Table: enrolled_medi_cal_fee_for_service_ffs_providers , legal_name like H*

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
40	Fee-for-Service	1912100546	1912100546	1	1	HARDER, PRIYA S MD	4/18/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	112800	40	Pediatrics	0	In state provider	None	1442 FOOTHILL BLVD	None	LA CANADA FLINTRI	CA	91011	2107	19	06037	34.20871102	-118.2096542	Los Angeles County
80	Fee-for-Service	1871594473	1871594473	2	1	HEP PHARMACY INC	8/27/2012	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	19530 VENTURA BLVD	None	TARZANA	CA	91356	2917	19	06037	34.17276552	-118.558783	Los Angeles County
102	Fee-for-Service	1689761769	1689761769	1	1	HYDEN, PHILIP W MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	83725	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
181	Fee-for-Service	1194104570	1194104570	1	1	HOWARD, RYAN H MD	7/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155497	01	General Practice	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
184	Fee-for-Service	1063973444	1063973444	1	1	HSIEH, KRISTIE J OT	6/22/2022	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
233	Fee-for-Service	1205215936	1205215936	1	1	HERZFELDT, ZACHARY C MD	7/1/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	148801	36	Psychiatry	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
239	Fee-for-Service	1477583565	1477583565	1	1	HEWES, GEORGE R MD	11/15/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	13639	18	Ophthalmology	0	In state provider	None	123 DI SALVO AVE	STE G	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
263	Fee-for-Service	1538433370	1538433370	1	1	HARKINS, COLEEN A NP	9/12/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
309	Fee-for-Service	1770623209	1770623209	1	1	HACKMAN, STEPHANIE MD	8/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77103	30	Radiology	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
404	Fee-for-Service	1922099415	1922099415	1	1	HAMBY, DENNIS L MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	26833	41	Internal Medicine	0	In state provider	None	1500 SOUTHGATE AVE	STE 201	DALY CITY	CA	94015	2231	41	06081	37.67558248	-122.4750825	San Mateo County
426	Fee-for-Service	1124405881	1124405881	1	1	HEALTH CARE INTEGRATED	6/13/2017	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	SERVICES	2600 N CENTRAL AVENUE	ROOM B1	COMPTON	CA	90222	1640	19	06037	33.91517914	-118.2543338	Los Angeles County
432	Fee-for-Service	1043381973	1043381973	1	1	HARDY, CAROLYN A MD	1/4/2008	207R00000X	NA	Other	026	PHYSICIANS	89986	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
442	Fee-for-Service	1437111390	1437111390	1	1	HELZER, KIMBERLY F LMFT	8/27/2018	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
459	Fee-for-Service	1326703935	1326703935	1	1	HARVEY, SHAWN C LMFT	4/3/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8110 BIRMINGHAM WAY	BLDG 28	SAN DIEGO	CA	92123	2758	37	06073	32.79648424	-117.1521397	San Diego County
497	Fee-for-Service	1518053495	1518053495	1	1	HUISH, JAMES F DPM	8/29/1980	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	700 W OLIVE AVE	STE C	MERCED	CA	95348	2435	24	06047	37.31918006	-120.480202	Merced County
525	Fee-for-Service	1427165877	1427165877	1	1	HARPER, MATTHEW P MD	8/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55739	None	None	0	In state provider	None	5176 HILL RD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
527	Fee-for-Service	1477583565	1477583565	1	1	HEWES, GEORGE R MD	11/15/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	13639	01	General Practice	0	In state provider	None	123 DI SALVO AVE	STE G	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
635	Fee-for-Service	1154335297	1154335297	1	1	HABERLY, RICHARD MD	9/11/2008	207L00000X	NA	Other	026	PHYSICIANS	104757	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
647	Fee-for-Service	1053581892	1053581892	1	1	HOME HEALTH CARE SOLUTIONS	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SOLUTIONS, INC	9007 ARROW ROUTE	SUITE 100	RANCHO CUCAMONGA	CA	91730	4461	36	06071	34.09930349	-117.6077025	San Bernardino County
663	Fee-for-Service	1437485075	1437485075	1	1	HUANG, BETSY Y MD	9/16/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3006 S MARYLAND PKWY	STE 315	LAS VEGAS	NV	89109	6205	00	None	36.135288	-115.1368705	Clark County
758	Fee-for-Service	1548278120	1548278120	1	1	HOWARD J GLIDDEN PHD PSYCH I	9/17/2020	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	NC	1660 E HERNDON AVE	SUITE 150	FRESNO	CA	93720	3359	10	06019	36.8375615	-119.7575595	Fresno County
769	Fee-for-Service	1033677539	1033677539	1	1	HODE, ISHTAR S NP	7/18/2019	207Q00000X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3737 MARTIN LUTHER KING	# 605B	LYNWOOD	CA	90262	3513	19	06037	33.92872742	-118.2006921	Los Angeles County
786	Fee-for-Service	1265663520	1265663520	1	1	HUNG, CRYSTAL MD	5/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115667	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
815	Fee-for-Service	1477583565	1477583565	1	1	HEWES, GEORGE R MD	11/15/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	13639	30	Radiology	0	In state provider	None	123 DI SALVO AVE	STE G	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
833	Fee-for-Service	1174576094	1174576094	1	1	HELLBERG, SARA E. 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	401 W POPLAR ST	None	WALLA WALLA	WA	99362	2846	00	None	46.06269104	-118.3437284	Walla Walla County
855	Fee-for-Service	1275282600	1275282600	1	1	HSU, COURTNEY MD	11/28/2024	390200000X	NA	Other	026	PHYSICIANS	189400	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
866	Fee-for-Service	1033148523	1033148523	1	1	HORNING, JOHN A MD	8/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85580	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
912	Fee-for-Service	1992965818	1992965818	1	1	HAN, HYOSUN MD	7/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135750	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
940	Fee-for-Service	1750878385	1750878385	1	1	HANNEKEN, KEVIN MD	6/18/2021	207P00000X	NA	Other	026	PHYSICIANS	172448	None	None	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
947	Fee-for-Service	1851407605	1851407605	1	1	HADDEN, DAVID M	10/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	16077	22	Pathology (M.D. only)	0	In state provider	None	5151 N PALM AVE	STE 200	FRESNO	CA	93704	2221	10	06019	36.81119879	-119.808555	Fresno County
949	Fee-for-Service	1023033495	1023033495	1	1	HWANG, THOMAS N MD	7/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84710	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
953	Fee-for-Service	1265600910	1265600910	1	1	HASAN, AMBREEN MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114479	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
1017	Fee-for-Service	1760660336	1760660336	1	1	HERMINIO F DELEON	12/5/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MONARCH HOME	877 MUIRFIELD DR	None	OCEANSIDE	CA	92058	7017	37	06073	33.23838662	-117.3480051	San Diego County
1052	Fee-for-Service	1073841839	1073841839	1	1	HIBINO, AIMEE PT	6/15/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	680 E ROMIE LN	A	SALINAS	CA	93901	4206	27	06053	36.65922321	-121.6430933	Monterey County
1080	Fee-for-Service	1205856960	1205856960	1	1	HARBER, PHILIP I MD	1/1/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	46187	41	Internal Medicine	0	In state provider	UCLA CTR DEPT OF MEDICIN	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
1094	Fee-for-Service	1639734551	1639734551	1	1	HOLLANDER, JEFFREY DO	11/4/2022	390200000X	NA	Other	026	PHYSICIANS	19400	None	None	0	In state provider	None	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	19	06037	34.27684353	-118.4684024	Los Angeles County
1130	Fee-for-Service	1669868964	1669868964	1	1	HITI, COREY J MD	2/3/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146529	None	None	0	In state provider	None	2309 ANTONIO AVENUE	None	CAMARILLO	CA	93010	1414	56	06111	34.24435917	-119.0191975	Ventura County
1149	Fee-for-Service	1801943063	1801943063	2	1	HSU, ALETHEA T MD	11/1/2016	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	32678	25	Physical Medicine and Rehabilitation	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1205	19	06037	34.06794352	-118.1229278	Los Angeles County
1199	Fee-for-Service	1992965818	1992965818	1	1	HAN, HYOSUN MD	7/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135750	10	Gastroenterology (M.D. only)	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
1202	Fee-for-Service	1043742158	1043742158	1	1	HWANG, HUI LAC	6/23/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
1225	Fee-for-Service	1053341446	1053341446	1	1	HARRIS, MICHAEL MD	10/1/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	58482	40	Pediatrics	0	In state provider	DEPT PEDIATRICS	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
1236	Fee-for-Service	1942829981	1942829981	1	1	HUNG, ALAN MD	10/31/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
1257	Fee-for-Service	1568536431	1568536431	1	1	HANGER P & O WEST INC.	6/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2400 BROAD ST	None	SAN LUIS OBISPO	CA	93401	5702	40	06079	35.26714731	-120.6543967	San Luis Obispo County
1262	Fee-for-Service	1790471340	1790471340	1	1	HERNANDEZ, MICHELA DOULA	6/15/2023	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	12	06023	0	0	None
1297	Fee-for-Service	1902860109	1902860109	1	1	HOFFMAN, MARK A MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87000	40	Pediatrics	0	In state provider	None	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	19	06037	34.13887038	-118.1504485	Los Angeles County
1299	Fee-for-Service	1699204081	1699204081	1	1	HOANG, KEVIN MD	5/4/2020	207R00000X	NA	Other	026	PHYSICIANS	162300	30	Radiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
1323	Fee-for-Service	1205127651	1205127651	1	1	HUNTER, JACQUELINE A NP	9/12/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	202 W WILLOW AVE	SUITE 502	VISALIA	CA	93291	6268	54	06107	36.328536	-119.293569	Tulare County
1325	Fee-for-Service	1487085486	1487085486	1	1	HAO, ANNIE R LMFT	2/5/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	19	06037	34.28133474	-118.4198166	Los Angeles County
1327	Fee-for-Service	1073544722	1073544722	1	1	HADDAD, MAHA N MD	7/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91988	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
1345	Fee-for-Service	1932604642	1932604642	1	1	HUERTAS-ARIAS, BRIGITTE T MD	6/10/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	167173	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
1362	Fee-for-Service	1497836720	1497836720	1	1	HSUEH, GILLIAN C LAC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1000 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4709	19	06037	34.084557	-118.123042	Los Angeles County
1368	Fee-for-Service	1205856960	1205856960	1	1	HARBER, PHILIP I MD	1/1/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	46187	29	Pulmonary Diseases (M.D. only)	0	In state provider	UCLA CTR DEPT OF MEDICIN	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
1381	Fee-for-Service	1982781191	1982781191	1	1	HIGGINS, JAMES R MD	8/29/2008	207R00000X	NA	Other	026	PHYSICIANS	88417	41	Internal Medicine	0	In state provider	None	14624 SHERMAN WY	STE 603	VAN NUYS	CA	91405	2241	19	06037	34.20078354	-118.450843	Los Angeles County
1384	Fee-for-Service	1740677095	1740677095	1	1	HOJJAT, HOUMEHR MD	8/10/2021	207YS0123X	NA	ENT/Otolaryngology	026	PHYSICIANS	171120	None	None	0	In state provider	None	3828 DELMAS TERRACE	None	CULVER CITY	CA	90232	2113	19	06037	34.02308948	-118.3972101	Los Angeles County
1387	Fee-for-Service	1851315626	1851315626	1	1	HAMILTON, DAVID R MD	8/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69988	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	# 1-340	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
1421	Fee-for-Service	1225783079	1225783079	1	1	HOWARD-WALLER, ASHA	5/3/2024	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
1471	Fee-for-Service	1225125529	1225125529	1	1	HOENIG, DAVID B MD	1/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	82847	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
1501	Fee-for-Service	1407865652	1407865652	1	1	HIGH DESERT NEPHROLOGY	10/22/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	None	12675 HESPERIA RD	None	VICTORVILLE	CA	92395	5878	36	06071	34.48143043	-117.2906246	San Bernardino County
1552	Fee-for-Service	1821566787	1821566787	1	1	HEALTHY HEART CARDIOLOGY INC	2/14/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	23961 CALLE DE LA MAGDAL	STE 517	LAGUNA HILLS	CA	92653	7628	30	06059	33.60999658	-117.7126577	Orange County
1558	Fee-for-Service	1245336585	1245336585	1	1	HUR, JIM RONG MD	9/1/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	41834	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2585 SAMARITAN DR	None	SAN JOSE	CA	95124	4107	43	06085	37.25083752	-121.9503884	Santa Clara County
1564	Fee-for-Service	1477692408	1477692408	1	1	HAWTHORNE MORNINGSIDE MEDICA	10/30/2001	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	L CLINIC	15901 HAWTHORNE BLVD	SUITE 250	LAWNDALE	CA	90260	9025	19	06037	33.8863737	-118.352778	Los Angeles County
1567	Fee-for-Service	1033174537	1033174537	1	1	HEAD, DAVID K MD	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
1585	Fee-for-Service	1902860109	1902860109	1	1	HOFFMAN, MARK A MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87000	41	Internal Medicine	0	In state provider	None	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	19	06037	34.13887038	-118.1504485	Los Angeles County
1614	Fee-for-Service	1033321427	1033321427	1	1	HACIENDA COLIMA INVSTMNT	8/21/2007	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HACIENDA PHARMACY	3120 S HACIENDA BLVD	STE 105	HACIENDA HEIGHTS	CA	91745	6305	19	06037	33.98067045	-117.9727398	Los Angeles County
1618	Fee-for-Service	1790106300	1790106300	1	1	HARMONY DIALYSIS LLC	10/15/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1800 N TEXAS ST	None	FAIRFIELD	CA	94533	3874	48	06095	38.26227647	-122.034196	Solano County
1622	Fee-for-Service	1578309175	1578309175	1	1	HSU, HUI-FEN PT	11/7/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	301 LENNON LN	202	WALNUT CREEK	CA	94598	2483	07	06013	37.92672613	-122.0291022	Contra Costa County
1641	Fee-for-Service	1528569340	1528569340	1	1	HINES, CASEY N	3/16/2018	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
1669	Fee-for-Service	1982781191	1982781191	1	1	HIGGINS, JAMES R MD	8/29/2008	207R00000X	NA	Other	026	PHYSICIANS	88417	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	14624 SHERMAN WY	STE 603	VAN NUYS	CA	91405	2241	19	06037	34.20078354	-118.450843	Los Angeles County
1670	Fee-for-Service	1679765838	1679765838	1	1	HWANG, ELIZABETH W MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107452	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
1681	Fee-for-Service	1659305027	1659305027	1	1	HOM, DAVID B MD	3/9/2020	207YS0123X	NA	ENT/Otolaryngology	026	PHYSICIANS	50542	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
1694	Fee-for-Service	1366452781	1366452781	1	1	HUOTT, PATRICK A MD	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72646	13	Neurology (M.D. only)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
1754	Fee-for-Service	1154749588	1154749588	1	1	HOVSEPIAN, DOMINIC A MD	12/14/2023	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	141089	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
1774	Fee-for-Service	1619062486	1619062486	1	1	HIRSCH, ANITA MD	9/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87488	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
1791	Fee-for-Service	1407865652	1407865652	1	1	HIGH DESERT NEPHROLOGY	10/22/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	12675 HESPERIA RD	None	VICTORVILLE	CA	92395	5878	36	06071	34.48143043	-117.2906246	San Bernardino County
1817	Fee-for-Service	1639141013	1639141013	1	1	HARRISON, TERRY A MD	10/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	43784	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
1842	Fee-for-Service	1730386269	1730386269	1	1	HAVEY, JOHN T PHD	9/25/2024	103T00000X	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
1865	Fee-for-Service	1992024483	1992024483	1	1	HAYEK, SAMI MD	3/12/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	147165	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	315 N THIRD AVE	STE 207	COVINA	CA	91723	1915	19	06037	34.08873786	-117.8923869	Los Angeles County
1887	Fee-for-Service	1164681334	1164681334	1	1	HOMAN, DAVID J MD	9/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119413	41	Internal Medicine	0	In state provider	None	2615 CHESTER AVENUE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
1910	Fee-for-Service	1649342841	1649342841	1	1	HARRIS, STEPHEN R MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	89244	05	Anesthesiology	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3132	07	06013	37.9141514	-122.0422089	Contra Costa County
1920	Fee-for-Service	1942255005	1942255005	1	1	HELLER, GARY DO	2/21/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	21432	07	Dermatology	0	In state provider	None	147 BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
1947	Fee-for-Service	1538205604	1538205604	1	1	HUANG, XIAN S AC	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	408 7TH ST	None	OAKLAND	CA	94607	3928	01	06001	37.79921344	-122.2733192	Alameda County
1962	Fee-for-Service	1679765838	1679765838	1	1	HWANG, ELIZABETH W MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107452	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
1964	Fee-for-Service	1174629950	1174629950	1	1	HADAYA, BASSEL MD	3/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	79960	45	Nephrology (Renal-Kidney)	0	In state provider	None	1759 W AVENUE J	STE 101	LANCASTER	CA	93534	2703	19	06037	34.68944351	-118.163124	Los Angeles County
1972	Fee-for-Service	1659305027	1659305027	1	1	HOM, DAVID B MD	3/9/2020	207YS0123X	NA	ENT/Otolaryngology	026	PHYSICIANS	50542	24	Plastic 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
1998	Fee-for-Service	1497808646	1497808646	1	1	HERNANDEZ-PAMPALONI	2/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106219	30	Radiology	0	In state provider	JOSE MD	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
2010	Fee-for-Service	1609293919	1609293919	1	1	HARO, GREG MD	9/1/2023	208600000X	NA	General Surgery	026	PHYSICIANS	140049	None	None	0	In state provider	None	18350 ROSCOE BLVD	STE 201	NORTHRIDGE	CA	91325	4148	19	06037	34.22071855	-118.5341175	Los Angeles County
2059	Fee-for-Service	1548310840	1548310840	1	1	HSIA, DAVID W MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79048	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
2086	Fee-for-Service	1184687337	1184687337	1	1	HANNA, KAREN J MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	88851	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
2092	Fee-for-Service	1497797260	1497797260	1	1	HANNANEY, MARYANNE A MD	2/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	41869	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
2139	Fee-for-Service	1043545502	1043545502	1	1	HARBELL, MONICA W MD	9/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109421	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
2143	Fee-for-Service	1043281926	1043281926	2	1	HOEN, ALEXIS G MD	3/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	17258	41	Internal Medicine	0	In state provider	None	1245 WILSHIRE BLVD	SUITE 307	LOS ANGELES	CA	90017	4810	19	06037	34.05362775	-118.2661889	Los Angeles County
2157	Fee-for-Service	1710036710	1710036710	1	1	HAYMES, JULIE A	5/19/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
2180	Fee-for-Service	1841712502	1841712502	1	1	HSIAO, PHILIP MD	7/10/2023	208800000X	NA	Other	026	PHYSICIANS	153381	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
2233	Fee-for-Service	1346671856	1346671856	1	1	HURST, AMANDA PT	1/11/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	25381 RAILROAD CANYON RD	1101 AND 1102	LAKE ELSINORE	CA	92532	2705	33	06065	33.66885662	-117.2636558	Riverside County
2249	Fee-for-Service	1174629950	1174629950	1	1	HADAYA, BASSEL MD	3/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	79960	41	Internal Medicine	0	In state provider	None	1759 W AVENUE J	STE 101	LANCASTER	CA	93534	2703	19	06037	34.68944351	-118.163124	Los Angeles County
2251	Fee-for-Service	1629043799	1629043799	1	1	HOOL, KALPANA S MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	66964	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
2258	Fee-for-Service	1437306313	1437306313	1	1	HANFT, RACHELLE T MD	4/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121649	08	Family Practice	0	In state provider	None	2700 GRANT STREET	#200	CONCORD	CA	94520	2270	07	06013	37.98417931	-122.0361585	Contra Costa County
2274	Fee-for-Service	1811009731	1811009731	1	1	HEN YAG INC	8/24/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6325 TOPANGA CANYON BLVD	STE 102	WOODLAND HILLS	CA	91367	2006	19	06037	34.184934	-118.6059175	Los Angeles County
2287	Fee-for-Service	1053773754	1053773754	1	1	HOLLIDAY, TESSINY I NP	3/4/2021	363LF0000X	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
2293	Fee-for-Service	1952366932	1952366932	1	1	HOLTZ, S J MD	11/30/1980	2084N0400X	NA	Neurology	026	PHYSICIANS	30609	13	Neurology (M.D. only)	0	In state provider	None	130 LA CASA VIA	BLDG 2	WALNUT CREEK	CA	94598	3045	07	06013	37.91175467	-122.0414101	Contra Costa County
2298	Fee-for-Service	1235407826	1235407826	1	2	HEALTHWISE HOME HEALTH CARE	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1615 SWEETWATER ROAD	STE I	NATIONAL CITY	CA	91950	7688	37	06073	32.6613311	-117.0829803	San Diego County
2317	Fee-for-Service	1033227582	1033227582	1	1	HAHN, WILLIAM V MD	1/1/1982	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	24182	10	Gastroenterology (M.D. only)	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
2342	Fee-for-Service	1457310641	1457310641	1	1	HUANG, BENJAMIN E MD	6/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	85607	05	Anesthesiology	0	In state provider	None	1301 N ROSE DRIVE	None	PLACENTIA	CA	92870	3802	30	06059	33.8868003	-117.8420447	Orange County
2402	Fee-for-Service	1417136128	1417136128	1	1	HASSAN, ALSHAFIE M MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99070	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
2408	Fee-for-Service	1558744938	1558744938	1	1	HEFLEY, ALLISON K	4/12/2020	103TC0700X	NA	Mental Health Outpatient Services	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
2439	Fee-for-Service	1245412188	1245412188	1	1	HOPE HOSPICE & HLTHCARE, INC	9/26/2007	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	29826 HAUN ROAD	SUITE 108	SUN CITY	CA	92586	6547	33	06065	33.68719818	-117.1748757	Riverside County
2452	Fee-for-Service	1427110709	1427110709	1	1	HUYNH, DANH MD	12/1/2003	2084P0800X	NA	Psychiatry	026	PHYSICIANS	51656	36	Psychiatry	0	In state provider	None	401 RIDGE VISTA AVE	None	SAN JOSE	CA	95127	1501	43	06085	37.37837217	-121.8351069	Santa Clara County
2453	Fee-for-Service	1083648778	1083648778	1	1	HEFLIN, DANIEL W MD	5/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87333	05	Anesthesiology	0	In state provider	None	2626 N CALIFORNIA ST	STE G	STOCKTON	CA	95204	5500	39	06077	37.97724966	-121.2917368	San Joaquin County
2506	Fee-for-Service	1174664353	1174664353	1	1	HERFKENS, ROBERT J MD	8/31/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	33467	30	Radiology	0	In state provider	None	3RD AND PARNASSUS AVE M3	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.762974	-122.459769	San Francisco County
2515	Fee-for-Service	1235407826	1235407826	1	1	HEALTHWISE HOME HEALTH CARE	12/24/2020	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1615 SWEETWATER ROAD	STE I	NATIONAL CITY	CA	91950	7688	37	06073	32.6613311	-117.0829803	San Diego County
2526	Fee-for-Service	1316695091	1316695091	1	1	HARVARD HOME HEALTH, INC	8/21/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	415 E HARVARD ST	STE 103	GLENDALE	CA	91205	1045	19	06037	34.14448348	-118.250604	Los Angeles County
2670	Fee-for-Service	1588195176	1588195176	1	1	HUANG, ALICIA H DO	9/24/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	16727	40	Pediatrics	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
2727	Fee-for-Service	1245412188	1245412188	1	1	HOPE HOSPICE & HLTHCARE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	29826 HAUN ROAD	SUITE 108	SUN CITY	CA	92586	6547	33	06065	33.68719818	-117.1748757	Riverside County
2736	Fee-for-Service	1164604658	1164604658	1	1	HERNANDEZ, JOHN M OD	5/25/2007	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6134 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2923	19	06037	33.98457344	-118.2251414	Los Angeles County
2740	Fee-for-Service	1023635448	1023635448	1	1	HERBERT, KRISTA	2/19/2024	103T00000X	NA	Mental Health Outpatient Services	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
2750	Fee-for-Service	1336325737	1336325737	1	1	HORIZON SERVICES INC	6/12/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2575 DEPOT RD	None	HAYWARD	CA	94545	0000	01	06001	37.63875614	-122.1146645	Alameda County
2776	Fee-for-Service	1407909468	1407909468	1	1	HUANG, MORGAN C MD	2/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83085	18	Ophthalmology	0	In state provider	None	650 W DUARTE RD	STE 100 D	ARCADIA	CA	91007	7113	19	06037	34.12621324	-118.0537434	Los Angeles County
2799	Fee-for-Service	1588812317	1588812317	1	1	HALILHODZIC, MERITA MD	12/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108710	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
2840	Fee-for-Service	1235152794	1235152794	2	2	HODOR, LAWRENCE DPM	1/22/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5220 CLARK AVE	SUITE 125	LAKEWOOD	CA	90712	2623	19	06037	33.8527092	-118.1337623	Los Angeles County
2844	Fee-for-Service	1811158728	1811158728	1	2	HART0NIAN, IVET MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	112893	79	Neurology-Child	0	In state provider	None	1700 E CESAR E CHAVEZ	SUITE 3000	LOS ANGELES	CA	90033	2424	19	06037	34.05101259	-118.217259	Los Angeles County
2845	Fee-for-Service	1497702179	1497702179	1	1	HEER, MANAVJYOT S MD	12/19/2007	208M00000X	NA	Other	026	PHYSICIANS	96928	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
2891	Fee-for-Service	1518556737	1518556737	1	1	HEMPHILL, TARALYN LMFT	3/5/2025	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
2948	Fee-for-Service	1578008314	1578008314	1	1	HENRY, KATHERINE MD	8/2/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153567	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
3018	Fee-for-Service	1851403547	1851403547	1	1	HEREM, ALLAN B LMFT	2/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14443 PARK AVE	A2	VICTORVILLE	CA	92392	2388	36	06071	34.513236	-117.3248945	San Bernardino County
3022	Fee-for-Service	1295965325	1295965325	1	1	HERBST, SHAWNA M CSW	4/25/2023	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
3040	Fee-for-Service	1255822698	1255822698	1	1	HOSAINI, AMINA LCSW	10/23/2024	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
3054	Fee-for-Service	1932129848	1932129848	1	1	HEARING SCIENCE OF DALY	6/1/1996	193400000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	CITY	333 GELLERT BLVD	STE 118	DALY CITY	CA	94015	2690	41	06081	37.66672018	-122.4685948	San Mateo County
3071	Fee-for-Service	1598102584	1598102584	1	1	HALLORAN, KATRINA M MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141346	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
3080	Fee-for-Service	1861406654	1861406654	1	1	HARDEY, MICHAEL A	2/8/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7209 TAVIRA CT	None	ELK GROVE	CA	95757	3472	34	06067	38.384793	-121.418946	Sacramento County
3091	Fee-for-Service	1003016643	1003016643	1	1	HUSNI, CLAUDIA M MD	2/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78723	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
3122	Fee-for-Service	1952405326	1952405326	1	1	HEMPHILL, JONATHAN A MD	4/1/1988	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	44304	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	6347 COYLE AVE	None	CARMICHAEL	CA	95608	0438	34	06067	38.668257	-121.316301	Sacramento County
3127	Fee-for-Service	1609855121	1609855121	1	1	HARVEY, JOHN M MD	10/1/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80291	40	Pediatrics	0	In state provider	ROWE, MAISEL & HEATH MDS	599 SIR FRANCIS DRAKE BL	STE 102	GREENBRAE	CA	94904	1730	21	06041	37.95026531	-122.5332546	Marin County
3134	Fee-for-Service	1639188188	1639188188	1	1	HOANG, JAYSON H DC	5/11/2004	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	CHIROPRACTIC CARE CLINIC	4629 EL CAJON BLVD	None	SAN DIEGO	CA	92115	4402	37	06073	32.75567114	-117.0947419	San Diego County
3152	Fee-for-Service	1982837456	1982837456	1	1	HAN, JENNIFER Y MD	11/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108421	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
3161	Fee-for-Service	1013902733	1013902733	1	1	HEANEY, JOHN D MD	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	30142	41	Internal Medicine	0	In state provider	None	1120 N CHINOWTH ST	None	VISALIA	CA	93291	7896	54	06107	36.338517	-119.3341455	Tulare County
3214	Fee-for-Service	1417179318	1417179318	1	1	HASSAN-ELSAYED, AMINA MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94330	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
3258	Fee-for-Service	1548689623	1548689623	1	1	HELO VILLEGAS, VALENTINA LM	4/11/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	99 S ALMADEN BLVD	STE 600	SAN JOSE	CA	95113	1605	43	06085	37.33257807	-121.8940377	Santa Clara County
3342	Fee-for-Service	1932129848	1932129848	1	1	HEARING SCIENCE OF DALY	7/8/2024	193400000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	CITY	333 GELLERT BLVD	STE 118	DALY CITY	CA	94015	2690	41	06081	37.66672018	-122.4685948	San Mateo County
3360	Fee-for-Service	1700807369	1700807369	1	1	HA, CONNIE K OD	8/3/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	SAN BRUNO EYE CARE CTR	931 SAN BRUNO AVE W	RM 4	SAN BRUNO	CA	94066	3435	41	06081	37.62774029	-122.4191925	San Mateo County
3364	Fee-for-Service	1932276839	1932276839	1	1	HANTZ, TIMOTHY D MD	11/27/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67579	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
3366	Fee-for-Service	1265789960	1265789960	1	1	HSU, NANCY MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126662	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
3376	Fee-for-Service	1720432404	1720432404	1	1	HURTUBISE, BRIGITTE F MD	7/10/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	156296	13	Neurology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	STE 1000A	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
3384	Fee-for-Service	1881703791	1881703791	1	1	HEE, TOM 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	3006 WEBSTER ST	None	OMAHA	NE	68131	2027	00	None	41.26591338	-95.95704674	Douglas County
3415	Fee-for-Service	1831594126	1831594126	1	1	HULL, CODY DO	3/11/2025	207R00000X	NA	Other	026	PHYSICIANS	16720	01	General Practice	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
3446	Fee-for-Service	1427212844	1427212844	1	1	HIGGINS, JILL R RN	3/30/2012	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
3449	Fee-for-Service	1013902733	1013902733	1	1	HEANEY, JOHN D MD	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	30142	45	Nephrology (Renal-Kidney)	0	In state provider	None	1120 N CHINOWTH ST	None	VISALIA	CA	93291	7896	54	06107	36.338517	-119.3341455	Tulare County
3487	Fee-for-Service	1245499060	1245499060	1	1	HERMAN, DANIEL C MD	9/29/2021	2081S0010X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	174837	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
3505	Fee-for-Service	1710954516	1710954516	1	1	HELLINGER, DEBORAH R DO	11/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12754	30	Radiology	0	In state provider	None	2740 M ST	None	MERCED	CA	95340	2880	24	06047	37.31239905	-120.478839	Merced County
3552	Fee-for-Service	1740305630	1740305630	1	1	HARNED, THERESA M MD	3/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83397	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
3557	Fee-for-Service	1265549067	1265549067	1	1	HOPPE, JASON A DO	6/18/2018	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
3560	Fee-for-Service	1568241537	1568241537	1	1	HERNANDEZ, ALFREDO	3/20/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	554 E BASELINE RD	None	CLAREMONT	CA	91711	2236	19	06037	34.1215617	-117.7060025	Los Angeles County
3609	Fee-for-Service	1043534944	1043534944	1	1	HSIEH, KRISTINE K MD	4/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106953	41	Internal Medicine	0	In state provider	None	9201 BIG HORN BLVD	None	SACRAMENTO	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento
3611	Fee-for-Service	1477693612	1477693612	1	1	HICKERSON, KATHERINE H CRNA	8/12/2019	367500000X	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
3620	Fee-for-Service	1417421850	1417421850	1	1	HEALTH ACCESS FOR ALL INC	3/21/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1030 WEST GARDENA BLVD	None	GARDENA	CA	90247	4956	19	06037	33.88154027	-118.2925662	Los Angeles County
3652	Fee-for-Service	1932276839	1932276839	1	1	HANTZ, TIMOTHY D MD	11/27/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67579	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
3690	Fee-for-Service	1215175120	1215175120	1	1	HUA, VAN B MD	7/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106573	41	Internal Medicine	0	In state provider	None	616 N GARFIELD AVE	STE 303	MONTEREY PARK	CA	91754	1101	19	06037	34.06916465	-118.1229039	Los Angeles County
3722	Fee-for-Service	1366771818	1366771818	1	1	HERTZ, JENNIFER	5/7/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	110193	20	Orthopedic Surgery	0	In state provider	None	3617 AVALON BLVD STE 200	None	LOS ANGELES	CA	90011	5601	19	06037	34.012953	-118.2652865	Los Angeles County
3725	Fee-for-Service	1588183099	1588183099	1	1	HURLEY, JENNIFER M NP	10/3/2017	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
3733	Fee-for-Service	1194090266	1194090266	1	1	HANSON, HANNA C LMFT	12/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43460 RIDGE PARK DR	STE 245	TEMECULA	CA	92590	3619	33	06065	33.49676946	-117.1608841	Riverside County
3762	Fee-for-Service	1548587926	1548587926	1	1	HU, MYRA Q MD	9/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137148	13	Neurology (M.D. only)	0	In state provider	None	2030 SUTTER PLACE	SUITE 1300	DAVIS	CA	95616	6201	57	06113	38.56292466	-121.7715423	Yolo County
3770	Fee-for-Service	1245920586	1245920586	1	1	HOLT, JASMINE R PSYD	8/14/2023	103TC0700X	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
3806	Fee-for-Service	1902960941	1902960941	2	1	HUNTER, LLOYD JR MD	11/25/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	27170	40	Pediatrics	0	In state provider	None	3701 STOCKTON ST	STE 204	LOS ANGELES	CA	90008	5144	19	06037	33.90974623	-118.2029092	Los Angeles
3823	Fee-for-Service	1023056843	1023056843	1	1	HENRICHSEN, TOD M MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68727	None	None	0	In state provider	None	27401 LOS ALTOS	STE 180	MISSION VIEJO	CA	92691	8580	30	06059	33.56489118	-117.665546	Orange County
3830	Fee-for-Service	1649489394	1649489394	1	1	HINZ, CHRISTINA L MD	7/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88921	05	Anesthesiology	0	In state provider	None	995 BLANCO CIR	STE A	SALINAS	CA	93901	4447	27	06053	36.65488958	-121.6372749	Monterey County
3847	Fee-for-Service	1740305630	1740305630	1	1	HARNED, THERESA M MD	3/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83397	68	Hematology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
3850	Fee-for-Service	1386806156	1386806156	1	1	HUNT, JUSTIN T MD	8/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131362	02	General Surgery	0	In state provider	None	6480 PENTZ ROAD	SUITE A	PARADISE	CA	95969	3672	04	06007	39.771162	-121.5795825	Butte County
3889	Fee-for-Service	1487834560	1487834560	1	1	HSU, LANNY DO	1/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10191	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
3893	Fee-for-Service	1194278309	1194278309	1	1	HOANG, BRIAN B	8/21/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	13121 PHILADELPHIA ST	None	WHITTIER	CA	90601	4302	19	06037	33.97912551	-118.0353645	Los Angeles County
3910	Fee-for-Service	1417421850	1417421850	1	1	HEALTH ACCESS FOR ALL INC	3/21/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1030 WEST GARDENA BLVD	None	GARDENA	CA	90247	4956	19	06037	33.88154027	-118.2925662	Los Angeles County
3946	Fee-for-Service	1144733569	1144733569	1	1	HAN, SOHYUN C PHD	10/7/2022	390200000X	NA	Other	031	PSYCHOLOGISTS	-	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
3993	Fee-for-Service	1205961034	1205961034	1	1	HEALTHCARE MEDICAL CLINIC OF	10/6/2009	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	POMONA INC	822 N GAREY AVE	None	POMONA	CA	91767	4616	19	06037	34.06563676	-117.7509698	Los Angeles County
3995	Fee-for-Service	1790758415	1790758415	1	1	HIRSCH, RAPHAEL MD	12/23/2019	2080P0216X	NA	Other	026	PHYSICIANS	165119	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
4061	Fee-for-Service	1689024523	1689024523	1	1	HENWOOD, JOANN OD	7/31/2019	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
4094	Fee-for-Service	1255698429	1255698429	1	1	HUANG, DEREK D MD	8/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127110	18	Ophthalmology	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
4117	Fee-for-Service	1871631507	1871631507	1	1	HATANO, HIROYU MD	3/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87614	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
4125	Fee-for-Service	1780982835	1780982835	1	1	HONEYFLOWER HOLDINGS LLC	6/7/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	3688 NYE AVENUE	None	RIVERSIDE	CA	92505	1818	33	06065	33.90700032	-117.4663905	Riverside County
4146	Fee-for-Service	1801836077	1801836077	1	1	HANSCH, LAUREL P MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	69913	30	Radiology	0	In state provider	None	345 S A ST	None	OXNARD	CA	93030	5804	56	06111	34.19938431	-119.1786013	Ventura County
4148	Fee-for-Service	1841692381	1841692381	1	1	HEP ENTERPRISES, INC	1/26/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15315 MAGNOLIA BLVD	SUITE 324	SHERMAN OAKS	CA	91403	1175	19	06037	34.16488161	-118.4666419	Los Angeles County
4154	Fee-for-Service	1235161597	1235161597	1	1	HUSTANA, LARA DAWN OD	6/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
4169	Fee-for-Service	1023542099	1023542099	1	1	HUI, JAMES Z MD	1/23/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	157096	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
4177	Fee-for-Service	1497796155	1497796155	1	1	HOPPING, HEATHER J	2/10/2009	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	9625 MONTE VISTA AVENUE	STE 102	MONTCLAIR	CA	91763	2234	36	06071	34.08006762	-117.6982272	San Bernardino County
4179	Fee-for-Service	1689741514	1689741514	1	1	HAJOSY, ROBERT C MD	12/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	52757	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
4245	Fee-for-Service	1508896689	1508896689	1	1	HALES, KEIR F MD	9/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	SUITE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
4247	Fee-for-Service	1932541448	1932541448	1	1	HAYFRON, KWEKU A MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134874	41	Internal Medicine	0	In state provider	None	1411 EAST 31 ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
4253	Fee-for-Service	1003942301	1003942301	1	1	HANOWELL, LELAND H MD	11/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	37864	41	Internal Medicine	0	In state provider	None	PO BOX 478	None	CEDARVILLE	CA	96104	0478	25	06049	0	0	None
4279	Fee-for-Service	1801415161	1801415161	1	1	HAYAT, MOHAMMED MD	12/10/2024	390200000X	NA	Other	026	PHYSICIANS	189318	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
4304	Fee-for-Service	1063933117	1063933117	1	1	HANSON & ASSOCIATES PHYSICAL	4/10/2020	225100000X	NA	Physical Therapist	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	Y & WELLNESS	4300 GREEN RIVER RD	114	CORONA	CA	92880	1506	33	06065	33.87893694	-117.6486366	Riverside County
4307	Fee-for-Service	1346777570	1346777570	1	1	HASLAM, SAMUEL P	4/6/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	184861	None	None	0	In state provider	None	100 MOODY DRIVE	None	THOUSAND OAKS	CA	91360	6077	56	06111	34.17732532	-118.8654117	Ventura County
4309	Fee-for-Service	1336133255	1336133255	1	1	HOUGH, VICTOR J MD	11/23/1993	207L00000X	NA	Other	026	PHYSICIANS	30788	05	Anesthesiology	0	In state provider	None	2705 K ST	STE 5B	SACRAMENTO	CA	95816	5117	34	06067	38.573325	-121.470561	Sacramento County
4332	Fee-for-Service	1972758407	1972758407	1	1	HALLER, ISABELLE C DO	1/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10602	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
4336	Fee-for-Service	1902877889	1902877889	1	1	HECHT, STEPHEN T MD	3/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	45283	None	None	0	In state provider	None	1441 LIBERTY ST	STE 305	REDDING	CA	96001	0848	45	06089	40.5857177	-122.3870781	Shasta County
4361	Fee-for-Service	1851339345	1851339345	1	1	HASTEH, FARNAZ MD	11/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84168	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
4389	Fee-for-Service	1942543566	1942543566	1	1	HOPKINS, MELISSA A MD	10/1/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	132103	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
4398	Fee-for-Service	1134275167	1134275167	1	1	HARI, DANIELLE M MD	1/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116693	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
4418	Fee-for-Service	1043467335	1043467335	1	1	HA, ANN MD	5/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110115	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
4433	Fee-for-Service	1154502144	1154502144	1	1	HOVSEPIAN, RAFFI V MD	7/3/2009	208200000X	NA	General Surgery	026	PHYSICIANS	96283	02	General Surgery	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
4436	Fee-for-Service	1841692381	1841692381	1	1	HEP ENTERPRISES, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15315 MAGNOLIA BLVD	SUITE 324	SHERMAN OAKS	CA	91403	1175	19	06037	34.16488161	-118.4666419	Los Angeles County
4454	Fee-for-Service	1467689950	1467689950	1	1	HAGES, ANDREA M DO	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15629	05	Anesthesiology	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3352	48	06095	38.26109552	-122.0470245	Solano County
4469	Fee-for-Service	1992120026	1992120026	1	1	HANNSUN, GEMMY MD	7/6/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	153743	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
4482	Fee-for-Service	1326004748	1326004748	1	1	HUNG, LYNNE MD	12/30/2009	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	69214	41	Internal Medicine	0	In state provider	None	26800 CROWN VALLEY PKWY	#250	MISSION VIEJO	CA	92691	8533	30	06059	33.56286021	-117.6673449	Orange County
4488	Fee-for-Service	1396730339	1396730339	1	1	HUDMAN A. HOO, JR., 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	1530 9TH ST N	None	ST PETERSBURG	FL	33704	4202	00	None	27.78664382	-82.64678576	Pinellas County
4492	Fee-for-Service	1053557975	1053557975	1	1	HERINGER, KATRINA L	1/26/2016	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
4502	Fee-for-Service	1790147866	1790147866	1	1	HUANG, IRVIN DO	9/24/2021	207RR0500X	NA	Other	026	PHYSICIANS	18610	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
4508	Fee-for-Service	1922263896	1922263896	1	1	HARTMANN, EMILY C MD	4/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129965	24	Plastic Surgery	0	In state provider	None	251 COHASSET ROAD	SUITE 340	CHICO	CA	95926	2239	04	06007	39.75090044	-121.8522609	Butte County
4515	Fee-for-Service	1063531507	1063531507	1	1	HOM, RAYMOND P MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123424	05	Anesthesiology	0	In state provider	None	501 SOUTH BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
4525	Fee-for-Service	1982059366	1982059366	1	1	HOSSEINIFAR, NEGAR DO	8/3/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16061	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
4533	Fee-for-Service	1891159984	1891159984	1	1	HUANG, QIUYING DO	1/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15795	01	General Practice	0	In state provider	None	1570 EAST HERDON AVE	None	FRESNO	CA	93720	3303	10	06019	36.83756046	-119.759841	Fresno County
4541	Fee-for-Service	1003942301	1003942301	1	1	HANOWELL, LELAND H MD	11/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	37864	66	Emergency Medicine (Urgent Care)	0	In state provider	None	PO BOX 478	None	CEDARVILLE	CA	96104	0478	25	06049	0	0	None
4568	Fee-for-Service	1124286869	1124286869	1	1	HU, CAROL T MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131250	77	Infectious Disease	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
4587	Fee-for-Service	1851368252	1851368252	1	1	HOUGEN, MERRITT L MD	8/11/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	31625	01	General Practice	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
4589	Fee-for-Service	1669835740	1669835740	1	1	HSU, ROBERT C MD	8/1/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	161565	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
4633	Fee-for-Service	1710236005	1710236005	1	1	HARMS, MARIANA LMFT	3/21/2023	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
4666	Fee-for-Service	1598279473	1598279473	1	1	HOLISTIC HOSPICE CARE	12/21/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1616 VICTORY BLVD	SUITE 202	GLENDALE	CA	91201	2960	19	06037	34.16022036	-118.2989479	Los Angeles County
4671	Fee-for-Service	1700199056	1700199056	1	1	HUTCHISON, TERRI M	2/22/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	26284 OSO RD	STE 114	SAN JUAN CAPISTRA	CA	92675	1629	30	06059	33.5155829	-117.6717393	Orange County
4689	Fee-for-Service	1043883440	1043883440	1	1	HIGH QUALITY CARE FOR ALL IN	3/24/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	3360 BARHAM BLVD	SUITE D	LOS ANGELES	CA	90068	1473	19	06037	34.13249611	-118.3442219	Los Angeles County
4696	Fee-for-Service	1659376606	1659376606	1	1	HSIEH, JOHN T MD	3/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73107	None	None	0	In state provider	None	3780 KILROY AIRPORT WAY	STE 115	LONG BEACH	CA	90806	2458	19	06037	33.80733529	-118.1450095	Los Angeles County
4702	Fee-for-Service	1992133474	1992133474	1	1	HP ANESTHESIA INC	4/7/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
4705	Fee-for-Service	1194873083	1194873083	1	1	HUBER, KAY T MD	11/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81011	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
4731	Fee-for-Service	1992459754	1992459754	1	1	HALASEH, RAMI MD	9/13/2024	207R00000X	NA	Other	026	PHYSICIANS	187236	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
4771	Fee-for-Service	1326004748	1326004748	1	1	HUNG, LYNNE MD	12/30/2009	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	69214	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	26800 CROWN VALLEY PKWY	#250	MISSION VIEJO	CA	92691	8533	30	06059	33.56286021	-117.6673449	Orange County
4809	Fee-for-Service	1982059366	1982059366	1	1	HOSSEINIFAR, NEGAR DO	8/3/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16061	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
4829	Fee-for-Service	1003942301	1003942301	1	1	HANOWELL, LELAND H MD	11/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	37864	01	General Practice	0	In state provider	None	PO BOX 478	None	CEDARVILLE	CA	96104	0478	25	06049	0	0	None
4831	Fee-for-Service	1447371208	1447371208	1	1	HUONG LAN T NGUYEN	1/1/2004	183700000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	UNION PHARMACY	2420 ULRIC ST	None	SAN DIEGO	CA	92111	6040	37	06073	32.78699441	-117.1712837	San Diego County
4856	Fee-for-Service	1124286869	1124286869	1	1	HU, CAROL T MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131250	41	Internal Medicine	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
4893	Fee-for-Service	1275973265	1275973265	1	1	HESS, GRETCHEN A	8/16/2017	No Taxonomy Provided	NA	None	037	SPEECH 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
4926	Fee-for-Service	1356752000	1356752000	1	2	HAWKINS, FREDRIK C AU	1/20/2021	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8512 MADISON AVE.	None	FAIR OAKS	CA	95628	3809	34	06067	38.663712	-121.242654	Sacramento County
4954	Fee-for-Service	1598279473	1598279473	1	1	HOLISTIC HOSPICE CARE	12/21/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	1616 VICTORY BLVD	SUITE 202	GLENDALE	CA	91201	2960	19	06037	34.16022036	-118.2989479	Los Angeles County
4973	Fee-for-Service	1326855313	1326855313	1	1	HUDSON, NHATALIE R BIRTH DOU	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	27	06053	0	0	None
4984	Fee-for-Service	1447411590	1447411590	1	1	HADPAWAT-LEE, ANITA MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55783	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	555 TACHEVAH DRIVE	SUITE 3W105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
4987	Fee-for-Service	1528304391	1528304391	2	1	HEMENDRA GOYAL	9/6/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	196 W LEGION RD	STE A	BRAWLEY	CA	92227	9998	13	06025	32.95996431	-115.5523437	Imperial County
5037	Fee-for-Service	1356568810	1356568810	1	1	HOO, CHARLES C MD	12/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93239	30	Radiology	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
5040	Fee-for-Service	1518270743	1518270743	1	1	HENRY, EVE A MD	8/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117701	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE #365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
5050	Fee-for-Service	1154495752	1154495752	1	1	HERRERA, GREGORY A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40461	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
5081	Fee-for-Service	1184706475	1184706475	1	1	HEESS, JOHN E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	60636	05	Anesthesiology	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
5083	Fee-for-Service	1396790200	1396790200	1	1	HCA - HEALTHONE LLC	3/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SWEDISH MEDICAL CENTER	501 E HAMPDEN AVE	None	ENGLEWOOD	CO	80113	2702	00	None	39.6531952	-104.9810967	Arapahoe County
5099	Fee-for-Service	1982059366	1982059366	1	1	HOSSEINIFAR, NEGAR DO	8/3/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16061	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
5114	Fee-for-Service	1962741892	1962741892	1	1	HIBEL, SARAH C CRNA	10/21/2019	367500000X	NA	Other	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
5134	Fee-for-Service	1144431230	1144431230	1	1	HAMDAN, AYAD MD	8/5/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	162882	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
5149	Fee-for-Service	1952533820	1952533820	1	1	HARTMAN, RICHARD	1/21/2025	204D00000X	NA	Other	026	PHYSICIANS	17532	25	Physical Medicine and Rehabilitation	0	In state provider	None	401 E CARRILLO ST	None	SANTA BARBARA	CA	93101	1460	42	06083	34.42588572	-119.6972176	Santa Barbara County
5150	Fee-for-Service	1134506207	1134506207	1	1	HU, YAN MD	6/12/2020	390200000X	NA	Other	026	PHYSICIANS	152318	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
5211	Fee-for-Service	1538470547	1538470547	1	1	HEISLER, MICHAEL A MD	2/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129886	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
5214	Fee-for-Service	1235520917	1235520917	1	1	HASANAIN, MOHAMMED	10/20/2017	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	650 ROOSEVELT	2F	IRVINE	CA	92620	3621	30	06059	33.69504926	-117.7671222	Orange County
5217	Fee-for-Service	1548385289	1548385289	1	1	HOLMES, CYNTHIA M LMFT	7/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1501 W CAMERON 110-2	None	WEST COVINA	CA	91790	2127	19	06037	34.06831975	-117.9417887	Los Angeles County
5222	Fee-for-Service	1386690980	1386690980	1	1	HAY, DOUGLAS J MD	5/31/1982	207R00000X	NA	Other	026	PHYSICIANS	47396	01	General Practice	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
5268	Fee-for-Service	1528340015	1528340015	1	2	HUTCHFUL, MINA M	12/6/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5965 CLEGHORN CT	None	FONTANA	CA	92336	4553	36	06071	34.14538027	-117.4590898	San Bernardino County
5279	Fee-for-Service	1346732260	1346732260	1	1	HOANG, KENNY P MD	6/21/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
5318	Fee-for-Service	1649555616	1649555616	2	1	HOLY FAMILY HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7250 BEVERLY BLVD	SUITE 203	LOS ANGELES	CA	90036	2560	19	06037	34.07613953	-118.347669	Los Angeles County
5355	Fee-for-Service	1194739540	1194739540	1	1	HEIDERSBACH, JENNIFER O MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55142	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
5363	Fee-for-Service	1598811051	1598811051	1	1	HOUSTON, MITCHELL J PHD	2/14/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
5368	Fee-for-Service	1396790200	1396790200	1	1	HCA - HEALTHONE LLC	3/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SWEDISH MEDICAL CENTER	501 E HAMPDEN AVE	None	ENGLEWOOD	CO	80113	2702	00	None	39.6531952	-104.9810967	Arapahoe County
5382	Fee-for-Service	1518049048	1518049048	1	1	HSIA, HENRY H MD	10/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87565	06	Cardiovascular Disease (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
5395	Fee-for-Service	1124130117	1124130117	2	1	HOPE J & S INC	12/7/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10222 RESEDA BLVD	None	NORTHRIDGE	CA	91324	3255	19	06037	34.256304	-118.5360605	Los Angeles County
5407	Fee-for-Service	1417996745	1417996745	1	1	HUNT, LEONEL A MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72199	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
5413	Fee-for-Service	1760466924	1760466924	1	1	HALL, ALLEN D MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68302	08	Family Practice	0	In state provider	None	7911 LAGUNA BLVD	None	ELK GROVE	CA	95758	7920	34	06067	38.422971	-121.410873	Sacramento County
5422	Fee-for-Service	1144431230	1144431230	1	1	HAMDAN, AYAD MD	8/5/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	162882	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
5443	Fee-for-Service	1275646317	1275646317	1	1	HENDERSON,PAULA C MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66348	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
5448	Fee-for-Service	1992120794	1992120794	1	1	HIZON MEDICAL CORPORATION	12/21/2018	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	27699 JEFFERSON AVE	101	TEMECULA	CA	92590	2661	33	06065	33.51449799	-117.1593524	Riverside County
5455	Fee-for-Service	1881646917	1881646917	1	1	HAQ, CYNTHIA L MD	1/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152578	08	Family Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
5466	Fee-for-Service	1891044806	1891044806	1	1	HAGLER, ERIN R LMFT	6/13/2020	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
5506	Fee-for-Service	1497866214	1497866214	1	1	HURT, CHRISTOPHER J MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109207	None	None	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
5527	Fee-for-Service	1912347063	1912347063	1	1	HADDAN, RACHEL LMFT	5/2/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	86040	-	NOT APPLICABLE	0	In state provider	None	22245 MAIN STREET	SUITE 200	HAYWARD	CA	94541	4028	01	06001	37.67674766	-122.0863181	Alameda County
5545	Fee-for-Service	1598832917	1598832917	1	1	HOFF, JOHN D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	48345	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2950 WHIPPLE AVE	STE 1	REDWOOD CITY	CA	94062	2842	41	06081	37.4783159	-122.2550908	San Mateo County
5557	Fee-for-Service	1528340015	1528340015	1	2	HUTCHFUL, MINA M	12/6/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5965 CLEGHORN CT	None	FONTANA	CA	92336	4553	36	06071	34.14538027	-117.4590898	San Bernardino County
5558	Fee-for-Service	1326301227	1326301227	1	1	HERNANDEZ, HERMINIA PSY	4/27/2017	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
5605	Fee-for-Service	1649555616	1649555616	2	1	HOLY FAMILY HOSPICE	6/29/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7250 BEVERLY BLVD	SUITE 203	LOS ANGELES	CA	90036	2560	19	06037	34.07613953	-118.347669	Los Angeles County
5629	Fee-for-Service	1801280953	1801280953	1	1	HSUEH, PO-WEN MD FAAP	7/21/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	18688	None	None	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
5630	Fee-for-Service	1063732170	1063732170	1	1	HSU, EUGENE MD	7/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135201	05	Anesthesiology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	41	06081	37.43920432	-122.162109	Santa Clara County
5645	Fee-for-Service	1194739540	1194739540	1	1	HEIDERSBACH, JENNIFER O MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55142	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
5665	Fee-for-Service	1902448913	1902448913	1	1	HOLLIS, MYRA LMFT	8/7/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2716 S VERMONT AVE	UNIT 9	LOS ANGELES	CA	90007	2671	19	06037	34.029891	-118.2915225	Los Angeles County
5695	Fee-for-Service	1417996745	1417996745	1	1	HUNT, LEONEL A MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72199	20	Orthopedic Surgery	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
5718	Fee-for-Service	1235159054	1235159054	1	1	HONGOLA, JAMES R MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	24239	02	General Surgery	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
5731	Fee-for-Service	1275646317	1275646317	1	1	HENDERSON,PAULA C MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66348	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
5739	Fee-for-Service	1932579463	1932579463	1	1	HARMONY HEALTHCARE-EAST BAY	1/28/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	LLC	140 GREGORY LN	STE 270	PLEASANT HILL	CA	94523	3349	07	06013	37.94794183	-122.0649162	Contra Costa County
5742	Fee-for-Service	1780674507	1780674507	1	1	HAJALILOO, FARHAD J MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84010	20	Orthopedic Surgery	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
5786	Fee-for-Service	1831400811	1831400811	1	1	HANDLER, SUZANNE P MD INC	4/27/2010	207W00000X	NA	Ophthalmology	026	PHYSICIANS	69070	18	Ophthalmology	0	In state provider	None	3900 FIFTH AVENUE	SUITE 270	SAN DIEGO	CA	92103	3137	37	06073	32.748516	-117.1604695	San Diego County
5833	Fee-for-Service	1053327049	1053327049	1	1	HERRMANN, MICHAEL J MD	8/24/2004	207L00000X	NA	Other	026	PHYSICIANS	80684	05	Anesthesiology	0	In state provider	None	1650 CREEKSIDE DR	None	FOLSOM	CA	95630	3400	34	06067	38.67021	-121.145382	Sacramento County
5834	Fee-for-Service	1841322195	1841322195	1	1	HOFFMAYER, KURT S MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	98256	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
5858	Fee-for-Service	1245217587	1245217587	1	1	HANDLER, SHERYL M MD	6/4/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	60161	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
5868	Fee-for-Service	1225208077	1225208077	1	1	HORI, GENE MD INC	11/30/1993	208800000X	NA	Other	026	PHYSICIANS	64261	34	Urology and Urological Surgery	0	In state provider	None	4251 S HIGUERA ST	STE 402	SAN LUIS OBISPO	CA	93401	7740	40	06079	35.24181209	-120.6767798	San Luis Obispo County
5879	Fee-for-Service	1386843001	1386843001	1	1	HWANG, CATHY MD	11/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108517	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
5888	Fee-for-Service	1003139445	1003139445	1	1	HENRY, JOSEPH MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116018	41	Internal Medicine	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
5910	Fee-for-Service	1881608594	1881608594	1	1	HUSSAIN, FAHEEM MD	11/5/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	168073	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
5914	Fee-for-Service	1609055094	1609055094	1	1	HASSID, ARASH R	6/28/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	43112 N 15TH STREET W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
5919	Fee-for-Service	1417006701	1417006701	1	1	HOANG, YEN MD	3/29/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85761	None	None	0	In state provider	None	3628 E IMPERIAL HWY	STE 200	LYNWOOD	CA	90262	2646	19	06037	33.93070837	-118.2044557	Los Angeles County
5982	Fee-for-Service	1033147632	1033147632	1	1	HULT, ROBIN A DC	10/13/2004	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1109 HARTNELL AVE	STE 5	REDDING	CA	96002	2257	45	06089	40.56377229	-122.3507568	Shasta County
5994	Fee-for-Service	1699854257	1699854257	1	1	HARRIS,JAMES B	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	83403	0000	00	None	43.470198	-111.9901955	Bonneville County
5999	Fee-for-Service	1902363047	1902363047	1	1	HETTINGA, LORENA LMFT	1/24/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4043 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	0000	15	06029	35.35411151	-119.0532915	Kern County
6007	Fee-for-Service	1851316822	1851316822	1	1	HAYNES, BETH A PHD	9/1/2000	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	830 RIM CREST DR	None	WESTLAKE VILLAGE	CA	91361	2047	56	06111	34.1562681	-118.8338085	Ventura County
6010	Fee-for-Service	1073864427	1073864427	1	1	HOLLOWAY, JOVANNI L LCSW	1/14/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
6016	Fee-for-Service	1235615501	1235615501	1	1	HEALTHRIGHT360	7/27/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1835 CUNNINGHAM AVE	None	SAN JOSE	CA	95122	1712	43	06085	37.33159025	-121.8306882	Santa Clara County
6050	Fee-for-Service	1740441971	1740441971	1	1	HAYWARD, ROBERT M MD	5/11/2020	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	115245	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
6136	Fee-for-Service	1205914850	1205914850	1	1	HOLEYFIELD, KATHRYN C MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	77652	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
6143	Fee-for-Service	1790929164	1790929164	1	1	HAM, SUNG W MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103684	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
6167	Fee-for-Service	1992060198	1992060198	1	1	HASHMI, SYED S MD	8/4/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149745	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
6168	Fee-for-Service	1225056906	1225056906	1	1	HYDE, PAUL MD INC	12/12/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	32646	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9850 GENESEE AVE	STE 660	LA JOLLA	CA	92037	1231	37	06073	32.882913	-117.226341	San Diego County
6212	Fee-for-Service	1396334926	1396334926	1	1	HOUSE OF GRACE LLC	10/25/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2815 E MESA DRIVE	None	WEST COVINA	CA	91791	2223	19	06037	34.06765491	-117.885232	Los Angeles County
6213	Fee-for-Service	1316974561	1316974561	1	1	HOANG, MINH Q MD	8/29/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80102	40	Pediatrics	0	In state provider	None	10362 BOLSA AVE	None	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
6226	Fee-for-Service	1336320589	1336320589	1	1	HARLAN, KATHLEEN J	3/27/1996	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	333 N PRAIRIE AVE	None	INGLEWOOD	CA	90301	4501	19	06037	33.9670722	-118.3439911	Los Angeles County
6236	Fee-for-Service	1548396328	1548396328	1	1	HOYLE, LINDA J LMFT	6/25/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3628 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2153	15	06029	35.35426453	-119.045007	Kern County
6242	Fee-for-Service	1659512325	1659512325	1	1	HARBINDER S BRAR MD INC	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	40011	15	Obstetrics (D.O. only)	0	In state provider	None	3637 ARLINGTON AVE	SUITE 202	RIVERSIDE	CA	92506	3920	33	06065	33.94628551	-117.394335	Riverside County
6243	Fee-for-Service	1942563226	1942563226	1	1	HAYES, CHELSEA A MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	117944	68	Hematology	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1864	19	06037	34.07671715	-118.3799413	Los Angeles County
6247	Fee-for-Service	1326224858	1326224858	1	1	HUANG, HUI MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104196	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
6257	Fee-for-Service	1437294469	1437294469	1	1	HOU, LAWRENCE C MD	9/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89635	18	Ophthalmology	0	In state provider	None	1700 ALHAMBRA BLVD	STE 202	SACRAMENTO	CA	95816	7050	34	06067	38.564847	-121.469121	Sacramento County
6276	Fee-for-Service	1437134186	1437134186	1	1	HANNON, MATTHEW P MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93101	02	General Surgery	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
6294	Fee-for-Service	1740296730	1740296730	1	1	HARRIS, DIXIE L. MD	5/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	170 N 1100 E	None	AMERICAN FORK	UT	84003	2096	00	None	40.38039	-111.769053	Utah County
6308	Fee-for-Service	1598936171	1598936171	1	1	HYNDS, KELLIE M LMFT	7/21/2020	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
6355	Fee-for-Service	1962405290	1962405290	1	1	HAYASHI, GRANT M MD	10/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	1	Border provider	None	1350 STARDUST ST	STE D	RENO	NV	89503	4264	00	None	39.52858204	-119.8347915	Washoe County
6366	Fee-for-Service	1518457761	1518457761	1	1	HUYNH, HUONG N DO	6/9/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18218	None	None	0	In state provider	None	802 W. COLTON AVE	SUITE E	REDLANDS	CA	92374	2905	36	06071	34.06290649	-117.1918845	San Bernardino County
6384	Fee-for-Service	1790814168	1790814168	1	1	HARRADINE, BRANT P MD	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98648	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
6397	Fee-for-Service	1982771564	1982771564	1	1	HAUBURSIN, SCOTT	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
6400	Fee-for-Service	1023128741	1023128741	1	1	HARF, ROBERT A MD	4/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	40626	20	Orthopedic Surgery	0	In state provider	ROBERT HARF ORTHOPEDICS	181 ANDRIEUX ST	STE 111	SONOMA	CA	95476	6920	49	06097	38.28809911	-122.4613026	Sonoma County
6457	Fee-for-Service	1225056906	1225056906	1	1	HYDE, PAUL MD INC	12/12/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	32646	02	General Surgery	0	In state provider	None	9850 GENESEE AVE	STE 660	LA JOLLA	CA	92037	1231	37	06073	32.882913	-117.226341	San Diego County
6476	Fee-for-Service	1841469640	1841469640	1	1	HAN, EDGAR H DO	1/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9856	25	Physical Medicine and Rehabilitation	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
6499	Fee-for-Service	1598936346	1598936346	1	1	HANKIN, DINA C PHD	3/29/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
6507	Fee-for-Service	1770930992	1770930992	1	1	HALEY, LIN T LMFT	8/13/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1151 BROADWAY	SUITE 103	SONOMA	CA	95476	7583	49	06097	38.28016015	-122.4596884	Sonoma County
6513	Fee-for-Service	1538709324	1538709324	1	1	HAVEN OF SANDPOINTE LLC	3/30/2022	314000000X	NA	Skilled Nursing Facility	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	1	Border provider	None	2222 S AVENUE A	None	YUMA	AZ	85364	8315	00	None	32.68693033	-114.6333332	Yuma County
6521	Fee-for-Service	1467685677	1467685677	1	1	HARB, JAD MD	10/18/2022	207R00000X	NA	Other	026	PHYSICIANS	174584	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
6524	Fee-for-Service	1811697527	1811697527	1	1	HOUSE OF GRACE 3 INC	4/6/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2178 URSINUS CIRCLE	None	CLAREMONT	CA	91711	1817	19	06037	34.12381444	-117.7133615	Los Angeles County
6535	Fee-for-Service	1760906663	1760906663	1	1	HERRERA, ASHLEIGH N C LCSW	5/22/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	77652	-	NOT APPLICABLE	0	In state provider	None	6838 SUNSET BLVD	None	HOLLYWOOD	CA	90028	7008	19	06037	34.09794248	-118.340001	Los Angeles County
6539	Fee-for-Service	1356536965	1356536965	1	1	HERITAGE ESTATES, INC	3/26/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	304 WAWONA ST	None	MANTECA	CA	95337	6819	39	06077	37.78930714	-121.2196834	San Joaquin County
6548	Fee-for-Service	1841806924	1841806924	1	1	HICKS JR, DANNY R LPCC	6/7/2024	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
6565	Fee-for-Service	1033621610	1033621610	1	1	HEATHER BERRY COUNSELING INC	9/14/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14 SIERRA DR	STE A	KERNVILLE	CA	93238	1006	15	06029	35.75584104	-118.4202673	Kern County
6601	Fee-for-Service	1770037236	1770037236	2	3	HOSPITAL MEDICINE OF CALIFOR	6/20/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	NIA, INC.	1010 MURRAY AVE	None	SAN LUIS OBISPO	CA	93405	1806	40	06079	35.292168	-120.6658665	San Luis Obispo County
6680	Fee-for-Service	1427150531	1427150531	1	1	HEINRICH, MICHAEL R MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53480	01	General Practice	0	In state provider	None	275 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
6688	Fee-for-Service	1093728693	1093728693	1	1	HUANG, ELSIE H MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	63808	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6614 MERCY CT	None	FAIR OAKS	CA	95628	3133	34	06067	38.665863	-121.3103205	Sacramento County
6724	Fee-for-Service	1932287927	1932287927	1	1	HOFFMAN, DOUGLAS S MD	2/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	72930	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94956	5318	07	06013	37.89189148	-122.057999	Contra Costa County
6730	Fee-for-Service	1144301433	1144301433	1	1	HAU, THOMAS L MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129325	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 HOSPITAL PARKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
6735	Fee-for-Service	1912051715	1912051715	1	1	HOSEIN, NADEEN MD	5/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113255	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
6740	Fee-for-Service	1346566221	1346566221	1	1	HOFFMAN, ARI B M MD	10/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120766	01	General Practice	0	In state provider	None	400 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
6748	Fee-for-Service	1578300786	1578300786	1	1	HINOJOSA, EVELYN DOULA	12/31/2024	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
6755	Fee-for-Service	1992755391	1992755391	1	2	HYAMS, DAVID M MD	3/22/2019	2086X0206X	NA	General Surgery	026	PHYSICIANS	42387	02	General Surgery	0	In state provider	None	39000 BOB HOPE DR	KIEWIT BUILDING SUITE 20	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
6780	Fee-for-Service	1659519304	1659519304	1	1	HANGER P & O WEST INC	6/18/2009	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	201 S BUENA VISTA ST	#240 & 245	BURBANK	CA	91505	4555	19	06037	34.15978726	-118.3289164	Los Angeles County
6787	Fee-for-Service	1073533345	1073533345	1	1	HABIBI, HOSSEIN MD	10/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	43718	34	Urology and Urological Surgery	0	In state provider	None	175 N JACKSON AVE	STE 206	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
6788	Fee-for-Service	1952478877	1952478877	1	1	HESS, EDWARD A MD	1/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	40603	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
6804	Fee-for-Service	1306194469	1306194469	1	1	HO, GARY OD	7/3/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1033 THIRD ST	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
6811	Fee-for-Service	1376816231	1376816231	1	1	HERNANDEZ, COLLEEN LMFT	11/13/2018	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
6814	Fee-for-Service	1861036691	1861036691	1	1	HOOD, TERESA LMFT	11/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	790 MASON ST	STE 102	VACAVILLE	CA	95688	4661	48	06095	38.3550515	-121.9832505	Solano County
6818	Fee-for-Service	1407192438	1407192438	1	1	HOLM, AMY J NP	9/28/2018	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
6834	Fee-for-Service	1982953329	1982953329	1	1	HARRIS, LILLIAN CNP	12/9/2015	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
6839	Fee-for-Service	1639555725	1639555725	1	1	HOSSEINI, SAMIRA LCSW	10/27/2021	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
6854	Fee-for-Service	1205468451	1205468451	1	1	HUYNH, JIMMY LMFT	5/13/2024	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
6863	Fee-for-Service	1093757247	1093757247	1	1	HUANG, EUGENE MD	8/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86671	05	Anesthesiology	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
6872	Fee-for-Service	1417472424	1417472424	1	1	HENNEN, ARAINA L LCSW	4/11/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	WORK	1201 PINE ST	334	OAKLAND	CA	94607	1470	01	06001	37.81256172	-122.3002425	Alameda County
6889	Fee-for-Service	1245233717	1245233717	2	1	HUSSEIN, FATIMA Y MD	5/2/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	175219	None	None	0	In state provider	None	1007 E COOLEY DR	STE 111	COLTON	CA	92324	3901	36	06071	34.05461152	-117.310599	San Bernardino County
6904	Fee-for-Service	1457574071	1457574071	1	1	HAAS, DOROTHY C	1/13/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	10850 ARROW ROUTE	None	RANCHO CUCAMONGA	CA	91730	4833	36	06071	34.0991609	-117.5680267	San Bernardino County
6912	Fee-for-Service	1124138359	1124138359	1	1	HO, VINCENT MD	8/31/1990	207R00000X	NA	Other	026	PHYSICIANS	47753	41	Internal Medicine	0	In state provider	None	1669 W AVENUE J	None	LANCASTER	CA	93534	2866	19	06037	34.68944746	-118.1608785	Los Angeles County
6931	Fee-for-Service	1306378690	1306378690	1	1	HONG, BRYANT MD	7/1/2021	390200000X	NA	Other	026	PHYSICIANS	160732	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
6973	Fee-for-Service	1477588051	1477588051	1	1	HOYER, WILLIAM F OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	112 W 1ST ST	None	CLOVERDALE	CA	95425	3607	49	06097	38.80497622	-123.0176553	Sonoma County
6974	Fee-for-Service	1093131484	1093131484	1	1	HUGHES, MEAGAN MD	7/18/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	134936	07	Dermatology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
6991	Fee-for-Service	1033316195	1033316195	1	1	HSIAO, JONIE J MD	2/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105960	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
7026	Fee-for-Service	1407524606	1407524606	1	1	HAWES, KELLY BIRTH DOULA	6/14/2024	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	27	06053	0	0	None
7028	Fee-for-Service	1023043189	1023043189	2	1	HAHN, CLAN H	8/29/2017	207RH0003X	NA	Oncology	026	PHYSICIANS	78245	68	Hematology	0	In state provider	None	500 S VIRGIL AVE	SUITE 502	LOS ANGELES	CA	90020	1404	19	06037	34.064964	-118.2870335	Los Angeles County
7076	Fee-for-Service	1952478877	1952478877	1	1	HESS, EDWARD A MD	1/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	40603	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
7152	Fee-for-Service	1861593253	1861593253	1	1	HAR, UN HUI MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78027	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
7153	Fee-for-Service	1518557826	1518557826	1	1	HURYK, KATHRYN M PHD	7/8/2021	103T00000X	NA	Mental Health Outpatient Services	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
7156	Fee-for-Service	1659106334	1659106334	1	1	HURANI, SARA	11/4/2024	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
7168	Fee-for-Service	1598815987	1598815987	1	1	HASSAN KANJ MD	3/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	20 WILLS WAY	None	PISCATAWAY	NJ	08854	3770	00	None	40.55456671	-74.47696318	Middlesex County
7171	Fee-for-Service	1831385020	1831385020	1	1	HINSON, KRYSTA V LMFT	2/7/2024	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
7172	Fee-for-Service	1770037236	1770037236	2	4	HOSPITAL MEDICINE OF CALIFOR	6/20/2023	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	NIA, INC.	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
7205	Fee-for-Service	1114218401	1114218401	1	1	HAGIYA, ASHLEY S MD	8/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121552	22	Pathology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06269295	-118.2030006	Los Angeles County
7213	Fee-for-Service	1659512325	1659512325	1	3	HARBINDER S BRAR MD INC	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	40011	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	81880 DOCTOR CARREON BLV	STE C202	INDIO	CA	92201	5587	33	06065	33.70742953	-116.23572	Riverside County
7258	Fee-for-Service	1174694087	1174694087	1	1	HSIA, PATRICIA C MD	9/18/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67035	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
7264	Fee-for-Service	1932626553	1932626553	1	1	HUO, COREEN K MD	10/7/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	None	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
7268	Fee-for-Service	1013277466	1013277466	1	1	HOSPICE CARE PROVIDERS INC	10/15/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	9581 BUSINESS CENTER DR	BLDG 12 SUITE H	RANCHO CUCAMONGA	CA	91730	4556	36	06071	34.09805648	-117.595944	San Bernardino County
7280	Fee-for-Service	1245625326	1245625326	1	1	HAKIMIAN, SHAHRAD MD	4/6/2021	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	171473	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
7296	Fee-for-Service	1831153048	1831153048	1	1	HUGHES, LISA B MD	10/30/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170488	30	Radiology	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
7299	Fee-for-Service	1790703288	1790703288	1	1	HACKLEY, DAVID R MD	11/30/1995	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	75801	20	Orthopedic Surgery	0	In state provider	None	9850 GENESEE AVE	STE 210	LA JOLLA	CA	92037	1206	37	06073	32.882913	-117.226341	San Diego County
7386	Fee-for-Service	1609946110	1609946110	1	1	HARTFORD, IRVING H	1/1/1983	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27875 BERWICK DR	None	CARMEL	CA	93923	8678	27	06053	36.52204244	-121.8087006	Monterey County
7431	Fee-for-Service	1437144367	1437144367	1	1	HEDRICK, WINTHROP B DO	5/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	7953	01	General Practice	0	In state provider	None	52 MISSION CIRCLE	SUITE 121	SANTA ROSA	CA	95409	5370	49	06097	38.457882	-122.674104	Sonoma County
7435	Fee-for-Service	1679514012	1679514012	1	1	HALDERMAN, JAMES R MD	11/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	68157	05	Anesthesiology	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
7440	Fee-for-Service	1861593253	1861593253	1	1	HAR, UN HUI MD	10/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78027	01	General Practice	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
7456	Fee-for-Service	1811158728	1811158728	1	1	HART0NIAN, IVET MD	5/1/2013	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	9320 TELSTAR AVE	SUITE 226	EL MONTE	CA	91731	2816	19	06037	34.06878549	-118.066401	Los Angeles County
7478	Fee-for-Service	1497892533	1497892533	1	1	HELMUTH, KAREN L PSYD	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
7509	Fee-for-Service	1154312429	1154312429	1	1	HURON REGIONAL MED CTR	4/22/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	172 4TH ST SE	None	HURON	SD	57350	2510	00	None	44.36199848	-98.211186	Beadle County
7549	Fee-for-Service	1174694087	1174694087	1	1	HSIA, PATRICIA C MD	9/18/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67035	10	Gastroenterology (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
7552	Fee-for-Service	1205947884	1205947884	1	1	HOSSEINI, MEHRA MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79483	10	Gastroenterology (M.D. only)	0	In state provider	None	2999 REGENT ST	STE 425	BERKELEY	CA	94705	2119	01	06001	37.85592021	-122.2566436	Alameda County
7556	Fee-for-Service	1013277466	1013277466	1	1	HOSPICE CARE PROVIDERS INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	9581 BUSINESS CENTER DR	BLDG 12 SUITE H	RANCHO CUCAMONGA	CA	91730	4556	36	06071	34.09805648	-117.595944	San Bernardino County
7562	Fee-for-Service	1942578646	1942578646	1	1	HALL, STACY A	1/4/2012	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	480 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13286634	-121.6142652	Sutter County
7567	Fee-for-Service	1467169391	1467169391	1	1	HINES, REBECCA LMFT	1/16/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	814 BROADWAY	None	SONOMA	CA	95476	7584	49	06097	38.28627132	-122.4586519	Sonoma County
7570	Fee-for-Service	1174534101	1174534101	1	1	HAMIDI, MAHSHID M MD	2/16/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63702	08	Family Practice	0	In state provider	SAN DIEGO ASSOCIATES	5222 BALBOA AVE	STE 31	SAN DIEGO	CA	92117	6952	37	06073	32.81873589	-117.1838368	San Diego County
7600	Fee-for-Service	1063801488	1063801488	1	1	HEALTHY LIVING AT HOME	7/8/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	MONTEREY LLC	2100 GARDEN ROAD	SUITE I	MONTEREY	CA	93940	5366	27	06053	36.58615983	-121.8608488	Monterey County
7646	Fee-for-Service	1720761810	1720761810	1	1	HAUGABROOK, ADESOLA Y BIRTH	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
7663	Fee-for-Service	1093012452	1093012452	1	1	HANSON, JENNIFER C MD	3/12/2021	363LP0200X	NA	Nurse Practitioner	026	PHYSICIANS	116732	None	None	0	In state provider	None	160 GLEN COVE MARINA	103	VALLEJO	CA	94591	7290	48	06095	38.07062486	-122.2124251	Solano County
7667	Fee-for-Service	1811316755	1811316755	1	1	HUEN, KATHY H MD	5/11/2022	208800000X	NA	Other	026	PHYSICIANS	139956	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
7678	Fee-for-Service	1447978093	1447978093	1	1	HASKIN, BRENDA LPCC	10/18/2022	101YM0800X	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
7690	Fee-for-Service	1659512325	1659512325	1	6	HARBINDER S BRAR MD INC	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	40011	01	General Practice	0	In state provider	None	25109 JEFERSON AVE	STE 210	MURRIETA	CA	92562	5109	33	06065	33.55410071	-117.2028115	Riverside County
7711	Fee-for-Service	1720519127	1720519127	1	1	HAIBER, KAREN E MD	8/2/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	158841	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
7743	Fee-for-Service	1780670091	1780670091	1	1	HIRSCHFIELD, KRISTINE MD	3/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93777	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
7797	Fee-for-Service	1154312429	1154312429	1	1	HURON REGIONAL MED CTR	4/22/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	172 4TH ST SE	None	HURON	SD	57350	2510	00	None	44.36199848	-98.211186	Beadle County
7826	Fee-for-Service	1336778844	1336778844	1	1	HARTUNG, CHAYCE W MD	8/3/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187954	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
7839	Fee-for-Service	1205947884	1205947884	1	1	HOSSEINI, MEHRA MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79483	41	Internal Medicine	0	In state provider	None	2999 REGENT ST	STE 425	BERKELEY	CA	94705	2119	01	06001	37.85592021	-122.2566436	Alameda County
7840	Fee-for-Service	1720216179	1720216179	1	1	HEART, ANITA D MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117596	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
7865	Fee-for-Service	1417690975	1417690975	1	1	HETZEL RAMOS, CASEY L BIRTH	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	37	06073	0	0	None
7949	Fee-for-Service	1083259360	1083259360	1	1	HARRISON, LINDA E NP	12/3/2021	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
7957	Fee-for-Service	1790128163	1790128163	1	1	HARRYSSON, ILIANA N V J MD	5/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131905	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
7974	Fee-for-Service	1659512325	1659512325	1	9	HARBINDER S BRAR MD INC	5/26/2020	174400000X	NA	Other	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	1740 PLUM LN	STE B	REDLANDS	CA	92374	0109	36	06071	34.06899169	-117.2145582	San Bernardino County
7980	Fee-for-Service	1659512325	1659512325	1	6	HARBINDER S BRAR MD INC	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	40011	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	25109 JEFERSON AVE	STE 210	MURRIETA	CA	92562	5109	33	06065	33.55410071	-117.2028115	Riverside County
7994	Fee-for-Service	1659512325	1659512325	1	10	HARBINDER S BRAR MD INC	10/25/2024	174400000X	NA	Other	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	None	102 E 6TH ST	STE 200	CORONA	CA	92879	1450	33	06065	33.87540602	-117.5666997	Riverside County
8000	Fee-for-Service	1558698407	1558698407	1	1	HOLDEN, ARTHUR E JR PSY	1/23/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	9379	-	NOT APPLICABLE	0	In state provider	None	1225/1227 W 6TH ST	None	SANTA ANA	CA	92703	2101	30	06059	33.74968219	-117.8838075	Orange County
8012	Fee-for-Service	1649081621	1649081621	1	1	HOOPER, GABRIELLE M CRNA	4/29/2025	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
8015	Fee-for-Service	1457383267	1457383267	1	1	HEIDERHOFF,CLEMENS	6/14/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	234 E 149TH STREET	None	BRONX	NY	10451	5504	00	None	40.817538	-73.9240965	Bronx County
8044	Fee-for-Service	1124365911	1124365911	1	1	HEIDI WESTERN,DC	6/14/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1150 PRAIRIE PKWY	STE 102	WEST FARGO	ND	58078	3168	00	None	46.86369557	-96.88476354	Cass County
8053	Fee-for-Service	1477601490	1477601490	1	1	HONG, THOMAS S CRNA	8/7/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1805 N CALIFORNIA ST	STE 101	STOCKTON	CA	95204	6032	39	06077	37.9711691	-121.2894221	San Joaquin County
8092	Fee-for-Service	1750316030	1750316030	1	1	HSIAO, EDWARD C MD	5/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85538	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
8105	Fee-for-Service	1326063496	1326063496	1	1	HAUBRICH, RICHARD H MD	7/30/1990	207R00000X	NA	Other	026	PHYSICIANS	53356	77	Infectious Disease	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
8137	Fee-for-Service	1023210069	1023210069	1	1	HESS, CONNIE N MD	9/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (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
8156	Fee-for-Service	1437646031	1437646031	1	1	HUANG, PAMELA MD	6/8/2022	207L00000X	NA	Other	026	PHYSICIANS	168223	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
8198	Fee-for-Service	1588748115	1588748115	1	1	HEMET HEART MEDICAL CNTR	11/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1275 E LATHAM AVE	SUITE A	HEMET	CA	92543	4424	33	06065	33.74938248	-116.9589555	Riverside County
8215	Fee-for-Service	1932155223	1932155223	1	1	HOOPER, ALLEN H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30054	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
8249	Fee-for-Service	1598714800	1598714800	1	1	HARRIS, RUSSELL H MD	5/16/2023	207P00000X	NA	Other	026	PHYSICIANS	183782	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
8270	Fee-for-Service	1922028539	1922028539	1	1	HIGH DESERT NEURO-DIAG	4/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP INC	18523 CORWIN RD	STE A	APPLE VALLEY	CA	92307	2300	36	06071	34.54095703	-117.2601143	San Bernardino County
8291	Fee-for-Service	1306253422	1306253422	1	1	HAUSBERGER, MICHAEL D DO	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16343	66	Emergency Medicine (Urgent Care)	0	In state provider	None	275 HOSPITAL DRIVE	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
8317	Fee-for-Service	1407464225	1407464225	1	1	HUNT, EMILY PHD	10/11/2024	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
8347	Fee-for-Service	1740964915	1740964915	1	1	H&Z HOMECARE INC	10/11/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	4020 EL CAMINO AVE	STE D3	SACRAMENTO	CA	95821	6674	34	06067	38.609793	-121.369545	Sacramento County
8352	Fee-for-Service	1184796419	1184796419	1	1	HOLLAND, KEVIN W MD	12/31/1993	2085R0001X	NA	Other	026	PHYSICIANS	78918	78	Neoplastic Diseases/Oncology	0	In state provider	None	4747 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
8395	Fee-for-Service	1215979380	1215979380	1	1	HONDA, SHARON N MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83165	40	Pediatrics	0	In state provider	None	502 TORRANCE BLVD	None	REDONDO BEACH	CA	90277	3413	19	06037	33.83783749	-118.3832414	Los Angeles County
8424	Fee-for-Service	1457780165	1457780165	1	1	HAMLIN, KATHRYN E MD	3/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133158	01	General Practice	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
8439	Fee-for-Service	1932761608	1932761608	1	1	HERRERA, JOSE R CRNA	7/12/2019	367500000X	NA	Other	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
8461	Fee-for-Service	1922272707	1922272707	2	1	HOWELL, THOMAS J MD	4/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109350	40	Pediatrics	0	In state provider	None	2880 ATLANTIC AVE	SUITE 170	LONG BEACH	CA	90806	1715	19	06037	33.809382	-118.185001	Los Angeles County
8463	Fee-for-Service	1578598199	1578598199	1	1	HOLLEY, SHAY MD	4/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 E 3900 S	None	SALT LAKE CTY	UT	84124	1300	00	None	40.68703142	-111.857243	Salt Lake County
8487	Fee-for-Service	1588748115	1588748115	1	1	HEMET HEART MEDICAL CNTR	11/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1275 E LATHAM AVE	SUITE A	HEMET	CA	92543	4424	33	06065	33.74938248	-116.9589555	Riverside County
8491	Fee-for-Service	1700987211	1700987211	1	1	HACKMANN, AMY E MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107448	33	Thoracic Surgery	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
8544	Fee-for-Service	1720012107	1720012107	1	1	HENTZ, ROBERT MD	10/18/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	147601	08	Family Practice	0	In state provider	None	717 CENTER ST	None	HEALDSBURG	CA	95448	3604	49	06097	38.61783	-122.8707965	Sonoma County
8571	Fee-for-Service	1679300222	1679300222	1	1	HERNANDEZ, LYN NP	10/16/2024	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
8574	Fee-for-Service	1891365722	1891365722	1	1	HAYNES, CRYSTAL L CNP	9/29/2022	363LF0000X	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
8594	Fee-for-Service	1295726347	1295726347	1	1	HOREJSI, JOSEPH M MD	2/28/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55701	47	Miscellaneous	0	In state provider	None	3160 RED HILL AVE	None	COSTA MESA	CA	92626	3402	30	06059	33.68024793	-117.8734988	Orange County
8620	Fee-for-Service	1437173804	1437173804	1	1	HIGH DESERT HEART	3/3/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INSTITUTE	12780 HESPERIA RD	None	VICTORVILLE	CA	92395	4796	36	06071	34.4833646	-117.2904386	San Bernardino County
8635	Fee-for-Service	1598786444	1598786444	1	1	HARRITY, WILLIAM V MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	58058	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 S LAKE AVE	STE 535	PASADENA	CA	91101	3010	19	06037	34.141905	-118.1323975	Los Angeles County
8681	Fee-for-Service	1215979380	1215979380	1	1	HONDA, SHARON N MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83165	41	Internal Medicine	0	In state provider	None	502 TORRANCE BLVD	None	REDONDO BEACH	CA	90277	3413	19	06037	33.83783749	-118.3832414	Los Angeles County
8706	Fee-for-Service	1972576841	1972576841	1	1	HUANG, WEI MD	6/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79966	41	Internal Medicine	0	In state provider	None	133 N ALTADENA DR	2N FL	PASADENA	CA	91107	7325	19	06037	34.14843	-118.0986385	Los Angeles County
8759	Fee-for-Service	1881912871	1881912871	1	1	HIROHAMA, DAVID H PHD	1/7/2011	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	17215 STUDEBAKER RD	STE 110	CERRITOS	CA	90703	2521	19	06037	33.874686	-118.0998595	Los Angeles County
8780	Fee-for-Service	1700987211	1700987211	1	1	HACKMANN, AMY E MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107448	02	General Surgery	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
8791	Fee-for-Service	1255170791	1255170791	1	1	HUMPHREYS, JUSTIN CRNA	8/12/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
8793	Fee-for-Service	1114481835	1114481835	1	1	HAMILTON, KATHERINE A PT	4/26/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
8829	Fee-for-Service	1487045043	1487045043	1	1	HOLLIS, KIMMIL J LMFT	4/29/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4849 RONSON CT	SUITE 207	SAN DIEGO	CA	92111	1805	37	06073	32.83028739	-117.1459009	San Diego County
8838	Fee-for-Service	1558781807	1558781807	1	1	HOLLOWAY, BRIAN A MD	8/10/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	143055	07	Dermatology	0	In state provider	None	2950 RESEARCH PARK DR	None	SOQUEL	CA	95073	2000	44	06087	36.98692657	-121.9685264	Santa Cruz County
8851	Fee-for-Service	1417301128	1417301128	1	1	HO, BAO MD	6/14/2019	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
8853	Fee-for-Service	1164572715	1164572715	1	1	HALL, SUSAN J P MD INC	5/1/2003	193400000X	NA	Other	026	PHYSICIANS	76766	08	Family Practice	0	In state provider	None	432 W J ST	STE A	TEHACHAPI	CA	93561	1349	15	06029	35.13547731	-118.4538972	Kern County
8865	Fee-for-Service	1609001908	1609001908	1	1	HAMIDUZZAMAN, KAUSAR MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142988	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
8879	Fee-for-Service	1184772055	1184772055	1	1	HARTMAN, C THOMAS JR MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25306	03	Allergy	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
8910	Fee-for-Service	1437173804	1437173804	1	1	HIGH DESERT HEART	3/3/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	INSTITUTE	12780 HESPERIA RD	None	VICTORVILLE	CA	92395	4796	36	06071	34.4833646	-117.2904386	San Bernardino County
8933	Fee-for-Service	1629263231	1629263231	1	1	HERITAGE ESTATES, INC	9/4/1986	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	790 TAHOE STREET	None	MANTECA	CA	95337	6817	39	06077	37.78668628	-121.225948	San Joaquin County
8999	Fee-for-Service	1184799017	1184799017	1	1	HILLEMAN, RICHARD D DC	6/5/1992	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	8275 SIERRA AVE	SUITE 104	FONTANA	CA	92335	3557	36	06071	34.103448	-117.435754	San Bernardino County
9080	Fee-for-Service	1932724705	1932724705	1	1	HAMBURGER, ANNA N CCC-SLP	1/12/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3140 KEARNEY ST.	None	FREMONT	CA	94538	2292	01	06001	37.54882758	-121.9749511	Alameda County
9100	Fee-for-Service	1134633845	1134633845	1	1	HAN, DAVID LCSW	1/8/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9942 BROADWAY	None	ANAHEIM	CA	92804	2308	30	06059	33.82885329	-117.9595736	Orange County
9133	Fee-for-Service	1467634436	1467634436	1	1	HONG, WAN-JEN MD	10/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	105339	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
9136	Fee-for-Service	1356449425	1356449425	1	1	HENDERSON,TREVOR H MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65341	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
9152	Fee-for-Service	1609001908	1609001908	1	1	HAMIDUZZAMAN, KAUSAR MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142988	45	Nephrology (Renal-Kidney)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
9176	Fee-for-Service	1417978461	1417978461	1	1	HERBERT'S PHARMACY	7/10/1987	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9001 WILSHIRE BLVD	SUITE 101	BEVERLY HILLS	CA	90211	1839	19	06037	34.06708548	-118.3880025	Los Angeles County
9192	Fee-for-Service	1942229885	1942229885	1	1	HILLCREST SURG MED GRP I	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	4060 4TH AVE	STE 330	SAN DIEGO	CA	92103	2190	37	06073	32.75053673	-117.1616539	San Diego County
9193	Fee-for-Service	1932515970	1932515970	1	1	HAMMAM YAHYA	3/12/2019	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	2719	00	None	35.08771808	-106.6192188	Bernalillo County
9212	Fee-for-Service	1467997700	1467997700	1	1	HIDY, NATALIE PT	10/20/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1520 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	2379	19	06037	34.01926577	-118.1154058	Los Angeles County
9221	Fee-for-Service	1598323891	1598323891	1	1	HELPING HANDS HOSPICE CARE	2/28/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	2221 W OLIVE AVE	SUITE E	BURBANK	CA	91506	2600	19	06037	34.16315855	-118.3275742	Los Angeles County
9230	Fee-for-Service	1326087917	1326087917	1	1	HAGER, STEVEN J DO	3/26/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	1836	68	Hematology	0	In state provider	None	7257 N FRESNO ST	None	FRESNO	CA	93720	2950	10	06019	36.84225164	-119.7833937	Fresno County
9283	Fee-for-Service	1174601934	1174601934	1	1	HUANG, REGINA LINROL MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75382	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
9346	Fee-for-Service	1467460469	1467460469	1	1	HUYNH, KHA K MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	62484	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
9385	Fee-for-Service	1447519673	1447519673	1	1	HUANG, JOYCE	10/18/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	139796	40	Pediatrics	0	In state provider	None	160 E ARTESIA ST	STE 235	POMONA	CA	91767	2900	19	06037	34.07556833	-117.7507835	Los Angeles County
9420	Fee-for-Service	1467634436	1467634436	1	1	HONG, WAN-JEN MD	10/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	105339	68	Hematology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
9423	Fee-for-Service	1356449425	1356449425	1	1	HENDERSON,TREVOR H MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65341	40	Pediatrics	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
9432	Fee-for-Service	1710331871	1710331871	1	1	HARMS, DEBRA CCC-SLP	2/5/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3601 MARCONI AVE	None	SACRAMENTO	CA	95821	5309	34	06067	38.618109	-121.380255	Sacramento County
9435	Fee-for-Service	1013392448	1013392448	1	1	HODGSKISS, VALERIE W LMFT	6/12/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
9482	Fee-for-Service	1417946096	1417946096	1	1	HILDRETH, THOMAS A MD	9/25/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	38117	34	Urology and Urological Surgery	0	In state provider	None	1950 JEFFERSON ST	None	NAPA	CA	94559	1215	28	06055	38.30528099	-122.2948233	Napa County
9500	Fee-for-Service	1194195693	1194195693	1	1	HOANG-WU, TERESA V MD	11/4/2019	390200000X	NA	Other	026	PHYSICIANS	160482	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
9509	Fee-for-Service	1598323891	1598323891	1	1	HELPING HANDS HOSPICE CARE	2/28/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	GROUP INC	2221 W OLIVE AVE	SUITE E	BURBANK	CA	91506	2600	19	06037	34.16315855	-118.3275742	Los Angeles County
9513	Fee-for-Service	1891800538	1891800538	1	1	HENSLEY, ALLISON C MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65446	40	Pediatrics	0	In state provider	None	11401 HEACOCK ST	STE 330	MORENO VALLEY	CA	92557	7908	33	06065	33.954858	-117.243978	Riverside County
9518	Fee-for-Service	1326087917	1326087917	1	1	HAGER, STEVEN J DO	3/26/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	1836	41	Internal Medicine	0	In state provider	None	7257 N FRESNO ST	None	FRESNO	CA	93720	2950	10	06019	36.84225164	-119.7833937	Fresno County
9530	Fee-for-Service	1609985530	1609985530	1	1	HARTLIEB, DONALD C MD	1/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2075 EAST FLAMINGO RD	None	LAS VEGAS	NV	89119	5188	00	None	36.112671	-115.1248725	Clark County
9535	Fee-for-Service	1649339300	1649339300	1	1	HSU, JOHN C MD	10/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55731	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
9539	Fee-for-Service	1770037236	1770037236	2	2	HOSPITAL MEDICINE OF CALIFOR	9/9/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	NIA, INC.	7300 MEDICAL CENTER DR	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
9543	Fee-for-Service	1629480389	1629480389	1	1	HSU, CHIH-HSIN	7/29/2024	208M00000X	NA	Other	026	PHYSICIANS	168564	03	Allergy	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
9550	Fee-for-Service	1801854450	1801854450	1	1	HASSANEIN, TAREK I MD	1/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	54452	10	Gastroenterology (M.D. only)	0	In state provider	None	675 CAMINO DEL LOS MARES	STE 210	SAN CLEMENTE	CA	92673	2836	30	06059	33.45710369	-117.6474248	Orange County
9576	Fee-for-Service	1457489759	1457489759	1	1	HARBOR HEALTH CARE, INC	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9902 ROSE ST	None	BELLFLOWER	CA	90706	6915	19	06037	33.86963453	-118.122543	Los Angeles County
9578	Fee-for-Service	1235990193	1235990193	1	1	HOME CARE MEDICAL SUPPLIES L	7/8/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	LC	7616 FOOTHILL BLVD	UNIT 3	TUJUNGA	CA	91042	2185	19	06037	34.25503764	-118.2985085	Los Angeles County
9579	Fee-for-Service	1669447736	1669447736	1	1	HILLS, DAWN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	34407	02	General Surgery	0	In state provider	None	1560 E CHEVY CHASE DR	STE 255	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
9581	Fee-for-Service	1609289412	1609289412	1	1	HARPER, MARISOL M LCSW	5/3/2024	101YM0800X	NA	Other	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
9585	Fee-for-Service	1578913679	1578913679	1	1	HERNANDEZ, LISA M MFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1605 HOPE ST	STE 350	SOUTH PASADENA	CA	91030	2628	19	06037	34.11679363	-118.150088	Los Angeles County
9589	Fee-for-Service	1205984242	1205984242	1	1	HURST, SUSAN E NP	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6860 AVENIDA ENCINAS	None	CARLSBAD	CA	92009	3201	37	06073	33.10754269	-117.3146974	San Diego County
9592	Fee-for-Service	1215442199	1215442199	1	1	HERNANDEZ, ARIELLE M LMFT	12/27/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6800 INDIANA AVE	SUITE 130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
9599	Fee-for-Service	1013280668	1013280668	1	1	HASSON, ASHTON D LCSW	12/5/2023	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
9602	Fee-for-Service	1336670728	1336670728	1	1	HUSSAIN, SAMIYA MD	8/26/2020	207R00000X	NA	Other	026	PHYSICIANS	158803	41	Internal Medicine	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
9606	Fee-for-Service	1255095501	1255095501	1	1	HINEMAN, DANIELLE M NP	4/6/2022	363LP0222X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2825 CAPITOL AVE	None	SACRAMENTO	CA	95816	5615	34	06067	38.570805	-121.4696385	Sacramento County
9619	Fee-for-Service	1376984351	1376984351	1	1	HARATI, HADI MD	11/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141684	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
9644	Fee-for-Service	1467498121	1467498121	1	1	HOLLAND, WILLIAM 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	200 E CHESTNUT ST	None	LOUISVILLE	KY	40202	1831	00	None	38.24813211	-85.7507777	Jefferson County
9663	Fee-for-Service	1750650289	1750650289	1	1	HOLTZMAN, GENE ANNE	8/27/2024	363LG0600X	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
9666	Fee-for-Service	1306151386	1306151386	1	1	HASHIM, YASSAR M MD	9/14/2020	208600000X	NA	General Surgery	026	PHYSICIANS	131095	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
9695	Fee-for-Service	1356400980	1356400980	1	1	HARBAUGH, JOHN T MD	10/1/1998	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	47359	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
9709	Fee-for-Service	1467634436	1467634436	1	1	HONG, WAN-JEN MD	10/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	105339	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
9713	Fee-for-Service	1003875493	1003875493	1	1	HEALTHYLIFE INC	8/3/1999	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CENTER	11613 W. WASHINGTON BLVD	None	LOS ANGELES	CA	90066	0000	19	06037	34.00018629	-118.4174218	Los Angeles County
9720	Fee-for-Service	1528335841	1528335841	1	1	HECTOR LUQUE, D.O., INC.	2/23/2023	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	326 N SOTO ST	None	LOS ANGELES	CA	90033	1815	19	06037	34.04755972	-118.2072992	Los Angeles County
9743	Fee-for-Service	1962431940	1962431940	1	1	HELENIUS, MIKKO CHRISTOPHER	6/23/2010	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	89048	41	Internal Medicine	0	In state provider	MD	23795 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.57664711	-121.9143421	Monterey County
9774	Fee-for-Service	1023404118	1023404118	1	1	HARROW, BRIAN R MD	8/15/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	181119	None	None	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
9794	Fee-for-Service	1538681770	1538681770	1	1	HULSEY, SUMMER N LMFT	11/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3535 WEST COMMONWEALTH A	None	FULLERTON	CA	92833	2821	30	06059	33.8700505	-117.9749565	Orange County
9802	Fee-for-Service	1841752649	1841752649	1	1	HALPERIN, JEFFREY	2/4/2023	208M00000X	NA	Other	026	PHYSICIANS	182367	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
9805	Fee-for-Service	1326087917	1326087917	1	1	HAGER, STEVEN J DO	3/26/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	1836	78	Neoplastic Diseases/Oncology	0	In state provider	None	7257 N FRESNO ST	None	FRESNO	CA	93720	2950	10	06019	36.84225164	-119.7833937	Fresno County
9808	Fee-for-Service	1215384102	1215384102	1	1	HASEGAWA, IAN G MD	8/4/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	175724	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
9814	Fee-for-Service	1619109519	1619109519	1	1	HENDERSON, GREGORY P MD	8/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125261	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	STE 450,465	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
9828	Fee-for-Service	1093941973	1093941973	1	1	HOANG, HANH NGAN MD	8/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115323	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
9870	Fee-for-Service	1194149997	1194149997	1	1	HUNG, ERIN Y PT	8/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
9874	Fee-for-Service	1710244900	1710244900	1	1	HABECKER, ERIN L MD	5/16/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	165020	36	Psychiatry	0	In state provider	None	3454 HILLCREST AVE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
9907	Fee-for-Service	1134455710	1134455710	1	1	HART, TODD A LMFT	11/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ELING	576 B STREET	1A	SANTA ROSA	CA	95401	5269	49	06097	38.44377	-122.718393	Sonoma County
9913	Fee-for-Service	1780115741	1780115741	1	1	HIROTSU, KELSEY E MD	7/29/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	156863	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
9954	Fee-for-Service	1811370505	1811370505	1	1	HARRIS, MATTHEW MD	5/29/2018	390200000X	NA	Other	026	PHYSICIANS	153851	40	Pediatrics	0	In state provider	None	1640 NEWPORT BLVD	SUITE 210	COSTA MESA	CA	92627	3786	30	06059	33.63437128	-117.9221659	Orange County
9968	Fee-for-Service	1851679021	1851679021	1	1	HOWE, MARGARET C MD	8/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118449	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
9971	Fee-for-Service	1699933002	1699933002	1	1	HILL, ALLISON C MD	6/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108982	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
9975	Fee-for-Service	1316900038	1316900038	1	1	HUGIN, MICHELLE P MD	12/1/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	81997	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
9990	Fee-for-Service	1184374852	1184374852	1	1	HUANG, RICK MD	10/17/2024	207P00000X	NA	Other	026	PHYSICIANS	187664	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
10034	Fee-for-Service	1942298559	1942298559	1	1	HASAN, NAUSHABA MD	9/18/2023	207R00000X	NA	Other	026	PHYSICIANS	188317	None	None	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
10045	Fee-for-Service	1932195484	1932195484	1	1	HARMAN, HERBERT J MD	8/1/2017	2084P0800X	NA	Psychiatry	026	PHYSICIANS	145591	36	Psychiatry	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
10082	Fee-for-Service	1679004543	1679004543	1	1	HARIHARAN, NISHA MD	7/31/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	157468	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
10083	Fee-for-Service	1609856947	1609856947	1	1	HEART HOSPITAL OF BK	10/6/1999	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	BAKERSFIELD HEART HOSP	3001 SILLECT AVE	None	BAKERSFIELD	CA	93308	6337	15	06029	35.38601911	-119.0400416	Kern County
10116	Fee-for-Service	1699717074	1699717074	1	1	HOOPES, CHARLES W MD	10/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80731	33	Thoracic Surgery	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
10135	Fee-for-Service	1114313418	1114313418	1	2	HEART OF HOPE ASIAN AMERICAN	3/16/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE, A NON-PROF	1879 LUNDY AVE	SUITE #223	SAN JOSE	CA	95131	1881	43	06085	37.39301965	-121.8906676	Santa Clara County
10146	Fee-for-Service	1851473144	1851473144	1	1	HOME HEALTH DEPOT	7/1/2000	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2059 PACIFIC COAST HWY	None	LOMITA	CA	90717	2604	19	06037	33.78953651	-118.316592	Los Angeles County
10188	Fee-for-Service	1619064953	1619064953	1	1	HABASHY, TAHANY M MD	2/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65338	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
10197	Fee-for-Service	1497073001	1497073001	1	1	HELLMUTH, JOANNA M MD	7/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121554	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
10215	Fee-for-Service	1790092237	1790092237	2	1	HANGER PROSTHETICS & ORTHOTI	5/27/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC	25982 PALA DR	STE 100	MISSION VIEJO	CA	92691	6724	30	06059	33.61983904	-117.6772494	Orange County
10226	Fee-for-Service	1316253545	1316253545	1	1	HERSH, MELISSA MD	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149931	01	General Practice	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
10259	Fee-for-Service	1699933002	1699933002	1	1	HILL, ALLISON C MD	6/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108982	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
10271	Fee-for-Service	1326044462	1326044462	1	1	HABASHY, HOSNY L MD	10/31/2017	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
10300	Fee-for-Service	1447224183	1447224183	1	1	HARDIN, CLEO 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	1501 N CAMPBELL AVE	None	TUCSON	AZ	85724	0001	00	None	32.240493	-110.9460825	Pima County
10316	Fee-for-Service	1023410602	1023410602	1	1	HANGER PROSTHESTICS AND	4/27/2015	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	2020 COLORADO AVE	SUITE B	TURLOCK	CA	95382	1129	50	06099	37.51154259	-120.8352538	Stanislaus County
10331	Fee-for-Service	1720145626	1720145626	1	1	HOLMES, MICHELLE M MD	11/28/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	83960	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
10338	Fee-for-Service	1558432534	1558432534	1	1	HYUN, BYUNG-CHYUL MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80040	08	Family Practice	0	In state provider	ATTN MGA OFFICE	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
10344	Fee-for-Service	1770513616	1770513616	1	1	HATZKILSON, JENNIFER A	2/8/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	ADVANCED HEARING SVCS	62 CORPORATE PARK	STE 112	IRVINE	CA	92606	3138	30	06059	33.69197468	-117.8247858	Orange County
10345	Fee-for-Service	1851598452	1851598452	1	1	HIRA-BRAR, SHABNEET K MD	10/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112447	26	Psychiatry (child)	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
10370	Fee-for-Service	1396206587	1396206587	1	1	HOPPER, IAN C DO	12/6/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	19517	None	None	0	In state provider	O	1179 MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	49	06097	38.26876442	-122.6598332	Sonoma County
10397	Fee-for-Service	1699852525	1699852525	1	1	HENDRICKS, KATRINA A MD	2/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79961	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
10401	Fee-for-Service	1699717074	1699717074	1	1	HOOPES, CHARLES W MD	10/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80731	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
10423	Fee-for-Service	1114313418	1114313418	1	2	HEART OF HOPE ASIAN AMERICAN	3/16/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE, A NON-PROF	1879 LUNDY AVE	SUITE #223	SAN JOSE	CA	95131	1881	43	06085	37.39301965	-121.8906676	Santa Clara County
10441	Fee-for-Service	1134381411	1134381411	1	1	HSU, REBECCA Y MD	6/2/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	104596	30	Radiology	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
10472	Fee-for-Service	1366947202	1366947202	1	1	HOANG, KEVIN MD	7/7/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	165510	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
10474	Fee-for-Service	1538219829	1538219829	1	1	HONG, MIMI H MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77490	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2005 WILSHIRE BLVD	None	LOS ANGELES	CA	90057	3505	19	06037	34.05752693	-118.2749902	Los Angeles County
10476	Fee-for-Service	1619064953	1619064953	1	1	HABASHY, TAHANY M MD	2/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65338	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
10505	Fee-for-Service	1922260389	1922260389	1	1	HUYNH, PHUC DO CPC INC	7/29/2010	193400000X	NA	Other	026	PHYSICIANS	7890	08	Family Practice	0	In state provider	None	2619 SO WATERMAN AVE	STE B	SAN BERNARDINO	CA	92408	3737	36	06071	34.053786	-117.278703	San Bernardino County
10573	Fee-for-Service	1588687867	1588687867	1	1	HAKIM, MELINDA A MD	10/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83655	None	None	0	In state provider	None	8635 W 3RD ST	STE 390W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
10599	Fee-for-Service	1659395853	1659395853	1	1	HOPEWELL, PHILIP C MD	1/1/1982	207LC0200X	NA	Other	026	PHYSICIANS	17780	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
10603	Fee-for-Service	1497158901	1497158901	1	1	HIGWIT, MARIA N NP	2/22/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
10699	Fee-for-Service	1740357615	1740357615	1	1	HOLMES, JUDITH M MD	4/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66561	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
10747	Fee-for-Service	1295059996	1295059996	1	1	HAILESELASSIE, BEREKETEAB MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143395	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
10752	Fee-for-Service	1346339330	1346339330	1	1	HAN, PAUL Y DPM	1/1/1988	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2621 S BRISTOL ST	STE 209	SANTA ANA	CA	92704	5719	30	06059	33.711876	-117.885371	Orange County
10780	Fee-for-Service	1902847320	1902847320	1	2	HAGA, JEFFREY A DO	4/18/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	9334	-	NOT APPLICABLE	0	In state provider	None	1841 E MAIN STREET	None	BARSTOW	CA	92311	3234	36	06071	34.8901829	-116.9978731	San Bernardino County
10795	Fee-for-Service	1265798458	1265798458	1	1	HECK, IVY A LMFT	9/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1848 S ELENA AVE	STE 105	REDONDO BEACH	CA	90277	5710	19	06037	33.81677685	-118.3865084	Los Angeles County
10806	Fee-for-Service	1396139853	1396139853	1	1	HENSHAW, SARAH E DO	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16436	40	Pediatrics	0	In state provider	None	3100 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3866	31	06061	38.74399612	-121.2349547	Placer County
10834	Fee-for-Service	1710923552	1710923552	1	1	HU DING MD	12/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	630 MEDICAL DR	None	BOUNTIFUL	UT	84010	4908	00	None	40.88671331	-111.8683023	Davis County
10854	Fee-for-Service	1962797670	1962797670	1	1	HIRSCHBEIN, JONAH S MD	5/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123982	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
10871	Fee-for-Service	1255595583	1255595583	1	1	HADERS, ALLISON L MD	5/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131121	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
10877	Fee-for-Service	1528570967	1528570967	1	1	HAACK, LAUREN M PHD	7/28/2017	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
10930	Fee-for-Service	1164644746	1164644746	1	1	HUMBOLDT SENIOR RESOURCE	7/1/1993	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	1901 CALIFORNIA ST	None	EUREKA	CA	95501	2809	12	06023	40.79014544	-124.1719158	Humboldt County
10945	Fee-for-Service	1699909507	1699909507	1	1	HOLLOWAY, NATHANIEL L MD	2/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70859	05	Anesthesiology	0	In state provider	None	7417 N CEDAR AVE	None	FRESNO	CA	93720	3637	10	06019	36.844227	-119.7568975	Fresno County
10964	Fee-for-Service	1245285113	1245285113	1	1	HAWTHORNE, HILARY L OD	12/1/1995	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	RY	8619 S VERMONT AVENUE	None	LOS ANGELES	CA	90044	4827	19	06037	33.95942681	-118.2919294	Los Angeles County
10983	Fee-for-Service	1972826865	1972826865	1	1	HEWITT MEDICAL GROUP INC	9/21/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1701 26TH STREET	None	BAKERSFIELD	CA	93301	2803	15	06029	35.3828695	-119.021481	Kern County
10985	Fee-for-Service	1851736235	1851736235	1	1	HAIDAR, YARAH M MD	7/23/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	135746	04	Otology, Laryngology, Rhinology	0	In state provider	None	101 CITY DR S	BLDG 25	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
10987	Fee-for-Service	1841220324	1841220324	1	1	HUTCHISON, MARGARET CNM	12/6/2005	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
10988	Fee-for-Service	1780862250	1780862250	1	1	HONANIAN, LILIAN LMFT	1/21/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12001 W WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5801	19	06037	33.99760695	-118.4228296	Los Angeles County
11032	Fee-for-Service	1235201062	1235201062	1	1	HASSAN, SHEIK Y MD	7/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	6666	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
11038	Fee-for-Service	1437343076	1437343076	1	1	HARA, WENDY Y MD	1/11/2008	2085R0001X	NA	Other	026	PHYSICIANS	83815	78	Neoplastic Diseases/Oncology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
11041	Fee-for-Service	1356965206	1356965206	1	1	HAYNES, MEGAN M CRNA	6/15/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
11067	Fee-for-Service	1356376925	1356376925	1	1	HUTTINGER, ANDREA AU	11/3/2020	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4201 TORRANCE	140	TORRANCE	CA	90503	4504	19	06037	33.8375955	-118.358748	Los Angeles County
11071	Fee-for-Service	1053536722	1053536722	1	1	HE, FRANCIS H PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2428 DWIGHT WAY	None	BERKELEY	CA	94704	3503	01	06001	37.86496482	-122.259389	Alameda County
11076	Fee-for-Service	1235769845	1235769845	1	1	HERA HOME HEALTH INC	12/1/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9221 CORBIN AVE	SUITE 220	NORTHRIDGE	CA	91324	2494	19	06037	34.23776171	-118.5623227	Los Angeles County
11147	Fee-for-Service	1629551049	1629551049	1	1	HOWARD, MADELINE J PT	3/25/2020	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
11157	Fee-for-Service	1326297730	1326297730	1	1	HUTSON, SHANDEE M MD	9/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110197	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
11179	Fee-for-Service	1023503653	1023503653	1	1	HAMMOND, JAMES H MD	2/27/2024	207L00000X	NA	Other	026	PHYSICIANS	178173	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
11199	Fee-for-Service	1356535389	1356535389	1	1	HERITAGE ESTATES, INC	7/6/1992	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14646 NAVAJO WAY	None	MANTECA	CA	95336	2525	39	06077	37.82975848	-121.2156108	San Joaquin County
11210	Fee-for-Service	1679650535	1679650535	1	1	HWANG, ANDREW MD	9/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80397	41	Internal Medicine	0	In state provider	None	220 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26914953	-121.9566285	Santa Clara County
11220	Fee-for-Service	1740513555	1740513555	1	1	HUERTA, NORMA A LMFT	11/19/2019	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
11236	Fee-for-Service	1831401447	1831401447	1	1	HETZNER, JENNIFER A MD	7/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125035	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
11270	Fee-for-Service	1164774576	1164774576	1	1	HENDERSON, ELIZABETH A CSW	8/22/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	421 N BROOKHURST ST	STE 119	ANAHEIM	CA	92801	5618	30	06059	33.83743497	-117.9590498	Orange County
11273	Fee-for-Service	1720762099	1720762099	1	1	HEALTH RIDE EXPRESS LLC	8/7/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	9400 TOPANGA CANYON BLVD	210	CHATSWORTH	CA	91311	5757	19	06037	34.24094034	-118.6060939	Los Angeles County
11275	Fee-for-Service	1306291299	1306291299	1	1	HONG, JOY MD	10/5/2018	390200000X	NA	Other	026	PHYSICIANS	151905	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
11279	Fee-for-Service	1679861272	1679861272	1	1	HUBER, CHEYENNE C OD	1/9/2014	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
11311	Fee-for-Service	1972661254	1972661254	1	1	HICKS, KIMBERLY MD	8/24/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79714	41	Internal Medicine	0	In state provider	05D09203421	3317 ELM ST	STE 102	OAKLAND	CA	94609	3053	01	06001	37.82175028	-122.2653725	Alameda County
11321	Fee-for-Service	1982001004	1982001004	1	1	HAYWORTH PROPERTIES LLC	9/1/2015	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	325 N HAYWORTH AVE	None	LOS ANGELES	CA	90048	2701	19	06037	34.07682262	-118.3626602	Los Angeles County
11325	Fee-for-Service	1437343076	1437343076	1	1	HARA, WENDY Y MD	1/11/2008	2085R0001X	NA	Other	026	PHYSICIANS	83815	30	Radiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
11338	Fee-for-Service	1457858631	1457858631	1	1	HSU, PAUL	7/3/2023	207RR0500X	NA	Other	026	PHYSICIANS	164984	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
11344	Fee-for-Service	1043790249	1043790249	1	1	HARRIS, NILE M MD	2/26/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 MISSION BLVD	None	JACKSON	CA	95642	2564	03	06005	38.35007723	-120.7659932	Amador County
11380	Fee-for-Service	1316171846	1316171846	1	1	HFL HARBOR GATEWAY HOMES	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1418 WEST 218TH STREET	None	TORRANCE	CA	90501	4003	19	06037	33.83027544	-118.3023073	Los Angeles County
11397	Fee-for-Service	1730419003	1730419003	1	1	HARTLE, ALEJANDRA A J	6/29/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3205 HURLEY WAY	None	SACRAMENTO	CA	95864	3853	34	06067	38.589552	-121.3893675	Sacramento County
11475	Fee-for-Service	1598069775	1598069775	1	1	HERNANDEZ, JUAN M MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119284	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
11483	Fee-for-Service	1639527799	1639527799	1	1	HEARTFELT HOSPICE AND	8/23/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	13363 SATICOY ST	UNIT 106B	NORTH HOLLYWOOD	CA	91605	3400	19	06037	34.2086537	-118.424562	Los Angeles County
11521	Fee-for-Service	1194747824	1194747824	1	1	HAGA, MICHAEL D MD	7/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81573	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
11573	Fee-for-Service	1467704189	1467704189	1	1	HARPER, AMY E LMFT	9/8/2021	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
11574	Fee-for-Service	1477866531	1477866531	1	1	HUYNH, JESSICA T OD	3/14/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
11583	Fee-for-Service	1871655423	1871655423	1	1	HUANG, GEORGE J MD	10/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	96878	34	Urology and Urological Surgery	0	In state provider	None	975 MAPLE STREET	None	REDWOOD CITY	CA	94063	2057	41	06081	37.48822836	-122.2226601	San Mateo County
11598	Fee-for-Service	1124093356	1124093356	1	1	HERRING, GARY A	7/2/2009	No Taxonomy Provided	NA	None	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
11612	Fee-for-Service	1740290535	1740290535	1	1	HERNANDEZ, GIAN P DO	1/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8740	08	Family Practice	0	In state provider	None	15107 VAN OWEN STREET	None	VAN NUYS	CA	91405	4598	19	06037	34.19395645	-118.463265	Los Angeles County
11642	Fee-for-Service	1548440050	1548440050	1	1	HARRIS, WILLIAM B DO	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	23	Peripheral Vascular Disease or Surgery (D.O. only)	1	Border provider	None	6850 N DURANGO DR	STE 204	LAS VEGAS	NV	89149	4596	00	None	36.285876	-115.285266	Clark County
11681	Fee-for-Service	1104196120	1104196120	1	1	HESS, JAMIE M NP	5/23/2019	363LW0102X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
11698	Fee-for-Service	1548290422	1548290422	1	1	HORVATH, TONI J LMFT	8/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5330 PRIMROSE DR	STE 240	FAIR OAKS	CA	95628	3542	34	06067	38.662623	-121.275936	Sacramento County
11700	Fee-for-Service	1649453671	1649453671	1	1	HOGAN, KATHRYN 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	47 NEW SCOTLAND AVE	None	ALBANY	NY	12208	3412	00	None	42.65281106	-73.77466567	Albany County
11716	Fee-for-Service	1932166691	1932166691	1	1	HENRY, APRIL	8/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	1	Border provider	None	235 W 6TH ST	None	RENO	NV	89503	4548	00	None	39.53165987	-119.8181899	Washoe County
11719	Fee-for-Service	1093006116	1093006116	1	1	HE, TAO MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147568	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
11721	Fee-for-Service	1902850209	1902850209	1	1	HICKS, KATHLEEN J MD	12/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76518	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
11750	Fee-for-Service	1902224934	1902224934	1	1	HINDUJA, SANJAY MD	8/26/2019	208M00000X	NA	Other	026	PHYSICIANS	145500	41	Internal Medicine	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
11758	Fee-for-Service	1164523569	1164523569	1	1	HEATER, RICHARD D MD	5/11/2009	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	31294	20	Orthopedic Surgery	0	In state provider	None	2801 K STREET	STE 330	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
11770	Fee-for-Service	1639527799	1639527799	1	1	HEARTFELT HOSPICE AND	8/23/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	13363 SATICOY ST	UNIT 106B	NORTH HOLLYWOOD	CA	91605	3400	19	06037	34.2086537	-118.424562	Los Angeles County
11788	Fee-for-Service	1235217001	1235217001	1	1	HUSOKOWSKI, JOHN T MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30380	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
11796	Fee-for-Service	1093766990	1093766990	1	1	HUANES,CARLOS J MD	12/18/2007	207L00000X	NA	Other	026	PHYSICIANS	50399	05	Anesthesiology	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
11845	Fee-for-Service	1447609342	1447609342	1	1	HANS, GURKAMAL MD	9/9/2020	207R00000X	NA	Other	026	PHYSICIANS	162202	41	Internal Medicine	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	1821	38	06075	37.7634502	-122.4579779	San Francisco County
11874	Fee-for-Service	1932376159	1932376159	1	2	HWANG, LISA K MD	6/23/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	104598	None	None	0	In state provider	None	1471 RIVERSIDE	None	RIALTO	CA	92376	7703	36	06071	34.07459705	-117.3702576	San Bernardino County
11882	Fee-for-Service	1013122761	1013122761	1	1	HOANG, TUAN MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70085	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
11891	Fee-for-Service	1861135766	1861135766	1	1	HASTINGS, KIMBERLY A PT	10/21/2022	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
11961	Fee-for-Service	1033125414	1033125414	1	1	HOLDEN, JOHN BRYAN MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	56141	41	Internal Medicine	0	In state provider	None	FRESNO & R STREETS	None	FRESNO	CA	93721	0000	10	06019	36.741663	-119.7841005	Fresno County
11968	Fee-for-Service	1033321187	1033321187	1	1	HEALTH N JOY, CORP	11/28/2003	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	12110 FIRESTONE BLVD	None	NORWALK	CA	90650	4320	19	06037	33.90899245	-118.0751533	Los Angeles County
11990	Fee-for-Service	1013995299	1013995299	1	1	HITCHCOCK, TODD M MD	8/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80632	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
12013	Fee-for-Service	1093006116	1093006116	1	1	HE, TAO MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147568	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
12052	Fee-for-Service	1619945185	1619945185	1	1	HASSAN, KEITH MD	5/8/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	184721	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
12063	Fee-for-Service	1811178080	1811178080	1	1	HANFORD DIALYSIS LLC	1/20/2010	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	900 N DOUTY ST	None	HANFORD	CA	93230	3918	16	06031	36.33417687	-119.646063	Kings County
12128	Fee-for-Service	1184734212	1184734212	1	1	HUANG, ANITA N OD	2/23/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91913	1800	37	06073	32.62382113	-116.9960539	San Diego County
12139	Fee-for-Service	1174532444	1174532444	1	1	HUDA, ZARINTAJ S MD INC	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42445	05	Anesthesiology	0	In state provider	None	3111 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5829	19	06037	33.97284681	-118.2119367	Los Angeles County
12169	Fee-for-Service	1285675538	1285675538	1	1	HOROWITZ, DAVID C DO	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	4092	None	None	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
12175	Fee-for-Service	1366428351	1366428351	1	1	HANSCH, ERNST MD	8/17/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	54637	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
12198	Fee-for-Service	1891750345	1891750345	1	1	HIRNIAK, OKSANA B DO	1/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11789	08	Family Practice	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
12203	Fee-for-Service	1457573446	1457573446	1	1	HEMET OB-GYN INC	2/6/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2390 E FLORIDA AVE	STE 104	HEMET	CA	92544	4711	33	06065	33.7477405	-116.94681	Riverside County
12244	Fee-for-Service	1144624958	1144624958	1	1	HUISO, CELSO Q NP	12/26/2018	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
12245	Fee-for-Service	1033125414	1033125414	1	1	HOLDEN, JOHN BRYAN MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	56141	30	Radiology	0	In state provider	None	FRESNO & R STREETS	None	FRESNO	CA	93721	0000	10	06019	36.741663	-119.7841005	Fresno County
12254	Fee-for-Service	1962451682	1962451682	1	1	HA, PATRICK K MD	10/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138878	04	Otology, Laryngology, Rhinology	0	In state provider	None	1001 POTRERO AVE	RM 4M45	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
12278	Fee-for-Service	1306476742	1306476742	1	1	HARVARD CREEK POST ACUTE LLC	2/1/2020	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	519 W BADILLO ST	None	COVINA	CA	91722	3763	19	06037	34.0864202	-117.8995877	Los Angeles County
12324	Fee-for-Service	1013338698	1013338698	1	1	HALL, KIMBERLY A LCSW	9/19/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3798 JANES RD	STE 20	ARCATA	CA	95521	4957	12	06023	40.89649119	-124.0930501	Humboldt County
12348	Fee-for-Service	1023235934	1023235934	1	1	HENRY, TANYA MD	6/26/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	134681	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
12388	Fee-for-Service	1861592735	1861592735	1	1	HADLEY, HENRY R MD	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	32717	34	Urology and Urological Surgery	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
12401	Fee-for-Service	1013109677	1013109677	1	2	HAWKINS, ETHEL MARIE	9/9/2017	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3713 E ARABELLA ST	None	LONG BEACH	CA	90805	3915	19	06037	33.86282464	-118.1486557	Los Angeles County
12412	Fee-for-Service	1518910868	1518910868	1	1	HANSON, JEFFREY B MD	9/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	501 EAST HAMPDEN AVENUE	None	ENGLEWOOD	CO	80113	2702	00	None	39.6531952	-104.9810967	Arapahoe County
12457	Fee-for-Service	1477079820	1477079820	1	1	HUNTER, GLENYS N NP	12/31/2018	363LP2300X	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
12458	Fee-for-Service	1518173939	1518173939	1	1	HAIR, DAVID B MD	8/5/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	96015	18	Ophthalmology	0	In state provider	INSTITUTE INC	7508 MEANY AVE	None	BAKERSFIELD	CA	93308	5178	15	06029	35.3942895	-119.0858445	Kern County
12489	Fee-for-Service	1811152705	1811152705	1	1	HUANG, ELAINE Y Y OD	1/5/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
12496	Fee-for-Service	1649444050	1649444050	1	1	HONG, LINDA J MD	9/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109422	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	SUITE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
12520	Fee-for-Service	1487290789	1487290789	1	1	HOANG, BRITTANY R CNP	1/25/2024	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
12537	Fee-for-Service	1760745277	1760745277	1	1	HU, MENGJUN MD	4/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129374	07	Dermatology	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
12552	Fee-for-Service	1770904690	1770904690	1	1	HORIZON CRITICAL CARE	1/1/2014	193400000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GROUP INC	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
12560	Fee-for-Service	1447454871	1447454871	1	1	HOFFMAN, TREVOR L MD	12/11/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	89842	38	Geriatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
12564	Fee-for-Service	1942812516	1942812516	1	1	HODSON, SCOTT	11/12/2020	2251X0800X	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
12623	Fee-for-Service	1033348024	1033348024	1	1	HANGER P & O WEST INC	10/12/2010	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	1	Border provider	None	5255 S HIGHWAY 95	#7	FORT MOJAVE	AZ	86426	9111	00	None	35.00382964	-114.598065	Mohave County
12676	Fee-for-Service	1861592735	1861592735	1	1	HADLEY, HENRY R MD	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	32717	02	General Surgery	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
12704	Fee-for-Service	1083817399	1083817399	1	1	HSU, ANDREW S MD	5/20/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108956	02	General Surgery	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
12735	Fee-for-Service	1336245539	1336245539	1	1	HOWARD, JANET M MD	1/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55298	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
12753	Fee-for-Service	1386715324	1386715324	1	1	HAUSMAN, NICOLE MD	5/1/1998	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	64630	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
12759	Fee-for-Service	1710976055	1710976055	1	2	HENDRICKS, JAMES MD	8/26/2024	208800000X	NA	Other	026	PHYSICIANS	84825	34	Urology and Urological Surgery	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3220	33	06065	33.763572	-116.4056895	Riverside County
12789	Fee-for-Service	1972544369	1972544369	1	1	HANSTEIN, CONRAD G MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87958	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
12800	Fee-for-Service	1174785075	1174785075	1	1	HILL, JESSE R MD	8/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106572	05	Anesthesiology	0	In state provider	None	790 E COLORADO BLVD	STE 909A	PASADENA	CA	91101	2113	19	06037	34.14586347	-118.1342295	Los Angeles County
12810	Fee-for-Service	1831106103	1831106103	1	1	HAZELBAKER, PAUL N DO	12/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	7147	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
12849	Fee-for-Service	1447454871	1447454871	1	1	HOFFMAN, TREVOR L MD	12/11/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	89842	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
12851	Fee-for-Service	1619978715	1619978715	1	1	HAJJAR, GEORGE MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52459	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
12873	Fee-for-Service	1710029988	1710029988	1	1	HECK, JOSEPH J DO	1/1/2002	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
12897	Fee-for-Service	1508971243	1508971243	1	1	HWANG, GRACE Y MD	7/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80874	08	Family Practice	0	In state provider	None	510 N PROSPECT AVE	STE 208	REDONDO BEACH	CA	90277	3030	19	06037	33.85259344	-118.379739	Los Angeles County
12898	Fee-for-Service	1184956161	1184956161	1	1	HOUSTON, JOHN ALLEN C MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124667	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
12904	Fee-for-Service	1982195889	1982195889	1	1	HABERLACH, MARISSA J DO	9/13/2021	207P00000X	NA	Other	026	PHYSICIANS	19073	None	None	0	In state provider	None	75 NIELSON ST	None	WATSONVILLE	CA	95076	2468	44	06087	36.9282117	-121.7937089	Santa Cruz County
12921	Fee-for-Service	1033562988	1033562988	1	1	HATCHER, AARON J LMFT	4/7/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	124950	-	NOT APPLICABLE	0	In state provider	None	710 & 714 N ANAHEIM BLVD	None	ANAHEIM	CA	92805	2652	30	06059	33.84260597	-117.916209	Orange County
12926	Fee-for-Service	1225518467	1225518467	1	1	HERNANDO, RAYMUND PT	1/17/2022	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
12966	Fee-for-Service	1669532081	1669532081	1	1	HUSTED, MARTA	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
12968	Fee-for-Service	1023185980	1023185980	1	1	HSIEH, YING P MD	7/21/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	42897	84	Surgery-Head and Neck	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
12975	Fee-for-Service	1720147333	1720147333	1	1	HARRIS, MARK A MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82210	25	Physical Medicine and Rehabilitation	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
12981	Fee-for-Service	1417499153	1417499153	1	1	HOPKINS, TERESA E	6/29/2017	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
13001	Fee-for-Service	1538198205	1538198205	1	1	HO, FRANKLIN A MD	7/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67549	41	Internal Medicine	0	In state provider	None	8135 PAINTER AVE	STE 303	WHITTIER	CA	90602	3173	19	06037	33.965829	-118.032738	Los Angeles County
13006	Fee-for-Service	1407027196	1407027196	1	1	HERMAN, SARA C MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121029	05	Anesthesiology	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
13018	Fee-for-Service	1730275637	1730275637	1	1	HAMILTON, STANLEY R MD	9/24/2020	207ZP0102X	NA	Other	026	PHYSICIANS	169583	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
13048	Fee-for-Service	1013912781	1013912781	1	1	HAPPY CAMP VOLUNTEER	8/1/1996	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	AMBULANCE SERVICE, INC	38 PARK WAY	None	HAPPY CAMP	CA	96039	0596	47	06093	41.79618192	-123.3737982	Siskiyou County
13094	Fee-for-Service	1134539828	1134539828	1	1	HAHAMBIS, ILEANA G MSW LCSW	9/20/2024	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
13106	Fee-for-Service	1114260072	1114260072	1	1	HUANG, LI-WEN MD	6/27/2019	207RH0003X	NA	Oncology	026	PHYSICIANS	142254	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
13131	Fee-for-Service	1467988691	1467988691	1	1	HEALTHRIGHT 360	6/22/2017	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1563 MISSION ST	1ST & 3RD FL	SAN FRANCISCO	CA	94103	2543	38	06075	37.77327874	-122.4183559	San Francisco County
13138	Fee-for-Service	1619978715	1619978715	1	1	HAJJAR, GEORGE MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52459	04	Otology, Laryngology, Rhinology	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
13149	Fee-for-Service	1801885736	1801885736	1	1	HAW, EDDY L OD	3/1/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY	1377 MACARTHUR BLVD	None	SAN LEANDRO	CA	94577	3918	01	06001	37.72917298	-122.1387677	Alameda County
13174	Fee-for-Service	1730363151	1730363151	1	1	HEALTHRIGHT 360	2/25/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1563 MISSION ST	5TH FL	SAN FRANCISCO	CA	94103	2543	38	06075	37.77327874	-122.4183559	San Francisco County
13186	Fee-for-Service	1053781633	1053781633	1	1	HUANG, CECILIA MD	9/14/2022	207R00000X	NA	Other	026	PHYSICIANS	178215	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
13197	Fee-for-Service	1326041864	1326041864	1	1	HONG, MARIA ELIZA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	86354	40	Pediatrics	0	In state provider	None	1001 MAIN ST	None	DELANO	CA	93215	1731	15	06029	35.76932624	-119.245737	Kern County
13229	Fee-for-Service	1932121787	1932121787	1	1	HANSON, BERKELEY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8TH ANVEUE + C STREET	None	SALT LAKE CITY	UT	84143	0000	00	None	40.779063	-111.8805548	Salt Lake County
13247	Fee-for-Service	1922058718	1922058718	1	1	HENRIQUEZ, JAIME O MD	7/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79202	None	None	0	In state provider	None	50 ALESSANDRO PL	STE 200	PASADENA	CA	91105	4002	19	06037	34.13101049	-118.151532	Los Angeles County
13255	Fee-for-Service	1023185980	1023185980	1	1	HSIEH, YING P MD	7/21/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	42897	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
13280	Fee-for-Service	1013906551	1013906551	1	1	HARB, ELISE N OD	10/3/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
13291	Fee-for-Service	1538198205	1538198205	1	1	HO, FRANKLIN A MD	7/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	67549	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8135 PAINTER AVE	STE 303	WHITTIER	CA	90602	3173	19	06037	33.965829	-118.032738	Los Angeles County
13305	Fee-for-Service	1659549277	1659549277	1	1	HEU MEDICAL GROUP INC	10/9/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1735 VILLA AVE.	STE 102	CLOVIS	CA	93612	2443	10	06019	36.81104995	-119.7135987	Fresno County
13306	Fee-for-Service	1730275637	1730275637	1	1	HAMILTON, STANLEY R MD	9/24/2020	207ZP0102X	NA	Other	026	PHYSICIANS	169583	22	Pathology (M.D. only)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
13318	Fee-for-Service	1881601615	1881601615	1	1	HOLST, GREGORY S MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	52586	08	Family Practice	0	In state provider	None	2280 HARRISON AVENUE	SUITE B	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
13347	Fee-for-Service	1851591325	1851591325	1	1	HOFFORT, LISA M PSYD	3/6/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	595 E COLORADO BLVD	SUITE 610	PASADENA	CA	91101	2045	19	06037	34.14588202	-118.1380722	Los Angeles County
13351	Fee-for-Service	1902457427	1902457427	1	1	HESSLER, JOHN F CRNA	12/16/2019	367500000X	NA	Other	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
13359	Fee-for-Service	1306919691	1306919691	1	1	HUANG, CHUN-KANG MD	4/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44680	41	Internal Medicine	0	In state provider	None	275 VICTORIA ST	STE 2B	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
13362	Fee-for-Service	1346253093	1346253093	1	1	HANDE, RASHMI MD	7/14/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	98569	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
13377	Fee-for-Service	1649894536	1649894536	1	1	HAMOUDA, HEBA CNM	12/31/2020	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	23141 MOULTON PKWY	108	LAGUNA HILLS	CA	92653	1241	30	06059	33.62613379	-117.7305831	Orange County
13426	Fee-for-Service	1619978715	1619978715	1	1	HAJJAR, GEORGE MD	2/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52459	41	Internal Medicine	0	In state provider	None	1500 E DUARTE ROAD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
13430	Fee-for-Service	1437598687	1437598687	1	1	HUNG, STEVEN W MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147179	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
13434	Fee-for-Service	1528072683	1528072683	1	1	HIXSON, THOMAS M OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8007 LA MESA BLVD	None	LA MESA	CA	91941	6434	37	06073	32.76370542	-117.0247794	San Diego County
13461	Fee-for-Service	1730363151	1730363151	1	1	HEALTHRIGHT 360	6/8/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1563 MISSION ST	5TH FL	SAN FRANCISCO	CA	94103	2543	38	06075	37.77327874	-122.4183559	San Francisco County
13484	Fee-for-Service	1275796674	1275796674	1	1	HASSAN, KASHIF Z MD	9/23/2008	207RC0200X	NA	Other	026	PHYSICIANS	95481	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
13486	Fee-for-Service	1790072106	1790072106	1	1	HATEFI, DUSTIN MD	2/1/2018	390200000X	NA	Other	026	PHYSICIANS	124325	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
13493	Fee-for-Service	1891248217	1891248217	1	1	HOFMEYER, ERICKA E LMFT	3/18/2021	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
13519	Fee-for-Service	1386156420	1386156420	1	1	HERRERA SALAIS, DANIEL OT	2/23/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4010 ORANGE AVE	None	LONG BEACH	CA	90807	3717	19	06037	33.831612	-118.176291	Los Angeles County
13581	Fee-for-Service	1821296732	1821296732	1	1	HURLEY OPTICAL	2/8/2015	No Taxonomy Provided	NA	None	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	914 LINDEN AVE	None	CARPINTERIA	CA	93013	2045	42	06083	34.39844093	-119.5188593	Santa Barbara County
13599	Fee-for-Service	1083944995	1083944995	1	1	HARO, CONNIE J	10/5/2010	No Taxonomy Provided	NA	None	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
13615	Fee-for-Service	1710029657	1710029657	1	1	HO, CHEN NAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110971	08	Family Practice	0	In state provider	None	314 NORTH MAIN STREET	None	PORTERVILLE	CA	93257	3730	54	06107	36.071568	-119.016152	Tulare County
13632	Fee-for-Service	1487826764	1487826764	1	1	HOVENIC, WHITNEY W MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125661	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
13636	Fee-for-Service	1447218482	1447218482	1	1	HEALTHEAST ST JOHN'S HOS	5/1/1999	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1575 BEAM AVE	None	MAPLEWOOD	MN	55109	1126	00	None	45.02818044	-93.03372281	Ramsey County
13639	Fee-for-Service	1609935352	1609935352	1	1	HOVANESSIAN, ARAM MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50559	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
13647	Fee-for-Service	1306919691	1306919691	1	1	HUANG, CHUN-KANG MD	4/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44680	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	275 VICTORIA ST	STE 2B	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
13684	Fee-for-Service	1528644614	1528644614	1	1	HANCOCK, RACHELLE MD	9/9/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	190290	40	Pediatrics	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
13686	Fee-for-Service	1558471607	1558471607	1	1	HENRY K CHANG MD A PROF	9/3/1994	207R00000X	NA	Other	026	PHYSICIANS	23454	41	Internal Medicine	0	In state provider	None	6401 COYLE AVE	STE 213	CARMICHAEL	CA	95608	0310	34	06067	38.668698	-121.3148745	Sacramento County
13745	Fee-for-Service	1225471048	1225471048	1	1	HAYASHI, YUICHIRO MD	6/6/2019	207LP2900X	NA	Other	026	PHYSICIANS	134873	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
13749	Fee-for-Service	1730363151	1730363151	1	1	HEALTHRIGHT 360	2/25/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1563 MISSION ST	5TH FL	SAN FRANCISCO	CA	94103	2543	38	06075	37.77327874	-122.4183559	San Francisco County
13771	Fee-for-Service	1811951429	1811951429	1	1	HONORHEALTH	8/7/2015	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	N MEDICAL CENTER	7400 E OSBORN RD	None	SCOTTSDALE	AZ	85251	6432	00	None	33.488748	-111.9225285	Maricopa County
13780	Fee-for-Service	1245601749	1245601749	1	1	HUANG, SARAH F NP	3/8/2019	363LF0000X	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
13868	Fee-for-Service	1184970725	1184970725	1	1	HORST, MARISA N CRNA	8/22/2019	367500000X	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
13909	Fee-for-Service	1700964582	1700964582	1	1	HUYNH, VAN MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61591	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
13922	Fee-for-Service	1609935352	1609935352	1	1	HOVANESSIAN, ARAM MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50559	01	General 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
13923	Fee-for-Service	1447218482	1447218482	1	1	HEALTHEAST ST JOHN'S HOS	5/1/1999	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1575 BEAM AVE	None	MAPLEWOOD	MN	55109	1126	00	None	45.02818044	-93.03372281	Ramsey County
13939	Fee-for-Service	1629840277	1629840277	1	1	HEINRICHS, EMMA	12/10/2024	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	10	06019	0	0	None
13954	Fee-for-Service	1649795642	1649795642	1	1	HECTOR O PACHECO MD INC	5/17/2024	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	25150 HANCOCK AVE	SUITE 200	MURRIETA	CA	92562	5988	33	06065	33.56635084	-117.1823956	Riverside County
13964	Fee-for-Service	1932687696	1932687696	1	1	HALL, RASHONDA CNP	11/1/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
13979	Fee-for-Service	1568466381	1568466381	1	1	HOLMES, VICTOR A MD	6/3/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	69242	18	Ophthalmology	0	In state provider	None	1541 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	2606	15	06029	35.64931328	-117.669909	Kern County
13993	Fee-for-Service	1144557539	1144557539	1	1	HENAWI, I MD INC	4/12/2010	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	62143	None	None	0	In state provider	None	4020 W FLORIDA AVE	None	HEMET	CA	92545	5279	33	06065	33.74543265	-117.0148924	Riverside County
14013	Fee-for-Service	1790434686	1790434686	1	1	HUI, JUSTIN	4/1/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189529	08	Family Practice	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
14019	Fee-for-Service	1134603483	1134603483	1	1	HO, HIEN T NP	4/15/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
14038	Fee-for-Service	1730363151	1730363151	1	1	HEALTHRIGHT 360	2/25/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1563 MISSION ST	5TH FL	SAN FRANCISCO	CA	94103	2543	38	06075	37.77327874	-122.4183559	San Francisco County
14052	Fee-for-Service	1245630243	1245630243	1	1	HEARTWATCH SOLUTIONS INC	4/11/2016	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	None	9400 EMPIRE STATE DR	None	BAKERSFIELD	CA	93311	9009	15	06029	35.30024978	-119.1068218	Kern County
14058	Fee-for-Service	1639294192	1639294192	1	1	HERNANDEZ, LAYLA I LCSW	12/7/2022	1041C0700X	NA	Mental Health Outpatient Services	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
14061	Fee-for-Service	1811951429	1811951429	1	1	HONORHEALTH	8/7/2015	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	N MEDICAL CENTER	7400 E OSBORN RD	None	SCOTTSDALE	AZ	85251	6432	00	None	33.488748	-111.9225285	Maricopa County
14063	Fee-for-Service	1427122928	1427122928	1	1	HASSLER, SHAWN K MD	4/17/2006	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	62683	41	Internal Medicine	0	In state provider	None	870 MARKET ST	STE 600	SAN FRANCISCO	CA	94102	3002	38	06075	37.7848184	-122.4070488	San Francisco County
14094	Fee-for-Service	1073058087	1073058087	1	1	HORWICH, BRIAN H MD	4/23/2025	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	164684	10	Gastroenterology (M.D. only)	0	In state provider	None	1223 16TH STREET 3RD FLO	SUITE 3100 PODS A AND B	SANTA MONICA	CA	90404	1275	19	06037	34.02773198	-118.4862675	Los Angeles County
14098	Fee-for-Service	1366671638	1366671638	1	2	HUNG, CHIA-YI S DO	7/19/2022	207R00000X	NA	Other	026	PHYSICIANS	12280	None	None	0	In state provider	None	2410 SAMARITAN DRIVE	SUITE 201	SAN JOSE	CA	95124	3909	43	06085	37.25107654	-121.9451342	Santa Clara County
14124	Fee-for-Service	1265414155	1265414155	1	1	HOSNY, AYMAN MD	12/21/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	40878	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
14159	Fee-for-Service	1356399778	1356399778	1	1	HATASHITA, MICHAEL B OD	10/30/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	AN OPTOMETRIC CORP	6456 ANTELOPE RD	# A3	CITRUS HEIGHTS	CA	95621	1045	34	06067	38.706633	-121.313619	Sacramento County
14160	Fee-for-Service	1457373219	1457373219	1	1	HAMMIG, MEREDITH S CNW	11/25/2008	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
14173	Fee-for-Service	1992065692	1992065692	1	1	HARRISON, TRACY N MD FACOG	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130402	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
14176	Fee-for-Service	1427553304	1427553304	1	1	HILL, BREANA MD	6/17/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	179277	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
14181	Fee-for-Service	1619298353	1619298353	1	1	HUSSAIN, TASMINA MD	10/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132887	40	Pediatrics	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
14183	Fee-for-Service	1598058646	1598058646	1	1	HINDIN, DAVID I MD	12/4/2020	208600000X	NA	General Surgery	026	PHYSICIANS	165907	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
14196	Fee-for-Service	1649698127	1649698127	1	1	HU, JOHN Y MD	8/7/2020	207RH0003X	NA	Oncology	026	PHYSICIANS	149516	68	Hematology	0	In state provider	None	27800 MEDICAL CENTER RD	STE 461	MISSION VIEJO	CA	92691	6424	30	06059	33.55952733	-117.6645199	Orange County
14221	Fee-for-Service	1124386032	1124386032	1	1	HAMIDI, SEPEHR MD	6/24/2019	207ZP0105X	NA	Other	026	PHYSICIANS	133336	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
14266	Fee-for-Service	1770707432	1770707432	1	1	HOCHBERG, DEBRA A	6/16/2011	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
14293	Fee-for-Service	1841335817	1841335817	1	1	HAMILTON, MARLA D DC	2/15/2018	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1211 W IMPERIAL HWY	SUITE 204	BREA	CA	92821	3724	30	06059	33.9174843	-117.9167733	Orange County
14307	Fee-for-Service	1457489916	1457489916	1	1	HUNT & SHAW ODS	10/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7965 HIGHWAY 9	None	BEN LOMOND	CA	95005	9703	44	06087	37.07236228	-122.0843381	Santa Cruz County
14346	Fee-for-Service	1760562821	1760562821	1	1	HASSON, MORRIS B MD	12/9/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	64364	01	General Practice	0	In state provider	None	2650 ELM AVE	STE 309	LONG BEACH	CA	90806	1600	19	06037	33.805521	-118.1882945	Los Angeles County
14353	Fee-for-Service	1619371101	1619371101	1	1	HOWARD, JULIE LMFT	9/15/2021	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
14365	Fee-for-Service	1578605390	1578605390	1	1	HANA MEDICAL GROUP	10/1/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	8615 KNOTT AVE	STE 3	BUENA PARK	CA	90620	3886	30	06059	33.83765695	-118.0111408	Orange County
14379	Fee-for-Service	1073058087	1073058087	1	1	HORWICH, BRIAN H MD	4/23/2025	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	164684	41	Internal Medicine	0	In state provider	None	1223 16TH STREET 3RD FLO	SUITE 3100 PODS A AND B	SANTA MONICA	CA	90404	1275	19	06037	34.02773198	-118.4862675	Los Angeles County
14392	Fee-for-Service	1306965587	1306965587	1	1	HURTT FAMILY HEALTH CLINIC,	5/13/2010	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	1 HOPE DR	None	TUSTIN	CA	92782	0221	30	06059	33.71470753	-117.8323965	Orange County
14399	Fee-for-Service	1588989529	1588989529	1	1	HSU, YIO-FAN D MD	1/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118854	41	Internal Medicine	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
14414	Fee-for-Service	1265414155	1265414155	1	1	HOSNY, AYMAN MD	12/21/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	40878	41	Internal Medicine	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
14420	Fee-for-Service	1255475307	1255475307	1	1	HERNANDEZ, LILIANA C LMFT	7/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
14470	Fee-for-Service	1265835870	1265835870	1	1	HOEKMAN, DAWN LMFT	12/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5001 BIRCH ST.	None	NEWPORT BEACH	CA	92660	2116	30	06059	33.66651211	-117.8592186	Orange County
14509	Fee-for-Service	1124386032	1124386032	1	1	HAMIDI, SEPEHR MD	6/24/2019	207ZP0105X	NA	Other	026	PHYSICIANS	133336	21	Pathologic Anatomy: Clinical Pathology (D.O. 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
14522	Fee-for-Service	1487802674	1487802674	1	1	HUYNH, TAM T MD	1/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105303	41	Internal Medicine	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
14529	Fee-for-Service	1083787907	1083787907	1	1	HOSSAIN, SYED M G MD	5/16/2013	207R00000X	NA	Other	026	PHYSICIANS	77221	01	General Practice	0	In state provider	None	1711 W TEMPLE ST	STE 5658	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
14544	Fee-for-Service	1992968820	1992968820	1	1	HIROSHIMA, DAVID T MD	12/29/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	97627	08	Family Practice	0	In state provider	None	2734 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3007	43	06085	37.35228637	-121.9754073	Santa Clara County
14590	Fee-for-Service	1821594144	1821594144	1	7	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	714 W LODI AVE	None	LODI	CA	95240	3429	39	06077	38.1299637	-121.2823792	San Joaquin County
14600	Fee-for-Service	1912651621	1912651621	1	1	HEALTH HUB HOME HEALTH INC	11/13/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15130 VENTURA BLVD	SUITE 307	SHERMAN OAKS	CA	91403	3378	19	06037	34.15320952	-118.4627115	Los Angeles County
14606	Fee-for-Service	1629168307	1629168307	1	1	HASSELL, KATHRYN L MD	11/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	68	Hematology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
14616	Fee-for-Service	1164062287	1164062287	1	1	HARRAH, BETTY J	12/20/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
14629	Fee-for-Service	1619556180	1619556180	1	1	HASSAN, SHARJEEL DO	7/19/2024	207R00000X	NA	Other	026	PHYSICIANS	21551	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
14636	Fee-for-Service	1942629514	1942629514	1	1	HENG, CHAMROEUN MD	8/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144148	41	Internal Medicine	0	In state provider	None	3800 DALE RD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
14646	Fee-for-Service	1558577072	1558577072	1	1	HULME, JOAN MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43317	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
14658	Fee-for-Service	1679087829	1679087829	1	1	HEARY, JESSICA J PT	6/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	210 W PINE ST	None	LODI	CA	95240	2020	39	06077	38.13427214	-121.2755342	San Joaquin County
14662	Fee-for-Service	1679996102	1679996102	1	1	HUR, KEVIN MD	8/30/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	138738	04	Otology, Laryngology, Rhinology	0	In state provider	None	1450 SAN PABLO STREET	SUITE 5901	LOS ANGELES	CA	90033	5313	19	06037	34.06189518	-118.203256	Los Angeles County
14665	Fee-for-Service	1073058087	1073058087	1	1	HORWICH, BRIAN H MD	4/23/2025	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	164684	68	Hematology	0	In state provider	None	1223 16TH STREET 3RD FLO	SUITE 3100 PODS A AND B	SANTA MONICA	CA	90404	1275	19	06037	34.02773198	-118.4862675	Los Angeles County
14680	Fee-for-Service	1306965587	1306965587	1	1	HURTT FAMILY HEALTH CLINIC,	5/13/2010	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INC	1 HOPE DR	None	TUSTIN	CA	92782	0221	30	06059	33.71470753	-117.8323965	Orange County
14683	Fee-for-Service	1316156037	1316156037	1	1	HARVEY R GOLDSTONE OD	4/19/2007	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL CORP	2280 E CARSON ST	None	LONG BEACH	CA	90807	3044	19	06037	33.83241248	-118.164456	Los Angeles County
14690	Fee-for-Service	1871621755	1871621755	1	1	HOLDEN KNAPP & LANGSFOR	2/4/2008	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	FAMILY OPTOMETRIC GROUP	1545 W 5TH ST	STE 100	OXNARD	CA	93030	6510	56	06111	34.19757729	-119.1961091	Ventura County
14717	Fee-for-Service	1760457808	1760457808	1	1	HAN, THEIN H MD	7/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	82881	36	Psychiatry	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
14726	Fee-for-Service	1811952971	1811952971	1	1	HEMINGWAY, THOMAS J MD	9/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87616	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
14727	Fee-for-Service	1740691294	1740691294	1	1	HAN, YOUNG M MD	10/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144222	41	Internal Medicine	0	In state provider	None	43112 15TH ST WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
14736	Fee-for-Service	1760411086	1760411086	1	1	HERINGER, SARAH J MD	5/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9055	None	None	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
14755	Fee-for-Service	1467870733	1467870733	1	1	HARO, SARA L MD	8/24/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	141380	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
14757	Fee-for-Service	1972762227	1972762227	1	1	HADI, JOSEPH M MD	3/14/2019	208VP0000X	NA	Other	026	PHYSICIANS	149672	25	Physical Medicine and Rehabilitation	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
14819	Fee-for-Service	1083787907	1083787907	1	1	HOSSAIN, SYED M G MD	5/16/2013	207R00000X	NA	Other	026	PHYSICIANS	77221	41	Internal Medicine	0	In state provider	None	1711 W TEMPLE ST	STE 5658	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
14838	Fee-for-Service	1174659064	1174659064	1	1	HADI, GHASSAN MD INC	1/15/2009	207R00000X	NA	Other	026	PHYSICIANS	52261	None	None	0	In state provider	None	1060 E FOOTHILL BLVD	SUITE 103	UPLAND	CA	91786	4070	36	06071	34.1070235	-117.6371235	San Bernardino County
14865	Fee-for-Service	1063021467	1063021467	1	1	HUAYI MEDICAL PROFESSIONAL C	8/6/2020	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	ORPORATION	2000 MOWRY	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
14883	Fee-for-Service	1558449371	1558449371	1	1	HAZRATI, YASSAMIN MD	6/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86090	20	Orthopedic Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
14893	Fee-for-Service	1629168307	1629168307	1	1	HASSELL, KATHRYN L MD	11/1/2018	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
14928	Fee-for-Service	1285796938	1285796938	1	1	HILGERS, SARAH A	8/8/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
14934	Fee-for-Service	1558577072	1558577072	1	1	HULME, JOAN MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43317	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
14957	Fee-for-Service	1033140702	1033140702	1	2	HASSID, EDWIN J MD	7/6/2017	207R00000X	NA	Other	026	PHYSICIANS	26176	41	Internal Medicine	0	In state provider	None	2300 SUTTER ST	SUITE 203	SAN FRANCISCO	CA	94115	3029	38	06075	37.78546004	-122.4384038	San Francisco County
14958	Fee-for-Service	1346399607	1346399607	1	1	HO, CUONG N MD	12/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9138	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
14968	Fee-for-Service	1306965587	1306965587	1	1	HURTT FAMILY HEALTH CLINIC,	5/13/2010	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	1 HOPE DR	None	TUSTIN	CA	92782	0221	30	06059	33.71470753	-117.8323965	Orange County
14971	Fee-for-Service	1588930788	1588930788	1	1	HANF, JUDITH B LMFT	1/14/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1588 HOMESTEAD RD.	SUITE A, M/B 5	SANTA CLARA	CA	95050	4783	43	06085	37.34637328	-121.9509049	Santa Clara County
15083	Fee-for-Service	1407934102	1407934102	1	1	HINE, JAMES E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36076	18	Ophthalmology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
15109	Fee-for-Service	1992343651	1992343651	1	1	HIGHLAND HOSPICE INC	1/19/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21220 DEVONSHIRE STREET	STE 211	CHATSWORTH	CA	91311	8260	19	06037	34.25721448	-118.594494	Los Angeles County
15112	Fee-for-Service	1790791614	1790791614	1	1	HUERTA-IBARRA, JOSE F MD	12/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94115	41	Internal Medicine	0	In state provider	None	1150 MAIN ST	STE 3	WATSONVILLE	CA	95076	3760	44	06087	36.9163164	-121.7698107	Santa Cruz County
15118	Fee-for-Service	1386405975	1386405975	1	1	HUA, JUSTIN OD	9/27/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1909 N WATERMAN AVE	3	SAN BERNARDINO	CA	92404	4842	36	06071	34.132626	-117.2787445	San Bernardino County
15127	Fee-for-Service	1164413969	1164413969	1	1	HOLMES, CATHY DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	310 WENDELL AVE STE 103	None	LEWISTOWN	MT	59457	0000	00	None	47.058021	-109.4434515	Fergus County
15164	Fee-for-Service	1740643436	1740643436	1	1	HODSON, MEGHAN NP	9/12/2017	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
15172	Fee-for-Service	1346736600	1346736600	1	1	HENSHAW, JENNIFER L LMFT	5/10/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	288 W 9TH ST	None	UPLAND	CA	91786	5949	36	06071	34.0960435	-117.6548445	San Bernardino County
15176	Fee-for-Service	1821594144	1821594144	1	1	HEARINGLIFE HEARING AID CENT	11/20/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	1850 DOUGLAS BLVD	STE 992	ROSEVILLE	CA	95661	3639	31	06061	38.74415734	-121.2570324	Placer County
15181	Fee-for-Service	1629168307	1629168307	1	1	HASSELL, KATHRYN L MD	11/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	78	Neoplastic Diseases/Oncology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
15195	Fee-for-Service	1962594879	1962594879	1	1	HYDE,MARC MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2055 NORTH MAIN	None	TOOELE	UT	84074	2794	00	None	40.56668579	-112.2959013	Tooele County
15203	Fee-for-Service	1720288855	1720288855	1	1	HIPPEN, RACHELLE M MD	10/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	104469	08	Family Practice	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
15223	Fee-for-Service	1730250713	1730250713	1	1	HOLMES, CHONITA L MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	54205	30	Radiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
15255	Fee-for-Service	1306965587	1306965587	1	1	HURTT FAMILY HEALTH CLINIC,	5/13/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INC	1 HOPE DR	None	TUSTIN	CA	92782	0221	30	06059	33.71470753	-117.8323965	Orange County
15281	Fee-for-Service	1770908923	1770908923	1	1	HARKIN, DEBORAH A LMFT	8/13/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	111 E ARRELLAGA ST	None	SANTA BARBARA	CA	93101	1903	42	06083	34.42855504	-119.7080507	Santa Barbara County
15310	Fee-for-Service	1548224819	1548224819	1	1	HUA, SAMANTHA P OD	3/8/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
15318	Fee-for-Service	1740213487	1740213487	1	1	HOLDEN, MATTHEW G PHD	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2830 4TH AVE	None	SAN DIEGO	CA	92103	6208	37	06073	32.734971	-117.161257	San Diego County
15361	Fee-for-Service	1245380617	1245380617	1	1	HO, RAYMOND C T MD	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	36519	40	Pediatrics	0	In state provider	None	1818 N ORANGE GROVE AVE	STE 200	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
15397	Fee-for-Service	1992343651	1992343651	1	1	HIGHLAND HOSPICE INC	1/19/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21220 DEVONSHIRE STREET	STE 211	CHATSWORTH	CA	91311	8260	19	06037	34.25721448	-118.594494	Los Angeles County
15432	Fee-for-Service	1881779023	1881779023	1	1	HAN, DONG S OD	8/10/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3323 WEST OLYMPIC BLVD	None	LOS ANGELES	CA	90019	2351	19	06037	34.0526805	-118.30986	Los Angeles County
15445	Fee-for-Service	1902320443	1902320443	1	1	HOLDEN, HALIE N NP	11/16/2021	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
15457	Fee-for-Service	1801955638	1801955638	1	1	HORN, HELEN F LCSW	9/18/2018	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
15458	Fee-for-Service	1730593682	1730593682	1	1	HUNG, HENRY C MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145914	41	Internal Medicine	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
15477	Fee-for-Service	1225124076	1225124076	1	1	HOWE, KEVIN K MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60095	None	None	0	In state provider	None	990 SONOMA AVE	STE 8	SANTA ROSA	CA	95404	4813	49	06097	38.439729	-122.701545	Sonoma County
15514	Fee-for-Service	1447347901	1447347901	1	1	HART, RICHARD H MD	8/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	21051	01	General Practice	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
15517	Fee-for-Service	1164876801	1164876801	1	1	HSIEH, CLIFFORD MD	10/31/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	169244	07	Dermatology	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
15540	Fee-for-Service	1699867986	1699867986	1	1	HU, LI-MIN JIMMY MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	76001	40	Pediatrics	0	In state provider	None	1411 E 31ST ST	# A3	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
15549	Fee-for-Service	1437260601	1437260601	1	1	HACKER,TREVOR W MD	1/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	79481	08	Family Practice	0	In state provider	None	7601 HOSPITAL DR	STE 103	SACRAMENTO	CA	95823	5408	34	06067	38.464794	-121.415571	Sacramento County
15590	Fee-for-Service	1770568255	1770568255	1	1	HUGHES, STEVEN 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	1400 EAST BOULDER	None	COLORADO SPRINGS	CO	80909	0000	00	None	38.8388119	-104.7995065	El Paso County
15599	Fee-for-Service	1104916808	1104916808	1	1	HOFFMAN WINBERRY, KAREN S LM	2/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	3532 KATELLA AVENUE	221	LOS ALAMITOS	CA	90720	3112	30	06059	33.80299947	-118.071135	Orange County
15616	Fee-for-Service	1275623753	1275623753	1	1	HILLER,II FREDRICK 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	4301 W MARKHAM ST	SLOT 521	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
15642	Fee-for-Service	1083621957	1083621957	1	1	HALAMANDARIS, GUS G MD	10/13/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	57889	14	Neurological Surgery	0	In state provider	None	220 SAN JOSE ST	None	SALINAS	CA	93901	3901	27	06053	36.65846024	-121.64729	Monterey County
15659	Fee-for-Service	1760575195	1760575195	1	1	HILL DRUGS INC	3/18/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1441 AVOCADO AVE	STE 101	NEWPORT BEACH	CA	92660	7702	30	06059	33.61338536	-117.8693961	Orange County
15673	Fee-for-Service	1407557069	1407557069	1	1	HIDALGO, CLARISSA L BIRTH DO	8/7/2023	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	24	06047	0	0	None
15705	Fee-for-Service	1912727728	1912727728	1	1	HATTON, A'YANNA DOULA	1/29/2025	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	37	06073	0	0	None
15713	Fee-for-Service	1831146240	1831146240	1	1	HOLLAND, JAMES P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35778	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
15724	Fee-for-Service	1154644334	1154644334	1	1	HOLT, MARK MANNING MD APC	10/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	53118	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	35400 BOB HOPE DRIVE	SUITE 103	RANCHO MIRAGE	CA	92270	1772	33	06065	33.7914	-116.4058625	Riverside County
15784	Fee-for-Service	1194802322	1194802322	1	1	HINSDALE, JAMES G MD	7/27/2005	208600000X	NA	General Surgery	026	PHYSICIANS	29741	02	General Surgery	0	In state provider	None	2505 SAMARITAN DR	STE 504	SAN JOSE	CA	95124	4014	43	06085	37.25111447	-121.9483395	Santa Clara County
15789	Fee-for-Service	1184784035	1184784035	1	1	HOLLBLAD-FADIMAN, KATERI	3/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	54453	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
15822	Fee-for-Service	1255537163	1255537163	1	1	HALKIAS, JOANNA MD	8/19/2008	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	83656	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
15861	Fee-for-Service	1174570576	1174570576	1	1	HAYS, STEVEN RICHARD MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68227	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
15927	Fee-for-Service	1669583811	1669583811	2	1	HOOL, ARMANDO MD	7/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44087	41	Internal Medicine	0	In state provider	None	17071 SPRINGDALE ST	None	HUNTINGTON BEACH	CA	92649	4669	30	06059	33.7144429	-118.0239762	Orange County
15930	Fee-for-Service	1659674547	1659674547	1	1	HIGH QUALITY HOSPICE CARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	21707 HAWTHORNE BLVD	SUITE 304	TORRANCE	CA	90503	6708	19	06037	33.83065871	-118.3526165	Los Angeles County
15948	Fee-for-Service	1013798743	1013798743	1	1	HERNANDEZ, SUSANA J AU	12/6/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W. PROVIDENCE	None	ORANGE	CA	92868	3808	30	06059	33.78142951	-117.866583	Orange County
15949	Fee-for-Service	1356637698	1356637698	1	2	HUYNH, DANNY L MD	5/22/2019	208800000X	NA	Other	026	PHYSICIANS	142398	34	Urology and Urological Surgery	0	In state provider	None	2120 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3703	15	06029	35.3734495	-119.026503	Kern County
15963	Fee-for-Service	1962502773	1962502773	1	1	HUA, MENG	3/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81531	41	Internal Medicine	0	In state provider	None	6719 ALVARADO RD	STE 206	SAN DIEGO	CA	92120	5261	37	06073	32.77684978	-117.055137	San Diego County
15968	Fee-for-Service	1780699538	1780699538	1	1	HALIO, AMY A MD	3/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	57604	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
15983	Fee-for-Service	1659864783	1659864783	1	1	HUYNH, JONATHAN MD	8/7/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	365 HAWTHORNE AVE	STE 101-102	OAKLAND	CA	94609	3107	01	06001	37.82079728	-122.2633226	Alameda County
16014	Fee-for-Service	1154644334	1154644334	1	1	HOLT, MARK MANNING MD APC	10/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	53118	41	Internal Medicine	0	In state provider	None	35400 BOB HOPE DRIVE	SUITE 103	RANCHO MIRAGE	CA	92270	1772	33	06065	33.7914	-116.4058625	Riverside County
16021	Fee-for-Service	1437335759	1437335759	1	1	HSU, YAO W MD INC	10/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61296	None	None	0	In state provider	None	5240 E BEVERLY BLVD	None	LOS ANGELES	CA	90022	2002	19	06037	34.03136608	-118.1524713	Los Angeles County
16058	Fee-for-Service	1689145427	1689145427	1	1	HANSEN, BRIAN K CRNA	11/13/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
16060	Fee-for-Service	1538684790	1538684790	1	1	HAWARI, FERAS I MD	6/3/2020	207RC0200X	NA	Other	026	PHYSICIANS	62303	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	0001	39	06077	37.97026329	-121.2890849	San Joaquin County
16073	Fee-for-Service	1194480566	1194480566	1	1	HOMSANY, KATHERINE LMFT	8/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8775 AERO DRIVE	STE 238	SAN DIEGO	CA	92123	1756	37	06073	32.80965551	-117.1391563	San Diego County
16109	Fee-for-Service	1497839484	1497839484	1	1	HANANEL, ORNA MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53315	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
16122	Fee-for-Service	1164721395	1164721395	1	1	HUNTER, DONNA M	6/17/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	2874 N CARSON ST	STE 300	CARSON CITY	NV	89706	1683	00	None	39.185271	-119.7710595	Consolidated Municipality of Carson City
16146	Fee-for-Service	1174570576	1174570576	1	1	HAYS, STEVEN RICHARD MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68227	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
16163	Fee-for-Service	1407033970	1407033970	1	1	HSIEH, SHAWN J MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108345	25	Physical Medicine and Rehabilitation	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
16184	Fee-for-Service	1083685606	1083685606	1	1	HERMAN SANITARIUM	6/30/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2295 PLUMMER AVE	None	SAN JOSE	CA	95125	4767	43	06085	37.28276536	-121.899161	Santa Clara County
16190	Fee-for-Service	1134749914	1134749914	1	1	HANSON, NICOLE DO	4/29/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	21276	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
16220	Fee-for-Service	1659674547	1659674547	1	1	HIGH QUALITY HOSPICE CARE	8/24/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	21707 HAWTHORNE BLVD	SUITE 304	TORRANCE	CA	90503	6708	19	06037	33.83065871	-118.3526165	Los Angeles County
16237	Fee-for-Service	1760442248	1760442248	1	1	HAYASHI, ROGER A OD	6/8/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7409 N CEDAR AVE	STE 103	FRESNO	CA	93720	3836	10	06019	36.84340721	-119.756868	Fresno County
16253	Fee-for-Service	1962502773	1962502773	1	1	HUA, MENG	3/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81531	10	Gastroenterology (M.D. only)	0	In state provider	None	6719 ALVARADO RD	STE 206	SAN DIEGO	CA	92120	5261	37	06073	32.77684978	-117.055137	San Diego County
16278	Fee-for-Service	1518025865	1518025865	1	1	HOOVER, CORA R MD	8/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76450	08	Family Practice	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
16307	Fee-for-Service	1588652762	1588652762	1	1	HECKER, CARRIE T CRNA	12/17/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
16309	Fee-for-Service	1164622155	1164622155	1	1	HAMLIN, CORETTA J MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	100276	41	Internal Medicine	0	In state provider	None	444 BRUCE ST	None	YREKA	CA	96097	3450	47	06093	41.71863548	-122.6458755	Siskiyou County
16339	Fee-for-Service	1033642996	1033642996	2	1	HANAMI, DYLAN MD	3/22/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157901	None	None	0	In state provider	None	8627 ATLANTIC AVE	None	SOUTH GATE	CA	90280	3501	19	06037	33.95462085	-118.1838426	Los Angeles County
16349	Fee-for-Service	1730648510	1730648510	1	1	HAYOSTEK, OLIVIA C MD	3/21/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178148	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
16376	Fee-for-Service	1558687715	1558687715	1	1	HOWARD, CATHERINE C	4/4/2011	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
16440	Fee-for-Service	1013109677	1013109677	1	1	HAWKINS, ETHEL MARIE	5/11/2007	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3713 E ARABELLA ST	None	LONG BEACH	CA	90805	3915	19	06037	33.86282464	-118.1486557	Los Angeles County
16452	Fee-for-Service	1083174452	1083174452	1	1	HITE, ASHLEY N MD	4/30/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	180581	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
16495	Fee-for-Service	1427644731	1427644731	1	1	HOFFMAN, COURTNEY T LCSW	4/16/2021	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
16539	Fee-for-Service	1225640220	1225640220	1	2	HOLLOWAY, CHRISTOPHER J CO	10/11/2023	335E00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	4517 MARKET STREET	SUITE 4	VENTURA	CA	93003	7841	56	06111	34.25728623	-119.2321419	Ventura County
16541	Fee-for-Service	1932471141	1932471141	1	1	HUANG, HUI-CHIA NP	9/21/2018	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
16590	Fee-for-Service	1235375270	1235375270	1	1	HUGHES, TRACY LCSW	2/27/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11838 BERNARDO PLAZA CT	STE 250	SAN DIEGO	CA	92128	2411	37	06073	33.02037119	-117.0760729	San Diego County
16623	Fee-for-Service	1174673040	1174673040	1	1	HUGHES, JOSEPH A MD	5/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	82108	22	Pathology (M.D. only)	0	In state provider	None	4077 5TH AVENUE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
16628	Fee-for-Service	1740360650	1740360650	1	1	HATASAKA, HARRY H MD	8/9/2023	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	65740	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
16630	Fee-for-Service	1720307242	1720307242	1	1	HO, SZE CHUN WINSON MD	8/4/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	179290	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
16635	Fee-for-Service	1699876011	1699876011	1	1	HANNEKEN, ANNE M MD	3/22/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	68946	18	Ophthalmology	0	In state provider	None	810 E OHIO AVE	None	ESCONDIDO	CA	92025	3421	37	06073	33.12651511	-117.0715892	San Diego County
16636	Fee-for-Service	1972738581	1972738581	1	1	HARMANN INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3649 W BEECHWOOD AVE	SUITE 106-A	FRESNO	CA	93711	1296	10	06019	36.8382345	-119.8591335	Fresno County
16645	Fee-for-Service	1740423888	1740423888	1	1	HUNG, MAO H MD AMC	1/25/2010	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	30974	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	313 E BUENA VISTA ST	STE 103	BARSTOW	CA	92311	2801	36	06071	34.8956289	-117.0238856	San Bernardino County
16675	Fee-for-Service	1922009687	1922009687	1	1	HOLT, TODD 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	921 GESSNER RD	STE 2225	HOUSTON	TX	77024	2501	00	None	29.78103452	-95.54443544	Harris County
16679	Fee-for-Service	1700976305	1700976305	1	1	HUANG, IVAN MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	74604	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
16689	Fee-for-Service	1942684618	1942684618	1	1	HARDEMAN, JOSEPH C	1/4/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	39899 BALENTINE	200	NEWARK	CA	94560	5355	01	06001	37.52205657	-121.993549	Alameda County
16690	Fee-for-Service	1861673014	1861673014	1	1	HSIEH, RUSSELL M MD	11/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113760	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
16717	Fee-for-Service	1255963930	1255963930	1	1	HOPE & MERCY HOSPICE CARE	6/8/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	4959 PALO VERDE STREET	STE 204C-2	MONTCLAIR	CA	91763	2331	36	06071	34.08129954	-117.6966135	San Bernardino County
16732	Fee-for-Service	1689854010	1689854010	1	1	H&A HOSPICE, INC	11/9/2007	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	299 W HILLCREST DR	STE 106	THOUSAND OAKS	CA	91360	7823	56	06111	34.18347138	-118.8843918	Ventura County
16738	Fee-for-Service	1225186539	1225186539	1	1	HAMMERSTEAD, H E MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23114	41	Internal Medicine	0	In state provider	None	10717 CAMINO RUIZ	STE 222	SAN DIEGO	CA	92126	2364	37	06073	32.91373261	-117.1437822	San Diego County
16740	Fee-for-Service	1326127051	1326127051	1	1	HUANG, JERRY C DO	10/31/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8381	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
16744	Fee-for-Service	1962053793	1962053793	1	1	HARDING, ERIC LMFT	9/25/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41555 COOK ST	100	PALM DESERT	CA	92211	5184	33	06065	33.74651823	-116.3563827	Riverside County
16758	Fee-for-Service	1184044760	1184044760	1	1	HO, ELLIOT Y DO	8/1/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	14281	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
16779	Fee-for-Service	1629063185	1629063185	1	1	HAUSMAN, JONATHAN MD	7/17/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79835	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
16782	Fee-for-Service	1114932506	1114932506	1	1	HOOFFSTETTER, JUDITH B MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	51507	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
16814	Fee-for-Service	1710123872	1710123872	1	1	HAMMER, ELIZABETH S PHD	8/15/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5353 MISSION CENTER RD	SUITE 224	SAN DIEGO	CA	92108	1306	37	06073	32.77207362	-117.154699	San Diego County
16820	Fee-for-Service	1073804696	1073804696	1	1	HSIEH, CHRISTINE MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148103	02	General Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
16867	Fee-for-Service	1376255711	1376255711	1	1	HILLEARY, DOROTHY M LMFT	3/27/2023	101YM0800X	NA	Other	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
16892	Fee-for-Service	1629127428	1629127428	1	1	HWANG, PETER H MD	4/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75836	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
16904	Fee-for-Service	1669641460	1669641460	1	1	HUANG, LAWRENCE PO DO	10/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	9701	25	Physical Medicine and Rehabilitation	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
16922	Fee-for-Service	1972738581	1972738581	1	1	HARMANN INC	7/7/2010	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3649 W BEECHWOOD AVE	SUITE 106-A	FRESNO	CA	93711	1296	10	06019	36.8382345	-119.8591335	Fresno County
16928	Fee-for-Service	1689177529	1689177529	1	1	HARDY, BRIDGET CCC-SLP	7/25/2022	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
16936	Fee-for-Service	1932799871	1932799871	1	1	HOPE HEALTH CENTRAL COAST	3/17/2022	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	14900 EL CAMINO REAL	None	ATASCADERO	CA	93422	6417	40	06079	35.42950475	-120.6067977	San Luis Obispo County
16941	Fee-for-Service	1003093816	1003093816	1	1	HURVITZ, TARYN U	5/6/2008	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 N ROSE AVE	#460	OXNARD	CA	93030	7629	56	06111	34.21746	-119.155545	Ventura County
16952	Fee-for-Service	1902978745	1902978745	1	1	HADAP, VAISHALI V MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69433	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
17007	Fee-for-Service	1255963930	1255963930	1	1	HOPE & MERCY HOSPICE CARE	6/8/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	4959 PALO VERDE STREET	STE 204C-2	MONTCLAIR	CA	91763	2331	36	06071	34.08129954	-117.6966135	San Bernardino County
17018	Fee-for-Service	1689854010	1689854010	1	1	H&A HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	299 W HILLCREST DR	STE 106	THOUSAND OAKS	CA	91360	7823	56	06111	34.18347138	-118.8843918	Ventura County
17026	Fee-for-Service	1225186539	1225186539	1	1	HAMMERSTEAD, H E MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23114	02	General Surgery	0	In state provider	None	10717 CAMINO RUIZ	STE 222	SAN DIEGO	CA	92126	2364	37	06073	32.91373261	-117.1437822	San Diego County
17065	Fee-for-Service	1356343172	1356343172	1	1	HANTKE, DAVID R MD INC	10/31/1985	174400000X	NA	Other	026	PHYSICIANS	48701	04	Otology, Laryngology, Rhinology	0	In state provider	None	3003 LOMA VISTA RD	STE A	VENTURA	CA	93003	2938	56	06111	34.27572109	-119.255478	Ventura County
17078	Fee-for-Service	1881746246	1881746246	1	1	HO, IRENE KA SHUEN MD	7/8/1996	207R00000X	NA	Other	026	PHYSICIANS	78995	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
17106	Fee-for-Service	1730157751	1730157751	1	1	HAMAMOTO, VALERIE K 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
17123	Fee-for-Service	1356019038	1356019038	1	1	HALL, JAMEELA LCSW	3/20/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
17141	Fee-for-Service	1710540083	1710540083	1	1	HILLMAN, JOSHUA MD	7/19/2022	207R00000X	NA	Other	026	PHYSICIANS	178507	None	None	0	In state provider	None	320 SANTA FE DRIVE	107-B	ENCINITAS	CA	92024	1334	37	06073	33.038847	-117.285579	San Diego County
17149	Fee-for-Service	1588770531	1588770531	1	1	HERNANDEZ-SCHNEIDER,ANA	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	58282	08	Family Practice	0	In state provider	None	500 S ANAHEIM HILLS RD	STE 128	ANAHEIM	CA	92807	4762	30	06059	33.8427954	-117.7772895	Orange County
17166	Fee-for-Service	1437656378	1437656378	1	1	HUYNH, DUY HOA DO	10/15/2021	207R00000X	NA	Other	026	PHYSICIANS	17887	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
17182	Fee-for-Service	1003974346	1003974346	1	1	HILL, DENNIS R MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	17225	30	Radiology	0	In state provider	None	3012 SUMMIT ST	# 2675	OAKLAND	CA	94609	3480	01	06001	37.81947101	-122.264516	Alameda County
17192	Fee-for-Service	1891254165	1891254165	1	1	HUI, CARESSA Y MD	8/8/2024	2085R0001X	NA	Other	026	PHYSICIANS	182429	30	Radiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
17205	Fee-for-Service	1922065788	1922065788	1	1	HARRIS, WILLIAM G MD	7/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	64493	03	Allergy	0	In state provider	None	505 SOUTH MAIN STREET	#250	ORANGE	CA	92868	4515	30	06059	33.78004808	-117.8672472	Orange County
17213	Fee-for-Service	1336224617	1336224617	1	1	HARRINGTON,MICHAEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMER PHYS PROF ASSN	4401 GARTH ROAD	None	BAYTOWN	TX	77521	0000	00	None	29.76910842	-94.97759843	Harris County
17214	Fee-for-Service	1215286588	1215286588	1	1	HUAN, LIANG F MD	6/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121557	40	Pediatrics	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
17227	Fee-for-Service	1134633845	1134633845	1	2	HAN, DAVID LCSW	5/24/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	96434	-	NOT APPLICABLE	0	In state provider	None	3535 W COMMONWEALTH AVE	None	FULLERTON	CA	92833	2821	30	06059	33.8700505	-117.9749565	Orange County
17279	Fee-for-Service	1851016869	1851016869	2	1	HWANG, OH JOO OD	1/8/2025	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	953 N EUCLID ST	None	ANAHEIM	CA	92801	3633	30	06059	33.84539633	-117.9416732	Orange County
17281	Fee-for-Service	1629150396	1629150396	1	1	HODGE, JULIE A MD	3/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	48399	None	None	0	In state provider	None	433 W BASTANCHURY RD	None	FULLERTON	CA	92835	3404	30	06059	33.89344341	-117.9338865	Orange County
17284	Fee-for-Service	1184698516	1184698516	1	1	HARRIS, KENNETH W MD	8/27/2021	207R00000X	NA	Other	026	PHYSICIANS	45727	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
17290	Fee-for-Service	1134607963	1134607963	1	1	HEU, MAYBO NP	2/24/2020	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
17309	Fee-for-Service	1447253943	1447253943	1	1	HOME HEALTH CARE	9/2/1993	251E00000X	NA	Other	073	AIDS WAIVER SERVICES	-	-	NOT APPLICABLE	0	In state provider	MANAGEMENT, INC	1398 RIDGEWOOD DR	None	CHICO	CA	95973	7801	04	06007	39.77506005	-121.8388441	Butte County
17313	Fee-for-Service	1225186539	1225186539	1	1	HAMMERSTEAD, H E MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	23114	33	Thoracic Surgery	0	In state provider	None	10717 CAMINO RUIZ	STE 222	SAN DIEGO	CA	92126	2364	37	06073	32.91373261	-117.1437822	San Diego County
17315	Fee-for-Service	1730442369	1730442369	1	1	HILL, TYLER L DO	10/29/2022	207P00000X	NA	Other	026	PHYSICIANS	20164	None	None	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
17321	Fee-for-Service	1023829959	1023829959	1	1	HUYNH, VAN T NP	3/1/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
17327	Fee-for-Service	1932688363	1932688363	1	1	HERNANDEZ, REGINA LCSW	9/17/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
17358	Fee-for-Service	1174054639	1174054639	1	1	HANNA, HELEN MD	6/3/2020	208M00000X	NA	Other	026	PHYSICIANS	165382	41	Internal Medicine	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
17407	Fee-for-Service	1700177615	1700177615	1	2	HAZEN, JANET I PSYD	1/26/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1255 TRAVIS BLVD	None	FAIRFIELD	CA	94533	4801	48	06095	38.25815459	-122.0487714	Solano County
17409	Fee-for-Service	1225158033	1225158033	1	1	HURT-COPPOLA, JACQUELINE N L	4/16/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10098 JIBBOOM ST	101	TRUCKEE	CA	96161	0287	29	06057	39.32833822	-120.1860851	Nevada County
17412	Fee-for-Service	1114144219	1114144219	1	1	HOBLEY, DAVID A MD	4/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120004	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
17466	Fee-for-Service	1629265715	1629265715	1	1	HI-DESERT SURGERY CTR	5/24/1994	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	18002 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2149	36	06071	34.54051774	-117.2711054	San Bernardino County
17468	Fee-for-Service	1114940343	1114940343	1	1	HARGROVE, ROBERT H MD	3/1/1984	207N00000X	NA	Dermatology	026	PHYSICIANS	46499	07	Dermatology	0	In state provider	None	10 SIERRA GATE PLZ	STE 120	ROSEVILLE	CA	95678	6647	31	06061	38.75443205	-121.2666222	Placer County
17493	Fee-for-Service	1568100261	1568100261	1	1	HONDA, JANE AU	6/14/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
17498	Fee-for-Service	1295844850	1295844850	1	1	HUGHES, KEITH MD	2/28/1988	207P00000X	NA	Other	026	PHYSICIANS	42735	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2311 LOVERIDGE RD	None	PITTSBURG	CA	94565	5117	07	06013	38.00694767	-121.8712439	Contra Costa County
17503	Fee-for-Service	1245590884	1245590884	1	1	HERNANDEZ, STEPHANIE L LMFT	2/12/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
17518	Fee-for-Service	1679118475	1679118475	1	1	HEAVENLY ADHC INC	3/5/2025	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	4506 KINGSWELL AVENUE	None	LOS ANGELES	CA	90027	4406	19	06037	34.10267186	-118.2877932	Los Angeles County
17534	Fee-for-Service	1164814224	1164814224	1	1	HIOE, DANIEL R S CRNA	6/3/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	400 N PEPPER AVE	2ND FL ANESTHESIA DEPT	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
17535	Fee-for-Service	1104352210	1104352210	2	1	HEATH, HOBART B DO	4/27/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18236	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
17598	Fee-for-Service	1447253943	1447253943	1	1	HOME HEALTH CARE	4/1/2010	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	MANAGEMENT, INC	1398 RIDGEWOOD DR	None	CHICO	CA	95973	7801	04	06007	39.77506005	-121.8388441	Butte County
17627	Fee-for-Service	1720196777	1720196777	1	1	HEADDEN,GARY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	171 ASHLEY AVE	None	CHARLESTON	SC	29425	0001	00	None	32.78556	-79.9467075	Charleston County
17654	Fee-for-Service	1194133389	1194133389	1	1	HARDING, CAMERON MD	5/5/2019	208M00000X	NA	Other	026	PHYSICIANS	161280	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
17656	Fee-for-Service	1992795124	1992795124	1	1	HOGAN-DAWN, COLLEEN MD	12/31/1985	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	48464	40	Pediatrics	0	In state provider	None	200 PORTER DR	STE 300	SAN RAMON	CA	94583	1524	07	06013	37.77372204	-121.9911155	Contra Costa County
17657	Fee-for-Service	1124700489	1124700489	1	1	HODGE, LATOYA	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	10	06019	0	0	None
17662	Fee-for-Service	1912932062	1912932062	1	1	HANDY, MARK W MD	2/21/1995	207P00000X	NA	Other	026	PHYSICIANS	65022	01	General Practice	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
17698	Fee-for-Service	1033768346	1033768346	1	1	HACKETT, ALLISON CCC-SLP	3/31/2020	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
17699	Fee-for-Service	1700488921	1700488921	1	1	HUDSON, ASHLEY N PHD	3/23/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2195 CLUB CENTER DR	STE L	SAN BERNARDINO	CA	92408	4162	36	06071	34.06055692	-117.2814193	San Bernardino County
17750	Fee-for-Service	1831346352	1831346352	1	1	HEREDIA, HECTOR MD APC	12/8/2008	207R00000X	NA	Other	026	PHYSICIANS	50069	01	General Practice	0	In state provider	None	401 H STREET	STE 5	CHULA VISTA	CA	91910	4321	37	06073	32.6332882	-117.0813972	San Diego County
17753	Fee-for-Service	1013594399	1013594399	1	1	HERRERA, GABRIELLA MD	10/28/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
17801	Fee-for-Service	1801044789	1801044789	1	1	HUSSAN, HISHAM MD	11/1/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	179407	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
17813	Fee-for-Service	1336362524	1336362524	1	1	HANCOCK,ROBERT DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1441 N BECKLEY AVE	None	DALLAS	TX	75203	1201	00	None	32.76063	-96.8257485	Dallas County
17846	Fee-for-Service	1114389574	1114389574	1	1	HOLLIDAY, JESSICA R MD	7/14/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	151349	None	None	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
17882	Fee-for-Service	1427179662	1427179662	1	1	HAWKEY, DAVID N PHD	4/8/2015	No Taxonomy Provided	NA	None	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
17883	Fee-for-Service	1447253943	1447253943	1	1	HOME HEALTH CARE	6/22/1992	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	MANAGEMENT, INC	1398 RIDGEWOOD DR	None	CHICO	CA	95973	7801	04	06007	39.77506005	-121.8388441	Butte County
17935	Fee-for-Service	1255505053	1255505053	1	1	HALABI, WISSAM J MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122307	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
17976	Fee-for-Service	1639340102	1639340102	1	1	HEIDARIAN, SHEDA MD	11/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102940	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
17988	Fee-for-Service	1245443803	1245443803	1	1	HUADI, TONG MD	3/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50029	05	Anesthesiology	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
18031	Fee-for-Service	1912387143	1912387143	1	1	HOLAHAN, HEATHER M MD	3/18/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	176864	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
18033	Fee-for-Service	1104913136	1104913136	1	1	HE, CHAOYING MD	9/8/2021	207L00000X	NA	Other	026	PHYSICIANS	82287	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
18039	Fee-for-Service	1831346352	1831346352	1	1	HEREDIA, HECTOR MD APC	12/8/2008	207R00000X	NA	Other	026	PHYSICIANS	50069	41	Internal Medicine	0	In state provider	None	401 H STREET	STE 5	CHULA VISTA	CA	91910	4321	37	06073	32.6332882	-117.0813972	San Diego County
18078	Fee-for-Service	1548504897	1548504897	1	1	HOWELL, TRACIE LMFT	8/9/2023	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
18086	Fee-for-Service	1356515365	1356515365	1	1	HUANG, ERIC CHUANG-HAN MD	11/4/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	123210	08	Family Practice	0	In state provider	None	1550 SUPERIOR AVE	None	COSTA MESA	CA	92627	3653	30	06059	33.63305341	-117.9266303	Orange County
18107	Fee-for-Service	1437175445	1437175445	1	1	HUDSON, WILLIAM H RPT	7/28/1982	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	16018 TUSCOLA RD	STE 5	APPLE VALLEY	CA	92307	1329	36	06071	34.542207	-117.269316	San Bernardino County
18141	Fee-for-Service	1295979946	1295979946	1	1	HAMILTON, JOSEPH L LMFT	11/13/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1910 S COURT ST	None	VISALIA	CA	93277	5426	54	06107	36.313605	-119.2914765	Tulare County
18193	Fee-for-Service	1770839334	1770839334	1	1	HARRIS, CAROLE L NP	2/3/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
18220	Fee-for-Service	1245210137	1245210137	1	1	HERBERT, JOSEPH J MD	8/1/2007	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	213 ARCHER DR	None	SANTA CRUZ	CA	95060	2444	44	06087	36.97445899	-122.0475811	Santa Cruz County
18223	Fee-for-Service	1255505053	1255505053	1	1	HALABI, WISSAM J MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122307	28	Proctology (colon and rectal)	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
18228	Fee-for-Service	1154419091	1154419091	2	1	HANNA PHARMACY INC	12/22/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	653 LONG BEACH BLVD	None	LONG BEACH	CA	90802	1323	19	06037	33.77516168	-118.1894952	Los Angeles County
18257	Fee-for-Service	1740607852	1740607852	1	1	HEATH, JORDAN LPCC	11/17/2023	101YM0800X	NA	Other	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
18262	Fee-for-Service	1639340102	1639340102	1	1	HEIDARIAN, SHEDA MD	11/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102940	38	Geriatrics	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
18272	Fee-for-Service	1174050611	1174050611	1	1	HARDOON, SAIDA MD	7/31/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165705	08	Family Practice	0	In state provider	None	5957 W RAMSEY ST	None	BANNING	CA	92220	3508	33	06065	33.92937645	-116.942463	Riverside County
18292	Fee-for-Service	1700819406	1700819406	1	1	HUFANA, DONNA M MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141439	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
18324	Fee-for-Service	1891840815	1891840815	1	1	HARGIS, COLETTA M MD	12/1/1999	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	54747	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
18347	Fee-for-Service	1902882046	1902882046	1	1	HIGASHIDA, RANDALL T MD	10/31/1985	174400000X	NA	Other	026	PHYSICIANS	37111	01	General Practice	0	In state provider	None	533 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2208	38	06075	37.76304484	-122.4592904	San Francisco County
18350	Fee-for-Service	1407048002	1407048002	1	1	HUYNH, BARBARA DO	11/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11233	36	Psychiatry	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
18363	Fee-for-Service	1760800262	1760800262	1	1	HAHN, LUKE MD	10/3/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	139867	30	Radiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
18391	Fee-for-Service	1265524847	1265524847	1	1	HITCHCOCK, CHRISTINA 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	317 MARTIN LUTHER KING J	None	TACOMA	WA	98405	4234	00	None	47.25960844	-122.4534238	Pierce County
18431	Fee-for-Service	1295091130	1295091130	1	1	HAY, JANA D DO	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13072	01	General Practice	0	In state provider	None	475 PIONEER DRIVE	None	WOODLAND	CA	95776	4905	57	06113	38.67357823	-121.7456787	Yolo County
18443	Fee-for-Service	1861502973	1861502973	1	1	HRAIR SIMONIAN	2/28/2021	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
18453	Fee-for-Service	1942372792	1942372792	1	1	HADID, AMIR G MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	44678	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
18479	Fee-for-Service	1215425608	1215425608	1	1	HUANG, BRIAN MD	9/20/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	175729	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
18500	Fee-for-Service	1245867613	1245867613	1	1	HO, DANIEL MD	2/5/2025	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	176545	41	Internal Medicine	0	In state provider	None	3701 SKYPARK DRIVE	200	TORRANCE	CA	90505	4749	19	06037	33.81114782	-118.349449	Los Angeles County
18510	Fee-for-Service	1245210137	1245210137	1	1	HERBERT, JOSEPH J MD	9/22/1972	No Taxonomy Provided	NA	None	026	PHYSICIANS	29372	40	Pediatrics	0	In state provider	None	213 ARCHER DR	None	SANTA CRUZ	CA	95060	2444	44	06087	36.97445899	-122.0475811	Santa Cruz County
18523	Fee-for-Service	1467482877	1467482877	1	1	HARE,MARC A MD	7/17/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72618	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 CAMPUS POINT DR	None	LA JOLLA	CA	92037	1300	37	06073	32.877999	-117.225891	San Diego County
18531	Fee-for-Service	1083901409	1083901409	1	1	HAVENS, AMANDA P OD	8/31/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	0001	19	06037	34.06482757	-118.4443441	Los Angeles County
18534	Fee-for-Service	1649240334	1649240334	1	1	HAMEL, TERENCE H	10/12/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	71064	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
18543	Fee-for-Service	1881928620	1881928620	1	1	HUYNH, HIEN H H MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	116954	22	Pathology (M.D. only)	0	In state provider	None	2131 W 3RD ST	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
18549	Fee-for-Service	1891301073	1891301073	1	1	HELIX DIAGNOSTIX LLC	7/14/2021	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	3745 PARK CENTRAL BLVD N	None	POMPANO BEACH	FL	33064	2251	00	None	26.26708846	-80.14274095	Broward County
18552	Fee-for-Service	1245452564	1245452564	1	1	HANMAEUM SENIOR SVS, INC	2/8/2006	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE	2001 W OLYMPIC BLVD	None	LOS ANGELES	CA	90006	3705	19	06037	34.0513347	-118.2789167	Los Angeles County
18560	Fee-for-Service	1821160599	1821160599	1	1	HALPERN, STEPHEN W MD	4/3/2002	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	30604	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	A PROFESSIONAL CORP	4740 HOEN AVE	None	SANTA ROSA	CA	95405	7824	49	06097	38.442249	-122.6636775	Sonoma County
18625	Fee-for-Service	1366804593	1366804593	1	1	HARRIS, KEVIN MD	7/30/2021	208600000X	NA	General Surgery	026	PHYSICIANS	172505	None	None	0	In state provider	None	205 E RIVER PARK CIR	STE 460	FRESNO	CA	93720	1585	10	06019	36.85456375	-119.7863981	Fresno County
18649	Fee-for-Service	1376926626	1376926626	1	1	HEALTHCARE & KIDNEY CLINIC A	7/30/2015	261QP2300X	NA	Other	026	PHYSICIANS	10714	41	Internal Medicine	0	In state provider	PROFESSIONAL CORPORATION	929 CLAY ST	SUITE 302	SAN FRANCISCO	CA	94108	1570	38	06075	37.79398652	-122.4083496	San Francisco County
18650	Fee-for-Service	1609819358	1609819358	1	1	HUANG, ALBERT K MD	9/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68732	22	Pathology (M.D. only)	0	In state provider	None	654 CAMINO DE LOS MARES	None	SAN CLEMENTE	CA	92673	2827	30	06059	33.45756029	-117.6497373	Orange County
18684	Fee-for-Service	1518223726	1518223726	1	1	HOOKE, PATRICIA L LMFT	6/11/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	48171	-	NOT APPLICABLE	0	In state provider	None	20331 FLANAGAN ROAD	None	TRABUCO CANYON	CA	92679	0975	30	06059	33.66711239	-117.5844411	Orange County
18719	Fee-for-Service	1396841680	1396841680	1	1	HAINING, ROBERT R MD	7/1/2004	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
18722	Fee-for-Service	1356633978	1356633978	1	1	HOLMES, DENNIS R M D INC	10/4/2011	208600000X	NA	General Surgery	026	PHYSICIANS	68940	02	General Surgery	0	In state provider	None	1401 S GRAND	None	LOS ANGELES	CA	90015	3021	19	06037	34.03719097	-118.2654105	Los Angeles County
18729	Fee-for-Service	1871518514	1871518514	1	1	HWANG, HARVEY MD	3/11/2016	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
18787	Fee-for-Service	1265966576	1265966576	1	1	HOAG, KENSIE LCSW	1/8/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9942 BROADWAY	None	ANAHEIM	CA	92804	2308	30	06059	33.82885329	-117.9595736	Orange County
18790	Fee-for-Service	1245867613	1245867613	1	1	HO, DANIEL MD	2/5/2025	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	176545	77	Infectious Disease	0	In state provider	None	3701 SKYPARK DRIVE	200	TORRANCE	CA	90505	4749	19	06037	33.81114782	-118.349449	Los Angeles County
18820	Fee-for-Service	1932705241	1932705241	1	1	HOSPITALIST MEDICINE PHYSICI	3/17/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	1	Border provider	ANS OF NEVADA-LAS VEGAS	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
18848	Fee-for-Service	1821160599	1821160599	1	1	HALPERN, STEPHEN W MD	4/3/2002	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	30604	66	Emergency Medicine (Urgent Care)	0	In state provider	A PROFESSIONAL CORP	4740 HOEN AVE	None	SANTA ROSA	CA	95405	7824	49	06097	38.442249	-122.6636775	Sonoma County
18851	Fee-for-Service	1558634063	1558634063	1	1	HICKEY, DYLAN B DO	7/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12125	08	Family Practice	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
18867	Fee-for-Service	1760490510	1760490510	1	1	HAUT, LEWIS L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	36231	45	Nephrology (Renal-Kidney)	0	In state provider	None	2039 FOREST AVE	STE 301	SAN JOSE	CA	95128	4830	43	06085	37.32711929	-121.934266	Santa Clara County
18939	Fee-for-Service	1376926626	1376926626	1	1	HEALTHCARE & KIDNEY CLINIC A	7/30/2015	261QP2300X	NA	Other	026	PHYSICIANS	10714	45	Nephrology (Renal-Kidney)	0	In state provider	PROFESSIONAL CORPORATION	929 CLAY ST	SUITE 302	SAN FRANCISCO	CA	94108	1570	38	06075	37.79398652	-122.4083496	San Francisco County
18953	Fee-for-Service	1104159375	1104159375	1	1	HOLTSBERRY, AMY G OT	10/19/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7098	34	06067	38.56554	-121.4664615	Sacramento County
18964	Fee-for-Service	1912169517	1912169517	1	1	HSIEH, TIFFANY I MD	4/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110644	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5601 DE SOTO AVENUE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
18978	Fee-for-Service	1275906166	1275906166	1	1	HARANO, TAKASHI MD	6/30/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	None	33	Thoracic Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
19005	Fee-for-Service	1194041913	1194041913	1	1	HSU, HAROLD MD INCORPORATED	8/1/1993	261QP2300X	NA	Other	026	PHYSICIANS	51859	41	Internal Medicine	0	In state provider	None	8622 GARVEY AVE	STE 103	ROSEMEAD	CA	91770	3291	19	06037	34.06264953	-118.081098	Los Angeles County
19006	Fee-for-Service	1396841680	1396841680	1	1	HAINING, ROBERT R MD	12/30/1995	2081P0010X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	38652	25	Physical Medicine and Rehabilitation	0	In state provider	None	747 52ND STREET	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
19032	Fee-for-Service	1942708821	1942708821	1	1	HEYDARI, SEYEDEH FARANEH NP	6/21/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
19034	Fee-for-Service	1720128259	1720128259	1	1	HOLT, JONATHAN A DO	8/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8980	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
19064	Fee-for-Service	1437426541	1437426541	1	1	HERNANDEZ, VANESSA CCC-SLP	12/10/2015	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	740 S PLACENTIA AVE	STE 100	PLACENTIA	CA	92870	6832	30	06059	33.86285731	-117.8822066	Orange County
19102	Fee-for-Service	1861857831	1861857831	1	1	HARTMAN, JONATHAN R	12/18/2017	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
19115	Fee-for-Service	1124103882	1124103882	1	1	HORNER, SARAH G DO	11/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	6816	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
19135	Fee-for-Service	1821160599	1821160599	1	1	HALPERN, STEPHEN W MD	4/3/2002	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	30604	06	Cardiovascular Disease (M.D. only)	0	In state provider	A PROFESSIONAL CORP	4740 HOEN AVE	None	SANTA ROSA	CA	95405	7824	49	06097	38.442249	-122.6636775	Sonoma County
19139	Fee-for-Service	1588173025	1588173025	1	1	HYATT, JENNIFER LMFT	4/11/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41860 VIA BALDERAMA	None	TEMECULA	CA	92592	6338	33	06065	33.51272386	-117.0915177	Riverside County
19153	Fee-for-Service	1760490510	1760490510	1	1	HAUT, LEWIS L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	36231	41	Internal Medicine	0	In state provider	None	2039 FOREST AVE	STE 301	SAN JOSE	CA	95128	4830	43	06085	37.32711929	-121.934266	Santa Clara County
19163	Fee-for-Service	1952749525	1952749525	1	1	HEARTS & LIVES	3/25/2024	106H00000X	NA	Mental Health Outpatient Services	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	24028 LAKE DR	None	CRESTLINE	CA	92325	4644	36	06071	34.24350549	-117.2789521	San Bernardino County
19200	Fee-for-Service	1225130057	1225130057	1	1	HERBELIN-FARRAR, KELLY R	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77034	08	Family Practice	0	In state provider	None	7420 GREENHAVEN DR	STE 130	SACRAMENTO	CA	95831	5164	34	06067	38.488518	-121.517838	Sacramento County
19205	Fee-for-Service	1649289885	1649289885	1	1	HESS, CHRISTOPHER P MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86272	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
19241	Fee-for-Service	1750508792	1750508792	1	1	HHJ, INC	3/17/2003	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	401 W WHITTER BLVD	STE 201	LA HABRA	CA	90631	3793	30	06059	33.93914851	-117.949752	Orange County
19247	Fee-for-Service	1770640583	1770640583	1	1	HUANG, AI M	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5435 SUTTER AVE	None	RICHMOND	CA	94804	5250	07	06013	37.90696579	-122.3141368	Contra Costa County
19251	Fee-for-Service	1447494190	1447494190	1	1	HOPKINS, STEVEN DO	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7924	00	None	35.110926	-114.5552445	Mohave County
19267	Fee-for-Service	1104887132	1104887132	1	1	HOFFMAN, CHARLES MD	4/24/2019	207R00000X	NA	Other	026	PHYSICIANS	160561	41	Internal Medicine	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
19287	Fee-for-Service	1205867421	1205867421	1	1	HARRIS, HARVEY M MD	5/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	13638	40	Pediatrics	0	In state provider	None	44216 N 10TH ST W	None	LANCASTER	CA	93534	4134	19	06037	34.6862307	-118.1479298	Los Angeles County
19289	Fee-for-Service	1811082001	1811082001	1	1	HUGH, ARLENE F MD	6/9/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50818	40	Pediatrics	0	In state provider	None	3300 E SOUTH ST	STE 303	LONG BEACH	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
19297	Fee-for-Service	1396858429	1396858429	1	1	HILLIARD, GENERAL K MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	32269	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	13851 E 14TH ST	STE 204	SAN LEANDRO	CA	94578	2627	01	06001	37.71458918	-122.1418781	Alameda County
19298	Fee-for-Service	1528695046	1528695046	1	1	HARDLEY, MACY	1/10/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	19	06037	34.14595648	-118.1287575	Los Angeles County
19319	Fee-for-Service	1780820217	1780820217	1	1	HURWITZ-ROBERTS A MEDICAL	12/1/2008	2086S0129X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CORPORATION	1019 S CENTRAL AVENUE	None	GLENDALE	CA	91204	2542	19	06037	34.13405999	-118.2578839	Los Angeles County
19332	Fee-for-Service	1053679308	1053679308	1	1	HOTAKI, TANYA M LMFT	8/8/2019	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
19333	Fee-for-Service	1407292907	1407292907	1	1	HARRIS, MARVIN K MD	10/28/2019	207PS0010X	NA	Other	026	PHYSICIANS	150772	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
19344	Fee-for-Service	1316209711	1316209711	1	1	HEALTHRIGHT 360	12/31/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	202 E BELLEVUE AVE	None	SAN MATEO	CA	94401	2305	41	06081	37.57231998	-122.3357822	San Mateo County
19353	Fee-for-Service	1285722181	1285722181	1	1	HINMAN-SEABROOKS, DONNA	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71380	18	Ophthalmology	0	In state provider	MD	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
19388	Fee-for-Service	1417008632	1417008632	1	1	HOSSEINI, ROBERT B MD INC	3/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63298	08	Family Practice	0	In state provider	None	1728 S CATALINA AVENUE	None	REDONDO BEACH	CA	90277	5504	19	06037	33.817345	-118.3876625	Los Angeles County
19404	Fee-for-Service	1841684370	1841684370	1	1	HAFEEZ, YAMAMA DO	6/8/2023	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	18310 US HWY 18	STE 100	APPLE VALLEY	CA	92307	2206	36	06071	34.54034956	-117.2645069	San Bernardino County
19414	Fee-for-Service	1427274661	1427274661	1	1	HAWKS, JAMIE M LMFT	10/3/2024	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
19415	Fee-for-Service	1639310055	1639310055	1	1	HOCHBERG, AARON MD	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121061	30	Radiology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
19426	Fee-for-Service	1215564083	1215564083	1	1	HESSABI, REZA MD	1/30/2024	207P00000X	NA	Other	026	PHYSICIANS	180715	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
19445	Fee-for-Service	1740086081	1740086081	1	1	HEAR4U LLC	4/14/2025	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1370 VALLEY VISTA DR	SUITE 227	DIAMOND BAR	CA	91765	3921	19	06037	33.99742278	-117.8381087	Los Angeles County
19482	Fee-for-Service	1639156326	1639156326	1	1	HUANG, AMY H MD	9/6/2007	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	98312	None	None	0	In state provider	None	3700 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
19486	Fee-for-Service	1679715957	1679715957	1	1	HUMBERT, SARAH E MD	8/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113762	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
19505	Fee-for-Service	1699054387	1699054387	1	2	HOVAIDA, MARJAN M MD	6/27/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	125701	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
19508	Fee-for-Service	1821368648	1821368648	1	1	HILDALGO, ARIEL MD	8/5/2017	207RC0200X	NA	Other	026	PHYSICIANS	147632	None	None	0	In state provider	None	5TH & ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.741948	-121.848921	Butte County
19525	Fee-for-Service	1881783165	1881783165	1	1	HA, OANH H MD	3/1/1999	207L00000X	NA	Other	026	PHYSICIANS	62889	05	Anesthesiology	0	In state provider	None	521 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2206	38	06075	37.7634502	-122.4579779	San Francisco County
19587	Fee-for-Service	1811162399	1811162399	1	1	HERNANDEZ, EDITH M	5/14/2008	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	13614 ZIRCON WAY	None	VICTORVILLE	CA	92394	0563	36	06071	34.52681969	-117.3662789	San Bernardino County
19638	Fee-for-Service	1285722181	1285722181	1	1	HINMAN-SEABROOKS, DONNA	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	71380	66	Emergency Medicine (Urgent Care)	0	In state provider	MD	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
19650	Fee-for-Service	1649595042	1649595042	1	1	HARTVIG, EVELYN MD	10/5/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	120838	08	Family Practice	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
19656	Fee-for-Service	1568468684	1568468684	1	1	HATTORI, VERNON T MD	3/16/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	37866	41	Internal Medicine	0	In state provider	None	301 N PRAIRIE AVE	STE 611	INGLEWOOD	CA	90301	4513	19	06037	33.965712	-118.3439965	Los Angeles County
19672	Fee-for-Service	1588723209	1588723209	1	1	HUSSAIN, RAYMOND J CRNA	1/12/2011	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
19700	Fee-for-Service	1073099156	1073099156	1	1	HUBBARD, KATHRYN J NP	10/30/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
19704	Fee-for-Service	1326461351	1326461351	1	1	HARRISON, LAUREN K	8/19/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2815 CAMINO DEL RIO S	STE 220	SAN DIEGO	CA	92108	3817	37	06073	32.77000054	-117.1343627	San Diego County
19725	Fee-for-Service	1053575563	1053575563	1	1	HURST, CRAIG A. MD	3/31/2009	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
19747	Fee-for-Service	1306135710	1306135710	1	1	HART, DAVID M MD	7/29/2014	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
19798	Fee-for-Service	1134293285	1134293285	1	1	HANGER P & O WEST INC.	9/1/1997	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	5880 W LAS POSITAS BLVD	SUITE 57	PLEASANTON	CA	94588	8552	01	06001	37.68371601	-121.8980138	Alameda County
19816	Fee-for-Service	1578680716	1578680716	1	1	HAN, MYO M MD	11/5/2007	207U00000X	NA	Other	026	PHYSICIANS	95841	42	Nuclear Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
19875	Fee-for-Service	1811162399	1811162399	1	1	HERNANDEZ, EDITH M	5/14/2008	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	13614 ZIRCON WAY	None	VICTORVILLE	CA	92394	0563	36	06071	34.52681969	-117.3662789	San Bernardino County
19886	Fee-for-Service	1962254391	1962254391	1	1	HILOU, HEBA PSYD	4/22/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2810 E DEL MAR BLVD	None	PASADENA	CA	91107	4320	19	06037	34.14212984	-118.092328	Los Angeles County
19921	Fee-for-Service	1528381696	1528381696	1	1	HERNANDEZ, KELLY S LMFT	10/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1600 HUMBOLDT RD	SUITE 3	CHICO	CA	95928	8100	04	06007	39.73660489	-121.8115227	Butte County
19945	Fee-for-Service	1568468684	1568468684	1	1	HATTORI, VERNON T MD	3/16/1989	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	37866	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
19956	Fee-for-Service	1841635000	1841635000	1	1	HOPPE, JOLIE MARIE O DO	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13659	01	General Practice	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
20031	Fee-for-Service	1356896906	1356896906	1	1	HOLMES, MAYA LCSW	10/29/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8876 VINTAGE PARK DR	None	SACRAMENTO	CA	95828	5893	34	06067	38.46501	-121.372848	Sacramento County
20032	Fee-for-Service	1730498718	1730498718	1	1	HERRING, ANDREW A MD	10/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111998	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20103 LAKE CHABOT ROAD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
20041	Fee-for-Service	1164983474	1164983474	1	1	HA, DIANA F MD	11/3/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	182194	None	None	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
20044	Fee-for-Service	1154864403	1154864403	1	1	HERSKOVIC, KELLY G	4/17/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
20060	Fee-for-Service	1538841648	1538841648	1	1	HINZ, ALYSON C LPCC	10/27/2023	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
20093	Fee-for-Service	1033577044	1033577044	1	1	HIGH DESERT HEART VASCULAR	3/28/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	INSTITUTE A CALIFORNIA	12780 HESPERIA RD	None	VICTORVILLE	CA	92395	5806	36	06071	34.4833646	-117.2904386	San Bernardino County
20118	Fee-for-Service	1003944422	1003944422	1	1	HUANG, JANE I MD	8/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82007	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
20125	Fee-for-Service	1457595019	1457595019	1	1	HOLLY, MIKAELA K MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113334	08	Family Practice	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
20190	Fee-for-Service	1306011259	1306011259	1	1	HADIASHAR, MARYAM MD	4/7/2023	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	105164	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
20232	Fee-for-Service	1801326848	1801326848	1	1	HICKEY, KATHRYN E	6/26/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10255 LIVE OAK BLVD	None	LIVE OAK	CA	95953	2015	51	06101	39.28004385	-121.661271	Sutter County
20258	Fee-for-Service	1407885759	1407885759	1	1	HAMILTON, ROBERT S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	62011	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1950 ROSALINE AVE	None	REDDING	CA	96001	2543	45	06089	40.57330004	-122.3943613	Shasta County
20312	Fee-for-Service	1730566191	1730566191	1	1	HOCHMAN, STEVEN MD MPH	11/29/2023	207R00000X	NA	Other	026	PHYSICIANS	161568	None	None	0	In state provider	None	8330 RED OAK ST	201	RANCHO CUCAMONGA	CA	91730	0602	36	06071	34.10217525	-117.5693231	San Bernardino County
20343	Fee-for-Service	1841494986	1841494986	1	1	HARLANDER, KENNETH D LMFT	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
20368	Fee-for-Service	1659312593	1659312593	1	25	HEALTHCARE PARTNERS AFFILIAT	4/6/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	225 W BROADWAY	SUITE 100	GLENDALE	CA	91204	1393	19	06037	34.14673469	-118.257145	Los Angeles County
20378	Fee-for-Service	1114901303	1114901303	1	1	HARDY, PAT C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23188	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
20381	Fee-for-Service	1033577044	1033577044	1	1	HIGH DESERT HEART VASCULAR	3/28/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INSTITUTE A CALIFORNIA	12780 HESPERIA RD	None	VICTORVILLE	CA	92395	5806	36	06071	34.4833646	-117.2904386	San Bernardino County
20391	Fee-for-Service	1053424895	1053424895	1	1	HAWTHORNE, CATHERINE G MD	1/18/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86219	20	Orthopedic Surgery	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
20433	Fee-for-Service	1396804993	1396804993	1	1	HWANG, JULIE M MD	12/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78078	78	Neoplastic Diseases/Oncology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
20445	Fee-for-Service	1336443852	1336443852	1	1	HILL, KATHRYN LMFT	5/24/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	25653	-	NOT APPLICABLE	0	In state provider	None	704 MILL ST	None	LOYALTON	CA	96118	0265	46	06091	39.67395553	-120.241026	Sierra County
20448	Fee-for-Service	1265820302	1265820302	1	1	HOGAN, LINDSEY C PHD	1/28/2015	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
20461	Fee-for-Service	1184348617	1184348617	1	1	HAN, THOMAS Y NP	7/30/2024	363L00000X	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
20462	Fee-for-Service	1619374097	1619374097	1	1	HELTON, ELIZABETH CNM	1/23/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
20491	Fee-for-Service	1144403874	1144403874	1	1	HYNES, CATHERINE M LMFT	12/28/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 N. MOUNTAIN	219	UPLAND	CA	91786	1002	36	06071	34.10424442	-117.6701797	San Bernardino County
20511	Fee-for-Service	1225116783	1225116783	1	1	HOU, EMMELINE F MD	1/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101041	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
20514	Fee-for-Service	1609088640	1609088640	1	1	HINMAN, ADRIAN D MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91437	20	Orthopedic Surgery	0	In state provider	None	39400 PASEO PADRE PARKWA	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
20517	Fee-for-Service	1861505927	1861505927	1	2	HASTINGS, JENNIFER L MD	4/12/2016	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	72643	-	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
20520	Fee-for-Service	1023310414	1023310414	1	1	HEALTHRIGHT 360	8/14/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2261 & 2263 BRYANT ST	None	SAN FRANCISCO	CA	94110	2833	38	06075	37.75816964	-122.4095796	San Francisco County
20548	Fee-for-Service	1851465736	1851465736	1	1	HANGER P & O WEST INC.	7/1/1998	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	13771 MONO WAY	STE A	SONORA	CA	95370	8803	55	06109	37.97606453	-120.3437996	Tuolumne County
20560	Fee-for-Service	1578627907	1578627907	1	1	HSU, EUGENIE PHD	9/11/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
20583	Fee-for-Service	1497061816	1497061816	1	1	HICKS, SHARI R PSYD	7/21/2021	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
20613	Fee-for-Service	1538909650	1538909650	1	1	HERO TRANSIT LLC	7/19/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	17913 JOSHUA DR	None	YORBA LINDA	CA	92886	3344	30	06059	33.89368699	-117.8216968	Orange County
20638	Fee-for-Service	1194896746	1194896746	1	1	HILER, KEVIN R	9/30/1983	208600000X	NA	General Surgery	026	PHYSICIANS	39357	02	General Surgery	0	In state provider	None	1700 CALIFORNIA ST	STE 550	SAN FRANCISCO	CA	94109	4591	38	06075	37.79030099	-122.4230289	San Francisco County
20654	Fee-for-Service	1659312593	1659312593	1	25	HEALTHCARE PARTNERS AFFILIAT	4/6/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	225 W BROADWAY	SUITE 100	GLENDALE	CA	91204	1393	19	06037	34.14673469	-118.257145	Los Angeles County
20667	Fee-for-Service	1114901303	1114901303	1	1	HARDY, PAT C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23188	68	Hematology	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
20688	Fee-for-Service	1932773181	1932773181	1	1	HARTMAN, SHANNON R LCSW	6/23/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1020 29TH ST	#550	SACRAMENTO	CA	95816	5126	34	06067	38.572803	-121.4685	Sacramento County
20690	Fee-for-Service	1548269137	1548269137	1	1	HEARTHCOCK ROBERT B. MD	6/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	400 S 43RD ST	None	RENTON	WA	98055	5714	00	None	47.44115887	-122.2138846	King County
20698	Fee-for-Service	1275669731	1275669731	1	1	HENNESSEY, LETICIA S PSYD	8/15/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1061 TIERRA DEL REY	SUITE 200	CHULA VISTA	CA	91910	7880	37	06073	32.63799018	-117.017426	San Diego County
20750	Fee-for-Service	1245272137	1245272137	1	1	HELLWITZ, FREDERI 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
20776	Fee-for-Service	1952345977	1952345977	1	1	HUI, NOEL T MD	7/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	33847	34	Urology and Urological Surgery	0	In state provider	None	11370 ANDERSON ST	STE 1100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
20791	Fee-for-Service	1376992347	1376992347	1	1	HSU, GLORIA J	9/23/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL 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
20820	Fee-for-Service	1023541232	1023541232	1	1	HARVATIN, GOLDA M DO	2/3/2025	1835C0206X	NA	None	026	PHYSICIANS	17102	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
20844	Fee-for-Service	1841484227	1841484227	1	1	HABIBI, SHAGHAYEGH S PHD	2/17/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	16661 VENTURA BLVD	SUITE 226A	ENCINO	CA	91436	1914	19	06037	34.15820737	-118.496492	Los Angeles County
20864	Fee-for-Service	1679032569	1679032569	1	1	HSU, LEO C	12/12/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178196	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
20865	Fee-for-Service	1376714659	1376714659	1	1	HANAUMI, ERIKA L LCSW	8/1/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
20866	Fee-for-Service	1508151721	1508151721	1	1	HECHTMAN, SARA B LMFT	5/8/2024	390200000X	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
20885	Fee-for-Service	1649289943	1649289943	1	1	HEWITT, RHONDA L NP	9/13/2018	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
20896	Fee-for-Service	1235252529	1235252529	1	1	HILLYER, KIMBERLY L NP	5/27/2022	363LN0000X	NA	Nurse Practitioner	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
20912	Fee-for-Service	1144378118	1144378118	1	1	HARTMAN, PERLA DO	3/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	6350	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
20931	Fee-for-Service	1053515254	1053515254	1	1	HAQUE, SAADIYA A DO	3/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	9724	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	2374 EAST PACIFICA PLACE	None	RANCHO DOMINGUEZ	CA	90220	6214	19	06037	33.84864797	-118.2240829	Los Angeles County
20958	Fee-for-Service	1114901303	1114901303	1	1	HARDY, PAT C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	23188	78	Neoplastic Diseases/Oncology	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
20998	Fee-for-Service	1881099497	1881099497	1	1	HOLY SAVER HOSPICE INC	3/14/2017	251E00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14011 VENTURA BLVD	SUITE 405E	SHERMAN OAKS	CA	91423	3533	19	06037	34.14915291	-118.4378798	Los Angeles County
21024	Fee-for-Service	1306839352	1306839352	1	1	HOLIDAY, BRENDA L NP	5/11/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	15461	-	NOT APPLICABLE	0	In state provider	None	1105-1111 N. EL DORADO S	SUITES 2, 3, 5, AND 12A	STOCKTON	CA	95202	1305	39	06077	37.96379262	-121.2929073	San Joaquin County
21043	Fee-for-Service	1962058172	1962058172	1	1	HANCOCK, ROSAMOND CNP	10/4/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16773 BERNARDO CENTER DR	None	SAN DIEGO	CA	92128	2525	37	06073	33.01874412	-117.0752752	San Diego County
21080	Fee-for-Service	1114392065	1114392065	1	1	HOSPICE OF HUMBOLDT INC	10/6/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3327 TIMBER FALL COURT	BUILDING A	EUREKA	CA	95503	4894	12	06023	40.778478	-124.135642	Humboldt County
21091	Fee-for-Service	1093281453	1093281453	1	1	HERSH, LINDSEY E LCSW	6/8/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	33	06065	33.98177617	-117.3807605	Riverside County
21097	Fee-for-Service	1790764611	1790764611	1	1	HEINRICHS, GENE W MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	26614	01	General Practice	0	In state provider	None	800 N ST	None	SANGER	CA	93657	3116	10	06019	36.70500385	-119.5569573	Fresno County
21104	Fee-for-Service	1891986550	1891986550	1	1	HEALTHRIGHT 360	1/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1855 LUCRETIA AVE	None	SAN JOSE	CA	95122	3730	43	06085	37.32042717	-121.8478629	Santa Clara County
21105	Fee-for-Service	1104060375	1104060375	1	1	HAN, SONG Y MD	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137729	05	Anesthesiology	0	In state provider	None	531 W COLLEGE STREET	None	LOS ANGELES	CA	90012	2315	19	06037	34.0645892	-118.2391033	Los Angeles County
21123	Fee-for-Service	1699370817	1699370817	1	1	HUTCHINSON, ASHLEY LCSW	4/19/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
21134	Fee-for-Service	1548736788	1548736788	1	1	HONEST HOME HEALTH INC	1/26/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18570 SHERMAN WAY	SUITE G	RESEDA	CA	91335	8637	19	06037	34.20101951	-118.538424	Los Angeles County
21154	Fee-for-Service	1104344399	1104344399	1	1	HESS, COURTNEY W PHD	5/9/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
21171	Fee-for-Service	1750886743	1750886743	1	1	HEALTH CARE TRANSPORT INC	6/4/2018	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	6051 HOLLYWOOD BLVD	STE 212	LOS ANGELES	CA	90028	5496	19	06037	34.10168352	-118.321686	Los Angeles County
21172	Fee-for-Service	1790774446	1790774446	1	1	HINTZ, SONYA D	1/1/1988	2084P0800X	NA	Psychiatry	026	PHYSICIANS	58561	36	Psychiatry	0	In state provider	None	3252 HOLIDAY CT	STE 100	LA JOLLA	CA	92037	1807	37	06073	32.8705156	-117.2323734	San Diego County
21209	Fee-for-Service	1033628334	1033628334	1	1	HUANG, VICKI PT	7/10/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	801 TRAEGER AVE	STE 209	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
21229	Fee-for-Service	1770605453	1770605453	1	1	HAWES, DEBRA MD	6/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52667	22	Pathology (M.D. only)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
21285	Fee-for-Service	1881099497	1881099497	1	1	HOLY SAVER HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14011 VENTURA BLVD	SUITE 405E	SHERMAN OAKS	CA	91423	3533	19	06037	34.14915291	-118.4378798	Los Angeles County
21306	Fee-for-Service	1639185903	1639185903	1	1	HANNA, TODD C MD	7/30/1991	207P00000X	NA	Other	026	PHYSICIANS	73905	66	Emergency Medicine (Urgent Care)	0	In state provider	A	400 E 4TH ST	None	NATIONAL CITY	CA	91950	1350	37	06073	32.68038513	-117.1040623	San Diego County
21346	Fee-for-Service	1194894394	1194894394	1	1	HO, JET KING-SHING MD	10/31/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73270	13	Neurology (M.D. only)	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
21368	Fee-for-Service	1114392065	1114392065	1	1	HOSPICE OF HUMBOLDT INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3327 TIMBER FALL COURT	BUILDING A	EUREKA	CA	95503	4894	12	06023	40.778478	-124.135642	Humboldt County
21393	Fee-for-Service	1952309437	1952309437	1	1	HOLDEN, RICHARD C DO	8/3/2004	207R00000X	NA	Other	026	PHYSICIANS	7641	41	Internal Medicine	0	In state provider	None	6327 N FRESNO ST	STE 104	FRESNO	CA	93710	5236	10	06019	36.82875536	-119.781417	Fresno County
21467	Fee-for-Service	1629097399	1629097399	1	1	HOOPER, TIMOTHY D MD	8/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	55188	01	General Practice	0	In state provider	None	1508 N WEST LN	None	STOCKTON	CA	95205	3340	39	06077	37.97076726	-121.2783924	San Joaquin County
21478	Fee-for-Service	1659906337	1659906337	1	1	HENRY HU MD A PROFESSIONAL C	3/1/2022	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ORPORATION	845 JACKSON ST	None	SAN FRANCISCO	CA	94133	4851	38	06075	37.79571919	-122.4089166	San Francisco County
21498	Fee-for-Service	1225106198	1225106198	1	1	HAN, YUSHAN	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	HANS ACUPUNCTURE CLINIC	10050 GARVEY AVE	STE 103	EL MONTE	CA	91733	2089	19	06037	34.06270952	-118.049481	Los Angeles County
21517	Fee-for-Service	1770581316	1770581316	1	1	HONICK, ARNOLD B MD	12/31/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53128	30	Radiology	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
21522	Fee-for-Service	1205918455	1205918455	1	1	HAN, JEUNG S CA	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	327 S WESTERN AVE	None	LOS ANGELES	CA	90020	3804	19	06037	34.0681472	-118.3091427	Los Angeles County
21523	Fee-for-Service	1659312593	1659312593	1	27	HEALTHCARE PARTNERS AFFILIAT	8/2/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
21542	Fee-for-Service	1518069269	1518069269	1	1	HITZEMAN, NATHAN C MD	11/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84171	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	None	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
21548	Fee-for-Service	1740824275	1740824275	1	1	HINES, ANTHONY L RN MA	9/15/2020	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 E COMMONWEALTH AVE	SUITE 101	FULLERTON	CA	92832	1905	30	06059	33.87034048	-117.922437	Orange County
21593	Fee-for-Service	1386604106	1386604106	1	1	HUMMER, BETH L MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	78	Neoplastic Diseases/Oncology	1	Border provider	None	975 RYLAND ST	None	RENO	NV	89502	1667	00	None	39.52386346	-119.7990902	Washoe County
21621	Fee-for-Service	1639229446	1639229446	1	1	HEGARTY, P GALEN MD	12/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93583	08	Family Practice	0	In state provider	None	97 SAN MARIN DR	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
21635	Fee-for-Service	1720528763	1720528763	1	1	HASENSTAUB, JENNIFER B LMFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	245 E OLIVE AVE	STE 400	BURBANK	CA	91502	1214	19	06037	34.18145335	-118.3081834	Los Angeles County
21708	Fee-for-Service	1588183099	1588183099	1	2	HURLEY, JENNIFER M NP	10/31/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 W HERNDON AVE	None	CLOVIS	CA	93612	0204	10	06019	36.83766747	-119.715174	Fresno County
21744	Fee-for-Service	1073296372	1073296372	1	1	HAE SEUNG LEE. M.D. INC	10/12/2023	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	None	4201 TORRANCE BLVD	STE. 750	TORRANCE	CA	90503	4504	19	06037	33.8375955	-118.358748	Los Angeles County
21757	Fee-for-Service	1457378671	1457378671	1	1	HAUBACH, CAROL M MD	9/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	79431	01	General Practice	0	In state provider	None	335 KATHERINE AVE	STE 2	SALINAS	CA	93901	3176	27	06053	36.65981144	-121.6491192	Monterey County
21780	Fee-for-Service	1407879950	1407879950	1	1	HENRY, DEBORAH C MD	4/27/2006	207T00000X	NA	General Surgery	026	PHYSICIANS	53188	14	Neurological Surgery	0	In state provider	None	620 S PASADENA AVE	STE C	PASADENA	CA	91105	3040	19	06037	34.135128	-118.1540915	Los Angeles County
21787	Fee-for-Service	1700317260	1700317260	1	1	HAMAMOTO, JASON T MD	11/14/2024	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	184697	25	Physical Medicine and Rehabilitation	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
21805	Fee-for-Service	1538514724	1538514724	1	1	HOUPIS, KATRINA MD	3/15/2021	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
21811	Fee-for-Service	1659312593	1659312593	1	27	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
21820	Fee-for-Service	1215033501	1215033501	1	1	HARRIS, RONALD M MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	69136	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
21821	Fee-for-Service	1255707766	1255707766	1	1	HUYNH, STEVE Q DPM	8/9/2020	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	SOCIATES LLC	200 JOSE FIGUERES AVE	STE 260	SAN JOSE	CA	95116	1555	43	06085	37.36122014	-121.8505998	Santa Clara County
21826	Fee-for-Service	1649359340	1649359340	1	1	HUANG,TIMOTHY MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70785	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
21859	Fee-for-Service	1609856947	1609856947	1	3	HEART HOSPITAL OF BK	4/6/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	BAKERSFIELD HEART HOSP	3001 SILLECT AVE	None	BAKERSFIELD	CA	93308	6337	15	06029	35.38601911	-119.0400416	Kern County
21881	Fee-for-Service	1386604106	1386604106	1	1	HUMMER, BETH L MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	975 RYLAND ST	None	RENO	NV	89502	1667	00	None	39.52386346	-119.7990902	Washoe County
21921	Fee-for-Service	1073584637	1073584637	1	1	HALL, JOY R MD	1/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	70477	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
21944	Fee-for-Service	1346336864	1346336864	1	1	HOPKINS, GAIL E II MD	8/15/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68162	20	Orthopedic Surgery	0	In state provider	None	400 N PEPPER AVE	FL 6	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
22017	Fee-for-Service	1265063085	1265063085	1	1	HEAL THE HURT COUNSELING	3/10/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2512 FOOTHILL BLVD	STE 4	LA CRESCENTA	CA	91214	3506	19	06037	34.22004247	-118.2332548	Los Angeles County
22031	Fee-for-Service	1972527810	1972527810	1	1	HURVITZ, SARA A MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73967	41	Internal Medicine	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
22043	Fee-for-Service	1164717385	1164717385	1	1	HESTERMAN, CHELSEA M MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137347	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
22056	Fee-for-Service	1700233301	1700233301	1	1	HANSEN, BRETT M MD	8/25/2020	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
22060	Fee-for-Service	1588600753	1588600753	1	1	HERMAN, MICHELE MD	6/1/2000	207R00000X	NA	Other	026	PHYSICIANS	54190	41	Internal Medicine	0	In state provider	None	140 BROOKWOOD RD	STE 201	ORINDA	CA	94563	3047	07	06013	37.87712752	-122.1816965	Contra Costa County
22075	Fee-for-Service	1609827369	1609827369	1	1	HERMAN, BRIAN K MD	6/1/1998	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	76895	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
22086	Fee-for-Service	1083758643	1083758643	1	1	HUIZENGA, LINDA J LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	44974	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDLOW ROAD	None	LONG BEACH	CA	90503	1727	19	06037	33.8188341	-118.1923297	Los Angeles County
22099	Fee-for-Service	1659312593	1659312593	1	27	HEALTHCARE PARTNERS AFFILIAT	5/11/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
22118	Fee-for-Service	1144380247	1144380247	1	1	HO, VIET A OD	2/11/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4201 W CHAPMAN AVE	None	ORANGE	CA	92868	1505	30	06059	33.78900343	-117.8985235	Orange County
22123	Fee-for-Service	1578565438	1578565438	1	1	HILL, ALLAN S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50413	02	General Surgery	0	In state provider	None	555 PETALUMA AVE	STE C	SEBASTOPOL	CA	95472	4225	49	06097	38.39744712	-122.8206197	Sonoma County
22162	Fee-for-Service	1972221794	1972221794	1	1	HEALTHY ME NURSING, INC	1/23/2025	261QM0801X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	3930 4TH AVE	STE 300	SAN DIEGO	CA	92103	3119	37	06073	32.74892723	-117.1616459	San Diego County
22163	Fee-for-Service	1548028426	1548028426	1	1	HEALTH EDUCATION COUNCIL SER	6/26/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	RVING POPULATIONS AT RIS	7617 ALMA VISTA WAY	STE C	SACRAMENTO	CA	95831	4000	34	06067	38.481507	-121.507245	Sacramento County
22181	Fee-for-Service	1891912465	1891912465	1	1	HOLLAND, AMY MD	2/18/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	173129	36	Psychiatry	0	In state provider	None	1742 OREGON STREET	None	REDDING	CA	96001	1717	45	06089	40.5808265	-122.3932989	Shasta County
22207	Fee-for-Service	1205073723	1205073723	1	1	HIGGINS, DAVID W CRNA	12/18/2017	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
22221	Fee-for-Service	1821338567	1821338567	1	1	HENDY, DYLAN M DO	4/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13602	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
22237	Fee-for-Service	1013654995	1013654995	1	1	HEINBACH, MICHAEL P NP	7/8/2022	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
22250	Fee-for-Service	1417452343	1417452343	1	1	HINES, ELIZABETH C LMFT	1/2/2023	101YM0800X	NA	Other	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
22252	Fee-for-Service	1558372185	1558372185	1	1	HAIGHT, MICHAEL A MD	4/28/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	53221	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
22257	Fee-for-Service	1386960854	1386960854	1	1	HAKHAM, SALAR DO	1/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	13968	30	Radiology	0	In state provider	None	4640 ADMIRALTY WAY	STE 102	MARINA DEL REY	CA	90292	6629	19	06037	33.98120707	-118.4409729	Los Angeles County
22270	Fee-for-Service	1982162210	1982162210	1	1	HERRERA, MICHELLE LMFT	6/29/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3393 14TH ST STE A	None	RIVERSIDE	CA	92501	3857	33	06065	33.97447738	-117.3746729	Riverside County
22282	Fee-for-Service	1326585266	1326585266	1	1	HARVEY HOUSE INC	10/31/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	11372 SAN JUAN DR	UNIT A & B	LOMA LINDA	CA	92354	3329	36	06071	34.0471341	-117.2667313	San Bernardino County
22299	Fee-for-Service	1376527804	1376527804	1	1	HALLETT, ROSEMARY MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71662	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
22362	Fee-for-Service	1639136310	1639136310	1	1	HUANG, WILSON H MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64819	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
22387	Fee-for-Service	1659312593	1659312593	1	27	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
22411	Fee-for-Service	1467696468	1467696468	1	1	HUSSAIN, MONA R PT	2/16/2022	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
22414	Fee-for-Service	1740322890	1740322890	1	1	HUIE, MICHAEL A MD PHD APMC	3/8/2012	207N00000X	NA	Dermatology	026	PHYSICIANS	81413	07	Dermatology	0	In state provider	None	2320 SUTTER ST	STE 101	SAN FRANCISCO	CA	94115	3023	38	06075	37.78543348	-122.4386415	San Francisco County
22426	Fee-for-Service	1104310713	1104310713	1	1	HIGNEY, REBECCA PSYD	1/17/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2324 SACRAMENTO ST	111	SAN FRANCISCO	CA	94115	2383	38	06075	37.79020149	-122.4313011	San Francisco County
22427	Fee-for-Service	1497715031	1497715031	1	1	HARRIS, TIFFENIE A OD	6/23/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	309 E SECOND STREET	None	POMONA	CA	91766	1854	19	06037	34.05789396	-117.7476284	Los Angeles County
22449	Fee-for-Service	1972221794	1972221794	1	1	HEALTHY ME NURSING, INC	1/23/2025	261QM0801X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3930 4TH AVE	STE 300	SAN DIEGO	CA	92103	3119	37	06073	32.74892723	-117.1616459	San Diego County
22473	Fee-for-Service	1720054000	1720054000	1	1	HSU, YU-LUEN MD	4/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	91805	03	Allergy	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
22494	Fee-for-Service	1962579870	1962579870	1	1	HAYES, KATHRYN L MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	59704	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
22496	Fee-for-Service	1912347063	1912347063	1	2	HADDAN, RACHEL 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
22508	Fee-for-Service	1659986016	1659986016	1	1	HIDALGO, JAVIER RCP	6/21/2024	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
22523	Fee-for-Service	1366707184	1366707184	1	1	HWANG, TINA D MD	11/13/2017	207L00000X	NA	Other	026	PHYSICIANS	129629	05	Anesthesiology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
22562	Fee-for-Service	1245326263	1245326263	1	1	HAMILTON, VINCENT D MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	37268	02	General Surgery	0	In state provider	A MEDICAL CORP	870 SHASTA ST	STE 400	YUBA CITY	CA	95991	4117	51	06101	39.14204	-121.6161711	Sutter County
22571	Fee-for-Service	1740217207	1740217207	1	1	HOLTHOUSE, MARK E MD	7/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	75717	08	Family Practice	0	In state provider	None	1008 FOWLER WAY	STE C	PLACERVILLE	CA	95667	5701	09	06017	38.72648857	-120.791716	El Dorado County
22581	Fee-for-Service	1811127343	1811127343	1	1	HADDAD, RIHAM K LCSW	11/6/2023	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
22584	Fee-for-Service	1730331380	1730331380	1	1	HSU, STEVEN L MD	1/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	98258	30	Radiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
22588	Fee-for-Service	1376527804	1376527804	1	1	HALLETT, ROSEMARY MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71662	40	Pediatrics	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
22621	Fee-for-Service	1487660023	1487660023	1	1	HECKMANN, JAMES R MD	10/20/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	29205	41	Internal Medicine	0	In state provider	None	125 SOUTH DR	None	MOUNTAIN VIEW	CA	94040	4310	43	06085	37.36722947	-122.079033	Santa Clara County
22632	Fee-for-Service	1992955090	1992955090	1	1	HOWELL, LORI K MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121506	24	Plastic 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
22652	Fee-for-Service	1295080729	1295080729	1	1	HOCHSTEIN, GRANT MD	8/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126942	41	Internal Medicine	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
22653	Fee-for-Service	1033237284	1033237284	1	1	HUA JUDY CHEN 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	9141 GRANT ST	STE 237	THORNTON	CO	80229	4318	00	None	39.86385504	-104.983935	Adams County
22674	Fee-for-Service	1659312593	1659312593	1	27	HEALTHCARE PARTNERS AFFILIAT	12/19/2016	193200000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8311 FLORENCE AVE	None	DOWNEY	CA	90240	3928	19	06037	33.95103918	-118.1247373	Los Angeles County
22701	Fee-for-Service	1396895355	1396895355	1	1	HUME, PATRICIA E MD	5/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85409	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
22713	Fee-for-Service	1407019334	1407019334	1	1	HOLAYTER, RIAN MD	1/25/2024	2085R0204X	NA	Other	026	PHYSICIANS	181304	None	None	0	In state provider	None	105 N BASCOM AVE	SUITE 104	SAN JOSE	CA	95128	1811	43	06085	37.325853	-121.932068	Santa Clara County
22720	Fee-for-Service	1922526003	1922526003	1	1	HANDMAIDS OF CHARITY	9/21/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8 N 1ST AVE	None	ARCADIA	CA	91006	3205	19	06037	34.14039915	-118.0283293	Los Angeles County
22739	Fee-for-Service	1649684549	1649684549	1	1	HOYTE, JOEL MD	5/16/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	70	Clinic (mixed specialty)	1	Border provider	None	3100 N TENAYA WAY	None	LAS VEGAS	NV	89128	0436	00	None	36.21499805	-115.2504953	Clark County
22747	Fee-for-Service	1386953925	1386953925	1	1	HOR B. CHHAY, M.D., INC.	12/4/1996	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	56425	01	General Practice	0	In state provider	None	2148 E. ANAHEIM ST	None	LONG BEACH	CA	90804	3408	19	06037	33.78257051	-118.165896	Los Angeles County
22761	Fee-for-Service	1720054000	1720054000	1	1	HSU, YU-LUEN MD	4/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	91805	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
22783	Fee-for-Service	1962579870	1962579870	1	1	HAYES, KATHRYN L MD	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	59704	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
22809	Fee-for-Service	1427552041	1427552041	1	1	HONG, CATALINA S DO	10/19/2021	207R00000X	NA	Other	026	PHYSICIANS	18002	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
22870	Fee-for-Service	1447782321	1447782321	1	1	HOSSAIN, MAHMOOD DO	10/25/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	18821	None	None	0	In state provider	None	5016 CHESEBRO RD	STE 200	AGOURA HILLS	CA	91301	2277	19	06037	34.14134802	-118.7392827	Los Angeles County
22875	Fee-for-Service	1376527804	1376527804	1	1	HALLETT, ROSEMARY MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71662	03	Allergy	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
22879	Fee-for-Service	1487970547	1487970547	1	1	HO, GWENDOLYN H MD	6/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118908	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
22887	Fee-for-Service	1114058815	1114058815	1	1	HIRANO, KIMBERLY A LCSW	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21211	-	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
22904	Fee-for-Service	1982745139	1982745139	1	1	HUTTON, PAULINE N PT	2/9/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1535 RIVER PARK DR	STE 1000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
22947	Fee-for-Service	1538141627	1538141627	1	2	HANFORD COMMUNITY HOSPITAL	1/12/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
22982	Fee-for-Service	1588026017	1588026017	1	1	HUVERSERIAN, ARI R MD	7/9/2020	390200000X	NA	Other	026	PHYSICIANS	154407	05	Anesthesiology	0	In state provider	None	PUEBLO AT BATH STREETS	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
22996	Fee-for-Service	1548704349	1548704349	1	1	HAZLEHURST, KELSEA M	4/27/2017	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
23000	Fee-for-Service	1255419354	1255419354	1	1	HLAVAC, MARK A MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62304	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
23003	Fee-for-Service	1285679258	1285679258	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	7863 LA MESA BLVD	STE 100	LA MESA	CA	91942	0657	37	06073	32.76738848	-117.0283515	San Diego County
23009	Fee-for-Service	1922526003	1922526003	1	1	HANDMAIDS OF CHARITY	9/21/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8 N 1ST AVE	None	ARCADIA	CA	91006	3205	19	06037	34.14039915	-118.0283293	Los Angeles County
23027	Fee-for-Service	1649684549	1649684549	1	1	HOYTE, JOEL MD	5/16/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	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
23030	Fee-for-Service	1093330599	1093330599	1	1	HAIDAR, TAREK MD	2/27/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	280 E STANDLEY ST	None	UKIAH	CA	95482	4414	23	06045	39.15101964	-123.205602	Mendocino County
23038	Fee-for-Service	1407907447	1407907447	1	1	HECHANOVA, RUBEN D	5/27/2011	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
23058	Fee-for-Service	1508325317	1508325317	1	1	HOLLINGSWORTH, PARKER MD	8/7/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	186371	None	None	0	In state provider	None	THREE MEDICAL PLAZA	STE 120	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
23097	Fee-for-Service	1205808763	1205808763	1	1	HEBERT-BROWN, JEAN L LCS	8/1/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	3633 CAMINO DEL RIO	# 102	SAN DIEGO	CA	92108	4011	37	06073	32.77801447	-117.1163618	San Diego County
23106	Fee-for-Service	1083092027	1083092027	1	1	HAN, HAESUN MD	8/19/2021	207L00000X	NA	Other	026	PHYSICIANS	172573	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
23131	Fee-for-Service	1508968330	1508968330	1	1	HENDERSON, HERB H DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	5505	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
23152	Fee-for-Service	1689737157	1689737157	1	1	HAYNES-TUCKER, LYNNE L	7/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	55360	36	Psychiatry	0	In state provider	MD	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
23173	Fee-for-Service	1407949274	1407949274	1	1	HELWANI, BERJOUHI	9/10/1997	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	HELWANI, BERJOUHI	401 TORRANCE BLVD	None	REDONDO BEACH	CA	90277	3326	19	06037	33.83816116	-118.3839512	Los Angeles County
23178	Fee-for-Service	1427625219	1427625219	1	1	HEROUT, KYLE DO	7/7/2023	207P00000X	NA	Other	026	PHYSICIANS	20627	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
23198	Fee-for-Service	1194977744	1194977744	1	1	HELALI, JONATHAN M MD	10/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111463	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90021	1178	19	06037	34.0696407	-118.3836988	Los Angeles County
23209	Fee-for-Service	1972851103	1972851103	1	1	HANIG, APRIL LMFT	3/7/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
23234	Fee-for-Service	1538141627	1538141627	1	2	HANFORD COMMUNITY HOSPITAL	1/12/2012	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
23284	Fee-for-Service	1881838530	1881838530	1	1	HOANG, UYEN B MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107126	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
23324	Fee-for-Service	1497758593	1497758593	1	1	HOSPICE TOUCH INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3401 W SUNFLOWER AVE	STE 100	SANTA ANA	CA	92704	7961	30	06059	33.69575566	-117.9144503	Orange County
23331	Fee-for-Service	1396152419	1396152419	1	1	HARTNETT, JESSICA D MD	9/10/2019	207L00000X	NA	Other	026	PHYSICIANS	142281	05	Anesthesiology	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
23337	Fee-for-Service	1215490008	1215490008	1	1	HENARY, MARK M MD	5/21/2024	207R00000X	NA	Other	026	PHYSICIANS	182610	41	Internal Medicine	0	In state provider	None	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	19	06037	33.8375955	-118.358748	Los Angeles County
23358	Fee-for-Service	1649310681	1649310681	1	1	HOPKINS, SCOTT A MD	10/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	34	Urology and Urological Surgery	1	Border provider	None	691 MURPHY RD	STE 107	MEDFORD	OR	97504	4311	00	None	42.317676	-122.8288145	Jackson County
23359	Fee-for-Service	1710541958	1710541958	1	1	HONG, TRACEY MD	2/22/2024	390200000X	NA	Other	026	PHYSICIANS	182324	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
23379	Fee-for-Service	1710332499	1710332499	1	1	HOLLERN, DOUGLAS A MD	9/9/2021	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	170931	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
23389	Fee-for-Service	1801844758	1801844758	1	1	HANSEN, GEORGE R MD	9/18/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67032	66	Emergency Medicine (Urgent Care)	0	In state provider	None	505 E PLAZA DR	None	SANTA MARIA	CA	93454	6907	42	06083	34.93739727	-120.4299571	Santa Barbara County
23397	Fee-for-Service	1164411518	1164411518	2	1	HEALTHMED PHARMACEUTICAL INC	4/5/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	421 E BEACH AVE	STE A	INGLEWOOD	CA	90302	3103	19	06037	33.97040752	-118.3486128	Los Angeles County
23408	Fee-for-Service	1447754676	1447754676	1	1	HWANG, ALEXANDER C MD	10/27/2021	207P00000X	NA	Other	026	PHYSICIANS	164657	None	None	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
23412	Fee-for-Service	1255373742	1255373742	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	475 N GRAPE ST	None	ESCONDIDO	CA	92025	3000	37	06073	33.12737137	-117.0757875	San Diego County
23420	Fee-for-Service	1467492256	1467492256	1	1	HEGAZY, JIHAN MD	10/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138784	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
23425	Fee-for-Service	1306209135	1306209135	1	1	HITCH, ALICIA M MD	5/18/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	157737	None	None	0	In state provider	None	1665 ESPLANADE	None	CHICO	CA	95926	3312	04	06007	39.74388808	-121.8503372	Butte County
23443	Fee-for-Service	1730406224	1730406224	1	1	HOVE, JASON A MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121114	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
23457	Fee-for-Service	1336223304	1336223304	1	1	HAUPTMAN, ARI MD	10/2/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67176	40	Pediatrics	0	In state provider	None	1800 SULLIVAN AVE	RM 202	DALY CITY	CA	94015	2222	41	06081	37.68077723	-122.4728941	San Mateo County
23464	Fee-for-Service	1477884187	1477884187	1	1	HERNER, MARY B MD	1/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107080	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
23508	Fee-for-Service	1245658525	1245658525	1	1	HUANG, JANMEI D MD	11/25/2019	390200000X	NA	Other	026	PHYSICIANS	139609	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
23516	Fee-for-Service	1295730331	1295730331	1	1	HORNER, GREGORY MD	9/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	54276	20	Orthopedic Surgery	0	In state provider	None	5601 NORRIS CANYON RD	None	SAN RAMON	CA	94583	5407	07	06013	37.77772182	-121.9579459	Contra Costa County
23519	Fee-for-Service	1275598401	1275598401	1	1	HILERA, EFREN F PSYD	10/26/2015	No Taxonomy Provided	NA	None	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
23558	Fee-for-Service	1568608487	1568608487	1	1	HENNIGAN, KARI PHD	5/9/2013	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
23572	Fee-for-Service	1144584343	1144584343	1	1	HEIBY, MICHAEL J MD	8/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137771	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
23575	Fee-for-Service	1952387581	1952387581	1	1	HANAMSAGAR, SEEMA A MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92218	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
23580	Fee-for-Service	1265596233	1265596233	1	1	HOWELL, JEVERE A MD	11/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	116587	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
23583	Fee-for-Service	1407812290	1407812290	1	1	HIRAMOTO, JADE S MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	64206	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
23586	Fee-for-Service	1447229232	1447229232	1	1	HEBERT, LAUREEN M 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
23588	Fee-for-Service	1043503675	1043503675	1	1	HAN, MOONJOO MD	8/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156570	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
23597	Fee-for-Service	1851626824	1851626824	1	1	HOENIG, JOHNATHAN MD	2/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121505	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
23608	Fee-for-Service	1497758593	1497758593	1	1	HOSPICE TOUCH INC	5/21/2003	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3401 W SUNFLOWER AVE	STE 100	SANTA ANA	CA	92704	7961	30	06059	33.69575566	-117.9144503	Orange County
23648	Fee-for-Service	1750652418	1750652418	1	1	HASHEMI, NEDA MD	10/17/2016	No Taxonomy Provided	NA	None	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
23674	Fee-for-Service	1598215725	1598215725	1	1	HO, KATHERINE T LMFT	7/22/2021	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
23678	Fee-for-Service	1801844758	1801844758	1	1	HANSEN, GEORGE R MD	9/18/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	67032	01	General Practice	0	In state provider	None	505 E PLAZA DR	None	SANTA MARIA	CA	93454	6907	42	06083	34.93739727	-120.4299571	Santa Barbara County
23690	Fee-for-Service	1053326850	1053326850	1	1	HITE, BRIAN W MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65449	05	Anesthesiology	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
23696	Fee-for-Service	1619537644	1619537644	1	1	HANS, SIMAR S MD	9/14/2022	207R00000X	NA	Other	026	PHYSICIANS	181291	None	None	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
23705	Fee-for-Service	1427287945	1427287945	1	1	HURD, SOPHIA T MD	8/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106998	40	Pediatrics	0	In state provider	None	27303 SLEEPY HOLLOW AVE	None	HAYWARD	CA	94545	4203	01	06001	37.63208871	-122.0939191	Alameda County
23746	Fee-for-Service	1306138375	1306138375	1	1	HADJES, REBECCA M CRNA	9/5/2017	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
23778	Fee-for-Service	1053639385	1053639385	1	1	HSU, RICHARD L MD	11/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131169	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
23795	Fee-for-Service	1285191213	1285191213	1	1	H & M HOME HEALTH CARE INC	7/21/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	232 N LAKE AVE	SUITE 209	PASADENA	CA	91101	1862	19	06037	34.150005	-118.1323505	Los Angeles County
23823	Fee-for-Service	1255486247	1255486247	1	1	HALL, DOUGLAS B	3/2/2004	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1205 GARCES HWY	STE 207	DELANO	CA	93215	3658	15	06029	35.76144147	-119.2400687	Kern County
23853	Fee-for-Service	1720451081	1720451081	1	1	HARRIS-POTCH, MOLLY LMFT	6/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
23896	Fee-for-Service	1992879217	1992879217	1	1	HEILMAN, ELIZABETH R MD	12/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84169	47	Miscellaneous	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
23910	Fee-for-Service	1528386505	1528386505	1	1	HEAD, EMILY J	6/18/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	32670 HIGHWAY 20 UNDEFIN	None	FORT BRAGG	CA	95437	5708	23	06045	39.41929319	-123.8026579	Mendocino County
23914	Fee-for-Service	1730158981	1730158981	1	1	HANOVER HOSPITAL INC.	12/22/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	300 HIGHLAND AVE	None	HANOVER	PA	17331	2297	00	None	39.80813626	-76.9829073	York County
23952	Fee-for-Service	1437140928	1437140928	1	1	HARMEET SINGH	9/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8300 W 38TH AVE	None	WHEAT RIDGE	CO	80033	6005	00	None	39.76932763	-105.0903492	Jefferson County
23984	Fee-for-Service	1588962138	1588962138	1	1	HASAN, AMATUL S MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115244	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	43112 15TH STREET	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
23990	Fee-for-Service	1144237009	1144237009	1	1	HARRIS, ODETTE A MD	2/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	63104	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
24010	Fee-for-Service	1780144162	1780144162	1	1	HUBERT, JOSHUA T DO	7/5/2023	207L00000X	NA	Other	026	PHYSICIANS	21255	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
24017	Fee-for-Service	1316957723	1316957723	1	1	HARRIS, LINDSAY R OD	8/15/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	450 N ROXBURY DR	3RD FLR	BEVERLY HILLS	CA	90210	4321	19	06037	34.06820793	-118.4070317	Los Angeles County
24043	Fee-for-Service	1215977103	1215977103	1	1	HOPPE, BRYAN K	12/10/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	740 S PLACENTIA AVE	STE 100	PLACENTIA	CA	92870	6832	30	06059	33.86285731	-117.8822066	Orange County
24049	Fee-for-Service	1164728788	1164728788	1	1	HESPERIA CLINICA MEDICA	11/8/2012	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	FAMILIAR A MEDICAL CORP	15888 MAIN STREET	SUITE 112B	HESPERIA	CA	92345	3467	36	06071	34.42375898	-117.3163823	San Bernardino County
24071	Fee-for-Service	1942731575	1942731575	1	1	HICKMAN, JUSTIN MD	8/14/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	1400 E CHURCH ST	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
24102	Fee-for-Service	1659312593	1659312593	1	17	HEALTHCARE PARTNERS AFFILIAT	1/29/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	747 WAREHOUSE ST	None	LOS ANGELES	CA	90021	1106	19	06037	34.03450435	-118.2393996	Los Angeles County
24115	Fee-for-Service	1831263433	1831263433	1	1	HERSCH, JULIE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	57788	41	Internal Medicine	0	In state provider	None	1595 SOQUEL DR	STE 140	SANTA CRUZ	CA	95065	1717	44	06087	36.98879599	-121.9826354	Santa Cruz County
24149	Fee-for-Service	1922245059	1922245059	1	1	HANNA'S HOUSE	12/12/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	5900 S EASTERN AVENUE	SUITE 186, 188	COMMERCE	CA	90040	4017	19	06037	33.98421287	-118.162224	Los Angeles County
24166	Fee-for-Service	1184245235	1184245235	1	1	HAN, BRANDEN DO	1/2/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22523	27	Psychiatry Neurology (D.O. 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
24176	Fee-for-Service	1265103196	1265103196	1	1	HONEYWELL HOME HEALTH CARE	8/30/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17050 CHATSWORTH STREET	UNIT 101B	GRANADA HILLS	CA	91344	5847	19	06037	34.26477251	-118.5039945	Los Angeles County
24240	Fee-for-Service	1225267966	1225267966	1	1	HOLMES, ANN T DO	12/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13365	01	General Practice	0	In state provider	None	4770 W HERNDON AVE	None	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
24288	Fee-for-Service	1801536545	1801536545	1	1	HONG, ANDREW W MD	3/21/2025	207R00000X	NA	Other	026	PHYSICIANS	188180	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
24367	Fee-for-Service	1619252020	1619252020	1	1	HOPE NEUROLOGIC CENTER	12/8/2011	193200000X	NA	Other	026	PHYSICIANS	62033	13	Neurology (M.D. only)	0	In state provider	None	79440 CORPORATE CENTER	SUITE 108	LA QUINTA	CA	92253	7243	33	06065	33.70937862	-116.2788139	Riverside County
24371	Fee-for-Service	1306007299	1306007299	1	1	HUANG, JOHN C MD	11/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112328	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
24395	Fee-for-Service	1700084464	1700084464	1	1	HOLLAND, MARIAN C MD	2/7/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	100523	None	None	0	In state provider	None	2773 HARRIS ST	STE A & D	EUREKA	CA	95503	4866	12	06023	40.78052829	-124.1363953	Humboldt County
24397	Fee-for-Service	1659312593	1659312593	1	28	HEALTHCARE PARTNERS AFFILIAT	6/26/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
24402	Fee-for-Service	1831263433	1831263433	1	1	HERSCH, JULIE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	57788	78	Neoplastic Diseases/Oncology	0	In state provider	None	1595 SOQUEL DR	STE 140	SANTA CRUZ	CA	95065	1717	44	06087	36.98879599	-121.9826354	Santa Cruz County
24452	Fee-for-Service	1699087908	1699087908	1	1	HWANG, BRIAN MD	1/10/2024	193400000X	NA	Other	026	PHYSICIANS	175159	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
24513	Fee-for-Service	1801911581	1801911581	1	1	HOANG, TRANG LCSW	4/27/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13075 BLACKBIRD ST	None	GARDEN GROVE	CA	92843	2902	30	06059	33.77353611	-117.9130729	Orange County
24569	Fee-for-Service	1740508787	1740508787	1	1	HERNANDEZ, ERIKA M LMFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1317 W FOOTHILL BLVD	STE 140	UPLAND	CA	91786	3686	36	06071	34.10715453	-117.6734115	San Bernardino County
24584	Fee-for-Service	1033208269	1033208269	1	1	HEIFETS, RAISA MD	11/1/1983	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	40429	01	General Practice	0	In state provider	None	6027 YORK BLVD	None	LOS ANGELES	CA	90042	3503	19	06037	34.11793708	-118.188309	Los Angeles County
24606	Fee-for-Service	1629157755	1629157755	1	1	HOU, CRAIG E MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78390	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	# A887	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
24617	Fee-for-Service	1821034000	1821034000	1	1	HECK, RICHARD JAMES MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	74995	08	Family Practice	0	In state provider	None	1448 FLORIDA AVE	None	MODESTO	CA	95350	4424	50	06099	37.66523613	-120.9962072	Stanislaus County
24653	Fee-for-Service	1619252020	1619252020	1	1	HOPE NEUROLOGIC CENTER	12/8/2011	193200000X	NA	Other	026	PHYSICIANS	62033	79	Neurology-Child	0	In state provider	None	79440 CORPORATE CENTER	SUITE 108	LA QUINTA	CA	92253	7243	33	06065	33.70937862	-116.2788139	Riverside County
24654	Fee-for-Service	1891336798	1891336798	1	1	HUANG, JOHN C	1/20/2020	235Z00000X	NA	Other	037	SPEECH 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
24679	Fee-for-Service	1588185482	1588185482	1	1	HAMDI, ANAS MD	4/6/2022	208800000X	NA	Other	026	PHYSICIANS	176478	None	None	0	In state provider	None	782 MEDICAL CENTER DR E	111	CLOVIS	CA	93611	6889	10	06019	36.84379626	-119.6609117	Fresno County
24682	Fee-for-Service	1114004058	1114004058	1	1	HO, IRENE MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74470	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
24685	Fee-for-Service	1659312593	1659312593	1	28	HEALTHCARE PARTNERS AFFILIAT	6/26/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
24690	Fee-for-Service	1831263433	1831263433	1	1	HERSCH, JULIE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	57788	68	Hematology	0	In state provider	None	1595 SOQUEL DR	STE 140	SANTA CRUZ	CA	95065	1717	44	06087	36.98879599	-121.9826354	Santa Cruz County
24719	Fee-for-Service	1295354306	1295354306	1	1	HA, KEVIN MD	8/21/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	192230	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
24753	Fee-for-Service	1730267824	1730267824	1	1	HAWKINS, JOHN E DO	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	4924	36	Psychiatry	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
24773	Fee-for-Service	1942497797	1942497797	1	1	HICKS, BRANDI MD	7/30/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	149162	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
24780	Fee-for-Service	1033496351	1033496351	1	1	HIDAY, LAURA E NP	2/2/2022	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11374 MT VIEW AVE STE A	None	LOMA LINDA	CA	92354	3816	36	06071	34.0465275	-117.2436991	San Bernardino County
24798	Fee-for-Service	1780621045	1780621045	1	1	HINKSON TERRY	4/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	RAPID CITY REGIONAL HOSP	353 FAIRMONT BLVD	None	RAPID CITY	SD	57701	7375	00	None	44.05854729	-103.2246985	Pennington County
24817	Fee-for-Service	1629076807	1629076807	1	1	HALAI, ZAKIR H MD	4/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146369	41	Internal Medicine	0	In state provider	None	97 SAN MARIN DRIVE	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
24870	Fee-for-Service	1750726485	1750726485	1	1	HAMBY, DONALD L DO	1/9/2019	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	14027	25	Physical Medicine and Rehabilitation	0	In state provider	None	18406 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.2206967	-118.5342638	Los Angeles County
24876	Fee-for-Service	1437237674	1437237674	1	1	HSIAO, KATHERINE T MD	9/15/2017	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	51088	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2300 CALIFORNIA ST	STE 103	SAN FRANCISCO	CA	94115	2753	38	06075	37.78910083	-122.4323944	San Francisco County
24927	Fee-for-Service	1124056197	1124056197	1	1	HOLMES, DENNIS R MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68940	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
24972	Fee-for-Service	1659312593	1659312593	1	28	HEALTHCARE PARTNERS AFFILIAT	6/20/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
24982	Fee-for-Service	1952459877	1952459877	1	1	HARMON, DAVID L DO	7/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	5882	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
24988	Fee-for-Service	1205900370	1205900370	1	1	HARRIS COUNTY HOSPITAL	1/24/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1504 TAUB LOOP	None	HOUSTON	TX	77030	1608	00	None	29.71128275	-95.39374083	Harris County
25000	Fee-for-Service	1871669309	1871669309	1	1	HARMON, CURTIS L	7/31/1991	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1115 N D ST	None	SAN BERNARDINO	CA	92410	3523	36	06071	34.11985587	-117.2918875	San Bernardino County
25041	Fee-for-Service	1730267824	1730267824	1	1	HAWKINS, JOHN E DO	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	4924	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
25050	Fee-for-Service	1902847320	1902847320	1	1	HAGA, JEFFREY A DO	4/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9334	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
25092	Fee-for-Service	1528672789	1528672789	1	1	HALF MOON BAY HOLDINGS LLC	11/4/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5425 MAYME AVE	None	SAN JOSE	CA	95129	4833	43	06085	37.29372959	-121.9995658	Santa Clara County
25110	Fee-for-Service	1972022325	1972022325	1	1	HESKIN, ALYSSA F LCSW	5/9/2024	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
25141	Fee-for-Service	1487841409	1487841409	1	1	HIGHMAN, LAWRENCE M MD	1/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	INC	155 E WEBSTER ST	None	COLUSA	CA	95932	2949	06	06011	39.20744387	-122.0007933	Colusa County
25183	Fee-for-Service	1598250573	1598250573	1	1	HARMON, AMANDA M LPCC	10/25/2022	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
25190	Fee-for-Service	1366498966	1366498966	1	1	HOSPITALIST SERVICES	4/11/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP INC	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
25216	Fee-for-Service	1871931964	1871931964	1	1	HANNAH, JOSEF M DO	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14790	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
25230	Fee-for-Service	1902980980	1902980980	1	1	HOLLY, RUTH A MD	8/15/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	63241	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
25239	Fee-for-Service	1427198290	1427198290	1	1	HABEEB, RIZWAN H MD	3/17/2020	207L00000X	NA	Other	026	PHYSICIANS	167663	05	Anesthesiology	0	In state provider	None	7417 N CEDAR AVE	None	FRESNO	CA	93720	3637	10	06019	36.844227	-119.7568975	Fresno County
25257	Fee-for-Service	1760838551	1760838551	1	1	HINES, MICHELLE MD	1/22/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	150911	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
25263	Fee-for-Service	1659312593	1659312593	1	28	HEALTHCARE PARTNERS AFFILIAT	2/19/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
25303	Fee-for-Service	1942273040	1942273040	1	1	HOLMES COUNTY JOEL POMERENE	11/10/2012	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEMORIAL HOSPITAL	981 WOOSTER RD	None	MILLERSBURG	OH	44654	1536	00	None	40.56505408	-81.92083095	Holmes County
25313	Fee-for-Service	1205958360	1205958360	1	1	HA, HUAN T MD	10/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137559	78	Neoplastic Diseases/Oncology	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
25363	Fee-for-Service	1396731386	1396731386	1	1	HETZEL, ROBERT J	4/30/1994	207L00000X	NA	Other	026	PHYSICIANS	62119	05	Anesthesiology	0	In state provider	None	526 E MILL ST	None	SANTA MARIA	CA	93454	4536	42	06083	34.95529593	-120.4288049	Santa Barbara County
25386	Fee-for-Service	1063771038	1063771038	1	1	HERRERA, TANYA M MD	4/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127326	40	Pediatrics	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
25411	Fee-for-Service	1306280581	1306280581	1	1	HARRIS, CRAIG A MD	1/30/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	134384	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
25421	Fee-for-Service	1457401812	1457401812	1	1	HUNTER, DIANA L OD	8/8/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	910 MAPLE ST	None	REDWOOD CITY	CA	94063	2034	41	06081	37.48867968	-122.2222351	San Mateo County
25471	Fee-for-Service	1508138405	1508138405	1	1	HUNANYAN, ELENA MD	5/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113805	36	Psychiatry	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
25506	Fee-for-Service	1831291699	1831291699	1	1	HOGUE,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	450 EAST 23RD STREET	None	FREMONT	NE	68025	0000	00	None	41.454306	-96.491349	Dodge County
25510	Fee-for-Service	1710277215	1710277215	1	1	HAUG, SHELLY	10/15/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	520 MEDICAL CENTER DRIVE	SUITE 201	MEDFORD	OR	97504	4334	00	None	42.318801	-122.831728	Jackson County
25524	Fee-for-Service	1568075596	1568075596	1	1	HOFFMANN, CATIUSSI C NP	9/15/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	213 OCONNOR DR	None	SAN JOSE	CA	95128	1624	43	06085	37.32414516	-121.9397609	Santa Clara County
25525	Fee-for-Service	1245388123	1245388123	1	1	HAMEED, NUZHAT J MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	41778	40	Pediatrics	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
25549	Fee-for-Service	1922398320	1922398320	1	1	HACKETT, LAUREN K MD	11/6/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	114224	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
25551	Fee-for-Service	1255587820	1255587820	2	1	HURTADO RODRIGUEZ, ANTONIO	7/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	109646	01	General Practice	0	In state provider	MD	363 S PARK AVENUE	SUITE 104-A	POMONA	CA	91766	1560	19	06037	34.05615	-117.7544751	Los Angeles County
25571	Fee-for-Service	1699863662	1699863662	1	1	HOM, JOHN D DPM	3/1/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2614	43	06085	37.313433	-121.9318385	Santa Clara County
25592	Fee-for-Service	1942273040	1942273040	1	1	HOLMES COUNTY JOEL POMERENE	11/10/2012	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEMORIAL HOSPITAL	981 WOOSTER RD	None	MILLERSBURG	OH	44654	1536	00	None	40.56505408	-81.92083095	Holmes County
25599	Fee-for-Service	1942374822	1942374822	1	1	HANGER P & O WEST INC	3/27/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2773 HARRIS ST	# C	EUREKA	CA	95503	4866	12	06023	40.78052829	-124.1363953	Humboldt County
25608	Fee-for-Service	1952787616	1952787616	1	1	HANKS, MADELEINE B MD	7/22/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	158059	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
25663	Fee-for-Service	1750584355	1750584355	1	1	HASHEMI, MOHAMMAD T MD	11/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154842	20	Orthopedic Surgery	0	In state provider	None	2601 OSWELL STREET	SUITE 101	BAKERSFIELD	CA	93306	3173	15	06029	35.39259632	-118.9496489	Kern County
25716	Fee-for-Service	1508080227	1508080227	1	1	HERRERA, FRESCO PT	6/28/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1723 27TH ST	None	BAKERSFIELD	CA	93301	2807	15	06029	35.38383629	-119.0218323	Kern County
25718	Fee-for-Service	1548340607	1548340607	1	1	HU, KE-QIN MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62017	01	General Practice	0	In state provider	None	11234 ANDERSON ST	STE 1405	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
25745	Fee-for-Service	1104972850	1104972850	1	1	HEPBURN, BONNIE MD	1/1/1999	207RR0500X	NA	Other	026	PHYSICIANS	83568	83	Rheumatology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
25765	Fee-for-Service	1760535959	1760535959	1	1	HUTTON, TODD M MD	8/26/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	69246	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	180 S LAKE AVE	SUITE 615	PASADENA	CA	91101	4763	19	06037	34.14274552	-118.1322395	Los Angeles County
25775	Fee-for-Service	1861777195	1861777195	1	1	HENRICHON, STEPHEN S MD	6/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137666	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
25792	Fee-for-Service	1235226077	1235226077	1	1	HOFSTADLER, GUENTER W MD	7/27/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75989	40	Pediatrics	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
25827	Fee-for-Service	1205221231	1205221231	1	1	HUANG, TERESA M CRNA	2/26/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3440 E LA PALMA AVE	None	ANAHEIM	CA	92806	2020	30	06059	33.852105	-117.8444835	Orange County
25891	Fee-for-Service	1285782672	1285782672	1	1	HAYES, LISA A LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1392	43	06085	37.23418124	-121.7818366	Santa Clara County
25892	Fee-for-Service	1114031051	1114031051	1	1	HEMET FAMILY CARE CENTER	1/16/1997	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	880 N STATE ST	None	HEMET	CA	92543	1459	33	06065	33.76159592	-116.9717828	Riverside County
25952	Fee-for-Service	1215274667	1215274667	1	1	HIXSON, ROXANA Y MD	5/26/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	141254	None	None	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
25955	Fee-for-Service	1639257488	1639257488	1	1	HAZRA, GURPREET K MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65176	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
25978	Fee-for-Service	1861131161	1861131161	2	1	HELM PHARMACY INC	11/21/2024	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	443 W COLORADO ST	None	GLENDALE	CA	91204	1537	19	06037	34.14254552	-118.2627585	Los Angeles County
26071	Fee-for-Service	1144574799	1144574799	1	1	HALL, ASJA LCSW	2/7/2025	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
26081	Fee-for-Service	1275937955	1275937955	1	1	HUYNH, JESSICA OD PC	2/26/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2401 15TH STREET	None	SACRAMENTO	CA	95818	2238	34	06067	38.562687	-121.4931195	Sacramento County
26106	Fee-for-Service	1134933831	1134933831	1	1	HERBAN ROSE LLC	4/23/2025	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	38	06075	0	0	None
26179	Fee-for-Service	1114031051	1114031051	1	1	HEMET FAMILY CARE CENTER	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	880 N STATE ST	None	HEMET	CA	92543	1459	33	06065	33.76159592	-116.9717828	Riverside County
26221	Fee-for-Service	1194012617	1194012617	2	1	HORIE, TIA L OD	10/11/2016	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2581 NUT TREE RD	STE C	VACAVILLE	CA	95687	6915	48	06095	38.33447259	-121.9532847	Solano County
26222	Fee-for-Service	1982967493	1982967493	1	1	HTWE, YINN M MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133741	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
26245	Fee-for-Service	1104289586	1104289586	1	1	HERMAN, JONATHAN D MD	11/27/2024	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
26277	Fee-for-Service	1679553556	1679553556	1	1	HARVEY, KATHRYN L MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79070	08	Family Practice	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
26319	Fee-for-Service	1477081339	1477081339	1	1	HASAN, NOSHEEN MD	3/31/2020	390200000X	NA	Other	026	PHYSICIANS	165593	41	Internal Medicine	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
26376	Fee-for-Service	1255385597	1255385597	1	1	HAHN, DAVID D DO	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8638	08	Family Practice	0	In state provider	None	5TH & ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.741948	-121.848921	Butte County
