405300000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	527 S STATE ST	B	UKIAH	CA	95482	4910	23	06045	39.1462656	-123.2068701	Mendocino County
269871	Fee-for-Service	1841250719	1841250719	1	1	FORSTHOFF, CYNTHIA A MD	12/31/1992	174400000X	NA	Other	026	PHYSICIANS	59518	68	Hematology	0	In state provider	None	2653 ELM AVE	STE 300	LONG BEACH	CA	90806	1636	19	06037	33.805512	-118.188348	Los Angeles County
269874	Fee-for-Service	1134154388	1134154388	1	1	FORTNER, CORWYN D MD	7/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	87236	05	Anesthesiology	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
269882	Fee-for-Service	1154301935	1154301935	1	1	FLYNN, NEIL M	7/18/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	27631	None	None	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
269907	Fee-for-Service	1831403526	1831403526	1	1	FUJIKAWA, REYNOLD N PSYD	2/10/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVE	230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
269932	Fee-for-Service	1578791661	1578791661	1	1	FARUKHI, MOHAMMAD U MD	7/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115239	41	Internal Medicine	0	In state provider	None	1211 W LA PALMA AVE	STE 207	ANAHEIM	CA	92801	3815	30	06059	33.84718298	-117.933758	Orange County
269949	Fee-for-Service	1114981594	1114981594	1	1	FENG, SANDY MD	5/21/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83048	45	Nephrology (Renal-Kidney)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
269994	Fee-for-Service	1386797959	1386797959	1	1	FEIN, NATASHA M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71990	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
270002	Fee-for-Service	1982663837	1982663837	1	1	FOGEL, STEVEN P	1/10/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	67570	22	Pathology (M.D. only)	0	In state provider	None	2828 H ST	STE D	BAKERSFIELD	CA	93301	1900	15	06029	35.38544945	-119.0211132	Kern County
270042	Fee-for-Service	1558797118	1558797118	1	13	FIRST CHOICE PHYSICIAN PARTN	9/10/2017	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	ARTNERS	47647 CALEO BAY DR	STE 210	LA QUINTA	CA	92253	8858	33	06065	33.70305235	-116.2936509	Riverside County
270137	Fee-for-Service	1780805879	1780805879	1	1	FRYE, NANCY	5/1/1994	313M00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	556 VALLEY VIEW DR	None	PARADISE	CA	95969	3033	04	06007	39.7648344	-121.6304529	Butte County
270149	Fee-for-Service	1841250719	1841250719	1	1	FORSTHOFF, CYNTHIA A MD	12/31/1992	174400000X	NA	Other	026	PHYSICIANS	59518	78	Neoplastic Diseases/Oncology	0	In state provider	None	2653 ELM AVE	STE 300	LONG BEACH	CA	90806	1636	19	06037	33.805512	-118.188348	Los Angeles County
270151	Fee-for-Service	1174661227	1174661227	1	1	FARRAHI, FARINAZ MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	95425	03	Allergy	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
270174	Fee-for-Service	1538608898	1538608898	1	1	FRESNO COMMUNITY BASED ADULT	3/11/2020	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	SERVICES CENTER LLC	1060 FULTON MALL #105	STE 105	FRESNO	CA	93721	0000	10	06019	36.73452631	-119.7907356	Fresno County
270216	Fee-for-Service	1003076621	1003076621	1	1	FARAHVASH, SHAHRAM MD	10/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115190	05	Anesthesiology	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
270224	Fee-for-Service	1811381734	1811381734	1	1	FERIA, JORGE L MD	3/30/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	168197	40	Pediatrics	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
270227	Fee-for-Service	1114981594	1114981594	1	1	FENG, SANDY MD	5/21/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83048	02	General Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
270272	Fee-for-Service	1386797959	1386797959	1	1	FEIN, NATASHA M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71990	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
270292	Fee-for-Service	1306930052	1306930052	1	1	FAMILY PLANNING ASSOCIATES M	1/1/1983	261QA0005X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	EDICAL GROUP INC	425 EAST COLORADO STREET	SUITE 420	GLENDALE	CA	91205	5123	19	06037	34.14266036	-118.2504208	Los Angeles County
270314	Fee-for-Service	1902950447	1902950447	1	1	FARAG, SALWA S MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	48537	01	General Practice	0	In state provider	None	50 BELLEFONTAINE ST	STE 201	PASADENA	CA	91105	3132	19	06037	34.13155953	-118.1517525	Los Angeles County
270315	Fee-for-Service	1164517744	1164517744	1	4	FAMILY HEALTHCARE NETWORK	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	682 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.2977601	-119.2009571	Tulare County
270318	Fee-for-Service	1558797118	1558797118	1	13	FIRST CHOICE PHYSICIAN PARTN	9/10/2017	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	ARTNERS	47647 CALEO BAY DR	STE 210	LA QUINTA	CA	92253	8858	33	06065	33.70305235	-116.2936509	Riverside County
270548	Fee-for-Service	1255951794	1255951794	1	1	FIRSTMED HOSPICE INC	8/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1135 E ROUTE 66	STE 207	GLENDORA	CA	91740	3778	19	06037	34.12888853	-117.845127	Los Angeles County
270588	Fee-for-Service	1659901239	1659901239	1	1	FAUCETT-MAPLES, ELAYNE M NP	6/8/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
270590	Fee-for-Service	1164517744	1164517744	1	4	FAMILY HEALTHCARE NETWORK	9/30/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	682 E VISALIA RD	None	FARMERSVILLE	CA	93223	1641	54	06107	36.2977601	-119.2009571	Tulare County
270708	Fee-for-Service	1003122854	1003122854	1	1	FRANCE, SHADAVIA PSYD	6/14/2021	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
270797	Fee-for-Service	1043445794	1043445794	1	1	FLORIE, BRETT M DO	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9732	05	Anesthesiology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
270834	Fee-for-Service	1255951794	1255951794	1	1	FIRSTMED HOSPICE INC	8/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1135 E ROUTE 66	STE 207	GLENDORA	CA	91740	3778	19	06037	34.12888853	-117.845127	Los Angeles County
270846	Fee-for-Service	1255300406	1255300406	1	1	FISHER, CHRISTOPHER J MD	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
270861	Fee-for-Service	1104056761	1104056761	1	1	FARRIS, DAVID M	5/25/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	400 CRAVEN RD	None	SAN MARCOS	CA	92078	4201	37	06073	33.12746646	-117.17028	San Diego County
270912	Fee-for-Service	1174507347	1174507347	1	1	FRISHMAN, RICHARD D	8/5/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	54270	None	None	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
271028	Fee-for-Service	1891959722	1891959722	1	1	FREE, GREGORY	5/15/2008	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1035 GRAYSON ST	None	BERKELEY	CA	94710	2642	01	06001	37.85605581	-122.2888417	Alameda County
271033	Fee-for-Service	1184723280	1184723280	1	1	FAULK,CATHERINE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2500 N STATE ST	None	JACKSON	MS	39216	0000	00	None	32.33121732	-90.17553957	Hinds County
271109	Fee-for-Service	1669497822	1669497822	1	1	FERREYRA, HENRY A MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77921	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	DEPT 8201	SAN DIEGO	CA	92103	8201	37	06073	32.7537975	-117.1658298	San Diego County
271116	Fee-for-Service	1124325816	1124325816	1	1	FERRA, JOSEPH W LMFT	7/2/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45177	-	NOT APPLICABLE	0	In state provider	None	1523 LONGBRANCH AVE	None	GROVER BEACH	CA	93433	2508	40	06079	35.11917729	-120.6126498	San Luis Obispo County
271141	Fee-for-Service	1548325152	1548325152	1	1	FOUNG, STEVEN K MD	9/18/2023	207ZP0101X	NA	Other	026	PHYSICIANS	32807	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
271147	Fee-for-Service	1013988625	1013988625	1	1	FRALEY, LINDA L MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	35360	40	Pediatrics	0	In state provider	FRESNO CHILDRENS MED GRP	7720 N FRESNO ST	STE 104	FRESNO	CA	93720	2407	10	06019	36.85068226	-119.7836282	Fresno County
271204	Fee-for-Service	1689633638	1689633638	1	1	FLETCHER, DONALD C MD	7/11/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	56961	18	Ophthalmology	0	In state provider	None	2340 CLAY ST	STE 514	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
271219	Fee-for-Service	1124341771	1124341771	1	1	FALK, AARON E MD	5/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105956	41	Internal Medicine	0	In state provider	None	2175 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7024	09	06017	38.91234551	-119.9972565	El Dorado County
271232	Fee-for-Service	1669552840	1669552840	1	1	FELDMAN, JOANNE MD	1/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88786	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
271250	Fee-for-Service	1528030046	1528030046	1	1	FISCHER, HANS J MD	5/24/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53913	30	Radiology	0	In state provider	None	21828 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.829101	-118.299183	Los Angeles County
271287	Fee-for-Service	1710905690	1710905690	1	1	FORMULA MEDICAL GROUP	5/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	A PROF MED CORP	18182 HWY 18	STE 105	APPLE VALLEY	CA	92307	0000	36	06071	34.54087945	-117.267147	San Bernardino County
271319	Fee-for-Service	1497047575	1497047575	1	1	FU, LIYING MD	2/27/2024	207ZP0102X	NA	Other	026	PHYSICIANS	166103	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
271414	Fee-for-Service	1154336576	1154336576	1	1	FREEMAN, ROGER A MD	6/14/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	29093	None	None	0	In state provider	None	7485 MISSION VALLEY RD	STE 103	SAN DIEGO	CA	92108	4422	37	06073	32.77950357	-117.1604951	San Diego County
271428	Fee-for-Service	1891766861	1891766861	1	1	FAUST, ROBERT L MD	8/31/1993	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	46484	01	General Practice	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
271440	Fee-for-Service	1720385420	1720385420	1	1	FORTUNA REHABILITATION &	4/1/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTER LP	2321 NEWBURG ROAD	None	FORTUNA	CA	95540	2815	12	06023	40.59056657	-124.1412296	Humboldt County
271448	Fee-for-Service	1649253162	1649253162	1	1	FOGEL, LAWRENCE J MD	7/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	18977	13	Neurology (M.D. only)	0	In state provider	None	628 CALIFORNIA BLVD	SUITE A-3	SAN LUIS OBISPO	CA	93401	2542	40	06079	35.28917428	-120.6578269	San Luis Obispo County
271478	Fee-for-Service	1033552187	1033552187	1	1	FARBER, MARK MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141401	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1737	19	06037	34.07671715	-118.3799413	Los Angeles County
271533	Fee-for-Service	1700027877	1700027877	1	1	FERRO, DIEGO F	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106012	None	None	0	In state provider	None	530 W ACACIA ST	STE 1	STOCKTON	CA	95203	2400	39	06077	37.96109625	-121.3011471	San Joaquin County
271556	Fee-for-Service	1326658329	1326658329	1	1	FOCUS NON-EMERGENCY TRANSPOR	12/27/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TATION	1222 MONACO CT	None	STOCKTON	CA	95207	4919	39	06077	37.9883327	-121.3201864	San Joaquin County
271675	Fee-for-Service	1225181399	1225181399	1	1	FECHTER, BRIAN S MD	1/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97500	18	Ophthalmology	0	In state provider	None	1011 SYLVAN AVE	STE C	MODESTO	CA	95350	1693	50	06099	37.68896459	-120.979468	Stanislaus County
271717	Fee-for-Service	1932362316	1932362316	1	1	FARJAD, HELEN OD	10/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
271722	Fee-for-Service	1649253162	1649253162	1	1	FOGEL, LAWRENCE J MD	7/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	18977	79	Neurology-Child	0	In state provider	None	628 CALIFORNIA BLVD	SUITE A-3	SAN LUIS OBISPO	CA	93401	2542	40	06079	35.28917428	-120.6578269	San Luis Obispo County
271764	Fee-for-Service	1275996944	1275996944	1	1	FRANKLIN WELBORN MD	3/23/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9601 BAPTIST HEALTH DR	None	LITTLE ROCK	AR	72205	6321	00	None	34.744437	-92.3813595	Pulaski County
271793	Fee-for-Service	1376566455	1376566455	1	2	FEIG, KEVIN P MD	9/24/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	86632	-	NOT APPLICABLE	0	In state provider	None	40700 CALIFORNIA OAKS RD	STE 201 202 203	MURRIETA	CA	92562	5789	33	06065	33.57067363	-117.2045035	Riverside County
271808	Fee-for-Service	1609849884	1609849884	1	1	FELMET, KATHRYN A MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	3181 SW SAM JACKSON PARK	None	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
271831	Fee-for-Service	1568740355	1568740355	1	1	FAHID, AMIR H MD	6/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128773	41	Internal Medicine	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
271833	Fee-for-Service	1982752465	1982752465	1	1	FAROOQUI, MOHAMMED S MD	1/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97911	41	Internal Medicine	0	In state provider	None	4955 VAN NUYS BLVD	STE 502	SHERMAN OAKS	CA	91403	1817	19	06037	34.160805	-118.4487295	Los Angeles County
271881	Fee-for-Service	1669451969	1669451969	1	1	FOSTER, ATHANASIOS J MD	8/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	37725	08	Family Practice	0	In state provider	None	1335 CAMINO DEL MAR	None	DEL MAR	CA	92014	2507	37	06073	32.95822287	-117.2647474	San Diego County
271903	Fee-for-Service	1447308432	1447308432	1	1	FERNANDO, PETER E MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44723	05	Anesthesiology	0	In state provider	ATTN MGA	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
272040	Fee-for-Service	1316931934	1316931934	1	1	FAYED, ALI M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56454	41	Internal Medicine	0	In state provider	None	1133 R ST	None	FRESNO	CA	93721	1313	10	06019	36.74124515	-119.7837131	Fresno County
272058	Fee-for-Service	1326448317	1326448317	1	1	FILICIOTTO, SAM MD INC	1/12/2015	208600000X	NA	General Surgery	026	PHYSICIANS	65491	02	General Surgery	0	In state provider	None	15708 POMERADO ROAD	SUITE N-207	POWAY	CA	92064	2036	37	06073	32.99948815	-117.0580342	San Diego County
272176	Fee-for-Service	1447308432	1447308432	1	1	FERNANDO, PETER E MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	44723	01	General Practice	0	In state provider	ATTN MGA	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
272309	Fee-for-Service	1578037867	1578037867	1	1	FERNANDEZ, KAYLA I LCSW	11/10/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	45445 PORTOLA AVE	SUITE 1	PALM DESERT	CA	92260	4844	33	06065	33.7186073	-116.3737698	Riverside County
272384	Fee-for-Service	1457131674	1457131674	1	1	FROEHLICH, KATHERINE CRNA	12/2/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1150 INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
272429	Fee-for-Service	1194762542	1194762542	1	1	FEATHERLY, CHARLES DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2727 MCCLELLAND BLVD	None	JOPLIN	MO	64804	1626	00	None	37.06080628	-94.53202788	Jasper County
272583	Fee-for-Service	1306045398	1306045398	1	1	FEDERMAN, NOAH C MD	4/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87474	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	BLDG 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
272653	Fee-for-Service	1992246227	1992246227	1	1	FAZIO, JANE C MD	1/31/2023	207R00000X	NA	Other	026	PHYSICIANS	170295	None	None	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
272691	Fee-for-Service	1770933608	1770933608	1	1	FRIES, JULIA CNP	9/16/2022	363L00000X	NA	Nurse Practitioner	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
272706	Fee-for-Service	1245203116	1245203116	1	1	FALK, JENNIFER S MD	2/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	60585	08	Family Practice	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
272732	Fee-for-Service	1881946028	1881946028	2	1	FIALK, JAMES LANGAN	2/1/2023	175F00000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	130 PETALUMA AVE	SUITE 2E	SEBASTOPOL	CA	95472	4234	49	06097	38.40200716	-122.8229065	Sonoma County
272736	Fee-for-Service	1871212662	1871212662	1	1	FENDER-BADGLEY, MIKAYLA R PT	9/28/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	350 JOHN MUIR PKWY	250	BRENTWOOD	CA	94513	5183	07	06013	37.91980577	-121.734715	Contra Costa County
272800	Fee-for-Service	1275022626	1275022626	1	1	FOOTHILL MEDICAL PHARMACY	11/26/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7220 FOOTHILL BLVD	None	TUJUNGA	CA	91042	3464	19	06037	34.24871469	-118.2888969	Los Angeles County
272816	Fee-for-Service	1467027458	1467027458	1	1	FRANKLIN, VERONICA S LCSW	9/24/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	01	06001	37.70755227	-121.7149933	Alameda County
272829	Fee-for-Service	1679951347	1679951347	1	1	FOO, BILL MD	7/11/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	155650	40	Pediatrics	0	In state provider	None	2480 SONOMA STREET	None	REDDING	CA	96001	3027	45	06089	40.57326337	-122.403701	Shasta County
272895	Fee-for-Service	1184043085	1184043085	1	2	FILIPPA, ALYSON LCSW	8/27/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	656 PIEZZI RD	None	SANTA ROSA	CA	95401	5538	49	06097	38.4289122	-122.7973378	Sonoma County
272998	Fee-for-Service	1972603447	1972603447	1	1	FRANEY, KRISTINA L MD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	614 5TH AVE	STE A	SAN DIEGO	CA	92101	6964	37	06073	32.71204632	-117.1601718	San Diego County
273028	Fee-for-Service	1578526356	1578526356	1	1	FRYER, DARRIN MD	3/1/2001	207P00000X	NA	Other	026	PHYSICIANS	54794	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2353 N CHESTER AVE	None	BAKERSFIELD	CA	93308	1713	15	06029	35.42733	-119.0213685	Kern County
273062	Fee-for-Service	1376563296	1376563296	1	1	FLEISCHMANN, JACOB MD	12/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	40660	77	Infectious Disease	0	In state provider	None	1100 LAS TABLAS ROAD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
273070	Fee-for-Service	1295900439	1295900439	1	1	FACULTY PHYS & SURG OF	6/25/2008	2088P0231X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	LLUSM	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
273217	Fee-for-Service	1003016049	1003016049	1	1	FUJII, LORENA M NP	8/3/2021	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
273254	Fee-for-Service	1093893612	1093893612	1	1	FUNG, RAMONA QUAN-SEN MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60008	04	Otology, Laryngology, Rhinology	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
273270	Fee-for-Service	1093229650	1093229650	1	1	FILLERUP, CASEY B DPM	5/27/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1145 CLARK AVE	STE A	SANTA MARIA	CA	93455	5105	42	06083	34.8650893	-120.4170345	Santa Barbara County
273336	Fee-for-Service	1295900439	1295900439	1	1	FACULTY PHYS & SURG OF	5/2/2017	2088P0231X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	LLUSM	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
273402	Fee-for-Service	1164185583	1164185583	1	1	FUNK, BRANDON PT	11/1/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1626 SWEETWATER ROAD	SUITES A & B	NATIONAL CITY	CA	91950	7645	37	06073	32.66147525	-117.0818981	San Diego County
273451	Fee-for-Service	1730590290	1730590290	1	1	FELLMANN, ANNA T MD	11/11/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	138371	08	Family Practice	0	In state provider	None	202 W WILLOW AVE	SUITE 502	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
273461	Fee-for-Service	1881630002	1881630002	1	1	FRAIOLI, RICHARD MD	1/2/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	20537	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
273518	Fee-for-Service	1144425950	1144425950	1	1	FREEMAN, MICHAEL A MD	9/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	56681	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
273586	Fee-for-Service	1265464820	1265464820	1	6	FOOT & ANKLE CONCEPTS INC	12/7/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	650 COMMERCE AVE	STE D	PALMDALE	CA	93551	3884	19	06037	34.58955354	-118.141074	Los Angeles County
273605	Fee-for-Service	1295900439	1295900439	1	1	FACULTY PHYS & SURG OF	6/25/2008	2088P0231X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	LLUSM	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
273684	Fee-for-Service	1821206038	1821206038	1	1	FIDEL, DINA CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	167 E FREMONT AVE	None	SUNNYVALE	CA	94087	2501	43	06085	37.35224336	-122.0313665	Santa Clara County
273735	Fee-for-Service	1013996685	1013996685	1	1	FERRER, EDWARD B MD	6/2/2020	207L00000X	NA	Other	026	PHYSICIANS	42866	05	Anesthesiology	0	In state provider	None	975 SOUTH FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
273964	Fee-for-Service	1629093893	1629093893	1	1	FEIN, STEPHANIE P MD	6/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68024	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
274015	Fee-for-Service	1609926419	1609926419	1	1	FASHINELL, THOMAS MD INC	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	16623	41	Internal Medicine	0	In state provider	#C	1515 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3063	07	06013	37.91352028	-122.0431023	Contra Costa County
274152	Fee-for-Service	1992835078	1992835078	1	1	FORMAN, MARVIN OD APC	1/31/1986	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15066 ROSECRANS AVE	None	LA MIRADA	CA	90638	4740	19	06037	33.89842482	-118.0096606	Los Angeles County
274161	Fee-for-Service	1558797118	1558797118	1	12	FIRST CHOICE PHYSICIAN PARTN	7/7/2017	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	ARTNERS	1180 N INDIAN CANYON DR	SUITE 200	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
274162	Fee-for-Service	1265788822	1265788822	1	1	FRANCIS-CISNEROS, JANET M LM	2/21/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	2030 EAST 4TH STREET	138F	SANTA ANA	CA	92705	3920	30	06059	33.74808045	-117.8378273	Orange County
274212	Fee-for-Service	1578941076	1578941076	1	1	FATIMA, NUZHAT MD	1/28/2020	208M00000X	NA	Other	026	PHYSICIANS	155821	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
274372	Fee-for-Service	1225167737	1225167737	1	1	FIGUEROA, GABRIEL A LMFT	1/21/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
274385	Fee-for-Service	1790030179	1790030179	1	1	FRANCIS, NICOLE J MD	9/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	119021	40	Pediatrics	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
274425	Fee-for-Service	1558797118	1558797118	1	12	FIRST CHOICE PHYSICIAN PARTN	7/7/2017	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	ARTNERS	1180 N INDIAN CANYON DR	SUITE 200	PALM SPRINGS	CA	92262	4800	33	06065	33.839505	-116.5455735	Riverside County
274461	Fee-for-Service	1366526634	1366526634	1	1	FERRANTI, JESSICA A MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97215	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
274464	Fee-for-Service	1063554475	1063554475	1	1	FOYGELMAN, ALEKSANDR DPM	6/1/2002	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	7531 SANTA MONICA BLVD	STE 100B	WEST HOLLYWOOD	CA	90046	6401	19	06037	34.09081315	-118.3541261	Los Angeles County
274466	Fee-for-Service	1083831572	1083831572	1	1	FU, DAISY H OD	5/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	888 S HILL RD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
274488	Fee-for-Service	1376017459	1376017459	1	1	FINLINSON, NICHOLAS CRNA	9/1/2022	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
274507	Fee-for-Service	1548295371	1548295371	1	1	FU, SHIH-WEN MD	7/1/1983	207RP1001X	NA	Pulmonology	026	PHYSICIANS	37728	41	Internal Medicine	0	In state provider	None	399 E HIGHLAND AVE	STE 416	SAN BERNARDINO	CA	92404	3867	36	06071	34.1358627	-117.2757898	San Bernardino County
274514	Fee-for-Service	1972156479	1972156479	1	1	FLOREA, ANDREI MD	8/1/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	177123	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
274528	Fee-for-Service	1427077874	1427077874	1	1	FOSTER,MARTIN C MD	4/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	811 13TH STREET	None	HOOD RIVER	OR	97031	0000	00	None	45.70453292	-121.5251149	Hood River County
274542	Fee-for-Service	1316908304	1316908304	1	1	FRAM, EVAN K. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	350 W THOMAS RD	None	PHOENIX	AZ	85013	4409	00	None	33.480864	-112.0795155	Maricopa County
274567	Fee-for-Service	1184031056	1184031056	1	1	FORBES, RACHAEL A LMFT	4/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	300 MONTGOMERY	STE 204	SAN FRANCISCO	CA	94104	1902	38	06075	37.7923269	-122.4026145	San Francisco County
274571	Fee-for-Service	1720011711	1720011711	1	1	FEDERAL WAY MEDICAL	2/21/2014	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	2	Out of state provider	INVESTORS LLC	491 S 338TH STREET	None	FEDERAL WAY	WA	98003	6290	00	None	47.29858373	-122.3266982	King County
274639	Fee-for-Service	1407315864	1407315864	1	1	FARIBA, KAMRON A DO	2/12/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22760	36	Psychiatry	0	In state provider	None	510 S SECOND AVE	SUITE 6 & 7	COVINA	CA	91723	3017	19	06037	34.0805013	-117.8878213	Los Angeles County
274646	Fee-for-Service	1558797118	1558797118	1	17	FIRST CHOICE PHYSICIAN PARTN	5/19/2022	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	& SPECIALTY CARE	1180 N INDIAN CANYON DR	SUITE W201	PALM SPRINGS	CA	92262	4876	33	06065	33.839505	-116.5455735	Riverside County
274767	Fee-for-Service	1386273977	1386273977	1	1	FIRMO, FELIPE MD	10/1/2023	207P00000X	NA	Other	026	PHYSICIANS	187436	None	None	0	In state provider	None	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
274773	Fee-for-Service	1548295371	1548295371	1	1	FU, SHIH-WEN MD	7/1/1983	207RP1001X	NA	Pulmonology	026	PHYSICIANS	37728	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	399 E HIGHLAND AVE	STE 416	SAN BERNARDINO	CA	92404	3867	36	06071	34.1358627	-117.2757898	San Bernardino County
274812	Fee-for-Service	1083819874	1083819874	1	1	FLYNN, NANETTE M	6/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
274842	Fee-for-Service	1912343104	1912343104	1	1	FACULTY PHYSICIANS AND	7/25/2013	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	SURGEONS OF LLUSM	1101 N EUCLID AVE	STE B	UPLAND	CA	91786	3233	36	06071	34.10857828	-117.6513819	San Bernardino County
274875	Fee-for-Service	1326203233	1326203233	1	1	FAMILY DOCTORS OF SANTA	9/23/2008	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	CRUZ APC	550 WATER STREET	STE A	SANTA CRUZ	CA	95060	4124	44	06087	36.98046158	-122.018718	Santa Cruz County
274905	Fee-for-Service	1407315864	1407315864	1	1	FARIBA, KAMRON A DO	2/28/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	22760	-	NOT APPLICABLE	0	In state provider	None	510 S SECOND AVE	SUITE 6 & 7	COVINA	CA	91723	3017	19	06037	34.0805013	-117.8878213	Los Angeles County
274920	Fee-for-Service	1073599072	1073599072	1	1	FISHER, ROBERT DALE MD	6/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
274929	Fee-for-Service	1265697270	1265697270	1	1	FAMILY WELLNESS CENTER & WAL	2/27/2019	261Q00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	K IN CLINIC INC	1159 N CHERRY ST	None	TULARE	CA	93274	2231	54	06107	36.22432851	-119.3370775	Tulare County
274974	Fee-for-Service	1902366628	1902366628	1	1	FORD, JAMES S MD	5/9/2022	207P00000X	NA	Other	026	PHYSICIANS	177775	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
274997	Fee-for-Service	1215087770	1215087770	1	1	FARMER, STEVEN G DPM	10/1/1983	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5814 VAN ALLEN WAY	STE 150	CARLSBAD	CA	92008	7359	37	06073	33.13600632	-117.2876273	San Diego County
275000	Fee-for-Service	1538186432	1538186432	1	1	FARNEY, KENT J MD	5/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	41657	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	165 ROWLAND WAY	STE 311	NOVATO	CA	94945	5059	21	06041	38.09824386	-122.559872	Marin County
275074	Fee-for-Service	1598938771	1598938771	1	1	FLEMING, SHANNA M LMFT	10/13/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	321 RAMPART ST	STE 210	ORANGE	CA	92868	1860	30	06059	33.7916061	-117.8822879	Orange County
275075	Fee-for-Service	1952329443	1952329443	1	1	FORTNER, SANDRA T MD	7/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	78957	05	Anesthesiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.049547	-117.264078	San Bernardino County
275103	Fee-for-Service	1912343104	1912343104	1	1	FACULTY PHYSICIANS AND	7/25/2013	193200000X	NA	Other	022	PHYSICIANS GROUP	-	35	Pediatric Cardiology (M.D. only)	0	In state provider	SURGEONS OF LLUSM	1101 N EUCLID AVE	STE B	UPLAND	CA	91786	3233	36	06071	34.10857828	-117.6513819	San Bernardino County
275136	Fee-for-Service	1932634045	1932634045	1	1	FOLLANSBEE, MATTHEW R MD	8/26/2022	207L00000X	NA	Other	026	PHYSICIANS	159794	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
275176	Fee-for-Service	1043943228	1043943228	1	1	FONG, MICHELA OD	11/7/2024	390200000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3801 KATELLA AVE	STE 130	LOS ALAMITOS	CA	90720	3362	30	06059	33.80318951	-118.066068	Orange County
275218	Fee-for-Service	1598747065	1598747065	1	1	FULLER, WILLIAM D MD	7/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87087	02	General Surgery	0	In state provider	None	7301 TOPANGA CANYON BLVD	STE 330	CANOGA PARK	CA	91303	1357	19	06037	34.203222	-118.605988	Los Angeles County
275313	Fee-for-Service	1992853261	1992853261	1	1	FLAHERTY, MICHAEL E DPM	3/31/1988	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5405 W HILLSDALE AVE	None	VISALIA	CA	93291	5156	54	06107	36.329364	-119.3510385	Tulare County
275405	Fee-for-Service	1780143578	1780143578	1	1	FRANCIS, NATALIE K MD	2/5/2024	208M00000X	NA	Other	026	PHYSICIANS	192237	None	None	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
275451	Fee-for-Service	1952969024	1952969024	1	1	FOWLER CARE CENTER LLC	12/3/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	8448 E ADAMS AVE	None	FOWLER	CA	93625	9773	10	06019	36.63439504	-119.6378291	Fresno County
275519	Fee-for-Service	1285910356	1285910356	1	1	FAZEL, MARYAM S MD	1/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114531	08	Family Practice	0	In state provider	None	1100 W GLENOAKS BLVD	None	GLENDALE	CA	91202	2606	19	06037	34.16406001	-118.28021	Los Angeles County
275528	Fee-for-Service	1700681905	1700681905	1	1	FAVIA, GIULIA C	4/21/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	27	06053	0	0	None
275579	Fee-for-Service	1619130374	1619130374	1	1	FRIBERG, TRAVIS K	9/21/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2220 5TH AVE	None	OROVILLE	CA	95965	5816	04	06007	39.50224076	-121.5649012	Butte County
275652	Fee-for-Service	1669879284	1669879284	1	1	FLORES, CHRISTINA	12/3/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4835 N. F STREET	None	SAN BERNARDINO	CA	92407	3122	36	06071	34.17223131	-117.2961478	San Bernardino County
275664	Fee-for-Service	1710643168	1710643168	1	1	FRESENIUS MEDICAL CARE SAN	5/1/2023	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	BERNARDINO LLC	10557 JUNIPER AVE	BUILDING A, STE B	FONTANA	CA	92337	7589	36	06071	34.061742	-117.4399605	San Bernardino County
275768	Fee-for-Service	1265464820	1265464820	1	2	FOOT & ANKLE CONCEPTS INC	5/7/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3180 WILLOW LANE	STE 108	THOUSAND OAKS	CA	93161	4981	56	06111	34.16552629	-118.8390377	Ventura County
275787	Fee-for-Service	1871664821	1871664821	1	1	FUJII, CINDY MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	52183	40	Pediatrics	0	In state provider	None	4077 5TH AVE	FL 4	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
275803	Fee-for-Service	1255459756	1255459756	1	1	FERNANDO, KURUKULASOORIYA MD	11/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98088	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
275845	Fee-for-Service	1801975461	1801975461	1	1	FUNK,KEVIN C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4401 HARRISON BLVD	None	OGDEN	UT	84403	0000	00	None	41.18328	-111.9536955	Weber County
275905	Fee-for-Service	1669879284	1669879284	1	1	FLORES, CHRISTINA	12/3/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4835 N. F STREET	None	SAN BERNARDINO	CA	92407	3122	36	06071	34.17223131	-117.2961478	San Bernardino County
275948	Fee-for-Service	1003071051	1003071051	1	1	FIELDS, ADELE A MD	5/21/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	167040	None	None	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
275975	Fee-for-Service	1033421417	1033421417	1	1	FNU KAWEETA MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	877 JEFFERSON AVE	None	MEMPHIS	TN	38103	2807	00	None	35.14259562	-90.03187321	Shelby County
275976	Fee-for-Service	1114246329	1114246329	1	1	FRANKE, MARK A MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118792	30	Radiology	0	In state provider	None	10833 LE CONTE AVENUE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
276010	Fee-for-Service	1245399294	1245399294	1	1	FRANK XAVIER GARIGALI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	104 EAST ROUTE 59	None	NANUET	NY	10954	0000	00	None	41.096385	-74.007117	Rockland County
276057	Fee-for-Service	1144245101	1144245101	1	1	FRANCO, EDSON S MD	2/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63372	02	General Surgery	0	In state provider	None	11234 ANDERSON ST	# 1405	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
276067	Fee-for-Service	1790922839	1790922839	1	1	FREIS, ADAM CRNA	7/26/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	18111 BROOKHURST STREET	None	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
276070	Fee-for-Service	1306946397	1306946397	1	1	FORTER, JODY L LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
276107	Fee-for-Service	1144849175	1144849175	1	1	FERGUSON, HEATHER MD	10/16/2023	207R00000X	NA	Other	026	PHYSICIANS	178860	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
276265	Fee-for-Service	1407991797	1407991797	1	1	FITZPATRICK, MATTHEW MD	7/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93389	36	Psychiatry	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
276272	Fee-for-Service	1528696366	1528696366	1	1	FOSTER, BENICA J LCSW	2/26/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 18TH ST	SUITE 350	SAN FRANCISCO	CA	94110	2077	38	06075	37.76218347	-122.4141845	San Francisco County
276273	Fee-for-Service	1659396182	1659396182	1	1	FOSTER, MARK A LMFT	10/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1330 Q ST	None	SACRAMENTO	CA	95811	5705	34	06067	38.570931	-121.4915355	Sacramento County
276290	Fee-for-Service	1962915090	1962915090	1	1	FUJITANI, KURT L CRNA	1/22/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	700 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
276295	Fee-for-Service	1932647336	1932647336	1	1	FAMILY SERVICE AGENCY OF	7/1/2017	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SANTA BARBARA COUNTY	105 N LINCOLN ST	None	SANTA MARIA	CA	93458	4319	42	06083	34.9535882	-120.4374049	Santa Barbara County
276317	Fee-for-Service	1912110149	1912110149	1	1	FATEMI, LILA M MD	2/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92973	08	Family Practice	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
276340	Fee-for-Service	1467539395	1467539395	1	1	FEINER, ROBERT H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32806	01	General Practice	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
276345	Fee-for-Service	1720019243	1720019243	1	1	FAUST, IRENE B MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	43186	41	Internal Medicine	0	In state provider	None	7345 MEDICAL CENTER DR	STE 200	WEST HILLS	CA	91307	1953	19	06037	34.20369349	-118.629837	Los Angeles County
276357	Fee-for-Service	1215008552	1215008552	1	1	FRANCIS, LARRY N MD	2/8/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	34827	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
276452	Fee-for-Service	1679585715	1679585715	1	1	FRIEDMAN, STUART MD	2/28/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	35132	41	Internal Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
276539	Fee-for-Service	1174777437	1174777437	1	1	FISTES- TSANGARIDES, RITSA M	7/1/2009	106H00000X	NA	Mental Health Outpatient Services	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	16654 SOLEDAD CYN RD	#302	CANYON COUNTRY	CA	91387	3217	19	06037	34.4266161	-118.4262864	Los Angeles County
276609	Fee-for-Service	1730282658	1730282658	1	1	FAN, LI MD FACOG	4/24/2017	174400000X	NA	Other	026	PHYSICIANS	132851	None	None	0	In state provider	None	15725 POMERADO ROAD	STE 207	POWAY	CA	92064	2059	37	06073	33.00037882	-117.0580735	San Diego County
276624	Fee-for-Service	1659441293	1659441293	1	3	FOSHAG, LELAND J MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	61645	02	General Surgery	0	In state provider	None	11818 WILSHIRE BLVD	None	LOS ANGELES	CA	90025	6646	19	06037	34.04781497	-118.4629576	Los Angeles County
276641	Fee-for-Service	1114001617	1114001617	1	1	FORNARI, LUKE C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	KAUAI MEDICAL CLINIC	3420 KUHIO HIGHWAY	None	LIHUE	HI	96766	0000	00	None	21.98583	-159.362658	Kauai County
276764	Fee-for-Service	1295779692	1295779692	1	1	FISHER, JAY B. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 OSTRUM ST	None	BETHLEHEM	PA	18015	1000	00	None	40.60853156	-75.39270674	Lehigh County
276770	Fee-for-Service	1912295163	1912295163	1	1	FOSSATI-BELLANI, MARCO R MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125564	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6041 CADILLAC AVENUE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
276867	Fee-for-Service	1760482731	1760482731	1	1	FONTAN, GARY P MD	5/1/2000	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69054	08	Family Practice	0	In state provider	None	1770 N ORANGE GROVE AVE	STE 101	POMONA	CA	91767	3027	19	06037	34.07637624	-117.7492622	Los Angeles County
276931	Fee-for-Service	1528353539	1528353539	1	1	FAMILIES FOR CHILDREN INC	9/30/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2504 W MANCHESTER BLVD	None	INGLEWOOD	CA	90305	2520	19	06037	33.9598587	-118.3211468	Los Angeles County
277055	Fee-for-Service	1245420447	1245420447	1	1	FOUNTAIN, JEFFREY S DO	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12177	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
277103	Fee-for-Service	1780784629	1780784629	1	1	FORNCROOK, JONATHON A DO	2/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10861	40	Pediatrics	0	In state provider	None	21890 COLORADO AVE	None	SAN JOAQUIN	CA	93660	0737	10	06019	36.60503136	-120.1850897	Fresno County
277139	Fee-for-Service	1881607067	1881607067	1	1	FLORES, ROCIO M MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69424	41	Internal Medicine	0	In state provider	None	655 EUCLID AVE	STE 208	NATIONAL CITY	CA	91950	2969	37	06073	32.68353398	-117.082625	San Diego County
277173	Fee-for-Service	1609954312	1609954312	1	1	FREEMAN, DOUGLAS W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	44462	04	Otology, Laryngology, Rhinology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
277214	Fee-for-Service	1447364567	1447364567	1	1	FRIESE, STEVEN B MD	7/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85938	66	Emergency Medicine (Urgent Care)	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
277231	Fee-for-Service	1962900498	1962900498	1	1	FISH PIEPOL, KARI M NP	12/21/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2575 E BIDWELL ST	STE 100	FOLSOM	CA	95630	6445	34	06067	38.658888	-121.1303835	Sacramento County
277269	Fee-for-Service	1992288310	1992288310	1	1	FRAY, SASHA NP	11/7/2024	207QA0505X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2810 CAMINO DEL RIO S	STE 102	SAN DIEGO	CA	92108	3819	37	06073	32.77081335	-117.1316557	San Diego County
277271	Fee-for-Service	1184892135	1184892135	1	1	FRALEY, CHARLES F DO	9/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9721	08	Family Practice	0	In state provider	None	28780 SINGLE OAK DR	SUITE 160	TEMECULA	CA	92590	4080	33	06065	33.49890392	-117.1612965	Riverside County
277272	Fee-for-Service	1619264074	1619264074	1	1	FREY, SARAH L L MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124618	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
277286	Fee-for-Service	1386689701	1386689701	1	1	FAMILY HEALTH CENTERS OF	8/16/1991	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	3705 MISSION BLVD	None	SAN DIEGO	CA	92109	7104	37	06073	32.78273202	-117.2524549	San Diego County
277295	Fee-for-Service	1154344778	1154344778	1	1	FRAGOLA, JOHN F JR MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	49141	05	Anesthesiology	0	In state provider	None	2701 W ALAMEDA AVE	STE 405	BURBANK	CA	91505	4409	19	06037	34.15751343	-118.3303715	Los Angeles County
277324	Fee-for-Service	1063490670	1063490670	1	1	FISHER, JONATHAN S MD	6/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79829	02	General Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
277334	Fee-for-Service	1679579304	1679579304	1	1	FONG, VOY K	5/23/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
277350	Fee-for-Service	1780784629	1780784629	1	1	FORNCROOK, JONATHON A DO	2/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10861	41	Internal Medicine	0	In state provider	None	21890 COLORADO AVE	None	SAN JOAQUIN	CA	93660	0737	10	06019	36.60503136	-120.1850897	Fresno County
277396	Fee-for-Service	1043914377	1043914377	1	1	FETT, SAMANTHA DOULA	6/8/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
277403	Fee-for-Service	1033276696	1033276696	1	3	FRANCK, LEELIA L MD	9/30/2019	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	121957	-	NOT APPLICABLE	0	In state provider	None	241 EAST LAKE AVENUE	None	WATSONVILLE	CA	95076	4717	44	06087	36.91439331	-121.7546492	Santa Cruz County
277473	Fee-for-Service	1548603921	1548603921	1	1	FERNANDEZ-POL, SEBASTIAN MD	6/11/2019	207ZP0102X	NA	Other	026	PHYSICIANS	131935	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
277488	Fee-for-Service	1720234610	1720234610	1	1	FLUSHMAN, CLAUDIA LMFT	8/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	163 SECOND ST	None	WOODLAND	CA	95695	0000	57	06113	38.68060768	-121.7718082	Yolo County
277512	Fee-for-Service	1760575468	1760575468	1	1	FLEMMING, DAVID R MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73785	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 PACIFIC ST	# 2	MONTEREY	CA	93940	2819	27	06053	36.59463401	-121.8978403	Monterey County
277532	Fee-for-Service	1386689701	1386689701	1	1	FAMILY HEALTH CENTERS OF	8/16/1991	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO INC	3705 MISSION BLVD	None	SAN DIEGO	CA	92109	7104	37	06073	32.78273202	-117.2524549	San Diego County
277533	Fee-for-Service	1215091947	1215091947	1	1	FORTIN, MARY D	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
277552	Fee-for-Service	1639115611	1639115611	1	1	FREIBERG, MOSHE I MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	42970	41	Internal Medicine	0	In state provider	None	1510 S CENTRAL AVE	STE 300	GLENDALE	CA	91204	2569	19	06037	34.12709764	-118.2577911	Los Angeles County
277588	Fee-for-Service	1952475428	1952475428	1	1	FUERTEZ, ROLAND M MD	8/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102508	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
277676	Fee-for-Service	1922005297	1922005297	1	1	FREY, JANE HELEN MD	3/1/1984	207R00000X	NA	Other	026	PHYSICIANS	51533	01	General Practice	0	In state provider	None	4835 VAN NUYS BLVD	STE 215	SHERMAN OAKS	CA	91403	2146	19	06037	34.1587068	-118.4487394	Los Angeles County
277708	Fee-for-Service	1275911844	1275911844	1	1	FLORIAN, ROSEMARIE B MD	6/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148259	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92345	3450	36	06071	34.047153	-117.2611485	San Bernardino County
277711	Fee-for-Service	1184793762	1184793762	1	1	FEDOROWICZ, ARTHUR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CVPH MEDICAL CENTER	75 BEEKMAN ST	None	PLATTSBURGH	NY	12901	0000	00	None	44.701011	-73.4692635	Clinton County
277719	Fee-for-Service	1497073951	1497073951	1	1	FISCALE, LAUREN T OD	12/1/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	425 W BONITA AVE	SUITE 110B	SAN DIMAS	CA	91773	2543	19	06037	34.10669347	-117.814932	Los Angeles County
277757	Fee-for-Service	1760575468	1760575468	1	1	FLEMMING, DAVID R MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73785	34	Urology and Urological Surgery	0	In state provider	None	757 PACIFIC ST	# 2	MONTEREY	CA	93940	2819	27	06053	36.59463401	-121.8978403	Monterey County
277773	Fee-for-Service	1912555640	1912555640	1	1	FIRST CHOICE HOSPICE HEALTH	7/2/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	17037 CHATSWORTH ST	STE 210	GRANADA HILLS	CA	91344	7364	19	06037	34.26483049	-118.50372	Los Angeles County
277789	Fee-for-Service	1972557502	1972557502	1	1	FIELDS, ERIC M DO	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10519	66	Emergency Medicine (Urgent Care)	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2854	56	06111	34.2746295	-119.2573399	Ventura County
277796	Fee-for-Service	1639115611	1639115611	1	1	FREIBERG, MOSHE I MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	42970	01	General Practice	0	In state provider	None	1510 S CENTRAL AVE	STE 300	GLENDALE	CA	91204	2569	19	06037	34.12709764	-118.2577911	Los Angeles County
277802	Fee-for-Service	1154485431	1154485431	1	1	FISHMAN, DAVID J MD	6/1/2013	207L00000X	NA	Other	026	PHYSICIANS	45277	05	Anesthesiology	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
277882	Fee-for-Service	1033661558	1033661558	1	1	FAMILY HEALTHCARE NETWORK	7/24/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	927 CENTER STREET	None	PIXLEY	CA	93256	6000	54	06107	35.96573223	-119.2915684	Tulare County
277921	Fee-for-Service	1922005297	1922005297	1	1	FREY, JANE HELEN MD	3/1/1984	207R00000X	NA	Other	026	PHYSICIANS	51533	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4835 VAN NUYS BLVD	STE 215	SHERMAN OAKS	CA	91403	2146	19	06037	34.1587068	-118.4487394	Los Angeles County
277955	Fee-for-Service	1770650582	1770650582	1	1	FU, XINTING MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56517	68	Hematology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
277979	Fee-for-Service	1255528436	1255528436	1	1	FERGUSON, ARIANNE M MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101438	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
278014	Fee-for-Service	1912555640	1912555640	1	1	FIRST CHOICE HOSPICE HEALTH	7/2/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	17037 CHATSWORTH ST	STE 210	GRANADA HILLS	CA	91344	7364	19	06037	34.26483049	-118.50372	Los Angeles County
278086	Fee-for-Service	1902254402	1902254402	1	1	FALGOUT, DAVID M MD	9/6/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	171848	None	None	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
278126	Fee-for-Service	1033661558	1033661558	1	1	FAMILY HEALTHCARE NETWORK	7/24/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	927 CENTER STREET	None	PIXLEY	CA	93256	6000	54	06107	35.96573223	-119.2915684	Tulare County
278155	Fee-for-Service	1962644310	1962644310	1	1	FINDLEY, CLARENCE M MD	10/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116625	41	Internal Medicine	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
278198	Fee-for-Service	1770650582	1770650582	1	1	FU, XINTING MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	56517	78	Neoplastic Diseases/Oncology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
278247	Fee-for-Service	1629002068	1629002068	1	1	FRANKVILLE, DAVID D MD	10/31/1985	207L00000X	NA	Other	026	PHYSICIANS	55841	05	Anesthesiology	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
278257	Fee-for-Service	1750355103	1750355103	1	1	FINKELSTEIN, JASON MD	11/27/2023	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	175092	None	None	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
278262	Fee-for-Service	1417911462	1417911462	1	1	FANG, MARGARET C MD	7/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83381	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
278456	Fee-for-Service	1285211433	1285211433	1	1	FU, YIWEN MD	10/4/2023	207R00000X	NA	Other	026	PHYSICIANS	183810	None	None	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
278553	Fee-for-Service	1215251822	1215251822	1	1	FARJOUDI, FARHAD MD	7/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123543	None	None	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
278570	Fee-for-Service	1265507297	1265507297	1	1	FRESNO NEW CONNECTIONS, INC	12/17/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4411 N CEDAR AVE	SUITE 108	FRESNO	CA	93726	2509	10	06019	36.79798989	-119.7543649	Fresno County
278635	Fee-for-Service	1598725236	1598725236	1	1	FIGATNER, JOEL G MD INC	6/8/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32022	08	Family Practice	0	In state provider	PO BOX I	48677 VICTORIA LN	None	OAKHURST	CA	93644	9216	20	06039	37.32772782	-119.6601883	Madera County
278650	Fee-for-Service	1033395843	1033395843	1	1	FAMILY HEALTH CTRS OF SD	6/1/2000	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 W CHASE AVE	None	EL CAJON	CA	92020	5710	37	06073	32.78161035	-116.9764603	San Diego County
278663	Fee-for-Service	1245640499	1245640499	1	1	FOX, MICHAEL P DO	11/20/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	17465	None	None	0	In state provider	None	1200 CLAY ST	None	OAKLAND	CA	94612	1400	01	06001	37.80422981	-122.2742222	Alameda County
278796	Fee-for-Service	1013151976	1013151976	1	1	FAZIOLA, LAWRENCE R MD	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107356	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	BLDG 53	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
278839	Fee-for-Service	1215477351	1215477351	1	1	FOGLE, MELISSA LMFT	11/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	650 E TAHQUITZ CANYON WA	SUITE 2	PALM SPRINGS	CA	92262	6712	33	06065	33.8232273	-116.5408916	Riverside County
278908	Fee-for-Service	1699232694	1699232694	1	1	FREEMAN, QUENETTE LCSW	7/10/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVENUE	SUITE 110	SAN JOSE	CA	95119	1325	43	06085	37.23598537	-121.7783065	Santa Clara County
278928	Fee-for-Service	1578564506	1578564506	1	1	FIMAN, KEITH MD	3/1/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
278940	Fee-for-Service	1477969996	1477969996	1	1	FRERKING, ANDREW A MD	4/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	14325	01	General Practice	0	In state provider	None	300 N SAN ANTONIO ROAD	None	SANTA BARBARA	CA	93110	1332	42	06083	34.4458497	-119.779596	Santa Barbara County
278991	Fee-for-Service	1912264862	1912264862	1	23	FIRST CHOICE PHYSICIAN PARTN	3/23/2021	208200000X	NA	General Surgery	022	PHYSICIANS GROUP	-	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 101	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
279002	Fee-for-Service	1154301935	1154301935	1	2	FLYNN, NEIL M MD	11/28/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3647 40TH ST	None	SACRAMENTO	CA	95817	3609	34	06067	38.541456	-121.4604765	Sacramento County
279043	Fee-for-Service	1336324805	1336324805	1	1	FORD, GARY E MD APC	10/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	36302	01	General Practice	0	In state provider	None	1141 W REDONDO BEACH BLV	STE 402	GARDENA	CA	90247	3582	19	06037	33.89247036	-118.2941482	Los Angeles County
279111	Fee-for-Service	1538362140	1538362140	1	1	FONG, LORI A PT	9/18/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
279132	Fee-for-Service	1033409149	1033409149	1	1	FUJITA, KARI A MD	9/18/2017	207R00000X	NA	Other	026	PHYSICIANS	148777	41	Internal Medicine	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
279160	Fee-for-Service	1972699775	1972699775	1	1	FRAZIER, YUKI LMFT	4/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1661 N RAYMOND AVE	SUITE 214	ANAHEIM	CA	92801	1167	30	06059	33.858234	-117.906788	Orange County
279207	Fee-for-Service	1053553131	1053553131	1	1	FARASAT, SHARIFEH MD	10/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123744	07	Dermatology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
279228	Fee-for-Service	1912264862	1912264862	1	23	FIRST CHOICE PHYSICIAN PARTN	3/23/2021	208200000X	NA	General Surgery	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	ARTNERS	1444 FLORIDA AVE	STE 101	MODESTO	CA	95350	4400	50	06099	37.66487562	-120.9961927	Stanislaus County
279233	Fee-for-Service	1043387814	1043387814	1	1	FONG-YIM, ELAINE S OD	1/24/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3699 WILSHIRE BLVD	FLOOR 3RD	LOS ANGELES	CA	90010	2718	19	06037	34.06175152	-118.306215	Los Angeles County
279315	Fee-for-Service	1821317058	1821317058	1	1	FORSBERG, SARAH E PHD	10/3/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
279335	Fee-for-Service	1710076054	1710076054	1	1	FRANKL, SALLY B MD	7/8/2020	207R00000X	NA	Other	026	PHYSICIANS	64000	41	Internal Medicine	0	In state provider	None	5525 ETIWANDA AVE	STE 320	TARZANA	CA	91356	3647	19	06037	34.17046451	-118.5308463	Los Angeles County
279407	Fee-for-Service	1780041350	1780041350	1	1	FOSS, KEVIN L	10/22/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	4300 MARKETPOINTE DRIVE	SUITE 100	MINNEAPOLIS	MN	55435	5435	00	None	44.8612569	-93.33472789	Hennepin County
279412	Fee-for-Service	1760418263	1760418263	1	2	FUNKE, DONNA J CRNA	2/6/2015	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	430 AVENIDA DE LOS ARBOL	None	THOUSAND OAKS	CA	91360	3017	56	06111	34.21786948	-118.8693896	Ventura County
279417	Fee-for-Service	1679612378	1679612378	1	1	FUCHS, LANCE C MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64350	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
279436	Fee-for-Service	1740262914	1740262914	2	1	FAMILY PHARMACY INC	7/29/2008	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	FAMILY PHARMACY	1033 N WATERMAN AVE	STE C	SAN BERNARDINO	CA	92410	3808	36	06071	34.11819969	-117.2787193	San Bernardino County
279442	Fee-for-Service	1770692923	1770692923	1	1	FINCH, MICHAEL H MD	10/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	35442	10	Gastroenterology (M.D. only)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
279566	Fee-for-Service	1265464820	1265464820	1	5	FOOT & ANKLE CONCEPTS INC	5/8/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	230 W PUEBLO ST	STE A	SANTA BARBARA	CA	93105	6810	42	06083	34.43081942	-119.7216759	Santa Barbara County
279568	Fee-for-Service	1033596093	1033596093	1	1	FRISHE, KATHERINE M MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146259	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
279674	Fee-for-Service	1770692923	1770692923	1	1	FINCH, MICHAEL H MD	10/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	35442	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
279712	Fee-for-Service	1073962171	1073962171	1	2	FARIED BANIMAHD MD INC	4/7/2020	207LA0401X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	1533 E 4TH ST	STE A	SANTA ANA	CA	92701	5115	30	06059	33.74814149	-117.848421	Orange County
279754	Fee-for-Service	1295789550	1295789550	1	1	FAHY, JOHN V MD	12/31/1994	207R00000X	NA	Other	026	PHYSICIANS	53767	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
279788	Fee-for-Service	1922033992	1922033992	1	1	FRITZELL, JAMES A JR MD	7/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136808	None	None	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
279858	Fee-for-Service	1013024447	1013024447	1	1	FRANSETH, DEBRA K	10/1/1997	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	PHYS THERAPY & WELLNESS	2490 S MAIN ST	None	RED BLUFF	CA	96080	4337	52	06103	40.15020135	-122.2183126	Tehama County
279916	Fee-for-Service	1306846498	1306846498	1	1	FULLER, EDWIN B MD	5/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	26937	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 4TH AVE	STE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
279944	Fee-for-Service	1275573669	1275573669	1	1	FOUCHE, KIM V MD	3/31/1987	207P00000X	NA	Other	026	PHYSICIANS	62088	01	General Practice	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
279952	Fee-for-Service	1013370931	1013370931	1	1	FENG, CHIN-HSIANG MD	11/24/2019	207P00000X	NA	Other	026	PHYSICIANS	161558	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
279976	Fee-for-Service	1538217872	1538217872	1	1	FEIN, CHARLES L MD	12/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	78781	41	Internal Medicine	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
280068	Fee-for-Service	1194750901	1194750901	1	1	FRITZ, ANTHONY W MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	914 S SCHEUBER RD	None	CENTRALIA	WA	98531	9027	00	None	46.71220956	-122.9870103	Lewis County
280103	Fee-for-Service	1013578046	1013578046	1	1	FLORECER THERAPY, FAMILY, MA	9/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6303 OWENSMOUTH AVE	10TH FLOOR SUITE 1068	WOODLAND HILLS	CA	91367	2263	19	06037	34.18490848	-118.6015408	Los Angeles County
280125	Fee-for-Service	1346332335	1346332335	1	1	FALK, LOIS R NP	12/26/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	46900 OCEAN DR	None	GUALALA	CA	95445	9999	23	06045	38.80460137	-123.5780677	Mendocino County
280127	Fee-for-Service	1598384943	1598384943	1	1	FOWLER, DAVID	5/14/2024	207P00000X	NA	Other	026	PHYSICIANS	186612	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
280141	Fee-for-Service	1306846498	1306846498	1	1	FULLER, EDWIN B MD	5/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	26937	20	Orthopedic Surgery	0	In state provider	None	450 4TH AVE	STE 311	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
280198	Fee-for-Service	1497721724	1497721724	1	1	FORCIER, NANCY J MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72420	01	General Practice	0	In state provider	MS317	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
280204	Fee-for-Service	1871900399	1871900399	1	1	FARDGHASSEMI, MOHAMMAD S	9/11/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	230 E 17TH ST	SUITE 170	COSTA MESA	CA	92627	7326	30	06059	33.63478648	-117.9177815	Orange County
280219	Fee-for-Service	1609810597	1609810597	1	1	FEINSTEIN DAVID M MD	11/20/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	83862	41	Internal Medicine	0	In state provider	None	345 HALCYON RD	None	ARROYO GRANDE	CA	93420	0000	40	06079	35.113419	-120.5915945	San Luis Obispo County
280324	Fee-for-Service	1881250413	1881250413	1	1	FLORES HARTFORD, MARIBEL LM	4/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	110 MONTCLAIR STREET	205	BAKERSFIELD	CA	93309	3100	15	06029	35.35373011	-119.0546591	Kern County
280344	Fee-for-Service	1952728107	1952728107	1	1	FONG, KELLY MD	8/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139665	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
280358	Fee-for-Service	1366717324	1366717324	1	1	FAMILY PLANNING ASSOCIATES M	12/10/2019	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	EDICAL GROUP INC	41715 WINCHESTER RD	SUITE 204	TEMECULA	CA	92590	4854	33	06065	33.51843041	-117.1680022	Riverside County
280404	Fee-for-Service	1962442087	1962442087	1	1	FANNING, JEFFREY J MD	10/22/2019	2080P0203X	NA	Other	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
280410	Fee-for-Service	1245418896	1245418896	1	1	FLANAGAN, RENEE D	8/1/1994	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 CALIFORNIA AVE	SUITE 100	CORONA	CA	92881	6472	33	06065	33.86171794	-117.5440764	Riverside County
280424	Fee-for-Service	1497721724	1497721724	1	1	FORCIER, NANCY J MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72420	30	Radiology	0	In state provider	MS317	10666 N TORREY PINES RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
280726	Fee-for-Service	1376659995	1376659995	1	1	FRANKLIN, SHERRY L MD	8/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	67338	67	Endocrinology	0	In state provider	PEDIATRIC ENDOCRINOLOGY	8010 FROST ST	STE 408	SAN DIEGO	CA	92123	4222	37	06073	32.80026879	-117.1520059	San Diego County
280820	Fee-for-Service	1043924855	1043924855	1	1	FAUSTO, TALISA E DOULA	1/10/2023	374J00000X	NA	Other	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	36	06071	0	0	None
280848	Fee-for-Service	1205878493	1205878493	1	1	FORMENTO, MELIA A NP	11/14/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
280852	Fee-for-Service	1134299134	1134299134	1	1	FINNEGAN, MARIA CNM	4/5/2018	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	333 LAWS AVE	None	UKIAH	CA	95482	6540	23	06045	39.12772164	-123.2111168	Mendocino County
280890	Fee-for-Service	1740263623	1740263623	2	1	FULL GREEN PHARMACY, INC	9/27/2007	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	T & C PHARMACY	2340 E PACIFIC COAST HWY	STE G	LONG BEACH	CA	90804	1575	19	06037	33.78982953	-118.163709	Los Angeles County
280936	Fee-for-Service	1366685349	1366685349	1	1	FAIAD, GRACIELA S MD	9/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106074	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
280939	Fee-for-Service	1134154594	1134154594	1	1	FARJAMI, SASSAN MD	10/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94020	68	Hematology	0	In state provider	None	3791 KATELLA AVE	STE 205	LOS ALAMITOS	CA	90720	2016	30	06059	33.80318449	-118.0672965	Orange County
280946	Fee-for-Service	1376659995	1376659995	1	1	FRANKLIN, SHERRY L MD	8/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	67338	40	Pediatrics	0	In state provider	PEDIATRIC ENDOCRINOLOGY	8010 FROST ST	STE 408	SAN DIEGO	CA	92123	4222	37	06073	32.80026879	-117.1520059	San Diego County
280974	Fee-for-Service	1790833762	1790833762	1	1	FENG, LEI MD	8/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86724	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90074	0001	19	06037	34.06373445	-118.443537	Los Angeles County
281034	Fee-for-Service	1881652493	1881652493	1	1	FRANCIS NOEL LEBLANC M.D.	12/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1300 ANNE ST NW	None	BEMIDJI	MN	56601	5103	00	None	47.50502202	-94.89949542	Beltrami County
281140	Fee-for-Service	1730129719	1730129719	1	1	FLYNN, MARTIN E MD	10/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80840	05	Anesthesiology	0	In state provider	None	4650 LINCOLN BLVD	None	MARINA DEL REY	CA	90292	6306	19	06037	33.98160766	-118.4400667	Los Angeles County
281145	Fee-for-Service	1083672653	1083672653	1	1	FELDMAN, BARRY S	10/20/2017	207RP1001X	NA	Pulmonology	026	PHYSICIANS	85669	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	525 E PLAZA DR	STE 204A	SANTA MARIA	CA	93454	6954	42	06083	34.9373822	-120.4296004	Santa Barbara County
281157	Fee-for-Service	1134154594	1134154594	1	1	FARJAMI, SASSAN MD	10/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94020	78	Neoplastic Diseases/Oncology	0	In state provider	None	3791 KATELLA AVE	STE 205	LOS ALAMITOS	CA	90720	2016	30	06059	33.80318449	-118.0672965	Orange County
281165	Fee-for-Service	1306231618	1306231618	1	1	FRANK, EMILY W MD	4/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144940	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
281194	Fee-for-Service	1104839778	1104839778	1	1	FRAZEE, GIANNA M MD	3/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	80183	40	Pediatrics	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
281220	Fee-for-Service	1790146918	1790146918	1	1	FRAZER, BRITTANY MD	6/21/2021	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
281293	Fee-for-Service	1689719353	1689719353	1	1	FERRER, GERRARD F DO	5/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14083	13	Neurology (M.D. only)	0	In state provider	AGRINGO DO	1194 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4802	49	06097	38.443302	-122.699133	Sonoma County
281335	Fee-for-Service	1750577797	1750577797	1	1	FREYNE, BRIGID M MD INC	3/1/2001	193400000X	NA	Other	026	PHYSICIANS	64382	83	Rheumatology	0	In state provider	None	39755 MURRIETA HOT SPRIN	STE F110	MURRIETA	CA	92563	9119	33	06065	33.55575954	-117.1627899	Riverside County
281409	Fee-for-Service	1053331595	1053331595	1	1	FOZAILOFF, ALAN MD	4/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	76164	41	Internal Medicine	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
281437	Fee-for-Service	1558797118	1558797118	1	11	FIRST CHOICE PHYSICIAN PARTN	3/13/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	33	Thoracic Surgery	0	In state provider	PARTNERS	1280 E LATHAM AVE	None	HEMET	CA	92543	4445	33	06065	33.7494633	-116.9588798	Riverside County
281486	Fee-for-Service	1982193751	1982193751	1	1	FRANCIS, ROSS H MD	8/12/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	177411	None	None	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
281544	Fee-for-Service	1609121201	1609121201	1	1	FRIBOURG, LYRE C PSY	10/12/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10833 LE CONTE AVE	12311 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
281552	Fee-for-Service	1750577797	1750577797	1	1	FREYNE, BRIGID M MD INC	3/1/2001	193400000X	NA	Other	026	PHYSICIANS	64382	41	Internal Medicine	0	In state provider	None	39755 MURRIETA HOT SPRIN	STE F110	MURRIETA	CA	92563	9119	33	06065	33.55575954	-117.1627899	Riverside County
281563	Fee-for-Service	1801021399	1801021399	1	1	FRESENIUS MED CARE BALBOA	10/1/2009	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	630 BAY BLVD	STE 101	CHULA VISTA	CA	91910	5262	37	06073	32.62444179	-117.0947529	San Diego County
281611	Fee-for-Service	1174507115	1174507115	1	1	FLEMING, CHRISTINE	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3033 S PARKER RD STE 800	None	AURORA	CO	80014	0000	00	None	39.6612	-104.8603095	Arapahoe County
281623	Fee-for-Service	1821049297	1821049297	2	1	FISK, DAVID MD	6/20/2024	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	52511	77	Infectious Disease	0	In state provider	None	400 PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
281647	Fee-for-Service	1558797118	1558797118	1	11	FIRST CHOICE PHYSICIAN PARTN	3/13/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	PARTNERS	1280 E LATHAM AVE	None	HEMET	CA	92543	4445	33	06065	33.7494633	-116.9588798	Riverside County
281648	Fee-for-Service	1013235811	1013235811	1	1	FELDMAN, TATYANA MD	6/1/2020	207L00000X	NA	Other	026	PHYSICIANS	167887	05	Anesthesiology	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
281677	Fee-for-Service	1528611910	1528611910	1	1	FULCHER, TANISHA LMFT	2/18/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18191 VON KARMAN AVE	100	IRVINE	CA	92612	7103	30	06059	33.67831005	-117.852138	Orange County
281727	Fee-for-Service	1336694470	1336694470	1	1	FRALEY, KRISTEN E LCSW	5/26/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	6022 VARIEL AVENUE	None	WOODLAND HILLS	CA	91367	3719	19	06037	34.180029	-118.592771	Los Angeles County
281738	Fee-for-Service	1063771426	1063771426	1	1	FAISON, GIULIA M	1/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119327	None	None	0	In state provider	None	101 EAST REDLANDS BLVD	SUITE 106	REDLANDS	CA	92373	4870	36	06071	34.05731952	-117.181197	San Bernardino County
281789	Fee-for-Service	1952559585	1952559585	1	1	FONG, GRACE DO	4/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9698	08	Family Practice	0	In state provider	None	550 W RANCH VIEW DR	None	ROCKLIN	CA	95765	5396	31	06061	38.83760761	-121.2972372	Placer County
281800	Fee-for-Service	1780125724	1780125724	1	1	FRIERSON, ANDREW C DO	5/23/2019	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
281857	Fee-for-Service	1336322437	1336322437	1	1	FRESNO PEDIATRICS A	6/4/2007	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL CORPORATION	2900 FRESNO STREET	STE 102	FRESNO	CA	93721	1439	10	06019	36.74256783	-119.7827878	Fresno County
281872	Fee-for-Service	1710787379	1710787379	1	1	FREDI THE DOULA LLC	4/11/2025	No Taxonomy Provided	NA	None	106	DOULA INDIVIDUAL PROVIDER	-	-	NOT APPLICABLE	0	In state provider	Addresses not published for Doula Providers	N/A	N/A	N/A	N/A	N/A	N/A	19	06037	0	0	None
281895	Fee-for-Service	1275038572	1275038572	1	1	FOURTOUNIS, JOANNA V DO	3/28/2023	207P00000X	NA	Other	026	PHYSICIANS	20224	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
281961	Fee-for-Service	1790063766	1790063766	1	1	FERNANDEZ, KRISTINE LMFT	8/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	132 S THOMPSON ST	None	HEMET	CA	92543	4351	33	06065	33.74675899	-116.9651207	Riverside County
281993	Fee-for-Service	1063720431	1063720431	1	1	FENTON, CYNTHIA L MD	9/30/1991	207R00000X	NA	Other	026	PHYSICIANS	71207	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1330 CUTTING BLVD	None	RICHMOND	CA	94804	2555	07	06013	37.92518651	-122.3564715	Contra Costa County
282070	Fee-for-Service	1518025709	1518025709	1	1	FINEMAN, JEFFERY R MD	5/9/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62808	40	Pediatrics	0	In state provider	None	1200 EL CAMINO REAL	None	S SAN FRANCISCO	CA	94080	3208	41	06081	37.65894608	-122.440161	San Mateo County
282084	Fee-for-Service	1538173141	1538173141	1	1	FLOWER, ELIZABETH MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66505	None	None	0	In state provider	None	347 ANDRIEUX ST	None	SONOMA	CA	95476	6811	49	06097	38.28843573	-122.4651035	Sonoma County
282175	Fee-for-Service	1932551900	1932551900	1	1	FONG, JONATHAN DO	8/28/2020	207P00000X	NA	Other	026	PHYSICIANS	18268	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
282247	Fee-for-Service	1205908373	1205908373	1	1	FOERSTER, JAMES M MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	24587	41	Internal Medicine	0	In state provider	None	5301 F ST	STE 207	SACRAMENTO	CA	95819	3221	34	06067	38.571354	-121.4368695	Sacramento County
282298	Fee-for-Service	1740244995	1740244995	1	1	FOSTER, TIMOTHY C MD	11/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	146129	40	Pediatrics	0	In state provider	None	7060 N RECREATION AVE	101	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
282351	Fee-for-Service	1972839975	1972839975	1	1	FEELY, HOMIRA NP	12/27/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
282411	Fee-for-Service	1619930955	1619930955	1	1	FOGG, MAXWELL AND LANIER	11/1/2001	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MD INC	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
282419	Fee-for-Service	1407906027	1407906027	1	1	FOCIL, AUGUSTO E MD	12/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	44207	01	General Practice	0	In state provider	None	300 S A ST	STE 105	OXNARD	CA	93030	5851	56	06111	34.2000746	-119.1785373	Ventura County
282422	Fee-for-Service	1497728141	1497728141	1	1	FEDERLE,MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3705 FIFTH AVE	STE 3950	PITTSBURGH	PA	15213	0000	00	None	40.44154544	-79.95885126	Allegheny County
282446	Fee-for-Service	1801093570	1801093570	1	1	FAN, JENNIE OD	6/26/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15333 CULVER DR	SUITE 690	IRVINE	CA	92604	7143	30	06059	33.69534179	-117.7972555	Orange County