26426	Fee-for-Service	1356418206	1356418206	1	1	HA, BENJAMIN P MD	1/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74131	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
26432	Fee-for-Service	1245770015	1245770015	1	1	HUNT, MARJHA LMFT	5/21/2021	106H00000X	NA	Mental Health Outpatient Services	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
26440	Fee-for-Service	1700964467	1700964467	1	1	HOFFMAN, LAURA S	2/18/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	68997	01	General Practice	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
26465	Fee-for-Service	1114031051	1114031051	1	1	HEMET FAMILY CARE CENTER	3/1/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	880 N STATE ST	None	HEMET	CA	92543	1459	33	06065	33.76159592	-116.9717828	Riverside County
26485	Fee-for-Service	1184797995	1184797995	1	1	HICKEY, KATHLEEN S	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
26504	Fee-for-Service	1558528455	1558528455	1	1	HERSH CHANDARANA	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
26506	Fee-for-Service	1629161385	1629161385	1	1	HALAJYAN, GALUST G MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69068	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
26508	Fee-for-Service	1144321308	1144321308	1	1	HUERTA, ALFREDO M LCSW	2/10/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	514 N. CALIFORNIA AVE.	15	BEAUMONT	CA	92223	2113	33	06065	33.92824357	-116.9812965	Riverside County
26509	Fee-for-Service	1841283298	1841283298	1	1	HOETTE, PETRA MD	12/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54761	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
26533	Fee-for-Service	1104289586	1104289586	1	1	HERMAN, JONATHAN D MD	11/27/2024	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	77	Infectious Disease	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
26542	Fee-for-Service	1306108386	1306108386	1	1	HOLE, STEVEN MD	5/10/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	169834	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
26545	Fee-for-Service	1689605206	1689605206	2	1	HICKS, ROGER G MD	8/11/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	32049	None	None	0	In state provider	None	107 MARGARET LN	None	GRASS VALLEY	CA	95945	5211	29	06057	39.22931377	-121.0463561	Nevada County
26555	Fee-for-Service	1881622066	1881622066	1	1	HANLON,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	3181 SW SAM JACKSON PARK	RD	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
26566	Fee-for-Service	1679553556	1679553556	1	1	HARVEY, KATHRYN L MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	79070	66	Emergency Medicine (Urgent Care)	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
26593	Fee-for-Service	1972683464	1972683464	1	1	HARVEY, ELIZABETH H OD	6/6/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	510 CYPRESS STREET	STE A	FORT BRAGG	CA	95437	5411	23	06045	39.43260152	-123.798942	Mendocino County
26602	Fee-for-Service	1124062500	1124062500	1	1	HUNTER, JOHN MD	4/30/1988	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	57697	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 DICKINSON ST	# H210	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
26653	Fee-for-Service	1124040274	1124040274	1	1	HUGHES, LUMAN H III MD	3/9/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	52764	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	112 LA CASA VIA	STE 200	WALNUT CREEK	CA	94598	3011	07	06013	37.91229899	-122.0423696	Contra Costa County
26658	Fee-for-Service	1306234232	1306234232	1	1	HSU, RICHARD DO	7/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13691	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
26677	Fee-for-Service	1104195908	1104195908	1	1	HO, BOSCO LMFT	3/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15434 W SAGE ST	None	VICTORVILLE	CA	92395	3965	36	06071	34.51210263	-117.3272335	San Bernardino County
26695	Fee-for-Service	1336164771	1336164771	1	1	HERFINDAHL, GARY A MD	4/30/1987	208600000X	NA	General Surgery	026	PHYSICIANS	51667	02	General Surgery	0	In state provider	None	908 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31782298	-122.3215321	Siskiyou County
26714	Fee-for-Service	1932376407	1932376407	1	1	HELMI, NADER DO	4/16/2012	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
26721	Fee-for-Service	1093844342	1093844342	1	1	HOLMSTROM, STEVEN D OD	7/23/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	31740 RAILROAD CANYON RD	STE 4	CANYON LAKE	CA	92587	9490	33	06065	33.67324972	-117.2538921	Riverside County
26744	Fee-for-Service	1740255983	1740255983	1	1	HART, SHANNON L DO	6/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13012	15	Obstetrics (D.O. only)	0	In state provider	None	488 E VALLEY PARKWAY	STE 310	ESCONDIDO	CA	92025	3373	37	06073	33.12523814	-117.0769715	San Diego County
26762	Fee-for-Service	1114031051	1114031051	1	1	HEMET FAMILY CARE CENTER	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	880 N STATE ST	None	HEMET	CA	92543	1459	33	06065	33.76159592	-116.9717828	Riverside County
26801	Fee-for-Service	1184294787	1184294787	1	1	HOME HEALTH OF ST CAMILLUS	10/31/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	LLC	50 SAND CREEK ROAD	STE 236	BRENTWOOD	CA	94513	7302	07	06013	37.94657758	-121.6971754	Contra Costa County
26830	Fee-for-Service	1184784555	1184784555	1	1	HIGH DESERT WOMENS MEM	9/18/2007	174400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	BARSTOW WOMENS MEDICAL	801 E MOUNTAIN VIEW ST	STE C	BARSTOW	CA	92311	3052	36	06071	34.89324445	-117.0177579	San Bernardino County
26841	Fee-for-Service	1922696442	1922696442	1	1	HORIZON AID INC	4/28/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	639 S GLENWOOD PL	UNIT 103	BURBANK	CA	91506	2819	19	06037	34.16551979	-118.3138484	Los Angeles County
26891	Fee-for-Service	1730127069	1730127069	1	1	HEBERT, STEPHEN A MD	3/24/1997	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	40602	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9339 GENESEE AVE	STE 220	SAN DIEGO	CA	92121	2121	37	06073	32.87610483	-117.2139185	San Diego County
26918	Fee-for-Service	1689696023	1689696023	1	1	HUNG, HINSHING J MD	9/20/2007	207L00000X	NA	Other	026	PHYSICIANS	47712	05	Anesthesiology	0	In state provider	None	23560 CRENSHAW BLVD	STE 104	TORRANCE	CA	90505	5233	19	06037	33.811677	-118.328042	Los Angeles County
26932	Fee-for-Service	1033875729	1033875729	1	1	HOPE RX PHARMACY LLC	1/4/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10084 CHAPMAN AVE	None	GARDEN GROVE	CA	92840	2821	30	06059	33.78856195	-117.9573359	Orange County
26940	Fee-for-Service	1316629231	1316629231	1	1	HENDERSON, TYLER	7/11/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3416 AMERICAN RIVER DR	STE B	SACRAMENTO	CA	95864	5753	34	06067	38.569212	-121.3840755	Sacramento County
26966	Fee-for-Service	1205887064	1205887064	1	1	HENDERSON,SEAN O MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	69803	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
26985	Fee-for-Service	1336164771	1336164771	1	1	HERFINDAHL, GARY A MD	4/30/1987	208600000X	NA	General Surgery	026	PHYSICIANS	51667	66	Emergency Medicine (Urgent Care)	0	In state provider	None	908 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31782298	-122.3215321	Siskiyou County
27033	Fee-for-Service	1740255983	1740255983	1	1	HART, SHANNON L DO	6/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13012	09	Gynecology (D.O. only)	0	In state provider	None	488 E VALLEY PARKWAY	STE 310	ESCONDIDO	CA	92025	3373	37	06073	33.12523814	-117.0769715	San Diego County
27047	Fee-for-Service	1053341206	1053341206	1	1	HAWN, GLENNA LCSW	8/18/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	334 SHAW AVE	SUITE 100	CLOVIS	CA	93612	3839	10	06019	36.80839352	-119.7049776	Fresno County
27092	Fee-for-Service	1760449581	1760449581	1	1	HAGLUND, ALICIA MD	4/1/2001	207P00000X	NA	Other	026	PHYSICIANS	68398	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
27130	Fee-for-Service	1124155387	1124155387	1	2	HAMILTON, AMBER L LMFT	2/15/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18700 S BEACH BLVD	STE 160	HUNTINGTON BEACH	CA	92648	2006	30	06059	33.69070037	-117.9886896	Orange County
27165	Fee-for-Service	1275561060	1275561060	1	1	HELLIWELL, SINIVA L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82543	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8501 BRIMHALL RD	BLDG 300	BAKERSFIELD	CA	93312	2254	15	06029	35.36876784	-119.0971029	Kern County
27166	Fee-for-Service	1427124668	1427124668	1	1	HURLEY, JENNIFER L	1/25/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
27180	Fee-for-Service	1730127069	1730127069	1	1	HEBERT, STEPHEN A MD	3/24/1997	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	40602	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9339 GENESEE AVE	STE 220	SAN DIEGO	CA	92121	2121	37	06073	32.87610483	-117.2139185	San Diego County
27185	Fee-for-Service	1821594979	1821594979	1	1	HOBAN, SHEILA R PHD	6/11/2018	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
27208	Fee-for-Service	1891843702	1891843702	1	1	HWU, HENRY B MD	10/31/1984	208C00000X	NA	General Surgery	026	PHYSICIANS	39841	28	Proctology (colon and rectal)	0	In state provider	None	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	19	06037	34.06891181	-118.2638033	Los Angeles County
27217	Fee-for-Service	1699842567	1699842567	1	1	HUFFORD, GARY L MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	42203	30	Radiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
27244	Fee-for-Service	1457669475	1457669475	1	1	HEALTHRIGHT 360	7/20/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	845 E ARROW HWY	None	POMONA	CA	91767	2535	19	06037	34.09032048	-117.734769	Los Angeles County
27309	Fee-for-Service	1912321878	1912321878	1	1	HOANG, DON MD	10/24/2019	208200000X	NA	General Surgery	026	PHYSICIANS	128539	24	Plastic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
27325	Fee-for-Service	1952304081	1952304081	1	1	HANUMANDLA, SAROJANA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2669 SCENIC DR	None	ALAMOGORDO	NM	88310	8700	00	None	32.92683131	-105.9341287	Otero County
27352	Fee-for-Service	1528043445	1528043445	1	1	HWANG, JUDITH C F MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	74948	05	Anesthesiology	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
27372	Fee-for-Service	1992070130	1992070130	1	1	HO, DEBORAH Y MD MPH	8/1/2019	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	163115	35	Pediatric Cardiology (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
27425	Fee-for-Service	1457010209	1457010209	1	1	HNC, LLC	9/11/2023	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	576 MAGNOLIA AVE.	None	CLOVIS	CA	93611	9207	10	06019	36.83918526	-119.6661886	Fresno County
27468	Fee-for-Service	1386754646	1386754646	1	1	HUNTER,CLAIRE 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	601 N 30TH STREET	None	OMAHA	NE	68131	0000	00	None	41.2654263	-95.95644327	Douglas County
27478	Fee-for-Service	1922531177	1922531177	1	1	HO-LE, LILY T MD	10/12/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165589	08	Family Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
27532	Fee-for-Service	1699830042	1699830042	1	1	HARTMAN, REBECCA J	2/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	350 SAINT JOSEPHS AVE	None	SAN FRANCISCO	CA	94115	3255	38	06075	37.78245426	-122.4421849	San Francisco County
27556	Fee-for-Service	1538387428	1538387428	1	1	HUBBELL, JARED K MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94459	66	Emergency Medicine (Urgent Care)	0	In state provider	None	347 ANDRIEUX ST	None	SONOMA	CA	95476	6811	49	06097	38.28843573	-122.4651035	Sonoma County
27573	Fee-for-Service	1437230943	1437230943	1	1	HUMANGOOD NORCAL	3/1/1966	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	110 41ST ST	None	OAKLAND	CA	94611	5219	01	06001	37.82617734	-122.2513788	Alameda County
27606	Fee-for-Service	1124180302	1124180302	1	1	HSIAO, FEEI-WEN A MD	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	68942	08	Family Practice	0	In state provider	None	3010 COLBY ST	#221	BERKELEY	CA	94705	2056	01	06001	37.85492078	-122.2576101	Alameda County
27615	Fee-for-Service	1013146059	1013146059	1	1	HUYNH, BE T MD	2/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	116402	22	Pathology (M.D. only)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
27629	Fee-for-Service	1649271131	1649271131	1	1	HIGGINS, STANLEY M MD	6/14/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	138733	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
27664	Fee-for-Service	1093827917	1093827917	1	1	HINAS MERCY SW PHARMACY	2/24/2004	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HINAS HOME CARE PHARMACY	9508 STOCKDALE HWY	STE 130	BAKERSFIELD	CA	93311	3623	15	06029	35.35453237	-119.1086014	Kern County
27673	Fee-for-Service	1730613985	1730613985	1	1	HERNANDEZ, AUDREY LMFT	2/5/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28100 BOUQUET CANYON RD.	SUITE 218	SANTA CLARITA	CA	91350	2009	19	06037	34.45052733	-118.497654	Los Angeles County
27696	Fee-for-Service	1720321920	1720321920	1	1	HU, MARIA C LCSW	6/9/2022	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
27698	Fee-for-Service	1639153984	1639153984	1	1	HARTMAN, RONALD H MD INC	7/11/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	8227	18	Ophthalmology	0	In state provider	None	3801 KATELLA AVE	STE 414	LOS ALAMITOS	CA	90720	3386	30	06059	33.80318951	-118.066068	Orange County
27707	Fee-for-Service	1477599371	1477599371	1	1	HOANG, PHILIP MD	10/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85468	30	Radiology	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
27727	Fee-for-Service	1528022357	1528022357	1	1	HO, CHERYL J MD	12/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77240	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
27746	Fee-for-Service	1922049055	1922049055	2	1	HONG, JEFFREY C MD	1/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	71794	18	Ophthalmology	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
27804	Fee-for-Service	1295823292	1295823292	1	1	HUH, JOSEPH MD	5/2/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	72871	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
27817	Fee-for-Service	1891981502	1891981502	1	1	HEALTHCARE PARTNERS	11/13/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	AFFILIATES MEDICAL GROUP	14591 NEWPORT AVE	STE 206	TUSTIN	CA	92780	6027	30	06059	33.7317307	-117.8285651	Orange County
27838	Fee-for-Service	1114084530	1114084530	1	1	HOFFMAN, NANCY A PHD	1/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
27851	Fee-for-Service	1124074901	1124074901	1	1	HOUSTON, DARRIN F DO	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
27868	Fee-for-Service	1497479091	1497479091	1	1	HEALTHWORKS PHARMA INC	10/20/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	78385 VARNER RD	STE C	PALM DESERT	CA	92211	4118	33	06065	33.7602334	-116.2963656	Riverside County
27938	Fee-for-Service	1548363708	1548363708	1	1	HALASWAMY, RAVI H MD	12/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	143187	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
27950	Fee-for-Service	1164462479	1164462479	1	1	HOOTEN,JODY 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
27971	Fee-for-Service	1821594144	1821594144	1	4	HEARINGLIFE HEARING AID CENT	10/10/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	420 BULLARD AVE	STE 101	CLOVIS	CA	93612	1054	10	06019	36.82298124	-119.7038474	Fresno County
28007	Fee-for-Service	1831112036	1831112036	2	1	HILLMAN, STEPHEN A MD	2/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	70482	None	None	0	In state provider	None	555 E HARDY STREET	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
28026	Fee-for-Service	1053609164	1053609164	1	1	HEALEY, DARCY ERIN	12/23/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
28041	Fee-for-Service	1962436782	1962436782	1	1	HARRISON, AMY E MD	8/29/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	175785	None	None	0	In state provider	None	1225 LATHAM AVE	SUITE A	HEMET	CA	92543	4423	33	06065	33.74937952	-116.959626	Riverside County
28052	Fee-for-Service	1104339878	1104339878	1	1	HAND IN HEART HOME HEALTH	10/8/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	950 COUNTY SQUARE DR	STE 107	VENTURA	CA	93003	5472	56	06111	34.26650142	-119.2145321	Ventura County
28107	Fee-for-Service	1891981502	1891981502	1	1	HEALTHCARE PARTNERS	11/13/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	14591 NEWPORT AVE	STE 206	TUSTIN	CA	92780	6027	30	06059	33.7317307	-117.8285651	Orange County
28118	Fee-for-Service	1245377597	1245377597	1	2	HOGAN, CRAIG A MD	8/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
28128	Fee-for-Service	1336342369	1336342369	1	1	HONG, MICHAEL MD	5/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128680	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	ONE DANIEL BURNHAM CIR	SUITE 205C	SAN FRANCISCO	CA	94109	5472	38	06075	37.78693724	-122.4225429	San Francisco County
28133	Fee-for-Service	1891272084	1891272084	1	1	HUTCHISON, SEAN A CRNA	1/30/2020	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
28190	Fee-for-Service	1356510176	1356510176	1	1	HARDY-LUKES, LYNNE M	11/29/2018	No Taxonomy Provided	NA	None	037	SPEECH 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
28251	Fee-for-Service	1851495501	1851495501	1	1	HEMATOLOGY ONCOLOGY	2/23/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	CONSULTANTS	6850 SEPULVEDA BLVD	STE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
28299	Fee-for-Service	1316333891	1316333891	1	1	HUBBARD, JOSHUA W MD	3/3/2023	207R00000X	NA	Other	026	PHYSICIANS	19431	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
28319	Fee-for-Service	1144552290	1144552290	1	1	HERNANDEZ, MILASENT E	3/15/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
28339	Fee-for-Service	1659329837	1659329837	1	1	HATAMY, ESMATULLAH MD	3/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90147	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
28346	Fee-for-Service	1538141841	1538141841	2	1	HOSPICE CARE OF THE WEST LLC	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	505 N EUCLID STREET	SUITE 480	ANAHEIM	CA	92801	5507	30	06059	33.8379454	-117.9416147	Orange County
28352	Fee-for-Service	1992985634	1992985634	1	1	HOU, LEWIS C MD	11/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85677	14	Neurological Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
28361	Fee-for-Service	1851670871	1851670871	1	1	HUANG, DIANA OD	5/16/2011	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	138 N MILPITAS BLVD	None	MILPITAS	CA	95035	4401	43	06085	37.43348259	-121.8999829	Santa Clara County
28371	Fee-for-Service	1700811700	1700811700	1	1	HOLMES, WILLIAM N MD	8/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104831	30	Radiology	0	In state provider	None	431 S BATAVIA STREET	STE 103	ORANGE	CA	92868	3906	30	06059	33.781851	-117.8618145	Orange County
28376	Fee-for-Service	1407926009	1407926009	1	1	HELMAN, DALE MD	7/31/1987	2084N0400X	NA	Neurology	026	PHYSICIANS	62762	13	Neurology (M.D. only)	0	In state provider	None	256 SAN JOSE ST	STE A	SALINAS	CA	93901	3933	27	06053	36.65812904	-121.6458733	Monterey County
28391	Fee-for-Service	1881787786	1881787786	1	1	HOLLMAN, JESSICA C MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	85256	40	Pediatrics	0	In state provider	None	250 BON AIR ROAD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
28393	Fee-for-Service	1891981502	1891981502	1	1	HEALTHCARE PARTNERS	11/13/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	AFFILIATES MEDICAL GROUP	14591 NEWPORT AVE	STE 206	TUSTIN	CA	92780	6027	30	06059	33.7317307	-117.8285651	Orange County
28448	Fee-for-Service	1801882071	1801882071	1	1	HALLERT, GREGORY E MD	11/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73357	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
28456	Fee-for-Service	1841828233	1841828233	1	1	HEGDE, SHEFALI MD	9/27/2024	1835P1300X	NA	Other	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	1761 BROADWAY ST	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
28498	Fee-for-Service	1588741425	1588741425	1	1	HWANG, JEMMY C MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65020	02	General Surgery	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
28506	Fee-for-Service	1255493532	1255493532	1	1	HSU, ANDREW S MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	36242	40	Pediatrics	0	In state provider	None	8283 GROVE AVE	STE 202	RANCHO CUCAMONGA	CA	91730	3140	36	06071	34.10380433	-117.6285116	San Bernardino County
28510	Fee-for-Service	1720275613	1720275613	1	1	HOANG, PAUL T LCSW	9/22/2015	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	30	06059	33.77387145	-117.9966555	Orange County
28512	Fee-for-Service	1205903887	1205903887	1	1	HILT, JENNIFER F LCSW	9/15/2018	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2150 E TAHQUITZ CANYON W	STE 3	PALM SPRINGS	CA	92262	7045	33	06065	33.82322949	-116.5230675	Riverside County
28527	Fee-for-Service	1508601238	1508601238	1	1	HIGHUM, ROBERT PHILIP	7/7/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1532 CRESTVIEW RD	None	REDLANDS	CA	92374	6387	36	06071	34.04143096	-117.1494696	San Bernardino County
28539	Fee-for-Service	1851495501	1851495501	1	1	HEMATOLOGY ONCOLOGY	2/23/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CONSULTANTS	6850 SEPULVEDA BLVD	STE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
28560	Fee-for-Service	1992895593	1992895593	1	1	HOFFMAN, ROBERT O. 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
28566	Fee-for-Service	1124739685	1124739685	1	1	HITCHCOCK, JACQUELINE OT	1/3/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
28627	Fee-for-Service	1598142317	1598142317	1	1	HUTNER, DENICE LMFT	11/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	1	Border provider	None	187 WARM SPRINGS	SUITE B157	LAS VEGAS	NV	89119	4110	00	None	36.05690954	-115.164216	Clark County
28630	Fee-for-Service	1093754541	1093754541	1	1	HOLLOWAY, ALLEN 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	2525 E ROOSEVELT ST	None	PHOENIX	AZ	85008	4948	00	None	33.4584867	-112.0269093	Maricopa County
28632	Fee-for-Service	1538141841	1538141841	2	1	HOSPICE CARE OF THE WEST LLC	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	505 N EUCLID STREET	SUITE 480	ANAHEIM	CA	92801	5507	30	06059	33.8379454	-117.9416147	Orange County
28642	Fee-for-Service	1669426409	1669426409	1	1	HOFFMAN, HEIDI MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78534	30	Radiology	0	In state provider	None	14860 ROSCOE BLVD	STE 100	PANORAMA CITY	CA	91402	4687	19	06037	34.2214515	-118.4573205	Los Angeles County
28689	Fee-for-Service	1962829812	1962829812	1	1	HA, TUONG-VI V OD	10/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15500	01	General Practice	0	In state provider	None	1955 COWELL BLVD	None	DAVIS	CA	95618	6325	57	06113	38.5399459	-121.7284328	Yolo County
28693	Fee-for-Service	1982131892	1982131892	1	1	HUANG, ALEX Z MD	4/7/2021	207P00000X	NA	Other	026	PHYSICIANS	157902	None	None	0	In state provider	None	3001 SILLECT AVE	None	BAKERSFIELD	CA	93308	6337	15	06029	35.38601911	-119.0400416	Kern County
28695	Fee-for-Service	1932201761	1932201761	1	1	HERSHBERGER, NEIL A	6/7/2006	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1340 LAKE BLVD	None	DAVIS	CA	95616	2619	57	06113	38.55491538	-121.7876886	Yolo County
28746	Fee-for-Service	1275616757	1275616757	1	1	HOFFMAN, CATHERINE A MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61269	07	Dermatology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
28748	Fee-for-Service	1083033468	1083033468	1	1	HABIBI, NAVEEDA LMFT	5/26/2023	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
28756	Fee-for-Service	1598055196	1598055196	1	1	HARVEY, KIMBER A LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
28786	Fee-for-Service	1821200312	1821200312	1	1	HORAN, SIOBAN M MD	6/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107696	33	Thoracic Surgery	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
28791	Fee-for-Service	1144662438	1144662438	1	1	HUMPHREY, ASHLEY A LCSW	10/7/2019	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
28810	Fee-for-Service	1508601238	1508601238	1	1	HIGHUM, ROBERT PHILIP	7/7/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1532 CRESTVIEW RD	None	REDLANDS	CA	92374	6387	36	06071	34.04143096	-117.1494696	San Bernardino County
28816	Fee-for-Service	1760560478	1760560478	1	1	HARTMAN, JONATHAN MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	85845	30	Radiology	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
28820	Fee-for-Service	1316182397	1316182397	1	1	HABICHT, MICHAEL E R MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110639	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 MARSHALL WY	None	PLACERVILLE	CA	95667	6533	09	06017	38.72453536	-120.7921649	El Dorado County
28828	Fee-for-Service	1851495501	1851495501	1	1	HEMATOLOGY ONCOLOGY	6/1/1997	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	CONSULTANTS	6850 SEPULVEDA BLVD	STE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
28851	Fee-for-Service	1316011463	1316011463	1	1	HANGER PROSTHETICS &	4/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	654 N EL CAMINO REAL	None	SAN MATEO	CA	94401	3713	41	06081	37.57235292	-122.3392732	San Mateo County
28874	Fee-for-Service	1588004634	1588004634	1	1	HAJSADEGHI, FERESHTEH MD	6/3/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	137974	None	None	0	In state provider	None	10101 RIVERSIDE DR	None	TOLUCA LAKE	CA	91602	2517	19	06037	34.15223753	-118.3508865	Los Angeles County
28875	Fee-for-Service	1194395400	1194395400	1	1	HAVEN-A REFUGE FOR PREGNANCY	2/20/2023	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	34	06067	0	0	None
28883	Fee-for-Service	1235654138	1235654138	1	1	HARBER, JANA E LMFT	10/2/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9033 BASELINE AVE	STE A	RANCHO CUCAMONGA	CA	91730	1214	36	06071	34.12151248	-117.6080805	San Bernardino County
28917	Fee-for-Service	1053599407	1053599407	1	1	HANCOCK 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	2800 10TH AVE N	None	BILLINGS	MT	59101	0703	00	None	45.789696	-108.5132835	Yellowstone County
28935	Fee-for-Service	1245384791	1245384791	1	1	HOH, JOHN J L MD	6/30/1989	261QC1500X	NA	Other	026	PHYSICIANS	66101	38	Geriatrics	0	In state provider	None	16500 VENTURA BLVD	STE 414	ENCINO	CA	91436	5050	19	06037	34.15756758	-118.4926374	Los Angeles County
28963	Fee-for-Service	1891981502	1891981502	1	2	HEALTHCARE PARTNERS	11/13/2013	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	17071 SPRINGDALE ST	None	HUNTINGTON BEACH	CA	92649	4669	30	06059	33.7144429	-118.0239762	Orange County
28969	Fee-for-Service	1467884676	1467884676	1	1	HSU, LAWRENCE MD INC	5/27/2014	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	120677	20	Orthopedic Surgery	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
29003	Fee-for-Service	1649645797	1649645797	1	1	HERNANDEZ, ODESSA NP	1/8/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6440 PLATT AVE	None	WEST HILLS	CA	91307	3216	19	06037	34.18784988	-118.6427021	Los Angeles County
29115	Fee-for-Service	1851495501	1851495501	1	1	HEMATOLOGY ONCOLOGY	5/10/1995	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	CONSULTANTS	6850 SEPULVEDA BLVD	STE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
29128	Fee-for-Service	1528634169	1528634169	1	1	HOSNER, TENA A DC	6/18/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3 COURT ST	None	WOODLAND	CA	95695	3111	57	06113	38.67888652	-121.783788	Yolo County
29132	Fee-for-Service	1831411446	1831411446	1	1	HILLS DIALYSIS LLC	5/1/2010	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	757 E WASHINGTON BLVD	None	LOS ANGELES	CA	90021	3016	19	06037	34.02697596	-118.2555867	Los Angeles County
29178	Fee-for-Service	1891010161	1891010161	1	1	HOANG, QUYNH N MD	11/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129939	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
29179	Fee-for-Service	1720191505	1720191505	1	1	HUNG, MIA M OD	3/30/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	14461 MERCED AVE	STE 101	BALDWIN PARK	CA	91706	5176	19	06037	34.07249163	-117.9613001	Los Angeles County
29232	Fee-for-Service	1760938971	1760938971	1	1	HAMZA, MOHAMED MD	2/27/2025	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
29253	Fee-for-Service	1891981502	1891981502	1	2	HEALTHCARE PARTNERS	11/13/2013	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	17071 SPRINGDALE ST	None	HUNTINGTON BEACH	CA	92649	4669	30	06059	33.7144429	-118.0239762	Orange County
29266	Fee-for-Service	1184903437	1184903437	1	1	HAREESH GUNDLAPALLI MD	11/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2700 SE STRATUS AVE	None	MCMINNVILLE	OR	97128	6255	00	None	45.20010494	-123.1656951	Yamhill County
29273	Fee-for-Service	1023026309	1023026309	1	1	HOTAN,TANIE 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 N 10TH AVE	None	STAYTON	OR	97383	0000	00	None	44.805159	-122.7841775	Marion County
29282	Fee-for-Service	1457671117	1457671117	1	1	HA, RICHARD-TIEN V MD	8/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	85168	33	Thoracic Surgery	0	In state provider	None	300 PASTEUR DR	MC: 500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
29302	Fee-for-Service	1174823173	1174823173	1	1	HIGGINS, PATRICIA M PHD	10/11/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	OGICAL SERVICES AT PASO	1140 RAILROAD STREET	None	PASO ROBLES	CA	93446	2532	40	06079	35.62645486	-120.6881426	San Luis Obispo County
29309	Fee-for-Service	1447694450	1447694450	1	1	HINDMAN, DIANE E MD	3/2/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
29312	Fee-for-Service	1750698635	1750698635	1	1	HOLMES, JONATHAN W MD	3/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122213	02	General Surgery	0	In state provider	None	1125 E SPRUCE AVE	SUITE 101	FRESNO	CA	93720	3387	10	06019	36.839817	-119.7616905	Fresno County
29348	Fee-for-Service	1750383766	1750383766	1	1	HURWITZ, ANDREW S MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	75481	33	Thoracic Surgery	0	In state provider	None	1510 S CENTRAL AVE	STE 530	GLENDALE	CA	91204	2542	19	06037	34.12709764	-118.2577911	Los Angeles County
29381	Fee-for-Service	1962843748	1962843748	1	1	HOSHINO, CHRISTOPHER MD	7/26/2014	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	108050	20	Orthopedic Surgery	0	In state provider	INC	2865 ATLANTIC AVE	SUITE 221	LONG BEACH	CA	90806	7430	19	06037	33.809418	-118.185058	Los Angeles County
29385	Fee-for-Service	1073596946	1073596946	1	1	HAMILTON, STEPHANIE	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
29399	Fee-for-Service	1063445401	1063445401	1	1	HALSEY, MATTHEW F MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75955	20	Orthopedic Surgery	0	In state provider	None	8455 N MILLBROOK AVE	STE 107	FRESNO	CA	93720	2152	10	06019	36.858105	-119.7657995	Fresno County
29418	Fee-for-Service	1265404719	1265404719	1	1	HOLMAN, HERBERT A MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	37361	07	Dermatology	0	In state provider	None	20055 LAKE CHABOT RD	STE 150	CASTRO VALLEY	CA	94546	5389	01	06001	37.69836512	-122.0873587	Alameda County
29422	Fee-for-Service	1356872022	1356872022	1	1	HOCKETT, KALI R MD	9/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	165563	40	Pediatrics	0	In state provider	None	726 N MEDICAL CTR DR E	STE 209	CLOVIS	CA	93611	6886	10	06019	36.84186593	-119.6624867	Fresno County
29427	Fee-for-Service	1194733204	1194733204	1	1	HARA PODIATRISTS GRP INC	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1257 W SAN BERNARDINO RD	None	COVINA	CA	91722	3509	19	06037	34.08850782	-117.9158316	Los Angeles County
29460	Fee-for-Service	1760580310	1760580310	1	1	HIATT, JASON M DPM	5/1/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1401 SPANOS CT	STE 104	MODESTO	CA	95355	2811	50	06099	37.66975543	-120.9724048	Stanislaus County
29514	Fee-for-Service	1043889637	1043889637	1	1	HAN, THAW MD	12/17/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
29558	Fee-for-Service	1992169437	1992169437	1	1	HARRAH, TANNER DO	3/22/2024	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	15819	None	None	0	In state provider	None	1334 W COVINA BLVD 105	None	SAN DIMAS	CA	91773	3211	19	06037	34.097067	-117.833751	Los Angeles County
29559	Fee-for-Service	1720772098	1720772098	1	1	HUYNH, TYLER RCP	9/25/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	43	06085	37.23951066	-121.8013511	Santa Clara County
29564	Fee-for-Service	1972715985	1972715985	1	1	HALLIGAN, BENJAMIN W MD	9/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84498	20	Orthopedic Surgery	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
29570	Fee-for-Service	1528174778	1528174778	1	2	HARSHA PARESH SHETH M.D. INC	2/20/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	.	13768 ROSWELL AVE	SUITE 115	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
29593	Fee-for-Service	1184952681	1184952681	1	1	HAMIDJAJA, LINDA MD	6/27/2023	207R00000X	NA	Other	026	PHYSICIANS	109960	None	None	0	In state provider	None	300 WEST HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
29607	Fee-for-Service	1124071311	1124071311	1	1	HARMAN, SCOTT A MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	57284	30	Radiology	0	In state provider	None	25405 HANCOCK AVE	STE 107	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
29629	Fee-for-Service	1093049702	1093049702	1	1	HERCULEAN BABIES PEDIATRICS	7/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	51091	40	Pediatrics	0	In state provider	None	500 ALFRED NOBEL DR	STE 255A	HERCULES	CA	94547	1843	07	06013	38.01799847	-122.2743374	Contra Costa County
29633	Fee-for-Service	1750383766	1750383766	1	1	HURWITZ, ANDREW S MD	7/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	75481	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1510 S CENTRAL AVE	STE 530	GLENDALE	CA	91204	2542	19	06037	34.12709764	-118.2577911	Los Angeles County
29640	Fee-for-Service	1821017427	1821017427	1	1	HA, JULIE Y MD	12/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137954	40	Pediatrics	0	In state provider	None	1300 CRANE ST	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
29688	Fee-for-Service	1033261250	1033261250	1	1	HABIB, NAZIR J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37866	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
29691	Fee-for-Service	1477153039	1477153039	1	1	HOSPICE CARE, INC	9/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15826 VENTURA BLVD	SUITE 223	ENCINO	CA	91436	5226	19	06037	34.15560786	-118.4784661	Los Angeles County
29695	Fee-for-Service	1518006550	1518006550	1	1	HERNANDEZ, CLAUDIA MD	1/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109704	08	Family Practice	0	In state provider	None	4530 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	2057	19	06037	34.0086118	-118.0813633	Los Angeles County
29707	Fee-for-Service	1861405003	1861405003	2	1	HELTON-SKALLY, KATHY J MD	12/16/2021	2085P0229X	NA	Other	026	PHYSICIANS	171541	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
29722	Fee-for-Service	1679013502	1679013502	1	1	HERNANDEZ, ESTHER V CRNA	2/28/2017	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
29742	Fee-for-Service	1891705869	1891705869	1	1	HO, CONNIE L MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82002	01	General 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
29764	Fee-for-Service	1265607204	1265607204	1	1	HALL, JILL C MD	5/6/2009	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	95746	None	None	0	In state provider	None	701 E 28TH ST	STE 212	LONG BEACH	CA	90806	2774	19	06037	33.80803441	-118.1847137	Los Angeles County
29767	Fee-for-Service	1235541962	1235541962	1	1	HSU, LEEYEN MD	1/3/2022	207R00000X	NA	Other	026	PHYSICIANS	140050	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
29768	Fee-for-Service	1538878632	1538878632	1	1	HAINLEY, ISAAC CRNA	2/28/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
29791	Fee-for-Service	1578053864	1578053864	1	1	HUMBOLDT MEDICAL EYE ASSOCIA	3/19/2019	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	TES	2434 HARRISON AVE	None	EUREKA	CA	95501	3219	12	06023	40.78524281	-124.1396701	Humboldt County
29803	Fee-for-Service	1710212634	1710212634	1	1	HINIKER, ANNE MD	9/24/2024	207ZP0105X	NA	Other	026	PHYSICIANS	117444	21	Pathologic Anatomy: Clinical Pathology (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
29806	Fee-for-Service	1003101379	1003101379	1	1	HART, DANIEL E MD	10/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143021	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2500 MERCED ST	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
29812	Fee-for-Service	1902831902	1902831902	1	1	HENRICH, TIMOTHY J MD	1/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138609	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
29833	Fee-for-Service	1366781296	1366781296	1	1	HU, QING L MD	1/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147558	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
29838	Fee-for-Service	1093330599	1093330599	1	2	HAIDAR, TAREK MD	3/13/2025	207QA0401X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	None	-	NOT APPLICABLE	0	In state provider	None	1240 BROADWAY	None	EL CAJON	CA	92021	4994	37	06073	32.80773552	-116.9384985	San Diego County
29841	Fee-for-Service	1982633582	1982633582	1	1	HARVEY, DEAN A MD	9/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	19962	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
29859	Fee-for-Service	1114391935	1114391935	1	1	HOSSEINI, SOHEILA PHD	9/22/2020	101YA0400X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	E	127 BROADWAY	SUITE 200	SANTA MONICA	CA	90401	2330	19	06037	34.01334753	-118.4957836	Los Angeles County
29870	Fee-for-Service	1821249111	1821249111	1	1	HO, CATHERINE J DO	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10581	41	Internal Medicine	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
29880	Fee-for-Service	1780903773	1780903773	1	1	HUHDANPAA, HANNU T MD	2/19/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	121766	None	None	0	In state provider	None	207 LEGION	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
29893	Fee-for-Service	1154523504	1154523504	1	1	HIRSCH, BETH F CNP	9/20/2017	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	840 S AKERS ST	None	VISALIA	CA	93277	8309	54	06107	36.322398	-119.3484285	Tulare County
29904	Fee-for-Service	1679832604	1679832604	1	1	HAYWARD OPTOMETRY, INC	5/28/2019	261QP2300X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	865 B ST	None	HAYWARD	CA	94541	5107	01	06001	37.67179004	-122.084486	Alameda County
29956	Fee-for-Service	1700872488	1700872488	1	1	HARMAN, ERNEST L MD	4/23/2021	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	-	-	NOT APPLICABLE	1	Border provider	None	2150 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	8472	00	None	35.11197	-114.567993	Mohave County
29964	Fee-for-Service	1710273396	1710273396	1	1	HINGULA, LEE P MD	4/1/2022	207L00000X	NA	Other	026	PHYSICIANS	176550	None	None	0	In state provider	None	2105 FOREST AVENUE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
29972	Fee-for-Service	1437509494	1437509494	1	1	HEBRONI, FRANK F MD	4/22/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	152505	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
29981	Fee-for-Service	1477153039	1477153039	1	1	HOSPICE CARE, INC	9/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15826 VENTURA BLVD	SUITE 223	ENCINO	CA	91436	5226	19	06037	34.15560786	-118.4784661	Los Angeles County
29994	Fee-for-Service	1972954303	1972954303	1	1	HOLLANDSWORTH, HANNAH M MD	7/3/2023	208600000X	NA	General Surgery	026	PHYSICIANS	152712	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
30008	Fee-for-Service	1487198917	1487198917	1	1	HOVERMAN, CLARA LCSW	6/14/2021	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
30033	Fee-for-Service	1891705869	1891705869	1	1	HO, CONNIE L MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82002	07	Dermatology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
30056	Fee-for-Service	1871683532	1871683532	1	1	HWANG, DANIEL H MD	7/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76684	45	Nephrology (Renal-Kidney)	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
30075	Fee-for-Service	1003582339	1003582339	1	1	HO, JENNIFER OD	12/27/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	43112 N 15TH ST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
30094	Fee-for-Service	1104926989	1104926989	1	1	HINSMAN,DAVID 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	PLATSBURG	NY	12901	0000	00	None	44.701011	-73.4692635	Clinton County
30103	Fee-for-Service	1164728036	1164728036	1	1	HOLLYWOOD VISION CENTER	2/8/2011	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY INC	955 CARRILLO DR	STE 105	LOS ANGELES	CA	90048	5400	19	06037	34.05972732	-118.368048	Los Angeles County
30121	Fee-for-Service	1881634780	1881634780	1	1	HAWLEY, JOHN F OD	11/5/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PREMIER EYECARE OPTOMETR	8150 HAGEMAN RD	None	BAKERSFIELD	CA	93312	1959	15	06029	35.40166449	-119.0933415	Kern County
30124	Fee-for-Service	1437616000	1437616000	1	1	HOME CONNECT HOME HEALTH LLC	7/13/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	200 BROWN ROAD	SUITE 210	FREMONT	CA	94539	7957	01	06001	37.49494016	-121.9251914	Alameda County
30137	Fee-for-Service	1649366600	1649366600	1	1	HAGEMAN, ARNOLD P MD	11/2/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	9943	30	Radiology	0	In state provider	None	2501 S HOPE ST	None	LOS ANGELES	CA	90007	2667	19	06037	34.02798845	-118.2731102	Los Angeles County
30139	Fee-for-Service	1891024071	1891024071	1	1	HOLLIE HUYNH OD INC	10/6/2009	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11893 VALLEY VIEW ST	None	GARDEN GROVE	CA	92545	1236	30	06059	33.7905371	-118.0287927	Orange County
30144	Fee-for-Service	1841493046	1841493046	1	1	HU, MEITUCK 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 NE 139TH ST	None	VANCOUVER	WA	98686	2742	00	None	45.720117	-122.647986	Clark County
30148	Fee-for-Service	1043622020	1043622020	1	1	HATFIELD, ANDREA M LMFT	4/16/2024	106H00000X	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
30171	Fee-for-Service	1023196920	1023196920	1	1	HANNA, DINAH MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66119	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
30180	Fee-for-Service	1518311745	1518311745	1	1	HOJDA, HENRY MFT	5/25/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46742	-	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
30310	Fee-for-Service	1851330039	1851330039	1	1	HEYNE, TIMOTHY R MD	7/1/1989	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	66100	20	Orthopedic Surgery	0	In state provider	None	933 BLANCO CIR	None	SALINAS	CA	93901	4446	27	06053	36.65466617	-121.6377278	Monterey County
30346	Fee-for-Service	1871683532	1871683532	1	1	HWANG, DANIEL H MD	7/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76684	41	Internal Medicine	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
30352	Fee-for-Service	1811236474	1811236474	1	1	HARRIS, ROBIN C CCC-SLP	9/11/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3180 ARDEN WY	None	SACRAMENTO	CA	95825	3701	34	06067	38.595528	-121.3903395	Sacramento County
30356	Fee-for-Service	1891766994	1891766994	1	1	HAMMES, JOHN S MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	84351	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
30364	Fee-for-Service	1407890601	1407890601	1	1	HUBBARD, KEVIN W DO	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
30412	Fee-for-Service	1497789176	1497789176	1	1	HARRIS, CRAIG R MD	9/1/1991	207L00000X	NA	Other	026	PHYSICIANS	61119	05	Anesthesiology	0	In state provider	None	4643 QUAIL LAKES DR	STE 204	STOCKTON	CA	95207	5269	39	06077	37.987092	-121.343391	San Joaquin County
30429	Fee-for-Service	1194868497	1194868497	1	1	HAGHBIN, ZHILA MD	11/5/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	61626	36	Psychiatry	0	In state provider	None	1325 COTTONWOOD ST	None	WOODLAND	CA	95695	5131	57	06113	38.664027	-121.7933505	Yolo County
30453	Fee-for-Service	1548976947	1548976947	1	1	HARE KRISHNA HEALTH GROUP IN	3/17/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	341 E MAIN ST	STE 104	SAN JACINTO	CA	92583	4206	33	06065	33.78391437	-116.9562698	Riverside County
30460	Fee-for-Service	1023196920	1023196920	1	1	HANNA, DINAH MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66119	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
30471	Fee-for-Service	1215135058	1215135058	1	1	HOCHLEITNER, JOSEF	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
30501	Fee-for-Service	1922364009	1922364009	1	1	HO-HOANG, DUONG V MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	13202	36	Psychiatry	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
30512	Fee-for-Service	1942310313	1942310313	1	1	HUBERT, JENNIFER N DO	1/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8236	None	None	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
30516	Fee-for-Service	1962806521	1962806521	1	1	HEUER, LESLEE NP	12/10/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	222 WEST HENDERSON AVE	None	PORTERVILLE	CA	93257	1731	54	06107	36.0804034	-119.0217006	Tulare County
30531	Fee-for-Service	1386785038	1386785038	1	1	HUGHES, HOLLY LCSW	9/2/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	740 FRONT ST	STE 370	SANTA CRUZ	CA	95060	4584	44	06087	36.97547419	-122.0254852	Santa Cruz County
30578	Fee-for-Service	1063933117	1063933117	1	2	HANSON & ASSOCIATES PHYSICAL	6/28/2021	225X00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	Y AND WELLNESS	4300 GREEN RIVER ROAD	114	CORONA	CA	92878	2306	33	06065	33.87886214	-117.6493182	Riverside County
30587	Fee-for-Service	1023329885	1023329885	1	1	HALEY, JESSICA E MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	125568	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
30629	Fee-for-Service	1457514978	1457514978	1	1	HARUTUNIANS, MICHAEL DO	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10390	05	Anesthesiology	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1819	36	06071	34.073505	-117.3505995	San Bernardino County
30636	Fee-for-Service	1114458809	1114458809	1	1	HWANG, ANDREW MD	9/1/2020	207R00000X	NA	Other	026	PHYSICIANS	162469	41	Internal Medicine	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
30705	Fee-for-Service	1245427871	1245427871	2	1	HI DIAGNOSTIC IMAGING CENTER	3/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	46577	30	Radiology	0	In state provider	INC	318 W COLORADO ST	ST 2	GLENDALE	CA	91204	1670	19	06037	34.14252447	-118.258893	Los Angeles County
30722	Fee-for-Service	1659312593	1659312593	1	42	HEALTHCARE PARTNERS AFFILIAT	3/10/2022	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	3628 EAST IMPERIAL HWY	202	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
30732	Fee-for-Service	1235583642	1235583642	1	1	HERSH, KYLE MD	10/5/2018	390200000X	NA	Other	026	PHYSICIANS	152592	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
30748	Fee-for-Service	1518920974	1518920974	1	1	HIJAZI, ZEINA MD	7/31/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60285	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
30793	Fee-for-Service	1083812937	1083812937	1	1	HENDERSON, CRESSIDA LMFT	8/31/2018	No Taxonomy Provided	NA	None	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
30796	Fee-for-Service	1497855266	1497855266	1	1	HUYNH, JACK S DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	500 EAST CALAVERAS BLVD	STE 120	MILPITAS	CA	95035	0007	43	06085	37.43274015	-121.8967534	Santa Clara County
30802	Fee-for-Service	1396412920	1396412920	1	1	HERNANDEZ-AGUILAR, AIME PT	10/22/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1721 TECHNOLOGY DR	None	SAN JOSE	CA	95110	1305	43	06085	37.36464282	-121.9163895	Santa Clara County
30810	Fee-for-Service	1871206235	1871206235	1	1	HOLLINGSEAD, DUSTIN NP	5/29/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3933 COFFEE RD	STE A	BAKERSFIELD	CA	93308	5024	15	06029	35.395335	-119.092336	Kern County
30823	Fee-for-Service	1427285816	1427285816	1	1	HEATH, JAYME E MD	7/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116632	None	None	0	In state provider	None	10833 LE CONTE AVE	12411 MDCC	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
30843	Fee-for-Service	1053488999	1053488999	1	1	HIGA, TAMI A MD	10/27/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73616	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
30846	Fee-for-Service	1255568929	1255568929	1	1	HANNA, SYLVESTER F DO	11/7/2016	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
30857	Fee-for-Service	1114624210	1114624210	1	1	HERRMANN, DANIEL W CRNA	4/14/2023	367500000X	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
30860	Fee-for-Service	1063933117	1063933117	1	2	HANSON & ASSOCIATES PHYSICAL	6/28/2021	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	Y AND WELLNESS	4300 GREEN RIVER ROAD	114	CORONA	CA	92878	2306	33	06065	33.87886214	-117.6493182	Riverside County
30864	Fee-for-Service	1790027670	1790027670	1	1	HACKETT, JOSHUA J MD	11/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139483	05	Anesthesiology	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
30900	Fee-for-Service	1649735044	1649735044	1	1	HUNT, CHARLES H AU	4/22/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	42	06083	34.45144647	-119.7604485	Santa Barbara County
30903	Fee-for-Service	1447954797	1447954797	1	1	HONG, ESTHER PHD	4/1/2024	103T00000X	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
30945	Fee-for-Service	MSS00039F	None	1	1	HUMAN SERVICES ASSOCIAT	3/1/2001	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	ASSOCIATION	6800 FLORENCE AVE	None	BELL GARDENS	CA	90201	4957	19	06037	33.96111453	-118.1449438	Los Angeles County
30989	Fee-for-Service	1245658822	1245658822	1	1	HOURANY, DARLENE S LMFT	8/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16800 DEVONSHIRE STE	STE 212	GRANADA HILLS	CA	91344	7400	19	06037	34.25745651	-118.4982159	Los Angeles County
30992	Fee-for-Service	1356637698	1356637698	1	1	HUYNH, DANNY L MD	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142398	None	None	0	In state provider	None	3838 SAN DIMAS STREET	B231	BAKERSFIELD	CA	93301	1494	15	06029	35.3946385	-119.008203	Kern County
30994	Fee-for-Service	1255619656	1255619656	1	1	HICKEY, ANTONIA M PSYD	8/6/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 S BARRINGTON AVE	SUITE 314	LOS ANGELES	CA	90025	5379	19	06037	34.03672191	-118.4500156	Los Angeles County
30996	Fee-for-Service	1225178007	1225178007	1	1	HELMS, SVETLANA DO	3/1/2018	207L00000X	NA	Other	026	PHYSICIANS	9853	05	Anesthesiology	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
31010	Fee-for-Service	1659312593	1659312593	1	42	HEALTHCARE PARTNERS AFFILIAT	3/10/2022	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	3628 EAST IMPERIAL HWY	202	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
31032	Fee-for-Service	1871633479	1871633479	1	1	HOMECARE MEDICAL PRODUCT	6/17/2004	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	KAVOUKJIAN, ARMEN	478 W COLORADO ST	None	GLENDALE	CA	91204	1504	19	06037	34.14248953	-118.2641805	Los Angeles County
31058	Fee-for-Service	1972555142	1972555142	1	1	HEEG, MICHAEL C MD	10/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86405	18	Ophthalmology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
31075	Fee-for-Service	1336202225	1336202225	1	1	HERITAGE VALLEY EYE CARE	5/31/1993	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CENTER	414 CENTRAL AVE	None	FILLMORE	CA	93015	1330	56	06111	34.4012415	-118.9138415	Ventura County
31134	Fee-for-Service	1699137646	1699137646	1	1	HOLMBERG, PAULINE R MD	6/10/2020	207P00000X	NA	Other	026	PHYSICIANS	168222	66	Emergency Medicine (Urgent Care)	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
31144	Fee-for-Service	1104847763	1104847763	1	1	HUBBELL, FLOYD A MD	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	37079	41	Internal Medicine	0	In state provider	None	101 CITY DR S	# 102	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
31145	Fee-for-Service	1518348846	1518348846	1	1	HEINS, MICHELLE L NP	2/25/2020	363LX0001X	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
31150	Fee-for-Service	1063933117	1063933117	1	2	HANSON & ASSOCIATES PHYSICAL	6/28/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	Y AND WELLNESS	4300 GREEN RIVER ROAD	114	CORONA	CA	92878	2306	33	06065	33.87886214	-117.6493182	Riverside County
31204	Fee-for-Service	1477867505	1477867505	1	1	HUANG, GRACE Y MD	11/15/2012	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	106574	25	Physical Medicine and Rehabilitation	0	In state provider	None	450 STANYAN STREET	STE 658	SAN FRANCISCO	CA	94117	1019	38	06075	37.7738933	-122.4544685	San Francisco County
31228	Fee-for-Service	1124000211	1124000211	1	1	HOLMES, NICHOLAS M MD	9/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84322	34	Urology and Urological Surgery	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
31247	Fee-for-Service	1487988457	1487988457	1	1	HANFORD MEDICAL ASSOCIATES	2/26/2010	282N00000X	NA	Hospitals	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	450 N. GREENFIELD AVENUE	None	HANFORD	CA	93230	0000	16	06031	36.328968	-119.6582195	Kings County
31302	Fee-for-Service	1659312593	1659312593	1	42	HEALTHCARE PARTNERS AFFILIAT	11/17/2022	204C00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3628 EAST IMPERIAL HWY	202	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
31312	Fee-for-Service	1043299076	1043299076	1	1	HUYNH, THANH TUYEN T MD	9/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	77376	02	General Surgery	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
31315	Fee-for-Service	1366986069	1366986069	1	1	HENDRICKS, SYDNEY S NP	6/28/2021	363LF0000X	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
31317	Fee-for-Service	1205846797	1205846797	1	1	HAWKINS, RANDALL S MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	35063	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
31328	Fee-for-Service	1386143253	1386143253	1	1	HOOPER, HAILEY PT	10/29/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8901 ACTIVITY	200	SAN DIEGO	CA	92126	4432	37	06073	32.8960193	-117.1345934	San Diego County
31401	Fee-for-Service	1467698928	1467698928	1	1	HERON, IMA LPCC	10/8/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
31410	Fee-for-Service	1306096300	1306096300	1	2	HOFF, STEPHEN MD	12/2/2024	207YP0228X	NA	ENT/Otolaryngology	026	PHYSICIANS	111915	04	Otology, Laryngology, Rhinology	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
31426	Fee-for-Service	1548296106	1548296106	1	1	HUMILTY OF MARY HEALTH	4/30/2006	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	PARTNERS	1044 BELMONT AVE	None	YOUNGSTOWN	OH	44504	1006	00	None	41.11436659	-80.65577948	Mahoning County
31452	Fee-for-Service	1275641714	1275641714	1	1	HADSALL, JEFFREY M MD	3/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	65339	41	Internal Medicine	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4310	42	06083	34.42967671	-119.7228362	Santa Barbara County
31468	Fee-for-Service	1780102434	1780102434	1	1	HENRIQUEZ, RACHELLE H 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
31516	Fee-for-Service	1225202542	1225202542	1	1	HSIN, KEN MD	8/1/2018	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	112653	25	Physical Medicine and Rehabilitation	0	In state provider	None	10565 CIVIC CENTER DR	WEST BLDG., SUITE 165	RANCHO CUCAMONGA	CA	91730	3853	36	06071	34.10278226	-117.5747989	San Bernardino County
31529	Fee-for-Service	1316286735	1316286735	1	1	HAYNES, MELINDA B MFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	572 RIO LINDA AVE	STE 104F	CHICO	CA	95926	7648	04	06007	39.75508407	-121.8487933	Butte County
31562	Fee-for-Service	1962415018	1962415018	1	1	HO, JOYCE MD	3/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	94331	25	Physical Medicine and Rehabilitation	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
31587	Fee-for-Service	1801206107	1801206107	1	1	HOLISTIC HOSPICE AND	5/6/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	105 W ALAMEDA AVE	STE 218	BURBANK	CA	91502	2254	19	06037	34.17127378	-118.303279	Los Angeles County
31609	Fee-for-Service	1205846797	1205846797	1	1	HAWKINS, RANDALL S MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	35063	13	Neurology (M.D. only)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
31613	Fee-for-Service	1184804825	1184804825	1	1	HAPPY HHA INC	1/9/2010	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	650 WEST DURATE RD	SUITE 402	ARCADIA	CA	91007	7658	19	06037	34.12621324	-118.0537434	Los Angeles County
31621	Fee-for-Service	1831553544	1831553544	2	1	HATLEN, SARA MD	12/8/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	152502	None	None	0	In state provider	None	8041 NEWMAN AVE	None	HUNTINGTON BEACH	CA	92647	7034	30	06059	33.70481104	-117.9882948	Orange County
31653	Fee-for-Service	1447262316	1447262316	1	1	HEARD, CARL E MD	11/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	45495	08	Family Practice	0	In state provider	None	23 MAIN STREET	None	WINTERS	CA	95694	1722	57	06113	38.52163272	-121.9695765	Yolo County
31661	Fee-for-Service	1518953181	1518953181	1	1	HOEK, KENNETH J MD	7/28/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	30409	20	Orthopedic Surgery	0	In state provider	None	415 HOSPITAL DR	None	UKIAH	CA	95482	4545	23	06045	39.15408161	-123.2020675	Mendocino County
31663	Fee-for-Service	1952341141	1952341141	1	1	HADDY, STEVEN MD	5/11/1995	207L00000X	NA	Other	026	PHYSICIANS	36992	05	Anesthesiology	0	In state provider	None	16520 HARBOR BLVD	None	FOUNTAIN VALLEY	CA	92708	1360	30	06059	33.7234142	-117.919744	Orange County
31685	Fee-for-Service	1285202374	1285202374	1	1	HOT LINE HOMECARE	2/28/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16200 VENTURA BLVD	STE 407	ENCINO	CA	94136	4696	19	06037	34.15659457	-118.485532	Los Angeles County
31696	Fee-for-Service	1093862047	1093862047	1	1	HALLSTEIN, WILLIAM C MD	7/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	24247	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
31714	Fee-for-Service	1548296106	1548296106	1	1	HUMILTY OF MARY HEALTH	4/30/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	PARTNERS	1044 BELMONT AVE	None	YOUNGSTOWN	OH	44504	1006	00	None	41.11436659	-80.65577948	Mahoning County
31798	Fee-for-Service	1043408420	1043408420	1	1	HYATT, BRANDON M LMFT	9/14/2018	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
31811	Fee-for-Service	1508678723	1508678723	1	1	HEALTHPLUS RX	2/18/2025	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1220 W GLENOAKS BLVD	STE 203	GLENDALE	CA	91201	4120	19	06037	34.16551419	-118.2821828	Los Angeles County
31817	Fee-for-Service	1497746960	1497746960	1	1	HO, FIRMIN C MD	5/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	44894	10	Gastroenterology (M.D. only)	0	In state provider	None	711 W COLLEGE ST	STE 310	LOS ANGELES	CA	90012	1093	19	06037	34.06541412	-118.2414102	Los Angeles County
31836	Fee-for-Service	1619067212	1619067212	1	1	HUNZIKER, JASON 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	50 N MEDICAL DR	None	SALT LAKE CTY	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
31874	Fee-for-Service	1801206107	1801206107	1	1	HOLISTIC HOSPICE AND	5/6/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	105 W ALAMEDA AVE	STE 218	BURBANK	CA	91502	2254	19	06037	34.17127378	-118.303279	Los Angeles County
31910	Fee-for-Service	1740424829	1740424829	1	1	HEARD, JAMES CRNA	11/5/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2805 J STREET	STE 200	SACRAMENTO	CA	95816	4307	34	06067	38.573982	-121.468419	Sacramento County
31939	Fee-for-Service	1124082516	1124082516	1	1	HARRIS, STEPHEN J MD	7/31/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	69137	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
31998	Fee-for-Service	1114214970	1114214970	1	1	HELLMAN, MICHAEL D MD	10/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149739	20	Orthopedic Surgery	0	In state provider	None	18 BON AIR ROAD	None	LARKSPUR	CA	94939	1123	21	06041	37.94413684	-122.5391261	Marin County
32006	Fee-for-Service	1558510743	1558510743	1	1	HOLLAND, JAMES E LCSW	5/21/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4646 WILSON RD	SUITE 101A	BAKERSFIELD	CA	93309	5895	15	06029	35.33233648	-119.0551005	Kern County
32055	Fee-for-Service	1679577142	1679577142	1	1	HUGHES, ROBERT M. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	2	Out of state provider	None	2930 SQUALICUM PKWY	#101	BELLINGHAM	WA	98225	1854	00	None	48.77232859	-122.4750679	Whatcom County
32064	Fee-for-Service	1568562247	1568562247	1	1	HAKKAK, FATIMA H MD	2/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	10650	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	399 EAST HIGHLAND AVENUE	SUITE 307	SAN BERNARDINO	CA	92404	3853	36	06071	34.1358627	-117.2757898	San Bernardino County
32078	Fee-for-Service	1447273248	1447273248	1	1	HART,LISA S MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71352	66	Emergency Medicine (Urgent Care)	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
32086	Fee-for-Service	1649525486	1649525486	1	1	HARRIS, ELIZABETH S LCSW	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	71286	-	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
32101	Fee-for-Service	1871648139	1871648139	1	1	HUANG, KELIN CA	2/8/2015	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3373 MISSION ST	None	SAN FRANCISCO	CA	94110	5027	38	06075	37.74270391	-122.4217542	San Francisco County
32106	Fee-for-Service	1407831829	1407831829	1	1	HAMMOND, TERESE C MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55366	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1033 LOS PLAOS DRIVE	None	SALINAS	CA	93901	7759	27	06053	36.65911769	-121.6448024	Monterey County
32132	Fee-for-Service	1922316751	1922316751	1	1	HANNA, IBRAHIM MD INC	1/26/2012	207R00000X	NA	Other	026	PHYSICIANS	50259	41	Internal Medicine	0	In state provider	None	640 W FOOTHILL BLVD	STE 100	GLENDORA	CA	91741	2403	19	06037	34.1360115	-117.876672	Los Angeles County
32138	Fee-for-Service	1982825543	1982825543	1	1	HILDRETH, KERRY 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	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
32142	Fee-for-Service	1619059664	1619059664	1	1	HOLLINGSWORTH, DENNIS J LMFT	10/11/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95751	-	NOT APPLICABLE	0	In state provider	None	500B JEFFERSON BLVD	STE 195	WEST SACRAMENTO	CA	95605	2349	57	06113	38.58811316	-121.5270471	Yolo County
32179	Fee-for-Service	1457682775	1457682775	1	1	HULLENDER RUBIN, LEE E LAC	6/27/2018	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	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
32186	Fee-for-Service	1184859175	1184859175	1	1	HUANG, CLIFTON S MD	7/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118198	10	Gastroenterology (M.D. only)	0	In state provider	None	9300 VALLEY CHILDRENS	PLACE	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
32195	Fee-for-Service	1548405996	1548405996	1	1	HAFEZI, MARYAM R PSY	4/27/2017	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
32242	Fee-for-Service	1083990246	1083990246	1	1	HENRICH, JACQUELINE M CNM	3/3/2016	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
32321	Fee-for-Service	1609976000	1609976000	1	1	HERRERA, CHARITY A	4/27/2006	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1180 N INDIAN CANYON DR	STE 302	PALM SPRINGS	CA	92262	4858	33	06065	33.839505	-116.5455735	Riverside County
32327	Fee-for-Service	1659394864	1659394864	1	1	HOOSHI, PARIZAD MD	11/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84616	30	Radiology	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
32331	Fee-for-Service	1841202033	1841202033	1	1	HINRICHS, BRAD ALAN	6/28/1995	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	75555	None	None	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
32342	Fee-for-Service	1417930215	1417930215	1	1	HUNTER, CHARLES A MD	6/1/2000	208600000X	NA	General Surgery	026	PHYSICIANS	42322	02	General Surgery	0	In state provider	None	201 S ALVARADO ST	STE 716	LOS ANGELES	CA	90057	2390	19	06037	34.06417777	-118.2719543	Los Angeles County
32344	Fee-for-Service	1770663502	1770663502	1	1	HANKINS, ELMER A III MD	12/10/1976	207N00000X	NA	Dermatology	026	PHYSICIANS	11159	49	Unknown	0	In state provider	None	5220 TELFORD ST	None	LOS ANGELES	CA	90022	1722	19	06037	34.03466612	-118.1526126	Los Angeles County
32366	Fee-for-Service	1447273248	1447273248	1	1	HART,LISA S MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71352	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
32373	Fee-for-Service	1922619881	1922619881	1	1	HANLEY, OLIVIA LCSW	1/23/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	415 KNOLLCREST DR	STE 101	REDDING	CA	96002	0181	45	06089	40.57267376	-122.3643496	Shasta County
32387	Fee-for-Service	1497896799	1497896799	1	1	HEROPOULOS, ANGELO N	3/31/1991	207P00000X	NA	Other	026	PHYSICIANS	48718	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
32394	Fee-for-Service	1275768103	1275768103	1	1	HOUSTON, LEAH C MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136896	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
32397	Fee-for-Service	1407831829	1407831829	1	1	HAMMOND, TERESE C MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55366	41	Internal Medicine	0	In state provider	None	1033 LOS PLAOS DRIVE	None	SALINAS	CA	93901	7759	27	06053	36.65911769	-121.6448024	Monterey County
32400	Fee-for-Service	1720166457	1720166457	1	1	HUBER, P WENDY	3/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	53857	07	Dermatology	0	In state provider	None	5600 STONERIDGE MALL RD	None	PLEASANTON	CA	94588	2820	01	06001	37.6921981	-121.9276072	Alameda County
32408	Fee-for-Service	1275095754	1275095754	1	1	HUME, PAULINA C MD	8/5/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	177782	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
32453	Fee-for-Service	1699751966	1699751966	1	1	HERTNER, GEORGE L MD	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMERGENCY MED SPCLSTS PC	2550 S PARKER RD, #206	None	AURORA	CO	80014	0000	00	None	39.670515	-104.8642785	Arapahoe County
32461	Fee-for-Service	1972578466	1972578466	1	1	HERATH, NIHAL 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 W KINNICKINNIC RIVE	STE 630	MILWAUKEE	WI	53215	5212	00	None	42.99129153	-87.9502185	Milwaukee County
32467	Fee-for-Service	1699061051	1699061051	1	1	HUANG, WILLIAM OD	10/18/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3401 DALE ROAD	STE 100	MODESTO	CA	95356	0594	50	06099	37.688733	-121.0540815	Stanislaus County
32472	Fee-for-Service	1184859175	1184859175	1	1	HUANG, CLIFTON S MD	7/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118198	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS	PLACE	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
32482	Fee-for-Service	1548562937	1548562937	1	1	HARRON, MIMI G NP	10/31/2018	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
32549	Fee-for-Service	1114900693	1114900693	1	1	HUETTNER, GLENN A MD	8/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	47711	30	Radiology	0	In state provider	None	5525 W SLAUSON AVE	None	LOS ANGELES	CA	90056	1047	19	06037	33.98912847	-118.3784926	Los Angeles County
32589	Fee-for-Service	1891215984	1891215984	1	1	HILL, KAITLYN M MD	2/1/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171635	None	None	0	In state provider	None	9888 GENESSEE AVENUE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
32634	Fee-for-Service	1770663502	1770663502	1	1	HANKINS, ELMER A III MD	12/10/1976	207N00000X	NA	Dermatology	026	PHYSICIANS	11159	07	Dermatology	0	In state provider	None	5220 TELFORD ST	None	LOS ANGELES	CA	90022	1722	19	06037	34.03466612	-118.1526126	Los Angeles County
32640	Fee-for-Service	1710914775	1710914775	1	1	HARTLEY, KRISTEN L MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	97625	18	Ophthalmology	0	In state provider	None	1033 THIRD STREET	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
32668	Fee-for-Service	1215986948	1215986948	1	1	HORNER, JOSEPH D DO	7/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	18716	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
32671	Fee-for-Service	1962561076	1962561076	1	1	HENRIQUEZ, WALDO N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	95061	40	Pediatrics	0	In state provider	None	501 N BRIDGE ST	None	VISALIA	CA	93291	5014	54	06107	36.334107	-119.289186	Tulare County
32708	Fee-for-Service	1609824382	1609824382	1	1	HUA,KENNETH C MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85387	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
32727	Fee-for-Service	1699715664	1699715664	1	1	HILL, BRUCE 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	3550 N UNIVERSITY AVE	STE 250	PROVO	UT	84604	6685	00	None	40.28087789	-111.6581666	Utah County
32797	Fee-for-Service	1043418551	1043418551	1	1	HARRIS, JAN	9/5/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
32809	Fee-for-Service	1831135540	1831135540	1	1	HOGAN, JENNIFER L CRNA	8/1/2002	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
32819	Fee-for-Service	1992757363	1992757363	1	1	HORTON, JONATHAN C MD	6/5/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	65872	18	Ophthalmology	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
32846	Fee-for-Service	1194714758	1194714758	1	1	HEPP, MARK 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	455 PINELLAS ST	STE 400	CLEARWATER	FL	33756	3356	00	None	27.95178047	-82.8005715	Pinellas County
32895	Fee-for-Service	1609296318	1609296318	1	2	HEALTHPEAK HOME HEALTH, INC	2/9/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7339 EL CAJON BLVD	STE L	LA MESA	CA	91942	7435	37	06073	32.76875533	-117.0388333	San Diego County
32902	Fee-for-Service	1508431842	1508431842	1	1	HOME GENETICS LTD	8/9/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	13611 E 104TH AVE	UNIT 500	COMMERCE CITY	CO	80022	8434	00	None	39.88539602	-104.8287615	Adams County
32906	Fee-for-Service	1942605282	1942605282	1	1	HAILEMICAEL, SEMHAR NP	1/21/2021	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
32963	Fee-for-Service	1659512325	1659512325	1	4	HARBINDER S BRAR MD INC	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	40011	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	15995 TUSCOLA RD	STE 205	APPLE VALLEY	CA	92307	2159	36	06071	34.54161034	-117.2692275	San Bernardino County
32998	Fee-for-Service	1962420919	1962420919	1	1	HOLLANDER, DANIEL MD	1/1/1982	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	38280	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
33011	Fee-for-Service	1003177056	1003177056	1	1	HOBEL, BRANDON K MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132135	01	General Practice	0	In state provider	None	3288 BELL ROAD	None	AUBURN	CA	95603	9243	31	06061	38.94193048	-121.1046075	Placer County
33014	Fee-for-Service	1922172527	1922172527	1	1	HUTCHINSON, KENDRA MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64354	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
33019	Fee-for-Service	1871090993	1871090993	1	1	HAGGERTY, LAUREN E MD	2/22/2022	208M00000X	NA	Other	026	PHYSICIANS	164175	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
33031	Fee-for-Service	1154855484	1154855484	1	1	HONSVALL HOEFLER, AMANDA M M	12/18/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170105	None	None	0	In state provider	D	1225 15TH ST	2100	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
33040	Fee-for-Service	1104976141	1104976141	1	1	HWANG, WEI C MD	4/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111144	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
33057	Fee-for-Service	1992422703	1992422703	1	1	HERRERA, MARIA J NP	4/14/2023	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
33066	Fee-for-Service	1396783833	1396783833	1	1	HUCZKO, ERIC L MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	85678	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
33072	Fee-for-Service	1538195078	1538195078	1	1	HARB, ALMA A MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	78028	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
33086	Fee-for-Service	1699868224	1699868224	1	1	HAN, KYUNG M	4/30/1990	207R00000X	NA	Other	026	PHYSICIANS	45923	41	Internal Medicine	0	In state provider	None	2681 W OLYMPIC BLVD	STE 221	LOS ANGELES	CA	90006	2883	19	06037	34.05247511	-118.290851	Los Angeles County
33089	Fee-for-Service	1720413339	1720413339	1	1	HIDDEN HILLS HOSPICE &	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE LLC	1016 E BROADWAY	STE 101	GLENDALE	CA	91205	4533	19	06037	34.14623151	-118.242261	Los Angeles County
33095	Fee-for-Service	1841583010	1841583010	1	1	HUESTIS, SAMANTHA E PHD	9/9/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
33099	Fee-for-Service	1245515923	1245515923	1	1	HENON, KIM T DO	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11983	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
33114	Fee-for-Service	1902856602	1902856602	1	1	HONDA, NATHAN S MD	5/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	41628	22	Pathology (M.D. only)	0	In state provider	None	7032 COMSTOCK AVE	SUITE 206	WHITTIER	CA	90602	1390	19	06037	33.97776493	-118.0385448	Los Angeles County
33118	Fee-for-Service	1447360714	1447360714	1	1	HANTEN, KAREN L MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	45862	40	Pediatrics	0	In state provider	ALPINE PEDIATRICS MED	2733 ALPINE BLVD	None	ALPINE	CA	91901	2226	37	06073	32.83452956	-116.754991	San Diego County
33177	Fee-for-Service	1265841118	1265841118	1	1	HERNANDEZ, TERESA E LCSW	9/23/2022	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
33213	Fee-for-Service	1699853176	1699853176	1	1	HOANG, TON T MD	10/31/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78643	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
33283	Fee-for-Service	1487832762	1487832762	1	1	HASHEMI, VAHIDEH MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106218	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
33305	Fee-for-Service	1235546185	1235546185	1	1	HAPPY PHARMACY INC	3/21/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9143 VALLEY BLVD	STE 101 B	ROSEMEAD	CA	91770	1993	19	06037	34.08096534	-118.0700742	Los Angeles County
33337	Fee-for-Service	1396061651	1396061651	1	1	HILL, BRYAN J MD	8/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118687	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON STREET	STE 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
33343	Fee-for-Service	1740613272	1740613272	1	2	HEINLEIN, MICHAEL LCSW	1/31/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	386 W. LINE ST	None	BISHOP	CA	93514	1100	14	06027	37.36135856	-118.3979892	Inyo County
33351	Fee-for-Service	1316544364	1316544364	1	1	HONMA, CHELSEY K OD	8/24/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3300 E SOUTH ST	STE 105	LAKEWOOD	CA	90805	4579	19	06037	33.86018093	-118.1537163	Los Angeles County
33376	Fee-for-Service	1720413339	1720413339	1	1	HIDDEN HILLS HOSPICE &	10/31/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE LLC	1016 E BROADWAY	STE 101	GLENDALE	CA	91205	4533	19	06037	34.14623151	-118.242261	Los Angeles County
33414	Fee-for-Service	1053497685	1053497685	1	1	HENEHAN, MICHAEL J.	6/30/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	25 N 14TH ST	STE 1020	SAN JOSE	CA	95112	6209	43	06085	37.34293357	-121.8775187	Santa Clara County
33439	Fee-for-Service	1962766451	1962766451	1	1	HO, JOSEPH MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137389	18	Ophthalmology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
33505	Fee-for-Service	1912916446	1912916446	1	1	HUI, LISA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	888 S KING ST	None	HONOLULU	HI	96813	3009	00	None	21.30218603	-157.8505732	Honolulu County
33520	Fee-for-Service	1306395181	1306395181	1	1	HENRY, SARAH M PHD	5/2/2022	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	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
33533	Fee-for-Service	1558422717	1558422717	1	1	HORAN, KATHLEEN L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35154	08	Family Practice	0	In state provider	None	3208 MONTGOMERY DR	None	SANTA ROSA	CA	95405	5139	49	06097	38.448792	-122.6799405	Sonoma County
33549	Fee-for-Service	1912032160	1912032160	1	1	HOLLY, LEANNA M 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
33561	Fee-for-Service	1003822594	1003822594	1	1	HOWARD K. SONG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1827 SW PALTINE RD	None	PORTLAND	OR	97219	0000	00	None	45.44451692	-122.6966647	Multnomah County
33562	Fee-for-Service	1669612180	1669612180	1	1	HOLMES, KRISTIN A CRNA	5/31/2011	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
33563	Fee-for-Service	1891835435	1891835435	1	1	HORVET, BRUCE E DC	4/24/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	14427 CHASE ST	202	PANORAMA CITY	CA	91402	3020	19	06037	34.22477664	-118.4478733	Los Angeles County
33601	Fee-for-Service	1457581415	1457581415	1	1	HARRIS, CARYN ADAIR PT	4/16/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7737 MEANY AVE	B5-7	BAKERSFIELD	CA	93308	5266	15	06029	35.39423549	-119.0882835	Kern County
33611	Fee-for-Service	1306022959	1306022959	1	1	HSIAO, JAMES MD	7/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104525	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
33614	Fee-for-Service	1710406848	1710406848	1	1	HALL, KIRK A CNP	3/25/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5640 AZTEC DR	None	LA MESA	CA	91942	1948	37	06073	32.7819769	-117.0276318	San Diego County
33616	Fee-for-Service	1811645914	1811645914	1	1	HAPPY RIDES INC.	6/21/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	175 E CHURCH ST	None	UKIAH	CA	95482	0000	23	06045	39.14943734	-123.2067981	Mendocino County
33619	Fee-for-Service	1124220652	1124220652	1	1	HUBBARD, NATALIE J MD	5/22/2023	208600000X	NA	General Surgery	026	PHYSICIANS	136829	None	None	0	In state provider	None	370 VILLA	None	PORTERVILLE	CA	93257	3320	54	06107	36.0726781	-119.0306167	Tulare County
33638	Fee-for-Service	1801843149	1801843149	1	1	HINKLE, MARCIA J MD	11/27/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	45119	30	Radiology	0	In state provider	None	768 MOUNTAIN RANCH RD	None	SAN ANDREAS	CA	95249	9707	05	06009	38.19058212	-120.6709481	Calaveras County
33651	Fee-for-Service	1669604260	1669604260	1	1	HEIFETS, BORIS D MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113253	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
33656	Fee-for-Service	1083673685	1083673685	1	1	HARRELL, WILLIAM C MD	4/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	64492	41	Internal Medicine	0	In state provider	None	2001 SANTA MONICA BLVD	STE 1060W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
33673	Fee-for-Service	1538117502	1538117502	1	1	HALE, THOMAS MD	2/28/1982	207PE0004X	NA	Other	026	PHYSICIANS	40078	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3100 S SUSANA RD	None	COMPTON	CA	90221	5418	19	06037	33.87386619	-118.2070981	Los Angeles County
33685	Fee-for-Service	1669448726	1669448726	1	1	HARMON, MICHAEL G OD	11/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
33692	Fee-for-Service	1952421521	1952421521	1	1	HOWARD, SCOTT E PHD	3/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1341 W ROBINHOOD DR	STE B2	STOCKTON	CA	95207	5517	39	06077	37.99838007	-121.3243901	San Joaquin County
33698	Fee-for-Service	1609027770	1609027770	1	1	HO, CALI OT	10/11/2022	225X00000X	NA	Other	019	OCCUPATIONAL 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
33712	Fee-for-Service	1225665938	1225665938	1	1	HAN, STACY S MD	7/24/2024	207QG0300X	NA	Adult Primary Care	026	PHYSICIANS	185378	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
33717	Fee-for-Service	1376562017	1376562017	1	1	HENRY GILLIAN	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
33727	Fee-for-Service	1649555723	1649555723	1	1	HAYTIN, ARI K NP	10/16/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	712075	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	WARD 93/95	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
33739	Fee-for-Service	1669067252	1669067252	1	1	HUANG, ERIKA NP	9/3/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
33822	Fee-for-Service	1184630683	1184630683	2	1	HUETE, RICARDO E MD	10/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	42753	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	824 E CARSON ST	STE 203	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
33824	Fee-for-Service	1386013464	1386013464	1	1	HARRINGTON, EMILY PSYD	6/24/2024	390200000X	NA	Other	031	PSYCHOLOGISTS	-	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
33838	Fee-for-Service	1942500475	1942500475	1	1	HINGORANY, SHIPRA P MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121556	06	Cardiovascular Disease (M.D. only)	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
33847	Fee-for-Service	1154654770	1154654770	1	1	HUNG, SAMMY T MD INC	1/31/1979	207RP1001X	NA	Pulmonology	026	PHYSICIANS	34867	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	27001 CALAROGA AVENUE	SUITE 2	HAYWARD	CA	94545	4345	01	06001	37.63388965	-122.0898396	Alameda County
33857	Fee-for-Service	1619003993	1619003993	1	1	HIBBARD, CYNTHIA LMFT	8/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2200 PACIFIC COAST HWY	STE 302	HERMOSA BEACH	CA	90254	2700	19	06037	33.87079831	-118.3947051	Los Angeles County
33951	Fee-for-Service	1437245701	1437245701	2	1	HIGER, DEBORAH ANN MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72167	08	Family Practice	0	In state provider	None	725 PINE STREET	None	MOUNT SHASTA	CA	96067	2133	47	06093	41.31593884	-122.3193143	Siskiyou County
33962	Fee-for-Service	1649707688	1649707688	1	1	HUANG, WEIYING LAC	10/23/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	540 RALSTON AVE	STE G	BELMONT	CA	94002	2866	41	06081	37.52244767	-122.273743	San Mateo County
33984	Fee-for-Service	1659598944	1659598944	1	1	HU, 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	24800 SE STARK ST	None	GRESHAM	OR	97030	3378	00	None	45.516762	-122.4070245	Multnomah County
33988	Fee-for-Service	1528175346	1528175346	1	1	HASS, LEIF R MD	6/1/1995	207R00000X	NA	Other	026	PHYSICIANS	80367	05	Anesthesiology	0	In state provider	None	1000 NUT TREE RD	None	VACAVILLE	CA	95687	4100	48	06095	38.35581953	-121.9530257	Solano County
33992	Fee-for-Service	1427179456	1427179456	1	1	HUNG, MICHAEL K MD	7/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94908	05	Anesthesiology	0	In state provider	None	222 W 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
34030	Fee-for-Service	1013941483	1013941483	1	1	HOLDEN, STUART MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	36194	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
34056	Fee-for-Service	1982775748	1982775748	1	1	HOM, XENIA B MD	9/18/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86642	None	None	0	In state provider	None	3020 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
34074	Fee-for-Service	1295809176	1295809176	1	1	HANGER PROSTHETICS & ORTHOTI	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	325 E HILLCREST DR	SUITE 145	THOUSAND OAKS	CA	91360	5828	56	06111	34.1812975	-118.8718187	Ventura County
34098	Fee-for-Service	1114216728	1114216728	1	1	HIRUMA, JESSICA R MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125081	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
34120	Fee-for-Service	1982086310	1982086310	1	1	HEALTHY FAMILY HOME HEALTH	6/18/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE, INC	14532 FRIAR ST	STE G	VAN NUYS	CA	91411	2358	19	06037	34.18564854	-118.4499135	Los Angeles County
34135	Fee-for-Service	1154654770	1154654770	1	1	HUNG, SAMMY T MD INC	1/31/1979	207RP1001X	NA	Pulmonology	026	PHYSICIANS	34867	41	Internal Medicine	0	In state provider	None	27001 CALAROGA AVENUE	SUITE 2	HAYWARD	CA	94545	4345	01	06001	37.63388965	-122.0898396	Alameda County
34141	Fee-for-Service	1376590471	1376590471	1	1	HOURIANI,FARHAD MD	5/1/2001	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60973	30	Radiology	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
34145	Fee-for-Service	1861759383	1861759383	1	1	HOSSEINI, AVA A MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118231	02	General Surgery	0	In state provider	None	505 PARNASSUS	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
34154	Fee-for-Service	1922101989	1922101989	1	1	HOME AVENUE ADULT DAY	5/21/2003	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE CENTER	8114 TELEGRAPH RD	None	DOWNEY	CA	90240	2140	19	06037	33.96781621	-118.1165347	Los Angeles County
34173	Fee-for-Service	1790813186	1790813186	1	1	HOLGUIN, MICHELLE LMFT	6/12/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5588 N PALM AVE	None	FRESNO	CA	93704	1913	10	06019	36.818874	-119.8082415	Fresno County
34201	Fee-for-Service	1134173818	1134173818	1	1	HASYAGAR, CHHAYA P MD	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93237	10	Gastroenterology (M.D. only)	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
34220	Fee-for-Service	1548285729	1548285729	1	1	HEFFELFINGER, STEVEN J PT	6/27/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1425 E PROSPERITY AVE	None	TULARE	CA	93274	8051	54	06107	36.22582254	-119.3255267	Tulare County
34232	Fee-for-Service	1053794016	1053794016	1	1	HOUMAN, JUSTIN MD	4/15/2019	390200000X	NA	Other	026	PHYSICIANS	143235	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
34252	Fee-for-Service	1265510358	1265510358	1	1	HO, DELPHINE K MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34321	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
34255	Fee-for-Service	1528056066	1528056066	1	1	HAMILTON MEDICAL CENTER	10/8/2006	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	1200 MEMORIAL DR	None	DALTON	GA	30720	2529	00	None	34.78888415	-84.9847189	Whitfield County
34276	Fee-for-Service	1861446064	1861446064	1	1	HOLST VALERIE 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
34279	Fee-for-Service	1528175346	1528175346	1	1	HASS, LEIF R MD	6/1/1995	207R00000X	NA	Other	026	PHYSICIANS	80367	41	Internal Medicine	0	In state provider	None	1000 NUT TREE RD	None	VACAVILLE	CA	95687	4100	48	06095	38.35581953	-121.9530257	Solano County
34289	Fee-for-Service	1679669691	1679669691	2	1	HANNAFIN, BLAINE M MD	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134676	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
34315	Fee-for-Service	1992723936	1992723936	1	1	HAHN, BEVRA H MD	5/11/1995	207RR0500X	NA	Other	026	PHYSICIANS	41163	83	Rheumatology	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
34325	Fee-for-Service	1285960005	1285960005	1	1	HAN, MAY HTWE MD	12/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108510	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
34378	Fee-for-Service	1316982614	1316982614	1	1	HOMER, RONALD J MD	12/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69300	30	Radiology	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
34412	Fee-for-Service	1568641470	1568641470	1	1	HIS IDEAS, INC	6/29/2012	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	LING SERVICES	590 ANTELOPE BLVD	STE B30	RED BLUFF	CA	96080	2476	52	06103	40.18602075	-122.2057399	Tehama County
34427	Fee-for-Service	1588350904	1588350904	1	1	HARMONY HEALTH MEDICAL	8/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	114 D STREET	None	WHEATLAND	CA	95692	9743	58	06115	39.01036374	-121.426453	Yuba County
34480	Fee-for-Service	1386893006	1386893006	1	1	HANNA, WAAD MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115243	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
34482	Fee-for-Service	1548377062	1548377062	1	1	HIETT, CINDY L LMFT	4/1/2024	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
34502	Fee-for-Service	1730146093	1730146093	1	1	HUBERMAN, ROBERT P MD	5/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	36077	30	Radiology	0	In state provider	None	2625 W ALAMEDA AVE	STE 110	BURBANK	CA	91505	4815	19	06037	34.1577056	-118.329779	Los Angeles County
34533	Fee-for-Service	1083049159	1083049159	1	1	HEVEZI, SARAH E LCSW	4/11/2022	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
34545	Fee-for-Service	1528056066	1528056066	1	1	HAMILTON MEDICAL CENTER	10/8/2006	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	INC	1200 MEMORIAL DR	None	DALTON	GA	30720	2529	00	None	34.78888415	-84.9847189	Whitfield County
34553	Fee-for-Service	1730710831	1730710831	1	1	HAN, YEONGMIN PT	5/25/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8545 SIERRA AVE	None	FONTANA	CA	92335	3868	36	06071	34.09849683	-117.4356608	San Bernardino County
34589	Fee-for-Service	1982022281	1982022281	1	1	HASHMI, SOHAIB MD	2/17/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	162711	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
34608	Fee-for-Service	1477819829	1477819829	1	1	HERNANDEZ, SALVADOR C	5/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121367	01	General Practice	0	In state provider	None	275 N EL CIELO	None	PALM SPRINGS	CA	92262	1423	33	06065	33.82736911	-116.5109632	Riverside County
34609	Fee-for-Service	1013132596	1013132596	1	1	HOUSTON, CARON A MD	9/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52967	41	Internal Medicine	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
34638	Fee-for-Service	1871577056	1871577056	1	2	HUYNH, PAUL D MD	4/18/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	79141	18	Ophthalmology	0	In state provider	None	10737 CAMINO RUIZ	STE 100	SAN DIEGO	CA	92126	2370	37	06073	32.91416051	-117.1437943	San Diego County
34674	Fee-for-Service	1245243567	1245243567	1	1	HANSON, CHARLES H MD	12/11/2002	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	36822	40	Pediatrics	0	In state provider	None	1855 SAN MIGUEL DR	STE 15	WALNUT CREEK	CA	94596	5290	07	06013	37.89490348	-122.0529351	Contra Costa County
34679	Fee-for-Service	1518618990	1518618990	1	1	HUMMINGBIRD HOME HEALTH	5/28/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	855 N LARK ELLEN AVE	STE O	WEST COVINA	CA	91791	1099	19	06037	34.087707	-117.9166385	Los Angeles County
34695	Fee-for-Service	1730189614	1730189614	1	1	HU, HENRY H MD	2/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	55304	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
34713	Fee-for-Service	1588350904	1588350904	1	1	HARMONY HEALTH MEDICAL	8/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	114 D STREET	None	WHEATLAND	CA	95692	9743	58	06115	39.01036374	-121.426453	Yuba County
34723	Fee-for-Service	1801152657	1801152657	1	1	HARPER, DEVIN A MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137291	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
34735	Fee-for-Service	1942048574	1942048574	1	1	HURLEY, TREVOR LMFT	1/28/2025	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
34770	Fee-for-Service	1861436594	1861436594	1	1	HAMZEH, ALI R MD	4/1/2010	174400000X	NA	Other	026	PHYSICIANS	61671	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	BIENESTAR MED CNTR INC	1125 E 17TH ST	STE N152	SANTA ANA	CA	92701	2205	30	06059	33.76004145	-117.854838	Orange County
34814	Fee-for-Service	1619218559	1619218559	1	1	HAN, YUNG MD	3/22/2018	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	124276	20	Orthopedic Surgery	0	In state provider	None	505 S VIRGIL AVE	205	LOS ANGELES	CA	90020	1443	19	06037	34.064883	-118.287086	Los Angeles County
34877	Fee-for-Service	1144093428	1144093428	1	1	HAERI, SEYED EHSAN PT	12/4/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	137 E THOUSAND OAKS BLVD	None	THOUSAND OAKS	CA	91360	1985	56	06111	34.17919939	-118.8745721	Ventura County
34898	Fee-for-Service	1922162502	1922162502	1	1	HARTFORD, JAMES MATTHEW	4/15/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81676	20	Orthopedic Surgery	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
34919	Fee-for-Service	1659312593	1659312593	1	14	HEALTHCARE PARTNERS AFFILIAT	2/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GREATER VALLEY MED GROUP	11600 INDIAN HILLS RD	None	MISSION HILLS	CA	91345	1225	19	06037	34.2811228	-118.4588429	Los Angeles County
34944	Fee-for-Service	1184642605	1184642605	1	1	HISATAKE, GARRETT M MD	5/24/2001	204F00000X	NA	General Surgery	026	PHYSICIANS	86074	47	Miscellaneous	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
34950	Fee-for-Service	1417049479	1417049479	2	1	HUBBARD, GAIL L	12/17/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1132 SAN MARINO DR	SUITE 104	SAN MARCOS	CA	92078	4641	37	06073	33.12486539	-117.2107986	San Diego County
34984	Fee-for-Service	1235233461	1235233461	1	1	HUANG, JONG T MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	25939	01	General Practice	0	In state provider	None	1245 WILSHIRE BLVD	STE 501	LOS ANGELES	CA	90017	4805	19	06037	34.05362775	-118.2661889	Los Angeles County
34988	Fee-for-Service	1457425282	1457425282	2	1	HAMAMJI, SAMI B MD FACS	5/8/2021	208600000X	NA	General Surgery	026	PHYSICIANS	49367	None	None	0	In state provider	None	1010 W LA VETA AVE STE	775	ORANGE	CA	92868	4306	30	06059	33.78028244	-117.8635552	Orange County
35030	Fee-for-Service	1326158478	1326158478	1	1	HOM, MILTON M OD	11/1/1982	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1131 E ALOSTA AVE	None	AZUSA	CA	91702	2740	19	06037	34.1288583	-117.8832599	Los Angeles County
35036	Fee-for-Service	1487701538	1487701538	1	1	HOPKINS, JOSEPH R MD	12/29/1989	207R00000X	NA	Other	026	PHYSICIANS	31624	08	Family Practice	0	In state provider	None	704 WEBSTER ST	None	PALO ALTO	CA	94301	2628	43	06085	37.44781183	-122.1553126	Santa Clara County
35043	Fee-for-Service	1275560955	1275560955	1	1	HAMMER, LINDA R OD	8/10/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9375 SAN FERNANDO RD	None	SUN VALLEY	CA	91352	1418	19	06037	34.2395322	-118.3939944	Los Angeles County
35084	Fee-for-Service	1548334147	1548334147	1	1	HAMILTON, JOHN D MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	56659	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
35101	Fee-for-Service	1972506988	1972506988	1	1	HAN, PAUL Y DPM	11/5/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2621 S BRISTOL ST	STE 209	SANTA ANA	CA	92704	5719	30	06059	33.711876	-117.885371	Orange County
35151	Fee-for-Service	1619505252	1619505252	1	1	HENDRICKS, LINDSEY R MD	7/5/2023	207R00000X	NA	Other	026	PHYSICIANS	181365	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
35156	Fee-for-Service	1891149761	1891149761	1	2	HOME SWEET CARE HOMES INC	2/16/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4248 WILSON LANE	None	CONCORD	CA	94521	1262	07	06013	37.96870125	-121.9871421	Contra Costa County
35173	Fee-for-Service	1750449625	1750449625	1	1	HAWTHORNE, KAREN MFT	1/8/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30240 HWY 78	None	SANTA YSABEL	CA	90270	0035	37	06073	33.10894332	-116.6750407	San Diego County
35177	Fee-for-Service	1619221777	1619221777	1	1	HOLMAN, MICHAEL J MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127646	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 MEDICAL CENTER COURT	None	CHULA VISTA	CA	91911	6617	37	06073	32.61822301	-117.0234938	San Diego County
35184	Fee-for-Service	1366400574	1366400574	1	1	HSU, PHILLIP T MD	10/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112896	07	Dermatology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
35191	Fee-for-Service	1639149875	1639149875	1	1	HERRERA, EILENE R CRNA	12/15/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	115 MALL DR	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
35206	Fee-for-Service	1346317229	1346317229	1	1	HOKOKI, AMENA A MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68816	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
35210	Fee-for-Service	1053458950	1053458950	1	1	HISCOX, DWIGHT E MD	6/28/1995	207L00000X	NA	Other	026	PHYSICIANS	34805	05	Anesthesiology	0	In state provider	None	400 E MAIN ST	STE 200	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
35234	Fee-for-Service	1891980363	1891980363	1	1	HECKEL-MUNC, MOLLIE M PSYD	7/8/2021	103TC0700X	NA	Mental Health Outpatient Services	026	PHYSICIANS	None	None	None	0	In state provider	None	510 DOYLE PARK DR	None	SANTA ROSA	CA	95405	4570	49	06097	38.442618	-122.6984265	Sonoma County
35243	Fee-for-Service	1851834840	1851834840	1	1	HEALTHCARE PHYSICAL THERAPY,	3/20/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	18856 AMAR RD	SUITE 8	WALNUT	CA	91789	7102	19	06037	34.02908247	-117.8901301	Los Angeles County
35251	Fee-for-Service	1144666322	1144666322	1	1	HO, TRAN B	10/20/2020	208600000X	NA	General Surgery	026	PHYSICIANS	18219	02	General Surgery	0	In state provider	None	7887 N CEDAR AVE	None	FRESNO	CA	93720	2685	10	06019	36.850473	-119.756917	Fresno County
35269	Fee-for-Service	1780732685	1780732685	1	1	HAN, KYOUNG E MD	4/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51696	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
35272	Fee-for-Service	1811351463	1811351463	1	1	HSU, KEVIN P MD	8/1/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	156251	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
35273	Fee-for-Service	1235233461	1235233461	1	1	HUANG, JONG T MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	25939	41	Internal Medicine	0	In state provider	None	1245 WILSHIRE BLVD	STE 501	LOS ANGELES	CA	90017	4805	19	06037	34.05362775	-118.2661889	Los Angeles County
35275	Fee-for-Service	1639154438	1639154438	1	1	HART, LYNETTE C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	28419	01	General Practice	0	In state provider	SPLIT RADIOLOGY	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
35282	Fee-for-Service	1275894214	1275894214	1	1	HASAN, SAQIB MD	8/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149350	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
35292	Fee-for-Service	1497014419	1497014419	1	1	HU, YESHI MD	1/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122856	40	Pediatrics	0	In state provider	None	2574 SAN BRUNO AVENUE	None	SAN FRANCISCO	CA	94134	1505	38	06075	37.72907852	-122.4042585	San Francisco County
35344	Fee-for-Service	1134756703	1134756703	1	1	HERNANDEZ, CHRISTINA MD	7/1/2023	390200000X	NA	Other	026	PHYSICIANS	183459	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
35355	Fee-for-Service	1407064728	1407064728	1	1	HERMAN, HEATHER G	5/6/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200 W ARBOR DR	STE 8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
35364	Fee-for-Service	1225049406	1225049406	1	1	HAAS, RICHARD B DPM	5/31/1992	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	28999 FRONT ST	STE 205	TEMECULA	CA	92590	5806	33	06065	33.48405305	-117.1437088	Riverside County
35386	Fee-for-Service	1912383472	1912383472	1	1	HONGS ACUPUNCTURE & HEALING	3/29/2018	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	CENTER INC	15731 S WESTERN AVE	None	GARDENA	CA	90247	6179	19	06037	33.887511	-118.309189	Los Angeles County
35406	Fee-for-Service	1487435913	1487435913	1	1	HESS, STEVEN RCP	12/29/2023	225B00000X	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
35422	Fee-for-Service	1336469659	1336469659	1	1	HARRAHER, CIARA D MD	8/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112650	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
35431	Fee-for-Service	1942654371	1942654371	1	1	HASTINGS, CHELSEA A DO	6/8/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	20173	None	None	0	In state provider	None	2480 SONOMA STREET	None	REDDING	CA	96001	3027	45	06089	40.57326337	-122.403701	Shasta County
35454	Fee-for-Service	1376743914	1376743914	1	1	HOHLASTOS,MICHAEL S DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	120 N OAK STREET	None	HINSDALE	IL	60521	3829	00	None	41.80563019	-87.92010764	DuPage County
35471	Fee-for-Service	1386106565	1386106565	1	1	HSIAO, JOYCE DO	4/26/2023	207L00000X	NA	Other	026	PHYSICIANS	20636	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
35473	Fee-for-Service	1639256563	1639256563	1	1	HAMMONS, DAVID D	3/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	35991	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
35483	Fee-for-Service	1912309618	1912309618	1	1	HUYNH, TUAN N MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140907	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
35485	Fee-for-Service	1447034095	1447034095	1	1	HUNTER, APRYL CCC-SLP	11/27/2023	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
35488	Fee-for-Service	1043273766	1043273766	1	1	HURWITZ, MELISSA MD	7/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66123	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
35501	Fee-for-Service	1083104319	1083104319	1	1	HENDRICKS, CHELSEA A DPM	7/19/2022	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2131 SAN JOAQUIN HILLS	None	NEWPORT BEACH	CA	92660	6507	30	06059	33.61632004	-117.8687553	Orange County
35529	Fee-for-Service	1467886549	1467886549	1	1	HEALTHY LIVING MEDICAL, INC	1/18/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	None	None	0	In state provider	None	301 S FAIR OAKS AVE	SUITE 404	PASADENA	CA	91105	2561	19	06037	34.140348	-118.1504565	Los Angeles County
35548	Fee-for-Service	1043313018	1043313018	1	1	HOUSTON, JENNIFER A MD	12/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	72044	01	General Practice	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
35555	Fee-for-Service	1780732685	1780732685	1	1	HAN, KYOUNG E MD	4/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51696	38	Geriatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
35565	Fee-for-Service	1639154438	1639154438	1	1	HART, LYNETTE C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	28419	30	Radiology	0	In state provider	SPLIT RADIOLOGY	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
35566	Fee-for-Service	1881162196	1881162196	1	1	HUDNALL, HANNAH CCC-SLP	3/9/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
35570	Fee-for-Service	1982848636	1982848636	1	1	HAMILTON, ALLIE M CRNA	11/19/2013	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	5330 S HWY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
35576	Fee-for-Service	1265606776	1265606776	1	1	HOEHLER, AMANDA E MD	4/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131693	40	Pediatrics	0	In state provider	None	2333 BUCHANAN STREET	EMERGENCY DEPARTMENT	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
35615	Fee-for-Service	1336382316	1336382316	1	1	HWANG, MICHAEL S MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121559	36	Psychiatry	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
35630	Fee-for-Service	1396233003	1396233003	1	1	HERNANDEZ, JUANA	10/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
35693	Fee-for-Service	1558804807	1558804807	1	1	HACOPIANS, SAREEN	11/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	419 W FOOTHILL BLVD	None	MONROVIA	CA	91016	2025	19	06037	34.15128951	-118.008477	Los Angeles County
35699	Fee-for-Service	1487665212	1487665212	1	1	HANGER PROSTHETICS & ORTHOTI	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	6840 INDIANA AVE	SUITE 120	RIVERSIDE	CA	92506	0100	33	06065	33.94246965	-117.3926366	Riverside County
35740	Fee-for-Service	1699986810	1699986810	1	1	HUSSAIN, ALIASGHER MD	8/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100040	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
35742	Fee-for-Service	1346559879	1346559879	1	1	HOAG URGENT CARE TUSTIN INC	9/13/2012	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2560 BRYAN AVE	STE A	TUSTIN	CA	92782	8922	30	06059	33.72956017	-117.7962762	Orange County
35748	Fee-for-Service	1972958627	1972958627	1	1	HULL, CHARLOTTE DO	7/29/2019	207P00000X	NA	Other	026	PHYSICIANS	17162	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
35805	Fee-for-Service	1053795914	1053795914	1	1	HEROLD, JESSICA DO	6/1/2023	207P00000X	NA	Other	026	PHYSICIANS	14912	None	None	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
35826	Fee-for-Service	1144582081	1144582081	1	1	HUNT, KIMBERLY MD	8/15/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	1423 MAGNOLIA	None	CHICO	CA	95926	3226	04	06007	39.74063551	-121.8499048	Butte County
35828	Fee-for-Service	1316956691	1316956691	1	1	HUSSAIN, HIBA M MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	33329	05	Anesthesiology	0	In state provider	LAPALMA HOSPITAL	7901 WALKER ST	None	LA PALMA	CA	90623	1722	30	06059	33.84755382	-118.0373024	Orange County
35838	Fee-for-Service	1215947346	1215947346	2	1	HOMEDICAL INC	8/1/2011	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	3506 W LAKE CENTER DR	STE B	SANTA ANA	CA	92704	6985	30	06059	33.69919974	-117.9166739	Orange County
35840	Fee-for-Service	1194229898	1194229898	1	1	HERNANDEZ LOPEZ, ADRIAN L MD	7/6/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163755	09	Gynecology (D.O. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
35867	Fee-for-Service	1033293634	1033293634	1	1	HAHN, JAMES C MD	8/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	36933	None	None	0	In state provider	None	3323 W OLYMPIC BLVD	STE 101	LOS ANGELES	CA	90019	2351	19	06037	34.0526805	-118.30986	Los Angeles County
35876	Fee-for-Service	1336216266	1336216266	1	1	HWANG, CIFF J MD	5/26/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	43665	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
35880	Fee-for-Service	1194014860	1194014860	1	2	HAYERI, REZA MD	10/28/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	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
35884	Fee-for-Service	1891139010	1891139010	1	1	HO, BARAN MD	5/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132580	07	Dermatology	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
35941	Fee-for-Service	1700912318	1700912318	1	1	HSU, RONALD K MD	3/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	44067	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
35982	Fee-for-Service	1225455488	1225455488	1	1	HAN, BOB	9/25/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	15826	36	Psychiatry	0	In state provider	None	200 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	43	06085	37.26846327	-121.9547306	Santa Clara County
36019	Fee-for-Service	1104143593	1104143593	1	1	HOANG, MAI P MD	8/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130031	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
36029	Fee-for-Service	1407274913	1407274913	1	1	HADI, TAMER M MD	6/19/2018	390200000X	NA	Other	026	PHYSICIANS	156074	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
36034	Fee-for-Service	1912221060	1912221060	1	1	HEIDT, RACHEL MD	9/10/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157289	40	Pediatrics	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
36047	Fee-for-Service	1366854226	1366854226	1	1	HOLMGREN, BRYCE C MD	5/3/2021	207L00000X	NA	Other	026	PHYSICIANS	153895	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
36057	Fee-for-Service	1184652935	1184652935	1	1	HUYNH, KLEMENS N MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69249	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
36070	Fee-for-Service	1669634101	1669634101	1	1	HARGETT, DAMAYEA I MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111876	20	Orthopedic Surgery	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	7303	56	06111	34.27623479	-119.2520218	Ventura County
36095	Fee-for-Service	1407841935	1407841935	1	1	HUANG, LINDA MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	53911	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
36111	Fee-for-Service	1578067971	1578067971	1	1	HIGA, REYN F MD	3/1/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165640	None	None	0	In state provider	None	18460 ROSCOE BLVD	FL 2	NORTHRIDGE	CA	91325	4107	19	06037	34.22071454	-118.5357375	Los Angeles County
36139	Fee-for-Service	1437306032	1437306032	1	1	HINDI, AMMAR M MD	5/20/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171714	30	Radiology	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
36164	Fee-for-Service	1336216266	1336216266	1	1	HWANG, CIFF J MD	5/26/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	43665	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
36183	Fee-for-Service	1134345820	1134345820	1	1	HALL, JASON R	4/15/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	94503	1719	49	06097	38.484045	-122.7376395	Sonoma County
36186	Fee-for-Service	1619233426	1619233426	1	1	HEREDIA, JORGE L MD	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134003	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
36188	Fee-for-Service	1922005602	1922005602	1	1	HUYNH, PHUC T DO	10/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	7890	08	Family Practice	0	In state provider	None	2619 S WATERMAN AVE	STE B	SAN BERNARDINO	CA	92408	3737	36	06071	34.053786	-117.278703	San Bernardino County
36214	Fee-for-Service	1336130475	1336130475	1	1	HIXSON, JOHN D MD	9/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96211	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
36217	Fee-for-Service	1235115981	1235115981	1	1	HILL M DOUGLAS	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	CAREPOINT PC	2550 S PARKER RD	STE 206	AURORA	CO	80014	1679	00	None	39.670515	-104.8642785	Arapahoe County
36229	Fee-for-Service	1700912318	1700912318	1	1	HSU, RONALD K MD	3/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	44067	10	Gastroenterology (M.D. only)	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
36231	Fee-for-Service	1871503755	1871503755	1	1	HUANG, CHARLENE E MD	9/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76427	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	STE 12311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
36257	Fee-for-Service	1023203924	1023203924	1	1	HONG, YUHWAN MD	8/21/2008	207XX0004X	NA	Orthopedic Surgery	026	PHYSICIANS	102860	02	General Surgery	0	In state provider	None	1201 ALHAMBRA BLVD	#400	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
36320	Fee-for-Service	1568750073	1568750073	1	1	HOWELL, TIMOTHY W MD	10/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123673	01	General Practice	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
36323	Fee-for-Service	1417020942	1417020942	2	1	HORSLEY, ANDREW P MD	3/17/2020	207L00000X	NA	Other	026	PHYSICIANS	73934	05	Anesthesiology	0	In state provider	None	23625 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
36328	Fee-for-Service	1992736854	1992736854	1	1	HEALTH DIAGNOSTICS OF	7/16/2009	261QR0200X	NA	Mammography/MRI Provider	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	99 EL CAMINO REAL	None	MENLO PARK	CA	94025	5232	41	06081	37.44762427	-122.173042	San Mateo County
36339	Fee-for-Service	1053627778	1053627778	1	1	HALMAGEAN, SONIA C CNM	5/5/2014	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
36340	Fee-for-Service	1083667307	1083667307	1	1	HEICHEL, CHRISTOPHER MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75001	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
36341	Fee-for-Service	1174637466	1174637466	1	1	HOURANI, BENJAMIN T MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	19821	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
36357	Fee-for-Service	1154741478	1154741478	1	1	HARRIS, HOLLY	12/28/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	None	33.786909	-112.129047	Maricopa County
36375	Fee-for-Service	1205132370	1205132370	1	1	HECHT EYE INSTITUTE INC	6/14/2013	193400000X	NA	Other	026	PHYSICIANS	64034	None	None	0	In state provider	None	4161 REDONDO BEACH BLVD	SUITE 300	LAWNDALE	CA	90260	3360	19	06037	33.87608777	-118.3477232	Los Angeles County
36406	Fee-for-Service	1407898737	1407898737	1	1	HALACOGLU, WILLIAM B DO	11/21/2017	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
36427	Fee-for-Service	1386702587	1386702587	1	1	HAHN, JIN S	3/31/1987	2084N0400X	NA	Neurology	026	PHYSICIANS	59732	13	Neurology (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
36428	Fee-for-Service	1144774621	1144774621	1	1	HANRAHAN, KARA R NP	9/23/2022	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
36455	Fee-for-Service	1407880982	1407880982	1	1	HERD, CLAUDIA L MD	12/1/1987	207L00000X	NA	Other	026	PHYSICIANS	48459	05	Anesthesiology	0	In state provider	None	12440 FIRESTONE BLVD	STE 101	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
36487	Fee-for-Service	1346351566	1346351566	1	1	HILL, RAISSA M DO	3/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	7288	08	Family Practice	0	In state provider	None	77 W MARCH LN	STE A	STOCKTON	CA	95207	5723	39	06077	37.99583483	-121.3064011	San Joaquin County
36515	Fee-for-Service	1457988669	1457988669	1	1	HAN, JONATHAN MD	9/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186098	None	None	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
36520	Fee-for-Service	1801878954	1801878954	1	1	HWANG, DAVID K	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	THOUSAND OAKS FAMILY CHI	268 LOMBARD ST	STE B	THOUSAND OAKS	CA	91360	8225	56	06111	34.17803636	-118.8715813	Ventura County
36521	Fee-for-Service	1689612228	1689612228	1	1	HARTLEY, BELINDA F MD	2/23/2017	2084P0800X	NA	Psychiatry	026	PHYSICIANS	-	36	Psychiatry	1	Border provider	None	1732 S 72ND STREET WEST	None	BILLINGS	MT	59106	3500	00	None	45.737316	-108.699975	Yellowstone County
36523	Fee-for-Service	1508465071	1508465071	1	1	HAMILTON, CHRISTINA CCC-SLP	9/24/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
36535	Fee-for-Service	1871178301	1871178301	1	1	HEARING SOLUTIONS, INC.	3/25/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	175 N JACKSON AVE	STE 204	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
36544	Fee-for-Service	1023203924	1023203924	1	1	HONG, YUHWAN MD	8/21/2008	207XX0004X	NA	Orthopedic Surgery	026	PHYSICIANS	102860	20	Orthopedic Surgery	0	In state provider	None	1201 ALHAMBRA BLVD	#400	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
36611	Fee-for-Service	1770962516	1770962516	1	1	HOFFMANN, JESSICA M MD	5/15/2018	390200000X	NA	Other	026	PHYSICIANS	148176	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
36623	Fee-for-Service	1649358946	1649358946	1	1	HU, EMILY N MD	3/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76856	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1850 SULLIVAN AVE	STE 550	DALY CITY	CA	94015	2234	41	06081	37.68085904	-122.4728842	San Mateo County
36637	Fee-for-Service	1033439864	1033439864	1	1	HUYNH, VU Q MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125001	None	None	0	In state provider	None	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
36638	Fee-for-Service	1770037236	1770037236	2	1	HOSPITAL MEDICINE OF CALIFOR	4/13/2017	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CALIFORNIA INC	820 E MOUNTAIN VIEW ST	None	BARSTOW	CA	92311	3004	36	06071	34.89327944	-117.0174383	San Bernardino County
36645	Fee-for-Service	1770680506	1770680506	1	1	HONG, RICHARD W MD	5/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98942	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
36678	Fee-for-Service	1861785842	1861785842	1	1	HIGHER GROUND HOMES INC	7/13/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	302 BALBOA DR	None	DELANO	CA	93215	4007	15	06029	35.75657044	-119.2538533	Kern County
36684	Fee-for-Service	1174192892	1174192892	1	1	HOAG HOME HEALTH LLC	6/1/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4041 MACARTHUR BLVD	STE 400, OFFICE 04W116	NEWPORT BEACH	CA	92660	2554	30	06059	33.66197804	-117.8635581	Orange County
36726	Fee-for-Service	1962467357	1962467357	1	1	HINSON, GRETCHEN 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
36755	Fee-for-Service	1386208296	1386208296	1	1	HOYLE, LAWANDA A	3/10/2023	104100000X	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
36804	Fee-for-Service	1912918962	1912918962	1	2	HERON, KYLE B MD	2/18/2020	207LP2900X	NA	Other	026	PHYSICIANS	83786	05	Anesthesiology	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4404	33	06065	37.66508443	-120.9962589	Stanislaus County
36829	Fee-for-Service	1881323442	1881323442	1	1	HAUG, HAILEY N CNP	1/24/2024	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
36838	Fee-for-Service	1760987630	1760987630	1	1	HSU, MICHAEL M MD	8/1/2022	207P00000X	NA	Other	026	PHYSICIANS	175589	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
36847	Fee-for-Service	1982645024	1982645024	1	1	HOUCK, JEFFREY A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PATHOLOGY CONSULTANTS	755 E 11TH ST	STE 200	EUGENE	OR	97401	0000	00	None	44.04772253	-123.0811297	Lane County
36853	Fee-for-Service	1295164903	1295164903	1	1	HENNEBERG, CHRISTINE M MD	2/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132905	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
36858	Fee-for-Service	1073835617	1073835617	1	1	HANLEY, JEAN M	6/7/2023	207K00000X	NA	Other	026	PHYSICIANS	72969	None	None	0	In state provider	None	1131 N PACIFIC AVE	None	GLENDALE	CA	91202	2358	19	06037	34.1620727	-118.2647253	Los Angeles County
36868	Fee-for-Service	1730743022	1730743022	1	1	HUYNH, THATCHER T DO	7/1/2022	207R00000X	NA	Other	026	PHYSICIANS	20094	None	None	0	In state provider	None	147 BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
36904	Fee-for-Service	1801936760	1801936760	1	1	HASHIMI, HABEEBA MD	12/19/2023	283Q00000X	NA	Hospitals	026	PHYSICIANS	119362	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
36915	Fee-for-Service	1659512325	1659512325	1	8	HARBINDER S BRAR MD INC	1/31/2011	193200000X	NA	Other	026	PHYSICIANS	40011	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	399 E HIGHLAND AVE	STE 518	SAN BERNARDINO	CA	92404	3990	36	06071	34.1358627	-117.2757898	San Bernardino County
36921	Fee-for-Service	1265415830	1265415830	1	1	HAGGE, ROSALIE J MD	11/27/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86720	42	Nuclear Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
36928	Fee-for-Service	1770037236	1770037236	2	1	HOSPITAL MEDICINE OF CALIFOR	4/13/2017	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CALIFORNIA INC	820 E MOUNTAIN VIEW ST	None	BARSTOW	CA	92311	3004	36	06071	34.89327944	-117.0174383	San Bernardino County
36949	Fee-for-Service	1851516843	1851516843	1	1	HUSEN, LENNY C MD	9/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96932	41	Internal Medicine	0	In state provider	None	3901 LONE TREE WAY	None	ANTIOCH	CA	94509	6200	07	06013	37.98252	-121.8030615	Contra Costa County
37057	Fee-for-Service	1487716130	1487716130	1	1	HOGLIN, SHERRIE L	12/31/1983	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	175 W LA VERNE AVE	STE B	POMONA	CA	91767	2347	19	06037	34.08615354	-117.7522473	Los Angeles County
37085	Fee-for-Service	1487490447	1487490447	1	1	HERNAL, ALEXANDRIA E NP	3/11/2025	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25405 HANCOCK AVE	SUITE 101	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
37128	Fee-for-Service	1730693037	1730693037	1	1	HARDY, EMILY CNM	1/12/2018	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
37132	Fee-for-Service	1225151343	1225151343	1	1	HOON JI M.D.	1/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	800 WASHINGTON ST	None	BOSTON	MA	02111	1552	00	None	42.349662	-71.063514	Suffolk County
37143	Fee-for-Service	1427388230	1427388230	1	1	HARDMAN, BETANIA M LMFT	1/24/2022	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
37161	Fee-for-Service	1093725277	1093725277	1	1	HARRIS, GRACE K DO	6/25/2021	207P00000X	NA	Other	026	PHYSICIANS	17056	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
37170	Fee-for-Service	1477538452	1477538452	1	1	HUERTA, KRISTA MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75515	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
37178	Fee-for-Service	1669071056	1669071056	1	1	HABKO HOME HEALTH CARE INC	11/21/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 265	ENCINO	CA	91436	2914	19	06037	34.15524484	-118.4756687	Los Angeles County
37182	Fee-for-Service	1831652189	1831652189	1	1	HATFIELD, DEREK A MD	2/1/2024	207P00000X	NA	Other	026	PHYSICIANS	192550	None	None	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
37218	Fee-for-Service	1972545754	1972545754	1	1	HABIBE, MICHAEL N MD	11/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78642	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
37261	Fee-for-Service	1902949696	1902949696	1	1	HAN, SUSAN C OD	1/23/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3772 HOWE STREET	None	OAKLAND	CA	94612	3429	01	06001	37.8243542	-122.2566075	Alameda County
37295	Fee-for-Service	1427107366	1427107366	1	1	HAMILTON, MICHAEL D MD	1/1/1984	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	46284	08	Family Practice	0	In state provider	None	333 E NUTWOOD ST	STE B	INGLEWOOD	CA	90301	2356	19	06037	33.96053226	-118.3506276	Los Angeles County
37312	Fee-for-Service	1194782714	1194782714	1	1	HEARST, NORMAN MD	9/30/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45419	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
37332	Fee-for-Service	1861029753	1861029753	1	1	HALL, SARAH K MD	6/14/2023	390200000X	NA	Other	026	PHYSICIANS	185989	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
37359	Fee-for-Service	1912139320	1912139320	1	1	HAMRICK, JUSTIN T MD	7/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	96416	01	General Practice	0	In state provider	None	3626 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80975208	-117.1193406	San Diego County
37366	Fee-for-Service	1710767041	1710767041	1	1	HVIDSTEN, AUSTEN CCC-SLP	11/3/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
37390	Fee-for-Service	1265400154	1265400154	1	1	HABIB, ZABIHULLAH 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	5282	00	None	33.660657	-112.3736175	Maricopa County
37400	Fee-for-Service	1902902067	1902902067	1	1	HAERLE, DEREK P MD	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83813	05	Anesthesiology	0	In state provider	None	CLAY & BUCHANAN STREETS	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.791126	-122.4309105	San Francisco County
37450	Fee-for-Service	1023313715	1023313715	1	1	HAYATDAVOUDI, ASHKAN MD	10/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115320	01	General Practice	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
37462	Fee-for-Service	1164698528	1164698528	1	1	HYDE, TAMARA J LMFT	7/26/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	482 N ROSEMEAD BLVD	STE 103	PASADENA	CA	91107	3000	19	06037	34.15457831	-118.078192	Los Angeles County
37514	Fee-for-Service	1215052014	1215052014	1	2	HOUSTON, DEENNE I LCSW	11/29/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
37515	Fee-for-Service	1205423084	1205423084	1	1	HEAVENLY CARE HOME HEALTH	12/14/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14545 FRIAR ST	SUITE 323	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
37562	Fee-for-Service	1639100654	1639100654	1	1	HEKMATI, MANIA LMFT	10/19/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11805 MAYFIELD AVE	102	LOS ANGELES	CA	90049	5748	19	06037	34.05039597	-118.4652368	Los Angeles County
37587	Fee-for-Service	1790447191	1790447191	1	1	HAYMES-ELLIOTT, LINDA K PHD	2/10/2025	103K00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
37605	Fee-for-Service	1356441307	1356441307	1	1	HERNANDEZ, CARLOS E MD	1/27/2021	2080P0204X	NA	Other	026	PHYSICIANS	171249	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
37628	Fee-for-Service	1619141413	1619141413	1	1	HOUSHYAR, ROOZBEH MD	5/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118157	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
37648	Fee-for-Service	1912139320	1912139320	1	1	HAMRICK, JUSTIN T MD	7/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	96416	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
37674	Fee-for-Service	1699824771	1699824771	2	1	HA, ALICE MD	9/1/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	179275	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
37756	Fee-for-Service	1700066693	1700066693	1	1	HWANG, JULIET H MD	12/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95362	40	Pediatrics	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
37775	Fee-for-Service	1699115386	1699115386	1	1	HERNANDEZ, VANESSA A DO	10/15/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	15452	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 MAIN ST	None	BRAWLEY	CA	92227	2630	13	06025	32.9785797	-115.5285802	Imperial County
37800	Fee-for-Service	1093433187	1093433187	1	1	HANNEMAN, MADELEINE I PT	1/15/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3009 STRATOFORTRESS AVE	B	ATWATER	CA	95301	5170	24	06047	37.36164294	-120.5703841	Merced County
37818	Fee-for-Service	1770537144	1770537144	1	1	HOANG, CHRISTINE T MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69074	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	10362 BOLSA AVE	None	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
37823	Fee-for-Service	1316992068	1316992068	1	1	HIGHMAN, LAWRENCE M MD	4/2/1985	208600000X	NA	General Surgery	026	PHYSICIANS	40201	02	General Surgery	0	In state provider	A PROFESSIONAL CORP	199 E WEBSTER ST	None	COLUSA	CA	95932	2954	06	06011	39.20737704	-122.0004043	Colusa County
37844	Fee-for-Service	1255913075	1255913075	1	1	HONG, JENNY MD	10/3/2024	208M00000X	NA	Other	026	PHYSICIANS	191355	41	Internal Medicine	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
37849	Fee-for-Service	1538276324	1538276324	1	1	HARE, CHARLES B MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71109	41	Internal Medicine	0	In state provider	None	995 POTRERO AVE	None	SAN FRANCISCO	CA	94110	2859	38	06075	37.75729541	-122.4066641	San Francisco County
37852	Fee-for-Service	1629564869	1629564869	1	1	HOM, MEGAN E DPM	5/16/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2272 BACON ST	None	SAN FRANCISCO	CA	94520	0000	38	06075	37.98200856	-122.0347914	Contra Costa County
37890	Fee-for-Service	1538664479	1538664479	1	1	HODGKIN, JONATHAN MD	7/15/2022	207R00000X	NA	Other	026	PHYSICIANS	174097	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
37896	Fee-for-Service	1174735658	1174735658	1	1	HO, JASON S MD	7/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81221	78	Neoplastic Diseases/Oncology	0	In state provider	None	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
37907	Fee-for-Service	1518306851	1518306851	1	1	HOROWITZ, MICHAEL J MD	6/29/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	135132	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
37908	Fee-for-Service	1568828275	1568828275	1	1	HOLZ, KELLY MD	10/20/2023	207P00000X	NA	Other	026	PHYSICIANS	191421	None	None	0	In state provider	None	20103 LAKE CHABOT	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
37909	Fee-for-Service	1326292400	1326292400	1	1	HUNDAL, PRADEEP K MD	12/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121063	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
37954	Fee-for-Service	1215091772	1215091772	1	1	HOLBROOK, PAMELA L DO	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	7078	None	None	0	In state provider	None	450 W CLARA ST	None	OXNARD	CA	93033	8363	56	06111	34.15118052	-119.182338	Ventura County
37969	Fee-for-Service	1396162335	1396162335	1	1	HENRY, JANELLE NP	10/8/2020	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
37973	Fee-for-Service	1396855540	1396855540	1	1	HOSKINS, DAVID PSYD	2/11/2025	103T00000X	NA	Mental Health Outpatient Services	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
37980	Fee-for-Service	1609886209	1609886209	1	1	HOFFMAN, GARY HALL MD	5/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40007	02	General Surgery	0	In state provider	None	9400 BRIGHTON WAY	STE 307	BEVERLY HILLS	CA	90210	4760	19	06037	34.07043476	-118.4011952	Los Angeles County
38035	Fee-for-Service	1891752069	1891752069	1	1	HIRSCH, JENNIFER S CNM	4/1/2016	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
38057	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	3/24/2021	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
38071	Fee-for-Service	1912995952	1912995952	1	1	HALIMI, KADEER, M MD	7/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8832	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
38079	Fee-for-Service	1336104082	1336104082	1	1	HAYASHI, AARON K MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65175	30	Radiology	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
38110	Fee-for-Service	1053921510	1053921510	1	1	HENGESTEG CHIROPRACTIC, INC	1/26/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	14168 POWAY RD STE 105	None	POWAY	CA	92064	4938	37	06073	32.9565281	-117.024298	San Diego County
38118	Fee-for-Service	1669932422	1669932422	1	1	HUBNER, GWENDOLYN S MD	8/24/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	177073	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
38132	Fee-for-Service	1003994799	1003994799	1	1	HEYKES, JAMES MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	48344	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3660 ARLINGTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94621853	-117.3953655	Riverside County
38138	Fee-for-Service	1538276324	1538276324	1	1	HARE, CHARLES B MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71109	77	Infectious Disease	0	In state provider	None	995 POTRERO AVE	None	SAN FRANCISCO	CA	94110	2859	38	06075	37.75729541	-122.4066641	San Francisco County
38151	Fee-for-Service	1942531629	1942531629	1	1	HOELSCHER, THILO	1/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	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
38152	Fee-for-Service	1023033743	1023033743	1	1	HARA,KEVIN 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	98-1079 MOANALUA RD	STE 430	AIEA	HI	96701	0000	00	None	21.38373524	-157.937629	Honolulu County
38184	Fee-for-Service	1174735658	1174735658	1	1	HO, JASON S MD	7/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81221	68	Hematology	0	In state provider	None	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
38203	Fee-for-Service	1124475355	1124475355	1	1	HARDING, ANDREW C MD	7/1/2024	208G00000X	NA	General Surgery	026	PHYSICIANS	171789	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
38215	Fee-for-Service	1053334698	1053334698	2	1	HURWITZ, ALFRED L MD	3/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	20286	10	Gastroenterology (M.D. only)	0	In state provider	None	455 OCONNOR DRIVE	SUITE 350	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
38325	Fee-for-Service	1194390773	1194390773	1	1	HOWE, GEORGIA DO	12/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22590	08	Family Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
38333	Fee-for-Service	1285152298	1285152298	1	1	HALL, DIEGO JOSHUA P LMFT	7/7/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	621 CHERRY ST	None	SANTA ROSA	CA	95404	4202	49	06097	38.444877	-122.7163005	Sonoma County
38339	Fee-for-Service	1497817035	1497817035	1	1	HANSEN-COOK, PAULA LMFT	11/16/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
38343	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	12/14/2016	193200000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
38344	Fee-for-Service	1295702728	1295702728	1	1	HOLMES REGIONAL MED CTR	7/1/1998	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1350 HICKORY ST	None	MELBOURNE	FL	32901	3224	00	None	28.0881	-80.61354601	Brevard County
38347	Fee-for-Service	1245345701	1245345701	1	1	HUA, LAN B MD	9/21/2009	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	108459	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
38367	Fee-for-Service	1144356536	1144356536	1	1	HO, DENNIS ANHVU OD	8/15/1997	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9039 BOLSA AVE	STE 110	WESTMINSTER	CA	92683	5593	30	06059	33.7449633	-117.9717088	Orange County
38399	Fee-for-Service	1881153658	1881153658	1	1	HO, ISAIAH	1/29/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179705	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
38466	Fee-for-Service	1629353511	1629353511	1	1	HAND IN HAND TRANSPORTATION	9/13/2012	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	4181 W BROADWAY	#A	HAWTHORNE	CA	90250	4047	19	06037	33.92006869	-118.3478003	Los Angeles County
38476	Fee-for-Service	1578533972	1578533972	1	1	HYATT, RICHARD A MD	6/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	20596	08	Family Practice	0	In state provider	None	2279 E PALMDALE	#A	PALMDALE	CA	93550	4909	19	06037	34.58020552	-118.087164	Los Angeles County
38488	Fee-for-Service	1568805612	1568805612	1	1	HERNANDEZ-MORGAN, MARISA E M	10/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	135140	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
38569	Fee-for-Service	1447624226	1447624226	1	2	HIETT, ROXIE LCSW	4/16/2025	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
38631	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
38633	Fee-for-Service	1295702728	1295702728	1	1	HOLMES REGIONAL MED CTR	3/27/2018	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1350 HICKORY ST	None	MELBOURNE	FL	32901	3224	00	None	28.0881	-80.61354601	Brevard County
38665	Fee-for-Service	1598758336	1598758336	1	1	HAERTER, CHARLTON 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	250 E DUNLAP AVE	None	PHOENIX	AZ	85020	2825	00	None	33.568947	-112.0712985	Maricopa County
38694	Fee-for-Service	1518034370	1518034370	1	1	HONG, QUYEN T OD	1/13/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	2020	30	06059	33.85429451	-117.8446551	Orange County
38729	Fee-for-Service	1861540767	1861540767	1	1	HODGE, RICHARD A OD	12/16/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8080 PARKWAY DRIVE	None	LA MESA	CA	91942	2104	37	06073	32.77560706	-117.0231998	San Diego County
38808	Fee-for-Service	1225026446	1225026446	1	1	HUH, JULIE J MD	9/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87004	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2100 WEBSTER ST	STE 319	SAN FRANCISCO	CA	94115	2377	38	06075	37.7904826	-122.4324477	San Francisco County
38809	Fee-for-Service	1023349636	1023349636	1	1	HARDGRAVE, BRIAN D LCSW	7/22/2022	101YM0800X	NA	Other	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
38816	Fee-for-Service	1063653111	1063653111	1	1	HORN, ROBERT W CRNA	5/13/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 THE CITY DR SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
38859	Fee-for-Service	1396942868	1396942868	1	1	HAHN, JUDITH L LCSW	6/12/2017	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
38884	Fee-for-Service	1346757135	1346757135	1	2	HEMATOLOGY AND ONCOLOGY ASSO	10/26/2018	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	CIATES OF NORTHERN CALIF	1631 CREEKSIDE DR	102	FOLSOM	CA	95630	3820	34	06067	38.671425	-121.14747	Sacramento County
38920	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	12/14/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
38926	Fee-for-Service	1720078678	1720078678	1	1	HATHEWAY, JOHN MD	4/22/2024	163WP0000X	NA	Other	026	PHYSICIANS	86199	None	None	0	In state provider	None	568 N SUNRISE AVE	STE 250	ROSEVILLE	CA	95661	3035	31	06061	38.7576732	-121.2534645	Placer County
38945	Fee-for-Service	1114182870	1114182870	1	1	HEARTEN HOME HEALTH, INC	8/4/2009	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1720 E LOS ANGELES AVE	SUITE 217	SIMI VALLEY	CA	93065	2033	56	06111	34.2716455	-118.7653635	Ventura County
38958	Fee-for-Service	1003977158	1003977158	1	1	HUME, QUINN S DO	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7772	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
38987	Fee-for-Service	1538263819	1538263819	1	1	HESSMAN, JEFFREY A DPM	7/1/1976	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1111 W 4TH ST	STE A	MADERA	CA	93637	4474	20	06039	36.95563823	-120.0735861	Madera County
39001	Fee-for-Service	1568998748	1568998748	1	1	HAMUD-AHMED, WALID A MD	8/1/2020	207P00000X	NA	Other	026	PHYSICIANS	158549	None	None	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
39009	Fee-for-Service	MSS00009F	None	1	1	HUMBOLDT SENIOR	7/1/1998	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	RESOURCE CTR, INC.	1910 CALIFORNIA ST	None	EUREKA	CA	95501	2870	12	06023	40.79038981	-124.1719658	Humboldt County
39015	Fee-for-Service	1174670228	1174670228	2	2	HUTRX PHARMACY INCORPORATED	12/4/2019	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	737 COLUSA AVE	None	YUBA CITY	CA	95991	3791	51	06101	39.14175898	-121.6268906	Sutter County
39037	Fee-for-Service	1497764641	1497764641	1	1	HAYASHIDA, KENNETH H JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56162	40	Pediatrics	0	In state provider	None	500 S ANAHEIM HILLS RD	STE 234	ANAHEIM	CA	92807	4760	30	06059	33.8427954	-117.7772895	Orange County
39113	Fee-for-Service	1922156801	1922156801	1	1	HWANG, EUGENE Y MD	12/4/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81162	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
39129	Fee-for-Service	1255389474	1255389474	1	1	HAYNES, ROBERT R MD	11/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83816	41	Internal Medicine	0	In state provider	None	1201 ALHAMBRA BLVD	STE 220	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
39133	Fee-for-Service	1902938632	1902938632	2	1	HB-MEDI-CAL TRANSPORTATION	11/19/2014	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1010 E STREET	None	FRESNO	CA	93706	3305	10	06019	36.73004024	-119.7962002	Fresno County
39135	Fee-for-Service	1508995317	1508995317	1	1	HUTCHERSON, ROSWITHA H	2/8/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	6633 COYLE AVE	STE 1	CARMICHAEL	CA	95608	6332	34	06067	38.668275	-121.3097265	Sacramento County
39156	Fee-for-Service	1952343873	1952343873	1	1	HOPKINS, LINDA M MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71063	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	A	1001 POTRERO AVE # 6D14	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.75548534	-122.4065362	San Francisco County
39158	Fee-for-Service	1669862942	1669862942	1	1	HUNTSINGER, TAMARA J LMFT	2/20/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25000 AVENUE STANFORD	STE 218	VALENCIA	CA	91355	4596	19	06037	34.43847322	-118.5729968	Los Angeles County
39164	Fee-for-Service	1245900679	1245900679	1	1	HART, KRISTEN LMFT	11/26/2024	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
39176	Fee-for-Service	1699710442	1699710442	1	1	HAUGABROOK, ANITA	9/25/2023	208M00000X	NA	Other	026	PHYSICIANS	150812	None	None	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
39207	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	12/14/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
39265	Fee-for-Service	1073632345	1073632345	1	1	HORVATH, MARKUS MD	4/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	84400	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
39307	Fee-for-Service	1992792378	1992792378	1	1	HELMBRECHT, LEON J MD	7/1/1979	208800000X	NA	Other	026	PHYSICIANS	15645	34	Urology and Urological Surgery	0	In state provider	None	1904 N ORANGE GROVE AVE	None	POMONA	CA	91767	3008	19	06037	34.07852627	-117.7481309	Los Angeles County
39312	Fee-for-Service	1659945863	1659945863	1	1	HURTT FAMILY HEALTH CLINIC	8/13/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	14642 NEWPORT AVE	STE 200	TUSTIN	CA	92780	6058	30	06059	33.73082212	-117.8293987	Orange County
39318	Fee-for-Service	1104904945	1104904945	1	1	HART JR, JOHN H MD	4/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81027	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
39343	Fee-for-Service	1225405723	1225405723	1	1	HEALTH CONNECT NURSING	6/12/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	205 MAIN STREET	SUITE A	PLEASANTON	CA	94566	7359	01	06001	37.65707814	-121.8783341	Alameda County
39400	Fee-for-Service	1437464179	1437464179	1	1	HALL, VICTORIA L LMFT	1/15/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	40 WEST G STREET	SUITES A-E	LOS BANOS	CA	93635	3657	24	06047	37.06661683	-120.8545413	Merced County
39429	Fee-for-Service	1467402016	1467402016	1	1	HIGH DESERT THERAPISTS, INC	12/1/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	60 PENNY LANE	None	WATSONVILLE	CA	95076	3079	44	06087	36.93074806	-121.7788515	Santa Cruz County
39436	Fee-for-Service	1093453144	1093453144	1	1	HILL COUNTRY COMMUNITY CLINI	4/20/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1201 INDUSTRIAL ST	SUITE 101	REDDING	CA	96002	0757	45	06089	40.57469253	-122.349645	Shasta County
39464	Fee-for-Service	1477969566	1477969566	1	1	HTUT, WINMIN MD	10/25/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	156403	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
39475	Fee-for-Service	1164850111	1164850111	1	1	HALPERT, EILEEN LMFT	3/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
39496	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	9/2/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
39497	Fee-for-Service	1821187956	1821187956	1	1	HALUPKA, ROBERT F JR OD	10/16/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
39498	Fee-for-Service	1780178996	1780178996	1	1	HOLMES, MADISON A CNP	12/31/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	19121 BEACH BLVD	None	HUNTINGTON BEACH	CA	92648	2307	30	06059	33.685155	-117.988868	Orange County
39523	Fee-for-Service	1629023718	1629023718	1	1	HANDY, JERRY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 COTTONWOOD ST	None	SALT LAKE CTY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
39528	Fee-for-Service	1003926973	1003926973	1	1	HUSAYN, FAROOQ J MD	7/1/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	31910	40	Pediatrics	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
39544	Fee-for-Service	1174600365	1174600365	1	1	HAMMERMAN KENNETH JM	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	25963	10	Gastroenterology (M.D. only)	0	In state provider	None	1199 BUSH ST	STE 500	SAN FRANCISCO	CA	94109	5976	38	06075	37.7891291	-122.4167087	San Francisco County
39557	Fee-for-Service	1326434655	1326434655	1	1	HASSANEIN, MOHAMED T MD MPH	9/24/2023	208G00000X	NA	General Surgery	026	PHYSICIANS	167128	None	None	0	In state provider	None	8010 FROST ST	SUITE 408	SAN DIEGO	CA	92123	2778	37	06073	32.80026879	-117.1520059	San Diego County
39558	Fee-for-Service	1245902840	1245902840	1	1	HILLSIDE HOME HEALTH INC	9/8/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	20969 VENTURA BLVD	SUITE 213	WOODLAND HILLS	CA	91364	6619	19	06037	34.16664447	-118.5903846	Los Angeles County
39569	Fee-for-Service	1124086269	1124086269	1	1	HSU, LINDA W T	12/1/2003	No Taxonomy Provided	NA	None	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
39600	Fee-for-Service	1659945863	1659945863	1	1	HURTT FAMILY HEALTH CLINIC	6/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	14642 NEWPORT AVE	STE 200	TUSTIN	CA	92780	6058	30	06059	33.73082212	-117.8293987	Orange County
39620	Fee-for-Service	1124663034	1124663034	1	1	HAMOA LLC	10/1/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	515 EAST ORANGEBURG AVE	None	MODESTO	CA	95350	5510	50	06099	37.66364745	-120.9862845	Stanislaus County
39639	Fee-for-Service	1174292866	1174292866	1	1	HEADWAY CALIFORNIA BEHAVIORA	5/10/2024	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	L HEALTH SERVICES PC	2211 POST ST	SUITE 300	SAN FRANCISCO	CA	94115	3464	38	06075	37.78446663	-122.4382772	San Francisco County
39655	Fee-for-Service	1063518397	1063518397	1	1	HAME, SHARON L MD	8/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	82238	20	Orthopedic Surgery	0	In state provider	None	200 MEDICAL PLAZA	RM 140	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
39701	Fee-for-Service	1518427855	1518427855	1	1	HUA, KIET G MD	6/20/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	184817	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
39705	Fee-for-Service	1710042502	1710042502	1	1	HILLENBURG, LENA K MD	11/22/2010	207R00000X	NA	Other	026	PHYSICIANS	74279	41	Internal Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
39730	Fee-for-Service	1063475614	1063475614	1	1	HUYNH, LINH C DPM	4/21/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	FOOT & ANKLE CARE CLINIC	875 E CANAL DR	STE 10	TURLOCK	CA	95380	4542	50	06099	37.50044845	-120.839607	Stanislaus County
39768	Fee-for-Service	1245294115	1245294115	1	1	HAROLD B JONES	4/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3651 WHEELER RD	None	AUGUSTA	GA	30909	6521	00	None	33.486183	-82.0945845	Richmond County
39780	Fee-for-Service	1285601872	1285601872	1	1	HARI P GADDE MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	330 MADISON ST	STE L11	JOLIET	IL	60435	6569	00	None	41.52896123	-88.13464571	Will County
39781	Fee-for-Service	1821069394	1821069394	1	1	HOLZ, HUCK A MD	10/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86178	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
39784	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	2/21/2019	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
39804	Fee-for-Service	1811007859	1811007859	1	1	HENDERSON-MEYER, TONYA R	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66963	40	Pediatrics	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
39813	Fee-for-Service	1043305774	1043305774	1	1	HA, BEN MD	3/1/2000	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	70143	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	711 W COLLEGE ST	STE 540	LOS ANGELES	CA	90012	1246	19	06037	34.06541412	-118.2414102	Los Angeles County
39824	Fee-for-Service	1538122270	1538122270	1	1	HANAFUSA, KEI MD	1/1/1998	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	84175	30	Radiology	0	In state provider	None	285 SOUTH DR	STE 8	MOUNTAIN VIEW	CA	94040	4313	43	06085	37.36723055	-122.080599	Santa Clara County
39834	Fee-for-Service	1770962920	1770962920	1	1	HARDING, GRACE DO	6/18/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15134	08	Family Practice	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
39842	Fee-for-Service	1184908329	1184908329	1	1	HEART CENTER OF ORANGE	4/29/2013	174400000X	NA	Other	026	PHYSICIANS	74657	06	Cardiovascular Disease (M.D. only)	0	In state provider	COUNTY	11180 WARNER AVE	STE 165	FOUNTAIN VALLEY	CA	92708	7515	30	06059	33.71632048	-117.9334575	Orange County
39856	Fee-for-Service	1508979501	1508979501	1	1	HAMNER, DYSON L MD	1/1/1998	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	82196	20	Orthopedic Surgery	0	In state provider	None	525 3RD AVE	None	CHULA VISTA	CA	91910	5616	37	06073	32.63367609	-117.0769202	San Diego County
39867	Fee-for-Service	1184939381	1184939381	1	1	HUANG, SOLOMON C MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122487	45	Nephrology (Renal-Kidney)	0	In state provider	None	536 E FOOTHILL BLVD	STE B	UPLAND	CA	91796	3988	36	06071	34.10683091	-117.6438976	San Bernardino County
39888	Fee-for-Service	1659945863	1659945863	1	1	HURTT FAMILY HEALTH CLINIC	12/8/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	14642 NEWPORT AVE	STE 200	TUSTIN	CA	92780	6058	30	06059	33.73082212	-117.8293987	Orange County
39890	Fee-for-Service	1609841865	1609841865	1	1	HANIF, BADRUNNISA I MD	4/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	3006 S MARYLAND PKWY	STE 315	LAS VEGAS	NV	89109	6205	00	None	36.135288	-115.1368705	Clark County
39900	Fee-for-Service	1730143785	1730143785	1	1	HEINING, TRAVIS J MD	1/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86894	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
39918	Fee-for-Service	1376975185	1376975185	1	1	HOANG, HUY D MD	8/18/2020	208600000X	NA	General Surgery	026	PHYSICIANS	144539	02	General Surgery	0	In state provider	None	205 E RIVER PARK CIR	STE 460	FRESNO	CA	93720	1585	10	06019	36.85456375	-119.7863981	Fresno County
39927	Fee-for-Service	1174292866	1174292866	1	1	HEADWAY CALIFORNIA BEHAVIORA	5/10/2024	193200000X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	L HEALTH SERVICES PC	2211 POST ST	SUITE 300	SAN FRANCISCO	CA	94115	3464	38	06075	37.78446663	-122.4382772	San Francisco County
39940	Fee-for-Service	1316035082	1316035082	1	1	HUGH, PETER C DO	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	6005	08	Family Practice	0	In state provider	None	3300 E SOUTH ST	STE 303	LAKEWOOD	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
39953	Fee-for-Service	1336715515	1336715515	1	1	HOMET, KATHARINE T LMFT	10/31/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43585 MONTEREY AVE	SUITE 1	PALM DESERT	CA	92260	9342	33	06065	33.731946	-116.3912695	Riverside County
39979	Fee-for-Service	1568968030	1568968030	1	1	HEMMATI, DAVID M MD	7/26/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	165063	None	None	0	In state provider	None	2080 CENTURY PARK E	STE 300	LOS ANGELES	CA	90067	2006	19	06037	34.05887194	-118.4122914	Los Angeles County
39988	Fee-for-Service	1710042502	1710042502	1	1	HILLENBURG, LENA K MD	11/22/2010	207R00000X	NA	Other	026	PHYSICIANS	74279	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
40050	Fee-for-Service	1417051095	1417051095	1	1	HOUSE, JOHN W MD	1/1/1982	207YX0901X	NA	ENT/Otolaryngology	026	PHYSICIANS	14971	01	General Practice	0	In state provider	None	2122 W 3RD ST	None	LOS ANGELES	CA	90057	1902	19	06037	34.0630888	-118.2733329	Los Angeles County
40068	Fee-for-Service	1316551971	1316551971	1	1	HUANG, CECILIA S PT	10/30/2020	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
40073	Fee-for-Service	1659312593	1659312593	1	31	HEALTHCARE PARTNERS AFFILIAT	12/14/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	AFFILIATES MEDICAL GROUP	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
40086	Fee-for-Service	1316011638	1316011638	1	1	HOOD,JAMES S MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72599	06	Cardiovascular Disease (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
40090	Fee-for-Service	1316972334	1316972334	1	1	HARADA, RANDALL K MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	87483	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11480 BROOKSHIRE AVE	SUITE 300	DOWNEY	CA	90241	5018	19	06037	33.93622932	-118.1311752	Los Angeles County
40125	Fee-for-Service	1205316155	1205316155	1	1	HENDERSON, GAGE LMFT	8/6/2024	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
40129	Fee-for-Service	1184908329	1184908329	1	1	HEART CENTER OF ORANGE	4/29/2013	174400000X	NA	Other	026	PHYSICIANS	74657	41	Internal Medicine	0	In state provider	COUNTY	11180 WARNER AVE	STE 165	FOUNTAIN VALLEY	CA	92708	7515	30	06059	33.71632048	-117.9334575	Orange County
40139	Fee-for-Service	1396154308	1396154308	1	1	HAMATI, TAWFIK MD	11/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	2	Out of state provider	None	2640 E BARNETT RD E333	None	MEDFORD	OR	97504	4301	00	None	42.31645852	-122.834421	Jackson County
40140	Fee-for-Service	1518124288	1518124288	1	1	HABIB, ALI A MD	9/29/2017	2084N0400X	NA	Neurology	026	PHYSICIANS	115119	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3210	30	06059	33.78674051	-117.8888713	Orange County
40142	Fee-for-Service	1467896464	1467896464	1	1	HASSAN, MAHEEN A MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	124406	10	Gastroenterology (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
40158	Fee-for-Service	1184939381	1184939381	1	1	HUANG, SOLOMON C MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122487	41	Internal Medicine	0	In state provider	None	536 E FOOTHILL BLVD	STE B	UPLAND	CA	91796	3988	36	06071	34.10683091	-117.6438976	San Bernardino County
40177	Fee-for-Service	1659945863	1659945863	1	1	HURTT FAMILY HEALTH CLINIC	6/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	14642 NEWPORT AVE	STE 200	TUSTIN	CA	92780	6058	30	06059	33.73082212	-117.8293987	Orange County
40214	Fee-for-Service	1174292866	1174292866	1	1	HEADWAY CALIFORNIA BEHAVIORA	5/10/2024	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	L HEALTH SERVICES PC	2211 POST ST	SUITE 300	SAN FRANCISCO	CA	94115	3464	38	06075	37.78446663	-122.4382772	San Francisco County
40225	Fee-for-Service	1275565046	1275565046	1	1	HALL, KIMBERLY L PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	17675 VAN BUREN BLVD	None	RIVERSIDE	CA	92504	6076	33	06065	33.88266109	-117.35497	Riverside County
40229	Fee-for-Service	1316035082	1316035082	1	1	HUGH, PETER C DO	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	6005	01	General Practice	0	In state provider	None	3300 E SOUTH ST	STE 303	LAKEWOOD	CA	90805	4594	19	06037	33.86018093	-118.1537163	Los Angeles County
40230	Fee-for-Service	1164957049	1164957049	1	1	HICKS, ADENA M MD	10/28/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	161509	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
40237	Fee-for-Service	1811408008	1811408008	1	1	HONE, DESTINEE L LMFT	3/25/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3288 EL CAJON BLVD	STE 1A,1B,3,5-6,8-13	SAN DIEGO	CA	92104	1430	37	06073	32.75537145	-117.1228095	San Diego County
40292	Fee-for-Service	1114984648	1114984648	1	1	HAUER, KAREN E MD	12/31/1994	207R00000X	NA	Other	026	PHYSICIANS	80601	41	Internal Medicine	0	In state provider	None	375 LAGUNA HONDA BLVD	None	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
40306	Fee-for-Service	1033342118	1033342118	1	1	HUNTINGTON EYE MEDICAL GROUP	9/8/2015	207W00000X	NA	Ophthalmology	026	PHYSICIANS	71794	None	None	0	In state provider	INC	800 SOUTH FAIRMOUNT AVE	SUITE 219	PASADENA	CA	91105	3153	19	06037	34.13193177	-118.1517805	Los Angeles County
40337	Fee-for-Service	1699853291	1699853291	1	1	HOWSE, JOHN J MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43930	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
40343	Fee-for-Service	1972704856	1972704856	1	1	HAMILTON, MARIA PDI MD	12/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72291	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
40365	Fee-for-Service	1982877056	1982877056	1	1	HERNANDEZ, ESTEBES A MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116994	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
40393	Fee-for-Service	1821594144	1821594144	1	11	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	600 NUT TREE RD	STE 250	VACAVILLE	CA	95687	4686	48	06095	38.36133624	-121.9496789	Solano County
40396	Fee-for-Service	1033366752	1033366752	1	1	HO, PHUONG KHANH T OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
40425	Fee-for-Service	1962019398	1962019398	1	1	HINKLE, KAYLA B CRNA	11/20/2024	367500000X	NA	Other	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
40430	Fee-for-Service	1467896464	1467896464	1	1	HASSAN, MAHEEN A MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	124406	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
40448	Fee-for-Service	1316381528	1316381528	1	1	HALLDORSON, CHRISTINA M MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143765	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
40493	Fee-for-Service	1700957099	1700957099	1	1	HASSID, GRACEW DIGIOIA	2/28/1996	207R00000X	NA	Other	026	PHYSICIANS	62760	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
40516	Fee-for-Service	1508289158	1508289158	1	1	HEALTHY FOUNDATIONS MEDICAL	3/20/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP	1045 ATLANTIC ST	SUITE 715	LONG BEACH	CA	90813	3412	19	06037	33.780267	-118.1850795	Los Angeles County
40522	Fee-for-Service	1114007366	1114007366	1	1	HOWARD, STEVEN M MD	10/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	35447	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
40524	Fee-for-Service	1043351646	1043351646	1	1	HWANG, PAUL T MD	2/28/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	76970	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
40541	Fee-for-Service	1639261084	1639261084	1	1	HOCHSTETLER, MARCUS PSYD	3/25/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	27349 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	5634	33	06065	33.51993406	-117.1641955	Riverside County
40549	Fee-for-Service	1801263322	1801263322	1	1	HUYNH, VAUGHN OD	10/25/2017	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
40565	Fee-for-Service	1063499283	1063499283	1	1	HENRY, TAMIKA C MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73743	08	Family Practice	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
40594	Fee-for-Service	1659355691	1659355691	1	1	HILLIARD, DENNIS MD	10/18/1987	163WX0200X	NA	Other	026	PHYSICIANS	33679	78	Neoplastic Diseases/Oncology	0	In state provider	None	29099 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.26652661	-117.1690546	San Bernardino County
40668	Fee-for-Service	1275149940	1275149940	1	1	HIXON, ASPEN	3/8/2022	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
40681	Fee-for-Service	1386829604	1386829604	1	1	HO, ALLEN S MD	2/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	102384	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	8631 W 3RD STREET	None	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
40682	Fee-for-Service	1295132777	1295132777	1	1	HIGGS, JAHA LMFT	3/21/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
40727	Fee-for-Service	1104133800	1104133800	1	1	HARVEY, JENNIFER NP	12/8/2022	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
40730	Fee-for-Service	1053393033	1053393033	1	1	HUANG, SARA M MD	1/1/1982	2085R0001X	NA	Other	026	PHYSICIANS	37873	30	Radiology	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
40769	Fee-for-Service	1689741522	1689741522	1	1	HUANG, CHARN-JIUAN T MD	11/25/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	39009	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
40788	Fee-for-Service	1972583599	1972583599	1	1	HIPPEN, JOHN T MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103982	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
40792	Fee-for-Service	1730442609	1730442609	1	1	HEARD, KIYUMI MD	9/13/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	140266	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
40851	Fee-for-Service	1063499283	1063499283	1	1	HENRY, TAMIKA C MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73743	66	Emergency Medicine (Urgent Care)	0	In state provider	None	555 E HARDY ST	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
40860	Fee-for-Service	1679798656	1679798656	1	1	HATHAWAY, ELIZABETH GAIL	3/12/2007	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1344 N ATKINS PL	None	PORTERVILLE	CA	93257	1020	54	06107	36.09001936	-119.0478852	Tulare County
40876	Fee-for-Service	1164507869	1164507869	1	1	HSIAO, RAY J MD	12/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70571	41	Internal Medicine	0	In state provider	None	1850 S AZUSA AVE	STE 308	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
40881	Fee-for-Service	1659355691	1659355691	1	1	HILLIARD, DENNIS MD	10/18/1987	163WX0200X	NA	Other	026	PHYSICIANS	33679	01	General Practice	0	In state provider	None	29099 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	0000	36	06071	34.26652661	-117.1690546	San Bernardino County
40888	Fee-for-Service	1730114554	1730114554	1	1	HAN, LAURA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9938 BOLSA AVE	STE 105	WESTMINSTER	CA	92683	6039	30	06059	33.74481854	-117.956025	Orange County
40918	Fee-for-Service	1790796514	1790796514	1	1	HANGER PROSTHETICS &	7/2/2008	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	351 SANTA FE DR	SUITE 240	ENCINITAS	CA	92024	5137	37	06073	33.03617853	-117.2843775	San Diego County
40930	Fee-for-Service	1972807428	1972807428	1	1	HSU, RAY J MD	7/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128881	40	Pediatrics	0	In state provider	None	2501 E CHAPMAN AVENUE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
40970	Fee-for-Service	1124520473	1124520473	1	1	HO, MARISSA PT	1/9/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
40997	Fee-for-Service	1831873595	1831873595	1	1	HERNANDEZ, LINA NP	9/25/2023	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
40999	Fee-for-Service	1174739973	1174739973	1	1	HICHOICE HEALTHCARE, INC	9/3/2003	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	ARARAT ADULT DAY HEALTH	721 S GLENDALE AVE	None	GLENDALE	CA	91205	2317	19	06037	34.13801724	-118.2512568	Los Angeles County
41004	Fee-for-Service	1427639863	1427639863	1	1	HUNT, ANDREW P DO	7/17/2024	207P00000X	NA	Other	026	PHYSICIANS	22652	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
41008	Fee-for-Service	1366976607	1366976607	1	1	HAYSBERT, DONNA B MD	9/2/2022	390200000X	NA	Other	026	PHYSICIANS	179702	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
41017	Fee-for-Service	1053393033	1053393033	1	1	HUANG, SARA M MD	1/1/1982	2085R0001X	NA	Other	026	PHYSICIANS	37873	47	Miscellaneous	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
41033	Fee-for-Service	1740330653	1740330653	1	1	HORST, DAVID A MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	501 EAST HAMPDEN AVENUE	None	ENGLEWOOD	CO	80113	2702	00	None	39.6531952	-104.9810967	Arapahoe County
41042	Fee-for-Service	1669012571	1669012571	1	1	HENDERSON, SHANA M CNP	11/22/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8850 VALLEY VIEW ST	None	BUENA PARK	CA	90620	3562	30	06059	33.833988	-118.0282915	Orange County
41067	Fee-for-Service	1417412289	1417412289	1	1	HERNANDEZ, JEANNETTE R LMFT	4/12/2021	101YM0800X	NA	Other	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
41121	Fee-for-Service	1962499392	1962499392	1	1	HOLDER, KATHRYN K MD	11/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54342	01	General Practice	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
41149	Fee-for-Service	1679798656	1679798656	1	1	HATHAWAY, ELIZABETH GAIL	3/8/2007	163W00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1344 N ATKINS PL	None	PORTERVILLE	CA	93257	1020	54	06107	36.09001936	-119.0478852	Tulare County
41164	Fee-for-Service	1164507869	1164507869	1	1	HSIAO, RAY J MD	12/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70571	08	Family Practice	0	In state provider	None	1850 S AZUSA AVE	STE 308	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
41187	Fee-for-Service	1932524097	1932524097	1	1	HOLLE, TYLER C	4/9/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	9625 MONTE VISTA AVE	STE 102	MONTCLAIR	CA	91763	2234	36	06071	34.08006762	-117.6982272	San Bernardino County
41188	Fee-for-Service	1972598639	1972598639	1	1	HACKFORD, THOMAS N MD	12/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77102	41	Internal Medicine	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
41210	Fee-for-Service	1730391020	1730391020	2	1	HOANGQUOCGIA, MICHELLE DO M	4/17/2018	207L00000X	NA	Other	026	PHYSICIANS	13341	05	Anesthesiology	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	99243	4306	13	06025	32.78144947	-115.568541	Imperial County
41218	Fee-for-Service	1851840839	1851840839	1	1	H P CHANG MD INC	10/7/2016	207L00000X	NA	Other	026	PHYSICIANS	66328	05	Anesthesiology	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
41227	Fee-for-Service	1093167264	1093167264	1	1	HOLLYWOOD MEDICAL REHABILITA	12/17/2019	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	TION CARE, INC.	5232 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5710	19	06037	34.09810648	-118.304811	Los Angeles County
41256	Fee-for-Service	1023247871	1023247871	1	1	HARRIOTT, ALLISON J MD	10/20/2023	207RC0200X	NA	Other	026	PHYSICIANS	160565	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
41259	Fee-for-Service	1700582772	1700582772	1	1	HALL, ROBIN A LCSW	12/6/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
41269	Fee-for-Service	1528359593	1528359593	1	1	HUANG, ROBERT J MD	8/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122152	10	Gastroenterology (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
41277	Fee-for-Service	1992778120	1992778120	1	1	HO, EMAI MD	12/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2551 W 84TH AVE	None	WESTMINISTER	CO	80031	0000	00	None	39.84905501	-105.0182452	Adams County
41293	Fee-for-Service	1508054800	1508054800	1	1	HOVSEPIAN, LESLIE L PHD	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4565 RUFFNER STREET	STE 210	SAN DIEGO	CA	92111	2259	37	06073	32.823771	-117.157283	San Diego County
41309	Fee-for-Service	1245726199	1245726199	1	1	HARVEY, LINDSEY CNP	8/11/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3910 VISTA WAY	106	OCEANSIDE	CA	92056	4513	37	06073	33.18382239	-117.2937426	San Diego County
41310	Fee-for-Service	1740817451	1740817451	1	1	HARIHARAN, GIRIJA MD	4/21/2023	208M00000X	NA	Other	026	PHYSICIANS	182983	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
41334	Fee-for-Service	1982412045	1982412045	1	1	HOLLY, TAYLOR NP	2/11/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	117 E 8TH ST	SUITE 100	LONG BEACH	CA	90813	4397	19	06037	33.77660645	-118.1920095	Los Angeles County
41344	Fee-for-Service	1073505913	1073505913	1	1	HOLLINGSEAD, JOHN D CPO	7/7/1992	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	8260 MORRO RD	None	ATASCADERO	CA	93422	3954	40	06079	35.47251366	-120.6688389	San Luis Obispo County
41348	Fee-for-Service	1528152295	1528152295	1	1	HOLLINS, VIOLA R MD	6/15/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166997	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1625 STOCKTON BLVD	205	SACRAMENTO	CA	95816	7092	34	06067	38.56554	-121.4664615	Sacramento County
41455	Fee-for-Service	1972990562	1972990562	1	1	HSU, DIANE MD	8/2/2024	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	161194	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
41470	Fee-for-Service	1457911349	1457911349	1	1	HOLLOWAY, EVAN D PHD	6/26/2023	103T00000X	NA	Mental Health Outpatient Services	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
41519	Fee-for-Service	1174062301	1174062301	1	1	HANNAN, MOHAMMED A CRNA	3/9/2017	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
41540	Fee-for-Service	1356754741	1356754741	2	1	HANONO, ABRAHAM OD	8/12/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	894 PALM AVE	STE B	IMPERIAL BEACH	CA	91932	1573	37	06073	32.58408652	-117.114766	San Diego County
41544	Fee-for-Service	1952366650	1952366650	1	1	HEIDARI, SHIREEN O MD	8/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90499	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5821 JAMESON CT	None	CARMICHAEL	CA	95608	0820	34	06067	38.651409	-121.3290945	Sacramento County
41602	Fee-for-Service	1912233792	1912233792	1	1	HERLING, JENNIFER L	3/5/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
41607	Fee-for-Service	1396977278	1396977278	1	1	HOYE, AUBREY J DO	1/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1600 MEDICAL PARKWAY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
41618	Fee-for-Service	1598950107	1598950107	1	1	HO, JIMMY LMFT	7/8/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
41627	Fee-for-Service	1275013013	1275013013	1	1	HUSTEAD, JERICA LMFT	6/5/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1789 W YOSEMITE AVE	None	MANTECA	CA	95337	5160	39	06077	37.79964	-121.246425	San Joaquin County
41632	Fee-for-Service	1073618633	1073618633	1	1	HABASHY, MICHAEL F MD	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	83772	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
41646	Fee-for-Service	1205276714	1205276714	1	1	HERNANDEZ, IRMA L MD	10/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136130	01	General 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
41689	Fee-for-Service	1548462955	1548462955	1	1	HENDERSON, ANDREA LCSW	4/16/2024	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
41698	Fee-for-Service	1326259680	1326259680	1	1	HIRSCH, DANNAH L MD	7/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84399	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
41719	Fee-for-Service	1235751918	1235751918	1	1	HOBBINS, MARK MD	8/27/2023	207R00000X	NA	Other	026	PHYSICIANS	188538	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
41720	Fee-for-Service	1619326113	1619326113	1	1	HALL, JOSEPH	8/14/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	151011	36	Psychiatry	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
41763	Fee-for-Service	1487684965	1487684965	1	1	HARRISON, GEORGE H MD	2/14/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	72867	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
41816	Fee-for-Service	1144635731	1144635731	1	1	HANIF, AISHA MD	7/19/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	144509	08	Family Practice	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
41821	Fee-for-Service	1003176017	1003176017	1	1	HAJDU, LANNY D	2/4/2025	174400000X	NA	Other	026	PHYSICIANS	43452	41	Internal Medicine	0	In state provider	None	8383 WILSHIRE BLVD	STE 800 OFFICE 889	BEVERLY HILLS	CA	90211	2440	19	06037	34.06457438	-118.3736146	Los Angeles County
41827	Fee-for-Service	1184222671	1184222671	1	1	HOPE SOARS BEHAVIORAL HEALTH	7/13/2021	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	INC	14393 PARK AVE	STE 200	VICTORVILLE	CA	92392	3302	36	06071	34.5123	-117.3248825	San Bernardino County
41898	Fee-for-Service	1902244882	1902244882	1	1	HAMILTON, NICOLE K OD	10/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9333 E ROSECRANS AVE	None	BELLFLOWER	CA	90706	2141	19	06037	33.90413858	-118.1346616	Los Angeles County
41909	Fee-for-Service	1043686355	1043686355	1	1	HEDDEN, DAVID M LMFT	9/10/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	534 B ST	None	SANTA ROSA	CA	95401	5211	49	06097	38.44296	-122.7177585	Sonoma County
41996	Fee-for-Service	1326112913	1326112913	1	1	HANNA, SAMEH R MD	6/25/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	168064	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
42014	Fee-for-Service	1699139287	1699139287	1	1	HSIAO, JOSEPH S MD	10/15/2021	207RE0101X	NA	Endocrinology	026	PHYSICIANS	153987	None	None	0	In state provider	None	845 LA VETA	STE 108	ORANGE	CA	92868	3930	30	06059	33.78064548	-117.8611107	Orange County
42042	Fee-for-Service	1689767196	1689767196	1	1	HARTLEROAD, JEFFREY Y MD	8/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74469	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
42055	Fee-for-Service	1376590554	1376590554	1	1	HAAG, ROBERT K MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52930	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
42074	Fee-for-Service	1003338500	1003338500	1	1	HODGSON, STEPHANIE A NP	4/25/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
42103	Fee-for-Service	1245961887	1245961887	1	1	HEATHER SCHWARTZ COUNSELING	9/10/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CORP	427 F ST	SUITE 208	EUREKA	CA	95501	1049	12	06023	40.80253539	-124.1660942	Humboldt County
42115	Fee-for-Service	1760579718	1760579718	1	1	HO, PHILIP T MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88334	84	Surgery-Head and Neck	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
42140	Fee-for-Service	1154748325	1154748325	1	1	HASTY, BRITTANY MD	9/30/2024	2086S0120X	NA	General Surgery	026	PHYSICIANS	152087	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
42142	Fee-for-Service	1396943817	1396943817	1	1	HSII, ANNE C MD	1/23/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	98570	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
42193	Fee-for-Service	1558630665	1558630665	1	1	HUTHMAN, MICHAEL	11/26/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
42218	Fee-for-Service	1376565374	1376565374	1	1	HARSOLIA, ASIF R MD	10/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99453	78	Neoplastic Diseases/Oncology	0	In state provider	None	3800 HOMESTEAD RD	None	SANTA CLARA	CA	95051	4542	43	06085	37.3377485	-122.001453	Santa Clara County
42285	Fee-for-Service	1326112913	1326112913	1	1	HANNA, SAMEH R MD	6/25/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	168064	41	Internal Medicine	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
42302	Fee-for-Service	1386838696	1386838696	1	1	HAIDER, UZMA T MD	6/12/2021	207RE0101X	NA	Endocrinology	026	PHYSICIANS	94425	None	None	0	In state provider	None	1515 W FLORIDA AVE	None	HEMET	CA	92543	3817	33	06065	33.74738653	-116.9879535	Riverside County
42320	Fee-for-Service	1578631560	1578631560	1	1	HANEGAN, LORRAINE A H	6/3/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	CRNA	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
42365	Fee-for-Service	1861919573	1861919573	1	1	HEALTHRIGHT 360	11/1/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3355 MISSION AVE	STE 234-237 & 239	OCEANSIDE	CA	92058	1326	37	06073	33.21762263	-117.3420186	San Diego County
42374	Fee-for-Service	1730489899	1730489899	1	1	HAILEY, LOVELLA S NP	11/4/2016	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
42387	Fee-for-Service	1972609295	1972609295	1	1	HAHN, RHODA K MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	55207	36	Psychiatry	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
42401	Fee-for-Service	1699353177	1699353177	1	1	HATAMI, NEGIN MD	10/21/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
42426	Fee-for-Service	1649204009	1649204009	1	1	HEGSTAD, DOUGLAS R MD	5/12/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	45118	41	Internal Medicine	0	In state provider	None	6926 BROCKTON AVE	STE 6	RIVERSIDE	CA	92506	3804	33	06065	33.947919	-117.3967225	Riverside County
42432	Fee-for-Service	1366897043	1366897043	1	1	HONMA, JEFFREY S CPO	8/29/2016	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	7700 IMPERIAL HWY	STE E2	DOWNEY	CA	90242	3469	19	06037	33.92670648	-118.1580043	Los Angeles County
42437	Fee-for-Service	1831116862	1831116862	1	1	HESKETT, TAMMY 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	2801 N GANTENBEIN AVE	None	PORTLAND	OR	97227	1623	00	None	45.54387841	-122.6696022	Multnomah County
42455	Fee-for-Service	1841218880	1841218880	1	1	HAN, STEVEN-HUY B MD	7/31/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	72513	41	Internal Medicine	0	In state provider	None	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	19	06037	33.929829	-118.157607	Los Angeles County
42473	Fee-for-Service	1124524228	1124524228	1	1	HEIN, PAUL N MD	8/1/2022	207P00000X	NA	Other	026	PHYSICIANS	179932	None	None	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
42483	Fee-for-Service	1154725521	1154725521	1	1	HERNANDEZ SALDIVAR, MIRNA V	12/17/2021	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
42490	Fee-for-Service	1013756980	1013756980	1	1	HANFORD HEALTHCARE INC	8/14/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1870 W LACEY BLVD	None	HANFORD	CA	93230	7301	16	06031	36.330183	-119.675349	Kings County
42493	Fee-for-Service	1851834840	1851834840	1	2	HEALTHCARE PHYSICAL THERAPY,	8/6/2019	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC.	12598 CENTRAL AVENUE	102A	CHINO	CA	91710	3530	36	06071	34.02430506	-117.6894721	San Bernardino County
42514	Fee-for-Service	1396151213	1396151213	1	1	HUANG, LUCILLE NP	8/19/2017	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
42524	Fee-for-Service	1609299957	1609299957	1	1	HARDEN, COURTNEY S LCSW	10/10/2019	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
42551	Fee-for-Service	1275017782	1275017782	1	1	HERNANDEZ, CARLA LCSW	3/25/2025	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
42564	Fee-for-Service	1154312536	1154312536	1	1	HACK, BRADFORD H MD	2/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	46616	20	Orthopedic Surgery	0	In state provider	None	301 W HUNTINGTON DR	STE 408	ARCADIA	CA	91007	1502	19	06037	34.13481053	-118.0425638	Los Angeles County
42607	Fee-for-Service	1144332560	1144332560	1	1	HARDY, JAMES C MD	9/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86353	66	Emergency Medicine (Urgent Care)	0	In state provider	None	301 E 13TH ST	None	MERCED	CA	95340	6211	24	06047	37.29248035	-120.4730619	Merced County
42623	Fee-for-Service	1669597746	1669597746	1	1	HSU, CHUN X MD	10/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	159011	10	Gastroenterology (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
42625	Fee-for-Service	1447266010	1447266010	1	1	HOWDIESHELL, THOMAS	9/28/2008	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
42681	Fee-for-Service	1710939962	1710939962	1	1	HEMATOLOGY ONCOLOGY	1/1/1979	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	MED GRP OF ORANGE CO	1010 W LA VETA	STE 200	ORANGE	CA	92868	4228	30	06059	33.78028244	-117.8635552	Orange County
42686	Fee-for-Service	1518016898	1518016898	1	1	HUANG, STEVE YAU-E MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	62893	25	Physical Medicine and Rehabilitation	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
42700	Fee-for-Service	1760565428	1760565428	1	1	HOLSCHEN, JOLIE C MD	12/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54317	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
42706	Fee-for-Service	1912315052	1912315052	1	1	HIRAD, SARA LMFT	11/5/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9666 BUSINESSPARK AVENUE	SUITE 207	SAN DIEGO	CA	92131	1646	37	06073	32.89839401	-117.1124102	San Diego County
42713	Fee-for-Service	1528141520	1528141520	1	1	HOSSAIN, NAGMA A MD	2/16/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	88596	None	None	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
42728	Fee-for-Service	1447876552	1447876552	1	1	HR HOSPICE CARE INC	12/22/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8823 FENWICK ST	STE B	SUNLAND	CA	91040	1903	19	06037	34.2613351	-118.324758	Los Angeles County
42733	Fee-for-Service	1518161967	1518161967	1	1	HELPING KIDS TO RECOVER, INC	9/3/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	637 E ALBERTONI ST	SUITE 200, 201 , 203	CARSON	CA	90746	1543	19	06037	33.87193192	-118.2647009	Los Angeles County
42744	Fee-for-Service	1518297753	1518297753	1	1	HARPER, MARY K DO	4/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
42748	Fee-for-Service	1881786002	1881786002	1	1	HOEHNE, FRANCESCA M MD INC	8/12/2005	208600000X	NA	General Surgery	026	PHYSICIANS	78908	78	Neoplastic Diseases/Oncology	0	In state provider	None	500 OLD RIVER RD	STE 250	BAKERSFIELD	CA	93311	9515	15	06029	35.35127492	-119.1142991	Kern County
42771	Fee-for-Service	1093913667	1093913667	1	1	HIESINGER, WILLIAM MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141989	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
42775	Fee-for-Service	1952326399	1952326399	1	1	HALPERN, CRAIG LCSW	1/31/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	317 W F ST	None	ONTARIO	CA	91762	3205	36	06071	34.06932	-117.6542865	San Bernardino County
42785	Fee-for-Service	1467123604	1467123604	1	1	HOANG, KIM M NP	10/26/2021	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
42801	Fee-for-Service	1871927962	1871927962	1	1	HONG, SEOGEUN MD	9/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131303	41	Internal Medicine	0	In state provider	None	1010 W LA VETA AVE	STE 750	ORANGE	CA	92868	4312	30	06059	33.78028244	-117.8635552	Orange County
42803	Fee-for-Service	1053575282	1053575282	1	1	HSIAO, HSING F OD	1/6/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	None	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
42868	Fee-for-Service	1669434684	1669434684	1	1	HOME OF GUIDING HANDS	8/26/1999	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	8318 RUMSON DR	None	SANTEE	CA	92071	2251	37	06073	32.84553447	-117.022284	San Diego County
42884	Fee-for-Service	1790015881	1790015881	1	1	HOFFMAN, CAREN T MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130960	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
42906	Fee-for-Service	1154571297	1154571297	1	1	HAUCK, JESSE H LMFT	7/23/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	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
42935	Fee-for-Service	1093165581	1093165581	1	1	HEALTHY CONNECTIONS COUNSELI	8/16/2024	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	NG CENTER	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
42937	Fee-for-Service	1821435637	1821435637	1	1	HEIDARI, PANIZ DO	1/10/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	15478	15	Obstetrics (D.O. only)	0	In state provider	None	18300 ROSCOE BLVD.	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
42945	Fee-for-Service	1265059901	1265059901	1	1	HECKER, CHARLENE K LMFT	2/25/2025	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
42969	Fee-for-Service	1710939962	1710939962	1	1	HEMATOLOGY ONCOLOGY	1/1/1979	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MED GRP OF ORANGE CO	1010 W LA VETA	STE 200	ORANGE	CA	92868	4228	30	06059	33.78028244	-117.8635552	Orange County
43018	Fee-for-Service	1447876552	1447876552	1	1	HR HOSPICE CARE INC	12/22/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8823 FENWICK ST	STE B	SUNLAND	CA	91040	1903	19	06037	34.2613351	-118.324758	Los Angeles County
43036	Fee-for-Service	1881786002	1881786002	1	1	HOEHNE, FRANCESCA M MD INC	8/12/2005	208600000X	NA	General Surgery	026	PHYSICIANS	78908	02	General Surgery	0	In state provider	None	500 OLD RIVER RD	STE 250	BAKERSFIELD	CA	93311	9515	15	06029	35.35127492	-119.1142991	Kern County
43057	Fee-for-Service	1891180568	1891180568	1	1	HAWKINS, MORGAN J MD	7/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144371	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
43060	Fee-for-Service	1093913667	1093913667	1	1	HIESINGER, WILLIAM MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141989	33	Thoracic Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
43086	Fee-for-Service	1780655670	1780655670	1	1	HOSPITAL OF BARSTOW INC	1/13/1993	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	820 E MOUNTAIN VIEW ST	None	BARSTOW	CA	92311	3004	36	06071	34.89327944	-117.0174383	San Bernardino County
43087	Fee-for-Service	1922586403	1922586403	1	1	HARTFORD, TYLER LMFT	11/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	1	Border provider	None	115 E BUTLER LANE	None	ASHLAND	OR	97520	7520	00	None	42.23235237	-122.739308	Jackson County
43114	Fee-for-Service	1427033125	1427033125	1	1	HOCH, WILLIAM H MD	11/19/1998	208800000X	NA	Other	026	PHYSICIANS	24530	34	Urology and Urological Surgery	0	In state provider	None	2020 SUTTER PL	STE 102	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
43121	Fee-for-Service	1083858740	1083858740	1	1	HUSAIN, KAMRAN MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113257	05	Anesthesiology	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
43129	Fee-for-Service	1285155697	1285155697	1	1	HENDERSON, HUNTER J CCC-SLP	4/18/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1251 E DYER RD	SUITE 150	SANTA ANA	CA	92705	5662	30	06059	33.70870351	-117.8551005	Orange County
43137	Fee-for-Service	1437210879	1437210879	1	1	HITTALMANI, SHANKAR N MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	35513	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
43154	Fee-for-Service	1720220841	1720220841	2	2	HERMESCH, AMY MD	7/7/2023	207VM0101X	NA	Obstetrics & Gynecology	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
43158	Fee-for-Service	1740513647	1740513647	1	1	HUANG, FRANK MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125263	29	Pulmonary Diseases (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
43188	Fee-for-Service	1194053116	1194053116	1	1	HETRICK, LLUVIA J LMFT	3/2/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3615 BECHELLI LANE	None	REDDING	CA	96002	2429	45	06089	40.55480112	-122.3625666	Shasta County
43216	Fee-for-Service	1376681304	1376681304	1	1	HUANG, TANNIE Q MD	7/1/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	98778	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
43221	Fee-for-Service	1346412533	1346412533	1	1	HEGDE, SHAINY B MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114453	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
43226	Fee-for-Service	1093165581	1093165581	1	1	HEALTHY CONNECTIONS COUNSELI	8/16/2024	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	NG CENTER	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
43227	Fee-for-Service	1821435637	1821435637	1	1	HEIDARI, PANIZ DO	1/10/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	15478	09	Gynecology (D.O. only)	0	In state provider	None	18300 ROSCOE BLVD.	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
43263	Fee-for-Service	1710939962	1710939962	1	1	HEMATOLOGY ONCOLOGY	1/1/1979	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	MED GRP OF ORANGE CO	1010 W LA VETA	STE 200	ORANGE	CA	92868	4228	30	06059	33.78028244	-117.8635552	Orange County
43289	Fee-for-Service	1699278978	1699278978	1	1	HE, JIANHONG CNP	6/22/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	19	06037	34.01379685	-118.4159354	Los Angeles County
43300	Fee-for-Service	1780845909	1780845909	1	1	HAN, TERESA M MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119936	15	Obstetrics (D.O. only)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
43305	Fee-for-Service	1316279813	1316279813	1	1	HAKKAK, FATIMA H DO INC	2/25/2011	174400000X	NA	Other	026	PHYSICIANS	10650	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	685 N 13TH AVENUE	#10	UPLAND	CA	91786	4165	36	06071	34.10202219	-117.6339091	San Bernardino County
43332	Fee-for-Service	1366071052	1366071052	1	1	HOVSEPYAN, AREG MD	10/23/2023	207R00000X	NA	Other	026	PHYSICIANS	187440	None	None	0	In state provider	None	2975 NORTH SYCAMORE DR.	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
43352	Fee-for-Service	1225557937	1225557937	1	1	HAPPY LIFE ADHC INC	12/14/2017	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	4227 LANKERSHIM BLVD	None	TOLUCA LAKE	CA	91602	2856	19	06037	34.14670637	-118.3636551	Los Angeles County
43366	Fee-for-Service	1093882946	1093882946	1	1	HUSSAIN, TANVEER F MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54891	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
43368	Fee-for-Service	1780655670	1780655670	1	1	HOSPITAL OF BARSTOW INC	1/13/1993	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	820 E MOUNTAIN VIEW ST	None	BARSTOW	CA	92311	3004	36	06071	34.89327944	-117.0174383	San Bernardino County
43385	Fee-for-Service	1154325652	1154325652	1	1	HUANG, DAVID MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64100	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
43408	Fee-for-Service	1386787042	1386787042	1	1	HUGGINS, JENNIFER L PHD	9/3/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
43409	Fee-for-Service	1083858740	1083858740	1	1	HUSAIN, KAMRAN MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113257	40	Pediatrics	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
43427	Fee-for-Service	1477841492	1477841492	1	1	HEDAYAT, TINA MD	7/14/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	152672	None	None	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
43431	Fee-for-Service	1942348313	1942348313	1	1	HAVIV, YORAM M MD	11/9/2018	208200000X	NA	General Surgery	026	PHYSICIANS	41860	46	Hand Surgery	0	In state provider	GERY	2001 SANTA MONICA BLVD.	665W	SANTA MONICA	CA	90404	2118	19	06037	34.02891163	-118.4797466	Los Angeles County
43448	Fee-for-Service	1932195195	1932195195	1	1	HENSON, RODNEY D	8/25/2005	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	HENSON O&P ENT	2540 PACIFIC AVE	STE 2B	STOCKTON	CA	95204	4400	39	06077	37.97343421	-121.301734	San Joaquin County
43509	Fee-for-Service	1346412533	1346412533	1	1	HEGDE, SHAINY B MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114453	01	General Practice	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
43511	Fee-for-Service	1093165581	1093165581	1	1	HEALTHY CONNECTIONS COUNSELI	8/16/2024	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	NG CENTER	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
43550	Fee-for-Service	1023160462	1023160462	1	1	HANEHAN, MICHAEL LMFT	5/6/2020	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
43551	Fee-for-Service	1225088164	1225088164	1	1	HWANG, KALENA K MD	5/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89575	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
43555	Fee-for-Service	1730248444	1730248444	1	1	HUH, JOON CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3148 EL CAMINO REAL	STE 106	SANTA CLARA	CA	95051	2930	43	06085	37.35229248	-121.98294	Santa Clara County
43587	Fee-for-Service	1780845909	1780845909	1	1	HAN, TERESA M MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119936	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
43589	Fee-for-Service	1316279813	1316279813	1	1	HAKKAK, FATIMA H DO INC	2/25/2011	174400000X	NA	Other	026	PHYSICIANS	10650	41	Internal Medicine	0	In state provider	None	685 N 13TH AVENUE	#10	UPLAND	CA	91786	4165	36	06071	34.10202219	-117.6339091	San Bernardino County
43593	Fee-for-Service	1295705440	1295705440	1	1	HARR, PHYLLIS	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
43625	Fee-for-Service	1508972944	1508972944	1	1	HUANG, THOMAS L MD	12/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97337	30	Radiology	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
43654	Fee-for-Service	1073193611	1073193611	1	1	HAUEISEN, ALEXANDER J MD	4/30/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	18111 BROOKHURST ST	6400	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
43655	Fee-for-Service	1093882946	1093882946	1	1	HUSSAIN, TANVEER F MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54891	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
43663	Fee-for-Service	1154997385	1154997385	1	1	HINES, MILCAH BIRTH DOULA	1/8/2024	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	19	06037	0	0	None
43664	Fee-for-Service	1861741431	1861741431	1	1	HANI SNOUNOU M.D	5/16/2016	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
43697	Fee-for-Service	1730357039	1730357039	1	1	HAERI, SINA MD	5/15/2023	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	176475	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
43759	Fee-for-Service	1447624226	1447624226	1	1	HIETT, ROXIE LCSW	11/24/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28239	-	NOT APPLICABLE	0	In state provider	None	225 BARSTOW ROAD	None	BARSTOW	CA	92311	2903	36	06071	34.89681047	-117.0229105	San Bernardino County
43783	Fee-for-Service	1164843348	1164843348	1	1	HAHN, GRETCHEN LMFT	3/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	337 E. REDWOOD AVE	B	FORT BRAGG	CA	95437	3549	23	06045	39.4442763	-123.8028239	Mendocino County
43785	Fee-for-Service	1891957957	1891957957	1	1	HO, LINDA C MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121469	01	General Practice	0	In state provider	None	216 W PUEBLO STREET	SUITE A	SANTA BARBARA	CA	93105	6806	42	06083	34.43124151	-119.7211927	Santa Barbara County
43803	Fee-for-Service	1952718447	1952718447	1	1	HUNT, SARA J CNP	4/10/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1350 FLORIN RD	None	SACRAMENTO	CA	95822	4202	34	06067	38.495232	-121.505409	Sacramento County
43824	Fee-for-Service	1275774325	1275774325	1	1	HAGHVERDIAN ABOULIAN,	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103413	40	Pediatrics	0	In state provider	KARINEH MD	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
43831	Fee-for-Service	1548521511	1548521511	1	1	HILDRETH, AMBER N DO	6/1/2021	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	14177	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
43850	Fee-for-Service	1053559914	1053559914	1	1	HOLDER, LINDA J PHD	1/7/2020	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
43854	Fee-for-Service	1457511396	1457511396	1	1	HWANG, JASON S	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113073	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
43876	Fee-for-Service	1083000830	1083000830	1	1	HV HEALTHCARE INC	6/5/2015	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12464 E WASHINGTON BLVD	None	WHITTIER	CA	90602	1005	19	06037	33.96774843	-118.0457572	Los Angeles County
43911	Fee-for-Service	1174614051	1174614051	1	1	HOOK, ERNEST DPM	7/19/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1580 CREEKSIDE DR	STE 100	FOLSOM	CA	95630	3886	34	06067	38.668914	-121.148028	Sacramento County
43974	Fee-for-Service	1174076723	1174076723	1	1	HERNANDEZ, LUS O LCSW	10/5/2023	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
43981	Fee-for-Service	1295316172	1295316172	1	1	HEGDE, SALONI A MD	7/24/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	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
43986	Fee-for-Service	1952931784	1952931784	1	1	HM PSYCHOLOGICAL SERVICES, I	8/17/2020	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	NC.	3130 5TH AVE	8	SAN DIEGO	CA	92103	5839	37	06073	32.73813729	-117.1603812	San Diego County
43990	Fee-for-Service	1194853499	1194853499	1	1	HARBOR HEALTH CARE	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MINUET DIVISION	9634 ROSE ST	None	BELLFLOWER	CA	90706	6622	19	06037	33.8695901	-118.1279385	Los Angeles County
43992	Fee-for-Service	1255619656	1255619656	1	2	HICKEY, ANTONIA M PSYD	12/10/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3826 SAWTELLE BLVD	None	LOS ANGELES	CA	90066	4063	19	06037	34.01058764	-118.4190549	Los Angeles County
44011	Fee-for-Service	1952151862	1952151862	1	1	HINZO, STEPHANIE	5/21/2024	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	15	06029	0	0	None
44017	Fee-for-Service	1326207283	1326207283	1	1	HSIEH, LESLIE Q MD	8/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120282	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
44057	Fee-for-Service	1871545210	1871545210	1	1	HAWKINS, TRACY B DO	9/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	7525	41	Internal Medicine	0	In state provider	None	5TH & ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.741948	-121.848921	Butte County
44064	Fee-for-Service	1437173325	1437173325	1	1	HIGHTOWER, DANIEL J MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73127	30	Radiology	0	In state provider	None	1700 S COURT ST	STE A	VISALIA	CA	93277	4931	54	06107	36.315108	-119.2916925	Tulare County
44073	Fee-for-Service	1891957957	1891957957	1	1	HO, LINDA C MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121469	68	Hematology	0	In state provider	None	216 W PUEBLO STREET	SUITE A	SANTA BARBARA	CA	93105	6806	42	06083	34.43124151	-119.7211927	Santa Barbara County
44074	Fee-for-Service	1336583301	1336583301	1	1	HOFF, JASON M MD	7/17/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	142741	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
44099	Fee-for-Service	1205221843	1205221843	1	1	HOLDEN, SMITA S MD	9/28/2022	2084V0102X	NA	Neurology	026	PHYSICIANS	173202	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
44119	Fee-for-Service	1578799276	1578799276	1	1	HAN, RICHARD J MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128319	None	None	0	In state provider	None	1409 E BRIGGSMORE AVE	None	MODESTO	CA	95355	2707	50	06099	37.66742737	-120.9731413	Stanislaus County
44122	Fee-for-Service	1649987082	1649987082	1	1	HAWKEY, MICHAEL PT	6/3/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1676 EAST 6TH ST	None	BEAUMONT	CA	92223	2550	33	06065	33.92948188	-116.9484306	Riverside County
44131	Fee-for-Service	1447364062	1447364062	1	1	HARDESTY, JEFFREY S MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46835	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
44132	Fee-for-Service	1295783694	1295783694	1	1	HILLARD, PAULA J A MD	4/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87997	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
44135	Fee-for-Service	1588906929	1588906929	1	1	HANNA, PETER MD	8/21/2019	207R00000X	NA	Other	026	PHYSICIANS	133503	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
44163	Fee-for-Service	1255343760	1255343760	1	1	HEINLE, ANDREW T MD	4/29/1999	207L00000X	NA	Other	026	PHYSICIANS	67665	05	Anesthesiology	0	In state provider	None	5469 KEARNY VILLA RD	STE 302	SAN DIEGO	CA	92123	1159	37	06073	32.83298834	-117.1388725	San Diego County
44166	Fee-for-Service	1790833630	1790833630	1	1	HILL, KRISTIE A OD	3/13/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4650 PALM AVE	None	SAN DIEGO	CA	92154	8404	37	06073	32.5839467	-117.0337851	San Diego County
44167	Fee-for-Service	1992075386	1992075386	1	1	HARRIS, DANIELLE S CP	10/22/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3625 E THOUSAND OAKS BLV	106	WESTLAKE VILLAGE	CA	91362	3551	19	06037	34.16480359	-118.8299997	Ventura County
44179	Fee-for-Service	1952369407	1952369407	1	1	HAWORTH, LOREN I MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74745	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
44207	Fee-for-Service	1295134393	1295134393	1	1	HAYMAN, YISRAELA J LMFT	9/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1827 VIRGINIA RD	None	LOS ANGELES	CA	90019	5938	19	06037	34.04109988	-118.3343684	Los Angeles County
44244	Fee-for-Service	1891385324	1891385324	1	1	HAKIM, TIFFANY LMFT	8/19/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
44247	Fee-for-Service	1396442653	1396442653	1	1	HOM, VERONICA M OD	5/20/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
44249	Fee-for-Service	1457334989	1457334989	1	1	HARRIS, TONI A MD	12/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	48594	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
44256	Fee-for-Service	1518953926	1518953926	1	1	HAJI AMOU ASSAR, MAHDIEH MD	5/12/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	144315	30	Radiology	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
44275	Fee-for-Service	1952931784	1952931784	1	1	HM PSYCHOLOGICAL SERVICES, I	4/29/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	NC.	3130 5TH AVE	8	SAN DIEGO	CA	92103	5839	37	06073	32.73813729	-117.1603812	San Diego County
44281	Fee-for-Service	1215590443	1215590443	1	1	HARIRI, NEEMA DO	8/23/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	20510	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
44338	Fee-for-Service	1225119472	1225119472	1	1	HILL, BRYAN S	7/25/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3959 RUFFIN RD	STE F	SAN DIEGO	CA	92123	1830	37	06073	32.81438099	-117.1216603	San Diego County
44346	Fee-for-Service	1932187457	1932187457	1	1	HOLUM, ROBERT J MFT	6/28/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	40503	-	NOT APPLICABLE	0	In state provider	None	470 CASTRO STREET	None	SAN FRANCISCO	CA	94114	2482	38	06075	37.76132744	-122.4350734	San Francisco County
44361	Fee-for-Service	1336583301	1336583301	1	1	HOFF, JASON M MD	7/17/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	142741	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
44362	Fee-for-Service	1891957957	1891957957	1	1	HO, LINDA C MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121469	02	General Surgery	0	In state provider	None	216 W PUEBLO STREET	SUITE A	SANTA BARBARA	CA	93105	6806	42	06083	34.43124151	-119.7211927	Santa Barbara County
44408	Fee-for-Service	1558127605	1558127605	1	1	HANNAH LEE DPM PROF CORP	1/27/2025	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	101 S SAN MATEO DR	STE 302	SAN MATEO	CA	94401	3844	41	06081	37.56590481	-122.325549	San Mateo County
44418	Fee-for-Service	1447364062	1447364062	1	1	HARDESTY, JEFFREY S MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	46835	08	Family Practice	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
44450	Fee-for-Service	1255664611	1255664611	1	1	HANA MEDICAL CENTER INC	2/17/2010	193200000X	NA	Other	026	PHYSICIANS	54010	41	Internal Medicine	0	In state provider	None	2017 W OLYMPIC BLVD	None	LOS ANGELES	CA	90006	3705	19	06037	34.0514335	-118.2791224	Los Angeles County
44463	Fee-for-Service	1720367659	1720367659	1	1	HORAN, JENNIFER H DO	12/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11855	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
44467	Fee-for-Service	1952369407	1952369407	1	1	HAWORTH, LOREN I MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74745	01	General Practice	0	In state provider	None	445 11TH ST	None	ORANGE COVE	CA	93646	2211	10	06019	36.62723052	-119.319103	Fresno County
44489	Fee-for-Service	1063835213	1063835213	1	1	HERALD CHRISTIAN HEALTH	5/6/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER	1661 HANOVER ROAD	SUITE 103	CITY OF INDUSTRY	CA	91748	1796	19	06037	33.99109665	-117.920988	Los Angeles County
44494	Fee-for-Service	1710367107	1710367107	1	1	HINZ, JOSEPH P	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
44509	Fee-for-Service	1376852889	1376852889	1	1	HASSANI, HOSSEIN MD	10/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	113475	None	None	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6363	50	06099	37.64720049	-120.982338	Stanislaus County
44544	Fee-for-Service	1861491748	1861491748	1	1	HAJJ, AHMAD M. MD	4/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1700 N OREGON ST	STE 540	EL PASO	TX	79902	3559	00	None	31.76954435	-106.4978732	El Paso County
44547	Fee-for-Service	1588812044	1588812044	1	1	HIRUGAMI, CLAUDIA LCSW	6/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9400 E ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
44563	Fee-for-Service	1548232911	1548232911	1	1	HENSLEY, DAVID A MD	4/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74318	36	Psychiatry	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
44564	Fee-for-Service	1306402961	1306402961	1	1	HEENEY, MEGAN E MD	8/12/2024	207P00000X	NA	Other	026	PHYSICIANS	186075	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
44583	Fee-for-Service	1588820518	1588820518	1	1	HUYNH, HELEN T DO	10/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10923	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	600 N GARFIELD AVE	STE 307	MONTEREY PARK	CA	91754	1172	19	06037	34.06820797	-118.1228835	Los Angeles County
44600	Fee-for-Service	1881733731	1881733731	1	1	HOWARTH, CATHRYN MD	1/1/1982	2080P0207X	NA	Hematology	026	PHYSICIANS	34496	40	Pediatrics	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
44614	Fee-for-Service	1225448533	1225448533	1	1	HO, ALLEN L MD	5/17/2022	207T00000X	NA	General Surgery	026	PHYSICIANS	138691	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
44690	Fee-for-Service	1497174957	1497174957	1	1	HU, RONG MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142223	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
44732	Fee-for-Service	1942212279	1942212279	1	1	HARRIS, MICHAEL MD	4/28/1999	174400000X	NA	Other	026	PHYSICIANS	46836	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	STE 601	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
44736	Fee-for-Service	1770094054	1770094054	1	1	HOLISTIC HOSPICE CARE INC	12/12/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12598 CENTRAL AVE	SUITE 212	CHINO	CA	91710	3530	36	06071	34.02430506	-117.6894721	San Bernardino County
44778	Fee-for-Service	1063835213	1063835213	1	1	HERALD CHRISTIAN HEALTH	5/6/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER	1661 HANOVER ROAD	SUITE 103	CITY OF INDUSTRY	CA	91748	1796	19	06037	33.99109665	-117.920988	Los Angeles County
44788	Fee-for-Service	1114960861	1114960861	1	1	HIROSO, THOMAS G MD	5/1/1999	207ZP0102X	NA	Other	026	PHYSICIANS	66676	22	Pathology (M.D. only)	0	In state provider	None	1437 LOMITA BLVD	None	HARBOR CITY	CA	90710	2041	19	06037	33.79784951	-118.303308	Los Angeles County
44821	Fee-for-Service	1124072467	1124072467	1	1	HERZIG, CHRISTOPHER E MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	54959	None	None	0	In state provider	None	401 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4227	42	06083	34.42940104	-119.7230763	Santa Barbara County
44866	Fee-for-Service	1952458929	1952458929	1	1	HAZZAN, SAMAR MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73965	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
44897	Fee-for-Service	1760633630	1760633630	1	1	HODIKIAN, RAFFI MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107319	41	Internal Medicine	0	In state provider	None	210 W SAN BERNARDINO RD	None	COVINA	CA	91722	5108	19	06037	34.088004	-117.893475	Los Angeles County
44919	Fee-for-Service	1689617581	1689617581	1	1	HWANG, JIMEE MD	10/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86731	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
44928	Fee-for-Service	1568422079	1568422079	1	1	HELEEM, JAMAL A MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149814	41	Internal Medicine	0	In state provider	None	3000 Q ST	FL 3	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
44985	Fee-for-Service	1659312593	1659312593	1	36	HEALTHCARE PARTNERS AFFILIAT	3/19/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	13357 SOUTH STREET	None	CERRITOS	CA	90703	7308	19	06037	33.85879153	-118.0466145	Los Angeles County
45011	Fee-for-Service	1376581934	1376581934	1	1	HUFFER, BRUCE R MD	6/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	46464	20	Orthopedic Surgery	0	In state provider	None	150 N JACKSON AVE	STE 104	SAN JOSE	CA	95116	1908	43	06085	37.36190683	-121.8468659	Santa Clara County
45012	Fee-for-Service	1750596631	1750596631	1	1	HADLEY, ZACHARY S MD	9/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102486	20	Orthopedic Surgery	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
45019	Fee-for-Service	1942212279	1942212279	1	1	HARRIS, MICHAEL MD	4/28/1999	174400000X	NA	Other	026	PHYSICIANS	46836	67	Endocrinology	0	In state provider	None	250 N ROBERTSON BLVD	STE 601	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
45026	Fee-for-Service	1770094054	1770094054	1	1	HOLISTIC HOSPICE CARE INC	12/12/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12598 CENTRAL AVE	SUITE 212	CHINO	CA	91710	3530	36	06071	34.02430506	-117.6894721	San Bernardino County
45066	Fee-for-Service	1588917058	1588917058	1	1	HENRY, SUE M OT	8/17/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	911 BERN CT	STE 140	SAN JOSE	CA	95112	1242	43	06085	37.37594797	-121.8941096	Santa Clara County
45106	Fee-for-Service	1356435713	1356435713	1	1	HENTELEFF, RONALD A OD	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	13029 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	2925	19	06037	34.1867115	-118.4164695	Los Angeles County
45152	Fee-for-Service	1194884171	1194884171	1	1	HINES, LATANYA R MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65104	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
45168	Fee-for-Service	1962898601	1962898601	1	1	HDMC HOLDINGS, LLC	11/20/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	SUITE A-5	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
45212	Fee-for-Service	1275363616	1275363616	1	1	HOOPER, GRACE	9/12/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	431 N ESCONDIDO BLVD	None	ESCONDIDO	CA	92025	2625	37	06073	33.12384583	-117.0867814	San Diego County
45237	Fee-for-Service	1083847107	1083847107	1	1	HERRERA, RICARDO	7/11/2011	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
45261	Fee-for-Service	1962563262	1962563262	1	1	HAIGHT, DEBORAH A CRNA	3/16/2004	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
45263	Fee-for-Service	1659312593	1659312593	1	30	HEALTHCARE PARTNERS AFFILIAT	3/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	AFFILIATES MEDICAL GROUP	4910 AIRPORT PLAZA DRIVE	SUITE 100	LONG BEACH	CA	90815	1264	19	06037	33.80854316	-118.1359209	Los Angeles County
45273	Fee-for-Service	1659312593	1659312593	1	36	HEALTHCARE PARTNERS AFFILIAT	3/19/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	13357 SOUTH STREET	None	CERRITOS	CA	90703	7308	19	06037	33.85879153	-118.0466145	Los Angeles County
45289	Fee-for-Service	1023158664	1023158664	1	1	HAIT, JEANNETTE B	10/9/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	44630 MONTEREY AVE	SUITE 100	PALM DESERT	CA	92260	3326	33	06065	33.72415798	-116.3912386	Riverside County
45306	Fee-for-Service	1669696753	1669696753	1	1	HAN, DUKE S PHD	7/26/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06269295	-118.2030006	Los Angeles County
45326	Fee-for-Service	1124155387	1124155387	1	1	HAMILTON, AMBER L LMFT	9/10/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45644	-	NOT APPLICABLE	0	In state provider	None	1207 EAST FRUIT ST	None	SANTA ANA	CA	92701	4206	30	06059	33.75238847	-117.8539245	Orange County
45396	Fee-for-Service	1861780645	1861780645	1	1	HILBERT, KATE L	2/3/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST 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
45414	Fee-for-Service	1962545459	1962545459	1	1	HATCH, KIEU L 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
45456	Fee-for-Service	1699084665	1699084665	1	1	HALL, MARINA OT	6/1/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	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
45458	Fee-for-Service	1538422092	1538422092	1	1	HOEGER, YUMIKO E MD	6/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132743	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
45482	Fee-for-Service	1306398805	1306398805	1	1	HIXSON, CHERYL A LMFT	7/16/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6276 N 1ST ST	STE 103	FRESNO	CA	93710	5400	10	06019	36.82794977	-119.7721574	Fresno County
45491	Fee-for-Service	1427013663	1427013663	1	2	HEALTHWISE HOME CARE	2/11/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1100 N VENTURA RD	STE 102	OXNARD	CA	93030	3841	56	06111	34.212771	-119.1944035	Ventura County
45531	Fee-for-Service	1629254024	1629254024	1	1	HORIZON SERVICES INC	6/4/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3837, 3839, 3841, 3843	3845, 3847 TELEGRAPH AVE	OAKLAND	CA	94609	2419	01	06001	0	0	None
45553	Fee-for-Service	1659312593	1659312593	1	30	HEALTHCARE PARTNERS AFFILIAT	6/20/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	4910 AIRPORT PLAZA DRIVE	SUITE 100	LONG BEACH	CA	90815	1264	19	06037	33.80854316	-118.1359209	Los Angeles County
45555	Fee-for-Service	1699453886	1699453886	1	1	HAGAN, NATALIE NP	11/2/2023	208600000X	NA	General Surgery	007	CERTIFIED NURSE PRACTIONER	-	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
45564	Fee-for-Service	1659312593	1659312593	1	36	HEALTHCARE PARTNERS AFFILIAT	5/11/2021	204C00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	13357 SOUTH STREET	None	CERRITOS	CA	90703	7308	19	06037	33.85879153	-118.0466145	Los Angeles County
45574	Fee-for-Service	1376943183	1376943183	1	1	HAMEER, MUNEER A MD	7/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147550	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
45577	Fee-for-Service	1184619892	1184619892	1	1	HORTON, CURTIS C MD	2/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82215	02	General Surgery	0	In state provider	None	2001 4TH AVENUE	None	SAN DIEGO	CA	92103	2303	37	06073	32.72663119	-117.1611714	San Diego County
45611	Fee-for-Service	1710235510	1710235510	1	1	HAMLINE, MICHELLE Y MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136659	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
45629	Fee-for-Service	1730311507	1730311507	1	1	HUI, ANDREA M MD	1/3/2017	207N00000X	NA	Dermatology	026	PHYSICIANS	131152	07	Dermatology	0	In state provider	None	555 S DORA ST	STE B	UKIAH	CA	95482	5424	23	06045	39.14592307	-123.211583	Mendocino County
45638	Fee-for-Service	1679675029	1679675029	1	1	HAMAKO, CONRAD	12/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	25285	18	Ophthalmology	0	In state provider	None	160 GREEN VALLEY RD	STE 202	FREEDOM	CA	95019	3160	44	06087	36.93732602	-121.7715374	Santa Cruz County
45667	Fee-for-Service	1871240465	1871240465	1	1	HUYNH, MICHAEL PT	3/9/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10900 WARNER AVE	STE 117	FOUNTAIN VALLEY	CA	92708	7203	30	06059	33.71628153	-117.9388215	Orange County
45677	Fee-for-Service	1598262925	1598262925	1	1	HUDSON, CINDY T MD	4/3/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	165523	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
45710	Fee-for-Service	1730232356	1730232356	1	1	HALL, KIMBERLY A S PSYD	6/8/2018	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
45715	Fee-for-Service	1851465603	1851465603	1	1	HUNTINGTON ORTHOPEDICS	7/16/2009	207X00000X	NA	Orthopedic Surgery	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	SURGICAL MEDICAL GROUP	10 CONGRESS ST	STE 103	PASADENA	CA	91105	3027	19	06037	34.13396893	-118.1528162	Los Angeles County
45722	Fee-for-Service	1235658485	1235658485	1	1	HOANG, ANDY MD	7/8/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	177364	None	None	0	In state provider	None	1306 MARICOPA HIGHWAY	None	OJAI	CA	93023	3131	56	06111	34.44229705	-119.2645703	Ventura County
45839	Fee-for-Service	1659312593	1659312593	1	30	HEALTHCARE PARTNERS AFFILIAT	2/19/2019	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	4910 AIRPORT PLAZA DRIVE	SUITE 100	LONG BEACH	CA	90815	1264	19	06037	33.80854316	-118.1359209	Los Angeles County
45860	Fee-for-Service	1194922153	1194922153	1	1	HAW, KIMBERLY H OD	10/12/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1377 MACARTHUR BLVD	None	SAN LEANDRO	CA	94577	3918	01	06001	37.72917298	-122.1387677	Alameda County
45906	Fee-for-Service	1154184190	1154184190	1	1	HIROTA, CARY PT	6/21/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
45921	Fee-for-Service	1902984776	1902984776	1	1	HADLEY, DOUGLAS MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78906	30	Radiology	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
45971	Fee-for-Service	1891731089	1891731089	1	1	HERMANSON, CHRISTOPHER G	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67810	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
45976	Fee-for-Service	1538671383	1538671383	1	1	HUBBARD, MEGAN DO	1/26/2022	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	6900 NORTH DURANGO DRIVE	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
45980	Fee-for-Service	1831366236	1831366236	1	1	HOLLENBECK, ANNETTE M NP	5/29/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	600 NORTH MOUNTAIN AVE	A104	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
45981	Fee-for-Service	1083602825	1083602825	1	1	HOLLY HEAVER JENNINGS MD	8/12/2023	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
45990	Fee-for-Service	1639257389	1639257389	1	1	HOLDEN, PHILIP G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30711	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
46005	Fee-for-Service	1619360435	1619360435	1	1	HUNTER, MARY M NP	11/1/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	320539	-	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
46015	Fee-for-Service	1992907323	1992907323	1	1	HOLMES, SETH M MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	116232	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
46017	Fee-for-Service	1700871183	1700871183	1	1	HELLER,MATT 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	2414 E STATE BLVD	STE # 202	FORTWAYNE	IN	46805	0000	00	None	41.09707528	-85.10753613	Allen County
46036	Fee-for-Service	1306308721	1306308721	1	1	HOPPER, AUSTIN B	7/9/2024	2085R0001X	NA	Other	026	PHYSICIANS	180840	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
46044	Fee-for-Service	1104862366	1104862366	1	1	HARRIS, JAMES B MD	3/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
46064	Fee-for-Service	1942361225	1942361225	1	1	HOLLAND, VIRGIL D OD	3/26/2025	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14210 CULVER DR STE F	None	IRVINE	CA	92604	0313	30	06059	33.70788676	-117.7843445	Orange County
46075	Fee-for-Service	1851425391	1851425391	1	1	HILL, MARTHA LMFT	3/26/2025	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
46083	Fee-for-Service	1659312593	1659312593	1	9	HEALTHCARE PARTNERS AFFILIAT	3/15/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEDICAL GROUP	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
46086	Fee-for-Service	1669907135	1669907135	1	1	HERALD CHRISTIAN HEALTH	3/2/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4320 GENESEE AVENUE	SUITE 103	SAN DIEGO	CA	92117	4900	37	06073	32.82169422	-117.1832742	San Diego County
46094	Fee-for-Service	1558591479	1558591479	1	1	HSU, JENNIFER P MD	6/30/2011	207LC0200X	NA	Other	026	PHYSICIANS	114867	66	Emergency Medicine (Urgent Care)	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
46098	Fee-for-Service	1932376159	1932376159	1	1	HWANG, LISA K MD	9/19/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	104598	None	None	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
46111	Fee-for-Service	1033377023	1033377023	1	1	HAUGEN, THORSEN W MD	8/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121829	04	Otology, Laryngology, Rhinology	0	In state provider	None	2773 HARRIS STREET	SUITE D	EUREKA	CA	95503	4866	12	06023	40.78052829	-124.1363953	Humboldt County
46120	Fee-for-Service	1588058333	1588058333	1	1	HOLGUIN, KATHRYN	10/24/2024	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
46127	Fee-for-Service	1659312593	1659312593	1	30	HEALTHCARE PARTNERS AFFILIAT	3/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	4910 AIRPORT PLAZA DRIVE	SUITE 100	LONG BEACH	CA	90815	1264	19	06037	33.80854316	-118.1359209	Los Angeles County
46155	Fee-for-Service	1487273314	1487273314	1	1	HOLLY ANGELS OF LA HOSPICE	6/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	13615 VICTORY BLVD	STE 113	VAN NUYS	CA	91401	6406	19	06037	34.18671049	-118.429353	Los Angeles County
46172	Fee-for-Service	1598228223	1598228223	1	1	HINAGA, BRENDA OT	11/27/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
46176	Fee-for-Service	1861569881	1861569881	1	1	HTOO, AUNG K MD	8/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83401	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
46187	Fee-for-Service	1568008225	1568008225	1	1	HUYNH, KATHERINE T NP	10/2/2023	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
46211	Fee-for-Service	1437726924	1437726924	1	1	HAZEL, JACQUELINE M LMFT	6/7/2024	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
46226	Fee-for-Service	1952382095	1952382095	1	1	HAFNER, MARK C MD	7/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87487	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
46228	Fee-for-Service	1871533968	1871533968	1	1	HUNT, EVERETT J MD	2/1/1983	207R00000X	NA	Other	026	PHYSICIANS	26312	41	Internal Medicine	0	In state provider	None	2320 BATH ST	STE 105B	SANTA BARBARA	CA	93105	4339	42	06083	34.43082689	-119.7223032	Santa Barbara County
46286	Fee-for-Service	1447800057	1447800057	1	1	HIGHLAND SPRINGS TELENEUROLO	7/29/2020	2084N0400X	NA	Neurology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GY SERVICES A MEDICAL CO	600 N HIGHLAND SPRINGS A	None	BANNING	CA	92220	3046	33	06065	33.9316595	-116.9468639	Riverside County
46299	Fee-for-Service	1053452292	1053452292	1	1	HAMLETT, LILIANA MD	1/1/1993	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	50126	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2820 ALUM ROCK AVE	None	SAN JOSE	CA	95127	5608	43	06085	37.3631929	-121.8334108	Santa Clara County
46319	Fee-for-Service	1982915427	1982915427	1	1	HALONEN, JEFF S DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12212	05	Anesthesiology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
46334	Fee-for-Service	1063865590	1063865590	1	1	HENSEN, ERICA W P OD	6/19/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	425 W BONITA AVE	STE 110B	SAN DIMAS	CA	91773	2543	19	06037	34.10669347	-117.814932	Los Angeles County
46378	Fee-for-Service	1669907135	1669907135	1	1	HERALD CHRISTIAN HEALTH	3/2/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4320 GENESEE AVENUE	SUITE 103	SAN DIEGO	CA	92117	4900	37	06073	32.82169422	-117.1832742	San Diego County
46382	Fee-for-Service	1558591479	1558591479	1	1	HSU, JENNIFER P MD	6/30/2011	207LC0200X	NA	Other	026	PHYSICIANS	114867	05	Anesthesiology	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
46403	Fee-for-Service	1356327134	1356327134	1	1	HUYNH, DANIEL S DO	4/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8644	08	Family Practice	0	In state provider	None	5700 CANOGA AVE	STE 500	WOODLAND HILLS	CA	91367	6582	19	06037	34.17400487	-118.5973608	Los Angeles County
46416	Fee-for-Service	1659312593	1659312593	1	30	HEALTHCARE PARTNERS AFFILIAT	3/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	AFFILIATES MEDICAL GROUP	4910 AIRPORT PLAZA DRIVE	SUITE 100	LONG BEACH	CA	90815	1264	19	06037	33.80854316	-118.1359209	Los Angeles County
46426	Fee-for-Service	1891486387	1891486387	1	1	HAWKEY, REBECCA CRNA	7/17/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
46442	Fee-for-Service	1487273314	1487273314	1	1	HOLLY ANGELS OF LA HOSPICE	6/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	13615 VICTORY BLVD	STE 113	VAN NUYS	CA	91401	6406	19	06037	34.18671049	-118.429353	Los Angeles County
46472	Fee-for-Service	1992753685	1992753685	1	1	HANKINS, JORDAN H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
46493	Fee-for-Service	1194245795	1194245795	1	1	HEHE, KYLE DPM	1/25/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	26691 PLAZA DRIVE	201	MISSION VIEJO	CA	92691	6329	30	06059	33.56533763	-117.6645538	Orange County
46496	Fee-for-Service	1649395906	1649395906	1	1	HEALTHRIGHT 360	1/29/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1776 EDUCATIONAL PARK DR	A 05	SAN JOSE	CA	95133	1703	43	06085	37.36917	-121.857768	Santa Clara County
46501	Fee-for-Service	1841242807	1841242807	1	1	HAYDEN, JONATHAN M MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55343	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
46515	Fee-for-Service	1235621061	1235621061	1	1	HU, LYDIE X LAC	2/1/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	620 E WASHINGTON ST	STE 110	PETALUMA	CA	94952	5911	49	06097	38.24070016	-122.6337031	Sonoma County
46546	Fee-for-Service	1588148670	1588148670	1	1	HASKIN, JOANNA LCSW	10/14/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2926 LONE TREE	None	ANTIOCH	CA	94509	4924	07	06013	37.99273556	-121.8078829	Contra Costa County
46629	Fee-for-Service	1326468661	1326468661	1	1	HSIA, YEN C MD	5/12/2017	390200000X	NA	Other	026	PHYSICIANS	133168	18	Ophthalmology	0	In state provider	None	1001 POTRERO AVE	ROOM 4M31	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
46632	Fee-for-Service	1083110456	1083110456	1	1	HARMSSEN, BROOKE DO	9/7/2022	207R00000X	NA	Other	026	PHYSICIANS	17897	None	None	0	In state provider	None	1509 WILSON TERRACE	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
46665	Fee-for-Service	1598305245	1598305245	1	1	HERMOSILLO, ROSITA D LCSW	3/21/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
46669	Fee-for-Service	1275540114	1275540114	1	1	HUANG, KEVIN T MD	4/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77037	45	Nephrology (Renal-Kidney)	0	In state provider	None	8135 PAINTER AVE	STE 205	WHITTIER	CA	90602	3170	19	06037	33.965829	-118.032738	Los Angeles County
46716	Fee-for-Service	1184858029	1184858029	1	1	HAWKES, JAMES E MD	11/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6900 N DURANGO DR	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
46752	Fee-for-Service	1821220351	1821220351	1	2	HORIZON VALLEY HOME HEALTH	1/14/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	29377 RANCHO CA RD	SUITE 200	TEMECULA	CA	92591	5206	33	06065	33.50543172	-117.1445545	Riverside County
46779	Fee-for-Service	1083781942	1083781942	1	1	HARTMAN, ROGER J MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65797	01	General Practice	0	In state provider	ATTN MGA OFFICE	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
46788	Fee-for-Service	1215962402	1215962402	1	1	HEALEY, PATRICK T MD	8/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88656	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
46830	Fee-for-Service	1265404537	1265404537	2	1	HOPSON, CHRISTINA T DO	12/23/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	6894	41	Internal Medicine	0	In state provider	None	2800 BENEDICT DRIVE	None	SAN LEANDRO	CA	94568	2923	01	06001	37.71593435	-122.131151	Alameda County
46835	Fee-for-Service	1255524427	1255524427	1	1	HASHISHO, MAZEN M MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94329	33	Thoracic Surgery	0	In state provider	None	520 W JUNIPERO STREET	None	SANTA BARBARA	CA	93105	4212	42	06083	34.4292679	-119.7255944	Santa Barbara County
46840	Fee-for-Service	1891972212	1891972212	1	1	HOLLOWAY, BRIAN L MD	8/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99713	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
46859	Fee-for-Service	1922082247	1922082247	1	1	HAHN, YOAV MD	7/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81498	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
46876	Fee-for-Service	1174960686	1174960686	1	1	HUBER, REBECCA E MD	9/22/2021	2084P0804X	NA	Psychiatry	026	PHYSICIANS	133711	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
46901	Fee-for-Service	1225640220	1225640220	1	1	HOLLOWAY, CHRISTOPHER J CO	8/1/2020	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	2240 E GONZALES ROAD	SUITE 260	OXNARD	CA	93036	8220	56	06111	34.21873112	-119.1469396	Ventura County
46924	Fee-for-Service	1336784883	1336784883	1	1	HUYNH, JOHN V	4/2/2020	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	14221 EUCLID ST	SUITE F	GARDEN GROVE	CA	92843	4991	30	06059	33.757191	-117.937638	Orange County
46925	Fee-for-Service	1184936965	1184936965	1	1	HOBERMAN, DANIEL M MD	1/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126130	41	Internal Medicine	0	In state provider	None	450 E ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
46931	Fee-for-Service	1356796536	1356796536	1	1	HARTMANN, PHILLIPP MD	7/8/2022	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	157817	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
46950	Fee-for-Service	1215496609	1215496609	1	1	HUYNH, TERESA MD	8/25/2024	208600000X	NA	General Surgery	026	PHYSICIANS	181104	02	General Surgery	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
47015	Fee-for-Service	1265575047	1265575047	1	1	HELLER, MELBA OTR	2/8/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1327 STILLMAN AVE	None	REDLANDS	CA	92374	4006	36	06071	34.06204958	-117.1587752	San Bernardino County
47017	Fee-for-Service	1073597332	1073597332	1	1	HIRSCH, CALVIN H MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	47136	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
47036	Fee-for-Service	1053355701	1053355701	1	1	HEPGUR, MEHMET F G MD	9/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115019	78	Neoplastic Diseases/Oncology	0	In state provider	None	1180 N INDIAN CANYON DR	E218	PALM SPRINGS	CA	92262	4885	33	06065	33.839505	-116.5455735	Riverside County
47052	Fee-for-Service	1093884447	1093884447	1	1	HADLER, KENNETH MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	48649	22	Pathology (M.D. only)	0	In state provider	None	2325 EL CAMINO REAL	None	PALO ALTO	CA	94306	1620	43	06085	37.42549644	-122.1464806	Santa Clara County
47066	Fee-for-Service	1083781942	1083781942	1	1	HARTMAN, ROGER J MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65797	07	Dermatology	0	In state provider	ATTN MGA OFFICE	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
47122	Fee-for-Service	1376584722	1376584722	1	1	HEWES, EVA H MD	5/20/1987	207W00000X	NA	Ophthalmology	026	PHYSICIANS	24236	18	Ophthalmology	0	In state provider	None	123 DI SALVO AVE	STE G	SAN JOSE	CA	95128	1717	43	06085	37.32628785	-121.9371289	Santa Clara County
47123	Fee-for-Service	1255524427	1255524427	1	1	HASHISHO, MAZEN M MD	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94329	02	General Surgery	0	In state provider	None	520 W JUNIPERO STREET	None	SANTA BARBARA	CA	93105	4212	42	06083	34.4292679	-119.7255944	Santa Barbara County
47127	Fee-for-Service	1891972212	1891972212	1	1	HOLLOWAY, BRIAN L MD	8/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99713	30	Radiology	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
47132	Fee-for-Service	1437194628	1437194628	1	1	HUNTINGTON REHAB MED	12/1/1993	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ASSOCIATES APMC	630 S RAYMOND AVE	STE 120	PASADENA	CA	91105	3283	19	06037	34.13505223	-118.1487761	Los Angeles County
47148	Fee-for-Service	1053590208	1053590208	1	2	HICHANG CHOI, M.D., INC.	8/21/2020	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	3801 KATELLA AVE	STE 207	LOS ALAMITOS	CA	90720	3382	30	06059	33.80318951	-118.066068	Orange County
47155	Fee-for-Service	1780631390	1780631390	1	1	HCA HEALTH SVS OKLAHOMA	6/3/2001	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	UNIV HEALTH PARTNERS	1200 EVERETT DR	None	OKLAHOMA CITY	OK	73104	5047	00	None	35.48160555	-97.49642128	Oklahoma County
47163	Fee-for-Service	1902831894	1902831894	1	1	HSU, CHUN YEN MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	37929	10	Gastroenterology (M.D. only)	0	In state provider	None	600 N GARFIELD AVE	STE 310	MONTEREY PARK	CA	91754	1172	19	06037	34.06820797	-118.1228835	Los Angeles County
47204	Fee-for-Service	1770950040	1770950040	1	1	HILL, TABITHA CCC-SLP	12/5/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	667 LIGHTHOUSE AVE	201	PACIFIC GROVE	CA	93950	2644	27	06053	36.62205802	-121.9200608	Monterey County
47233	Fee-for-Service	1912005307	1912005307	1	1	HIGH DESERT SPEECH AND LANGU	8/7/2018	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	AGE PATHOLOGY CENTER, IN	16785 BEAR VALLEY RD	SUITE 2	HESPERIA	CA	92345	0825	36	06071	34.47087433	-117.2973498	San Bernardino County
47237	Fee-for-Service	1659312593	1659312593	1	23	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	500 ALAMITOS AVENUE	None	LONG BEACH	CA	90802	1614	19	06037	33.77330398	-118.1807838	Los Angeles County
47326	Fee-for-Service	1053355701	1053355701	1	1	HEPGUR, MEHMET F G MD	9/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115019	68	Hematology	0	In state provider	None	1180 N INDIAN CANYON DR	E218	PALM SPRINGS	CA	92262	4885	33	06065	33.839505	-116.5455735	Riverside County
47377	Fee-for-Service	1518057322	1518057322	1	1	HUANG, SUSAN H MD	2/19/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	82228	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
47413	Fee-for-Service	1114937927	1114937927	1	1	HELL, RICHARD W MD	12/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	55116	66	Emergency Medicine (Urgent Care)	0	In state provider	None	17821 PIONEER BLVD	None	ARTESIA	CA	90701	3901	19	06037	33.8691791	-118.0823685	Los Angeles County
47421	Fee-for-Service	1831152040	1831152040	1	1	HARRIS, IRWIN E MD	4/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87574	20	Orthopedic Surgery	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
47433	Fee-for-Service	1487872859	1487872859	1	1	HWANG, HARRY S MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99268	84	Surgery-Head and Neck	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
47442	Fee-for-Service	1902981707	1902981707	1	1	HARRAST, MARK A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HARBORVIEW MEDICAL CTRE	325 9TH AVE	C/O UWP MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
47443	Fee-for-Service	1780631390	1780631390	1	1	HCA HEALTH SVS OKLAHOMA	6/3/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	UNIV HEALTH PARTNERS	1200 EVERETT DR	None	OKLAHOMA CITY	OK	73104	5047	00	None	35.48160555	-97.49642128	Oklahoma County
47452	Fee-for-Service	1902831894	1902831894	1	1	HSU, CHUN YEN MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	37929	41	Internal Medicine	0	In state provider	None	600 N GARFIELD AVE	STE 310	MONTEREY PARK	CA	91754	1172	19	06037	34.06820797	-118.1228835	Los Angeles County
47478	Fee-for-Service	1114018868	1114018868	1	1	HONG, SYDNEY OD	4/20/2017	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1950 AUTO CENTRE DR	None	GLENDORA	CA	91740	6700	19	06037	34.11746952	-117.826875	Los Angeles County
47485	Fee-for-Service	1417268079	1417268079	1	1	HAHN-SMITH, ANNE PHD	11/4/2024	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
47524	Fee-for-Service	1659312593	1659312593	1	23	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	500 ALAMITOS AVENUE	None	LONG BEACH	CA	90802	1614	19	06037	33.77330398	-118.1807838	Los Angeles County
47529	Fee-for-Service	1326354853	1326354853	1	1	HOCHSTIM, CHRISTIAN J MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113584	04	Otology, Laryngology, Rhinology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
47553	Fee-for-Service	1104213693	1104213693	1	1	HALPIN, LAURA MD	9/16/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	155230	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
47587	Fee-for-Service	1417409236	1417409236	1	1	HUTH, ALEXIS LMFT	1/31/2025	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
47601	Fee-for-Service	1366985632	1366985632	1	1	HELLER, JOHN W 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
47637	Fee-for-Service	1861690448	1861690448	1	1	HORECZKO, TIMOTHY A MD	4/15/2008	207P00000X	NA	Other	026	PHYSICIANS	96599	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1937	19	06037	33.808185	-118.1850575	Los Angeles County
47640	Fee-for-Service	1720655079	1720655079	1	1	HOANG, JUSTIN DO	7/8/2024	207R00000X	NA	Other	026	PHYSICIANS	22374	41	Internal Medicine	0	In state provider	None	300 WEST HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
47700	Fee-for-Service	1114937927	1114937927	1	1	HELL, RICHARD W MD	12/1/1995	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	55116	41	Internal Medicine	0	In state provider	None	17821 PIONEER BLVD	None	ARTESIA	CA	90701	3901	19	06037	33.8691791	-118.0823685	Los Angeles County
47719	Fee-for-Service	1710909726	1710909726	1	1	HSU, CARL K MD	12/1/1997	207P00000X	NA	Other	026	PHYSICIANS	53121	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3600 SISK RD	STE 1A	MODESTO	CA	95356	0536	50	06099	37.69033236	-121.0612655	Stanislaus County
47756	Fee-for-Service	1720087323	1720087323	1	1	HAGGERTY, MICHAEL 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	10500 MONTGOMERY ROAD	None	CINCINNATI	OH	45242	0000	00	None	39.252267	-84.3413535	Hamilton County
47801	Fee-for-Service	1487731329	1487731329	1	1	HERDOCIA, ANA S MD	10/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81315	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
47809	Fee-for-Service	1801382379	1801382379	1	1	HAKIM, MATTEEN MD	7/31/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
47810	Fee-for-Service	1124194618	1124194618	1	1	HANNAWAY, BASSAM Z PT	9/24/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2131 ELKS DR	STE 201	SAN BERNARDINO	CA	92404	5544	36	06071	34.13470788	-117.262434	San Bernardino County
47811	Fee-for-Service	1659312593	1659312593	1	23	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 ALAMITOS AVENUE	None	LONG BEACH	CA	90802	1614	19	06037	33.77330398	-118.1807838	Los Angeles County
47828	Fee-for-Service	1801992839	1801992839	1	1	HELTON, DEREK A MD	6/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76208	68	Hematology	0	In state provider	None	910 SYCAMORE AVE	STE 270	VISTA	CA	92081	7852	37	06073	33.15991913	-117.2205623	San Diego County
47837	Fee-for-Service	1205893104	1205893104	1	1	HURST, MICHAEL D DO	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8081	41	Internal Medicine	0	In state provider	None	2151 W GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75424753	-121.455621	San Joaquin County
47842	Fee-for-Service	1619995628	1619995628	1	1	HENRY, ROBERT P JR MD	7/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140995	None	None	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
47846	Fee-for-Service	1821594144	1821594144	1	3	HEARINGLIFE HEARING AID CENT	9/12/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	8953 N CHESTNUT AVE	None	FRESNO	CA	93720	5366	10	06019	36.86634375	-119.7388705	Fresno County
47874	Fee-for-Service	1669409827	1669409827	1	1	HSU, WEI-LI DO	3/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10945	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
47902	Fee-for-Service	1922289115	1922289115	1	1	HILLIARD, SUSAN L LMFT	5/9/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	288 W 9TH ST	None	UPLAND	CA	91786	5949	36	06071	34.0960435	-117.6548445	San Bernardino County
47928	Fee-for-Service	1578766051	1578766051	1	1	HAN, JEONG S MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120603	22	Pathology (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
47961	Fee-for-Service	1619135241	1619135241	1	1	HUYNH, DOQUYEN H MD	8/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110198	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
47975	Fee-for-Service	1528716875	1528716875	1	1	HASSAN, KANWAL LMFT	3/31/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10722 ARROW ROUTE	SUITE 712	RANCHO CUCAMONGA	CA	91730	4841	36	06071	34.09917725	-117.5708877	San Bernardino County
47990	Fee-for-Service	1306833512	1306833512	1	1	HARRINGTON, NIAMH M MD	8/1/1993	208600000X	NA	General Surgery	026	PHYSICIANS	49904	02	General Surgery	0	In state provider	None	1541 FLORIDA AVE	None	MODESTO	CA	95350	4429	50	06099	37.666863	-120.9962775	Stanislaus County
47997	Fee-for-Service	1740711332	1740711332	1	1	HONGO, MEAGHAN V MD	8/24/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	169570	40	Pediatrics	0	In state provider	None	700 17TH ST	None	MODESTO	CA	95354	1209	50	06099	37.64283069	-120.9903982	Stanislaus County
48008	Fee-for-Service	1710909726	1710909726	1	1	HSU, CARL K MD	12/1/1997	207P00000X	NA	Other	026	PHYSICIANS	53121	41	Internal Medicine	0	In state provider	None	3600 SISK RD	STE 1A	MODESTO	CA	95356	0536	50	06099	37.69033236	-121.0612655	Stanislaus County
48014	Fee-for-Service	1083297907	1083297907	1	1	HARIRI, LANA M MD	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	309 WEST BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
48089	Fee-for-Service	1659759348	1659759348	1	1	HASLER, HOLLY M PHD	10/12/2021	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
48107	Fee-for-Service	1477533776	1477533776	1	1	HITCHCOCK, PATRICK 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	2800 E AJO WAY	None	TUCSON	AZ	85713	6204	00	None	32.175801	-110.9306925	Pima County
48112	Fee-for-Service	1205893104	1205893104	1	1	HURST, MICHAEL D DO	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8081	40	Pediatrics	0	In state provider	None	2151 W GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75424753	-121.455621	San Joaquin County
48118	Fee-for-Service	1801992839	1801992839	1	1	HELTON, DEREK A MD	6/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76208	78	Neoplastic Diseases/Oncology	0	In state provider	None	910 SYCAMORE AVE	STE 270	VISTA	CA	92081	7852	37	06073	33.15991913	-117.2205623	San Diego County
48126	Fee-for-Service	1609952597	1609952597	1	1	HAQUE, FAIZUL MD	10/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54874	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	365 HAWTHORNE AVENUE	SUITE 201	OAKLAND	CA	94609	3111	01	06001	37.82079728	-122.2633226	Alameda County
48144	Fee-for-Service	1033106802	1033106802	1	1	HALLORAN, LINDARA L MD	9/5/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	175728	40	Pediatrics	0	In state provider	None	10775 PIONEER TRL	STE 215	TRUCKEE	CA	96161	0234	29	06057	39.33573744	-120.180872	Nevada County
48145	Fee-for-Service	1730281494	1730281494	1	1	HYMAN, NANETTE MD	3/16/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	66205	40	Pediatrics	0	In state provider	None	77 CADILLAC DR	STE 130	SACRAMENTO	CA	95825	8337	34	06067	38.572551	-121.4181585	Sacramento County
48172	Fee-for-Service	1821002858	1821002858	1	1	HONG, CHONG IL MD	10/31/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	29713	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
48183	Fee-for-Service	1992025191	1992025191	1	1	HODOSH, JUDY Z AU	1/25/2021	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
48187	Fee-for-Service	1548445786	1548445786	1	1	HEALTHCARE 2000 MED CORP	2/20/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GUADALUPE FAMILY MED CL	2402 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5727	19	06037	33.97467392	-118.2299851	Los Angeles County
48196	Fee-for-Service	1548623937	1548623937	1	1	HARRIS, BREJON	4/12/2023	103K00000X	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
48238	Fee-for-Service	1952690505	1952690505	1	1	HUERTA, LUIS E MD	9/1/2020	207RC0200X	NA	Other	026	PHYSICIANS	168735	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
48252	Fee-for-Service	1881816411	1881816411	1	1	HICKERSON, ADAM D MD	7/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107318	34	Urology and Urological Surgery	0	In state provider	None	160 E ARTESIA	STE 220	POMONA	CA	91767	2921	19	06037	34.07556833	-117.7507835	Los Angeles County
48255	Fee-for-Service	1497746960	1497746960	1	2	HO, FIRMIN C MD	11/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	44894	41	Internal Medicine	0	In state provider	None	500 N GARFIELD AVE	STE 301	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
48261	Fee-for-Service	1780129163	1780129163	1	1	HILTON MANOR LLC	4/4/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	42 WEST HILTON AVE	None	REDLANDS	CA	92373	7012	36	06071	34.0366545	-117.167823	San Bernardino County
48275	Fee-for-Service	1710045612	1710045612	1	1	HESS, HALEY N PHD	9/6/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
48287	Fee-for-Service	1093961757	1093961757	1	1	HAUSER, DEREK L DO	8/25/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10044	38	Geriatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
48344	Fee-for-Service	1538208574	1538208574	1	1	HALTOM, STEPHEN B MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110640	30	Radiology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
48355	Fee-for-Service	1811699630	1811699630	1	1	HILL, MAXWELL	1/30/2025	390200000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
48356	Fee-for-Service	1861509465	1861509465	1	1	HAIDAR-AHMAD, ZAHI 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 W CLARENDON AVE	STE 375	PHOENIX	AZ	85013	3476	00	None	33.49179	-112.07844	Maricopa County
48407	Fee-for-Service	1235485152	1235485152	1	1	HOM, NICOLE T OD	3/24/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1575 B ST	None	HAYWARD	CA	94541	3017	01	06001	37.67905755	-122.072805	Alameda County
48417	Fee-for-Service	1295962272	1295962272	1	2	HENRY T OISHI OD A PROFESSIO	2/28/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	31843 RANCHO CALIFORNIA	SUITE 100	TEMECULA	CA	92591	5120	33	06065	33.51458011	-117.1034303	Riverside County
48476	Fee-for-Service	1548445786	1548445786	1	1	HEALTHCARE 2000 MED CORP	2/20/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GUADALUPE FAMILY MED CL	2402 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5727	19	06037	33.97467392	-118.2299851	Los Angeles County
48483	Fee-for-Service	1407968274	1407968274	1	1	HILBERMAN, BERNARD M MD	4/28/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	13467	None	None	0	In state provider	None	1505 SOQUEL DR	STE 2	SANTA CRUZ	CA	95065	1716	44	06087	36.98803429	-121.9848045	Santa Cruz County
48513	Fee-for-Service	1366742629	1366742629	1	1	HAKHAMIMI, KAMRON MD	5/11/2023	207QA0401X	NA	Adult Primary Care	026	PHYSICIANS	74169	None	None	0	In state provider	None	191 S BUENA VISTA ST STE	None	BURBANK	CA	91505	4562	19	06037	34.15872557	-118.3283863	Los Angeles County
48519	Fee-for-Service	1023130432	1023130432	1	1	HOLLYWOOD HLTH SERVICES INC	6/4/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	17835 VENTURA BLVD	STE 105	ENCINO	CA	91316	3663	19	06037	34.1633551	-118.5215171	Los Angeles County
48521	Fee-for-Service	1619630860	1619630860	1	1	HEARN, HORNELL CPO	5/10/2022	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3800 WATT AVE	151	SACRAMENTO	CA	95821	2670	34	06067	38.634417	-121.3818435	Sacramento County
48527	Fee-for-Service	1255470415	1255470415	1	1	HALPERN, BARRY R MD	3/18/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	30704	40	Pediatrics	0	In state provider	None	18350 ROSCOE BLVD	STE 502	NORTHRIDGE	CA	91325	4177	19	06037	34.22071855	-118.5341175	Los Angeles County
48542	Fee-for-Service	1023028024	1023028024	1	1	HALPERIN, JONATHAN S MD	6/30/1989	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	62759	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
48544	Fee-for-Service	1497746960	1497746960	1	2	HO, FIRMIN C MD	11/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	44894	10	Gastroenterology (M.D. only)	0	In state provider	None	500 N GARFIELD AVE	STE 301	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
48563	Fee-for-Service	1235917840	1235917840	1	1	HOT WHEELS COURIER SERVICES	11/22/2023	343800000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	355 PARK PLAZA DR	206	DALY CITY	CA	94015	1561	41	06081	37.69628477	-122.4803966	San Mateo County
48614	Fee-for-Service	1467428789	1467428789	1	1	HIUGA STEPHEN GM	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33680	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2277 FAIR OAKS BLVD	STE 355	SACRAMENTO	CA	95825	5595	34	06067	38.575404	-121.4121195	Sacramento County
48654	Fee-for-Service	1457482515	1457482515	1	1	HERZ, KATHERINE E MD	3/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83704	40	Pediatrics	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
48685	Fee-for-Service	1588150361	1588150361	1	1	HARRISON, STEPHANIE	8/13/2018	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	879 W 190TH ST	4TH FL	GARDENA	CA	90248	4223	19	06037	33.85927671	-118.2896516	Los Angeles County
48709	Fee-for-Service	1457060857	1457060857	1	1	HILLSIDE OPTOMETRY INC	1/17/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	16907 SAN FERNANDO MISSI	STE. C3	SAN FERNANDO	CA	91340	4250	19	06037	34.27207425	-118.5004598	Los Angeles County
48715	Fee-for-Service	1477532018	1477532018	1	1	HA, RICHARD J MD	8/3/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	144964	None	None	0	In state provider	None	2780 EUREKA WAY	None	REDDING	CA	96001	0223	45	06089	40.58585835	-122.4124086	Shasta County
48740	Fee-for-Service	1699203489	1699203489	1	1	HADDADIN, ZAID M MD	2/25/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	159460	None	None	0	In state provider	None	2309 ANTONIO AVENUE	None	CAMARILLO	CA	93010	1414	56	06111	34.24435917	-119.0191975	Ventura County
48775	Fee-for-Service	1154096428	1154096428	1	1	HIGGINSON, BRITTANY E CPO	12/13/2021	222Z00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1755 GRASS VALLEY HWY	None	AUBURN	CA	95603	2854	31	06061	38.92773221	-121.0870403	Placer County
48786	Fee-for-Service	1750750220	1750750220	1	1	HOYUM, DESIREE M	11/30/2015	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
48830	Fee-for-Service	1023028024	1023028024	1	1	HALPERIN, JONATHAN S MD	6/30/1989	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	62759	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
48905	Fee-for-Service	1023624152	1023624152	1	1	HOSPICE OF OC INC	10/13/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7430 ORANGETHORPE AVE	None	BUENA PARK	CA	90621	3315	30	06059	33.8589057	-118.003293	Orange County
48916	Fee-for-Service	1336844414	1336844414	1	1	HAWKINS, MITCHELL OT	10/20/2023	225X00000X	NA	Other	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
48926	Fee-for-Service	1790166197	1790166197	1	1	HALL, PHILIP DO	1/8/2024	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
48946	Fee-for-Service	1710798616	1710798616	1	1	HAKOPYAN, ELLEN	3/17/2025	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
48966	Fee-for-Service	1104282789	1104282789	1	1	HERNANDEZ, ADRIANA M MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135706	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
48968	Fee-for-Service	1811941701	1811941701	1	1	HOFFNER, RICHARD JAY MD	12/3/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54567	None	None	0	In state provider	None	5925 SAN VICENTE BLVD	None	LOS ANGELES	CA	90019	6630	19	06037	34.05682871	-118.360716	Los Angeles County
48980	Fee-for-Service	1134535479	1134535479	1	1	HOOVER, ANNIE C	7/8/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
48983	Fee-for-Service	1710410105	1710410105	1	1	HALL, CARA J MD	8/27/2021	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	173347	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
49011	Fee-for-Service	1497863278	1497863278	1	1	HATHOUT, GASSER M MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66261	30	Radiology	0	In state provider	None	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	19	06037	34.32450186	-118.4456317	Los Angeles County
49015	Fee-for-Service	1023196888	1023196888	1	1	HUI, STANLEY C MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66039	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
49027	Fee-for-Service	1033225784	1033225784	1	1	HABIB, ASMA MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142940	41	Internal Medicine	0	In state provider	None	2734 EL CAMINO REAL	None	SANTA CLARA	CA	95051	3041	43	06085	37.35228637	-121.9754073	Santa Clara County
49077	Fee-for-Service	1194342139	1194342139	1	1	HELPING HANDS HOME HEALTH	7/6/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE SERVICES INC	4119 W BURBANK BLVD	STE 128	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
49165	Fee-for-Service	1467617621	1467617621	1	1	HILL, NICOLE M MD	6/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	102418	02	General Surgery	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
49166	Fee-for-Service	1598166126	1598166126	1	1	HICKLIN, JABBAR M PHD	9/25/2014	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
49176	Fee-for-Service	1477670370	1477670370	1	1	HEALTHPRO PHARMACEUTICAL	11/8/2007	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	CONSULTING & MGMNT, CORP	12650 SHERMAN WAY	STE 9	NORTH HOLLYWOOD	CA	91605	5248	19	06037	34.20116854	-118.409013	Los Angeles County
49178	Fee-for-Service	1780767269	1780767269	1	1	HARRELL, PRISCILLA G MD	5/25/2022	207L00000X	NA	Other	026	PHYSICIANS	176678	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
49180	Fee-for-Service	1932327038	1932327038	1	1	HENDERSON, GENEVA A LPCC	1/29/2025	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
49189	Fee-for-Service	1174735294	1174735294	1	1	HWANG, CHRISTINE S MD	1/26/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108248	02	General Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94605	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
49196	Fee-for-Service	1023624152	1023624152	1	1	HOSPICE OF OC INC	10/13/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7430 ORANGETHORPE AVE	None	BUENA PARK	CA	90621	3315	30	06059	33.8589057	-118.003293	Orange County
49217	Fee-for-Service	1245434547	1245434547	1	1	HAFEEZ, ZEBA H MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97151	36	Psychiatry	0	In state provider	None	3554 ROUNDBARN AVE	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
49252	Fee-for-Service	1861618340	1861618340	1	1	HOSKINS, FREDERICK I INC	4/12/1994	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2630 DALEMEAD ST	None	TORRANCE	CA	90505	7027	19	06037	33.79035962	-118.3324529	Los Angeles County
49269	Fee-for-Service	1588781918	1588781918	1	1	HAMMER, MORELLA M LMFT	8/22/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	446 S MARENGO AVE	SUITE A	PASADENA	CA	91101	3113	19	06037	34.138512	-118.1458425	Los Angeles County
49274	Fee-for-Service	1568741494	1568741494	1	1	HELGERSON, ERIN J MD	10/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117804	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
49294	Fee-for-Service	1881011740	1881011740	1	1	HASKINS, MEREDITH E MD	4/21/2018	207R00000X	NA	Other	026	PHYSICIANS	149976	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
49318	Fee-for-Service	1760500664	1760500664	1	1	HAYES, JUNE D.	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4772 TOPEKA DR	None	TARZANA	CA	91356	4728	19	06037	34.15637809	-118.5481105	Los Angeles County
49319	Fee-for-Service	1679621494	1679621494	1	1	HU, KENNETH H MD	5/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74892	08	Family Practice	0	In state provider	MGA OFFICE	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
49353	Fee-for-Service	1487187829	1487187829	1	1	HOFFMAN, SETH MD	10/24/2023	207R00000X	NA	Other	026	PHYSICIANS	169608	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
49371	Fee-for-Service	1114016292	1114016292	1	1	HOCHMAN, FRANK P MD	11/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	36423	08	Family Practice	0	In state provider	None	1900 MOWRY AVE	STE 309	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
49384	Fee-for-Service	1194067660	1194067660	1	1	HARVEY, CARLY R MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155149	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
49398	Fee-for-Service	1043463714	1043463714	1	2	HENRY, MICHAEL R PHD	3/15/2019	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	831 ALAMO DR	STE 5C, 6B, 6C, 6D	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
49406	Fee-for-Service	1982667606	1982667606	1	1	HSIAO, ERIC I MD	12/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65453	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	65 N 14TH ST	None	SAN JOSE	CA	95112	6207	43	06085	37.34351079	-121.8779494	Santa Clara County
49438	Fee-for-Service	1578575395	1578575395	1	1	HERR, GEORGE P MD	8/21/1996	207L00000X	NA	Other	026	PHYSICIANS	24770	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
49441	Fee-for-Service	1114095221	1114095221	1	1	HOYER, KATHERINE L	10/21/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
49473	Fee-for-Service	1518015395	1518015395	1	1	HORNBY, ANN E MD	6/27/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	46590	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
49502	Fee-for-Service	1194132837	1194132837	1	1	HUNTER, JAY M NP	11/26/2018	No Taxonomy Provided	NA	None	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
49504	Fee-for-Service	1093857930	1093857930	1	1	HINTZ, SUSAN R MD	5/1/1999	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	78246	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
49509	Fee-for-Service	1043718950	1043718950	1	1	HAINLEY, DANIEL M CRNA	8/14/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
49545	Fee-for-Service	1467981290	1467981290	1	1	HOWELL HEALTHCARE TO INC	8/17/2018	193400000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	166 N MOORPARK RD	SUITE 102-104	THOUSAND OAKS	CA	91360	4409	56	06111	34.18064394	-118.8759861	Ventura County
49546	Fee-for-Service	1992200398	1992200398	1	1	HESS, ROBERT T	7/18/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	165668	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
49561	Fee-for-Service	1699547604	1699547604	1	1	HUNTER, KAYLA LCSW	11/5/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
49562	Fee-for-Service	1750302188	1750302188	1	1	HA, ROBERT T MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	55299	41	Internal Medicine	0	In state provider	None	9896 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92844	1643	30	06059	33.77397653	-117.959571	Orange County
49566	Fee-for-Service	1154971265	1154971265	1	2	HAWKING STEAM CHARTER	9/19/2019	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOLS INC	1275 30TH STREET	None	SAN DIEGO	CA	92154	3476	37	06073	32.573178	-117.0689035	San Diego County
49605	Fee-for-Service	1124657630	1124657630	1	1	HOWARD, DIANA J MD	9/1/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186674	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
49646	Fee-for-Service	1356582662	1356582662	1	1	HARISH, MONICA G MD	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108424	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
49659	Fee-for-Service	1740358738	1740358738	1	1	HERBOLD, THOMAS A MD	10/9/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	72292	30	Radiology	0	In state provider	None	16661 VENTURA BLVD	STE 100	ENCINO	CA	91436	1922	19	06037	34.15820737	-118.496492	Los Angeles County
49687	Fee-for-Service	1043463714	1043463714	1	2	HENRY, MICHAEL R PHD	3/15/2019	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	831 ALAMO DR	STE 5C, 6B, 6C, 6D	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
49696	Fee-for-Service	1982667606	1982667606	1	1	HSIAO, ERIC I MD	12/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	65453	66	Emergency Medicine (Urgent Care)	0	In state provider	None	65 N 14TH ST	None	SAN JOSE	CA	95112	6207	43	06085	37.34351079	-121.8779494	Santa Clara County
49697	Fee-for-Service	1770026791	1770026791	1	1	HORNGREN, MICHELLE L LMFT	9/6/2022	1041C0700X	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
49708	Fee-for-Service	1477115400	1477115400	1	1	HEALTHY HEARTS HOME HEALTH	3/2/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14664 VICTORY BLVD	STE 206	VAN NUYS	CA	91411	1621	19	06037	34.18663547	-118.4529105	Los Angeles County
49746	Fee-for-Service	1831692631	1831692631	1	1	HOEFERLIN, CORY M MD	8/1/2024	207W00000X	NA	Ophthalmology	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
49802	Fee-for-Service	1508005430	1508005430	1	1	HOUSTON, MARJORIE M	12/31/1991	193400000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	325 W 3RD AVE	STE 101	ESCONDIDO	CA	92025	4140	37	06073	33.11826682	-117.0833866	San Diego County
49834	Fee-for-Service	1003352568	1003352568	1	1	HILTON, ANTOINETTE PT	7/10/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1676 EAST 6TH ST	None	BEAUMONT	CA	92223	2550	33	06065	33.92948188	-116.9484306	Riverside County
49839	Fee-for-Service	1972923498	1972923498	1	1	HERNANDEZ, CHRISTINA MD	2/9/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	155008	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
49857	Fee-for-Service	1053385609	1053385609	3	1	HILL, JEFFREY H MD	2/6/2014	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
49863	Fee-for-Service	1851015176	1851015176	1	1	HEALTH FIRST FAMILY PRACTICE	12/7/2024	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2270 E PALMDALE BLVD	STE K	PALMDALE	CA	93550	4933	19	06037	34.58009827	-118.0881861	Los Angeles County
49865	Fee-for-Service	1861540684	1861540684	1	1	HERRMAN, MARTA L MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64818	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
49875	Fee-for-Service	1437296399	1437296399	1	1	HSIEH, GEORGE C MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97430	07	Dermatology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
49887	Fee-for-Service	1558996835	1558996835	1	1	HOLDEN, LISA LMFT	10/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 41ST AVE	SUITE 240	CAPITOLA	CA	95010	2900	44	06087	36.972108	-121.964831	Santa Cruz County
49920	Fee-for-Service	1861433385	1861433385	1	1	HENDEL, JEFFREY	10/6/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	57286	None	None	0	In state provider	None	1300 N VERMONT AVENUE	SUITE 505	LOS ANGELES	CA	90027	9005	19	06037	34.0956033	-118.2916918	Los Angeles County
49928	Fee-for-Service	1619387495	1619387495	1	1	HORTON, TERRI L LCSW	7/23/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
49943	Fee-for-Service	1861692584	1861692584	1	1	HANGER PROSTHETICS &	7/2/2009	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	104 MARGARET LN	STE A	GRASS VALLEY	CA	95945	5261	29	06057	39.22982781	-121.046717	Nevada County
50004	Fee-for-Service	1972856904	1972856904	1	1	HAYES, MELLODY R MD	5/11/2021	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	122763	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
50046	Fee-for-Service	1598054470	1598054470	1	1	HOLLAND, MICHAEL E MD	6/23/2023	207L00000X	NA	Other	026	PHYSICIANS	179276	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
50066	Fee-for-Service	1093938664	1093938664	1	1	HEICKLEN, OKSANA LMFT	10/27/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2564 STATE ST	SUITE B	CARLSBAD	CA	92008	1662	37	06073	33.16421723	-117.3524732	San Diego County
50118	Fee-for-Service	1730347360	1730347360	1	1	HEIT, JEREMY J MD	7/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123284	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
50129	Fee-for-Service	1144594706	1144594706	1	1	HURVITZ, KIMBERLY UHLES MD	6/2/2014	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	INC	2936 DE LA VINA ST	STE 200	SANTA BARBARA	CA	93105	3376	42	06083	34.4383104	-119.7278207	Santa Barbara County
50147	Fee-for-Service	1851015176	1851015176	1	1	HEALTH FIRST FAMILY PRACTICE	12/7/2024	261QP2300X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	2270 E PALMDALE BLVD	STE K	PALMDALE	CA	93550	4933	19	06037	34.58009827	-118.0881861	Los Angeles County
50159	Fee-for-Service	1619195625	1619195625	1	1	HANNA, SUZAN MD	6/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	55301	40	Pediatrics	0	In state provider	None	2005 WILSHIRE BLVD	None	LOS ANGELES	CA	90057	3503	19	06037	34.05752693	-118.2749902	Los Angeles County
50168	Fee-for-Service	1235350893	1235350893	1	1	HAJJAR, MOHAMMAD A MD	3/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137003	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2621 S BRISTOL ST	SUITE 108	SANTA ANA	CA	92704	5766	30	06059	33.711876	-117.885371	Orange County
50194	Fee-for-Service	1407288806	1407288806	1	1	HASHMAT, FAHAD MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139528	01	General Practice	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
50217	Fee-for-Service	1609083666	1609083666	1	1	HAZAN, ALBERTO MD	8/5/2009	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
50233	Fee-for-Service	1992868764	1992868764	1	1	HAYAT, SUMERA K MD	5/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	54515	01	General Practice	0	In state provider	None	2006 SHAW AVE	None	CLOVIS	CA	93611	4192	10	06019	36.80848025	-119.6771991	Fresno County
50241	Fee-for-Service	1205900180	1205900180	1	1	HANGER P & O WEST INC	9/1/1997	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	644 EAST HARDING WAY	SUITE A	STOCKTON	CA	95202	5613	39	06077	37.96885394	-121.2856908	San Joaquin County
50272	Fee-for-Service	1841494994	1841494994	1	1	HOSKINS, VICTORIA O LMFT	8/27/2018	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
50282	Fee-for-Service	1154881274	1154881274	1	1	HODAPP, SAMANTHA L MD	6/26/2023	207L00000X	NA	Other	026	PHYSICIANS	181786	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
50286	Fee-for-Service	1336126614	1336126614	1	1	HAYATA, NANCY T	2/8/2015	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	7098 EDINGER AVE	None	HUNTINGTON BEACH	CA	92647	3503	30	06059	33.73008051	-118.005885	Orange County
50287	Fee-for-Service	1134693401	1134693401	1	1	HAHN, ELIZABETH K CRNA	4/23/2019	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
50314	Fee-for-Service	1316709652	1316709652	1	1	HOLISTIC PSYCHOTHERAPY INC	7/16/2024	225XM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	23331 EL TORO ROAD	SUITE 208	LAKE FOREST	CA	92630	4883	30	06059	33.62393128	-117.6965164	Orange County
50366	Fee-for-Service	1639527286	1639527286	1	1	HUMANN, LEAH M MD	2/26/2020	2083P0901X	NA	Adult Primary Care	026	PHYSICIANS	156292	44	Public Health	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
50422	Fee-for-Service	1386718385	1386718385	1	1	HUYNH, RICHARD MD	8/31/1984	207R00000X	NA	Other	026	PHYSICIANS	40131	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 106B	LOMA LINDA	CA	92354	3139	36	06071	34.04805253	-117.249534	San Bernardino County
50424	Fee-for-Service	1639304405	1639304405	1	1	HERR, LESLIE L	3/8/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
50436	Fee-for-Service	1174272983	1174272983	1	1	HAIGLER, CHRISTYN MD	5/26/2024	390200000X	NA	Other	026	PHYSICIANS	189724	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
50480	Fee-for-Service	1609290774	1609290774	1	1	HOWELL, STACEY MD	9/5/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	145082	None	None	0	In state provider	None	18111 BROOKHURST ST	STE 5100	FOUNTAIN VALLEY	CA	92708	6728	30	06059	33.70027259	-117.9544055	Orange County
50503	Fee-for-Service	1487124806	1487124806	1	1	HOLLEY, SARAH R PHD	9/26/2018	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
50550	Fee-for-Service	1467441931	1467441931	1	1	HORNER, KERRY A OD	6/1/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1011 SYLVAN AVE	STE A	MODESTO	CA	95350	1693	50	06099	37.68896459	-120.979468	Stanislaus County
50567	Fee-for-Service	1831367523	1831367523	1	1	HANGER P & O WEST INC	10/21/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	24655 MONROE AVE	#A-101	MURRIETA	CA	92562	9598	33	06065	33.56697691	-117.2021843	Riverside County
50569	Fee-for-Service	1306035902	1306035902	1	1	HERRON, LARRY D INC	6/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	25538	None	None	0	In state provider	None	1304 ELLA ST	STE B1	SAN LUIS OBISPO	CA	93401	4166	40	06079	35.27704692	-120.6496857	San Luis Obispo County
50572	Fee-for-Service	1225420961	1225420961	1	1	HUANG, DEBORAH MD	5/23/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	177810	None	None	0	In state provider	None	1001 POTRERO AVE	RM 4M62	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
50575	Fee-for-Service	1447324322	1447324322	1	1	HANGER PROSTHETICS & ORTHOTI	4/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	2175 WINCHESTER BLVD	None	CAMPBELL	CA	95008	3425	43	06085	37.28380271	-121.9498552	Santa Clara County
50620	Fee-for-Service	1316528466	1316528466	1	1	HOFMANN, NATHAN C	9/25/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3082 MCMURRAY	None	ANDERSON	CA	96007	3544	45	06089	40.45499506	-122.2929002	Shasta County
50624	Fee-for-Service	1851796460	1851796460	1	1	HER, RUTH A LCSW	5/18/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3564 SAN AUGUSTINE AVE	None	MERCED	CA	95348	3571	24	06047	37.3299706	-120.4985977	Merced County
50631	Fee-for-Service	1023789484	1023789484	1	1	HALLER, STACY E PT	1/28/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
50638	Fee-for-Service	1578646469	1578646469	1	1	HOPE HOUSE CORPORATION	2/21/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	710 & 714 N ANAHEIM BLVD	None	ANAHEIM	CA	92805	2652	30	06059	33.84260597	-117.916209	Orange County
50643	Fee-for-Service	1669852802	1669852802	1	1	HOOSHVAR, NINA MD	2/7/2024	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	146688	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
50646	Fee-for-Service	1902303092	1902303092	1	1	HUNT, MICHELLE MD	11/13/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
50654	Fee-for-Service	1639527286	1639527286	1	1	HUMANN, LEAH M MD	2/26/2020	2083P0901X	NA	Adult Primary Care	026	PHYSICIANS	156292	39	Preventive (M.D. only)	0	In state provider	None	24785 STEWART ST	STE 111	LOMA LINDA	CA	92350	1721	36	06071	34.0538151	-117.2632755	San Bernardino County
50664	Fee-for-Service	1528038692	1528038692	1	1	HUSON, HENRY II DO	2/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12585	30	Radiology	0	In state provider	None	1025 N DOUTY ST	None	HANFORD	CA	93230	3722	16	06031	36.33611794	-119.6460191	Kings County
50690	Fee-for-Service	1790703304	1790703304	1	1	HONDA, HENRY M MD	3/31/1992	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	63664	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MED PLAZA #365	None	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
50709	Fee-for-Service	1720052988	1720052988	1	1	HOOPER, WILLIAM W MD	3/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	35446	41	Internal Medicine	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5139	37	06073	33.03623896	-117.2837308	San Diego County
50730	Fee-for-Service	1053810937	1053810937	1	1	HAPPY MOMENTS ADHC	9/13/2023	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	2929 WASHINGTON BLVD	None	MARINA DEL REY	CA	90292	5546	19	06037	33.98889516	-118.4508605	Los Angeles County
50739	Fee-for-Service	1922006162	1922006162	1	1	HOSPICE PARTNERS OF THE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CENTRAL COAST	277 SOUTH ST	STE R	SAN LUIS OBISPO	CA	93401	5038	40	06079	35.2695025	-120.6663615	San Luis Obispo County
50761	Fee-for-Service	1528711207	1528711207	1	1	HAMILTON, REBECCA CRNA	9/27/2022	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
50774	Fee-for-Service	1619015526	1619015526	1	1	HODGES, HEATHER LMFT	5/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
50779	Fee-for-Service	1730566191	1730566191	1	2	HOCHMAN, STEVEN MD	12/31/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	161568	-	NOT APPLICABLE	0	In state provider	None	5715 S BROADWAY AVE	None	LOS ANGELES	CA	90037	4131	19	06037	33.990273	-118.2783255	Los Angeles County
50802	Fee-for-Service	1912915539	1912915539	1	1	HOOVER, JOSHUA LCSW	2/13/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7215 55TH ST	None	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
50806	Fee-for-Service	1700918893	1700918893	1	1	HERNANDEZ, GRISELDA LMFT	2/4/2022	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
50873	Fee-for-Service	1285331470	1285331470	1	1	HILL, FAITH NP	9/9/2024	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2071 EAST HERNDON	None	CLOVIS	CA	93611	6001	10	06019	36.8375685	-119.6781105	Fresno County
50890	Fee-for-Service	1821618638	1821618638	1	1	HANSON, RODOLFO J NP	11/19/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1080 N. INDIAN CANYON DR	SUITE 201	PALM SPRINGS	CA	92262	4869	33	06065	33.837354	-116.545572	Riverside County
50910	Fee-for-Service	1952528002	1952528002	1	1	HERRERA, GASTON MD	2/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	23808	None	None	0	In state provider	None	10901 CRENSHAW BLVD	STE D	INGLEWOOD	CA	90303	5479	19	06037	33.936444	-118.326586	Los Angeles County
50957	Fee-for-Service	1710369186	1710369186	1	1	HARA, TRINA MD	4/14/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171253	None	None	0	In state provider	None	460 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	51	06101	39.13140416	-121.6141951	Sutter County
50981	Fee-for-Service	1750655502	1750655502	1	1	HANNA, SYLVIA R DO	2/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12180	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
50994	Fee-for-Service	1023036068	1023036068	1	1	HAJMOMENIAN, HAMID R MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70780	41	Internal Medicine	0	In state provider	None	600 N 13TH AVE	None	UPLAND	CA	91786	4905	36	06071	34.10113004	-117.6336234	San Bernardino County
50995	Fee-for-Service	1720052988	1720052988	1	1	HOOPER, WILLIAM W MD	3/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	35446	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5139	37	06073	33.03623896	-117.2837308	San Diego County
51004	Fee-for-Service	1518150283	1518150283	1	1	HANNA, RAMY M MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108568	41	Internal Medicine	0	In state provider	None	3610 ATLANTIC AVENUE	None	LONG BEACH	CA	90807	3418	19	06037	33.822621	-118.185002	Los Angeles County
51012	Fee-for-Service	1700147469	1700147469	1	1	HOANG, ANH T H LMFT	3/15/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	831 ALAMO DRIVE	SUITE 6C	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
51026	Fee-for-Service	1023149044	1023149044	1	1	HANSEN, ERIK N MD	5/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100389	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
51027	Fee-for-Service	1922006162	1922006162	1	1	HOSPICE PARTNERS OF THE	4/1/1999	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CENTRAL COAST	277 SOUTH ST	STE R	SAN LUIS OBISPO	CA	93401	5038	40	06079	35.2695025	-120.6663615	San Luis Obispo County
51032	Fee-for-Service	1962040998	1962040998	1	1	HERNANDEZ, MARGARITA PT	5/11/2021	2081S0010X	NA	Physical Medicine and Rehabilitation	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1191 CRESTON RD	STE 115	PASO ROBLES	CA	93446	3033	40	06079	35.6227971	-120.6606503	San Luis Obispo County
51046	Fee-for-Service	1114454519	1114454519	1	1	HASSANEIN, ROUKAYA MD	11/2/2023	208600000X	NA	General Surgery	026	PHYSICIANS	174110	None	None	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
51078	Fee-for-Service	1629142500	1629142500	1	2	HANGER PROSTHETICS & ORTHOTI	11/13/2019	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST INC	1101 BRYAN AVE.	SUITE C	TUSTIN	CA	92780	0000	30	06059	33.74272355	-117.8149529	Orange County
51119	Fee-for-Service	1588907349	1588907349	1	1	HUSS-BAWAB, JULIE M MD	5/12/2023	207ZP0105X	NA	Other	026	PHYSICIANS	134673	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
51170	Fee-for-Service	1861524910	1861524910	1	1	HARDY, RICHILDA C MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	44078	-	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
51188	Fee-for-Service	1164960878	1164960878	1	1	HUANG, EVIE MD	10/14/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	156293	40	Pediatrics	0	In state provider	None	15400 LOS GATOS BLVD	None	LOS GATOS	CA	95032	2502	43	06085	37.24572659	-121.957997	Santa Clara County
51203	Fee-for-Service	1225206253	1225206253	1	1	HYDER, SHAZIA MD	12/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106954	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
51217	Fee-for-Service	1336227131	1336227131	1	1	HODGES, RUTLANDRA K MD	8/12/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	50315	05	Anesthesiology	0	In state provider	None	5565 W LAS POSITAS BLVD	STE 220	PLEASANTON	CA	94588	5806	01	06001	37.69215143	-121.8800337	Alameda County
51257	Fee-for-Service	1407933104	1407933104	1	1	HORAK, DEBORAH A CRNA	7/9/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	200 WEBSTER ST	STE 100	OAKLAND	CA	94607	4108	01	06001	37.7954391	-122.2736939	Alameda County
51280	Fee-for-Service	1023036068	1023036068	1	1	HAJMOMENIAN, HAMID R MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70780	45	Nephrology (Renal-Kidney)	0	In state provider	None	600 N 13TH AVE	None	UPLAND	CA	91786	4905	36	06071	34.10113004	-117.6336234	San Bernardino County
51290	Fee-for-Service	1982867297	1982867297	1	1	HU, PING MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128681	78	Neoplastic Diseases/Oncology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
51294	Fee-for-Service	1922614056	1922614056	1	1	HORN, TRACEY NP	10/18/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
51303	Fee-for-Service	1407870454	1407870454	1	1	HUBBARD, DENA K MD	1/15/2024	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
51317	Fee-for-Service	1467400234	1467400234	3	1	HYE NURSES HOME HEALTH INC	10/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12011 VICTORY BLVD	SUITE 202	NORTH HOLLYWOOD	CA	91606	3330	19	06037	34.18670845	-118.394784	Los Angeles County
51331	Fee-for-Service	1225665391	1225665391	1	1	HSU, KEVIN DO	11/20/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20503	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
51346	Fee-for-Service	1881226322	1881226322	1	1	HEALTHVIEW HOME HEALTH LLC	2/3/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12750 CENTER COURT DR	STE 670	CERRITOS	CA	90703	5611	19	06037	33.86790649	-118.0604745	Los Angeles County
51349	Fee-for-Service	1922078294	1922078294	1	1	HARTMAN, DENNIS W OD	1/24/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	580 COLLINS DR	None	MERCED	CA	95348	3121	24	06047	37.32266954	-120.4774245	Merced County
51425	Fee-for-Service	1952390395	1952390395	1	1	HUNTER, NEALA J MD	3/30/1991	174400000X	NA	Other	026	PHYSICIANS	49464	None	None	0	In state provider	None	393 E WALNUT ST	None	PASADENA	CA	91188	0001	19	06037	34.14955087	-118.1422348	Los Angeles County
51453	Fee-for-Service	1174720288	1174720288	1	1	HARRIS, JACOB D MD	4/15/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	123862	None	None	0	In state provider	None	830 2ND ST	STE A	SANTA ROSA	CA	95404	4620	49	06097	38.440746	-122.7085605	Sonoma County
51456	Fee-for-Service	1619981057	1619981057	1	1	HIGASHI, STEPHANIE C DC	1/16/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3030 SAWTELLE BLVD	None	LOS ANGELES	CA	90066	1408	19	06037	34.02558195	-118.4308546	Los Angeles County
51477	Fee-for-Service	1154766129	1154766129	1	1	HWANG, JEAN H MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136813	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
51504	Fee-for-Service	1336227131	1336227131	1	1	HODGES, RUTLANDRA K MD	8/12/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	50315	01	General Practice	0	In state provider	None	5565 W LAS POSITAS BLVD	STE 220	PLEASANTON	CA	94588	5806	01	06001	37.69215143	-121.8800337	Alameda County
51519	Fee-for-Service	1003913914	1003913914	1	1	HAUSNER, RICHARD 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	10655 STEEPLETOP DR	None	HOUSTON	TX	77065	4222	00	None	29.927088	-95.58856699	Harris County
51527	Fee-for-Service	1184625212	1184625212	1	1	HA, KHAN G MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	50338	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
51537	Fee-for-Service	1639355449	1639355449	1	1	HUBSCHMAN, JEAN-PIERRE MD	2/20/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	115123	18	Ophthalmology	0	In state provider	None	200 STEIN PLZ	#1-340	LOS ANGELES	CA	90095	7002	19	06037	34.06482757	-118.4443441	Los Angeles County
51554	Fee-for-Service	1689639544	1689639544	1	1	HEALTHTRACKRX INDIANA INC	8/18/2017	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	1500 INTERSTATE 35 W	None	DENTON	TX	76207	2402	00	None	33.200703	-97.167024	Denton County
51568	Fee-for-Service	1720098205	1720098205	1	1	HARPER, JOHN R MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80250	None	None	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
51570	Fee-for-Service	1386792034	1386792034	1	1	HLUSAK, MARTIN G OD	1/31/1989	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	914 MAIN ST	None	SUSANVILLE	CA	96130	4407	18	06035	40.41780488	-120.6586341	Lassen County
51579	Fee-for-Service	1982867297	1982867297	1	1	HU, PING MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128681	68	Hematology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
51616	Fee-for-Service	1881046555	1881046555	1	1	HARDING, KATHERINE M LMFT	3/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	701 HIGH ST	SUITE 205	AUBURN	CA	95603	4735	31	06061	38.90214664	-121.0682262	Placer County
51631	Fee-for-Service	1568812113	1568812113	1	1	HA, ALVIN M DO	10/10/2019	207R00000X	NA	Other	026	PHYSICIANS	16674	41	Internal Medicine	0	In state provider	None	1211 W LA PALMA AVE	STE 207	ANAHEIM	CA	92801	2139	30	06059	33.84718298	-117.933758	Orange County
51674	Fee-for-Service	1528022357	1528022357	1	2	HO, CHERYL J MD	5/31/2024	207R00000X	NA	Other	086	MEDICAL DIRECTORS	77240	-	NOT APPLICABLE	0	In state provider	None	9300 WREN AVE	None	GILROY	CA	95020	7636	43	06085	37.02972645	-121.5874031	Santa Clara County
51676	Fee-for-Service	1720605371	1720605371	1	1	HODGE, JESSICA LMFT	1/2/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
51695	Fee-for-Service	1366971830	1366971830	1	1	HODGES, VAUGHN MD	12/27/2021	207N00000X	NA	Dermatology	026	PHYSICIANS	162470	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
51752	Fee-for-Service	1700145539	1700145539	1	1	HOANG, JIMMY MD	1/3/2024	207LP3000X	NA	Other	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
51766	Fee-for-Service	1174550511	1174550511	1	1	HIBBERT, MORTON P MD	11/25/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	51326	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
51788	Fee-for-Service	1851906002	1851906002	1	1	HOSPICE OF PRISTINE CARE INC	11/18/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7311 VAN NUYS BLVD	UNIT 10	VAN NUYS	CA	91405	1999	19	06037	34.203393	-118.4487795	Los Angeles County
51789	Fee-for-Service	1396762936	1396762936	1	1	HAMMER, HALI MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55867	08	Family Practice	0	In state provider	None	4433 MISSION ST	None	SAN FRANCISCO	CA	94112	1926	38	06075	37.72724234	-122.4327536	San Francisco County
51826	Fee-for-Service	1447937388	1447937388	1	1	HOWEY, STEPHEN J MD	7/10/2024	207L00000X	NA	Other	026	PHYSICIANS	None	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
51832	Fee-for-Service	1124019526	1124019526	1	1	HAO, STEVEN C MD	4/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80799	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2 BON AIR RD	STE 100	LARKSPUR	CA	94939	1144	21	06041	37.94364568	-122.5396483	Marin County
51867	Fee-for-Service	1982867297	1982867297	1	1	HU, PING MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128681	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
51876	Fee-for-Service	1780648766	1780648766	1	1	HONEGGER, MOLLY M MD	7/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94905	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
51892	Fee-for-Service	1104249838	1104249838	1	1	HERMAN, THOMAS A CP	8/19/2021	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	181 LYNCH CREEK WAY	STE. # 101	PETALUMA	CA	94954	2388	49	06097	38.25155449	-122.6349373	Sonoma County
51916	Fee-for-Service	1356978241	1356978241	1	1	HUYNH, MICHELLE MD	9/27/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	190863	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
51919	Fee-for-Service	1164878245	1164878245	1	1	HUANG, MICHAEL H MD	12/12/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	180885	None	None	0	In state provider	None	1798 N GAREY AVE	None	POMONA	CA	91767	2918	19	06037	34.076894	-117.7522688	Los Angeles County
51930	Fee-for-Service	1861569865	1861569865	1	1	HAN, CAROL KS DO	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7638	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
51937	Fee-for-Service	1487611687	1487611687	1	1	HUMPHREYS, LISA M MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66693	None	None	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
51976	Fee-for-Service	1235763574	1235763574	1	1	HOPE AVENUE MARRIAGE AND FAM	5/19/2020	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	CES	1400 E COOLEY DR	SUITE 200A	COLTON	CA	92324	3939	36	06071	34.05447652	-117.305298	San Bernardino County
51989	Fee-for-Service	1174539415	1174539415	1	1	HACOBIAN, MELKON MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129903	41	Internal Medicine	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
52063	Fee-for-Service	1760500813	1760500813	1	1	HWANG, SAM T Y MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	75334	None	None	0	In state provider	None	3301 C STREET	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
52075	Fee-for-Service	1851906002	1851906002	1	1	HOSPICE OF PRISTINE CARE INC	11/18/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7311 VAN NUYS BLVD	UNIT 10	VAN NUYS	CA	91405	1999	19	06037	34.203393	-118.4487795	Los Angeles County
52108	Fee-for-Service	1194873919	1194873919	1	1	HILL, RICHARD R MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37118	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
52113	Fee-for-Service	1265648851	1265648851	1	1	HALL, KIRK F	12/12/2012	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1805 CIRBY WAY	STE 8	ROSEVILLE	CA	95661	5533	31	06061	38.72957646	-121.256406	Placer County
52118	Fee-for-Service	1437436938	1437436938	1	1	HAWKINS, LYNNETTA LMFT	5/16/2020	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2185 W GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75425686	-121.4567805	San Joaquin County
52124	Fee-for-Service	1588668842	1588668842	1	1	HALIFAX REGIONAL HOSPITAL	7/16/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2204 WILBORN AVE	None	SOUTH BOSTON	VA	24592	1638	00	None	36.71275859	-78.91288198	Halifax County
52131	Fee-for-Service	1205019510	1205019510	1	1	HOGAN, ROSELYNN J 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
52161	Fee-for-Service	1396703047	1396703047	1	1	HAROLD K FIGUEROA, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1515 N SAN FRANCISCO ST	None	FLAGSTAFF	AZ	86001	1435	00	None	35.21286	-111.642435	Coconino County
52163	Fee-for-Service	1306211669	1306211669	1	1	HU, KACEY J MD	7/20/2023	2084N0400X	NA	Neurology	026	PHYSICIANS	176554	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
52223	Fee-for-Service	1528017621	1528017621	3	1	HOH, DAVID A OD	8/11/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	373 9TH STREET	SUITE 201	OAKLAND	CA	94607	6516	01	06001	37.80008607	-122.2714059	Alameda County
52235	Fee-for-Service	1598999823	1598999823	1	1	HUSSAIN, AHMAD S MD	12/30/2022	2086S0129X	NA	General Surgery	026	PHYSICIANS	142881	None	None	0	In state provider	None	16506 LAKEWOOD BLVD	STE 200	BELLFLOWER	CA	90706	5165	19	06037	33.88470916	-118.1424401	Los Angeles County
52258	Fee-for-Service	1487732137	1487732137	1	1	HALL, RANDOLPH M MD	3/3/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	21151	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
52259	Fee-for-Service	1174056691	1174056691	1	1	HO, DEREK K MD	6/24/2021	207L00000X	NA	Other	026	PHYSICIANS	157178	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
52263	Fee-for-Service	1235763574	1235763574	1	1	HOPE AVENUE MARRIAGE AND FAM	3/3/2025	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	CES	1400 E COOLEY DR	SUITE 200A	COLTON	CA	92324	3939	36	06071	34.05447652	-117.305298	San Bernardino County
52273	Fee-for-Service	1174539415	1174539415	1	1	HACOBIAN, MELKON MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129903	06	Cardiovascular Disease (M.D. only)	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