282451	Fee-for-Service	1205908373	1205908373	1	1	FOERSTER, JAMES M MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	24587	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F ST	STE 207	SACRAMENTO	CA	95819	3221	34	06067	38.571354	-121.4368695	Sacramento County
282497	Fee-for-Service	1265588552	1265588552	1	1	FRENCH, GREGORY C. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 E 3900 SOUTH	None	SALT LAKE CITY	UT	84124	1300	00	None	40.68703142	-111.857243	Salt Lake County
282500	Fee-for-Service	1740244995	1740244995	1	1	FOSTER, TIMOTHY C MD	11/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	146129	13	Neurology (M.D. only)	0	In state provider	None	7060 N RECREATION AVE	101	FRESNO	CA	93720	8022	10	06019	36.8388	-119.7404335	Fresno County
282554	Fee-for-Service	1174502793	1174502793	1	1	FERRY, DAVID A MD	12/10/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	45628	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	5400 BALBOA BLVD	STE 202	ENCINO	CA	91316	1529	19	06037	34.169283	-118.501072	Los Angeles County
282597	Fee-for-Service	1316448533	1316448533	1	1	FERRER, CAMILLE A NP	4/19/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
282598	Fee-for-Service	1720280175	1720280175	1	1	FARMAKIS, SHANNON G MD	1/25/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	168320	None	None	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
282647	Fee-for-Service	1669635082	1669635082	1	1	FEBLES, TAYNET T MD	5/23/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	109536	None	None	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
282741	Fee-for-Service	1225058076	1225058076	1	1	FOUTS, LOREN K W CRNA	8/14/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
282752	Fee-for-Service	1265464820	1265464820	1	1	FOOT & ANKLE CONCEPTS INC	9/9/2003	193400000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2100 SOLAR DR	STE 105	OXNARD	CA	93036	0649	56	06111	34.22156515	-119.14488	Ventura County
282838	Fee-for-Service	1669544227	1669544227	1	1	FAMILY HEALTHCARE OF CORONA	8/21/2018	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1810 FULLERTON AVE	STE 105	CORONA	CA	92881	3109	33	06065	33.85971	-117.5503495	Riverside County
282885	Fee-for-Service	1194088617	1194088617	1	1	FLORES, CRYSTAL LMFT	5/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
282907	Fee-for-Service	1215034384	1215034384	1	1	FREDERICKS, NICOLE L OT	12/1/2005	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9280 W STOCKTON BLVD	STE 116	ELK GROVE	CA	95758	8073	34	06067	38.420235	-121.394961	Sacramento County
282979	Fee-for-Service	1255645123	1255645123	1	1	FARRELL, BRIAN M MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115155	89	Surgery-Traumatic	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
282988	Fee-for-Service	1699790808	1699790808	1	1	FIRESTEIN, GARY S MD	5/31/1983	207RR0500X	NA	Other	026	PHYSICIANS	46824	01	General Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
283002	Fee-for-Service	1174546246	1174546246	1	1	FELDMAN, BRIAN J MD	8/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84899	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
283060	Fee-for-Service	1912333980	1912333980	1	1	FOX, RICK D CRNA	10/6/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVENUE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
283108	Fee-for-Service	1780921536	1780921536	1	1	FAMILY HEALTH CENTERS	12/9/2013	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	140 ELM STREET	None	SAN DIEGO	CA	92101	2602	37	06073	32.72409551	-117.1632195	San Diego County
283121	Fee-for-Service	1487275194	1487275194	1	1	FADEYI, OLANIYI A MD	7/3/2024	207R00000X	NA	Other	026	PHYSICIANS	191379	41	Internal Medicine	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
283166	Fee-for-Service	1376162271	1376162271	1	1	FU, REGINA MD DO	1/28/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22969	36	Psychiatry	0	In state provider	None	100 PINE ST	STE 1250	SAN FRANCISCO	CA	94111	5235	38	06075	37.79237874	-122.3989278	San Francisco County
283170	Fee-for-Service	1508881665	1508881665	1	1	FOX, DAN K DC	9/10/2018	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	8101 2ND ST	None	DOWNEY	CA	90241	3623	19	06037	33.94294905	-118.1359924	Los Angeles County
283173	Fee-for-Service	1255645123	1255645123	1	1	FARRELL, BRIAN M MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115155	20	Orthopedic Surgery	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
283178	Fee-for-Service	1992880645	1992880645	1	1	FINLAYSON, CAROL	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13123 E 16TH AVE	None	AURORA	CO	80045	7106	00	None	39.742164	-104.8350375	Adams County
283201	Fee-for-Service	1033206891	1033206891	1	1	FREEDMAN, JULIE E MD	2/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86989	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
283205	Fee-for-Service	1326173022	1326173022	1	1	FOX, ARTHUR H MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80873	02	General Surgery	0	In state provider	None	1141 W REDONDO BEACH BLV	STE 202	GARDENA	CA	90247	3584	19	06037	33.89247036	-118.2941482	Los Angeles County
283266	Fee-for-Service	1972651958	1972651958	1	1	FUQUA, EVERETTE E MD	6/11/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	78382	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
283286	Fee-for-Service	1780203216	1780203216	1	1	FIRESTONE, GRACE G MD	6/21/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	183764	None	None	0	In state provider	None	1131 WILSHIRE BLVD	SUITE 302	SANTA MONICA	CA	90401	2061	19	06037	34.02509887	-118.4909994	Los Angeles County
283321	Fee-for-Service	1114418118	1114418118	1	1	FUKUDA, KEIKO A MD	4/14/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	177250	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
283323	Fee-for-Service	1013177906	1013177906	1	1	FAELDONEA-SERUELO, RHYL ANN	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104676	01	General Practice	0	In state provider	None	225 EAST 2ND AVENUE	None	ESCONDIDO	CA	92025	4249	37	06073	33.12175817	-117.0787555	San Diego County
283331	Fee-for-Service	1912264862	1912264862	1	19	FIRST CHOICE PHYSICIAN PARTN	10/21/2020	207YX0905X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	ARTNERS	2121 COLORADO AVE	SUITE C	TURLOCK	CA	95382	2012	50	06099	37.5117454	-120.8353096	Stanislaus County
283368	Fee-for-Service	1316205313	1316205313	1	1	FRIEDMAN, LAUREN M MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122481	05	Anesthesiology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
283462	Fee-for-Service	1396900593	1396900593	1	1	FITZPATRICK, MARGARET M CRNA	4/6/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14847323	-122.2180997	Tehama County
283512	Fee-for-Service	1013177906	1013177906	1	1	FAELDONEA-SERUELO, RHYL ANN	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104676	08	Family Practice	0	In state provider	None	225 EAST 2ND AVENUE	None	ESCONDIDO	CA	92025	4249	37	06073	33.12175817	-117.0787555	San Diego County
283537	Fee-for-Service	1912264862	1912264862	1	19	FIRST CHOICE PHYSICIAN PARTN	10/21/2020	207YX0905X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	24	Plastic Surgery	0	In state provider	ARTNERS	2121 COLORADO AVE	SUITE C	TURLOCK	CA	95382	2012	50	06099	37.5117454	-120.8353096	Stanislaus County
283541	Fee-for-Service	1760083679	1760083679	1	1	FLANAGAN, HEIDI J LMFT	2/3/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3609 SACRAMENTO ST	None	SAN FRANCISCO	CA	94118	1709	38	06075	37.78748183	-122.4522257	San Francisco County
283548	Fee-for-Service	1235526617	1235526617	1	1	FAIERMAN, MICHELLE MD	7/1/2018	207R00000X	NA	Other	026	PHYSICIANS	145830	41	Internal Medicine	0	In state provider	None	2185 CITRACADO PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
283649	Fee-for-Service	1871671487	1871671487	1	1	FONG, PANSY MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42189	01	General Practice	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
283692	Fee-for-Service	1750867164	1750867164	1	1	FONSECA, SILVIA MD	10/7/2019	390200000X	NA	Other	026	PHYSICIANS	163401	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
283748	Fee-for-Service	1467800680	1467800680	1	1	FISCHER, SETH J MD	5/31/2022	207L00000X	NA	Other	026	PHYSICIANS	165957	None	None	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
283774	Fee-for-Service	1770957094	1770957094	1	1	FULLER, DANIEL E CRNA	11/21/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
283796	Fee-for-Service	1235694761	1235694761	1	1	FIGUEROA ARAGON, AILICEC	10/12/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17772 IRVINE BLVD	SUITE 209	TUSTIN	CA	92780	3234	30	06059	33.74824746	-117.8220736	Orange County
283817	Fee-for-Service	1508978685	1508978685	1	1	FUENTES-AFFLICK, ELENA G	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	62650	40	Pediatrics	0	In state provider	None	1001 POTRERO AVE	RM 6E	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
283823	Fee-for-Service	1205082195	1205082195	1	1	FEINBERG, BARBARA E LMFT	10/1/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	100 N BRAND BLVD	STE 223	GLENDALE	CA	91203	2641	19	06037	34.14652066	-118.2549229	Los Angeles County
283844	Fee-for-Service	1083973259	1083973259	2	1	FTF PHARMACY CORPORATION	5/2/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17742 BEACH BLVD	SUITE 100	HUNTINGTON BEACH	CA	92647	6847	30	06059	33.704487	-117.989061	Orange County
283846	Fee-for-Service	1699048561	1699048561	1	1	FERNANDO HOSPICE CARE LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	SUITE 610	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
283881	Fee-for-Service	1861578452	1861578452	1	1	FRONT PORCH COMMUNITIES	3/1/2006	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	AND SERVICES	22445 CUPERTINO RD	None	CUPERTINO	CA	95014	1052	43	06085	37.32310827	-122.0668923	Santa Clara County
283977	Fee-for-Service	1619983830	1619983830	1	1	FIORE, JOSEPH P MD	8/31/1985	207P00000X	NA	Other	026	PHYSICIANS	42159	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
283983	Fee-for-Service	1174708671	1174708671	1	1	FRASSINELLI, LAURA J MD	9/30/1985	207R00000X	NA	Other	026	PHYSICIANS	53563	41	Internal Medicine	0	In state provider	None	150 W WASHINGTON ST	None	SAN DIEGO	CA	92103	2005	37	06073	32.74999225	-117.1647027	San Diego County
284008	Fee-for-Service	1134585086	1134585086	1	1	FACULTY PHYSICIANS AND	12/2/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	SURGEONS OF LLUSM	26780 BARTON RD	None	REDLANDS	CA	92373	4308	36	06071	34.04826046	-117.2205914	San Bernardino County
284011	Fee-for-Service	1033113006	1033113006	1	1	FARINHA, PEDRO L MD	8/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	63404	41	Internal Medicine	0	In state provider	None	1041 N CHINA LAKE BLVD	STE C	RIDGECREST	CA	93555	3168	15	06029	35.63953945	-117.669891	Kern County
284016	Fee-for-Service	1932809464	1932809464	1	2	FEDELIA B DAIZ	10/13/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	20905 EL NIDO AVE	None	PERRIS	CA	92571	8806	33	06065	33.81681919	-117.1956002	Riverside County
284022	Fee-for-Service	1194775122	1194775122	1	1	FACULTY PHYSICIANS AND SURGE	3/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ONS OF LLUSM	11370 ANDERSON ST	# 2600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
284029	Fee-for-Service	1699048561	1699048561	1	1	FERNANDO HOSPICE CARE LLC	9/7/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	SUITE 610	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
284059	Fee-for-Service	1508230186	1508230186	1	1	FRY, EDWARD LAC	1/1/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	510 CYPRESS ST	C200	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
284060	Fee-for-Service	1790246460	1790246460	1	1	FARMER, JESSICA MD	7/18/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177184	08	Family Practice	0	In state provider	None	3100 SUMMIT ST	2ND FLOOR	OAKLAND	CA	94609	3410	01	06001	37.82018974	-122.2643221	Alameda County
284165	Fee-for-Service	1245670504	1245670504	1	1	FONG, BRENDAN M MD	5/5/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	165019	14	Neurological Surgery	0	In state provider	None	101 CITY DR S	STE 313	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
284195	Fee-for-Service	1043851231	1043851231	1	1	FANTIN, BROOKE PT	11/4/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
284273	Fee-for-Service	1093809667	1093809667	1	1	FOLSOM, BERGEN E MD	9/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88203	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
284277	Fee-for-Service	1982360459	1982360459	1	1	FERNANDEZ, MONICA E NP	9/3/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	436 S RIVERSIDE AVE	None	RIALTO	CA	92376	6523	36	06071	34.093089	-117.3703775	San Bernardino County
284361	Fee-for-Service	1932986007	1932986007	1	1	FRANCHEZ LLC	6/10/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1356 41ST ST	B	LOS ANGELES	CA	90011	3302	19	06037	34.00896877	-118.2501438	Los Angeles County
284370	Fee-for-Service	1346421591	1346421591	1	1	FLORES, ERIKA J MD	10/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136314	41	Internal Medicine	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
284405	Fee-for-Service	1437425352	1437425352	1	1	FOOTE, ERIC M MD	8/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137290	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
284563	Fee-for-Service	1023166337	1023166337	1	1	FALLBROOK UNION HIGH SD	7/18/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	STUDENT SERVICES	2400 S STAGE COACH LANE	None	FALLBROOK	CA	92028	4429	37	06073	33.34948248	-117.2417405	San Diego County
284578	Fee-for-Service	1932745676	1932745676	1	1	FAMILY COMFORT HOSPICE INC	5/18/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7502 FOOTHILL BLVD	SUITE 203	TUJUNGA	CA	91402	3816	19	06037	34.25295017	-118.2957018	Los Angeles County
284640	Fee-for-Service	1063973352	1063973352	1	1	FLEISCHER, NATHANIEL M DO	11/8/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19955	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
284743	Fee-for-Service	1932745676	1932745676	1	1	FAMILY COMFORT HOSPICE INC	5/18/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7502 FOOTHILL BLVD	SUITE 203	TUJUNGA	CA	91402	3816	19	06037	34.25295017	-118.2957018	Los Angeles County
284783	Fee-for-Service	1922559715	1922559715	1	1	FRIDAY, ALSTON LMFT	5/22/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
284793	Fee-for-Service	1356617609	1356617609	1	1	FANG, DANIEL Z MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126505	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
284810	Fee-for-Service	1629003991	1629003991	1	1	FOX, ERIC R MD	11/30/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	63965	08	Family Practice	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
284821	Fee-for-Service	1477965598	1477965598	1	1	FRANZ, VANESSA G MD	8/28/2020	208600000X	NA	General Surgery	026	PHYSICIANS	143063	02	General Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
284879	Fee-for-Service	1962598896	1962598896	1	1	FUJITA, RICHARD A MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	51874	05	Anesthesiology	0	In state provider	None	2601 E CHAPMAN AVE	None	ORANGE	CA	92869	3206	30	06059	33.78785251	-117.826365	Orange County
284991	Fee-for-Service	1043359870	1043359870	1	1	FAMILY PLANNING ASSOCS	6/27/2006	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP INC	165 W HOSPITALITY LN	STE 1	SAN BERNARDINO	CA	92408	3334	36	06071	34.0658125	-117.2867985	San Bernardino County
284994	Fee-for-Service	1396416863	1396416863	1	1	FAMILY CHOICE ACO INC	2/23/2022	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	7631 WYOMING ST	STE 201	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
285034	Fee-for-Service	1376568162	1376568162	1	1	FERRACO, ERIC A	4/2/1994	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	HUMAN DESIGN PROS & ORTH	49 E FOOTHILL BLVD	None	ARCADIA	CA	91006	2307	19	06037	34.15102815	-118.0293628	Los Angeles County
285133	Fee-for-Service	1821656786	1821656786	1	1	FERNANDEZ, DANNY MD	7/11/2023	207P00000X	NA	Other	026	PHYSICIANS	181310	None	None	0	In state provider	None	1050 LINDEN AVENUE	None	LONG BEACH	CA	90813	3321	19	06037	33.78003775	-118.1866604	Los Angeles County
285161	Fee-for-Service	1306290143	1306290143	1	1	FERRAIOLO, NATALIE K MD	10/18/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152372	08	Family Practice	0	In state provider	None	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	37	06073	32.55831005	-117.0475102	San Diego County
285232	Fee-for-Service	1689652653	1689652653	1	1	FESKE, WILLIAM I	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73152	01	General Practice	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
285299	Fee-for-Service	1245736727	1245736727	1	1	FELDER-HEIM, CAITLIN MD	8/3/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	166235	None	None	0	In state provider	None	1001 POTRERO AVE	BLDG 80 WARD 83	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
285356	Fee-for-Service	1770244758	1770244758	1	1	FORWARD FOCUS COUNSELING INC	9/26/2022	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	16052 BEACH BLVD STE 218	None	HUNTINGTON BEACH	CA	92647	3809	30	06059	33.72949639	-117.989162	Orange County
285392	Fee-for-Service	1518044452	1518044452	1	1	FONG, CHRISTINA M MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87948	66	Emergency Medicine (Urgent Care)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
285497	Fee-for-Service	1447477906	1447477906	1	1	FEELEY, KELLEY R MD	12/5/2007	207P00000X	NA	Other	026	PHYSICIANS	94456	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
285505	Fee-for-Service	1689751547	1689751547	1	1	FETTERS, DEBRA A MD	3/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76054	66	Emergency Medicine (Urgent Care)	0	In state provider	None	675 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1932	43	06085	37.34275712	-121.8768207	Santa Clara County
285512	Fee-for-Service	1770244758	1770244758	1	1	FORWARD FOCUS COUNSELING INC	7/18/2024	101YM0800X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	16052 BEACH BLVD STE 218	None	HUNTINGTON BEACH	CA	92647	3809	30	06059	33.72949639	-117.989162	Orange County
285560	Fee-for-Service	1689844318	1689844318	1	1	FUNG, KENT K MD	12/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98253	40	Pediatrics	0	In state provider	None	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
285666	Fee-for-Service	1760403901	1760403901	1	1	FABBRO, ANILLA DEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2211 LOMAS BLVD NE	None	ALBUQUERQUE	NM	87106	2745	00	None	35.08771808	-106.6192188	Bernalillo County
285706	Fee-for-Service	1225324023	1225324023	1	1	FALDOWSKI, GREGORY F OD	8/8/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	293 WILLOW STREET	None	BISHOP	CA	93514	2720	14	06027	37.36287548	-118.3915755	Inyo County
285744	Fee-for-Service	1881768026	1881768026	1	1	FRID, GERMAINE J MD	3/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	37057	08	Family Practice	0	In state provider	None	1100 N PALM CANYON DR	STE 103	PALM SPRINGS	CA	92262	4418	33	06065	33.838182	-116.546744	Riverside County
285800	Fee-for-Service	1649234733	1649234733	1	1	FOX, CARLA G MD	1/20/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	39405	41	Internal Medicine	0	In state provider	None	4033 3RD AVE	STE 300	SAN DIEGO	CA	92103	2138	37	06073	32.75053781	-117.1627168	San Diego County
285870	Fee-for-Service	1891081253	1891081253	1	1	FATEHCHEHR, SOORENA MD	4/7/2020	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	132575	15	Obstetrics (D.O. only)	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
285898	Fee-for-Service	1235422353	1235422353	1	1	FRANK DELUCA, JACQUELINE J	9/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133876	07	Dermatology	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
285931	Fee-for-Service	1881185502	1881185502	1	1	FRAGOSO, IRMA	8/15/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 335	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
286016	Fee-for-Service	1417005224	1417005224	1	1	FELIX, DENISON A MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66906	22	Pathology (M.D. only)	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
286022	Fee-for-Service	1891081253	1891081253	1	1	FATEHCHEHR, SOORENA MD	4/7/2020	207VF0040X	NA	Obstetrics & Gynecology	026	PHYSICIANS	132575	09	Gynecology (D.O. only)	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
286039	Fee-for-Service	1346328184	1346328184	1	1	FROMER, ERIC S MD	10/16/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60780	07	Dermatology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
286078	Fee-for-Service	1487101739	1487101739	1	1	FREE SPIRIT HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5924 E LOS ANGELES AVE	SUITE R	SIMI VALLEY	CA	93063	5526	56	06111	34.27171481	-118.6755673	Ventura County
286084	Fee-for-Service	1972763993	1972763993	1	1	FARDANESH, REZA MD	9/28/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172279	None	None	0	In state provider	None	757 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	8358	19	06037	34.06633051	-118.4452686	Los Angeles County
286100	Fee-for-Service	1184734121	1184734121	1	1	FONG, DANIEL K	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5301 FREEPORT BLVD	STE 200	SACRAMENTO	CA	95822	2701	34	06067	38.52657	-121.496085	Sacramento County
286124	Fee-for-Service	1649284274	1649284274	1	1	FERRIES, SARAH H MD	2/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42292	36	Psychiatry	0	In state provider	None	607 CABOT WAY	None	NAPA	CA	94559	4731	28	06055	38.281136	-122.2891927	Napa County
286132	Fee-for-Service	1639128895	1639128895	1	1	FRANK, JEFFREY E MD	2/11/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	63369	None	None	0	In state provider	None	1420 TARA HILLS DR	None	PINOLE	CA	94564	2530	07	06013	37.99573909	-122.304492	Contra Costa County
286146	Fee-for-Service	1053316794	1053316794	1	1	FRIEDMAN, EDWARD B MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32330	13	Neurology (M.D. only)	0	In state provider	None	450 4TH AVE	STE 214	CHULA VISTA	CA	91910	4428	37	06073	32.63513513	-117.0820663	San Diego County
286180	Fee-for-Service	1730472655	1730472655	1	1	FRANCE, JOEL J DO	7/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	77 PRINGLE	None	RENO	NV	89502	1970	00	None	39.52484706	-119.7951825	Washoe County
286229	Fee-for-Service	1487101739	1487101739	1	1	FREE SPIRIT HOSPICE INC	6/8/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5924 E LOS ANGELES AVE	SUITE R	SIMI VALLEY	CA	93063	5526	56	06111	34.27171481	-118.6755673	Ventura County
286243	Fee-for-Service	1164404901	1164404901	1	1	FUSSELL, KEVIN M MD	7/23/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	172323	None	None	0	In state provider	None	326 SANTA FE DRIVE	100	ENCINITAS	CA	92024	5138	37	06073	33.040332	-117.285102	San Diego County
286259	Fee-for-Service	1558721704	1558721704	1	1	FEDULOW, IRINA	3/30/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
286298	Fee-for-Service	1053316794	1053316794	1	1	FRIEDMAN, EDWARD B MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32330	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 4TH AVE	STE 214	CHULA VISTA	CA	91910	4428	37	06073	32.63513513	-117.0820663	San Diego County
286375	Fee-for-Service	1497935183	1497935183	1	1	FRANCIS-ROGERS, SANDRA M MD	5/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
286405	Fee-for-Service	1881658532	1881658532	1	1	FRAZIER EALES, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 E 28TH ST	None	MINNEAPOLIS	MN	55407	3720	00	None	44.95428	-93.2614155	Hennepin County
286421	Fee-for-Service	1508329061	1508329061	1	1	FREEMAN, VIRGINIA T AU	8/1/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
286441	Fee-for-Service	1932809464	1932809464	1	1	FEDELIA B DAIZ	10/13/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	26690 MCCLURE CT	None	PERRIS	CA	92571	8734	33	06065	33.82840631	-117.1964681	Riverside County
286469	Fee-for-Service	1518299957	1518299957	1	2	F&S RADIOLOGY PC	6/2/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
286497	Fee-for-Service	1972523579	1972523579	1	1	FRIEDRICH, ESTHER MD	10/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89096	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	STE 800	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
286534	Fee-for-Service	1023100310	1023100310	1	1	FORD, HENRI R MD	2/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87405	85	Surgery-Pediatric	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
286539	Fee-for-Service	1538835004	1538835004	1	1	FLECK, HELEN	4/8/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	685 TWELVE BRIDGES DR	None	LINCOLN	CA	95648	8689	31	06061	38.85108687	-121.2886018	Placer County
286668	Fee-for-Service	1780794644	1780794644	1	1	FISHER, JACK E DPM INC	1/1/1979	193400000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	80 5TH ST	None	GILROY	CA	95020	5702	43	06085	37.0080574	-121.5703312	Santa Clara County
286701	Fee-for-Service	1154478550	1154478550	1	1	FENTON, JOHN W MD	3/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	96589	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
286750	Fee-for-Service	1811075617	1811075617	1	1	FAGAN, JAMES P DPM	12/31/1987	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
286810	Fee-for-Service	1467523423	1467523423	1	1	FASSETT, MICHAEL J MD	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79704	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
286926	Fee-for-Service	1073034799	1073034799	1	1	FAZEL, MARIAM MD	6/14/2022	207R00000X	NA	Other	026	PHYSICIANS	178242	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
286934	Fee-for-Service	1740207737	1740207737	1	1	FEIBLEMAN, CARY E MD	8/24/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	40658	07	Dermatology	0	In state provider	None	701 E 28TH ST	STE 311	LONG BEACH	CA	90806	2780	19	06037	33.80803441	-118.1847137	Los Angeles County
287037	Fee-for-Service	1427694298	1427694298	1	1	FOO, PHOEBE CNP	10/26/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4700 NORTHGATE BLVD	STE 100	SACRAMENTO	CA	95834	1149	34	06067	38.654262	-121.4770455	Sacramento County
287044	Fee-for-Service	1487115044	1487115044	1	1	FAMILY & FRIENDS HOME HEALTH	7/17/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	417 W ARDEN AVE	SUITE 106-A	GLENDALE	CA	91203	4045	19	06037	34.15847866	-118.2621835	Los Angeles County
287099	Fee-for-Service	1821134123	1821134123	1	1	FEDER, KEITH S MD INC	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	63788	20	Orthopedic Surgery	0	In state provider	None	1200 ROSECRANS AVE	STE 208	MANHATTAN BEACH	CA	90266	2470	19	06037	33.90178953	-118.3931775	Los Angeles County
287116	Fee-for-Service	1962580548	1962580548	1	1	FRANCIS, JAYA J MD	7/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85316	41	Internal Medicine	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
287170	Fee-for-Service	1568145647	1568145647	1	1	FADDA, RAFAELA J LCSW	2/14/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
287186	Fee-for-Service	1902836141	1902836141	1	1	FREI, KAREN P MD	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85492	13	Neurology (M.D. only)	0	In state provider	None	9940 TALBERT AVE	STE 204	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.70166347	-117.955494	Orange County
287259	Fee-for-Service	1760535843	1760535843	1	1	FITTS-SHEEHAN, SUSAN D PSYD	3/9/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5311	01	06001	37.8237837	-122.2590026	Alameda County
287344	Fee-for-Service	1427262203	1427262203	1	1	FONG, HAROLD K MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99628	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	0648	38	06075	37.7634502	-122.4579779	San Francisco County
287360	Fee-for-Service	1710306659	1710306659	1	1	FUNK, JONATHAN D MD	7/9/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	153926	36	Psychiatry	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
287393	Fee-for-Service	1700697869	1700697869	1	1	FELICIA WILLIAMS, LICENSED C	3/6/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LINICAL SOCIAL WORKER	1609 RIVENDEL DR	None	CORONA	CA	92883	0717	33	06065	33.81286782	-117.5448441	Riverside County
287396	Fee-for-Service	1265986756	1265986756	1	1	FRANER, BRUCE LMFT	1/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA CT	STE C4	PALMDALE	CA	93550	7607	19	06037	34.64013337	-118.1280539	Los Angeles County
287413	Fee-for-Service	1013398973	1013398973	1	1	FLORES, LARAVIC T MD	10/7/2019	390200000X	NA	Other	026	PHYSICIANS	151665	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
287448	Fee-for-Service	1194704569	1194704569	1	1	FISHMAN, SCOTT M MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85010	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
287455	Fee-for-Service	1740589407	1740589407	2	1	FRESNO MEDICAL SUPPLY INC	3/2/2014	332BX2000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N FRESNO ST	None	FRESNO	CA	93703	2240	10	06019	36.77124614	-119.7815106	Fresno County
287465	Fee-for-Service	1962509273	1962509273	1	2	FLORES, MICAELA V M LCSW	10/13/2015	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	503 1/2 S MYRTLE AVE	SUITE 4	MONROVIA	CA	91016	5100	19	06037	34.14685311	-118.001028	Los Angeles County
287469	Fee-for-Service	1598761298	1598761298	1	1	FULFORD, JEFFREY R	4/22/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVENUE	RMC MOB2	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
287491	Fee-for-Service	1548348238	1548348238	1	1	FANDRICH, BRYAN L MD	2/8/2015	208600000X	NA	General Surgery	026	PHYSICIANS	53202	02	General Surgery	0	In state provider	None	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0660	26	06051	37.64575895	-118.9638914	Mono County
287515	Fee-for-Service	1457387482	1457387482	1	1	FIELDS, GEORGE DO	12/31/1985	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	4941	08	Family Practice	0	In state provider	None	2632 PACIFIC AVE	None	LONG BEACH	CA	90806	2611	19	06037	33.805224	-118.1936835	Los Angeles County
287552	Fee-for-Service	1598468704	1598468704	1	1	FRASER, SARAH LCSW	8/17/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
287608	Fee-for-Service	1235577560	1235577560	1	1	FIELDING, JOSEPH S PT	2/26/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5648 LAKE MURRAY BLVD	None	LA MESA	CA	91942	1929	37	06073	32.78184153	-117.03104	San Diego County
287647	Fee-for-Service	1720343718	1720343718	1	1	FORSTER, AMBER M NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
287680	Fee-for-Service	1154678720	1154678720	1	1	FOSCO, CHRISTOPHER R MD	8/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141708	05	Anesthesiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2854	56	06111	34.2746295	-119.2573399	Ventura County
287688	Fee-for-Service	1558759597	1558759597	1	1	FAIRY HOSPICE CARE, INC	7/9/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	512 E WILSON AVE	SUITE 303	GLENDALE	CA	91206	4351	19	06037	34.14813015	-118.2494202	Los Angeles County
287716	Fee-for-Service	1902908080	1902908080	1	1	FARAH, AMIN MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71338	None	None	0	In state provider	None	3621 MARTIN LUTHER KING	None	LYNWOOD	CA	90262	3512	19	06037	33.93082719	-118.2024698	Los Angeles County
287819	Fee-for-Service	1558759597	1558759597	1	1	FAIRY HOSPICE CARE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	512 E WILSON AVE	SUITE 303	GLENDALE	CA	91206	4351	19	06037	34.14813015	-118.2494202	Los Angeles County
287848	Fee-for-Service	1861063752	1861063752	1	1	FLYNN, TERRANCE LCSW	10/8/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
288017	Fee-for-Service	1508036708	1508036708	1	1	FISCHEL, ABIGAIL R LMFT	8/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
288020	Fee-for-Service	1942224357	1942224357	1	1	FELIX YEMI AKINBI	6/29/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	FAY MEDICAL SUPPLY	2272 PACIFIC AVE.	SUITE C	LONG BEACH	CA	90806	4312	19	06037	33.798582	-118.193644	Los Angeles County
288070	Fee-for-Service	1083147870	1083147870	1	1	FORTUNE SENIOR ENT INC	1/10/2024	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	6060 SUNRISE VISTA DR	STE 1180	CITRUS HEIGHTS	CA	95610	0054	34	06067	38.676861	-121.263903	Sacramento County
288084	Fee-for-Service	1366539793	1366539793	1	1	FERNANDEZ, RODRIGO J MD	10/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	44441	45	Nephrology (Renal-Kidney)	0	In state provider	INC	480 4TH AVE	STE 516	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
288107	Fee-for-Service	1033647409	1033647409	1	1	FLORES, JOE B MD	9/21/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171135	None	None	0	In state provider	None	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	37	06073	32.70162897	-117.1465065	San Diego County
288110	Fee-for-Service	1174510218	1174510218	1	1	FRED DUTTON,MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1423 N JEFFERSON AVE	None	SPRINGFIELD	MO	65802	1917	00	None	37.22492991	-93.28917587	Greene County
288145	Fee-for-Service	1679623037	1679623037	1	1	FOGARTY, REBECCA LMFT	10/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	353 PARK MARINA CIRCLE	None	REDDING	CA	96001	0965	45	06089	40.57650059	-122.3737972	Shasta County
288147	Fee-for-Service	1851588727	1851588727	1	1	FAIR OAKS ESTATES, INC	8/1/2008	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	ADMINISTRATOR	8845 FAIR OAKS BLVD	None	CARMICHAEL	CA	95608	2652	34	06067	38.637531	-121.296186	Sacramento County
288200	Fee-for-Service	1366539793	1366539793	1	1	FERNANDEZ, RODRIGO J MD	10/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	44441	41	Internal Medicine	0	In state provider	INC	480 4TH AVE	STE 516	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
288211	Fee-for-Service	1265464820	1265464820	1	3	FOOT & ANKLE CONCEPTS INC	5/7/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	3901 LAS POSAS RD	STE 204	CAMARILLO	CA	93010	1507	56	06111	34.2415821	-119.0183756	Ventura County
288275	Fee-for-Service	1942264015	1942264015	1	1	FALKOFF, GARY E MD	8/31/1990	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	59757	30	Radiology	0	In state provider	None	515 E ROMIE LN	None	SALINAS	CA	93901	4018	27	06053	36.65992397	-121.6459411	Monterey County
288318	Fee-for-Service	1366539793	1366539793	1	1	FERNANDEZ, RODRIGO J MD	10/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	44441	66	Emergency Medicine (Urgent Care)	0	In state provider	INC	480 4TH AVE	STE 516	CHULA VISTA	CA	91910	4414	37	06073	32.63411298	-117.0816772	San Diego County
288331	Fee-for-Service	1801186648	1801186648	1	2	FRANCIS, ADAM C MD	2/28/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	122054	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3569 ROUND BARN CIR	STE 200	SANTA ROSA	CA	95403	1757	49	06097	38.479743	-122.729625	Sonoma County
288384	Fee-for-Service	1255466835	1255466835	1	1	FITTER, JUNAID D MD	3/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	67870	66	Emergency Medicine (Urgent Care)	0	In state provider	None	43830 10TH ST W	None	LANCASTER	CA	93534	4826	19	06037	34.67913961	-118.1478725	Los Angeles County
288469	Fee-for-Service	1336602002	1336602002	1	1	FLOYD, JACLYN MD	8/17/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
288631	Fee-for-Service	1073776068	1073776068	1	1	FARUQUI, AAMIR A MD INC	7/1/2001	207RC0200X	NA	Other	026	PHYSICIANS	70207	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2121 YGNACIO VALLEY RD	#E104	WALNUT CREEK	CA	94598	3383	07	06013	37.92145513	-122.0324849	Contra Costa County
288675	Fee-for-Service	1134270135	1134270135	3	1	FRD SPECIALTY PHARMACY INC	12/8/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6253 FOOTHILL BLVD	None	TUJUNGA	CA	91042	2723	19	06037	34.2412449	-118.2674415	Los Angeles County
288722	Fee-for-Service	1578589719	1578589719	1	1	FEHR, JAMES J MD	7/31/2019	207L00000X	NA	Other	026	PHYSICIANS	162477	05	Anesthesiology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
288765	Fee-for-Service	1164730560	1164730560	1	1	FIKSE, MELANIE L LPCC	8/27/2020	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	412 E MAIN ST	STE F	GRASS VALLEY	CA	95945	6533	29	06057	39.2215704	-121.0543391	Nevada County
288775	Fee-for-Service	1528343753	1528343753	1	1	FOLTZ, ANNE	8/14/2012	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11105 KNOTT AVE	STE B	CYPRESS	CA	90630	5137	30	06059	33.80083909	-118.0111199	Orange County
288812	Fee-for-Service	1134757099	1134757099	1	1	FIVELSTAD, KATHRYN	8/14/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
288876	Fee-for-Service	1982137550	1982137550	1	1	FISCHER, JAKOB L MD	4/13/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	185337	None	None	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
288907	Fee-for-Service	1609836196	1609836196	1	1	FILLOUX, RUTH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3580 W 9000 S	None	WEST JORDAN	UT	84088	8812	00	None	40.590153	-111.974634	Salt Lake County
288921	Fee-for-Service	1811389943	1811389943	1	1	FULLER, CARL W LCSW	11/17/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
288952	Fee-for-Service	1770069130	1770069130	1	1	FERNANDEZ, MERRITT PT	6/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
288965	Fee-for-Service	1417946526	1417946526	1	1	FORAN, JON M MD	1/31/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	56399	66	Emergency Medicine (Urgent Care)	0	In state provider	None	65 N MADISON AVE	None	PASADENA	CA	91101	2035	19	06037	34.14705803	-118.1384317	Los Angeles County
289040	Fee-for-Service	1265454672	1265454672	1	1	FRASER, GARY MD	1/1/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	33706	None	None	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
289070	Fee-for-Service	1417946526	1417946526	1	1	FORAN, JON M MD	1/31/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	56399	30	Radiology	0	In state provider	None	65 N MADISON AVE	None	PASADENA	CA	91101	2035	19	06037	34.14705803	-118.1384317	Los Angeles County
289155	Fee-for-Service	1407114341	1407114341	1	1	FLIPPO, LANA Y MD	12/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138358	40	Pediatrics	0	In state provider	None	2450 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4356	52	06103	40.14921426	-122.2216794	Tehama County
289269	Fee-for-Service	1578850921	1578850921	1	1	FOOTHILL AIDS PROJECT	9/4/2024	251S00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	678 S. INDIAN HILL BLVD	SUITE 220	CLAREMONT	CA	91711	3157	19	06037	34.083495	-117.719192	Los Angeles County
289397	Fee-for-Service	1528116340	1528116340	1	1	FRIEDRICHSEN, ERIC J MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	63730	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	11370 ANDERSON ST	# 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
289434	Fee-for-Service	1457359663	1457359663	1	1	FATUNDE, OLUYEMISI J MD	2/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51242	40	Pediatrics	0	In state provider	None	12712 HEACOCK ST	STE 3	MORENO VALLEY	CA	92553	3037	33	06065	33.936165	-117.2437645	Riverside County
289454	Fee-for-Service	1295760999	1295760999	1	1	FISHER, MARSHALL P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12106	30	Radiology	0	In state provider	None	4334 CENTRAL AVE	None	RIVERSIDE	CA	92506	2918	33	06065	33.95346346	-117.3993495	Riverside County
289463	Fee-for-Service	1518284959	1518284959	1	1	FARRAND, ERICA D MD	5/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136447	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
289536	Fee-for-Service	1124239397	1124239397	1	1	FARGAHI, SIMA MD	3/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	88366	22	Pathology (M.D. only)	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
289547	Fee-for-Service	1518284959	1518284959	1	1	FARRAND, ERICA D MD	5/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136447	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
289557	Fee-for-Service	1770892176	1770892176	1	1	FINE, LAUREN C MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111414	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
289661	Fee-for-Service	1578040531	1578040531	1	1	FRANCIS, MICHELLE E CNM	6/27/2023	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
289689	Fee-for-Service	1689896847	1689896847	1	1	FLEMING, DOUGLAS OD INC	7/30/1990	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	940 SYLVA LN	STE H	SONORA	CA	95370	5969	55	06109	37.98764779	-120.3681842	Tuolumne County
289730	Fee-for-Service	1093139313	1093139313	1	1	FREEDOM PATHOLOGY PARTNERS L	8/10/2023	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	LC	524 E ELM ST	STE A	CONSHOHOCKEN	PA	19428	1913	00	None	40.07340244	-75.29620024	Montgomery County
289758	Fee-for-Service	1093868283	1093868283	1	1	FERGUSON, LISA W MD	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	89250	05	Anesthesiology	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
289766	Fee-for-Service	1689058166	1689058166	1	1	FLANNERY, JANESSA L LMFT	5/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2008 MORSE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
289772	Fee-for-Service	1942491436	1942491436	1	1	FARSHIDI, ARTA MD	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114932	07	Dermatology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
289786	Fee-for-Service	1902875362	1902875362	1	1	FITZPATRICK, ELLEN M MD	11/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
289799	Fee-for-Service	1972651701	1972651701	1	1	FLORES, NICTE MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65331	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
289832	Fee-for-Service	1164031068	1164031068	1	1	FLORDELIS, MYRANDA R PSYD	3/11/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVE	SUITE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
289894	Fee-for-Service	1720025455	1720025455	1	1	FAIZER, RUMI MD	5/26/2023	2086S0129X	NA	General Surgery	026	PHYSICIANS	185786	None	None	0	In state provider	None	15030 7TH ST.	None	VICTORVILLE	CA	92395	3811	36	06071	34.52471945	-117.3042336	San Bernardino County
289925	Fee-for-Service	1497844757	1497844757	1	1	FELDMAN, PAUL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	NELPHROLOGY & HYPERTEN	169 N. PLANK ROAD	None	NEWBURGH	NY	12550	0000	00	None	41.538375	-74.0417265	Orange County
290021	Fee-for-Service	1023441110	1023441110	1	1	FRIEDMAN, LISA A LMFT	2/21/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17782 COWAN STE A	None	IRVINE	CA	92614	6041	30	06059	33.69590054	-117.862371	Orange County
290046	Fee-for-Service	1700106259	1700106259	1	1	FISCHETTI, TARA L PSYD	4/26/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
290131	Fee-for-Service	1972764116	1972764116	1	1	FORBESS, LINDSY J MD	2/7/2023	207RR0500X	NA	Other	026	PHYSICIANS	120710	None	None	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
290163	Fee-for-Service	1588858500	1588858500	1	1	FARLEY, RYAN M MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109051	None	None	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
290195	Fee-for-Service	1053616086	1053616086	1	2	FOOT AND ANKLE	6/29/2018	193400000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	SPECIALIST	16405 SAND CANYON AVE	STE 270	IRVINE	CA	92618	3792	30	06059	33.66098519	-117.7747816	Orange County
290311	Fee-for-Service	1194828822	1194828822	1	1	FULLER, JULIE M MD	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73782	41	Internal Medicine	0	In state provider	None	1236 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	2607	30	06059	33.8508897	-117.9761562	Orange County
290337	Fee-for-Service	1417427469	1417427469	1	1	FREITAS, ELIZABETH A CNP	8/12/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
290464	Fee-for-Service	1912472754	1912472754	1	1	FEITH, MEGAN CNP	3/26/2021	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2510 EL CAMINO REAL	None	CARLSBAD	CA	92008	1273	37	06073	33.17942276	-117.3266425	San Diego County
290502	Fee-for-Service	1801186648	1801186648	1	1	FRANCIS, ADAM C MD	8/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122054	01	General Practice	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
290564	Fee-for-Service	1336368562	1336368562	1	1	FAMILY CIRCLE INC	7/1/2002	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	2100 OUTLET CENTER DR	#370	OXNARD	CA	93036	0627	56	06111	34.22162992	-119.1483519	Ventura County
290644	Fee-for-Service	1487689188	1487689188	1	1	FAN, PAUL C MD	6/30/1991	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	62619	None	None	0	In state provider	None	10861 CHERRY ST	STE 200	LONG BEACH	CA	90806	2768	19	06037	33.80465174	-118.0680053	Orange County
290665	Fee-for-Service	1285761791	1285761791	1	1	FARRELL, RANDOLPH J PHD	12/26/2012	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1006 S MARJAN ST	None	ANAHEIM	CA	92806	5033	30	06059	33.82380531	-117.8726163	Orange County
290846	Fee-for-Service	1679574511	1679574511	1	1	FRANCE, ANTHONY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 JAMES SIMPSON JR WA	None	COVINGTON	KY	41011	0801	00	None	39.0715176	-84.51775131	Kenton County
290862	Fee-for-Service	1891155115	1891155115	1	1	FOUNDATION FOR HEARING RESEA	7/31/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3518 JEFFERSON AVE	None	REDWOOD CITY	CA	94062	3136	41	06081	37.46715891	-122.2492205	San Mateo County
290890	Fee-for-Service	1891155115	1891155115	1	1	FOUNDATION FOR HEARING RESEA	7/31/2019	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3518 JEFFERSON AVE	None	REDWOOD CITY	CA	94062	3136	41	06081	37.46715891	-122.2492205	San Mateo County
290897	Fee-for-Service	1194265579	1194265579	1	1	FAMILY HEALTHCARE NETWORK	7/28/2017	261QF0400X	NA	Federally Qualified Health Center	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	MOBILE	31180 ROAD 72	None	GOSHEN	CA	93291	9672	54	06107	36.35594779	-119.4124242	Tulare County
290900	Fee-for-Service	1881801678	1881801678	1	1	FILIPWOSKI, PIOTR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2121 E HARMONY RD	UNIT 300	FORT COLLINS	CO	80528	3403	00	None	40.52313048	-105.036552	Larimer County
290918	Fee-for-Service	1891155115	1891155115	1	1	FOUNDATION FOR HEARING RESEA	7/31/2019	225X00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	3518 JEFFERSON AVE	None	REDWOOD CITY	CA	94062	3136	41	06081	37.46715891	-122.2492205	San Mateo County
290939	Fee-for-Service	1528400744	1528400744	1	1	FLOYD, TALAINA LPCC	11/27/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
290945	Fee-for-Service	1811205701	1811205701	1	1	FATATO, ANTOINETTE M LCSW	8/13/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3831 HUGHES AVE	SUITE 708	CULVER CITY	CA	90232	6842	19	06037	34.02243278	-118.3981492	Los Angeles County
291003	Fee-for-Service	1508153297	1508153297	1	1	FUENTES, MARIA G MD INC	6/2/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	83896	None	None	0	In state provider	None	717 THIRD AVE	None	CHULA VISTA	CA	91910	5803	37	06073	32.62686486	-117.0742194	San Diego County
291022	Fee-for-Service	1871658740	1871658740	1	1	FAN, JUDY S OD	12/3/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9428 VALLEY BLVD	STE 201	ROSEMEAD	CA	91770	1513	19	06037	34.0811223	-118.0635319	Los Angeles County
291033	Fee-for-Service	1437146552	1437146552	1	1	FEIN, STEVEN G MD	2/4/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	174752	None	None	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
291065	Fee-for-Service	1649880410	1649880410	1	1	FUSS, ELIZABETH PSYD	3/17/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
291077	Fee-for-Service	1578989943	1578989943	1	1	FERNANDEZ-CRAFT, FRITZIE LM	12/16/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	115139	-	NOT APPLICABLE	0	In state provider	FT	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	12	06023	40.89808837	-124.0923819	Humboldt County
291190	Fee-for-Service	1184822819	1184822819	1	1	FRANCISCO J QUILES-CRUZ M.D.	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2776 CLEVELAND AVE	None	FORT MYERS	FL	33901	5864	00	None	26.628237	-81.873945	Lee County
291225	Fee-for-Service	1376817270	1376817270	1	1	FINNICUM, RENEE M LPCC	7/27/2020	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	307 2ND AVE	None	SAN MATEO	CA	94403	1326	41	06081	37.56642166	-122.3231158	San Mateo County
291256	Fee-for-Service	1689138620	1689138620	1	1	FERRELL, CHRISTINE M RCP	2/15/2019	2279C0205X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
291258	Fee-for-Service	1083029946	1083029946	1	1	FISHER, JENNIFER H OD	7/4/2020	152WV0400X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE ST	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
291268	Fee-for-Service	1508801069	1508801069	1	1	FAMILY HEALTH CENTERS	2/1/1999	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	8788 JAMACHA RD	None	SPRING VALLEY	CA	91977	4035	37	06073	32.71482507	-117.0098243	San Diego County
291277	Fee-for-Service	1508801069	1508801069	1	1	FAMILY HEALTH CENTERS	2/1/1999	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	8788 JAMACHA RD	None	SPRING VALLEY	CA	91977	4035	37	06073	32.71482507	-117.0098243	San Diego County
291379	Fee-for-Service	1992719249	1992719249	1	1	FANCHER, TONYA L MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67806	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
291589	Non-Physician Medical Practitioner	None	1972744399	0	0	FERNANDO, ACOSTA	6/22/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 W FERN AVE	None	REDLANDS	CA	92373	5916	00	06000	34.05016907	-117.1793443	San Bernardino County
291622	Non-Physician Medical Practitioner	None	1821492216	0	0	FUJINAKA, CHRISTINE S	12/23/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 MURPHY RANCH RD	APT 418	MILPITAS	CA	95035	7948	00	06000	37.4183445	-121.9271746	Santa Clara County
291684	Non-Physician Medical Practitioner	None	1760594154	0	0	FALL, STEPHEN A	6/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3838 NORTH AVE	None	MODESTO	CA	95358	8936	00	06000	37.6745074	-121.0645666	Stanislaus County
291706	Non-Physician Medical Practitioner	None	1255851259	0	0	FAKHOURY, HIND	11/22/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7320 SANTA MONICA BLVD	#344	WEST HOLLYWOOD	CA	90046	6688	00	06000	34.09069784	-118.349737	Los Angeles County
291708	Non-Physician Medical Practitioner	None	1245471853	0	0	FLORENCE, BRYNA E	3/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1723 RAMON ST	None	LEMON GROVE	CA	91945	4307	00	06000	32.72280457	-117.045152	San Diego County
291712	Non-Physician Medical Practitioner	None	1982684205	0	0	FANTAUZZI, SANDRA D	12/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 S MANCHESTER AVE	315	ORANGE	CA	92868	3201	00	06000	33.788457	-117.8932475	Orange County
291731	Non-Physician Medical Practitioner	None	1316517923	0	0	FOWLER, RICHARD NP	7/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1026 MANGROVE AVE	STE 10	CHICO	CA	95926	3556	00	06000	39.73971182	-121.8368837	Butte County
291734	Non-Physician Medical Practitioner	None	1922555721	0	0	FARNAZ, JAFARINEJAD	10/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6863 BRANDY CIRCLE	None	GRANITE BAY	CA	95746	6240	00	06000	38.74291743	-121.1726116	Placer County
291774	Non-Physician Medical Practitioner	None	1073540449	0	0	FERNANDEZ, SAM	8/1/1999	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	00	06000	36.83626596	-119.7674879	Fresno County
291824	Non-Physician Medical Practitioner	None	1639448178	0	0	FRUMAN, PASHA S	8/3/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8652 WILLOW DR	None	RANCHO CUCAMONGA	CA	91730	4631	00	06000	34.096617	-117.588676	San Bernardino County
291873	Non-Physician Medical Practitioner	None	1891890950	0	0	FOX, TERESA A NP	6/25/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8454 COBBLE CREEK LN	None	ORANGEVALE	CA	95662	3868	00	06000	38.682486	-121.2464925	Sacramento County
291880	Non-Physician Medical Practitioner	None	1790211985	0	0	FRITZ, ROXANNE A PA-C	4/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
291894	Non-Physician Medical Practitioner	None	1558030130	0	0	FUREDI, JAMES D PA	12/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	00	06000	34.68938848	-118.158354	Los Angeles County
291934	Non-Physician Medical Practitioner	None	1528331287	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO INC	9/21/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	140 ELM STREET	None	SAN DIEGO	CA	92101	0000	00	06000	32.72409551	-117.1632195	San Diego County
291960	Non-Physician Medical Practitioner	None	1972342855	0	0	FIELDS, KAREN	10/28/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6502 BOLSA AVE	SUITE 105	HUNTINGTON BEACH	CA	92647	2661	00	06000	33.74431567	-118.0153924	Orange County
291969	Non-Physician Medical Practitioner	None	1528441482	0	0	FRONTIERO, JESSICA M NP	8/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6621 FANNIN STREET	None	HOUSTON	TX	77030	2303	00	06000	29.70724683	-95.4026169	Harris County
291971	Non-Physician Medical Practitioner	None	1184851545	0	0	FOSTER, KEVIN PA	7/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14614 VICTORY BLVD.	None	VAN NUYS	CA	91411	1621	00	06000	34.18663148	-118.451421	Los Angeles County
292023	Non-Physician Medical Practitioner	None	1467846964	0	0	FRIEDMAN, MICHELLE L NP	10/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15505 LA MAIDA ST	None	ENCINO	CA	91436	1604	00	06000	34.15851523	-118.472281	Los Angeles County
292084	Non-Physician Medical Practitioner	None	1013093103	0	0	FORBES, LAJEAN AVON	11/8/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12712 HEACOCK ST	SUITE 7	MORENO VALLEY	CA	92553	3037	00	06000	33.936165	-117.2437645	Riverside County
292114	Non-Physician Medical Practitioner	None	1306205109	0	0	FAUSETT, KISHA A NP	12/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
292123	Non-Physician Medical Practitioner	None	1396317517	0	0	FRYDENDALL, MATTHEW J PA-C	10/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8805 HAVEN AVE	SUITE 200	RANCHO CUCAMONGA	CA	91730	5149	00	06000	34.09424614	-117.5756838	San Bernardino County
292160	Non-Physician Medical Practitioner	None	1295100683	0	0	FUNG, FELICITY N	12/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2218 RIVER RUN DR	112	SAN DIEGO	CA	92108	5818	00	06000	32.77845546	-117.1346678	San Diego County
292196	Non-Physician Medical Practitioner	None	1659683720	0	0	FOOTHILL EMERGENCY MEDICAL ASSOCIATES, INC	11/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	438 W LAS TUNAS DR	None	SAN GABRIEL	CA	91776	1216	00	06000	34.10243051	-118.105902	Los Angeles County
292227	Non-Physician Medical Practitioner	None	1508627373	0	0	FAUSTINO, COURTNEY	8/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 LIGHTHOUSE AVE	None	MONTEREY	CA	93940	1439	00	06000	36.61275747	-121.9010674	Monterey County
292312	Non-Physician Medical Practitioner	None	1982726378	0	0	FARWELL, NICOLE	1/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1518 WHITE SAGE WAY	None	CARLSBAD	CA	92011	4023	00	06000	33.10950607	-117.2890487	San Diego County
292330	Non-Physician Medical Practitioner	None	1487702304	0	0	FINEBAUM, ELIZABETH	10/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1301 17TH ST	210	SANTA MONICA	CA	90404	1959	00	06000	34.02758138	-118.4842468	Los Angeles County
292359	Non-Physician Medical Practitioner	None	1770989758	0	0	FARAJIAN, SOSSY R NP	9/6/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	58 HERITAGE WOOD CIRCLE	None	SACRAMENTO	CA	95831	3906	00	06000	38.484801	-121.518558	Sacramento County
292398	Non-Physician Medical Practitioner	None	1447281936	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	2/4/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
292434	Non-Physician Medical Practitioner	None	1841957578	0	0	FRYMIER, AMBER M NP	2/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
292451	Non-Physician Medical Practitioner	None	1730299215	0	0	FISHMAN, LAURIE P	9/7/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3196 S MARYLAND PKWY	SUITE 217	LAS VEGAS	NV	89109	2305	00	06000	36.13194	-115.136873	Clark County
292507	Non-Physician Medical Practitioner	None	1700834124	0	0	FLEMING, MICHAEL PA-C	12/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	850 E WASHINGTON ST	None	COLTON	CA	92324	8101	00	06000	34.04819847	-117.3132225	San Bernardino County
292515	Non-Physician Medical Practitioner	None	1912053851	0	0	FLORES, HILDA	2/11/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	531 N AZUSA AVE	None	AZUSA	CA	91702	2936	00	06000	34.13084062	-117.9076256	Los Angeles County
292540	Non-Physician Medical Practitioner	None	1164997573	0	0	FRENSLEY, JOSEPH L NP	8/12/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1739 COLORADO AVE	None	TURLOCK	CA	95382	2714	00	06000	37.508976	-120.835306	Stanislaus County
292567	Non-Physician Medical Practitioner	None	1578266789	0	0	FLORES-CAMPOS, JESSICA NP	10/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6385	00	06000	37.36812305	-122.0312314	Santa Clara County
292595	Non-Physician Medical Practitioner	None	1487794376	0	0	FITE, JEFFREY B	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9518 NEWINGTON WAY	None	ELK GROVE	CA	95758	4441	00	06000	38.413314	-121.4241165	Sacramento County
292623	Non-Physician Medical Practitioner	None	1316928807	0	0	FENTON, DEBRA K NP	12/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5516 OAK RIDGE DRIVE	None	KELSEYVILLE	CA	95451	9374	00	06000	38.97449631	-122.8230534	Lake County
292628	Non-Physician Medical Practitioner	None	1700326998	0	0	FERNANDEZ, JOSEPH C NP	6/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2200 W. 3RD ST.	SUITE 120	LOS ANGELES	CA	90057	1934	00	06000	34.06329642	-118.2739484	Los Angeles County
292633	Non-Physician Medical Practitioner	None	1992823579	0	0	FINDLEY, FELIPE PA-C	11/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 W SUNSET BLVD	SUITE 812	WEST HOLLYWOOD	CA	90069	3709	00	06000	34.09054375	-118.392295	Los Angeles County
292659	Non-Physician Medical Practitioner	None	1386362309	0	0	FLORES, NADIA NP	3/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4817 CENTENNIAL PLZ WAY	SUITE B	BAKERSFIELD	CA	93312	1957	00	06000	35.40389036	-119.093518	Kern County
292684	Non-Physician Medical Practitioner	None	1346628674	0	0	FRUHNER, PAUL	6/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10 CONGRESS ST.	STE. 103	PASADENA	CA	91105	3027	00	06000	34.13396893	-118.1528162	Los Angeles County
292698	Non-Physician Medical Practitioner	None	1841964293	0	0	FANUCCHI-FUNES, SAGE J CNM	11/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3200 WALFORD AVE	None	EUREKA	CA	95503	4828	00	06000	40.77887445	-124.1378239	Humboldt County
292733	Non-Physician Medical Practitioner	None	1730770942	0	0	FELIX, FRANCISCO J PA-C	5/11/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1307 WEST SIXTH STREET	105	CORONA	CA	92882	3294	00	06000	33.87790309	-117.589666	Riverside County
292775	Non-Physician Medical Practitioner	None	1912961061	0	0	FRY, PAUL D	6/6/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7127 HOLLISTER AVE	APT 25A-254	GOLETA	CA	93117	2859	00	06000	34.42991137	-119.8772702	Santa Barbara County
292855	Non-Physician Medical Practitioner	None	1336320407	0	0	FAYSMAN, KAROLINA NP	10/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	00	06000	34.065126	-118.446237	Los Angeles County
292858	Non-Physician Medical Practitioner	None	1235858358	0	0	FORD, PATRICK N PA-C	2/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	00	06000	34.06287152	-118.2029433	Los Angeles County
292898	Non-Physician Medical Practitioner	None	1811032436	0	0	FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,	5/17/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22310 WARDHAM AVE	None	HAWAIIAN GARDENS	CA	90716	1740	00	06000	33.82667708	-118.0650149	Los Angeles County
292915	Non-Physician Medical Practitioner	None	1184817249	0	0	FLEMING, JENNIFER C NP	8/25/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 S CLARK	APT 101	LOS ANGELES	CA	90036	1430	00	06000	34.05695028	-118.384715	Los Angeles County
292919	Non-Physician Medical Practitioner	None	1609402114	0	0	FRANCO, VANESSA PA	11/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2141 N HARBOR BLVD	STE 25000	FULLERTON	CA	92835	3830	00	06000	33.89443025	-117.9288328	Orange County
292963	Non-Physician Medical Practitioner	None	1134537244	0	0	FLAGG, KIRSTEN K NP	1/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
293012	Non-Physician Medical Practitioner	None	1154521102	0	0	FRASER, ANTHONY M	9/28/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	264 CLOVIS AVE	SUITE 107	CLOVIS	CA	93612	1115	00	06000	36.8268544	-119.7007055	Fresno County
293016	Non-Physician Medical Practitioner	None	1497154959	0	0	FOGEL, RICHARD M JR NP	12/16/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11849 FAIRFORD AVE	None	NORWALK	CA	90650	7745	00	06000	33.92384032	-118.095379	Los Angeles County
293101	Non-Physician Medical Practitioner	None	1750830758	0	0	FITZGERALD, MEGAN E	6/19/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4194 1ST AVE	None	SACRAMENTO	CA	95817	2112	00	06000	38.551788	-121.457565	Sacramento County
293104	Non-Physician Medical Practitioner	None	1871366740	0	0	FLORES CARBAJAL, LEONEL A	1/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	00	06000	36.06953472	-119.0273379	Tulare County
293165	Non-Physician Medical Practitioner	None	1609154517	0	0	FAGAN, TRISHA J	11/12/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3547 WASATCH DR	None	REDDING	CA	96001	2979	00	06000	40.56973776	-122.4176171	Shasta County
293258	Non-Physician Medical Practitioner	None	1346449634	0	0	FULLER, MARTHA GRANT	8/23/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	MAIL CODE 8452	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
293276	Non-Physician Medical Practitioner	None	1265263834	0	0	FARFAN AYALA, DIANA M PA-C	12/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	00	06000	34.95203385	-120.4131707	Santa Barbara County
293294	Non-Physician Medical Practitioner	None	1932827078	0	0	FILIPPELLO, LAUREN A NP	7/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3863 CLAIREMONT DRIVE	None	SAN DIEGO	CA	92117	5831	00	06000	32.81064075	-117.2008928	San Diego County
293426	Non-Physician Medical Practitioner	None	1407974066	0	0	FRANCK, SHANNON J NP	6/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3465 SHOWBOAT CT	None	REDDING	CA	96003	5327	00	06000	40.60877181	-122.414897	Shasta County
293429	Non-Physician Medical Practitioner	None	1245804194	0	0	FOSTER, EMERALD PA	8/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	869 N CHERRY ST	None	TULARE	CA	93274	2207	00	06000	36.220932	-119.337698	Tulare County
293535	Non-Physician Medical Practitioner	None	1528095866	0	0	FERNANDO, ZOLISSA	7/1/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14427 CHASE ST	STE.100	PANORAMA CITY	CA	91402	3020	00	06000	34.22477664	-118.4478733	Los Angeles County
293550	Non-Physician Medical Practitioner	None	1760884530	0	0	FIELDSTED, TYSON M NP	3/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	230 S MONTCLAIR ST	SUITE 101	BAKERSFIELD	CA	93309	3117	00	06000	35.35252191	-119.0555354	Kern County
293560	Non-Physician Medical Practitioner	None	1851880512	0	0	FERNANDEZ, JOSE	10/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
293585	Non-Physician Medical Practitioner	None	1235915216	0	0	FRANCISCO, KAREN NP	12/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2077 HARBOR BLVD	A	COSTA MESA	CA	92627	9384	00	06000	33.64990963	-117.9190918	Orange County
293586	Non-Physician Medical Practitioner	None	1386320125	0	0	FRAZIER, MARI K PA-C	2/1/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	00	06000	33.89552551	-117.186021	Riverside County
293620	Non-Physician Medical Practitioner	None	1669782645	0	0	FREDERICK, ANDREA JAYNE	11/9/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR.	ROOM A260	STANFORD	CA	94305	5319	00	06000	37.43304542	-122.1759654	Santa Clara County
293626	Non-Physician Medical Practitioner	None	1538783519	0	0	FLETCHER, BROOKE N PA	9/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2633 PACIFIC AVE	None	STOCKTON	CA	95204	4429	00	06000	37.97483455	-121.3028311	San Joaquin County
293656	Non-Physician Medical Practitioner	None	1740695352	0	0	FEASTER, CARRISSIA A CNM	3/22/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1155 MILL ST	None	RENO	NV	89502	1576	00	06000	39.52483792	-119.7968314	Washoe County
293722	Non-Physician Medical Practitioner	None	1982914792	0	0	FARNAM, PATRICIA DIANNE	5/31/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7955 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4001	00	06000	33.75932839	-117.9902744	Orange County
293791	Non-Physician Medical Practitioner	None	1689254039	0	0	FALCON, JOANNA L NP	6/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1590 SOUTH IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	00	06000	32.77950118	-115.5697279	Imperial County
293893	Non-Physician Medical Practitioner	None	1760472724	0	0	FEENEY, MICHELLE WILKERSON	9/21/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	155 HWY 50	None	STATELINE	NV	89449	0000	00	06000	38.96860553	-119.9356859	Douglas County
293899	Non-Physician Medical Practitioner	None	1629060967	0	0	FIELDS, ALMA JEAN	9/30/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	00	06000	38.746836	-121.250529	Placer County
293930	Non-Physician Medical Practitioner	None	1538442611	0	0	FONG, PATRICK	8/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1415 EL SERENO AVE	APT 3	PASADENA	CA	91103	2156	00	06000	34.17009401	-118.1522225	Los Angeles County
293960	Non-Physician Medical Practitioner	None	1790234599	0	0	FOOTE, BRIANA R NP	3/24/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5550 W KESLER STREET	None	CHANDLER	AZ	85226	4474	00	06000	33.294447	-111.9377565	Maricopa County
293968	Non-Physician Medical Practitioner	None	1912065228	0	0	FAZZALARO, WILLIAM PA	3/7/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24411 HEALTH CENTER DR	STE 680	LAGUNA HILLS	CA	92653	3692	00	06000	33.6087201	-117.7076948	Orange County
294050	Non-Physician Medical Practitioner	None	1588147185	0	0	FUCHS, HALEY M	2/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	77 MORAGA WAY	STE G	ORINDA	CA	94563	3019	00	06000	37.87787873	-122.1803048	Contra Costa County
294052	Non-Physician Medical Practitioner	None	1275807703	0	0	FOBBS-MITCHELL, INGRID D NP	12/2/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10399 CROSSING GREEN CR	None	MORENO VALLEY	CA	92557	2690	00	06000	33.96975085	-117.2654679	Riverside County
294094	Non-Physician Medical Practitioner	None	1912972340	0	0	FERGUSON, LORIN E PA-C	10/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1575 SOQUEL DRIVE	SUITE C	SANTA CRUZ	CA	95065	1700	00	06000	36.98861921	-121.9831127	Santa Cruz County
294113	Non-Physician Medical Practitioner	None	1457088247	0	0	FATHI, MARYAM NP	10/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	50 ALESSANDRO PLACE	SUITE 440	PASADENA	CA	91105	0000	00	06000	34.13101049	-118.151532	Los Angeles County
294139	Non-Physician Medical Practitioner	None	1710626122	0	0	FADEYIBI, YETUNDE NP	4/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4199 CAMPUS DR	SUITE 550, OFFICE 57	IRVINE	CA	92612	4684	00	06000	33.650775	-117.838296	Orange County
294198	Non-Physician Medical Practitioner	None	1629205323	0	0	FERNANDEZ, JENNIFER M	8/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2900 4TH STREET	APT 1	SANTA MONICA	CA	90405	5529	00	06000	34.00102631	-118.4785797	Los Angeles County
294310	Non-Physician Medical Practitioner	None	1023855756	0	0	FONG, TIFFANY K NP	9/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6385	00	06000	37.36812305	-122.0312314	Santa Clara County
294330	Non-Physician Medical Practitioner	None	1144794629	0	0	FREEBERG, SCOTT K PA	1/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1515 E OCEAN AVE	None	LOMPOC	CA	93436	7092	00	06000	34.63941491	-120.4393023	Santa Barbara County
294356	Non-Physician Medical Practitioner	None	1144545823	0	0	FAN, SAU-MI P NP	12/18/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1550 3RD ST	None	LINCOLN	CA	95648	1576	00	06000	38.88920653	-121.304718	Placer County
294378	Non-Physician Medical Practitioner	None	1508931122	0	0	FERRIS, NADA IRENE	10/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
294384	Non-Physician Medical Practitioner	None	1114341898	0	0	FRESNO LONG TERM CARE MEDICAL GROUP INC	1/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35324 HIGHWAY 41 # A	None	COARSEGOLD	CA	93614	9285	00	06000	37.26242065	-119.6987402	Madera County
294395	Non-Physician Medical Practitioner	None	1194122457	0	0	FAMILIES TOGETHER OF ORANGE COUNTY	6/11/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	661 W FIRST ST	STE G	TUSTIN	CA	92780	2939	00	06000	33.74578153	-117.831231	Orange County
294412	Non-Physician Medical Practitioner	None	1326077900	0	0	FRASHER, SUSANA	10/25/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1020 SOUTH RIDGEMARK DR	None	HOLLISTER	CA	95023	6459	00	06000	36.80738662	-121.3549657	San Benito County
294423	Non-Physician Medical Practitioner	None	1295724375	0	0	FAUCHER, VICKI	10/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 E ROMIE LN	A	SALINAS	CA	93901	4031	00	06000	36.65998191	-121.6461895	Monterey County
294444	Non-Physician Medical Practitioner	None	1538744156	0	0	FREMBLING, HEIDI C NP	6/18/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4900 COMMERCE DR	None	BAKERSFIELD	CA	93309	0418	00	06000	35.3696013	-119.0558857	Kern County
294554	Non-Physician Medical Practitioner	None	1992259709	0	0	FEENEY, JENNIFER E NP	5/6/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	77 CADILLAC DR	STE 230	SACRAMENTO	CA	95825	5453	00	06000	38.572551	-121.4181585	Sacramento County
294584	Non-Physician Medical Practitioner	None	1013496892	0	0	FAZZINO, DANIEL L PA	3/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 W SUNSET BLVD	SUITE 812	WEST HOLLYWOOD	CA	90069	3709	00	06000	34.09054375	-118.392295	Los Angeles County
294614	Non-Physician Medical Practitioner	None	1699326132	0	0	FINCALERO, FRANCISCO NP	4/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7035 N MAPLE AVE	102A	FRESNO	CA	93720	8027	00	06000	36.83856379	-119.7452911	Fresno County
294648	Non-Physician Medical Practitioner	None	1144746140	0	0	FLACK, KRISTEN E	3/14/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1639 GRACE CT	None	CAMARILLO	CA	93010	2074	00	06000	34.23695777	-119.0476403	Ventura County
294684	Non-Physician Medical Practitioner	None	1003248576	0	0	FERRARO, MERISSA NP	10/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 E PALOMAR ST	None	CHULA VISTA	CA	91931	1800	00	06000	32.62382113	-116.9960539	San Diego County
294708	Non-Physician Medical Practitioner	None	1366862526	0	0	FJERSTAD, KYLE E	10/28/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5418 LANE STAR DRIVE	None	TUCSON	AZ	85713	6733	00	06000	32.19856327	-111.0956918	Pima County
294729	Non-Physician Medical Practitioner	None	1033425640	0	0	FINEMAN, SANDRA	10/29/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21707 CASINO RIDGE RD	None	YORBA LINDA	CA	92887	1207	00	06000	33.90810396	-117.7550322	Orange County
294752	Non-Physician Medical Practitioner	None	1336963552	0	0	FIELD, DANIELLE NP	3/24/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1139 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	00	06000	38.91323462	-119.9965999	El Dorado County
294806	Non-Physician Medical Practitioner	None	1447402516	0	0	FARAZ, ASEFEH NP	8/11/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	102 S ORANGE GROVE BLVD	105	PASADENA	CA	91105	0000	00	06000	34.14411346	-118.1600094	Los Angeles County
294826	Non-Physician Medical Practitioner	None	1417512302	0	0	FARES, LINDA	10/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
294862	Non-Physician Medical Practitioner	None	1043613458	0	0	FINNEY-BEVERLY, ARNETA NP	5/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	00	06000	34.21957849	-118.6082685	Los Angeles County
294899	Non-Physician Medical Practitioner	None	1912378332	0	0	FELKINS, TAERA	1/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4062 GARFIELD ST	APT C	CARLSBAD	CA	92008	7402	00	06000	33.1462275	-117.3414051	San Diego County
294903	Non-Physician Medical Practitioner	None	1306897962	0	0	FORT MOJAVE INDIAN TRIBE	8/23/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1607 PLANTATION RD	None	MOHAVE VALLEY	AZ	86440	9686	00	06000	34.851987	-114.5952675	Mohave County
294960	Non-Physician Medical Practitioner	None	1831667591	0	0	FLOWERS, KRISTIAN M RN PNP	4/9/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16661 VENTURA BLVD	408	ENCINO	CA	91436	1914	00	06000	34.15820737	-118.496492	Los Angeles County
294963	Non-Physician Medical Practitioner	None	1801963673	0	0	FAN, RICHARD D	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24796 ARGUS DR	None	MISSION VIEJO	CA	92691	4614	00	06000	33.6020101	-117.6794471	Orange County
294967	Non-Physician Medical Practitioner	None	1700119567	0	0	FAJEMISIN, BABAJIDE A	7/18/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7261 PLUM TREE PL	None	FONTANA	CA	92336	5719	00	06000	34.122132	-117.4670645	San Bernardino County
294968	Non-Physician Medical Practitioner	None	1093804213	0	0	FARNWORTH, CARLA RAE	2/10/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1200 MOUNTAIN ST	None	CARSON CITY	NV	89703	3821	00	06000	39.17115	-119.773521	Consolidated Municipality of Carson City
294983	Non-Physician Medical Practitioner	None	1851451140	0	0	FORD, PHILIP D PA	2/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	515 MICHIGAN BLVD	None	WEST SACRAMENTO	CA	95691	2705	00	06000	38.58298316	-121.5265736	Yolo County
295017	Non-Physician Medical Practitioner	None	1437566395	0	0	FONG, JEREMY D	3/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3422 ANDOVER ST	APT 205	OAKLAND	CA	94609	2842	00	06000	37.82260521	-122.2639629	Alameda County
295027	Non-Physician Medical Practitioner	None	1124300959	0	0	FORNASERO, AUTUMN LECI	10/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	00	06000	32.95809	-115.5537045	Imperial County
295044	Non-Physician Medical Practitioner	None	1841423449	0	0	FLOWER, VICTORIA S W NP	3/29/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	134 COBBLE RIDGE DR	None	FOLSOM	CA	95630	3286	00	06000	38.666241	-121.172949	Sacramento County
295088	Non-Physician Medical Practitioner	None	1114372174	0	0	FISHER, CRAIG PA	8/5/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	00	06000	33.93500365	-118.1321119	Los Angeles County
295105	Non-Physician Medical Practitioner	None	1316448533	0	0	FERRER, CAMILLE A NP	5/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 SOUTH LARKWOOD ST	None	ANAHEIM	CA	92808	1215	00	06000	33.86624273	-117.7396326	Orange County
295158	Non-Physician Medical Practitioner	None	1821347030	0	0	FELARCA, CLIFFORD U NP	5/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1946 CLEARBROOK DRIVE	None	CHULA VISTA	CA	91913	2330	00	06000	32.65010653	-116.982666	San Diego County
295188	Non-Physician Medical Practitioner	None	1689138851	0	0	FLORES, BRIANNA PA-C	8/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14650 AVIATION BLVD	200	HAWTHORNE	CA	90250	6668	00	06000	33.898788	-118.3786825	Los Angeles County
295193	Non-Physician Medical Practitioner	None	1518151984	0	0	FRAUSTO, LILIA	6/18/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 EASTLAKE AVE	NOR 8302E	LOS ANGELES	CA	90089	0112	00	06000	34.06169385	-118.2044698	Los Angeles County
295318	Non-Physician Medical Practitioner	None	1063750743	0	0	FERGUSON, CORY G PA	7/15/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	34532 FAWN RIDGE PL	None	YUCAIPA	CA	92399	6869	00	06000	34.04669101	-117.0514314	San Bernardino County
295333	Non-Physician Medical Practitioner	None	1477942647	0	0	FOGELTANZ, JESSICA A	3/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1880 DEL CIERVO PLACE	None	CAMARILLO	CA	93012	3542	00	06000	34.2356702	-119.013831	Ventura County
295384	Non-Physician Medical Practitioner	None	1871579664	0	0	FOSTER, NICOLE LEIGH	8/20/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	00	06000	36.7382512	-119.7543688	Fresno County
295390	Non-Physician Medical Practitioner	None	1306357454	0	0	FLORES, MARIA A M NP	1/14/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	880 SYCAMORE CANYON RD	None	PASO ROBLES	CA	93446	4770	00	06000	35.60617877	-120.645501	San Luis Obispo County
295508	Non-Physician Medical Practitioner	None	1841540721	0	0	FRASER, JACKSON PA	5/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2122 W KETTLEMAN LANE	None	LODI	CA	95242	4321	00	06000	38.11537452	-121.299291	San Joaquin County
295547	Non-Physician Medical Practitioner	None	1114783164	0	0	FARRAR, BRITTANY NP	6/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12301 S HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	2369	00	06000	33.92064813	-118.3528905	Los Angeles County
295600	Non-Physician Medical Practitioner	None	1295400679	0	0	FLETCHER, SABRINA NP	9/10/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1740 ROSECRANS ST	None	SAN DIEGO	CA	92106	1928	00	06000	32.72903913	-117.2254885	San Diego County
295622	Non-Physician Medical Practitioner	None	1912437047	0	0	FRAZIER, JENNA E	9/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1113 BROAD ST	APT 4	SAN LUIS OBISPO	CA	93401	3542	00	06000	35.27866735	-120.6643181	San Luis Obispo County
295670	Non-Physician Medical Practitioner	None	1568933794	0	0	FRYE, BLAIR L PA-C	7/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1303 EAST HERNDON AVENUE	None	FRESNO	CA	93720	3309	00	06000	36.83626596	-119.7674879	Fresno County
295686	Non-Physician Medical Practitioner	None	1306231360	0	0	FUATA, VERONICA V R NP	3/24/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3925 BRANSON DR	None	SAN MATEO	CA	94403	3608	00	06000	37.53781646	-122.2827464	San Mateo County
295699	Non-Physician Medical Practitioner	None	1659303881	0	0	FURTEK, MARYANNE MENDOZA	10/26/1994	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 WEST STEWART DRIVE	None	ORANGE	CA	92868	3849	00	06000	33.78236558	-117.8648414	Orange County
295721	Non-Physician Medical Practitioner	None	1144489998	0	0	FEDER, ERICA C NP	11/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6032 ROSWITHA CT	None	CARMICHAEL	CA	95608	6452	00	06000	38.630169	-121.324104	Sacramento County
295723	Non-Physician Medical Practitioner	None	1205267911	0	0	FREKING, DIONI A R NP	11/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 MONTROSE AVENUE	None	SOUTH PASADENA	CA	91030	2816	00	06000	34.1163718	-118.1428449	Los Angeles County
295769	Non-Physician Medical Practitioner	None	1255668570	0	0	FAJARDO, RAY JASON S PA	1/5/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2275 LAS POSAS RD	None	CAMARILLO	CA	93010	3344	00	06000	34.23650167	-119.0395125	Ventura County
295810	Non-Physician Medical Practitioner	None	1528694304	0	0	FROZ, RASHAD A PA	1/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100A SAN PABLO TOWNE CTR	None	SAN PABLO	CA	94806	0000	00	06000	37.95446487	-122.3326626	Contra Costa County
295870	Non-Physician Medical Practitioner	None	1144687047	0	0	FLETCHER, TYISHA R NP	3/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1859 HELMICK ST	None	CARSON	CA	90746	2516	00	06000	33.85209597	-118.2360782	Los Angeles County
295875	Non-Physician Medical Practitioner	None	1104917285	0	0	FERRARA, SUSAN T	7/12/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4834 P STREET	None	SACRAMENTO	CA	95819	4412	00	06000	38.559222	-121.446765	Sacramento County
295918	Non-Physician Medical Practitioner	None	1972166478	0	0	FISHER, MICHELLE L PA-C	5/6/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	00	06000	38.443806	-122.701374	Sonoma County
295995	Non-Physician Medical Practitioner	None	1033590278	0	0	FREUND, BRANDON J	8/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	411 E BAY STATE STREET	SUITE 58	ALHAMBRA	CA	91801	3990	00	06000	34.09542487	-118.120186	Los Angeles County
296049	Non-Physician Medical Practitioner	None	1790967453	0	0	FRESNO STATE UNIVERSITY HEALTH AND PSYCHOLOGICAL S	1/7/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	UNIVERSITY HEALTH AND PS	5044 NORTH BARTON AVENUE	FRESNO	CA	93740	0001	00	06000	0	0	None
296066	Non-Physician Medical Practitioner	None	1104378702	0	0	FAIN, JESSICA PA-C	2/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	00	06000	32.781483	-117.007182	San Diego County
296136	Non-Physician Medical Practitioner	None	1073684270	0	0	FARRELL, LAWANNA G	7/25/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6431 N DOLORES AVE	None	FRESNO	CA	93711	1322	00	06000	36.83049501	-119.8293437	Fresno County
296156	Non-Physician Medical Practitioner	None	1275117814	0	0	FRANCO, MAGDALENA ATONDO NP	10/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1230 JEFFERSON ST	None	DELANO	CA	93215	2204	00	06000	35.77274103	-119.2450573	Kern County
296174	Non-Physician Medical Practitioner	None	1316108616	0	0	FISHER, MELISSA NP	11/25/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6555 COYLE AVE	SUITE 301	CARMICHAEL	CA	95608	0302	00	06000	38.66859	-121.3118055	Sacramento County
296204	Non-Physician Medical Practitioner	None	1194770578	0	0	FAYAD, HAMDAN FAYEZ	6/11/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2505 SAMARITAN DR STE 10	None	SAN JOSE	CA	95124	4007	00	06000	37.25111447	-121.9483395	Santa Clara County
296207	Non-Physician Medical Practitioner	None	1730499617	0	0	FERRON, NICKESHIA SIMONE PA-C	4/26/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1207 E FLORIDA AVE	None	HEMET	CA	92543	4513	00	06000	33.74753552	-116.9593245	Riverside County
296322	Non-Physician Medical Practitioner	None	1073399119	0	0	FIGUEROA, JOANNA NP	1/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
296337	Non-Physician Medical Practitioner	None	1306891510	0	0	FERBER, ALEX L	1/29/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	503 CLUBHOUSE DRIVE	None	APTOS	CA	95003	4823	00	06000	36.97055316	-121.8858496	Santa Cruz County
296339	Non-Physician Medical Practitioner	None	1194416230	0	0	FONTAINE, DIANNE NP	2/25/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	415 KNOLLCREST DR	STE 101	REDDING	CA	96002	0181	00	06000	40.57267376	-122.3643496	Shasta County
296410	Non-Physician Medical Practitioner	None	1447911029	0	0	FRIEND, JESSICA	10/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
296427	Non-Physician Medical Practitioner	None	1902175276	0	0	FORDHAM, ROBIN L	7/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	00	06000	33.861339	-118.281473	Los Angeles County
296550	Non-Physician Medical Practitioner	None	1235613191	0	0	FRANKE, CLAUDIA PA	2/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
296564	Non-Physician Medical Practitioner	None	1508431362	0	0	FISHER, MADELEINE PA	3/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
296574	Non-Physician Medical Practitioner	None	1114411709	0	0	FIEL, JOYCE H B NP	8/7/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8213 CRYSTAL WALK CIR	None	ELK GROVE	CA	95758	8081	00	06000	38.417139	-121.4079615	Sacramento County
296575	Non-Physician Medical Practitioner	None	1649652843	0	0	FEUCHT, ELIZABETH NP	10/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4600 BOHANNON DR	STE 100	MENLO PARK	CA	90245	1037	00	06000	37.479573	-122.1755445	San Mateo County
296597	Non-Physician Medical Practitioner	None	1306063912	0	0	FERGUSON, HOLLY M	2/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 E VAN BIBBER	None	ORANGE	CA	92866	2027	00	06000	33.78329473	-117.8485878	Orange County
296672	Non-Physician Medical Practitioner	None	1326232455	0	0	FONTANA, SONJA IRENE	11/12/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1011 N. DEMAREE ST.	None	VISALIA	CA	93291	5156	00	06000	36.337932	-119.333646	Tulare County
296699	Non-Physician Medical Practitioner	None	1619612033	0	0	FERNANDEZ, MADELEINE A PA-C	6/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3434 MIDWAY DRIVE	SUITE 2001	SAN DIEGO	CA	92110	4924	00	06000	32.75065153	-117.2126147	San Diego County
296709	Non-Physician Medical Practitioner	None	1396815775	0	0	FERNANDEZ, ANDREW NP	6/29/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.55831005	-117.0475102	San Diego County
296764	Non-Physician Medical Practitioner	None	1942530571	0	0	FLORES, WILLIAM BENJAMIN	8/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	465 N ROXBURY DR	903	BEVERLY HILLS	CA	90210	4206	00	06000	34.06832918	-118.4072114	Los Angeles County
296768	Non-Physician Medical Practitioner	None	1891335766	0	0	FISHER, ERIN M PA-C	5/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3883 AIRWAY DRIVE	SUITE 220	SANTA ROSA	CA	95403	1670	00	06000	38.483226	-122.739705	Sonoma County
296866	Non-Physician Medical Practitioner	None	1154673523	0	0	FELLION, LAUREN A PA	12/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
296873	Non-Physician Medical Practitioner	None	1982899274	0	0	FALLARME, RONALD P PA	5/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
296894	Non-Physician Medical Practitioner	None	1164970844	0	0	FIODEMBO, INXS M NP	1/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26 RANCHO DEL MAR	None	APTOS	CA	95003	3973	00	06000	36.97832273	-121.9080422	Santa Cruz County
296911	Non-Physician Medical Practitioner	None	1689158396	0	0	FOSTER, PHILLIP A PA	11/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	00	06000	33.74496	-117.818857	Orange County
296913	Non-Physician Medical Practitioner	None	1770517799	0	0	FANNIN, CHARESE M	7/16/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18206 LEAF CIRCLE	None	HUNTINGTON BEACH	CA	92648	1060	00	06000	33.69817442	-118.0189665	Orange County
296922	Non-Physician Medical Practitioner	None	1548329451	0	0	FLORES, BRENDA L NP	6/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 THE CITY DR S	None	ORANGE	CA	92868	3298	00	06000	33.78674051	-117.8888713	Orange County
296955	Non-Physician Medical Practitioner	None	1750718680	0	0	FLORES, RIZALIE S	11/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12200 MONTECITO ROAD	APT B105	SEAL BEACH	CA	90740	2602	00	06000	33.78554379	-118.076205	Orange County
296982	Non-Physician Medical Practitioner	None	1255720025	0	0	FENNER, GAYLE M	3/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2100 POWELL ST	STE 900	EMERYVILLE	CA	94608	1844	00	06000	37.83953006	-122.2990736	Alameda County
296989	Non-Physician Medical Practitioner	None	1073248324	0	0	FIGUEROA, NELLIE	6/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
296998	Non-Physician Medical Practitioner	None	1174745632	0	0	FERMAN, DIANA	5/13/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
297002	Non-Physician Medical Practitioner	None	1154355758	0	0	FONG, NANETTE C NP	2/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10716 ASHBY AVE	None	LOS ANGELES	CA	90064	3211	00	06000	34.03779494	-118.4226103	Los Angeles County
297033	Non-Physician Medical Practitioner	None	1639626724	0	0	FENNELL, NICOLE E PA-C	1/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1775 THOMPSON ROAD	None	COOS BAY	OR	97420	2125	00	06000	43.383456	-124.2330435	Coos County
297051	Non-Physician Medical Practitioner	None	1932346095	0	0	FORSTER, ELENA T	9/20/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1812 LEE AVE	None	ARCADIA	CA	91006	4640	00	06000	34.1188725	-118.026009	Los Angeles County
297065	Non-Physician Medical Practitioner	None	1174696033	0	0	FLICK, CATALINA P NP	12/22/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	657 MARINE ST	None	SANTA MONICA	CA	90405	5644	00	06000	34.00210937	-118.4742206	Los Angeles County
297109	Non-Physician Medical Practitioner	None	1689962946	0	0	FINK, ELLEN E PA-C	10/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
297165	Non-Physician Medical Practitioner	None	1598891764	0	0	FLEDDERUS, MARGARETHA D	11/17/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
297215	Non-Physician Medical Practitioner	None	1477723815	0	0	FAAFIU, ERICA Q	3/26/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 W MACARTHUR	None	OAKLAND	CA	94611	5641	00	06000	37.82397231	-122.2578822	Alameda County
297303	Non-Physician Medical Practitioner	None	1093441875	0	0	FERNANDEZ, ANTHONY R NP	10/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	00	06000	33.12181055	-117.2840499	San Diego County
297315	Non-Physician Medical Practitioner	None	1265788087	0	0	FULLER, JULIANA N	8/28/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	125 SUNRIDGE WAY	None	REDLANDS	CA	92373	7155	00	06000	34.03177409	-117.1593632	San Bernardino County
297322	Non-Physician Medical Practitioner	None	1780921536	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO	12/9/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	823 GATEWAY CENTER WAY	None	SAN DIEGO	CA	92102	4541	00	06000	32.71503452	-117.1134945	San Diego County
297343	Non-Physician Medical Practitioner	None	1871090001	0	0	FLORES, JOSE R R NP	2/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3805 KILLARNEY CT	None	BAKERSFIELD	CA	93311	2275	00	06000	35.31998323	-119.1230712	Kern County
297348	Non-Physician Medical Practitioner	None	1396049755	0	0	FALLON, SEAN C	12/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1350 ALTA VISTA DRIVE	None	VISTA	CA	92084	5640	00	06000	33.20598768	-117.2219287	San Diego County
297355	Non-Physician Medical Practitioner	None	1063729648	0	0	FITZGIBBONS, ERICA D NP	12/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6098	00	06000	34.0956033	-118.2916918	Los Angeles County
297412	Non-Physician Medical Practitioner	None	1952552762	0	0	FISHER, PATRICIA L NP	11/8/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	314 HENDERSON	None	EUREKA	CA	95501	4353	00	06000	40.78286158	-124.1653294	Humboldt County
297432	Non-Physician Medical Practitioner	None	1093089872	0	0	FEROLI, MICHAEL A	10/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	615 WEATHERSTONE WAY	None	SAN MARCOS	CA	92078	1096	00	06000	33.09820253	-117.1777996	San Diego County
297538	Non-Physician Medical Practitioner	None	1518349042	0	0	FARRAR, KATHERINE A PA	8/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
297548	Non-Physician Medical Practitioner	None	1316226426	0	0	FREY, MARY B CNP	7/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
297588	Non-Physician Medical Practitioner	None	1831867621	0	0	FARES, KELVIN	9/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	00	06000	33.9040752	-118.1328995	Los Angeles County
297613	Non-Physician Medical Practitioner	None	1689790842	0	0	FIGUEROA, JOHN A	3/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5734 CORNFLOWER TRAIL	None	SAN DIEGO	CA	92130	6917	00	06000	32.96260708	-117.1932269	San Diego County
297615	Non-Physician Medical Practitioner	None	1063133692	0	0	FRYE, MAGGIE NP	12/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	760 OTAY LAKES RD	None	CHULA VISTA	CA	91910	6915	00	06000	32.64603447	-117.0015068	San Diego County
297618	Non-Physician Medical Practitioner	None	1932235355	0	0	FURMULY, ROHINA PA-C	1/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17609 VENTURA BLVD	SUITE 106	ENCINO	CA	91316	3866	00	06000	34.16197507	-118.5167485	Los Angeles County
297627	Non-Physician Medical Practitioner	None	1356336226	0	0	FONG, SUZANNE CARI	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	00	06000	38.425365	-121.4068185	Sacramento County
297638	Non-Physician Medical Practitioner	None	1093799967	0	0	FLAHARTY, GINA E NP	5/28/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	404 MEISTER WAY	None	SACRAMENTO	CA	95819	2024	00	06000	38.57841	-121.4461215	Sacramento County
297694	Non-Physician Medical Practitioner	None	1912599572	0	0	FREESE, ELIZABETH PA-C	5/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
297724	Non-Physician Medical Practitioner	None	1295384030	0	0	FRANKLIN, SHANTE R NP	10/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
297729	Non-Physician Medical Practitioner	None	1083798482	0	0	FERNANDES, SARAH E	10/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3253 CAMINITO EASTBLUFF	UNIT 30	LA JOLLA	CA	90237	2895	00	06000	32.85858249	-117.2334555	San Diego County
297738	Non-Physician Medical Practitioner	None	1518414366	0	0	FAIQ, JAMILA NP	11/30/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	664 VINEYARD ROAD	SUITE 205	SAN MARCOS	CA	92069	7807	00	06000	33.15001533	-117.1563396	San Diego County
297782	Non-Physician Medical Practitioner	None	1073187936	0	0	FISHER, CAMERON PA	11/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2700 GRANT ST	STE 200	CONCORD	CA	94520	2266	00	06000	37.98417931	-122.0361585	Contra Costa County
297808	Non-Physician Medical Practitioner	None	1992273957	0	0	FLORES, ARIANE-JANE PA	1/23/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	00	06000	32.90618683	-117.1814064	San Diego County
297844	Non-Physician Medical Practitioner	None	1679030936	0	0	FORNEY, DANIEL E PA-C	4/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	00	06000	33.969141	-118.0489095	Los Angeles County
297858	Non-Physician Medical Practitioner	None	1568838779	0	0	FUENTES, VANESSA I NP	3/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	00	06000	39.33573744	-120.180872	Nevada County
297871	Non-Physician Medical Practitioner	None	1730477514	0	0	FLOIED, MICHAEL J PA-C	11/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17150 EUCLID ST	200	FOUNTAIN VALLEY	CA	92708	4092	00	06000	33.714171	-117.9369905	Orange County
297898	Non-Physician Medical Practitioner	None	1790913929	0	0	FONSECA, ROBERT R	7/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	814 VINEMEAD DR	None	WHITTIER	CA	90601	1040	00	06000	34.04073658	-118.0074809	Los Angeles County
297960	Non-Physician Medical Practitioner	None	1265265482	0	0	FOROUTANI, AZITA NP	10/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3700 SUNSET LN STE 4	None	ANTIOCH	CA	94509	6123	00	06000	37.98481899	-121.8042927	Contra Costa County
297985	Non-Physician Medical Practitioner	None	1508217613	0	0	FOX, ANDREA A PA-C	6/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
298019	Non-Physician Medical Practitioner	None	1588901045	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO INC	4/24/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1250 6TH AVE	SUITE 100	SAN DIEGO	CA	92101	4368	00	06000	32.71854144	-117.1593008	San Diego County
298023	Non-Physician Medical Practitioner	None	1134159247	0	0	FOWLER, MELINDA I CNM	4/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1211 E PERRIN DRIVE	APT 204	FRESNO	CA	93720	5036	00	06000	36.87339721	-119.7625961	Fresno County
298069	Non-Physician Medical Practitioner	None	1730502725	0	0	FAMILY HEALTHCARE NETWORK	6/26/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 E SCHOOL AVE	None	VISALIA	CA	93291	0000	00	06000	36.332757	-119.288682	Tulare County
298096	Non-Physician Medical Practitioner	None	1629456900	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO INC	6/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
298106	Non-Physician Medical Practitioner	None	1386769883	0	0	FITZGERALD, ADAM W	3/6/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	32054 BAYWOOD ST	None	LAKE ELSINORE	CA	92532	2529	00	06000	33.66160138	-117.2575097	Riverside County
298132	Non-Physician Medical Practitioner	None	1538341557	0	0	FERRADA-MASIA, CLAUDIA A	2/19/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2260 N QUINCY RD	None	TURLOCK	CA	95382	8116	00	06000	37.51376081	-120.8214149	Stanislaus County
298171	Non-Physician Medical Practitioner	None	1871818138	0	0	FRIENDS OF FAMILY HEALTH CENTER	6/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 S IDAHO ST	SUITE 100	LA HABRA	CA	90631	6047	00	06000	33.927525	-117.959216	Orange County
298227	Non-Physician Medical Practitioner	None	1538946041	0	0	FIERRO, MONICA NP	3/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16167 SISKIYOU ROAD	SUITE A	APPLE VALLEY	CA	92307	0837	00	06000	34.54496692	-117.2664417	San Bernardino County
298246	Non-Physician Medical Practitioner	None	1164765061	0	0	FARHADIAN, BAHARE NP	10/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	965 HYDE ST	APT 7	SAN FRANCISCO	CA	94109	4830	00	06000	37.78989794	-122.4171961	San Francisco County
298264	Non-Physician Medical Practitioner	None	1508425281	0	0	FUNDORA, KATHERINE J PA	5/25/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
298321	Non-Physician Medical Practitioner	None	1164897179	0	0	FLOWERS, AMBER D NP	1/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1231 SIVERADO AVE	None	MCKINLEYVILLE	CA	95519	9117	00	06000	40.96317308	-124.1089308	Humboldt County
298329	Non-Physician Medical Practitioner	None	1326449778	0	0	FREIHEIT, BARBARA L NP	11/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	553 GERARD COURT	None	PLEASANTON	CA	94566	6805	00	06000	37.65987997	-121.8606897	Alameda County
298331	Non-Physician Medical Practitioner	None	1245653807	0	0	FRANCIS, CAITLIN E NP	8/26/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	50 HORGAN AVE	35	REDWOOD CITY	CA	94061	3646	00	06000	37.46369839	-122.2229805	San Mateo County
298419	Non-Physician Medical Practitioner	None	1689382327	0	0	FORINASH, KAYCEE NP	10/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	00	06000	37.36217918	-121.8472051	Santa Clara County
298430	Non-Physician Medical Practitioner	None	1619487394	0	0	FOSTER, BRITTANY A	1/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2607 2ND STREET	1	SANTA MONICA	CA	90405	4123	00	06000	34.00216891	-118.4826441	Los Angeles County
298438	Non-Physician Medical Practitioner	None	1457658502	0	0	FAN, APRIL K NP	3/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1814 8TH AVENUE	Q	MONROVIA	CA	91016	4396	00	06000	34.13154394	-118.0156901	Los Angeles County
298457	Non-Physician Medical Practitioner	None	1346965803	0	0	FISHER, NATALIE E	9/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
298464	Non-Physician Medical Practitioner	None	1073551263	0	0	FRAIZER, JAISON C	6/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7005 NEWTON PL	None	ALTA LOMA	CA	91701	5967	00	06000	34.12696831	-117.5929639	San Bernardino County
298597	Non-Physician Medical Practitioner	None	1649262429	0	0	FENNELLY, KATHLEEN MARIE	3/13/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	896 E FOOTHILL BLVD	None	SAN LUIS OBISPO	CA	93405	1761	00	06000	35.29410117	-120.6700122	San Luis Obispo County
298680	Non-Physician Medical Practitioner	None	1336569862	0	0	FEIZABADI, NARGES NP	7/26/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16100 SAND CANYON AVE	STE 240	IRVINE	CA	92618	3724	00	06000	33.6632187	-117.7721984	Orange County
298775	Non-Physician Medical Practitioner	None	1619429503	0	0	FRANKENTHAL, RACHEL PA	10/30/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 MEDICAL PLAZA	265	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
298792	Non-Physician Medical Practitioner	None	1700122462	0	0	FLORES, DAVID C	1/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3280 COLONY CIRCLE	None	LOS ANGELES	CA	90027	2201	00	06000	34.11199175	-118.2772632	Los Angeles County
298828	Non-Physician Medical Practitioner	None	1548810591	0	0	FAJILAN, MADELEINE K PA-C	1/29/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26024 ACERO	None	MISSION VIEJO	CA	92691	2768	00	06000	33.61784172	-117.6769661	Orange County
298856	Non-Physician Medical Practitioner	None	1235827429	0	0	FAZIL, MARIAM NP	8/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 W STEWART DR	None	ORANGE	CA	92868	3849	00	06000	33.78236558	-117.8648414	Orange County
298871	Non-Physician Medical Practitioner	None	1710322664	0	0	FIDLER, ALLYSE C	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	193 CRESTVIEW DRIVE	None	ORINDA	CA	94563	3933	00	06000	37.85890127	-122.1726062	Contra Costa County
298872	Non-Physician Medical Practitioner	None	1740356708	0	0	FERNANDEZ, NWANEE	6/7/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13624 HAWTHORNE BLVD STE	None	HAWTHORNE	CA	90250	5818	00	06000	33.9083784	-118.3523983	Los Angeles County
298890	Non-Physician Medical Practitioner	None	1912532342	0	0	FONG, KURENE M PA-C	4/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1105 E SPRUCE AVE	STE 201	FRESNO	CA	93720	3313	00	06000	36.839466	-119.762685	Fresno County
298896	Non-Physician Medical Practitioner	None	1447872205	0	0	FLYNN, FRANCESCA PA	6/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4000 CIVIC CENTER	SUITE 209	SAN RAFAEL	CA	94903	4171	00	06000	38.0041783	-122.538861	Marin County
298899	Non-Physician Medical Practitioner	None	1285277624	0	0	FUTRITSKI, VIKTORIA NP	9/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	00	06000	37.72851602	-122.4296638	San Francisco County
298919	Non-Physician Medical Practitioner	None	1023462066	0	0	FAMILY HEALTH CENTERS	6/24/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	248 LANDIS AVENUE	None	CHULA VISTA	CA	91910	2609	00	06000	32.6430374	-117.0817455	San Diego County
298997	Non-Physician Medical Practitioner	None	1750653929	0	0	FERNANDEZ, DIVINA NP	4/16/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
299086	Non-Physician Medical Practitioner	None	1760648117	0	0	FRASER-GRAY, MIKHAIL W	9/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	448 N POINTSETTIA PL	None	LOS ANGELES	CA	90036	2505	00	06000	34.07965999	-118.3486491	Los Angeles County
299088	Non-Physician Medical Practitioner	None	1285148569	0	0	FINCH, AUSTIN J PA	7/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	00	06000	37.66508443	-120.9962589	Stanislaus County
299116	Non-Physician Medical Practitioner	None	1831251990	0	0	FONG, ELLIE M PA-C	3/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5977 E SPRING ST	None	LONG BEACH	CA	90808	3752	00	06000	33.81062147	-118.1154555	Los Angeles County
299237	Non-Physician Medical Practitioner	None	1225042666	0	0	FALLS, ALICIA PA	12/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	06000	33.38982	-111.8760885	Maricopa County
299250	Non-Physician Medical Practitioner	None	1992906465	0	0	FUENTES, JENNIFER ANNE	9/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18080 IMPERIAL HWY	None	YORBA LINDA	CA	92886	3436	00	06000	33.89287302	-117.8194305	Orange County
299265	Non-Physician Medical Practitioner	None	1336674571	0	0	FUENTES, WENDY NP	5/30/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	00	06000	34.58364037	-118.1441012	Los Angeles County
299298	Non-Physician Medical Practitioner	None	1215566922	0	0	FIHN, SARAH NP	9/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 REDONDO AVE	STE B	LONG BEACH	CA	90814	2651	00	06000	33.768324	-118.152404	Los Angeles County
299315	Non-Physician Medical Practitioner	None	1508958893	0	0	FLECK, MICHAEL S	2/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	819 DURANT PL NE	STE 8	ATLANTA	GA	30308	1600	00	06000	33.77694086	-84.37522885	Fulton County
299334	Non-Physician Medical Practitioner	None	1790208544	0	0	FREEMAN, DERRICK B	9/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5943 ARLENE WAY	None	LIVERMORE	CA	94550	8101	00	06000	37.69407766	-121.7219626	Alameda County
299345	Non-Physician Medical Practitioner	None	1598441503	0	0	FRANS, MIKALI	12/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	06000	33.786909	-112.129047	Maricopa County
299381	Non-Physician Medical Practitioner	None	1306456223	0	0	FETALCO, KATE NP	11/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
299413	Non-Physician Medical Practitioner	None	1932740305	0	0	FRERICHS, JANICE	8/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
299416	Non-Physician Medical Practitioner	None	1013638477	0	0	FORTUGALEZA, RUPERT NP	4/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
299491	Non-Physician Medical Practitioner	None	1417350976	0	0	FARRELL, SHANNON L	2/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1422 BELLEVUE AVENUE	APT 403	BURLINGAME	CA	94010	3909	00	06000	37.57896713	-122.3512832	San Mateo County
299493	Non-Physician Medical Practitioner	None	1730590829	0	0	FOMBRUN, FRED PA	11/6/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	9300 W SUNSET RD	None	LAS VEGAS	NV	89148	4844	00	06000	36.072729	-115.295094	Clark County
299506	Non-Physician Medical Practitioner	None	1487326450	0	0	FELL, JOHN C PA	11/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	00	06000	39.74473059	-121.8488381	Butte County
299538	Non-Physician Medical Practitioner	None	1134232218	0	0	FISCHER, ANNE WHITMORE	4/30/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	604 E EVELYN AVE	None	SUNNYVALE	CA	94086	6459	00	06000	37.37336439	-122.0207566	Santa Clara County
299540	Non-Physician Medical Practitioner	None	1508137753	0	0	FREEDMAN, NICOLE J NP	10/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	718 LINCOLN BLVD	UNIT 4	SANTA MONICA	CA	90402	2856	00	06000	34.02810796	-118.5014954	Los Angeles County
299541	Non-Physician Medical Practitioner	None	1174077507	0	0	FRANZ, CORTNEY D NP	9/29/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2809 CAMINO DEL MAR	None	DEL MAR	CA	92014	2059	00	06000	32.97205351	-117.2683569	San Diego County
299569	Non-Physician Medical Practitioner	None	1427221324	0	0	FUJIMOTO-YAMAGUCHI, LISA	9/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4062 LYCEUM AVE	None	LOS ANGELES	CA	90066	5114	00	06000	33.99352363	-118.43756	Los Angeles County
299590	Non-Physician Medical Practitioner	None	1801140090	0	0	FUNG, CATHERINE L NP	8/8/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23761 NEW DELHI ST	None	MISSION VIEJO	CA	92691	3036	00	06000	33.61704332	-117.6849835	Orange County
299629	Non-Physician Medical Practitioner	None	1720366255	0	0	FALLON, MITCHELL T PA-C	11/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
299634	Non-Physician Medical Practitioner	None	1861589186	0	0	FERRARI, OMAR	12/21/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2213 CHERRY ST	None	TOLEDO	OH	43608	2603	00	06000	41.66854087	-83.54177085	Lucas County
299667	Non-Physician Medical Practitioner	None	1003364514	0	0	FABIAN, MICHAEL T NP	2/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	00	06000	38.555631	-121.459203	Sacramento County
299770	Non-Physician Medical Practitioner	None	1184003402	0	0	FLORES, KELLY M	7/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	835 MODOC STREET	None	MERCED	CA	95340	1417	00	06000	37.32210873	-120.4614158	Merced County
299823	Non-Physician Medical Practitioner	None	1265164644	0	0	FAVELA, DARREN A PA-C	9/16/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2333 FOOTHILL BLVD	None	LA VERNE	CA	91750	3027	00	06000	34.11220804	-117.7613999	Los Angeles County
299898	Non-Physician Medical Practitioner	None	1942875778	0	0	FANTAYE, NISEBHO PA-C	9/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
299906	Non-Physician Medical Practitioner	None	1871682815	0	0	FLOWE, CHELSEA L NP	8/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9565 NORTH WOODROW AVE	None	FRESNO	CA	93720	4606	00	06000	36.87510351	-119.7445312	Fresno County
299924	Non-Physician Medical Practitioner	None	1659926384	0	0	FRAZIER, TARA D NP	6/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22419 KENT AVE	None	TORRANCE	CA	90505	2303	00	06000	33.824448	-118.3564765	Los Angeles County
299990	Non-Physician Medical Practitioner	None	1871882027	0	0	FESHARAKI, SAYEH CNP	3/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1155 MILL ST	None	RENO	NV	89502	1576	00	06000	39.52483792	-119.7968314	Washoe County
300058	Non-Physician Medical Practitioner	None	1942229281	0	0	FULLER, JAMES A	4/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	928 S FARRAGUT ST	None	RIDGECREST	CA	93555	7508	00	06000	35.60632351	-117.6928895	Kern County
300072	Non-Physician Medical Practitioner	None	1639391634	0	0	FRANCISCO, GERARD G	6/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	00	06000	34.06373445	-118.443537	Los Angeles County
300114	Non-Physician Medical Practitioner	None	1548371008	0	0	FOX, BARBARA J	2/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2020 SUTTER PL	#203	DAVIS	CA	95616	6201	00	06000	38.56287659	-121.7715536	Yolo County
300124	Non-Physician Medical Practitioner	None	1831520048	0	0	FAMILY HEALTHCARE NETWORK	1/16/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9416 ROAD 238	None	TERRA BELLA	CA	93270	9400	00	06000	35.96072962	-119.0399481	Tulare County
300156	Non-Physician Medical Practitioner	None	1942448303	0	0	FRAZIER, SARAH E PA-C	11/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
300161	Non-Physician Medical Practitioner	None	1417292368	0	0	FIGGE, LESLIE A NP	6/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	707 W VALLEY BLVD	None	TEHACHAPI	CA	93561	2119	00	06000	35.12433846	-118.4591228	Kern County
300291	Non-Physician Medical Practitioner	None	1548708720	0	0	FASCIO, JOANNE R NP	2/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1655 S WESTERN AVE	None	LOS ANGELES	CA	90006	5801	00	06000	34.042653	-118.3090565	Los Angeles County
300302	Non-Physician Medical Practitioner	None	1720181647	0	0	FORSTER, TODD A	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1269 LONG VIEW DR	None	CHULA VISTA	CA	91915	1662	00	06000	32.6425834	-116.9428544	San Diego County
300333	Non-Physician Medical Practitioner	None	1326440488	0	0	FULLER, WILLIAM M PA	2/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	00	06000	32.7537975	-117.1658298	San Diego County
300345	Non-Physician Medical Practitioner	None	1063651867	0	0	FISH, PAMELA B	4/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1430 KLAMATH DRIVE	None	CHULA VISTA	CA	91913	3800	00	06000	32.61901941	-117.0060982	San Diego County
300352	Non-Physician Medical Practitioner	None	1750933024	0	0	FOWLER, KATHERINE L NP	3/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2701 OLD EUREKA WAY	1E	REDDING	CA	96001	0228	00	06000	40.58555878	-122.4101367	Shasta County
300353	Non-Physician Medical Practitioner	None	1457185365	0	0	FOKSHA, ANA	2/24/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2800 L ST	STE 260	SACRAMENTO	CA	95816	5616	00	06000	38.571237	-121.469958	Sacramento County
300365	Non-Physician Medical Practitioner	None	1154613552	0	0	FILES, JARED M PA-C	10/18/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 EAST CHURCH ST	None	SANTA MARIA	CA	93454	5906	00	06000	34.95203385	-120.4131707	Santa Barbara County
300392	Non-Physician Medical Practitioner	None	1376988899	0	0	FABIAN, ARLENE TORRES	7/5/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1825 N AVON ST	None	BURBANK	CA	91505	1506	00	06000	34.18375349	-118.3481098	Los Angeles County
300437	Non-Physician Medical Practitioner	None	1710694559	0	0	FISHER, ROSE PA	9/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 S BROADWAY	STE 212	WALNUT CREEK	CA	94596	5219	00	06000	37.89702115	-122.0569066	Contra Costa County
300464	Non-Physician Medical Practitioner	None	1689027534	0	0	FUNG, KIT YUNG NP	1/17/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10012 TOWNWAY DR	None	SOUTH EL MONTE	CA	91733	1132	00	06000	34.06665	-118.050962	Los Angeles County
300465	Non-Physician Medical Practitioner	None	1497452957	0	0	FLORES, MARYSE NP	8/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1433 W MERCED AVE	STE 114-8	WEST COVINA	CA	91790	3402	00	06000	34.06252177	-117.9477117	Los Angeles County
300531	Non-Physician Medical Practitioner	None	1689206260	0	0	FITZSIMMONS, GARRET PA-C	6/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
300546	Non-Physician Medical Practitioner	None	1295467447	0	0	FRYER, KEVIN L PA-C	2/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	341 MAGNOLIA AVE	STE 101	CORONA	CA	92879	3331	00	06000	33.85291987	-117.5664344	Riverside County
300573	Non-Physician Medical Practitioner	None	1386745909	0	0	FAYMAN, MARIANA	2/23/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8536 WILSHIRE BLVD	SUITE 202	BEVERLY HILLS	CA	90211	0000	00	06000	34.06550726	-118.3775199	Los Angeles County
300703	Non-Physician Medical Practitioner	None	1780701151	0	0	FONTWIT, KATHRYN J PA	2/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 POTRERO AVE	RM 342	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
300708	Non-Physician Medical Practitioner	None	1083122659	0	0	FERRO, ANNA NP	10/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18316 VICKIE AVE	None	CERRITOS	CA	90703	6165	00	06000	33.86515735	-118.0528267	Los Angeles County
300736	Non-Physician Medical Practitioner	None	1063718443	0	0	FLUHARTY, ELIZABETH	4/29/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
300746	Non-Physician Medical Practitioner	None	1760534382	0	0	FOLK, CONNIE JEANNE	9/30/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	00	06000	36.84133078	-119.7824983	Fresno County
300751	Non-Physician Medical Practitioner	None	1215407051	0	0	FAUBERT, CLIFFORD L NP	5/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
300857	Non-Physician Medical Practitioner	None	1396091542	0	0	FRENCH, LUCAS D	12/28/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1360 HAMPSHIRE STREET	None	SAN FRANCISCO	CA	94110	4228	00	06000	37.75052375	-122.4070815	San Francisco County
300865	Non-Physician Medical Practitioner	None	1801842901	0	0	FREY, EMILY TREADWELL	1/1/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	00	06000	39.15305697	-123.2037774	Mendocino County
300881	Non-Physician Medical Practitioner	None	1336681675	0	0	FREE, PATRICK L NP	12/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5209 GENTLE RIVER AVE	None	LAS VEGAS	NV	89130	2931	00	06000	36.22862969	-115.2154423	Clark County
300993	Non-Physician Medical Practitioner	None	1487702387	0	0	FARB, BRIAN S	2/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2903 CORTE JARDIN	None	CARLSBAD	CA	92009	9253	00	06000	33.07350966	-117.249428	San Diego County
301015	Non-Physician Medical Practitioner	None	1205893666	0	0	FORTHMAN, JENNIFER D	4/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22212 MCCARTHY DRIVE	None	TEHACHAPI	CA	93561	1607	00	06000	35.14281657	-118.501617	Kern County
301025	Non-Physician Medical Practitioner	None	1891232252	0	0	FULLER, NIKOL S NP	10/2/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4723 W MESA AVE	None	FRESNO	CA	93722	3268	00	06000	36.82381578	-119.878906	Fresno County
301030	Non-Physician Medical Practitioner	None	1053727008	0	0	FLOREZ, ALICIA K NP	3/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4427 MORSE CT	None	NAPA	CA	94558	1752	00	06000	38.34254127	-122.3209773	Napa County
301084	Non-Physician Medical Practitioner	None	1225895774	0	0	FAGGARD, DELANEY PA	4/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	277 COHASSET ROAD	None	CHICO	CA	95926	2242	00	06000	39.75152348	-121.8511763	Butte County
301138	Non-Physician Medical Practitioner	None	1811925050	0	0	FRANCIS, KARYN M NP	1/24/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11515 NORGATE CIRCLE	None	CORONA	CA	92880	9117	00	06000	33.88071411	-117.6640558	Riverside County
301181	Non-Physician Medical Practitioner	None	1033340625	0	0	FLORES, XOCHITL	8/11/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 E GRAND AVE	None	ESCONDIDO	CA	92025	4604	00	06000	33.12634291	-117.0682058	San Diego County
301254	Non-Physician Medical Practitioner	None	1164401154	0	0	FARKAS, LORRAINE M CNM	9/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1941 N WISHON AVE	None	FRESNO	CA	93704	6153	00	06000	36.768276	-119.801086	Fresno County
301259	Non-Physician Medical Practitioner	None	1912496423	0	0	FUECONCILLO, WADE G PA-C	1/24/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
301275	Non-Physician Medical Practitioner	None	1528210333	0	0	FUTRELL, MELEA D	10/14/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5641 SHERBOURNE DR	None	LOS ANGELES	CA	90056	1318	00	06000	33.98970099	-118.3751479	Los Angeles County
301310	Non-Physician Medical Practitioner	None	1225463730	0	0	FULLER-CHRISTIE, JENNIFER S NP	12/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27720 JEFFERSON	SUITE 200	TEMECULA	CA	92590	2610	00	06000	33.51188961	-117.1586219	Riverside County
301329	Non-Physician Medical Practitioner	None	1285199091	0	0	FOUST, DIANA NP	2/11/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
301363	Non-Physician Medical Practitioner	None	1548540727	0	0	FUNG, LILLY NP	2/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 POTRERO AVE	RM 3C34	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
301374	Non-Physician Medical Practitioner	None	1609281252	0	0	FORD, MEGAN PA-C	7/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3273 CLAREMONT WAY	SUITE 100	NAPA	CA	94558	3306	00	06000	38.32062499	-122.3012501	Napa County
301401	Non-Physician Medical Practitioner	None	1659086783	0	0	FAN, ALEX I PA-C	3/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1127 WILSHIRE BLVD	SUITE 800	LOS ANGELES	CA	90017	3901	00	06000	34.05270508	-118.2641005	Los Angeles County
301479	Non-Physician Medical Practitioner	None	1386711158	0	0	FATHOLLAZADEH, MAHMOOD	10/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6549 OLIVE AVE	None	SAN BERNARDINO	CA	92407	2137	00	06000	34.1999542	-117.3504381	San Bernardino County
301495	Non-Physician Medical Practitioner	None	1528468501	0	0	FISHBACK, TAWNE B NP	10/31/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2510 HERNDON AVE	APT 204	CLOVIS	CA	93611	8966	00	06000	36.83723948	-119.666304	Fresno County
301526	Non-Physician Medical Practitioner	None	1639632847	0	0	FAHEY, EVELYN J PA	2/19/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	00	06000	34.062852	-117.9446658	Los Angeles County
301545	Non-Physician Medical Practitioner	None	1558861740	0	0	FISHER-GAMEZ, LORI K NP	9/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	00	06000	33.03623896	-117.2837308	San Diego County
301554	Non-Physician Medical Practitioner	None	1427316280	0	0	FOOTE, MANDY M	11/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	4455 WHITE FISH DRIVE	None	RENO	NV	89511	6091	00	06000	39.38389591	-119.7790395	Washoe County
301556	Non-Physician Medical Practitioner	None	1457583098	0	0	FEATHERS, DIANA YVETTE	11/12/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3009 S VERMONT AVE	None	LOS ANGELES	CA	90007	3033	00	06000	34.02747	-118.2915685	Los Angeles County
301585	Non-Physician Medical Practitioner	None	1548517311	0	0	FIELDS, JESSICA MARIE	9/19/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25455 BARTON RD	None	LOMA LINDA	CA	92354	3128	00	06000	34.04805253	-117.249534	San Bernardino County
301616	Non-Physician Medical Practitioner	None	1235377367	0	0	FERNANDEZ, DIANA M	1/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1620 W FLOWER AVENUE	None	FULLERTON	CA	92833	3819	00	06000	33.86282608	-117.9564645	Orange County
301665	Non-Physician Medical Practitioner	None	1679944573	0	0	FU, JENNY PA-C	5/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
301678	Non-Physician Medical Practitioner	None	1033676622	0	0	FOGARTY, LUCAS	4/15/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3600 BROADWAY	None	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
301690	Non-Physician Medical Practitioner	None	1205051695	0	0	FRAZER, JEFFREY E	8/20/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4612 17TH STREET	None	SAN FRANCISCO	CA	94117	4413	00	06000	37.76177993	-122.4472219	San Francisco County
301714	Non-Physician Medical Practitioner	None	1164059010	0	0	FRIMPONG, STEPHANIE A NP	8/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1845 CHICAGO AVE	B	RIVERSIDE	CA	92507	2366	00	06000	33.994269	-117.3485375	Riverside County
301723	Non-Physician Medical Practitioner	None	1154861318	0	0	FLORIN, SARAH M PA-C	3/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	565 N MOUNT VERNON AVE	None	SAN BERNARDINO	CA	92411	2661	00	06000	34.109406	-117.313813	San Bernardino County
301733	Non-Physician Medical Practitioner	None	1326438268	0	0	FUCHS, MARTHA M	4/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 B GROVE ST	None	MONTEREY	CA	93940	4431	00	06000	36.590372	-121.901074	Monterey County
301734	Non-Physician Medical Practitioner	None	1295321263	0	0	FISCHER, GINA PA-C	6/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	00	06000	37.79926205	-122.2314248	Alameda County
301743	Non-Physician Medical Practitioner	None	1104959345	0	0	FORRETTE, LYNNE W	4/28/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	255 NEW YORK RANCH RD	SUITE C	JACKSON	CA	95642	2174	00	06000	38.35486618	-120.7676002	Amador County
301747	Non-Physician Medical Practitioner	None	1316297286	0	0	FENDRICK, KRISTA J PA-C	1/10/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3151 AIRWAY AVE	SUITE G1	COSTA MESA	CA	92626	4624	00	06000	33.67783408	-117.8720921	Orange County
301827	Non-Physician Medical Practitioner	None	1831206499	0	0	FAND-FREEMAN, THEA	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1200 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	0000	00	06000	37.65894608	-122.440161	San Mateo County
301839	Non-Physician Medical Practitioner	None	1851310494	0	0	FULLER, ROBYN L	9/25/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	67780 E PALM CANYON DR	None	CATHEDRAL CITY	CA	92234	5441	00	06000	33.78603183	-116.478185	Riverside County
301855	Non-Physician Medical Practitioner	None	1922489665	0	0	FRIENDS OF FAMILY HEALTH CENTER	5/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13152 NEWPORT AVE	None	TUSTIN	CA	92780	3469	00	06000	33.74737358	-117.812672	Orange County
301896	Non-Physician Medical Practitioner	None	1952597338	0	0	FOWLER, CURTIS PA-C	10/14/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
301902	Non-Physician Medical Practitioner	None	1992577803	0	0	FARRUKH, AMNA NP	7/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2001 4TH ST	SUITE 104	SANTA ANA	CA	92705	3916	00	06000	33.74826075	-117.8385386	Orange County
301955	Non-Physician Medical Practitioner	None	1811324221	0	0	FRANCO, RACHEL D CNM	8/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	380 S EUCLID AVE	None	PASADENA	CA	91101	3161	00	06000	34.13903839	-118.1428435	Los Angeles County
301980	Non-Physician Medical Practitioner	None	1447501549	0	0	FOSTER, ALEA L NP	8/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15347 CRIMSON STREET	None	FONTANA	CA	92336	0770	00	06000	34.16295576	-117.4701774	San Bernardino County
302001	Non-Physician Medical Practitioner	None	1699395897	0	0	FRESE, JILL F NP	8/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
302030	Non-Physician Medical Practitioner	None	1831478742	0	0	FEE, KELLY C	4/25/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24661 CAMDEN CT	None	LAGUNA NIGUEL	CA	92677	2189	00	06000	33.52278772	-117.7004917	Orange County
302033	Non-Physician Medical Practitioner	None	1366930794	0	0	FAUCETT, JOYCE M	12/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	00	06000	38.56554	-121.4664615	Sacramento County
302037	Non-Physician Medical Practitioner	None	1699318014	0	0	FAKHRUTDINOV, DANYL L PA-C	6/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16300 ROSCOE BLVD	STE 1-A	VAN NUYS	CA	91406	1258	00	06000	34.22128033	-118.4884471	Los Angeles County
302240	Non-Physician Medical Practitioner	None	1194789750	0	0	FAJARDO, ROBERT R	4/14/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 W. FERN AVE.	None	REDLANDS	CA	92373	5916	00	06000	34.05016907	-117.1793443	San Bernardino County
302241	Non-Physician Medical Practitioner	None	1659612265	0	0	FERNANDEZ, MARIEL E NP	3/18/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11686 NAVEL AVE	None	MORENO VALLEY	CA	92557	6627	00	06000	33.95080578	-117.2161231	Riverside County
302259	Non-Physician Medical Practitioner	None	1134479512	0	0	FITZPATRICK, MORGAN L	10/22/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	213 APPLE BLOSSOM DR	None	MURPHYS	CA	95247	9558	00	06000	38.1445829	-120.453511	Calaveras County
302340	Non-Physician Medical Practitioner	None	1164604971	0	0	F, PRINCE A	11/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4551 VISTA STREET	None	SAN DIEGO	CA	92116	4846	00	06000	32.75982984	-117.1031932	San Diego County
302348	Non-Physician Medical Practitioner	None	1265688337	0	0	FOOTRACER, KATHERINE G PA-C	9/7/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	00	06000	34.06269295	-118.2030006	Los Angeles County
302426	Non-Physician Medical Practitioner	None	1104374883	0	0	FRIMMER, BENJAMIN R	11/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2719 3RD AVENUE	None	SAN DIEGO	CA	92103	6269	00	06000	32.73378915	-117.1621152	San Diego County
302439	Non-Physician Medical Practitioner	None	1962894220	0	0	FIORE, MICHAEL W	5/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8 ANDOVER DRIVE	None	BOHEMIA	CA	11716	1906	00	06000	40.771944	-73.118187	Suffolk County
302443	Non-Physician Medical Practitioner	None	1891178182	0	0	FAGUNDES, ANNIE M NP	3/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8093 NORTH ANGUS STREET	None	FRESNO	CA	93720	2007	00	06000	36.85328774	-119.7796631	Fresno County
302513	Non-Physician Medical Practitioner	None	1215597992	0	0	FORCE, JESSICA A PA	8/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	800 E WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	00	06000	41.77272521	-124.1940494	Del Norte County
302535	Non-Physician Medical Practitioner	None	1417476060	0	0	FROMHOLD, ERIKA NP	10/29/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10 SANTA ROSA ST	STE 201	SAN LUIS OBISPO	CA	93405	5825	00	06000	35.29325417	-120.667547	San Luis Obispo County
302572	Non-Physician Medical Practitioner	None	1518539196	0	0	FANUA, SAMUELA PA	3/11/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	415 E HARDING WAY	STE D	STOCKTON	CA	95204	6118	00	06000	37.96819912	-121.2900761	San Joaquin County
302594	Non-Physician Medical Practitioner	None	1346742384	0	0	FLOYD, ISABELLE C CNM	11/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2907 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	00	06000	36.98793933	-121.9782322	Santa Cruz County
302625	Non-Physician Medical Practitioner	None	1679867782	0	0	FOWLE, KATHRYN S	7/18/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3030 CHILDRENS WAY	SUITE 410	SAN DIEGO	CA	92123	4232	00	06000	32.798889	-117.150826	San Diego County
302630	Non-Physician Medical Practitioner	None	1326325069	0	0	FLORES, ELVIRA P NP	11/10/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7803 DACOSTA ST	None	DOWNEY	CA	90240	3719	00	06000	33.95754394	-118.1319163	Los Angeles County
302634	Non-Physician Medical Practitioner	None	1841553658	0	0	FOX, LAUREN N	10/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20197 SAHALE RD	None	APPLE VALLEY	CA	92307	5636	00	06000	34.50140806	-117.2232283	San Bernardino County
302806	Non-Physician Medical Practitioner	None	1568976710	0	0	FOSTER, RACHEL M NP	1/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	260 OAK ST	None	AUBURN	CA	95603	4320	00	06000	38.90724651	-121.0630383	Placer County
302807	Non-Physician Medical Practitioner	None	1902403223	0	0	FOX, MALLORY E PA-C	11/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
302894	Non-Physician Medical Practitioner	None	1356992150	0	0	FRANCISCO, ADELBERT-MARC PA	1/31/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	00	06000	33.969141	-118.0489095	Los Angeles County
302916	Non-Physician Medical Practitioner	None	1730621848	0	0	FRIEDMAN, ALEXANDER J PA-C	3/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	355 ABBOTT STREET	100	SALINAS	CA	93901	4310	00	06000	36.66552031	-121.6439174	Monterey County
302948	Non-Physician Medical Practitioner	None	1730179433	0	0	FIELDS, JOHN H PA	10/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 GREENLEY RD	None	SONORA	CA	95370	4685	00	06000	37.97749352	-120.3700335	Tuolumne County
302966	Non-Physician Medical Practitioner	None	1659191989	0	0	FRIA, LEIGH ANNE PA-C	2/28/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3905 WARING RD	None	OCEANSIDE	CA	92056	4405	00	06000	33.18781249	-117.2923383	San Diego County
302975	Non-Physician Medical Practitioner	None	1629522438	0	0	FLORES, MICHELLE C NP	10/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3865 CHESSA LN	None	CLOVIS	CA	93619	5145	00	06000	36.85921883	-119.6366507	Fresno County
303074	Non-Physician Medical Practitioner	None	1487895850	0	0	FERNBACH, ALISON E NP	1/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	755 THORSEN CT	None	LOS ALTOS	CA	94024	6630	00	06000	37.34523506	-122.0943312	Santa Clara County
303088	Non-Physician Medical Practitioner	None	1548276173	0	0	FRISBIE, JOHN A	9/16/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10634 CARILLON COURT	None	SAN DIEGO	CA	92131	3307	00	06000	32.91988695	-117.0814344	San Diego County
303090	Non-Physician Medical Practitioner	None	1477516763	0	0	FEARNEYHOUGH, COLLETTE MARIE	8/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1625 STOCKTON BLVD	#106	SACRAMENTO	CA	95816	0000	00	06000	38.56554	-121.4664615	Sacramento County
303091	Non-Physician Medical Practitioner	None	1619540358	0	0	FONG, JIMMY E NP	6/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
303097	Non-Physician Medical Practitioner	None	1538118831	0	0	FRAZER, TRUDE L	4/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	737 BLUE LAKE BLVD	None	BLUE LAKE	CA	95525	0000	00	06000	40.88275756	-123.9819999	Humboldt County
303101	Non-Physician Medical Practitioner	None	1215365002	0	0	FRYE, KATHRYN A NP	2/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5704 E PERRIN RD	None	CLOVIS	CA	93619	9528	00	06000	36.87378332	-119.6797426	Fresno County
303111	Non-Physician Medical Practitioner	None	1639692445	0	0	FONG, AMY NP	1/31/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	00	06000	37.51438187	-122.2607682	San Mateo County
303140	Non-Physician Medical Practitioner	None	1760783286	0	0	FELIX, KATIE	2/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2077 JACKSON ST	APT 105	SAN FRANCISCO	CA	94109	2829	00	06000	37.79312696	-122.4291728	San Francisco County
303157	Non-Physician Medical Practitioner	None	1942422662	0	0	FRITZ, DONNA	11/1/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9900 TALBERT AVE	SUITE 202	FOUNTAIN VALLEY	CA	92708	5153	00	06000	33.7016655	-117.955521	Orange County
303211	Non-Physician Medical Practitioner	None	1740928597	0	0	FRANZONE, EMILY G PA-C	12/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	750 REDWOOD HWY	SUITE 1204	MILL VALLEY	CA	94941	2483	00	06000	37.89525674	-122.5158838	Marin County
303265	Non-Physician Medical Practitioner	None	1952654386	0	0	FREW, ASHLEY MARIE	12/12/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1975 VERDUGO BLVD	None	LA CANADA FLINTRI	CA	91011	3018	00	06000	34.20501855	-118.219857	Los Angeles County
303266	Non-Physician Medical Practitioner	None	1093386591	0	0	FRASCH, JORDIN M NP	12/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
303269	Non-Physician Medical Practitioner	None	1356673685	0	0	FUENTES, RUTH ALICIA	9/16/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14442 WHITTIER BLVD	SUITE # 105	WHITTIER	CA	90605	2107	00	06000	33.95385901	-118.0164461	Los Angeles County
303305	Non-Physician Medical Practitioner	None	1417521006	0	0	FAHEY, JAMES G PA-C	3/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7115 GREENBACK LN	FL 2	CITRUS HEIGHTS	CA	95621	6133	00	06000	38.679237	-121.298859	Sacramento County
303310	Non-Physician Medical Practitioner	None	1528647104	0	0	FINCH, ROBERT M PA	6/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	00	06000	34.0956033	-118.2916918	Los Angeles County
303341	Non-Physician Medical Practitioner	None	1720708365	0	0	FANG, SAMANTHA	7/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
303412	Non-Physician Medical Practitioner	None	1861552556	0	0	FIERRO, MARC A PA	3/3/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	TWO MEDICAL PLAZA	STE 180	ROSEVILLE	CA	95661	3049	00	06000	38.76507948	-121.2477476	Placer County
303414	Non-Physician Medical Practitioner	None	1891730628	0	0	FOSTER, SUSAN DIANE	12/21/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2720 LOW CT	None	FAIRFIELD	CA	94534	9771	00	06000	38.23580279	-122.0858445	Solano County
303427	Non-Physician Medical Practitioner	None	1740805175	0	0	FRASER, ALEXANDRA S PA-C	7/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2351 CLAY STREET	SUITE 512	SAN FRANCISCO	CA	94115	1931	00	06000	37.79101512	-122.4316059	San Francisco County
303429	Non-Physician Medical Practitioner	None	1831513373	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO	6/23/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1250 6TH AVE	SUITE 100	SAN DIEGO	CA	92101	4300	00	06000	32.71854144	-117.1593008	San Diego County
303500	Non-Physician Medical Practitioner	None	1376969949	0	0	FIORI, MICHELE PA-C	9/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
303524	Non-Physician Medical Practitioner	None	1982798112	0	0	FLOCO, VIRGINIA A	9/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16356 PINTO RIDGE CT	None	SAN DIEGO	CA	92127	3429	00	06000	33.00898603	-117.1171887	San Diego County
303547	Non-Physician Medical Practitioner	None	1083911135	0	0	FLORES, SARAH O	11/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	00	06000	36.98191238	-121.9975767	Santa Cruz County
303641	Non-Physician Medical Practitioner	None	1619217601	0	0	FIELDS, KATIE E	6/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	428 CAPP STREET	None	SAN FRANCISCO	CA	94140	1810	00	06000	37.75981975	-122.4180983	San Francisco County
303679	Non-Physician Medical Practitioner	None	1992356273	0	0	FRAIRE, MATTHEW R PA-C	2/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	00	06000	34.06269295	-118.2030006	Los Angeles County
303705	Non-Physician Medical Practitioner	None	1518996594	0	0	FLEURY-MILFORT, EVELYNE	12/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	SUITE 1000	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
303711	Non-Physician Medical Practitioner	None	1225057847	0	0	FRIESEN, JULIA A	3/2/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	632 W GIBSON RD	None	WOODLAND	CA	95695	0000	00	06000	38.66314048	-121.794696	Yolo County
303764	Non-Physician Medical Practitioner	None	1548833510	0	0	FAN, WILLIAM W NP	9/25/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	2833	00	06000	37.37715796	-122.0651926	Santa Clara County
303826	Non-Physician Medical Practitioner	None	1356492771	0	0	FAUST, YVETTE A NP	4/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6290 WEST RIDGE COURT	None	EUREKA	CA	95503	9201	00	06000	40.73618469	-124.1623424	Humboldt County
303829	Non-Physician Medical Practitioner	None	1144418856	0	0	FASSBINDER, MELISSA A	2/4/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	800 N STATE COLLEGE BLVD	None	FULLERTON	CA	92834	0000	00	06000	33.879987	-117.886086	Orange County
303833	Non-Physician Medical Practitioner	None	1396751764	0	0	FREEMAN, PATRICIA A PA	6/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
303856	Non-Physician Medical Practitioner	None	1710751227	0	0	FONG, DEANNA Y PA-C	3/3/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6385	00	06000	37.36812305	-122.0312314	Santa Clara County
303859	Non-Physician Medical Practitioner	None	1881847382	0	0	FARMER, STACEY L PA-C	1/6/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	00	06000	39.33573744	-120.180872	Nevada County
303871	Non-Physician Medical Practitioner	None	1740761154	0	0	FULTON, RACHAEL R PA-C	9/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28062 BAXTER RD	None	MURRIETA	CA	92563	1401	00	06000	33.61350847	-117.1691225	Riverside County
303968	Non-Physician Medical Practitioner	None	1235240557	0	0	FARRELL, KENNETH W	2/16/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11110 CAMARILLO ST	APT 114	NORTH HOLLYWOOD	CA	91602	1602	00	06000	34.15762504	-118.3727992	Los Angeles County
303994	Non-Physician Medical Practitioner	None	1710900584	0	0	FRANDSEN, DAVID	10/14/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	00	06000	34.1010559	-117.6369445	San Bernardino County
303995	Non-Physician Medical Practitioner	None	1356854152	0	0	FILLMORE, VALERIE NP	12/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2755 HERNDON	None	CLOVIS	CA	93611	6800	00	06000	36.83745149	-119.6604315	Fresno County
304087	Non-Physician Medical Practitioner	None	1508682022	0	0	FRANDJIAN, LOUSINE NP	1/29/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	504 S SIERRA MADRE BLVD	None	PASADENA	CA	91107	5240	00	06000	34.137603	-118.101464	Los Angeles County
304117	Non-Physician Medical Practitioner	None	1811079163	0	0	FEHLBERG, KAEDI R NP	5/23/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1679 WESTWOOD DR	None	CONCORD	CA	94514	1231	00	06000	37.96967768	-121.9859082	Contra Costa County
304176	Non-Physician Medical Practitioner	None	1417971987	0	0	FARSI, BEHROUZ DARABI	4/29/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
304178	Non-Physician Medical Practitioner	None	1790999241	0	0	FELONGCO, KATHERINE KEENER	10/6/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3186 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	06000	36.132948	-115.136874	Clark County
304186	Non-Physician Medical Practitioner	None	1689058901	0	0	FELIX, CYNTHIA L NP	9/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6812 N CHESTNUT AVENUE	None	FRESNO	CA	93710	4864	00	06000	36.83527899	-119.7360876	Fresno County
304252	Non-Physician Medical Practitioner	None	1386723203	0	0	FORD, TERA KIRTLEY	4/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
304369	Non-Physician Medical Practitioner	None	1417661489	0	0	FINN, CHRISTIANNA NP	1/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1777 N BELLFLOWER BLVD	STE 101	LONG BEACH	CA	90815	4019	00	06000	33.78791149	-118.1240221	Los Angeles County
304398	Non-Physician Medical Practitioner	None	1649288549	0	0	FISCHER, STEVEN J PA-C	3/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	770 MAGNOLIA AVE	STE 1H	CORONA	CA	92879	3121	00	06000	33.85936872	-117.5534605	Riverside County
304412	Non-Physician Medical Practitioner	None	1629144092	0	0	FINGER, JOCELYN E CNM	11/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	# 3611	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
304426	Non-Physician Medical Practitioner	None	1073997201	0	0	FAMILY HEALTHCARE NETWORK	9/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	263 S. WEST STREET	None	TULARE	CA	93274	0000	00	06000	36.20460711	-119.3668926	Tulare County
304457	Non-Physician Medical Practitioner	None	1427886209	0	0	FOX, MICKEY	10/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
304467	Non-Physician Medical Practitioner	None	1235650383	0	0	FURROW, SHANTAY	6/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
304491	Non-Physician Medical Practitioner	None	1184263717	0	0	FRYE, JORDAN M PA-C	9/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 DOYLE PARK	STE 205	SANTA ROSA	CA	95405	4559	00	06000	38.44332	-122.6985255	Sonoma County
304496	Non-Physician Medical Practitioner	None	1851718530	0	0	FABIAN, LORETA A NP	5/14/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11507 OXNARD ST	# 3	NORTH HOLLYWOOD	CA	91606	4809	00	06000	34.17944448	-118.382598	Los Angeles County
304506	Non-Physician Medical Practitioner	None	1356013049	0	0	FORTE, MARINA	6/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
304548	Non-Physician Medical Practitioner	None	1023228566	0	0	FANCHER, TAMARA KATE	8/20/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
304563	Non-Physician Medical Practitioner	None	1548205115	0	0	FAITH, REBECCA NP	12/31/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3505 LAKESHORE AVENUE	APT 8	OAKLAND	CA	94610	2243	00	06000	37.81193748	-122.2423525	Alameda County
304600	Non-Physician Medical Practitioner	None	1780005710	0	0	FISCHER, LINDSAY A NP	12/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	185 CHANNEL ST	APT 637	SAN FRANCISCO	CA	94158	1733	00	06000	37.7744191	-122.3907175	San Francisco County
304651	Non-Physician Medical Practitioner	None	1891453403	0	0	FEISE, NATASHA K PA	6/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
304705	Non-Physician Medical Practitioner	None	1881212066	0	0	FUJIMOTO, HILDA A NP	8/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5794	00	06000	34.47092468	-117.2977236	San Bernardino County
304737	Non-Physician Medical Practitioner	None	1699709972	0	0	FRIAS, GIOVANNI S	7/6/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10833 LECONTE AVE	None	LOS ANGELES	CA	90095	0001	00	06000	34.06373445	-118.443537	Los Angeles County
304743	Non-Physician Medical Practitioner	None	1336659218	0	0	FONG, RYAN C PA-C	8/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	00	06000	33.02257788	-117.0856332	San Diego County
304769	Non-Physician Medical Practitioner	None	1790160539	0	0	FRANCO, AIMEE M NP	1/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6112 TAHITIAN PEARL DR	None	BAKERSFIELD	CA	93309	5326	00	06000	35.29360072	-119.0714685	Kern County
304830	Non-Physician Medical Practitioner	None	1740664416	0	0	FIGUEROA, PAOLA M	6/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10005 PARROT AVE	None	DOWNEY	CA	90240	3822	00	06000	33.95436973	-118.1275092	Los Angeles County
304914	Non-Physician Medical Practitioner	None	1003525585	0	0	FUNG, LESLIE CNM	4/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 WEST AVENUE J	None	LANCASTER	CA	93534	2814	00	06000	34.68938848	-118.158354	Los Angeles County
304928	Non-Physician Medical Practitioner	None	1477743961	0	0	FISHER, BETHANY S	4/17/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9700 EL CAMINO REAL	STE 100	ATASCADERO	CA	93422	5569	00	06000	35.46523281	-120.647999	San Luis Obispo County
304964	Non-Physician Medical Practitioner	None	1912568205	0	0	FELLMAN, ANDREA L	7/19/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	617 VETERANS BLVD	STE 101	REDWOOD CITY	CA	94063	1496	00	06000	37.4924484	-122.2318516	San Mateo County
304986	Non-Physician Medical Practitioner	None	1992712400	0	0	FITZGERALD, PATRICIA M NP	8/18/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	00	06000	40.78355148	-124.1420294	Humboldt County