52274	Fee-for-Service	1831326180	1831326180	1	1	HARSHBARGER, HEATHER LMFT	7/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1821 4TH ST	None	SANTA ROSA	CA	95404	3202	49	06097	38.450619	-122.69781	Sonoma County
52294	Fee-for-Service	1497192611	1497192611	1	1	HEPNER, JESSICA L 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
52326	Fee-for-Service	1548488661	1548488661	1	1	HAWKINS HEARING AID CENTER	1/20/2021	332B00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8512 MADISON AVE.	None	FAIR OAKS	CA	95628	3809	34	06067	38.663712	-121.242654	Sacramento County
52328	Fee-for-Service	1992876957	1992876957	1	1	HUNT, WILLIAM P MD	10/24/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	37814	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
52351	Fee-for-Service	1649575135	1649575135	1	1	HOANG, VY U MD	8/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125768	40	Pediatrics	0	In state provider	None	250 E CHASE AVENUE	SUITE 108	EL CAJON	CA	92020	6305	37	06073	32.78042748	-116.9591715	San Diego County
52352	Fee-for-Service	1871122747	1871122747	1	1	HWANG, SOO KYUNG MD	10/5/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181616	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
52359	Fee-for-Service	1215052014	1215052014	1	1	HOUSTON, DEENNE I LCSW	7/31/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	29131	-	NOT APPLICABLE	0	In state provider	None	5849 CROCKER STREET	None	LOS ANGELES	CA	90003	1311	19	06037	33.988626	-118.268568	Los Angeles County
52397	Fee-for-Service	1194873919	1194873919	1	1	HILL, RICHARD R MD	9/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37118	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
52426	Fee-for-Service	1245258623	1245258623	1	1	HUDSON, JENNIFER R	8/18/2008	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	705 E VIRGINIA WAY	STE N	BARSTOW	CA	92311	3978	36	06071	34.88815781	-117.018543	San Bernardino County
52430	Fee-for-Service	1639247950	1639247950	1	1	HAN, ERNEST S MD	3/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85994	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
52432	Fee-for-Service	1639566151	1639566151	1	1	HARARAH, MOHAMMAD K MD	8/31/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	178883	None	None	0	In state provider	None	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	34	06067	38.571084	-121.471074	Sacramento County
52438	Fee-for-Service	1083759997	1083759997	1	1	HABIBI, MEHDI MD	6/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	39878	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
52480	Fee-for-Service	1346773199	1346773199	1	1	HSU, ANGELA MD	6/15/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	169757	None	None	0	In state provider	None	2331 MONTPELIER DRIVE	B	SAN JOSE	CA	95116	1673	43	06085	37.3649965	-121.8479359	Santa Clara County
52505	Fee-for-Service	1902087539	1902087539	1	1	HOUSHMAND, ELIZABETH B MD	6/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	92654	07	Dermatology	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
52542	Fee-for-Service	1821057019	1821057019	1	1	HUANG, ALEXANDER S MD	12/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	69302	None	None	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
52553	Fee-for-Service	1235763574	1235763574	1	1	HOPE AVENUE MARRIAGE AND FAM	2/5/2025	251S00000X	NA	Other	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	CES	1400 E COOLEY DR	SUITE 200A	COLTON	CA	92324	3939	36	06071	34.05447652	-117.305298	San Bernardino County
52562	Fee-for-Service	1942240106	1942240106	1	1	HARRIS, DALE 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	5444 GREEN STREET	None	MURRAY	UT	84123	0000	00	None	40.651605	-111.90357	Salt Lake County
52593	Fee-for-Service	1740812718	1740812718	1	1	HANSEN, JAMIE PSYD	7/10/2020	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
52599	Fee-for-Service	1598283368	1598283368	2	1	HARDY, TRON S	10/31/2017	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
52600	Fee-for-Service	1790279917	1790279917	1	1	HUTCO CORPORATION	1/23/2019	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2690 BECHELLI LN	STE E	REDDING	CA	96002	0930	45	06089	40.56812181	-122.3627416	Shasta County
52610	Fee-for-Service	1396242301	1396242301	1	1	HSIEH, VICKI DO	8/9/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17765	None	None	0	In state provider	None	2251 N HARBOR BLVD	None	FULLERTON	CA	92835	2601	30	06059	33.89691672	-117.9291749	Orange County
52611	Fee-for-Service	1588731426	1588731426	1	1	HEDAYI, RUDY S MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74278	18	Ophthalmology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
52616	Fee-for-Service	1992876957	1992876957	1	1	HUNT, WILLIAM P MD	10/24/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	37814	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
52679	Fee-for-Service	1821594144	1821594144	1	5	HEARINGLIFE HEARING AID CENT	10/17/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	11723 FAIR OAKS BLVD	None	FAIR OAKS	CA	95628	2816	34	06067	38.664945	-121.263111	Sacramento County
52698	Fee-for-Service	1639880040	1639880040	1	1	HEIN, YAN PT	7/26/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	17270 BEAR VALLEY RD	STE 105	VICTORVILLE	CA	92395	7751	36	06071	34.47103946	-117.2849598	San Bernardino County
52706	Fee-for-Service	1730156241	1730156241	1	1	HUFF, GREGORY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	620 SKYLINE DRIVE	None	JACKSON	TN	38301	3901	00	None	35.63721	-88.831359	Madison County
52715	Fee-for-Service	1558448480	1558448480	1	1	HIJAZI, KAMAL A MD	6/17/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	37975	01	General Practice	0	In state provider	None	595 BUCKINGHAM WAY	STE 417	SAN FRANCISCO	CA	94132	1912	38	06075	37.73012679	-122.4767395	San Francisco County
52726	Fee-for-Service	1083759997	1083759997	1	1	HABIBI, MEHDI MD	6/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	39878	14	Neurological Surgery	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
52743	Fee-for-Service	1093049702	1093049702	1	2	HERCULEAN BABIES PEDIATRICS	6/4/2015	261QP2300X	NA	Other	026	PHYSICIANS	51091	40	Pediatrics	0	In state provider	None	6333 TELEGRAPH AVE	STE 203	OAKLAND	CA	94609	1359	01	06001	37.84914135	-122.260702	Alameda County
52756	Fee-for-Service	1568824860	1568824860	1	1	HENDOW, CHELSEA J MD	4/8/2025	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	179264	20	Orthopedic Surgery	0	In state provider	None	4140 JADE STREET	SUITE 100	CAPITOLA	CA	95010	3956	44	06087	36.97026148	-121.9638195	Santa Cruz County
52777	Fee-for-Service	1700801867	1700801867	1	1	HAAS, RICHARD H MD	8/1/2001	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	38555	13	Neurology (M.D. only)	0	In state provider	None	225 DICKINSON ST	# H208	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
52783	Fee-for-Service	1821594144	1821594144	1	6	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	400 30TH ST	STE 101	OAKLAND	CA	94609	3306	01	06001	37.81907725	-122.2648838	Alameda County
52784	Fee-for-Service	1831177575	1831177575	1	1	HOWARD, JAMES D MD	5/1/1983	207L00000X	NA	Other	026	PHYSICIANS	43147	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
52808	Fee-for-Service	1073672770	1073672770	1	1	HART, STEPHEN M OD	12/24/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
52884	Fee-for-Service	1811971658	1811971658	1	1	HAWKLEY, REDGE M	5/31/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	7062 SKYWAY	None	PARADISE	CA	95969	3940	04	06007	39.76482102	-121.6183741	Butte County
52910	Fee-for-Service	1912952656	1912952656	1	1	HOBBS, SUSAN MD	8/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86886	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
52928	Fee-for-Service	1861811366	1861811366	1	1	HANOVNIKIAN, JOSEPH V MD	4/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144342	41	Internal Medicine	0	In state provider	None	4312 WOODMAN AVE	SUITE 102	SHERMAN OAKS	CA	91423	5523	19	06037	34.148637	-118.4312035	Los Angeles County
52946	Fee-for-Service	1336335306	1336335306	1	1	HSU, CHARLES S MD	6/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84401	24	Plastic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
52962	Fee-for-Service	1720032808	1720032808	1	2	HAJISEYEDJAVADI, OMID MD	1/30/2019	208G00000X	NA	General Surgery	026	PHYSICIANS	55150	33	Thoracic Surgery	0	In state provider	None	2505 SAMARITAN DR	STE 503	SAN JOSE	CA	95124	4006	43	06085	37.25111447	-121.9483395	Santa Clara County
52970	Fee-for-Service	1144263039	1144263039	1	1	HSU, I-CHOW J MD	9/12/1994	2085R0001X	NA	Other	026	PHYSICIANS	51033	78	Neoplastic Diseases/Oncology	0	In state provider	None	365 34TH ST	None	OAKLAND	CA	94609	2814	01	06001	37.82206763	-122.2621954	Alameda County
52987	Fee-for-Service	1841508504	1841508504	1	1	HUYNH, THEM MD INC	9/22/2011	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	38341	01	General Practice	0	In state provider	None	1855 ALUM ROCK AVE	STE C	SAN JOSE	CA	95116	1398	43	06085	37.35399602	-121.8531134	Santa Clara County
52989	Fee-for-Service	1417563149	1417563149	1	1	HUYNH, GRACE OD	2/2/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
53036	Fee-for-Service	1538203120	1538203120	1	1	HOLY SPIIRIT DME INC	5/29/1996	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	12711 RAMONA BLVD	STE 108	IRWINDALE	CA	91706	3679	19	06037	34.07844514	-117.9949346	Los Angeles County
53040	Fee-for-Service	1568090082	1568090082	1	1	HICKMAN, DASHAWN MD	11/16/2023	207P00000X	NA	Other	026	PHYSICIANS	184834	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
53052	Fee-for-Service	1669906616	1669906616	2	1	HERNANDEZ, KRISTIN LMFT	2/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	167 E LA VERNE AVE	None	POMONA	CA	91767	2748	19	06037	34.08455683	-117.7498593	Los Angeles County
53063	Fee-for-Service	1700801867	1700801867	1	1	HAAS, RICHARD H MD	8/1/2001	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	38555	40	Pediatrics	0	In state provider	None	225 DICKINSON ST	# H208	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
53075	Fee-for-Service	1215959820	1215959820	1	1	HOVENSTINE, DANIEL R MD	8/31/1989	2085R0001X	NA	Other	026	PHYSICIANS	58285	78	Neoplastic Diseases/Oncology	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
53159	Fee-for-Service	1154854206	1154854206	1	1	HASASSRI, METHUS E MD	2/8/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	157700	None	None	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
53176	Fee-for-Service	1992876122	1992876122	1	1	HUGH,CECIL 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
53205	Fee-for-Service	1528648243	1528648243	1	1	HORIZON ASSISTED LIVING FACI	11/3/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	9708 VALJEAN AVE	None	NORTH HILLS	CA	91343	1936	19	06037	34.2468656	-118.4871801	Los Angeles County
53207	Fee-for-Service	1457436107	1457436107	1	1	HOE, FRANCIS M MD	6/23/2008	2080P0205X	NA	Endocrinology	026	PHYSICIANS	103139	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
53209	Fee-for-Service	1568714111	1568714111	1	1	HAW, JONATHAN MD	10/8/2018	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	127324	20	Orthopedic Surgery	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
53211	Fee-for-Service	1285324467	1285324467	1	1	HATCH HEALTH, INC.	5/17/2023	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	43	06085	0	0	None
53226	Fee-for-Service	1912228370	1912228370	1	1	HSIAO, ESTHER Y H MD	10/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138650	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
53242	Fee-for-Service	1528761202	1528761202	1	1	HATA, JENNIFER K PT	8/27/2023	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
53243	Fee-for-Service	1942620919	1942620919	1	1	HARBOUR, LEIA D MD	7/19/2021	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	172063	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
53258	Fee-for-Service	1144263039	1144263039	1	1	HSU, I-CHOW J MD	9/12/1994	2085R0001X	NA	Other	026	PHYSICIANS	51033	30	Radiology	0	In state provider	None	365 34TH ST	None	OAKLAND	CA	94609	2814	01	06001	37.82206763	-122.2621954	Alameda County
53283	Fee-for-Service	1114223773	1114223773	1	1	HAN, PEGGY K MD	8/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	112112	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
53302	Fee-for-Service	1598760373	1598760373	1	1	HEISMAN MICHAEL AD	1/1/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1816 TULLY RD	None	SAN JOSE	CA	95122	4405	43	06085	37.32297177	-121.8247897	Santa Clara County
53338	Fee-for-Service	1063701266	1063701266	1	1	HO, JIUNLING J MD	8/18/2020	2081H0002X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	169084	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
53364	Fee-for-Service	1215959820	1215959820	1	1	HOVENSTINE, DANIEL R MD	8/31/1989	2085R0001X	NA	Other	026	PHYSICIANS	58285	30	Radiology	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
53396	Fee-for-Service	1437798253	1437798253	1	1	HOPE & PEACE HOSPICE	10/29/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14401 GILMORE ST	SUITE 203B	VAN NUYS	CA	91401	6231	19	06037	34.18766945	-118.446723	Los Angeles County
53400	Fee-for-Service	1124194618	1124194618	1	2	HANNAWAY, BASSAM Z PT	9/24/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	15325 FAIRFIELD RANCH RD	STE. 150	CHINO HILLS	CA	91709	8834	36	06071	33.9729714	-117.6918388	San Bernardino County
53439	Fee-for-Service	1467788588	1467788588	1	1	HOLLENBECK, PAUL L OT	8/15/2020	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
53454	Fee-for-Service	1902896921	1902896921	1	1	HAYNES, MARY E NP	7/13/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
53524	Fee-for-Service	1972114478	1972114478	1	1	HOSHIZAKI, JESSE K OD	9/8/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4200 CHINO HILLS PKWY	STE 390	CHINO HILLS	CA	91709	5825	36	06071	33.98274451	-117.7129305	San Bernardino County
53531	Fee-for-Service	1518261239	1518261239	1	1	HASSANI, CAMERON H MD	9/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121973	None	None	0	In state provider	None	1520 SAN PABLO	L-1600	LOS ANGELES	CA	90033	5317	19	06037	34.06269295	-118.2030006	Los Angeles County
53666	Fee-for-Service	1316252844	1316252844	1	1	HONG, REAN PHD	10/27/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1320 STANDIFORD AVENUE	SUITE 5	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
53687	Fee-for-Service	1437798253	1437798253	1	1	HOPE & PEACE HOSPICE	10/29/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14401 GILMORE ST	SUITE 203B	VAN NUYS	CA	91401	6231	19	06037	34.18766945	-118.446723	Los Angeles County
53704	Fee-for-Service	1063063030	1063063030	1	1	HARRIS, CHRISTINA L	9/21/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2542 E AVENUE K2	None	LANCASTER	CA	93535	4632	19	06037	34.673103	-118.084428	Los Angeles County
53708	Fee-for-Service	1881019891	1881019891	1	1	HTUN, SANDAR MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132315	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
53718	Fee-for-Service	1316479058	1316479058	1	1	HIRATA, SARAH Y MD	5/12/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157243	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
53725	Fee-for-Service	1134100209	1134100209	1	1	HAN, JAY J MD	8/23/2005	207W00000X	NA	Ophthalmology	026	PHYSICIANS	92157	25	Physical Medicine and Rehabilitation	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
53730	Fee-for-Service	1730185760	1730185760	1	1	HUANG, MARK W MD	3/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74711	None	None	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
53751	Fee-for-Service	1336458421	1336458421	1	1	HOLLAND, BRIAN OD INC	11/1/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2179 S MOONEY BLVD	None	VISALIA	CA	93277	6242	54	06107	36.310662	-119.315214	Tulare County
53763	Fee-for-Service	1467447714	1467447714	1	1	HAMWI, GERALD R MD	10/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	65266	08	Family Practice	0	In state provider	None	6255 W SUNSET BLVD	STE 2100	LOS ANGELES	CA	90028	7403	19	06037	34.09802749	-118.3255515	Los Angeles County
53773	Fee-for-Service	1124148523	1124148523	1	1	HILLIARD, PAULA 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	1500 E MEDICAL CENTER DR	None	ANN ARBOR	MI	48109	5000	00	None	42.28391347	-83.72716554	Washtenaw County
53803	Fee-for-Service	1154484475	1154484475	1	1	HSU, DENISE DEFANC AC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	665 S KNICKERBOCKER DR	STE 11	SUNNYVALE	CA	94087	1059	43	06085	37.37243191	-122.0590527	Santa Clara County
53811	Fee-for-Service	1851388847	1851388847	1	1	HSIEH, SAN C MD	1/1/1979	207R00000X	NA	Other	026	PHYSICIANS	25709	41	Internal Medicine	0	In state provider	None	3955 1ST AVE	None	SAN DIEGO	CA	92103	3015	37	06073	32.74932905	-117.1638906	San Diego County
53824	Fee-for-Service	1619071867	1619071867	1	1	HINCHLIFFE, CHERYL E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	44276	41	Internal Medicine	0	In state provider	None	31852 COAST HWY	STE 400	LAGUNA BEACH	CA	92651	6767	30	06059	33.49997237	-117.7425025	Orange County
53827	Fee-for-Service	1477908911	1477908911	1	1	HUGHES, TYLER M MD	8/1/2021	390200000X	NA	Other	026	PHYSICIANS	153844	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
53886	Fee-for-Service	1598896581	1598896581	1	1	HUFFMAN-DRACHT, HEATHER	3/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92669	66	Emergency Medicine (Urgent Care)	0	In state provider	B MD	PUEBLO AT BATH	None	SANTA BARBARA	CA	93105	4311	42	06083	34.430526	-119.72196	Santa Barbara County
53897	Fee-for-Service	1659312593	1659312593	1	1	HEALTHCARE PARTNERS AFFILIAT	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
53903	Fee-for-Service	1124133798	1124133798	1	1	HOLLYWOOD HEALTHCARE CORP	7/25/2012	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	15851 SW 41ST STREET	SUITE 700	DAVIE	FL	33331	1540	00	None	26.06842567	-80.36079737	Broward County
53908	Fee-for-Service	1639458540	1639458540	1	1	HENNER, JARYN T MD	7/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132906	41	Internal Medicine	0	In state provider	None	4053 LONE TREE WAY	STE 101	ANTIOCH	CA	94531	6210	07	06013	37.97569499	-121.800733	Contra Costa County
53927	Fee-for-Service	1326493693	1326493693	1	1	HUSAIN, MAJID MD	5/5/2019	390200000X	NA	Other	026	PHYSICIANS	153628	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
53935	Fee-for-Service	1922156728	1922156728	1	1	HSU, CONNIE WEI-CHEN MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68651	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
53975	Fee-for-Service	1548758436	1548758436	1	1	HOFFMAN, PETER L LMFT	6/6/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2904 ROWENA AVE	None	LOS ANGELES	CA	90039	2042	19	06037	34.10830863	-118.2681393	Los Angeles County
53980	Fee-for-Service	1881965549	1881965549	1	1	HUBBARD, SONJA R	2/4/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43839 N 15TH ST WEST	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
53983	Fee-for-Service	1639365919	1639365919	1	1	HOLDEN-BROOKS, TALIA PSYD	3/14/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
53994	Fee-for-Service	1063063030	1063063030	1	1	HARRIS, CHRISTINA L	9/21/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2542 E AVENUE K2	None	LANCASTER	CA	93535	4632	19	06037	34.673103	-118.084428	Los Angeles County
54014	Fee-for-Service	1215015003	1215015003	1	1	HSU, CHIACHEN MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90444	25	Physical Medicine and Rehabilitation	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
54026	Fee-for-Service	1952543373	1952543373	1	1	HEETER, ZACHARY R MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	842 E MAIN STREET	None	MEDFORD	OR	97504	7134	00	None	42.32787853	-122.863311	Jackson County
54054	Fee-for-Service	1174652259	1174652259	1	1	HLINE, SU S MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88832	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
54059	Fee-for-Service	1104054717	1104054717	1	1	HANSON-LOPEZ, GABRIELA LCSW	11/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
54077	Fee-for-Service	1427347640	1427347640	1	1	HUTCHEON, DOUGLASS B MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130818	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
54085	Fee-for-Service	1598823288	1598823288	1	1	HODGSON, STEVEN W	8/17/2007	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1191 CRESTON RD	STE 115	PASO ROBLES	CA	93446	3033	40	06079	35.6227971	-120.6606503	San Luis Obispo County
54089	Fee-for-Service	1093077141	1093077141	1	1	HERNANDEZ, STACI LMFT	11/2/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1300 E SHAW AVE	SUITE 149	FRESNO	CA	93710	7917	10	06019	36.80872147	-119.765979	Fresno County
54110	Fee-for-Service	1417419474	1417419474	1	1	HABIB, ANAND R MD	6/28/2022	208M00000X	NA	Other	026	PHYSICIANS	179246	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
54115	Fee-for-Service	1871636746	1871636746	1	1	HOLLAND, MARIUM G MD	1/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152460	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
54154	Fee-for-Service	1508927997	1508927997	1	1	HAHN, RICHARD J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	25115	02	General Surgery	0	In state provider	None	44215 15TH ST W	STE 203	LANCASTER	CA	93534	5504	19	06037	34.68666415	-118.1568572	Los Angeles County
54155	Fee-for-Service	1194950998	1194950998	1	1	HYONG S CHOI MD	3/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9225 N 3RD ST	STE 304	PHOENIX	AZ	85020	2466	00	None	33.57054	-112.0692465	Maricopa County
54183	Fee-for-Service	1659312593	1659312593	1	1	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL GROUP	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
54199	Fee-for-Service	1760034219	1760034219	1	1	HAPPY VISIT HOME HEALTH	7/26/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1434 HAUSER BLVD	None	LOS ANGELES	CA	90019	3934	19	06037	34.04780648	-118.3571951	Los Angeles County
54211	Fee-for-Service	1396276085	1396276085	1	1	HERNANDEZ, SARAH J MD	10/11/2021	207QH0002X	NA	Adult Primary Care	026	PHYSICIANS	164675	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
54240	Fee-for-Service	1518980267	1518980267	1	1	HIRSCHMAN, DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	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
54272	Fee-for-Service	1922637024	1922637024	1	1	HUEY, THOMAS B MD	10/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180740	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
54293	Fee-for-Service	1144315797	1144315797	1	1	HAN, SUK-JIN MD	3/22/1996	207W00000X	NA	Ophthalmology	026	PHYSICIANS	61197	18	Ophthalmology	0	In state provider	None	3030 W OLYMPIC BLVD	STE 220	LOS ANGELES	CA	90006	6507	19	06037	34.05260995	-118.3015825	Los Angeles County
54296	Fee-for-Service	1083294664	1083294664	1	1	HAPPAWANA, MEVAN D MD	7/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1920 COLORADO AVENUE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
54312	Fee-for-Service	1346674561	1346674561	1	1	HINCHCLIFF, KATHARINE M MD	2/22/2021	208200000X	NA	General Surgery	026	PHYSICIANS	135631	None	None	0	In state provider	None	7920 FROST STREET	SUITE 200	SAN DIEGO	CA	92123	4289	37	06073	32.80027449	-117.153846	San Diego County
54317	Fee-for-Service	1972619500	1972619500	1	1	HASSAN SALLOUM M.D	8/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7102 WESTWIND DR	None	EL PASO	TX	79912	1726	00	None	31.85649555	-106.5426881	El Paso County
54323	Fee-for-Service	1134211931	1134211931	1	1	HENRY, CHARLES S MD	1/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53349	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
54369	Fee-for-Service	1558561878	1558561878	1	1	HO, LILY MD INC	4/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	63149	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	947 S ANAHEIM BLVD	STE 270	ANAHEIM	CA	92805	5584	30	06059	33.82164135	-117.909385	Orange County
54400	Fee-for-Service	1851888697	1851888697	1	1	HALLORAN, JOHN T DO	1/18/2022	207R00000X	NA	Other	026	PHYSICIANS	19224	None	None	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
54409	Fee-for-Service	1518322247	1518322247	1	1	HUANG, ALLEN MD	6/9/2021	204E00000X	NA	Dental Provider	026	PHYSICIANS	165177	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
54415	Fee-for-Service	1972540516	1972540516	1	1	HAUSDORF, JOHN A MD	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72868	41	Internal Medicine	0	In state provider	None	23845 HOLMAN HIGHWAY	SUITE 210	MONTEREY	CA	93940	5907	27	06053	36.57594044	-121.9132944	Monterey County
54419	Fee-for-Service	1003817347	1003817347	1	1	HOLSINGER, ERIN E MD	3/1/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153588	None	None	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
54420	Fee-for-Service	1467414037	1467414037	1	1	HECKLER, LINDA K MD	7/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
54422	Fee-for-Service	1265443949	1265443949	1	1	HAYNES, SHANE 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	1441 N BECKLEY AVE	None	DALLAS	TX	75203	1201	00	None	32.76063	-96.8257485	Dallas County
54436	Fee-for-Service	1245479492	1245479492	1	1	HOLMES, CHRISTINE LCSW	10/2/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1415 RIMPAU AVE	STE 215	CORONA	CA	92879	5324	33	06065	33.86578253	-117.5457668	Riverside County
54452	Fee-for-Service	1700237682	1700237682	1	1	HAQUE, ADNAN F MD	11/19/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	177982	40	Pediatrics	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
54456	Fee-for-Service	1659312593	1659312593	1	41	HEALTHCARE PARTNERS AFFILIAT	9/2/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	11525 BROOKSHIRE AVENUE	300	DOWNEY	CA	90241	4985	19	06037	33.93544635	-118.1318321	Los Angeles County
54469	Fee-for-Service	1659312593	1659312593	1	1	HEALTHCARE PARTNERS AFFILIAT	9/2/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
54471	Fee-for-Service	1679559496	1679559496	1	1	HARRISON, CLARK A	8/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	1	Border provider	None	880 RYLAND ST	None	RENO	NV	89502	1603	00	None	39.52378631	-119.8009873	Washoe County
54486	Fee-for-Service	1679567598	1679567598	1	1	HUGHES, THOMAS L MD	10/31/1995	207L00000X	NA	Other	026	PHYSICIANS	58287	05	Anesthesiology	0	In state provider	None	317 COURT ST	STE A	STOCKTON	CA	95205	6309	39	06077	37.9548163	-121.2596789	San Joaquin County
54507	Fee-for-Service	1407897093	1407897093	1	1	HASEEB, ABDUL M MD	9/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76480	78	Neoplastic Diseases/Oncology	0	In state provider	None	6121 N THESTA ST	STE 204	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
54511	Fee-for-Service	1811078421	1811078421	2	1	HERNANDEZ, WILFREDO MD	7/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	26402	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1513 S GRAND AVENUE	STE 400	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
54565	Fee-for-Service	1760740229	1760740229	1	1	HERRERA, RAUL J MD	12/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136745	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
54593	Fee-for-Service	1962913244	1962913244	1	1	HEXA REHABILITATION, INC.	2/5/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	None	None	0	In state provider	None	115 CAPITOL STREET	None	SALINAS	CA	93906	2013	27	06053	36.67556044	-121.660579	Monterey County
54599	Fee-for-Service	1952720013	1952720013	1	1	HSU, DEREK MD	8/6/2019	207L00000X	NA	Other	026	PHYSICIANS	140476	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
54603	Fee-for-Service	1194491183	1194491183	1	1	HAHN, JULIE A NP	7/9/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
54614	Fee-for-Service	1992586598	1992586598	1	1	HARRIS, MARCELLIS A RCP	1/26/2024	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
54620	Fee-for-Service	1295708345	1295708345	1	1	HERBERT, TOM M MD	12/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	1155 MILL STREET	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
54644	Fee-for-Service	1033941174	1033941174	1	1	HOPPER, MONICA CCC-SLP	8/26/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3416 AMERICAN RIVER DR	STE B	SACRAMENTO	CA	95864	5753	34	06067	38.569212	-121.3840755	Sacramento County
54647	Fee-for-Service	1922019017	1922019017	1	1	HARTMANN, ROBERT C MD	3/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	42503	41	Internal Medicine	0	In state provider	None	815 COURT ST	STE 7	JACKSON	CA	95642	2154	03	06005	38.35293152	-120.7676346	Amador County
54658	Fee-for-Service	1235199704	1235199704	1	1	HENRIKSON, CHARLES A MD	9/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	2	Out of state provider	None	3181 SW SAM JACKSON PARK	RD	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
54663	Fee-for-Service	1972537835	1972537835	1	1	HSU, ERIC S MD	8/21/1998	207L00000X	NA	Other	026	PHYSICIANS	44212	05	Anesthesiology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
54678	Fee-for-Service	1124003660	1124003660	1	1	HO-LAUMANN, NANCY N MD	10/23/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	97428	None	None	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
54681	Fee-for-Service	1699933952	1699933952	1	1	HARIAGJIT, MAAN S MD	11/3/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	101051	08	Family Practice	0	In state provider	None	101 ADKISSON WAY	None	TAFT	CA	93268	3602	15	06029	35.13635548	-119.4480461	Kern County
54711	Fee-for-Service	1972540516	1972540516	1	1	HAUSDORF, JOHN A MD	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	72868	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23845 HOLMAN HIGHWAY	SUITE 210	MONTEREY	CA	93940	5907	27	06053	36.57594044	-121.9132944	Monterey County
54739	Fee-for-Service	1700237682	1700237682	1	1	HAQUE, ADNAN F MD	11/19/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	177982	70	Clinic (mixed specialty)	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
54744	Fee-for-Service	1659312593	1659312593	1	41	HEALTHCARE PARTNERS AFFILIAT	9/2/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	11525 BROOKSHIRE AVENUE	300	DOWNEY	CA	90241	4985	19	06037	33.93544635	-118.1318321	Los Angeles County
54747	Fee-for-Service	1134722374	1134722374	1	1	HEROLD, SCHEYDEN W LMFT	8/10/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5790 MAGNOLIA AVE	STE 202	RIVERSIDE	CA	92506	1874	33	06065	33.96267292	-117.3905848	Riverside County
54754	Fee-for-Service	1164839502	1164839502	1	1	HREISH, MARK N MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137381	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
54757	Fee-for-Service	1659312593	1659312593	1	1	HEALTHCARE PARTNERS AFFILIAT	12/20/2004	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
54779	Fee-for-Service	1649625500	1649625500	1	1	HENRY, MICHAEL MD	9/1/2021	207L00000X	NA	Other	026	PHYSICIANS	168636	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
54781	Fee-for-Service	1578527156	1578527156	1	1	HUFFAKER, ARDATH K MD	10/1/1997	207ZC0500X	NA	Other	026	PHYSICIANS	42895	22	Pathology (M.D. only)	0	In state provider	None	250 PROSPECT PL	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
54793	Fee-for-Service	1407897093	1407897093	1	1	HASEEB, ABDUL M MD	9/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76480	41	Internal Medicine	0	In state provider	None	6121 N THESTA ST	STE 204	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
54800	Fee-for-Service	1811078421	1811078421	2	1	HERNANDEZ, WILFREDO MD	7/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	26402	78	Neoplastic Diseases/Oncology	0	In state provider	None	1513 S GRAND AVENUE	STE 400	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
54804	Fee-for-Service	1528018488	1528018488	1	1	HOLBERT, CHRISTINE D MD	2/25/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80168	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	401 E HIGHLAND AVE	STE 450	SAN BERNARDINO	CA	92404	3836	36	06071	34.1358627	-117.2757778	San Bernardino County
54838	Fee-for-Service	1386830677	1386830677	1	1	HELMER, JAMES J MD	9/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	10011	41	Internal Medicine	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
54884	Fee-for-Service	1750446381	1750446381	1	1	HINMAN, KYLE E MD	7/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86667	26	Psychiatry (child)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
54926	Fee-for-Service	1326399924	1326399924	1	1	HORTON, LAUREN M NP	8/12/2013	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
54938	Fee-for-Service	1972942266	1972942266	1	1	HAMOUDI, IHSAN MD	8/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141092	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
54940	Fee-for-Service	1659686111	1659686111	1	1	HEMMAD, ASEEM R MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130805	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
54975	Fee-for-Service	1619333952	1619333952	1	1	HSIANG, ESTHER Y MD	9/7/2022	208M00000X	NA	Other	026	PHYSICIANS	177721	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
54985	Fee-for-Service	1275982829	1275982829	1	1	HUBBARD, MONICA LMFT	10/23/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	539 G ST	108	EUREKA	CA	95501	1030	12	06023	40.80141234	-124.1647338	Humboldt County
55019	Fee-for-Service	1417018011	1417018011	1	1	HIXSON, PHILIP D	2/22/2013	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
55031	Fee-for-Service	1659312593	1659312593	1	41	HEALTHCARE PARTNERS AFFILIAT	9/2/2021	204C00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	11525 BROOKSHIRE AVENUE	300	DOWNEY	CA	90241	4985	19	06037	33.93544635	-118.1318321	Los Angeles County
55077	Fee-for-Service	1346810025	1346810025	1	1	HEALTHY SMILES HOME HEALTH	3/28/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14545 VICTORY BLVD	STE 608	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
55082	Fee-for-Service	1407897093	1407897093	1	1	HASEEB, ABDUL M MD	9/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76480	68	Hematology	0	In state provider	None	6121 N THESTA ST	STE 204	FRESNO	CA	93710	5294	10	06019	36.82493955	-119.783139	Fresno County
55088	Fee-for-Service	1417082165	1417082165	1	1	HEALTH CENTER #2	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1301 PIERCE ST	None	SAN FRANCISCO	CA	94115	4005	38	06075	37.78238106	-122.4359186	San Francisco County
55122	Fee-for-Service	1255957767	1255957767	1	1	HAYER, RANDEEP J DO	6/22/2023	207P00000X	NA	Other	026	PHYSICIANS	20802	None	None	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
55123	Fee-for-Service	1083081558	1083081558	1	1	HARMONY HOMES INC	9/1/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6258 N CALLISCH AVE	None	FRESNO	CA	93710	5415	10	06019	36.82762203	-119.7762727	Fresno County
55163	Fee-for-Service	1104873611	1104873611	1	1	HOLE, THEODORE W MD	1/1/1979	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	36661	08	Family Practice	0	In state provider	None	2937 LOMA VISTA RD	None	VENTURA	CA	93003	2915	56	06111	34.27553522	-119.2567631	Ventura County
55247	Fee-for-Service	1811550072	1811550072	1	1	HEILBRONN, JACKSON DO	7/1/2022	207R00000X	NA	Other	026	PHYSICIANS	19729	None	None	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
55255	Fee-for-Service	1447585047	1447585047	1	1	HERNANDEZ, ELIZABETH LCSW	4/12/2022	1041C0700X	NA	Mental Health Outpatient Services	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
55266	Fee-for-Service	1194557132	1194557132	1	1	HONEY ROOTS BIRTHING SERVICE	8/22/2024	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	33	06065	0	0	None
55269	Fee-for-Service	1386671907	1386671907	1	1	HSUEH, CHUNG-TSEN	7/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52669	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
55278	Fee-for-Service	1578182697	1578182697	1	1	HOLMES, KARIMA A MD	10/16/2024	390200000X	NA	Other	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
55280	Fee-for-Service	1821594144	1821594144	1	12	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	805 TWELVE BRIDGES DR	#25	LINCOLN	CA	95648	8811	31	06061	38.85113012	-121.2860415	Placer County
55285	Fee-for-Service	1689068538	1689068538	1	1	HAJNIK, CORINNE S LMFT	1/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1303 SAN CARLOS AVE	None	SAN CARLOS	CA	94070	2317	41	06081	37.50572931	-122.2621879	San Mateo County
55369	Fee-for-Service	1487656567	1487656567	1	1	HARRISON, ANIL MD	5/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149918	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
55380	Fee-for-Service	1194112813	1194112813	1	1	HUSSAINI, SYED H DO	11/1/2022	2085P0229X	NA	Other	026	PHYSICIANS	20259	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
55389	Fee-for-Service	1245316751	1245316751	1	1	HOU, DENNIS MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	63030	None	None	0	In state provider	None	3838 CALIFORNIA ST	RM 408	SAN FRANCISCO	CA	94118	1506	38	06075	37.78591809	-122.4575439	San Francisco County
55406	Fee-for-Service	1215534490	1215534490	1	1	HONEST HOSPICE CARE INC	6/17/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 180	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
55417	Fee-for-Service	1174385389	1174385389	1	1	HASHAWAY, MARGARET CNP	7/1/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	19	06037	34.01379685	-118.4159354	Los Angeles County
55428	Fee-for-Service	1700813425	1700813425	1	1	HAMILTON, JULIE H MD	1/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70784	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1950 ROSALINE AVE	None	REDDING	CA	96001	2543	45	06089	40.57330004	-122.3943613	Shasta County
55438	Fee-for-Service	1851325211	1851325211	1	1	HWANG, TZONG-YUEH MD	5/1/1992	207R00000X	NA	Other	026	PHYSICIANS	48093	41	Internal Medicine	0	In state provider	None	12146 SOUTH ST	STE B	ARTESIA	CA	90701	6844	19	06037	33.85844249	-118.073151	Los Angeles County
55440	Fee-for-Service	1205974292	1205974292	1	1	HARIRIFAR, MAZIAR OD	9/21/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	910 MAPLE ST	None	REDWOOD CITY	CA	94063	2034	41	06081	37.48867968	-122.2222351	San Mateo County
55489	Fee-for-Service	1861570566	1861570566	1	1	HOOTEN, SUSAN L MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	55700	40	Pediatrics	0	In state provider	None	1840 SIERRA GARDENS	None	ROSEVILLE	CA	95661	2912	31	06061	38.74730831	-121.2613758	Placer County
55491	Fee-for-Service	1801926274	1801926274	1	1	HOPKINS, WILLIAM E DPM	10/31/1987	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1992 MAIN ST	None	WATSONVILLE	CA	95076	3066	44	06087	36.91850314	-121.7825983	Santa Cruz County
55498	Fee-for-Service	1700585452	1700585452	1	1	HONN, CARRIE E	5/17/2023	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
55549	Fee-for-Service	1811602394	1811602394	1	1	HINES, DANIEL PT	4/3/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
55573	Fee-for-Service	1235165861	1235165861	1	1	HENEVELD, EDWARD M MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	29319	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
55626	Fee-for-Service	1396488250	1396488250	1	1	HARDY-SURINA, JENNA LMFT	1/23/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2377 W FOOTHILL BLVD	STE 11	UPLAND	CA	91786	3577	36	06071	34.10690963	-117.6975663	San Bernardino County
55649	Fee-for-Service	1962557041	1962557041	1	1	HERSCH, JENNIFER R DO	4/2/2013	2084P0800X	NA	Psychiatry	026	PHYSICIANS	8539	36	Psychiatry	0	In state provider	None	1720 TERMINO AVENUE	None	LONG BEACH	CA	90804	2104	19	06037	33.78889871	-118.1458784	Los Angeles County
55669	Fee-for-Service	1982115572	1982115572	1	1	HULL, DAWN	3/6/2023	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
55680	Fee-for-Service	1851464275	1851464275	1	1	HODSMAN, HUGH K MD	7/29/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	44239	08	Family Practice	0	In state provider	None	145 THUNDER DR	None	VISTA	CA	92083	6010	37	06073	33.18535652	-117.288201	San Diego County
55681	Fee-for-Service	1326436122	1326436122	1	1	HUMMINGBIRD ANESTHESIA INC	2/25/2015	193400000X	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
55686	Fee-for-Service	1427781137	1427781137	1	1	HITCHCOCK, ELIZABETH A LCSW	7/13/2022	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
55692	Fee-for-Service	1215534490	1215534490	1	1	HONEST HOSPICE CARE INC	6/17/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 180	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
55699	Fee-for-Service	1689651671	1689651671	1	1	HART, KENNETH W MD	9/30/1983	2083P0901X	NA	Adult Primary Care	026	PHYSICIANS	19894	40	Pediatrics	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
55701	Fee-for-Service	1578784948	1578784948	1	1	HUMBOLDT MEDI TRANS	3/31/2012	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SPEERS, MICHAEL C	3120 HALFWAY AVE	None	MCKINLEYVILLE	CA	95519	9332	12	06023	40.96148302	-124.1138961	Humboldt County
55712	Fee-for-Service	1093724635	1093724635	1	1	HU, CALVIN T MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143239	20	Orthopedic Surgery	0	In state provider	None	131 RALEY BLVD	None	CHICO	CA	95928	8347	04	06007	39.7160105	-121.788999	Butte County
55728	Fee-for-Service	1811937683	1811937683	2	1	HOULIHAN, HEIDI E MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87124	None	None	0	In state provider	None	605 W EAST AVE	None	CHICO	CA	95926	7201	04	06007	39.75094119	-121.8710492	Butte County
55731	Fee-for-Service	1659429611	1659429611	1	1	HAMORI, CHARLES J MD	10/1/1995	207R00000X	NA	Other	026	PHYSICIANS	80423	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
55768	Fee-for-Service	1841431129	1841431129	1	1	HAGIWARA, EUGENE MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108419	30	Radiology	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
55795	Fee-for-Service	1598089823	1598089823	1	1	HOU, STEPHANIE W MD	1/17/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	114094	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
55805	Fee-for-Service	1881658235	1881658235	1	1	HAHN, DAVID T PHD	5/4/2005	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1620 ALPINE BLVD	STE B	ALPINE	CA	91901	1102	37	06073	32.83781579	-116.7799366	San Diego County
55819	Fee-for-Service	1972826931	1972826931	1	1	HOLLYWOOD PRESBYTERIAN EMERG	4/1/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	ENCY MEDICAL ASSOCIATES,	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
55865	Fee-for-Service	1700935814	1700935814	1	1	HOANG, THIEUHA T MD	4/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97879	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
55866	Fee-for-Service	1720195407	1720195407	1	1	HEYBOER, MARVIN MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82214	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
55884	Fee-for-Service	1770693558	1770693558	1	1	HATHAWAY, WILMIE M DO	1/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9378	None	None	0	In state provider	None	9089 BASELINE RD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
55885	Fee-for-Service	1467462390	1467462390	1	1	HENRY, JEANNE MD PHD	11/1/1996	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2220 5TH AVE	None	SAN DIEGO	CA	92101	2104	37	06073	32.72859436	-117.160304	San Diego County
55886	Fee-for-Service	1194378703	1194378703	1	1	HOUSTON, SAMANTHA CCC-SLP	2/7/2025	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	15928 VENTURA BLVD	STE 218	ENCINO	CA	91436	4413	19	06037	34.15585301	-118.4801465	Los Angeles County
55895	Fee-for-Service	1992793269	1992793269	1	1	H & H DRUG STORES, INC	6/1/2003	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	WESTERN DRUG MEDICL SPLY	3604 SAN FERNANDO RD	None	GLENDALE	CA	91204	2917	19	06037	34.12073199	-118.2516727	Los Angeles County
55957	Fee-for-Service	1669608287	1669608287	1	1	HALL, AUDREY E MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113325	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
55967	Fee-for-Service	1467751800	1467751800	1	1	HOMELESS HEALTH CARE	1/30/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	LOS ANGELES	2330 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2220	19	06037	34.0681396	-118.2738016	Los Angeles County
55968	Fee-for-Service	1649580713	1649580713	1	1	HEALING LODGE OF THE SEVEN	9/6/2013	324500000X	NA	Other	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	2	Out of state provider	NATIONS	5600 E 8TH AVE	None	SPOKANE VALLEY	WA	99212	0220	00	None	47.646432	-117.328806	Spokane County
55971	Fee-for-Service	1306995188	1306995188	1	1	HIRSCH,SARAH 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	190 E BANNOCK ST	None	BOISE	ID	83701	0000	00	None	43.6124738	-116.1926844	Ada County
55998	Fee-for-Service	1467511089	1467511089	1	1	HESS, LARRY R MD	10/11/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64305	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
56002	Fee-for-Service	1437274941	1437274941	1	1	HARDY, BERNARD L SR MD	10/31/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59086	08	Family Practice	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
56016	Fee-for-Service	1568678605	1568678605	1	1	HONG, JEANNE	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95624	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
56025	Fee-for-Service	1891726436	1891726436	2	1	HANELIN, MICHAEL MD	10/12/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176206	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
56068	Fee-for-Service	1598993859	1598993859	1	1	HAVLENA, GREGORY T MD	9/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113756	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
56144	Fee-for-Service	1255710661	1255710661	1	1	HO, HANG T MD	8/26/2021	208600000X	NA	General Surgery	026	PHYSICIANS	173621	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
56176	Fee-for-Service	1912342882	1912342882	1	1	HOU, DONG L LCSW	6/28/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
56181	Fee-for-Service	1831180975	1831180975	1	1	HOPP, KAREN T MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84575	08	Family Practice	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
56206	Fee-for-Service	1194951194	1194951194	1	1	HARRIS, MATTHEW E MD	10/9/2018	207LP2900X	NA	Other	026	PHYSICIANS	99869	05	Anesthesiology	0	In state provider	None	2888 LONG BEACH BLVD	SUITE 210	LONG BEACH	CA	90806	1530	19	06037	33.809706	-118.189343	Los Angeles County
56213	Fee-for-Service	1184925075	1184925075	1	1	HATFIELD, STEFANIE K MD	10/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118598	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1779 DOMINICAN WAY	SUITE B	SANTA CRUZ	CA	95065	1526	44	06087	36.9902958	-121.9808957	Santa Cruz County
56235	Fee-for-Service	1457535940	1457535940	1	1	HSIAO, ANDREW MD	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104285	20	Orthopedic Surgery	0	In state provider	None	341 MAGNOLIA AVE	STE 101	CORONA	CA	92879	3331	33	06065	33.85291987	-117.5664344	Riverside County
56250	Fee-for-Service	1629379706	1629379706	1	1	HELLERSTEIN, LEAH C LCSW	2/26/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
56259	Fee-for-Service	1649580713	1649580713	1	1	HEALING LODGE OF THE SEVEN	9/6/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	2	Out of state provider	NATIONS	5600 E 8TH AVE	None	SPOKANE VALLEY	WA	99212	0220	00	None	47.646432	-117.328806	Spokane County
56268	Fee-for-Service	1043463714	1043463714	1	1	HENRY, MICHAEL R PHD	3/15/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	831 ALAMO DRIVE	SUITE 5C, 6B, 6C, 6D	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
56305	Fee-for-Service	1750362570	1750362570	1	1	HO, WENDY W MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103077	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
56311	Fee-for-Service	1013349083	1013349083	1	1	HERRON, PETE LMFT	9/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	615 13TH ST	B3	MODESTO	CA	95354	2456	50	06099	37.6392035	-120.9933879	Stanislaus County
56322	Fee-for-Service	1487643698	1487643698	1	1	HURD, MELISSA E MD	3/1/1999	174400000X	NA	Other	026	PHYSICIANS	61672	08	Family Practice	0	In state provider	None	3142 VISTA WAY	STE 100	OCEANSIDE	CA	92056	3627	37	06073	33.18253858	-117.3252818	San Diego County
56329	Fee-for-Service	1275668634	1275668634	1	1	HALLUM, COURTNEY E MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79046	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
56364	Fee-for-Service	1144240003	1144240003	1	1	HUFFMAN, JASON T	7/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74510	None	None	0	In state provider	None	1100 TRANCAS ST	STE 250	NAPA	CA	94558	2908	28	06055	38.32316569	-122.2981938	Napa County
56366	Fee-for-Service	1679843353	1679843353	1	1	HARDEN-BERNAL, NAOMI F LMFT	8/8/2022	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
56385	Fee-for-Service	1043377039	1043377039	1	1	HUYNH, NGOC MY THI MD	10/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	55080	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8900 BOLSA AVE	STE C	WESTMINSTER	CA	92683	5475	30	06059	33.74480556	-117.9740439	Orange County
56395	Fee-for-Service	1013405547	1013405547	1	1	HAYDEN, JOEL MD	11/20/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
56418	Fee-for-Service	1659565281	1659565281	1	1	HOLT, ALICIA D MD	8/14/2008	208600000X	NA	General Surgery	026	PHYSICIANS	84707	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
56419	Fee-for-Service	1922212950	1922212950	1	1	HAMBARDZUMYAN, ERNA	2/2/2006	No Taxonomy Provided	Both NEMT & NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	VICTORVILLE MED TRANSPOR	15159 PALMDALE RD	None	VICTORVILLE	CA	92392	2547	36	06071	34.50685607	-117.3326192	San Bernardino County
56424	Fee-for-Service	1366020737	1366020737	1	1	HUANG, WEI C MD	9/27/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
56435	Fee-for-Service	1730664376	1730664376	1	1	HEAL HOME HEALTH INC	10/28/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1041 E SHIELDS AVE	UNIT B	FRESNO	CA	93704	5051	10	06019	36.7795785	-119.797614	Fresno County
56450	Fee-for-Service	1962667618	1962667618	1	1	HONG, DAVID S MD	6/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	93361	36	Psychiatry	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
56470	Fee-for-Service	1831180975	1831180975	1	1	HOPP, KAREN T MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84575	36	Psychiatry	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
56549	Fee-for-Service	1780962035	1780962035	1	1	HOFFMAN, CARLY N NP	4/4/2016	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
56559	Fee-for-Service	1821057191	1821057191	1	1	HAILEMICHAEL, EYASSU 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
56561	Fee-for-Service	1659550861	1659550861	1	1	HOLLAND, VANESSA R MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101766	07	Dermatology	0	In state provider	None	11370 ANDERSON ST	SUITE 2600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
56562	Fee-for-Service	1528674868	1528674868	1	1	HAPPY DAYS HOSPICE LLC	4/14/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3639 FOOTHILL BLVD	SUITE 202	GLENDALE	CA	91214	1758	19	06037	34.23595478	-118.2589332	Los Angeles County
56596	Fee-for-Service	1750362570	1750362570	1	1	HO, WENDY W MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103077	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7002	19	06037	34.06527974	-118.4462792	Los Angeles County
56611	Fee-for-Service	1780675850	1780675850	1	1	HEMAYA, EMAD	4/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90395	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
56623	Fee-for-Service	1497104673	1497104673	1	1	HARRIS, DUSTIN MD	2/19/2020	207P00000X	NA	Other	026	PHYSICIANS	161917	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
56697	Fee-for-Service	1750321931	1750321931	1	1	HUANG, FANNIE	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42971	08	Family Practice	0	In state provider	None	280 HOPE ST	None	MOUNTAIN VIEW	CA	94041	1308	43	06085	37.39234309	-122.0785697	Santa Clara County
56715	Fee-for-Service	1114472180	1114472180	1	1	HARTLINE, KENNETH D PSYD	9/30/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
56736	Fee-for-Service	1790833663	1790833663	1	1	HAN, LAURIE J MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70672	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
56749	Fee-for-Service	1417035023	1417035023	1	1	HOM, GERALD A MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42318	01	General 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
56767	Fee-for-Service	1417016031	1417016031	1	1	HSU, SHAYNA T MD	5/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87002	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
56780	Fee-for-Service	1700429081	1700429081	1	1	HUDSON, JULIANA N LCSW	3/7/2024	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
56799	Fee-for-Service	1992941751	1992941751	1	1	HERNANDEZ, NICOLAS R DO	8/23/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	10580	08	Family Practice	0	In state provider	None	731 NORTH BEACH BLVD	None	LA HABRA	CA	90631	3657	30	06059	33.93812202	-117.9680337	Orange County
56811	Fee-for-Service	1679041347	1679041347	1	1	HERNANDEZ, TIEN-CHING T CNP	9/9/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	500 DOYLE PARK	STE 205	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
56850	Fee-for-Service	1649804972	1649804972	1	1	HALL, VANESSA M NP	3/31/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95014022	-	NOT APPLICABLE	0	In state provider	None	717 LINCOLN BLVD.	None	VENICE	CA	90291	2845	19	06037	33.99949766	-118.464069	Los Angeles County
56852	Fee-for-Service	1528674868	1528674868	1	1	HAPPY DAYS HOSPICE LLC	4/14/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3639 FOOTHILL BLVD	SUITE 202	GLENDALE	CA	91214	1758	19	06037	34.23595478	-118.2589332	Los Angeles County
56866	Fee-for-Service	1831170935	1831170935	1	1	HASELHORST, 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	13677 W MCDOWELL RD	None	GOODYEAR	AZ	85395	2635	00	None	33.461982	-112.3535475	Maricopa County
56876	Fee-for-Service	1346368388	1346368388	1	1	HASSAN, REHAM A DO	9/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9054	None	None	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	4809	19	06037	34.158213	-118.328112	Los Angeles County
56886	Fee-for-Service	1235116732	1235116732	1	1	HARDIN, KIMBERLY A MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60838	01	General Practice	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
56916	Fee-for-Service	1881673283	1881673283	1	1	HEATH, ERIN N MD	12/31/1990	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	65494	40	Pediatrics	0	In state provider	#102	599 SIR FRANCIS DRAKE BL	None	GREENBRAE	CA	94904	1712	21	06041	37.95026531	-122.5332546	Marin County
56936	Fee-for-Service	1659570174	1659570174	1	1	HSIEH, YVONNE MD	7/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99871	03	Allergy	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
56945	Fee-for-Service	1205996097	1205996097	1	1	HOSALKAR, HARISH S MD	5/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107847	20	Orthopedic Surgery	0	In state provider	None	3030 CHILDREN'S WAY	SUITE 410	SAN DIEGO	CA	92123	4228	37	06073	32.798889	-117.150826	San Diego County
56950	Fee-for-Service	1558355677	1558355677	1	1	HAYASHI, RONALD D MD	4/30/1987	207L00000X	NA	Other	026	PHYSICIANS	43719	05	Anesthesiology	0	In state provider	None	1900 POINT WEST WAY	STE 222	SACRAMENTO	CA	95815	4704	34	06067	38.599677	-121.431447	Sacramento County
56951	Fee-for-Service	1285064824	1285064824	1	1	HOMAN, JASON DPM	9/1/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	883 SNEATH LANE	SUITE 160	SAN BRUNO	CA	94066	2409	41	06081	37.63591781	-122.4231037	San Mateo County
56988	Fee-for-Service	1750321931	1750321931	1	1	HUANG, FANNIE	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42971	41	Internal Medicine	0	In state provider	None	280 HOPE ST	None	MOUNTAIN VIEW	CA	94041	1308	43	06085	37.39234309	-122.0785697	Santa Clara County
56991	Fee-for-Service	1043871288	1043871288	1	1	HAGHNAZARIAN, EDITH MD	1/25/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	178017	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
56998	Fee-for-Service	1720259476	1720259476	1	1	HOTCHKISS, JOHN H IV MD	12/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134271	30	Radiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
57006	Fee-for-Service	1093241952	1093241952	1	1	HUYNH, KAREN MD	11/21/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	158259	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
57015	Fee-for-Service	1720680143	1720680143	1	1	HOMEBRIDGE HOSPICE, INC	6/25/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	127 S BRAND BLVD	STE 226	GLENDALE	CA	91204	1374	19	06037	34.145289	-118.255096	Los Angeles County
57037	Fee-for-Service	1356716039	1356716039	1	1	HISAKA, NICOLE M PSYD	4/8/2022	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
57038	Fee-for-Service	1689098162	1689098162	1	1	HA, THANH T DO	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13089	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
57081	Fee-for-Service	1699193979	1699193979	1	1	HICKLE, TYSON MD	8/30/2022	207P00000X	NA	Other	026	PHYSICIANS	178399	None	None	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	4685	55	06109	37.97749352	-120.3700335	Tuolumne County
57110	Fee-for-Service	1891722773	1891722773	1	1	HEIDE, AARON C MD	9/14/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	132537	13	Neurology (M.D. only)	0	In state provider	None	3400 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
57123	Fee-for-Service	1528062569	1528062569	1	1	HARRISON COUNTY COMMUNITY HO	7/29/2019	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SPITAL	2600 MILLER ST	None	BETHANY	MO	64424	2701	00	None	40.26524033	-94.02562696	Harrison County
57128	Fee-for-Service	1720285273	1720285273	1	1	HODA, KAVEH MD	7/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95531	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
57137	Fee-for-Service	1366654162	1366654162	1	1	HAYS, JOHNATHAN MD	10/12/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	181762	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
57157	Fee-for-Service	1467913954	1467913954	1	1	HASSID, BRANDON MD	7/17/2024	2083S0010X	NA	Adult Primary Care	026	PHYSICIANS	176691	25	Physical Medicine and Rehabilitation	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
57166	Fee-for-Service	1912317736	1912317736	1	1	HORTON, RYAN W MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149010	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
57169	Fee-for-Service	1164412763	1164412763	1	1	HWANG, JANICE J MD	12/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147940	30	Radiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
57176	Fee-for-Service	1659312593	1659312593	1	3	HEALTHCARE PARTNERS AFFILIAT	5/1/1994	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP	2750 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	3063	19	06037	33.98916573	-118.2210574	Los Angeles County
57232	Fee-for-Service	1316567118	1316567118	1	1	HERRIMAN, RACHAEL A MD	1/2/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	186164	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
57243	Fee-for-Service	1659429686	1659429686	1	1	HENRY, TASMIA Q MD	6/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94761	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
57253	Fee-for-Service	1841695889	1841695889	1	1	HANSRA, HARAMRIT MD	10/1/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	162201	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
57259	Fee-for-Service	1760703565	1760703565	1	1	HAYNES, RACHEL E LMFT	5/10/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21700 REDWOOD RD	SUITE B	CASTRO VALLEY	CA	94546	6434	01	06001	37.68919396	-122.0735402	Alameda County
57270	Fee-for-Service	1710926167	1710926167	1	1	HEARING ASSOCIATES INC	9/23/2005	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	18433 ROSCOE BLVD	#204	NORTHRIDGE	CA	91325	4136	19	06037	34.22076747	-118.534725	Los Angeles County
57280	Fee-for-Service	1679520076	1679520076	1	1	HSIEH, ABRAHAM G MD	4/30/1991	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	44211	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
57290	Fee-for-Service	1487881827	1487881827	1	1	HURVITZ, MANJU S MD	2/1/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	152440	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
57306	Fee-for-Service	1720680143	1720680143	1	1	HOMEBRIDGE HOSPICE, INC	6/25/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	127 S BRAND BLVD	STE 226	GLENDALE	CA	91204	1374	19	06037	34.145289	-118.255096	Los Angeles County
57320	Fee-for-Service	1508971938	1508971938	1	1	HARDY, KAREN A MD	12/1/2003	2080P0214X	NA	Pulmonology	026	PHYSICIANS	44088	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
57328	Fee-for-Service	1346398641	1346398641	1	1	HENDRICKS, MARTHA J PHD	5/15/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1721 ARTESIA BLVD	SUITE A	MANHATTAN BEACH	CA	90266	7158	19	06037	33.8729275	-118.382202	Los Angeles County
57340	Fee-for-Service	1871892331	1871892331	1	1	HEIKENS, MARC J MD	9/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138136	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
57388	Fee-for-Service	1336532365	1336532365	1	1	HERRERA, CINDY LMFT	1/9/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	105007	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVE	SUITE 150	SAN JOSE	CA	95119	1371	43	06085	37.23598537	-121.7783065	Santa Clara County
57409	Fee-for-Service	1578548236	1578548236	1	1	HLAVACEK, JAMES M MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	45574	None	None	0	In state provider	None	400 E MAIN ST	STE 200	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
57411	Fee-for-Service	1528062569	1528062569	1	1	HARRISON COUNTY COMMUNITY HO	7/29/2019	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SPITAL	2600 MILLER ST	None	BETHANY	MO	64424	2701	00	None	40.26524033	-94.02562696	Harrison County
57476	Fee-for-Service	1053722892	1053722892	1	1	HANSEN, DANIEL	8/25/2023	207L00000X	NA	Other	026	PHYSICIANS	186214	None	None	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
57484	Fee-for-Service	1346277324	1346277324	1	1	HINDS, JACKIE L MD	8/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85713	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
57509	Fee-for-Service	1639259997	1639259997	1	1	HSU, DEBORAH C MD	12/2/2023	2080P0204X	NA	Other	026	PHYSICIANS	191942	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
57521	Fee-for-Service	1912918962	1912918962	1	3	HERON, KYLE B MD	2/18/2020	207LP2900X	NA	Other	026	PHYSICIANS	83786	05	Anesthesiology	0	In state provider	None	4016 DALE RD	None	MODESTO	CA	95356	9268	50	06099	37.69723812	-121.049967	Stanislaus County
57535	Fee-for-Service	1104836519	1104836519	1	1	HOOVER, TAMARA J MD	5/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74348	None	None	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
57576	Fee-for-Service	1972720357	1972720357	1	1	HIMES, HAILEY K	4/21/2017	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	609 E ORANGEBURG AVE	STE 201	MODESTO	CA	95350	5512	50	06099	37.66364947	-120.9857985	Stanislaus County
57596	Fee-for-Service	1487897153	1487897153	1	1	HALDIPUR, ANSHUL G MD	6/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131703	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
57610	Fee-for-Service	1508971938	1508971938	1	1	HARDY, KAREN A MD	12/1/2003	2080P0214X	NA	Pulmonology	026	PHYSICIANS	44088	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
57632	Fee-for-Service	1760497572	1760497572	1	1	HAHN, EDWARD J MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	83898	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
57637	Fee-for-Service	1982253100	1982253100	1	1	HERR, KEVIN PT	3/22/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5337 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	2807	15	06029	35.36721148	-119.0622416	Kern County
57656	Fee-for-Service	1073817474	1073817474	1	1	HOLDSAMBECK AND ASSOCIATES,	11/19/2020	103K00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2342 PROFESSIONAL PARKWA	SUITE 300	SANTA MARIA	CA	93455	6819	42	06083	34.91786968	-120.4383001	Santa Barbara County
57676	Fee-for-Service	1922187426	1922187426	1	1	HUYNH, CHI T OD	10/12/2012	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	605 FLETCHER PKWY	None	EL CAJON	CA	92020	2522	37	06073	32.8075167	-116.9697503	San Diego County
57748	Fee-for-Service	1871746958	1871746958	1	1	HEREDIA, JULIA-ALEXANDRA	5/18/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
57750	Fee-for-Service	1043934482	1043934482	1	1	HEINRICH, LEAH V CNP	12/13/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2323 BERTHARDS DRIVE	None	SANTA ROSA	CA	95405	8500	49	06097	38.427075	-122.6666655	Sonoma County
57757	Fee-for-Service	1265966576	1265966576	1	2	HOAG, KENSIE LCSW	5/24/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	93562	-	NOT APPLICABLE	0	In state provider	None	3535 W COMMONWEALTH AVE	None	FULLERTON	CA	92833	2821	30	06059	33.8700505	-117.9749565	Orange County
57768	Fee-for-Service	1356634331	1356634331	1	1	HIGHER GROUND HOMES INC	7/13/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	422 BALBOA	None	DELANO	CA	93215	4006	15	06029	35.75658152	-119.2507155	Kern County
57816	Fee-for-Service	1760892368	1760892368	1	1	HENRY, KATHRYN	12/8/2018	207P00000X	NA	Other	026	PHYSICIANS	16128	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
57824	Fee-for-Service	1184745820	1184745820	1	1	HEAD & NECK & NEUROLOGIC	7/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	IMAGING ASSOC MED GRP	2827 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	4801	19	06037	34.03803747	-118.4750347	Los Angeles County
57833	Fee-for-Service	1962468215	1962468215	1	1	HUNG, LYNN L MD	12/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	82327	25	Physical Medicine and Rehabilitation	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
57835	Fee-for-Service	1376017962	1376017962	1	1	HARDER, TAYLOR B	9/25/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2115 J ST	SUITE 210	SACRAMENTO	CA	95816	4738	34	06067	38.576475	-121.4777745	Sacramento County
57892	Fee-for-Service	1053636977	1053636977	1	1	HENKE, THERESA N MD	6/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121297	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
57903	Fee-for-Service	1659312593	1659312593	1	22	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1002 N FAIRVIEW ST	None	SANTA ANA	CA	92703	1811	30	06059	33.75346151	-117.9023004	Orange County
57915	Fee-for-Service	1477584738	1477584738	1	1	HEALEY, MARK A MD	1/19/2024	207LC0200X	NA	Other	026	PHYSICIANS	52696	None	None	0	In state provider	None	838 NORDAHL RD	SUITE 270	SAN MARCOS	CA	92069	3513	37	06073	33.13569751	-117.1191477	San Diego County
57937	Fee-for-Service	1760600621	1760600621	1	1	HUBBARD, ERIC R DPM PC	7/28/2005	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEMORIAL PODIATRY GROUP	2333 PACIFIC AVE	None	LONG BEACH	CA	90806	3025	19	06037	33.799608	-118.193798	Los Angeles County
57941	Fee-for-Service	1073817474	1073817474	1	1	HOLDSAMBECK AND ASSOCIATES,	11/19/2020	103K00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	2342 PROFESSIONAL PARKWA	SUITE 300	SANTA MARIA	CA	93455	6819	42	06083	34.91786968	-120.4383001	Santa Barbara County
57947	Fee-for-Service	1245280841	1245280841	1	1	HAGGERTY, PATRICK J MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	45845	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9834 GENESEE AVE	STE 120	LA JOLLA	CA	92037	1225	37	06073	32.884074	-117.225855	San Diego County
57949	Fee-for-Service	1295715878	1295715878	1	1	HOWLAND, CHARLENE CRNA	9/28/2015	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
58020	Fee-for-Service	1881095644	1881095644	1	1	HARRINGTON, SARAH E MD	8/9/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	142436	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2901 N VENTURA RD	SUITE 100	OXNARD	CA	93036	1126	56	06111	34.24479149	-119.1814409	Ventura County
58024	Fee-for-Service	1932196672	1932196672	1	1	HIREN P PATEL	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
58039	Fee-for-Service	1417927534	1417927534	1	1	HAMILTON, HENRY H MD	5/27/2013	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	39569	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	35 BAYWOOD AVE	# 1	SAN MATEO	CA	94402	1516	41	06081	37.5646848	-122.3290657	San Mateo County
58075	Fee-for-Service	1811953623	1811953623	1	1	HILL, JOHN V MD	1/1/1982	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	27613	20	Orthopedic Surgery	0	In state provider	None	3170 LOMA VISTA RD	None	VENTURA	CA	93003	2970	56	06111	34.27597804	-119.2533398	Ventura County
58117	Fee-for-Service	1689685281	1689685281	1	1	HOH, MICHELE K MD	11/24/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	59183	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
58149	Fee-for-Service	1386037000	1386037000	1	1	HIRAMOTO, BRENT A MD	1/6/2025	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	164531	10	Gastroenterology (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
58174	Fee-for-Service	1053803411	1053803411	1	1	HUANG, MANLI NP	4/22/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	680 E ROMIE LN	STE B	SALINAS	CA	93901	4206	27	06053	36.65922321	-121.6430933	Monterey County
58189	Fee-for-Service	1659312593	1659312593	1	22	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1002 N FAIRVIEW ST	None	SANTA ANA	CA	92703	1811	30	06059	33.75346151	-117.9023004	Orange County
58193	Fee-for-Service	1336287689	1336287689	1	1	HSU, ALEXANDER C K MD	8/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87961	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
58202	Fee-for-Service	1619956695	1619956695	1	1	HOFFMAN, DAVID NOLAN INC	10/12/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	P S OPTOMETRY	8165 E WARDLOW RD	None	LONG BEACH	CA	90808	3204	19	06037	33.81763448	-118.0705545	Los Angeles County
58213	Fee-for-Service	1265884142	1265884142	1	1	HOSLLER DIALYSIS LLC	2/25/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	125 CORPORATE PL	SUITE B	VALLEJO	CA	94590	6968	48	06095	38.09460847	-122.2483788	Solano County
58235	Fee-for-Service	1245280841	1245280841	1	1	HAGGERTY, PATRICK J MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	45845	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9834 GENESEE AVE	STE 120	LA JOLLA	CA	92037	1225	37	06073	32.884074	-117.225855	San Diego County
58242	Fee-for-Service	1023486891	1023486891	1	1	HUFFMIRE, DAVID	9/3/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
58278	Fee-for-Service	1659312593	1659312593	1	5	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL GROUP	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
58285	Fee-for-Service	1457371767	1457371767	1	1	HOPPER, ANDREW O MD	7/3/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	37522	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	# 1200	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
58338	Fee-for-Service	1689622755	1689622755	1	1	HOTCHKISS, LAURA A MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	75961	30	Radiology	0	In state provider	None	101221 PINE ST	None	TRUCKEE	CA	96161	0000	29	06057	39.31768994	-120.2926543	Nevada County
58369	Fee-for-Service	1649813379	1649813379	1	1	HALL, CHRISTIE B CCC-SLP	1/10/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 MEDICAL PLAZA	STE 550	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
58373	Fee-for-Service	1790470763	1790470763	1	1	HEALTHTRACKRX OF CALIFORNIA	3/8/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	LLC	14743 VENTURA BLVD	STE 101	SHERMAN OAKS	CA	91403	3641	19	06037	34.15187275	-118.4543653	Los Angeles County
58421	Fee-for-Service	1134381536	1134381536	2	1	HOBEIKA, ELIE M MD	10/27/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	108245	None	None	0	In state provider	None	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	0000	54	06107	36.0663928	-119.01714	Tulare County
58429	Fee-for-Service	1285777391	1285777391	1	1	HADDAD, SHIHAB	2/8/2015	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	42212 10TH ST W	STE 10A	LANCASTER	CA	93534	7001	19	06037	34.64993879	-118.1475588	Los Angeles County
58435	Fee-for-Service	1447703400	1447703400	1	1	HEALTH ACCESS FOR ALL INC	4/10/2024	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1919 WEST 7TH ST	2ND & 3RD FLOOR	LOS ANGELES	CA	90057	4103	19	06037	34.05575686	-118.2751751	Los Angeles County
58441	Fee-for-Service	1043522261	1043522261	1	1	HAN, SOOJUNG LCSW	8/4/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	28607	-	NOT APPLICABLE	0	In state provider	None	982 MISSION STREET	None	SAN FRANCISCO	CA	94103	2911	38	06075	37.7813638	-122.4082438	San Francisco County
58458	Fee-for-Service	1942832647	1942832647	1	1	HELMUS, JENNA CRNA	9/12/2023	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
58463	Fee-for-Service	1891573291	1891573291	1	1	HANSEN, ALLYSON OT	3/1/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
58472	Fee-for-Service	1366670077	1366670077	1	1	HAGOPIAN, TARA A DO	2/15/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	20564	None	None	0	In state provider	None	465 N ROXBURY DR	STE 101&715	BEVERLY HILLS	CA	90210	4206	19	06037	34.06832918	-118.4072114	Los Angeles County
58477	Fee-for-Service	1962463026	1962463026	1	1	HUYNH, THANH H MD	9/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93650	08	Family Practice	0	In state provider	None	1001 BROADWAY	SUITE 302	MILLBRAE	CA	94030	1978	41	06081	37.60544641	-122.3978603	San Mateo County
58480	Fee-for-Service	1659312593	1659312593	1	22	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	1002 N FAIRVIEW ST	None	SANTA ANA	CA	92703	1811	30	06059	33.75346151	-117.9023004	Orange County
58484	Fee-for-Service	1285615922	1285615922	1	1	HAMANN, KENDAL L MD	6/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81803	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
58493	Fee-for-Service	1619341500	1619341500	1	1	HAMAN, AISSATOU MD INC	3/21/2016	207R00000X	NA	Other	026	PHYSICIANS	115745	None	None	0	In state provider	None	1 SHRADER ST	SUITE 570	SAN FRANCISCO	CA	94117	1016	38	06075	37.77467326	-122.4529451	San Francisco County
58519	Fee-for-Service	1215965207	1215965207	1	1	HASAN, SHAZIA M MD INC	5/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	55223	41	Internal Medicine	0	In state provider	None	11633 HAWTHORNE BLVD	STE 400	HAWTHORNE	CA	90250	2370	19	06037	33.928488	-118.3527475	Los Angeles County
58539	Fee-for-Service	1730826223	1730826223	1	1	HEIDI REGENASS, M.D., PC.	9/29/2022	208200000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	1945 E 17TH ST	107	SANTA ANA	CA	92705	6862	30	06059	33.75999352	-117.838899	Orange County
58554	Fee-for-Service	1881133353	1881133353	1	1	HUANG, NIYA NP	1/21/2021	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
58567	Fee-for-Service	1659312593	1659312593	1	5	HEALTHCARE PARTNERS AFFILIAT	5/26/2020	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
58597	Fee-for-Service	1003483660	1003483660	1	1	HAWKINS, JOHN MD	3/15/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	186608	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
58599	Fee-for-Service	1003270299	1003270299	1	1	HAIDER, SHANZAY MD	11/5/2024	207R00000X	NA	Other	026	PHYSICIANS	191340	41	Internal Medicine	0	In state provider	None	400 PEPPER	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
58608	Fee-for-Service	1356928105	1356928105	1	1	HEALTHCHOICE PRIMARY CARE, I	8/11/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	INIC	10737 CAMINO RUIZ	STE. 143	SAN DIEGO	CA	92126	2361	37	06073	32.91416051	-117.1437943	San Diego County
58643	Fee-for-Service	1669797882	1669797882	1	1	HUANG, JIN R MD	9/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109705	41	Internal Medicine	0	In state provider	None	3132 WEST MARCH LANE	STE 5	STOCKTON	CA	95219	2354	39	06077	37.9839146	-121.3516231	San Joaquin County
58718	Fee-for-Service	1861564692	1861564692	1	1	HE, XIAO-YAN MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73966	36	Psychiatry	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
58724	Fee-for-Service	1447703400	1447703400	1	1	HEALTH ACCESS FOR ALL INC	5/1/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1919 WEST 7TH ST	2ND & 3RD FLOOR	LOS ANGELES	CA	90057	4103	19	06037	34.05575686	-118.2751751	Los Angeles County
58725	Fee-for-Service	1891747812	1891747812	1	1	HAYWARD, ULRIKE M MD	5/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76084	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
58749	Fee-for-Service	1972622132	1972622132	1	1	HUANG, YI-WEN C DO	2/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11273	05	Anesthesiology	0	In state provider	None	2626 N CALIFORNIA	STE G	STOCKTON	CA	95204	5500	39	06077	37.97724966	-121.2917368	San Joaquin County
58761	Fee-for-Service	1114172640	1114172640	1	1	HACC INC	8/9/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	599 W 9TH STREET	None	SAN PEDRO	CA	90731	3504	19	06037	33.73602055	-118.28997	Los Angeles County
58764	Fee-for-Service	1396330957	1396330957	1	1	HELIUS HOSPICE AND	5/17/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE, INC	4195 VALLEY FAIR STREET	SUITE 201A	SIMI VALLEY	CA	93063	2953	56	06111	34.27259857	-118.7126789	Ventura County
58765	Fee-for-Service	1962463026	1962463026	1	1	HUYNH, THANH H MD	9/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93650	01	General Practice	0	In state provider	None	1001 BROADWAY	SUITE 302	MILLBRAE	CA	94030	1978	41	06081	37.60544641	-122.3978603	San Mateo County
58799	Fee-for-Service	1841210382	1841210382	1	1	HEUSTIS, DARRYL G MD	1/1/1984	207ZP0105X	NA	Other	026	PHYSICIANS	29068	22	Pathology (M.D. only)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
58806	Fee-for-Service	1215965207	1215965207	1	1	HASAN, SHAZIA M MD INC	5/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	55223	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11633 HAWTHORNE BLVD	STE 400	HAWTHORNE	CA	90250	2370	19	06037	33.928488	-118.3527475	Los Angeles County
58839	Fee-for-Service	1356774350	1356774350	2	1	H & N PHARMACY INC	8/1/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	10106 WESTMINSTER AVE	None	GARDEN GROVE	CA	92843	4753	30	06059	33.75946054	-117.9533745	Orange County
58845	Fee-for-Service	1679936660	1679936660	1	1	HAN, YONG S MD	7/8/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	151306	None	None	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
58853	Fee-for-Service	1659312593	1659312593	1	5	HEALTHCARE PARTNERS AFFILIAT	5/31/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
58856	Fee-for-Service	1306137625	1306137625	1	1	HANAK, BRIAN E MD	8/21/2019	207T00000X	NA	General Surgery	026	PHYSICIANS	162995	14	Neurological Surgery	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
58870	Fee-for-Service	1699869552	1699869552	1	1	HANTEN, STEPHEN J JR MD	2/28/1990	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	38921	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
58878	Fee-for-Service	1558364257	1558364257	1	1	HOFFMAN, CARY J MD DO	6/3/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	87957	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
58884	Fee-for-Service	1932457736	1932457736	1	1	HER, BONNIE MD	3/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121804	41	Internal Medicine	0	In state provider	None	333 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
58911	Fee-for-Service	1215430723	1215430723	1	1	HAYWOOD, GLORIA D LMFT	11/1/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9650 BUSINESS CENTER DR	STE 104	RANCHO CUCAMONGA	CA	91730	4536	36	06071	34.09810852	-117.594162	San Bernardino County
58945	Fee-for-Service	1578910923	1578910923	1	1	HOFF, LEEINA E NP	5/15/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
58966	Fee-for-Service	1497829709	1497829709	1	1	HOPF, RICHARD H MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40038	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
59010	Fee-for-Service	1447703400	1447703400	1	1	HEALTH ACCESS FOR ALL INC	6/22/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1919 WEST 7TH ST	2ND & 3RD FLOOR	LOS ANGELES	CA	90057	4103	19	06037	34.05575686	-118.2751751	Los Angeles County
59050	Fee-for-Service	1396330957	1396330957	1	1	HELIUS HOSPICE AND	5/17/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE, INC	4195 VALLEY FAIR STREET	SUITE 201A	SIMI VALLEY	CA	93063	2953	56	06111	34.27259857	-118.7126789	Ventura County
59055	Fee-for-Service	1558446351	1558446351	1	1	HALLDORSON, JEFFREY B MD	6/7/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86089	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
59062	Fee-for-Service	1639274251	1639274251	1	1	HELLER, DAVID M MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46643	41	Internal Medicine	0	In state provider	None	2017 1ST AVE	STE 100	SAN DIEGO	CA	92101	9001	37	06073	32.72646147	-117.1638767	San Diego County
59076	Fee-for-Service	1932237047	1932237047	1	1	HOCHSTADTER, JODI LMFT	6/10/2024	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
59082	Fee-for-Service	1629323522	1629323522	1	1	HINDS, DARTAGNAN F MD	10/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156636	66	Emergency Medicine (Urgent Care)	0	In state provider	None	ONE HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
59096	Fee-for-Service	1063873891	1063873891	1	1	HAKIMI, MANUEL MD	5/29/2020	207R00000X	NA	Other	026	PHYSICIANS	155416	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	CARDIOLOGY DEPARTMENT	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
59141	Fee-for-Service	1659312593	1659312593	1	5	HEALTHCARE PARTNERS AFFILIAT	2/21/2019	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	MEDICAL GROUP	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
59155	Fee-for-Service	1215013446	1215013446	1	1	HAZAN, LYDIE L MD INC	12/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53116	01	General Practice	0	In state provider	None	8500 WILSHIRE BLVD	STE 700	BEVERLY HILLS	CA	90211	3105	19	06037	34.06521956	-118.3764689	Los Angeles County
59165	Fee-for-Service	1336215383	1336215383	1	1	HARE, DONOVAN R MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75959	22	Pathology (M.D. only)	0	In state provider	None	800 S MAIN STREET	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
59177	Fee-for-Service	1730255571	1730255571	1	1	HASEMANN, DAWN M PHD	9/11/2012	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
59186	Fee-for-Service	1912972779	1912972779	1	1	HENICK, KATHRYN A MD	4/1/1999	207RH0003X	NA	Oncology	026	PHYSICIANS	78994	78	Neoplastic Diseases/Oncology	0	In state provider	None	2336 SANTA MONICA BLVD	STE 301	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
59200	Fee-for-Service	1184657488	1184657488	1	1	HUI, EDWARD K MD	6/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81094	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
59202	Fee-for-Service	1285610618	1285610618	1	1	HUHN, DANIEL MD	10/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	68201	None	None	0	In state provider	None	1625 E MAIN ST	STE 100	EL CAJON	CA	92021	5240	37	06073	32.80969963	-116.9203429	San Diego County
59210	Fee-for-Service	1437398815	1437398815	1	1	HUEMER, ERIS LMFT	12/1/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4100 W ALAMEDA AVE FL 3	STE 365	BURBANK	CA	91505	4191	19	06037	34.1526111	-118.3447742	Los Angeles County
59218	Fee-for-Service	1144474420	1144474420	1	1	HOFFMAN, CINDY K LCSW	12/8/2008	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	5212 MANOR RIDGE LANE	None	SAN DIEGO	CA	92130	2884	37	06073	32.93404517	-117.2049726	San Diego County
59220	Fee-for-Service	1679006811	1679006811	1	1	HAMMAMI, SAFA MD	1/18/2024	207RE0101X	NA	Endocrinology	026	PHYSICIANS	164911	None	None	0	In state provider	None	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
59237	Fee-for-Service	1700116399	1700116399	1	1	HEILVEIL, IRA P PHD	9/6/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	410 ARDEN AVE	STE 201	GLENDALE	CA	91203	4006	19	06037	34.15842441	-118.2618749	Los Angeles County
59250	Fee-for-Service	1699074740	1699074740	1	1	HART, MONA R OT	11/18/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5895 BALL RD	None	CYPRESS	CA	90630	3244	30	06059	33.81715998	-118.0298386	Orange County
59298	Fee-for-Service	1447703400	1447703400	1	1	HEALTH ACCESS FOR ALL INC	5/1/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1919 WEST 7TH ST	2ND & 3RD FLOOR	LOS ANGELES	CA	90057	4103	19	06037	34.05575686	-118.2751751	Los Angeles County
59319	Fee-for-Service	1275619199	1275619199	1	1	HIGGINS, KIMBERLY M LCSW	2/25/2022	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
59330	Fee-for-Service	1528597879	1528597879	1	1	HUYNH, DIANA MD	5/22/2020	207P00000X	NA	Other	026	PHYSICIANS	166379	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
59345	Fee-for-Service	1447294301	1447294301	1	1	HAUSER, MARK G MD	11/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	57600	66	Emergency Medicine (Urgent Care)	0	In state provider	None	PUEBLO AT BATH	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
59418	Fee-for-Service	1578797213	1578797213	1	1	HARRIS, STEVEN J MD	12/1/2017	207P00000X	NA	Other	026	PHYSICIANS	152586	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J STREET	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
59440	Fee-for-Service	1245306745	1245306745	1	1	HONG, WILLIAM H MD	3/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	52579	41	Internal Medicine	0	In state provider	None	501 E HARDY ST	STE 410	INGLEWOOD	CA	90301	4025	19	06037	33.9491005	-118.348857	Los Angeles County
59443	Fee-for-Service	1215013446	1215013446	1	1	HAZAN, LYDIE L MD INC	12/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53116	40	Pediatrics	0	In state provider	None	8500 WILSHIRE BLVD	STE 700	BEVERLY HILLS	CA	90211	3105	19	06037	34.06521956	-118.3764689	Los Angeles County
59457	Fee-for-Service	1962435792	1962435792	1	1	HOUSTON HOSPITALS, INC	6/8/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1601 WATSON BLVD	None	WARNER ROBINS	GA	31093	3431	00	None	32.61818351	-83.6305245	Houston County
59474	Fee-for-Service	1912972779	1912972779	1	1	HENICK, KATHRYN A MD	4/1/1999	207RH0003X	NA	Oncology	026	PHYSICIANS	78994	68	Hematology	0	In state provider	None	2336 SANTA MONICA BLVD	STE 301	SANTA MONICA	CA	90404	2067	19	06037	34.03136627	-118.4766854	Los Angeles County
59482	Fee-for-Service	1104834464	1104834464	1	1	HANGER P & O WEST INC	1/1/1998	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	820 S. AKERS ST	SUITE 230	VISALIA	CA	93277	1591	54	06107	36.323757	-119.3491755	Tulare County
59496	Fee-for-Service	1194941237	1194941237	1	1	HABASHY, MICHAEL F MD	4/3/2008	193200000X	NA	Other	026	PHYSICIANS	83722	45	Nephrology (Renal-Kidney)	0	In state provider	CORP	2625 W ALAMEDA	STE 516	BURBANK	CA	91505	4806	19	06037	34.1577056	-118.329779	Los Angeles County
59497	Fee-for-Service	1659459758	1659459758	1	1	HU, JIANFEI MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54067	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
59505	Fee-for-Service	1396912614	1396912614	1	1	HANSEN, DIANA F MD	10/8/2021	207LC0200X	NA	Other	026	PHYSICIANS	173563	None	None	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
59525	Fee-for-Service	1164866034	1164866034	1	1	HUIBREGTSE, KELLY E MD	7/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	135616	40	Pediatrics	0	In state provider	None	3490 CALIFORNIA STREET	SUITE 200	SAN FRANCISCO	CA	94118	1892	38	06075	37.78668333	-122.4514243	San Francisco County
59526	Fee-for-Service	1285769885	1285769885	1	1	HANSEN, MARIAH A PHD	10/28/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5900 STATE FARM DRIVE	None	ROHNERT PARK	CA	94928	2149	49	06097	38.35358835	-122.7073105	Sonoma County
59547	Fee-for-Service	1093860439	1093860439	1	1	HATASHITA, MICHAEL B AN	9/17/1980	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	7900 ZENITH DR	None	CITRUS HEIGHTS	CA	95621	1075	34	06067	38.709072	-121.314654	Sacramento County
59616	Fee-for-Service	1053321646	1053321646	1	1	HOFFMAN, DAVID P MD	7/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77925	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
59623	Fee-for-Service	1760457576	1760457576	1	1	HERNANDEZ, HOMER M MD	1/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	40460	08	Family Practice	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
59640	Fee-for-Service	1881811800	1881811800	1	1	HANS, NITU PHD	11/30/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	4633	07	06013	38.00771973	-122.1331484	Contra Costa County
59659	Fee-for-Service	1275609729	1275609729	1	1	HEATLEY, SCOTT MD	5/21/2020	207R00000X	NA	Other	026	PHYSICIANS	46367	41	Internal Medicine	0	In state provider	None	100 MISSION BLVD	STE 2800	JACKSON	CA	95642	2536	03	06005	38.35163001	-120.7670107	Amador County
59695	Fee-for-Service	1659312593	1659312593	1	29	HEALTHCARE PARTNERS AFFILIAT	2/1/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	AFFILIATES MEDICAL GROUP	901 W CIVIC CENTER DR	STE 120	SANTA ANA	CA	92703	2380	30	06059	33.75155572	-117.8778014	Orange County
59729	Fee-for-Service	1245306745	1245306745	1	1	HONG, WILLIAM H MD	3/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	52579	83	Rheumatology	0	In state provider	None	501 E HARDY ST	STE 410	INGLEWOOD	CA	90301	4025	19	06037	33.9491005	-118.348857	Los Angeles County
59734	Fee-for-Service	1750626909	1750626909	1	1	HUANG, LEAH CCC-SLP	6/13/2020	235Z00000X	NA	Other	037	SPEECH 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
59745	Fee-for-Service	1962435792	1962435792	1	1	HOUSTON HOSPITALS, INC	6/8/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1601 WATSON BLVD	None	WARNER ROBINS	GA	31093	3431	00	None	32.61818351	-83.6305245	Houston County
59751	Fee-for-Service	1699712349	1699712349	1	1	HINTON, JAY PHILLIP A MD	5/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	23731	02	General Surgery	0	In state provider	A PROF CORP	1247 E ALLUVIAL AVE	STE 101	FRESNO	CA	93720	2686	10	06019	36.84470048	-119.7606195	Fresno County
59753	Fee-for-Service	1861738353	1861738353	1	1	HOMYAK, MICHELLE MD	10/1/2019	207L00000X	NA	Other	026	PHYSICIANS	79145	05	Anesthesiology	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	4809	19	06037	34.158213	-118.328112	Los Angeles County
59783	Fee-for-Service	1063445682	1063445682	1	1	HANSEN, METTE V MD	6/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	68649	25	Physical Medicine and Rehabilitation	0	In state provider	None	3975 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.484045	-122.7376395	Sonoma County
59785	Fee-for-Service	1194941237	1194941237	1	1	HABASHY, MICHAEL F MD	4/3/2008	193200000X	NA	Other	026	PHYSICIANS	83722	41	Internal Medicine	0	In state provider	CORP	2625 W ALAMEDA	STE 516	BURBANK	CA	91505	4806	19	06037	34.1577056	-118.329779	Los Angeles County
59799	Fee-for-Service	1205220894	1205220894	1	1	HU, KEVIN MD	3/10/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163179	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
59813	Fee-for-Service	1184916017	1184916017	1	1	HO, HAO H MD	6/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136528	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3809	30	06059	33.78236558	-117.8648414	Orange County
59831	Fee-for-Service	1255312005	1255312005	1	1	HYUN, DAVID MD	1/23/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	56256	06	Cardiovascular Disease (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
59832	Fee-for-Service	1508849514	1508849514	1	1	HALLAHAN, TARA 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
59852	Fee-for-Service	1134121460	1134121460	1	1	HONCH, JOHN A MD	4/1/1998	207ND0900X	NA	Dermatology	026	PHYSICIANS	40665	07	Dermatology	0	In state provider	DESCANSO DERM. MED GRP	1346 FOOTHILL BLVD	STE 203	LA CANADA	CA	91011	2141	19	06037	34.20780552	-118.2076252	Los Angeles County
59882	Fee-for-Service	1487019972	1487019972	1	1	HETHERINGTON, FRANCES S MD	12/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148413	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
59911	Fee-for-Service	1609465038	1609465038	1	1	HELPING HEARTS HOSPICE CARE	9/7/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	143 S GLENDALE AVE	SUITE 105	GLENDALE	CA	91205	1137	19	06037	34.14478204	-118.2478537	Los Angeles County
59916	Fee-for-Service	1265511398	1265511398	1	1	HOLT, RONALD R II DO	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	6769	27	Psychiatry Neurology (D.O. only)	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
59938	Fee-for-Service	1891251849	1891251849	1	1	HEACOCK HEALTH MEDICAL GROUP	2/26/2021	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	24060 FIR AVE	SUITE A	MORENO VALLEY	CA	92553	2895	33	06065	33.93543049	-117.242604	Riverside County
59963	Fee-for-Service	1013171339	1013171339	1	1	HU, JETHRO L MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94764	13	Neurology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
59972	Fee-for-Service	1417942665	1417942665	1	1	HAUSWIRTH, SCOTT G OD	1/1/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
59983	Fee-for-Service	1659312593	1659312593	1	29	HEALTHCARE PARTNERS AFFILIAT	5/26/2020	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	901 W CIVIC CENTER DR	STE 120	SANTA ANA	CA	92703	2380	30	06059	33.75155572	-117.8778014	Orange County
59996	Fee-for-Service	1376771816	1376771816	1	1	HIGGINS, NANCY J SP	10/19/2010	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKON BLVD	None	SACRAMENTO	CA	95816	7098	34	06067	38.56554	-121.4664615	Sacramento County
60018	Fee-for-Service	1184087322	1184087322	1	1	HOANG, AMBER MD	8/14/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	120 W HELLMAN AVE	#302	MONTEREY PARK	CA	91754	1209	19	06037	34.06972847	-118.124154	Los Angeles County
60019	Fee-for-Service	1871917195	1871917195	1	1	HUDSON, SARAH W	5/4/2015	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	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
60022	Fee-for-Service	1548289416	1548289416	1	1	HUANG, BENJAMIN TAI-YUEN MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66797	42	Nuclear 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
60040	Fee-for-Service	1699712349	1699712349	1	1	HINTON, JAY PHILLIP A MD	5/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	23731	01	General Practice	0	In state provider	A PROF CORP	1247 E ALLUVIAL AVE	STE 101	FRESNO	CA	93720	2686	10	06019	36.84470048	-119.7606195	Fresno County
60044	Fee-for-Service	1821594144	1821594144	1	10	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	3553 CAMINO MIRA COSTA	STE C	SAN CLEMENTE	CA	92672	3512	30	06059	33.45584347	-117.6573285	Orange County
60058	Fee-for-Service	1487684965	1487684965	1	2	HARRISON, GEORGE H MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	72867	-	NOT APPLICABLE	0	In state provider	None	1930 MARKET ST	None	SAN FRANCISCO	CA	94102	6228	38	06075	37.77037155	-122.4255051	San Francisco County
60063	Fee-for-Service	1154479012	1154479012	1	1	HUQ, SAHANA MD	2/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69303	36	Psychiatry	0	In state provider	MGA OFFICE	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
60074	Fee-for-Service	1184944738	1184944738	1	1	HOMAFAR, HANANEH MD	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137348	13	Neurology (M.D. only)	0	In state provider	None	2601 E MAIN ST	None	VENTURA	CA	93003	2801	56	06111	34.27443821	-119.2609368	Ventura County
60079	Fee-for-Service	1093322711	1093322711	1	1	HERITAGE HOSPICE SERVICES	11/10/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	7200 VINELAND AVE	STE 212	SUN VALLEY	CA	91352	5088	19	06037	34.2016328	-118.3703012	Los Angeles County
60094	Fee-for-Service	1023420742	1023420742	1	1	HERON-CARMIGNANI, SIMONE D	1/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PHD	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
60107	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	9/27/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	67	Endocrinology	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
60110	Fee-for-Service	1215015086	1215015086	1	1	HSU, EVERETT MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67878	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
60119	Fee-for-Service	1053555029	1053555029	1	1	HOWELL, JEAN G MD	1/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123548	01	General Practice	0	In state provider	None	3234 MARYSVILLE BOULEVAR	None	SACRAMENTO	CA	95815	1411	34	06067	38.626371	-121.4322615	Sacramento County
60121	Fee-for-Service	1255312005	1255312005	1	1	HYUN, DAVID MD	1/23/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	56256	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
60123	Fee-for-Service	1922332014	1922332014	1	1	HAMMON, APRIL OT	4/23/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	5255 EL CAMINO REAL	SUITE C	ATASCADERO	CA	93422	3351	40	06079	35.49280107	-120.6762923	San Luis Obispo County
60156	Fee-for-Service	1790700748	1790700748	1	1	HARRELL, JAMES H II MD	7/3/1997	207R00000X	NA	Other	026	PHYSICIANS	22567	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
60166	Fee-for-Service	1821594144	1821594144	1	8	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	350 BON AIR RD	STE 100	GREENBRAE	CA	94904	1753	21	06041	37.94974377	-122.5342016	Marin County
60167	Fee-for-Service	1902809817	1902809817	1	1	HERRICK, ROBERT S MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	24395	18	Ophthalmology	0	In state provider	None	882 W RIALTO AVE	None	RIALTO	CA	92376	5658	36	06071	34.0995813	-117.3876688	San Bernardino County
60201	Fee-for-Service	1609465038	1609465038	1	1	HELPING HEARTS HOSPICE CARE	9/7/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	143 S GLENDALE AVE	SUITE 105	GLENDALE	CA	91205	1137	19	06037	34.14478204	-118.2478537	Los Angeles County
60207	Fee-for-Service	1659312593	1659312593	1	26	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	2925 N PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
60216	Fee-for-Service	1407821317	1407821317	1	1	HANSEN, ROBERT M MD	4/30/1993	207LP2900X	NA	Other	026	PHYSICIANS	47619	01	General Practice	0	In state provider	None	300 PARK MARINA CIR	STE 204	REDDING	CA	96001	0964	45	06089	40.57646517	-122.3723537	Shasta County
60271	Fee-for-Service	1659312593	1659312593	1	29	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	901 W CIVIC CENTER DR	STE 120	SANTA ANA	CA	92703	2380	30	06059	33.75155572	-117.8778014	Orange County
60272	Fee-for-Service	1104964824	1104964824	1	1	HACKLEY, SHARON U CRNA	6/8/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
60282	Fee-for-Service	1548209539	1548209539	1	1	HENNEMEYER, CHARLES T MD	4/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82709	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
60287	Fee-for-Service	1649801168	1649801168	1	1	HERMANO, LANI D PT	6/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3180 ARDEN WY	None	SACRAMENTO	CA	95825	3701	34	06067	38.595528	-121.3903395	Sacramento County
60311	Fee-for-Service	1548289416	1548289416	1	1	HUANG, BENJAMIN TAI-YUEN MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66797	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
60314	Fee-for-Service	1518991983	1518991983	1	1	HERNANDEZ, ARMAND R MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	72645	40	Pediatrics	0	In state provider	None	1329 SPANOS CT	STE C4	MODESTO	CA	95355	2806	50	06099	37.66976149	-120.9731145	Stanislaus County
60321	Fee-for-Service	1184244014	1184244014	1	1	HRYNIEWICKI, ADAM MD	6/10/2024	207P00000X	NA	Other	026	PHYSICIANS	185419	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
60331	Fee-for-Service	1972621100	1972621100	1	1	HAWKINS, MATTHEW T JR MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	74091	41	Internal Medicine	0	In state provider	None	2767 OLIVE HIGHWAY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
60359	Fee-for-Service	1245261171	1245261171	2	1	HWEE, THOMAS N MD	9/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	31812	08	Family Practice	0	In state provider	None	993 N BROADWAY ST	STE A	LOS ANGELES	CA	90012	1764	19	06037	34.0663686	-118.2361889	Los Angeles County
60362	Fee-for-Service	1659312593	1659312593	1	34	HEALTHCARE PARTNERS AFFILIAT	8/16/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	6900 LINCOLN AVENUE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
60364	Fee-for-Service	1093322711	1093322711	1	1	HERITAGE HOSPICE SERVICES	11/10/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	7200 VINELAND AVE	STE 212	SUN VALLEY	CA	91352	5088	19	06037	34.2016328	-118.3703012	Los Angeles County
60393	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	3/27/2023	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	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
60449	Fee-for-Service	1437870839	1437870839	1	1	HENG, DALIYA DPM	8/1/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	23141 MOULTON PKWY	STE 109	LAGUNA HILLS	CA	92653	1241	30	06059	33.62613379	-117.7305831	Orange County
60471	Fee-for-Service	1235314246	1235314246	1	1	HOUSE PSYCHIATRIC CLINIC, IN	2/14/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	C.	1322 E SHAW AVE	SUITE 410	FRESNO	CA	93710	0000	10	06019	36.8087145	-119.7644625	Fresno County
60479	Fee-for-Service	1710035985	1710035985	1	1	HAMBY, KEVIN A CRNA	3/16/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
60495	Fee-for-Service	1659312593	1659312593	1	26	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2925 N PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
60508	Fee-for-Service	1063275899	1063275899	1	1	HARIRI, GEOFFROY MD	7/8/2024	207LC0200X	NA	Other	026	PHYSICIANS	None	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
60518	Fee-for-Service	1003312208	1003312208	1	1	HENDERSON, SHEENA R LMFT	8/26/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5871 PINE AVE	SUITE 230	CHINO HILLS	CA	91709	6545	36	06071	33.94767013	-117.6754339	San Bernardino County
60563	Fee-for-Service	1659312593	1659312593	1	29	HEALTHCARE PARTNERS AFFILIAT	2/1/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	901 W CIVIC CENTER DR	STE 120	SANTA ANA	CA	92703	2380	30	06059	33.75155572	-117.8778014	Orange County
60573	Fee-for-Service	1376983411	1376983411	1	1	HUI, KATHERINE C LCSW	3/13/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
60585	Fee-for-Service	1710012117	1710012117	1	1	HEREFORD, ELIZABETH A MD	7/31/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	53434	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	999 S FAIRMONT AVE	STE 220	LODI	CA	95240	5142	39	06077	38.1206163	-121.2858323	San Joaquin County
60651	Fee-for-Service	1659312593	1659312593	1	34	HEALTHCARE PARTNERS AFFILIAT	5/21/2020	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	6900 LINCOLN AVENUE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
60657	Fee-for-Service	1417274838	1417274838	1	1	HARVEY, REED E MD	6/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118280	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
60680	Fee-for-Service	1619968583	1619968583	1	1	HIGHGROVE MEDICAL CLINIC	1/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	INC	1524 27TH ST	STE 305	BAKERSFIELD	CA	93301	2056	15	06029	35.38387747	-119.0197575	Kern County
60681	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	9/27/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
60692	Fee-for-Service	1528263274	1528263274	1	1	HAUSER, ANDREA A MD	8/8/2022	208000000X	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
60727	Fee-for-Service	1558917377	1558917377	1	1	HEYANO, BRITTANY OD	2/24/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1537 PACIFIC AVE	SUITE 100	SANTA CRUZ	CA	95060	3942	44	06087	36.97596432	-122.0267851	Santa Cruz County
60773	Fee-for-Service	1659312593	1659312593	1	12	HEALTHCARE PARTNERS AFFILIAT	5/31/1994	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	55 E CALIFORNIA BLVD	FL 3	PASADENA	CA	91105	3944	19	06037	34.13582278	-118.1491634	Los Angeles County
60784	Fee-for-Service	1659312593	1659312593	1	26	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	2925 N PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
60785	Fee-for-Service	1497803282	1497803282	1	1	HEIN, PETER S MD	3/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	46896	None	None	0	In state provider	None	7215 55TH ST	None	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
60789	Fee-for-Service	1164614525	1164614525	1	1	HARRIS, DANA L MD	7/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100456	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
60803	Fee-for-Service	1356749956	1356749956	1	1	HUNTER, AUSTIN M PT	8/12/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4960 VERDUGO	None	CAMARILLO	CA	93012	8632	56	06111	34.21547303	-119.0040356	Ventura County
60816	Fee-for-Service	1427155969	1427155969	1	1	HOUSEHOLDER, JOHN A MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	28965	18	Ophthalmology	0	In state provider	None	200 S A ST	STE 210	OXNARD	CA	93030	5717	56	06111	34.201467	-119.178521	Ventura County
60841	Fee-for-Service	1386221109	1386221109	1	1	HODSON, DANIEL Z MD	3/18/2025	207R00000X	NA	Other	026	PHYSICIANS	184841	41	Internal Medicine	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
60849	Fee-for-Service	1659312593	1659312593	1	29	HEALTHCARE PARTNERS AFFILIAT	2/1/2016	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	AFFILIATES MEDICAL GROUP	901 W CIVIC CENTER DR	STE 120	SANTA ANA	CA	92703	2380	30	06059	33.75155572	-117.8778014	Orange County
60850	Fee-for-Service	1003252206	1003252206	1	1	HELPING HANDS HOME HEALTH	11/1/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE AND HOSPICE INC	1710 S AMPHLETT BLVD	STE 112	SAN MATEO	CA	94402	2704	41	06081	37.55823076	-122.3014602	San Mateo County
60854	Fee-for-Service	1699768259	1699768259	1	1	HORTH, ROBERT M MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	60893	41	Internal Medicine	0	In state provider	None	12401 HESPERIA RD	None	VICTORVILLE	CA	92395	7707	36	06071	34.4771995	-117.2911483	San Bernardino County
60936	Fee-for-Service	1659312593	1659312593	1	20	HEALTHCARE PARTNERS AFFILIAT	5/26/2020	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1236 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	2607	30	06059	33.8508897	-117.9761562	Orange County
60963	Fee-for-Service	1619968583	1619968583	1	1	HIGHGROVE MEDICAL CLINIC	1/1/2002	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	INC	1524 27TH ST	STE 305	BAKERSFIELD	CA	93301	2056	15	06029	35.38387747	-119.0197575	Kern County
60969	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	1/29/2023	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
60992	Fee-for-Service	1306104120	1306104120	1	1	HOSSEINI-HEDRICK, MOJGAN MD	10/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125572	None	None	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
61011	Fee-for-Service	1588096317	1588096317	1	1	HUYNH, MICHAEL MD	7/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140664	41	Internal Medicine	0	In state provider	None	3687 MT DIABLO BLVD	STE 200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
61013	Fee-for-Service	1689091134	1689091134	1	1	HEATH, PATRICE	8/8/2023	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
61019	Fee-for-Service	1336343136	1336343136	1	2	HEALTHY LIFE HOME HLTH CARE	10/1/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7136 HASKELL AVE	SUITE 210	VAN NUYS	CA	91406	4112	19	06037	34.20024577	-118.4748679	Los Angeles County
61037	Fee-for-Service	1003304593	1003304593	1	1	HUSSAIN, MARVI MD	2/20/2023	207R00000X	NA	Other	026	PHYSICIANS	173968	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
61041	Fee-for-Service	1154530566	1154530566	1	1	HUBERT, KRISTIN E MD	6/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108515	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
61044	Fee-for-Service	1043655483	1043655483	1	1	HASTINGS, MELISSA E NP	10/9/2018	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
61053	Fee-for-Service	1346292224	1346292224	1	1	HWANG, DAVID	8/31/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	56748	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
61058	Fee-for-Service	1518329341	1518329341	1	1	HOSHAL, STEVEN MD	7/1/2021	390200000X	NA	Other	026	PHYSICIANS	150450	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
61069	Fee-for-Service	1457093791	1457093791	1	1	HILL, CHERISHA M CNP	6/1/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14220 SCHLEISMAN RD	None	EASTVALE	CA	92880	4020	33	06065	33.96068153	-117.5938972	Riverside County
61085	Fee-for-Service	1659312593	1659312593	1	8	HEALTHCARE PARTNERS AFFILIAT	8/5/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL GROUP, INC	824 E CARSON ST	STE 104	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
61128	Fee-for-Service	1386221109	1386221109	1	1	HODSON, DANIEL Z MD	3/18/2025	207R00000X	NA	Other	026	PHYSICIANS	184841	40	Pediatrics	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
61167	Fee-for-Service	1548804230	1548804230	1	1	HEER, JASREEN K PT	1/11/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
61178	Fee-for-Service	1164507059	1164507059	1	1	HANSON, FREDRICK N MD	2/8/2015	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30478	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
61180	Fee-for-Service	1194451864	1194451864	1	1	HERMES, ERIN CNP	10/4/2023	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
61187	Fee-for-Service	1437218047	1437218047	1	1	HSU, SHIHYEN MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	80831	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
61197	Fee-for-Service	1699156364	1699156364	1	1	HALL, MEGAN DO	3/31/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	23864	40	Pediatrics	0	In state provider	None	3636 N. FIRST STREET	120-121	FRESNO	CA	93726	6818	10	06019	36.78322578	-119.7724022	Fresno County
61200	Fee-for-Service	1235139346	1235139346	1	1	HOGEN, VICTOR S JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	35543	13	Neurology (M.D. only)	0	In state provider	None	11550 INDIAN HILLS RD	STE 330	MISSION HILLS	CA	91345	1203	19	06037	34.28024575	-118.4588775	Los Angeles County
61204	Fee-for-Service	1285675447	1285675447	1	1	HOLLIS, ROBERT MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4900 HOUSTON RD	None	FLORENCE	KY	41042	4824	00	None	39.016422	-84.6300285	Boone County
61207	Fee-for-Service	1538141627	1538141627	1	1	HANFORD COMMUNITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	3513	16	06031	36.32396253	-119.6688834	Kings County
61226	Fee-for-Service	1659312593	1659312593	1	20	HEALTHCARE PARTNERS AFFILIAT	6/20/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1236 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	2607	30	06059	33.8508897	-117.9761562	Orange County
61259	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	3/9/2023	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
61300	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	8/23/2024	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
61313	Fee-for-Service	1669491320	1669491320	1	1	HALABI, SAFWAN S MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	105003	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
61319	Fee-for-Service	1679151310	1679151310	1	1	HAASE, TYLER MD	7/1/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
61358	Fee-for-Service	1467449629	1467449629	1	1	HEH, CHEN WEN C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	42611	36	Psychiatry	0	In state provider	None	1320 STANDIFORD AVENUE	SUITE 5	MODESTO	CA	95350	0726	50	06099	37.68934252	-121.0140405	Stanislaus County
61376	Fee-for-Service	1659312593	1659312593	1	8	HEALTHCARE PARTNERS AFFILIAT	8/5/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	MEDICAL GROUP, INC	824 E CARSON ST	STE 104	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
61389	Fee-for-Service	1972882223	1972882223	1	1	HTUN, NANG Z MD	9/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129515	41	Internal Medicine	0	In state provider	None	600 COFFEE ROAD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
61429	Fee-for-Service	1659312593	1659312593	1	40	HEALTHCARE PARTNERS AFFILIAT	9/1/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	10441 LAKEWOOD BLVD	None	DOWNEY	CA	90241	2744	19	06037	33.94358034	-118.1193714	Los Angeles County
61458	Fee-for-Service	1023107976	1023107976	1	1	HUNDAL, RANJIT S MD	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76830	41	Internal Medicine	0	In state provider	None	250 BON AIR RD	FL 3	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
61461	Fee-for-Service	1912390444	1912390444	1	1	HUANG, LI MD	5/6/2019	207R00000X	NA	Other	026	PHYSICIANS	152235	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
61464	Fee-for-Service	1164507059	1164507059	1	1	HANSON, FREDRICK N MD	2/8/2015	207RP1001X	NA	Pulmonology	026	PHYSICIANS	30478	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	9850 GENESEE AVE	STE 780	LA JOLLA	CA	92037	1232	37	06073	32.882913	-117.226341	San Diego County
61476	Fee-for-Service	1780070821	1780070821	1	1	HONG, CHENG W MD	6/5/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146520	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
61479	Fee-for-Service	1396356473	1396356473	1	1	HAN, SOPHIA PT	6/18/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
61481	Fee-for-Service	1104559236	1104559236	1	1	HOMETOWN MEDICAL SUPPLIES LL	11/2/2023	332BC3200X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	3093 WILJAN CT	STE E	SANTA ROSA	CA	95407	5750	49	06097	38.402118	-122.7203595	Sonoma County
61486	Fee-for-Service	1295041713	1295041713	1	1	HAO, MINGHUA MD	4/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	117122	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	5609 J STREET	STE A	SACRAMENTO	CA	95819	3957	34	06067	38.564829	-121.434228	Sacramento County
61494	Fee-for-Service	1538141627	1538141627	1	1	HANFORD COMMUNITY HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	3513	16	06031	36.32396253	-119.6688834	Kings County
61513	Fee-for-Service	1659312593	1659312593	1	34	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	6900 LINCOLN AVENUE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
61536	Fee-for-Service	1992736409	1992736409	1	1	HARMON, THOMAS P CRNA	4/1/2002	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
61540	Fee-for-Service	1912918962	1912918962	1	1	HERON, KYLE B MD	12/1/1999	207LP2900X	NA	Other	026	PHYSICIANS	83786	05	Anesthesiology	0	In state provider	None	1524 MCHENRY AVE	STE 445	MODESTO	CA	95350	4569	50	06099	37.666233	-120.993933	Stanislaus County
61546	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	12/20/2021	193200000X	NA	Other	025	PHYSICAL THERAPISTS	-	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
61556	Fee-for-Service	1356843973	1356843973	1	1	HOMAYOUN SIMAN APC	8/21/2023	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	73211 FRED WARING DR	101	PALM DESERT	CA	92260	2888	33	06065	33.72862966	-116.3870098	Riverside County
61563	Fee-for-Service	1679905145	1679905145	1	1	HANNIGAN, MAUREEN H CNP	11/5/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2514 BERRYESSA RD	None	SAN JOSE	CA	95132	2947	43	06085	37.38738217	-121.8595232	Santa Clara County
61587	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
61594	Fee-for-Service	1881601748	1881601748	1	1	HSIEH, CHANG-YU, J	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	320 S GARFIELD AVE	STE 302	ALHAMBRA	CA	91801	6815	19	06037	34.09184212	-118.1245127	Los Angeles County
61596	Fee-for-Service	1659312593	1659312593	1	6	HEALTHCARE PARTNERS AFFILIAT	12/19/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	None	23430 HAWTHORNE BLVD	STE 105	TORRANCE	CA	90505	4777	19	06037	33.81316465	-118.3510077	Los Angeles County
61610	Fee-for-Service	1689692956	1689692956	1	2	HADDAD, FADI MD	12/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	80687	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
61613	Fee-for-Service	1134374333	1134374333	1	1	HECKMANN, MAURA K NP	12/21/2020	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
61614	Fee-for-Service	1659312593	1659312593	1	21	HEALTHCARE PARTNERS AFFILIAT	5/11/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	818 W ALONDRA BLVD	None	COMPTON	CA	90220	3500	19	06037	33.88834265	-118.2377666	Los Angeles County
61667	Fee-for-Service	1871804690	1871804690	1	1	HARTZELL, KATHERINE A MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120930	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
61713	Fee-for-Service	1659312593	1659312593	1	40	HEALTHCARE PARTNERS AFFILIAT	9/1/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	10441 LAKEWOOD BLVD	None	DOWNEY	CA	90241	2744	19	06037	33.94358034	-118.1193714	Los Angeles County
61715	Fee-for-Service	1619399052	1619399052	1	1	HUBEL, KERRY PHD	11/2/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	123 DI SALVO AVE	SUITE 40	SAN JOSE	CA	95112	4043	43	06085	37.32628785	-121.9371289	Santa Clara County
61792	Fee-for-Service	1265897870	1265897870	1	1	HALL, KARLEEN M LMFT	11/25/2019	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
61797	Fee-for-Service	1093125742	1093125742	1	1	HODGSON, TRENT S MD	6/14/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	156294	13	Neurology (M.D. only)	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
61801	Fee-for-Service	1659312593	1659312593	1	20	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	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
61805	Fee-for-Service	1154303543	1154303543	2	1	HASS, VIRGINIA M NP	5/1/1999	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	None	SACRAMENTO	CA	95820	1532	34	06067	38.546091	-121.447305	Sacramento County
61834	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	9/27/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
61876	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	8/7/2024	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
61883	Fee-for-Service	1659312593	1659312593	1	6	HEALTHCARE PARTNERS AFFILIAT	9/2/2021	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	23430 HAWTHORNE BLVD	STE 105	TORRANCE	CA	90505	4777	19	06037	33.81316465	-118.3510077	Los Angeles County
61902	Fee-for-Service	1659312593	1659312593	1	21	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	818 W ALONDRA BLVD	None	COMPTON	CA	90220	3500	19	06037	33.88834265	-118.2377666	Los Angeles County
61905	Fee-for-Service	1982751004	1982751004	1	1	HARTMAN, GARY MD	2/28/1984	208600000X	NA	General Surgery	026	PHYSICIANS	31166	01	General Practice	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
61906	Fee-for-Service	1497752794	1497752794	1	1	HENNRIKUS, EILEEN F MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53571	41	Internal Medicine	0	In state provider	None	758 E BULLARD AVE	STE 100	FRESNO	CA	93710	5472	10	06019	36.82313646	-119.7733995	Fresno County
61980	Fee-for-Service	1326250077	1326250077	1	1	HANNA, IYAD MD	10/1/2007	207R00000X	NA	Other	026	PHYSICIANS	99630	41	Internal Medicine	0	In state provider	None	255 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.3639177	-121.8490241	Santa Clara County
61983	Fee-for-Service	1124018148	1124018148	1	1	HEWITT, DAVID S MD	1/31/1993	207ZC0500X	NA	Other	026	PHYSICIANS	48679	22	Pathology (M.D. only)	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
62007	Fee-for-Service	1508315128	1508315128	1	1	HANSAM CORP	10/31/2016	3336H0001X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	17332 VON KARMAN AVE	SUITE 110	IRVINE	CA	92614	6280	30	06059	33.6898038	-117.8419528	Orange County
62080	Fee-for-Service	1346565660	1346565660	1	1	HSU, AMY MD	11/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126294	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
62090	Fee-for-Service	1659312593	1659312593	1	20	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1236 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	2607	30	06059	33.8508897	-117.9761562	Orange County
62121	Fee-for-Service	1982269031	1982269031	1	2	HUBMD PC	1/30/2024	193200000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	104 E OLIVE AVE	STE 100	REDLANDS	CA	92373	5255	36	06071	34.0540723	-117.1800104	San Bernardino County
62159	Fee-for-Service	1104087071	1104087071	1	2	HAGEN, JAYNE D PHD	12/23/2019	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CES	1213 MASONIC AVENUE	None	BERKELEY	CA	94706	2329	01	06001	37.88278881	-122.2910366	Alameda County
62165	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	1/17/2024	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
62171	Fee-for-Service	1659312593	1659312593	1	6	HEALTHCARE PARTNERS AFFILIAT	6/19/2020	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	23430 HAWTHORNE BLVD	STE 105	TORRANCE	CA	90505	4777	19	06037	33.81316465	-118.3510077	Los Angeles County
62181	Fee-for-Service	1437127545	1437127545	1	1	HANALLA, YOUSSEF A MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51677	78	Neoplastic Diseases/Oncology	0	In state provider	None	1316 NELSON AVE	None	MODESTO	CA	95350	5341	50	06099	37.66206042	-120.9881734	Stanislaus County
62183	Fee-for-Service	1093804247	1093804247	1	1	HUANG, KATIE MD	12/5/2024	208600000X	NA	General Surgery	026	PHYSICIANS	70677	02	General Surgery	0	In state provider	None	303 SANTA FE DR	None	ENCINITAS	CA	92024	5132	37	06073	33.03619553	-117.2851965	San Diego County
62190	Fee-for-Service	1659312593	1659312593	1	21	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	818 W ALONDRA BLVD	None	COMPTON	CA	90220	3500	19	06037	33.88834265	-118.2377666	Los Angeles County
62264	Fee-for-Service	1669804761	1669804761	1	1	HIBBERT, DEVON R PSYD	1/21/2020	103T00000X	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
62306	Fee-for-Service	1053324145	1053324145	1	1	HUFTY, MARY P MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41213	08	Family Practice	0	In state provider	None	12183 LOCKSLEY LN	STE 108	AUBURN	CA	95602	2050	31	06061	38.9503293	-121.0966898	Placer County
62375	Fee-for-Service	1780797902	1780797902	1	1	HADAYA, TAWFIK MD	2/6/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	39485	34	Urology and Urological Surgery	0	In state provider	None	44241 15TH ST W	STE 301	LANCASTER	CA	93534	5502	19	06037	34.68712999	-118.1569096	Los Angeles County
62377	Fee-for-Service	1659312593	1659312593	1	34	HEALTHCARE PARTNERS AFFILIAT	8/16/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	AFFILIATES MEDICAL GROUP	6900 LINCOLN AVENUE	None	BUENA PARK	CA	90620	4148	30	06059	33.83179154	-118.012518	Orange County
62382	Fee-for-Service	1336579705	1336579705	1	1	HOPE & HEALTH HOSPICE INC	3/13/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 208	ENCINO	CA	91436	4773	19	06037	34.15524484	-118.4756687	Los Angeles County
62387	Fee-for-Service	1285036640	1285036640	1	1	HAJIAN, PETROS DO	7/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13557	01	General Practice	0	In state provider	None	191 S BUENA VISTA ST	STE 200	BURBANK	CA	91505	4542	19	06037	34.15872557	-118.3283863	Los Angeles County
62404	Fee-for-Service	1558854018	1558854018	1	1	HETHCOAT, JESSICA	9/15/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
62415	Fee-for-Service	1447201900	1447201900	1	1	HODES, ERIC M MD	9/1/1994	207L00000X	NA	Other	026	PHYSICIANS	61202	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
62437	Fee-for-Service	1851828594	1851828594	1	1	HURLESS, MICHELLE DPM	9/16/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1 SHRADER ST	SUITE 580	SAN FRANCISCO	CA	94117	1016	38	06075	37.77467326	-122.4529451	San Francisco County
62452	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	7/11/2022	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
62463	Fee-for-Service	1194375634	1194375634	2	1	HARBIN, THERESA E LCSW	3/27/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	SS	8554 BOLERO DR	None	YUCCA VALLEY	CA	92284	9517	36	06071	34.09485026	-116.4154403	San Bernardino County
62471	Fee-for-Service	1659312593	1659312593	1	11	HEALTHCARE PARTNERS AFFILIAT	4/12/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	675 S ARROYO PKWY	None	PASADENA	CA	91105	3263	19	06037	34.13385453	-118.1474229	Los Angeles County
62477	Fee-for-Service	1659312593	1659312593	1	21	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	818 W ALONDRA BLVD	None	COMPTON	CA	90220	3500	19	06037	33.88834265	-118.2377666	Los Angeles County
62485	Fee-for-Service	1174229181	1174229181	1	1	HUANG, JU-LU NP	12/14/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93730	3309	10	06019	36.83626596	-119.7674879	Fresno County
62516	Fee-for-Service	1093725442	1093725442	2	1	HOEHNE, FRANCESCA M MD	3/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	78908	02	General Surgery	0	In state provider	None	500 OLD RIVER RD	STE 250	BAKERSFIELD	CA	93311	9515	15	06029	35.35127492	-119.1142991	Kern County
62537	Fee-for-Service	1528056850	1528056850	1	1	HARRIS, PENNY B MD	4/16/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	26304	40	Pediatrics	0	In state provider	None	1332 PARK ST	STE 202	ALAMEDA	CA	94501	4554	01	06001	37.76330843	-122.2435444	Alameda County
62547	Fee-for-Service	1093871204	1093871204	1	1	HURDLE, CHRISTOPHER F	8/11/2005	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	HURDLE HEARING AND AUDIO	220 S PALISADE DR	STE 202	SANTA MARIA	CA	93454	8903	42	06083	34.95143521	-120.412098	Santa Barbara County
62559	Fee-for-Service	1518654532	1518654532	1	1	HOPE & HEALING FAMILY THERAP	9/8/2023	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	Y CENTER INC	349 E BULLARD AVE	STE 102	FRESNO	CA	93710	5298	10	06019	36.82285854	-119.7825885	Fresno County
62568	Fee-for-Service	1114391935	1114391935	1	2	HOSSEINI, SOHEILA	12/5/2021	101YA0400X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	127 BROADWAY	SUITE 200	SANTA MONICA	CA	90401	2330	19	06037	34.01334753	-118.4957836	Los Angeles County
62574	Fee-for-Service	1891718318	1891718318	1	1	HUYNH, BO T MD	3/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87250	08	Family Practice	0	In state provider	None	2630 SAN GABRIEL BLVD	STE 105	ROSEMEAD	CA	91770	5204	19	06037	34.059978	-118.0905515	Los Angeles County
62590	Fee-for-Service	1659549830	1659549830	1	1	HASHIM, ZULFIQAR MD	5/31/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	175464	08	Family Practice	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
62644	Fee-for-Service	1649744939	1649744939	1	1	HERRERA, EDWARD S CRNA	2/12/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
62665	Fee-for-Service	1659312593	1659312593	1	20	HEALTHCARE PARTNERS AFFILIAT	4/1/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1236 N MAGNOLIA AVE	None	ANAHEIM	CA	92801	2607	30	06059	33.8508897	-117.9761562	Orange County
62670	Fee-for-Service	1336579705	1336579705	1	1	HOPE & HEALTH HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 208	ENCINO	CA	91436	4773	19	06037	34.15524484	-118.4756687	Los Angeles County
62685	Fee-for-Service	1023140738	1023140738	1	1	HANLON, VICTORIA L LMFT	9/26/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6501 WINTER RUSH DR	None	ROCKLIN	CA	95677	4519	31	06061	38.77637274	-121.2202005	Placer County
62708	Fee-for-Service	1538232798	1538232798	1	1	HOPE PSYCHOLOGY GROUP INC	8/4/2004	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2062 BUSINESS CENTER DR	STE 130	IRVINE	CA	92612	1109	30	06059	33.67850591	-117.8567471	Orange County
62738	Fee-for-Service	1639876436	1639876436	1	1	HU, KACEY B CNP	4/21/2023	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
62740	Fee-for-Service	1073786646	1073786646	1	1	HUGHES, KRISTEN MD	6/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108957	40	Pediatrics	0	In state provider	None	11370 ANDERSON STREET	SUITE B-100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
62741	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	12/1/1977	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
62742	Fee-for-Service	1710342514	1710342514	1	1	HERNANDEZ, ERIKA M LPCC	6/7/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6840 INDIANA AVE	275	RIVERSIDE	CA	92506	4279	33	06065	33.94246965	-117.3926366	Riverside County
62767	Fee-for-Service	1659312593	1659312593	1	21	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	818 W ALONDRA BLVD	None	COMPTON	CA	90220	3500	19	06037	33.88834265	-118.2377666	Los Angeles County
62782	Fee-for-Service	1851401830	1851401830	1	1	HOPKINS, JAMES M DO	11/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	5829	40	Pediatrics	0	In state provider	NIGHT OWL PEDIATRICS	425 GREGORY LN	STE 203	PLEASANT HILL	CA	94523	2813	07	06013	37.94796706	-122.0739453	Contra Costa County
62791	Fee-for-Service	1316166630	1316166630	1	1	HANDWERKER, JASON MD	11/30/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	114704	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
62800	Fee-for-Service	1093725442	1093725442	2	1	HOEHNE, FRANCESCA M MD	3/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	78908	78	Neoplastic Diseases/Oncology	0	In state provider	None	500 OLD RIVER RD	STE 250	BAKERSFIELD	CA	93311	9515	15	06029	35.35127492	-119.1142991	Kern County
62824	Fee-for-Service	1811199086	1811199086	1	1	HIRSCH, JAN MD	2/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97335	05	Anesthesiology	0	In state provider	None	1001 POTRERO AVENUE	RM 3634	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
62832	Fee-for-Service	1659941144	1659941144	1	1	HOLECHEK, SAMUEL CRNA	11/16/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
62841	Fee-for-Service	1154403780	1154403780	1	1	HUYNH, LANG Q MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53893	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1661 BURDETTE DR	STE C	SAN JOSE	CA	95121	1681	43	06085	37.32012377	-121.8254031	Santa Clara County
62849	Fee-for-Service	1467470765	1467470765	1	1	HSU, DANIEL P MD	7/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130033	30	Radiology	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
62851	Fee-for-Service	1518654532	1518654532	1	1	HOPE & HEALING FAMILY THERAP	2/10/2025	106H00000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	Y CENTER INC	349 E BULLARD AVE	STE 102	FRESNO	CA	93710	5298	10	06019	36.82285854	-119.7825885	Fresno County
62855	Fee-for-Service	1114391935	1114391935	1	2	HOSSEINI, SOHEILA	9/22/2020	101YA0400X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	127 BROADWAY	SUITE 200	SANTA MONICA	CA	90401	2330	19	06037	34.01334753	-118.4957836	Los Angeles County
62868	Fee-for-Service	1033262985	1033262985	1	1	HAMPSON, CHRISTOPHER O MD	3/14/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183543	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
62871	Fee-for-Service	1801319884	1801319884	1	1	HELLMAN, GINA V OD	8/4/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	628 CALIFORNIA BLVD	STE B	SAN LUIS OBISPO	CA	93401	2554	40	06079	35.28917428	-120.6578269	San Luis Obispo County
62873	Fee-for-Service	1093785206	1093785206	1	1	HOFMEISTER, ERIC P MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138235	20	Orthopedic Surgery	0	In state provider	None	955 LANE AVE	STE 200	CHULA VISTA	CA	91914	4525	37	06073	32.65121611	-116.9615942	San Diego County
62910	Fee-for-Service	1841461399	1841461399	1	1	HUYNH, VU N DO	2/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9804	66	Emergency Medicine (Urgent Care)	0	In state provider	None	420 34TH STREET	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
62925	Fee-for-Service	1053526590	1053526590	1	1	HILL, JAY B MD	7/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89117	40	Pediatrics	0	In state provider	None	17577 ARROW BLVD	None	FONTANA	CA	92335	4011	36	06071	34.09938951	-117.421272	San Bernardino County
62957	Fee-for-Service	1861120446	1861120446	1	1	HUANG, JUEMIN MD	12/12/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	86895	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
63008	Fee-for-Service	1659312593	1659312593	1	38	HEALTHCARE PARTNERS AFFILIAT	4/16/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	6261 STANTON AVE	None	BUENA PARK	CA	90621	2436	30	06059	33.86943847	-117.9938846	Orange County
63027	Fee-for-Service	1275578817	1275578817	1	1	HAZEL HAWKINS MEM HOSP	10/7/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5602	35	06069	36.83504962	-121.3858245	San Benito County
63029	Fee-for-Service	1659312593	1659312593	1	13	HEALTHCARE PARTNERS AFFILIAT	7/31/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	GREATER VALLEY MED GROUP	7325 MEDICAL CENTER DR	STE 300	WEST HILLS	CA	91307	4117	19	06037	34.20369349	-118.629837	Los Angeles County
63031	Fee-for-Service	1154929495	1154929495	1	1	HOLLAND, EDRIS Y CNP	2/1/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	38780 TRADE CENTER DR	SUITE 1C	PALMDALE	CA	93551	3641	19	06037	34.58685376	-118.1430494	Los Angeles County
63032	Fee-for-Service	1700306917	1700306917	1	1	HOWARD, JASON MD	11/27/2024	2086S0129X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	34	06067	38.571084	-121.471074	Sacramento County
63066	Fee-for-Service	1164640777	1164640777	1	1	HELLER-JUAREZ, JENNIFER PT	10/29/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2625 W ALAMEDA AVE	102	BURBANK	CA	91505	4815	19	06037	34.1577056	-118.329779	Los Angeles County
63073	Fee-for-Service	1851401830	1851401830	1	1	HOPKINS, JAMES M DO	11/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	5829	66	Emergency Medicine (Urgent Care)	0	In state provider	NIGHT OWL PEDIATRICS	425 GREGORY LN	STE 203	PLEASANT HILL	CA	94523	2813	07	06013	37.94796706	-122.0739453	Contra Costa County
63077	Fee-for-Service	1508886730	1508886730	1	1	HUBBARD, MARK D MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	82539	08	Family Practice	0	In state provider	None	488 E VALLEY PKWY	SUITE 201	ESCONDIDO	CA	92025	3398	37	06073	33.12523814	-117.0769715	San Diego County
63093	Fee-for-Service	1164626339	1164626339	1	1	HANZY, KELLY K	2/20/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
63095	Fee-for-Service	1376030536	1376030536	1	1	HUNT, MADISON M MD	8/17/2022	207P00000X	NA	Other	026	PHYSICIANS	175727	None	None	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
63103	Fee-for-Service	1528031457	1528031457	1	1	HOKE, EILEEN M MD	12/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	62558	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
63105	Fee-for-Service	1619990488	1619990488	1	2	HEARING SERVICES OF ANTIOCH,	9/3/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL AUDIOLOG	4045 LONE TREE WAY	SUITE D	ANTIOCH	CA	94531	6206	07	06013	37.976122	-121.8012402	Contra Costa County
63109	Fee-for-Service	1275195562	1275195562	1	1	HERNANDEZ, DAVID M OD	4/20/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6134 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2923	19	06037	33.98457344	-118.2251414	Los Angeles County
63111	Fee-for-Service	1801257712	1801257712	1	1	HOERGER, JOSHUA L MD	2/14/2022	390200000X	NA	Other	026	PHYSICIANS	154233	None	None	0	In state provider	None	1508 ALHAMBRA BLVD	200	SACRAMENTO	CA	95816	6510	34	06067	38.567007	-121.468068	Sacramento County
63115	Fee-for-Service	1215085113	1215085113	1	1	HUERTA, ADALBERTO R MD	2/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	42746	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
63124	Fee-for-Service	1922461862	1922461862	1	1	HABER, ZACHARY M MD	5/4/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	152893	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
63129	Fee-for-Service	1154403780	1154403780	1	1	HUYNH, LANG Q MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53893	08	Family Practice	0	In state provider	None	1661 BURDETTE DR	STE C	SAN JOSE	CA	95121	1681	43	06085	37.32012377	-121.8254031	Santa Clara County
63145	Fee-for-Service	1326405135	1326405135	1	1	HILL, DEVIN	10/1/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	16122 PONDEROSA LANE	None	RIVERSIDE	CA	92557	8338	33	06065	33.87617747	-117.3813615	Riverside County
63162	Fee-for-Service	1093785206	1093785206	1	1	HOFMEISTER, ERIC P MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138235	46	Hand Surgery	0	In state provider	None	955 LANE AVE	STE 200	CHULA VISTA	CA	91914	4525	37	06073	32.65121611	-116.9615942	San Diego County
63174	Fee-for-Service	1043522261	1043522261	1	2	HAN, SOOJUNG LCSW	8/4/2016	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
63184	Fee-for-Service	1598297293	1598297293	1	1	HEDLAND, JULY L MD	5/27/2020	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	157004	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
63196	Fee-for-Service	1235196197	1235196197	1	1	HELBOCK, HAROLD J MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	18015	40	Pediatrics	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
63203	Fee-for-Service	1124216098	1124216098	1	1	HAWASLY, TAREK H OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11100 VALLEY BLVD	STE 108	EL MONTE	CA	91731	2533	19	06037	34.07383477	-118.0332998	Los Angeles County
63212	Fee-for-Service	1912040387	1912040387	1	1	HELANDER, CAROL B LMFT	11/7/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	965 E YOSEMITE AVE	#12	MANTECA	CA	95336	5943	39	06077	37.79749432	-121.2033865	San Joaquin County
63218	Fee-for-Service	1487378329	1487378329	1	1	HAYASHI, SAYA OD	12/12/2022	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
63230	Fee-for-Service	1285701011	1285701011	1	1	HEVER, AVIV MD	12/26/2007	207ZP0102X	NA	Other	026	PHYSICIANS	84121	22	Pathology (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
63283	Fee-for-Service	1194818757	1194818757	1	1	HARRIS, DEBORAH NP	10/1/1998	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
63296	Fee-for-Service	1659312593	1659312593	1	38	HEALTHCARE PARTNERS AFFILIAT	4/16/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	6261 STANTON AVE	None	BUENA PARK	CA	90621	2436	30	06059	33.86943847	-117.9938846	Orange County
63304	Fee-for-Service	1629251566	1629251566	1	1	HO, ALEXANDER S MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114491	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
63305	Fee-for-Service	1942452271	1942452271	1	1	HIROTA, SEAN K MD	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111268	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	801 N TUSTIN AVE	SUITE 706	SANTA ANA	CA	92705	3611	30	06059	33.752286	-117.8341735	Orange County
63323	Fee-for-Service	1295711547	1295711547	1	1	HELLER, JOSHUE 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	3033 S PARKER RD	STE 800	AURORA	CO	80014	2938	00	None	39.6612	-104.8603095	Arapahoe County
63338	Fee-for-Service	1326022161	1326022161	1	1	HUR, BECK A MD	4/11/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	89444	30	Radiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
63349	Fee-for-Service	1811173388	1811173388	1	1	HOOPER, AMBER LMFT	12/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
63391	Fee-for-Service	1619990488	1619990488	1	2	HEARING SERVICES OF ANTIOCH,	9/3/2019	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL AUDIOLOG	4045 LONE TREE WAY	SUITE D	ANTIOCH	CA	94531	6206	07	06013	37.976122	-121.8012402	Contra Costa County
63422	Fee-for-Service	1073009171	1073009171	1	1	HWANG, GRACE S MD INC	10/1/2018	193400000X	NA	Other	026	PHYSICIANS	125505	02	General Surgery	0	In state provider	None	1010 W LA VETA AVENUE	STE 470	ORANGE	CA	92868	4305	30	06059	33.78028244	-117.8635552	Orange County
63434	Fee-for-Service	1326405135	1326405135	1	1	HILL, DEVIN	10/1/2016	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	16122 PONDEROSA LANE	None	RIVERSIDE	CA	92557	8338	33	06065	33.87617747	-117.3813615	Riverside County
63442	Fee-for-Service	1275952699	1275952699	1	1	HAYTEMA, TARA P NP	6/9/2017	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
63483	Fee-for-Service	1598843682	1598843682	1	1	HANNA, PAUL A MD	10/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87696	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
63508	Fee-for-Service	1861657744	1861657744	1	1	HORMAN, SARAH F MD	8/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110036	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
63509	Fee-for-Service	1114031382	1114031382	1	1	HOSAIN, FARZAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	296 W SPRING ST	None	SOUTH ELGIN	IL	60177	1534	00	None	41.99502151	-88.2984735	Kane County
63511	Fee-for-Service	1528362076	1528362076	1	1	HOMESCRIPTS COM LLC	8/21/2017	332B00000X	NA	Other	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	500 KIRTS BLVD	SUITE 300	TROY	MI	48084	4135	00	None	42.5564555	-83.15312395	Oakland County
63526	Fee-for-Service	1609296318	1609296318	1	1	HEALTHPEAK HOME HEALTH, INC	10/27/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1605 SCOTT AVENUE	SUITE 400	EL CENTRO	CA	92243	1790	13	06025	32.8013607	-115.5712388	Imperial County
63584	Fee-for-Service	1659312593	1659312593	1	38	HEALTHCARE PARTNERS AFFILIAT	4/16/2021	204C00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	6261 STANTON AVE	None	BUENA PARK	CA	90621	2436	30	06059	33.86943847	-117.9938846	Orange County
63593	Fee-for-Service	1942452271	1942452271	1	1	HIROTA, SEAN K MD	5/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111268	41	Internal Medicine	0	In state provider	None	801 N TUSTIN AVE	SUITE 706	SANTA ANA	CA	92705	3611	30	06059	33.752286	-117.8341735	Orange County
63630	Fee-for-Service	1528643277	1528643277	1	1	HAWE, URSULA OT	8/30/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
63677	Fee-for-Service	1336284561	1336284561	1	1	HOPP, MARTY MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	37521	04	Otology, Laryngology, Rhinology	0	In state provider	None	8631 W 3RD ST	STE 440E	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
63684	Fee-for-Service	1245607456	1245607456	1	1	HILL HEALTH INC A MEDICAL	8/21/2017	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CORPORATION	3300 WEBSTER ST	SUITE 1000	OAKLAND	CA	94609	3125	01	06001	37.82132826	-122.2621843	Alameda County
63694	Fee-for-Service	1447890744	1447890744	1	1	HENLEY, JASON LMFT	6/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1845 BUSINESS CENTER DR	215	SAN BERNARDINO	CA	92408	3467	36	06071	34.06865027	-117.2832038	San Bernardino County
63704	Fee-for-Service	1376163709	1376163709	1	1	HERNANDEZ, STEPHANIE A MD	8/11/2023	207P00000X	NA	Other	026	PHYSICIANS	187467	None	None	0	In state provider	None	20103 LAKE CHABOT	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
63737	Fee-for-Service	1104647924	1104647924	1	1	HALL, PEYTON B BIRTH DOULA	1/23/2025	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
63742	Fee-for-Service	1215372172	1215372172	2	1	HENDLEY, ELIZABETH M CP	1/14/2014	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	125 CIRO AVE	#240	SAN JOSE	CA	95128	1671	43	06085	37.32634135	-121.9382543	Santa Clara County
63765	Fee-for-Service	1083784938	1083784938	1	1	HAIRSTON, KIMBERLY LCSW	9/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
63786	Fee-for-Service	1124647482	1124647482	1	1	HUANG, ALICE MD	1/10/2025	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	190262	04	Otology, Laryngology, Rhinology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
63787	Fee-for-Service	1033309190	1033309190	1	1	HEINONEN, SARAH A NP	6/12/2017	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
63794	Fee-for-Service	1750578746	1750578746	1	1	HUYNH, LUONG T MD	10/14/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	97338	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
63795	Fee-for-Service	1699801134	1699801134	1	1	HELINSKI, LINDA J PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3235 4TH AVE	None	SAN DIEGO	CA	92103	5701	37	06073	32.739309	-117.1612415	San Diego County
63802	Fee-for-Service	1285938092	1285938092	1	1	HART, JOCELYN A	7/29/2022	2084P0804X	NA	Psychiatry	026	PHYSICIANS	-	None	None	2	Out of state provider	None	700 CHILDRENS DRIVE	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
63804	Fee-for-Service	1134564198	1134564198	1	1	HERRERA, MARISSE DO	3/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13853	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
63849	Fee-for-Service	1932500303	1932500303	1	1	HARDY-JOEL, RHONDA M CRNA	6/1/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
63852	Fee-for-Service	1104991744	1104991744	1	1	HUMBOLDT STATE UNIVERSTY	6/18/2007	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	STUDENT HLTH CENTER	PLAZA AVENUE	NEAR LIBRARY CIRCLE	ARCATA	CA	95521	8299	12	06023	40.87718316	-124.0811195	Humboldt County
63854	Fee-for-Service	1760777528	1760777528	1	1	HORIKAWA, YOUSUKE T MD	10/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123209	40	Pediatrics	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
63861	Fee-for-Service	1801523816	1801523816	1	1	HERRERA, FIDEL F NP	3/19/2024	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
63885	Fee-for-Service	1376613992	1376613992	1	1	HINMAN, PRISCILLA A MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43995	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
63886	Fee-for-Service	1588250864	1588250864	1	1	HENSON, JOSHUA H	2/21/2025	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
63889	Fee-for-Service	1649604257	1649604257	1	1	HLAVIN, DARCY M PT	10/26/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9501 FLUSHING QUAIL RD	SUITES 8,9 & 10	BAKERSFIELD	CA	93312	2660	15	06029	35.38617049	-119.10825	Kern County
63912	Fee-for-Service	1811920655	1811920655	1	1	HARTLEY, LARRY J MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	23858	08	Family Practice	0	In state provider	None	2705 LOMA VISTA RD	None	VENTURA	CA	93003	1581	56	06111	34.27504051	-119.2600018	Ventura County
63916	Fee-for-Service	1023413952	1023413952	1	1	HAMILTON, NICKI L CRNA	9/10/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1015 W YOSEMITE	None	MADERA	CA	93737	4581	20	06039	36.95442695	-120.0708623	Madera County
63920	Fee-for-Service	1447388749	1447388749	1	1	HARBOR HEALTH CARE	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CAPISTRANO DIVISION	9906 ROSE ST	None	BELLFLOWER	CA	90706	6915	19	06037	33.8696067	-118.1223615	Los Angeles County
63973	Fee-for-Service	1336284561	1336284561	1	1	HOPP, MARTY MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	37521	01	General Practice	0	In state provider	None	8631 W 3RD ST	STE 440E	LOS ANGELES	CA	90048	5901	19	06037	34.07361928	-118.3803143	Los Angeles County
63982	Fee-for-Service	1619022167	1619022167	1	1	HARRIS, DAVID C MD INC	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	57789	05	Anesthesiology	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
63983	Fee-for-Service	1841360328	1841360328	1	1	HOM, RICHARD C. O.D.	8/1/2002	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1826 BUCHANAN ST	STE A	SAN FRANCISCO	CA	94115	3211	38	06075	37.78696345	-122.4300353	San Francisco County
64017	Fee-for-Service	1043473341	1043473341	1	1	HA, HONGPHUC P MD	5/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	10601	02	General Surgery	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
64077	Fee-for-Service	1588140842	1588140842	1	1	HARMON, KATHERINE A MD	7/8/2022	207P00000X	NA	Other	026	PHYSICIANS	160060	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
64093	Fee-for-Service	1124199195	1124199195	1	1	HAIGH, PHILIP I MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	62890	78	Neoplastic Diseases/Oncology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
64109	Fee-for-Service	1063984912	1063984912	1	1	HAMRELL, ANNA LCSW	3/4/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20700 VENTURA BLVD	228	WOODLAND HILLS	CA	91364	6269	19	06037	34.16687239	-118.5840442	Los Angeles County
64129	Fee-for-Service	1598742413	1598742413	1	1	HUYNH, PHI T N MD	4/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	91806	01	General Practice	0	In state provider	None	10362 BOLSA AVE	None	WESTMINSTER	CA	92683	6763	30	06059	33.74488248	-117.94806	Orange County
64150	Fee-for-Service	1508165960	1508165960	1	1	HO, PHILIP W MD	2/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145787	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
64273	Fee-for-Service	1205916566	1205916566	1	1	HARATI, YADOLLAH MD	5/4/2017	2084N0008X	NA	Neurology	026	PHYSICIANS	145982	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
64288	Fee-for-Service	1104380070	1104380070	1	1	HADDOCK, CANDACE A MD	2/20/2019	2086S0120X	NA	General Surgery	026	PHYSICIANS	160473	85	Surgery-Pediatric	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
64297	Fee-for-Service	1497730659	1497730659	1	1	HELPING HANDS MEDICAL	1/18/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SUPPLIES, INC	2955 E HILLCREST DR	STE 106	THOUSAND OAKS	CA	91362	3177	56	06111	34.17313733	-118.8347453	Ventura County
64324	Fee-for-Service	1154971265	1154971265	1	1	HAWKING STEAM CHARTER	7/1/2019	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOLS INC	489 E ST	None	CHULA VISTA	CA	91910	2445	37	06073	32.64271228	-117.0887593	San Diego County
64330	Fee-for-Service	1760416622	1760416622	1	1	HALEY,JENNIFER C MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85372	07	Dermatology	0	In state provider	None	2000 UCLA MED PLAZA STE	None	LOS ANGELES	CA	90095	0001	19	06037	34.06531814	-118.44621	Los Angeles County
64333	Fee-for-Service	1295199248	1295199248	1	1	HANLE, AMY S LMFT	10/9/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1509 SEABRIGHT AVE	SUITE C1	SANTA CRUZ	CA	95062	2555	44	06087	36.9780203	-122.0096433	Santa Cruz County
64339	Fee-for-Service	1558510743	1558510743	1	2	HOLLAND, JAMES E LCSW	12/8/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	81335	-	NOT APPLICABLE	0	In state provider	None	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	12	06023	40.89808837	-124.0923819	Humboldt County
64398	Fee-for-Service	1194160119	1194160119	1	1	HONG, KAREN J MD	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136097	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
64399	Fee-for-Service	1518034529	1518034529	1	1	HARDLEY, TINA L MD	3/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74317	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
64423	Fee-for-Service	1437512092	1437512092	1	1	HENDERSON, CHERYL R	4/27/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	304 W CERRITOS AVE	None	ANAHEIM	CA	92805	6549	30	06059	33.809904	-117.908676	Orange County
64425	Fee-for-Service	1881951093	1881951093	1	1	HUGH, ANABEL M MD	6/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126663	41	Internal Medicine	0	In state provider	None	200 ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.06481928	-118.3836235	Los Angeles County
64430	Fee-for-Service	1851823454	1851823454	1	1	HADDOCK, ELLEN E MD	11/15/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	157683	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
64437	Fee-for-Service	1417084369	1417084369	1	1	HOWELL, ERIC T LMFT	5/31/2024	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
64452	Fee-for-Service	1821314741	1821314741	1	1	HUANG, SUSAN MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142904	18	Ophthalmology	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
64467	Fee-for-Service	1578136107	1578136107	1	2	H&Z LOGISTICS INC	10/13/2023	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3400 COTTAGE WAY	G3	SACRAMENTO	CA	95825	7441	34	06067	38.602854	-121.3836525	Sacramento County
64469	Fee-for-Service	1710941141	1710941141	1	1	HOME OF GUIDING HANDS	10/10/1986	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	2349 WINDMILL VIEW RD	None	EL CAJON	CA	92020	1357	37	06073	32.81736286	-116.9976116	San Diego County
64492	Fee-for-Service	1023223757	1023223757	1	1	HERWITT, PETER S MD	7/22/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	23669	30	Radiology	0	In state provider	None	1111 W LA PALMA AVE	None	ANAHEIM	CA	92801	2804	30	06059	33.84718298	-117.933758	Orange County
64503	Fee-for-Service	1659312593	1659312593	1	43	HEALTHCARE PARTNERS AFFILIAT	3/19/2021	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	1501 COMMONWEALTH	None	FULLERTON	CA	92833	2727	30	06059	33.87020089	-117.9476741	Orange County
64537	Fee-for-Service	1699252957	1699252957	1	1	HARLEY, AIKISHA L PSYD	8/4/2021	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	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
64541	Fee-for-Service	1245646009	1245646009	1	1	HARRIS, JENEE L LMFT	7/23/2021	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
64542	Fee-for-Service	1629268792	1629268792	1	1	HU, PETER MD	1/30/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	54801	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	317 W F ST	None	ONTARIO	CA	91762	3205	36	06071	34.06932	-117.6542865	San Bernardino County
64550	Fee-for-Service	1538247341	1538247341	1	1	HANSER, JAMES A MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35372	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
64573	Fee-for-Service	1609971746	1609971746	1	2	HARTSHORN, RACHEL M MD	1/20/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	72140	-	NOT APPLICABLE	0	In state provider	None	180 E LELAND ROAD	SUITES A & B	PITTSBURG	CA	94565	4949	07	06013	38.01163475	-121.8891333	Contra Costa County
64585	Fee-for-Service	1528414133	1528414133	1	1	HOPKINS, NICHOLAS H MD	9/29/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169895	09	Gynecology (D.O. only)	0	In state provider	None	1552 COFFEE RD	FL 1	MODESTO	CA	95355	3107	50	06099	37.666872	-120.975684	Stanislaus County
64654	Fee-for-Service	1922179837	1922179837	1	1	HO, LETITIA D MD	9/4/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69689	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
64661	Fee-for-Service	1407129273	1407129273	1	1	HO, EUGENE MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	117054	01	General Practice	0	In state provider	None	400 NORTH PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
64665	Fee-for-Service	1760687107	1760687107	1	1	HUYNH, ADRIC H	5/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114868	08	Family Practice	0	In state provider	None	2400 BALFOUR RD	STE 120	BRENTWOOD	CA	94513	4956	07	06013	37.92519383	-121.734461	Contra Costa County
64677	Fee-for-Service	1447632773	1447632773	1	1	HWANG, GLORIA MD	1/13/2023	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	182928	None	None	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
64691	Fee-for-Service	1437776739	1437776739	1	1	HEAVENLY LOVE HOSPICE INC	7/28/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	183 N HILL AVE	STE 202	PASADENA	CA	91106	1915	19	06037	34.149339	-118.1214055	Los Angeles County
64716	Fee-for-Service	1861193757	1861193757	1	1	HOME OXYGEN COMPANY, INC	12/20/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	5039 PENTECOST DR	SUITE C	MODESTO	CA	95356	9290	50	06099	37.71240694	-121.002114	Stanislaus County
64758	Fee-for-Service	1942715925	1942715925	1	1	HONE SOO KAW MD INC	2/5/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	500 N GARFIELD AVE	306	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
64774	Fee-for-Service	1841618386	1841618386	1	1	HOYAL, RACHEL DPM A	12/27/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	PROFESSIONAL CORPORATION	1041 4TH ST	STE B	SANTA ROSA	CA	95404	4329	49	06097	38.444229	-122.7061935	Sonoma County
64786	Fee-for-Service	1659312593	1659312593	1	37	HEALTHCARE PARTNERS AFFILIAT	4/13/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	33	06065	33.74751552	-116.991432	Riverside County
64822	Fee-for-Service	1922105618	1922105618	1	1	HIRT, DAVID M MD	1/1/1982	207L00000X	NA	Other	026	PHYSICIANS	36627	05	Anesthesiology	0	In state provider	None	525 E MICHELTORENA ST	STE 1	SANTA BARBARA	CA	93103	2254	42	06083	34.4320636	-119.7020672	Santa Barbara County
64824	Fee-for-Service	1659312593	1659312593	1	39	HEALTHCARE PARTNERS AFFILIAT	8/18/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	15111 WHITTIER BLVD	102	WHITTIER	CA	90603	2180	19	06037	33.94841455	-118.0049729	Los Angeles County
64830	Fee-for-Service	1376674887	1376674887	1	1	HUMBOLDT COUNTY HEALTH D	12/1/1977	No Taxonomy Provided	NA	None	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	FAMILY PLANNING CLINIC D	529 I ST	None	EUREKA	CA	95501	1116	12	06023	40.80213826	-124.162569	Humboldt County
64832	Fee-for-Service	1376557801	1376557801	1	1	HARDOIN, KEITH A	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	7220 FAIR OAKS BLVD	STE B	CARMICHAEL	CA	95608	6400	34	06067	38.632401	-121.327614	Sacramento County
64853	Fee-for-Service	1891310470	1891310470	1	1	HEALING HALO HOSPICE AND	9/14/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	30101 AGOURA COURT	SUITE 234	AGOURA HILLS	CA	91301	5901	19	06037	34.14595891	-118.7777602	Los Angeles County
64872	Fee-for-Service	1528414133	1528414133	1	1	HOPKINS, NICHOLAS H MD	9/29/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	169895	15	Obstetrics (D.O. only)	0	In state provider	None	1552 COFFEE RD	FL 1	MODESTO	CA	95355	3107	50	06099	37.666872	-120.975684	Stanislaus County
64914	Fee-for-Service	1093843245	1093843245	1	1	HOLLANDER, SETH A MD	11/26/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	94458	40	Pediatrics	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
64960	Fee-for-Service	1841833415	1841833415	1	1	HOPKINS, TIKIA BIRTH DOULA	10/24/2024	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	34	06067	0	0	None
64966	Fee-for-Service	1265766364	1265766364	1	1	HSU, ALBERT C MD	6/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	113761	20	Orthopedic Surgery	0	In state provider	None	9333 IMPERIAL HIGHWAY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
64980	Fee-for-Service	1437776739	1437776739	1	1	HEAVENLY LOVE HOSPICE INC	7/28/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	183 N HILL AVE	STE 202	PASADENA	CA	91106	1915	19	06037	34.149339	-118.1214055	Los Angeles County
65005	Fee-for-Service	1114095106	1114095106	1	1	HAMBLIN, BASIL C MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76893	08	Family Practice	0	In state provider	None	14600 SHERMAN WAY	STE 300	VAN NUYS	CA	91405	2272	19	06037	34.20025916	-118.4500763	Los Angeles County
65016	Fee-for-Service	1104480730	1104480730	1	1	HAKMAN, ERYK MD	10/3/2023	207P00000X	NA	Other	026	PHYSICIANS	188145	None	None	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
65033	Fee-for-Service	1427612290	1427612290	1	1	HAUCK, AARON M MD	7/17/2023	207P00000X	NA	Other	026	PHYSICIANS	182185	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
65048	Fee-for-Service	1942715925	1942715925	1	1	HONE SOO KAW MD INC	2/5/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	None	45	Nephrology (Renal-Kidney)	0	In state provider	None	500 N GARFIELD AVE	306	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
65049	Fee-for-Service	1487771739	1487771739	1	1	HERRINGTON, VALERIE R DO	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	6534	13	Neurology (M.D. only)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
65051	Fee-for-Service	1568018075	1568018075	1	1	HERMES, JET PSYD	2/18/2025	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
65075	Fee-for-Service	1073176913	1073176913	1	1	HUYNH, CHRISTINA G MD	4/28/2023	207R00000X	NA	Other	026	PHYSICIANS	183465	None	None	0	In state provider	None	1721 TECHNOLOGY DR	None	SAN JOSE	CA	95110	1305	43	06085	37.36464282	-121.9163895	Santa Clara County
65076	Fee-for-Service	1659312593	1659312593	1	37	HEALTHCARE PARTNERS AFFILIAT	4/13/2021	204C00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	33	06065	33.74751552	-116.991432	Riverside County
65088	Fee-for-Service	1508217266	1508217266	1	1	HIGNIGHT, CORTNEY J CCC-SLP	3/23/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3722 KATELLA AVE	STE C	LOS ALAMITOS	CA	90720	3102	30	06059	33.8029617	-118.0678946	Orange County
65110	Fee-for-Service	1548559131	1548559131	1	1	HSIAO, JENNIFER L MD	12/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118409	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
65111	Fee-for-Service	1659312593	1659312593	1	39	HEALTHCARE PARTNERS AFFILIAT	8/18/2021	204C00000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	15111 WHITTIER BLVD	102	WHITTIER	CA	90603	2180	19	06037	33.94841455	-118.0049729	Los Angeles County
65132	Fee-for-Service	1851850986	1851850986	1	1	HU, JEFFREY MD	6/14/2022	2279E0002X	NA	Other	026	PHYSICIANS	177443	None	None	0	In state provider	None	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
65137	Fee-for-Service	1144277955	1144277955	1	1	HUGGINS, JANICE L LMFT	7/15/2019	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
65140	Fee-for-Service	1891310470	1891310470	1	1	HEALING HALO HOSPICE AND	9/14/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	30101 AGOURA COURT	SUITE 234	AGOURA HILLS	CA	91301	5901	19	06037	34.14595891	-118.7777602	Los Angeles County
65185	Fee-for-Service	1558379610	1558379610	1	1	HUYNH, TAYLOR N OD	8/17/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3775 BEACON AVENUE	SUITE 140	FREMONT	CA	94538	1466	01	06001	37.54785737	-121.9830193	Alameda County
65216	Fee-for-Service	1366410714	1366410714	1	1	HUANG, JERRY C MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69769	41	Internal Medicine	0	In state provider	None	1182 N EUCLID ST	None	ANAHEIM	CA	92801	1900	30	06059	33.849909	-117.9416115	Orange County
65234	Fee-for-Service	1033439864	1033439864	1	2	HUYNH, VU Q MD	6/10/2022	207P00000X	NA	Other	086	MEDICAL DIRECTORS	125001	-	NOT APPLICABLE	0	In state provider	None	410 WEST J ST	STE A	TEHACHAPI	CA	93561	8604	15	06029	35.13539151	-118.4529719	Kern County
65296	Fee-for-Service	1063904829	1063904829	1	1	HOWARD GREEN, JORDAN MD	10/1/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	4300 GOLDEN CENTER DRIVE	SUITE C	PLACERVILLE	CA	95667	6278	09	06017	38.70657265	-120.82856	El Dorado County
65300	Fee-for-Service	1730216136	1730216136	1	1	HOLLAND, DAVID L MD	2/28/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	27374	02	General Surgery	0	In state provider	None	11370 ANDERSON ST	# 2600	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
65321	Fee-for-Service	1215038294	1215038294	1	1	HAWKINS, CANDICE M OT	2/5/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3601 MARCONI AVE	None	SACRAMENTO	CA	95821	5309	34	06067	38.618109	-121.380255	Sacramento County
65322	Fee-for-Service	1659312593	1659312593	1	10	HEALTHCARE PARTNERS AFFILIAT	5/24/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	MEDICAL GROUP	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	19	06037	34.13887038	-118.1504485	Los Angeles County
65335	Fee-for-Service	1619175890	1619175890	1	1	HALVERSON, MARK MD	6/11/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
65362	Fee-for-Service	1659312593	1659312593	1	37	HEALTHCARE PARTNERS AFFILIAT	4/13/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1850 W. FLORIDA AVE.	None	HEMET	CA	92545	6738	33	06065	33.74751552	-116.991432	Riverside County
65375	Fee-for-Service	1679513733	1679513733	1	1	HIRSCH, EVAN MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61540	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
65400	Fee-for-Service	1659312593	1659312593	1	39	HEALTHCARE PARTNERS AFFILIAT	8/18/2021	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	15111 WHITTIER BLVD	102	WHITTIER	CA	90603	2180	19	06037	33.94841455	-118.0049729	Los Angeles County
65412	Fee-for-Service	1407920721	1407920721	1	1	HSU, JAMES T MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71065	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
65414	Fee-for-Service	1043771710	1043771710	1	1	HAYAT, NAWEED MD	3/4/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178487	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
65473	Fee-for-Service	1184773269	1184773269	1	1	HUI, TIM S LMFT	5/24/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3526 INVESTMENT BLVD.	219	HAYWARD	CA	94545	1542	01	06001	37.62459786	-122.1209257	Alameda County
65478	Fee-for-Service	1366432254	1366432254	1	1	HARFORD, DAVID J MD	5/14/2020	2080P0207X	NA	Hematology	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
65490	Fee-for-Service	1508386517	1508386517	1	1	HONG, PAUL S DPM	5/6/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	15315 FAIRFIELD RANCH RO	SUITE 220	CHINO HILLS	CA	91709	8836	36	06071	33.97340322	-117.6922495	San Bernardino County
65491	Fee-for-Service	1891826384	1891826384	1	1	HOSAKA, RUSSELL Y OD	5/25/2004	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PACIFIC VISION OPTOMETRI	22809 HAWTHORNE BLVD	None	TORRANCE	CA	90505	3615	19	06037	33.819993	-118.3512385	Los Angeles County
65492	Fee-for-Service	1093909228	1093909228	1	1	HAKIM, AMY A MD	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100716	09	Gynecology (D.O. only)	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
65511	Fee-for-Service	1124041256	1124041256	1	1	HOWELL, THU N MD	12/4/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	77900	01	General Practice	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
65527	Fee-for-Service	1962461012	1962461012	1	1	HIGHT, RACHEL A MD	4/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53989	02	General Surgery	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
65528	Fee-for-Service	1912015637	1912015637	2	1	HORN, MATTHEW J MD	2/10/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	42320	None	None	0	In state provider	None	435 H STREET	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
65555	Fee-for-Service	1760443725	1760443725	1	1	HERTZ, PHILIP MD	10/12/1977	207RN0300X	NA	Nephrology	026	PHYSICIANS	19222	41	Internal Medicine	0	In state provider	None	2001 UNION ST	STE 490	SAN FRANCISCO	CA	94123	4130	38	06075	37.7974427	-122.432532	San Francisco County
65577	Fee-for-Service	1750661534	1750661534	1	1	HILLCREST HOSP SOUTH	11/15/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8801 S 101ST EAST AVE	None	TULSA	OK	74133	5716	00	None	36.03563038	-95.86465321	Tulsa County
65610	Fee-for-Service	1659312593	1659312593	1	10	HEALTHCARE PARTNERS AFFILIAT	5/24/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	19	06037	34.13887038	-118.1504485	Los Angeles County
65633	Fee-for-Service	1770567539	1770567539	1	1	HEMSLEY, JAMES W DO	1/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6490 S MCCARRAN BLVD	STE 13	RENO	NV	89509	6120	00	None	39.47672552	-119.796471	Washoe County
65690	Fee-for-Service	1164435715	1164435715	1	1	HITZFIELD, RONALD J MD	9/30/1986	207R00000X	NA	Other	026	PHYSICIANS	50211	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
65722	Fee-for-Service	1972611994	1972611994	1	1	HOSSEINI-ASLINIA	5/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88419	01	General Practice	0	In state provider	FLORENCE M MD	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
65748	Fee-for-Service	1891990065	1891990065	1	1	HOMELIVING HEALTH PROVIDERS,	4/20/2009	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	18321 VENTURA BLVD	SUITE 780	TARZANA	CA	91356	6441	19	06037	34.16710334	-118.5318618	Los Angeles County
65753	Fee-for-Service	1962760991	1962760991	1	1	HUNTINGTON PAIN AND WELLNESS	3/8/2013	193200000X	NA	Other	026	PHYSICIANS	11212	05	Anesthesiology	0	In state provider	CENTER INC	301 S FAIR OAKS AVENUE	STE 402	PASADENA	CA	91105	2561	19	06037	34.140348	-118.1504565	Los Angeles County
65760	Fee-for-Service	1215196480	1215196480	1	1	HOANG, NHAT H MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	11291	02	General Surgery	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
65779	Fee-for-Service	1093909228	1093909228	1	1	HAKIM, AMY A MD	10/9/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100716	02	General Surgery	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
65860	Fee-for-Service	1407806797	1407806797	1	1	HASSOUN, HEITHAM T MD	3/12/2020	2086S0129X	NA	General Surgery	026	PHYSICIANS	160417	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
65884	Fee-for-Service	1609458868	1609458868	1	1	HERNANDEZ, NATALIE MD	8/28/2024	207P00000X	NA	Other	026	PHYSICIANS	186603	66	Emergency Medicine (Urgent Care)	0	In state provider	None	18600 SOUTH FIGUEROA ST	None	GARDENA	CA	90248	4505	19	06037	33.861339	-118.281473	Los Angeles County
65912	Fee-for-Service	1659312593	1659312593	1	10	HEALTHCARE PARTNERS AFFILIAT	5/24/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP	401 S FAIR OAKS AVE	None	PASADENA	CA	91105	2603	19	06037	34.13887038	-118.1504485	Los Angeles County
65913	Fee-for-Service	1659312593	1659312593	1	15	HEALTHCARE PARTNERS AFFILIAT	7/22/1991	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	GREATER VALLEY MED GROUP	14600 SHERMAN WAY	STE 300	VAN NUYS	CA	91405	2272	19	06037	34.20025916	-118.4500763	Los Angeles County
65921	Fee-for-Service	1164928248	1164928248	1	1	HASSAN, MOHAMED MD	6/10/2024	208M00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
65923	Fee-for-Service	1831167543	1831167543	1	1	HO, JACQUELINE MD	8/2/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80039	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2 MEDICAL PLAZA DR	STE 205	ROSEVILLE	CA	95661	3044	31	06061	38.76507948	-121.2477476	Placer County
65926	Fee-for-Service	1437779501	1437779501	1	1	HOLLAND, LAURA A DO	6/19/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	22813	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
66007	Fee-for-Service	1679644579	1679644579	1	1	HERSKOWITZ, MARC J MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76730	34	Urology and Urological Surgery	0	In state provider	None	575 E HARDY ST	STE 205	INGLEWOOD	CA	90301	4044	19	06037	33.94909392	-118.3477665	Los Angeles County
66022	Fee-for-Service	1306370747	1306370747	1	1	HIRT, SPENCER DO	9/13/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	None	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
66033	Fee-for-Service	1396794632	1396794632	1	1	HASHAD, RASHA A MD	6/1/2000	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	63988	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	26732 CROWN VALLEY PKWY	STE 443	MISSION VIEJO	CA	92691	6375	30	06059	33.56347704	-117.66546	Orange County
66073	Fee-for-Service	1821594144	1821594144	1	13	HEARINGLIFE HEARING AID CENT	8/15/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	14911 NATIONAL AVE	STE 2	LOS GATOS	CA	95032	2632	43	06085	37.25172742	-121.951483	Santa Clara County
66089	Fee-for-Service	1700142528	1700142528	1	1	HASSANEIN, OMAR MD	7/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	123747	02	General Surgery	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
66095	Fee-for-Service	1497313290	1497313290	1	1	HUANG, EMILY MD	6/26/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182154	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
66106	Fee-for-Service	1144603606	1144603606	1	1	HSU, JENNIFER MD	1/13/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	147335	None	None	0	In state provider	None	2920 TELEGRAPH AVE	None	BERKELEY	CA	94705	2031	01	06001	37.85686573	-122.2596307	Alameda County
66182	Fee-for-Service	1184703225	1184703225	1	1	HARRIS, ROBERT G	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	50941	34	Urology and Urological Surgery	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
66207	Fee-for-Service	1821594144	1821594144	1	9	HEARINGLIFE HEARING AID CENT	11/27/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	11990 HERITAGE OAK PL	STE 11	AUBURN	CA	95603	2455	31	06061	38.941389	-121.0988205	Placer County
66210	Fee-for-Service	1588169221	1588169221	1	1	HUIZAR, JOHN P MD	6/29/2023	207RR0500X	NA	Other	026	PHYSICIANS	166629	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
66214	Fee-for-Service	1699772350	1699772350	3	1	HON, GEORGE G MD	6/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73910	41	Internal Medicine	0	In state provider	None	16415 COLORADO AVENUE	SUITE 410	PARAMOUNT	CA	90723	5084	19	06037	33.8853075	-118.1614695	Los Angeles County
66231	Fee-for-Service	1386671832	1386671832	1	1	HOLMES, KYLE D MD	12/18/2002	207P00000X	NA	Other	026	PHYSICIANS	77374	66	Emergency Medicine (Urgent Care)	0	In state provider	None	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
66272	Fee-for-Service	1942643655	1942643655	1	1	HYOUN, SARA	12/13/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	135684	-	NOT APPLICABLE	0	In state provider	None	2330 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2220	19	06037	34.0681396	-118.2738016	Los Angeles County
66280	Fee-for-Service	1851753875	1851753875	1	1	HAIGHT, STEPHEN D MD	8/1/2019	207P00000X	NA	Other	026	PHYSICIANS	150595	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
66322	Fee-for-Service	1609192871	1609192871	1	1	HURTADO, ANGEL A LCSW	4/21/2017	No Taxonomy Provided	NA	None	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
66331	Fee-for-Service	1134201189	1134201189	1	1	HAGERTY,BRAIN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5301 E GRANT	None	TUCSON	AZ	85712	0000	00	None	32.252391	-110.8790055	Pima County
66347	Fee-for-Service	1669778882	1669778882	1	1	HOLY HILL HOME CARE	9/7/2012	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	33922 COLORADO ST	None	YUCAIPA	CA	92399	2330	36	06071	34.01751724	-117.0649134	San Bernardino County
66369	Fee-for-Service	MSS00048F	None	1	1	HEALTH PROJECTS CENTER	12/1/2008	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	9000 SOQUEL AVE	SUITE 103	SANTA CRUZ	CA	95062	2097	44	06087	36.98201547	-121.9663408	Santa Cruz County
66445	Fee-for-Service	1699481887	1699481887	1	1	HOOGERVORST, JACQUELINE M NP	5/19/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	26520 CACTUS AVE	STE 2021	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
66470	Fee-for-Service	1730479866	1730479866	1	1	HULLEY, GEORGE S MD	3/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122311	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
66475	Fee-for-Service	1992253231	1992253231	1	1	HULSEY, JACLYN M LMFT	1/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
66478	Fee-for-Service	1528097987	1528097987	1	1	HACKNER, DANI MD	12/1/2000	174400000X	NA	Other	026	PHYSICIANS	55598	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
66485	Fee-for-Service	1073709887	1073709887	1	1	HADLEY, VANESSA L MD	9/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116976	05	Anesthesiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92359	2804	36	06071	34.049547	-117.264078	San Bernardino County
66501	Fee-for-Service	1699772350	1699772350	3	1	HON, GEORGE G MD	6/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73910	45	Nephrology (Renal-Kidney)	0	In state provider	None	16415 COLORADO AVENUE	SUITE 410	PARAMOUNT	CA	90723	5084	19	06037	33.8853075	-118.1614695	Los Angeles County
66513	Fee-for-Service	1063741502	1063741502	1	1	HUH, JENNIE JUNG	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
66533	Fee-for-Service	1801334461	1801334461	1	1	HEALTH IS WEALTH HOME HEALTH	8/8/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY LLC	3135 CLAYTON RD	202	CONCORD	CA	94519	2795	07	06013	37.97326554	-122.0205438	Contra Costa County
66544	Fee-for-Service	1942626767	1942626767	1	1	HYON, MAXIMILIANO DO	3/16/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	13210	67	Endocrinology	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
66582	Fee-for-Service	1568039089	1568039089	1	1	HONG, JONATHAN PT	8/13/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	81 CERNON ST.	None	VACAVILLE	CA	95688	2803	48	06095	38.36102104	-121.9906107	Solano County
66608	Fee-for-Service	1629242839	1629242839	1	1	HAN, ANGELA D NP	3/15/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1450 TREAT BLVD	SUITE 200	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
66642	Fee-for-Service	1952343915	1952343915	1	1	HASAN, SOBIA DO	2/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9034	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
66655	Fee-for-Service	1184986879	1184986879	1	1	HOU, WEI-HSIEN MD	5/1/2018	2085R0001X	NA	Other	026	PHYSICIANS	129865	30	Radiology	0	In state provider	None	44151 15TH ST WEST	STE 409	LANCASTER	CA	93534	5504	19	06037	34.68551775	-118.1568686	Los Angeles County
66704	Fee-for-Service	1639113491	1639113491	1	1	HADIAN, MEHRNAZ MD	7/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92370	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
66710	Fee-for-Service	1861505927	1861505927	1	1	HASTINGS, JENNIFER L MD	9/30/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72643	01	General Practice	0	In state provider	None	1119 PACIFIC AVE	STE 200	SANTA CRUZ	CA	95060	4464	44	06087	36.9722444	-122.0256836	Santa Cruz County
66744	Fee-for-Service	1689377657	1689377657	1	1	HENNRICK, HEATHER C PHD	10/12/2023	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
66755	Fee-for-Service	1376867010	1376867010	1	1	HOGAN, CHRISTOPHER M MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125379	10	Gastroenterology (M.D. only)	0	In state provider	None	1350 S ELISEO DR	STE 130	GREENBRAE	CA	94904	2011	21	06041	37.94490653	-122.537021	Marin County
66765	Fee-for-Service	1528097987	1528097987	1	1	HACKNER, DANI MD	12/1/2000	174400000X	NA	Other	026	PHYSICIANS	55598	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
66767	Fee-for-Service	1548472962	1548472962	1	2	HOOD, SHARON L MD	1/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55662	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1617 N CALIFORNIA ST	STE 2D	STOCKTON	CA	95204	6117	39	06077	37.9697906	-121.2890104	San Joaquin County
66805	Fee-for-Service	1003929225	1003929225	1	1	HO, MARION K MD	4/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	75129	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
66808	Fee-for-Service	1528150729	1528150729	1	1	HSU, PENELOPE MD	3/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88553	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
66826	Fee-for-Service	1164663670	1164663670	1	1	HAYWOOD, MONIQUE N LCSW	7/1/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	86669	-	NOT APPLICABLE	0	In state provider	None	1303 WEST WALNUT PKWY	None	COMPTON	CA	90220	5030	19	06037	33.87724562	-118.2446904	Los Angeles County
66834	Fee-for-Service	1811962699	1811962699	1	1	HARRISON, JOHNNY R MD	5/31/1988	207L00000X	NA	Other	026	PHYSICIANS	32912	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
66836	Fee-for-Service	1942626767	1942626767	1	1	HYON, MAXIMILIANO DO	3/16/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	13210	41	Internal Medicine	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
66865	Fee-for-Service	1174977987	1174977987	1	1	HUYNH, JIMMY L MD	5/7/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170535	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
66892	Fee-for-Service	1003889528	1003889528	1	1	HOWARD, ROBERT S MD	10/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	64048	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
66897	Fee-for-Service	1639120165	1639120165	1	1	HOON, HWANG I LAC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	EL CENTRO ACUPUNCTURE	1121 S 4TH ST	STE A	EL CENTRO	CA	92243	4742	13	06025	32.78192719	-115.5523629	Imperial County
66899	Fee-for-Service	1609839745	1609839745	1	1	HAY, ARLENE P MD	10/6/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	64152	40	Pediatrics	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7098	34	06067	38.56554	-121.4664615	Sacramento County
66930	Fee-for-Service	1174920664	1174920664	1	1	HOFSTATTER, LINDSAY A	7/18/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	18700 BEACH BLVD	STE 120	HUNTINGTON BEACH	CA	92648	2030	30	06059	33.69070037	-117.9886896	Orange County
66938	Fee-for-Service	1144852039	1144852039	1	2	HOME GROWN OCCUPATIONAL & PH	6/22/2021	225XP0200X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	YSICAL THERAPY 4 KIDS, P	30033 TECHNOLOGY DR	STE 104-105	MURRIETA	CA	92563	2640	33	06065	33.55982681	-117.1355341	Riverside County
66947	Fee-for-Service	1396939237	1396939237	1	1	HELLER, MARK J MD	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101407	41	Internal Medicine	0	In state provider	None	2801 K STREET	STE 520	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
66948	Fee-for-Service	1518048743	1518048743	1	1	HARDIE,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	3333 BURNET AVE	None	CINCINNATI	OH	45229	0000	00	None	39.14105892	-84.50040782	Hamilton County
66949	Fee-for-Service	1154762151	1154762151	1	1	HOANG, AICHAU T DO	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14092	01	General Practice	0	In state provider	None	35800 BOB HOPE DR	SUITE 225	RANCHO MIRAGE	CA	92270	1740	33	06065	33.790527	-116.4058645	Riverside County
66954	Fee-for-Service	1659312593	1659312593	1	4	HEALTHCARE PARTNERS AFFILIAT	8/27/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	MEDICAL GROUP	5400 W ROSECRANS AVE	STE 100	LAWNDALE	CA	90260	6609	19	06037	33.90173207	-118.3748814	Los Angeles County
66955	Fee-for-Service	1093412751	1093412751	1	1	HARRIS, CAMILLE PT	3/21/2023	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
66976	Fee-for-Service	1790073419	1790073419	1	1	HUSAIN, ALI DO	10/29/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18432	08	Family Practice	0	In state provider	None	3612 DALE RD	None	MODESTO	CA	95356	0500	50	06099	37.69097901	-121.0498748	Stanislaus County
66979	Fee-for-Service	1548318769	1548318769	1	1	HA, SIU K 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
67001	Fee-for-Service	1770717209	1770717209	1	1	HOME FOR LIFE FOUNDATION	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	20902 DENKER AVE	None	TORRANCE	CA	90501	2329	19	06037	33.83979183	-118.3039216	Los Angeles County
67016	Fee-for-Service	1659803146	1659803146	1	1	HWANG, JAMES MD	10/10/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	185481	None	None	0	In state provider	None	111 RALEY BLVD	SUITE 100	CHICO	CA	95928	8351	04	06007	39.71601447	-121.790817	Butte County
67021	Fee-for-Service	1609297597	1609297597	1	1	HERRERA, ELSA LCSW	1/8/2019	1041C0700X	NA	Mental Health Outpatient Services	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
67042	Fee-for-Service	1649899519	1649899519	1	1	HINTON, ANDREA N MD	8/23/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	189458	07	Dermatology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
67091	Fee-for-Service	1003929225	1003929225	1	1	HO, MARION K MD	4/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	75129	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
67093	Fee-for-Service	1528150729	1528150729	1	1	HSU, PENELOPE MD	3/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88553	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
67135	Fee-for-Service	1134418056	1134418056	1	1	HOLLYWOOD PSYCHOTHERAPY AND	1/18/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	COUNSELING CENTER, INC	11336 DONA LISA DR	None	STUDIO CITY	CA	91604	4315	19	06037	34.1313147	-118.3775371	Los Angeles County
67145	Fee-for-Service	1972812287	1972812287	1	1	HA, DAT M MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12246	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
67175	Fee-for-Service	1922261593	1922261593	1	1	HEALTHY STANDARDS, INC	9/23/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	445 W GARFIELD AVE	UNIT 1	GLENDALE	CA	91204	3208	19	06037	34.1353465	-118.262727	Los Angeles County
67178	Fee-for-Service	1306867395	1306867395	1	1	HLADIK, ANDREA J MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	70335	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
67225	Fee-for-Service	1144852039	1144852039	1	2	HOME GROWN OCCUPATIONAL & PH	6/22/2021	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	YSICAL THERAPY 4 KIDS, P	30033 TECHNOLOGY DR	STE 104-105	MURRIETA	CA	92563	2640	33	06065	33.55982681	-117.1355341	Riverside County
67257	Fee-for-Service	1972952703	1972952703	1	1	HUNTER, BENJAMIN N MD	9/14/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	180526	None	None	0	In state provider	None	3307 RENNER DR	None	FORTUNA	CA	95540	3119	12	06023	40.58239431	-124.1358906	Humboldt County
67322	Fee-for-Service	1467529305	1467529305	1	1	HEBARD, RONALD L MD	6/30/1990	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	58876	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
67325	Fee-for-Service	1831240373	1831240373	1	1	HELPING HANDS ADHC CTR	5/24/2000	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	9051 WOODMAN AVE	None	ARLETA	CA	91331	6404	19	06037	34.23411011	-118.4395658	Los Angeles County
67353	Fee-for-Service	1679949192	1679949192	1	1	HOWER, TAJ-ZSA LCSW	10/21/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	741 S A STREET	None	OXNARD	CA	93030	7179	56	06111	34.19408787	-119.1786608	Ventura County
67366	Fee-for-Service	1295180958	1295180958	1	1	HOME CARE-RX INC	5/23/2016	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3303 HARBOR BLVD	STE C-2	COSTA MESA	CA	92612	1530	30	06059	33.6925522	-117.9195808	Orange County
67469	Fee-for-Service	1861881658	1861881658	1	1	HUANG, ANNSA C MD	3/7/2022	207R00000X	NA	Other	026	PHYSICIANS	145767	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
67471	Fee-for-Service	1275673964	1275673964	1	1	HESS, SHERI K LMFT	11/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	42091	-	NOT APPLICABLE	0	In state provider	None	3711 SUNSET LANE	SUITES A, B	ANTIOCH	CA	94509	6101	07	06013	37.98434728	-121.8042006	Contra Costa County
67485	Fee-for-Service	1659312593	1659312593	1	16	HEALTHCARE PARTNERS AFFILIAT	5/1/1995	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	880 S ATLANTIC BLVD	STE 101	MONTEREY PARK	CA	91754	4700	19	06037	34.05038485	-118.1383456	Los Angeles County
67486	Fee-for-Service	1972144061	1972144061	1	1	HOP, NANCY S LCSW	8/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	461 TENNESSEE ST	SUITE C	REDLANDS	CA	92373	8161	36	06071	34.058745	-117.2000975	San Bernardino County
67491	Fee-for-Service	1619059748	1619059748	1	1	HSU, ROBERT T MD	10/1/1998	207R00000X	NA	Other	026	PHYSICIANS	66437	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
67495	Fee-for-Service	1457342677	1457342677	1	1	HACIENDA DIALYSIS CENTER	12/17/2001	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	A MEDICAL CORPORATION	2020 S HACIENDA BLVD	STE G	HACIENDA HEIGHTS	CA	91745	4265	19	06037	33.99657166	-117.9678579	Los Angeles County
67499	Fee-for-Service	1356829618	1356829618	1	1	HOWZE, RODERICK T RCP	10/24/2018	227900000X	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
67504	Fee-for-Service	1518043777	1518043777	1	1	HERSH, LAYNE MD	3/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	36407	01	General Practice	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
67508	Fee-for-Service	1265012520	1265012520	1	1	HUANG, YA-GIN HANNA MD	7/31/2024	390200000X	NA	Other	026	PHYSICIANS	191884	41	Internal Medicine	0	In state provider	None	375 HUNTINGTON DR	STE G	SAN MARINO	CA	91108	2357	19	06037	34.1067704	-118.1349621	Los Angeles County
67537	Fee-for-Service	1174186290	1174186290	1	1	HAIGHT, JOANNA MD	2/6/2025	207L00000X	NA	Other	026	PHYSICIANS	181363	05	Anesthesiology	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
67542	Fee-for-Service	1457621195	1457621195	1	1	HAMMES, JILLIAN M DO	10/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12086	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
67550	Fee-for-Service	1093764813	1093764813	1	1	HERNANDEZ, BERNADETTE PT	11/12/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
67567	Fee-for-Service	1568825958	1568825958	1	1	HUANG, JOHNNY C DPM	5/6/2022	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	15315 FAIRFIELD RANCH RO	SUITE 220	CHINO HILLS	CA	91709	8836	36	06071	33.97340322	-117.6922495	San Bernardino County
67604	Fee-for-Service	1801821202	1801821202	1	1	HOANG, VANESSA TAN OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	SPECTRUM OPTOMETRIC CTR	939 W EL CAMINO REAL	STE 116	SUNNYVALE	CA	94087	1179	43	06085	37.37138844	-122.0458446	Santa Clara County
67615	Fee-for-Service	1295860823	1295860823	1	1	HOWARD & TIBBETTS PHYSICAL	10/5/2015	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	THERAPY INC	4615 SCOTTS VALLEY DR	SUITE D	SCOTTS VALLEY	CA	95066	4278	44	06087	37.0485587	-122.0166863	Santa Cruz County
67618	Fee-for-Service	1356429146	1356429146	1	1	HUNT, ERIC J MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	63666	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
67623	Fee-for-Service	1780616508	1780616508	1	1	HSU, JOE Y MD	12/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99998	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
67635	Fee-for-Service	1154698058	1154698058	1	1	HUSSAIN, SALWA MD	7/20/2019	207R00000X	NA	Other	026	PHYSICIANS	157279	10	Gastroenterology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
67642	Fee-for-Service	1114321437	1114321437	1	1	HENKE, JOHN LCSW	2/4/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
67678	Fee-for-Service	1104204775	1104204775	1	1	HIGH DESERT FOOT & ANKLE	1/4/2016	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	CLINIC, APC	15366 ELEVENTH STREET	SUITE A	VICTORVILLE	CA	92395	3726	36	06071	34.530156	-117.292539	San Bernardino County
67682	Fee-for-Service	1275824518	1275824518	1	1	HANNON, MARY C MD	6/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123928	66	Emergency Medicine (Urgent Care)	0	In state provider	None	555 EAST HARDY STREET	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
67700	Fee-for-Service	1396030102	1396030102	1	1	HEAFNER, THOMAS A	4/7/2020	2086S0129X	NA	General Surgery	026	PHYSICIANS	165653	02	General Surgery	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
67728	Fee-for-Service	1053716639	1053716639	1	1	HLAING, ARKAR YE MD	8/10/2020	282N00000X	NA	Hospitals	026	PHYSICIANS	168970	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
67780	Fee-for-Service	1760757439	1760757439	1	1	HARBOR HEALTHY LIVING	2/21/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY INC	16040 HARBOR BLVD	STE K	FOUNTAIN VALLEY	CA	92708	1327	30	06059	33.730461	-117.919794	Orange County
67782	Fee-for-Service	1659312593	1659312593	1	35	HEALTHCARE PARTNERS AFFILIAT	10/13/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	925 S. EUCLID ST.	None	ANAHEIM	CA	92802	1522	30	06059	33.81918207	-117.9415353	Orange County
67783	Fee-for-Service	1568759678	1568759678	1	1	HENNESSY, MAEVE M MD	6/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	52099	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
67787	Fee-for-Service	1578528295	1578528295	1	1	HSU, CHI-YUAN MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85235	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
67829	Fee-for-Service	1457621195	1457621195	1	1	HAMMES, JILLIAN M DO	10/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12086	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
67834	Fee-for-Service	1366649089	1366649089	1	1	HARSHBARGER, TODD L MD	7/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66076	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
67836	Fee-for-Service	1700011004	1700011004	1	1	HAMIDUZZAMAN, SABA MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142766	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
67844	Fee-for-Service	1437264132	1437264132	1	1	HEALING TOUCH REHAB, INC.	11/24/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	42220 N. 10TH ST WEST	SUITE 109	LANCASTER	CA	93534	4800	19	06037	34.65072	-118.1475825	Los Angeles County
67846	Fee-for-Service	1659939254	1659939254	1	1	HUNTER, KIMBERLY DOULA	5/3/2024	174N00000X	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	50	06099	0	0	None
67853	Fee-for-Service	1598835902	1598835902	1	1	HENNING, JAMES S MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	25982	05	Anesthesiology	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
67898	Fee-for-Service	1508932849	1508932849	1	1	HICKS, GAYLE E	6/1/2003	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2815 CAMINO DEL RIO S	STE 220	SAN DIEGO	CA	92108	3817	37	06073	32.77000054	-117.1343627	San Diego County
67921	Fee-for-Service	1154698058	1154698058	1	1	HUSSAIN, SALWA MD	7/20/2019	207R00000X	NA	Other	026	PHYSICIANS	157279	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
67965	Fee-for-Service	1407110174	1407110174	1	1	HEMMING, MARK T MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136928	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
67966	Fee-for-Service	1588861157	1588861157	1	1	HORMOZYARI, ATOSA MD	9/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93584	08	Family Practice	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
68025	Fee-for-Service	1154328532	1154328532	1	1	HONG, GEORGE A MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73442	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
68063	Fee-for-Service	1659312593	1659312593	1	35	HEALTHCARE PARTNERS AFFILIAT	10/13/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	925 S. EUCLID ST.	None	ANAHEIM	CA	92802	1522	30	06059	33.81918207	-117.9415353	Orange County
68069	Fee-for-Service	1689201543	1689201543	1	1	HONG, KEVIN S MD	11/10/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	182769	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
68077	Fee-for-Service	1578528295	1578528295	1	1	HSU, CHI-YUAN MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85235	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
68079	Fee-for-Service	1548924574	1548924574	1	2	HORIZON OC LLC	10/31/2022	2278P4000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1920 E KATELLA AVE	K	ORANGE	CA	92867	5146	30	06059	33.80935	-117.8339093	Orange County
68090	Fee-for-Service	1932860392	1932860392	1	1	HEISEN, MCKENNA OT	10/25/2024	225X00000X	NA	Other	019	OCCUPATIONAL 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
68099	Fee-for-Service	1205856218	1205856218	2	1	HONG, STEPHEN S MD	12/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	35437	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	921 W 7TH STREET	None	OXNARD	CA	93030	6755	56	06111	34.19516476	-119.1890959	Ventura County
68104	Fee-for-Service	1861435430	1861435430	1	1	HADDAD, MARK E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	221 MAHALANI ST	None	WAILUKU	HI	96793	2526	00	None	20.88554026	-156.4902142	Maui County
68147	Fee-for-Service	1518045384	1518045384	2	1	HU, GENA	7/26/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	79006	-	NOT APPLICABLE	0	In state provider	None	6203 SAN IGNACIO AVE	SUITE 150	SAN JOSE	CA	95119	1371	43	06085	37.23598537	-121.7783065	Santa Clara County
68149	Fee-for-Service	1821594144	1821594144	1	2	HEARINGLIFE HEARING AID CENT	9/12/2019	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ER LLC	5293 PROSPECT RD	STE D	SAN JOSE	CA	95129	5037	43	06085	37.29226153	-121.9955301	Santa Clara County
68184	Fee-for-Service	1851415285	1851415285	2	1	HOLT, TINYA K LCSW	6/14/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11 SOUTH D STREET	10	PERRIS	CA	92570	2126	33	06065	33.78635384	-117.2282024	Riverside County
68196	Fee-for-Service	1134135098	1134135098	1	1	HARRISON, MARK J MD	11/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88910	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
68224	Fee-for-Service	1023093838	1023093838	1	1	HUYNH, MINH T MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86434	68	Hematology	0	In state provider	None	1505 SOUTH MAIN STREET	None	WALNUT CREEK	CA	94596	0000	07	06013	37.89003052	-122.0574583	Contra Costa County
68235	Fee-for-Service	1770634081	1770634081	1	1	HAGEN KATHARYN M MD	12/4/2007	207L00000X	NA	Other	026	PHYSICIANS	49903	05	Anesthesiology	0	In state provider	None	700 ALAMO PINATO RD	None	SOLVANG	CA	93463	2220	42	06083	0	0	None
68259	Fee-for-Service	1093852105	1093852105	1	1	HAMM, KARL R OD	9/7/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	710B W ONSTOTT RD	None	YUBA CITY	CA	95991	3511	51	06101	39.1331447	-121.6352208	Sutter County
68297	Fee-for-Service	1154662773	1154662773	1	1	HU, JAMES L DO	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15183	01	General Practice	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
68299	Fee-for-Service	1437194248	1437194248	1	1	HOLT,ROSE 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	325 9TH AVE	MS 359110 C/O UWP	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
68316	Fee-for-Service	1538217443	1538217443	1	1	HIATT, CHRISTINE L	12/26/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	17140 BERNARDO CENTER DR	STE 100	SAN DIEGO	CA	92128	2088	37	06073	33.0249487	-117.0758524	San Diego County
68368	Fee-for-Service	1174636872	1174636872	1	1	HUYNH, HOLLIE H OD	2/6/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11893 VALLEY VIEW ST	None	GARDEN GROVE	CA	92845	1236	30	06059	33.7905371	-118.0287927	Orange County
68370	Fee-for-Service	1346800406	1346800406	1	1	HWANG, JOSEPHINE C MD MPH	5/9/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	177311	29	Pulmonary Diseases (M.D. only)	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
68387	Fee-for-Service	1205856218	1205856218	2	1	HONG, STEPHEN S MD	12/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	35437	41	Internal Medicine	0	In state provider	None	921 W 7TH STREET	None	OXNARD	CA	93030	6755	56	06111	34.19516476	-119.1890959	Ventura County
68473	Fee-for-Service	1104346063	1104346063	1	1	HEDBERG, MATTHEW MD	7/29/2024	207ZD0900X	NA	Other	026	PHYSICIANS	None	22	Pathology (M.D. only)	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
68478	Fee-for-Service	1467830836	1467830836	1	1	HEIGHT STREET SKILLED CARE	4/3/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	1611 HEIGHT STREET	None	BAKERSFIELD	CA	93305	2840	15	06029	35.39385254	-118.9735965	Kern County
68486	Fee-for-Service	1235274564	1235274564	1	1	HECOX, DOUGLAS B MD	12/2/2022	174400000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	760 GOLF VIEW DRIVE	SUITE 200	MEDFORD	OR	97504	9685	00	None	42.315228	-122.8230985	Jackson County
68505	Fee-for-Service	1740335611	1740335611	1	1	HUANG, DI-LU CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3235 SAN GABRIEL BLVD	None	ROSEMEAD	CA	91770	2539	19	06037	34.06729886	-118.0906075	Los Angeles County
68514	Fee-for-Service	1023093838	1023093838	1	1	HUYNH, MINH T MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86434	78	Neoplastic Diseases/Oncology	0	In state provider	None	1505 SOUTH MAIN STREET	None	WALNUT CREEK	CA	94596	0000	07	06013	37.89003052	-122.0574583	Contra Costa County
68559	Fee-for-Service	1457960114	1457960114	1	1	HANNA, LAUREN OT	1/25/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1359 PARK AVE	None	ALAMEDA	CA	94501	4511	01	06001	37.76329307	-122.2420565	Alameda County
68563	Fee-for-Service	1538459441	1538459441	1	1	HANSON, ANDREW J DO	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15001	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
68573	Fee-for-Service	1043601727	1043601727	1	1	HUANG, IVY	8/26/2020	208600000X	NA	General Surgery	026	PHYSICIANS	165224	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
68582	Fee-for-Service	1346381076	1346381076	2	1	HOSPICARE PHARMACY INLAND EM	10/10/2019	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PIRE	425 W RIDER ST	STE B2	PERRIS	CA	92571	3245	33	06065	33.83022523	-117.2355363	Riverside County
68598	Fee-for-Service	1659648962	1659648962	1	1	HOSEINY, DORNA	2/6/2012	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
68618	Fee-for-Service	1114305273	1114305273	1	1	HOFMAN, ARIEL MD	1/4/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
68631	Fee-for-Service	1659312593	1659312593	1	19	HEALTHCARE PARTNERS AFFILIAT	4/19/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP INC	2025 E ROUTE 66	None	GLENDORA	CA	91740	4670	19	06037	34.12802719	-117.8255325	Los Angeles County
68659	Fee-for-Service	1346800406	1346800406	1	1	HWANG, JOSEPHINE C MD MPH	5/9/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	177311	41	Internal Medicine	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
68671	Fee-for-Service	1609255850	1609255850	1	1	HAGBOM, ROBERT MD	3/26/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	156494	None	None	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
68673	Fee-for-Service	1215219225	1215219225	1	1	HENSLEY, JANICE S	6/30/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1133 NORTH H ST	SUITE I	LOMPOC	CA	93436	8137	42	06083	34.65630848	-120.457646	Santa Barbara County
68703	Fee-for-Service	1700873957	1700873957	1	1	HOME FOR THE AGED OF THE	5/1/1979	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LITTLE SISTS OF THE POOR	300 LAKE ST	None	SAN FRANCISCO	CA	94118	1357	38	06075	37.78679802	-122.4624937	San Francisco County
68730	Fee-for-Service	1245337039	1245337039	1	1	HARWOOD, DYLAN G PHD	9/1/2013	No Taxonomy Provided	NA	None	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
68743	Fee-for-Service	1932392792	1932392792	1	1	HOWARD, DANA R MD	3/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	90975	41	Internal Medicine	0	In state provider	None	14600 SHERMAN WAY	STE 300	VAN NUYS	CA	91405	2272	19	06037	34.20025916	-118.4500763	Los Angeles County
68758	Fee-for-Service	1003547340	1003547340	1	3	HEART AND VASCULAR CENTERS O	12/10/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	F AMERICA	980 FULTON AVE.	None	SACRAMENTO	CA	95825	4558	34	06067	38.583153	-121.400406	Sacramento County
68770	Fee-for-Service	1811908692	1811908692	1	1	HAN, KAREN FLORENCE MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69817	07	Dermatology	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
68797	Fee-for-Service	1467299685	1467299685	1	1	HWANG, KYUNG MIN NP	9/30/2024	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	401 S LA BREA BLVD	SUITE 205	INGLEWOOD	CA	90301	2321	19	06037	33.95921962	-118.3533372	Los Angeles County
68811	Fee-for-Service	1285654145	1285654145	1	1	HALLENBECK, MICHAEL G MD	8/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75602	30	Radiology	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
68829	Fee-for-Service	1104087261	1104087261	1	1	HSIONG, MINDY M S MD	1/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131550	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
68830	Fee-for-Service	1285697342	1285697342	1	1	HUFF, KENNETH R MD	8/26/1994	2084N0402X	NA	Neurology	026	PHYSICIANS	50874	13	Neurology (M.D. only)	0	In state provider	None	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	19	06037	33.83155851	-118.2920625	Los Angeles County
68853	Fee-for-Service	1720214703	1720214703	1	1	HWANG, STEVEN K MD INC	8/1/2001	193400000X	NA	Other	026	PHYSICIANS	62230	01	General Practice	0	In state provider	None	145 E DUARTE RD AA	#604	ARCADIA	CA	91006	7500	19	06037	34.13029985	-118.0260173	Los Angeles County
68907	Fee-for-Service	1740488998	1740488998	1	1	HOVHANNISYAN, ARMEN MD	4/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99959	41	Internal Medicine	0	In state provider	None	5250 W CENTURY BLVD	STE 333	LOS ANGELES	CA	90045	5919	19	06037	33.9451882	-118.371997	Los Angeles County
68911	Fee-for-Service	1134157910	1134157910	1	1	HOFFMANN, KLAUS D MD INC	8/1/1984	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	None	6323 N FRESNO ST	STE 105	FRESNO	CA	93710	5282	10	06019	36.82867612	-119.7814182	Fresno County
68926	Fee-for-Service	1265499719	1265499719	1	1	HSU, ALEX MD	6/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96309	41	Internal Medicine	0	In state provider	None	3300 E SOUTH ST	STE 110	LONG BEACH	CA	90805	4550	19	06037	33.86018093	-118.1537163	Los Angeles County
68930	Fee-for-Service	1992130470	1992130470	1	1	HOWARD, AUSTIN L MD	11/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139359	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
68950	Fee-for-Service	1245736719	1245736719	1	1	HAMIDI, MOHAMMAD K MD	9/8/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	173890	None	None	0	In state provider	None	2505 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
68958	Fee-for-Service	1801836036	1801836036	1	1	HSIEH, TSENGTING J MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	69075	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
69006	Fee-for-Service	1104231760	1104231760	1	1	HUNG, RAYMOND MD INC	5/16/2014	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	80929	30	Radiology	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
69007	Fee-for-Service	1679864227	1679864227	1	2	HEARWELL AUDIOLOGY INC	4/17/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	14911 NATIONAL AVE	STE 2	LOS GATOS	CA	95032	2632	43	06085	37.25172742	-121.951483	Santa Clara County
69052	Fee-for-Service	1497766364	1497766364	1	1	HUYNH, ANTHONY V MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69919	01	General Practice	0	In state provider	None	718 S 4TH ST	None	EL CENTRO	CA	92243	3319	13	06025	32.786478	-115.552546	Imperial County
69071	Fee-for-Service	1023323763	1023323763	1	1	HUTTENHOFF, ANDREW	12/17/2012	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9855 ERMA RD	STE 130	SAN DIEGO	CA	92131	1092	37	06073	32.91965883	-117.1142366	San Diego County
69107	Fee-for-Service	1972588192	1972588192	1	1	HERMOSA BEACH FIRE DEPT	1/1/1995	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	549 PIER AVE	None	HERMOSA BEACH	CA	90254	3822	19	06037	33.86453471	-118.3960345	Los Angeles County
69196	Fee-for-Service	1881198208	1881198208	1	1	HASDAY, STEVEN J MD	6/5/2023	390200000X	NA	Other	026	PHYSICIANS	163748	None	None	0	In state provider	None	1111 EXPOSITION BLVD	BLDG 700	SACRAMENTO	CA	95815	4300	34	06067	38.598876	-121.4502885	Sacramento County
69217	Fee-for-Service	1265499719	1265499719	1	1	HSU, ALEX MD	6/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	96309	45	Nephrology (Renal-Kidney)	0	In state provider	None	3300 E SOUTH ST	STE 110	LONG BEACH	CA	90805	4550	19	06037	33.86018093	-118.1537163	Los Angeles County
69241	Fee-for-Service	1396884086	1396884086	1	1	HWANG, WENDER MD	3/7/2008	207P00000X	NA	Other	026	PHYSICIANS	93103	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
69268	Fee-for-Service	1497285720	1497285720	1	1	HARLOS, RACHEL K	10/9/2018	390200000X	NA	Other	026	PHYSICIANS	157465	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
69311	Fee-for-Service	1245270495	1245270495	1	1	HANCOCK, DANIEL G MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85760	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
69328	Fee-for-Service	1194427047	1194427047	1	1	HENNESSEE, DEBORAH A LPCC	1/22/2025	No Taxonomy Provided	NA	None	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1588 HOMESTEAD RD	M/B 10, SUITE B	SANTA CLARA	CA	95050	4721	43	06085	37.34637328	-121.9509049	Santa Clara County
69333	Fee-for-Service	1154901726	1154901726	1	1	HERALD CHRISTIAN HEALTH CTR	6/2/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	3401 AEROJET AVE	None	EL MONTE	CA	91731	2801	19	06037	34.070031	-118.068778	Los Angeles County
69339	Fee-for-Service	1497766364	1497766364	1	1	HUYNH, ANTHONY V MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69919	66	Emergency Medicine (Urgent Care)	0	In state provider	None	718 S 4TH ST	None	EL CENTRO	CA	92243	3319	13	06025	32.786478	-115.552546	Imperial County
69365	Fee-for-Service	1780046334	1780046334	1	1	HAWLEY, LAUREN E MD	10/3/2022	208600000X	NA	General Surgery	026	PHYSICIANS	152117	None	None	0	In state provider	None	1450 SAN PABLO STREET	SUITE 6200	LOS ANGELES	CA	90033	4500	19	06037	34.06189518	-118.203256	Los Angeles County
69373	Fee-for-Service	1992776405	1992776405	1	1	HCA HEALTH SERVICES OF	3/19/2012	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TENNESSSEE INC	200 STONECREST BLVD	None	SMYRNA	TN	37167	0000	00	None	35.97623621	-86.56578589	Rutherford County
69393	Fee-for-Service	1629075718	1629075718	1	1	HOFER, GLENN A MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	43153	30	Radiology	0	In state provider	None	6600 MADISON AVE	STE 11	CARMICHAEL	CA	95608	0645	34	06067	38.663028	-121.310271	Sacramento County
69397	Fee-for-Service	1760549182	1760549182	1	1	HAGAR, ROBERT W MD	10/21/1987	207R00000X	NA	Other	026	PHYSICIANS	53126	68	Hematology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
69398	Fee-for-Service	1790180073	1790180073	1	1	HANSEN-ANKERSTAR, ALEXANDRA	1/25/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	A LMFT	14140 BEACH BLVD	STE 120, 155, 200	WESTMINSTER	CA	92683	4453	30	06059	33.756966	-117.9894915	Orange County
69399	Fee-for-Service	1578549622	1578549622	1	1	HOLT, STEVEN 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	79-1019 HAUKAPILA ST.	None	KEALAKEKUA	HI	96750	0000	00	None	19.519965	-155.918154	Hawaii County
69438	Fee-for-Service	1477998375	1477998375	1	1	HEKIMYAN, AVETIS MD	10/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133933	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
69443	Fee-for-Service	1750769998	1750769998	1	1	HUANG, KATHERINE MD	4/27/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162074	15	Obstetrics (D.O. only)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
69462	Fee-for-Service	1942743042	1942743042	1	1	HAAMANKULI, MUZUNGU M NP	3/5/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
69470	Fee-for-Service	1356328355	1356328355	1	1	HARTMAN, ANDREW P MD	12/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82976	02	General Surgery	0	In state provider	None	1635 LAKE SAN MARCOS DR	None	SAN MARCOS	CA	92078	4661	37	06073	33.12584927	-117.211016	San Diego County
69529	Fee-for-Service	1154303121	1154303121	1	1	HERN, HERBERT E JR MD	6/1/2000	207P00000X	NA	Other	026	PHYSICIANS	64099	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
69530	Fee-for-Service	1861556821	1861556821	1	1	HOSALKAR, HETAL H MD	8/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109083	05	Anesthesiology	0	In state provider	None	200 W ARBOR DRIVE	STE 8201	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
69556	Fee-for-Service	1427286343	1427286343	1	1	HWANG, NINA X MD	3/18/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	107879	40	Pediatrics	0	In state provider	None	1310 W STEWART DR	STE 606	ORANGE	CA	92868	3835	30	06059	33.78236048	-117.8664975	Orange County
69572	Fee-for-Service	1447390083	1447390083	1	1	HAMMER, DAVID A LMFT	8/9/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1845 IRON POINT ROAD	SUITE 180	FOLSOM	CA	95630	8760	34	06067	38.643048	-121.145328	Sacramento County
69576	Fee-for-Service	1336227222	1336227222	1	1	HO, TZE C MD	10/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77241	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
69621	Fee-for-Service	1154901726	1154901726	1	1	HERALD CHRISTIAN HEALTH CTR	6/2/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	3401 AEROJET AVE	None	EL MONTE	CA	91731	2801	19	06037	34.070031	-118.068778	Los Angeles County
69644	Fee-for-Service	1750799771	1750799771	1	2	HEMMAT, MATIN R MD	8/1/2024	2083A0300X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	133295	-	NOT APPLICABLE	0	In state provider	None	13525 CIELO AZUL WAY	None	DESERT HOT SPRING	CA	92240	6235	33	06065	33.95048031	-116.4811265	Riverside County
69678	Fee-for-Service	1760549182	1760549182	1	1	HAGAR, ROBERT W MD	10/21/1987	207R00000X	NA	Other	026	PHYSICIANS	53126	78	Neoplastic Diseases/Oncology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
69695	Fee-for-Service	1285908111	1285908111	1	1	HTAY, ANDRE A MD	11/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	137464	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
69700	Fee-for-Service	1285783746	1285783746	1	1	HART, KEVIN G MD	4/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	60072	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
69709	Fee-for-Service	1265429013	1265429013	1	1	HARVEY, CARRIE L MD	12/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83164	None	None	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
69757	Fee-for-Service	1356328355	1356328355	1	1	HARTMAN, ANDREW P MD	12/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82976	20	Orthopedic Surgery	0	In state provider	None	1635 LAKE SAN MARCOS DR	None	SAN MARCOS	CA	92078	4661	37	06073	33.12584927	-117.211016	San Diego County
69801	Fee-for-Service	1275148272	1275148272	1	1	HAVEN HOSPICE INC.	11/19/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2605 1/2 BEVERLY BLVD	None	MONTEBELLO	CA	90640	2309	19	06037	34.02082471	-118.1308052	Los Angeles County
69832	Fee-for-Service	1134575343	1134575343	1	1	HUEMOELLER, RACHELLE NP	7/14/2020	363LG0600X	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
69842	Fee-for-Service	1871146167	1871146167	1	1	HOWE, AMY A CNM	11/8/2022	367A00000X	NA	Certified Nurse Midwife	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
69850	Fee-for-Service	1427286343	1427286343	1	1	HWANG, NINA X MD	3/18/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	107879	68	Hematology	0	In state provider	None	1310 W STEWART DR	STE 606	ORANGE	CA	92868	3835	30	06059	33.78236048	-117.8664975	Orange County
69864	Fee-for-Service	1235662677	1235662677	1	1	HASSON, WILLIAM D MD	10/30/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169243	08	Family Practice	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
69872	Fee-for-Service	1598055709	1598055709	1	1	HSIEH, JERRY N MD	9/29/2017	207RP1001X	NA	Pulmonology	026	PHYSICIANS	150260	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	4234 RIVERWALK PKWY	230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
69879	Fee-for-Service	1457315806	1457315806	1	1	HOME OF GUIDING HANDS	11/30/2001	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1712 MILTON MANOR DR	None	EL CAJON	CA	92021	3611	37	06073	32.81859888	-116.9243631	San Diego County
69890	Fee-for-Service	1316388812	1316388812	1	1	HIGH QUALITY HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	610 N GLENOAKS BLVD	SUITE 102	BURBANK	CA	91502	1046	19	06037	34.18707434	-118.3115081	Los Angeles County
69899	Fee-for-Service	1952618613	1952618613	1	1	HOYE, MARY C LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17777 VENTURA BLVD	STE 105	ENCINO	CA	91316	3738	19	06037	34.16286556	-118.5200521	Los Angeles County
69914	Fee-for-Service	1013545730	1013545730	1	1	HORMOZI, BRIAN MD	9/26/2023	207R00000X	NA	Other	026	PHYSICIANS	185125	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
69930	Fee-for-Service	1386656726	1386656726	2	1	HSU, GOETHE I MD	10/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65018	41	Internal Medicine	0	In state provider	None	12651 LAKEWOOD BLVD	None	DOWNEY	CA	90242	4563	19	06037	33.91612375	-118.1389293	Los Angeles County
69943	Fee-for-Service	1538610563	1538610563	1	1	HO, CHI MAN NP	7/22/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
69965	Fee-for-Service	1962452292	1962452292	1	1	HEJJA, PAUL MD	5/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	51066	05	Anesthesiology	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4552	19	06037	34.19395645	-118.463265	Los Angeles County
69967	Fee-for-Service	1760549182	1760549182	1	1	HAGAR, ROBERT W MD	10/21/1987	207R00000X	NA	Other	026	PHYSICIANS	53126	41	Internal Medicine	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
70091	Fee-for-Service	1275148272	1275148272	1	1	HAVEN HOSPICE INC.	11/19/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2605 1/2 BEVERLY BLVD	None	MONTEBELLO	CA	90640	2309	19	06037	34.02082471	-118.1308052	Los Angeles County
70111	Fee-for-Service	1790478139	1790478139	1	1	HOVHANNES HOVHANNISYAN, OD,	7/20/2023	152WC0802X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	16970 SAN FERNANDO MISSI	C-3	GRANADA HILLS	CA	91344	4262	19	06037	34.27202252	-118.501425	Los Angeles County
70144	Fee-for-Service	1992980262	1992980262	1	2	HUNT, KENNETH J MD	6/1/2018	207XX0004X	NA	Orthopedic Surgery	026	PHYSICIANS	-	20	Orthopedic Surgery	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
70159	Fee-for-Service	1609349794	1609349794	1	1	HELLENS HOME HEALTH CARE INC	1/7/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1400 COLORADO BLVD	STE C	EAGLE ROCK	CA	90041	2321	19	06037	34.13938724	-118.1947058	Los Angeles County
70178	Fee-for-Service	1316388812	1316388812	1	1	HIGH QUALITY HOSPICE INC	9/12/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	610 N GLENOAKS BLVD	SUITE 102	BURBANK	CA	91502	1046	19	06037	34.18707434	-118.3115081	Los Angeles County
70181	Fee-for-Service	1164596805	1164596805	1	1	HUANG, ERIC C MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116401	22	Pathology (M.D. only)	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
70185	Fee-for-Service	1821177569	1821177569	1	1	HUANG, WILLIAM MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	52800	68	Hematology	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
70208	Fee-for-Service	1588778054	1588778054	1	1	HATTON, PATRICIA ANN MD	4/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	37702	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	435 E HARDING WAY	STE 1	STOCKTON	CA	95204	6108	39	06077	37.96837783	-121.2890917	San Joaquin County
70216	Fee-for-Service	1982733549	1982733549	1	1	HALL, MARILYN K LMFT	6/8/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	494 N MOUNTAIN AVE	STE 1	UPLAND	CA	91786	5178	36	06071	34.09934738	-117.6700781	San Bernardino County
70285	Fee-for-Service	1912320888	1912320888	1	1	HOANG, STEPHEN PT	7/4/2020	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
70287	Fee-for-Service	1821079377	1821079377	1	1	HARGIS, CHERIE A MD	3/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53432	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
70320	Fee-for-Service	1992794465	1992794465	1	1	HASKELL, RICHARD J MD	11/19/1996	174400000X	NA	Other	026	PHYSICIANS	41879	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	361 HOSPITAL RD	STE 227	NEWPORT BEACH	CA	92663	3523	30	06059	33.62579141	-117.9299554	Orange County
70356	Fee-for-Service	1700877842	1700877842	1	1	HONG, ANDREW J MD	11/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80562	08	Family Practice	0	In state provider	None	26991 CROWN VALLEY PKWY	None	MISSION VIEJO	CA	92691	6528	30	06059	33.56210341	-117.6694207	Orange County
70391	Fee-for-Service	1619004546	1619004546	1	1	HORNE, CARMELITA E LMFT	6/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2050 PEABODY RD	SUITE 300	VACAVILLE	CA	95687	6695	48	06095	38.333556	-121.9704855	Solano County
70394	Fee-for-Service	1659312593	1659312593	1	7	HEALTHCARE PARTNERS AFFILIAT	9/27/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP	2601 VIA CAMPO	None	MONTEBELLO	CA	90640	1807	19	06037	34.03278164	-118.1237597	Los Angeles County
70401	Fee-for-Service	1053339127	1053339127	1	1	HUBLII, SHITAL MD	11/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85509	08	Family Practice	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	0000	39	06077	37.88652418	-121.2820956	San Joaquin County
70410	Fee-for-Service	1831536382	1831536382	1	1	HANTULI, JAWDAT M DO	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	13969	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
70430	Fee-for-Service	1730119413	1730119413	1	1	HALTHORE, SRINIVAS N MD	8/27/2019	174400000X	NA	Other	026	PHYSICIANS	-	13	Neurology (M.D. only)	1	Border provider	None	3186 S MARYLAND PARKWAY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
70441	Fee-for-Service	1407914260	1407914260	1	1	HILL COUNTRY COMM CLINIC	12/14/1997	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	PO BOX 228	29632 HIGHWAY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0000	45	06089	40.80385331	-121.9397745	Shasta County
70454	Fee-for-Service	1023088630	1023088630	1	1	HONG, JOHN J MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63582	10	Gastroenterology (M.D. only)	0	In state provider	None	521 E ELDER ST	STE 104	FALLBROOK	CA	92028	3082	37	06073	33.38015149	-117.246267	San Diego County
70457	Fee-for-Service	1518030022	1518030022	1	1	HAWKSLEY, CARLENE A MD	2/1/2001	207ZP0102X	NA	Other	026	PHYSICIANS	53698	22	Pathology (M.D. only)	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
70493	Fee-for-Service	1659312593	1659312593	1	33	HEALTHCARE PARTNERS AFFILIAT	7/11/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	AFFILIATES MEDICAL GROUP	7301 MEDICAL CENTER DR	SUITE 500	WEST HILLS	CA	91307	4101	19	06037	34.20285756	-118.6294575	Los Angeles County
70494	Fee-for-Service	1174579734	1174579734	1	1	HOFMANN, GARY MD	10/30/1991	207P00000X	NA	Other	026	PHYSICIANS	64046	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1350 W COVINA BLVD	None	SAN DIMAS	CA	91773	3245	19	06037	34.09906108	-117.8343639	Los Angeles County
70546	Fee-for-Service	1821543737	1821543737	1	1	HOLT-REBER, KRISTINA PSYD	12/1/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1201 ALHAMBRA BLVD	STE 210	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
70554	Fee-for-Service	1407175342	1407175342	1	1	HUANG, KATHIE K MD	6/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125114	41	Internal Medicine	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
70598	Fee-for-Service	1417268095	1417268095	1	1	HEMENWAY,SHAWN 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	0000	00	None	43.6124738	-116.1926844	Ada County
70609	Fee-for-Service	1083149801	1083149801	1	1	HAIDARY SARDABY, TAHMINEH M	6/14/2021	390200000X	NA	Other	026	PHYSICIANS	170370	None	None	0	In state provider	D	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
70612	Fee-for-Service	1689299679	1689299679	1	1	HSU, RICK MD	11/3/2023	207R00000X	NA	Other	026	PHYSICIANS	183329	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
70630	Fee-for-Service	1376560318	1376560318	1	1	HOPPER, ISUZU F LMFT	2/11/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24353 SUNNYMEAD BLVD	STE B	MORENO VALLEY	CA	92553	7772	33	06065	33.93904347	-117.237843	Riverside County
70683	Fee-for-Service	1659312593	1659312593	1	7	HEALTHCARE PARTNERS AFFILIAT	9/27/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP	2601 VIA CAMPO	None	MONTEBELLO	CA	90640	1807	19	06037	34.03278164	-118.1237597	Los Angeles County
70731	Fee-for-Service	1285676395	1285676395	1	1	HALIKIS, NICHOLAS MD	4/2/2024	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	65021	None	None	0	In state provider	None	2200 E. MAPLE AVE	None	EL SEGUNDO	CA	90245	6507	19	06037	33.92690475	-118.3857342	Los Angeles County
70732	Fee-for-Service	1407914260	1407914260	1	1	HILL COUNTRY COMM CLINIC	12/14/1997	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	PO BOX 228	29632 HIGHWAY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0000	45	06089	40.80385331	-121.9397745	Shasta County
70778	Fee-for-Service	1659312593	1659312593	1	33	HEALTHCARE PARTNERS AFFILIAT	7/11/2017	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	7301 MEDICAL CENTER DR	SUITE 500	WEST HILLS	CA	91307	4101	19	06037	34.20285756	-118.6294575	Los Angeles County
70788	Fee-for-Service	1588664478	1588664478	2	1	HAWKINS, ALBERT W JR MD	11/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	41368	41	Internal Medicine	0	In state provider	None	1300 E CYPRESS ST	STE G1	SANTA MARIA	CA	93454	4736	42	06083	34.95102551	-120.4164	Santa Barbara County
70798	Fee-for-Service	1598914384	1598914384	1	1	HAYS, CHAD J MD	1/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104387	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
70827	Fee-for-Service	1467537019	1467537019	1	1	HERNANDEZ, BLAS D MD	10/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	59733	05	Anesthesiology	0	In state provider	None	9300 STOCKDALE HWY	None	BAKERSFIELD	CA	93311	3613	15	06029	35.3545315	-119.1053925	Kern County
70852	Fee-for-Service	1316234560	1316234560	1	1	HOPKINS, HOLLIS M MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123104	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
70854	Fee-for-Service	1700964368	1700964368	1	1	HEMPSTEAD, ANNA J MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	65441	36	Psychiatry	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
70862	Fee-for-Service	1447886304	1447886304	1	1	HOOD, MARISSA O DO	7/22/2023	207P00000X	NA	Other	026	PHYSICIANS	20308	None	None	0	In state provider	None	2050 VIBORG RD	None	SOLVANG	CA	93463	2220	42	06083	34.60246267	-120.1261332	Santa Barbara County
70879	Fee-for-Service	1851169908	1851169908	1	1	HERRERA-WILSON, DANNHAE DOU	12/26/2023	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	38	06075	0	0	None
70890	Fee-for-Service	1295296275	1295296275	1	1	HESS, DIANA H MD	10/18/2024	207R00000X	NA	Other	026	PHYSICIANS	178427	70	Clinic (mixed specialty)	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
70903	Fee-for-Service	1053553339	1053553339	1	1	HAN, PAUL J MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116816	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
70924	Fee-for-Service	1124599139	1124599139	2	1	H26 HEALTHCARE CORP	11/15/2021	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	20 GOLDENLAND CT	None	SACRAMENTO	CA	95834	2420	34	06067	38.651202	-121.5037125	Sacramento County
70938	Fee-for-Service	1962420950	1962420950	1	1	HSU, VIRGINIA H MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	88812	40	Pediatrics	0	In state provider	None	589 LOS COCHES ST	None	MILPITAS	CA	95035	5423	43	06085	37.43176807	-121.8935163	Santa Clara County
70939	Fee-for-Service	1629817150	1629817150	1	1	HERNANDEZ LOPEZ, CARMEN DOU	10/24/2024	390200000X	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
70968	Fee-for-Service	1477819837	1477819837	1	1	HONAKER, SUSAN	12/24/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	840 WILLOW ST	STE 300	SAN JOSE	CA	95125	2377	43	06085	37.31069335	-121.8963251	Santa Clara County
71029	Fee-for-Service	1710356720	1710356720	1	1	HESHAM A YASIN	9/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	200 HAWKINS DR	None	IOWA CITY	IA	52242	1009	00	None	41.659929	-91.548099	Johnson County
71102	Fee-for-Service	1164500062	1164500062	1	1	HAIDEN, ANN DO	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6711	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
71113	Fee-for-Service	1689679045	1689679045	1	1	HARDY, DANIEL E MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	77650	08	Family Practice	0	In state provider	None	801 W L ST	None	LOS BANOS	CA	93635	3953	24	06047	37.05962558	-120.8625896	Merced County
71116	Fee-for-Service	1639110364	1639110364	1	1	HIATT, LYNDA S LCSW	7/11/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
71135	Fee-for-Service	1235237306	1235237306	1	1	HAPNER, EDIE R	3/10/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5315	19	06037	34.06269295	-118.2030006	Los Angeles County
71145	Fee-for-Service	1477646826	1477646826	1	1	HANDLER, MICHAEL H MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	14	Neurological Surgery	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
71192	Fee-for-Service	1205214442	1205214442	1	1	HORNBEAK, KIRSTEN B MD	7/1/2018	207P00000X	NA	Other	026	PHYSICIANS	143934	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
71200	Fee-for-Service	1427255967	1427255967	1	1	HAN, FREDERICK T MD	8/24/2018	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	112325	06	Cardiovascular Disease (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
71209	Fee-for-Service	1649377078	1649377078	1	1	HUYNH, PAULINE	6/27/2023	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
71261	Fee-for-Service	1912935586	1912935586	1	1	HORSLEY, CHERYL MD	6/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	46416	41	Internal Medicine	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
71382	Fee-for-Service	1285320622	1285320622	1	1	HITCHCOCK, ERIC	5/3/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11879 KEMPER RD.	SUITE 4	AUBURN	CA	95603	9021	31	06061	38.93136899	-121.0916266	Placer County
71383	Fee-for-Service	1366512626	1366512626	1	1	HEALEY, KATHLEEN M MD	4/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	49386	18	Ophthalmology	0	In state provider	None	980 TRANCAS ST	STE 10	NAPA	CA	94558	2933	28	06055	38.32369771	-122.2951869	Napa County
71417	Fee-for-Service	1972656429	1972656429	1	1	HECHT, DAVID A DO	1/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11835	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
71442	Fee-for-Service	1013521681	1013521681	1	1	HENDRICK, TANNER PT	10/30/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1870 CENTRAL ST	None	VISALIA	CA	93277	4418	54	06107	36.314541	-119.310201	Tulare County
71451	Fee-for-Service	1962520080	1962520080	1	1	HOOPES, DAVID J MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128063	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
71493	Fee-for-Service	1235268624	1235268624	1	1	HUNG, ERICK K MD	6/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92799	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
71538	Fee-for-Service	1427285097	1427285097	1	1	HUSTON, CURTIS L PT	9/1/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	9999	30	06059	33.85429451	-117.8446551	Orange County
71541	Fee-for-Service	1073023107	1073023107	1	2	HUMBOLDT RECOVERY CENTER, IN	4/22/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1024 N ST.	None	EUREKA	CA	95501	2047	12	06023	40.79883077	-124.1563311	Humboldt County
71543	Fee-for-Service	1073930939	1073930939	1	1	HIRSCHTRITT, MATTHEW MD	11/24/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	139189	36	Psychiatry	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
71555	Fee-for-Service	1649833872	1649833872	1	1	HILL, HARRISON MD	4/9/2024	390200000X	NA	Other	026	PHYSICIANS	186606	36	Psychiatry	0	In state provider	None	1225 W 190TH ST	SUITE 280	GARDENA	CA	90248	4305	19	06037	33.85835623	-118.2987754	Los Angeles County
71584	Fee-for-Service	1760942841	1760942841	1	1	HO, GAVIN K MD	7/20/2022	207R00000X	NA	Other	026	PHYSICIANS	180278	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
71616	Fee-for-Service	1326074261	1326074261	1	1	HOFFMAN, HAROLD M MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53101	40	Pediatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
71669	Fee-for-Service	1992064893	1992064893	1	1	HENDERSON, BLAKE T MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128571	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
71671	Fee-for-Service	1861075632	1861075632	1	1	HEALING POWER HOME HEALTH IN	9/12/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12610 GLENOAKS BLVD	SUITE 4	SYLMAR	CA	91342	4785	19	06037	34.299351	-118.4390254	Los Angeles County
71705	Fee-for-Service	1437772407	1437772407	1	1	HARTNETT, SARAH LMFT	12/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	814 BROADWAY	None	SONOMA	CA	95476	7584	49	06097	38.28627132	-122.4586519	Sonoma County
71706	Fee-for-Service	1609849603	1609849603	1	1	HICKEY, RENE M	9/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86127	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
71741	Fee-for-Service	1962520080	1962520080	1	1	HOOPES, DAVID J MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128063	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
71746	Fee-for-Service	1184959272	1184959272	1	1	HERR, JARED J MD	8/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110432	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	STE 100	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
71758	Fee-for-Service	1417483587	1417483587	1	1	HUTCHISON, HEIDI A MD	8/24/2020	207P00000X	NA	Other	026	PHYSICIANS	169940	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
71759	Fee-for-Service	1750497400	1750497400	1	1	HANDLEY, JOHN A MD	12/11/2002	207RP1001X	NA	Pulmonology	026	PHYSICIANS	46618	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
71788	Fee-for-Service	1023492600	1023492600	1	1	HELMY, DANIEL MD	4/27/2020	111NR0200X	NA	Other	026	PHYSICIANS	148104	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
71816	Fee-for-Service	1669117511	1669117511	1	1	HERNANDEZ, GABRIELA	6/13/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
71826	Fee-for-Service	1700921194	1700921194	1	1	HAPPY VALLEY UNION SD	8/16/2001	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	16300 CLOVERDALE ROAD	None	ANDERSON	CA	96007	8241	45	06089	40.47413716	-122.4535507	Shasta County
71833	Fee-for-Service	1659312593	1659312593	1	24	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
71851	Fee-for-Service	1316049067	1316049067	1	1	HODEL, SUSAN F	9/1/2002	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
71859	Fee-for-Service	1528657871	1528657871	1	1	HEARTS EASE HOSPICE	8/31/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	STE 200	NORTH HOLLYWOOD	CA	91602	1874	19	06037	34.15389329	-118.3679999	Los Angeles County
71880	Fee-for-Service	1588012124	1588012124	1	2	HESHAM EL MOKADEM, MD INC.	9/30/2016	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	R	4500 BROCKTON AVE.	315	RIVERSIDE	CA	92501	4006	33	06065	33.97785263	-117.3836152	Riverside County
71906	Fee-for-Service	1326074261	1326074261	1	1	HOFFMAN, HAROLD M MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53101	03	Allergy	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
71909	Fee-for-Service	1871671362	1871671362	1	1	HEYWOOD, TERENCE J MD	1/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71328	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
71910	Fee-for-Service	1881635191	1881635191	1	1	HURTADO, ALFREDO W MD	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87876	30	Radiology	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
71954	Fee-for-Service	1376610204	1376610204	1	1	HUANG, WINNIE MD	9/30/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53510	77	Infectious Disease	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
71956	Fee-for-Service	1629240817	1629240817	1	1	HILKER, CARL F III PSYD	8/1/2013	No Taxonomy Provided	NA	None	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
71957	Fee-for-Service	1497702740	1497702740	1	1	HOWE, STEVEN C MD	1/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79076	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
72005	Fee-for-Service	1952359929	1952359929	1	1	HALL, DAVID M. PA	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	2200 E SHOW LOW LAKE RD	None	SHOW LOW	AZ	85901	7831	00	None	34.202988	-110.0176695	Navajo County
72034	Fee-for-Service	1184959272	1184959272	1	1	HERR, JARED J MD	8/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110432	41	Internal Medicine	0	In state provider	None	300 PASTEUR DR	STE 100	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
72044	Fee-for-Service	1750497400	1750497400	1	1	HANDLEY, JOHN A MD	12/11/2002	207RP1001X	NA	Pulmonology	026	PHYSICIANS	46618	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
72046	Fee-for-Service	1518366327	1518366327	1	1	HOLLAND, KIMBERLY A LMFT	3/28/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	631 TENNESSEE ST	STE 201	VALLEJO	CA	94590	4432	48	06095	38.10992398	-122.2522919	Solano County
72055	Fee-for-Service	1801293600	1801293600	1	1	HEALTH NOW HOME HEALTHCARE	9/9/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	23591 FOLEY STREET	None	HAYWARD	CA	94545	1676	01	06001	37.640439	-122.131387	Alameda County
72106	Fee-for-Service	1073922969	1073922969	1	1	HWANG, SUNGSIM LAC	9/11/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	7235 ORANGETHORPE AVE	None	BUENA PARK	CA	90621	3311	30	06059	33.8589933	-118.0064214	Orange County
72113	Fee-for-Service	1700124971	1700124971	1	1	HARWOOD, PAULA S NP	12/31/2018	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	328 ENCINITAS BLVD	STE 100	ENCINITAS	CA	92024	8704	37	06073	33.04815637	-117.2842827	San Diego County
72119	Fee-for-Service	1659312593	1659312593	1	24	HEALTHCARE PARTNERS AFFILIAT	6/20/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
72147	Fee-for-Service	1528657871	1528657871	1	1	HEARTS EASE HOSPICE	8/31/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4605 LANKERSHIM BLVD	STE 200	NORTH HOLLYWOOD	CA	91602	1874	19	06037	34.15389329	-118.3679999	Los Angeles County
72178	Fee-for-Service	1336145895	1336145895	1	1	HELPER, STEPHEN 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	29001 CEDAR RD	STE 519	LYNDHURST	OH	44124	4041	00	None	41.50118549	-81.475623	Cuyahoga County
72192	Fee-for-Service	1801230032	1801230032	1	1	HERNANDEZ, ANGELA MARIE MD	8/13/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	160470	15	Obstetrics (D.O. only)	0	In state provider	None	2828 FRESNO ST	SUITE 203	FRESNO	CA	93721	1327	10	06019	36.7418099	-119.7838487	Fresno County
72193	Fee-for-Service	1700987369	1700987369	1	2	HOPKINS, SUSAN M MD	12/4/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	79146	-	NOT APPLICABLE	0	In state provider	None	6166 VESPER AVE	None	VAN NUYS	CA	91411	2851	19	06037	34.182189	-118.450893	Los Angeles County
72197	Fee-for-Service	1568581726	1568581726	1	1	HASAN, FARAH S MD	9/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89245	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
72216	Fee-for-Service	1144200486	1144200486	1	1	HENJUM, STANLEY C MD	12/2/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	62392	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F ST	STE 117	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
72228	Fee-for-Service	1245478882	1245478882	1	1	HE, MING S MD	8/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129966	78	Neoplastic Diseases/Oncology	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
72244	Fee-for-Service	1235559436	1235559436	1	1	HEAN, SINDALISA MD	6/6/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	137717	77	Infectious Disease	0	In state provider	None	1040 ELM AVE	STE 300	LONG BEACH	CA	90813	3267	19	06037	33.779799	-118.1879535	Los Angeles County
72262	Fee-for-Service	1629452131	1629452131	1	1	HUANG, PENG-YUN A MD APC	8/17/2015	261QP2300X	NA	Other	026	PHYSICIANS	110931	41	Internal Medicine	0	In state provider	None	113 WATERWORKS WAY	STE 110	IRVINE	CA	92618	3167	30	06059	33.66497942	-117.7635578	Orange County
72268	Fee-for-Service	1619125176	1619125176	1	1	HOWARD, ESME J CNM	5/19/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
72286	Fee-for-Service	1578199253	1578199253	1	1	HICKS, JEFFERY C PSYD	3/25/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	595 E COLORADO BLVD STE	324	PASADENA	CA	91101	2021	19	06037	34.14588202	-118.1380722	Los Angeles County
72313	Fee-for-Service	1639510225	1639510225	1	1	HU, XIAOMING LCSW	6/6/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	86746	-	NOT APPLICABLE	0	In state provider	None	1930 MARKET STREET	None	SAN FRANCISCO	CA	94102	6228	38	06075	37.77037155	-122.4255051	San Francisco County
72321	Fee-for-Service	1972661726	1972661726	1	1	HUGELMEYER, CHARLES D DO	6/10/2008	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
72337	Fee-for-Service	1760523351	1760523351	1	1	HILL, CHARLES CHRISTIAN	6/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89660	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
72338	Fee-for-Service	1629023270	1629023270	1	1	HAN, BETTY B OD	11/22/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	31740 RAILROAD CANYON RD	STE 4	CANYON LAKE	CA	92587	9490	33	06065	33.67324972	-117.2538921	Riverside County
72409	Fee-for-Service	1659312593	1659312593	1	24	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
72452	Fee-for-Service	1114391935	1114391935	1	3	HOSSEINI, SOHEILA PHD	9/22/2020	101YA0400X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	127 BROADWAY	SUITE 200	SANTA MONICA	CA	90401	2330	19	06037	34.01334753	-118.4957836	Los Angeles County
72476	Fee-for-Service	1487794053	1487794053	1	1	HOO, LISA D MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	78870	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
72484	Fee-for-Service	1801230032	1801230032	1	1	HERNANDEZ, ANGELA MARIE MD	8/13/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	160470	09	Gynecology (D.O. only)	0	In state provider	None	2828 FRESNO ST	SUITE 203	FRESNO	CA	93721	1327	10	06019	36.7418099	-119.7838487	Fresno County
72512	Fee-for-Service	1518095819	1518095819	1	1	HARBOR HEALTH CARE	7/21/2023	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	13638 CLARK AVE	None	BELLFLOWER	CA	90706	2203	19	06037	33.90658016	-118.1340735	Los Angeles County
72518	Fee-for-Service	1245478882	1245478882	1	1	HE, MING S MD	8/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129966	68	Hematology	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
72533	Fee-for-Service	1497902225	1497902225	1	1	HAMAMURA, EDWARD T MD	8/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111033	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
72541	Fee-for-Service	1295924710	1295924710	1	1	HAMADE, WAEL MD	9/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	100880	None	None	0	In state provider	None	26520 CACTUS AVE	# B2018	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
72552	Fee-for-Service	1467506451	1467506451	1	4	HALO MEDICAL GROUP	6/22/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	A MEDICAL CORPORATION	57725 29 PALMS HWY	STE 104	YUCCA VALLEY	CA	92284	3044	36	06071	34.12648753	-116.4039272	San Bernardino County
72558	Fee-for-Service	1285638718	1285638718	2	1	HANGER PROSTHETICS &	10/31/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	6300 WILSHIRE BLVD	SUITE 950	LOS ANGELES	CA	90048	5211	19	06037	34.06348793	-118.3662896	Los Angeles County
72563	Fee-for-Service	1396904785	1396904785	1	1	HARRIS, BRIAN D MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	100114	05	Anesthesiology	0	In state provider	None	2151 W GRANT LINE ROAD	None	TRACY	CA	95377	7309	39	06077	37.75424753	-121.455621	San Joaquin County
72598	Fee-for-Service	1710451638	1710451638	1	1	HOUNNOU, STEPHANIE A LCSW	9/7/2022	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1103 BUTTE HOUSE RD	SUITE E	YUBA CITY	CA	95991	3109	51	06101	39.14536728	-121.6306637	Sutter County
72633	Fee-for-Service	1598260986	1598260986	1	1	H&M MOLECULAR DIAGNOSTICS, L	3/1/2020	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	3770 TANSY STREET	None	SAN DIEGO	CA	92121	1550	37	06073	32.89582746	-117.2195306	San Diego County
72637	Fee-for-Service	1114146834	1114146834	1	1	HOSKINS, ELIZA N MD	5/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103364	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
72671	Fee-for-Service	1760576839	1760576839	1	1	HUDSON, BRADLEY O.	4/27/1999	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
72678	Fee-for-Service	1841990785	1841990785	1	1	HEIL, ROBERT SEAN	3/30/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	9547 IONA AVE	None	HANFORD	CA	93230	8808	16	06031	36.28406401	-119.6290955	Kings County
72698	Fee-for-Service	1659312593	1659312593	1	24	HEALTHCARE PARTNERS AFFILIAT	12/19/2016	193200000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
72704	Fee-for-Service	1316922107	1316922107	1	1	HELFGOTT, PAUL C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40274	13	Neurology (M.D. only)	0	In state provider	None	101 E BEVERLY BLVD	STE 104	MONTEBELLO	CA	90640	4314	19	06037	34.01556395	-118.0983878	Los Angeles County
72715	Fee-for-Service	1922175835	1922175835	1	1	HAGH, PARISSA J MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60353	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
72717	Fee-for-Service	1942818240	1942818240	1	1	HOWARD, KARLA M CNP	12/15/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
72777	Fee-for-Service	1972679041	1972679041	1	1	HUO, CHRISTINE MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73618	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
72803	Fee-for-Service	1356448336	1356448336	1	1	HECHT, FREDERICK MD	11/30/1990	207R00000X	NA	Other	026	PHYSICIANS	71793	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	# 5H	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
72805	Fee-for-Service	1366550378	1366550378	1	1	HEALTHMED MEDICAL GROUP INC	5/21/2012	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	5933	07	Dermatology	0	In state provider	None	995 W FOOTHILL BLVD	None	CLAREMONT	CA	91711	3304	19	06037	34.10715052	-117.7342425	Los Angeles County
72837	Fee-for-Service	1841601507	1841601507	1	1	HUIZAR, JAEL LMFT	6/26/2021	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
72862	Fee-for-Service	1366642225	1366642225	1	1	HOPKINS, WILLIAM C MD	7/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	24984	05	Anesthesiology	0	In state provider	None	3803 S BASCOM AVE	STE 210	CAMPBELL	CA	95008	7317	43	06085	37.25907527	-121.9475431	Santa Clara County
72892	Fee-for-Service	1447589809	1447589809	1	1	HIGUERA, GRISELDA MD	12/10/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	169681	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
72893	Fee-for-Service	1174003040	1174003040	1	1	HASNAIN, AMIR NP	10/18/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	510 PLAZA DR	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
72894	Fee-for-Service	1902534902	1902534902	1	1	HUNTER, MARY G PT	9/27/2022	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
72898	Fee-for-Service	1396131041	1396131041	1	2	HDMC HOLDINGS, LLC	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	SUITE A-5	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
72932	Fee-for-Service	1396906061	1396906061	1	1	HOLT, LARKIN MD	4/14/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	107987	08	Family Practice	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
72965	Fee-for-Service	1841990785	1841990785	1	1	HEIL, ROBERT SEAN	3/30/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	9547 IONA AVE	None	HANFORD	CA	93230	8808	16	06031	36.28406401	-119.6290955	Kings County
72984	Fee-for-Service	1659312593	1659312593	1	24	HEALTHCARE PARTNERS AFFILIAT	5/21/2020	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
72994	Fee-for-Service	1659669182	1659669182	1	1	HUYNH, THANH M	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122254	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
72996	Fee-for-Service	1962913434	1962913434	1	1	HARRIS, GINA M LMFT	5/17/2024	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
73000	Fee-for-Service	1629210414	1629210414	1	1	HARPER-KIRKSEY, KATRINA L MD	5/1/2020	207P00000X	NA	Other	026	PHYSICIANS	129964	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
73021	Fee-for-Service	1811076557	1811076557	1	1	HANA, ANAS MD	11/2/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	73394	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
73024	Fee-for-Service	1881764959	1881764959	1	1	HARMS, CASSANDRA LMFT	10/28/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
73035	Fee-for-Service	1770501769	1770501769	1	1	HUYNH, EDWARD P MD	6/3/2009	207RH0003X	NA	Oncology	026	PHYSICIANS	85175	68	Hematology	0	In state provider	None	625 W CITRACADO PKWY	SUITE 110	ESCONDIDO	CA	92025	6428	37	06073	33.09166731	-117.0784699	San Diego County
73037	Fee-for-Service	1952667040	1952667040	1	1	HEIVAND, NEEMA M MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141875	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
73058	Fee-for-Service	1538390687	1538390687	1	1	HALL, JANET M NP	9/11/2023	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
73067	Fee-for-Service	1871536623	1871536623	1	1	HP ANESTHESIA MEDICAL	12/22/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	GROUP INC	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
73080	Fee-for-Service	1831323567	1831323567	1	1	HEO, YEONG HOE LAC	2/28/2025	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	6877 WESTERN AVE	None	BUENA PARK	CA	90621	3231	30	06059	33.86050951	-118.0025662	Orange County
73088	Fee-for-Service	1033401120	1033401120	1	1	HAPPY RIDE INC	10/1/2012	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	13550 SHERMAN WAY	UNIT 1B	VAN NUYS	CA	91405	2830	19	06037	34.20116249	-118.4284935	Los Angeles County
73102	Fee-for-Service	1952472854	1952472854	1	1	HARRISON, LAWRENCE	4/30/1984	2085B0100X	NA	MRI Provider	026	PHYSICIANS	35445	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
73148	Fee-for-Service	1659487866	1659487866	1	1	HAN, JAE H OD	3/28/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	955 CARRILLO DR	STE 105	LOS ANGELES	CA	90048	5400	19	06037	34.05972732	-118.368048	Los Angeles County
73155	Fee-for-Service	1790838936	1790838936	1	1	HUGGETT, WILLIAM L MD	6/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53088	36	Psychiatry	0	In state provider	None	3825 HOPYARD ROAD	SUITE 140	PLEASANTON	CA	94566	8528	01	06001	37.683009	-121.9036935	Alameda County
73174	Fee-for-Service	1649321761	1649321761	1	1	HAN,HUY Q MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66690	45	Nephrology (Renal-Kidney)	0	In state provider	None	9014 GARVEY AVE	STE I	ROSEMEAD	CA	91770	5306	19	06037	34.0625937	-118.0725204	Los Angeles County
73186	Fee-for-Service	1396131041	1396131041	1	2	HDMC HOLDINGS, LLC	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	SUITE A-5	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
73235	Fee-for-Service	1487761870	1487761870	1	1	HUANG, JOHN Y MD INC	2/8/2015	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	31014	01	General Practice	0	In state provider	None	9460 N NAME UNO	STE 215	GILROY	CA	95020	3532	43	06085	37.037781	-121.570965	Santa Clara County
73274	Fee-for-Service	1659312593	1659312593	1	24	HEALTHCARE PARTNERS AFFILIAT	3/30/2015	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
73288	Fee-for-Service	1912389537	1912389537	1	1	HERNANDEZ SALAS, EDIRIEL MD	1/2/2020	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
73322	Fee-for-Service	1770501769	1770501769	1	1	HUYNH, EDWARD P MD	6/3/2009	207RH0003X	NA	Oncology	026	PHYSICIANS	85175	78	Neoplastic Diseases/Oncology	0	In state provider	None	625 W CITRACADO PKWY	SUITE 110	ESCONDIDO	CA	92025	6428	37	06073	33.09166731	-117.0784699	San Diego County
73327	Fee-for-Service	1255304044	1255304044	1	1	HARWOOD, BRYNA JENNIFER MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	62569	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
73366	Fee-for-Service	1386701530	1386701530	1	1	HALL, DAVID K OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
73391	Fee-for-Service	1730300500	1730300500	1	1	HELVEY, DUSTIN W	6/8/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
73427	Fee-for-Service	1700987369	1700987369	1	1	HOPKINS, SUSAN M MD	9/25/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79146	08	Family Practice	0	In state provider	None	18350 ROSCOE BLVD	STE 600	NORTHRIDGE	CA	91325	4187	19	06037	34.22071855	-118.5341175	Los Angeles County
73432	Fee-for-Service	1275114027	1275114027	1	1	HUQ, JARAAD B DO	8/1/2024	207R00000X	NA	Other	026	PHYSICIANS	22894	41	Internal Medicine	0	In state provider	None	6261 STANTON AVE	None	BUENA PARK	CA	90621	2436	30	06059	33.86943847	-117.9938846	Orange County
73452	Fee-for-Service	1649686452	1649686452	1	1	HLAING, MYO E MD	12/12/2019	207R00000X	NA	Other	026	PHYSICIANS	164013	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
73456	Fee-for-Service	1700871001	1700871001	1	1	HAMILTON, ANN E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22428	22	Pathology (M.D. only)	0	In state provider	MEDICAL CORPORATION	4294 ORANGE ST	None	RIVERSIDE	CA	92501	3827	33	06065	33.9766779	-117.3763732	Riverside County
73461	Fee-for-Service	1649321761	1649321761	1	1	HAN,HUY Q MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66690	41	Internal Medicine	0	In state provider	None	9014 GARVEY AVE	STE I	ROSEMEAD	CA	91770	5306	19	06037	34.0625937	-118.0725204	Los Angeles County
73517	Fee-for-Service	1093114449	1093114449	1	1	HOFFMAN, JOE M LMFT	7/22/2016	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	501 MARIN STREET	SUITE 113	THOUSAND OAKS	CA	91360	4265	56	06111	34.18371146	-118.8824904	Ventura County
73522	Fee-for-Service	1235287285	1235287285	1	1	HAMAMAH, SHANT A MD	5/31/1987	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	61422	None	None	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
73525	Fee-for-Service	1487761870	1487761870	1	1	HUANG, JOHN Y MD INC	2/8/2015	2080A0000X	NA	Pediatric Primary Care	026	PHYSICIANS	31014	40	Pediatrics	0	In state provider	None	9460 N NAME UNO	STE 215	GILROY	CA	95020	3532	43	06085	37.037781	-121.570965	Santa Clara County
73526	Fee-for-Service	1780979120	1780979120	1	2	HEINRICI, ALEKA D MD	1/26/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	125329	-	NOT APPLICABLE	0	In state provider	None	2049 SKYLINE DR	None	LEMON GROVE	CA	91945	4221	37	06073	32.72729271	-117.0254695	San Diego County
73534	Fee-for-Service	1659312593	1659312593	1	2	HEALTHCARE PARTNERS AFFILIAT	3/1/1977	204C00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
73544	Fee-for-Service	1841359437	1841359437	1	1	HYDE, MANLY R MD	3/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	36697	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
73561	Fee-for-Service	1962658682	1962658682	1	1	HOLDBROOK, EVA E MD	10/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121894	None	None	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
73568	Fee-for-Service	1336188739	1336188739	1	1	HAMRANG, SULTANA N MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50709	36	Psychiatry	0	In state provider	None	1908 SWEETWATER RD	None	NATIONAL CITY	CA	91950	7628	37	06073	32.66119079	-117.0786584	San Diego County
73574	Fee-for-Service	1427517796	1427517796	1	1	HANSRA, HARJOT MD	9/13/2024	2084V0102X	NA	Neurology	026	PHYSICIANS	185567	13	Neurology (M.D. only)	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
73634	Fee-for-Service	1326236993	1326236993	1	1	HARRISON, MICHELLE M LFMT	9/14/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	100165	-	NOT APPLICABLE	0	In state provider	None	4990 WILLIAMS AVENUE	None	LA MESA	CA	91942	7409	37	06073	32.76933362	-117.0371085	San Diego County
73657	Fee-for-Service	1104850676	1104850676	1	1	HENRINKSEN, JULIE A MD	5/1/1998	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	65016	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
73701	Fee-for-Service	1235372673	1235372673	1	1	HOANG, PHUONG T MD	5/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92219	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
73724	Fee-for-Service	1609263565	1609263565	1	1	HOEFLER, EDWARD C MD	7/2/2018	No Taxonomy Provided	NA	None	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
73740	Fee-for-Service	1619990488	1619990488	1	3	HEARING SERVICES OF ANTIOCH,	1/29/2020	231H00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL AUDIOLOG	4045 LONE TREE WAY	SUITE D	ANTIOCH	CA	94531	6206	07	06013	37.976122	-121.8012402	Contra Costa County
73746	Fee-for-Service	1700871001	1700871001	1	1	HAMILTON, ANN E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22428	01	General Practice	0	In state provider	MEDICAL CORPORATION	4294 ORANGE ST	None	RIVERSIDE	CA	92501	3827	33	06065	33.9766779	-117.3763732	Riverside County
73750	Fee-for-Service	1063906642	1063906642	1	1	HASHMI, SARAH DO	11/2/2021	207R00000X	NA	Other	026	PHYSICIANS	19177	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
73752	Fee-for-Service	1649321761	1649321761	1	1	HAN,HUY Q MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	66690	40	Pediatrics	0	In state provider	None	9014 GARVEY AVE	STE I	ROSEMEAD	CA	91770	5306	19	06037	34.0625937	-118.0725204	Los Angeles County
73755	Fee-for-Service	1023033271	1023033271	1	1	HENDERSON, STEVEN R MD	10/1/2000	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	66099	None	None	0	In state provider	None	515 E ROMIE LN	None	SALINAS	CA	93901	4018	27	06053	36.65992397	-121.6459411	Monterey County
73756	Fee-for-Service	1497744189	1497744189	1	1	HUANG, KUN MD	6/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	66759	41	Internal Medicine	0	In state provider	None	400 EVELYN AVE	STE 107	ALBANY	CA	94706	1312	01	06001	37.89873243	-122.2971602	Alameda County
73793	Fee-for-Service	1164953857	1164953857	1	1	HERNDON, ALEXANDRA N MD	5/3/2021	207P00000X	NA	Other	026	PHYSICIANS	171309	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
73816	Fee-for-Service	1174502785	1174502785	1	1	HURST, NICOLE D MD	7/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	111116	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4802	37	06073	32.798691	-117.150829	San Diego County
73833	Fee-for-Service	1184846834	1184846834	1	1	HARRINGTON, LEIGH MD	8/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	90076	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
73838	Fee-for-Service	1366595985	1366595985	1	1	HOM, CHRISTINE PHD	10/3/2013	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
73858	Fee-for-Service	1730523945	1730523945	1	1	HEYRANI, NASSER MD	8/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133075	20	Orthopedic Surgery	0	In state provider	None	2120 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1337	34	06067	38.558079	-121.461885	Sacramento County
73874	Fee-for-Service	1942631643	1942631643	1	1	HURT, PHYLLIS ANITA	12/28/2013	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	214 CALLE DE LA PALOMA	None	FALLBROOK	CA	92028	3022	37	06073	33.38001765	-117.2342336	San Diego County
73899	Fee-for-Service	1336863422	1336863422	1	1	HOBBS, ROXANNE S NP	10/4/2024	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
73901	Fee-for-Service	1588733786	1588733786	1	1	HUANG, MIKE MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65019	40	Pediatrics	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
73923	Fee-for-Service	1689047821	1689047821	1	1	HUYNH, HELEN DO INC	3/16/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3006 SAN GABRIEL BLVD	None	ROSEMEAD	CA	91770	2536	19	06037	34.06337572	-118.0904536	Los Angeles County
73942	Fee-for-Service	1538247242	1538247242	1	1	HUNTER, DARRYL C MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67810	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
73948	Fee-for-Service	1255310900	1255310900	1	1	HOME HEALTH INTEGRATED	2/9/2015	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	704 S MAIN ST	None	BURBANK	CA	91506	2529	19	06037	34.16653596	-118.313104	Los Angeles County
73953	Fee-for-Service	1104879584	1104879584	1	1	HOMES, FRED MD	10/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	222 W THOMAS RD	STE 102	PHOENIX	AZ	85013	4493	00	None	33.480558	-112.077027	Maricopa County
73983	Fee-for-Service	1043447436	1043447436	1	1	HOLZMAN, MADELYN MD MC	7/2/2009	208800000X	NA	Other	026	PHYSICIANS	53106	34	Urology and Urological Surgery	0	In state provider	None	572 RIO LINDA AVE	STE 201	CHICO	CA	95926	1851	04	06007	39.75508407	-121.8487933	Butte County
74030	Fee-for-Service	1003854571	1003854571	1	1	HOPE, BRADLEY E MD	12/3/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	61390	-	NOT APPLICABLE	0	In state provider	None	110 LA PAZ AVE	None	SANTA BARBARA	CA	93101	1905	42	06083	34.42780141	-119.7075735	Santa Barbara County
74031	Fee-for-Service	1619990488	1619990488	1	3	HEARING SERVICES OF ANTIOCH,	1/29/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	A PROFESSIONAL AUDIOLOG	4045 LONE TREE WAY	SUITE D	ANTIOCH	CA	94531	6206	07	06013	37.976122	-121.8012402	Contra Costa County
74052	Fee-for-Service	1932630621	1932630621	1	1	HARUTYUNYAN, NIKA M MD	4/27/2020	207R00000X	NA	Other	026	PHYSICIANS	160412	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
74087	Fee-for-Service	1750799771	1750799771	1	1	HEMMAT, MATIN R MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133295	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
74092	Fee-for-Service	1043216542	1043216542	1	1	HUA, DAVID DO	9/2/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	14293	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 EAST HAMILTON AVE	220	CAMPBELL	CA	95008	0665	43	06085	37.29428651	-121.934403	Santa Clara County
74104	Fee-for-Service	1801267679	1801267679	1	1	HUNT, JOHN P CRNA	8/8/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
74136	Fee-for-Service	1285828855	1285828855	1	1	HYUN, CHRISTINE U MD	6/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102861	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
74143	Fee-for-Service	1104001734	1104001734	1	1	HUXLEY, ANGIE K DO	11/18/2015	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
74150	Fee-for-Service	1528346111	1528346111	1	1	HWANG, INYONG MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127657	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5020 COMMERCE DR	None	BAKERSFIELD	CA	93309	0631	15	06029	35.36787086	-119.0579597	Kern County
74163	Fee-for-Service	1942631643	1942631643	1	1	HURT, PHYLLIS ANITA	12/28/2013	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	214 CALLE DE LA PALOMA	None	FALLBROOK	CA	92028	3022	37	06073	33.38001765	-117.2342336	San Diego County
74167	Fee-for-Service	1144588989	1144588989	1	1	HOLOYDA, BRIAN J MD	8/24/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	126944	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
74179	Fee-for-Service	1558981449	1558981449	1	1	HERNANDEZ, MATTHEW MD	5/29/2024	207ZP0105X	NA	Other	026	PHYSICIANS	None	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
74220	Fee-for-Service	1114107240	1114107240	1	1	HEIMER, WILLIAM L II MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	85498	07	Dermatology	0	In state provider	None	320 SANTA FE DR	STE 310	ENCINITAS	CA	92024	5140	37	06073	33.038847	-117.285579	San Diego County
74252	Fee-for-Service	1447312483	1447312483	1	1	HUANG, J ANDREW MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31140	40	Pediatrics	0	In state provider	None	911 W 7TH ST	None	OXNARD	CA	93030	6755	56	06111	34.19516388	-119.1889217	Ventura County
74275	Fee-for-Service	1275074155	1275074155	1	1	HEARTSAVER HOME HEALTH CARE	12/19/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES, INC	1737 E WASHINGTON BLVD	UNIT 4	PASADENA	CA	91104	2771	19	06037	34.16915749	-118.1146455	Los Angeles County
74279	Fee-for-Service	1306995931	1306995931	1	1	HARWOOD, DAVID M MD	8/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98417	20	Orthopedic Surgery	0	In state provider	None	340 W EAST AVE	None	CHICO	CA	95926	7238	04	06007	39.75353271	-121.8668176	Butte County
74303	Fee-for-Service	1114034915	1114034915	1	1	HAVLIR, DIANE	11/9/1990	207R00000X	NA	Other	026	PHYSICIANS	57011	78	Neoplastic Diseases/Oncology	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
74335	Fee-for-Service	1346430337	1346430337	1	1	HOUSEMAN, JODY R J LMFT	8/28/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47488	-	NOT APPLICABLE	0	In state provider	None	13715 EL CAMINO REAL	None	ATASCADERO	CA	93422	6334	40	06079	35.43641042	-120.6221242	San Luis Obispo County
74340	Fee-for-Service	1932630621	1932630621	1	1	HARUTYUNYAN, NIKA M MD	4/27/2020	207R00000X	NA	Other	026	PHYSICIANS	160412	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
74342	Fee-for-Service	1083834964	1083834964	1	1	HEESE, CURT J MD	6/27/2023	2085R0001X	NA	Other	026	PHYSICIANS	187234	None	None	0	In state provider	None	1316 NELSON AVENUE	None	MODESTO	CA	95350	5341	50	06099	37.66206042	-120.9881734	Stanislaus County
74348	Fee-for-Service	1316111669	1316111669	1	1	HARAKO, MICHELLE E MD	3/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	94063	05	Anesthesiology	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
74350	Fee-for-Service	1619951654	1619951654	1	1	HORTON, CHRISTOPHER MD	8/12/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191325	08	Family Practice	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
74367	Fee-for-Service	1942913561	1942913561	1	1	HLAING, KHINE T NP	3/22/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2455 SAN RAMON VALLEY BL	None	SAN RAMON	CA	94583	1601	07	06013	37.77494737	-121.9771019	Contra Costa County
74385	Fee-for-Service	1730269655	1730269655	1	1	HAROUNIAN, KOUROSH DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1016 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	1505	19	06037	34.05875861	-118.3836306	Los Angeles County
74401	Fee-for-Service	1326360637	1326360637	1	1	HAKIMI, AHMAD N MD	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95840	02	General Surgery	0	In state provider	PROFESSIONAL CORP	557 W MORTON AVE	STE B	PORTERVILLE	CA	93257	3383	54	06107	36.07322866	-119.0294842	Tulare County
74433	Fee-for-Service	1508266727	1508266727	1	1	HAMMETT, GREGORY J DO	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14761	41	Internal Medicine	0	In state provider	None	250 PROSPECT PLACE	None	CORONADO	CA	92118	1943	37	06073	32.69409033	-117.1680508	San Diego County
74470	Fee-for-Service	1992901573	1992901573	1	1	HUANG, PEI-HSIU MD	8/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126295	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5301 F STREET	SUITE 117	SACRAMENTO	CA	95819	3220	34	06067	38.571354	-121.4368695	Sacramento County
74517	Fee-for-Service	1275573404	1275573404	1	1	HOLCOMBE, JOHN W MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	64047	05	Anesthesiology	0	In state provider	None	901 DOVER DR	STE 214	NEWPORT BEACH	CA	92660	5500	30	06059	33.62418668	-117.9053624	Orange County
74535	Fee-for-Service	1033310917	1033310917	1	1	HOLT, TINA L CRNA	6/23/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
74559	Fee-for-Service	1134179179	1134179179	1	1	HOLLAND, HEIDI S. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	13677 W MCDOWELL RD	None	GOODYEAR	AZ	85395	2635	00	None	33.461982	-112.3535475	Maricopa County
74567	Fee-for-Service	1306995931	1306995931	1	1	HARWOOD, DAVID M MD	8/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98417	25	Physical Medicine and Rehabilitation	0	In state provider	None	340 W EAST AVE	None	CHICO	CA	95926	7238	04	06007	39.75353271	-121.8668176	Butte County
74587	Fee-for-Service	1467536516	1467536516	1	1	HARRINGTON, ROBERT A MD	11/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89175	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
74593	Fee-for-Service	1114034915	1114034915	1	1	HAVLIR, DIANE	11/9/1990	207R00000X	NA	Other	026	PHYSICIANS	57011	77	Infectious Disease	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
74598	Fee-for-Service	1972698231	1972698231	2	1	HAVILAND, THERESE B LMFT	9/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1108 OPAL ST	C	REDONDO BEACH	CA	90277	3923	19	06037	33.8370536	-118.3755052	Los Angeles County
74628	Fee-for-Service	1700318904	1700318904	1	1	HENSCHEL, MATTHEW R DO	8/1/2019	207P00000X	NA	Other	026	PHYSICIANS	16751	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
74634	Fee-for-Service	1407210008	1407210008	1	1	HOATAM, GERARD J	8/25/2020	390200000X	NA	Other	026	PHYSICIANS	166837	08	Family Practice	0	In state provider	None	225 N JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
74652	Fee-for-Service	1851479604	1851479604	1	1	HECKMANN, SUSAN JEAN MD	12/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	41186	02	General Surgery	0	In state provider	None	2505 SAMARITAN DR	STE 402	SAN JOSE	CA	95124	4012	43	06085	37.25111447	-121.9483395	Santa Clara County
74670	Fee-for-Service	1932875226	1932875226	1	1	HOO, DERRICK CRNA	3/11/2024	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
74701	Fee-for-Service	1568729861	1568729861	1	1	HOFMANN, HEATHER N MD	5/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130062	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92863	4091	30	06059	33.78674051	-117.8888713	Orange County
74720	Fee-for-Service	1134291966	1134291966	1	1	HEMPSTEAD, URSULA K MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73910	40	Pediatrics	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
74750	Fee-for-Service	1548375223	1548375223	1	1	HAMMID, CHERINE A. MN	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
74752	Fee-for-Service	1952545535	1952545535	1	1	HIRSCH, JASON G MD	11/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114749	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
74755	Fee-for-Service	1447217898	1447217898	1	1	HENDERSON, DONALD W MD	6/30/1985	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	41897	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2720 N HARBOR BLVD	STE 130	FULLERTON	CA	92835	2625	30	06059	33.90126238	-117.9292154	Orange County
74788	Fee-for-Service	1114094984	1114094984	1	1	HEISLER, KAMALA L NP	10/18/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1200 DISCOVERY PLAZA	None	BAKERSFIELD	CA	93309	7032	15	06029	35.36397746	-119.0589062	Kern County
74854	Fee-for-Service	1053015156	1053015156	1	1	HEAVENLY CASTLE CARE INC	5/10/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1651 WHITE ROCK RD	None	FRAZIER PARK	CA	93225	9588	15	06029	34.836957	-119.066787	Kern County
74874	Fee-for-Service	1467536516	1467536516	1	1	HARRINGTON, ROBERT A MD	11/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89175	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
74881	Fee-for-Service	1114034915	1114034915	1	1	HAVLIR, DIANE	11/9/1990	207R00000X	NA	Other	026	PHYSICIANS	57011	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
74886	Fee-for-Service	1972698231	1972698231	2	1	HAVILAND, THERESE B LMFT	9/10/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1108 OPAL ST	C	REDONDO BEACH	CA	90277	3923	19	06037	33.8370536	-118.3755052	Los Angeles County
74923	Fee-for-Service	1285796813	1285796813	1	1	HOGG, PENELOPE K PHD	12/26/2018	No Taxonomy Provided	NA	None	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
74960	Fee-for-Service	1063453769	1063453769	1	1	HANDELSMAN, YEHUDA MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	44525	67	Endocrinology	0	In state provider	None	18372 CLARK ST	STE 212	TARZANA	CA	91356	3551	19	06037	34.16975876	-118.533174	Los Angeles County
74987	Fee-for-Service	1609211366	1609211366	1	1	HAN, DANIEL S MD	8/20/2021	208800000X	NA	Other	026	PHYSICIANS	136524	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
75008	Fee-for-Service	1316126931	1316126931	2	1	HUGGINS, KATHLEEN E	9/15/2015	332BN1400X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2705 MCMILLAN AVE	SUITE 130	SAN LUIS OBISPO	CA	93401	4742	40	06079	35.26487101	-120.6482058	San Luis Obispo County
75020	Fee-for-Service	1881461036	1881461036	1	1	HAGE, RABIH MD	7/3/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	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
75050	Fee-for-Service	1346546322	1346546322	1	1	HSU, FORREST D MD	7/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121831	14	Neurological Surgery	0	In state provider	None	3170 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27597804	-119.2533398	Ventura County
75071	Fee-for-Service	1881881431	1881881431	1	1	HOSHINO, CHRISTOPHER M MD	3/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	108050	20	Orthopedic Surgery	0	In state provider	None	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	30	06059	33.56008604	-117.6657795	Orange County
75089	Fee-for-Service	1750746939	1750746939	1	1	HENNESSEE, ELLE LMFT	4/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
75111	Fee-for-Service	1952453672	1952453672	1	1	HERRERA, JOSE DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1095 N D ST	None	SAN BERNARDINO	CA	92410	3539	36	06071	34.119279	-117.291883	San Bernardino County
75176	Fee-for-Service	1255975959	1255975959	1	1	HENSLEY, MARISSA PT	4/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	588 NORTH SUNRISE AVENUE	SUITE 100	ROSEVILLE	CA	95661	2843	31	06061	38.7585915	-121.2527015	Placer County
75186	Fee-for-Service	1881772770	1881772770	1	1	HEYNE, STEVEN P MD	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	68995	08	Family 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
75200	Fee-for-Service	1386988483	1386988483	1	1	HANNA, MARY A MD	6/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123172	08	Family Practice	0	In state provider	None	25455 BARTON RD	None	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
75248	Fee-for-Service	1063453769	1063453769	1	1	HANDELSMAN, YEHUDA MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	44525	41	Internal Medicine	0	In state provider	None	18372 CLARK ST	STE 212	TARZANA	CA	91356	3551	19	06037	34.16975876	-118.533174	Los Angeles County
75281	Fee-for-Service	1568861946	1568861946	1	1	HOUSE OF 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	5627 SEPULVEDA BLVD	SUITE 218	VAN NUYS	CA	91411	2934	19	06037	34.173171	-118.466177	Los Angeles County
75335	Fee-for-Service	1518384056	1518384056	1	1	HEARTEN HOSPICE CARE INC	3/6/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12235 BEACH BLVD	SUITE 200 E	STANTON	CA	90680	3939	30	06059	33.784425	-117.9930265	Orange County
75359	Fee-for-Service	1669634861	1669634861	1	1	HEDDLESON, STANLEY R	3/2/2009	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	LCSW	1129 MARSH STREET	None	SAN LUIS OBISPO	CA	93401	4804	40	06079	35.28151781	-120.6582022	San Luis Obispo County
75365	Fee-for-Service	1790910552	1790910552	1	1	HARRIS, GLORIA J	4/1/2009	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	506 AMANTHA AVE	None	COMPTON	CA	90220	3413	19	06037	33.89095167	-118.2512799	Los Angeles County
75373	Fee-for-Service	1083904940	1083904940	1	1	HABIB, SALMA A MD	9/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150557	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	19	06037	33.93500365	-118.1321119	Los Angeles County
75392	Fee-for-Service	1467045781	1467045781	1	1	HARBOR HOME HEALTH INC	10/21/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	640 S SUNSET AVENUE	SUITE 205	WEST COVINA	CA	91790	2808	19	06037	34.06977627	-117.9371391	Los Angeles County
75414	Fee-for-Service	1871557900	1871557900	1	1	HO, Y-LAN N MD	4/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79433	30	Radiology	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
75424	Fee-for-Service	1922427053	1922427053	1	1	HARRIS, JEREMY P MD	7/22/2019	390200000X	NA	Other	026	PHYSICIANS	137804	32	Radiation Therapy (D.O. only)	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
75435	Fee-for-Service	1912919416	1912919416	1	1	HAAS, GERALD R MD	9/30/1996	207L00000X	NA	Other	026	PHYSICIANS	51605	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
75446	Fee-for-Service	1861158909	1861158909	1	1	HAPPINESS HEALTH CARE INC	1/16/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6005 VINELAND AVE	UNIT 113	NORTH HOLLYWOOD	CA	91606	4983	19	06037	34.179921	-118.3703275	Los Angeles County
75471	Fee-for-Service	1881772770	1881772770	1	1	HEYNE, STEVEN P MD	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	68995	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
75511	Fee-for-Service	1083881494	1083881494	1	2	HELPING HANDS HOME HEALTH	2/8/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2116 WILSHIRE BOULEVARD	SUITE 248	SANTA MONICA	CA	90403	5749	19	06037	34.03235702	-118.4818939	Los Angeles County
75525	Fee-for-Service	1740958099	1740958099	1	1	HOOVER CLINICA URGENCIA	7/27/2022	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1620 S HOOVER ST	SUITE B	LOS ANGELES	CA	90006	4910	19	06037	34.043076	-118.284114	Los Angeles County
75543	Fee-for-Service	1851332126	1851332126	1	1	HUGGARD III, JOHN T CRNA	11/22/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	136 ASPEN COURT	STE A	VISALIA	CA	93291	5175	54	06107	36.32887484	-119.3528574	Tulare County
75547	Fee-for-Service	1427589209	1427589209	1	1	HOLTON-BURKE, ROBERT MD	2/22/2022	390200000X	NA	Other	026	PHYSICIANS	157245	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
75553	Fee-for-Service	1497250468	1497250468	1	1	HOLMAN, PATRICK J MD	2/22/2022	207R00000X	NA	Other	026	PHYSICIANS	166725	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
75560	Fee-for-Service	1528817731	1528817731	1	1	HARTMAN, RAYMOND N PT	7/1/2024	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2100 SOLAR DRIVE	204	OXNARD	CA	93036	2602	56	06111	34.22156515	-119.14488	Ventura County
75561	Fee-for-Service	1750707055	1750707055	2	1	HANGER PROSTHETICS & ORTHOTI	5/19/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	2151 N HARBOR BLVD	SUITE 1200	FULLERTON	CA	92835	3820	30	06059	33.89443025	-117.9288328	Orange County
75565	Fee-for-Service	1538141627	1538141627	1	9	HANFORD COMMUNITY HOSPITAL	1/12/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HEALTH LAB & IMAGING	125 MALL DRIVE	None	HANFORD	CA	93230	5787	16	06031	36.3246477	-119.6685218	Kings County
75569	Fee-for-Service	1568861946	1568861946	1	1	HOUSE OF ANGELS HOSPICE INC	10/26/2016	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5627 SEPULVEDA BLVD	SUITE 218	VAN NUYS	CA	91411	2934	19	06037	34.173171	-118.466177	Los Angeles County
75618	Fee-for-Service	1528147550	1528147550	1	1	HENDERSON, LINDA R MD	10/24/2005	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	23340	None	None	0	In state provider	None	1162 ARIZONA STREET	None	REDDING	CA	96002	3809	45	06089	40.54289917	-122.3503983	Shasta County
75620	Fee-for-Service	1518384056	1518384056	1	1	HEARTEN 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	12235 BEACH BLVD	SUITE 200 E	STANTON	CA	90680	3939	30	06059	33.784425	-117.9930265	Orange County
75631	Fee-for-Service	1306524087	1306524087	1	1	HUOBER, MARGARITA A NP	9/17/2023	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
75634	Fee-for-Service	1043571797	1043571797	1	1	HOPE ALIVE COUNSELING CENTER	9/1/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	S, LLC	1301 E COMPTON BLVD	202 & 203	COMPTON	CA	90221	3401	19	06037	33.89605089	-118.2091703	Los Angeles County
75641	Fee-for-Service	1821157462	1821157462	1	1	HUSSAIN, ABID MD	12/8/2013	207R00000X	NA	Other	026	PHYSICIANS	55869	41	Internal Medicine	0	In state provider	None	255 N GIBLERT ST	BLDG B SUITE A	HEMET	CA	92543	4078	33	06065	33.75067797	-116.976072	Riverside County
75644	Fee-for-Service	1356648703	1356648703	1	1	HARRIS, JOHN W MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137473	41	Internal Medicine	0	In state provider	None	435 ARDEN AVE	STE 350	GLENDALE	CA	91203	4108	19	06037	34.15848148	-118.2628845	Los Angeles County
75647	Fee-for-Service	1326771171	1326771171	1	1	HUMBATOVA, KERRIE NP	1/8/2024	363L00000X	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
75658	Fee-for-Service	1366521361	1366521361	1	1	HERHUSKY, MICHAEL J MD	8/20/1994	207L00000X	NA	Other	026	PHYSICIANS	62902	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
75702	Fee-for-Service	1639555865	1639555865	1	1	HCH TUCSON HOLDINGS LLC	12/9/2018	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1171 W TARGET RANGE RD	None	NOGALES	AZ	85621	2415	00	None	31.340529	-110.960856	Santa Cruz County
75703	Fee-for-Service	1871557900	1871557900	1	1	HO, Y-LAN N MD	4/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79433	40	Pediatrics	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
75723	Fee-for-Service	1841248812	1841248812	1	1	HUANG, SAM S MD	7/31/1995	174400000X	NA	Other	026	PHYSICIANS	76131	None	None	0	In state provider	None	1140 W LA VETA AVE	STE 430	ORANGE	CA	92868	4226	30	06059	33.7802984	-117.8651669	Orange County
75729	Fee-for-Service	1356672323	1356672323	1	1	HURD, MELISSA MEDICAL CORP	3/11/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	ORATION	161 THUNDER DR	STE 103	VISTA	CA	92083	6051	37	06073	33.18638925	-117.2882216	San Diego County
75751	Fee-for-Service	1093177990	1093177990	1	1	HANSRA, RAJKAMAL S MD	4/21/2022	390200000X	NA	Other	026	PHYSICIANS	176797	None	None	0	In state provider	None	FIVE MEDICAL PLAZA	STE 190	ROSEVILLE	CA	95661	2865	31	06061	38.76523677	-121.2493453	Placer County
75769	Fee-for-Service	1528609427	1528609427	1	1	HUANG, DIANA CNP	1/29/2021	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
75796	Fee-for-Service	1013092782	1013092782	1	1	HOM, FREDERICK G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33159	01	General Practice	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
75827	Fee-for-Service	1700132693	1700132693	1	1	HUNT, DANIEL I MD	10/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143309	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
75856	Fee-for-Service	1053733527	1053733527	1	1	HI-DESERT MEMORIAL HEALTH	3/16/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	6380 SPLIT ROCK AVE	SUITE 101, 102, 103	TWENTYNINE PALMS	CA	92277	2550	36	06071	34.13767948	-116.0602373	San Bernardino County
75859	Fee-for-Service	1689791121	1689791121	1	1	HO, CHANDA K MD	4/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105706	41	Internal Medicine	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
75869	Fee-for-Service	1528147550	1528147550	1	2	HENDERSON, LINDA R MD	7/1/2004	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	MTU CONSULTANT	1162 ARIZONA STREET	None	REDDING	CA	96002	3809	45	06089	40.54289917	-122.3503983	Shasta County
75880	Fee-for-Service	1720276025	1720276025	1	1	HAYES, BRYAN CPO	10/23/2008	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1248 32ND ST	None	SACRAMENTO	CA	95816	5210	34	06067	38.569824	-121.464873	Sacramento County
75883	Fee-for-Service	1316025141	1316025141	1	1	HILLS, JOHN F MD	6/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	53359	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
75892	Fee-for-Service	1831188499	1831188499	1	1	HAROLD WALKER M.D.	1/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 S CRISMON RD	None	MESA	AZ	85209	3767	00	None	33.391494	-111.611862	Maricopa County
75910	Fee-for-Service	1679549281	1679549281	1	1	HUDSON, CHARLES MD	1/1/1979	2084P0800X	NA	Psychiatry	026	PHYSICIANS	34859	36	Psychiatry	0	In state provider	None	660 SANITARIUM RD	STE 302	DEER PARK	CA	94576	9714	28	06055	38.54206023	-122.47561	Napa County
75931	Fee-for-Service	1356648703	1356648703	1	1	HARRIS, JOHN W MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137473	77	Infectious Disease	0	In state provider	None	435 ARDEN AVE	STE 350	GLENDALE	CA	91203	4108	19	06037	34.15848148	-118.2628845	Los Angeles County
75943	Fee-for-Service	1134119886	1134119886	1	1	HOPKINS, JOHN MD	5/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99265	30	Radiology	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
75958	Fee-for-Service	1033880828	1033880828	1	1	HUMBLE HAVEN RCFE LLC	6/2/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	37801 RUDALL AVENUE	None	PALMDALE	CA	93550	5555	19	06037	34.56963	-118.081999	Los Angeles County
75990	Fee-for-Service	1639555865	1639555865	1	1	HCH TUCSON HOLDINGS LLC	12/9/2018	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1171 W TARGET RANGE RD	None	NOGALES	AZ	85621	2415	00	None	31.340529	-110.960856	Santa Cruz County
76000	Fee-for-Service	1679864227	1679864227	1	4	HEARWELL AUDIOLOGY INC	4/17/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	511 3RD ST W	None	SONOMA	CA	95476	6501	49	06097	38.29184839	-122.4635981	Sonoma County
76030	Fee-for-Service	1356498398	1356498398	1	1	HOLBROOK, MARY G LMFT	8/13/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	837 3RD STREET	None	EUREKA	CA	95501	0511	12	06023	40.80417466	-124.1627039	Humboldt County
76075	Fee-for-Service	1942342647	1942342647	1	1	HYLAND, KAREN Z PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3255 FOURTH AVENUE	None	SAN DIEGO	CA	92103	5701	37	06073	32.739435	-117.161241	San Diego County
76096	Fee-for-Service	1487041018	1487041018	1	1	HELLMAN, JUSTIN B MD	10/20/2022	207WX0200X	NA	Ophthalmology	026	PHYSICIANS	147716	18	Ophthalmology	0	In state provider	None	628 CALIFORNIA BLVD	STE B	SAN LUIS OBISPO	CA	93401	2554	40	06079	35.28917428	-120.6578269	San Luis Obispo County
76125	Fee-for-Service	1639193147	1639193147	1	1	HUANG, DAVID MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	38235	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
76146	Fee-for-Service	1053733527	1053733527	1	1	HI-DESERT MEMORIAL HEALTH	5/4/2016	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	6380 SPLIT ROCK AVE	SUITE 101, 102, 103	TWENTYNINE PALMS	CA	92277	2550	36	06071	34.13767948	-116.0602373	San Bernardino County
76152	Fee-for-Service	1801820261	1801820261	1	1	HWANG, GLORIA W MD	6/1/1998	207L00000X	NA	Other	026	PHYSICIANS	84719	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
76161	Fee-for-Service	1992807341	1992807341	1	1	HRYNIEWICKI, THOMAS MD	7/17/2024	207R00000X	NA	Other	026	PHYSICIANS	50543	41	Internal Medicine	0	In state provider	None	2540 N SANTIAGO BLVD	None	ORANGE	CA	92867	1862	30	06059	33.83083711	-117.8334144	Orange County
76170	Fee-for-Service	1588831374	1588831374	1	1	HEKMAT, SOHEIL MD INC	6/27/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	32561	41	Internal Medicine	0	In state provider	None	511 E MANCHESTER BLVD	None	INGLEWOOD	CA	90301	1907	19	06037	33.96161457	-118.3478552	Los Angeles County
76173	Fee-for-Service	1265458038	1265458038	1	1	H & S MEDICAL TRANSPORTA	1/5/2005	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TRANZIT LINE	4304 S. ALGER ST.	None	LOS ANGELES	CA	90039	1206	19	06037	34.13191736	-118.2646772	Los Angeles County