304992	Non-Physician Medical Practitioner	None	1760892285	0	0	FRASER, ROBIN F	3/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2601 LUCAS ST	None	EUREKA	CA	95501	1486	00	06000	40.79130362	-124.1387963	Humboldt County
304996	Non-Physician Medical Practitioner	None	1326270877	0	0	FREEMAN, SHANNA L	12/18/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1823 12TH ST	APT 3	SANTA MONICA	CA	90404	4635	00	06000	34.01638725	-118.4803317	Los Angeles County
305017	Non-Physician Medical Practitioner	None	1043321565	0	0	FORSTER, ROSEMARY A	12/23/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2800 L ST	#500	SACRAMENTO	CA	95816	5616	00	06000	38.571237	-121.469958	Sacramento County
305070	Non-Physician Medical Practitioner	None	1427673748	0	0	FORD, CAROLINE M NP	7/6/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	165 N CLARK ST	None	FRESNO	CA	93701	2108	00	06000	36.74454278	-119.786043	Fresno County
305121	Non-Physician Medical Practitioner	None	1780213363	0	0	FISHER, AMANDA C PA	2/18/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	615 OCEAN ST	None	SANTA CRUZ	CA	95060	4005	00	06000	36.97734512	-122.0204895	Santa Cruz County
305197	Non-Physician Medical Practitioner	None	1770553273	0	0	FOLLESTAD, JENNIFER NP	5/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3466 EL CAMINO REAL	None	SANTA CLARA	CA	95051	2809	00	06000	37.35225555	-121.9921875	Santa Clara County
305252	Non-Physician Medical Practitioner	None	1851405989	0	0	FRANK, HAROLD T	10/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	841 DANICA PL	None	ESCONDIDO	CA	92025	5907	00	06000	33.09816673	-117.0811944	San Diego County
305451	Non-Physician Medical Practitioner	None	1669863429	0	0	FROMSTEIN, SAMANTHA R NP	7/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39897 S CREEK CIR	None	MURRIETA	CA	92563	2818	00	06000	33.54176058	-117.124177	Riverside County
305483	Non-Physician Medical Practitioner	None	1336587039	0	0	FLORES, JOANNA D NP	4/25/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3630 COLINGROVE AVE	None	COVINA	CA	91724	3403	00	06000	0	0	None
305505	Non-Physician Medical Practitioner	None	1720016702	0	0	FELDMAN, CORRINE T	9/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4221 DEVON CIRCLE	None	CYPRESS	CA	90630	2713	00	06000	33.82458569	-118.0593655	Orange County
305529	Non-Physician Medical Practitioner	None	1386282705	0	0	FOSTER, ALEXANDRA	4/16/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
305586	Non-Physician Medical Practitioner	None	1154512986	0	0	FISHER, SEAN G	12/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2936 DE LAVINA ST	STE 200	SANTA BARBARA	CA	93105	0706	00	06000	34.4383104	-119.7278207	Santa Barbara County
305597	Non-Physician Medical Practitioner	None	1669730230	0	0	FRIESCH, CATHERINE C NP	7/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	368 SONG BIRD WAY	None	PETALUMA	CA	94954	3919	00	06000	38.25936406	-122.6201737	Sonoma County
305606	Non-Physician Medical Practitioner	None	1306119417	0	0	FISHER-BECK, JASON A	8/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9431 GOLDEN DRIVE	None	ORANGEVALE	CA	95662	5406	00	06000	38.667177	-121.200786	Sacramento County
305645	Non-Physician Medical Practitioner	None	1437822434	0	0	FERRARA, SAMANTHA L PA	1/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16167 SISKIYOU ROAD	SUITE A	APPLE VALLEY	CA	92307	0837	00	06000	34.54496692	-117.2664417	San Bernardino County
305688	Non-Physician Medical Practitioner	None	1992880645	0	0	FINLAYSON, CAROL D NP	9/23/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	314 GROUSE CT	None	LOUISVILLE	CO	80027	2270	00	06000	39.97301573	-105.1504876	Boulder County
305733	Non-Physician Medical Practitioner	None	1821587478	0	0	FISSEL, SARA R PA-C	6/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1680 E 120 ST	None	LOS ANGELES	CA	90059	3026	00	06000	33.92456051	-118.2417525	Los Angeles County
305762	Non-Physician Medical Practitioner	None	1053316703	0	0	FORRED, DANA J NP	1/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	499 E BRADDOCK DR	None	FRESNO	CA	93720	1277	00	06000	36.86824257	-119.7743506	Fresno County
305770	Non-Physician Medical Practitioner	None	1427073162	0	0	FLORIN, JOSEPH G	8/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15578 IRON SPRINGS LN	None	FONTANA	CA	92336	4562	00	06000	34.14614446	-117.4604895	San Bernardino County
305807	Non-Physician Medical Practitioner	None	1982840609	0	0	FISHER, ELENA DENISE RODRIGUEZ	8/12/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2330 POST ST STE 610	None	SAN FRANCISCO	CA	94115	3495	00	06000	37.78424041	-122.4403628	San Francisco County
305821	Non-Physician Medical Practitioner	None	1750893640	0	0	FISCHER, DOUGLAS J NP	4/30/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5577 GLEN DR	None	PARADISE	CA	95969	5253	00	06000	39.74992986	-121.602893	Butte County
305834	Non-Physician Medical Practitioner	None	1356151963	0	0	FEI, YIMENG NP	2/27/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1655 S WESTERN AVE	None	LOS ANGELES	CA	90006	5801	00	06000	34.042653	-118.3090565	Los Angeles County
305865	Non-Physician Medical Practitioner	None	1588820765	0	0	FORAN, JESSICA LYNN	2/18/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
305909	Non-Physician Medical Practitioner	None	1477280006	0	0	FRY, CHANTAL A PA	10/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	00	06000	37.32710433	-121.9386474	Santa Clara County
305917	Non-Physician Medical Practitioner	None	1659530970	0	0	FAIGELES, BONNIE S	8/4/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	00	06000	37.48948529	-122.2232468	San Mateo County
306012	Non-Physician Medical Practitioner	None	1316050636	0	0	FERGUSON, JUDITH L NP	7/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3241 W GREEN OAKS DR	None	VISALIA	CA	93277	7518	00	06000	36.30165837	-119.2947696	Tulare County
306079	Non-Physician Medical Practitioner	None	1245718980	0	0	FLYNN, SEAN PA-C	2/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
306099	Non-Physician Medical Practitioner	None	1831272962	0	0	FONG, BETTY Y	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
306139	Non-Physician Medical Practitioner	None	1467741397	0	0	FERRELL, BARBARA G	11/5/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43600 MISSION BLVD	None	FREMONT	CA	94539	5847	00	06000	37.52727628	-121.9182972	Alameda County
306203	Non-Physician Medical Practitioner	None	1912964842	0	0	FAULKNER, MARY	10/28/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 30TH ST	SUITE 205	OAKLAND	CA	94609	3424	00	06000	37.81892183	-122.2640154	Alameda County
306236	Non-Physician Medical Practitioner	None	1629475538	0	0	FARVON, SHIVA NP	10/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2613 PIPER COURT	None	BAKERSFIELD	CA	93306	2818	00	06000	35.39728222	-118.9364626	Kern County
306260	Non-Physician Medical Practitioner	None	1194225482	0	0	FIRMEZA, ALLISON T NP	3/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7749 CROSSRIDGE RD	None	DUBLIN	CA	94568	7319	00	06000	37.7249798	-121.9145361	Alameda County
306275	Non-Physician Medical Practitioner	None	1730848029	0	0	FOFANA, SHEKU NP	3/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	00	06000	34.06704253	-118.3835029	Los Angeles County
306326	Non-Physician Medical Practitioner	None	1528317872	0	0	FERNANDES, SUSAN MARIE	2/12/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
306353	Non-Physician Medical Practitioner	None	1518086388	0	0	FERMIL MITCHELL, YVONNE D NP	8/25/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1251 PECAN PLACE	None	CHULA VISTA	CA	91911	3731	00	06000	32.61583458	-117.0401804	San Diego County
306361	Non-Physician Medical Practitioner	None	1902439938	0	0	FUHRMAN, COLLIN M PA-C	3/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 VALENCIA MESA	None	FULLERTON	CA	92835	3809	00	06000	33.89356031	-117.9271656	Orange County
306367	Non-Physician Medical Practitioner	None	1831489350	0	0	FIERRO, JOANNE M NP	3/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22748 BAYSHORE LANE	None	LAKE FOREST	CA	92630	3006	00	06000	33.63262738	-117.7069029	Orange County
306377	Non-Physician Medical Practitioner	None	1396129458	0	0	FRANK, ERIN M PA-C	3/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 TRANCAS ST	SUITE 256	NAPA	CA	94558	2921	00	06000	38.32316569	-122.2981938	Napa County
306417	Non-Physician Medical Practitioner	None	1457543530	0	0	FUNES, GLADIS	8/21/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6007 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4401	00	06000	34.01716937	-118.141858	Los Angeles County
306477	Non-Physician Medical Practitioner	None	1265912570	0	0	FILARSKI, CAROLYN F PA-C	1/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8635 W 3RD ST	STE 1190W	LOS ANGELES	CA	90048	6101	00	06000	34.07361928	-118.3803143	Los Angeles County
306552	Non-Physician Medical Practitioner	None	1437363462	0	0	FERNANDEZ, MARIA E	6/22/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1408 1/2 VALLEY VIEW RD	None	GLENDALE	CA	91202	1782	00	06000	34.16717494	-118.2605028	Los Angeles County
306554	Non-Physician Medical Practitioner	None	1679753354	0	0	FUNK, BRANDI M NP	8/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	00	06000	34.12632952	-117.1956652	San Bernardino County
306577	Non-Physician Medical Practitioner	None	1881450666	0	0	FRANCIA, DIANNE	3/24/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
306580	Non-Physician Medical Practitioner	None	1174114078	0	0	FLORESCA, MARY JOY	8/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1040 ELM AVE,	SUITE 303	LONG BEACH	CA	90813	3267	00	06000	33.779799	-118.1879535	Los Angeles County
306581	Non-Physician Medical Practitioner	None	1215572417	0	0	FAVOT, ANTHONY A PA-C	6/19/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16850 BEAR VALLEY RD	None	VICTORVILLE	CA	92395	5794	00	06000	34.47092468	-117.2977236	San Bernardino County
306587	Non-Physician Medical Practitioner	None	1669863155	0	0	FALLON, THOMAS PA-C	1/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9745 PROSPECT AVE	STE 100	SANTEE	CA	92071	6209	00	06000	32.83136651	-116.9842605	San Diego County
306627	Non-Physician Medical Practitioner	None	1386014181	0	0	FIGUEROA, JENNIFER A	4/8/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2337 HOPI CIR	None	BISHOP	CA	93514	8017	00	06000	37.38657972	-118.4175718	Inyo County
306639	Non-Physician Medical Practitioner	None	1811142201	0	0	FERNANDEZ, ELRICO B PA	11/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19227-19231 SOLEDAD CANY	None	SANTA CLARITA	CA	91351	3367	00	06000	34.4157783	-118.471714	Los Angeles County
306647	Non-Physician Medical Practitioner	None	1043530082	0	0	FRANCIS, STEPHANIE A PA	11/15/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31739 RIVERSIDE DR	STE A1	LAKE ELSINORE	CA	92530	7818	00	06000	33.67696555	-117.373482	Riverside County
306670	Non-Physician Medical Practitioner	None	1124173117	0	0	FAHLSING, MICHELLE	10/14/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
306683	Non-Physician Medical Practitioner	None	1487199428	0	0	FRANCESCHI, JOE E PA-C	5/10/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23530 HAWTHORNE BLVD	BLDG 1, STE. 290	TORRANCE	CA	90505	4765	00	06000	33.811983	-118.351014	Los Angeles County
306752	Non-Physician Medical Practitioner	None	1568877405	0	0	FAHERTY, AMBER M PA	11/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	00	06000	38.12188356	-121.285872	San Joaquin County
306799	Non-Physician Medical Practitioner	None	1336439603	0	0	FOURNIER, CHRYSTAL MARIE	5/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
306801	Non-Physician Medical Practitioner	None	1972088763	0	0	FARAH, PAMELA M	10/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21514 BARBI LANE	None	DIAMOND BAR	CA	91765	3807	00	06000	33.96671027	-117.840246	Los Angeles County
306877	Non-Physician Medical Practitioner	None	1780076042	0	0	FRANCO, LAURA E	1/23/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3830 CLARKE ST APT B	None	OAKLAND	CA	94609	2783	00	06000	37.82774327	-122.2634912	Alameda County
306937	Non-Physician Medical Practitioner	None	1417575929	0	0	FELIX, JESSIE A PA-C	10/23/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2911 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	00	06000	36.98821335	-121.978125	Santa Cruz County
306992	Non-Physician Medical Practitioner	None	1114376829	0	0	FLORES, STEPHANIE A PA-C	8/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
307041	Non-Physician Medical Practitioner	None	1952729303	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO INC	10/22/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1550 BROADWAY	SUITE 2	SAN DIEGO	CA	92101	0000	00	06000	32.71579987	-117.1499238	San Diego County
307092	Non-Physician Medical Practitioner	None	1407804206	0	0	FAIRBURN, CHRISTOPHER JASON	8/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	325 POSADA LN	A-C	TEMPLETON	CA	93465	4003	00	06000	35.55257494	-120.7214826	San Luis Obispo County
307095	Non-Physician Medical Practitioner	None	1235172289	0	0	FOLEY, SANDRA JOY	12/12/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6475 ALVARADO RD	SUITE 120	SAN DIEGO	CA	92120	5003	00	06000	32.77826653	-117.061265	San Diego County
307099	Non-Physician Medical Practitioner	None	1477093714	0	0	FUKASAWA, JENNIFER K	5/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3005 CAROLWOOD LN	None	TORRANCE	CA	90505	7109	00	06000	33.79042935	-118.343425	Los Angeles County
307104	Non-Physician Medical Practitioner	None	1912217787	0	0	FITZGERALD, JENNIFER	11/30/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	TRAUMA DEPT	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
307107	Non-Physician Medical Practitioner	None	1417315391	0	0	FISK, SUZANNE M NP	3/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43457 N YEW STREET	None	LANCASTER	CA	93536	6600	00	06000	34.67271757	-118.193109	Los Angeles County
307111	Non-Physician Medical Practitioner	None	1578565198	0	0	FREDRICKSON, SARI	5/3/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	00	06000	37.89189148	-122.057999	Contra Costa County
307117	Non-Physician Medical Practitioner	None	1568816213	0	0	FOWLKES, CANDACE	2/26/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
307126	Non-Physician Medical Practitioner	None	1093287161	0	0	FRONIEWSKI, MICHAEL E PA-C	5/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	00	06000	38.76553806	-121.2497067	Placer County
307152	Non-Physician Medical Practitioner	None	1710416763	0	0	FOSTER, MORGAN PA-C	7/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	00	06000	34.0653985	-118.3769177	Los Angeles County
307191	Non-Physician Medical Practitioner	None	1356406904	0	0	FISHER, DAVID HOWARD	3/8/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	00	06000	37.66508443	-120.9962589	Stanislaus County
307225	Non-Physician Medical Practitioner	None	1326209123	0	0	FLADOOS, SHIRLEY K	3/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1033 6TH STREET	STE 2	SANTA MONICA	CA	90403	3934	00	06000	34.02268929	-118.4987626	Los Angeles County
307234	Non-Physician Medical Practitioner	None	1790051423	0	0	FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,	11/30/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12113 WOODRUFF AVE	SUITE A	DOWNEY	CA	90241	0000	00	06000	33.9238587	-118.11678	Los Angeles County
307260	Non-Physician Medical Practitioner	None	1841786795	0	0	FOWLER, JULIE D NP	2/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	40342 SALEM WAY	None	TEMECULA	CA	92591	7533	00	06000	33.53479522	-117.1587014	Riverside County
307325	Non-Physician Medical Practitioner	None	1346387073	0	0	FROST, MARLENE ELAINE	9/24/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11318 SKYLINE VW	None	SANTA ANA	CA	92705	2411	00	06000	33.76065056	-117.7817805	Orange County
307327	Non-Physician Medical Practitioner	None	1639595119	0	0	FRONCZEK, ADAM M NP	1/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13934 BORA WAY	APT E	MARINA DEL REY	CA	90292	9998	00	06000	0	0	None
307328	Non-Physician Medical Practitioner	None	1801516380	0	0	FEYZBAKHSH, NATALI PA-C	4/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39350 CIVIC CENTER DR	SUITE 300	FREMONT	CA	94538	2331	00	06000	37.55399458	-121.9756047	Alameda County
307366	Non-Physician Medical Practitioner	None	1578930731	0	0	FIFE, JARED K PA-C	1/12/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	911 MORAGA RD STE 200	None	LAFAYETTE	CA	94549	4500	00	06000	37.88758326	-122.1181419	Contra Costa County
307368	Non-Physician Medical Practitioner	None	1992243331	0	0	FRIEDMAN MUNKSGARD, FLETCHER NP	5/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	43360 MISSION BLVD	SUITE 100	FREMONT	CA	94539	5829	00	06000	37.53249631	-121.9198141	Alameda County
307385	Non-Physician Medical Practitioner	None	1144002684	0	0	FROHLING, JULIA PA-C	1/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	511 BATH ST	None	SANTA BARBARA	CA	93101	3403	00	06000	34.41386476	-119.6993335	Santa Barbara County
307397	Non-Physician Medical Practitioner	None	1609305184	0	0	FREEMAN, MELANIE R PA	4/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
307475	Non-Physician Medical Practitioner	None	1447679790	0	0	FAVILA, SUSANA NP	7/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	667 YUCCA ST	None	IMPERIAL	CA	92251	8925	00	06000	32.81901162	-115.5927524	Imperial County
307492	Non-Physician Medical Practitioner	None	1669549432	0	0	FUREY, AARON A	10/22/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10736 JEFFERSON BLVD	418	CULVER CITY	CA	90230	4933	00	06000	34.00259978	-118.3941387	Los Angeles County
307538	Non-Physician Medical Practitioner	None	1568970838	0	0	FELLOWS, JULIA M PA	5/4/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5800 HOLLIS ST	None	EMERYVILLE	CA	94608	2016	00	06000	37.84043576	-122.2894291	Alameda County
307598	Non-Physician Medical Practitioner	None	1316176712	0	0	FIELD, LESLEY M PA-C	8/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	00	06000	38.443806	-122.701374	Sonoma County
307661	Non-Physician Medical Practitioner	None	1356847149	0	0	FLORES ESCOBAR, YESSICA NP	9/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1301 MISSION STREET	None	SANTA CRUZ	CA	95030	3528	00	06000	36.96817615	-122.0381947	Santa Cruz County
307664	Non-Physician Medical Practitioner	None	1326875550	0	0	FISHER, JESSICA V NP	11/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	00	06000	37.78594176	-122.421322	San Francisco County
307713	Non-Physician Medical Practitioner	None	1619379013	0	0	FROST, BREA E	8/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5336 KNIGHTWOOD DR	None	KLAMATH FALLS	OR	97603	8527	00	06000	42.17656081	-121.7270361	Klamath County
307729	Non-Physician Medical Practitioner	None	1851179154	0	0	FELIX, ANDREW PA	1/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
307866	Non-Physician Medical Practitioner	None	1881219715	0	0	FLOOD, JUDITH M CNP	8/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
307913	Non-Physician Medical Practitioner	None	1801984612	0	0	FOUGHT, MELISSA	7/12/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
308050	Non-Physician Medical Practitioner	None	1023160132	0	0	FROMM, LEORA CNM	9/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6774 HWY 9	None	FELTON	CA	95018	9715	00	06000	37.05840599	-122.0778441	Santa Cruz County
308172	Non-Physician Medical Practitioner	None	1043543473	0	0	FULLER BAECKER, STACY	2/23/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	34 MAPLE ST	NORWALK HOSPITAL	NORWALK	CT	06856	0000	00	06000	41.11220241	-73.42093438	Western Connecticut Planning Region
308188	Non-Physician Medical Practitioner	None	1285299628	0	0	FRANCO, ERIKA R NP	6/6/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13010 HESPERIA RD	600	VICTORVILLE	CA	92395	8321	00	06000	34.48843676	-117.2909745	San Bernardino County
308196	Non-Physician Medical Practitioner	None	1548236862	0	0	FARNBACH, AMELIA R PA	12/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	06000	33.38982	-111.8760885	Maricopa County
308233	Non-Physician Medical Practitioner	None	1326317819	0	0	FAMILY HEALTHCARE NETWORK	1/27/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	730 N FARMERSVILLE BLVD	None	FARMERSVILLE	CA	93223	1220	00	06000	36.30345652	-119.2070774	Tulare County
308263	Non-Physician Medical Practitioner	None	1497709844	0	0	FROMETA SONG, KATE NORMAN CNM	11/29/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20101 LAKE CHABOT RD	3RD FLOOR	CASTRO VALLEY	CA	94546	5305	00	06000	37.69819004	-122.0873124	Alameda County
308266	Non-Physician Medical Practitioner	None	1255878765	0	0	FLORES, SHONDRA L NP	3/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	936 EAST LOCUST AVE	None	FRESNO	CA	93720	3216	00	06000	36.84003592	-119.7671337	Fresno County
308301	Non-Physician Medical Practitioner	None	1790051357	0	0	FINCH, TONI M	3/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3906 CAMINITO CASSIS	None	SAN DIEGO	CA	92122	1992	00	06000	32.85583917	-117.2274423	San Diego County
308338	Non-Physician Medical Practitioner	None	1578209391	0	0	FISHER, OLIVIA J PA-C	11/14/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	604 N MAGNOLIA AVE	100	CLOVIS	CA	93611	9204	00	06000	36.83939464	-119.6661479	Fresno County
308347	Non-Physician Medical Practitioner	None	1720407786	0	0	FERGUSON, ANA MARIE V NP	5/24/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2906 GREENSPRINGS DRIVE	None	KLAMATH FALLS	OR	97601	5644	00	06000	42.19495136	-121.7946478	Klamath County
308402	Non-Physician Medical Practitioner	None	1417324534	0	0	FOX, BRADLEY C NP	7/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2401 PUEBLO DRIVE	None	KINGMAN	AZ	86401	7362	00	06000	35.193717	-113.9794155	Mohave County
308415	Non-Physician Medical Practitioner	None	1801432513	0	0	FOYE, MARY B NP	8/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	54910 PINECREST DRIVE	None	IDYLLWILD	CA	92549	0000	00	06000	33.7525352	-116.7068573	Riverside County
308436	Non-Physician Medical Practitioner	None	1447573779	0	0	FOO, DARVIN C	10/16/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3532 KOSO ST	None	DAVIS	CA	95618	6041	00	06000	38.54728149	-121.708377	Yolo County
308440	Non-Physician Medical Practitioner	None	1417560194	0	0	FULLER, VANESSA R NP	10/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	00	06000	39.15305697	-123.2037774	Mendocino County
308485	Non-Physician Medical Practitioner	None	1760911523	0	0	FLIPPEN, RICARDO L JR	10/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	38534 DUNLAP RD	None	SQUAW VALLEY	CA	93675	0000	00	06000	36.74889595	-119.128483	Fresno County
308487	Non-Physician Medical Practitioner	None	1063612661	0	0	FIACCO, CYNTHIA MARIE	2/26/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5051 VERDUGO WAY	SUITE 110	CAMARILLO	CA	93012	0000	00	06000	34.21524684	-119.0033176	Ventura County
308501	Non-Physician Medical Practitioner	None	1295249167	0	0	FERNANDEZ-BELL, EMILY NP	8/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	00	06000	33.94354395	-117.394926	Riverside County
308532	Non-Physician Medical Practitioner	None	1922287929	0	0	FERNANDEZ, GERMAN ERNESTO	12/17/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4214 BEVERLY BLVD STE 21	None	LOS ANGELES	CA	90004	4429	00	06000	34.0762665	-118.3010445	Los Angeles County
308574	Non-Physician Medical Practitioner	None	1245562610	0	0	FORBES, MICHAEL W NP	8/24/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	580 MONDALE ST	None	CORONA	CA	92879	5888	00	06000	33.89514602	-117.512462	Riverside County
308578	Non-Physician Medical Practitioner	None	1578919502	0	0	FREEMAN, ALEX L NP	6/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19 SAN RAFAEL AVE	None	SAN ANSELMO	CA	94960	2119	00	06000	37.97650843	-122.565042	Marin County
308597	Non-Physician Medical Practitioner	None	1104934033	0	0	FERGON, JOLYN C NP	8/5/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	49256 ESCALANTE ST	None	INDIO	CA	92201	8850	00	06000	33.69087	-116.2637935	Riverside County
308711	Non-Physician Medical Practitioner	None	1447490842	0	0	FULGHAM, WALTER DAN	3/5/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
308723	Non-Physician Medical Practitioner	None	1609629799	0	0	FLIT, FRANCES B NP	6/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	612 E JANSS ROAD	None	THOUSAND OAKS	CA	91360	5113	00	06000	34.19957051	-118.8666284	Ventura County
308739	Non-Physician Medical Practitioner	None	1679560346	0	0	FUNK, MELINDA NP	12/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
308748	Non-Physician Medical Practitioner	None	1700945649	0	0	FONG, NANCY NP	12/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	248 APOLLO CIRCLE	None	BISHOP	CA	93514	7050	00	06000	37.32457771	-118.5385567	Inyo County
308749	Non-Physician Medical Practitioner	None	1912367830	0	0	FREIWALD, ADAM PA-C	1/23/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	00	06000	35.640783	-117.6698475	Kern County
308750	Non-Physician Medical Practitioner	None	1295487163	0	0	FRANCO, CHARITO CHALIE SALASAC NP	12/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	123 ATLANTIC AVENUE	None	LONG BEACH	CA	90802	5121	00	06000	33.7685184	-118.1850803	Los Angeles County
308802	Non-Physician Medical Practitioner	None	1134956816	0	0	FELICIANO, CASSANDRA PA-C	2/16/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29826 HAUN RD	314	MENIFEE	CA	92586	6546	00	06000	33.68719818	-117.1748757	Riverside County
308813	Non-Physician Medical Practitioner	None	1306529102	0	0	FUNES, IVETTE A NP	5/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
308866	Non-Physician Medical Practitioner	None	1477795805	0	0	FOLSOM, FLENE A	8/26/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18876 JAYHAWK DRIVE	None	PENN VALLEY	CA	95946	9218	00	06000	39.23033388	-121.197045	Nevada County
308959	Non-Physician Medical Practitioner	None	1699040873	0	0	FALK, LEAH ROSE NP	12/29/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1090 SULLIVAN STREET	None	UPLAND	CA	91784	1819	00	06000	34.12244418	-117.6676407	San Bernardino County
308976	Non-Physician Medical Practitioner	None	1669402079	0	0	FARRELL, ROMAYNE E	2/5/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2536 WASHOE CT	None	SANTA ROSA	CA	95405	8048	00	06000	38.43225	-122.6725605	Sonoma County
308987	Non-Physician Medical Practitioner	None	1487018784	0	0	FORTIN, KRISTEN L NP	5/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3004 MERMAID DRIVE	None	ATWATER	CA	95301	4775	00	06000	37.36465933	-120.5913014	Merced County
309039	Non-Physician Medical Practitioner	None	1992214886	0	0	FIGUEROA, JENNIFER J	3/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21361 AUGUSTA CIRCLE	None	HUNTINGTON BEACH	CA	92646	7539	00	06000	33.65199941	-117.9609296	Orange County
309043	Non-Physician Medical Practitioner	None	1588826374	0	0	FEATHER RIVER TRIBAL HEALTH INC	1/2/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1231 PLUMAS ST	None	YUBA CITY	CA	95991	3410	00	06000	39.14838521	-121.617531	Sutter County
309074	Non-Physician Medical Practitioner	None	1811921257	0	0	FRANKS, JANICE D NP	11/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	868 E DAVIS DR	None	DINUBA	CA	93618	3130	00	06000	36.55648848	-119.386819	Tulare County
309103	Non-Physician Medical Practitioner	None	1497127278	0	0	FERNANDEZ, XIOMARA A PA-C	11/11/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	199 WEST PORTAL AVE	None	SAN FRANCISCO	CA	94127	1305	00	06000	37.73890204	-122.467945	San Francisco County
309117	Non-Physician Medical Practitioner	None	1801902077	0	0	FOX, RODNEY P	8/21/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 W SUNSET BLVD	SUITE 812	WEST HOLLYWOOD	CA	90069	3709	00	06000	34.09054375	-118.392295	Los Angeles County
309127	Non-Physician Medical Practitioner	None	1154500882	0	0	FOX, MOLLY A	12/9/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2751 B STREET	None	SAN DIEGO	CA	92102	1023	00	06000	32.71790894	-117.1349077	San Diego County
309162	Non-Physician Medical Practitioner	None	1144738170	0	0	FRENCH, ADRIANNE D PA-C	7/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	00	06000	37.48093988	-122.2531826	San Mateo County
309226	Non-Physician Medical Practitioner	None	1760020853	0	0	FENG, MEI	1/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4784 PECK RD	STE A	EL MONTE	CA	91732	1360	00	06000	34.09071973	-118.0144474	Los Angeles County
309369	Non-Physician Medical Practitioner	None	1205587607	0	0	FONG, NICHOLAS PA-C	9/12/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	00	06000	37.98252	-121.8030615	Contra Costa County
309465	Non-Physician Medical Practitioner	None	1992917348	0	0	FINDLAY, ANNE E	8/23/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2315 STOCKTON BLVD	HSF 2021	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
309487	Non-Physician Medical Practitioner	None	1114044633	0	0	FROST, ROBERT D	4/17/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	134 WALNUT HILLS DRIVE	None	SAN MARCOS	CA	92078	4429	00	06000	33.13671432	-117.1475598	San Diego County
309521	Non-Physician Medical Practitioner	None	1366779084	0	0	FLYNN, RENATE M NP	8/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	33 MANZANITA RD	None	FAIRFAX	CA	94930	1955	00	06000	37.98511738	-122.5937893	Marin County
309539	Non-Physician Medical Practitioner	None	1477025450	0	0	FLORES, AURORA E NP	3/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	00	06000	36.60784193	-119.4520057	Fresno County
309586	Non-Physician Medical Practitioner	None	1831527506	0	0	FLORES, ANGELINA	12/18/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6914 PROSPECT AVE	None	BELL	CA	90201	3631	00	06000	33.97240112	-118.1839823	Los Angeles County
309628	Non-Physician Medical Practitioner	None	1992120281	0	0	FEIGENBAUM, ADAM G PA	12/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1628 PALM AVE	None	SAN DIEGO	CA	92154	1027	00	06000	32.58396546	-117.098649	San Diego County
309672	Non-Physician Medical Practitioner	None	1790154862	0	0	FAMILY HEALTHCARE NETWORK	1/22/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4177 AVE. 368	None	TRAVER	CA	93673	0000	00	06000	36.45902619	-119.480968	Tulare County
309749	Non-Physician Medical Practitioner	None	1689067787	0	0	FU, THOMAS PA	6/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
309765	Non-Physician Medical Practitioner	None	1538631825	0	0	FERREY, SARAH E NP	8/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	00	06000	34.06169385	-118.2044698	Los Angeles County
309792	Non-Physician Medical Practitioner	None	1487141677	0	0	FLORES, GESSELLE C NP	10/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3805 KILLARNEY CT	None	BAKERSFIELD	CA	93311	2275	00	06000	35.31998323	-119.1230712	Kern County
309825	Non-Physician Medical Practitioner	None	1134420631	0	0	FOROOZAN, SALMA PA	3/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1590 SOUTH IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	00	06000	32.77950118	-115.5697279	Imperial County
309869	Non-Physician Medical Practitioner	None	1871121269	0	0	FLINCHUM, BETHANY S PA	3/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4437	00	06000	37.666053	-120.996222	Stanislaus County
309876	Non-Physician Medical Practitioner	None	1043260086	0	0	FRIZE, ROSINA B	4/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15413 BOLERO DRIVE	None	FONTANA	CA	92337	9029	00	06000	34.04318141	-117.4690056	San Bernardino County
309891	Non-Physician Medical Practitioner	None	1972613404	0	0	FRANZ, LINDA MARGARET	11/23/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	00	06000	37.8242017	-122.2578306	Alameda County
310022	Non-Physician Medical Practitioner	None	1871361543	0	0	FREDONA, DOUGLAS	1/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1212 S MAIN ST	None	SALINAS	CA	93901	2260	00	06000	36.65759539	-121.6594973	Monterey County
310060	Non-Physician Medical Practitioner	None	1790741197	0	0	FORD, LEIGH A	9/17/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2545 W HAMMER LN	None	STOCKTON	CA	95209	2839	00	06000	38.0214303	-121.3461515	San Joaquin County
310071	Non-Physician Medical Practitioner	None	1073793691	0	0	FULLER, BERTRAM PA-C	5/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	00	06000	34.0956033	-118.2916918	Los Angeles County
310095	Non-Physician Medical Practitioner	None	1558810218	0	0	FULLEMAN, ALEXANDRA M PA	12/10/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	06000	33.38982	-111.8760885	Maricopa County
310104	Non-Physician Medical Practitioner	None	1578591673	0	0	FLORES, CYNTHIA L	3/25/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	359 GREENPARK WAY	None	SAN JOSE	CA	95136	2156	00	06000	37.26737767	-121.8444415	Santa Clara County
310154	Non-Physician Medical Practitioner	None	1528725132	0	0	FORTES, AARON JOHN PA	12/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	00	06000	33.03623896	-117.2837308	San Diego County
310217	Non-Physician Medical Practitioner	None	1902242480	0	0	FUENTES, VANESSA JIMENEZ	9/23/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	120 W COLE BLVD	None	CALEXICO	CA	92231	9700	00	06000	32.69395652	-115.5013425	Imperial County
310364	Non-Physician Medical Practitioner	None	1194371203	0	0	FARAHZADI, THRITHI CNP	10/16/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
310414	Non-Physician Medical Practitioner	None	1477224152	0	0	FOUCH, HANNAH NP	8/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5189 HOSPITAL RD	None	MARIPOSA	CA	95338	9524	00	06000	37.50033166	-119.9769163	Mariposa County
310421	Non-Physician Medical Practitioner	None	1881986057	0	0	FIGUEROA, FRANK A NP	6/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	347 MOUNTAIN VIEW STREET	None	ALTADENA	CA	91001	4629	00	06000	34.1892527	-118.1576236	Los Angeles County
310472	Non-Physician Medical Practitioner	None	1750751533	0	0	FARZAN, DINA N	1/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2007 S BEVERLY GLEN BLVD	UNIT 102	LOS ANGELES	CA	90025	5138	00	06000	34.05309347	-118.422547	Los Angeles County
310512	Non-Physician Medical Practitioner	None	1649037029	0	0	FREDERICKS, ANNE M NP	3/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	00	06000	34.42887662	-119.7237878	Santa Barbara County
310519	Non-Physician Medical Practitioner	None	1477080869	0	0	FIESS, MATTHEW S PA-C	12/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	00	06000	36.68590557	-121.8010492	Monterey County
310524	Non-Physician Medical Practitioner	None	1821727421	0	0	FAUGHT, COURTNEY A	10/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	5965	00	06000	33.5580705	-117.1835458	Riverside County
310528	Non-Physician Medical Practitioner	None	1821270273	0	0	FISHER, DENA MARIE	8/19/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1040 N HARPER AVE	None	WEST HOLLYWOOD	CA	90046	5907	00	06000	34.08993791	-118.3691189	Los Angeles County
310539	Non-Physician Medical Practitioner	None	1104136696	0	0	FAMINI, AMY G NP	9/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	131 STONY CIR	1600	SANTA ROSA	CA	95401	9520	00	06000	38.439477	-122.7451095	Sonoma County
310557	Non-Physician Medical Practitioner	None	1689857229	0	0	FONT, SUSAN A PA-C	5/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	69780 STELLAR DR	SUITE A	RANCHO MIRAGE	CA	92270	2954	00	06000	33.76299197	-116.444597	Riverside County
310567	Non-Physician Medical Practitioner	None	1285324699	0	0	FROHBERG, SOPHIA	12/25/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1409 E BRIGGSMORE AVE	None	MODESTO	CA	95355	2707	00	06000	37.66742737	-120.9731413	Stanislaus County
310574	Non-Physician Medical Practitioner	None	1790870384	0	0	FRANCISCO, PATRICIA L PA-C	4/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1732 S 72ND ST W	None	BILLINGS	MT	59106	3500	00	06000	45.737316	-108.699975	Yellowstone County
310602	Non-Physician Medical Practitioner	None	1184391153	0	0	FENSTER, APRIL N PA	12/7/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	245 TERRACINA BLVD	SUITE 102	REDLANDS	CA	92373	4865	00	06000	34.03858912	-117.2066515	San Bernardino County
310639	Non-Physician Medical Practitioner	None	1962775924	0	0	FIELD, LAURA E PA-C	6/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3801 W TEMPLE AVE	BUILDING #46	POMONA	CA	91768	2557	00	06000	34.061508	-117.821268	Los Angeles County
310675	Non-Physician Medical Practitioner	None	1619398914	0	0	FERRARI, VHE T	3/8/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4141 NORIEGA ST	STE 2	SAN FRANCISCO	CA	94122	3958	00	06000	37.75281125	-122.5081957	San Francisco County
310683	Non-Physician Medical Practitioner	None	1114337649	0	0	FRANCO, KELLY NP	9/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	00	06000	37.55769729	-121.9808861	Alameda County
310751	Non-Physician Medical Practitioner	None	1124147285	0	0	FLORES, MARIA E	5/7/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2126 SEQUOIA AVE	None	SANGER	CA	93657	2005	00	06000	36.71722248	-119.5658341	Fresno County
310758	Non-Physician Medical Practitioner	None	1184726069	0	0	FARRAR, MICHELE F NP	2/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 LAKESIDE VILLAGE COM	None	CHICO	CA	95926	2281	00	06000	39.750084	-121.7934327	Butte County
310797	Non-Physician Medical Practitioner	None	1437226271	0	0	FILEK, BRITTANI M	3/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	680 VIEW LANE	None	CORONA	CA	92881	8347	00	06000	33.83585186	-117.5621558	Riverside County
310801	Non-Physician Medical Practitioner	None	1427236678	0	0	FIRMIN, CATHERINE PARAS	8/20/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5901 W OLYMPIC BLVD	SUITE 301	LOS ANGELES	CA	90036	4667	00	06000	34.05764121	-118.3603115	Los Angeles County
310808	Non-Physician Medical Practitioner	None	1396179586	0	0	FEDIE, JESSICA E PA-C	10/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	00	06000	38.443806	-122.701374	Sonoma County
310826	Non-Physician Medical Practitioner	None	1750342895	0	0	FENSKE, GINA L	8/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3576 HILTOP DRIVE	None	MARIPOSA	CA	95338	9795	00	06000	37.44329535	-119.8698283	Mariposa County
310837	Non-Physician Medical Practitioner	None	1013961796	0	0	FARRONAN, MARLENE F.	7/18/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9040 TELEGRAPH RD STE 10	None	DOWNEY	CA	90240	2395	00	06000	33.96022961	-118.1090321	Los Angeles County
310867	Non-Physician Medical Practitioner	None	1477903151	0	0	FUROY, JACLYN R PA	6/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	938 4TH ST	UNIT 206	SANTA MONICA	CA	90403	2629	00	06000	34.02229976	-118.5021035	Los Angeles County
310874	Non-Physician Medical Practitioner	None	1912320359	0	0	FELDKAMP, KRISTEN M NP	6/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2326 MANHATTAN AVE	None	HERMOSA BEACH	CA	90254	4430	00	06000	33.87053131	-118.4032671	Los Angeles County
310963	Non-Physician Medical Practitioner	None	1518417633	0	0	FRANCO, ARNOLD NP	8/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26730 TOWNE CENTRE DR ST	SUITE 102	FOOTHILL RANCH	CA	92610	2857	00	06000	33.67419218	-117.6628315	Orange County
310984	Non-Physician Medical Practitioner	None	1740606920	0	0	FERDIANTO, FERRY	8/15/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1393 KEARNEY AVE	None	BRONX	NY	10465	1351	00	06000	40.841622	-73.8246555	Bronx County
311131	Non-Physician Medical Practitioner	None	1124471230	0	0	FORS, JOHN	9/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	661 WINDSOR DR	None	MENLO PARK	CA	94025	5105	00	06000	37.44330712	-122.1856016	San Mateo County
311161	Non-Physician Medical Practitioner	None	1497791412	0	0	FRANCIS, LYNDA A	12/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	00	06000	36.83626596	-119.7674879	Fresno County
311177	Non-Physician Medical Practitioner	None	1023897451	0	0	FENG, JIAO CNP	11/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8112 MILLIKEN AVE	SUITE 201	RANCHO CUCAMONGA	CA	91730	7473	00	06000	34.10480366	-117.5570863	San Bernardino County
311191	Non-Physician Medical Practitioner	None	1881071959	0	0	FAJARDO, MICHAELA N	12/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	181 SOUTH MARENGO AVE	APT 2	PASADENA	CA	91101	2435	00	06000	34.14267743	-118.1459503	Los Angeles County
311221	Non-Physician Medical Practitioner	None	1316482250	0	0	FLANDEZ, JUDITH A	12/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 LOPES COURT	None	PINOLE	CA	94564	1972	00	06000	38.00636802	-122.2971136	Contra Costa County
311287	Non-Physician Medical Practitioner	None	1114051588	0	0	FERRARONE, CARLO PA	9/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
311297	Non-Physician Medical Practitioner	None	1831561448	0	0	FOFANAH, HAWANATU NP	2/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11210 4TH ST	APT 2119	RANCHO CUCAMONGA	CA	91730	6060	00	06000	34.07738753	-117.5602635	San Bernardino County
311337	Non-Physician Medical Practitioner	None	1003308347	0	0	FRANKLIN, ELIZABETH	1/7/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
311348	Non-Physician Medical Practitioner	None	1104473016	0	0	FORCHE, MAURINE B NP	2/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
311401	Non-Physician Medical Practitioner	None	1497871644	0	0	FIERRO, ROBERT A	2/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	820 W FERN DR	None	FULLERTON	CA	92832	1016	00	06000	33.87995866	-117.9405251	Orange County
311419	Non-Physician Medical Practitioner	None	1386267896	0	0	FREEMAN, TAWNEY PA-C	2/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8767 WILSHIRE BLVD	2ND AND 3RD FLOOR	BEVERLY HILLS	CA	90211	2714	00	06000	34.06704253	-118.3835029	Los Angeles County
311430	Non-Physician Medical Practitioner	None	1326680240	0	0	FANNIN, HANAAH PA-C	2/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29995 TECHNOLOGY	202	MURRIETA	CA	92563	2632	00	06000	33.56041691	-117.1370428	Riverside County
311445	Non-Physician Medical Practitioner	None	1548994171	0	0	FULP, ELIZABETH W PA	12/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
311458	Non-Physician Medical Practitioner	None	1649510330	0	0	FOSSE, KRYSTAL R NP	9/5/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1277 1/2 DEVON AVE	None	LOS ANGELES	CA	90024	5377	00	06000	34.06516626	-118.4264379	Los Angeles County
311459	Non-Physician Medical Practitioner	None	1083959464	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO INC	6/20/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	352 L ST	None	CHULA VISTA	CA	91911	1523	00	06000	32.61997526	-117.0739163	San Diego County
311464	Non-Physician Medical Practitioner	None	1265675995	0	0	FUCANAN, MARIA C NP	7/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	260 SANTIAGO LANE	None	DANVILLE	CA	94526	1976	00	06000	37.82850611	-121.9805961	Contra Costa County
311487	Non-Physician Medical Practitioner	None	1477101624	0	0	FONTEJON, RALPH VINCENT A NP	5/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	00	06000	34.2395322	-118.3939944	Los Angeles County
311541	Non-Physician Medical Practitioner	None	1801296611	0	0	FELIX, GARY J	11/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6097 N SEVENTH ST	None	FRESNO	CA	93710	5819	00	06000	36.82489584	-119.7623053	Fresno County
311577	Non-Physician Medical Practitioner	None	1508519661	0	0	FLORENTINO, ARJIE A PA-C	6/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3585 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2654	00	06000	33.93049543	-118.2057312	Los Angeles County
311643	Non-Physician Medical Practitioner	None	1255394797	0	0	FOLTZ, TAMARA	11/20/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
311653	Non-Physician Medical Practitioner	None	1942452149	0	0	FRAWLEY, ERIN C PA-C	1/22/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4128 26TH ST	None	SAN FRANCISCO	CA	94131	1915	00	06000	37.74823627	-122.4322537	San Francisco County
311692	Non-Physician Medical Practitioner	None	1740041425	0	0	FINKEL, TEALE	9/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	236 SAN JOSE	None	SALINAS	CA	93901	3901	00	06000	36.6582359	-121.6463252	Monterey County
311700	Non-Physician Medical Practitioner	None	1952625881	0	0	FOWLER, VICKIE L NP	3/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2675 HARRIS ST	None	EUREKA	CA	95503	4806	00	06000	40.78053022	-124.1369379	Humboldt County
311708	Non-Physician Medical Practitioner	None	1366083610	0	0	FULINARA, VANESSA M NP	3/26/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	00	06000	34.13682	-117.243687	San Bernardino County
311721	Non-Physician Medical Practitioner	None	1215197033	0	0	FARRELL, CHRISTINE L NP	4/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	00	06000	34.2064445	-118.8824085	Ventura County
311741	Non-Physician Medical Practitioner	None	1073769055	0	0	FLINDERS, JESSICA	7/15/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	104 LYNCH CREEK WAY	SUITE 10	PETALUMA	CA	94954	2355	00	06000	38.25218808	-122.6339241	Sonoma County
311751	Non-Physician Medical Practitioner	None	1477926319	0	0	FARABAUGH, AMY PA	8/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 E PALOMAR ST	None	CHULA VISTA	CA	91931	1800	00	06000	32.62382113	-116.9960539	San Diego County
311767	Non-Physician Medical Practitioner	None	1184828659	0	0	FICK, KIRSTEN H PA	1/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25461 RANCHO NIGUEL ROAD	None	LAGUNA NIGUEL	CA	92677	7304	00	06000	33.55527857	-117.6857875	Orange County
311804	Non-Physician Medical Practitioner	None	1134836133	0	0	FORD, BRANDI E NP	1/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	00	06000	34.2064445	-118.8824085	Ventura County
311966	Non-Physician Medical Practitioner	None	1497409403	0	0	FENTON, KRISTI L NP	11/17/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1306 MARICOPA HIGHWAY	None	OJAI	CA	93023	3131	00	06000	34.44229705	-119.2645703	Ventura County
312046	Non-Physician Medical Practitioner	None	1285954073	0	0	FREEMAN GIL, JOANNE ELIZABETH	7/23/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	240 N VIRGIL AVE	SUITE 14	LOS ANGELES	CA	90004	5399	00	06000	34.07594901	-118.2867871	Los Angeles County
312156	Non-Physician Medical Practitioner	None	1174007165	0	0	FEDERIGHI, CAROLINE PA	9/8/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	00	06000	37.89281357	-122.0598728	Contra Costa County
312174	Non-Physician Medical Practitioner	None	1750751905	0	0	FORREST JAIMES, SARA MARIE CNM	8/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2020 SUTTER PL	None	DAVIS	CA	95616	6201	00	06000	38.56287659	-121.7715536	Yolo County
312207	Non-Physician Medical Practitioner	None	1699050385	0	0	FANTOZZI, CHRISTINA L	10/23/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	669 P STREET	None	SACRAMENTO	CA	95814	6324	00	06000	38.575449	-121.500486	Sacramento County
312247	Non-Physician Medical Practitioner	None	1891330999	0	0	FIDE, AMY E NP	1/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 MEDICAL CENTER DR E	221	CLOVIS	CA	93611	6811	00	06000	36.84186593	-119.6624867	Fresno County
312250	Non-Physician Medical Practitioner	None	1518120971	0	0	FOMBRUN, FRED	11/6/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2815 DAWN CROSSING DR	None	HENDERSON	NV	89074	7018	00	06000	36.03345292	-115.111423	Clark County
312325	Non-Physician Medical Practitioner	None	1063513000	0	0	FRANCISCO, CORAZON E NP	9/6/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23181 VERDUGO DR STE 103	None	LAGUNA HILLS	CA	92653	1313	00	06000	33.62609529	-117.7293191	Orange County
312351	Non-Physician Medical Practitioner	None	1386454205	0	0	FRARY, EMMA-LEE	3/13/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	321 W HOBSONWAY	STE C	BLYTHE	CA	92225	1651	00	06000	33.61039423	-114.5999197	Riverside County
312391	Non-Physician Medical Practitioner	None	1467881821	0	0	FINGER, LISA S	10/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3393 AMHERST LANE	None	SAN JOSE	CA	95117	3010	00	06000	37.3060477	-121.9574265	Santa Clara County
312397	Non-Physician Medical Practitioner	None	1952764680	0	0	FOYABO, JUDITH M NP	5/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	140 NORTH ORANGE AVE	STE 100	WEST COVINA	CA	91790	2032	00	06000	34.07369406	-117.9431173	Los Angeles County
312421	Non-Physician Medical Practitioner	None	1982779336	0	0	FARNSWORTH, VIRGINIA MARIE	7/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	00	06000	38.00450116	-122.5540001	Marin County
312422	Non-Physician Medical Practitioner	None	1912561689	0	0	FRITZ, JULIANA R PA	12/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2850 TELEGRAPH AVE	120	BERKELEY	CA	94705	1159	00	06000	37.85808554	-122.2594469	Alameda County
312438	Non-Physician Medical Practitioner	None	1912096942	0	0	FISCH, ALLYSON ANDERS	2/13/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	900 VETERANS BLVD	SUITE 300	REDWOOD CITY	CA	94063	1715	00	06000	37.49009082	-122.2276816	San Mateo County
312491	Non-Physician Medical Practitioner	None	1225756919	0	0	FLORES, ARMANDO NP	2/2/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1207 E FLORIDA AVE	None	HEMET	CA	92543	4513	00	06000	33.74753552	-116.9593245	Riverside County
312513	Non-Physician Medical Practitioner	None	1306518196	0	0	FARIGHI, TANNAZ R NP	2/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	00	06000	33.78785649	-117.8276715	Orange County
312562	Non-Physician Medical Practitioner	None	1033512595	0	0	FALARDEAU, DENISE L NP	10/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	247A EAST LAUREL AVE	None	SIERRA MADRE	CA	91024	2018	00	06000	34.16563159	-118.047154	Los Angeles County
312564	Non-Physician Medical Practitioner	None	1275729873	0	0	FELDMAN, BRETT J	6/8/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4221 DEVON CIRCLE	None	CYPRESS	CA	90630	2713	00	06000	33.82458569	-118.0593655	Orange County
312579	Non-Physician Medical Practitioner	None	1942617089	0	0	FLORES, RONALDO	10/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4728 DONNIE LYN WY	None	CARMICHAEL	CA	95608	3520	00	06000	38.61855	-121.353093	Sacramento County
312666	Non-Physician Medical Practitioner	None	1497700066	0	0	FOMUKONG, NDIKA	4/5/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 CANAL ST	None	KING CITY	CA	93930	3432	00	06000	36.20731142	-121.1325532	Monterey County
312678	Non-Physician Medical Practitioner	None	1538807003	0	0	FISHER, SLOANE M NP	7/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
312698	Non-Physician Medical Practitioner	None	1760046742	0	0	FRISCH, BAILEY PA-C	8/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
312737	Non-Physician Medical Practitioner	None	1013167402	0	0	FAGAN, DEVONA L NP	12/4/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2 VIA SIENA PLACE	None	HENDERSON	NV	89011	2219	00	06000	36.10830909	-114.9104231	Clark County
312791	Non-Physician Medical Practitioner	None	1932561198	0	0	FAMILY HEALTH CENTERS OF SAN	6/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	525 E MAIN STREET	None	EL CAJON	CA	92020	4007	00	06000	32.79492347	-116.955981	San Diego County
312845	Non-Physician Medical Practitioner	None	1720526635	0	0	FARSAKH, JOSEPH H	4/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	363 62ND ST	UNIT A	OAKLAND	CA	94618	1241	00	06000	37.84896253	-122.2552005	Alameda County
312897	Non-Physician Medical Practitioner	None	1629472105	0	0	FROST, RYAN PA-C	1/9/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12746 W JEFFERSON BLVD	FL 2-4	LOS ANGELES	CA	90094	2885	00	06000	33.97751255	-118.417598	Los Angeles County
312914	Non-Physician Medical Practitioner	None	1922416411	0	0	FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES,	4/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4943 SLAUSON AVE	None	MAYWOOD	CA	90270	3020	00	06000	33.98616183	-118.1749602	Los Angeles County
312950	Non-Physician Medical Practitioner	None	1679996896	0	0	FLOWERS, REGINA N NP	12/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3425 GEORGE AVE	None	MODESTO	CA	94356	3255	00	06000	37.6937968	-121.0605978	Stanislaus County
312995	Non-Physician Medical Practitioner	None	1497731053	0	0	FARRELL, IAN R	4/5/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1712 CURRENT LN	None	PASO ROBLES	CA	93446	1900	00	06000	35.60964021	-120.6827375	San Luis Obispo County
313015	Non-Physician Medical Practitioner	None	1649714650	0	0	FORD, JAY D NP	4/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	101 CIVIC CTR LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	06000	34.480224	-114.3390555	Mohave County
313113	Non-Physician Medical Practitioner	None	1780888784	0	0	FRENCH, MEGAN E NP	12/28/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	117 WHARF ROW	None	REDWOOD CITY	CA	94065	1252	00	06000	37.53873654	-122.2505998	San Mateo County
313148	Non-Physician Medical Practitioner	None	1174285779	0	0	FAHEY, ALLISON	11/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	00	06000	36.68590557	-121.8010492	Monterey County
313152	Non-Physician Medical Practitioner	None	1417427469	0	0	FREITAS, ELIZABETH A NP	6/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2907 CHANTICLEER AVE	None	SANTA CRUZ	CA	95065	1815	00	06000	36.98793933	-121.9782322	Santa Cruz County
313189	Non-Physician Medical Practitioner	None	1659450641	0	0	FOSTER, MARY B.	2/10/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3001 ST ROSE PARKWAY	MOB SUITE 400	HENDERSON	NV	89052	0000	00	06000	36.00555274	-115.1163108	Clark County
313267	Non-Physician Medical Practitioner	None	1235521782	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO INC	6/19/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2325 COMMERCIAL ST	STE 1400	SAN DIEGO	CA	92113	1189	00	06000	32.70514724	-117.1429916	San Diego County
313293	Non-Physician Medical Practitioner	None	1093894594	0	0	FULLER, LA CRYSTAL L.	5/26/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1950 SUNNY CREST DR	SUITE 2800 MEDICAL CENTE	FULLERTON	CA	92835	3618	00	06000	33.89240507	-117.9313904	Orange County
313329	Non-Physician Medical Practitioner	None	1558880351	0	0	FERO, JONATHAN R NP	4/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	00	06000	37.43920432	-122.162109	Santa Clara County
313337	Non-Physician Medical Practitioner	None	1336525906	0	0	FAMILY HEALTH CENTERS	6/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	525 E MAIN STREET	None	EL CAJON	CA	92020	4007	00	06000	32.79492347	-116.955981	San Diego County
313338	Non-Physician Medical Practitioner	None	1437494515	0	0	FLOWERS, STEPHANIE R CNP	4/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1155 MILL ST	None	RENO	NV	89502	1576	00	06000	39.52483792	-119.7968314	Washoe County
313342	Non-Physician Medical Practitioner	None	1861889370	0	0	FEIZI, SEDI NP	5/31/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17161 ALVA RD	None	SAN DIEGO	CA	92127	4545	00	06000	33.02484043	-117.105197	San Diego County
313415	Non-Physician Medical Practitioner	None	1467166546	0	0	FELT, JASON NP	7/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
313428	Non-Physician Medical Practitioner	None	1972657161	0	0	FARRELL, CATHERINE CHISTINE	9/5/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2238 GEARYBLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
313442	Non-Physician Medical Practitioner	None	1275104705	0	0	FERNANDEZ, CHRISTINE M PA-C	3/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
313519	Non-Physician Medical Practitioner	None	1417668088	0	0	FUKUDA, MICHELLE PA	3/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	00	06000	34.13998921	-118.7070142	Los Angeles County
313535	Non-Physician Medical Practitioner	None	1518015460	0	0	FROST, JOHN L	2/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5403 CAMINITO HERALDO	None	LA JOLLA	CA	92037	7192	00	06000	32.81418388	-117.2524967	San Diego County
313536	Non-Physician Medical Practitioner	None	1366659252	0	0	FAHNHORST, BETH	4/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4150 CLEMENT ST	None	SAN FRANCISCO	CA	94121	1545	00	06000	37.78109398	-122.5051321	San Francisco County
313552	Non-Physician Medical Practitioner	None	1568238301	0	0	FUERTE CALDERON, GENESIS NP	2/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	403 W ADAMS BLVD	None	LOS ANGELES	CA	90007	2664	00	06000	34.02741539	-118.2743622	Los Angeles County
313576	Non-Physician Medical Practitioner	None	1992468623	0	0	FARIAS, EDGAR L PA	3/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1414 E FLORENCE AVE	None	LOS ANGELES	CA	90001	1937	00	06000	33.97471853	-118.249407	Los Angeles County
313680	Non-Physician Medical Practitioner	None	1063677581	0	0	FRAZER, JASON	8/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	616 RANGER ST	None	OAKDALE	CA	95361	8693	00	06000	37.7538882	-120.8584692	Stanislaus County
313736	Non-Physician Medical Practitioner	None	1700522539	0	0	FUNG, VICTORIA PA-C	8/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2395 LOMBARD ST	None	SAN FRANCISCO	CA	94123	2601	00	06000	37.79922688	-122.4406853	San Francisco County
313772	Non-Physician Medical Practitioner	None	1295196020	0	0	FRENKEL, ANDREY	11/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2625 E DIVISADERO ST	None	FRESNO	CA	93721	1431	00	06000	36.74334386	-119.7795358	Fresno County
313782	Non-Physician Medical Practitioner	None	1003862145	0	0	FREEMAN, BRENDA JOYCE	4/13/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13152 NEWPORT AVE	None	TUSTIN	CA	92780	3469	00	06000	33.74737358	-117.812672	Orange County
313907	Non-Physician Medical Practitioner	None	1073976528	0	0	FINLEY, MAY C NP	2/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	00	06000	35.640783	-117.6698475	Kern County
313925	Non-Physician Medical Practitioner	None	1154598092	0	0	FRANKLIN, ZELEEN AMELIA	3/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4760 S FIGUEROA ST	None	LOS ANGELES	CA	90037	3159	00	06000	33.99970148	-118.2826935	Los Angeles County
313932	Non-Physician Medical Practitioner	None	1508281148	0	0	FRACOLLI, KATIE PA	6/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
313993	Non-Physician Medical Practitioner	None	1518277508	0	0	FRANCO, DAISY GOLEZ	10/15/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 WILSHIRE BLVD	None	LOS ANGELES	CA	90057	3602	00	06000	34.0565363	-118.2728437	Los Angeles County
313995	Non-Physician Medical Practitioner	None	1982365490	0	0	FUNARI, CHRISTOPHER P PA	11/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	625 W CITRACADO PKWY	108	ESCONDIDO	CA	92025	6428	00	06000	33.09166731	-117.0784699	San Diego County
314028	Non-Physician Medical Practitioner	None	1841697596	0	0	FRANK-KREMER, LIORIT CNM	10/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	665 CAMINO DE LOS MARES	303	SAN CLEMENTE	CA	92673	2859	00	06000	33.45730192	-117.6483252	Orange County
314032	Non-Physician Medical Practitioner	None	1114953155	0	0	FIZZARD, STEPHANI Q	1/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25902 TIPPERARY LANE	None	LAKE FOREST	CA	92630	8059	00	06000	33.64950707	-117.6789884	Orange County
314051	Non-Physician Medical Practitioner	None	1730701285	0	0	FRUTH, KELLY PA-C	4/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5189 HOSPITAL RD	None	MARIPOSA	CA	95338	9524	00	06000	37.50033166	-119.9769163	Mariposa County
314083	Non-Physician Medical Practitioner	None	1538536693	0	0	FUNAHASI, JESSICA L NP	10/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	134 E PRINCETON AVENUE	None	FRESNO	CA	93704	5221	00	06000	36.77574343	-119.8100908	Fresno County
314084	Non-Physician Medical Practitioner	None	1356802763	0	0	FORSYTH, CASSIDY PA	7/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4312 WOODMAN AVENUE	SUITE 102	SHERMAN OAKS	CA	91423	5546	00	06000	34.148637	-118.4312035	Los Angeles County
314091	Non-Physician Medical Practitioner	None	1871201384	0	0	FORD, SHAWNA N CNM	1/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
314103	Non-Physician Medical Practitioner	None	1619252509	0	0	FASSETT, JOHN A CNM	1/7/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10 GLENDALE ST	206	SAN FRANCISCO	CA	94114	2702	00	06000	37.75648833	-122.4424948	San Francisco County
314137	Non-Physician Medical Practitioner	None	1942378583	0	0	FIELDS, KAREN L NP	9/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31343 LONE TREE RD	None	VALLEY HOME	CA	95361	7600	00	06000	37.82764591	-120.9263124	San Joaquin County
314145	Non-Physician Medical Practitioner	None	1275122921	0	0	FELIX, CHARLA M NP	6/7/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
314180	Non-Physician Medical Practitioner	None	1366955890	0	0	FINN, SIOBHAN C PA	3/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	00	06000	37.36217918	-121.8472051	Santa Clara County
314197	Non-Physician Medical Practitioner	None	1366057606	0	0	FALZON, MELISSA	2/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 GREENLEY RD	None	SONORA	CA	95370	4685	00	06000	37.97749352	-120.3700335	Tuolumne County
314208	Non-Physician Medical Practitioner	None	1063074755	0	0	FORDE, HAILEY PA-C	7/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3110 CHINO AVE	SUITE 150	CHINO HILLS	CA	91709	1211	00	06000	34.01077341	-117.738406	San Bernardino County
314246	Non-Physician Medical Practitioner	None	1154413946	0	0	FINCHER, JILL ANN	9/7/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	657 N TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	06000	36.180999	-115.3174815	Clark County
314295	Non-Physician Medical Practitioner	None	1659651479	0	0	FRAZER, STACY L PA-C	1/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1558 POOLE BLVD	STE B	YUBA CITY	CA	95993	2667	00	06000	39.14469453	-121.642578	Sutter County
314356	Non-Physician Medical Practitioner	None	1689319683	0	0	FAUNCE, VICTORIA NP	8/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	00	06000	36.74333844	-119.7831874	Fresno County
314388	Non-Physician Medical Practitioner	None	1326088618	0	0	FINK, STEVEN JAY	7/31/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6100 DE SOTO AVE	321	WOODLAND HILLS	CA	91367	0000	00	06000	34.181676	-118.5903735	Los Angeles County
314406	Non-Physician Medical Practitioner	None	1265754337	0	0	FEINSTEIN, EVAN E	7/10/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1353 RIDGESIDE DR	None	MONTEREY PARK	CA	91754	9491	00	06000	34.04655826	-118.1458974	Los Angeles County
314425	Non-Physician Medical Practitioner	None	1154786168	0	0	FIELDS, TATIANA W	12/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10119 RIVERSIDE DR	None	TRUCKEE	CA	96161	0303	00	06000	39.32635682	-120.1855328	Nevada County
314480	Non-Physician Medical Practitioner	None	1386156537	0	0	FELIX, MATTHEW D	11/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39425 GIANT OAK RD	None	OAKHURST	CA	93644	8911	00	06000	37.32115851	-119.6266012	Madera County
314507	Non-Physician Medical Practitioner	None	1760597769	0	0	FRENCH, JACK TODT	3/23/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1114 6TH ST	None	MODESTO	CA	95354	2203	00	06000	37.63901905	-121.0057149	Stanislaus County
314545	Non-Physician Medical Practitioner	None	1841279858	0	0	FRANQUIZ, HERMINIO JR	10/13/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1112 W HICKORY AVE	None	LOMPOC	CA	93436	7845	00	06000	34.63553011	-120.4713864	Santa Barbara County
314567	Non-Physician Medical Practitioner	None	1558515874	0	0	FLORES, DANIEL P	11/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	619 E LA VIDA AVENUE	None	VISALIA	CA	93292	4449	00	06000	36.302229	-119.286495	Tulare County
314577	Non-Physician Medical Practitioner	None	1316721335	0	0	FARQUHAR, RYAN	4/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1401 S GRANDE AVE	None	LOS ANGELES	CA	90015	3010	00	06000	34.03719097	-118.2654105	Los Angeles County
314596	Non-Physician Medical Practitioner	None	1982814638	0	0	FROGOZO, DEBBIE P	6/24/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6980 SANTA FE CANYON PL	None	SAN DIEGO	CA	92129	2251	00	06000	32.95907723	-117.167944	San Diego County
314621	Non-Physician Medical Practitioner	None	1447311170	0	0	FREDERICK, KRISTINA L	6/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	102 RODNEY AVE	None	ENCINITAS	CA	92024	2902	00	06000	33.04590877	-117.2511041	San Diego County
314662	Non-Physician Medical Practitioner	None	1649874504	0	0	FUNG, JOSEPH PA-C	5/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	707 S GARFIELD AVE	None	ALHAMBRA	CA	91801	5859	00	06000	34.088688	-118.123106	Los Angeles County
314701	Non-Physician Medical Practitioner	None	1003016049	0	0	FUJII, LORENA M NP	3/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3020 CHILDREN'S WAY	MC 5069	SAN DIEGO	CA	92123	4223	00	06000	32.798691	-117.150829	San Diego County
314736	Non-Physician Medical Practitioner	None	1669547972	0	0	FRESE, LAURA C PA	2/21/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
314747	Non-Physician Medical Practitioner	None	1134427891	0	0	FISCHER, STACEY M RN PNP	1/24/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8112 MILLIKEN AVE	SUITE 201	RANCHO CUCAMONGA	CA	91730	7473	00	06000	34.10480366	-117.5570863	San Bernardino County
314788	Non-Physician Medical Practitioner	None	1780616870	0	0	FROST, LAWRENCE J PA-C	8/29/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 CANAL ST	None	KING CITY	CA	93930	3432	00	06000	36.20731142	-121.1325532	Monterey County
314795	Non-Physician Medical Practitioner	None	1306091996	0	0	FRANKO, KATHARINE R	8/22/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 ALVISO CT	None	DANVILLE	CA	94526	5425	00	06000	37.79640173	-121.9664761	Contra Costa County
314799	Non-Physician Medical Practitioner	None	1942619069	0	0	FEE, TRACI ALEXA	10/10/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	10400 READING RD	SUITE 105	CINCINNATI	OH	45241	4816	00	06000	39.252519	-84.4209045	Hamilton County
314860	Non-Physician Medical Practitioner	None	1285700864	0	0	FOREST, CHRISTOPHER P	12/30/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12134 VICTORY BLVD	SUITE A	NORTH HOLLYWOOD	CA	91606	3205	00	06000	34.18664618	-118.3978356	Los Angeles County
314890	Non-Physician Medical Practitioner	None	1780207449	0	0	FINEGAN, NICOLE PA	11/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	00	06000	34.19395645	-118.463265	Los Angeles County
314986	Non-Physician Medical Practitioner	None	1619511706	0	0	FRAKES, NICOLE PA-C	1/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	00	06000	34.07671715	-118.3799413	Los Angeles County
315136	Non-Physician Medical Practitioner	None	1275550709	0	0	FITZSIMMONS, RICHARD	1/1/1988	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	125 SOUTH 5TH ST	None	BRAWLEY	CA	92227	0000	00	06000	32.97758931	-115.5337892	Imperial County
315209	Non-Physician Medical Practitioner	None	1689612921	0	0	FALLO, PAMELA R	8/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	726 4TH STREET	None	MARYSVILLE	CA	94901	0000	00	06000	39.13872267	-121.5944372	Yuba County
315264	Non-Physician Medical Practitioner	None	1205302403	0	0	FOSTER, AMY M PA-C	11/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8090 PARKWAY DR	None	LA MESA	CA	91942	2105	00	06000	32.77549578	-117.0233009	San Diego County
315293	Non-Physician Medical Practitioner	None	1396071908	0	0	FARAHVASHI, SHIVA	12/28/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	450 N. BEDORD DR. STE 20	None	BEVERLY HILLS	CA	90210	4306	00	06000	34.06885525	-118.4059408	Los Angeles County
315302	Non-Physician Medical Practitioner	None	1528179983	0	0	FARAH, NANCY K PA-C	9/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	00	06000	37.25111017	-121.9465891	Santa Clara County
315306	Non-Physician Medical Practitioner	None	1689203978	0	0	FRAATS, DAVID PA-C	3/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1225 NORTH H STREET	None	LOMPOC	CA	93436	3301	00	06000	34.65803329	-120.4576446	Santa Barbara County
315354	Non-Physician Medical Practitioner	None	1144384678	0	0	FENTON, ROSALIND	6/24/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	230 PROSPECT PL STE 340B	None	CORONADO	CA	92118	1991	00	06000	32.69468235	-117.1677128	San Diego County
315365	Non-Physician Medical Practitioner	None	1033759345	0	0	FREITAS, UYEN NP	1/16/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	00	06000	38.570076	-121.4657145	Sacramento County
315401	Non-Physician Medical Practitioner	None	1477953933	0	0	FAMILY HEALTH CENTERS OF SAN DIEGO, INC	6/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4874 POLK AVE	None	SAN DIEGO	CA	92105	2026	00	06000	32.75139818	-117.0895121	San Diego County
315411	Non-Physician Medical Practitioner	None	1538894597	0	0	FRICKS, ALYSSA PA	12/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	00	06000	32.75034388	-117.161023	San Diego County
315433	Non-Physician Medical Practitioner	None	1174741342	0	0	FRIDLIB, MARINA A NP	6/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	550 ORTEGA AVE	None	MOUNTAIN VIEW	CA	94040	1500	00	06000	37.3989754	-122.1056011	Santa Clara County
315442	Non-Physician Medical Practitioner	None	1659814648	0	0	FELIX, IRAN M	8/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1914 CORTE MARAVILLA	None	CHULA VISTA	CA	91914	4627	00	06000	32.67219193	-116.9920702	San Diego County
315456	Non-Physician Medical Practitioner	None	1730835083	0	0	FELD, KEREN E NP	3/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	610 EUCLID AVE	200	NATIONAL CITY	CA	91950	2951	00	06000	32.68419388	-117.0829524	San Diego County
315468	Non-Physician Medical Practitioner	None	1245540459	0	0	FLYNN, MALLORY J	3/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	402 HAIGHT STREET	None	SAN FRANCISCO	CA	94117	3598	00	06000	37.77233428	-122.4289721	San Francisco County
315505	Non-Physician Medical Practitioner	None	1912964248	0	0	FOX, JILLIAN PA	10/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
315510	Non-Physician Medical Practitioner	None	1366405896	0	0	FABROS, MILDRED G PA-C	7/9/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 DUARTE RD	DIVISION OF RADIATION ON	DUARTE	CA	91010	3012	00	06000	34.129683	-117.970857	Los Angeles County
315538	Non-Physician Medical Practitioner	None	1285786376	0	0	FLOYD, CHERYL ANN	2/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	00	06000	38.746836	-121.250529	Placer County
315582	Non-Physician Medical Practitioner	None	1023409513	0	0	FONG, AUDREY A NP	12/22/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	57 JOHN ST	None	SAN FRANCISCO	CA	94133	4810	00	06000	37.79590964	-122.4109198	San Francisco County
315591	Non-Physician Medical Practitioner	None	1427503515	0	0	FLORES, MICHAEL PA-C	10/22/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1231 N AVALON BLVD	None	WILMINGTON	CA	90744	2601	00	06000	33.78765728	-118.2630655	Los Angeles County
315593	Non-Physician Medical Practitioner	None	1194848457	0	0	FUENTES, SEBASTIAN	8/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1817 EVERGREEN AVE	None	FULLERTON	CA	92835	2124	00	06000	33.90582553	-117.8951124	Orange County
315645	Non-Physician Medical Practitioner	None	1962169334	0	0	FRENCH, NICOLE D NP	11/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	00	06000	33.12181055	-117.2840499	San Diego County