76218	Fee-for-Service	1811933690	1811933690	1	1	HONG, MAY C MD	3/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	93205	08	Family Practice	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
76223	Fee-for-Service	1639133200	1639133200	1	1	HSU, FRANK K MD	9/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	STE 100	LAS VEGAS	NV	89106	4812	00	None	36.16257648	-115.170696	Clark County
76253	Fee-for-Service	1780621367	1780621367	1	1	HERRON, NANCY B MD	12/13/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	131658	None	None	0	In state provider	None	1287 FULTON ROAD	None	SANTA ROSA	CA	95401	4923	49	06097	38.45043	-122.7715245	Sonoma County
76282	Fee-for-Service	1477611283	1477611283	1	1	HERRON, ANDREA NITA	7/1/1993	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	GROWING WITH BABY	1230 MARSH ST	None	SAN LUIS OBISPO	CA	93401	3326	40	06079	35.2825106	-120.6566872	San Luis Obispo County
76322	Fee-for-Service	1134179377	1134179377	1	1	HUMBOLDT MEDICAL GRP	3/9/1990	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	3306 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58239845	-124.1360414	Humboldt County
76335	Fee-for-Service	1134101454	1134101454	1	2	HORST, ROBERT O MD	6/22/2023	2084P0804X	NA	Psychiatry	086	MEDICAL DIRECTORS	82376	-	NOT APPLICABLE	0	In state provider	None	7730 ANTELOPE RD	None	CITRUS HEIGHTS	CA	95610	2311	34	06067	38.705148	-121.279914	Sacramento County
76348	Fee-for-Service	1871957829	1871957829	1	1	HUA, KATHLEEN DO	5/2/2023	2084P0802X	NA	Psychiatry	026	PHYSICIANS	20084	None	None	0	In state provider	None	15030 7TH ST.	None	VICTORVILLE	CA	92395	3811	36	06071	34.52471945	-117.3042336	San Bernardino County
76356	Fee-for-Service	1053469841	1053469841	1	1	HAYES-REAMS PHYLLIS E	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73024	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
76399	Fee-for-Service	1801874219	1801874219	1	1	HARGRAVE, RITA R MD	7/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	48650	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
76430	Fee-for-Service	1083016836	1083016836	1	1	HESTON, JONATHAN P A MD	10/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132216	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	1-340	LOS ANGELES	CA	90095	0001	19	06037	34.06482757	-118.4443441	Los Angeles County
76434	Fee-for-Service	1053733527	1053733527	1	1	HI-DESERT MEMORIAL HEALTH	3/16/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	6380 SPLIT ROCK AVE	SUITE 101, 102, 103	TWENTYNINE PALMS	CA	92277	2550	36	06071	34.13767948	-116.0602373	San Bernardino County
76479	Fee-for-Service	1699765412	1699765412	1	1	HENNESSY, ROBERT W MD	6/30/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	114538	None	None	0	In state provider	None	1045 N TUSTIN ST	None	ORANGE	CA	92867	5904	30	06059	33.80481643	-117.8356481	Orange County
76482	Fee-for-Service	1811047335	1811047335	1	1	HUFF, KAREN A CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
76504	Fee-for-Service	1679585806	1679585806	1	1	HANGER P & O WEST INC	1/1/1999	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	16661 VENTURA BLVD	#120	ENCINO	CA	91436	1931	19	06037	34.15820737	-118.496492	Los Angeles County
76515	Fee-for-Service	1023309887	1023309887	1	1	HAN, KELLY MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138607	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
76528	Fee-for-Service	1821234170	1821234170	1	1	HOSONO, HIDEKAZU MD	1/22/2014	2080P0205X	NA	Endocrinology	026	PHYSICIANS	104407	67	Endocrinology	0	In state provider	None	5333 HOLLISTER AVE	STE 250	GOLETA	CA	93111	2466	42	06083	34.43491982	-119.8105484	Santa Barbara County
76571	Fee-for-Service	1477611283	1477611283	1	1	HERRON, ANDREA NITA	1/1/1996	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	GROWING WITH BABY	1230 MARSH ST	None	SAN LUIS OBISPO	CA	93401	3326	40	06079	35.2825106	-120.6566872	San Luis Obispo County
76605	Fee-for-Service	1467718015	1467718015	1	1	HALL, ELIZABETH A MD	7/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153789	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
76606	Fee-for-Service	1164885844	1164885844	1	1	HWONG, ALISON R MD	2/20/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	151251	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
76611	Fee-for-Service	1023540325	1023540325	1	1	HAN, JOOYOUNG DPM	10/4/2024	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5445 DEL AMO BLVD	SUITE 102	LAKEWOOD	CA	90712	2761	19	06037	33.84714748	-118.126521	Los Angeles County
76618	Fee-for-Service	1497215214	1497215214	1	1	HARRIS, LAUREN N PHD	9/27/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3100 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70453535	-121.8586496	Alameda County
76629	Fee-for-Service	1073553145	1073553145	1	1	HORRIGAN, RICHARD W MD	8/21/1996	207L00000X	NA	Other	026	PHYSICIANS	26123	05	Anesthesiology	0	In state provider	CALIFORNIA PACIFIC MED	3700 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
76642	Fee-for-Service	1053469841	1053469841	1	1	HAYES-REAMS PHYLLIS E	11/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73024	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
76648	Fee-for-Service	1497208581	1497208581	1	1	HASHMI, MOHAMMEDALI A DO	11/1/2022	207P00000X	NA	Other	026	PHYSICIANS	20392	None	None	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
76654	Fee-for-Service	1629010590	1629010590	1	1	HUBER, MICHELLE MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	79-1019 HAUKAPILA ST.	None	KEALAKEKUA	HI	96750	7920	00	None	19.519965	-155.918154	Hawaii County
76667	Fee-for-Service	1053582692	1053582692	1	1	HOFTMAN, ALICE D MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80770	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
76682	Fee-for-Service	1497867865	1497867865	1	1	HUMMOS, ALI MD	8/6/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	120267	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
76693	Fee-for-Service	1679524292	1679524292	1	1	HURTADO-WARNECKE, IRMA	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	55445	08	Family Practice	0	In state provider	None	1701 E CESAR E CHAVEZ AV	STE 230	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
76726	Fee-for-Service	1649284316	1649284316	1	1	HOEK, ALLEN D OD	6/30/1991	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1048 W MAIN ST	None	RIPON	CA	95366	2326	39	06077	37.73944453	-121.135167	San Joaquin County
76735	Fee-for-Service	1548502073	1548502073	1	1	HEARING AID CONSULTANTS, INC	3/17/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	2239 TOWNSGATE ROAD	STE 106	WESTLAKE VILLAGE	CA	91361	2426	56	06111	34.16117552	-118.8369945	Ventura County
76738	Fee-for-Service	1225518301	1225518301	1	1	HUGHEY, STEVIE PT	12/16/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
76769	Fee-for-Service	1245321843	1245321843	1	1	HERR, BENJAMIN S DC	10/1/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	CHIROPRACTIC CARE CENTER	7275 E SOUTHGATE DR	STE 405	SACRAMENTO	CA	95823	2632	34	06067	38.493576	-121.436559	Sacramento County
76772	Fee-for-Service	1093335473	1093335473	1	1	HEYDARI, SEYED FARAZ	11/24/2023	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	34	06067	38.571084	-121.471074	Sacramento County
76792	Fee-for-Service	1679585806	1679585806	1	1	HANGER P & O WEST INC	3/23/2018	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	16661 VENTURA BLVD	#120	ENCINO	CA	91436	1931	19	06037	34.15820737	-118.496492	Los Angeles County
76840	Fee-for-Service	1518281831	1518281831	1	1	HORNER, CARLI J LCSW	8/12/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
76878	Fee-for-Service	1316141815	1316141815	1	1	HONG, JANE H MD	2/8/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	84574	None	None	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
76930	Fee-for-Service	1073661872	1073661872	1	1	HURWITZ, DAVID C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22197	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
76935	Fee-for-Service	1982895132	1982895132	1	1	HAWKINS, ALBERT W MD INC	5/17/2013	174400000X	NA	Other	026	PHYSICIANS	41368	41	Internal Medicine	0	In state provider	None	1300 E CYPRESS ST	STE G1	SANTA MARIA	CA	93454	4736	42	06083	34.95102551	-120.4164	Santa Barbara County
76951	Fee-for-Service	1053582692	1053582692	1	1	HOFTMAN, ALICE D MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80770	83	Rheumatology	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
76995	Fee-for-Service	1932379245	1932379245	1	1	HOLY CHILD MED SUPLY INC	4/28/2009	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	HOLY CHILD MED SUPLY INC	8619 RESEDA BLVD	STE 201	NORTHRIDGE	CA	91324	4044	19	06037	34.226982	-118.536098	Los Angeles County
77015	Fee-for-Service	1013622026	1013622026	1	1	HAYNES, TANARA L DOULA	3/7/2023	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	34	06067	0	0	None
77022	Fee-for-Service	1184978918	1184978918	1	1	HOW, HEATHER W OT	2/24/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
77033	Fee-for-Service	1427493691	1427493691	1	1	HUYNH, NHAN T MD	1/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136823	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
77034	Fee-for-Service	1801321948	1801321948	1	1	HOWELL HEALTHCARE MP, INC	5/22/2017	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	35 W LOS ANGELES	None	MOORPARK	CA	93021	1820	56	06111	34.27900253	-118.8824532	Ventura County
77075	Fee-for-Service	1659312593	1659312593	1	32	HEALTHCARE PARTNERS AFFILIAT	5/11/2021	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATES MEDICAL GROUP	4281 KATELLA AVE	SUITE 220	LOS ALAMITOS	CA	90720	6506	30	06059	33.80315853	-118.058328	Orange County
77199	Fee-for-Service	1053580191	1053580191	1	1	HOWELL, MICHAEL A MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118799	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
77203	Fee-for-Service	1427322197	1427322197	1	1	HUYNH, NICHOLAS P MD	5/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124120	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
77225	Fee-for-Service	1437287711	1437287711	1	1	HARBOR HEALTH CARE, INC	8/1/2001	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	13556 DESTINO PLACE	None	CERRITOS	CA	90703	8836	19	06037	33.87134374	-118.0423423	Los Angeles County
77242	Fee-for-Service	1962465781	1962465781	1	1	HUNT, MATTHEW J MD	6/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80217	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
77243	Fee-for-Service	1295813038	1295813038	1	1	HERMANSON, SUSAN C MD	6/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	46186	30	Radiology	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
77271	Fee-for-Service	1336893098	1336893098	1	1	HOLISTIC NURSING MEDICAL INC	12/8/2023	363LP0808X	NA	Nurse Practitioner	022	PHYSICIANS GROUP	-	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
77280	Fee-for-Service	1134101454	1134101454	1	1	HORST, ROBERT O	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82376	36	Psychiatry	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
77292	Fee-for-Service	1124042882	1124042882	1	1	HOSSEINIAN, GHOLAM R MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72485	None	None	0	In state provider	None	2428 W WHITTIER BLVD	None	MONTEBELLO	CA	90640	3041	19	06037	34.01435784	-118.1281402	Los Angeles County
77328	Fee-for-Service	1962607606	1962607606	1	1	HIZON, LEANNA N NP	12/1/2014	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
77343	Fee-for-Service	1942502703	1942502703	1	1	HANKERSON, MATTHEW J MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128331	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
77363	Fee-for-Service	1659312593	1659312593	1	32	HEALTHCARE PARTNERS AFFILIAT	12/22/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AFFILIATES MEDICAL GROUP	4281 KATELLA AVE	SUITE 220	LOS ALAMITOS	CA	90720	6506	30	06059	33.80315853	-118.058328	Orange County
77400	Fee-for-Service	1487366571	1487366571	1	1	HOLDEN, JACK T OD	1/25/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1545 W 5TH ST	STE 100	OXNARD	CA	93030	6510	56	06111	34.19757729	-119.1961091	Ventura County
77407	Fee-for-Service	1992985543	1992985543	1	1	HERZBERG, ROBERT M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12714	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
77424	Fee-for-Service	1508028895	1508028895	1	1	HALOL, ATHENA J O MD	8/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124323	01	General Practice	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
77439	Fee-for-Service	1629635081	1629635081	1	1	HEALING SOLUTIONS HOME CARE	2/18/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	13746 VICTORY BLVD	STE 216	VAN NUYS	CA	91401	6725	19	06037	34.18664551	-118.432764	Los Angeles County
77485	Fee-for-Service	1679712624	1679712624	1	1	HOWARD, ADAM S DPM	6/13/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	10353 TORRE AVE	None	CUPERTINO	CA	95014	3217	43	06085	37.31739526	-122.0293011	Santa Clara County
77491	Fee-for-Service	1427322197	1427322197	1	1	HUYNH, NICHOLAS P MD	5/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	124120	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
77508	Fee-for-Service	1710932223	1710932223	1	1	HEIL, JUSTIN W MD	7/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53613	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
77560	Fee-for-Service	1336893098	1336893098	1	1	HOLISTIC NURSING MEDICAL INC	7/22/2022	363LP0808X	NA	Nurse Practitioner	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	7828 HAVEN AVE	215	RANCHO CUCAMONGA	CA	91730	3049	36	06071	34.111854	-117.5759995	San Bernardino County
77610	Fee-for-Service	1588634521	1588634521	1	1	HOLT, JUSTIN C OD	8/14/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2890 VENTURA STREET	None	ANDERSON	CA	96007	3533	45	06089	40.45284128	-122.2938885	Shasta County
77632	Fee-for-Service	1912076456	1912076456	1	1	HAYES-BIST, JENNIFER D	6/5/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
77641	Fee-for-Service	1902009343	1902009343	1	1	HOLLAND, SUSAN	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
77651	Fee-for-Service	1659312593	1659312593	1	32	HEALTHCARE PARTNERS AFFILIAT	12/22/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	AFFILIATES MEDICAL GROUP	4281 KATELLA AVE	SUITE 220	LOS ALAMITOS	CA	90720	6506	30	06059	33.80315853	-118.058328	Orange County
77672	Fee-for-Service	1104823954	1104823954	1	1	HONE, JENNIFER MD	4/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	88479	67	Endocrinology	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
77686	Fee-for-Service	1235180936	1235180936	1	1	HRISTIC, DJORDJE MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
77696	Fee-for-Service	1124674387	1124674387	1	1	HOSPICIO DE SAN MIGUEL INC	8/3/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	24301 SOUTHLAND DR	STE 618	HAYWARD	CA	94545	1555	01	06001	37.65344508	-122.1045736	Alameda County
77725	Fee-for-Service	1821358862	1821358862	1	1	HSIEN, SUN T MD	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155488	24	Plastic Surgery	0	In state provider	None	7920 FROST ST	STE 200	SAN DIEGO	CA	92123	4289	37	06073	32.80027449	-117.153846	San Diego County
77753	Fee-for-Service	1831150127	1831150127	1	1	HSIEH, TONY MINGTAH MD	8/1/2003	207ZP0102X	NA	Other	026	PHYSICIANS	62763	22	Pathology (M.D. only)	0	In state provider	GLENDORA PATHOLOGY	150 W ROUTE 66	None	GLENDORA	CA	91740	6207	19	06037	34.12866152	-117.86535	Los Angeles County
77781	Fee-for-Service	1265505069	1265505069	1	1	HUANG, ZHEN Z AC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3900 GEARY BLVD	STE 203	SAN FRANCISCO	CA	94118	3251	38	06075	37.78125174	-122.4612618	San Francisco County
77802	Fee-for-Service	1801868286	1801868286	1	1	HEBREO, JOSEPH D MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	93436	45	Nephrology (Renal-Kidney)	0	In state provider	None	631 E GRAND AVENUE	None	ESCONDIDO	CA	92025	4402	37	06073	33.12468152	-117.073451	San Diego County
77823	Fee-for-Service	1245718899	1245718899	1	1	HOOVER, LINDSEY M	1/29/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1610 ARDEN WAY	SUITE 195	SACRAMENTO	CA	95815	4035	34	06067	38.598597	-121.42863	Sacramento County
77864	Fee-for-Service	1457857831	1457857831	1	1	HUI, WILLIAM C MD	4/30/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164255	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
77890	Fee-for-Service	1316309685	1316309685	1	1	HARRISON, BRITTANY MD	8/13/2019	390200000X	NA	Other	026	PHYSICIANS	153668	30	Radiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
77912	Fee-for-Service	1114910163	1114910163	1	1	HERRIFORD, CARLA E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40031	None	None	0	In state provider	None	6200 WILSHIRE BLVD	STE 1012	LOS ANGELES	CA	90048	5811	19	06037	34.06319291	-118.3636025	Los Angeles County
77924	Fee-for-Service	1518293943	1518293943	1	1	HO, ANTHONY H DO	11/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10893	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
77932	Fee-for-Service	1295180461	1295180461	1	1	HENDRICKS, BENJAMIN K MD	9/14/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	188657	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
77933	Fee-for-Service	1720181282	1720181282	1	1	HERNANDEZ VELASCO, BENJAMIN	12/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150323	41	Internal Medicine	0	In state provider	A MD	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
77938	Fee-for-Service	1659312593	1659312593	1	32	HEALTHCARE PARTNERS AFFILIAT	10/16/2020	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AFFILIATES MEDICAL GROUP	4281 KATELLA AVE	SUITE 220	LOS ALAMITOS	CA	90720	6506	30	06059	33.80315853	-118.058328	Orange County
77939	Fee-for-Service	1013697473	1013697473	1	1	HALE-ALVAREZ, NYEESHA LMFT	8/23/2023	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
77960	Fee-for-Service	1104823954	1104823954	1	1	HONE, JENNIFER MD	4/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	88479	41	Internal Medicine	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
77988	Fee-for-Service	1124674387	1124674387	1	1	HOSPICIO DE SAN MIGUEL INC	8/3/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	24301 SOUTHLAND DR	STE 618	HAYWARD	CA	94545	1555	01	06001	37.65344508	-122.1045736	Alameda County
77994	Fee-for-Service	1710752464	1710752464	1	2	HEALTH SEED LA	3/26/2024	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	1131 ARIZONA AVE	None	SANTA MONICA	CA	90401	2009	19	06037	34.02370279	-118.4894957	Los Angeles County
78038	Fee-for-Service	1548503329	1548503329	1	1	HARPER, LAUREN K MD	5/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134826	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
78096	Fee-for-Service	1922095116	1922095116	1	1	HUNTERDON MEDICAL CENTER	12/9/2008	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2100 WESCOTT DR	None	FLEMINGTON	NJ	08822	4603	00	None	40.53194519	-74.86004477	Hunterdon County
78171	Fee-for-Service	1720337371	1720337371	1	1	HILL, CATHERINE	11/18/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2220 F STREET	None	SACRAMENTO	CA	95816	3517	34	06067	38.579931	-121.4746065	Sacramento County
78206	Fee-for-Service	1467484667	1467484667	1	1	HAROLD WERNER, MD	9/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1400 S COULTER ST	None	AMARILLO	TX	79106	1786	00	None	35.200422	-101.924559	Potter County
78281	Fee-for-Service	1821438565	1821438565	1	1	HORMBERG, LUCY Y MD	8/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149882	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
78317	Fee-for-Service	1699094763	1699094763	1	1	HALSTED, KAREN C MD	12/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120145	02	General Surgery	0	In state provider	None	863 N DOUGLAS STREET	SUITE 100	EL SEGUNDO	CA	90245	2081	19	06037	33.92830583	-118.3831669	Los Angeles County
78332	Fee-for-Service	1366476079	1366476079	1	1	HUGGINS HOSPITAL	7/26/2013	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	240 SOUTH MAIN ST	None	WOLFEBORO	NH	03894	4411	00	None	43.5809775	-71.20159914	Carroll County
78338	Fee-for-Service	1831335116	1831335116	1	1	HEALTHY HEARTS MEDICAL GROUP	3/2/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66698	None	None	0	In state provider	INC	555 SIXTH ST	None	ORANGE COVE	CA	93646	2136	10	06019	36.62528929	-119.3124175	Fresno County
78340	Fee-for-Service	1114118023	1114118023	1	1	HARRIS, LEITA J MD	1/11/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	64281	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
78360	Fee-for-Service	1588051015	1588051015	1	1	HOSSAIN, NOREEN MD	4/17/2025	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	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
78375	Fee-for-Service	1053521344	1053521344	1	1	HEALTHCARE WITH HEART LLC	8/3/2018	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	2	Out of state provider	None	823 CENTER AVE	None	PAYETTE	ID	82661	2535	00	None	44.07486653	-116.9341515	Payette County
78377	Fee-for-Service	1194939165	1194939165	1	1	HALLWAY, MARY K	2/22/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	12281 KNOTT ST	STE 103	GARDEN GROVE	CA	92841	3939	30	06059	33.78524517	-118.0112189	Orange County
78382	Fee-for-Service	1922095116	1922095116	1	1	HUNTERDON MEDICAL CENTER	12/9/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2100 WESCOTT DR	None	FLEMINGTON	NJ	08822	4603	00	None	40.53194519	-74.86004477	Hunterdon County
78405	Fee-for-Service	1649383084	1649383084	1	1	HOME DELIVERY INCONTINENT	12/8/2011	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	SUPPLIES, CO. INC	9385 DIELMAN INDUSTRIAL	None	OLIVETTE	MO	63132	2214	00	None	38.67940946	-90.374724	St. Louis County
78418	Fee-for-Service	1861633430	1861633430	1	1	HAYES, BRIAN J LMFT	9/14/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3650 AUBURN BLVD	C 208	SACRAMENTO	CA	95821	2082	34	06067	38.638503	-121.378518	Sacramento County
78460	Fee-for-Service	1720337371	1720337371	1	1	HILL, CATHERINE	11/18/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2220 F STREET	None	SACRAMENTO	CA	95816	3517	34	06067	38.579931	-121.4746065	Sacramento County
78478	Fee-for-Service	1184663825	1184663825	1	1	HANSEN, BARRY R MD	7/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	50405	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
78488	Fee-for-Service	1174989693	1174989693	1	1	HONG, JANIE J PHD	5/6/2020	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
78490	Fee-for-Service	1275566010	1275566010	1	1	HOO, PAMELA A	9/20/2007	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
78554	Fee-for-Service	1558826180	1558826180	1	1	HO, BENSEN LMFT	1/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2790 SKYPARK DRIVE	215	TORRANCE	CA	90505	5388	19	06037	33.80456075	-118.3357569	Los Angeles County
78558	Fee-for-Service	1831544113	1831544113	1	1	HEPPENSTALL, ASTRID M MD	2/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	25571	40	Pediatrics	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1083	19	06037	34.05855992	-118.209755	Los Angeles County
78561	Fee-for-Service	1093912958	1093912958	1	2	HAYATDAVOUDI, SAMAN MD	4/19/2013	207RC0200X	NA	Other	026	PHYSICIANS	116819	41	Internal Medicine	0	In state provider	None	1485 RIVER PARK DR	STE 200	SACRAMENTO	CA	95815	4501	34	06067	38.599614	-121.438728	Sacramento County
78586	Fee-for-Service	1790954378	1790954378	1	1	HASAN, TAOHEED	10/15/2004	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	VALLEY PHARMACY	1324 W AVENUE J	STE 1	LANCASTER	CA	93534	2948	19	06037	34.68939948	-118.1557935	Los Angeles County
78612	Fee-for-Service	1760770424	1760770424	1	1	HUBBARD, GABRIEL J PSYD	10/29/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	595 E COLORADO BLVD	SUITE 409	PASADENA	CA	91101	2039	19	06037	34.14588202	-118.1380722	Los Angeles County
78617	Fee-for-Service	1538794888	1538794888	2	1	HAPPYJOY CORPORATION	6/15/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	9972 WESTMINSTER AVE	100	GARDEN GROVE	CA	92844	5142	30	06059	33.7594385	-117.9553365	Orange County
78620	Fee-for-Service	1366476079	1366476079	1	1	HUGGINS HOSPITAL	7/26/2013	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	240 SOUTH MAIN ST	None	WOLFEBORO	NH	03894	4411	00	None	43.5809775	-71.20159914	Carroll County
78621	Fee-for-Service	1003986415	1003986415	1	1	HACKETT, TIFFANY S MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77101	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
78625	Fee-for-Service	1164805941	1164805941	1	1	HARTLAND CARE INC	2/6/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	8224 ZELZAH AVE	None	RESEDA	CA	91335	1552	19	06037	34.21936243	-118.5230295	Los Angeles County
78640	Fee-for-Service	1679764369	1679764369	1	1	HEALTHRIGHT 360	1/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 SENTER ROAD	B3	SAN JOSE	CA	95111	1399	43	06085	37.29207728	-121.8317345	Santa Clara County
78659	Fee-for-Service	1760633770	1760633770	1	1	HUANG, MICHAEL C MD	8/18/2010	207T00000X	NA	General Surgery	026	PHYSICIANS	113256	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
78679	Fee-for-Service	1588197354	1588197354	1	1	HARGRAVE, ANITA S MD	6/15/2020	390200000X	NA	Other	026	PHYSICIANS	160586	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
78707	Fee-for-Service	1659733459	1659733459	1	1	HSU, KAREN MD	12/2/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	170534	None	None	0	In state provider	None	2501 E CHAPMAN AVE	None	ORANGE	CA	92869	3204	30	06059	33.78785649	-117.8276715	Orange County
78709	Fee-for-Service	1437209343	1437209343	1	1	HERNANDEZ, BERENICE A NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3900 ALAMO ST	None	SIMI VALLEY	CA	93063	9999	56	06111	34.28628637	-118.7195497	Ventura County
78719	Fee-for-Service	1487676854	1487676854	1	1	HEATHER, RICHARD E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	45637	41	Internal Medicine	0	In state provider	None	2035 9TH ST	STE A	LOS OSOS	CA	93402	3209	40	06079	35.31429444	-120.8333418	San Luis Obispo County
78740	Fee-for-Service	1982012019	1982012019	1	1	HEALTHY LIVING AT HOME INC	10/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	39899 BALENTINE DR	STE 314	NEWARK	CA	94560	5359	01	06001	37.52205657	-121.993549	Alameda County
78748	Fee-for-Service	1023108255	1023108255	1	1	HADLEY, CHERYL D MD	12/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60892	08	Family Practice	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
78755	Fee-for-Service	1851300552	1851300552	1	1	HASKELL, ANDREW MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67959	20	Orthopedic Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A436	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
78758	Fee-for-Service	1821160821	1821160821	1	1	HILD, TANNAZ G MD	11/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91524	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
78762	Fee-for-Service	1184663825	1184663825	1	1	HANSEN, BARRY R MD	7/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	50405	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
78824	Fee-for-Service	1619903689	1619903689	1	1	HUBBARD, STANLEY MD	12/31/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	64425	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1225 15TH ST	None	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
78832	Fee-for-Service	1639192032	1639192032	1	1	HUMBOLDT PULMONOLOGY A M	1/10/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3798 JANES RD	STE 4	ARCATA	CA	95521	4745	12	06023	40.89649119	-124.0930501	Humboldt County
78837	Fee-for-Service	1811508385	1811508385	1	1	HA, MICHELLE	10/17/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8282 WHITE OAK AVE	107, 108, AND 111	RANCHO CUCAMONGA	CA	91730	7680	36	06071	34.10361339	-117.5644472	San Bernardino County
78838	Fee-for-Service	1689056335	1689056335	1	1	HUANG, KUN MD PHD INC	1/11/2016	207R00000X	NA	Other	026	PHYSICIANS	67591	41	Internal Medicine	0	In state provider	None	400 EVELYN AVENUE	SUITE 107	ALBANY	CA	94706	1350	01	06001	37.89873243	-122.2971602	Alameda County
78850	Fee-for-Service	1093912958	1093912958	1	2	HAYATDAVOUDI, SAMAN MD	4/19/2013	207RC0200X	NA	Other	026	PHYSICIANS	116819	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1485 RIVER PARK DR	STE 200	SACRAMENTO	CA	95815	4501	34	06067	38.599614	-121.438728	Sacramento County
78851	Fee-for-Service	1710252648	1710252648	1	1	HARTON, MARY H DO	5/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12088	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
78877	Fee-for-Service	1629333919	1629333919	1	1	HAIG, SAWYER B DO	11/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13392	41	Internal Medicine	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4310	42	06083	34.42967671	-119.7228362	Santa Barbara County
78910	Fee-for-Service	1063629905	1063629905	1	1	HUMPHREY, LOURDES V PSYD	1/23/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
78923	Fee-for-Service	1639433246	1639433246	1	1	HAKIMI, MATTHEW MD	11/18/2019	207R00000X	NA	Other	026	PHYSICIANS	128649	41	Internal Medicine	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
78926	Fee-for-Service	1437496361	1437496361	1	1	HERNANDEZ, CELESTE	2/12/2013	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	25078 PEACHLAND AVE	SUITE F	NEWHALL	CA	91321	2554	19	06037	34.37865037	-118.5468731	Los Angeles County
78968	Fee-for-Service	1245275668	1245275668	1	1	HANSA, S NIC MD INC	7/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70534	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3838 SAN DIMAS	BLDG A, STE 250	BAKERSFIELD	CA	93301	2284	15	06029	35.3946385	-119.008203	Kern County
78969	Fee-for-Service	1912263948	1912263948	1	1	HAMADANI, LARA MD	8/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129819	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
78978	Fee-for-Service	1164506069	1164506069	1	1	HERS BREAST CANCER FOUNDATIO	5/3/2022	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	N	2500 MOWRY AVE	SUITE #130	FREMONT	CA	94538	1605	01	06001	37.555011	-121.9801005	Alameda County
79019	Fee-for-Service	1487755526	1487755526	1	1	HOLMES, LAURA L MD	5/24/2010	207R00000X	NA	Other	026	PHYSICIANS	88250	66	Emergency Medicine (Urgent Care)	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
79035	Fee-for-Service	1982784906	1982784906	1	1	HARAKE, BILAL MD	8/30/1991	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	44445	40	Pediatrics	0	In state provider	None	2425 BATH ST	None	SANTA BARBARA	CA	93105	4324	42	06083	34.43207592	-119.7241221	Santa Barbara County
79064	Fee-for-Service	1730353756	1730353756	1	1	HINDNAVIS, VINDHYA MD	8/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115662	41	Internal Medicine	0	In state provider	None	3687 MT DIABLO BLVD	# 200	LAFAYETTE	CA	94549	3746	07	06013	37.8898926	-122.1304235	Contra Costa County
79079	Fee-for-Service	1104383074	1104383074	1	1	HAND REHAB PROS ANTELOPE VAL	10/16/2019	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	LEY	38925 TRADE CENTER DR	UNIT H	PALMDALE	CA	93551	3655	19	06037	34.59028112	-118.1433053	Los Angeles County
79098	Fee-for-Service	1518059955	1518059955	1	1	HUMAYUN, SAEED MD	7/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	39209	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	SUITE 530	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
79144	Fee-for-Service	1124208426	1124208426	2	1	HYBL, ROBIN A MD	11/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	71672	40	Pediatrics	0	In state provider	None	12665 GARDEN GROVE BLVD	SUITE 300	GARDEN GROVE	CA	92843	1917	30	06059	33.77450141	-117.9123364	Orange County
79190	Fee-for-Service	1861504003	1861504003	1	1	HUANG, JUDY H MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77534	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
79201	Fee-for-Service	1699753665	1699753665	1	1	HUGHES, C. RODGER MD	9/1/1995	2085R0204X	NA	Other	026	PHYSICIANS	82197	05	Anesthesiology	0	In state provider	None	2525 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
79232	Fee-for-Service	1962748681	1962748681	1	1	HURST, MELINDA B CNM	5/23/2016	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
79243	Fee-for-Service	1477718161	1477718161	1	1	HUMMEL, DEBRA J 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
79257	Fee-for-Service	1245275668	1245275668	1	1	HANSA, S NIC MD INC	7/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70534	01	General Practice	0	In state provider	None	3838 SAN DIMAS	BLDG A, STE 250	BAKERSFIELD	CA	93301	2284	15	06029	35.3946385	-119.008203	Kern County
79271	Fee-for-Service	1225661663	1225661663	1	1	HEATH, DORIS NP	12/6/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1080 N. INDIAN CANYON DR	SUITE 201	PALM SPRINGS	CA	92262	4869	33	06065	33.837354	-116.545572	Riverside County
79278	Fee-for-Service	1528340817	1528340817	1	1	HERNANDEZ, KARINA	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	79023	-	NOT APPLICABLE	0	In state provider	None	370 S CRENSHAW BLVD	SUITE E-100	TORRANCE	CA	90503	1727	19	06037	33.84549	-118.3287415	Los Angeles County
79286	Fee-for-Service	1548500473	1548500473	1	1	HOSPICE GROUP OF SOUTHERN	5/5/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	7041 OWENSMOUTH AVE	SUITE 202	CANOGA PARK	CA	91303	2006	19	06037	34.1985716	-118.6015863	Los Angeles County
79291	Fee-for-Service	1952763054	1952763054	1	1	HE, KAIDI MD	7/15/2021	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	154409	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
79308	Fee-for-Service	1629572680	1629572680	1	1	HEDNI, MEGANA	12/6/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	33423 N 32ND AVE	None	PHOENIX	AZ	85085	8874	00	None	33.786909	-112.129047	Maricopa County
79317	Fee-for-Service	1144274747	1144274747	1	1	HU, SERENA S MD	11/30/1989	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	64368	20	Orthopedic Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
79320	Fee-for-Service	1467816322	1467816322	1	1	HARBOR HEALTHY LIVING	3/28/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY INC	10900 WESTMINSTER AVE	SUITE 3	GARDEN GROVE	CA	92843	4984	30	06059	33.75955055	-117.9388485	Orange County
79321	Fee-for-Service	1982784906	1982784906	1	1	HARAKE, BILAL MD	8/30/1991	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	44445	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2425 BATH ST	None	SANTA BARBARA	CA	93105	4324	42	06083	34.43207592	-119.7241221	Santa Barbara County
79326	Fee-for-Service	1518941624	1518941624	1	1	HYUN, JAMES Y MD	5/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	67698	None	None	0	In state provider	None	1300 WEST 7TH ST	None	SAN PEDRO	CA	90732	3505	19	06037	33.73793948	-118.3036095	Los Angeles County
79340	Fee-for-Service	1407027964	1407027964	1	1	HOWARD, JACQUELINE L T	11/15/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
79373	Fee-for-Service	1164885224	1164885224	1	1	HALL, JAMES MD	1/28/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	151313	40	Pediatrics	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
79375	Fee-for-Service	1467794990	1467794990	1	1	HYATT, ADIL LMFT	9/5/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
79413	Fee-for-Service	1639377021	1639377021	1	1	HURST, KATHERINE	12/11/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157777	None	None	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
79417	Fee-for-Service	1003979931	1003979931	1	1	HEWCHUCK, ANDREW D MD	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	310 W LINE ST	None	BISHOP	CA	93514	3413	14	06027	37.36137047	-118.3972321	Inyo County
79457	Fee-for-Service	1710969506	1710969506	1	1	HAMPARIAN, MIREILLE P MD	11/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	75480	18	Ophthalmology	0	In state provider	None	1560 E CHEVY CHASE DR	STE 220	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
79494	Fee-for-Service	1629222526	1629222526	1	1	HOSPICE OF GRACE INC	3/15/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	351 E FOOTHILL BLVD	STE 250	ARCADIA	CA	91006	7426	19	06037	34.15116368	-118.0215744	Los Angeles County
79495	Fee-for-Service	1306845946	1306845946	1	1	HARRISON, JUDITH A MD	2/1/1983	2085R0001X	NA	Other	026	PHYSICIANS	23191	30	Radiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
79573	Fee-for-Service	1548500473	1548500473	1	1	HOSPICE GROUP OF SOUTHERN	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA, INC	7041 OWENSMOUTH AVE	SUITE 202	CANOGA PARK	CA	91303	2006	19	06037	34.1985716	-118.6015863	Los Angeles County
79578	Fee-for-Service	1093593998	1093593998	1	1	HOOD, WILLEENA CLARICE	11/8/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1549 PHOENIX DR	None	BEAUMONT	CA	92223	7813	33	06065	33.93556116	-116.9530218	Riverside County
79585	Fee-for-Service	1427028927	1427028927	1	1	HAN, TONY S MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133252	41	Internal Medicine	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
79612	Fee-for-Service	1295391928	1295391928	1	1	HILL, KYLE R DO	8/1/2022	207P00000X	NA	Other	026	PHYSICIANS	19740	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
79613	Fee-for-Service	1487702411	1487702411	1	1	HAYES-ADAMS, JASMINE S	2/28/2008	207W00000X	NA	Ophthalmology	026	PHYSICIANS	87485	18	Ophthalmology	0	In state provider	MD	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
79614	Fee-for-Service	1801967716	1801967716	1	1	HENRY, HAROLD M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45539	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
79615	Fee-for-Service	1205045564	1205045564	1	1	HOLLAND, CHRISTIAN S DO	7/15/2008	207R00000X	NA	Other	026	PHYSICIANS	9854	41	Internal Medicine	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92552	3927	33	06065	33.912117	-117.195849	Riverside County
79645	Fee-for-Service	1063183192	1063183192	1	1	HUMA, MARISSA PT	3/9/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
79650	Fee-for-Service	1013277045	1013277045	1	1	HEMPERLY, STEPHEN E DO	4/30/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	14658	07	Dermatology	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
79659	Fee-for-Service	1558825422	1558825422	1	1	HOANG, NICHOLAS	2/22/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	911 BERN CT	STE 140	SAN JOSE	CA	95112	1242	43	06085	37.37594797	-121.8941096	Santa Clara County
79670	Fee-for-Service	1205826583	1205826583	1	1	HAGHIGHAT, KAMRAN MD	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	56353	41	Internal Medicine	0	In state provider	None	26991 CROWN VALLEY PKWY	None	MISSION VIEJO	CA	92691	6528	30	06059	33.56210341	-117.6694207	Orange County
79677	Fee-for-Service	1629374426	1629374426	1	1	HEIL, KARI A NP	5/4/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	517 S MYRTLE AVE	SUITE 101	MONROVIA	CA	91016	6100	19	06037	34.14639513	-118.0009744	Los Angeles County
79695	Fee-for-Service	1710913983	1710913983	1	1	HABERT,JOSEPH	10/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	760 BROADWAY	None	BROOKLYN	NY	11206	5317	00	None	40.700349	-73.9416015	Kings County
79721	Fee-for-Service	1457538860	1457538860	1	1	HEREDIA, VERONICA MD	3/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73219	40	Pediatrics	0	In state provider	None	2016 FOREST AVENUE	STE 7	SAN JOSE	CA	95128	4804	43	06085	37.327006	-121.933009	Santa Clara County
79743	Fee-for-Service	1346881299	1346881299	1	1	HOWELL, KATHLEEN M CRNA	5/7/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
79784	Fee-for-Service	1629222526	1629222526	1	1	HOSPICE OF GRACE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	351 E FOOTHILL BLVD	STE 250	ARCADIA	CA	91006	7426	19	06037	34.15116368	-118.0215744	Los Angeles County
79795	Fee-for-Service	1912127580	1912127580	1	1	HOUGEIR, SERGE MD	7/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108572	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3555 CESAR CHAVEZ ST	None	LOS ANGELES	CA	94110	4403	19	06037	37.7479947	-122.4209132	San Francisco County
79830	Fee-for-Service	1245477652	1245477652	1	1	HSU, YUNG-SHEE J MD	6/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111465	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MEDICAL PLZ	STE 430	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
79852	Fee-for-Service	1073587663	1073587663	1	1	HAWKINS, BRANDON J DPM	7/10/2006	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4000 STOCKDALE HWY	STE C	BAKERSFIELD	CA	93309	2059	15	06029	35.35429352	-119.0531115	Kern County
79858	Fee-for-Service	1245376607	1245376607	1	1	HAYWOOD, STACEY A LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	13004 BRIXTON PLACE	None	SAN DIEGO	CA	92130	5703	37	06073	32.95658376	-117.2193916	San Diego County
79866	Fee-for-Service	1093593998	1093593998	1	1	HOOD, WILLEENA CLARICE	11/8/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1549 PHOENIX DR	None	BEAUMONT	CA	92223	7813	33	06065	33.93556116	-116.9530218	Riverside County
79868	Fee-for-Service	1275614638	1275614638	1	1	HAJEWSKI, PAULA J	2/18/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	11930 HERITAGE OAK PLACE	NO 9	AUBURN	CA	95603	2458	31	06061	38.94059662	-121.0995593	Placer County
79872	Fee-for-Service	1083081954	1083081954	1	1	HARMONY HOMES INC	7/21/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6429 N ELLENDALE AVE	None	FRESNO	CA	93722	7132	10	06019	36.830448	-119.888876	Fresno County
79896	Fee-for-Service	1407914260	1407914260	1	3	HILL COUNTRY COMM CLINIC	4/7/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	PO BOX 228	29632 HWY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0000	45	06089	40.80385331	-121.9397745	Shasta County
79904	Fee-for-Service	1801967716	1801967716	1	1	HENRY, HAROLD M MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45539	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
79921	Fee-for-Service	1326509282	1326509282	1	1	HUEY, TRACEY B MD	7/28/2022	390200000X	NA	Other	026	PHYSICIANS	177719	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
79935	Fee-for-Service	1083078646	1083078646	1	1	HUANG, CHENG-WEI	11/27/2017	390200000X	NA	Other	026	PHYSICIANS	151514	41	Internal Medicine	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
79936	Fee-for-Service	1629194824	1629194824	1	1	HO, PAUL OD	2/28/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	444 GLEN OAKS BLVD	None	GLENDALE	CA	91202	2917	19	06037	34.1598361	-118.2632528	Los Angeles County
79972	Fee-for-Service	1114193133	1114193133	1	1	HOPPER, RACHEL K MD	9/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	110573	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
79974	Fee-for-Service	1023541745	1023541745	1	1	HE, JING MD	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
80000	Fee-for-Service	1205976438	1205976438	1	1	HOMECARE MEDICAL PRODUCTS IN	11/4/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	478 W COLORADO ST	None	GLENDALE	CA	91204	1504	19	06037	34.14248953	-118.2641805	Los Angeles County
80011	Fee-for-Service	1003547340	1003547340	1	2	HEART AND VASCULAR CENTERS O	3/23/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	F AMERICA	3247 ESPLANADE	SUITE 165	CHICO	CA	95973	4970	04	06007	39.77298379	-121.8776758	Butte County
80014	Fee-for-Service	1346622842	1346622842	1	1	HEPWORTH, SQUIRE D MD	9/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	1600 MEDICAL PKWY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
80051	Fee-for-Service	1376576033	1376576033	1	1	HUF, ROGER L MD INC	10/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	30313	79	Neurology-Child	0	In state provider	None	5855 GREEN VALLEY CIRCLE	STE 200	CULVER CITY	CA	90230	0102	19	06037	33.98317787	-118.3886464	Los Angeles County
80060	Fee-for-Service	1336758663	1336758663	1	1	HELPING HAND HOSPICE	3/15/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	303 S GLENOAKS BLVD	STE 6	BURBANK	CA	91502	1319	19	06037	34.18156737	-118.3040137	Los Angeles County
80064	Fee-for-Service	1326145012	1326145012	1	1	HARRAH, MARVIN D MD	3/26/1981	207L00000X	NA	Other	026	PHYSICIANS	28483	05	Anesthesiology	0	In state provider	None	2023 VALE RD	STE 115	SAN PABLO	CA	94806	3891	07	06013	37.95369824	-122.3378493	Contra Costa County
80104	Fee-for-Service	1265482020	1265482020	1	1	HUAN, ENG H MD	6/30/1982	207R00000X	NA	Other	026	PHYSICIANS	36658	41	Internal Medicine	0	In state provider	STE 102	725 E SANTA CLARA ST	None	SAN JOSE	CA	95112	1900	43	06085	37.34328626	-121.8756374	Santa Clara County
80128	Fee-for-Service	1386669679	1386669679	1	1	HAMMOND, JASON M MD	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109461	05	Anesthesiology	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
80149	Fee-for-Service	1144317645	1144317645	1	1	HARRISLUNA, MARCIA L NP	7/17/1998	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8250 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5427	19	06037	34.22078654	-118.4326211	Los Angeles County
80155	Fee-for-Service	1134389141	1134389141	1	1	HUSAIN, ZAIN A MD	11/8/2023	2085R0001X	NA	Other	026	PHYSICIANS	179088	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
80185	Fee-for-Service	1407914260	1407914260	1	3	HILL COUNTRY COMM CLINIC	10/15/1997	261QF0400X	NA	Federally Qualified Health Center	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	PO BOX 228	29632 HWY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0000	45	06089	40.80385331	-121.9397745	Shasta County
80201	Fee-for-Service	1700011293	1700011293	1	1	HUYNH, WINNIE PSYD	4/21/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2425 BISSO LN	STE 200	CONCORD	CA	94520	4886	07	06013	37.98393807	-122.0466953	Contra Costa County
80209	Fee-for-Service	1861585010	1861585010	1	1	HUA, KEVIN V	11/4/2008	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
80237	Fee-for-Service	1184833857	1184833857	1	1	HE, CHENYIN MD	6/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111643	None	None	0	In state provider	None	2222 EAST ST	STE 305	CONCORD	CA	94520	2066	07	06013	37.98125538	-122.0329375	Contra Costa County
80239	Fee-for-Service	1407071327	1407071327	1	1	HASSOURI, PARIA MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97799	40	Pediatrics	0	In state provider	None	8733 BEVERLY BLVD	STE 200	WEST HOLLYWOOD	CA	90048	1844	19	06037	34.07688048	-118.3815765	Los Angeles County
80241	Fee-for-Service	1841210523	1841210523	1	1	HASLER, PETER MD	9/30/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	49237	40	Pediatrics	0	In state provider	None	15 E ARRELLAGA ST	None	SANTA BARBARA	CA	93101	2531	42	06083	34.42731739	-119.7094444	Santa Barbara County
80262	Fee-for-Service	1114193133	1114193133	1	1	HOPPER, RACHEL K MD	9/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	110573	35	Pediatric Cardiology (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
80276	Fee-for-Service	1104131226	1104131226	1	1	HUYNH, ALISSA K LAC	11/2/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	LINIC	5110 WESTMINSTER AVE	#K	SANTA ANA	CA	92703	1167	30	06059	33.75956711	-117.93704	Orange County
80284	Fee-for-Service	1912364506	1912364506	1	1	HAN, EUGENE Y DO	9/24/2018	208M00000X	NA	Other	026	PHYSICIANS	16050	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
80308	Fee-for-Service	1497806129	1497806129	1	1	HUIRAS, TRISTA A	1/30/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
80326	Fee-for-Service	1780758656	1780758656	1	1	HANGER P & O WEST INC	4/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1127 WILSHIRE BLVD	#310	LOS ANGELES	CA	90017	3904	19	06037	34.05270508	-118.2641005	Los Angeles County
80339	Fee-for-Service	1376576033	1376576033	1	1	HUF, ROGER L MD INC	10/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	30313	13	Neurology (M.D. only)	0	In state provider	None	5855 GREEN VALLEY CIRCLE	STE 200	CULVER CITY	CA	90230	0102	19	06037	33.98317787	-118.3886464	Los Angeles County
80349	Fee-for-Service	1336758663	1336758663	1	1	HELPING HAND HOSPICE	3/15/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	303 S GLENOAKS BLVD	STE 6	BURBANK	CA	91502	1319	19	06037	34.18156737	-118.3040137	Los Angeles County
80403	Fee-for-Service	1235287178	1235287178	1	1	HAUTER, FRED E MD	3/1/1984	207RN0300X	NA	Nephrology	026	PHYSICIANS	51015	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
80412	Fee-for-Service	1366642837	1366642837	1	1	HEYL, JENNIFER M MD	10/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117124	07	Dermatology	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
80435	Fee-for-Service	1568812360	1568812360	1	1	HANDLER, STEPHANIE MD	7/23/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	140489	None	None	0	In state provider	None	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
80459	Fee-for-Service	1932468477	1932468477	1	1	HEIDENREICH, ROBYN J MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127325	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
80475	Fee-for-Service	1609965557	1609965557	1	1	HATCH, HEATHER	4/22/2022	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
80528	Fee-for-Service	1588195457	1588195457	1	1	HARTONO, STELLA MD	11/1/2024	207K00000X	NA	Other	026	PHYSICIANS	None	03	Allergy	0	In state provider	None	7471 N FRESNO STREET	None	FRESNO	CA	93720	2457	10	06019	36.84632065	-119.783885	Fresno County
80536	Fee-for-Service	1003547340	1003547340	1	1	HEART AND VASCULAR CENTERS O	1/12/2023	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	F AMERICA	1233 PLUMAS ST	None	YUBA CITY	CA	95991	3410	51	06101	39.14818027	-121.6175196	Sutter County
80546	Fee-for-Service	1063660298	1063660298	1	1	HT FAMILY PHYSICIANS INC	12/11/2008	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	77 W MARCH LANE	SUITE A	STOCKTON	CA	95207	5723	39	06077	37.99583483	-121.3064011	San Joaquin County
80549	Fee-for-Service	1114193133	1114193133	1	1	HOPPER, RACHEL K MD	9/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	110573	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
80566	Fee-for-Service	1417160474	1417160474	1	1	HILLER, LUCAS P MD	7/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91321	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
80625	Fee-for-Service	1376576033	1376576033	1	1	HUF, ROGER L MD INC	10/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	30313	40	Pediatrics	0	In state provider	None	5855 GREEN VALLEY CIRCLE	STE 200	CULVER CITY	CA	90230	0102	19	06037	33.98317787	-118.3886464	Los Angeles County
80641	Fee-for-Service	1861834715	1861834715	1	1	HO, ECHING PHD	6/19/2018	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
80654	Fee-for-Service	1134158926	1134158926	1	1	HUNDAL, APEET K MD	7/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104686	41	Internal Medicine	0	In state provider	None	3111 PROFESSIONAL DR	None	AUBURN	CA	95603	2456	31	06061	38.940327	-121.1007585	Placer County
80657	Fee-for-Service	1578634556	1578634556	1	1	HARNESS, NEIL G MD	9/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84398	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
80719	Fee-for-Service	1780079699	1780079699	1	1	HICKS, ROBERT M MD	3/1/2021	390200000X	NA	Other	026	PHYSICIANS	146810	None	None	0	In state provider	None	1101 VAN NESS AVE	3RD FLOOR	SAN FRANCISCO	CA	94109	6919	38	06075	37.78610439	-122.421569	San Francisco County
80731	Fee-for-Service	1447479746	1447479746	1	1	HADDAD, GABRIEL G MD	4/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52238	29	Pulmonary Diseases (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
80745	Fee-for-Service	1336219765	1336219765	1	1	HARDY, DAVID J MD	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75603	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
80751	Fee-for-Service	1598754129	1598754129	1	1	HIRNI, ELIZABETH B DO	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	2640 E BARNETT RD	E333	MEDFORD	OR	97504	4301	00	None	42.31645852	-122.834421	Jackson County
80761	Fee-for-Service	1003245887	1003245887	1	1	HEART INC	3/26/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4312 WOODMAN AVE	STE 201	SHERMAN OAKS	CA	91423	5526	19	06037	34.148637	-118.4312035	Los Angeles County
80767	Fee-for-Service	1275710600	1275710600	1	1	HANNA, AMGAD H N MD	11/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104936	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
80776	Fee-for-Service	1922344100	1922344100	1	1	HAWKINS, LEE ETTA	6/19/2013	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1392 SCENIC COURT	None	PERRIS	CA	92571	7319	33	06065	33.83614496	-117.1970459	Riverside County
80835	Fee-for-Service	1740304237	1740304237	1	1	HONGSAKAPHADANA, ALINA MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112371	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
80844	Fee-for-Service	1679747778	1679747778	1	1	HUARD, LEANNA L MD	5/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110788	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	32-263 CHS	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
80882	Fee-for-Service	1982927877	1982927877	1	1	HOAG OTHOPEDIC INSTITUTE LLC	11/19/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	16250 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.66136831	-117.7739731	Orange County
80918	Fee-for-Service	1265071393	1265071393	1	1	HEPIUS HOME HEALTH CARE	3/25/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	GROUP	2652 HONOLULU AVE 1/2	None	MONTROSE	CA	91020	1763	19	06037	34.20974575	-118.2373236	Los Angeles County
80924	Fee-for-Service	1003845934	1003845934	1	1	HOPE, ANDREW P MD	8/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90310	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
80944	Fee-for-Service	1154372597	1154372597	1	1	HOFMANN, LAWRENCE V MD	3/1/1999	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	67451	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
80973	Fee-for-Service	1023234747	1023234747	1	1	HERITAGE CLINIC AND THE COMM	1/24/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	43807 10TH ST W	D	LANCASTER	CA	93534	4805	19	06037	34.6788	-118.1479295	Los Angeles County
80979	Fee-for-Service	1295807527	1295807527	1	1	HUANG, RAYMOND W MD	8/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87501	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
81018	Fee-for-Service	1447479746	1447479746	1	1	HADDAD, GABRIEL G MD	4/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52238	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
81022	Fee-for-Service	1396893681	1396893681	1	1	HETTIARATCHI, JAMIE	11/26/2012	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
81031	Fee-for-Service	1295802205	1295802205	1	1	HARLAN, DONALD E MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	52938	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
81039	Fee-for-Service	1578221453	1578221453	1	1	HP INTENSIVIST MEDICAL GROUP	2/24/2022	207RC0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	, INC	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
81051	Fee-for-Service	1013605526	1013605526	1	1	HUANG, GRACE M OD	9/9/2024	390200000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 W 6TH ST	SUITE 165	SAN PEDRO	CA	90732	3540	19	06037	33.73886546	-118.3075065	Los Angeles County
81062	Fee-for-Service	1720266059	1720266059	1	1	HUNDAL, RAJBARINDER S MD	9/29/2008	208M00000X	NA	Other	026	PHYSICIANS	94163	41	Internal Medicine	0	In state provider	None	3555 CESAR CHAVEZ ST	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.7479947	-122.4209132	San Francisco County
81065	Fee-for-Service	1922344100	1922344100	1	1	HAWKINS, LEE ETTA	6/19/2013	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1392 SCENIC COURT	None	PERRIS	CA	92571	7319	33	06065	33.83614496	-117.1970459	Riverside County
81077	Fee-for-Service	1558879015	1558879015	1	1	HAMAOUI, SHEREE LMFT	7/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	177 BOVET RD	SUITE 300	SAN MATEO	CA	94402	3140	41	06081	37.5502646	-122.3169875	San Mateo County
81103	Fee-for-Service	1003332248	1003332248	1	1	HAGHVERDIAN, ARGINA OD	4/30/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9420 RESEDA BLVD	8	NORTHRIDGE	CA	91324	6005	19	06037	34.241679	-118.536053	Los Angeles County
81126	Fee-for-Service	1821596438	1821596438	1	1	HALPRIN, CHELSEA E DO	12/21/2021	207ZB0001X	NA	Other	026	PHYSICIANS	17146	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
81173	Fee-for-Service	1982927877	1982927877	1	1	HOAG OTHOPEDIC INSTITUTE LLC	11/19/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	16250 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.66136831	-117.7739731	Orange County
81191	Fee-for-Service	1639336365	1639336365	1	1	HAFFAR, NOOR A MD	9/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127699	18	Ophthalmology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
81215	Fee-for-Service	1831864057	1831864057	1	1	HEYDARI, MASON PT	6/15/2022	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
81233	Fee-for-Service	1598183550	1598183550	1	1	HUMPHREYS, JESSICA N MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138928	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
81234	Fee-for-Service	1093913949	1093913949	1	1	HULUGALLE, CERI M LMFT	2/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2531 CHESTER AVE	None	BAKERSFIELD	CA	93301	2012	15	06029	35.382582	-119.0188955	Kern County
81239	Fee-for-Service	1184792293	1184792293	1	1	HANSEN, ALICIA S PHD	3/1/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	450 BRAND	638	GLENDALE	CA	91203	2347	19	06037	34.152633	-118.254971	Los Angeles County
81250	Fee-for-Service	1659465771	1659465771	1	1	HOFFMAN, JILL A MD	11/30/1989	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	68269	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
81252	Fee-for-Service	1871864504	1871864504	1	1	HRHK LLC	5/8/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4740 GREEN RIVER ROAD	STE 318	CORONA	CA	92880	9435	33	06065	33.87767018	-117.6610165	Riverside County
81266	Fee-for-Service	1285156141	1285156141	1	1	HECKMULLER, ELIZABETH PT	1/7/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3418 LOMA VISTA RD	A	VENTURA	CA	93003	3016	56	06111	34.27643562	-119.2503132	Ventura County
81304	Fee-for-Service	1962439703	1962439703	1	1	HARRELL, DONALD S MD	9/30/1987	2085R0204X	NA	Other	026	PHYSICIANS	51370	None	None	0	In state provider	None	1360 W 6TH ST	STE 100	SAN PEDRO	CA	90732	3514	19	06037	33.73886546	-118.3075065	Los Angeles County
81315	Fee-for-Service	1871667956	1871667956	1	1	HSU, ANGELA L	2/26/2013	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
81336	Fee-for-Service	1962724450	1962724450	1	1	HELPING KIDS TO RECOVER, INC	9/3/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	601 S ACACIA AVE	ROOM C5	COMPTON	CA	90220	3702	19	06037	33.89109319	-118.2262935	Los Angeles County
81338	Fee-for-Service	1720196702	1720196702	1	1	HIGH DESERT MEDICAL GRP	12/12/2017	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	INC	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
81342	Fee-for-Service	1023380086	1023380086	1	1	HOOSHMAND, BABAK MD	9/6/2013	No Taxonomy Provided	NA	None	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
81354	Fee-for-Service	1700440724	1700440724	1	1	HICKS, JALIL MD	9/1/2024	207L00000X	NA	Other	026	PHYSICIANS	162052	05	Anesthesiology	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
81421	Fee-for-Service	1205310786	1205310786	1	1	HOMAN, KELSEA J PT	10/22/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2908 E WHITMORE AVE	STE E	CERES	CA	95307	2800	50	06099	37.59473048	-120.9412035	Stanislaus County
81428	Fee-for-Service	1801979844	1801979844	1	1	HORTON, PETER C PT	5/17/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
81542	Fee-for-Service	1871864504	1871864504	1	1	HRHK LLC	5/8/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4740 GREEN RIVER ROAD	STE 318	CORONA	CA	92880	9435	33	06065	33.87767018	-117.6610165	Riverside County
81589	Fee-for-Service	1386660462	1386660462	1	1	HARRIS, HEATHER A MD	12/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77033	None	None	0	In state provider	None	2450 ASHBY AVE	RM 1002	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
81625	Fee-for-Service	1720196702	1720196702	1	1	HIGH DESERT MEDICAL GRP	11/5/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	INC	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
81630	Fee-for-Service	1790970077	1790970077	1	1	HIGH DESERT WOMENS MEM	9/18/2007	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NTER	18158 US HWY 18	0	APPLE VALLEY	CA	92307	2200	36	06071	34.5408963	-117.267827	San Bernardino County
81678	Fee-for-Service	1093750051	1093750051	1	1	HORLANDER, KENNETH T MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	303 SMITH ST	None	LAGRANGE	GA	30240	2745	00	None	33.04332482	-85.03423653	Troup County
81701	Fee-for-Service	1124286018	1124286018	1	1	HERMOGENO, CONNIE NP	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1515 N VERMONT AVE	None	LOS ANGELES	CA	90027	5337	19	06037	34.09851639	-118.2918012	Los Angeles County
81713	Fee-for-Service	1689014177	1689014177	1	1	HEIDI DIANA MITCHELL	6/28/2013	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	17470 NEW YORK HOUSE RD	None	BROWNSVILLE	CA	95919	9703	58	06115	39.4719569	-121.2436149	Yuba County
81765	Fee-for-Service	1558325787	1558325787	1	1	HOWARD, NATHANIEL JR MD	6/30/1984	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	54153	10	Gastroenterology (M.D. only)	0	In state provider	None	2721 OLIVE HWY	STE 9	OROVILLE	CA	95966	6115	04	06007	39.50452062	-121.5420592	Butte County
81803	Fee-for-Service	1528418837	1528418837	1	1	HERITAGE BOARD AND CARE INC	5/14/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2445 PACIFIC AVE	None	LONG BEACH	CA	90806	2901	19	06037	33.80159842	-118.1938032	Los Angeles County
81834	Fee-for-Service	1861869653	1861869653	1	1	HUNT, AUGUSTA LCSW	3/27/2023	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
81840	Fee-for-Service	1821136565	1821136565	1	1	HUANG, RAYMOND Z OD	9/1/1996	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1409 S MONTEREY ST	None	ALHAMBRA	CA	91801	5142	19	06037	34.0782513	-118.1208887	Los Angeles County
81842	Fee-for-Service	1467481655	1467481655	1	1	HAGBOM, NELDEN W MD	1/1/1982	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	26150	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3838 CALIFORNIA ST	STE 5	SAN FRANCISCO	CA	94118	1522	38	06075	37.78591809	-122.4575439	San Francisco County
81845	Fee-for-Service	1922185735	1922185735	1	1	HONBO, KEN S MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31053	67	Endocrinology	0	In state provider	None	16311 VENTURA BLVD	STE 880	ENCINO	CA	91436	4335	19	06037	34.15706864	-118.4885978	Los Angeles County
81913	Fee-for-Service	1720196702	1720196702	1	1	HIGH DESERT MEDICAL GRP	12/31/1989	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
81914	Fee-for-Service	1962635854	1962635854	1	1	HOANG, KIM MD	9/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104344	08	Family Practice	0	In state provider	None	850 E LATHAM AVE	STE A	HEMET	CA	92543	4391	33	06065	33.74941446	-116.963559	Riverside County
81922	Fee-for-Service	1174548267	1174548267	1	1	HILL, JANE A	11/1/1999	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	676 N 12TH ST	#21	GROVER BEACH	CA	93433	2057	40	06079	35.12791646	-120.6162709	San Luis Obispo County
81937	Fee-for-Service	1588756647	1588756647	1	1	HANGER PROSTHETICS & ORTHOTI	12/7/2006	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	753 SOUTH ARROYO PKWY	STE 120	PASADENA	CA	91105	3902	19	06037	34.132707	-118.1474175	Los Angeles County
81965	Fee-for-Service	1093750051	1093750051	1	1	HORLANDER, KENNETH T MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	303 SMITH ST	None	LAGRANGE	GA	30240	2745	00	None	33.04332482	-85.03423653	Troup County
81982	Fee-for-Service	1073525036	1073525036	1	1	HAMKAR, BEHROZ MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88787	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
81992	Fee-for-Service	1528307360	1528307360	1	1	HAMILTON, LINDA W LMFT	1/13/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	621 RIDGEVIEW CT	None	DIAMOND BAR	CA	91765	6111	19	06037	34.01152164	-117.8006549	Los Angeles County
81999	Fee-for-Service	1912921792	1912921792	1	1	HOLLANDER, DAVID A MD	6/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77419	18	Ophthalmology	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
82005	Fee-for-Service	1689014177	1689014177	1	1	HEIDI DIANA MITCHELL	6/28/2013	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	17470 NEW YORK HOUSE RD	None	BROWNSVILLE	CA	95919	9703	58	06115	39.4719569	-121.2436149	Yuba County
82007	Fee-for-Service	1508930488	1508930488	1	1	HANGER P&O WEST INC	10/4/2005	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	16185 KAMANA RD	None	APPLE VALLEY	CA	92307	1377	36	06071	34.54537747	-117.2686262	San Bernardino County
82017	Fee-for-Service	1164688859	1164688859	1	1	HAMBY, BLAKE A MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137272	02	General Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
82046	Fee-for-Service	1639574122	1639574122	1	1	HILTON KANANEN, CAROLYN R	4/11/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	572 DUNHOLME WAY	None	SUNNYVALE	CA	94087	3300	43	06085	37.34482247	-122.0283135	Santa Clara County
82052	Fee-for-Service	1720006604	1720006604	1	1	HITCHCOCK, DAWN MD	8/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83119	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
82058	Fee-for-Service	1659150209	1659150209	1	1	HARDY, TATIANA PT	1/27/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
82061	Fee-for-Service	1386732915	1386732915	1	1	HEILBRON, MAURICIO JR MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	82239	02	General Surgery	0	In state provider	None	1045 ATLANTIC AVE	STE 1002	LONG BEACH	CA	90813	3409	19	06037	33.780267	-118.1850795	Los Angeles County
82171	Fee-for-Service	1316396252	1316396252	1	2	HOFSTETTER, DOUGLAS TAYLOR	12/12/2022	No Taxonomy Provided	NA	None	026	PHYSICIANS	150829	66	Emergency Medicine (Urgent Care)	0	In state provider	D	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1214	36	06071	34.131303	-117.3225325	San Bernardino County
82188	Fee-for-Service	1265238984	1265238984	1	1	HAGOOD, MARCHAEL	5/14/2025	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
82189	Fee-for-Service	1134461908	1134461908	1	1	HOLTZ, MICHAEL J MD	12/11/2017	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
82200	Fee-for-Service	1720196702	1720196702	1	1	HIGH DESERT MEDICAL GRP	2/14/2020	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	INC	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
82207	Fee-for-Service	1386697159	1386697159	1	1	HERMAN, LEE SCOTT MD	4/30/1980	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	38944	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	416 W LAS TUNAS DR	STE 300	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
82236	Fee-for-Service	1538127832	1538127832	1	1	HADDADAN, KAYVAN D MD	12/10/2007	208VP0000X	NA	Other	026	PHYSICIANS	87957	25	Physical Medicine and Rehabilitation	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
82260	Fee-for-Service	1588644470	1588644470	1	1	HERNANDEZ, DONALDO M	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	67177	41	Internal Medicine	0	In state provider	None	393 E WALNUT ST	None	PASADENA	CA	91188	0001	19	06037	34.14955087	-118.1422348	Los Angeles County
82286	Fee-for-Service	1821205709	1821205709	1	5	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP OF SF VALLEY	6850 SEPULVEDA BLVD	SUITE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
82289	Fee-for-Service	1538188081	1538188081	1	1	HIRASUNA, JON D MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	32351	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
82294	Fee-for-Service	1093342826	1093342826	1	1	HYNES, STEPHANIE G MD	10/18/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	179257	None	None	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
82323	Fee-for-Service	1255583118	1255583118	1	1	HINDO, HEATHER K MD	11/12/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53474	77	Infectious Disease	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
82325	Fee-for-Service	1164559456	1164559456	1	1	HEARING SCIENCE OF RANCHO	9/27/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	8263 GROVE AVE	STE 203	RANCHO CUCAMONGA	CA	91730	3107	36	06071	34.10436536	-117.6285141	San Bernardino County
82330	Fee-for-Service	1467840074	1467840074	1	1	HARRIS, CHRISTINA LCSW	6/27/2024	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
82415	Fee-for-Service	1952902090	1952902090	1	1	HEALTH CORNER HOSPICE	3/3/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3901 FOOTHILL BLVD	SUITE 104	LA CRESCENTA	CA	91214	1667	19	06037	34.23935711	-118.2643706	Los Angeles County
82474	Fee-for-Service	1851075899	1851075899	1	1	HENDERSON, MICHELLE BIRTH D	8/21/2023	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
82492	Fee-for-Service	1720196702	1720196702	1	1	HIGH DESERT MEDICAL GRP	12/19/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	INC	43839 15TH ST W	None	LANCASTER	CA	93534	4756	19	06037	34.678791	-118.156867	Los Angeles County
82493	Fee-for-Service	1821205709	1821205709	1	2	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GROUP OF SF VALLEY	15243 VANOWEN STREET	SUITE 210	VAN NUYS	CA	91405	3605	19	06037	34.19394848	-118.4654115	Los Angeles County
82506	Fee-for-Service	1356991137	1356991137	1	1	HOLLYWOOD FAMILY THERAPY GRO	3/1/2020	193200000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3111 LOS FELIZ BLVD	106	LOS ANGELES	CA	90039	1599	19	06037	34.12432566	-118.2669792	Los Angeles County
82523	Fee-for-Service	1053517243	1053517243	1	1	HAN, PAUL D MD	10/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86943	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
82528	Fee-for-Service	1295936755	1295936755	1	1	HADDAD, EVELYN V MD	7/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94382	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
82536	Fee-for-Service	1801942909	1801942909	1	1	HORNBERGER, JOHN C MD	11/30/1992	207R00000X	NA	Other	026	PHYSICIANS	59734	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
82556	Fee-for-Service	1720347826	1720347826	1	1	HAMADANI, ALI DO	6/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14617	05	Anesthesiology	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
82560	Fee-for-Service	1912924499	1912924499	1	1	HAKIMIAN, KAMRAN MD, INC	4/30/1984	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	38773	25	Physical Medicine and Rehabilitation	0	In state provider	None	50 N LA CIENEGA BLVD	STE 219	BEVERLY HILLS	CA	90211	2246	19	06037	34.06689439	-118.3762514	Los Angeles County
82563	Fee-for-Service	1376770354	1376770354	1	1	HUANG, HOI MD	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	177051	30	Radiology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
82573	Fee-for-Service	1821205709	1821205709	1	5	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GROUP OF SF VALLEY	6850 SEPULVEDA BLVD	SUITE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
82581	Fee-for-Service	1841632643	1841632643	1	1	HANKINS, ELIZABETH M OD	8/31/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1160 LIVE OAK BLVD	None	YUBA CITY	CA	95991	3407	51	06101	39.14528537	-121.6208248	Sutter County
82587	Fee-for-Service	1346736212	1346736212	1	1	HARRIS, WILLIE J LCSW	5/25/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	44447 N 10TH STREET	BUILDING B	LANCASTER	CA	93534	3324	19	06037	34.69104127	-118.1480655	Los Angeles County
82608	Fee-for-Service	1255583118	1255583118	1	1	HINDO, HEATHER K MD	11/12/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53474	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
82612	Fee-for-Service	1164559456	1164559456	1	1	HEARING SCIENCE OF RANCHO	4/13/2005	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	8263 GROVE AVE	STE 203	RANCHO CUCAMONGA	CA	91730	3107	36	06071	34.10436536	-117.6285141	San Bernardino County
82619	Fee-for-Service	1073696720	1073696720	1	1	HAY, SUNTHARA R DO	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7829	None	None	0	In state provider	None	24060 FIR AVE	STE B	MORENO VALLEY	CA	92553	2841	33	06065	33.93543049	-117.242604	Riverside County
82621	Fee-for-Service	1760513758	1760513758	1	1	HICKS, TOMMY L MD INC	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	48888	08	Family Practice	0	In state provider	None	23521 PASEO DE VALENCIA	STE 108	LAGUNA HILLS	CA	92653	3137	30	06059	33.61113028	-117.7126684	Orange County
82703	Fee-for-Service	1285049296	1285049296	1	1	HUTCHISON, JULIA DO	11/17/2019	207P00000X	NA	Other	026	PHYSICIANS	16513	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
82705	Fee-for-Service	1952902090	1952902090	1	1	HEALTH CORNER HOSPICE	3/3/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3901 FOOTHILL BLVD	SUITE 104	LA CRESCENTA	CA	91214	1667	19	06037	34.23935711	-118.2643706	Los Angeles County
82728	Fee-for-Service	1831351493	1831351493	1	1	HELLAWELL, JENNIFER L MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	129864	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
82730	Fee-for-Service	1194896019	1194896019	1	1	HULBERT, TIMOTHY V MD	7/1/1998	207RC0200X	NA	Other	026	PHYSICIANS	60712	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
82735	Fee-for-Service	1215145545	1215145545	1	1	HOZUMI, OMID J MD	11/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	5330 SOUTH HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
82762	Fee-for-Service	1720285091	1720285091	1	1	HUANG, CHUN CHEN PT	10/18/2023	225100000X	NA	Physical Therapist	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
82782	Fee-for-Service	1821205709	1821205709	1	2	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GROUP OF SF VALLEY	15243 VANOWEN STREET	SUITE 210	VAN NUYS	CA	91405	3605	19	06037	34.19394848	-118.4654115	Los Angeles County
82791	Fee-for-Service	1356991137	1356991137	1	1	HOLLYWOOD FAMILY THERAPY GRO	3/1/2020	193200000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3111 LOS FELIZ BLVD	106	LOS ANGELES	CA	90039	1599	19	06037	34.12432566	-118.2669792	Los Angeles County
82794	Fee-for-Service	1164527214	1164527214	1	1	HOSPICE OF THE FOOTHILLS	8/3/1994	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11270 ROUGH & READY HWY	None	GRASS VALLEY	CA	95945	8530	29	06057	39.22661994	-121.0813126	Nevada County
82815	Fee-for-Service	1477593556	1477593556	1	1	HENRIE, JOHN 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	8TH AVE & C ST	None	SLC	UT	84143	0001	00	None	40.778496	-111.8805615	Salt Lake County
82857	Fee-for-Service	1518976448	1518976448	1	1	HUANG, CATHERINE OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	I-WEAR OPTOMETRY	1679 S AZUSA AVE	None	HACIENDA HEIGHTS	CA	91745	3832	19	06037	33.99211845	-117.9318351	Los Angeles County
82861	Fee-for-Service	1821205709	1821205709	1	5	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GROUP OF SF VALLEY	6850 SEPULVEDA BLVD	SUITE 211	VAN NUYS	CA	91405	4451	19	06037	34.1955	-118.4661705	Los Angeles County
82909	Fee-for-Service	1073655841	1073655841	1	1	HEKMAT, FARAH L MD	10/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38022	40	Pediatrics	0	In state provider	None	9301 WILSHIRE BLVD	STE 402	BEVERLY HILLS	CA	90210	6134	19	06037	34.06707307	-118.3946743	Los Angeles County
82922	Fee-for-Service	1285985473	1285985473	1	1	HELTON, SALATHA LMFT	3/15/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	831 ALAMO DRIVE	SUITE 6C	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
82934	Fee-for-Service	1174739460	1174739460	2	1	HARDY, TYRONE L MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	57014	14	Neurological Surgery	0	In state provider	None	5565 GROSSMONT CENTER DR	STE 1-119	LA MESA	CA	91942	3000	37	06073	32.77978322	-117.0094766	San Diego County
82951	Fee-for-Service	1770879116	1770879116	1	1	HUH, BRIAN INC	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54802	41	Internal Medicine	0	In state provider	None	520 S VIRGIL AVE	STE 300	LOS ANGELES	CA	90020	1425	19	06037	34.064487	-118.2870305	Los Angeles County
82967	Fee-for-Service	1619180171	1619180171	1	1	HARANO & HAW OPTOMETRIC	3/10/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORP	3935 BEACON AVE	None	FREMONT	CA	94538	1458	01	06001	37.5472134	-121.9839684	Alameda County
82972	Fee-for-Service	1255659181	1255659181	1	1	HURTADO, ARIEL M	6/2/2010	207L00000X	NA	Other	026	PHYSICIANS	98260	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
82980	Fee-for-Service	1114954856	1114954856	1	1	HERNANDEZ, JOHN M OD	11/5/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6134 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2923	19	06037	33.98457344	-118.2251414	Los Angeles County
82981	Fee-for-Service	1407157522	1407157522	1	1	HATCHER-DEWEY, MARY S MD	12/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112113	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
82985	Fee-for-Service	1124388103	1124388103	1	1	HINSHAW, MCKENZIE L NP	10/28/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95030629	-	NOT APPLICABLE	0	In state provider	None	1240 BROADWAY	None	EL CAJON	CA	92021	4994	37	06073	32.80773552	-116.9384985	San Diego County
82990	Fee-for-Service	1093827883	1093827883	1	1	HONG, JAEKYOUNG A MD	12/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	01	General Practice	1	Border provider	None	520 MEDICAL CENTER DR	STE 200	MEDFORD	OR	97504	4314	00	None	42.318801	-122.831728	Jackson County
83066	Fee-for-Service	1043331481	1043331481	1	1	HSIAO, JONATHAN G MD	1/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101293	05	Anesthesiology	0	In state provider	None	2420 CAMINO RAMON	None	SAN RAMON	CA	94583	4385	07	06013	37.77229042	-121.9634581	Contra Costa County
83069	Fee-for-Service	1558779439	1558779439	1	1	HARMONY CONGREGATE LIVING, I	4/26/2018	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6507 BABCOCK AVENUE	None	NORTH HOLLYWOOD	CA	91606	2308	19	06037	34.18880459	-118.4063505	Los Angeles County
83070	Fee-for-Service	1821205709	1821205709	1	2	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP OF SF VALLEY	15243 VANOWEN STREET	SUITE 210	VAN NUYS	CA	91405	3605	19	06037	34.19394848	-118.4654115	Los Angeles County
83078	Fee-for-Service	1871786293	1871786293	1	1	HOGELING, MARCIA MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86818	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	SUITE 450, 465	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
83079	Fee-for-Service	1164527214	1164527214	1	1	HOSPICE OF THE FOOTHILLS	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11270 ROUGH & READY HWY	None	GRASS VALLEY	CA	95945	8530	29	06057	39.22661994	-121.0813126	Nevada County
83109	Fee-for-Service	1598864126	1598864126	1	1	HENRY,O LINDA 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 AVENUE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
83129	Fee-for-Service	1881605848	1881605848	1	1	HOFFMAN, ALLEN L MD APC	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72104	02	General Surgery	0	In state provider	None	201 S ALVARADO ST	STE 321	LOS ANGELES	CA	90057	2354	19	06037	34.06417777	-118.2719543	Los Angeles County
83136	Fee-for-Service	1194751750	1194751750	1	1	HO, JEFFREY TAN INC	7/6/2009	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	8218	25	Physical Medicine and Rehabilitation	0	In state provider	None	9191 WESTMINSTER AVENUE	None	GARDEN GROVE	CA	92844	2751	30	06059	33.75946879	-117.9688437	Orange County
83174	Fee-for-Service	1376170969	1376170969	1	1	HO, BRIAN MD	11/14/2023	390200000X	NA	Other	026	PHYSICIANS	186507	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
83178	Fee-for-Service	1235622077	1235622077	1	1	HIRASHIMA, CARLA J CNP	2/3/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1111 GRAND AVENUE	UNIT L	DIAMOND BAR	CA	91765	4171	19	06037	34.00172352	-117.813184	Los Angeles County
83189	Fee-for-Service	1932139565	1932139565	1	1	HORVATH, G DENNIS DO	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	4522	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
83200	Fee-for-Service	1073655841	1073655841	1	1	HEKMAT, FARAH L MD	10/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38022	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	9301 WILSHIRE BLVD	STE 402	BEVERLY HILLS	CA	90210	6134	19	06037	34.06707307	-118.3946743	Los Angeles County
83213	Fee-for-Service	1891131819	1891131819	1	1	HELPING HANDS HOSPICE CARE	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	600 N MOUNTAIN AVE	SUITE D105	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
83229	Fee-for-Service	1346282340	1346282340	1	1	HSU, ANDY C MD	7/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92122	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
83232	Fee-for-Service	1942682323	1942682323	1	2	HOPE PHYSICAL THERAPY PC	12/5/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10900 WARNER AVE	STE 117	FOUNTAIN VALLEY	CA	92708	7203	30	06059	33.71628153	-117.9388215	Orange County
83239	Fee-for-Service	1770879116	1770879116	1	1	HUH, BRIAN INC	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54802	83	Rheumatology	0	In state provider	None	520 S VIRGIL AVE	STE 300	LOS ANGELES	CA	90020	1425	19	06037	34.064487	-118.2870305	Los Angeles County
83301	Fee-for-Service	1134434236	1134434236	1	1	HUR, CHEE Y OD	6/20/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
83311	Fee-for-Service	1801822911	1801822911	1	1	HOUSTON,MARC R DO	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	None	SALEM	OR	97301	0000	00	None	44.933211	-123.0355125	Marion County
83368	Fee-for-Service	1871786293	1871786293	1	1	HOGELING, MARCIA MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86818	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	SUITE 450, 465	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
83377	Fee-for-Service	1245248277	1245248277	1	1	HU, HSIAO-PING MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55118	40	Pediatrics	0	In state provider	None	1832 BUENAVENTURA BLVD	None	REDDING	CA	96001	3700	45	06089	40.55644085	-122.3971882	Shasta County
83379	Fee-for-Service	1396934188	1396934188	1	1	HARRISON, ALEXANDER T MD	2/28/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	89322	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1510 E MAIN ST	SUITE 101	SANTA MARIA	CA	93454	4826	42	06083	34.95282793	-120.4100798	Santa Barbara County
83473	Fee-for-Service	1144666165	1144666165	1	1	HACKENBERG, ANNA L MD	6/19/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	144560	08	Family Practice	0	In state provider	None	525 3RD AVE	None	CHULA VISTA	CA	91910	5696	37	06073	32.63367609	-117.0769202	San Diego County
83476	Fee-for-Service	1902816390	1902816390	1	1	HEATON, J BEN MD	9/30/1989	207P00000X	NA	Other	026	PHYSICIANS	69203	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
83500	Fee-for-Service	1699062190	1699062190	1	1	HEUNG, YVONNE J MD	9/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131097	01	General Practice	0	In state provider	None	25455 BARTON RD	None	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
83503	Fee-for-Service	1891131819	1891131819	1	1	HELPING HANDS HOSPICE CARE	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	600 N MOUNTAIN AVE	SUITE D105	UPLAND	CA	91786	4359	36	06071	34.10094187	-117.6700806	San Bernardino County
83527	Fee-for-Service	1356876437	1356876437	1	1	HOBSON, JESSICA A PHD	6/16/2020	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3555 KENYON ST	101/102	SAN DIEGO	CA	92110	5333	37	06073	32.75016963	-117.2160064	San Diego County
83530	Fee-for-Service	1174349484	1174349484	1	1	HUNTER, ARTIS BIRTH DOULA	12/19/2024	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	34	06067	0	0	None
83532	Fee-for-Service	1992891006	1992891006	1	1	HENRICKS, CAROL 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	7598 N LA CHOLLA BLVD	None	TUCSON	AZ	85741	2307	00	None	32.344173	-111.010806	Pima County
83548	Fee-for-Service	1114211448	1114211448	1	1	HILDRETH, MARILYN	7/25/1996	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5750 DOWNEY AVE	STE 305	LAKEWOOD	CA	90712	1479	19	06037	33.859611	-118.1511435	Los Angeles County
83552	Fee-for-Service	1083308555	1083308555	1	1	HKH HEALTH INC	10/8/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	17332 LAURIE LANE	None	TUSTIN	CA	92780	1815	30	06059	33.7638215	-117.8297879	Orange County
83560	Fee-for-Service	1790074953	1790074953	1	1	HATEFI, ARIAN MD	5/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124117	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
83572	Fee-for-Service	1306932330	1306932330	1	1	HWANG, JAMES Q MD	12/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85681	None	None	0	In state provider	None	7808 EL CAJON BLVD	None	SAN DIEGO	CA	92104	0000	37	06073	32.755302	-117.1248412	San Diego County
83576	Fee-for-Service	1740809631	1740809631	1	1	HAKOUPIAN, JOYCE	8/2/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
83581	Fee-for-Service	1689801342	1689801342	1	1	HAYEK, JOSEPH P MD DO	6/9/2017	207P00000X	NA	Other	026	PHYSICIANS	139255	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
83600	Fee-for-Service	1164696811	1164696811	1	1	HORACIO LOPEZ	2/3/2023	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2105 BEVERLY BLVD	129	LOS ANGELES	CA	90057	2216	19	06037	34.06682861	-118.2706286	Los Angeles County
83617	Fee-for-Service	1306460019	1306460019	1	1	HUBER, DAVID DO	9/19/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20502	None	None	0	In state provider	None	8701 CUYAMACA ST	None	SANTEE	CA	92071	4253	37	06073	32.83439779	-116.98366	San Diego County
83625	Fee-for-Service	1144470162	1144470162	1	1	HAMIDI, REYHANEH MD	9/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111135	07	Dermatology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
83629	Fee-for-Service	1851505218	1851505218	1	1	HAN, ALISA S MD	4/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139449	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
83653	Fee-for-Service	1063660264	1063660264	1	1	HARUTUNIANS, TINA I DO	12/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10391	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
83682	Fee-for-Service	1336281625	1336281625	1	1	HO, GILBERT J MD	9/5/2006	2084N0400X	NA	Neurology	026	PHYSICIANS	55117	13	Neurology (M.D. only)	0	In state provider	None	15725 POMERADO RD	STE 203	POWAY	CA	92064	2058	37	06073	33.00037882	-117.0580735	San Diego County
83728	Fee-for-Service	1497739106	1497739106	1	1	HIDER, STEVEN SAGE OD	10/31/1993	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7605 MORRO RD	None	ATASCADERO	CA	93422	4433	40	06079	35.47630284	-120.6676657	San Luis Obispo County
83763	Fee-for-Service	1255728101	1255728101	1	1	HAAS, PENINA M	7/26/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1827 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.25641704	-119.2199387	Ventura County
83773	Fee-for-Service	1093142085	1093142085	1	1	HYPERBARIC CONSULTANTS MEDIC	6/29/2015	2083P0011X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	AL GROUP, INC	2107 OFARRELL STREET	None	SAN FRANCISCO	CA	94115	3419	38	06075	37.7823723	-122.4396091	San Francisco County
83774	Fee-for-Service	1275883118	1275883118	1	1	HYDER, SAKINA DO	8/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14192	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
83780	Fee-for-Service	1447839980	1447839980	1	1	HODSON, TREVOR MD	7/15/2024	390200000X	NA	Other	026	PHYSICIANS	None	43	Pediatric Allergy	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
83801	Fee-for-Service	1851355259	1851355259	1	1	HARGROVE, CLAIRE MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87332	None	None	0	In state provider	None	747 52 ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
83842	Fee-for-Service	1598813420	1598813420	1	1	HOLZINGER, OFELIA N CRNA	10/26/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
83865	Fee-for-Service	1396024568	1396024568	1	1	HOLLADAY, SHANNA S LMFT	9/19/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	39276	-	NOT APPLICABLE	0	In state provider	None	1820 SCENIC AVENUE	None	BERKELEY	CA	94709	1324	01	06001	37.87536985	-122.2622489	Alameda County
83949	Fee-for-Service	1467423749	1467423749	1	1	HARTSFIELD, JERSHONDA F, MD	2/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	87484	40	Pediatrics	0	In state provider	None	2001 FOURTH AVENUE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
83960	Fee-for-Service	1255726881	1255726881	1	1	HONG, SAMUEL W MD	6/4/2020	390200000X	NA	Other	026	PHYSICIANS	146326	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
83963	Fee-for-Service	1336129600	1336129600	1	1	HANSEN, MARGARET E MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87337	30	Radiology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
84028	Fee-for-Service	1205830635	1205830635	1	1	HYGIEIA HOME HEALTH	7/17/2002	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	11401 E CARSON ST	STE N	LAKEWOOD	CA	90715	2546	19	06037	33.8315703	-118.090311	Los Angeles County
84040	Fee-for-Service	1205980190	1205980190	1	1	HARRIS, SALLY S MD	4/30/1989	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	45966	20	Orthopedic Surgery	0	In state provider	None	1015 GAYLEY AVE	# 1273	LOS ANGELES	CA	90024	3424	19	06037	34.0616224	-118.447693	Los Angeles County
84063	Fee-for-Service	1093142085	1093142085	1	1	HYPERBARIC CONSULTANTS MEDIC	4/28/2021	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	AL GROUP, INC	2107 OFARRELL STREET	None	SAN FRANCISCO	CA	94115	3419	38	06075	37.7823723	-122.4396091	San Francisco County
84072	Fee-for-Service	1811931611	1811931611	1	1	HOLLETT, MICHAEL D MD	1/25/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	75906	None	None	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
84111	Fee-for-Service	1437202132	1437202132	1	2	HANSEN, LARS C MD	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137833	40	Pediatrics	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
84149	Fee-for-Service	1700474608	1700474608	1	1	HONG SHEN MD INC	1/7/2021	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	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
84156	Fee-for-Service	1003558446	1003558446	1	1	HANNAH KIRBY MD INC	4/15/2022	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	277 RANCHEROS DR	101	SAN MARCOS	CA	92069	2976	37	06073	33.13859391	-117.1604009	San Diego County
84198	Fee-for-Service	1447782685	1447782685	2	1	HUYNH, BICHTRAM MD	11/25/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	173130	40	Pediatrics	0	In state provider	None	220 S PALISADE DR	STE 203	SANTA MARIA	CA	93454	8903	42	06083	34.95143521	-120.412098	Santa Barbara County
84227	Fee-for-Service	1750737862	1750737862	1	1	HALLE, TREVOR W	2/9/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
84302	Fee-for-Service	1366481459	1366481459	1	1	HILSER, 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	759 CHESTNUT ST	None	WOBURN	MA	01815	0001	00	None	42.48538605	-71.15416184	Middlesex County
84349	Fee-for-Service	1588285811	1588285811	1	1	HOANG, ROSE K OD	10/9/2020	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
84353	Fee-for-Service	1114189354	1114189354	1	1	HAKIMISEFAT, BABAK DO	3/24/2010	207R00000X	NA	Other	026	PHYSICIANS	11100	41	Internal Medicine	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91328	4105	19	06037	34.22073847	-118.532988	Los Angeles County
84357	Fee-for-Service	1295885804	1295885804	1	1	HIGA, BRIAN N OD	9/8/1993	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 S LYON AVE	SP C	HEMET	CA	92543	3851	33	06065	33.746143	-116.9890862	Riverside County
84422	Fee-for-Service	1801085816	1801085816	1	1	HERSHFIELD, JENNIFER A PHD	5/1/2018	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
84452	Fee-for-Service	1679864227	1679864227	1	1	HEARWELL AUDIOLOGY INC	1/4/2016	193400000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5406 THORNWOOD DR	SUITE 145	SAN JOSE	CA	95123	1221	43	06085	37.25447848	-121.8642255	Santa Clara County
84454	Fee-for-Service	1588775787	1588775787	2	1	HOUSTON, MARSHA L	11/12/2015	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	44709 DATE AVE	None	LANCASTER	CA	93534	3101	19	06037	34.69471258	-118.1403055	Los Angeles County
84461	Fee-for-Service	1679524391	1679524391	1	1	HORIZON THERAPY SERVICES	12/13/2018	225100000X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8265 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10330723	-117.5642502	San Bernardino County
84472	Fee-for-Service	1043456916	1043456916	1	1	HEALTHY LIVING AT HOME LLC	8/31/2009	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1879 LUNDY AVE	STE 113	SAN JOSE	CA	95131	1877	43	06085	37.39301965	-121.8906676	Santa Clara County
84516	Fee-for-Service	1528205101	1528205101	1	1	HERRMANN, KATHRYN A	11/2/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1687 ERRINGER ROAD	STE 109	SIMI VALLEY	CA	93065	3357	56	06111	34.268886	-118.761426	Ventura County
84518	Fee-for-Service	1649355256	1649355256	2	1	HOSSEINI, ROBERT B MD	3/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	63298	08	Family Practice	0	In state provider	None	1728 S CATALINA AVENUE	None	REDONDO BEACH	CA	90277	5504	19	06037	33.817345	-118.3876625	Los Angeles County
84529	Fee-for-Service	1659339422	1659339422	1	1	HOFFMAN, WILLIAM Y MD	2/28/1994	2086S0122X	NA	General Surgery	026	PHYSICIANS	38023	02	General Surgery	0	In state provider	None	1600 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3010	38	06075	37.78475261	-122.43973	San Francisco County
84531	Fee-for-Service	1407010069	1407010069	1	1	HARTING, MATTHEW T MD	7/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	85	Surgery-Pediatric	2	Out of state provider	None	6410 FANNIN STREET	STE 950	HOUSTON	TX	77030	5204	00	None	29.71419639	-95.39755562	Harris County
84558	Fee-for-Service	1326607011	1326607011	1	2	HEROCARE LLC	3/17/2025	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	12598 CENTRAL AVE	STE 109	CHINO	CA	91710	3500	36	06071	34.02430506	-117.6894721	San Bernardino County
84564	Fee-for-Service	1669925376	1669925376	1	1	HESPENHIDE, JASON A LMFT	1/19/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	90949	-	NOT APPLICABLE	0	In state provider	None	6244 EL CAJON BOULEVARD	STE 15,16,17,18	SAN DIEGO	CA	92115	3918	37	06073	32.76342577	-117.0636924	San Diego County
84580	Fee-for-Service	1215405519	1215405519	1	1	HO, STEPHANIE PT	5/21/2021	390200000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
84635	Fee-for-Service	1205898558	1205898558	1	1	HIZON, GERARDO W MD	8/16/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55359	08	Family Practice	0	In state provider	None	25495 MEDICAL CENTER DR	SUITE 305	MURRIETA	CA	92562	4902	33	06065	33.55804188	-117.1834064	Riverside County
84642	Fee-for-Service	1588243877	1588243877	1	1	HOUSE OF HEALTH HOME CARE	3/17/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY INC	2321 W OLIVE AVE	STE A	BURBANK	CA	91506	2603	19	06037	34.16225637	-118.3284986	Los Angeles County
84646	Fee-for-Service	1619218815	1619218815	1	1	HUTCHASON, SUZANNE	6/27/2024	1041C0700X	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
84647	Fee-for-Service	1881990513	1881990513	1	1	HURST OSTEOPATHIC MEDICINE A	2/18/2011	207R00000X	NA	Other	026	PHYSICIANS	8081	40	Pediatrics	0	In state provider	PROFESSIONAL CORPORATION	632 W 11TH ST	STE 119	TRACY	CA	95376	3856	39	06077	37.73965648	-121.4352045	San Joaquin County
84728	Fee-for-Service	1871501205	1871501205	1	1	HEKMAT, RAZI DARA MD	2/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75886	41	Internal Medicine	0	In state provider	None	610 EUCLID AVE	STE 201	NATIONAL CITY	CA	91950	2952	37	06073	32.68419388	-117.0829524	San Diego County
84746	Fee-for-Service	1679524391	1679524391	1	1	HORIZON THERAPY SERVICES	7/25/2006	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8265 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10330723	-117.5642502	San Bernardino County
84792	Fee-for-Service	1306036884	1306036884	1	1	HEGDE, SANJEET R MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112326	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
84804	Fee-for-Service	1912051434	1912051434	1	1	HOGAN, CHRISTA PSYD	9/9/2022	103TC0700X	NA	Mental Health Outpatient Services	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
84830	Fee-for-Service	1205886629	1205886629	1	1	HAMILTON, ERA E MD	10/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	74708	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
84867	Fee-for-Service	1790769131	1790769131	1	1	HSING, ANDREW Y MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127271	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5139	37	06073	33.03623896	-117.2837308	San Diego County
84891	Fee-for-Service	1164799219	1164799219	1	1	HERBIN, CATHERINE LAC	7/31/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	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
84938	Fee-for-Service	1881990513	1881990513	1	1	HURST OSTEOPATHIC MEDICINE A	2/18/2011	207R00000X	NA	Other	026	PHYSICIANS	8081	41	Internal Medicine	0	In state provider	PROFESSIONAL CORPORATION	632 W 11TH ST	STE 119	TRACY	CA	95376	3856	39	06077	37.73965648	-121.4352045	San Joaquin County
84950	Fee-for-Service	1831553171	1831553171	1	1	HABERMAN, ZACHARY C MD	5/9/2019	207P00000X	NA	Other	026	PHYSICIANS	144140	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
84990	Fee-for-Service	1669525572	1669525572	1	1	HEDLEY, SHAWNA K MD	3/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54752	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2200 O'FARRELL STREET	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
85022	Fee-for-Service	1104813351	1104813351	1	1	HUANG, DAVID L MD	5/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	53995	36	Psychiatry	0	In state provider	None	820 LAS GALLINAS	None	SAN RAFAEL	CA	94903	3410	21	06041	38.00702954	-122.5471567	Marin County
85035	Fee-for-Service	1679524391	1679524391	1	1	HORIZON THERAPY SERVICES	1/2/2025	225100000X	NA	Physical Therapist	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	8265 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10330723	-117.5642502	San Bernardino County
85069	Fee-for-Service	1063506962	1063506962	1	1	HENDERSON, FIONA V MD	8/27/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78124	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
85081	Fee-for-Service	1306036884	1306036884	1	1	HEGDE, SANJEET R MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	112326	35	Pediatric Cardiology (M.D. only)	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
85129	Fee-for-Service	1922504133	1922504133	1	1	HORVATH, SARAH E LMFT	1/29/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	36	06071	34.13682	-117.243687	San Bernardino County
85160	Fee-for-Service	1609877349	1609877349	1	1	HEYOUNG L MCBRIDE, 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	350 W THOMAS RD	None	PHOENIX	AZ	85013	4409	00	None	33.480864	-112.0795155	Maricopa County
85164	Fee-for-Service	1902459944	1902459944	1	1	HUYNH, KEVIN PT	6/13/2020	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
85201	Fee-for-Service	1336875061	1336875061	1	1	HAM, SONNY M CNP	3/6/2023	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
85213	Fee-for-Service	1427129493	1427129493	1	1	HOLLAND, DARLA S MD	1/21/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	42443	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
85265	Fee-for-Service	1740793751	1740793751	1	1	HATFIELD, JENNIFER A LCSW	8/18/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	357 W 2ND ST	3	SAN BERNARDINO	CA	92401	1800	36	06071	34.10268251	-117.2909205	San Bernardino County
85267	Fee-for-Service	1679841944	1679841944	1	1	HAWLEY, RENEE S LCSW	5/1/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
85268	Fee-for-Service	1578775565	1578775565	1	1	HUNG, CALVIN C MD	8/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94606	08	Family Practice	0	In state provider	None	24355 LYONS AVE	STE 210	NEWHALL	CA	91321	2381	19	06037	34.37868281	-118.5605291	Los Angeles County
85276	Fee-for-Service	1841761764	1841761764	1	1	HIDALGO, ALANI L RCP	8/28/2020	2279G1100X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
85291	Fee-for-Service	1578973020	1578973020	1	1	HTEIN, KYI KYI MD	1/5/2018	208M00000X	NA	Other	026	PHYSICIANS	148932	41	Internal Medicine	0	In state provider	None	6555 COYLE AVENUE	SUITE 280	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
85362	Fee-for-Service	1972862092	1972862092	1	1	HOLZER, LAURA E MD	8/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131150	41	Internal Medicine	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
85371	Fee-for-Service	1053483313	1053483313	1	1	HUGGINS, LAURA K OD	9/18/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 DISCOVERY DRIVE	None	BAKERSFIELD	CA	93309	7032	15	06029	35.36397746	-119.0589062	Kern County
85403	Fee-for-Service	1568574937	1568574937	1	1	HALEM, LARRY T MD	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89000	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
85408	Fee-for-Service	1245355759	1245355759	1	1	HOUSSIERE, DANIEL D DO	1/31/1989	207P00000X	NA	Other	026	PHYSICIANS	4796	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
85428	Fee-for-Service	1790798247	1790798247	1	1	HANNON, JUNE R PHD	3/29/2018	103G00000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2111 LIDO CIRCLE	None	STOCKTON	CA	95207	6014	39	06077	37.99102747	-121.3294136	San Joaquin County
85433	Fee-for-Service	1629125414	1629125414	1	1	HUI JOHN ZHAO MD	11/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7400 E OSBORN RD	None	SCOTTSDALE	AZ	85251	6432	00	None	33.488748	-111.9225285	Maricopa County
85435	Fee-for-Service	1396034450	1396034450	1	1	HO, WENDY MD	1/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	126997	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
85467	Fee-for-Service	1538609961	1538609961	1	1	HEALTHY LIFE HOME SERVICES	4/13/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	4730 WOODMAN AVE	STE 305	SHERMAN OAKS	CA	91423	2427	19	06037	34.156701	-118.4312045	Los Angeles County
85493	Fee-for-Service	1831300722	1831300722	1	1	HSU, SHERI W MD	8/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97156	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
85518	Fee-for-Service	1861818759	1861818759	1	1	HARPER, MARY K LMFT	9/7/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1120 COLLEGE AVE	None	SANTA ROSA	CA	95404	3906	49	06097	38.445219	-122.7074625	Sonoma County
85549	Fee-for-Service	1164518593	1164518593	1	1	HUTTONKLEIN, KATHLEEN MD	10/16/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	71065	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
85570	Fee-for-Service	1043272487	1043272487	1	1	HAJDUCZEK, ANDREW J MD	3/13/2013	208600000X	NA	General Surgery	026	PHYSICIANS	41573	02	General Surgery	0	In state provider	None	1094 W 7TH ST	None	SAN PEDRO	CA	90731	2928	19	06037	33.73794676	-118.3010807	Los Angeles County
85615	Fee-for-Service	1063590735	1063590735	1	1	HAVENS, CAROL S MD	3/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	43386	08	Family Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
85623	Fee-for-Service	1659452894	1659452894	1	1	HUSSAIN,HERO 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	DRIVE	ANN ARBOR	MI	48109	5030	00	None	42.28391347	-83.72716554	Washtenaw County
85630	Fee-for-Service	1871589911	1871589911	1	3	HOFFMANN HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4401 BUENA VISTA ROAD	None	BAKERSFIELD	CA	93311	8702	15	06029	35.314983	-119.128119	Kern County
85683	Fee-for-Service	1932557261	1932557261	1	1	HOUN, ALICIA M	7/25/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	980 R00SEVELT	STE 100	IRVINE	CA	92620	3670	30	06059	33.69380208	-117.7653165	Orange County
85697	Fee-for-Service	1407975139	1407975139	1	1	HINKLEY OPTOMETRIC	2/14/2007	193400000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1019 16TH ST	STE A	MODESTO	CA	95354	1105	50	06099	37.645377	-120.9952958	Stanislaus County
85708	Fee-for-Service	1881753580	1881753580	1	1	HURGUY, SHELLEY L CRNA	4/22/2011	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
85738	Fee-for-Service	1235572595	1235572595	1	1	HARAKE, DANIELLE E MD	4/13/2021	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	133313	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
85744	Fee-for-Service	1447651310	1447651310	1	3	HALLBROOKS, LANDON LCSW	11/22/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	7316 W AVENUE D8	None	LANCASTER	CA	93536	8815	19	06037	34.76924231	-118.2625396	Los Angeles County
85752	Fee-for-Service	1285925164	1285925164	1	1	HARDING, CHRISTINA A MD	4/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138443	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
85787	Fee-for-Service	1093773079	1093773079	1	1	HEREDIA, VERONICA MD	12/31/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	73219	40	Pediatrics	0	In state provider	A MEDICAL CORP	2016 FOREST AVE	STE 7	SAN JOSE	CA	95128	4804	43	06085	37.327006	-121.933009	Santa Clara County
85808	Fee-for-Service	1326736356	1326736356	1	1	HAN, NEURIGO PT	4/9/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
85830	Fee-for-Service	1114041050	1114041050	1	1	HO, WENDY W CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	822 S ATLANTIC BLVD	None	MONTEREY PARK	CA	91754	4714	19	06037	34.05216368	-118.1372429	Los Angeles County
85857	Fee-for-Service	1043272487	1043272487	1	1	HAJDUCZEK, ANDREW J MD	3/13/2013	208600000X	NA	General Surgery	026	PHYSICIANS	41573	33	Thoracic Surgery	0	In state provider	None	1094 W 7TH ST	None	SAN PEDRO	CA	90731	2928	19	06037	33.73794676	-118.3010807	Los Angeles County
85881	Fee-for-Service	1669964540	1669964540	1	1	HALLDORSDOTTIR, KAREN E MD	7/31/2023	390200000X	NA	Other	026	PHYSICIANS	177325	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
85897	Fee-for-Service	1437248937	1437248937	1	1	HUIBONHOA, AMY M MD	4/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	77311	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3779 PIEDMONT AVENUE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
85918	Fee-for-Service	1871589911	1871589911	1	3	HOFFMANN HOSPICE	12/9/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4401 BUENA VISTA ROAD	None	BAKERSFIELD	CA	93311	8702	15	06029	35.314983	-119.128119	Kern County
85919	Fee-for-Service	1972679645	1972679645	1	1	HOLDEN, JENNIFER F MD	2/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	63088	40	Pediatrics	0	In state provider	None	1450 TREAT BLVD	STE 140	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
85941	Fee-for-Service	1508927575	1508927575	1	1	HUMBOLDT COUNTY CCS	6/13/2003	No Taxonomy Provided	NA	None	046	REHABILITATION CLINIC	-	-	NOT APPLICABLE	0	In state provider	GLEN PAUL MTU	2501 CYPRESS ST	None	EUREKA	CA	95503	6212	12	06023	40.76590625	-124.1395294	Humboldt County
85943	Fee-for-Service	1174942882	1174942882	1	1	HSIAO, RUTH MD	10/24/2017	208M00000X	NA	Other	026	PHYSICIANS	137828	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
85951	Fee-for-Service	1609080027	1609080027	1	1	HAYES, EARLE W DO	4/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14184	41	Internal Medicine	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
85976	Fee-for-Service	1720418502	1720418502	1	1	HICKEY, PATRICIA G LCSW	3/5/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	330 S FAIRMONT AVE	STE 7	LODI	CA	95240	3843	39	06077	38.12892266	-121.2858458	San Joaquin County
86005	Fee-for-Service	1225039167	1225039167	1	1	HENDERSON, JANNELL F MD	12/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78011	None	None	0	In state provider	MD	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
86009	Fee-for-Service	1588601785	1588601785	1	1	HSU, CINDY MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105463	05	Anesthesiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
86036	Fee-for-Service	1730295189	1730295189	1	1	HERNANDEZ, LOUIS MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44447	08	Family Practice	0	In state provider	None	405 RIVERSIDE DR	None	MADERA	CA	93638	2439	20	06039	36.96866531	-120.0628808	Madera County
86041	Fee-for-Service	1295291813	1295291813	1	1	HOME HEALTH FOR LIFE INC	8/28/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2060 HUNTINGTON DR	UNIT 9	SAN MARINO	CA	91108	2044	19	06037	34.12068542	-118.108905	Los Angeles County
86053	Fee-for-Service	1760027619	1760027619	1	1	HUI, EVA OD	6/14/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 DISCOVERY DR	None	BAKERSFIELD	CA	93309	7032	15	06029	35.36397746	-119.0589062	Kern County
86068	Fee-for-Service	1669509279	1669509279	1	1	HARBOR HEALTH CARE, INC	8/1/2001	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	11262 HOBACK ST	None	NORWALK	CA	90650	3637	19	06037	33.90885	-118.092914	Los Angeles County
86084	Fee-for-Service	1730543083	1730543083	1	1	HUBER, KYLE DPM	6/27/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5020 COMMERCE DR	None	BAKERSFIELD	CA	93309	0631	15	06029	35.36787086	-119.0579597	Kern County
86085	Fee-for-Service	1326130071	1326130071	1	1	HOM, FRED B INC	5/31/1987	207RP1001X	NA	Pulmonology	026	PHYSICIANS	50415	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	909 HYDE ST	STE 508	SAN FRANCISCO	CA	94109	4833	38	06075	37.78939387	-122.4170945	San Francisco County
86101	Fee-for-Service	1992733463	1992733463	1	1	HUDSON, MARK A 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	2014	15	06029	35.38333823	-119.0188872	Kern County
86188	Fee-for-Service	1336164151	1336164151	1	1	HOLLYWOOD PRESBYTERIAN	1/1/2005	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MEDICAL CENTER D/P SNF	4636 FOUNTAIN AVE	None	LOS ANGELES	CA	90029	1830	19	06037	34.09555203	-118.2909646	Los Angeles County
86200	Fee-for-Service	1639131212	1639131212	1	1	HENRY, MECHEL M MD INC	2/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	76404	25	Physical Medicine and Rehabilitation	0	In state provider	None	1125 SIR FRANCIS DRAKE B	STE M	KENTFIELD	CA	94904	1418	21	06041	37.95921858	-122.5523703	Marin County
86207	Fee-for-Service	1144319773	1144319773	1	1	HEMMATABADI, MEHDI MD	9/3/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	32724	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	621 S BUTTE ST	None	SAN PEDRO	CA	90732	3510	19	06037	33.73839738	-118.3065444	Los Angeles County
86224	Fee-for-Service	1891729265	1891729265	1	1	HOLM, EDWARD B MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	27647	02	General Surgery	0	In state provider	None	920 DELBON AVE	None	TURLOCK	CA	95382	2019	50	06099	37.51045858	-120.8376324	Stanislaus County
86232	Fee-for-Service	1225069537	1225069537	1	1	HARMON, ADAM L MD	3/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77973	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1900 MOWRY AVE	STE 401	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
86248	Fee-for-Service	1285721571	1285721571	1	1	HOLT MEDICAL CORPORATION	6/21/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	5153 HOLT BLVD	STE B1	MONTCLAIR	CA	91763	4837	36	06071	34.0631015	-117.692694	San Bernardino County
86252	Fee-for-Service	1427031970	1427031970	1	1	HUSAIN, SOHAIL Z MD	9/11/2019	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	164935	10	Gastroenterology (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
86285	Fee-for-Service	1538487848	1538487848	1	1	HANIFI, MOHAMMAD T MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141903	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
86298	Fee-for-Service	1518904598	1518904598	1	1	HENZLER, 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	100 KEOKEA PL	None	KULA	HI	96790	7450	00	None	20.70160237	-156.3575903	Maui County
86309	Fee-for-Service	1356364707	1356364707	1	1	HADDAD, MARK HA	11/13/2010	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	SUNCOAST HEARING AIDS	6888 LINCOLN AVE	STE E	BUENA PARK	CA	90620	4107	30	06059	33.83179254	-118.013031	Orange County
86313	Fee-for-Service	1467536458	1467536458	1	1	HUBER, MADELINE MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62713	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
86338	Fee-for-Service	1629362298	1629362298	1	1	HARLE, KATIA M PHD	7/26/2017	101YM0800X	NA	Other	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
86341	Fee-for-Service	1073778767	1073778767	1	1	HUFF, TINA M NP	6/21/2019	363L00000X	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
86350	Fee-for-Service	1053639500	1053639500	1	1	HOLZAPFEL, MARIE K MD	12/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110897	78	Neoplastic Diseases/Oncology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
86370	Fee-for-Service	1326130071	1326130071	1	1	HOM, FRED B INC	5/31/1987	207RP1001X	NA	Pulmonology	026	PHYSICIANS	50415	41	Internal Medicine	0	In state provider	None	909 HYDE ST	STE 508	SAN FRANCISCO	CA	94109	4833	38	06075	37.78939387	-122.4170945	San Francisco County
86403	Fee-for-Service	1013995133	1013995133	1	1	HEALTH ALLIANCE	2/27/2005	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITALS INC	60 HOSPITAL RD	None	LEOMINSTER	MA	01453	2205	00	None	42.540507	-71.7625485	Worcester County
86406	Fee-for-Service	1912123951	1912123951	1	1	HALL, SHARON A	5/16/2011	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
86413	Fee-for-Service	1033641816	1033641816	1	1	HAMMOND, CHARLES F MD	9/14/2020	208M00000X	NA	Other	026	PHYSICIANS	169655	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
86421	Fee-for-Service	1225355951	1225355951	1	1	HALLOCK, JENNIFER L MD	10/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148308	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
86423	Fee-for-Service	1417226572	1417226572	1	1	HUANG, RWOWEN MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143053	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
86455	Fee-for-Service	1477782035	1477782035	1	1	HUANG, MONQUEN MD	5/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109296	13	Neurology (M.D. only)	0	In state provider	None	701 E 28TH STREET	SUITE 319	LONG BEACH	CA	90806	2783	19	06037	33.80803441	-118.1847137	Los Angeles County
86458	Fee-for-Service	1750148300	1750148300	1	1	HUYNH, LAM-THUY OT	3/29/2024	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
86497	Fee-for-Service	1467509968	1467509968	1	2	HARVILLE-WASHINGTON, GWENDOL	12/22/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	INGTON LCSW	78150 CALLE TAMPICO	SUITE 200 I	LA QUINTA	CA	92253	2907	33	06065	33.67817382	-116.30003	Riverside County
86502	Fee-for-Service	1164559456	1164559456	1	4	HEARING SCIENCE OF RANCHO	11/22/2013	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5385 WALNUT AVE	SUITE 8	CHINO	CA	91710	2605	36	06071	34.02627451	-117.6872175	San Bernardino County
86504	Fee-for-Service	1477802148	1477802148	1	1	HADIAN JAZI, RAZIEH MD	11/2/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	162616	None	None	0	In state provider	None	31001 RANCHO VIEJO RD	STE 200	SAN JUAN CAPISTRA	CA	92675	8703	30	06059	33.50974262	-117.6596065	Orange County
86509	Fee-for-Service	1053346833	1053346833	1	1	HECIMOVICH, MICHAEL J DO	1/1/2011	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	11446	30	Radiology	0	In state provider	None	2800 L ST	STE 260	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
86514	Fee-for-Service	1891729265	1891729265	1	1	HOLM, EDWARD B MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	27647	01	General Practice	0	In state provider	None	920 DELBON AVE	None	TURLOCK	CA	95382	2019	50	06099	37.51045858	-120.8376324	Stanislaus County
86518	Fee-for-Service	1043741580	1043741580	1	1	HSU, CHRISTINE DO	11/14/2020	207R00000X	NA	Other	026	PHYSICIANS	18466	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
86519	Fee-for-Service	1225069537	1225069537	1	1	HARMON, ADAM L MD	3/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77973	33	Thoracic Surgery	0	In state provider	None	1900 MOWRY AVE	STE 401	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
86521	Fee-for-Service	1164500369	1164500369	1	1	HENRY, KIMBERLY A MD	7/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74346	24	Plastic Surgery	0	In state provider	None	1100 S ELISEO DR	STE 1B	GREENBRAE	CA	94904	2017	21	06041	37.94358265	-122.5345035	Marin County
86535	Fee-for-Service	1285721571	1285721571	1	1	HOLT MEDICAL CORPORATION	6/21/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	5153 HOLT BLVD	STE B1	MONTCLAIR	CA	91763	4837	36	06071	34.0631015	-117.692694	San Bernardino County
86546	Fee-for-Service	1528312998	1528312998	2	1	HARRIS, PATRICE LMFT	2/3/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ING	1025 S GILBERT ST	63	HEMET	CA	92543	7090	33	06065	33.73061743	-116.9759153	Riverside County
86555	Fee-for-Service	1023544681	1023544681	1	1	HALL, JAMIE A LMFT	7/3/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1430 EAST AVE	STE 4A	CHICO	CA	95926	1629	04	06007	39.76116577	-121.8188568	Butte County
86561	Fee-for-Service	1215153358	1215153358	1	1	HENSLEE, HEIDI B MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106489	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
86568	Fee-for-Service	1154425742	1154425742	1	1	HOEFS, JOHN C MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	26324	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
86570	Fee-for-Service	1871971523	1871971523	1	1	HEIDERICH, GABRIEL MD	9/20/2020	207P00000X	NA	Other	026	PHYSICIANS	161793	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
86615	Fee-for-Service	1760783476	1760783476	1	1	HIGH DESERT HOSPICE SERVICES	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12998 HESPERIA RD	SUITE 202	VICTORVILLE	CA	92395	8317	36	06071	34.48789715	-117.2906992	San Bernardino County
86617	Fee-for-Service	1689602294	1689602294	1	1	HUBENY, CHARLES M MD	3/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114492	30	Radiology	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
86639	Fee-for-Service	1053639500	1053639500	1	1	HOLZAPFEL, MARIE K MD	12/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110897	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
86644	Fee-for-Service	1225148398	1225148398	1	1	HARKEN, ALDEN H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	86974	02	General Surgery	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
86650	Fee-for-Service	1326309055	1326309055	1	1	HARMANDAYAN, GARO Z MD	12/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119206	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
86655	Fee-for-Service	1659381770	1659381770	1	1	HAKIMI, SOLEMON MD INC	4/3/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45921	25	Physical Medicine and Rehabilitation	0	In state provider	None	2915 SANTA MONICA BLVD	STE 1	SANTA MONICA	CA	90404	2438	19	06037	34.03592657	-118.4710747	Los Angeles County
86692	Fee-for-Service	1013995133	1013995133	1	1	HEALTH ALLIANCE	2/27/2005	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITALS INC	60 HOSPITAL RD	None	LEOMINSTER	MA	01453	2205	00	None	42.540507	-71.7625485	Worcester County
86730	Fee-for-Service	1801959671	1801959671	1	1	HICKS, CHARLES B MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	42891	77	Infectious Disease	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
86764	Fee-for-Service	1093874687	1093874687	1	1	HSU, JEFFREY H MD	2/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91257	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
86790	Fee-for-Service	1760913529	1760913529	1	1	HASSAN, OMAR T MD	6/16/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	162029	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
86806	Fee-for-Service	1225069537	1225069537	1	1	HARMON, ADAM L MD	3/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77973	02	General Surgery	0	In state provider	None	1900 MOWRY AVE	STE 401	FREMONT	CA	94538	1722	01	06001	37.55862396	-121.9799952	Alameda County
86823	Fee-for-Service	1568429165	1568429165	1	1	HUPFELD, CHRISTOPHER MD	2/8/2015	207RE0101X	NA	Endocrinology	026	PHYSICIANS	64102	41	Internal Medicine	0	In state provider	None	3300 VISTA WAY	STE B	OCEANSIDE	CA	92056	3633	37	06073	33.18081595	-117.3156434	San Diego County
86824	Fee-for-Service	1417437047	1417437047	1	1	HERGIE & ASSOCIATES INC	11/13/2019	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1743 E CHENNAULT	None	FRESNO	CA	93720	3813	10	06019	36.84328053	-119.751441	Fresno County
86825	Fee-for-Service	1285721571	1285721571	1	1	HOLT MEDICAL CORPORATION	6/21/2005	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	5153 HOLT BLVD	STE B1	MONTCLAIR	CA	91763	4837	36	06071	34.0631015	-117.692694	San Bernardino County
86843	Fee-for-Service	1518903814	1518903814	1	1	HUYNH, NHAN H MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80923	40	Pediatrics	0	In state provider	None	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
86848	Fee-for-Service	1164417093	1164417093	1	1	HEDRICK, GUADALUPE N MD	9/20/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45846	40	Pediatrics	0	In state provider	None	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	49	06097	38.62729851	-122.8637785	Sonoma County
86885	Fee-for-Service	1861438947	1861438947	1	1	HOM, DARREN MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78129	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1301 N ROSE DR	None	PLACENTIA	CA	92870	3802	30	06059	33.8868003	-117.8420447	Orange County
86904	Fee-for-Service	1760783476	1760783476	1	1	HIGH DESERT HOSPICE SERVICES	12/9/2011	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12998 HESPERIA RD	SUITE 202	VICTORVILLE	CA	92395	8317	36	06071	34.48789715	-117.2906992	San Bernardino County
86907	Fee-for-Service	1760477681	1760477681	1	2	HYUN, PETER S MD	12/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	101042	25	Physical Medicine and Rehabilitation	0	In state provider	None	2120 PROFESSIONAL DRIVE	None	ROSEVILLE	CA	95678	3700	31	06061	38.74247397	-121.2508672	Placer County
86914	Fee-for-Service	1336338516	1336338516	1	1	HEYWOOD, CHRISTINE M	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
86927	Fee-for-Service	1285823575	1285823575	1	1	HOMENTCOVSCHI, ZENAIDA M MD	8/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102359	40	Pediatrics	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
86930	Fee-for-Service	1861271132	1861271132	1	1	HSD TRANSPORTATION INC	6/14/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2560 N PERRIS BLVD	STE N 3, SPACE# E-13	PERRIS	CA	92571	3251	33	06065	33.819705	-117.2262155	Riverside County
86932	Fee-for-Service	1689783292	1689783292	1	1	HON, GEORGE M D A	10/4/2004	193400000X	NA	Other	026	PHYSICIANS	73910	45	Nephrology (Renal-Kidney)	0	In state provider	PROFESSIONAL CORP	3610 LONG BEACH BLVD	SUITE 201	LONG BEACH	CA	90807	6036	19	06037	33.822396	-118.1893225	Los Angeles County
86936	Fee-for-Service	1467509968	1467509968	1	1	HARVILLE-WASHINGTON, GWENDOL	7/22/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	YN LCSW	71687 HIGHWAY 111	SUITE 205	RANCHO MIRAGE	CA	92270	4515	33	06065	33.74279697	-116.4137932	Riverside County
87018	Fee-for-Service	1801959671	1801959671	1	1	HICKS, CHARLES B MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	42891	41	Internal Medicine	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
87037	Fee-for-Service	1508271842	1508271842	1	1	HARRIS, STUART R DO	10/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14456	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
87041	Fee-for-Service	1639242035	1639242035	1	1	HOWEY, SUSAN MD	2/17/2025	208M00000X	NA	Other	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
87048	Fee-for-Service	1407863368	1407863368	1	1	HILDEBRAND, JANETTE M OD	10/14/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
87054	Fee-for-Service	1093874687	1093874687	1	1	HSU, JEFFREY H MD	2/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	91257	23	Peripheral Vascular Disease or Surgery (D.O. only)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
87064	Fee-for-Service	1164500724	1164500724	1	1	HERMAN, VALERIE J MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61121	36	Psychiatry	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
87097	Fee-for-Service	1447318316	1447318316	1	1	HARRINGTON, JENNIFER L MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55672	24	Plastic Surgery	0	In state provider	None	750 REDWOOD HWY	STE 1204	GREENBRAE	CA	94904	1702	21	06041	37.94092249	-122.5153603	Marin County
87108	Fee-for-Service	1811209810	1811209810	1	1	HO, EDMUND S MD	9/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	104190	None	None	0	In state provider	None	1680 E 120TH ST	None	LOS ANGELES	CA	90059	3026	19	06037	33.92456051	-118.2417525	Los Angeles County
87110	Fee-for-Service	1568429165	1568429165	1	1	HUPFELD, CHRISTOPHER MD	2/8/2015	207RE0101X	NA	Endocrinology	026	PHYSICIANS	64102	67	Endocrinology	0	In state provider	None	3300 VISTA WAY	STE B	OCEANSIDE	CA	92056	3633	37	06073	33.18081595	-117.3156434	San Diego County
87114	Fee-for-Service	1992928873	1992928873	1	1	HOWE, CANDACE N MD	11/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86545	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
87120	Fee-for-Service	1740531573	1740531573	1	1	HANSEN, SARA M MD	5/8/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	128569	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
87129	Fee-for-Service	1518903814	1518903814	1	1	HUYNH, NHAN H MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80923	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
87152	Fee-for-Service	1730393364	1730393364	1	1	HSU, MELODY S N MD	12/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	102308	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
87219	Fee-for-Service	1689783292	1689783292	1	1	HON, GEORGE M D A	10/4/2004	193400000X	NA	Other	026	PHYSICIANS	73910	41	Internal Medicine	0	In state provider	PROFESSIONAL CORP	3610 LONG BEACH BLVD	SUITE 201	LONG BEACH	CA	90807	6036	19	06037	33.822396	-118.1893225	Los Angeles County
87222	Fee-for-Service	1528143286	1528143286	1	1	HWANG, JANET L MD	3/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73404	18	Ophthalmology	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
87280	Fee-for-Service	1114364403	1114364403	1	1	HERION, BARBARA	8/23/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1300 E SHAW AVE	SUITE 109	FRESNO	CA	93710	7903	10	06019	36.80872147	-119.765979	Fresno County
87313	Fee-for-Service	1184686156	1184686156	1	1	HOROUPIAN, RUPERT R MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84866	02	General Surgery	0	In state provider	None	365 HAWTHORNE AVE	SUITE 101	OAKLAND	CA	94609	3120	01	06001	37.82079728	-122.2633226	Alameda County
87319	Fee-for-Service	1750362323	1750362323	1	1	HALKI, JOHN J II MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	1	Border provider	None	555 N ARLINGTON AVE	None	RENO	NV	89503	4723	00	None	39.53124039	-119.8188498	Washoe County
87328	Fee-for-Service	1639242035	1639242035	1	1	HOWEY, SUSAN MD	2/17/2025	208M00000X	NA	Other	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
87331	Fee-for-Service	1437218187	1437218187	1	1	HOWARD, BRENT A MD	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	46945	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
87408	Fee-for-Service	1770651986	1770651986	1	1	HAWKINS, EVAN R LMFT	10/5/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1230 ROSECRANS AVE	STE 300	MANHATTAN BEACH	CA	90266	2494	19	06037	33.90178852	-118.392192	Los Angeles County
87436	Fee-for-Service	1114098183	1114098183	1	1	HAMILTON, CLARENCE A MD	1/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65958	18	Ophthalmology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
87448	Fee-for-Service	1811487820	1811487820	1	1	HEAVEN'S HERITAGE INC	12/17/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	22201 TAJANTA COURT	None	APPLE VALLEY	CA	92307	4069	36	06071	34.52044641	-117.1794276	San Bernardino County
87459	Fee-for-Service	1225056831	1225056831	1	1	HONG, KURT M MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72848	70	Clinic (mixed specialty)	0	In state provider	None	200 MED PLAZA STE 420	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
87481	Fee-for-Service	1427249499	1427249499	1	1	HOLLINGER, MARSHALL T NP	10/14/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95010533	-	NOT APPLICABLE	0	In state provider	None	1550 HUMBOLDT RD	STE 3	CHICO	CA	95928	9115	04	06007	39.73641173	-121.8122593	Butte County
87484	Fee-for-Service	1649275330	1649275330	1	1	HOM, LOUISE MD	11/11/2019	208600000X	NA	General Surgery	026	PHYSICIANS	62353	02	General Surgery	0	In state provider	None	20126 STANTON AVENUE	SUITE 201	CASTRO VALLEY	CA	94546	5270	01	06001	37.69722866	-122.090936	Alameda County
87503	Fee-for-Service	1992737381	1992737381	1	1	HEGDE, HEMANT K. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MCKAY DEE HOSPITALISTS	4401 HARRISON BLVD	None	OGDEN	UT	84403	3195	00	None	41.18328	-111.9536955	Weber County
87527	Fee-for-Service	1053332973	1053332973	1	1	HENNIGAN, PATRICIA PHD	10/30/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
87588	Fee-for-Service	1538583919	1538583919	1	2	HOBBS, KARI A NP	4/5/2016	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
87616	Fee-for-Service	1619912680	1619912680	1	1	HICKS, LAWREN S MD	12/11/2002	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	52908	08	Family Practice	0	In state provider	None	1455 MONTEGO	STE 202	WALNUT CREEK	CA	94598	2956	07	06013	37.91046956	-122.0418669	Contra Costa County
87621	Fee-for-Service	1366768525	1366768525	1	1	HARRIS, JILLION T MD	7/29/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	141442	08	Family Practice	0	In state provider	None	5555 RESERVOIR DR	303	SAN DIEGO	CA	92120	5181	37	06073	32.77628471	-117.0563688	San Diego County
87651	Fee-for-Service	1043598196	1043598196	1	1	HUYNH, ANH-THU T OD	7/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
87666	Fee-for-Service	1366445413	1366445413	1	1	HOANG, THUY T MD	5/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77533	41	Internal Medicine	0	In state provider	None	2593 S KING RD	STE 7	SAN JOSE	CA	95122	1880	43	06085	37.31897012	-121.8226795	Santa Clara County
87679	Fee-for-Service	1497040117	1497040117	1	1	HILLSBOROUGH MANOR INC	4/10/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1776 ADAMS STREET	None	SAN MATEO	CA	94403	1108	41	06081	37.55575664	-122.2972547	San Mateo County
87680	Fee-for-Service	1124788526	1124788526	1	1	HIRMIZ, BRIAN G PT	1/10/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3745 AVOCADO	None	LA MESA	CA	91941	7301	37	06073	32.747301	-116.9590455	San Diego County
87709	Fee-for-Service	1326090010	1326090010	1	1	HUANG, BIH-JU R MD	12/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	37493	None	None	0	In state provider	None	1100 PACIFIC COAST HWY	None	HARBOR CITY	CA	90710	3511	19	06037	33.7899001	-118.2974971	Los Angeles County
87714	Fee-for-Service	1932336997	1932336997	1	1	HUFF, TAMARA N MD	5/1/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	147538	None	None	0	In state provider	None	2800 L STREET	200	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
87719	Fee-for-Service	1164044483	1164044483	1	1	HEIMER, CORINNE PSYD	5/25/2020	103T00000X	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
87725	Fee-for-Service	1356862585	1356862585	1	1	HORVITZ, LEANNE K 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
87726	Fee-for-Service	1114098183	1114098183	1	1	HAMILTON, CLARENCE A MD	1/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65958	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
87738	Fee-for-Service	1972516441	1972516441	1	1	HONG, JIN MD	3/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88789	41	Internal Medicine	0	In state provider	None	925 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4442	19	06037	34.08499473	-118.1230937	Los Angeles County
87746	Fee-for-Service	1376018697	1376018697	1	1	HEFZIBA MARRIAGE AND FAMILY	3/15/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	COUNSELING CENTER, APC	6809 INDIANA AVE	131	RIVERSIDE	CA	92506	4221	33	06065	33.94312844	-117.3918196	Riverside County
87772	Fee-for-Service	1508886326	1508886326	1	1	HABENER, PAUL E OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	220 W CYPRESS ST	None	ANAHEIM	CA	92805	2932	30	06059	33.83699057	-117.9175286	Orange County
87780	Fee-for-Service	1114556560	1114556560	1	1	HUANG, ERIC MD	8/25/2023	207R00000X	NA	Other	026	PHYSICIANS	185718	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
87807	Fee-for-Service	1144885062	1144885062	1	1	HANNANI, CANDICE PSYD	4/9/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
87813	Fee-for-Service	1124548052	1124548052	1	1	HU, ASHLEY Y MD	6/17/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	158588	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
87829	Fee-for-Service	1962427682	1962427682	1	1	HOH, CARL K MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	61309	30	Radiology	0	In state provider	None	7625 MESA COLLEGE DR	None	SAN DIEGO	CA	92111	5343	37	06073	32.80089797	-117.1572727	San Diego County
87867	Fee-for-Service	1447552658	1447552658	1	1	HUI, ISABEL PT	7/29/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	22722 LAMBERT ST	1709	LAKE FOREST	CA	92630	1618	30	06059	33.63264633	-117.7130631	Orange County
87872	Fee-for-Service	1356349690	1356349690	1	1	HSUEH, PANG FU	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9214 LAS TUNAS DR	None	TEMPLE CITY	CA	91780	1907	19	06037	34.10572616	-118.0674698	Los Angeles County
87879	Fee-for-Service	1235158262	1235158262	1	1	HOPKINS, MILAN L MD, A	1/1/1979	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	34406	01	General Practice	0	In state provider	MEDICAL CORP	9479 MAIN ST	None	UPPER LAKE	CA	95485	0638	17	06033	39.16425565	-122.9109027	Lake County
87906	Fee-for-Service	1942204979	1942204979	1	1	HASSANI, FARZANEH MD	1/30/2023	207R00000X	NA	Other	026	PHYSICIANS	54458	None	None	0	In state provider	None	2000 STOCKTON BLVD	2300	SACRAMENTO	CA	95817	1348	34	06067	38.559222	-121.462362	Sacramento County
87907	Fee-for-Service	1750588836	1750588836	1	3	HEFFERNAN, MICHAEL J MD	5/1/2022	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	2302 SOUTH GRAMERCY PL	None	LOS ANGELES	CA	90018	1323	19	06037	34.035948	-118.313292	Los Angeles County
87918	Fee-for-Service	1346434586	1346434586	1	1	HO, ERIC W MD	1/2/2008	207L00000X	NA	Other	026	PHYSICIANS	90309	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
87934	Fee-for-Service	1760454672	1760454672	1	1	HOSPICE OF SANTA CRUZ COUNTY	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	940 DISC DR	None	SCOTTS VALLEY	CA	95066	4544	44	06087	37.04750055	-122.0155809	Santa Cruz County
87958	Fee-for-Service	1558309039	1558309039	1	1	HASELWOOD, DOUGLAS M MD	10/3/2014	207RR0500X	NA	Other	026	PHYSICIANS	25216	83	Rheumatology	0	In state provider	None	6608 MERCY CT	STE A	FAIR OAKS	CA	95628	3133	34	06067	38.665917	-121.3106895	Sacramento County
87974	Fee-for-Service	1982182127	1982182127	1	1	HARRY CHEN MD INC A	9/17/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	128 N 6TH STREET	None	FOWLER	CA	93625	2332	10	06019	36.63119007	-119.6796956	Fresno County
87989	Fee-for-Service	1245356476	1245356476	1	1	HONDA, DOROTHY J OD	1/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6860 AVENIDA ENCINAS	None	CARLSBAD	CA	92009	3201	37	06073	33.10754269	-117.3146974	San Diego County
88040	Fee-for-Service	1073023107	1073023107	1	7	HUMBOLDT RECOVERY CENTER, IN	4/28/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	905 L ST	None	EUREKA	CA	95501	1943	12	06023	40.79941167	-124.1585712	Humboldt County
88065	Fee-for-Service	1831476365	1831476365	1	1	HAWTHORNE HEALTHCARE &	12/1/2011	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WELLNESS CENTRE LP	11630 S GREVILLEA AVE	None	HAWTHORNE	CA	90250	2221	19	06037	33.92878801	-118.3547488	Los Angeles County
88081	Fee-for-Service	1235193814	1235193814	1	1	HOLBURT, ERNEST N MD	3/31/1992	207ZP0102X	NA	Other	026	PHYSICIANS	47137	22	Pathology (M.D. only)	0	In state provider	MEDICAL LABORATORY SVCS	1667 S MISSION RD	STE E	FALLBROOK	CA	92028	4119	37	06073	33.362262	-117.2493485	San Diego County
88103	Fee-for-Service	1053401125	1053401125	1	1	HTUN, MICHELLE P MD	2/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92977	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
88118	Fee-for-Service	1962427682	1962427682	1	1	HOH, CARL K MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	61309	42	Nuclear Medicine	0	In state provider	None	7625 MESA COLLEGE DR	None	SAN DIEGO	CA	92111	5343	37	06073	32.80089797	-117.1572727	San Diego County
88154	Fee-for-Service	1144828112	1144828112	1	1	HAMILTON, JULIE M NP	1/30/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
88182	Fee-for-Service	1508990227	1508990227	1	1	HOLTKAMP, ALLISON A PSYD	12/26/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	17744 SKY PARK CIRCLE	SUITE 285	IRVINE	CA	92614	6421	30	06059	33.68866483	-117.8555287	Orange County
88200	Fee-for-Service	1487146213	1487146213	1	1	HUMBERT, COLEMAN NP	10/4/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3201 DATA DRIVE	None	RANCHO CORDOVA	CA	95670	7374	34	06067	38.58561	-121.2838875	Sacramento County
88211	Fee-for-Service	1255511424	1255511424	1	1	HAYSLETT-ATKISON, AMBER L LM	12/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
88224	Fee-for-Service	1760454672	1760454672	1	1	HOSPICE OF SANTA CRUZ COUNTY	1/1/1988	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	940 DISC DR	None	SCOTTS VALLEY	CA	95066	4544	44	06087	37.04750055	-122.0155809	Santa Cruz County
88225	Fee-for-Service	1386635787	1386635787	1	1	HONGO, RICHARD H MD	7/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68402	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
88259	Fee-for-Service	1982182127	1982182127	1	1	HARRY CHEN MD INC A	9/17/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	128 N 6TH STREET	None	FOWLER	CA	93625	2332	10	06019	36.63119007	-119.6796956	Fresno County
88271	Fee-for-Service	1528345113	1528345113	1	1	HABIBI, REZA MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120189	30	Radiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
88300	Fee-for-Service	1710118658	1710118658	1	1	HUANG, MEI Z OD	11/4/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2155 IRON POINT ROAD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
88322	Fee-for-Service	1184812596	1184812596	1	1	HAAVISTO, DAWN R LMFT	1/19/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2291 W MARCH LANE	SUITE D200	STOCKTON	CA	95207	6670	39	06077	37.98597497	-121.3344334	San Joaquin County
88335	Fee-for-Service	1114069283	1114069283	1	1	HECTOR, WINSLEY B LMFT	8/31/2018	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
88358	Fee-for-Service	1700010626	1700010626	1	1	HERING, NORMAN C LMFT	8/10/2021	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
88368	Fee-for-Service	1992705818	1992705818	1	1	HERRERA, LAURIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMERGENCY ROOM ASSOCIATE	350 N WILMONT	None	TUCSON	AZ	85711	0000	00	None	32.227209	-110.8556595	Pima County
88370	Fee-for-Service	1073023107	1073023107	1	6	HUMBOLDT RECOVERY CENTER, IN	4/23/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1116 9TH ST	None	EUREKA	CA	95501	1936	12	06023	40.79954785	-124.1584022	Humboldt County
88407	Fee-for-Service	1063765576	1063765576	1	1	HSIEH, GILLIAN L MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134657	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
88452	Fee-for-Service	1750392437	1750392437	1	1	HADLEY, JOHN L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	40172	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
88471	Fee-for-Service	1700374626	1700374626	1	1	HU, BO MD	8/3/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	176965	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
88500	Fee-for-Service	1013156520	1013156520	1	1	HULL, JANICE L MD INC	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80999	None	None	0	In state provider	None	8475 S VAN NESS AVE	SUITE 101	INGLEWOOD	CA	90305	1566	19	06037	33.960645	-118.317798	Los Angeles County
88502	Fee-for-Service	1720549983	1720549983	1	1	HENDERSON, TATYANNA A	4/20/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	181714	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
88531	Fee-for-Service	1396119830	1396119830	2	1	HL PHARMACY	9/28/2018	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	705 EAST ANAHEIM ST	None	LONG BEACH	CA	90813	3507	19	06037	33.78263447	-118.1827035	Los Angeles County
88604	Fee-for-Service	1023038924	1023038924	1	1	HARVEY, RICHARD A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	22974	66	Emergency Medicine (Urgent Care)	0	In state provider	None	75 DIAMOND VALLEY RD	UNIT B	MARKLEEVILLE	CA	96120	9579	02	06003	38.76971302	-119.8167951	Alpine County
88606	Fee-for-Service	1649270653	1649270653	1	1	HELM, DOUGLAS A MD	10/11/1994	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	50409	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	110 N VALERIA ST	STE 308	FRESNO	CA	93701	2168	10	06019	36.74388938	-119.7847725	Fresno County
88625	Fee-for-Service	1326333147	1326333147	1	1	HONG, PAUL S MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149259	20	Orthopedic Surgery	0	In state provider	None	2800 L ST	SUITE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
88639	Fee-for-Service	1770554271	1770554271	1	1	HILDEBRANDT, KURT H MD	10/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	64070	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
88678	Fee-for-Service	1063822310	1063822310	1	1	HEFLEY, ERIN MD	11/7/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	155750	15	Obstetrics (D.O. only)	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
88691	Fee-for-Service	1225651284	1225651284	1	1	HIMURO-FITZGERALD, NICOLE F	1/7/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYD	2001 JUNIPERO SERRA BLVD	STE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
88694	Fee-for-Service	1396796058	1396796058	1	1	HOUPT, WAYNE E MD	10/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	45153	36	Psychiatry	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
88746	Fee-for-Service	1275074197	1275074197	1	1	HUCKERT, GREG M CPO	1/16/2020	1744P3200X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3830 AUBURN BLVD.	A	SACRAMENTO	CA	95821	2136	34	06067	38.63979	-121.3748595	Sacramento County
88763	Fee-for-Service	1235185695	1235185695	1	1	HARANO, RICHARD C MD	7/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	29066	41	Internal Medicine	0	In state provider	None	27871 MEDICAL CENTER RD	STE 200	MISSION VIEJO	CA	92691	6406	30	06059	33.558534	-117.6641255	Orange County
88778	Fee-for-Service	1477904209	1477904209	1	1	HLAING, NGU MD	1/3/2020	207R00000X	NA	Other	026	PHYSICIANS	158098	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	07	06013	37.94947636	-121.7752571	Contra Costa County
88790	Fee-for-Service	1952705725	1952705725	1	1	HEALING HAND FAMILY CARE CLI	4/13/2015	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	INIC	81800 DR. CARREON BLVD	SUITE A	INDIO	CA	92201	5595	33	06065	33.70743053	-116.2372995	Riverside County
88832	Fee-for-Service	1841612082	1841612082	1	1	HI-DESERT MEMORIAL HEALTH	3/16/2016	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	58375 29 PALMS HIGHWAY	None	YUCCA VALLEY	CA	92284	5890	36	06071	34.13141256	-116.3904357	San Bernardino County
88854	Fee-for-Service	1710923560	1710923560	1	1	HANSEN,SONJA E MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	AINSWORTH FAMILY CLINIC	913 E ZERO ST	None	AINSWORTH	NE	69210	0287	00	None	42.54486827	-99.85092754	Brown County
88869	Fee-for-Service	1962475442	1962475442	1	1	HERMENS, DONALD J MD	8/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	89414	10	Gastroenterology (M.D. only)	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
88871	Fee-for-Service	1194762294	1194762294	1	1	HCA HEALTH SERVICES OF	11/1/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	VIRGINIA	1602 SKIPWITH RD	None	RICHMOND	VA	23229	5205	00	None	37.604061	-77.540103	Henrico County
88880	Fee-for-Service	1467490425	1467490425	1	3	HARBOR COMMUNITY CLINIC	1/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	731 SOUTH BEACON STREET	None	SAN PEDRO	CA	90731	3738	19	06037	33.73713	-118.2804675	Los Angeles County
88895	Fee-for-Service	1649270653	1649270653	1	1	HELM, DOUGLAS A MD	10/11/1994	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	50409	15	Obstetrics (D.O. only)	0	In state provider	None	110 N VALERIA ST	STE 308	FRESNO	CA	93701	2168	10	06019	36.74388938	-119.7847725	Fresno County
88905	Fee-for-Service	1104213438	1104213438	1	1	HONDORP, BRIAN MD	5/17/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	148648	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
88907	Fee-for-Service	1174669550	1174669550	1	1	HENDRY D COVELLI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 W IRONWOOD DR	STE 336	COEUR ALENE	ID	83814	0000	00	None	47.69438484	-116.7931559	Kootenai County
88912	Fee-for-Service	1326333147	1326333147	1	1	HONG, PAUL S MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149259	84	Surgery-Head and Neck	0	In state provider	None	2800 L ST	SUITE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
88946	Fee-for-Service	1598778268	1598778268	1	1	HILARIO, ROSA O	3/1/2014	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1700 ALAMEDA ST	None	POMONA	CA	91768	1727	19	06037	34.07825822	-117.7555489	Los Angeles County
88969	Fee-for-Service	1730292483	1730292483	1	1	HOOD, RON L MD	10/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51017	01	General Practice	0	In state provider	None	101 HOSPITAL RD	None	SONORA	CA	95370	5227	55	06109	37.9744944	-120.3778743	Tuolumne County
88970	Fee-for-Service	1194403204	1194403204	1	1	HAYES GUESS CONSULTING, LLC	7/21/2023	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	01	06001	0	0	None
89010	Fee-for-Service	1497214605	1497214605	1	1	HO, LIANNE T MD	9/30/2022	207R00000X	NA	Other	026	PHYSICIANS	177236	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
89019	Fee-for-Service	1578025102	1578025102	1	1	HIS DAUGHTERS HOUSE	9/28/2024	177F00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	11741 STERLING AVE	C2	RIVERSIDE	CA	92503	4954	33	06065	33.89472302	-117.4879737	Riverside County
89028	Fee-for-Service	1124106927	1124106927	1	1	HAMILTON, GRAHAM 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
89033	Fee-for-Service	1942371794	1942371794	1	1	HAYEK, ALBERTO	10/31/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	26609	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
89038	Fee-for-Service	1396833117	1396833117	1	1	HUIE, TIMOTHY Y MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	67390	18	Ophthalmology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
89044	Fee-for-Service	1932187705	1932187705	1	1	HUANG, ANDREW MD	11/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	74999	34	Urology and Urological Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
89057	Fee-for-Service	1184714610	1184714610	1	1	HOODEI, SHIRIN MD	2/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97282	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
89113	Fee-for-Service	1396578761	1396578761	1	1	HUNTER, CATHERINE OT	11/14/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
89116	Fee-for-Service	1841612082	1841612082	1	1	HI-DESERT MEMORIAL HEALTH	3/16/2016	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	58375 29 PALMS HIGHWAY	None	YUCCA VALLEY	CA	92284	5890	36	06071	34.13141256	-116.3904357	San Bernardino County
89133	Fee-for-Service	1245869825	1245869825	1	1	HONG, HELENA Y MD	9/3/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	186453	16	Obstetrics-Gynecology (M.D. Only) Neonatal	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
89135	Fee-for-Service	1275900201	1275900201	1	1	HEREDIA, MARIA G LCSW	11/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8153 BRAMFIELD WAY	None	SACRAMENTO	CA	95829	6000	34	06067	38.46177	-121.343994	Sacramento County
89158	Fee-for-Service	1194762294	1194762294	1	1	HCA HEALTH SERVICES OF	11/1/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	VIRGINIA	1602 SKIPWITH RD	None	RICHMOND	VA	23229	5205	00	None	37.604061	-77.540103	Henrico County
89159	Fee-for-Service	1649596719	1649596719	1	1	HUSSAIN, ZOHAIR A MD	7/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119668	05	Anesthesiology	0	In state provider	None	400 PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
89167	Fee-for-Service	1467490425	1467490425	1	3	HARBOR COMMUNITY CLINIC	1/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	731 SOUTH BEACON STREET	None	SAN PEDRO	CA	90731	3738	19	06037	33.73713	-118.2804675	Los Angeles County
89201	Fee-for-Service	1497372890	1497372890	1	1	HUANG, APRIL S OD	10/11/2021	152W00000X	NA	Other	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
89204	Fee-for-Service	1477681773	1477681773	1	1	HARBOR HEALTH CARE	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9632 ROSE ST	None	BELLFLOWER	CA	90706	6622	19	06037	33.86956004	-118.1282722	Los Angeles County
89207	Fee-for-Service	1003272238	1003272238	1	1	HEALER, CORI N	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
89239	Fee-for-Service	1841382991	1841382991	1	1	HANGER P & O WEST INC	8/15/2007	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1480 SOUTH HARBOR BLVD	SUITE 1	LA HABRA	CA	90631	7534	30	06059	33.91276851	-117.931697	Orange County
89244	Fee-for-Service	1932116514	1932116514	1	1	HARRISON, JOHN T PT	12/17/2023	225100000X	NA	Physical Therapist	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
89255	Fee-for-Service	1730292483	1730292483	1	1	HOOD, RON L MD	10/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51017	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
89265	Fee-for-Service	1508944216	1508944216	1	1	HUI, LAI F MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	50910	68	Hematology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
89274	Fee-for-Service	1982615712	1982615712	1	1	HANGER PROSTHETICS & ORTHOTI	3/1/1996	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	680 PARKRIDGE AVE.	None	NORCO	CA	92860	0001	33	06065	33.89747604	-117.5675762	Riverside County
89304	Fee-for-Service	1073756136	1073756136	1	1	HATFIELD, BRADLEY D MD	7/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114326	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
89306	Fee-for-Service	1639256894	1639256894	1	1	HALLEGUA, DAVID MD APC	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	55599	83	Rheumatology	0	In state provider	None	8737 BEVERLY BLVD	STE 203	LOS ANGELES	CA	90048	1840	19	06037	34.07687959	-118.381876	Los Angeles County
89326	Fee-for-Service	1336266238	1336266238	1	1	HIROYASU, STUART K OD	5/31/1994	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	459 W LINE ST	None	BISHOP	CA	93514	3333	14	06027	37.36140652	-118.398942	Inyo County
89351	Fee-for-Service	1346281748	1346281748	1	1	HORWICH, TAMARA B MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73443	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
89385	Fee-for-Service	1922321561	1922321561	1	1	HERMANSTYNE, KEITH A MD	11/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	115322	-	NOT APPLICABLE	0	In state provider	None	1930 MARKET ST	None	SAN FRANCISCO	CA	94102	6228	38	06075	37.77037155	-122.4255051	San Francisco County
89393	Fee-for-Service	1558927293	1558927293	1	1	HELMS, NIKKI	4/25/2024	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	2801 4TH AVE	None	SAN DIEGO	CA	92103	6207	37	06073	32.73471	-117.1612005	San Diego County
89397	Fee-for-Service	1861594228	1861594228	1	1	HTAY, THEIN MD	1/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	77109	41	Internal Medicine	0	In state provider	None	2208 W 7TH ST	None	LOS ANGELES	CA	90057	4002	19	06037	34.05710805	-118.2782502	Los Angeles County
89422	Fee-for-Service	1306924972	1306924972	1	1	HORNG, GEORGE S MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81295	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
89457	Fee-for-Service	1508082892	1508082892	1	1	HEATHER BORDERS	4/18/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	915 HIGHLAND BLVD	None	BOZEMAN	MT	59715	6902	00	None	45.669708	-111.020157	Gallatin County
89495	Fee-for-Service	1629674619	1629674619	1	1	HARRIS, MEGAN M PSYD	5/3/2021	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
89499	Fee-for-Service	1528497070	1528497070	1	1	HUDGINS, JAY P DO	12/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14379	22	Pathology (M.D. 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
89513	Fee-for-Service	1417213281	1417213281	1	1	HUCKO, ALICE H J MD	12/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151853	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
89518	Fee-for-Service	1356830384	1356830384	1	1	HERZOG, LOUIS NP	4/5/2024	363LP0808X	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
89531	Fee-for-Service	1992744379	1992744379	1	1	HARMON, TERESITA S MD	7/26/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
89553	Fee-for-Service	1508944216	1508944216	1	1	HUI, LAI F MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	50910	78	Neoplastic Diseases/Oncology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
89557	Fee-for-Service	1720488471	1720488471	1	1	HENSEN, SHAWN LCSW	3/4/2025	1041C0700X	NA	Mental Health Outpatient Services	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
89571	Fee-for-Service	1790932010	1790932010	1	1	HSU, ANGELA T MD	10/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	94114	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
89580	Fee-for-Service	1629118989	1629118989	1	1	HAGA, NAOKO LMFT	5/11/2020	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
89596	Fee-for-Service	1639256894	1639256894	1	1	HALLEGUA, DAVID MD APC	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	55599	41	Internal Medicine	0	In state provider	None	8737 BEVERLY BLVD	STE 203	LOS ANGELES	CA	90048	1840	19	06037	34.07687959	-118.381876	Los Angeles County
89599	Fee-for-Service	1295854388	1295854388	1	2	HOME HEALTH 4U INC	10/10/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	15650 DEVONSHIRE ST	SUITE 200	GRANADA HILLS	CA	91344	7245	19	06037	34.2573035	-118.473615	Los Angeles County
89619	Fee-for-Service	1255593174	1255593174	1	1	HAN, CHRISTINA MD	6/25/2020	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	95748	15	Obstetrics (D.O. only)	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
89635	Fee-for-Service	1346281748	1346281748	1	1	HORWICH, TAMARA B MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	73443	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
89648	Fee-for-Service	1952496218	1952496218	1	1	HOO, ROBERT K MD INC	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	78736	None	None	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
89660	Fee-for-Service	1134388218	1134388218	1	1	HUANG, ERICK F DO	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11272	41	Internal Medicine	0	In state provider	None	10862 CALLE VERDE	None	LA MESA	CA	91941	7340	37	06073	32.74823231	-116.9602609	San Diego County
89680	Fee-for-Service	1225186018	1225186018	1	1	HUYNH, DUKE D DO	5/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8541	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
89693	Fee-for-Service	1740343367	1740343367	1	1	HUYNH, THU THUY T MD	3/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93982	None	None	0	In state provider	None	1998 N ARROWHEAD AVE	None	SAN BERNARDINO	CA	92405	4116	36	06071	34.1334	-117.289677	San Bernardino County
89705	Fee-for-Service	1225286008	1225286008	1	1	HUANG, SHAN FU MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13594	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
89717	Fee-for-Service	1972971349	1972971349	1	1	HUANG, MERCY M PHD	5/8/2023	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
89751	Fee-for-Service	1972724391	1972724391	1	1	HUANG, JIN J MD	10/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105561	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVENUE	0648	SAN FRANCISCO	CA	94122	0648	38	06075	37.76332993	-122.4582988	San Francisco County
89761	Fee-for-Service	1073616041	1073616041	1	1	HAWLEY, CHRISTOPHER J MD	3/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82212	08	Family Practice	0	In state provider	None	830 SCENIC DR	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
89779	Fee-for-Service	1356462824	1356462824	1	1	HAUS, BRIAN M MD	6/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123463	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2201	34	06067	38.552211	-121.449429	Sacramento County
89786	Fee-for-Service	1114988847	1114988847	1	1	HOME OF GUIDING HANDS	12/1/1988	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10045 ANJA PL	None	LAKESIDE	CA	92040	2715	37	06073	32.85999594	-116.9605588	San Diego County
89794	Fee-for-Service	1174918122	1174918122	1	1	HAMMER, LAUREN H MD	6/22/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	167920	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
89806	Fee-for-Service	1528632437	1528632437	1	1	HINES, REBECCA L NP	9/8/2021	363LP0222X	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
89819	Fee-for-Service	1740450956	1740450956	1	1	HSU, SHERRY X MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111271	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
89827	Fee-for-Service	1639766462	1639766462	1	1	HILLHURST HOSPICE INC	12/6/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1670 HILLHURST AVE	SUITE 203	LOS ANGELES	CA	90027	5584	19	06037	34.101495	-118.2873905	Los Angeles County
89828	Fee-for-Service	1174536726	1174536726	1	1	HARWER, OLINA E MD	10/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40090	08	Family Practice	0	In state provider	None	32241 CAMINO CAPISTRANO	STE 105	SAN JUAN CAPISTRA	CA	92675	3708	30	06059	33.49431861	-117.6626549	Orange County
89845	Fee-for-Service	1518292747	1518292747	1	1	HEARTHSTONE OPERATOR LLC	8/5/2013	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	1	Border provider	None	2901 E BARNETT RD	None	MEDFORD	OR	97504	8308	00	None	42.31648546	-122.8278645	Jackson County
89858	Fee-for-Service	1861862906	1861862906	3	1	HOANG, MARY KIM OD	5/20/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1102 IRVINE BLVD	None	TUSTIN	CA	92780	3529	30	06059	33.74822099	-117.8105618	Orange County
89868	Fee-for-Service	1962497289	1962497289	1	1	HSU, KEVIN M MD	8/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73444	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
89874	Fee-for-Service	1659468759	1659468759	1	1	HARRIS, CHRISTOPHER E MD	2/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88204	40	Pediatrics	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1865	19	06037	34.07671715	-118.3799413	Los Angeles County
89891	Fee-for-Service	1104928852	1104928852	1	1	HUDNUT, ANDREW G MD	8/7/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66215	08	Family Practice	0	In state provider	None	8170 LAGUNA BLVD	STE 304	ELK GROVE	CA	95758	7903	34	06067	38.421054	-121.405365	Sacramento County
89897	Fee-for-Service	1275712408	1275712408	1	2	HORWOOD, KERYN J LMFT	5/21/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
89899	Fee-for-Service	1558483479	1558483479	1	1	HUIBERS, ANAMARIA P LMFT	6/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
89912	Fee-for-Service	1295775237	1295775237	1	1	HALSEY, WILLIAM T MD INC	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	37471	05	Anesthesiology	0	In state provider	None	45 CASTRO ST	None	SAN FRANCISCO	CA	94114	1010	38	06075	37.76829732	-122.4357056	San Francisco County
89923	Fee-for-Service	1497750244	1497750244	1	1	HENRY COUNTY GEN HOSP	9/16/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	301 TYSON AVE	None	PARIS	TN	38242	1030	00	None	36.29690253	-88.31126758	Henry County
89957	Fee-for-Service	1659344802	1659344802	1	1	HUANG, ANTHONY J OD	8/1/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14329 WOODRUFF AVE	STE E	BELLFLOWER	CA	90706	3260	19	06037	33.90123788	-118.1167412	Los Angeles County
89958	Fee-for-Service	1972735165	1972735165	1	1	HAFKENSCHEID, CATHERINE J	8/21/2009	163WP0200X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2680 STANBRIDGE AVE	None	LONG BEACH	CA	90815	1233	19	06037	33.80497058	-118.1292751	Los Angeles County
89960	Fee-for-Service	1720033483	1720033483	1	1	HASTINGS, GEOFFREY S MD	9/1/2000	2085R0204X	NA	Other	026	PHYSICIANS	75634	30	Radiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
90018	Fee-for-Service	1740351774	1740351774	1	1	HAENDEL, MARK S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	31355	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
90028	Fee-for-Service	1497226906	1497226906	1	1	HAYWARD, HSIEN PHD	7/23/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	333 BRADFORD	STE 270	REDWOOD CITY	CA	94063	1571	41	06081	37.48799425	-122.2320157	San Mateo County
90056	Fee-for-Service	1013415116	1013415116	1	1	HAYSBERT, CONNOR W MD	6/19/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	183499	None	None	0	In state provider	None	2621 10TH	None	BERKELEY	CA	94710	2674	01	06001	37.85811852	-122.2898175	Alameda County
90058	Fee-for-Service	1376682070	1376682070	1	1	HORVATH, AGNES G MD	1/16/2004	2080P0207X	NA	Hematology	026	PHYSICIANS	48541	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
90095	Fee-for-Service	1427114511	1427114511	1	1	HATCH, JOHN F 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
90113	Fee-for-Service	1639766462	1639766462	1	1	HILLHURST HOSPICE INC	12/6/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1670 HILLHURST AVE	SUITE 203	LOS ANGELES	CA	90027	5584	19	06037	34.101495	-118.2873905	Los Angeles County
90125	Fee-for-Service	1538168174	1538168174	1	1	HMAYAKYAN, SAMVEL MD	4/1/2001	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66625	01	General Practice	0	In state provider	None	1133 S CENTRAL AVE	None	GLENDALE	CA	91204	2212	19	06037	34.132356	-118.2578485	Los Angeles County
90128	Fee-for-Service	1962820621	1962820621	1	1	HAWKINS, PETER MD	10/23/2019	2085R0001X	NA	Other	026	PHYSICIANS	161883	None	None	0	In state provider	None	301 PROFESSIONAL CENTER	None	ROHNERT PARK	CA	94928	2152	49	06097	38.35471913	-122.7076253	Sonoma County
90151	Fee-for-Service	1396873493	1396873493	1	1	HUSTED, JOHN D MD	4/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	68530	02	General Surgery	0	In state provider	None	3660 PARK SIERRA DR	STE 105	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
90203	Fee-for-Service	1689722993	1689722993	1	1	HALL, ROGER V MD	11/30/1995	208G00000X	NA	General Surgery	026	PHYSICIANS	-	33	Thoracic Surgery	1	Border provider	None	2954 SISKIYOU BLVD	None	MEDFORD	OR	97504	8161	00	None	42.31932447	-122.8263165	Jackson County
90209	Fee-for-Service	1497750244	1497750244	1	1	HENRY COUNTY GEN HOSP	9/16/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	301 TYSON AVE	None	PARIS	TN	38242	1030	00	None	36.29690253	-88.31126758	Henry County
90237	Fee-for-Service	1922219880	1922219880	1	1	HILTON, KEVIN R MD INC	11/7/2013	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	79838	20	Orthopedic Surgery	0	In state provider	None	576 N SUNRISE AVE	STE 230A	ROSEVILLE	CA	95661	2847	31	06061	38.75781026	-121.253352	Placer County
90244	Fee-for-Service	1013904424	1013904424	1	1	HABIBIPOUR, SAIED MD	8/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80162	01	General Practice	0	In state provider	None	1180 N INDIAN CANYON DR	STE E318	PALM SPRINGS	CA	92262	4809	33	06065	33.839505	-116.5455735	Riverside County
90248	Fee-for-Service	1972735165	1972735165	1	1	HAFKENSCHEID, CATHERINE J	8/21/2009	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2680 STANBRIDGE AVE	None	LONG BEACH	CA	90815	1233	19	06037	33.80497058	-118.1292751	Los Angeles County
90263	Fee-for-Service	1255325577	1255325577	1	1	HNATKO, CRYSTAL L DO	1/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11584	08	Family Practice	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
90285	Fee-for-Service	1164439386	1164439386	1	1	HAQQANI, MOHAMMED S MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97552	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
90329	Fee-for-Service	1316986045	1316986045	1	1	HO, JEFFREY T DO	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8218	25	Physical Medicine and Rehabilitation	0	In state provider	None	2840 LONG BEACH BLVD	STE 130	LONG BEACH	CA	90806	1593	19	06037	33.808743	-118.189341	Los Angeles County
90335	Fee-for-Service	1548766488	1548766488	1	1	HASHIM, BROCK W MD	7/5/2022	207P00000X	NA	Other	026	PHYSICIANS	166380	None	None	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
90343	Fee-for-Service	1235570656	1235570656	1	1	HERRERA, JENNIFER LCSW	10/4/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
90345	Fee-for-Service	1376682070	1376682070	1	1	HORVATH, AGNES G MD	1/16/2004	2080P0207X	NA	Hematology	026	PHYSICIANS	48541	68	Hematology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
90395	Fee-for-Service	1487732566	1487732566	1	1	HASHIMOTO, GARY MD	3/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	63378	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
90416	Fee-for-Service	1417988783	1417988783	1	1	HARRIS, JEFFREY PAUL MD	10/2/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	39264	04	Otology, Laryngology, Rhinology	0	In state provider	None	225 DICKINSON ST	# H211	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
90421	Fee-for-Service	1629452099	1629452099	1	1	HA, DAVID DO	10/13/2021	207L00000X	NA	Other	026	PHYSICIANS	18427	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
90448	Fee-for-Service	1093880171	1093880171	1	1	HONG, NICOLE J MD	6/30/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77957	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
90458	Fee-for-Service	1275761553	1275761553	1	1	HERRERA, ALEX F MD	9/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130569	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
90459	Fee-for-Service	1487677449	1487677449	1	1	HIMAYA, PAUL J MD	7/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83118	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
90468	Fee-for-Service	1699890947	1699890947	1	1	HEDRICK, REBECCA M MD	12/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86544	36	Psychiatry	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
90472	Fee-for-Service	1104976661	1104976661	1	1	HOMAN, STEPHEN E DO	7/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12755	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1117 E DEVONSHIRE AVENUE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
90489	Fee-for-Service	1649050097	1649050097	1	1	HOBBS, KAITLIN	2/18/2025	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
90530	Fee-for-Service	1174053318	1174053318	1	1	HENNESSY, MORGAN L MD	8/16/2023	208600000X	NA	General Surgery	026	PHYSICIANS	187629	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
90551	Fee-for-Service	1912464058	1912464058	1	1	HERBENICK, SARA K CNP	9/4/2019	363LF0000X	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
90566	Fee-for-Service	1033117734	1033117734	1	2	HOLY ANGEL HOME HEALTH CARE	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	3470 WILSHIRE BLVD	SUITE 641-642	LOS ANGELES	CA	90010	2207	19	06037	34.06172649	-118.299546	Los Angeles County
90572	Fee-for-Service	1891317954	1891317954	1	1	HORWITZ, ALEXANDER MD	3/4/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	181639	None	None	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
90619	Fee-for-Service	1316986045	1316986045	1	1	HO, JEFFREY T DO	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8218	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2840 LONG BEACH BLVD	STE 130	LONG BEACH	CA	90806	1593	19	06037	33.808743	-118.189341	Los Angeles County
90634	Fee-for-Service	1780273417	1780273417	1	1	HILLHURST HOME HEALTH CARE I	6/26/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1670 HILLHURST AVE	STE 202	LOS ANGELES	CA	90027	5584	19	06037	34.101495	-118.2873905	Los Angeles County
90667	Fee-for-Service	1033476452	1033476452	1	1	HARRIS, MIRIAM I MD	11/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129594	01	General Practice	0	In state provider	None	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
90676	Fee-for-Service	1023379260	1023379260	1	1	HERNESS, JOEL E MD	5/9/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182768	None	None	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
90707	Fee-for-Service	1962447961	1962447961	1	1	HEINEN, GREGORY T MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81061	20	Orthopedic Surgery	0	In state provider	None	4444 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4136	33	06065	33.97614344	-117.3797664	Riverside County
90724	Fee-for-Service	1942705751	1942705751	1	1	HALL, KAITLIN M MD	5/28/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	166838	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
90733	Fee-for-Service	1972085694	1972085694	1	1	HARRIS, MADISON OT	8/5/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	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
90753	Fee-for-Service	1265478911	1265478911	1	1	HAMZA, HEATHER CRNA	7/1/2003	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
90773	Fee-for-Service	1396479028	1396479028	1	1	HABIBI, SHABNAM OD	10/6/2022	390200000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	855 W FOOTHILL BLVD	None	MONROVIA	CA	91016	1938	19	06037	34.1511692	-118.0177106	Los Angeles County
90845	Fee-for-Service	1245471275	1245471275	1	1	HUOH, KEVIN CHUNG-KAI MD	9/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106715	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	4203	30	06059	33.78077578	-117.8673468	Orange County
90866	Fee-for-Service	1053585935	1053585935	1	1	HARMINDER,GANDHOK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	875 OAK ST SE	STE 5080	SALEM	OR	97301	0000	00	None	44.933598	-123.0339735	Marion County
90886	Fee-for-Service	1649710062	1649710062	1	1	HOBBS, SAMUEL D MD	5/19/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	172237	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
90913	Fee-for-Service	1245875749	1245875749	1	1	HOSPICE AND PALLIATIVE CARE	7/1/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	OF CALIFORNIA, INC	1007 N LAKE AVE	STE A	PASADENA	CA	91104	2340	19	06037	34.163244	-118.132517	Los Angeles County
90931	Fee-for-Service	1487854964	1487854964	1	1	HINDI, AMJAD MD	4/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145162	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
90941	Fee-for-Service	1073023107	1073023107	1	1	HUMBOLDT RECOVERY CENTER, IN	4/22/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1219 10TH ST	None	EUREKA	CA	95501	2024	12	06023	40.79900809	-124.157158	Humboldt County
90944	Fee-for-Service	1104945542	1104945542	1	1	HERVEY-JUMPER, SHAWN L MD	10/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124755	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
90958	Fee-for-Service	1780975029	1780975029	1	1	HARRINGTON, JAMIE K MD	9/28/2022	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	181413	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
90972	Fee-for-Service	1366479123	1366479123	1	1	HARDIN, EUGENE MD	7/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	32643	41	Internal Medicine	0	In state provider	None	357 E CARSON ST	STE 102	CARSON	CA	90745	2766	19	06037	33.83173847	-118.2703815	Los Angeles County
90974	Fee-for-Service	1245868587	1245868587	1	1	HUYNH, NANCY DO	8/10/2022	207P00000X	NA	Other	026	PHYSICIANS	19872	None	None	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
91004	Fee-for-Service	1891843785	1891843785	1	1	HINDS, STUART C MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61146	36	Psychiatry	0	In state provider	None	1000 W CARSON ST	None	TORRANCE	CA	90502	2004	19	06037	33.83155851	-118.2920625	Los Angeles County
91057	Fee-for-Service	1699889766	1699889766	1	1	HERNANDEZ, VIVIAN S MD	3/16/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	42420	40	Pediatrics	0	In state provider	None	4770 W HERNDON AVE	None	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
91074	Fee-for-Service	1457878027	1457878027	1	1	HUIE, CHARLOTTE J NP	12/15/2017	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
91075	Fee-for-Service	1780944199	1780944199	1	1	HERM MED TRANS, INC	10/22/2012	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1887 S BUSINESS CENTER	SUITE 6	SAN BERNARDINO	CA	92408	3400	36	06071	34.06775227	-117.2802835	San Bernardino County
91094	Fee-for-Service	1518228782	1518228782	1	1	HONG, KRISTIE S	8/11/2017	No Taxonomy Provided	NA	None	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
91096	Fee-for-Service	1295244796	1295244796	1	1	HUNDLEY, LANCE	2/27/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1676 EAST 6TH ST	None	BEAUMONT	CA	92223	2550	33	06065	33.92948188	-116.9484306	Riverside County
91125	Fee-for-Service	1992195416	1992195416	1	1	HALILI, ELMA	4/8/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3555 WHIPPLE RD	BLDG A	UNION CITY	CA	94587	1521	01	06001	37.60574038	-122.0836254	Alameda County
91143	Fee-for-Service	1669685673	1669685673	1	1	HARIRI, ARVIN MD	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100284	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
91163	Fee-for-Service	1831305879	1831305879	1	1	HERNANDEZ, NANCY S DO	5/6/2010	207R00000X	NA	Other	026	PHYSICIANS	9829	45	Nephrology (Renal-Kidney)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
91199	Fee-for-Service	1245875749	1245875749	1	1	HOSPICE AND PALLIATIVE CARE	7/1/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	OF CALIFORNIA, INC	1007 N LAKE AVE	STE A	PASADENA	CA	91104	2340	19	06037	34.163244	-118.132517	Los Angeles County
91220	Fee-for-Service	1588054076	1588054076	1	1	HANA HOLISTIC MEDICAL CENTER	10/23/2015	193400000X	NA	Other	026	PHYSICIANS	73394	41	Internal Medicine	0	In state provider	None	2107 CHANNING WAY	None	BERKELEY	CA	94704	2020	01	06001	37.86586772	-122.2670937	Alameda County
91229	Fee-for-Service	1801815428	1801815428	1	1	HARRIS, THOMAS G MD	9/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90250	20	Orthopedic Surgery	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3229	19	06037	34.133598	-118.1534895	Los Angeles County
91270	Fee-for-Service	1841378494	1841378494	1	1	HOWSON, PATRICIA M MD	6/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	42950	20	Orthopedic Surgery	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
91281	Fee-for-Service	1871507020	1871507020	1	1	HARTNETT, MARY ELIZABETH MD	5/31/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	185717	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
91292	Fee-for-Service	1386207801	1386207801	1	1	HOLLOWAY, JOHN J DO	7/2/2024	390200000X	NA	Other	026	PHYSICIANS	22658	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
91315	Fee-for-Service	1750361077	1750361077	1	1	HINZ, PATRICIA G MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77310	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
91318	Fee-for-Service	1346685864	1346685864	1	1	HEMSTREET, JOANN LCSW	10/8/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	64009	-	NOT APPLICABLE	0	In state provider	None	2330 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2220	19	06037	34.0681396	-118.2738016	Los Angeles County
91341	Fee-for-Service	1679717250	1679717250	1	1	HUANG, GENE O MD	9/5/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	113169	34	Urology and Urological 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
91351	Fee-for-Service	1881709210	1881709210	1	1	HOLLEMON, MARK R DO	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14383	41	Internal Medicine	0	In state provider	None	450 EAST ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
91390	Fee-for-Service	1538119292	1538119292	1	1	HEJAZI, NAZILA MD	6/7/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	90468	22	Pathology (M.D. only)	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
91392	Fee-for-Service	1992126965	1992126965	1	1	HATA, ANDREA L NP	12/16/2020	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
91407	Fee-for-Service	1124261854	1124261854	1	1	HUNTINGTON PARK DIALYSIS LLC	1/28/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	5942 RUGBY AVE	None	HUNTINGTON PARK	CA	90255	2803	19	06037	33.98795179	-118.2265484	Los Angeles County
91451	Fee-for-Service	1689098501	1689098501	1	1	HEREDIA, KARLA P LMFT	6/19/2018	No Taxonomy Provided	NA	None	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
91456	Fee-for-Service	1225558349	1225558349	1	1	HAMLIN, FORREST R DO	10/18/2022	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	17023	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
91490	Fee-for-Service	1326477217	1326477217	1	1	HERBERS, RACHEL L A NP	5/11/2018	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
91495	Fee-for-Service	1457811929	1457811929	1	1	HOLTZMAN, JESSICA N MD	10/10/2022	207R00000X	NA	Other	026	PHYSICIANS	177031	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
91529	Fee-for-Service	1386619922	1386619922	1	1	HUDSON, PETER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EMERGENCY PHYS AT PORTER	7852 S ELATI ST, STE 101	None	LITTLETON	CO	80127	0000	00	None	39.575232	-104.997042	Arapahoe County
91544	Fee-for-Service	1821174137	1821174137	1	1	HAMILTON, SHAWN H MD INC	1/1/1998	207R00000X	NA	Other	026	PHYSICIANS	60652	41	Internal Medicine	0	In state provider	None	4902 IRVINE CENTER DR	STE 105	IRVINE	CA	92604	3334	30	06059	33.68521738	-117.786657	Orange County
91548	Fee-for-Service	1992851083	1992851083	2	1	HYUNDAI DRUGS	9/25/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	461 S WESTERN AVE	None	LOS ANGELES	CA	90020	4102	19	06037	34.065486	-118.309136	Los Angeles County
91552	Fee-for-Service	1619469509	1619469509	1	1	HILLHOUSE, KRISTINA L LCSW	7/1/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2500 MILVIA ST	None	BERKELEY	CA	94704	2636	01	06001	37.86338897	-122.2698455	Alameda County
91584	Fee-for-Service	1154818797	1154818797	1	1	HASTIE, ELIZABETH B MD	1/21/2022	207R00000X	NA	Other	026	PHYSICIANS	166345	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
91614	Fee-for-Service	1720028962	1720028962	1	1	HSIEH, ANNA MD	11/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86059	05	Anesthesiology	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
91630	Fee-for-Service	1750040465	1750040465	1	1	HOMETOWN MEDICAL SUPPLIES,	11/29/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	4873 WEST LN ST	STE C	STOCKTON	CA	95210	4548	39	06077	37.99861886	-121.289451	San Joaquin County
91644	Fee-for-Service	1538144563	1538144563	1	1	HASSON, RICHARD M MD	6/1/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
91651	Fee-for-Service	1922252873	1922252873	1	1	HITSELBERGER, JILL A PSYD	7/14/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	18621	-	NOT APPLICABLE	0	In state provider	None	1680 N FAIR OAKS AVE	None	PASADENA	CA	91103	1642	19	06037	34.17483072	-118.150706	Los Angeles County
91692	Fee-for-Service	1336224401	1336224401	1	1	HUNTER EMS INC.	9/21/2016	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	40 SHERIDAN BLVD	None	INWOOD	NY	11096	1817	00	None	40.61241	-73.752831	Nassau County
91714	Fee-for-Service	1295762409	1295762409	1	1	HESSELTINE, STEPHEN M MD	6/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94552	None	None	0	In state provider	None	2151 APPIAN WAY	None	PINOLE	CA	94564	2514	07	06013	37.99738125	-122.3013414	Contra Costa County
91715	Fee-for-Service	1477990521	1477990521	1	1	HERMANN, MATTHEW D MD	11/1/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	154369	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
91719	Fee-for-Service	1194050302	1194050302	1	1	HERNANDEZ, MAYRA Y LMFT	6/23/2020	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
91760	Fee-for-Service	1285122549	1285122549	1	1	HICKS, MARIA D LMFT	5/10/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23470 OLIVE WOOD PLAZA D	110	MORENO VALLEY	CA	92553	5264	33	06065	33.94013493	-117.2532525	Riverside County
91769	Fee-for-Service	1205989258	1205989258	1	1	HURVITZ, KEITH A MD	6/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74511	24	Plastic Surgery	0	In state provider	None	2880 ATLANTIC AVE	STE 290	LONG BEACH	CA	90806	1716	19	06037	33.809382	-118.185001	Los Angeles County
91770	Fee-for-Service	1518046242	1518046242	1	1	HUYNH,VAN KHANH MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71111	41	Internal Medicine	0	In state provider	None	2055 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.60261141	-121.392277	Sacramento County
91781	Fee-for-Service	1497122477	1497122477	1	1	HOME, MIRIAM A LMFT	7/15/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	205 E 3RD AVE	STE 409	SAN MATEO	CA	94401	4050	41	06081	37.565161	-122.3229376	San Mateo County
91788	Fee-for-Service	1164445938	1164445938	1	1	HAMILTON,JOY M MD	6/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78847	25	Physical Medicine and Rehabilitation	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
91814	Fee-for-Service	1184011066	1184011066	1	1	HUGHES, JEFFREY R MD	11/14/2018	207R00000X	NA	Other	026	PHYSICIANS	149006	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
91816	Fee-for-Service	1063026060	1063026060	1	1	HARMONY CARE CORPORATION	6/10/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4193 TERESA AVE	None	CYPRESS	CA	90630	5457	30	06059	33.8108335	-118.059948	Orange County
91860	Fee-for-Service	1720399298	1720399298	1	1	HEINTZ, JACQUE A LMFT	10/8/2021	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
91865	Fee-for-Service	1750588836	1750588836	1	2	HEFFERNAN, MICHAEL J MD	1/31/2022	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	119411	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
91884	Fee-for-Service	1720147341	1720147341	1	1	HWANG, PAUL S MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	63153	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
91926	Fee-for-Service	1376170498	1376170498	1	1	HASHIM, SALMAN M MD	4/11/2025	2084N0400X	NA	Neurology	026	PHYSICIANS	187231	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
91936	Fee-for-Service	1952385874	1952385874	1	1	HARRINGTON, JAMES S MD	1/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	87045	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
91939	Fee-for-Service	1033696786	1033696786	1	1	HASIN, MELISSA LMFT	3/14/2025	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST 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
91947	Fee-for-Service	1043308745	1043308745	1	1	HSIA, ROSALIND A MD	10/31/1992	2084N0400X	NA	Neurology	026	PHYSICIANS	40222	13	Neurology (M.D. only)	0	In state provider	None	3319 J ST	None	SACRAMENTO	CA	95816	4502	34	06067	38.572101	-121.4621505	Sacramento County
91969	Fee-for-Service	1134408958	1134408958	1	1	HIGHT, MEGAN J OT	9/25/2020	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2115 J ST	SUITE 210	SACRAMENTO	CA	95816	4738	34	06067	38.576475	-121.4777745	Sacramento County
91974	Fee-for-Service	1346398294	1346398294	1	1	HUFNAGEL-PINNEY, BIRGITT	5/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53494	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
92005	Fee-for-Service	1619976800	1619976800	1	1	HIRSCH, CALEB W MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62063	41	Internal Medicine	0	In state provider	None	23101 SHERMAN PL	STE 500	WEST HILLS	CA	91307	2038	19	06037	34.20099112	-118.6297991	Los Angeles County
92013	Fee-for-Service	1538402516	1538402516	1	1	HELLER, ANDREAS MD INC	5/1/2013	207R00000X	NA	Other	026	PHYSICIANS	84414	41	Internal Medicine	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	9860	10	06019	36.83626596	-119.7674879	Fresno County
92053	Fee-for-Service	1801972401	1801972401	1	1	HSU, THOMAS K MD	12/1/1984	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	36335	01	General Practice	0	In state provider	None	13768 ROSWELL AVE	# 117	CHINO	CA	91710	1402	36	06071	34.0038	-117.7218555	San Bernardino County
92056	Fee-for-Service	1205989258	1205989258	1	1	HURVITZ, KEITH A MD	6/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74511	04	Otology, Laryngology, Rhinology	0	In state provider	None	2880 ATLANTIC AVE	STE 290	LONG BEACH	CA	90806	1716	19	06037	33.809382	-118.185001	Los Angeles County
92076	Fee-for-Service	1184071441	1184071441	1	1	HUSSAIN, YASIN MD	8/18/2023	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	186105	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
92078	Fee-for-Service	1407578024	1407578024	1	1	HINOJOS, SUSAN LMFT	10/29/2024	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
92089	Fee-for-Service	1538462080	1538462080	1	1	HUYNH, VAN T MD	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93585	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	93868	3874	30	06059	33.78077578	-117.8673468	Orange County
92094	Fee-for-Service	1528556297	1528556297	1	1	HURTT, WILLIAM DPM	5/1/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	700 W OLIVE AVE	SUITE C	MERCED	CA	95348	2435	24	06047	37.31918006	-120.480202	Merced County
92147	Fee-for-Service	1558752907	1558752907	1	1	HALBACH, EMILIE H MD	9/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	161992	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
92169	Fee-for-Service	1790868982	1790868982	1	1	HUMILITY OF MARY HEALTH	7/10/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	PARTNERS	8401 MARKET STREET	None	BOARDMAN	OH	44512	6777	00	None	40.994469	-80.6599575	Mahoning County
92184	Fee-for-Service	1427104777	1427104777	1	1	HUENEME SCHOOL DISTRICT	7/8/1997	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	205 N VENTURA RD	None	PORT HUENEME	CA	93041	3084	56	06111	34.14916135	-119.1956507	Ventura County
92203	Fee-for-Service	1790097004	1790097004	1	1	HOUR, BILLY T MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125737	45	Nephrology (Renal-Kidney)	0	In state provider	None	11550 INDIAN HILLS ROAD	SUITE 371	MISSION HILLS	CA	91345	1252	19	06037	34.28024575	-118.4588775	Los Angeles County
92216	Fee-for-Service	1760524979	1760524979	1	1	HARSH IV, GRIFFITH R MD	7/31/1985	207T00000X	NA	General Surgery	026	PHYSICIANS	46537	14	Neurological Surgery	0	In state provider	None	1001 POTRERO AVE	# 4M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
92231	Fee-for-Service	1457382079	1457382079	1	1	HEIFETZ, LAURENCE J MD	4/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	26341	78	Neoplastic Diseases/Oncology	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
92235	Fee-for-Service	1609055300	1609055300	1	1	HAN, NANCY J MD	8/31/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99261	41	Internal Medicine	0	In state provider	None	19066 MAGNOLIA ST	None	HUNTINGTON BEACH	CA	92646	2232	30	06059	33.68568661	-117.9714001	Orange County
92236	Fee-for-Service	1407914260	1407914260	1	16	HILL COUNTRY COMM CLINIC	7/22/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3270 CHURN CREEK ROAD	None	REDDING	CA	96002	2504	45	06089	40.560021	-122.353087	Shasta County
92264	Fee-for-Service	1932540671	1932540671	1	1	HORMOZI, LINDA MD	8/14/2018	207L00000X	NA	Other	026	PHYSICIANS	144706	05	Anesthesiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
92273	Fee-for-Service	1730683483	1730683483	1	1	HARTLEY, ANGELA BIRTH DOULA	9/7/2024	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	44	06087	0	0	None
92276	Fee-for-Service	1376553891	1376553891	1	1	HU, BOB S MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	56747	06	Cardiovascular Disease (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
92329	Fee-for-Service	1669974689	1669974689	1	1	HOSSEIN EFTEKHARI MD	4/27/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3630 IMPERIAL HWY	None	LYNWOOD	CA	90262	0000	19	06037	33.93112671	-118.2035532	Los Angeles County
92351	Fee-for-Service	1891749131	1891749131	1	1	HARTER, LAWRENCE P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37266	01	General Practice	0	In state provider	None	345 S A ST	None	OXNARD	CA	93030	5804	56	06111	34.19938431	-119.1786013	Ventura County
92391	Fee-for-Service	1205818465	1205818465	1	1	HOLE, JAMES W DO	9/23/2019	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	17508	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
92401	Fee-for-Service	1851475594	1851475594	1	1	HAVUNJIAN, RICHARD H MD	2/1/1996	207W00000X	NA	Ophthalmology	026	PHYSICIANS	63659	18	Ophthalmology	0	In state provider	None	1500 S CENTRAL AVE	STE 221	GLENDALE	CA	91204	2555	19	06037	34.12736888	-118.257777	Los Angeles County
92424	Fee-for-Service	1902379993	1902379993	1	1	HOBSON, GAIL M NP	3/10/2020	363LF0000X	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
92458	Fee-for-Service	1790868982	1790868982	1	1	HUMILITY OF MARY HEALTH	7/10/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	PARTNERS	8401 MARKET STREET	None	BOARDMAN	OH	44512	6777	00	None	40.994469	-80.6599575	Mahoning County
92481	Fee-for-Service	1790707883	1790707883	1	1	HEFFEL, DOMINIC F MD	1/1/1998	208600000X	NA	General Surgery	026	PHYSICIANS	62093	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
92490	Fee-for-Service	1750498010	1750498010	1	1	HUMBOLDT GENERAL HOSP	3/17/2010	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	118 E HASKELL ST	None	WINNEMUCCA	NV	89445	3247	00	None	40.97178964	-117.7282344	Humboldt County
92491	Fee-for-Service	1790097004	1790097004	1	1	HOUR, BILLY T MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125737	41	Internal Medicine	0	In state provider	None	11550 INDIAN HILLS ROAD	SUITE 371	MISSION HILLS	CA	91345	1252	19	06037	34.28024575	-118.4588775	Los Angeles County
92503	Fee-for-Service	1669762001	1669762001	1	1	HSIEH, BRIAN J D MD	8/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123006	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
92523	Fee-for-Service	1174153787	1174153787	1	1	HOLISTIC CARE HOSPICE AND	3/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE SERVICES INC	7037 LAUREL CANYON BLVD	UNIT 102	NORTH HOLLYWOOD	CA	91605	5738	19	06037	34.198704	-118.3965295	Los Angeles County
92528	Fee-for-Service	1407914260	1407914260	1	16	HILL COUNTRY COMM CLINIC	7/22/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3270 CHURN CREEK ROAD	None	REDDING	CA	96002	2504	45	06089	40.560021	-122.353087	Shasta County
92534	Fee-for-Service	1477121762	1477121762	1	1	HERMAN, RACHEL PT	10/5/2021	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
92537	Fee-for-Service	1669459392	1669459392	1	1	HAIMES, ALISON B MD	5/7/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	86684	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
92549	Fee-for-Service	1669967006	1669967006	1	1	HAPPY LIFE HOME HEALTH CARE	2/21/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	225 EAST BROADWAY ST	STE 203	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
92559	Fee-for-Service	1205943131	1205943131	1	1	HENDRICK, VICTORIA C MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	72458	36	Psychiatry	0	In state provider	None	300 MEDICAL PLZ	None	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
92588	Fee-for-Service	1922879675	1922879675	1	1	HANSON, RACHEL J DOULA	4/7/2024	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	12	06023	0	0	None
92593	Fee-for-Service	1700984911	1700984911	1	1	HEIDENFELDER, RICHARD P	2/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	79836	36	Psychiatry	0	In state provider	MD, INC	830 ORANGE AVE	STE A3	CORONADO	CA	92118	2658	37	06073	32.68811587	-117.1787057	San Diego County
92601	Fee-for-Service	1689862401	1689862401	1	1	HILL, MICAH J MD	5/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88742	04	Otology, Laryngology, Rhinology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
92609	Fee-for-Service	1508804808	1508804808	1	1	HILLIARD, CLARENCE R III PHD	12/28/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3330 HEIGHTS DR	STE 120	CAMERON PARK	CA	95682	9614	09	06017	38.66076236	-120.981666	El Dorado County
92637	Fee-for-Service	1891749131	1891749131	1	1	HARTER, LAWRENCE P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37266	30	Radiology	0	In state provider	None	345 S A ST	None	OXNARD	CA	93030	5804	56	06111	34.19938431	-119.1786013	Ventura County
92658	Fee-for-Service	1851300032	1851300032	1	1	HOLTOM, PAUL D MD	7/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	44895	41	Internal Medicine	0	In state provider	None	1300 S SUNSET AVE	None	WEST COVINA	CA	91790	3342	19	06037	34.0601054	-117.9474205	Los Angeles County
92677	Fee-for-Service	1205818465	1205818465	1	1	HOLE, JAMES W DO	9/23/2019	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	17508	15	Obstetrics (D.O. only)	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
92696	Fee-for-Service	1639634777	1639634777	1	1	HANCOCK, STEPHANIE F NP	7/29/2019	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2547 W SHAW AVE	STE 117	FRESNO	CA	93711	3321	10	06019	36.80804173	-119.8385565	Fresno County
92701	Fee-for-Service	1205896206	1205896206	1	1	HA, TAM T MD	6/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	42997	40	Pediatrics	0	In state provider	None	756 E HOLT AVE	None	POMONA	CA	91767	5628	19	06037	34.06269352	-117.7357635	Los Angeles County
92705	Fee-for-Service	1144616590	1144616590	1	1	HADDOCK, LINDSEY M MD	2/5/2020	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	156235	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
92728	Fee-for-Service	1417310897	1417310897	1	1	HATCH, KATIE L MD	8/11/2020	390200000X	NA	Other	026	PHYSICIANS	154525	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
92738	Fee-for-Service	1760917397	1760917397	1	1	HUANG, JEFFREY H MD	6/1/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176393	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
92739	Fee-for-Service	1780095802	1780095802	1	1	HOOPER, JESSICA M MD	7/9/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	162814	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
92743	Fee-for-Service	1629182845	1629182845	1	1	HAMMOND, JAMES L OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10850 ARROW ROUTE	None	RANCHO CUCAMONGA	CA	91730	4833	36	06071	34.0991609	-117.5680267	San Bernardino County
92744	Fee-for-Service	1730571928	1730571928	1	1	HOPE SPEECH AND LANGUAGE THE	1/22/2020	103K00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	RAPY, INC.	41760 IVY ST	SUITE 101	MURRIETA	CA	92562	9416	33	06065	33.55331844	-117.2081759	Riverside County
92747	Fee-for-Service	1871520320	1871520320	1	1	HERNANDEZ, VALENTIN MD	11/1/1984	207R00000X	NA	Other	026	PHYSICIANS	40229	41	Internal Medicine	0	In state provider	INC	13440 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5806	19	06037	33.91009714	-118.3524091	Los Angeles County
92748	Fee-for-Service	1295882603	1295882603	1	1	HOLT, SCOTT	1/10/1985	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	EAST BAY HEARING SRVS	1260 A ST	STE 100	HAYWARD	CA	94541	2961	01	06001	37.67705643	-122.0794392	Alameda County
92765	Fee-for-Service	1174924328	1174924328	1	1	HAMM, DEANNA LCSW	3/7/2023	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
92766	Fee-for-Service	1902375793	1902375793	1	1	HASHMY, ZINAT LMFT	10/31/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 SANTA MONICA	370W, 380W, 860W, 1070	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
92767	Fee-for-Service	1114034873	1114034873	1	1	HUANG, LAWRENCE MD	2/7/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	75070	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
92769	Fee-for-Service	1790707883	1790707883	1	1	HEFFEL, DOMINIC F MD	1/1/1998	208600000X	NA	General Surgery	026	PHYSICIANS	62093	02	General Surgery	0	In state provider	None	4929 VAN NUYS BLVD	None	SHERMAN OAKS	CA	91403	1702	19	06037	34.1602022	-118.4487313	Los Angeles County
92777	Fee-for-Service	1740739499	1740739499	1	1	HUANG, JIN YI LCSW	5/10/2021	101YM0800X	NA	Other	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
92779	Fee-for-Service	1750498010	1750498010	1	1	HUMBOLDT GENERAL HOSP	5/22/2002	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	118 E HASKELL ST	None	WINNEMUCCA	NV	89445	3247	00	None	40.97178964	-117.7282344	Humboldt County
92786	Fee-for-Service	1174981989	1174981989	1	2	HANGER PROSTHETICS & ORTHOTI	10/7/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	41707 WINCHESTER RD	SUITE 102	TEMECULA	CA	92590	4867	33	06065	33.51901547	-117.1674976	Riverside County
92807	Fee-for-Service	1942512199	1942512199	1	1	HORWITZ, DAVID A MD	2/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	2400 SOUTH AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
92811	Fee-for-Service	1174153787	1174153787	1	1	HOLISTIC CARE HOSPICE AND	3/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE SERVICES INC	7037 LAUREL CANYON BLVD	UNIT 102	NORTH HOLLYWOOD	CA	91605	5738	19	06037	34.198704	-118.3965295	Los Angeles County
92862	Fee-for-Service	1528738556	1528738556	1	1	HEALTH CARE AND EDUCATION IN	12/6/2021	103TC1900X	NA	Mental Health Outpatient Services	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9042 GARFIELD AVE	206	HUNTINGTON BEACH	CA	92646	2340	30	06059	33.68669351	-117.970569	Orange County
92866	Fee-for-Service	1407824972	1407824972	1	1	HEBERT, JEFFREY MD	8/19/2024	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
92886	Fee-for-Service	1962791640	1962791640	1	2	HARNISH, DIANE PHD	6/6/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6741 REDWOOD AVE	None	SEBASTOPOL	CA	95472	4514	49	06097	38.39130744	-122.8133022	Sonoma County
92973	Fee-for-Service	1528615465	1528615465	1	1	HEART OF HOPE HOME	1/19/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE INC	10999 RIVERSIDE DR	STE 103	STUDIO CITY	CA	91602	2239	19	06037	34.15230395	-118.3693888	Los Angeles County
93000	Fee-for-Service	1265848972	1265848972	1	1	HANDLER, ELLIOT M MD	8/28/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164334	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
93034	Fee-for-Service	1730571928	1730571928	1	1	HOPE SPEECH AND LANGUAGE THE	1/22/2020	103K00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	RAPY, INC.	41760 IVY ST	SUITE 101	MURRIETA	CA	92562	9416	33	06065	33.55331844	-117.2081759	Riverside County
93042	Fee-for-Service	1881736320	1881736320	1	1	HARTLEY, SUSAN M OD	9/15/1982	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 PARK AVE	STE 4	LAGUNA BEACH	CA	92651	2352	30	06059	33.54209576	-117.7816969	Orange County
93054	Fee-for-Service	1114034873	1114034873	1	1	HUANG, LAWRENCE MD	2/7/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	75070	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
93082	Fee-for-Service	1679936298	1679936298	1	1	HOWELL HALDEMAN, ANNA MD	9/11/2023	208200000X	NA	General Surgery	026	PHYSICIANS	153533	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
93104	Fee-for-Service	1679899710	1679899710	1	1	HASSID, BENJAMIN G MD	9/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125570	41	Internal Medicine	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
93148	Fee-for-Service	1972898286	1972898286	1	1	HERSI, IDIL MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150119	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
93152	Fee-for-Service	1245799519	1245799519	1	1	HERNANDEZ RUBIO, RAUL DO	8/1/2023	390200000X	NA	Other	026	PHYSICIANS	20884	None	None	0	In state provider	None	5555 GROSSMONT CENTER	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
93158	Fee-for-Service	1952944241	1952944241	1	1	HARRIS, SAVANNAH J NP	5/12/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	168 N BRENT ST	STE 503	VENTURA	CA	93003	2892	56	06111	34.27448266	-119.2572489	Ventura County
93160	Fee-for-Service	1386877892	1386877892	1	1	HERRERA, FARANAK F DO	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10651	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
93181	Fee-for-Service	1972714335	1972714335	1	1	HUDGINS, JENNIFER LMFT	4/15/2020	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
93226	Fee-for-Service	1891164901	1891164901	1	1	HOM, STEPHANIE A NP	6/9/2016	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
93241	Fee-for-Service	1902225816	1902225816	1	1	HARIK, DANIELLE E DO	10/16/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18396	08	Family Practice	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
93247	Fee-for-Service	1427221522	1427221522	1	1	HONG, DAVID S MD	9/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131151	40	Pediatrics	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
93254	Fee-for-Service	1821371576	1821371576	1	1	HUMBOLDT MEDICAL SPECIALISTS	10/14/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
93259	Fee-for-Service	1679985105	1679985105	1	1	HAYOUN, MICHAEL A MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154633	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
93275	Fee-for-Service	1407415912	1407415912	1	1	HAPPY CARING HOME HEALTH	8/4/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	5311 TOPANGA CANYON BLVD	STE 223	WOODLAND HILLS	CA	91364	1742	19	06037	34.166313	-118.6059365	Los Angeles County
93280	Fee-for-Service	1457317091	1457317091	1	1	HINH, ANH K OD	10/28/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11640 CENTRAL AVE	None	CHINO	CA	91710	1923	36	06071	34.041888	-117.689646	San Bernardino County
93309	Fee-for-Service	1306950415	1306950415	1	1	HILLMAN, JOSEPH D MD	4/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84572	22	Pathology (M.D. only)	0	In state provider	None	10833 LE CONTE AVE	STE B186	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
93315	Fee-for-Service	1346412897	1346412897	1	1	HENKE, VANESSA G MD	9/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115321	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
93324	Fee-for-Service	1104036235	1104036235	1	1	HAWKINS, DAVID J DO	8/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9363	08	Family Practice	0	In state provider	None	12291 WASHINGTON BLVD	STE 500	WHITTIER	CA	91766	2551	19	06037	33.96734104	-118.0508773	Los Angeles County
93337	Fee-for-Service	1104995000	1104995000	1	1	HUMBER, DAVID 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	128 LEHUA ST	None	WAHIAWA	HI	96786	2036	00	None	21.49863008	-158.0272825	Honolulu County
93341	Fee-for-Service	1114034873	1114034873	1	1	HUANG, LAWRENCE MD	2/7/1995	207RP1001X	NA	Pulmonology	026	PHYSICIANS	75070	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
93346	Fee-for-Service	1942613740	1942613740	1	1	HARAN, KATHRYN C DO	2/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14273	66	Emergency Medicine (Urgent Care)	0	In state provider	None	17095 MAIN ST	None	HESPERIA	CA	92345	6004	36	06071	34.41984761	-117.2904344	San Bernardino County
93402	Fee-for-Service	1790792281	1790792281	1	1	HUANG, MORGAN C MD	3/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	83095	18	Ophthalmology	0	In state provider	None	650 W DUARTE ROAD	SUITE 100 D	ARCADIA	CA	91007	7113	19	06037	34.12621324	-118.0537434	Los Angeles County
93439	Fee-for-Service	1356598098	1356598098	1	2	HOME HEALTH ALLIANCE, INC.	12/7/2021	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1 N MAIN ST	SUITE 1	MILPITAS	CA	95035	4324	43	06085	37.43084529	-121.9069611	Santa Clara County
93481	Fee-for-Service	1003953100	1003953100	1	1	HUCKLEBERRY YOUTH PROGRAMS,	8/3/2015	251K00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	361 3RD STREET	SUITE G	SAN RAFAEL	CA	94901	3580	21	06041	37.97011695	-122.5160089	Marin County
93531	Fee-for-Service	1467502336	1467502336	1	1	HOLDER, CHRIS TODD	7/1/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	313 N 2ND AVE	SUITE G	UPLAND	CA	91786	6065	36	06071	34.09747494	-117.6484697	San Bernardino County
93532	Fee-for-Service	1427221522	1427221522	1	1	HONG, DAVID S MD	9/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131151	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
93541	Fee-for-Service	1831699560	1831699560	1	1	HARRIS, MICHAEL LMFT	7/1/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FAMILY THERAPIST	6627 BAY LAUREL PL	SUITE A	AVILA BEACH	CA	93424	3504	40	06079	35.18961759	-120.7206781	San Luis Obispo County
93545	Fee-for-Service	1467473157	1467473157	1	1	HALES, KLANE L MD	8/24/2004	207L00000X	NA	Other	026	PHYSICIANS	64172	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
93565	Fee-for-Service	1790558856	1790558856	1	1	HERNANDEZ, KEESHA DOULA	11/3/2023	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
93592	Fee-for-Service	1457675118	1457675118	1	1	HOWARD, BENJAMIN M MD	2/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	119847	02	General Surgery	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4310	42	06083	34.42967671	-119.7228362	Santa Barbara County
93613	Fee-for-Service	1841750999	1841750999	1	1	HATELEY, ROBERT W MD	5/24/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	176544	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
93633	Fee-for-Service	1831203744	1831203744	1	1	HESHMATI, SHAHLA MD	12/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	50416	40	Pediatrics	0	In state provider	None	14150 CULVER DR	STE 302	IRVINE	CA	92604	0323	30	06059	33.70834263	-117.7839373	Orange County
93665	Fee-for-Service	1427347210	1427347210	1	1	HIRT, DANIEL MD	11/1/2018	207T00000X	NA	General Surgery	026	PHYSICIANS	124278	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
93674	Fee-for-Service	1275699092	1275699092	1	1	HARRINGTON, DAVID	9/11/2012	No Taxonomy Provided	NA	None	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
93681	Fee-for-Service	1467490425	1467490425	1	1	HARBOR COMMUNITY CLINIC	11/25/2005	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	19	06037	33.73875253	-118.2899475	Los Angeles County
93757	Fee-for-Service	1881632081	1881632081	1	1	HOM, MATTHEW H MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68160	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
93762	Fee-for-Service	1518922061	1518922061	1	1	HANH MY NGUYEN, MD INC	6/22/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1692 TULLY RD	STE 10	SAN JOSE	CA	95122	2550	43	06085	37.3212391	-121.8273245	Santa Clara County
93763	Fee-for-Service	1023471018	1023471018	1	1	HUSAIN, FARHAN MD	9/5/2023	207R00000X	NA	Other	026	PHYSICIANS	151465	None	None	0	In state provider	None	13355 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5802	19	06037	33.91091877	-118.3527745	Los Angeles County
93769	Fee-for-Service	1003250093	1003250093	1	1	HURTT FAMILY HEALTH CLINIC	5/1/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	1100 B N. TUSTIN AVE	SUITES A, D, F	SANTA ANA	CA	92705	3509	30	06059	33.754707	-117.8342455	Orange County
93772	Fee-for-Service	1134480817	1134480817	1	1	HUMANGOOD FRESNO	7/1/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5551 N FRESNO ST	None	FRESNO	CA	93710	6006	10	06019	36.817956	-119.784195	Fresno County
93789	Fee-for-Service	1477506707	1477506707	1	1	HOLM, LAWRENCE MD	9/15/1998	207L00000X	NA	Other	026	PHYSICIANS	49764	05	Anesthesiology	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
93805	Fee-for-Service	1154655165	1154655165	1	1	HARPER, ROBERT PT	7/15/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1630 W REDLANDS BLVD.	SUITE L	REDLANDS	CA	92373	8032	36	06071	34.06293049	-117.2104992	San Bernardino County
93841	Fee-for-Service	1265580153	1265580153	1	1	HUMES, HASCAL O MD II	3/31/1991	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	71884	25	Physical Medicine and Rehabilitation	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
93873	Fee-for-Service	1265615389	1265615389	1	1	HUNT, JULIETTE L MD	7/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121438	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
93881	Fee-for-Service	1437311768	1437311768	1	1	HANNA, SHERRY MD	3/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121330	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
93891	Fee-for-Service	1376691204	1376691204	1	1	HAGHANI, KAMYAR MD	10/31/1991	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	73375	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
93897	Fee-for-Service	1922793249	1922793249	1	1	HOLISTIC HOME HEALTH SERVICE	11/14/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	12444 VICTORY BLVD	STE 310	NORTH HOLLYWOOD	CA	91606	3199	19	06037	34.18663951	-118.4043555	Los Angeles County
93916	Fee-for-Service	1114947660	1114947660	1	1	HOME CARE EXCELLENCE HEALTH	4/29/2006	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	10900 183RD STREET	SUITE 190	CERRITOS	CA	90703	5346	19	06037	33.86553452	-118.1019285	Los Angeles County
93919	Fee-for-Service	1609822204	1609822204	1	1	HINDLE, DAVID C MD	9/12/2019	207P00000X	NA	Other	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
93954	Fee-for-Service	1780654525	1780654525	1	1	HWANG, STANLEY	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	58772	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
93966	Fee-for-Service	1467490425	1467490425	1	1	HARBOR COMMUNITY CLINIC	2/6/2020	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	19	06037	33.73875253	-118.2899475	Los Angeles County
93980	Fee-for-Service	1730111907	1730111907	1	1	HIRSCHFELD, DAVID S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	22502	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2585 SAMARITAN DR	STE 303	SAN JOSE	CA	95124	4107	43	06085	37.25083752	-121.9503884	Santa Clara County
93982	Fee-for-Service	1063892016	1063892016	1	1	HARMON, JENNIFER L LCSW	4/21/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
94029	Fee-for-Service	1407940216	1407940216	1	1	HART, MARIA K L DO	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12183	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2091	19	06037	34.02980528	-118.4786605	Los Angeles County
94042	Fee-for-Service	1255779179	1255779179	1	1	HUANG, WENDY C MD	6/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148307	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
94051	Fee-for-Service	1861618258	1861618258	1	1	HUANG, JULIA W OD	4/1/2000	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1756 MONTEBELLO TOWN CTR	None	MONTEBELLO	CA	90640	2163	19	06037	34.03743928	-118.0828172	Los Angeles County
94055	Fee-for-Service	1003250093	1003250093	1	1	HURTT FAMILY HEALTH CLINIC	5/1/2015	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INC	1100 B N. TUSTIN AVE	SUITES A, D, F	SANTA ANA	CA	92705	3509	30	06059	33.754707	-117.8342455	Orange County
94073	Fee-for-Service	1326080128	1326080128	1	1	HEKMATI, ARMAN MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	63893	38	Geriatrics	0	In state provider	None	6360 WILSHIRE BLVD	STE 203	LOS ANGELES	CA	90048	5601	19	06037	34.06363617	-118.3676811	Los Angeles County
94080	Fee-for-Service	1861529463	1861529463	1	1	HARRIS, MEGAN E LCSW	4/5/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23 W SAINT CHARLES	None	SAN ANDREAS	CA	95249	0000	05	06009	38.19634106	-120.6814732	Calaveras County
94089	Fee-for-Service	1144560681	1144560681	1	1	HINDUJA, SNEHA	1/2/2015	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
94111	Fee-for-Service	1700637964	1700637964	1	1	HOWARD, QUINCY L DOULA	4/7/2024	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	17	06033	0	0	None
94130	Fee-for-Service	1760682330	1760682330	1	1	HAWKINS, VIDYA P DO	1/12/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	9421	27	Psychiatry Neurology (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
94135	Fee-for-Service	1417282062	1417282062	1	1	HAYDEN, ANDREW	9/11/2012	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
94141	Fee-for-Service	1467424929	1467424929	1	1	HU, JAMES S MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85637	78	Neoplastic Diseases/Oncology	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
94163	Fee-for-Service	1851776686	1851776686	1	1	HONG, JISUN DO	12/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16714	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
94211	Fee-for-Service	1275791501	1275791501	1	1	HUANG, PHILBERT Y MD	7/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104805	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
94253	Fee-for-Service	1467490425	1467490425	1	1	HARBOR COMMUNITY CLINIC	11/25/2005	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	19	06037	33.73875253	-118.2899475	Los Angeles County
94292	Fee-for-Service	1437204369	1437204369	1	1	HEALING LODGE OF THE SEVEN	9/6/2013	324500000X	NA	Other	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	2	Out of state provider	NATIONS	5600 E 8TH AVE	None	SPOKANE VALLEY	WA	99212	0220	00	None	47.646432	-117.328806	Spokane County
94310	Fee-for-Service	1043250178	1043250178	1	1	HUNT, STEVEN 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	3195	00	None	41.18328	-111.9536955	Weber County
94345	Fee-for-Service	1003250093	1003250093	1	1	HURTT FAMILY HEALTH CLINIC	5/1/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	1100 B N. TUSTIN AVE	SUITES A, D, F	SANTA ANA	CA	92705	3509	30	06059	33.754707	-117.8342455	Orange County
94360	Fee-for-Service	1326080128	1326080128	1	1	HEKMATI, ARMAN MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	63893	41	Internal Medicine	0	In state provider	None	6360 WILSHIRE BLVD	STE 203	LOS ANGELES	CA	90048	5601	19	06037	34.06363617	-118.3676811	Los Angeles County
94415	Fee-for-Service	1497774954	1497774954	1	1	HIRSCH, RICK M DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	7234	08	Family Practice	0	In state provider	INLAND FAMILY HEALTHCARE	77 E 7TH ST	STE B	UPLAND	CA	91786	6601	36	06071	34.08883959	-117.6501014	San Bernardino County
94429	Fee-for-Service	1467424929	1467424929	1	1	HU, JAMES S MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85637	68	Hematology	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
94438	Fee-for-Service	1245769298	1245769298	1	1	HUNT, FELICIA L CNP	4/12/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14330 CULVER DR	None	IRVINE	CA	92604	0303	30	06059	33.70654758	-117.7857461	Orange County
94441	Fee-for-Service	1396155875	1396155875	1	1	HARRISON, PHILLIP A MD	8/3/2020	1223S0112X	NA	Dental Provider	026	PHYSICIANS	151750	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
94445	Fee-for-Service	1821134511	1821134511	1	1	HEALDSBURG PRIMARY CARE	12/21/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1312 PRENTICE DR	None	HEALDSBURG	CA	95448	3381	49	06097	38.62736288	-122.8667004	Sonoma County
94478	Fee-for-Service	1457543662	1457543662	1	1	HSU, JOSH MD	1/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	83122	34	Urology and Urological Surgery	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
94520	Fee-for-Service	1427357425	1427357425	1	1	HOMCHICK, SANDRA A LMFT	12/18/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6200 WILSHIRE BLVD	SUITE 1008	LOS ANGELES	CA	90048	5811	19	06037	34.06319291	-118.3636025	Los Angeles County
94530	Fee-for-Service	1407935489	1407935489	1	1	HEDBERG, ALLAN G MD	7/1/1998	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5100 N 6TH ST	STE 140	FRESNO	CA	93710	7506	10	06019	36.810666	-119.763204	Fresno County
94535	Fee-for-Service	1538265681	1538265681	1	1	HERNANDEZ & GRADY,ASSOC	1/1/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	34	Urology and Urological Surgery	0	In state provider	ASSOCIATES	1850 SULLIVAN AVE	STE 300	DALY CITY	CA	94015	2204	41	06081	37.68085904	-122.4728842	San Mateo County
94539	Fee-for-Service	1649357021	1649357021	1	1	HARTUNIAN, SUSAN L MD	8/23/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63737	02	General Surgery	0	In state provider	None	470 GREENFIELD AVE	STE 35	HANFORD	CA	93230	3513	16	06031	36.32996137	-119.6580167	Kings County
94542	Fee-for-Service	1467490425	1467490425	1	1	HARBOR COMMUNITY CLINIC	11/25/2005	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	593 W 6TH ST	None	SAN PEDRO	CA	90731	2521	19	06037	33.73875253	-118.2899475	Los Angeles County
94545	Fee-for-Service	1417213307	1417213307	1	1	HOSKINS, BETTY LCSW	10/13/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26208	-	NOT APPLICABLE	0	In state provider	None	105 HOSPITAL ROAD	None	SONORA	CA	95370	5227	55	06109	37.9746569	-120.3783281	Tuolumne County
94549	Fee-for-Service	1790780047	1790780047	1	1	HARRINGTON MEMORIAL HOPS	7/31/2008	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	100 SOUTH ST	STE 1	SOUTHBRIDGE	MA	01550	4047	00	None	42.078546	-72.0420255	Worcester County
94555	Fee-for-Service	1073080131	1073080131	1	1	HOPPER, TAMARIND CNM	11/6/2023	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	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
94569	Fee-for-Service	1366948598	1366948598	1	1	HUANG, NATALIE MD	5/3/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	185086	None	None	0	In state provider	None	2470 HILBORN RD	STE 150	FAIRFIELD	CA	94534	1072	48	06095	38.27531165	-122.0522555	Solano County
94578	Fee-for-Service	1437204369	1437204369	1	1	HEALING LODGE OF THE SEVEN	9/6/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	2	Out of state provider	NATIONS	5600 E 8TH AVE	None	SPOKANE VALLEY	WA	99212	0220	00	None	47.646432	-117.328806	Spokane County
94580	Fee-for-Service	1639416142	1639416142	1	1	HEBRON, RONALD H NP	10/4/2018	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
94602	Fee-for-Service	1497126379	1497126379	1	1	HOFFMAN, LAURENT 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
94604	Fee-for-Service	1437484193	1437484193	1	1	HONG, KAREN DO	7/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10922	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	969 PLUMAS BLVD	116	YUBA CITY	CA	95991	4011	51	06101	39.14263634	-121.6176593	Sutter County
94624	Fee-for-Service	1164463881	1164463881	1	1	HORTON, KAREN M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	87734	24	Plastic Surgery	0	In state provider	None	2100 WEBSTER ST	STE 506	SAN FRANCISCO	CA	94115	2381	38	06075	37.7904826	-122.4324477	San Francisco County
94666	Fee-for-Service	1356631873	1356631873	1	1	HAWKES, JASON E MD	10/7/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	162994	07	Dermatology	0	In state provider	None	3301 C ST	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
94714	Fee-for-Service	1003230814	1003230814	1	1	HOLMEN, JENNA E MD	10/7/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	128679	40	Pediatrics	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
94718	Fee-for-Service	1396062279	1396062279	1	1	HU, GLORIA C MD	11/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	114328	01	General Practice	0	In state provider	None	3460 KATELLA AVENUE	None	LOS ALAMITOS	CA	90720	2334	30	06059	33.8029707	-118.073517	Orange County
94743	Fee-for-Service	1245257948	1245257948	1	1	HAFEZI, ALI MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70333	01	General Practice	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
94744	Fee-for-Service	1386736015	1386736015	1	1	HUA, NANCY WH MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63344	41	Internal Medicine	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
94745	Fee-for-Service	1073872248	1073872248	1	1	HECHT, GARIN G MD	10/2/2019	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	128824	20	Orthopedic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
94753	Fee-for-Service	1326430141	1326430141	1	1	HASTINGS-ROBINSON, ASHLEY M	7/7/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	165851	None	None	0	In state provider	D	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
94759	Fee-for-Service	1720294515	1720294515	1	1	HICHOICE HEALTH CARE INC	11/15/1999	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	VICTORY ADHC	1745 VICTORY BLVD	None	GLENDALE	CA	91201	2864	19	06037	34.16224563	-118.3016918	Los Angeles County
94760	Fee-for-Service	1063774305	1063774305	1	1	HOLMAN, MELISSA L LMFT	5/16/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
94788	Fee-for-Service	1104020312	1104020312	1	1	HAN, WEN MD	8/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116200	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
94823	Fee-for-Service	1306274956	1306274956	1	1	HOOPS, KATHERINE J CCC-SLP	3/7/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	170 17TH ST	STE B	PACIFIC GROVE	CA	93950	7201	27	06053	36.62215796	-121.9186041	Monterey County
94830	Fee-for-Service	1609160118	1609160118	1	1	HANLEY, ERIN LMFT	4/22/2022	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
94842	Fee-for-Service	1386275881	1386275881	1	1	HAAS, JENNIFER NP	2/11/2020	2080P0207X	NA	Hematology	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
94889	Fee-for-Service	1467575993	1467575993	1	1	HOENIG, MARIANNE PIA OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1559 FARMERS LN	None	SANTA ROSA	CA	95405	7525	49	06097	38.433663	-122.6902275	Sonoma County
94933	Fee-for-Service	1659809804	1659809804	1	1	HALL, MARK MD	9/23/2024	207R00000X	NA	Other	026	PHYSICIANS	157847	41	Internal Medicine	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
94953	Fee-for-Service	1396817128	1396817128	1	1	HENRY, CHERYL L MD	1/19/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	61199	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1530 RAILROAD AVE	None	SAINT HELENA	CA	94574	1106	28	06055	38.50733846	-122.4714652	Napa County
94975	Fee-for-Service	1710030192	1710030192	1	1	HAYTON, BRUCE A MD INC	9/20/2007	174400000X	NA	Other	026	PHYSICIANS	55511	41	Internal Medicine	0	In state provider	None	27990 SHERMAN RD	None	SUN CITY	CA	92585	9155	33	06065	33.7145741	-117.1801244	Riverside County
94986	Fee-for-Service	1750314191	1750314191	1	1	HAMILTON, PAUL D MD	11/19/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	34402	01	General Practice	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
95007	Fee-for-Service	1891967790	1891967790	1	1	HU, JANE B MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116400	36	Psychiatry	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
95040	Fee-for-Service	1396792487	1396792487	1	1	HORNS, RICHARD C MD JR	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	37523	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8283 GROVE AVE	STE 207	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
95047	Fee-for-Service	1902491947	1902491947	1	1	HEANEY, CATHERINE LCSW	2/12/2025	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
95053	Fee-for-Service	1477742161	1477742161	1	1	HADLEY, KATIE 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	315 MARTIN LUTHER KING	None	TACOMA	WA	98405	0000	00	None	47.25960844	-122.4534238	Pierce County
95075	Fee-for-Service	1982837688	1982837688	1	1	HALE, KIMBERLY	11/26/2012	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
95078	Fee-for-Service	1104020312	1104020312	1	1	HAN, WEN MD	8/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116200	67	Endocrinology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
95087	Fee-for-Service	1588125256	1588125256	1	1	HAAS, LISA T LCSW	10/10/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16055 VENTURA BLVD	810	ENCINO	CA	91436	2610	19	06037	34.15632563	-118.4832351	Los Angeles County
95115	Fee-for-Service	1669544110	1669544110	1	1	HENAO, GWENDOLYN MD	2/18/2009	174400000X	NA	Other	026	PHYSICIANS	92651	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7910 FROST ST	STE 400	SAN DIEGO	CA	92123	2753	37	06073	32.80027449	-117.153846	San Diego County
95118	Fee-for-Service	1932421625	1932421625	1	1	HOU, SAMUEL Y MD	3/16/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	97972	30	Radiology	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	8344	19	06037	34.06373445	-118.443537	Los Angeles County
95211	Fee-for-Service	1316400401	1316400401	1	1	HOANG, THANH D DO	10/30/2022	207R00000X	NA	Other	026	PHYSICIANS	19730	None	None	0	In state provider	None	5TH & ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.741948	-121.848921	Butte County
95213	Fee-for-Service	1619721560	1619721560	1	1	HAWKINS, ANGELA DOULA	4/18/2024	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	37	06073	0	0	None
95224	Fee-for-Service	1396756912	1396756912	1	1	HERNANDEZ, DAVID J MD	2/19/2016	207R00000X	NA	Other	026	PHYSICIANS	48343	None	None	0	In state provider	None	22030 SHERMAN WY	STE 215	CANOGA PARK	CA	91303	1883	19	06037	34.20099551	-118.6071615	Los Angeles County
95258	Fee-for-Service	1306980057	1306980057	1	1	HEARING CARE ASSOCIATES-	1/1/1995	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4001 W ALAMEDA AVE	STE 101	BURBANK	CA	91505	4338	19	06037	34.15302397	-118.3436924	Los Angeles County
95260	Fee-for-Service	1710030192	1710030192	1	1	HAYTON, BRUCE A MD INC	9/20/2007	174400000X	NA	Other	026	PHYSICIANS	55511	68	Hematology	0	In state provider	None	27990 SHERMAN RD	None	SUN CITY	CA	92585	9155	33	06065	33.7145741	-117.1801244	Riverside County
95277	Fee-for-Service	1750314191	1750314191	1	1	HAMILTON, PAUL D MD	11/19/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	34402	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
95312	Fee-for-Service	1598384752	1598384752	1	1	HARTENIAN, MELANIE	7/1/2023	207P00000X	NA	Other	026	PHYSICIANS	185386	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
95326	Fee-for-Service	1396792487	1396792487	1	1	HORNS, RICHARD C MD JR	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	37523	41	Internal Medicine	0	In state provider	None	8283 GROVE AVE	STE 207	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
95399	Fee-for-Service	1164581823	1164581823	1	1	HANNA, RICHARD C MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77381	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
95410	Fee-for-Service	1124059274	1124059274	2	1	HEALTH DIAGNOSTICS OF	1/24/2012	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	1860 EL CAMINO REAL	SUITE 101	BURLINGAME	CA	94010	3106	41	06081	37.59615729	-122.3846379	San Mateo County
95429	Fee-for-Service	1538411632	1538411632	1	1	HEALTHY LIVING AT HOME	8/27/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	EAST BAY LLC	1320 WILLOW PASS ROAD	SUITE 555	CONCORD	CA	94520	7990	07	06013	37.96879608	-122.0519798	Contra Costa County
95433	Fee-for-Service	1447451935	1447451935	1	1	HOFELING, TODD J MD	9/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112651	41	Internal Medicine	0	In state provider	None	4725-A HOEN AVE	None	SANTA ROSA	CA	95405	7862	49	06097	38.442564	-122.664141	Sonoma County
95515	Fee-for-Service	1881011856	1881011856	1	1	HAGHSHENAS, AREZOO MD	2/8/2020	207RR0500X	NA	Other	026	PHYSICIANS	145283	41	Internal Medicine	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
95519	Fee-for-Service	1992865091	1992865091	1	1	HUANG, DAVID L OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1550 W MANCHESTER AVE	None	LOS ANGELES	CA	90047	5424	19	06037	33.95996247	-118.3043925	Los Angeles County
95550	Fee-for-Service	1710030192	1710030192	1	1	HAYTON, BRUCE A MD INC	9/20/2007	174400000X	NA	Other	026	PHYSICIANS	55511	78	Neoplastic Diseases/Oncology	0	In state provider	None	27990 SHERMAN RD	None	SUN CITY	CA	92585	9155	33	06065	33.7145741	-117.1801244	Riverside County
95552	Fee-for-Service	1417658634	1417658634	1	1	HOANG, DANNY RCP	12/17/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
95564	Fee-for-Service	1750314191	1750314191	1	1	HAMILTON, PAUL D MD	11/19/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	34402	08	Family Practice	0	In state provider	None	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
95601	Fee-for-Service	1316203250	1316203250	1	1	HITESHI, AMIT K MD	1/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133969	41	Internal Medicine	0	In state provider	None	19582 BEACH BLVD	SUITE 250	HUNTINGTON BEACH	CA	92648	5977	30	06059	33.67831649	-117.9885198	Orange County
95603	Fee-for-Service	1326563040	1326563040	1	1	HERTD INC	11/13/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	16385 W SCHENDEL AVE	STE K	DELHI	CA	95315	9476	24	06047	37.42677314	-120.7844402	Merced County
95609	Fee-for-Service	1063576403	1063576403	1	1	HANNIGAN, LINA M PSYD	9/26/2013	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
95615	Fee-for-Service	1396792487	1396792487	1	1	HORNS, RICHARD C MD JR	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	37523	68	Hematology	0	In state provider	None	8283 GROVE AVE	STE 207	RANCHO CUCAMONGA	CA	91730	3141	36	06071	34.10380433	-117.6285116	San Bernardino County
95671	Fee-for-Service	1154420107	1154420107	1	1	HOVSEPIAN, MICHAEL M MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85250	30	Radiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
95703	Fee-for-Service	1407920556	1407920556	1	1	HANGER PROSTHETICS &	5/31/1996	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	1460 NORTH CAMINO ALTO	SUITE 106	VALLEJO	CA	94589	2567	48	06095	38.13262019	-122.2386804	Solano County
95722	Fee-for-Service	1902332471	1902332471	1	1	HU, PETER MD	7/17/2023	2085R0204X	NA	Other	026	PHYSICIANS	157851	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
95723	Fee-for-Service	1447451935	1447451935	1	1	HOFELING, TODD J MD	9/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112651	83	Rheumatology	0	In state provider	None	4725-A HOEN AVE	None	SANTA ROSA	CA	95405	7862	49	06097	38.442564	-122.664141	Sonoma County
95744	Fee-for-Service	1144947920	1144947920	1	1	HAMMERS, ZACHARIAH LPCC	8/28/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
95751	Fee-for-Service	1609279694	1609279694	1	1	HERNANDEZ, KARA D LMFT	6/15/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16275 MONTEREY RD	STE C	MORGAN HILL	CA	95037	5466	43	06085	37.11612997	-121.6448825	Santa Clara County
95755	Fee-for-Service	1174894547	1174894547	1	1	HAMILTON, LYDIA L LMFT	5/4/2020	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
95760	Fee-for-Service	1982756359	1982756359	1	1	HAN, PAUL B MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66959	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
95804	Fee-for-Service	1881011856	1881011856	1	1	HAGHSHENAS, AREZOO MD	2/8/2020	207RR0500X	NA	Other	026	PHYSICIANS	145283	83	Rheumatology	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
95825	Fee-for-Service	1043232473	1043232473	1	1	HEALY, MICHAEL P LMFT	12/16/2015	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2308 J STREET	SUITE D	SACRAMENTO	CA	95816	4718	34	06067	38.575188	-121.475565	Sacramento County
95827	Fee-for-Service	1174606834	1174606834	1	1	HOWARD, JULIE A MD	7/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92287	08	Family Practice	0	In state provider	None	1510 SAN PABLO ST	STE 104	LOS ANGELES	CA	90033	5392	19	06037	34.06287152	-118.2029433	Los Angeles County
95853	Fee-for-Service	1922568609	1922568609	1	1	HO, DAVE MD	8/1/2024	2084N0008X	NA	Neurology	026	PHYSICIANS	183638	13	Neurology (M.D. only)	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
95859	Fee-for-Service	1588940647	1588940647	1	2	HA, LAURA K OD OPTOMETRY APC	5/7/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15336 DEVONSHIRE ST	STE 4	MISSION HILLS	CA	93291	5032	19	06037	34.25726849	-118.4664285	Los Angeles County
95891	Fee-for-Service	1295257061	1295257061	1	1	HALAVI, SHINA PHD	5/3/2022	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	O SCENE	11040 SANTA MONICA BLVD	STE 430	LOS ANGELES	CA	90025	7581	19	06037	34.04800261	-118.4425929	Los Angeles County
95895	Fee-for-Service	1457440547	1457440547	1	1	HENNES, SCOTT C MD	1/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	43338	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
95912	Fee-for-Service	1154370690	1154370690	1	1	HALLIDAY, BLAIR A MD	12/31/1992	207L00000X	NA	Other	026	PHYSICIANS	55354	05	Anesthesiology	0	In state provider	None	182 FARMERS LN	STE 100A	SANTA ROSA	CA	95405	4718	49	06097	38.450979	-122.687253	Sonoma County
95922	Fee-for-Service	1821165655	1821165655	1	1	HOANG, ROBERT D MD	12/14/2007	2084P0800X	NA	Psychiatry	026	PHYSICIANS	85998	36	Psychiatry	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
95923	Fee-for-Service	1265590525	1265590525	1	1	HINGARH, NILESH H MD	10/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80963	77	Infectious Disease	0	In state provider	None	23861 MCBEAN PKWY	STE E26	VALENCIA	CA	91355	4457	19	06037	34.39567343	-118.5542698	Los Angeles County
95937	Fee-for-Service	1275501496	1275501496	1	1	HUNTSMAN, KEVIN P MD	12/5/1986	207R00000X	NA	Other	026	PHYSICIANS	34408	41	Internal Medicine	0	In state provider	None	1360 PARK NEWPORT	None	NEWPORT BEACH	CA	92660	5035	30	06059	33.62701245	-117.8798913	Orange County
95969	Fee-for-Service	1396058095	1396058095	1	1	HARRELL, JEFFREY L MD	6/12/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	144982	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
95987	Fee-for-Service	1821356189	1821356189	1	1	HUISH, ERIC G DO	8/27/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	13013	20	Orthopedic Surgery	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
95990	Fee-for-Service	1790978021	1790978021	1	1	HENRY, JAMES G MD	10/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	107929	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
96007	Fee-for-Service	1487215372	1487215372	1	1	HAUGEN, JESSICA G DO	10/28/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19812	None	None	0	In state provider	None	815 W WASHINGTON BLVD	None	MONTEBELLO	CA	90640	6123	19	06037	33.99411697	-118.1169341	Los Angeles County
96019	Fee-for-Service	1437491156	1437491156	1	1	HSU, VICTOR A MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132137	41	Internal Medicine	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
96050	Fee-for-Service	1609076546	1609076546	1	1	HAWARI, ASHRAF H MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	99262	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
96051	Fee-for-Service	1326545914	1326545914	1	1	HAGHIGHIAN, CYRUS MD	8/1/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	174963	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
96052	Fee-for-Service	1366485542	1366485542	1	1	HULKA, FRIEDA M MD	5/8/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	89	Surgery-Traumatic	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
96091	Fee-for-Service	1932287653	1932287653	1	1	HENKE, ARTUR Z MD	10/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72699	07	Dermatology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
96092	Fee-for-Service	1881219558	1881219558	1	1	HEBBERT, LUISA A	7/30/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	7209 CASCADE AVE	None	OAK HILLS	CA	92344	8116	36	06071	34.3814056	-117.3580282	San Bernardino County
96110	Fee-for-Service	1720231475	1720231475	1	1	HAYES, KEVIN P	6/9/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	78075	None	None	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
96116	Fee-for-Service	1073023107	1073023107	1	4	HUMBOLDT RECOVERY CENTER, IN	4/22/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1303 11TH ST	None	EUREKA	CA	95501	2028	12	06023	40.79830188	-124.1559332	Humboldt County
96121	Fee-for-Service	1922201573	1922201573	1	1	HUMSI, JULIETTE A MD	1/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112654	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
96122	Fee-for-Service	1245598937	1245598937	1	1	HONG, LINDY DO	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14195	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1650 RESPONSE RD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
96126	Fee-for-Service	1124657580	1124657580	1	1	HAIDARY, HABIB A MD	8/21/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182110	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
96137	Fee-for-Service	1518999143	1518999143	1	1	HOWELL, WILLIAM M MD INC	3/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81313	67	Endocrinology	0	In state provider	HOWELL MEDICAL GROUP	1245 WILSHIRE BLVD	STE 316	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
96160	Fee-for-Service	1912239963	1912239963	1	1	HIGGS, DAVID E MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121690	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
96161	Fee-for-Service	1427291004	1427291004	1	1	HALVERSON, SARA E MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113167	08	Family Practice	0	In state provider	None	25455 BARTON RD	None	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
96169	Fee-for-Service	1417395633	1417395633	1	1	HALL, BONNIE H MD	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125569	01	General Practice	0	In state provider	None	1715 LUNDY AVENUE	STE 108-116	SAN JOSE	CA	95131	1837	43	06085	37.3881873	-121.8869157	Santa Clara County
96183	Fee-for-Service	1255482055	1255482055	2	1	HILL, RICHARD A MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	65674	18	Ophthalmology	0	In state provider	None	1200 N TUSTIN AVENUE	SUITE 240	SANTA ANA	CA	92705	3534	30	06059	33.75564579	-117.8342574	Orange County
96186	Fee-for-Service	1427033091	1427033091	1	1	HOLMES, JAMES F MD	1/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	60112	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
96210	Fee-for-Service	1265590525	1265590525	1	1	HINGARH, NILESH H MD	10/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	80963	41	Internal Medicine	0	In state provider	None	23861 MCBEAN PKWY	STE E26	VALENCIA	CA	91355	4457	19	06037	34.39567343	-118.5542698	Los Angeles County
96239	Fee-for-Service	1538203674	1538203674	1	1	HSU, RAYMOND M MD	7/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83124	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
96261	Fee-for-Service	1700959392	1700959392	1	1	HALL, DENA L LMFT	5/7/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	673 S AUBURN ST	STE B	GRASS VALLEY	CA	95945	7576	29	06057	39.2060146	-121.0613316	Nevada County
96263	Fee-for-Service	1396058095	1396058095	1	1	HARRELL, JEFFREY L MD	6/12/2020	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	144982	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
96266	Fee-for-Service	1558716845	1558716845	1	1	HOLLICK, NATALIE	9/27/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	16170	40	Pediatrics	0	In state provider	None	865 3RD AVE	STE 101	CHULA VISTA	CA	91911	1349	37	06073	32.62189562	-117.0722453	San Diego County
96295	Fee-for-Service	1770559148	1770559148	1	1	HOFFMANN,MARK 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	1406 6TH AVE NO	None	ST CLOUD	MN	56303	0000	00	None	45.5746739	-94.17010435	Stearns County
96315	Fee-for-Service	1730454182	1730454182	1	1	HAJRA, ASHIM B MD	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123205	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
96324	Fee-for-Service	1487659405	1487659405	1	1	HOFFMAN, JAMES K MD	10/24/1981	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38543	08	Family Practice	0	In state provider	None	505 E ROMIE LN	None	SALINAS	CA	93901	4031	27	06053	36.65998191	-121.6461895	Monterey County
96341	Fee-for-Service	1366485542	1366485542	1	1	HULKA, FRIEDA M MD	5/8/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
96357	Fee-for-Service	1528003597	1528003597	1	1	HOLLANDER, ETHAN D MD	4/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78030	08	Family Practice	0	In state provider	None	2305 CAMINO RAMON	STE 120	SAN RAMON	CA	94583	1394	07	06013	37.77544224	-121.9657563	Contra Costa County
96358	Fee-for-Service	1407876865	1407876865	1	1	HALLETT, RICHARD LEE MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87256	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
96368	Fee-for-Service	1528297462	1528297462	1	1	HATTI, KALPITA M MD	9/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129430	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92408	3234	36	06071	34.047153	-117.2611485	San Bernardino County
96378	Fee-for-Service	1407038896	1407038896	1	1	HEALING HANDS CHIROPRACT	10/13/2004	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	130 N BUTTE ST	STE AB	WILLOWS	CA	95988	2836	11	06021	39.52141639	-122.1953507	Glenn County
96381	Fee-for-Service	1881219558	1881219558	1	1	HEBBERT, LUISA A	7/30/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	7209 CASCADE AVE	None	OAK HILLS	CA	92344	8116	36	06071	34.3814056	-117.3580282	San Bernardino County
96421	Fee-for-Service	1518999143	1518999143	1	1	HOWELL, WILLIAM M MD INC	3/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81313	01	General Practice	0	In state provider	HOWELL MEDICAL GROUP	1245 WILSHIRE BLVD	STE 316	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
96422	Fee-for-Service	1215981741	1215981741	1	1	HUANG PO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1512 12TH AVE RD	None	NAMPA	ID	83686	0000	00	None	43.55346193	-116.5727785	Canyon County
96425	Fee-for-Service	1982674065	1982674065	1	1	HEMET HEALTHCARE	3/11/1993	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SURGERY INC	301 N SAN JACINTO ST	None	HEMET	CA	92543	3119	33	06065	33.75162	-116.9586895	Riverside County
96443	Fee-for-Service	1013304880	1013304880	1	1	HONG, JESSICA K MD	10/18/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	144848	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
96472	Fee-for-Service	1326028663	1326028663	1	1	HAMKER ALLEN J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HAMKER ALLEN J MD	5701 N PORTLAND	SUITE 210	OKLAHOMA CITY	OK	73112	0000	00	None	35.52798155	-97.58348007	Oklahoma County
96481	Fee-for-Service	1558627992	1558627992	1	1	HOLECKO, JOSEPH W MD	8/12/2019	207L00000X	NA	Other	026	PHYSICIANS	161027	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
96487	Fee-for-Service	1225439854	1225439854	1	1	HWANG, LINDA H OD	12/24/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 STEIN PLAZA	1-340	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
96499	Fee-for-Service	1992705529	1992705529	3	1	HYGEIA APOTHECARY INC	4/19/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2331 E CESAR E CHAVEZ	None	LOS ANGELES	CA	90033	1810	19	06037	34.04697166	-118.2081041	Los Angeles County
96501	Fee-for-Service	1912187113	1912187113	1	1	HAMPARIAN, MIREILLE P MD	5/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75480	18	Ophthalmology	0	In state provider	INC	1560 E CHEVY CHASE DR	STE 220	GLENDALE	CA	91206	4140	19	06037	34.15290734	-118.2302295	Los Angeles County
96510	Fee-for-Service	1124120878	1124120878	1	1	HOFFMAN, JOSHUA H MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	52944	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
96517	Fee-for-Service	1437769072	1437769072	1	1	HOPE STAR HOSPICE CARE INC	9/30/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12444 VICTORY BLVD	UNIT 324	NORTH HOLLYWOOD	CA	91606	3199	19	06037	34.18663951	-118.4043555	Los Angeles County
96520	Fee-for-Service	1467667147	1467667147	1	1	HELBIG, CLAIRE E MD	3/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115018	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
96568	Fee-for-Service	1659749182	1659749182	1	1	HUA, TRANSAM PT	12/7/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
96615	Fee-for-Service	1851385405	1851385405	1	1	HAYES, MEGHAN E MD	12/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54242	41	Internal Medicine	0	In state provider	None	2801 K STREET	SUITE 220	SACRAMENTO	CA	95816	5118	34	06067	38.572947	-121.46904	Sacramento County
96621	Fee-for-Service	1508037714	1508037714	1	1	HOFFMAN, JEANNE A NP	9/24/2018	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
96673	Fee-for-Service	1205985793	1205985793	1	1	HESPERIA FIRE DEPARTMENT	1/1/1979	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	17288 OLIVE ST	None	HESPERIA	CA	92345	6012	36	06071	34.41562564	-117.2858376	San Bernardino County
96704	Fee-for-Service	1821205709	1821205709	1	6	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GROUP OF S F VALLEY	27420 TOURNEY ROAD	SUITE 210	SANTA CLARITA	CA	91355	5634	19	06037	34.42122797	-118.5787489	Los Angeles County
96707	Fee-for-Service	1518999143	1518999143	1	1	HOWELL, WILLIAM M MD INC	3/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81313	41	Internal Medicine	0	In state provider	HOWELL MEDICAL GROUP	1245 WILSHIRE BLVD	STE 316	LOS ANGELES	CA	90017	4803	19	06037	34.05362775	-118.2661889	Los Angeles County
96761	Fee-for-Service	1326371733	1326371733	1	1	HUMA RASHID	11/13/2018	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
96766	Fee-for-Service	1366428880	1366428880	1	1	HUNT DELWIN	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
96767	Fee-for-Service	1669785861	1669785861	1	1	HSIEH, KAREN K MD	11/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	12009	08	Family Practice	0	In state provider	None	12550 HESPERIA RD	None	VICTORVILLE	CA	92395	5873	36	06071	34.47928534	-117.2909553	San Bernardino County
96771	Fee-for-Service	1003558420	1003558420	1	1	HALAIS FRANGIEH, ANTONIO MD	6/10/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (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
96800	Fee-for-Service	1124120878	1124120878	1	1	HOFFMAN, JOSHUA H MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	52944	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3087	31	06061	38.76566391	-121.2457432	Placer County
96804	Fee-for-Service	1437769072	1437769072	1	1	HOPE STAR HOSPICE CARE INC	9/30/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12444 VICTORY BLVD	UNIT 324	NORTH HOLLYWOOD	CA	91606	3199	19	06037	34.18663951	-118.4043555	Los Angeles County
96811	Fee-for-Service	1467667147	1467667147	1	1	HELBIG, CLAIRE E MD	3/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115018	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
96812	Fee-for-Service	1134261134	1134261134	1	1	HAUG, KEVIN S MD	7/8/2008	2080P0204X	NA	Other	026	PHYSICIANS	81885	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
96836	Fee-for-Service	1124596713	1124596713	1	1	HU, MELISSA PT	8/2/2019	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
96869	Fee-for-Service	1235316993	1235316993	1	1	HACKLEY, SHAWN R	3/26/2008	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18661 OLD COAST HIGHWAY	None	FORT BRAGG	CA	95437	8260	23	06045	39.41472517	-123.8094471	Mendocino County
96972	Fee-for-Service	1558018697	1558018697	1	1	HARTZELL, ERIN A RCP	4/7/2023	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
96978	Fee-for-Service	1720548399	1720548399	1	1	HAIDAR, JASON DO	8/26/2024	207L00000X	NA	Other	026	PHYSICIANS	22343	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
96987	Fee-for-Service	1396874202	1396874202	2	1	HINOJOSA, VITAL MD	3/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	37463	01	General Practice	0	In state provider	None	6245 DE LONGPRE AVE	STE 206	HOLLYWOOD	CA	90028	8253	19	06037	34.0962065	-118.325178	Los Angeles County
96992	Fee-for-Service	1821205709	1821205709	1	6	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP OF S F VALLEY	27420 TOURNEY ROAD	SUITE 210	SANTA CLARITA	CA	91355	5634	19	06037	34.42122797	-118.5787489	Los Angeles County
97023	Fee-for-Service	1568741734	1568741734	1	1	HARRIS, DANIELLE M CRNA	5/22/2019	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
97028	Fee-for-Service	1285818518	1285818518	1	1	HA, EDWARD L MD	5/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98159	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
97036	Fee-for-Service	1174677207	1174677207	1	1	HERNANDEZ, JOSE G MD	8/28/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	85712	40	Pediatrics	0	In state provider	AAA PEDIATRICS	1950 E CHAPMAN AVE	STE 3	FULLERTON	CA	92831	4141	30	06059	33.87415649	-117.896778	Orange County
97039	Fee-for-Service	1922669142	1922669142	1	1	HESLIN, ANDREW DO	9/19/2022	207P00000X	NA	Other	026	PHYSICIANS	20044	None	None	0	In state provider	None	555 EAST HARDY STREET	None	INGLEWOOD	CA	90301	4011	19	06037	33.94909549	-118.3481595	Los Angeles County
97048	Fee-for-Service	1033731997	1033731997	1	1	HERNANDEZ, CARLOS DO	4/3/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	23815	36	Psychiatry	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
97052	Fee-for-Service	1104091974	1104091974	1	1	HOLLINQUEST, TRUVETTE LPCC	5/31/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
97100	Fee-for-Service	1134261134	1134261134	1	1	HAUG, KEVIN S MD	7/8/2008	2080P0204X	NA	Other	026	PHYSICIANS	81885	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
97117	Fee-for-Service	1780094672	1780094672	1	1	HIGGINS, YULIA LCSW	10/3/2022	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
97121	Fee-for-Service	1831155654	1831155654	1	1	HUTCHISON, HARROL T MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	36024	None	None	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
97158	Fee-for-Service	1437706397	1437706397	1	1	HD ELSHIRE III MD PHD FACS,	2/5/2020	261QM2500X	NA	Other	026	PHYSICIANS	None	02	General Surgery	0	In state provider	INC	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	37	06073	32.78144947	-115.568541	Imperial County
97220	Fee-for-Service	1689648693	1689648693	1	1	HEE, TODD MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43433	41	Internal Medicine	0	In state provider	None	675 S ARROYO PKWY	None	PASADENA	CA	91105	3263	19	06037	34.13385453	-118.1474229	Los Angeles County
97234	Fee-for-Service	1467506451	1467506451	1	3	HALO MEDICAL GROUP	12/1/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	A MEDICAL CORPORATION	1133 N PALM CANYON DR	STE B	PALM SPRINGS	CA	92262	4431	33	06065	33.838164	-116.546796	Riverside County
97256	Fee-for-Service	1548478977	1548478977	1	1	HO, JOHN MD	7/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108571	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	500 OLD RIVER ROAD	SUITE 105	BAKERSFIELD	CA	93311	9505	15	06029	35.35127492	-119.1142991	Kern County
97281	Fee-for-Service	1821205709	1821205709	1	6	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GROUP OF S F VALLEY	27420 TOURNEY ROAD	SUITE 210	SANTA CLARITA	CA	91355	5634	19	06037	34.42122797	-118.5787489	Los Angeles County
97319	Fee-for-Service	1588691745	1588691745	1	1	HOLT, DANICA C MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62944	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
97350	Fee-for-Service	1851355473	1851355473	1	1	HASHEMI, RAY H MD	4/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	71742	30	Radiology	0	In state provider	ADVANCED IMAGING CENTER	43731 15TH ST W	STE D	LANCASTER	CA	93534	4785	19	06037	34.67731742	-118.1564784	Los Angeles County
97357	Fee-for-Service	1336452085	1336452085	1	1	HARI OM GOYAL MD & SHALINI	9/3/2010	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GUPTA MD	414 G STREET	STE 240	MARYSVILLE	CA	95901	5670	58	06115	39.13913942	-121.5934649	Yuba County
97426	Fee-for-Service	1447620182	1447620182	1	1	HARMANDJIAN, ALINE A	4/5/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
97437	Fee-for-Service	1023076692	1023076692	1	1	HARGRAVE, THOMAS B MD	7/13/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	44506	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3300 WEBSTER ST	STE 312	OAKLAND	CA	94609	3118	01	06001	37.82132826	-122.2621843	Alameda County
97442	Fee-for-Service	1083813158	1083813158	1	1	HUANG, GALEN C L MD	1/1/1979	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	32354	41	Internal Medicine	0	In state provider	None	6958 BROCKTON AVE	STE 202	RIVERSIDE	CA	92506	3832	33	06065	33.947244	-117.3967305	Riverside County
97459	Fee-for-Service	1063783405	1063783405	1	1	HEYMAN, MARK F PHD	3/12/2012	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
97484	Fee-for-Service	1689729253	1689729253	1	1	HANJAN, TIVA MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81862	25	Physical Medicine and Rehabilitation	0	In state provider	None	1501 N PLACENTIA AVENUE	None	PLACENTIA	CA	92870	2332	30	06059	33.89044889	-117.8741363	Orange County
97488	Fee-for-Service	1629006168	1629006168	1	1	HUTCHENS MICHAEL 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	934 SE 38TH AVE	None	PORTLAND	OR	97214	0000	00	None	45.51589909	-122.6243912	Multnomah County
97504	Fee-for-Service	1720461841	1720461841	1	1	HARRIS-FITZSIMONS, EVIE LMF	7/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	531 S WASHINGTON ST	None	SONORA	CA	95370	5114	55	06109	37.97813417	-120.3806265	Tuolumne County
97522	Fee-for-Service	1861684664	1861684664	1	1	HUGHES, STEVEN A LMFT	11/3/2020	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
97530	Fee-for-Service	1275525651	1275525651	1	1	HEYER, ROBERT	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3390 N CAMPBELL AVE	STE 110	TUCSON	AZ	85719	2380	00	None	32.26833	-110.94327	Pima County
97558	Fee-for-Service	1972759447	1972759447	1	1	HUANG, EUGENE Y MD	6/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	100212	07	Dermatology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
97566	Fee-for-Service	1346579596	1346579596	1	1	HAN, SAMANTHA H MD A	8/24/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	67693	None	None	0	In state provider	PROFESSIONAL CORPORATION	1505 WILSON TERRACE	STE 160	GLENDALE	CA	91206	4073	19	06037	34.14960934	-118.2313491	Los Angeles County
97597	Fee-for-Service	1619175759	1619175759	1	1	HANSEN, ALLAN V MD	5/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101406	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
97599	Fee-for-Service	1558497891	1558497891	1	1	HADI, GHASSAN E MD	1/15/2009	207R00000X	NA	Other	026	PHYSICIANS	52261	41	Internal Medicine	0	In state provider	None	2352 DEL MARINO	None	LA VERNE	CA	91750	1106	19	06037	34.14458085	-117.7602036	Los Angeles County
97607	Fee-for-Service	1306379623	1306379623	1	1	HUANG, KATHERINE C DO	8/6/2020	208M00000X	NA	Other	026	PHYSICIANS	18083	41	Internal Medicine	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
97608	Fee-for-Service	1588891907	1588891907	1	1	HEITMANN, GREGORY M P MD	12/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114944	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
97617	Fee-for-Service	1962403493	1962403493	1	1	HERRMANN, ANGELA MD INC	7/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	75988	40	Pediatrics	0	In state provider	None	630 S GLASSELL ST	STE 106A	ORANGE	CA	92866	3091	30	06059	33.77799	-117.8532285	Orange County
97622	Fee-for-Service	1417275108	1417275108	1	1	HUANG, EMERALD MD	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110310	25	Physical Medicine and Rehabilitation	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
97646	Fee-for-Service	1689816290	1689816290	1	1	HAKANSON, MATTHEW G OD	10/10/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2417 NAGLEE RD	SUITE 8A	TRACY	CA	95304	7324	39	06077	37.75489119	-121.4665269	San Joaquin County
97677	Fee-for-Service	1114086790	1114086790	1	1	HEMSLEY, LAURI B MD	4/1/1995	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	74648	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
97700	Fee-for-Service	1366685927	1366685927	1	1	HAMILTON, NICHOLAS J MD	3/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102702	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
97724	Fee-for-Service	1407317001	1407317001	1	1	HOTCA-CHO, ALEXANDRA ELENA	8/14/2024	2085R0001X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	MD	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
97725	Fee-for-Service	1023076692	1023076692	1	1	HARGRAVE, THOMAS B MD	7/13/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	44506	10	Gastroenterology (M.D. only)	0	In state provider	None	3300 WEBSTER ST	STE 312	OAKLAND	CA	94609	3118	01	06001	37.82132826	-122.2621843	Alameda County
97730	Fee-for-Service	1083813158	1083813158	1	1	HUANG, GALEN C L MD	1/1/1979	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	32354	10	Gastroenterology (M.D. only)	0	In state provider	None	6958 BROCKTON AVE	STE 202	RIVERSIDE	CA	92506	3832	33	06065	33.947244	-117.3967305	Riverside County
97745	Fee-for-Service	1104952084	1104952084	1	1	HAKIM RAGAIE L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56354	01	General Practice	0	In state provider	None	1959 1/2 E FLORENCE AVE	None	LOS ANGELES	CA	90001	2700	19	06037	33.9747873	-118.2355217	Los Angeles County
97761	Fee-for-Service	1578544094	1578544094	1	1	HUNTLEY, ARTHUR C MD	5/8/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	24292	07	Dermatology	0	In state provider	UCD PROF SVS GRP	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
97764	Fee-for-Service	1164916029	1164916029	1	1	HARRIS, EBONY A LMFT	2/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3700 MALL VIEW RD	None	BAKERSFIELD	CA	93306	3050	15	06029	35.39462173	-118.9518506	Kern County
97768	Fee-for-Service	1538242292	1538242292	1	1	HALEY-WIEN, SARAH E DO	3/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11583	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
97838	Fee-for-Service	1457411050	1457411050	1	1	HOSEA, STEPHEN W MD	3/1/1982	207R00000X	NA	Other	026	PHYSICIANS	45763	41	Internal Medicine	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
97853	Fee-for-Service	1235201088	1235201088	1	1	HUR, LINNEA K MD	1/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90445	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
97932	Fee-for-Service	1003993932	1003993932	1	1	HEALZER, JAMES M	8/4/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69387	41	Internal Medicine	0	In state provider	None	400 PARNASSUS AVE	# 540	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
97933	Fee-for-Service	1588195853	1588195853	1	1	HARWIN, JOELLE R MD	6/16/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161147	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
97944	Fee-for-Service	1114090461	1114090461	2	1	HURWITZ, KATHLEEN B MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	61204	40	Pediatrics	0	In state provider	None	25395 HANCOCK AVE	STE 250	MURRIETA	CA	92562	9009	33	06065	33.5591482	-117.185187	Riverside County
97974	Fee-for-Service	1225303779	1225303779	1	1	HEATH, MEGAN E LMFT	7/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
97980	Fee-for-Service	1295914208	1295914208	1	1	HUNKING, JANICE P LCSW	1/17/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23180 HEMLOCK AVE	SUITE 100	MORENO VALLEY	CA	92557	8001	33	06065	33.94245952	-117.2585565	Riverside County
98008	Fee-for-Service	1598001349	1598001349	1	1	HEARING STATION CORP	7/9/2012	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	ELLEN L NATHAN	1415 E COLORADO STREET	SUITE 201	GLENDALE	CA	91205	1536	19	06037	34.14279663	-118.2333245	Los Angeles County
98013	Fee-for-Service	1023076692	1023076692	1	1	HARGRAVE, THOMAS B MD	7/13/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	44506	41	Internal Medicine	0	In state provider	None	3300 WEBSTER ST	STE 312	OAKLAND	CA	94609	3118	01	06001	37.82132826	-122.2621843	Alameda County
98033	Fee-for-Service	1477044931	1477044931	1	1	HODGE, LEWIE E LCSW	1/26/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
98038	Fee-for-Service	1619049749	1619049749	2	1	HUNG, CHUANG T MD	6/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	36336	01	General Practice	0	In state provider	None	629 N 13TH AVE	None	UPLAND	CA	91786	4906	36	06071	34.10133639	-117.6337219	San Bernardino County
98055	Fee-for-Service	1801390810	1801390810	1	1	HSU, ERIKA MD	4/19/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164519	None	None	0	In state provider	None	300 UCLA MEDICAL PLAZA	3300	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
98094	Fee-for-Service	1124187794	1124187794	1	1	HAKIMIAN, OMID MD	4/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53802	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
98125	Fee-for-Service	1457411050	1457411050	1	1	HOSEA, STEPHEN W MD	3/1/1982	207R00000X	NA	Other	026	PHYSICIANS	45763	77	Infectious Disease	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
98143	Fee-for-Service	1720665680	1720665680	1	1	HOJJAT, ARMIN MD	12/9/2024	261QU0200X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
98169	Fee-for-Service	1972734804	1972734804	1	1	HAVILAND, COLLEEN R LCSW	12/5/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15400 LOS GATOS BLVD	None	LOS GATOS	CA	95032	2502	43	06085	37.24572659	-121.957997	Santa Clara County
98171	Fee-for-Service	1518077908	1518077908	1	2	HOYME, HAROLD E MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	36235	01	General Practice	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
98175	Fee-for-Service	1972063352	1972063352	1	1	HANIFF TRAN, SABRINA N MD	2/3/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	182635	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
98187	Fee-for-Service	1982384756	1982384756	1	1	HOAR, SAMANTHA J	5/15/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
98198	Fee-for-Service	1518101070	1518101070	1	1	HA, BO YOON MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108922	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
98200	Fee-for-Service	1083607212	1083607212	1	1	HYE PHARMACY INC	4/17/1986	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5236 SANTA MONICA BLVD	None	LOS ANGELES	CA	90029	1210	19	06037	34.09077051	-118.3046976	Los Angeles County
98260	Fee-for-Service	1780603274	1780603274	1	1	HOCHHALTER, TIMOTHY J LMFT	8/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4144 S DAMAREE ST	STE A	VISALIA	CA	93277	9514	54	06107	36.293157	-119.33073	Tulare County
98296	Fee-for-Service	1801340047	1801340047	1	1	HUIZAR-HERRERA, SANDRA NP	8/31/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	798 S WINCHESTER BLVD	None	SAN JOSE	CA	95128	2928	43	06085	37.313361	-121.9499825	Santa Clara County
98331	Fee-for-Service	1801216742	1801216742	1	1	HOFFMAN, BRYCE C MD	4/27/2020	207K00000X	NA	Other	026	PHYSICIANS	163410	03	Allergy	0	In state provider	None	97 SAN MARIN DR	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
98341	Fee-for-Service	1366636995	1366636995	1	1	HO, JOYCE M MD	7/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92759	02	General Surgery	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
98361	Fee-for-Service	1679905715	1679905715	1	1	HYDE DIALYSIS LLC	3/24/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	8231 E STOCKTON BLVD	None	SACRAMENTO	CA	95828	8202	34	06067	38.459727	-121.410315	Sacramento County
98364	Fee-for-Service	1114325917	1114325917	1	2	HARVEY, RACHAEL A LMFT	2/10/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17325 PENN VALLEY	D	PENN VALLEY	CA	95946	9340	29	06057	39.19854475	-121.1747888	Nevada County
98372	Fee-for-Service	1427002856	1427002856	1	3	HAWTHORNE RADIOLOGY	5/31/2011	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	ASSOCIATES MEDICAL GROUP	1918 WEST BEVERLY BLVD	None	MONTEBELLO	CA	90640	3957	19	06037	34.02023731	-118.1199715	Los Angeles County
98373	Fee-for-Service	1750366746	1750366746	1	1	HYATT, AMANDA PHD	5/16/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
98383	Fee-for-Service	1598785594	1598785594	1	1	HAKE, STEVEN E MD	10/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	64491	30	Radiology	0	In state provider	None	25020 LAS BRISAS ROAD	STE 205D	MURRIETA	CA	92562	4064	33	06065	33.57370977	-117.1829111	Riverside County
98394	Fee-for-Service	1609515642	1609515642	1	1	HAN HWANG, YOHAN NP	10/18/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
98397	Fee-for-Service	1831480185	1831480185	1	1	HARDING, BENJAMIN R MD FAAP	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122251	None	None	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
98408	Fee-for-Service	1508944562	1508944562	1	1	HOM, MELANIE L MD	9/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86406	18	Ophthalmology	0	In state provider	None	491 30TH ST	STE 201	OAKLAND	CA	94609	3235	01	06001	37.81935528	-122.2667902	Alameda County
98425	Fee-for-Service	1598859654	1598859654	1	1	HOFF, JAMES S MD APC	5/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	50029	41	Internal Medicine	0	In state provider	None	999 S FAIRMONT AVE	STE 135	LODI	CA	95240	5141	39	06077	38.1206163	-121.2858323	San Joaquin County
98426	Fee-for-Service	1740746726	1740746726	1	1	HANK, MARGARET LCSW	2/1/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
98450	Fee-for-Service	1750563011	1750563011	1	1	HSU, WENDY W MD	10/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101768	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
98452	Fee-for-Service	1356367692	1356367692	1	1	HINSHAW, DAVID B JR MD	12/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	22897	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
98478	Fee-for-Service	1467778217	1467778217	1	1	HERTZER, KATHLEEN M MD	11/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121173	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
98479	Fee-for-Service	1932745585	1932745585	1	1	HIBBELN, JOSEPH R MD	7/6/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	-	36	Psychiatry	1	Border provider	None	155 HIGHWAY 50	None	STATELINE	NV	89449	0000	00	None	38.96860553	-119.9356859	Douglas County
98498	Fee-for-Service	1174756241	1174756241	1	1	HILL, TIFFANY E MD	2/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106853	08	Family Practice	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
98516	Fee-for-Service	1669946331	1669946331	1	1	HOANG, ANNA PT	8/15/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1085 W EL CAMINO REAL	None	SUNNYVALE	CA	94087	1030	43	06085	37.37270741	-122.0517412	Santa Clara County
98527	Fee-for-Service	1033198130	1033198130	1	1	HECTOR O LAUREL M.D	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	COMPREHENSIVE ANESTHESIA	2006 FRANKLIN ST STE 301	None	HUNTSVILLE	AL	35801	0000	00	None	34.719084	-86.57680148	Madison County
98531	Fee-for-Service	1376782755	1376782755	1	1	HO CAIN, KITTY MD	11/27/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
98591	Fee-for-Service	1720314867	1720314867	1	1	HEATH, THAYER A MD	6/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116820	05	Anesthesiology	0	In state provider	None	3000 COLBY STREET	SUITE 205	BERKELEY	CA	94705	2058	01	06001	37.85473248	-122.2575793	Alameda County
98609	Fee-for-Service	1982821179	1982821179	1	1	HERNANDEZ, SILVIA E LMFT	10/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
98615	Fee-for-Service	1861476855	1861476855	1	1	HOHL, WILLIAM M MD	1/31/1992	174400000X	NA	Other	026	PHYSICIANS	76221	20	Orthopedic Surgery	0	In state provider	None	1043 ELM AVE	STE 407	LONG BEACH	CA	90813	3296	19	06037	33.779655	-118.1880065	Los Angeles County
98623	Fee-for-Service	MSS00052F	None	1	1	HEALTH PROJECT CENTER	2/1/2012	No Taxonomy Provided	NA	None	074	MULTIPURPOSE SENIOR SERVICES PROGRAM	-	-	NOT APPLICABLE	0	In state provider	MONTEREY	9000 SOQUEL AVENUE	SUITE 103	SANTA CRUZ	CA	95062	2097	44	06087	36.98201547	-121.9663408	Santa Cruz County
98629	Fee-for-Service	1366636995	1366636995	1	1	HO, JOYCE M MD	7/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92759	34	Urology and Urological Surgery	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
98744	Fee-for-Service	1548816713	1548816713	1	1	HESS, SHERI LMFT	12/17/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3707 SUNSET LANE AND 371	A & B	ANTIOCH	CA	94509	6101	07	06013	37.98459755	-121.8042179	Contra Costa County
98747	Fee-for-Service	1831623503	1831623503	1	1	HOBAN, LAUREN E NP	10/2/2019	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
98751	Fee-for-Service	1497042840	1497042840	1	1	HOUSECALL MD INC	7/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	1171 S ROBERTSON BLVD	SUITE 242	LOS ANGELES	CA	90035	1403	19	06037	34.05510581	-118.3837417	Los Angeles County
98783	Fee-for-Service	1275891954	1275891954	1	1	HORIZON AMBULANCE INC	12/31/2013	3416L0300X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3305 E MIRALOMA AVE	STE 171	ANAHEIM	CA	92806	1935	30	06059	33.86027357	-117.8512129	Orange County
98852	Fee-for-Service	1184685208	1184685208	1	1	HUANG, CANDICE C MD	6/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88131	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
98859	Fee-for-Service	1902161359	1902161359	1	1	HUR, LINDA H OD	10/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
98915	Fee-for-Service	1528074531	1528074531	1	1	HARNEY, BRIAN P MD	7/3/1997	207L00000X	NA	Other	026	PHYSICIANS	36496	05	Anesthesiology	0	In state provider	None	5469 KEARNY VILLA RD	None	SAN DIEGO	CA	92123	1152	37	06073	32.83298834	-117.1388725	San Diego County
98916	Fee-for-Service	1366636995	1366636995	1	1	HO, JOYCE M MD	7/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92759	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
98919	Fee-for-Service	1720199672	1720199672	1	1	HOOKER, WILLIAM D PHD	9/3/2013	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
98927	Fee-for-Service	1033435904	1033435904	3	1	HANNON, MONICA Y MD	12/13/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	129228	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	402 8TH AVE	201	SAN FRANCISCO	CA	94118	3057	38	06075	37.78061549	-122.4663704	San Francisco County
98941	Fee-for-Service	1144682378	1144682378	1	1	HARDIT, VINEY MD	9/19/2023	2080P0207X	NA	Hematology	026	PHYSICIANS	186819	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
98956	Fee-for-Service	1720258379	1720258379	1	1	HICKS, REBECCA A MD	6/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101764	67	Endocrinology	0	In state provider	None	2650 ELM AVENUE	SUITE 210	LOS ANGELES	CA	90806	1600	19	06037	33.805521	-118.1882945	Los Angeles
98961	Fee-for-Service	1184816654	1184816654	1	1	HOANG, KHANH NGAN P	8/2/2023	103TB0200X	NA	Mental Health Outpatient Services	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
98965	Fee-for-Service	1053676601	1053676601	1	1	HULL, ROBIN S CNP	1/19/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2791 AGOURA RD	None	THOUSAND OAKS	CA	91361	3101	56	06111	34.15068671	-118.8255597	Ventura County
98971	Fee-for-Service	1144671579	1144671579	1	1	HALCON, RANDI S LMFT	2/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
98988	Fee-for-Service	1538583919	1538583919	1	1	HOBBS, KARI A NP	11/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	812571	-	NOT APPLICABLE	0	In state provider	None	433 TURK STREET	None	SAN FRANCISCO	CA	94102	3392	38	06075	37.78247225	-122.4163506	San Francisco County
98992	Fee-for-Service	1235524612	1235524612	1	1	HUSSEIN, WALEED MD	2/1/2023	390200000X	NA	Other	026	PHYSICIANS	156472	None	None	0	In state provider	None	911 SUNSET DR	None	HOLLISTER	CA	95023	5695	35	06069	36.83504962	-121.3858245	San Benito County
99012	Fee-for-Service	1437126067	1437126067	1	1	HANNON, ELENA MD	2/13/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
99014	Fee-for-Service	1669961520	1669961520	1	1	HALL, NATALIE J MD	9/24/2024	163WG0100X	NA	Other	026	PHYSICIANS	166846	70	Clinic (mixed specialty)	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
99023	Fee-for-Service	1114926367	1114926367	1	1	HOU, ANTONY C MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73744	41	Internal Medicine	0	In state provider	None	548 N 13TH AVE	STE 204	UPLAND	CA	91786	4976	36	06071	34.10032426	-117.6334669	San Bernardino County
99026	Fee-for-Service	1548897093	1548897093	1	1	HO, MELISSA	1/31/2024	207R00000X	NA	Other	026	PHYSICIANS	187607	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
99053	Fee-for-Service	1760565162	1760565162	1	1	HRISHIKESAN, ANITA G LCSW	5/19/2017	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
99063	Fee-for-Service	1013937747	1013937747	1	1	HUANG, SUMIN M OD	9/1/1981	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1909 N WATERMAN AVE	STE 4	SAN BERNARDINO	CA	92404	4842	36	06071	34.132626	-117.2787445	San Bernardino County
99150	Fee-for-Service	1457917551	1457917551	1	1	HAYAWI AND BARKA INVESTMENT	2/18/2021	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	2667 CAMINO DEL RIO S	301-13	SAN DIEGO	CA	92108	3707	37	06073	32.76977026	-117.135564	San Diego County
99198	Fee-for-Service	1164291878	1164291878	1	1	HANSEN, DENISE RCP	1/5/2024	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
99204	Fee-for-Service	1194928770	1194928770	1	1	HANELIN, JOSHUA D MD	4/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115815	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2721	38	06075	37.76386986	-122.4568084	San Francisco County
99212	Fee-for-Service	1043358369	1043358369	1	1	HEKMAT, SOHEIL MD	3/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	32561	41	Internal Medicine	0	In state provider	None	511 E MANCHESTER BLVD	None	INGLEWOOD	CA	90301	1907	19	06037	33.96161457	-118.3478552	Los Angeles County
99238	Fee-for-Service	1457493843	1457493843	1	1	HADDAD, FRANCOIS MD	7/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92140	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
99247	Fee-for-Service	1720258379	1720258379	1	1	HICKS, REBECCA A MD	6/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101764	40	Pediatrics	0	In state provider	None	2650 ELM AVENUE	SUITE 210	LOS ANGELES	CA	90806	1600	19	06037	33.805521	-118.1882945	Los Angeles
99261	Fee-for-Service	1265799613	1265799613	1	1	HSU, DAVID	3/25/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4623 QUAIL LAKES DRIVE	None	STOCKTON	CA	95207	5258	39	06077	37.987257	-121.3401973	San Joaquin County
99276	Fee-for-Service	1861662215	1861662215	1	1	HARRIS, JULIA M CRNA	6/30/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
99300	Fee-for-Service	1437126067	1437126067	1	1	HANNON, ELENA MD	2/13/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
99301	Fee-for-Service	1669961520	1669961520	1	1	HALL, NATALIE J MD	9/24/2024	163WG0100X	NA	Other	026	PHYSICIANS	166846	41	Internal Medicine	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
99307	Fee-for-Service	1215988878	1215988878	1	1	HADDAD-TEHRANI, NOUSHIN	9/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	69067	41	Internal Medicine	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
99345	Fee-for-Service	1417919085	1417919085	1	1	HASAN, KHALID S MD	10/10/2019	2080P0205X	NA	Endocrinology	026	PHYSICIANS	134457	40	Pediatrics	0	In state provider	None	43112 N 15TH ST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
99370	Fee-for-Service	1740712421	1740712421	1	1	HSIAO, EMILY MD	10/5/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170005	08	Family Practice	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
99396	Fee-for-Service	1295781201	1295781201	1	1	HOGHOOGHI, DONNA MD	9/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70268	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
99426	Fee-for-Service	1801569868	1801569868	1	1	HONIG, AMANDA J CRNA	5/17/2022	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
99475	Fee-for-Service	1932330222	1932330222	1	1	HUYNH, NHI T MD	12/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129741	30	Radiology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
99491	Fee-for-Service	1083783997	1083783997	1	1	HORVATH, NICOLE R MD	3/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86873	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
99513	Fee-for-Service	1205339835	1205339835	1	1	HODOS, LINDSEY J LMFT	3/20/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39350 CIVIC CENTER DR	None	FREMONT	CA	94538	2343	01	06001	37.55399458	-121.9756047	Alameda County
99566	Fee-for-Service	1740291541	1740291541	1	1	HANGER P & O WEST INC	10/1/1998	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1043 ELM AVE	STE 202	LONG BEACH	CA	90813	3244	19	06037	33.779655	-118.1880065	Los Angeles County
99573	Fee-for-Service	1528118262	1528118262	1	1	HAHN, RUTH A MD	1/12/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	88964	None	None	0	In state provider	None	3779 PIEDMONT	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
99590	Fee-for-Service	1669961520	1669961520	1	1	HALL, NATALIE J MD	9/24/2024	163WG0100X	NA	Other	026	PHYSICIANS	166846	10	Gastroenterology (M.D. only)	0	In state provider	None	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70554251	-121.873005	Alameda County
99614	Fee-for-Service	1932759131	1932759131	1	1	HOME FRONT PUMPS, LLC	1/4/2022	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	14839 CORTA DRIVE	UNIT A	VICTORVILLE	CA	92395	4066	36	06071	34.52105399	-117.3052274	San Bernardino County
99625	Fee-for-Service	1194427476	1194427476	1	1	HUGHES, JESSI L BIRTH DOULA	5/11/2023	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	37	06073	0	0	None
99632	Fee-for-Service	1942390687	1942390687	1	1	HOBART, EDWARD A MD	8/13/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161765	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
99716	Fee-for-Service	1952627861	1952627861	1	1	HARPER, AARON W MD	12/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120713	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
99728	Fee-for-Service	1790776805	1790776805	1	1	HERNANDEZ, RICHARD B MD	7/1/1984	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38178	08	Family Practice	0	In state provider	None	722 BAKER ST	None	COSTA MESA	CA	92626	4320	30	06059	33.68016047	-117.886563	Orange County
99733	Fee-for-Service	1093745630	1093745630	1	1	HSIEH, CHARLOTTE J MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71388	77	Infectious Disease	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
99756	Fee-for-Service	1952365140	1952365140	1	1	HUGHES, ELIZABETH C MD	12/1/1998	207N00000X	NA	Dermatology	026	PHYSICIANS	81881	07	Dermatology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
99761	Fee-for-Service	1679666754	1679666754	1	1	HUCADY,SUSAN DEBORAH 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
99838	Fee-for-Service	1962560250	1962560250	1	1	HITES, LASZLO MD	10/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	37112	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	368 JUANA AVE	None	SAN LEANDRO	CA	94577	4811	01	06001	37.72419995	-122.1515717	Alameda County
99841	Fee-for-Service	1164750394	1164750394	1	1	HONG, SABRINA S MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108425	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
99888	Fee-for-Service	1154890093	1154890093	1	1	HOPKINS, SARAH K NP	12/4/2018	No Taxonomy Provided	NA	None	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
99894	Fee-for-Service	1295080984	1295080984	1	1	HASSAN, ZAYNB A MD	8/7/2017	390200000X	NA	Other	026	PHYSICIANS	135846	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
99903	Fee-for-Service	1851399844	1851399844	2	1	HOME MEDIX INC	2/17/2017	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	3811 ATLANTIC AVE	None	LONG BEACH	CA	90807	3505	19	06037	33.82704	-118.185107	Los Angeles County
99926	Fee-for-Service	1639762529	1639762529	1	1	HUYNH, THANH K MD	8/2/2021	207L00000X	NA	Other	026	PHYSICIANS	162632	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
99966	Fee-for-Service	1528153350	1528153350	1	1	HOANG, TUAN ANH MD	3/1/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	35049	01	General Practice	0	In state provider	None	835 JACKSON ST	STE 401	SAN FRANCISCO	CA	94133	4856	38	06075	37.79571605	-122.4089175	San Francisco County
99991	Fee-for-Service	1326005091	1326005091	1	1	HERR, STEPHEN L MD	1/8/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	19501	10	Gastroenterology (M.D. only)	0	In state provider	None	50 ALESSANDRO PLACE	SUITE 440	PASADENA	CA	91105	0000	19	06037	34.13101049	-118.151532	Los Angeles County
100006	Fee-for-Service	1093267361	1093267361	1	1	HOFFMAN, JESSICA L LMFT	8/16/2021	101YM0800X	NA	Other	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
100007	Fee-for-Service	1639375108	1639375108	1	2	HEALING ARTS SURGERY CENTER	6/25/2016	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2700 F ST	STE 101	BAKERSFIELD	CA	93301	1849	15	06029	35.384184	-119.023442	Kern County
100015	Fee-for-Service	1942621222	1942621222	1	1	HODOR, LAWRENCE DPM INC	1/22/2015	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5220 CLARK AVE	SUITE 125	LAKEWOOD	CA	90712	2623	19	06037	33.8527092	-118.1337623	Los Angeles County
100016	Fee-for-Service	1285780866	1285780866	2	1	HALSTEAD, SARAH M MD	9/20/2017	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
100021	Fee-for-Service	1093745630	1093745630	1	1	HSIEH, CHARLOTTE J MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71388	40	Pediatrics	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
100028	Fee-for-Service	1871552661	1871552661	1	1	HENDEL, ELI E	8/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36257	None	None	0	In state provider	None	1500 S CENTRAL AVE	STE 117	GLENDALE	CA	91204	2580	19	06037	34.12736888	-118.257777	Los Angeles County
100111	Fee-for-Service	1316151806	1316151806	1	1	HUONG PHAM OPTOMETRY CORPORA	5/26/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14251 EUCLID ST	STE F101	GARDEN GROVE	CA	92843	4957	30	06059	33.755166	-117.937627	Orange County
100126	Fee-for-Service	1962560250	1962560250	1	1	HITES, LASZLO MD	10/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	37112	41	Internal Medicine	0	In state provider	None	368 JUANA AVE	None	SAN LEANDRO	CA	94577	4811	01	06001	37.72419995	-122.1515717	Alameda County
100182	Fee-for-Service	1104403393	1104403393	1	1	HOSPICE NUMBER 12 INC	8/23/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	260 S GLENDORA AVE	STE #208	WEST COVINA	CA	91790	3041	19	06037	34.06934983	-117.923019	Los Angeles County
100186	Fee-for-Service	1205940889	1205940889	1	1	HENSHAW, WILLIAM C OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	801 S FAIRMONT AVE	STE 5	LODI	CA	95240	5106	39	06077	38.124486	-121.285886	San Joaquin County
100191	Fee-for-Service	1588868640	1588868640	1	1	HUNTINGTON PARK COMM	5/10/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	CARE MED ASSOCS INC	5600 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2537	19	06037	33.991695	-118.2252015	Los Angeles County
100203	Fee-for-Service	1043853732	1043853732	1	1	HUAYHUA, GRAMMY NP	4/19/2022	363LF0000X	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
100227	Fee-for-Service	1518935337	1518935337	1	1	HMP DIAGNOSTICS LLC	6/12/2015	293D00000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	2	Out of state provider	None	205 CLEVELAND RD	SUITE B	BOGART	GA	30622	6821	00	None	33.94311044	-83.47482957	Clarke County
100248	Fee-for-Service	1386635639	1386635639	1	1	HOFER, MARK A MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84172	20	Orthopedic Surgery	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
100265	Fee-for-Service	1518054477	1518054477	1	1	HETHUMUNI, REHANA M DO	1/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	8993	08	Family Practice	0	In state provider	None	675 ARROYO PKWY	None	PASADENA	CA	91105	3263	19	06037	34.13385453	-118.1474229	Los Angeles County
100271	Fee-for-Service	1144201120	1144201120	1	1	HARTVIGSEN,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	630 MEDICAL DR	None	BOUNTIFUL	UT	84010	0000	00	None	40.88671331	-111.8683023	Davis County
100272	Fee-for-Service	1851579981	1851579981	1	1	HWANG, LORIS Y MD	3/6/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	60237	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
100273	Fee-for-Service	1093155756	1093155756	1	1	HALLAHAN, LAURA B MD	9/17/2018	207R00000X	NA	Other	026	PHYSICIANS	145365	41	Internal Medicine	0	In state provider	None	1661 SOQUEL DR	STE D	SANTA CRUZ	CA	95065	1816	44	06087	36.98895429	-121.9821088	Santa Cruz County
100283	Fee-for-Service	1710752464	1710752464	1	1	HEALTH SEED LA	3/26/2024	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	None	01	General Practice	0	In state provider	None	4515 HUNTINGTON DR	None	LOS ANGELES	CA	90032	1940	19	06037	34.08405479	-118.1882702	Los Angeles County
100296	Fee-for-Service	1043384191	1043384191	1	1	HANGER P & O WEST INC.	9/1/1997	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1660 SAN PABLO AVE	STE 200	PINOLE	CA	94564	2072	07	06013	38.0043007	-122.2979847	Contra Costa County
100304	Fee-for-Service	1285780866	1285780866	2	1	HALSTEAD, SARAH M MD	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
100340	Fee-for-Service	1326677642	1326677642	1	1	HOWIE W QUE DPM INC	6/20/2024	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	750 MEDICAL CENTER CT	STE 6	CHULA VISTA	CA	91911	6634	37	06073	32.61830281	-117.0237339	San Diego County
100345	Fee-for-Service	1467506451	1467506451	1	5	HALO MEDICAL GROUP	11/16/2021	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	1720 ESPLANADE	None	CHICO	CA	95926	3315	04	06007	39.74490068	-121.8505328	Butte County
100349	Fee-for-Service	1134774904	1134774904	1	1	HSIEH, REBEKAH H LPCC	6/13/2020	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	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
100363	Fee-for-Service	1083632624	1083632624	1	1	HANLEY, FRANK MD	8/21/1996	208G00000X	NA	General Surgery	026	PHYSICIANS	42443	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	# M593	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