315655	Non-Physician Medical Practitioner	None	1457579989	0	0	FLETCHER, BRANDI S	11/27/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	630 VENICE WAY	UNIT 317	INGLEWOOD	CA	90302	4041	00	06000	33.96999062	-118.3660437	Los Angeles County
315704	Non-Physician Medical Practitioner	None	1477725737	0	0	FITTERER, BARBARA S	1/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	610 LANCASTER STREET	None	OAKLAND	CA	94601	2831	00	06000	37.77212646	-122.2296324	Alameda County
315709	Non-Physician Medical Practitioner	None	1477132835	0	0	FITZGERALD, IAN T PA-C	9/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	00	06000	37.66508443	-120.9962589	Stanislaus County
315739	Non-Physician Medical Practitioner	None	1770957557	0	0	FOX, KALANDRA	3/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1209 W ESPLANADE STREET	None	MESA	AZ	85201	3809	00	06000	33.433029	-111.856833	Maricopa County
315769	Non-Physician Medical Practitioner	None	1568803468	0	0	FISHER, KATHRYN L NP	8/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1984 PALMERSTON PLACE	None	LOS ANGELES	CA	90027	1816	00	06000	34.10760182	-118.2982251	Los Angeles County
315794	Non-Physician Medical Practitioner	None	1861619876	0	0	FLOOD, CANDICE ANNE	11/5/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1066 ATLANTIC AVE STE D	None	LONG BEACH	CA	90813	3400	00	06000	33.78015	-118.1850225	Los Angeles County
315796	Non-Physician Medical Practitioner	None	1891985479	0	0	FREEMAN, ROBERTA	4/15/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	00	06000	34.06473399	-118.445865	Los Angeles County
315831	Non-Physician Medical Practitioner	None	1508323361	0	0	FELTER, BRENDA M NP	4/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	00	06000	34.13502	-117.2758635	San Bernardino County
315842	Non-Physician Medical Practitioner	None	1023680196	0	0	FLATTERY, DELANEY PA-C	2/5/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7257 FRESNO	FIRST FLOOR	FRESNO	CA	93720	2950	00	06000	36.84225164	-119.7833937	Fresno County
315844	Non-Physician Medical Practitioner	None	1780093237	0	0	FLAMING, SUSAN L NP	3/8/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18785 BROOKHURST STREET	STE 101	FOUNTAIN VALLEY	CA	92708	7300	00	06000	33.68987636	-117.9542321	Orange County
315848	Non-Physician Medical Practitioner	None	1558854612	0	0	FESSLER, LAURA NP	12/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4950 BARRANCA PARKWAY	SUITE 104	IRVINE	CA	92604	4630	00	06000	33.67620851	-117.7948348	Orange County
315874	Non-Physician Medical Practitioner	None	1205101987	0	0	FURLONG, KATHLEEN M NP	8/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3 NIGHT HERON LN	None	ALISO VIEJO	CA	92656	2200	00	06000	33.60236236	-117.7424284	Orange County
315901	Non-Physician Medical Practitioner	None	1669442778	0	0	FONSECA, TERESA A S NP	2/22/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24214 KHAN DR	None	LOMA LINDA	CA	92354	4877	00	06000	34.05044201	-117.2760261	San Bernardino County
316009	Non-Physician Medical Practitioner	None	1205044104	0	0	FRANCIS, DENICHE J	8/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1429 W 92ND ST	None	LOS ANGELES	CA	90047	3628	00	06000	33.95274948	-118.3013781	Los Angeles County
316013	Non-Physician Medical Practitioner	None	1215023718	0	0	FRANKLIN, NICOLE M	7/30/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4 NEWBURY WAY	None	LADERA RANCH	CA	92694	0519	00	06000	33.56266915	-117.6361415	Orange County
316071	Ordering, Referring, Prescribing	N/A	1003048521	0	0	FILIPIOGLU-FAGO, ALIS PHARMD	5/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	41879	N/A	N/A	N/A	N/A	N/A	895 E H ST	None	CHULA VISTA	CA	91910	7807	00	06000	32.63598747	-117.022005	San Diego County
316092	Ordering, Referring, Prescribing	N/A	1003103581	0	0	FRAUSTO, STEVEN LCSW	1/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71909	N/A	N/A	N/A	N/A	N/A	222 W SIXTH STREET	230	SAN PEDRO	CA	90221	3332	00	06000	33.73876969	-118.2824628	Los Angeles County
316096	Ordering, Referring, Prescribing	N/A	1003110917	0	0	FRY, LIANE M LMFT	5/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42570	N/A	N/A	N/A	N/A	N/A	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.55831005	-117.0475102	San Diego County
316141	Ordering, Referring, Prescribing	N/A	1003176249	0	0	FAJARDO, STEFANIE LCSW	10/29/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89746	N/A	N/A	N/A	N/A	N/A	21840 NORMANDIE AVENUE	SUITE 500	TORRANCE	CA	90502	2047	00	06000	33.82982744	-118.2991395	Los Angeles County
316169	Ordering, Referring, Prescribing	N/A	1003212275	0	0	FARBER, RACHEL LAC	8/23/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC6901	N/A	N/A	N/A	N/A	N/A	21507 E CLIFF DR	None	SANTA CRUZ	CA	95062	4844	00	06000	36.96330203	-121.9900666	Santa Cruz County
316185	Ordering, Referring, Prescribing	N/A	1003227877	0	0	FRAUSTO, KRYSTAL LPCC	3/22/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC6542	N/A	N/A	N/A	N/A	N/A	17800 HIGHWAY 18	None	APPLE VALLEY	CA	92307	0009	00	06000	34.54007429	-117.2744761	San Bernardino County
316216	Ordering, Referring, Prescribing	N/A	1003270505	0	0	FEESE, MIRIAM R LCSW	4/13/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101097	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	None	WEIMAR	CA	95736	0486	00	06000	39.03521526	-120.9755343	Placer County
316249	Ordering, Referring, Prescribing	N/A	1003318023	0	0	FUENTES, IVANNIA LMFT	7/1/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT133530	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
316254	Ordering, Referring, Prescribing	N/A	1003328402	0	0	FUNG, RICHARD PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77338	N/A	N/A	N/A	N/A	N/A	8209 MCGRAW HILL DRIVE	None	BAKERSFIELD	CA	93311	1755	00	06000	35.33686851	-119.0945138	Kern County
316275	Ordering, Referring, Prescribing	N/A	1003356296	0	0	FERNANDES, RONALD LPCC	7/11/2023	Taxonomy not applicable	NA	n/a	000	Unknown	14111	N/A	N/A	N/A	N/A	N/A	108 W VICTORIA ST	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
316323	Ordering, Referring, Prescribing	N/A	1003415472	0	0	FLORES, RYANLEO NP	9/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95013892	N/A	N/A	N/A	N/A	N/A	2017 FIRST AVE	301	SAN DIEGO	CA	92101	2033	00	06000	32.72646147	-117.1638767	San Diego County
316351	Ordering, Referring, Prescribing	N/A	1003453192	0	0	FILLY, JOSEPH M PHARMD	7/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80881	N/A	N/A	N/A	N/A	N/A	1301 E 17TH ST	None	SANTA ANA	CA	92705	8503	00	06000	33.75995053	-117.851211	Orange County
316417	Ordering, Referring, Prescribing	N/A	1003691320	0	0	FUNG, DARLENE PHARMD	8/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88331	N/A	N/A	N/A	N/A	N/A	1051 W BURBANK BLVD	None	BURBANK	CA	91506	1421	00	06000	34.186032	-118.324359	Los Angeles County
316421	Ordering, Referring, Prescribing	N/A	1003814765	0	0	FORTNER, WENDE D H NP	4/10/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	444305	N/A	N/A	N/A	N/A	N/A	5000 ROCKLIN ROAD	None	ROCKLIN	CA	95677	3337	00	06000	38.790729	-121.2153525	Placer County
316449	Ordering, Referring, Prescribing	N/A	1003940180	0	0	FORNASIER, VANESSA I LMFT	12/28/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47766	N/A	N/A	N/A	N/A	N/A	11850 SEBASTIAN WAY	104	RANCHO CUCAMONGA	CA	91730	0703	00	06000	34.10422153	-117.546741	San Bernardino County
316470	Ordering, Referring, Prescribing	N/A	1003970443	0	0	FRAKA, KENDRA E LCSW	7/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23782	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
316472	Ordering, Referring, Prescribing	N/A	1003978917	0	0	FRANK, RICHARD A LMFT	12/13/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT21400	N/A	N/A	N/A	N/A	N/A	631 TENNESSEE ST	None	VALLEJO	CA	94590	4432	00	06000	38.10992398	-122.2522919	Solano County
316480	Ordering, Referring, Prescribing	N/A	1003987587	0	0	FLANIGAN, KEVIN S MD	6/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G156347	N/A	N/A	N/A	N/A	N/A	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	00	06000	35.640783	-117.6698475	Kern County
316482	Ordering, Referring, Prescribing	N/A	1003993379	0	0	FULMER, ROBIN M LCSW	3/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26385	N/A	N/A	N/A	N/A	N/A	1861 SILVERWOOD DR	None	CONCORD	CA	94519	1352	00	06000	37.98555372	-122.0030109	Contra Costa County
316498	Ordering, Referring, Prescribing	N/A	1013036888	0	0	FISCHER, KAREN A LMFT	9/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT46699	N/A	N/A	N/A	N/A	N/A	2731 NUGGET AVE	None	LAKE ISABELLA	CA	93240	1101	00	06000	35.62655748	-118.4731192	Kern County
316527	Ordering, Referring, Prescribing	N/A	1013080449	0	0	FANG, JOHN LAC	8/17/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC6976	N/A	N/A	N/A	N/A	N/A	16200 AMBER VALLEY DR	None	WHITTIER	CA	90604	4051	00	06000	33.92458653	-117.9826605	Los Angeles County
316550	Ordering, Referring, Prescribing	N/A	1013115740	0	0	FLOOD, TIFFANY LCSW	11/4/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27330	N/A	N/A	N/A	N/A	N/A	108 W VICTORIA ST	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
316580	Ordering, Referring, Prescribing	N/A	1013183763	0	0	FLORES, RUTH D LMFT	12/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103771	N/A	N/A	N/A	N/A	N/A	3161 DWIGHT RD	None	ELK GROVE	CA	95758	6456	00	06000	38.427372	-121.4606025	Sacramento County
316584	Ordering, Referring, Prescribing	N/A	1013189448	0	0	FLORES, MICHELLE LMFT	7/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84536	N/A	N/A	N/A	N/A	N/A	500 CITY PKWY W	#200	ORANGE	CA	92868	2941	00	06000	33.78299346	-117.895788	Orange County
316595	Ordering, Referring, Prescribing	N/A	1013212430	0	0	FAYAD, HOUSSAM MD	4/27/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133149	N/A	N/A	N/A	N/A	N/A	18601 VALLEY BLVD	None	BLOOMINGTON	CA	92316	1831	00	06000	34.07045653	-117.3982455	San Bernardino County
316630	Ordering, Referring, Prescribing	N/A	1013272061	0	0	FABIAN, BONNIE PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65556	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	5C063	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
316635	Ordering, Referring, Prescribing	N/A	1013279132	0	0	FAVIS, TARA L NP	10/2/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013467	N/A	N/A	N/A	N/A	N/A	77 CADILLAC DRIVE	SUITE 200	SACRAMENTO	CA	95825	8337	00	06000	38.572551	-121.4181585	Sacramento County
316698	Ordering, Referring, Prescribing	N/A	1013371004	0	0	FALLON, TINA U MD	2/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A161739	N/A	N/A	N/A	N/A	N/A	2210 MESA DR	SUITE 300	OCEANSIDE	CA	92054	3756	00	06000	33.20786753	-117.3579677	San Diego County
316719	Ordering, Referring, Prescribing	N/A	1013398973	0	0	FLORES, LARAVIC T MD	8/20/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151665	N/A	N/A	N/A	N/A	N/A	700 ADELINE ST	None	OAKLAND	CA	94607	2608	00	06000	37.80430011	-122.2879962	Alameda County
316723	Ordering, Referring, Prescribing	N/A	1013399450	0	0	FARZAMDOOST, SHOULAMIT G PHARMD	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60076	N/A	N/A	N/A	N/A	N/A	1268 MADERA RD	None	SIMI VALLEY	CA	93065	4002	00	06000	34.261767	-118.796193	Ventura County
316768	Ordering, Referring, Prescribing	N/A	1013478023	0	0	FREEDMAN, JESSICA LCSW	10/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88503	N/A	N/A	N/A	N/A	N/A	1100 MAIN ST.	B	FORTUNA	CA	95540	2024	00	06000	40.59800573	-124.1553951	Humboldt County
316781	Ordering, Referring, Prescribing	N/A	1013494749	0	0	FARRIOR, VANESSA LCSW	6/22/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW102114	N/A	N/A	N/A	N/A	N/A	4990 WILLIAMS AVE	None	LA MESA	CA	91942	7409	00	06000	32.76933362	-117.0371085	San Diego County
316840	Ordering, Referring, Prescribing	N/A	1013680123	0	0	FUENTES, WENDY T LMFT	6/29/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126714	N/A	N/A	N/A	N/A	N/A	840 N AVENUE 66	None	LOS ANGELES	CA	90042	1508	00	06000	34.12110842	-118.1725545	Los Angeles County
316851	Ordering, Referring, Prescribing	N/A	1013739416	0	0	FOX, DEVYN PA	2/20/2025	Taxonomy not applicable	NA	n/a	000	Unknown	66001	N/A	N/A	N/A	N/A	N/A	316 S STRATFORD AVE	STE B	SANTA MARIA	CA	93454	0001	00	06000	34.95019447	-120.4147816	Santa Barbara County
316858	Ordering, Referring, Prescribing	N/A	1013924141	0	0	FABRIS, CECILIA LMFT	12/28/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91250	N/A	N/A	N/A	N/A	N/A	415 W FOOTHILL BLVD	217	CLAREMONT	CA	91711	2766	00	06000	34.10715265	-117.7210551	Los Angeles County
316859	Ordering, Referring, Prescribing	N/A	1013947597	0	0	FERREN, PETER M MD	1/11/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79672	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
316882	Ordering, Referring, Prescribing	N/A	1013974880	0	0	FIALKOFF, HENIE MD	6/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A48416	N/A	N/A	N/A	N/A	N/A	4211 S. AVALON BLVD.	BUILDING A	LOS ANGELES	CA	90011	0000	00	06000	34.007238	-118.2653065	Los Angeles County
316916	Ordering, Referring, Prescribing	N/A	1023152600	0	0	FROILAN, MARIA P LMFT	2/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT38702	N/A	N/A	N/A	N/A	N/A	3569 LEXINGTON AVE	None	EL MONTE	CA	91731	2606	00	06000	34.0744277	-118.039296	Los Angeles County
316941	Ordering, Referring, Prescribing	N/A	1023200466	0	0	FAUCHEUX, SHANNON B LCSW	11/27/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75074	N/A	N/A	N/A	N/A	N/A	29632 HWY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0228	00	06000	40.80385331	-121.9397745	Shasta County
316949	Ordering, Referring, Prescribing	N/A	1023217767	0	0	FAKHRABADI, HAYDEH	11/17/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	22502	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
316955	Ordering, Referring, Prescribing	N/A	1023228566	0	0	FANCHER, TAMARA K PA-C	2/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	18358	N/A	N/A	N/A	N/A	N/A	700 S. TUSTIN STREET	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
316984	Ordering, Referring, Prescribing	N/A	1023311503	0	0	FARBER, JOEL S LCSW	12/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99295	N/A	N/A	N/A	N/A	N/A	811 GRAND AVE	D	SACRAMENTO	CA	95838	3466	00	06000	38.637621	-121.4470125	Sacramento County
316995	Ordering, Referring, Prescribing	N/A	1023334125	0	0	FAITH, KRISTEN D MD	3/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	MD20130485	N/A	N/A	N/A	N/A	N/A	1100 CENTRAL AVE SE	None	ALBUQUERQUE	NM	87106	4930	00	06000	35.08239279	-106.6353509	Bernalillo County
317012	Ordering, Referring, Prescribing	N/A	1023366077	0	0	FERNANDEZ, PRISCILLA E LCSW	5/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94895	N/A	N/A	N/A	N/A	N/A	9660 HAVEN AVE	203	RANCHO CUCAMONGA	CA	91701	0001	00	06000	34.08001728	-117.5758578	San Bernardino County
317233	Ordering, Referring, Prescribing	N/A	1023851995	0	0	FRANK, MEGAN R	2/12/2024	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236436	N/A	N/A	N/A	N/A	N/A	760 RENZ LN	None	GILROY	CA	95020	9584	00	06000	37.00466254	-121.5555242	Santa Clara County
317237	Ordering, Referring, Prescribing	N/A	1023896073	0	0	FRAKES, KRISTYNA B PHARMD	9/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88657	N/A	N/A	N/A	N/A	N/A	745 W NAOMI AVE	None	ARCADIA	CA	91007	7517	00	06000	34.12373262	-118.0574689	Los Angeles County
317241	Ordering, Referring, Prescribing	N/A	1023897451	0	0	FENG, JIAO CNP	6/28/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025735	N/A	N/A	N/A	N/A	N/A	8112 MILLIKEN AVE	201	RANCHO CUCAMONGA	CA	91730	7471	00	06000	34.10480366	-117.5570863	San Bernardino County
317271	Ordering, Referring, Prescribing	N/A	1033214010	0	0	FURST, BENJAMIN A MD	11/10/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A81540	N/A	N/A	N/A	N/A	N/A	1968 W ADAMS BLVD	101	LOS ANGELES	CA	90018	3515	00	06000	34.03266053	-118.3081635	Los Angeles County
317310	Ordering, Referring, Prescribing	N/A	1033276696	0	0	FRANCK, LEELIA MD	9/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A121957	N/A	N/A	N/A	N/A	N/A	21507 E CLIFF DR	None	SANTA CRUZ	CA	95062	4844	00	06000	36.96330203	-121.9900666	Santa Cruz County
317312	Ordering, Referring, Prescribing	N/A	1033248091	0	0	FRANCO, EVELIO	3/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52548	N/A	N/A	N/A	N/A	N/A	3303 N. BROADWAY BLVD.	None	LOS ANGELES	CA	90031	0000	00	06000	34.07380397	-118.20586	Los Angeles County
317337	Ordering, Referring, Prescribing	N/A	1033310081	0	0	FERRER, ROBERT LMFT	2/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113230	N/A	N/A	N/A	N/A	N/A	988 MCCOURTNEY RD	None	GRASS VALLEY	CA	95949	7400	00	06000	39.2089732	-121.0729043	Nevada County
317411	Ordering, Referring, Prescribing	N/A	1033446638	0	0	FIGUEROA, ARTURO LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27811	N/A	N/A	N/A	N/A	N/A	1831 RIDGE RD	None	BAKERSFIELD	CA	93305	4119	00	06000	35.38658088	-118.9697274	Kern County
317610	Ordering, Referring, Prescribing	N/A	1033759345	0	0	FREITAS, UYEN H NP	3/2/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024463	N/A	N/A	N/A	N/A	N/A	1540 FLORIDA AVENUE	None	MODESTO	CA	95350	4408	00	06000	37.667115	-120.9962205	Stanislaus County
317724	Ordering, Referring, Prescribing	N/A	1043379407	0	0	FRIEDLANDER, SANFORD L LMFT	7/13/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	34501	N/A	N/A	N/A	N/A	N/A	676 PISMO ST	None	SAN LUIS OBISPO	CA	93401	3945	00	06000	35.27640631	-120.6628883	San Luis Obispo County
317734	Ordering, Referring, Prescribing	N/A	1043403181	0	0	FLORES, SHELLI LMFT	8/11/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51261	N/A	N/A	N/A	N/A	N/A	17800 HIGHWAY 18	None	APPLE VALLEY	CA	92307	0000	00	06000	34.54007429	-117.2744761	San Bernardino County
317745	Ordering, Referring, Prescribing	N/A	1043420284	0	0	FRIEDLANDER, FAITH A LMFT	9/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT28413	N/A	N/A	N/A	N/A	N/A	864 E SANTA CLARA ST	None	VENTURA	CA	93001	2939	00	06000	34.27952351	-119.287537	Ventura County
317769	Ordering, Referring, Prescribing	N/A	1043472970	0	0	FRANCIS, SHANI MD	11/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C150098	N/A	N/A	N/A	N/A	N/A	1700 N. ROSE AVE	450	OXNARD	CA	93030	7626	00	06000	34.21746	-119.155545	Ventura County
317922	Ordering, Referring, Prescribing	N/A	1043729262	0	0	FARGO, NABEEL DC	5/27/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	33808	N/A	N/A	N/A	N/A	N/A	1303 W 6TH ST	SUITE 105	CORONA	CA	92882	3196	00	06000	33.87785815	-117.5891694	Riverside County
317934	Ordering, Referring, Prescribing	N/A	1043743362	0	0	FU, KATHERINE A MD	4/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158439	N/A	N/A	N/A	N/A	N/A	300 UCLA MEDICAL PLZ	SUITE B200	LOS ANGELES	CA	90095	8346	00	06000	34.06465655	-118.4461	Los Angeles County
318150	Ordering, Referring, Prescribing	N/A	1053476663	0	0	FOO, LOUISE H PHD	6/30/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	18413	N/A	N/A	N/A	N/A	N/A	1385 MISSION STREET	SUITE 200	SAN FRANCISCO	CA	94103	2631	00	06000	37.77552014	-122.4155639	San Francisco County
318165	Ordering, Referring, Prescribing	N/A	1053503326	0	0	FRANCIS, JANETTE CNP	12/14/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	13156	N/A	N/A	N/A	N/A	N/A	29101 HOSPITAL RD	None	LAKE ARROWHEAD	CA	92352	0070	00	06000	34.26577765	-117.1695461	San Bernardino County
318168	Ordering, Referring, Prescribing	N/A	1053513309	0	0	FANY, RACHEL H PHARMD	10/17/2018	Taxonomy not applicable	NA	n/a	000	Unknown	58473	N/A	N/A	N/A	N/A	N/A	1444 SHATTUCK PLACE	BERKELEY	CA	CA	94709	1411	00	06000	37.88110279	-122.2697021	Alameda County
318178	Ordering, Referring, Prescribing	N/A	1053523712	0	0	FOXFOOT, CINDY A	1/24/2018	Taxonomy not applicable	NA	n/a	082	LICENSED MIDWIVES	131	N/A	N/A	N/A	N/A	N/A	17064 OLD DOWNIEVILLE HW	None	NEVADA CITY	CA	95959	8748	00	06000	39.2645607	-121.0508751	Nevada County
318209	Ordering, Referring, Prescribing	N/A	1053580035	0	0	FISHELL, BETHANNE M PSYD	3/4/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28111	N/A	N/A	N/A	N/A	N/A	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
318295	Ordering, Referring, Prescribing	N/A	1053716233	0	0	FOLTZ, DANIELLE NP	10/26/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001158	N/A	N/A	N/A	N/A	N/A	4618 FOUNTAIN AVE	None	LOS ANGELES	CA	90029	1830	00	06000	34.095582	-118.290195	Los Angeles County
318356	Ordering, Referring, Prescribing	N/A	1053784215	0	0	FRENCH, JOZELLA M LMFT	8/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121025	N/A	N/A	N/A	N/A	N/A	1300 S GRAND AVE	BLDG C, STE 213-W	SANTA ANA	CA	92705	4434	00	06000	33.73222238	-117.8504455	Orange County
318479	Ordering, Referring, Prescribing	N/A	1063052207	0	0	FERREIRA, LEAH LMFT	10/14/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128659	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS STE 22	STE 220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
318514	Ordering, Referring, Prescribing	N/A	1063181428	0	0	FAUST, REIKA LMFT	4/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138938	N/A	N/A	N/A	N/A	N/A	491 FERNWOOD DR	None	SAN BRUNO	CA	94066	1944	00	06000	37.63397527	-122.4410958	San Mateo County
318523	Ordering, Referring, Prescribing	N/A	1063268902	0	0	FLORES, TERESA D	4/10/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95029761	N/A	N/A	N/A	N/A	N/A	3229 HOLLYPARK DRIVE	UNIT 3	INGLEWOOD	CA	90305	0001	00	06000	33.95447708	-118.3285362	Los Angeles County
318526	Ordering, Referring, Prescribing	N/A	1063294668	0	0	FLORES, STACEY A NP	10/12/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95196387	N/A	N/A	N/A	N/A	N/A	1116 LEGEND CIR	None	VALLEJO	CA	94591	8679	00	06000	38.13009187	-122.2155732	Solano County
318529	Ordering, Referring, Prescribing	N/A	1063277325	0	0	FURTADO, GENALINDA	6/6/2023	Taxonomy not applicable	NA	n/a	000	Unknown	467367	N/A	N/A	N/A	N/A	N/A	150 DISTRICT CENTER DR	None	PALM DESERT	CA	92264	3626	00	06000	33.82485354	-116.4955129	Riverside County
318547	Ordering, Referring, Prescribing	N/A	1063449155	0	0	FERNANDEZ, ROWENA C LCSW	4/11/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW16840	N/A	N/A	N/A	N/A	N/A	27800 MEDICAL CENTER RD	SUITE 110	MISSION VIEJO	CA	92691	6410	00	06000	33.55952733	-117.6645199	Orange County
318563	Ordering, Referring, Prescribing	N/A	1063518868	0	0	FISHER, MASARU J MD	3/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80499	N/A	N/A	N/A	N/A	N/A	760 HARRISON STREET	None	SAN FRANCISCO	CA	94107	1235	00	06000	37.78155484	-122.3987081	San Francisco County
318572	Ordering, Referring, Prescribing	N/A	1063533271	0	0	FILLET, PAUL DMD	2/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	28312	N/A	N/A	N/A	N/A	N/A	343 OAK ST	None	RED BLUFF	CA	96080	3304	00	06000	40.17616563	-122.2349564	Tehama County
318584	Ordering, Referring, Prescribing	N/A	1063543684	0	0	FIERRO, JOSEPH A LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48179	N/A	N/A	N/A	N/A	N/A	1870 N MAIN ST	None	SALINAS	CA	93906	2042	00	06000	36.71784314	-121.6554107	Monterey County
318607	Ordering, Referring, Prescribing	N/A	1063580322	0	0	FEDASZ, JEANETTE L CNP	9/5/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	15814	N/A	N/A	N/A	N/A	N/A	3095 YERBA BUENA ROAD	None	SAN JOSE	CA	95135	1513	00	06000	37.300122	-121.7627775	Santa Clara County
318635	Ordering, Referring, Prescribing	N/A	1063639045	0	0	FOX, ROGER E MD	7/31/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A46325	N/A	N/A	N/A	N/A	N/A	1375 CAMINO REAL	#130	SAN BERNARDINO	CA	92408	2764	00	06000	34.07548152	-117.2966625	San Bernardino County
318684	Ordering, Referring, Prescribing	N/A	1063727550	0	0	FALCON, CHRISTINA PSYD	12/21/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27011	N/A	N/A	N/A	N/A	N/A	1500 S MCDONNELL AVE	None	COMMERCE	CA	90040	5623	00	06000	34.01248474	-118.1699451	Los Angeles County
318778	Ordering, Referring, Prescribing	N/A	1063842631	0	0	FUENTES, EDWARD R LMFT	5/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105637	N/A	N/A	N/A	N/A	N/A	401 IMPERIAL HWY	None	FULLERTON	CA	92835	1145	00	06000	33.91748848	-117.925704	Orange County
318791	Ordering, Referring, Prescribing	N/A	1063870343	0	0	FARLEY, JENNIFER LPCC	3/15/2024	Taxonomy not applicable	NA	n/a	000	Unknown	2700	N/A	N/A	N/A	N/A	N/A	700 FREDERICK ST	SUITE 103	SANTA CRUZ	CA	95062	2239	00	06000	36.98031434	-122.004438	Santa Cruz County
318848	Ordering, Referring, Prescribing	N/A	1063936946	0	0	FEREDAY, LAUREN E OD	12/9/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33774	N/A	N/A	N/A	N/A	N/A	12880 CARMEL COUNTRY ROA	D110	SAN DIEGO	CA	92130	3137	00	06000	32.95455912	-117.2293046	San Diego County
318899	Ordering, Referring, Prescribing	N/A	1073032389	0	0	FRAZIER-PHILO, KRYSTLE R	6/30/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31885	N/A	N/A	N/A	N/A	N/A	461 TENNESSEE ST	SUITE C	REDLANDS	CA	92373	8161	00	06000	34.058745	-117.2000975	San Bernardino County
318910	Ordering, Referring, Prescribing	N/A	1073057196	0	0	FRANK, EMILY L	6/28/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101264	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
318934	Ordering, Referring, Prescribing	N/A	1073087029	0	0	FARAJ, NADIA P	2/27/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113898	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE	None	OAKLAND	CA	94602	3311	00	06000	37.8007257	-122.2064578	Alameda County
318957	Ordering, Referring, Prescribing	N/A	1073137212	0	0	FALLS, LAKEISHA S CNP	7/27/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022027	N/A	N/A	N/A	N/A	N/A	1305 BEAR MOUNTAIN BLVD	None	ARVIN	CA	93203	1231	00	06000	35.20895551	-118.839294	Kern County
318966	Ordering, Referring, Prescribing	N/A	1073161071	0	0	FRANCO, TAYLER C PA-C	10/11/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57349	N/A	N/A	N/A	N/A	N/A	307 PLACENTIA AVE.	107	NEWPORT BEACH	CA	92663	3307	00	06000	33.62631386	-117.9310576	Orange County
318994	Ordering, Referring, Prescribing	N/A	1073248324	0	0	FIGUEROA, NELLIE NP	6/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95021362	N/A	N/A	N/A	N/A	N/A	1414 S GRAND AVE	456	LOS ANGELES	CA	90015	3071	00	06000	34.03661142	-118.2657227	Los Angeles County
319191	Ordering, Referring, Prescribing	N/A	1073948931	0	0	FINCH, JACQUELINE W LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82996	N/A	N/A	N/A	N/A	N/A	11303 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	6003	00	06000	34.00408212	-118.4147433	Los Angeles County
319194	Ordering, Referring, Prescribing	N/A	1073955829	0	0	FOWLER, ELENA C LCSW	6/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76514	N/A	N/A	N/A	N/A	N/A	1385 MISSION ST	STE 200	SAN FRANCISCO	CA	94103	2623	00	06000	37.77552014	-122.4155639	San Francisco County
319202	Ordering, Referring, Prescribing	N/A	1073969465	0	0	FLORES, EILEEN M LMFT	4/8/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146255	N/A	N/A	N/A	N/A	N/A	1045 N LAKE AVE	None	PASADENA	CA	91104	4521	00	06000	34.16394511	-118.1324885	Los Angeles County
319209	Ordering, Referring, Prescribing	N/A	1073976478	0	0	FENG, KENT Y MD	6/9/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160534	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
319257	Ordering, Referring, Prescribing	N/A	1083030985	0	0	FINCH, THOMAS K PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69667	N/A	N/A	N/A	N/A	N/A	2000 PORTOLA AVE	None	LIVERMORE	CA	94551	1762	00	06000	37.69125899	-121.7746983	Alameda County
319269	Ordering, Referring, Prescribing	N/A	1083050207	0	0	FRAGOSO, ROBERT LMFT	9/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121957	N/A	N/A	N/A	N/A	N/A	190 SIERRA COURT, UNIT C	None	PALMDALE	CA	93550	7609	00	06000	34.64013337	-118.1280539	Los Angeles County
319303	Ordering, Referring, Prescribing	N/A	1083097968	0	0	FAGOUT, REGINA LMFT	1/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112511	N/A	N/A	N/A	N/A	N/A	2667 CAMINO DEL RIO S	301-1	SAN DIEGO	CA	92108	3707	00	06000	32.76977026	-117.135564	San Diego County
319351	Ordering, Referring, Prescribing	N/A	1083169643	0	0	FITZGERALD, TAMARA OT	9/21/2022	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	15759	N/A	N/A	N/A	N/A	N/A	875 EL CAJON BLVD	None	EL CAJON	CA	92020	5714	00	06000	32.78535272	-116.9770049	San Diego County
319379	Ordering, Referring, Prescribing	N/A	1083223382	0	0	FENDER, SARAH NP	7/2/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	F07200288	N/A	N/A	N/A	N/A	N/A	7275 E SOUTHGATE DR	204	SACRAMENTO	CA	95823	2629	00	06000	38.493576	-121.436559	Sacramento County
319456	Ordering, Referring, Prescribing	N/A	1083493100	0	0	FERNANDO, MAVIS NP	7/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026155	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
319466	Ordering, Referring, Prescribing	N/A	1083673792	0	0	FRANKLIN, LYDIA M CNP	6/9/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007768	N/A	N/A	N/A	N/A	N/A	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	00	06000	35.640783	-117.6698475	Kern County
319510	Ordering, Referring, Prescribing	N/A	1083787022	0	0	FAILOR, SCOTT H	9/17/2017	Taxonomy not applicable	NA	n/a	000	Unknown	14691	N/A	N/A	N/A	N/A	N/A	21507 E CLIFF DR	None	SANTA CRUZ	CA	95062	4844	00	06000	36.96330203	-121.9900666	Santa Cruz County
319514	Ordering, Referring, Prescribing	N/A	1083793335	0	0	FRITCH, MICHAEL A LMFT	12/29/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39822	N/A	N/A	N/A	N/A	N/A	1125 MISSOURI ST	SUITE 101	FAIRFIELD	CA	94533	6000	00	06000	38.24811048	-122.047884	Solano County
319539	Ordering, Referring, Prescribing	N/A	1083849848	0	0	FERRIS, JANICE	9/17/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	14982	N/A	N/A	N/A	N/A	N/A	4233 DON ALANIS PL	None	LOS ANGELES	CA	90008	4201	00	06000	34.00869089	-118.3477634	Los Angeles County
319545	Ordering, Referring, Prescribing	N/A	1083856355	0	0	FISHER, SCOTT LMFT	4/6/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132161	N/A	N/A	N/A	N/A	N/A	768 PLEASANT VALLEY RD	None	DIAMOND SPRINGS	CA	95619	9260	00	06000	38.69498433	-120.8070771	El Dorado County
319562	Ordering, Referring, Prescribing	N/A	1083911135	0	0	FLORES, SARAH O	5/28/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0742833	N/A	N/A	N/A	N/A	N/A	1119 PACIFIC AVE	STE G	SANTA CRUZ	CA	95060	7503	00	06000	36.9722444	-122.0256836	Santa Cruz County
319586	Ordering, Referring, Prescribing	N/A	1083943757	0	0	FEES, CASSAUNDRA PHD	5/21/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	28396	N/A	N/A	N/A	N/A	N/A	467 HAMILTON AVE.	STE. 23	PALO ALTO	CA	94301	1828	00	06000	37.44718736	-122.1582933	Santa Clara County
319736	Ordering, Referring, Prescribing	N/A	1093183196	0	0	FONG, BENJAMIN	10/14/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73203	N/A	N/A	N/A	N/A	N/A	4860 Y ST	1200	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
319757	Ordering, Referring, Prescribing	N/A	1093202749	0	0	FAN, KATHERINE LMFT	1/13/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125274	N/A	N/A	N/A	N/A	N/A	455 1ST STREET	None	WOODLAND	CA	95669	4023	00	06000	38.675781	-121.773122	Yolo County
319821	Ordering, Referring, Prescribing	N/A	1093316168	0	0	FETT, ERICA LCSW	4/7/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW1549	N/A	N/A	N/A	N/A	N/A	2521 E 15TH ST	None	CASPER	WY	82609	4126	00	06000	42.834753	-106.2938295	Natrona County
319891	Ordering, Referring, Prescribing	N/A	1093709586	0	0	FLANIGAN, KATHLEEN M LCSW	8/22/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	10380	N/A	N/A	N/A	N/A	N/A	741 GARDEN VIEW COURT	109	ENCINITAS	CA	92024	2471	00	06000	33.05965324	-117.2605596	San Diego County
319906	Ordering, Referring, Prescribing	N/A	1093772139	0	0	FOROUTAN, AUDREY A	10/28/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D49315	N/A	N/A	N/A	N/A	N/A	217 EARLHAM ST	None	RAMONA	CA	92065	1589	00	06000	33.05113763	-116.8543952	San Diego County
319940	Ordering, Referring, Prescribing	N/A	1093867269	0	0	FELICIANO, EDWIN A MD	3/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C51764	N/A	N/A	N/A	N/A	N/A	277 SOUTH STREET	J	SAN LUIS OBISPO	CA	93401	5039	00	06000	35.2695025	-120.6663615	San Luis Obispo County
319978	Ordering, Referring, Prescribing	N/A	1093919466	0	0	FUNG, EDMOND K	3/8/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D42469	N/A	N/A	N/A	N/A	N/A	2020 J STREET	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
319985	Ordering, Referring, Prescribing	N/A	1093934077	0	0	FORSYTH, MICHELLE L LMFT	3/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88573	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON AVE	2	PORTERVILLE	CA	93257	1490	00	06000	36.08036906	-119.0410926	Tulare County
320025	Ordering, Referring, Prescribing	N/A	1104012608	0	0	FABIAN, VANESSA LCSW	3/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27352	N/A	N/A	N/A	N/A	N/A	350 90TH ST	None	DALY CITY	CA	94015	1879	00	06000	37.69111548	-122.473143	San Mateo County
320063	Ordering, Referring, Prescribing	N/A	1104104421	0	0	FITZSTEVENS, RYAN D	5/11/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	ASW81055	N/A	N/A	N/A	N/A	N/A	1859 BIRD STREET	None	OROVILLE	CA	95965	4854	00	06000	39.51259228	-121.5566418	Butte County
320089	Ordering, Referring, Prescribing	N/A	1104157601	0	0	FELDSHER, ZHANNA MD	5/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A110463	N/A	N/A	N/A	N/A	N/A	2928 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	3110	00	06000	34.04364362	-118.2006515	Los Angeles County
320093	Ordering, Referring, Prescribing	N/A	1104168756	0	0	FREEMAN, ALEXANDRA H MD	7/19/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133612	N/A	N/A	N/A	N/A	N/A	2525 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78246242	-122.4448129	San Francisco County
320103	Ordering, Referring, Prescribing	N/A	1104183680	0	0	FILIO, JANSEN C PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73855	N/A	N/A	N/A	N/A	N/A	24930 WESTERN AVE	None	HARBOR CITY	CA	90710	2029	00	06000	33.7981282	-118.3074768	Los Angeles County
320115	Ordering, Referring, Prescribing	N/A	1104195510	0	0	FOGE, MIDHASSO PHARMD	5/14/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66228	N/A	N/A	N/A	N/A	N/A	326 E AVENUE I	None	LANCASTER	CA	93535	1914	00	06000	34.7040153	-118.1250757	Los Angeles County
320138	Ordering, Referring, Prescribing	N/A	1104230275	0	0	FONG, ISABEL N PHARMD	5/19/2019	Taxonomy not applicable	NA	n/a	000	Unknown	76827	N/A	N/A	N/A	N/A	N/A	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
320145	Ordering, Referring, Prescribing	N/A	1104244532	0	0	FLEMING-VAGHJIANI, JUDE MD	9/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C174748	N/A	N/A	N/A	N/A	N/A	330 N BRAND BLVD	SUITE 700	GLENDALE	CA	91203	2308	00	06000	34.15116156	-118.2549512	Los Angeles County
320289	Ordering, Referring, Prescribing	N/A	1104493980	0	0	FARMER, PHILLIP P NP	3/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017037	N/A	N/A	N/A	N/A	N/A	2933 UNIVERSITY AVENUE	None	RIVERSIDE	CA	92507	4243	00	06000	33.97760919	-117.3651828	Riverside County
320337	Ordering, Referring, Prescribing	N/A	1104890326	0	0	FAKHRI, FARIBORZ D DO	2/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A8959	N/A	N/A	N/A	N/A	N/A	3727 MARCONI AVE,	None	SACRAMENTO	CA	95821	5303	00	06000	38.618118	-121.376988	Sacramento County
320357	Ordering, Referring, Prescribing	N/A	1104952902	0	0	FLETCHER, LETTERIA LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51886	N/A	N/A	N/A	N/A	N/A	380 W MACARTHUR BLVD	None	OAKLAND	CA	94609	2819	00	06000	37.82519027	-122.2609525	Alameda County
320401	Ordering, Referring, Prescribing	N/A	1114030467	0	0	FRENANDEZ, DANILO F MD	9/24/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80133	N/A	N/A	N/A	N/A	N/A	29325 KIMBERLINA RD	None	WASCO	CA	93280	7617	00	06000	35.55797351	-119.3289345	Kern County
320406	Ordering, Referring, Prescribing	N/A	1114040029	0	0	FARRAR, MIMSIE M NP	2/26/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	405732	N/A	N/A	N/A	N/A	N/A	3621 FOREST GLENN DR	None	MODESTO	CA	95355	1339	00	06000	37.69124429	-120.974069	Stanislaus County
320412	Ordering, Referring, Prescribing	N/A	1114051570	0	0	FONG, DOUGLAS J LMFT	3/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT33984	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
320436	Ordering, Referring, Prescribing	N/A	1114091469	0	0	FEDOVSKIY, KANEY J MD	6/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A97005	N/A	N/A	N/A	N/A	N/A	1080 MARINA VILLAGE PKW	SUITE 100	ALAMEDA	CA	94501	1011	00	06000	37.78544731	-122.270323	Alameda County
320439	Ordering, Referring, Prescribing	N/A	1114093325	0	0	FEET, ROSANNA R LMFT	11/13/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT44002	N/A	N/A	N/A	N/A	N/A	2743 HIGHLAND AVE	None	NATIONAL CITY	CA	91950	7410	00	06000	32.66109542	-117.0920417	San Diego County
320471	Ordering, Referring, Prescribing	N/A	1114157906	0	0	FLORES, RAUDEL LMFT	6/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119511	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	STE. 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
320486	Ordering, Referring, Prescribing	N/A	1114201019	0	0	FARMER, TASHA L LCSW	2/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29813	N/A	N/A	N/A	N/A	N/A	1255 KENDALL RD	None	SAN LUIS OBISPO	CA	93401	8750	00	06000	35.2372881	-120.6292313	San Luis Obispo County
320510	Ordering, Referring, Prescribing	N/A	1114238797	0	0	FORD, AMBER G	2/27/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029240	N/A	N/A	N/A	N/A	N/A	3302 RENNER DR	None	FORTUNA	CA	95540	3120	00	06000	40.5823206	-124.1359965	Humboldt County
320524	Ordering, Referring, Prescribing	N/A	1114272812	0	0	FRANCISCO, JOANNE PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65694	N/A	N/A	N/A	N/A	N/A	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	00	06000	37.66312028	-122.4631592	San Mateo County
320533	Ordering, Referring, Prescribing	N/A	1114287497	0	0	FOULADI RAD, SHERVIN MD	6/8/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A135003	N/A	N/A	N/A	N/A	N/A	8041 NEWMAN AVE	None	HUNTINGTON BEACH	CA	92647	7034	00	06000	33.70481104	-117.9882948	Orange County
320572	Ordering, Referring, Prescribing	N/A	1114342425	0	0	FONG, DAVID A LMFT	3/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97350	N/A	N/A	N/A	N/A	N/A	942 S SANTA FE ST	None	VISALIA	CA	93292	2912	00	06000	36.320796	-119.287359	Tulare County
320577	Ordering, Referring, Prescribing	N/A	1114346509	0	0	FISHER, JESSICA PSYD	12/15/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30859	N/A	N/A	N/A	N/A	N/A	1722 S. LEWIS ROAD	None	CAMARILLO	CA	93012	8520	00	06000	34.18921316	-119.0340743	Ventura County
320664	Ordering, Referring, Prescribing	N/A	1114490752	0	0	FLORES, GABRIELA LMFT	9/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	134869	N/A	N/A	N/A	N/A	N/A	725 E MAIN ST	3RD FLOOR	SANTA PAULA	CA	93060	2748	00	06000	34.35240876	-119.0649129	Ventura County
320739	Ordering, Referring, Prescribing	N/A	1114698339	0	0	FISCHER, KARLI D PA	12/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60458	N/A	N/A	N/A	N/A	N/A	40910 FREMONT BLVD	None	FREMONT	CA	94538	4375	00	06000	37.53384106	-121.9607241	Alameda County
320742	Ordering, Referring, Prescribing	N/A	1114699683	0	0	FALLIN, CHRISTY NP	4/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017221	N/A	N/A	N/A	N/A	N/A	200 7TH AVENUE	150	SANTA CRUZ	CA	95062	4669	00	06000	36.96438797	-121.998448	Santa Cruz County
320762	Ordering, Referring, Prescribing	N/A	1114930336	0	0	FIERRO, AMY P LMFT	1/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT37851	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DRIVE	None	SACRAMENTO	CA	95841	3905	00	06000	38.662227	-121.3378965	Sacramento County
320831	Ordering, Referring, Prescribing	N/A	1124159892	0	0	FLORES, GABRIELA LCSW	1/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW65560	N/A	N/A	N/A	N/A	N/A	1005 E WASHINGTON BLVD	A	LOS ANGELES	CA	90021	3020	00	06000	34.02578238	-118.2530622	Los Angeles County
320838	Ordering, Referring, Prescribing	N/A	1124173117	0	0	FAHLSING, MICHELLE	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0585721	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
320850	Ordering, Referring, Prescribing	N/A	1124179262	0	0	FINKELSTEIN, DAVID M MD	11/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A125377	N/A	N/A	N/A	N/A	N/A	5776 STONERIDGE MALL RD	300	PLEASANTON	CA	94588	4522	00	06000	37.69272221	-121.9305836	Alameda County
320883	Ordering, Referring, Prescribing	N/A	1124254404	0	0	FAIRCLOTH, MICHELE K MD	4/18/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	48481	N/A	N/A	N/A	N/A	N/A	7691 POPLAR AVE	None	GERMANTOWN	TN	38138	3904	00	06000	35.089929	-89.807931	Shelby County
320895	Ordering, Referring, Prescribing	N/A	1124285077	0	0	FABECK, ASHLEY LMFT	12/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT81547	N/A	N/A	N/A	N/A	N/A	815 N EL CENTRO AVE	None	LOS ANGELES	CA	90038	3805	00	06000	34.08577365	-118.3244665	Los Angeles County
320915	Ordering, Referring, Prescribing	N/A	1124325832	0	0	FRIEDMAN, MARVIN PHARMD	3/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	033056	N/A	N/A	N/A	N/A	N/A	2660 PARK CENTER DR	None	SIMI VALLEY	CA	93065	6207	00	06000	34.28442036	-118.7968257	Ventura County
320917	Ordering, Referring, Prescribing	N/A	1124328406	0	0	FERNANDEZ, RONNIE LCSW	10/21/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW85914	N/A	N/A	N/A	N/A	N/A	10810 PARAMOUNT BLVD	202	DOWNEY	CA	90241	3351	00	06000	33.94590205	-118.1355368	Los Angeles County
320966	Ordering, Referring, Prescribing	N/A	1124409610	0	0	FAIZI, AMBARIN S DO	12/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15230	N/A	N/A	N/A	N/A	N/A	1330 E. COOLEY DR.	None	COLTON	CA	92324	9999	00	06000	34.0544745	-117.305721	San Bernardino County
321019	Ordering, Referring, Prescribing	N/A	1124483979	0	0	FACCHINI, BRENNEN N LMFT	5/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115420	N/A	N/A	N/A	N/A	N/A	391 TAYLOR BLVD	100	PLEASANT HILL	CA	94523	2294	00	06000	37.96119614	-122.070409	Contra Costa County
321020	Ordering, Referring, Prescribing	N/A	1124488481	0	0	FARAZIAN, REBECCA LMFT	3/2/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	145493	N/A	N/A	N/A	N/A	N/A	555 E OCEAN BLVD	330	LONG BEACH	CA	90802	5003	00	06000	33.76653325	-118.185777	Los Angeles County
321021	Ordering, Referring, Prescribing	N/A	1124490347	0	0	FITTANTE, EMILY E LCSW	3/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89251	N/A	N/A	N/A	N/A	N/A	250 LOCUST ST	None	SANTA CRUZ	CA	95060	3813	00	06000	36.97493323	-122.028799	Santa Cruz County
321075	Ordering, Referring, Prescribing	N/A	1124575840	0	0	FONG, I-CHEN PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74813	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY DEPT 3	DEPT 362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
321084	Ordering, Referring, Prescribing	N/A	1124581491	0	0	FAYARD, LISA MD	7/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176532	N/A	N/A	N/A	N/A	N/A	820 E GILBERT ST	None	SAN BERNARDINO	CA	92415	0920	00	06000	34.1268333	-117.2687417	San Bernardino County
321138	Ordering, Referring, Prescribing	N/A	1124688932	0	0	FERNANDEZ, MARCO A LCSW	5/27/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW108257	N/A	N/A	N/A	N/A	N/A	355 DOVER PARKWAY	None	DELANO	CA	93215	3440	00	06000	35.7610493	-119.2523273	Kern County
321217	Ordering, Referring, Prescribing	N/A	1134253354	0	0	FISHER, WILLIAM H MD	11/21/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G77013	N/A	N/A	N/A	N/A	N/A	201 N. CIVIC DR.	183	WALNUT CREEK	CA	94596	3864	00	06000	37.91024298	-122.0593495	Contra Costa County
321219	Ordering, Referring, Prescribing	N/A	1134253594	0	0	FRID, DINA MD	2/10/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A97458	N/A	N/A	N/A	N/A	N/A	6850 MORRO RD	None	ATASCADERO	CA	93422	4123	00	06000	35.48202343	-120.6660628	San Luis Obispo County
321230	Ordering, Referring, Prescribing	N/A	1134266893	0	0	FINN, LISA A LCSW	2/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22778	N/A	N/A	N/A	N/A	N/A	1414 S. MILLER STREET	SUITE D	SANTA MARIA	CA	93454	6915	00	06000	34.937433	-120.431561	Santa Barbara County
321236	Ordering, Referring, Prescribing	N/A	1134288939	0	0	FREY, LANCE W LCSW	4/24/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20709	N/A	N/A	N/A	N/A	N/A	61 RENATO CT	23	REDWOOD CITY	CA	94061	4093	00	06000	37.46889425	-122.213662	San Mateo County
321280	Ordering, Referring, Prescribing	N/A	1134400179	0	0	FONG, LIZ PHARMD	8/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	42910	N/A	N/A	N/A	N/A	N/A	2300 OTIS DR	None	ALAMEDA	CA	94501	5722	00	06000	37.75772853	-122.2487248	Alameda County
321307	Ordering, Referring, Prescribing	N/A	1134427891	0	0	FISCHER, STACEY M RN PNP	1/24/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	20543	N/A	N/A	N/A	N/A	N/A	8112 MILLIKEN AVE	201	RANCHO CUCAMONGA	CA	91730	7471	00	06000	34.10480366	-117.5570863	San Bernardino County
321353	Ordering, Referring, Prescribing	N/A	1134514540	0	0	FELLER, SOPHIE	12/29/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A161122	N/A	N/A	N/A	N/A	N/A	1433 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	3414	00	06000	34.05373818	-118.3839685	Los Angeles County
321361	Ordering, Referring, Prescribing	N/A	1134531197	0	0	FLORES, LUIS H	5/5/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107942	N/A	N/A	N/A	N/A	N/A	600 N ARROWHEAD	300	SAN BERNARDINO	CA	92401	0000	00	06000	34.110486	-117.2896755	San Bernardino County
321372	Ordering, Referring, Prescribing	N/A	1134560915	0	0	FICARO, NICOLE C	8/5/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0844201	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
321400	Ordering, Referring, Prescribing	N/A	1134583487	0	0	FONG, MARVIN PHARMD	7/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	46421	N/A	N/A	N/A	N/A	N/A	399 E HIGHLAND AVE	SUITE 103	SAN BERNARDINO	CA	92404	3808	00	06000	34.1358627	-117.2757898	San Bernardino County
321425	Ordering, Referring, Prescribing	N/A	1134627284	0	0	FEIJO, HAILEY A LMFT	6/21/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT133347	N/A	N/A	N/A	N/A	N/A	327 S K ST	None	TULARE	CA	93274	5416	00	06000	36.20476387	-119.3454489	Tulare County
321458	Ordering, Referring, Prescribing	N/A	1134691488	0	0	FRENCH, ANNE M	7/12/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010613	N/A	N/A	N/A	N/A	N/A	1324 MARYLAND DR	None	VISTA	CA	92083	2914	00	06000	33.21657975	-117.2579443	San Diego County
321464	Ordering, Referring, Prescribing	N/A	1134694128	0	0	FOWLER, GRACE PHD	12/27/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY34771	N/A	N/A	N/A	N/A	N/A	20101 HAMILTON AVE	None	TORRANCE	CA	90502	1314	00	06000	33.84828383	-118.2860386	Los Angeles County
321491	Ordering, Referring, Prescribing	N/A	1134743701	0	0	FOSTER, CHERIE NP	3/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024595	N/A	N/A	N/A	N/A	N/A	2017 FIRST AVE	100	SAN DIEGO	CA	92108	0000	00	06000	32.72646147	-117.1638767	San Diego County
321494	Ordering, Referring, Prescribing	N/A	1134760895	0	0	FEARING, JESSELYN S PA	6/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	57195	N/A	N/A	N/A	N/A	N/A	3772 TIBBETTS ST	None	RIVERSIDE	CA	92506	2605	00	06000	33.94720849	-117.399204	Riverside County
321510	Ordering, Referring, Prescribing	N/A	1134806466	0	0	FRANCIS, JOSEPH DMD	7/18/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110335	N/A	N/A	N/A	N/A	N/A	330-340 E 8TH ST	None	NATIONAL CITY	CA	91950	2312	00	06000	32.67687664	-117.1030716	San Diego County
321528	Ordering, Referring, Prescribing	N/A	1134909302	0	0	FRENCH, LINDSAY LMFT	10/3/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT150335	N/A	N/A	N/A	N/A	N/A	202 PROVIDENCE MINE RD	105	NEVADA CITY	CA	95959	2947	00	06000	39.25034906	-121.0306425	Nevada County
321532	Ordering, Referring, Prescribing	N/A	1134967144	0	0	FEHRENBACHER, MONICA NP	1/17/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028710	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
321661	Ordering, Referring, Prescribing	N/A	1144511437	0	0	FAHMI SHENODA, SHERRY R	12/21/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A153272	N/A	N/A	N/A	N/A	N/A	455 E COLUMBIA ST	201	LONG BEACH	CA	90806	1602	00	06000	33.80900524	-118.1874314	Los Angeles County
321732	Ordering, Referring, Prescribing	N/A	1144627407	0	0	FAVELA-GARY, OLIVIA CNM	2/24/2024	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235720	N/A	N/A	N/A	N/A	N/A	1530 S OLIVE ST	None	LOS ANGELES	CA	90015	3023	00	06000	34.03542552	-118.2652073	Los Angeles County
321733	Ordering, Referring, Prescribing	N/A	1144631441	0	0	FISCHBECK, TUCKER DO	4/11/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14474	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
321861	Ordering, Referring, Prescribing	N/A	1144802380	0	0	FARMANIAN, ALIREZA PHD	8/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82287	N/A	N/A	N/A	N/A	N/A	30192 TOWN CENTER DR	None	LAGUNA NIGUEL	CA	92677	2037	00	06000	33.52498705	-117.7152032	Orange County
321920	Ordering, Referring, Prescribing	N/A	1144940453	0	0	FAGAN, ASHLEY C LMFT	7/25/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	148323	N/A	N/A	N/A	N/A	N/A	16580 HARBOR BLVD	UNIT M	FOUNTAIN VALLEY	CA	92708	1386	00	06000	33.72282	-117.9197845	Orange County
321953	Ordering, Referring, Prescribing	N/A	1154046506	0	0	FRANCO, LAURA J MSW LCSW	12/10/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127692	N/A	N/A	N/A	N/A	N/A	1105 E FLORIDA AVE	None	HEMET	CA	92543	4512	00	06000	33.74750951	-116.960463	Riverside County
321978	Ordering, Referring, Prescribing	N/A	1154155042	0	0	FAY, TAMMIE L	8/31/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	LEP4391	N/A	N/A	N/A	N/A	N/A	4200 ASHE RD	None	BAKERSFIELD	CA	93313	2029	00	06000	35.316864	-119.0744405	Kern County
322051	Ordering, Referring, Prescribing	N/A	1154492494	0	0	FUNG, WENDY W	8/28/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D53393	N/A	N/A	N/A	N/A	N/A	2710 MIDDLEFIELD RD	None	REDWOOD CITY	CA	94063	3404	00	06000	37.47644946	-122.2110919	San Mateo County
322116	Ordering, Referring, Prescribing	N/A	1154613552	0	0	FILES, JARED PA-C	6/21/2022	Taxonomy not applicable	NA	n/a	000	Unknown	52631	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
322230	Ordering, Referring, Prescribing	N/A	1154791879	0	0	FAVELA, CYNTHIA J	12/28/2015	Taxonomy not applicable	NA	n/a	000	Unknown	61986	N/A	N/A	N/A	N/A	N/A	4211 S AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
322259	Ordering, Referring, Prescribing	N/A	1154857456	0	0	FREEDMAN, AARON G LMFT	11/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123163	N/A	N/A	N/A	N/A	N/A	982 MISSION ST	None	SAN FRANCISCO	CA	94103	2911	00	06000	37.7813638	-122.4082438	San Francisco County
322269	Ordering, Referring, Prescribing	N/A	1154870004	0	0	FISHER, RAENNA LMFT	9/27/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84934	N/A	N/A	N/A	N/A	N/A	3400 BECHELLI LN	E	REDDING	CA	96002	2466	00	06000	40.557978	-122.362666	Shasta County
322279	Ordering, Referring, Prescribing	N/A	1154886802	0	0	FARR-RICE, CLARA G LCSW	6/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76297	N/A	N/A	N/A	N/A	N/A	995 POTRERO AVE	BLDG 80	SAN FRANCISCO	CA	94110	2859	00	06000	37.75729541	-122.4066641	San Francisco County
322309	Ordering, Referring, Prescribing	N/A	1154956068	0	0	FONTANA, COURTNEY N NP	3/6/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95014145	N/A	N/A	N/A	N/A	N/A	637 MERCED ST	None	NEWMAN	CA	95360	1070	00	06000	37.31481158	-121.0162228	Stanislaus County
322387	Ordering, Referring, Prescribing	N/A	1164102323	0	0	FACTORA, NORMAN A	8/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95022017	N/A	N/A	N/A	N/A	N/A	25518 SOTO RD	APT 4	HAYWARD	CA	94544	2176	00	06000	37.65147324	-122.0785874	Alameda County
322412	Ordering, Referring, Prescribing	N/A	1164197422	0	0	FRISIUS, ANN E CNP	6/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017918	N/A	N/A	N/A	N/A	N/A	706 PEACH ST	None	CORNING	CA	96021	3355	00	06000	39.928689	-122.174397	Tehama County
322452	Ordering, Referring, Prescribing	N/A	1164533329	0	0	FRANKLIN, ROBERT C MD	11/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G44663	N/A	N/A	N/A	N/A	N/A	4378 AUBURN BLVD	None	SACRAMENTO	CA	95841	4175	00	06000	38.645082	-121.3614315	Sacramento County
322455	Ordering, Referring, Prescribing	N/A	1164531976	0	0	FARD, SHAROUZ C	5/16/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D51924	N/A	N/A	N/A	N/A	N/A	2216 S EL CAMINO REAL	STE 121	OCEANSIDE	CA	92054	6356	00	06000	33.18564585	-117.3279882	San Diego County
322522	Ordering, Referring, Prescribing	N/A	1164657086	0	0	FAN, TSUEY-JING PHD	3/23/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	22599	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
322524	Ordering, Referring, Prescribing	N/A	1164660452	0	0	FODDA, RAMI NP	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	18788	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
322547	Ordering, Referring, Prescribing	N/A	1164706941	0	0	FONG, CHRISELLE PHARMD	8/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60745	N/A	N/A	N/A	N/A	N/A	250 FLORIN RD	None	SACRAMENTO	CA	95831	1405	00	06000	38.509461	-121.543011	Sacramento County
322570	Ordering, Referring, Prescribing	N/A	1164749032	0	0	FISHER, SUSAN OT	10/12/2022	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	4939	N/A	N/A	N/A	N/A	N/A	1400 EMELINE AVE	None	SANTA CRUZ	CA	95060	1976	00	06000	36.99276804	-122.0178271	Santa Cruz County
322614	Ordering, Referring, Prescribing	N/A	1164817292	0	0	FRIEDMAN, SHARIN	10/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131268	N/A	N/A	N/A	N/A	N/A	2 PADRE PARKWAY	SUITE 302A	ROHNERT PARK	CA	94928	2116	00	06000	38.34982429	-122.7083127	Sonoma County
322674	Ordering, Referring, Prescribing	N/A	1164913265	0	0	FERGUSON, CLAIRE N PHARMD	4/13/2018	Taxonomy not applicable	NA	n/a	000	Unknown	78395	N/A	N/A	N/A	N/A	N/A	775 S TUCKER RD	None	TEHACHAPI	CA	93561	2502	00	06000	35.125704	-118.4678675	Kern County
322722	Ordering, Referring, Prescribing	N/A	1174004576	0	0	FOY, ANNE J LCSW	9/11/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW110157	N/A	N/A	N/A	N/A	N/A	410 CAMINO REAL	None	REDONDO BEACH	CA	90277	3815	00	06000	33.83681569	-118.3816317	Los Angeles County
322761	Ordering, Referring, Prescribing	N/A	1174074702	0	0	FIELDING, CHELA LCSW	8/16/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	103208	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	None	SANTA ROSA	CA	95407	5478	00	06000	38.425266	-122.749875	Sonoma County
322784	Ordering, Referring, Prescribing	N/A	1174104251	0	0	FRISCH, TY H PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84253	N/A	N/A	N/A	N/A	N/A	2331 S ATLANTIC BLVD.	None	MONTEREY PARK	CA	91754	6805	00	06000	34.03684323	-118.147526	Los Angeles County
322839	Ordering, Referring, Prescribing	N/A	1174234983	0	0	FORTUNATO, MARIA DELIA D NP	1/23/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023985	N/A	N/A	N/A	N/A	N/A	4211 AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
322856	Ordering, Referring, Prescribing	N/A	1174292239	0	0	FISHER, KIMBERLY NP	3/21/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018673	N/A	N/A	N/A	N/A	N/A	1522 BUSH ST	None	SAN FRANCISCO	CA	94109	5420	00	06000	37.78842019	-122.4225944	San Francisco County
322877	Ordering, Referring, Prescribing	N/A	1174547814	0	0	FUKUTAKI, KAREN V MD	6/9/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G147227	N/A	N/A	N/A	N/A	N/A	6950 65TH STREET	None	SACRAMENTO	CA	95823	2316	00	06000	38.50065	-121.4357265	Sacramento County
322937	Ordering, Referring, Prescribing	N/A	1174696033	0	0	FLICK, CATALINA	2/4/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0553017	N/A	N/A	N/A	N/A	N/A	1316 3RD ST PROMENADE	STE 201	SANTA MONICA	CA	90401	1382	00	06000	34.01670895	-118.497462	Los Angeles County
323011	Ordering, Referring, Prescribing	N/A	1174851836	0	0	FEIN, LEAH LMFT	1/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98914	N/A	N/A	N/A	N/A	N/A	4820 BUSINESS CENTER DR	210	FAIRFIELD	CA	94534	1696	00	06000	38.22055392	-122.1386622	Solano County
323022	Ordering, Referring, Prescribing	N/A	1174870315	0	0	FOGARTY, MADELAINE M LCSW	8/12/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW125041	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
323172	Ordering, Referring, Prescribing	N/A	1184052748	0	0	FRAZIER, SUMMER M MD	8/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A121686	N/A	N/A	N/A	N/A	N/A	250 N SEE VEE LN	None	BISHOP	CA	93514	8130	00	06000	37.365066	-118.410912	Inyo County
323200	Ordering, Referring, Prescribing	N/A	1184092876	0	0	FLORES, JOHN R PHARMD	2/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73175	N/A	N/A	N/A	N/A	N/A	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	00	06000	34.072245	-117.4319685	San Bernardino County
323201	Ordering, Referring, Prescribing	N/A	1184092744	0	0	FRAUSTO, KARINA LCSW	6/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95008	N/A	N/A	N/A	N/A	N/A	1908 BUSINESS CENTER DR.	220	SAN BERNARDINO	CA	92408	3468	00	06000	34.06732096	-117.2801085	San Bernardino County
323221	Ordering, Referring, Prescribing	N/A	1184116915	0	0	FINAZZO, CHRISTY LCSW	8/28/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22412	N/A	N/A	N/A	N/A	N/A	333 S. BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
323237	Ordering, Referring, Prescribing	N/A	1184148744	0	0	FABRIS, JOANNA MD	8/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A169858	N/A	N/A	N/A	N/A	N/A	121 BARBOZA ST	None	MENDOTA	CA	93640	1901	00	06000	36.76619136	-120.3839072	Fresno County
323261	Ordering, Referring, Prescribing	N/A	1184175754	0	0	FLORES, MADAI LCSW	11/8/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW113538	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
323337	Ordering, Referring, Prescribing	N/A	1184333262	0	0	FONG, AUSTIN C PHARMD	10/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH87125	N/A	N/A	N/A	N/A	N/A	2605 MIDDLEFIELD RD	None	PALO ALTO	CA	94306	2516	00	06000	37.43410933	-122.1303843	Santa Clara County
323402	Ordering, Referring, Prescribing	N/A	1184739658	0	0	FRENCH, DENISE DDS	3/6/2025	Taxonomy not applicable	NA	n/a	000	Unknown	59049	N/A	N/A	N/A	N/A	N/A	1201 INDUSTRIAL ST	None	REDDING	CA	96002	0757	00	06000	40.57469253	-122.349645	Shasta County
323451	Ordering, Referring, Prescribing	N/A	1184836298	0	0	FORESTA, MARY-JO LCSW	2/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93144	N/A	N/A	N/A	N/A	N/A	2600 REDONDO AVE	3RD FLOOR	LONG BEACH	CA	90806	2325	00	06000	33.806097	-118.151378	Los Angeles County
323487	Ordering, Referring, Prescribing	N/A	1184897431	0	0	FISH, SHERLYN M LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51848	N/A	N/A	N/A	N/A	N/A	10155 COLIMA ROAD	None	WHITTIER	CA	90603	2042	00	06000	33.94349601	-118.0106968	Los Angeles County
323500	Ordering, Referring, Prescribing	N/A	1184909129	0	0	FAISAL, MUMTAZ H PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61635	N/A	N/A	N/A	N/A	N/A	1138 W TENNYSON RD	None	HAYWARD	CA	94544	4422	00	06000	37.63123947	-122.076639	Alameda County
323603	Ordering, Referring, Prescribing	N/A	1194100263	0	0	FLORES MILLAN, YESENIA LCSW	8/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96445	N/A	N/A	N/A	N/A	N/A	901 W VICTORIA ST	SUITE F&G	COMPTON	CA	90220	5807	00	06000	33.86784006	-118.2368928	Los Angeles County
323620	Ordering, Referring, Prescribing	N/A	1194123885	0	0	FALICKI, JULIE K LMFT	1/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	34925	N/A	N/A	N/A	N/A	N/A	470 CHADBOURNE ROAD	SUITE E	FAIRFIELD	CA	94533	9620	00	06000	38.23474317	-122.0838031	Solano County
323624	Ordering, Referring, Prescribing	N/A	1194137679	0	0	FAUSTIN-GABRIEL, JUDITH NP	9/22/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012131	N/A	N/A	N/A	N/A	N/A	5168 HONPIE RD	None	PLACERVILLE	CA	95667	8682	00	06000	38.6943603	-120.9018271	El Dorado County
323631	Ordering, Referring, Prescribing	N/A	1194152355	0	0	FELTEN, CARLA M LCSW	6/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82350	N/A	N/A	N/A	N/A	N/A	3165 OLIN AVE	None	SAN JOSE	CA	95117	1635	00	06000	37.3204645	-121.9521375	Santa Clara County
323761	Ordering, Referring, Prescribing	N/A	1194416230	0	0	FONTAINE, DIANNE NP	6/7/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025486	N/A	N/A	N/A	N/A	N/A	740 SOLANO ST	None	CORNING	CA	96021	3352	00	06000	39.92792649	-122.175513	Tehama County
323868	Ordering, Referring, Prescribing	N/A	1194902270	0	0	FONG, CYNTHIA LCSW	7/5/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26870	N/A	N/A	N/A	N/A	N/A	2727 MACDONALD AVE	None	RICHMOND	CA	94804	3006	00	06000	37.93503193	-122.3422799	Contra Costa County
323875	Ordering, Referring, Prescribing	N/A	1194916957	0	0	FANNIN, BARBARA E PSYD	4/26/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26371	N/A	N/A	N/A	N/A	N/A	7192 N TEILMAN AVE	None	FRESNO	CA	93711	0546	00	06000	36.8407584	-119.8215453	Fresno County
323890	Ordering, Referring, Prescribing	N/A	1194937102	0	0	FARHAT, LAURA L NP	9/5/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95003881	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	None	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
323907	Ordering, Referring, Prescribing	N/A	1194975656	0	0	FAUST, HOA N LMFT	2/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT93273	N/A	N/A	N/A	N/A	N/A	9353 EAST VALLEY BLVD	None	ROSEMEAD	CA	91770	1934	00	06000	34.08115618	-118.0651957	Los Angeles County
323922	Ordering, Referring, Prescribing	N/A	1205022449	0	0	FITZGERALD, ILJIE MD	1/7/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A100934	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DRIVE	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
323986	Ordering, Referring, Prescribing	N/A	1205145208	0	0	FINCHER, KAREN L LMFT	1/3/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77877	N/A	N/A	N/A	N/A	N/A	7402 HOLLISTER AVE	None	GOLETA	CA	93117	2583	00	06000	34.42987025	-119.8878468	Santa Barbara County
324000	Ordering, Referring, Prescribing	N/A	1205154705	0	0	FORREST, JEFFREY S MD	2/10/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A156743	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	None	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
324008	Ordering, Referring, Prescribing	N/A	1205203304	0	0	FOROUGHI, ASHKAN N	3/6/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D65023	N/A	N/A	N/A	N/A	N/A	18740 VENTURA BLVD	None	TARZANA	CA	91356	0000	00	06000	34.17115254	-118.5420873	Los Angeles County
324207	Ordering, Referring, Prescribing	N/A	1205612587	0	0	FU, HAO PHARMD	6/8/2023	Taxonomy not applicable	NA	n/a	000	Unknown	87987	N/A	N/A	N/A	N/A	N/A	2605 MIDDLEFIELD RD	None	PALO ALTO	CA	94306	2516	00	06000	37.43410933	-122.1303843	Santa Clara County
324241	Ordering, Referring, Prescribing	N/A	1205887965	0	0	FERNANDEZ, ANNA LMFT	4/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39029	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	95128	2407	00	06000	37.31712017	-121.9185451	Santa Clara County
324274	Ordering, Referring, Prescribing	N/A	1205973005	0	0	FOX, REBECCA L LCSW	6/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61382	N/A	N/A	N/A	N/A	N/A	3200 CLAYTON RD	None	CONCORD	CA	94519	2819	00	06000	37.97283909	-122.0196497	Contra Costa County
324331	Ordering, Referring, Prescribing	N/A	1215085386	0	0	FELIPE, YVETTE E	11/10/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D43953	N/A	N/A	N/A	N/A	N/A	82934 CIVIC CENTER DR	None	INDIO	CA	92201	4308	00	06000	33.71864703	-116.2178997	Riverside County
324346	Ordering, Referring, Prescribing	N/A	1215122643	0	0	FLORES, DAISY Y LMFT	2/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	85900	N/A	N/A	N/A	N/A	N/A	1339 20TH ST	None	SANTA MONICA	CA	90404	2033	00	06000	34.02917949	-118.4805651	Los Angeles County
324374	Ordering, Referring, Prescribing	N/A	1215194014	0	0	FLORES-MORALES, MARTA L PSYD	7/26/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30020	N/A	N/A	N/A	N/A	N/A	3270 KERNER BLVD	1ST FLOOR	SAN RAFAEL	CA	94901	4840	00	06000	37.96108677	-122.5017451	Marin County
324408	Ordering, Referring, Prescribing	N/A	1215237367	0	0	FRANCO GOMEZ, ANGELA M LMFT	8/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT108835	N/A	N/A	N/A	N/A	N/A	3270 KERNER BLVD	None	SAN RAFAEL	CA	94901	4840	00	06000	37.96108677	-122.5017451	Marin County
324454	Ordering, Referring, Prescribing	N/A	1215313309	0	0	FLORES, EILEEN LCSW	10/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97711	N/A	N/A	N/A	N/A	N/A	1720 E 120TH ST	None	LOS ANGELES	CA	90059	3052	00	06000	33.92455929	-118.2423557	Los Angeles County
324461	Ordering, Referring, Prescribing	N/A	1215323035	0	0	FRIEDMAN, LAUREN NP	1/29/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021908	N/A	N/A	N/A	N/A	N/A	3626 BALBOA ST	None	SAN FRANCISCO	CA	94121	2604	00	06000	37.77571711	-122.4980286	San Francisco County
324476	Ordering, Referring, Prescribing	N/A	1215342118	0	0	FAJARDO, JACQUELINE M LCSW	1/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87322	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
324481	Ordering, Referring, Prescribing	N/A	1215354865	0	0	FISHER, MIA	10/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	HAP929	N/A	N/A	N/A	N/A	N/A	57019 YUCCA TRAIL	#C	YUCCA VALLEY	CA	92284	7909	00	06000	34.1205273	-116.4202324	San Bernardino County
324487	Ordering, Referring, Prescribing	N/A	1215365002	0	0	FRYE, KATHRYN A NP	10/30/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN415178	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
324539	Ordering, Referring, Prescribing	N/A	1215454145	0	0	FREEMAN, EBONY D LMFT	4/6/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132177	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	275	BAKERSFIELD	CA	93309	2667	00	06000	35.35413152	-119.058471	Kern County
324624	Ordering, Referring, Prescribing	N/A	1215617196	0	0	FUJINAKA, DAVID LMFT	7/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140459	N/A	N/A	N/A	N/A	N/A	5601 W SLAUSON AVE	None	CULVER CITY	CA	90230	6582	00	06000	33.98900447	-118.37979	Los Angeles County
324651	Ordering, Referring, Prescribing	N/A	1215704127	0	0	FORBES, KRYSTINE PA-C	9/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63395	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1378	00	06000	34.29321532	-119.1597424	Ventura County
324750	Ordering, Referring, Prescribing	N/A	1225213531	0	0	FLORES, ROCIO R LMFT	6/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	80005	N/A	N/A	N/A	N/A	N/A	290 IOOF AVE	None	GILROY	CA	95020	5204	00	06000	37.01377513	-121.5685719	Santa Clara County
324793	Ordering, Referring, Prescribing	N/A	1225311277	0	0	FLORES, JAMIE L LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102091	N/A	N/A	N/A	N/A	N/A	3200 CLAYTON RD	None	CONCORD	CA	94519	2819	00	06000	37.97283909	-122.0196497	Contra Costa County
324801	Ordering, Referring, Prescribing	N/A	1225313539	0	0	FABILLARAN, GLORIA B PHARMD	7/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH56139	N/A	N/A	N/A	N/A	N/A	2851 S ROSE AVE	None	OXNARD	CA	93033	3953	00	06000	34.17389279	-119.1601891	Ventura County
324934	Ordering, Referring, Prescribing	N/A	1225517493	0	0	FLORES, LESLYE LMFT	5/2/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT132626	N/A	N/A	N/A	N/A	N/A	2420 MARTIN RD	200	FAIRFIELD	CA	94534	8651	00	06000	38.27452806	-122.0511683	Solano County
324959	Ordering, Referring, Prescribing	N/A	1225560139	0	0	FOX, JENNIFER M NP	10/4/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95006050	N/A	N/A	N/A	N/A	N/A	200 PORTER STREET	SUITE 200	SAN RAMON	CA	94583	1529	00	06000	37.77372204	-121.9911155	Contra Costa County
324987	Ordering, Referring, Prescribing	N/A	1225605736	0	0	FLOWERS, AMINA T PSYD	6/11/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY32588	N/A	N/A	N/A	N/A	N/A	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	00	06000	33.929829	-118.157607	Los Angeles County
325026	Ordering, Referring, Prescribing	N/A	1225709421	0	0	FERNANDEZ, BLANCA LMFT	5/15/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139558	N/A	N/A	N/A	N/A	N/A	3605 VISTA WAY	None	OCEANSIDE	CA	92056	4565	00	06000	33.1818929	-117.3104591	San Diego County
325057	Ordering, Referring, Prescribing	N/A	1235160243	0	0	FEENEY, MARY P	12/12/2013	Taxonomy not applicable	NA	n/a	034	MEDICARE CROSSOVER PROVIDER ONLY	LCS018352	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD ROAD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
325066	Ordering, Referring, Prescribing	N/A	1235193665	0	0	FOWLER, TIMOTHY P MD	2/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	MD43689	N/A	N/A	N/A	N/A	N/A	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	1009	00	06000	41.659929	-91.548099	Johnson County
325084	Ordering, Referring, Prescribing	N/A	1235225186	0	0	FINKELSHTEIN, INESSA	1/31/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0548746	N/A	N/A	N/A	N/A	N/A	1316 3RD ST PROMENADE	STE 201	SANTA MONICA	CA	90401	1382	00	06000	34.01670895	-118.497462	Los Angeles County
325101	Ordering, Referring, Prescribing	N/A	1235271644	0	0	FULLERTON, MARY T	3/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT	N/A	N/A	N/A	N/A	N/A	310 HARBOR BLVD	BLDG E	BELMONT	CA	94002	4018	00	06000	37.52045283	-122.2680405	San Mateo County
325245	Ordering, Referring, Prescribing	N/A	1235528290	0	0	FONZECA, MARISOL LCSW	6/4/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101873	N/A	N/A	N/A	N/A	N/A	101 WIKIUP DR	None	SANTA ROSA	CA	95403	1375	00	06000	38.50788547	-122.7587646	Sonoma County
325272	Ordering, Referring, Prescribing	N/A	1235570060	0	0	FORCINA, ANDREA V LMFT	7/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106743	N/A	N/A	N/A	N/A	N/A	595 E COLORADO BLVD	502	PASADENA	CA	91101	2039	00	06000	34.14588202	-118.1380722	Los Angeles County
325273	Ordering, Referring, Prescribing	N/A	1235568866	0	0	FISHER, TRACY LCSW	11/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83221	N/A	N/A	N/A	N/A	N/A	5100 S EASTERN AVE	110	COMMERCE	CA	90040	2950	00	06000	33.98882955	-118.1615175	Los Angeles County
325288	Ordering, Referring, Prescribing	N/A	1235581232	0	0	FREEMAN, ELKIE LMFT	12/17/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130030	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
325324	Ordering, Referring, Prescribing	N/A	1235648627	0	0	FLYNN, ERIN NP	12/30/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013899	N/A	N/A	N/A	N/A	N/A	163 PUUMAKANI ST	None	KAHULUI	HI	96732	3147	00	06000	20.8770393	-156.4886585	Maui County
325330	Ordering, Referring, Prescribing	N/A	1235656273	0	0	FLORESPEREZ, FATIMA I LCSW	7/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108991	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
325332	Ordering, Referring, Prescribing	N/A	1235653262	0	0	FRAZIER, MEGAN J PSYD	12/27/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31338	N/A	N/A	N/A	N/A	N/A	1722 S LEWIS RD	None	CAMARILLO	CA	93012	8520	00	06000	34.18921316	-119.0340743	Ventura County
325371	Ordering, Referring, Prescribing	N/A	1235744491	0	0	FOLSOM, KARRIE	8/31/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LEP4050	N/A	N/A	N/A	N/A	N/A	229 S. DALE AVE.	None	ANAHEIM	CA	92804	2006	00	06000	33.82922632	-117.9847597	Orange County