100381	Fee-for-Service	1912970369	1912970369	1	1	HILZ, STEVEN H OD	2/28/1990	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	136 W NUEVO RD	STE E&F	PERRIS	CA	92571	0858	33	06065	33.80109593	-117.2288652	Riverside County
100403	Fee-for-Service	1649366501	1649366501	1	1	HEARING DYNAMIC ENTERPRISES	5/16/2006	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1700 ALAMEDA ST	None	POMONA	CA	91768	1727	19	06037	34.07825822	-117.7555489	Los Angeles County
100468	Fee-for-Service	1740280668	1740280668	1	1	HASKINS, DAYLE A. MD	9/30/1989	207L00000X	NA	Other	026	PHYSICIANS	47903	05	Anesthesiology	0	In state provider	None	7500 HOSPITAL DR	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
100469	Fee-for-Service	1104403393	1104403393	1	1	HOSPICE NUMBER 12 INC	8/23/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	260 S GLENDORA AVE	STE #208	WEST COVINA	CA	91790	3041	19	06037	34.06934983	-117.923019	Los Angeles County
100479	Fee-for-Service	1588868640	1588868640	1	1	HUNTINGTON PARK COMM	5/10/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CARE MED ASSOCS INC	5600 PACIFIC BLVD	None	HUNTINGTON PARK	CA	90255	2537	19	06037	33.991695	-118.2252015	Los Angeles County
100499	Fee-for-Service	1235491580	1235491580	1	1	HWANG, JUNG S DO	6/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	13323	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
100529	Fee-for-Service	1215534557	1215534557	1	1	HOMESERVE HOSPICE INC	4/11/2025	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2777 PACIFIC AVE	STE J	LONG BEACH	CA	90806	2625	19	06037	33.80761478	-118.193744	Los Angeles County
100536	Fee-for-Service	1225371123	1225371123	1	1	HAMMER, KIMBERLY F OT	1/22/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	41760 IVY ST	SUITE 101	MURRIETA	CA	92562	9416	33	06065	33.55331844	-117.2081759	Riverside County
100553	Fee-for-Service	1518242080	1518242080	1	1	HUNDLEY, JAMIE H LCSW	12/16/2015	No Taxonomy Provided	NA	None	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
100576	Fee-for-Service	1457405532	1457405532	1	1	HUTCHINS, DEBRA A LCSW	3/28/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5078 BULLION ST	SUITE 4	MARIPOSA	CA	95338	0000	22	06043	37.48819922	-119.967001	Mariposa County
100583	Fee-for-Service	1215307954	1215307954	1	1	HOANG, TUAN M MD	11/7/2019	1223S0112X	NA	Dental Provider	026	PHYSICIANS	141937	02	General Surgery	0	In state provider	None	16045 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	1544	30	06059	33.72971615	-117.9548048	Orange County
100584	Fee-for-Service	1770119778	1770119778	1	1	HEN, EDEN	9/27/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	187472	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
100591	Fee-for-Service	1295787166	1295787166	1	1	HUANG, WILLIAM MD	5/17/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	84462	-	NOT APPLICABLE	0	In state provider	None	18663 VENTURA BLVD	SUITE 300	TARZANA	CA	91356	4162	19	06037	34.17051848	-118.5402557	Los Angeles County
100608	Fee-for-Service	1053516641	1053516641	1	1	HIRSCH, KAREN G MD	2/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109462	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
100611	Fee-for-Service	1952713810	1952713810	1	1	HAO, WEI D MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156291	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
100622	Fee-for-Service	1528531225	1528531225	1	1	HERNANDEZ, JACINTO LMFT	1/17/2022	106H00000X	NA	Mental Health Outpatient Services	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
100637	Fee-for-Service	1033775069	1033775069	1	1	HARDING, JAMES	5/22/2023	207R00000X	NA	Other	026	PHYSICIANS	181178	None	None	0	In state provider	None	180 ROWLAND WAY	None	NOVATO	CA	94945	5009	21	06041	38.09825699	-122.5598561	Marin County
100644	Fee-for-Service	1568634822	1568634822	1	1	HO, MATTHEW MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111269	13	Neurology (M.D. only)	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
100675	Fee-for-Service	1508180233	1508180233	1	1	HSIEH, MIRIAM N CCC-SLP	6/2/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	600 MOUNTAIN	A201	UPLAND	CA	91786	4331	36	06071	34.10094187	-117.6700806	San Bernardino County
100739	Fee-for-Service	1518912609	1518912609	1	1	HARRISON MEDICAL CENTER	2/5/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2520 CHERRY AVE	None	BREMERTON	WA	98310	4229	00	None	47.58282763	-122.6259856	Kitsap County
100761	Fee-for-Service	1538164470	1538164470	1	1	HASAN, MOHAMED N MD	3/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55321	None	None	0	In state provider	None	725 WELCH ROAD MC 5500	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
100764	Fee-for-Service	1104286459	1104286459	1	1	HONG, YESOL NP	11/4/2019	364SF0001X	NA	Other	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
100815	Fee-for-Service	1215534557	1215534557	1	1	HOMESERVE HOSPICE INC	4/11/2025	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2777 PACIFIC AVE	STE J	LONG BEACH	CA	90806	2625	19	06037	33.80761478	-118.193744	Los Angeles County
100816	Fee-for-Service	1902065956	1902065956	1	1	HORNG, LILY M MD	1/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	120501	41	Internal Medicine	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94556	1639	41	06081	37.53039072	-122.2987772	San Mateo County
100826	Fee-for-Service	1174757819	1174757819	1	1	HAO, MIN QI MD	4/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109204	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
100829	Fee-for-Service	1669462891	1669462891	1	1	HEALTHCARE INVESTMENTS,	1/1/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	1140 W ROSECRANS AVE	None	GARDENA	CA	90247	2664	19	06037	33.90181609	-118.2950659	Los Angeles County
100850	Fee-for-Service	1528170925	1528170925	1	1	HERBERT, LAWRENCE 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	2800 10TH AVE. NORTH	None	BILLING	MT	59101	0703	00	None	45.789696	-108.5132835	Yellowstone County
100862	Fee-for-Service	1649488461	1649488461	1	1	HANNA-KASTOUN, AHED MD	12/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	102476	13	Neurology (M.D. only)	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
100882	Fee-for-Service	1205912920	1205912920	1	1	HAWN, THOMAS R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HARBORVIEW MED CENTRE	325 9TH AVE,	C/O UWP MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
100888	Fee-for-Service	1912611625	1912611625	1	1	HASSAN, SUCDI M NP	10/2/2024	363LP0808X	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
100963	Fee-for-Service	1619942034	1619942034	2	1	HANONO, HELFON OD	8/12/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	894 PALM AVE	SUITE B	IMPERIAL BEACH	CA	91932	1573	37	06073	32.58408652	-117.114766	San Diego County
100977	Fee-for-Service	1598827685	1598827685	1	1	HANSEN, ANITA J LCSW	3/8/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PKWY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
101011	Fee-for-Service	1538397252	1538397252	1	1	HERNANDEZ, WILHELMINA MD	3/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127201	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3450	36	06071	34.04824949	-117.2401425	San Bernardino County
101019	Fee-for-Service	1093861569	1093861569	1	2	HERGAN, LORI ANN MD	10/17/2023	208800000X	NA	Other	026	PHYSICIANS	86666	None	None	0	In state provider	None	1225 E LATHAM AVE	STE B	HEMET	CA	92543	4423	33	06065	33.74937952	-116.959626	Riverside County
101024	Fee-for-Service	1518912609	1518912609	1	1	HARRISON MEDICAL CENTER	2/5/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2520 CHERRY AVE	None	BREMERTON	WA	98310	4229	00	None	47.58282763	-122.6259856	Kitsap County
101045	Fee-for-Service	1285749937	1285749937	1	1	HADWEH, YOUSSEF B MD	10/24/2001	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1020 VENTURA AVE	None	CHOWCHILLA	CA	93610	2368	20	06039	37.12167009	-120.2723602	Madera County
101047	Fee-for-Service	1235334749	1235334749	1	1	HWANG, STEVEN K MD INC	12/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	62230	01	General Practice	0	In state provider	None	145 E DUARTE ROAD AA	#604	ARCADIA	CA	91006	7500	19	06037	34.13029985	-118.0260173	Los Angeles County
101063	Fee-for-Service	1659445963	1659445963	1	1	HILLMAN, LORENA F MD	12/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87172	08	Family Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
101092	Fee-for-Service	1245822311	1245822311	1	1	HEALTHYU HOSPICE INC	9/26/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	STE 303	LA CRESCENTA	CA	91214	4579	19	06037	34.22121465	-118.2352382	Los Angeles County
101124	Fee-for-Service	1710013016	1710013016	1	1	HAROUNIAN, KOUROSH DPM	3/7/2007	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	INC	1832 W 7TH ST	None	LOS ANGELES	CA	90057	4102	19	06037	34.05529485	-118.2742943	Los Angeles County
101130	Fee-for-Service	1144682444	1144682444	1	1	HAKIM, NATALYA MD	7/22/2021	207ZP0102X	NA	Other	026	PHYSICIANS	167623	None	None	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
101162	Fee-for-Service	1346202868	1346202868	1	1	HOSHIKO, MELVIN MD	12/31/1989	207ZP0102X	NA	Other	026	PHYSICIANS	26468	22	Pathology (M.D. only)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
101200	Fee-for-Service	1083761670	1083761670	1	2	HONZEL, MARK R MD	10/15/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	43785	-	NOT APPLICABLE	0	In state provider	None	347 NORMANDIE AVE	None	LOS ANGELES	CA	90020	3167	19	06037	34.06760427	-118.3003795	Los Angeles County
101210	Fee-for-Service	1437199916	1437199916	1	1	HULBURD, CHRISTOPHER S	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	59812	18	Ophthalmology	0	In state provider	MD INC	1020 VINE ST	STE A	PASO ROBLES	CA	93446	2559	40	06079	35.62477827	-120.6937799	San Luis Obispo County
101218	Fee-for-Service	1851928154	1851928154	1	1	HO, CAROLYN A MD	8/23/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	180913	None	None	0	In state provider	None	651 1ST ST WEST	STE H	SONOMA	CA	95476	7045	49	06097	38.28938482	-122.4593996	Sonoma County
101220	Fee-for-Service	1205884616	1205884616	1	1	HOLBROOK,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	4840 N CLOVERDALE RD	None	BOISE	ID	83713	0000	00	None	43.649046	-116.334361	Ada County
101223	Fee-for-Service	1306306949	1306306949	1	1	HARDWICK, ROBERT M MD	3/3/2025	207R00000X	NA	Other	026	PHYSICIANS	178482	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
101230	Fee-for-Service	1912988734	1912988734	1	1	HEARTLAND HEALTH SYSTEM INC.	8/15/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	650 W TAYLOR ST	None	VANDALIA	IL	62471	1296	00	None	38.97065999	-89.09850248	Fayette County
101250	Fee-for-Service	1447651310	1447651310	1	1	HALLBROOKS, LANDON D MSW LCS	6/19/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	317 W F ST	None	ONTARIO	CA	91762	3205	36	06071	34.06932	-117.6542865	San Bernardino County
101253	Fee-for-Service	1558391011	1558391011	1	1	HAGEN, JEFFREY A MD	10/31/1993	208600000X	NA	General Surgery	026	PHYSICIANS	72928	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
101265	Fee-for-Service	1932326956	1932326956	1	1	HOOVER, JACOB G MD	11/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117392	41	Internal Medicine	0	In state provider	None	3 MEDICAL PLAZA	None	ROSEVILLE	CA	95661	3037	31	06061	38.76566391	-121.2457432	Placer County
101332	Fee-for-Service	1982804563	1982804563	1	1	HAROUTUNIAN, TENY MD	5/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96361	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
101351	Fee-for-Service	1659445963	1659445963	1	1	HILLMAN, LORENA F MD	12/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87172	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
101361	Fee-for-Service	1033486519	1033486519	1	1	HAWKINS, STEPHANIE T DO	3/8/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	6557	01	General Practice	0	In state provider	None	10670 WHITE ROCK ROAD	SUITE 100	RANCHO CORDOVA	CA	95670	6146	34	06067	38.586177	-121.291812	Sacramento County
101378	Fee-for-Service	1245822311	1245822311	1	1	HEALTHYU HOSPICE INC	9/26/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2600 FOOTHILL BLVD	STE 303	LA CRESCENTA	CA	91214	4579	19	06037	34.22121465	-118.2352382	Los Angeles County
101389	Fee-for-Service	1588193031	1588193031	1	1	HULBERT, BRETT M DO	8/12/2022	390200000X	NA	Other	026	PHYSICIANS	19432	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
101411	Fee-for-Service	1093049546	1093049546	1	1	HERITAGE CLINIC AND THE COMM	1/24/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	UNITY ASSISTANCE PROGRAM	3600 WILSHIRE BLVD	2200	LOS ANGELES	CA	90010	2632	19	06037	34.0617065	-118.3036455	Los Angeles County
101446	Fee-for-Service	1689753337	1689753337	1	1	HUANG, PAUL I MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96717	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
101457	Fee-for-Service	1245239540	1245239540	1	2	HOME CARE DELIVERED INC	3/25/2013	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	11013 WEST BROAD STREET	FOURTH FLOOR	GLEN ALLEN	VA	23060	6017	00	None	37.64737936	-77.588009	Henrico County
101459	Fee-for-Service	1518980556	1518980556	1	1	HINMAN, JON A MD	7/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	86140	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2975 N SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
101471	Fee-for-Service	1346399441	1346399441	1	1	HAHM, RACHEL M PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1370 VALLEY VISTA DR	STE 104	DIAMOND BAR	CA	91765	3950	19	06037	33.99742278	-117.8381087	Los Angeles County
101513	Fee-for-Service	1306306949	1306306949	1	1	HARDWICK, ROBERT M MD	3/3/2025	207R00000X	NA	Other	026	PHYSICIANS	178482	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
101519	Fee-for-Service	1912988734	1912988734	1	1	HEARTLAND HEALTH SYSTEM INC.	8/15/2008	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	650 W TAYLOR ST	None	VANDALIA	IL	62471	1296	00	None	38.97065999	-89.09850248	Fayette County
101536	Fee-for-Service	1669471892	1669471892	1	1	HANDLER, BARRY S MD	8/1/1999	2086S0122X	NA	General Surgery	026	PHYSICIANS	85293	24	Plastic Surgery	0	In state provider	None	6699 ALVARADO RD	STE 2305	SAN DIEGO	CA	92120	5241	37	06073	32.77665383	-117.0540279	San Diego County
101557	Fee-for-Service	1851989255	1851989255	1	1	HEACOCK HEALTH MEDICAL GROUP	4/14/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	13939 SAN ANTONIO DRIVE	None	NORWALK	CA	90650	4036	19	06037	33.90444257	-118.0803356	Los Angeles County
101558	Fee-for-Service	1184052011	1184052011	1	1	HALPERN, NETTA LMFT	8/20/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	600 W SANTA ANA BLVD	STE 107 108 109 110	SANTA ANA	CA	92701	4558	30	06059	33.74804119	-117.874111	Orange County
101562	Fee-for-Service	1679682876	1679682876	1	1	HSU, LINDA P MD	6/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	77291	41	Internal Medicine	0	In state provider	None	10230 ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
101609	Fee-for-Service	1487818373	1487818373	1	1	HASSANI, ALI MD	7/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115083	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
101616	Fee-for-Service	1982635140	1982635140	1	1	HOSPICE CHEER	1/18/1996	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2555 EAST COLORADO BLVD	SUITE 301	PASADENA	CA	91107	6646	19	06037	34.14612746	-118.0979505	Los Angeles County
101635	Fee-for-Service	1740867670	1740867670	1	1	HINES, CAMERON	11/5/2024	207R00000X	NA	Other	026	PHYSICIANS	183928	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
101677	Fee-for-Service	1750372389	1750372389	1	1	HANN, CYNTHIA J MD	1/1/1998	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	72970	40	Pediatrics	0	In state provider	None	200 PORTER DR	STE 300	SAN RAMON	CA	94583	1524	07	06013	37.77372204	-121.9911155	Contra Costa County
101682	Fee-for-Service	1366899742	1366899742	1	1	HUDDLESTON, LEONOR NP	3/18/2019	363L00000X	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
101690	Fee-for-Service	1346702891	1346702891	1	1	HAMILTON, VICTORIA MD	4/21/2023	390200000X	NA	Other	026	PHYSICIANS	176851	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
101699	Fee-for-Service	1902080112	1902080112	1	1	HASHIMOTO, WESLEY K MD	6/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76655	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
101702	Fee-for-Service	1194884791	1194884791	1	1	HAKAKHA, MICHAEL J MD	9/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63580	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
101705	Fee-for-Service	1144327008	1144327008	1	1	HERNANDEZ, LEOPOLDO G MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	39635	07	Dermatology	0	In state provider	INC	3406 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	19	06037	34.0276007	-118.2006211	Los Angeles County
101762	Fee-for-Service	1932199676	1932199676	1	1	HAILE,LYDIA 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
101767	Fee-for-Service	1346684156	1346684156	1	1	HONOWITZ, SCOTT C MD	5/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	134287	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
101768	Fee-for-Service	1225308711	1225308711	1	1	HAYNES, MATTHEW T LCSW	3/5/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
101776	Fee-for-Service	1821061466	1821061466	1	1	HAN, RICHARD S MD	10/31/1995	207R00000X	NA	Other	026	PHYSICIANS	79142	41	Internal Medicine	0	In state provider	None	5730 BEACH BLVD	STE 100	BUENA PARK	CA	90621	2090	30	06059	33.87709616	-117.9981771	Orange County
101797	Fee-for-Service	1689644817	1689644817	1	1	HENRY, MICHAEL J MD	9/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94551	18	Ophthalmology	0	In state provider	None	1062 S K ST	None	TULARE	CA	93274	6421	54	06107	36.19548226	-119.3433058	Tulare County
101811	Fee-for-Service	1851363121	1851363121	1	1	HOWARD LEIBOWITZ, 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	1010 W 1ST ST	None	REDFIELD	SD	57469	1502	00	None	44.871219	-98.52003802	Spink County
101825	Fee-for-Service	1669471892	1669471892	1	1	HANDLER, BARRY S MD	8/1/1999	2086S0122X	NA	General Surgery	026	PHYSICIANS	85293	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6699 ALVARADO RD	STE 2305	SAN DIEGO	CA	92120	5241	37	06073	32.77665383	-117.0540279	San Diego County
101848	Fee-for-Service	1922097914	1922097914	1	1	HILL MEDICAL CORPORATION	1/1/1998	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	625 S FAIR OAKS AVE	SUITE #140	PASADENA	CA	91105	2650	19	06037	34.134894	-118.1504155	Los Angeles County
101860	Fee-for-Service	1588161145	1588161145	1	1	HUANG, SIYI MD	8/23/2021	207R00000X	NA	Other	026	PHYSICIANS	173306	None	None	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
101905	Fee-for-Service	1982635140	1982635140	1	1	HOSPICE CHEER	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2555 EAST COLORADO BLVD	SUITE 301	PASADENA	CA	91107	6646	19	06037	34.14612746	-118.0979505	Los Angeles County
101913	Fee-for-Service	1710500491	1710500491	1	1	HUGHES, MATTHEW J MD	7/31/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
101921	Fee-for-Service	1437479516	1437479516	1	1	HART, MELISSA A MD	7/15/2018	208M00000X	NA	Other	026	PHYSICIANS	154608	41	Internal Medicine	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
101966	Fee-for-Service	1134105851	1134105851	1	1	HUGHEY, ANDREW G	7/15/2014	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
101968	Fee-for-Service	1225698566	1225698566	1	1	HATA, LISA MD	9/9/2024	208800000X	NA	Other	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
101971	Fee-for-Service	1396833265	1396833265	1	1	HEWITT, JOHN M MD	8/24/2004	207R00000X	NA	Other	026	PHYSICIANS	42525	41	Internal Medicine	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
101972	Fee-for-Service	1073584785	1073584785	1	1	HABARADAS, CAROLINE G MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75376	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1067 4TH ST	None	SOUTH LAKE TAHOE	CA	96150	3459	09	06017	38.91384447	-119.9985861	El Dorado County
101987	Fee-for-Service	1902080112	1902080112	1	1	HASHIMOTO, WESLEY K MD	6/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76655	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
101991	Fee-for-Service	1144327008	1144327008	1	1	HERNANDEZ, LEOPOLDO G MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	39635	01	General Practice	0	In state provider	INC	3406 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	19	06037	34.0276007	-118.2006211	Los Angeles County
102057	Fee-for-Service	1417729120	1417729120	1	2	HARJIT AND NAVGEET RCFE LLC	5/10/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4400 BELMONT PLACE LANE	None	SACRAMENTO	CA	95841	4104	34	06067	38.646513	-121.367349	Sacramento County
102070	Fee-for-Service	1992892822	1992892822	1	1	HARRISON, AMY N MD	11/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100728	40	Pediatrics	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
102071	Fee-for-Service	1205158946	1205158946	1	1	HOEFER, MICHAEL E MD	2/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113523	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
102091	Fee-for-Service	1396787461	1396787461	1	1	HUANG, KUN MD	6/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77200	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
102128	Fee-for-Service	1427326750	1427326750	3	1	HAJJA WADDAH	5/1/2018	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
102167	Fee-for-Service	1649473414	1649473414	1	1	HENDIFAR, ANDREW E MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88863	68	Hematology	0	In state provider	None	2811 WILSHIRE BLVD	STE 414	SANTA MONICA	CA	90403	4803	19	06037	34.03785224	-118.4752132	Los Angeles County
102177	Fee-for-Service	1083070825	1083070825	1	1	HETLAND, LEA N CRNA	4/19/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10 WOODLAND RD	None	SAINT HELENA	CA	94574	9554	28	06055	38.54196972	-122.4751787	Napa County
102213	Fee-for-Service	1083761670	1083761670	1	1	HONZEL, MARK R MD	12/12/2006	207RA0401X	NA	Other	026	PHYSICIANS	43785	05	Anesthesiology	0	In state provider	MRH MEDICAL GRP	8920 WILSHIRE BLVD	STE 310	BEVERLY HILLS	CA	90211	2003	19	06037	34.06703599	-118.3863456	Los Angeles County
102218	Fee-for-Service	1700965456	1700965456	1	1	HOFFMAN, CRAIG J MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	56016	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
102219	Fee-for-Service	1518255892	1518255892	1	1	HUGUENARD, ERIKA D LCSW	7/26/2016	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2811 COLLEGE AVE	STE A	BERKELEY	CA	94705	2167	01	06001	37.85941283	-122.2532597	Alameda County
102238	Fee-for-Service	1144780313	1144780313	1	1	HELPING HANDS HOME HEALTH	7/7/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14545 FRIAR ST	SUITE 202D	VAN NUYS	CA	91411	2398	19	06037	34.18570347	-118.450386	Los Angeles County
102243	Fee-for-Service	1306243597	1306243597	1	1	HUANG, PHYU P MD	2/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133904	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 WEST HUNTINGTON DR	None	ARCADIA	CA	91007	1249	19	06037	34.13489987	-118.0424069	Los Angeles County
102252	Fee-for-Service	1871055178	1871055178	1	1	HUA, ALBERT PHD	8/3/2020	101YM0800X	NA	Other	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
102264	Fee-for-Service	1376522847	1376522847	1	1	HERNANDEZ CONTE, ANTONIO T	5/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	79978	05	Anesthesiology	0	In state provider	MD	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
102282	Fee-for-Service	1134236516	1134236516	1	1	HEARTFIELD, WESLEY R MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79276	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
102304	Fee-for-Service	1730171661	1730171661	1	1	HARDACRE, MICHAEL C MD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	78	Neoplastic Diseases/Oncology	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
102354	Fee-for-Service	1780058552	1780058552	1	1	HAYES, UNIQUE LCSW	7/3/2024	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
102369	Fee-for-Service	1457555161	1457555161	2	1	HERNANDEZ, ANATOLY K DO	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	10642	05	Anesthesiology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
102385	Fee-for-Service	1821894494	1821894494	1	1	HOLMAN, MADISON O DOULA	4/13/2025	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	38	06075	0	0	None
102424	Fee-for-Service	1225518533	1225518533	1	1	HONG, JUDY S NP	6/10/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	350 SAINT JOSEPHS AVE	None	SAN FRANCISCO	CA	94115	3255	38	06075	37.78245426	-122.4421849	San Francisco County
102429	Fee-for-Service	1659384881	1659384881	1	1	HELLNER, MARK T MD	2/8/2015	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	52055	20	Orthopedic Surgery	0	In state provider	None	900 W OLIVE AVE	STE A	MERCED	CA	95348	2429	24	06047	37.31913547	-120.4842784	Merced County
102437	Fee-for-Service	1225617442	1225617442	1	1	HERNANDEZ, CRISTINA LCSW	9/16/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10601 CIVIC CENTER DR	STE 100 A-D	RANCHO CUCAMONGA	CA	91730	3878	36	06071	34.1023554	-117.5735696	San Bernardino County
102444	Fee-for-Service	1427376284	1427376284	1	1	HWANG, CINDY S MD	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136245	18	Ophthalmology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
102456	Fee-for-Service	1649473414	1649473414	1	1	HENDIFAR, ANDREW E MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88863	78	Neoplastic Diseases/Oncology	0	In state provider	None	2811 WILSHIRE BLVD	STE 414	SANTA MONICA	CA	90403	4803	19	06037	34.03785224	-118.4752132	Los Angeles County
102463	Fee-for-Service	1871052779	1871052779	1	1	HOANG, JOHNNY M MD	7/1/2023	207L00000X	NA	Other	026	PHYSICIANS	182143	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
102467	Fee-for-Service	1578607669	1578607669	1	1	HORNING, SANDRA MD	1/1/1982	207RX0202X	NA	Oncology	026	PHYSICIANS	37872	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
102482	Fee-for-Service	1922096411	1922096411	1	1	HORWITZ, LEE J MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76767	08	Family Practice	0	In state provider	None	1425 W H ST	STE 200	OAKDALE	CA	95361	3590	50	06099	37.75771796	-120.8627767	Stanislaus County
102483	Fee-for-Service	1205908688	1205908688	1	1	HANSEN, DOUGLAS	9/11/2012	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
102528	Fee-for-Service	1225097421	1225097421	1	1	HOOVER, RODNEY F CRNA	6/1/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	372 W CYPRESS AVE	None	REEDLEY	CA	93654	2113	10	06019	36.60784193	-119.4520057	Fresno County
102529	Fee-for-Service	1487792503	1487792503	1	1	HANIF, MUHAMMAD S MD	6/14/2023	207R00000X	NA	Other	026	PHYSICIANS	143104	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
102539	Fee-for-Service	1487187019	1487187019	1	1	HA, ALBERT S MD	6/5/2023	208800000X	NA	Other	026	PHYSICIANS	184362	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
102572	Fee-for-Service	1134236516	1134236516	1	1	HEARTFIELD, WESLEY R MD	9/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79276	28	Proctology (colon and rectal)	0	In state provider	None	1245 WILSHIRE BLVD	STE 905	LOS ANGELES	CA	90017	4809	19	06037	34.05362775	-118.2661889	Los Angeles County
102583	Fee-for-Service	1487242699	1487242699	1	1	HAM CARE LLC	7/6/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	7331 KATHERINE AVE	None	VAN NUYS	CA	91405	2437	19	06037	34.20416963	-118.4433538	Los Angeles County
102616	Fee-for-Service	1609971746	1609971746	1	1	HARTSHORN, RACHEL M MD	7/29/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	72140	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
102629	Fee-for-Service	1083842371	1083842371	1	1	HURVITZ, ANDREW P MD	5/14/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	155743	20	Orthopedic Surgery	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
102633	Fee-for-Service	1780856427	1780856427	1	1	HOM, JEFFREY J MD	7/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102859	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
102655	Fee-for-Service	1346225364	1346225364	1	1	HOLVIK, WILLIAM C MD	9/1/1999	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72459	66	Emergency Medicine (Urgent Care)	0	In state provider	None	221 E CALDWELL AVE	None	VISALIA	CA	93277	7605	54	06107	36.297693	-119.2888935	Tulare County
102678	Fee-for-Service	1063467751	1063467751	1	1	HEINRICH, MARK THOMAS MD	1/31/1988	207P00000X	NA	Other	026	PHYSICIANS	5375	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2615 EYE ST	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
102686	Fee-for-Service	1962288167	1962288167	1	1	HAMEED, SYED M MD	9/10/2024	208600000X	NA	General Surgery	026	PHYSICIANS	None	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
102689	Fee-for-Service	1588726475	1588726475	1	1	HART, FONDA L MFT	1/3/2017	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6073 N FRESNO ST	STE 105	FRESNO	CA	93710	8614	10	06019	36.82404	-119.7814395	Fresno County
102701	Fee-for-Service	1003130626	1003130626	1	1	HASAN, SHADEED LCSW	12/1/2023	1041C0700X	NA	Mental Health Outpatient Services	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
102702	Fee-for-Service	1154427920	1154427920	1	1	HUANG, DANIEL B MD	1/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	84935	None	None	0	In state provider	None	11480 BROOKSHIRE AVE	STE 309	DOWNEY	CA	90241	5025	19	06037	33.93622932	-118.1311752	Los Angeles County
102704	Fee-for-Service	1588940647	1588940647	1	1	HA, LAURA K OD OPTOMETRY APC	2/8/2013	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7217 RESEDA BLVD	None	RESEDA	CA	91335	3046	19	06037	34.201791	-118.5360655	Los Angeles County
102727	Fee-for-Service	1003858622	1003858622	1	1	HUYNH, NGOC-ANH T	7/26/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8900 BOLSA AVE	STE A	WESTMINSTER	CA	92683	5474	30	06059	33.74480556	-117.9740439	Orange County
102742	Fee-for-Service	1447257993	1447257993	1	1	HANSON,ANTHONY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	NORTH HOUSTON RENAL	CONSULTANTS,PA	18955 MEMORIAL N STE 300	HUMBLE	TX	77338	0000	00	None	0	0	None
102760	Fee-for-Service	1356801708	1356801708	1	1	HURABIELLE CLAVERIE, CHARLOT	6/26/2023	207RR0500X	NA	Other	026	PHYSICIANS	176790	None	None	0	In state provider	TE MD	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
102766	Fee-for-Service	1538216981	1538216981	1	1	HINKLE, BRENDAN R LCSW	12/8/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	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
102825	Fee-for-Service	1699421149	1699421149	1	1	HEARING SOLUTIONS HEARING AI	4/5/2023	261QH0700X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	D CENTER INC.	3830 BROAD ST	STE 5	SAN LUIS OBISPO	CA	93401	7187	40	06079	35.25091414	-120.6444472	San Luis Obispo County
102856	Fee-for-Service	1013162452	1013162452	1	1	HONG, ERIC A MD	11/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101767	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
102857	Fee-for-Service	1205833662	1205833662	1	1	HO, GERALD Y MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	67106	83	Rheumatology	0	In state provider	None	5451 LA PALMA AVE	STE 25	LA PALMA	CA	90623	1730	30	06059	33.84643146	-118.038843	Orange County
102874	Fee-for-Service	1043382997	1043382997	1	1	HAGGERTY, JULIE	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
102875	Fee-for-Service	1366953986	1366953986	1	1	HO, JENNEFER S PHD	6/11/2018	103TC0700X	NA	Mental Health Outpatient Services	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
102891	Fee-for-Service	1629431747	1629431747	1	1	HABIB, SANA	8/5/2024	207K00000X	NA	Other	026	PHYSICIANS	173985	03	Allergy	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
102916	Fee-for-Service	1891800165	1891800165	1	1	HENTHORN, THOMAS K MD	9/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
102974	Fee-for-Service	1275105942	1275105942	1	1	HEARONS, DOMINGA B NP	12/6/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9508 STOCKDALE HWY	STE 150	BAKERSFIELD	CA	93311	3623	15	06029	35.35453237	-119.1086014	Kern County
102980	Fee-for-Service	1831296730	1831296730	1	1	HADADY, VANESSA S LMFT	7/11/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1151 W ROBINHOOD DR	STE C6	STOCKTON	CA	95207	5628	39	06077	37.99954017	-121.3212828	San Joaquin County
102986	Fee-for-Service	1144397910	1144397910	1	1	HERZBERGER, BRIAN R 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
103089	Fee-for-Service	1902023476	1902023476	1	1	HOE, MARVIN OD	4/10/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1539 W GARVEY AVE	None	WEST COVINA	CA	91790	2138	19	06037	34.07276147	-117.9396	Los Angeles County
103095	Fee-for-Service	1972909356	1972909356	1	1	HOUSE OF FAITH CONGREGATE	5/4/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	8500 ROBERT AVE	None	SUN VALLEY	CA	91352	3353	19	06037	34.22409561	-118.3692974	Los Angeles County
103124	Fee-for-Service	1386886729	1386886729	1	1	HOLT, DERICK G MD	7/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130445	18	Ophthalmology	0	In state provider	None	7075 N SHARON	None	FRESNO	CA	93720	3329	10	06019	36.83882737	-119.7590708	Fresno County
103137	Fee-for-Service	1427085067	1427085067	1	1	HAYES, MICHELLE A MD	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86972	30	Radiology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
103148	Fee-for-Service	1831257104	1831257104	1	1	HANNA, MEREDITH T LMFT	2/19/2020	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
103171	Fee-for-Service	1548259500	1548259500	1	1	HARVIN, HOWARD J MD	7/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82535	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
103177	Fee-for-Service	1508847625	1508847625	1	1	HASHIMI, LABIB A MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	47961	68	Hematology	0	In state provider	None	13768 ROSWELL AVE	STE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
103195	Fee-for-Service	1649599648	1649599648	1	1	HAYES, JENNIFER A MD	7/7/2017	207N00000X	NA	Dermatology	026	PHYSICIANS	136325	07	Dermatology	0	In state provider	None	555 S DORA ST	STE B	UKIAH	CA	95482	5424	23	06045	39.14592307	-123.211583	Mendocino County
103206	Fee-for-Service	1467485334	1467485334	1	1	HOWARD, DAVID S MD	3/31/1994	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	76899	None	None	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
103217	Fee-for-Service	1144378712	1144378712	1	1	HADDIX, TERRI L MD	5/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	82165	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
103305	Fee-for-Service	1982700597	1982700597	1	1	HABIBE, ALEX O MD INC	2/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91655	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1383 E HERNDON	STE 105	FRESNO	CA	93720	3302	10	06019	36.83690167	-119.7635813	Fresno County
103307	Fee-for-Service	1033238605	1033238605	1	1	HERNRIED, SUZANNE L MD	10/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	49994	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
103326	Fee-for-Service	1992896757	1992896757	1	1	HAWTHORNE, N JAMES MD	4/3/1989	208800000X	NA	Other	026	PHYSICIANS	19194	34	Urology and Urological Surgery	0	In state provider	None	784 SANTA ROSA ST	None	SAN LUIS OBISPO	CA	93401	2884	40	06079	35.28453497	-120.6615771	San Luis Obispo County
103340	Fee-for-Service	1831468388	1831468388	1	1	HIDAKA, MIO LCSW	12/26/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	29789	-	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
103356	Fee-for-Service	1306840392	1306840392	2	1	HANGER PROSTHETICS & ORTHOTI	5/18/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	623 N MAIN ST	None	ORANGE	CA	92868	1103	30	06059	33.79716	-117.866533	Orange County
103362	Fee-for-Service	1598054405	1598054405	1	1	HARRIS, SHILONDA R CRNA	1/13/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
103403	Fee-for-Service	1386796514	1386796514	1	1	HAGE-FISCHER, LILLIAN MD	8/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80380	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
103422	Fee-for-Service	1164581724	1164581724	1	1	HARRIS, MYRA G LMFT	8/9/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
103453	Fee-for-Service	1750970984	1750970984	1	1	HEAL HOME HEALTH CARE	12/6/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1101 N PACIFIC AVE	STE 200	GLENDALE	CA	91202	4366	19	06037	34.16078708	-118.2644824	Los Angeles County
103467	Fee-for-Service	1508847625	1508847625	1	1	HASHIMI, LABIB A MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	47961	78	Neoplastic Diseases/Oncology	0	In state provider	None	13768 ROSWELL AVE	STE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
103472	Fee-for-Service	1457617359	1457617359	1	1	HEELAS HEALTH CARE SERVICES	8/2/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	2777 ALVARADO STREET	SUITE G	SAN LEANDRO	CA	94577	5701	01	06001	37.70857373	-122.1542019	Alameda County
103527	Fee-for-Service	1437197837	1437197837	1	1	HASSAN, KHALED A. MD	5/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73930	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
103529	Fee-for-Service	1346724754	1346724754	1	1	HOLZENKAEMPFER, NEELE E PT	11/19/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	401 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6387	43	06085	37.36777579	-122.0276404	Santa Clara County
103537	Fee-for-Service	1891855524	1891855524	1	1	HEALY, JAMES R PHD	10/15/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21160	-	NOT APPLICABLE	0	In state provider	None	2650 EAST FOOTHILL BLVD	SUITE 100 & 200	PASADENA	CA	91107	3439	19	06037	34.14982934	-118.0957459	Los Angeles County
103570	Fee-for-Service	1568823664	1568823664	1	1	HO, VICTORIA M MD	6/16/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	149664	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
103578	Fee-for-Service	1265759906	1265759906	1	1	HORSTMANN, ELIZABETH MD	7/15/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	129888	26	Psychiatry (child)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
103585	Fee-for-Service	1225033152	1225033152	1	1	HUGHES, EVERARD H MD	4/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	32722	78	Neoplastic Diseases/Oncology	0	In state provider	None	2280 HARRISON AVE	SUITE B	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
103590	Fee-for-Service	1447232335	1447232335	1	1	HOME REHABILITATION HEALTH	4/4/2009	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE AGENCY	644 E REGENT ST	SUITE 101	INGLEWOOD	CA	90301	1439	19	06037	33.96448447	-118.345059	Los Angeles County
103593	Fee-for-Service	1306902465	1306902465	1	1	HOLM, LILLIAN CRNA	6/2/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
103594	Fee-for-Service	1982700597	1982700597	1	1	HABIBE, ALEX O MD INC	2/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91655	41	Internal Medicine	0	In state provider	None	1383 E HERNDON	STE 105	FRESNO	CA	93720	3302	10	06019	36.83690167	-119.7635813	Fresno County
103630	Fee-for-Service	1902268758	1902268758	1	1	HEALTHY LIFE CONGREGATE CARE	12/1/2017	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	3011 NORTH PEORIA AVENUE	None	SIMI VALLEY	CA	93063	1654	56	06111	34.2900775	-118.7170495	Ventura County
103631	Fee-for-Service	1245687490	1245687490	1	1	HOUSHMAND, SINA MD	6/21/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170690	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
103652	Fee-for-Service	1346515442	1346515442	1	1	HONG, KIMBERLY N MD	9/27/2019	207RA0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	156242	06	Cardiovascular Disease (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
103670	Fee-for-Service	1194330043	1194330043	1	1	HANSEN, DEREK PT	6/27/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1132 E LELAND AVE	None	TULARE	CA	93274	7811	54	06107	36.22949281	-119.3296994	Tulare County
103695	Fee-for-Service	1033179379	1033179379	1	1	HASHEM, HANI H MD	12/21/2009	207R00000X	NA	Other	026	PHYSICIANS	79405	41	Internal Medicine	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
103715	Fee-for-Service	1053831362	1053831362	1	1	HIOE, TANYA DO	6/13/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	19319	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
103729	Fee-for-Service	1265651046	1265651046	1	1	HIGGINS, THOMAS M	1/1/1979	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	255 W CENTRAL AVE	None	BREA	CA	92821	3373	30	06059	33.93213242	-117.8971516	Orange County
103748	Fee-for-Service	1447368576	1447368576	1	1	HAYWARD, DAVID R MD	5/16/2023	208M00000X	NA	Other	026	PHYSICIANS	182225	None	None	0	In state provider	None	1661 SOQUEL DR	STE D	SANTA CRUZ	CA	95065	1816	44	06087	36.98895429	-121.9821088	Santa Cruz County
103749	Fee-for-Service	1932205275	1932205275	1	1	HORN, ERICH P MD	11/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60783	18	Ophthalmology	0	In state provider	None	491 30TH ST	STE 201	OAKLAND	CA	94609	3235	01	06001	37.81935528	-122.2667902	Alameda County
103757	Fee-for-Service	1508847625	1508847625	1	1	HASHIMI, LABIB A MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	47961	41	Internal Medicine	0	In state provider	None	13768 ROSWELL AVE	STE 105	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
103767	Fee-for-Service	1407914260	1407914260	1	11	HILL COUNTRY COMM CLINIC	2/9/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8544 AIRPORT ROAD	None	REDDING	CA	96002	9210	45	06089	40.53599623	-122.3028375	Shasta County
103789	Fee-for-Service	1235287269	1235287269	1	1	HAMMI, DON P MD	2/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90556	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
103803	Fee-for-Service	1588338909	1588338909	1	1	HONATH, CASEY	11/23/2024	225XP0200X	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
103804	Fee-for-Service	1528104437	1528104437	1	1	HANCOCK, CLIFFORD A MD	8/1/1979	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	34353	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3490 LINDEN AVE	None	LONG BEACH	CA	90807	4559	19	06037	33.819912	-118.1864615	Los Angeles County
103818	Fee-for-Service	1154403335	1154403335	1	1	HILLYER, JENNIFER Q NP	7/14/2022	363L00000X	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
103819	Fee-for-Service	1952691503	1952691503	1	1	HELO, NASEEM S MD	6/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125830	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
103837	Fee-for-Service	1295276830	1295276830	1	1	HUISH, RYAN D	2/11/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
103842	Fee-for-Service	1619957776	1619957776	1	1	HERMAN, LINDA L MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132510	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
103861	Fee-for-Service	1194713222	1194713222	1	1	HANCOCK, JOSEPH E MD	8/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	39430	10	Gastroenterology (M.D. only)	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
103863	Fee-for-Service	1053487231	1053487231	1	1	HENRY, LORI A NP	9/13/2018	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
103879	Fee-for-Service	1528084878	1528084878	1	1	HAN, ABRAHAM P MD	9/1/1991	207VX0000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	72378	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1850 S AZUSA AVE	STE 309	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
103903	Fee-for-Service	1609992940	1609992940	1	1	HA, NICOLE-NINHCO P OD	9/2/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4605 BROCKTON AVENUE	100	RIVERSIDE	CA	92506	0106	33	06065	33.97611422	-117.3860257	Riverside County
103907	Fee-for-Service	1447651310	1447651310	1	2	HALLBROOKS, LANDON D MSW LCS	10/25/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	435 W MISSION BLVD	301	POMONA	CA	91766	1632	19	06037	34.05503335	-117.7536603	Los Angeles County
103915	Fee-for-Service	1588863237	1588863237	1	1	HUEN, WILLIAM MD	8/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98729	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	ROOM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
103916	Fee-for-Service	1609170042	1609170042	1	1	HANNA, KARIM A MD	7/13/2011	207L00000X	NA	Other	026	PHYSICIANS	117275	05	Anesthesiology	0	In state provider	None	9920 TALBERT AVE	None	FOUNTAIN VALLEY	CA	92708	5153	30	06059	33.7016655	-117.955521	Orange County
103953	Fee-for-Service	1801050331	1801050331	1	1	HEGDE, PRAVACHAN V C MD	8/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135467	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2335 E KASHIAN LANE	STE 301	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
103957	Fee-for-Service	1699350256	1699350256	1	1	HYGIEIA HEALTH SYSTEM, INC	9/21/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11401 CARSON ST	STE M	LAKEWOOD	CA	90715	2546	19	06037	33.83154096	-118.0904409	Los Angeles County
103965	Fee-for-Service	1326026964	1326026964	1	1	HEYD, ROBERT 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	10 E 31ST ST	None	KEARNEY	NE	68847	2926	00	None	40.70647332	-99.08130081	Buffalo County
104001	Fee-for-Service	1982167375	1982167375	1	1	HOROWITZ, ISAAC S DO	8/2/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	20038	None	None	0	In state provider	None	500 40TH STREET	None	BAKERSFIELD	CA	93301	1224	15	06029	35.39619932	-119.0074457	Kern County
104015	Fee-for-Service	1164835716	1164835716	1	1	HERBERT, CARLY J LMFT	4/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11840 MAGNOLIA	STE C	RIVERSIDE	CA	92503	7112	33	06065	33.89540021	-117.4902651	Riverside County
104022	Fee-for-Service	1073691721	1073691721	1	1	HSZICH, RAINA C MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65455	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
104050	Fee-for-Service	1205444999	1205444999	1	1	HUFFMAN, JARED L DO	8/29/2023	204D00000X	NA	Other	026	PHYSICIANS	21485	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
104052	Fee-for-Service	1407914260	1407914260	1	11	HILL COUNTRY COMM CLINIC	2/9/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	8544 AIRPORT ROAD	None	REDDING	CA	96002	9210	45	06089	40.53599623	-122.3028375	Shasta County
104054	Fee-for-Service	1205097011	1205097011	1	1	HENDERSON, SHELLY L PHD	7/2/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	08	Family Practice	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
104111	Fee-for-Service	1437560034	1437560034	1	1	HWEE, JONATHAN MD	2/16/2021	208600000X	NA	General Surgery	026	PHYSICIANS	160641	None	None	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
104123	Fee-for-Service	1316387285	1316387285	1	1	HUFF, KATHLEEN E LMFT	5/16/2019	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
104153	Fee-for-Service	1528171600	1528171600	1	1	HEAD, KATHY L MD	11/1/1998	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	61758	25	Physical Medicine and Rehabilitation	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
104154	Fee-for-Service	1720204696	1720204696	1	1	HUMANISTIC ALTERNATIVES TO	4/11/1983	261QM2800X	NA	Other	051	OUTPATIENT HEROIN DETOX CENTER	-	-	NOT APPLICABLE	0	In state provider	ADDICTION RESEARCH AND	10850 MACARTHUR BLVD	None	OAKLAND	CA	94605	5266	01	06001	37.7414325	-122.1498379	Alameda County
104246	Fee-for-Service	1699350256	1699350256	1	1	HYGIEIA HEALTH SYSTEM, INC	9/21/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11401 CARSON ST	STE M	LAKEWOOD	CA	90715	2546	19	06037	33.83154096	-118.0904409	Los Angeles County
104340	Fee-for-Service	1396009478	1396009478	1	1	HO, AMIEE S OD	5/24/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	342 F STREET	None	CHULA VISTA	CA	91910	2625	37	06073	32.64073026	-117.0815293	San Diego County
104396	Fee-for-Service	1336251693	1336251693	1	1	HOFFMANN, VICTORINA P MD	10/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	44547	41	Internal Medicine	0	In state provider	None	140 BROOKWOOD RD #201	None	ORINDA	CA	94563	3047	07	06013	37.87712752	-122.1816965	Contra Costa County
104442	Fee-for-Service	1518313410	1518313410	1	1	HANDA, GARIMA MD FACC	1/29/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	192312	None	None	0	In state provider	None	310 MERCY AVE	None	MERCED	CA	95340	8319	24	06047	37.33870622	-120.4661454	Merced County
104444	Fee-for-Service	1720204696	1720204696	1	1	HUMANISTIC ALTERNATIVES TO	9/29/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ADDICTION RESEARCH AND	10850 MACARTHUR BLVD	None	OAKLAND	CA	94605	5266	01	06001	37.7414325	-122.1498379	Alameda County
104454	Fee-for-Service	1457389918	1457389918	1	1	HORWITZ, DAVID MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	43389	41	Internal Medicine	0	In state provider	None	2025 ZONAL AVE	None	LOS ANGELES	CA	90089	0264	19	06037	34.05998665	-118.2058023	Los Angeles County
104464	Fee-for-Service	1225053911	1225053911	1	1	HARRITY, SHAWN MD	8/31/1985	207R00000X	NA	Other	026	PHYSICIANS	54321	01	General Practice	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
104482	Fee-for-Service	1376802140	1376802140	1	1	HERMAN, SANDRA S MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134714	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
104491	Fee-for-Service	1750343778	1750343778	1	1	HOME OF GUIDING HANDS	1/5/1993	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10835 GREENCASTLE ST	None	SANTEE	CA	92071	1941	37	06073	32.85700903	-116.9629906	San Diego County
104539	Fee-for-Service	1356474381	1356474381	1	1	HILTON, PAULINE A NP	12/14/2007	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1329 NORTH H ST	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
104540	Fee-for-Service	1841665650	1841665650	1	1	HOFF, KAITLIN M MD	11/4/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	139413	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4502 EAST AVE S	None	PALMDALE	CA	93552	4480	19	06037	34.55800153	-118.0488825	Los Angeles County
104552	Fee-for-Service	1316347578	1316347578	1	1	HERNANDEZ-RAMIREZ, NORMA NP	12/18/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
104564	Fee-for-Service	1740399450	1740399450	1	1	HILL, LAWRENCE N MD	5/20/1987	207R00000X	NA	Other	026	PHYSICIANS	23043	41	Internal Medicine	0	In state provider	None	730 HARRIS ST	None	EUREKA	CA	95503	4414	12	06023	40.78034799	-124.1605914	Humboldt County
104568	Fee-for-Service	1437854023	1437854023	1	1	HENRY, MATTHEW	2/9/2025	111NR0200X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
104636	Fee-for-Service	1922110329	1922110329	1	1	HUTCHINSON, STUART R MD	7/28/1997	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	30665	20	Orthopedic Surgery	0	In state provider	A PROFESSIONAL CORP	536 E ARRELLAGA ST	STE 101	SANTA BARBARA	CA	93103	2262	42	06083	34.43335006	-119.702891	Santa Barbara County
104643	Fee-for-Service	1790943983	1790943983	1	1	HOMSI, YASER MD	4/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145827	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
104660	Fee-for-Service	1851990949	1851990949	1	1	HOSPICE FOR YOU INC	2/21/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2525 EAST COLORADO BLVD	STE 108	PASADENA	CA	91107	3771	19	06037	34.1461235	-118.097982	Los Angeles County
104675	Fee-for-Service	1700879897	1700879897	1	1	HERNANDEZ, RUBEN A MD	5/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74132	08	Family Practice	0	In state provider	None	14124 FOOTHILL BLVD	STE 100	SYLMAR	CA	91342	8051	19	06037	34.31598785	-118.4413895	Los Angeles County
104698	Fee-for-Service	1699959346	1699959346	1	1	HOANG, VIVIAN MD	6/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115249	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
104734	Fee-for-Service	1336450956	1336450956	1	1	HOLLINGER, FABIENNE S 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
104755	Fee-for-Service	1457554073	1457554073	1	1	HUGHES, TILDEN L	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	95323	None	None	0	In state provider	None	930 SUNSET DR	STE 1A	HOLLISTER	CA	95023	5780	35	06069	36.83510073	-121.385707	San Benito County
104870	Fee-for-Service	1184201444	1184201444	1	1	HOSPICE NUMBER 10 INC	5/5/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7621 INDUSTRY AVE	UNIT 2B	PICO RIVERA	CA	90660	4301	19	06037	33.97922516	-118.1125495	Los Angeles County
104890	Fee-for-Service	1699716860	1699716860	1	1	HOANG, MINH-TUAN R MD	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65177	07	Dermatology	0	In state provider	None	5222 BALBOA AVE	FL 6	SAN DIEGO	CA	92117	6963	37	06073	32.81873589	-117.1838368	San Diego County
104921	Fee-for-Service	1730643362	1730643362	1	1	HOOD, TIFFANY M NP	6/28/2019	261QP2300X	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
104923	Fee-for-Service	1841450517	1841450517	1	1	HWANG, JENNIFER Y MD	9/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116403	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
104932	Fee-for-Service	1790943983	1790943983	1	1	HOMSI, YASER MD	4/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145827	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
104940	Fee-for-Service	1467994285	1467994285	1	1	HILGARDS DIALYSIS LLC	1/9/2019	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	20821 HAWTHORNE BLVD	None	TORRANCE	CA	90503	4609	19	06037	33.840738	-118.3538675	Los Angeles County
104948	Fee-for-Service	1851990949	1851990949	1	1	HOSPICE FOR YOU INC	2/21/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2525 EAST COLORADO BLVD	STE 108	PASADENA	CA	91107	3771	19	06037	34.1461235	-118.097982	Los Angeles County
104954	Fee-for-Service	1114004801	1114004801	1	1	HEITKE, PETER J MD	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	46389	01	General Practice	0	In state provider	None	2305 SUNSET BLVD	None	ROCKLIN	CA	95765	4337	31	06061	38.7979323	-121.2667966	Placer County
104966	Fee-for-Service	1861661365	1861661365	1	1	HUPA HLTH ASSOC INC AMB	4/2/1980	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1200 AIRPORT RD	None	HOOPA	CA	95546	1288	12	06023	41.04526615	-123.6661741	Humboldt County
104979	Fee-for-Service	1205463171	1205463171	1	1	HARTMAN, MATTHEW MD	12/18/2023	390200000X	NA	Other	026	PHYSICIANS	180912	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
105030	Fee-for-Service	1578566972	1578566972	1	1	HANAHAN, LAURA J MD	11/19/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	174927	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
105054	Fee-for-Service	1609887280	1609887280	1	2	HONG SHENG MEDICINE LLC	12/4/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3309 N EASTERN AVE	None	LOS ANGELES	CA	90032	1931	19	06037	34.083927	-118.1780795	Los Angeles County
105064	Fee-for-Service	1932408119	1932408119	1	1	HIROMI YOSHIDA MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4800 SAND POINT WAY NE	None	SEATTLE	WA	98105	3901	00	None	47.662389	-122.281857	King County
105079	Fee-for-Service	1144327875	1144327875	1	1	HUSSAIN, AKHTAR MD	12/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	11212 STATE HIGHWAY 151	STE 220	SAN ANTONIO	TX	78251	4501	00	None	29.46743939	-98.69462674	Bexar County
105089	Fee-for-Service	1497977110	1497977110	1	1	HAYS, SHEILA B PHD	8/21/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
105116	Fee-for-Service	1851331011	1851331011	1	1	HANSON, TIMOTHY B MD	1/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78817	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
105119	Fee-for-Service	1851695340	1851695340	1	1	HEPPNER, JENNIFER D MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118974	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
105123	Fee-for-Service	1366557514	1366557514	1	1	HARPER, SHEILA ZARB PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	744 EMPIRE ST	STE 220	FAIRFIELD	CA	94533	5550	48	06095	38.2503715	-122.0429115	Solano County
105126	Fee-for-Service	1760454672	1760454672	1	2	HOSPICE OF SANTA CRUZ COUNTY	5/27/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	65 NIELSON ST	SUITE 121	WATSONVILLE	CA	95076	2491	44	06087	36.9282117	-121.7933197	Santa Cruz County
105160	Fee-for-Service	1184201444	1184201444	1	1	HOSPICE NUMBER 10 INC	5/5/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7621 INDUSTRY AVE	UNIT 2B	PICO RIVERA	CA	90660	4301	19	06037	33.97922516	-118.1125495	Los Angeles County
105171	Fee-for-Service	1962667154	1962667154	1	1	HOANG NGUYEN MD	10/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1305 W 18TH ST	None	SIOUX FALLS	SD	57105	0401	00	None	43.535484	-96.7428585	Minnehaha County
105192	Fee-for-Service	1407874134	1407874134	1	1	HIGH DESERT GASTROENTERO	7/18/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	MEDICAL CORP	1753 W AVENUE J	STE B	LANCASTER	CA	93534	9823	19	06037	34.6894465	-118.163097	Los Angeles County
105193	Fee-for-Service	1821222175	1821222175	1	1	HOANG, HAN L T MD	5/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131248	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
105196	Fee-for-Service	1649489402	1649489402	1	1	HOUGHTON, GREGORY S MD	9/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121765	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 DOYLE PARK DR	SUITE 303	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
105256	Fee-for-Service	1760556088	1760556088	1	1	HERMES, MARY J MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68729	None	None	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
105274	Fee-for-Service	1164696811	1164696811	1	2	HORACIO LOPEZ	6/29/2023	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	18350 ROSCOE BLVD	205	NORTHRIDGE	CA	91325	4109	19	06037	34.22071855	-118.5341175	Los Angeles County
105284	Fee-for-Service	1588788806	1588788806	1	1	HARDEN, JOYCE D LMFT	5/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	TICE	6112 CHANTEL DRIVE	None	FONTANA	CA	92336	1013	36	06071	34.14279376	-117.470177	San Bernardino County
105355	Fee-for-Service	1073727004	1073727004	1	1	HEBSHI, LEILA D MD	8/5/2008	207L00000X	NA	Other	026	PHYSICIANS	97153	05	Anesthesiology	0	In state provider	None	1783 EL CAMINO REAL	None	BURLINGAME	CA	94010	3205	41	06081	37.59324015	-122.3818088	San Mateo County
105373	Fee-for-Service	1922039148	1922039148	1	1	HARMON, STACY F MD	11/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78276	66	Emergency Medicine (Urgent Care)	0	In state provider	None	505 PLAZA DR	None	SANTA MARIA	CA	93454	6907	42	06083	34.93736276	-120.4298781	Santa Barbara County
105394	Fee-for-Service	1568511061	1568511061	1	1	HUANG, EMILY DO	11/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11122	25	Physical Medicine and Rehabilitation	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
105405	Fee-for-Service	1982626537	1982626537	1	1	HADDAD, FADI G MD	3/17/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51575	10	Gastroenterology (M.D. only)	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
105412	Fee-for-Service	1760454672	1760454672	1	2	HOSPICE OF SANTA CRUZ COUNTY	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	65 NIELSON ST	SUITE 121	WATSONVILLE	CA	95076	2491	44	06087	36.9282117	-121.7933197	Santa Cruz County
105420	Fee-for-Service	1003888256	1003888256	1	1	HITE, DESISLAVA 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 J	None	TACOMA	WA	98405	4234	00	None	47.25960844	-122.4534238	Pierce County
105424	Fee-for-Service	1336313121	1336313121	1	1	HEMET EYE CARE CENTER OF	7/14/2004	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRY, INC	999 E MORTON PL	None	HEMET	CA	92543	4534	33	06065	33.74663453	-116.9621775	Riverside County
105442	Fee-for-Service	1609817733	1609817733	1	1	HSIEH, S JUDY PHD	10/15/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	19925 STEVENS CREEK BLVD	SUITE 100	CUPERTINO	CA	95014	2358	43	06085	37.32302547	-122.021586	Santa Clara County
105446	Fee-for-Service	1457799942	1457799942	1	1	HABRAT, DOROTHY A DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15666	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
105450	Fee-for-Service	1548255003	1548255003	1	1	HAROW, ETHAN E DO	7/31/1995	207L00000X	NA	Other	026	PHYSICIANS	4520	None	None	0	In state provider	None	11601 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2907	19	06037	34.04458879	-118.4542015	Los Angeles County
105474	Fee-for-Service	1811941974	1811941974	1	1	HSIEH, ERIC P MD	6/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89735	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
105480	Fee-for-Service	1407874134	1407874134	1	1	HIGH DESERT GASTROENTERO	7/18/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL CORP	1753 W AVENUE J	STE B	LANCASTER	CA	93534	9823	19	06037	34.6894465	-118.163097	Los Angeles County
105499	Fee-for-Service	1700989001	1700989001	1	1	HENDERSON, DIANE J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	22020	40	Pediatrics	0	In state provider	None	2300 S FLOWER ST	STE 300	LOS ANGELES	CA	90007	2677	19	06037	34.0294397	-118.2734132	Los Angeles County
105516	Fee-for-Service	1821013145	1821013145	1	1	HENNRIKUS, WILLIAM L MD	2/8/2015	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	41574	20	Orthopedic Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
105524	Fee-for-Service	1487664934	1487664934	1	1	HANGER P & O WEST INC	6/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	298 SAN ANTONIO RD	None	MOUNTAIN VIEW	CA	94040	1212	43	06085	37.40613603	-122.1106999	Santa Clara County
105525	Fee-for-Service	1346354420	1346354420	1	1	HEILER, JUDITH MD	4/30/1983	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	51876	08	Family Practice	0	In state provider	None	651 CHERRY ST	None	SANTA ROSA	CA	95404	4202	49	06097	38.444841	-122.7154995	Sonoma County
105538	Fee-for-Service	1346396579	1346396579	1	1	HEIMER, KELLY J LMFT	8/21/2018	No Taxonomy Provided	NA	None	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
105546	Fee-for-Service	1821183773	1821183773	1	1	HOLMES, ADAM R MD	3/1/2001	2080P0203X	NA	Other	026	PHYSICIANS	72700	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	# M680	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
105553	Fee-for-Service	1427072909	1427072909	1	1	HE, KONGYUAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	61934	05	Anesthesiology	0	In state provider	KONG HE MEDICAL CORP	2701 W ALAMEDA AVE	STE 203	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
105558	Fee-for-Service	1922540053	1922540053	1	1	HARRISON, SUSAN L LMFT	5/16/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3960 INDUSTRIAL BLVD	200	WEST SACRAMENTO	CA	95691	5024	57	06113	38.57029234	-121.5767941	Yolo County
105575	Fee-for-Service	1104802149	1104802149	1	1	HAN, JAESU MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66813	08	Family Practice	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
105606	Fee-for-Service	1235969486	1235969486	1	1	HAMILTON, DAVID NP	9/13/2024	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
105617	Fee-for-Service	1578821914	1578821914	1	1	HOMER-BERTRAND, DANA R DO	2/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	12960	01	General Practice	0	In state provider	None	1601 MONTE VISTA AVE	STE 190	CLAREMONT	CA	91711	6601	19	06037	34.112259	-117.698539	Los Angeles County
105640	Fee-for-Service	1568877900	1568877900	1	1	HALL, BLANCA LCSW	9/23/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
105660	Fee-for-Service	1285845404	1285845404	1	1	HUSSAIN, NAMATH S MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142618	14	Neurological Surgery	0	In state provider	None	25455 BARTON RD	STE A108	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
105675	Fee-for-Service	1114184587	1114184587	1	1	HALLAJ-POUR, ALI MD	11/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	103981	40	Pediatrics	0	In state provider	None	5700 TELEGRAPH AVE	STE 100	OAKLAND	CA	94609	1710	01	06001	37.84323585	-122.2614659	Alameda County
105690	Fee-for-Service	1952356438	1952356438	1	1	HOPKINS, JANET J MD	4/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51780	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
105704	Fee-for-Service	1245411180	1245411180	1	1	HENTZEN, ERIC R MD	12/3/2008	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	83117	20	Orthopedic Surgery	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
105713	Fee-for-Service	1215983614	1215983614	1	1	HALNON, NANCY J MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64705	35	Pediatric Cardiology (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
105742	Fee-for-Service	1649638396	1649638396	1	1	HOLISTIC PALLIATIVE CARE INC	1/8/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	5707 REDWOOD RD	SUITE 1	OAKLAND	CA	94619	2400	01	06001	37.79999164	-122.170733	Alameda County
105768	Fee-for-Service	1952740938	1952740938	1	1	HA, DAON MD	4/23/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
105820	Fee-for-Service	1104236348	1104236348	1	2	HOROWITZ, JENNY E MD	6/20/2017	390200000X	NA	Other	026	PHYSICIANS	137829	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
105832	Fee-for-Service	1134638984	1134638984	1	1	HARMAN, MEGHAN E PT	4/27/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
105850	Fee-for-Service	1013150630	1013150630	1	1	HARPER, CHRIS J E MD	1/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137455	07	Dermatology	0	In state provider	None	585 N MOUNTAIN AVE	STE A	UPLAND	CA	91786	8516	36	06071	34.10114204	-117.6702497	San Bernardino County
105854	Fee-for-Service	1740693894	1740693894	1	1	HOUSKEEPER, KARLA L NP	7/9/2018	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
105863	Fee-for-Service	1104802149	1104802149	1	1	HAN, JAESU MD	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66813	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
105890	Fee-for-Service	1659334274	1659334274	1	1	HAWK, THOMAS A MD	3/19/2019	207L00000X	NA	Other	026	PHYSICIANS	159645	05	Anesthesiology	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
105919	Fee-for-Service	1740332436	1740332436	1	1	HUANG, WILMER MD	5/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85258	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
105933	Fee-for-Service	1780979120	1780979120	1	1	HEINRICI, ALEKA D MD	8/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125329	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
105960	Fee-for-Service	1902123383	1902123383	1	1	HASHEMI, PANTEA MD	1/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132379	07	Dermatology	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
106027	Fee-for-Service	1649638396	1649638396	1	1	HOLISTIC PALLIATIVE CARE INC	1/8/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	5707 REDWOOD RD	SUITE 1	OAKLAND	CA	94619	2400	01	06001	37.79999164	-122.170733	Alameda County
106053	Fee-for-Service	1265997092	1265997092	1	1	HOURIGAN, BRYAN M 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
106062	Fee-for-Service	1427245349	1427245349	1	1	HORMOZDIARAN, ROYA MD	8/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96931	08	Family Practice	0	In state provider	None	441 NORTH LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
106090	Fee-for-Service	1558757120	1558757120	1	1	HSU, RUTH S	12/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144115	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94556	1639	41	06081	37.53039072	-122.2987772	San Mateo County
106108	Fee-for-Service	1144935636	1144935636	1	1	HERNANDEZ, SHEENA C CRNA	4/23/2023	367500000X	NA	Other	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
106119	Fee-for-Service	1144462508	1144462508	1	1	HIERSCHE, MATTHEW A MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	116201	24	Plastic Surgery	0	In state provider	None	9300 VALLEY CHILDRENS PL	GE07	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
106133	Fee-for-Service	1134870603	1134870603	1	1	HUGHES, ELISA OT	1/31/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
106138	Fee-for-Service	1013150630	1013150630	1	1	HARPER, CHRIS J E MD	1/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137455	01	General Practice	0	In state provider	None	585 N MOUNTAIN AVE	STE A	UPLAND	CA	91786	8516	36	06071	34.10114204	-117.6702497	San Bernardino County
106150	Fee-for-Service	1033132105	1033132105	1	1	HURT, CATHERINE M MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54660	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
106156	Fee-for-Service	1760877237	1760877237	1	1	HOFTMAN, GIL D MD	3/13/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	160859	26	Psychiatry (child)	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
106183	Fee-for-Service	1730244369	1730244369	1	1	HAGAN, DAWN C MD	9/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92083	05	Anesthesiology	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
106211	Fee-for-Service	1417520057	1417520057	1	1	HONG, MORGAN LMFT	5/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
106221	Fee-for-Service	1184283855	1184283855	1	1	HOMEDIC HOSPICE CARE	12/29/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	358 E OLIVE AVE	UNIT 102	BURBANK	CA	91502	1215	19	06037	34.18286702	-118.3066106	Los Angeles County
106256	Fee-for-Service	1548897416	1548897416	1	1	HE, ANNE DPM	8/7/2023	213ES0103X	NA	Other	027	PODIATRISTS	-	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
106288	Fee-for-Service	1750694931	1750694931	1	1	HARPER, ABIGAIL L	9/1/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3460 E LA PALMA AVE	None	ANAHEIM	CA	92806	9999	30	06059	33.85429451	-117.8446551	Orange County
106290	Fee-for-Service	1801338017	1801338017	1	1	HIMELES, DARREN M MD	8/31/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	149268	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
106319	Fee-for-Service	1679506612	1679506612	1	1	HARWAY, ELANA C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68268	20	Orthopedic Surgery	0	In state provider	None	1304 ELLA ST	STE A	SAN LUIS OBISPO	CA	93401	4165	40	06079	35.27704692	-120.6496857	San Luis Obispo County
106330	Fee-for-Service	1710998810	1710998810	1	1	HOURIHAN, ELIZABETH A MD	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74602	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
106349	Fee-for-Service	1962229252	1962229252	1	1	HERZEG, AKOS MD	10/8/2024	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
106358	Fee-for-Service	1841686508	1841686508	1	1	HAMILTON, AMBER V MD	8/21/2018	364SP0200X	NA	Other	026	PHYSICIANS	154914	40	Pediatrics	0	In state provider	None	31170 TEMECULA PARKWAY	SUITE 200	TEMECULA	CA	92592	2905	33	06065	33.47598766	-117.1199967	Riverside County
106367	Fee-for-Service	1073730685	1073730685	1	1	HOBBY, BRYON MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120879	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
106389	Fee-for-Service	1629158068	1629158068	1	1	HANNAH F SMITHERMAN MD	8/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	801 7TH AVE	None	FORTH WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
106405	Fee-for-Service	1427395144	1427395144	1	1	HENRY, SHANIQUA L	8/14/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
106416	Fee-for-Service	1568437325	1568437325	1	1	HUMANGOOD SOCAL	2/4/1988	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	REGENTS POINT-WINDCREST	19191 HARVARD AVE	None	IRVINE	CA	92612	4670	30	06059	33.65150104	-117.8317924	Orange County
106453	Fee-for-Service	1396272183	1396272183	1	1	HE, CHUYI L MD	10/23/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	161579	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
106499	Fee-for-Service	1184283855	1184283855	1	1	HOMEDIC HOSPICE CARE	12/29/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	358 E OLIVE AVE	UNIT 102	BURBANK	CA	91502	1215	19	06037	34.18286702	-118.3066106	Los Angeles County
106504	Fee-for-Service	1629332390	1629332390	1	1	HOFFMAN, MARTHA L OT	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
106517	Fee-for-Service	1548215783	1548215783	1	1	HOWARD,MILES 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	13555 W MCDOWELL RD	None	GOODYEAR	AZ	85338	0000	00	None	33.463737	-112.350645	Maricopa County
106531	Fee-for-Service	1629575279	1629575279	1	1	HERNANDEZ, MARIA C LMFT	12/11/2023	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
106542	Fee-for-Service	1679935688	1679935688	1	1	HAMILTON, JEFFREY R MD	9/20/2022	207LP3000X	NA	Other	026	PHYSICIANS	154155	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
106581	Fee-for-Service	1952479339	1952479339	1	1	HENRY, MICHELLE D MD	8/31/1995	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	74047	None	None	0	In state provider	None	12665 GARDEN GROVE BLVD	STE 713	GARDEN GROVE	CA	92843	1921	30	06059	33.77450141	-117.9123364	Orange County
106588	Fee-for-Service	1679126353	1679126353	1	1	HAWKINS, JEFFREY NP	1/27/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3131 BERGER AVE	None	SAN DIEGO	CA	92123	4233	37	06073	32.8019999	-117.1515447	San Diego County
106597	Fee-for-Service	1528565637	1528565637	1	1	HEFFNER, MICHAEL MD	8/9/2023	390200000X	NA	Other	026	PHYSICIANS	163585	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
106608	Fee-for-Service	1588742183	1588742183	1	1	HERMAN, MARK A MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	66675	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
106630	Fee-for-Service	1609898253	1609898253	1	1	HANNA, ROBERT J MD	10/31/1992	207L00000X	NA	Other	026	PHYSICIANS	53478	05	Anesthesiology	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
106637	Fee-for-Service	1184838286	1184838286	1	1	HEATH,KIRK MD	3/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1120 1 COLONIAL RD	STE 203	VIRGINA BEACH	VA	23454	2418	00	None	36.8666554	-76.02945618	Virginia Beach
106658	Fee-for-Service	1821192105	1821192105	1	1	HENDRA, CANDACE J LCSW	5/10/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1844 SAN MIGUEL DR	STE 300B	WALNUT CREEK	CA	94596	8612	07	06013	37.89504879	-122.0529911	Contra Costa County
106689	Fee-for-Service	1992853865	1992853865	1	1	HOFFMAN, VICKI R MD	1/1/1982	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	36233	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
106708	Fee-for-Service	1073023107	1073023107	1	3	HUMBOLDT RECOVERY CENTER, IN	4/22/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	944 N ST	None	EUREKA	CA	95501	2045	12	06023	40.79949486	-124.156494	Humboldt County
106717	Fee-for-Service	1023065570	1023065570	1	1	HABERMEHL, DEIRDRE MD	2/13/2023	2084A0401X	NA	Psychiatry	026	PHYSICIANS	60299	None	None	0	In state provider	None	18800 MAIN ST	STE 101	HUNTINGTON BEACH	CA	92648	1707	30	06059	33.68890364	-117.9949974	Orange County
106736	Fee-for-Service	1669546545	1669546545	2	1	HANGER O & P WEST INC	7/30/2007	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	4659 LAS POSITAS RD	STE A	LIVERMORE	CA	94551	8860	01	06001	37.69671865	-121.7348742	Alameda County
106740	Fee-for-Service	1962463745	1962463745	1	1	HOME OF GUIDING HANDS	3/17/1992	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10200 AQUILLA DR	None	LAKESIDE	CA	92040	2212	37	06073	32.86222465	-116.9611659	San Diego County
106789	Fee-for-Service	1174538631	1174538631	1	1	HUYLER, FRANK MD	9/28/2008	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
106802	Fee-for-Service	1568434595	1568434595	1	1	HOUSHYAR, ALI A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53412	41	Internal Medicine	0	In state provider	None	1275 N ROSE DR	STE 126	PLACENTIA	CA	92870	3919	30	06059	33.8868003	-117.8420447	Orange County
106861	Fee-for-Service	1770621260	1770621260	1	1	HUNG, WARREN C MD	6/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55808	41	Internal Medicine	0	In state provider	None	14150 CULVER DR	STE 306	IRVINE	CA	92604	0323	30	06059	33.70834263	-117.7839373	Orange County
106891	Fee-for-Service	1750453023	1750453023	1	1	HENDRICKS, H THOMAS	9/11/2012	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
106916	Fee-for-Service	1851431431	1851431431	1	1	HO, LILY MD INC	12/21/2004	174400000X	NA	Other	026	PHYSICIANS	63149	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	9209 S COLIMA RD	STE 4300	WHITTIER	CA	90605	1822	19	06037	33.9505367	-118.0054552	Los Angeles County
106917	Fee-for-Service	1063133049	1063133049	1	1	HOME CARE PARTNER INC	9/6/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	5435 BALBOA BLVD	STE 104	ENCINO	CA	91316	1518	19	06037	34.16995337	-118.5011287	Los Angeles County
106931	Fee-for-Service	1588012124	1588012124	1	4	HESHAM EL MOKADEM, MD INC.	9/30/2016	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	R	12712 HEACOCK STREET	9B	MORENO VALLEY	CA	92553	3037	33	06065	33.936165	-117.2437645	Riverside County
106953	Fee-for-Service	1285809632	1285809632	1	1	HANSLICK, JENNIFER L MD	12/23/2019	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
106985	Fee-for-Service	1467033886	1467033886	1	1	HOFFMAN, TAMMIE M NP	10/30/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	202 W WILLOW AVE	SUITE 502	VISALIA	CA	93291	6238	54	06107	36.328536	-119.293569	Tulare County
107002	Fee-for-Service	1821205709	1821205709	1	4	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GROUP OF SF VALLEY	16801 DEVONSHIRE ST	None	GRANADA HILLS	CA	91344	7405	19	06037	34.25751298	-118.4982318	Los Angeles County
107031	Fee-for-Service	1174845036	1174845036	1	1	HENSLEY, ANGELINA C LMFT	10/11/2017	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2200 L STREET	None	SACRAMENTO	CA	95816	4927	34	06067	38.573523	-121.4780805	Sacramento County
107044	Fee-for-Service	1629020953	1629020953	1	1	HILL, KENNETH J MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73908	05	Anesthesiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
107050	Fee-for-Service	1023198181	1023198181	1	1	HERMANOWICZ, NEAL S MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84077	13	Neurology (M.D. only)	0	In state provider	None	637 LUCAS AVE	STE 501	LOS ANGELES	CA	90017	1912	19	06037	34.05351827	-118.2646017	Los Angeles County
107156	Fee-for-Service	1659382257	1659382257	1	1	HEPLER, ROBERT S MD INC	12/31/1989	207W00000X	NA	Ophthalmology	026	PHYSICIANS	20233	18	Ophthalmology	0	In state provider	JULES STEIN EYE INST	200 WESTWOOD PLAZA#I-340	None	LOS ANGELES	CA	90024	0000	19	06037	34.07315131	-118.4447245	Los Angeles County
107204	Fee-for-Service	1659601987	1659601987	1	1	HARTSTEIN, ILAN MD INC	2/26/2010	193400000X	NA	Other	026	PHYSICIANS	59917	18	Ophthalmology	0	In state provider	None	7851 WALKER ST	STE 207	LA PALMA	CA	90623	1746	30	06059	33.848253	-118.037309	Orange County
107222	Fee-for-Service	1285957241	1285957241	1	1	HENRY-CODORNIZ, AGNES C MD	6/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107532	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
107225	Fee-for-Service	1902859945	1902859945	1	1	HANSS,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	2601 E ROOSEVELT	None	PHOENIX	AZ	85008	0000	00	None	33.457203	-112.0262625	Maricopa County
107231	Fee-for-Service	1952483786	1952483786	1	1	HACK, HOWARD M MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	68575	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
107239	Fee-for-Service	1629013669	1629013669	1	1	HILL, RICHARD MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	38103	01	General Practice	0	In state provider	None	418 E ARBOR VITAE ST	None	INGLEWOOD	CA	90301	3450	19	06037	33.9526858	-118.3501337	Los Angeles County
107243	Fee-for-Service	1144519257	1144519257	1	1	HEDLIN, CHRYSTAL LCSW	3/24/2025	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
107263	Fee-for-Service	1770741134	1770741134	1	1	HSU, PATRICIA MD	10/11/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	184026	None	None	0	In state provider	None	1409 E BRIGGSMORE AVE	None	MODESTO	CA	95355	2707	50	06099	37.66742737	-120.9731413	Stanislaus County
107272	Fee-for-Service	1477577575	1477577575	1	1	HUYNH, ALEC T MD	4/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85680	66	Emergency Medicine (Urgent Care)	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
107277	Fee-for-Service	1548757644	1548757644	1	1	HOLSCLAW, LYNNE L MD	11/18/2022	207QH0002X	NA	Adult Primary Care	026	PHYSICIANS	174812	None	None	0	In state provider	None	2055 KELLOGG AVE	None	CORONA	CA	92879	3111	33	06065	33.85626255	-117.5559289	Riverside County
107279	Fee-for-Service	1013952001	1013952001	1	1	HILD, BRIAN D MD	12/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91177	20	Orthopedic Surgery	0	In state provider	None	4444 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4136	33	06065	33.97614344	-117.3797664	Riverside County
107294	Fee-for-Service	1821205709	1821205709	1	4	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GROUP OF SF VALLEY	16801 DEVONSHIRE ST	None	GRANADA HILLS	CA	91344	7405	19	06037	34.25751298	-118.4982318	Los Angeles County
107387	Fee-for-Service	1548686058	1548686058	1	1	HEALTHRIGHT 360	7/20/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	6109 AFTON PLACE	None	LOS ANGELES	CA	90028	8313	19	06037	34.09531447	-118.3226631	Los Angeles County
107390	Fee-for-Service	1891785267	1891785267	1	1	HIRWE, EVA MD	12/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90685	08	Family Practice	0	In state provider	None	400 E OAK AVE	None	VISALIA	CA	93291	5034	54	06107	36.332253	-119.288691	Tulare County
107393	Fee-for-Service	1457679649	1457679649	1	1	HA, THOA K MD	11/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136757	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
107407	Fee-for-Service	1053579235	1053579235	1	1	HIBBARD, MICHAEL L MD	8/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115608	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
107426	Fee-for-Service	1871513341	1871513341	1	1	HEYWOOD, 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	1135 116TH AVE NE	STE 600	BELLEVUE	WA	98004	4623	00	None	47.62130171	-122.1857045	King County
107474	Fee-for-Service	1285776187	1285776187	1	1	HUANG, CHING-CHICH D MD	11/27/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	47754	40	Pediatrics	0	In state provider	None	160 E ARTESIA ST	SUITE 235	POMONA	CA	91767	2900	19	06037	34.07556833	-117.7507835	Los Angeles County
107478	Fee-for-Service	1811217573	1811217573	1	1	HESSAM AFSHARI MD	12/6/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
107491	Fee-for-Service	1861701856	1861701856	1	1	HOWARD, YAHAIRA O	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	6087	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDOLW ROAD	None	LONG BEACH	CA	90503	1727	19	06037	33.8188341	-118.1923297	Los Angeles County
107493	Fee-for-Service	1386322287	1386322287	1	1	HEART ARRHYTHMIA CLINIC OF S	8/1/2023	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	None	None	0	In state provider	AN DIEGO	501 WASHINGTON ST	STE 512	SAN DIEGO	CA	92103	2238	37	06073	32.74986289	-117.1599343	San Diego County
107526	Fee-for-Service	1629013669	1629013669	1	1	HILL, RICHARD MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	38103	66	Emergency Medicine (Urgent Care)	0	In state provider	None	418 E ARBOR VITAE ST	None	INGLEWOOD	CA	90301	3450	19	06037	33.9526858	-118.3501337	Los Angeles County
107580	Fee-for-Service	1821205709	1821205709	1	4	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP OF SF VALLEY	16801 DEVONSHIRE ST	None	GRANADA HILLS	CA	91344	7405	19	06037	34.25751298	-118.4982318	Los Angeles County
107584	Fee-for-Service	1366770679	1366770679	1	1	HINTZ, CAROLINE D OT	8/12/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
107609	Fee-for-Service	1366561383	1366561383	1	1	HOLLIS-OCHETTI, MARLENE LCS	5/28/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
107647	Fee-for-Service	1902869621	1902869621	1	1	HILE, DANIEL OD	11/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1112 VINE ST	None	PASO ROBLES	CA	93446	5505	40	06079	35.62602516	-120.6938682	San Luis Obispo County
107677	Fee-for-Service	1891748158	1891748158	1	1	HUYNH, VU T MD	10/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87125	05	Anesthesiology	0	In state provider	None	225 E SANTA CLARA ST	STE 101	SAN JOSE	CA	95113	1906	43	06085	37.33852363	-121.885759	Santa Clara County
107690	Fee-for-Service	1891149571	1891149571	1	1	HAMMAMI, MUHAMMAD B MD	9/1/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	158659	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
107731	Fee-for-Service	1043399017	1043399017	1	1	HARDEMAN, JAMES L MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	38943	41	Internal Medicine	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
107732	Fee-for-Service	1780072637	1780072637	1	1	HARMONY HOME MEDICAL	5/28/2021	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	7640 CLAIREMONT MESA	None	SAN DIEGO	CA	92111	1535	37	06073	32.83275353	-117.155637	San Diego County
107735	Fee-for-Service	1396811501	1396811501	1	1	HONG, DAVID M MD	1/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	65267	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
107773	Fee-for-Service	1477970515	1477970515	1	1	HAWKINS, MITZI MD	8/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	157426	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94114	2202	38	06075	37.76344756	-122.4581992	San Francisco County
107817	Fee-for-Service	1588785166	1588785166	1	1	HUNT, JUDITH L PSYD	11/15/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	30131 TOWN CENTER DR	STE 280	LAGUNA NIGUEL	CA	92677	2086	30	06059	33.52530096	-117.7148334	Orange County
107831	Fee-for-Service	1629595830	1629595830	1	1	HOFMANN, JOSEPH	3/13/2025	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
107840	Fee-for-Service	1306841556	1306841556	1	1	HOMMA,ARTURO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7950 FLOYD CURL	STE 620	SAN ANTONIO	TX	78229	0000	00	None	29.51244802	-98.57663128	Bexar County
107897	Fee-for-Service	1720330756	1720330756	1	1	HEALING ANGELS HOSPICE	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	144 N GLENDALE AVE	STE 304	GLENDALE	CA	91206	4903	19	06037	34.14799289	-118.2464845	Los Angeles County
107965	Fee-for-Service	1760471759	1760471759	1	2	HILL MEDICAL CORPORATION	3/6/2019	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1509 W CAMERON AVE	STE D-100	WEST COVINA	CA	91790	2725	19	06037	34.06870559	-117.9422297	Los Angeles County
108015	Fee-for-Service	1982725131	1982725131	1	1	HAN, ROGER C S MD	4/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138945	30	Radiology	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
108017	Fee-for-Service	1336327683	1336327683	1	1	HA, NGUYEN K MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130540	18	Ophthalmology	0	In state provider	None	1690 BARTON RD	None	REDLANDS	CA	92373	4229	36	06071	34.04836346	-117.2125293	San Bernardino County
108090	Fee-for-Service	1104398478	1104398478	1	1	HARRIS, BROOKE A CRNA	7/17/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1311 S MILLER ST	STE 100	SANTA MARIA	CA	93454	6900	42	06083	34.93818375	-120.4316485	Santa Barbara County
108148	Fee-for-Service	1518984525	1518984525	1	1	HENEGHAN, AMY M MD	12/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87921	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
108149	Fee-for-Service	1194179135	1194179135	1	1	HANNAWI, ANDREW P MD	7/1/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	153161	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
108171	Fee-for-Service	1598483836	1598483836	1	1	HERNANDEZ, ALONDRA LMFT	12/28/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
108174	Fee-for-Service	1104193358	1104193358	1	2	HAROLD CARDINAL VALERY M.D.	10/31/2024	163WG0000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	INC.	6316 HOLMES AVE	None	LOS ANGELES	CA	90001	1824	19	06037	33.982263	-118.2411845	Los Angeles County
108182	Fee-for-Service	1528370616	1528370616	1	1	HENDRYK, HILLARY G MD	11/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130809	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
108184	Fee-for-Service	1720330756	1720330756	1	1	HEALING ANGELS HOSPICE	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	144 N GLENDALE AVE	STE 304	GLENDALE	CA	91206	4903	19	06037	34.14799289	-118.2464845	Los Angeles County
108187	Fee-for-Service	1255353496	1255353496	1	1	HASBUN, GIOVINETZA MD	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85995	01	General Practice	0	In state provider	None	2001 SANTA MONICA	370W,380W,860W,1070	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
108189	Fee-for-Service	1932455144	1932455144	1	1	HERNANDEZ, AMELIA I LCSW	9/9/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CSW	5709 E BEVERLY BLVD	None	LOS ANGELES	CA	90022	2823	19	06037	34.02720445	-118.145245	Los Angeles County
108193	Fee-for-Service	1164516647	1164516647	1	1	HAROLD K. REICH	4/21/2004	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HAROLD K REICH'S PHRMCY	39 W 10TH ST	None	TRACY	CA	95376	3901	39	06077	37.73856338	-121.4269479	San Joaquin County
108205	Fee-for-Service	1710925987	1710925987	1	1	HEGE, KRISTEN M MD	5/31/1995	207R00000X	NA	Other	026	PHYSICIANS	74793	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
108226	Fee-for-Service	1831124890	1831124890	1	1	HOME OF GUIDING HANDS	5/31/1985	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10111 LOS RANCHITOS RD	None	LAKESIDE	CA	92040	2725	37	06073	32.86066666	-116.9597115	San Diego County
108241	Fee-for-Service	1295859759	1295859759	1	1	HUTTON, ANGELA M LCSW	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27188	-	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
108250	Fee-for-Service	1942821038	1942821038	1	1	HWANG, MELISSA L CNP	5/11/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	19	06037	33.896799	-118.3959415	Los Angeles County
108252	Fee-for-Service	1235224601	1235224601	1	1	HARRIS, JOHN P MD	3/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75604	30	Radiology	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1019	38	06075	37.7738933	-122.4544685	San Francisco County
108253	Fee-for-Service	1659432284	1659432284	1	1	HEALTH GUARD INC	2/1/2010	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE	5648-5652 VINELAND AVE	None	NORTH HOLLYWOOD	CA	91601	2028	19	06037	34.17374219	-118.3702596	Los Angeles County
108292	Fee-for-Service	1932194123	1932194123	1	1	HELLER, BRUCE G MD	11/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84653	08	Family Practice	0	In state provider	None	4000 CIVIC CENTER DR	None	SAN RAFAEL	CA	94903	4171	21	06041	38.0041783	-122.538861	Marin County
108302	Fee-for-Service	1427654391	1427654391	1	1	HART HOSPICE	5/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	16106C HART STREET	None	VAN NUYS	CA	91406	3903	19	06037	34.19745738	-118.4839658	Los Angeles County
108311	Fee-for-Service	1316961550	1316961550	1	1	HUANG, BARRY P MD	5/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90561	None	None	0	In state provider	None	1180 N INDIAN CANYON DR	STE E155	PALM SPRINGS	CA	92262	4835	33	06065	33.839505	-116.5455735	Riverside County
108331	Fee-for-Service	1336646249	1336646249	1	1	HASSAN, SYED Z MD	4/10/2023	207R00000X	NA	Other	026	PHYSICIANS	-	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
108338	Fee-for-Service	1952319253	1952319253	1	1	HIJAZIN, MUNTHER A MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64753	01	General Practice	0	In state provider	None	11525 BROOKSHIRE AVE	STE 400	DOWNEY	CA	90241	4982	19	06037	33.93544635	-118.1318321	Los Angeles County
108362	Fee-for-Service	1679150197	1679150197	1	1	HAJIABBASI, MARYAM MD	6/4/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1250 16TH STREET	2100	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
108366	Fee-for-Service	1558652701	1558652701	1	1	HSU, JEFFREY J MD	9/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124119	41	Internal Medicine	0	In state provider	None	2424 WILSHIRE BLVD	None	SANTA MONICA	CA	90403	5806	19	06037	34.03455172	-118.4792084	Los Angeles County
108386	Fee-for-Service	1609215359	1609215359	1	1	HOZELLA, JOSHUA B MD	8/14/2024	207L00000X	NA	Other	026	PHYSICIANS	None	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
108422	Fee-for-Service	1851787295	1851787295	1	1	HDMC HOLDINGS, LLC	7/1/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
108444	Fee-for-Service	1508131442	1508131442	1	1	HOFFMAN, KATEY K MD	4/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116399	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
108491	Fee-for-Service	1710925987	1710925987	1	1	HEGE, KRISTEN M MD	5/31/1995	207R00000X	NA	Other	026	PHYSICIANS	74793	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
108558	Fee-for-Service	1578037115	1578037115	1	1	HOUSE MEDICINE	1/7/2020	207LC0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2040 E MARIPOSA AVE	None	EL SEGUNDO	CA	90245	5027	19	06037	33.92356852	-118.389987	Los Angeles County
108576	Fee-for-Service	1558679217	1558679217	1	1	HAYMOND, TAWNNY R LMFT	12/3/2021	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
108591	Fee-for-Service	1427654391	1427654391	1	1	HART HOSPICE	5/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	16106C HART STREET	None	VAN NUYS	CA	91406	3903	19	06037	34.19745738	-118.4839658	Los Angeles County
108603	Fee-for-Service	1215372032	1215372032	1	1	HE, YONG MD	10/29/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	132102	07	Dermatology	0	In state provider	None	8220 WYMARK DRIVE	STE 200	ELK GROVE	CA	95757	6298	34	06067	38.406888	-121.4100495	Sacramento County
108615	Fee-for-Service	1134384225	1134384225	1	1	HSIEH, JOYCE I OD	2/14/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 PARNASSUS AVE	7TH FLOOR	SAN FRANCISCO	CA	94143	0344	38	06075	37.76344756	-122.4581992	San Francisco County
108616	Fee-for-Service	1780955971	1780955971	1	1	HUEN, HETTY S	1/11/2013	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
108618	Fee-for-Service	1821670084	1821670084	1	1	HOJJAT MD INC	8/10/2021	207YS0123X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	None	None	0	In state provider	C SURGERY	3828 DELMAS TERRACE	None	CULVER CITY	CA	90232	2113	19	06037	34.02308948	-118.3972101	Los Angeles County
108625	Fee-for-Service	1952319253	1952319253	1	1	HIJAZIN, MUNTHER A MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64753	13	Neurology (M.D. only)	0	In state provider	None	11525 BROOKSHIRE AVE	STE 400	DOWNEY	CA	90241	4982	19	06037	33.93544635	-118.1318321	Los Angeles County
108652	Fee-for-Service	1598847543	1598847543	1	1	HERRICK, KEVIN R MD	8/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	69299	None	None	0	In state provider	None	7520 ARROYO CIRCLE	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
108666	Fee-for-Service	1578881330	1578881330	1	1	HARIDAS, ARUN MD	1/29/2018	2084P0805X	NA	Psychiatry	026	PHYSICIANS	121503	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
108671	Fee-for-Service	1235296864	1235296864	1	1	HISERODT, JOHN C MD	12/1/2000	207ZP0105X	NA	Other	026	PHYSICIANS	77372	22	Pathology (M.D. only)	0	In state provider	None	2130 MAIN ST	STE 210	HUNTINGTON BEACH	CA	92648	6465	30	06059	33.680385	-117.9976275	Orange County
108702	Fee-for-Service	1114987997	1114987997	1	1	HENRY, TIMOTHY D MD	2/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	89453	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
108706	Fee-for-Service	1962408815	1962408815	1	1	HANSON, NONA L MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73987	None	None	0	In state provider	None	2095 W VISTA WAY	SUITE 218	VISTA	CA	92083	6029	37	06073	33.18438885	-117.2876725	San Diego County
108709	Fee-for-Service	1851787295	1851787295	1	1	HDMC HOLDINGS, LLC	7/1/2015	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
108710	Fee-for-Service	1710026935	1710026935	1	1	HSIEH, JENNIFER L DO	4/7/2014	207RE0101X	NA	Endocrinology	026	PHYSICIANS	6896	67	Endocrinology	0	In state provider	None	1090 THIRD STREET	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
108787	Fee-for-Service	1801110457	1801110457	1	1	HUYNH, CHRISTOPHER P MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120005	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
108793	Fee-for-Service	1821661075	1821661075	1	1	HEALTH IS WEALTH HOME CARE	4/14/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	3360 BARHAM BLVD	SUITE E	LOS ANGELES	CA	90068	1473	19	06037	34.13249611	-118.3442219	Los Angeles County
108810	Fee-for-Service	1174622617	1174622617	1	1	HAAGENSEN, DARROW E JR	8/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42830	02	General Surgery	0	In state provider	None	7248 S LAND PARK DR	STE 112	SACRAMENTO	CA	95831	3661	34	06067	38.494602	-121.513743	Sacramento County
108825	Fee-for-Service	1245541242	1245541242	1	1	HODGKISS-HARLOW, CHELSEA J	1/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118797	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
108844	Fee-for-Service	1821205709	1821205709	1	1	HEMATOLOGY-ONCOLOGY MEDICAL	9/17/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP OF SF VALLEY	16133 VENTURA BLVD	STE 470	ENCINO	CA	91436	2402	19	06037	34.15656164	-118.4849569	Los Angeles County
108861	Fee-for-Service	1184668154	1184668154	1	1	HASHEM, MEHYAR N MD	11/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87247	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
108863	Fee-for-Service	1790967743	1790967743	1	1	HAN, ALEXANDER K J MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102857	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
108919	Fee-for-Service	1114199882	1114199882	1	1	HERITAGE BOARD & CARE, INC.	3/11/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2330 E 15TH STREET	None	LONG BEACH	CA	90804	1410	19	06037	33.78620147	-118.163943	Los Angeles County
108926	Fee-for-Service	1225294572	1225294572	1	1	HOM, ROBERT C MD	5/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125162	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
108990	Fee-for-Service	1114987997	1114987997	1	1	HENRY, TIMOTHY D MD	2/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	89453	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
108999	Fee-for-Service	1710026935	1710026935	1	1	HSIEH, JENNIFER L DO	4/7/2014	207RE0101X	NA	Endocrinology	026	PHYSICIANS	6896	41	Internal Medicine	0	In state provider	None	1090 THIRD STREET	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
109002	Fee-for-Service	1265963961	1265963961	1	1	HERNANDEZ, GUSTAVO MD	8/28/2024	208M00000X	NA	Other	026	PHYSICIANS	173017	29	Pulmonary Diseases (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
109015	Fee-for-Service	1811672249	1811672249	1	1	HERNANDEZ, MARYSSA DOULA	1/10/2024	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	27	06053	0	0	None
109018	Fee-for-Service	1851345433	1851345433	1	1	HODGSON, JONATHAN DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MERCY GILBERT MED CTR	3555 S VAL VISTA DR	None	GILBERT	AZ	85297	7323	00	None	33.286572	-111.7527525	Maricopa County
109032	Fee-for-Service	1750453585	1750453585	1	1	HEART, JOYA MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	79791	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
109048	Fee-for-Service	1134515406	1134515406	1	1	HENDY, BENJAMIN A MD	5/5/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	172043	None	None	0	In state provider	None	2300 W SUNNYSIDE AVE	None	VISALIA	CA	93277	7287	54	06107	36.303597	-119.316294	Tulare County
109098	Fee-for-Service	1861545956	1861545956	1	1	HAMILTON, APRIL E LMFT	12/17/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	800 SERENO DR	None	VALLEJO	CA	94589	2411	48	06095	38.12792924	-122.2506587	Solano County
109168	Fee-for-Service	1063533842	1063533842	1	1	HEARNE, GEORGE W LCSW	12/15/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3517 MARCONI AVE	SUITE 205	SACRAMENTO	CA	95821	5328	34	06067	38.618208	-121.3817445	Sacramento County
109181	Fee-for-Service	1003939422	1003939422	1	1	HOENIG, ERIC P MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	62573	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
109192	Fee-for-Service	1437233509	1437233509	1	1	HEDIN, ANDREA L MDM	5/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46755	36	Psychiatry	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
109206	Fee-for-Service	1649815325	1649815325	1	1	HALL, NICHOLAS MD	7/12/2024	207P00000X	NA	Other	026	PHYSICIANS	189470	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
109224	Fee-for-Service	1437140811	1437140811	1	1	HOWARD, CHRISTOS R MD	1/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	72245	08	Family Practice	0	In state provider	None	845 W LA VETA AVE	STE 108	ORANGE	CA	92868	3930	30	06059	33.78064548	-117.8611107	Orange County
109258	Fee-for-Service	1497947675	1497947675	1	1	HOYT, CREIG S MD	3/31/1988	207W00000X	NA	Ophthalmology	026	PHYSICIANS	18325	18	Ophthalmology	0	In state provider	CHILDRENS EYE	UC MEDICAL CTR RM 704-A	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.76140244	-122.4583252	San Francisco County
109269	Fee-for-Service	1154305571	1154305571	1	1	HORNICEK, FRANCIS MD	5/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148755	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
109289	Fee-for-Service	1265963961	1265963961	1	1	HERNANDEZ, GUSTAVO MD	8/28/2024	208M00000X	NA	Other	026	PHYSICIANS	173017	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
109290	Fee-for-Service	1114387990	1114387990	1	2	HARPERS PHARMACY INC	5/3/2016	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	132 S. ANITA DRIVE	SUITE 310	ORANGE	CA	92868	3317	30	06059	33.787386	-117.8812055	Orange County
109301	Fee-for-Service	1992532329	1992532329	1	1	HAPPY BABY JOURNEY	10/7/2024	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	19	06037	0	0	None
109308	Fee-for-Service	1700296720	1700296720	1	1	HODGDON, ANDREW T	7/7/2014	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7300 N FRESNO STREET	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
109321	Fee-for-Service	1053508820	1053508820	1	1	HUTCHINSON HEALTH CARE	12/22/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1095 HWY 15 S	None	HUTCHINSON	MN	55350	0000	00	None	44.875836	-94.3755125	McLeod County
109335	Fee-for-Service	1316348253	1316348253	1	3	HAN ORTHOPAEDICS INC	10/9/2024	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	505 S VIRGIL AVE	205	LOS ANGELES	CA	90020	1406	19	06037	34.064883	-118.287086	Los Angeles County
109356	Fee-for-Service	1801902051	1801902051	1	1	HO, CHARLES Y MD	11/19/1985	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	31364	01	General Practice	0	In state provider	None	5450 JEFFERSON AVE	STE 6	CHINO	CA	91710	3522	36	06071	34.0247326	-117.6862355	San Bernardino County
109374	Fee-for-Service	1255403168	1255403168	1	1	HOOKER, MICHELLE LCSW	8/26/2024	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
109384	Fee-for-Service	1073729539	1073729539	1	1	HAYREH, HARLEEN K MD	2/11/2011	390200000X	NA	Other	026	PHYSICIANS	104937	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
109413	Fee-for-Service	1801097340	1801097340	1	1	HAYMES, CESAR A DPM	10/14/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
109524	Fee-for-Service	1609978600	1609978600	1	1	HSU, LAWRENCE MD	9/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86730	66	Emergency Medicine (Urgent Care)	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
109557	Fee-for-Service	1447038922	1447038922	1	1	HEATH, KIMBERLY J	1/21/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11900 S AVALON BLVD	100 B	LOS ANGELES	CA	90061	2866	19	06037	33.92451047	-118.2652101	Los Angeles County
109559	Fee-for-Service	1912074204	1912074204	1	1	HAMAMOTO, STACI M OD	4/5/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	6767 N FRESNO ST	None	FRESNO	CA	93710	3709	10	06019	36.83686637	-119.7813437	Fresno County
109601	Fee-for-Service	1396276788	1396276788	1	1	HATAMI, NISA MD	5/13/2020	390200000X	NA	Other	026	PHYSICIANS	158064	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
109603	Fee-for-Service	1417181041	1417181041	1	1	HORTON, JENNIFER G LAC	12/29/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
109626	Fee-for-Service	1316348253	1316348253	1	3	HAN ORTHOPAEDICS INC	9/27/2021	261QH0100X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	505 S VIRGIL AVE	205	LOS ANGELES	CA	90020	1406	19	06037	34.064883	-118.287086	Los Angeles County
109658	Fee-for-Service	1689628521	1689628521	1	1	HOOVER,DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1400 E BOULDER	None	COLORADO SPRINGS	CO	80909	0000	00	None	38.8388119	-104.7995065	El Paso County
109660	Fee-for-Service	1699964700	1699964700	1	1	HOLT, ZACHARY B MD	7/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101798	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
109684	Fee-for-Service	1265782510	1265782510	1	1	HERNANDEZ, JURIANA LMFT	8/27/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43112 15TH ST WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
109687	Fee-for-Service	1457351371	1457351371	1	1	HERBERT,ANDREA 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 W ST MARYS RD	None	TUCSON	AZ	85745	0000	00	None	32.228199	-111.0000825	Pima County
109696	Fee-for-Service	1326317470	1326317470	1	1	HAMOUI, NAHID MD INC	5/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	74889	78	Neoplastic Diseases/Oncology	0	In state provider	None	16300 SAND CANYON AVE	STE 604	IRVINE	CA	92618	3711	30	06059	33.66115075	-117.7742405	Orange County
109722	Fee-for-Service	1689052482	1689052482	1	1	HARVEY, JACK ANDREW DPM INC	3/15/2016	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1210 E NORTH STREET	None	MANTECA	CA	95336	4962	39	06077	37.80101012	-121.1978848	San Joaquin County
109738	Fee-for-Service	1235155151	1235155151	1	1	HONG, SUNG J MD	1/1/1979	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	34082	None	None	0	In state provider	None	3000 W OLYMPIC BLVD	STE 304	LOS ANGELES	CA	90006	6513	19	06037	34.05260947	-118.3003335	Los Angeles County
109778	Fee-for-Service	1700820826	1700820826	1	1	HENRY, GERALD P MD	10/30/1990	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	39477	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5953 ATLANTIC BLVD	None	MAYWOOD	CA	90270	3133	19	06037	33.98590138	-118.1858597	Los Angeles County
109817	Fee-for-Service	1144311705	1144311705	1	1	HO, HELEN W MD	11/1/1990	207R00000X	NA	Other	026	PHYSICIANS	70295	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
109839	Fee-for-Service	1932891124	1932891124	1	1	HENRY, KYLE NP	9/7/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	19042 SOLEDAD CANYON RD	A	SANTA CLARITA	CA	91351	3362	19	06037	34.4156522	-118.46848	Los Angeles County
109842	Fee-for-Service	1982161550	1982161550	1	1	HOME CONNECT HOSPICE LLC	2/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	200 BROWN ROAD	STE 106	FREMONT	CA	94539	7956	01	06001	37.49494016	-121.9251914	Alameda County
109843	Fee-for-Service	1124009147	1124009147	1	1	HASKINS, RUTH E MD	6/4/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	64514	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	6660 COYLE AVE	STE 360	CARMICHAEL	CA	95608	6367	34	06067	38.667447	-121.3091505	Sacramento County
109858	Fee-for-Service	1679621643	1679621643	1	1	HO, ANHNGUYET T MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	61604	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
109908	Fee-for-Service	1376686410	1376686410	1	1	HIRST, DAVID B MD	8/13/1996	207L00000X	NA	Other	026	PHYSICIANS	47876	05	Anesthesiology	0	In state provider	None	6969 BROCKTON AVE	STE B	RIVERSIDE	CA	92506	3813	33	06065	33.94701	-117.396786	Riverside County
109935	Fee-for-Service	1093754913	1093754913	1	1	HARIRI, KEYVAN MD	7/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90146	08	Family Practice	0	In state provider	None	1010 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	5929	19	06037	33.886314	-118.395912	Los Angeles County
109939	Fee-for-Service	1609472646	1609472646	1	1	HEALING HEART FAMILY THERAPY	6/7/2021	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC.	13819 AMARGOSA RD	STE 4	VICTORVILLE	CA	92392	6405	36	06071	34.50176153	-117.3300559	San Bernardino County
109944	Fee-for-Service	1184851081	1184851081	1	1	HAAS, BRIAN M MD	6/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130129	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
109947	Fee-for-Service	1669060117	1669060117	1	1	HOWELL, SHIVA Z LMFT	2/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20969 VENTURA BLVD STE 2	None	WOODLAND HILLS	CA	91364	6620	19	06037	34.16664447	-118.5903846	Los Angeles County
109951	Fee-for-Service	1245913441	1245913441	1	1	HUSSAIN, MOHAMMAD I NP	12/27/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1007 E COOLEY DR	STE 111	COLTON	CA	92324	3901	36	06071	34.05461152	-117.310599	San Bernardino County
110000	Fee-for-Service	1548322381	1548322381	1	1	HUMAYUN, MARK S. M.D.	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	52637	18	Ophthalmology	0	In state provider	None	1450 SAN PABLO STREET ST	None	LOS ANGELES	CA	90089	0106	19	06037	34.06189518	-118.203256	Los Angeles County
110007	Fee-for-Service	1497783351	1497783351	1	1	HERBST, KENNETH D MD	1/1/1979	207R00000X	NA	Other	026	PHYSICIANS	20622	68	Hematology	0	In state provider	None	4033 3RD AVE	STE 200	SAN DIEGO	CA	92103	2198	37	06073	32.75053781	-117.1627168	San Diego County
110022	Fee-for-Service	1023036076	1023036076	1	1	HSUEH, WILLA A MD	3/31/1995	207RE0101X	NA	Endocrinology	026	PHYSICIANS	33724	67	Endocrinology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
110039	Fee-for-Service	1700945318	1700945318	1	1	HINO, WENDELL M MD	4/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	69859	36	Psychiatry	0	In state provider	CEDARS-SINAI FLTY GRP	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
110107	Fee-for-Service	1467648493	1467648493	1	1	HORODEZKY, RACHEL J PSYD	6/11/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	303 POTRERO ST	STE 29-307	SANTA CRUZ	CA	95060	2759	44	06087	36.98079126	-122.030791	Santa Cruz County
110111	Fee-for-Service	1396777546	1396777546	1	1	HOWARD, LAWRENCE PHD	10/19/1988	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	12575 PRESTON WAY	None	LOS ANGELES	CA	90066	1823	19	06037	34.00946738	-118.4416808	Los Angeles County
110114	Fee-for-Service	1831417120	1831417120	1	1	HICKEY, NICOLE C MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106712	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
110115	Fee-for-Service	1386062115	1386062115	1	1	HOLLINGSWORTH, JESSICA G MD	8/10/2021	207L00000X	NA	Other	026	PHYSICIANS	141070	None	None	0	In state provider	None	8141 VISTA DR	None	LA MESA	CA	91941	2208	40	06079	32.76042344	-117.0218981	San Diego County
110133	Fee-for-Service	1982161550	1982161550	1	1	HOME CONNECT HOSPICE LLC	2/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	200 BROWN ROAD	STE 106	FREMONT	CA	94539	7956	01	06001	37.49494016	-121.9251914	Alameda County
110177	Fee-for-Service	1861599466	1861599466	1	1	HERZOG, RUDOLF E MD AMC	1/31/1995	207R00000X	NA	Other	026	PHYSICIANS	77598	41	Internal Medicine	0	In state provider	None	106 THORN ST	None	SAN DIEGO	CA	92103	5629	37	06073	32.73975297	-117.1637893	San Diego County
110189	Fee-for-Service	1528444171	1528444171	1	1	HAGSTROM, LINDSEY MD CORP	10/6/2015	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	137350	20	Orthopedic Surgery	0	In state provider	None	8008 FROST ST	STE 403	SAN DIEGO	CA	92123	4209	37	06073	32.80027859	-117.1524832	San Diego County
110198	Fee-for-Service	1598045387	1598045387	1	1	HIRALDO, MARIA S PHD	12/28/2015	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
110254	Fee-for-Service	1134235286	1134235286	1	1	HOROWITZ, SHEILA J LMFT	2/13/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 MORRIS ST.	203	SEBASTOPOL	CA	95472	3843	49	06097	38.40346176	-122.819183	Sonoma County
110259	Fee-for-Service	1811127855	1811127855	1	1	HINDIYEH, RASHA A MD	5/25/2010	207R00000X	NA	Other	026	PHYSICIANS	106490	41	Internal Medicine	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	8589	30	06059	33.62421676	-117.9309656	Orange County
110316	Fee-for-Service	1023036076	1023036076	1	1	HSUEH, WILLA A MD	3/31/1995	207RE0101X	NA	Endocrinology	026	PHYSICIANS	33724	41	Internal Medicine	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
110317	Fee-for-Service	1740441823	1740441823	1	1	HONG, JISON MD	7/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119003	83	Rheumatology	0	In state provider	None	300 PASTEUR DR	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
110322	Fee-for-Service	1588012124	1588012124	1	1	HESHAM EL MOKADEM, MD INC.	9/30/2016	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	R	3975 JACKSON STREET	SUITE 110	RIVERSIDE	CA	92503	3946	33	06065	33.92729721	-117.4413503	Riverside County
110333	Fee-for-Service	1679193619	1679193619	1	1	HELDRETH, TYLER MD	10/19/2023	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
110335	Fee-for-Service	1316901861	1316901861	1	1	HEDGE, THOMAS L MD	2/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	35064	25	Physical Medicine and Rehabilitation	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
110346	Fee-for-Service	1912202938	1912202938	1	1	HERNANDEZ, JOSE L MD	2/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115246	41	Internal Medicine	0	In state provider	None	191 S BUENA VIST ST	150	BURBANK	CA	91505	4522	19	06037	34.15872557	-118.3283863	Los Angeles County
110394	Fee-for-Service	1346440112	1346440112	1	1	HEKMATRAVAN, HAMID MD	8/25/1982	174400000X	NA	Other	026	PHYSICIANS	24438	30	Radiology	0	In state provider	None	8920 WILSHIRE BLVD	STE 301	BEVERLY HILLS	CA	90211	2003	19	06037	34.06703599	-118.3863456	Los Angeles County
110402	Fee-for-Service	1487235792	1487235792	1	1	HEALTHY PALACE HOME HEALTH	11/15/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	1141 N BRAND BLVD	STE 206	GLENDALE	CA	91202	2511	19	06037	34.162983	-118.2550855	Los Angeles County
110413	Fee-for-Service	1831559178	1831559178	1	1	HILLMAN, JENNIFER M LMFT	9/29/2023	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
110420	Fee-for-Service	1174550768	1174550768	1	1	HO, ANNE B OD	9/9/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
110426	Fee-for-Service	1184872327	1184872327	1	1	HAMAME, ANTHONY MD	5/23/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	173125	None	None	0	In state provider	None	2208 W 7TH ST	None	LOS ANGELES	CA	90057	4002	19	06037	34.05710805	-118.2782502	Los Angeles County
110435	Fee-for-Service	1285785097	1285785097	1	1	HAMAM, HISHAM MD	5/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	901 W REX ALLEN DR	None	WILLCOX	AZ	85643	1009	00	None	32.265	-109.8382095	Cochise County
110472	Fee-for-Service	1740450121	1740450121	1	1	HOUSTON NORTHWEST	7/18/2015	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OPERATING COMPANY LLC	710 CYPRESS CREEK PKWY	None	HOUSTON	TX	77090	3402	00	None	30.020697	-95.4426555	Harris County
110491	Fee-for-Service	1467813568	1467813568	1	1	HEARD, JANNELLE C LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
110528	Fee-for-Service	1720018344	1720018344	1	1	HIRSCH, KEVIN S MD	4/30/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	43952	41	Internal Medicine	0	In state provider	None	5030 BONITA RD	None	BONITA	CA	91902	1701	37	06073	32.66930417	-117.022787	San Diego County
110536	Fee-for-Service	1598797847	1598797847	1	1	HEYNEMAN, ELLEN K MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68996	26	Psychiatry (child)	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
110582	Fee-for-Service	1932819943	1932819943	1	1	HAYES, KELLY L LMFT	10/10/2023	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
110651	Fee-for-Service	1316027071	1316027071	1	1	HUANG, TAOSHENG MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76405	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
110707	Fee-for-Service	1124050653	1124050653	1	1	HO, JASON Y MD	2/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97281	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
110715	Fee-for-Service	1730108218	1730108218	1	1	HILLMAN,STEVEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	530 BOGACHIEL WAY	None	FORKS	WA	98331	0000	00	None	47.946141	-124.3931915	Clallam County
110723	Fee-for-Service	1912096553	1912096553	1	1	HENAR, EVELYN T MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44512	40	Pediatrics	0	In state provider	None	1820 W LINCOLN AVE	None	ANAHEIM	CA	92801	6730	30	06059	33.83242148	-117.946809	Orange County
110726	Fee-for-Service	1306007430	1306007430	2	1	HENTZEN, ANDREW S MD FACS	12/11/2019	208600000X	NA	General Surgery	026	PHYSICIANS	-	02	General Surgery	2	Out of state provider	None	3243 E MURDOCK	STE 404	WICHITA	KS	67208	3007	00	None	37.6974125	-97.2972675	Sedgwick County
110747	Fee-for-Service	1720773690	1720773690	1	1	HULSE, STEPHANIE D CD	11/7/2023	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	50	06099	0	0	None
110752	Fee-for-Service	1437159803	1437159803	1	2	HARRIS, RONALD L OD	3/19/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1225 N MCDOWELL BLVD	None	PETALUMA	CA	94954	1112	49	06097	38.2702492	-122.6613983	Sonoma County
110757	Fee-for-Service	1295189470	1295189470	1	1	HARI, ANJALI MD	8/4/2020	390200000X	NA	Other	026	PHYSICIANS	154974	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
110760	Fee-for-Service	1740450121	1740450121	1	1	HOUSTON NORTHWEST	7/18/2015	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OPERATING COMPANY LLC	710 CYPRESS CREEK PKWY	None	HOUSTON	TX	77090	3402	00	None	30.020697	-95.4426555	Harris County
110835	Fee-for-Service	1518200765	1518200765	1	1	HSU, EMILY MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141612	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
110849	Fee-for-Service	1548224694	1548224694	1	1	HANSEN, SCOTT L MD	3/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	67958	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
110852	Fee-for-Service	1558872655	1558872655	1	1	HERNANDEZ, JUAN C LCSW	8/19/2024	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
110935	Fee-for-Service	1740914522	1740914522	1	1	HE, ANGELA S CCC-SLP	10/7/2022	208100000X	NA	Physical Medicine and Rehabilitation	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
110936	Fee-for-Service	1558686501	1558686501	1	1	HASKELL, ROBERT J MD	5/8/2023	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	125983	-	NOT APPLICABLE	0	In state provider	None	3200 MOTOR AVE	None	LOS ANGELES	CA	90034	3710	19	06037	34.03321301	-118.4109122	Los Angeles County
110956	Fee-for-Service	1265821011	1265821011	1	1	HAN, BRIAN S MD	2/8/2023	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	143895	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
111007	Fee-for-Service	1912096553	1912096553	1	1	HENAR, EVELYN T MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44512	01	General Practice	0	In state provider	None	1820 W LINCOLN AVE	None	ANAHEIM	CA	92801	6730	30	06059	33.83242148	-117.946809	Orange County
111013	Fee-for-Service	1801919014	1801919014	1	1	HO, ANDREW T MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73617	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
111014	Fee-for-Service	1952396491	1952396491	1	1	HERMAN, JAMES M MD	4/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	72516	14	Neurological Surgery	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
111041	Fee-for-Service	1699753103	1699753103	1	1	HARPER, KIMBERLY L MD	7/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73309	45	Nephrology (Renal-Kidney)	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
111053	Fee-for-Service	1972545747	1972545747	1	1	HEIDELBAUGH, SHELLY MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66962	01	General Practice	0	In state provider	None	7955 WESTMINSTER BLVD	STE A&B	WESTMINSTER	CA	92683	4001	30	06059	33.75932839	-117.9902744	Orange County
111106	Fee-for-Service	1356574396	1356574396	1	1	HUYNH, TOAI T MD	10/14/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126328	36	Psychiatry	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
111117	Fee-for-Service	1003369463	1003369463	1	1	HUMPHREY, SHARON A PSYD	10/5/2020	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	177 BOVET RD	SUITE 300	SAN MATEO	CA	94402	3140	41	06081	37.5502646	-122.3169875	San Mateo County
111145	Fee-for-Service	1275784225	1275784225	1	1	HARRAL, ANIKA G	8/2/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2016 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
111183	Fee-for-Service	1053592956	1053592956	1	1	HUBIAK, MELISSA M MD	1/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97556	41	Internal Medicine	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
111222	Fee-for-Service	1245435536	1245435536	1	1	HIGASHIGAWA, KEVIN H MD	3/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108801	20	Orthopedic Surgery	0	In state provider	None	260 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
111244	Fee-for-Service	1154043982	1154043982	1	1	HU, JESSICA OD	7/30/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1909 N WATERMAN AVE	3	SAN BERNARDINO	CA	92404	4842	36	06071	34.132626	-117.2787445	San Bernardino County
111255	Fee-for-Service	1033795273	1033795273	1	1	HSIEH, JASON J	6/2/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	401 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6387	43	06085	37.36777579	-122.0276404	Santa Clara County
111258	Fee-for-Service	1427385715	1427385715	1	1	HAMMOND, MYESHIA LMFT	10/27/2023	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
111261	Fee-for-Service	1376102152	1376102152	1	1	HARISH YALAMANCHILI MD INC	2/12/2020	208600000X	NA	General Surgery	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2121 E COAST HWY	150	CORONA DEL MAR	CA	92625	1931	30	06059	33.60580088	-117.876276	Orange County
111298	Fee-for-Service	1487330965	1487330965	1	1	HSIEH, SARAH	12/15/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
111311	Fee-for-Service	1629264247	1629264247	1	1	HARRIS, FLORA LMFT	1/13/2020	225400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5800 HANNUM AVE	105	CULVER CITY	CA	90230	6553	19	06037	33.98724995	-118.3858338	Los Angeles County
111328	Fee-for-Service	1023239860	1023239860	1	1	HUNTSMAN, OLIVIA D LMFT	8/12/2020	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
111340	Fee-for-Service	1972545747	1972545747	1	1	HEIDELBAUGH, SHELLY MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66962	41	Internal Medicine	0	In state provider	None	7955 WESTMINSTER BLVD	STE A&B	WESTMINSTER	CA	92683	4001	30	06059	33.75932839	-117.9902744	Orange County
111421	Fee-for-Service	1164684056	1164684056	1	1	HODGKISS-HARLOW, KELLEY D MD	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93677	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
111437	Fee-for-Service	1164840724	1164840724	1	3	HASNAIN, ABBAS S	1/25/2019	208M00000X	NA	Other	026	PHYSICIANS	144151	41	Internal Medicine	0	In state provider	None	350 N VILLA	None	PORTERVILLE	CA	93257	3211	54	06107	36.07243368	-119.0306223	Tulare County
111448	Fee-for-Service	1427584143	1427584143	1	1	HUANG, SIU-WEI MD	4/5/2021	207R00000X	NA	Other	026	PHYSICIANS	160096	None	None	0	In state provider	None	2100 WEBSTER ST	516	SAN FRANCISCO	CA	94115	2373	38	06075	37.7904826	-122.4324477	San Francisco County
111466	Fee-for-Service	1548237936	1548237936	1	1	HOENECKE, HEINZ R MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62447	20	Orthopedic Surgery	0	In state provider	None	7920 FROST ST	STE 200	SAN DIEGO	CA	92123	4289	37	06073	32.80027449	-117.153846	San Diego County
111474	Fee-for-Service	1528332483	1528332483	1	1	HU, MAOWEN MD	6/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117598	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
111491	Fee-for-Service	1730203118	1730203118	1	1	HOLCOMB, JOHN R OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	25910 IRIS AVE	STE 2A	MORENO VALLEY	CA	92551	1657	33	06065	33.89152577	-117.2098097	Riverside County
111508	Fee-for-Service	1003389149	1003389149	1	1	HVH HOME HEALTH INC	12/18/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	7034 VAN NUYS BLVD	SUITE G	VAN NUYS	CA	91405	3062	19	06037	34.19812463	-118.4487475	Los Angeles County
111510	Fee-for-Service	1841208444	1841208444	1	1	HANSEN, GAIL C MD	9/30/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	25205	30	Radiology	0	In state provider	None	14445 OLIVE VIEW DR	None	SYLMAR	CA	91342	1437	19	06037	34.32450186	-118.4456317	Los Angeles County
111528	Fee-for-Service	1891449062	1891449062	1	1	HARRIS, DEANNA R PT	3/3/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	14682 CENTRAL AVE	None	CHINO	CA	91710	9505	36	06071	33.986601	-117.689039	San Bernardino County
111543	Fee-for-Service	1336175397	1336175397	1	1	HAND, PATRICK P	7/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	84225	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
111570	Fee-for-Service	1871526517	1871526517	1	1	HALADA, ANN M MD	5/13/2009	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
111576	Fee-for-Service	1205369345	1205369345	1	1	HO-A-SHOO, CALEB R	8/1/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	160315	None	None	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
111589	Fee-for-Service	1467490425	1467490425	1	2	HARBOR COMMUNITY CLINIC	1/29/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	425 S PACIFIC AVE	None	SAN PEDRO	CA	90731	2625	19	06037	33.740073	-118.2879355	Los Angeles County
111591	Fee-for-Service	1578076063	1578076063	1	1	HAWAII LIFE FLIGHT, LLC	11/14/2020	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	67-1270 KAMALOO ST	None	KAMUELA	HI	96743	8389	00	None	20.01565137	-155.672805	Hawaii County
111598	Fee-for-Service	1710640610	1710640610	1	1	HARTIN, BRITTANY I CNP	2/21/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	19	06037	33.896799	-118.3959415	Los Angeles County
111627	Fee-for-Service	1730214594	1730214594	1	1	HALAMEK, LOUIS P MD	11/30/1991	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	68606	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
111628	Fee-for-Service	1124466594	1124466594	1	1	HSIEH, ANYIR A MD	8/9/2021	207LC0200X	NA	Other	026	PHYSICIANS	143068	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
111637	Fee-for-Service	1659751295	1659751295	1	1	HUNSAKER, BRANDEN C MD	6/20/2022	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
111639	Fee-for-Service	1851640668	1851640668	1	1	HARVEY, GRACE A LMFT	8/18/2021	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1819 CLIFF DR	F	SANTA BARBARA	CA	93109	1650	42	06083	34.40137954	-119.7214154	Santa Barbara County
111656	Fee-for-Service	1275875973	1275875973	1	1	HAUG, JAMES C MD	2/2/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	16915	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
111668	Fee-for-Service	1700380623	1700380623	1	1	HATHOUT, LEITH MD	12/13/2023	261QX0203X	NA	Other	026	PHYSICIANS	166091	None	None	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
111689	Fee-for-Service	1124091772	1124091772	1	1	HERZ, JEFFREY H MD	12/31/1981	208800000X	NA	Other	026	PHYSICIANS	30050	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
111759	Fee-for-Service	1225244411	1225244411	1	1	HAUGEN, BRIAN O MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111494	18	Ophthalmology	0	In state provider	None	400 SIERRA COLLEGE DR	STE A	GRASS VALLEY	CA	95945	5089	29	06057	39.23646768	-121.0569129	Nevada County
111777	Fee-for-Service	1871097386	1871097386	1	1	HOWE, REBECCA MD	9/20/2021	390200000X	NA	Other	026	PHYSICIANS	163691	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
111781	Fee-for-Service	1235634304	1235634304	1	1	HU, ADRIANA DO	10/25/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19077	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
111797	Fee-for-Service	1487217907	1487217907	1	1	HOSSEPIAN, KRISTENE PSYD	11/30/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
111810	Fee-for-Service	1356384481	1356384481	1	1	HUNT, CHRISTOPHER M MD	9/30/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	53537	41	Internal Medicine	0	In state provider	HOME PHYSICIANS MED GRP	9619 CHESAPEAKE DR	STE 102	SAN DIEGO	CA	92123	1373	37	06073	32.83359409	-117.1237093	San Diego County
111838	Fee-for-Service	1124213475	1124213475	1	1	HIROMURA, CHRISTOPHER M MD	8/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97223	08	Family Practice	0	In state provider	None	1701 CESAR E CHAVEZ AVE	# 402	LOS ANGELES	CA	90033	2496	19	06037	34.05112725	-118.2173921	Los Angeles County
111848	Fee-for-Service	1346226123	1346226123	1	1	HUANG, MICHAEL OD	10/4/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	265 CAROUSEL MALL	None	SAN BERNARDINO	CA	92401	1505	36	06071	34.1058389	-117.2969437	San Bernardino County
111859	Fee-for-Service	1871526517	1871526517	1	1	HALADA, ANN M MD	5/13/2009	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
111878	Fee-for-Service	1467490425	1467490425	1	2	HARBOR COMMUNITY CLINIC	1/29/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	425 S PACIFIC AVE	None	SAN PEDRO	CA	90731	2625	19	06037	33.740073	-118.2879355	Los Angeles County
111911	Fee-for-Service	1467506451	1467506451	1	1	HALO MEDICAL GROUP	7/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	A MEDICAL CORPORATION	74785 US HIGHWAY 111	STE 101	INDIAN WELLS	CA	92210	7129	33	06065	33.72131925	-116.360116	Riverside County
111917	Fee-for-Service	1336133636	1336133636	1	1	HELBERG, ADAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51166	08	Family Practice	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
111936	Fee-for-Service	1750528048	1750528048	1	1	HOOPER, HOSSON LMFT	10/3/2024	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
111967	Fee-for-Service	1588968960	1588968960	1	1	HICHAM AZZOUZI M.D.	8/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	101 SIVLEY RD SW	None	HUNTSVILLE	AL	35801	4421	00	None	34.72122889	-86.58120307	Madison County
111979	Fee-for-Service	1679855464	1679855464	1	1	HASNAIN, MADINA OD	3/9/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5478 N PALM AVE	None	FRESNO	CA	93704	1940	10	06019	36.81697011	-119.8082669	Fresno County
111980	Fee-for-Service	1629100045	1629100045	1	1	HUANG, FU QIAN	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	912 E BELMONT AVE	None	FRESNO	CA	93701	1603	10	06019	36.75040247	-119.7999405	Fresno County
111998	Fee-for-Service	1194941229	1194941229	1	1	HARRELL,ANDREW J IV MD	2/9/2010	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
112054	Fee-for-Service	1801053350	1801053350	1	1	HICKS, DAVID S	12/19/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94595	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
112062	Fee-for-Service	1104963081	1104963081	1	1	HUI, KIM MD	9/4/2015	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	110645	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
112064	Fee-for-Service	1922751692	1922751692	1	1	H M E MEDICAL GROUP	2/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	1590 IMPERIAL AVE	None	EL CENTRO	CA	92243	4241	13	06025	32.77950118	-115.5697279	Imperial County
112073	Fee-for-Service	1164660072	1164660072	1	1	HOLMSTROM, STEVEN D OD INC	3/3/2009	193400000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CANYON LAKE OPTOMETRY	31722 RAILROAD CANYON RD	None	CANYON LAKE	CA	92587	9486	33	06065	33.67325255	-117.253143	Riverside County
112129	Fee-for-Service	1598930075	1598930075	1	1	HAYWARD, JESSICA H MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123620	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
112149	Fee-for-Service	1831519719	1831519719	1	1	HASSANIAN, MOHAMMAD R MD	9/17/2018	207L00000X	NA	Other	026	PHYSICIANS	145247	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
112150	Fee-for-Service	1164666533	1164666533	1	1	HUSAIN, LUBNA F MD	7/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123007	None	None	0	In state provider	None	20103 LAKE CHABOT ROAD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
112157	Fee-for-Service	1902859721	1902859721	1	1	HARRIS, KURT G MD	6/16/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176007	None	None	0	In state provider	None	1127 WILSHIRE BLVD	SUITE 100	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
112163	Fee-for-Service	1700018694	1700018694	1	1	HEMMATI, MAHNAZ	11/10/2009	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	MEDICAL TRANSPORT SVC	42072 FIFTH ST	STE 201B	TEMECULA	CA	92590	2728	33	06065	33.49444084	-117.1508389	Riverside County
112164	Fee-for-Service	1710291570	1710291570	1	1	HAGHDOOST, MOHAMMAD MD	5/31/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111081	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
112186	Fee-for-Service	1902973720	1902973720	1	1	HARRISON RAGHAVAN, PAT	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70674	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
112204	Fee-for-Service	1336133636	1336133636	1	1	HELBERG, ADAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51166	05	Anesthesiology	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
112215	Fee-for-Service	1437816493	1437816493	1	1	HEVENER, AMENDDA LCSW	2/25/2022	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
112238	Fee-for-Service	1578037115	1578037115	1	2	HOUSE MEDICINE	10/12/2021	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	02	General Surgery	0	In state provider	None	25550 HAWTHORNE BLVD	STE 209	TORRANCE	CA	90505	6832	19	06037	33.79398714	-118.3491878	Los Angeles County
112246	Fee-for-Service	1508087255	1508087255	1	1	HENRY T YEATES, D.O.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2675 W TAYLORSVILLE BLVD	None	TAYLORSVILLE	UT	84129	2208	00	None	40.65438556	-111.9571398	Salt Lake County
112287	Fee-for-Service	1538663513	1538663513	1	1	HORTON, JOHN M MD	7/28/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	166834	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
112311	Fee-for-Service	1679584676	1679584676	1	1	HAYDON, MICHAEL L MD	3/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78308	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DRIVE S	None	ORANGE	CA	92868	0000	30	06059	33.78674051	-117.8888713	Orange County
112324	Fee-for-Service	1982700365	1982700365	1	2	HARRIS, SUSAN MD	6/18/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50886	None	None	0	In state provider	None	5838 EDISON PL	None	CARLSBAD	CA	92008	5520	37	06073	33.12181055	-117.2840499	San Diego County
112327	Fee-for-Service	1992554372	1992554372	1	1	HINDMAN, SHERRY M NP	7/1/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
112333	Fee-for-Service	1235573650	1235573650	1	1	HENCH, ALISON N DO	1/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13571	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
112347	Fee-for-Service	1174875850	1174875850	1	1	HANKEE, LISA D PSYD	3/5/2015	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
112385	Fee-for-Service	1992718662	1992718662	1	1	HUTTENHOFF, ANDREW A OD	2/26/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3653 AVOCADO BLVD	None	LA MESA	CA	91941	7337	37	06073	32.74642082	-116.9629891	San Diego County
112391	Fee-for-Service	1578552519	1578552519	1	1	HERBERT J TOMASO, MD	12/21/2010	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	0000	00	None	33.47892	-112.2579	Maricopa County
112410	Fee-for-Service	1033146469	1033146469	1	1	HESS, DAVID M MD	12/3/2010	207RC0200X	NA	Other	026	PHYSICIANS	24770	41	Internal Medicine	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
112427	Fee-for-Service	1013071570	1013071570	1	1	HOGUE, LIZBETH LMFT	10/25/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15447 ANACAPA RD	SUITE 200	VICTORVILLE	CA	92392	2462	36	06071	34.50573979	-117.3249541	San Bernardino County
112452	Fee-for-Service	1710291570	1710291570	1	1	HAGHDOOST, MOHAMMAD MD	5/31/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111081	01	General Practice	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
112466	Fee-for-Service	1144957945	1144957945	1	1	HARVARD PRO HOME HEALTH, INC	11/26/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	121 W LEXINGTON DR	SUITE 503A	GLENDALE	CA	91203	2230	19	06037	34.1517575	-118.2560706	Los Angeles County
112526	Fee-for-Service	1578037115	1578037115	1	2	HOUSE MEDICINE	10/12/2021	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	25550 HAWTHORNE BLVD	STE 209	TORRANCE	CA	90505	6832	19	06037	33.79398714	-118.3491878	Los Angeles County
112544	Fee-for-Service	1750619250	1750619250	1	2	HERNANDEZ, BARBARA ANN	4/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	STE 201	NORWALK	CA	90650	9323	19	06037	33.90523023	-118.0681168	Los Angeles County
112550	Fee-for-Service	1710032313	1710032313	1	1	HALIO, MICHON M MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50740	30	Radiology	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3101	30	06059	33.80318353	-118.0666665	Orange County
112568	Fee-for-Service	1346706256	1346706256	1	1	HICKEY, TIMOTHY CNP	12/6/2019	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
112580	Fee-for-Service	1841242161	1841242161	1	1	HOME HEALTH SERVICES OF	7/15/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	611 S CATALINA ST	STE 318	LOS ANGELES	CA	90005	1703	19	06037	34.06315788	-118.295401	Los Angeles County
112638	Fee-for-Service	1245568385	1245568385	1	1	HADDAD, ELIAS E MD	1/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99495	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
112653	Fee-for-Service	1801955513	1801955513	1	1	HERNANDEZ, DIANE M CNM	11/1/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1255 W ARROW HWY	None	SAN DIMAS	CA	91773	2340	19	06037	34.10676133	-117.8312617	Los Angeles County
112670	Fee-for-Service	1457584062	1457584062	1	1	HENDERSON, LARANN R LCSW	7/1/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1940 CLOVER DRIVE	None	WILLITS	CA	95490	8867	23	06045	39.43483349	-123.3943448	Mendocino County
112671	Fee-for-Service	1245309806	1245309806	2	1	HARRISON, STEVEN W MD	6/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	45884	08	Family Practice	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
112676	Fee-for-Service	1396193561	1396193561	1	1	HAGHIGHAT, LEILA MD	6/12/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	169096	41	Internal Medicine	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
112679	Fee-for-Service	1588621676	1588621676	1	1	HASSON, GRANT E MD	3/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79200	05	Anesthesiology	0	In state provider	None	200 MISSION BLVD	None	JACKSON	CA	95642	2564	03	06005	38.35007723	-120.7659932	Amador County
112683	Fee-for-Service	1659607737	1659607737	1	1	HIX, CARLA S PHD	12/12/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
112691	Fee-for-Service	1043238769	1043238769	1	1	HYUN, MOSES MD INC	7/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	40302	41	Internal Medicine	0	In state provider	None	966 S WESTERN AVE	STE 204	LOS ANGELES	CA	90006	1015	19	06037	34.053777	-118.3090505	Los Angeles County
112705	Fee-for-Service	1275729345	1275729345	1	1	HELLER, DAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	250 E DUNLAP AVE	None	PHOENIX	AZ	85020	2825	00	None	33.568947	-112.0712985	Maricopa County
112717	Fee-for-Service	1053312108	1053312108	1	1	HEIDEN, DAVID MD	1/1/1982	207W00000X	NA	Ophthalmology	026	PHYSICIANS	25331	41	Internal Medicine	0	In state provider	None	PO BOX 7999	None	SAN FRANCISCO	CA	94120	7999	38	06075	0	0	None
112731	Fee-for-Service	1891738639	1891738639	1	1	HAMIDI, MARYAM PT	10/25/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	777 CORPORATE DR	STE 160	LADERA RANCH	CA	92694	2136	30	06059	33.557436	-117.6293075	Orange County
112757	Fee-for-Service	1992755888	1992755888	1	1	HUH, JOHN MD	8/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	84990	36	Psychiatry	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
112771	Fee-for-Service	1699825083	1699825083	1	1	HSU, ADAM YH MD	3/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108052	18	Ophthalmology	0	In state provider	None	18575 GALE AVE	SUITE 168	CITY OF INDUSTRY	CA	91748	1384	19	06037	33.99497471	-117.8986874	Los Angeles County
112788	Fee-for-Service	1740627843	1740627843	1	2	HOUSE OF HOPE FOUNDATION INC	2/1/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	221 223 225 227 229 235	None	SAN PEDRO	CA	90731	3711	19	06037	0	0	None
112804	Fee-for-Service	1801424981	1801424981	1	1	HAYNES, BRADLEY DO	3/12/2025	207L00000X	NA	Other	026	PHYSICIANS	22893	05	Anesthesiology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
112808	Fee-for-Service	1578637203	1578637203	1	1	HARDIN, LISA L	9/26/2016	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
112813	Fee-for-Service	1578037115	1578037115	1	2	HOUSE MEDICINE	10/12/2021	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	25550 HAWTHORNE BLVD	STE 209	TORRANCE	CA	90505	6832	19	06037	33.79398714	-118.3491878	Los Angeles County
112863	Fee-for-Service	1649583360	1649583360	1	1	HTUN, HNIN N MD	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125573	None	None	0	In state provider	None	6235 N FRESNO ST	103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
112873	Fee-for-Service	1841242161	1841242161	1	1	HOME HEALTH SERVICES OF	1/2/2020	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	INC	611 S CATALINA ST	STE 318	LOS ANGELES	CA	90005	1703	19	06037	34.06315788	-118.295401	Los Angeles County
112876	Fee-for-Service	1568055119	1568055119	1	1	HEALTH FOR ALL IN HOME CARE	5/19/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	2321 W OLIVE AVE	STE B	BURBANK	CA	91506	2603	19	06037	34.16225637	-118.3284986	Los Angeles County
112879	Fee-for-Service	1447296694	1447296694	1	1	HENDERSON, BRYN J DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	4401	08	Family Practice	0	In state provider	PACIFIC DIAGNOSTICS AMC	11180 WARNER AVE	STE 361	FOUNTAIN VALLEY	CA	92708	7516	30	06059	33.71632048	-117.9334575	Orange County
112891	Fee-for-Service	1275684847	1275684847	1	1	HO, HOANG M OD	12/13/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	222 E COLE BLVD	None	CALEXICO	CA	92231	3211	13	06025	32.69391949	-115.495038	Imperial County
112899	Fee-for-Service	1194858936	1194858936	1	1	HSU, SAUNDERS C MD	3/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97224	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5417	01	06001	37.82263926	-122.2597946	Alameda County
112900	Fee-for-Service	1740728831	1740728831	1	2	HULST, GINGER CNP	10/30/2024	207QA0401X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1711 VIA EL PRADO	301	REDONDO BEACH	CA	90277	5723	19	06037	33.81782505	-118.3869848	Los Angeles County
112936	Fee-for-Service	1083835623	1083835623	1	1	HULSE, STEPHEN B MD	6/30/2008	2085R0204X	NA	Other	026	PHYSICIANS	87249	30	Radiology	0	In state provider	None	9888 GENESEE AVENUE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
112937	Fee-for-Service	1710157888	1710157888	1	1	HARMAN, LAURA D CRNA	5/3/2011	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
112962	Fee-for-Service	1396193561	1396193561	1	1	HAGHIGHAT, LEILA MD	6/12/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	169096	70	Clinic (mixed specialty)	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
112970	Fee-for-Service	1003901554	1003901554	2	1	HWANG, BRYAN J MD	9/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80251	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
112983	Fee-for-Service	1568943546	1568943546	1	1	HUNTER, LAUREN LMFT	8/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
112989	Fee-for-Service	1760471759	1760471759	1	1	HILL MEDICAL CORPORATION	8/1/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	130 W ROUTE 66	STE 110	GLENDORA	CA	91740	6207	19	06037	34.12865951	-117.8651745	Los Angeles County
113045	Fee-for-Service	1891337234	1891337234	1	1	HIGHLAND HEALTHCARE CAMELLIA	9/18/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GARDENS LLC	1920 N FAIR OAKS AVE	None	PASADENA	CA	91103	1623	19	06037	34.17901815	-118.1507407	Los Angeles County
113071	Fee-for-Service	1245596329	1245596329	1	1	HSIN, HONOR MD	2/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126619	36	Psychiatry	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
113081	Fee-for-Service	1386711216	1386711216	1	1	HENAR, ERIC LUCIEN MD	10/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	48091	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
113086	Fee-for-Service	1497979629	1497979629	1	1	HSU, KENNETH K MD INC	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50577	41	Internal Medicine	0	In state provider	None	511 W COLUMBUS ST	None	BAKERSFIELD	CA	93301	1201	15	06029	35.39718795	-119.0060452	Kern County
113103	Fee-for-Service	1316284953	1316284953	1	1	HOLLOWAY, BYRON B DO	9/27/2021	208600000X	NA	General Surgery	026	PHYSICIANS	18619	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
113115	Fee-for-Service	1790895746	1790895746	1	1	HAQ, MUHAMMAD S MD	10/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	78386	67	Endocrinology	0	In state provider	None	3883 AIRWAY DR	STE 202	SANTA ROSA	CA	95403	1671	49	06097	38.483226	-122.739705	Sonoma County
113146	Fee-for-Service	1093893844	1093893844	1	1	HONG, DONNA MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64479	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
113171	Fee-for-Service	1285385849	1285385849	1	1	HOFFMAN, KERRY	3/13/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1317 DEL NORTE ROAD	200	CAMARILLO	CA	93010	8368	56	06111	34.22312217	-119.1046861	Ventura County
113178	Fee-for-Service	1982864617	1982864617	1	1	HINMAN, JASON D MD	5/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106491	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
113187	Fee-for-Service	1376987453	1376987453	1	1	HSU, EMORY MD	11/1/2019	207R00000X	NA	Other	026	PHYSICIANS	162690	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
113216	Fee-for-Service	1164599072	1164599072	1	1	HWANG, ALLEN L MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	60713	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
113223	Fee-for-Service	1083835623	1083835623	1	1	HULSE, STEPHEN B MD	6/30/2008	2085R0204X	NA	Other	026	PHYSICIANS	87249	02	General Surgery	0	In state provider	None	9888 GENESEE AVENUE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
113231	Fee-for-Service	1063737914	1063737914	1	1	HARTER, JACOB L MD	6/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	117802	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
113232	Fee-for-Service	1417083031	1417083031	1	1	HAMEED, FASIH A MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	96814	08	Family Practice	0	In state provider	None	1301 SOUTHPOINT BLVD	None	PETALUMA	CA	94954	6858	49	06097	38.26109022	-122.6476782	Sonoma County
113251	Fee-for-Service	1396193561	1396193561	1	1	HAGHIGHAT, LEILA MD	6/12/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	169096	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
113257	Fee-for-Service	1124422787	1124422787	1	1	HOFFMAN HEALTH AND HOLISTICS	2/20/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	102147	None	None	0	In state provider	INC	175 CONCOURSE BLVD	None	SANTA ROSA	CA	95403	8217	49	06097	38.51157204	-122.7885509	Sonoma County
113265	Fee-for-Service	1639592496	1639592496	1	1	HAN, ANNEY M OD	5/13/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
113280	Fee-for-Service	1538332853	1538332853	1	1	HAQ, TAHMINA S MD DO	10/9/2018	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	116126	41	Internal Medicine	0	In state provider	None	16671 YORBA LINDA BLVD	SUITE 200	YORBA LINDA	CA	92886	2025	30	06059	33.8884134	-117.8435449	Orange County
113292	Fee-for-Service	1184828824	1184828824	1	1	HERNANDEZ, GEORGINE F	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
113295	Fee-for-Service	1265498539	1265498539	1	1	HOPKINS, STEPHEN J MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	50509	02	General Surgery	0	In state provider	None	680 GUZZI LN	STE 103	SONORA	CA	95370	5288	55	06109	37.97611058	-120.3719921	Tuolumne County
113323	Fee-for-Service	1356366652	1356366652	1	1	HOLT, LORI E PHD	12/11/2002	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
113346	Fee-for-Service	1578142535	1578142535	1	1	HANKINS, EDZELLE R MD	7/30/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	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
113351	Fee-for-Service	1043201155	1043201155	1	1	HUANG, THOMAS C MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	61652	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	801 N TUSTIN AVE	STE 500	SANTA ANA	CA	92705	3609	30	06059	33.752286	-117.8341735	Orange County
113353	Fee-for-Service	1841472511	1841472511	1	1	HO, GLENN M MD	4/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	38922	01	General Practice	0	In state provider	None	1505 S BALDWIN AVE	None	ARCADIA	CA	91007	7925	19	06037	34.1219725	-118.055215	Los Angeles County
113361	Fee-for-Service	1093040123	1093040123	1	1	HOPE, THOMAS A MD	5/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107695	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
113365	Fee-for-Service	1891956710	1891956710	1	1	HANUDEL, MARK R MD	4/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110834	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	MDCC 12-311	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
113373	Fee-for-Service	1497979629	1497979629	1	1	HSU, KENNETH K MD INC	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50577	83	Rheumatology	0	In state provider	None	511 W COLUMBUS ST	None	BAKERSFIELD	CA	93301	1201	15	06029	35.39718795	-119.0060452	Kern County
113386	Fee-for-Service	1598771511	1598771511	1	1	HUM, GARY T MD	12/2/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71745	None	None	0	In state provider	None	332 S JUNIPER ST	STE 108	ESCONDIDO	CA	92025	4941	37	06073	33.12066536	-117.0770413	San Diego County
113396	Fee-for-Service	1396063707	1396063707	1	1	HU, HUAYONG MD	7/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129035	05	Anesthesiology	0	In state provider	None	11234 ANDERSON STREET	None	LOMA LINDA	CA	92354	3450	36	06071	34.049547	-117.264078	San Bernardino County
113424	Fee-for-Service	1780617571	1780617571	1	1	HAEUSSLEIN, ERNEST MS	2/1/1998	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54926	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2340 CLAY ST	FL 2	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
113445	Fee-for-Service	1932309614	1932309614	1	1	HOANG, KHIET C MD	12/27/2007	207R00000X	NA	Other	026	PHYSICIANS	94113	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
113519	Fee-for-Service	1871589911	1871589911	1	1	HOFFMANN HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4325 BUENA VISTA RD	None	BAKERSFIELD	CA	93311	8701	15	06029	35.31546	-119.128116	Kern County
113564	Fee-for-Service	1649252636	1649252636	1	1	HAFFIE, DAVID A MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7420	08	Family Practice	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
113567	Fee-for-Service	1538332853	1538332853	1	1	HAQ, TAHMINA S MD DO	10/9/2018	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	116126	10	Gastroenterology (M.D. only)	0	In state provider	None	16671 YORBA LINDA BLVD	SUITE 200	YORBA LINDA	CA	92886	2025	30	06059	33.8884134	-117.8435449	Orange County
113614	Fee-for-Service	1477676955	1477676955	1	1	HARDY, HUNTER T MD	5/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52746	22	Pathology (M.D. only)	0	In state provider	None	1401 N PALM CANYON DR	STE 203	PALM SPRINGS	CA	92262	4434	33	06065	33.841269	-116.546807	Riverside County
113680	Fee-for-Service	1710177928	1710177928	1	1	HUANG, CHAO H DO	10/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9335	41	Internal Medicine	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
113686	Fee-for-Service	1003821729	1003821729	1	1	HUNTINGTON MEMORIAL HOSPITAL	7/16/2022	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2001 STULTS RD	None	HUNTINGTON	IN	46750	1291	00	None	40.9057512	-85.49052046	Huntington County
113704	Fee-for-Service	1689029928	1689029928	1	1	HARKINS, ANDREW R MD	6/4/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	150919	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
113716	Fee-for-Service	1407295033	1407295033	1	1	HUYNH, LINDA DO	10/20/2020	207R00000X	NA	Other	026	PHYSICIANS	17137	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
113731	Fee-for-Service	1215585492	1215585492	1	1	HAPPY2HELP TRANSPORTATION LL	8/16/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	C	2667 CAMINO DEL RIO SOUT	110-3	SAN DIEGO	CA	92108	0002	37	06073	32.76979794	-117.1355701	San Diego County
113768	Fee-for-Service	1174715825	1174715825	1	1	HEUSTIS, KAREN S CNP	10/13/2023	207Q00000X	NA	Adult Primary Care	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
113792	Fee-for-Service	1841812104	1841812104	1	1	HE, JIXI MD	12/11/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	186369	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
113808	Fee-for-Service	1871589911	1871589911	1	1	HOFFMANN HOSPICE	7/6/1995	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4325 BUENA VISTA RD	None	BAKERSFIELD	CA	93311	8701	15	06029	35.31546	-119.128116	Kern County
113839	Fee-for-Service	1780848085	1780848085	1	1	HASEK, GENEVIEVE L MD	5/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110835	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
113863	Fee-for-Service	1396823001	1396823001	1	1	HERBERT, DAVID A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34962	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
113883	Fee-for-Service	1720155153	1720155153	1	1	HUGHES, WILLIAM R LCSW	12/18/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3454 HILLCREST AVENUE	None	ANTIOCH	CA	94531	8238	07	06013	37.98739901	-121.7808007	Contra Costa County
113905	Fee-for-Service	1063476448	1063476448	1	1	HANSCOM, THOMAS A MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	34319	None	None	0	In state provider	None	2021 SANTA MONICA BLVD	STE 720E	SANTA MONICA	CA	90404	2223	19	06037	34.02922048	-118.4793681	Los Angeles County
113956	Fee-for-Service	1245696194	1245696194	1	1	HOUSE, DHAHN L	10/17/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	245 TERRACINA BLVD	STE 102	REDLANDS	CA	92373	4865	36	06071	34.03858912	-117.2066515	San Bernardino County
113975	Fee-for-Service	1003821729	1003821729	1	1	HUNTINGTON MEMORIAL HOSPITAL	7/16/2022	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2001 STULTS RD	None	HUNTINGTON	IN	46750	1291	00	None	40.9057512	-85.49052046	Huntington County
113978	Fee-for-Service	1588850713	1588850713	1	1	HAU, VINCENT S MD	1/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116082	18	Ophthalmology	0	In state provider	None	800 FAIRMOUNT AVE	STE 312	PASADENA	CA	91105	3154	19	06037	34.13193177	-118.1517805	Los Angeles County
113991	Fee-for-Service	1447330501	1447330501	1	1	HUNT, LYNN MD	9/18/1996	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	52602	40	Pediatrics	0	In state provider	UCIMC DEPT OF PEDIACTRIC	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
113995	Fee-for-Service	1245334309	1245334309	1	1	HESLOV, STEVEN F MD	4/17/1995	208600000X	NA	General Surgery	026	PHYSICIANS	48959	02	General Surgery	0	In state provider	None	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
114027	Fee-for-Service	1316471485	1316471485	1	1	HOSSEIN ZADEH MALEKI, ANA M	7/9/2021	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	171291	None	None	0	In state provider	D	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
114054	Fee-for-Service	1821203894	1821203894	1	1	HICKEY, PATRICK T DO	11/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15308	13	Neurology (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
114067	Fee-for-Service	1538761689	1538761689	1	1	HEALING ANGELS HOME HEALTH	3/23/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	30700 RUSSELL RANCH RD	SUITE 254	WESTLAKE VILLAGE	CA	91362	9507	19	06037	34.14987261	-118.7943115	Los Angeles County
114069	Fee-for-Service	1962173815	1962173815	1	1	HAPPY MARRIAGE & FAMILY THER	4/26/2023	261QM0801X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	APIST INCORPORATED	1225 W 190TH ST	455H	GARDENA	CA	90248	4320	19	06037	33.85835623	-118.2987754	Los Angeles County
114077	Fee-for-Service	1548846082	1548846082	1	1	HAMADE, SOUAD DO	9/1/2024	207R00000X	NA	Other	026	PHYSICIANS	20769	41	Internal Medicine	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
114080	Fee-for-Service	1205326923	1205326923	1	1	HASSAN, DUA MD	10/20/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	184375	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
114100	Fee-for-Service	1942509310	1942509310	1	1	HUANG, HAO H MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130132	01	General Practice	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
114122	Fee-for-Service	1851075865	1851075865	1	1	HERRERA, MARIA D NP	8/20/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
114141	Fee-for-Service	1821543950	1821543950	1	1	HUANG, CATHERINE OD	9/19/2016	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
114155	Fee-for-Service	1396823001	1396823001	1	1	HERBERT, DAVID A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34962	41	Internal Medicine	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
114167	Fee-for-Service	1689724445	1689724445	1	1	HANNSJOERG HASCHE-KLUENDER M	8/25/2013	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	4379	00	None	47.608326	-122.3207985	King County
114171	Fee-for-Service	1821275637	1821275637	2	1	HOLY FAMILY CHILDRENS CARE	6/25/2013	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	INC	340 CALLE CABALLEROS	None	WALNUT	CA	91789	1618	19	06037	34.01609501	-117.8749569	Los Angeles County
114184	Fee-for-Service	1861684664	1861684664	1	2	HUGHES, STEVEN A LMFT	6/30/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1345 BRENTWOOD CIR	UNIT B	CORONA	CA	92882	7058	33	06065	33.8634316	-117.5983665	Riverside County
114185	Fee-for-Service	1144830464	1144830464	1	1	HSIEH, TUNGCHEN LAC	4/29/2021	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	78 S ROSEMEAD BLVD	None	PASADENA	CA	91107	3959	19	06037	34.14485189	-118.0732813	Los Angeles County
114224	Fee-for-Service	1437189966	1437189966	1	1	HO, GUSTIN MD	2/13/1995	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	49169	66	Emergency Medicine (Urgent Care)	0	In state provider	None	929 CLAY ST	STE 401	SAN FRANCISCO	CA	94108	1556	38	06075	37.79398652	-122.4083496	San Francisco County
114226	Fee-for-Service	1003013582	1003013582	1	1	HAGGERTY, TREAH 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 MEDICAL CENTER DR	None	MORGANTOWN	WV	26507	0897	00	None	39.65333742	-79.95924145	Monongalia County
114231	Fee-for-Service	1417904400	1417904400	1	1	HARPER, RYUN W MD	3/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83398	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
114253	Fee-for-Service	1730190430	1730190430	1	1	HIPSKIND, JOHN E MD	7/31/1989	207P00000X	NA	Other	026	PHYSICIANS	67034	66	Emergency Medicine (Urgent Care)	0	In state provider	None	199 W SHIELDS AVE	None	FRESNO	CA	93705	4102	10	06019	36.77936354	-119.8139535	Fresno County
114268	Fee-for-Service	1861239477	1861239477	1	1	HAO, JIMMY NP	10/4/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	760 OTAY LAKES RD	None	CHULA VISTA	CA	91910	6915	37	06073	32.64603447	-117.0015068	San Diego County
114280	Fee-for-Service	1750330478	1750330478	1	1	HAAS, MARK MD	7/14/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	88500	22	Pathology (M.D. only)	0	In state provider	None	200 N ROBERTSON	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
114284	Fee-for-Service	1982764379	1982764379	1	1	HAAS, LISA J	6/2/2004	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
114286	Fee-for-Service	1487739322	1487739322	1	1	HUNTINGTON RADIATION	1/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	ONCOLOGY MED GROUP	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
114293	Fee-for-Service	1003261652	1003261652	1	1	HU, CASPER MD	2/11/2021	207L00000X	NA	Other	026	PHYSICIANS	144058	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
114301	Fee-for-Service	1992900427	1992900427	1	1	HSIEH, MENG-HSUEH LAC	9/24/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	3318 DEL MAR AVE	SUITE 205	ROSEMEAD	CA	91770	2373	19	06037	34.06859814	-118.0994741	Los Angeles County
114303	Fee-for-Service	1255794731	1255794731	1	1	HOWARD, MARK C MD	7/18/2022	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	150343	None	None	0	In state provider	None	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	5730	27	06053	36.57482436	-121.8101797	Monterey County
114333	Fee-for-Service	1457702045	1457702045	1	1	HEWITT, LORETTA J	8/1/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
114353	Fee-for-Service	1487673026	1487673026	1	1	HU, SUET-PING R	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
114360	Fee-for-Service	1962173815	1962173815	1	1	HAPPY MARRIAGE & FAMILY THER	4/26/2023	261QM0801X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	APIST INCORPORATED	1225 W 190TH ST	455H	GARDENA	CA	90248	4320	19	06037	33.85835623	-118.2987754	Los Angeles County
114376	Fee-for-Service	1083287015	1083287015	1	1	HADJIYIANNI, LOUKIA OD	10/25/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1104 PEAR TREE LN	None	NAPA	CA	94558	6446	28	06055	38.32088172	-122.2945763	Napa County
114380	Fee-for-Service	1902955263	1902955263	1	1	HO, MATTHEW R MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	63405	66	Emergency Medicine (Urgent Care)	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
114382	Fee-for-Service	1316408719	1316408719	1	1	HENNEBERG, CAMERON J MD	4/8/2022	207R00000X	NA	Other	026	PHYSICIANS	177235	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
114385	Fee-for-Service	1851141139	1851141139	1	1	HIGH DESERT INTERNAL MEDICIN	11/5/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	E	12765 MAIN ST	STE 630	HESPERIA	CA	92345	9134	36	06071	34.42655837	-117.3840207	San Bernardino County
114390	Fee-for-Service	1689924581	1689924581	1	1	HERNDON, JAMES D PA	10/13/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	16694	-	NOT APPLICABLE	0	In state provider	None	559 S PALM CANYON DR	STE B101	PALM SPRINGS	CA	92264	8743	33	06065	33.81480199	-116.5463873	Riverside County
114400	Fee-for-Service	1689094989	1689094989	1	1	HONDA, MALIA A K MD	3/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139453	41	Internal Medicine	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
114411	Fee-for-Service	1689629974	1689629974	1	1	HARDWICK, JOSEPH A MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	34437	41	Internal Medicine	0	In state provider	None	2021 SANTA MONICA BLVD	STE 212E	SANTA MONICA	CA	90404	2208	19	06037	34.02922048	-118.4793681	Los Angeles County
114414	Fee-for-Service	1013676048	1013676048	1	1	HANSON, LISA M CNP	2/16/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16465 SIERRA LAKES PKWY	SUITE 275	FONTANA	CA	92336	1242	36	06071	34.13805177	-117.4457839	San Bernardino County
114445	Fee-for-Service	1063643419	1063643419	1	1	HOANG, HWA SOO MD	7/26/2022	2084P0804X	NA	Psychiatry	026	PHYSICIANS	170555	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
114466	Fee-for-Service	1477121093	1477121093	1	1	HEALTHY MIND THERAPY, LICENS	9/5/2023	101YM0800X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	ED CLINICAL SOCIAL WORKE	7530 WOODMAN PL	None	VAN NUYS	CA	91405	1544	19	06037	34.20710514	-118.4301398	Los Angeles County
114497	Fee-for-Service	1154313732	1154313732	1	1	HALLMAN, CHRISTIAAN P MD	6/5/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	54658	None	None	0	In state provider	None	191 S BUENA VISTA STREET	SUITE 200-240	BURBANK	CA	91505	4542	19	06037	34.15872557	-118.3283863	Los Angeles County
114523	Fee-for-Service	1558701144	1558701144	1	1	HARRIS, BRIANNA N MD	3/19/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	133452	04	Otology, Laryngology, Rhinology	0	In state provider	None	6645 ALVARADO RD	STE 4000	SAN DIEGO	CA	92120	5208	37	06073	32.7772577	-117.0575222	San Diego County
114524	Fee-for-Service	1588740013	1588740013	1	1	HU, CHARLOTTE MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40823	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
114533	Fee-for-Service	1811951965	1811951965	1	1	HONG, KISUNG S MD	3/24/2008	207R00000X	NA	Other	026	PHYSICIANS	83707	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
114539	Fee-for-Service	1730190430	1730190430	1	1	HIPSKIND, JOHN E MD	7/31/1989	207P00000X	NA	Other	026	PHYSICIANS	67034	01	General Practice	0	In state provider	None	199 W SHIELDS AVE	None	FRESNO	CA	93705	4102	10	06019	36.77936354	-119.8139535	Fresno County
114554	Fee-for-Service	1740355098	1740355098	1	1	HUANG, JING W CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	JW HUANG ACTRU AND HB MD	15 WENTWORTH PL	None	SAN FRANCISCO	CA	94108	1306	38	06075	37.79540854	-122.4061321	San Francisco County
114568	Fee-for-Service	1770517245	1770517245	1	1	HERRINGTON, CYNTHIA S MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84606	33	Thoracic Surgery	0	In state provider	None	4650 W SUNSET BLVD	MS 66	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
114573	Fee-for-Service	1790177301	1790177301	1	1	HAWKINS, LURA LMFT	8/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
114574	Fee-for-Service	1487739322	1487739322	1	1	HUNTINGTON RADIATION	1/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	42	Nuclear Medicine	0	In state provider	ONCOLOGY MED GROUP	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
114603	Fee-for-Service	1265585053	1265585053	1	1	HOHLWEG, LINDA S PHD	2/5/2014	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
114619	Fee-for-Service	1306905914	1306905914	1	1	HINSON, MELANIE V MD	3/31/1985	207R00000X	NA	Other	026	PHYSICIANS	54558	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
114658	Fee-for-Service	1588804215	1588804215	1	1	HARRIS, HOLLY G	4/25/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6670 ALTON PARKWAY	None	IRVINE	CA	92618	3734	30	06059	33.65837833	-117.7727118	Orange County
114678	Fee-for-Service	1952458143	1952458143	1	1	HYLTON-LAWRENCE LUMBSDEN	8/22/2005	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	DONETTE C.	9955 AMHERST AVE	None	MONTCLAIR	CA	91763	3002	36	06071	34.07299788	-117.7100267	San Bernardino County
114685	Fee-for-Service	1407957780	1407957780	1	1	HANGER P & O WEST INC	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1177 IDAHO ST	#101	REDLANDS	CA	92374	4586	36	06071	34.06900684	-117.2157971	San Bernardino County
114690	Fee-for-Service	1891811907	1891811907	1	1	HAZEL HAWKINS HEALTH CLN	6/17/2003	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	301 THE ALAMEDA	STE B3	SAN JUAN BAUTISTA	CA	95045	9746	35	06069	36.8416281	-121.5341688	San Benito County
114694	Fee-for-Service	1578191854	1578191854	1	1	HUBEISHY, MOUDI MD	7/25/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	757 WESTWOOD PLAZA	STE 1517	LOS ANGELES	CA	90095	7402	19	06037	34.06633051	-118.4452686	Los Angeles County
114699	Fee-for-Service	1689629974	1689629974	1	1	HARDWICK, JOSEPH A MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	34437	01	General Practice	0	In state provider	None	2021 SANTA MONICA BLVD	STE 212E	SANTA MONICA	CA	90404	2208	19	06037	34.02922048	-118.4793681	Los Angeles County
114710	Fee-for-Service	1598298093	1598298093	1	1	HE, ANGIE LMFT	1/15/2021	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
114712	Fee-for-Service	1013513332	1013513332	1	1	HORSEY, KATHLEEN L LMFT	8/26/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1103 BUTTE HOUSE RD	SUITE E	YUBA CITY	CA	95991	3109	51	06101	39.14536728	-121.6306637	Sutter County
114718	Fee-for-Service	1427778638	1427778638	1	1	HART, JEREMY	2/20/2025	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
114722	Fee-for-Service	1437309762	1437309762	1	1	HOSSEINI-RIVANDI, ALI MD	6/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114228	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
114731	Fee-for-Service	1912461195	1912461195	1	1	HERRIAN, JASMINDAR K RCP	6/18/2021	2279P1004X	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
114740	Fee-for-Service	1366452823	1366452823	1	1	HARLESS, W THOMAS MD INC	8/1/1988	207R00000X	NA	Other	026	PHYSICIANS	27839	41	Internal Medicine	0	In state provider	None	4060 4TH AVE	STE 303	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
114743	Fee-for-Service	1194214908	1194214908	1	1	HUTCHINS, STACY J 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
114756	Fee-for-Service	1518125210	1518125210	1	1	HAYDEN, MELANIE G MD	8/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	105004	14	Neurological Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
114761	Fee-for-Service	1285891549	1285891549	1	1	HASTINGS, ELLIOTT C PSYD	8/15/2023	103T00000X	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
114772	Fee-for-Service	1508956335	1508956335	1	1	HENDRICKSON, MICHAEL MD	1/1/1982	207ZP0102X	NA	Other	026	PHYSICIANS	26353	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
114841	Fee-for-Service	1023074127	1023074127	1	1	HERAMB K. SINGH MD	10/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7930 DONIPHAN DR	None	VINTON	TX	79821	7613	00	None	31.95611453	-106.6034713	El Paso County
114859	Fee-for-Service	1720038946	1720038946	1	1	HCA HEALTHONE, LLC	6/1/1998	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	1719 E 19TH AVE	None	DENVER	CO	80218	1235	00	None	39.74609655	-104.9669133	Denver County
114874	Fee-for-Service	1245254614	1245254614	1	1	HASHEMI, SAID M MD	1/1/1982	207L00000X	NA	Other	026	PHYSICIANS	37109	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
114960	Fee-for-Service	1871739557	1871739557	1	1	HALL, NOVA D MD	11/24/2009	207R00000X	NA	Other	026	PHYSICIANS	103539	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
114965	Fee-for-Service	1952458143	1952458143	1	1	HYLTON-LAWRENCE LUMBSDEN	8/22/2005	163W00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	DONETTE C.	9955 AMHERST AVE	None	MONTCLAIR	CA	91763	3002	36	06071	34.07299788	-117.7100267	San Bernardino County
114967	Fee-for-Service	1043379613	1043379613	1	1	HOWEY, GINA A MD	3/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	62545	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
114976	Fee-for-Service	1891811907	1891811907	1	1	HAZEL HAWKINS HEALTH CLN	6/17/2003	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	301 THE ALAMEDA	STE B3	SAN JUAN BAUTISTA	CA	95045	9746	35	06069	36.8416281	-121.5341688	San Benito County
114990	Fee-for-Service	1689629974	1689629974	1	1	HARDWICK, JOSEPH A MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	34437	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2021 SANTA MONICA BLVD	STE 212E	SANTA MONICA	CA	90404	2208	19	06037	34.02922048	-118.4793681	Los Angeles County
115038	Fee-for-Service	1053392035	1053392035	1	1	HANLEY, LAUREN E MD	4/5/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	174771	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
115099	Fee-for-Service	1417351388	1417351388	1	1	HODGDON, DANA F PHD	2/22/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3424 EAST 4TH STREET,	None	LONG BEACH	CA	90814	1557	19	06037	33.77166254	-118.1517916	Los Angeles County
115114	Fee-for-Service	1487049714	1487049714	1	1	HICKEY, MATTHEW D MD	8/2/2018	390200000X	NA	Other	026	PHYSICIANS	148607	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
115135	Fee-for-Service	1821050758	1821050758	1	1	HAY, JAMES T MD	12/1/1978	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	25996	08	Family Practice	0	In state provider	SUITE A306	477 N EL CAMINO REAL	None	ENCINITAS	CA	92024	1328	37	06073	33.05700866	-117.262449	San Diego County
115149	Fee-for-Service	1720038946	1720038946	1	1	HCA HEALTHONE, LLC	8/25/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER	1719 E 19TH AVE	None	DENVER	CO	80218	1235	00	None	39.74609655	-104.9669133	Denver County
115160	Fee-for-Service	1548409857	1548409857	1	1	HYUN, CARROL C LCSW	8/14/2017	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
115218	Fee-for-Service	1528105640	1528105640	1	1	HARJANI, VASHDEO D MD	5/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154589	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
115235	Fee-for-Service	1336170679	1336170679	2	1	HARPERS PHARMACY INC	4/9/2009	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	132 S ANITA DR	SECOND FLOOR	ORANGE	CA	92868	3317	30	06059	33.787386	-117.8812055	Orange County
115237	Fee-for-Service	1073568903	1073568903	1	1	HILLOCK, RONALD W MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79884	20	Orthopedic Surgery	0	In state provider	None	10883 LE CONTE AVE	None	LOS ANGELES	CA	90024	3010	19	06037	34.0637433	-118.4449733	Los Angeles County
115263	Fee-for-Service	1891811907	1891811907	1	1	HAZEL HAWKINS HEALTH CLN	1/4/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	301 THE ALAMEDA	STE B3	SAN JUAN BAUTISTA	CA	95045	9746	35	06069	36.8416281	-121.5341688	San Benito County
115273	Fee-for-Service	1730248493	1730248493	1	1	HILLIARD, VIRGIL A MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84705	05	Anesthesiology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
115283	Fee-for-Service	1285742338	1285742338	1	2	HARNEY DISTRICT HOSPITAL	1/21/2021	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	557 W WASHINGTON ST	None	BURNS	OR	97720	1441	00	None	43.58870813	-119.060725	Harney County
115293	Fee-for-Service	1548799786	1548799786	1	1	HANFT, WYATT J MD	3/14/2025	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	187830	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
115295	Fee-for-Service	1316197932	1316197932	1	1	HODES, SUSAN A MD	11/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98728	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
115322	Fee-for-Service	1376777268	1376777268	1	1	HUBBARD, MICHAEL R DO	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11587	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
115363	Fee-for-Service	1508937418	1508937418	1	1	HENSON, ARNOLD M MD	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64802	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
115390	Fee-for-Service	1588680805	1588680805	1	1	HILARY RENO,MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	660 S EUCLID AVE	None	SAINT LOUIS	MO	63110	1010	00	None	38.63518793	-90.26307576	St. Louis city
115414	Fee-for-Service	1851495154	1851495154	1	2	HECTOR, BRUCE P MD INC	9/30/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19850	08	Family Practice	0	In state provider	None	8660 WOODLEY AVE	None	NORTH HILLS	CA	91343	5745	19	06037	34.22803936	-118.4851286	Los Angeles County
115460	Fee-for-Service	1427389014	1427389014	1	1	HOSPITALIST CARE AMC	7/12/2010	207R00000X	NA	Other	026	PHYSICIANS	63064	41	Internal Medicine	0	In state provider	None	1050 LINDEN AVENUE	None	LONG BEACH	CA	90813	3321	19	06037	33.78003775	-118.1866604	Los Angeles County
115483	Fee-for-Service	1104052232	1104052232	1	1	HERNANDEZ, JOSEPH D MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107450	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
115549	Fee-for-Service	1174586283	1174586283	1	1	HOSPITAL SERVICE DISTRICT	9/4/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	2	Out of state provider	NO 1-A OF THE PARISH OF	508 BROADWAY STREET	None	DELHI	LA	71232	3002	00	None	32.452947	-91.49287597	Richland Parish
115572	Fee-for-Service	1174909402	1174909402	1	1	HANGER PROSTHETICS &	2/16/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	635 ANDERSON RD	SUITE 18	DAVIS	CA	95616	3505	57	06113	38.5487623	-121.7587554	Yolo County
115575	Fee-for-Service	1285742338	1285742338	1	2	HARNEY DISTRICT HOSPITAL	1/21/2021	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	557 W WASHINGTON ST	None	BURNS	OR	97720	1441	00	None	43.58870813	-119.060725	Harney County
115616	Fee-for-Service	1346220191	1346220191	1	1	HANNON, VIVIENNE N MD	9/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	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
115649	Fee-for-Service	1508937418	1508937418	1	1	HENSON, ARNOLD M MD	9/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64802	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
115660	Fee-for-Service	1275911562	1275911562	1	1	HOVSEPYAN, HARUT	11/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145584	66	Emergency Medicine (Urgent Care)	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
115664	Fee-for-Service	1760662092	1760662092	1	1	HANGER P & O WEST INC	7/22/2008	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3024 W FLORIDA AVE	None	HEMET	CA	92545	3619	33	06065	33.7474743	-117.0034585	Riverside County
115671	Fee-for-Service	1104130269	1104130269	1	1	HERSKOVIC, ETHEL S DO	6/27/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	19294	30	Radiology	0	In state provider	None	255 E BONITA AVE	None	POMONA	CA	91767	1923	19	06037	34.097913	-117.7474635	Los Angeles County
115680	Fee-for-Service	1982163101	1982163101	1	1	HSU, YOUNG C MD	8/1/2024	246ZN0300X	NA	Other	026	PHYSICIANS	177388	45	Nephrology (Renal-Kidney)	0	In state provider	None	2100 WEBSTER ST	STE 320	SAN FRANCISCO	CA	94115	2373	38	06075	37.7904826	-122.4324477	San Francisco County
115690	Fee-for-Service	1326112921	1326112921	1	1	HUANG, SHIRLEY J MD	11/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55429	22	Pathology (M.D. only)	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
115700	Fee-for-Service	1851495154	1851495154	1	2	HECTOR, BRUCE P MD INC	9/30/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19850	01	General Practice	0	In state provider	None	8660 WOODLEY AVE	None	NORTH HILLS	CA	91343	5745	19	06037	34.22803936	-118.4851286	Los Angeles County
115711	Fee-for-Service	1356737191	1356737191	1	1	HIJAZI, HUSSEIN MD	7/25/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169664	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
115752	Fee-for-Service	1841303088	1841303088	1	1	HOWARD MICHAEL UMAN	10/20/2014	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	4379	00	None	47.608326	-122.3207985	King County
115775	Fee-for-Service	1255456141	1255456141	1	1	HAKER, KATHERINE M MD	11/30/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	70718	30	Radiology	0	In state provider	UCLA RADIOLOGY MED GRP	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
115839	Fee-for-Service	1174586283	1174586283	1	1	HOSPITAL SERVICE DISTRICT	9/4/2018	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	2	Out of state provider	NO 1-A OF THE PARISH OF	508 BROADWAY STREET	None	DELHI	LA	71232	3002	00	None	32.452947	-91.49287597	Richland Parish
115851	Fee-for-Service	1407146533	1407146533	1	1	HUI, FELICIA A MD	10/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129771	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
115866	Fee-for-Service	1780668434	1780668434	1	2	HENRY MAYO NEWHALL	5/12/2021	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	24525 TOWN CENTER DR	None	VALENCIA	CA	91355	1328	19	06037	34.41828351	-118.5640426	Los Angeles County
115915	Fee-for-Service	1609070234	1609070234	1	1	HOLMES, REGINA N LMFT	8/24/2018	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
115944	Fee-for-Service	1659982593	1659982593	1	1	HEALTHY HOSPICE INC	5/12/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6735 VAN NUYS BLVD	UNIT 304	VAN NUYS	CA	91405	4645	19	06037	34.193133	-118.4487775	Los Angeles County
115951	Fee-for-Service	1952777278	1952777278	1	1	HAKE, MARGARET C NP	12/7/2015	No Taxonomy Provided	NA	None	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
115962	Fee-for-Service	1164559456	1164559456	1	5	HEARING SCIENCE OF RANCHO	5/12/2015	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7740 EDISON AVE	STE 104	FONTANA	CA	92336	3637	36	06071	34.11329434	-117.489984	San Bernardino County
116033	Fee-for-Service	1043476138	1043476138	1	1	HILEMAN, LAURA LMFT	12/25/2024	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
116088	Fee-for-Service	1548277999	1548277999	1	1	HAGE, JOHN N MD	2/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	87481	None	None	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
116091	Fee-for-Service	1407914260	1407914260	1	15	HILL COUNTRY COMM CLINIC	7/26/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1201 INDUSTRIAL ST	None	REDDING	CA	96002	0757	45	06089	40.57469253	-122.349645	Shasta County
116122	Fee-for-Service	1831193895	1831193895	1	1	HUANG, CHIN-WEI MD	4/19/2016	207RC0200X	NA	Other	026	PHYSICIANS	55446	None	None	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
116129	Fee-for-Service	1104989706	1104989706	1	1	HOFFMAN, ROBERT S MD	7/7/1983	2084N0400X	NA	Neurology	026	PHYSICIANS	27114	36	Psychiatry	0	In state provider	ST MARYS MEDICAL CTR	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
116131	Fee-for-Service	1821100983	1821100983	1	1	HARKEN, TABETHA R MD	8/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95354	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
116138	Fee-for-Service	1407146533	1407146533	1	1	HUI, FELICIA A MD	10/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129771	01	General Practice	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
116139	Fee-for-Service	1578094314	1578094314	1	1	HAMMOND, JAMES D MD	8/1/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	187385	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
116154	Fee-for-Service	1306037759	1306037759	1	1	HONCE, JUSTIN M MD	1/1/2018	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
116174	Fee-for-Service	1740230291	1740230291	1	1	HOYT, ANNE C MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80928	None	None	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
116181	Fee-for-Service	1689195166	1689195166	1	1	HIDALGO, MARICELA LMFT	2/15/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5266 HOLLISTER AVE	STE 205	SANTA BARBARA	CA	93111	2037	42	06083	34.43497016	-119.8071895	Santa Barbara County
116185	Fee-for-Service	1194759688	1194759688	1	1	HARVEY, DANIEL E MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54957	08	Family Practice	0	In state provider	None	20401 AVALON BLVD	STE C	CARSON	CA	90746	3226	19	06037	33.84655123	-118.2648105	Los Angeles County
116195	Fee-for-Service	1457481244	1457481244	1	1	HETTICH, RANDALL R LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
116203	Fee-for-Service	1205880994	1205880994	1	1	HEPNER, ABSALOM D MD	5/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78126	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
116208	Fee-for-Service	1902046410	1902046410	1	1	HUANG, HSUAN-WEN C MD	12/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	94663	41	Internal Medicine	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANGE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
116210	Fee-for-Service	1598178626	1598178626	1	1	HOMAYOUNFAR, GELAREH MD	7/19/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	153765	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
116233	Fee-for-Service	1659982593	1659982593	1	1	HEALTHY HOSPICE INC	5/12/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6735 VAN NUYS BLVD	UNIT 304	VAN NUYS	CA	91405	4645	19	06037	34.193133	-118.4487775	Los Angeles County
116251	Fee-for-Service	1164559456	1164559456	1	5	HEARING SCIENCE OF RANCHO	11/8/2013	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	7740 EDISON AVE	STE 104	FONTANA	CA	92336	3637	36	06071	34.11329434	-117.489984	San Bernardino County
116292	Fee-for-Service	1992923833	1992923833	1	1	HUANG, GRACE W C DO	6/5/2008	207R00000X	NA	Other	026	PHYSICIANS	9345	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
116327	Fee-for-Service	1790149136	1790149136	1	1	HWE, CHRISTOPHER K MD	2/14/2023	207RP1001X	NA	Pulmonology	026	PHYSICIANS	151296	None	None	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
116358	Fee-for-Service	1215042270	1215042270	1	1	HO, EUGENIA MD	6/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85172	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
116407	Fee-for-Service	1477624385	1477624385	1	1	HONIGMAN, WILLIAM A MD	9/21/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	46105	66	Emergency Medicine (Urgent Care)	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
116409	Fee-for-Service	1801924709	1801924709	1	1	HOFFMAN, KENNETH L MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77233	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
116450	Fee-for-Service	1528275310	1528275310	1	1	HUMELBAUGH, GIA MD	11/7/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	95749	08	Family Practice	0	In state provider	None	5000 OVERLAND BLVD	#5C	CULVER CITY	CA	30231	4495	19	06037	34.00638832	-118.3954405	Los Angeles County
116452	Fee-for-Service	1548337439	1548337439	1	1	HELMSTEDTER, CHRIS S MD	2/28/1996	204D00000X	NA	Other	026	PHYSICIANS	72869	20	Orthopedic Surgery	0	In state provider	None	1510 SAN PABLO ST	STE 322	LOS ANGELES	CA	90033	5305	19	06037	34.06287152	-118.2029433	Los Angeles County
116475	Fee-for-Service	1780806604	1780806604	1	1	HELGE, TRUDY D PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
116485	Fee-for-Service	1083693923	1083693923	1	1	HAIGHT, HOLLY J MD	8/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98489	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
116566	Fee-for-Service	1134547664	1134547664	1	1	HERNANDEZ, JONATHAN MD	12/8/2018	207W00000X	NA	Ophthalmology	026	PHYSICIANS	140638	18	Ophthalmology	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
116577	Fee-for-Service	1992923833	1992923833	1	1	HUANG, GRACE W C DO	6/5/2008	207R00000X	NA	Other	026	PHYSICIANS	9345	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
116580	Fee-for-Service	1194042168	1194042168	1	1	HONARI, SARA MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149947	23	Peripheral Vascular Disease or Surgery (D.O. only)	0	In state provider	None	4901 CENTENNIAL PLAZA	None	BAKERSFIELD	CA	93312	2011	15	06029	35.40395294	-119.0935511	Kern County
116583	Fee-for-Service	1427193721	1427193721	1	1	HOLTZ, JENAE LMFT	8/5/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4849 RONSON CT	SUITE 207	SAN DIEGO	CA	92111	1805	37	06073	32.83028739	-117.1459009	San Diego County
116599	Fee-for-Service	1992746234	1992746234	1	1	HSU, CHRISTOPHER T MD	3/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89324	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
116627	Fee-for-Service	1477729127	1477729127	1	1	HUNT, TAMMY L LCSW	5/21/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NS	9179 G AVE	None	HESPERIA	CA	92345	6121	36	06071	34.41787422	-117.2881315	San Bernardino County
116647	Fee-for-Service	1215042270	1215042270	1	1	HO, EUGENIA MD	6/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85172	13	Neurology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
116662	Fee-for-Service	1174634828	1174634828	1	1	HABIBIPOUR, SAIED MD	4/2/2007	193200000X	NA	Other	026	PHYSICIANS	80162	01	General Practice	0	In state provider	DESERT HEART INSTITUTE	1180 N INDIAN CANYON DR	STE E318	PALM SPRINGS	CA	92262	4809	33	06065	33.839505	-116.5455735	Riverside County
116672	Fee-for-Service	1649362468	1649362468	1	1	HALDAR, SAPTARSI MD	2/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140274	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
116690	Fee-for-Service	1154592012	1154592012	1	1	HUANG, ALEXANDER S MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69302	05	Anesthesiology	0	In state provider	AMC	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
116695	Fee-for-Service	1477624385	1477624385	1	1	HONIGMAN, WILLIAM A MD	9/21/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	46105	01	General Practice	0	In state provider	ATTN MGA OFFICE	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
116699	Fee-for-Service	1629746326	1629746326	1	1	HEALING DAYS HOME HEALTH INC	11/27/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1545 N VERDUGO RD	SUITE 218	GLENDALE	CA	91208	3222	19	06037	34.16921698	-118.2280083	Los Angeles County
116712	Fee-for-Service	1659423002	1659423002	1	1	HIRST, ROSALIND A CNM	11/1/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	250 TRAVELODGE DRIVE	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
116724	Fee-for-Service	1548670573	1548670573	1	1	HARRIS, ERIN C	7/20/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	661 W 1ST ST	STE E	TUSTIN	CA	92780	2939	30	06059	33.74578153	-117.831231	Orange County
116739	Fee-for-Service	1306231550	1306231550	1	1	HEATH, JASON MD	11/8/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
116790	Fee-for-Service	1174795959	1174795959	1	1	HASHMI, AIJAZ MD INC	7/1/2002	193400000X	NA	Other	026	PHYSICIANS	66814	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	555 E TACHEVAH DR	2W-105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
116824	Fee-for-Service	1114049186	1114049186	1	1	HOUSE OF METAMORPHOSIS, INC	12/4/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2970 MARKET STREET	None	SAN DIEGO	CA	92102	3241	37	06073	32.71167553	-117.1306215	San Diego County
116826	Fee-for-Service	1376571414	1376571414	1	1	HENDERSON, LEON B JR MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	80100	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
116879	Fee-for-Service	1639152598	1639152598	1	1	HENDREN, ROBERT L DO	9/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	4572	26	Psychiatry (child)	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
116889	Fee-for-Service	1710196886	1710196886	1	1	HUNTINGTON BEACH UHSD	4/25/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SPECIAL EDUCATION	5832 BOLSA AVE	None	HUNTINGTON BEACH	CA	92649	1115	30	06059	33.74436154	-118.0270575	Orange County
116891	Fee-for-Service	1477534881	1477534881	1	1	HEALY, FRANCIS T MD	6/30/1981	207RP1001X	NA	Pulmonology	026	PHYSICIANS	37366	01	General Practice	0	In state provider	None	1100 TRANCAS ST	# 254	NAPA	CA	94558	2908	28	06055	38.32316569	-122.2981938	Napa County
116896	Fee-for-Service	1053498915	1053498915	1	1	HUNG, SHAUN S.J.	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	44886	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
116904	Fee-for-Service	1275719742	1275719742	1	1	HARRINGTON, ANNIE R MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100767	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
116909	Fee-for-Service	1780050054	1780050054	1	1	HARBOR PSYCHIATRY & MENTAL H	6/27/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	EALTH	4631 TELLER AVE	100	NEWPORT BEACH	CA	92660	8105	30	06059	33.66641504	-117.857408	Orange County
116938	Fee-for-Service	1558697334	1558697334	1	1	HSIEH, HUI-I E MD	11/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113618	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
116943	Fee-for-Service	1932217965	1932217965	1	1	HIDALGO-TAMOLA, JOSEPHINE M	10/17/2023	208800000X	NA	Other	026	PHYSICIANS	185664	None	None	0	In state provider	D	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
116952	Fee-for-Service	1417428749	1417428749	1	1	HSU, LOR-SHING PT	3/1/2019	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
117029	Fee-for-Service	1326197641	1326197641	1	1	HANNA, FIKRY F MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	50435	22	Pathology (M.D. only)	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
117042	Fee-for-Service	1114037421	1114037421	1	1	HAMEED, BILAL MD	5/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109128	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
117073	Fee-for-Service	1093291379	1093291379	1	1	HAILE, RAHWA CNP	4/28/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	365 HAWTHORNE AVENUE	SUITE 201	OAKLAND	CA	94609	3114	01	06001	37.82079728	-122.2633226	Alameda County
117079	Fee-for-Service	1174795959	1174795959	1	1	HASHMI, AIJAZ MD INC	7/1/2002	193400000X	NA	Other	026	PHYSICIANS	66814	40	Pediatrics	0	In state provider	None	555 E TACHEVAH DR	2W-105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
117112	Fee-for-Service	1568521284	1568521284	1	1	HAUSER, MATHEW D OD	1/27/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	200 N LEWIS ST	None	ORANGE	CA	92868	1537	30	06059	33.7900136	-117.8975432	Orange County
117169	Fee-for-Service	1639152598	1639152598	1	1	HENDREN, ROBERT L DO	9/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	4572	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
117173	Fee-for-Service	1770567711	1770567711	1	1	HYER, JENNIFER J DO	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8450	41	Internal Medicine	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
117189	Fee-for-Service	1275719742	1275719742	1	1	HARRINGTON, ANNIE R MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100767	29	Pulmonary Diseases (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
117195	Fee-for-Service	1780050054	1780050054	1	1	HARBOR PSYCHIATRY & MENTAL H	2/29/2016	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	EALTH	4631 TELLER AVE	100	NEWPORT BEACH	CA	92660	8105	30	06059	33.66641504	-117.857408	Orange County
117243	Fee-for-Service	1588043079	1588043079	1	1	HANKINS, KURT E	11/28/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM DR	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
117288	Fee-for-Service	1083193304	1083193304	1	1	HASSAN, MUHAMMAD MD	8/20/2021	207R00000X	NA	Other	026	PHYSICIANS	173970	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
117318	Fee-for-Service	1205399052	1205399052	1	1	HAMBRO, BENJAMIN C MD	11/14/2022	207R00000X	NA	Other	026	PHYSICIANS	179951	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
117327	Fee-for-Service	1114037421	1114037421	1	1	HAMEED, BILAL MD	5/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109128	10	Gastroenterology (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
117397	Fee-for-Service	1902821945	1902821945	1	1	HEMMEN, THOMAS M MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72645	13	Neurology (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
117413	Fee-for-Service	1568477107	1568477107	1	1	HUTTON, KEVIN C MD	1/31/1989	207P00000X	NA	Other	026	PHYSICIANS	65677	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
117478	Fee-for-Service	1275719742	1275719742	1	1	HARRINGTON, ANNIE R MD	8/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100767	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
117483	Fee-for-Service	1780050054	1780050054	1	1	HARBOR PSYCHIATRY & MENTAL H	2/29/2016	103TC0700X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	EALTH	4631 TELLER AVE	100	NEWPORT BEACH	CA	92660	8105	30	06059	33.66641504	-117.857408	Orange County
117498	Fee-for-Service	1396194858	1396194858	1	1	HULL, MITTIE TYSHAWN	4/28/2022	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	44040 32ND ST W	None	LANCASTER	CA	93536	6178	19	06037	34.68334089	-118.1881213	Los Angeles County
117575	Fee-for-Service	1871754754	1871754754	1	1	HSIEH, WEN-YUAN E MD	2/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113023	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
117633	Fee-for-Service	1730166604	1730166604	1	1	HACEIN-BEY, LOTFI MD	7/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53295	30	Radiology	0	In state provider	None	2801 K STREET	STE 110	SACRAMENTO	CA	95816	5120	34	06067	38.572947	-121.46904	Sacramento County
117678	Fee-for-Service	1114977840	1114977840	1	1	HERBST, KAREN L MD	12/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80165	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
117684	Fee-for-Service	1902821945	1902821945	1	1	HEMMEN, THOMAS M MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72645	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
117709	Fee-for-Service	1679864227	1679864227	1	3	HEARWELL AUDIOLOGY INC	4/17/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	5293 PROSPECT RD	STE D	SAN JOSE	CA	95129	5037	43	06085	37.29226153	-121.9955301	Santa Clara County
117730	Fee-for-Service	1033761895	1033761895	1	1	HARMELL, ALEXANDREA PHD	1/27/2020	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
117758	Fee-for-Service	1851494728	1851494728	1	1	HORWITZ, BRUCE A MD	5/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	25572	40	Pediatrics	0	In state provider	None	411 30TH ST	STE 212	OAKLAND	CA	94609	3303	01	06001	37.81903474	-122.2649444	Alameda County
117769	Fee-for-Service	1417991662	1417991662	1	1	HOYING, JOHN P MD	7/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	41006	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
117783	Fee-for-Service	1396194858	1396194858	1	1	HULL, MITTIE TYSHAWN	4/28/2022	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	44040 32ND ST W	None	LANCASTER	CA	93536	6178	19	06037	34.68334089	-118.1881213	Los Angeles County
117796	Fee-for-Service	1245313287	1245313287	1	1	HOUSER, JAN L MD	12/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	48247	01	General Practice	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
117838	Fee-for-Service	1629519848	1629519848	1	1	HAGHIGHAT, SHIDA MD	1/26/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	160701	None	None	0	In state provider	None	4343 LANKERSHIM BLVD	200	NORTH HOLLYWOOD	CA	91602	2705	19	06037	34.14917579	-118.3651663	Los Angeles County
117862	Fee-for-Service	1245790229	1245790229	1	1	HUYNH, JENNIFER	2/29/2024	207R00000X	NA	Other	026	PHYSICIANS	176202	None	None	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
117898	Fee-for-Service	1477864049	1477864049	1	1	HAMPTON, DAVID M MD	10/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135138	20	Orthopedic Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
117913	Fee-for-Service	1073908802	1073908802	1	1	HARRIS, JENNIFER MD	7/9/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	172647	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
117936	Fee-for-Service	1598365793	1598365793	1	1	HDE HOME HEALTH CARE INC	2/22/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	225 E BROADWAY	STE B103B	GLENDALE	CA	91205	1008	19	06037	34.14633765	-118.2529554	Los Angeles County
117982	Fee-for-Service	1144378019	1144378019	1	1	HONSBERGER, PAMELA E MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75607	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
118001	Fee-for-Service	1659725406	1659725406	1	1	HAYWARD, CHRISTIANA M MD	10/31/2024	207RP1001X	NA	Pulmonology	026	PHYSICIANS	168847	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
118040	Fee-for-Service	1578192472	1578192472	1	1	HAYS, TRAVIS MD	10/11/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179955	None	None	0	In state provider	None	10121 PINE AVE	None	TRUCKEE	CA	96161	4835	29	06057	39.3245308	-120.2013097	Nevada County
118051	Fee-for-Service	1265498828	1265498828	1	1	HOYAL, RALPH P DPM	1/1/1979	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1041 4TH ST	STE B	SANTA ROSA	CA	95404	4329	49	06097	38.444229	-122.7061935	Sonoma County
118057	Fee-for-Service	1417991662	1417991662	1	1	HOYING, JOHN P MD	7/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	41006	83	Rheumatology	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
118076	Fee-for-Service	1770670531	1770670531	1	1	HEARST, DAVID P MD	1/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	44965	08	Family Practice	0	In state provider	None	33255 9TH ST	None	UNION CITY	CA	94587	2137	01	06001	37.60286569	-122.0260874	Alameda County
118085	Fee-for-Service	1942283148	1942283148	1	1	HERNANDEZ, ALFONSO LCSW	12/17/2023	106H00000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14570 MONO WAY STE A	None	SONORA	CA	95370	8997	55	06109	37.97766299	-120.3251922	Tuolumne County
118092	Fee-for-Service	1073758652	1073758652	1	1	HSIEH, TUNG-CHIN MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120604	34	Urology and Urological Surgery	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
118097	Fee-for-Service	1437618287	1437618287	1	1	HIRSCHMANN, CLAIRE MD	1/8/2023	207P00000X	NA	Other	026	PHYSICIANS	180333	None	None	0	In state provider	None	275 HOSPITAL DR	None	UKIAH	CA	95482	4531	23	06045	39.15305697	-123.2037774	Mendocino County
118126	Fee-for-Service	1003090085	1003090085	1	1	HWANG, CAROLINE MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108110	10	Gastroenterology (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	SUITE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
118152	Fee-for-Service	1790557304	1790557304	1	1	HENDERSON, MALIA AU	1/17/2024	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
118155	Fee-for-Service	1790103406	1790103406	1	1	HWANG, DANIEL L MD	8/13/2019	207L00000X	NA	Other	026	PHYSICIANS	141888	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
118158	Fee-for-Service	1962546176	1962546176	1	1	HEALTH CARE PROVIDERS	5/5/1995	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	MATIAS CLINICAL LAB INC	14411 PALMROSE AVE	None	BALDWIN PARK	CA	91706	3318	19	06037	34.0891953	-117.9601428	Los Angeles County
118168	Fee-for-Service	1700301827	1700301827	1	1	HERMOSILLO, DESIREE R LMFT	11/12/2021	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
118178	Fee-for-Service	1851657050	1851657050	1	1	HALABI, CATHRA MD	6/12/2017	390200000X	NA	Other	026	PHYSICIANS	127931	13	Neurology (M.D. only)	0	In state provider	None	1001 POTRERO AVENUE	RM 4M62	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
118194	Fee-for-Service	1306271606	1306271606	1	1	HOSPICE CARE AT HOME, INC	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	400 N MOUNTAIN AVE	SUITE 123D	UPLAND	CA	91786	5176	36	06071	34.098489	-117.670074	San Bernardino County
118208	Fee-for-Service	1295931731	1295931731	1	1	HURRIA, ANJU MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107533	36	Psychiatry	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
118213	Fee-for-Service	1114387990	1114387990	1	1	HARPERS PHARMACY INC	5/3/2016	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	132 S ANITA DR	SECOND FLOOR	ORANGE	CA	92868	3317	30	06059	33.787386	-117.8812055	Orange County
118228	Fee-for-Service	1255533402	1255533402	1	1	HU, XINGE MD	12/19/2007	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	96716	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
118238	Fee-for-Service	1164602728	1164602728	1	1	HUOH, MICHAEL C MD	10/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	99382	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
118240	Fee-for-Service	1346265436	1346265436	1	2	HARRISON, DAVID T MD	9/8/2021	207RH0003X	NA	Oncology	026	PHYSICIANS	37637	None	None	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
118241	Fee-for-Service	1992853956	1992853956	1	1	HASLER, GLORIA L MD	12/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77735	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
118385	Fee-for-Service	1740398999	1740398999	1	1	HAMDANI, SAIDA MD	9/30/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45922	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
118414	Fee-for-Service	1003090085	1003090085	1	1	HWANG, CAROLINE MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108110	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO ST	SUITE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
118415	Fee-for-Service	1114173325	1114173325	1	1	HUANG, HSIN YI GRACE MD	3/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	104119	06	Cardiovascular Disease (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
118461	Fee-for-Service	1386007383	1386007383	1	1	HEADLEY, ALISON J MD	8/4/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	153316	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
118463	Fee-for-Service	1326080078	1326080078	1	1	HULBERT, NIHRA A MD	11/25/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	25553	08	Family Practice	0	In state provider	None	1293 6TH ST	None	COACHELLA	CA	92236	1707	33	06065	33.67731363	-116.1789134	Riverside County
118481	Fee-for-Service	1306271606	1306271606	1	1	HOSPICE CARE AT HOME, INC	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	400 N MOUNTAIN AVE	SUITE 123D	UPLAND	CA	91786	5176	36	06071	34.098489	-117.670074	San Bernardino County
118498	Fee-for-Service	1942380209	1942380209	1	1	HAN, YONG S MD	8/15/2016	No Taxonomy Provided	NA	None	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
118528	Fee-for-Service	1376954529	1376954529	1	1	HOESLY, PAUL M MD	9/4/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	170076	07	Dermatology	0	In state provider	None	3301 C ST	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
118529	Fee-for-Service	1215334099	1215334099	1	1	HYE TRANS MEDICAL	12/5/2014	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	TRANSPORTATION	269 W ALAMEDA AVE	B	BURBANK	CA	91502	2520	19	06037	34.16723083	-118.3075057	Los Angeles County
118549	Fee-for-Service	1164522413	1164522413	1	1	HAWTHORNE, HEATHER T MD	10/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121650	78	Neoplastic Diseases/Oncology	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
118553	Fee-for-Service	1376629121	1376629121	1	1	HOLEN, ANNA L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	HARBORVIEW MEDICAL CNTRE	325 9TH AVE	C/O UWP MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
118558	Fee-for-Service	1366484248	1366484248	1	1	HAAS-KOGAN, DAPHNE A MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76324	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
118594	Fee-for-Service	1154408763	1154408763	1	1	HUMBERSON, CORA S MD	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	64369	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
118633	Fee-for-Service	1770720401	1770720401	2	1	HERNANDEZ, MARIA G LCSW	4/8/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	735 STATE STREET	SUITE 219	SANTA BARBARA	CA	93101	3351	42	06083	34.41942344	-119.6991527	Santa Barbara County
118642	Fee-for-Service	1881761617	1881761617	1	1	HOANG, DAN N MD	4/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90558	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
118703	Fee-for-Service	1114173325	1114173325	1	1	HUANG, HSIN YI GRACE MD	3/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	104119	41	Internal Medicine	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
118708	Fee-for-Service	1528194511	1528194511	1	1	HEALTH CENTER #5	7/1/1994	261QP2300X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1351 24TH AVE	None	SAN FRANCISCO	CA	94122	1698	38	06075	37.76240258	-122.4824643	San Francisco County
118714	Fee-for-Service	1881014066	1881014066	1	1	HAILE, MERON K MD	9/12/2018	207W00000X	NA	Ophthalmology	026	PHYSICIANS	137834	18	Ophthalmology	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
118721	Fee-for-Service	1073023107	1073023107	1	5	HUMBOLDT RECOVERY CENTER, IN	4/24/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	.	1120 9TH ST	None	EUREKA	CA	95501	1936	12	06023	40.7995529	-124.1583646	Humboldt County
118744	Fee-for-Service	1043462112	1043462112	1	1	HAN, DAVID MD	9/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106217	05	Anesthesiology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
118766	Fee-for-Service	1245599729	1245599729	1	1	HORNE, CHRISTOPHER B MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127579	36	Psychiatry	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
118783	Fee-for-Service	1053984195	1053984195	1	1	HOLLY HUGHES & CO., INC.	9/2/2024	104100000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	740 FRONT ST	STE 370	SANTA CRUZ	CA	95060	4584	44	06087	36.97547419	-122.0254852	Santa Cruz County
118793	Fee-for-Service	1336548551	1336548551	1	1	HAMILTON, MARINA LMFT	10/3/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
118806	Fee-for-Service	1821669987	1821669987	1	1	HERNANDEZ, ISABEL LMFT	10/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	138 N BRAND BLVD	STE 303	GLENDALE	CA	91203	4621	19	06037	34.147755	-118.2549335	Los Angeles County
118831	Fee-for-Service	1174144513	1174144513	1	1	H & H HOSPICE INC	6/10/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 251	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
118837	Fee-for-Service	1164522413	1164522413	1	1	HAWTHORNE, HEATHER T MD	10/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121650	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
118848	Fee-for-Service	1366484248	1366484248	1	1	HAAS-KOGAN, DAPHNE A MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76324	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
118884	Fee-for-Service	1790743185	1790743185	1	1	HUBBARD, EUSTRATIA M MD FAAP	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71707	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
118901	Fee-for-Service	1750469896	1750469896	1	1	HO, OSCAR H MD	9/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	109264	24	Plastic Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
118931	Fee-for-Service	1659390227	1659390227	1	1	HAMILTON, MICHELE MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	57890	06	Cardiovascular Disease (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
118932	Fee-for-Service	1891978813	1891978813	1	1	HIRAYAMA, KRISTINE L PHD	10/17/2014	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
118966	Fee-for-Service	1902023625	1902023625	1	1	HSU, ANNA P MD	4/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	80339	04	Otology, Laryngology, Rhinology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
118989	Fee-for-Service	1366079337	1366079337	1	1	HONG, ADRIENNE MD	7/12/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	186966	None	None	0	In state provider	None	700 17TH ST	None	MODESTO	CA	95354	1209	50	06099	37.64283069	-120.9903982	Stanislaus County
119003	Fee-for-Service	1114907706	1114907706	1	1	HERNANDEZ-ESTRADA, F MD	8/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	36108	02	General Surgery	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
119022	Fee-for-Service	1346621760	1346621760	1	1	HUANG, ALICE C MD	5/24/2023	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	155348	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
119024	Fee-for-Service	1740627843	1740627843	1	3	HOUSE OF HOPE FOUNDATION INC	7/25/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	240 WEST 9TH STREET	None	SAN PEDRO	CA	90731	3711	19	06037	33.73604549	-118.2823358	Los Angeles County
119026	Fee-for-Service	1902463094	1902463094	1	1	HOANG, DALE T	10/4/2022	390200000X	NA	Other	026	PHYSICIANS	176210	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
119056	Fee-for-Service	1023027992	1023027992	1	1	HANNA, ZIAD DO	10/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9548	02	General Surgery	0	In state provider	None	1050 N STATE ST	None	UKIAH	CA	95482	3414	23	06045	39.1623719	-123.2098216	Mendocino County
119060	Fee-for-Service	1174981989	1174981989	1	1	HANGER PROSTHETICS & ORTHOTI	3/7/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	9460 NO NAME UNO	SUITE 240	GILROY	CA	95020	3538	43	06085	37.037781	-121.570965	Santa Clara County
119066	Fee-for-Service	1528112190	1528112190	1	1	HARMAN, STEPHANIE M MD	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88319	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
119074	Fee-for-Service	1184689465	1184689465	1	1	HAGEN, DEREK A DO	5/10/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18096	None	None	0	In state provider	None	3800 DALE ROAD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
119104	Fee-for-Service	1912162058	1912162058	1	1	HENKE, ANNETTE E LCSW	9/19/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1420 THIRD ST.	STE. 2	NAPA	CA	94559	5210	28	06055	38.29599116	-122.2880209	Napa County
119110	Fee-for-Service	1366754251	1366754251	1	1	HENAO, JOHN P MD	11/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144568	05	Anesthesiology	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
119121	Fee-for-Service	1174144513	1174144513	1	1	H & H HOSPICE INC	6/10/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 251	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
119141	Fee-for-Service	1174011530	1174011530	1	1	HSU, PATRICK DO	6/1/2021	207P00000X	NA	Other	026	PHYSICIANS	18749	None	None	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
119147	Fee-for-Service	1164559456	1164559456	1	2	HEARING SCIENCE OF RANCHO	5/31/2011	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	711 W CAMINO REAL	STE 202	ARCADIA	CA	91007	9326	19	06037	34.12214338	-118.0557376	Los Angeles County
119165	Fee-for-Service	1427337815	1427337815	1	1	HING, TRESSIA C MD	6/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123322	10	Gastroenterology (M.D. only)	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
119167	Fee-for-Service	1629252325	1629252325	1	1	HAN, WARD Z MD	11/16/2010	390200000X	NA	Other	026	PHYSICIANS	112855	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
119169	Fee-for-Service	1831594639	1831594639	1	1	HARRISON, NATHANIEL J NP	12/12/2024	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
119206	Fee-for-Service	1114423076	1114423076	1	1	HARUNO, JULIA MD	12/13/2022	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	164685	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
119234	Fee-for-Service	1356768261	1356768261	2	1	HANGER PROSTHETICS & ORTHOTI	6/19/2023	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 BRYAN AVE STE	C	TUSTIN	CA	92780	4401	30	06059	33.74272355	-117.8149529	Orange County
119281	Fee-for-Service	1841315348	1841315348	1	1	HAHN, MICHAEL P MD	1/4/2008	204D00000X	NA	Other	026	PHYSICIANS	89321	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
119294	Fee-for-Service	1114907706	1114907706	1	1	HERNANDEZ-ESTRADA, F MD	8/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	36108	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
119323	Fee-for-Service	1518911908	1518911908	1	1	HEGGENESS, OLE A DO	2/17/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	4925	01	General Practice	0	In state provider	None	11525 BROOKSHIRE AVE	STE 301	DOWNEY	CA	90241	4982	19	06037	33.93544635	-118.1318321	Los Angeles County
119338	Fee-for-Service	1699772756	1699772756	1	1	HEUNG, RAYMOND C MD	12/31/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	48119	68	Hematology	0	In state provider	None	5222 BALBOA AVE	STE 33	SAN DIEGO	CA	92117	6953	37	06073	32.81873589	-117.1838368	San Diego County
119348	Fee-for-Service	1063892172	1063892172	1	1	HABER, MATTHEW A MD	2/24/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171433	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
119368	Fee-for-Service	1912064809	1912064809	1	1	HERNANDEZ, ESTELA MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70990	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
119373	Fee-for-Service	1861894917	1861894917	1	1	HARTER, KATHERINE R MD	10/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132578	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
119408	Fee-for-Service	1578329876	1578329876	1	1	HAMAD, HANAN AU	2/29/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2160 WEST ADAMS BLVD.	None	LOS ANGELES	CA	90018	2039	19	06037	34.03262662	-118.3138579	Los Angeles County
119429	Fee-for-Service	1558301010	1558301010	1	1	HENDRY, JOHN E MD	1/1/1979	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	20774	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5525 DEWEY DR	STE 104	FAIR OAKS	CA	95628	3130	34	06067	38.666592	-121.309182	Sacramento County
119438	Fee-for-Service	1164559456	1164559456	1	2	HEARING SCIENCE OF RANCHO	9/27/2021	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	711 W CAMINO REAL	STE 202	ARCADIA	CA	91007	9326	19	06037	34.12214338	-118.0557376	Los Angeles County
119457	Fee-for-Service	1619086246	1619086246	1	1	HAUF, ZUO-FEN MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	67131	01	General Practice	0	In state provider	None	1580 SEBASTOPOL RD	STE 1	SANTA ROSA	CA	95407	6839	49	06097	38.427255	-122.737293	Sonoma County
119463	Fee-for-Service	1669583167	1669583167	1	1	HIGA, LISA KUNIKO MD	3/1/1998	174400000X	NA	Other	026	PHYSICIANS	76897	01	General Practice	0	In state provider	None	2999 REGENT ST	STE 425	BERKELEY	CA	94705	2119	01	06001	37.85592021	-122.2566436	Alameda County
119474	Fee-for-Service	1578591319	1578591319	1	1	HAMMERMAN, CURTIS S MD	12/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	87424	None	None	0	In state provider	None	72855 FRED WARING DRIVE	None	PALM DESERT	CA	92260	9367	33	06065	33.72858055	-116.3943135	Riverside County
119499	Fee-for-Service	1972161669	1972161669	1	1	HALFF, MARGARET LCSW	9/20/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	109492	-	NOT APPLICABLE	0	In state provider	None	2330 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2220	19	06037	34.0681396	-118.2738016	Los Angeles County
119544	Fee-for-Service	1861734592	1861734592	1	1	HANNEMANN, NATHAN P DO	12/14/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	22145	None	None	0	In state provider	None	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	04	06007	39.74352822	-121.8495394	Butte County
119547	Fee-for-Service	1639139983	1639139983	1	1	HACKSHAW, BARRY T	11/30/1988	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	42563	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
119584	Fee-for-Service	1558342022	1558342022	1	1	HACHIGIAN, GREG MD	5/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	52260	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
119613	Fee-for-Service	1275214785	1275214785	1	1	HK BEYOND CARE INC	8/22/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	544 W 9TH STREET	None	UPLAND	CA	91786	5801	36	06071	34.09603329	-117.6577485	San Bernardino County
119616	Fee-for-Service	1841777257	1841777257	1	1	HINERMAN, NATHANIEL P LMFT	5/21/2024	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
119629	Fee-for-Service	1699772756	1699772756	1	1	HEUNG, RAYMOND C MD	12/31/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	48119	78	Neoplastic Diseases/Oncology	0	In state provider	None	5222 BALBOA AVE	STE 33	SAN DIEGO	CA	92117	6953	37	06073	32.81873589	-117.1838368	San Diego County
119690	Fee-for-Service	1427093046	1427093046	1	3	HEAD AND NECK ASSOCIATES OF	8/13/2021	174400000X	NA	Other	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	ANGE	26726 CROWN VALLEY PKWY	#200	MISSION VIEJO	CA	92691	8003	30	06059	33.56385623	-117.6639538	Orange County
119694	Fee-for-Service	1992060958	1992060958	1	1	HIROTA, TOMOYA MD	7/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135407	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
119710	Fee-for-Service	1619025418	1619025418	1	1	HAUGHTON, DANA K MD	3/30/1991	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72644	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
119727	Fee-for-Service	1407998164	1407998164	1	1	HAESSLER, ALEXANDRA L MD	6/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	69765	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3838 CALIFORNIA STREET	SUITE 305	SAN FRANCISCO	CA	94118	1505	38	06075	37.78591809	-122.4575439	San Francisco County
119730	Fee-for-Service	1114359429	1114359429	1	1	HERNANDEZ, RUBICELI NP	1/12/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18785 BROOKHURST STREET	STE 101	FOUNTAIN VALLEY	CA	92708	7300	30	06059	33.68987636	-117.9542321	Orange County
119737	Fee-for-Service	1104017169	1104017169	1	1	HU, PHONG C MD	12/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97801	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
119738	Fee-for-Service	1750699393	1750699393	1	1	HOWELL, BARBARA H LMFT	6/6/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	828 SAN PABLO AVE	STE 120A	ALBANY	CA	94706	1603	01	06001	37.89159884	-122.2994097	Alameda County
119763	Fee-for-Service	1205681939	1205681939	1	1	HUNDAL, GURPREET S PT	10/9/2024	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
119803	Fee-for-Service	1164506069	1164506069	1	2	HERS BREAST CANCER FOUNDATIO	10/5/2023	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	N	2401 MERCED ST	100	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
119832	Fee-for-Service	1790719854	1790719854	1	1	HUANG, LIH-SYH MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64385	40	Pediatrics	0	In state provider	None	612 W DUARTE RD	STE 203	ARCADIA	CA	91007	9227	19	06037	34.12647805	-118.051994	Los Angeles County
119844	Fee-for-Service	1912319179	1912319179	1	1	HILLTOP RECOVERY SERVICES	7/7/2014	261QR0405X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	6316 E HIGHWAY 20	None	LUCERNE	CA	95458	7801	17	06033	39.08608009	-122.7921592	Lake County
119849	Fee-for-Service	1871269522	1871269522	1	1	HEARTS HANDS SERENETHOS SNF	2/21/2022	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	130 DANA ST	None	FORT BRAGG	CA	95437	4506	23	06045	39.44136519	-123.7886158	Mendocino County
119861	Fee-for-Service	1669482147	1669482147	1	1	HART, CAROL S MD	6/30/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51538	40	Pediatrics	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
119868	Fee-for-Service	1699715953	1699715953	1	1	HORSTMANN, JONATHAN W MD	12/31/1978	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	41212	01	General Practice	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
119907	Fee-for-Service	1821205709	1821205709	1	3	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP OF SF VALLEY	23101 SHERMAN PLACE	SUITE 410	WEST HILLS	CA	91307	2026	19	06037	34.20099112	-118.6297991	Los Angeles County
119915	Fee-for-Service	1699772756	1699772756	1	1	HEUNG, RAYMOND C MD	12/31/1995	207RH0003X	NA	Oncology	026	PHYSICIANS	48119	41	Internal Medicine	0	In state provider	None	5222 BALBOA AVE	STE 33	SAN DIEGO	CA	92117	6953	37	06073	32.81873589	-117.1838368	San Diego County
119932	Fee-for-Service	1679338479	1679338479	1	1	HEALING HORIZONS INC.	6/1/2024	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5743 CORSA AVE	STE 112	WESTLAKE VILLAGE	CA	91362	6441	19	06037	34.156863	-118.7994295	Los Angeles County
119943	Fee-for-Service	1811982630	1811982630	1	1	HARBISON, HARRY A DPM	6/3/1986	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	ABASIA PODIATRY GROUP	2865 ATLANTIC AVE	STE 212	LONG BEACH	CA	90806	7421	19	06037	33.809418	-118.185058	Los Angeles County
119946	Fee-for-Service	1184724932	1184724932	1	1	HEINZERLING, KEITH G MD	7/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	79201	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
119976	Fee-for-Service	1003811340	1003811340	1	1	HEGDE, SUNIL K MD	8/1/1994	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	45472	25	Physical Medicine and Rehabilitation	0	In state provider	None	800 FAIRMOUNT AVE	STE 310	PASADENA	CA	91105	3153	19	06037	34.13193177	-118.1517805	Los Angeles County
120020	Fee-for-Service	1841562709	1841562709	1	1	HH KILLEEN HEALTH SYSTEM LLC	3/6/2024	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HEIGHTS	850 W CENTRAL TEXAS EXPY	None	HARKER HEIGHTS	TX	76548	1890	00	None	31.07384653	-97.68230128	Bell County
120082	Fee-for-Service	1053785022	1053785022	1	1	HANGER P & O WEST INC	11/30/2015	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 OLD RIVER ROAD	SUITE 100	BAKERSFIELD	CA	93311	9505	15	06029	35.35127492	-119.1142991	Kern County
120094	Fee-for-Service	1124512330	1124512330	1	1	HAMILTON, KACEY M MD	9/6/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	175995	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
120121	Fee-for-Service	1821645383	1821645383	1	1	HACKETT, MICHELLE M LMFT	1/17/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
120139	Fee-for-Service	1144457516	1144457516	1	1	HAWRYLYSHYN, KATHRYN A MD	2/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113687	05	Anesthesiology	0	In state provider	None	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
120144	Fee-for-Service	1316913973	1316913973	1	1	HO, DONALD MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	26123	30	Radiology	0	In state provider	None	1515 TROUSDALE DR	STE 201	BURLINGAME	CA	94010	4515	41	06081	37.59358295	-122.3841295	San Mateo County
120197	Fee-for-Service	1821205709	1821205709	1	3	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	GROUP OF SF VALLEY	23101 SHERMAN PLACE	SUITE 410	WEST HILLS	CA	91307	2026	19	06037	34.20099112	-118.6297991	Los Angeles County
120201	Fee-for-Service	1538247226	1538247226	1	1	HELMS, JEFFREY R MD	6/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76969	40	Pediatrics	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
120256	Fee-for-Service	1285634618	1285634618	1	1	HERITAGE DIABETIC SUPPLY INC	2/15/2013	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	2993 US HWY 221 N	STE A	MARLON	NC	28752	7792	00	None	35.716743	-82.04022	McDowell County
120262	Fee-for-Service	1467648428	1467648428	1	1	HAMZE, JENNIFER J L	6/27/2011	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
120279	Fee-for-Service	1538672969	1538672969	1	1	HUMBERT, KIMBERLY A CRNA	3/14/2018	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
120300	Fee-for-Service	1639100522	1639100522	2	1	HUANG, PETER D OD	11/19/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	557 H STREET	SUITE B	CHULA VISTA	CA	91910	4340	37	06073	32.63145066	-117.087815	San Diego County
120308	Fee-for-Service	1841562709	1841562709	1	1	HH KILLEEN HEALTH SYSTEM LLC	3/6/2024	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HEIGHTS	850 W CENTRAL TEXAS EXPY	None	HARKER HEIGHTS	TX	76548	1890	00	None	31.07384653	-97.68230128	Bell County
120310	Fee-for-Service	1821802182	1821802182	1	1	HEALING RHYTHMS	2/5/2025	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	12561 PALM DR	STE D	DESERT HOT SPRING	CA	92240	4521	33	06065	33.95736	-116.501348	Riverside County
120344	Fee-for-Service	1598025058	1598025058	1	1	HO, KIMBERLY T MD	1/21/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	13080	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
120398	Fee-for-Service	1750892055	1750892055	1	1	HANLEY, ERIC PSYD	4/2/2023	103T00000X	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
120404	Fee-for-Service	1881654739	1881654739	1	1	HONG, TINA S MD	2/1/1999	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64539	40	Pediatrics	0	In state provider	None	3100 TELEGRAPH AVE	None	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
120422	Fee-for-Service	1356563233	1356563233	1	1	HO, KY DPM	5/25/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3501 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2150	15	06029	35.35408422	-119.0424307	Kern County
120432	Fee-for-Service	1316913973	1316913973	1	1	HO, DONALD MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	26123	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1515 TROUSDALE DR	STE 201	BURLINGAME	CA	94010	4515	41	06081	37.59358295	-122.3841295	San Mateo County
120475	Fee-for-Service	1760407498	1760407498	1	1	HANSEN, LAWRENCE A MD	6/30/1989	207ZN0500X	NA	Other	026	PHYSICIANS	62538	02	General Surgery	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
120482	Fee-for-Service	1821205709	1821205709	1	3	HEMATOLOGY-ONCOLOGY MEDICAL	7/25/2016	193200000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	GROUP OF SF VALLEY	23101 SHERMAN PLACE	SUITE 410	WEST HILLS	CA	91307	2026	19	06037	34.20099112	-118.6297991	Los Angeles County
120487	Fee-for-Service	1396932257	1396932257	1	1	HUDSON, EVA C	6/19/2017	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
120512	Fee-for-Service	1306994926	1306994926	1	1	HEARTH-HOLMES, MICHELENE MD	9/25/2023	207RR0500X	NA	Other	026	PHYSICIANS	167219	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
120519	Fee-for-Service	1568627602	1568627602	1	1	HOLLERAN, ADAM M MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	113103	20	Orthopedic Surgery	0	In state provider	None	11190 WARNER AVE	SUITE 300	FOUNTAIN VALLEY	CA	92708	4045	30	06059	33.714	-117.9333585	Orange County
120559	Fee-for-Service	1821042979	1821042979	1	1	HCA HEALTHONE LLC	6/10/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	9191 GRANT ST	None	THORNTON	CO	80229	4361	00	None	39.86420881	-104.9846155	Adams County
120588	Fee-for-Service	1609906783	1609906783	1	1	HONG, STEVEN OD	12/17/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
120592	Fee-for-Service	1215104310	1215104310	1	1	HITO, RANIA MD	4/6/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171857	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
120596	Fee-for-Service	1588228985	1588228985	1	1	HANRIHAN, TANYA A LMFT	1/30/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3133 PROFESSIONAL DR	STE 20	AUBURN	CA	95603	2463	31	06061	38.9412	-121.100888	Placer County
120617	Fee-for-Service	1306479696	1306479696	1	1	HAFCO ELDER CARE INC	12/23/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1420 HAMPSHIRE ST	None	SAN FRANCISCO	CA	94110	4818	38	06075	37.74957775	-122.4068485	San Francisco County
120623	Fee-for-Service	1265782510	1265782510	1	2	HERNANDEZ, JURIANA LMFT	4/30/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23550 LYONS AVE	SUITE 211	NEWHALL	CA	91321	2520	19	06037	34.37938495	-118.5458635	Los Angeles County
120657	Fee-for-Service	1265705123	1265705123	1	1	HETTINGER, HEATHER	2/7/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	12522 MOORPARK ST	106	STUDIO CITY	CA	91604	1355	19	06037	34.15033253	-118.406061	Los Angeles County
120673	Fee-for-Service	1215232210	1215232210	1	1	HENNESSEY, JENNIFER M	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
120675	Fee-for-Service	1194035501	1194035501	1	1	HOAI-HUONG, HUYNH NP	10/13/2011	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	200W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.75385831	-117.1628029	San Diego County
120692	Fee-for-Service	1609845189	1609845189	1	1	HANKS, WILLIAM E MD	5/11/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31359	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
120731	Fee-for-Service	1679589766	1679589766	1	1	HESGARD, TIMOTHY LMFT	4/11/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
120762	Fee-for-Service	1760407498	1760407498	1	1	HANSEN, LAWRENCE A MD	6/30/1989	207ZN0500X	NA	Other	026	PHYSICIANS	62538	22	Pathology (M.D. only)	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
120774	Fee-for-Service	1477096105	1477096105	1	1	HAYES, KAYLA T LMFT	4/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9324 W STOCKTON BLVD	None	ELK GROVE	CA	95758	8012	34	06067	38.418309	-121.3939665	Sacramento County
120834	Fee-for-Service	1063783850	1063783850	1	1	HIGHT, MICHAEL DO	9/1/2019	171000000X	NA	Other	026	PHYSICIANS	17121	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
120845	Fee-for-Service	1821042979	1821042979	1	1	HCA HEALTHONE LLC	6/10/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	9191 GRANT ST	None	THORNTON	CO	80229	4361	00	None	39.86420881	-104.9846155	Adams County
120870	Fee-for-Service	1487705463	1487705463	1	1	HAYS, PEGGY D CRNA	5/3/2022	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
120878	Fee-for-Service	1467493676	1467493676	1	1	HASTINGS, RANDOLPH H MD	9/30/1988	207L00000X	NA	Other	026	PHYSICIANS	58695	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
120893	Fee-for-Service	1932788866	1932788866	1	1	HELD, AMANDA S	2/23/2023	104100000X	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
120894	Fee-for-Service	1386959872	1386959872	1	1	HLAING, WIN WIN MD	8/11/2022	207RN0300X	NA	Nephrology	026	PHYSICIANS	123323	None	None	0	In state provider	None	101 E BEVERLY BLVD	STE 304	MONTEBELLO	CA	90640	4316	19	06037	34.01556395	-118.0983878	Los Angeles County
120915	Fee-for-Service	1396744850	1396744850	1	1	HALL, MICHAEL J MD	5/28/2004	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	82333	08	Family Practice	0	In state provider	None	1625 SCHRADER BLVD	None	LOS ANGELES	CA	90028	6213	19	06037	34.100523	-118.3324855	Los Angeles County
120971	Fee-for-Service	1720047707	1720047707	1	1	HOFFMAN, MICHAEL L DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	10163	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	329 WEST 8TH STREET	STE 101	HANFORD	CA	93230	4533	16	06031	36.32698307	-119.6503466	Kings County
120978	Fee-for-Service	1609845189	1609845189	1	1	HANKS, WILLIAM E MD	5/11/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31359	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
120994	Fee-for-Service	1790913408	1790913408	1	1	HOU, WILLIAM MD	10/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117550	41	Internal Medicine	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
121007	Fee-for-Service	1912914482	1912914482	1	1	HORNE, JOSEPH OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	234 HEATHER CT	STE 102	TEMPLETON	CA	93465	8765	40	06079	35.55398686	-120.7176543	San Luis Obispo County
121015	Fee-for-Service	1497744999	1497744999	1	1	HUNTER III, OLIVER 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 GARTH RD	None	BAYTOWN	TX	77521	2122	00	None	29.76910842	-94.97759843	Harris County
121023	Fee-for-Service	1821094475	1821094475	1	1	HIGHT, DOUGLAS R DPM	5/16/1985	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	5400 W HILLSDALE AVE	None	VISALIA	CA	93291	8222	54	06107	36.330327	-119.351943	Tulare County
121050	Fee-for-Service	1760407498	1760407498	1	1	HANSEN, LAWRENCE A MD	6/30/1989	207ZN0500X	NA	Other	026	PHYSICIANS	62538	13	Neurology (M.D. only)	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
121195	Fee-for-Service	1831463702	1831463702	1	1	HUGHES, GERALD E JR MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34407	18	Ophthalmology	0	In state provider	MEDICAL CORP	175 N JACKSON AVE	STE 213	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
121201	Fee-for-Service	1780958967	1780958967	1	1	HADADIAN, SEDI MD	5/11/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	102620	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	23101 SHERMAN PLACE	SUITE 401	WEST HILLS	CA	91307	2028	19	06037	34.20099112	-118.6297991	Los Angeles County
121239	Fee-for-Service	1184075772	1184075772	1	1	HO, JOANNE W MD	9/10/2021	207W00000X	NA	Ophthalmology	026	PHYSICIANS	172577	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
121269	Fee-for-Service	1811377955	1811377955	1	1	HU, AUSTIN H MD	12/18/2018	207R00000X	NA	Other	026	PHYSICIANS	154632	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
121288	Fee-for-Service	1053344861	1053344861	1	1	HLAVATY,TAMARA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	601 WEST LEOTA	None	NORTH PLATTE	NE	69103	0000	00	None	41.12078954	-100.7706728	Lincoln County
121291	Fee-for-Service	1386969608	1386969608	1	1	HINDS, BRIAN R MD	6/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130130	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
121299	Fee-for-Service	1477328938	1477328938	1	1	HINES, DEVYN PT	12/4/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3901 LAS POSAS RD	STE 8	CAMARILLO	CA	93010	1502	56	06111	34.2415821	-119.0183756	Ventura County
121305	Fee-for-Service	1245628510	1245628510	1	1	HO, ALISON U DO	7/15/2022	390200000X	NA	Other	026	PHYSICIANS	14655	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
121307	Fee-for-Service	1386070472	1386070472	1	1	HANIG, JOHN L LMFT	6/13/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3150 18TH ST	207	SAN FRANCISCO	CA	94110	2074	38	06075	37.76218347	-122.4141845	San Francisco County
121309	Fee-for-Service	1447801048	1447801048	1	1	HELPING HEARTS HOME HEALTHCA	1/10/2020	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	RE CORP	1101 MARINA VILLAGE PKWY	#201	ALAMEDA	CA	94501	6472	01	06001	37.78594823	-122.2729465	Alameda County
121328	Fee-for-Service	1730470428	1730470428	1	1	HAN, BO YOUNG INC	11/15/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27100 EUCALYPTUS AVE	None	MORENO VALLEY	CA	92555	4522	33	06065	33.938001	-117.1896705	Riverside County
121350	Fee-for-Service	1740728831	1740728831	1	1	HULST, GINGER CNP	8/8/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	552256	-	NOT APPLICABLE	0	In state provider	None	11500 PARAMOUNT BLVD	None	DOWNEY	CA	90241	4350	19	06037	33.94027357	-118.139714	Los Angeles County
121379	Fee-for-Service	1508273095	1508273095	1	1	HUGHES, MARIA B DO	2/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12867	01	General Practice	0	In state provider	None	1222 PINE ST	None	ST HELENA	CA	94574	1830	28	06055	38.50589667	-122.4722577	Napa County
121432	Fee-for-Service	1417005240	1417005240	1	1	HANSEN, DUANE G MD JR	6/30/1988	207P00000X	NA	Other	026	PHYSICIANS	63236	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
121448	Fee-for-Service	1710171749	1710171749	1	1	HERITAGE ESTATES INC	7/26/1985	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1151 LOCUST AVE	None	MANTECA	CA	95337	6863	39	06077	37.78601967	-121.2263107	San Joaquin County
121467	Fee-for-Service	1750886594	1750886594	1	1	HAUSER, KAREN A MD	7/28/2021	208M00000X	NA	Other	026	PHYSICIANS	165809	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
121473	Fee-for-Service	1164928800	1164928800	1	1	HUNJAN, HARDEEP S DO	8/10/2021	207P00000X	NA	Other	026	PHYSICIANS	17704	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
121530	Fee-for-Service	1104308592	1104308592	1	1	HAWAII LIFE FLIGHT, LLC	5/21/2020	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	50 MALIHINI PL	None	WAILUKU	HI	96793	3505	00	None	20.86964522	-156.5092469	Maui County
121541	Fee-for-Service	1689891673	1689891673	1	1	HODGSON, ERIC MD	12/17/2024	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	2888 LONG BEACH BLVD	STE 400	LONG BEACH	CA	90806	1530	19	06037	33.809706	-118.189343	Los Angeles County
121552	Fee-for-Service	1164841334	1164841334	1	1	HALEVI, ALEXANDRA E MD	8/1/2022	390200000X	NA	Other	026	PHYSICIANS	178761	None	None	0	In state provider	None	3301 C ST	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
121571	Fee-for-Service	1255308086	1255308086	1	1	HUANG, ZUO M MD	8/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100595	68	Hematology	0	In state provider	None	1505 S MAIN ST	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89003052	-122.0574583	Contra Costa County
121577	Fee-for-Service	1851720320	1851720320	1	1	HOWARD, TINA T LCSW	9/1/2017	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	5969	19	06037	34.09817553	-118.293237	Los Angeles County
121580	Fee-for-Service	1093304438	1093304438	1	1	HARMONIA HOSPICE CARE LLC	8/25/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3221 N SAN FERNANDO RD	STE G	LOS ANGELES	CA	90065	1414	19	06037	34.11630202	-118.2472203	Los Angeles County
121591	Fee-for-Service	1689450090	1689450090	1	1	HOLLEY, REBECCA CCC-SLP	7/9/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2208 CAMINO RAMON	None	SAN RAMON	CA	94583	1328	07	06013	37.77746122	-121.9677166	Contra Costa County
121606	Fee-for-Service	1750309746	1750309746	1	1	HOUGEN, CHRISTOPHER A	5/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	66627	08	Family Practice	0	In state provider	None	11211 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	0000	19	06037	34.27497644	-118.4679634	Los Angeles County
121613	Fee-for-Service	1851653729	1851653729	1	1	HURLEY, RICHARD K JR MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155224	20	Orthopedic Surgery	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
121615	Fee-for-Service	1902974306	1902974306	1	1	HOUGHTALING, JOSEPH G 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
121626	Fee-for-Service	1972774958	1972774958	1	1	HO, CHRISTOPHER S MD	8/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81725	41	Internal Medicine	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
121641	Fee-for-Service	1003067620	1003067620	1	1	HALVERSON, SAMANTHA LCSW	10/24/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25500 HAWTHORNE BLVD	SUITE 1152	TORRANCE	CA	90505	6829	19	06037	33.7949648	-118.3489484	Los Angeles County
121645	Fee-for-Service	1528553930	1528553930	1	1	HOWARD, REBECCA T	12/13/2018	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 30TH ST	STE 311	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
121672	Fee-for-Service	1750305983	1750305983	1	1	HINKES, PAUL MD INC	2/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	23515	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
121693	Fee-for-Service	1528521531	1528521531	1	1	HAQUE, HUMZA 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
121697	Fee-for-Service	1134186273	1134186273	1	1	HEALTHEAST ST JOSEPH'S	7/7/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	69 EXCHANGE ST W	None	SAINT PAUL	MN	55102	1004	00	None	44.94809812	-93.09980256	Ramsey County
121701	Fee-for-Service	1437861457	1437861457	1	1	HILL, CLARESE C DOULA	2/1/2023	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
121730	Fee-for-Service	1245344720	1245344720	1	1	HOOD, KOREY K PHD	5/2/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
121745	Fee-for-Service	1578662490	1578662490	1	1	HANSUVADHA, KASEMSANT MD	2/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38775	40	Pediatrics	0	In state provider	A PROFESSIONAL CORP	963 W 7TH ST	None	OXNARD	CA	93030	6756	56	06111	34.19516388	-119.1889217	Ventura County
121752	Fee-for-Service	1144255514	1144255514	1	1	HUANG, MING-LU MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39811	33	Thoracic Surgery	0	In state provider	None	1520 SAN PABLO ST	STE 4300	LOS ANGELES	CA	90033	5330	19	06037	34.06269295	-118.2030006	Los Angeles County
121757	Fee-for-Service	1629157763	1629157763	1	1	HORBERG, MICHAEL MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	83494	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
121765	Fee-for-Service	1942247606	1942247606	1	1	HADCOCK, MARY M MD	9/16/2020	2086X0206X	NA	General Surgery	026	PHYSICIANS	52091	None	None	0	In state provider	None	1247 E ALLUVIAL AVE	SUITE 101	FRESNO	CA	93720	2686	10	06019	36.84470048	-119.7606195	Fresno County
121779	Fee-for-Service	1043451073	1043451073	1	1	HSI, RYAN S MD	6/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134875	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
121790	Fee-for-Service	1588012124	1588012124	1	3	HESHAM EL MOKADEM, MD INC.	9/30/2016	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	R	760 S WASHBURN AVE	3A	CORONA	CA	92882	3303	33	06065	33.87374611	-117.567875	Riverside County
121813	Fee-for-Service	1770710501	1770710501	1	1	HURLEY, BRIAN M MD	4/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130543	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
121830	Fee-for-Service	1689891673	1689891673	1	1	HODGSON, ERIC MD	12/17/2024	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	2888 LONG BEACH BLVD	STE 400	LONG BEACH	CA	90806	1530	19	06037	33.809706	-118.189343	Los Angeles County
121834	Fee-for-Service	1871934596	1871934596	1	1	HAWRYLUK, GREGORY W MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126826	14	Neurological Surgery	0	In state provider	None	1001 PORTERO AVE	RM 4M39	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
121860	Fee-for-Service	1255308086	1255308086	1	1	HUANG, ZUO M MD	8/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100595	78	Neoplastic Diseases/Oncology	0	In state provider	None	1505 S MAIN ST	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89003052	-122.0574583	Contra Costa County
121867	Fee-for-Service	1104566389	1104566389	1	1	HERRERA, NATHALIE MD	2/11/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
121868	Fee-for-Service	1093304438	1093304438	1	1	HARMONIA HOSPICE CARE LLC	8/25/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3221 N SAN FERNANDO RD	STE G	LOS ANGELES	CA	90065	1414	19	06037	34.11630202	-118.2472203	Los Angeles County
121875	Fee-for-Service	1497735849	1497735849	1	1	HOLTZ, JOEL MD	3/31/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	53572	08	Family Practice	0	In state provider	None	3275 SKYPARK DR	None	TORRANCE	CA	90505	5027	19	06037	33.80825394	-118.343391	Los Angeles County
121930	Fee-for-Service	1639784580	1639784580	1	1	HUMECKY, TAYLOR PT	6/2/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8790 CUYAMACA ST.	SUITE A	SANTEE	CA	92071	4295	37	06073	32.83583009	-116.9839098	San Diego County
121962	Fee-for-Service	1477501450	1477501450	1	1	HOSTETLER, KARL Y	2/1/1983	207R00000X	NA	Other	026	PHYSICIANS	32005	11	Aviation (M.D. only)	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
121964	Fee-for-Service	1184771370	1184771370	1	1	HAAS, MARCY A MD	10/8/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	89985	01	General Practice	0	In state provider	None	33025 ROAD 159	None	IVANHOE	CA	93235	1234	54	06107	36.38892365	-119.2180107	Tulare County
121978	Fee-for-Service	1487406906	1487406906	1	1	HUITRON, LESLIE OT	11/2/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	201 COLLEGE DR	203	SANTA MARIA	CA	93454	4614	42	06083	34.954461	-120.424836	Santa Barbara County
121982	Fee-for-Service	1134186273	1134186273	1	1	HEALTHEAST ST JOSEPH'S	3/1/2003	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	69 EXCHANGE ST W	None	SAINT PAUL	MN	55102	1004	00	None	44.94809812	-93.09980256	Ramsey County
121983	Fee-for-Service	1407391253	1407391253	1	1	HOFF, MARY J NP	4/9/2020	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
121986	Fee-for-Service	1962465096	1962465096	1	1	HO, ANDREW P MD	4/30/1995	2084P0800X	NA	Psychiatry	026	PHYSICIANS	76898	01	General Practice	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
122008	Fee-for-Service	1659506368	1659506368	1	1	HILL, JULIE L NP	3/18/2024	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
122009	Fee-for-Service	1770935264	1770935264	1	1	HERNANDEZ, CONSUELO L LPCC	11/4/2024	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
122010	Fee-for-Service	1508940677	1508940677	1	1	HENDERSON, SHARON E MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78029	40	Pediatrics	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
122015	Fee-for-Service	1457487738	1457487738	1	1	HOME DIALYSIS THERAPIES	5/9/2005	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO, INC	10672 WEXFORD ST	STE 250	SAN DIEGO	CA	92131	3975	37	06073	32.93895724	-117.0981469	San Diego County
122039	Fee-for-Service	1144255514	1144255514	1	1	HUANG, MING-LU MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39811	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1520 SAN PABLO ST	STE 4300	LOS ANGELES	CA	90033	5330	19	06037	34.06269295	-118.2030006	Los Angeles County
122051	Fee-for-Service	1508916321	1508916321	1	1	HOSSEINI, ATEFEH MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71064	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
122056	Fee-for-Service	1942722202	1942722202	1	1	HONOLUA BAY HOLDINGS LLC	9/1/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2120 BENTON DR	None	REDDING	CA	96003	2151	45	06089	40.59845257	-122.3999855	Shasta County
122126	Fee-for-Service	1619997624	1619997624	1	1	HOROWITZ, STEVEN E DO	9/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	4926	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
122129	Fee-for-Service	1538217823	1538217823	1	1	HOFMANN, ELAINE	9/11/2012	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
122203	Fee-for-Service	1992710768	1992710768	2	1	HERA OB-GYN MEDICAL GROUP, I	5/14/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	NC.	1552 COFFEE RD	1ST FLOOR	MODESTO	CA	95355	3107	50	06099	37.666872	-120.975684	Stanislaus County
122219	Fee-for-Service	1205881950	1205881950	1	1	HASHIMOTO, TOMOKI MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72809	05	Anesthesiology	0	In state provider	None	1001 POTRERO AVE	# 3C34	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
122226	Fee-for-Service	1154313880	1154313880	1	1	HEPPS, KENNETH S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	60798	01	General Practice	0	In state provider	None	18411 CLARK ST	STE 204	TARZANA	CA	91356	3535	19	06037	34.16981538	-118.5337442	Los Angeles County
122232	Fee-for-Service	1689864506	1689864506	1	1	HSIEH, KEVIN E MD	1/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137973	14	Neurological Surgery	0	In state provider	None	1430 22ND STREET	None	SACRAMENTO	CA	95816	5708	34	06067	38.570715	-121.4797995	Sacramento County
122236	Fee-for-Service	1417028325	1417028325	1	1	HANDLER, JOEL MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	36757	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
122273	Fee-for-Service	1710066857	1710066857	1	1	HRISTOVA, ELENA N MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79963	22	Pathology (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
122277	Fee-for-Service	1962465096	1962465096	1	1	HO, ANDREW P MD	4/30/1995	2084P0800X	NA	Psychiatry	026	PHYSICIANS	76898	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
122313	Fee-for-Service	1962451039	1962451039	1	1	HENDRIX, TINA M MD	9/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2400 S AVE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
122326	Fee-for-Service	1497784813	1497784813	1	1	HOLLY, THOMAS MD	1/29/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	170567	None	None	0	In state provider	None	9390 BIG HORN BLVD	None	ELK GROVE	CA	95758	7978	34	06067	38.420172	-121.4083485	Sacramento County
122332	Fee-for-Service	1144255514	1144255514	1	1	HUANG, MING-LU MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39811	02	General Surgery	0	In state provider	None	1520 SAN PABLO ST	STE 4300	LOS ANGELES	CA	90033	5330	19	06037	34.06269295	-118.2030006	Los Angeles County
122333	Fee-for-Service	1962538835	1962538835	1	1	HAIGH, KATHLEEN G LMFT	2/6/2024	261QM0850X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	11567 KELSEY ST	None	STUDIO CITY	CA	91604	3023	19	06037	34.14190921	-118.3847902	Los Angeles County
122353	Fee-for-Service	1861693533	1861693533	1	1	HENDERSON, GAVIN J MD	5/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108340	40	Pediatrics	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
122363	Fee-for-Service	1134148034	1134148034	1	1	HARRIS, ROBERT D MD	9/23/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	163362	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
122364	Fee-for-Service	1316483902	1316483902	1	1	HELD, MARIE C CCC-SLP	5/16/2020	235Z00000X	NA	Other	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
122455	Fee-for-Service	1255656013	1255656013	1	1	HANNAH IRENE BELL MD	10/19/2015	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
122493	Fee-for-Service	1992710768	1992710768	2	1	HERA OB-GYN MEDICAL GROUP, I	5/14/2021	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	NC.	1552 COFFEE RD	1ST FLOOR	MODESTO	CA	95355	3107	50	06099	37.666872	-120.975684	Stanislaus County
122495	Fee-for-Service	1174505721	1174505721	1	1	HERTER, AMY L LMFT	2/18/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	954 WEST FOOTHILL BLVD	SUITE A	UPLAND	CA	91786	3782	36	06071	34.10675048	-117.6646365	San Bernardino County
122504	Fee-for-Service	1790856474	1790856474	1	1	HUSAIN,AMREEN MD	8/31/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85866	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
122525	Fee-for-Service	1104027085	1104027085	1	1	HEMMINGER, ERIC J MD	4/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93721	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
122549	Fee-for-Service	1720591209	1720591209	1	1	HAWAII LIFE FLIGHT, LLC	4/22/2024	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	1156 HIALOA ST	None	HILO	HI	96720	3283	00	None	19.68545007	-155.1013201	Hawaii County
122572	Fee-for-Service	1750525028	1750525028	1	1	HECHANOVA, LISA A MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113168	41	Internal Medicine	0	In state provider	None	11370 ANDERSON	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
122583	Fee-for-Service	1811960982	1811960982	1	1	HAN, KENNETH DO	1/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	7952	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
122589	Fee-for-Service	1194254391	1194254391	1	1	HEARE, MICHELLE R	4/25/2023	2084P0804X	NA	Psychiatry	026	PHYSICIANS	158580	None	None	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
122606	Fee-for-Service	1275614455	1275614455	2	1	HUH, BRIAN N MD	9/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54802	41	Internal Medicine	0	In state provider	None	520 S VIRGIL AVE	STE 300	LOS ANGELES	CA	90020	1425	19	06037	34.064487	-118.2870305	Los Angeles County
122619	Fee-for-Service	1508861667	1508861667	1	1	HONG, ANDY MD	1/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76731	41	Internal Medicine	0	In state provider	None	16415 COLORADO AVE	STE 410	PARAMOUNT	CA	90723	0000	19	06037	33.8853075	-118.1614695	Los Angeles County
122624	Fee-for-Service	1114103892	1114103892	1	1	HRISTO HRISTOV	9/30/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9310 N CENTRAL AVE	STE 1	PHOENIX	AZ	85020	2418	00	None	33.570612	-112.0742325	Maricopa County
122651	Fee-for-Service	1962433474	1962433474	1	1	HENRY, CHRISTINE N NP	5/27/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9400 E ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
122679	Fee-for-Service	1649235219	1649235219	1	1	HARRIS, VICTORIA	11/15/2024	207PE0004X	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
122684	Fee-for-Service	1558337444	1558337444	1	1	HEMET VALLEY IMAGING	10/1/1991	174400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL GROUP, INC	1001 E LATHAM AVE	STE X	HEMET	CA	92543	4435	33	06065	33.74937254	-116.961804	Riverside County
122690	Fee-for-Service	1336303478	1336303478	1	1	HOLMES, LOLA C LMFT	8/22/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1242 PARK ST	SUITE C	ALAMEDA	CA	94501	5500	01	06001	37.76187672	-122.2447503	Alameda County
122714	Fee-for-Service	1447570031	1447570031	1	1	HIDY, BENJAMIN J MD	6/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118905	36	Psychiatry	0	In state provider	None	2185 CITRCADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
122719	Fee-for-Service	1245263953	1245263953	1	1	HAMPTON, BLANCA B MD	1/23/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45098	None	None	0	In state provider	None	1110 W LA PALMA AVENUE	SUITE 1	ANAHEIM	CA	92801	2822	30	06059	33.84712953	-117.9320355	Orange County
122755	Fee-for-Service	1972670800	1972670800	1	1	HUANG, NING MD	9/19/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76560	None	None	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
122759	Fee-for-Service	1770842841	1770842841	1	1	HOLMES, MICHAEL G MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	129223	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
122782	Fee-for-Service	1669413878	1669413878	1	1	HOROWITZ, MARK K DO	10/15/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	7642	07	Dermatology	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
122787	Fee-for-Service	1316026065	1316026065	1	1	HUYNH, MAI P MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64540	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
122801	Fee-for-Service	1962772947	1962772947	1	1	HENRIKSEN, VANESSA A	1/11/2013	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
122809	Fee-for-Service	1831799485	1831799485	1	1	HUNG, CHERLENE OT	8/6/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
122813	Fee-for-Service	1861664849	1861664849	1	1	HUH, KENNETH Y MD	1/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99455	20	Orthopedic Surgery	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
122893	Fee-for-Service	1275614455	1275614455	2	1	HUH, BRIAN N MD	9/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54802	80	UNKNOWN	0	In state provider	None	520 S VIRGIL AVE	STE 300	LOS ANGELES	CA	90020	1425	19	06037	34.064487	-118.2870305	Los Angeles County
122898	Fee-for-Service	1831270651	1831270651	1	1	HEINE, JOHN P MD	3/31/2008	208800000X	NA	Other	026	PHYSICIANS	24518	34	Urology and Urological Surgery	0	In state provider	None	1999 MOWRY AVE	STE 2M	FREMONT	CA	94538	1706	01	06001	37.55783419	-121.9808484	Alameda County
122907	Fee-for-Service	1508861667	1508861667	1	1	HONG, ANDY MD	1/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76731	45	Nephrology (Renal-Kidney)	0	In state provider	None	16415 COLORADO AVE	STE 410	PARAMOUNT	CA	90723	0000	19	06037	33.8853075	-118.1614695	Los Angeles County
122932	Fee-for-Service	1215141114	1215141114	1	1	HWANG, JASON L MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	88813	30	Radiology	0	In state provider	None	411 30TH STREET	SUITE 508	OAKLAND	CA	94609	3031	01	06001	37.81903474	-122.2649444	Alameda County
122937	Fee-for-Service	1164581583	1164581583	1	1	HAUPT, JOHN J III	9/26/1989	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	642 3RD AVE	STE G	CHULA VISTA	CA	91910	5733	37	06073	32.62949684	-117.0753169	San Diego County
122944	Fee-for-Service	1639461064	1639461064	1	1	HACOPIAN, TOMIC MD	11/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123319	22	Pathology (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
122951	Fee-for-Service	1235170440	1235170440	1	1	HIMMELVO, JANE T MD	4/12/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	95816	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
122952	Fee-for-Service	1043589351	1043589351	1	1	HILL, STEPHANIE A LCSW	10/17/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
122961	Fee-for-Service	1467474569	1467474569	1	1	HEATON, KEVIN T DO	4/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	1	Border provider	KLAMATH ORTHOPEDIC CLIN	2200 BRYANT WILLIAMS DR	FL 1	KLAMATH FALLS	OR	97601	1121	00	None	42.25198664	-121.7841082	Klamath County
123009	Fee-for-Service	1427470202	1427470202	1	1	HORIZON HOME CARE LLC	4/8/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	255 WEST FALLBROOK	SUITE 101	FRESNO	CA	93711	6151	10	06019	36.84933348	-119.796228	Fresno County
123031	Fee-for-Service	1710223623	1710223623	1	1	HEAD, SANDRA	6/28/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	18700 BEACH BLVD	SUITE 120 SUITE 110	HUNTINGTON BEACH	CA	92648	2089	30	06059	33.69070037	-117.9886896	Orange County
123096	Fee-for-Service	1235107053	1235107053	1	1	HU, SAMUEL J MD	9/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96816	20	Orthopedic Surgery	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
123148	Fee-for-Service	1982624128	1982624128	1	1	HOWARD, MARK W MD	10/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	58286	20	Orthopedic Surgery	0	In state provider	None	12 UPPER RAGSDALE	None	MONTEREY	CA	93940	7821	27	06053	36.57482436	-121.8101797	Monterey County
123171	Fee-for-Service	1508834466	1508834466	1	1	HAUGLAND, GORDON MD	11/7/2007	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	5282	00	None	33.660657	-112.3736175	Maricopa County
123175	Fee-for-Service	1679915219	1679915219	1	1	HINARD, VALERIE J LMFT	5/9/2016	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	21 TAMAL VISTA BLVD.	185	CORTE MADERA	CA	94925	1114	21	06041	37.93173997	-122.5179353	Marin County
123182	Fee-for-Service	1376821785	1376821785	1	1	HONG, JANELLA E MD	12/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142769	36	Psychiatry	0	In state provider	None	710 S BROADWAY ST	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
123196	Fee-for-Service	1023192523	1023192523	1	1	HUNT, DINA M CRNA	5/28/2010	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
123202	Fee-for-Service	1366463721	1366463721	1	1	HOLLEY, FREDERICK O MD	4/28/1999	207L00000X	NA	Other	026	PHYSICIANS	43502	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
123206	Fee-for-Service	1306929252	1306929252	1	1	HARRIS, JOHN S MD	4/25/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	3001 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1114	00	None	42.25288307	-121.7896138	Klamath County
123249	Fee-for-Service	1508397985	1508397985	1	1	HANKINS, MARGARET MD	9/25/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	184312	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
123257	Fee-for-Service	1225092463	1225092463	1	1	HEKIER, ELAN MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85321	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
123265	Fee-for-Service	1700644226	1700644226	1	1	HALL, DILLON A CRNA	8/1/2024	367500000X	NA	Other	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
123272	Fee-for-Service	1033295480	1033295480	1	1	HOLLINGSHEAD, GLENN W MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38248	08	Family Practice	0	In state provider	None	1225 15TH ST	None	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
123279	Fee-for-Service	1467636662	1467636662	1	1	HUANG, REX W MD	9/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104286	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
123280	Fee-for-Service	1659799799	1659799799	1	1	HINOHARA, TOMOYA T MD	6/6/2024	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	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
123287	Fee-for-Service	1912210329	1912210329	1	1	HULLEY, BENJAMIN JOHN MD	8/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120502	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
123288	Fee-for-Service	1306025994	1306025994	1	1	HENNING, JUDY	11/2/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	40500 MURRIETA HOT SPRIN	None	MURRIETA	CA	92563	6403	33	06065	33.55317	-117.177678	Riverside County
123304	Fee-for-Service	1528235009	1528235009	1	1	HUANG, CHING-CHIH MD INC	6/7/2007	261QM0855X	NA	Other	026	PHYSICIANS	47754	40	Pediatrics	0	In state provider	SUNSHINE PEDIATR MED GRP	756 N EUCLID AVE	STE B	ONTARIO	CA	91762	2712	36	06071	34.072335	-117.6506415	San Bernardino County
123356	Fee-for-Service	1013082403	1013082403	1	1	HO, JENNIE Y F MD	5/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	67001	01	General Practice	0	In state provider	None	800 N STATE COLLEGE BLVD	None	FULLERTON	CA	92834	6830	30	06059	33.879987	-117.886086	Orange County
123378	Fee-for-Service	1891843629	1891843629	1	1	HUSBAND, ROBERT P DO	7/31/1988	207P00000X	NA	Other	026	PHYSICIANS	5357	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
123400	Fee-for-Service	1003475039	1003475039	1	1	HWANG, DAVID DO	2/1/2023	207R00000X	NA	Other	026	PHYSICIANS	19885	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
123402	Fee-for-Service	1194832006	1194832006	1	1	HISSONG, KIMBERLY K MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139617	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
123419	Fee-for-Service	1750452710	1750452710	1	1	HYATT, JOEL D MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	34969	08	Family Practice	0	In state provider	None	1100 PACIFIC COAST HWY	None	HARBOR CITY	CA	90710	3511	19	06037	33.7899001	-118.2974971	Los Angeles County
123424	Fee-for-Service	1699051003	1699051003	1	1	HANOUNI, MONA MD	12/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112892	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
123427	Fee-for-Service	1255751764	1255751764	1	1	HANZAL, TIFFANY A LMFT	5/26/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9000 MING AVE	STE L-1B	BAKERSFIELD	CA	93311	1318	15	06029	35.33989328	-119.1034715	Kern County
123448	Fee-for-Service	1134464795	1134464795	1	1	HONG, DAVID S MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147658	78	Neoplastic Diseases/Oncology	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
123488	Fee-for-Service	1366463721	1366463721	1	1	HOLLEY, FREDERICK O MD	4/28/1999	207L00000X	NA	Other	026	PHYSICIANS	43502	01	General Practice	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
123530	Fee-for-Service	1801927876	1801927876	1	1	HSIEH, PEI-CHIN MD	10/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	93240	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	506 W VALLEY BLVD	None	SAN GABRIEL	CA	91776	3731	19	06037	34.07936003	-118.1070139	Los Angeles County
123539	Fee-for-Service	1184062960	1184062960	1	1	HERNANDEZ, EMILIO LMFT	1/10/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
123547	Fee-for-Service	1225092463	1225092463	1	1	HEKIER, ELAN MD	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85321	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
123561	Fee-for-Service	1154356822	1154356822	1	1	HESS, MICHAEL L MD	11/2/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76988	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2740 M ST	None	MERCED	CA	95340	2813	24	06047	37.31239905	-120.478839	Merced County
123582	Fee-for-Service	1902520257	1902520257	1	1	HARRIS, ALEXIA R LMFT	7/10/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29970 TECHNOLOGY DR	SUITE 111	MURRIETA	CA	92563	2647	33	06065	33.5604702	-117.1370275	Riverside County
123602	Fee-for-Service	1760580716	1760580716	1	1	HAMI, ANOOSHIRAVAN MD	7/31/1993	207R00000X	NA	Other	026	PHYSICIANS	67031	None	None	0	In state provider	None	2000 STADIUM WAY	None	LOS ANGELES	CA	90026	2606	19	06037	34.07578277	-118.248587	Los Angeles County
123633	Fee-for-Service	1962681718	1962681718	1	1	HOFER, JASON K MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97369	20	Orthopedic Surgery	0	In state provider	None	10666 N TORREY PINES RD	None	LA JOLLA	CA	92307	1027	37	06073	32.89687721	-117.2418677	San Diego County
123649	Fee-for-Service	1477746816	1477746816	1	1	HERNANDEZ, VIRGINIA MD	1/8/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174953	None	None	0	In state provider	None	892 AEROVISTA PLACE	210	SAN LUIS OBISPO	CA	93401	8252	40	06079	35.24277125	-120.6405941	San Luis Obispo County
123663	Fee-for-Service	1427083195	1427083195	1	1	HENDERSON, ROBERT W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25042	30	Radiology	0	In state provider	None	333 S HOPE ST	STE C145	LOS ANGELES	CA	90071	3019	19	06037	34.05335946	-118.2526978	Los Angeles County
123667	Fee-for-Service	1841216603	1841216603	1	1	HANSON, PETER B MD	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	61117	20	Orthopedic Surgery	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
123671	Fee-for-Service	1245762715	1245762715	1	1	HUSSAIN, BATOOL A MD	2/9/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	164915	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
123686	Fee-for-Service	1164714853	1164714853	1	1	HSIEH, ROBERT W MD	11/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114705	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTUER DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
123690	Fee-for-Service	1194832006	1194832006	1	1	HISSONG, KIMBERLY K MD	2/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139617	40	Pediatrics	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
123732	Fee-for-Service	1316509797	1316509797	1	1	HWANG, HELEN H	7/12/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	355 E PHILLIPS BOULEVARD	None	POMONA	CA	91766	4570	19	06037	34.04429361	-117.7467882	Los Angeles County
123738	Fee-for-Service	1134464795	1134464795	1	1	HONG, DAVID S MD	7/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147658	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
123762	Fee-for-Service	1255759254	1255759254	1	1	HIGGINS, KENNETH E MD	11/19/2019	207L00000X	NA	Other	026	PHYSICIANS	143196	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
123772	Fee-for-Service	1437158136	1437158136	1	1	HINO, STANLEY T MD	7/3/1997	207ZP0102X	NA	Other	026	PHYSICIANS	46039	None	None	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
123775	Fee-for-Service	1487691143	1487691143	1	1	HU, BENJAMIN B MD	4/30/1995	207L00000X	NA	Other	026	PHYSICIANS	79626	05	Anesthesiology	0	In state provider	None	1600 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3010	38	06075	37.78475261	-122.43973	San Francisco County
123792	Fee-for-Service	1194169763	1194169763	1	1	HAQ, HEATHER A MD	4/1/2021	208000000X	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
123809	Fee-for-Service	1942371901	1942371901	1	1	HARTMAN, PAUL E MD	4/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50700	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
123812	Fee-for-Service	1043435548	1043435548	1	1	HOLWITT, DANA M MD	12/21/2022	208600000X	NA	General Surgery	026	PHYSICIANS	183542	None	None	0	In state provider	None	782 MEDICAL CENTER DR	101	CLOVIS	CA	93611	6889	10	06019	36.84379626	-119.6609117	Fresno County
123865	Fee-for-Service	1386617124	1386617124	1	1	HIEB, LEE D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	1	Border provider	None	1951 W 25TH ST	None	YUMA	AZ	85364	6925	00	None	32.681853	-114.6435705	Yuma County
123878	Fee-for-Service	1285385849	1285385849	1	2	HOFFMAN, KERRY LMFT	8/13/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	40123	-	NOT APPLICABLE	0	In state provider	None	2100 PIERPONT BLVD	None	VENTURA	CA	93001	3861	56	06111	34.26711733	-119.2746188	Ventura County
123885	Fee-for-Service	1801038658	1801038658	1	1	HALL, ARTHUR L PSYD	1/27/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
123886	Fee-for-Service	1811235666	1811235666	1	1	HUCKABEE, IRINA P CRNA	12/15/2014	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
123943	Fee-for-Service	1376536672	1376536672	1	1	HYE PHARMACY, INC	4/5/1996	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12509 VICTORY BLVD	None	NORTH HOLLYWOOD	CA	91606	3135	19	06037	34.18670353	-118.405791	Los Angeles County
123964	Fee-for-Service	1306801352	1306801352	1	1	HOFFMAN, CLEMENT P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32353	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
123973	Fee-for-Service	1164714853	1164714853	1	1	HSIEH, ROBERT W MD	11/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114705	41	Internal Medicine	0	In state provider	None	300 PASTUER DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
123987	Fee-for-Service	1174063556	1174063556	1	1	HEAGERTY, LORI M LMFT	4/29/2024	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
124014	Fee-for-Service	1962860676	1962860676	1	1	HOLTKAMP, MITCHELL PT	5/12/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1044 MANGROVE AVE	None	CHICO	CA	95926	3509	04	06007	39.74053676	-121.8373879	Butte County
124021	Fee-for-Service	1316509797	1316509797	1	1	HWANG, HELEN H	7/12/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	355 E PHILLIPS BOULEVARD	None	POMONA	CA	91766	4570	19	06037	34.04429361	-117.7467882	Los Angeles County
124033	Fee-for-Service	1205903135	1205903135	1	1	HSUEH, MING KANG MD	2/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85679	42	Nuclear Medicine	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
124037	Fee-for-Service	1558588939	1558588939	1	1	HOLUBAR, MARISA K MD	7/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110386	77	Infectious Disease	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
124047	Fee-for-Service	1275547549	1275547549	1	1	HOODA, SHAMSUDDIN N PA	10/6/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	15628	-	NOT APPLICABLE	0	In state provider	None	2650 JONES WAY	SUITE 10	SIMI VALLEY	CA	93065	1215	56	06111	34.28861251	-118.745991	Ventura County
124053	Fee-for-Service	1295241537	1295241537	1	1	HEIM, JESSICA L PT	11/6/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1626 SWEETWATER	SUITES A & B	NATIONAL CITY	CA	91950	7645	37	06073	32.66147525	-117.0818981	San Diego County
124071	Fee-for-Service	1013558089	1013558089	1	1	HOBURN, MONETTE	7/21/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
124075	Fee-for-Service	1235446519	1235446519	1	1	HUNT, ALICIA M LCSW	3/31/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	3186	19	06037	34.1665161	-118.3755868	Los Angeles County
124110	Fee-for-Service	1407860299	1407860299	1	1	HUANG, BRADY K MD	10/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108832	30	Radiology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
124125	Fee-for-Service	1285166405	1285166405	1	1	HICKEY, SEAN M MD	9/1/2023	207LC0200X	NA	Other	026	PHYSICIANS	171790	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
124175	Fee-for-Service	1013306661	1013306661	1	1	HOLLANDER, NATTAN LMFT	6/11/2024	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
124176	Fee-for-Service	1851790893	1851790893	1	1	HSU, GRACE W OD	2/23/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	661 N EUCLID ST	None	ANAHEIM	CA	92801	4622	30	06059	33.840603	-117.943902	Orange County
124197	Fee-for-Service	1720626229	1720626229	1	1	HUMES, SHARON	12/31/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	5850 ESTRELLA AVE	None	LOS ANGELES	CA	90044	6322	19	06037	33.98826449	-118.2848525	Los Angeles County
124199	Fee-for-Service	1215108782	1215108782	1	1	HAGGERTY, KEVIN M MD	1/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102085	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
124206	Fee-for-Service	1962723643	1962723643	1	1	HUMMEL, DEBORAH L NP	4/21/2017	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
124234	Fee-for-Service	1962795443	1962795443	1	1	HUANG, SHIHYAU G MD	8/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111880	None	None	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
124291	Fee-for-Service	1457304594	1457304594	1	1	HAND SURGERY ASSOCIATES	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	46	Hand Surgery	0	In state provider	A MEDICAL GRP INC	1201 ALHAMBRA BLVD	STE 410	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
124294	Fee-for-Service	1215714183	1215714183	1	1	HARDIN, APRIL E CNP	12/7/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
124309	Fee-for-Service	1417923533	1417923533	1	1	HOYT, LAURA 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	347 SMITH AVE N	None	SAINT PAUL	MN	55102	2387	00	None	44.94164123	-93.10866966	Ramsey County
124320	Fee-for-Service	1205903135	1205903135	1	1	HSUEH, MING KANG MD	2/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85679	30	Radiology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
124325	Fee-for-Service	1558588939	1558588939	1	1	HOLUBAR, MARISA K MD	7/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110386	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
124333	Fee-for-Service	1710985437	1710985437	1	1	HAMID, RUKAIYA K MD	3/3/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	42491	05	Anesthesiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
124378	Fee-for-Service	1033850706	1033850706	1	1	HO, AARON DO	11/16/2024	207P00000X	NA	Other	026	PHYSICIANS	21893	66	Emergency Medicine (Urgent Care)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
124380	Fee-for-Service	1275533481	1275533481	1	1	HUSSAIN, AHMED MD	10/7/2022	208800000X	NA	Other	026	PHYSICIANS	52122	None	None	0	In state provider	None	2333 MOWRY AVE	STE 300	FREMONT	CA	94538	1602	01	06001	37.55614438	-121.9822469	Alameda County
124397	Fee-for-Service	1376580373	1376580373	1	1	HYER, KEVIN C MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
124410	Fee-for-Service	1518589357	1518589357	1	1	HASSAN J AZIMI MD INC	12/24/2020	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	8008 FROST ST	403	SAN DIEGO	CA	92123	4209	37	06073	32.80027859	-117.1524832	San Diego County
124463	Fee-for-Service	1972670826	1972670826	1	1	HOWITT, LORETTA Y MD	4/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	60887	36	Psychiatry	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
124487	Fee-for-Service	1720626229	1720626229	1	1	HUMES, SHARON	12/31/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	5850 ESTRELLA AVE	None	LOS ANGELES	CA	90044	6322	19	06037	33.98826449	-118.2848525	Los Angeles County
124494	Fee-for-Service	1740439967	1740439967	1	1	HUANG, THOMAS L MD	10/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90503	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
124513	Fee-for-Service	1063741106	1063741106	1	1	HARO, PATRICIA ANNE Y MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124044	41	Internal Medicine	0	In state provider	None	4053 LONE TREE WAY	STE 101	ANTIOCH	CA	94531	6200	07	06013	37.97569499	-121.800733	Contra Costa County
124578	Fee-for-Service	1457304594	1457304594	1	1	HAND SURGERY ASSOCIATES	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	A MEDICAL GRP INC	1201 ALHAMBRA BLVD	STE 410	SACRAMENTO	CA	95816	5243	34	06067	38.570076	-121.4657145	Sacramento County
124605	Fee-for-Service	1194777144	1194777144	1	1	HO, SAMUEL B MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	57012	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
124644	Fee-for-Service	1336611458	1336611458	1	1	HOLLOWAY, LOLETTA M LMFT	7/15/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ILY THERAPY SERVICES	190 S ORCHARD AVE	A107	VACAVILLE	CA	95688	3647	48	06095	38.358945	-122.004786	Solano County
124662	Fee-for-Service	1790853125	1790853125	1	1	HAGEN, ELIZA C MD	9/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142544	13	Neurology (M.D. only)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
124676	Fee-for-Service	1295304178	1295304178	1	1	HORTON, MICHELLE CRNA	8/26/2021	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
124683	Fee-for-Service	1518041235	1518041235	1	1	HOWARD S LEWIS, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	550 17TH AVE	STE 680	SEATTLE	WA	98122	5795	00	None	47.60689769	-122.3102467	King County
124684	Fee-for-Service	1649781121	1649781121	1	1	HEALING SOURCE MEDICAL, INC.	7/24/2019	261QM0801X	NA	Other	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	1601 DOVE ST STE 185	None	NEWPORT BEACH	CA	92660	2441	30	06059	33.66438646	-117.8660587	Orange County
124699	Fee-for-Service	1619337029	1619337029	1	1	H&H PHARMACY SERVICES INC	3/28/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1801 W ROMNEYA DR	SUITE 108	ANAHEIM	CA	92081	1824	30	06059	33.8506615	-117.946413	Orange County
124703	Fee-for-Service	1154746964	1154746964	1	1	HIZON MEDICAL CORPORATION	8/16/2018	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	25495 MEDICAL CENTER DR	SUITE 305	MURRIETA	CA	92562	4902	33	06065	33.55804188	-117.1834064	Riverside County
124707	Fee-for-Service	1083733695	1083733695	1	1	HAUPTSCHEIN, MARTIN MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	46619	41	Internal Medicine	0	In state provider	None	1550 REEVES ST	None	LOS ANGELES	CA	90035	2929	19	06037	34.05104832	-118.3964278	Los Angeles County
124726	Fee-for-Service	1740627843	1740627843	1	1	HOUSE OF HOPE FOUNDATION INC	7/7/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	205 WEST 9TH STREET	None	SAN PEDRO	CA	90731	3711	19	06037	33.7359805	-118.281609	Los Angeles County
124733	Fee-for-Service	1477782910	1477782910	1	1	HOSURU, SURESH B MD	8/13/2018	207R00000X	NA	Other	026	PHYSICIANS	137688	41	Internal Medicine	0	In state provider	None	2505 W HAMMER LN	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
124766	Fee-for-Service	1891105375	1891105375	1	1	HAVARD, ALEXANDRA L MD	6/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140844	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MED PLAZA	STE 430	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
124782	Fee-for-Service	1073931036	1073931036	1	1	HANSON, RYAN E MD	5/14/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	161061	13	Neurology (M.D. only)	0	In state provider	None	888 S HILL ROAD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
124831	Fee-for-Service	1982939955	1982939955	1	1	HAMPSON, LINDSAY A MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	114428	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
124847	Fee-for-Service	1639200272	1639200272	1	1	HEMMINGER, JENNIFER L LCSW	3/22/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18144 SECO STREET	None	JAMESTOWN	CA	95327	9737	55	06109	37.95208073	-120.4216785	Tuolumne County
124868	Fee-for-Service	1679636518	1679636518	1	1	HUI, CINDY CHING WAH OD	9/21/2005	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	377 E CHAPMAN AVE	STE 240	PLACENTIA	CA	92870	5091	30	06059	33.87122847	-117.8635161	Orange County
124896	Fee-for-Service	1194777144	1194777144	1	1	HO, SAMUEL B MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	57012	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
124943	Fee-for-Service	1841220258	1841220258	1	1	HAHN, ALBERT I MD	3/9/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	62354	None	None	0	In state provider	None	191 S BUENA VISTA STREET	SUITE 420-440	BURBANK	CA	91505	4551	19	06037	34.15872557	-118.3283863	Los Angeles County
124948	Fee-for-Service	1104189000	1104189000	1	1	HARRISON, DAVID Z MD	11/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127729	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7901 FROST STREET	None	SAN DIEGO	CA	92123	2788	37	06073	32.8002375	-117.1546269	San Diego County
124960	Fee-for-Service	1609967116	1609967116	1	1	HSU, LINDA P MD	6/1/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	38	Geriatrics	0	In state provider	A PRO FESIONAL CORP	10230 E ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
124991	Fee-for-Service	1285937839	1285937839	1	1	HEMMERT, ROGER LCSW	10/1/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	415 KNOLLCREST DR	STE 101	REDDING	CA	96002	0181	45	06089	40.57267376	-122.3643496	Shasta County
125033	Fee-for-Service	1336317205	1336317205	1	1	HOLLOWAY, EARL L MD INC	5/27/2016	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	18104	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3318 ELM STREET	SUITE 2	OAKLAND	CA	94609	3001	01	06001	37.82171753	-122.2652776	Alameda County
125035	Fee-for-Service	1457447393	1457447393	1	1	HOGAN, ANJANETTE MD INC	12/7/2005	261QP2300X	NA	Other	026	PHYSICIANS	73220	40	Pediatrics	0	In state provider	None	1141 W REDONDO BCH	STE 409	GARDENA	CA	90247	3528	19	06037	33.89247036	-118.2941482	Los Angeles County
125051	Fee-for-Service	1912902677	1912902677	1	1	HAYES, GEORGE	11/5/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	42817	None	None	0	In state provider	None	199 E WEBSTER ST	None	COLUSA	CA	95932	2954	06	06011	39.20737704	-122.0004043	Colusa County
125088	Fee-for-Service	1215005525	1215005525	1	1	HAILEMARIAM, ELENI MD	2/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54450	79	Neurology-Child	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
125094	Fee-for-Service	1063473486	1063473486	1	1	HARRISON, SCOTT R MD	1/22/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	71664	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
125142	Fee-for-Service	1104121342	1104121342	1	1	HOLSTON, JESSECA LMFT	11/5/2024	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
125162	Fee-for-Service	1730464918	1730464918	1	1	HWAN Z. SUK, M.D., CORPORATI	10/13/2004	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	ON	1560 E CHEVY CHASE	240	GLENDALE	CA	91206	4197	19	06037	34.15290734	-118.2302295	Los Angeles County
125170	Fee-for-Service	1598183451	1598183451	1	1	HANNA, MARIA N MD	3/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140389	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
125172	Fee-for-Service	1073655841	1073655841	1	2	HEKMAT, FARAH L MD	4/6/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	14673 PARTHENIA ST	STE 110	PANORAMA CITY	CA	91402	2991	19	06037	34.22819333	-118.4523118	Los Angeles County
125223	Fee-for-Service	1548498744	1548498744	1	1	HUSSAIN, TANVIR MD	10/9/2018	207R00000X	NA	Other	026	PHYSICIANS	155360	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
125246	Fee-for-Service	1609967116	1609967116	1	1	HSU, LINDA P MD	6/1/2007	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A PRO FESIONAL CORP	10230 E ARTESIA BLVD	STE 104	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
125293	Fee-for-Service	1891882833	1891882833	1	1	HILLCREST BAPTIST MEDICAL CE	7/11/2021	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER HILLCREST	100 HILLCREST MEDICAL BL	None	WACO	TX	76712	8897	00	None	31.48901333	-97.15696333	McLennan County
125299	Fee-for-Service	1255988200	1255988200	1	1	HERNANDEZ, EDGAR A PT	6/1/2023	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
125304	Fee-for-Service	1467625491	1467625491	1	1	HATTANGADI-GLUTH, JONA A MD	11/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122308	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
125309	Fee-for-Service	1417909615	1417909615	1	1	HICKEY, ANN ELIZABETH MD	3/1/1998	174400000X	NA	Other	026	PHYSICIANS	46361	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
125321	Fee-for-Service	1952557332	1952557332	1	1	HIREMATH MALLIKARJUN,	5/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115159	40	Pediatrics	0	In state provider	GURUMURTHY MD	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
125372	Fee-for-Service	1215005525	1215005525	1	1	HAILEMARIAM, ELENI MD	2/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54450	36	Psychiatry	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
125375	Fee-for-Service	1487018255	1487018255	1	1	HUSSAIN, MOHAMMED S MD	6/22/2021	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	171155	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
125396	Fee-for-Service	1720130529	1720130529	1	1	HSIEH-PARK, VANNESSA L MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67075	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
125398	Fee-for-Service	1184710063	1184710063	1	1	HORODYSKI, JAMES T MD	11/1/2000	207P00000X	NA	Other	026	PHYSICIANS	68731	41	Internal Medicine	0	In state provider	None	6144 COFFEE RD	None	MODESTO	CA	95357	0821	50	06099	37.72900729	-120.9768377	Stanislaus County