325378	Ordering, Referring, Prescribing	N/A	1235769894	0	0	FORTNER, ALYSON M LCSW	10/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104592	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	STE. 100	LOS ANGELES	CA	90018	1353	00	06000	34.037415	-118.3176815	Los Angeles County
325387	Ordering, Referring, Prescribing	N/A	1235791765	0	0	FAYYAZ, FARZOOK M MD	2/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184176	N/A	N/A	N/A	N/A	N/A	1922 THE ALAMEDA	SUITE 440	SAN JOSE	CA	95126	1457	00	06000	37.34128547	-121.9236047	Santa Clara County
325414	Ordering, Referring, Prescribing	N/A	1235889825	0	0	FRISOLI, KENDALL N MD	1/31/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191084	N/A	N/A	N/A	N/A	N/A	1043 ELM AVE.	SUITE 302	LONG BEACH	CA	90813	3295	00	06000	33.779655	-118.1880065	Los Angeles County
325523	Ordering, Referring, Prescribing	N/A	1245420447	0	0	FOUNTAIN, JEFFREY DO	6/29/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A12177	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
325538	Ordering, Referring, Prescribing	N/A	1245442342	0	0	FAIRBURN, ANDREW PA-C	9/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA19301	N/A	N/A	N/A	N/A	N/A	430 S BLOSSER RD	None	SANTA MARIA	CA	93458	4908	00	06000	34.94869196	-120.4537258	Santa Barbara County
325548	Ordering, Referring, Prescribing	N/A	1245469345	0	0	FAKEH, AYMAN MD	9/5/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C173261	N/A	N/A	N/A	N/A	N/A	7777 MILLIKEN AVE	240	RANCHO CUCAMONGA	CA	91730	6780	00	06000	34.10843256	-117.5570865	San Bernardino County
325553	Ordering, Referring, Prescribing	N/A	1245478114	0	0	FOX, TIFFANY M LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111048	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS RD	None	OAKLAND	CA	94605	4124	00	06000	37.76047483	-122.157608	Alameda County
325579	Ordering, Referring, Prescribing	N/A	1245518588	0	0	FORD, LAURA L	3/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	49961	N/A	N/A	N/A	N/A	N/A	2100 DR MARTIN LUTHER KI	None	CHICO	CA	95928	4422	00	06000	39.721077	-121.811508	Butte County
325710	Ordering, Referring, Prescribing	N/A	1245741644	0	0	FLORES, LINDA O LCSW	3/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107495	N/A	N/A	N/A	N/A	N/A	840 N AVENUE 66	None	LOS ANGELES	CA	90042	1508	00	06000	34.12110842	-118.1725545	Los Angeles County
325725	Ordering, Referring, Prescribing	N/A	1245761584	0	0	FONG, ALVIN	7/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	57589	N/A	N/A	N/A	N/A	N/A	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	00	06000	37.78324881	-122.4405738	San Francisco County
325753	Ordering, Referring, Prescribing	N/A	1245783273	0	0	FARLEY, SHAWANA L LCSW	4/8/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW121925	N/A	N/A	N/A	N/A	N/A	1600 E BELLE TER	None	BAKERSFIELD	CA	93307	3871	00	06000	35.34672702	-118.9837495	Kern County
325764	Ordering, Referring, Prescribing	N/A	1245806850	0	0	FERNANDEZ, JESSICA NP	9/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014983	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
325770	Ordering, Referring, Prescribing	N/A	1245817311	0	0	FLAHERTY, ELIZABETH E MD	6/19/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197038	N/A	N/A	N/A	N/A	N/A	2200 TYDD ST	None	EUREKA	CA	95501	1284	00	06000	40.80241902	-124.1462268	Humboldt County
325792	Ordering, Referring, Prescribing	N/A	1245851211	0	0	FLEMING, CARA M MD	3/4/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A194351	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
325886	Ordering, Referring, Prescribing	N/A	1255325452	0	0	FLEMING, DEANA L LCSW	10/25/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	13921	N/A	N/A	N/A	N/A	N/A	207 N BUTTE ST	None	WILLOWS	CA	95988	2803	00	06000	39.52212468	-122.195408	Glenn County
325938	Ordering, Referring, Prescribing	N/A	1255478061	0	0	FREEMAN, KERRI A LMFT	12/31/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	41389	N/A	N/A	N/A	N/A	N/A	7849 OCEANUS DRIVE	None	LOS ANGELES	CA	90046	2042	00	06000	34.11135643	-118.3657961	Los Angeles County
325957	Ordering, Referring, Prescribing	N/A	1255513172	0	0	FITZGERALD, PATRICK LMFT	6/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT40990	N/A	N/A	N/A	N/A	N/A	6221 GEARY BOULEVARD	2ND FLOOR	SAN FRANCISCO	CA	94121	1887	00	06000	37.77994312	-122.4862014	San Francisco County
326011	Ordering, Referring, Prescribing	N/A	1255622437	0	0	FISKIN, ANNA MD	6/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A136643	N/A	N/A	N/A	N/A	N/A	729 FILBERT ST	None	SAN FRANCISCO	CA	94133	2760	00	06000	37.80103613	-122.4119083	San Francisco County
326013	Ordering, Referring, Prescribing	N/A	1255626107	0	0	FREITAS, MELISSA C LMFT	3/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT86925	N/A	N/A	N/A	N/A	N/A	5180 GROVE ST	None	ROCKLIN	CA	95677	0021	00	06000	38.78939438	-121.2322891	Placer County
326046	Ordering, Referring, Prescribing	N/A	1255683199	0	0	FORRESTER, BRYAN PHD	6/1/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	28794	N/A	N/A	N/A	N/A	N/A	555 SCHOOL ST	None	PITTSBURG	CA	94565	3937	00	06000	38.01980655	-121.8792708	Contra Costa County
326055	Ordering, Referring, Prescribing	N/A	1255710687	0	0	FULLER, RYAN M MD	8/9/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146731	N/A	N/A	N/A	N/A	N/A	2150 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1337	00	06000	38.557287	-121.461444	Sacramento County
326099	Ordering, Referring, Prescribing	N/A	1255770632	0	0	FLAGG, SHANIA K MD	8/14/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151117	N/A	N/A	N/A	N/A	N/A	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	00	06000	36.60784193	-119.4520057	Fresno County
326184	Ordering, Referring, Prescribing	N/A	1255903803	0	0	FERGUSON, KERSTIN L NP	6/11/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017535	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	None	WEIMAR	CA	95736	0486	00	06000	39.03521526	-120.9755343	Placer County
326207	Ordering, Referring, Prescribing	N/A	1255935482	0	0	FOLKMAN, SAMANTHA L PA-C	2/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59139	N/A	N/A	N/A	N/A	N/A	4455 W 117TH ST	200	HAWTHORNE	CA	90250	2241	00	06000	33.92825048	-118.3539285	Los Angeles County
326220	Ordering, Referring, Prescribing	N/A	1255969754	0	0	FERNANDEZ, MELISSA LCSW	4/7/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	121900	N/A	N/A	N/A	N/A	N/A	204 HAMPTON DR.	None	VENICE	CA	90291	8633	00	06000	33.99779632	-118.4781798	Los Angeles County
326238	Ordering, Referring, Prescribing	N/A	1255997045	0	0	FRIAL, KRISTIN CARIDAD F NP	5/15/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011791	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
326273	Ordering, Referring, Prescribing	N/A	1265079180	0	0	FRIZZELLE, MICHELLE LMFT	5/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132628	N/A	N/A	N/A	N/A	N/A	658 E BRIER DR	200	SAN BERNARDINO	CA	92408	2880	00	06000	34.07137738	-117.2702805	San Bernardino County
326293	Ordering, Referring, Prescribing	N/A	1265153639	0	0	FRENCH, GEORGE J DDS	4/15/2024	Taxonomy not applicable	NA	n/a	000	Unknown	DDS107927	N/A	N/A	N/A	N/A	N/A	16055 VENTURA BLVD	400	ENCINO	CA	91436	2601	00	06000	34.15632563	-118.4832351	Los Angeles County
326298	Ordering, Referring, Prescribing	N/A	1265154868	0	0	FOWKES, SLOANE E LCSW	1/22/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113084	N/A	N/A	N/A	N/A	N/A	345 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	1633	00	06000	34.04602976	-118.2429461	Los Angeles County
326368	Ordering, Referring, Prescribing	N/A	1265559686	0	0	FLORES, ARACELI L LCSW	8/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW68102	N/A	N/A	N/A	N/A	N/A	359 GABILAN DR.	None	SOLEDAD	CA	93960	3550	00	06000	36.43614633	-121.3277604	Monterey County
326443	Ordering, Referring, Prescribing	N/A	1265711782	0	0	FERRERA, ABBIE D LMFT	6/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96870	N/A	N/A	N/A	N/A	N/A	299 12TH ST	None	MARINA	CA	93933	6003	00	06000	36.66784472	-121.8011077	Monterey County
326457	Ordering, Referring, Prescribing	N/A	1265717821	0	0	FREEMAN, ROBYN R LMFT	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117312	N/A	N/A	N/A	N/A	N/A	572 N ARROWHEAD AVE	None	SAN BERNARDINO	CA	92401	1251	00	06000	34.109667	-117.289669	San Bernardino County
326460	Ordering, Referring, Prescribing	N/A	1265718324	0	0	FEER, MICHAEL H LCSW	7/30/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27562	N/A	N/A	N/A	N/A	N/A	2743 HIGHLAND AVE	None	NATIONAL CITY	CA	91950	7410	00	06000	32.66109542	-117.0920417	San Diego County
326549	Ordering, Referring, Prescribing	N/A	1265869895	0	0	FORD, MARIE CNP	5/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	AP8878	N/A	N/A	N/A	N/A	N/A	1607 E PLANTATION RD	None	MOHAVE VALLEY	AZ	86440	8420	00	06000	34.851987	-114.5952675	Mohave County
326558	Ordering, Referring, Prescribing	N/A	1265884654	0	0	FORD, JERRI LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105745	N/A	N/A	N/A	N/A	N/A	811 GRAND AVE	None	SACRAMENTO	CA	95838	3466	00	06000	38.637621	-121.4470125	Sacramento County
326570	Ordering, Referring, Prescribing	N/A	1265905236	0	0	FISS, NICOLE PA	10/19/2018	Taxonomy not applicable	NA	n/a	000	Unknown	PA56184	N/A	N/A	N/A	N/A	N/A	1578 COLORADO BLVD	13	LOS ANGELES	CA	90041	1451	00	06000	34.13947661	-118.2009328	Los Angeles County
326576	Ordering, Referring, Prescribing	N/A	1265899785	0	0	FERNANDEZ, JUAN CARLOS MSW LCSW	1/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93946	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
326589	Ordering, Referring, Prescribing	N/A	1265926802	0	0	FEREBEE, JULIE L RN PHN	9/25/2018	Taxonomy not applicable	NA	n/a	000	Unknown	428873	N/A	N/A	N/A	N/A	N/A	39139 10TH ST E	None	PALMDALE	CA	93550	3419	00	06000	34.592544	-118.1120755	Los Angeles County
326590	Ordering, Referring, Prescribing	N/A	1265931760	0	0	FILGAS, BERGEN LMFT	12/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34569	N/A	N/A	N/A	N/A	N/A	6200 CLAUS RD	None	RIVERBANK	CA	95367	2678	00	06000	37.730763	-120.9197745	Stanislaus County
326659	Ordering, Referring, Prescribing	N/A	1275075376	0	0	FITZGERALD, EMILY J LCSW	12/15/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	91687	N/A	N/A	N/A	N/A	N/A	1234 EMPIRE ST	None	FAIRFIELD	CA	94533	5711	00	06000	38.25037548	-122.049045	Solano County
326750	Ordering, Referring, Prescribing	N/A	1275316176	0	0	FONSECA-TWEED, ASHLEY NP	7/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025817	N/A	N/A	N/A	N/A	N/A	11980 MOUNT VERNON AVENU	None	GRAND TERRACE	CA	92313	5172	00	06000	34.036353	-117.3136565	San Bernardino County
326828	Ordering, Referring, Prescribing	N/A	1275685653	0	0	FALVO, FREDERICK J MD	12/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A86045	N/A	N/A	N/A	N/A	N/A	4000 ORANGE ST	None	RIVERSIDE	CA	92501	3613	00	06000	33.97899555	-117.37481	Riverside County
326841	Ordering, Referring, Prescribing	N/A	1275728347	0	0	FORD, ANN R LMFT	2/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105653	N/A	N/A	N/A	N/A	N/A	2750 E. WASHINGTON BLVD.	None	PASADENA	CA	91107	1448	00	06000	34.1680038	-118.0943955	Los Angeles County
326851	Ordering, Referring, Prescribing	N/A	1275758070	0	0	FRIEDMAN, AMANDA S NP	12/5/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0611590	N/A	N/A	N/A	N/A	N/A	4501 MISSION BAY DRIVE	SUITE 1	SAN DIEGO	CA	92109	4923	00	06000	32.80307971	-117.2166446	San Diego County
326934	Ordering, Referring, Prescribing	N/A	1275897647	0	0	FARAHMAND, FARHOOD MD	10/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A169073	N/A	N/A	N/A	N/A	N/A	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	0000	00	06000	34.17030266	-118.5881699	Los Angeles County
326955	Ordering, Referring, Prescribing	N/A	1275925232	0	0	FAZEL, ZOHAL PHARMD	2/3/2020	Taxonomy not applicable	NA	n/a	000	Unknown	72252	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD. M	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
326966	Ordering, Referring, Prescribing	N/A	1275933087	0	0	FRANCO, SUSANA LMFT	6/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126437	N/A	N/A	N/A	N/A	N/A	42455 10TH ST. WEST	SUITE 103	LANCASTER	CA	93534	7060	00	06000	34.65438079	-118.1478341	Los Angeles County
327014	Ordering, Referring, Prescribing	N/A	1285005801	0	0	FALKNER, MICHAELA	1/21/2019	Taxonomy not applicable	NA	n/a	000	Unknown	ND835	N/A	N/A	N/A	N/A	N/A	435 PETALUMA AVE	150	SEBASTOPOL	CA	95472	4207	00	06000	38.39899727	-122.8215695	Sonoma County
327043	Ordering, Referring, Prescribing	N/A	1285041764	0	0	FICKENSCHER, NICHOLE MD	7/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A141598	N/A	N/A	N/A	N/A	N/A	1028 E VERNON AVE	None	LOS ANGELES	CA	90011	3717	00	06000	34.00389853	-118.257615	Los Angeles County
327114	Ordering, Referring, Prescribing	N/A	1285148742	0	0	FERNANDEZ, EUNICE NP	4/24/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007889	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
327119	Ordering, Referring, Prescribing	N/A	1285157263	0	0	FUENTES, HONEYMAE LCSW	5/29/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW122807	N/A	N/A	N/A	N/A	N/A	6615 VALLEY HI DR	SUITE A	SACRAMENTO	CA	95823	7076	00	06000	38.470986	-121.4276985	Sacramento County
327145	Ordering, Referring, Prescribing	N/A	1285213488	0	0	FRANKENBERGER, MIRONDA DDS	11/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	108179	N/A	N/A	N/A	N/A	N/A	2928 EASTERN AVE	None	SACRAMENTO	CA	95821	4210	00	06000	38.618703	-121.3635915	Sacramento County
327158	Ordering, Referring, Prescribing	N/A	1285221440	0	0	FULLER, JEREMY W	7/27/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015009	N/A	N/A	N/A	N/A	N/A	29632 HWY 299 E	None	ROUND MOUNTAIN	CA	96084	0228	00	06000	40.80385331	-121.9397745	Shasta County
327218	Ordering, Referring, Prescribing	N/A	1285368712	0	0	FRAZIER, LOUISA PA-C	10/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61306	N/A	N/A	N/A	N/A	N/A	1735 MISSION ST	None	SAN FRANCISCO	CA	94103	2417	00	06000	37.76957692	-122.4199811	San Francisco County
327268	Ordering, Referring, Prescribing	N/A	1285720003	0	0	FLYNN, KEVIN M LCSW	7/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW15686	N/A	N/A	N/A	N/A	N/A	33692 BLUE LANTERN ST	J	DANA POINT	CA	92629	1734	00	06000	33.47364855	-117.7049945	Orange County
327287	Ordering, Referring, Prescribing	N/A	1285763615	0	0	FARABAUGH, PHILIP MD	10/29/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C55939	N/A	N/A	N/A	N/A	N/A	11980 MOUNT VERNON AVENU	None	GRAND TERRACE	CA	92313	5172	00	06000	34.036353	-117.3136565	San Bernardino County
327305	Ordering, Referring, Prescribing	N/A	1285787382	0	0	FUHRMAN, BEVERLY A LMFT	10/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39724	N/A	N/A	N/A	N/A	N/A	2311 LOVERIDGE RD	None	PITTSBURG	CA	94565	5117	00	06000	38.00694767	-121.8712439	Contra Costa County
327374	Ordering, Referring, Prescribing	N/A	1285927509	0	0	FRYE, TIFFANY L DO	7/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17429	N/A	N/A	N/A	N/A	N/A	37491 ENTERPRISE DRIVE	None	BURNEY	CA	96013	4380	00	06000	40.88784451	-121.6526265	Shasta County
327428	Ordering, Referring, Prescribing	N/A	1295029429	0	0	FIGUEROA-PHILLIPS, LAURA MD	11/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C163031	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
327539	Ordering, Referring, Prescribing	N/A	1295241180	0	0	FLETCHER, AMBER R AU	9/2/2022	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	AU3733	N/A	N/A	N/A	N/A	N/A	5333 HOLLISTER AVENUE	165	SANTA BARBARA	CA	93111	2461	00	06000	34.43491982	-119.8105484	Santa Barbara County
327548	Ordering, Referring, Prescribing	N/A	1295251585	0	0	FRIDLEY, DANIEL	10/24/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111385	N/A	N/A	N/A	N/A	N/A	339 PAJARO ST	SUITE D	SALINAS	CA	93901	3400	00	06000	36.6725294	-121.6522021	Monterey County
327679	Ordering, Referring, Prescribing	N/A	1295776334	0	0	FRENDO, JUDY L LMFT	1/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT24909	N/A	N/A	N/A	N/A	N/A	419 MASON ST	206B	VACAVILLE	CA	95688	4546	00	06000	38.35495952	-121.988385	Solano County
327718	Ordering, Referring, Prescribing	N/A	1295878098	0	0	FLORESCIO, PEDRO M MD	11/19/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A44757	N/A	N/A	N/A	N/A	N/A	9101 WHITTIER BLVD.	None	PICO RIVERA	CA	90660	2405	00	06000	34.00074139	-118.0822944	Los Angeles County
327745	Ordering, Referring, Prescribing	N/A	1295941417	0	0	FREITAS, JULIE LMFT	7/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42369	N/A	N/A	N/A	N/A	N/A	137 N. COTTONWOOD STREET	None	WOODLAND	CA	95695	2206	00	06000	38.68538399	-121.7933582	Yolo County
327785	Ordering, Referring, Prescribing	N/A	1306026737	0	0	FORSMAN, SHANA A PA	2/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	19437	N/A	N/A	N/A	N/A	N/A	1130 2ND ST	None	ENCINITAS	CA	92024	5008	00	06000	33.03747413	-117.2936839	San Diego County
327791	Ordering, Referring, Prescribing	N/A	1306045976	0	0	FU, EMERY J MD	2/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A91981	N/A	N/A	N/A	N/A	N/A	2275 ARLINGTON DR	None	SAN LEANDRO	CA	94578	1132	00	06000	37.70851907	-122.1117036	Alameda County
327841	Ordering, Referring, Prescribing	N/A	1306140090	0	0	FUENTES, KARINA LMFT	12/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123490	N/A	N/A	N/A	N/A	N/A	1255 KENDALL RD	None	SAN LUIS OBISPO	CA	93401	8750	00	06000	35.2372881	-120.6292313	San Luis Obispo County
327854	Ordering, Referring, Prescribing	N/A	1306149257	0	0	FERRER, CELIA T LPCC	4/10/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC7226	N/A	N/A	N/A	N/A	N/A	777 N FIRST STREET	400	SAN JOSE	CA	95112	6339	00	06000	37.35064564	-121.9015633	Santa Clara County
327877	Ordering, Referring, Prescribing	N/A	1306192398	0	0	FISHER, AARON M PSYD	10/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30124	N/A	N/A	N/A	N/A	N/A	447 N EL MOLINO AVE	None	PASADENA	CA	91101	1403	00	06000	34.15365596	-118.1370318	Los Angeles County
327879	Ordering, Referring, Prescribing	N/A	1306193933	0	0	FIGUEROA, CARLOS J LMFT	4/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102315	N/A	N/A	N/A	N/A	N/A	1212 N CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
327887	Ordering, Referring, Prescribing	N/A	1306209010	0	0	FUNGHI, CRISTINA MD	6/5/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160783	N/A	N/A	N/A	N/A	N/A	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
327908	Ordering, Referring, Prescribing	N/A	1306231998	0	0	FARKAS-SKILES, CRISTINA M MD	3/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147776	N/A	N/A	N/A	N/A	N/A	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	0000	00	06000	33.808185	-118.1850575	Los Angeles County
327921	Ordering, Referring, Prescribing	N/A	1306236799	0	0	FULLER-SINKLER, HALEY A NP	11/22/2017	Taxonomy not applicable	NA	n/a	000	Unknown	780214	N/A	N/A	N/A	N/A	N/A	655 REDWOOD HWY FRONTAGE	SUITE 240	MILL VALLEY	CA	94941	3034	00	06000	37.89126837	-122.5169784	Marin County
327951	Ordering, Referring, Prescribing	N/A	1306306584	0	0	FINLEY, JOSHUA B	1/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176165	N/A	N/A	N/A	N/A	N/A	6800 OWENSMOUTH AVE.	#160	CANOGA PARK	CA	91303	3159	00	06000	34.194276	-118.6014945	Los Angeles County
327957	Ordering, Referring, Prescribing	N/A	1306309026	0	0	FLORES, CHERYL A NP	6/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	NP95011511	N/A	N/A	N/A	N/A	N/A	1880 E WASHINGTON ST	None	COLTON	CA	92324	4621	00	06000	34.04839648	-117.2955915	San Bernardino County
327970	Ordering, Referring, Prescribing	N/A	1306333505	0	0	FIRRIOLO, JOSEPH M MD	9/13/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174913	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
327987	Ordering, Referring, Prescribing	N/A	1306367792	0	0	FREER, ZACHARY L	6/1/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	101384	N/A	N/A	N/A	N/A	N/A	678 3RD AVE	None	CHULA VISTA	CA	91910	5736	00	06000	32.62870793	-117.0750108	San Diego County
328009	Ordering, Referring, Prescribing	N/A	1306423694	0	0	FRESCHL, GUILLE MD	5/1/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185020	N/A	N/A	N/A	N/A	N/A	5580 CALLE REAL	None	SANTA BARBARA	CA	93111	1646	00	06000	34.44131559	-119.8184752	Santa Barbara County
328052	Ordering, Referring, Prescribing	N/A	1306509021	0	0	FACIANA, CANDICE	11/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	25775	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD ROAD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
328090	Ordering, Referring, Prescribing	N/A	1306819586	0	0	FLORES, DEBORAH L MD	11/2/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70890	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST.	#498	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
328097	Ordering, Referring, Prescribing	N/A	1306855630	0	0	FORGETTE, GINA M	6/27/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26403	N/A	N/A	N/A	N/A	N/A	1989 VICENTE DR	None	SAN LUIS OBISPO	CA	93405	6863	00	06000	35.25396985	-120.6858341	San Luis Obispo County
328161	Ordering, Referring, Prescribing	N/A	1306982244	0	0	FINE, HEATHER M LMFT	5/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52003	N/A	N/A	N/A	N/A	N/A	776 S. STATE ST	SUITE 107	UKIAH	CA	95482	5847	00	06000	39.13987386	-123.2059844	Mendocino County
328164	Ordering, Referring, Prescribing	N/A	1316023310	0	0	FAAL, FARIDA K CNP	9/23/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	16295	N/A	N/A	N/A	N/A	N/A	5300 TUJUNGA AVE	None	NORTH HOLLYWOOD	CA	91601	3121	00	06000	34.167276	-118.3789445	Los Angeles County
328169	Ordering, Referring, Prescribing	N/A	1316018294	0	0	FRIEDLER, ELIJAH E MD	1/25/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C41058	N/A	N/A	N/A	N/A	N/A	9990 COUNTY FARM RD	None	RIVERSIDE	CA	92503	3542	00	06000	33.9201112	-117.4577963	Riverside County
328227	Ordering, Referring, Prescribing	N/A	1316162514	0	0	FISCHER, ROBERT D LCSW	7/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81027	N/A	N/A	N/A	N/A	N/A	604 PEARL ST	None	MONTEREY	CA	93940	3070	00	06000	36.59779529	-121.8889498	Monterey County
328233	Ordering, Referring, Prescribing	N/A	1316163801	0	0	FERGUSON, SHERYLE A LMFT	1/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT44104	N/A	N/A	N/A	N/A	N/A	209 E. 7TH ST.	None	MADERA	CA	93638	4460	00	06000	36.96069768	-120.0559841	Madera County
328240	Ordering, Referring, Prescribing	N/A	1316175524	0	0	FERRER, ADAREZZA MD	7/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A123390	N/A	N/A	N/A	N/A	N/A	1465 30TH ST	K	SAN DIEGO	CA	92154	3497	00	06000	32.72113554	-117.1302118	San Diego County
328251	Ordering, Referring, Prescribing	N/A	1316212848	0	0	FOGLESONG, CHRISTOPHER P MD	12/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140877	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
328294	Ordering, Referring, Prescribing	N/A	1316297518	0	0	FRANCIS, JEANETTE E PSY	6/18/2017	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27729	N/A	N/A	N/A	N/A	N/A	2350 BUHNE ST	None	EUREKA	CA	95501	3205	00	06000	40.78592523	-124.1422103	Humboldt County
328297	Ordering, Referring, Prescribing	N/A	1316297286	0	0	FENDRICK, KRISTA PA	6/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	22477	N/A	N/A	N/A	N/A	N/A	2900 S. HARBOR BLVD	100	SANTA ANA	CA	92704	6429	00	06000	33.70816839	-117.9197655	Orange County
328391	Ordering, Referring, Prescribing	N/A	1316428592	0	0	FOX, KATHLEEN J	9/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113943	N/A	N/A	N/A	N/A	N/A	1800 GRAVENSTEIN HWY, N	None	SEBASTOPOL	CA	95472	2607	00	06000	38.42104172	-122.8461197	Sonoma County
328451	Ordering, Referring, Prescribing	N/A	1316506306	0	0	FALLOWS, JODIE PHARMD	4/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76669	N/A	N/A	N/A	N/A	N/A	3190 CONTRA LOMA BLVD	None	ANTIOCH	CA	94509	5400	00	06000	37.99041765	-121.8226034	Contra Costa County
328498	Ordering, Referring, Prescribing	N/A	1316598741	0	0	FERNANDEZ, KATELYN PA-C	10/16/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA65254	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
328547	Ordering, Referring, Prescribing	N/A	1316976152	0	0	FREEDMAN, ERIC R MD	3/7/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C51515	N/A	N/A	N/A	N/A	N/A	6600 COYLE AVE	None	CARMICHAEL	CA	95608	6344	00	06000	38.667807	-121.310748	Sacramento County
328553	Ordering, Referring, Prescribing	N/A	1316985203	0	0	FATU, ANCA E NP	3/17/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	559580	N/A	N/A	N/A	N/A	N/A	7100 VAN NUYS BLVD	STE 108	VAN NUYS	CA	91326	3063	00	06000	34.19957761	-118.4487663	Los Angeles County
328574	Ordering, Referring, Prescribing	N/A	1326098534	0	0	FIDEL, MANOLITO B MD	2/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A81909	N/A	N/A	N/A	N/A	N/A	23700 CAMINO DEL SOL	None	TORRANCE	CA	90505	5017	00	06000	33.8102385	-118.3441185	Los Angeles County
328619	Ordering, Referring, Prescribing	N/A	1326168782	0	0	FERRIS, MARY E	10/24/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G45336	N/A	N/A	N/A	N/A	N/A	518 GARDEN ST	None	SANTA BARBARA	CA	93101	1606	00	06000	34.42054634	-119.6928135	Santa Barbara County
328643	Ordering, Referring, Prescribing	N/A	1326196932	0	0	FELIX, STACY K	7/17/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D52742	N/A	N/A	N/A	N/A	N/A	425 N DATE ST	None	ESCONDIDO	CA	92025	3413	00	06000	33.1292461	-117.0716509	San Diego County
328648	Ordering, Referring, Prescribing	N/A	1326214867	0	0	FULLER, MARIEL LMFT	2/13/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	137909	N/A	N/A	N/A	N/A	N/A	2008 N. GAREY AVE	None	POMONA	CA	91767	2722	00	06000	34.08295003	-117.7528173	Los Angeles County
328668	Ordering, Referring, Prescribing	N/A	1326261967	0	0	FELIZ, TRISHA L LCSW	8/30/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71288	N/A	N/A	N/A	N/A	N/A	4600 PANAMA LN	102B	BAKERSFIELD	CA	93313	3509	00	06000	35.29596129	-119.0543102	Kern County
328674	Ordering, Referring, Prescribing	N/A	1326265422	0	0	FARAJZADEH, FARSHID PT	3/15/2018	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT20075	N/A	N/A	N/A	N/A	N/A	4501 MISSION BAY DRIVE	SUITE 3K	SAN DIEGO	CA	92109	4926	00	06000	32.80307971	-117.2166446	San Diego County
328689	Ordering, Referring, Prescribing	N/A	1326301201	0	0	FIGUEROA, NICHOLAS MD	12/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158621	N/A	N/A	N/A	N/A	N/A	4760 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
328694	Ordering, Referring, Prescribing	N/A	1326301854	0	0	FLOWERS, SHERETTE	5/18/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	16184	N/A	N/A	N/A	N/A	N/A	5843 1/2 OVERHILL DR	None	LOS ANGELES	CA	90043	2727	00	06000	33.98748969	-118.3544033	Los Angeles County
328736	Ordering, Referring, Prescribing	N/A	1326345620	0	0	FOLEY, MELISSA A LCSW	2/3/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82314	N/A	N/A	N/A	N/A	N/A	7200 SKYWAY AVE.	None	PARADISE	CA	95969	3280	00	06000	39.76584095	-121.6165325	Butte County
328745	Ordering, Referring, Prescribing	N/A	1326356072	0	0	FISHER, VICTORIA LCSW	4/26/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW66435	N/A	N/A	N/A	N/A	N/A	51 ZACA LN	SUITE 100	SAN LUIS OBISPO	CA	93401	7399	00	06000	35.25121029	-120.673119	San Luis Obispo County
328789	Ordering, Referring, Prescribing	N/A	1326423633	0	0	FROLLI, LETA	9/20/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC6544	N/A	N/A	N/A	N/A	N/A	1420 WILLOW PASS RD	200	CONCORD	CA	94520	5823	00	06000	37.96956948	-122.0507563	Contra Costa County
328802	Ordering, Referring, Prescribing	N/A	1326435447	0	0	FLYNN, ANNE N MD	6/30/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173088	N/A	N/A	N/A	N/A	N/A	3100 COHASSET RD	None	CHICO	CA	95973	0962	00	06000	39.77184653	-121.8436243	Butte County
328945	Ordering, Referring, Prescribing	N/A	1326704651	0	0	FELDHAUS, BARBARA PA-C	3/19/2024	Taxonomy not applicable	NA	n/a	000	Unknown	60464	N/A	N/A	N/A	N/A	N/A	193 FAIRVIEW LN	None	SONORA	CA	95370	4828	00	06000	37.97880957	-120.3912459	Tuolumne County
329009	Ordering, Referring, Prescribing	N/A	1336210707	0	0	FREEDMAN, MD, GARY MD	2/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A41220	N/A	N/A	N/A	N/A	N/A	720 WOOD STREET	None	EUREKA	CA	95521	0000	00	06000	40.78118068	-124.1607622	Humboldt County
329010	Ordering, Referring, Prescribing	N/A	1336233295	0	0	FISHER, ROBYN J LCSW	8/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	103242	N/A	N/A	N/A	N/A	N/A	592 RIO LINDO AVE	None	CHICO	CA	95926	1817	00	06000	39.75427022	-121.8482553	Butte County
329020	Ordering, Referring, Prescribing	N/A	1336228337	0	0	FIELD, GLADYS NP	11/17/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP16524	N/A	N/A	N/A	N/A	N/A	4460 BROAD ST	STE 110	SAN LUIS OBISPO	CA	93401	0001	00	06000	35.24211197	-120.6389543	San Luis Obispo County
329037	Ordering, Referring, Prescribing	N/A	1336275999	0	0	FANG, NANCY PSYD	10/29/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	23671	N/A	N/A	N/A	N/A	N/A	1021 S. EL CAMINO REAL	None	SAN MATEO	CA	94402	2801	00	06000	37.55684528	-122.31914	San Mateo County
329051	Ordering, Referring, Prescribing	N/A	1336311315	0	0	FAROOQI, OMAR MD	5/10/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A112480	N/A	N/A	N/A	N/A	N/A	2085 RUSTIN AVE	None	RIVERSIDE	CA	92507	2498	00	06000	33.99323085	-117.3355363	Riverside County
329054	Ordering, Referring, Prescribing	N/A	1336320407	0	0	FAYSMAN, KAROLINA	3/4/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0559302	N/A	N/A	N/A	N/A	N/A	200 UCLA MEDICAL PLZ	STE 120	LOS ANGELES	CA	90095	8344	00	06000	34.065126	-118.446237	Los Angeles County
329058	Ordering, Referring, Prescribing	N/A	1336329366	0	0	FLORES, SABRINA LCSW	6/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27907	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE.	125-C	OAKLAND	CA	94605	2424	00	06000	37.768221	-122.17608	Alameda County
329076	Ordering, Referring, Prescribing	N/A	1336347798	0	0	FAIRON, MICHEL M MD	3/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G21394	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	BUILDING A	NAPA	CA	94558	6216	00	06000	38.24829023	-122.2745626	Napa County
329121	Ordering, Referring, Prescribing	N/A	1336442409	0	0	FRAZIER, BRANDON S LMFT	5/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112752	N/A	N/A	N/A	N/A	N/A	391 TAYLOR BLVD	100	PLEASANT HILL	CA	94523	2294	00	06000	37.96119614	-122.070409	Contra Costa County
329142	Ordering, Referring, Prescribing	N/A	1336491521	0	0	FARD, ARRASH MD	6/15/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A156502	N/A	N/A	N/A	N/A	N/A	124 MACAW LN	None	SIMI VALLEY	CA	93065	3152	00	06000	34.2595744	-118.7948374	Ventura County
329148	Ordering, Referring, Prescribing	N/A	1336495548	0	0	FIGUEROA, CARMEN T LCSW	6/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87402	N/A	N/A	N/A	N/A	N/A	349 EAST AVENUE K-6	A	LANCASTER	CA	93535	4508	00	06000	34.6750509	-118.1246552	Los Angeles County
329248	Ordering, Referring, Prescribing	N/A	1336637107	0	0	FELDMAN, JACOB A MD	8/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174694	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD.	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
329249	Ordering, Referring, Prescribing	N/A	1336637909	0	0	FONG, JOEL A	6/16/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	104341	N/A	N/A	N/A	N/A	N/A	11670 ATWOOD RD	None	AUBURN	CA	95603	9522	00	06000	38.93485327	-121.0988193	Placer County
329252	Ordering, Referring, Prescribing	N/A	1336641125	0	0	FRIDAY, BENJAMIN LMFT	10/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122263	N/A	N/A	N/A	N/A	N/A	2750 SUTTERVILLE RD	None	SACRAMENTO	CA	95820	1024	00	06000	38.540124	-121.4786745	Sacramento County
329286	Ordering, Referring, Prescribing	N/A	1336674571	0	0	FUENTES, WENDY S NP	12/26/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006492	N/A	N/A	N/A	N/A	N/A	45104 10TH ST W	None	LANCASTER	CA	93534	2310	00	06000	34.702929	-118.1480935	Los Angeles County
329314	Ordering, Referring, Prescribing	N/A	1336747153	0	0	FLORES, PATRICIA	10/28/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	150948	N/A	N/A	N/A	N/A	N/A	20101 HAMILTON AVE	155	TORRANCE	CA	90502	1306	00	06000	33.84828383	-118.2860386	Los Angeles County
329319	Ordering, Referring, Prescribing	N/A	1336764646	0	0	FODEN, MELINA PSYD	7/18/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	33810	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
329395	Ordering, Referring, Prescribing	N/A	1346228707	0	0	FONG BECK, MEI-LING E MD	2/23/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A63227	N/A	N/A	N/A	N/A	N/A	1000 S. ELISEO DR.	STE. 200	GREENBRAE	CA	94904	2107	00	06000	37.94348559	-122.5335273	Marin County
329402	Ordering, Referring, Prescribing	N/A	1346271947	0	0	FUCHS, LESLIE MD	3/22/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G70089	N/A	N/A	N/A	N/A	N/A	2034 DE LA VINA ST	None	SANTA BARBARA	CA	93105	3814	00	06000	34.4295686	-119.7179965	Santa Barbara County
329419	Ordering, Referring, Prescribing	N/A	1346316031	0	0	FUJIMOTO, STEVEN H	12/7/2004	Taxonomy not applicable	NA	n/a	099	DENTIST	D50056	N/A	N/A	N/A	N/A	N/A	8505 GULANA AVE	UNIT 6114	PLAYA DEL REY	CA	90293	8380	00	06000	33.95886964	-118.4346226	Los Angeles County
329427	Ordering, Referring, Prescribing	N/A	1346313921	0	0	FLORES, OLGA S PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46156	N/A	N/A	N/A	N/A	N/A	10992 SAN DIEGO MISSION	3RD FLOOR HOSPICE AREA	SAN DIEGO	CA	92108	2444	00	06000	32.78503881	-117.1020911	San Diego County
329458	Ordering, Referring, Prescribing	N/A	1346384930	0	0	FLEISHMAN, JANET R LCSW	12/2/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	14312	N/A	N/A	N/A	N/A	N/A	14112 S. KINGSLEY DRIVE	1ST FLOOR	GARDENA	CA	90249	3018	00	06000	33.902901	-118.304243	Los Angeles County
329498	Ordering, Referring, Prescribing	N/A	1346477585	0	0	FITO, DENNIS ALLEN M MD	3/11/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C161245	N/A	N/A	N/A	N/A	N/A	6 TARMAN DR	None	CLOVERDALE	CA	95425	3932	00	06000	38.79822374	-123.0176641	Sonoma County
329510	Ordering, Referring, Prescribing	N/A	1346510435	0	0	FOK, JAMES Y PHARMD	5/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	74011	N/A	N/A	N/A	N/A	N/A	5301 ALMADEN EXPY	None	SAN JOSE	CA	95118	3603	00	06000	37.253214	-121.880196	Santa Clara County
329604	Ordering, Referring, Prescribing	N/A	1346640695	0	0	FUNG, ALEXANDER PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71032	N/A	N/A	N/A	N/A	N/A	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	00	06000	38.644479	-121.1349735	Sacramento County
329627	Ordering, Referring, Prescribing	N/A	1346687639	0	0	FRIEDMAN, KAREN A LMFT	7/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97619	N/A	N/A	N/A	N/A	N/A	2621 OSWELL ST	119	BAKERSFIELD	CA	93306	3172	00	06000	35.393283	-118.9496505	Kern County
329651	Ordering, Referring, Prescribing	N/A	1346719002	0	0	FREGEAU, JOELLE LMFT	2/25/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124583	N/A	N/A	N/A	N/A	N/A	455 1ST STREET	None	WOODLAND	CA	95695	4023	00	06000	38.675781	-121.773122	Yolo County
329680	Ordering, Referring, Prescribing	N/A	1346767647	0	0	FASULO, CHRISTOPHER F PA-C	4/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54918	N/A	N/A	N/A	N/A	N/A	7202 N MILLBROOK AVE	202	FRESNO	CA	93720	3341	00	06000	36.83958089	-119.7645538	Fresno County
329763	Ordering, Referring, Prescribing	N/A	1346963196	0	0	FINK, MARGARET H NP	3/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95021691	N/A	N/A	N/A	N/A	N/A	3522 W MAGNOLIA BLVD	None	BURBANK	CA	91505	0000	00	06000	34.16824582	-118.3457832	Los Angeles County
329776	Ordering, Referring, Prescribing	N/A	1356002745	0	0	FOULAD, SHARON H PA	1/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60568	N/A	N/A	N/A	N/A	N/A	40910 FREMONT BLVD	None	FREMONT	CA	94538	4375	00	06000	37.53384106	-121.9607241	Alameda County
329879	Ordering, Referring, Prescribing	N/A	1356512578	0	0	FUENMAYOR, MARIELA J MD	5/22/2020	Taxonomy not applicable	NA	n/a	000	Unknown	C168841	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE STE 100	STE 100	GILROY	CA	95020	3675	00	06000	37.03080985	-121.5741639	Santa Clara County
329884	Ordering, Referring, Prescribing	N/A	1356518096	0	0	FAUSCETTE, NICOLE C LMFT	11/13/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53153	N/A	N/A	N/A	N/A	N/A	2121 W TEMPLE ST	None	LOS ANGELES	CA	90026	4915	00	06000	34.07053729	-118.268744	Los Angeles County
329933	Ordering, Referring, Prescribing	N/A	1356625644	0	0	FELIX, MARIE HELENE M	8/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62628	N/A	N/A	N/A	N/A	N/A	24790 VALLEY STREET	None	NEWHALL	CA	91321	3290	00	06000	34.3792796	-118.5405452	Los Angeles County
329965	Ordering, Referring, Prescribing	N/A	1356685028	0	0	FRIDMAN DOUGHERTY, VICTORIA LMFT	10/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88819	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
329969	Ordering, Referring, Prescribing	N/A	1356686653	0	0	FUENTES, NIKOLE K LMFT	7/11/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38469	N/A	N/A	N/A	N/A	N/A	21380 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	3050	00	06000	34.41078438	-118.510775	Los Angeles County
330000	Ordering, Referring, Prescribing	N/A	1356716468	0	0	FERNANDEZ, RACHELLE LMFT	3/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118556	N/A	N/A	N/A	N/A	N/A	760 W MOUNTAIN VIEW STRE	None	ALTADENA	CA	91001	4925	00	06000	34.19178664	-118.1657029	Los Angeles County
330012	Ordering, Referring, Prescribing	N/A	1356750202	0	0	FLORES, JOANNA J LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113106	N/A	N/A	N/A	N/A	N/A	6301 BEACH BLVD STE 245	None	BUENA PARK	CA	90621	4031	00	06000	33.86880928	-117.9983013	Orange County
330066	Ordering, Referring, Prescribing	N/A	1356820336	0	0	FIEBER, RANDALL S RN PHN	3/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	220101796	N/A	N/A	N/A	N/A	N/A	3240 ERSKINE CREEK RD	None	LAKE ISABELLA	CA	93240	9608	00	06000	35.60975725	-118.4650869	Kern County
330085	Ordering, Referring, Prescribing	N/A	1356855142	0	0	FILLMORE, MELISSA	1/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013755	N/A	N/A	N/A	N/A	N/A	2001 WILSHIRE BLVD	320	SANTA MONICA	CA	90401	5683	00	06000	34.03162362	-118.4829513	Los Angeles County
330087	Ordering, Referring, Prescribing	N/A	1356869374	0	0	FREEMAN, DEBORAH I NP	8/25/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95003297	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
330089	Ordering, Referring, Prescribing	N/A	1356869002	0	0	FURNESS, MAURA	9/24/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104062	N/A	N/A	N/A	N/A	N/A	700 FREDERICK ST	103	SANTA CRUZ	CA	95062	2239	00	06000	36.98031434	-122.004438	Santa Cruz County
330140	Ordering, Referring, Prescribing	N/A	1356970883	0	0	FOX, MARISSA MD	5/25/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178987	N/A	N/A	N/A	N/A	N/A	5901 W OLYMPIC BLVD	310	LOS ANGELES	CA	90036	4667	00	06000	34.05764121	-118.3603115	Los Angeles County
330156	Ordering, Referring, Prescribing	N/A	1366000226	0	0	FUENTES, EUNICE D CP	6/22/2020	Taxonomy not applicable	NA	n/a	000	Unknown	6171	N/A	N/A	N/A	N/A	N/A	4425 S CENTRAL AVE	None	LOS ANGELES	CA	90011	3629	00	06000	34.003116	-118.2565185	Los Angeles County
330186	Ordering, Referring, Prescribing	N/A	1366070013	0	0	FLAUTERO ARCOS, JORGE MD	5/22/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A186482	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
330194	Ordering, Referring, Prescribing	N/A	1366083610	0	0	FULINARA, VANESSA M NP	5/1/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016619	N/A	N/A	N/A	N/A	N/A	47825 OASIS ST	None	INDIO	CA	92201	6950	00	06000	33.70112861	-116.2209066	Riverside County
330214	Ordering, Referring, Prescribing	N/A	1366129249	0	0	FAILINGER, LAURA NP	6/22/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025692	N/A	N/A	N/A	N/A	N/A	4212 MISSOURI FLAT RD	None	PLACERVILLE	CA	95667	6269	00	06000	38.706228	-120.834891	El Dorado County
330216	Ordering, Referring, Prescribing	N/A	1366136517	0	0	FLORES, JESSICA LCSW	10/8/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	126621	N/A	N/A	N/A	N/A	N/A	301 VICTORIA ST	CSU	COSTA MESA	CA	92627	1995	00	06000	33.65258952	-117.9121545	Orange County
330267	Ordering, Referring, Prescribing	N/A	1366519670	0	0	FUKUI, TOMONORI MD	7/14/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A75713	N/A	N/A	N/A	N/A	N/A	3177 OCEAN VIEW BLVD	None	SAN DIEGO	CA	92113	1432	00	06000	32.7011883	-117.1261025	San Diego County
330347	Ordering, Referring, Prescribing	N/A	1366719080	0	0	FORRESTER, STEFANIE PA-C	7/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	22003	N/A	N/A	N/A	N/A	N/A	18880 CHERRY VALLEY BLVD	None	TUOLUMNE	CA	95379	9506	00	06000	37.96511668	-120.2399015	Tuolumne County
330350	Ordering, Referring, Prescribing	N/A	1366720583	0	0	FIORENTINI, ELIO P LMFT	3/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT94340	N/A	N/A	N/A	N/A	N/A	1001 S GRAND AVE	B	SANTA ANA	CA	92705	4121	00	06000	33.73586511	-117.8502452	Orange County
330370	Ordering, Referring, Prescribing	N/A	1366761645	0	0	FRAZIER, JENNIFER PHD	12/3/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32262	N/A	N/A	N/A	N/A	N/A	251 LLEWELLYN AVE	None	CAMPBELL	CA	95008	1940	00	06000	37.29173129	-121.9584335	Santa Clara County
330387	Ordering, Referring, Prescribing	N/A	1366787780	0	0	FORD, KAMISHA N LMFT	1/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97715	N/A	N/A	N/A	N/A	N/A	9220 HAVEN AVENUE	SUITE 100	RANCHO CUCAMONGA	CA	91730	8551	00	06000	34.08525	-117.5758875	San Bernardino County
330474	Ordering, Referring, Prescribing	N/A	1366918187	0	0	FELIPE, JERALD V PHARMD	3/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79722	N/A	N/A	N/A	N/A	N/A	320 LENNON LN	BUILDING 1	WALNUT CREEK	CA	94598	2419	00	06000	37.92699561	-122.0292732	Contra Costa County
330490	Ordering, Referring, Prescribing	N/A	1366948143	0	0	FUNK, LUCY MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A165419	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
330526	Ordering, Referring, Prescribing	N/A	1376000745	0	0	FENTON, JESSICA LMFT	11/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129110	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	120	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
330539	Ordering, Referring, Prescribing	N/A	1376023374	0	0	FRITCHMAN, KATHERINE N	5/4/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130978	N/A	N/A	N/A	N/A	N/A	604 E WALKER ST	None	ORLAND	CA	95963	2203	00	06000	39.74726221	-122.1746908	Glenn County
330551	Ordering, Referring, Prescribing	N/A	1376046144	0	0	FAGUNDES, CHARLES MD	5/28/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173896	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	00	06000	37.34293689	-121.9270392	Santa Clara County
330647	Ordering, Referring, Prescribing	N/A	1376300962	0	0	FERNANDEZ, CESAR DDS	2/29/2024	Taxonomy not applicable	NA	n/a	000	Unknown	DDS109923	N/A	N/A	N/A	N/A	N/A	2500 MAIN ST	None	RED BLUFF	CA	96080	2336	00	06000	40.19240296	-122.2399354	Tehama County
330661	Ordering, Referring, Prescribing	N/A	1376541482	0	0	FOROUTAN, JOHN H	12/21/1985	Taxonomy not applicable	NA	n/a	099	DENTIST	D32956	N/A	N/A	N/A	N/A	N/A	8727 VAN NUYS BLVD	STE 203	PANORAMA CITY	CA	91402	2462	00	06000	34.22817174	-118.4502885	Los Angeles County
330677	Ordering, Referring, Prescribing	N/A	1376614545	0	0	FISHER-PRICE, AUDREY LCSW	9/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS18353	N/A	N/A	N/A	N/A	N/A	801 E CHAPMAN AVE	SUITE 203	FULLERTON	CA	92831	3839	00	06000	33.87407517	-117.9110814	Orange County
330679	Ordering, Referring, Prescribing	N/A	1376617134	0	0	FRANCE, DAVID P LMFT	3/3/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT79260	N/A	N/A	N/A	N/A	N/A	327 COLLEGE AVE	None	SANTA ROSA	CA	95401	5117	00	06000	38.445957	-122.7215205	Sonoma County
330684	Ordering, Referring, Prescribing	N/A	1376624023	0	0	FUNG TAM, NANCY PSYD	6/28/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21226	N/A	N/A	N/A	N/A	N/A	16350 FILBERT ST	None	SYLMAR	CA	91342	1002	00	06000	34.31595736	-118.4853828	Los Angeles County
330699	Ordering, Referring, Prescribing	N/A	1376663211	0	0	FRAUSTO, SONA B PHARMD	1/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54592	N/A	N/A	N/A	N/A	N/A	2930 FREEPORT BLVD	None	SACRAMENTO	CA	95818	3843	00	06000	38.551599	-121.4889165	Sacramento County
330701	Ordering, Referring, Prescribing	N/A	1376664458	0	0	FANG, KO B PHD	2/1/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	18841	N/A	N/A	N/A	N/A	N/A	1748 MILES COURT	SUITE B	MERCED	CA	95348	4300	00	06000	37.31095088	-120.5087292	Merced County
330704	Ordering, Referring, Prescribing	N/A	1376667881	0	0	FULEKI, MARIBEL LCSW	6/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW65758	N/A	N/A	N/A	N/A	N/A	16350 FILBERT STREET	None	SYLMAR	CA	91342	1002	00	06000	34.31595736	-118.4853828	Los Angeles County
330731	Ordering, Referring, Prescribing	N/A	1376694232	0	0	FLORES-CHAVEZ, MARIA DOLORES LCSW	2/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88621	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	A211	NAPA	CA	94558	6216	00	06000	38.24829023	-122.2745626	Napa County
330737	Ordering, Referring, Prescribing	N/A	1376728204	0	0	FLORES, NANCY LCSW	11/9/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW61038	N/A	N/A	N/A	N/A	N/A	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	00	06000	34.32450186	-118.4456317	Los Angeles County
330755	Ordering, Referring, Prescribing	N/A	1376773739	0	0	FERNANDEZ, BRIAN LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84136	N/A	N/A	N/A	N/A	N/A	13001 RAMONA BLVD.	SUITE A	IRWINDALE	CA	91706	3752	00	06000	34.07969659	-117.9895641	Los Angeles County
330811	Ordering, Referring, Prescribing	N/A	1376882381	0	0	FOX, JONATHAN H LMFT	1/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90115	N/A	N/A	N/A	N/A	N/A	720 WOOD ST.	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
330842	Ordering, Referring, Prescribing	N/A	1376925271	0	0	FLORES, MELISSA PSYD	8/29/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	33563	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT	None	LAKEPORT	CA	95453	9754	00	06000	39.03772106	-122.9223338	Lake County
330862	Ordering, Referring, Prescribing	N/A	1376959726	0	0	FEDOR, HEATHER	4/17/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029849	N/A	N/A	N/A	N/A	N/A	1907 BORDER AVE	None	TORRANCE	CA	90501	3606	00	06000	33.828615	-118.3130985	Los Angeles County
330885	Ordering, Referring, Prescribing	N/A	1376988899	0	0	FABIAN, ARLENE T CNP	1/13/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22792	N/A	N/A	N/A	N/A	N/A	15206 PARTHENIA ST	None	NORTH HILLS	CA	91343	5305	00	06000	34.22817313	-118.4636497	Los Angeles County
330888	Ordering, Referring, Prescribing	N/A	1376993196	0	0	FLOREZA, HANNAH	2/11/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99957	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVENUE	100	GILROY	CA	95020	0000	00	06000	37.03080985	-121.5741639	Santa Clara County
330890	Ordering, Referring, Prescribing	N/A	1376996025	0	0	FLOYD, ANDREA N PHARMD	10/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74574	N/A	N/A	N/A	N/A	N/A	1625 N SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
331006	Ordering, Referring, Prescribing	N/A	1386169639	0	0	FERRELL, CHELSEY DO	11/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17613	N/A	N/A	N/A	N/A	N/A	711 W. FLORENCE AVENUE	None	LOS ANGELES	CA	90044	6105	00	06000	33.9746755	-118.286415	Los Angeles County
331072	Ordering, Referring, Prescribing	N/A	1386282705	0	0	FOSTER, ALEXANDRA D PA	6/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57343	N/A	N/A	N/A	N/A	N/A	7526 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92111	1504	00	06000	32.83275147	-117.157122	San Diego County
331091	Ordering, Referring, Prescribing	N/A	1386318962	0	0	FERREIRA, MARIA G LCSW	8/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94406	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
331096	Ordering, Referring, Prescribing	N/A	1386331585	0	0	FARID, FAIZAN DDS	11/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	108372	N/A	N/A	N/A	N/A	N/A	725 W I STREET	None	LOS BANOS	CA	93635	3478	00	06000	37.06257631	-120.8618873	Merced County
331126	Ordering, Referring, Prescribing	N/A	1386481265	0	0	FOSS, MADISON NP	10/24/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95032719	N/A	N/A	N/A	N/A	N/A	711 STONY POINT ROAD	SUITE 17	SANTA ROSA	CA	95407	6848	00	06000	38.428848	-122.7420045	Sonoma County
331165	Ordering, Referring, Prescribing	N/A	1386746113	0	0	FOGARTY, ALFRED M MD	1/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C52241	N/A	N/A	N/A	N/A	N/A	2311 W EL SEGUNDO BLVD	None	HAWTHORNE	CA	90250	3315	00	06000	33.91647947	-118.3189815	Los Angeles County
331223	Ordering, Referring, Prescribing	N/A	1386824753	0	0	FERRAZ, REYNALD JOSEPH S MD	6/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C133036	N/A	N/A	N/A	N/A	N/A	4000 ORANGE ST	None	RIVERSIDE	CA	92501	3613	00	06000	33.97899555	-117.37481	Riverside County
331252	Ordering, Referring, Prescribing	N/A	1386883114	0	0	FIERRO, MIRANDA LCSW	8/3/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	73926	N/A	N/A	N/A	N/A	N/A	14 E CARRILLO ST	UNIT B	SANTA BARBARA	CA	93101	6727	00	06000	34.42168751	-119.7016163	Santa Barbara County
331253	Ordering, Referring, Prescribing	N/A	1386894343	0	0	FURUTA, SHELLIE LMFT	9/19/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48334	N/A	N/A	N/A	N/A	N/A	30969 EAGLE CT	None	TEMECULA	CA	92591	3923	00	06000	33.51265825	-117.1170161	Riverside County
331332	Ordering, Referring, Prescribing	N/A	1396032975	0	0	FLANAGAN, CHANTAL M NP	4/5/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	19747	N/A	N/A	N/A	N/A	N/A	474 W VERMONT AVE	104	ESCONDIDO	CA	92025	6584	00	06000	33.10046604	-117.0729623	San Diego County
331339	Ordering, Referring, Prescribing	N/A	1396040390	0	0	FAMOUS, ANGELA LMFT	9/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99943	N/A	N/A	N/A	N/A	N/A	10235 MADRID WAY	#128	SPRING VALLEY	CA	91977	1177	00	06000	32.74600991	-116.9731522	San Diego County
331344	Ordering, Referring, Prescribing	N/A	1396052833	0	0	FEWEL, REBECCA LCSW	6/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65315	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	300	SAN JOSE	CA	95128	0000	00	06000	37.3160785	-121.937121	Santa Clara County
331387	Ordering, Referring, Prescribing	N/A	1396141743	0	0	FJELD, KERRI NP	2/2/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001723	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
331424	Ordering, Referring, Prescribing	N/A	1396186524	0	0	FULTON, BRIANNE LPCC	3/24/2020	Taxonomy not applicable	NA	n/a	000	Unknown	4041	N/A	N/A	N/A	N/A	N/A	2640 BRESLAUER WAY	None	REDDING	CA	96001	4246	00	06000	40.5496754	-122.3791396	Shasta County
331448	Ordering, Referring, Prescribing	N/A	1396222477	0	0	FATOHA, MARYAM	11/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77859	N/A	N/A	N/A	N/A	N/A	1201 AVOCADO AVE	None	EL CAJON	CA	92020	7704	00	06000	32.778864	-116.9579805	San Diego County
331463	Ordering, Referring, Prescribing	N/A	1396249728	0	0	FELD, ZOE M MD	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164398	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
331572	Ordering, Referring, Prescribing	N/A	1396476511	0	0	FOSTER, ASHLEY E NP	11/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	NP95023226	N/A	N/A	N/A	N/A	N/A	5321 VIA MARISOL	None	LOS ANGELES	CA	90042	4883	00	06000	34.10448723	-118.1846451	Los Angeles County
331578	Ordering, Referring, Prescribing	N/A	1396478434	0	0	FRANKS, KAYLA CNM	7/12/2023	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236380	N/A	N/A	N/A	N/A	N/A	1908 N BEALE RD	SUITE E	MARYSVILLE	CA	95901	6937	00	06000	39.1278388	-121.5457994	Yuba County
331585	Ordering, Referring, Prescribing	N/A	1396495040	0	0	FLAHERTY, DANIEL M DO	4/3/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21634	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
331602	Ordering, Referring, Prescribing	N/A	1396751533	0	0	FELDMAN, CLIFFORD R MD	6/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G78112	N/A	N/A	N/A	N/A	N/A	6736 LAUREL CANYON BLVD	None	LOS ANGELES	CA	91606	1538	00	06000	34.193493	-118.3964925	Los Angeles County
331641	Ordering, Referring, Prescribing	N/A	1396860938	0	0	FERNANDEZ, LARRY LCSW	3/26/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29009	N/A	N/A	N/A	N/A	N/A	3785 S PLAZA DR	None	SANTA ANA	CA	92704	7463	00	06000	33.69733061	-117.8886342	Orange County
331693	Ordering, Referring, Prescribing	N/A	1396938676	0	0	FLORES URIBE, SILVIA KAREN LMFT	12/31/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86534	N/A	N/A	N/A	N/A	N/A	18217 HALE AVE	None	MORGAN HILL	CA	95037	3550	00	06000	37.13761496	-121.6664813	Santa Clara County
331698	Ordering, Referring, Prescribing	N/A	1396941159	0	0	FINNEGAN, CHRISTOPHER B DC	12/19/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	17131	N/A	N/A	N/A	N/A	N/A	1835 N BROADWAY	None	SANTA MARIA	CA	93454	1404	00	06000	34.97345984	-120.4356472	Santa Barbara County
331813	Ordering, Referring, Prescribing	N/A	1407191794	0	0	FERNANDO, APARNA	8/30/2023	Taxonomy not applicable	NA	n/a	000	Unknown	68489	N/A	N/A	N/A	N/A	N/A	12021 WILMINGTON AV BLDG	1600	LOS ANGELES	CA	90059	3019	00	06000	33.922863	-118.2431655	Los Angeles County
331844	Ordering, Referring, Prescribing	N/A	1407253263	0	0	FUKUWA, MIIKA NP	6/30/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95004479	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
331904	Ordering, Referring, Prescribing	N/A	1407345184	0	0	FELARCA, JESSICA L LCSW	8/19/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW125338	N/A	N/A	N/A	N/A	N/A	1000 EUCLID AVE	None	NATIONAL CITY	CA	91950	3856	00	06000	32.68067201	-117.0804893	San Diego County
331916	Ordering, Referring, Prescribing	N/A	1407351521	0	0	FISHER, MELISSA LMFT	7/16/2018	Taxonomy not applicable	NA	n/a	000	Unknown	102583	N/A	N/A	N/A	N/A	N/A	2600 S. EL CAMINO REAL	SUITE 100	SAN MATEO	CA	94403	2380	00	06000	37.54393248	-122.3052118	San Mateo County
331948	Ordering, Referring, Prescribing	N/A	1407416829	0	0	FEYTSER, ANDREY LCSW	8/14/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW115996	N/A	N/A	N/A	N/A	N/A	1000 SUNSET BLVD	None	ROCKLIN	CA	95765	3791	00	06000	38.81665958	-121.2884287	Placer County
331981	Ordering, Referring, Prescribing	N/A	1407516859	0	0	FARR, MARY E CNP	5/18/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015008	N/A	N/A	N/A	N/A	N/A	2501 W EL SEGUNDO BLVD	B	HAWTHORNE	CA	90250	3317	00	06000	33.91648148	-118.3206645	Los Angeles County
331993	Ordering, Referring, Prescribing	N/A	1407562531	0	0	FULKS, ZACKARY C DC	1/20/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC36546	N/A	N/A	N/A	N/A	N/A	10039 VINE ST	None	LAKESIDE	CA	92040	3120	00	06000	32.86110914	-116.9211687	San Diego County
332076	Ordering, Referring, Prescribing	N/A	1407988025	0	0	FORD, MICHAEL R MSW LCSW	12/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	5419	N/A	N/A	N/A	N/A	N/A	108 W VICTORIA ST	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
332111	Ordering, Referring, Prescribing	N/A	1417074279	0	0	FREEMAN, VIVIAN H	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0271187	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
332167	Ordering, Referring, Prescribing	N/A	1417156118	0	0	FELDMAN, DANIELE S MD	10/14/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A106571	N/A	N/A	N/A	N/A	N/A	116 SOUTH PALISADE DRIVE	SUITE 104	SANTA MARIA	CA	93454	8905	00	06000	34.9523869	-120.4120717	Santa Barbara County
332174	Ordering, Referring, Prescribing	N/A	1417180118	0	0	FELDMAN, IRINA LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT92444	N/A	N/A	N/A	N/A	N/A	12821 VICTORY BOULEVARD	None	NORTH HOLLYWOOD	CA	91606	3012	00	06000	34.18670951	-118.41246	Los Angeles County
332192	Ordering, Referring, Prescribing	N/A	1417206830	0	0	FELIX, DAVID	11/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	93399	N/A	N/A	N/A	N/A	N/A	760 MOUNTAIN VIEW ST	None	ALTADENA	CA	91001	4925	00	06000	34.19178664	-118.1657029	Los Angeles County
332204	Ordering, Referring, Prescribing	N/A	1417238866	0	0	FERNANDEZ, MARA N LMFT	7/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120248	N/A	N/A	N/A	N/A	N/A	855 N EUCLID AVE	None	ONTARIO	CA	91762	2729	00	06000	34.074063	-117.6514785	San Bernardino County
332215	Ordering, Referring, Prescribing	N/A	1417261405	0	0	FOGEL, JONATHAN M PHD	1/21/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	23570	N/A	N/A	N/A	N/A	N/A	400 E OAK AVE	None	VISALIA	CA	93291	5034	00	06000	36.332253	-119.288691	Tulare County
332253	Ordering, Referring, Prescribing	N/A	1417326364	0	0	FOO, GARRETT	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72809	N/A	N/A	N/A	N/A	N/A	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	00	06000	38.57535	-121.407633	Sacramento County
332330	Ordering, Referring, Prescribing	N/A	1417446543	0	0	FRATTOLILLO, ANNA V LMFT	9/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128132	N/A	N/A	N/A	N/A	N/A	652 PETALUMA AVE	H	SEBASTOPOL	CA	95472	4266	00	06000	38.39662494	-122.8201368	Sonoma County
332332	Ordering, Referring, Prescribing	N/A	1417444100	0	0	FORNES, MARY ANN LMFT	3/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118523	N/A	N/A	N/A	N/A	N/A	2743 HIGHLAND AVE	None	NATIONAL CITY	CA	91950	7410	00	06000	32.66109542	-117.0920417	San Diego County
332349	Ordering, Referring, Prescribing	N/A	1417476680	0	0	FIGUEROA, SHARON NP	8/11/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007474	N/A	N/A	N/A	N/A	N/A	2333 COURAGE DR.	None	FAIRFIELD	CA	94533	6715	00	06000	38.23527423	-122.0742019	Solano County
332382	Ordering, Referring, Prescribing	N/A	1417521006	0	0	FAHEY, JAMES G PA-C	5/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59574	N/A	N/A	N/A	N/A	N/A	10423 OLD PLACERVILLE RD	A	SACRAMENTO	CA	95827	2540	00	06000	38.570382	-121.3075395	Sacramento County
332411	Ordering, Referring, Prescribing	N/A	1417588542	0	0	FONES, DONOVAN D LCSW	4/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26295	N/A	N/A	N/A	N/A	N/A	31 TOWER ROAD	None	SAN MATEO	CA	94402	4000	00	06000	37.51232162	-122.3333429	San Mateo County
332420	Ordering, Referring, Prescribing	N/A	1417610056	0	0	FRANCISCO, LOIS PHARMD	1/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84872	N/A	N/A	N/A	N/A	N/A	4905 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90027	6101	00	06000	34.10180109	-118.2963991	Los Angeles County
332437	Ordering, Referring, Prescribing	N/A	1417645888	0	0	FLORES, NATALIE LMFT	10/31/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	142507	N/A	N/A	N/A	N/A	N/A	23461 S POINTE DRIVE,	SUITE 100	LAGUNA HILLS	CA	92653	1573	00	06000	33.62535142	-117.7206568	Orange County
332468	Ordering, Referring, Prescribing	N/A	1417919564	0	0	FRAMPTON, LISA B LCSW	4/1/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100899	N/A	N/A	N/A	N/A	N/A	7780 N FRESNO ST STE 105	STE 105	FRESNO	CA	93720	2413	00	06000	36.85162237	-119.7836163	Fresno County
332469	Ordering, Referring, Prescribing	N/A	1417937798	0	0	FAUST, MICHAEL D MD	1/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	MD063512L	N/A	N/A	N/A	N/A	N/A	155 WILSON AVE	None	WASHINGTON	PA	15301	3336	00	06000	40.18297389	-80.24677018	Washington County
332470	Ordering, Referring, Prescribing	N/A	1417935081	0	0	FRENETTE, CATHERINE T MD	10/26/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80461	N/A	N/A	N/A	N/A	N/A	4094 4TH AVE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
332483	Ordering, Referring, Prescribing	N/A	1427043280	0	0	FACEMIRE, ANABEL S MD	10/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C135547	N/A	N/A	N/A	N/A	N/A	20601 WEST PAOLI LANE	None	WEIMAR	CA	95736	0486	00	06000	39.03521526	-120.9755343	Placer County
332636	Ordering, Referring, Prescribing	N/A	1427393123	0	0	FOLMSBEE, MARK A DO	7/26/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14847	N/A	N/A	N/A	N/A	N/A	16127 FOOTHILL BLVD	None	FONTANA	CA	92335	3347	00	06000	34.10650281	-117.4531156	San Bernardino County
332680	Ordering, Referring, Prescribing	N/A	1427459809	0	0	FURMAN, TATSIANA NP	11/10/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000808	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
332686	Ordering, Referring, Prescribing	N/A	1427469782	0	0	FRIEDRICH, CASSY MD	4/2/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140240	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
332786	Ordering, Referring, Prescribing	N/A	1427623677	0	0	FIELDS, CHRISTOPHER M MD	6/18/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A196968	N/A	N/A	N/A	N/A	N/A	4725 MARKET STREET	None	SAN DIEGO	CA	92102	4715	00	06000	32.71127386	-117.0929781	San Diego County
332805	Ordering, Referring, Prescribing	N/A	1427669506	0	0	FISCHER, KYLE C PHARMD	1/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82811	N/A	N/A	N/A	N/A	N/A	9245 RESEDA BLVD	None	NORTHRIDGE	CA	91324	3137	00	06000	34.238583	-118.536108	Los Angeles County
332810	Ordering, Referring, Prescribing	N/A	1427673250	0	0	FRITTS, DENISE LMFT	4/24/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139257	N/A	N/A	N/A	N/A	N/A	3545 LONG BEACH BLVD	None	LONG BEACH	CA	90807	3941	00	06000	33.82086796	-118.18938	Los Angeles County
332812	Ordering, Referring, Prescribing	N/A	1427694298	0	0	FOO, PHOEBE K NP	11/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017082	N/A	N/A	N/A	N/A	N/A	2020 J STREET	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
332853	Ordering, Referring, Prescribing	N/A	1427836576	0	0	FOUNTAIN, JENNIFER PA-C	7/5/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64783	N/A	N/A	N/A	N/A	N/A	101 WEST COAST RD	None	REDWAY	CA	95560	0769	00	06000	40.11704433	-123.8133408	Humboldt County
332910	Ordering, Referring, Prescribing	N/A	1437267689	0	0	FEALK, EUGENE L DO	11/30/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6182	N/A	N/A	N/A	N/A	N/A	1420 ROCKY RIDGE DR	230	ROSEVILLE	CA	95661	2835	00	06000	38.75342679	-121.246502	Placer County
332943	Ordering, Referring, Prescribing	N/A	1437332210	0	0	FIGUEROA-WESTON, MARIA E LMFT	7/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT48620	N/A	N/A	N/A	N/A	N/A	3605 VISTA WAY	STE 258	OCEANSIDE	CA	92056	4565	00	06000	33.1818929	-117.3104591	San Diego County
332953	Ordering, Referring, Prescribing	N/A	1437353141	0	0	FELDMAN, DAVID J LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	24418	N/A	N/A	N/A	N/A	N/A	2335 PLAZA DEL AMO	None	TORRANCE	CA	90501	3420	00	06000	33.82819611	-118.3213536	Los Angeles County
333030	Ordering, Referring, Prescribing	N/A	1437468816	0	0	FISH, LINDSEY L LMFT	3/11/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124883	N/A	N/A	N/A	N/A	N/A	2600 S EL CAMINO REAL	200	SAN MATEO	CA	94403	2380	00	06000	37.54393248	-122.3052118	San Mateo County
333112	Ordering, Referring, Prescribing	N/A	1437588779	0	0	FLORES, YUMI	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH65734	N/A	N/A	N/A	N/A	N/A	830 3RD ST	None	SAN RAFAEL	CA	94901	3302	00	06000	37.97188236	-122.5255096	Marin County
333144	Ordering, Referring, Prescribing	N/A	1437633203	0	0	FORD, SERGIO LMFT	4/10/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102147	N/A	N/A	N/A	N/A	N/A	4150 UTE DR	B1	SAN DIEGO	CA	92117	5853	00	06000	32.80925642	-117.2018921	San Diego County
333152	Ordering, Referring, Prescribing	N/A	1437645801	0	0	FRIED, SARAH	9/30/2022	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	24204	N/A	N/A	N/A	N/A	N/A	185 MARTINVALE LN	None	SAN JOSE	CA	95119	1319	00	06000	37.22953469	-121.7790244	Santa Clara County
333268	Ordering, Referring, Prescribing	N/A	1437880721	0	0	FEITOSA, VINCENT D CNP	11/2/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95014252	N/A	N/A	N/A	N/A	N/A	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	00	06000	35.37461686	-119.020062	Kern County
333276	Ordering, Referring, Prescribing	N/A	1437912482	0	0	FELIX, LIZA J LCSW	2/1/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	128440	N/A	N/A	N/A	N/A	N/A	2201 MISSION AVE	None	OCEANSIDE	CA	92058	2313	00	06000	33.20742226	-117.3612486	San Diego County
333353	Ordering, Referring, Prescribing	N/A	1447339940	0	0	FIELDS, LISA G MSW LCSW	12/29/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61430	N/A	N/A	N/A	N/A	N/A	529 SOUTH MAPLE AVE	None	LOS ANGELES	CA	90013	1511	00	06000	34.04465262	-118.2472846	Los Angeles County
333382	Ordering, Referring, Prescribing	N/A	1447460381	0	0	FURUZAWA, ADRIANA M LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99416	N/A	N/A	N/A	N/A	N/A	1005 ATLANTIC AVENUE	None	ALAMEDA	CA	94501	1148	00	06000	37.78080326	-122.2676078	Alameda County
333403	Ordering, Referring, Prescribing	N/A	1447500616	0	0	FRIEDRICH, COREY A LCSW	9/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74790	N/A	N/A	N/A	N/A	N/A	4309 3RD AVE	None	SAN DIEGO	CA	92103	1407	00	06000	32.75638577	-117.162084	San Diego County
333406	Ordering, Referring, Prescribing	N/A	1447512991	0	0	FONSECA, DAVID A LMFT	3/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131688	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON AVE	None	PORTERVILLE	CA	93257	1490	00	06000	36.08036906	-119.0410926	Tulare County
333429	Ordering, Referring, Prescribing	N/A	1447541560	0	0	FENG, RICHARD	3/29/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A121970	N/A	N/A	N/A	N/A	N/A	1990 41ST AVE	None	SAN FRANCISCO	CA	94116	1101	00	06000	37.74984135	-122.4997872	San Francisco County
333453	Ordering, Referring, Prescribing	N/A	1447609581	0	0	FLORES, ANJELICA D LCSW	6/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87882	N/A	N/A	N/A	N/A	N/A	1030 W WARNER AVE	None	SANTA ANA	CA	92707	3147	00	06000	33.71597598	-117.8819134	Orange County
333466	Ordering, Referring, Prescribing	N/A	1447634548	0	0	FARZAMDOOST, KAMBIZ PHARMD	3/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	48839	N/A	N/A	N/A	N/A	N/A	435 ARDEN AVE	110	GLENDALE	CA	91203	4029	00	06000	34.15848148	-118.2628845	Los Angeles County
333499	Ordering, Referring, Prescribing	N/A	1447681143	0	0	FOLMER, KELLY A RN PNP	2/7/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23455	N/A	N/A	N/A	N/A	N/A	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	00	06000	36.88437894	-119.8003484	Madera County
333683	Ordering, Referring, Prescribing	N/A	1457303869	0	0	FOWLER, ELENA B MD	5/1/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A78119	N/A	N/A	N/A	N/A	N/A	2101 COURAGE DR	None	FAIRFIELD	CA	94533	6717	00	06000	38.23737478	-122.0676832	Solano County
333717	Ordering, Referring, Prescribing	N/A	1457441974	0	0	FARAG, BASEM R MD	1/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C53207	N/A	N/A	N/A	N/A	N/A	16127 FOOTHILL BLVD	None	FONTANA	CA	92335	3374	00	06000	34.10650281	-117.4531156	San Bernardino County
333741	Ordering, Referring, Prescribing	N/A	1457492696	0	0	FORTIN, LAWRENCE LMFT	10/27/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	30548	N/A	N/A	N/A	N/A	N/A	1237 GREEN OAK RD	None	VISTA	CA	92081	7821	00	06000	33.15721445	-117.2278895	San Diego County
333758	Ordering, Referring, Prescribing	N/A	1457530180	0	0	FALEY, MONSITA J NP	2/28/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	16545	N/A	N/A	N/A	N/A	N/A	201 S. HARBOR BLVD	None	LA HABRA	CA	90631	5654	00	06000	33.93029897	-117.9331306	Orange County
333796	Ordering, Referring, Prescribing	N/A	1457605891	0	0	FEULNER, ERIN M LMFT	8/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108041	N/A	N/A	N/A	N/A	N/A	260 COHASSET RD	SUITE 120	CHICO	CA	95926	2282	00	06000	39.754035	-121.851117	Butte County
333818	Ordering, Referring, Prescribing	N/A	1457642803	0	0	FERTIG, PATRICIA DO	10/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14928	N/A	N/A	N/A	N/A	N/A	19531 MCLANE ST STE B	None	PALM SPRINGS	CA	92262	3019	00	06000	33.90666798	-116.5523429	Riverside County
333888	Ordering, Referring, Prescribing	N/A	1457771297	0	0	FLOREZ, GINA LCSW	5/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93039	N/A	N/A	N/A	N/A	N/A	2940 INLAND EMPIRE BLVD.	None	ONTARIO	CA	91764	4898	00	06000	34.069788	-117.5884605	San Bernardino County
333933	Ordering, Referring, Prescribing	N/A	1457827768	0	0	FLUHARTY, MELISSA L	1/25/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009075	N/A	N/A	N/A	N/A	N/A	5100 BULLION ST	None	MARIPOSA	CA	95338	2411	00	06000	37.48928959	-119.9679953	Mariposa County
333958	Ordering, Referring, Prescribing	N/A	1457859340	0	0	FERRER, CLAUDIA I PA	5/21/2023	Taxonomy not applicable	NA	n/a	000	Unknown	58943	N/A	N/A	N/A	N/A	N/A	1907 BORDER AVE	None	TORRANCE	CA	90501	3606	00	06000	33.828615	-118.3130985	Los Angeles County
334039	Ordering, Referring, Prescribing	N/A	1457993172	0	0	FERNANDEZ, MELISSA A LMFT	11/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105773	N/A	N/A	N/A	N/A	N/A	4600 BROADWAY	None	SACRAMENTO	CA	95820	1527	00	06000	38.546127	-121.452669	Sacramento County
334058	Ordering, Referring, Prescribing	N/A	1467049296	0	0	FLINT, TEAGAN PA-C	3/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60914	N/A	N/A	N/A	N/A	N/A	3800 KILROY AIRPORT WAY	None	LONG BEACH	CA	90806	2494	00	06000	33.80725242	-118.14497	Los Angeles County
334143	Ordering, Referring, Prescribing	N/A	1467490805	0	0	FAWVER, TRAVIS DO	9/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	1710	N/A	N/A	N/A	N/A	N/A	10820 PARKSIDE DR	None	KNOXVILLE	TN	37934	1956	00	06000	35.90003918	-84.14416556	Knox County
334164	Ordering, Referring, Prescribing	N/A	1467556951	0	0	FINE, JOEL A MD	11/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G67628	N/A	N/A	N/A	N/A	N/A	555 MASON STREET	260	VACAVILLE	CA	95688	4648	00	06000	38.35494546	-121.98609	Solano County
334167	Ordering, Referring, Prescribing	N/A	1467575449	0	0	FOY, MICHELLE L LCSW	4/26/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	64462	N/A	N/A	N/A	N/A	N/A	10737 CAMINO RUIZ	None	SAN DIEGO	CA	92126	2359	00	06000	32.91416051	-117.1437943	San Diego County
334293	Ordering, Referring, Prescribing	N/A	1467805812	0	0	FLAX, MARIA PHD	1/21/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY24642	N/A	N/A	N/A	N/A	N/A	27715 JEFFERSON AVE STE	None	TEMEMCULA	CA	92590	0660	00	06000	33.51272967	-117.1590194	Riverside County
334307	Ordering, Referring, Prescribing	N/A	1467820720	0	0	FOWLER, PETE PHARMD	3/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73372	N/A	N/A	N/A	N/A	N/A	200 MUIR RD.	None	MARTINEZ	CA	94553	4614	00	06000	37.99430233	-122.1107194	Contra Costa County
334329	Ordering, Referring, Prescribing	N/A	1467848903	0	0	FISHER, EMILY P MD	7/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A148350	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
334416	Ordering, Referring, Prescribing	N/A	1467968909	0	0	FLICKINGER, NICHOLAS F	6/10/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	89415	N/A	N/A	N/A	N/A	N/A	1625 N SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
334426	Ordering, Referring, Prescribing	N/A	1467984427	0	0	FAIZY, RUBINA M MD	10/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164312	N/A	N/A	N/A	N/A	N/A	770 MAGNOLIA AVE	SUITE 2F	CORONA	CA	92879	3122	00	06000	33.85936872	-117.5534605	Riverside County
334516	Ordering, Referring, Prescribing	N/A	1477152353	0	0	FIELDING, ROBERT PA	11/8/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA58864	N/A	N/A	N/A	N/A	N/A	147 N BRENT ST.	None	VENTURA	CA	93003	2809	00	06000	34.2746295	-119.2573399	Ventura County
334517	Ordering, Referring, Prescribing	N/A	1477164408	0	0	FARID, LAYLA PHARMD	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80094	N/A	N/A	N/A	N/A	N/A	1899 FILLMORE ST	None	SAN FRANCISCO	CA	94115	3125	00	06000	37.78678656	-122.4334322	San Francisco County
334549	Ordering, Referring, Prescribing	N/A	1477210565	0	0	FONG, TIMOTHY	11/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60415	N/A	N/A	N/A	N/A	N/A	305 E CENTER AVE	None	VISALIA	CA	93291	6331	00	06000	36.330984	-119.2892445	Tulare County
334616	Ordering, Referring, Prescribing	N/A	1477621126	0	0	FRANK, EMILY S LCSW	9/29/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26749	N/A	N/A	N/A	N/A	N/A	8530 LA MESA BOULEVARD	#306	LA MESA	CA	91942	0966	00	06000	32.76873337	-117.0134248	San Diego County
334621	Ordering, Referring, Prescribing	N/A	1477621316	0	0	FUERZA, DIANA LCSW	1/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26887	N/A	N/A	N/A	N/A	N/A	1021 S EL CAMINO REAL	None	SAN MATEO	CA	94402	2801	00	06000	37.55684528	-122.31914	San Mateo County
334635	Ordering, Referring, Prescribing	N/A	1477642775	0	0	FICERE, IRMA I LMFT	6/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92350	N/A	N/A	N/A	N/A	N/A	40925 COUNTY CENTER DR.	200	TEMECULA	CA	92591	4025	00	06000	33.52802214	-117.1605544	Riverside County
334650	Ordering, Referring, Prescribing	N/A	1477682201	0	0	FONG, VICTOR D	7/28/2014	Taxonomy not applicable	NA	n/a	099	DENTIST	D43956	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
334651	Ordering, Referring, Prescribing	N/A	1477693406	0	0	FIELDS, ROBERT S	12/21/1985	Taxonomy not applicable	NA	n/a	099	DENTIST	D22346	N/A	N/A	N/A	N/A	N/A	7843 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91605	2523	00	06000	34.213581	-118.3878055	Los Angeles County
334653	Ordering, Referring, Prescribing	N/A	1477692325	0	0	FAGAN, NATALIE H LMFT	10/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47535	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
334711	Ordering, Referring, Prescribing	N/A	1477808707	0	0	FRYE, JOSHUA R DDS	1/26/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	103695	N/A	N/A	N/A	N/A	N/A	554-850 MEDICAL CENTER D	None	BIEBER	CA	96009	0277	00	06000	0	0	None
334750	Ordering, Referring, Prescribing	N/A	1477867323	0	0	FELIX, PEDRO LCSW	5/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29730	N/A	N/A	N/A	N/A	N/A	1930 MARKET ST	None	SAN FRANCISCO	CA	94102	6228	00	06000	37.77037155	-122.4255051	San Francisco County
334755	Ordering, Referring, Prescribing	N/A	1477894467	0	0	FEROLITO, MICHELLE Y	4/2/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0713016	N/A	N/A	N/A	N/A	N/A	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	00	06000	34.02749142	-118.486063	Los Angeles County
334767	Ordering, Referring, Prescribing	N/A	1477907905	0	0	FERNANDES, CARLO R DO	12/15/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17851	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
334790	Ordering, Referring, Prescribing	N/A	1477948677	0	0	FELIBERTI, JOSE R MD	4/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150657	N/A	N/A	N/A	N/A	N/A	4250 AUBURN BLVD	None	SACRAMENTO	CA	95841	4100	00	06000	38.642832	-121.3649325	Sacramento County
334793	Ordering, Referring, Prescribing	N/A	1477949063	0	0	FRYE, LINDSAY DO	4/30/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22864	N/A	N/A	N/A	N/A	N/A	43658 HWY 299 E	None	FALL RIVER MILLS	CA	96028	0490	00	06000	41.02828938	-121.4208217	Shasta County
334812	Ordering, Referring, Prescribing	N/A	1477974111	0	0	FOZAILOFF, AREZOO MD	9/28/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A122855	N/A	N/A	N/A	N/A	N/A	1828 E CESAR E CHAVEZ AV	5000	LOS ANGELES	CA	90033	2400	00	06000	34.05023174	-118.2154927	Los Angeles County
334822	Ordering, Referring, Prescribing	N/A	1477992493	0	0	FUNG, ANDREW PHARMD	2/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67319	N/A	N/A	N/A	N/A	N/A	1011 SNEATH LN	None	SAN BRUNO	CA	94066	2311	00	06000	37.63437084	-122.4264474	San Mateo County
334836	Ordering, Referring, Prescribing	N/A	1487008025	0	0	FONSECA, ALLENE MD	9/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150457	N/A	N/A	N/A	N/A	N/A	2707 S. CENTRAL AVENUE	None	LOS ANGELES	CA	90011	5527	00	06000	34.01754879	-118.2555246	Los Angeles County
334939	Ordering, Referring, Prescribing	N/A	1487147104	0	0	FERN, VERONICA D NP	2/9/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009889	N/A	N/A	N/A	N/A	N/A	4434 MISSION STREET	None	SAN FRANCISCO	CA	94112	1927	00	06000	37.72675413	-122.4332747	San Francisco County
334995	Ordering, Referring, Prescribing	N/A	1487232070	0	0	FITZPATRICK, JUDITH MD	9/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	7060	N/A	N/A	N/A	N/A	N/A	455 OCONNOR DR	SUITE 200	SAN JOSE	CA	95128	1632	00	06000	37.326654	-121.939897	Santa Clara County
335038	Ordering, Referring, Prescribing	N/A	1487323119	0	0	FIGUEROA, CHRISTOPHER DC	2/22/2024	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC36911	N/A	N/A	N/A	N/A	N/A	10039 VINE ST	None	LAKESIDE	CA	92040	3120	00	06000	32.86110914	-116.9211687	San Diego County
335066	Ordering, Referring, Prescribing	N/A	1487427423	0	0	FOK, DIANA PT	8/2/2023	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT304434	N/A	N/A	N/A	N/A	N/A	4725 MARKET ST	None	SAN DIEGO	CA	92102	4715	00	06000	32.71127386	-117.0929781	San Diego County
335160	Ordering, Referring, Prescribing	N/A	1487821690	0	0	FULLER, WILLIAM S LMFT	2/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97486	N/A	N/A	N/A	N/A	N/A	123 WEST GUTIERREZ STREE	None	SANTA BARBARA	CA	93101	3424	00	06000	34.41387023	-119.6962788	Santa Barbara County
335271	Ordering, Referring, Prescribing	N/A	1497037170	0	0	FAN-AGUTOS, RALNA PHARMD	3/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	52019	N/A	N/A	N/A	N/A	N/A	2800 INDEPENDENCE DR	None	LIVERMORE	CA	94551	7628	00	06000	37.70342494	-121.8115224	Alameda County
335283	Ordering, Referring, Prescribing	N/A	1497056048	0	0	FENOLIO, JAMES D PHARMD	2/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	26061	N/A	N/A	N/A	N/A	N/A	4440 TASSAJARA RD	None	DUBLIN	CA	94568	4501	00	06000	37.7067598	-121.8722011	Alameda County
335290	Ordering, Referring, Prescribing	N/A	1497068001	0	0	FRANZESE, ADRIENNE K NP	2/17/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22110	N/A	N/A	N/A	N/A	N/A	425 DIVISADERO ST	None	SAN FRANCISCO	CA	94117	2242	00	06000	37.77336026	-122.4375022	San Francisco County
335503	Ordering, Referring, Prescribing	N/A	1497466635	0	0	FLEISCHER, MALORIE	11/30/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA62040	N/A	N/A	N/A	N/A	N/A	5385 FRANKLIN BLVD	A-D	SACRAMENTO	CA	95820	4717	00	06000	38.526282	-121.471398	Sacramento County
335511	Ordering, Referring, Prescribing	N/A	1497489157	0	0	FLORES, ELIZABETH C PA-C	7/2/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64747	N/A	N/A	N/A	N/A	N/A	1005 E WASHINGTON BLVD	STE. A	LOS ANGELES	CA	90021	3082	00	06000	34.02578238	-118.2530622	Los Angeles County
335609	Ordering, Referring, Prescribing	N/A	1497947295	0	0	FAYE, MARGARET PHD	11/4/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY16770	N/A	N/A	N/A	N/A	N/A	100 W WALNUT	None	PASADENA	CA	91121	0001	00	06000	34.14963648	-118.1522925	Los Angeles County
335690	Ordering, Referring, Prescribing	N/A	1508145889	0	0	FUENTES, ANGEL LMFT	3/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	81064	N/A	N/A	N/A	N/A	N/A	1215 1ST STREET	None	GILROY	CA	95020	4733	00	06000	37.01355551	-121.5947655	Santa Clara County
335761	Ordering, Referring, Prescribing	N/A	1508262411	0	0	FITZPATRICK, ERIN C LMFT	8/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121371	N/A	N/A	N/A	N/A	N/A	1221 E DYER RD	120	SANTA ANA	CA	92705	5600	00	06000	33.70872153	-117.857052	Orange County
335808	Ordering, Referring, Prescribing	N/A	1508326364	0	0	FARABI, NABILA MD	5/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178439	N/A	N/A	N/A	N/A	N/A	501 S IDAHO ST	SUITE 100	LA HABRA	CA	90631	6047	00	06000	33.927525	-117.959216	Orange County
335872	Ordering, Referring, Prescribing	N/A	1508448069	0	0	FERNANDEZ, JHAIMY	10/2/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184788	N/A	N/A	N/A	N/A	N/A	8399 GARVEY AVE	None	ROSEMEAD	CA	91770	0300	00	06000	34.06268752	-118.086759	Los Angeles County
335910	Ordering, Referring, Prescribing	N/A	1508532359	0	0	FOREMAN, ANNA LMFT	12/10/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	151938	N/A	N/A	N/A	N/A	N/A	2828 FORD ST	None	OAKLAND	CA	94601	2114	00	06000	37.77357837	-122.2352589	Alameda County
335913	Ordering, Referring, Prescribing	N/A	1508538950	0	0	FUSCO, JESSICA NP	6/10/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95021224	N/A	N/A	N/A	N/A	N/A	3505 LONE TREE WAY	STE 1	ANTIOCH	CA	94509	6067	00	06000	37.98725411	-121.8065036	Contra Costa County
335916	Ordering, Referring, Prescribing	N/A	1508573577	0	0	FERNANDEZ, GABRYELA O NP	6/19/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030364	N/A	N/A	N/A	N/A	N/A	217 W KERN AVE	None	MC FARLAND	CA	93250	1360	00	06000	35.67801221	-119.2297708	Kern County
335935	Ordering, Referring, Prescribing	N/A	1508627183	0	0	FERNANDEZ-CARVAJAL, YAN NP	2/15/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029109	N/A	N/A	N/A	N/A	N/A	3505 LONE TREE WAY	STE 1	ANTIOCH	CA	94509	6067	00	06000	37.98725411	-121.8065036	Contra Costa County
335952	Ordering, Referring, Prescribing	N/A	1508842303	0	0	FARRELL, MAUREEN E MD FACOG	10/29/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A82843	N/A	N/A	N/A	N/A	N/A	4575 COLLEGE AVENUE	None	SAN DIEGO	CA	92115	4011	00	06000	32.76023438	-117.0667611	San Diego County
336043	Ordering, Referring, Prescribing	N/A	1518053735	0	0	FLOUTSIS, GRACE MD	9/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72158	N/A	N/A	N/A	N/A	N/A	1828 E CESAR E CHAVEZ AV	5000	LOS ANGELES	CA	90033	2487	00	06000	34.05023174	-118.2154927	Los Angeles County
336126	Ordering, Referring, Prescribing	N/A	1518224328	0	0	FEELEY, ROBERT J MD	8/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147533	N/A	N/A	N/A	N/A	N/A	23622 CALABASAS RD	320	CALABASAS	CA	91302	1574	00	06000	34.15634882	-118.6418781	Los Angeles County
336162	Ordering, Referring, Prescribing	N/A	1518267863	0	0	FORDHAM, LIBERTY C NP	9/19/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	718361	N/A	N/A	N/A	N/A	N/A	2633 16TH ST	None	BAKERSFIELD	CA	93301	3417	00	06000	35.37232854	-119.0327985	Kern County
336168	Ordering, Referring, Prescribing	N/A	1518279645	0	0	FINN, MITCHELL LMFT	7/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53034	N/A	N/A	N/A	N/A	N/A	720 WOOD ST.	None	EUREKA	CA	95501	4413	00	06000	40.78118068	-124.1607622	Humboldt County
336175	Ordering, Referring, Prescribing	N/A	1518315282	0	0	FARALA, JOHN P MD	2/1/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152594	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
336181	Ordering, Referring, Prescribing	N/A	1518323831	0	0	FERRELL, SHILOH M LMFT	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT92680	N/A	N/A	N/A	N/A	N/A	675 TEXAS ST	3800	FAIRFIELD	CA	94533	6372	00	06000	38.24921151	-122.0412735	Solano County
336217	Ordering, Referring, Prescribing	N/A	1518378546	0	0	FONG BALART, JOSUE MD	11/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145030	N/A	N/A	N/A	N/A	N/A	2000 PHYSICIANS BLVD	None	BAKERSFIELD	CA	93301	1277	00	06000	35.396994	-119.0084938	Kern County
336229	Ordering, Referring, Prescribing	N/A	1518391812	0	0	FONG, TARYN J PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69274	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
336290	Ordering, Referring, Prescribing	N/A	1518488097	0	0	FENG, SHIRLEY PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75223	N/A	N/A	N/A	N/A	N/A	1327 LEAVENWORTH ST.	3	SAN FRANCISCO	CA	94109	0001	00	06000	37.79355123	-122.4162429	San Francisco County
336305	Ordering, Referring, Prescribing	N/A	1518528983	0	0	FEIST, CHRISTIAN L LMFT	2/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	137730	N/A	N/A	N/A	N/A	N/A	123 W GUTIERREZ ST	None	SANTA BARBARA	CA	93101	3424	00	06000	34.41387023	-119.6962788	Santa Barbara County
336407	Ordering, Referring, Prescribing	N/A	1528118544	0	0	FORESTER, DALENE LMFT	7/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT33095	N/A	N/A	N/A	N/A	N/A	353 PARK MARINA CIRCLE	None	REDDING	CA	96001	0965	00	06000	40.57650059	-122.3737972	Shasta County
336462	Ordering, Referring, Prescribing	N/A	1528257631	0	0	FARAJIAN, TARA B LCSW	11/23/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW25082	N/A	N/A	N/A	N/A	N/A	4301 ATLANTIC AVE	6	LONG BEACH	CA	90807	2833	00	06000	33.834555	-118.1850955	Los Angeles County
336465	Ordering, Referring, Prescribing	N/A	1528260577	0	0	FERRANTE, MICHELLE L LMFT	11/5/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT48391	N/A	N/A	N/A	N/A	N/A	15305 RAYEN STREET	None	NORTH HILLS	CA	91343	5117	00	06000	34.23191048	-118.4657625	Los Angeles County
336473	Ordering, Referring, Prescribing	N/A	1528291481	0	0	FLORES, ROSEMARY K LMFT	2/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52724	N/A	N/A	N/A	N/A	N/A	6736 LAUREL CANYON BLVD	STE 200	NORTH HOLLYWOOD	CA	91606	1576	00	06000	34.193493	-118.3964925	Los Angeles County
336507	Ordering, Referring, Prescribing	N/A	1528342482	0	0	FAHMY, AMAL L PHARMD	7/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58019	N/A	N/A	N/A	N/A	N/A	9720 WOODMAN AVE	None	ARLETA	CA	91331	6422	00	06000	34.24681994	-118.4479794	Los Angeles County
336552	Ordering, Referring, Prescribing	N/A	1528423738	0	0	FINKELSTEIN, LAUREN R LMFT	9/19/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT109448	N/A	N/A	N/A	N/A	N/A	3036 REGENT STREET	None	BERKELEY	CA	94705	2551	00	06000	37.85421434	-122.2563471	Alameda County
336607	Ordering, Referring, Prescribing	N/A	1528483781	0	0	FRALEY, DELYN M LCSW	7/21/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88145	N/A	N/A	N/A	N/A	N/A	23461 S POINTE DR	SUITE 220	LAGUNA HILLS	CA	92653	1547	00	06000	33.62535142	-117.7206568	Orange County
336627	Ordering, Referring, Prescribing	N/A	1528528452	0	0	FERREIRO, CYNTHIA LMFT	5/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102531	N/A	N/A	N/A	N/A	N/A	202 N 8TH ST	None	EL CENTRO	CA	92243	2302	00	06000	32.794335	-115.5614775	Imperial County
336717	Ordering, Referring, Prescribing	N/A	1528694304	0	0	FROZ, RASHAD A PA	1/31/2020	Taxonomy not applicable	NA	n/a	000	Unknown	57781	N/A	N/A	N/A	N/A	N/A	300 HARTLE CT	None	NAPA	CA	94559	4078	00	06000	38.28326249	-122.2801759	Napa County
336726	Ordering, Referring, Prescribing	N/A	1528696366	0	0	FOSTER, BENICA J LCSW	12/18/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW119896	N/A	N/A	N/A	N/A	N/A	3150 18TH ST	350-202	SAN FRANCISCO	CA	94110	2074	00	06000	37.76218347	-122.4141845	San Francisco County
336778	Ordering, Referring, Prescribing	N/A	1538192471	0	0	FREDRICK, NOMI J MD	4/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G69855	N/A	N/A	N/A	N/A	N/A	15339 SATICOY STREET	None	VAN NUYS	CA	91406	3345	00	06000	34.2084865	-118.4678505	Los Angeles County
336848	Ordering, Referring, Prescribing	N/A	1538323977	0	0	FONG, JOICE C LMFT	2/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102869	N/A	N/A	N/A	N/A	N/A	9353 E VALLEY BLVD	None	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
336851	Ordering, Referring, Prescribing	N/A	1538332309	0	0	FRILOUX-GONZALES, LASHON LCSW	11/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100829	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
336890	Ordering, Referring, Prescribing	N/A	1538418256	0	0	FEIN, LAUREN LMFT	11/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	89424	N/A	N/A	N/A	N/A	N/A	400 ENCINAL STREET	None	SANTA CRUZ	CA	95060	2115	00	06000	36.98766458	-122.0391267	Santa Cruz County
336914	Ordering, Referring, Prescribing	N/A	1538444682	0	0	FORD, CHRISTOPHER O PHARMD	9/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	66440	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS ST RM G35	None	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
336929	Ordering, Referring, Prescribing	N/A	1538469614	0	0	FONG, BRIAN D PHARMD	3/22/2018	Taxonomy not applicable	NA	n/a	000	Unknown	50966	N/A	N/A	N/A	N/A	N/A	867 ISLAND DR	None	ALAMEDA	CA	94502	6751	00	06000	37.73780627	-122.2387418	Alameda County
336930	Ordering, Referring, Prescribing	N/A	1538477823	0	0	FORD, EMMA R NP	2/14/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN766636	N/A	N/A	N/A	N/A	N/A	29 BAYWOOD AVE	None	SAN MATEO	CA	94402	1516	00	06000	37.56478204	-122.3289243	San Mateo County
336959	Ordering, Referring, Prescribing	N/A	1538524806	0	0	FREEMIRE, EMMA LCSW	9/25/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	118229	N/A	N/A	N/A	N/A	N/A	3200 CLAYTON RD	None	CONCORD	CA	94519	2819	00	06000	37.97283909	-122.0196497	Contra Costa County
336981	Ordering, Referring, Prescribing	N/A	1538553565	0	0	FLORES, MICHAEL L DO	4/7/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15079	N/A	N/A	N/A	N/A	N/A	26520 CACTUS AVE	None	MONERO VALLEY	CA	92555	1000	00	06000	33.912117	-117.195849	Riverside County
337011	Ordering, Referring, Prescribing	N/A	1538592266	0	0	FIGUEROA, AYDE LCSW	9/14/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88291	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
337023	Ordering, Referring, Prescribing	N/A	1538611025	0	0	FLORES, JULIE L LCSW	11/9/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80368	N/A	N/A	N/A	N/A	N/A	470 N GREENFIELD AVE	STE 303	HANFORD	CA	93230	3576	00	06000	36.32996137	-119.6580167	Kings County
337069	Ordering, Referring, Prescribing	N/A	1538696232	0	0	FELDMAN, LAUREN K LMFT	7/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119983	N/A	N/A	N/A	N/A	N/A	6957 N FIGUEROA ST	None	LOS ANGELES	CA	90042	1245	00	06000	34.12873587	-118.18774	Los Angeles County
337177	Ordering, Referring, Prescribing	N/A	1548243884	0	0	FREEMAN, ROBERT B MD	5/1/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C139284	N/A	N/A	N/A	N/A	N/A	301 SCIENCE DR	STE 150	MOORPARK	CA	93021	2097	00	06000	34.27992368	-118.8694411	Ventura County
337217	Ordering, Referring, Prescribing	N/A	1548351158	0	0	FEELEY, DUANE T MD	12/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G75366	N/A	N/A	N/A	N/A	N/A	1950 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1222	00	06000	37.545779	-122.3213093	San Mateo County
337268	Ordering, Referring, Prescribing	N/A	1548465024	0	0	FAUNI, NINEVETH R G PSY	8/14/2017	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	29092	N/A	N/A	N/A	N/A	N/A	4151 MEXICALI DR	None	BAKERSFIELD	CA	93313	2065	00	06000	35.317233	-119.081649	Kern County
337294	Ordering, Referring, Prescribing	N/A	1548532948	0	0	FAULKENDER, SAMANTHA L LCSW	6/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95044	N/A	N/A	N/A	N/A	N/A	2750 SUTTERVILLE RD	None	SACRAMENTO	CA	95820	1024	00	06000	38.540124	-121.4786745	Sacramento County
337297	Ordering, Referring, Prescribing	N/A	1548541980	0	0	FUSTINI, JULIE M PHARMD	7/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH55326	N/A	N/A	N/A	N/A	N/A	2976 SEPULVEDA BLVD	None	TORRANCE	CA	90505	2804	00	06000	33.82402224	-118.3392271	Los Angeles County
337299	Ordering, Referring, Prescribing	N/A	1548535602	0	0	FERNANDEZ, GABRIELA I	6/27/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92401	N/A	N/A	N/A	N/A	N/A	1401 N TUSTIN AVE	225	SANTA ANA	CA	92705	8644	00	06000	33.757254	-117.8341425	Orange County
337303	Ordering, Referring, Prescribing	N/A	1548540727	0	0	FUNG, LILLY NP	1/28/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000607	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVENUE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
337308	Ordering, Referring, Prescribing	N/A	1548560642	0	0	FINN, ANNE M PHARMD	2/1/2020	Taxonomy not applicable	NA	n/a	000	Unknown	36548	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRY BLVD	None	JACKSON	CA	95642	9373	00	06000	38.36981229	-120.8002806	Amador County
337355	Ordering, Referring, Prescribing	N/A	1548642184	0	0	FONTES, BYANKA D LMFT	7/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120004	N/A	N/A	N/A	N/A	N/A	3301 E. 12TH STREET	259	OAKLAND	CA	94601	2940	00	06000	37.77617499	-122.2247899	Alameda County
337518	Ordering, Referring, Prescribing	N/A	1558037465	0	0	FRANCO, TATSIANA PA-C	10/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60952	N/A	N/A	N/A	N/A	N/A	3750 ROHNERVILLE RD	None	FORTUNA	CA	95540	3118	00	06000	40.58219346	-124.1308513	Humboldt County
337533	Ordering, Referring, Prescribing	N/A	1558107490	0	0	FRANCO, TREAHNA LMFT	5/13/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT146863	N/A	N/A	N/A	N/A	N/A	516 GIBSON DR	STE 100	ROSEVILLE	CA	95678	5792	00	06000	38.77885319	-121.2746879	Placer County
337550	Ordering, Referring, Prescribing	N/A	1558311456	0	0	FAM, HANAA W MD	11/6/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A68093	N/A	N/A	N/A	N/A	N/A	3751 STOCKER ST	None	VIEW PARK	CA	90008	5101	00	06000	34.00616017	-118.3385751	Los Angeles County
337623	Ordering, Referring, Prescribing	N/A	1558546465	0	0	FRATES, DIANA L LCSW	1/24/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26857	N/A	N/A	N/A	N/A	N/A	2145 FIFTH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
337654	Ordering, Referring, Prescribing	N/A	1558618066	0	0	FARIAS-RENTERIA, ELSA LCSW	6/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80915	N/A	N/A	N/A	N/A	N/A	1161 BAY BLVD	STE B	CHULA VISTA	CA	91911	2670	00	06000	32.6050811	-117.0922508	San Diego County
337750	Ordering, Referring, Prescribing	N/A	1558784512	0	0	FARLEY, AUCHAIA PA-C	2/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	55300	N/A	N/A	N/A	N/A	N/A	1120 EAST CHURCH AVE	SUITE 100	FRESNO	CA	93706	0000	00	06000	36.7140837	-119.7975576	Fresno County
337770	Ordering, Referring, Prescribing	N/A	1558818153	0	0	FLEVIYA, SMITHA NP	9/19/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	696172	N/A	N/A	N/A	N/A	N/A	1101 NORTH CHERRY STREET	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
337780	Ordering, Referring, Prescribing	N/A	1558840215	0	0	FITCH, SARAH R LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115273	N/A	N/A	N/A	N/A	N/A	1624 SANTA CLARA DR.	SUITE 145	ROSEVILLE	CA	95661	3522	00	06000	38.74308965	-121.2620987	Placer County
337806	Ordering, Referring, Prescribing	N/A	1558874560	0	0	FERNANDEZ, VANESSA LCSW	4/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101187	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	BLDG 400 STE 202	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
337809	Ordering, Referring, Prescribing	N/A	1558873158	0	0	FISHER, CHANTAL N LMFT	8/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121397	N/A	N/A	N/A	N/A	N/A	7003 N FIGUEROA ST	None	LOS ANGELES	CA	90042	1247	00	06000	34.12951669	-118.1880773	Los Angeles County
337818	Ordering, Referring, Prescribing	N/A	1558885269	0	0	FLORES DE SANTIAGO, ANNET LMFT	3/24/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131960	N/A	N/A	N/A	N/A	N/A	4500 E PACIFIC COAST HWY	None	LONG BEACH	CA	90804	3275	00	06000	33.78808863	-118.1399827	Los Angeles County
337841	Ordering, Referring, Prescribing	N/A	1558945238	0	0	FLORES, ELENA LCSW	1/30/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW128027	N/A	N/A	N/A	N/A	N/A	9650 ZELZAH AVE	None	NORTHRIDGE	CA	91325	2003	00	06000	34.24628267	-118.5232668	Los Angeles County
337855	Ordering, Referring, Prescribing	N/A	1558978643	0	0	FLORES, MAYRA NP	8/23/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015214	N/A	N/A	N/A	N/A	N/A	40910 FREMONT BLVD	None	FREMONT	CA	94538	4375	00	06000	37.53384106	-121.9607241	Alameda County
337862	Ordering, Referring, Prescribing	N/A	1558997569	0	0	FERNANDES, NICOLE NP	5/1/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012649	N/A	N/A	N/A	N/A	N/A	1300 N DUTTON AVE	None	SANTA ROSA	CA	95401	7112	00	06000	38.449791	-122.733027	Sonoma County
337893	Ordering, Referring, Prescribing	N/A	1568061703	0	0	FEMATT BRIZUELA, EDITH LPCC	5/22/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16597	N/A	N/A	N/A	N/A	N/A	4660 EL CAJON BLVD	None	SAN DIEGO	CA	92115	4711	00	06000	32.75587585	-117.093663	San Diego County
337988	Ordering, Referring, Prescribing	N/A	1568524387	0	0	FLASHER, LYDIA V PHD	6/30/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	16024	N/A	N/A	N/A	N/A	N/A	650 CLARK WAY	None	PALO ALTO	CA	94304	2300	00	06000	37.43949537	-122.1784133	Santa Clara County
338021	Ordering, Referring, Prescribing	N/A	1568591550	0	0	FUENTES, PAULA R LMFT	3/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113516	N/A	N/A	N/A	N/A	N/A	1215WEST WEST COVINA PAR	None	WEST COVINA	CA	91790	2815	00	06000	34.06877078	-117.9349578	Los Angeles County
338034	Ordering, Referring, Prescribing	N/A	1568640043	0	0	FORSTER, HOLLIS	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0308716	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
338036	Ordering, Referring, Prescribing	N/A	1568644599	0	0	FRIEDLING, NAOMI H	5/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51970	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	BUILDING 5 STE 6B	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
338050	Ordering, Referring, Prescribing	N/A	1568660298	0	0	FINCH, MARYBETH MS RPT	6/14/2020	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT25206	N/A	N/A	N/A	N/A	N/A	312 CLAY ST	None	OAKLAND	CA	94607	3530	00	06000	37.79802567	-122.2780981	Alameda County
338054	Ordering, Referring, Prescribing	N/A	1568688554	0	0	FARRELL, TIM A	3/4/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D64294	N/A	N/A	N/A	N/A	N/A	7843 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91605	2523	00	06000	34.213581	-118.3878055	Los Angeles County
338105	Ordering, Referring, Prescribing	N/A	1568762193	0	0	FUNG, SHERRY L PHARMD	3/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH 51695	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
338120	Ordering, Referring, Prescribing	N/A	1568775039	0	0	FERRARELLA, NICHOLAS C PHARMD	4/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64077	N/A	N/A	N/A	N/A	N/A	411 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	00	06000	33.8531521	-117.8160824	Orange County
338233	Ordering, Referring, Prescribing	N/A	1568940609	0	0	FANG, CELIA LMFT	2/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124338	N/A	N/A	N/A	N/A	N/A	3787 S VERMONT AVE	None	LOS ANGELES	CA	90007	4203	00	06000	34.01739	-118.291567	Los Angeles County
338289	Ordering, Referring, Prescribing	N/A	1578040531	0	0	FRANCIS, MICHELLE E NP	12/26/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008465	N/A	N/A	N/A	N/A	N/A	6120 SEVILLE AVENUE	None	HUNTINGTON PARK	CA	90255	6325	00	06000	33.98438021	-118.2226279	Los Angeles County
338335	Ordering, Referring, Prescribing	N/A	1578095493	0	0	FARRIMOND, FRANCES M MD	7/18/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157193	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT 384	SANTA CLARA	CA	95021	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
338366	Ordering, Referring, Prescribing	N/A	1578160362	0	0	FERRUGIA, ANTHONY C LCSW	9/6/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW125831	N/A	N/A	N/A	N/A	N/A	680 FLETCHER PARKWAY	SUITE 200	EL CAJON	CA	92020	2516	00	06000	32.80780847	-116.970687	San Diego County
338372	Ordering, Referring, Prescribing	N/A	1578191169	0	0	FLORES, TRINITY LCSW	2/17/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW106953	N/A	N/A	N/A	N/A	N/A	4155 OUTER TRAFFIC CIR	None	LONG BEACH	CA	90804	2111	00	06000	33.78904192	-118.1439401	Los Angeles County
338400	Ordering, Referring, Prescribing	N/A	1578281978	0	0	FONAREV, BRENDA LMFT	1/14/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152654	N/A	N/A	N/A	N/A	N/A	680 WILSON AVE	None	NOVATO	CA	94947	3825	00	06000	38.1040296	-122.5964315	Marin County
338419	Ordering, Referring, Prescribing	N/A	1578508545	0	0	FOREHAND, LYLE B MD	6/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79117	N/A	N/A	N/A	N/A	N/A	82675 HWY 111	JBDC	INDIO	CA	92201	5635	00	06000	33.71479133	-116.2215662	Riverside County
338439	Ordering, Referring, Prescribing	N/A	1578591673	0	0	FLORES, CYNTHIA L PA-C	6/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	12856	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE# A	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
338474	Ordering, Referring, Prescribing	N/A	1578687745	0	0	FALLON, DAVID P LMFT	11/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52389	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
338585	Ordering, Referring, Prescribing	N/A	1578851085	0	0	FUSELIER, LEE F LCSW	11/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98422	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
338662	Ordering, Referring, Prescribing	N/A	1578949145	0	0	FISHER, LAURA LPCC	3/11/2020	Taxonomy not applicable	NA	n/a	000	Unknown	6035	N/A	N/A	N/A	N/A	N/A	1801 VICENTE STREET	None	SAN FRANCISCO	CA	94116	2923	00	06000	37.7388459	-122.4861544	San Francisco County
338665	Ordering, Referring, Prescribing	N/A	1578959573	0	0	FAMENINI, SHANNON MD	10/4/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147808	N/A	N/A	N/A	N/A	N/A	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	00	06000	34.17030266	-118.5881699	Los Angeles County
338698	Ordering, Referring, Prescribing	N/A	1588003073	0	0	FAJIMOLU, AJIBOLA A PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76371	N/A	N/A	N/A	N/A	N/A	5224 COLDWATER CANYON AV	None	VALLEY VILLAGE	CA	91401	2566	00	06000	34.1656773	-118.4137318	Los Angeles County
338734	Ordering, Referring, Prescribing	N/A	1588044903	0	0	FRANK, SAMUEL B LCSW	12/6/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW92505	N/A	N/A	N/A	N/A	N/A	19400 SANTA MARIA AVE	None	CASTRO VALLEY	CA	94546	3400	00	06000	37.70465128	-122.0785627	Alameda County
338759	Ordering, Referring, Prescribing	N/A	1588063838	0	0	FARAHVASH, YASHAR	9/5/2023	Taxonomy not applicable	NA	n/a	000	Unknown	108596	N/A	N/A	N/A	N/A	N/A	1500 CAPITOLA ROAD	None	SANTA CRUZ	CA	95062	2912	00	06000	36.97641295	-121.9850639	Santa Cruz County
338776	Ordering, Referring, Prescribing	N/A	1588081921	0	0	FRANCO ESQUIVIAS, CRUZ R LCSW	3/29/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100843	N/A	N/A	N/A	N/A	N/A	3671 BUSINESS DR	110	SACRAMENTO	CA	95820	2165	00	06000	38.54133	-121.41891	Sacramento County
338860	Ordering, Referring, Prescribing	N/A	1588225643	0	0	FRENCH, LAUREN LCSW	3/2/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107149	N/A	N/A	N/A	N/A	N/A	928 BROADWAY	None	SAN DIEGO	CA	92101	5514	00	06000	32.71575045	-117.1560915	San Diego County
338938	Ordering, Referring, Prescribing	N/A	1588681084	0	0	FIELD, CLIFFORD MD	9/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G154374	N/A	N/A	N/A	N/A	N/A	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	00	06000	39.3245308	-120.2013097	Nevada County
338946	Ordering, Referring, Prescribing	N/A	1588709711	0	0	FONG, DEBORAH S PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52957	N/A	N/A	N/A	N/A	N/A	1851 OAKWOOD AVE	None	ARCADIA	CA	91006	1724	00	06000	34.1663607	-118.030735	Los Angeles County
338949	Ordering, Referring, Prescribing	N/A	1588719090	0	0	FRIEDMAN, JODY LCSW	6/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18537	N/A	N/A	N/A	N/A	N/A	995 POTRERO AVE	BASEMENT	SAN FRANCISCO	CA	94110	2859	00	06000	37.75729541	-122.4066641	San Francisco County
338981	Ordering, Referring, Prescribing	N/A	1588788988	0	0	FONG, NATALIE LMFT	12/21/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50855	N/A	N/A	N/A	N/A	N/A	1968 W ADAMS BLVD	None	LOS ANGELES	CA	90018	3515	00	06000	34.03266053	-118.3081635	Los Angeles County
338996	Ordering, Referring, Prescribing	N/A	1588799159	0	0	FLORIANO, ADRIENNE A PHD	9/30/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	486894	N/A	N/A	N/A	N/A	N/A	351 S HUDSON AVE	130	PASADENA	CA	91101	3507	00	06000	34.1397867	-118.1338422	Los Angeles County
339021	Ordering, Referring, Prescribing	N/A	1588864821	0	0	FLORES-LOPEZ, JOSE T MD	6/18/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G50533	N/A	N/A	N/A	N/A	N/A	172 E GRANT AVE	None	WINTERS	CA	95694	1780	00	06000	38.5264496	-121.9668052	Yolo County
339100	Ordering, Referring, Prescribing	N/A	1588996912	0	0	FLANIGAN, MARILYN Y LMFT	4/5/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97326	N/A	N/A	N/A	N/A	N/A	740 SOLANO ST	None	CORNING	CA	96021	3352	00	06000	39.92792649	-122.175513	Tehama County
339159	Ordering, Referring, Prescribing	N/A	1598075418	0	0	FRANSISCA, ANASTASIA NP	11/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021873	N/A	N/A	N/A	N/A	N/A	150 N RENO ST	None	LOS ANGELES	CA	90026	4656	00	06000	34.07274763	-118.2804096	Los Angeles County
339212	Ordering, Referring, Prescribing	N/A	1598157679	0	0	FUJIKAWA, SATOMI PHARMD	9/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68441	N/A	N/A	N/A	N/A	N/A	2589 JENSEN AVE	None	SANGER	CA	93657	2234	00	06000	36.7067485	-119.5739611	Fresno County
339268	Ordering, Referring, Prescribing	N/A	1598257560	0	0	FUHRMANN, ANDREAS LCSW	10/8/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW126619	N/A	N/A	N/A	N/A	N/A	20375 TAMARACK AVE.	None	BURNEY	CA	96013	0000	00	06000	40.87997081	-121.6720505	Shasta County
339306	Ordering, Referring, Prescribing	N/A	1598314635	0	0	FAQEERZADA, FARAIBA PA	4/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA57331	N/A	N/A	N/A	N/A	N/A	4425 S CENTRAL AVE	None	LOS ANGELES	CA	90011	3629	00	06000	34.003116	-118.2565185	Los Angeles County
339318	Ordering, Referring, Prescribing	N/A	1598343287	0	0	FRANCK, ELIZABETH A PA-C	4/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59386	N/A	N/A	N/A	N/A	N/A	6127 FAIR OAKS BLVD	None	FAIR OAKS	CA	95608	4818	00	06000	38.61252	-121.329387	Sacramento County
339352	Ordering, Referring, Prescribing	N/A	1598408155	0	0	FORD, MICHAEL D LCSW	8/11/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	102854	N/A	N/A	N/A	N/A	N/A	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	00	06000	34.100523	-118.3324855	Los Angeles County
339456	Ordering, Referring, Prescribing	N/A	1598932345	0	0	FORDE, RUTH MD	3/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C176513	N/A	N/A	N/A	N/A	N/A	3441 MARYSVILLE BLVD	None	SACRAMENTO	CA	95838	4512	00	06000	38.631231	-121.431402	Sacramento County
339462	Ordering, Referring, Prescribing	N/A	1598938771	0	0	FLEMING, SHANNA M LMFT	2/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	27164	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
339473	Ordering, Referring, Prescribing	N/A	1598962466	0	0	FALCON, JANEL C LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29441	N/A	N/A	N/A	N/A	N/A	1940 E DEERE AVE	None	SANTA ANA	CA	92705	5718	00	06000	33.70430421	-117.8482556	Orange County
339504	Ordering, Referring, Prescribing	N/A	1609050012	0	0	FORMAN, LYNN G LMFT	5/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43834	N/A	N/A	N/A	N/A	N/A	2640 BRESLAUER WAY	None	REDDING	CA	96001	4246	00	06000	40.5496754	-122.3791396	Shasta County
339574	Ordering, Referring, Prescribing	N/A	1609172436	0	0	FLORES, MYRNA A LMFT	3/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92101	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	95128	2407	00	06000	37.31712017	-121.9185451	Santa Clara County
339600	Ordering, Referring, Prescribing	N/A	1609213297	0	0	FIELDS, LAKESIA LMFT	12/22/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112964	N/A	N/A	N/A	N/A	N/A	5150 E PACIFIC COAST HWY	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
339635	Ordering, Referring, Prescribing	N/A	1609282623	0	0	FRANCISCO, CARLA LCSW	4/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88136	N/A	N/A	N/A	N/A	N/A	1720 E 120TH ST	None	LOS ANGELES	CA	90059	3052	00	06000	33.92455929	-118.2423557	Los Angeles County
339671	Ordering, Referring, Prescribing	N/A	1609317304	0	0	FERNANDEZ, VIOLETTA LCSW	4/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	92784	N/A	N/A	N/A	N/A	N/A	6043 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90028	5411	00	06000	34.1016835	-118.321569	Los Angeles County
339674	Ordering, Referring, Prescribing	N/A	1609322833	0	0	FORREY, GRETCHEN F LMFT	8/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112938	N/A	N/A	N/A	N/A	N/A	250 BON AIR RD	UNIT B	LARKSPUR	CA	94939	0000	00	06000	37.9469952	-122.5373892	Marin County
339681	Ordering, Referring, Prescribing	N/A	1609338730	0	0	FOGEL, ALEXIS H MD MPH	3/29/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL1800	N/A	N/A	N/A	N/A	N/A	747 52ND STREET	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
339684	Ordering, Referring, Prescribing	N/A	1609347251	0	0	FELLER, CHELSEA PSYD	10/15/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	35414	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK ROAD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
339807	Ordering, Referring, Prescribing	N/A	1609882638	0	0	FRANCIS, PATRICIA O MD	9/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G47861	N/A	N/A	N/A	N/A	N/A	930 DEWING AVE	None	LAFAYETTE	CA	94549	4223	00	06000	37.88865608	-122.1230076	Contra Costa County
339870	Ordering, Referring, Prescribing	N/A	1619004371	0	0	FREED, KAREN W MD	12/18/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C41256	N/A	N/A	N/A	N/A	N/A	10605 BALBOA BLVD	SUITE 100	GRANADA HILLS	CA	91344	6342	00	06000	34.263378	-118.5022965	Los Angeles County
339959	Ordering, Referring, Prescribing	N/A	1619175817	0	0	FREEDMAN, DIANA R LMFT	7/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85712	N/A	N/A	N/A	N/A	N/A	2235 CHALLENGER WAY	STE 101	SANTA ROSA	CA	95407	5421	00	06000	38.425491	-122.7519	Sonoma County
340059	Ordering, Referring, Prescribing	N/A	1619346145	0	0	FLORES, ANTONIO LCSW	2/27/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	105491	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
340105	Ordering, Referring, Prescribing	N/A	1619417342	0	0	FLORES, ANTHONY LPCC	9/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	10296	N/A	N/A	N/A	N/A	N/A	14140 BEACH BLVD	155	WESTMINSTER	CA	92683	4453	00	06000	33.756966	-117.9894915	Orange County
340121	Ordering, Referring, Prescribing	N/A	1619434156	0	0	FLORES, BIANCA V LMFT	5/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114565	N/A	N/A	N/A	N/A	N/A	2280 N VALENTINE AVE	None	FRESNO	CA	93722	5553	00	06000	36.76966023	-119.8532997	Fresno County
340249	Ordering, Referring, Prescribing	N/A	1629004957	0	0	FELIZARTA, FRANCO A MD	11/26/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A63225	N/A	N/A	N/A	N/A	N/A	1530 MANNING AVE	None	REEDLEY	CA	93654	2346	00	06000	36.60413846	-119.4316515	Fresno County
340297	Ordering, Referring, Prescribing	N/A	1629141866	0	0	FRIEDMAN, DAVID MD	2/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G57885	N/A	N/A	N/A	N/A	N/A	1165 N. EUCLID ST	None	ANAHEIM	CA	92801	1938	00	06000	33.849792	-117.941806	Orange County
340343	Ordering, Referring, Prescribing	N/A	1629257001	0	0	FONG, JENIN PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60264	N/A	N/A	N/A	N/A	N/A	1200 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	3208	00	06000	37.65894608	-122.440161	San Mateo County
340353	Ordering, Referring, Prescribing	N/A	1629275540	0	0	FRANKLIN, NICOLE Y MD	1/11/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	165291	N/A	N/A	N/A	N/A	N/A	670 PLACERVILLE DR	SUITE 2	PLACERVILLE	CA	95667	4200	00	06000	38.73161765	-120.8213885	El Dorado County
340437	Ordering, Referring, Prescribing	N/A	1629419627	0	0	FRIERSON, LISA N LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71405	N/A	N/A	N/A	N/A	N/A	1521 UNIVERSITY AVE.	None	BERKELEY	CA	94703	1422	00	06000	37.87060038	-122.2812128	Alameda County
340438	Ordering, Referring, Prescribing	N/A	1629422670	0	0	FLEEK, STEVEN DC	7/3/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	33292	N/A	N/A	N/A	N/A	N/A	9380 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3749	00	06000	33.9215355	-117.4442978	Riverside County
340502	Ordering, Referring, Prescribing	N/A	1629527932	0	0	FORCUM, MEGAN R NP	10/18/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95047281	N/A	N/A	N/A	N/A	N/A	4786 N PECK RD	STE B	EL MONTE	CA	91732	1665	00	06000	34.0907378	-118.0144392	Los Angeles County
340523	Ordering, Referring, Prescribing	N/A	1629572011	0	0	FISHER, JAKE A MD	3/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163365	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
340638	Ordering, Referring, Prescribing	N/A	1629843503	0	0	FENG, SAMMY PA	2/8/2024	Taxonomy not applicable	NA	n/a	000	Unknown	64053	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
340672	Ordering, Referring, Prescribing	N/A	1639226871	0	0	FINKELDEY, MEGAN R LCSW	11/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	16492	N/A	N/A	N/A	N/A	N/A	3061 FILLMORE ST	None	SAN FRANCISCO	CA	94123	4009	00	06000	37.79787328	-122.4356778	San Francisco County
340691	Ordering, Referring, Prescribing	N/A	1639280886	0	0	FESSEL, MARY	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0456427	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
340696	Ordering, Referring, Prescribing	N/A	1639295348	0	0	FLEMING, VICTORIA C LCSW	6/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28404	N/A	N/A	N/A	N/A	N/A	2225 CHALLENGER WAY	None	SANTA ROSA	CA	95407	5441	00	06000	38.425482	-122.75262	Sonoma County
340697	Ordering, Referring, Prescribing	N/A	1639304207	0	0	FROEHLICH, STACY L LMFT	10/3/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46901	N/A	N/A	N/A	N/A	N/A	5801 SUNDALE AVE.	None	BAKERSFIELD	CA	93309	2924	00	06000	35.34387226	-119.0654328	Kern County
340699	Ordering, Referring, Prescribing	N/A	1639303118	0	0	FALKENSTEIN, IRYNA A MD	11/20/2017	Taxonomy not applicable	NA	n/a	000	Unknown	C145657	N/A	N/A	N/A	N/A	N/A	711 VAN NESS AVE	SUITE 330	SAN FRANCISCO	CA	94102	3285	00	06000	37.78218473	-122.4208156	San Francisco County
340751	Ordering, Referring, Prescribing	N/A	1639412091	0	0	FONSWORTH, PEOLIA K MD	6/11/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132680	N/A	N/A	N/A	N/A	N/A	1100B N TUSTIN AVE	F	SANTA ANA	CA	92705	3509	00	06000	33.7548117	-117.8342879	Orange County
340757	Ordering, Referring, Prescribing	N/A	1639432545	0	0	FAJARDO GOMEZ, OSCAR S MD	4/23/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145639	N/A	N/A	N/A	N/A	N/A	1025 NORTH DOUTY ST	None	HANFORD	CA	93230	3722	00	06000	36.33611794	-119.6460191	Kings County
340761	Ordering, Referring, Prescribing	N/A	1639444821	0	0	FELDSHTERN, EVGENIA LMFT	12/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43776	N/A	N/A	N/A	N/A	N/A	3575 SAN PABLO DAM RD	# 12	EL SOBRANTE	CA	94803	7205	00	06000	37.96412374	-122.3186737	Contra Costa County
340764	Ordering, Referring, Prescribing	N/A	1639440977	0	0	FERNANDEZ, LUIS A MD	2/3/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184052	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95127	1439	00	06000	37.34293689	-121.9270392	Santa Clara County
340765	Ordering, Referring, Prescribing	N/A	1639446099	0	0	FRANCHUK, JENNIFER A MD	9/17/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C137951	N/A	N/A	N/A	N/A	N/A	29632 HWY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0228	00	06000	40.80385331	-121.9397745	Shasta County
340847	Ordering, Referring, Prescribing	N/A	1639556418	0	0	FRENI STERRANTINO, CINZIA LPCC	4/23/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC7269	N/A	N/A	N/A	N/A	N/A	1250 MORENA BLVD	None	SAN DIEGO	CA	92110	3815	00	06000	32.76963745	-117.2036361	San Diego County
340855	Ordering, Referring, Prescribing	N/A	1639561871	0	0	FERNANDEZ, JOHN J LMFT	9/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132941	N/A	N/A	N/A	N/A	N/A	232 E GISH RD	None	SAN JOSE	CA	95112	4706	00	06000	37.36411044	-121.9052075	Santa Clara County
340910	Ordering, Referring, Prescribing	N/A	1639640840	0	0	FERNANDEZ, ARMANDO	5/14/2018	Taxonomy not applicable	NA	n/a	000	Unknown	LEP2273	N/A	N/A	N/A	N/A	N/A	9510 ELK GROVE-FLORIN RD	None	ELK GROVE	CA	95624	6032	00	06000	38.413008	-121.372344	Sacramento County
340913	Ordering, Referring, Prescribing	N/A	1639644958	0	0	FAIRCHILD, AUDREY V LMFT	5/28/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125638	N/A	N/A	N/A	N/A	N/A	1720 MARCO POLO WAY STE	STE E	BURLINGAME	CA	94010	4513	00	06000	37.58986055	-122.3842811	San Mateo County
340969	Ordering, Referring, Prescribing	N/A	1639744766	0	0	FERRETTA, MEEKA LMFT	8/1/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	148540	N/A	N/A	N/A	N/A	N/A	101 WEST COAST RD	None	REDWAY	CA	95560	0769	00	06000	40.11704433	-123.8133408	Humboldt County
341034	Ordering, Referring, Prescribing	N/A	1649088923	0	0	FOWLER, BRITNI D NP	11/19/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033036	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVENUE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
341073	Ordering, Referring, Prescribing	N/A	1649318387	0	0	FU, MICHI PSYD	4/20/2017	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	19701	N/A	N/A	N/A	N/A	N/A	701 S ATLANTIC BLVD	STE 100	MONTEREY PARK	CA	91754	1746	00	06000	34.05382447	-118.1363489	Los Angeles County
341104	Ordering, Referring, Prescribing	N/A	1649371634	0	0	FABIANO, SELENE PHD	2/18/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY14541	N/A	N/A	N/A	N/A	N/A	510 16TH STREET	None	OAKLAND	CA	94612	1520	00	06000	37.80621729	-122.2710575	Alameda County
341107	Ordering, Referring, Prescribing	N/A	1649381831	0	0	FENG, DANIEL K	4/26/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	54152	N/A	N/A	N/A	N/A	N/A	1717 E WALNUT ST	None	PASADENA	CA	91106	1611	00	06000	34.14957646	-118.115019	Los Angeles County
341114	Ordering, Referring, Prescribing	N/A	1649399809	0	0	FISHER, ORLY S LCSW	8/29/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	17593	N/A	N/A	N/A	N/A	N/A	333 S BEAUDRY AVE	None	LOS ANGELES	CA	90017	1466	00	06000	34.05611213	-118.2570905	Los Angeles County
341127	Ordering, Referring, Prescribing	N/A	1649432246	0	0	FLANSBAUM, DREW MD	1/14/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	54961	N/A	N/A	N/A	N/A	N/A	391 WALLACE RD	None	NASHVILLE	TN	37211	4851	00	06000	36.076509	-86.7213405	Davidson County
341199	Ordering, Referring, Prescribing	N/A	1649585753	0	0	FABRIKANT, JORDAN DO	6/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A13142	N/A	N/A	N/A	N/A	N/A	1127 WILSHIRE BLVD	600	LOS ANGELES	CA	90017	3907	00	06000	34.05270508	-118.2641005	Los Angeles County
341255	Ordering, Referring, Prescribing	N/A	1649652843	0	0	FEUCHT, ELIZABETH A NP	8/24/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031438	N/A	N/A	N/A	N/A	N/A	4600 BOHANNON DR STE 100	STE 100	MENLO PARK	CA	94025	1037	00	06000	37.479573	-122.1755445	San Mateo County
341272	Ordering, Referring, Prescribing	N/A	1649683350	0	0	FREMPONG, ERIC MD	8/22/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150090	N/A	N/A	N/A	N/A	N/A	525 ROBERTS LANE	None	BAKERSFIELD	CA	93308	4799	00	06000	35.40860151	-119.0317455	Kern County
341277	Ordering, Referring, Prescribing	N/A	1649687450	0	0	FULTON, JUANA S LCSW	10/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87062	N/A	N/A	N/A	N/A	N/A	1250 MORENA BLVD	None	SAN DIEGO	CA	92110	3815	00	06000	32.76963745	-117.2036361	San Diego County
341342	Ordering, Referring, Prescribing	N/A	1649806696	0	0	FONG, ANNA M MD	2/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL3647	N/A	N/A	N/A	N/A	N/A	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	00	06000	33.78034779	-117.8655767	Orange County
341426	Ordering, Referring, Prescribing	N/A	1659016665	0	0	FISCUS, TIMOTHY M DO	12/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21774	N/A	N/A	N/A	N/A	N/A	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	00	06000	36.83626596	-119.7674879	Fresno County
341453	Ordering, Referring, Prescribing	N/A	1659102838	0	0	FERNANDEZ AYON, SUGEY M DDS	8/9/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110523	N/A	N/A	N/A	N/A	N/A	1101 N CHERRY ST	None	TULARE	CA	93274	2231	00	06000	36.22333808	-119.337575	Tulare County
341496	Ordering, Referring, Prescribing	N/A	1659423473	0	0	FUHS, SARAH K LMFT	5/4/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132603	N/A	N/A	N/A	N/A	N/A	1303 SAN CARLOS AVE	None	SAN CARLOS	CA	94070	2317	00	06000	37.50572931	-122.2621879	San Mateo County
341533	Ordering, Referring, Prescribing	N/A	1659504264	0	0	FREEMAN, WANDA NP	2/16/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003903	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
341562	Ordering, Referring, Prescribing	N/A	1659564201	0	0	FENN, RALPH C MD	5/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79192	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN ST	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
341605	Ordering, Referring, Prescribing	N/A	1659648392	0	0	FLORES, ANA B LCSW	3/30/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82291	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY	SUITE 200	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
341614	Ordering, Referring, Prescribing	N/A	1659657542	0	0	FIELDS BREWER, ASHA DC	11/14/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC36427	N/A	N/A	N/A	N/A	N/A	3311 PACIFIC AVE	None	LIVERMORE	CA	94550	7007	00	06000	37.67610149	-121.755159	Alameda County
341654	Ordering, Referring, Prescribing	N/A	1659708295	0	0	FAHIMI, RAHA I OD	5/25/2020	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34405	N/A	N/A	N/A	N/A	N/A	955 SOUTH CARILLO AVE	STE 105	LOS ANGELES	CA	90048	5400	00	06000	33.73540787	-118.2946295	Los Angeles County
341726	Ordering, Referring, Prescribing	N/A	1659825370	0	0	FLORES, GABRIELLE LCSW	4/6/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100959	N/A	N/A	N/A	N/A	N/A	242 N. VILLA AVE.	None	WILLOWS	CA	95988	2641	00	06000	39.52243848	-122.208844	Glenn County
341834	Ordering, Referring, Prescribing	N/A	1669044863	0	0	FRANKLIN, SAWYER E LCSW	10/15/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114862	N/A	N/A	N/A	N/A	N/A	4065 3RD AVE	None	SAN DIEGO	CA	92103	2184	00	06000	32.75123948	-117.1627318	San Diego County
341867	Ordering, Referring, Prescribing	N/A	1669154241	0	0	FLEMING, FELICIA A LCSW	10/24/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW66341	N/A	N/A	N/A	N/A	N/A	602 WOODLARK DR	None	SUISUN CITY	CA	94585	2244	00	06000	38.24578795	-121.9999968	Solano County
341878	Ordering, Referring, Prescribing	N/A	1669170387	0	0	FATAPOUR, NIKKI N NP	2/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024276	N/A	N/A	N/A	N/A	N/A	1066 S WHITE RD,	SUITE 170	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
341907	Ordering, Referring, Prescribing	N/A	1669457834	0	0	FERNANDEZ Y GARCIA, ERIK O	9/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A77325	N/A	N/A	N/A	N/A	N/A	2020 J ST	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
341918	Ordering, Referring, Prescribing	N/A	1669504700	0	0	FINE, STEPHEN LMFT	6/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	34932	N/A	N/A	N/A	N/A	N/A	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	00	06000	35.640783	-117.6698475	Kern County
341975	Ordering, Referring, Prescribing	N/A	1669639092	0	0	FRASER, DOUGLAS R MD	12/21/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	14823	N/A	N/A	N/A	N/A	N/A	801 HOPE PL	None	LAS VEGAS	NV	89106	4400	00	06000	36.1615287	-115.167727	Clark County
342035	Ordering, Referring, Prescribing	N/A	1669786869	0	0	FUENTES, LILIA C	10/13/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D59318	N/A	N/A	N/A	N/A	N/A	6901 S ATLANTIC AVE	None	BELL	CA	90201	3646	00	06000	33.97291242	-118.1878808	Los Angeles County
342123	Ordering, Referring, Prescribing	N/A	1669944112	0	0	FLEMING, SUSAN LMFT	11/19/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42133	N/A	N/A	N/A	N/A	N/A	295 N FIRST ST	None	BLYTHE	CA	92225	1703	00	06000	33.61391466	-114.5955973	Riverside County
342139	Ordering, Referring, Prescribing	N/A	1669968574	0	0	FLORES, JESSICA	7/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	55720	N/A	N/A	N/A	N/A	N/A	2801 S SAN PEDRO ST	None	LOS ANGELES	CA	90011	2023	00	06000	34.01966657	-118.2625434	Los Angeles County
342195	Ordering, Referring, Prescribing	N/A	1679062632	0	0	FULLER, CHAD MD	9/25/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174124	N/A	N/A	N/A	N/A	N/A	1250 PEACH ST	STE A	SAN LUIS OBISPO	CA	93401	2871	00	06000	35.28647825	-120.6599674	San Luis Obispo County
342259	Ordering, Referring, Prescribing	N/A	1679183602	0	0	FAHLIOGULLARI-SMITH, HAYAT I	9/11/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	105189	N/A	N/A	N/A	N/A	N/A	133 W MAIN ST	STE 100	EL CAJON	CA	92020	3325	00	06000	32.79492453	-116.9627861	San Diego County
342293	Ordering, Referring, Prescribing	N/A	1679291728	0	0	FRANKE, JULIE T	7/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021636	N/A	N/A	N/A	N/A	N/A	46896 HIGHWAY 1	None	BIG SUR	CA	93920	9693	00	06000	36.26867238	-121.8064797	Monterey County
342434	Ordering, Referring, Prescribing	N/A	1679832232	0	0	FLORES, ROXANA LCSW	6/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW75285	N/A	N/A	N/A	N/A	N/A	5740 RALSTON STREET	SUITE 201	VENTURA	CA	93003	6571	00	06000	34.26070802	-119.213699	Ventura County
342456	Ordering, Referring, Prescribing	N/A	1679871636	0	0	FLORES, KASEY L PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61231	N/A	N/A	N/A	N/A	N/A	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	00	06000	38.746836	-121.250529	Placer County
342500	Ordering, Referring, Prescribing	N/A	1679964175	0	0	FLAMENCO, ERICA V LCSW	5/21/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83080	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVENUE	None	LOS ANGELES	CA	90001	9998	00	06000	33.9664185	-118.2477481	Los Angeles County
342544	Ordering, Referring, Prescribing	N/A	1689027534	0	0	FUNG, KIT YING NP	1/27/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95006292	N/A	N/A	N/A	N/A	N/A	210 N GARFIELD AVE	316	MONTEREY PARK	CA	91754	1746	00	06000	34.064181	-118.122834	Los Angeles County
342680	Ordering, Referring, Prescribing	N/A	1689250201	0	0	FUNK, DIANA M MD	4/8/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A193724	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
342681	Ordering, Referring, Prescribing	N/A	1689251753	0	0	FLEMING, ROBYN J OT	3/23/2021	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	22226	N/A	N/A	N/A	N/A	N/A	1901 N RICE AVE	None	OXNARD	CA	93030	7912	00	06000	34.21960355	-119.1421345	Ventura County
342695	Ordering, Referring, Prescribing	N/A	1689276255	0	0	FARZINFARID, FARAZ PHARMD	7/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83779	N/A	N/A	N/A	N/A	N/A	305 N BREED ST	None	LOS ANGELES	CA	90033	1801	00	06000	34.04750163	-118.208751	Los Angeles County
342741	Ordering, Referring, Prescribing	N/A	1689618878	0	0	FREINHAR, JACK P MD	3/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G53350	N/A	N/A	N/A	N/A	N/A	23700 CAMINO DEL SOL	None	TORRANCE	CA	90505	5017	00	06000	33.8102385	-118.3441185	Los Angeles County
342817	Ordering, Referring, Prescribing	N/A	1689849655	0	0	FOSTER, BECKY M LMFT	12/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51865	N/A	N/A	N/A	N/A	N/A	2150 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1337	00	06000	38.557287	-121.461444	Sacramento County
342945	Ordering, Referring, Prescribing	N/A	1699071571	0	0	FLOYD, JANAE D PA-C	8/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	21315	N/A	N/A	N/A	N/A	N/A	121 S LONG BEACH BLVD	None	COMPTON	CA	90221	3423	00	06000	33.89475493	-118.2080292	Los Angeles County
342964	Ordering, Referring, Prescribing	N/A	1699103804	0	0	FEDOR, NICHOLAS P	9/11/2017	Taxonomy not applicable	NA	n/a	000	Unknown	2427	N/A	N/A	N/A	N/A	N/A	1907 BORDER AVE	None	TORRANCE	CA	90501	3606	00	06000	33.828615	-118.3130985	Los Angeles County
343034	Ordering, Referring, Prescribing	N/A	1699232694	0	0	FREEMAN, QUENETTE LCSW	2/17/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106958	N/A	N/A	N/A	N/A	N/A	1525 PLUMAS CT	STE C & D	YUBA CITY	CA	95991	2971	00	06000	39.15274768	-121.6184473	Sutter County
343048	Ordering, Referring, Prescribing	N/A	1699256859	0	0	FISHMAN, ISAAC D LMFT	8/1/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105589	N/A	N/A	N/A	N/A	N/A	312 S. LINCOLN STREET	None	FORT BRAGG	CA	95437	3550	00	06000	39.43892314	-123.7955129	Mendocino County
343080	Ordering, Referring, Prescribing	N/A	1699321562	0	0	FUENTES, FRANCISCO M LPCC	7/20/2024	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC17003	N/A	N/A	N/A	N/A	N/A	17695 INDUSTRIAL FARM RD	None	BAKERSFIELD	CA	93308	9520	00	06000	35.510481	-119.1086895	Kern County
343120	Ordering, Referring, Prescribing	N/A	1699397372	0	0	FLOWERS, TANISHA LMFT	8/15/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	140780	N/A	N/A	N/A	N/A	N/A	325 W HOSPITALITY LN	312	SAN BERNARDINO	CA	92408	3243	00	06000	34.0658995	-117.29034	San Bernardino County
343129	Ordering, Referring, Prescribing	N/A	1699411694	0	0	FAHRNI, JOSSLYN CCC-SLP	5/17/2021	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	31442	N/A	N/A	N/A	N/A	N/A	2350 W LATHAM AVE	None	HEMET	CA	92545	3654	00	06000	33.74924428	-116.9966408	Riverside County
343158	Ordering, Referring, Prescribing	N/A	1699498121	0	0	FAULDING, CHRISTINA NP	9/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022707	N/A	N/A	N/A	N/A	N/A	518 GARDEN STREET	None	SANTA BARBARA	CA	93101	1606	00	06000	34.42054634	-119.6928135	Santa Barbara County
343179	Ordering, Referring, Prescribing	N/A	1699758359	0	0	FERRERIA, CHRISTY J PHARMD	2/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	55681	N/A	N/A	N/A	N/A	N/A	2270 CLOVIS AVE	None	CLOVIS	CA	93612	3915	00	06000	36.806301	-119.703312	Fresno County
343245	Ordering, Referring, Prescribing	N/A	1699897678	0	0	FERNANDEZ, HUGO A LMFT	9/25/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51617	N/A	N/A	N/A	N/A	N/A	22445 ALESSANDRO BLVD	113-114	MORENO VALLEY	CA	92553	8358	00	06000	33.91687854	-117.270999	Riverside County
343247	Ordering, Referring, Prescribing	N/A	1699903666	0	0	FILANOSKY, VICTORIA PSYD	4/1/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY22440	N/A	N/A	N/A	N/A	N/A	1500 GRANT AVENUE	SUITE 108	NOVATO	CA	94945	3150	00	06000	38.10880398	-122.5762623	Marin County
343311	Ordering, Referring, Prescribing	N/A	1700083540	0	0	FAGUNDES, MEGHAN E PHD	7/26/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31947	N/A	N/A	N/A	N/A	N/A	9445 FARNHAM ST	None	SAN DIEGO	CA	92123	1399	00	06000	32.83274967	-117.1248508	San Diego County
343312	Ordering, Referring, Prescribing	N/A	1700086253	0	0	FRAME, LAURA C LCSW	6/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS22401	N/A	N/A	N/A	N/A	N/A	312 CLAY STREET	None	OAKLAND	CA	94607	3510	00	06000	37.79802567	-122.2780981	Alameda County
343318	Ordering, Referring, Prescribing	N/A	1700095353	0	0	FRANCK, CATHERINE D LCSW	5/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW15178	N/A	N/A	N/A	N/A	N/A	2045 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1088	00	06000	37.709892	-122.118966	Alameda County
343332	Ordering, Referring, Prescribing	N/A	1700115862	0	0	FESPERMAN, RENEE LMFT	4/14/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	46294	N/A	N/A	N/A	N/A	N/A	190 N WIGET LN	275	WALNUT CREEK	CA	94598	2440	00	06000	37.92628945	-122.0245576	Contra Costa County
343394	Ordering, Referring, Prescribing	N/A	1700203361	0	0	FERRARO, PIA NP	2/16/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000557	N/A	N/A	N/A	N/A	N/A	2292 FARADAY AVE	100	CARLSBAD	CA	92008	7238	00	06000	33.13490794	-117.2765569	San Diego County
343439	Ordering, Referring, Prescribing	N/A	1700267010	0	0	FONSECA, ABIGAIL LCSW	10/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81614	N/A	N/A	N/A	N/A	N/A	14659 OLIVE VIEW DR	None	SYLMAR	CA	91342	1652	00	06000	34.32412624	-118.4525494	Los Angeles County
343505	Ordering, Referring, Prescribing	N/A	1700367562	0	0	FAGUNDES, MATTHEW J PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73417	N/A	N/A	N/A	N/A	N/A	2730 SHAFFER RD	None	ATWATER	CA	95301	2225	00	06000	37.36230716	-120.5957396	Merced County
343514	Ordering, Referring, Prescribing	N/A	1700375250	0	0	FORD, KAITLIN M MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166720	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
343593	Ordering, Referring, Prescribing	N/A	1700536836	0	0	FELTON, ERIN MD	8/31/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A189836	N/A	N/A	N/A	N/A	N/A	3569 ROUND BARN CIRCLE	None	SANTA ROSA	CA	95403	5781	00	06000	38.479743	-122.729625	Sonoma County
343633	Ordering, Referring, Prescribing	N/A	1700853462	0	0	FLORYAN, JOHN A OD	6/20/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT5389TPG	N/A	N/A	N/A	N/A	N/A	2895 LOMA VISTA RD	STE. A	VENTURA	CA	93003	1572	00	06000	34.27543868	-119.2574459	Ventura County
343661	Ordering, Referring, Prescribing	N/A	1700947157	0	0	FISCHER, JANET E MD	6/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A89318	N/A	N/A	N/A	N/A	N/A	1441 CONSTITUTION BLVD	SUITE 202	SALINAS	CA	93906	3100	00	06000	36.696987	-121.633164	Monterey County
343706	Ordering, Referring, Prescribing	N/A	1710026612	0	0	FOLSOM, DAVID P MD	3/31/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A65435	N/A	N/A	N/A	N/A	N/A	1501 IMPERIAL AVE	None	SAN DIEGO	CA	92101	7638	00	06000	32.70625742	-117.1498948	San Diego County
343709	Ordering, Referring, Prescribing	N/A	1710048376	0	0	FORD, FREDDY LMFT	1/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49630	N/A	N/A	N/A	N/A	N/A	2101 COURAGE DR	None	FAIRFIELD	CA	94533	6717	00	06000	38.23737478	-122.0676832	Solano County
343723	Ordering, Referring, Prescribing	N/A	1710070859	0	0	FRANK, ERIC C LCSW	1/27/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22363	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	200	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
343788	Ordering, Referring, Prescribing	N/A	1710234760	0	0	FOLEY, COLLEEN	12/13/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30581	N/A	N/A	N/A	N/A	N/A	3031 S VERMONT AVE	None	LOS ANGELES	CA	90007	3033	00	06000	34.02666679	-118.2915608	Los Angeles County
343846	Ordering, Referring, Prescribing	N/A	1710320676	0	0	FISCHER, JEREMY S	12/1/2014	Taxonomy not applicable	NA	n/a	000	Unknown	570	N/A	N/A	N/A	N/A	N/A	4849 VAN NUYS BLVD	SUITE 104	SHERMAN OAKS	CA	91403	2119	00	06000	34.159113	-118.4487465	Los Angeles County
343861	Ordering, Referring, Prescribing	N/A	1710353040	0	0	FARIAS, VICTORIA LCSW	3/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87946	N/A	N/A	N/A	N/A	N/A	3368 TRADEWINDS AVE	None	TULARE	CA	93274	0000	00	06000	36.19172566	-119.2978707	Tulare County
343893	Ordering, Referring, Prescribing	N/A	1710388947	0	0	FANG, LANG J LCSW	8/11/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCW88534	N/A	N/A	N/A	N/A	N/A	3030 EXPLORER DR.	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
343906	Ordering, Referring, Prescribing	N/A	1710408646	0	0	FONG, ALEYNA S	3/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75570	N/A	N/A	N/A	N/A	N/A	395 HICKEY BLVD	None	DALY CITY	CA	94015	2770	00	06000	37.66312028	-122.4631592	San Mateo County
343923	Ordering, Referring, Prescribing	N/A	1710432265	0	0	FRANCO, MIA L LCSW	8/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96475	N/A	N/A	N/A	N/A	N/A	982 MISSION ST	None	SAN FRANCISCO	CA	94103	2911	00	06000	37.7813638	-122.4082438	San Francisco County
343930	Ordering, Referring, Prescribing	N/A	1710448303	0	0	FERNANDEZ ARCE, OSCAR F MD	3/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176798	N/A	N/A	N/A	N/A	N/A	725 W LA VETA AVE	260	ORANGE	CA	92868	4403	00	06000	33.78063949	-117.8603285	Orange County
344004	Ordering, Referring, Prescribing	N/A	1710604673	0	0	FAJARDO, EMELLE F NP	3/27/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022899	N/A	N/A	N/A	N/A	N/A	207 EL CAMINO REAL	None	REDWOOD CITY	CA	94062	1111	00	06000	37.49241836	-122.2425944	San Mateo County
344048	Ordering, Referring, Prescribing	N/A	1710908579	0	0	FETZ, DANA R LMFT	11/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT29024	N/A	N/A	N/A	N/A	N/A	3150 HILLTOP MALL RD., S	None	RICHMOND	CA	94806	1921	00	06000	37.9802423	-122.3244075	Contra Costa County
344138	Ordering, Referring, Prescribing	N/A	1720236540	0	0	FOSTER-BARBARA, ERIN G LMFT	6/4/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51124	N/A	N/A	N/A	N/A	N/A	516 N SEPULVEDA BLVD	105	MANHATTAN BEACH	CA	90266	6706	00	06000	33.88269686	-118.3959016	Los Angeles County
344187	Ordering, Referring, Prescribing	N/A	1720313406	0	0	FAKOOR, KHALED PHARMD	3/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60026	N/A	N/A	N/A	N/A	N/A	340 LAKEWOOD CENTER MALL	None	LAKEWOOD	CA	90712	2409	00	06000	33.85044	-118.136997	Los Angeles County
344221	Ordering, Referring, Prescribing	N/A	1720375264	0	0	FIGUEROA, ANGELICA CSW	5/16/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	72045	N/A	N/A	N/A	N/A	N/A	1450 E HOLT AVENUE	None	POMONA	CA	91767	5822	00	06000	34.06299829	-117.7215562	Los Angeles County
344230	Ordering, Referring, Prescribing	N/A	1720394646	0	0	FLORES AMBRIZ, ANA B	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103840	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	GOLETA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
344275	Ordering, Referring, Prescribing	N/A	1720440837	0	0	FREEMAN, HILLARY A MD	4/9/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151953	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
344315	Ordering, Referring, Prescribing	N/A	1720495047	0	0	FRANCIS, AMBER R LCSW	3/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW77908	N/A	N/A	N/A	N/A	N/A	2940 INLAND EMPIRE BLVD	None	ONTARIO	CA	91764	4898	00	06000	34.069788	-117.5884605	San Bernardino County
344367	Ordering, Referring, Prescribing	N/A	1720557713	0	0	FRITZ, CAREY LMFT	3/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112587	N/A	N/A	N/A	N/A	N/A	391 TAYLOR BLD	SUITE 100	PLEASANT HILL	CA	94523	2272	00	06000	37.96119614	-122.070409	Contra Costa County
344490	Ordering, Referring, Prescribing	N/A	1730139866	0	0	FOSTER, BRANDON PHD	1/19/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21449	N/A	N/A	N/A	N/A	N/A	401 E SCHOOL AVE	None	VISALIA	CA	93291	5032	00	06000	36.332757	-119.288682	Tulare County
344542	Ordering, Referring, Prescribing	N/A	1730252875	0	0	FERRARA-GUTHRIE, PATRIZIA G MD	2/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A51731	N/A	N/A	N/A	N/A	N/A	1720 E 120TH ST	None	LOS ANGELES	CA	90059	3052	00	06000	33.92455929	-118.2423557	Los Angeles County
344602	Ordering, Referring, Prescribing	N/A	1730418971	0	0	FOWLER, STEPHANIE LCSW	4/24/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW66144	N/A	N/A	N/A	N/A	N/A	2238 MONTE VISTA AVE	None	OROVILLE	CA	95966	6956	00	06000	39.474855	-121.5431325	Butte County
344603	Ordering, Referring, Prescribing	N/A	1730412529	0	0	FREEMAN, MARI PATRICIA PA-C	12/11/2017	Taxonomy not applicable	NA	n/a	000	Unknown	17251	N/A	N/A	N/A	N/A	N/A	147 N BRENT ST	None	VENTURA	CA	93003	2809	00	06000	34.2746295	-119.2573399	Ventura County
344616	Ordering, Referring, Prescribing	N/A	1730435520	0	0	FIELD, DENISE G LCSW	4/11/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114754	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON AVE	2	PORTERVILLE	CA	93257	1490	00	06000	36.08036906	-119.0410926	Tulare County
344630	Ordering, Referring, Prescribing	N/A	1730460726	0	0	FONG, FLORENCE P	8/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH46871	N/A	N/A	N/A	N/A	N/A	3434 HIGH ST	None	OAKLAND	CA	94619	1859	00	06000	37.78638461	-122.1965622	Alameda County
344688	Ordering, Referring, Prescribing	N/A	1730550112	0	0	FLORES, JUAN R NP	7/10/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	95053130	N/A	N/A	N/A	N/A	N/A	2020 J STREET	None	SACRAMENTO	CA	95811	3120	00	06000	38.576331	-121.4791155	Sacramento County
344713	Ordering, Referring, Prescribing	N/A	1730601444	0	0	FONG, JOYCE M OD	9/13/2017	Taxonomy not applicable	NA	n/a	000	Unknown	33768TLG	N/A	N/A	N/A	N/A	N/A	10118 BRADLEY DR	SUITE C	CUPERTINO	CA	95014	2155	00	06000	0	0	None
344723	Ordering, Referring, Prescribing	N/A	1730613019	0	0	FOBIA, IMAN M MD	10/30/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A161943	N/A	N/A	N/A	N/A	N/A	1971 UNIVERSITY AVE	None	RIVERSIDE	CA	92507	5263	00	06000	33.97570846	-117.354501	Riverside County
344850	Ordering, Referring, Prescribing	N/A	1730862467	0	0	FUENTES, ADRIANA LCSW	9/6/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125817	N/A	N/A	N/A	N/A	N/A	480 CHADBOURNE RD	None	FAIRFIELD	CA	94534	9639	00	06000	38.23538389	-122.0821428	Solano County
344887	Ordering, Referring, Prescribing	N/A	1740281112	0	0	FEATHERSTONE, ELISHA L	11/8/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A70571	N/A	N/A	N/A	N/A	N/A	7107 REMMET AVE	None	CANOGA PARK	CA	91303	2016	00	06000	34.199406	-118.6003185	Los Angeles County
345048	Ordering, Referring, Prescribing	N/A	1740621101	0	0	FIRDOOS, SAIMA MD	3/11/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A171938	N/A	N/A	N/A	N/A	N/A	16 RITTER ST	None	SAN RAFAEL	CA	94901	3323	00	06000	37.97151013	-122.5251246	Marin County
345049	Ordering, Referring, Prescribing	N/A	1740625516	0	0	FADNESS, JULIE NP	3/25/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23146	N/A	N/A	N/A	N/A	N/A	101 OLD MCCLOUD RD	None	MOUNT SHASTA	CA	96067	2796	00	06000	41.30516006	-122.3104613	Siskiyou County
345074	Ordering, Referring, Prescribing	N/A	1740670637	0	0	FINELLI MCLEAN, REGINA F CCC-SLP	7/28/2019	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	24122	N/A	N/A	N/A	N/A	N/A	INC 1901 N. RICE AVENUE	SUITE 170-180	OXNARD	CA	93030	7912	00	06000	34.21960355	-119.1421345	Ventura County
345084	Ordering, Referring, Prescribing	N/A	1740692029	0	0	FERNANDEZ, HECTOR M DDS	6/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	38520	N/A	N/A	N/A	N/A	N/A	5385 FRANKLIN BLVD	K	SACRAMENTO	CA	95820	4756	00	06000	38.526282	-121.471398	Sacramento County
345088	Ordering, Referring, Prescribing	N/A	1740694140	0	0	FINLEY, SARAH J LCSW	7/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94866	N/A	N/A	N/A	N/A	N/A	928 BROADWAY	None	SAN DIEGO	CA	92101	5514	00	06000	32.71575045	-117.1560915	San Diego County
345108	Ordering, Referring, Prescribing	N/A	1740713734	0	0	FERRETTI-GALLON, JENIKA MD	3/29/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A172106	N/A	N/A	N/A	N/A	N/A	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	1084	00	06000	38.602089	-121.3925895	Sacramento County
345120	Ordering, Referring, Prescribing	N/A	1740733112	0	0	FRENCH, SHANNON S LCSW	12/30/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112909	N/A	N/A	N/A	N/A	N/A	9837 FOLSOM BLVD	STE F	SACRAMENTO	CA	95827	1356	00	06000	38.575764	-121.330647	Sacramento County