125413	Fee-for-Service	1386831220	1386831220	1	1	HANSEN, JENNA A MD	6/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	101345	05	Anesthesiology	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
125440	Fee-for-Service	1376195180	1376195180	1	1	HON, SIMSON MD	9/13/2024	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
125451	Fee-for-Service	1093886855	1093886855	1	1	HONOLD JOSE	8/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51798	40	Pediatrics	0	In state provider	CALIF NEONATOLOGY SERV	514 N PROSPECT AVE	None	REDONDO BEACH	CA	90277	3036	19	06037	33.85253987	-118.3796668	Los Angeles County
125454	Fee-for-Service	1720251911	1720251911	1	1	HALIKO, SHANNON A MD	9/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145242	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
125460	Fee-for-Service	1801186671	1801186671	1	1	HOANG, NGOC B MD	12/10/2021	207P00000X	NA	Other	026	PHYSICIANS	174116	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
125528	Fee-for-Service	1447241039	1447241039	1	1	HARMS, STEPHEN A DO	8/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6556	01	General Practice	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
125535	Fee-for-Service	1144385766	1144385766	1	2	HY PHUNG NGO MD INC	10/22/2008	207R00000X	NA	Other	026	PHYSICIANS	69736	None	None	0	In state provider	None	5801 S FIGUEROA STREET	None	LOS ANGELES	CA	90003	1016	19	06037	33.98958	-118.2827085	Los Angeles County
125548	Fee-for-Service	1962539346	1962539346	1	1	HUHN STEPHEN L	12/18/1995	207T00000X	NA	General Surgery	026	PHYSICIANS	76900	None	None	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
125553	Fee-for-Service	1548859606	1548859606	1	1	HANNAH HOSPICE AND PALITIVE	12/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	4314 W SLAUSON AVE	STE 8 A	LOS ANGELES	CA	90043	2808	19	06037	33.98885257	-118.3509655	Los Angeles County
125578	Fee-for-Service	1891882833	1891882833	1	1	HILLCREST BAPTIST MEDICAL CE	7/11/2021	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CENTER HILLCREST	100 HILLCREST MEDICAL BL	None	WACO	TX	76712	8897	00	None	31.48901333	-97.15696333	McLennan County
125595	Fee-for-Service	1467625491	1467625491	1	1	HATTANGADI-GLUTH, JONA A MD	11/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122308	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
125602	Fee-for-Service	1982828554	1982828554	1	1	HEAD NECK MED & FACIAL	11/20/2008	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PLASTIC SURGERY INC	1300 N VERMONT AVE	STE 604	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
125607	Fee-for-Service	1952557332	1952557332	1	1	HIREMATH MALLIKARJUN,	5/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115159	06	Cardiovascular Disease (M.D. only)	0	In state provider	GURUMURTHY MD	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
125615	Fee-for-Service	1952761454	1952761454	1	1	HEALTHRIGHT 360	4/27/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1341 N ESCONDIDO BLVD	None	ESCONDIDO	CA	92026	2507	37	06073	33.14046993	-117.0924096	San Diego County
125635	Fee-for-Service	1417062159	1417062159	1	2	HUYNH, THANG T	10/16/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14541 BROOKHURST ST	STE C 11	WESTMINSTER	CA	92683	7846	30	06059	33.75135	-117.954936	Orange County
125644	Fee-for-Service	1548427941	1548427941	1	1	HALL, TRACY D NP	1/2/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
125653	Fee-for-Service	1124175310	1124175310	1	1	HIGGINS, ANNE B PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2120 PROFESSIONAL DRIVE	None	ROSEVILLE	CA	95661	3700	31	06061	38.74247397	-121.2508672	Placer County
125717	Fee-for-Service	1407387814	1407387814	1	1	HICKERSON, HOLLY A OD	1/11/2019	152W00000X	NA	Other	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
125724	Fee-for-Service	1689600090	1689600090	1	1	HATWALKAR, ARUN S MD	7/10/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83226	41	Internal Medicine	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
125739	Fee-for-Service	1093886855	1093886855	1	1	HONOLD JOSE	8/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51798	66	Emergency Medicine (Urgent Care)	0	In state provider	CALIF NEONATOLOGY SERV	514 N PROSPECT AVE	None	REDONDO BEACH	CA	90277	3036	19	06037	33.85253987	-118.3796668	Los Angeles County
125740	Fee-for-Service	1720251911	1720251911	1	1	HALIKO, SHANNON A MD	9/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145242	41	Internal Medicine	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
125780	Fee-for-Service	1174048607	1174048607	1	1	HARPER, ALINA R NP	11/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
125805	Fee-for-Service	1487650040	1487650040	1	1	HARDIE, RICHARD 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	1205 S GRANGE AVE	STE 407	SIOUX FALLS	SD	57105	0410	00	None	43.534575	-96.742845	Minnehaha County
125822	Fee-for-Service	1790933570	1790933570	1	1	HILL, ERIK N MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115746	30	Radiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
125824	Fee-for-Service	1558395558	1558395558	1	1	HOCKO, JANET M MD	1/31/1993	2085R0001X	NA	Other	026	PHYSICIANS	67108	30	Radiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
125825	Fee-for-Service	1306126339	1306126339	1	1	HEALTH ESSENTIALS LLC	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	560 E HOSPITALITY	STE 300	SAN BERNARDINO	CA	92408	3546	36	06071	34.06629273	-117.2738513	San Bernardino County
125841	Fee-for-Service	1548859606	1548859606	1	1	HANNAH HOSPICE AND PALITIVE	12/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	4314 W SLAUSON AVE	STE 8 A	LOS ANGELES	CA	90043	2808	19	06037	33.98885257	-118.3509655	Los Angeles County
125881	Fee-for-Service	1508101585	1508101585	1	1	HOM, ALLISON M PT	1/27/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3215 CALIFORNIA STREET	4	STOCKTON	CA	95204	3433	39	06077	37.98127088	-121.2934355	San Joaquin County
125935	Fee-for-Service	1164984555	1164984555	1	1	HOWARD, ABIGAIL K MD	12/12/2023	207L00000X	NA	Other	026	PHYSICIANS	181361	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
126012	Fee-for-Service	1689600090	1689600090	1	1	HATWALKAR, ARUN S MD	7/10/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83226	01	General Practice	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
126020	Fee-for-Service	1396746228	1396746228	1	1	HIGH POINT REGIONAL HEALTH	4/9/2001	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SYSTEM	601 N ELM ST	None	HIGH POINT	NC	27262	4331	00	None	35.962947	-80.0134155	Guilford County
126038	Fee-for-Service	1770523995	1770523995	1	1	HOCH, JOHN R MD	12/31/1990	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	70570	08	Family Practice	0	In state provider	None	13391 CALIFORNIA ST	STE 1	YUCAIPA	CA	92399	5105	36	06071	34.010847	-117.038842	San Bernardino County
126041	Fee-for-Service	1487755542	1487755542	1	1	HILL, ALLISON A MD	1/11/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60760	None	None	0	In state provider	None	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
126087	Fee-for-Service	1689628083	1689628083	1	1	HITTLE, TED A MD	11/30/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	50541	30	Radiology	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
126100	Fee-for-Service	1659573889	1659573889	1	1	HEYBORNE, RAYAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1512 12TH AVE RD	None	NAMPA	ID	83686	0000	00	None	43.55346193	-116.5727785	Canyon County
126104	Fee-for-Service	1851853055	1851853055	1	1	HALMAN, ERIN M MD	6/30/2023	2081H0002X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	186168	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
126109	Fee-for-Service	1881772689	1881772689	1	1	HATCH, JOSHUA D MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	81835	20	Orthopedic Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
126117	Fee-for-Service	1306126339	1306126339	1	1	HEALTH ESSENTIALS LLC	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	560 E HOSPITALITY	STE 300	SAN BERNARDINO	CA	92408	3546	36	06071	34.06629273	-117.2738513	San Bernardino County
126159	Fee-for-Service	1356360929	1356360929	1	1	HENRY, MELANIE M MD	9/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	81865	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
126160	Fee-for-Service	1518129972	1518129972	1	1	HAGGAG, AMINA Z MD	10/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114940	08	Family Practice	0	In state provider	None	441 N LAKVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
126165	Fee-for-Service	1013917483	1013917483	1	1	HERNDON HEALTHCARE INC	5/1/2001	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HERNDON PHARMACY	1827 E FIR AVE	STE 101	FRESNO	CA	93720	3841	10	06019	36.83911549	-119.749248	Fresno County
126167	Fee-for-Service	1174649263	1174649263	1	1	HERNANDEZ, LILIANA LMFT	5/9/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	110 NORTH MACLAY AVENUE	108	SAN FERNANDO	CA	91340	2989	19	06037	34.28449525	-118.4396137	Los Angeles County
126209	Fee-for-Service	1528230679	1528230679	1	1	HERSCU, GABRIEL MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	98129	84	Surgery-Head and Neck	0	In state provider	None	39141 CIVIC CENTER DR	STE 335	FREMONT	CA	94538	5878	01	06001	37.55436307	-121.9764708	Alameda County
126219	Fee-for-Service	1588028021	1588028021	1	1	HOUSE, ADRIAN E MD	1/25/2023	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	155304	None	None	0	In state provider	None	1001 POTRERO AVE	RM 4M45	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
126222	Fee-for-Service	1629615638	1629615638	1	1	HAN, SARAH J 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
126227	Fee-for-Service	1932272994	1932272994	1	1	HASSAN, MAGDA A MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	35725	05	Anesthesiology	0	In state provider	None	725 S ORANGE AVE	None	WEST COVINA	CA	91790	2614	19	06037	34.07079634	-117.9445034	Los Angeles County
126253	Fee-for-Service	1093920928	1093920928	1	1	HILL, JAMES A MD	7/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136758	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	5609 J ST	STE A	SACRAMENTO	CA	95819	3957	34	06067	38.564829	-121.434228	Sacramento County
126275	Fee-for-Service	1598836405	1598836405	1	1	HOUSHIAR, AMIR M MD	8/1/1998	208800000X	NA	Other	026	PHYSICIANS	78355	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
126294	Fee-for-Service	1386918548	1386918548	1	1	HUFFMAN, KATHERINE B MD	8/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120338	40	Pediatrics	0	In state provider	None	1332 PARK ST	STE 200	ALAMEDA	CA	94501	4553	01	06001	37.76330843	-122.2435444	Alameda County
126299	Fee-for-Service	1649384553	1649384553	1	1	HICKS, GREGORY B MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43909	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10622 PETUNIA LN	None	PALO CEDRO	CA	96073	9776	45	06089	40.59677943	-122.2515531	Shasta County
126302	Fee-for-Service	1720211279	1720211279	1	1	HEUBLEIN, MOLLY R MD	7/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120931	44	Public Health	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
126306	Fee-for-Service	1396746228	1396746228	1	1	HIGH POINT REGIONAL HEALTH	4/9/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	SYSTEM	601 N ELM ST	None	HIGH POINT	NC	27262	4331	00	None	35.962947	-80.0134155	Guilford County
126313	Fee-for-Service	1164604195	1164604195	1	1	HANSEN, ERICA D MD	12/24/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	101874	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	3191	07	06013	38.00771973	-122.1331484	Contra Costa County
126330	Fee-for-Service	1316914179	1316914179	1	1	HARRIS, RICHARD E MD	4/28/1999	207L00000X	NA	Other	026	PHYSICIANS	34175	05	Anesthesiology	0	In state provider	None	3281 PEARL LN	None	OCEANSIDE	CA	92056	4114	37	06073	33.18396873	-117.3024706	San Diego County
126337	Fee-for-Service	1972551356	1972551356	1	1	HONG, JOE C MD	5/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85257	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
126391	Fee-for-Service	1609856582	1609856582	1	1	HART, WILLIAM T MD	4/30/1987	207RP1001X	NA	Pulmonology	026	PHYSICIANS	62162	08	Family Practice	0	In state provider	None	520 E CENTER ST	None	MANTECA	CA	95336	4720	39	06077	37.79906255	-121.2105195	San Joaquin County
126432	Fee-for-Service	1952622557	1952622557	1	1	HOWLETT, JONATHON R MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121691	36	Psychiatry	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
126469	Fee-for-Service	1811457799	1811457799	1	1	HUA, PHOEBE T MD	3/7/2025	2084P0804X	NA	Psychiatry	026	PHYSICIANS	178090	36	Psychiatry	0	In state provider	None	23700 CAMINO DEL SOL	None	TORRANCE	CA	90505	5017	19	06037	33.8102385	-118.3441185	Los Angeles County
126479	Fee-for-Service	1699085290	1699085290	1	1	HISTOPATHOLOGY SERVICES INC	9/25/2013	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	15012 RED HILL AVENUE	SUITE H	TUSTIN	CA	92780	6524	30	06059	33.72079846	-117.8280915	Orange County
126490	Fee-for-Service	1972643906	1972643906	1	1	HANSEN, ROBERT B MD	9/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	97152	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
126529	Fee-for-Service	1790868735	1790868735	1	1	HANSEN, DOYLE D MD	7/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39762	07	Dermatology	0	In state provider	None	1625 E MAIN ST	STE 206	EL CAJON	CA	92021	5224	37	06073	32.80969963	-116.9203429	San Diego County
126536	Fee-for-Service	1336109768	1336109768	1	1	HOSPITAL SERVICE DISTRICT	9/4/2018	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	NO 1-A OF THE PARISH OF	407 CINCINNATI STREET	None	DELHI	LA	71232	3007	00	None	32.452785	-91.493991	Richland Parish
126558	Fee-for-Service	1447324678	1447324678	1	2	HENRY, MICHAEL J MD	4/22/2024	174400000X	NA	Other	026	PHYSICIANS	40497	25	Physical Medicine and Rehabilitation	0	In state provider	None	648 NORTHFIELD DR	None	SACRAMENTO	CA	95833	2442	34	06067	38.607786	-121.47723	Sacramento County
126588	Fee-for-Service	1649384553	1649384553	1	1	HICKS, GREGORY B MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	43909	08	Family Practice	0	In state provider	None	10622 PETUNIA LN	None	PALO CEDRO	CA	96073	9776	45	06089	40.59677943	-122.2515531	Shasta County
126640	Fee-for-Service	1831359801	1831359801	1	1	HANDLER, ETHAN B MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	112649	84	Surgery-Head and Neck	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
126656	Fee-for-Service	1093294738	1093294738	1	1	HAMMOND, LAUREN LMFT	1/16/2023	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
126679	Fee-for-Service	1609856582	1609856582	1	1	HART, WILLIAM T MD	4/30/1987	207RP1001X	NA	Pulmonology	026	PHYSICIANS	62162	66	Emergency Medicine (Urgent Care)	0	In state provider	None	520 E CENTER ST	None	MANTECA	CA	95336	4720	39	06077	37.79906255	-121.2105195	San Joaquin County
126714	Fee-for-Service	1114914397	1114914397	1	1	HALIKIS, MARK N MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	68749	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
126718	Fee-for-Service	1952622557	1952622557	1	1	HOWLETT, JONATHON R MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	121691	13	Neurology (M.D. only)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
126726	Fee-for-Service	1427234921	1427234921	1	1	HORIZON SERVICES INC	10/18/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2035 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1088	01	06001	37.71033965	-122.1212739	Alameda County
126732	Fee-for-Service	1073762613	1073762613	1	2	HENSLEY, SONYA S LCSW	3/22/2017	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
126784	Fee-for-Service	1912085788	1912085788	1	1	HAYWARD, JEAN C	10/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	51721	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
126825	Fee-for-Service	1275710279	1275710279	1	1	HERNANDEZ, VERONICA LMFT	3/16/2022	1041C0700X	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
126848	Fee-for-Service	1861855694	1861855694	1	1	HEMAL, KSHITIJ MD	7/7/2022	208800000X	NA	Other	026	PHYSICIANS	177355	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
126884	Fee-for-Service	1558600122	1558600122	1	1	HOUSER, ELKE A NP	2/6/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1090 3RD ST	None	SOUTH LAKE TAHOE	CA	96150	3462	09	06017	38.91492536	-119.9966528	El Dorado County
126911	Fee-for-Service	1245499896	1245499896	1	1	HYUN, JEONG S MD	7/9/2020	2086S0120X	NA	General Surgery	026	PHYSICIANS	113335	85	Surgery-Pediatric	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
126944	Fee-for-Service	1265494751	1265494751	1	1	HUANG,ENOCH 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	10123 SE MARKET STREET	None	PORTLAND	OR	97216	2599	00	None	45.51158947	-122.5586205	Multnomah County
126954	Fee-for-Service	1104483759	1104483759	1	1	HERNANDEZ, DENISE LMFT	3/25/2025	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
126969	Fee-for-Service	1215382635	1215382635	1	1	HAKAMI MAJD, NIV MD	12/31/2019	207R00000X	NA	Other	026	PHYSICIANS	155698	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
126981	Fee-for-Service	1386923993	1386923993	1	1	HEART 2 HEART HOME HLTH SERV	12/1/2011	253Z00000X	NA	Other	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	19412 VILLAGE DRIVE	None	SONORA	CA	95370	9228	55	06109	37.97592376	-120.3215239	Tuolumne County
126997	Fee-for-Service	1275712408	1275712408	1	1	HORWOOD, KERYN J LMFT	11/30/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	50062	-	NOT APPLICABLE	0	In state provider	None	1235 MCHENRY AVENUE	SUITES A & B	MODESTO	CA	95350	5370	50	06099	37.66105327	-120.9939108	Stanislaus County
127047	Fee-for-Service	1376079020	1376079020	1	1	HERNANDEZ, MARILYN	7/1/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15330 AMAR RD	SUITE A	LA PUENTE	CA	91744	2001	19	06037	34.03714077	-117.9509701	Los Angeles County
127056	Fee-for-Service	1194157107	1194157107	1	1	HERRERA, WENDY	12/30/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	939 ELLIS ST	None	SAN FRANCISCO	CA	94109	7714	38	06075	37.78368811	-122.4218578	San Francisco County
127058	Fee-for-Service	1497739650	1497739650	1	1	HOFFMAN, REX MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65450	30	Radiology	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
127072	Fee-for-Service	1912085788	1912085788	1	1	HAYWARD, JEAN C	10/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	51721	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
127112	Fee-for-Service	1235612656	1235612656	1	1	HO, TUYEN N LCSW	9/26/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
127131	Fee-for-Service	1306106281	1306106281	1	1	HOGG, ELLIOTT J MD	6/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123621	13	Neurology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
127150	Fee-for-Service	1760729016	1760729016	1	1	HELLMAN, JULIA L MD	3/8/2019	207P00000X	NA	Other	026	PHYSICIANS	144340	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
127167	Fee-for-Service	1700418548	1700418548	1	1	HAEFELE, LIDIA M LCSW	1/18/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	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
127184	Fee-for-Service	1801893177	1801893177	1	1	HOSPICE SERVICES OF LAKE	12/12/1989	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	COUNTY	1862 PARALLEL DRIVE	None	LAKEPORT	CA	95453	9388	17	06033	39.02912659	-122.9214579	Lake County
127185	Fee-for-Service	1740277037	1740277037	1	1	HEALTHCARE MANAGEMENT	10/1/1997	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	SYSTEMS INC	980 W 7TH ST	None	SAN JACINTO	CA	92582	3814	33	06065	33.7801425	-116.977581	Riverside County
127195	Fee-for-Service	1356420053	1356420053	1	1	HERRERA, JOSE F MD	5/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66516	08	Family Practice	0	In state provider	None	1433 W MERCED AVE	STE 115	WEST COVINA	CA	91790	3402	19	06037	34.06252177	-117.9477117	Los Angeles County
127205	Fee-for-Service	1770823569	1770823569	1	1	HORNYAK, MONIKA CRNA	10/2/2015	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
127208	Fee-for-Service	1184935983	1184935983	1	1	HALL, KENT M MD	6/4/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	156017	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
127239	Fee-for-Service	1518916832	1518916832	1	1	HUFFMAN, JEFFRY L MD	2/8/2015	208800000X	NA	Other	026	PHYSICIANS	54827	40	Pediatrics	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0178	19	06037	34.06169385	-118.2044698	Los Angeles County
127261	Fee-for-Service	1710932660	1710932660	1	1	HEWETT, BRUCE T MD	5/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	61856	40	Pediatrics	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
127267	Fee-for-Service	1073090346	1073090346	1	1	HAMAR, BRADLEY R OD	8/6/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 MAPLE AVE	None	YUBA CITY	CA	95991	3323	51	06101	39.14226664	-121.6223232	Sutter County
127384	Fee-for-Service	1073656062	1073656062	1	1	HARRELL, JILL L MD	7/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65174	20	Orthopedic Surgery	0	In state provider	None	2557 MOWRY AVENUE	SUITE 10	FREMONT	CA	94538	1614	01	06001	37.55561575	-121.9826617	Alameda County
127397	Fee-for-Service	1174563175	1174563175	1	1	HANNO, PHILIP M MD	8/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139173	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
127423	Fee-for-Service	1780668434	1780668434	1	1	HENRY MAYO NEWHALL	9/15/1988	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	MEMORIAL HOSPITAL	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2083	19	06037	34.39696803	-118.5525278	Los Angeles County
127427	Fee-for-Service	1336106012	1336106012	1	1	HABBE, THOMAS 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	2929 5TH ST	STE 100	RAPID CITY	SD	57701	7355	00	None	44.05598594	-103.2274757	Pennington County
127474	Fee-for-Service	1801893177	1801893177	1	1	HOSPICE SERVICES OF LAKE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	COUNTY	1862 PARALLEL DRIVE	None	LAKEPORT	CA	95453	9388	17	06033	39.02912659	-122.9214579	Lake County
127476	Fee-for-Service	1679027627	1679027627	1	1	HENSLEY, JAMES R LCSW	3/24/2021	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
127495	Fee-for-Service	1629146832	1629146832	1	1	HANGER P & O WEST INC	9/1/1997	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	433 HEGENBERGER RD	STE 100	OAKLAND	CA	94621	1448	01	06001	37.73637438	-122.1971166	Alameda County
127497	Fee-for-Service	1023332988	1023332988	1	1	HU, YU-CHEN MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112449	41	Internal Medicine	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4899	38	06075	37.78956486	-122.417072	San Francisco County
127530	Fee-for-Service	1518916832	1518916832	1	1	HUFFMAN, JEFFRY L MD	2/8/2015	208800000X	NA	Other	026	PHYSICIANS	54827	02	General Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0178	19	06037	34.06169385	-118.2044698	Los Angeles County
127539	Fee-for-Service	1053893818	1053893818	1	1	HSU, BRANDON J PT	2/7/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
127540	Fee-for-Service	1326129115	1326129115	1	1	HERMAN,BRUCE 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	100 MARIO CAPECCHI DR	None	SALT LAKE CTY	UT	84113	1103	00	None	40.77048596	-111.8394574	Salt Lake County
127555	Fee-for-Service	1124083944	1124083944	1	1	HAMILL, TIMOTHY R MD	3/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	54149	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
127568	Fee-for-Service	1083704167	1083704167	1	1	HILL, SEAN M	7/25/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3959 RUFFIN RD	STE F	SAN DIEGO	CA	92123	1830	37	06073	32.81438099	-117.1216603	San Diego County
127602	Fee-for-Service	1639486327	1639486327	1	1	HIA MYINT, MD	8/18/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	760 BROADWAY	None	BROOKLYN	NY	11206	5317	00	None	40.700349	-73.9416015	Kings County
127613	Fee-for-Service	1114008984	1114008984	1	1	HSIAO, MARK S MD	4/8/2022	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	154038	None	None	0	In state provider	None	707 S GARFIELD AVE	None	ALHAMBRA	CA	91801	5859	19	06037	34.088688	-118.123106	Los Angeles County
127621	Fee-for-Service	1225325129	1225325129	1	2	HUANG, GINTIEN MD	11/9/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	133985	18	Ophthalmology	0	In state provider	None	1909 NORTH WATERMAN AVE	3	SAN BERNARDINO	CA	92404	4842	36	06071	34.132626	-117.2787445	San Bernardino County
127628	Fee-for-Service	1972659191	1972659191	1	1	HESSLING, THOMAS A MD	1/1/2014	174400000X	NA	Other	026	PHYSICIANS	39433	36	Psychiatry	0	In state provider	None	106 THORN ST	None	SAN DIEGO	CA	92103	5629	37	06073	32.73975297	-117.1637893	San Diego County
127650	Fee-for-Service	1598154486	1598154486	1	1	HA, ZOE Y DO	7/16/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16524	05	Anesthesiology	0	In state provider	None	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	19	06037	33.93500365	-118.1321119	Los Angeles County
127651	Fee-for-Service	1689069759	1689069759	1	1	HARDIN, KAITLYN A MD	11/1/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	146675	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
127656	Fee-for-Service	1013510957	1013510957	1	1	HOUSTON, CHINWAH W	12/11/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1100 E 70TH WAY	None	LONG BEACH	CA	90805	1015	19	06037	33.88270833	-118.1792062	Los Angeles County
127661	Fee-for-Service	1295197598	1295197598	1	1	HASTINGS, BRADFORD MD	1/16/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184564	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
127662	Fee-for-Service	1104914233	1104914233	1	1	HAMERSLEY, JANE R MD	12/1/2003	207R00000X	NA	Other	026	PHYSICIANS	40175	41	Internal Medicine	0	In state provider	None	490 POST ST	STE 1427	SAN FRANCISCO	CA	94102	1305	38	06075	37.78812774	-122.4096884	San Francisco County
127710	Fee-for-Service	1457362634	1457362634	1	1	HIRSCHBERG, RAIMUND R MD	8/31/1989	207RN0300X	NA	Nephrology	026	PHYSICIANS	47752	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
127711	Fee-for-Service	1780668434	1780668434	1	1	HENRY MAYO NEWHALL	12/1/1977	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	MEMORIAL HOSPITAL	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2083	19	06037	34.39696803	-118.5525278	Los Angeles County
127723	Fee-for-Service	1528102993	1528102993	1	1	HANCOCK, JAMIE OD	8/5/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HGHWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
127767	Fee-for-Service	1902291776	1902291776	1	1	HAKIMIAN, TINA R MD	11/4/2019	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	159441	39	Preventive (M.D. only)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
127771	Fee-for-Service	1104042209	1104042209	1	1	HAPONSKI, LAUREN B	6/22/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2040 PACIFIC COAST HWY	None	LOMITA	CA	90717	2660	19	06037	33.78948351	-118.316493	Los Angeles County
127777	Fee-for-Service	1053405829	1053405829	1	1	HOLLISTER SCHOOL DISTRICT	2/6/2001	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	2690 CIENEGA RD	None	HOLLISTER	CA	95023	9687	35	06069	36.82375129	-121.4010426	San Benito County
127783	Fee-for-Service	1689952863	1689952863	1	1	HARTMANS, SHARON G MD	1/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124953	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
127799	Fee-for-Service	1215566021	1215566021	1	1	HUANG, SHERRI	9/27/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
127801	Fee-for-Service	1750776324	1750776324	1	1	HOANG, ALEXANDER M MD	6/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147760	None	None	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5179	39	06077	38.12188356	-121.285872	San Joaquin County
127821	Fee-for-Service	1518916832	1518916832	1	1	HUFFMAN, JEFFRY L MD	2/8/2015	208800000X	NA	Other	026	PHYSICIANS	54827	34	Urology and Urological Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0178	19	06037	34.06169385	-118.2044698	Los Angeles County
127833	Fee-for-Service	1508002460	1508002460	1	1	HEALTH 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	12158 HAMLIN ST	SUITE 6	NORTH HOLLYWOOD	CA	91606	1433	19	06037	34.18845983	-118.3984616	Los Angeles County
127844	Fee-for-Service	1124083944	1124083944	1	1	HAMILL, TIMOTHY R MD	3/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	54149	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
127876	Fee-for-Service	1902073232	1902073232	1	1	HUA, MENG MD INC	10/8/2004	193400000X	NA	Other	026	PHYSICIANS	81531	10	Gastroenterology (M.D. only)	0	In state provider	None	6699 ALVARADO RD	2306	SAN DIEGO	CA	92120	5241	37	06073	32.77665383	-117.0540279	San Diego County
127891	Fee-for-Service	1427002856	1427002856	1	2	HAWTHORNE RADIOLOGY	5/31/2011	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	309 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
127909	Fee-for-Service	1538405865	1538405865	1	1	HIRCHAK, DAVID M DO	2/13/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	14682	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
127938	Fee-for-Service	1013510957	1013510957	1	1	HOUSTON, CHINWAH W	12/11/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1100 E 70TH WAY	None	LONG BEACH	CA	90805	1015	19	06037	33.88270833	-118.1792062	Los Angeles County
127945	Fee-for-Service	1659472058	1659472058	1	1	HAJIANI, RAFIEH MD	10/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81116	41	Internal Medicine	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
127947	Fee-for-Service	1154324069	1154324069	1	1	HOFFMAN, LEONARD S MD	1/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130032	03	Allergy	0	In state provider	None	3020 CHILDREN'S WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
128018	Fee-for-Service	1649813932	1649813932	1	1	HESS, SIERRA CRNA	11/14/2021	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
128023	Fee-for-Service	1487006557	1487006557	1	1	HOSOKI, MACHIKO MD MPH	7/14/2022	2080P0006X	NA	Psychiatry	026	PHYSICIANS	159412	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
128035	Fee-for-Service	1598744658	1598744658	1	1	HASSAN A GHANDOUR MD	9/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1460 G ST	None	SPRINGFIELD	OR	97477	4112	00	None	44.0524395	-123.0035985	Lane County
128093	Fee-for-Service	1306961644	1306961644	1	1	HAMILTON, ANITA PHD	8/27/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
128122	Fee-for-Service	1508002460	1508002460	1	1	HEALTH FIRST HOSPICE INC	8/5/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12158 HAMLIN ST	SUITE 6	NORTH HOLLYWOOD	CA	91606	1433	19	06037	34.18845983	-118.3984616	Los Angeles County
128127	Fee-for-Service	1942901319	1942901319	1	1	HIGHER VISION WELLNESS CENTE	11/15/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	R	722 W WILSON AVE	None	GLENDALE	CA	91203	2409	19	06037	34.1479745	-118.2709305	Los Angeles County
128133	Fee-for-Service	1124083944	1124083944	1	1	HAMILL, TIMOTHY R MD	3/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	54149	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
128152	Fee-for-Service	1356787105	1356787105	1	1	HAGSTROM, JENNIFER M MD	4/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131997	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
128163	Fee-for-Service	1902073232	1902073232	1	1	HUA, MENG MD INC	10/8/2004	193400000X	NA	Other	026	PHYSICIANS	81531	41	Internal Medicine	0	In state provider	None	6699 ALVARADO RD	2306	SAN DIEGO	CA	92120	5241	37	06073	32.77665383	-117.0540279	San Diego County
128186	Fee-for-Service	1477692176	1477692176	1	1	HAKAKHA, BENJAMIN A MD	7/1/1998	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60168	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
128221	Fee-for-Service	1689827404	1689827404	1	1	HOLLINGSWORTH-MOORE, ANNETTE	9/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	105398	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	I MD	249 E HIGHLAND AVENUE	None	SAN BERNARDINO	CA	92404	3707	36	06071	34.13591253	-117.280809	San Bernardino County
128229	Fee-for-Service	1851495550	1851495550	1	1	HUANG, XUSHAO OD	8/10/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	79710 HIGHWAY 111	STE 101	LA QUINTA	CA	92253	6516	33	06065	33.70746746	-116.2737855	Riverside County
128235	Fee-for-Service	1154324069	1154324069	1	1	HOFFMAN, LEONARD S MD	1/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130032	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
128237	Fee-for-Service	1568672673	1568672673	1	1	HAYES, TREVOR M DO	8/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9781	08	Family Practice	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
128269	Fee-for-Service	1710979687	1710979687	1	1	HESSELGESSER, ROBERT MD	10/27/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	22896	30	Radiology	0	In state provider	None	2985 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28953746	-118.7439291	Ventura County
128279	Fee-for-Service	1215015094	1215015094	1	1	HONG, JEFFREY C MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	73546	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
128306	Fee-for-Service	1366832032	1366832032	1	1	HSI, ANDY C MD	5/25/2021	207ZP0102X	NA	Other	026	PHYSICIANS	149487	None	None	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
128361	Fee-for-Service	1861406803	1861406803	1	1	HEYM,MATTHEW KENNETH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	COOK CHILDRENS PHYSICAN	NETWORKCOOK CHILDRENS	801 SEVENTH AVENUE	FORT WORTH	TX	76104	0000	00	None	32.70148861	-97.28204041	Tarrant County
128382	Fee-for-Service	1811128531	1811128531	2	1	HOWARD, MECHELLE A NP	3/4/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16412 LOS GATOS BLVD	None	LOS GATOS	CA	95030	5525	43	06085	37.23046706	-121.9654506	Santa Clara County
128408	Fee-for-Service	1760968796	1760968796	2	1	HANGER PROSTHETICS & ORTHOTI	5/18/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	3650 E. SOUTH STREET	SUITE 110B	LAKEWOOD	CA	90712	0000	05	06009	33.8601747	-118.1494013	Los Angeles County
128409	Fee-for-Service	1306905013	1306905013	1	1	HERAVI, SUSAN M CRNA	6/24/2011	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
128410	Fee-for-Service	1780285650	1780285650	1	1	HAWKES, MICHELLE A CNP	4/20/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16773 BERNARDO CENTER DR	None	SAN DIEGO	CA	92128	2525	37	06073	33.01874412	-117.0752752	San Diego County
128484	Fee-for-Service	1003202714	1003202714	1	1	HOROMANSKI, AUDRA L MD	5/11/2020	207RR0500X	NA	Other	026	PHYSICIANS	144932	83	Rheumatology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
128503	Fee-for-Service	1306810122	1306810122	1	1	HSU, CARL C MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34512	40	Pediatrics	0	In state provider	None	1995 ZINFANDEL DR	STE 105	RANCHO CORDOVA	CA	95670	2862	34	06067	38.612124	-121.27131	Sacramento County
128516	Fee-for-Service	1942317391	1942317391	1	1	HENDEY, GREGORY WILLIAM	4/30/1990	207P00000X	NA	Other	026	PHYSICIANS	69858	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
128548	Fee-for-Service	1952700239	1952700239	1	1	HEALTHCOM MEDICAL GROUP INC	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	45435	08	Family Practice	0	In state provider	None	289 W HUNTINGTON DR	SUITE 205	ARCADIA	CA	91007	3492	19	06037	34.13549119	-118.0419175	Los Angeles County
128569	Fee-for-Service	1972173185	1972173185	1	1	HEN, JEFFREY CRNA	7/25/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
128609	Fee-for-Service	1659145589	1659145589	1	1	HERNANDEZ, CHRISTINE G PT	1/27/2024	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
128645	Fee-for-Service	1083638456	1083638456	1	1	HALTERMAN, MARK W MD	7/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	50795	05	Anesthesiology	0	In state provider	None	43830 N 10TH ST W	None	LANCASTER	CA	93534	4862	19	06037	34.67913961	-118.1478725	Los Angeles County
128667	Fee-for-Service	1932553948	1932553948	1	1	HASAN, IRSA S MD	12/18/2023	208G00000X	NA	General Surgery	026	PHYSICIANS	191199	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
128680	Fee-for-Service	1285723957	1285723957	1	1	HENNEBERRY, KYLE J MD	12/11/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	98865	30	Radiology	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
128685	Fee-for-Service	1528422169	1528422169	1	1	HOANG, DAN DO	10/8/2021	207L00000X	NA	Other	026	PHYSICIANS	18098	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
128696	Fee-for-Service	1528899671	1528899671	1	1	HAMBERRY, CLARISSA BIRTH DO	8/23/2024	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	37	06073	0	0	None
128708	Fee-for-Service	1942273933	1942273933	1	1	HERITAGE HEALTH CARE INC	3/1/1966	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	25271 BARTON RD	None	LOMA LINDA	CA	92354	3013	36	06071	34.04804454	-117.253044	San Bernardino County
128732	Fee-for-Service	1386070985	1386070985	1	1	HARRISON, KRISTEN M CCC-SLP	9/24/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3002 DOW AVE STE 114	None	TUSTIN	CA	92780	7247	30	06059	33.70954889	-117.8043627	Orange County
128799	Fee-for-Service	1427090729	1427090729	1	1	HORN-NOVAKOVIC, B MD	4/4/1995	2080P0207X	NA	Hematology	026	PHYSICIANS	55140	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
128860	Fee-for-Service	1154388692	1154388692	1	1	HIYAMA, SHARON S OD	7/25/2005	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 201	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
128867	Fee-for-Service	1477589323	1477589323	1	1	HUNTER, WILLARD M MD	12/1/2003	207R00000X	NA	Other	026	PHYSICIANS	30611	08	Family Practice	0	In state provider	None	2412 BUHNE ST	None	EUREKA	CA	95501	3207	12	06023	40.78592828	-124.1411482	Humboldt County
128886	Fee-for-Service	1003279209	1003279209	1	1	HENKEL, ANDREA G MD	4/22/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	151537	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
128890	Fee-for-Service	1609222090	1609222090	1	1	HAMIDI, AFSHIN MD	11/23/2021	207RE0101X	NA	Endocrinology	026	PHYSICIANS	162227	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
128944	Fee-for-Service	1891873956	1891873956	1	1	HANSEN, CHARLES H III MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	45312	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
128983	Fee-for-Service	1740642248	1740642248	1	1	HSU, TIFFANY L MD	6/1/2020	207R00000X	NA	Other	026	PHYSICIANS	151024	41	Internal Medicine	0	In state provider	None	3330 LOMITA BLVD	CARDIOLOGY DEPARTMENT	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
129008	Fee-for-Service	1740276682	1740276682	1	1	HARISH,SHAH 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 EAST 86TH PLACE	None	MERRILLVILLE	IN	46410	0000	00	None	41.46016867	-87.33472256	Lake County
129019	Fee-for-Service	1992101737	1992101737	1	1	HV INC.	8/20/2019	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ON	777 MINNEWAWA AVE	21	CLOVIS	CA	93612	1729	10	06019	36.82095971	-119.7089183	Fresno County
129031	Fee-for-Service	1073801809	1073801809	1	1	HAMMAMI, MUHAMMAD B MD	2/19/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	131069	10	Gastroenterology (M.D. only)	0	In state provider	D	9140 HAVEN AVE	115	RANCHO CUCAMONGA	CA	91730	5414	36	06071	34.087491	-117.5758895	San Bernardino County
129038	Fee-for-Service	1669653077	1669653077	1	1	HOVHANNISYAN, ARMEN MD	1/24/2008	261Q00000X	NA	Other	026	PHYSICIANS	99959	44	Public Health	0	In state provider	INC	8444 CRENSHAW BLVD	None	INGLEWOOD	CA	90305	1914	19	06037	33.96209673	-118.3272094	Los Angeles County
129049	Fee-for-Service	1427010198	1427010198	1	1	HARISH, GORLI	11/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	41095	None	None	0	In state provider	None	2500 H ST	None	BAKERSFIELD	CA	93301	2818	15	06029	35.38232703	-119.0211171	Kern County
129059	Fee-for-Service	1346516069	1346516069	1	1	HO, GORDON MD	6/19/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	117703	06	Cardiovascular Disease (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
129074	Fee-for-Service	1831258326	1831258326	1	1	HORSNYDER PHARMACY	7/12/1998	332BC3200X	NA	Other	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1226 SOQUEL AVE	None	SANTA CRUZ	CA	95062	2157	44	06087	36.98018906	-122.0096569	Santa Cruz County
129091	Fee-for-Service	1831131804	1831131804	1	1	HERNANDEZ, MARCO F MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72141	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5925 SAN VICENTE BLVD	None	LOS ANGELES	CA	90019	6630	19	06037	34.05682871	-118.360716	Los Angeles County
129111	Fee-for-Service	1700993342	1700993342	1	1	HILL, RICHARD F PHD	9/23/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2880 ZANKER ROAD	STE 203	SAN JOSE	CA	95134	2122	43	06085	37.39537119	-121.9293808	Santa Clara County
129121	Fee-for-Service	1174932701	1174932701	1	1	HEALTH DIAGNOSTICS OF	2/22/2018	193400000X	NA	Other	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	665 MUNRAS AVENUE	STE 109	MONTEREY	CA	93940	3136	27	06053	36.59569303	-121.8931095	Monterey County
129160	Fee-for-Service	1568003044	1568003044	1	1	HAMLIN HOME HEALTH CARE INC	12/18/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3959 FOOTHILL BLVD	STE 304	LA CRESCENTA	CA	91214	1664	19	06037	34.24025956	-118.2658392	Los Angeles County
129205	Fee-for-Service	1053369397	1053369397	1	1	HO, JONATHAN K O MD	7/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86273	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
129237	Fee-for-Service	1174888200	1174888200	1	1	HASAN, LARA T MD	9/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141184	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1100 N PALM CANYON DR	STE 212	PALM SPRINGS	CA	92262	4426	33	06065	33.838182	-116.546744	Riverside County
129247	Fee-for-Service	1134265911	1134265911	1	1	HOWE, KARLA B LMFT	7/12/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	350 E ST	STE 303	EUREKA	CA	95501	0351	12	06023	40.8030305	-124.1674522	Humboldt County
129285	Fee-for-Service	1750812608	1750812608	1	1	HUDNALL, MATTHEW MD	5/26/2023	208800000X	NA	Other	026	PHYSICIANS	185710	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
129325	Fee-for-Service	1942287180	1942287180	2	1	HAYES, CARL E MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	66485	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1729 WEST AVE J	STE 101	LANCASTER	CA	93534	2703	19	06037	34.68944953	-118.162287	Los Angeles County
129355	Fee-for-Service	1124089685	1124089685	1	1	HUANG, STEPHEN MD	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54719	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
129420	Fee-for-Service	1154313518	1154313518	1	1	HULLER, RALPH 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 MEDICAL VILLAGE DR	None	EDGEWOOD	KY	41017	3403	00	None	39.01457332	-84.56298791	Kenton County
129485	Fee-for-Service	1003685546	1003685546	1	1	HAGOPIAN, ARMENUHI A NP	8/14/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	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
129491	Fee-for-Service	1578889762	1578889762	1	1	HACK, HOWARD M MD PC	8/23/2013	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	68575	41	Internal Medicine	0	In state provider	None	153 PEARSON RD	None	PARADISE	CA	95969	5045	04	06007	39.75272738	-121.6254323	Butte County
129501	Fee-for-Service	1689969487	1689969487	1	2	HALIM, SONIA LMFT	3/4/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CES	28991 OLD TOWN FRONT ST	102	TEMECULA	CA	92591	2660	33	06065	33.48435441	-117.1437755	Riverside County
129517	Fee-for-Service	1629199195	1629199195	1	1	HSU, JONATHAN C MD	8/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104474	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
129536	Fee-for-Service	1235281460	1235281460	1	1	HAUGEN, DONALD R MD	8/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	65149	40	Pediatrics	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
129543	Fee-for-Service	1780844597	1780844597	1	1	HEU, YU	1/9/2009	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6285 W MENLO AVE	None	FRESNO	CA	93722	8509	10	06019	36.83134909	-119.9049938	Fresno County
129548	Fee-for-Service	1982919478	1982919478	1	1	HARBOR HEALTHY LIVING	11/28/2011	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY, INC.	646 S. HARBOR BOULEVARD	None	SANTA ANA	CA	92704	1384	30	06059	33.73925531	-117.9201794	Orange County
129590	Fee-for-Service	1942248083	1942248083	1	1	HANTASH, BASIL M MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84839	07	Dermatology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
129602	Fee-for-Service	1326011040	1326011040	1	1	HOLDER, DEBORAH L MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56110	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
129610	Fee-for-Service	1891854279	1891854279	1	1	HARRER, MARGARET A 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
129613	Fee-for-Service	1235278615	1235278615	1	1	HARFORD, PAMELA J DO	12/2/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	A MEDICAL CORPORATION	5253 RIVERSIDE DR	None	CHINO	CA	91710	4151	36	06071	34.01903847	-117.690363	San Bernardino County
129645	Fee-for-Service	1124089685	1124089685	1	1	HUANG, STEPHEN MD	5/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54719	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
129656	Fee-for-Service	1770957326	1770957326	1	1	HUGHES, ELIZABETH V LMFT	10/8/2019	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
129657	Fee-for-Service	1366999237	1366999237	1	1	HOLISTIC PSYCHSOLUTIONS INC	1/31/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2945 HARDING STREET	STE 104	CARLSBAD	CA	92008	1818	37	06073	33.16250689	-117.345105	San Diego County
129658	Fee-for-Service	1275845265	1275845265	1	1	HUDSON & WALKER A PHYSICAL	10/1/2010	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	THERAPIST CORPORATION	2131 ELKS DR	STE 102	SAN BERNARDINO	CA	92404	5544	36	06071	34.13470788	-117.262434	San Bernardino County
129759	Fee-for-Service	1124247861	1124247861	1	1	HUANG, RICHARD H MD	3/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	81227	10	Gastroenterology (M.D. only)	0	In state provider	None	12565 HESPERIA RD	STE 1	VICTORVILLE	CA	92395	8318	36	06071	34.47971486	-117.2908434	San Bernardino County
129763	Fee-for-Service	1912919812	1912919812	1	1	HADSALL, GLORIA MD	2/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	65863	41	Internal Medicine	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
129780	Fee-for-Service	1578889762	1578889762	1	1	HACK, HOWARD M MD PC	8/23/2013	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	68575	10	Gastroenterology (M.D. only)	0	In state provider	None	153 PEARSON RD	None	PARADISE	CA	95969	5045	04	06007	39.75272738	-121.6254323	Butte County
129799	Fee-for-Service	1891419420	1891419420	1	1	HALO CLINICAL LAB INC	10/2/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	21 ARGONAUT	STE B	ALISO VIEJO	CA	92656	4150	30	06059	33.59303024	-117.7263302	Orange County
129800	Fee-for-Service	1306970900	1306970900	1	1	HENRY, ROBERT EMMETT MD	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	74794	25	Physical Medicine and Rehabilitation	0	In state provider	None	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	19	06037	33.929829	-118.157607	Los Angeles County
129833	Fee-for-Service	1780844597	1780844597	1	1	HEU, YU	1/9/2009	163W00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6285 W MENLO AVE	None	FRESNO	CA	93722	8509	10	06019	36.83134909	-119.9049938	Fresno County
129851	Fee-for-Service	1780616243	1780616243	1	1	HARDING, R MICHAEL MD	7/1/2017	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
129862	Fee-for-Service	1518235308	1518235308	1	1	HUBERT, ANGELINA CRNA	2/13/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
129887	Fee-for-Service	1417993502	1417993502	1	1	HALL, DAVID H MD	9/1/1985	207P00000X	NA	Other	026	PHYSICIANS	56138	66	Emergency Medicine (Urgent Care)	0	In state provider	None	560 COHASSET RD	None	CHICO	CA	95926	2212	04	06007	39.7519137	-121.8477606	Butte County
129902	Fee-for-Service	1235278615	1235278615	1	1	HARFORD, PAMELA J DO	12/2/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	A MEDICAL CORPORATION	5253 RIVERSIDE DR	None	CHINO	CA	91710	4151	36	06071	34.01903847	-117.690363	San Bernardino County
129911	Fee-for-Service	1962624841	1962624841	1	1	HARMON-MANCINI, KARYN J	5/22/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYD	275 VICTORIA STREET	SUITE 2A	COSTA MESA	CA	92627	1906	30	06059	33.6526055	-117.910746	Orange County
129942	Fee-for-Service	1063246585	1063246585	1	1	HELPFUL HANDS TRANSPORTATION	8/30/2024	No Taxonomy Provided	Both NEMT & NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	155 LAKE AVE	8TH FLOOR	PASADENA	CA	91101	1848	19	06037	34.148538	-118.132407	Los Angeles County
129962	Fee-for-Service	1316907413	1316907413	1	1	HELGAGER, JAMES A MD	1/1/1982	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	35434	20	Orthopedic Surgery	0	In state provider	None	3927 WARING RD	None	OCEANSIDE	CA	92056	4458	37	06073	33.18776771	-117.2893136	San Diego County
129976	Fee-for-Service	1598076838	1598076838	1	1	HO, ANNETTE M MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125700	30	Radiology	0	In state provider	None	43112 15TH ST W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
129979	Fee-for-Service	1912653601	1912653601	1	1	HARBOR HHA	10/29/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	135 N VICTORY BLVD	STE 7	BURBANK	CA	91502	1837	19	06037	34.17458874	-118.3170539	Los Angeles County
129998	Fee-for-Service	1396064390	1396064390	1	1	HTUN, KHIN T MD	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	111319	01	General Practice	0	In state provider	None	600 N 13TH AVE	STE 150	UPLAND	CA	91786	1900	36	06071	34.10113004	-117.6336234	San Bernardino County
130007	Fee-for-Service	1497983449	1497983449	1	1	HORAK, ROBIN V MD	8/1/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	115325	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
130020	Fee-for-Service	1740626019	1740626019	1	1	HO, JENNIFER C MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154792	78	Neoplastic Diseases/Oncology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
130033	Fee-for-Service	1548213101	1548213101	1	1	HINES, RUSSELL H MD	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77511	41	Internal Medicine	0	In state provider	None	2230 LYNN RD	STE 200	THOUSAND OAKS	CA	91360	1900	56	06111	34.20894685	-118.885185	Ventura County
130039	Fee-for-Service	1255529152	1255529152	1	1	HONG, WILLIAM H MD INC	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	52579	41	Internal Medicine	0	In state provider	None	323 N PRARIE AVE	STE 435	INGLEWOOD	CA	90301	4506	19	06037	33.966333	-118.3439975	Los Angeles County
130085	Fee-for-Service	1407829286	1407829286	1	1	HARDAN, ANTONIO Y MD	1/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52121	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130086	Fee-for-Service	1124214341	1124214341	1	1	HERMAN CARRILLO MD & MARVIN	7/31/2018	208D00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	L GROUP INC	14342 RAMONA BLVD	None	BALDWIN PARK	CA	91706	3241	19	06037	34.08608595	-117.9612248	Los Angeles County
130174	Fee-for-Service	1003809187	1003809187	1	1	HOM, DENISE L MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60972	08	Family Practice	0	In state provider	None	3605 ALAMO ST	STE 100	SIMI VALLEY	CA	93063	2186	56	06111	34.28647147	-118.726119	Ventura County
130183	Fee-for-Service	1477940625	1477940625	1	1	HENRY, GINA MD	6/5/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	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
130221	Fee-for-Service	1912040502	1912040502	1	1	HERKERT, KIMBERLY J LMFT	8/20/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2625 WILSON ST	None	EUREKA	CA	95503	4829	12	06023	40.77932692	-124.1380059	Humboldt County
130232	Fee-for-Service	1487835963	1487835963	2	1	HANNAH HOME HEALTH INC	4/1/2012	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	963 N LA BREA AVE	SUITE A	INGLEWOOD	CA	90302	2207	19	06037	33.975423	-118.357669	Los Angeles County
130251	Fee-for-Service	1609452853	1609452853	1	1	HARMONY COUNSELING GROUP APC	9/3/2021	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	FOR MARRIAGE AND FAMILY	230 N MARYLAND AVE	STE 303	GLENDALE	CA	91206	4281	19	06037	34.149357	-118.2537315	Los Angeles County
130257	Fee-for-Service	1508422015	1508422015	1	1	HUMBOLDT FOOT & ANKLE	8/12/2024	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	2504 HARRISON AVE	A	EUREKA	CA	95501	3236	12	06023	40.785408	-124.139668	Humboldt County
130268	Fee-for-Service	1760862007	1760862007	1	1	HUR, STEVEN	7/26/2021	207L00000X	NA	Other	026	PHYSICIANS	148702	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
130269	Fee-for-Service	1396859393	1396859393	1	1	HARRIS, ABDUL K MD	3/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	61120	89	Surgery-Traumatic	0	In state provider	None	3536 MENDOCINO AVE	STE 250	SANTA ROSA	CA	95403	3612	49	06097	38.473326	-122.725935	Sonoma County
130306	Fee-for-Service	1740626019	1740626019	1	1	HO, JENNIFER C MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154792	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
130318	Fee-for-Service	1548213101	1548213101	1	1	HINES, RUSSELL H MD	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	77511	01	General Practice	0	In state provider	None	2230 LYNN RD	STE 200	THOUSAND OAKS	CA	91360	1900	56	06111	34.20894685	-118.885185	Ventura County
130355	Fee-for-Service	1659726784	1659726784	1	1	HERZIK, ANDREW J MD	7/22/2019	207P00000X	NA	Other	026	PHYSICIANS	145801	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
130372	Fee-for-Service	1528249885	1528249885	1	1	HANSON, LARS E MD	3/16/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79925	01	General Practice	0	In state provider	None	8811 E GARVEY AVE	STE 101	ROSEMEAD	CA	91770	2476	19	06037	34.06275027	-118.0766145	Los Angeles County
130393	Fee-for-Service	1255325486	1255325486	1	1	HEATON, KOBJIT W MD	6/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52635	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
130402	Fee-for-Service	1972521078	1972521078	1	1	HU, CATHERINE MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	65866	41	Internal Medicine	0	In state provider	None	2333 BUCHANAN STREET	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
130405	Fee-for-Service	1972681856	1972681856	1	1	HOFFING, MARC A MD	11/14/2018	207R00000X	NA	Other	026	PHYSICIANS	58486	01	General Practice	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
130425	Fee-for-Service	1619010899	1619010899	1	1	HOLDEN, THOMAS E OD	2/4/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1545 W 5TH ST	STE 100	OXNARD	CA	93030	6510	56	06111	34.19757729	-119.1961091	Ventura County
130451	Fee-for-Service	1407914260	1407914260	1	4	HILL COUNTRY COMM CLINIC	11/26/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2710 EUREKA WAY	SUITE 1	REDDING	CA	96001	0230	45	06089	40.58598589	-122.4109655	Shasta County
130458	Fee-for-Service	1699050104	1699050104	1	1	HOLLAND, KELLI A	8/20/2012	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
130480	Fee-for-Service	1821701590	1821701590	1	1	HOLLYLEAF HEALTHCARE INC	2/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5017 E CHAPMAN AVE	None	ORANGE	CA	92869	4211	30	06059	33.78773649	-117.79965	Orange County
130492	Fee-for-Service	1447683537	1447683537	1	1	HADIPRODJO, DAVID A	4/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131943	None	None	0	In state provider	None	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4019	30	06059	33.715035	-117.936993	Orange County
130502	Fee-for-Service	1073553962	1073553962	1	1	HARRIS, CHRISTINA E MD	12/19/2022	207R00000X	NA	Other	026	PHYSICIANS	56051	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
130503	Fee-for-Service	1396166534	1396166534	1	1	HO, THOMAS MD INC	12/30/2013	207L00000X	NA	Other	026	PHYSICIANS	121504	05	Anesthesiology	0	In state provider	None	12601 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92843	1908	30	06059	33.77450951	-117.913014	Orange County
130536	Fee-for-Service	1619032224	1619032224	1	1	HO, DORA Y MD	9/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80640	77	Infectious Disease	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130551	Fee-for-Service	1487099834	1487099834	1	1	HARRIS, LELE C MD	9/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136841	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
130555	Fee-for-Service	1710387436	1710387436	1	1	HOBAN, CHRISTINE L NP	9/6/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
130558	Fee-for-Service	1245650456	1245650456	1	1	HSIAO, STEPHANIE MD	5/3/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	141281	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
130581	Fee-for-Service	1467124248	1467124248	1	1	HERNANDEZ, VICTORIA LCSW	3/5/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	415 KNOLLCREST DR	STE 101	REDDING	CA	96002	0181	45	06089	40.57267376	-122.3643496	Shasta County
130591	Fee-for-Service	1184776528	1184776528	1	1	HELLER, KARIN E 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
130594	Fee-for-Service	1013147388	1013147388	1	1	HSIEH, TYKEN C MD	9/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104194	05	Anesthesiology	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
130629	Fee-for-Service	1902810997	1902810997	1	1	HARDASMALANI, MADHU MD	10/8/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53789	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
130630	Fee-for-Service	1982700365	1982700365	1	1	HARRIS, SUSAN MD	2/11/2021	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	50886	-	NOT APPLICABLE	0	In state provider	None	700 BRASHEAR ST	None	SUSANVILLE	CA	96130	4302	18	06035	40.41515699	-120.663048	Lassen County
130636	Fee-for-Service	1063874089	1063874089	1	1	HOM, KATHERINE MD	1/13/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168356	None	None	0	In state provider	None	2185 CITRACADA PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
130658	Fee-for-Service	1922072099	1922072099	1	1	HAUSCHILDT, JOHN P MD	8/22/1995	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	76429	None	None	0	In state provider	None	8745 AERO DR	STE 200	SAN DIEGO	CA	92123	1774	37	06073	32.80965551	-117.1391563	San Diego County
130663	Fee-for-Service	1184771974	1184771974	1	1	HWANG, MEI-TSUEY MD	8/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99715	45	Nephrology (Renal-Kidney)	0	In state provider	None	568 E HERNDON AVE	STE 201	FRESNO	CA	93720	2989	10	06019	36.83752653	-119.7776433	Fresno County
130703	Fee-for-Service	1134571821	1134571821	1	1	HAGAR, JENNIFER LMFT	4/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10940 FAIR OAKS BLVD STE	None	FAIR OAKS	CA	95628	5958	34	06067	38.650077	-121.263678	Sacramento County
130725	Fee-for-Service	1467511055	1467511055	1	1	HA, LEWIS D MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	61527	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
130737	Fee-for-Service	1477583458	1477583458	1	1	HANPETER, DAVID E MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	83832	66	Emergency Medicine (Urgent Care)	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
130738	Fee-for-Service	1407914260	1407914260	1	4	HILL COUNTRY COMM CLINIC	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	2710 EUREKA WAY	SUITE 1	REDDING	CA	96001	0230	45	06089	40.58598589	-122.4109655	Shasta County
130787	Fee-for-Service	1427109453	1427109453	1	2	HANDLEY, CAROL N NP	6/12/2020	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
130800	Fee-for-Service	1760556641	1760556641	1	1	HANGER PROSTHETICS &	2/25/1999	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	5525 DEWEY DR	SUITE 102 & 104	FAIR OAKS	CA	95628	3130	34	06067	38.666592	-121.309182	Sacramento County
130806	Fee-for-Service	1295778116	1295778116	1	1	HORNER, HEATHER A	7/1/2001	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	123 HOLDENCAMP RD	None	THOUSAND OAKS	CA	91360	0000	56	06111	34.17959329	-118.8685829	Ventura County
130818	Fee-for-Service	1023101813	1023101813	1	1	HANUMAN, ANIL K DO	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	7464	41	Internal Medicine	0	In state provider	None	433 W BASTANCHURY ROAD	None	FULLERTON	CA	92535	3404	30	06059	33.89344341	-117.9338865	Orange County
130838	Fee-for-Service	1508037664	1508037664	1	1	HUYNH, VIET M MD	8/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103080	41	Internal Medicine	0	In state provider	None	510 SUPERIOR AVE	None	NEWPORT BEACH	CA	92663	3664	30	06059	33.63019271	-117.9294795	Orange County
130849	Fee-for-Service	1851737043	1851737043	1	1	HUMMEL, CHARLES S MD	9/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147678	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
130855	Fee-for-Service	1619032224	1619032224	1	1	HO, DORA Y MD	9/19/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80640	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
130890	Fee-for-Service	1851730584	1851730584	1	1	HERRERA-MALDONADO, BRENDA E	1/21/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	NP	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
130911	Fee-for-Service	1982282356	1982282356	1	1	HSU, ERIC MD	8/8/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	300 WEST HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
130916	Fee-for-Service	1922034636	1922034636	1	1	HOLLY SHILL M.D.	2/6/2017	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	3742	00	None	33.480864	-112.0795155	Maricopa County
130919	Fee-for-Service	1770296758	1770296758	1	1	HALLMARK SENIOR LIVING LLC	3/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2001 AKERS ROAD	None	BAKERSFIELD	CA	93309	5058	15	06029	35.336781	-119.047787	Kern County
130925	Fee-for-Service	1104463371	1104463371	1	1	HIGH DESERT PSYCHOLOGICAL SE	11/2/2020	103TP2701X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	RVICES	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
130930	Fee-for-Service	1366731424	1366731424	1	1	HAN, CHEONGSOO LAC	1/8/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	680 WILSHIRE PL	UNIT 312	LOS ANGELES	CA	90005	3950	19	06037	34.060581	-118.2877945	Los Angeles County
130966	Fee-for-Service	1851545214	1851545214	1	1	HOPSON, LISA LMFT	4/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
130971	Fee-for-Service	1518076538	1518076538	1	1	HAMMAR, SUSAN K MD INC	10/16/2018	193400000X	NA	Other	026	PHYSICIANS	53696	40	Pediatrics	0	In state provider	None	2211 W MAGNOLIA BLVD	STE 210	BURBANK	CA	91506	1771	19	06037	34.1728873	-118.3320905	Los Angeles County
130979	Fee-for-Service	1982612065	1982612065	1	1	HUERFANO COUNTY HOSPITAL	1/25/2008	282NC0060X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	23500 US HIGHWAY	160	WALSENBURG	CO	81089	9524	00	None	37.59934866	-104.8393728	Huerfano County
131015	Fee-for-Service	1932646288	1932646288	1	1	HUTTON, SHANNON E NP	9/27/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
131026	Fee-for-Service	1477583458	1477583458	1	1	HANPETER, DAVID E MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	83832	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
131110	Fee-for-Service	1710458369	1710458369	1	1	HOPKINS, ADRIAN R LMFT	5/9/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3200 E GUASTI RD	#100	ONTARIO	CA	91761	8660	36	06071	34.06518	-117.5822055	San Bernardino County
131111	Fee-for-Service	1205053030	1205053030	1	1	HARTMAN, LAUREN B MD	9/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	111642	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
131127	Fee-for-Service	1306062476	1306062476	1	1	HIBLER, ANITA M MD	5/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	36494	08	Family Practice	0	In state provider	None	12900 AVALON BLVD	None	LOS ANGELES	CA	90061	2734	19	06037	33.91521644	-118.2652318	Los Angeles County
131146	Fee-for-Service	1083877393	1083877393	1	1	HUANG, VICTOR MD	7/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154031	07	Dermatology	0	In state provider	None	3301 C STREET	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
131163	Fee-for-Service	1649481441	1649481441	1	1	HAYES, MICHELLE	10/4/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
131164	Fee-for-Service	1649377318	1649377318	1	1	HASAN, SYED A MD	5/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	84932	41	Internal Medicine	0	In state provider	None	8510 BALBOA BLVD	STE 150	NORTHRIDGE	CA	91325	5810	19	06037	34.224507	-118.5026015	Los Angeles County
131213	Fee-for-Service	1104463371	1104463371	1	1	HIGH DESERT PSYCHOLOGICAL SE	7/15/2021	103TP2701X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	RVICES	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
131264	Fee-for-Service	1932368347	1932368347	1	1	HABASHY, TAHANY M MD INC	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65338	01	General Practice	0	In state provider	None	222 W MAIN ST	STE 102	TUSTIN	CA	92780	7711	30	06059	33.74205891	-117.8253675	Orange County
131266	Fee-for-Service	1982612065	1982612065	1	1	HUERFANO COUNTY HOSPITAL	1/25/2008	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	23500 US HIGHWAY	160	WALSENBURG	CO	81089	9524	00	None	37.59934866	-104.8393728	Huerfano County
131275	Fee-for-Service	1134296973	1134296973	1	1	HU, WANPING MD	3/4/2008	207RH0003X	NA	Oncology	026	PHYSICIANS	94554	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
131296	Fee-for-Service	1578812905	1578812905	1	1	HARRY PAPASOZOMENOS 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	500 MEDICAL CENTER BLVD	None	WEBSTER	TX	77598	4220	00	None	29.54039936	-95.1268706	Harris County
131320	Fee-for-Service	1891718748	1891718748	1	1	HIRATA, RUSSELL S MD	2/28/1995	207L00000X	NA	Other	026	PHYSICIANS	48754	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
131321	Fee-for-Service	1386755833	1386755833	1	1	HESH, MATTHEW DO	6/7/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	18053	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
131356	Fee-for-Service	1609171230	1609171230	1	1	HURWITZ, ALFRED L MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	20286	10	Gastroenterology (M.D. only)	0	In state provider	None	455 OCONNOR DRIVE	SUITE 350	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
131382	Fee-for-Service	1821053539	1821053539	1	1	HILLEL BRYK	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
131402	Fee-for-Service	1962723965	1962723965	1	1	HULL, JAMES L MD INC	1/1/1979	193400000X	NA	Other	026	PHYSICIANS	26453	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8475 S VAN NESS AVE	STE 101	INGLEWOOD	CA	90304	1566	19	06037	33.960645	-118.317798	Los Angeles County
131417	Fee-for-Service	1306062476	1306062476	1	1	HIBLER, ANITA M MD	5/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	36494	04	Otology, Laryngology, Rhinology	0	In state provider	None	12900 AVALON BLVD	None	LOS ANGELES	CA	90061	2734	19	06037	33.91521644	-118.2652318	Los Angeles County
131452	Fee-for-Service	1558075754	1558075754	1	1	HUETTER, VIOLET	11/22/2023	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1921 DOUGLAS BLVD	106	ROSEVILLE	CA	95661	3817	31	06061	38.74437581	-121.2552522	Placer County
131459	Fee-for-Service	1215499256	1215499256	1	1	HASAN, ASBAT MD	6/25/2024	207RR0500X	NA	Other	026	PHYSICIANS	None	83	Rheumatology	0	In state provider	None	6180 BROCKTON AVE	SUITE 204	RIVERSIDE	CA	92506	2233	33	06065	33.958692	-117.3967415	Riverside County
131488	Fee-for-Service	1801814876	1801814876	1	1	HJORT, AMY N MD	9/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85802	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	102 SAN MIGUEL AVE	None	SALINAS	CA	93901	3057	27	06053	36.65895947	-121.6556795	Monterey County
131496	Fee-for-Service	1831811330	1831811330	1	1	HARRIS, COLLEEN E CNP	11/2/2022	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
131501	Fee-for-Service	1831156389	1831156389	1	1	HETNAL, CELINA A MD	6/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	46561	67	Endocrinology	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
131502	Fee-for-Service	1104463371	1104463371	1	1	HIGH DESERT PSYCHOLOGICAL SE	11/5/2020	103TP2701X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
131520	Fee-for-Service	1669797197	1669797197	1	1	HOWITT, BROOKE E MD	12/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	153314	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
131521	Fee-for-Service	1841534641	1841534641	1	1	HONAKER, BRUCE A	12/24/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	20122 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5306	01	06001	37.69738066	-122.087041	Alameda County
131526	Fee-for-Service	1538383104	1538383104	1	1	HOANG, KHANG Q DO	5/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9733	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
131544	Fee-for-Service	1083979710	1083979710	1	1	HOLZ, GRANT S MD	2/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128826	30	Radiology	0	In state provider	None	8700 BEVERLY BLVD	M-335	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
131556	Fee-for-Service	1932368347	1932368347	1	1	HABASHY, TAHANY M MD INC	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65338	08	Family Practice	0	In state provider	None	222 W MAIN ST	STE 102	TUSTIN	CA	92780	7711	30	06059	33.74205891	-117.8253675	Orange County
131588	Fee-for-Service	1639174907	1639174907	1	1	HARDIN, DAVID M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82975	89	Surgery-Traumatic	0	In state provider	None	451 MARCH AVE	STE B	HEALDSBURG	CA	95448	3387	49	06097	38.62594212	-122.8645263	Sonoma County
131636	Fee-for-Service	1487785093	1487785093	1	1	HARKNESS, RUMIKO NP	9/2/2017	363LX0001X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3998 VISTA WAY	SUITE C	OCEANSIDE	CA	92056	4514	37	06073	33.18370179	-117.292963	San Diego County
131719	Fee-for-Service	1629161146	1629161146	1	1	HO, CHAO MD	7/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	55987	41	Internal Medicine	0	In state provider	None	13847 E 14TH ST	STE 113	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
131730	Fee-for-Service	1346577160	1346577160	1	1	HARA ORTHOTICS AND	7/30/2018	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	PROSTHETICS INC	1343 W VALENCIA DRIVE	SUITE E	FULLERTON	CA	92833	4044	30	06059	33.866554	-117.9493816	Orange County
131788	Fee-for-Service	1104463371	1104463371	1	1	HIGH DESERT PSYCHOLOGICAL SE	11/2/2020	103TP2701X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	RVICES	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
131838	Fee-for-Service	1588961163	1588961163	1	1	HOSKINS, JASON D MD	3/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	150198	30	Radiology	0	In state provider	None	3161 L STREET	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
131862	Fee-for-Service	1164577433	1164577433	2	1	HEARING AND SPEECH CENTER OF	8/1/2011	193200000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	NORTHERN CALIFORNIA	1234 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3911	38	06075	37.781144	-122.4390035	San Francisco County
131873	Fee-for-Service	1144485384	1144485384	1	1	HANGER P & O WEST INC	2/2/2009	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	23206 LYONS AVE	None	SANTA CLARITA	CA	91321	2667	19	06037	34.37981956	-118.5384385	Los Angeles County
131885	Fee-for-Service	1639819014	1639819014	1	1	HAPPY LIFE SENIOR CARE INC	5/26/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	20565 CALIFA ST	None	WOODLAND HILLS	CA	91367	5309	19	06037	34.17565064	-118.5818885	Los Angeles County
131904	Fee-for-Service	1649035312	1649035312	1	1	HA, KELLEY OD	5/22/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15315 MAGNOLIA BLVD	100	SHERMAN OAKS	CA	91403	1173	19	06037	34.16488161	-118.4666419	Los Angeles County
131907	Fee-for-Service	1578983714	1578983714	1	1	HENRY, AUSTIN J DO	10/8/2019	207L00000X	NA	Other	026	PHYSICIANS	16320	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
131925	Fee-for-Service	1275544876	1275544876	1	1	HIYAMA, DARRYL T. MD	12/31/1989	208600000X	NA	General Surgery	026	PHYSICIANS	70040	02	General 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
131929	Fee-for-Service	1245325315	1245325315	1	1	HAPAK, SHARON A NP	8/1/2019	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	34	06067	38.571084	-121.471074	Sacramento County
131933	Fee-for-Service	1912046616	1912046616	1	1	HARRISON, JON D MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81597	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
131945	Fee-for-Service	1447318456	1447318456	1	1	HESS, JOHN W DC DBA	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	ORANGE HILL CHIROPRACTIC	1520 E LINCOLN AVE	None	ORANGE	CA	92865	1928	30	06059	33.83492452	-117.8383599	Orange County
131961	Fee-for-Service	1376538868	1376538868	1	1	HUEY, HENRY	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	75399	None	None	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
132006	Fee-for-Service	1245733849	1245733849	1	1	HENDSON, STEPHANIE OT	11/8/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
132024	Fee-for-Service	1417032004	1417032004	1	1	HOLISTIC MEDICAL GROUP	5/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	GARFIELD HOLISTIC MED	405 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1201	19	06037	34.066431	-118.122906	Los Angeles County
132035	Fee-for-Service	1649275637	1649275637	1	1	HADDAD, NAZIH M MD	3/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	31234	04	Otology, Laryngology, Rhinology	0	In state provider	None	9201 E WHITTIER BLVD	None	PICO RIVERA	CA	90660	2450	19	06037	34.00017083	-118.0809649	Los Angeles County
132058	Fee-for-Service	1205464294	1205464294	1	1	HARRIS, KEVIN DO	8/9/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21162	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
132068	Fee-for-Service	1255638912	1255638912	1	1	HEMAK, MICHAEL J MD	9/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115816	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
132075	Fee-for-Service	1104463371	1104463371	1	1	HIGH DESERT PSYCHOLOGICAL SE	11/2/2020	103TP2701X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
132116	Fee-for-Service	1760796593	1760796593	1	1	HENSON, ADAM PT	6/26/2023	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
132159	Fee-for-Service	1144485384	1144485384	1	1	HANGER P & O WEST INC	3/23/2018	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	23206 LYONS AVE	None	SANTA CLARITA	CA	91321	2667	19	06037	34.37981956	-118.5384385	Los Angeles County
132163	Fee-for-Service	1083079990	1083079990	1	1	HOGUE, MICHAEL D CRNA	12/8/2020	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
132200	Fee-for-Service	1760861702	1760861702	1	1	HO, JOSEPHINE P LMFT	5/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
132232	Fee-for-Service	1598001349	1598001349	1	2	HEARING STATION CORP	7/25/2014	237600000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1045 W REDONDO BEACH BL	SUITE 575	GARDENA	CA	90247	4128	19	06037	33.89247044	-118.2931941	Los Angeles County
132252	Fee-for-Service	1568773448	1568773448	1	1	HE, XU L	11/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12717	41	Internal Medicine	0	In state provider	None	1600 E CITRUS AVE	None	REDLANDS	CA	92374	4270	36	06071	34.05557272	-117.1468659	San Bernardino County
132254	Fee-for-Service	1194712380	1194712380	1	1	HARRINGTON, RONALD R MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	23347	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
132270	Fee-for-Service	1225229388	1225229388	1	1	HWANG, EMILY C OD	10/7/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12302 GARDEN GROVE BLVD	STE 6	GARDEN GROVE	CA	92843	1802	30	06059	33.77428392	-117.9181185	Orange County
132312	Fee-for-Service	1417032004	1417032004	1	1	HOLISTIC MEDICAL GROUP	5/1/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GARFIELD HOLISTIC MED	405 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1201	19	06037	34.066431	-118.122906	Los Angeles County
132334	Fee-for-Service	1164955514	1164955514	1	1	HARRIS, OLIVIA MD	7/8/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
132362	Fee-for-Service	1104463371	1104463371	1	1	HIGH DESERT PSYCHOLOGICAL SE	11/2/2020	103TP2701X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
132366	Fee-for-Service	1407894009	1407894009	1	1	HODIS, HOWARD MD	1/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	55699	41	Internal Medicine	0	In state provider	None	2025 ZONAL AVE	None	LOS ANGELES	CA	90089	0264	19	06037	34.05998665	-118.2058023	Los Angeles County
132382	Fee-for-Service	1770642662	1770642662	1	1	HO, LIN MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	21444	20	Orthopedic Surgery	0	In state provider	None	2340 CLAY STREET	#610	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
132394	Fee-for-Service	1962575563	1962575563	1	1	HAGSTROM, MATS F MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80721	02	General Surgery	0	In state provider	None	1310 W STEWART DR	STE 610	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
132420	Fee-for-Service	1902354293	1902354293	1	1	HERRERA, KAORI LMFT	1/17/2024	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
132427	Fee-for-Service	1477756815	1477756815	1	1	HOLVE, TAYLOR J MD	4/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	97970	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
132436	Fee-for-Service	1750586731	1750586731	1	1	HOOKER, TERESA J PSYD	3/26/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
132444	Fee-for-Service	1689362956	1689362956	1	1	HUCKLEBERRY TRANSPORTATION,	3/7/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	LLC	520 N MAIN ST	None	FORT BRAGG	CA	95437	3218	23	06045	39.44722019	-123.8058885	Mendocino County
132475	Fee-for-Service	1669440988	1669440988	1	1	HO, JAMES C MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	78385	01	General Practice	0	In state provider	None	750 N ARCHIBALD AVE	STE L	ONTARIO	CA	91764	4647	36	06071	34.071309	-117.592101	San Bernardino County
132485	Fee-for-Service	1316325889	1316325889	1	1	HANNA, CHRISTINE M N MD	2/1/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	153639	41	Internal Medicine	0	In state provider	None	191 S BUENA VISTA ST	STE 200	BURBANK	CA	91505	4542	19	06037	34.15872557	-118.3283863	Los Angeles County
132532	Fee-for-Service	1265584536	1265584536	1	1	HO, DAVID OD	2/9/2015	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
132618	Fee-for-Service	1457322430	1457322430	1	1	HOLLENBERG, SANDRA A MD	11/15/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	43388	40	Pediatrics	0	In state provider	#101	1818 N ORANGE GROVE AVE	None	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
132662	Fee-for-Service	1316126477	1316126477	1	1	HAKIMI DAWSON, NAZANIN LPCC	6/21/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	29995 TECHNOLOGY DR	101A	MURRIETA	CA	92563	2633	33	06065	33.56041691	-117.1370428	Riverside County
132669	Fee-for-Service	1013933225	1013933225	1	1	HONG, JANE K MD	11/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	79885	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1174 N EUCLID ST	None	ANAHEIM	CA	92801	1900	30	06059	33.849621	-117.941612	Orange County
132677	Fee-for-Service	1629462924	1629462924	1	1	HEFFNER, AMY DO MD	1/1/2018	207P00000X	NA	Other	026	PHYSICIANS	14974	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
132679	Fee-for-Service	1114346913	1114346913	1	1	HASTINGS, JEFFREY W MD	9/23/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171965	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
132683	Fee-for-Service	1962575563	1962575563	1	1	HAGSTROM, MATS F MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	80721	24	Plastic Surgery	0	In state provider	None	1310 W STEWART DR	STE 610	ORANGE	CA	92868	3857	30	06059	33.78236048	-117.8664975	Orange County
132712	Fee-for-Service	1194073262	1194073262	1	1	HSU, ISABEL R H MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119149	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
132723	Fee-for-Service	1558454397	1558454397	1	1	HUSS, ROD L MD	4/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	53859	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 S B ST	STE B	LOMPOC	CA	93436	6933	42	06083	34.63860089	-120.4503641	Santa Barbara County
132740	Fee-for-Service	1861529182	1861529182	1	1	HUANG, DEMING CA	2/1/1999	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
132751	Fee-for-Service	1235139189	1235139189	1	1	HARRIS, DAWN E MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75244	66	Emergency Medicine (Urgent Care)	0	In state provider	None	155 GLASSON WAY	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
132765	Fee-for-Service	1669440988	1669440988	1	1	HO, JAMES C MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	78385	08	Family Practice	0	In state provider	None	750 N ARCHIBALD AVE	STE L	ONTARIO	CA	91764	4647	36	06071	34.071309	-117.592101	San Bernardino County
132802	Fee-for-Service	1255759825	1255759825	1	1	HUANG, IRIS N MD	8/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148933	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
132827	Fee-for-Service	1548440100	1548440100	1	1	HAINES, LAURA N MD	9/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120673	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
132839	Fee-for-Service	1386991669	1386991669	1	1	HIRSCHBERG, AMANDA O MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51811	-	NOT APPLICABLE	0	In state provider	None	15305 RAYEN ST	None	NORTH HILLS	CA	91343	5117	19	06037	34.23191048	-118.4657625	Los Angeles County
132867	Fee-for-Service	1932776481	1932776481	1	1	HATCHETT, DEXTER L MD	8/2/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
132909	Fee-for-Service	1538259577	1538259577	1	1	HA, DAVID TAM MD	4/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38081	01	General Practice	0	In state provider	None	5025 STOCKTON BLVD	None	SACRAMENTO	CA	95820	5407	34	06067	38.529306	-121.4439435	Sacramento County
132937	Fee-for-Service	1871664375	1871664375	1	1	HANNA, GINA V MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87504	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1135 S SUNSET AVE	STE 402	WEST COVINA	CA	91790	3938	19	06037	34.06215064	-117.9453997	Los Angeles County
132967	Fee-for-Service	1225117351	1225117351	1	1	HENDRICKSON, KRISTINE MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61805	40	Pediatrics	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
132975	Fee-for-Service	1750669578	1750669578	1	1	HUNG, SHARON W MD	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	122662	41	Internal Medicine	0	In state provider	None	725 WELCH ROAD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
133003	Fee-for-Service	1194073262	1194073262	1	1	HSU, ISABEL R H MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119149	67	Endocrinology	0	In state provider	None	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
133010	Fee-for-Service	1396788345	1396788345	1	1	HO, JAI H MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64504	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1111 W LA PALMA AVE	None	ANAHEIM	CA	92801	2804	30	06059	33.84718298	-117.933758	Orange County
133018	Fee-for-Service	1962494278	1962494278	1	1	HUGES, ANNE MD	8/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	67178	01	General 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
133034	Fee-for-Service	1497011340	1497011340	1	1	HAN, RACHAEL DO	9/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13148	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
133045	Fee-for-Service	1184688400	1184688400	1	1	HOFFMAN, PAUL L MD	2/26/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	39346	40	Pediatrics	0	In state provider	None	2505 SAMARITAN DR	STE 600	SAN JOSE	CA	95124	4017	43	06085	37.25111447	-121.9483395	Santa Clara County
133085	Fee-for-Service	1992897508	1992897508	1	1	HERNANDEZ, VIVIEN D MD	11/9/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	37667	40	Pediatrics	0	In state provider	None	48 PARK PLAZA DR	STE 317	DALY CITY	CA	94015	1356	41	06081	37.70128623	-122.4818531	San Mateo County
133086	Fee-for-Service	1780627190	1780627190	1	1	HASTINGS, CHARLES J DPM	2/11/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	12520 MAGNOLIA BLVD	#304	VALLEY VILLAGE	CA	91607	2355	19	06037	34.16485451	-118.406106	Los Angeles County
133091	Fee-for-Service	1952492621	1952492621	1	1	HINTON, SAMUEL P MD	6/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86470	18	Ophthalmology	0	In state provider	None	7075 N SHARON AVE	None	FRESNO	CA	93720	3329	10	06019	36.83882737	-119.7590708	Fresno County
133095	Fee-for-Service	1154784866	1154784866	1	1	HANNABASS, KYLE R MD	6/18/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	152363	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
133096	Fee-for-Service	1457072118	1457072118	1	1	HEROLD, RYAN PT	3/3/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	411 W. MAIN ST.	None	BRAWLEY	CA	92227	2244	13	06025	32.97866153	-115.5481515	Imperial County
133120	Fee-for-Service	1700116209	1700116209	1	1	HELPING KIDS TO RECOVER, INC	9/3/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2606 N CENTRAL AVE	63, 64, 76, B2, B6, B7	COMPTON	CA	90222	1640	19	06037	33.91523797	-118.2543123	Los Angeles County
133165	Fee-for-Service	1427132406	1427132406	1	1	HERR, JAN L MD	11/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43634	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
133171	Fee-for-Service	1487915153	1487915153	1	1	HAGEN, JONATHAN T MD	8/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148997	20	Orthopedic Surgery	0	In state provider	None	1139 THIRD STREET	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
133180	Fee-for-Service	1598967812	1598967812	1	1	HORKY, LAURA L MD	9/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	85870	42	Nuclear Medicine	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
133205	Fee-for-Service	1487695706	1487695706	1	1	HALL, MICHAEL MD	12/9/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66822	None	None	0	In state provider	None	18200 YORBA LIND BLVD	SUITE 250	YORBA LINDA	CA	92886	4044	30	06059	33.88842824	-117.8154698	Orange County
133208	Fee-for-Service	1386020022	1386020022	1	1	HUYNH, LINDA LMFT	7/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 GELLERT BLVD.	SUITE 280	DALY CITY	CA	94015	2619	41	06081	37.66608413	-122.4686507	San Mateo County
133276	Fee-for-Service	1538257803	1538257803	1	1	HO, JOHN L MD	10/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	46040	41	Internal Medicine	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
133291	Fee-for-Service	1205094539	1205094539	1	1	HOSSEINI, NIMA MD	9/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	104471	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3609	34	06067	38.626056	-121.3834455	Sacramento County
133313	Fee-for-Service	1629185970	1629185970	1	1	HARRISON, ROBERT J MD	1/1/1982	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	43031	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
133331	Fee-for-Service	1043828114	1043828114	1	1	HOPE & PEACE HOSPICE CARE	8/27/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	135 S JACKSON ST	SUITE 102	GLENDALE	CA	91205	4917	19	06037	34.14506735	-118.2501278	Los Angeles County
133337	Fee-for-Service	1235283029	1235283029	1	1	HELMICK-O'BRIEN, BONNIE M LM	8/25/2020	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
133352	Fee-for-Service	1023480613	1023480613	1	1	HHS HOMECARE INC	6/12/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	10875 LA TUNA CANYON RD	None	SUN VALLEY	CA	91352	1087	19	06037	34.23445791	-118.3683232	Los Angeles County
133353	Fee-for-Service	1972651834	1972651834	1	1	HOGAN, ROBERT W MD	8/14/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	34537	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
133354	Fee-for-Service	1578052437	1578052437	1	1	HALLE, MCKENZIE MD	5/10/2022	390200000X	NA	Other	026	PHYSICIANS	165870	None	None	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	0000	19	06037	34.158213	-118.328112	Los Angeles County
133355	Fee-for-Service	1295116127	1295116127	1	1	HAGHIGHI, AREZU MD	8/3/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	145103	18	Ophthalmology	0	In state provider	None	751 DAILY DR	STE 110	CAMARILLO	CA	93010	6077	56	06111	34.21880533	-119.0593374	Ventura County
133377	Fee-for-Service	1215016738	1215016738	1	1	HAWKINS, RACHEL E PSYD	4/16/2015	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
133415	Fee-for-Service	1184002073	1184002073	1	1	HOCHMAN SEGAL, HANNAH R MD	11/19/2024	207R00000X	NA	Other	026	PHYSICIANS	161961	41	Internal Medicine	0	In state provider	None	11806 WHITTIER BLVD	STE A & B	WHITTIER	CA	90601	0001	19	06037	33.98055873	-118.0506023	Los Angeles County
133445	Fee-for-Service	1992818892	1992818892	1	1	HOANG, THANH X MD	7/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91008	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
133492	Fee-for-Service	1063559698	1063559698	1	1	HILLTOP PEDIATRICS MEDICAL	12/3/1987	193400000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	GROUP	2970 HILLTOP MALL RD	STE 305	RICHMOND	CA	94806	5274	07	06013	37.97819764	-122.329244	Contra Costa County
133513	Fee-for-Service	1417946534	1417946534	1	1	HEDLEY, CHRISTOPHER G MD	2/28/1989	2085B0100X	NA	MRI Provider	026	PHYSICIANS	42219	30	Radiology	0	In state provider	None	100 CONGRESS ST	None	PASADENA	CA	91105	0000	19	06037	34.13395172	-118.1534955	Los Angeles County
133558	Fee-for-Service	1346804432	1346804432	1	1	HERITAGE GROUP HOMES, INC.	4/29/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	957 S. VILLAGE OAKS DR	None	COVINA	CA	91724	3696	19	06037	34.07216025	-117.8631234	Los Angeles County
133623	Fee-for-Service	1043828114	1043828114	1	1	HOPE & PEACE HOSPICE CARE	8/27/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	135 S JACKSON ST	SUITE 102	GLENDALE	CA	91205	4917	19	06037	34.14506735	-118.2501278	Los Angeles County
133638	Fee-for-Service	1477631968	1477631968	1	1	HILL, SABINE U DO	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	7193	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
133659	Fee-for-Service	1720395858	1720395858	1	1	HURTADO LEON, MONICA PSYD	10/20/2023	390200000X	NA	Other	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
133665	Fee-for-Service	1326246232	1326246232	1	1	HARBER, JENNIFER L 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
133727	Fee-for-Service	1932278157	1932278157	1	1	HWANG, GLORIA MD	10/2/2008	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	79881	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
133735	Fee-for-Service	1992818892	1992818892	1	1	HOANG, THANH X MD	7/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91008	45	Nephrology (Renal-Kidney)	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
133755	Fee-for-Service	1972847895	1972847895	1	1	HARVEY, DANIEL MD A P C	6/1/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	54957	01	General Practice	0	In state provider	MEDICINE	824 E CARSON STREET	SUITE 206	CARSON	CA	90745	2262	19	06037	33.83159904	-118.2605506	Los Angeles County
133760	Fee-for-Service	1275647521	1275647521	1	1	HANSEN, DAVID P MD INC	8/31/1986	207R00000X	NA	Other	026	PHYSICIANS	24261	41	Internal Medicine	0	In state provider	None	1117 10TH ST	None	CORONADO	CA	92118	3401	37	06073	32.68577283	-117.1793826	San Diego County
133779	Fee-for-Service	1619396512	1619396512	1	1	HOANG, JENNIFER U DO	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14473	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
133813	Fee-for-Service	1285749937	1285749937	1	2	HADWEH, YOUSSEF B MD	7/7/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74536	08	Family Practice	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
133817	Fee-for-Service	1326139163	1326139163	1	1	HESS, DANA J MD	1/10/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	134993	20	Orthopedic Surgery	0	In state provider	None	171 A BUTCHER RD	None	VACAVILLE	CA	95687	5656	48	06095	38.34394876	-121.9980023	Solano County
133819	Fee-for-Service	1841552940	1841552940	1	1	HARKER, DANIEL B OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8001 VENTURA CANYON AVE	None	PANORAMA CITY	CA	91402	6312	19	06037	34.21619623	-118.4287605	Los Angeles County
133845	Fee-for-Service	1114965092	1114965092	1	1	HSU, ERIC L MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66350	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
133848	Fee-for-Service	1346636842	1346636842	1	1	HERDES, RACHEL E DO	5/17/2023	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	17178	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
133865	Fee-for-Service	1245401314	1245401314	1	1	HEKMAT, J J MD & HEKMAT,	5/28/1985	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	F F MD MEDICAL GROUP	9763 W PICO BLVD	STE 200	LOS ANGELES	CA	90035	4749	19	06037	34.05426203	-118.401426	Los Angeles County
133876	Fee-for-Service	1407487200	1407487200	1	1	HARRISON, LECIA LCSW	1/25/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	343 E MAIN ST	STE 400	STOCKTON	CA	95202	3057	39	06077	37.95334019	-121.2862084	San Joaquin County
133893	Fee-for-Service	1912637505	1912637505	1	2	HORIZON TRANSPORTATION LLC	8/24/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	500 STATE COLLEGE BLVD	1114	ORANGE	CA	92868	1604	30	06059	33.79565477	-117.8893624	Orange County
133979	Fee-for-Service	1568995546	1568995546	1	1	HODGES, BEVERLY CNP	6/19/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	814 14TH ST	STE E	MODESTO	CA	95354	1028	50	06099	37.6418777	-120.9946568	Stanislaus County
134010	Fee-for-Service	1417465204	1417465204	1	1	HOCKETT, WILLIAM MD	4/2/2023	207P00000X	NA	Other	026	PHYSICIANS	177117	None	None	0	In state provider	None	5451 WALNUT AVE	None	CHINO	CA	91710	2609	36	06071	34.02626886	-117.6858645	San Bernardino County
134021	Fee-for-Service	1679750624	1679750624	1	1	HUELS, DARRYL J	6/15/2023	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
134036	Fee-for-Service	1437547247	1437547247	1	1	HWANG, KAREN S CRNA	6/19/2018	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
134038	Fee-for-Service	1760805782	1760805782	1	1	HARESH M KHILNANI MEDICAL CO	8/18/2014	174400000X	NA	Other	026	PHYSICIANS	50550	None	None	0	In state provider	RP	51 5TH AVE	STE 302	ARCADIA	CA	91006	3710	19	06037	34.1412293	-118.0205477	Los Angeles County
134101	Fee-for-Service	1285706796	1285706796	1	1	HOFFMAN, IRWIN PHD	1/1/1979	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1240 S WESTLAKE BLVD	STE 211	WESTLAKE VILLAGE	CA	91361	1993	56	06111	34.14966879	-118.8378084	Ventura County
134136	Fee-for-Service	1174546766	1174546766	1	1	HUA, SHERWIN E MD	8/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92374	14	Neurological Surgery	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
134256	Fee-for-Service	1871676213	1871676213	1	1	HUMBOLDT CO COMM CLINIC	4/7/1989	No Taxonomy Provided	NA	None	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	529 I ST	None	EUREKA	CA	95501	1116	12	06023	40.80213826	-124.162569	Humboldt County
134264	Fee-for-Service	1598780066	1598780066	1	1	HYONG, KIM S MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65876	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
134268	Fee-for-Service	1700816535	1700816535	2	1	HO, KEVIN L DPM INC	12/5/2011	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	14571 MAGNOLIA STREET	STE 206	WESTMINSTER	CA	92683	5576	30	06059	33.75097286	-117.9723502	Orange County
134279	Fee-for-Service	1972543296	1972543296	1	1	HEWETT, JOHN J MD	2/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52896	30	Radiology	0	In state provider	None	323 N PRAIRIE AVE	STE 114	INGLEWOOD	CA	90301	4503	19	06037	33.966333	-118.3439975	Los Angeles County
134282	Fee-for-Service	1942405956	1942405956	1	1	HSIEH, PATRICK C MD	10/20/2008	207T00000X	NA	General Surgery	026	PHYSICIANS	104473	14	Neurological Surgery	0	In state provider	None	1520 SAN PABLO STREET	SUITE 3800	LOS ANGELES	CA	90089	3137	19	06037	34.06269295	-118.2030006	Los Angeles County
134290	Fee-for-Service	1861838658	1861838658	1	1	HARTER, ANNA MD	8/29/2017	390200000X	NA	Other	026	PHYSICIANS	131795	05	Anesthesiology	0	In state provider	None	PUEBLO AT BATHS STREETS	None	SANTA BARBARA	CA	93105	0000	42	06083	34.430526	-119.72196	Santa Barbara County
134318	Fee-for-Service	1265848683	1265848683	1	1	HEALTHY LIVING AT HOME	11/19/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PALM DESERT LLC	36953 COOK STREET	SUITE 102	PALM DESERT	CA	92211	6083	33	06065	33.77921935	-116.3558752	Riverside County
134352	Fee-for-Service	1598928426	1598928426	1	1	HSIAU, MARGARET C MD	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84934	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
134397	Fee-for-Service	1003066630	1003066630	1	1	HEGDE, MEENAKSHI G MD	11/1/2022	2080P0207X	NA	Hematology	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
134450	Fee-for-Service	1174143721	1174143721	1	1	HUFF, ESTEE LMFT	1/21/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
134475	Fee-for-Service	1689103392	1689103392	1	1	HECKENDORN, TIFFANY A MD	8/14/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157864	40	Pediatrics	0	In state provider	None	1840 SIERRA GARDENS	None	ROSEVILLE	CA	95678	2912	31	06061	38.74730831	-121.2613758	Placer County
134507	Fee-for-Service	1235337106	1235337106	1	1	HOWARD, JAMES P MD	6/13/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100155	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
134509	Fee-for-Service	1972885077	1972885077	1	1	HAUSMAN, NINA H LCSW	1/6/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	969 BROADWAY	None	OAKLAND	CA	94607	4017	01	06001	37.80134725	-122.273069	Alameda County
134543	Fee-for-Service	1881931590	1881931590	1	1	HOANG, TU MD A PROFESSIONAL	9/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79962	41	Internal Medicine	0	In state provider	MEDICAL CORPORATION	1881 COMMERCENTER E	STE 120	SAN BERNARDINO	CA	92408	3442	36	06071	34.06770327	-117.2822565	San Bernardino County
134571	Fee-for-Service	1528026978	1528026978	1	1	HENDERSON, JEFFREY L MD	3/31/2018	No Taxonomy Provided	NA	None	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
134590	Fee-for-Service	1235216102	1235216102	2	1	HEALTHY PHARMACY INC	7/22/2008	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	600 W MAIN ST	STE 106	ALHAMBRA	CA	91801	3362	19	06037	34.09202393	-118.1334721	Los Angeles County
134610	Fee-for-Service	1972923316	1972923316	1	1	HUREZEANU, RAZVAN 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
134622	Fee-for-Service	1144285776	1144285776	1	1	HAWGOOD, SAMUEL MD	1/1/1990	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	42857	01	General Practice	0	In state provider	None	1336 MOFFITT	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.73743268	-122.4331132	San Francisco County
134652	Fee-for-Service	1982708988	1982708988	1	1	HO, MICHAEL MD	2/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92159	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
134687	Fee-for-Service	1063492031	1063492031	1	1	HOLLAND, CHRISTOPHER V MD	5/28/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	84573	41	Internal Medicine	0	In state provider	None	1250 PEACH STREET	SUITE M	SAN LUIS OBISPO	CA	93401	2877	40	06079	35.28647825	-120.6599674	San Luis Obispo County
134712	Fee-for-Service	1073711701	1073711701	1	1	HSIA, ELISA C MD	3/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	93324	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
134737	Fee-for-Service	1194217588	1194217588	1	1	HMG HEALTH CARE	8/3/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	74132	08	Family Practice	0	In state provider	None	44215 15TH ST WEST	STE 315	LANCASTER	CA	93534	5505	19	06037	34.68666415	-118.1568572	Los Angeles County
134757	Fee-for-Service	1861555252	1861555252	1	1	HANKINS, ABIGAIL S	6/9/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	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
134776	Fee-for-Service	1720469547	1720469547	1	1	HUANG, RONG MD INC	1/11/2016	207R00000X	NA	Other	026	PHYSICIANS	67591	41	Internal Medicine	0	In state provider	None	400 EVELYN AVENUE	SUITE 107	ALBANY	CA	94706	1350	01	06001	37.89873243	-122.2971602	Alameda County
134777	Fee-for-Service	1497413371	1497413371	1	1	HERNANDEZ FAMILY COUNSELING	12/27/2021	193400000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	6800 INDIANA AVE	SUITE 130	RIVERSIDE	CA	92506	4266	33	06065	33.94303679	-117.391856	Riverside County
134783	Fee-for-Service	1861000945	1861000945	1	1	HIGHLAND SENIOR HOME CARE	3/16/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	7513 SWEETMEADOW CT	None	HIGHLAND	CA	92346	3746	36	06071	34.11733651	-117.2060857	San Bernardino County
134789	Fee-for-Service	1790153153	1790153153	1	1	HOOVER, VALERIE J PHD	10/1/2015	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
134822	Fee-for-Service	1144524430	1144524430	1	1	HEBERT, DANIEL R NP	12/13/2022	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
134865	Fee-for-Service	1952841173	1952841173	1	1	HARRELL, AAMBER D LMFT	7/15/2021	106H00000X	NA	Mental Health Outpatient Services	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
134877	Fee-for-Service	1679136634	1679136634	1	1	HEALING RHYTHMS PSYCHOLOGICA	2/20/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	L SERVICES, PC	521 1/2 S MYRTLE AVE	STE 9/10	MONROVIA	CA	91016	5131	19	06037	34.14635952	-118.0010148	Los Angeles County
134893	Fee-for-Service	1982605986	1982605986	1	1	HARWARD, TIMOTHY R MD	6/30/1982	2086S0129X	NA	General Surgery	026	PHYSICIANS	46797	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
134896	Fee-for-Service	1053322743	1053322743	1	1	HUANG, HELEN MD DBA	10/31/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	69976	01	General Practice	0	In state provider	VINEYARD PEDIATRICS	1850 S AZUSA AVE	STE 209	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
134924	Fee-for-Service	1063497220	1063497220	1	1	HUSSAIN, SHAHID MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80449	45	Nephrology (Renal-Kidney)	0	In state provider	None	790 W ORANGE AVE	STE B	EL CENTRO	CA	92243	3274	13	06025	32.7888123	-115.5609792	Imperial County
134937	Fee-for-Service	1063982775	1063982775	1	1	HIRSCH, KEELY PSYD	3/25/2020	103T00000X	NA	Mental Health Outpatient Services	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
134975	Fee-for-Service	1528542156	1528542156	1	1	HERNANDEZ, SARA L MSW LCSW	8/3/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27451 TOURNEY ROAD	SUITE 120	VALENCIA	CA	91355	6304	19	06037	34.42210981	-118.5795785	Los Angeles County
135004	Fee-for-Service	1841785839	1841785839	1	1	HUFF, VIRGINIA LCSW	5/13/2020	101YP2500X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	520 CHADBOURNE RD	None	FAIRFIELD	CA	94534	0000	48	06095	38.235248	-122.0817079	Solano County
135032	Fee-for-Service	1265627160	1265627160	1	1	HUGHES, KISHA C MD	7/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111916	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
135039	Fee-for-Service	1336582790	1336582790	1	1	HUYNH, LINDA MD	10/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137325	41	Internal Medicine	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
135068	Fee-for-Service	1225473143	1225473143	1	1	HU, ZHONGXIA MD	6/9/2020	2085R0204X	NA	Other	026	PHYSICIANS	167990	30	Radiology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
135080	Fee-for-Service	1821338682	1821338682	1	1	HUYNH-LE, MINH-PHUONG MD	12/1/2023	2085R0001X	NA	Other	026	PHYSICIANS	145610	None	None	0	In state provider	None	3800 HOMESTEAD RD	None	SANTA CLARA	CA	95051	4542	43	06085	37.3377485	-122.001453	Santa Clara County
135107	Fee-for-Service	1396039301	1396039301	1	2	HEGYI, EDIT MD	12/30/2019	261Q00000X	NA	Other	026	PHYSICIANS	89002	01	General Practice	0	In state provider	None	16769 BERNARDO CENTER DR	SUITE K13	SAN DIEGO	CA	92128	2546	37	06073	33.01790702	-117.0755758	San Diego County
135162	Fee-for-Service	1386071447	1386071447	1	1	HIRSHMARTIN, DARRA PHD	4/4/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	334 SHAW AVE	SUITE 100	CLOVIS	CA	93612	3839	10	06019	36.80839352	-119.7049776	Fresno County
135166	Fee-for-Service	1225032162	1225032162	2	1	HANGER PROSTHETICS & ORTHOTI	8/9/2021	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	2933 LONG BEACH BLVD	None	LONG BEACH	CA	90806	1517	19	06037	33.81062601	-118.1895059	Los Angeles County
135172	Fee-for-Service	1932138427	1932138427	1	1	HULL, RONALD A DPM	9/20/2007	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	19830 LAKE CHABOT RD	STE B	CASTRO VALLEY	CA	94546	4063	01	06001	37.70011045	-122.0877799	Alameda County
135182	Fee-for-Service	1598790479	1598790479	1	1	HERNANDEZ, OSCAR A MD IN	4/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	72101	08	Family Practice	0	In state provider	None	590 W PUTNAM AVE	#10	PORTERVILLE	CA	93257	3257	54	06107	36.06962449	-119.030337	Tulare County
135213	Fee-for-Service	1063497220	1063497220	1	1	HUSSAIN, SHAHID MD	7/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80449	41	Internal Medicine	0	In state provider	None	790 W ORANGE AVE	STE B	EL CENTRO	CA	92243	3274	13	06025	32.7888123	-115.5609792	Imperial County
135248	Fee-for-Service	1881222792	1881222792	1	1	HUYNH, CHRISTINE M MD	7/17/2023	207P00000X	NA	Other	026	PHYSICIANS	178154	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
135385	Fee-for-Service	1982782793	1982782793	1	1	HYNSON, JAMES M	11/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	61308	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
135391	Fee-for-Service	1568880508	1568880508	1	1	HU, STEVE MD	3/23/2022	207R00000X	NA	Other	026	PHYSICIANS	154980	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
135397	Fee-for-Service	1992236269	1992236269	1	1	HOLMES, BRANDON B MD	7/29/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	160270	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
135424	Fee-for-Service	1114456639	1114456639	1	1	HAJEK, MICHAEL MD	1/14/2025	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	04	Otology, Laryngology, Rhinology	0	In state provider	None	550 WATER ST	SUITE A	SANTA CRUZ	CA	95060	4126	44	06087	36.98046158	-122.018718	Santa Cruz County
135451	Fee-for-Service	1831452002	1831452002	1	1	HELLEWELL, DAVID DPM	8/5/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	17822 BEACH BLVD	SUITE 407	HUNTINGTON BEACH	CA	92647	7101	30	06059	33.70331388	-117.9890471	Orange County
135458	Fee-for-Service	1306958996	1306958996	1	1	HOLDER, PINELLA A DO	5/16/2016	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	11255	25	Physical Medicine and Rehabilitation	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
135473	Fee-for-Service	1992344873	1992344873	1	1	HEALING HOME HEALTH	9/9/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	815 S CENTRAL AVE	STE 4	GLENDALE	CA	91204	2073	19	06037	34.13606127	-118.2578932	Los Angeles County
135512	Fee-for-Service	1164524815	1164524815	1	1	HILL, KEVIN B MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	7076	41	Internal Medicine	0	In state provider	None	11795 EDUCATION ST	STE 201	AUBURN	CA	95602	2469	31	06061	38.94433757	-121.098912	Placer County
135525	Fee-for-Service	1184624769	1184624769	1	1	HOLZMAN, MADELYN MD	10/16/2009	208800000X	NA	Other	026	PHYSICIANS	53106	34	Urology and Urological Surgery	0	In state provider	None	572 RIO LINDO AVE	STE 201	CHICO	CA	95926	1851	04	06007	39.75508407	-121.8487933	Butte County
135526	Fee-for-Service	1013946870	1013946870	1	1	HEMMERT, RAYMOND J DO	12/10/2019	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
135538	Fee-for-Service	1871767020	1871767020	1	1	HILL, SHANA M MD	7/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112894	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
135548	Fee-for-Service	1457379455	1457379455	1	1	HARRIS, DIANNE Y MD	9/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	64099	18	Ophthalmology	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
135580	Fee-for-Service	1598928475	1598928475	2	1	HEALTHCARE TLC INC	5/19/2021	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	7504 CAPPS AVE	None	RESEDA	CA	91335	2710	19	06037	34.20673636	-118.5393193	Los Angeles County
135604	Fee-for-Service	1811194970	1811194970	1	1	HADDICK, ERIK A	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
135618	Fee-for-Service	1811104649	1811104649	1	1	HITSUMOTO, MIWA MFT	1/27/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1910 HUNTINGTON DR	STE 10	SOUTH PASADENA	CA	91030	4887	19	06037	34.10428151	-118.143801	Los Angeles County
135709	Fee-for-Service	1548460249	1548460249	1	1	HANGER P & O WEST INC	12/21/2009	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	7551 TIMBERLAKE WAY	#110	SACRAMENTO	CA	95823	5421	34	06067	38.466225	-121.415958	Sacramento County
135715	Fee-for-Service	1508935107	1508935107	1	1	HHC INC	8/1/2002	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	HEARING HEALTH CENTER	6728 WHITE OAK AVE	None	VAN NUYS	CA	91406	5359	19	06037	34.193133	-118.518531	Los Angeles County
135730	Fee-for-Service	1942481619	1942481619	1	1	HO, EDITH Y MD	11/26/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	105337	10	Gastroenterology (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
135740	Fee-for-Service	1457983942	1457983942	1	1	HUGHSON SAMARITAN HOME CARE	1/7/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	LLC	7700 FOX RD	SUITE A	HUGHSON	CA	95326	9100	50	06099	37.60192442	-120.8522606	Stanislaus County
135748	Fee-for-Service	1770018301	1770018301	1	1	HAN, TIFFANY S MD	6/10/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	176140	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
135774	Fee-for-Service	1609264761	1609264761	1	1	HILL, MARY L LMFT	11/16/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1650 LINDA VISTA DR	SUITE 210	SAN MARCOS	CA	92078	3810	37	06073	33.13999169	-117.2023756	San Diego County
135780	Fee-for-Service	1083045595	1083045595	1	1	HOME OF COMPASSION	12/31/2013	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	13276 TERRA BELLA STREET	None	PACOIMA	CA	91331	3105	19	06037	34.25557337	-118.4220096	Los Angeles County
135801	Fee-for-Service	1164524815	1164524815	1	1	HILL, KEVIN B MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	7076	10	Gastroenterology (M.D. only)	0	In state provider	None	11795 EDUCATION ST	STE 201	AUBURN	CA	95602	2469	31	06061	38.94433757	-121.098912	Placer County
135825	Fee-for-Service	1871767020	1871767020	1	1	HILL, SHANA M MD	7/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112894	41	Internal Medicine	0	In state provider	None	270 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
135844	Fee-for-Service	1063825172	1063825172	1	1	HWEE, ANDREA C MD	6/10/2019	207P00000X	NA	Other	026	PHYSICIANS	160260	66	Emergency Medicine (Urgent Care)	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
135849	Fee-for-Service	1982745444	1982745444	1	1	HOLZ, ANDREW L MD	8/5/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	108343	30	Radiology	0	In state provider	None	6305 COYLE AVE	None	CARMICHAEL	CA	95608	0438	34	06067	38.668248	-121.3181415	Sacramento County
135860	Fee-for-Service	1730276825	1730276825	1	1	HENCHCLIFFE, CLAIRE MD	12/21/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	170951	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
135863	Fee-for-Service	1083137608	1083137608	1	1	HOSSEINPUR, NAJLA LCSW	3/27/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17000 S. HARLAN RD	None	LATHROP	CA	95330	8738	39	06077	37.80929182	-121.2956055	San Joaquin County
135868	Fee-for-Service	1376743229	1376743229	1	1	HUNT, LEONEL A AMC	10/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	72199	None	None	0	In state provider	None	8306 WILSHIRE BLVD	STE 597	BEVERLY HILLS	CA	90211	2304	19	06037	34.06425377	-118.3724288	Los Angeles County
135879	Fee-for-Service	1841677416	1841677416	1	1	HANSEN-CRUZ, NICHOLE A MD	2/1/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	144722	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
135941	Fee-for-Service	1154903912	1154903912	1	1	HONG, DIANA	8/17/2023	1835P1300X	NA	Other	026	PHYSICIANS	183141	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
135957	Fee-for-Service	1568956712	1568956712	1	1	HARRIS, LAURA MD	9/26/2019	390200000X	NA	Other	026	PHYSICIANS	163937	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
135986	Fee-for-Service	1568923449	1568923449	1	1	HUANG, CECILIA H MD	9/9/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181270	None	None	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
135993	Fee-for-Service	1851366348	1851366348	1	1	HIEB, KENNETH L OD	1/1/1990	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3173 E SHIELDS AVE	None	FRESNO	CA	93726	6902	10	06019	36.77966576	-119.7709687	Fresno County
135994	Fee-for-Service	1891905345	1891905345	1	1	HUANG, GARY Y MD	9/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104195	36	Psychiatry	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3358	38	06075	37.78272203	-122.4433297	San Francisco County
136028	Fee-for-Service	1033441365	1033441365	1	1	HALLETT, BRENDA LCSW	8/24/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19 WILLIAMSBURG LN	None	CHICO	CA	95926	2225	04	06007	39.7525191	-121.8551479	Butte County
136029	Fee-for-Service	1477504892	1477504892	1	1	HA, NGA T MD	4/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	31496	41	Internal Medicine	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
136032	Fee-for-Service	1174587208	1174587208	1	1	HARRIS, HOBART W MD	1/31/1990	208600000X	NA	General Surgery	026	PHYSICIANS	57599	02	General Surgery	0	In state provider	None	CASTRO & DUBOCE ST	None	S SAN FRANCISCO	CA	94114	0000	41	06081	37.769049	-122.43582	San Francisco County
136070	Fee-for-Service	1730333790	1730333790	1	2	HEBEYO ACUPUNCTURE INC	3/12/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1906 OCEANSIDE BLVD	SUITE S	OCEANSIDE	CA	92054	4423	37	06073	33.19353612	-117.356368	San Diego County
136089	Fee-for-Service	1124028691	1124028691	1	1	HEWLETT, HOWARD A DPM	8/15/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1038 E CHAPMAN AVE	None	ORANGE	CA	92866	2111	30	06059	33.78782652	-117.84249	Orange County
136090	Fee-for-Service	1437613213	1437613213	1	1	HARTMANN, JENNIFER LMFT	10/2/2023	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
136097	Fee-for-Service	1023497138	1023497138	1	1	HANNA, JAMILEH MD	9/3/2020	207R00000X	NA	Other	026	PHYSICIANS	144230	41	Internal Medicine	0	In state provider	None	2550 HOLLYWOOD	STE 100	BURBANK	CA	91505	1055	19	06037	34.195086	-118.348892	Los Angeles County
136106	Fee-for-Service	1730726407	1730726407	2	1	HOSIER, MARTY A	3/19/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	D THERAPY	388 E CITRUS DR	None	FARMERSVILLE	CA	93223	1008	54	06107	36.30802451	-119.2039695	Tulare County
136129	Fee-for-Service	1417729120	1417729120	1	1	HARJIT AND NAVGEET RCFE LLC	5/10/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5324 NYODA WAY	None	CARMICHAEL	CA	95608	3080	34	06067	38.63088	-121.3403445	Sacramento County
136136	Fee-for-Service	1982745444	1982745444	1	1	HOLZ, ANDREW L MD	8/5/2009	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	108343	42	Nuclear Medicine	0	In state provider	None	6305 COYLE AVE	None	CARMICHAEL	CA	95608	0438	34	06067	38.668248	-121.3181415	Sacramento County
136140	Fee-for-Service	1063512812	1063512812	1	1	HAN,SAMANTHA H MD	11/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	67693	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2031 W ALAMEDA AVE	STE 220	BURBANK	CA	91506	2959	19	06037	34.15972797	-118.3237055	Los Angeles County
136141	Fee-for-Service	1497118871	1497118871	1	1	HONG, ELIZABETH MD	7/19/2021	207L00000X	NA	Other	026	PHYSICIANS	151535	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
136156	Fee-for-Service	1962595611	1962595611	1	1	HURRAY, ALVIE S DPM	1/1/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	634 FREDERICK STREET	None	SANTA CRUZ	CA	95062	2203	44	06087	36.98007098	-122.0043791	Santa Cruz County
136172	Fee-for-Service	1730253048	1730253048	1	1	HAHN, CAROLINE C MD	8/18/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81219	05	Anesthesiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
136187	Fee-for-Service	1710481528	1710481528	1	1	HANNA, GEORGE S MD	1/13/2023	207R00000X	NA	Other	026	PHYSICIANS	173439	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
136240	Fee-for-Service	1073147898	1073147898	1	1	HANI HASHEM MD INC	7/1/2020	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	546 BADILLO	SUITE D	COVINA	CA	91722	3786	19	06037	34.08626451	-117.9002475	Los Angeles County
136274	Fee-for-Service	1518907187	1518907187	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	1600 S IMPERIAL AVE	STE 15	EL CENTRO	CA	92243	4242	13	06025	32.77882919	-115.5697116	Imperial County
136299	Fee-for-Service	1700951233	1700951233	1	1	HWANG, DONG HA MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	42394	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
136303	Fee-for-Service	1245409598	1245409598	1	1	HASKINS, RUTH E MD INC	8/28/2008	193400000X	NA	Other	026	PHYSICIANS	64514	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1611 CREEKSIDE DRIVE	SUITE 103	FOLSOM	CA	95630	3490	34	06067	38.670534	-121.1479605	Sacramento County
136370	Fee-for-Service	1023048816	1023048816	1	1	HAGGLOV, CALVIN G MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85993	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 204B	LOMA LINDA	CA	92354	3172	36	06071	34.04805253	-117.249534	San Bernardino County
136385	Fee-for-Service	1407103872	1407103872	1	1	HARDCASTLE-ORR, WESLEY J LCS	11/5/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	W	2560 INVERNESS DR	None	LINCOLN	CA	95648	9576	31	06061	38.89786544	-121.3267635	Placer County
136395	Fee-for-Service	1093863896	1093863896	1	1	HASSANI, SIMA MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	6455	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
136400	Fee-for-Service	1730221821	1730221821	1	1	HOPPE, RICHARD MD	1/1/1982	2085R0001X	NA	Other	026	PHYSICIANS	23743	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
136405	Fee-for-Service	1679631634	1679631634	1	1	HSU, SUSAN MD	10/20/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60610	None	None	0	In state provider	None	2287 MOWRY AVE	C	FREMONT	CA	94538	1622	01	06001	37.55664244	-121.9818434	Alameda County
136450	Fee-for-Service	1528132123	1528132123	1	1	HUNDAL, SANT S MD	10/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93678	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
136470	Fee-for-Service	1750647285	1750647285	1	1	HUGHES, PIPER J MD	6/1/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	159466	45	Nephrology (Renal-Kidney)	0	In state provider	None	151 N SUNRISE AVE	STE 1205	ROSEVILLE	CA	95661	2926	31	06061	38.74746043	-121.2655348	Placer County
136547	Fee-for-Service	1366809790	1366809790	1	2	HANSEN BEHAVIORAL HEALTH A P	3/1/2021	103TC0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	450 BRAND	600	GLENDALE	CA	91203	2347	19	06037	34.152633	-118.254971	Los Angeles County
136566	Fee-for-Service	1053169094	1053169094	1	1	HARDAGE, JASON B PT	3/6/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	420 B ST	None	YUBA CITY	CA	95991	5070	51	06101	39.13415904	-121.6121453	Sutter County
136579	Fee-for-Service	1619186848	1619186848	1	1	HERNANDEZ, EDWARD P &	5/16/2006	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	DIANE M OD	1235 BUENA VISTA ST	None	DUARTE	CA	91010	2408	19	06037	34.138485	-117.9775775	Los Angeles County
136616	Fee-for-Service	1306198296	1306198296	1	4	HEALTH AND LIFE ORGANIZATION	12/19/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE-NTSA	7215 55TH ST	None	SACRAMENTO	CA	95823	2659	34	06067	38.495196	-121.440681	Sacramento County
136642	Fee-for-Service	1316249188	1316249188	1	1	HIGHSHAW, RALPH A MD INC	6/27/2011	208800000X	NA	Other	026	PHYSICIANS	56419	34	Urology and Urological Surgery	0	In state provider	None	10683 MAGNOLIA AVENUE	STE B	RIVERSIDE	CA	92505	1893	33	06065	33.90827892	-117.4680748	Riverside County
136652	Fee-for-Service	1942239157	1942239157	2	1	HARDESTY, DAVID E MD	1/23/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	55386	13	Neurology (M.D. only)	0	In state provider	None	850 FAIR OAKS AVE	STE 100	ARROYO GRANDE	CA	93420	3929	40	06079	35.11274104	-120.588873	San Luis Obispo County
136670	Fee-for-Service	1861709131	1861709131	1	1	HARRIS, JAMES R PSYD	3/24/2016	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
136702	Fee-for-Service	1992191613	1992191613	1	1	HULLETT, PATRICK MD	6/22/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	147727	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
136759	Fee-for-Service	1699805093	1699805093	1	1	HOPE, MICHAEL D MD	5/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95359	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
136771	Fee-for-Service	1134203136	1134203136	1	1	HARRIS, JEFFREY S MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	76130	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
136775	Fee-for-Service	1669926853	1669926853	1	1	HARRIS, DANA M LMFT	11/14/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	116286	-	NOT APPLICABLE	0	In state provider	None	2330 BEVERLY BLVD	None	LOS ANGELES	CA	90057	2220	19	06037	34.0681396	-118.2738016	Los Angeles County
136800	Fee-for-Service	1427346527	1427346527	1	1	HOLLYWOOD ELDERLY CARE INC	10/3/2011	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6054 FRANKLIN AVE	None	LOS ANGELES	CA	90028	5521	19	06037	34.10521652	-118.321587	Los Angeles County
136841	Fee-for-Service	1366809790	1366809790	1	2	HANSEN BEHAVIORAL HEALTH A P	3/1/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	450 BRAND	600	GLENDALE	CA	91203	2347	19	06037	34.152633	-118.254971	Los Angeles County
136852	Fee-for-Service	1225201379	1225201379	1	1	HATFIELD, LAURA E N MD	10/29/2009	2086X0206X	NA	General Surgery	026	PHYSICIANS	103804	02	General Surgery	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
136867	Fee-for-Service	1225103369	1225103369	1	1	HEALTHY STEPS WEIGHT	1/12/2006	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LOSS CTR MEDICAL CORP	1701 FOURTH ST	STE 200	SANTA ROSA	CA	95404	3601	49	06097	38.448801	-122.699439	Sonoma County
136868	Fee-for-Service	1487682845	1487682845	1	1	HERSHEY, ALLEN L MD	12/31/1993	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	78153	01	General Practice	0	In state provider	None	10666 N TORREY PINES RD	# MS317	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
136880	Fee-for-Service	1710174180	1710174180	1	1	HART, NATHAN D MD	4/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100631	20	Orthopedic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
136893	Fee-for-Service	1124048517	1124048517	1	1	HASTINGS, PATRICIA C LCSW	12/8/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1201 FILLMORE ST	None	SAN FRANCISCO	CA	94115	4110	38	06075	37.78096742	-122.4322568	San Francisco County
136905	Fee-for-Service	1306198296	1306198296	1	4	HEALTH AND LIFE ORGANIZATION	12/19/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE-NTSA	7215 55TH ST	None	SACRAMENTO	CA	95823	2659	34	06067	38.495196	-121.440681	Sacramento County
136916	Fee-for-Service	1902001266	1902001266	1	1	HEALER, SHANNON M LCSW	11/25/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3333 MISSION DR	None	SANTA CRUZ	CA	95065	1136	44	06087	36.99144769	-121.9801727	Santa Cruz County
136938	Fee-for-Service	1538145362	1538145362	1	1	HLINKA, MICHAEL MD	8/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78819	30	Radiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
136957	Fee-for-Service	1558345348	1558345348	1	1	HARDY, RUSSELL I MD	7/30/1990	207RH0003X	NA	Oncology	026	PHYSICIANS	59375	41	Internal Medicine	0	In state provider	None	864 2ND ST	None	SANTA ROSA	CA	95404	4610	49	06097	38.440953	-122.7075165	Sonoma County
136999	Fee-for-Service	1588044549	1588044549	1	1	HERRICK, STEPHEN C DO	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15251	01	General Practice	0	In state provider	None	1400 E CHURCH STREET	None	SANTA MARIA	CA	93454	5906	42	06083	34.95203385	-120.4131707	Santa Barbara County
137000	Fee-for-Service	1619055308	1619055308	1	1	HARTMAN, LUKAS C W MD	9/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	75379	04	Otology, Laryngology, Rhinology	0	In state provider	None	2155 IRON POINT RD	None	FOLSOM	CA	95630	8707	34	06067	38.644479	-121.1349735	Sacramento County
137011	Fee-for-Service	1689748568	1689748568	1	1	HANGER P & O WEST INC	6/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	13203 HADLEY ST	STE 209	WHITTIER	CA	90601	4538	19	06037	33.98273153	-118.0347615	Los Angeles County
137018	Fee-for-Service	1447308937	1447308937	1	1	HONG, CHRISTINA MD	7/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78032	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
137026	Fee-for-Service	1023358256	1023358256	1	1	HOLLOWAY, DANIELLE	10/31/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15260 VENTURA BLVD	1200	SHERMAN OAKS	CA	91403	5307	19	06037	34.15370926	-118.4656644	Los Angeles County
137043	Fee-for-Service	1346424355	1346424355	1	1	HARTVIG, PAMELA H LCSW	8/13/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3000 T ST	STE 102	SACRAMENTO	CA	95816	7052	34	06067	38.561742	-121.4712045	Sacramento County
137059	Fee-for-Service	1699399766	1699399766	1	1	HOSPICE OF BEST CHOICE CORP	8/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	539 N GLENOAKS BLVD	STE 202	BURBANK	CA	91502	4637	19	06037	34.18652984	-118.310858	Los Angeles County
137083	Fee-for-Service	1437186756	1437186756	1	1	HINKELMAN, LORI A MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	74487	05	Anesthesiology	0	In state provider	None	9212 MIRA ESTE CT	STE 204	SAN DIEGO	CA	92126	6337	37	06073	32.88927901	-117.1482338	San Diego County
137090	Fee-for-Service	1407957665	1407957665	1	1	HUSARI, AHMAD W MD	3/16/2021	207RP1001X	NA	Pulmonology	026	PHYSICIANS	49093	None	None	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
137171	Fee-for-Service	1679720429	1679720429	1	1	HSU, LAWRENCE P MD	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120677	20	Orthopedic Surgery	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	6720	30	06059	33.85429563	-117.8166478	Orange County
137175	Fee-for-Service	1912072406	1912072406	1	1	HO, DAVID C MD	4/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86879	05	Anesthesiology	0	In state provider	None	6760 N WEST AVE	STE 101	FRESNO	CA	93711	1396	10	06019	36.83680611	-119.8262508	Fresno County
137268	Fee-for-Service	1366832917	1366832917	1	1	HORGAN, DANIEL R PT	7/4/2020	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
137304	Fee-for-Service	1205959392	1205959392	1	1	HOURANY, JOSEPH MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	55807	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	255 E BONITA AVE	None	POMONA	CA	91769	1923	19	06037	34.097913	-117.7474635	Los Angeles County
137312	Fee-for-Service	1144683137	1144683137	1	1	HAJIGHASEMI-OSSAREH, MOHAMMA	7/1/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	150719	27	Psychiatry Neurology (D.O. only)	0	In state provider	D MD	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
137328	Fee-for-Service	1629324140	1629324140	1	1	HOSSEINI, ALIREZA MD	8/27/2020	207RE0101X	NA	Endocrinology	026	PHYSICIANS	142579	41	Internal Medicine	0	In state provider	None	4600 CAMPUS DR	203	NEWPORT BEACH	CA	92660	1801	30	06059	33.67110839	-117.8658914	Orange County
137347	Fee-for-Service	1699399766	1699399766	1	1	HOSPICE OF BEST CHOICE CORP	8/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	539 N GLENOAKS BLVD	STE 202	BURBANK	CA	91502	4637	19	06037	34.18652984	-118.310858	Los Angeles County
137364	Fee-for-Service	1629150081	1629150081	1	1	HWANG, DANIEL K	7/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	91913	None	None	0	In state provider	None	3660 PARK SIERRA DR	STE 208	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
137366	Fee-for-Service	1235394032	1235394032	1	1	HENDERSON, EDITH MD	8/9/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
137407	Fee-for-Service	1710272547	1710272547	1	1	HOLLOWAY, JONATHAN S MD	12/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138053	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
137421	Fee-for-Service	1346313434	1346313434	1	1	HUNT, CYNTHIA B MD	2/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	62341	41	Internal Medicine	0	In state provider	None	847 WEST CHILDS AVE	None	MERCED	CA	95341	6862	24	06047	37.28825369	-120.4963159	Merced County
137433	Fee-for-Service	1568287068	1568287068	1	1	HOLSTINE, CHLOE L PT	12/2/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1191 CRESTON RD	STE 115	PASO ROBLES	CA	93446	3033	40	06079	35.6227971	-120.6606503	San Luis Obispo County
137437	Fee-for-Service	1063523587	1063523587	4	1	HEDAYATI, POYA MD	6/7/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	124407	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
137455	Fee-for-Service	1427310127	1427310127	1	1	HARMONY HOSPICE CARE INC	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6422 BELLINGHAM AVE	SUITE 205	NORTH HOLLYWOOD	CA	91606	1438	19	06037	34.187391	-118.398713	Los Angeles County
137471	Fee-for-Service	1477614071	1477614071	1	1	HOCKETT, LISA	9/11/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
137511	Fee-for-Service	1841489341	1841489341	1	1	HOM, STEVE M MD	5/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98257	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
137517	Fee-for-Service	1225104441	1225104441	1	1	HARRIS, AIMEE L MD	2/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	90557	40	Pediatrics	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
137534	Fee-for-Service	1639190085	1639190085	1	1	HANSEN, JOYCE E MD	1/31/1982	207R00000X	NA	Other	026	PHYSICIANS	34890	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3801 SACRAMENTO ST	FL 3	SAN FRANCISCO	CA	94118	1625	38	06075	37.78707021	-122.4555217	San Francisco County
137590	Fee-for-Service	1205959392	1205959392	1	1	HOURANY, JOSEPH MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	55807	41	Internal Medicine	0	In state provider	None	255 E BONITA AVE	None	POMONA	CA	91769	1923	19	06037	34.097913	-117.7474635	Los Angeles County
137604	Fee-for-Service	1144683137	1144683137	1	1	HAJIGHASEMI-OSSAREH, MOHAMMA	7/1/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	150719	13	Neurology (M.D. only)	0	In state provider	D MD	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
137618	Fee-for-Service	1689017345	1689017345	1	1	HUCKABEE, JENNIFER P MD	5/6/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	625 S FAIR OAKS AVE	SUITE #140	PASADENA	CA	91105	2650	19	06037	34.134894	-118.1504155	Los Angeles County
137635	Fee-for-Service	1649469297	1649469297	1	1	HARE, SANDRA F MD	11/13/2008	207R00000X	NA	Other	026	PHYSICIANS	88365	41	Internal Medicine	0	In state provider	None	1125 SIR FRANCIS DRAKE	None	KENTFIELD	CA	94904	1418	21	06041	37.95899686	-122.5520873	Marin County
137668	Fee-for-Service	1063867851	1063867851	1	1	HEART OF GOLD HOSPICE, INC	4/24/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4110 EDISON AVE	SUITE 200A	CHINO	CA	91710	8409	36	06071	33.99723746	-117.7140555	San Bernardino County
137709	Fee-for-Service	1346313434	1346313434	1	1	HUNT, CYNTHIA B MD	2/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	62341	36	Psychiatry	0	In state provider	None	847 WEST CHILDS AVE	None	MERCED	CA	95341	6862	24	06047	37.28825369	-120.4963159	Merced County
137721	Fee-for-Service	1083797633	1083797633	1	1	HALES, KATHLEEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2450 S TELSHOR BLVD	None	LAS CRUCES	NM	88011	5069	00	None	32.29238673	-106.7351331	Doña Ana County
137737	Fee-for-Service	1295356830	1295356830	1	2	HIGH DESERT INSTITUTE OF OPH	5/2/2022	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	THALMOLOGY	13010 HESPERIA RD	STE 101	VICTORVILLE	CA	92395	5837	36	06071	34.48843676	-117.2909745	San Bernardino County
137739	Fee-for-Service	1841248820	1841248820	2	1	HULL, JANICE L MD	2/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	80999	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8475 S VAN NESS AVE	SUITE 101	INGLEWOOD	CA	90305	1566	19	06037	33.960645	-118.317798	Los Angeles County
137744	Fee-for-Service	1427310127	1427310127	1	1	HARMONY HOSPICE CARE INC	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6422 BELLINGHAM AVE	SUITE 205	NORTH HOLLYWOOD	CA	91606	1438	19	06037	34.187391	-118.398713	Los Angeles County
137752	Fee-for-Service	1821484759	1821484759	1	1	HAN, JAEHONG MD	9/14/2020	207W00000X	NA	Ophthalmology	026	PHYSICIANS	167376	18	Ophthalmology	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
137766	Fee-for-Service	1104855600	1104855600	1	1	HANNA, ANTOINE THOMAS MD	2/28/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	43969	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1700 N ROSE AVE	STE 230	OXNARD	CA	93030	7641	56	06111	34.21746	-119.155545	Ventura County
137774	Fee-for-Service	1972601755	1972601755	1	1	HORAK, DAVID MD	5/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40765	01	General Practice	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
137789	Fee-for-Service	1013492867	1013492867	1	1	HIGGINS, JOHN MD	8/25/2024	1835E0208X	NA	None	026	PHYSICIANS	187603	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
137792	Fee-for-Service	1285767715	1285767715	1	1	HAUGABOOK, PHYLLIS LMFT	7/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
137807	Fee-for-Service	1487732053	1487732053	1	1	HATCH, THEODORE L MD	10/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83252	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
137819	Fee-for-Service	1639190085	1639190085	1	1	HANSEN, JOYCE E MD	1/31/1982	207R00000X	NA	Other	026	PHYSICIANS	34890	41	Internal Medicine	0	In state provider	None	3801 SACRAMENTO ST	FL 3	SAN FRANCISCO	CA	94118	1625	38	06075	37.78707021	-122.4555217	San Francisco County
137872	Fee-for-Service	1063617934	1063617934	1	1	HARRIS, JUSTIN D MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123173	41	Internal Medicine	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
137880	Fee-for-Service	1447773304	1447773304	1	1	HABICH, LAURA E CCC-SLP	5/7/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
137889	Fee-for-Service	1144683137	1144683137	1	1	HAJIGHASEMI-OSSAREH, MOHAMMA	7/1/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	150719	14	Neurological Surgery	0	In state provider	D MD	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
137951	Fee-for-Service	1891944351	1891944351	1	1	HYMAN, LINDA T	3/13/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	35325 DATE PALM DR	STE 151C	CATHEDRAL CITY	CA	92234	7002	33	06065	33.79144444	-116.4581341	Riverside County
137954	Fee-for-Service	1063867851	1063867851	1	1	HEART OF GOLD HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4110 EDISON AVE	SUITE 200A	CHINO	CA	91710	8409	36	06071	33.99723746	-117.7140555	San Bernardino County
137963	Fee-for-Service	1487606125	1487606125	1	1	HUNTER, MARK J CRNA	2/8/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
138024	Fee-for-Service	1326127747	1326127747	1	2	HUTCHINGS, DONOVAN K DC	12/19/2022	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1725 E. CYPRESS AVE	None	REDDING	CA	96002	1440	45	06089	40.57096595	-122.3392687	Shasta County
138025	Fee-for-Service	1295356830	1295356830	1	2	HIGH DESERT INSTITUTE OF OPH	5/2/2022	207W00000X	NA	Ophthalmology	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	THALMOLOGY	13010 HESPERIA RD	STE 101	VICTORVILLE	CA	92395	5837	36	06071	34.48843676	-117.2909745	San Bernardino County
138029	Fee-for-Service	1174739619	1174739619	1	1	HIRANRATTANA, ANUNYA MD	7/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104804	40	Pediatrics	0	In state provider	None	210 CANAL STREET	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
138034	Fee-for-Service	1053110189	1053110189	1	1	HABITUAL CARE LLC	3/28/2025	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	37	06073	0	0	None
138093	Fee-for-Service	1144385766	1144385766	1	4	HY PHUNG NGO MD INC	7/14/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	625 E VALLEY BLVD	SUITE H,I &G	SAN GABRIEL	CA	91776	3591	19	06037	34.0801262	-118.0919781	Los Angeles County
138110	Fee-for-Service	1043533383	1043533383	1	1	HEALTHCARE PARTNERS MEDICAL	6/25/2013	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	1	Border provider	GROUP BACCHUS LTD	700 E WARM SPRINGS RD	SUITE 300	LAS VEGAS	NV	89119	4311	00	None	36.05715691	-115.1475945	Clark County
138124	Fee-for-Service	1053471847	1053471847	1	2	HIGH QUALITY HOME HEALTH	6/1/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY INC	21707 HAWTHORNE BLVD	SUITE 202	TORRANCE	CA	90503	3692	19	06037	33.83065871	-118.3526165	Los Angeles County
138152	Fee-for-Service	1265847214	1265847214	1	1	HEIDARI BATENI, GIV MD	10/1/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	168576	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
138165	Fee-for-Service	1518348085	1518348085	1	1	HWANG, KEVIN MD	5/5/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	147008	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
138208	Fee-for-Service	1679916787	1679916787	1	1	HEALING HEARTS COUNSELING CE	5/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NTER, INC.	229 S RIVERSIDE AVE	SUITE M	RIALTO	CA	92376	6467	36	06071	34.0977093	-117.3701818	San Bernardino County
138250	Fee-for-Service	1265465405	1265465405	1	1	HUNTINGTON PATHOLOGY MED	7/1/1983	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP, INC	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
138262	Fee-for-Service	1700876323	1700876323	1	1	HAKIK, ZOUHAIR MD	1/24/2005	207R00000X	NA	Other	026	PHYSICIANS	51024	41	Internal Medicine	0	In state provider	None	1330 WEST COVINA BLVD	STE 206	SAN DIMAS	CA	91773	3200	19	06037	34.09894509	-117.8340464	Los Angeles County
138291	Fee-for-Service	1295937415	1295937415	1	1	HARVEST MOON	10/20/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1017 E HARVEST MOON ST	None	WEST COVINA	CA	91792	1023	19	06037	34.04295208	-117.9248792	Los Angeles County
138327	Fee-for-Service	1831586783	1831586783	1	1	HOFMANN, MARTIN MD	8/1/2022	208800000X	NA	Other	026	PHYSICIANS	144764	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
138350	Fee-for-Service	1033343561	1033343561	1	1	HOME FOR LIFE FOUNDATION	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	489 N MADISON AVE	None	PASADENA	CA	91101	1123	19	06037	34.15441886	-118.138473	Los Angeles County
138357	Fee-for-Service	1639120371	1639120371	1	1	HOVHANESSIAN, BENNY P MD	11/14/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	37868	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
138365	Fee-for-Service	1881155836	1881155836	1	1	HEACOCK, NATHAN J CRNA	9/5/2019	367500000X	NA	Other	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
138367	Fee-for-Service	1063679421	1063679421	1	1	HUANG, PETER D OD INC	1/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	557 H STREET	SUITE B	CHULA VISTA	CA	91910	4340	37	06073	32.63145066	-117.087815	San Diego County
138374	Fee-for-Service	1134875768	1134875768	1	1	HARPER'S HAVEN MARRIAGE, FAM	1/19/2024	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ILY, & CHILD COUNSELIN	626 W LANCASTER BLVD	None	LANCASTER	CA	93534	3108	19	06037	34.69792171	-118.1404554	Los Angeles County
138437	Fee-for-Service	1942352166	1942352166	1	1	HIDALGO, ALVARO F MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	75887	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
138440	Fee-for-Service	1265847214	1265847214	1	1	HEIDARI BATENI, GIV MD	10/1/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	168576	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
138482	Fee-for-Service	1326234667	1326234667	1	1	HSIEH, TING HUI MD	11/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	1	Border provider	None	880 RYLAND ST	None	RENO	NV	89502	1631	00	None	39.52378631	-119.8009873	Washoe County
138485	Fee-for-Service	1801244512	1801244512	1	1	HA, IRIS C MD	4/1/2019	207R00000X	NA	Other	026	PHYSICIANS	153330	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
138504	Fee-for-Service	1063859874	1063859874	1	1	HEGDE, JOHN V MD	5/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133952	None	None	0	In state provider	None	200 MEDICAL PLAZA	STE B265	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
138564	Fee-for-Service	1033346465	1033346465	1	1	HUMPHREY, STERLING L MD	6/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114948	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
138612	Fee-for-Service	1184813958	1184813958	1	1	HOLDEN, ANGELICA NP	7/9/2020	363LX0001X	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
138621	Fee-for-Service	1942356027	1942356027	1	1	HEARING CLINIC & SPEECH	11/7/2012	174400000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	HEALTH SERVICES AND SALE	1700 ALAMEDA STREET	None	POMONA	CA	91768	1727	19	06037	34.07825822	-117.7555489	Los Angeles County
138659	Fee-for-Service	1245559509	1245559509	1	1	HYLTON, JARED MD	4/17/2024	207L00000X	NA	Other	026	PHYSICIANS	129036	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
138695	Fee-for-Service	1659355980	1659355980	1	1	HARPER, RICHART W MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79755	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
138733	Fee-for-Service	1528276797	1528276797	1	1	HIGH DESERT CHILD ADOLESCENT	11/13/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	AND FAMILY SERVICES	16248 VICTOR STREET	None	VICTORVILLE	CA	92395	3934	36	06071	34.52357429	-117.3079468	San Bernardino County
138760	Fee-for-Service	1093006397	1093006397	1	1	HAMANDI, HASSAN W MD	7/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149865	10	Gastroenterology (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
138832	Fee-for-Service	1720502610	1720502610	1	1	HARMONY HEALTH MEDICAL	9/14/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	920 CHESTNUT STREET	None	YUBA CITY	CA	95991	4020	51	06101	39.14177011	-121.6199293	Sutter County
138841	Fee-for-Service	1801037635	1801037635	1	1	HOLLY, TSIONE M NP	11/2/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
138846	Fee-for-Service	1831414234	1831414234	1	1	HOLLIDAY, MICHAEL A MD	5/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135471	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
138912	Fee-for-Service	1578681904	1578681904	1	1	HANNA, MICHAEL D LMFT	8/21/2018	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
138965	Fee-for-Service	1104463371	1104463371	1	2	HIGH DESERT PSYCHOLOGICAL SE	11/9/2020	103TP2701X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
138966	Fee-for-Service	1144386111	1144386111	1	1	HEARTLAND PARAMEDICS	8/1/2003	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	6255 MISSION GORGE RD	None	SAN DIEGO	CA	92120	3505	37	06073	32.788476	-117.0976905	San Diego County
138972	Fee-for-Service	1750332813	1750332813	1	1	HILDEBRANT, NATHAN 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	335 SE 8TH AVE	None	HILLSBORO	OR	97123	4246	00	None	45.51948957	-122.9773135	Washington County
138983	Fee-for-Service	1659355980	1659355980	1	1	HARPER, RICHART W MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79755	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
138988	Fee-for-Service	1891808499	1891808499	1	1	HOUSTON HOSPITALS INC	3/31/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1120 MORNINGSIDE DR	None	PERRY	GA	31069	2906	00	None	32.45934472	-83.71119921	Houston County
139001	Fee-for-Service	1164231593	1164231593	1	1	HAMPTON, DESTINY D DOULA	2/5/2025	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	37	06073	0	0	None
139046	Fee-for-Service	1093006397	1093006397	1	1	HAMANDI, HASSAN W MD	7/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149865	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
139077	Fee-for-Service	1972047397	1972047397	1	1	HOM-TEDLA, MARIANNE MD	9/17/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	146335	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
139106	Fee-for-Service	1295187458	1295187458	1	1	HARDING, ANNA K OD	8/8/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1800 FOURTH ST	None	LIVERMORE	CA	94550	4454	01	06001	37.67808567	-121.7724653	Alameda County
139121	Fee-for-Service	1720502610	1720502610	1	1	HARMONY HEALTH MEDICAL	9/14/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	920 CHESTNUT STREET	None	YUBA CITY	CA	95991	4020	51	06101	39.14177011	-121.6199293	Sutter County
139134	Fee-for-Service	1699823583	1699823583	1	1	HOFFMAN, JENNIFER L CNM	12/16/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	75036 GERALD FORD DRIVE	None	PALM DESERT	CA	92211	2080	33	06065	33.78158473	-116.353994	Riverside County
139148	Fee-for-Service	1598171027	1598171027	1	1	HAYASHI, JARED OD	7/23/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
139153	Fee-for-Service	1710054648	1710054648	1	1	HUYNH, LYNN N MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	60081	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
139154	Fee-for-Service	1326105115	1326105115	1	1	HAO, STANLEY W OD	2/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1900 DRESDEN DRIVE	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
139206	Fee-for-Service	1639517972	1639517972	1	1	HWANG, CHARLES W MD	8/26/2022	207P00000X	NA	Other	026	PHYSICIANS	178972	None	None	0	In state provider	None	6501 COYLE AVENUE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
139218	Fee-for-Service	1649395492	1649395492	1	1	HILAIRE, FRANCINE J	2/8/2015	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1010 CASS ST	STE B-5	MONTEREY	CA	93940	4515	27	06053	36.59171985	-121.8968501	Monterey County
139228	Fee-for-Service	1962943316	1962943316	1	1	HO, JOYCE L MD	3/4/2021	208M00000X	NA	Other	026	PHYSICIANS	163256	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
139233	Fee-for-Service	1598767949	1598767949	1	1	HUANG, RUSONG MD	10/19/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76831	None	None	0	In state provider	None	4580 CALIFORNIA AVE	None	BAKERSFIELD	CA	93309	1104	15	06029	35.36605632	-119.0531502	Kern County
139238	Fee-for-Service	1205846771	1205846771	1	1	HAZLEHURST, THOMAS B	2/7/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	37365	None	None	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
139243	Fee-for-Service	1124083738	1124083738	1	1	HOME OF GUIDING HANDS	8/5/2002	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	2198 CUMBRE PL	None	EL CAJON	CA	92020	1005	37	06073	32.82579615	-116.9888911	San Diego County
139244	Fee-for-Service	1891885760	1891885760	1	1	HAMREUS, MEGAN DO	11/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8992	08	Family Practice	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
139251	Fee-for-Service	1104463371	1104463371	1	2	HIGH DESERT PSYCHOLOGICAL SE	11/9/2020	103TP2701X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
139269	Fee-for-Service	1659355980	1659355980	1	1	HARPER, RICHART W MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79755	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
139277	Fee-for-Service	1891808499	1891808499	1	1	HOUSTON HOSPITALS INC	3/31/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1120 MORNINGSIDE DR	None	PERRY	GA	31069	2906	00	None	32.45934472	-83.71119921	Houston County
139307	Fee-for-Service	1265009161	1265009161	1	1	HANSON, ANNE E LPCC	11/7/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6310 SAN VICENTE BLVD	410	LOS ANGELES	CA	90048	5426	19	06037	34.06093425	-118.3673115	Los Angeles County
139341	Fee-for-Service	1780693093	1780693093	1	1	HIATT, JOHN F MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	19583	36	Psychiatry	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
139343	Fee-for-Service	1629213194	1629213194	1	1	HUNG, JAMIE Y DO	2/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13322	78	Neoplastic Diseases/Oncology	0	In state provider	None	155 GLASSON WAY	STE L10	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
139356	Fee-for-Service	1972761211	1972761211	1	1	HELBIG, GREGORY M MD	7/29/2011	207T00000X	NA	General Surgery	026	PHYSICIANS	114866	13	Neurology (M.D. only)	0	In state provider	None	205 W GRANGER AVE	None	MODESTO	CA	95350	4402	50	06099	37.6673525	-120.9954534	Stanislaus County
139367	Fee-for-Service	1144363086	1144363086	1	1	HEALTHRIGHT 360	10/12/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	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
139376	Fee-for-Service	1417992801	1417992801	1	1	HAJIAN, HAGOP MD	11/15/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	80315	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
139381	Fee-for-Service	1902127038	1902127038	1	1	HART-RATHBUN, HELENA A MD	10/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119565	36	Psychiatry	0	In state provider	None	1643 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.74688342	-121.2469903	Placer County
139407	Fee-for-Service	1033240080	1033240080	1	1	HICKS, MATTHEW R LCSW	2/13/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5549 VAN BUREN BLVD	None	RIVERSIDE	CA	92503	2068	33	06065	33.939216	-117.453893	Riverside County
139419	Fee-for-Service	1528073848	1528073848	1	1	HIGASHI, WAYNE E DC	1/16/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3030 SAWTELLE BLVD	None	LOS ANGELES	CA	90066	1408	19	06037	34.02558195	-118.4308546	Los Angeles County
139446	Fee-for-Service	1700059318	1700059318	1	1	HARTON, NICHELLE N LMFT	8/4/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	306 W COMPTON BLVD	SUITE 201	COMPTON	CA	90220	6647	19	06037	33.89594452	-118.226772	Los Angeles County
139455	Fee-for-Service	1932273810	1932273810	2	1	HANGER P & O WEST INC	8/14/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1755 GRASS VALLEY HWY	None	AUBURN	CA	95603	2854	31	06061	38.92773221	-121.0870403	Placer County
139471	Fee-for-Service	1336167618	1336167618	1	1	HSU, CHRISTOPHER H MD	10/1/1998	207W00000X	NA	Ophthalmology	026	PHYSICIANS	65973	18	Ophthalmology	0	In state provider	None	2232 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2312	19	06037	34.0306404	-118.4775425	Los Angeles County
139499	Fee-for-Service	1184693285	1184693285	1	1	HSU, KANG MD JR	5/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73026	41	Internal Medicine	0	In state provider	None	1310 W STEWART DR	STE 410	ORANGE	CA	92868	3855	30	06059	33.78236048	-117.8664975	Orange County
139539	Fee-for-Service	1104463371	1104463371	1	2	HIGH DESERT PSYCHOLOGICAL SE	2/3/2022	103TP2701X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	RVICES	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
139553	Fee-for-Service	1780238691	1780238691	1	1	HUTTON, ALICIA LMFT	3/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7471 RUDELL RD	None	CORONA	CA	92881	4278	33	06065	33.8360945	-117.528093	Riverside County
139580	Fee-for-Service	1750530440	1750530440	1	1	HEJRI, GHAZALEH MD	1/21/2009	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	105122	09	Gynecology (D.O. only)	0	In state provider	None	988 S FAIR OAKS	None	PASADENA	CA	91105	2603	19	06037	34.12907598	-118.1503058	Los Angeles County
139613	Fee-for-Service	1114086709	1114086709	1	1	HICKEY, TIMOTHY J MD	4/30/1989	207RP1001X	NA	Pulmonology	026	PHYSICIANS	65962	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
139634	Fee-for-Service	1629213194	1629213194	1	1	HUNG, JAMIE Y DO	2/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13322	68	Hematology	0	In state provider	None	155 GLASSON WAY	STE L10	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
139646	Fee-for-Service	1306872411	1306872411	1	1	HOWARD, GAYLE C MD	7/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52755	18	Ophthalmology	0	In state provider	None	681 3RD AVE	None	CHULA VISTA	CA	91910	5703	37	06073	32.6284656	-117.0748498	San Diego County
139664	Fee-for-Service	1891377826	1891377826	1	1	HERNANDEZ, GRISELDA NP	5/8/2024	163WP0808X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5850 EL CAMINO REAL	None	ATASCADERO	CA	93422	3318	40	06079	35.48962035	-120.670989	San Luis Obispo County
139672	Fee-for-Service	1609041441	1609041441	1	1	HERMAN, SETH MD	5/26/2020	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	161882	25	Physical Medicine and Rehabilitation	0	In state provider	None	2080 CENTURY PARK E	STE 300	LOS ANGELES	CA	90067	2006	19	06037	34.05887194	-118.4122914	Los Angeles County
139691	Fee-for-Service	1649701699	1649701699	1	1	HOLZMEISTER, ADAM MD	8/1/2022	207XS0114X	NA	Orthopedic Surgery	026	PHYSICIANS	176052	None	None	0	In state provider	None	25455 BARTON RD	101B 102B 104B 106B 108B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
139710	Fee-for-Service	1023423217	1023423217	1	1	HA, PHONG X MD	4/22/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	152513	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
139726	Fee-for-Service	1720093115	1720093115	1	1	HANDS ON PROSTHETICS INC	2/15/2006	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	18800 DELAWARE ST	# 309	HUNTINGTON BEACH	CA	92648	1959	30	06059	33.68911733	-117.9931535	Orange County
139740	Fee-for-Service	1811218092	1811218092	1	1	HYLER, BRYAN R MD	6/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122488	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
139819	Fee-for-Service	1467673665	1467673665	1	1	HAN-OH, EMILY S OD	2/7/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
139825	Fee-for-Service	1427138262	1427138262	1	1	HIFUMI, GLENN T MD	6/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68228	02	General Surgery	0	In state provider	None	9604 ARTESIA BLVD	STE 200	BELLFLOWER	CA	90706	8044	19	06037	33.87472842	-118.1288599	Los Angeles County
139829	Fee-for-Service	1104463371	1104463371	1	2	HIGH DESERT PSYCHOLOGICAL SE	11/9/2020	103TP2701X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	RVICES	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
139847	Fee-for-Service	1285687574	1285687574	1	1	HARRIS, BRIAN W MD	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70720	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2550 N HOLLYWOOD WAY	STE 209	BURBANK	CA	91505	5019	19	06037	34.195086	-118.348892	Los Angeles County
139890	Fee-for-Service	1609343102	1609343102	1	1	HOLLINGSWORTH, YANYAN NP	12/7/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
139897	Fee-for-Service	1851354336	1851354336	1	1	HAFFNER, DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1046 W 6TH AVE	None	ALBANY	OR	97321	0000	00	None	44.63214872	-123.1157723	Linn County
139929	Fee-for-Service	1720678675	1720678675	1	1	HARBOR HEALTHY LIVING PHARMA	3/30/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	5015 W EDINGER AVE	SUITE B	SANTA ANA	CA	92704	1968	30	06059	33.73103842	-117.9345019	Orange County
139947	Fee-for-Service	1750467908	1750467908	1	1	HOPKINS, WILLIAM C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	24984	05	Anesthesiology	0	In state provider	None	3803 S BASCOM AVE	STE 210	CAMPBELL	CA	95008	7317	43	06085	37.25907527	-121.9475431	Santa Clara County
139949	Fee-for-Service	1184962490	1184962490	1	1	HALBOWER, LOTUS L	12/1/2016	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
139951	Fee-for-Service	1154513547	1154513547	1	1	HOU, JINGWEN MD	7/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119470	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
139960	Fee-for-Service	1518369313	1518369313	1	1	HOWELL, ERIN C MD	12/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140246	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
139984	Fee-for-Service	1164587499	1164587499	1	1	HANFORD ELEM SCHOOL DIST	5/22/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	714 N WHITE ST	None	HANFORD	CA	93230	4029	16	06031	36.332613	-119.6395665	Kings County
139987	Fee-for-Service	1275302150	1275302150	1	1	HILL, NAKILA LMFT	11/14/2024	1041C0700X	NA	Mental Health Outpatient Services	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
140014	Fee-for-Service	1235309493	1235309493	1	1	HEGER, JOEL W MD INC	3/5/1976	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	26079	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	55 E CALIFORNIA BLVD	FL 3	PASADENA	CA	91105	3944	19	06037	34.13582278	-118.1491634	Los Angeles County
140039	Fee-for-Service	1285954370	1285954370	1	1	HAYWARD, THERESA C OT	2/9/2021	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1535 RIVER PARK DR	STE 1000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
140054	Fee-for-Service	1417973686	1417973686	1	1	HOMETOWN MED SUPP INC	5/24/2005	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	2426 W 8TH ST	STE 108	LOS ANGELES	CA	90057	3840	19	06037	34.05650917	-118.2815796	Los Angeles County
140062	Fee-for-Service	1780014084	1780014084	1	1	HERNANDEZ, MARIABRIL LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	97607	-	NOT APPLICABLE	0	In state provider	None	370 CRENSHAW BLVD	SUITE E-100	TORRANCE	CA	90503	1727	19	06037	33.84549	-118.3287415	Los Angeles County
140065	Fee-for-Service	1477993996	1477993996	1	1	HOGLE, LINDSEY	10/24/2024	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
140075	Fee-for-Service	1174384606	1174384606	1	1	HAN, MI AE NP	1/28/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3030 W OLYMPIC BLVD	STE 217	LOS ANGELES	CA	90006	6507	19	06037	34.05260995	-118.3015825	Los Angeles County
140099	Fee-for-Service	1154316297	1154316297	1	1	HANKEY, JOHN C MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	44961	66	Emergency Medicine (Urgent Care)	0	In state provider	None	800 EAST WASHINGTON BLVD	None	CRESCENT CITY	CA	95531	8359	08	06015	41.77272521	-124.1940494	Del Norte County
140105	Fee-for-Service	1851341739	1851341739	1	1	HAMMILL, PATRICK MD	10/9/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184331	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
140118	Fee-for-Service	1104463371	1104463371	1	2	HIGH DESERT PSYCHOLOGICAL SE	11/9/2020	103TP2701X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
140140	Fee-for-Service	1376574624	1376574624	1	1	HUANG, JIMMY C MD	6/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77455	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
140142	Fee-for-Service	1407967029	1407967029	1	1	HONG, ROY W MD	12/31/1995	2086S0122X	NA	General Surgery	026	PHYSICIANS	83787	24	Plastic Surgery	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
140157	Fee-for-Service	1013021062	1013021062	1	1	HANNA, PHILIP 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	10103 RIDGEGATE PKWY	STE 312	LONE TREE	CO	80124	5525	00	None	39.52891442	-104.8736461	Douglas County
140173	Fee-for-Service	1275683286	1275683286	1	1	HOGBERG, INGRID M MD	6/11/2008	207R00000X	NA	Other	026	PHYSICIANS	97154	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
140187	Fee-for-Service	1558867168	1558867168	1	1	HUANG, MICHAEL S MD	6/5/2022	207L00000X	NA	Other	026	PHYSICIANS	163747	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
140252	Fee-for-Service	1134207855	1134207855	1	1	HAASE, CAROLYN E MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	49635	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
140300	Fee-for-Service	1235309493	1235309493	1	1	HEGER, JOEL W MD INC	3/5/1976	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	26079	41	Internal Medicine	0	In state provider	None	55 E CALIFORNIA BLVD	FL 3	PASADENA	CA	91105	3944	19	06037	34.13582278	-118.1491634	Los Angeles County
140364	Fee-for-Service	1134169394	1134169394	1	1	HALDEN, 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	1521 S. COTTONWOOD ST	None	SALT LAKE CITY	UT	84157	0000	00	None	40.657167	-111.8958315	Salt Lake County
140387	Fee-for-Service	1144418070	1144418070	1	1	HOLMES, WILLIAM J MD INC	11/28/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81678	20	Orthopedic Surgery	0	In state provider	None	1335 COFFEE RD	STE 100	MODESTO	CA	95355	3192	50	06099	37.66291854	-120.9756994	Stanislaus County
140388	Fee-for-Service	1629040878	1629040878	1	1	HWANG, CHORNG-LII MD	7/8/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	43799	01	General Practice	0	In state provider	None	81709 DR CARREON BLVD	STE B2	INDIO	CA	92201	5510	33	06065	33.70733082	-116.2400326	Riverside County
140397	Fee-for-Service	1538302856	1538302856	1	1	HARVEY, MICHELLE L MD	8/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	113690	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
140404	Fee-for-Service	1104463371	1104463371	1	2	HIGH DESERT PSYCHOLOGICAL SE	11/9/2020	103TP2701X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	RVICES	14390 PARK AVE.	None	VICTORVILLE	CA	92392	2910	36	06071	34.512453	-117.324936	San Bernardino County
140414	Fee-for-Service	1457988156	1457988156	1	1	HALAJIAN, MERAY M MD	11/30/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	184681	None	None	0	In state provider	None	12761 SCHABARUM AVE	None	BALDWIN PARK	CA	91706	6807	19	06037	34.08060971	-117.9958001	Los Angeles County
140443	Fee-for-Service	1982690962	1982690962	1	1	HWANG, KAIGO K MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71997	05	Anesthesiology	0	In state provider	None	313 E PLAZA DR	STE 12	SANTA MARIA	CA	93454	6931	42	06083	34.93744014	-120.4329079	Santa Barbara County
140467	Fee-for-Service	1346398203	1346398203	1	1	HARMAN-FRIEDMAN, RACHEL	1/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	65101	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
140470	Fee-for-Service	1407889355	1407889355	1	1	HAMMOND, CARLA C MD	11/22/2023	207LP2900X	NA	Other	026	PHYSICIANS	64987	None	None	0	In state provider	None	11801 PIERCE ST	STE 200	RIVERSIDE	CA	92505	5191	33	06065	33.90100297	-117.49363	Riverside County
140499	Fee-for-Service	1407288368	1407288368	1	1	HERNANDEZ, PIA	11/15/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6640 ALTON PARKWAY	None	IRVINE	CA	92618	3734	30	06059	33.65911992	-117.7737909	Orange County
140505	Fee-for-Service	1538736319	1538736319	1	1	HANDS FREE TRANSPORTATION LL	9/6/2021	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	C	1045 N EL DORADO ST	6A	STOCKTON	CA	95202	1323	39	06077	37.96325102	-121.2927546	San Joaquin County
140512	Fee-for-Service	1427628569	1427628569	1	1	HOPE WELLNESS COUNSELING, IN	7/23/2021	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	C.	12155 MAGNOLIA AVE	STE 3G	RIVERSIDE	CA	92503	4969	33	06065	33.89321127	-117.4945798	Riverside County
140612	Fee-for-Service	1154957124	1154957124	1	1	HUI, KENNETH MD	10/22/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	179706	None	None	0	In state provider	None	20101 LAKE CHABOT RD	4TH FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
140641	Fee-for-Service	1043564586	1043564586	1	1	HAZRAT, EHSAN MD	9/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1450 TREAT BLVD	STE 160	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
140665	Fee-for-Service	1467585471	1467585471	1	1	HAZEL HAWKINS MEMORIAL	3/1/1966	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	911 SUNSET DR	None	HOLLISTER	CA	95023	5606	35	06069	36.83504962	-121.3858245	San Benito County
140673	Fee-for-Service	1144418070	1144418070	1	1	HOLMES, WILLIAM J MD INC	11/28/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81678	89	Surgery-Traumatic	0	In state provider	None	1335 COFFEE RD	STE 100	MODESTO	CA	95355	3192	50	06099	37.66291854	-120.9756994	Stanislaus County
140677	Fee-for-Service	1629040878	1629040878	1	1	HWANG, CHORNG-LII MD	7/8/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	43799	40	Pediatrics	0	In state provider	None	81709 DR CARREON BLVD	STE B2	INDIO	CA	92201	5510	33	06065	33.70733082	-116.2400326	Riverside County
140729	Fee-for-Service	1093860645	1093860645	1	1	HOWELL, KYLE P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	75381	66	Emergency Medicine (Urgent Care)	0	In state provider	None	185 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.643877	-118.963932	Mono County
140744	Fee-for-Service	1962799700	1962799700	1	1	HOLTHOUSE, AMANDA S DO	8/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	11271	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1100 TRANCAS STREET	SUITE 209	NAPA	CA	94558	2906	28	06055	38.32316569	-122.2981938	Napa County
140752	Fee-for-Service	1427427327	1427427327	1	1	HONEST CARDIOLOGY INC	4/19/2017	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	None	None	0	In state provider	None	2525 HONOLULU AVE	None	MONTROSE	CA	91020	9120	19	06037	34.2079541	-118.2343071	Los Angeles County
140924	Fee-for-Service	1487047585	1487047585	1	1	HIRSCH, CARA B	2/2/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
140950	Fee-for-Service	1811942295	1811942295	1	1	HARRISONVILLE HOME HEALTH	3/23/2018	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	EQUIPMENT INC	204 ORIOLE STREET	None	HARRISONVILLE	MO	64701	2817	00	None	38.65372036	-94.33245077	Cass County
140954	Fee-for-Service	1164489217	1164489217	1	1	HAMDAN, ALLEN	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	110 FRANCIS ST SB	None	BOSTON	MA	02215	0000	00	None	42.337107	-71.1099495	Suffolk County
140956	Fee-for-Service	1962586933	1962586933	1	1	HAMMER, HELEN L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38594	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
140967	Fee-for-Service	1437224417	1437224417	2	1	HIGH DESERT MEDICAL & SLEEP	7/20/2017	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SUPPLIES INC	112 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3916	15	06029	35.6232285	-117.669858	Kern County
140983	Fee-for-Service	1487678827	1487678827	1	1	HARRISON, JAMES A MD	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	43499	01	General Practice	0	In state provider	MORENO VLY IMED CARE CTR	12199 HEACOCK ST	STE 6	MORENO VALLEY	CA	92557	7107	33	06065	33.943491	-117.243818	Riverside County
141026	Fee-for-Service	1285689752	1285689752	1	1	HOECHLIN, DONALD R MD	9/21/1999	207P00000X	NA	Other	026	PHYSICIANS	33098	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1701 SANTA ANITA AVE	None	EL MONTE	CA	91733	3411	19	06037	34.04810648	-118.0424794	Los Angeles County
141051	Fee-for-Service	1891781621	1891781621	1	1	HENSTORF, JAN E MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	44884	20	Orthopedic Surgery	0	In state provider	None	39500 FREMONT BLVD	SUITE 100	FREMONT	CA	94538	2101	01	06001	37.5448266	-121.9802588	Alameda County
141055	Fee-for-Service	1033641253	1033641253	1	1	HORSTMAN, HEIDI D MD	8/24/2020	390200000X	NA	Other	026	PHYSICIANS	169654	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
141063	Fee-for-Service	1265863666	1265863666	1	1	HOLM, MARIA LMFT	2/29/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	247219	-	NOT APPLICABLE	0	In state provider	None	1260 E ARROW HIGHWAY	BLDGS B AND C	UPLAND	CA	91786	4982	36	06071	34.09953339	-117.6333297	San Bernardino County
141074	Fee-for-Service	1639330798	1639330798	1	1	HAMILTON, SARAH E MD	8/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111805	05	Anesthesiology	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
141086	Fee-for-Service	1275088916	1275088916	1	1	HYDE PARK REHABILITATION	9/1/2016	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	6520 W BLVD	None	LOS ANGELES	CA	90043	4311	19	06037	34.69838465	-118.136962	Los Angeles
141111	Fee-for-Service	1780796151	1780796151	1	1	HESS, JOHN Y MD	1/31/1981	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	32627	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2220 LYNN RD	STE 201	THOUSAND OAKS	CA	91360	8011	56	06111	34.20863046	-118.8852156	Ventura County
141122	Fee-for-Service	1336443001	1336443001	1	1	HIDAS, GUY MD	2/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	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
141123	Fee-for-Service	1215935622	1215935622	1	1	HSU, LARRY C MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	36314	41	Internal Medicine	0	In state provider	None	254 COHASSET RD	STE 10	CHICO	CA	95926	2210	04	06007	39.75189732	-121.8525897	Butte County
141132	Fee-for-Service	1114942802	1114942802	1	1	HOWELL, STEPHEN B MD	1/1/2002	207R00000X	NA	Other	026	PHYSICIANS	25869	68	Hematology	0	In state provider	DEPT OF MEDICINE	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
141182	Fee-for-Service	1104805290	1104805290	1	1	HACHICHO, HODA M MD	5/9/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	191373	13	Neurology (M.D. only)	0	In state provider	None	3275 APTOS RANCHO RD	1A	APTOS	CA	95003	3971	44	06087	36.9795274	-121.9068693	Santa Cruz County
141230	Fee-for-Service	1043239833	1043239833	2	1	HO, LIN MD	8/23/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	21444	20	Orthopedic Surgery	0	In state provider	None	2340 CLAY STREET	#610	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
141258	Fee-for-Service	1780117390	1780117390	1	1	HERRERA, KRISZTINA NP	4/5/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2651 S C ST	200	OXNARD	CA	93033	3560	56	06111	34.17497898	-119.1811966	Ventura County
141263	Fee-for-Service	1629083902	1629083902	1	1	HUSSAIN, SABRINA J MD	12/24/2008	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	93539	15	Obstetrics (D.O. only)	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
141270	Fee-for-Service	1487678827	1487678827	1	1	HARRISON, JAMES A MD	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	43499	66	Emergency Medicine (Urgent Care)	0	In state provider	MORENO VLY IMED CARE CTR	12199 HEACOCK ST	STE 6	MORENO VALLEY	CA	92557	7107	33	06065	33.943491	-117.243818	Riverside County
141295	Fee-for-Service	1538194840	1538194840	1	1	HALL, THEODORE R MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	56139	30	Radiology	0	In state provider	UCLA RADIOLOGY MED GRP	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
141311	Fee-for-Service	1285689752	1285689752	1	1	HOECHLIN, DONALD R MD	9/21/1999	207P00000X	NA	Other	026	PHYSICIANS	33098	01	General Practice	0	In state provider	None	1701 SANTA ANITA AVE	None	EL MONTE	CA	91733	3411	19	06037	34.04810648	-118.0424794	Los Angeles County
141409	Fee-for-Service	1336443001	1336443001	1	1	HIDAS, GUY MD	2/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
141413	Fee-for-Service	1316095292	1316095292	1	1	HSU, CHUNG-PANG C MD	12/3/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	41423	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
141415	Fee-for-Service	1689969487	1689969487	1	1	HALIM, SONIA LMFT	12/18/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	156015	-	NOT APPLICABLE	0	In state provider	None	2452 & 2456 WILSHIRE ST	None	RIVERSIDE	CA	92501	2144	33	06065	33.9944179	-117.3676132	Riverside County
141435	Fee-for-Service	1932203387	1932203387	1	1	HALLBOURG, MARK A	11/29/2005	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3 MEDICAL PLAZA DR	STE 100	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
141458	Fee-for-Service	1205914074	1205914074	1	1	HELFEND, LISA K MD	9/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	68156	22	Pathology (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
141460	Fee-for-Service	1992883649	1992883649	1	1	HUEY, ELTON MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	42492	40	Pediatrics	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
141473	Fee-for-Service	1548348139	1548348139	1	1	HOLOYDA, OLAF A MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60351	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
141494	Fee-for-Service	1134107790	1134107790	1	1	HUNTER, JOHN C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	21897	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
141507	Fee-for-Service	1801043625	1801043625	1	1	HEISEN, LINDA K LMFT	6/26/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	33023	-	NOT APPLICABLE	0	In state provider	None	3600 WILSHIRE BLVD	2200	LOS ANGELES	CA	90010	2632	19	06037	34.0617065	-118.3036455	Los Angeles County
141541	Fee-for-Service	1710019369	1710019369	1	1	HERZ, SUSANNE P MD	1/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93776	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
141571	Fee-for-Service	1386767192	1386767192	1	1	HOSMER, DANIELLE 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	1015 NW 22ND AVE	None	PORTLAND	OR	97210	3025	00	None	45.53024175	-122.6966202	Multnomah County
141572	Fee-for-Service	1467540203	1467540203	1	1	HAGE, ANTOINE MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46166	01	General Practice	0	In state provider	None	2301 W MAGNOLIA BLVD	None	BURBANK	CA	91506	1735	19	06037	34.17252521	-118.3332018	Los Angeles County
141573	Fee-for-Service	1013634823	1013634823	1	1	HAMILTON, ANNETTE G CNP	7/30/2024	163WG0600X	NA	Other	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	19	06037	34.01379685	-118.4159354	Los Angeles County
141581	Fee-for-Service	1851620447	1851620447	1	1	HAWKINS, MELISSA A MD	4/14/2014	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	62780	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1000 VALE TERRACE DR	None	VISTA	CA	92084	5218	37	06073	33.20904502	-117.2286439	San Diego County
141621	Fee-for-Service	1487200317	1487200317	1	1	HORAK, IAN PT	9/23/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1519 W YOSEMITE AVE	None	MANTECA	CA	95337	5159	39	06077	37.79738017	-121.2413628	San Joaquin County
141728	Fee-for-Service	1902109796	1902109796	1	1	HABTEZION, AIDA MD	5/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	83654	10	Gastroenterology (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
141740	Fee-for-Service	1205214608	1205214608	1	1	HOWARD, KEVIN C DO MD	7/9/2018	207R00000X	NA	Other	026	PHYSICIANS	16156	41	Internal Medicine	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
141763	Fee-for-Service	1467781252	1467781252	1	1	HA, JAMES C MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117068	13	Neurology (M.D. only)	0	In state provider	None	8635 W 3RD STREET	SUITE 1190W	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
141775	Fee-for-Service	1659602050	1659602050	1	1	HARVARD FAMILY PHARMACY INC	9/15/2010	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	145 S. GLENDALE AVENUE	None	GLENDALE	CA	91205	1108	19	06037	34.1444487	-118.2480605	Los Angeles County
141776	Fee-for-Service	1346272887	1346272887	1	1	HEALHTCARE INNOVATIONS, INC.	5/28/2009	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	440 S OCOTILLO AVE	None	BENSON	AZ	85602	6403	00	None	31.96428395	-110.3072175	Cochise County
141806	Fee-for-Service	1649966680	1649966680	1	1	HEALING STEPS GUEST HOMES	10/24/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	8184 CAROB STREET	None	CYPRESS	CA	90630	2057	30	06059	33.843519	-118.057071	Orange County
141811	Fee-for-Service	1104213941	1104213941	1	1	HAUGHTON, ROBERT MD	11/10/2020	207L00000X	NA	Other	026	PHYSICIANS	149000	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
141813	Fee-for-Service	1053585984	1053585984	1	1	HUNG, JUICHUNG J MD	8/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124883	05	Anesthesiology	0	In state provider	None	5974 PENTZ ROAD	None	PARADISE	CA	95969	5509	04	06007	39.75705992	-121.572292	Butte County
141837	Fee-for-Service	1871037283	1871037283	1	1	HEGEDUS, CHRISTINE M OT	5/25/2021	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
141848	Fee-for-Service	1821294216	1821294216	1	1	HOBLEY, KENLYN J MD	3/16/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 SOUTH AVE A	None	YUMA	AZ	95364	7127	00	None	32.683167	-114.633459	Yuma County
141874	Fee-for-Service	1306149612	1306149612	1	1	HANSEN, CATHERINE N NP	3/27/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
141920	Fee-for-Service	1164637435	1164637435	1	1	HOUTERMAN, ANNA L K MD	7/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86277	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
141926	Fee-for-Service	1144681065	1144681065	1	1	HAKIM, BELAL I MD	8/12/2019	207R00000X	NA	Other	026	PHYSICIANS	151716	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
141951	Fee-for-Service	1497586531	1497586531	1	1	HE, SHENGYU OD	1/13/2025	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
141983	Fee-for-Service	1689016271	1689016271	1	1	HALLS, VALERIE L MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	134339	01	General Practice	0	In state provider	None	276 INTERNATIONAL CIRCLE	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
142004	Fee-for-Service	1699988097	1699988097	1	1	HOUSTON, KATHRYN A MD	6/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99714	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
142017	Fee-for-Service	1902109796	1902109796	1	1	HABTEZION, AIDA MD	5/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	83654	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
142032	Fee-for-Service	1639687890	1639687890	1	1	HERRINGSHAW, ABBEY J MD	6/1/2023	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
142058	Fee-for-Service	1477794402	1477794402	1	1	HORTON, CHERYL L MD	11/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127976	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
142064	Fee-for-Service	1023068525	1023068525	1	1	HERNANDEZ, MARIA S MD	5/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	44210	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	54	06107	36.05128153	-119.0422344	Tulare County
142120	Fee-for-Service	1245816511	1245816511	1	1	HELPFUL HOSPICE CARE	12/20/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	STE 207	ENCINO	CA	91436	2968	19	06037	34.15524484	-118.4756687	Los Angeles County
142133	Fee-for-Service	1114096104	1114096104	1	1	HO, ALINA	11/23/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3150 E IMPERIAL HWY	UNIT A202-2	LYNWOOD	CA	90262	3223	19	06037	33.93024589	-118.2144381	Los Angeles County
142147	Fee-for-Service	1811156078	1811156078	1	1	HANCOCK, RISE D LMFT	5/11/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	32184	-	NOT APPLICABLE	0	In state provider	None	510 EAST MAGNOLIA ST	100	STOCKTON	CA	95202	1812	39	06077	37.96446348	-121.2872245	San Joaquin County
142150	Fee-for-Service	1669761920	1669761920	1	1	HOUSTON, MI'QUAEL A MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107684	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
142175	Fee-for-Service	1477841070	1477841070	1	1	HA, TONY D MD	10/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	122709	30	Radiology	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
142205	Fee-for-Service	1700047842	1700047842	1	1	HOQUE, MUNTASIR MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	109688	30	Radiology	0	In state provider	None	4640 ADMIRALTY WAY	STE 102	MARINA DEL REY	CA	90292	6629	19	06037	33.98120707	-118.4409729	Los Angeles County
142212	Fee-for-Service	1871175737	1871175737	1	1	HALLER, LEONARD MD	7/1/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	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
142232	Fee-for-Service	1760675110	1760675110	1	1	HAKIM, ALEXIS D MD	8/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	104405	41	Internal Medicine	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
142243	Fee-for-Service	1639220585	1639220585	1	1	HUGHES, VICKI OD	8/31/1992	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
142255	Fee-for-Service	1932462413	1932462413	1	1	HARTENSTINE, JAVI L DO MD	9/29/2017	390200000X	NA	Other	026	PHYSICIANS	14783	22	Pathology (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
142264	Fee-for-Service	1265405070	1265405070	1	1	HENRY, RANDALL 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	200 LOTHROP ST	None	PITTSBURGH	PA	15213	2536	00	None	40.44188737	-79.96079711	Allegheny County
142318	Fee-for-Service	1255864955	1255864955	1	1	HIGGINS, BRENNAN V MD	4/3/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	159684	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
142338	Fee-for-Service	1124091129	1124091129	1	1	HUSTON, TIMOTHY P MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44816	08	Family Practice	0	In state provider	None	27231 LA PAZ RD	STE A	LAGUNA NIGUEL	CA	92677	3627	30	06059	33.56889655	-117.7077443	Orange County
142340	Fee-for-Service	1831286046	1831286046	1	1	HUANG, YING H MD	10/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90077	18	Ophthalmology	0	In state provider	WASHINGTON EYE CLINIC	416 W LAS TUNAS DR	STE 304	SAN GABRIEL	CA	91776	1217	19	06037	34.10243845	-118.1046106	Los Angeles County
142375	Fee-for-Service	1639475437	1639475437	1	1	HOLLEMAN, KEVIN T DO	2/12/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	12213	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
142408	Fee-for-Service	1245816511	1245816511	1	1	HELPFUL HOSPICE CARE	12/20/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	STE 207	ENCINO	CA	91436	2968	19	06037	34.15524484	-118.4756687	Los Angeles County
142409	Fee-for-Service	1316235245	1316235245	1	1	HYLTON, JULIE H MD	11/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127601	36	Psychiatry	0	In state provider	None	2008 MORSE AVE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
142437	Fee-for-Service	1558433391	1558433391	1	1	HAN, SHERRY S MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65569	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
142458	Fee-for-Service	1508924135	1508924135	1	1	HERITAGE ADULT DAY	11/7/2001	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	2020 N WEBER AVENUE	UNIT 123	FRESNO	CA	93705	4313	10	06019	36.76954961	-119.8332794	Fresno County
142482	Fee-for-Service	1073885711	1073885711	1	1	HENDERSON, BREANNA K	3/26/2012	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
142525	Fee-for-Service	1376698357	1376698357	1	1	HOLCOMBE, DAVID OD	11/26/2012	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
142534	Fee-for-Service	1568485258	1568485258	1	1	HUNTER, MARQUE 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	3621 22ND ST	STE 400	LUBBOCK	TX	79410	1302	00	None	33.57504866	-101.8937396	Lubbock County
142562	Fee-for-Service	1285715086	1285715086	1	1	HAMMOUDEH, JEFFREY A MD	7/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94991	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
142573	Fee-for-Service	1720286453	1720286453	1	1	HOPE, JASON M MD	12/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	1	Border provider	None	1350 STARDUST ST	STE D	RENO	NV	89503	4264	00	None	39.52858204	-119.8347915	Washoe County
142584	Fee-for-Service	1114193000	1114193000	1	1	HU, LIN AUNG REX	7/26/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	107850	None	None	0	In state provider	None	4784 PECK RD	STE A	EL MONTE	CA	91732	1360	19	06037	34.09071973	-118.0144474	Los Angeles County
142593	Fee-for-Service	1710062401	1710062401	1	1	HSIAO, RAY JUI YANG INC	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70571	41	Internal Medicine	0	In state provider	None	1850 S AZUSA AVE	STE 308	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
142620	Fee-for-Service	1124091129	1124091129	1	1	HUSTON, TIMOTHY P MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	44816	01	General Practice	0	In state provider	None	27231 LA PAZ RD	STE A	LAGUNA NIGUEL	CA	92677	3627	30	06059	33.56889655	-117.7077443	Orange County
142630	Fee-for-Service	1881336675	1881336675	1	1	HONG, CLARA S OD	8/14/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
142660	Fee-for-Service	1992006654	1992006654	3	1	HEALTH GUARD RX, INC.	12/12/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2355 HONOLULU AVE	None	MONTROSE	CA	91020	2500	19	06037	34.20632029	-118.2303322	Los Angeles County
142678	Fee-for-Service	1992704506	1992704506	1	1	HOSPICE OF THE NO COAST	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY OUTREACH	2525 PIO PICO DRIVE	SUITE 301	CARLSBAD	CA	92008	1568	37	06073	33.16988164	-117.3444828	San Diego County
142699	Fee-for-Service	1164714143	1164714143	1	1	HOLMBERG, CARRIE MD	6/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122061	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
142801	Fee-for-Service	1922019371	1922019371	1	1	HARRIS, LESLIE MD	3/8/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	80321	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
142813	Fee-for-Service	1023472818	1023472818	1	1	HUERTO, RYAN B MD	8/2/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	152167	None	None	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
142837	Fee-for-Service	1427580349	1427580349	1	1	HTWE, KHAING KHAING MD	4/23/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	166094	41	Internal Medicine	0	In state provider	None	100 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
142896	Fee-for-Service	1922531904	1922531904	1	1	HO, VY	9/25/2024	2086S0129X	NA	General Surgery	026	PHYSICIANS	159920	89	Surgery-Traumatic	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
142932	Fee-for-Service	1104970219	1104970219	1	1	HARVEY, JOYCE A 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
142947	Fee-for-Service	1295713360	1295713360	1	1	HOBSON, MARGARET D MD	7/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52378	07	Dermatology	0	In state provider	None	15025 INNOVATION DR	None	SAN DIEGO	CA	92128	3409	37	06073	32.98956795	-117.0767228	San Diego County
142965	Fee-for-Service	1992704506	1992704506	1	1	HOSPICE OF THE NO COAST	7/22/1999	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	COMMUNITY OUTREACH	2525 PIO PICO DRIVE	SUITE 301	CARLSBAD	CA	92008	1568	37	06073	33.16988164	-117.3444828	San Diego County
142975	Fee-for-Service	1427047174	1427047174	1	1	HEITER, DONNA M CRNA	1/9/2004	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	255 MANOR CT	None	SUTTER CREEK	CA	95685	4315	03	06005	38.39940309	-120.7939887	Amador County
142989	Fee-for-Service	1952060337	1952060337	1	1	HOLLYCARE HOME HEALTH INC	1/11/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14242 VENTURA BLVD	SUITE 213	SHERMAN OAKS	CA	91423	2757	19	06037	34.14999696	-118.4433632	Los Angeles County
143010	Fee-for-Service	1306189188	1306189188	1	1	HARSHA NALLURI	9/9/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	202 N DIVISION ST	None	AUBURN	WA	98001	4939	00	None	47.308698	-122.2297715	King County
143019	Fee-for-Service	1265973689	1265973689	1	1	HO, DEREK MD	8/8/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	171259	07	Dermatology	0	In state provider	None	115 S 1ST AVE	None	ARCADIA	CA	91006	3606	19	06037	34.13833544	-118.0283334	Los Angeles County
143069	Fee-for-Service	1417444563	1417444563	1	1	HSUEH, MARION DO	8/23/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18948	None	None	0	In state provider	None	5400 W HILLSDALE AVE	None	VISALIA	CA	93291	6238	54	06107	36.330327	-119.351943	Tulare County
143080	Fee-for-Service	1063012060	1063012060	1	1	HOEFKE, ANGELA CNP	2/17/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1792 GARNET AVE	None	SAN DIEGO	CA	92109	3350	37	06073	32.80054833	-117.2374979	San Diego County
143109	Fee-for-Service	1497892525	1497892525	1	1	HARTMAN, ANGELA R LCSW	12/4/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	61934	-	NOT APPLICABLE	0	In state provider	None	2344 OLD SONOMA ROAD	BLDGS A, B, C, F, J	NAPA	CA	94559	1344	28	06055	38.2878005	-122.298057	Napa County
143119	Fee-for-Service	1427580349	1427580349	1	1	HTWE, KHAING KHAING MD	4/23/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	166094	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	100 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06544724	-118.4459249	Los Angeles County
143120	Fee-for-Service	1528003514	1528003514	1	1	HUANG, PATTY Y MD	11/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66914	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
143146	Fee-for-Service	1376504738	1376504738	1	1	HAGER, NELSON 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	1959 NE PACIFIC ST	None	SEATTLE	WA	98195	0001	00	None	47.65080692	-122.3081828	King County
143147	Fee-for-Service	1316050024	1316050024	1	1	HARE, 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	665 WINTER STREET	None	SALEM	OR	97301	0000	00	None	44.933211	-123.0355125	Marion County
143170	Fee-for-Service	1194335810	1194335810	1	1	HELP AND CARE HOSPICE INC	6/6/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	10545 BURBANK BLVD	UNIT 130	NORTH HOLLYWOOD	CA	91601	2249	19	06037	34.1721655	-118.3608315	Los Angeles County
143208	Fee-for-Service	1053055160	1053055160	1	1	HARDING, ANDREW OT	5/23/2022	225XP0019X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
143215	Fee-for-Service	1760010011	1760010011	1	1	HONG, JAMES J DO	7/1/2024	207R00000X	NA	Other	026	PHYSICIANS	21393	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
143231	Fee-for-Service	1750825345	1750825345	1	1	HERNANDEZ, ASHLEY J	4/27/2017	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
143258	Fee-for-Service	1699285528	1699285528	1	1	HIBBS, SHELBY	2/27/2024	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1827 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.25641704	-119.2199387	Ventura County
143312	Fee-for-Service	1205994092	1205994092	1	1	HANNA, NANCY F MD	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	67051	41	Internal Medicine	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
143315	Fee-for-Service	1124086376	1124086376	1	1	HOPKINS, GARY A MD	9/8/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	64269	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25500 MEDICAL CTR DR	None	MURRIETA	CA	92562	5965	33	06065	33.5580705	-117.1835458	Riverside County
143325	Fee-for-Service	1689616757	1689616757	1	1	HARVEY, WILLIAM B MD	8/1/2002	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	79834	None	None	0	In state provider	None	735 GALVESTON DR	None	REDWOOD CITY	CA	94063	4722	41	06081	37.4989557	-122.2170646	San Mateo County
143352	Fee-for-Service	1801982525	1801982525	2	1	HAMILTON, MAGDA A	12/14/2007	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1201 ALHAMBRA BLVD	STE 200	SACRAMENTO	CA	95816	5241	34	06067	38.570076	-121.4657145	Sacramento County
143386	Fee-for-Service	1184617508	1184617508	1	1	HECK, CAROL A PHD	2/28/1991	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	31877 PASEO LINDO	None	BONSALL	CA	92003	4903	37	06073	33.29190267	-117.2473434	San Diego County
143415	Fee-for-Service	1518906247	1518906247	1	1	HALVORSON, GARY MD	8/29/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	EUGENE EMERGENCY PHYS	1255 HILYARD ST	None	EUGENE	OR	97401	3718	00	None	44.04647879	-123.0820996	Lane County
143422	Fee-for-Service	1225392582	1225392582	1	1	HOEKSTRA, RYAN P OD	3/2/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1246 E ARROW HWY	STE A	UPLAND	CA	91786	4955	36	06071	34.09974849	-117.634842	San Bernardino County
143439	Fee-for-Service	1417339961	1417339961	1	1	HALUSIC, ANGELA MD	10/15/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162491	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	35 CASA ST	STE 220	SAN LUIS OBISPO	CA	93405	1890	40	06079	35.29359615	-120.6654304	San Luis Obispo County
143441	Fee-for-Service	1083928337	1083928337	1	1	HAGGERTY, KATE A MD	5/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118728	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
143455	Fee-for-Service	1194335810	1194335810	1	1	HELP AND CARE HOSPICE INC	6/6/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	10545 BURBANK BLVD	UNIT 130	NORTH HOLLYWOOD	CA	91601	2249	19	06037	34.1721655	-118.3608315	Los Angeles County
143463	Fee-for-Service	1952499519	1952499519	1	1	HUANG, JAMES MD	10/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52552	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
143475	Fee-for-Service	1386842748	1386842748	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	31757 TEMECULA PKWY	STE D	TEMECULA	CA	92592	6813	33	06065	33.477552	-117.104283	Riverside County
143480	Fee-for-Service	1932149135	1932149135	1	1	HENRY, GINARD I MD	11/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	68936	46	Hand Surgery	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
143486	Fee-for-Service	1184607392	1184607392	1	1	HOLT, ELIZABETH H MD	3/15/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	184617	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
143513	Fee-for-Service	1639681414	1639681414	1	1	HESSION, KELLY F NP	3/18/2025	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
143526	Fee-for-Service	1114192473	1114192473	1	1	HAHN, JOSEPH M MD	7/21/2017	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	109460	20	Orthopedic Surgery	0	In state provider	None	160 E ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	19	06037	34.07556833	-117.7507835	Los Angeles County
143540	Fee-for-Service	1952960551	1952960551	1	1	HERALD CHRISTIAN HEALTH	8/22/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7423 NEWMARK AVE	None	ROSEMEAD	CA	91731	2801	19	06037	34.06032883	-118.1071687	Los Angeles County
143545	Fee-for-Service	1235709973	1235709973	1	1	HENNESSY, KIMIKO A	1/23/2023	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
143552	Fee-for-Service	1346363348	1346363348	1	1	HAMILTON, JUSTIN W	6/25/2010	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
143553	Fee-for-Service	1063437309	1063437309	1	1	HUYNH, MINH QUAN MD	6/10/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41782	01	General Practice	0	In state provider	None	57 N 13TH ST	None	SAN JOSE	CA	95112	3439	43	06085	37.34278534	-121.8786963	Santa Clara County
143594	Fee-for-Service	1396267043	1396267043	1	1	HWANG, MINRU NP	6/25/2024	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
143597	Fee-for-Service	1902994932	1902994932	1	2	HUANG, JIAKANG MD	3/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1800 E FLORENCE BLVD	None	CASA GRANDE	AZ	85122	5303	00	None	32.881311	-111.7096155	Pinal County
143663	Fee-for-Service	1780725226	1780725226	1	1	HANSON, SHARON A NP	12/24/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43563 HIGHWAY 299 E	None	FALL RIVER MILLS	CA	96028	0861	45	06089	41.02401196	-121.4246219	Shasta County
143665	Fee-for-Service	1487941928	1487941928	1	1	HALAWI, HOUSSAM MD	10/2/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	163845	10	Gastroenterology (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
143682	Fee-for-Service	1477078343	1477078343	1	1	HALLADAY, MARGARET L NP	12/10/2018	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
143700	Fee-for-Service	1326480385	1326480385	1	1	HUO, SIYA MD	6/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149724	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
143708	Fee-for-Service	1336157379	1336157379	2	1	HURST, SUSAN I PHD	4/27/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	23 WEST ST. CHARLES ST.	None	SAN ANDREAS	CA	95249	9324	05	06009	38.19634106	-120.6814732	Calaveras County
143721	Fee-for-Service	1598253833	1598253833	1	1	HICKS, MARYA L MD	4/19/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	175261	None	None	0	In state provider	None	280 SIERRA COLLEGE DR	STE 120	GRASS VALLEY	CA	95945	5763	29	06057	39.23410746	-121.0515391	Nevada County
143780	Fee-for-Service	1760444194	1760444194	1	1	HYE QUALITY HOME HEALTH,	6/25/2002	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	2855 TEMPLE AVE	STE A	SIGNAL HILL	CA	90755	2212	19	06037	33.809013	-118.1589655	Los Angeles County
143782	Fee-for-Service	1528064649	1528064649	1	1	HENDRICK MEDICAL CENTER	7/22/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1900 PINE ST	None	ABILENE	TX	79601	1667	00	None	32.472216	-99.733275	Taylor County
143795	Fee-for-Service	1811058142	1811058142	1	1	HOFFMAN, MERYL LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR ROAD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
143828	Fee-for-Service	1952960551	1952960551	1	1	HERALD CHRISTIAN HEALTH	8/22/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7423 NEWMARK AVE	None	ROSEMEAD	CA	91731	2801	19	06037	34.06032883	-118.1071687	Los Angeles County
143844	Fee-for-Service	1063437309	1063437309	1	1	HUYNH, MINH QUAN MD	6/10/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41782	41	Internal Medicine	0	In state provider	None	57 N 13TH ST	None	SAN JOSE	CA	95112	3439	43	06085	37.34278534	-121.8786963	Santa Clara County
143846	Fee-for-Service	1487820197	1487820197	1	1	HSIUNG, DEBORAH DO	11/22/2010	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	10294	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
143868	Fee-for-Service	1396856233	1396856233	1	1	HAUGHT, KAREN A MD	7/26/2002	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	86585	40	Pediatrics	0	In state provider	None	5957 S MOONEY BLVD	None	VISALIA	CA	93277	9394	54	06107	36.277425	-119.3147955	Tulare County
143875	Fee-for-Service	1871779017	1871779017	1	1	HEROLD, AMY M MD	5/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99527	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2425 SAMARITAN DR	None	SAN JOSE	CA	95124	3908	43	06085	37.25111017	-121.9465891	Santa Clara County
143960	Fee-for-Service	1376599076	1376599076	1	1	HANFT, ALAN C MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61424	36	Psychiatry	0	In state provider	None	2252 45TH ST	None	SACRAMENTO	CA	95817	1514	34	06067	38.55487602	-121.4529879	Sacramento County
143963	Fee-for-Service	1639895832	1639895832	1	1	HUYNH, DANIEL V PT	3/3/2023	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
143989	Fee-for-Service	1083731319	1083731319	1	1	HILL, JOHN D MD	1/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	30181	08	Family Practice	0	In state provider	None	777 ACADEMY DR	None	SOLANA BEACH	CA	92075	2031	37	06073	32.9910987	-117.2591873	San Diego County
144002	Fee-for-Service	1568720332	1568720332	1	1	HEFLIN, THOMAS H MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134809	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
144004	Fee-for-Service	1649728569	1649728569	1	1	HERME, ALYSON C PHD	11/21/2018	208VP0000X	NA	Other	031	PSYCHOLOGISTS	-	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
144066	Fee-for-Service	1225018278	1225018278	1	1	HOLLENBECK, KERRY J MD	3/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	88891	05	Anesthesiology	0	In state provider	None	5176 HILL ROAD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
144070	Fee-for-Service	1528064649	1528064649	1	1	HENDRICK MEDICAL CENTER	7/22/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1900 PINE ST	None	ABILENE	TX	79601	1667	00	None	32.472216	-99.733275	Taylor County
144166	Fee-for-Service	1336330323	1336330323	1	1	HSIEH, BERTRAN MD	11/13/2007	207R00000X	NA	Other	026	PHYSICIANS	96016	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
144177	Fee-for-Service	1083076608	1083076608	1	1	HANSEN, KEITH S MD	7/10/2020	208600000X	NA	General Surgery	026	PHYSICIANS	152999	02	General Surgery	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
144241	Fee-for-Service	1154585123	1154585123	1	1	HIDDLESON, KIMBERLY J	2/8/2015	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	901 DOVE STREET	SUITE 280	NEWPORT BEACH	CA	92660	3038	30	06059	33.65871202	-117.8642984	Orange County
144290	Fee-for-Service	1366463192	1366463192	1	1	HYATT, WILLIAM J OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	BLOSSOM VALLEY EYECARE	590 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	3212	43	06085	37.25054647	-121.840839	Santa Clara County
144305	Fee-for-Service	1023177680	1023177680	1	1	HUFFAKER, GARY G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29747	18	Ophthalmology	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
144311	Fee-for-Service	1477048676	1477048676	1	1	HEE CHUNG, ESTEFANI MD	5/23/2024	2080N0001X	NA	Pediatric Primary Care	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
144330	Fee-for-Service	1306132782	1306132782	1	1	HILL, MOLLY A CCC-SLP	3/7/2019	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	170 17TH ST	STE B	PACIFIC GROVE	CA	93950	7201	27	06053	36.62215796	-121.9186041	Monterey County
144340	Fee-for-Service	1013022169	1013022169	1	1	HARBOUR, MICHAEL J MD	7/1/1998	207R00000X	NA	Other	026	PHYSICIANS	84853	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
144386	Fee-for-Service	1184200339	1184200339	1	1	HEALTH RUS URGENT-CARE CORP	8/2/2021	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	13622 BEAR VALLEY RD	STE 9 & 10	VICTORVILLE	CA	92392	8509	19	06037	34.47041135	-117.3662247	San Bernardino County
144390	Fee-for-Service	1972500403	1972500403	1	1	HANNA, EHAB MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	86056	36	Psychiatry	0	In state provider	None	23961 CALLE DE LA MAGDAL	STE 424	LAGUNA HILLS	CA	92653	3685	30	06059	33.60999658	-117.7126577	Orange County
144397	Fee-for-Service	1528017894	1528017894	1	1	HSIEH, SONYA C MD	8/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104408	08	Family Practice	0	In state provider	None	375 HUNTINGTON DRIVE	STE G	SAN MARINO	CA	91108	2357	19	06037	34.1067704	-118.1349621	Los Angeles County
144429	Fee-for-Service	1184895856	1184895856	1	1	HENDERSON, MARK C MD	10/10/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	50464	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
144458	Fee-for-Service	1194960963	1194960963	1	1	HAMEL, JEANNE V MD	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	61993	01	General Practice	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
144479	Fee-for-Service	1396217840	1396217840	1	1	HUTTON, JEREMY LMFT	3/4/2025	No Taxonomy Provided	NA	None	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
144491	Fee-for-Service	1508055310	1508055310	1	1	HERBELIN-FARRAR, M MD	10/21/2003	146D00000X	NA	Other	026	PHYSICIANS	79684	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
144522	Fee-for-Service	1740667534	1740667534	1	1	HAN, HWARANG S DO	6/9/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	15603	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
144532	Fee-for-Service	1508211368	1508211368	1	1	HUYNH, SANDY MD	10/21/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153157	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
144574	Fee-for-Service	1124884838	1124884838	1	1	HSA ACUPUNCTURE PROF. CORP.	3/12/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	33428 ALVARADO NILES RD	None	UNION CITY	CA	94587	3110	01	06001	37.59183257	-122.0377067	Alameda County
144577	Fee-for-Service	1346545266	1346545266	1	1	HWANG, JAMES C MD	10/31/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114395	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
144619	Fee-for-Service	1316237068	1316237068	1	1	HERNANDEZ GONZALEZ, LIZ K MD	10/28/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	127667	08	Family Practice	0	In state provider	None	27303 SLEEPY HOLLOW	None	HAYWARD	CA	94545	4203	01	06001	37.63208871	-122.0939191	Alameda County
144651	Fee-for-Service	1538313648	1538313648	1	1	HUYNH, BAO QUYNH N MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117809	83	Rheumatology	0	In state provider	None	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
144676	Fee-for-Service	1821047705	1821047705	1	1	HART, ROLAND MD	12/1/2008	207N00000X	NA	Dermatology	026	PHYSICIANS	34191	07	Dermatology	0	In state provider	None	3031 W MARCH LANE	SUITE 336E	STOCKTON	CA	95219	6500	39	06077	37.9842796	-121.3494311	San Joaquin County
144686	Fee-for-Service	1962446179	1962446179	1	1	HANSEN, JOHN C MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	23	Peripheral Vascular Disease or Surgery (D.O. only)	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
144689	Fee-for-Service	1134651516	1134651516	1	1	HASAN, FARIA N MD	4/9/2024	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	188174	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
144698	Fee-for-Service	1396350468	1396350468	1	1	HOSPICE OF SERENE CARE INC	3/14/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7311 VAN NUYS BLVD	UNIT 16	VAN NUYS	CA	91405	1999	19	06037	34.203393	-118.4487795	Los Angeles County
144733	Fee-for-Service	1437407863	1437407863	1	1	HEALY, ERIN H MD	12/20/2021	2085R0001X	NA	Other	026	PHYSICIANS	175519	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
144797	Fee-for-Service	1851493274	1851493274	1	1	HOWELL, JEFFREY PT	12/6/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	710 SOLANO ST	None	CORNING	CA	96021	3352	52	06103	39.92792426	-122.174722	Tehama County
144828	Fee-for-Service	1275611378	1275611378	1	1	HENNING, LISA C MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7579	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
144836	Fee-for-Service	1619988375	1619988375	1	1	HUI, PETER Y MD	8/31/1987	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	51492	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3838 CALIFORNIA ST	RM 712	SAN FRANCISCO	CA	94118	1509	38	06075	37.78591809	-122.4575439	San Francisco County
144842	Fee-for-Service	1386846939	1386846939	1	1	HU, ERIC C MD	2/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	84577	24	Plastic Surgery	0	In state provider	None	23485 MCBEAN PARKWAY	None	VALENCIA	CA	91355	2001	19	06037	34.42107219	-118.5628381	Los Angeles County
144848	Fee-for-Service	1912402496	1912402496	1	1	HOLLIDAY, WILLIAM B MD	7/29/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164022	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
144858	Fee-for-Service	1013164243	1013164243	1	1	HERRERA, FERNANDO A JR MD	5/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92667	02	General 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
144887	Fee-for-Service	1508196759	1508196759	1	1	HIGH DESERT NEPHROLOGY	3/2/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL ASSOCIATES	655 HELEN RUNYON DR	None	BARSTOW	CA	92311	3001	36	06071	34.89143486	-117.0195466	San Bernardino County
144891	Fee-for-Service	1245247790	1245247790	1	1	HOLSON,DAVE	6/3/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8268 164TH ST	None	JAMAICA	NY	11432	1121	00	None	40.717917	-73.804086	Queens County
144899	Fee-for-Service	1346306008	1346306008	1	1	HAMPAPUR, KUSUMA A MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137106	01	General Practice	0	In state provider	None	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
144941	Fee-for-Service	1538313648	1538313648	1	1	HUYNH, BAO QUYNH N MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117809	41	Internal Medicine	0	In state provider	None	1700 MOUNT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
144977	Fee-for-Service	1962446179	1962446179	1	1	HANSEN, JOHN C MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	02	General Surgery	1	Border provider	None	75 PRINGLE WAY	STE 1002	RENO	NV	89502	1475	00	None	39.52621891	-119.7944075	Washoe County
144985	Fee-for-Service	1396350468	1396350468	1	1	HOSPICE OF SERENE CARE INC	8/18/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7311 VAN NUYS BLVD	UNIT 16	VAN NUYS	CA	91405	1999	19	06037	34.203393	-118.4487795	Los Angeles County
145033	Fee-for-Service	1699144030	1699144030	1	1	HAUDRICOURT, CONNIE	1/27/2024	104100000X	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
145034	Fee-for-Service	1710922984	1710922984	1	1	HO, LINH T MD	6/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	78718	30	Radiology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
145076	Fee-for-Service	1770070369	1770070369	1	1	HERRERA, MAYRA J	8/6/2020	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	561 N MOUNTAIN AVE	None	UPLAND	CA	91786	5016	36	06071	34.100505	-117.6703307	San Bernardino County
145106	Fee-for-Service	1043789605	1043789605	1	1	HUMPHREY, MEGAN L MD	8/29/2023	207R00000X	NA	Other	026	PHYSICIANS	189170	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
145108	Fee-for-Service	1922065606	1922065606	1	1	HOYT, DAVID B MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	36210	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
145121	Fee-for-Service	1720585730	1720585730	1	1	HANNA, MARIAM S MD	3/22/2022	390200000X	NA	Other	026	PHYSICIANS	173393	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
145122	Fee-for-Service	1538587118	1538587118	1	1	HORIKAWA, MASAHIRO MD	11/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	3181 SW SAM JACKSON PARK	RD	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
145126	Fee-for-Service	1275906471	1275906471	1	1	HERNANDEZ, RUTH MD MEDICAL	1/2/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	87453	01	General Practice	0	In state provider	PROFESSIONAL CORPORATION	517 E HOLT BLVD	None	ONTARIO	CA	91761	1704	36	06071	34.063497	-117.6453765	San Bernardino County
145136	Fee-for-Service	1053760488	1053760488	1	1	HAMILTON, MOLLIE C MD FAAP	2/5/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	164249	40	Pediatrics	0	In state provider	None	6942 UNIVERSITY AVE	#A	LA MESA	CA	91941	5963	37	06073	32.75532823	-117.0487443	San Diego County
145139	Fee-for-Service	1033181417	1033181417	1	1	HANSCOME, JANN M MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60191	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
145175	Fee-for-Service	1508196759	1508196759	1	1	HIGH DESERT NEPHROLOGY	3/2/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	MEDICAL ASSOCIATES	655 HELEN RUNYON DR	None	BARSTOW	CA	92311	3001	36	06071	34.89143486	-117.0195466	San Bernardino County
145182	Fee-for-Service	1396918041	1396918041	1	1	HELLWIG, ALETA LMFT	7/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	55 W SIERRA MADRE BLVD	STE 300	SIERRA MADRE	CA	91024	3017	19	06037	34.16192887	-118.054081	Los Angeles County
145221	Fee-for-Service	1922254697	1922254697	1	1	HALABY, MOHSEN MD	7/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105208	41	Internal Medicine	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
145242	Fee-for-Service	1306352596	1306352596	1	1	HAQ, AYESHA NP	7/19/2021	363L00000X	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
145285	Fee-for-Service	1942732318	1942732318	1	1	HALL, JENNIFER M MD	5/23/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	160518	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
145316	Fee-for-Service	1275285603	1275285603	1	1	HOUSE INSTITUTE FOUNDATION	3/8/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	TER	1127 WILSHIRE BLVD	1620	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
145344	Fee-for-Service	1568808509	1568808509	1	1	HIGH DESERT CHILD ADOLESCENT	7/9/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	AND FAMILY SERVICES	225 BARSTOW ROAD	None	BARSTOW	CA	92311	2903	36	06071	34.89681047	-117.0229105	San Bernardino County
145360	Fee-for-Service	1972550077	1972550077	1	1	HESHMATI, SIAMAK MD	2/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84044	08	Family Practice	0	In state provider	None	44469 10TH ST W	None	LANCASTER	CA	93534	3324	19	06037	34.691454	-118.148068	Los Angeles County
145379	Fee-for-Service	1679660716	1679660716	1	1	HAGMAN, JENNIFER O MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	13	Neurology (M.D. only)	2	Out of state provider	None	13123 E 16TH AVE	None	AURORA	CO	80045	7106	00	None	39.742164	-104.8350375	Adams County
145407	Fee-for-Service	1720514821	1720514821	1	1	HO, CARRIE I MD	10/28/2024	207RH0003X	NA	Oncology	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
145430	Fee-for-Service	1033181417	1033181417	1	1	HANSCOME, JANN M MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60191	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
145443	Fee-for-Service	1629510409	1629510409	1	1	HEALTHELECT CARE INC	10/8/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6742 VAN NUYS BLVD	210	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
145455	Fee-for-Service	1073662490	1073662490	1	1	HILL, DEBORAH L MD	11/3/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79221	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
145488	Fee-for-Service	1144205634	1144205634	1	1	HILGER, WESLEY S MD FACOG	8/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95529	None	None	0	In state provider	None	87 SCRIPPS DR	STE 310	SACRAMENTO	CA	95825	6318	34	06067	38.572092	-121.410261	Sacramento County
145502	Fee-for-Service	1083175947	1083175947	1	1	HEMPHILL, KAFI MD	6/11/2024	2085R0204X	NA	Other	026	PHYSICIANS	179132	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
145510	Fee-for-Service	1609408541	1609408541	1	1	HEISER, CHRISTOPHER K CRNA	3/16/2020	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
145560	Fee-for-Service	1023170362	1023170362	1	1	HEALTHRIGHT 360	1/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2020 HAYES ST	None	SAN FRANCISCO	CA	94117	1128	38	06075	37.77350967	-122.4496417	San Francisco County
145604	Fee-for-Service	1275285603	1275285603	1	1	HOUSE INSTITUTE FOUNDATION	3/27/2023	231H00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	TER	1127 WILSHIRE BLVD	1620	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
145667	Fee-for-Service	1679660716	1679660716	1	1	HAGMAN, JENNIFER O MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	36	Psychiatry	2	Out of state provider	None	13123 E 16TH AVE	None	AURORA	CO	80045	7106	00	None	39.742164	-104.8350375	Adams County
145723	Fee-for-Service	1063586873	1063586873	1	1	HUGHES, M. K LCSW	1/1/2000	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2129 ROOSEVELT AVE	None	BERKELEY	CA	94703	1521	01	06001	37.86912638	-122.2761375	Alameda County
145766	Fee-for-Service	1992522007	1992522007	1	1	HURTADO, MAGDALENA M	11/18/2024	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
145778	Fee-for-Service	1285754325	1285754325	1	1	HUNSAKER, SHARON R LMFT	6/10/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	4025 GRIFFITH AVE	None	CLOVIS	CA	93619	7278	10	06019	36.78982852	-119.6318835	Fresno County
145785	Fee-for-Service	1518915859	1518915859	1	1	HO, ANDREW P MD	12/31/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84793	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
145812	Fee-for-Service	1124488572	1124488572	1	1	HARPER, ROBERT A MD	6/1/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	146327	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
145824	Fee-for-Service	1851975866	1851975866	1	1	HUYNH, HUY M DO	11/14/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	23096	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
145832	Fee-for-Service	1215966775	1215966775	1	1	HAMID, OMID MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74233	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
145843	Fee-for-Service	1164199501	1164199501	1	2	HASSAN, DANIYAL	1/6/2022	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	5216 JILSON WAY	None	ELK GROVE	CA	95757	3501	34	06067	38.381301	-121.442436	Sacramento County
145877	Fee-for-Service	1457907842	1457907842	1	1	HOSPICE BEST CARE INC	2/4/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	417 S SAN GABRIEL BLVD	SUITE D	SAN GABRIEL	CA	91776	1976	19	06037	34.09733977	-118.0909734	Los Angeles County
145893	Fee-for-Service	1275285603	1275285603	1	1	HOUSE INSTITUTE FOUNDATION	3/8/2023	231H00000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	TER	1127 WILSHIRE BLVD	1620	LOS ANGELES	CA	90017	3901	19	06037	34.05270508	-118.2641005	Los Angeles County
145905	Fee-for-Service	1003163551	1003163551	1	1	HOWSE, ELIZABETH A MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138873	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
145910	Fee-for-Service	1033736079	1033736079	1	1	HOFFMAN, STEVEN OD	3/21/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
145987	Fee-for-Service	1053346627	1053346627	1	1	HORIZON ANESTHESIA & PAIN	9/23/2004	193400000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	A MEDICAL CORPORATION	350 S OAK AVE	None	OAKDALE	CA	95361	3519	50	06099	37.75764557	-120.8600743	Stanislaus County
145993	Fee-for-Service	1558621003	1558621003	1	1	HAJHOSSEINI, BABAK MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	126618	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
146006	Fee-for-Service	1881841914	1881841914	1	1	HOFFMAN, RISA M MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85173	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
146020	Fee-for-Service	1538722384	1538722384	1	1	HEALTH-EU, INTEGRATIVE MEDIC	1/26/2024	207R00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	INE, A PROFESSIONAL ME	121 E TENTH ST	None	AZUSA	CA	91702	2445	19	06037	34.13907755	-117.907009	Los Angeles County
146033	Fee-for-Service	1457478059	1457478059	1	1	HENRY, STEPHEN G MD	7/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121893	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
146036	Fee-for-Service	1033240080	1033240080	1	2	HICKS, MATTHEW R LCSW	1/21/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21132	-	NOT APPLICABLE	0	In state provider	None	950 N STATE STREET	SUITE D&E	HEMET	CA	92543	1485	33	06065	33.763266	-116.9717935	Riverside County
146047	Fee-for-Service	1164500831	1164500831	1	1	HEMPSTEAD, KENNETH D MD	4/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73169	40	Pediatrics	0	In state provider	None	425 UNIVERSITY AVE	STE 200	SACRAMENTO	CA	95825	6509	34	06067	38.570067	-121.4177265	Sacramento County
146054	Fee-for-Service	1093219198	1093219198	1	1	HEIN, NINA MD	1/16/2025	207KA0200X	NA	Other	026	PHYSICIANS	191411	03	Allergy	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
146060	Fee-for-Service	1427238948	1427238948	1	1	HENDERSON, SEDERIA LMFT	8/29/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	S	5635 STRATFORD CIRCLE	B-34	STOCKTON	CA	95207	5068	39	06077	37.99977626	-121.3228713	San Joaquin County
146063	Fee-for-Service	1043287345	1043287345	1	1	HAJJ, AHMAD A MD	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	40971	20	Orthopedic Surgery	0	In state provider	#203	9635 MONTE VISTA AVE	None	MONTCLAIR	CA	91763	2235	36	06071	34.07975926	-117.6982207	San Bernardino County
146065	Fee-for-Service	1841267366	1841267366	1	1	HO, JOHN E MD	9/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145781	41	Internal Medicine	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
146068	Fee-for-Service	1932435781	1932435781	1	1	HALL, JOAN PSYD	2/21/2025	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9829 BLUE LARKSPUR LN	SUITE 2	MONTEREY	CA	93940	6535	27	06053	36.57109892	-121.8021077	Monterey County
146072	Fee-for-Service	1033549399	1033549399	1	1	HUEY, ROBERT G	7/5/2016	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
146120	Fee-for-Service	1215966775	1215966775	1	1	HAMID, OMID MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74233	78	Neoplastic Diseases/Oncology	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
146156	Fee-for-Service	1609817667	1609817667	1	1	HEGEDUS, DALMA MD	6/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	110969	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
146167	Fee-for-Service	1457907842	1457907842	1	1	HOSPICE BEST CARE INC	2/4/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	417 S SAN GABRIEL BLVD	SUITE D	SAN GABRIEL	CA	91776	1976	19	06037	34.09733977	-118.0909734	Los Angeles County
146218	Fee-for-Service	1851616064	1851616064	1	1	HERTZOG, HANS D MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118549	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA	I-340	LOS ANGELES	CA	90095	7065	19	06037	34.06489065	-118.4443287	Los Angeles County
146226	Fee-for-Service	1376588343	1376588343	1	1	HACKETHAL, CLAUDIA M MD	8/11/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82207	40	Pediatrics	0	In state provider	None	1010 MURRAY ST	None	SAN LUIS OBISPO	CA	93405	8800	40	06079	35.29101669	-120.6663647	San Luis Obispo County
146233	Fee-for-Service	1659521847	1659521847	1	1	HOLLOWAY, DIANA B LMFT	12/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	MFT	874 GRAVENSTEIN HIGHWAY	12	SEBASTOPOL	CA	95472	0203	49	06097	38.3933079	-122.8184087	Sonoma County
146262	Fee-for-Service	1689626301	1689626301	1	1	H P GULESSERIAN MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	24341	02	General Surgery	0	In state provider	None	393 BLOSSOM HILL RD	STE 330	SAN JOSE	CA	95123	1659	43	06085	37.25148009	-121.8269584	Santa Clara County
146325	Fee-for-Service	1912291287	1912291287	1	1	HOUCK PATEL, KIMBERLY M MD	4/1/2022	2084N0402X	NA	Neurology	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
146337	Fee-for-Service	1548430135	1548430135	1	1	HOVAV, KAREN MD	8/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102943	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
146360	Fee-for-Service	1316692247	1316692247	1	1	HOUSTON, ANJELICA P	7/18/2022	225XP0200X	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
146366	Fee-for-Service	1801246962	1801246962	1	1	HOLGREN, SARAH E MD	3/3/2021	207P00000X	NA	Other	026	PHYSICIANS	157418	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
146369	Fee-for-Service	1205828308	1205828308	1	1	HELSETH, PETER H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	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
146370	Fee-for-Service	1306306758	1306306758	1	1	HOLMGREN, SARAH K PT	7/17/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2221 WANKEL WAY	None	OXNARD	CA	93030	0192	56	06111	34.21677352	-119.1475125	Ventura County
146384	Fee-for-Service	1811927429	1811927429	1	1	HAYATDAVOUDI, G H MD	9/5/1981	207RP1001X	NA	Pulmonology	026	PHYSICIANS	36736	None	None	0	In state provider	None	4748 ENGLE RD	STE 206	CARMICHAEL	CA	95608	2238	34	06067	38.631285	-121.3531065	Sacramento County
146396	Fee-for-Service	1871035287	1871035287	1	1	HERRERA, BRANDEY P LMFT	4/24/2023	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
146409	Fee-for-Service	1922549948	1922549948	1	1	HAVEN EYE INSTITUTE INC	5/21/2019	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9190 HAVEN AVE	SUITE 200	RANCHO CUCAMONGA	CA	91730	5431	36	06071	34.086816	-117.5758865	San Bernardino County
146439	Fee-for-Service	1700345212	1700345212	1	1	HAMILL, JAMES PSYD	4/11/2025	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	521 1/2 S MYRTLE AVE	STE 9/10	MONROVIA	CA	91016	5131	19	06037	34.14635952	-118.0010148	Los Angeles County
146491	Fee-for-Service	1194068031	1194068031	1	1	HALL, JACOB N MD	5/15/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132420	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
146561	Fee-for-Service	1255657664	1255657664	1	1	HAMRA, STEPHEN W MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120543	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
146564	Fee-for-Service	1740637636	1740637636	1	1	HAN, TINA K MD	2/27/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	153837	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
146600	Fee-for-Service	1972894541	1972894541	1	1	HO, THUAN M MD	5/16/2019	207L00000X	NA	Other	026	PHYSICIANS	122765	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
146615	Fee-for-Service	1326266495	1326266495	1	1	HORN, BRANDON A LAC	1/9/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
146649	Fee-for-Service	1295883007	1295883007	1	1	HEATH, CARMEN E MD	7/2/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	68993	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
146660	Fee-for-Service	1215547609	1215547609	1	1	HEALTHY WAY HOSPICE INC	8/24/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6741 VAN NUYS BLVD	UNIT 212	VAN NUYS	CA	91405	4630	19	06037	34.19331814	-118.4487786	Los Angeles County
146665	Fee-for-Service	1699341131	1699341131	1	1	HIGH QUALITY HOME HEALTH OC	12/8/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	1100 E ORANGETHORPE AVE	SUITE 200-Q	ANAHEIM	CA	92801	1144	30	06059	33.85953934	-117.9075761	Orange County
146670	Fee-for-Service	1447546072	1447546072	1	1	HOLT, KURT A DO	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13466	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
146685	Fee-for-Service	1629428677	1629428677	1	1	HARRIS, GREGORY PT	1/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1700 E BULLARD AVE	102	FRESNO	CA	93710	5866	10	06019	36.82318621	-119.7562623	Fresno County
146686	Fee-for-Service	1881790186	1881790186	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	1319 WEST CARSON ST	None	TORRANCE	CA	90501	3909	19	06037	33.83156351	-118.300248	Los Angeles County
146693	Fee-for-Service	1649410317	1649410317	1	1	HUYN, ANDREA C OD	8/5/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	#110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
146702	Fee-for-Service	1114314754	1114314754	1	1	HUYNH, DONOVAN P MD	9/14/2018	208M00000X	NA	Other	026	PHYSICIANS	147059	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
146775	Fee-for-Service	1629052527	1629052527	1	1	HARTMAN, CARL T MD	10/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	60568	18	Ophthalmology	0	In state provider	None	3801 KATELLA AVE	STE 414	LOS ALAMITOS	CA	90720	3386	30	06059	33.80318951	-118.066068	Orange County
146801	Fee-for-Service	1316149735	1316149735	1	1	HUANG, JENNIFER S MD	4/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107989	18	Ophthalmology	0	In state provider	None	100 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	3075	19	06037	34.06489065	-118.4443287	Los Angeles County
146839	Fee-for-Service	1265482731	1265482731	2	1	HOME HEALTH RESOURCE INC	7/31/2015	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	4361 TECHNOLOGY DRIVE	SUITE C	LIVERMORE	CA	94551	4989	01	06001	37.69207148	-121.7436041	Alameda County
146870	Fee-for-Service	1598800971	1598800971	1	1	HEALTHY WAY PHARMACY	5/7/2003	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HEALTHY WAY PHARMACY	7223 BALBOA BLVD	None	VAN NUYS	CA	91406	2702	19	06037	34.2022173	-118.5012288	Los Angeles County
146881	Fee-for-Service	1710154968	1710154968	1	1	HERMAN, JEREMY R MD	10/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90149	41	Internal Medicine	0	In state provider	None	8536 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3103	19	06037	34.06550726	-118.3775199	Los Angeles County
146884	Fee-for-Service	1376587212	1376587212	1	1	HERNANDEZ, ANTHONY C MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74599	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1101 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5808	19	06037	34.06470063	-117.984656	Los Angeles County
146894	Fee-for-Service	1669534483	1669534483	1	1	HUANG, DAVID MD	8/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81004	18	Ophthalmology	0	In state provider	None	2617 E CHAPMAN AVE	STE 301	ORANGE	CA	92869	3234	30	06059	33.7878445	-117.8254845	Orange County
146917	Fee-for-Service	1255436044	1255436044	1	1	HILZINGER, REINHARDT G MD	8/22/2016	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67727	01	General Practice	0	In state provider	None	1 MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
146948	Fee-for-Service	1215547609	1215547609	1	1	HEALTHY WAY HOSPICE INC	8/24/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6741 VAN NUYS BLVD	UNIT 212	VAN NUYS	CA	91405	4630	19	06037	34.19331814	-118.4487786	Los Angeles County
146950	Fee-for-Service	1386167914	1386167914	1	1	HOWARD, IAN C LCSW	9/13/2023	104100000X	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
146954	Fee-for-Service	1689730806	1689730806	1	1	HUNTINGTON BEACH CITY SD	9/14/1998	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	ATTN: DISTRICT	8750 DORSETT DRIVE	None	HUNTINGTON BEACH	CA	92646	7149	30	06059	33.6557942	-117.9748745	Orange County
146958	Fee-for-Service	1699341131	1699341131	1	1	HIGH QUALITY HOME HEALTH OC	12/8/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	1100 E ORANGETHORPE AVE	SUITE 200-Q	ANAHEIM	CA	92801	1144	30	06059	33.85953934	-117.9075761	Orange County
147005	Fee-for-Service	1265408678	1265408678	1	1	HELSTEN, TERESA L MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71996	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
147053	Fee-for-Service	1457664807	1457664807	1	1	HERNANDEZ DE CASTANEDA, MART	9/18/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	HA E LMFT	1500 PALMA DR FL 2	None	VENTURA	CA	93003	6451	56	06111	34.25975064	-119.2276657	Ventura County
147072	Fee-for-Service	1215690698	1215690698	1	1	HENDRICKS, SARAH R NP	1/1/2022	363L00000X	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
147145	Fee-for-Service	1366518920	1366518920	1	1	HOWELL, TIFFANY ANN MD	8/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81320	40	Pediatrics	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
147165	Fee-for-Service	1649581604	1649581604	1	1	HU, PATRICK B MD	6/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117946	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
147182	Fee-for-Service	1790965903	1790965903	1	1	HAMZA, MOHSEN M MD INC	2/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	43543	13	Neurology (M.D. only)	0	In state provider	None	11600 WILSHIRE BLVD	SUITE 420	LOS ANGELES	CA	90025	1785	19	06037	34.05055194	-118.4594619	Los Angeles County
147201	Fee-for-Service	1811382831	1811382831	1	1	HEINZERLING, AMY P MD	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	145758	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
147229	Fee-for-Service	1235511627	1235511627	1	1	HAYNAM, STEPHEN T DPM	8/1/2018	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	5120 MANZANITA AVE	SUITE 100	CARMICHAEL	CA	95608	0558	34	06067	38.659392	-121.327155	Sacramento County
147267	Fee-for-Service	1881874519	1881874519	1	1	HUMKE, ERIC W MD	9/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95625	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
147284	Fee-for-Service	1689710378	1689710378	1	1	HILLS, ADELINA L MFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	44946	-	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
147323	Fee-for-Service	1336229970	1336229970	1	1	HOSPICE PREFERRED CHOICE	10/3/2008	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	545 E ALLUVIAL AVE	SUITE 108	FRESNO	CA	93720	2826	10	06019	36.84465651	-119.7760635	Fresno County
147342	Fee-for-Service	1134711054	1134711054	1	1	HAYMOND, IAN PT	10/31/2024	225100000X	NA	Physical Therapist	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
147348	Fee-for-Service	1538134762	1538134762	1	1	HASHMI, AIJAZ MD	2/21/2010	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	66814	35	Pediatric Cardiology (M.D. only)	0	In state provider	INC	555 E TACHEVAH DR	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
147361	Fee-for-Service	1841443975	1841443975	1	1	HABOUKH, MOHAMAD N MD	12/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105822	41	Internal Medicine	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
147363	Fee-for-Service	1538215603	1538215603	1	1	HIGHUM, JON E MD	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	65798	36	Psychiatry	0	In state provider	None	225 W MADISON AVE	# 2	EL CAJON	CA	92020	3454	37	06073	32.80066448	-116.9642655	San Diego County
147370	Fee-for-Service	1770649816	1770649816	1	1	HEADRICK, DANIEL J MD	2/14/2019	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	45144	-	NOT APPLICABLE	0	In state provider	None	9431 ALDERBURY ST.	None	CYPRESS	CA	90630	5458	30	06059	33.82530417	-118.0507332	Orange County
147407	Fee-for-Service	1285616920	1285616920	1	1	HOWELL, LYDIA P MD	9/3/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58488	22	Pathology (M.D. only)	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
147443	Fee-for-Service	1154849800	1154849800	1	1	HAINES, JESSILYN E NP	4/24/2019	363LA2100X	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
147445	Fee-for-Service	1447480314	1447480314	1	1	HALOFF, JEFFREY S LAC	9/17/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	517 3RD ST	18	EUREKA	CA	95501	0460	12	06023	40.80367671	-124.166036	Humboldt County
147446	Fee-for-Service	1609826098	1609826098	1	1	HAKIMIAN, BEHROOZ MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	75476	78	Neoplastic Diseases/Oncology	0	In state provider	None	8700 BEVERLY BLVD	STE C2000	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
147467	Fee-for-Service	1891747184	1891747184	1	1	HULTON, MICHAEL R	2/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	31306	01	General 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
147495	Fee-for-Service	1467540500	1467540500	1	1	HAFER, KURT M	7/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	73393	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
147496	Fee-for-Service	1356354914	1356354914	1	1	HERBST, ELLEN D	11/8/2010	2084P0800X	NA	Psychiatry	026	PHYSICIANS	84083	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
147539	Fee-for-Service	1184835332	1184835332	1	1	HUMANISTIC ALTERNATIVES TO	9/29/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ADDICTION RESEARCH AND T	20094 MISSION BLVD	None	HAYWARD	CA	94541	1237	01	06001	37.68697869	-122.1024518	Alameda County
147541	Fee-for-Service	1922358415	1922358415	1	1	HESHMAT, ALIREZA MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144564	06	Cardiovascular Disease (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
147555	Fee-for-Service	1558317594	1558317594	1	1	HAMED KOMAIHA	9/17/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3000 CORAL HILLS DR	None	CORAL SPRINGS	FL	33065	4108	00	None	26.26864328	-80.25418587	Broward County
147556	Fee-for-Service	1225561723	1225561723	1	1	HUDSON, CAROLINE MD	6/13/2022	390200000X	NA	Other	026	PHYSICIANS	175756	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
147557	Fee-for-Service	1174695993	1174695993	1	1	HSU-WINGES, CHARLENE MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34648	18	Ophthalmology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
147579	Fee-for-Service	1982751871	1982751871	1	1	HUTCHINGS, CELESTE LMFT	9/14/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2180 JEFFERSON ST	STE 200	NAPA	CA	94559	1250	28	06055	38.30685587	-122.2952796	Napa County
147611	Fee-for-Service	1336229970	1336229970	1	1	HOSPICE PREFERRED CHOICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	545 E ALLUVIAL AVE	SUITE 108	FRESNO	CA	93720	2826	10	06019	36.84465651	-119.7760635	Fresno County
147622	Fee-for-Service	1871672618	1871672618	1	1	HOLLAND HOSPITAL	4/22/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	602 MICHIGAN AVE	None	HOLLAND	MI	49423	4918	00	None	42.77452357	-86.11286271	Ottawa County
147635	Fee-for-Service	1538134762	1538134762	1	1	HASHMI, AIJAZ MD	2/21/2010	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	66814	40	Pediatrics	0	In state provider	INC	555 E TACHEVAH DR	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
147650	Fee-for-Service	1841443975	1841443975	1	1	HABOUKH, MOHAMAD N MD	12/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105822	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
147671	Fee-for-Service	1083640775	1083640775	1	1	HOUSTON PLATT N CANDIS 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 METROHEALTH DR	None	CLEVELAND	OH	44109	1998	00	None	41.46242416	-81.69888235	Cuyahoga County
147673	Fee-for-Service	1689111890	1689111890	1	1	HAGANS, LEE J	10/23/2018	No Taxonomy Provided	NA	None	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
147688	Fee-for-Service	1629258892	1629258892	1	1	HUANG, AUDREY H MD	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94259	25	Physical Medicine and Rehabilitation	0	In state provider	None	2840 LONG BEACH BLVD	STE 130	LONG BEACH	CA	90806	1593	19	06037	33.808743	-118.189341	Los Angeles County
147694	Fee-for-Service	1962550376	1962550376	1	1	HEITZ, DANIEL R MD	9/30/1994	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	71019	30	Radiology	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
147734	Fee-for-Service	1609826098	1609826098	1	1	HAKIMIAN, BEHROOZ MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	75476	30	Radiology	0	In state provider	None	8700 BEVERLY BLVD	STE C2000	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
147748	Fee-for-Service	1235200270	1235200270	1	1	HERRMAN, JAN M MD	10/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40972	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
147750	Fee-for-Service	1902815350	1902815350	1	1	HUNDAL, KULJIT S MD	3/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81082	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
147765	Fee-for-Service	1225143597	1225143597	2	1	HENDRICKSE, ADRIAN D MD	2/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
147796	Fee-for-Service	1073515920	1073515920	1	1	HUBER, TIMOTHY E MD	2/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52370	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1065 BUCKS LAKE ROAD	None	QUINCY	CA	95971	9507	32	06063	39.93916024	-120.9619096	Plumas County
147834	Fee-for-Service	1952649907	1952649907	2	1	HOME AND COMMUNITY HOSPICE	5/10/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	337 N VINEYARD AVE	SUITE 306	ONTARIO	CA	91764	4483	36	06071	34.066728	-117.611622	San Bernardino County
147839	Fee-for-Service	1104310358	1104310358	1	1	HUDSON, PARKE W MD	9/3/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	163639	20	Orthopedic Surgery	0	In state provider	None	25455 BARTON RD	101B 102B 104B 106B 108B	LOMA LINDA	CA	92354	3128	36	06071	34.04805253	-117.249534	San Bernardino County
147857	Fee-for-Service	1942305099	1942305099	1	1	HONG, RAYMOND J MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89574	30	Radiology	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
147868	Fee-for-Service	1346379690	1346379690	1	1	HWU, LYNN A PHD	11/18/2013	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
147870	Fee-for-Service	1437218344	1437218344	1	1	HARARI, DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	50027	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4045 3RD AVE	STE 301	SAN DIEGO	CA	92103	2132	37	06073	32.75080807	-117.162721	San Diego County
147891	Fee-for-Service	1205854809	1205854809	1	1	HARTENBOWER, DAVID L MD	11/29/1972	No Taxonomy Provided	NA	None	026	PHYSICIANS	30071	41	Internal Medicine	0	In state provider	None	11600 WILSHIRE BLVD	STE 200	LOS ANGELES	CA	90025	1782	19	06037	34.05055194	-118.4594619	Los Angeles County
147907	Fee-for-Service	1740416445	1740416445	1	1	HAMIDI, TANYA MD	3/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113021	41	Internal Medicine	0	In state provider	None	2800 BENEDICT DR	None	SAN LEANDRO	CA	94577	6840	01	06001	37.71593435	-122.131151	Alameda County
147920	Fee-for-Service	1366555922	1366555922	1	1	HOGAN, 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	101 STADIUM DR	None	MORGANTOWN	WV	26506	7911	00	None	39.65345878	-79.95562791	Monongalia County
147939	Fee-for-Service	1043397979	1043397979	1	1	HOLTZAPPLE, THOMAS P MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	62659	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
147941	Fee-for-Service	1033275847	1033275847	1	1	HUANG, DIANA S OD	11/19/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	138 N MILPITAS BLVD	None	MILPITAS	CA	95035	4401	43	06085	37.43348259	-121.8999829	Santa Clara County
147958	Fee-for-Service	1447624119	1447624119	1	1	HEALTH LINK HOSPICE SERVICES	12/2/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1000 BRANNAN ST	STE 206	SAN FRANCISCO	CA	94103	4888	38	06075	37.76981986	-122.407341	San Francisco County
147979	Fee-for-Service	1497083141	1497083141	1	1	HULL, MARY E CNP	5/1/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	775 E FOOTHILL BLVD	None	POMONA	CA	91767	1223	19	06037	34.1072493	-117.7374988	Los Angeles County
148023	Fee-for-Service	1609826098	1609826098	1	1	HAKIMIAN, BEHROOZ MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	75476	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	STE C2000	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
148046	Fee-for-Service	1275616963	1275616963	2	1	HUGHES, GERALD E JR MD	3/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	34407	18	Ophthalmology	0	In state provider	None	175 N JACKSON AVE	STE 213	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
148122	Fee-for-Service	1871682724	1871682724	1	1	HEBLE, AUDREY B LMFT	11/15/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	45980	-	NOT APPLICABLE	0	In state provider	None	2035 E BALL ROAD	STE 100A, 100P	ANAHEIM	CA	92806	5158	30	06059	33.81812448	-117.8880075	Orange County
148126	Fee-for-Service	1952649907	1952649907	2	1	HOME AND COMMUNITY HOSPICE	5/10/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	337 N VINEYARD AVE	SUITE 306	ONTARIO	CA	91764	4483	36	06071	34.066728	-117.611622	San Bernardino County
148132	Fee-for-Service	1710664297	1710664297	1	1	HORNSTEIN, SARAH CD	7/13/2023	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	49	06097	0	0	None
148178	Fee-for-Service	1205854809	1205854809	1	1	HARTENBOWER, DAVID L MD	11/29/1972	No Taxonomy Provided	NA	None	026	PHYSICIANS	30071	45	Nephrology (Renal-Kidney)	0	In state provider	None	11600 WILSHIRE BLVD	STE 200	LOS ANGELES	CA	90025	1782	19	06037	34.05055194	-118.4594619	Los Angeles County
148246	Fee-for-Service	1033230404	1033230404	1	1	HUGHES, LORENZO T MD	8/17/2020	207L00000X	NA	Other	026	PHYSICIANS	168826	05	Anesthesiology	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
148247	Fee-for-Service	1447624119	1447624119	1	1	HEALTH LINK HOSPICE SERVICES	12/2/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1000 BRANNAN ST	STE 206	SAN FRANCISCO	CA	94103	4888	38	06075	37.76981986	-122.407341	San Francisco County
148255	Fee-for-Service	1376981118	1376981118	1	1	HA, DUKE T DO	9/12/2019	207R00000X	NA	Other	026	PHYSICIANS	17358	41	Internal Medicine	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
148259	Fee-for-Service	1033429253	1033429253	1	1	HOONPONGSIMANONT, WIRACHIN	3/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114539	66	Emergency Medicine (Urgent Care)	0	In state provider	MD	101 THE CITY DR S	STE 1A	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
148262	Fee-for-Service	1588614523	1588614523	1	1	HAMASAKI,CRAIG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 PUNCHBOWL STREET	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
148283	Fee-for-Service	1356668016	1356668016	1	1	HENDRICK, LAUREN LMFT	7/27/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 GELLERT BLVD	STE 280	DALY CITY	CA	94015	2619	41	06081	37.66608413	-122.4686507	San Mateo County
148312	Fee-for-Service	1477630275	1477630275	1	1	HUSSAIN, SAYED A MD INC	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	30580	41	Internal Medicine	0	In state provider	None	729 SUNRISE AVENUE	SUITE 604	ROSEVILLE	CA	95661	4542	31	06061	38.73444822	-121.2720033	Placer County
148331	Fee-for-Service	1558556530	1558556530	1	1	HOLM, WILLIAM L MD	12/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	56818	40	Pediatrics	0	In state provider	None	1115 SOUTH SUNSET AVENUE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
148334	Fee-for-Service	1487691952	1487691952	1	1	HULL, ALEC M MD	9/30/1995	207R00000X	NA	Other	026	PHYSICIANS	62784	41	Internal Medicine	0	In state provider	None	400 W CENTRAL AVE	STE 206	BREA	CA	92821	3008	30	06059	33.93194888	-117.9029987	Orange County
148343	Fee-for-Service	1770619447	1770619447	1	4	HARRY M MILLER MD INC	1/18/2013	207L00000X	NA	Other	026	PHYSICIANS	60912	None	None	0	In state provider	None	641 WEST ROUTE 66	SUITE E	GLENDORA	CA	91740	4149	19	06037	34.12882851	-117.8757225	Los Angeles County
148348	Fee-for-Service	1457705147	1457705147	1	1	HINDS, DANIEL E DO	10/1/2021	207P00000X	NA	Other	026	PHYSICIANS	18220	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
148357	Fee-for-Service	1053844860	1053844860	1	1	HOLTZ, JAMIE N MD	6/9/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	159682	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
148368	Fee-for-Service	1730556093	1730556093	1	1	HARDGE, CARLY C LMFT	5/13/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	139325	-	NOT APPLICABLE	0	In state provider	None	371 E STREET	None	CHULA VISTA	CA	91910	2615	37	06073	32.64400836	-117.0841513	San Diego County
148399	Fee-for-Service	1871605782	1871605782	1	1	HEATH H CHUNG, 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	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
148420	Fee-for-Service	1477971836	1477971836	1	1	HO, YOONA K MD	5/15/2019	390200000X	NA	Other	026	PHYSICIANS	139743	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
148520	Fee-for-Service	1972677581	1972677581	1	1	HUA, FENG MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	52439	13	Neurology (M.D. only)	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
148529	Fee-for-Service	1093219768	1093219768	1	1	HO, CAROLINE DO	11/12/2020	390200000X	NA	Other	026	PHYSICIANS	17617	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
148535	Fee-for-Service	1396868386	1396868386	1	1	HIGHUM, DIANE M MD	12/10/2016	2084P0800X	NA	Psychiatry	026	PHYSICIANS	68947	36	Psychiatry	0	In state provider	None	301 VICTORIA ST	None	COSTA MESA	CA	92627	1995	30	06059	33.65258952	-117.9121545	Orange County
148574	Fee-for-Service	1265507321	1265507321	1	1	HOM, CYNTHIA A MD	10/31/1993	207R00000X	NA	Other	026	PHYSICIANS	77977	41	Internal Medicine	0	In state provider	None	1 CENTRAL AVE	None	SAN FRANCISCO	CA	94117	4114	38	06075	37.7690226	-122.443365	San Francisco County
148596	Fee-for-Service	1023237351	1023237351	1	1	HERRERA GUERRA, ANGEL A MD	8/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	114650	83	Rheumatology	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
148617	Fee-for-Service	1558556530	1558556530	1	1	HOLM, WILLIAM L MD	12/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	56818	67	Endocrinology	0	In state provider	None	1115 SOUTH SUNSET AVENUE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
148628	Fee-for-Service	1598825788	1598825788	1	1	HOFFMAN, MARC A DO	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	5506	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
148629	Fee-for-Service	1063504405	1063504405	1	1	HUANG, NANCY S MD	10/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81880	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
148634	Fee-for-Service	1427246735	1427246735	2	1	HERRON, SCOTT MD	7/20/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	79144	20	Orthopedic Surgery	0	In state provider	None	41278 MARGARITA RD	STE 201	TEMECULA	CA	92591	5579	33	06065	33.52438442	-117.1492152	Riverside County
148644	Fee-for-Service	1972598472	1972598472	1	1	HARRIS, JAMES B MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71798	22	Pathology (M.D. only)	0	In state provider	None	1509 WILSON TER	None	GLENDALE	CA	91206	4007	19	06037	34.14950866	-118.2311155	Los Angeles County
148660	Fee-for-Service	1821151630	1821151630	1	1	HODEL, BETTINA PHD	2/11/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3220 HIGUERA ST	230	SAN LUIS OBISPO	CA	93401	6987	40	06079	35.25657973	-120.6686548	San Luis Obispo County
148692	Fee-for-Service	1386710150	1386710150	1	1	HERNANDEZ, EDWARD J MD	4/1/2011	207P00000X	NA	Other	026	PHYSICIANS	68032	66	Emergency Medicine (Urgent Care)	0	In state provider	HC PROF MED GROUP, INC	121 E WASHINGTON AVE	None	SANTA ANA	CA	92701	3779	30	06059	33.75562217	-117.8666135	Orange County
148709	Fee-for-Service	1093134223	1093134223	1	1	HELLING, TARA A MD	8/13/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	139308	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
148756	Fee-for-Service	1508877879	1508877879	1	1	HAN, JUNG HEE MD	3/8/2019	207L00000X	NA	Other	026	PHYSICIANS	156750	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
148793	Fee-for-Service	1740224518	1740224518	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	895 THIRD AVE	BLDG 2	CHULA VISTA	CA	91911	1304	37	06073	32.62119593	-117.0719915	San Diego County
148809	Fee-for-Service	1053358598	1053358598	1	1	HUDDLESTON, HEATHER G MD	8/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91387	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
148816	Fee-for-Service	1730728692	1730728692	1	1	HUSSAIN, SHEHNAZ NP	2/16/2024	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
148860	Fee-for-Service	1710326905	1710326905	1	1	HUONG TRAN QUY INC	8/2/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11084	None	None	0	In state provider	None	7855 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	9268	30	06059	33.7593093	-117.9920302	Orange County
148862	Fee-for-Service	1336205731	1336205731	1	1	HIMSL, KYLE K MD	11/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	60233	01	General Practice	0	In state provider	None	415 ROLLING OAKS DR	STE 260	THOUSAND OAKS	CA	91361	1033	56	06111	34.17439717	-118.8691161	Ventura County
148871	Fee-for-Service	1548639438	1548639438	1	1	HEDGPETH, MILES LMFT	4/5/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	119304	-	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
148886	Fee-for-Service	1023237351	1023237351	1	1	HERRERA GUERRA, ANGEL A MD	8/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	114650	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
148899	Fee-for-Service	1104446525	1104446525	1	1	HOCKER, NICHOLAS MD	12/13/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	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
148918	Fee-for-Service	1780761866	1780761866	1	1	HAVASU REGIONAL MEDICAL	12/26/2006	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	CENTER LLC	101 CIVIC CENTER LN	None	LK HAVASU CTY	AZ	86403	5683	00	None	34.480224	-114.3390555	Mohave County
148925	Fee-for-Service	1356375463	1356375463	1	1	HABERMEHL, BRADLEY E OD	10/23/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND ST	STE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
149016	Fee-for-Service	1952742744	1952742744	1	1	HAHN, PETER	1/1/2020	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	2701 ATLANTIC AVE	None	LONG BEACH	CA	90806	2701	19	06037	33.807735	-118.1850575	Los Angeles County
149033	Fee-for-Service	1215038229	1215038229	1	1	HORNER, ANITA J NP	3/10/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
149058	Fee-for-Service	1063782209	1063782209	1	1	HOLMES TISCH, ALISON J 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
149083	Fee-for-Service	1245339357	1245339357	1	1	HASTREITER, DAWN MD	1/15/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	186166	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
149132	Fee-for-Service	1154354108	1154354108	1	1	HEALTHCARE FOR WOMEN	12/5/1986	207V00000X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 SAN JOSE ST	None	SALINAS	CA	93901	3901	27	06053	36.65817286	-121.6460674	Monterey County
149156	Fee-for-Service	1205815164	1205815164	1	1	HOEKZEMA, NATHAN A MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132314	02	General Surgery	0	In state provider	None	2210 E ILLINOIS AVE	SUITE 401	FRESNO	CA	93701	2184	10	06019	36.74500687	-119.7846885	Fresno County
149171	Fee-for-Service	1831151851	1831151851	1	1	HOME OF GUIDING HANDS	12/31/1982	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	533 CLAYDELLE AVE	None	EL CAJON	CA	92020	6002	37	06073	32.78943816	-116.9587611	San Diego County
149189	Fee-for-Service	1093160459	1093160459	1	1	HEYRANA, KATRINA J MD	7/26/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168712	None	None	0	In state provider	None	8700 BEVERLY BLVD	# 3611	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
149206	Fee-for-Service	1801865266	1801865266	1	1	HEIMAN, THOMAS D MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	76539	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
149210	Fee-for-Service	1780761866	1780761866	1	1	HAVASU REGIONAL MEDICAL	12/26/2006	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	1	Border provider	CENTER LLC	101 CIVIC CENTER LN	None	LK HAVASU CTY	AZ	86403	5683	00	None	34.480224	-114.3390555	Mohave County
149233	Fee-for-Service	1457478646	1457478646	1	1	HIROSE, SHINJIRO MD	4/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68938	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
149272	Fee-for-Service	1649403486	1649403486	1	1	HEALTHRIGHT 360	7/3/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2015 PIONEER COURT	SUITE B	SAN MATEO	CA	94403	1736	41	06081	37.54712403	-122.3120681	San Mateo County
149294	Fee-for-Service	1104943000	1104943000	1	1	HURTH, KYLE M MD	10/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126864	22	Pathology (M.D. 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
149303	Fee-for-Service	1952742744	1952742744	1	1	HAHN, PETER	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131717	20	Orthopedic Surgery	0	In state provider	None	2701 ATLANTIC AVE	None	LONG BEACH	CA	90806	2701	19	06037	33.807735	-118.1850575	Los Angeles County
149307	Fee-for-Service	1881262897	1881262897	1	1	HERMAN, SHANNON PT	7/22/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1625 EAST MAIN ST.	STE 104	EL CAJON	CA	92021	5223	37	06073	32.80969963	-116.9203429	San Diego County
149323	Fee-for-Service	1730673526	1730673526	1	1	HOVEYDA, NILOUFAR LMFT	6/16/2022	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
149325	Fee-for-Service	1356024590	1356024590	1	1	HEALTH IS WEALTH MH SOLUTION	1/8/2024	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	S, LICENSED CLINICAL SOC	16873 RIDGE CLIFF DR	None	RIVERSIDE	CA	92503	0251	33	06065	33.87206228	-117.4737176	Riverside County
149338	Fee-for-Service	1457454761	1457454761	1	1	HALLIGAN, THOMAS S MD	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	71870	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
149342	Fee-for-Service	1003923517	1003923517	1	1	HEISER, JOEL M MD	5/2/1980	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	32046	41	Internal Medicine	0	In state provider	None	2023 W VISTA WAY	None	VISTA	CA	92083	6030	37	06073	33.18569169	-117.2846332	San Diego County
149348	Fee-for-Service	1679968218	1679968218	1	1	HOLDEN, THOMAS L MD	7/6/2022	207RX0202X	NA	Oncology	026	PHYSICIANS	177323	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
149368	Fee-for-Service	1710045893	1710045893	1	1	HAMAN, HANAN N MD	12/27/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	89907	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
149372	Fee-for-Service	1013696186	1013696186	1	1	HERMANAS ADOLESCENT AND FAMI	7/19/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	G	3742 TIBBETTS ST	STE 201	RIVERSIDE	CA	92506	2641	33	06065	33.9472255	-117.3982995	Riverside County
149376	Fee-for-Service	1598118077	1598118077	1	1	HAMMOND, ANDREW PT	5/7/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
149377	Fee-for-Service	1386006823	1386006823	1	1	HICKS, TIMOTHY D MD	7/24/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157165	40	Pediatrics	0	In state provider	None	101 THE CITY DR S	BLDG 29	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
149417	Fee-for-Service	1760560460	1760560460	1	1	HAYNES, RICHARD M MD	11/7/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	64547	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
149467	Fee-for-Service	1023395951	1023395951	1	1	HSU, DAVINA R DO	11/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11967	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
149478	Fee-for-Service	1366592982	1366592982	1	1	H JOSEPH KHAN M D INC	5/22/2000	207VH0002X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PARAMOUNT CARE MED	1629 W 17TH ST	STE A&B	SANTA ANA	CA	92706	3335	30	06059	33.7601103	-117.890505	Orange County
149494	Fee-for-Service	1073663878	1073663878	1	1	HARRIS, HUGH R MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70608	29	Pulmonary Diseases (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
149554	Fee-for-Service	1982759734	1982759734	1	1	HELM, CRAIG MD APC	9/20/2016	207W00000X	NA	Ophthalmology	026	PHYSICIANS	46407	18	Ophthalmology	0	In state provider	None	27420 TOURNEY ROAD	SUITE 100	VALENCIA	CA	91355	5631	19	06037	34.42122797	-118.5787489	Los Angeles County
149571	Fee-for-Service	1225417090	1225417090	1	1	HOZIC, AMELA DO	8/31/2022	390200000X	NA	Other	026	PHYSICIANS	19302	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
149602	Fee-for-Service	1154473916	1154473916	1	1	HOM GREGORY GEORGE	8/24/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11230 SORRENTO VALLEY RD	STE 115	SAN DIEGO	CA	92121	1335	37	06073	32.90734306	-117.2281918	San Diego County
149634	Fee-for-Service	1366993503	1366993503	1	1	HAKIM, MIRIAM N MD	8/9/2021	207R00000X	NA	Other	026	PHYSICIANS	165361	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
149639	Fee-for-Service	1730141755	1730141755	1	1	HOME OF GUIDING HANDS CORP	1/12/1998	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GERMON HOUSE	10315 EVERELL PL	None	SANTEE	CA	92071	5011	37	06073	32.86483292	-116.96455	San Diego County
149663	Fee-for-Service	1578587721	1578587721	1	1	HONBO, BRIAN A MD	4/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91656	08	Family Practice	0	In state provider	None	2305 CAMINO RAMON	STE 120	SAN RAMON	CA	94583	1394	07	06013	37.77544224	-121.9657563	Contra Costa County
149712	Fee-for-Service	1972914133	1972914133	1	1	HASAN BADDAY MD PC	12/11/2019	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	16405 SAND CANYON AVE	SUITE 215	IRVINE	CA	92618	3785	30	06059	33.66098519	-117.7747816	Orange County
149778	Fee-for-Service	1164593125	1164593125	1	1	HARRISON, VERONICA MD	11/6/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66515	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
149779	Fee-for-Service	1073663878	1073663878	1	1	HARRIS, HUGH R MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70608	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
149811	Fee-for-Service	1518920677	1518920677	1	1	HSU, DORA T MD	6/30/1993	207L00000X	NA	Other	026	PHYSICIANS	47874	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
149901	Fee-for-Service	1497472757	1497472757	1	1	HOLY HOME 2020 INC	11/3/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13449 BIOLA AVE	None	LA MIRADA	CA	90638	2954	19	06037	33.9096798	-118.0197566	Los Angeles County
149907	Fee-for-Service	1164678322	1164678322	1	1	HARIPOTEPORNKUL, NORA H MD	11/23/2010	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	101038	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
149951	Fee-for-Service	1568803401	1568803401	1	1	HOPE HOME HEALTH CARE INC	9/27/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	11040 SANTA MONICA BLVD	SUITE 340	LOS ANGELES	CA	90025	7515	19	06037	34.04800261	-118.4425929	Los Angeles County
149961	Fee-for-Service	1184663965	1184663965	1	2	HOSPITALIST MEDICINE PHYSICI	3/13/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	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
149972	Fee-for-Service	1992334726	1992334726	1	1	HUYNH, BRANDON D DO	7/2/2024	207R00000X	NA	Other	026	PHYSICIANS	21337	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
149994	Fee-for-Service	1467694877	1467694877	1	1	HOOKER, MELANIE A	4/17/2009	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3111 N TUSTIN ST	STE 100	ORANGE	CA	92865	1751	30	06059	33.84194315	-117.8331501	Orange County
150013	Fee-for-Service	1508234907	1508234907	1	1	HEIN, JEREMIAH P LCSW	12/1/2022	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2309 PACIFIC COAST	STE 202	HERMOSA BEACH	CA	90254	2751	19	06037	33.87101437	-118.3948248	Los Angeles County
150017	Fee-for-Service	1962884858	1962884858	1	1	HIGGINS, SUZANNE A OT	11/15/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
150044	Fee-for-Service	1336227016	1336227016	1	1	HWANG, KUO Y MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	6382	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
150070	Fee-for-Service	1073663878	1073663878	1	1	HARRIS, HUGH R MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70608	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
150081	Fee-for-Service	1225102379	1225102379	1	1	HANGER P & O WEST INC	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	350 N WIGET LN	SUITE 100	WALNUT CREEK	CA	94598	2479	07	06013	37.92948925	-122.0275099	Contra Costa County
150083	Fee-for-Service	1851535413	1851535413	1	1	HOLMES, MICHELLE L	5/16/2011	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
150100	Fee-for-Service	1083971618	1083971618	1	1	HOANG, VANESSA K DO	6/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	13188	None	None	0	In state provider	None	2615 EYE STREET	None	BAKERSFIELD	CA	93301	2006	15	06029	35.38291587	-119.0199632	Kern County
150121	Fee-for-Service	1003283813	1003283813	1	1	HEGARTY, MADISON M 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
150155	Fee-for-Service	1831228774	1831228774	1	1	HAMMON, ANN L MD	11/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	36	Psychiatry	2	Out of state provider	None	1200 N BEAVER ST	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
150169	Fee-for-Service	1851600514	1851600514	1	2	HARRIS, BRANDY A LMFT	12/29/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5150 CANDLEWOOD ST	16F	LAKEWOOD	CA	90712	1927	19	06037	33.85362254	-118.1326815	Los Angeles County
150186	Fee-for-Service	1629151527	1629151527	1	1	HOFFMAN, DEBORAH A PHD	5/13/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	22951	-	NOT APPLICABLE	0	In state provider	None	6736 LAUREL CANYON BLVD	SUITE 200	NORTH HOLLYWOOD	CA	91606	1576	19	06037	34.193493	-118.3964925	Los Angeles County
150188	Fee-for-Service	1376151308	1376151308	1	1	HAMZA, DUNIA LCSW	1/23/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	700 N CENTRAL AVE STE 34	None	GLENDALE	CA	91203	4238	19	06037	34.15708991	-118.2579615	Los Angeles County
150219	Fee-for-Service	1003179128	1003179128	1	1	HO, TAMMY S MD	7/7/2017	208800000X	NA	Other	026	PHYSICIANS	149421	34	Urology and Urological Surgery	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
150227	Fee-for-Service	1306300686	1306300686	1	1	HERNANDEZ, BRENDA LMFT	4/11/2024	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
150232	Fee-for-Service	1437101870	1437101870	1	1	HAWKINS TERRANCE D	6/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	7538	41	Internal Medicine	0	In state provider	None	5TH & ESPLANADE	None	CHICO	CA	95926	3226	04	06007	39.741948	-121.848921	Butte County
150288	Fee-for-Service	1356760292	1356760292	1	1	HIDALGO, SYLVANA M MD FAAP	2/24/2021	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	148800	None	None	0	In state provider	AAP	1000 W CARSON ST	None	TORRANCE	CA	90502	2059	19	06037	33.83155851	-118.2920625	Los Angeles County
150297	Fee-for-Service	1720373764	1720373764	1	1	HENRY, ALLISON F MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131957	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
150314	Fee-for-Service	1336189448	1336189448	1	1	HOM, EDWIN MD	1/30/1997	207L00000X	NA	Other	026	PHYSICIANS	28922	05	Anesthesiology	0	In state provider	None	3700 CALIFORNIA ST	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
150318	Fee-for-Service	1255689758	1255689758	1	1	HUSAIN, FATIMA Z MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142089	34	Urology and Urological Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0112	19	06037	34.06169385	-118.2044698	Los Angeles County
150335	Fee-for-Service	1336227016	1336227016	1	1	HWANG, KUO Y MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	6382	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
150369	Fee-for-Service	1568627644	1568627644	1	1	HO OPTOMETRY INC A	10/23/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA	1360 EASTLAKE PKWY	None	CHULA VISTA	CA	91915	4116	37	06073	32.63198831	-116.9665341	San Diego County
150404	Fee-for-Service	1578959318	1578959318	1	1	HOSPITALIST GROUP OF MONTEBE	6/3/2021	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LLO INC	309 WEST BEVERLY BLVD	None	MONTEBELLO	CA	90640	4308	19	06037	34.01597577	-118.1003516	Los Angeles County
150420	Fee-for-Service	1841260353	1841260353	1	1	HAWLEY, DANIEL B MD	5/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114748	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
150441	Fee-for-Service	1942593322	1942593322	1	1	HAYS, KRISTINE CRNA	7/15/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	19	06037	34.58364037	-118.1441012	Los Angeles County
150502	Fee-for-Service	1356392815	1356392815	1	1	HURD, J MARK MD	4/30/1989	207L00000X	NA	Other	026	PHYSICIANS	43826	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
150552	Fee-for-Service	1003836263	1003836263	1	1	HOFKIN, STEPHEN L MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85080	30	Radiology	0	In state provider	None	410 N TAYLOR ST	None	WEAVERVILLE	CA	96093	0000	53	06105	40.74021082	-122.9387157	Trinity County
150590	Fee-for-Service	1437214632	1437214632	1	1	HENSLICK, JAMES R OD	3/11/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27451 LA PAZ RD	STE B	LAGUNA NIGUEL	CA	92677	4082	30	06059	33.56418247	-117.7079814	Orange County
150593	Fee-for-Service	1326809369	1326809369	1	1	HUIZAR MEDICAL TRANSPORTATIO	2/23/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	N LLC	18375 MINDANAO ST	None	BLOOMINGTON	CA	92316	2653	36	06071	34.05989908	-117.4034912	San Bernardino County
150613	Fee-for-Service	1558715508	1558715508	1	1	HOU, EILEEN MD	10/21/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	153156	None	None	0	In state provider	None	797 WEST CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.2882498	-120.4963024	Merced County
150631	Fee-for-Service	1487107454	1487107454	1	1	HIRSHMAN, BRIAN R	8/27/2024	207T00000X	NA	General Surgery	026	PHYSICIANS	155873	14	Neurological 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
150638	Fee-for-Service	1386805109	1386805109	1	1	HARTNESS, CHRISTOPHER B MD	3/17/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	183637	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
150668	Fee-for-Service	1265550529	1265550529	1	1	HOLIWELL, KEVIN K OD	12/1/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	AN OPTOMETRIC CORP	4022 NILES ST	STE A	BAKERSFIELD	CA	93306	4630	15	06029	35.37611945	-118.937619	Kern County
150670	Fee-for-Service	1467138206	1467138206	1	1	HORMONES AND HEALTH,INC	7/24/2023	2080P0205X	NA	Endocrinology	026	PHYSICIANS	None	None	None	0	In state provider	None	25078 PEACHLAND AVE STE	None	NEWHALL	CA	91321	2558	19	06037	34.37865037	-118.5468731	Los Angeles County
150676	Fee-for-Service	1952700650	1952700650	1	1	HTIKE, SWE SWE H MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139498	01	General Practice	0	In state provider	None	1880 N ORANGE GROVE AVE	None	POMONA	CA	91767	3006	19	06037	34.07803211	-117.74833	Los Angeles County
150689	Fee-for-Service	1376276170	1376276170	1	1	HILDEBRAND, PAUL C LCSW	2/7/2024	101YM0800X	NA	Other	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
150702	Fee-for-Service	1437246972	1437246972	1	1	HINOJOSA, ALEJANDRO G MD INC	8/18/2005	207R00000X	NA	Other	026	PHYSICIANS	69515	41	Internal Medicine	0	In state provider	ALEJANDRO G MD INC	340 4TH AVENUE	SUITE 8	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
150705	Fee-for-Service	1912537531	1912537531	1	1	HOWSE, MARSHALL L CRNA	8/9/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
150758	Fee-for-Service	1366013880	1366013880	1	1	HO, PAULINA OT	2/22/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	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
150779	Fee-for-Service	1740793223	1740793223	1	1	HAWAII LIFE FLIGHT, LLC	4/13/2023	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	150 LAGOON DR	None	HONOLULU	HI	96819	1891	00	None	21.32256017	-157.906501	Honolulu County
150812	Fee-for-Service	1891300364	1891300364	1	1	HANFORD PHARMACY INC	4/1/2021	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	365 CAMPUS DR	STE. 101	HANFORD	CA	93230	4374	16	06031	36.32752076	-119.6631038	Kings County
150893	Fee-for-Service	1487630497	1487630497	1	1	HARRIS, BRENT L DO	10/16/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8377	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
150939	Fee-for-Service	1699706648	1699706648	2	1	HEALTH DIAGNOSTICS OF	1/23/2012	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	4144 REDWOOD HIGHWAY	SUITE B	SAN RAFAEL	CA	94903	2646	21	06041	38.00989565	-122.5416079	Marin County
150943	Fee-for-Service	1235145327	1235145327	1	1	HARRIS, KENNETH C MD	5/28/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44882	05	Anesthesiology	0	In state provider	None	792 W TOWN AND COUNTRY R	None	ORANGE	CA	92868	4710	30	06059	33.77649954	-117.860409	Orange County
150990	Fee-for-Service	1437246972	1437246972	1	1	HINOJOSA, ALEJANDRO G MD INC	8/18/2005	207R00000X	NA	Other	026	PHYSICIANS	69515	66	Emergency Medicine (Urgent Care)	0	In state provider	ALEJANDRO G MD INC	340 4TH AVENUE	SUITE 8	CHULA VISTA	CA	91910	3813	37	06073	32.63831293	-117.0833536	San Diego County
151047	Fee-for-Service	1477789949	1477789949	1	1	HORAK, HELENA M MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116821	66	Emergency Medicine (Urgent Care)	0	In state provider	None	215 WEST JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
151078	Fee-for-Service	1164476362	1164476362	1	1	HAJJAR, ATHIR J MD	1/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54733	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	6719 ALVARADO RD	STE 108	SAN DIEGO	CA	92120	5254	37	06073	32.77684978	-117.055137	San Diego County
151123	Fee-for-Service	1780751552	1780751552	1	1	HOUSON, PAUL W OD	12/16/2013	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
151140	Fee-for-Service	1528009727	1528009727	1	1	HAN, NICHOLAS K MD	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4110	00	None	36.163269	-115.1654465	Clark County
151180	Fee-for-Service	1427494558	1427494558	1	1	HAGOES, MARILYN A LMFT	12/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6200 WILSHIRE BLVD	SUITE 1008	LOS ANGELES	CA	90048	5811	19	06037	34.06319291	-118.3636025	Los Angeles County
151192	Fee-for-Service	1104814037	1104814037	1	1	HOLTRY, LANCE D DO	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10368	08	Family Practice	0	In state provider	None	5137 GOLDEN FOOTHILL PRK	SUITE 120	EL DORADO HILLS	CA	95762	9671	09	06017	38.63972246	-121.0689815	El Dorado County
151200	Fee-for-Service	1487636858	1487636858	1	1	HARDICK DACKO, ANNE	11/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53733	None	None	0	In state provider	None	14901 RINALDI ST	STE 315	MISSION HILLS	CA	91345	1254	19	06037	34.27903452	-118.457433	Los Angeles County
151211	Fee-for-Service	1861644783	1861644783	1	1	HICKS, KIMBERLY A OT	4/10/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2200 E. MAPLE AVE	None	EL SEGUNDO	CA	90245	6507	19	06037	33.92690475	-118.3857342	Los Angeles County
151214	Fee-for-Service	1891248415	1891248415	1	1	HERNANDEZ, ERNESTO LMFT	5/3/2023	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
151227	Fee-for-Service	1093792723	1093792723	1	1	HAGEN, JEFFREY L DPM	6/25/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	938 N CHERRY ST	None	VISALIA	CA	93274	2210	54	06107	36.221211	-119.337643	Tulare County
151262	Fee-for-Service	1235227984	1235227984	1	1	HOLMES, RANDOLPH P MD	4/30/1993	174400000X	NA	Other	026	PHYSICIANS	42202	08	Family Practice	0	In state provider	None	15725 WHITTIER BLVD	None	WHITTIER	CA	90603	2347	19	06037	33.94435533	-117.9931159	Los Angeles County
151280	Fee-for-Service	1629238134	1629238134	1	1	HOLLERO, ELAINE M MD	7/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113759	41	Internal Medicine	0	In state provider	None	26357 MCBEAN PKWY	None	VALENCIA	CA	91355	4488	19	06037	34.41257644	-118.5597683	Los Angeles County
151282	Fee-for-Service	1053872192	1053872192	1	1	HAGEMAN, ABBIE C MD	8/23/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	179995	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
151304	Fee-for-Service	1346201209	1346201209	1	1	HUSSONG, JERRY W MD	10/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86484	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BL	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
151315	Fee-for-Service	1073565107	1073565107	1	1	HASAN, SHAZIA M MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	55223	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11633 HAWTHORNE BLVD	SUITE 400	HAWTHORNE	CA	90250	2370	19	06037	33.928488	-118.3527475	Los Angeles County
151320	Fee-for-Service	1477768000	1477768000	1	1	HARDMAN, MARY 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	4301 W MARKHAM ST	SLOT 783	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
151337	Fee-for-Service	1699963231	1699963231	1	1	HUANG, STEPHANIE S MD	4/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	91911	04	Otology, Laryngology, Rhinology	0	In state provider	None	1701 4TH STREET	STE 120	SANTA ROSA	CA	95404	3661	49	06097	38.448801	-122.699439	Sonoma County
151349	Fee-for-Service	1043382872	1043382872	1	1	HU, KEGANG MD	7/17/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79838	05	Anesthesiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
151379	Fee-for-Service	1932260619	1932260619	1	1	HWANG, HEAJIN MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72751	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
151399	Fee-for-Service	1053515551	1053515551	1	1	HUNTER, WENDY L MD	8/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94607	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
151427	Fee-for-Service	1992023444	1992023444	1	1	HOMANN, KATHERINE A MD	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124827	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 CAMPUS POINT DR	None	LA JOLLA	CA	92037	1300	37	06073	32.877999	-117.225891	San Diego County
151431	Fee-for-Service	1861822355	1861822355	1	1	HARO TRUJILLO, GUADALUPE LM	7/15/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	T	27851 BRADLEY	SUITE 130K	MENIFEE	CA	92586	2286	33	06065	33.71630969	-117.1904696	Riverside County
151493	Fee-for-Service	1528760949	1528760949	1	1	HOLGUIN ARBOLEDA, SILVIA BI	3/20/2023	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	33	06065	0	0	None
151508	Fee-for-Service	1124479233	1124479233	1	1	HUNTER, KRYSTIN R LMFT	3/20/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1461 HOLLOW GLEN ROAD	None	JULIAN	CA	92036	9203	37	06073	33.07625626	-116.5905011	San Diego County
151541	Fee-for-Service	1285645648	1285645648	1	1	HO, CANDICE C MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74600	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
151552	Fee-for-Service	1699882365	1699882365	1	1	HEREDIA-MARTINEZ, HECTOR	5/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50069	03	Allergy	0	In state provider	None	401 H STREET	STE 5	CHULA VISTA	CA	91910	5104	37	06073	32.6332882	-117.0813972	San Diego County
151568	Fee-for-Service	1487647905	1487647905	1	1	HILLS, JAMES R MD	7/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	842 EAST MAIN STREET	None	MEDFORD	OR	97504	7134	00	None	42.32787853	-122.863311	Jackson County
151613	Fee-for-Service	1164751541	1164751541	1	1	HILL, DENNIS R MD	11/17/2010	174400000X	NA	Other	026	PHYSICIANS	17225	78	Neoplastic Diseases/Oncology	0	In state provider	PROFESSIONAL CORPORATION	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
151632	Fee-for-Service	1841697646	1841697646	1	1	HALIPOTO, FAATIMA CCC-SLP	8/9/2019	235Z00000X	NA	Other	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
151636	Fee-for-Service	1063448306	1063448306	1	1	HY-VEE, INC.	11/29/2010	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	1	Border provider	None	1221 CENTRAL AVENUE	None	ESTHERVILLE	IA	51334	2432	00	None	43.40207734	-94.82897916	Emmet County
151667	Fee-for-Service	1932260619	1932260619	1	1	HWANG, HEAJIN MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72751	15	Obstetrics (D.O. only)	0	In state provider	None	900 KIELY BLVD	None	SANTA CLARA	CA	95051	5329	43	06085	37.34234284	-121.9776787	Santa Clara County
151686	Fee-for-Service	1215452628	1215452628	1	1	HO, CHRISTINA E	9/26/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	401 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6387	43	06085	37.36777579	-122.0276404	Santa Clara County
151725	Fee-for-Service	1023140464	1023140464	1	1	HENRY MAYO NEWHALL	1/1/1995	273R00000X	NA	Other	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	MEMORIAL HOSP	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
151727	Fee-for-Service	1922569961	1922569961	1	1	HABIBI, MANUCHEHR MD	1/5/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
151734	Fee-for-Service	1871888230	1871888230	1	1	HODSON, SIMON B LMFT	7/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	347 CYPRESS ST	STE B	FORT BRAGG	CA	95437	5407	23	06045	39.43270236	-123.8026618	Mendocino County
151768	Fee-for-Service	1245998616	1245998616	1	1	HUANG, CINDY CNP	12/29/2021	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
151781	Fee-for-Service	1306911102	1306911102	1	1	HAYS, F MYRON PHD	9/11/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
151801	Fee-for-Service	1194886309	1194886309	1	1	HUTCHINS, LINDSAY A LCSW	12/8/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1201 FILLMORE ST	None	SAN FRANCISCO	CA	94115	4110	38	06075	37.78096742	-122.4322568	San Francisco County
151816	Fee-for-Service	1447862974	1447862974	1	1	HRAIZ, BRITTANY LCSW	10/5/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
151841	Fee-for-Service	1699882365	1699882365	1	1	HEREDIA-MARTINEZ, HECTOR	5/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50069	01	General Practice	0	In state provider	None	401 H STREET	STE 5	CHULA VISTA	CA	91910	5104	37	06073	32.6332882	-117.0813972	San Diego County
151866	Fee-for-Service	1891418117	1891418117	1	1	HASSAN, SALMA Y PT	1/27/2023	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
151889	Fee-for-Service	1487252425	1487252425	1	1	HERNANDEZ, KRISTINA M NP	1/8/2021	208D00000X	NA	Adult Primary Care	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
151900	Fee-for-Service	1164751541	1164751541	1	1	HILL, DENNIS R MD	11/17/2010	174400000X	NA	Other	026	PHYSICIANS	17225	30	Radiology	0	In state provider	PROFESSIONAL CORPORATION	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
151921	Fee-for-Service	1962822114	1962822114	1	1	HAYASHI, TOMOMI S MD	7/14/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	141550	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
151938	Fee-for-Service	1831352582	1831352582	1	1	HOLMES, GALEN R MD	4/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111140	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
151963	Fee-for-Service	1457419731	1457419731	1	1	HEMATOLOGY ONCOLOGY ASSO	2/26/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	CIATES INC	3100 TELEGRAPH AVE	STE 3101	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
151982	Fee-for-Service	1548656796	1548656796	1	1	HILL, JASON F MD	9/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
152010	Fee-for-Service	1255861027	1255861027	1	1	HARPER, JONATHAN W MD	7/1/2020	207R00000X	NA	Other	026	PHYSICIANS	157173	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
152033	Fee-for-Service	1023396355	1023396355	1	1	HERBERT, SAMUEL J OD	11/2/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1104 PEAR TREE LANE	None	NAPA	CA	94558	6446	28	06055	38.32088172	-122.2945763	Napa County
152045	Fee-for-Service	1497766596	1497766596	2	1	HORNING, SANDRA W MD	4/30/2019	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
152077	Fee-for-Service	1306995691	1306995691	2	1	HERNANDEZ, EDWARD P OD	1/23/2010	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15330 AMAR RD	STE A	LA PUENTE	CA	91744	2001	19	06037	34.03714077	-117.9509701	Los Angeles County
152123	Fee-for-Service	1417033291	1417033291	1	1	HUGHES, LARRY C MD	10/4/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59842	08	Family Practice	0	In state provider	None	4020 W FLORIDA AVE	None	HEMET	CA	92545	5279	33	06065	33.74543265	-117.0148924	Riverside County
152129	Fee-for-Service	1699882365	1699882365	1	1	HEREDIA-MARTINEZ, HECTOR	5/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50069	41	Internal Medicine	0	In state provider	None	401 H STREET	STE 5	CHULA VISTA	CA	91910	5104	37	06073	32.6332882	-117.0813972	San Diego County
152133	Fee-for-Service	1578060034	1578060034	1	1	HAASE, VICTORIA S MD	9/1/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	163501	None	None	0	In state provider	None	11370 ANDERSON ST	# 3900	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
152137	Fee-for-Service	1801357330	1801357330	1	1	HARTNETT, EMILY A OT	9/26/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	39180 FARWELL DR	SUITE 211	FREMONT	CA	94538	1000	01	06001	37.53211262	-121.9981587	Alameda County
152229	Fee-for-Service	1770120529	1770120529	1	1	HILL, LASHONDA R LMFT	11/16/2023	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
152238	Fee-for-Service	1740665025	1740665025	1	1	HOLDEN, THOMAS E LMFT	5/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	AMILY THERAPIST	320 10TH ST	202A	SANTA ROSA	CA	95401	5291	49	06097	38.443572	-122.719698	Sonoma County
152239	Fee-for-Service	1861925273	1861925273	1	1	HOGAN, NICHOLAS T MD	6/16/2020	390200000X	NA	Other	026	PHYSICIANS	158898	41	Internal Medicine	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
152247	Fee-for-Service	1114991411	1114991411	1	1	HERING, KEITH A CRNA	3/9/2006	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
152251	Fee-for-Service	1457419731	1457419731	1	1	HEMATOLOGY ONCOLOGY ASSO	2/26/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	CIATES INC	3100 TELEGRAPH AVE	STE 3101	OAKLAND	CA	94609	3210	01	06001	37.82037533	-122.2667839	Alameda County
152258	Fee-for-Service	1831641323	1831641323	1	1	HUANG, STEPHANIE NP	8/13/2019	363LF0000X	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
152269	Fee-for-Service	1588041412	1588041412	1	1	HAROUTUNIAN, ARMEN MD	12/6/2019	207L00000X	NA	Other	026	PHYSICIANS	160423	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
152270	Fee-for-Service	1154531218	1154531218	1	1	HAMDY, MOSTAFA A MD AMC	6/3/2005	193400000X	NA	Other	026	PHYSICIANS	43951	10	Gastroenterology (M.D. only)	0	In state provider	None	1600 S IMPERIAL AVE	STE 8	EL CENTRO	CA	92243	4242	13	06025	32.77882919	-115.5697116	Imperial County
152283	Fee-for-Service	1710066469	1710066469	1	1	HUYNH, MYLINH D MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91120	30	Radiology	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
152299	Fee-for-Service	1841767308	1841767308	1	1	HOLMES, RACHEL PT	6/17/2020	282N00000X	NA	Hospitals	025	PHYSICAL THERAPISTS	-	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
152324	Fee-for-Service	1649238080	1649238080	1	1	HWANG, CHUN MD	9/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	85442	01	General Practice	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
152327	Fee-for-Service	1619088614	1619088614	1	1	HEARING HELP PROVIDER	9/6/1995	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	HEARING CARE ASSOCIATES	437 S ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	3603	19	06037	34.0583914	-118.3836908	Los Angeles County
152418	Fee-for-Service	1760977573	1760977573	1	1	HENSON, HEIDI E DO	8/31/2021	207R00000X	NA	Other	026	PHYSICIANS	17947	None	None	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
152464	Fee-for-Service	1326361460	1326361460	1	1	HAPY BEAR SURGERY CENTER LLC	2/14/2012	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1979 HILLMAN ST	None	TULARE	CA	93274	1601	54	06107	36.2342026	-119.3311559	Tulare County
152471	Fee-for-Service	1023404498	1023404498	1	1	HAYNES, JON R MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145049	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
152490	Fee-for-Service	1669807244	1669807244	1	1	HAFEEZ, AHSAN MD	7/20/2023	207R00000X	NA	Other	026	PHYSICIANS	171856	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
152496	Fee-for-Service	1538318027	1538318027	1	1	HABBU, AMIT A MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129165	30	Radiology	0	In state provider	None	5000 SAN BERNARDINO ST	None	MONTCLAIR	CA	91763	2326	36	06071	34.07768647	-117.6957498	San Bernardino County
152562	Fee-for-Service	1629500806	1629500806	1	1	HASELI, JAVAD MD	9/3/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
152565	Fee-for-Service	1225347099	1225347099	1	1	HEALTHY CARE CLINICAL LABORA	12/1/2018	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	TORY, INC.	4650 ARROW HWY	SUITE F4	MONTCLAIR	CA	91763	1218	36	06071	34.09259534	-117.7037171	San Bernardino County
152572	Fee-for-Service	1598961161	1598961161	1	1	HARDY, DIANE L LMFT	8/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	522 BROADWAY	STE D	KING CITY	CA	93930	1412	27	06053	36.21109736	-121.1298997	Monterey County
152596	Fee-for-Service	1174101513	1174101513	1	1	HEARING AID SERVICES OF ANTI	5/31/2022	261QH0700X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	OCH	4045 LONE TREE WAY	D	ANTIOCH	CA	94531	6206	07	06013	37.976122	-121.8012402	Contra Costa County
152647	Fee-for-Service	1083759831	1083759831	1	1	HSU, LUKUANG L MD	7/20/2019	2084P0804X	NA	Psychiatry	026	PHYSICIANS	109587	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	19000 HOMESTEAD RD	None	CUPERTINO	CA	95014	0712	43	06085	37.33773494	-122.0043395	Santa Clara County
152681	Fee-for-Service	1770619447	1770619447	1	5	HARRY M MILLER MD INC	7/21/2021	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9900 LARKIN ROAD	None	LIVE OAK	CA	95953	2442	51	06101	39.274749	-121.659999	Sutter County
152685	Fee-for-Service	1558502625	1558502625	1	1	HAYWARD PEDIATRIC	5/13/1986	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL CLINIC	21297 FOOTHILL BLVD	STE 100	HAYWARD	CA	94541	1554	01	06001	37.68517105	-122.0923896	Alameda County
152687	Fee-for-Service	1548283005	1548283005	1	1	HO, RICHARD MD	2/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	32985	41	Internal Medicine	0	In state provider	None	19830 LAKE CHABOT RD	STE A	CASTRO VALLEY	CA	94546	4063	01	06001	37.70011045	-122.0877799	Alameda County
152691	Fee-for-Service	1689889206	1689889206	1	1	HU, CAROLINE Y MD	10/25/2019	2080P0207X	NA	Hematology	026	PHYSICIANS	162620	40	Pediatrics	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
152699	Fee-for-Service	1922628114	1922628114	1	1	HOOKER, ANDREW MD	1/30/2025	207R00000X	NA	Other	026	PHYSICIANS	186604	41	Internal Medicine	0	In state provider	None	1100 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6978	38	06075	37.78594176	-122.421322	San Francisco County
152702	Fee-for-Service	1861400988	1861400988	1	1	HABAS, ALLISON B MD	4/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133537	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
152708	Fee-for-Service	1871186908	1871186908	1	1	HOSPITALITY HOME HEALTH CARE	5/17/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	210 N PASS AVE	STE 203	BURBANK	CA	91505	3936	19	06037	34.15345895	-118.3447101	Los Angeles County
152725	Fee-for-Service	1124886148	1124886148	1	1	HARRIS, CHRISTOPHER LCSW	10/15/2024	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
152733	Fee-for-Service	1598736498	1598736498	1	1	HARRIS, CONSTANCE A	6/15/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
152763	Fee-for-Service	1871722496	1871722496	1	1	HAYNIE, HEKIMA A	10/5/2009	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 WEST 6TH ST	SUITE 111	LOS ANGELES	CA	90017	1823	19	06037	34.05416748	-118.2622848	Los Angeles County
152789	Fee-for-Service	1790954832	1790954832	1	1	HUANG, HELEN OD	12/28/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17251 FOOTHILL BLVD	None	FONTANA	CA	92335	9044	36	06071	34.10656453	-117.428166	San Bernardino County
152793	Fee-for-Service	1073540225	1073540225	1	1	HO, JOHN S MD	3/31/1987	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	43073	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	728 PACIFIC AVE	STE 503	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
152805	Fee-for-Service	1619036530	1619036530	1	1	HAMILTON, TROY A	12/18/2017	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE RD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
152811	Fee-for-Service	1740498062	1740498062	1	1	HINDES, ANDREA R PHD	4/27/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
152834	Fee-for-Service	1750469573	1750469573	1	1	HOLLISON, LYNNE K MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	58401	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
152851	Fee-for-Service	1154571230	1154571230	1	1	HAGER, JACKIE J LMFT	12/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	410 S. GLENDORA AVE.	130	GLENDORA	CA	91741	6207	19	06037	34.13122731	-117.863713	Los Angeles County
152881	Fee-for-Service	1174101513	1174101513	1	1	HEARING AID SERVICES OF ANTI	2/3/2022	261QH0700X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	OCH	4045 LONE TREE WAY	D	ANTIOCH	CA	94531	6206	07	06013	37.976122	-121.8012402	Contra Costa County
152889	Fee-for-Service	1558405712	1558405712	1	1	HUFF, DAVID L OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3747 SUNSET LN	None	ANTIOCH	CA	94509	6101	07	06013	37.98340082	-121.8048051	Contra Costa County
152927	Fee-for-Service	1841961836	1841961836	1	1	HERNANDEZ RODRIGUEZ, LEIDY	3/5/2025	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
152977	Fee-for-Service	1295839405	1295839405	1	1	HU, QINGLONG MD	11/23/2021	207ZP0102X	NA	Other	026	PHYSICIANS	54993	None	None	0	In state provider	None	6125 N FRESNO STREET	None	FRESNO	CA	93710	5207	10	06019	36.825057	-119.7814395	Fresno County
152981	Fee-for-Service	1376191528	1376191528	1	1	HARTLEY, MEGAN L LCSW	10/16/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3620 LONG BEACH BLVD	C6	LONG BEACH	CA	90807	4022	19	06037	33.822837	-118.1893245	Los Angeles County
152996	Fee-for-Service	1730364969	1730364969	1	1	HAMZEH, RABIH K MD	9/15/2020	174400000X	NA	Other	026	PHYSICIANS	83298	40	Pediatrics	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
152998	Fee-for-Service	1043643539	1043643539	1	1	HUTTEN, BURTON M LCSW	5/23/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	93640	-	NOT APPLICABLE	0	In state provider	None	280 E STANDLEY ST	None	UKIAH	CA	95482	4414	23	06045	39.15101964	-123.205602	Mendocino County
153011	Fee-for-Service	1770624363	1770624363	1	2	HATHORN, REBECCA E LCSW	12/16/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
153029	Fee-for-Service	1598804783	1598804783	1	1	HOLLANDER, RENE D PHD	12/21/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4715 VIEWRIDGE AVENUE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
153037	Fee-for-Service	1144450032	1144450032	1	1	HOFFMANN, JENNY R MD	11/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116500	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
153049	Fee-for-Service	1841316098	1841316098	1	1	HOANG, MICHELLE V OD	6/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3451 W CENTURY BLVD	SUITE B-3	INGLEWOOD	CA	90303	1218	19	06037	33.948198	-118.3321575	Los Angeles County
153074	Fee-for-Service	1831203900	1831203900	1	1	HU, CHRISTINE K MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	60588	45	Nephrology (Renal-Kidney)	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
153081	Fee-for-Service	1902034226	1902034226	1	1	HIGGINS, NEAVE LCSW	11/20/2024	104100000X	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
153084	Fee-for-Service	1215360813	1215360813	1	1	HARNEY, REIS T MD	8/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136457	None	None	0	In state provider	None	3291 LOMA VISTA RD	BLDG 340 STE 302	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
153111	Fee-for-Service	1942359195	1942359195	1	1	HOCKBERGER, ROBERT MD	3/31/1982	207P00000X	NA	Other	026	PHYSICIANS	41424	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3100 S SUSANA RD	None	COMPTON	CA	90221	5418	19	06037	33.87386619	-118.2070981	Los Angeles County
153117	Fee-for-Service	1528165149	1528165149	1	1	HUMANA MEDICAL GRP	5/8/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	4621 RUBIO AVE	None	ENCINO	CA	91436	3203	19	06037	34.15513416	-118.4945833	Los Angeles County
153133	Fee-for-Service	1689278087	1689278087	1	1	HENDRICKS, JESSICA NP	3/16/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12304 SANTA MONICA BLVD	STE 116	LOS ANGELES	CA	90025	2586	19	06037	34.03948285	-118.4656304	Los Angeles County
153146	Fee-for-Service	1982611950	1982611950	1	1	HARRIS, BRIAN N MD	2/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	78320	None	None	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
153222	Fee-for-Service	1467598151	1467598151	1	1	HERNDON, DEBRA LYN NP	11/22/2010	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2175 ROSALINE AVENUE	None	REDDING	CA	96001	2509	45	06089	40.57278686	-122.3958519	Shasta County
153241	Fee-for-Service	1639886161	1639886161	1	1	HUEZOAGUILAR, TANIA K NP	2/21/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
153255	Fee-for-Service	1801851571	1801851571	1	1	HOEFT, WAYNE W OD	5/23/2006	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	907 N SAN FERNANDO BLVD	None	BURBANK	CA	91504	4326	19	06037	34.18664771	-118.3166612	Los Angeles County
153289	Fee-for-Service	1407472707	1407472707	1	1	HOLLYWOOD CARE HOME INC	10/20/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	13307 STAGG STREET	None	N. HOLLYWOOD	CA	91605	1736	19	06037	34.21252385	-118.4230644	Los Angeles County
153295	Fee-for-Service	1336158567	1336158567	1	1	HARTWICK, FRANK M MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	48886	30	Radiology	0	In state provider	None	845 JACKSON ST	None	SAN FRANCISCO	CA	94133	4851	38	06075	37.79571919	-122.4089166	San Francisco County
153309	Fee-for-Service	1528188414	1528188414	1	1	HA, CHRISTINA Y MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123282	10	Gastroenterology (M.D. only)	0	In state provider	None	200 MED PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
153315	Fee-for-Service	1851924427	1851924427	1	1	HAYMAN, MALKA M NP	6/14/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3855 ALAMO ST	None	SIMI VALLEY	CA	93063	2104	56	06111	34.28644751	-118.721655	Ventura County
153323	Fee-for-Service	1326031980	1326031980	1	1	HURSCHMAN, ALAN B MD	10/4/2019	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	155336	25	Physical Medicine and Rehabilitation	0	In state provider	None	5395 RUFFIN ROAD	STE. 204	SAN DIEGO	CA	92123	1338	37	06073	32.832387	-117.1266225	San Diego County
153339	Fee-for-Service	1881840353	1881840353	1	1	HAKIMIAN, NAVID MD APC	11/1/1998	207RP1001X	NA	Pulmonology	026	PHYSICIANS	70719	41	Internal Medicine	0	In state provider	None	8540 S SEPULVEDA BLVD	SUITE 1111	LOS ANGELES	CA	90045	3819	19	06037	33.96022076	-118.3961982	Los Angeles County
153342	Fee-for-Service	1740234038	1740234038	1	1	HOROWITZ, MARDI J MD	11/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	18785	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
153354	Fee-for-Service	1821758541	1821758541	1	1	HANDY HOME HEALTH INC	5/3/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3371 GLENDALE BLVD	SUITE 208	LOS ANGELES	CA	90039	1857	19	06037	34.11982032	-118.2590659	Los Angeles County
153364	Fee-for-Service	1235368267	1235368267	1	1	HUMANE CARE 7 DAYS MEDICAL	11/4/2009	207RN0300X	NA	Nephrology	026	PHYSICIANS	84863	41	Internal Medicine	0	In state provider	GROUP INC	6552 BOLSA AVE	STE N	HUNTINGTON BEACH	CA	92647	2656	30	06059	33.74431776	-118.0144684	Orange County
153402	Fee-for-Service	1801015250	1801015250	1	1	HERR, PETER P DPM	2/28/2008	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	378 W OLIVE AVE	STE C	MERCED	CA	95348	3137	24	06047	37.31916808	-120.4752646	Merced County
153410	Fee-for-Service	1942386453	1942386453	1	1	HUNG, LISA MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	8024	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
153418	Fee-for-Service	1144254723	1144254723	1	1	HORNSTEIN, JONATHAN B MD	8/1/2018	207P00000X	NA	Other	026	PHYSICIANS	156475	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
153428	Fee-for-Service	1639587454	1639587454	1	1	HARRY, RISHI I MD	1/24/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	500 SW RAMSEY AVE	None	GRANTS PASS	OR	97527	5543	00	None	42.4198785	-123.3432318	Josephine County
153450	Fee-for-Service	1285992115	1285992115	1	1	HWANG, STEPHANIE S MD	12/26/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118285	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
153481	Fee-for-Service	1427523232	1427523232	1	1	HEGNER, PAMELA C LCSW	6/29/2019	104100000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1643 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.74688342	-121.2469903	Placer County
153490	Fee-for-Service	1578795647	1578795647	1	1	HARMON, ASHLEY S NP	3/26/2015	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
153523	Fee-for-Service	1619983343	1619983343	1	1	HSU, DAVID I-FENG MD	1/30/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	83121	78	Neoplastic Diseases/Oncology	0	In state provider	None	605 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1102	19	06037	34.06890387	-118.1229537	Los Angeles County
153525	Fee-for-Service	1770845364	1770845364	1	1	HARPER, CAMESHA M LCSW	8/18/2024	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
153538	Fee-for-Service	1841362696	1841362696	1	1	HARRIS-TURNER,ELAINE MD	3/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70481	18	Ophthalmology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
153574	Fee-for-Service	1952740805	1952740805	1	1	HARRIS, SHEILA L	4/4/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4401 ATLANTIC AVE	430	LONG BEACH	CA	90807	2218	19	06037	33.836976	-118.185096	Los Angeles County
153585	Fee-for-Service	1528188414	1528188414	1	1	HA, CHRISTINA Y MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123282	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
153588	Fee-for-Service	1366409286	1366409286	2	1	HONOLULU PHARMACY INC	8/14/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	450-452 S CENTRAL AVE	None	GLENDALE	CA	91204	1602	19	06037	34.140825	-118.2578225	Los Angeles County
153599	Fee-for-Service	1336251362	1336251362	1	1	HOFF, COLLEEN C PHD	7/2/2008	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
153609	Fee-for-Service	1598226250	1598226250	1	1	HO, STACEY N MD	11/1/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	182512	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	800 S MAIN ST	None	CORONA	CA	92882	3420	33	06065	33.872958	-117.568359	Riverside County
153614	Fee-for-Service	1447870365	1447870365	1	1	HANNA, MONICA S DO	10/23/2023	207R00000X	NA	Other	026	PHYSICIANS	21042	None	None	0	In state provider	None	18035 BROOKHURST ST	SUITE 1300	FOUNTAIN VALLEY	CA	92708	6738	30	06059	33.701184	-117.9544385	Orange County
153635	Fee-for-Service	1972101038	1972101038	1	1	HO, MADISON N PT	12/20/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	907 EMBARCADERO DR	None	EL DORADO HILLS	CA	95762	4087	09	06017	38.70864351	-121.0826115	El Dorado County
153638	Fee-for-Service	1609865716	1609865716	1	1	HERNANDEZ, JESUS MD INC	12/5/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	30246	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1211 W LA PALMA AVE	STE 408	ANAHEIM	CA	92801	2806	30	06059	33.84718298	-117.933758	Orange County
153651	Fee-for-Service	1235368267	1235368267	1	1	HUMANE CARE 7 DAYS MEDICAL	11/4/2009	207RN0300X	NA	Nephrology	026	PHYSICIANS	84863	45	Nephrology (Renal-Kidney)	0	In state provider	GROUP INC	6552 BOLSA AVE	STE N	HUNTINGTON BEACH	CA	92647	2656	30	06059	33.74431776	-118.0144684	Orange County
153667	Fee-for-Service	1336264837	1336264837	1	1	HARRIS, AMANDA A NP	11/1/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14011 PARK AVE	None	VICTORVILLE	CA	92392	2413	36	06071	34.505647	-117.3265457	San Bernardino County
153693	Fee-for-Service	1114345683	1114345683	1	1	HAN, SHELLEY H MD	3/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139242	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
153731	Fee-for-Service	1568656213	1568656213	1	1	HIXSON, MICHAEL M MD	11/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7924	00	None	35.110926	-114.5552445	Mohave County
153741	Fee-for-Service	1548274350	1548274350	1	1	HOYLE, KELLY Y MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3300 GALLOWS RD	None	FALLS CHURCH	VA	22042	3307	00	None	38.858193	-77.226426	City of Fairfax
153829	Fee-for-Service	1881341089	1881341089	1	1	HEALTHRIGHT 360	11/1/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	NTER	12021 S WILMINGTON AVE	BUILDING 18, SUITE 300	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
153838	Fee-for-Service	1710736954	1710736954	1	1	HENRY, LAURA CRNA	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
153945	Fee-for-Service	1215015896	1215015896	1	1	HAGEY, SCOT M MD	6/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	60044	34	Urology and Urological 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
153967	Fee-for-Service	1316971419	1316971419	1	1	HUCHUN, TERESA MD	5/1/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	63106	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
153973	Fee-for-Service	1386038768	1386038768	1	1	HOLLAND, MICHAEL C MD	4/29/2024	208200000X	NA	General Surgery	026	PHYSICIANS	145235	24	Plastic Surgery	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
153986	Fee-for-Service	1912156787	1912156787	1	1	HENRY, JENNIFER M LMFT	1/8/2021	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
153987	Fee-for-Service	1962466888	1962466888	1	1	HY C SUSSMAN MD	11/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	25 HOSPITAL CENTER BLVD	None	HILTON HEAD	SC	29926	2738	00	None	32.22332663	-80.71420459	Beaufort County
153988	Fee-for-Service	1881613644	1881613644	1	1	HUI, KA KIT MD	1/1/1995	207R00000X	NA	Other	026	PHYSICIANS	32629	None	None	0	In state provider	UCLA CTR F/T HLTH SCIENC	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
154002	Fee-for-Service	1518026145	1518026145	1	1	HAYON, IRWIN I MD	12/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45754	30	Radiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
154003	Fee-for-Service	1063506970	1063506970	1	1	HUH, WINSTON W MD	10/10/2018	2080P0207X	NA	Hematology	026	PHYSICIANS	157444	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
154025	Fee-for-Service	1700297728	1700297728	1	1	HADDAD, AHMED MD	2/16/2021	208800000X	NA	Other	026	PHYSICIANS	170790	None	None	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
154083	Fee-for-Service	1578766275	1578766275	1	1	HONG, JU EUY LAC	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	HOLISTIC ACUPUNCTURE	3171 LOS FELIZ BLVD	STE 304	LOS ANGELES	CA	90039	1537	19	06037	34.12369709	-118.2682266	Los Angeles County
154099	Fee-for-Service	1629088620	1629088620	1	1	HAMPSHIRE, KRISTIN J MD	11/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67130	08	Family Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
154100	Fee-for-Service	1801502653	1801502653	1	1	HOWARD, ANDREA K	3/31/2023	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
154108	Fee-for-Service	1932378601	1932378601	1	1	HUNG, JENNIFER MD	3/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106918	18	Ophthalmology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
154125	Fee-for-Service	1477921252	1477921252	1	1	HO, MICHELLE D PT	6/14/2016	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
154133	Fee-for-Service	1770660730	1770660730	1	1	HEIDEN,RICHARD	6/14/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2601 OCEAN PARKWAY	None	BROOKLYN	NY	11235	7745	00	None	40.586031	-73.9657305	Kings County
154146	Fee-for-Service	1992885040	1992885040	1	1	HAMEED,AFSHAN B MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	52209	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
154174	Fee-for-Service	1851520688	1851520688	1	1	HARDISON, JOY M MD	8/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121027	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
154262	Fee-for-Service	1023081924	1023081924	1	1	HARPER, SABRINA A MD	4/29/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	71220	41	Internal Medicine	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
154273	Fee-for-Service	1982041786	1982041786	1	1	HOLTBY, LYNNELL J MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	41129	-	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
154284	Fee-for-Service	1396754511	1396754511	1	1	HARWOOD, JAMES W MD	4/30/1980	208600000X	NA	General Surgery	026	PHYSICIANS	29940	02	General Surgery	0	In state provider	None	1111 SONOMA AVE	STE 320	SANTA ROSA	CA	95405	4820	49	06097	38.442042	-122.700033	Sonoma County
154373	Fee-for-Service	1891861464	1891861464	1	1	HINER, SHARON L MD	10/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	50583	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
154394	Fee-for-Service	1801174479	1801174479	1	1	HOLMES, SARA M MD	4/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133361	45	Nephrology (Renal-Kidney)	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
154403	Fee-for-Service	1932249844	1932249844	1	1	HOUSEL, F BEN MD	10/31/1991	207P00000X	NA	Other	026	PHYSICIANS	72577	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
154431	Fee-for-Service	1992885040	1992885040	1	1	HAMEED,AFSHAN B MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	52209	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
154434	Fee-for-Service	1275799587	1275799587	1	1	HUANG, AMY H OD	4/4/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10605 BALBOA BLVD	STE 330	ANAHEIM	CA	92804	4305	30	06059	33.79385082	-117.939519	Orange County
154466	Fee-for-Service	1467614800	1467614800	1	1	HALL II, DAVID C MD	7/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99761	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
154528	Fee-for-Service	1356309322	1356309322	1	1	HEALTHEAST WOODWINDS HOSPITA	3/4/2009	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1925 WOODWINDS DR	None	WOODBURY	MN	55125	4445	00	None	44.921817	-92.9764305	Washington County
154566	Fee-for-Service	1063404978	1063404978	1	1	HASSOUN, ALI 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	420 LOWELL DR SE	STE 301	HUNTSVILLE	AL	35801	3762	00	None	34.72197767	-86.5757163	Madison County
154569	Fee-for-Service	1417101965	1417101965	1	1	HALL, TIMOTHY M MD	5/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108863	36	Psychiatry	0	In state provider	None	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
154570	Fee-for-Service	1992784888	1992784888	1	1	HILL, EVA M LCSW	5/28/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	333 UNIVERSITY AVENUE	STE 200	SACRAMENTO	CA	95825	6531	34	06067	38.570976	-121.416651	Sacramento County
154624	Fee-for-Service	1134241060	1134241060	1	1	HUTFLESS, RYAN D MD	1/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	99071	05	Anesthesiology	0	In state provider	None	99 MONTECILLO ROAD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
154628	Fee-for-Service	1336160571	1336160571	1	1	HENKEL, GARY F MD	7/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54418	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
154645	Fee-for-Service	1417113168	1417113168	1	1	HOUKOM, KIMBERLY B MD	3/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	99997	40	Pediatrics	0	In state provider	None	7910 FROST STREET	STE 350	SAN DIEGO	CA	92123	2753	37	06073	32.80027449	-117.153846	San Diego County
154654	Fee-for-Service	1033175484	1033175484	1	1	HOVANESIAN, JOHN A MD	1/31/1995	207W00000X	NA	Ophthalmology	026	PHYSICIANS	83665	18	Ophthalmology	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
154663	Fee-for-Service	1083322432	1083322432	1	1	HEALTH KULTURE LLC	1/12/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	8050 N PALM AVE	320	FRESNO	CA	93711	5510	10	06019	36.85231752	-119.8052619	Fresno County
154672	Fee-for-Service	1649219080	1649219080	1	1	HEILPERN, ALAN M MD	11/30/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	45755	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1414 S HOPE ST	None	LOS ANGELES	CA	90015	2904	19	06037	34.03801945	-118.2665952	Los Angeles County
154681	Fee-for-Service	1255612941	1255612941	1	1	HINKO, ALLISON M MD	3/30/2022	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	136569	None	None	0	In state provider	None	800 TRANCAS ST	SUITE A	NAPA	CA	94558	3044	28	06055	38.32419306	-122.2923825	Napa County
154722	Fee-for-Service	1790292092	1790292092	1	1	HAWKER, MEGAN E LMFT	3/2/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82451	-	NOT APPLICABLE	0	In state provider	None	550 W WASHINGTON AVE	None	ESCONDIDO	CA	92025	1643	37	06073	33.12462731	-117.0914704	San Diego County
154735	Fee-for-Service	1508278813	1508278813	1	1	HA, NGHIEM B MD	6/6/2024	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	160517	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
154791	Fee-for-Service	1437468824	1437468824	1	1	HARRIES AARON J MD	7/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110929	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
154812	Fee-for-Service	1578767455	1578767455	1	1	HEINZE, BRENT A LPCC	1/27/2023	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1311 ORO RIDGE	None	PALM SPRINGS	CA	92262	1254	33	06065	33.86561334	-116.5677857	Riverside County
154880	Fee-for-Service	1043764624	1043764624	1	1	HAWTHORNE, BAABA A LMFT	7/24/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
154894	Fee-for-Service	1144866872	1144866872	1	1	HORN, TREVOR S	4/16/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	30141 ANTELOPE RD.	STE A	MENIFEE	CA	92584	7001	33	06065	33.68176015	-117.1680307	Riverside County
154925	Fee-for-Service	1366642944	1366642944	1	1	HARBERT, GWENDOLYN R MD	3/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	87818	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
154928	Fee-for-Service	1619940707	1619940707	1	1	HOLTGREWE SEIB, MARY H CRNA	4/9/2018	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
154935	Fee-for-Service	1124011689	1124011689	1	1	HARRIS, ETHAN G MD INC	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	18727	01	General Practice	0	In state provider	None	720 HOWE AVE	STE 110	SACRAMENTO	CA	95825	4687	34	06067	38.578374	-121.4149455	Sacramento County
154946	Fee-for-Service	1720273683	1720273683	1	1	HOSPITAL PEDIATRICS	11/10/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	SPECIALIST MED GROUP INC	18321 CLARK STREET	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
154947	Fee-for-Service	1952891871	1952891871	1	1	HONG, SCOTT MD	8/12/2024	207YX0007X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	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
154952	Fee-for-Service	1356592000	1356592000	1	1	HAMM, ERIC LCSW	11/18/2024	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
154961	Fee-for-Service	1548278005	1548278005	1	1	HEINRICH,MICHAEL 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	3710 SW US VETERANS HOSP	RD R&D 19	PORTLAND	OR	97239	2964	00	None	45.49665733	-122.6830773	Multnomah County
154962	Fee-for-Service	1881766814	1881766814	1	1	HUANG, ERIC MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	53991	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
154973	Fee-for-Service	1659526630	1659526630	1	1	HEMMER, SARAH A MD	9/23/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	103540	40	Pediatrics	0	In state provider	None	1176 YGNACIO VALLEY RD	STE 100	WALNUT CREEK	CA	94598	3100	07	06013	37.90933082	-122.0511433	Contra Costa County
155013	Fee-for-Service	1225691173	1225691173	1	1	HVA HOME HEALTH CARE INC	7/1/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6368 VAN NUYS BLVD	UNIT F	VAN NUYS	CA	91401	2601	19	06037	34.18624448	-118.4487069	Los Angeles County
155036	Fee-for-Service	1316965494	1316965494	1	1	HWANG, JIMMY H MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	38692	41	Internal Medicine	0	In state provider	None	18251 ROSCOE BLVD	STE 102	NORTHRIDGE	CA	91325	4207	19	06037	34.22081017	-118.5314078	Los Angeles County
155079	Fee-for-Service	1437468824	1437468824	1	1	HARRIES AARON J MD	7/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110929	01	General Practice	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
155084	Fee-for-Service	1093997488	1093997488	1	1	HOLLY WYDER, 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	12412 JUDSON RD	None	LIVE OAK	TX	78233	3255	00	None	29.55143216	-98.34776707	Bexar County
155097	Fee-for-Service	1649219882	1649219882	1	1	HOLLANDER-RODRIGUEZ, J	12/10/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	MD	2865 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
155123	Fee-for-Service	1265745855	1265745855	1	1	HANSON, KRISTINA LMFT	9/24/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1809 W. REDLANDS BLVD	None	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
155138	Fee-for-Service	1104195882	1104195882	1	1	HEU, LINDA K	7/8/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
155148	Fee-for-Service	1821314485	1821314485	1	1	HINDOYAN, NAREEN A MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121555	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
155159	Fee-for-Service	1568605525	1568605525	1	1	HOWSE, SEAN J MD	6/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135472	None	None	0	In state provider	None	2276 PACIFIC AVENUE	None	LONG BEACH	CA	90806	2613	19	06037	33.79860574	-118.1936011	Los Angeles County
155184	Fee-for-Service	1194759159	1194759159	1	1	HARMON PHYSICAL THERAPY INC	8/29/2005	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1250 S SUNSET AVE	STE 204	WEST COVINA	CA	91790	3911	19	06037	34.0610671	-117.9463685	Los Angeles County
155185	Fee-for-Service	1194110486	1194110486	1	1	HARTMAN, ERIC M MD	9/24/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	154731	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
155192	Fee-for-Service	1144361577	1144361577	1	1	HOANG, LAM H MD	9/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104595	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
155208	Fee-for-Service	1841601747	1841601747	1	1	HUYNH, KOVIN DO	1/13/2022	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
155224	Fee-for-Service	1124011689	1124011689	1	1	HARRIS, ETHAN G MD INC	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	18727	66	Emergency Medicine (Urgent Care)	0	In state provider	None	720 HOWE AVE	STE 110	SACRAMENTO	CA	95825	4687	34	06067	38.578374	-121.4149455	Sacramento County
155277	Fee-for-Service	1902004096	1902004096	1	1	HUSSEIN, FADI A MD	5/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116822	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
155284	Fee-for-Service	1790117489	1790117489	1	1	HEINZ, ANNA E	1/26/2022	367A00000X	NA	Certified Nurse Midwife	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
155288	Fee-for-Service	1073596870	1073596870	1	1	HARFORD, ROBERT MD	7/23/2018	207N00000X	NA	Dermatology	026	PHYSICIANS	86180	07	Dermatology	0	In state provider	None	750 E LATHAM AVE	SUITE 3	HEMET	CA	92543	4370	33	06065	33.74940646	-116.964504	Riverside County
155326	Fee-for-Service	1316965494	1316965494	1	1	HWANG, JIMMY H MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	38692	83	Rheumatology	0	In state provider	None	18251 ROSCOE BLVD	STE 102	NORTHRIDGE	CA	91325	4207	19	06037	34.22081017	-118.5314078	Los Angeles County
155338	Fee-for-Service	1295934032	1295934032	1	1	HARBERT, MARY JO MD	1/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	101736	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
155358	Fee-for-Service	1790125912	1790125912	1	1	HEAL, GINA MD INC	5/1/2014	207RP1001X	NA	Pulmonology	026	PHYSICIANS	85249	41	Internal Medicine	0	In state provider	None	11 THOMAS OWENS WAY	STE 101	MONTEREY	CA	93940	5816	27	06053	36.58075924	-121.8180566	Monterey County
155428	Fee-for-Service	1720777469	1720777469	1	1	HANSON, TERRI CNP	10/17/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	14330 CULVER DR	None	IRVINE	CA	92604	0303	30	06059	33.70654758	-117.7857461	Orange County
155438	Fee-for-Service	1821314485	1821314485	1	1	HINDOYAN, NAREEN A MD	7/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121555	66	Emergency Medicine (Urgent Care)	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
155443	Fee-for-Service	1114324118	1114324118	2	1	HEALOGICS SPECIALTY PHYSICIA	2/18/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NS OF CALIFORNIA, PC	370 N VILLA ST	None	PORTERVILLE	CA	93257	3320	54	06107	36.0726781	-119.0306167	Tulare County
155458	Fee-for-Service	1679816698	1679816698	1	1	HARDCASTLE, ALICIA A DO	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14064	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	GW 12	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
155463	Fee-for-Service	1588822142	1588822142	2	1	HUANG, ALAN W MD	6/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	111806	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
155509	Fee-for-Service	1023046034	1023046034	1	1	HUMPHRIES, BRIDGET D MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62947	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
155528	Fee-for-Service	1972124295	1972124295	1	1	HWANG, JAY MD	3/10/2023	208M00000X	NA	Other	026	PHYSICIANS	178859	None	None	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
155564	Fee-for-Service	1902004096	1902004096	1	1	HUSSEIN, FADI A MD	5/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116822	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
155567	Fee-for-Service	1427482363	1427482363	1	1	HEALTH MOBILE	2/19/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1659 SCOTT BLVD	STE 4	SANTA CLARA	CA	95050	4137	43	06085	37.35434281	-121.9594982	Santa Clara County
155580	Fee-for-Service	1356769699	1356769699	1	1	HASHEMI, SEAN MD	9/29/2020	2082S0099X	NA	General Surgery	026	PHYSICIANS	161622	24	Plastic Surgery	0	In state provider	None	135 MISSION RANCH BLVD	SUITE 100	CHICO	CA	95926	2175	04	06007	39.75330715	-121.8611016	Butte County
155584	Fee-for-Service	1336907468	1336907468	1	1	HENDRY, KRISTEN M LMFT	2/25/2025	106H00000X	NA	Mental Health Outpatient Services	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
155636	Fee-for-Service	1184343055	1184343055	1	1	HEALTH ALLIANCE SOCAL, INC	12/10/2022	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1300 N. VERMONT AVE.	None	LOS ANGELES	CA	90027	6098	19	06037	34.0956033	-118.2916918	Los Angeles County
155641	Fee-for-Service	1215039631	1215039631	2	1	HABIB, SHEHNAZ N MD	3/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	50211	41	Internal Medicine	0	In state provider	None	14860 ROSCOE BLVD	SUITE 300	VAN NUYS	CA	91402	7902	19	06037	34.2214515	-118.4573205	Los Angeles County
155645	Fee-for-Service	1790125912	1790125912	1	1	HEAL, GINA MD INC	5/1/2014	207RP1001X	NA	Pulmonology	026	PHYSICIANS	85249	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	11 THOMAS OWENS WAY	STE 101	MONTEREY	CA	93940	5816	27	06053	36.58075924	-121.8180566	Monterey County
155670	Fee-for-Service	1639106800	1639106800	1	1	HIEB, MICHAEL L MD	6/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95842	05	Anesthesiology	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
155701	Fee-for-Service	1912911066	1912911066	1	1	HUGHES, RICHARD L MD	12/1/2018	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
155702	Fee-for-Service	1285072082	1285072082	1	1	HEARNEY, KELLY M MD	11/7/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	147712	40	Pediatrics	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
155708	Fee-for-Service	1043705296	1043705296	1	1	HOGUE, BRENNA L MD	11/1/2021	207P00000X	NA	Other	026	PHYSICIANS	164457	None	None	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
155719	Fee-for-Service	1902812621	1902812621	1	1	HART, BLAINE	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	2719	00	None	35.08771808	-106.6192188	Bernalillo County
155726	Fee-for-Service	1215191465	1215191465	1	1	HUANG-BEGOVIC, CATHERINE K	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	85941	24	Plastic Surgery	0	In state provider	MD	159 LEXINGTON LANE	None	COSTA MESA	CA	92626	6569	30	06059	33.6600659	-117.9065679	Orange County
155766	Fee-for-Service	1730254624	1730254624	1	1	HARDEN, SUSAN PHD	7/17/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1500 DUARTE RD	None	LOS ANGELES	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles
155794	Fee-for-Service	1790897460	1790897460	1	1	HICK, KAREN 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	345 SMITH AVE N	None	SAINT PAUL	MN	55102	2346	00	None	44.94251219	-93.1074995	Ramsey County
155798	Fee-for-Service	1023046034	1023046034	1	1	HUMPHRIES, BRIDGET D MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	62947	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
155814	Fee-for-Service	1538178397	1538178397	1	1	HUNTER, RICHARD J MD	8/24/2004	207L00000X	NA	Other	026	PHYSICIANS	34967	05	Anesthesiology	0	In state provider	DEPT OF ANESTHESIA	170 ALAMEDA DE LAS PULGA	None	REDWOOD CITY	CA	94062	2751	41	06081	37.48093988	-122.2531826	San Mateo County
155854	Fee-for-Service	1871525493	1871525493	1	1	HARRIS, GENEVIEVE N AU	5/23/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
155867	Fee-for-Service	1912178237	1912178237	1	1	HAI SHAO MD PH.D, A MEDICAL	5/16/2008	193400000X	NA	Other	026	PHYSICIANS	79601	41	Internal Medicine	0	In state provider	CORPORATION	3400 E 8TH STREET	STE 107	NATIONAL CITY	CA	91950	3168	37	06073	32.68571247	-117.0716254	San Diego County
155869	Fee-for-Service	1356769699	1356769699	1	1	HASHEMI, SEAN MD	9/29/2020	2082S0099X	NA	General Surgery	026	PHYSICIANS	161622	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	135 MISSION RANCH BLVD	SUITE 100	CHICO	CA	95926	2175	04	06007	39.75330715	-121.8611016	Butte County
155916	Fee-for-Service	1912584210	1912584210	1	1	HARRISON, JESSICA DO	10/31/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	22474	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
155924	Fee-for-Service	1770167918	1770167918	1	1	HOPP, JESSICA POSTPARTUM DO	4/10/2024	174N00000X	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
155927	Fee-for-Service	1043384050	1043384050	1	1	HSU, JUDY W MD	6/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	64207	41	Internal Medicine	0	In state provider	None	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
155929	Fee-for-Service	1578327706	1578327706	1	1	HUBERTY, BRANDON	4/5/2024	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
155930	Fee-for-Service	1790125912	1790125912	1	1	HEAL, GINA MD INC	5/1/2014	207RP1001X	NA	Pulmonology	026	PHYSICIANS	85249	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11 THOMAS OWENS WAY	STE 101	MONTEREY	CA	93940	5816	27	06053	36.58075924	-121.8180566	Monterey County
155947	Fee-for-Service	1548884463	1548884463	1	1	HOPE CARE HOSPICE INC	8/30/2023	163WH1000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	601 E YORBA LINDA BLVD	STE 1E	PLACENTIA	CA	92870	3006	30	06059	33.88937165	-117.8544856	Orange County
155970	Fee-for-Service	1730359118	1730359118	1	1	HONARI, GOLARA MD	11/13/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124118	07	Dermatology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
156036	Fee-for-Service	1023062098	1023062098	1	1	HCA-HEALTHONE LLC	11/1/1998	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4567 E 9TH AVE	None	DENVER	CO	80220	3908	00	None	39.73107153	-104.934114	Denver County
156046	Fee-for-Service	1629554597	1629554597	1	1	HAROUTUNIAN, PAULINE MD	8/1/2024	207P00000X	NA	Other	026	PHYSICIANS	164942	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
156057	Fee-for-Service	1154714046	1154714046	1	1	HUYNH, STELLA MD	7/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128516	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
156059	Fee-for-Service	1376595116	1376595116	1	1	HUBER, DANIEL G MD	10/27/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87538	05	Anesthesiology	0	In state provider	None	650 SANITARIUM RD	None	DEER PARK	CA	94576	9714	28	06055	38.5417293	-122.4756328	Napa County
156168	Fee-for-Service	1720024391	1720024391	1	1	HAWTHORNE HOLDINGS, LLC	9/11/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	WHITE BLOSSOM CARE CTR	1990 FRUITDALE AVE	None	SAN JOSE	CA	95128	2709	43	06085	37.31065241	-121.9285256	Santa Clara County
156181	Fee-for-Service	1194068312	1194068312	1	1	HENDRICKSON, BRIAN P MD	9/13/2019	2084P0804X	NA	Psychiatry	026	PHYSICIANS	160555	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
156196	Fee-for-Service	1982991915	1982991915	1	1	HUDDLESTON, LINDSEY L MD	7/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121213	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.7634502	-122.4579779	San Francisco County
156210	Fee-for-Service	1972603389	1972603389	1	1	HOVEY, REGINA MARIE	2/1/1997	208800000X	NA	Other	026	PHYSICIANS	79529	34	Urology and Urological Surgery	0	In state provider	None	4301 X ST	STE 2210	SACRAMENTO	CA	95817	2214	34	06067	38.5536003	-121.455135	Sacramento County
156302	Fee-for-Service	1255381547	1255381547	1	1	HOSPICE BY THE BAY	7/1/2004	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	17 E SIR FRANCIS DRAKE B	None	LARKSPUR	CA	94939	1727	21	06041	37.94515886	-122.5127109	Marin County
156308	Fee-for-Service	1871012203	1871012203	1	1	HEALING HEARTS MARRIAGE AND	11/6/2018	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FAMILY THERAPY, INC.	3610 CENTRAL AVE STE 400	None	RIVERSIDE	CA	92506	5907	33	06065	33.95352247	-117.3917745	Riverside County
156322	Fee-for-Service	1023062098	1023062098	1	1	HCA-HEALTHONE LLC	11/1/1998	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4567 E 9TH AVE	None	DENVER	CO	80220	3908	00	None	39.73107153	-104.934114	Denver County
156338	Fee-for-Service	1043419682	1043419682	1	1	HARRISON HANSON	5/9/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1000 LINCOLN CIR SE	None	ORANGE CITY	IA	51041	1836	00	None	42.99560241	-96.04464101	Sioux County
156339	Fee-for-Service	1225220130	1225220130	1	1	HOCHMAN, MICHAEL E MD	8/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	107932	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
156342	Fee-for-Service	1245543214	1245543214	1	1	HAO, JOY MD	10/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132377	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
156349	Fee-for-Service	1295754729	1295754729	1	1	HALL, CHRISTOPHER S MD	10/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77488	None	None	0	In state provider	None	2850 TELEGRAPH AVE	STE 110	BERKELEY	CA	94705	1159	01	06001	37.85808554	-122.2594469	Alameda County
156382	Fee-for-Service	1790216281	1790216281	1	1	HIRPARA, AZAD MD	11/3/2022	390200000X	NA	Other	026	PHYSICIANS	160488	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
156476	Fee-for-Service	1851479679	1851479679	1	1	HANDLER, GLENN A MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43138	07	Dermatology	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
156502	Fee-for-Service	1154644425	1154644425	1	1	HAJYAN, KARINE DO	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12220	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3779 PIEDMONT AVENUE	None	OAKLAND	CA	94611	5347	01	06001	37.82384659	-122.2558913	Alameda County
156515	Fee-for-Service	1356901631	1356901631	1	1	HO, MICHAEL H MD	8/17/2023	207R00000X	NA	Other	026	PHYSICIANS	185159	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
156522	Fee-for-Service	1912177205	1912177205	1	1	HAMILTON, JACQULEN R	5/4/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
156526	Fee-for-Service	1720187545	1720187545	1	1	HUNT, JASON E DO	1/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8643	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
156551	Fee-for-Service	1598767725	1598767725	1	1	HITT,JR, WILBUR 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	4301 W MARKHAM ST	None	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
156580	Fee-for-Service	1487960779	1487960779	1	1	HERBERT, SHARONNE D PHD	10/16/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1120 W LA VETA AVENUE	STE 470	ORANGE	CA	92868	4233	30	06059	33.78029455	-117.864369	Orange County
156590	Fee-for-Service	1255381547	1255381547	1	1	HOSPICE BY THE BAY	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	17 E SIR FRANCIS DRAKE B	None	LARKSPUR	CA	94939	1727	21	06041	37.94515886	-122.5127109	Marin County
156604	Fee-for-Service	1205903762	1205903762	1	1	HASHEMIYOON, ROBERT B MD	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	86202	01	General Practice	0	In state provider	None	4312 WOODMAN AVE	STE 102	SHERMAN OAKS	CA	91423	5523	19	06037	34.148637	-118.4312035	Los Angeles County
156711	Fee-for-Service	1922137090	1922137090	1	1	HONG, ANTHONY H LMFT	2/24/2020	171M00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2820 PORTER ST	None	SOQUEL	CA	95073	2423	44	06087	36.987156	-121.9573505	Santa Cruz County
156733	Fee-for-Service	1255392544	1255392544	1	1	HUANG, CRAIG JAMES 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
156761	Fee-for-Service	1518951300	1518951300	1	27	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16105 SAND CANYON AVE	SUITE 230	IRVINE	CA	92618	3780	30	06059	33.66320123	-117.7725531	Orange County
156768	Fee-for-Service	1497822316	1497822316	1	1	HONG, CALVIN Y MD	10/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	61013	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
156834	Fee-for-Service	1396920047	1396920047	1	1	HOME PORTABLE X RAY SVC	1/1/1979	No Taxonomy Provided	NA	None	028	PORTABLE X-RAY	-	-	NOT APPLICABLE	0	In state provider	None	801 MAPLE ST	None	SAN MATEO	CA	94402	2302	41	06081	37.55711794	-122.3243746	San Mateo County
156840	Fee-for-Service	1669114252	1669114252	1	1	HORTON, TYLER B OD	8/14/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	82227 US HWY 111	STE B2	INDIO	CA	92201	5668	33	06065	33.71471443	-116.2312195	Riverside County
156847	Fee-for-Service	1568429231	1568429231	1	1	HOYT, JAMES MD	10/31/1991	208200000X	NA	General Surgery	026	PHYSICIANS	61493	None	None	0	In state provider	None	1205 E NORTH ST	None	MANTECA	CA	95336	4932	39	06077	37.80110374	-121.1974853	San Joaquin County
156867	Fee-for-Service	1619362605	1619362605	1	1	HIGHTOWER, JESSICA S MD	3/2/2021	390200000X	NA	Other	026	PHYSICIANS	144227	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
156890	Fee-for-Service	1154546497	1154546497	1	1	HOSSAIN, SYED M MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97737	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
156895	Fee-for-Service	1205903762	1205903762	1	1	HASHEMIYOON, ROBERT B MD	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	86202	41	Internal Medicine	0	In state provider	None	4312 WOODMAN AVE	STE 102	SHERMAN OAKS	CA	91423	5523	19	06037	34.148637	-118.4312035	Los Angeles County
156916	Fee-for-Service	1821157405	1821157405	1	1	HSIEH, TIMOTHY MD	11/30/1992	207RE0101X	NA	Endocrinology	026	PHYSICIANS	71934	67	Endocrinology	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
156922	Fee-for-Service	1801218102	1801218102	1	1	HEXOM, DEBRA J NP	9/13/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	387742	-	NOT APPLICABLE	0	In state provider	None	161 N DATE STREET	None	ESCONDIDO	CA	92025	3405	37	06073	33.12662288	-117.070312	San Diego County
156933	Fee-for-Service	1922485929	1922485929	1	1	HUYNH, MONICA DO	12/3/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	17416	07	Dermatology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
156958	Fee-for-Service	1265620090	1265620090	1	1	HEMET EMERGENCY MED GRP	2/28/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	28400 MCCALL BLVD	None	SUN CITY	CA	92585	9658	33	06065	33.71805454	-117.1672547	Riverside County
156966	Fee-for-Service	1215076468	1215076468	1	1	HUGHES, DENNIS N MD	6/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	52756	41	Internal Medicine	0	In state provider	None	1301 SHOREWAY RD	STE 100	BELMONT	CA	94002	4110	41	06081	37.5239043	-122.2667778	San Mateo County
156973	Fee-for-Service	1790703742	1790703742	1	1	HECHT, JOEL R MD	7/30/1989	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	63119	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
156974	Fee-for-Service	1952489551	1952489551	1	1	HOBERMAN, BRIAN P MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	54730	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
156993	Fee-for-Service	1902003817	1902003817	1	1	HILL, FORREST G MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110261	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
157032	Fee-for-Service	1154310415	1154310415	1	1	HILL MEDICAL CORPORATION	4/1/1981	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	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
157039	Fee-for-Service	1134270069	1134270069	1	1	HAMILTON, SHAWN H MD	1/1/1998	207R00000X	NA	Other	026	PHYSICIANS	60652	None	None	0	In state provider	None	4902 BARRANCA PKWY	STE 105	IRVINE	CA	92604	4629	30	06059	33.6762462	-117.7955383	Orange County
157043	Fee-for-Service	1326734625	1326734625	1	1	HILBORN CARE INC	3/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	850 SONOMA AVENUE	None	SANTA ROSA	CA	95404	4715	49	06097	38.439162	-122.7063555	Sonoma County
157061	Fee-for-Service	1427232537	1427232537	1	1	HAJIMIRSADEGHI, AMIR N	10/16/2008	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	DPM	450 4TH AVENUE	STE 401	CHULA VISTA	CA	91910	4430	37	06073	32.63513513	-117.0820663	San Diego County
157066	Fee-for-Service	1639661234	1639661234	1	1	HATHI, SEJAL MD	10/9/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
157073	Fee-for-Service	1548584139	1548584139	1	1	HARRISON, ZHANETTA M MD	8/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119207	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
157087	Fee-for-Service	1366809790	1366809790	1	1	HANSEN BEHAVIORAL HEALTH A P	5/10/2016	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYCHOLOGICAL CORPORATIO	524 N MARYLAND AVE	SUITE 1	GLENDALE	CA	91206	2266	19	06037	34.15384532	-118.2537908	Los Angeles County
157088	Fee-for-Service	1710980677	1710980677	1	1	HARRIS, TODD S MD	11/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105121	02	General Surgery	0	In state provider	None	17100 EUCLID STREET	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
157090	Fee-for-Service	1952599490	1952599490	1	1	HAMER, BRENDA K MD	9/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107846	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
157099	Fee-for-Service	1033805023	1033805023	1	1	HONORE, ALEXANDER 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
157107	Fee-for-Service	1952927584	1952927584	1	1	HSUEH, JESSICA MD	5/20/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
157111	Fee-for-Service	1134208887	1134208887	1	1	HUANG, GEORGE M MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87719	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
157125	Fee-for-Service	1275792632	1275792632	1	1	HUANG, FRANKLIN W MD	4/14/2021	207RX0202X	NA	Oncology	026	PHYSICIANS	158704	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
157129	Fee-for-Service	1134154628	1134154628	1	1	HANBERG, FRANCINE MD	1/1/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	77	Infectious Disease	0	In state provider	None	2701 W ALAMEDA AVE	STE 201	BURBANK	CA	91505	4406	19	06037	34.15751343	-118.3303715	Los Angeles County
157148	Fee-for-Service	1265193783	1265193783	1	1	HOPE PLUS HEALTH CARE	2/16/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	21044 SHERMAN WAY	STE 230	CANOGA PARK	CA	91303	3669	19	06037	34.20094854	-118.592208	Los Angeles County
157156	Fee-for-Service	1023431582	1023431582	1	1	HADIDI, KATHERINE MFT	11/6/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52243	-	NOT APPLICABLE	0	In state provider	None	16433 MONTEREY RD	SUITE 140	MORGAN HILL	CA	95037	7168	43	06085	37.11844359	-121.6461623	Santa Clara County
157167	Fee-for-Service	1225039142	1225039142	1	1	HELMS, ILEANA A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	48003	41	Internal Medicine	0	In state provider	None	365 LENNON LANE	SUITE 250	WALNUT CREEK	CA	94598	5915	07	06013	37.92784983	-122.0301444	Contra Costa County
157180	Fee-for-Service	1205903762	1205903762	1	1	HASHEMIYOON, ROBERT B MD	6/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	86202	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4312 WOODMAN AVE	STE 102	SHERMAN OAKS	CA	91423	5523	19	06037	34.148637	-118.4312035	Los Angeles County
157208	Fee-for-Service	1164590501	1164590501	1	1	HECHT, JONATHAN H MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72698	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
157211	Fee-for-Service	1841453321	1841453321	1	1	HUDSON, ANDREW E MD	11/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121175	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
157215	Fee-for-Service	1952853368	1952853368	1	1	HSU, SHAO-PU P MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140653	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
157229	Fee-for-Service	1144217654	1144217654	1	1	HERRON, GEORGE JR MD INC	7/20/2008	207R00000X	NA	Other	026	PHYSICIANS	10082	41	Internal Medicine	0	In state provider	None	1610 N EL DORADO ST	STE 17	STOCKTON	CA	95204	5930	39	06077	37.96862394	-121.2942407	San Joaquin County
157242	Fee-for-Service	1689179632	1689179632	1	1	HUNG, MATTHEW L MD	4/22/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
157254	Fee-for-Service	1588155998	1588155998	1	1	HAILS, JUDITH A LMFT	9/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	101 E LINCOLN AVE	STE 230	FOUNTAIN VALLEY	CA	92805	3206	30	06059	33.8368447	-117.9138391	Orange County
157270	Fee-for-Service	1366598161	1366598161	2	1	HALLERS LTC PHARMACY INC	3/1/2020	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4067 PERALTA BLVD	None	FREMONT	CA	94536	4849	01	06001	37.55736284	-122.0074555	Alameda County
157294	Fee-for-Service	1578520722	1578520722	1	1	HUGHES, THOMAS C MD	1/1/1982	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	27376	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2720 N HARBOR BLVD	STE 1	FULLERTON	CA	92835	2609	30	06059	33.90126238	-117.9292154	Orange County
157295	Fee-for-Service	1215958251	1215958251	1	1	HULT, KJELL N MD	8/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	80340	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
157314	Fee-for-Service	1922324037	1922324037	1	1	HUNG, MARY M DO	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11895	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
157325	Fee-for-Service	1578668703	1578668703	1	1	HONG, GREGORY K MD	3/3/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53990	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2727 W OLYMPIC BLVD	STE 305	LOS ANGELES	CA	90006	2699	19	06037	34.0527015	-118.2931155	Los Angeles County
157326	Fee-for-Service	1194751958	1194751958	1	1	HOLY CROSS HOSPITAL	1/1/2000	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1397 WEIMER RD	None	TAOS	NM	87571	6284	00	None	36.3676834	-105.5778122	Taos County
157340	Fee-for-Service	1255623088	1255623088	1	1	HARBISON, ANNA L MD	10/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	122060	35	Pediatric Cardiology (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
157366	Fee-for-Service	1649276940	1649276940	1	1	HOFMANN, VIRGINIA E MD	6/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53196	36	Psychiatry	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	94612	3429	49	06097	38.471625	-122.7259935	Sonoma County
157390	Fee-for-Service	1457987265	1457987265	1	1	HUANG, WENDY C MD	9/27/2020	207R00000X	NA	Other	026	PHYSICIANS	63704	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
157440	Fee-for-Service	1174027254	1174027254	1	1	HAASE, DAVID A MD	4/1/2022	207P00000X	NA	Other	026	PHYSICIANS	163749	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
157454	Fee-for-Service	1225039142	1225039142	1	1	HELMS, ILEANA A MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	48003	45	Nephrology (Renal-Kidney)	0	In state provider	None	365 LENNON LANE	SUITE 250	WALNUT CREEK	CA	94598	5915	07	06013	37.92784983	-122.0301444	Contra Costa County
157467	Fee-for-Service	1124176482	1124176482	1	1	HERNANDEZ, OSCAR MD MEDICAL	2/9/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72101	08	Family Practice	0	In state provider	CORPORATION	139 E PUTMAN AVE	None	PORTERVILLE	CA	93257	3832	54	06107	36.06294315	-119.0201214	Tulare County
157503	Fee-for-Service	1053342378	1053342378	1	1	HSU, KENNETH K MD	9/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50577	83	Rheumatology	0	In state provider	None	511 W COLUMBUS ST	None	BAKERSFIELD	CA	93301	1201	15	06029	35.39718795	-119.0060452	Kern County
157517	Fee-for-Service	1144217654	1144217654	1	1	HERRON, GEORGE JR MD INC	7/20/2008	207R00000X	NA	Other	026	PHYSICIANS	10082	45	Nephrology (Renal-Kidney)	0	In state provider	None	1610 N EL DORADO ST	STE 17	STOCKTON	CA	95204	5930	39	06077	37.96862394	-121.2942407	San Joaquin County
157535	Fee-for-Service	1902302128	1902302128	1	1	HE, CALVIN DO	7/12/2022	207R00000X	NA	Other	026	PHYSICIANS	17903	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
157571	Fee-for-Service	1326155482	1326155482	1	1	HALL-HEIM, JOSEFINE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
157576	Fee-for-Service	1629278494	1629278494	1	1	HODGSON, JEFFREY R MD	12/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100211	05	Anesthesiology	0	In state provider	None	210 CANAL STREET	None	KING CITY	CA	93930	3431	27	06053	36.20731142	-121.1325532	Monterey County
157609	Fee-for-Service	1912910076	1912910076	1	1	HANSEN, STEVEN H MD	10/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	82292	08	Family Practice	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
157615	Fee-for-Service	1215346887	1215346887	1	1	HUGHES, JESSICA A PHD	2/20/2019	103TC0700X	NA	Mental Health Outpatient Services	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
157616	Fee-for-Service	1194751958	1194751958	1	1	HOLY CROSS HOSPITAL	1/1/2000	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1397 WEIMER RD	None	TAOS	NM	87571	6284	00	None	36.3676834	-105.5778122	Taos County
157627	Fee-for-Service	1043700503	1043700503	1	1	HUNTER, DYLAN J MD	9/20/2022	207L00000X	NA	Other	026	PHYSICIANS	178478	None	None	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3522	48	06095	38.26109552	-122.0470245	Solano County
157648	Fee-for-Service	1861835316	1861835316	1	1	HONG, PHILIP MD	4/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142215	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
157654	Fee-for-Service	1851715627	1851715627	1	1	HERNANDEZ, LARISSA MD	12/2/2020	207R00000X	NA	Other	026	PHYSICIANS	169142	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
157666	Fee-for-Service	1639379431	1639379431	1	1	HUNTE,S 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	3500 W WHEATLAND RD	None	DALLAS	TX	75237	0000	00	None	32.64745255	-96.8764365	Dallas County
157678	Fee-for-Service	1457544488	1457544488	1	1	HWANG, JULIE S OD	5/18/2020	152W00000X	NA	Other	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
157682	Fee-for-Service	1306971148	1306971148	1	1	HOLSCHER, DONNA A MD	10/31/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59568	08	Family Practice	0	In state provider	None	1114 6TH ST	None	MODESTO	CA	95354	2203	50	06099	37.63901905	-121.0057149	Stanislaus County
157696	Fee-for-Service	1518062736	1518062736	1	1	HAMILTON, JONI LYNN M MD	9/15/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	72957	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
157729	Fee-for-Service	1023524394	1023524394	1	1	HOWER, GRANT	6/27/2024	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
157750	Fee-for-Service	1285712372	1285712372	1	1	HSU, PEGGY MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	77634	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
157780	Fee-for-Service	1053342378	1053342378	1	1	HSU, KENNETH K MD	9/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	50577	41	Internal Medicine	0	In state provider	None	511 W COLUMBUS ST	None	BAKERSFIELD	CA	93301	1201	15	06029	35.39718795	-119.0060452	Kern County
157813	Fee-for-Service	1730216276	1730216276	1	1	HELPER, SUSAN J MD	9/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	37388	41	Internal Medicine	0	In state provider	None	3838 SAN DIMAS ST	STE A200	BAKERSFIELD	CA	93301	1115	15	06029	35.3946385	-119.008203	Kern County
157841	Fee-for-Service	1437445798	1437445798	1	1	HEALY, MARK	9/1/2024	2086X0206X	NA	General Surgery	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	236 SAN JOSE	None	SALINAS	CA	93901	3901	27	06053	36.6582359	-121.6463252	Monterey County
157896	Fee-for-Service	1548209935	1548209935	1	1	HEIDENREICH, ERIC 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	2003 LINCOLN WAY	None	COEUR D ALENE	ID	83814	2611	00	None	47.69465937	-116.7917936	Kootenai County
157901	Fee-for-Service	1780670836	1780670836	1	1	HAMDY, MOSTAFA A MD	8/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	43951	10	Gastroenterology (M.D. only)	0	In state provider	None	1550 N IMPERIAL AVE	STE 2	EL CENTRO	CA	92243	6304	13	06025	32.80696546	-115.5702795	Imperial County
157928	Fee-for-Service	1356800668	1356800668	1	1	HO, SAMANTHA B DO	9/21/2022	208M00000X	NA	Other	026	PHYSICIANS	20183	None	None	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
157943	Fee-for-Service	1952707457	1952707457	1	1	HOLNESS, SHEMIAH Y PT	3/2/2020	2251X0800X	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
157954	Fee-for-Service	1992862072	1992862072	1	1	HOANG, CHUONG D MD	10/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105823	33	Thoracic Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
157964	Fee-for-Service	1548479074	1548479074	1	1	HU, PATRICK P MD	10/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	90311	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
157981	Fee-for-Service	1578816211	1578816211	1	1	HODGES, DAMIAN T CRNA	4/1/2019	367500000X	NA	Other	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
158074	Fee-for-Service	1790986131	1790986131	1	1	HOFFMANN, HENRICA M LMFT	12/8/2020	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
158093	Fee-for-Service	1831394667	1831394667	1	1	HASAN, NAZIA MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137560	10	Gastroenterology (M.D. only)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
158125	Fee-for-Service	1578009098	1578009098	1	1	HIJADA, MAHALIA A	7/20/2023	106S00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
158144	Fee-for-Service	1568792034	1568792034	1	1	HAAYER, MICHELLE K	11/24/2014	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
158212	Fee-for-Service	1760626477	1760626477	1	3	HASSAN KAFRI MD, INC.	4/12/2022	207RI0011X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	NIC	429 BROADWAY	None	CHULA VISTA	CA	91910	4320	37	06073	32.63325568	-117.0903455	San Diego County
158217	Fee-for-Service	1659800365	1659800365	1	1	HUR, ELIZABETH Y MD	7/30/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158722	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
158242	Fee-for-Service	1386800266	1386800266	1	1	HORMOZDI, BAHRAM MD	4/29/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	133891	13	Neurology (M.D. only)	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
158244	Fee-for-Service	1316388325	1316388325	1	1	HUBER, ANDREW T MD	11/25/2019	208600000X	NA	General Surgery	026	PHYSICIANS	134599	None	None	0	In state provider	None	1552 COFFEE ROAD	SUITE 200	MODESTO	CA	95355	3122	50	06099	37.666872	-120.975684	Stanislaus County
158292	Fee-for-Service	1952807851	1952807851	1	1	HAMBARDZUMYAN, ARAM MD	8/20/2021	208M00000X	NA	Other	026	PHYSICIANS	173734	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
158340	Fee-for-Service	1770782484	1770782484	1	1	HANNAN, JOHN M PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1001 SNEATH LANE	STE 204	SAN BRUNO	CA	94066	2349	41	06081	37.63462925	-122.4259247	San Mateo County
158404	Fee-for-Service	1821310038	1821310038	1	1	HO, JUDY K PHD	2/6/2012	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
158425	Fee-for-Service	1992920763	1992920763	1	1	HUNTER, MARGARET R LMFT	1/2/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1246 E CANAL DR	None	TURLOCK	CA	95380	4156	50	06099	37.50017587	-120.8375289	Stanislaus County
158476	Fee-for-Service	1407898661	1407898661	1	1	HOPKINS, KELLY S CRNA	5/1/2006	No Taxonomy Provided	NA	None	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
158489	Fee-for-Service	1710039573	1710039573	1	1	HARBOR MEDICAL GROUP	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEDICAL CORPORATION	1661 SOQUEL DR	STE A	SANTA CRUZ	CA	95065	1787	44	06087	36.98895429	-121.9821088	Santa Cruz County
158522	Fee-for-Service	1356329122	1356329122	1	1	HOPE INTERNATIONAL HOSPICE	4/30/2004	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	20705 S WESTERN AVE	STE 112	TORRANCE	CA	90501	1844	19	06037	33.84278062	-118.3093853	Los Angeles County
158571	Fee-for-Service	1912110321	1912110321	1	1	HALEAKALA,ANN 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	54-383 HOSPITAL RD	None	KAPAAU	HI	96755	0000	00	None	20.23176242	-155.7971949	Hawaii County
158598	Fee-for-Service	1770017477	1770017477	1	1	HANMI PHARMACY, INC.	3/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	325 1/2 S WESTERN AVE	None	LOS ANGELES	CA	90020	3804	19	06037	34.06828086	-118.3091451	Los Angeles County
158600	Fee-for-Service	1669978524	1669978524	1	1	HUR, JIN A DO	10/20/2021	207R00000X	NA	Other	026	PHYSICIANS	19068	None	None	0	In state provider	None	14550 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91387	2200	19	06037	34.43539863	-118.39023	Los Angeles County
158606	Fee-for-Service	1821037987	1821037987	1	1	HALLS, JAMES MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	30677	30	Radiology	0	In state provider	None	333 S HOPE ST	STE C145	LOS ANGELES	CA	90071	3019	19	06037	34.05335946	-118.2526978	Los Angeles County
158646	Fee-for-Service	1063483873	1063483873	1	1	HUDSON, ROSALIE MD	9/9/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2020 GENESEE AVE	None	SAN DIEGO	CA	92123	4219	37	06073	32.7921973	-117.1571251	San Diego County
158659	Fee-for-Service	1194815134	1194815134	1	1	HASTINGS, JOSEPH R MD	4/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102126	08	Family Practice	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
158679	Fee-for-Service	1225450919	1225450919	1	1	HALE, MARJA K NP	5/19/2023	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
158693	Fee-for-Service	1609952779	1609952779	1	1	HANNIGAN, VALERIE CCC-SLP	6/8/2022	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
158701	Fee-for-Service	1871939058	1871939058	1	1	HARDLAND, JANNA MD	9/18/2018	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
158750	Fee-for-Service	1104993898	1104993898	1	1	HASSEL, TRICIA L PHD	7/17/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	410 S GLENDORA AVE	STE 130	GLENDORA	CA	91741	6207	19	06037	34.13122731	-117.863713	Los Angeles County
158776	Fee-for-Service	1063520120	1063520120	1	1	HAIDER, SYED M MD	12/29/2009	208M00000X	NA	Other	026	PHYSICIANS	108923	41	Internal Medicine	0	In state provider	None	1100 BUTTE ST	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
158783	Fee-for-Service	1225534308	1225534308	1	2	HEALTHQUEST, INC.	8/16/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	8141 GREENBACK LN	None	FAIR OAKS	CA	95628	2502	34	06067	38.678985	-121.260492	Sacramento County
158798	Fee-for-Service	1578004339	1578004339	1	1	HO, COTY MD INC	9/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	52833	78	Neoplastic Diseases/Oncology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
158801	Fee-for-Service	1487600920	1487600920	1	1	HABER-PEREZ, ADA L	2/2/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2030 SUTTER PLACE	STE 1300	DAVIS	CA	95616	6215	57	06113	38.56292466	-121.7715423	Yolo County
158805	Fee-for-Service	1356329122	1356329122	1	1	HOPE INTERNATIONAL HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	20705 S WESTERN AVE	STE 112	TORRANCE	CA	90501	1844	19	06037	33.84278062	-118.3093853	Los Angeles County
158833	Fee-for-Service	1700466570	1700466570	1	1	HUNNICUTT, RICHARD P CRNA	8/17/2021	367500000X	NA	Other	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
158855	Fee-for-Service	1891923462	1891923462	1	1	HILGER, KEREN A MD	7/28/2020	207P00000X	NA	Other	026	PHYSICIANS	113331	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
158856	Fee-for-Service	1194388595	1194388595	1	1	HEALING HANDS HOSPICE INC	8/27/2024	2081H0002X	NA	Physical Medicine and Rehabilitation	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	202M	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
158871	Fee-for-Service	1972624658	1972624658	1	1	HALE, BERNARD J OD	4/30/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1960 BROADWAY	None	OAKLAND	CA	94612	2206	01	06001	37.80861936	-122.2684225	Alameda County
158895	Fee-for-Service	1467026138	1467026138	1	1	HANKS, NATALIE MD	9/1/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	187741	08	Family Practice	0	In state provider	None	2732 NAVAJO RD	202A	EL CAJON	CA	92020	2149	37	06073	32.80217534	-117.0025853	San Diego County
158904	Fee-for-Service	1861722134	1861722134	1	1	HORMOZI, JONES DPM	4/12/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	43112 N 15TH W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
158927	Fee-for-Service	1396010914	1396010914	1	1	HANZY, RICHARD C LMFT	9/22/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ING SERVICES	3105 LONE TREE WAY	STE B	ANTIOCH	CA	94509	4974	07	06013	37.99144473	-121.8076057	Contra Costa County
158942	Fee-for-Service	1144233537	1144233537	1	1	HILL, MICHAEL E MD	2/20/2008	208200000X	NA	General Surgery	026	PHYSICIANS	87752	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
158944	Fee-for-Service	1316231681	1316231681	1	1	HAMIDI, VALA MD	9/13/2017	207RE0101X	NA	Endocrinology	026	PHYSICIANS	150069	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
158950	Fee-for-Service	1821049230	1821049230	1	1	HOLMAN, PETER R MD	6/30/1996	207RH0003X	NA	Oncology	026	PHYSICIANS	63150	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
158959	Fee-for-Service	1982811634	1982811634	1	1	HONG, MICHAEL S MD	8/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106888	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
158983	Fee-for-Service	1023208683	1023208683	1	1	HAWTHORNE, KINJI L	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64097	None	None	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
158987	Fee-for-Service	1285215863	1285215863	1	1	HONEST PHARMACY LLC	5/13/2022	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7740 GARVEY AVE	UNIT A	ROSEMEAD	CA	91770	3061	19	06037	34.06259448	-118.10061	Los Angeles County
158993	Fee-for-Service	1245374578	1245374578	1	1	HAMMOND, CATHY M	6/13/2003	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3703 CAMINO DEL RIO S	STE 200	SAN DIEGO	CA	92108	4033	37	06073	32.7779427	-117.1148901	San Diego County
159015	Fee-for-Service	1588822670	1588822670	1	1	HIBLER, JOHN T DO	4/29/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	14908	07	Dermatology	0	In state provider	None	2215 TRUXTUN AVE	STE 100	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
159088	Fee-for-Service	1376985234	1376985234	1	1	HERNANDEZ, GILBERTO MD	11/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137734	41	Internal Medicine	0	In state provider	None	3801 HOWE ST	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
159089	Fee-for-Service	1649582594	1649582594	1	1	HAZANY, SALAR MD	9/6/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	118281	07	Dermatology	0	In state provider	None	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	15	06029	35.356203	-119.0612695	Kern County
159116	Fee-for-Service	1700924545	1700924545	1	1	HEARD, CHRISTINE A	5/31/1990	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2100 CARLMONT DR	STE 4	BELMONT	CA	94002	3465	41	06081	37.5100845	-122.2935176	San Mateo County
159122	Fee-for-Service	1184740367	1184740367	1	2	HEALING HANDS MEDICAL GROUP,	10/9/2019	207RN0300X	NA	Nephrology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORPORATION	2975 WILSHIRE BLVD	SUITE 450	LOS ANGELES	CA	90010	1107	19	06037	34.06183451	-118.286712	Los Angeles County
159141	Fee-for-Service	1962432674	1962432674	1	1	HIGASHI, JULIE M MD	10/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73358	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
159154	Fee-for-Service	1447230255	1447230255	1	1	HASAN TUNA OZGUR M.D.	3/16/2014	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
159176	Fee-for-Service	1215131883	1215131883	1	1	HO, KI H MD	10/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	110838	04	Otology, Laryngology, Rhinology	0	In state provider	None	1711 TARAVAL ST	None	SAN FRANCISCO	CA	94116	2308	38	06075	37.74263686	-122.4845313	San Francisco County
159214	Fee-for-Service	1548458706	1548458706	1	1	HIREGOUDAR, MAMATHA MD	5/13/2008	207R00000X	NA	Other	026	PHYSICIANS	101765	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
159241	Fee-for-Service	1821049230	1821049230	1	1	HOLMAN, PETER R MD	6/30/1996	207RH0003X	NA	Oncology	026	PHYSICIANS	63150	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
159250	Fee-for-Service	1356376172	1356376172	1	1	HAN, KEVIN	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9938 BOLSA AVE	STE 105	WESTMINSTER	CA	92683	6039	30	06059	33.74481854	-117.956025	Orange County
159296	Fee-for-Service	1144318734	1144318734	1	1	HERNANDEZ, JAVIER MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	77736	01	General Practice	0	In state provider	None	81-709 DR CARREON BLVD	SUITE C5	INDIO	CA	92201	5577	33	06065	33.70743317	-116.2302643	Riverside County
159313	Fee-for-Service	1821251042	1821251042	1	1	HYNES, JAMES T MD	1/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121177	None	None	0	In state provider	None	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
159314	Fee-for-Service	1134192842	1134192842	1	1	HOUSE, MATTHEW DO	2/14/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	7888	36	Psychiatry	0	In state provider	None	1322 E SHAW AVE	SUITE 410	FRESNO	CA	93710	0000	10	06019	36.8087145	-119.7644625	Fresno County
159321	Fee-for-Service	1710290713	1710290713	1	1	HAZEN, CHARLES P DO	11/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12785	25	Physical Medicine and Rehabilitation	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
159335	Fee-for-Service	1598914376	1598914376	1	1	HSIEH, PRISCILLA PSYD	6/14/2018	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10470 FOOTHILL BLVD	SUITE 116	RANCHO CUCAMONGA	CA	91730	3754	36	06071	34.10659649	-117.576603	San Bernardino County
159347	Fee-for-Service	1992758601	1992758601	1	1	HSIAO, ROBERT MD	11/9/2018	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	657 TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
159373	Fee-for-Service	1508407453	1508407453	1	1	HANSEN, EMILEE K LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
159408	Fee-for-Service	1780776039	1780776039	1	1	HESSEL, TRACEY M MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	78717	40	Pediatrics	0	In state provider	None	400 PROFESSIONAL CENTER	STE 424	NOVATO	CA	94947	4368	21	06041	38.09591405	-122.5779059	Marin County
159425	Fee-for-Service	1962432674	1962432674	1	1	HIGASHI, JULIE M MD	10/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73358	77	Infectious Disease	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
159436	Fee-for-Service	1487813655	1487813655	1	1	HILL, CHARITY MD	8/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121401	25	Physical Medicine and Rehabilitation	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
159456	Fee-for-Service	1053971903	1053971903	1	1	HARMEYER, DANIEL P	8/5/2024	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
159481	Fee-for-Service	1154958445	1154958445	1	1	HAN, LICHY MD	5/22/2024	207L00000X	NA	Other	026	PHYSICIANS	190861	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
159490	Fee-for-Service	1104858620	1104858620	1	1	HURVITZ, GRAHAM R MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	68405	20	Orthopedic Surgery	0	In state provider	None	533 E MICHELTORENA ST	STE 204	SANTA BARBARA	CA	93103	2284	42	06083	34.43233822	-119.701775	Santa Barbara County
159509	Fee-for-Service	1053541029	1053541029	1	1	HURD, AMANDA DO	10/9/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
159538	Fee-for-Service	1417912155	1417912155	1	1	HERNY, ROBERT 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	5323 HARRY HINES BLVD	None	DALLAS	TX	75390	7201	00	None	32.812245	-96.841584	Dallas County
159544	Fee-for-Service	1295484434	1295484434	1	1	HADYAH, SANA MD	9/9/2024	207P00000X	NA	Other	026	PHYSICIANS	189963	66	Emergency Medicine (Urgent Care)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
159585	Fee-for-Service	1144318734	1144318734	1	1	HERNANDEZ, JAVIER MD	4/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	77736	40	Pediatrics	0	In state provider	None	81-709 DR CARREON BLVD	SUITE C5	INDIO	CA	92201	5577	33	06065	33.70743317	-116.2302643	Riverside County
159601	Fee-for-Service	1316230550	1316230550	1	1	HANSBERRY, SHAWN R MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142238	05	Anesthesiology	0	In state provider	None	ONE HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
159623	Fee-for-Service	1215161740	1215161740	1	1	HOME FOR LIFE FOUNDATION	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	14029 S HARVEST AVE	None	NORWALK	CA	90650	3740	19	06037	33.90364042	-118.0923362	Los Angeles County
159628	Fee-for-Service	1508165069	1508165069	1	1	HOSPICE OF ST GEORGE INC	6/12/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	415 E HARVARD STREET	STE 101	GLENDALE	CA	91205	4921	19	06037	34.14448348	-118.250604	Los Angeles County
159657	Fee-for-Service	1750458600	1750458600	1	1	HARKER, TODD J MD	12/31/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	45494	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
159658	Fee-for-Service	1033389903	1033389903	1	1	HYLTON, DIANA J MD	2/28/1984	2084N0400X	NA	Neurology	026	PHYSICIANS	41225	13	Neurology (M.D. only)	0	In state provider	None	750 W OLIVE AVE	STE 105	MERCED	CA	95348	2436	24	06047	37.31917248	-120.480657	Merced County
159703	Fee-for-Service	1558382002	1558382002	1	1	HAN, PAULINA T Q OD, INC	4/1/1999	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	TEMPLE CITY SQUARE OPTMY	5803 ROSEMEAD BLVD	None	TEMPLE CITY	CA	91780	1833	19	06037	34.10525448	-118.0737134	Los Angeles County
159780	Fee-for-Service	1689061293	1689061293	1	1	HAWKINS, JOHN A DO MD	7/1/2018	207P00000X	NA	Other	026	PHYSICIANS	15205	66	Emergency Medicine (Urgent Care)	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
159832	Fee-for-Service	1376669747	1376669747	1	1	HUGHES, ELIZABETH PSYD	3/16/2020	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5656 CANTALOUPE AVENUE	None	VAN NUYS	CA	91401	4712	19	06037	34.17376701	-118.4344729	Los Angeles County
159838	Fee-for-Service	1780034710	1780034710	1	1	HWANG, JOONMYOUNG J	8/10/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 S FIRST ST	STE 1800	BURBANK	CA	91502	1959	19	06037	34.17942444	-118.3096895	Los Angeles County
159846	Fee-for-Service	1215458237	1215458237	1	1	HAJIHA, MOHAMMAD MD	8/11/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149926	34	Urology and Urological Surgery	0	In state provider	None	11370 ANDERSON STREET	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
159915	Fee-for-Service	1508165069	1508165069	1	1	HOSPICE OF ST GEORGE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	415 E HARVARD STREET	STE 101	GLENDALE	CA	91205	4921	19	06037	34.14448348	-118.250604	Los Angeles County
159979	Fee-for-Service	1801089727	1801089727	1	1	HARRIS, RODERICK E MD	2/24/1982	174400000X	NA	Other	026	PHYSICIANS	39701	None	None	0	In state provider	None	645 W OLIVE AVE	STE 320	MERCED	CA	95348	2433	24	06047	37.31939934	-120.4804685	Merced County
159984	Fee-for-Service	1437156627	1437156627	1	1	HELM, STANDIFORD MD	6/8/2021	208VP0014X	NA	Other	026	PHYSICIANS	38246	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
160001	Fee-for-Service	1437573581	1437573581	1	1	HALLS, ANDREW J MD	12/15/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	151033	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
160028	Fee-for-Service	1710066642	1710066642	1	1	HUYNH, NHI YEN MD	3/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	49296	36	Psychiatry	0	In state provider	None	1661 BURDETTE DR	STE N	SAN JOSE	CA	95121	1681	43	06085	37.32012377	-121.8254031	Santa Clara County
160089	Fee-for-Service	1548503717	1548503717	1	1	HESTON, SKYE R MD	7/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156044	01	General Practice	0	In state provider	None	2280 HARRISON AVE	STE B	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
160167	Fee-for-Service	1184663965	1184663965	1	3	HOSPITALIST MEDICINE PHYSICI	10/14/2021	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	IA III	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
160214	Fee-for-Service	1609018662	1609018662	1	1	HOSAMANI, POONAM L MD	8/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121030	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
160260	Fee-for-Service	1043397482	1043397482	1	1	HAGE, CHRISTOPHER N MD	5/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90308	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
160265	Fee-for-Service	1710142062	1710142062	1	1	HINDS, NATHAN D OD	10/28/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
160268	Fee-for-Service	1740423250	1740423250	1	1	HAKKI, NASER K MD	10/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	5400 SOUTH RAINBOW BLVD	None	LAS VEGAS	NV	89118	1859	00	None	36.090072	-115.2405585	Clark County
160286	Fee-for-Service	1629546460	1629546460	1	1	HEAD-LYONS, ROSLYN E LCSW	2/20/2019	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
160313	Fee-for-Service	1770867467	1770867467	1	1	HENDRIX, ALANA K LMFT	10/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19321 GROVE COMMUNITY DR	None	RIVERSIDE	CA	92508	8113	33	06065	33.90021098	-117.3250665	Riverside County
160323	Fee-for-Service	1770624363	1770624363	1	1	HATHORN, REBECCA E LCSW	5/2/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	26832	-	NOT APPLICABLE	0	In state provider	None	22245 MAIN STREET	SUITE 200	HAYWARD	CA	94541	4028	01	06001	37.67674766	-122.0863181	Alameda County
160338	Fee-for-Service	1114960937	1114960937	1	1	HOU, PEN MD	12/17/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	172450	08	Family Practice	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
160374	Fee-for-Service	1295782480	1295782480	1	1	HUYETTE, DAVID MD	1/2/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	12490 BUSINESS CENTER DR	200	VICTORVILLE	CA	92395	5833	36	06071	34.47770869	-117.2869719	San Bernardino County
160447	Fee-for-Service	1851604847	1851604847	1	1	HASAN, MARIAM S MD	9/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124405	41	Internal Medicine	0	In state provider	None	225 NORTH JACKSON AVENUE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
160451	Fee-for-Service	1184663965	1184663965	1	3	HOSPITALIST MEDICINE PHYSICI	3/13/2024	193200000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	IA III	225 NORTH JACKSON	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
160454	Fee-for-Service	1912319880	1912319880	1	1	HAUNSCHILD, CAROLYN MD	5/4/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	141902	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
160457	Fee-for-Service	1093862989	1093862989	1	1	HIMMELFARB, ERIC A MD	3/3/2021	207ZP0102X	NA	Other	026	PHYSICIANS	107200	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
160461	Fee-for-Service	1659325629	1659325629	1	1	HCA HEALTH ONE LLC	8/28/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	10101 RIDGEGATE PKWY	None	LANE TREE	CO	80124	5522	00	None	39.529305	-104.870799	Douglas County
160481	Fee-for-Service	1699540880	1699540880	1	1	HUYNH, ANN NP	2/24/2025	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
160484	Fee-for-Service	1720150733	1720150733	1	1	HANDS, GORDON R 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
160543	Fee-for-Service	1659667178	1659667178	1	1	HASSAN, KAMRAN MD	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130938	41	Internal Medicine	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
160551	Fee-for-Service	1891177226	1891177226	1	1	HOCKMAN, LUKAS MD	7/1/2020	208800000X	NA	Other	026	PHYSICIANS	168832	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
160606	Fee-for-Service	1639410343	1639410343	1	1	HAGHIGHAT, ROYA LMFT	5/8/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 NEWPORT CENTER DR	SUITE 202	NEWPORT BEACH	CA	92660	7503	30	06059	33.61264489	-117.8745305	Orange County
160616	Fee-for-Service	1023004652	1023004652	1	1	HOWERTON, PRESTON DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2305 S HIGHWAY 65	None	MARSHALL	MO	65340	3702	00	None	39.090222	-93.214935	Saline County
160651	Fee-for-Service	1316137904	1316137904	1	1	HIRSCHLER, NORA V MD	3/6/2008	207ZB0001X	NA	Other	026	PHYSICIANS	50083	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
160667	Fee-for-Service	1417049792	1417049792	1	1	HADIWIDJAJA, ANGELINE S	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67186	40	Pediatrics	0	In state provider	None	815 POLLARD RD	None	LOS GATOS	CA	95032	1438	43	06085	37.26214754	-121.9701986	Santa Clara County
160680	Fee-for-Service	1154341626	1154341626	1	1	HOVANESIAN, HAROUTUN MD	7/1/2000	207W00000X	NA	Ophthalmology	026	PHYSICIANS	67565	18	Ophthalmology	0	In state provider	None	409 N CENTRAL AVE	None	GLENDALE	CA	91203	2001	19	06037	34.15248444	-118.2579448	Los Angeles County
160685	Fee-for-Service	1235196411	1235196411	1	1	HYBARGER, CHAD K PHD	8/25/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7171 ALVARADO RD	STE 100A	LA MESA	CA	91942	8996	37	06073	32.77267798	-117.0445155	San Diego County
160735	Fee-for-Service	1255435301	1255435301	1	1	HARMATZ, PAUL MD	7/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	35255	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
160745	Fee-for-Service	1841529757	1841529757	1	1	HILLYER, SHAHAB P MD	8/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120045	34	Urology and Urological Surgery	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	1407	15	06029	35.382555	-118.970757	Kern County
160751	Fee-for-Service	1659325629	1659325629	1	1	HCA HEALTH ONE LLC	8/28/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	10101 RIDGEGATE PKWY	None	LANE TREE	CO	80124	5522	00	None	39.529305	-104.870799	Douglas County
160756	Fee-for-Service	1801664487	1801664487	1	1	HIGHLAND INDUSTRIES	4/25/2024	261QM0850X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	110 S MAIN AVE	None	FALLBROOK	CA	92028	2847	37	06073	33.38179393	-117.2513459	San Diego County
160826	Fee-for-Service	1659571198	1659571198	1	1	HANNA, JACQUELINE CRNA	6/6/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
160835	Fee-for-Service	1659667178	1659667178	1	1	HASSAN, KAMRAN MD	9/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	130938	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
160841	Fee-for-Service	1508821166	1508821166	1	1	HOME OF GUIDING HANDS	12/14/1982	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	518 ROBERTA AVE	None	EL CAJON	CA	92021	6316	37	06073	32.800851	-116.9417175	San Diego County
160843	Fee-for-Service	1588827422	1588827422	1	1	HAGEN, DANIEL R. DO	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 GLENN HENDREN DR	None	LIBERTY	MO	64068	9625	00	None	39.278767	-94.42102759	Clay County
160846	Fee-for-Service	1689019804	1689019804	1	1	HUR, JANE MD	5/24/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	186157	None	None	0	In state provider	None	215 W JANSS ROAD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
160871	Fee-for-Service	1467474205	1467474205	1	1	HSU, BEN M MD	2/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55488	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
160879	Fee-for-Service	1154375541	1154375541	1	1	HONIGMAN, DANIEL MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38407	01	General Practice	0	In state provider	None	326 N SOTO ST	None	LOS ANGELES	CA	90033	1815	19	06037	34.04755972	-118.2072992	Los Angeles County
160953	Fee-for-Service	1043336084	1043336084	2	1	HEALTHRIGHT 360	7/20/2016	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2650 E FOOTHILL BLVD	SUITE 100 & 200	PASADENA	CA	91107	3439	19	06037	34.14982934	-118.0957459	Los Angeles County
160957	Fee-for-Service	1679795082	1679795082	1	1	HWA,LINDA MD	8/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82978	30	Radiology	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
160997	Fee-for-Service	1184759797	1184759797	1	1	HSU, JAMES T MD	12/12/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	115666	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92255	4267	33	06065	33.838623	-116.542737	Riverside County
161049	Fee-for-Service	1417022559	1417022559	1	1	HALL, JENNIFER E DO	12/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	1200 N BEAVER STREET	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
161065	Fee-for-Service	1730716291	1730716291	1	1	HUANG, ANDREW	8/25/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	3772 HOWE ST	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
161109	Fee-for-Service	1467620005	1467620005	1	1	HOYE, STEPHEN L MD	6/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	None	LAS VEGAS	NV	89106	4842	00	None	36.16257648	-115.170696	Clark County
161119	Fee-for-Service	1386751576	1386751576	1	1	HIRANO, LANCE T MD	9/1/1994	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	76488	41	Internal Medicine	0	In state provider	None	2701 ATLANTIC AVE	None	LONG BEACH	CA	90806	2701	19	06037	33.807735	-118.1850575	Los Angeles County
161138	Fee-for-Service	1619976784	1619976784	1	1	HARRIMAN, IRMA MD	12/1/2003	207RN0300X	NA	Nephrology	026	PHYSICIANS	34846	41	Internal Medicine	0	In state provider	None	14624 SHERMAN WAY	STE 103	VAN NUYS	CA	91405	2287	19	06037	34.20078354	-118.450843	Los Angeles County
161149	Fee-for-Service	1679012611	1679012611	1	1	HU, ALISON W PSY	4/27/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 JUNIPERO SERRA BLVD	SUITE 650	DALY CITY	CA	94014	3891	41	06081	37.70124814	-122.4706974	San Mateo County
161151	Fee-for-Service	1306960562	1306960562	1	1	HERMOSILLO, LESLIE G LCSW	8/20/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
161166	Fee-for-Service	1154375541	1154375541	1	1	HONIGMAN, DANIEL MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38407	08	Family Practice	0	In state provider	None	326 N SOTO ST	None	LOS ANGELES	CA	90033	1815	19	06037	34.04755972	-118.2072992	Los Angeles County
161173	Fee-for-Service	1871911917	1871911917	1	1	HAWY, EMAN E MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138906	13	Neurology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
161176	Fee-for-Service	1669891503	1669891503	1	1	HODROGE, SAMMY MD	3/28/2019	207P00000X	NA	Other	026	PHYSICIANS	153624	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
161188	Fee-for-Service	1629086970	1629086970	1	1	HANGER P & O WEST INC	3/26/2002	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3663 N LAUGHLIN RD	#103	SANTA ROSA	CA	95403	1027	49	06097	38.51049551	-122.800387	Sonoma County
161197	Fee-for-Service	1700917721	1700917721	1	1	HEDAYATI, BEHZAD MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55151	30	Radiology	0	In state provider	None	3033 W ORANGE AVE	None	ANAHEIM	CA	92804	3156	30	06059	33.82476552	-117.994914	Orange County
161266	Fee-for-Service	1235217910	1235217910	1	1	HERNANDO, GARZON	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	74186	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
161303	Fee-for-Service	1306198296	1306198296	1	1	HEALTH AND LIFE ORGANIZATION	10/16/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INCORPORATED	2138 DEL PASO BLVD	None	SACRAMENTO	CA	95815	3002	34	06067	38.609811	-121.4510265	Sacramento County
161338	Fee-for-Service	1417022559	1417022559	1	1	HALL, JENNIFER E DO	12/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	1200 N BEAVER STREET	None	FLAGSTAFF	AZ	86001	3118	00	None	35.208594	-111.645099	Coconino County
161405	Fee-for-Service	1386751576	1386751576	1	1	HIRANO, LANCE T MD	9/1/1994	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	76488	77	Infectious Disease	0	In state provider	None	2701 ATLANTIC AVE	None	LONG BEACH	CA	90806	2701	19	06037	33.807735	-118.1850575	Los Angeles County
161414	Fee-for-Service	1487086724	1487086724	1	1	HANSON, MARTIN PSYD	4/17/2020	103T00000X	NA	Mental Health Outpatient Services	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
161437	Fee-for-Service	1174186118	1174186118	1	1	HOLSCLAW, MATTHEW E MD	7/1/2023	207L00000X	NA	Other	026	PHYSICIANS	178281	None	None	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
161444	Fee-for-Service	1407149495	1407149495	1	1	HARTMAN, STUART J DO	6/10/2019	207R00000X	NA	Other	026	PHYSICIANS	None	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
161449	Fee-for-Service	1427366244	1427366244	1	2	HALQUIST, RYAN M PSYD	10/20/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	27221	-	NOT APPLICABLE	0	In state provider	None	1695 N SUNRISE WAY	102	PALM SPRINGS	CA	92262	3701	33	06065	33.844239	-116.5282075	Riverside County
161460	Fee-for-Service	1457077760	1457077760	1	1	HOLLAND, CARISSA D NP	9/26/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8150 HAGEMAN RD	None	BAKERSFIELD	CA	93312	1959	15	06029	35.40166449	-119.0933415	Kern County
161462	Fee-for-Service	1871911917	1871911917	1	1	HAWY, EMAN E MD	8/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	138906	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
161536	Fee-for-Service	1952513392	1952513392	1	1	HSU, HOWARD CHIA-HAO MD	4/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105927	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
161545	Fee-for-Service	1750337341	1750337341	1	1	HUYNH, PAUL T MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8449	45	Nephrology (Renal-Kidney)	0	In state provider	None	4361 LATHAM ST	STE 150	RIVERSIDE	CA	92501	1768	33	06065	34.00212634	-117.3743133	Riverside County
161550	Fee-for-Service	1952447914	1952447914	1	1	HO, HAI N MD	7/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	77373	01	General Practice	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
161552	Fee-for-Service	1629000880	1629000880	1	1	HALPERN, SAMUEL E MD	1/1/1980	207RA0000X	NA	Pediatric Primary Care	026	PHYSICIANS	28976	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
161560	Fee-for-Service	1164157400	1164157400	1	1	HITCHCOCK, VASILIKI E PT	3/13/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3760 CONVOY STREET	100	SAN DIEGO	CA	92111	3743	37	06073	32.81197521	-117.1531278	San Diego County
161571	Fee-for-Service	1760448856	1760448856	1	1	HUANG, QIN MD	8/17/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	76271	None	None	0	In state provider	None	200 NORTH ROBERSTON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
161590	Fee-for-Service	1306198296	1306198296	1	1	HEALTH AND LIFE ORGANIZATION	10/16/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INCORPORATED	2138 DEL PASO BLVD	None	SACRAMENTO	CA	95815	3002	34	06067	38.609811	-121.4510265	Sacramento County
161592	Fee-for-Service	1639343866	1639343866	1	1	HALL, JEANINE E MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124840	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
161604	Fee-for-Service	1710019328	1710019328	1	1	HERNANDEZ-ESPINOZA, AMANDA	2/21/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
161627	Fee-for-Service	1134738040	1134738040	1	1	HO, ELAINE L NP	1/9/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	500 CAPITOL MALL	SUITE 2350	SACRAMENTO	CA	95814	4737	34	06067	38.578059	-121.501422	Sacramento County
161631	Fee-for-Service	1871743880	1871743880	1	1	HARRIS, CATHERINE G PSYD	1/12/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2547 W SHAW AVE	STE 117	FRESNO	CA	93711	3321	10	06019	36.80804173	-119.8385565	Fresno County
161638	Fee-for-Service	1225032576	1225032576	2	1	HANGER PROSTHETICS & ORTHOTI	5/19/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	351 HOSPITAL RD	SUITE 106	NEWPORT BEACH	CA	92663	3509	30	06059	33.62579141	-117.9299554	Orange County
161662	Fee-for-Service	1871522664	1871522664	1	1	HORNBECK, LAMONT W MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	51734	07	Dermatology	0	In state provider	None	729 SUNRISE AVE	# 700	ROSEVILLE	CA	95661	4565	31	06061	38.73444822	-121.2720033	Placer County
161700	Fee-for-Service	1457844318	1457844318	1	1	HILL COUNTRY COMM CLINIC	7/3/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1401 GOLD STREET	SUITE A	REDDING	CA	96001	1937	45	06089	40.57969704	-122.3893077	Shasta County
161705	Fee-for-Service	1407899909	1407899909	1	1	HAAK, RICHARD B MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	63026	30	Radiology	0	In state provider	None	101 PARK AVE	None	MODESTO	CA	95354	0556	50	06099	37.64601201	-120.9989475	Stanislaus County
161742	Fee-for-Service	1134329345	1134329345	1	1	HANADA, SATOSHI MD	10/25/2021	207L00000X	NA	Other	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
161751	Fee-for-Service	1861099459	1861099459	1	1	HEBER ELEMENTARY SCHOOL	7/1/2021	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	1052 HEBER AVE	None	HEBER	CA	92249	9759	13	06025	32.7271516	-115.5299681	Imperial County
161762	Fee-for-Service	1386263648	1386263648	1	1	HAN, JOY PT	7/19/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3100 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	01	06001	37.70453535	-121.8586496	Alameda County
161768	Fee-for-Service	1700893773	1700893773	2	1	HOOVER, KIMBERLY CA	1/31/1991	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	2852 ADAMS AVE	None	SAN DIEGO	CA	92116	1407	37	06073	32.76289804	-117.132443	San Diego County
161778	Fee-for-Service	1902862121	1902862121	1	1	HULL, ANDREW D MD	10/31/1994	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53578	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
161782	Fee-for-Service	1225044472	1225044472	1	1	HUANG, YUAN 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	44405 WOODWARD AVE	None	PONTIAC	MI	48341	5023	00	None	42.61531898	-83.27548255	Oakland County
161799	Fee-for-Service	1548765977	1548765977	1	1	HELM, TRAVIS A MD	11/1/2020	207P00000X	NA	Other	026	PHYSICIANS	166534	None	None	0	In state provider	None	1303 EAST HERNDON AVENUE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
161827	Fee-for-Service	1356772552	1356772552	1	1	HASHEMI, MICHAEL B	6/15/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9353 IMPERIAL HIGHWAY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
161830	Fee-for-Service	1750337341	1750337341	1	1	HUYNH, PAUL T MD	7/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8449	41	Internal Medicine	0	In state provider	None	4361 LATHAM ST	STE 150	RIVERSIDE	CA	92501	1768	33	06065	34.00212634	-117.3743133	Riverside County
161952	Fee-for-Service	1659078384	1659078384	1	1	HOBSON, SHANNON MARIE	5/17/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	12804 SCHOLARLY WAY	None	RANCHO CORDOVA	CA	95742	6927	34	06067	38.549781	-121.19184	Sacramento County
161979	Fee-for-Service	1154334498	1154334498	1	1	HEBREW HOME FOR THE	1/1/1966	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	AGED DISABLED	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	38	06075	37.72851602	-122.4296638	San Francisco County
161986	Fee-for-Service	1457844318	1457844318	1	1	HILL COUNTRY COMM CLINIC	7/3/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1401 GOLD STREET	SUITE A	REDDING	CA	96001	1937	45	06089	40.57969704	-122.3893077	Shasta County
161998	Fee-for-Service	1285673699	1285673699	1	1	HA, TUAN X MD	6/4/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	131942	30	Radiology	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
162047	Fee-for-Service	1750529210	1750529210	1	1	HEALTH GUARD INLAND LLC	12/29/2008	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	268 MCARTHUR WAY	None	UPLAND	CA	91786	5615	36	06071	34.097031	-117.6793105	San Bernardino County
162071	Fee-for-Service	1811942568	1811942568	1	1	HEMPHILL III, JESSE C MD	12/31/1993	2084N0400X	NA	Neurology	026	PHYSICIANS	74045	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	# A887	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
162073	Fee-for-Service	1558758755	1558758755	1	1	HART, KRISTINA M DO	5/28/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	15981	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
162087	Fee-for-Service	1598296683	1598296683	1	1	HADAYA, JOSEPH E MD	3/10/2020	208600000X	NA	General Surgery	026	PHYSICIANS	160992	02	General Surgery	0	In state provider	None	8110 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21850103	-118.4310944	Los Angeles County
162108	Fee-for-Service	1114459427	1114459427	1	1	HEMATI, KAVEH K MD	6/6/2022	207L00000X	NA	Other	026	PHYSICIANS	160070	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
162112	Fee-for-Service	1790758647	1790758647	1	1	HONG, HOON GI MD	6/1/1994	207R00000X	NA	Other	026	PHYSICIANS	53118	41	Internal Medicine	0	In state provider	None	6301 BEACH BLVD	STE 111	BUENA PARK	CA	90621	4030	30	06059	33.86880928	-117.9983013	Orange County
162121	Fee-for-Service	1568695427	1568695427	1	1	HAAS, MICHAEL W LMFT	4/11/2016	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2702 CLAYTON ROAD	None	CONCORD	CA	94519	2789	07	06013	37.97495822	-122.0271497	Contra Costa County
162133	Fee-for-Service	1356520175	1356520175	1	1	HAY, VERONICA LMFT	6/7/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	473 E. CARNEGIE DR.	SUITE 200	SAN BERNARDINO	CA	92408	0000	36	06071	34.0683677	-117.2746246	San Bernardino County
162141	Fee-for-Service	1437183993	1437183993	1	1	HOOVESTOL, DAVID R MD	8/1/1998	207P00000X	NA	Other	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
162147	Fee-for-Service	1316563737	1316563737	1	1	HEALTHCARE HD LLC	6/28/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	1281 SAN CHRISTOPHER DR	None	DUNEDIN	FL	34698	5334	00	None	28.02312882	-82.77102613	Pinellas County
162214	Fee-for-Service	1033845599	1033845599	1	1	HCM MED TRANSPORT	1/30/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	43700 17TH W ST	SUITE #202	LANCASTER	CA	93534	4661	19	06037	34.677063	-118.161233	Los Angeles County
162223	Fee-for-Service	1326022583	1326022583	1	1	HUSHAM P MISHU, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	303 PARKWAY DR NE	None	ATLANTA	GA	30312	1212	00	None	33.76329279	-84.37393322	Fulton County
162229	Fee-for-Service	1457764896	1457764896	1	1	HILL, CYNTHIA L	11/8/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	855 N LARK ELLEN AVENUE	SUITE J	WEST COVINA	CA	91971	1099	19	06037	34.087707	-117.9166385	Los Angeles County
162231	Fee-for-Service	1437238904	1437238904	1	1	HARLAN, GREGORY A MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	77104	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
162239	Fee-for-Service	1659078384	1659078384	1	1	HOBSON, SHANNON MARIE	5/17/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	12804 SCHOLARLY WAY	None	RANCHO CORDOVA	CA	95742	6927	34	06067	38.549781	-121.19184	Sacramento County
162264	Fee-for-Service	1457411878	1457411878	1	1	HENRI LEPIERROT, GENEVA P LM	3/1/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	H SERVICES	2118 P ST	None	SACRAMENTO	CA	95816	5997	34	06067	38.569194	-121.480848	Sacramento County
162275	Fee-for-Service	1508395229	1508395229	1	1	HEISER, SYLVIA P NP	8/27/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1307 WEST SIXTH STREET	105	CORONA	CA	92882	3294	33	06065	33.87790309	-117.589666	Riverside County
162279	Fee-for-Service	1184766750	1184766750	2	1	HELEN L. TAN, RPH, INC	12/26/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	326 N VERMONT AVE	SUITE B	LOS ANGELES	CA	90004	3511	19	06037	34.077159	-118.2916705	Los Angeles County
162324	Fee-for-Service	1780696898	1780696898	1	1	HA, DONG H DO	4/9/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7637	24	Plastic Surgery	0	In state provider	SOCAL PLASTIC SURGERY	1108 S GARFIELD AVE	None	ALHAMBRA	CA	91801	4713	19	06037	34.08235941	-118.12304	Los Angeles County
162328	Fee-for-Service	1104024389	1104024389	1	1	HAAVIK, PAMELA J LMFT	11/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	30706 CARROLL AVENUE	None	HAYWARD	CA	94544	7524	01	06001	37.61800036	-122.0436431	Alameda County
162371	Fee-for-Service	1780081554	1780081554	1	1	HEAVENLY GATES HOSPICE, INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1720 E LOS ANGELES AVE	SUITE 230-232	SIMI VALLEY	CA	93065	2033	56	06111	34.2716455	-118.7653635	Ventura County
162379	Fee-for-Service	1134325467	1134325467	1	1	HEKMAT, ANAHID MD	8/20/2019	2084S0012X	NA	Neurology	026	PHYSICIANS	111687	27	Psychiatry Neurology (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
162381	Fee-for-Service	1770539637	1770539637	1	1	HEART OF LANCASTER REG MED C	1/18/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1500 HIGHLANDS DR	None	LITITZ	PA	17543	7694	00	None	40.13128111	-76.31074292	Lancaster County
162385	Fee-for-Service	1437584646	1437584646	1	1	HERMLE, FELICIA L 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
162394	Fee-for-Service	1083854483	1083854483	1	1	HICKS, RACHEL C MD	9/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106095	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
162416	Fee-for-Service	1346672839	1346672839	1	1	HART, ROSEMARY	10/6/2023	101YM0800X	NA	Other	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
162499	Fee-for-Service	1588657845	1588657845	1	1	HEARING SERVICES CTR INC	11/1/1998	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1101 W TOKAY ST	STE 4	LODI	CA	95240	3808	39	06077	38.12636749	-121.2861105	San Joaquin County
162607	Fee-for-Service	1619155546	1619155546	1	1	HOLL, JONAS M	12/17/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	12062 VALLEY VIEW ST	STE 226	GARDEN GROVE	CA	92845	1738	30	06059	33.78720885	-118.028413	Orange County
162610	Fee-for-Service	1497995401	1497995401	1	1	HARRISON, ALEX MD INC	4/1/2011	193400000X	NA	Other	026	PHYSICIANS	89322	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1510 E MAIN ST	STE 101	SANTA MARIA	CA	93454	4826	42	06083	34.95282793	-120.4100798	Santa Barbara County
162615	Fee-for-Service	1780610196	1780610196	1	1	HYDEN, ELIZABETH C MD	11/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	57456	78	Neoplastic Diseases/Oncology	0	In state provider	None	27800 MEDICAL CENTER RD	STE 160	MISSION VIEJO	CA	92691	6442	30	06059	33.55952733	-117.6645199	Orange County
162618	Fee-for-Service	1023024213	1023024213	1	1	HEATHER N SPIES	12/3/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5019 S WESTERN AVE	None	SIOUX FALLS	SD	57108	5095	00	None	43.498224	-96.748704	Lincoln County
162659	Fee-for-Service	1780081554	1780081554	1	1	HEAVENLY GATES HOSPICE, INC	2/24/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1720 E LOS ANGELES AVE	SUITE 230-232	SIMI VALLEY	CA	93065	2033	56	06111	34.2716455	-118.7653635	Ventura County
162707	Fee-for-Service	1679779441	1679779441	1	1	HANLEY, HEATHER A MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	104858	40	Pediatrics	0	In state provider	None	25845 BARTON ROAD	SUITE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
162710	Fee-for-Service	1942245113	1942245113	1	1	HAKANSSON, MIKAEL K MD	2/16/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	88831	08	Family Practice	0	In state provider	None	533 SESPE AVENUE	STE C	FILLMORE	CA	93015	1942	56	06111	34.4005357	-118.9150097	Ventura County
162723	Fee-for-Service	1700230901	1700230901	1	1	HAN, WOODY MD	7/7/2022	2085N0700X	NA	MRI Provider	026	PHYSICIANS	180191	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
162728	Fee-for-Service	1013338706	1013338706	1	1	HOVSEPYAN, HAYKA MD	8/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132478	41	Internal Medicine	0	In state provider	None	8510 BALBOA BLVD	STE 150	NORTHRIDGE	CA	91325	5810	19	06037	34.224507	-118.5026015	Los Angeles County
162775	Fee-for-Service	1477996122	1477996122	1	1	HENRY, BRANDON A MD	1/28/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	135108	40	Pediatrics	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
162776	Fee-for-Service	1588977318	1588977318	1	1	HOLMES, KRISTEN L LAC	4/22/2020	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
162778	Fee-for-Service	1417478652	1417478652	1	1	HINGORANI, RYAN V MD	9/22/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164613	08	Family Practice	0	In state provider	None	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
162816	Fee-for-Service	1710097175	1710097175	2	1	HYGIEIA HEALTHCARE INC	2/28/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3801 KATELLA AVE	STE 120	LOS ALAMITOS	CA	90720	3360	30	06059	33.80318951	-118.066068	Orange County
162825	Fee-for-Service	1952826307	1952826307	1	1	HARVEY, BRIANNA LMFT	10/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1739 GARDEN ST.	APT 1	SAN LUIS OBISPO	CA	93401	5275	40	06079	35.27426514	-120.6589394	San Luis Obispo County
162887	Fee-for-Service	1699820589	1699820589	2	1	HORSNYDER PHARMACY INC	6/6/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1226A SOQUEL AVE	None	SANTA CRUZ	CA	95062	2157	44	06087	36.98004621	-122.0098944	Santa Cruz County
162896	Fee-for-Service	1497995401	1497995401	1	1	HARRISON, ALEX MD INC	2/28/2012	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1510 E MAIN ST	STE 101	SANTA MARIA	CA	93454	4826	42	06083	34.95282793	-120.4100798	Santa Barbara County
162906	Fee-for-Service	1780610196	1780610196	1	1	HYDEN, ELIZABETH C MD	11/8/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	57456	30	Radiology	0	In state provider	None	27800 MEDICAL CENTER RD	STE 160	MISSION VIEJO	CA	92691	6442	30	06059	33.55952733	-117.6645199	Orange County
162928	Fee-for-Service	1598360653	1598360653	1	1	HEAD, BRANDY M LCSW	9/15/2023	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
162932	Fee-for-Service	1902840176	1902840176	1	1	HEWITT, JOHN W	2/2/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	31314	01	General Practice	0	In state provider	None	5176 HILL RD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
162956	Fee-for-Service	1659624237	1659624237	1	1	HUGHES, JENNIFER L PHD	12/3/2012	No Taxonomy Provided	NA	None	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
162964	Fee-for-Service	1386831436	1386831436	1	1	HAMMOND, CARRIE L LMFT	9/13/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2101 N GLENOAKS BLVD	None	BURBANK	CA	91504	2828	19	06037	34.19790492	-118.3264418	Los Angeles County
162966	Fee-for-Service	1033798053	1033798053	1	1	HAK, SOKKHA DO	10/30/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22984	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
163068	Fee-for-Service	1194986109	1194986109	1	1	HUANG, NELSON MD	6/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LANE	None	LAS VEGAS	NV	89119	5168	00	None	36.163269	-115.1654465	Clark County
163097	Fee-for-Service	1831378157	1831378157	1	1	HILEN, PETER E LMFT	8/30/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47494	-	NOT APPLICABLE	0	In state provider	None	265 S ANITA DR	202	ORANGE	CA	92868	3346	30	06059	33.78499409	-117.8811837	Orange County
163136	Fee-for-Service	1902994932	1902994932	1	1	HUANG, JIAKANG 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 N WILMOT RD	None	TUCSON	AZ	85711	2602	00	None	32.227209	-110.8556595	Pima County
163142	Fee-for-Service	1689901746	1689901746	2	1	HONG, ALFRED MD	6/28/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	102767	09	Gynecology (D.O. only)	0	In state provider	None	3208 SANTA ANITA AVE	200	EL MONTE	CA	91733	1304	19	06037	34.06628897	-118.0425098	Los Angeles County
163150	Fee-for-Service	1679687982	1679687982	1	1	HO, KIM C OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 WILLOW RD	BLDG 334	MENLO PARK	CA	94025	2539	41	06081	37.466676	-122.160384	San Mateo County
163171	Fee-for-Service	1073288999	1073288999	1	1	HERNANDEZ, CHRISTOPHER PT	4/19/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1520 BROOKHOLLOW DR.	37	SANTA ANA	CA	92705	5429	30	06059	33.7145683	-117.8475378	Orange County
163222	Fee-for-Service	1902840176	1902840176	1	1	HEWITT, JOHN W	2/2/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	31314	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5176 HILL RD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
163334	Fee-for-Service	1740742667	1740742667	1	1	HYATT, JONATHAN	2/18/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	1	Border provider	None	2450 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2179	00	None	36.15900951	-115.175853	Clark County
163349	Fee-for-Service	1346251451	1346251451	1	1	HARRINGTON, JOHN C	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	45573	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
163351	Fee-for-Service	1164186979	1164186979	1	1	HILL, ZACHARY NP	2/15/2023	363LA2100X	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
163365	Fee-for-Service	1316425655	1316425655	1	1	HUTCHINSON, DEBRA K LMFT	8/12/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4000 BARRANCA PKWY	250	IRVINE	CA	92604	4710	30	06059	33.68357129	-117.8077084	Orange County
163392	Fee-for-Service	1518951300	1518951300	1	33	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16305 SAND CANYON AVE	SUITE 160	IRVINE	CA	92618	3790	30	06059	33.66201662	-117.7737316	Orange County
163398	Fee-for-Service	1255967063	1255967063	2	1	HEALTHY MIND & BRAIN CENTER	6/3/2021	207ZN0500X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	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
163409	Fee-for-Service	1528439395	1528439395	1	1	HELMER DIALYSIS LLC	3/13/2017	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1140 S BEN MADDOX WAY	None	VISALIA	CA	93292	3643	54	06107	36.320391	-119.2753215	Tulare County
163411	Fee-for-Service	1235425232	1235425232	1	1	HERNANDEZ, RUDY M LCSW	6/26/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
163478	Fee-for-Service	1255658068	1255658068	1	1	HUVERSERIAN, LINDA J MD	8/19/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120212	08	Family Practice	0	In state provider	None	26357 MCBEAN PARKWAY	None	VALENCIA	CA	91355	4488	19	06037	34.41257644	-118.5597683	Los Angeles County
163482	Fee-for-Service	1629496690	1629496690	1	1	HART, CASUARINA MD	1/27/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	156015	15	Obstetrics (D.O. only)	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
163491	Fee-for-Service	1366627788	1366627788	1	1	HURWITZ, JOHN PHILLIP MD APC	3/2/2015	207R00000X	NA	Other	026	PHYSICIANS	6856	41	Internal Medicine	0	In state provider	None	3751 MONTGOMERY DR	None	SANTA ROSA	CA	95405	5214	49	06097	38.453472	-122.6758185	Sonoma County
163495	Fee-for-Service	1649404534	1649404534	1	1	HABIBI, MEHDI MD INC	3/20/2009	193400000X	NA	Other	026	PHYSICIANS	39878	14	Neurological Surgery	0	In state provider	None	1300 N VERMONT AVE	STE 504	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
163524	Fee-for-Service	1578630570	1578630570	1	2	HASU, DOUGLAS H MD	5/26/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74126	36	Psychiatry	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
163547	Fee-for-Service	1871767244	1871767244	1	1	HWANG, JOSEPH KC MD	7/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97997	66	Emergency Medicine (Urgent Care)	0	In state provider	None	43830 N 10TH ST WEST	None	LANCASTER	CA	93534	4826	19	06037	34.67913961	-118.1478725	Los Angeles County
163575	Fee-for-Service	1063753010	1063753010	1	1	HEART 2 HEART HOSPICE CARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	2908 N NAOMI STREET	STE A	BURBANK	CA	91502	1624	19	06037	34.2043946	-118.339966	Los Angeles County
163623	Fee-for-Service	1659809267	1659809267	1	1	HAWKES O-SIDE 1 LLC	9/2/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2108 S EL CAMINO REAL	None	OCEANSIDE	CA	92054	6203	37	06073	33.19050245	-117.3279917	San Diego County
163625	Fee-for-Service	1215904099	1215904099	1	1	HARTFORD, STEVEN L MD	8/31/1992	174400000X	NA	Other	026	PHYSICIANS	45590	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1818 VERDUGO BLVD	STE 401	GLENDALE	CA	91208	1421	19	06037	34.20560177	-118.216054	Los Angeles County
163660	Fee-for-Service	1669435350	1669435350	1	1	HOCH, DANA F MD	1/31/1996	207R00000X	NA	Other	026	PHYSICIANS	55698	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
163666	Fee-for-Service	1497390462	1497390462	1	1	HAMP, EMILY S LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
163705	Fee-for-Service	1285084509	1285084509	1	1	HERITAGE BOARD & CARE INC	11/17/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1509 E 4TH ST	None	LONG BEACH	CA	90802	1806	19	06037	33.77174451	-118.1728488	Los Angeles County
163720	Fee-for-Service	1275858722	1275858722	1	1	HUANG, DAISY Q MD	5/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133856	30	Radiology	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
163731	Fee-for-Service	1730290826	1730290826	1	1	H C R ENTERPRISES INC FKA	1/1/1979	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	R & S MEDICAL ENTERPRISE	12401 SLAUSON AVENUE	None	WHITTIER	CA	90606	2830	19	06037	33.96012356	-118.0526509	Los Angeles County
163735	Fee-for-Service	1043709181	1043709181	1	1	HECZKO, JOSHUA MD	5/15/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	176322	None	None	0	In state provider	None	11370 ANDERSON ST	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
163780	Fee-for-Service	1679151344	1679151344	1	1	HEALTHY CA HOME HEALTH	9/28/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 356	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
163781	Fee-for-Service	1881642163	1881642163	1	1	HAY, WILLIAM H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
163803	Fee-for-Service	1710003967	1710003967	1	1	HRINDA, YVONNE M CRNA	6/15/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
163804	Fee-for-Service	1285153098	1285153098	1	1	HAN, RYAN CHRISTOPHER R CRNA	3/18/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	15	06029	35.39052148	-119.0070765	Kern County
163810	Fee-for-Service	1386673895	1386673895	1	1	HUANG, JOSEPH OD	9/9/2003	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	421 PIONEER AVE	STE B	WOODLAND	CA	95776	4948	57	06113	38.6759259	-121.7468988	Yolo County
163850	Fee-for-Service	1073940680	1073940680	1	1	HAYNES, ADAM L LCSW	9/15/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5117 MOUNT ROYAL	None	LOS ANGELES	CA	90041	1331	19	06037	34.14009233	-118.2034541	Los Angeles County
163859	Fee-for-Service	1285838821	1285838821	1	1	HOFFMANN, THASJA S LMFT	11/7/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	49366	-	NOT APPLICABLE	0	In state provider	None	1433 S ROBERTSON BLVD	None	LOS ANGELES	CA	90035	3414	19	06037	34.05373818	-118.3839685	Los Angeles County
163860	Fee-for-Service	1407880073	1407880073	1	1	HAHN, HYOJOON P MD	7/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	60353	30	Radiology	0	In state provider	None	14860 ROSCOE BLVD	STE 100	PANORAMA CITY	CA	91402	4687	19	06037	34.2214515	-118.4573205	Los Angeles County
163861	Fee-for-Service	1679556997	1679556997	1	1	HALL, CYNTHIA D MD	9/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	83721	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
163864	Fee-for-Service	1063753010	1063753010	1	1	HEART 2 HEART HOSPICE CARE	11/20/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	2908 N NAOMI STREET	STE A	BURBANK	CA	91502	1624	19	06037	34.2043946	-118.339966	Los Angeles County
163883	Fee-for-Service	1134238223	1134238223	1	1	HOLLAND, JENNIFER L MFT	1/15/2019	No Taxonomy Provided	NA	None	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
163895	Fee-for-Service	1033390331	1033390331	1	1	HATFIELD, TAMERA J MD	9/2/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	94383	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
163923	Fee-for-Service	1275774374	1275774374	1	1	HU, RENA MD	5/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	106531	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
163926	Fee-for-Service	1427545201	1427545201	1	1	HERNANDEZ, MAURICIO MD	9/22/2023	207L00000X	NA	Other	026	PHYSICIANS	167478	None	None	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
163932	Fee-for-Service	1295990216	1295990216	1	1	HAMILTON, HAYDEN R MD	12/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	146152	25	Physical Medicine and Rehabilitation	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
163948	Fee-for-Service	1598839649	1598839649	1	1	HANGER PROSTHETICS & ORTHOTI	12/1/1998	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	18250 ROSCOE BLVD	SUITE 250	NORTHRIDGE	CA	91325	4226	19	06037	34.22076142	-118.5313223	Los Angeles County
163968	Fee-for-Service	1770825275	1770825275	1	1	HAZLETON, KEITH MD	9/25/2023	2080T0004X	NA	Gastroenterology	026	PHYSICIANS	190821	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
163975	Fee-for-Service	1245320027	1245320027	1	1	HUSAIN, ISHRAT MD	2/8/2015	207N00000X	NA	Dermatology	026	PHYSICIANS	39629	07	Dermatology	0	In state provider	None	7365 CARNELIAN ST	STE 137	RANCHO CUCAMONGA	CA	91730	1100	36	06071	34.12038413	-117.6160525	San Bernardino County
164014	Fee-for-Service	1043356082	1043356082	1	1	HOH, ARLEN R MD	5/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37673	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
164063	Fee-for-Service	1255374419	1255374419	1	1	HONG, ERNEST C MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	22	Pathology (M.D. only)	1	Border provider	None	77 PRINGLE WAY	None	RENO	NV	89502	1474	00	None	39.52484706	-119.7951825	Washoe County
164086	Fee-for-Service	1003033309	1003033309	1	1	HAVEN, DEBBRA M PHD	4/26/2023	103T00000X	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
164115	Fee-for-Service	1295936615	1295936615	1	1	HONDA, STEPHAN T MD	2/8/2015	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	69860	08	Family Practice	0	In state provider	None	2301 W EL SEGUNDO BLVD	None	HAWTHORNE	CA	90250	3315	19	06037	33.91648639	-118.3186099	Los Angeles County
164158	Fee-for-Service	1366488801	1366488801	1	1	HUNG, CHRISTINE MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	69918	40	Pediatrics	0	In state provider	None	1295 E HILLSDALE BLVD	None	FOSTER CITY	CA	94404	1214	41	06081	37.56929845	-122.26533	San Mateo County
164164	Fee-for-Service	1578578944	1578578944	1	1	HEINEMANN, FRANCIS S MD	9/25/1995	207ZP0102X	NA	Other	026	PHYSICIANS	65741	22	Pathology (M.D. only)	0	In state provider	None	301 N NEWPORT BLVD	None	NEWPORT BEACH	CA	92663	4120	30	06059	33.6242782	-117.9284249	Orange County
164171	Fee-for-Service	1528407814	1528407814	1	1	HASAN, ZAINAB MD	2/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142945	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
164207	Fee-for-Service	1528085594	1528085594	1	1	HIDAKA, MISA	3/1/1999	207R00000X	NA	Other	026	PHYSICIANS	65233	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
164234	Fee-for-Service	1770136426	1770136426	1	1	HMK ELECTRIC INC	7/9/2020	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	9375 FERON	STE B	RANCHO CUCAMONGA	CA	91730	4561	36	06071	34.09323458	-117.6000898	San Bernardino County
164236	Fee-for-Service	1326342189	1326342189	1	1	HOLANOV, MARGARET LCSW	7/21/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	601 E DAILY DR	210	CAMARILLO	CA	93010	5806	56	06111	34.21906637	-119.0621709	Ventura County
164277	Fee-for-Service	1821526138	1821526138	1	1	HINDOYAN, RITA H MD	12/23/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	165101	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
164305	Fee-for-Service	1043356082	1043356082	1	1	HOH, ARLEN R MD	5/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37673	38	Geriatrics	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
164327	Fee-for-Service	1952467557	1952467557	1	1	HITTENBERGER, DREW A	8/1/1990	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	181 LYNCH CREEK WAY	#101	PETALUMA	CA	94954	2388	49	06097	38.25155449	-122.6349373	Sonoma County
164337	Fee-for-Service	1225472228	1225472228	1	2	HOOFT, ANNEKA	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	132136	40	Pediatrics	0	In state provider	None	3020 CHILDRENS WAY	MD5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
164339	Fee-for-Service	1730332784	1730332784	1	1	HADEN, WILLIAM C LMFT	7/2/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1125 MISSOURI ST	STE 101	FAIRFIELD	CA	94533	6012	48	06095	38.24811048	-122.047884	Solano County
164342	Fee-for-Service	1639287071	1639287071	1	1	HIRSCH, GREGORY L MD	1/1/1982	207RP1001X	NA	Pulmonology	026	PHYSICIANS	40467	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
164385	Fee-for-Service	1669708186	1669708186	1	1	HUANG, JACK Y MD	11/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121806	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
164387	Fee-for-Service	1821099359	1821099359	1	1	HOANG, KHOI N MD	11/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63481	45	Nephrology (Renal-Kidney)	0	In state provider	None	2505 SAMARITAN DR	STE 405	SAN JOSE	CA	95124	4013	43	06085	37.25111447	-121.9483395	Santa Clara County
164399	Fee-for-Service	1568483105	1568483105	1	1	HO, TONY C MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62782	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
164403	Fee-for-Service	1295936615	1295936615	1	1	HONDA, STEPHAN T MD	2/8/2015	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	69860	01	General Practice	0	In state provider	None	2301 W EL SEGUNDO BLVD	None	HAWTHORNE	CA	90250	3315	19	06037	33.91648639	-118.3186099	Los Angeles County
164414	Fee-for-Service	1952319055	1952319055	1	1	HERTZKA, ROBERT E MD	8/31/1989	207L00000X	NA	Other	026	PHYSICIANS	52030	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
164421	Fee-for-Service	1568572592	1568572592	1	1	HTUT, MYO MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78720	41	Internal Medicine	0	In state provider	None	2260 E PALMDALE BLVD	STE G-I	PALMDALE	CA	93550	4952	19	06037	34.58008951	-118.0884915	Los Angeles County
164465	Fee-for-Service	1316031461	1316031461	1	1	HUNDAL, TALMINDER S	10/31/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	45102	08	Family Practice	0	In state provider	None	1401 SPANOS CT	STE 106	MODESTO	CA	95355	2811	50	06099	37.66975543	-120.9724048	Stanislaus County
164486	Fee-for-Service	1801110481	1801110481	1	1	HEMENWAY, ROBIN PHD	11/2/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
164488	Fee-for-Service	1386772689	1386772689	1	1	HARBOR HEALTH CARE	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9630 ROSE ST	None	BELLFLOWER	CA	90706	6622	19	06037	33.86955962	-118.128317	Los Angeles County
164509	Fee-for-Service	1982835047	1982835047	1	1	HOVDA, SUZY M LMFT	7/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1801 CAPETOWN CIRCLE	None	COSTA MESA	CA	92627	6303	30	06059	33.639867	-117.9436585	Orange County
164511	Fee-for-Service	1023272309	1023272309	1	1	HASSAN, KHALED M MD	1/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111137	07	Dermatology	0	In state provider	None	2141 N HARBOR BLVD	SUITE 25000	FULLERTON	CA	92835	3830	30	06059	33.89443025	-117.9288328	Orange County
164518	Fee-for-Service	1659394401	1659394401	1	1	HAYWARD, ERNEST JR MD	9/30/1996	207L00000X	NA	Other	026	PHYSICIANS	62540	05	Anesthesiology	0	In state provider	#214	23201 LAKE CENTER DR	None	EL TORO	CA	92630	6804	30	06059	33.6255281	-117.7160257	Orange County
164537	Fee-for-Service	1518951300	1518951300	1	29	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16405 SAND CANYON AVE	SUITE 230	IRVINE	CA	92618	3787	30	06059	33.66098519	-117.7747816	Orange County
164587	Fee-for-Service	1134219413	1134219413	1	1	HOWARD ORTHOPEDICS INC	7/18/2007	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3065 RICHMOND PKWY	#112	RICHMOND	CA	94806	1904	07	06013	37.99005286	-122.3297916	Contra Costa County
164610	Fee-for-Service	1942462320	1942462320	1	1	HELALI, AMIR N MD	1/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114648	08	Family Practice	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
164637	Fee-for-Service	1548351927	1548351927	1	1	HEIDERSCHEIDT, PAUL MD	4/17/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76682	08	Family Practice	0	In state provider	None	26777 AGOURA RD	STE 4	CALABASAS	CA	91302	2967	19	06037	34.13998921	-118.7070142	Los Angeles County
164645	Fee-for-Service	1598717480	1598717480	1	1	HURLEY MEDICAL CENTER	8/14/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	ONE HURLEY PLAZA	None	FLINT	MI	48502	5902	00	None	43.02209539	-83.70490627	Genesee County
164673	Fee-for-Service	1669708186	1669708186	1	1	HUANG, JACK Y MD	11/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121806	67	Endocrinology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
164676	Fee-for-Service	1821099359	1821099359	1	1	HOANG, KHOI N MD	11/23/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63481	41	Internal Medicine	0	In state provider	None	2505 SAMARITAN DR	STE 405	SAN JOSE	CA	95124	4013	43	06085	37.25111447	-121.9483395	Santa Clara County
164692	Fee-for-Service	1629377189	1629377189	1	1	HUYNH, TRUNG V MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131593	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
164729	Fee-for-Service	1598427288	1598427288	1	1	HEAVENLY HEALTHCARE SERVICES	8/8/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	, INC	6470 VAN NUYS BLVD	STE E	VAN NUYS	CA	91401	1499	19	06037	34.188246	-118.4487125	Los Angeles County
164737	Fee-for-Service	1881688976	1881688976	1	1	HARLINGEN MEDICAL CENTER LP	6/7/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5501 SOUTH EXPRESSWAY 77	None	HARLINGEN	TX	78550	3213	00	None	26.15672025	-97.67611551	Cameron County
164741	Fee-for-Service	1295199867	1295199867	1	1	HONG, WAN XING MD	2/5/2024	208600000X	NA	General Surgery	026	PHYSICIANS	151094	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
164770	Fee-for-Service	1134653769	1134653769	1	1	HAGHI, MASOUD DO	8/8/2023	207RN0300X	NA	Nephrology	026	PHYSICIANS	18519	None	None	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
164790	Fee-for-Service	1639294986	1639294986	1	1	HOLT, PAULETTE J LCSW	6/25/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12204 S SAN PEDRO	None	LOS ANGELES	CA	90061	2848	19	06037	33.9209571	-118.2695637	Los Angeles County
164802	Fee-for-Service	1144249871	1144249871	1	1	HO, VINCENT D MD	5/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	84224	08	Family Practice	0	In state provider	None	8843 VALLEY BLVD	None	ROSEMEAD	CA	91770	1713	19	06037	34.08079474	-118.0761447	Los Angeles County
164861	Fee-for-Service	1073930079	1073930079	1	1	HUANG, DAVID MD RADIATION	6/16/2014	2085R0001X	NA	Other	026	PHYSICIANS	64100	78	Neoplastic Diseases/Oncology	0	In state provider	ONCOLOGIST INC	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1997	19	06037	34.05358988	-118.2661119	Los Angeles County
164902	Fee-for-Service	1417374281	1417374281	1	1	HLA, NYO Z MD	2/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149045	41	Internal Medicine	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
164925	Fee-for-Service	1194741256	1194741256	1	1	HODGE, KATHRYN K MD	5/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	43591	41	Internal Medicine	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
164933	Fee-for-Service	1598717480	1598717480	1	1	HURLEY MEDICAL CENTER	8/14/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	ONE HURLEY PLAZA	None	FLINT	MI	48502	5902	00	None	43.02209539	-83.70490627	Genesee County
164970	Fee-for-Service	1073559068	1073559068	1	1	HAMPSHIRE, ANDREW P MD	10/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68029	78	Neoplastic Diseases/Oncology	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
164973	Fee-for-Service	1013492461	1013492461	1	1	HEARTISTIC FAMILIES LLC	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
165002	Fee-for-Service	1154316933	1154316933	1	1	HB HEALTHCARE ASSOCIATES	9/1/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LLC	18811 FLORIDA ST	None	HUNTINGTON BEACH	CA	92648	1920	30	06059	33.689025	-117.991069	Orange County
165010	Fee-for-Service	1497713838	1497713838	1	1	HOFFMAN, MICHAEL G MD	10/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	43035	30	Radiology	0	In state provider	None	10445 BALBOA BLVD	None	GRANADA HILLS	CA	91344	7323	19	06037	34.259094	-118.5023365	Los Angeles County
165018	Fee-for-Service	1881688976	1881688976	1	1	HARLINGEN MEDICAL CENTER LP	6/7/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5501 SOUTH EXPRESSWAY 77	None	HARLINGEN	TX	78550	3213	00	None	26.15672025	-97.67611551	Cameron County
165056	Fee-for-Service	1841332053	1841332053	1	2	HABBESTAD, ROBERT MD	3/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	35077	04	Otology, Laryngology, Rhinology	0	In state provider	None	9214 S BROADWAY	None	LOS ANGELES	CA	90003	4042	19	06037	33.952329	-118.2782215	Los Angeles County
165060	Fee-for-Service	1235199530	1235199530	1	1	HA, DUN H MD	5/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	85706	04	Otology, Laryngology, Rhinology	0	In state provider	None	420 WEST ROWLAND STREET	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
165077	Fee-for-Service	1073592598	1073592598	1	1	HSU, TIEN-SHENG MD	1/1/1979	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	33787	40	Pediatrics	0	In state provider	None	980 E FOOTHILL BLVD	STE 101	UPLAND	CA	91786	4068	36	06071	34.10679351	-117.6379419	San Bernardino County
165117	Fee-for-Service	1104463371	1104463371	1	3	HIGH DESERT PSYCHOLOGICAL SE	9/17/2024	103TP2701X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES INC.	3610 CENTRAL AVE	SUITE 500	RIVERSIDE	CA	92506	5900	33	06065	33.95352247	-117.3917745	Riverside County
165125	Fee-for-Service	1134145592	1134145592	1	1	HURWITZ, STEPHEN S MD	10/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	53634	36	Psychiatry	0	In state provider	None	2335 E KASHIAN LN	STE 301	FRESNO	CA	93701	2234	10	06019	36.74333844	-119.7831874	Fresno County
165136	Fee-for-Service	1497797997	1497797997	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1968 VIA CENTRE DR	SUITE A	VISTA	CA	92081	6056	37	06073	33.183991	-117.2839002	San Diego County
165139	Fee-for-Service	1841266707	1841266707	1	1	HAVAS, STEFFAN T MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72099	67	Endocrinology	0	In state provider	None	2220 CLARK AVE	None	LONG BEACH	CA	90815	2521	19	06037	33.79772674	-118.1338339	Los Angeles County
165146	Fee-for-Service	1073930079	1073930079	1	1	HUANG, DAVID MD RADIATION	6/16/2014	2085R0001X	NA	Other	026	PHYSICIANS	64100	30	Radiology	0	In state provider	ONCOLOGIST INC	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1997	19	06037	34.05358988	-118.2661119	Los Angeles County
165170	Fee-for-Service	1730186677	1730186677	1	1	HO, PAUL P MD	12/17/1996	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	71148	None	None	0	In state provider	None	1033 LOS PALOS DR	None	SALINAS	CA	93901	3916	27	06053	36.65911769	-121.6448024	Monterey County
165183	Fee-for-Service	1396088977	1396088977	1	1	HUANG, LIZHOU MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136660	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
165189	Fee-for-Service	1942861083	1942861083	1	1	HURTADO, JANET K LCSW	6/6/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	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
165190	Fee-for-Service	1679002232	1679002232	1	1	HATFIELD, SAMUEL A MD	10/27/2020	208M00000X	NA	Other	026	PHYSICIANS	169543	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
165206	Fee-for-Service	1801876701	1801876701	1	1	HETZLER, DOUGLAS G MD	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	41078	04	Otology, Laryngology, Rhinology	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
165243	Fee-for-Service	1124343330	1124343330	1	1	HALL, LYNN M NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3240 FORDHAM ST	None	SAN DIEGO	CA	92110	5339	37	06073	32.7501009	-117.2142444	San Diego County
165246	Fee-for-Service	1609047117	1609047117	1	1	HIGHLAND PARK SKILLED	2/15/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	NURSING WELLNESS CTR LLC	5125 MONTE VISTA STREET	None	LOS ANGELES	CA	90042	3931	19	06037	34.108303	-118.2015543	Los Angeles County
165250	Fee-for-Service	1255397063	1255397063	1	1	HAYNES, JONATHAN M MD	6/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81798	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
165256	Fee-for-Service	1073559068	1073559068	1	1	HAMPSHIRE, ANDREW P MD	10/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68029	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
165266	Fee-for-Service	1922041037	1922041037	1	1	HINTON, ROBERT 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	3333 BURNET AVE	None	CINCINNATI	OH	45229	3026	00	None	39.14105892	-84.50040782	Hamilton County
165290	Fee-for-Service	1962118877	1962118877	1	1	HEISE, ANDREW G PHD	3/20/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
165295	Fee-for-Service	1679699839	1679699839	1	1	HARRELL, TERRIE J NP	10/21/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
165331	Fee-for-Service	1518950658	1518950658	1	1	HAMMERSCHLAG, STEVEN MD	11/30/1984	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	30603	30	Radiology	0	In state provider	None	3100 SUMMIT ST	None	OAKLAND	CA	94609	3410	01	06001	37.82018974	-122.2643221	Alameda County
165373	Fee-for-Service	1316145832	1316145832	1	1	HARSONO, RUSLY MD	5/29/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	92797	40	Pediatrics	0	In state provider	None	725 WELCH ROAD	MC 5548	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
165407	Fee-for-Service	1104463371	1104463371	1	3	HIGH DESERT PSYCHOLOGICAL SE	11/10/2023	103TP2701X	NA	Mental Health Outpatient Services	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	RVICES INC.	3610 CENTRAL AVE	SUITE 500	RIVERSIDE	CA	92506	5900	33	06065	33.95352247	-117.3917745	Riverside County
165413	Fee-for-Service	1982100277	1982100277	1	1	HOWELL, CHELSEA CNP	4/1/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8491 SANTA MONICA BLVD	None	WEST HOLLYWOOD	CA	90069	4218	19	06037	34.08988507	-118.3757716	Los Angeles County
165450	Fee-for-Service	1992817084	1992817084	1	1	HEER, THOMAS E MD	1/1/1993	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	66950	20	Orthopedic Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
165459	Fee-for-Service	1104849223	1104849223	1	1	HALL, RICHARD J	8/31/1990	174400000X	NA	Other	026	PHYSICIANS	66260	None	None	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
165477	Fee-for-Service	1770619447	1770619447	1	1	HARRY M MILLER MD INC	1/18/2013	207L00000X	NA	Other	026	PHYSICIANS	60912	None	None	0	In state provider	None	3564 VAN BUREN BOULEVARD	None	RIVERSIDE	CA	92503	4214	33	06065	33.91653752	-117.4434896	Riverside County
165511	Fee-for-Service	1528127230	1528127230	1	1	HEINER, JEREMY S CRNA	8/30/2011	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
165519	Fee-for-Service	1932955044	1932955044	1	1	HUYHN PHARMACY INC	11/4/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8102 WESTMINSTER BLVD	STE C	WESTMINSTER	CA	92683	3363	30	06059	33.75926369	-117.9878426	Orange County
165542	Fee-for-Service	1073559068	1073559068	1	1	HAMPSHIRE, ANDREW P MD	10/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	68029	68	Hematology	0	In state provider	None	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	37	06073	32.79692047	-117.1567137	San Diego County
165543	Fee-for-Service	1255306395	1255306395	1	1	HEDAYAT, KAMYAR M MD	9/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76934	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
165568	Fee-for-Service	1912131558	1912131558	1	1	HAMILTON, RICARDO O MD	4/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113755	41	Internal Medicine	0	In state provider	None	480 4TH AVE	STE 202	CHULA VISTA	CA	91910	4412	37	06073	32.63411298	-117.0816772	San Diego County
165571	Fee-for-Service	1417457094	1417457094	1	1	HOSSEINIAN, ASHRAF M	9/23/2019	363LF0000X	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
165576	Fee-for-Service	1730939075	1730939075	1	1	HOLISTIC ACUPUNCTURE SANTA C	7/20/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	RUZ	550 WATER ST	K2	SANTA CRUZ	CA	95060	4136	44	06087	36.98046158	-122.018718	Santa Cruz County
165618	Fee-for-Service	1336506997	1336506997	1	1	HEIGHTS CENTER FOR	9/9/2016	193200000X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	COUNSELING AND WELLNESS	440 REDONDO AVE	STE 103	LONG BEACH	CA	90814	5143	19	06037	33.77256451	-118.1523993	Los Angeles County
165630	Fee-for-Service	1134218332	1134218332	2	1	HEARBRIGHT, AN AUDIOLOGY COR	8/29/2024	174400000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	PORATION	200 JOSE FIGUERES AVE	SUITE 280	SAN JOSE	CA	95116	1500	43	06085	37.36122014	-121.8505998	Santa Clara County
165640	Fee-for-Service	1679512776	1679512776	1	1	HO, VANESSA H MD	8/12/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67416	08	Family Practice	0	In state provider	None	3660 PARK SIERRA DR	STE 110	RIVERSIDE	CA	92505	3071	33	06065	33.90330693	-117.4707039	Riverside County
165650	Fee-for-Service	1831296516	1831296516	1	1	HOFFMAN, PHILIP H LCSW	3/8/2011	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	580 FOREST SHADE DR	UNIT 10	CRESTLINE	CA	92325	1413	36	06071	34.24276938	-117.2780668	San Bernardino County
165661	Fee-for-Service	1518254663	1518254663	1	1	HAMIDI, ALI Y MD	12/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129643	01	General Practice	0	In state provider	None	26991 CROWN VALLEY PKWY	None	MISSION VIEJO	CA	92691	6528	30	06059	33.56210341	-117.6694207	Orange County
165687	Fee-for-Service	1629260898	1629260898	1	1	HUSSAIN, FILZA MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149583	01	General Practice	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
165692	Fee-for-Service	1104463371	1104463371	1	3	HIGH DESERT PSYCHOLOGICAL SE	6/30/2023	103TP2701X	NA	Mental Health Outpatient Services	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	RVICES INC.	3610 CENTRAL AVE	SUITE 500	RIVERSIDE	CA	92506	5900	33	06065	33.95352247	-117.3917745	Riverside County
165709	Fee-for-Service	1821146739	1821146739	1	1	HARMS, LAWRENCE MD	6/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	53038	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
165711	Fee-for-Service	1528090743	1528090743	1	1	HONG, KALEFORD F MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	70733	30	Radiology	0	In state provider	None	525 W ACACIA ST	None	STOCKTON	CA	95203	2405	39	06077	37.9611947	-121.3009489	San Joaquin County
165724	Fee-for-Service	1134155146	1134155146	1	1	HUANG, YING-FENG MD	11/9/1979	173000000X	NA	Other	026	PHYSICIANS	37673	01	General Practice	0	In state provider	None	1133 S SAN GABRIEL BLVD	None	SAN GABRIEL	CA	91776	3114	19	06037	34.086789	-118.0908485	Los Angeles County
165855	Fee-for-Service	1346506037	1346506037	1	1	HUSSAIN, ABID MD PC	4/25/2013	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	255 N GILBERT ST	BLDG B, STE A	HEMET	CA	92543	4066	33	06065	33.75067797	-116.976072	Riverside County
165883	Fee-for-Service	1053646893	1053646893	1	1	HUNG, FRANK MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109626	08	Family Practice	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
165902	Fee-for-Service	1780664581	1780664581	1	1	HANDOKO, JONARDI MD	1/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	43851	45	Nephrology (Renal-Kidney)	0	In state provider	None	811 E 11TH ST	STE 206	UPLAND	CA	91786	4872	36	06071	34.1034335	-117.6398415	San Bernardino County
165934	Fee-for-Service	1164902656	1164902656	1	1	HORNE, ADENA S LMFT	1/19/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	123308	-	NOT APPLICABLE	0	In state provider	None	1200 NORTH MAIN ST	STE 100B, 301, 500	SANTA ANA	CA	92701	3640	30	06059	33.755175	-117.8676195	Orange County
165953	Fee-for-Service	1093992901	1093992901	1	1	HAGEN, AMY J DO	7/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	11132	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
165975	Fee-for-Service	1629260898	1629260898	1	1	HUSSAIN, FILZA MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149583	36	Psychiatry	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
165982	Fee-for-Service	1104463371	1104463371	1	3	HIGH DESERT PSYCHOLOGICAL SE	6/30/2023	103TP2701X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES INC.	3610 CENTRAL AVE	SUITE 500	RIVERSIDE	CA	92506	5900	33	06065	33.95352247	-117.3917745	Riverside County
165985	Fee-for-Service	1245655034	1245655034	1	1	HOSIER, JOHN LMFT	8/27/2024	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
165997	Fee-for-Service	1306977038	1306977038	1	1	HSU, MING S MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	95066	30	Radiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
166008	Fee-for-Service	1841509049	1841509049	1	1	HWANG, DAVID C OD INC	8/15/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	13925 YALE AVE	SUITE 130	IRVINE	CA	92620	2668	30	06059	33.70497316	-117.772376	Orange County
166013	Fee-for-Service	1275983124	1275983124	1	1	HERNANDEZ, RICHARD D MD	7/19/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157967	08	Family Practice	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
166014	Fee-for-Service	1831247717	1831247717	1	1	HOSSEINIAN, KIARASH MD	10/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	80639	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
166019	Fee-for-Service	1699029553	1699029553	1	1	HEIDI CASCO SALGADO	12/19/2012	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	248 MORTON DR	None	DALY CITY	CA	94015	4444	41	06081	37.65599831	-122.4685364	San Mateo County
166038	Fee-for-Service	1013414374	1013414374	1	1	HANS, JASPREET K MD	10/7/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178015	36	Psychiatry	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
166046	Fee-for-Service	1679936538	1679936538	1	1	HALL, DAVID J DO	1/28/2020	207R00000X	NA	Other	026	PHYSICIANS	15852	None	None	0	In state provider	None	1818 N ORANGE GROVE AVE	# 204	POMONA	CA	91767	3028	19	06037	34.07694934	-117.7489598	Los Angeles County
166047	Fee-for-Service	1548468358	1548468358	1	1	HOEG, RASMUS T MD	3/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134631	78	Neoplastic Diseases/Oncology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
166049	Fee-for-Service	1811903537	1811903537	1	1	HARTSHORNE, MICHAEL	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
166071	Fee-for-Service	1720630049	1720630049	1	1	HOPPE, HILLARY A CNP	10/3/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	510 DOYLE PARK DR	None	SANTA ROSA	CA	95405	4570	49	06097	38.442618	-122.6984265	Sonoma County
166089	Fee-for-Service	1598860959	1598860959	1	1	HENCHELL, HEIDI M DO	3/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8537	08	Family Practice	0	In state provider	None	2020 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56287659	-121.7715536	Yolo County
166138	Fee-for-Service	1396521670	1396521670	1	1	HALE, NATALIE MD	11/15/2023	363LF0000X	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
166149	Fee-for-Service	1114361060	1114361060	1	1	HOANG, LEANN K MD	1/2/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	133825	79	Neurology-Child	0	In state provider	None	4234 RIVERWALK PKWY	280	RIVERSIDE	CA	92505	3370	33	06065	33.90290859	-117.4941562	Riverside County
166162	Fee-for-Service	1104840339	1104840339	1	1	HARWOOD, ROBERT A MD	5/16/2011	208600000X	NA	General Surgery	026	PHYSICIANS	9023	02	General Surgery	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
166173	Fee-for-Service	1558387449	1558387449	1	1	HIGGINS, DIANNE L MD	1/31/1987	207P00000X	NA	Other	026	PHYSICIANS	42102	08	Family Practice	0	In state provider	None	253 FRANKLIN ST	None	MOUNTAIN VIEW	CA	94041	1227	43	06085	37.39397633	-122.0816325	Santa Clara County
166184	Fee-for-Service	1740433101	1740433101	1	1	HUMBOLDT CO SUPER OF SCH	10/15/1996	251300000X	NA	Other	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	2755 MCKINLEYVILLE AVE	None	MCKINLEYVILLE	CA	95519	3400	12	06023	40.95480676	-124.1103387	Humboldt County
166191	Fee-for-Service	1780664581	1780664581	1	1	HANDOKO, JONARDI MD	1/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	43851	41	Internal Medicine	0	In state provider	None	811 E 11TH ST	STE 206	UPLAND	CA	91786	4872	36	06071	34.1034335	-117.6398415	San Bernardino County
166204	Fee-for-Service	1508253444	1508253444	1	1	HAN, ANDREW DO	11/11/2019	207L00000X	NA	Other	026	PHYSICIANS	15584	05	Anesthesiology	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
166265	Fee-for-Service	1538429113	1538429113	1	1	HUYNH, NICHOLAS MD	10/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121767	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
166273	Fee-for-Service	1104463371	1104463371	1	3	HIGH DESERT PSYCHOLOGICAL SE	2/15/2024	103TP2701X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	RVICES INC.	3610 CENTRAL AVE	SUITE 500	RIVERSIDE	CA	92506	5900	33	06065	33.95352247	-117.3917745	Riverside County
166305	Fee-for-Service	1699029553	1699029553	1	1	HEIDI CASCO SALGADO	12/19/2012	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	248 MORTON DR	None	DALY CITY	CA	94015	4444	41	06081	37.65599831	-122.4685364	San Mateo County
166312	Fee-for-Service	1134130198	1134130198	1	1	HOLLI S HOWE-DURBAN	3/24/2010	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2976 JACKS CREEK PL	None	ESCONDIDO	CA	92027	5248	37	06073	33.15249317	-117.0372668	San Diego County
166327	Fee-for-Service	1013414374	1013414374	1	1	HANS, JASPREET K MD	10/7/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	178015	70	Clinic (mixed specialty)	0	In state provider	None	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	41	06081	37.51438187	-122.2607682	San Mateo County
166335	Fee-for-Service	1548468358	1548468358	1	1	HOEG, RASMUS T MD	3/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134631	68	Hematology	0	In state provider	None	4501 X STREET	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
166337	Fee-for-Service	1801316526	1801316526	1	1	HUANG, YUE PHD	12/29/2022	207SG0201X	NA	Other	026	PHYSICIANS	164490	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
166342	Fee-for-Service	1588738421	1588738421	1	1	HALL, DOROTHEA MD	7/30/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100281	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
166349	Fee-for-Service	1184087645	1184087645	1	1	HANDLER, TED A MD	10/1/2019	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	151495	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
166362	Fee-for-Service	1629382213	1629382213	1	1	HOLMES, AMIE E MD	8/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	129969	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4770 W HERNDON AVE	STE 109	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
166373	Fee-for-Service	1669576211	1669576211	1	2	HEMATOLOGY ONCOLOGY	9/9/1998	No Taxonomy Provided	NA	None	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	CONSULTANTS	7301 MEDICAL CENTER	#300	WEST HILLS	CA	91307	1973	19	06037	34.20285756	-118.6294575	Los Angeles County
166404	Fee-for-Service	1730775644	1730775644	1	1	HARMONY HOSPICE SERVICES, IN	6/24/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	644 W BROADWAY	SUITE 104	GLENDALE	CA	91204	1026	19	06037	34.14675811	-118.268636	Los Angeles County
166433	Fee-for-Service	1114361060	1114361060	1	1	HOANG, LEANN K MD	1/2/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	133825	13	Neurology (M.D. only)	0	In state provider	None	4234 RIVERWALK PKWY	280	RIVERSIDE	CA	92505	3370	33	06065	33.90290859	-117.4941562	Riverside County
166455	Fee-for-Service	1063449866	1063449866	1	1	HOERTH, CATHERINE L MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60148	13	Neurology (M.D. only)	0	In state provider	None	1001 POTRERO AVE	# 4M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
166482	Fee-for-Service	1316562531	1316562531	1	1	HAN, SAMUEL T DO	7/1/2024	207L00000X	NA	Other	026	PHYSICIANS	21124	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
166490	Fee-for-Service	1073281762	1073281762	1	1	HANNA, DIANA OD	4/12/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7291 BOULDER AVENUE SUIT	None	HIGHLAND	CA	92346	3389	36	06071	34.12169346	-117.1953693	San Bernardino County
166494	Fee-for-Service	1710547781	1710547781	1	1	HOLMES, STEVEN A CRNA	5/1/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	15630 18TH AVE	None	CLEARLAKE	CA	95422	9336	17	06033	38.93612361	-122.6201499	Lake County
166500	Fee-for-Service	1841362688	1841362688	1	1	HUNT, STACEY D MD	10/28/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	69627	07	Dermatology	0	In state provider	None	320 LENNON LANE	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
166508	Fee-for-Service	1730405184	1730405184	1	1	HE, LINGMIN MD	10/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	118105	18	Ophthalmology	0	In state provider	None	3395 SOUTH BASCOM AVENUE	SUITE 140	CAMPBELL	CA	95008	6770	43	06085	37.26369847	-121.9433017	Santa Clara County
166515	Fee-for-Service	1770654527	1770654527	1	1	HOECKER, CYNTHIA C MD	6/21/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53189	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
166536	Fee-for-Service	1881850840	1881850840	1	1	HAN, ANNE MD	9/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130541	07	Dermatology	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
166539	Fee-for-Service	1083900690	1083900690	1	1	HIGGS, CHANEL R LMFT	6/6/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	138414	-	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
166552	Fee-for-Service	1538429113	1538429113	1	1	HUYNH, NICHOLAS MD	10/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121767	08	Family Practice	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
166557	Fee-for-Service	1104463371	1104463371	1	3	HIGH DESERT PSYCHOLOGICAL SE	10/12/2023	103TP2701X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	RVICES INC.	3610 CENTRAL AVE	SUITE 500	RIVERSIDE	CA	92506	5900	33	06065	33.95352247	-117.3917745	Riverside County
166595	Fee-for-Service	1811182983	1811182983	1	1	HO, DIANE T MD	4/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89573	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
166596	Fee-for-Service	1609009620	1609009620	1	1	HELOU, FERAS MD	8/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134693	41	Internal Medicine	0	In state provider	None	4077 5TH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
166602	Fee-for-Service	1093196875	1093196875	1	1	HUYNH, PETER M MD	6/6/2019	390200000X	NA	Other	026	PHYSICIANS	143890	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
166617	Fee-for-Service	1912937624	1912937624	1	1	HILTON HEAD HEALTH SYSTEM	12/29/2005	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LP	25 HOSPITAL CENTER BLVD	None	HILTON HEAD	SC	29926	2738	00	None	32.22332663	-80.71420459	Beaufort County
166620	Fee-for-Service	1891816369	1891816369	1	1	HOLT, EDWARD W MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108342	10	Gastroenterology (M.D. only)	0	In state provider	None	2340 CLAY ST	3RD FLOOR	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
166642	Fee-for-Service	1861890972	1861890972	1	1	HALE, LESLIE K MD	4/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	117889	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
166643	Fee-for-Service	1952475667	1952475667	1	1	HUDSON, ELIZABETH E DO	11/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8798	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
166660	Fee-for-Service	1316574783	1316574783	1	1	HA, HELEN L MD	7/21/2023	390200000X	NA	Other	026	PHYSICIANS	20504	None	None	0	In state provider	None	4760 SUNSET BLVD	None	LOS ANGELES	CA	90027	6063	19	06037	34.09811852	-118.293408	Los Angeles County
166673	Fee-for-Service	1952489536	1952489536	1	1	HO, PHUONG N MD	2/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	93945	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
166674	Fee-for-Service	1710963855	1710963855	1	1	HALBACH, VAN V MD	4/30/1984	174400000X	NA	Other	026	PHYSICIANS	47701	None	None	0	In state provider	DEPT OF RADIOLOGY	3RD & PARNASSUS	None	SAN FRANCISCO	CA	94143	0001	38	06075	37.762974	-122.459769	San Francisco County
166677	Fee-for-Service	1760549448	1760549448	1	1	HORSTMAN, KIMBERLY P MD	6/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81010	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
166681	Fee-for-Service	1285990143	1285990143	1	1	HANDY, GENEVIEVE NP	10/24/2019	363LP0200X	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
166690	Fee-for-Service	1730775644	1730775644	1	1	HARMONY HOSPICE SERVICES, IN	6/24/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	644 W BROADWAY	SUITE 104	GLENDALE	CA	91204	1026	19	06037	34.14675811	-118.268636	Los Angeles County
166740	Fee-for-Service	1083496947	1083496947	1	1	HOUGHTALING, AMY	10/18/2023	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	50	06099	0	0	None
166746	Fee-for-Service	1063788719	1063788719	1	1	HAWTHORNECAMPOS, MELISSA A	6/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
166776	Fee-for-Service	1932475597	1932475597	1	1	HAHM, SUSAN J MD INC	8/13/2012	208600000X	NA	General Surgery	026	PHYSICIANS	97007	02	General Surgery	0	In state provider	None	751 WEST LEGION ROAD	#201	BRAWLEY	CA	92227	7750	13	06025	32.95996012	-115.5538196	Imperial County
166779	Fee-for-Service	1063437887	1063437887	1	1	HAVTON, LEIF A MD	2/1/2000	2084N0400X	NA	Neurology	026	PHYSICIANS	51291	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
166802	Fee-for-Service	1770654527	1770654527	1	1	HOECKER, CYNTHIA C MD	6/21/2000	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53189	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
166886	Fee-for-Service	1831224351	1831224351	1	1	HEALTH CENTER #5	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1351 24TH AVE	None	SAN FRANCISCO	CA	94122	1698	38	06075	37.76240258	-122.4824643	San Francisco County
166906	Fee-for-Service	1912937624	1912937624	1	1	HILTON HEAD HEALTH SYSTEM	1/29/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LP	25 HOSPITAL CENTER BLVD	None	HILTON HEAD	SC	29926	2738	00	None	32.22332663	-80.71420459	Beaufort County
166937	Fee-for-Service	1659302503	1659302503	2	1	HEALTH DIAGNOSTICS OF CA	1/23/2012	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	LLC	50 FRANCISCO STREET	SUITE 105	SAN FRANCISCO	CA	94133	2108	38	06075	37.80564767	-122.4058523	San Francisco County
167030	Fee-for-Service	1063942647	1063942647	1	2	HERITAGE LIVING INC	11/21/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	6401 REDINGER ST	None	BAKERSFIELD	CA	93313	4900	15	06029	35.29746543	-119.0850077	Kern County
167034	Fee-for-Service	1235196411	1235196411	1	2	HYBARGER, CHAD K PHD	8/25/2018	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	7171 ALVARADO RD	STE 100A	LA MESA	CA	91942	8996	37	06073	32.77267798	-117.0445155	San Diego County
167079	Fee-for-Service	1518074830	1518074830	1	1	HANCHOCK, NICOLA B MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	50540	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
167113	Fee-for-Service	1124473715	1124473715	1	1	HELPING HANDS HOME HEALTH	3/22/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE LLC	1241 S GLENDALE AVE	SUITE 205B	GLENDALE	CA	91205	3389	19	06037	34.13065269	-118.2524619	Los Angeles County
167116	Fee-for-Service	1134681307	1134681307	1	1	HUANG, JENNY	1/6/2025	207R00000X	NA	Other	026	PHYSICIANS	176090	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
167120	Fee-for-Service	1578057717	1578057717	1	1	HOANG, JENNIFER OD	3/24/2025	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2650 ELM AVE	108	LONG BEACH	CA	90806	1651	19	06037	33.805521	-118.1882945	Los Angeles County
167148	Fee-for-Service	1891225892	1891225892	1	1	HAVEN HOSPICE CARE INC	2/11/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4225 VALLEY FAIR ST	SUITE 107	SIMI VALLEY	CA	93063	2954	56	06111	34.2726333	-118.7125045	Ventura County
167168	Fee-for-Service	1164536017	1164536017	1	1	HADLEY, DEAN MD	1/31/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	31798	01	General Practice	0	In state provider	None	6283 CLARK RD	STE 3	PARADISE	CA	95969	4100	04	06007	39.7674117	-121.6005321	Butte County
167173	Fee-for-Service	1225172489	1225172489	1	1	HUDSON, DANA L LMFT	5/24/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82994	-	NOT APPLICABLE	0	In state provider	None	1904 RICHLAND AVE	None	CERES	CA	95307	9440	50	06099	37.60031128	-120.9658226	Stanislaus County
167189	Fee-for-Service	1295793438	1295793438	1	1	HUANG, I-HUA MD	12/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	202 N DIVISON AVE	None	AUBURN	WA	98001	4939	00	None	47.308698	-122.2297715	King County
167211	Fee-for-Service	1043620222	1043620222	1	1	HUYNH, THIEN LY V DO	10/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15324	08	Family Practice	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
167214	Fee-for-Service	1720742638	1720742638	1	1	HERNANDEZ, MARIBEL DOULA	5/9/2024	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	10	06019	0	0	None
167223	Fee-for-Service	1750369641	1750369641	2	1	HERMAN, MICHAEL L OD	10/26/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2524 S FIGUEROA STREET	None	LOS ANGELES	CA	90007	2549	19	06037	34.02828035	-118.2748681	Los Angeles County
167271	Fee-for-Service	1861756975	1861756975	1	1	HO, JOSEPH M MD	10/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	73155	70	Clinic (mixed specialty)	0	In state provider	None	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5795	36	06071	34.47092468	-117.2977236	San Bernardino County
167281	Fee-for-Service	1275726333	1275726333	1	1	HAYWARD UNIF SCHOOL DIST	3/13/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	STUDENT SERV LEVEL D	24411 AMADOR ST	None	HAYWARD	CA	94544	1301	01	06001	37.65685536	-122.0934449	Alameda County
167285	Fee-for-Service	1528681376	1528681376	1	1	HENG, SHARON OD	9/1/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8110 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21850103	-118.4310944	Los Angeles County
167293	Fee-for-Service	1538844261	1538844261	1	1	HORTON, MOLLY J PT	10/12/2023	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
167303	Fee-for-Service	1053404525	1053404525	1	3	HOOPER, ANDREW H MD	3/1/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59811	01	General Practice	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
167305	Fee-for-Service	1447385018	1447385018	1	1	HON, EDWARD D MD	5/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	76325	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
167324	Fee-for-Service	1235196411	1235196411	1	2	HYBARGER, CHAD K PHD	8/25/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	7171 ALVARADO RD	STE 100A	LA MESA	CA	91942	8996	37	06073	32.77267798	-117.0445155	San Diego County
167332	Fee-for-Service	1912027426	1912027426	1	1	HAMMOUDI, MOSTAFA MD	2/6/2018	2084N0400X	NA	Neurology	026	PHYSICIANS	149844	13	Neurology (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
167371	Fee-for-Service	1780766238	1780766238	1	1	HAND, DWIGHT E MD	11/1/1998	208G00000X	NA	General Surgery	026	PHYSICIANS	84440	02	General Surgery	0	In state provider	None	160 E ARTESIA ST	STE 355	POMONA	CA	91767	2927	19	06037	34.07556833	-117.7507835	Los Angeles County
167404	Fee-for-Service	1134681307	1134681307	1	1	HUANG, JENNY	1/6/2025	207R00000X	NA	Other	026	PHYSICIANS	176090	03	Allergy	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
167433	Fee-for-Service	1295836757	1295836757	1	1	HICK, MARK	3/20/2001	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1280 W LAMBERT RD	STE B	BREA	CA	92821	2820	30	06059	33.9245607	-117.9171844	Orange County
167435	Fee-for-Service	1891225892	1891225892	1	1	HAVEN HOSPICE CARE INC	2/11/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4225 VALLEY FAIR ST	SUITE 107	SIMI VALLEY	CA	93063	2954	56	06111	34.2726333	-118.7125045	Ventura County
167473	Fee-for-Service	1104321959	1104321959	1	2	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	225 W HOSPITALITY LN	102	SAN BERNARDINO	CA	92408	3244	36	06071	34.06586109	-117.2884682	San Bernardino County
167475	Fee-for-Service	1841279668	1841279668	1	1	HORVAT, BOZIDAR MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62483	66	Emergency Medicine (Urgent Care)	0	In state provider	None	220 E 13TH ST	None	MERCED	CA	95340	6242	24	06047	37.29309532	-120.4748791	Merced County
167527	Fee-for-Service	1720046717	1720046717	1	1	HUSAIN, RUBINA MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	56495	41	Internal Medicine	0	In state provider	None	2699 ATLANTIC AVE	None	LONG BEACH	CA	90806	2710	19	06037	33.805971	-118.1850555	Los Angeles County
167543	Fee-for-Service	1235362880	1235362880	1	1	HERNANDEZ, HANNAH LCSW	7/13/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ND SUPERVISION	25109 JEFFERSON AVE	STE 120	MURRIETA	CA	92562	8117	33	06065	33.55410071	-117.2028115	Riverside County
167563	Fee-for-Service	1669050944	1669050944	1	1	HOSPICE PLUS INC	6/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	15130 VENTURA BLVD	SUITE 324	SHERMAN OAKS	CA	91403	3378	19	06037	34.15320952	-118.4627115	Los Angeles County
167568	Fee-for-Service	1902999188	1902999188	1	1	HUANG, HSIEN-JEN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37813	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2423 FOREST AVE	None	SAN JOSE	CA	95128	1505	43	06085	37.3269855	-121.947345	Santa Clara County
167569	Fee-for-Service	1275726333	1275726333	1	1	HAYWARD UNIF SCHOOL DIST	12/4/1994	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	STUDENT SERV LEVEL D	24411 AMADOR ST	None	HAYWARD	CA	94544	1301	01	06001	37.65685536	-122.0934449	Alameda County
167583	Fee-for-Service	1164021341	1164021341	1	1	HUYNH, KIM H PSYD	10/23/2020	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
167602	Fee-for-Service	1235217019	1235217019	1	1	HERNANDEZ, ROSEMARY E MD	12/29/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	40235	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
167604	Fee-for-Service	1104321959	1104321959	1	13	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
167641	Fee-for-Service	1619072964	1619072964	1	1	HINDS, ROBERT L MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	6768	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
167646	Fee-for-Service	1023114030	1023114030	1	1	HERSK, JULIE A MD	11/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	89497	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
167658	Fee-for-Service	1013920628	1013920628	1	1	HALL, CRAIG W MD	8/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60551	08	Family Practice	0	In state provider	None	52 E MAIN ST	None	IONE	CA	95640	9172	03	06005	38.35277344	-120.9328992	Amador County
167659	Fee-for-Service	1780766238	1780766238	1	1	HAND, DWIGHT E MD	11/1/1998	208G00000X	NA	General Surgery	026	PHYSICIANS	84440	33	Thoracic Surgery	0	In state provider	None	160 E ARTESIA ST	STE 355	POMONA	CA	91767	2927	19	06037	34.07556833	-117.7507835	Los Angeles County
167686	Fee-for-Service	1023543436	1023543436	1	1	HARNENZ, ZOE T MD	12/21/2022	2084N0402X	NA	Neurology	026	PHYSICIANS	157463	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
167705	Fee-for-Service	1518378835	1518378835	1	1	HERALD, JOHN R MD	7/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148177	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
167714	Fee-for-Service	1699934851	1699934851	1	1	HEALING PATHWAYS PSYCHOLOGIC	12/26/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	PSYCHOLOGICAL SERVICES	2710 X ST	None	SACRAMENTO	CA	95818	2757	34	06067	38.558358	-121.476924	Sacramento County
167726	Fee-for-Service	1619075256	1619075256	1	1	HARRITY, STEVEN L	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
167760	Fee-for-Service	1104321959	1104321959	1	2	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	225 W HOSPITALITY LN	102	SAN BERNARDINO	CA	92408	3244	36	06071	34.06586109	-117.2884682	San Bernardino County
167762	Fee-for-Service	1841279668	1841279668	1	1	HORVAT, BOZIDAR MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62483	41	Internal Medicine	0	In state provider	None	220 E 13TH ST	None	MERCED	CA	95340	6242	24	06047	37.29309532	-120.4748791	Merced County
167834	Fee-for-Service	1841654233	1841654233	1	1	HASSAMAL, SUNITA	8/30/2019	207R00000X	NA	Other	026	PHYSICIANS	160998	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
167842	Fee-for-Service	1801251210	1801251210	1	1	HARRISON, JOSEPH D OT	4/20/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
167850	Fee-for-Service	1669050944	1669050944	1	1	HOSPICE PLUS INC	6/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	15130 VENTURA BLVD	SUITE 324	SHERMAN OAKS	CA	91403	3378	19	06037	34.15320952	-118.4627115	Los Angeles County
167851	Fee-for-Service	1023544327	1023544327	1	1	HARRIS, LIAM MD	7/24/2024	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	160812	20	Orthopedic Surgery	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
167873	Fee-for-Service	1285838326	1285838326	1	1	HODGE-LEGGE, MARCIA K	9/15/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
167880	Fee-for-Service	1558333682	1558333682	1	1	HIGHLINE COMMUNITY HOSP	11/1/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	16251 SYLVESTER RD SW	None	BURIEN	WA	98166	3052	00	None	47.4569022	-122.3414115	King County
167882	Fee-for-Service	1821078726	1821078726	1	1	HERON, DARIEN H MD	11/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	84358	41	Internal Medicine	0	In state provider	None	7600 OLD DOMINION CT	None	APTOS	CA	95003	3821	44	06087	36.97913818	-121.9099818	Santa Cruz County
167891	Fee-for-Service	1104321959	1104321959	1	13	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
167913	Fee-for-Service	1619943537	1619943537	1	5	HEMET RADIOLOGY MEDICAL	1/30/1992	174400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP, INC	28400 MCCALL BLVD	None	SUN CITY	CA	92585	9658	33	06065	33.71805454	-117.1672547	Riverside County
167921	Fee-for-Service	1245440700	1245440700	1	1	HOPE, ROSETTA	5/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	260 MAPLE CT	STE 118	VENTURA	CA	93003	3561	56	06111	34.27027545	-119.24562	Ventura County
167959	Fee-for-Service	1740808831	1740808831	1	1	HONG THANH MAI MD INC	7/7/2020	2251P0200X	NA	Physical Therapist	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	2146 E. ANAHEIM STREET	None	LONG BEACH	CA	90804	3408	19	06037	33.78257051	-118.165896	Los Angeles County
167965	Fee-for-Service	1497840656	1497840656	1	1	HUMBOLDT OPEN DOOR CLN	3/1/1997	261QF0400X	NA	Federally Qualified Health Center	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	DEL NORTE COMM HLTH CTR	550 E WASHINGTON BLVD	STE 100	CRESCENT CITY	CA	95531	8342	08	06015	41.77274546	-124.19892	Del Norte County
167966	Fee-for-Service	1104353598	1104353598	1	1	HARSTON LOVING CARE, INC	12/20/2018	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	5205 HARSTON WAY	None	ANTELOPE	CA	95843	4688	34	06067	38.707803	-121.3412265	Sacramento County
167967	Fee-for-Service	1174599823	1174599823	1	1	HARRINGTON, DARRELL W MD	9/30/1993	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	73541	41	Internal Medicine	0	In state provider	None	21840 NORMANDIE AVE	STE 100	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
167968	Fee-for-Service	1164840898	1164840898	1	1	HANJRAA, LOVELEEN MD	6/2/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	146040	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
168006	Fee-for-Service	1730250630	1730250630	1	1	HUBER, CRAIG R MD	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71250	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
168018	Fee-for-Service	1689784977	1689784977	1	1	HAAS-BECKERT, BETSY 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
168019	Fee-for-Service	1982650024	1982650024	1	1	HCA HEALTH SERVICES OF	1/1/2011	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TENNESSEE INC	5655 FRIST BLVD	None	HERMITAGE	TN	37076	2053	00	None	36.17638593	-86.60728607	Davidson County
168039	Fee-for-Service	1235181413	1235181413	1	1	HUYNH, PHUNG M MD	3/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	97688	07	Dermatology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
168041	Fee-for-Service	1134563109	1134563109	1	1	HARRIS, PETER J MD	8/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136735	01	General Practice	0	In state provider	None	140 LITTON DRIVE	SUITE 100	GRASS VALLEY	CA	95945	5078	29	06057	39.23422354	-121.0525426	Nevada County
168070	Fee-for-Service	1144741315	1144741315	1	1	HENGAMEH MAHGEREFTEH	2/9/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6100 CENTER DRIVE	FL 5	LOS ANGELES	CA	90045	9206	19	06037	33.97753203	-118.3922717	Los Angeles County
168074	Fee-for-Service	1295807030	1295807030	1	1	HOWELL, EVELYN J MD	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67766	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
168101	Fee-for-Service	1205402179	1205402179	1	1	HABERMEHL, BRETT MD	4/30/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	189972	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
168144	Fee-for-Service	1285856609	1285856609	1	1	HO, JOSEPH T MD	4/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144558	05	Anesthesiology	0	In state provider	None	113 WATERWORKS WAY	SUITE 240	IRVINE	CA	92618	3175	30	06059	33.66497942	-117.7635578	Orange County
168168	Fee-for-Service	1558333682	1558333682	1	1	HIGHLINE COMMUNITY HOSP	11/1/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	16251 SYLVESTER RD SW	None	BURIEN	WA	98166	3052	00	None	47.4569022	-122.3414115	King County
168208	Fee-for-Service	1912902768	1912902768	1	1	HECHT, NEIL H DPM	1/1/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	18411 CLARK ST	STE 104	TARZANA	CA	91356	3525	19	06037	34.16981538	-118.5337442	Los Angeles County
168221	Fee-for-Service	1487150694	1487150694	1	1	HEMINGWAY, JACQUELYN MD	9/13/2024	208600000X	NA	General Surgery	026	PHYSICIANS	166647	02	General Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
168251	Fee-for-Service	1497840656	1497840656	1	1	HUMBOLDT OPEN DOOR CLN	1/1/1995	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	DEL NORTE COMM HLTH CTR	550 E WASHINGTON BLVD	STE 100	CRESCENT CITY	CA	95531	8342	08	06015	41.77274546	-124.19892	Del Norte County
168255	Fee-for-Service	1952454472	1952454472	1	1	HWANG, MATTHEW W MD	11/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103984	20	Orthopedic Surgery	0	In state provider	None	9400 ROSECRANS AVENUE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
168261	Fee-for-Service	1114099694	1114099694	1	1	HO, TIMOTHY S MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77869	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
168275	Fee-for-Service	1922021278	1922021278	1	1	HON, ROXANNE MD INC APC	8/21/1996	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	56292	25	Physical Medicine and Rehabilitation	0	In state provider	None	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3019	37	06073	32.781483	-117.007182	San Diego County
168303	Fee-for-Service	1700096385	1700096385	1	1	HOOKS, BERTINA M MD	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133270	41	Internal Medicine	0	In state provider	None	1 MEDICAL PLAZA DRIVE	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
168315	Fee-for-Service	1982650024	1982650024	1	1	HCA HEALTH SERVICES OF	1/1/2011	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	TENNESSEE INC	5655 FRIST BLVD	None	HERMITAGE	TN	37076	2053	00	None	36.17638593	-86.60728607	Davidson County
168346	Fee-for-Service	1598278202	1598278202	1	1	HERNANDEZ, SALVADOR MD	7/15/2020	207R00000X	NA	Other	026	PHYSICIANS	166769	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
168357	Fee-for-Service	1184740367	1184740367	1	1	HEALING HANDS MEDICAL GROUP,	11/1/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	A MEDICAL CORP	2975 WILSHIRE BLVD	# 401	LOS ANGELES	CA	90010	1112	19	06037	34.06183451	-118.286712	Los Angeles County
168359	Fee-for-Service	1043365760	1043365760	1	1	HSU, CARMEN P MD	4/29/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	83166	40	Pediatrics	0	In state provider	None	64 ASPEN WAY	STE 102	WATSONVILLE	CA	95076	3084	44	06087	36.93085993	-121.7799849	Santa Cruz County
168372	Fee-for-Service	1629607601	1629607601	1	1	HOLLOWAY, JAMILA	9/25/2023	1835E0208X	NA	None	026	PHYSICIANS	184455	None	None	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
168380	Fee-for-Service	1053346627	1053346627	1	2	HORIZON ANESTHESIA & PAIN	4/1/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	250 S OAK AVE	BLDG A STE 3	OAKDALE	CA	95361	3572	50	06099	37.75888818	-120.8609099	Stanislaus County
168448	Fee-for-Service	1104321959	1104321959	1	4	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	345 CONVENTION WAY	D-1	REDWOOD CITY	CA	94063	1444	41	06081	37.49391347	-122.2285705	San Mateo County
168501	Fee-for-Service	1528036738	1528036738	1	1	HOANG, HIEU V DO	5/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9909	01	General Practice	0	In state provider	None	150 N ROBERTSON BLVD	SUITE 300	BEVERLY HILLS	CA	90211	2145	19	06037	34.06812722	-118.3837146	Los Angeles County
168509	Fee-for-Service	1518591783	1518591783	1	1	HOLDING HANDS HOSPICE	9/9/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3169 BARBARA CT	STE F	LOS ANGELES	CA	90068	1700	19	06037	34.12773574	-118.3471473	Los Angeles County
168522	Fee-for-Service	1831516392	1831516392	1	1	HECKELMAN, AARON W MD	10/3/2017	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
168529	Fee-for-Service	1093918435	1093918435	1	1	HUMMELMAN, LENORE C OD	3/17/2004	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	480 4TH AVE	STE 412	CHULA VISTA	CA	91910	4413	37	06073	32.63411298	-117.0816772	San Diego County
168541	Fee-for-Service	1497840656	1497840656	1	1	HUMBOLDT OPEN DOOR CLN	1/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	DEL NORTE COMM HLTH CTR	550 E WASHINGTON BLVD	STE 100	CRESCENT CITY	CA	95531	8342	08	06015	41.77274546	-124.19892	Del Norte County
168590	Fee-for-Service	1700920345	1700920345	1	1	HEALTHRIGHT 360	10/12/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	815 BUENA VISTA WEST	None	SAN FRANCISCO	CA	94117	4108	38	06075	37.76921703	-122.4429461	San Francisco County
168621	Fee-for-Service	1740480045	1740480045	1	1	HOFFMAN, LARA W LCSW	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21966	-	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
168629	Fee-for-Service	1851763411	1851763411	1	1	HELLENAS, VICTORIA LMFT	8/9/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	334 SHAW AVE	SUITE 100	CLOVIS	CA	93612	3839	10	06019	36.80839352	-119.7049776	Fresno County
168652	Fee-for-Service	1609889484	1609889484	1	1	HSU, VICTOR Y MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76936	41	Internal Medicine	0	In state provider	None	845 W LAVETA AVENUE	STE 107A	ORANGE	CA	92868	3930	30	06059	33.78064548	-117.8611107	Orange County
168656	Fee-for-Service	1457931305	1457931305	1	1	HAYRAPETIAN, LAURIE S MD	9/11/2024	208M00000X	NA	Other	026	PHYSICIANS	192465	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
168687	Fee-for-Service	1811390115	1811390115	1	1	HAMER, BO J CSW	5/3/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	427 F STREET	SUITE #228	EUREKA	CA	95501	0172	12	06023	40.80253539	-124.1660942	Humboldt County
168689	Fee-for-Service	1366592982	1366592982	1	2	H JOSEPH KHAN M D INC	1/6/2014	207VH0002X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	111 W 17TH ST	None	SANTA ANA	CA	92706	2718	30	06059	33.76013946	-117.86832	Orange County
168691	Fee-for-Service	1649371212	1649371212	1	1	HENDRICKSEN, NORMAN E PHD	6/20/2003	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	521 W ENTERPRISE AVE	None	CLOVIS	CA	93619	8357	10	06019	36.85536385	-119.7231344	Fresno County
168695	Fee-for-Service	1548331606	1548331606	1	1	HOROWITZ, RICHARD S MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	43197	45	Nephrology (Renal-Kidney)	0	In state provider	None	8635 W 3RD ST	STE 885	LOS ANGELES	CA	90048	6107	19	06037	34.07361928	-118.3803143	Los Angeles County
168735	Fee-for-Service	1104321959	1104321959	1	4	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	345 CONVENTION WAY	D-1	REDWOOD CITY	CA	94063	1444	41	06081	37.49391347	-122.2285705	San Mateo County
168745	Fee-for-Service	1639226202	1639226202	1	1	HETHUMUNI, STEPHANEE MD	7/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33432	40	Pediatrics	0	In state provider	INC	101 E BEVERLY BLVD	STE 404	MONTEBELLO	CA	90640	4317	19	06037	34.01556395	-118.0983878	Los Angeles County
168748	Fee-for-Service	1649302324	1649302324	1	1	HERNANDEZ, LAURA PSYD	3/16/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5656 CANTALOUPE AVENUE	None	VAN NUYS	CA	91401	4712	19	06037	34.17376701	-118.4344729	Los Angeles County
168800	Fee-for-Service	1518591783	1518591783	1	1	HOLDING HANDS HOSPICE	9/9/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3169 BARBARA CT	STE F	LOS ANGELES	CA	90068	1700	19	06037	34.12773574	-118.3471473	Los Angeles County
168806	Fee-for-Service	1881956480	1881956480	1	1	HUNDAL, JASKIRAN K MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132595	01	General Practice	0	In state provider	None	5765 GREENBACK LANE	None	SACRAMENTO	CA	95841	2013	34	06067	38.681622	-121.327848	Sacramento County
168828	Fee-for-Service	1497840656	1497840656	1	1	HUMBOLDT OPEN DOOR CLN	1/1/1995	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	DEL NORTE COMM HLTH CTR	550 E WASHINGTON BLVD	STE 100	CRESCENT CITY	CA	95531	8342	08	06015	41.77274546	-124.19892	Del Norte County
168905	Fee-for-Service	1902839053	1902839053	1	1	HORVATH DAGMAR MM	6/1/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	25261	40	Pediatrics	0	In state provider	None	2101 FOREST AVE	STE 130	SAN JOSE	CA	95128	1424	43	06085	37.3270795	-121.93731	Santa Clara County
168914	Fee-for-Service	1528370863	1528370863	1	1	HEATHER R MERRILL	10/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1305 W 18TH ST	None	SIOUX FALLS	SD	57105	0401	00	None	43.535484	-96.7428585	Minnehaha County
168926	Fee-for-Service	1932609054	1932609054	1	1	HAYTOGLU, TAHIR MD	1/7/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	72482	None	None	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
168940	Fee-for-Service	1609889484	1609889484	1	1	HSU, VICTOR Y MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76936	77	Infectious Disease	0	In state provider	None	845 W LAVETA AVENUE	STE 107A	ORANGE	CA	92868	3930	30	06059	33.78064548	-117.8611107	Orange County
168943	Fee-for-Service	1427362441	1427362441	1	1	HOLDERNESS, BRYCE R MD	1/27/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118475	41	Internal Medicine	0	In state provider	None	215 PESETAS LANE	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
168951	Fee-for-Service	1326039751	1326039751	1	1	HARSHANY, MARK L MD	4/29/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	122371	30	Radiology	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
168964	Fee-for-Service	1235227984	1235227984	1	2	HOLMES, RANDOLPH P MD	12/7/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	42202	-	NOT APPLICABLE	0	In state provider	None	11015 BLOOMFIELD AVE	None	SANTA FE SPRINGS	CA	90670	4601	19	06037	33.931008	-118.064007	Los Angeles County
168975	Fee-for-Service	1609404847	1609404847	1	1	HERRON, STEVEN M MD	5/11/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
168978	Fee-for-Service	1548331606	1548331606	1	1	HOROWITZ, RICHARD S MD	11/30/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	43197	41	Internal Medicine	0	In state provider	None	8635 W 3RD ST	STE 885	LOS ANGELES	CA	90048	6107	19	06037	34.07361928	-118.3803143	Los Angeles County
168981	Fee-for-Service	1366592982	1366592982	1	2	H JOSEPH KHAN M D INC	1/6/2014	207VH0002X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	111 W 17TH ST	None	SANTA ANA	CA	92706	2718	30	06059	33.76013946	-117.86832	Orange County
169043	Fee-for-Service	1902467699	1902467699	1	1	HSU, FANG-WEI R PSYD	7/26/2022	103T00000X	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
169093	Fee-for-Service	1861754335	1861754335	1	1	HONG, CONNIE J MD	11/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115186	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
169178	Fee-for-Service	1013093541	1013093541	1	1	HARRIS, CLIFFORD H MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	84386	34	Urology and Urological Surgery	0	In state provider	None	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
169180	Fee-for-Service	1770650699	1770650699	1	1	HUYNH, DAN NGOC MD	3/1/1998	207R00000X	NA	Other	026	PHYSICIANS	61808	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
169183	Fee-for-Service	1083701411	1083701411	1	1	HINOJOSA-VALENCIA,	8/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	69515	41	Internal Medicine	0	In state provider	ALEJANDRO G MD	4004 BEYER BLVD	None	SAN YSIDRO	CA	92335	0000	37	06073	32.55831005	-117.0475102	San Diego County
169190	Fee-for-Service	1114933884	1114933884	1	1	HYTHEM A.OMAR, 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	5323 HARRY HINES BLVD	DEPT. OF RADIOLOGY MC 88	DALLAS	TX	75390	0000	00	None	32.812245	-96.841584	Dallas County
169194	Fee-for-Service	1225272008	1225272008	1	1	HINDI, SAHAR M MD	6/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125868	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
169237	Fee-for-Service	1043814882	1043814882	1	1	HFS HOSPICE CARE INC	9/7/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7335 VAN NUYS BLVD	SUITE 202	VAN NUYS	CA	91405	1969	19	06037	34.203843	-118.448776	Los Angeles County
169293	Fee-for-Service	1861013385	1861013385	1	1	HOYT, ERIN MD	6/27/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	184546	None	None	0	In state provider	None	2071 EAST HERNDON	None	CLOVIS	CA	93611	6001	10	06019	36.8375685	-119.6781105	Fresno County
169320	Fee-for-Service	1720520943	1720520943	1	1	HARRIS, CLARA M DO	2/3/2025	207R00000X	NA	Other	026	PHYSICIANS	22765	41	Internal Medicine	0	In state provider	None	7115 GREENBACK LN	FL 2	CITRUS HEIGHTS	CA	95621	6133	34	06067	38.679237	-121.298859	Sacramento County
169330	Fee-for-Service	1801892302	1801892302	1	1	HAMBURG, SOLOMON I MD	1/25/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	53431	41	Internal Medicine	0	In state provider	LOWER LEVEL	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
169351	Fee-for-Service	1578507380	1578507380	1	1	HINES, JONIE M MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	-	08	Family Practice	2	Out of state provider	None	201 YELLOWSTONE AVE	None	CODY	WY	82414	9313	00	None	44.51552075	-109.0958677	Park County
169368	Fee-for-Service	1316973605	1316973605	1	1	HASANIYA, NAHIDH W MD	6/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51994	33	Thoracic 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
169382	Fee-for-Service	1316934284	1316934284	1	1	HUYNH, JUDY M DO	11/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	8141	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
169448	Fee-for-Service	1639733280	1639733280	1	1	HUGH, ASHLEY F MD	2/12/2025	1835P0200X	NA	Other	026	PHYSICIANS	191866	40	Pediatrics	0	In state provider	None	655 REDWOOD HWY FRONTAGE	SUITE 216	MILL VALLEY	CA	94941	3009	21	06041	37.89126837	-122.5169784	Marin County
169497	Fee-for-Service	1477081370	1477081370	1	1	HODZIC, ZERINA MD	9/2/2020	208M00000X	NA	Other	026	PHYSICIANS	169481	41	Internal Medicine	0	In state provider	None	1250 16TH STREET	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
169506	Fee-for-Service	1871058396	1871058396	1	1	HOLBECK, DALLAS L CRNA	5/3/2019	367500000X	NA	Other	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
169525	Fee-for-Service	1043814882	1043814882	1	1	HFS HOSPICE CARE INC	9/7/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7335 VAN NUYS BLVD	SUITE 202	VAN NUYS	CA	91405	1969	19	06037	34.203843	-118.448776	Los Angeles County
169537	Fee-for-Service	1861678138	1861678138	1	1	HUNT, CHERIE N CRNA	12/18/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
169584	Fee-for-Service	1659445534	1659445534	1	1	HANGER P & O WEST INC	6/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3602 INLAND EMPIRE BLVD	STE C130	ONTARIO	CA	91764	4942	36	06071	34.07022	-117.572877	San Bernardino County
169627	Fee-for-Service	1043275373	1043275373	1	1	HOME OF GUIDING HANDS	12/31/1982	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1401 LEMON AVE	None	EL CAJON	CA	92020	7233	37	06073	32.77698149	-116.9725254	San Diego County
169633	Fee-for-Service	1952476327	1952476327	1	1	HUSSAIN, SABIHA MD	11/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	95750	40	Pediatrics	0	In state provider	None	5222 BALBOA AVE	STE 42	SAN DIEGO	CA	92117	6991	37	06073	32.81873589	-117.1838368	San Diego County
169666	Fee-for-Service	1306122908	1306122908	1	1	HOM, GARRETT K	4/19/2018	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
169700	Fee-for-Service	1720549827	1720549827	1	1	HENDRIE, KYLE A DO	7/31/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	21374	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
169716	Fee-for-Service	1124034053	1124034053	1	1	HUSSEMAN, JACOB W MD	10/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	95583	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
169734	Fee-for-Service	1346744190	1346744190	1	1	HERRMAN, SARAH L MD	8/3/2021	208M00000X	NA	Other	026	PHYSICIANS	173545	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
169761	Fee-for-Service	1629171434	1629171434	1	1	HADDOCK, SAMUEL 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	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
169766	Fee-for-Service	1477596096	1477596096	1	1	HAYMOND, ROBERT S MD	3/11/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70921	18	Ophthalmology	0	In state provider	None	PO BOX 309	None	ANGELS CAMP	CA	95222	0309	05	06009	0	0	None
169785	Fee-for-Service	1427366244	1427366244	1	1	HALQUIST, RYAN M PHD	8/17/2015	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
169796	Fee-for-Service	1508120726	1508120726	1	1	HAMILTON, DORRENCE S LCSW	7/24/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
169816	Fee-for-Service	1144544966	1144544966	1	1	H-CARE, INCORPORATED	2/24/2022	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	None	None	None	0	In state provider	None	125 E BARSTOW AVE	118	FRESNO	CA	93710	5023	10	06019	36.81570455	-119.787651	Fresno County
169832	Fee-for-Service	1295171296	1295171296	1	1	HOLTE, MARIKA MD	10/3/2018	207R00000X	NA	Other	026	PHYSICIANS	158637	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
169876	Fee-for-Service	1205369022	1205369022	1	1	HIMMELSBACH, RYAN MD	4/15/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
169895	Fee-for-Service	1043387913	1043387913	1	1	HERNANDEZ, REYNALDO D MD	2/28/1989	208800000X	NA	Other	026	PHYSICIANS	67542	01	General Practice	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
169910	Fee-for-Service	1952565491	1952565491	1	2	HAAK, LOGAN M MD	10/21/2020	207WX0107X	NA	Ophthalmology	026	PHYSICIANS	110896	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
169919	Fee-for-Service	1821143744	1821143744	1	1	HENSLEY, MICHAEL J OD	4/28/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4000 TYLER STREET	None	RIVERSIDE	CA	92503	3458	33	06065	33.91564903	-117.464488	Riverside County
169921	Fee-for-Service	1952476327	1952476327	1	1	HUSSAIN, SABIHA MD	11/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	95750	77	Infectious Disease	0	In state provider	None	5222 BALBOA AVE	STE 42	SAN DIEGO	CA	92117	6991	37	06073	32.81873589	-117.1838368	San Diego County
169929	Fee-for-Service	1750905535	1750905535	1	1	HOWARD, VINCENT M	6/25/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3086 PALOMINO WAY	None	HOLLISTER	CA	95023	9268	35	06069	36.82001381	-121.3876811	San Benito County
169936	Fee-for-Service	1982752978	1982752978	1	1	HELMER, EDWARD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	22174	30	Radiology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
169949	Fee-for-Service	1033528757	1033528757	1	1	HIDAY, MARK A NP	6/28/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
169951	Fee-for-Service	1801217724	1801217724	1	1	HENNING, MISHA LMFT	12/15/2022	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
170014	Fee-for-Service	1376794420	1376794420	1	1	HU, SCOTT B MD	9/21/2009	207R00000X	NA	Other	026	PHYSICIANS	101583	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90095	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
170071	Fee-for-Service	1376256693	1376256693	1	1	HAMLAT, ELISSA J PHD	4/19/2023	103TC0700X	NA	Mental Health Outpatient Services	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
170073	Fee-for-Service	1922556893	1922556893	1	1	HALL, REBECCA A NP	11/28/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
170076	Fee-for-Service	1629156526	1629156526	1	1	HEWITT, JANE E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41080	01	General Practice	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
170093	Fee-for-Service	1629520986	1629520986	1	1	HEART HEALTH CENTER OF SAN	3/7/2018	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	DIEGO AMC	502 EUCLID AVE	STE 104	NATIONAL CITY	CA	91950	2959	37	06073	32.68505421	-117.0832793	San Diego County
170095	Fee-for-Service	1386751816	1386751816	1	1	HONDO, RANDY H	7/18/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
170098	Fee-for-Service	1336227594	1336227594	1	1	HANJAN, HARBHAJAN K MD	5/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	38002	40	Pediatrics	0	In state provider	None	906 S SUNSET AVE	STE 103	WEST COVINA	CA	91790	3400	19	06037	34.06466364	-117.9424724	Los Angeles County
170115	Fee-for-Service	1861014417	1861014417	1	1	HOSPICE OF PROVIDENCE, INC	6/12/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4533 VAN NUYS BLVD	SUITE 301-B	SHERMAN OAKS	CA	91403	2950	19	06037	34.154037	-118.4487285	Los Angeles County
170204	Fee-for-Service	1548209646	1548209646	1	1	HSU, HSIEN-WEN MD	4/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82612	41	Internal Medicine	0	In state provider	None	2220 GLADSTONE DR	STE 3	PITTSBURG	CA	94565	5123	07	06013	38.00689525	-121.8661724	Contra Costa County
170215	Fee-for-Service	1750905535	1750905535	1	1	HOWARD, VINCENT M	6/25/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3086 PALOMINO WAY	None	HOLLISTER	CA	95023	9268	35	06069	36.82001381	-121.3876811	San Benito County
170219	Fee-for-Service	1851055396	1851055396	1	1	HANNAH KERN M.D., INC.	12/27/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	None	None	0	In state provider	None	354 SANTA FE DRIVE	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
170221	Fee-for-Service	1881024008	1881024008	1	1	HADLEY, LAUREN C LMFT	5/18/2020	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
170244	Fee-for-Service	1881014652	1881014652	1	1	HIGHTOWER, GEORGE K MD	8/19/2019	207NP0225X	NA	Dermatology	026	PHYSICIANS	156244	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
170252	Fee-for-Service	1942469838	1942469838	1	1	HODALY, RIMA MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	53114	-	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
170289	Fee-for-Service	1225355290	1225355290	1	1	HENLEY, ROBERT R PHD	7/8/2024	103T00000X	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
170316	Fee-for-Service	1821408865	1821408865	1	1	HODELL, EVAN MD	12/29/2023	207L00000X	NA	Other	026	PHYSICIANS	139030	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
170331	Fee-for-Service	1760755540	1760755540	1	1	HUBNER, LAUREN M MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119940	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
170343	Fee-for-Service	1720460884	1720460884	1	1	HOSSAIN, MUHAIMINU M DPM	10/24/2018	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
170346	Fee-for-Service	1952921298	1952921298	1	1	HILLCREST HOSPICE INC	6/21/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2955 E HILLCREST DRIVE	SUITE 128	THOUSAND OAKS	CA	91362	3176	56	06111	34.17313733	-118.8347453	Ventura County
170380	Fee-for-Service	1932133253	1932133253	1	1	HERBERT, NICHOLE R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74572	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
170403	Fee-for-Service	1861014417	1861014417	1	1	HOSPICE OF PROVIDENCE, INC	6/12/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4533 VAN NUYS BLVD	SUITE 301-B	SHERMAN OAKS	CA	91403	2950	19	06037	34.154037	-118.4487285	Los Angeles County
170450	Fee-for-Service	1700957560	1700957560	1	1	HORNER, ANTHONY A MD	9/1/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64424	40	Pediatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
170453	Fee-for-Service	1073642674	1073642674	1	1	HOLLSTEIN, ROLF D MD	10/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86128	30	Radiology	0	In state provider	None	330 LEWIS ST	None	SAN DIEGO	CA	92103	2108	37	06073	32.75187491	-117.1617402	San Diego County
170455	Fee-for-Service	1346755717	1346755717	1	1	HICKS, JULIANNE LMFT	7/25/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	790 MASON ST	STE 102	VACAVILLE	CA	95688	4661	48	06095	38.3550515	-121.9832505	Solano County
170456	Fee-for-Service	1790984607	1790984607	1	1	HANNA AL-KASS, FARAJALLAH M	3/18/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	137122	30	Radiology	0	In state provider	MD	5020 COMMERCE DR	None	BAKERSFIELD	CA	93309	0631	15	06029	35.36787086	-119.0579597	Kern County
170477	Fee-for-Service	1225483894	1225483894	1	1	HATTAR, ELLINA MD	7/26/2023	207T00000X	NA	General Surgery	026	PHYSICIANS	186524	None	None	0	In state provider	None	300 STEIN PLZ	420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
170483	Fee-for-Service	1043847627	1043847627	1	1	HATHAWAY, MILLIE MAE DO	5/30/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20053	None	None	0	In state provider	None	1601 N MONTE VISTA AVE	#100	CLAREMONT	CA	91711	6601	19	06037	34.112259	-117.698539	Los Angeles County
170500	Fee-for-Service	1649217316	1649217316	1	1	HENDRICKSON, IRENE MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65015	40	Pediatrics	0	In state provider	None	2300 S FLOWER ST	STE 200	LOS ANGELES	CA	90007	2676	19	06037	34.0294397	-118.2734132	Los Angeles County
170532	Fee-for-Service	1881014652	1881014652	1	1	HIGHTOWER, GEORGE K MD	8/19/2019	207NP0225X	NA	Dermatology	026	PHYSICIANS	156244	07	Dermatology	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
170577	Fee-for-Service	1629363965	1629363965	1	1	HALL, CYNTHIA L LMFT	11/13/2018	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
170583	Fee-for-Service	1871538579	1871538579	1	1	HEMET EMERGENCY MED GRP	6/13/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
170592	Fee-for-Service	1124339809	1124339809	1	1	HUGHES, ROBERT T MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111397	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
170640	Fee-for-Service	1952921298	1952921298	1	1	HILLCREST HOSPICE INC	6/21/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2955 E HILLCREST DRIVE	SUITE 128	THOUSAND OAKS	CA	91362	3176	56	06111	34.17313733	-118.8347453	Ventura County
170663	Fee-for-Service	1154474872	1154474872	1	1	HIGGINS, JOHN P MD	6/1/1999	207ZP0102X	NA	Other	026	PHYSICIANS	60350	22	Pathology (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
170687	Fee-for-Service	1750894879	1750894879	1	1	HOLY CROSS URGENT CARE INC	12/17/2019	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4864 SANTA MONICA BLVD	None	LOS ANGELES	CA	90029	2634	19	06037	34.09082353	-118.2957075	Los Angeles County
170723	Fee-for-Service	1043740939	1043740939	1	1	HLUCHAN, CHRISTINE M MD	11/5/2021	390200000X	NA	Other	026	PHYSICIANS	174964	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
170735	Fee-for-Service	1700957560	1700957560	1	1	HORNER, ANTHONY A MD	9/1/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	64424	03	Allergy	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
170755	Fee-for-Service	1710918388	1710918388	1	1	HADDADIN, HASSAN A MD	8/21/2017	207RP1001X	NA	Pulmonology	026	PHYSICIANS	54163	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
170762	Fee-for-Service	1104321959	1104321959	1	11	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	325 SACRAMENTO ST	None	SAN FRANCISCO	CA	94111	3601	38	06075	37.79424305	-122.3994352	San Francisco County
170772	Fee-for-Service	1609258938	1609258938	1	1	HIRA IMAD CHEEMA M.D.	8/16/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1555 EXCHANGE AVE	None	CONWAY	AR	72032	7824	00	None	35.056665	-92.4195825	Faulkner County
170787	Fee-for-Service	1043203003	1043203003	1	1	HAVAS, JEREMY D DO	11/2/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	18385	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
170793	Fee-for-Service	1841417540	1841417540	1	1	HERST, MELVIN E LMFT	6/21/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46763	-	NOT APPLICABLE	0	In state provider	None	1650 ADAMS AVE	None	COSTA MESA	CA	92626	4958	30	06059	33.67290025	-117.9250073	Orange County
170806	Fee-for-Service	1851055396	1851055396	1	2	HANNAH KERN M.D., INC.	12/27/2021	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	None	None	None	0	In state provider	None	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
170821	Fee-for-Service	1407461668	1407461668	1	1	HEALTHY WAY HOME HEALTH	6/24/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6320 VAN NUYS BLVD	STE 207	VAN NUYS	CA	91401	6610	19	06037	34.18545203	-118.4487091	Los Angeles County
170835	Fee-for-Service	1649854639	1649854639	1	1	HE, SISSI Y OD	8/15/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 S ATLANTIC BLVD	STE A	MONTEREY PARK	CA	91754	3872	19	06037	34.05627946	-118.1347926	Los Angeles County
170842	Fee-for-Service	1336145523	1336145523	1	1	HAYES, WILLISTON S MD	7/15/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41003	04	Otology, Laryngology, Rhinology	0	In state provider	None	2854 OLIVE HWY	STE A	OROVILLE	CA	95966	6112	04	06007	39.50347297	-121.5404768	Butte County
170873	Fee-for-Service	1730422528	1730422528	1	1	HSU, MICHAEL J MD	5/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153166	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
170876	Fee-for-Service	1104321959	1104321959	1	9	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	10111 HOLE	None	RIVERSIDE	CA	92503	3441	33	06065	33.91431544	-117.4585034	Riverside County
170897	Fee-for-Service	1861467276	1861467276	1	1	HALLAL, LOUIS 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	14555 LEVAN RD	STE E-402	LIVONIA	MI	48154	5083	00	None	42.39033517	-83.40270809	Wayne County
170900	Fee-for-Service	1144303793	1144303793	1	1	HEIBULT, TAMARA S MD	10/18/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95622	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8762	20	06039	36.88437894	-119.8003484	Madera County
170920	Fee-for-Service	1215030622	1215030622	1	1	HEYMAN, CATHERINE L	10/1/1996	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1342 E CHAPMAN AVE	None	FULLERTON	CA	92831	3954	30	06059	33.87409201	-117.9039639	Orange County
170924	Fee-for-Service	1437234119	1437234119	1	1	HAZLETT, EVELYN E MD	9/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87486	36	Psychiatry	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
170931	Fee-for-Service	1174713168	1174713168	1	1	HATA, JUSTIN T MD	11/27/2007	207L00000X	NA	Other	026	PHYSICIANS	86728	25	Physical Medicine and Rehabilitation	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
170950	Fee-for-Service	1851316749	1851316749	1	1	HENEIN, NASSEF MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63703	41	Internal Medicine	0	In state provider	None	1100 4TH ST	None	TAFT	CA	93268	2415	15	06029	35.14905085	-119.4534352	Kern County
170951	Fee-for-Service	1346221512	1346221512	2	1	HETZNER, PETER V OD	3/18/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	421 S HAM LANE	SUITE B	LODI	CA	95242	3523	39	06077	38.12880429	-121.2883229	San Joaquin County
170970	Fee-for-Service	1750106241	1750106241	1	1	HACKER, JERRY PT	1/9/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	30837 E THOUSAND OAKS BL	None	WESTLAKE VILLAGE	CA	91362	0000	19	06037	34.15512537	-118.7921942	Los Angeles County
170979	Fee-for-Service	1043746605	1043746605	1	1	HUANG, GRACE L MD	8/27/2020	207R00000X	NA	Other	026	PHYSICIANS	160891	41	Internal Medicine	0	In state provider	None	901 CAMPUS DR.	None	DALY CITY	CA	94015	4900	41	06081	37.66535778	-122.4763793	San Mateo County
170989	Fee-for-Service	1821385790	1821385790	1	1	HOYER, LANA C LMFT	2/10/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2083 LYNX WAY	None	SAN MARCOS	CA	92078	0905	37	06073	33.09908149	-117.2194268	San Diego County
171030	Fee-for-Service	1982897138	1982897138	1	1	HAN, YONGYI MD	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	67875	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
171038	Fee-for-Service	1609938893	1609938893	1	1	HAYCRAFT, DANIEL M MD	11/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	56075	36	Psychiatry	0	In state provider	None	913 WASHINGTON STREET	None	CALISTOGA	CA	94515	1433	28	06055	38.57812737	-122.5772111	Napa County
171039	Fee-for-Service	1790292092	1790292092	1	2	HAWKER, MEGAN LMFT	10/16/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82451	-	NOT APPLICABLE	0	In state provider	None	1820 SOUTH ESCONDIDO BOU	STE 101	ESCONDIDO	CA	92025	6524	37	06073	33.10274588	-117.0716978	San Diego County
171049	Fee-for-Service	1104321959	1104321959	1	11	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	325 SACRAMENTO ST	None	SAN FRANCISCO	CA	94111	3601	38	06075	37.79424305	-122.3994352	San Francisco County
171055	Fee-for-Service	1104321959	1104321959	1	5	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	8370 WILSHIRE	SUITE 110	BEVERLY HILLS	CA	90211	2333	19	06037	34.06453566	-118.373697	Los Angeles County
171057	Fee-for-Service	1588749246	1588749246	1	1	HLA, AUNG MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	52504	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
171068	Fee-for-Service	1639354285	1639354285	1	1	HUANG, TAJI PSY	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	22717	-	NOT APPLICABLE	0	In state provider	None	1303 WEST WALNUT PARKWAY	None	COMPTON	CA	90220	5030	19	06037	33.87724562	-118.2446904	Los Angeles County
171136	Fee-for-Service	1912108051	1912108051	1	1	HARRISON, MATTHEW J MD	7/23/2012	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	115319	20	Orthopedic Surgery	0	In state provider	None	511 BATH STREET	None	SANTA BARBARA	CA	93101	3403	42	06083	34.41386476	-119.6993335	Santa Barbara County
171140	Fee-for-Service	1598103145	1598103145	1	1	HROMALIK, PATRICIA T LMFT	5/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	720 SOUTHPOINT BLVD.	SUITE 202	PETALUMA	CA	94954	7495	49	06097	38.25846424	-122.6470803	Sonoma County
171163	Fee-for-Service	1104321959	1104321959	1	9	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	10111 HOLE	None	RIVERSIDE	CA	92503	3441	33	06065	33.91431544	-117.4585034	Riverside County
171220	Fee-for-Service	1174713168	1174713168	1	1	HATA, JUSTIN T MD	11/27/2007	207L00000X	NA	Other	026	PHYSICIANS	86728	05	Anesthesiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
171221	Fee-for-Service	1205211760	1205211760	1	1	HOFFMAN, TIFFANY M LMFT	10/19/2021	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
171235	Fee-for-Service	1093793242	1093793242	1	1	HEDMAN, BRON C MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66121	08	Family Practice	0	In state provider	None	11000 OLSON DR	STE 100	RANCHO CORDOVA	CA	95670	5605	34	06067	38.595123	-121.2820155	Sacramento County
171241	Fee-for-Service	1912939232	1912939232	1	1	HIBSCHMAN, PAUL W LCSW	12/13/2004	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	920 SAMOA BLVD	STE 223	ARCATA	CA	95521	6696	12	06023	40.86545166	-124.0893546	Humboldt County
171242	Fee-for-Service	1033295563	1033295563	1	1	HIRSCH, REBECCA L MD	8/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85537	36	Psychiatry	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
171250	Fee-for-Service	1811053697	1811053697	1	1	HEASLET, JACK E DC	3/30/2022	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	502 SPRING STREET	None	PASO ROBLES	CA	93446	3169	40	06079	35.61968517	-120.6907863	San Luis Obispo County
171290	Fee-for-Service	1902170673	1902170673	1	1	HU, ANDERSON DO	8/19/2016	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
171313	Fee-for-Service	1679892020	1679892020	1	1	HIGGINS, DAWN M PT	1/19/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	27722 CLINTON KEITH RD.,	#B	MURRIETA	CA	92562	0000	33	06065	33.59891845	-117.1765297	Riverside County
171334	Fee-for-Service	1588695902	1588695902	1	1	HARPER, BARON D MD	6/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88253	33	Thoracic Surgery	0	In state provider	None	401 I ST	STE A	MARYSVILLE	CA	95901	5626	58	06115	39.13882888	-121.5963884	Yuba County
171344	Fee-for-Service	1104321959	1104321959	1	5	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8370 WILSHIRE	SUITE 110	BEVERLY HILLS	CA	90211	2333	19	06037	34.06453566	-118.373697	Los Angeles County
171348	Fee-for-Service	1548537301	1548537301	1	1	HUGHES, BRENNA L CCC-SLP	2/12/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
171356	Fee-for-Service	1740683135	1740683135	1	1	HOLLY, PAULA	10/10/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	15499 JOJOBA LANE	None	VICTORVILLE	CA	92394	5597	36	06071	34.53107335	-117.3399452	San Bernardino County
171402	Fee-for-Service	1083798052	1083798052	1	1	HEINLEIN, PETER K MD	8/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72237	66	Emergency Medicine (Urgent Care)	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
171404	Fee-for-Service	1659344026	1659344026	1	1	HU, CHIA CHIEH MD	7/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71510	40	Pediatrics	0	In state provider	None	800 S SANTA ANITA AVE	STE 201	ARCADIA	CA	91006	3555	19	06037	34.131114	-118.031171	Los Angeles County
171467	Fee-for-Service	1851508550	1851508550	2	1	HOOPER, JODY E MD	9/4/2021	207ZP0101X	NA	Other	026	PHYSICIANS	70087	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
171468	Fee-for-Service	1396822243	1396822243	1	1	HATTLER, EDWARD S MD	10/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68659	01	General Practice	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
171470	Fee-for-Service	1609181437	1609181437	1	1	HERNANDEZ, ERNESTO S DPM	11/4/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4650 PALM AVE	None	SAN DIEGO	CA	92154	8404	37	06073	32.5839467	-117.0337851	San Diego County
171475	Fee-for-Service	1669576211	1669576211	1	1	HEMATOLOGY ONCOLOGY	1/12/1995	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	68	Hematology	0	In state provider	CONSULTANTS	23101 SHERMAN PL	STE 410	WEST HILLS	CA	91307	2026	19	06037	34.20099112	-118.6297991	Los Angeles County
171510	Fee-for-Service	1689970782	1689970782	1	1	HERNANDEZ, INGRID MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115661	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
171522	Fee-for-Service	1891845608	1891845608	1	1	HO, DIANA Q MD	8/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74281	07	Dermatology	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
171572	Fee-for-Service	1578020582	1578020582	1	1	HANGGIE, CRAIG LMFT	5/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
171624	Fee-for-Service	1588695902	1588695902	1	1	HARPER, BARON D MD	6/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88253	36	Psychiatry	0	In state provider	None	401 I ST	STE A	MARYSVILLE	CA	95901	5626	58	06115	39.13882888	-121.5963884	Yuba County
171645	Fee-for-Service	1740683135	1740683135	1	1	HOLLY, PAULA	10/10/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	15499 JOJOBA LANE	None	VICTORVILLE	CA	92394	5597	36	06071	34.53107335	-117.3399452	San Bernardino County
171651	Fee-for-Service	1922460617	1922460617	1	1	HA, DENNIS MD	7/1/2019	390200000X	NA	Other	026	PHYSICIANS	151317	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
171652	Fee-for-Service	1073624201	1073624201	1	1	HASSE,MIHAELA M MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	51426	40	Pediatrics	0	In state provider	None	10058 WOLF RD	None	GRASS VALLEY	CA	95949	8194	29	06057	39.04265452	-121.0952182	Nevada County
171700	Fee-for-Service	1902916323	1902916323	1	1	HANSON, BRIAN L MD	4/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	84433	10	Gastroenterology (M.D. only)	0	In state provider	None	415 HOSPITAL DR	None	UKIAH	CA	95482	4545	23	06045	39.15408161	-123.2020675	Mendocino County
171718	Fee-for-Service	1528125721	1528125721	1	1	HASRATYAN, ANUSH MD	5/24/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	97843	41	Internal Medicine	0	In state provider	None	17909 W SOLEDAD CANYON	None	CANYON COUNTRY	CA	91387	3210	19	06037	34.41652621	-118.4458684	Los Angeles County
171719	Fee-for-Service	1417941931	1417941931	1	1	HACKNER, ERROLL L MD	7/31/1995	207L00000X	NA	Other	026	PHYSICIANS	31419	05	Anesthesiology	0	In state provider	None	11601 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2907	19	06037	34.04458879	-118.4542015	Los Angeles County
171723	Fee-for-Service	1356353361	1356353361	1	1	HAGAN, MOWBRAY P MD INC	12/1/2001	261QP2300X	NA	Other	026	PHYSICIANS	29431	41	Internal Medicine	0	In state provider	None	482 CORONA MALL	None	CORONA	CA	92879	1418	33	06065	33.87658954	-117.5663302	Riverside County
171762	Fee-for-Service	1669576211	1669576211	1	1	HEMATOLOGY ONCOLOGY	1/12/1995	207RH0003X	NA	Oncology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	CONSULTANTS	23101 SHERMAN PL	STE 410	WEST HILLS	CA	91307	2026	19	06037	34.20099112	-118.6297991	Los Angeles County
171771	Fee-for-Service	1396908828	1396908828	1	1	HERITAGE WEST ADHC, LLC	7/3/2008	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HERITAGE WEST	3677 W BEECHWOOD AVE	None	FRESNO	CA	93711	0648	10	06019	36.8382303	-119.8597741	Fresno County
171803	Fee-for-Service	1831327121	1831327121	1	1	HOANG, VAN T MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123324	07	Dermatology	0	In state provider	None	441 N LAKEVIEW AVENUE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
171810	Fee-for-Service	1063589901	1063589901	1	1	HALL, CHRISTIE B MD	7/1/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	73479	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
171815	Fee-for-Service	1427671734	1427671734	1	1	HOSPICE PROVIDERS OF THE	2/24/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	DESERT INC	74333 HWY 111	SUITE 210	PALM DESERT	CA	92260	4132	33	06065	33.72105174	-116.3680184	Riverside County
171834	Fee-for-Service	1639460637	1639460637	1	1	HERBRICK, AVA CPO	5/12/2011	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	23033 LYONS AVE	SUITE 6	NEWHALL	CA	91321	2777	19	06037	34.38013033	-118.5361055	Los Angeles County
171836	Fee-for-Service	1659484723	1659484723	1	1	HARDISTY, TERESA K MD	5/31/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	61118	40	Pediatrics	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
171901	Fee-for-Service	1225340227	1225340227	1	1	HORANI, RAMI MD	3/9/2023	207R00000X	NA	Other	026	PHYSICIANS	155921	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
171909	Fee-for-Service	1619395597	1619395597	1	1	HISAW, LISA D MD	5/18/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	141079	07	Dermatology	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
171934	Fee-for-Service	1306564992	1306564992	1	1	HOUSE, SHELLBY O LAC	5/19/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	UPUNCTURE AND HERBS	525 2ND ST	STE 103	EUREKA	CA	95501	0488	12	06023	40.80456258	-124.1659537	Humboldt County
171942	Fee-for-Service	1073624201	1073624201	1	1	HASSE,MIHAELA M MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	51426	41	Internal Medicine	0	In state provider	None	10058 WOLF RD	None	GRASS VALLEY	CA	95949	8194	29	06057	39.04265452	-121.0952182	Nevada County
171954	Fee-for-Service	1861683286	1861683286	1	1	HASAN, JAMAL Y MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86663	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
171975	Fee-for-Service	1831672815	1831672815	1	1	HEYDARI, ZAHRA LMFT	7/27/2022	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
171976	Fee-for-Service	1386774271	1386774271	1	1	HURN, KATHRYN L PSYD	1/28/2016	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
171985	Fee-for-Service	1780871574	1780871574	1	1	HARRIS GAYLE, TANIKA PSYD	5/8/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5051 CANYON CREST DR	SUITE 204	RIVERSIDE	CA	92507	0000	33	06065	33.9589602	-117.3311519	Riverside County
171988	Fee-for-Service	1548448996	1548448996	1	1	HOSFIELD, ELIZABETH M MD	11/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91991	22	Pathology (M.D. only)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
172007	Fee-for-Service	1306006903	1306006903	1	1	HAAR, ROHINI J MD	2/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132626	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
172030	Fee-for-Service	1265173223	1265173223	1	1	HASAN, BUSHRA Z NP	10/10/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
172100	Fee-for-Service	1124330766	1124330766	1	1	HANIF, ARSLAN M MD	6/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118355	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
172105	Fee-for-Service	1427671734	1427671734	1	1	HOSPICE PROVIDERS OF THE	2/24/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	DESERT INC	74333 HWY 111	SUITE 210	PALM DESERT	CA	92260	4132	33	06065	33.72105174	-116.3680184	Riverside County
172128	Fee-for-Service	1679506604	1679506604	1	1	H. JOSEPH SPAETH JR. M.D.	10/3/2015	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
172130	Fee-for-Service	1801265046	1801265046	1	1	HAYRABEDIAN, MOVSES MD	6/10/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	178032	None	None	0	In state provider	None	1910 OUTLET CENTER DR	None	OXNARD	CA	93036	0677	56	06111	34.2202663	-119.1484221	Ventura County
172132	Fee-for-Service	1386770725	1386770725	1	3	HOGAN, W MICHAEL MD PC	12/11/2012	207VX0201X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	78	Neoplastic Diseases/Oncology	0	In state provider	None	540 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4230	42	06083	34.42739162	-119.7253175	Santa Barbara County
172174	Fee-for-Service	1083647226	1083647226	1	1	HARTLEY, LAURENCE W	3/27/2009	207VG0400X	NA	Obstetrics & Gynecology	026	PHYSICIANS	25739	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	333 LAWS AVENUE	None	UKIAH	CA	95482	6504	23	06045	39.12772164	-123.2111168	Mendocino County
172195	Fee-for-Service	1639450414	1639450414	1	1	HUONG-SCHLEIF, SHU TZE NP	4/3/2020	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
172208	Fee-for-Service	1174019582	1174019582	1	1	HUYNH, DESMOND T MD	9/10/2024	208600000X	NA	General Surgery	026	PHYSICIANS	160490	02	General Surgery	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
172235	Fee-for-Service	1154340545	1154340545	1	1	HIERRO, GLORIA	12/1/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	75998	40	Pediatrics	0	In state provider	None	17909 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91387	3210	19	06037	34.41652621	-118.4458684	Los Angeles County
172236	Fee-for-Service	1326108747	1326108747	1	1	HERNANDEZ, DIANE M	1/23/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1235 BUENA VISTA ST	None	DUARTE	CA	91010	2408	19	06037	34.138485	-117.9775775	Los Angeles County
172246	Fee-for-Service	1164494761	1164494761	1	1	HONG, ERICKA Y MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74412	40	Pediatrics	0	In state provider	None	9710 19TH ST	None	RANCHO CUCAMONGA	CA	91737	3538	36	06071	34.13274747	-117.593073	San Bernardino County
172286	Fee-for-Service	1538783709	1538783709	1	1	HOSPICE OF SOUTHERN	12/22/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA	18075 VENTURA BLVD	STE 228	ENCINO	CA	91316	3597	19	06037	34.16527698	-118.5267	Los Angeles County
172293	Fee-for-Service	1932151867	1932151867	1	1	HADDAD, THOMAS K MD	5/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95352	41	Internal Medicine	0	In state provider	None	909 HYDE ST	STE 125	SAN FRANCISCO	CA	94109	4832	38	06075	37.78939387	-122.4170945	San Francisco County
172329	Fee-for-Service	1639673536	1639673536	1	1	HOOKEY, GLEN C MD	10/1/2021	207P00000X	NA	Other	026	PHYSICIANS	174450	None	None	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
172335	Fee-for-Service	1538396841	1538396841	1	1	HSU, GRACE MD	9/16/2020	207LP3000X	NA	Other	026	PHYSICIANS	169695	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
172339	Fee-for-Service	1609994912	1609994912	1	1	HUGGINS, ROBERT D MD	12/31/2007	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	97370	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
172363	Fee-for-Service	1427174432	1427174432	1	1	HOLTMAN, KEVIN R OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
172376	Fee-for-Service	1255530853	1255530853	1	1	HANJANI, FARZODD E. MD	5/8/2009	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
172414	Fee-for-Service	1356442032	1356442032	1	1	HART, RONALD D MD	7/24/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85093	08	Family Practice	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
172415	Fee-for-Service	1780048090	1780048090	1	1	HO, THUANTHIEN DO	3/25/2020	208M00000X	NA	Other	026	PHYSICIANS	17469	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
172421	Fee-for-Service	1386770725	1386770725	1	3	HOGAN, W MICHAEL MD PC	12/11/2012	207VX0201X	NA	Obstetrics & Gynecology	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	540 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4230	42	06083	34.42739162	-119.7253175	Santa Barbara County
172422	Fee-for-Service	1396946273	1396946273	1	1	HUSSAIN, MARIA T CRNA	10/28/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
172451	Fee-for-Service	1427462688	1427462688	1	1	HWANG, MICHAEL H MD	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138739	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
172463	Fee-for-Service	1598912909	1598912909	1	1	HOANG, AMANDA P MD	12/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125736	30	Radiology	0	In state provider	None	440 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	51	06101	39.13140416	-121.6141951	Sutter County
172471	Fee-for-Service	1396850723	1396850723	1	1	HARLEMAN, ELIZABETH S MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	71994	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
172475	Fee-for-Service	1194987297	1194987297	1	1	HAKIMIPOUR, MEHDI MD	8/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105622	41	Internal Medicine	0	In state provider	None	1180 EAST SHAW	STE 125	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
172538	Fee-for-Service	1699038042	1699038042	1	1	HU, CHARLES J DO	11/3/2015	No Taxonomy Provided	NA	None	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
172545	Fee-for-Service	1962491480	1962491480	1	1	HEALTH CARE MEDICAL	9/16/1993	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PHARMACY INC	420 N GARFIELD AVE	STE 101	MONTEREY PARK	CA	91754	1206	19	06037	34.0670077	-118.1228585	Los Angeles County
172574	Fee-for-Service	1538783709	1538783709	1	1	HOSPICE OF SOUTHERN	12/22/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA	18075 VENTURA BLVD	STE 228	ENCINO	CA	91316	3597	19	06037	34.16527698	-118.5267	Los Angeles County
172582	Fee-for-Service	1932151867	1932151867	1	1	HADDAD, THOMAS K MD	5/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95352	10	Gastroenterology (M.D. only)	0	In state provider	None	909 HYDE ST	STE 125	SAN FRANCISCO	CA	94109	4832	38	06075	37.78939387	-122.4170945	San Francisco County
172583	Fee-for-Service	1275356453	1275356453	1	1	HARRIS, MCKENZIE D	11/12/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5100 N SIXTH ST	STE 120	FRESNO	CA	93710	7506	10	06019	36.810666	-119.763204	Fresno County
172603	Fee-for-Service	1417035254	1417035254	1	1	HAMILTON, MAURICE E MD	8/10/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	39999	83	Rheumatology	0	In state provider	None	534 E PINE ST	STE B	STOCKTON	CA	95204	5536	39	06077	37.97439027	-121.2897236	San Joaquin County
172628	Fee-for-Service	1619387537	1619387537	1	1	HALIM, NASIR MD	11/16/2021	207R00000X	NA	Other	026	PHYSICIANS	144923	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
172694	Fee-for-Service	1619286101	1619286101	1	1	HUYNH, JULIE MD	7/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113170	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
172722	Fee-for-Service	1588926141	1588926141	1	1	HOLMQUIST, TARA PSYD	6/15/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1605 HOPE ST	335	SOUTH PASADENA	CA	91030	2628	19	06037	34.11679363	-118.150088	Los Angeles County
172749	Fee-for-Service	1922578798	1922578798	1	1	HERNANDEZ, MICHELLE 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
172774	Fee-for-Service	1235217050	1235217050	1	1	HALL, JIM X MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70476	40	Pediatrics	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
172776	Fee-for-Service	1578943544	1578943544	1	1	HSIAO, THERESA DO	9/27/2019	207P00000X	NA	Other	026	PHYSICIANS	16943	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
172834	Fee-for-Service	1174151393	1174151393	1	1	HANKINSON, AUSTIN MD	10/18/2022	390200000X	NA	Other	026	PHYSICIANS	19726	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
172853	Fee-for-Service	1255009460	1255009460	1	1	HERD, BROOKE PSYD	11/29/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8300 UTICA AVE	STE 245	RANCHO CUCAMONGA	CA	91730	3852	36	06071	34.10227306	-117.5715643	San Bernardino County
172890	Fee-for-Service	1366027757	1366027757	1	1	HONG, KIOK	10/7/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	CLINIC	7461 LA PALMA AVE.	SUITE A	BUENA PARK	CA	90620	2655	30	06059	33.84665344	-118.0033141	Orange County
172892	Fee-for-Service	1760907539	1760907539	1	1	HARVEY, NATHAN CRNA	7/30/2024	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4501 SAND CREEK RD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
172899	Fee-for-Service	1619998192	1619998192	1	1	HENLEY, JON M OD	2/13/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1213 W FOOTHILL BLVD	None	UPLAND	CA	91786	3681	36	06071	34.108587	-117.6710625	San Bernardino County
172915	Fee-for-Service	1124186945	1124186945	1	1	HARRINGTON, M J MD INC	1/14/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	17618	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3419 VALLE VERDE DR	None	NAPA	CA	94558	2414	28	06055	38.32542048	-122.292335	Napa County
172948	Fee-for-Service	1194763219	1194763219	1	1	HUMBOLDT COUNTY	7/1/2016	No Taxonomy Provided	NA	None	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	720 WOOD STREET	None	EUREKA	CA	95501	4413	12	06023	40.78118068	-124.1607622	Humboldt County
172949	Fee-for-Service	1215319587	1215319587	1	1	HAUSER, NAOMI E MD	9/28/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	170304	77	Infectious Disease	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
172982	Fee-for-Service	1134538564	1134538564	1	1	HONG, MICHELLE PSYD	2/12/2019	390200000X	NA	Other	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
173027	Fee-for-Service	1912338518	1912338518	1	1	HOSPICE AND HOME CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	980 ENCHANTED WAY	SUITE 210	SIMI VALLEY	CA	93065	0914	56	06111	34.28347675	-118.7826819	Ventura County
173032	Fee-for-Service	1467606079	1467606079	1	1	HTUT, THINZAR A MD	4/27/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105267	08	Family Practice	0	In state provider	None	520 N PROSPECT AVE	STE 103	REDONDO BEACH	CA	90277	0000	19	06037	33.8529819	-118.3802954	Los Angeles County
173149	Fee-for-Service	1073846002	1073846002	1	1	HUYNH, UYEN P MD	11/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108461	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7601 STONERIDGE DRIVE	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
173199	Fee-for-Service	1548678881	1548678881	1	1	HENSLEY, JEFFREY M NP	4/21/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	72780 COUNTRY CLUB DR	STE C300	RANCHO MIRAGE	CA	92270	4150	33	06065	33.75795596	-116.392246	Riverside County
173203	Fee-for-Service	1124186945	1124186945	1	1	HARRINGTON, M J MD INC	1/14/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	17618	41	Internal Medicine	0	In state provider	None	3419 VALLE VERDE DR	None	NAPA	CA	94558	2414	28	06055	38.32542048	-122.292335	Napa County
173239	Fee-for-Service	1215319587	1215319587	1	1	HAUSER, NAOMI E MD	9/28/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	170304	41	Internal Medicine	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
173304	Fee-for-Service	1699874826	1699874826	1	1	HOANG, BRUCE K DO	11/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	9745 PROSPECT AVE	STE 100	SANTEE	CA	92071	6209	37	06073	32.83136651	-116.9842605	San Diego County
173316	Fee-for-Service	1912338518	1912338518	1	1	HOSPICE AND HOME CARE INC	8/17/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	980 ENCHANTED WAY	SUITE 210	SIMI VALLEY	CA	93065	0914	56	06111	34.28347675	-118.7826819	Ventura County
173332	Fee-for-Service	1225393499	1225393499	1	1	HERSKOVITZ, SCOTT A MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155234	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3020 CHILDRENS WAY	MC5069	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
173345	Fee-for-Service	1821471269	1821471269	1	1	HANSEN, NICOLE	7/21/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	9544 N SHARON AVENUE	None	FRESNO	CA	93720	1458	10	06019	36.87493002	-119.7571717	Fresno County
173364	Fee-for-Service	1386892735	1386892735	1	1	HUANG, POCHI OD	5/6/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	#115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
173379	Fee-for-Service	1588628812	1588628812	1	1	HOROWITZ, ROBERT N MD	1/31/1996	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	45180	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
173388	Fee-for-Service	1326263633	1326263633	1	1	HWYNN, JULIE MD	10/30/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	66861	41	Internal Medicine	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 301	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
173395	Fee-for-Service	1801960786	1801960786	1	1	HANGER P & O WEST INC	3/27/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2275 MYERS STREET	STE C	OROVILLE	CA	95966	5319	04	06007	39.50712757	-121.5514297	Butte County
173401	Fee-for-Service	1093397614	1093397614	1	1	HUR, CHRISTINE J OD	3/13/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	22015 S. AVALON BLVD.	STE A	CARSON	CA	90745	3355	19	06037	33.827382	-118.263757	Los Angeles County
173427	Fee-for-Service	1578511820	1578511820	1	1	HAAS, 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	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
173459	Fee-for-Service	1659384899	1659384899	1	1	HALSTED, MARK J MD	7/3/2019	2085P0229X	NA	Other	026	PHYSICIANS	80568	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
173486	Fee-for-Service	1760626477	1760626477	1	1	HASSAN KAFRI MD, INC.	7/7/2009	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	None	None	0	In state provider	NIC	328 HIGHLAND AVE	#200	EL CAJON	CA	92020	5207	37	06073	32.792103	-116.9611585	San Diego County
173506	Fee-for-Service	1215057443	1215057443	1	1	H MARK FATEMI & SAMI M SHOUK	10/15/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	AIR, PTR	5471 LA PALMA AVE	STE 203	LA PALMA	CA	90623	1798	30	06059	33.84643649	-118.0377675	Orange County
173522	Fee-for-Service	1891212296	1891212296	1	1	HEBA BOSHRA MD, INC.	3/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	5900 BROCKTON AVE	None	RIVERSIDE	CA	92506	1862	33	06065	33.96263615	-117.395639	Riverside County
173593	Fee-for-Service	1649910910	1649910910	1	1	HRINKO-OTERO, TINA CNP	3/14/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	520 WEST I ST	None	LOS BANOS	CA	95616	6201	24	06047	37.06346603	-120.8593647	Merced County
173612	Fee-for-Service	1750541660	1750541660	1	1	HO, HOAI-KY V MD	3/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	102385	18	Ophthalmology	0	In state provider	None	9191 WESTMINISTER AVE	None	GARDEN GROVE	CA	92844	2751	30	06059	33.75946879	-117.9688437	Orange County
173619	Fee-for-Service	1225393499	1225393499	1	1	HERSKOVITZ, SCOTT A MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155234	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
173620	Fee-for-Service	1467426049	1467426049	1	1	HERRING, LYNN B MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86523	40	Pediatrics	0	In state provider	None	12630 MONTE VISTA RD	STE 109	POWAY	CA	92064	2526	37	06073	32.99533582	-117.0560031	San Diego County
173632	Fee-for-Service	1821471269	1821471269	1	1	HANSEN, NICOLE	7/21/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	9544 N SHARON AVENUE	None	FRESNO	CA	93720	1458	10	06019	36.87493002	-119.7571717	Fresno County
173693	Fee-for-Service	1679244719	1679244719	1	1	HILBORN, TIFFANY LMFT	1/31/2025	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
173711	Fee-for-Service	1306890462	1306890462	1	1	HANTMAN, DAVID I MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	30141	01	General Practice	0	In state provider	None	5670 WILSHIRE BLVD	STE 17	LOS ANGELES	CA	90036	5679	19	06037	34.06236284	-118.3522745	Los Angeles County
173726	Fee-for-Service	1134655590	1134655590	1	1	HOSSAIN, SAIF MD	9/28/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	171715	None	None	0	In state provider	None	18300 HWY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
173732	Fee-for-Service	1508821554	1508821554	1	1	HU, WEI-LEE D MD	2/4/2013	207L00000X	NA	Other	026	PHYSICIANS	93063	05	Anesthesiology	0	In state provider	None	9080 COLIMA ROAD	None	WHITTIER	CA	90605	1600	19	06037	33.95062799	-118.0051627	Los Angeles County
173750	Fee-for-Service	1023104296	1023104296	1	1	HOM, CHARLES J OD	7/30/1998	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5679 GIBRALTAR DR	None	PLEASANTON	CA	94588	8547	01	06001	37.69081356	-121.890841	Alameda County
173751	Fee-for-Service	1699961664	1699961664	1	1	HSU, EMILY F MD	2/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92220	40	Pediatrics	0	In state provider	None	1045 ATLANTIC AVE	STE 605	LONG BEACH	CA	90813	3408	19	06037	33.780267	-118.1850795	Los Angeles County
173761	Fee-for-Service	1124898234	1124898234	1	1	HIGH DESERT CHILD ADOLESCENT	1/17/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	AND FAMILY SERVICES CEN	58945 BUSINESS CENTER DR	J, P, N	YUCCA VALLEY	CA	92284	7307	36	06071	34.12183989	-116.3776058	San Bernardino County
173763	Fee-for-Service	1942918552	1942918552	1	1	HERRIDGE, PATRICIA PT	8/27/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2820 BELLFLOWER BLVD	None	LONG BEACH	CA	90815	1125	19	06037	33.80733578	-118.125179	Los Angeles County
173785	Fee-for-Service	1346741261	1346741261	1	1	HEARTS HOME HEALTHCARE, INC	9/20/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2575 E BIDWELL ST	STE 200	FOLSOM	CA	95630	6446	34	06067	38.658888	-121.1303835	Sacramento County
173795	Fee-for-Service	1376695171	1376695171	1	1	HSU, YUN-LING MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73445	01	General 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
173844	Fee-for-Service	1750687638	1750687638	1	1	HOANG, LISA P MD	11/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115324	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
173847	Fee-for-Service	1407849466	1407849466	1	1	HOLT, CINDY R MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51327	40	Pediatrics	0	In state provider	None	920 CASS ST	None	MONTEREY	CA	93940	4507	27	06053	36.59295638	-121.8961062	Monterey County
173849	Fee-for-Service	1972678522	1972678522	1	1	HOLDEN, KELLEY A	10/24/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
173877	Fee-for-Service	1215471891	1215471891	1	1	HOYT, MICHELLE T OD	4/27/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1515 RESPONSE RD	None	SACRAMENTO	CA	95815	4805	34	06067	38.598687	-121.43646	Sacramento County
173879	Fee-for-Service	1487734547	1487734547	1	1	HIDALGO, ELSIE R MD	12/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	68199	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
173887	Fee-for-Service	1841262623	1841262623	1	1	HILLIARD, ANTHONY A MD	6/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108048	41	Internal Medicine	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
173917	Fee-for-Service	1114906088	1114906088	1	1	HOLMGREN, LEONARD PMD	4/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86132	None	None	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
173943	Fee-for-Service	1356772008	1356772008	1	1	HUGHES, JENNIFER S MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129116	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
173944	Fee-for-Service	1164049987	1164049987	1	1	HINSON, JULIAN MD	7/9/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191899	08	Family Practice	0	In state provider	None	4646 BROCKTON AVENUE	None	RIVERSIDE	CA	92506	0102	33	06065	33.9760171	-117.3860626	Riverside County
173945	Fee-for-Service	1538617188	1538617188	1	1	HEIMBIGNER, REBECCA L PT	1/30/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
173980	Fee-for-Service	1558865220	1558865220	1	1	HOOLEY, GWENDOLYN C MD	12/20/2022	207P00000X	NA	Other	026	PHYSICIANS	178792	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
173997	Fee-for-Service	1306890462	1306890462	1	1	HANTMAN, DAVID I MD	2/2/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	30141	41	Internal Medicine	0	In state provider	None	5670 WILSHIRE BLVD	STE 17	LOS ANGELES	CA	90036	5679	19	06037	34.06236284	-118.3522745	Los Angeles County
174048	Fee-for-Service	1518951300	1518951300	1	41	HOAG MEMORIAL HOSPITAL	1/28/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	26672 PORTOLA PARKWAY	STE 106	FOOTHILL RANCH	CA	92610	1773	30	06059	33.680925	-117.6676965	Orange County
174060	Fee-for-Service	1659803096	1659803096	1	1	HEBERT, NICOLE MD	8/3/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	172710	None	None	0	In state provider	None	77 CADILLAC DR	STE 230	SACRAMENTO	CA	95825	5453	34	06067	38.572551	-121.4181585	Sacramento County
174062	Fee-for-Service	1295951622	1295951622	1	1	HOSPICE CARE OF THE	4/13/2007	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	VALLEY, INC	1176 ROADRUNNER WAY	None	SIMI VALLEY	CA	93065	3158	56	06111	34.26012463	-118.7954058	Ventura County
174113	Fee-for-Service	1124138045	1124138045	1	1	HOUGHTON, ROBERT A MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	49774	08	Family Practice	0	In state provider	None	1855 1ST AVE	STE 200B	SAN DIEGO	CA	92101	2650	37	06073	32.7247631	-117.1638834	San Diego County
174171	Fee-for-Service	1407087232	1407087232	1	1	HILLIARD, PATRICIA E LCSW	6/11/2024	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
174178	Fee-for-Service	1841262623	1841262623	1	1	HILLIARD, ANTHONY A MD	6/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108048	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
174186	Fee-for-Service	1447483367	1447483367	1	1	HODEIB, RAFIK L MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10881	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
174208	Fee-for-Service	1063437101	1063437101	1	1	HUNT, GORDON C MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	60612	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
174255	Fee-for-Service	1003031394	1003031394	1	1	HE, WANYI CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	BAY ORIENTAL MED CLINIC	790 SAN RAMON VALLEY BLV	STE 225	DANVILLE	CA	94526	4081	07	06013	37.80967169	-121.9937002	Contra Costa County
174257	Fee-for-Service	1821664657	1821664657	1	1	HEINDL, STACEY E MD	11/22/2024	208M00000X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
174304	Fee-for-Service	1376251132	1376251132	1	1	HAVLICAK, ASHLEY CRNA	2/7/2023	367500000X	NA	Other	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
174315	Fee-for-Service	1245264704	1245264704	1	1	HOLMES-ASAMOAH, JOAN NP	10/1/2001	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
174335	Fee-for-Service	1831834449	1831834449	1	1	HUGG, RIZZLE ANNE MARIE Q CC	1/12/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	C-SP	1535 RIVER PARK	STE 2000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
174352	Fee-for-Service	1295951622	1295951622	1	1	HOSPICE CARE OF THE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	VALLEY, INC	1176 ROADRUNNER WAY	None	SIMI VALLEY	CA	93065	3158	56	06111	34.26012463	-118.7954058	Ventura County
174370	Fee-for-Service	1487995866	1487995866	1	1	HAMMONDS, KENNETH A DO	12/5/2018	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	14993	02	General Surgery	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
174383	Fee-for-Service	1841265790	1841265790	1	1	HO, YUNG-CHIEN MD	7/22/2005	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
174397	Fee-for-Service	1992759369	1992759369	1	1	HACOPIAN, AVA MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	63296	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
174461	Fee-for-Service	1174012199	1174012199	1	1	HUYNH, TRIDU MD	9/27/2024	207R00000X	NA	Other	026	PHYSICIANS	166714	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
174474	Fee-for-Service	1609008929	1609008929	1	1	HOLDEN, MEAGAN L MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	107541	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
174487	Fee-for-Service	1588807283	1588807283	1	1	HONG, ESTHER S MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119209	18	Ophthalmology	0	In state provider	None	3772 HOWE STREET	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
174558	Fee-for-Service	1952898462	1952898462	1	1	HENDIZADEH, LEENOY MD	10/23/2020	390200000X	NA	Other	026	PHYSICIANS	167070	36	Psychiatry	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
174604	Fee-for-Service	1760745988	1760745988	1	1	HOANG, MAIVI H MD	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132015	01	General Practice	0	In state provider	None	1020 29TH STREET	SUITE 480	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
174625	Fee-for-Service	1275859605	1275859605	1	1	HINIKER, SUSAN M MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	117702	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
174647	Fee-for-Service	1992453922	1992453922	1	1	HOPENET COMMUNITY COUNSELING	3/1/2023	104100000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3300 TULLY RD	B6	MODESTO	CA	95350	0848	50	06099	37.68597355	-121.012414	Stanislaus County
174661	Fee-for-Service	1306948294	1306948294	2	1	HUSSAIN, SAYED A MD	2/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	30580	None	None	0	In state provider	None	729 SUNRISE AVE	STE 604	ROSEVILLE	CA	95661	4542	31	06061	38.73444822	-121.2720033	Placer County
174676	Fee-for-Service	1538514831	1538514831	1	1	HANDA, SIDHARTH MD	8/30/2022	390200000X	NA	Other	026	PHYSICIANS	181650	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
174694	Fee-for-Service	1356405823	1356405823	1	1	HICKMAN, KALISTA R LMFT	12/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
174727	Fee-for-Service	1891963245	1891963245	1	1	HAREWOOD-BERGMANN, DENISE M	5/5/2014	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	9333 E ROSECRANS AVE	None	LOS ANGELES	CA	90706	2141	19	06037	33.90413858	-118.1346616	Los Angeles
174740	Fee-for-Service	1194159319	1194159319	1	1	HEYN, ANDREA N MD	7/8/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	132106	08	Family Practice	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
174756	Fee-for-Service	1982743282	1982743282	1	1	HORN, MICHAEL J MD	11/24/2014	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
174784	Fee-for-Service	1134655905	1134655905	1	1	HALLWEAVER, MOLLY MD	12/18/2019	207P00000X	NA	Other	026	PHYSICIANS	159039	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
174802	Fee-for-Service	1003073883	1003073883	1	1	HU, BRIAN R MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	106177	34	Urology and Urological Surgery	0	In state provider	None	11370 ANDERSON ST	STE 2050	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
174818	Fee-for-Service	1982164570	1982164570	1	1	HERNANDEZ COUNSELING & ASSOC	6/12/2020	101Y00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	AITES	12440 FIRESTONE BLVD	3001	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
174848	Fee-for-Service	1558509422	1558509422	1	1	HABER, LAWRENCE A MD	6/3/2010	207R00000X	NA	Other	026	PHYSICIANS	103074	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
174883	Fee-for-Service	1942239579	1942239579	1	1	HARMAN, LAURA M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85711	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
174884	Fee-for-Service	1336345040	1336345040	1	1	HEATHER CAMPION MD	2/22/2017	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
174896	Fee-for-Service	1245895192	1245895192	1	1	HEALTHCARE SERVICES, INC.	1/17/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	320 N WILSHIRE AVE	None	ANAHEIM	CA	92801	5825	30	06059	33.83456026	-117.9353538	Orange County
174901	Fee-for-Service	1710166640	1710166640	1	1	HUI, SAI-HUNG MD	2/28/2008	207P00000X	NA	Other	026	PHYSICIANS	97996	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2131 WEST THIRD STREET	None	LOS ANGELES	CA	90057	1901	19	06037	34.06324759	-118.2737045	Los Angeles County
174910	Fee-for-Service	1477081297	1477081297	1	1	HILL, THOMAS P MD	7/1/2021	207P00000X	NA	Other	026	PHYSICIANS	164564	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
174917	Fee-for-Service	1992453922	1992453922	1	1	HOPENET COMMUNITY COUNSELING	6/17/2022	104100000X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3300 TULLY RD	B6	MODESTO	CA	95350	0848	50	06099	37.68597355	-121.012414	Stanislaus County
174918	Fee-for-Service	1770940694	1770940694	1	1	HASSERT, SILVA M PHD	3/28/2016	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
174939	Fee-for-Service	1306123286	1306123286	1	1	HEATHER K KLATT D.O.	6/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2220 CANTERBURY DR	None	HAYS	KS	67601	2370	00	None	38.880486	-99.2961225	Ellis County
174991	Fee-for-Service	1104275668	1104275668	1	1	HODGE, TESSA LCSW	11/26/2024	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
175009	Fee-for-Service	1932368677	1932368677	1	1	HAYDON, ALEX S LMFT	6/18/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3330 HEIGHTS DR	STE 120	CAMERON PARK	CA	95682	8500	09	06017	38.66076236	-120.981666	El Dorado County
175015	Fee-for-Service	1750393633	1750393633	1	1	HADLEY, PATRICIA E MD	6/1/1998	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	73417	30	Radiology	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
175022	Fee-for-Service	1013261908	1013261908	1	1	HOHN, ERIC A MD	2/6/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	124203	20	Orthopedic Surgery	0	In state provider	None	4140 JADE ST	STE 100	CAPITOLA	CA	95010	3037	44	06087	36.97026148	-121.9638195	Santa Cruz County
175065	Fee-for-Service	1831727759	1831727759	1	1	HURTZ, SONA MD	7/26/2023	207R00000X	NA	Other	026	PHYSICIANS	186375	None	None	0	In state provider	None	1260 15TH STREET	1501, 1502	SANTA MONICA	CA	90404	1150	19	06037	34.02648965	-118.4867439	Los Angeles County
175090	Fee-for-Service	1578656906	1578656906	1	1	HAN, STEVE K MD	9/14/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	75243	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
175107	Fee-for-Service	1982164570	1982164570	1	1	HERNANDEZ COUNSELING & ASSOC	6/12/2020	101Y00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	AITES	12440 FIRESTONE BLVD	3001	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
175223	Fee-for-Service	1457051203	1457051203	1	1	HEMWAY HEALTH LLC	3/29/2023	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	867 BILLOWS CT	None	SAN JACINTO	CA	92582	6225	33	06065	33.80699297	-116.9841323	Riverside County
175276	Fee-for-Service	1912944802	1912944802	1	1	HOBSON, DONNIS S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	31452	24	Plastic Surgery	0	In state provider	None	3300 WEBSTER ST	STE 903	OAKLAND	CA	94609	3156	01	06001	37.82132826	-122.2621843	Alameda County
175361	Fee-for-Service	1962047142	1962047142	1	1	HARRIS, HEATHER LMFT	4/17/2025	No Taxonomy Provided	NA	None	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
175381	Fee-for-Service	1447317102	1447317102	1	1	HERRON, SUZANNE LMFT	9/21/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	615 13TH STREET	B7	MODESTO	CA	95354	2456	50	06099	37.6392035	-120.9933879	Stanislaus County
175383	Fee-for-Service	1841248903	1841248903	1	1	HADDON, MARGARET 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	101 3RD AVE SW	None	MINOT	ND	58701	3880	00	None	48.23336909	-101.2951165	Ward County
175406	Fee-for-Service	1982137501	1982137501	1	1	HUYNH, PATRICK N CNP	1/28/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
175438	Fee-for-Service	1750415758	1750415758	1	1	HAYWOOD, TABATHA D MFT	11/25/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	44363	-	NOT APPLICABLE	0	In state provider	None	3090 M STREET	None	MERCED	CA	95348	3212	24	06047	37.31892423	-120.4784315	Merced County
175441	Fee-for-Service	1831167162	1831167162	1	1	HESSAMI, SAM H MD	11/12/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	149086	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
175461	Fee-for-Service	1285858274	1285858274	1	1	HAN, JI Y MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108338	None	None	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
175529	Fee-for-Service	1215357058	1215357058	1	1	HEJAZI, SEYEDALI MD	12/13/2024	2251N0400X	NA	Physical Therapist	026	PHYSICIANS	152280	13	Neurology (M.D. only)	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
175581	Fee-for-Service	1649428160	1649428160	1	1	HO, CHAO MD INC	4/14/2009	193200000X	NA	Other	026	PHYSICIANS	55987	41	Internal Medicine	0	In state provider	None	13847 E 14TH STREET	SUITE 113	SAN LEANDRO	CA	94578	2625	01	06001	37.71457844	-122.1418551	Alameda County
175585	Fee-for-Service	1518498872	1518498872	1	1	HOSTETTER, OLIVIA MD	10/19/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	172062	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
175614	Fee-for-Service	1538475793	1538475793	1	1	HARDISON, CHARLES MD	4/8/1996	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	70382	01	General Practice	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
175634	Fee-for-Service	1104974070	1104974070	1	1	HERNANDEZ, DANIEL C MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64102	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
175672	Fee-for-Service	1972753069	1972753069	1	1	HALE, NATHAN A PHD	1/15/2019	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
175710	Fee-for-Service	1760531222	1760531222	1	1	HODGE, CHARLES H MD	2/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55338	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
175720	Fee-for-Service	1760516462	1760516462	1	1	HERNANDEZ, JOEL D MD	10/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82059	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
175746	Fee-for-Service	1861758179	1861758179	1	1	HSU, JENNIFER W MD	6/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152709	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
175751	Fee-for-Service	1316409204	1316409204	1	1	HAN, CHRISTINA C MD	8/2/2023	207L00000X	NA	Other	026	PHYSICIANS	179587	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
175755	Fee-for-Service	1992057574	1992057574	1	1	HELPING HAND PHARMACY	7/9/2021	3336C0003X	NA	Pharmacies	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	None	529 S MASON RD	None	KATY	TX	77450	2491	00	None	29.776509	-95.75165349	Harris County
175778	Fee-for-Service	1457639213	1457639213	1	1	HIKIN, AMANDA W OD	7/27/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
175794	Fee-for-Service	1649534330	1649534330	1	1	HOMIER, PHILLIP M DO	1/8/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	15601	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
175848	Fee-for-Service	1215381280	1215381280	1	1	HEBERT, SUZANNE C LCSW	3/4/2021	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
175849	Fee-for-Service	1467989731	1467989731	1	1	HUTTON, CHRISTOPHER F MD	10/30/2020	207P00000X	NA	Other	026	PHYSICIANS	169726	None	None	0	In state provider	None	2050 VIBORG RD	None	SOLVANG	CA	93463	2220	42	06083	34.60246267	-120.1261332	Santa Barbara County
175873	Fee-for-Service	1346747086	1346747086	1	1	HASAN, ABIDA F DO	8/10/2023	207RR0500X	NA	Other	026	PHYSICIANS	20789	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
175902	Fee-for-Service	1073672739	1073672739	1	1	HOWO, MITCHELL F MD	9/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	70088	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
175921	Fee-for-Service	1104974070	1104974070	1	1	HERNANDEZ, DANIEL C MD	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64102	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
175933	Fee-for-Service	1053711176	1053711176	1	1	HODGE, AALIYAH MD	12/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149007	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
175937	Fee-for-Service	1003369620	1003369620	1	1	HI-DESERT MEMORIAL HEALTH	6/5/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	57019 YUCCA TRAIL	SUITE C	YUCCA VALLEY	CA	92284	7909	36	06071	34.1205273	-116.4202324	San Bernardino County
175961	Fee-for-Service	1073607842	1073607842	1	1	HILLYARD, ROBERT L MD	8/26/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55855	01	General Practice	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
175962	Fee-for-Service	1801424775	1801424775	1	1	HICKMAN, LEONARD B MD	4/30/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	B200	LOS ANGELES	CA	90095	0001	19	06037	34.06473399	-118.445865	Los Angeles County
176044	Fee-for-Service	1164410783	1164410783	1	1	HERITAGE CARE, LLC	7/1/2003	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CENTER	21414 S VERMONT AVE	None	TORRANCE	CA	90502	1935	19	06037	33.833862	-118.290254	Los Angeles County
176067	Fee-for-Service	1417967845	1417967845	1	1	HBP PEDIATRICS MED GROUP	12/11/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
176085	Fee-for-Service	1669463808	1669463808	1	1	HAGEMAN, ROXANNA G LCSW	4/26/2013	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	#5 GOVERNORS LANE	None	CHICO	CA	95926	5504	04	06007	39.75515381	-121.8585154	Butte County
176177	Fee-for-Service	1184379356	1184379356	1	1	HAGE, PAULINE M	5/3/2024	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
176199	Fee-for-Service	1033139647	1033139647	1	1	HUANG, CHING-CHIH D MD INC	7/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	47754	40	Pediatrics	0	In state provider	SUNSHINE PEDIATRIC MEDIC	160 E ARTESIA ST	STE 235	POMONA	CA	91767	2900	19	06037	34.07556833	-117.7507835	Los Angeles County
176205	Fee-for-Service	1851307797	1851307797	1	1	HANDLER, SUZANNE P MD	9/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	69070	18	Ophthalmology	0	In state provider	None	3900 5TH AVE	STE 270	SAN DIEGO	CA	92103	3137	37	06073	32.748516	-117.1604695	San Diego County
176222	Fee-for-Service	1003369620	1003369620	1	1	HI-DESERT MEMORIAL HEALTH	6/5/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	57019 YUCCA TRAIL	SUITE C	YUCCA VALLEY	CA	92284	7909	36	06071	34.1205273	-116.4202324	San Bernardino County
176250	Fee-for-Service	1073607842	1073607842	1	1	HILLYARD, ROBERT L MD	8/26/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	55855	40	Pediatrics	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
176280	Fee-for-Service	1780646018	1780646018	1	1	HARRIS, RODERICK O MD	9/30/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	36995	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	A PROFESSIONAL CORP	681 MEDICAL CENTER DR W	STE 101	CLOVIS	CA	93611	6803	10	06019	36.840375	-119.6624845	Fresno County
176343	Fee-for-Service	1639192404	1639192404	1	1	HUNG, SAMMY T MD INC	1/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	34867	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	27001 CALAROGA AVE	STE 4	HAYWARD	CA	94545	4345	01	06001	37.63388965	-122.0898396	Alameda County
176348	Fee-for-Service	1720242613	1720242613	1	1	HAJYAN, JASMINE H LCSW	4/26/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1359 PINE ST	None	SAN FRANCISCO	CA	94109	4807	38	06075	37.7898738	-122.4183401	San Francisco County
176370	Fee-for-Service	1679002208	1679002208	1	1	HENEIDI, SALEH G MD	8/10/2022	207ZP0102X	NA	Other	026	PHYSICIANS	172575	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
176385	Fee-for-Service	1689665275	1689665275	1	1	HALL, NINA K MD	11/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	02	General Surgery	0	In state provider	None	200 MISSION BLVD	None	JACKSON	CA	95642	2564	03	06005	38.35007723	-120.7659932	Amador County
176386	Fee-for-Service	1114589280	1114589280	1	1	HSU, BILLY DO	9/11/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20899	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
176392	Fee-for-Service	1104321959	1104321959	1	8	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	155 N SAN VICENTE BLVD	None	BEVERLY HILLS	CA	90211	2303	19	06037	34.06818087	-118.3748275	Los Angeles County
176407	Fee-for-Service	1962485938	1962485938	1	1	HUSSAIN, HASSAN M MD	8/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70661	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1401 SPANOS CT	STE 230	MODESTO	CA	95355	2816	50	06099	37.66975543	-120.9724048	Stanislaus County
176429	Fee-for-Service	1336203207	1336203207	1	1	HORTON, SARAH	9/11/2012	No Taxonomy Provided	NA	None	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
176430	Fee-for-Service	1164402897	1164402897	1	1	HANSEN, SCOTT E MD	4/24/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158212	09	Gynecology (D.O. only)	0	In state provider	None	2185 CITRACADA PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
176471	Fee-for-Service	1538492020	1538492020	1	1	HAWK, PATRICIA K LPCC	5/25/2024	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
176486	Fee-for-Service	1033139647	1033139647	1	1	HUANG, CHING-CHIH D MD INC	1/12/2012	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	SUNSHINE PEDIATRIC MEDIC	160 E ARTESIA ST	STE 235	POMONA	CA	91767	2900	19	06037	34.07556833	-117.7507835	Los Angeles County
176494	Fee-for-Service	1851307797	1851307797	1	1	HANDLER, SUZANNE P MD	9/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	69070	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3900 5TH AVE	STE 270	SAN DIEGO	CA	92103	3137	37	06073	32.748516	-117.1604695	San Diego County
176498	Fee-for-Service	1265638811	1265638811	1	1	HOURANI, RAYAN R MD	9/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119614	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	300 SOUTH PIERCE ST	SUITE 102	EL CAJON	CA	92020	4124	37	06073	32.79286035	-116.9780352	San Diego County
176533	Fee-for-Service	1134536964	1134536964	1	1	HURLEY, JOHN G LMFT	11/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5184 CUNNINGHAM CT	None	CASTRO VALLEY	CA	94546	2538	01	06001	37.70993909	-122.061746	Alameda County
176553	Fee-for-Service	1861613515	1861613515	1	1	HOW, JOHN D MD	5/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	101876	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
176565	Fee-for-Service	1013526938	1013526938	1	1	HERRERA, BRANDEE LCSW	1/26/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2101 GEER RD	SUITE 102A	TURLOCK	CA	95382	1142	50	06099	37.512324	-120.8489985	Stanislaus County
176568	Fee-for-Service	1780646018	1780646018	1	1	HARRIS, RODERICK O MD	9/30/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	36995	22	Pathology (M.D. only)	0	In state provider	A PROFESSIONAL CORP	681 MEDICAL CENTER DR W	STE 101	CLOVIS	CA	93611	6803	10	06019	36.840375	-119.6624845	Fresno County
176578	Fee-for-Service	1982640413	1982640413	1	1	HY, ADAM DO	3/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	7891	08	Family Practice	0	In state provider	None	18957 COLIMA RD	STE B	ROWLAND HEIGHTS	CA	91748	2942	19	06037	33.98767704	-117.8912613	Los Angeles County
176580	Fee-for-Service	1124743307	1124743307	1	1	H KIRAN KUMAR REDDY MD PROFE	2/27/2023	2471C1101X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	SSIONAL CORPORATION	1114 W 6TH ST	STE 102	HANFORD	CA	93230	4902	16	06031	36.32405752	-119.662551	Kings County
176600	Fee-for-Service	1285793802	1285793802	1	1	HOLMES, SUKANYA E MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72144	25	Physical Medicine and Rehabilitation	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
176609	Fee-for-Service	1043581994	1043581994	1	1	HODEIB, MELISSA DO	12/18/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	11932	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
176632	Fee-for-Service	1639192404	1639192404	1	1	HUNG, SAMMY T MD INC	1/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	34867	41	Internal Medicine	0	In state provider	None	27001 CALAROGA AVE	STE 4	HAYWARD	CA	94545	4345	01	06001	37.63388965	-122.0898396	Alameda County
176636	Fee-for-Service	1346448081	1346448081	1	1	HEALING HANDS CARE INC	8/26/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	220 N GLENOAKS BLVD	SUITE C	BURBANK	CA	91502	1213	19	06037	34.1842049	-118.3075494	Los Angeles County
176638	Fee-for-Service	1275760910	1275760910	1	1	HUDACEK, KRISTIN D MD	11/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126296	07	Dermatology	0	In state provider	None	910 MAPLE STREET	None	REDWOOD CITY	CA	94063	2034	41	06081	37.48867968	-122.2222351	San Mateo County
176677	Fee-for-Service	1104321959	1104321959	1	8	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	155 N SAN VICENTE BLVD	None	BEVERLY HILLS	CA	90211	2303	19	06037	34.06818087	-118.3748275	Los Angeles County
176719	Fee-for-Service	1164402897	1164402897	1	1	HANSEN, SCOTT E MD	4/24/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	158212	15	Obstetrics (D.O. only)	0	In state provider	None	2185 CITRACADA PARKWAY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
176736	Fee-for-Service	1518951300	1518951300	1	34	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16305 SAND CANYON AVE	SUITE 270	IRVINE	CA	92618	3791	30	06059	33.66201662	-117.7737316	Orange County
176749	Fee-for-Service	1518303775	1518303775	1	1	HENDERSON, JOHN A MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	132202	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
176767	Fee-for-Service	1114901402	1114901402	1	1	HUBBELL, GAIL A MD	11/30/1988	207P00000X	NA	Other	026	PHYSICIANS	35947	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13855 E 14TH ST	None	SAN LEANDRO	CA	94578	2611	01	06001	37.712385	-122.143428	Alameda County
176831	Fee-for-Service	1659781078	1659781078	1	1	HART, PATRICE D NP	7/30/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
176838	Fee-for-Service	1831275346	1831275346	1	1	HARBUCK, ROBERT L DPM	10/1/1995	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	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
176871	Fee-for-Service	1578548764	1578548764	1	1	HWANG, JENNY M MD	6/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	76311	08	Family Practice	0	In state provider	None	1500 W WEST COVINA PKWY	STE 101	WEST COVINA	CA	91790	2703	19	06037	34.06953243	-117.9391587	Los Angeles County
176872	Fee-for-Service	1033147871	1033147871	1	1	HAWKINS, JOHN DO	1/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9572	05	Anesthesiology	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	4809	19	06037	34.158213	-118.328112	Los Angeles County
176920	Fee-for-Service	1417955287	1417955287	1	1	HOPKINS, DONALD G MD	9/1/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	40570	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3536 MENDOCINO AVE	STE 200	SANTA ROSA	CA	95403	3634	49	06097	38.473326	-122.725935	Sonoma County
176923	Fee-for-Service	1346448081	1346448081	1	1	HEALING HANDS CARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	220 N GLENOAKS BLVD	SUITE C	BURBANK	CA	91502	1213	19	06037	34.1842049	-118.3075494	Los Angeles County
176946	Fee-for-Service	1164864088	1164864088	1	1	HARE, SARAH M PT	12/14/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	552 S. PASEO DOROTEA	STE 4	PALM SPRINGS	CA	92264	1437	33	06065	33.81460283	-116.5017722	Riverside County
176955	Fee-for-Service	1528132248	1528132248	1	1	HASSID, STEVE M MD	6/1/1998	207R00000X	NA	Other	026	PHYSICIANS	62622	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
176975	Fee-for-Service	1679961387	1679961387	1	1	HOLMES, CORNELIA MD	11/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133878	01	General Practice	0	In state provider	None	12488 CENTRAL AVE	STE B	CHINO	CA	91710	3569	36	06071	34.026552	-117.6895065	San Bernardino County
176981	Fee-for-Service	1982848461	1982848461	1	1	HOU, JEAN MD	2/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	139880	22	Pathology (M.D. only)	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1828	19	06037	34.07671715	-118.3799413	Los Angeles County
176983	Fee-for-Service	1780651943	1780651943	1	1	HELSETH, EREK K MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142272	13	Neurology (M.D. only)	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
176999	Fee-for-Service	1275705931	1275705931	1	1	HAWAT, WADIH A DO	11/30/2010	390200000X	NA	Other	026	PHYSICIANS	10953	41	Internal Medicine	0	In state provider	None	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
177072	Fee-for-Service	1750767273	1750767273	1	1	HONG, LEE S MD	1/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143427	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
177099	Fee-for-Service	1114587797	1114587797	1	1	HORTON, CRYSTAL D LCSW	1/23/2024	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
177107	Fee-for-Service	1619957834	1619957834	1	1	HECHT, ADAM R MD	7/19/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	143557	30	Radiology	0	In state provider	None	29101 HOSPITAL RD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
177108	Fee-for-Service	1407915465	1407915465	1	1	HOLLINGSWORTH HORNOR, KIMBER	12/30/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LY S LMFT	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
177161	Fee-for-Service	1578548764	1578548764	1	1	HWANG, JENNY M MD	6/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	76311	41	Internal Medicine	0	In state provider	None	1500 W WEST COVINA PKWY	STE 101	WEST COVINA	CA	91790	2703	19	06037	34.06953243	-117.9391587	Los Angeles County
177189	Fee-for-Service	1568904803	1568904803	1	1	HILL, CHLOE CCC-SLP	1/30/2020	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
177249	Fee-for-Service	1568455780	1568455780	1	1	HYE PHARMACY INC	5/16/1994	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	TAGLYAN, PETROS	13745 VICTORY BLVD	None	VAN NUYS	CA	91401	2348	19	06037	34.18669945	-118.432755	Los Angeles County
177264	Fee-for-Service	1972827475	1972827475	1	1	HOLMES, BRITTANY J MD	6/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136529	22	Pathology (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
177267	Fee-for-Service	1700465721	1700465721	1	1	HAN, DIANE Y MD	12/15/2024	207P00000X	NA	Other	026	PHYSICIANS	190408	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
177271	Fee-for-Service	1780651943	1780651943	1	1	HELSETH, EREK K MD	6/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142272	30	Radiology	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
177280	Fee-for-Service	1578067484	1578067484	1	1	HUA, CHRISTIE T MD	8/19/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	174113	None	None	0	In state provider	None	9939 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.91571158	-117.4549231	Riverside County
177294	Fee-for-Service	1558529883	1558529883	1	1	HOSSEINI, PUYA MD	8/9/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107988	None	None	0	In state provider	None	1600 N ROSE AVE	None	OXNARD	CA	93030	3723	56	06111	34.21700406	-119.1582582	Ventura County
177306	Fee-for-Service	1386141844	1386141844	1	1	HINTON, AMANDA MD	10/16/2023	207P00000X	NA	Other	026	PHYSICIANS	186977	None	None	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
177308	Fee-for-Service	1578519252	1578519252	1	1	HOWARD G WEISBROD	8/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3300 NACOGDOCHES RD	STE 110	SAN ANTONIO	TX	78217	3368	00	None	29.52826083	-98.43418366	Bexar County
177315	Fee-for-Service	1295504314	1295504314	1	1	HEAL & RELEAF FAMILY COUNSEL	3/11/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ING PC	27851 BRADLEY RD	STE 107	MENIFEE	CA	92586	2213	33	06065	33.71630969	-117.1904696	Riverside County
177321	Fee-for-Service	1225687080	1225687080	1	1	HUTCHINS, BRIANCA OT	10/24/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
177324	Fee-for-Service	1396817136	1396817136	1	1	HUANG, CAROL T MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63328	25	Physical Medicine and Rehabilitation	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
177340	Fee-for-Service	1255488029	1255488029	1	1	HOSHYARSAR, PAYMAN R DPM	1/11/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	10816 VALLEY BLVD	None	EL MONTE	CA	91731	2513	19	06037	34.07594083	-118.0378009	Los Angeles County
177342	Fee-for-Service	1770014201	1770014201	2	1	HASHMI, MOHAMMAD MD	11/14/2024	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	17100	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
177343	Fee-for-Service	1407981129	1407981129	1	1	HOUSE RESEARCH INSTITUTE	1/15/1985	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	PEGGY NASOORDEEN	2100 W 3RD ST	FL 5	LOS ANGELES	CA	90057	1922	19	06037	34.06308947	-118.2733326	Los Angeles County
177380	Fee-for-Service	1447812896	1447812896	1	1	HUNEAU, KRISTIN LMFT	10/10/2024	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
177391	Fee-for-Service	1942296058	1942296058	1	1	HELMERS, SCOTT W MD	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	72814	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
177394	Fee-for-Service	1649232661	1649232661	1	1	HOME OF GUIDING HANDS	12/31/1992	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10939 GREENCASTLE ST	None	SANTEE	CA	92071	1943	37	06073	32.85700486	-116.9612443	San Diego County
177449	Fee-for-Service	1578548764	1578548764	1	1	HWANG, JENNY M MD	6/20/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	76311	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1500 W WEST COVINA PKWY	STE 101	WEST COVINA	CA	91790	2703	19	06037	34.06953243	-117.9391587	Los Angeles County
177471	Fee-for-Service	1700448164	1700448164	1	1	HAYDEN, AUDREY C	6/26/2023	101YA0400X	NA	Other	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
177473	Fee-for-Service	1386770725	1386770725	1	2	HOGAN, W MICHAEL MD PC	7/18/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2900 LOMA VISTA	SUITE 205	VENTURA	CA	93003	2909	56	06111	34.27545839	-119.2569382	Ventura County
177474	Fee-for-Service	1003347204	1003347204	1	1	HAN, ALBERT MD	10/31/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	158313	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
177475	Fee-for-Service	1013390137	1013390137	1	1	HAMPTON, JAMES	7/6/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	311 CHANGO CIRCLE	None	SACRAMENTO	CA	95835	2422	34	06067	38.681334	-121.539087	Sacramento County
177482	Fee-for-Service	1265423495	1265423495	1	1	HASLER, MICHAEL A MD	8/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73964	08	Family Practice	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
177486	Fee-for-Service	1548201239	1548201239	1	1	HENRIE, JENIFER A MD	11/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83186	05	Anesthesiology	0	In state provider	None	1531 THE ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
177516	Fee-for-Service	1821289836	1821289836	1	1	HO, SHERI MD PHD INC	8/14/2018	261QP2300X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	15785 LAGUNA CANYON	STE 115	IRVINE	CA	92618	3166	30	06059	33.66542536	-117.7615537	Orange County
177518	Fee-for-Service	1144600248	1144600248	1	1	HEALTH AND LIFE ORGANIZATION	10/20/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	3030 EXPLORER DRIVE	None	SACRAMENTO	CA	95827	2728	34	06067	38.563362	-121.332429	Sacramento County
177540	Fee-for-Service	1295733640	1295733640	1	1	HUANG, DAVID W MD	6/8/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	39514	20	Orthopedic Surgery	0	In state provider	HUANG, DAVID W MD	500 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
177568	Fee-for-Service	1750756714	1750756714	1	1	HAHN-HOOTEN, REBECCA LMFT	3/11/2025	No Taxonomy Provided	NA	None	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
177595	Fee-for-Service	1922192657	1922192657	1	1	HOLSINGER, FLOYD C MD	7/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	54859	04	Otology, Laryngology, Rhinology	0	In state provider	None	300 PASTEUR DRIVE	MC:5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
177605	Fee-for-Service	1548363070	1548363070	1	1	HO, RALPH T MD	12/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53547	None	None	0	In state provider	None	1125 SIR FRANCIS DRAKE B	None	KENTFIELD	CA	94914	1418	21	06041	37.95921858	-122.5523703	Marin County
177669	Fee-for-Service	1447842737	1447842737	1	1	HARTS, JOSEPHINE NP	1/28/2025	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11900 S AVALON BLVD	100 B	LOS ANGELES	CA	90061	2866	19	06037	33.92451047	-118.2652101	Los Angeles County
177681	Fee-for-Service	1104321959	1104321959	1	7	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	665 MUNRAS AVE	SUITE 109	MONTEREY	CA	93940	3136	27	06053	36.59569303	-121.8931095	Monterey County
177690	Fee-for-Service	1174108328	1174108328	1	1	HALL, THERESA	5/11/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	21	06041	37.9438204	-122.5395357	Marin County
177699	Fee-for-Service	1750814513	1750814513	1	1	HOUSTON, KASEE L MD	4/4/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	169767	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
177732	Fee-for-Service	1518975861	1518975861	1	1	HANGER P & O WEST INC	4/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2761 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3405	38	06075	37.78213625	-122.4487832	San Francisco County
177756	Fee-for-Service	1356757207	1356757207	1	1	HONAKER, MICHELLE C	9/16/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1485 CIVIC CT	STE 1330	CONCORD	CA	94520	5922	07	06013	37.97203702	-122.0490271	Contra Costa County
177766	Fee-for-Service	1013390137	1013390137	1	1	HAMPTON, JAMES	7/6/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	311 CHANGO CIRCLE	None	SACRAMENTO	CA	95835	2422	34	06067	38.681334	-121.539087	Sacramento County
177767	Fee-for-Service	1962484519	1962484519	1	2	HODDE, ILDIKO J MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	89003	36	Psychiatry	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
177769	Fee-for-Service	1770999773	1770999773	1	1	HIPOLITO, CECILIA L MD	8/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145850	40	Pediatrics	0	In state provider	None	847 W CHILDS AVE	None	MERCED	CA	95341	6805	24	06047	37.28825369	-120.4963159	Merced County
177781	Fee-for-Service	1295797397	1295797397	1	1	HAYASHI, EDWIN S	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74276	None	None	0	In state provider	None	77 CASA ST	STE 103	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
177807	Fee-for-Service	1144600248	1144600248	1	1	HEALTH AND LIFE ORGANIZATION	10/20/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	3030 EXPLORER DRIVE	None	SACRAMENTO	CA	95827	2728	34	06067	38.563362	-121.332429	Sacramento County
177819	Fee-for-Service	1619979606	1619979606	1	1	HAKIMIAN, NAVID MD APC	7/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	70719	41	Internal Medicine	0	In state provider	None	8540 S SEPULVEDA BLVD	STE 1111	LOS ANGELES	CA	90045	3819	19	06037	33.96022076	-118.3961982	Los Angeles County
177820	Fee-for-Service	1255515979	1255515979	1	1	HSIEH, CLAUDIA C DO	7/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9680	01	General Practice	0	In state provider	None	3801 HOWE STREET	None	OAKLAND	CA	94611	5312	01	06001	37.8242732	-122.2568561	Alameda County
177833	Fee-for-Service	1295733640	1295733640	1	1	HUANG, DAVID W MD	6/8/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	39514	66	Emergency Medicine (Urgent Care)	0	In state provider	HUANG, DAVID W MD	500 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
177838	Fee-for-Service	1447084454	1447084454	1	1	HUNTINGTON PARK FAMILY CARE,	11/15/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	INC	6526 RUGBY AVE	None	HUNTINGTON PARK	CA	90255	4006	19	06037	33.97960549	-118.2265049	Los Angeles County
177841	Fee-for-Service	1295277192	1295277192	1	1	HEALTHFLEX HOSPICE	6/13/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7677 OAKPORT ST	920	OAKLAND	CA	94621	1929	01	06001	37.74725101	-122.2028137	Alameda County
177864	Fee-for-Service	1588207351	1588207351	1	1	HOY, MEGAN C CNP	4/26/2021	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
177881	Fee-for-Service	1821059924	1821059924	2	1	HAGE, SAMIR E DO	10/11/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	7233	09	Gynecology (D.O. only)	0	In state provider	None	255 TERRACINA BLVD	SUITE 202	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
177882	Fee-for-Service	1215923453	1215923453	1	1	HERRING, LATRECIA 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	560 N CAMINO MERCADO	STE 7	CASA GRANDE	AZ	85222	5759	00	None	32.877936	-111.691107	Pinal County
177898	Fee-for-Service	1497814131	1497814131	1	1	HOOKS, SARAH E MD	5/11/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89843	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
177936	Fee-for-Service	1598895559	1598895559	1	1	HO, TIFFANY B MD	5/6/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	54798	27	Psychiatry Neurology (D.O. 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
177956	Fee-for-Service	1164468716	1164468716	1	1	HOSAKA, SHARON Y DPM	9/30/1985	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	233 SANSOME ST	STE 702	SAN FRANCISCO	CA	94014	2325	38	06075	37.79264662	-122.4010657	San Francisco County
177968	Fee-for-Service	1104321959	1104321959	1	7	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	665 MUNRAS AVE	SUITE 109	MONTEREY	CA	93940	3136	27	06053	36.59569303	-121.8931095	Monterey County
177970	Fee-for-Service	1336105238	1336105238	1	1	HARTMAN, GREGG P MD	5/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61757	20	Orthopedic Surgery	0	In state provider	None	3525 LOMA VISTA RD	None	VENTURA	CA	93003	3101	56	06111	34.27680789	-119.2480851	Ventura County
178007	Fee-for-Service	1548796402	1548796402	1	1	HULS, THOMAS A MD	3/12/2021	207P00000X	NA	Other	026	PHYSICIANS	167055	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
178008	Fee-for-Service	1881857340	1881857340	1	1	HALFORD, JONATHAN M MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110116	None	None	0	In state provider	None	1601 YGNACIO VALLEY ROAD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
178040	Fee-for-Service	1679969240	1679969240	1	1	HICKS, REAGHAN A MD	2/3/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	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
178041	Fee-for-Service	1346309440	1346309440	1	1	HOWARD, MARK L PHD	1/23/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
178045	Fee-for-Service	1033583505	1033583505	1	1	HENRICHSEN, RACHAEL L LAC	7/5/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1120 17TH AVE	A	SANTA CRUZ	CA	95062	3087	44	06087	36.97024563	-121.9847217	Santa Cruz County
178104	Fee-for-Service	1104291632	1104291632	1	1	HU, ALEX J MD	6/30/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	176686	None	None	0	In state provider	None	1260 15TH STREET	1501, 1502	SANTA MONICA	CA	90404	1150	19	06037	34.02648965	-118.4867439	Los Angeles County
178109	Fee-for-Service	1174586655	1174586655	1	1	HUI, WENDY T MD	3/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76895	40	Pediatrics	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
178128	Fee-for-Service	1295277192	1295277192	1	1	HEALTHFLEX HOSPICE	6/13/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7677 OAKPORT ST	920	OAKLAND	CA	94621	1929	01	06001	37.74725101	-122.2028137	Alameda County
178168	Fee-for-Service	1881981520	1881981520	1	1	HONG, DONNA M OD INC	9/21/2015	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10906 VALLEY MALL	None	EL MONTE	CA	91731	2616	19	06037	34.07569098	-118.0370272	Los Angeles County
178193	Fee-for-Service	1891795696	1891795696	1	1	HANSING, JERALD D MD	5/20/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	130947	None	None	0	In state provider	None	6412 LAUREL AVE	None	MOUNTAIN MESA	CA	93240	9529	15	06029	35.63564004	-118.407037	Kern County
178217	Fee-for-Service	1821023755	1821023755	1	1	HARRISON, STEVEN A MD	3/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	63736	01	General Practice	0	In state provider	None	1299 NEWELL HILL PL	STE 103	WALNUT CREEK	CA	94596	5230	07	06013	37.89387272	-122.0539301	Contra Costa County
178238	Fee-for-Service	1366861031	1366861031	1	1	HUYNH, KYLE MD	5/21/2018	390200000X	NA	Other	026	PHYSICIANS	155168	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
178267	Fee-for-Service	1881735421	1881735421	1	1	HERNANDEZ, NATALIE E LMFT	8/31/2018	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
178279	Fee-for-Service	1700045150	1700045150	1	1	HU, EDWARD K MD	6/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99960	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
178343	Fee-for-Service	1114563871	1114563871	1	1	HOLMBERG, ELIZABETH LCSW	6/28/2024	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
178481	Fee-for-Service	1720535222	1720535222	1	1	HALL, DAVID C	9/19/2016	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	5100 N SIXTH ST	STE 120	FRESNO	CA	93710	7506	10	06019	36.810666	-119.763204	Fresno County
178503	Fee-for-Service	1821023755	1821023755	1	1	HARRISON, STEVEN A MD	3/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	63736	18	Ophthalmology	0	In state provider	None	1299 NEWELL HILL PL	STE 103	WALNUT CREEK	CA	94596	5230	07	06013	37.89387272	-122.0539301	Contra Costa County
178523	Fee-for-Service	1518962083	1518962083	1	3	HOSPICE OF SAN JOAQUIN	3/1/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1300 W LODI AVE	SUITE S	LODI	CA	95242	3000	39	06077	38.13001447	-121.289931	San Joaquin County
178524	Fee-for-Service	1386820900	1386820900	2	1	HUDDE, BETH A LCSW	8/19/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NG	5053 LA MART DRIVE	SUITE 105	RIVERSIDE	CA	92507	5993	33	06065	33.95818206	-117.3320081	Riverside County
178542	Fee-for-Service	1790281707	1790281707	1	1	HOANG, PHUONG T MD	6/28/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	164885	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
178548	Fee-for-Service	1013018035	1013018035	1	1	HOLMES, JARROD P MD	6/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104861	78	Neoplastic Diseases/Oncology	0	In state provider	None	121 SOTOYOME ST	None	SANTA ROSA	CA	95405	4803	49	06097	38.44224	-122.70195	Sonoma County
178575	Fee-for-Service	1205396454	1205396454	1	1	HARRIS, EMILY L MD	8/25/2022	207R00000X	NA	Other	026	PHYSICIANS	177032	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
178581	Fee-for-Service	1295861433	1295861433	1	1	HOUSTON, DARYL K MD	9/30/1987	207R00000X	NA	Other	026	PHYSICIANS	36313	41	Internal Medicine	0	In state provider	None	3831 HUGHES AVE	STE 707	CULVER CITY	CA	90232	6841	19	06037	34.02243278	-118.3981492	Los Angeles County
178606	Fee-for-Service	1952412470	1952412470	1	1	HWANG,STEVE T MD	7/31/2008	174400000X	NA	Other	026	PHYSICIANS	31916	20	Orthopedic Surgery	0	In state provider	None	1919 N FAIRVIEW ST	STE 302	SANTA ANA	CA	92706	2245	30	06059	33.76258416	-117.9028357	Orange County
178631	Fee-for-Service	1598200503	1598200503	1	1	HIROSHIMA, HAZEL V NP	10/20/2021	363LP0200X	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
178650	Fee-for-Service	1588760227	1588760227	1	1	HERZOG, CYNTHIA A MD	3/1/1994	207QA0000X	NA	Pediatric Primary Care	026	PHYSICIANS	73087	08	Family Practice	0	In state provider	None	2701 ATLANTIC AVE	None	LONG BEACH	CA	90806	2701	19	06037	33.807735	-118.1850575	Los Angeles County
178688	Fee-for-Service	1568763050	1568763050	1	1	HODJATI, MANDANA PT	3/16/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10250 SANTA MONICA BLVD	2440	LOS ANGELES	CA	90067	6469	19	06037	34.05998846	-118.4200204	Los Angeles County
178690	Fee-for-Service	1528157922	1528157922	1	1	HUYNH, BINH MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116020	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