345122	Ordering, Referring, Prescribing	N/A	1740735232	0	0	FERRUFINO, CARLOS NP	3/21/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021685	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
345189	Ordering, Referring, Prescribing	N/A	1740840396	0	0	FONG, VINCENT W LMFT	6/13/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125206	N/A	N/A	N/A	N/A	N/A	1801 VICENTE ST	None	SAN FRANCISCO	CA	94116	2923	00	06000	37.7388459	-122.4861544	San Francisco County
345278	Ordering, Referring, Prescribing	N/A	1750169058	0	0	FLORES, DIANE NP	1/28/2025	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033757	N/A	N/A	N/A	N/A	N/A	9925 INTERNATIONAL BLVD	5	OAKLAND	CA	94603	2558	00	06000	37.74332565	-122.1698542	Alameda County
345308	Ordering, Referring, Prescribing	N/A	1750412839	0	0	FASHEMPOUR, MELISSA L LCSW	1/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24460	N/A	N/A	N/A	N/A	N/A	12797 THIRD ST.	None	YUCAIPA	CA	92399	4544	00	06000	34.02161307	-117.0474689	San Bernardino County
345336	Ordering, Referring, Prescribing	N/A	1750439816	0	0	FUJIMOTO, ROUXANN T PHARMD	4/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	44521	N/A	N/A	N/A	N/A	N/A	21255 BURBANK BLVD	105	WOODLAND HILLS	CA	91367	6610	00	06000	34.17331011	-118.5940107	Los Angeles County
345362	Ordering, Referring, Prescribing	N/A	1750519484	0	0	FRITCHEL, KELLIE B LMFT	6/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86708	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS, SUITE	None	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
345386	Ordering, Referring, Prescribing	N/A	1750585923	0	0	FEINGOLD, SARAH D LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29159	N/A	N/A	N/A	N/A	N/A	260 COHASSET RD	120	CHICO	CA	95926	2282	00	06000	39.754035	-121.851117	Butte County
345426	Ordering, Referring, Prescribing	N/A	1750678652	0	0	FLOREK, DEREK J DPM	7/3/2017	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	5112	N/A	N/A	N/A	N/A	N/A	210 N CHESTER AVE	None	BAKERSFIELD	CA	93308	4048	00	06000	35.407179	-119.0208925	Kern County
345433	Ordering, Referring, Prescribing	N/A	1750697231	0	0	FERNANDEZ, ANGELICA M LCSW	6/14/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75172	N/A	N/A	N/A	N/A	N/A	1450 E HOLT AVENUE	None	POMONA	CA	91767	5822	00	06000	34.06299829	-117.7215562	Los Angeles County
345450	Ordering, Referring, Prescribing	N/A	1750705992	0	0	FELICIANO, MICHELLE LMFT	7/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116683	N/A	N/A	N/A	N/A	N/A	957 BLANCO CIRCLE	None	SALINAS	CA	93901	4451	00	06000	36.65603805	-121.6365549	Monterey County
345455	Ordering, Referring, Prescribing	N/A	1750721338	0	0	FORD, LAUREN PSYD	1/4/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28806	N/A	N/A	N/A	N/A	N/A	1301 PINE AVENUE	None	LONG BEACH	CA	90813	3124	00	06000	33.782913	-118.192417	Los Angeles County
345481	Ordering, Referring, Prescribing	N/A	1750751905	0	0	FORREST JAIMES, SARA MARIE CNM	4/22/2020	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236114	N/A	N/A	N/A	N/A	N/A	500B JEFFERSON BLVD	180	WEST SACRAMENTO	CA	95605	2394	00	06000	38.58811316	-121.5270471	Yolo County
345482	Ordering, Referring, Prescribing	N/A	1750757480	0	0	FLORES, COLLEEN S LMFT	10/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122792	N/A	N/A	N/A	N/A	N/A	2121 W TEMPLE ST	None	LOS ANGELES	CA	90026	4915	00	06000	34.07053729	-118.268744	Los Angeles County
345619	Ordering, Referring, Prescribing	N/A	1760010383	0	0	FETTERS, KIRK B MD	3/6/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184789	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	00	06000	33.83155851	-118.2920625	Los Angeles County
345665	Ordering, Referring, Prescribing	N/A	1760125280	0	0	FAKOLADE, WHITNEY Y PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH86008	N/A	N/A	N/A	N/A	N/A	6650 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	3533	00	06000	33.98445039	-118.0959494	Los Angeles County
345666	Ordering, Referring, Prescribing	N/A	1760121222	0	0	FOSTER, JESSICA A NP	5/27/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021091	N/A	N/A	N/A	N/A	N/A	7275 E SOUTHGATE DR	204	SACRAMENTO	CA	95823	2628	00	06000	38.493576	-121.436559	Sacramento County
345855	Ordering, Referring, Prescribing	N/A	1760770655	0	0	FUNIESTAS, LAUREN LMFT	11/19/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121004	N/A	N/A	N/A	N/A	N/A	2051 JOHN JONES ROAD	None	DAVIS	CA	95616	9701	00	06000	38.56371578	-121.7691963	Yolo County
345861	Ordering, Referring, Prescribing	N/A	1760790943	0	0	FOWER, HELEN LMFT	7/25/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86603	N/A	N/A	N/A	N/A	N/A	17418 CHATSWORTH ST	201-B	GRANADA HILLS	CA	91344	7624	00	06000	34.26482277	-118.5138395	Los Angeles County
345871	Ordering, Referring, Prescribing	N/A	1760818082	0	0	FRANKS, LISA LCSW	12/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99058	N/A	N/A	N/A	N/A	N/A	28765 SINGLE OAK DR.	STE. 100	TEMECULA	CA	92590	3621	00	06000	33.49888048	-117.1608165	Riverside County
345910	Ordering, Referring, Prescribing	N/A	1760859508	0	0	FORGENG, GEORGE NP	9/17/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003946	N/A	N/A	N/A	N/A	N/A	4930 NAPLES ST	None	SAN DIEGO	CA	92110	3820	00	06000	32.77013831	-117.2030986	San Diego County
345935	Ordering, Referring, Prescribing	N/A	1760898605	0	0	FIELDS, JAMES G LMFT	3/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102544	N/A	N/A	N/A	N/A	N/A	1111 RIVERSIDE AVE	SUITE 404	PASO ROBLES	CA	93446	2682	00	06000	35.62633682	-120.6869278	San Luis Obispo County
345939	Ordering, Referring, Prescribing	N/A	1760911523	0	0	FLIPPEN, RICARDO L	1/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	54476	N/A	N/A	N/A	N/A	N/A	12586 AVENUE 408	STE 408	OROSI	CA	93647	9454	00	06000	36.53030229	-119.2915122	Tulare County
345956	Ordering, Referring, Prescribing	N/A	1760930721	0	0	FLORES, NORIELA LCSW	3/29/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100847	N/A	N/A	N/A	N/A	N/A	2600 REDONDO AVE	3RD FLOOR	LONG BEACH	CA	90806	2325	00	06000	33.806097	-118.151378	Los Angeles County
346053	Ordering, Referring, Prescribing	N/A	1770083776	0	0	FRANZINI, DANIELLE DO	9/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19109	N/A	N/A	N/A	N/A	N/A	1141 PEAR TREE LN	100	NAPA	CA	94558	6484	00	06000	38.32125908	-122.2921523	Napa County
346081	Ordering, Referring, Prescribing	N/A	1770148108	0	0	FRANCIS, JENNIFER NP	8/4/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011065	N/A	N/A	N/A	N/A	N/A	1300 N DUTTON AVE	None	SAN CLEMENTE	CA	95401	7112	00	06000	38.449791	-122.733027	Sonoma County
346110	Ordering, Referring, Prescribing	N/A	1770244600	0	0	FOX, KAREN M LMFT	7/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT133599	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	95128	2704	00	06000	37.31712017	-121.9185451	Santa Clara County
346146	Ordering, Referring, Prescribing	N/A	1770600140	0	0	FOURAS, GEORGE A MD	11/24/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72374	N/A	N/A	N/A	N/A	N/A	2323A E PALMDALE BLVD	None	PALMDALE	CA	93550	4957	00	06000	34.58021347	-118.0857516	Los Angeles County
346183	Ordering, Referring, Prescribing	N/A	1770662850	0	0	FRANCIS, CYNTHIA A PA	9/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	13476	N/A	N/A	N/A	N/A	N/A	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	00	06000	34.016157	-118.3088825	Los Angeles County
346282	Ordering, Referring, Prescribing	N/A	1770880270	0	0	FOSTER, TIMOTHY L LCSW	12/30/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	64403	N/A	N/A	N/A	N/A	N/A	1735 MISSION ST	None	SAN FRANCISCO	CA	94103	2417	00	06000	37.76957692	-122.4199811	San Francisco County
346291	Ordering, Referring, Prescribing	N/A	1770906703	0	0	FERRANTE-LACBAIN, LINDSEY P LMFT	4/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110098	N/A	N/A	N/A	N/A	N/A	6386 ALVARADO CT	310	SAN DIEGO	CA	92120	4905	00	06000	32.77666838	-117.0614255	San Diego County
346333	Ordering, Referring, Prescribing	N/A	1770963977	0	0	FREDRICKSON, LINDSAY PA-C	1/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95019785	N/A	N/A	N/A	N/A	N/A	844 OLD TUNNEL ROAD	None	GRASS VALLEY	CA	95945	8524	00	06000	39.23512508	-121.0306878	Nevada County
346349	Ordering, Referring, Prescribing	N/A	1770985558	0	0	FOUCHE, AIMEE A LMFT	2/13/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121673	N/A	N/A	N/A	N/A	N/A	2225 CHALLENGER WAY	None	SANTA ROSA	CA	95407	5418	00	06000	38.425482	-122.75262	Sonoma County
346467	Ordering, Referring, Prescribing	N/A	1780162057	0	0	FRANCE, KYLIE E NP	2/2/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009600	N/A	N/A	N/A	N/A	N/A	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
346494	Ordering, Referring, Prescribing	N/A	1780246256	0	0	FISHER, ERIKA N PA-C	9/20/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57240	N/A	N/A	N/A	N/A	N/A	4305 UNIVERSITY AVE	350	SAN DIEGO	CA	92105	1645	00	06000	32.74957853	-117.101439	San Diego County
346495	Ordering, Referring, Prescribing	N/A	1780245720	0	0	FONG, ARIANA M DMD	8/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	103822	N/A	N/A	N/A	N/A	N/A	1750 WRIGHT ST	None	SACRAMENTO	CA	95825	4041	00	06000	38.597742	-121.4057385	Sacramento County
346500	Ordering, Referring, Prescribing	N/A	1780255000	0	0	FERNANDEZ, SAMANTHA NP	6/8/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017510	N/A	N/A	N/A	N/A	N/A	1150 MAIN ST	3	WATSONVILLE	CA	95076	3747	00	06000	36.9163164	-121.7698107	Santa Cruz County
346528	Ordering, Referring, Prescribing	N/A	1780331439	0	0	FRUZZA, DIANA L NP	5/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95020841	N/A	N/A	N/A	N/A	N/A	6640 ALTON PKWY	None	IRVINE	CA	92604	3303	00	06000	33.65911992	-117.7737909	Orange County
346533	Ordering, Referring, Prescribing	N/A	1780343905	0	0	FISHER, CATHERINE LMFT	11/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123478	N/A	N/A	N/A	N/A	N/A	23201 MILL CREEK DR	220	LAGUNA HILLS	CA	92653	7905	00	06000	33.62516256	-117.7353393	Orange County
346583	Ordering, Referring, Prescribing	N/A	1780701151	0	0	FONTWIT, KATHRYN J	9/3/2018	Taxonomy not applicable	NA	n/a	000	Unknown	13637	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
346628	Ordering, Referring, Prescribing	N/A	1780795021	0	0	FAGILDE, CLAUDIA NP	7/8/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	5510	N/A	N/A	N/A	N/A	N/A	500 W HOSPITAL RD	SUITE # A, B AND C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
346746	Ordering, Referring, Prescribing	N/A	1790019578	0	0	FEENEY, LAURA L	11/17/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	63016	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	00	06000	37.75548534	-122.4065362	San Francisco County
346767	Ordering, Referring, Prescribing	N/A	1790063766	0	0	FERNANDEZ, KRISTINE C LMFT	1/31/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130901	N/A	N/A	N/A	N/A	N/A	10776 FREMONT STREET	None	YUCAIPA	CA	92399	9999	00	06000	34.058052	-117.0280305	San Bernardino County
346844	Ordering, Referring, Prescribing	N/A	1790160539	0	0	FRANCO, AIMEE M NP	9/9/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	662934	N/A	N/A	N/A	N/A	N/A	277 E FRONT ST	None	BUTTONWILLOW	CA	93206	0917	00	06000	35.39969257	-119.4650218	Kern County
346851	Ordering, Referring, Prescribing	N/A	1790167435	0	0	FU, JOSHUA L PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71652	N/A	N/A	N/A	N/A	N/A	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	00	06000	37.706364	-122.165163	Alameda County
346891	Ordering, Referring, Prescribing	N/A	1790227874	0	0	FIGUEROA, ERICA L LCSW	12/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99103	N/A	N/A	N/A	N/A	N/A	5000 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5861	00	06000	34.0981066	-118.2986382	Los Angeles County
346904	Ordering, Referring, Prescribing	N/A	1790244135	0	0	FAUST, SHANNAN A LPCC	7/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC11912	N/A	N/A	N/A	N/A	N/A	905 E 8TH ST	None	LOS ANGELES	CA	90021	1848	00	06000	34.03639545	-118.2465917	Los Angeles County
346909	Ordering, Referring, Prescribing	N/A	1790255933	0	0	FREY, KELIE M RN	2/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	515653	N/A	N/A	N/A	N/A	N/A	3211 PICO AVE	None	BAKERSFIELD	CA	93306	3531	00	06000	35.39038754	-118.9509851	Kern County
346961	Ordering, Referring, Prescribing	N/A	1790339067	0	0	FREIDENBERG, JULIA DMD	6/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	104158	N/A	N/A	N/A	N/A	N/A	8405 BEVERLY BLVD.	None	LOS ANGELES	CA	90048	3401	00	06000	34.07607952	-118.373418	Los Angeles County
346983	Ordering, Referring, Prescribing	N/A	1790396463	0	0	FRENCH, QUYEN D DMD	3/30/2022	Taxonomy not applicable	NA	n/a	000	Unknown	DDS105256	N/A	N/A	N/A	N/A	N/A	266 N. JACKSON AVE.	STE. 1	SAN JOSE	CA	95116	1606	00	06000	37.36445516	-121.8492308	Santa Clara County
347066	Ordering, Referring, Prescribing	N/A	1790829349	0	0	FRICKER, CAROLINE B LCSW	5/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27727	N/A	N/A	N/A	N/A	N/A	649 E ALBERTONI ST	SUITE 100	CARSON	CA	90746	1538	00	06000	33.87194399	-118.2643054	Los Angeles County
347097	Ordering, Referring, Prescribing	N/A	1790882728	0	0	FITZGERALD, PATRICK MD	3/17/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G80210	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
347134	Ordering, Referring, Prescribing	N/A	1790973022	0	0	FONROSE, LA'QUESHA M LCSW	5/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	64044	N/A	N/A	N/A	N/A	N/A	1160 BRICKYARD COVE ROAD	11	RICHMOND	CA	94801	2249	00	06000	37.91060122	-122.3777913	Contra Costa County
347139	Ordering, Referring, Prescribing	N/A	1790981132	0	0	FIGURSKI-EICHENSEHER, ANN C DO	5/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21183	N/A	N/A	N/A	N/A	N/A	16387 FIRST ST	None	GUERNEVILLE	CA	95446	0226	00	06000	38.50111158	-122.9999868	Sonoma County
347146	Ordering, Referring, Prescribing	N/A	1801004403	0	0	FRIAS KLETECKA, MARIA DEL CARMEN MD	5/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C154326	N/A	N/A	N/A	N/A	N/A	1 POST	STE 100	IRVINE	CA	92618	5218	00	06000	33.67803404	-117.7681061	Orange County
347181	Ordering, Referring, Prescribing	N/A	1801083605	0	0	FLORES HERNANDEZ, ALBERTO LCSW	3/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28152	N/A	N/A	N/A	N/A	N/A	1521 UNIVERSITY AVE	None	BERKELEY	CA	94703	1422	00	06000	37.87060038	-122.2812128	Alameda County
347215	Ordering, Referring, Prescribing	N/A	1801144563	0	0	FOREMAN, PATRICK C LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102254	N/A	N/A	N/A	N/A	N/A	1885 LUNDY AVE	STE. 223	SAN JOSE	CA	95131	1887	00	06000	37.39329538	-121.8907367	Santa Clara County
347223	Ordering, Referring, Prescribing	N/A	1801156567	0	0	FOWLER, BENJAMIN LCSW	3/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76696	N/A	N/A	N/A	N/A	N/A	4616 ROOSEVELT AVE	None	SACRAMENTO	CA	95820	4520	00	06000	38.533455	-121.4522955	Sacramento County
347344	Ordering, Referring, Prescribing	N/A	1801323084	0	0	FLORES, AUSTIN MD	8/5/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174356	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
347392	Ordering, Referring, Prescribing	N/A	1801415070	0	0	FORTMAN, JAMIE A MD	5/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178383	N/A	N/A	N/A	N/A	N/A	3800 W CHAPMAN AVE	500	ORANGE	CA	92868	1638	00	06000	33.78885849	-117.8950802	Orange County
347441	Ordering, Referring, Prescribing	N/A	1801518345	0	0	FORD, JENNIFER	12/16/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020710	N/A	N/A	N/A	N/A	N/A	1441 N TRACY BLVD	None	TRACY	CA	95376	0000	00	06000	37.744731	-121.4350375	San Joaquin County
347488	Ordering, Referring, Prescribing	N/A	1801902077	0	0	FOX, RODNEY NP	8/9/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95076372	N/A	N/A	N/A	N/A	N/A	627 N LARCHMONT BLVD	None	LOS ANGELES	CA	90004	1307	00	06000	34.08253418	-118.3236991	Los Angeles County
347549	Ordering, Referring, Prescribing	N/A	1811027477	0	0	FLORES, CLAUDIA LCSW	3/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80188	N/A	N/A	N/A	N/A	N/A	439 W 97TH ST	None	LOS ANGELES	CA	90003	3968	00	06000	33.94831439	-118.282325	Los Angeles County
347638	Ordering, Referring, Prescribing	N/A	1811227499	0	0	FRANKLIN, RALPH L LCSW	7/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80695	N/A	N/A	N/A	N/A	N/A	8144 ESCONDIDO CANYON RD	None	ACTON	CA	93510	1534	00	06000	34.490799	-118.2761685	Los Angeles County
347674	Ordering, Referring, Prescribing	N/A	1811279615	0	0	FATIRIAN, BABAK PHARMD	7/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64500	N/A	N/A	N/A	N/A	N/A	17479 VENTURA BLVD	None	ENCINO	CA	91316	3828	00	06000	34.16138071	-118.5132766	Los Angeles County
347739	Ordering, Referring, Prescribing	N/A	1811389943	0	0	FULLER, CARL W LCSW	1/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	97972	N/A	N/A	N/A	N/A	N/A	1420 ROCKY RIDGE DR	120	ROSEVILLE	CA	95661	2830	00	06000	38.75342679	-121.246502	Placer County
347767	Ordering, Referring, Prescribing	N/A	1811418197	0	0	FAROOQ, HINA MD	11/6/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A175161	N/A	N/A	N/A	N/A	N/A	500 W HOSPITAL RD	SUITE #C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
347906	Ordering, Referring, Prescribing	N/A	1811770928	0	0	FELIX, VALERIA PA-C	12/13/2023	Taxonomy not applicable	NA	n/a	000	Unknown	63816	N/A	N/A	N/A	N/A	N/A	430 S BLOSSER RD	None	SANTA MARIA	CA	93458	4908	00	06000	34.94869196	-120.4537258	Santa Barbara County
347967	Ordering, Referring, Prescribing	N/A	1821121435	0	0	FOWLER, LILY K LCSW	8/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS23195	N/A	N/A	N/A	N/A	N/A	1720 FRANKLIN AVE	None	LOS ANGELES	CA	90046	3002	00	06000	34.10343178	-118.3493413	Los Angeles County
347992	Ordering, Referring, Prescribing	N/A	1821189481	0	0	FRYER, LYNNE LCSW	12/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW13933	N/A	N/A	N/A	N/A	N/A	650 IMPERIAL WAY	None	NAPA	CA	94559	1344	00	06000	38.30691237	-122.283533	Napa County
348005	Ordering, Referring, Prescribing	N/A	1821226804	0	0	FISSEL, APRIL	3/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52165	N/A	N/A	N/A	N/A	N/A	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2033	00	06000	34.02980528	-118.4786605	Los Angeles County
348047	Ordering, Referring, Prescribing	N/A	1821310103	0	0	FARR, RITA PA-C	2/21/2019	Taxonomy not applicable	NA	n/a	000	Unknown	20864	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVENUE	100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
348066	Ordering, Referring, Prescribing	N/A	1821347147	0	0	FRANDSEN, JILL A LMFT	10/31/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91194	N/A	N/A	N/A	N/A	N/A	735 STATE ST	527	SANTA BARBARA	CA	93101	3329	00	06000	34.41942344	-119.6991527	Santa Barbara County
348224	Ordering, Referring, Prescribing	N/A	1821594938	0	0	FERNANDEZ, NOEMI LCSW	10/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97903	N/A	N/A	N/A	N/A	N/A	2600 REDONDO AVE	3RD FLOOR	LONG BEACH	CA	90806	2325	00	06000	33.806097	-118.151378	Los Angeles County
348270	Ordering, Referring, Prescribing	N/A	1821688151	0	0	FERRAROTTI, AMY F PHARMD	8/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83415	N/A	N/A	N/A	N/A	N/A	8400 ELK GROVE FLORIN RD	None	ELK GROVE	CA	95624	9450	00	06000	38.452203	-121.3727805	Sacramento County
348320	Ordering, Referring, Prescribing	N/A	1831171388	0	0	FULTZ, TRAVIS D PSYD	7/21/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	19419	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
348357	Ordering, Referring, Prescribing	N/A	1831260132	0	0	FENG, HELEN PHARMD	4/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57109	N/A	N/A	N/A	N/A	N/A	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	00	06000	33.904782	-117.469323	Riverside County
348370	Ordering, Referring, Prescribing	N/A	1831288315	0	0	FINO, DOREEN A LMFT	3/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42034	N/A	N/A	N/A	N/A	N/A	301 THE CITY DR S	None	ORANGE	CA	92868	3205	00	06000	33.78547994	-117.8888036	Orange County
348404	Ordering, Referring, Prescribing	N/A	1831378322	0	0	FIELDS-BLAKE, KERON R MD	5/20/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A52172	N/A	N/A	N/A	N/A	N/A	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	00	06000	34.016157	-118.3088825	Los Angeles County
348414	Ordering, Referring, Prescribing	N/A	1831402742	0	0	FLORES, KRISTOFFER J LMFT	1/13/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105357	N/A	N/A	N/A	N/A	N/A	1400 MONTECITO AVE	None	MOUNTAIN VIEW	CA	94043	4590	00	06000	37.40279015	-122.0841893	Santa Clara County
348416	Ordering, Referring, Prescribing	N/A	1831403526	0	0	FUJIKAWA, REYNOLD N PSYD	5/6/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26782	N/A	N/A	N/A	N/A	N/A	555 SCHOOL STREET	None	PITTSBURG	CA	94565	3937	00	06000	38.01980655	-121.8792708	Contra Costa County
348465	Ordering, Referring, Prescribing	N/A	1831501238	0	0	FARHAT, LINDA LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT81219	N/A	N/A	N/A	N/A	N/A	501 MARIN ST STE 100	None	THOUSAND OAKS	CA	91360	4265	00	06000	34.18371146	-118.8824904	Ventura County
348482	Ordering, Referring, Prescribing	N/A	1831527506	0	0	FLORES, ANGELINA PA-C	11/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA22978	N/A	N/A	N/A	N/A	N/A	6001 E WASHINGTON BLVD	STE 200	COMMERCE	CA	90040	2455	00	06000	33.99703164	-118.1499826	Los Angeles County
348505	Ordering, Referring, Prescribing	N/A	1831561448	0	0	FOFANAH, HAWANATU NP	12/28/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	557472	N/A	N/A	N/A	N/A	N/A	570 S MT VERNON AVE	STE G	SAN BERNARDINO	CA	92410	2760	00	06000	34.090776	-117.3138565	San Bernardino County
348553	Ordering, Referring, Prescribing	N/A	1831639186	0	0	FRANCO, FEDERICO R PHARMD	2/5/2019	Taxonomy not applicable	NA	n/a	000	Unknown	80236	N/A	N/A	N/A	N/A	N/A	3051 COUNTRYSIDE DR	None	TURLOCK	CA	95380	8400	00	06000	37.52105358	-120.8814178	Stanislaus County
348560	Ordering, Referring, Prescribing	N/A	1831645068	0	0	FLORES, LIANNA R LCSW	1/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99647	N/A	N/A	N/A	N/A	N/A	1900 THE ALAMEDA	4TH FLOOR	SAN JOSE	CA	95126	1404	00	06000	37.34098783	-121.923253	Santa Clara County
348574	Ordering, Referring, Prescribing	N/A	1831659887	0	0	FLORES, JEREMY A MD	4/29/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178229	N/A	N/A	N/A	N/A	N/A	345 S SAN PEDRO ST	None	LOS ANGELES	CA	90013	1633	00	06000	34.04602976	-118.2429461	Los Angeles County
348588	Ordering, Referring, Prescribing	N/A	1831672328	0	0	FLORES, AIKO MELANIE B PHARMD	9/7/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78860	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD. M	None	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
348605	Ordering, Referring, Prescribing	N/A	1831696160	0	0	FONG GOMEZ, STEPHANIE Y MD	8/20/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163399	N/A	N/A	N/A	N/A	N/A	3100 KERNER BLVD	None	SAN RAFAEL	CA	94901	5439	00	06000	37.9572941	-122.4997778	Marin County
348798	Ordering, Referring, Prescribing	N/A	1841408291	0	0	FELISKY, CATHERINE A MD	6/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G65729	N/A	N/A	N/A	N/A	N/A	3730 HOPYARD RD	SUITE 103	PLEASANTON	CA	94588	8562	00	06000	37.68061724	-121.9038915	Alameda County
348810	Ordering, Referring, Prescribing	N/A	1841444064	0	0	FLORES, SHERRY C LMFT	11/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53973	N/A	N/A	N/A	N/A	N/A	3741 STOCKER ST	100	LOS ANGELES	CA	90008	5109	00	06000	34.00623019	-118.3384304	Los Angeles County
348813	Ordering, Referring, Prescribing	N/A	1841449154	0	0	FLOURNOY, STEPHANIE E MSW LCSW	10/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW64657	N/A	N/A	N/A	N/A	N/A	4001 MISSION OAKS BLVD	SUITE I	CAMARILLO	CA	93012	5121	00	06000	34.21641579	-119.0166203	Ventura County
348822	Ordering, Referring, Prescribing	N/A	1841458080	0	0	FUENTES, AMADEE J LMFT	12/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86058	N/A	N/A	N/A	N/A	N/A	1234 EMPIRE ST	1500	FAIRFIELD	CA	94533	5711	00	06000	38.25037548	-122.049045	Solano County
348858	Ordering, Referring, Prescribing	N/A	1841531258	0	0	FIGUEROA, JULIE D LMFT	6/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103029	N/A	N/A	N/A	N/A	N/A	831 E. ARROW HWY.	None	POMONA	CA	91767	9535	00	06000	34.09030767	-117.7353578	Los Angeles County
348892	Ordering, Referring, Prescribing	N/A	1841571429	0	0	FROST-MORGAN, SARAH E PSYD	9/29/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32879	N/A	N/A	N/A	N/A	N/A	4600 PANAMA LN	102B	BAKERSFIELD	CA	93313	3509	00	06000	35.29596129	-119.0543102	Kern County
348931	Ordering, Referring, Prescribing	N/A	1841627759	0	0	FARSHLER, ANTHONY J	8/12/2020	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	32601	N/A	N/A	N/A	N/A	N/A	41840 ENTERPRISE CIR N	None	TEMECULA	CA	92590	5654	00	06000	33.51730799	-117.1697125	Riverside County
348945	Ordering, Referring, Prescribing	N/A	1841661071	0	0	FUNG, YENMEY PHARMD	2/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61377	N/A	N/A	N/A	N/A	N/A	2235 MERCURY WAY	240	SANTA ROSA	CA	95407	5473	00	06000	38.422404	-122.751261	Sonoma County
348948	Ordering, Referring, Prescribing	N/A	1841663416	0	0	FOWLER, NICOLE	6/21/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81129	N/A	N/A	N/A	N/A	N/A	2323 E PALMDALE BLVD	None	PALMDALE	CA	93550	4957	00	06000	34.58021347	-118.0857516	Los Angeles County
349009	Ordering, Referring, Prescribing	N/A	1841747888	0	0	FRANCK, MADI LCSW	2/17/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106956	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	201	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
349029	Ordering, Referring, Prescribing	N/A	1841772456	0	0	FREEDMAN, JULIE PT	10/1/2023	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT295304	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK ROAD	None	MAMMOTH LAKES	CA	93546	2073	00	06000	37.64575895	-118.9638914	Mono County
349082	Ordering, Referring, Prescribing	N/A	1841884343	0	0	FRANKMAN, NINA E LMFT	4/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT23124	N/A	N/A	N/A	N/A	N/A	2130 E. 4TH STREET	200	SANTA ANA	CA	92705	3818	00	06000	33.74808392	-117.836143	Orange County
349083	Ordering, Referring, Prescribing	N/A	1841897113	0	0	FOWLER, SARAH	11/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138632	N/A	N/A	N/A	N/A	N/A	45 SAN CLEMENTE DRIVE	A200D	CORTE MADERA	CA	94925	1244	00	06000	37.92429848	-122.5108365	Marin County
349148	Ordering, Referring, Prescribing	N/A	1851170096	0	0	FAHIMIPOUR, FARANAK DDS	9/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	109475	N/A	N/A	N/A	N/A	N/A	351 FELICE DRIVE	None	HOLLISTER	CA	95023	3361	00	06000	36.85325269	-121.4170104	San Benito County
349196	Ordering, Referring, Prescribing	N/A	1851437735	0	0	FLORES, COURTNEY L LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29811	N/A	N/A	N/A	N/A	N/A	1414 N. CALIFORNIA ST	None	STOCKTON	CA	95202	1515	00	06000	37.96761084	-121.2883234	San Joaquin County
349214	Ordering, Referring, Prescribing	N/A	1851469993	0	0	FISHER, DAWN C LCSW	2/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18471	N/A	N/A	N/A	N/A	N/A	555 N PERRIS BLVD	BLDG A	PERRIS	CA	92571	2811	00	06000	33.79131	-117.226053	Riverside County
349305	Ordering, Referring, Prescribing	N/A	1851657852	0	0	FUENTES, LORRAINE LCSW	1/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93911	N/A	N/A	N/A	N/A	N/A	1339 20TH ST	None	SANTA MONICA	CA	90404	2033	00	06000	34.02917949	-118.4805651	Los Angeles County
349341	Ordering, Referring, Prescribing	N/A	1851708986	0	0	FIGUEROA ARAGON, SERGIO MD	8/21/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A142840	N/A	N/A	N/A	N/A	N/A	2417 W WHITTIER BLVD	None	MONTEBELLO	CA	90640	3040	00	06000	34.01413253	-118.1278906	Los Angeles County
349346	Ordering, Referring, Prescribing	N/A	1851718530	0	0	FABIAN, LORETA NP	1/15/2019	Taxonomy not applicable	NA	n/a	000	Unknown	23842	N/A	N/A	N/A	N/A	N/A	15206 PARTHENIA ST	None	NORTH HILLS	CA	91343	5305	00	06000	34.22817313	-118.4636497	Los Angeles County
349347	Ordering, Referring, Prescribing	N/A	1851716898	0	0	FUIMAONO, RYAN LCSW	2/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71170	N/A	N/A	N/A	N/A	N/A	2712 MISSION ST	None	SAN FRANCISCO	CA	94110	1002	00	06000	37.75336705	-122.4185922	San Francisco County
349464	Ordering, Referring, Prescribing	N/A	1851884118	0	0	FRYE, JACQUELINE LMFT	2/6/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122092	N/A	N/A	N/A	N/A	N/A	401 E. IMPERIAL HWY	None	FULLERTON	CA	92835	0000	00	06000	33.9175203	-117.926132	Orange County
349469	Ordering, Referring, Prescribing	N/A	1851904833	0	0	FIELDS, JAMES F NP	4/17/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015169	N/A	N/A	N/A	N/A	N/A	706 PEACH ST	None	CORNING	CA	96021	3355	00	06000	39.928689	-122.174397	Tehama County
349473	Ordering, Referring, Prescribing	N/A	1851910657	0	0	FAM, MARIAM MD	4/25/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191652	N/A	N/A	N/A	N/A	N/A	12021 WILMINGTON AVE	None	LOS ANGELES	CA	90059	3019	00	06000	33.922863	-118.2431655	Los Angeles County
349527	Ordering, Referring, Prescribing	N/A	1861031296	0	0	FRANCO, ERIN LMFT	8/21/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	149013	N/A	N/A	N/A	N/A	N/A	25910 ACERO	160	MISSION VIEJO	CA	92691	2790	00	06000	33.61712389	-117.6780482	Orange County
349547	Ordering, Referring, Prescribing	N/A	1861073033	0	0	FLEXEN, BRIANNE J NP	9/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025938	N/A	N/A	N/A	N/A	N/A	31200 VIA COLINAS STE 20	STE 202	WESTLAKE VILLAGE	CA	91362	3955	00	06000	34.15405139	-118.8058232	Los Angeles County
349552	Ordering, Referring, Prescribing	N/A	1861092355	0	0	FERRER, VILMA NP	7/15/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014932	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM AVE	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
349581	Ordering, Referring, Prescribing	N/A	1861181703	0	0	FALLEN, SETH PA-C	2/14/2025	Taxonomy not applicable	NA	n/a	000	Unknown	PA65971	N/A	N/A	N/A	N/A	N/A	191 E POLK ST	None	COALINGA	CA	93210	2311	00	06000	36.1365831	-120.3601669	Fresno County
349592	Ordering, Referring, Prescribing	N/A	1861423964	0	0	FIDLER, DARLENE M OD	4/21/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	11352	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
349709	Ordering, Referring, Prescribing	N/A	1861720880	0	0	FEHLMAN, MICHELLE C LMFT	3/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49546	N/A	N/A	N/A	N/A	N/A	17800 HWY 18	None	APPLE VALLEY	CA	92307	0000	00	06000	34.54007429	-117.2744761	San Bernardino County
349749	Ordering, Referring, Prescribing	N/A	1861787574	0	0	FRASIER, SHARON	4/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT91255	N/A	N/A	N/A	N/A	N/A	1890 ALCATRAZ AVE	None	BERKELEY	CA	94703	2715	00	06000	37.84893892	-122.2696251	Alameda County
349782	Ordering, Referring, Prescribing	N/A	1861826398	0	0	FERGUSON, WENDY J LMFT	2/28/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131456	N/A	N/A	N/A	N/A	N/A	5150 PACIFIC COAST HIGHW	None	LONG BEACH	CA	90804	3394	00	06000	33.7831762	-118.1333125	Los Angeles County
349806	Ordering, Referring, Prescribing	N/A	1861876724	0	0	FU, CHRISTINE F	1/5/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D64151	N/A	N/A	N/A	N/A	N/A	2801 SILVER ST	None	ANDERSON	CA	96007	4239	00	06000	40.44713082	-122.2996783	Shasta County
349808	Ordering, Referring, Prescribing	N/A	1861880726	0	0	FERNANDES, SAMANTHA M MD	7/15/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139816	N/A	N/A	N/A	N/A	N/A	2525 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78246242	-122.4448129	San Francisco County
349816	Ordering, Referring, Prescribing	N/A	1861895443	0	0	FRANKLIN, VANESSA A LMFT	12/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90857	N/A	N/A	N/A	N/A	N/A	205 PASADENA AVE.	None	SOUTH PASADENA	CA	91030	2919	00	06000	34.11219143	-118.1709685	Los Angeles County
349818	Ordering, Referring, Prescribing	N/A	1861891178	0	0	FRIEDMAN, MELISSA LMFT	5/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT90858	N/A	N/A	N/A	N/A	N/A	755 SOUTH VAN NESS	None	SAN FRANCISCO	CA	94110	1908	00	06000	37.76103073	-122.4170932	San Francisco County
349831	Ordering, Referring, Prescribing	N/A	1861923112	0	0	FERGUSON, AMANDA J	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159250	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2307	00	06000	38.555181	-121.4566785	Sacramento County
349842	Ordering, Referring, Prescribing	N/A	1861933103	0	0	FENG, WENQI MD	2/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158053	N/A	N/A	N/A	N/A	N/A	14600 SHERMAN WAY	STE 100D	VAN NUYS	CA	91405	5869	00	06000	34.20025916	-118.4500763	Los Angeles County
349849	Ordering, Referring, Prescribing	N/A	1861946568	0	0	FLETCHER, AMANDA R LCSW	11/3/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	111822	N/A	N/A	N/A	N/A	N/A	5125 SKYWAY	None	PARADISE	CA	95969	5624	00	06000	39.74598961	-121.640736	Butte County
349853	Ordering, Referring, Prescribing	N/A	1861948614	0	0	FLAGG, CASSANDRA	11/26/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125950	N/A	N/A	N/A	N/A	N/A	423 F STREET	SUITE 203	DAVIS	CA	95616	4136	00	06000	38.54672626	-121.7409321	Yolo County
349868	Ordering, Referring, Prescribing	N/A	1861964553	0	0	FULLER, KELLY A LMFT	6/21/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130675	N/A	N/A	N/A	N/A	N/A	850 E FOOTHILL BLVD	None	RIALTO	CA	92376	5230	00	06000	34.10679449	-117.3542535	San Bernardino County
349897	Ordering, Referring, Prescribing	N/A	1871019174	0	0	FUGITA, STEPHANIE S LMFT	11/5/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39282	N/A	N/A	N/A	N/A	N/A	1889 LAWRENCE RD	None	SANTA CLARA	CA	95952	0397	00	06000	37.35761102	-121.9947195	Santa Clara County
349903	Ordering, Referring, Prescribing	N/A	1871026138	0	0	FIRULESCU, LIDIA MD	7/9/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173638	N/A	N/A	N/A	N/A	N/A	3117 WILSON RD	None	BAKERSFIELD	CA	93304	5319	00	06000	35.33217251	-119.0385045	Kern County
349915	Ordering, Referring, Prescribing	N/A	1871036392	0	0	FLORES, RUTH R LMFT	12/22/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112963	N/A	N/A	N/A	N/A	N/A	1301 PINE AVE.	None	LONG BEACH	CA	90813	3124	00	06000	33.782913	-118.192417	Los Angeles County
349924	Ordering, Referring, Prescribing	N/A	1871048868	0	0	FAWSON, BRANDON S PHARMD	6/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	74779	N/A	N/A	N/A	N/A	N/A	57590 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	2934	00	06000	34.12539561	-116.4079258	San Bernardino County
349988	Ordering, Referring, Prescribing	N/A	1871149922	0	0	FONG, CHIN L LCSW	2/23/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107049	N/A	N/A	N/A	N/A	N/A	2827 CONCORD BLVD	None	CONCORD	CA	94519	2608	00	06000	37.97746145	-122.0253615	Contra Costa County
350071	Ordering, Referring, Prescribing	N/A	1871599852	0	0	FINNIGAN, DAVID MD	2/3/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G89076	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
350087	Ordering, Referring, Prescribing	N/A	1871625426	0	0	FERNANDEZ, TANYA D	2/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24384	N/A	N/A	N/A	N/A	N/A	14700 MANZANITA PARK RD	None	BEAUMONT	CA	92223	3026	00	06000	33.909579	-116.971155	Riverside County
350105	Ordering, Referring, Prescribing	N/A	1871640110	0	0	FATTORE, TANIA M LMFT	12/8/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100419	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PARK	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
350141	Ordering, Referring, Prescribing	N/A	1871741033	0	0	FABER, ELIZABETH J NP	9/5/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18028	N/A	N/A	N/A	N/A	N/A	356 7TH ST	None	SAN FRANCISCO	CA	94103	4030	00	06000	37.77603792	-122.4069716	San Francisco County
350251	Ordering, Referring, Prescribing	N/A	1871915660	0	0	FENTON, ALEXA LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97289	N/A	N/A	N/A	N/A	N/A	3230 KERNER BLVD	None	SAN RAFAEL	CA	94901	1000	00	06000	37.96037915	-122.5019455	Marin County
350275	Ordering, Referring, Prescribing	N/A	1871937946	0	0	FOROUHAR, SARA MD	7/7/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145453	N/A	N/A	N/A	N/A	N/A	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43816059	-120.6279677	Lassen County
350288	Ordering, Referring, Prescribing	N/A	1871968537	0	0	FUKUMOTO, ANITA PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62040	N/A	N/A	N/A	N/A	N/A	3701 BROADWAY	None	OAKLAND	CA	94611	5613	00	06000	37.82533768	-122.258094	Alameda County
350289	Ordering, Referring, Prescribing	N/A	1871968297	0	0	FINLAY, MICHAEL PHD	6/30/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY31377	N/A	N/A	N/A	N/A	N/A	17053 E. FOOTHILL BLVD.	BLDG. B	FONTANA	CA	92335	3574	00	06000	34.10655148	-117.432828	San Bernardino County
350303	Ordering, Referring, Prescribing	N/A	1871981472	0	0	FLINT, CLARA I LCSW	4/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82972	N/A	N/A	N/A	N/A	N/A	3133 N MILLBROOK AVE	None	FRESNO	CA	93703	1425	00	06000	36.77841	-119.7635455	Fresno County
350307	Ordering, Referring, Prescribing	N/A	1871987784	0	0	FITZPATRICK, JESSE K MD	7/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146260	N/A	N/A	N/A	N/A	N/A	2425 GEARY BLVD	M160	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
350435	Ordering, Referring, Prescribing	N/A	1881176790	0	0	FANG, JOHNNY LMFT	2/11/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131105	N/A	N/A	N/A	N/A	N/A	11175 SAN PABLO AVE	None	EL CERRITO	CA	94530	2157	00	06000	37.91926262	-122.31424	Contra Costa County
350436	Ordering, Referring, Prescribing	N/A	1881176337	0	0	FARRELLY, CHRISTOPHER T	9/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	1010	N/A	N/A	N/A	N/A	N/A	4110 SORRENTO VALLEY BLV	None	SAN DIEGO	CA	92121	1429	00	06000	32.90375674	-117.2170258	San Diego County
350482	Ordering, Referring, Prescribing	N/A	1881250413	0	0	FLORES HARTFORD, MARIBEL LMFT	2/17/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT131240	N/A	N/A	N/A	N/A	N/A	110 SOUTH MONTCLAIR STRE	205	BAKERSFIELD	CA	93309	3111	00	06000	35.35373011	-119.0546591	Kern County
350497	Ordering, Referring, Prescribing	N/A	1881280774	0	0	FRANCISCO, SARAH V CNP	7/10/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014892	N/A	N/A	N/A	N/A	N/A	4211 AVALON BLVD	STE B	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
350508	Ordering, Referring, Prescribing	N/A	1881334217	0	0	FLORES, ELISHA NP	10/8/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017753	N/A	N/A	N/A	N/A	N/A	6030 ARROW PL.	None	RIVERSIDE	CA	92509	5154	00	06000	33.97795222	-117.4639005	Riverside County
350662	Ordering, Referring, Prescribing	N/A	1881946028	0	0	FIALK, JAMES L	11/7/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	626	N/A	N/A	N/A	N/A	N/A	130 PETALUMA AVE	2E	SEBASTOPOL	CA	95472	4234	00	06000	38.40200716	-122.8229065	Sonoma County
350705	Ordering, Referring, Prescribing	N/A	1891000188	0	0	FLORES, JOAN	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0738088	N/A	N/A	N/A	N/A	N/A	2185 PACHECO ST	None	CONCORD	CA	94520	2309	00	06000	37.97878977	-122.0345486	Contra Costa County
350722	Ordering, Referring, Prescribing	N/A	1891041612	0	0	FRANZEL, BERNADETTE LMFT	9/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92448	N/A	N/A	N/A	N/A	N/A	740 FRONT ST	370	SANTA CRUZ	CA	95060	4535	00	06000	36.97547419	-122.0254852	Santa Cruz County
350839	Ordering, Referring, Prescribing	N/A	1891219630	0	0	FLORENTINO, JESSICA LMFT	11/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129131	N/A	N/A	N/A	N/A	N/A	1120 W LA VETA AVE	STE. 660	ORANGE	CA	92868	4231	00	06000	33.78029455	-117.864369	Orange County
350895	Ordering, Referring, Prescribing	N/A	1891335618	0	0	FALSAFI, HASSAN P	3/2/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	D62174	N/A	N/A	N/A	N/A	N/A	410 MAIN ST	# 279	GREENVILLE	CA	95947	9514	00	06000	40.14051184	-120.9500717	Plumas County
350906	Ordering, Referring, Prescribing	N/A	1891345864	0	0	FREEMANTLE, ANNA PA-C	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59351	N/A	N/A	N/A	N/A	N/A	263 S WEST ST	None	TULARE	CA	93274	3411	00	06000	36.20460711	-119.3668926	Tulare County
350919	Ordering, Referring, Prescribing	N/A	1891380135	0	0	FERNANDEZ, LUCIA LMFT	11/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114158	N/A	N/A	N/A	N/A	N/A	500 N LORAINE AVE.	None	GLENDORA	CA	91741	2216	00	06000	34.14418507	-117.8462241	Los Angeles County
350923	Ordering, Referring, Prescribing	N/A	1891384244	0	0	FERNANDEZ, EDWIN A LCSW	10/16/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	95720	N/A	N/A	N/A	N/A	N/A	1303 SAN CARLOS AVENUE	None	SAN CARLOS	CA	94070	2317	00	06000	37.50572931	-122.2621879	San Mateo County
350952	Ordering, Referring, Prescribing	N/A	1891453403	0	0	FEISE, NATASHA K PA	4/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61047	N/A	N/A	N/A	N/A	N/A	400 W 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
350980	Ordering, Referring, Prescribing	N/A	1891798195	0	0	FAM, ALBERT A LCSW	2/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19253	N/A	N/A	N/A	N/A	N/A	2425 BISSO LN	100	CONCORD	CA	94520	4897	00	06000	37.98393807	-122.0466953	Contra Costa County
350982	Ordering, Referring, Prescribing	N/A	1891806477	0	0	FACTOR, ANDREW D MD	4/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A69626	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
350995	Ordering, Referring, Prescribing	N/A	1891821765	0	0	FULLER, CLAYTON S	11/4/1990	Taxonomy not applicable	NA	n/a	099	DENTIST	D34101	N/A	N/A	N/A	N/A	N/A	4004 BEYER BLVD	None	SAN YSIDRO	CA	92173	2007	00	06000	32.55831005	-117.0475102	San Diego County
351015	Ordering, Referring, Prescribing	N/A	1891852281	0	0	FESSLER, ERNEST W	7/24/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D20101	N/A	N/A	N/A	N/A	N/A	191 DAYTON CT	None	SAN RAMON	CA	94583	3412	00	06000	37.73697498	-121.9409849	Contra Costa County
351093	Ordering, Referring, Prescribing	N/A	1902028798	0	0	FRANKLIN, CHARLES R LMFT	11/12/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112029	N/A	N/A	N/A	N/A	N/A	6615 VALLEY HI DR	A	SACRAMENTO	CA	95823	9998	00	06000	38.470986	-121.4276985	Sacramento County
351160	Ordering, Referring, Prescribing	N/A	1902164304	0	0	FONTES, GLORIA E LCSW	6/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81836	N/A	N/A	N/A	N/A	N/A	1418 J ST	None	MODESTO	CA	95354	1013	00	06000	37.64385262	-120.9958717	Stanislaus County
351184	Ordering, Referring, Prescribing	N/A	1902191075	0	0	FISCHER, CHRISTOPHER MD	1/20/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124603	N/A	N/A	N/A	N/A	N/A	3800 WATT AVE	None	SACRAMENTO	CA	95821	2670	00	06000	38.634417	-121.3818435	Sacramento County
351198	Ordering, Referring, Prescribing	N/A	1902192701	0	0	FUNG, KA WING	10/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	63574	N/A	N/A	N/A	N/A	N/A	5918 STONERIDGE MALL RD	None	PLEASANTON	CA	94588	3229	00	06000	37.696693	-121.9317572	Alameda County
351358	Ordering, Referring, Prescribing	N/A	1902629348	0	0	FONSECA, THERESEMARIEL NP	10/9/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95032530	N/A	N/A	N/A	N/A	N/A	43322 GINGHAM	None	LANCASTER	CA	93535	4576	00	06000	34.67013731	-118.1222748	Los Angeles County
351373	Ordering, Referring, Prescribing	N/A	1902858194	0	0	FAROOQI, MUBASHIR A MD	3/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A56486	N/A	N/A	N/A	N/A	N/A	855 N EUCLID AVE	None	ONTARIO	CA	91762	2729	00	06000	34.074063	-117.6514785	San Bernardino County
351384	Ordering, Referring, Prescribing	N/A	1902895683	0	0	FOWLER, KELLY C NP	4/28/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020816	N/A	N/A	N/A	N/A	N/A	1570 SOQUEL DRIVE	None	SANTA CRUZ	CA	95065	1750	00	06000	36.98832521	-121.9837966	Santa Cruz County
351430	Ordering, Referring, Prescribing	N/A	1902960305	0	0	FAHEY, SHERRY-LYNN S LMFT	12/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT46910	N/A	N/A	N/A	N/A	N/A	355 TUOLUMNE STREET	MS 20-100	VALLEJO	CA	94590	5700	00	06000	38.10261225	-122.2382555	Solano County
351434	Ordering, Referring, Prescribing	N/A	1902967268	0	0	FINLEY, NANCI S LMFT	12/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT37313	N/A	N/A	N/A	N/A	N/A	1119 E MONTE VISTA AVE	None	VACAVILLE	CA	95688	3009	00	06000	38.36024633	-121.9763983	Solano County
351452	Ordering, Referring, Prescribing	N/A	1912017112	0	0	FERRARI, LAURIE LCSW	12/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24218	N/A	N/A	N/A	N/A	N/A	3161 DWIGHT ROAD	None	ELK GROVE	CA	95758	6456	00	06000	38.427372	-121.4606025	Sacramento County
351487	Ordering, Referring, Prescribing	N/A	1912066713	0	0	FADEM, BLAIR W	1/17/2005	Taxonomy not applicable	NA	n/a	099	DENTIST	D39399	N/A	N/A	N/A	N/A	N/A	4058 WILLOWS RD	# 2128	ALPINE	CA	91903	2128	00	06000	32.836428	-116.7257385	San Diego County
351507	Ordering, Referring, Prescribing	N/A	1912124082	0	0	FEZLER, KIMBERLY A OT	3/26/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	689	N/A	N/A	N/A	N/A	N/A	2000 ALAMEDA DE LAS PULG	None	SAN MATEO	CA	94403	1293	00	06000	37.54524373	-122.3205511	San Mateo County
351551	Ordering, Referring, Prescribing	N/A	1912228057	0	0	FERNANDEZ, ARALY A LMFT	3/6/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123485	N/A	N/A	N/A	N/A	N/A	4601 TELEPHONE RD	SUITE 117	VENTURA	CA	93003	5672	00	06000	34.25783504	-119.2351187	Ventura County
351655	Ordering, Referring, Prescribing	N/A	1912376427	0	0	FLORES, VANESSA T	11/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89572	N/A	N/A	N/A	N/A	N/A	515 COLUMBIA AVE	SUITE 200	LOS ANGELES	CA	90017	1209	00	06000	34.05683109	-118.265995	Los Angeles County
351663	Ordering, Referring, Prescribing	N/A	1912386293	0	0	FIERRO, SARA E LMFT	10/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT122776	N/A	N/A	N/A	N/A	N/A	16552 SUNHILL DR	SUITE 3 & 4	VICTORVILLE	CA	92395	4518	00	06000	34.5068043	-117.2986245	San Bernardino County
351678	Ordering, Referring, Prescribing	N/A	1912403239	0	0	FANG, ROZANNA Y MD	9/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177680	N/A	N/A	N/A	N/A	N/A	5454 EL CAJON BLVD	None	SAN DIEGO	CA	92115	3621	00	06000	32.75809043	-117.0778038	San Diego County
351687	Ordering, Referring, Prescribing	N/A	1912421249	0	0	FLORES, KAREN LCSW	3/18/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	121636	N/A	N/A	N/A	N/A	N/A	572 N ARROWHEAD AVE	None	SAN BERNARDINO	CA	92401	1251	00	06000	34.109667	-117.289669	San Bernardino County
351757	Ordering, Referring, Prescribing	N/A	1912532342	0	0	FONG, KURENE M PA-C	3/25/2020	Taxonomy not applicable	NA	n/a	000	Unknown	57976	N/A	N/A	N/A	N/A	N/A	4770 N CEDAR AVE	None	FRESNO	CA	93726	1065	00	06000	36.804717	-119.754103	Fresno County
351772	Ordering, Referring, Prescribing	N/A	1912556499	0	0	FANG, MICHELLE C PHARMD	9/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH80738	N/A	N/A	N/A	N/A	N/A	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
351842	Ordering, Referring, Prescribing	N/A	1912990656	0	0	FLORIN, JACK H MD	4/23/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G26561	N/A	N/A	N/A	N/A	N/A	100 LAGUNA RD	208	FULLERTON	CA	92835	3633	00	06000	33.89264089	-117.9298746	Orange County
351847	Ordering, Referring, Prescribing	N/A	1922028653	0	0	FISHER, SVETLANA OD	5/21/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	9936T	N/A	N/A	N/A	N/A	N/A	7976 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90046	1000	00	06000	34.0907785	-118.3641255	Los Angeles County
351848	Ordering, Referring, Prescribing	N/A	1922042076	0	0	FINLEY, JOHN M DO	4/11/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A5583	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
351853	Ordering, Referring, Prescribing	N/A	1922054527	0	0	FARAJIAN, ELHAM E DPM	6/12/2018	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E4550	N/A	N/A	N/A	N/A	N/A	17822 BEACH BLVD.	STE 437	HUNTINGTON BEACH	CA	92647	7197	00	06000	33.70331388	-117.9890471	Orange County
351890	Ordering, Referring, Prescribing	N/A	1922170521	0	0	FONG, AUDREY PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53904	N/A	N/A	N/A	N/A	N/A	200 MUIR RD	None	MARTINEZ	CA	94553	4614	00	06000	37.99430233	-122.1107194	Contra Costa County
351979	Ordering, Referring, Prescribing	N/A	1922374305	0	0	FRAUSTO, MARIA D LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103078	N/A	N/A	N/A	N/A	N/A	500 W FOSTER RD	None	SANTA MARIA	CA	93455	3620	00	06000	34.88351329	-120.4428974	Santa Barbara County
351982	Ordering, Referring, Prescribing	N/A	1922380328	0	0	FINK, PATRICK M PA-C	12/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA52704	N/A	N/A	N/A	N/A	N/A	3705 MISSION BLVD	None	SAN DIEGO	CA	92109	7104	00	06000	32.78273202	-117.2524549	San Diego County
352020	Ordering, Referring, Prescribing	N/A	1922431618	0	0	FLORES, CARLOS M	10/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT122789	N/A	N/A	N/A	N/A	N/A	149 PASADENA AVE	SUITE A	SOUTH PASADENA	CA	91030	2947	00	06000	34.11188281	-118.1734374	Los Angeles County
352097	Ordering, Referring, Prescribing	N/A	1922539584	0	0	FISSEHA, ELIZABETH MD	2/14/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159877	N/A	N/A	N/A	N/A	N/A	1530 HILLHURST AVE	None	LOS ANGELES	CA	90027	5516	00	06000	34.098921	-118.287374	Los Angeles County
352113	Ordering, Referring, Prescribing	N/A	1922559715	0	0	FRIDAY, ALSTON J CA	4/15/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146400	N/A	N/A	N/A	N/A	N/A	265 NEVADA ST	None	AUBURN	CA	95603	4617	00	06000	38.90388189	-121.0825738	Placer County
352162	Ordering, Referring, Prescribing	N/A	1922661446	0	0	FENG, ROWENA PHARMD	5/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	77016	N/A	N/A	N/A	N/A	N/A	1900 DAVIS ST	None	SAN LEANDRO	CA	94577	1209	00	06000	37.720791	-122.181849	Alameda County
352187	Ordering, Referring, Prescribing	N/A	1922757202	0	0	FARZAN NIKOU, ARIELLA	12/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A189499	N/A	N/A	N/A	N/A	N/A	2051 MARENGO ST	None	LOS ANGELES	CA	90033	1352	00	06000	34.05627579	-118.2064774	Los Angeles County
352229	Ordering, Referring, Prescribing	N/A	1932177839	0	0	FIELDS, DONALD W DO	7/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6702	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL STREET	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
352247	Ordering, Referring, Prescribing	N/A	1932233608	0	0	FERNANDEZ, GERARD	2/10/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A81777	N/A	N/A	N/A	N/A	N/A	951 BLANCO CIR	STE B	SALINAS	CA	93901	4451	00	06000	36.65589725	-121.6366313	Monterey County
352253	Ordering, Referring, Prescribing	N/A	1932236882	0	0	FALCON, EDGARDO A DDS	2/22/2023	Taxonomy not applicable	NA	n/a	000	Unknown	48806	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
352324	Ordering, Referring, Prescribing	N/A	1932413796	0	0	FELICANO, AGNES R	1/28/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	13077	N/A	N/A	N/A	N/A	N/A	180 SIERRA COLLEGE DR	None	GRASS VALLEY	CA	95945	5768	00	06000	39.23235449	-121.0475561	Nevada County
352368	Ordering, Referring, Prescribing	N/A	1932502820	0	0	FLOOD, JENNIFER L LMFT	11/13/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98661	N/A	N/A	N/A	N/A	N/A	8801 FOLSOM BLVD	None	SACRAMENTO	CA	95826	3257	00	06000	38.553381	-121.376421	Sacramento County
352382	Ordering, Referring, Prescribing	N/A	1932508900	0	0	FLEURY, ANGELIA LCSW	6/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81375	N/A	N/A	N/A	N/A	N/A	3301 E 12TH ST	None	CITY IS NOT LISTE	CA	94601	3424	00	06000	37.77617499	-122.2247899	Alameda County
352395	Ordering, Referring, Prescribing	N/A	1932533924	0	0	FREDRICKSON, LISA G NP	7/28/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026356	N/A	N/A	N/A	N/A	N/A	205 SOUTH ST	None	FORT BRAGG	CA	95437	5540	00	06000	39.43009931	-123.8032471	Mendocino County
352434	Ordering, Referring, Prescribing	N/A	1932586344	0	0	FAWIBE, FIYINFOLUWA MD	7/17/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145359	N/A	N/A	N/A	N/A	N/A	590 N D ST	None	SAN BERNARDINO	CA	92401	1352	00	06000	34.1099197	-117.2919257	San Bernardino County
352452	Ordering, Referring, Prescribing	N/A	1932592664	0	0	FINN, WILLIAM B	3/22/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH31293	N/A	N/A	N/A	N/A	N/A	3550 MURPHY CANYON	None	SAN DIEGO	CA	92123	2656	00	06000	32.80792564	-117.1150773	San Diego County
352482	Ordering, Referring, Prescribing	N/A	1932646502	0	0	FASSUSIANKAM, LINE ORNELLA PHARMD	12/7/2017	Taxonomy not applicable	NA	n/a	000	Unknown	76080	N/A	N/A	N/A	N/A	N/A	4211 S. AVALON	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
352486	Ordering, Referring, Prescribing	N/A	1932676970	0	0	FORBES, ALISON D PHARMD	4/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79292	N/A	N/A	N/A	N/A	N/A	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	3904	00	06000	34.21980849	-118.4301135	Los Angeles County
352505	Ordering, Referring, Prescribing	N/A	1932701042	0	0	FALDU, JEET PHARMD	8/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH83161	N/A	N/A	N/A	N/A	N/A	60 N HIGHLAND SPRINGS AV	None	BANNING	CA	92220	3048	00	06000	33.92988307	-116.9468586	Riverside County
352559	Ordering, Referring, Prescribing	N/A	1932768454	0	0	FOSTER, ANDREA C RN PNP	6/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	820381	N/A	N/A	N/A	N/A	N/A	1629 S. CENTER	None	SANTA ANA	CA	92704	4113	00	06000	33.72509144	-117.8980958	Orange County
352560	Ordering, Referring, Prescribing	N/A	1932795952	0	0	FITZGERALD, BRITTIANY N LMFT	3/27/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138856	N/A	N/A	N/A	N/A	N/A	768 PLEASANT VALLEY RD	None	DIAMOND SPRINGS	CA	95619	9260	00	06000	38.69498433	-120.8070771	El Dorado County
352567	Ordering, Referring, Prescribing	N/A	1932823101	0	0	FELCYN-GHENCO, SUMMER	2/6/2023	Taxonomy not applicable	NA	n/a	000	Unknown	NP95022825	N/A	N/A	N/A	N/A	N/A	30300 CAMINO CAPISTRANO	None	SAN JUAN CAPISTRA	CA	92675	1304	00	06000	33.5230101	-117.6683028	Orange County
352599	Ordering, Referring, Prescribing	N/A	1942032602	0	0	FLORES, BERTHA NP	7/8/2024	Taxonomy not applicable	NA	n/a	000	Unknown	95030959	N/A	N/A	N/A	N/A	N/A	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	00	06000	33.14066871	-117.156095	San Diego County
352613	Ordering, Referring, Prescribing	N/A	1942276886	0	0	FINNERTY, SARAH K MD	8/20/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C169902	N/A	N/A	N/A	N/A	N/A	475 BRUCE STREET	None	YREKA	CA	96097	3474	00	06000	41.71860037	-122.6467317	Siskiyou County
352627	Ordering, Referring, Prescribing	N/A	1942326293	0	0	FOX, CHERYL P LCSW	6/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW18915	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	None	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
352636	Ordering, Referring, Prescribing	N/A	1942336706	0	0	FELDMAN, RICHARD N PSYD	7/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A22141	N/A	N/A	N/A	N/A	N/A	2525 N CHESTER AVE	None	BAKERSFIELD	CA	93308	1770	00	06000	35.429463	-119.0213795	Kern County
352638	Ordering, Referring, Prescribing	N/A	1942334552	0	0	FETZ, SHARON M LMFT	12/29/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT46676	N/A	N/A	N/A	N/A	N/A	222 W 6TH ST	STE 230	SAN PEDRO	CA	90731	3332	00	06000	33.73876969	-118.2824628	Los Angeles County
352674	Ordering, Referring, Prescribing	N/A	1942393996	0	0	FERRER, FARAH MD	5/13/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A55258	N/A	N/A	N/A	N/A	N/A	5406 E. BEVERLY BLVD	None	LOS ANGELES	CA	90022	2208	00	06000	34.0294449	-118.1492635	Los Angeles County
352682	Ordering, Referring, Prescribing	N/A	1942440219	0	0	FANTACONE, KARI LCSW	3/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19966	N/A	N/A	N/A	N/A	N/A	870 MARKET STREET	549	SAN FRANCISCO	CA	94102	3001	00	06000	37.7848184	-122.4070488	San Francisco County
352693	Ordering, Referring, Prescribing	N/A	1942461918	0	0	FARRAHI, FARSHID MD	5/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A111798	N/A	N/A	N/A	N/A	N/A	1525 SILVER AVE	2ND FLOOR	SAN FRANCISCO	CA	94134	1229	00	06000	37.73224392	-122.4063707	San Francisco County
352700	Ordering, Referring, Prescribing	N/A	1942475983	0	0	FROELICH, RYAN C LCSW	3/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29462	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	SUITE 401	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
352705	Ordering, Referring, Prescribing	N/A	1942483011	0	0	FATIMA, KHAIR LMFT	4/15/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112287	N/A	N/A	N/A	N/A	N/A	9101 WHITTIER BLVD	None	PICO RIVERA	CA	90660	2443	00	06000	34.00074139	-118.0822944	Los Angeles County
352725	Ordering, Referring, Prescribing	N/A	1942523485	0	0	FAIRE, PAMELA CNP	12/14/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	383947	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	66	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
352745	Ordering, Referring, Prescribing	N/A	1942576657	0	0	FALIK, REBECCA C MD	10/31/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A126750	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPRESSWAY	DEPT 384	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
352773	Ordering, Referring, Prescribing	N/A	1942617493	0	0	FLOYD, SHEBET NP	11/1/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95000318	N/A	N/A	N/A	N/A	N/A	6501 GARFIELD AVE	None	BELL GARDENS	CA	90201	1805	00	06000	33.97292523	-118.1475473	Los Angeles County
352836	Ordering, Referring, Prescribing	N/A	1942707310	0	0	FOSTER, JESSICA F LPCC	12/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	10894	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	201	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
352932	Ordering, Referring, Prescribing	N/A	1942887336	0	0	FINORA, JAMES MD	5/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185018	N/A	N/A	N/A	N/A	N/A	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	00	06000	37.34293689	-121.9270392	Santa Clara County
352957	Ordering, Referring, Prescribing	N/A	1942971296	0	0	FURIO, FRANCES	8/16/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	103209	N/A	N/A	N/A	N/A	N/A	5168 HONPIE RD	None	PLACERVILLE	CA	95667	8682	00	06000	38.6943603	-120.9018271	El Dorado County
352986	Ordering, Referring, Prescribing	N/A	1952067142	0	0	FIELDING, KARRIEM M LMFT	11/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112955	N/A	N/A	N/A	N/A	N/A	50 REGENCY PARK CIRCLE	UNIT 13104	SACRAMENTO	CA	95835	1789	00	06000	38.672415	-121.503285	Sacramento County
352989	Ordering, Referring, Prescribing	N/A	1952067266	0	0	FIEDLER, NOELLE LMFT	10/31/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	142522	N/A	N/A	N/A	N/A	N/A	405 W 5TH ST	211	SANTA ANA	CA	92701	4599	00	06000	33.74893088	-117.8713859	Orange County
353024	Ordering, Referring, Prescribing	N/A	1952406605	0	0	FU, JULIUS H MD	5/5/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A52315	N/A	N/A	N/A	N/A	N/A	438 N WHITE RD	None	SAN JOSE	CA	95127	1439	00	06000	37.3776149	-121.8374887	Santa Clara County
353043	Ordering, Referring, Prescribing	N/A	1952427668	0	0	FUENTES, JORGE A MD	8/13/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A82371	N/A	N/A	N/A	N/A	N/A	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	00	06000	34.05855992	-118.209755	Los Angeles County
353118	Ordering, Referring, Prescribing	N/A	1952612863	0	0	FRAUSTO, ERIKA M LMFT	9/21/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT128222	N/A	N/A	N/A	N/A	N/A	6001 CLARA ST	None	BELL GARDENS	CA	90201	4723	00	06000	33.96259296	-118.1593487	Los Angeles County
353134	Ordering, Referring, Prescribing	N/A	1952648305	0	0	FERNANDEZ DURAN, DARA MD	8/15/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163385	N/A	N/A	N/A	N/A	N/A	1671 THE ALAMEDA	None	SAN JOSE	CA	95126	2222	00	06000	37.33686811	-121.9186321	Santa Clara County
353155	Ordering, Referring, Prescribing	N/A	1952679722	0	0	FABIAN, ERIC PHARMD	7/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66388	N/A	N/A	N/A	N/A	N/A	575 N SANBORN RD	None	SALINAS	CA	93905	2246	00	06000	36.68179908	-121.6229784	Monterey County
353171	Ordering, Referring, Prescribing	N/A	1952701732	0	0	FONTES, MATHEW LMFT	3/2/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT138254	N/A	N/A	N/A	N/A	N/A	3710 STATE HIGHWAY 45	None	COLUSA	CA	95932	0000	00	06000	39.25060345	-122.0314303	Colusa County
353194	Ordering, Referring, Prescribing	N/A	1952751042	0	0	FONG, HEEKONG MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160914	N/A	N/A	N/A	N/A	N/A	10535 HOSPITAL WAY	None	MATHER	CA	95655	4200	00	06000	38.572443	-121.2965235	Sacramento County
353218	Ordering, Referring, Prescribing	N/A	1952787285	0	0	FABIYI, SIMIADE I	9/24/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D64935	N/A	N/A	N/A	N/A	N/A	441 DIAZ AVE	None	DELANO	CA	93215	4121	00	06000	35.75593981	-119.2499764	Kern County
353359	Ordering, Referring, Prescribing	N/A	1962037911	0	0	FALCON-QUIROZ, BEATRIZ A LMFT	1/11/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	144329	N/A	N/A	N/A	N/A	N/A	3031 SOUTH VERMONT AV	None	LOS ANGELES	CA	90007	0001	00	06000	34.02666679	-118.2915608	Los Angeles County
353382	Ordering, Referring, Prescribing	N/A	1962061382	0	0	FELIX, KRISTYL PA-C	6/7/2019	Taxonomy not applicable	NA	n/a	000	Unknown	PA56862	N/A	N/A	N/A	N/A	N/A	2098 S. CENTRAL AVE.	None	LOS ANGELES	CA	90011	1235	00	06000	34.0227101	-118.2521314	Los Angeles County
353474	Ordering, Referring, Prescribing	N/A	1962569616	0	0	FEYGIN, POLINA MD	12/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G67378	N/A	N/A	N/A	N/A	N/A	1110 W ANAHEIM ST	6	WILMINGTON	CA	90744	4131	00	06000	33.77921216	-118.2759309	Los Angeles County
353557	Ordering, Referring, Prescribing	N/A	1962736439	0	0	FITZPATRICK, MICHAEL MD	12/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G80717	N/A	N/A	N/A	N/A	N/A	16350 FILBERT ST	None	SYLMAR	CA	91342	1002	00	06000	34.31595736	-118.4853828	Los Angeles County
353562	Ordering, Referring, Prescribing	N/A	1962740340	0	0	FULLER, RAEANNE PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71825	N/A	N/A	N/A	N/A	N/A	200 MUIR RD	None	MARTINEZ	CA	94553	4614	00	06000	37.99430233	-122.1107194	Contra Costa County
353627	Ordering, Referring, Prescribing	N/A	1962822031	0	0	FREGOSO, MARISOL L LMFT	2/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112121	N/A	N/A	N/A	N/A	N/A	315 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	00	06000	34.444881	-119.7793725	Santa Barbara County
353673	Ordering, Referring, Prescribing	N/A	1962879064	0	0	FIRL, VICTORIA PHARMD	7/8/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH72971	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE	STE 125A	OAKLAND	CA	94605	2457	00	06000	37.768221	-122.17608	Alameda County
353683	Ordering, Referring, Prescribing	N/A	1962887414	0	0	FUJINAGA, KEITH PHARMD	3/25/2019	Taxonomy not applicable	NA	n/a	000	Unknown	69965	N/A	N/A	N/A	N/A	N/A	665 N D ST	STE. H	SAN BERNARDINO	CA	92401	1109	00	06000	34.111737	-117.2918735	San Bernardino County
353697	Ordering, Referring, Prescribing	N/A	1962914440	0	0	FLORES, MELINA CNM	12/4/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235948	N/A	N/A	N/A	N/A	N/A	15403 PARK AVE E	None	VICTORVILLE	CA	92392	2482	00	06000	34.50640129	-117.3250645	San Bernardino County
353710	Ordering, Referring, Prescribing	N/A	1962946418	0	0	FERNANDEZ, ALEXANDRO NP	7/12/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	732594	N/A	N/A	N/A	N/A	N/A	2256 S SULTANA AVE	None	ONTARIO	CA	91761	4238	00	06000	34.03314441	-117.6459521	San Bernardino County
353979	Ordering, Referring, Prescribing	N/A	1972745990	0	0	FERNANDEZ, ELENA	1/31/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26494	N/A	N/A	N/A	N/A	N/A	808 W 58TH ST	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
354114	Ordering, Referring, Prescribing	N/A	1972955904	0	0	FELDMAN, SARA M LCSW	6/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29081	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVENUE	SUITE 300	SAN JOSE	CA	95128	2680	00	06000	37.3160785	-121.937121	Santa Clara County
354123	Ordering, Referring, Prescribing	N/A	1972964823	0	0	FROGOZO, DELILAH T PHARMD	5/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	35187	N/A	N/A	N/A	N/A	N/A	12155 TECH CENTER DR	None	POWAY	CA	92064	7156	00	06000	32.937048	-117.032895	San Diego County
354143	Ordering, Referring, Prescribing	N/A	1972989408	0	0	FOLK, CRYSTAL G LMFT	3/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117308	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	RIVERSIDE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
354195	Ordering, Referring, Prescribing	N/A	1982072526	0	0	FLORES, RICARDO W	6/8/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D65073	N/A	N/A	N/A	N/A	N/A	1100 TRANCAS ST	STE 300	NAPA	CA	94558	2921	00	06000	38.32316569	-122.2981938	Napa County
354262	Ordering, Referring, Prescribing	N/A	1982184768	0	0	FITZSIMMONS, KATHLEEN K	9/28/2017	Taxonomy not applicable	NA	n/a	000	Unknown	95071633	N/A	N/A	N/A	N/A	N/A	820 6TH ST	None	TAFT	CA	93268	2306	00	06000	35.14882336	-119.4568887	Kern County
354403	Ordering, Referring, Prescribing	N/A	1982749693	0	0	FUNDERBURG, CAROLIN P LMFT	1/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	103353	N/A	N/A	N/A	N/A	N/A	6950 65TH ST	None	SACRAMENTO	CA	95823	2316	00	06000	38.50065	-121.4357265	Sacramento County
354407	Ordering, Referring, Prescribing	N/A	1982759239	0	0	FABRY, LUCINDA PSYD	11/17/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY20776	N/A	N/A	N/A	N/A	N/A	550 WATER ST.	C-2	SANTA CRUZ	CA	95060	4124	00	06000	36.98046158	-122.018718	Santa Cruz County
354448	Ordering, Referring, Prescribing	N/A	1982847950	0	0	FARJAM, FARAHNAZ MD	8/21/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A83807	N/A	N/A	N/A	N/A	N/A	9380 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3749	00	06000	33.9215355	-117.4442978	Riverside County
354474	Ordering, Referring, Prescribing	N/A	1982900684	0	0	FAYAD, FREDERICA MD	4/27/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133968	N/A	N/A	N/A	N/A	N/A	22675 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	8551	00	06000	33.91695337	-117.2672536	Riverside County
354485	Ordering, Referring, Prescribing	N/A	1982924742	0	0	FERNANDEZ, GREGORY J MD	3/31/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A167447	N/A	N/A	N/A	N/A	N/A	2740 S ELM AVE	None	FRESNO	CA	93706	5435	00	06000	36.70101129	-119.7908643	Fresno County
354500	Ordering, Referring, Prescribing	N/A	1982952172	0	0	FELICIANO, KARLORICO PHARMD	4/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	66885	N/A	N/A	N/A	N/A	N/A	6750 STANFORD RANCH RD	None	ROSEVILLE	CA	95678	1907	00	06000	38.780055	-121.2657575	Placer County
354541	Ordering, Referring, Prescribing	N/A	1992009252	0	0	FLORES, FLOR D LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT93640	N/A	N/A	N/A	N/A	N/A	10929 SOUTH ST # 208B,	None	CERRITOS	CA	90703	5368	00	06000	33.85836353	-118.101204	Los Angeles County
354553	Ordering, Referring, Prescribing	N/A	1992028724	0	0	FATTORINI-OCAMPO, GIOVANNA F LMFT	3/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112677	N/A	N/A	N/A	N/A	N/A	225 S CABRILLO HIGHWAY	200A	HALF MOON BAY	CA	94019	7210	00	06000	37.46542425	-122.4337617	San Mateo County
354555	Ordering, Referring, Prescribing	N/A	1992038657	0	0	FLORES, HENRY P LMFT	9/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT128269	N/A	N/A	N/A	N/A	N/A	1212 N CALIFORNIA ST	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
354560	Ordering, Referring, Prescribing	N/A	1992052732	0	0	FREITAS-BROWN, WENDY A	6/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105362	N/A	N/A	N/A	N/A	N/A	299 12TH STREET	A	MARINA	CA	93933	6003	00	06000	36.66784472	-121.8011077	Monterey County
354586	Ordering, Referring, Prescribing	N/A	1992085914	0	0	FORBES, VERONICA LCSW	8/18/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	70029	N/A	N/A	N/A	N/A	N/A	1251 S ELISEO DR	None	GREENBRAE	CA	94904	2005	00	06000	37.94411957	-122.5361022	Marin County
354624	Ordering, Referring, Prescribing	N/A	1992138614	0	0	FACTOR, CRYSTAL N LCSW	9/9/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125899	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT.	None	LAKEPORT	CA	95453	9754	00	06000	39.03772106	-122.9223338	Lake County
354660	Ordering, Referring, Prescribing	N/A	1992205926	0	0	FUJIWARA, JOHN NP	9/27/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013404	N/A	N/A	N/A	N/A	N/A	5300 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4015	00	06000	34.02013512	-118.1561298	Los Angeles County
354683	Ordering, Referring, Prescribing	N/A	1992236756	0	0	FRIEDMAN, NATHAN A MD	2/20/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A155699	N/A	N/A	N/A	N/A	N/A	924 WESTWOOD BLVD	None	LOS ANGELES	CA	90024	2910	00	06000	34.06309787	-118.4452763	Los Angeles County
354691	Ordering, Referring, Prescribing	N/A	1992252803	0	0	FONG, DEREK N PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74891	N/A	N/A	N/A	N/A	N/A	2155 IRON POINT ROAD	None	FOLSOM	CA	95630	7338	00	06000	38.644479	-121.1349735	Sacramento County
354736	Ordering, Referring, Prescribing	N/A	1992350748	0	0	FRITZ, CHARLOTTE LMFT	11/5/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53606	N/A	N/A	N/A	N/A	N/A	3725 TAYLOR RD STE 1	None	LOOMIS	CA	95650	9283	00	06000	38.81963826	-121.1950015	Placer County
354747	Ordering, Referring, Prescribing	N/A	1992356984	0	0	FABRO, KATHARINE A PSYD	5/12/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY34208	N/A	N/A	N/A	N/A	N/A	250 S G ST	None	ANAHEIM	CA	92410	3320	00	06000	34.09693522	-117.2986838	San Bernardino County
354759	Ordering, Referring, Prescribing	N/A	1992382287	0	0	FENG, JIMMY J MD	1/2/2025	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A200570	N/A	N/A	N/A	N/A	N/A	1420 WILLOW PASS ROAD	200	CONCORD	CA	94520	5223	00	06000	37.96956948	-122.0507563	Contra Costa County
354777	Ordering, Referring, Prescribing	N/A	1992441562	0	0	FISHER, ALEXIS PA	8/23/2024	Taxonomy not applicable	NA	n/a	000	Unknown	114377071206	N/A	N/A	N/A	N/A	N/A	1515 SPRINGFIELD DR	STE 175	CHICO	CA	95928	5398	00	06000	39.73096434	-121.8089646	Butte County
354832	Ordering, Referring, Prescribing	N/A	1992823579	0	0	FINDLEY, FELIPE B PA-C	1/16/2024	Taxonomy not applicable	NA	n/a	000	Unknown	21351	N/A	N/A	N/A	N/A	N/A	1679 E 120TH ST	None	LOS ANGELES	CA	90059	3025	00	06000	33.92459248	-118.2436306	Los Angeles County
354869	Ordering, Referring, Prescribing	N/A	1992876395	0	0	FRAME, THOMAS	3/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	33123	N/A	N/A	N/A	N/A	N/A	815 HYDE STREET	None	SAN FRANCISCO	CA	94109	5998	00	06000	37.78855	-122.416917	San Francisco County
354871	Ordering, Referring, Prescribing	N/A	1992884803	0	0	FOSTER, ALLISON LCSW	8/8/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24391	N/A	N/A	N/A	N/A	N/A	1721 GRIFFIN AVE	None	LOS ANGELES	CA	90031	3312	00	06000	34.06331668	-118.2114477	Los Angeles County
354907	Ordering, Referring, Prescribing	N/A	1992958524	0	0	FOUST, SCOTT J MD	6/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A103610	N/A	N/A	N/A	N/A	N/A	801 S CHEVY CHASE DR	250	GLENDALE	CA	91205	4431	00	06000	34.136757	-118.2396195	Los Angeles County