178707	Fee-for-Service	1942727243	1942727243	1	1	HA, KATHERINE OD	12/10/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 301	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
178747	Fee-for-Service	1912474768	1912474768	1	1	HOFFMAN, JESSICA F	7/26/2024	363LF0000X	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
178775	Fee-for-Service	1548800840	1548800840	1	1	HUNTINGTON HOSPICE CARE INC	9/23/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12750 CENTER COURT DR	SUITE 660	CERRITOS	CA	90703	8581	19	06037	33.86790649	-118.0604745	Los Angeles County
178794	Fee-for-Service	1538143318	1538143318	1	1	HINDS HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2490 W SHAW AVE	STE 101	FRESNO	CA	93711	3305	10	06019	36.80841598	-119.8371594	Fresno County
178809	Fee-for-Service	1346772514	1346772514	1	1	HUA, SERENA MD	9/25/2024	207P00000X	NA	Other	026	PHYSICIANS	177540	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
178810	Fee-for-Service	1518962083	1518962083	1	3	HOSPICE OF SAN JOAQUIN	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1300 W LODI AVE	SUITE S	LODI	CA	95242	3000	39	06077	38.13001447	-121.289931	San Joaquin County
178825	Fee-for-Service	1548505100	1548505100	1	1	HSIEH, TSUNG-YEN MD	11/1/2024	207YX0905X	NA	ENT/Otolaryngology	026	PHYSICIANS	140264	04	Otology, Laryngology, Rhinology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
178834	Fee-for-Service	1013018035	1013018035	1	1	HOLMES, JARROD P MD	6/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104861	41	Internal Medicine	0	In state provider	None	121 SOTOYOME ST	None	SANTA ROSA	CA	95405	4803	49	06097	38.44224	-122.70195	Sonoma County
178844	Fee-for-Service	1720515216	1720515216	1	1	HUSAIN, ASMA A MD	9/6/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	167479	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
178845	Fee-for-Service	1548696123	1548696123	1	1	HINTON, JAIME M	8/4/2014	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
178865	Fee-for-Service	1881749513	1881749513	1	1	HENDERSON, JAIMIE M MD	8/26/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87275	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
178869	Fee-for-Service	1295861433	1295861433	1	1	HOUSTON, DARYL K MD	9/30/1987	207R00000X	NA	Other	026	PHYSICIANS	36313	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3831 HUGHES AVE	STE 707	CULVER CITY	CA	90232	6841	19	06037	34.02243278	-118.3981492	Los Angeles County
178871	Fee-for-Service	1003864059	1003864059	1	1	HUSTED, ROGER C MD	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	31289	18	Ophthalmology	0	In state provider	None	798 CASS ST	STE 204	MONTEREY	CA	93940	2918	27	06053	36.59428586	-121.8953825	Monterey County
178897	Fee-for-Service	1952551434	1952551434	1	1	HOMSY, MARGARET R LCSW	12/5/2014	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1335 MAIN ST	STE 105	ST HELENA	CA	94574	1940	28	06055	38.50465854	-122.4693538	Napa County
178933	Fee-for-Service	1194037010	1194037010	1	1	HARIS, SHAMAILA MD	12/2/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	148812	None	None	0	In state provider	None	1300 W LODI AVE	STE P	LODI	CA	95242	3038	39	06077	38.13001447	-121.289931	San Joaquin County
178940	Fee-for-Service	1669564167	1669564167	1	1	HAMBLY, MARK F MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	65867	20	Orthopedic Surgery	0	In state provider	None	2801 K ST	STE 410	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
178974	Fee-for-Service	1275678435	1275678435	1	1	HEINRICH, JOSPEH G OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	32241 CAMINO CAPISTRANO	APT 101	SAN JUAN CAPISTRA	CA	92675	3708	30	06059	33.49431861	-117.6626549	Orange County
178977	Fee-for-Service	1528157922	1528157922	1	1	HUYNH, BINH MD	10/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	116020	30	Radiology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
178992	Fee-for-Service	1417561051	1417561051	1	1	HERRERA, CHANTAL M LCSW	8/25/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
179005	Fee-for-Service	1558537225	1558537225	1	1	HEWETT, JENNIFER A MD	8/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108570	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
179017	Fee-for-Service	1386208833	1386208833	1	1	HEALY, GAIL E LCSW	5/4/2019	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	438 MAIN STREET	SUITE E 1	PLACERVILLE	CA	95667	0001	09	06017	38.72911319	-120.8008948	El Dorado County
179022	Fee-for-Service	1578889689	1578889689	1	1	HSU, HUI-SHAN MD	12/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118657	41	Internal Medicine	0	In state provider	None	222 WEST 39TH AVENUE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
179063	Fee-for-Service	1548800840	1548800840	1	1	HUNTINGTON HOSPICE CARE INC	9/23/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12750 CENTER COURT DR	SUITE 660	CERRITOS	CA	90703	8581	19	06037	33.86790649	-118.0604745	Los Angeles County
179083	Fee-for-Service	1538143318	1538143318	1	1	HINDS HOSPICE	9/18/1990	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2490 W SHAW AVE	STE 101	FRESNO	CA	93711	3305	10	06019	36.80841598	-119.8371594	Fresno County
179092	Fee-for-Service	1750493912	1750493912	1	1	HASSANPOUR, FEDRA	3/28/2023	251B00000X	NA	Other	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
179094	Fee-for-Service	1356861520	1356861520	1	1	HA, STEPHANIE LCSW	12/14/2021	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	244 CALIFORNIA	STE 300	SAN FRANCISCO	CA	94111	4302	38	06075	37.79331375	-122.3995607	San Francisco County
179115	Fee-for-Service	1558755678	1558755678	1	1	HAZBOUN, MICHAEL C MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	148096	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
179118	Fee-for-Service	1619943537	1619943537	1	4	HEMET RADIOLOGY MEDICAL	1/30/1992	174400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP, INC	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
179155	Fee-for-Service	1972709095	1972709095	1	1	HARRIS, BRYAN MD	6/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86469	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
179171	Fee-for-Service	1215282421	1215282421	1	1	HASSAN, TIJANI I MD	7/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129033	None	None	0	In state provider	None	1500 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
179181	Fee-for-Service	1245283613	1245283613	1	1	HALAWA, HANY M MD	12/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	56429	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
179184	Fee-for-Service	1164409983	1164409983	1	1	HENDRICKS, MARK D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	62541	41	Internal Medicine	0	In state provider	None	1835 EL CAJON BLVD	STE C	SAN DIEGO	CA	92103	2591	37	06073	32.75515551	-117.1453277	San Diego County
179278	Fee-for-Service	1700881083	1700881083	1	1	HAMEL, JEFFREY P OD	7/5/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2020 COLORADO AVE	STE A	TURLOCK	CA	95382	2002	50	06099	37.51154259	-120.8352538	Stanislaus County
179288	Fee-for-Service	1033154927	1033154927	1	1	HUNDAL, RAVINDER S MD	5/31/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	46299	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
179291	Fee-for-Service	1871973560	1871973560	1	1	HADDAD RIDDLE, VICTORIA H PT	10/24/2017	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
179313	Fee-for-Service	1720089527	1720089527	1	1	HIGHTOWER, DAVID 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	140 E BANNOCK ST	None	BOISE	ID	83712	6241	00	None	43.61256434	-116.1927808	Ada County
179345	Fee-for-Service	1477727170	1477727170	1	1	HAWKINS, LAKISHA Y MD	12/2/2013	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
179361	Fee-for-Service	1811927791	1811927791	1	1	HOQ, LALIMA A MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67190	41	Internal Medicine	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
179440	Fee-for-Service	1194935957	1194935957	1	1	HSU, DORA I NP	1/12/2016	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
179558	Fee-for-Service	1487266292	1487266292	1	1	HUDSON, MOLLIE S NP	2/25/2025	207RP1001X	NA	Pulmonology	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
179575	Fee-for-Service	1033154927	1033154927	1	1	HUNDAL, RAVINDER S MD	5/31/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	46299	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
179595	Fee-for-Service	1063966182	1063966182	1	1	HARTHORN, CHELSEA L CO	8/15/2016	222Z00000X	NA	Other	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	895 3RD AVENUE	BUILDING 2 SUITE 14	CHULA VISTA	CA	91911	1304	37	06073	32.62119593	-117.0719915	San Diego County
179605	Fee-for-Service	1609042308	1609042308	1	1	HOF, PIA A MD	5/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	116883	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
179617	Fee-for-Service	1528281839	1528281839	1	1	HERDA, DOMINIC J MD	9/29/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	77098	None	None	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
179665	Fee-for-Service	1083296263	1083296263	1	2	HIGH DESERT WELLNESS	1/5/2024	1041C0700X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	12555 MARIPOSA ROAD	SUITE J	VICTORVILLE	CA	92395	6010	36	06071	34.47849471	-117.3394137	San Bernardino County
179692	Fee-for-Service	1487689279	1487689279	1	1	HSU, JOHN MD	9/30/1991	207LP2900X	NA	Other	026	PHYSICIANS	66952	01	General Practice	0	In state provider	None	1400 BRISTOL ST N	STE 240	NEWPORT BEACH	CA	92660	2981	30	06059	33.65928642	-117.8694286	Orange County
179704	Fee-for-Service	1598900052	1598900052	1	2	HEALTH PROJECTS CENTER	3/3/2022	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	9000 SOQUEL AVE	SUITE 103	SANTA CRUZ	CA	95062	2097	44	06087	36.98201547	-121.9663408	Santa Cruz County
179713	Fee-for-Service	1104321959	1104321959	1	27	HEALTH DIAGNOSTICS OF CALIFO	5/30/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	8901 ACTIVITY RD	STE 103	SAN DIEGO	CA	92126	4436	37	06073	32.8960193	-117.1345934	San Diego County
179727	Fee-for-Service	1851525380	1851525380	1	1	HOME FOR LIFE FOUNDATION	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	54 N WILSON AVE	None	PASADENA	CA	91106	2306	19	06037	34.14696023	-118.128036	Los Angeles County
179746	Fee-for-Service	1336762244	1336762244	1	1	HOLMES, MICHELLE A OD	2/23/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5215 TORRANCE BLVD	STE 300	TORRANCE	CA	90503	4009	19	06037	33.83760237	-118.3692467	Los Angeles County
179748	Fee-for-Service	1518124015	1518124015	1	1	HADDAD, ASHRAF S MD	7/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111134	34	Urology and Urological Surgery	0	In state provider	None	3000 Q ST	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
179757	Fee-for-Service	1801245063	1801245063	1	1	HUSSAIN, MOHAMMAD AHRAZ	3/23/2022	207RN0300X	NA	Nephrology	026	PHYSICIANS	163153	None	None	0	In state provider	None	3660 PARK SIERRA DR	208	RIVERSIDE	CA	92501	1768	33	06065	33.90330693	-117.4707039	Riverside County
179763	Fee-for-Service	1851450506	1851450506	1	1	HURWITZ, RICHARD S MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35317	34	Urology and Urological 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
179768	Fee-for-Service	1083753875	1083753875	1	1	HOYO, ANDRES LMFT	5/24/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1695 SAN JACINTO	K	SAN JACINTO	CA	92583	5103	33	06065	33.770961	-116.954649	Riverside County
179801	Fee-for-Service	1447484373	1447484373	1	1	HUNT, JENNIFER L CRNA	4/18/2016	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
179826	Fee-for-Service	1679623599	1679623599	1	1	HARDY, ROBERT R PHD	10/14/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
179831	Fee-for-Service	1700170388	1700170388	1	1	HEAVENSTON, JENNIFER L CRNA	6/15/2011	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
179917	Fee-for-Service	1336271352	1336271352	1	1	HSIANG, MICHELLE S MD	1/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	98819	40	Pediatrics	0	In state provider	None	2200 O'FARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
179922	Fee-for-Service	1518951300	1518951300	1	36	HOAG MEMORIAL HOSPITAL	6/7/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	16305 SAND CANYON AVE	SUITE 210	IRVINE	CA	92618	3714	30	06059	33.66201662	-117.7737316	Orange County
179953	Fee-for-Service	1538188909	1538188909	1	1	HERSHEY, BRIAN D MD	2/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	52478	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
179954	Fee-for-Service	1083296263	1083296263	1	2	HIGH DESERT WELLNESS	9/4/2023	1041C0700X	NA	Mental Health Outpatient Services	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	12555 MARIPOSA ROAD	SUITE J	VICTORVILLE	CA	92395	6010	36	06071	34.47849471	-117.3394137	San Bernardino County
179956	Fee-for-Service	1932461134	1932461134	1	1	HEALTH DIAGNOSTICS OF	2/7/2017	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	105 SOUTH DRIVE	STE 110	MOUNTAIN VIEW	CA	94040	4317	43	06085	37.36723851	-122.0782528	Santa Clara County
179980	Fee-for-Service	1487689279	1487689279	1	1	HSU, JOHN MD	9/30/1991	207LP2900X	NA	Other	026	PHYSICIANS	66952	05	Anesthesiology	0	In state provider	None	1400 BRISTOL ST N	STE 240	NEWPORT BEACH	CA	92660	2981	30	06059	33.65928642	-117.8694286	Orange County
179988	Fee-for-Service	1598910168	1598910168	1	1	HO, FRANKLIN MD INC	4/14/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	67549	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2707 E VALLEY BLVD	#203	WEST COVINA	CA	91792	3197	19	06037	34.00296323	-117.8868537	Los Angeles County
179991	Fee-for-Service	1598900052	1598900052	1	2	HEALTH PROJECTS CENTER	1/1/2021	No Taxonomy Provided	NA	None	073	AIDS WAIVER SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	9000 SOQUEL AVE	SUITE 103	SANTA CRUZ	CA	95062	2097	44	06087	36.98201547	-121.9663408	Santa Cruz County
180000	Fee-for-Service	1104321959	1104321959	1	27	HEALTH DIAGNOSTICS OF CALIFO	11/18/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	8901 ACTIVITY RD	STE 103	SAN DIEGO	CA	92126	4436	37	06073	32.8960193	-117.1345934	San Diego County
180034	Fee-for-Service	1922392679	1922392679	1	1	HOANG, STANLEY MD	9/14/2022	207L00000X	NA	Other	026	PHYSICIANS	179364	None	None	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
180123	Fee-for-Service	1992921316	1992921316	1	1	HALTERMAN, TIMOTHY E MD	2/21/2013	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
180182	Fee-for-Service	1053995084	1053995084	1	1	HULSWIT, JACOB T AU	2/21/2022	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	622 W DUARTE RD	105	ARCADIA	CA	91007	9270	19	06037	34.12645266	-118.0521552	Los Angeles County
180213	Fee-for-Service	1356748818	1356748818	1	1	HAASCH, JAIME LMFT	3/17/2025	No Taxonomy Provided	NA	None	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
180227	Fee-for-Service	1295020758	1295020758	1	1	HO, DAVID DO	11/13/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	19356	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
180251	Fee-for-Service	1407051055	1407051055	1	1	HADDOCK, ALISON J MD	4/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124403	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J STREET	None	SACRAMENTO	CA	95819	3600	34	06067	38.570526	-121.4521695	Sacramento County
180278	Fee-for-Service	1598910168	1598910168	1	1	HO, FRANKLIN MD INC	4/14/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	67549	41	Internal Medicine	0	In state provider	None	2707 E VALLEY BLVD	#203	WEST COVINA	CA	91792	3197	19	06037	34.00296323	-117.8868537	Los Angeles County
180289	Fee-for-Service	1851893291	1851893291	1	1	HERITAGE CROSSING FRESNO INC	12/6/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2792 E ALLUVIAL AVENUE	None	CLOVIS	CA	93611	9104	10	06019	36.84482652	-119.732859	Fresno County
180307	Fee-for-Service	1306924055	1306924055	1	1	HERRERA, RALPH A MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63813	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
180311	Fee-for-Service	1093041626	1093041626	1	1	HARRIS, CATHERINE R MD	4/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111641	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
180326	Fee-for-Service	1932142296	1932142296	1	1	HERMISTON MICHELLE L MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68937	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
180338	Fee-for-Service	1306095963	1306095963	1	1	HUANG, YUN-SAN MD	4/17/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128784	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
180374	Fee-for-Service	1558449181	1558449181	1	1	HARI, ANIL KUMAR MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68811	30	Radiology	0	In state provider	None	22000 FARRELL STREET	None	SAN FRANCISCO	CA	94115	0000	38	06075	37.78213416	-122.4418316	San Francisco County
180389	Fee-for-Service	1023497336	1023497336	1	1	HUYNH, CHINH V MD INC	11/17/2015	261QP2300X	NA	Other	026	PHYSICIANS	44038	01	General Practice	0	In state provider	None	9411 BOLSA AVE	STE B	WESTMINSTER	CA	92683	5980	30	06059	33.7449829	-117.9639338	Orange County
180479	Fee-for-Service	1043379647	1043379647	1	1	HUI, EDMOND C MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73271	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
180497	Fee-for-Service	1316998248	1316998248	1	2	HASHIMOTO, NATHAN E MD	6/30/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77231	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
180515	Fee-for-Service	1215940168	1215940168	1	1	HOLMES, PAUL W MD	12/26/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	43203	08	Family Practice	0	In state provider	None	560 HOSPITAL LN	None	SUSANVILLE	CA	96130	4809	18	06035	40.40754008	-120.6666326	Lassen County
180541	Fee-for-Service	1801160650	1801160650	1	1	HO, VIET H MD APC	9/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	92798	18	Ophthalmology	0	In state provider	None	2299 BACON ST	STE 11	CONCORD	CA	94520	2046	07	06013	37.98199042	-122.0349518	Contra Costa County
180545	Fee-for-Service	1679889448	1679889448	1	1	HILLS, LISA A MD	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121805	40	Pediatrics	0	In state provider	None	4053 LONE TREE WAY	101	ANTIOCH	CA	94531	6210	07	06013	37.97569499	-121.800733	Contra Costa County
180560	Fee-for-Service	1497311468	1497311468	1	1	HECHT, DOVBER MD	1/22/2023	207R00000X	NA	Other	026	PHYSICIANS	176320	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
180561	Fee-for-Service	1518951300	1518951300	1	24	HOAG MEMORIAL HOSPITAL	6/9/2017	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	16300 SAND CANYON	STE 100	IRVINE	CA	92618	3704	30	06059	33.66115075	-117.7742405	Orange County
180566	Fee-for-Service	1598910168	1598910168	1	1	HO, FRANKLIN MD INC	4/14/2009	207RP1001X	NA	Pulmonology	026	PHYSICIANS	67549	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2707 E VALLEY BLVD	#203	WEST COVINA	CA	91792	3197	19	06037	34.00296323	-117.8868537	Los Angeles County
180578	Fee-for-Service	1851893291	1851893291	1	1	HERITAGE CROSSING FRESNO INC	12/6/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2792 E ALLUVIAL AVENUE	None	CLOVIS	CA	93611	9104	10	06019	36.84482652	-119.732859	Fresno County
180581	Fee-for-Service	1215031455	1215031455	1	1	HUANG, SHAO-I DO	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	9057	66	Emergency Medicine (Urgent Care)	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63347961	-122.0897735	Alameda County
180582	Fee-for-Service	1649211939	1649211939	1	1	HUSBY, RICAHRD 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 GARTH RD	None	BAYTOWN	TX	77521	2122	00	None	29.76910842	-94.97759843	Harris County
180591	Fee-for-Service	1568603546	1568603546	1	1	HAVENS, QUYEN K	6/2/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9280 W STOCKTON BLVD	STE 116	ELK GROVE	CA	95758	8073	34	06067	38.420235	-121.394961	Sacramento County
180609	Fee-for-Service	1083660245	1083660245	1	1	HUBBARD, BRADLEY B MD	8/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
180615	Fee-for-Service	1932142296	1932142296	1	1	HERMISTON MICHELLE L MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68937	78	Neoplastic Diseases/Oncology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
180658	Fee-for-Service	1023455854	1023455854	1	1	HAHN, LEWIS D MD	5/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	131884	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
180675	Fee-for-Service	1962921981	1962921981	1	1	HEART WELLNESS CLINIC INC.	10/17/2018	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	9333 BASELINE RD.	SUITE 250	RANCHO CUCAMONGA	CA	91730	1361	36	06071	34.12150849	-117.601407	San Bernardino County
180680	Fee-for-Service	1508818006	1508818006	1	1	HOWARD, ROBERT C MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	37525	30	Radiology	0	In state provider	None	23101 SHERMAN PL	STE 407	WEST HILLS	CA	91307	2032	19	06037	34.20099112	-118.6297991	Los Angeles County
180705	Fee-for-Service	1467500454	1467500454	1	1	HADDAD, NADIM S MD	10/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82123	05	Anesthesiology	0	In state provider	None	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	19	06037	34.17030266	-118.5881699	Los Angeles County
180706	Fee-for-Service	1699193052	1699193052	1	1	HEAVENLY HOSPICE CARE INC	5/24/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	514 COMMERCE AVE	SUITE G	PALMDALE	CA	93551	3799	19	06037	34.58955354	-118.141074	Los Angeles County
180734	Fee-for-Service	1043855208	1043855208	1	1	HISHAM ABUKAMLEH	5/19/2020	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	18144 US HIGHWAY 18	SUITE 140	APPLE VALLEY	CA	92307	2219	36	06071	34.54085172	-117.2681464	San Bernardino County
180742	Fee-for-Service	1053679324	1053679324	1	1	HOOVER, NATALIE S MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	126411	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
180746	Fee-for-Service	1104354554	1104354554	1	1	HICKS, JENNIFER PT	2/28/2022	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
180748	Fee-for-Service	1083769582	1083769582	1	1	HOPKINS, DEBORAH L	8/1/2013	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
180758	Fee-for-Service	1457360638	1457360638	1	1	HARLACHER, MARK E MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	62312	05	Anesthesiology	0	In state provider	None	11999 SAN VICENTE BLVD	STE 440	LOS ANGELES	CA	90049	5042	19	06037	34.05233327	-118.4727195	Los Angeles County
180802	Fee-for-Service	1215940168	1215940168	1	1	HOLMES, PAUL W MD	12/26/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	43203	01	General Practice	0	In state provider	None	560 HOSPITAL LN	None	SUSANVILLE	CA	96130	4809	18	06035	40.40754008	-120.6666326	Lassen County
180838	Fee-for-Service	1942869656	1942869656	1	1	HOANG PHARMACY CORPORATION	10/3/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	8701 CENTER PKWY	STE 150	SACRAMENTO	CA	95823	7920	34	06067	38.439684	-121.422735	Sacramento County
180840	Fee-for-Service	1588696223	1588696223	2	1	HOANG, TU MD	1/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	79962	41	Internal Medicine	0	In state provider	None	1881 COMMERCENTER E	STE 120	SAN BERNARDINO	CA	92408	3442	36	06071	34.06770327	-117.2822565	San Bernardino County
180843	Fee-for-Service	1316974694	1316974694	1	1	HASTA, FAKHRUDDIN MD	5/1/1995	207R00000X	NA	Other	026	PHYSICIANS	50871	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93305	4018	15	06029	35.382555	-118.970757	Kern County
180865	Fee-for-Service	1952498768	1952498768	1	1	HEKIMIAN, KARL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5585 N ORACLE RD	None	TUCSON	AZ	85704	3821	00	None	32.307768	-110.9793555	Pima County
180875	Fee-for-Service	1427348473	1427348473	1	1	HOLOYDA, KATHLEEN A MD	8/11/2021	208200000X	NA	General Surgery	026	PHYSICIANS	129448	None	None	0	In state provider	None	1139 THIRD ST	None	SOUTH LAKE TAHOE	CA	96150	3465	09	06017	38.91323462	-119.9965999	El Dorado County
180897	Fee-for-Service	1083660245	1083660245	1	1	HUBBARD, BRADLEY B MD	8/19/2008	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
180904	Fee-for-Service	1932142296	1932142296	1	1	HERMISTON MICHELLE L MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68937	68	Hematology	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
180967	Fee-for-Service	1427040187	1427040187	1	1	HELD, CHARLES N MD	2/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	1	Border provider	PULMONARY MEDICINE ASSOC	1516 VIRGINIA RANCH RD	None	GARDNERVILLE	NV	89410	5730	00	None	38.91947242	-119.7199658	Douglas County
180976	Fee-for-Service	1508586736	1508586736	1	1	HORTON, ALISON K NP	9/20/2022	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
180979	Fee-for-Service	1245849124	1245849124	1	1	HI-TOP HOSPICE CARE INC	11/10/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	829 N LA CADENA DR	None	COLTON	CA	92324	2747	36	06071	34.07375888	-117.3229535	San Bernardino County
180993	Fee-for-Service	1699193052	1699193052	1	1	HEAVENLY 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	514 COMMERCE AVE	SUITE G	PALMDALE	CA	93551	3799	19	06037	34.58955354	-118.141074	Los Angeles County
181059	Fee-for-Service	1104321959	1104321959	1	26	HEALTH DIAGNOSTICS OF CALIFO	11/18/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1401 N TUSTIN AVE.,	SUITE 170	SANTA ANA	CA	92705	8679	30	06059	33.757254	-117.8341425	Orange County
181076	Fee-for-Service	1790796530	1790796530	1	1	HANGER P & O WEST INC	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	6377 RIVERSIDE AVE	STE B100	RIVERSIDE	CA	92506	3133	33	06065	33.9516	-117.387977	Riverside County
181086	Fee-for-Service	1316181555	1316181555	1	1	HENNING MEHRENS, MD INC	5/29/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2130 LAKE TAHOE BLVD	None	SOUTH LAKE TAHOE	CA	96150	6405	09	06017	38.91603139	-120.0001807	El Dorado County
181096	Fee-for-Service	1336127679	1336127679	1	1	HOLMES, 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	4200 E 9TH AVE	None	DENVER	CO	80262	0001	00	None	39.73096549	-104.9380785	Denver County
181099	Fee-for-Service	1659570570	1659570570	1	1	HARVEY, NORAH M MD	1/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	100419	20	Orthopedic Surgery	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
181132	Fee-for-Service	1407218050	1407218050	1	1	HAN, JULLET MD	7/2/2021	208800000X	NA	Other	026	PHYSICIANS	155912	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
181149	Fee-for-Service	1902996069	1902996069	1	1	HOPKINS, FREDERICK W MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84697	01	General Practice	0	In state provider	None	945 BLANCO CIR	None	SALINAS	CA	93901	4421	27	06053	36.6547965	-121.6376683	Monterey County
181158	Fee-for-Service	1013351444	1013351444	1	1	HENLEY, NICHOLLE A DO	6/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	13742	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
181163	Fee-for-Service	1689941726	1689941726	1	1	HALPERN, ERIN LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17777 VENTURA BLVD	STE 105	ENCINO	CA	91316	3738	19	06037	34.16286556	-118.5200521	Los Angeles County
181227	Fee-for-Service	1104321959	1104321959	1	28	HEALTH DIAGNOSTICS OF CALIFO	11/18/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	101 S SAN MATEO DRIVE	SUITE 201	SAN MATEO	CA	94401	3843	41	06081	37.56590481	-122.325549	San Mateo County
181241	Fee-for-Service	1366761595	1366761595	1	1	HAMEL, MICHELLE G MD	6/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136865	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
181258	Fee-for-Service	1871685420	1871685420	1	1	HAN, CATHERINE J OD	7/12/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	19733 RINALDI ST	None	NORTHRIDGE	CA	91326	4143	19	06037	34.27487747	-118.5634395	Los Angeles County
181268	Fee-for-Service	1245849124	1245849124	1	1	HI-TOP HOSPICE CARE INC	11/10/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	829 N LA CADENA DR	None	COLTON	CA	92324	2747	36	06071	34.07375888	-117.3229535	San Bernardino County
181286	Fee-for-Service	1437602844	1437602844	1	1	HANNAH KIRSTEN WESTRE CNP	6/25/2017	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
181354	Fee-for-Service	1104321959	1104321959	1	26	HEALTH DIAGNOSTICS OF CALIFO	4/25/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1401 N TUSTIN AVE.,	SUITE 170	SANTA ANA	CA	92705	8679	30	06059	33.757254	-117.8341425	Orange County
181386	Fee-for-Service	1326068149	1326068149	1	1	HAESEMEYER, SCOTT 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	544 S 400 E	None	ST GEORGE	UT	84770	3705	00	None	37.09902122	-113.5748483	Washington County
181392	Fee-for-Service	1144407065	1144407065	1	1	HEALTH AMERICA MEDICAL	2/23/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	EQUIPMENTS & SUPPLY	16039 WALNUT ST	SUITE A	HESPERIA	CA	92345	4699	36	06071	34.42208615	-117.312651	San Bernardino County
181401	Fee-for-Service	1184600785	1184600785	1	1	HUDSON, THOMAS W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34780	08	Family Practice	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
181416	Fee-for-Service	1194937169	1194937169	1	1	HARO, WITHMAN H MD	5/25/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
181438	Fee-for-Service	1902996069	1902996069	1	1	HOPKINS, FREDERICK W MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	84697	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	945 BLANCO CIR	None	SALINAS	CA	93901	4421	27	06053	36.6547965	-121.6376683	Monterey County
181493	Fee-for-Service	1821600628	1821600628	1	1	HP HOSPICE CARE INC	1/12/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	427 W COLORADO ST	STE 207	GLENDALE	CA	91204	3046	19	06037	34.1425505	-118.262142	Los Angeles County
181503	Fee-for-Service	1295814341	1295814341	1	1	HUNTER, TERRY W MD	8/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	72381	18	Ophthalmology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
181516	Fee-for-Service	1104321959	1104321959	1	28	HEALTH DIAGNOSTICS OF CALIFO	6/4/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	101 S SAN MATEO DRIVE	SUITE 201	SAN MATEO	CA	94401	3843	41	06081	37.56590481	-122.325549	San Mateo County
181531	Fee-for-Service	1871590729	1871590729	1	1	HOME AGAIN MEDICAL	5/26/1993	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	200 DEREK PL	None	ROSEVILLE	CA	95678	7154	31	06061	38.76445993	-121.2966552	Placer County
181571	Fee-for-Service	1497721963	1497721963	1	1	HART, RICHARD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26918	41	Internal Medicine	0	In state provider	None	929 GEORGIA ST	None	LOS ANGELES	CA	90015	1321	19	06037	34.04665394	-118.2663654	Los Angeles County
181576	Fee-for-Service	1164872024	1164872024	1	1	HANDA, RAHUL R MD	1/4/2025	208G00000X	NA	General Surgery	026	PHYSICIANS	171372	33	Thoracic Surgery	0	In state provider	None	401 E HIGHLAND AVE	STE 450A	SAN BERNARDINO	CA	92404	3836	36	06071	34.1358627	-117.2757778	San Bernardino County
181592	Fee-for-Service	1891310934	1891310934	1	1	HEER, STEVEN T MD	5/2/2024	390200000X	NA	Other	026	PHYSICIANS	190875	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
181595	Fee-for-Service	1326110149	1326110149	1	1	HESS, EVA G MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	74347	22	Pathology (M.D. only)	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
181633	Fee-for-Service	1093894032	1093894032	1	1	HUANG, SUSAN M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67286	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
181647	Fee-for-Service	1063178531	1063178531	1	1	HENNIG, NOELLE R CRNA	5/20/2024	163W00000X	NA	Other	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
181659	Fee-for-Service	1467412973	1467412973	1	1	HEBREW,LINKE 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	3460 PIONEER PARKWAY	None	WEST VALLEY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
181670	Fee-for-Service	1780657601	1780657601	1	1	HOLLAND, MARTIN C MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67903	14	Neurological Surgery	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
181672	Fee-for-Service	1871604728	1871604728	1	1	HONG, ANDY MD INC	1/10/2005	207RN0300X	NA	Nephrology	026	PHYSICIANS	76731	41	Internal Medicine	0	In state provider	None	3625 MARTIN LUTHER KING	JR BLVD STE 5	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
181679	Fee-for-Service	1255652806	1255652806	1	1	HSUEH, WEI-ANN MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129833	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
181722	Fee-for-Service	1174597736	1174597736	2	1	HAWKINS, ROBERT A MD	10/24/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	168053	None	None	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2302	19	06037	34.02980528	-118.4786605	Los Angeles County
181729	Fee-for-Service	1922038314	1922038314	1	1	HODDICK, WILLIAM MD	2/28/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	42293	30	Radiology	0	In state provider	None	1601 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	3122	07	06013	37.9141514	-122.0422089	Contra Costa County
181754	Fee-for-Service	1891329892	1891329892	1	1	HEAVEN ROADS HOSPICE INC	4/21/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	SUITE 136	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
181762	Fee-for-Service	1033169065	1033169065	1	1	HOU, BETTY W MD	10/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55262	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
181771	Fee-for-Service	1275503609	1275503609	1	1	HELLER, LLOYD E. MD	4/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	18530 NW CORNELL RD	STE 100	HILLSBORO	OR	97124	9203	00	None	45.5395879	-122.9006133	Washington County
181775	Fee-for-Service	1649624776	1649624776	1	1	HEALTHYCENTER INC	4/29/2016	261QH0100X	NA	Other	026	PHYSICIANS	68356	40	Pediatrics	0	In state provider	None	135 N JACKSON AVE	STE 202	SAN JOSE	CA	95116	1917	43	06085	37.36164758	-121.8466827	Santa Clara County
181782	Fee-for-Service	1821600628	1821600628	1	1	HP HOSPICE CARE INC	1/12/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	427 W COLORADO ST	STE 207	GLENDALE	CA	91204	3046	19	06037	34.1425505	-118.262142	Los Angeles County
181799	Fee-for-Service	1265460158	1265460158	1	1	HOFTMAN, NIR N MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74421	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
181805	Fee-for-Service	1770655516	1770655516	1	1	HOH, MARGARET H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	55604	40	Pediatrics	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
181807	Fee-for-Service	1164008660	1164008660	1	1	HERNANDEZ, SOPHIA E MD	7/8/2024	208600000X	NA	General Surgery	026	PHYSICIANS	186921	02	General Surgery	0	In state provider	None	2238 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3416	38	06075	37.78324881	-122.4405738	San Francisco County
181811	Fee-for-Service	1982775961	1982775961	1	1	HACKETT, DANIEL L MD	1/1/1998	2084P0800X	NA	Psychiatry	026	PHYSICIANS	70610	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
181833	Fee-for-Service	1821167206	1821167206	1	1	HAUGH, SEAN Y I MD	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65107	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
181851	Fee-for-Service	1104893908	1104893908	1	1	HABASH, HANNA J MD	8/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	52823	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
181858	Fee-for-Service	1497721963	1497721963	1	1	HART, RICHARD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26918	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	929 GEORGIA ST	None	LOS ANGELES	CA	90015	1321	19	06037	34.04665394	-118.2663654	Los Angeles County
181875	Fee-for-Service	1538401914	1538401914	1	1	HILARY MICHEL	5/12/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
181886	Fee-for-Service	1447252507	1447252507	1	1	HIMEBAUGH, KAREN S MD	2/21/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	77976	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
181904	Fee-for-Service	1720032345	1720032345	1	1	HCA HEALTH SERVICES	9/20/2015	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OF TENESSEE INC	391 WALLACE RD	None	NASHVILLE	TN	37211	4851	00	None	36.076509	-86.7213405	Davidson County
181915	Fee-for-Service	1093894032	1093894032	1	1	HUANG, SUSAN M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67286	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
181958	Fee-for-Service	1871604728	1871604728	1	1	HONG, ANDY MD INC	1/10/2005	207RN0300X	NA	Nephrology	026	PHYSICIANS	76731	45	Nephrology (Renal-Kidney)	0	In state provider	None	3625 MARTIN LUTHER KING	JR BLVD STE 5	LYNWOOD	CA	90262	3509	19	06037	33.93044131	-118.2021564	Los Angeles County
181963	Fee-for-Service	1801245667	1801245667	1	1	HOLY CARE HOME HEALTH AND	3/8/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE	13758 VICTORY BLVD	SUITE 210	VAN NUYS	CA	91401	2359	19	06037	34.18664549	-118.4332815	Los Angeles County
181971	Fee-for-Service	1780743377	1780743377	1	1	HARTFIELD, PAUL S MD	12/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	57892	40	Pediatrics	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
181996	Fee-for-Service	1679284335	1679284335	1	1	HEART AND SOUL COUNSELING	5/17/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1341 KINGS WAY	None	TAHOE VISTA	CA	96148	9800	31	06061	39.25132034	-120.0647818	Placer County
182041	Fee-for-Service	1891329892	1891329892	1	1	HEAVEN ROADS HOSPICE INC	4/21/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	SUITE 136	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
182062	Fee-for-Service	1649624776	1649624776	1	1	HEALTHYCENTER INC	4/29/2016	261QH0100X	NA	Other	026	PHYSICIANS	68356	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	135 N JACKSON AVE	STE 202	SAN JOSE	CA	95116	1917	43	06085	37.36164758	-121.8466827	Santa Clara County
182080	Fee-for-Service	1003896945	1003896945	1	1	HINMAN, TIMOTHY S MD	8/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136840	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
182097	Fee-for-Service	1174584544	1174584544	1	1	HPC LLC	3/18/2015	3336S0011X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	None	63 SOUTH ROYAL STREET	SUITE 800	MOBILE	AL	36602	3235	00	None	30.69120397	-88.04052024	Mobile County
182119	Fee-for-Service	1821167206	1821167206	1	1	HAUGH, SEAN Y I MD	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	65107	26	Psychiatry (child)	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
182132	Fee-for-Service	1689642233	1689642233	1	1	HILLER, WAHEEDA S MD	4/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133350	41	Internal Medicine	0	In state provider	None	140 BROOKWOOD RD	SUITE 201	ORINDA	CA	94563	3047	07	06013	37.87712752	-122.1816965	Contra Costa County
182133	Fee-for-Service	1679860506	1679860506	1	1	HILL, LAUREN N LMFT	11/20/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ILY THERAPY INC	20212 REDWOOD RD	STE 104	CASTRO VALLEY	CA	94546	4375	01	06001	37.698066	-122.073924	Alameda County
182138	Fee-for-Service	1548456437	1548456437	1	1	HENINGER, CARLY A MD	5/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	101108	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
182149	Fee-for-Service	1407401342	1407401342	1	1	HUYNH, KATHLEEN CNP	11/23/2021	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
182154	Fee-for-Service	1013153568	1013153568	1	1	HILCHEY, REMYANNE	5/10/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	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
182164	Fee-for-Service	1932155298	1932155298	1	1	HOLLIE, NORRIS MD DO	6/11/2019	261QA0005X	NA	Other	026	PHYSICIANS	38157	01	General Practice	0	In state provider	None	515 MICHIGAN BLVD	None	WEST SACRAMENTO	CA	95691	2705	57	06113	38.58298316	-121.5265736	Yolo County
182166	Fee-for-Service	1265659726	1265659726	1	1	HAN, SOO H MD	10/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	91254	02	General Surgery	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
182189	Fee-for-Service	1720032345	1720032345	1	1	HCA HEALTH SERVICES	9/20/2015	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	OF TENESSEE INC	391 WALLACE RD	None	NASHVILLE	TN	37211	4851	00	None	36.076509	-86.7213405	Davidson County
182199	Fee-for-Service	1336463587	1336463587	1	1	HILL, MELISSA A	3/1/2011	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
182218	Fee-for-Service	1780774679	1780774679	1	1	HEATHER A MCPHILLIPS	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4500 SAND POINT WAY NE	None	SEATTLE	WA	98105	3900	00	None	47.66165594	-122.2864502	King County
182229	Fee-for-Service	1689159303	1689159303	1	1	HUMANE HOSPICE CARE	11/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1811 W KATELLA AVE	SUITE 217	ANAHEIM	CA	92804	6658	30	06059	33.80322346	-117.9464535	Orange County
182242	Fee-for-Service	1255346979	1255346979	1	1	HUNTLEY PAIN SPECIALISTS	1/24/2008	207L00000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	A MEDICAL CORPORATION	7592 METROPOLITAN DR	STE 404	SAN DIEGO	CA	92108	4428	37	06073	32.77772014	-117.1575637	San Diego County
182255	Fee-for-Service	1043741721	1043741721	1	1	HOESTEREY, DANIEL T MD	5/5/2020	207R00000X	NA	Other	026	PHYSICIANS	162471	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
182270	Fee-for-Service	1295924215	1295924215	1	1	HEYER, AMARDEEP S MD	1/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109785	05	Anesthesiology	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
182287	Fee-for-Service	1053395442	1053395442	1	1	HIXSON, AMANDA K	1/11/2013	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
182294	Fee-for-Service	1336487289	1336487289	1	1	HOPSTONE, MICHELLE D MD	6/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	129449	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
182325	Fee-for-Service	1235445586	1235445586	1	1	HAAS-KNIGHTEN, KRISTIN PSYD	4/20/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	750 B	2870	SAN DIEGO	CA	92101	8114	37	06073	32.71782447	-117.157905	San Diego County
182336	Fee-for-Service	1669520698	1669520698	1	1	HARTFIELD, CARL V CRNA	3/29/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
182349	Fee-for-Service	1619943537	1619943537	1	2	HEMET RADIOLOGY MEDICAL	3/1/1998	174400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	624 E ELDER ST	None	FALLBROOK	CA	92028	3004	37	06073	33.38020455	-117.2446307	San Diego County
182374	Fee-for-Service	1073129250	1073129250	1	1	HYLAND, NATHAN J PT	7/3/2023	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
182402	Fee-for-Service	1710499199	1710499199	1	1	HAITSUKA, SCOTT J LCSW	5/5/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	75745	-	NOT APPLICABLE	0	In state provider	None	315 TURK STREET	None	SAN FRANCISCO	CA	94102	3703	38	06075	37.78272091	-122.4143755	San Francisco County
182420	Fee-for-Service	1215323761	1215323761	1	1	HONG, JOSEPH MD	3/17/2021	208M00000X	NA	Other	026	PHYSICIANS	147201	None	None	0	In state provider	None	350 30TH ST	411	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
182450	Fee-for-Service	1437269503	1437269503	1	1	HERRON, ALETHA R LCSW	9/19/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 MAGNOLIA AVE	STE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
182451	Fee-for-Service	1669471868	1669471868	1	1	HARROD, CHARLES S MD	11/13/2018	207R00000X	NA	Other	026	PHYSICIANS	158724	41	Internal Medicine	0	In state provider	None	3941 J ST	STE 354	SACRAMENTO	CA	95819	3633	34	06067	38.570652	-121.4535465	Sacramento County
182489	Fee-for-Service	1578586046	1578586046	1	1	HORNG, FELIX Y MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64668	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
182492	Fee-for-Service	1013063833	1013063833	1	1	HWANG, DAVID Y MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	40132	41	Internal Medicine	0	In state provider	None	3010 W ORANGE AVE	STE 107	ANAHEIM	CA	92804	3170	30	06059	33.82472315	-117.994133	Orange County
182498	Fee-for-Service	1730624636	1730624636	1	1	HASHI, SHAMSUDINI O MD	1/27/2024	207L00000X	NA	Other	026	PHYSICIANS	182082	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
182519	Fee-for-Service	1689159303	1689159303	1	1	HUMANE HOSPICE CARE	11/1/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1811 W KATELLA AVE	SUITE 217	ANAHEIM	CA	92804	6658	30	06059	33.80322346	-117.9464535	Orange County
182533	Fee-for-Service	1982185823	1982185823	1	1	HORNAK, LISA E	11/16/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	16055 VENTURA BLVD	None	ENCINO	CA	91436	2601	19	06037	34.15632563	-118.4832351	Los Angeles County
182578	Fee-for-Service	1669565941	1669565941	1	1	HESS, BRIAN H MD	12/21/2019	207P00000X	NA	Other	026	PHYSICIANS	165158	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
182600	Fee-for-Service	1104321959	1104321959	1	20	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1690 BARTON RD	107 & 108	REDLANDS	CA	92373	4229	36	06071	34.04836346	-117.2125293	San Bernardino County
182603	Fee-for-Service	1871561100	1871561100	1	1	HUA, TINH DO	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12306	66	Emergency Medicine (Urgent Care)	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
182606	Fee-for-Service	1902997562	1902997562	1	1	HELMANDOLLAR, VICTORIA M NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4510 VIEWRIDGE DR	None	SAN DIEGO	CA	92123	1637	37	06073	32.82283469	-117.1248707	San Diego County
182608	Fee-for-Service	1548435860	1548435860	1	1	HUGEN, MARCIA C MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133300	01	General Practice	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
182638	Fee-for-Service	1720549736	1720549736	1	1	HAN, FELICIA DO	7/18/2024	208600000X	NA	General Surgery	026	PHYSICIANS	22892	02	General Surgery	0	In state provider	None	6555 COYLE	SUITE 220	CARMICHAEL	CA	95608	0303	34	06067	38.66859	-121.3118055	Sacramento County
182639	Fee-for-Service	1952729345	1952729345	1	1	HARE, ARTHUR S III CRNA	3/28/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
182645	Fee-for-Service	1033260260	1033260260	1	1	HELLMAN, IRVING D PHD	10/16/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2016 MORSE AVENUE	None	SACRAMENTO	CA	95825	2135	34	06067	38.601801	-121.391613	Sacramento County
182677	Fee-for-Service	1023011665	1023011665	1	1	HOSPICE OF THE VALLEYS	3/5/1998	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	25240 HANCOCK AVE	STE 120	MURRIETA	CA	92562	5991	33	06065	33.56227729	-117.1831012	Riverside County
182684	Fee-for-Service	1679542237	1679542237	1	1	HILDEBRANDT, RICHARD H	10/1/1998	207ZC0500X	NA	Other	026	PHYSICIANS	77024	22	Pathology (M.D. only)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
182689	Fee-for-Service	1982108635	1982108635	1	1	HART, TRAVIS P MD	10/29/2022	207L00000X	NA	Other	026	PHYSICIANS	163741	None	None	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
182692	Fee-for-Service	1881887271	1881887271	1	1	HOLDEN, KAREN F MD	9/29/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	85714	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
182709	Fee-for-Service	1457992927	1457992927	1	1	HUONG T L NGUYEN MD INC	6/10/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	4444 EL CAJON BLVD	6	SAN DIEGO	CA	92115	4392	37	06073	32.75515755	-117.0989261	San Diego County
182753	Fee-for-Service	1497275580	1497275580	1	1	HUANG, NANCY L	7/21/2017	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	10050 N WOLFE RD	None	CUPERTINO	CA	95014	2519	43	06085	37.323639	-122.014123	Santa Clara County
182754	Fee-for-Service	1790985232	1790985232	1	1	HENRY, MICHAEL LMFT	5/30/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2460 W 3RD ST	STE 230A	SANTA ROSA	CA	95401	6411	49	06097	38.437731	-122.7692385	Sonoma County
182778	Fee-for-Service	1578586046	1578586046	1	1	HORNG, FELIX Y MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64668	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
182780	Fee-for-Service	1013063833	1013063833	1	1	HWANG, DAVID Y MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	40132	01	General Practice	0	In state provider	None	3010 W ORANGE AVE	STE 107	ANAHEIM	CA	92804	3170	30	06059	33.82472315	-117.994133	Orange County
182796	Fee-for-Service	1467543322	1467543322	1	1	HABERLIN, POLLY 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	315 MARTIN LUTHER KING J	None	TACOMA	WA	98405	4234	00	None	47.25960844	-122.4534238	Pierce County
182802	Fee-for-Service	1912398629	1912398629	1	1	HARPER, NICOLE L LMFT	5/22/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	102195	-	NOT APPLICABLE	0	In state provider	None	1914 22ND ST	None	SACRAMENTO	CA	95816	7109	34	06067	38.565666	-121.482	Sacramento County
182818	Fee-for-Service	1780834770	1780834770	1	1	HUANG, ZHEN S MD	11/12/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136744	01	General Practice	0	In state provider	None	16917 ENADIA WAY	None	VAN NUYS	CA	91406	3602	19	06037	34.20015385	-118.5018777	Los Angeles County
182828	Fee-for-Service	1437207420	1437207420	1	1	HEARD, NOVELLYN H MD	4/12/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60028	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
182847	Fee-for-Service	1063942647	1063942647	1	1	HERITAGE LIVING INC	11/28/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	10411 BLYTHE CT	None	BAKERSFIELD	CA	93311	9681	15	06029	35.3089715	-119.118096	Kern County
182880	Fee-for-Service	1871027565	1871027565	1	1	HENRY, RHONITA C NP	5/11/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	473 EAST CARNEGIE DRIVE	200	SAN BERNARDINO	CA	92408	4201	36	06071	34.0683677	-117.2746246	San Bernardino County
182885	Fee-for-Service	1922057967	1922057967	1	1	HUSSAIN ,SHAHID 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	987400 NEBRASKA MED	CTR	OMAHA	NE	68198	0000	00	None	0	0	None
182889	Fee-for-Service	1104321959	1104321959	1	20	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1690 BARTON RD	107 & 108	REDLANDS	CA	92373	4229	36	06071	34.04836346	-117.2125293	San Bernardino County
182896	Fee-for-Service	1225186257	1225186257	1	1	HUANG, SCOTT L DO	1/7/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	9056	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
182925	Fee-for-Service	1720118490	1720118490	1	1	HEMANT R NAYAK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	751 NE BLAKELY DR	None	ISSAQUAH	WA	98029	8940	00	None	47.53652154	-122.0220045	King County
182942	Fee-for-Service	1598759417	1598759417	1	1	HUGHES, STEPHANIE A MD	5/31/1989	207L00000X	NA	Other	026	PHYSICIANS	59882	01	General Practice	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
182966	Fee-for-Service	1023011665	1023011665	1	1	HOSPICE OF THE VALLEYS	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	25240 HANCOCK AVE	STE 120	MURRIETA	CA	92562	5991	33	06065	33.56227729	-117.1831012	Riverside County
182974	Fee-for-Service	1407053895	1407053895	1	1	HARRIS, RICHARD W MD	2/2/2015	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
182991	Fee-for-Service	1487615449	1487615449	1	1	HERNANDEZ GUTIERREZ, DANIEL	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143962	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	I MD	1187 E HERNDON	STE 106	FRESNO	CA	93720	3166	10	06019	36.83640179	-119.7674647	Fresno County
183000	Fee-for-Service	1013165018	1013165018	1	1	HUITRON, MELISSA LCSW	8/13/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	13200 CROSSROADS PARKWAY	SUITE 355	CITY OF INDUSTRY	CA	91746	3409	19	06037	34.03038726	-118.0130115	Los Angeles County
183029	Fee-for-Service	1316989130	1316989130	1	1	HOYNAK, BRYAN C MD	6/30/1984	207P00000X	NA	Other	026	PHYSICIANS	51977	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
183032	Fee-for-Service	1386057313	1386057313	1	1	HWANG, ANGELA J MD	8/29/2019	207L00000X	NA	Other	026	PHYSICIANS	141080	05	Anesthesiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
183052	Fee-for-Service	1558043166	1558043166	1	1	HEALTHMED TRANSPORT L.L.C.	9/19/2023	342000000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1145 E DINUBA AVE	118	REEDLEY	CA	93654	3566	10	06019	36.58964443	-119.4365719	Fresno County
183075	Fee-for-Service	1306835723	1306835723	1	1	HAMSTRA, WILLIAM N DO	12/31/1990	208600000X	NA	General Surgery	026	PHYSICIANS	5413	02	General Surgery	0	In state provider	None	2305 CAMINO RAMON	STE 217	SAN RAMON	CA	94583	1316	07	06013	37.77544224	-121.9657563	Contra Costa County
183079	Fee-for-Service	1477866101	1477866101	1	1	HERIAL, NABEEL A MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124045	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
183091	Fee-for-Service	1932629615	1932629615	1	1	HERRIN, ASHLEY M DO	9/6/2022	207P00000X	NA	Other	026	PHYSICIANS	20050	None	None	0	In state provider	None	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
183122	Fee-for-Service	1821176728	1821176728	1	1	HINES, MICHAEL R MD	5/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	56039	30	Radiology	0	In state provider	None	121 SOTOYOME ST	None	SANTA ROSA	CA	95405	4823	49	06097	38.44224	-122.70195	Sonoma County
183126	Fee-for-Service	1326183666	1326183666	1	1	HILARY ANNE HEWES, 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
183136	Fee-for-Service	1144402348	1144402348	1	1	HUYNH, THU-TAM T MD	9/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	85103	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
183216	Fee-for-Service	1407333453	1407333453	1	1	HAGGERTY, JOSEPH F MD	8/11/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	178458	None	None	0	In state provider	None	3 ALTARINDA RD	#200	ORINDA	CA	94563	2601	07	06013	37.88212237	-122.1854034	Contra Costa County
183307	Fee-for-Service	1285054270	1285054270	1	1	HACK, LAURA M MD	10/5/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	158579	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
183308	Fee-for-Service	1104321959	1104321959	1	29	HEALTH DIAGNOSTICS OF CALIFO	8/31/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	LE	108 GREEN VALLEY RD	B	FREEDOM	CA	95019	3110	44	06087	36.93669269	-121.7720262	Santa Cruz County
183311	Fee-for-Service	1205517752	1205517752	1	1	HAVENS-STOKES, ELISA DOULA	8/6/2024	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	44	06087	0	0	None
183317	Fee-for-Service	1588676639	1588676639	1	1	HUBENETTE, ANTOINETTE MD	4/1/1995	174400000X	NA	Other	026	PHYSICIANS	35380	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
183320	Fee-for-Service	1518071679	1518071679	1	1	HANSON, KARI A LMFT	1/13/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
183346	Fee-for-Service	1336221324	1336221324	1	1	HELPING HANDS FOR BETTER	1/4/1999	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	LIVING ADHC	10281 CHAPMAN AVE	None	GARDEN GROVE	CA	92840	2944	30	06059	33.78864044	-117.9535004	Orange County
183362	Fee-for-Service	1376085290	1376085290	1	1	HAN, ANNIE J NP	6/16/2017	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
183396	Fee-for-Service	1104321959	1104321959	1	23	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	MEDICAL PARK	800 POLLARD RD	STE B101	LOS GATOS	CA	95032	1445	43	06085	37.26085007	-121.9698747	Santa Clara County
183422	Fee-for-Service	1003222803	1003222803	1	1	HAWK, BRANDI N PHD	2/28/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
183434	Fee-for-Service	1578554002	1578554002	1	1	HO, IVAN C MD	8/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103076	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1245 WILSHIRE BLVD	STE 703	LOS ANGELES	CA	90017	4807	19	06037	34.05362775	-118.2661889	Los Angeles County
183449	Fee-for-Service	1376552638	1376552638	1	1	HOLDEN, TIMOTHY P MD	10/12/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99762	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
183463	Fee-for-Service	1972506616	1972506616	1	1	HALE, MICAH D DO	11/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8534	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 S OAK AVE	None	OAKDALE	CA	95361	3519	50	06099	37.75764557	-120.8600743	Stanislaus County
183474	Fee-for-Service	1780866327	1780866327	1	1	HANSON, MATHU N PT	6/28/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4300 GREEN RIVER ROAD	114	CORONA	CA	92878	2306	33	06065	33.87886214	-117.6493182	Riverside County
183476	Fee-for-Service	1437654522	1437654522	1	1	HOLYOKE, ALBAN MD	6/27/2023	207P00000X	NA	Other	026	PHYSICIANS	185237	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2105 FOREST AVE	None	SAN JOSE	CA	95128	1425	43	06085	37.32710433	-121.9386474	Santa Clara County
183490	Fee-for-Service	1235520909	1235520909	1	1	HUNG, HSIANG-HUA MD	6/20/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	158116	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
183534	Fee-for-Service	1144643420	1144643420	1	1	HARRIS, NANCY S MD	5/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	53569	41	Internal Medicine	0	In state provider	None	143 E MAIN STREET	None	LOS GATOS	CA	95030	6903	43	06085	37.22117263	-121.9775316	Santa Clara County
183554	Fee-for-Service	1679882369	1679882369	1	1	HUYNH, LYANNE L MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114058	01	General Practice	0	In state provider	None	975 S FAIRMONT AVENUE	None	LODI	CA	95242	3635	39	06077	38.12188356	-121.285872	San Joaquin County
183563	Fee-for-Service	1790334696	1790334696	1	1	HARRISON, KEENA NP	12/20/2024	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
183596	Fee-for-Service	1861704645	1861704645	1	1	HURLBUT, EUGENIA L DO	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	14030	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1617 N CALIFORNIA ST	STE 2A	STOCKTON	CA	95204	6117	39	06077	37.9697906	-121.2890104	San Joaquin County
183615	Fee-for-Service	1013088046	1013088046	1	1	HUSAIN, SYEDA S MD	7/30/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	69519	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
183641	Fee-for-Service	1669420485	1669420485	1	1	HASSID, ERIC I MD	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	75478	13	Neurology (M.D. only)	0	In state provider	None	1970 LAKE BLVD	STE 2	DAVIS	CA	95616	5663	57	06113	38.56083314	-121.7861904	Yolo County
183665	Fee-for-Service	1487925145	1487925145	1	1	HESTERBERG, JULIANNE E MD	9/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119667	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
183667	Fee-for-Service	1457763575	1457763575	1	1	HANNA, MICHAEL W MD	12/27/2017	207R00000X	NA	Other	026	PHYSICIANS	151442	41	Internal Medicine	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2460	37	06073	32.99706	-117.05544	San Diego County
183685	Fee-for-Service	1790730521	1790730521	1	1	HAWTHORNE, HILARY OD AN	1/8/2019	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CORPORATION	8619 S VERMONT AVE	None	LOS ANGELES	CA	90044	4827	19	06037	33.95942681	-118.2919294	Los Angeles County
183689	Fee-for-Service	1104321959	1104321959	1	23	HEALTH DIAGNOSTICS OF CALIFO	2/12/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	MEDICAL PARK	800 POLLARD RD	STE B101	LOS GATOS	CA	95032	1445	43	06085	37.26085007	-121.9698747	Santa Clara County
183723	Fee-for-Service	1548683238	1548683238	1	1	HOSEIN, RAMI J MD	6/26/2020	207R00000X	NA	Other	026	PHYSICIANS	151343	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
183769	Fee-for-Service	1487863395	1487863395	1	1	HUNG, CT MD INC	7/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	36336	01	General Practice	0	In state provider	None	629 N 13TH AVE	None	UPLAND	CA	91786	4906	36	06071	34.10133639	-117.6337219	San Bernardino County
183798	Fee-for-Service	1730266131	1730266131	1	1	HILL, LISA MARIE	12/2/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 SOUTH FIRST STREET	SUITE 1800	BURBANK	CA	91502	1959	19	06037	34.17942444	-118.3096895	Los Angeles County
183810	Fee-for-Service	1336204163	1336204163	1	1	HALSTEAD, RENEE	2/8/2015	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	722 MEDICAL CENTER DR E	STE 101	CLOVIS	CA	93611	6810	10	06019	36.84107334	-119.6587409	Fresno County
183812	Fee-for-Service	1730109968	1730109968	2	1	HERRON, LARRY D	12/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	25538	20	Orthopedic Surgery	0	In state provider	None	1304 ELLA ST	STE B1	SAN LUIS OBISPO	CA	93401	4166	40	06079	35.27704692	-120.6496857	San Luis Obispo County
183820	Fee-for-Service	1497727598	1497727598	1	1	HERBERT, ERIC B MD	9/1/1998	207P00000X	NA	Other	026	PHYSICIANS	84441	66	Emergency Medicine (Urgent Care)	0	In state provider	None	354 SANTA FE DR	None	ENCINITAS	CA	92024	5142	37	06073	33.03623896	-117.2837308	San Diego County
183934	Fee-for-Service	1982730362	1982730362	1	1	HU, ROLLIN C MD	1/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118283	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
183983	Fee-for-Service	1285613943	1285613943	1	1	HARWITT, MARC H MD	11/27/1985	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	23138	10	Gastroenterology (M.D. only)	0	In state provider	None	11860 WILSHIRE BLVD	STE 106	LOS ANGELES	CA	90025	6613	19	06037	34.04705881	-118.4637989	Los Angeles County
183992	Fee-for-Service	1225156904	1225156904	1	1	HARRIS, CARMONIQUE LCSW	2/7/2022	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
184046	Fee-for-Service	1023205010	1023205010	1	1	HUANG, JIMMY C DO APC	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	6713	08	Family Practice	0	In state provider	None	3756 SANTA ROSALIA	#422	LOS ANGELES	CA	90008	3614	19	06037	34.00888336	-118.3389334	Los Angeles County
184071	Fee-for-Service	1255916649	1255916649	1	1	HAREWOOD, VENESSA LMFT	3/25/2022	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
184073	Fee-for-Service	1609247642	1609247642	1	1	HARUI, MICHELLE M PT	2/17/2016	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
184103	Fee-for-Service	1982966172	1982966172	1	1	HEALTH DIAGNOSTICS OF	2/7/2017	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	14651 S BASCOM AVE	STE 120	LOS GATOS	CA	95032	2004	43	06085	37.25556684	-121.9504578	Santa Clara County
184114	Fee-for-Service	1295314557	1295314557	1	1	HUANG, ANDY DO	3/15/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22248	None	None	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
184136	Fee-for-Service	1679612212	1679612212	1	1	HAN, AENA D MD	4/1/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	153714	40	Pediatrics	0	In state provider	None	210 CANAL ST	None	KING CITY	CA	93930	3432	27	06053	36.20731142	-121.1325532	Monterey County
184137	Fee-for-Service	1629697883	1629697883	1	1	HAYDEN-TOWN, CHARYS M CNP	9/16/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1100 TRANCAS ST	SUITE 256	NAPA	CA	94558	2921	28	06055	38.32316569	-122.2981938	Napa County
184160	Fee-for-Service	1255520268	1255520268	1	1	HALPIN, SHANNON M	7/24/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
184166	Fee-for-Service	1235580515	1235580515	1	1	HOOLEY, ARLEN DO	5/21/2021	207P00000X	NA	Other	026	PHYSICIANS	18194	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
184172	Fee-for-Service	1134229750	1134229750	1	1	HANSEN, AMY L	3/2/2012	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1625 STOCKTON BLVD.	None	SACRAMENTO	CA	95816	7097	34	06067	38.56554	-121.4664615	Sacramento County
184179	Fee-for-Service	1700129731	1700129731	2	1	HELPFUL HANDS DRUG AND	8/22/2017	207QA0401X	NA	Adult Primary Care	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	ALCOHOL OUTPATIENT PROGR	1249 SOUTH LA BREA AVE	None	LOS ANGELES	CA	90019	1627	19	06037	34.05185225	-118.3442887	Los Angeles County
184200	Fee-for-Service	1285210955	1285210955	1	1	HARPER, CARSON MD	6/8/2024	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
184241	Fee-for-Service	1225395734	1225395734	1	1	HAUFF, SAMANTHA J MD	1/15/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	123547	None	None	0	In state provider	None	321 E ST	None	CHULA VISTA	CA	91910	2667	37	06073	32.64457385	-117.0820661	San Diego County
184290	Fee-for-Service	1750916987	1750916987	1	1	HEGER, JULIE	9/1/2024	390200000X	NA	Other	026	PHYSICIANS	None	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
184330	Fee-for-Service	1548550718	1548550718	1	1	HUI, CHUI MAN CARMEN MD	1/25/2022	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1050 WEST GALLERIA DRIVE	None	HENDERSON	NV	89011	4800	00	None	36.07123413	-115.0308684	Clark County
184333	Fee-for-Service	1023205010	1023205010	1	1	HUANG, JIMMY C DO APC	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	6713	26	Psychiatry (child)	0	In state provider	None	3756 SANTA ROSALIA	#422	LOS ANGELES	CA	90008	3614	19	06037	34.00888336	-118.3389334	Los Angeles County
184354	Fee-for-Service	1356978548	1356978548	1	1	HSU, KRISTIE Y MD	7/21/2023	207R00000X	NA	Other	026	PHYSICIANS	183752	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
184355	Fee-for-Service	1356308167	1356308167	1	1	HAROUTUNIAN, GAGIK G MD	8/9/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54033	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
184374	Fee-for-Service	1902410442	1902410442	1	1	HOPE ELEMENTARY SCHOOL	1/1/2021	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	3970 LA COLINA RD	STE 14	SANTA BARBARA	CA	93110	2599	42	06083	34.44426392	-119.7540661	Santa Barbara County
184395	Fee-for-Service	1508057522	1508057522	1	1	HUYNH, ANTHONY V DO	10/3/2019	207RB0002X	NA	Other	026	PHYSICIANS	14321	41	Internal Medicine	0	In state provider	None	3100 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3866	31	06061	38.74399612	-121.2349547	Placer County
184403	Fee-for-Service	1033271515	1033271515	1	1	HAKHAMIMI, HOUSHANG MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	20777	02	General Surgery	0	In state provider	A PROF CORP	541 W AVENUE 26	None	LOS ANGELES	CA	90065	1033	19	06037	34.08469879	-118.2233339	Los Angeles County
184420	Fee-for-Service	1033442983	1033442983	1	1	HERNANDEZ, MAYRA A LMFT	11/4/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4624 ARLINGTON AVE	None	RIVERSIDE	CA	92504	2702	33	06065	33.94615854	-117.40365	Riverside County
184424	Fee-for-Service	1518175140	1518175140	1	1	HADAYA, STELLA M	4/9/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	21263 ERWIN ST	None	WOODLAND HILLS	CA	91367	3715	19	06037	34.18286951	-118.5949215	Los Angeles County
184465	Fee-for-Service	1043774474	1043774474	1	1	HINEK, DIANA DOULA	3/13/2025	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	41	06081	0	0	None
184466	Fee-for-Service	1326169590	1326169590	1	1	HERVEY-JUMPER, HEATHER L MD	10/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151948	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
184487	Fee-for-Service	1477551216	1477551216	1	1	HARMON, MICHAEL W MD	8/31/1992	2085U0001X	NA	Other	026	PHYSICIANS	71219	30	Radiology	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95525	0368	12	06023	40.78355148	-124.1420294	Humboldt County
184493	Fee-for-Service	1356499230	1356499230	1	1	HIRATA, KRIS K MD	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	74003	25	Physical Medicine and Rehabilitation	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
184496	Fee-for-Service	1104321959	1104321959	1	19	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	ISCO SFRMC	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
184524	Fee-for-Service	1649330010	1649330010	1	1	HAN, MAN LAC	12/29/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
184526	Fee-for-Service	1902067796	1902067796	1	1	HUSSAIN, SHAUN A MD	4/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	100286	79	Neurology-Child	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
184542	Fee-for-Service	1619054491	1619054491	1	1	HEITZMAN, GEORGE R MD	7/22/2008	2084P0800X	NA	Psychiatry	026	PHYSICIANS	27369	36	Psychiatry	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
184556	Fee-for-Service	1699955179	1699955179	1	1	HARIRI, SHERWIN R MD	7/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108924	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
184588	Fee-for-Service	1184677940	1184677940	1	1	HSU, SENZAN MD	11/15/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	70309	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5400 W HILLSDALE AVE	None	VISALIA	CA	93291	8222	54	06107	36.330327	-119.351943	Tulare County
184602	Fee-for-Service	1184494031	1184494031	1	1	HAMMOND, CLAUDIA SUUR-IB	3/6/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	7468 HAYSTACK LOOP	None	RIVERSIDE	CA	92507	9600	33	06065	34.011486	-117.292338	Riverside County
184618	Fee-for-Service	1790275055	1790275055	1	1	HAMLEY, RENEE M PT	8/30/2020	225100000X	NA	Physical Therapist	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
184624	Fee-for-Service	1023205010	1023205010	1	1	HUANG, JIMMY C DO APC	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	6713	32	Radiation Therapy (D.O. only)	0	In state provider	None	3756 SANTA ROSALIA	#422	LOS ANGELES	CA	90008	3614	19	06037	34.00888336	-118.3389334	Los Angeles County
184657	Fee-for-Service	1952930844	1952930844	1	1	HUSSAIN, SYED F MD	2/26/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
184659	Fee-for-Service	1922443928	1922443928	1	1	HEALING TOUCH OF CALIFORNIA	7/14/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HOME HEALTH AGENCY INC	8010 WAYLAND LANE	SUITE 1E	GILROY	CA	95020	4158	43	06085	37.01414531	-121.5818293	Santa Clara County
184681	Fee-for-Service	1548783392	1548783392	1	1	HEART RHYTHM OF SAN JOAQUIN,	9/28/2017	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	06	Cardiovascular Disease (M.D. only)	0	In state provider	INC	415 E HARDING WAY	SUITE I	STOCKTON	CA	95204	6118	39	06077	37.96819912	-121.2900761	San Joaquin County
184683	Fee-for-Service	1093873309	1093873309	1	1	HORAN, CHRISTOPHER J MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70850	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
184700	Fee-for-Service	1669590782	1669590782	1	1	HUYNH, TONY H MD	7/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99551	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
184733	Fee-for-Service	1639600562	1639600562	1	1	HWANG, MICHAEL MD	5/13/2020	390200000X	NA	Other	026	PHYSICIANS	16857	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
184737	Fee-for-Service	1194721035	1194721035	1	1	HILDEBRANDT, HANS JO MD	1/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	76378	30	Radiology	0	In state provider	None	231 W FIR AVE	None	CLOVIS	CA	93611	0220	10	06019	36.83897746	-119.715138	Fresno County
184747	Fee-for-Service	1396761300	1396761300	1	1	HAMILTON, CATHERINE L MD	6/21/2000	207L00000X	NA	Other	026	PHYSICIANS	74001	05	Anesthesiology	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
184763	Fee-for-Service	1285129270	1285129270	1	1	HEAR BY THE ROCK LLC	8/28/2018	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1052 MAIN ST	STE B	MORRO BAY	CA	93442	4004	40	06079	35.368326	-120.8500045	San Luis Obispo County
184771	Fee-for-Service	1720275829	1720275829	1	1	HATORI, DAYNE K CP	10/10/2017	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1270 EAST GARVEY AVE	STE 145	COVINA	CA	91724	3658	19	06037	34.07112702	-117.8633037	Los Angeles County
184776	Fee-for-Service	1508906272	1508906272	1	1	HA, THUY T OD	8/7/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
184777	Fee-for-Service	1104321959	1104321959	1	22	HEALTH DIAGNOSTICS OF CALIFO	12/11/2023	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	345 SAXONY RD	SUITE 106	ENCINITAS	CA	92024	2787	37	06073	33.05403165	-117.285548	San Diego County
184779	Fee-for-Service	1104321959	1104321959	1	19	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ISCO SFRMC	1180 POST ST	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
184822	Fee-for-Service	1316581499	1316581499	1	1	HERNANDEZ, TABITHA LCSW	2/7/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	118836	-	NOT APPLICABLE	0	In state provider	None	1240 BROADWAY	None	EL CAJON	CA	92021	4994	37	06073	32.80773552	-116.9384985	San Diego County
184840	Fee-for-Service	1982131058	1982131058	1	1	HENRY, REYNOLD MD MPH	8/15/2022	2086S0102X	NA	General Surgery	026	PHYSICIANS	146985	None	None	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
184847	Fee-for-Service	1497403778	1497403778	1	1	HAN, SHARON OD	9/14/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5991 E SPRING ST	None	LONG BEACH	CA	90808	3752	19	06037	33.81062147	-118.1154555	Los Angeles County
184890	Fee-for-Service	1184494031	1184494031	1	1	HAMMOND, CLAUDIA SUUR-IB	3/6/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	7468 HAYSTACK LOOP	None	RIVERSIDE	CA	92507	9600	33	06065	34.011486	-117.292338	Riverside County
184900	Fee-for-Service	1770739252	1770739252	1	1	HSIUNG, CHIH P MD	7/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	106821	05	Anesthesiology	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
184910	Fee-for-Service	1619440302	1619440302	1	1	HU ACUPUNCTURE INC	2/1/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	620 E WASHINGTON ST	STE 110	PETALUMA	CA	94952	5911	49	06097	38.24070016	-122.6337031	Sonoma County
184911	Fee-for-Service	1639464977	1639464977	1	1	HONARCHIAN, TALIN LMFT	9/13/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	138 N BRAND BLVD	STE 303	GLENDALE	CA	91203	4621	19	06037	34.147755	-118.2549335	Los Angeles County
184926	Fee-for-Service	1518259704	1518259704	1	1	HOSMER, MAEVA I LMFT	12/9/2021	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
184944	Fee-for-Service	1952930844	1952930844	1	1	HUSSAIN, SYED F MD	2/26/2025	207R00000X	NA	Other	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	20101 LAKE CHABOT RD	1ST FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
184994	Fee-for-Service	1568221588	1568221588	1	1	HOANG, HANNAH PT	6/3/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1710 PLUM LN	SUITE C	REDLANDS	CA	92374	0100	36	06071	34.06896096	-117.2134285	San Bernardino County
185005	Fee-for-Service	1972942829	1972942829	1	1	HOSSEINI, ATOOSA DO	12/3/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17574	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
185029	Fee-for-Service	1194040220	1194040220	1	1	HARRIS, BRONWYN U MD	8/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117801	35	Pediatric Cardiology (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
185044	Fee-for-Service	1730237793	1730237793	1	1	HUANG, BERYL J MD	6/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	60112	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
185053	Fee-for-Service	1447334511	1447334511	1	1	HAAS, ALBERT III MD	5/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	49236	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
185065	Fee-for-Service	1104321959	1104321959	1	22	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	345 SAXONY RD	SUITE 106	ENCINITAS	CA	92024	2787	37	06073	33.05403165	-117.285548	San Diego County
185087	Fee-for-Service	1356446470	1356446470	1	1	HUYNH, TUNG V MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79840	30	Radiology	0	In state provider	None	2224 MEDICAL CENTER DR	None	PERRIS	CA	92571	2638	33	06065	33.8123212	-117.2217309	Riverside County
185096	Fee-for-Service	1043832512	1043832512	1	1	HARDY, LEE-ANA G CRNA	5/4/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
185115	Fee-for-Service	1306154356	1306154356	1	1	HOWELL, JOANNE L LMFT	3/14/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ST	1940 CHANNING WAY	None	BERKELEY	CA	94704	1977	01	06001	37.86536992	-122.2704321	Alameda County
185144	Fee-for-Service	1053552109	1053552109	1	1	HSIEH, MICHAEL MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	82106	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
185156	Fee-for-Service	1710401229	1710401229	1	1	HASLAM, CINDY NP	10/3/2022	363LF0000X	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
185160	Fee-for-Service	1063284388	1063284388	1	1	HOLISTIC PHYSICAL THERAPY, I	12/20/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	NC.	65 S MAIN ST	STE 101	TEMPLETON	CA	93465	8703	40	06079	35.55478617	-120.7015206	San Luis Obispo County
185206	Fee-for-Service	1194927491	1194927491	1	1	HO, SAMUEL S MD	7/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	93329	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
185230	Fee-for-Service	1982646832	1982646832	1	1	HAGE, JEAN-CLAUDE	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	77308	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1690 BARTON RD	STE 106	REDLANDS	CA	92373	4230	36	06071	34.04836346	-117.2125293	San Bernardino County
185299	Fee-for-Service	1508820937	1508820937	1	1	HOME OF GUIDING HANDS	12/1/1988	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	6476 BISBY LAKE AVE	None	SAN DIEGO	CA	92119	2645	37	06073	32.79979106	-117.0147126	San Diego County
185320	Fee-for-Service	1194040220	1194040220	1	1	HARRIS, BRONWYN U MD	8/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117801	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
185323	Fee-for-Service	1689790164	1689790164	1	1	HADDAD, ZIAD M MD	10/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97736	13	Neurology (M.D. only)	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
185335	Fee-for-Service	1164407391	1164407391	1	1	HARTLEY, THOMAS M MD	10/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	89301	20	Orthopedic Surgery	0	In state provider	None	4343 MARKET STREET	STE A	RIVERSIDE	CA	92501	3567	33	06065	33.97734857	-117.3791849	Riverside County
185368	Fee-for-Service	1457932097	1457932097	1	1	HAMMILL, TIMOTHY OD	12/19/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1845 W REDLANDS BLVD	101	REDLANDS	CA	92373	3124	36	06071	34.06287653	-117.215955	San Bernardino County
185396	Fee-for-Service	1679790612	1679790612	1	1	HARRIS, VERNETTA L MD	2/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145558	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7500 HOSPITAL DR	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
185415	Fee-for-Service	1679187223	1679187223	1	1	HELP LINE HOME HEALTH	12/10/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16200 VENTURA BLVD	STE 420	ENCINO	CA	91436	4908	19	06037	34.15659457	-118.485532	Los Angeles County
185437	Fee-for-Service	1457621658	1457621658	1	1	HENNESSEY ROTH, LINDA LMFT	9/28/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	700 MILL ST	SUITE 14	HALF MOON BAY	CA	94019	1781	41	06081	37.46464841	-122.4293645	San Mateo County
185440	Fee-for-Service	1548472574	1548472574	1	1	HUSSAIN, RIZWANA B MD	5/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	38923	41	Internal Medicine	0	In state provider	None	18750 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2959	19	06037	33.98769568	-117.8941434	Los Angeles County
185455	Fee-for-Service	1316135742	1316135742	2	1	HERNANDEZ, MARIA C MD	1/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	40070	01	General Practice	0	In state provider	None	4530 ROSEMEAD BLVD	None	PICO RIVERA	CA	90660	2057	19	06037	34.0086118	-118.0813633	Los Angeles County
185515	Fee-for-Service	1982646832	1982646832	1	1	HAGE, JEAN-CLAUDE	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	77308	41	Internal Medicine	0	In state provider	None	1690 BARTON RD	STE 106	REDLANDS	CA	92373	4230	36	06071	34.04836346	-117.2125293	San Bernardino County
185530	Fee-for-Service	1578940573	1578940573	1	1	HANG, CALVIN MD	10/14/2022	207R00000X	NA	Other	026	PHYSICIANS	146806	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
185542	Fee-for-Service	1356037972	1356037972	1	1	HILL, KRYSTAL N NP	8/10/2023	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
185590	Fee-for-Service	1275147068	1275147068	1	1	HUSSEIN ABIDALI, D.O. DIGEST	12/11/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	IVE HEALTH INC.	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
185609	Fee-for-Service	1548433600	1548433600	1	1	HWANG, FRANK S W MD	10/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	144717	18	Ophthalmology	0	In state provider	None	11370 ANDERSON STREET	STE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
185619	Fee-for-Service	1194737080	1194737080	1	1	HAY, ANGELA R MD	11/5/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70207	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
185649	Fee-for-Service	1386883510	1386883510	1	1	HEAD TO TOE THERAPY	7/6/2016	193400000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1615 FRENCH ST	SUITE 103	SANTA ANA	CA	92701	2475	30	06059	33.759459	-117.863962	Orange County
185654	Fee-for-Service	1861435190	1861435190	1	1	HOJIWALA, TARA B MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	34098	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
185658	Fee-for-Service	1154818433	1154818433	1	1	HOFMAN, JENNIFER R LCSW	12/19/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3838 SAN DIMAS ST	B 231	BAKERSFIELD	CA	93301	2284	15	06029	35.3946385	-119.008203	Kern County
185676	Fee-for-Service	1669684437	1669684437	1	1	HAIR, AMY B MD	12/1/2020	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
185684	Fee-for-Service	1528385838	1528385838	1	1	HOPE, CHARITY B MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119938	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
185696	Fee-for-Service	1992105910	1992105910	1	1	HELMS, JOSEPH M CRNA	5/3/2019	367500000X	NA	Other	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
185743	Fee-for-Service	1174560940	1174560940	1	1	HOLTZCLAW, DAVID R MD	1/30/1997	207L00000X	NA	Other	026	PHYSICIANS	37301	05	Anesthesiology	0	In state provider	None	203 WILLOW ST	STE 302	SAN FRANCISCO	CA	94109	7733	38	06075	37.78326038	-122.4212876	San Francisco County
185784	Fee-for-Service	1235111097	1235111097	1	1	HOSPICE OF AMADOR	9/1/1995	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	& CALAVERAS	1500 S HIGHWAY 49	STE 205	JACKSON	CA	95642	2652	03	06005	38.33650857	-120.7585242	Amador County
185792	Fee-for-Service	1114955879	1114955879	1	1	HIGGINSON, MICHELLE C MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74420	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
185805	Fee-for-Service	1982646832	1982646832	1	1	HAGE, JEAN-CLAUDE	3/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	77308	38	Geriatrics	0	In state provider	None	1690 BARTON RD	STE 106	REDLANDS	CA	92373	4230	36	06071	34.04836346	-117.2125293	San Bernardino County
185839	Fee-for-Service	1346398252	1346398252	1	1	HENRY, JANET T NP	2/6/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	10990 SAN DIEGO MISSION	None	SAN DIEGO	CA	92108	2417	37	06073	32.7850186	-117.1023292	San Diego County
185843	Fee-for-Service	1831119882	1831119882	1	1	HABIB, ADIL MD	10/3/2022	208600000X	NA	General Surgery	026	PHYSICIANS	180343	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
185851	Fee-for-Service	1255641643	1255641643	1	1	HOPKINS, JAMES	11/26/2012	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
185854	Fee-for-Service	1669885380	1669885380	1	1	HOLFORD, MARVIN LCSW	10/18/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10470 FOOTHILL BLVD	SUITE 116	RANCHO CUCAMONGA	CA	91730	3754	36	06071	34.10659649	-117.576603	San Bernardino County
185861	Fee-for-Service	1982685509	1982685509	1	1	HONG, CAROLE L OD	6/1/1994	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1234 CHERRY ST	None	SAN CARLOS	CA	94070	3110	41	06081	37.50498903	-122.2601211	San Mateo County
185863	Fee-for-Service	1538459011	1538459011	1	1	HASSAMAL, SAMEER K	11/14/2016	2084P0800X	NA	Psychiatry	026	PHYSICIANS	133740	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
185909	Fee-for-Service	1194737080	1194737080	1	1	HAY, ANGELA R MD	11/5/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	70207	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
185911	Fee-for-Service	1417024241	1417024241	1	1	HUNTER, BETTY LYNN NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11911 CENTRAL AVE	None	CHINO	CA	91710	1906	36	06071	34.03704117	-117.6893971	San Bernardino County
185915	Fee-for-Service	1578507216	1578507216	1	1	HJERPE, DAVID E MD	1/1/1998	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	80101	08	Family Practice	0	In state provider	None	1450 MEDICAL CENTER DR	None	ROHNERT PARK	CA	94928	2924	49	06097	38.34758366	-122.6816633	Sonoma County
185923	Fee-for-Service	1245529643	1245529643	1	1	HENDRICKSON, MICHELE A MD	1/20/2023	207L00000X	NA	Other	026	PHYSICIANS	182722	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
185935	Fee-for-Service	1386883510	1386883510	1	1	HEAD TO TOE THERAPY	7/6/2016	193400000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1615 FRENCH ST	SUITE 103	SANTA ANA	CA	92701	2475	30	06059	33.759459	-117.863962	Orange County
185945	Fee-for-Service	1174132807	1174132807	1	1	HARVEST SAFE HAVEN FOR BOYS	3/11/2025	322D00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	5425 SIERRA VISTA AVENUE	None	RIVERSIDE	CA	92505	3113	33	06065	33.92652824	-117.5056425	Riverside County
185953	Fee-for-Service	1851522304	1851522304	1	1	HERRERA, JOSEFINA LMFT	5/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	349 E BULLARD AVE	STE 102	FRESNO	CA	93710	5298	10	06019	36.82285854	-119.7825885	Fresno County
185969	Fee-for-Service	1962468512	1962468512	1	1	HOSSEINZADEH, MINOOS MD	12/5/2008	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	52826	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
185973	Fee-for-Service	1528385838	1528385838	1	1	HOPE, CHARITY B MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119938	07	Dermatology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
185978	Fee-for-Service	1780067280	1780067280	1	1	HADDAD, ASEM P MD	8/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
185980	Fee-for-Service	1134230550	1134230550	1	1	HANKINS, RONALD L OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4703 E CHAPMAN AVE	None	ORANGE	CA	92869	4112	30	06059	33.78776046	-117.803367	Orange County
185990	Fee-for-Service	1235225194	1235225194	1	1	HERZBERG, GARY R MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	25421	08	Family Practice	0	In state provider	None	6800 PALM AVE	STE D	SEBASTOPOL	CA	95472	4235	49	06097	38.39602719	-122.8185446	Sonoma County
186011	Fee-for-Service	1598859399	1598859399	1	1	HOWELL, PATRICIA 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
186061	Fee-for-Service	1003816083	1003816083	2	1	HASS & NOUR LLC	11/21/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	11260 PLEASANT VALLEY RD	None	PENN VALLEY	CA	95946	9413	29	06057	39.22267045	-121.2039605	Nevada County
186062	Fee-for-Service	1114285988	1114285988	1	1	HUANG, VIOLA MD	10/13/2020	208600000X	NA	General Surgery	026	PHYSICIANS	169248	02	General Surgery	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
186079	Fee-for-Service	1235111097	1235111097	1	1	HOSPICE OF AMADOR	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	& CALAVERAS	1500 S HIGHWAY 49	STE 205	JACKSON	CA	95642	2652	03	06005	38.33650857	-120.7585242	Amador County
186081	Fee-for-Service	1114955879	1114955879	1	1	HIGGINSON, MICHELLE C MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	74420	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
186093	Fee-for-Service	1427069228	1427069228	1	1	HERRON, GORDON S MD	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	70721	07	Dermatology	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
186115	Fee-for-Service	1306977939	1306977939	1	1	HANSEN, MARCIA L CNM	1/23/2006	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1001 POTRERO AVE	RM 6D14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
186129	Fee-for-Service	1235580192	1235580192	1	1	HAGGERTY, ERIN K MD	8/1/2020	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	142903	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
186137	Fee-for-Service	1679942825	1679942825	1	1	HAMEL, MAI T PT	4/21/2020	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
186164	Fee-for-Service	1013153568	1013153568	1	2	HILCHEY, REMYANNE	12/3/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	CES	31122 TIVERTON RD	None	MENIFEE	CA	92584	6614	33	06065	33.66836318	-117.1490842	Riverside County
186195	Fee-for-Service	1104321959	1104321959	1	3	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	9134 W OLYMPIC BLVD	None	BEVERLY HILLS	CA	90212	3540	19	06037	34.05933351	-118.390959	Los Angeles County
186198	Fee-for-Service	1245792712	1245792712	1	1	HERNANDEZ, ANN MARIE M MD	6/13/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179229	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
186207	Fee-for-Service	1639818297	1639818297	1	1	HUTCHINSON, STEFANIE N NP	8/3/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
186210	Fee-for-Service	1154770774	1154770774	1	1	HOPP, ALIX C MD	2/2/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175684	None	None	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
186234	Fee-for-Service	1013936640	1013936640	1	1	HART, PAM S LMFT	4/7/2016	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17130 SEQUOIA	STE 103	HESPERIA	CA	92345	1827	36	06071	34.46911749	-117.289755	San Bernardino County
186236	Fee-for-Service	1457546244	1457546244	1	1	HSIAO, ALBERT MD	7/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	105882	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
186297	Fee-for-Service	1770545287	1770545287	1	1	HANSON, GERALD R MD	10/31/1990	207ZP0102X	NA	Other	026	PHYSICIANS	27838	22	Pathology (M.D. only)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
186303	Fee-for-Service	1841498300	1841498300	1	1	HUFFAKER, RICHARD K DO	8/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	1	Border provider	None	537 SW UNION AVE	None	GRANTS PASS	OR	97527	5546	00	None	42.42237366	-123.3423317	Josephine County
186333	Fee-for-Service	1700986312	1700986312	1	1	HU, ROSA MD	5/28/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	88704	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCICSO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco
186359	Fee-for-Service	1942850359	1942850359	1	1	HYPPOLITE, PAUL LMFT	8/18/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10 TANFIELD CT	None	SACRAMENTO	CA	95833	2602	34	06067	38.623248	-121.498686	Sacramento County
186360	Fee-for-Service	1467048629	1467048629	1	1	HEAVENLY HOSPICE CARE CENTER	8/10/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	6308 WOODMAN AVE	STE 218	VAN NUYS	CA	91401	2347	19	06037	34.185123	-118.4312405	Los Angeles County
186390	Fee-for-Service	1871625194	1871625194	1	1	HAVEL, THOMAS E MD	7/17/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	32044	36	Psychiatry	0	In state provider	None	2500 GRANT ROAD	2500 GRANT ROAD	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
186486	Fee-for-Service	1104321959	1104321959	1	3	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9134 W OLYMPIC BLVD	None	BEVERLY HILLS	CA	90212	3540	19	06037	34.05933351	-118.390959	Los Angeles County
186566	Fee-for-Service	1063068005	1063068005	1	1	HEAVENS ANGELS HOSPICE, INC	10/5/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14416 VICTORY BLVD	STE 207	VAN NUYS	CA	91401	6236	19	06037	34.1866455	-118.447209	Los Angeles County
186568	Fee-for-Service	1124190871	1124190871	1	1	HANCOCK, SHERYL L MD	9/7/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86893	30	Radiology	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
186580	Fee-for-Service	1790063964	1790063964	1	1	HENG, CHAD C S MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123347	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
186601	Fee-for-Service	1073830626	1073830626	1	1	HAMMAN, SHILPA G MD	3/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118596	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
186609	Fee-for-Service	1598900052	1598900052	1	1	HEALTH PROJECTS CENTER	2/10/2014	No Taxonomy Provided	NA	None	095	PRIVATE NON-PROFIT PROPRIETARY AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	1537 PACIFIC AVE	STE 300	SANTA CRUZ	CA	95060	3944	44	06087	36.97596432	-122.0267851	Santa Cruz County
186610	Fee-for-Service	1295131258	1295131258	1	1	HAN, ELAINE LAC	2/18/2025	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	646 E KATELLA AVE	# A	ORANGE	CA	92867	4954	30	06059	33.8091025	-117.8467785	Orange County
186640	Fee-for-Service	1194803312	1194803312	1	1	HAIDER, TAUSEEF MD	9/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92710	08	Family Practice	0	In state provider	None	3551 Q ST	STE 100	BAKERSFIELD	CA	93301	1658	15	06029	35.392059	-119.010556	Kern County
186647	Fee-for-Service	1467048629	1467048629	1	1	HEAVENLY HOSPICE CARE CENTER	8/10/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	6308 WOODMAN AVE	STE 218	VAN NUYS	CA	91401	2347	19	06037	34.185123	-118.4312405	Los Angeles County
186657	Fee-for-Service	1043595788	1043595788	1	1	HICKSON, RUBI A 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	2204	38	06075	37.7634502	-122.4579779	San Francisco County
186667	Fee-for-Service	1386013381	1386013381	1	1	HARRINGTON, KAYLA R MD	12/18/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	157454	None	None	0	In state provider	None	501 J ST	None	SACRAMENTO	CA	95814	2325	34	06067	38.582118	-121.499325	Sacramento County
186736	Fee-for-Service	1598938508	1598938508	1	1	HAZANY, RAMIN MD INC	8/20/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	72483	None	None	0	In state provider	None	323 N PRAIRIE AVE	STE 200	INGLEWOOD	CA	90301	4504	19	06037	33.966333	-118.3439975	Los Angeles County
186803	Fee-for-Service	1730239914	1730239914	1	1	HEBERLEIN, PAUL R PHD	11/24/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	602 E SANTA CLARA STREET	None	SAN JOSE	CA	95112	1908	43	06085	37.34219766	-121.8778507	Santa Clara County
186804	Fee-for-Service	1205879681	1205879681	1	1	HECKEY, ROBERT P MD	2/8/2015	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	30787	08	Family Practice	0	In state provider	None	4700 HOEN AVE	None	SANTA ROSA	CA	95405	7824	49	06097	38.440899	-122.6643975	Sonoma County
186815	Fee-for-Service	1427218486	1427218486	1	1	HUNG, IRENE	4/17/2025	207SG0201X	NA	Other	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	4900 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5814	19	06037	34.0981225	-118.2965085	Los Angeles County
186826	Fee-for-Service	1417584822	1417584822	1	1	HUEBNER, BRYAN MD	4/26/2024	390200000X	NA	Other	026	PHYSICIANS	186611	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
186840	Fee-for-Service	1376529263	1376529263	1	1	HWANG, GEUM JOO MD	2/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89119	30	Radiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
186854	Fee-for-Service	1063068005	1063068005	1	1	HEAVENS ANGELS HOSPICE, INC	10/5/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14416 VICTORY BLVD	STE 207	VAN NUYS	CA	91401	6236	19	06037	34.1866455	-118.447209	Los Angeles County
186859	Fee-for-Service	1932653078	1932653078	1	1	HILDRETH, BRICE	8/16/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5250 CLAREMONT AVE STE 1	None	STOCKTON	CA	95207	5700	39	06077	37.99861886	-121.3102123	San Joaquin County
186864	Fee-for-Service	1346529823	1346529823	1	1	HOBBS, KEYNAN NP	3/16/2022	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8900 GROSSMONT BLVD # 4-	None	LA MESA	CA	91941	4047	37	06073	32.77345049	-117.0040635	San Diego County
186876	Fee-for-Service	1104321959	1104321959	1	30	HEALTH DIAGNOSTICS OF CALIFO	6/5/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	101 S SAN MATEO DR	105	SAN MATEO	CA	94401	3819	41	06081	37.56590481	-122.325549	San Mateo County
186879	Fee-for-Service	1437499746	1437499746	1	1	HICKS, MONIQUE Y LMFT	7/19/2021	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
186885	Fee-for-Service	1235349101	1235349101	1	1	HANKS, BRENDEN J MD	12/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	97624	05	Anesthesiology	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	45	06089	40.57278686	-122.3958519	Shasta County
186923	Fee-for-Service	1891043097	1891043097	1	1	HOU, BORIN MD	7/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	131185	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
186924	Fee-for-Service	1902931959	1902931959	1	1	HOLNESS, RONALD MD INC	11/30/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	55605	02	General Surgery	0	In state provider	None	3801 KATELLA AVE	STE 420	LOS ALAMITOS	CA	90720	6903	30	06059	33.80318951	-118.066068	Orange County
186926	Fee-for-Service	1629098884	1629098884	1	1	HARRISON, DANIEL C MD	9/20/2007	207R00000X	NA	Other	026	PHYSICIANS	81812	None	None	0	In state provider	None	555 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
186973	Fee-for-Service	1437181617	1437181617	1	1	HUIE, VICTOR MD	1/18/1988	207R00000X	NA	Other	026	PHYSICIANS	43749	41	Internal Medicine	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
186976	Fee-for-Service	1740445121	1740445121	1	1	HENDERSON, PATRICK R MD	8/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125330	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
187027	Fee-for-Service	1245302090	1245302090	1	1	HUFFMAN, QIN X MD	12/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	88368	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
187057	Fee-for-Service	1063511475	1063511475	1	1	HERSEL, ALEXANDER P MD INC	4/26/2011	193200000X	NA	Other	026	PHYSICIANS	79277	None	None	0	In state provider	None	415 E ROLLING OAKS DR	STE 110	THOUSAND OAKS	CA	91361	1030	56	06111	34.17439717	-118.8691161	Ventura County
187059	Fee-for-Service	1891836425	1891836425	1	1	HERNANDEZ, VANESSA V MD	11/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92855	36	Psychiatry	0	In state provider	None	15400 FOOTHILL BLVD	None	SAN LEANDRO	CA	94578	1009	01	06001	37.7069698	-122.1191104	Alameda County
187063	Fee-for-Service	1427233345	1427233345	1	1	HERNANDEZ, FEDERICO DPM	1/1/1979	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	INC	1665 S IMPERIAL AVE	STE A	EL CENTRO	CA	92243	4247	13	06025	32.77860065	-115.5695241	Imperial County
187118	Fee-for-Service	1093166480	1093166480	1	1	HOYER, RILEY MD	2/15/2024	207P00000X	NA	Other	026	PHYSICIANS	186415	None	None	0	In state provider	None	41870 GARSTIN DR	None	BIG BEAR LAKE	CA	92315	1619	36	06071	34.24602097	-116.8885243	San Bernardino County
187141	Fee-for-Service	1942962691	1942962691	1	1	HIETT, MIRANDA PT	10/28/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2251 COUNTRY CLUB LN	None	SELMA	CA	93662	3859	10	06019	36.5662241	-119.5996308	Fresno County
187157	Fee-for-Service	1750460192	1750460192	1	1	HAMMAD QADIR	8/3/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1860 VIRGINIA AVE	STE 8	NORTH BEND	OR	97459	2355	00	None	43.40662203	-124.2373169	Coos County
187177	Fee-for-Service	1750345633	1750345633	1	1	HELMAN, SHOSHANA MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70214	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
187223	Fee-for-Service	1336244565	1336244565	1	1	HONG, GREGORY K MEDICAL	1/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	53990	06	Cardiovascular Disease (M.D. only)	0	In state provider	CORPORATION	520 S VIRGIL AVE	SUITE 501	LOS ANGELES	CA	90020	1442	19	06037	34.064487	-118.2870305	Los Angeles County
187265	Fee-for-Service	1972161255	1972161255	1	1	HOANG DUC NGUYEN, M.D., INC.	6/26/2019	261QP2300X	NA	Other	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	22110 ROSCOE BLVD	100	CANOGA PARK	CA	91304	3875	19	06037	34.21957849	-118.6082685	Los Angeles County
187308	Fee-for-Service	1619069820	1619069820	1	1	HURST, RONALD MD	3/1/1999	208600000X	NA	General Surgery	026	PHYSICIANS	76428	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
187319	Fee-for-Service	1487849279	1487849279	1	1	HANNA, ELIZABETH C PSYD	4/16/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	2425 BISSO LN	STE 200	CONCORD	CA	94520	4886	07	06013	37.98393807	-122.0466953	Contra Costa County
187341	Fee-for-Service	1104321959	1104321959	1	32	HEALTH DIAGNOSTICS OF CALIFO	12/24/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	ALLEY	15405 LOS GATOS BLVD	STE 104	LOS GATOS	CA	95032	2500	43	06085	37.24484745	-121.9587906	Santa Clara County
187351	Fee-for-Service	1952544520	1952544520	1	1	HADLEY, TIFFANY C MD	9/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113324	05	Anesthesiology	0	In state provider	None	2 WEST FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
187381	Fee-for-Service	1235370677	1235370677	1	1	HAILESELASSIE, TSEGANESH	7/23/2010	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
187385	Fee-for-Service	1932632148	1932632148	1	1	HAMMI, CLAUDIA M DO	3/8/2021	207L00000X	NA	Other	026	PHYSICIANS	17101	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
187394	Fee-for-Service	1144309873	1144309873	1	1	HUYNH, THAO N MD	11/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82109	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
187434	Fee-for-Service	1801053574	1801053574	1	1	HARRIS, MORGAN J MD	8/4/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	156144	13	Neurology (M.D. only)	0	In state provider	None	1100 TRANCAS ST	STE 205	NAPA	CA	94558	2909	28	06055	38.32316569	-122.2981938	Napa County
187490	Fee-for-Service	1770593501	1770593501	1	1	HENTZ, VINCENT R MD	2/1/1983	2086S0105X	NA	General Surgery	026	PHYSICIANS	32105	24	Plastic Surgery	0	In state provider	None	STANFORD UNIV HOSP RM 20	None	PALO ALTO	CA	94304	0000	43	06085	37.44392341	-122.1725368	Santa Clara County
187494	Fee-for-Service	1639457252	1639457252	1	1	HU, SHIAO CHUN DORA LMFT	5/16/2020	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
187595	Fee-for-Service	1770778029	1770778029	1	1	HAUSER, AMY F MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	94895	40	Pediatrics	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2614	43	06085	37.313433	-121.9318385	Santa Clara County
187632	Fee-for-Service	1104321959	1104321959	1	32	HEALTH DIAGNOSTICS OF CALIFO	3/11/2025	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	ALLEY	15405 LOS GATOS BLVD	STE 104	LOS GATOS	CA	95032	2500	43	06085	37.24484745	-121.9587906	Santa Clara County
187636	Fee-for-Service	1295705333	1295705333	1	1	HILL, MCARTHUR O MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	2	Out of state provider	None	8850 W 38TH AVE	STE 303	WHEAT RIDGE	CO	80033	4235	00	None	39.76932449	-105.095988	Jefferson County
187665	Fee-for-Service	1508881145	1508881145	1	1	HANG, JIMMY T	4/2/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	5 CENTERPOINTE DRIVE	SUITE 200	LA PALMA	CA	90623	1050	30	06059	33.86168254	-118.0308375	Orange County
187679	Fee-for-Service	1861889032	1861889032	1	1	HANSRA, SIMRAT K MD	10/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132139	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
187698	Fee-for-Service	1891347738	1891347738	1	1	HAJJALI, IBRAHIM R MD	9/28/2023	207ZP0105X	NA	Other	026	PHYSICIANS	186520	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
187716	Fee-for-Service	1518962083	1518962083	1	2	HOSPICE OF SAN JOAQUIN	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	179 W NORTH ST	None	MANTECA	CA	95336	4522	39	06077	37.80108034	-121.2176698	San Joaquin County
187806	Fee-for-Service	1477906741	1477906741	1	1	HERITAGE BOARD & CARE INC	11/17/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	2900 E 7TH ST	None	LONG BEACH	CA	90804	4816	19	06037	33.77532048	-118.157706	Los Angeles County
187836	Fee-for-Service	1942513841	1942513841	2	1	HOOD, JULIE K NP	8/22/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
187896	Fee-for-Service	1568976132	1568976132	1	1	HOPAL, BARINDER	12/4/2017	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	27848 SLUMBER LANE	None	MORENO VALLEY	CA	92555	5755	33	06065	33.91159153	-117.17694	Riverside County
187905	Fee-for-Service	1467643486	1467643486	1	1	HSUEH, TIFFANY OD	1/11/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
187913	Fee-for-Service	1841447745	1841447745	1	1	HUANG, MINNA F MD	1/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109423	41	Internal Medicine	0	In state provider	None	536 E FOOTHILL BLVD	STE B	UPLAND	CA	91786	3988	36	06071	34.10683091	-117.6438976	San Bernardino County
187934	Fee-for-Service	1053587667	1053587667	1	1	HARPER, CORTNEY E MD	10/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124116	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
187944	Fee-for-Service	1033250808	1033250808	1	1	HO, BING-KING JOSEPH	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
187979	Fee-for-Service	1417947110	1417947110	1	1	HARANO, KATHERINE S OD	1/7/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1377 MACARTHUR BLVD	None	SAN LEANDRO	CA	94577	3918	01	06001	37.72917298	-122.1387677	Alameda County
187987	Fee-for-Service	1316047913	1316047913	1	1	HAYAT, SHAHID J MD	3/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93981	None	None	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
188000	Fee-for-Service	1518962083	1518962083	1	2	HOSPICE OF SAN JOAQUIN	9/1/2013	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	179 W NORTH ST	None	MANTECA	CA	95336	4522	39	06077	37.80108034	-121.2176698	San Joaquin County
188001	Fee-for-Service	1831267939	1831267939	1	1	HOFF, GERARD A MD	7/30/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	62543	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2950 WHIPPLE AVE	STE 6	REDWOOD CITY	CA	94062	2842	41	06081	37.4783159	-122.2550908	San Mateo County
188017	Fee-for-Service	1982711495	1982711495	1	1	HUYNH, THUY NGOC MD	8/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73028	41	Internal Medicine	0	In state provider	None	174 S MAIN ST	None	MILPITAS	CA	95035	5313	43	06085	37.42805746	-121.90613	Santa Clara County
188069	Fee-for-Service	1124006382	1124006382	1	1	HEMP, JAMES R MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53854	06	Cardiovascular Disease (M.D. 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
188103	Fee-for-Service	1548269624	1548269624	1	1	HOSPITAL OF ST RAPHAEL	3/1/2012	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1450 CHAPEL STREET	None	NEW HAVEN	CT	06511	4405	00	None	41.31097732	-72.94308015	South Central Connecticut Planning Region
188164	Fee-for-Service	1326097072	1326097072	1	1	HOLMES, ALEXANDER T MD	4/3/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	48583	18	Ophthalmology	0	In state provider	None	798 CASS ST	STE 204	MONTEREY	CA	93940	2918	27	06053	36.59428586	-121.8953825	Monterey County
188173	Fee-for-Service	1972064913	1972064913	1	1	HICKMAN, GLENN NP	4/24/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
188184	Fee-for-Service	1568976132	1568976132	1	1	HOPAL, BARINDER	12/4/2017	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	27848 SLUMBER LANE	None	MORENO VALLEY	CA	92555	5755	33	06065	33.91159153	-117.17694	Riverside County
188185	Fee-for-Service	1356573992	1356573992	1	1	HAHN, MICHAEL E MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	119409	30	Radiology	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
188191	Fee-for-Service	1669575056	1669575056	2	1	HAMOOD, HASSNEY A MD	11/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	34404	04	Otology, Laryngology, Rhinology	0	In state provider	None	2785 PACIFIC AVE	SUITE A	LONG BEACH	CA	90806	2641	19	06037	33.807861	-118.193748	Los Angeles County
188203	Fee-for-Service	1841447745	1841447745	1	1	HUANG, MINNA F MD	1/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109423	45	Nephrology (Renal-Kidney)	0	In state provider	None	536 E FOOTHILL BLVD	STE B	UPLAND	CA	91786	3988	36	06071	34.10683091	-117.6438976	San Bernardino County
188232	Fee-for-Service	1245223932	1245223932	1	1	HUATUCO, AIBAR H MD	11/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	32630	41	Internal Medicine	0	In state provider	None	1530 BESSIE AVE	STE 102	TRACY	CA	95376	3080	39	06077	37.74570848	-121.4330255	San Joaquin County
188239	Fee-for-Service	1639515406	1639515406	1	1	HINDI, YOUSEF M MD	9/23/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	162863	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	230 SAN JOSE STREET	None	SALINAS	CA	93901	3901	27	06053	36.65837657	-121.6469645	Monterey County
188256	Fee-for-Service	1952765638	1952765638	1	1	HERNANDEZ DURAN, JOSE J MD	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	157201	01	General Practice	0	In state provider	None	1101 N CHERRY ST	None	TULARE	CA	93274	2231	54	06107	36.22333808	-119.337575	Tulare County
188273	Fee-for-Service	1629507868	1629507868	1	1	HOGAN, HALLIE MD	12/13/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	158581	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
188285	Fee-for-Service	1407989056	1407989056	1	1	HO-TRAN, HUONG M	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
188337	Fee-for-Service	1093151326	1093151326	1	1	HIREN BHAKTA	5/17/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	462 FIRST AVENUE 27TH ST	None	NEW YORK	NY	10016	9196	00	None	40.739544	-73.9763325	New York County
188357	Fee-for-Service	1124006382	1124006382	1	1	HEMP, JAMES R MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	53854	33	Thoracic 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
188391	Fee-for-Service	1548269624	1548269624	1	1	HOSPITAL OF ST RAPHAEL	3/1/2012	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1450 CHAPEL STREET	None	NEW HAVEN	CT	06511	4405	00	None	41.31097732	-72.94308015	South Central Connecticut Planning Region
188400	Fee-for-Service	1669739462	1669739462	1	1	HUSHMENDY, SHAZNEEN DO	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14749	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
188414	Fee-for-Service	1366904278	1366904278	1	1	HEALTH AID UNLIMITED	6/3/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	960 E. OJAI AVE	None	OJAI	CA	93023	2901	56	06111	34.44849269	-119.2356156	Ventura County
188426	Fee-for-Service	1821438458	1821438458	1	1	HARIRI, JENNY DO	1/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13570	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
188436	Fee-for-Service	1841392594	1841392594	1	1	HSIU, IMEI MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	66077	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
188443	Fee-for-Service	1639227952	1639227952	1	1	HIRPARA, CHINTU B DC	3/23/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	620 ALABAMA ST	None	REDLANDS	CA	92373	8059	36	06071	34.061841	-117.208804	San Bernardino County
188449	Fee-for-Service	1083664858	1083664858	1	1	HERNANDEZ-RODRIGUEZ, DAVID	4/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	102591	None	None	0	In state provider	None	1675 N PERRIS BLVD	STE A-10	PERRIS	CA	92505	5117	33	06065	33.802137	-117.2260135	Riverside County
188505	Fee-for-Service	1770057994	1770057994	1	1	HALOS PALLIATIVE AND HOSPICE	3/11/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE	2301 W LINCOLN AVE	STE 248	ANAHEIM	CA	92801	5148	30	06059	33.8325463	-117.9637271	Orange County
188520	Fee-for-Service	1245223932	1245223932	1	1	HUATUCO, AIBAR H MD	11/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	32630	45	Nephrology (Renal-Kidney)	0	In state provider	None	1530 BESSIE AVE	STE 102	TRACY	CA	95376	3080	39	06077	37.74570848	-121.4330255	San Joaquin County
188583	Fee-for-Service	1366906109	1366906109	1	1	HARRIS, SARAH C NP	4/19/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
188603	Fee-for-Service	1063926848	1063926848	1	2	HEATHER SHENKMAN MEDICAL COR	11/25/2024	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	PORATION	18663 VENTURA BLVD	STE 202	TARZANA	CA	91356	4151	19	06037	34.17051848	-118.5402557	Los Angeles County
188627	Fee-for-Service	1790835510	1790835510	1	1	HERZ, ARND MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	84671	40	Pediatrics	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
188668	Fee-for-Service	1144219072	1144219072	1	1	HARRIS, CAROLE A LCSW	9/20/2011	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	18381 GOLDENWEST ST	RED HORSE BARN	HUNTINGTON BEACH	CA	92648	1107	30	06059	33.697089	-118.008873	Orange County
188692	Fee-for-Service	1649590910	1649590910	1	1	HEINISCH, SILKE MD	10/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	130962	07	Dermatology	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
188720	Fee-for-Service	1215047196	1215047196	1	1	HADIKIN, WALTER R MD	9/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	89116	08	Family Practice	0	In state provider	None	150 N ROBERTSON DRIVE	SUITE 300	BEVERLY HILLS	CA	90211	2145	19	06037	34.06812722	-118.3837146	Los Angeles County
188754	Fee-for-Service	1912067273	1912067273	1	1	HENDERSON, CHARLES MD	10/6/2023	2088P0231X	NA	Other	026	PHYSICIANS	188367	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
188777	Fee-for-Service	1972697704	1972697704	1	1	HOWELL, STEPHEN M MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	59493	20	Orthopedic Surgery	0	In state provider	None	8120 TIMBERLAKE WAY	STE 112	SACRAMENTO	CA	95823	5413	34	06067	38.461023	-121.41414	Sacramento County
188793	Fee-for-Service	1770057994	1770057994	1	1	HALOS PALLIATIVE AND HOSPICE	3/11/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE	2301 W LINCOLN AVE	STE 248	ANAHEIM	CA	92801	5148	30	06059	33.8325463	-117.9637271	Orange County
188804	Fee-for-Service	1992852305	1992852305	1	1	HARRY, JONATHAN L MD	12/7/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	69582	-	NOT APPLICABLE	0	In state provider	None	5362 LEMEE LANE	None	MARIPOSA	CA	95338	9556	22	06043	37.499481	-119.984238	Mariposa County
188815	Fee-for-Service	1710164264	1710164264	1	1	HAIDER, KHURSHEED MD	9/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125910	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
188819	Fee-for-Service	1770901449	1770901449	1	1	HORWITZ, JULIAN K MD	5/19/2021	204F00000X	NA	General Surgery	026	PHYSICIANS	172579	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
188889	Fee-for-Service	1063926848	1063926848	1	2	HEATHER SHENKMAN MEDICAL COR	11/25/2024	193400000X	NA	Other	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	PORATION	18663 VENTURA BLVD	STE 202	TARZANA	CA	91356	4151	19	06037	34.17051848	-118.5402557	Los Angeles County
188932	Fee-for-Service	1043743719	1043743719	1	1	HULL, THOMAS H MD	8/1/2021	207P00000X	NA	Other	026	PHYSICIANS	157917	None	None	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
188972	Fee-for-Service	1396740338	1396740338	1	1	HALT, PETER S MD	6/13/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76207	30	Radiology	0	In state provider	None	914 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
189029	Fee-for-Service	1639344567	1639344567	1	1	HALL, CHANTEE V LMFT	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	51569	-	NOT APPLICABLE	0	In state provider	None	1303 WEST WALNUT PARKWAY	None	COMPTON	CA	90220	5030	19	06037	33.87724562	-118.2446904	Los Angeles County
189113	Fee-for-Service	1174732515	1174732515	2	1	HEALTHRIGHT 360	7/20/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	831 E ARROW HWY	None	POMONA	CA	91767	2535	19	06037	34.09030767	-117.7353578	Los Angeles County
189120	Fee-for-Service	1336745322	1336745322	1	1	HERRIN, BRITTANY A LCSW	4/6/2021	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
189144	Fee-for-Service	1760414957	1760414957	1	1	HARTY, PATRICK A MD	8/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94900	30	Radiology	0	In state provider	None	2801 K ST	STE 115	SACRAMENTO	CA	95816	5118	34	06067	38.572947	-121.46904	Sacramento County
189179	Fee-for-Service	1174622575	1174622575	1	1	HENSLEY, RANDALL D DC	11/3/2016	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	20601 W PAOLI LANE	None	WEIMAR	CA	95736	0486	31	06061	39.03521526	-120.9755343	Placer County
189202	Fee-for-Service	1760918155	1760918155	1	1	HE, INGRID Y MD	2/11/2022	207R00000X	NA	Other	026	PHYSICIANS	162240	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
189206	Fee-for-Service	1275503963	1275503963	1	1	HELLWIG, THOMAS M MD	2/1/1975	207RP1001X	NA	Pulmonology	026	PHYSICIANS	22531	41	Internal Medicine	0	In state provider	None	1700 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	5115	36	06071	34.130214	-117.2788065	San Bernardino County
189221	Fee-for-Service	1811308539	1811308539	1	1	HOAK, THOMAS C JR MD	7/29/2014	208600000X	NA	General Surgery	026	PHYSICIANS	79434	02	General Surgery	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
189226	Fee-for-Service	1487728366	1487728366	1	1	HANGER P & O WEST INC	6/1/1995	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2140 W CHAPMAN AVE	STE 121	ORANGE	CA	92868	2331	30	06059	33.78787403	-117.8757819	Orange County
189241	Fee-for-Service	1770631632	1770631632	1	1	HAMMERMAN, DANIELLE A MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79754	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
189288	Fee-for-Service	1598157588	1598157588	1	1	HAJI, FARNAZ MD	4/8/2020	208600000X	NA	General Surgery	026	PHYSICIANS	18097	02	General Surgery	0	In state provider	None	200 MEDICAL PLAZA	STE 214	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
189289	Fee-for-Service	1235628363	1235628363	1	1	HAIL, LISA A 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
189318	Fee-for-Service	1326466822	1326466822	1	1	HERRERA, MARIO A LMFT	2/17/2021	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
189343	Fee-for-Service	1710185459	1710185459	1	1	HENLEY, JON M OD	2/13/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	876 N MOUNTAIN AVE	STE 100	UPLAND	CA	91786	4166	36	06071	34.10485371	-117.6701493	San Bernardino County
189353	Fee-for-Service	1396517850	1396517850	1	1	HYUN, SAMMI LMFT	10/31/2023	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
189357	Fee-for-Service	1962495481	1962495481	1	1	HSIEH, PATRICK U MD	8/5/2009	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
189360	Fee-for-Service	1619377876	1619377876	1	1	HALEY, KERRI LMFT	4/15/2024	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
189407	Fee-for-Service	1396231965	1396231965	1	1	HENDRICKSON, JASON D MD	9/3/2023	207P00000X	NA	Other	026	PHYSICIANS	179734	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
189425	Fee-for-Service	1790172401	1790172401	1	1	HART, KIMBERLY R DO MD	7/30/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	16342	40	Pediatrics	0	In state provider	None	6555 COYLE AVENUE	SUITE 290	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
189459	Fee-for-Service	1003914516	1003914516	1	1	HUGHES, MARY B MD	3/18/1993	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	69138	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
189463	Fee-for-Service	1356581862	1356581862	1	1	HAM, MAGGIE Y MD	9/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106367	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
189496	Fee-for-Service	1104406586	1104406586	1	1	HOLLISTER, NATHANIEL MD	6/28/2024	390200000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	5330 S HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
189513	Fee-for-Service	1700911765	1700911765	1	1	HEALTH CENTER #1	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	3850 17TH ST	None	SAN FRANCISCO	CA	94114	2031	38	06075	37.76272129	-122.4318522	San Francisco County
189516	Fee-for-Service	1215255831	1215255831	1	1	HECHT, KIM DO	8/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11593	25	Physical Medicine and Rehabilitation	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
189529	Fee-for-Service	1104321959	1104321959	1	16	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	14651 S BASCOM AVE	SUITE 120	LOS GATOS	CA	95032	2004	43	06085	37.25556684	-121.9504578	Santa Clara County
189532	Fee-for-Service	1639197395	1639197395	1	1	HOLY CROSS HOSPITAL	12/19/2005	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4725 N FEDERAL HWY	None	FT LAUDERDALE	FL	33308	4668	00	None	26.186922	-80.119638	Broward County
189533	Fee-for-Service	1699985978	1699985978	1	1	HO,TIFFANY THI DC	5/16/2005	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	NORTH VLY CHIROPRACT CTR	2684 CROPLEY AVE	None	SAN JOSE	CA	95132	3711	43	06085	37.40431285	-121.8800743	Santa Clara County
189625	Fee-for-Service	1144775198	1144775198	1	1	HOANG M NGUYEN DO INC	7/17/2019	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2360 MCKEE ROAD	STE B-9	SAN JOSE	CA	95116	1618	43	06085	37.36657971	-121.8479925	Santa Clara County
189643	Fee-for-Service	1770684326	1770684326	1	1	HADI, EHSAN M MD	9/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102040	66	Emergency Medicine (Urgent Care)	0	In state provider	None	41870 GARSTIN RD	None	BIG BEAR LAKE	CA	92315	9999	36	06071	34.24602097	-116.8885243	San Bernardino County
189680	Fee-for-Service	1871537738	1871537738	1	1	HU, EDDIE HL MD	3/22/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46840	68	Hematology	0	In state provider	None	500 N GARFIELD AVE	STE 305	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
189742	Fee-for-Service	1982118261	1982118261	1	1	HUNG, SHUJUNG	3/10/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9711 VILLAGE CENTER DR	STE 11	GRANITE BAY	CA	95746	6493	31	06061	38.72308891	-121.2096364	Placer County
189755	Fee-for-Service	1356581862	1356581862	1	1	HAM, MAGGIE Y MD	9/23/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	106367	10	Gastroenterology (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
189763	Fee-for-Service	1578653028	1578653028	1	1	HARRIS-STANSIL, TONJA L MD	8/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88521	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1234 E NORTH ST	STE 102	MANTECA	CA	95336	4961	39	06077	37.80105524	-121.1968581	San Joaquin County
189809	Fee-for-Service	1861443350	1861443350	1	1	HELLINGER,JEFFREY	7/8/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	506 LENOX AVENUE	None	NEW YORK	NY	10037	1802	00	None	40.814352	-73.94031	New York County
189816	Fee-for-Service	1104321959	1104321959	1	16	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	14651 S BASCOM AVE	SUITE 120	LOS GATOS	CA	95032	2004	43	06085	37.25556684	-121.9504578	Santa Clara County
189819	Fee-for-Service	1588822720	1588822720	1	1	HAN, ALEX MD	5/31/2019	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	24691	01	General Practice	0	In state provider	None	408 W 8TH ST	None	NATIONAL CITY	CA	91950	1002	37	06073	32.67431337	-117.1122913	San Diego County
189820	Fee-for-Service	1639197395	1639197395	1	1	HOLY CROSS HOSPITAL	2/1/1997	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4725 N FEDERAL HWY	None	FT LAUDERDALE	FL	33308	4668	00	None	26.186922	-80.119638	Broward County
189843	Fee-for-Service	1518122449	1518122449	1	1	HLAING, MIN M MD	1/2/2009	207R00000X	NA	Other	026	PHYSICIANS	104774	41	Internal Medicine	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	9989	39	06077	37.88652418	-121.2820956	San Joaquin County
189928	Fee-for-Service	1740398213	1740398213	1	1	HOLKO, BRETT H DO	9/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8540	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
189937	Fee-for-Service	1053747121	1053747121	1	1	HUNTINGTON PARK EMERGENCY	11/27/2013	193200000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	19	06037	33.98921547	-118.2242565	Los Angeles County
189942	Fee-for-Service	1629075395	1629075395	1	1	HABIBE, ALEX O MD INC	2/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91655	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2634 TUOLUMNE ST	None	FRESNO	CA	93721	1227	10	06019	36.74274664	-119.7876591	Fresno County
189956	Fee-for-Service	1255918587	1255918587	1	1	HAGINO, JEFFREY DO	9/18/2024	390200000X	NA	Other	026	PHYSICIANS	22515	41	Internal Medicine	0	In state provider	None	8110 LAGUNA BLVD	None	ELK GROVE	CA	95758	7904	34	06067	38.421306	-121.408173	Sacramento County
189960	Fee-for-Service	1720466931	1720466931	1	1	HARAKAS, MICHAEL MD	11/8/2018	207P00000X	NA	Other	026	PHYSICIANS	154253	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
189967	Fee-for-Service	1871537738	1871537738	1	1	HU, EDDIE HL MD	3/22/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46840	78	Neoplastic Diseases/Oncology	0	In state provider	None	500 N GARFIELD AVE	STE 305	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
190008	Fee-for-Service	1841388428	1841388428	1	1	HUANG, XIAOYU MD	9/5/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88213	36	Psychiatry	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
190012	Fee-for-Service	1205898525	1205898525	1	1	HEARTBEAT CARDIOVASCULAR	3/1/1999	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	660 W BROADWAY	None	GLENDALE	CA	91204	1008	19	06037	34.14675547	-118.269153	Los Angeles County
190021	Fee-for-Service	1376548651	1376548651	1	1	HARRISON, SHARON K PT	4/13/2021	225100000X	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
190025	Fee-for-Service	1689648073	1689648073	1	1	HOLTZMAN, STEPHEN R MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78719	30	Radiology	0	In state provider	None	300 CANAL ST	None	KING CITY	CA	93930	3431	27	06053	36.20653258	-121.1319345	Monterey County
190048	Fee-for-Service	1528353059	1528353059	1	1	HAHN, MONICA U MD	8/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125699	01	General Practice	0	In state provider	None	1001 POTRERO AVE	ROOM 4F	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
190066	Fee-for-Service	1285712059	1285712059	1	1	HIRATA, JANIE D MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72816	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
190073	Fee-for-Service	1518043264	1518043264	1	1	HERNANDEZ, LUIS MD	10/10/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	42433	None	None	0	In state provider	None	1817 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	3935	19	06037	34.01983077	-118.1189072	Los Angeles County
190074	Fee-for-Service	1326098179	1326098179	1	1	HLA, TIN T MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	36657	41	Internal Medicine	0	In state provider	None	725 E SANTA CLARA ST	STE 102	SAN JOSE	CA	95112	1936	43	06085	37.34328626	-121.8756374	Santa Clara County
190102	Fee-for-Service	1104321959	1104321959	1	14	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	24022 CALLE DE LA PLATA	SUITE 100	LAGUNA HILLS	CA	92653	3627	30	06059	33.6104493	-117.7110924	Orange County
190103	Fee-for-Service	1497983761	1497983761	1	1	HSU, ANDREW R MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136753	20	Orthopedic Surgery	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
190108	Fee-for-Service	1003278714	1003278714	1	1	HAN, LUCY MD	8/8/2022	207ZP0102X	NA	Other	026	PHYSICIANS	153612	None	None	0	In state provider	None	1101 N VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6919	38	06075	37.78610439	-122.421569	San Francisco County
190109	Fee-for-Service	1245238591	1245238591	1	1	HSU, SHIH CHORNG MD	11/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	40695	13	Neurology (M.D. only)	0	In state provider	None	600 N GARFIELD AVE	STE 205	MONTEREY PARK	CA	91754	1169	19	06037	34.06820797	-118.1228835	Los Angeles County
190139	Fee-for-Service	1972218147	1972218147	1	1	HEALTHRIGHT 360	5/1/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1115 MISSION RD	None	SOUTH SAN FRANCIS	CA	94080	1302	41	06081	37.66051555	-122.4378449	San Mateo County
190161	Fee-for-Service	1720166432	1720166432	1	1	HAWK, MARK W MD	3/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54659	14	Neurological Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
190209	Fee-for-Service	1952454449	1952454449	1	1	HERNANDEZ, MARK D MD	6/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	52692	66	Emergency Medicine (Urgent Care)	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
190216	Fee-for-Service	1396005542	1396005542	1	1	HASKINS, MIRANDA G DO	9/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13942	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
190227	Fee-for-Service	1629075395	1629075395	1	1	HABIBE, ALEX O MD INC	2/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	91655	41	Internal Medicine	0	In state provider	None	2634 TUOLUMNE ST	None	FRESNO	CA	93721	1227	10	06019	36.74274664	-119.7876591	Fresno County
190251	Fee-for-Service	1255828562	1255828562	1	1	HOURIANI, ARIANNA R MD	9/9/2021	207R00000X	NA	Other	026	PHYSICIANS	173425	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
190256	Fee-for-Service	1871537738	1871537738	1	1	HU, EDDIE HL MD	3/22/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	46840	01	General Practice	0	In state provider	None	500 N GARFIELD AVE	STE 305	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
190281	Fee-for-Service	1053007153	1053007153	1	1	HOANG, JESSICA M OD	4/24/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4051 LONE TREE WAY STE E	None	ANTIOCH	CA	94531	6204	07	06013	37.97536168	-121.8003374	Contra Costa County
190285	Fee-for-Service	1245387315	1245387315	1	1	HAMEL, SUSAN H OD	11/5/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1901 MITCHELL RD	STE C	CERES	CA	95307	2400	50	06099	37.60176287	-120.9387462	Stanislaus County
190312	Fee-for-Service	1588944300	1588944300	1	1	HARVILL, ZENA A NP	6/28/2019	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
190330	Fee-for-Service	1144745712	1144745712	1	1	HAEUSSLEIN, LAUREL NP	5/21/2024	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
190348	Fee-for-Service	1750867875	1750867875	1	1	HEIDOHRN, CASEY AU	10/17/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
190351	Fee-for-Service	1295922680	1295922680	1	1	HERNANDEZ, TARA A	8/22/2016	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	813 W WHITTIER BLVD	STE 210 & 212	MONTEBELLO	CA	90640	7145	19	06037	34.01011387	-118.1086769	Los Angeles County
190353	Fee-for-Service	1285712059	1285712059	1	1	HIRATA, JANIE D MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	72816	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
190359	Fee-for-Service	1043418874	1043418874	1	1	HARRIS, SHAWN M CRNA	6/8/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
190362	Fee-for-Service	1619408531	1619408531	1	1	HILTON, JANAE MD	3/19/2025	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	1093 ROYAL COURT	None	MEDFORD	OR	97504	8383	00	None	42.34017467	-122.8666022	Jackson County
190377	Fee-for-Service	1346221710	1346221710	1	1	HWANG, JANINE M MD	6/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	88132	08	Family Practice	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
190380	Fee-for-Service	1104321959	1104321959	1	12	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	105 SOUTH DR	STE 110	MOUNTAIN VIEW	CA	94040	4317	43	06085	37.36723851	-122.0782528	Santa Clara County
190381	Fee-for-Service	1073026977	1073026977	1	1	HALLADAY, JOIE LMFT	5/25/2023	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
190384	Fee-for-Service	1417012576	1417012576	1	1	HAN, YUSHENG MD	7/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110472	22	Pathology (M.D. only)	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
190386	Fee-for-Service	1427084250	1427084250	1	1	HUNTER, JUDY A MD	10/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	72647	40	Pediatrics	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
190390	Fee-for-Service	1104321959	1104321959	1	14	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	24022 CALLE DE LA PLATA	SUITE 100	LAGUNA HILLS	CA	92653	3627	30	06059	33.6104493	-117.7110924	Orange County
190391	Fee-for-Service	1851616486	1851616486	1	1	HSU, MARK MD	8/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	117893	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
190448	Fee-for-Service	1558933283	1558933283	2	1	HAICK, ANGELA LMFT	1/29/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3143 CLAYTON RD	SUITE F	CONCORD	CA	94519	2732	07	06013	37.97331231	-122.0207119	Contra Costa County
190485	Fee-for-Service	1528066321	1528066321	1	1	HARNER, REX D MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	29415	08	Family Practice	0	In state provider	None	8109 LA PLZ	None	COTATI	CA	94931	4244	49	06097	38.32659528	-122.7075717	Sonoma County
190492	Fee-for-Service	1518951300	1518951300	1	32	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16305 SAND CANYON AVE	SUITE 150	IRVINE	CA	92618	3790	30	06059	33.66201662	-117.7737316	Orange County
190588	Fee-for-Service	1518951300	1518951300	1	1	HOAG MEMORIAL HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
190606	Fee-for-Service	1922468479	1922468479	1	1	HOLLAND, MARIKO M NP	7/14/2016	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
190620	Fee-for-Service	1013113125	1013113125	1	1	HUNT, LAURA T MD	3/18/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	184554	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
190634	Fee-for-Service	1568587061	1568587061	1	1	HA, VINCE HYUN MD	12/5/2007	207R00000X	NA	Other	026	PHYSICIANS	93908	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
190658	Fee-for-Service	1952862021	1952862021	1	1	HONG, YEN NP	12/6/2024	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
190662	Fee-for-Service	1518951300	1518951300	1	37	HOAG MEMORIAL HOSPITAL	2/9/2015	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	520 SUPERIOR AVE	SUITE 350	NEWPORT BEACH	CA	92663	4162	30	06059	33.628914	-117.9276525	Orange County
190666	Fee-for-Service	1104321959	1104321959	1	12	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	105 SOUTH DR	STE 110	MOUNTAIN VIEW	CA	94040	4317	43	06085	37.36723851	-122.0782528	Santa Clara County
190674	Fee-for-Service	1790977015	1790977015	1	1	HIGGINS, ERICA J	8/5/2008	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	26726 CROWN VALLEY PRKWY	STE 210	MISSION VIEJO	CA	92691	8006	30	06059	33.56385623	-117.6639538	Orange County
190682	Fee-for-Service	1265846182	1265846182	1	1	HATCH, DAVID C CRNA	10/6/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2832 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.74184632	-119.783737	Fresno County
190693	Fee-for-Service	1528173127	1528173127	1	1	HERINGER, WILLIAM J MD	9/17/1996	207R00000X	NA	Other	026	PHYSICIANS	38247	41	Internal Medicine	0	In state provider	None	2030 VIBORG RD	None	SOLVANG	CA	93463	2220	42	06083	34.60247248	-120.1271535	Santa Barbara County
190713	Fee-for-Service	1316269038	1316269038	1	1	HIRSCH, ANTHONY T MD	2/8/2015	207K00000X	NA	Other	026	PHYSICIANS	17022	03	Allergy	0	In state provider	None	1306 MARICOPA HWY	None	OJAI	CA	93023	3131	56	06111	34.44229705	-119.2645703	Ventura County
190727	Fee-for-Service	1083838684	1083838684	1	1	HASAN, HUSNI N MD	11/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82211	41	Internal Medicine	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
190746	Fee-for-Service	1962495671	1962495671	1	1	HILBERMAN, MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	16206	05	Anesthesiology	0	In state provider	None	1201 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3587	48	06095	38.26101326	-122.0475752	Solano County
190748	Fee-for-Service	1710321518	1710321518	1	1	HOANG, KIM B	7/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148006	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
190760	Fee-for-Service	1831109255	1831109255	1	1	HUGHES, MICHAEL D MD	9/30/1988	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	66337	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
190818	Fee-for-Service	1053404525	1053404525	1	2	HOOPER, ANDREW H MD	10/14/2016	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	59811	01	General Practice	0	In state provider	None	3770 JANES RD	None	ARCATA	CA	95521	4744	12	06023	40.89583739	-124.0932916	Humboldt County
190835	Fee-for-Service	1043586027	1043586027	1	1	HIRANANDANI, NITISHA	7/8/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	173520	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
190836	Fee-for-Service	1942360276	1942360276	1	1	HOEFT, CRAIG W OD	11/1/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	907 N SAN FERNANDO BLVD	None	BURBANK	CA	91504	4326	19	06037	34.18664771	-118.3166612	Los Angeles County
190853	Fee-for-Service	1902068331	1902068331	1	1	HARRINGTON, SIOBHAN K MD	6/10/2010	207L00000X	NA	Other	026	PHYSICIANS	104594	05	Anesthesiology	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94039	7025	43	06085	37.36893518	-122.0779448	Santa Clara County
190870	Fee-for-Service	1104359447	1104359447	1	1	HEIMBAUGH, CHELSEA N MD	7/1/2021	207ZP0101X	NA	Other	026	PHYSICIANS	160080	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
190872	Fee-for-Service	1912157736	1912157736	1	1	HAMPTON, ADRIANA LMFT	2/18/2025	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
190881	Fee-for-Service	1982057394	1982057394	1	1	HANGER PROSTHETICS &	1/24/2017	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	2930 INLAND EMPIRE BLVD	STE 110	ONTARIO	CA	91764	4802	36	06071	34.068753	-117.589491	San Bernardino County
190913	Fee-for-Service	1962939553	1962939553	1	1	HARDT, LESLIE R LMFT	6/28/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2201 F STREET	None	BAKERSFIELD	CA	93301	3850	15	06029	35.379342	-119.023506	Kern County
190938	Fee-for-Service	1386272961	1386272961	1	1	HERMIDA, ALEJANDRO MD	12/19/2023	343900000X	NA	Other	026	PHYSICIANS	191086	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
190959	Fee-for-Service	1891986279	1891986279	1	1	HUARINGA, ARMANDO J MD	12/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	44240	41	Internal Medicine	0	In state provider	INC	1720 CESAR CHAVEZ AVE	STE ZG 270	LOS ANGELES	CA	90033	0000	19	06037	34.04925	-118.2177405	Los Angeles County
190980	Fee-for-Service	1528173127	1528173127	1	1	HERINGER, WILLIAM J MD	9/17/1996	207R00000X	NA	Other	026	PHYSICIANS	38247	08	Family Practice	0	In state provider	None	2030 VIBORG RD	None	SOLVANG	CA	93463	2220	42	06083	34.60247248	-120.1271535	Santa Barbara County
190998	Fee-for-Service	1316269038	1316269038	1	1	HIRSCH, ANTHONY T MD	2/8/2015	207K00000X	NA	Other	026	PHYSICIANS	17022	43	Pediatric Allergy	0	In state provider	None	1306 MARICOPA HWY	None	OJAI	CA	93023	3131	56	06111	34.44229705	-119.2645703	Ventura County
191006	Fee-for-Service	1134495880	1134495880	1	1	HESSLER, CHRISTINE S MD	9/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128573	None	None	0	In state provider	None	1001 POTRERO AVE	RM 4M62	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
191018	Fee-for-Service	1033295274	1033295274	2	1	HANGER PROSTHETICS & ORTHOTI	5/18/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	2345 S BROADWAY	SUITE E	SANTA MARIA	CA	93454	7840	42	06083	34.91787028	-120.4361185	Santa Barbara County
191020	Fee-for-Service	1841482759	1841482759	1	1	HODGE, SHAWN B MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	87775	05	Anesthesiology	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
191025	Fee-for-Service	1942311998	1942311998	1	1	HANSON, VIRGINIA L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40454	66	Emergency Medicine (Urgent Care)	0	In state provider	None	40 DORMODY CT	None	MONTEREY	CA	93940	2908	27	06053	36.59443073	-121.8965084	Monterey County
191035	Fee-for-Service	1962495671	1962495671	1	1	HILBERMAN, MARK MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	16206	02	General Surgery	0	In state provider	None	1201 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3587	48	06095	38.26101326	-122.0475752	Solano County
191050	Fee-for-Service	1144587379	1144587379	1	1	HEALTHRIGHT 360	12/31/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	900 LAUREL AVE	None	SAN MATEO	CA	94401	4211	41	06081	37.56069077	-122.3192645	San Mateo County
191052	Fee-for-Service	1376920967	1376920967	1	1	HALL, JORDYN B CRNA	12/11/2015	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
191062	Fee-for-Service	1619943537	1619943537	1	3	HEMET RADIOLOGY MEDICAL	8/7/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	GROUP INC	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
191112	Fee-for-Service	1447373824	1447373824	1	1	HICKS, MICHAEL D LMFT	5/31/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9324 W STOCKTON BLVD	None	ELK GROVE	CA	95758	8012	34	06067	38.418309	-121.3939665	Sacramento County
191122	Fee-for-Service	1043950751	1043950751	1	1	HILL, CARLA	4/22/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
191125	Fee-for-Service	1063597961	1063597961	1	1	HULKOWER, JONATHAN L MD	9/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	80603	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
191172	Fee-for-Service	1184253106	1184253106	1	1	HOWARD, QUINN MD	7/1/2024	390200000X	NA	Other	026	PHYSICIANS	179009	25	Physical Medicine and Rehabilitation	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
191173	Fee-for-Service	1609149491	1609149491	1	1	HUNTINGTON PALLIATIVE	4/18/2012	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEICINE, A MEDICAL CORP	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
191184	Fee-for-Service	1194014423	1194014423	1	1	HUANG, BRIAN	5/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119150	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
191224	Fee-for-Service	1659477891	1659477891	1	1	HARBISON, DANA MD	1/14/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	100 W. CALIFORNIA BLVD.	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
191237	Fee-for-Service	1891986279	1891986279	1	1	HUARINGA, ARMANDO J MD	12/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	44240	66	Emergency Medicine (Urgent Care)	0	In state provider	INC	1720 CESAR CHAVEZ AVE	STE ZG 270	LOS ANGELES	CA	90033	0000	19	06037	34.04925	-118.2177405	Los Angeles County
191247	Fee-for-Service	1457593667	1457593667	1	1	HARRISON, JULIANNE M DO	3/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	9961	None	None	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
191299	Fee-for-Service	1447258199	1447258199	1	1	HOUPT, JONATHAN C MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79047	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
191315	Fee-for-Service	1942311998	1942311998	1	1	HANSON, VIRGINIA L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40454	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	40 DORMODY CT	None	MONTEREY	CA	93940	2908	27	06053	36.59443073	-121.8965084	Monterey County
191323	Fee-for-Service	1568604619	1568604619	1	1	HIEBERT, CHRISTINA J MD	11/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	107082	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
191343	Fee-for-Service	1962448522	1962448522	1	1	HAEMEL, ANNA K MD	10/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117202	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
191348	Fee-for-Service	1083785323	1083785323	1	1	HARRIS, SCOTT M	8/8/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
191355	Fee-for-Service	1386608735	1386608735	1	1	HOME OF GUIDING HANDS	8/16/2001	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	6215 LAKE SHORE DR	None	SAN DIEGO	CA	92119	3042	37	06073	32.792346	-117.0365105	San Diego County
191381	Fee-for-Service	1811180649	1811180649	1	1	HUANG, PENG-YUN ANGELA MD	5/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	110931	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
191401	Fee-for-Service	1902546757	1902546757	1	1	HASEEB, RAFAY	2/6/2025	390200000X	NA	Other	026	PHYSICIANS	21979	41	Internal Medicine	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	2620	33	06065	33.94354395	-117.394926	Riverside County
191416	Fee-for-Service	1114973633	1114973633	1	1	HAIRSTON, DOROTHY E MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78226	01	General Practice	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
191436	Fee-for-Service	1275797888	1275797888	1	1	HARO, JACQUELINE M OD	6/9/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12001 WASHINGTON BLVD	None	LOS ANGELES	CA	90066	5801	19	06037	33.99760695	-118.4228296	Los Angeles County
191486	Fee-for-Service	1003627100	1003627100	1	1	HILL, FANTOYA LCSW	3/18/2025	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
191503	Fee-for-Service	1649936964	1649936964	1	1	HA, DAYE LCSW	5/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
191519	Fee-for-Service	1053175604	1053175604	1	1	HORWITZ, JULIETTE LMFT	4/9/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9260 ALCOSTA BLVD	BUILDING A, SUITE A5	SAN RAMON	CA	94583	4134	07	06013	37.73166348	-121.9267174	Contra Costa County
191526	Fee-for-Service	1639787468	1639787468	1	1	HSIAO, CHENG YANG	6/21/2022	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
191540	Fee-for-Service	1891986279	1891986279	1	1	HUARINGA, ARMANDO J MD	12/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	44240	29	Pulmonary Diseases (M.D. only)	0	In state provider	INC	1720 CESAR CHAVEZ AVE	STE ZG 270	LOS ANGELES	CA	90033	0000	19	06037	34.04925	-118.2177405	Los Angeles County
191573	Fee-for-Service	1023166956	1023166956	1	1	HOANG, CATHERINE D MD	11/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92652	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
191584	Fee-for-Service	1801868302	1801868302	2	1	HAYWARD HILLS OPERATING	8/1/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	COMPANY LP	1768 B ST	None	HAYWARD	CA	94541	3102	01	06001	37.68112053	-122.0685527	Alameda County
191599	Fee-for-Service	1316149065	1316149065	1	1	HENKEN, HEATHER E MD	12/24/2007	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	93648	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
191620	Fee-for-Service	1609219658	1609219658	1	1	HERRING, MATTHEW J MD	7/25/2018	390200000X	NA	Other	026	PHYSICIANS	155599	None	None	0	In state provider	None	1001 POTRERO AVE	RM 3A36	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
191631	Fee-for-Service	1962448522	1962448522	1	1	HAEMEL, ANNA K MD	10/25/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117202	07	Dermatology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
191660	Fee-for-Service	1235488925	1235488925	1	1	HUI, ANNA Y MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123467	01	General Practice	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2614	43	06085	37.313433	-121.9318385	Santa Clara County
191700	Fee-for-Service	1386642551	1386642551	1	1	HILBERT, DIANA L MD	8/23/1994	207R00000X	NA	Other	026	PHYSICIANS	79073	41	Internal Medicine	0	In state provider	None	1 SHRADER ST	STE 640	SAN FRANCISCO	CA	94117	1018	38	06075	37.77467326	-122.4529451	San Francisco County
191828	Fee-for-Service	1235174822	1235174822	1	1	HEDRIANA, HERMAN L MD	6/4/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49510	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
191829	Fee-for-Service	1346729563	1346729563	1	1	HUMPHREY, JESSICA PT	10/17/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
191859	Fee-for-Service	1477949949	1477949949	1	1	HUSEN, DOROTHY N LMFT	7/13/2015	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7177 BROCKTON AVE	STE 452	RIVERSIDE	CA	92506	2635	33	06065	33.94289496	-117.3943941	Riverside County
191869	Fee-for-Service	1295294452	1295294452	1	1	HARSTAD, ALEXANDRA MD	11/28/2023	207L00000X	NA	Other	026	PHYSICIANS	181917	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
191882	Fee-for-Service	1053643387	1053643387	1	1	HICKS, MELISSA C 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
191902	Fee-for-Service	1740640937	1740640937	1	1	HIBL, LEAH D LPCC	10/2/2023	101YM0800X	NA	Other	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
191915	Fee-for-Service	1902357155	1902357155	1	5	HOU, SAMUEL MD PHD INC	2/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	97972	30	Radiology	0	In state provider	None	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	19	06037	34.15729818	-118.3277073	Los Angeles County
191948	Fee-for-Service	1215472246	1215472246	1	1	HELPING HANDS HOME HEALTH	11/4/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	132 N BROADWAY	None	BLYTHE	CA	92225	1608	33	06065	33.61106728	-114.5967709	Riverside County
191959	Fee-for-Service	1154309730	1154309730	1	1	HUTCHINSON, JUDITH MD	6/17/2020	207L00000X	NA	Other	026	PHYSICIANS	159616	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
191964	Fee-for-Service	1861801821	1861801821	1	1	HARMONY HEALTHCARE, LLC	8/14/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	295 89TH ST	SUITE 307	DALY CITY	CA	94015	1653	41	06081	37.6917981	-122.4719026	San Mateo County
191994	Fee-for-Service	1619396017	1619396017	1	1	HEALY, MICHAEL J MD	6/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139606	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
192008	Fee-for-Service	1851651624	1851651624	1	1	HOWELL, ALLEN S LMFT	8/25/2022	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
192019	Fee-for-Service	1477758340	1477758340	1	1	HAKIMI, SHINKAI MD	7/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140905	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	275 CROSSROADS	SUITE A	CARMEL	CA	93923	8650	27	06053	36.53645751	-121.9089649	Monterey County
192031	Fee-for-Service	1881697043	1881697043	1	1	HAYS MEDICAL CENTER, INC	5/15/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2220 CANTERBURY DR	None	HAYS	KS	67601	2370	00	None	38.880486	-99.2961225	Ellis County
192038	Fee-for-Service	1508995929	1508995929	1	1	HUSSAIN, KARIM M MD INC	4/10/2019	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	29548	01	General Practice	0	In state provider	None	3755 BEACON AVE	None	FREMONT	CA	94538	1411	01	06001	37.54813209	-121.9825183	Alameda County
192081	Fee-for-Service	1770869141	1770869141	1	1	HUANG, TED S	1/30/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 TRAVELODGE DR	None	EL CAJON	CA	92020	4126	37	06073	32.79312432	-116.980275	San Diego County
192108	Fee-for-Service	1679647556	1679647556	1	1	HANGER P & O WEST INC.	2/25/1999	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1248 32ND ST	None	SACRAMENTO	CA	95816	5210	34	06067	38.569824	-121.464873	Sacramento County
192114	Fee-for-Service	1235174822	1235174822	1	1	HEDRIANA, HERMAN L MD	6/4/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49510	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
192117	Fee-for-Service	1528330925	1528330925	1	1	HARO, ELISA A LMFT	6/9/2024	101YM0800X	NA	Other	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
192140	Fee-for-Service	1912160623	1912160623	1	1	HAPPER, GLADYS A CNP	12/21/2020	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
192152	Fee-for-Service	1053456285	1053456285	1	1	HITI, ALAN L MD	11/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	41833	22	Pathology (M.D. only)	0	In state provider	None	2250 ALCAZAR STREET	None	LOS ANGELES	CA	90089	0107	19	06037	34.06313563	-118.1997071	Los Angeles County
192170	Fee-for-Service	1831174150	1831174150	1	1	HUANG, LOUISE L MD	9/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	67497	08	Family Practice	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
192203	Fee-for-Service	1770079808	1770079808	1	1	HUANG, KATHIE OD	4/8/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
192208	Fee-for-Service	1720037864	1720037864	1	1	HAXTON, RONALD S MD	1/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	22838	40	Pediatrics	0	In state provider	None	27800 MEDICAL CENTER RD	STE 204	MISSION VIEJO	CA	92691	6408	30	06059	33.55952733	-117.6645199	Orange County
192229	Fee-for-Service	1912387572	1912387572	1	1	HEALTH QUEST HOMECARE INC	9/26/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6257 FOOTHILL BLVD	STE C	TUJUNGA	CA	91402	2780	19	06037	34.2412449	-118.2674415	Los Angeles County
192232	Fee-for-Service	1073081030	1073081030	1	1	HONG, JUSTIN S OT	12/31/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	520 S. VIRGIL AVE	201	LOS ANGELES	CA	90020	1425	19	06037	34.064487	-118.2870305	Los Angeles County
192243	Fee-for-Service	1144342403	1144342403	1	1	HELVINK, BADALIN MD	6/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	54488	36	Psychiatry	0	In state provider	None	2185 CITRACADO PKWY	None	ESCONDIDO	CA	92029	4159	37	06073	33.12123297	-117.1199417	San Diego County
192261	Fee-for-Service	1831308832	1831308832	1	1	HEYMING, THEODORE W MD	10/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93062	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1250 16TH ST	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
192266	Fee-for-Service	1619110384	1619110384	1	1	HAN, WIN T MD	9/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107199	41	Internal Medicine	0	In state provider	None	900 HYDE ST	None	SAN FRANCISCO	CA	94109	4809	38	06075	37.78956486	-122.417072	San Francisco County
192286	Fee-for-Service	1780210724	1780210724	1	1	HAMMERSHAIMB, BRYANT A MD	7/19/2022	207R00000X	NA	Other	026	PHYSICIANS	178677	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
192294	Fee-for-Service	1326453929	1326453929	1	1	HOLLANDER, KAITLIN P MD	12/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	139395	01	General Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	4633	07	06013	38.00771973	-122.1331484	Contra Costa County
192319	Fee-for-Service	1881697043	1881697043	1	1	HAYS MEDICAL CENTER, INC	5/15/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2220 CANTERBURY DR	None	HAYS	KS	67601	2370	00	None	38.880486	-99.2961225	Ellis County
192342	Fee-for-Service	1457717217	1457717217	1	1	HOFMANN, ERIK MD	12/8/2018	207P00000X	NA	Other	026	PHYSICIANS	139971	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
192354	Fee-for-Service	1841378577	1841378577	1	1	HSU, BENEDICT S MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62094	30	Radiology	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
192359	Fee-for-Service	1932184108	1932184108	1	1	HO, LISA YI-MEI MD	9/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80647	41	Internal Medicine	0	In state provider	None	2825 J ST	STE 300	SACRAMENTO	CA	95816	4300	34	06067	38.573757	-121.468248	Sacramento County
192406	Fee-for-Service	1639231483	1639231483	2	1	HOME CARE MEDICAL PRODUCTS,	8/7/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	15823 MONTE ST	STE E106	SYLMAR	CA	91342	7675	19	06037	34.31066295	-118.4756898	Los Angeles County
192425	Fee-for-Service	1104321959	1104321959	1	18	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1825 CIVIC CENTER DR	STE 1	SANTA CLARA	CA	95050	7302	43	06085	37.35595381	-121.9573173	Santa Clara County
192470	Fee-for-Service	1770576357	1770576357	1	1	HIDALGO, ROBERT D MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72815	05	Anesthesiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
192479	Fee-for-Service	1982763389	1982763389	1	1	HASHIMOTO, KEVIN T OD	4/14/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	860 E CARSON ST	STE 107	CARSON	CA	90745	2268	19	06037	33.83160274	-118.2601797	Los Angeles County
192482	Fee-for-Service	1740245828	1740245828	1	1	HU, JOHNNY L MD	10/7/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104409	22	Pathology (M.D. only)	0	In state provider	None	450 E ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
192571	Fee-for-Service	1720147390	1720147390	1	1	HUYNH, DEAN N MD	12/1/1997	207R00000X	NA	Other	026	PHYSICIANS	55732	41	Internal Medicine	0	In state provider	None	9985 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.07253232	-117.4356028	San Bernardino County
192579	Fee-for-Service	1063703759	1063703759	1	1	HARTWIG, KIM M MD	7/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115659	08	Family Practice	0	In state provider	None	280 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
192622	Fee-for-Service	1841378627	1841378627	1	1	HORNIK, BENJAMIN M MD	10/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	92653	24	Plastic Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
192711	Fee-for-Service	1104321959	1104321959	1	18	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1825 CIVIC CENTER DR	STE 1	SANTA CLARA	CA	95050	7302	43	06085	37.35595381	-121.9573173	Santa Clara County
192721	Fee-for-Service	1174692859	1174692859	1	1	HARRIS, MARLU LMFT	4/1/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1821 WILSHIRE BLVD	SUITE 411	SANTA MONICA	CA	90403	5679	19	06037	34.03037837	-118.4845524	Los Angeles County
192780	Fee-for-Service	1285822007	1285822007	1	1	HURA, STEFAN A MD	8/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90564	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
192824	Fee-for-Service	1588921498	1588921498	1	1	HUANG, HELEN C MD	5/30/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128682	06	Cardiovascular Disease (M.D. only)	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
192834	Fee-for-Service	1881694131	1881694131	1	1	HORIZON, ARASH A MD	6/10/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	69767	83	Rheumatology	0	In state provider	None	8640 WEST THIRD STREET	SUITE 300	LOS ANGELES	CA	90048	3386	19	06037	34.07357646	-118.3813447	Los Angeles County
192903	Fee-for-Service	1265720056	1265720056	1	1	HO, THUYET Q MD	9/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123466	41	Internal Medicine	0	In state provider	None	1310 W STEWART DRIVE	SUITE 410	ORANGE	CA	92868	3855	30	06059	33.78236048	-117.8664975	Orange County
192916	Fee-for-Service	1942943170	1942943170	1	1	HIGA-TANNER, RENEE NP	2/11/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1499 E HIGHLAND AVE	None	SAN BERNARDINO	CA	92404	4611	36	06071	34.1358425	-117.25479	San Bernardino County
192942	Fee-for-Service	1154657278	1154657278	1	1	HO, JESSICA M MD	8/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129967	30	Radiology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
192967	Fee-for-Service	1760427843	1760427843	1	1	HEALTHRIGHT 360	6/8/2016	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	558 CLAYTON ST	None	SAN FRANCISCO	CA	94117	2907	38	06075	37.76993716	-122.4485805	San Francisco County
192972	Fee-for-Service	1558718403	1558718403	1	1	HUGHES, ANDREW LCSW	12/1/2023	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
192993	Fee-for-Service	1851702948	1851702948	1	1	HER, CINDY MD	1/3/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	139120	08	Family Practice	0	In state provider	None	1550 GATEWAY BLVD	None	FAIRFIELD	CA	94533	6901	48	06095	38.2629133	-122.0560176	Solano County
193061	Fee-for-Service	1629064795	1629064795	1	2	HOLZER, RALF MD	12/1/2022	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	181115	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
193069	Fee-for-Service	1255516043	1255516043	2	1	HANFORD ORTHOPAEDICS INC	8/17/2015	193400000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	870 W 7TH STREET	None	HANFORD	CA	93230	4946	16	06031	36.32522548	-119.6583345	Kings County
193083	Fee-for-Service	1790753960	1790753960	1	1	HONG, TAMMY OD	11/26/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3000 LAS POSITAS ROAD	None	LIVERMORE	CA	94551	9627	01	06001	37.69960369	-121.7628917	Alameda County
193148	Fee-for-Service	1568004422	1568004422	1	1	HERRERA, RICHARDYOVANY LCSW	12/9/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1789 W YOSEMITE AVE	None	MANTECA	CA	95337	5160	39	06077	37.79964	-121.246425	San Joaquin County
193149	Fee-for-Service	1376605329	1376605329	1	1	HOBBY, DAVID L LMFT	10/19/2023	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
193168	Fee-for-Service	1356388516	1356388516	1	1	HOM, BARBARA MD	1/1/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	52479	41	Internal Medicine	0	In state provider	None	320 DARDANELLI LN	STE 25B	LOS GATOS	CA	95032	1419	43	06085	37.262079	-121.9673345	Santa Clara County
193198	Fee-for-Service	1477705101	1477705101	1	1	HUIE, HENRY N MD	2/29/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105399	25	Physical Medicine and Rehabilitation	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
193204	Fee-for-Service	1881683456	1881683456	1	1	HOPKINS, LISA A OD	10/1/1995	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5610 E 2ND ST	None	LONG BEACH	CA	90803	3904	19	06037	33.75718718	-118.1249064	Los Angeles County
193211	Fee-for-Service	1669770780	1669770780	1	1	HOMER, KRISTY A D	10/24/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 RESPONSE RD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
193215	Fee-for-Service	1447515630	1447515630	1	1	HAN, GIN H MD	4/6/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	128330	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
193231	Fee-for-Service	1528514759	1528514759	1	1	HEALTHRIGHT 360	9/11/2017	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2396 UNIVERSITY AVE	None	EAST PALO ALTO	CA	94303	5709	41	06081	37.47057981	-122.1399872	San Mateo County
193236	Fee-for-Service	1093212300	1093212300	1	1	HASHEMI, KADIA E MD	3/3/2023	207P00000X	NA	Other	026	PHYSICIANS	166830	None	None	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
193254	Fee-for-Service	1760427843	1760427843	1	1	HEALTHRIGHT 360	7/1/2000	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	558 CLAYTON ST	None	SAN FRANCISCO	CA	94117	2907	38	06075	37.76993716	-122.4485805	San Francisco County
193330	Fee-for-Service	1649247842	1649247842	1	1	HOANG,LONG 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	12438 FM 1960 RD W	None	HOUSTON	TX	77065	4809	00	None	29.92216486	-95.60417328	Harris County
193386	Fee-for-Service	1831271725	1831271725	1	1	HILL, JESSICA D MD	3/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85407	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
193387	Fee-for-Service	1295204113	1295204113	1	1	HUNTINGTON SPECIALTY SURGERY	10/8/2020	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	LLC	39 CONGRESS ST	310	PASADENA	CA	91105	3024	19	06037	34.13407645	-118.151226	Los Angeles County
193388	Fee-for-Service	1295153997	1295153997	1	1	HOGAN, SARA MD	7/2/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	162065	41	Internal Medicine	0	In state provider	None	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	19	06037	34.02901811	-118.4795396	Los Angeles County
193406	Fee-for-Service	1821444886	1821444886	1	1	HUANG CHEN, VIVIANA	12/19/2017	390200000X	NA	Other	026	PHYSICIANS	151181	08	Family Practice	0	In state provider	None	4733 SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
193453	Fee-for-Service	1407380603	1407380603	1	1	HATTORI, NAHO MD	5/4/2022	2084N0400X	NA	Neurology	026	PHYSICIANS	172772	None	None	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
193490	Fee-for-Service	1285612457	1285612457	1	1	HEYWOOD, JAMES T MD	1/31/1982	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	46103	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
193511	Fee-for-Service	1942863790	1942863790	1	1	HUANG, BRIAN MD	10/21/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	177312	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
193528	Fee-for-Service	1699254847	1699254847	1	1	HARTMAN, CHRISTY A RCP	8/21/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
193544	Fee-for-Service	1760427843	1760427843	1	1	HEALTHRIGHT 360	7/1/2000	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	558 CLAYTON ST	None	SAN FRANCISCO	CA	94117	2907	38	06075	37.76993716	-122.4485805	San Francisco County
193547	Fee-for-Service	1821040759	1821040759	1	1	HASNAIN, SYED S	1/1/1979	207W00000X	NA	Ophthalmology	026	PHYSICIANS	38554	18	Ophthalmology	0	In state provider	None	332 N VILLA ST	None	PORTERVILLE	CA	93257	3211	54	06107	36.07188535	-119.0306282	Tulare County
193556	Fee-for-Service	1801239868	1801239868	1	1	HOFMANN, MAKARY T DO	6/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	2865 DAGGETT AVE	None	KLAMATH FALLS	OR	97601	1106	00	None	42.25240042	-121.7859055	Klamath County
193561	Fee-for-Service	1427080670	1427080670	1	1	HEATHER CAMPBELL	10/8/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3460 SOUTH PIONEER PKWY	None	SALT LAKE CITY	UT	84120	2049	00	None	40.697982	-111.9903965	Salt Lake County
193596	Fee-for-Service	1700102290	1700102290	1	1	HARVEY, HELEN A MD	2/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	104860	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
193614	Fee-for-Service	1093020638	1093020638	1	1	HA, RAYMOND S MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123101	41	Internal Medicine	0	In state provider	None	450 STANYAN STREET	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
193645	Fee-for-Service	1164404018	1164404018	1	1	HANNON, CORA W MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83814	07	Dermatology	0	In state provider	None	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	49	06097	38.2304311	-122.5827918	Sonoma County
193659	Fee-for-Service	1801629449	1801629449	1	1	HEALTHRIGHT 360	8/29/2024	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	11227 VALLEY BLVD	None	EL MONTE	CA	91731	3225	19	06037	34.07208303	-118.0320879	Los Angeles County
193675	Fee-for-Service	1295153997	1295153997	1	1	HOGAN, SARA MD	7/2/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	162065	07	Dermatology	0	In state provider	None	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	19	06037	34.02901811	-118.4795396	Los Angeles County
193681	Fee-for-Service	1134809254	1134809254	1	1	HOLMES, LATASHIA DOULA	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	38	06075	0	0	None
193693	Fee-for-Service	1619048675	1619048675	1	1	HONG, PATRICIA S MD	1/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83629	25	Physical Medicine and Rehabilitation	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
193697	Fee-for-Service	1073697066	1073697066	1	1	HARRIS, DOUGLAS C MD	6/27/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75378	66	Emergency Medicine (Urgent Care)	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
193714	Fee-for-Service	1912957416	1912957416	1	1	HILBURN, DAVID A MD	1/1/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	41187	08	Family Practice	0	In state provider	None	66 N EL CIRCULO AVE	None	PATTERSON	CA	95363	2536	50	06099	37.47167131	-121.1323396	Stanislaus County
193721	Fee-for-Service	1780753723	1780753723	1	1	HAFEN, JANE M OD	11/1/2000	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1901 HARRISON ST	STE 103	OAKLAND	CA	94612	3501	01	06001	37.80665105	-122.2652946	Alameda County
193756	Fee-for-Service	1730620055	1730620055	1	1	HERRERA, ALEXANDER V	9/18/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169545	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
193764	Fee-for-Service	1821265828	1821265828	1	1	HOFFMAN, PAUL J MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111644	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
193850	Fee-for-Service	1780150367	1780150367	1	1	HIGGINS, MATTHEW NP	3/14/2025	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	275 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5641	01	06001	37.82397231	-122.2578822	Alameda County
193859	Fee-for-Service	1053590349	1053590349	1	1	HADDAD, FADI A MD INC	12/3/2007	261Q00000X	NA	Other	026	PHYSICIANS	80687	77	Infectious Disease	0	In state provider	None	8860 CENTER DRIVE	SUITE 320	LA MESA	CA	91942	7001	37	06073	32.78189749	-117.0075062	San Diego County
193892	Fee-for-Service	1619353091	1619353091	1	1	HARMONY HOMES INC	4/24/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6404 N CORNELIA AVENUE	None	FRESNO	CA	93722	7132	10	06019	36.830079	-119.880531	Fresno County
193895	Fee-for-Service	1912678343	1912678343	1	1	HOME CARE SOLUTIONS, INC	2/29/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	21618 GOLDEN TRIANGLE RD	STE 201	SANTA CLARITA	CA	91350	2615	19	06037	34.41525469	-118.5138076	Los Angeles County
193952	Fee-for-Service	1528012721	1528012721	1	1	HOLLIFIELD, RODNEY D MD	4/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	18	Ophthalmology	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
193953	Fee-for-Service	1770624793	1770624793	1	1	HWANG, HOSUN MD	5/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98908	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
193999	Fee-for-Service	1013116094	1013116094	1	1	HINDS, TYLER D LMFT	9/26/2019	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
194049	Fee-for-Service	1386149367	1386149367	1	1	HASHEMZADEH-GARGARI, ROBERT	1/18/2022	207P00000X	NA	Other	026	PHYSICIANS	165698	None	None	0	In state provider	H MD	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
194068	Fee-for-Service	1871525949	1871525949	1	1	HUGHES, JEFFERY M MD	2/28/1992	207P00000X	NA	Other	026	PHYSICIANS	74798	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
194109	Fee-for-Service	1730701418	1730701418	1	1	HEALTHY LIFESTYLE HOSPICE	5/26/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	CARE INC	6420 VAN NUYS BLVD	STE 103	VAN NUYS	CA	91401	1436	19	06037	34.187337	-118.448712	Los Angeles County
194146	Fee-for-Service	1841281813	1841281813	1	1	HO, MINH OD & ASSOC INC	4/24/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	NEWVUE OPTOMETRY	3652 ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	2055	19	06037	34.07491361	-118.0729461	Los Angeles County
194148	Fee-for-Service	1770171134	1770171134	1	1	HO, LINH T OD	10/11/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
194157	Fee-for-Service	1588980536	1588980536	1	1	HOBSON, JUNIPER S LMFT	3/19/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	286 E 4TH ST	None	CHICO	CA	95928	5414	04	06007	39.7300467	-121.8372312	Butte County
194163	Fee-for-Service	1508876905	1508876905	1	1	HOGAN, JEREMY L MD	3/10/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77108	13	Neurology (M.D. only)	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
194225	Fee-for-Service	1790737179	1790737179	1	1	HUQ, FIRDOUSE A MD	8/31/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76272	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
194237	Fee-for-Service	1528012721	1528012721	1	1	HOLLIFIELD, RODNEY D MD	4/11/2018	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
194260	Fee-for-Service	1386663052	1386663052	1	1	HISS, JOHN B MD	6/11/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	74796	41	Internal Medicine	0	In state provider	None	350 HAWTHORNE AVE	STE 2320	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
194263	Fee-for-Service	1821498486	1821498486	1	1	HERMANN, MITZI LCSW	9/4/2024	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
194277	Fee-for-Service	1104688167	1104688167	1	1	HER YONISTY FEMININE WELLNES	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	10	06019	0	0	None
194285	Fee-for-Service	1184048506	1184048506	1	1	HUNTER DIALYSIS LLC	4/1/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	883 PATRIOT DRIVE	STE C	MOORPARK	CA	93021	3352	56	06111	34.278447	-118.8647411	Ventura County
194317	Fee-for-Service	1699090175	1699090175	1	1	HAIDER, JANELLE M	10/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	100455	None	None	0	In state provider	None	300 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	1675	19	06037	34.06473399	-118.445865	Los Angeles County
194372	Fee-for-Service	1275581233	1275581233	1	3	HOANG, HUNG G MD	2/23/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	36371	None	None	0	In state provider	None	6540 STOCKTON BLVD	STE 3A	SACRAMENTO	CA	95823	1635	34	06067	38.507094	-121.434858	Sacramento County
194373	Fee-for-Service	1881986206	1881986206	1	1	HUAN, LAWRENCE M MD	9/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131505	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
194397	Fee-for-Service	1730701418	1730701418	1	1	HEALTHY LIFESTYLE HOSPICE	5/26/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	6420 VAN NUYS BLVD	STE 103	VAN NUYS	CA	91401	1436	19	06037	34.187337	-118.448712	Los Angeles County
194407	Fee-for-Service	1932577426	1932577426	1	1	HANG, JANNETTE N OD	1/13/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
194460	Fee-for-Service	1528078003	1528078003	1	1	HARPSTER, ELAINE F MD	1/31/1988	207N00000X	NA	Dermatology	026	PHYSICIANS	58279	07	Dermatology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
194461	Fee-for-Service	1225443500	1225443500	1	1	HART, ASHLEY N DO	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15136	40	Pediatrics	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
194466	Fee-for-Service	1275609356	1275609356	1	1	HATFIELD, ROCHELLE R LCSW	3/25/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
194471	Fee-for-Service	1295801819	1295801819	1	1	HILL, ROSALIE M LMFT	9/25/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	607 E PLAZA DR	STE C102	SANTA MARIA	CA	93454	6945	42	06083	34.93737507	-120.4285236	Santa Barbara County
194494	Fee-for-Service	1447236096	1447236096	1	1	HOOPER, MICHAEL K MD	7/14/1992	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	55770	01	General Practice	0	In state provider	None	11879 KEMPER RD	STE 15	AUBURN	CA	95603	9021	31	06061	38.93136899	-121.0916266	Placer County
194520	Fee-for-Service	1235179870	1235179870	1	2	HUANG, XIAOGUANG MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	64820	41	Internal Medicine	0	In state provider	None	388 9TH ST	STE 203	OAKLAND	CA	94607	4293	01	06001	37.80019425	-122.2715222	Alameda County
194560	Fee-for-Service	1194781005	1194781005	1	1	HORN, THOMAS J MD	2/28/1989	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	68161	20	Orthopedic Surgery	0	In state provider	None	2705 LOMA VISTA RD	None	VENTURA	CA	93003	1581	56	06111	34.27504051	-119.2600018	Ventura County
194632	Fee-for-Service	1750917936	1750917936	1	1	HUNG, JANICE Q OD	9/15/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
194637	Fee-for-Service	1033328497	1033328497	1	2	HARRISON, JESSICA F RN	2/8/2001	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1805 DONNER AVE	#1	DAVIS	CA	95618	0366	57	06113	38.56604039	-121.7293824	Yolo County
194640	Fee-for-Service	1104321959	1104321959	1	10	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	4144 REDWOOD HWY	STE B	SAN RAFAEL	CA	94903	2646	21	06041	38.00989565	-122.5416079	Marin County
194657	Fee-for-Service	1184258006	1184258006	1	1	HUERTA, ROMINA CCC-SLP	5/31/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4201 TORRANCE BLVD	SUITE 520	TORRANCE	CA	90503	4009	19	06037	33.8375955	-118.358748	Los Angeles County
194666	Fee-for-Service	1154371177	1154371177	1	1	HEROLD, EDWARD E MD	5/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	79072	None	None	0	In state provider	None	1555 SOQUEL DR	None	SANTA CRUZ	CA	95065	1705	44	06087	36.98863619	-121.9830754	Santa Cruz County
194684	Fee-for-Service	1114098969	1114098969	1	1	HUANG, SHERRY C MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55009	40	Pediatrics	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
194719	Fee-for-Service	1114939287	1114939287	2	1	HOOS, HOWARD J MD	7/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	33711	41	Internal Medicine	0	In state provider	None	943 WEST 7TH STREET	None	OXNARD	CA	93030	6756	56	06111	34.19517346	-119.189297	Ventura County
194736	Fee-for-Service	1760513576	1760513576	1	1	HEALTHRIGHT 360	1/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	CENTER	1735 MISSION ST	STE 101B	SAN FRANCISCO	CA	94103	2417	38	06075	37.76957692	-122.4199811	San Francisco County
194741	Fee-for-Service	1104321959	1104321959	1	15	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	499 EL CAMINO REAL	SUITE C100	ENCINITAS	CA	92024	1366	37	06073	33.05803268	-117.262602	San Diego County
194754	Fee-for-Service	1982708103	1982708103	1	1	HOLMES, MICHAEL D MD	10/31/1979	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	36366	47	Miscellaneous	0	In state provider	None	511 PETALUMA AVE	None	SEBASTOPOL	CA	95472	4215	49	06097	38.39783697	-122.8208805	Sonoma County
194762	Fee-for-Service	1407254220	1407254220	1	1	HALPRIN, HANNAH LCSW	4/8/2024	101YM0800X	NA	Other	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
194771	Fee-for-Service	1861841926	1861841926	1	1	HAMERA, JOSEPH MD	9/8/2022	207RC0200X	NA	Other	026	PHYSICIANS	180910	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
194789	Fee-for-Service	1467768341	1467768341	1	1	HAN, GENG	5/20/2024	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
194821	Fee-for-Service	1336788678	1336788678	1	1	HOLTOM, MARY E PSYD	2/25/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4300 LONG BEACH BLVD	STE 340	LONG BEACH	CA	90807	2011	19	06037	33.83662572	-118.1900605	Los Angeles County
194823	Fee-for-Service	1194751271	1194751271	1	1	HAWN, MARY T MD	6/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136685	02	General Surgery	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
194841	Fee-for-Service	1366855322	1366855322	1	1	HOYNE, TIFANY B DO	4/3/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14269	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
194842	Fee-for-Service	1003951013	1003951013	1	1	HUSSAIN, YUSRA N MD	7/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78910	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
194863	Fee-for-Service	1639835101	1639835101	1	1	HWANG, YOU RI LAC	4/29/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5471 LA PALMA AVE	# 203-A	LA PALMA	CA	90623	1795	30	06059	33.84643649	-118.0377675	Orange County
194910	Fee-for-Service	1619943537	1619943537	1	1	HEMET RADIOLOGY MEDICAL	1/30/1992	174400000X	NA	Other	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP, INC	1117 E DEVONSHIRE AVE	None	HEMET	CA	92543	3083	33	06065	33.75116909	-116.9601666	Riverside County
194915	Fee-for-Service	1932366440	1932366440	1	1	HAO, RAMADEVI LMFT	4/3/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
194923	Fee-for-Service	1881671576	1881671576	1	1	HUSSEY, STEPHEN A MD	2/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	700 SOUTH J STREET	None	LAKEVIEW	OR	97630	1623	00	None	42.181335	-120.351489	Lake County
194931	Fee-for-Service	1104321959	1104321959	1	10	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	4144 REDWOOD HWY	STE B	SAN RAFAEL	CA	94903	2646	21	06041	38.00989565	-122.5416079	Marin County
194933	Fee-for-Service	1346744885	1346744885	1	1	HUANG, OWEN Y MD	8/23/2021	208M00000X	NA	Other	026	PHYSICIANS	164895	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
194971	Fee-for-Service	1114098969	1114098969	1	1	HUANG, SHERRY C MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	55009	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
194987	Fee-for-Service	1225262694	1225262694	1	1	HUNG, ANDREW J MD	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	107697	None	None	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0112	19	06037	34.06169385	-118.2044698	Los Angeles County
194998	Fee-for-Service	1528193422	1528193422	1	1	HEALTH CENTER #1	7/1/1994	261QP2300X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	3850 17TH ST	None	SAN FRANCISCO	CA	94114	2031	38	06075	37.76272129	-122.4318522	San Francisco County
194999	Fee-for-Service	1104321959	1104321959	1	1	HEALTH DIAGNOSTICS OF CALIFO	10/19/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	225 W HOSPITALITY LN	100	SAN BERNARDINO	CA	92408	3244	36	06071	34.06586109	-117.2884682	San Bernardino County
195030	Fee-for-Service	1104321959	1104321959	1	15	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	499 EL CAMINO REAL	SUITE C100	ENCINITAS	CA	92024	1366	37	06073	33.05803268	-117.262602	San Diego County
195059	Fee-for-Service	1932527751	1932527751	1	1	HYLTON, DIANA J MD	8/12/2019	207L00000X	NA	Other	026	PHYSICIANS	140734	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
195132	Fee-for-Service	1003951013	1003951013	1	1	HUSSAIN, YUSRA N MD	7/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78910	38	Geriatrics	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
195148	Fee-for-Service	1902357155	1902357155	1	2	HOU, SAMUEL MD PHD INC	2/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	97972	30	Radiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
195198	Fee-for-Service	1033361225	1033361225	1	1	HO, ANDREW D MD	7/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109930	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
195225	Fee-for-Service	1376643213	1376643213	1	1	HERNANDEZ, MIGUEL A MD	2/1/1999	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	67811	08	Family Practice	0	In state provider	None	115 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3606	19	06037	34.0309884	-118.2642142	Los Angeles County
195230	Fee-for-Service	1174787121	1174787121	1	1	HAGAN, SHARON M PSYD	1/27/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	101 PARKSHORE DR	STE. 132	FOLSOM	CA	95630	4726	34	06067	38.656962	-121.1866875	Sacramento County
195247	Fee-for-Service	1396700753	1396700753	1	1	HALCYON LASER & SURGERY	5/2/1996	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER	303 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3817	40	06079	35.11467436	-120.5915779	San Luis Obispo County
195287	Fee-for-Service	1104321959	1104321959	1	1	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	225 W HOSPITALITY LN	100	SAN BERNARDINO	CA	92408	3244	36	06071	34.06586109	-117.2884682	San Bernardino County
195306	Fee-for-Service	1922534940	1922534940	1	1	HOMEASSIST SOLUTIONS INC	8/12/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1440 SOUTHGATE AVE	STE 5	DALY CITY	CA	94015	2246	41	06081	37.6755785	-122.478111	San Mateo County
195317	Fee-for-Service	1013684976	1013684976	1	1	HAUGABOOK, REGINA C LCSW	3/17/2023	104100000X	NA	Mental Health Outpatient Services	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
195321	Fee-for-Service	1891731048	1891731048	1	1	HANKS, SUE MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	63325	30	Radiology	0	In state provider	USC RADIOLOGY ASSOCIATES	333 S HOPE ST	STE C145	LOS ANGELES	CA	90071	3019	19	06037	34.05335946	-118.2526978	Los Angeles County
195325	Fee-for-Service	1851528137	1851528137	1	1	HARIJAN, ARAM MD	8/22/2018	390200000X	NA	Other	026	PHYSICIANS	117203	01	General Practice	0	In state provider	None	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	19	06037	34.28200485	-118.4030797	Los Angeles County
195332	Fee-for-Service	1336888478	1336888478	1	1	HART, DESIREE M NP	8/1/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5735 SUNRISE BLVD	None	CITRUS HEIGHTS	CA	95610	7623	34	06067	38.670597	-121.2722235	Sacramento County
195333	Fee-for-Service	1144649054	1144649054	1	1	HOLMAN, SHELLEY LMFT	7/26/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16279 WALNUT ST	None	HESPERIA	CA	92345	3622	36	06071	34.4213317	-117.3075694	San Bernardino County
195334	Fee-for-Service	1144619479	1144619479	1	1	HUANG, LISHUANG AU	4/2/2023	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 LOS GAMOS DR	None	SAN RAFAEL	CA	94903	1850	21	06041	38.02105246	-122.5420674	Marin County
195343	Fee-for-Service	1396089512	1396089512	1	1	HALLAM, ROBYN N MD	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123462	40	Pediatrics	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
195370	Fee-for-Service	1659357481	1659357481	1	1	HOLLAND, BETSY A MD	12/31/1987	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	46969	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
195377	Fee-for-Service	1417921701	1417921701	1	1	HAMIDAR, HUMAYUN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	311 N CLYDE MORRIS BLVD	STE 320	DAYTONA BEACH	FL	32114	2756	00	None	29.20123404	-81.05568542	Volusia County
195430	Fee-for-Service	1164685889	1164685889	1	1	HRONEK, IVAN MD INC	9/9/2008	207L00000X	NA	Other	026	PHYSICIANS	84708	05	Anesthesiology	0	In state provider	None	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
195433	Fee-for-Service	1043879216	1043879216	1	1	HIGGINS, NICOLE M CRNA	10/1/2019	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2823 FRESNO ST	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
195441	Fee-for-Service	1518977909	1518977909	1	1	HAYNES, ROBERT C MD	1/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	49592	42	Nuclear Medicine	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
195444	Fee-for-Service	1720852759	1720852759	1	1	HATHAWAY, CHARLES	10/27/2024	104100000X	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
195446	Fee-for-Service	1992874036	1992874036	1	1	HARIPRASAD, RAVI MD	8/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111640	36	Psychiatry	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
195484	Fee-for-Service	1033361225	1033361225	1	1	HO, ANDREW D MD	7/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109930	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
195494	Fee-for-Service	1609824705	1609824705	1	1	HERNANDEZ, PATRICIA R OD	2/20/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1960 BROADWAY	None	OAKLAND	CA	94612	2206	01	06001	37.80861936	-122.2684225	Alameda County
195505	Fee-for-Service	1891209219	1891209219	1	1	HONG, KRISTINA S NP	11/20/2024	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
195516	Fee-for-Service	1780035931	1780035931	1	1	HARTMAN, RAYNA LMFT	2/18/2025	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
195519	Fee-for-Service	1558810309	1558810309	1	1	HODGE, JAMES E NP	2/3/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
195553	Fee-for-Service	1861464265	1861464265	1	1	HAREWOOD, ANTHONY F MD	6/14/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	130172	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
195591	Fee-for-Service	1659553691	1659553691	1	1	HERNANDEZ, LEOPOLDO G MD	1/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	39635	07	Dermatology	0	In state provider	INC	3406 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	19	06037	34.0276007	-118.2006211	Los Angeles County
195607	Fee-for-Service	1407932155	1407932155	1	1	HOANG, ROBERT Q MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	50923	34	Urology and Urological Surgery	0	In state provider	None	728 PACIFIC AVENUE	SUITE 608	SAN FRANCISCO	CA	94133	4449	38	06075	37.79687859	-122.4074282	San Francisco County
195615	Fee-for-Service	1104321959	1104321959	1	25	HEALTH DIAGNOSTICS OF CALIFO	4/5/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	635 CAMINO DE LOS MARES	101 & 102	SAN CLEMENTE	CA	92673	2801	30	06059	33.45934006	-117.6514674	Orange County
195666	Fee-for-Service	1306907308	1306907308	1	1	HENSEN,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	310 SUNNYVIEW LANE	None	KALISPELL	MT	59901	3129	00	None	48.214773	-114.3236925	Flathead County
195682	Fee-for-Service	1811137557	1811137557	1	1	HEDGE, THOMAS L MD	2/22/2010	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	35064	25	Physical Medicine and Rehabilitation	0	In state provider	A MEDICAL CORPORATION	18300 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4105	19	06037	34.22073847	-118.532988	Los Angeles County
195726	Fee-for-Service	1871766576	1871766576	1	1	HARZSTARK, ANDREA L MD	10/27/2008	207RH0003X	NA	Oncology	026	PHYSICIANS	86175	68	Hematology	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
195729	Fee-for-Service	1518977909	1518977909	1	1	HAYNES, ROBERT C MD	1/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	49592	30	Radiology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
195730	Fee-for-Service	1063422665	1063422665	1	1	HAWKINS, HUEY LCSW	11/26/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1412 17TH ST	SUITE 559	BAKERSFIELD	CA	93301	5255	15	06029	35.37475293	-119.0182434	Kern County
195732	Fee-for-Service	1811253214	1811253214	1	1	HOANG, LINDA P MD	8/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153098	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
195817	Fee-for-Service	1366578510	1366578510	1	1	HAGUE, DOUGLAS A DPM	7/9/2008	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2431 V STREET	None	SACRAMENTO	CA	95818	1825	34	06067	38.561967	-121.479057	Sacramento County
195827	Fee-for-Service	1831521137	1831521137	1	1	HEALY, ROSEMARY 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
195851	Fee-for-Service	1922155530	1922155530	1	1	HOWARD, CLARINDA L PSYD	9/27/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2926 LONE TREE WAY	None	ANTIOCH	CA	94509	4924	07	06013	37.99273556	-121.8078829	Contra Costa County
195860	Fee-for-Service	1043238454	1043238454	1	1	HAMERNIK, PATTI A MD	2/8/2015	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	54751	40	Pediatrics	0	In state provider	None	3605 HOSPTIAL RD	None	ATWATER	CA	95301	5173	24	06047	37.36678073	-120.576731	Merced County
195879	Fee-for-Service	1659553691	1659553691	1	1	HERNANDEZ, LEOPOLDO G MD	1/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	39635	01	General Practice	0	In state provider	INC	3406 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	19	06037	34.0276007	-118.2006211	Los Angeles County
195881	Fee-for-Service	1558601955	1558601955	1	2	HO, DREW NP-C	3/29/2016	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
195894	Fee-for-Service	1558516898	1558516898	1	1	HENRY, BRIANA N LMFT	7/14/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1695 SAN JACINTO	K	SAN JACINTO	CA	92583	5103	33	06065	33.770961	-116.954649	Riverside County
195904	Fee-for-Service	1104321959	1104321959	1	25	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	635 CAMINO DE LOS MARES	101 & 102	SAN CLEMENTE	CA	92673	2801	30	06059	33.45934006	-117.6514674	Orange County
195926	Fee-for-Service	1205033420	1205033420	1	1	HAMERSKI, CHRISTOPHER M	8/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100282	41	Internal Medicine	0	In state provider	MD	2340 CLAY STREET	3RD FL	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
195930	Fee-for-Service	1255617148	1255617148	1	1	HATCH, MIKE G LCSW	2/24/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
195965	Fee-for-Service	1518909019	1518909019	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	1920 EAST KATELLA	#1	ORANGE	CA	95867	5146	30	06059	33.80935	-117.8339093	Orange County
195994	Fee-for-Service	1902165442	1902165442	1	1	HUANG, PO YIN MD	4/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122542	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
195995	Fee-for-Service	1083920003	1083920003	1	1	HUYNH, TUYEN H OD	10/14/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	51 TIERRA REJADA RD	None	SIMI VALLEY	CA	93065	2902	56	06111	34.27241292	-118.7987552	Ventura County
196001	Fee-for-Service	1790779866	1790779866	1	1	HUNTER STEPHAN 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	200 HAWKINS DRIVE	None	IOWA CITY	IA	52242	0000	00	None	41.659929	-91.548099	Johnson County
196010	Fee-for-Service	1043578958	1043578958	1	1	HEALING CARE HOSPICE INC	2/25/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8255 FIRESTONE BLVD	SUITE 403	DOWNEY	CA	90241	4800	19	06037	33.94042631	-118.1335423	Los Angeles County
196014	Fee-for-Service	1871766576	1871766576	1	1	HARZSTARK, ANDREA L MD	10/27/2008	207RH0003X	NA	Oncology	026	PHYSICIANS	86175	78	Neoplastic Diseases/Oncology	0	In state provider	None	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48941956	-122.2227204	San Mateo County
196076	Fee-for-Service	1083143648	1083143648	2	1	HERNANDEZ, JACINDA PHD	10/24/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	516 W SHAW AVE	STE 200 OFFICE #13	FRESNO	CA	93704	2515	10	06019	36.80857947	-119.8019619	Fresno County
196078	Fee-for-Service	1902068505	1902068505	1	1	HANUDEL, PRISCILLA P MD	9/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110687	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
196090	Fee-for-Service	1104046481	1104046481	1	1	HORIZONS UNLIMITED OF SAN	11/21/2016	251B00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	FRANCISCO, INC	440 POTRERO AVENUE	None	SAN FRANCISCO	CA	94110	1430	38	06075	37.76420358	-122.4074414	San Francisco County
196152	Fee-for-Service	1760461206	1760461206	1	1	HOREISH, ADAM K MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56089	None	None	0	In state provider	None	340 4TH AVE	SUITE 4	CHULA VISTA	CA	91910	3886	37	06073	32.63831293	-117.0833536	San Diego County
196165	Fee-for-Service	1225500473	1225500473	1	1	HARMON, AMBER MD	9/13/2023	207R00000X	NA	Other	026	PHYSICIANS	190263	None	None	0	In state provider	None	20101 LAKE CHABOT RD	4TH FLOOR	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
196187	Fee-for-Service	1114335239	1114335239	1	1	HINA SIDHU, M.D., INC.	3/4/2020	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	& TMS WELLNESS CENTER	1400 N HARBOR BLVD	SUITE 540	FULLERTON	CA	92835	4126	30	06059	33.88408114	-117.9253959	Orange County
196214	Fee-for-Service	1205033420	1205033420	1	1	HAMERSKI, CHRISTOPHER M	8/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	100282	10	Gastroenterology (M.D. only)	0	In state provider	MD	2340 CLAY STREET	3RD FL	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
196216	Fee-for-Service	1679986772	1679986772	1	1	HANKS, JOHN E MD	7/15/2019	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	163113	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
196225	Fee-for-Service	1447577879	1447577879	1	1	HALL, JEFFREY D	5/18/2010	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	4836 NORTH FIRST STREET	STE 102	FRESNO	CA	93726	0527	10	06019	36.80566205	-119.7720258	Fresno County
196232	Fee-for-Service	1568652865	1568652865	1	1	HWANG, TOMMY H PHD	8/21/2014	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
196269	Fee-for-Service	1174879837	1174879837	1	1	HO, JESSICA A OD	5/16/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4403 S VERMONT AVE	None	LOS ANGELES	CA	90037	2413	19	06037	34.00342736	-118.2915892	Los Angeles County
196280	Fee-for-Service	1518951300	1518951300	1	31	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16305 SAND CANYON AVE	SUITE 120	IRVINE	CA	92618	3783	30	06059	33.66201662	-117.7737316	Orange County
196296	Fee-for-Service	1043578958	1043578958	1	1	HEALING CARE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8255 FIRESTONE BLVD	SUITE 403	DOWNEY	CA	90241	4800	19	06037	33.94042631	-118.1335423	Los Angeles County
196297	Fee-for-Service	1003303413	1003303413	1	1	HOBBS, AMY LCSW	10/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	1	Border provider	None	1155 W 4TH ST	SUITE 225, EXECUTIVE SUI	RENO	NV	89503	5172	00	None	39.52595285	-119.8289757	Washoe County
196316	Fee-for-Service	1437526555	1437526555	1	1	HAHN, SARAH PSYD	8/30/2021	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
196349	Fee-for-Service	1235540469	1235540469	1	1	HONG, JULIAN C MD	7/30/2019	2085R0001X	NA	Other	026	PHYSICIANS	161783	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
196354	Fee-for-Service	1477574093	1477574093	1	1	HARRIS, JOHN MELTY MD	5/31/1987	207L00000X	NA	Other	026	PHYSICIANS	61198	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
196360	Fee-for-Service	1104890524	1104890524	2	1	HAYES, KARI L MD	7/1/2018	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
196393	Fee-for-Service	1770559874	1770559874	1	1	HENSLICK, JAMES R OD	8/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27451 LA PAZ RD	STE B	LAGUNA NIGUEL	CA	92677	4082	30	06059	33.56418247	-117.7079814	Orange County
196446	Fee-for-Service	1295457760	1295457760	1	1	HERNANDEZ, ANA M	3/6/2023	101YM0800X	NA	Other	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
196454	Fee-for-Service	1942442603	1942442603	1	1	HAGEN, EUNICE D DO	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	12641	01	General Practice	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
196471	Fee-for-Service	1275525115	1275525115	1	1	HEBREW HOME FOR AGED	3/1/1966	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	DISABLED	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	38	06075	37.72851602	-122.4296638	San Francisco County
196486	Fee-for-Service	1659383024	1659383024	1	1	HMH EMERGENCY MEDICAL	2/28/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	GROUP, INC	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
196522	Fee-for-Service	1245891506	1245891506	1	1	HUMBOLDT ACUPUNCTURE	7/22/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	517 3RD ST	18	EUREKA	CA	95501	0460	12	06023	40.80367671	-124.166036	Humboldt County
196549	Fee-for-Service	1508505835	1508505835	1	1	HOVHANNISYAN, HOVHANNES OD	7/20/2023	152WC0802X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	16970 SAN FERNANDO MISSI	C-3	GRANADA HILLS	CA	91344	4262	19	06037	34.27202252	-118.501425	Los Angeles County
196591	Fee-for-Service	1235213901	1235213901	1	1	HOWARD, RAISA CNP	5/1/2011	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	12304 SANTA MONICA BLVD	STE 208	LOS ANGELES	CA	90025	2587	19	06037	34.03948285	-118.4656304	Los Angeles County
196605	Fee-for-Service	1346494861	1346494861	1	1	HOLGADO, RUTH L	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
196618	Fee-for-Service	1215039631	1215039631	2	2	HABIB, SHEHNAZ N MD	8/31/2018	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	50211	-	NOT APPLICABLE	0	In state provider	None	8714 N SEPULVEDA BLVD	None	NORTH HILLS	CA	91343	5112	19	06037	34.228737	-118.4676215	Los Angeles County
196619	Fee-for-Service	1154755163	1154755163	1	1	HAZELTON DIALYSIS LLC	6/4/2014	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1950 SUNNYCREST DR	STE 1300	FULLERTON	CA	92835	3639	30	06059	33.89240507	-117.9313904	Orange County
196626	Fee-for-Service	1568834059	1568834059	1	1	HURVITZ, KEITH A MD A	2/2/2016	208200000X	NA	General Surgery	026	PHYSICIANS	74511	24	Plastic Surgery	0	In state provider	MEDICAL CORPORATION	6226 E SPRING	SUITE 380	LONG BEACH	CA	90815	1444	19	06037	33.81040053	-118.1102715	Los Angeles County
196708	Fee-for-Service	1518920230	1518920230	1	1	HO, ANDY T MD INC	2/3/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72198	01	General Practice	0	In state provider	ANDY TUAN HO MD INC	9081 BOLSA AVE	#109	WESTMINSTER	CA	92683	5590	30	06059	33.7449813	-117.9708224	Orange County
196730	Fee-for-Service	1407988322	1407988322	1	1	HENRIQUEZ, ANSELY M LCSW	10/24/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	420 S GLENDORA AVENUE	None	WEST COVINA	CA	91790	3001	19	06037	34.06750236	-117.925203	Los Angeles County
196775	Fee-for-Service	1659383024	1659383024	1	1	HMH EMERGENCY MEDICAL	2/28/1988	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP, INC	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
196788	Fee-for-Service	1902121742	1902121742	1	1	HALVERSON, BRYAN E MD	4/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114170	05	Anesthesiology	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
196840	Fee-for-Service	1821431842	1821431842	1	1	HODGSON, NICKISA MD	7/31/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	133980	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
196880	Fee-for-Service	1285637157	1285637157	1	1	HSEI, REX C MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71449	18	Ophthalmology	0	In state provider	None	1489 MAIN ST	STE 101	WATSONVILLE	CA	95076	3766	44	06087	36.9173455	-121.7767935	Santa Cruz County
196896	Fee-for-Service	1164502555	1164502555	1	1	HANA, NADA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	41069 DEQUINDRE RD	STE 101	TROY	MI	48085	6730	00	None	42.59384049	-83.08995114	Oakland County
196912	Fee-for-Service	1992165815	1992165815	1	1	HOPE ARTIFICIAL LIMB & BRACE	10/10/2019	335E00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	,LLC	2609 W. BEVERLY BLVD	#3	MONTEBELLO	CA	90640	2300	19	06037	34.0209037	-118.1311313	Los Angeles County
196983	Fee-for-Service	1891350740	1891350740	1	1	HONG, VICTOR MD	1/7/2025	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	177508	20	Orthopedic Surgery	0	In state provider	None	289 W. HUNTINGTON DR.	104	ARCADIA	CA	91007	3495	19	06037	34.13549119	-118.0419175	Los Angeles County
197011	Fee-for-Service	1861570541	1861570541	1	1	HSIEH, MELODY M MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	73476	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
197028	Fee-for-Service	1801253869	1801253869	1	1	HEALTH AND HUMAN SERVICES	5/16/2016	251K00000X	NA	Other	048	COUNTY CLINICS NOT ASSOCIATED WITH HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	AGENCY	3851 ROSECRANS ST	None	SAN DIEGO	CA	92110	3115	37	06073	32.75343795	-117.2028528	San Diego County
197039	Fee-for-Service	1912992710	1912992710	1	1	HORI, GENE MD	12/7/2008	208800000X	NA	Other	026	PHYSICIANS	64261	34	Urology and Urological Surgery	0	In state provider	None	148 CASA ST	None	SAN LUIS OBISPO	CA	93405	1804	40	06079	35.291727	-120.6647335	San Luis Obispo County
197061	Fee-for-Service	1164436713	1164436713	1	1	HART, STEVEN D MD	11/1/2007	207ZP0102X	NA	Other	026	PHYSICIANS	78530	None	None	0	In state provider	None	501 S BUENA VISTA STREET	None	BURBANK	CA	91505	4866	19	06037	34.15729818	-118.3277073	Los Angeles County
197068	Fee-for-Service	1902357155	1902357155	1	4	HOU, SAMUEL MD PHD INC	2/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	97972	30	Radiology	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2303	19	06037	34.02980528	-118.4786605	Los Angeles County
197078	Fee-for-Service	1336567551	1336567551	1	1	HUANG, EMILY MD	5/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	142470	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365, 420, 120	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
197085	Fee-for-Service	1740478783	1740478783	1	1	HTEIN, SANDY MD	12/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	96765	38	Geriatrics	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
197119	Fee-for-Service	1568680734	1568680734	1	1	HOFFMAN, VINCENT M PT	12/10/2020	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	414 E SAN BERNARDINO RD	None	COVINA	CA	91723	1704	19	06037	34.09060121	-117.8831282	Los Angeles County
197168	Fee-for-Service	1811021496	1811021496	1	1	HOWARD, MARCIA D LCSW	5/5/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	355 ABBOTT ST STE 201	STE 201	SALINAS	CA	93901	4483	27	06053	36.66552031	-121.6439174	Monterey County
197177	Fee-for-Service	1356544126	1356544126	1	1	HERZOG, VICTORIA LMFT	7/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1682 NOVATO BLVD	SUITE 250A	NOVATO	CA	94947	7002	21	06041	38.10598003	-122.5782662	Marin County
197200	Fee-for-Service	1073713616	1073713616	1	1	HSIEH, XAVIER J DO	12/7/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	10696	08	Family Practice	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3208	30	06059	33.85429563	-117.8166478	Orange County
197212	Fee-for-Service	1871662437	1871662437	1	1	HALL, WINTHROP H JR MD	1/1/1979	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	25895	04	Otology, Laryngology, Rhinology	0	In state provider	INC	165 ROWLAND WAY	STE 202	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
197224	Fee-for-Service	1518951300	1518951300	1	28	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16405 SAND CANYON AVE	SUITE 230	IRVINE	CA	92618	3787	30	06059	33.66098519	-117.7747816	Orange County
197306	Fee-for-Service	1306926308	1306926308	1	1	HOLMES, 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	325 9TH AVE	C/O UWP MS 359110	SEATTLE	WA	98104	2420	00	None	47.60414369	-122.3235136	King County
197308	Fee-for-Service	1649350612	1649350612	1	1	HOUMARD, BRENDA S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	ASSOC OF UNIV PHYS	4245 ROOSEVELT WAY NE	MS 359110	SEATTLE	WA	98105	6008	00	None	47.65883901	-122.3177928	King County
197319	Fee-for-Service	1295762078	1295762078	1	1	HUNTLEY, MICHAEL J MD	2/28/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70722	05	Anesthesiology	0	In state provider	None	9212 MIRA ESTE CT	STE 204	SAN DIEGO	CA	92126	6337	37	06073	32.88927901	-117.1482338	San Diego County
197320	Fee-for-Service	1881618023	1881618023	1	1	HEDAYA, JOSHUA MD	11/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95681	18	Ophthalmology	0	In state provider	None	44815 FIG AVE	None	LANCASTER	CA	93534	3144	19	06037	34.69630244	-118.1431105	Los Angeles County
197337	Fee-for-Service	1942762190	1942762190	1	1	HEIDARI BATENI, ZHOOBIN MD	7/5/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179170	None	None	0	In state provider	None	1379 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83694289	-119.7636839	Fresno County
197359	Fee-for-Service	1750461570	1750461570	1	1	HUMBOLDT NEUROLOGICAL	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	13	Neurology (M.D. only)	0	In state provider	MEDICAL GROUP INC	2828 ONEIL LN	None	EUREKA	CA	95503	4870	12	06023	40.782087	-124.1350885	Humboldt County
197374	Fee-for-Service	1487856142	1487856142	1	1	HAMDAN, HIBA A MD	7/29/2019	207RN0300X	NA	Nephrology	026	PHYSICIANS	107022	None	None	0	In state provider	None	151 N SUNRISE AVE	STE 1205	ROSEVILLE	CA	95661	2926	31	06061	38.74746043	-121.2655348	Placer County
197386	Fee-for-Service	1427625300	1427625300	1	1	HERBST, DEVON M NP	6/13/2022	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
197399	Fee-for-Service	1912015785	1912015785	1	1	HUNTER, JOHN W MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	45541	08	Family Practice	0	In state provider	None	920 E MORTON PL	None	HEMET	CA	92543	4529	33	06065	33.7466915	-116.962551	Riverside County
197425	Fee-for-Service	1295122356	1295122356	1	1	HAN, YU MD	8/4/2022	207R00000X	NA	Other	026	PHYSICIANS	163069	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
197458	Fee-for-Service	1265816631	1265816631	1	1	HANLEY, JASON C MD	5/26/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	144471	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
197496	Fee-for-Service	1326124272	1326124272	1	1	HO, WILLIAM KW MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	56209	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
197563	Fee-for-Service	1750426094	1750426094	1	1	HOWELL, DEMOYLE	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	71553	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
197606	Fee-for-Service	1912000423	1912000423	1	1	HOLLINGSHEAD, KOSSUTH F	12/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	50288	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
197607	Fee-for-Service	1245988724	1245988724	1	1	HULBERT, REBECCA LMFT	8/30/2023	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
197632	Fee-for-Service	1326686098	1326686098	1	1	HUANG, GING HAO LAC	9/15/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	14351 RED HILL AVE	C	TUSTIN	CA	92780	6271	30	06059	33.72948962	-117.8194882	Orange County
197649	Fee-for-Service	1518031129	1518031129	1	1	HAHN, ERIC R MD	12/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	87817	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
197665	Fee-for-Service	1902357155	1902357155	1	3	HOU, SAMUEL MD PHD INC	2/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	97972	30	Radiology	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
197699	Fee-for-Service	1487679189	1487679189	1	1	HADDADIAN, ARTO H MD	12/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	74992	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
197709	Fee-for-Service	1477508927	1477508927	1	1	HONG, JENNY E MD	1/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93018	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
197718	Fee-for-Service	1801851985	1801851985	1	1	HOME OF GUIDING HANDS	8/7/2002	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	2091 VENTANA WAY	None	EL CAJON	CA	92020	1042	37	06073	32.82392829	-116.9929734	San Diego County
197734	Fee-for-Service	1417480013	1417480013	1	1	HERNANDEZ, BRIAN O MD	7/15/2022	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	179274	None	None	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
197743	Fee-for-Service	1518951300	1518951300	1	38	HOAG MEMORIAL HOSPITAL	2/28/2019	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	500 SUPERIOR AVE	SUITE 315	NEWPORT BEACH	CA	92663	3660	30	06059	33.63017269	-117.929499	Orange County
197763	Fee-for-Service	1891536041	1891536041	1	1	HUNDLEY, ADAM S NP	10/3/2024	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
197790	Fee-for-Service	1164491171	1164491171	1	1	HURT, KIKI L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	96718	05	Anesthesiology	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
197806	Fee-for-Service	1134296031	1134296031	1	1	HSU, JOHN Y MD	10/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90687	05	Anesthesiology	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
197824	Fee-for-Service	1326416264	1326416264	1	1	HERTZBERG, RACHEL	6/1/2015	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	417 ALISO AVENUE	None	NEWPORT BEACH	CA	92663	5104	30	06059	33.62179858	-117.9181836	Orange County
197849	Fee-for-Service	1376741322	1376741322	1	1	HUANG, XIAOXUE MD	8/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	156783	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
197851	Fee-for-Service	1477903086	1477903086	1	1	HEARD, JASON	9/1/2022	208600000X	NA	General Surgery	026	PHYSICIANS	172506	None	None	0	In state provider	None	3301 C ST	None	SACRAMENTO	CA	95816	3300	34	06067	38.579877	-121.456143	Sacramento County
197863	Fee-for-Service	1336168186	1336168186	1	1	HU, PEIFENG MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67550	None	None	0	In state provider	None	200 MED PLAZA STE 365	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
197884	Fee-for-Service	1972932523	1972932523	1	1	HAMMACK, LILLY DO	10/16/2023	207R00000X	NA	Other	026	PHYSICIANS	21928	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
197910	Fee-for-Service	1699854398	1699854398	1	1	HOFFMAN, ROBERT P MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	28098	20	Orthopedic Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
197925	Fee-for-Service	1225019193	1225019193	1	1	HOGARTH, MICHAEL MD	11/30/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	51060	01	General Practice	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
198026	Fee-for-Service	1568662260	1568662260	1	1	HANGER P & O WEST INC	3/27/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1743 CREEKSIDE DRIVE	SUITE 110	FOLSOM	CA	95630	3541	34	06067	38.672658	-121.139199	Sacramento County
198052	Fee-for-Service	1720090137	1720090137	1	1	HSU, DIANA H MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62369	41	Internal Medicine	0	In state provider	None	12651 LAKEWOOD BLVD	None	DOWNEY	CA	90242	4563	19	06037	33.91612375	-118.1389293	Los Angeles County
198098	Fee-for-Service	1700927373	1700927373	1	1	HIRST, MARCEE	12/19/2000	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	11966 TILDEN PL	None	RIVERSIDE	CA	92505	3143	33	06065	33.91934765	-117.5096155	Riverside County
198112	Fee-for-Service	1326416264	1326416264	1	1	HERTZBERG, RACHEL	6/1/2015	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	417 ALISO AVENUE	None	NEWPORT BEACH	CA	92663	5104	30	06059	33.62179858	-117.9181836	Orange County
198174	Fee-for-Service	1639490493	1639490493	1	1	HABIB, NANCY MD	8/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129552	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
198178	Fee-for-Service	1891117826	1891117826	1	1	HEALTHRX PHARMACY INC	1/22/2014	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1844 EAST ROUTE 66	None	GLENDORA	CA	91740	3868	19	06037	34.12856885	-117.8298553	Los Angeles County
198182	Fee-for-Service	1821246141	1821246141	1	1	HUANG, ALEX A MD	7/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111999	18	Ophthalmology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
198185	Fee-for-Service	1710079991	1710079991	1	1	HITOMI, CLIFFORD MITS OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	525 N AZUSA AVE	None	COVINA	CA	91722	3502	19	06037	34.08967185	-117.9079487	Los Angeles County
198217	Fee-for-Service	1689794877	1689794877	1	1	HARROD, SHEILA A	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	6501 BRIGHT AVE	None	WHITTIER	CA	90601	4504	19	06037	33.982542	-118.0362065	Los Angeles County
198241	Fee-for-Service	1770619447	1770619447	1	2	HARRY M MILLER MD INC	1/18/2013	207L00000X	NA	Other	026	PHYSICIANS	60912	None	None	0	In state provider	None	4150 TRUXEL ROAD	SUITE B	SACRAMENTO	CA	95834	3761	34	06067	38.645658	-121.508397	Sacramento County
198258	Fee-for-Service	1215953070	1215953070	1	1	HOLT, ROBERT O MD	11/19/2018	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154798	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
198262	Fee-for-Service	1609837681	1609837681	1	1	HUHN, JAY R	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
198296	Fee-for-Service	1346398229	1346398229	1	1	HUGHES, JILL K MD	6/30/1989	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	60711	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
198321	Fee-for-Service	1700189404	1700189404	1	1	HOLT, DAVID J MD	4/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	114454	08	Family Practice	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
198332	Fee-for-Service	1740368422	1740368422	1	1	HUEY, RICHARD G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38826	01	General Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
198348	Fee-for-Service	1750458626	1750458626	1	1	HUNTLEY, MERLA A LCSW	7/23/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
198352	Fee-for-Service	1073001962	1073001962	1	1	HAGHVERDIAN, JUSTIN MD	9/25/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	164530	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
198429	Fee-for-Service	1063589943	1063589943	1	1	HENDERSON, RICHARD L MD	6/30/1989	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	46600	01	General Practice	0	In state provider	None	989 E COOLEY DR	None	COLTON	CA	92324	3947	36	06071	34.05505634	-117.3036443	San Bernardino County
198440	Fee-for-Service	1336766617	1336766617	1	1	HOMELINE HOSPICE INC	3/23/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	436 W COLORADO ST	SUITE 110	GLENDALE	CA	91204	3068	19	06037	34.14249549	-118.2624705	Los Angeles County
198453	Fee-for-Service	1104321959	1104321959	1	17	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	3531 FASHION WAY	STE 2	TORRANCE	CA	90503	3102	19	06037	33.8352235	-118.348254	Los Angeles County
198498	Fee-for-Service	1144245556	1144245556	1	2	HUANG, PETER S MD	3/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	86001	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
198507	Fee-for-Service	1245441054	1245441054	1	1	HE, WEIXIONG MD	10/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99496	84	Surgery-Head and Neck	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
198510	Fee-for-Service	1508944281	1508944281	1	1	HOLGUIN, RUDOLPH J MD	1/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	43129	08	Family Practice	0	In state provider	None	31739 RIVERSIDE DR	STE A	LAKE ELSINORE	CA	92530	7818	33	06065	33.67696555	-117.373482	Riverside County
198521	Fee-for-Service	1518045301	1518045301	1	1	HOVSEPIAN, ANNIE MD	5/31/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	79625	41	Internal Medicine	0	In state provider	None	305 OAK RIDGE DR	None	ROSEVILLE	CA	95661	3419	31	06061	38.74274671	-121.2701665	Placer County
198550	Fee-for-Service	1912078411	1912078411	1	1	HO, BERNARD L MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78128	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
198561	Fee-for-Service	1871547828	1871547828	1	1	HAKAN PAYDAK, MD	7/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4301 W MARKHAM ST	None	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
198564	Fee-for-Service	1518595347	1518595347	1	1	HOGENESCH, ELENA MD	6/14/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
198588	Fee-for-Service	1144245556	1144245556	1	1	HUANG, PETER S MD	11/30/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	86001	-	NOT APPLICABLE	0	In state provider	None	1131 SAN FELIPE RD	None	HOLLISTER	CA	95023	2800	35	06069	36.87280464	-121.400555	San Benito County
198645	Fee-for-Service	1588862957	1588862957	1	1	HARDEMAN-GUPTILL, MICHELLE M	8/14/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LMFT	406 CHINN ST	None	SANTA ROSA	CA	95404	4339	49	06097	38.444787	-122.707098	Sonoma County
198666	Fee-for-Service	1235366949	1235366949	1	1	HAWKINS, ELEANOR S MD	5/16/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	134075	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 LAGUNA RD	STE 100	FULLERTON	CA	92835	3634	30	06059	33.89326085	-117.9300987	Orange County
198667	Fee-for-Service	1740356807	1740356807	1	1	HOMEDIC INC	4/27/2005	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	HOMEDIC RESPIRATORY CARE	671 EAST COOLEY DR	#104	COLTON	CA	92324	4014	36	06071	34.05972406	-117.3042991	San Bernardino County
198710	Fee-for-Service	1407823735	1407823735	1	1	HILL, DEMETRICE L MD	1/2/2020	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	166620	15	Obstetrics (D.O. only)	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
198730	Fee-for-Service	1336766617	1336766617	1	1	HOMELINE HOSPICE INC	3/23/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	436 W COLORADO ST	SUITE 110	GLENDALE	CA	91204	3068	19	06037	34.14249549	-118.2624705	Los Angeles County
198738	Fee-for-Service	1740850973	1740850973	1	1	HAMZAVI, SAREH LMFT	12/8/2021	101YM0800X	NA	Other	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
198739	Fee-for-Service	1104321959	1104321959	1	17	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	3531 FASHION WAY	STE 2	TORRANCE	CA	90503	3102	19	06037	33.8352235	-118.348254	Los Angeles County
198751	Fee-for-Service	1306000229	1306000229	1	1	HUANG, ERIC J MD	11/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109265	05	Anesthesiology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
198762	Fee-for-Service	1487274825	1487274825	1	1	HOEFFER, TATIANA MD	12/30/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	191499	08	Family Practice	0	In state provider	None	15248 ELEVENTH ST	None	VICTORVILLE	CA	92395	3704	36	06071	34.52825401	-117.2925587	San Bernardino County
198791	Fee-for-Service	1770583429	1770583429	1	1	HILL, PHILIP E	11/30/1986	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	59809	None	None	0	In state provider	None	1760 TERMINO AVE	SUITE 208	LONG BEACH	CA	90804	2151	19	06037	33.78889871	-118.1458784	Los Angeles County
198794	Fee-for-Service	1043277916	1043277916	1	1	HILL, SALLIE P CNM	3/14/2016	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	350 30TH STREET	SUITE 208	OAKLAND	CA	94609	3425	01	06001	37.81892183	-122.2640154	Alameda County
198831	Fee-for-Service	1851739650	1851739650	1	1	HAKIMI, DEHNAD PSYD	2/6/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	11340 W OLYMPIC BLVD	385	LOS ANGELES	CA	90064	1639	19	06037	34.03770466	-118.4419168	Los Angeles County
198979	Fee-for-Service	1396037412	1396037412	1	1	HOLT, REBECCA L MD	7/11/2022	2080P0008X	NA	Neurology	026	PHYSICIANS	122710	None	None	0	In state provider	None	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93102	0689	42	06083	34.42887662	-119.7237878	Santa Barbara County
199017	Fee-for-Service	1295319929	1295319929	1	1	HOLLYWOOD PREMIUM HOME CARE	8/2/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1110 N WESTERN AVE	STE 109	LOS ANGELES	CA	90029	1087	19	06037	34.091289	-118.3091505	Los Angeles County
199081	Fee-for-Service	1821136631	1821136631	1	1	HANCOCK, STEVEN MD	11/30/1985	2085R0001X	NA	Other	026	PHYSICIANS	36308	30	Radiology	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
199105	Fee-for-Service	1326345869	1326345869	1	1	HOLLADAY, CHRISTINA LMFT	4/5/2020	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
199144	Fee-for-Service	1790205052	1790205052	1	1	HARPSTER, SANDRA N OD	7/5/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
199205	Fee-for-Service	1578958724	1578958724	1	1	HEIKALI, DANIEL MD	7/26/2022	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	146329	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
199260	Fee-for-Service	1710967906	1710967906	1	1	HALL, KRIS B MD	9/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	62482	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 SOUTH BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
199279	Fee-for-Service	1750516241	1750516241	1	1	HOBBS, KYLE S MD	6/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114171	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
199288	Fee-for-Service	1053418947	1053418947	1	1	HENNING, CHYNEL F MD	6/21/2000	207ZP0102X	NA	Other	026	PHYSICIANS	26610	22	Pathology (M.D. only)	0	In state provider	None	3816 WOODRUFF AVE	STE 105	LONG BEACH	CA	90808	2145	19	06037	33.828102	-118.1165525	Los Angeles County
199442	Fee-for-Service	1538904073	1538904073	1	1	HOLISTIC DOULA LLC	7/18/2024	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	33	06065	0	0	None
199448	Fee-for-Service	1619087681	1619087681	1	1	HOYT-DUNNING, JODY M LMFT	5/6/2020	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
199456	Fee-for-Service	1659590974	1659590974	1	1	HAMILTON, DAVID W NP	2/21/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4900 BROADWAY	SUITE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
199471	Fee-for-Service	1104320019	1104320019	1	1	HASBUN AVALOS, OSWALDO MD	12/9/2021	390200000X	NA	Other	026	PHYSICIANS	167874	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
199478	Fee-for-Service	1114159514	1114159514	1	1	HIJAZI, BILAL M MD	1/13/2022	207P00000X	NA	Other	026	PHYSICIANS	106411	None	None	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
199490	Fee-for-Service	1194892117	1194892117	1	1	HUYNH, DUNG V MD	9/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	74512	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
199557	Fee-for-Service	1356412266	1356412266	1	1	HUBERMAN, ARTHUR K MD	1/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41781	83	Rheumatology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
199599	Fee-for-Service	1235365925	1235365925	1	1	HENRY, MELINDA A MD	2/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	121689	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
199627	Fee-for-Service	1326543588	1326543588	1	1	HAGAMAN, DANIEL	8/7/2023	163WX0800X	NA	Other	026	PHYSICIANS	186978	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
199628	Fee-for-Service	1982264230	1982264230	1	1	HAIDER, ALINA MD	8/3/2022	207QA0505X	NA	Adult Primary Care	026	PHYSICIANS	179914	None	None	0	In state provider	None	1448 FLORIDA AVE	None	MODESTO	CA	95350	4443	50	06099	37.66523613	-120.9962072	Stanislaus County
199643	Fee-for-Service	1912657503	1912657503	1	1	HASYCHAK, MARKKUS DO	4/17/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22004	08	Family Practice	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
199645	Fee-for-Service	1316045156	1316045156	1	1	HARB, RULA ANWAR MD	11/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76030	10	Gastroenterology (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
199659	Fee-for-Service	1144457029	1144457029	1	1	HUANG, WILLIAM A MD	2/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115250	01	General Practice	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90024	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
199661	Fee-for-Service	1275896417	1275896417	1	1	HUDSON, RYAN A MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	5400 SOUTH RAINBOW BLVD	None	LAS VEGAS	NV	89118	1859	00	None	36.090072	-115.2405585	Clark County
199667	Fee-for-Service	1083783534	1083783534	1	1	HEASTON, SHARON D LMFT	12/18/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	237 W FOURTH STREET	None	CLAREMONT	CA	91711	4101	19	06037	34.09762547	-117.7173135	Los Angeles County
199668	Fee-for-Service	1336596444	1336596444	1	1	HOODENDIJK, MARTIN A	9/14/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1495 VICTOR AVE	STE D	REDDING	CA	96003	4093	45	06089	40.586022	-122.338834	Shasta County
199673	Fee-for-Service	1184702771	1184702771	1	1	HAQ, NAJM U MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70673	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
199678	Fee-for-Service	1053477356	1053477356	1	1	HAMMOND, LORELEI J LCSW	4/28/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	14769	-	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
199697	Fee-for-Service	1588876593	1588876593	1	1	HUNT, BEN M MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119287	02	General Surgery	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
199704	Fee-for-Service	1629742853	1629742853	1	3	HEART TO HEART CARDIOLOGY AN	5/30/2023	261QM2500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	D VASCULAR OF ORANGE COU	301 W BASTANCHURY RD	STE 240	FULLERTON	CA	92835	3430	30	06059	33.89397383	-117.9316737	Orange County
199791	Fee-for-Service	1760549109	1760549109	1	1	HOANG, SYLVIA H MD	4/26/2010	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	62015	08	Family Practice	0	In state provider	None	2333 MOWRY AVE	STE 300	FREMONT	CA	94538	1602	01	06001	37.55614438	-121.9822469	Alameda County
199792	Fee-for-Service	1407317399	1407317399	1	1	HEARTFORD HOSPICE CARE, INC	10/28/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3 PARK PLAZA	SUITE 550	IRVINE	CA	92614	2537	30	06059	33.67760183	-117.8382953	Orange County
199793	Fee-for-Service	1629459250	1629459250	1	1	HTUN, TAYZAR MD	11/2/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	150754	41	Internal Medicine	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
199803	Fee-for-Service	1518951300	1518951300	1	40	HOAG MEMORIAL HOSPITAL	9/18/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	MOBILE	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
199816	Fee-for-Service	1700050911	1700050911	1	1	HENDERSON, ALEXA P MD	12/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	114649	41	Internal Medicine	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
199843	Fee-for-Service	1255986394	1255986394	1	1	HAGEN, KAITLIN L LMFT	9/8/2021	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
199844	Fee-for-Service	1356412266	1356412266	1	1	HUBERMAN, ARTHUR K MD	1/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	41781	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
199882	Fee-for-Service	1225658776	1225658776	1	1	HOLMES, CAITLIN A CCC-SLP	9/21/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
199900	Fee-for-Service	1699898247	1699898247	1	1	HENSLEY, MARLENE M LCSW	3/18/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE BLVD	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
199925	Fee-for-Service	1780624841	1780624841	1	1	HUNTER, CURTIS T MD	8/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99961	33	Thoracic 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
199945	Fee-for-Service	1639720790	1639720790	1	1	HOUSE OF THE RISING SUN	10/30/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 154	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
199949	Fee-for-Service	1568760718	1568760718	1	1	HEALTHY LIVING AT HOME LLC	5/10/2012	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2450 VENTURE OAKS WAY	STE 220	SACRAMENTO	CA	95833	4225	34	06067	38.608056	-121.5102555	Sacramento County
199992	Fee-for-Service	1982276341	1982276341	1	1	HONG, DANA	9/23/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	22479	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
199993	Fee-for-Service	1952578973	1952578973	1	1	HUANG, ERIC J MD	1/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	106344	13	Neurology (M.D. only)	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
199995	Fee-for-Service	1194870519	1194870519	1	1	HAN, JENISE Y NP	12/16/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	789 E COOLEY DR	None	COLTON	CA	92324	4007	36	06071	34.05795035	-117.3040272	San Bernardino County
199997	Fee-for-Service	1043575715	1043575715	1	1	HOUR, SIVHENG L MD	9/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141740	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
200050	Fee-for-Service	1811642887	1811642887	1	1	HOMESLEEPCENTERINC	2/24/2023	261QS1200X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	13563 EGBERT ST	None	SYLMAR	CA	91342	1846	19	06037	34.32512848	-118.429335	Los Angeles County
200056	Fee-for-Service	1538312426	1538312426	1	1	H A HAMOOD M D INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34404	04	Otology, Laryngology, Rhinology	0	In state provider	None	2785 PACIFIC AVE	SUITE A	LONG BEACH	CA	90806	2641	19	06037	33.807861	-118.193748	Los Angeles County
200062	Fee-for-Service	1588738462	1588738462	1	1	HANGER O & P WEST INC	12/9/2002	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1477 LINCOLN ST	None	REDDING	CA	96001	2641	45	06089	40.57851566	-122.3895308	Shasta County
200063	Fee-for-Service	1780668665	1780668665	1	1	HANS, MARK C PT	3/27/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29645 RANCHO CALIFORNIA	SUITE 234	TEMECULA	CA	92591	6200	33	06065	33.50627123	-117.1431728	Riverside County
200078	Fee-for-Service	1407317399	1407317399	1	1	HEARTFORD HOSPICE CARE, INC	10/28/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3 PARK PLAZA	SUITE 550	IRVINE	CA	92614	2537	30	06059	33.67760183	-117.8382953	Orange County
200145	Fee-for-Service	1437452943	1437452943	1	1	HO, HAREL A MD APC	8/3/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	60917	08	Family Practice	0	In state provider	None	880 S ATLANTIC BLVD	STE 302	MONTEREY PARK	CA	91754	4758	19	06037	34.05038485	-118.1383456	Los Angeles County
200155	Fee-for-Service	1811075658	1811075658	1	1	HOLM, PETER F MD	12/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39366	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
200180	Fee-for-Service	1326224080	1326224080	1	1	HUA, JOHNSON MD	4/28/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102163	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
200194	Fee-for-Service	1275983272	1275983272	1	1	HUSSAIN, FARAH LMFT	3/24/2025	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
200198	Fee-for-Service	1962897017	1962897017	1	1	HAMMER-NAHMAN, SAMUEL DPM	4/13/2020	213E00000X	NA	Other	026	PHYSICIANS	None	47	Miscellaneous	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
200209	Fee-for-Service	1104099951	1104099951	1	1	HENDRIKSZ, TAMI DO	12/10/2009	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	10308	40	Pediatrics	0	In state provider	None	160 GLEN COVE MARINA RD	#103	VALLEJO	CA	94591	7290	48	06095	38.07062486	-122.2124251	Solano County
200231	Fee-for-Service	1124248570	1124248570	1	2	HEALTH ALLIANCE MEDICAL GROU	3/14/2024	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	P A PROFESSIONAL CORPORA	17170 COLIMA RD	G	HACIENDA HEIGHTS	CA	91745	6771	19	06037	33.9907128	-117.9325812	Los Angeles County
200232	Fee-for-Service	1982068748	1982068748	1	1	HALASA, RACHELLE MD	12/9/2019	207P00000X	NA	Other	026	PHYSICIANS	162521	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
200233	Fee-for-Service	1639720790	1639720790	1	1	HOUSE OF THE RISING SUN	10/30/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 154	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
200241	Fee-for-Service	1518037027	1518037027	2	1	HARTFORD, KIMBERLEE A OD	1/1/1983	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27875 BERWICK DR	STE B	CARMEL	CA	93923	8678	27	06053	36.52204244	-121.8087006	Monterey County
200248	Fee-for-Service	1467773515	1467773515	1	1	HICKS, DEBORAH L	3/25/2014	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11370 ANDERSON ST	STE 2100	LOMA LINDA	CA	92408	3234	36	06071	34.047153	-117.2611485	San Bernardino County
200268	Fee-for-Service	1427715515	1427715515	1	3	HEALTH AND LIFE ORGANIZATION	2/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7215 55TH STREET	SUITE B	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
200278	Fee-for-Service	1568539997	1568539997	1	1	HANA, RAAFAT M MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	92830	41	Internal Medicine	0	In state provider	None	655 CENTRAL VALLEY HWY	None	SHAFTER	CA	93263	2790	15	06029	35.5017226	-119.2731485	Kern County
200285	Fee-for-Service	1578632279	1578632279	1	1	HARDY, JAMES P MD	7/11/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141159	05	Anesthesiology	0	In state provider	None	3700 CALIFORNIA STREET	None	SAN FRANCISCO	CA	94118	1618	38	06075	37.78614008	-122.4556866	San Francisco County
200300	Fee-for-Service	1841437241	1841437241	1	10	H STREET CLINIC, INC.	1/24/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1127 WILSHIRE BLVD	SUITE 707	LOS ANGELES	CA	90017	3908	19	06037	34.05270508	-118.2641005	Los Angeles County
200317	Fee-for-Service	1083037535	1083037535	1	1	HAYNES, SUETTE LMFT	5/19/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16275 MONTEREY RD	STE C	MORGAN HILL	CA	95037	5466	43	06085	37.11612997	-121.6448825	Santa Clara County
200357	Fee-for-Service	1427324821	1427324821	1	1	HORTON, LUCY E MD	7/31/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	137391	77	Infectious Disease	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
200378	Fee-for-Service	1962627943	1962627943	1	1	HORNING, JUDITH K	2/8/2015	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	16766 BERNARDO CENTER DR	STE 206	SAN DIEGO	CA	92128	2545	37	06073	33.01756519	-117.0759175	San Diego County
200399	Fee-for-Service	1093911091	1093911091	1	1	HECTOR A PAYAN M.D.	8/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4305 N MESA ST	STE A	EL PASO	TX	79902	1124	00	None	31.79736	-106.511277	El Paso County
200485	Fee-for-Service	1265469399	1265469399	1	1	HOLTAN, BRIAN A MD	5/11/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	55076	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
200492	Fee-for-Service	1033615265	1033615265	1	1	HUANG, JANE Y DO	8/9/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	17814	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
200494	Fee-for-Service	1720582018	1720582018	1	1	HEAVEY, SEAN F MD	6/10/2022	390200000X	NA	Other	026	PHYSICIANS	167099	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
200507	Fee-for-Service	1184896615	1184896615	1	1	HUGHES, JERRY R MD	12/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	22497	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3800 JANES RD	None	ARCATA	CA	95521	4742	12	06023	40.89645172	-124.0930637	Humboldt County
200509	Fee-for-Service	1669772166	1669772166	1	1	HUGHES, ADRIANE R LCSW	12/2/2023	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
200511	Fee-for-Service	1235725698	1235725698	1	1	HOPE & LIGHT HOSPICE INC	4/26/2002	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR STREET	STE 175	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
200512	Fee-for-Service	1730287129	1730287129	1	1	HUR, IN HAING MD	12/1/1982	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	36111	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1801 W ROMNEYA DR	STE 607	ANAHEIM	CA	92801	1828	30	06059	33.8506615	-117.946413	Orange County
200550	Fee-for-Service	1801034194	1801034194	1	1	HERNANDEZ, DEMITRIA D MD	10/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
200558	Fee-for-Service	1427715515	1427715515	1	3	HEALTH AND LIFE ORGANIZATION	2/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7215 55TH STREET	SUITE B	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
200561	Fee-for-Service	1679740146	1679740146	1	1	HEROPOULOS, MARIA MD INC	10/23/2018	207L00000X	NA	Other	026	PHYSICIANS	69241	05	Anesthesiology	0	In state provider	None	24451 HEALTH CENTER DR	None	LAGUNA HILLS	CA	92653	3689	30	06059	33.60848903	-117.7079742	Orange County
200562	Fee-for-Service	1578543377	1578543377	1	1	HISLE, WILLA A OD	6/1/1999	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8048 SAN MIGUEL CANYON R	None	SALINAS	CA	93907	1208	27	06053	36.8007891	-121.6653293	Monterey County
200589	Fee-for-Service	1841437241	1841437241	1	10	H STREET CLINIC, INC.	1/24/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1127 WILSHIRE BLVD	SUITE 707	LOS ANGELES	CA	90017	3908	19	06037	34.05270508	-118.2641005	Los Angeles County
200639	Fee-for-Service	1841315389	1841315389	1	1	HUCKABAY, CHRISTINA A MD	11/8/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	112856	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
200640	Fee-for-Service	1811455652	1811455652	1	2	HANSEN KWOK MD INC	6/28/2021	207RG0100X	NA	Gastroenterology	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	None	1111 EXPOSITION BLVD	STE 400A	SACRAMENTO	CA	95815	4336	34	06067	38.598876	-121.4502885	Sacramento County
200654	Fee-for-Service	1265944656	1265944656	1	1	HENDERSON, KRISTEN	1/23/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
200669	Fee-for-Service	1750543674	1750543674	1	1	HERZOG, MARY MD	6/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125262	20	Orthopedic Surgery	0	In state provider	None	1001 POTRERO AVE	RM 3A	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
200693	Fee-for-Service	1427673193	1427673193	1	1	HERSHBERGER, AMY O MD	12/27/2024	207L00000X	NA	Other	026	PHYSICIANS	188017	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
200702	Fee-for-Service	1407886989	1407886989	1	1	HALL, HEATHER M MD	8/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	86039	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
200725	Fee-for-Service	1215919121	1215919121	1	1	HESSER, SANDRA R MD	4/10/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149907	30	Radiology	0	In state provider	None	1335 BUENAVENTURA BLVD	SUITE 204	REDDING	CA	96001	0160	45	06089	40.58222519	-122.4261823	Shasta County
200729	Fee-for-Service	1114038197	1114038197	1	1	HAMMES, MARY LMFT	2/6/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
200757	Fee-for-Service	1376631945	1376631945	1	1	HARDING, MARILYN LCSW	12/30/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	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
200761	Fee-for-Service	1437396736	1437396736	1	1	HAMILTON, BRITTANI K	12/7/2016	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
200764	Fee-for-Service	1629123872	1629123872	1	1	HENNINGSEN, JOY A MD	4/16/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97969	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
200779	Fee-for-Service	1699380410	1699380410	1	1	HEART TO HEART HOME HEALTH	8/6/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18711 SHERMAN WAY	STE 106C	RESEDA	CA	91335	4086	19	06037	34.20120092	-118.5408066	Los Angeles County
200799	Fee-for-Service	1235725698	1235725698	1	1	HOPE & LIGHT HOSPICE INC	4/26/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR STREET	STE 175	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
200810	Fee-for-Service	1861459190	1861459190	1	1	HECHT, CLAUS MD	9/5/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84499	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
200811	Fee-for-Service	1457567026	1457567026	1	1	HERRERA AND OBESO	5/18/2001	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEDICAL GROUP, INC	1135 S SUNSET AVE	STE 409	WEST COVINA	CA	91790	3964	19	06037	34.06215064	-117.9453997	Los Angeles County
200828	Fee-for-Service	1407883796	1407883796	1	1	HODGES, TONY N MD	11/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	79278	41	Internal Medicine	0	In state provider	None	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	30	06059	33.715035	-117.936993	Orange County
200831	Fee-for-Service	1346985777	1346985777	1	1	HERNANDEZ, ERNESTO NP	11/8/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5401 WHITE LANE	None	BAKERSFIELD	CA	93309	6279	15	06029	35.31803715	-119.0627831	Kern County
200839	Fee-for-Service	1023054814	1023054814	1	1	HWANG, ANDREW J MD	1/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	105533	30	Radiology	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
200887	Fee-for-Service	1255353835	1255353835	1	1	HENDERSON, STEVEN E MD	1/1/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42695	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
200918	Fee-for-Service	1023079183	1023079183	1	2	HAIDER SPINE CENTER MEDICAL	12/1/1999	193200000X	NA	Other	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	6276 RIVER CREST DR	STE. A	RIVERSIDE	CA	92507	0783	33	06065	33.93782112	-117.2922842	Riverside County
200921	Fee-for-Service	1780335034	1780335034	1	1	HARRIS, ANTONIO D LCSW	11/29/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1850 NORTH RIVERSIDE AVE	STE 180	RIVERSIDE	CA	92376	8071	33	06065	34.132905	-117.3704675	San Bernardino County
200926	Fee-for-Service	1114372158	1114372158	1	1	HANGUL ACUPUNCTURE INC	3/14/2017	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	7860 IMPERIAL HWY	SUITE A	DOWNEY	CA	90242	3464	19	06037	33.92529838	-118.1547578	Los Angeles County
200938	Fee-for-Service	1922455849	1922455849	1	1	HINSON, KYLE A LCSW	6/17/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16800 DEVONSHIRE ST	212	GRANADA HILLS	CA	91344	7403	19	06037	34.25745651	-118.4982159	Los Angeles County
200956	Fee-for-Service	1093286460	1093286460	1	1	HONG, JENNIFER LMFT	7/27/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2309 PACIFIC COAST	STE 202	HERMOSA BEACH	CA	90254	2751	19	06037	33.87101437	-118.3948248	Los Angeles County
200960	Fee-for-Service	1073693461	1073693461	1	1	HOHENTHANER, PETER W	3/5/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	534 PINE ST	STE A	STOCKTON	CA	95204	5536	39	06077	37.97439027	-121.2897236	San Joaquin County
200969	Fee-for-Service	1326589052	1326589052	1	1	HABIB, MARK G OD	3/20/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	43112 15TH STREET WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
200988	Fee-for-Service	1740228634	1740228634	1	1	HOPKINS, REBECCA J MD	5/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	80673	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
201049	Fee-for-Service	1013099902	1013099902	1	1	HAGOS, ASMERET LMFT	4/2/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	265 S RANDOLPH AVE	STE 120	BREA	CA	92821	5798	30	06059	33.91513051	-117.8897392	Orange County
201058	Fee-for-Service	1376721050	1376721050	1	1	HEATER, GALE E LMFT	8/27/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39812 MISSION BLVD	STE 106	FREMONT	CA	94539	3024	01	06001	37.5580997	-121.9527524	Alameda County
201065	Fee-for-Service	1134658958	1134658958	1	1	HUGHES, MICHAEL S MD	1/30/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	169768	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
201068	Fee-for-Service	1285988295	1285988295	1	1	HOANG, MIKE PSYD	7/22/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
201078	Fee-for-Service	1033443890	1033443890	1	1	HOLLEY, ANNA G OT	10/23/2009	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	15454 GALE AVE	STE F	HACIENDA HEIGHTS	CA	91745	1500	19	06037	34.01293546	-117.9699259	Los Angeles County
201090	Fee-for-Service	1871771428	1871771428	1	1	HERMOSILLO-HAHN, ANDREA	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
201139	Fee-for-Service	1043298938	1043298938	1	1	HIURA, RONALD N OD	9/17/1980	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1418 POLK ST	None	SAN FRANCISCO	CA	94109	4616	38	06075	37.78995542	-122.4205306	San Francisco County
201153	Fee-for-Service	1477549426	1477549426	1	1	HARNESS, JAY K MD	4/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70155	02	General Surgery	0	In state provider	A MEDICAL CORP	1000 W LA VENTA AVENUE	STE 460	ORANGE	CA	92868	4304	30	06059	33.78028244	-117.8635552	Orange County
201167	Fee-for-Service	1881794618	1881794618	1	1	HENKE, PETER K MD	11/6/2020	2086S0129X	NA	General Surgery	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1500 EAST MEDICAL CENTER	2ND FLOOR TAUBMAN CTR RE	ANN ARBOR	MI	48109	0329	00	None	42.28391347	-83.72716554	Washtenaw County
201204	Fee-for-Service	1023079183	1023079183	1	2	HAIDER SPINE CENTER MEDICAL	1/19/2019	193200000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	6276 RIVER CREST DR	STE. A	RIVERSIDE	CA	92507	0783	33	06065	33.93782112	-117.2922842	Riverside County
201210	Fee-for-Service	1982951851	1982951851	1	1	HASA, JENNIFER E MD	7/26/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	162784	None	None	0	In state provider	None	19270 SONOMA HIGHWAY 12	None	SONOMA	CA	95476	5414	49	06097	38.29871411	-122.4751509	Sonoma County
201225	Fee-for-Service	1952339111	1952339111	1	1	HACKERT, LYNNE A MD	8/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82209	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
201243	Fee-for-Service	1023702784	1023702784	1	1	HEALTHIER KIDS FOUNDATION	3/21/2025	251B00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	4040 MOORPARK AVE	STE 100	SAN JOSE	CA	95117	1851	43	06085	37.31582951	-121.97358	Santa Clara County
201263	Fee-for-Service	1861673998	1861673998	1	1	HINOJOSA, MARCELO W MD	9/6/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	94553	02	General Surgery	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
201276	Fee-for-Service	1861575383	1861575383	1	1	HAGHI, MARJAN MD	8/2/2012	2080P0205X	NA	Endocrinology	026	PHYSICIANS	61422	67	Endocrinology	0	In state provider	None	PUEBLO AT BATH ST	None	SANTA BARBARA	CA	93105	4311	42	06083	34.430526	-119.72196	Santa Barbara County
201278	Fee-for-Service	1861784860	1861784860	1	1	HOQUE, KRISTINA E MD	11/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	125036	30	Radiology	0	In state provider	None	4640 ADMIRALTY WAY	SUITE 102	MARINA DEL REY	CA	90292	6629	19	06037	33.98120707	-118.4409729	Los Angeles County
201304	Fee-for-Service	1720198203	1720198203	1	1	HANSEN, JAMES P MD	10/20/2008	207R00000X	NA	Other	026	PHYSICIANS	41832	41	Internal Medicine	0	In state provider	None	2001 UNION ST	# 400	SAN FRANCISCO	CA	94123	4109	38	06075	37.7974427	-122.432532	San Francisco County
201364	Fee-for-Service	1942469952	1942469952	1	1	HEYWOOD, CHRISTIAN S MD	5/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108711	20	Orthopedic Surgery	0	In state provider	None	4140 JADE ST	STE 100	CAPITOLA	CA	95010	3940	44	06087	36.97026148	-121.9638195	Santa Cruz County
201376	Fee-for-Service	1700521697	1700521697	1	1	HONE, TERESINA M LMFT	8/24/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1656 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.6893627	-118.1604668	Los Angeles County
201429	Fee-for-Service	1215565601	1215565601	1	1	HEER, HAILEY M MD	7/28/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	185434	None	None	0	In state provider	None	800 S FAIRMONT ST	STE 310	PASADENA	CA	91105	3153	19	06037	34.13193177	-118.1517805	Los Angeles County
201434	Fee-for-Service	1811012313	1811012313	1	1	HOUGHTON, GAEL M CRNA	9/14/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92111	2418	37	06073	32.79293009	-117.0952438	San Diego County
201440	Fee-for-Service	1477549426	1477549426	1	1	HARNESS, JAY K MD	4/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70155	67	Endocrinology	0	In state provider	A MEDICAL CORP	1000 W LA VENTA AVENUE	STE 460	ORANGE	CA	92868	4304	30	06059	33.78028244	-117.8635552	Orange County
201445	Fee-for-Service	1093857104	1093857104	1	1	HARDEN, ELIZABETH M LMFT	8/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7171 ALVARADO RD	STE 100A	LA MESA	CA	91942	8996	37	06073	32.77267798	-117.0445155	San Diego County
201467	Fee-for-Service	1508138447	1508138447	1	1	HAUSIG, IMMANUEL D DO	6/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11913	01	General Practice	0	In state provider	MCMF	7677 CENTER AVE	STE 100	HUNTINGTON BEACH	CA	92647	3030	30	06059	33.736257	-117.995535	Orange County
201478	Fee-for-Service	1366911786	1366911786	1	1	HAJY ISEYEDSOLEIMAN, FARIBA	12/3/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	CNP	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
201523	Fee-for-Service	1609950237	1609950237	1	2	HUNTINGTON FOUNDATION	8/1/1995	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEDICAL GROUP INC	800 S SANTA ANITA AVE	STE 201	ARCADIA	CA	91006	3555	19	06037	34.131114	-118.031171	Los Angeles County
201563	Fee-for-Service	1043745052	1043745052	1	1	HERNANDEZ, BRIAN S MD	8/10/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	159274	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
201565	Fee-for-Service	1861575383	1861575383	1	1	HAGHI, MARJAN MD	8/2/2012	2080P0205X	NA	Endocrinology	026	PHYSICIANS	61422	40	Pediatrics	0	In state provider	None	PUEBLO AT BATH ST	None	SANTA BARBARA	CA	93105	4311	42	06083	34.430526	-119.72196	Santa Barbara County
201570	Fee-for-Service	1760448302	1760448302	1	1	HOANG-XUAN, TUAN A	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7954	None	None	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
201571	Fee-for-Service	1316234156	1316234156	1	1	HSIA, JENNIFER K MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122541	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
201574	Fee-for-Service	1063585487	1063585487	1	1	HAUSNER ROBERT SM	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	26534	36	Psychiatry	0	In state provider	None	2354 POST ST	None	SAN FRANCISCO	CA	94115	3424	38	06075	37.78419694	-122.4407384	San Francisco County
201586	Fee-for-Service	1073895868	1073895868	1	1	HWU, PAUL B MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124757	45	Nephrology (Renal-Kidney)	0	In state provider	None	120 E EMERSON AVE	None	MONTEREY PARK	CA	91755	1709	19	06037	34.06610653	-118.1219085	Los Angeles County
201634	Fee-for-Service	1619219979	1619219979	1	1	HAWTHORNE, NOAH F MD	9/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134948	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
201639	Fee-for-Service	1588782270	1588782270	1	1	HIPOLITO, RAEDEL C LMFT	11/8/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
201643	Fee-for-Service	1104321959	1104321959	1	6	HEALTH DIAGNOSTICS OF CALIFO	10/20/2020	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	15775 LAGUNA CANYON RD	SUITE 140	IRVINE	CA	92618	3190	30	06059	33.6663745	-117.760682	Orange County
201650	Fee-for-Service	1952478760	1952478760	1	1	HARA, JIMMY H MD	4/12/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	24227	01	General Practice	0	In state provider	None	1072 GAYLEY AVE	None	LOS ANGELES	CA	90024	3402	19	06037	34.06071361	-118.4468596	Los Angeles County
201695	Fee-for-Service	1568913929	1568913929	1	1	HUTCHINSON, CASSANDRA R LMFT	12/9/2020	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST 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
201702	Fee-for-Service	1699065342	1699065342	1	1	HUYNH, MICHAEL V MD	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131349	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
201728	Fee-for-Service	1477549426	1477549426	1	1	HARNESS, JAY K MD	4/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70155	78	Neoplastic Diseases/Oncology	0	In state provider	A MEDICAL CORP	1000 W LA VENTA AVENUE	STE 460	ORANGE	CA	92868	4304	30	06059	33.78028244	-117.8635552	Orange County
201781	Fee-for-Service	1538459714	1538459714	1	1	HAYES, DAPHNE R MD	11/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112520	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
201816	Fee-for-Service	1770569279	1770569279	1	1	HEALTHCARE AUTHORITY OF	12/17/2008	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LAUDERDALE	201 W AVALON AVENUE	None	MUSCLE SHOALS	AL	35661	2805	00	None	34.747272	-87.6763215	Colbert County
201817	Fee-for-Service	1477517829	1477517829	1	1	HOME OF GUIDING HANDS CORP	12/14/1982	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	12116 GAY RIO DR	None	LAKESIDE	CA	92040	4911	37	06073	32.83891296	-116.9289969	San Diego County
201821	Fee-for-Service	1548606205	1548606205	1	1	HEROLD, RICHARD J MD	12/13/2019	207P00000X	NA	Other	026	PHYSICIANS	163559	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
201824	Fee-for-Service	1598817876	1598817876	1	1	HOLCROFT, JOHN J MD	8/15/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117488	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
201842	Fee-for-Service	1750568937	1750568937	1	1	HEALY, MATTHEW P MD	12/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103687	None	None	0	In state provider	None	6655 ALVARADO RD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
201884	Fee-for-Service	1073895868	1073895868	1	1	HWU, PAUL B MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124757	41	Internal Medicine	0	In state provider	None	120 E EMERSON AVE	None	MONTEREY PARK	CA	91755	1709	19	06037	34.06610653	-118.1219085	Los Angeles County
201931	Fee-for-Service	1104321959	1104321959	1	6	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	15775 LAGUNA CANYON RD	SUITE 140	IRVINE	CA	92618	3190	30	06059	33.6663745	-117.760682	Orange County
201937	Fee-for-Service	1952478760	1952478760	1	1	HARA, JIMMY H MD	4/12/1978	No Taxonomy Provided	NA	None	026	PHYSICIANS	24227	08	Family Practice	0	In state provider	None	1072 GAYLEY AVE	None	LOS ANGELES	CA	90024	3402	19	06037	34.06071361	-118.4468596	Los Angeles County
201951	Fee-for-Service	1972946564	1972946564	1	1	HUNG, LI-CHI V MD	8/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134077	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
201955	Fee-for-Service	1245849926	1245849926	1	1	HENARY, MARY MD	4/20/2023	208M00000X	NA	Other	026	PHYSICIANS	184657	None	None	0	In state provider	None	1250 16TH STREET	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
201974	Fee-for-Service	1437385598	1437385598	1	1	HESLET, ERICK S LMFT	6/12/2020	106H00000X	NA	Mental Health Outpatient Services	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
201981	Fee-for-Service	1952515801	1952515801	1	1	HUMBOLDT STATE UNIVERSIT	11/14/2006	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	STUDENT HEALTH CNT PHARM	PLAZA AVE, LIBRARY CIR	None	ARCATA	CA	95521	8222	12	06023	40.87718316	-124.0811195	Humboldt County
201984	Fee-for-Service	1447290598	1447290598	1	1	HEBDON, BRUCE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5121 COTTONWOOD ST	None	SALT LAKE CTY	UT	84107	5701	00	None	40.659588	-111.891798	Salt Lake County
202000	Fee-for-Service	1710067863	1710067863	1	1	HARRIS, ANNA LEE MD	8/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	74994	05	Anesthesiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
202047	Fee-for-Service	1518951300	1518951300	1	43	HOAG MEMORIAL HOSPITAL	3/25/2021	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	351 HOSPITAL ROAD	SUITE 514	NEWPORT BEACH	CA	92663	3500	30	06059	33.62579141	-117.9299554	Orange County
202069	Fee-for-Service	1689177453	1689177453	1	1	HOLMES, G. ALDEN W MD	8/22/2022	207N00000X	NA	Dermatology	026	PHYSICIANS	164631	None	None	0	In state provider	None	4300 ROSE DR	None	YORBA LINDA	CA	92886	2026	30	06059	33.89815111	-117.8419708	Orange County
202104	Fee-for-Service	1770569279	1770569279	1	1	HEALTHCARE AUTHORITY OF	12/17/2008	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	LAUDERDALE	201 W AVALON AVENUE	None	MUSCLE SHOALS	AL	35661	2805	00	None	34.747272	-87.6763215	Colbert County
202110	Fee-for-Service	1427377019	1427377019	1	1	HERNANDEZ, NATHANIEL D MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141384	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
202113	Fee-for-Service	1851095160	1851095160	1	1	HABIBIS PHARMACY LLC	6/3/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	340 4TH AVE	STE 1	CHULA VISTA	CA	91910	3882	37	06073	32.63831293	-117.0833536	San Diego County
202116	Fee-for-Service	1659356111	1659356111	1	1	HUMANAGOOD NORCAL	3/12/1993	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	800 BLOSSOM HILL RD	None	LOS GATOS	CA	95032	3562	43	06085	37.23497986	-121.9589778	Santa Clara County
202142	Fee-for-Service	1043291834	1043291834	1	1	HUBBARD, DIANNE C MD	7/31/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	62199	40	Pediatrics	0	In state provider	None	4770 W HERNDON AVE	None	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
202147	Fee-for-Service	1720306368	1720306368	1	1	HEMET HEALTHCARE MEDICAL	3/18/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	CORPORATION	1275 E LATHAM AVE	SUITE C	HEMET	CA	92543	4424	33	06065	33.74938248	-116.9589555	Riverside County
202153	Fee-for-Service	1588706592	1588706592	1	1	HILLIARD, DIANE L LCSW	10/30/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	854 MAGNOLIA AVE	STE 201	CORONA	CA	92879	3109	33	06065	33.8605591	-117.5513844	Riverside County
202186	Fee-for-Service	1104321959	1104321959	1	24	HEALTH DIAGNOSTICS OF CALIFO	7/8/2024	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	1005 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6913	38	06075	37.78499871	-122.4213851	San Francisco County
202207	Fee-for-Service	1467604934	1467604934	1	1	HOLLEY, JENNIFER M LAC	5/2/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	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
202220	Fee-for-Service	1972696094	1972696094	1	1	HAYMOND, REENA NP	8/21/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
202224	Fee-for-Service	1417453564	1417453564	1	1	HANSEN, ZACHARY H MD	11/29/2021	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
202238	Fee-for-Service	1316182405	1316182405	1	1	HASSAN, BENJAMIN J MD	8/25/2021	207R00000X	NA	Other	026	PHYSICIANS	136456	None	None	0	In state provider	None	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	42	06083	34.42967671	-119.7228362	Santa Barbara County
202248	Fee-for-Service	1124103502	1124103502	1	1	HOUCK, DAVID M	11/21/2006	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1650 RESPONSE RD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
202250	Fee-for-Service	1972803120	1972803120	1	1	HAUPTMAN, JASON S MD	7/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	98727	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
202273	Fee-for-Service	1285772343	1285772343	2	1	HOMETOWN MEDICAL SUPPLIES, L	7/11/2017	332BC3200X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1274 ALMA CT	None	SAN JOSE	CA	95112	5940	43	06085	37.31842904	-121.8734564	Santa Clara County
202300	Fee-for-Service	1235320938	1235320938	1	1	HI-DESERT MEDICAL CENTER	8/18/2017	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	ANESTHESIOLOGY GROUP	6601 WHITE FEATHER ROAD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
202328	Fee-for-Service	1376773242	1376773242	1	1	HONG, ROGER MD	9/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108458	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
202337	Fee-for-Service	1588601371	1588601371	1	1	HEINLEN, STEPHANIE S MD	4/5/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	97464	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
202343	Fee-for-Service	1164838009	1164838009	1	1	HEATH, BLAIRE A DO	7/27/2020	390200000X	NA	Other	026	PHYSICIANS	16778	36	Psychiatry	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
202368	Fee-for-Service	1619255296	1619255296	1	1	HOWARD-BALMER, JULIE L LMFT	10/13/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
202372	Fee-for-Service	1992115463	1992115463	1	1	HINTON, DOUGLAS W	8/29/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
202374	Fee-for-Service	1518951300	1518951300	1	42	HOAG MEMORIAL HOSPITAL	12/7/2020	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
202399	Fee-for-Service	1720163728	1720163728	1	1	HOURANY, JOSEPH MD	3/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	55807	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	9655 MONTE VISTA AVE	STE 402	MONTCLAIR	CA	91763	2238	36	06071	34.07991502	-117.6982245	San Bernardino County
202404	Fee-for-Service	1023052248	1023052248	1	1	HENSEL, ALVIN L MD	9/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	24800	None	None	0	In state provider	None	240 SPRUCE ST	None	GRIDLEY	CA	95948	2216	04	06007	39.36701046	-121.6895355	Butte County
202428	Fee-for-Service	1669715157	1669715157	1	1	HOWARD, AMBER N LMFT	11/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1740 PLUM LN	STE B	REDLANDS	CA	92374	0109	36	06071	34.06899169	-117.2145582	San Bernardino County
202434	Fee-for-Service	1720306368	1720306368	1	1	HEMET HEALTHCARE MEDICAL	3/18/2014	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CORPORATION	1275 E LATHAM AVE	SUITE C	HEMET	CA	92543	4424	33	06065	33.74938248	-116.9589555	Riverside County
202453	Fee-for-Service	1881965838	1881965838	1	1	HAHM, SCOTT A MD	6/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	123102	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
202463	Fee-for-Service	1164647244	1164647244	1	1	HARB, MOUCHIR MD, LTD	12/15/2008	2084N0400X	NA	Neurology	026	PHYSICIANS	-	13	Neurology (M.D. only)	1	Border provider	None	5380 S RAINBOW BLVD	#236	LAS VEGAS	NV	89118	1879	00	None	36.09117	-115.242894	Clark County
202472	Fee-for-Service	1104321959	1104321959	1	24	HEALTH DIAGNOSTICS OF CALIFO	2/27/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	1005 VAN NESS AVE	None	SAN FRANCISCO	CA	94109	6913	38	06075	37.78499871	-122.4213851	San Francisco County
202494	Fee-for-Service	1932356649	1932356649	1	1	HOWELL, AMANDA I MD	9/7/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	105123	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
202508	Fee-for-Service	1194721803	1194721803	1	1	HARTZ, WILLIAM H MD	4/9/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	149164	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
202516	Fee-for-Service	1174690994	1174690994	1	1	HOANG, THANH V MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	63933	41	Internal Medicine	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
202517	Fee-for-Service	1679954143	1679954143	1	1	HONG, JOE MD	11/23/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	154205	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
202554	Fee-for-Service	1588071112	1588071112	1	1	HELPFUL HANDS HOSPICE CARE	7/23/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	2670 S MYRTLE AVE	SUITE D-203	MONROVIA	CA	91016	8220	19	06037	34.11701663	-118.0013156	Los Angeles County
202569	Fee-for-Service	1205447976	1205447976	1	1	HEALTHY PEOPLE HOME CARE,	12/1/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14545 FRIAR ST	STE 305	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
202570	Fee-for-Service	1811967375	1811967375	1	1	HAQUE, MOFIZ MD	7/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	80316	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
202577	Fee-for-Service	1821176587	1821176587	1	1	HWANG, A GRACE E MD	2/28/1986	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	40850	08	Family Practice	0	In state provider	None	835 SEQUOIA AVE	None	LINDSAY	CA	93247	1424	54	06107	36.21351337	-119.0961199	Tulare County
202587	Fee-for-Service	1235320938	1235320938	1	1	HI-DESERT MEDICAL CENTER	4/2/2008	193400000X	NA	Other	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	ANESTHESIOLOGY GROUP	6601 WHITE FEATHER ROAD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
202606	Fee-for-Service	1538466362	1538466362	1	1	HUYNH, JACOB L MD	5/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	54539	08	Family Practice	0	In state provider	None	15725 WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
202661	Fee-for-Service	1518951300	1518951300	1	42	HOAG MEMORIAL HOSPITAL	12/7/2020	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	16200 SAND CANYON AVE	None	IRVINE	CA	92618	3714	30	06059	33.6617581	-117.7736362	Orange County
202664	Fee-for-Service	1861915043	1861915043	1	1	HODGDON, MAYARI S PSYD	10/8/2021	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
202686	Fee-for-Service	1720163728	1720163728	1	1	HOURANY, JOSEPH MD	3/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	55807	41	Internal Medicine	0	In state provider	None	9655 MONTE VISTA AVE	STE 402	MONTCLAIR	CA	91763	2238	36	06071	34.07991502	-117.6982245	San Bernardino County
202734	Fee-for-Service	1699762070	1699762070	1	1	HERSHMAN, DONALD E DPM	1/1/1982	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	450 SUTTER ST	RM 1101	SAN FRANCISCO	CA	94108	3913	38	06075	37.78934929	-122.4077786	San Francisco County
202781	Fee-for-Service	1104944412	1104944412	1	1	HOLMES, GLADYS LMFT	3/9/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	40289	-	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
202805	Fee-for-Service	1093334385	1093334385	1	1	HERNANDEZ CASTILLO, MANLIO S	9/5/2023	208M00000X	NA	Other	026	PHYSICIANS	186577	None	None	0	In state provider	MD	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
202816	Fee-for-Service	1811381825	1811381825	1	1	HUSSAIN, SANDAL MD	7/16/2021	2080P0204X	NA	Other	026	PHYSICIANS	171791	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
202821	Fee-for-Service	1487730909	1487730909	1	1	HERENYIOVA, MARIA MD	2/23/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82536	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
202831	Fee-for-Service	1326389560	1326389560	1	1	HARRIS, JENNIFER R LMFT	12/28/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	520 CHADBOURNE RD	None	FAIRFIELD	CA	94534	0000	48	06095	38.235248	-122.0817079	Solano County
202834	Fee-for-Service	1578084604	1578084604	1	1	HERNANDEZ RODRIGUEZ, JULIO I	10/14/2020	390200000X	NA	Other	026	PHYSICIANS	167448	08	Family Practice	0	In state provider	VAN ALEXANDER MD	450 E HUNTINGTON DR	None	ARCADIA	CA	91006	3748	19	06037	34.14015053	-118.0208745	Los Angeles County
202837	Fee-for-Service	1588071112	1588071112	1	1	HELPFUL HANDS HOSPICE CARE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	2670 S MYRTLE AVE	SUITE D-203	MONROVIA	CA	91016	8220	19	06037	34.11701663	-118.0013156	Los Angeles County
202859	Fee-for-Service	1366463879	1366463879	1	1	HENRETIG, ROBERT D MD	2/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	16850	30	Radiology	0	In state provider	None	4601 TELPHONE RD	STE 102	VENTURA	CA	93003	5670	56	06111	34.25783504	-119.2351187	Ventura County
202864	Fee-for-Service	1821176587	1821176587	1	1	HWANG, A GRACE E MD	2/28/1986	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	40850	40	Pediatrics	0	In state provider	None	835 SEQUOIA AVE	None	LINDSAY	CA	93247	1424	54	06107	36.21351337	-119.0961199	Tulare County
202871	Fee-for-Service	1083781900	1083781900	1	1	HARDEBECK, ANNE L MD	4/8/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	70425	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
202877	Fee-for-Service	1528378486	1528378486	1	1	HARRIS, STEPHANIE L CRNA	1/24/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	35-800 BOB HOPE DR	STE 100	RANCHO MIRAGE	CA	92270	1739	33	06065	33.78398109	-116.4059049	Riverside County
202880	Fee-for-Service	1093070260	1093070260	1	1	HOROWITZ, ARTHUR J LCSW	6/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
202906	Fee-for-Service	1255330833	1255330833	1	1	HARTZMAN, STEVEN MD	1/1/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	53570	None	None	0	In state provider	None	401 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4227	42	06083	34.42940104	-119.7230763	Santa Barbara County
202926	Fee-for-Service	1811273865	1811273865	1	1	HEALTHRIGHT 360	3/28/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	145 WEST 22ND STREET	1ST FLOOR	LOS ANGELES	CA	90007	1405	19	06037	34.0290608	-118.2680191	Los Angeles County
202950	Fee-for-Service	1518951300	1518951300	1	39	HOAG MEMORIAL HOSPITAL	6/12/2018	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	REHABILITATION	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
202977	Fee-for-Service	1578513230	1578513230	2	1	HAHN, HYUNDONG S MD	10/4/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	36	Psychiatry	0	In state provider	None	615 WEST AVE L	None	LANCASTER	CA	93545	7211	19	06037	34.6603515	-118.1419695	Los Angeles County
203014	Fee-for-Service	1629795695	1629795695	1	1	HARRELL, ANASTASIA E PHD	11/11/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
203020	Fee-for-Service	1245299619	1245299619	1	1	HOLSTINE, SUSAN DO	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
203077	Fee-for-Service	1700382694	1700382694	1	1	HESTER, JONATHAN D MD	8/21/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2874 N CARSON ST	STE 300	CARSON CITY	NV	89706	1683	00	None	39.185271	-119.7710595	Consolidated Municipality of Carson City
203093	Fee-for-Service	1902340417	1902340417	1	1	HARRIS, KATIE E CNM	3/1/2019	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
203110	Fee-for-Service	1619194446	1619194446	1	1	HALPERIN, GABRIEL J DPM	3/1/2001	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3616 E 1ST ST	None	LOS ANGELES	CA	90063	2326	19	06037	34.03597969	-118.1884647	Los Angeles County
203121	Fee-for-Service	1134274129	1134274129	1	1	HEISEL, NANCY J MD	1/10/2018	207R00000X	NA	Other	026	PHYSICIANS	145275	41	Internal Medicine	0	In state provider	None	6955 EL CAMINO REAL	STE 101	ATASCADERO	CA	93422	4216	40	06079	35.48656009	-120.6652493	San Luis Obispo County
203145	Fee-for-Service	1942754973	1942754973	1	1	HERBERT, JOYCE V NP	11/16/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3733 SAN DIMAS ST	STE 104	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
203150	Fee-for-Service	1518913607	1518913607	1	1	HCA HEALTH SERVICES OF NEW	6/29/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HAMPSHIRE	333 BORTHWICK AVE	None	PORTSMOUTH	NH	03801	7128	00	None	43.06383567	-70.7900637	Rockingham County
203156	Fee-for-Service	1083781900	1083781900	1	1	HARDEBECK, ANNE L MD	4/8/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	70425	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
203157	Fee-for-Service	1225126899	1225126899	1	1	HUANG, CHRIS MD	3/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81534	05	Anesthesiology	0	In state provider	None	6969 BROCKTON AVE	STE B	RIVERSIDE	CA	92506	3813	33	06065	33.94701	-117.396786	Riverside County
203165	Fee-for-Service	1770796773	1770796773	1	1	HEER, NONA K LCSW	10/5/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1003 COURT ST	None	WOODLAND	CA	95695	3520	57	06113	38.67874747	-121.7671425	Yolo County
203176	Fee-for-Service	1609212281	1609212281	1	1	HANNA, GEORGE MD	9/18/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	131944	14	Neurological Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
203197	Fee-for-Service	1265061857	1265061857	1	1	HABIBI, AARASH MD	6/22/2023	207P00000X	NA	Other	026	PHYSICIANS	184434	None	None	0	In state provider	None	726 4TH ST	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
203198	Fee-for-Service	1821471442	1821471442	1	1	HABIB, ALI S DO	8/17/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	16412	41	Internal Medicine	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
203213	Fee-for-Service	1477083434	1477083434	1	1	HUFF, TARA LCSW	12/30/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	733 CEDAR STREET	None	GARBERVILLE	CA	95542	3201	12	06023	40.10148699	-123.7927018	Humboldt County
203295	Fee-for-Service	1932410198	1932410198	1	1	HERNANDEZ ARCHER, RAQUEL G M	12/15/2023	207L00000X	NA	Other	026	PHYSICIANS	20993	None	None	0	In state provider	D	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	37	06073	33.1857	-117.290538	San Diego County
203301	Fee-for-Service	1144365529	1144365529	1	1	HAN, MICHAEL Y MD	9/19/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	73534	20	Orthopedic Surgery	0	In state provider	None	3000 Q STREET	4TH FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
203312	Fee-for-Service	1649358243	1649358243	1	1	HADDOW, GORDON R MD	7/31/1990	207L00000X	NA	Other	026	PHYSICIANS	48539	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
203320	Fee-for-Service	1629335476	1629335476	1	1	HWONG, JAMES S MD	6/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149247	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
203324	Fee-for-Service	1295762813	1295762813	1	1	HUANG, SAMUEL Y OD	1/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	140 W VALLEY BLVD	STE 115	SAN GABRIEL	CA	91776	3784	19	06037	34.07958215	-118.1021957	Los Angeles County
203339	Fee-for-Service	1932331113	1932331113	1	2	HARARAH, AMANY I PHD	8/9/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3694 HILBORN RD	STE 150	FAIRFIELD	CA	94534	7988	48	06095	38.29483631	-122.0362992	Solano County
203341	Fee-for-Service	1487630141	1487630141	1	1	HANSON, ROBIN L MD	6/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38443	40	Pediatrics	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
203346	Fee-for-Service	1982982849	1982982849	1	1	HUYNH, LILY OD	4/16/2025	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
203356	Fee-for-Service	1730684739	1730684739	1	1	HU, MELODY Y MD	10/14/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	164981	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
203358	Fee-for-Service	1417056904	1417056904	1	1	HUANG, CHARLES L MD	5/29/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	170143	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
203359	Fee-for-Service	1508974536	1508974536	1	1	HALLAM, GARY L MD	2/23/1982	207P00000X	NA	Other	026	PHYSICIANS	24861	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
203377	Fee-for-Service	1750450805	1750450805	1	1	HACKER, SCOTT A MD	8/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83881	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
203393	Fee-for-Service	1477536704	1477536704	1	1	HOBEL, CALVIN J	10/25/1991	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	26317	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
203415	Fee-for-Service	1275043911	1275043911	1	1	HUI, CHANNING L DO	9/25/2020	207P00000X	NA	Other	026	PHYSICIANS	18334	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
203420	Fee-for-Service	1073683546	1073683546	1	1	HERNANDEZ, JOHN M MD	7/31/1987	207R00000X	NA	Other	026	PHYSICIANS	42641	41	Internal Medicine	0	In state provider	None	526 N MONTEBELLO BLVD	None	MONTEBELLO	CA	90640	3630	19	06037	34.01812564	-118.1057128	Los Angeles County
203436	Fee-for-Service	1518913607	1518913607	1	1	HCA HEALTH SERVICES OF NEW	6/29/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HAMPSHIRE	333 BORTHWICK AVE	None	PORTSMOUTH	NH	03801	7128	00	None	43.06383567	-70.7900637	Rockingham County
203455	Fee-for-Service	1568467264	1568467264	1	1	HUNTINGTON BEACH FIRE	1/31/1993	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	DEPARTMENT	2000 MAIN ST	None	HUNTINGTON BEACH	CA	92648	2702	30	06059	33.67763296	-118.0015237	Orange County
203469	Fee-for-Service	1205367729	1205367729	1	1	HUANG, DAVID MD	7/20/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	159078	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
203500	Fee-for-Service	1609978345	1609978345	1	1	HINTON,RAYMOND K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	DIXIE REGIONAL MED CTR	1380 E MEDICAL CENTER DR	None	ST GEORGE	UT	84790	0000	00	None	37.097622	-113.553828	Washington County
203534	Fee-for-Service	1386710887	1386710887	1	1	HAN, YAN QING	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	HANS ACUPUNCTURE & HERBS	1200 S DIAMOND BAR BLVD	STE 205	DIAMOND BAR	CA	91765	2298	19	06037	34.00061637	-117.8112132	Los Angeles County
203559	Fee-for-Service	1174081905	1174081905	1	1	HOLTON, MELISSA D NP	6/8/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	30	06059	33.74496	-117.818857	Orange County
203569	Fee-for-Service	1407002157	1407002157	1	1	HSYEH, HSIANG FENG LMFT	10/18/2023	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
203576	Fee-for-Service	1932145257	1932145257	1	1	HOUGH, MICHAEL F CRNA	2/8/2015	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	05	Anesthesiology	0	In state provider	None	1141 ROSE AVE	None	SELMA	CA	93662	3241	10	06019	36.56881144	-119.5985344	Fresno County
203594	Fee-for-Service	1043321185	1043321185	1	1	HIGH DESERT CARDIO PULM	1/31/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	16017 TUSCOLA RD	STE A	APPLE VALLEY	CA	92307	1317	36	06071	34.542252	-117.2692645	San Bernardino County
203627	Fee-for-Service	1992095301	1992095301	1	1	HEALTH DIAGNOSTICS OF	2/7/2017	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	345 CONVENTION WAY	SUITE D-1	REDWOOD CITY	CA	94063	1444	41	06081	37.49391347	-122.2285705	San Mateo County
203647	Fee-for-Service	1508061300	1508061300	1	1	HUANG, EDMUND MD	6/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81770	45	Nephrology (Renal-Kidney)	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
203677	Fee-for-Service	1295795177	1295795177	1	1	HERZOG, ERIC	10/16/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	66400	None	None	0	In state provider	None	1114 6TH ST	None	MODESTO	CA	95354	2203	50	06099	37.63901905	-121.0057149	Stanislaus County
203679	Fee-for-Service	1912378324	1912378324	1	2	HUNTINGTON SPECIALIST &	5/4/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	None	5353 G STREET	None	CHINO	CA	91710	5249	36	06071	34.00987149	-117.6880905	San Bernardino County
203681	Fee-for-Service	1881726685	1881726685	1	1	HOLLANDER, TERESA D MD	10/31/1990	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	71329	None	None	0	In state provider	None	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	19	06037	34.098408	-118.296167	Los Angeles County
203697	Fee-for-Service	1679831515	1679831515	1	1	HOW, POH C MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127698	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
203698	Fee-for-Service	1184231409	1184231409	1	1	HUA, ORIANA O PT	10/7/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	39650 LIBERTY ST	STE 310	FREMONT	CA	94358	2227	01	06001	37.54662058	-121.9736002	Alameda County
203700	Fee-for-Service	1295740702	1295740702	1	1	HATTENHAUER, 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	3181 SW SAM JACKSON PARK	None	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
203701	Fee-for-Service	1275043911	1275043911	1	1	HUI, CHANNING L DO	9/25/2020	207P00000X	NA	Other	026	PHYSICIANS	18334	70	Clinic (mixed specialty)	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
203710	Fee-for-Service	1437201670	1437201670	1	1	HARRIS, KATHLEEN COOKE NP	5/3/2021	363L00000X	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
203729	Fee-for-Service	1013095512	1013095512	1	1	HELMER, NINA W MD	8/4/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	51930	26	Psychiatry (child)	0	In state provider	None	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60574038	-122.0836254	Alameda County
203787	Fee-for-Service	1275130163	1275130163	1	1	HIERS, JESSICA E AU	11/30/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	2054 W AVENUE K	None	LANCASTER	CA	93536	5216	19	06037	34.6749447	-118.16784	Los Angeles County
203806	Fee-for-Service	1114568730	1114568730	1	1	HEALING PATH HOME HEALTHCARE	8/5/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	6320 VAN NUYS BLVD	STE 307B	VAN NUYS	CA	91401	6662	19	06037	34.18545203	-118.4487091	Los Angeles County
203813	Fee-for-Service	1841313814	1841313814	1	1	HUGHES, MICHELLE	7/10/2024	1041C0700X	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
203847	Fee-for-Service	1912388950	1912388950	1	1	HWANG, JUSTIN DO	12/19/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17134	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
203857	Fee-for-Service	1821065095	1821065095	1	1	HENDERSON, DAVID A MD	12/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	55328	41	Internal Medicine	0	In state provider	None	1000 NUT TREE ROAD	None	FAIRFIELD	CA	95687	4100	48	06095	38.35581953	-121.9530257	Solano County
203872	Fee-for-Service	1477504082	1477504082	1	1	HAKIM, ASAAD	3/13/1996	207R00000X	NA	Other	026	PHYSICIANS	52666	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	7955 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4001	30	06059	33.75932839	-117.9902744	Orange County
203880	Fee-for-Service	1689786733	1689786733	1	1	HAYES, DANESE F MD	10/1/2000	207R00000X	NA	Other	026	PHYSICIANS	64098	None	None	0	In state provider	None	310 W B STREET	None	ONTARIO	CA	91762	3262	36	06071	34.064694	-117.653949	San Bernardino County
203882	Fee-for-Service	1043321185	1043321185	1	1	HIGH DESERT CARDIO PULM	1/31/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	16017 TUSCOLA RD	STE A	APPLE VALLEY	CA	92307	1317	36	06071	34.542252	-117.2692645	San Bernardino County
203895	Fee-for-Service	1760593214	1760593214	1	1	HONG, HELEN MD	9/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90559	41	Internal Medicine	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
203919	Fee-for-Service	1851346530	1851346530	1	1	HARMAN, PATRICIA J MD	9/1/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	67443	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
203925	Fee-for-Service	1679870554	1679870554	1	1	HUANG, AARON C DO	7/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10684	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
203935	Fee-for-Service	1508061300	1508061300	1	1	HUANG, EDMUND MD	6/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	81770	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
203936	Fee-for-Service	1316316920	1316316920	1	1	HEITZ, SARAH L LCSW	4/6/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17059 MAIN ST	None	HESPERIA	CA	92345	6067	36	06071	34.4199033	-117.2908045	San Bernardino County
203938	Fee-for-Service	1184343055	1184343055	1	2	HEALTH ALLIANCE SOCAL, INC	6/7/2023	2084P0800X	NA	Psychiatry	022	PHYSICIANS GROUP	-	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
203939	Fee-for-Service	1366880312	1366880312	1	1	HELMICK, LINSAY M MFT	12/2/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	85172	-	NOT APPLICABLE	0	In state provider	None	1849 SAWTELLE BLVD	SUITE 100	LOS ANGELES	CA	90025	7082	19	06037	34.04266851	-118.4451527	Los Angeles County
203968	Fee-for-Service	1912378324	1912378324	1	2	HUNTINGTON SPECIALIST &	5/4/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	5353 G STREET	None	CHINO	CA	91710	5249	36	06071	34.00987149	-117.6880905	San Bernardino County
203996	Fee-for-Service	1265502660	1265502660	1	1	HAYTON, TAMMY L MD	1/1/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	75892	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	36243 INLAND VALLEY DR	STE 100	WILDOMAR	CA	92595	9547	33	06065	33.591528	-117.2393325	Riverside County
204002	Fee-for-Service	1568669893	1568669893	1	1	HEISCHOBER, BRUCE S MD	5/1/1992	207P00000X	NA	Other	026	PHYSICIANS	43994	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
204048	Fee-for-Service	1356520019	1356520019	1	1	HUSAINI, ZAHA F MD	12/20/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	101411	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
204064	Fee-for-Service	1548497373	1548497373	1	1	HSIN, OLIVIA S PHD	3/25/2016	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
204078	Fee-for-Service	1629026141	1629026141	1	1	HOLMES, WILLIAM J MD	5/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	81678	20	Orthopedic Surgery	0	In state provider	None	1700 COFFEE RD	None	MODESTO	CA	95355	2803	50	06099	37.668645	-120.9756715	Stanislaus County
204122	Fee-for-Service	1316133754	1316133754	1	1	HIRSCHAUT, LESLIE ANN MD	2/23/2009	2084P0800X	NA	Psychiatry	026	PHYSICIANS	49811	36	Psychiatry	0	In state provider	None	4250 AUBURN BLVD	None	SACRAMENTO	CA	95841	4100	34	06067	38.642832	-121.3649325	Sacramento County
204132	Fee-for-Service	1417054214	1417054214	1	1	HERTZLER, ELEANOR L LCSW	9/30/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1475 HUNTINGTON AVE	SUITE 218	SOUTH SAN FRANCIS	CA	94080	5990	41	06081	37.64239261	-122.4202978	San Mateo County
204135	Fee-for-Service	1881041937	1881041937	1	1	HO, RICHARD MD	3/25/2022	208800000X	NA	Other	026	PHYSICIANS	171858	None	None	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
204136	Fee-for-Service	1477533727	1477533727	1	1	HOGAN, WILLIAM M MD	3/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	45615	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1280 S VICTORIA AVE	STE 204	VENTURA	CA	93003	6551	56	06111	34.26344767	-119.2119344	Ventura County
204137	Fee-for-Service	1407112923	1407112923	1	2	HORNER, DAVID J MD	9/20/2019	207Q00000X	NA	Adult Primary Care	086	MEDICAL DIRECTORS	141403	-	NOT APPLICABLE	0	In state provider	None	855 3RD AVE STE 2230	None	CHULA VISTA	CA	91911	1350	37	06073	32.62197574	-117.0723222	San Diego County
204144	Fee-for-Service	1235171273	1235171273	1	1	HEBL, CHRISTEN L CRNA	2/3/2006	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
204160	Fee-for-Service	1326257106	1326257106	1	1	HEUNG, LENA J MD	2/18/2020	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	160418	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
204164	Fee-for-Service	1700510872	1700510872	1	1	HEART BEAT MED TRANSIT LLC	10/7/2022	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	10213 STERLING SILVER ST	None	BAKERSFIELD	CA	93311	9846	15	06029	35.30478043	-119.1158115	Kern County
204165	Fee-for-Service	1841362654	1841362654	1	1	HAHN, JANET M MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67633	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
204169	Fee-for-Service	1851600514	1851600514	1	1	HARRIS, BRANDY A LMFT	6/17/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	104817	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDLOW ROAD	None	LONG BEACH	CA	90807	4417	19	06037	33.8188341	-118.1923297	Los Angeles County
204256	Fee-for-Service	1912378324	1912378324	1	2	HUNTINGTON SPECIALIST &	5/4/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	None	5353 G STREET	None	CHINO	CA	91710	5249	36	06071	34.00987149	-117.6880905	San Bernardino County
204265	Fee-for-Service	1295288348	1295288348	1	2	HEALTH ACCESS FOR ALL INC	2/17/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	6208 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98382489	-118.2226198	Los Angeles County
204289	Fee-for-Service	1568669893	1568669893	1	1	HEISCHOBER, BRUCE S MD	5/1/1992	207P00000X	NA	Other	026	PHYSICIANS	43994	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
204300	Fee-for-Service	1063573673	1063573673	1	1	HARTER, TODD J OD	12/13/2018	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 BURTON DR	STE 150	VACAVILLE	CA	95687	3560	48	06095	38.36439485	-121.9548858	Solano County
204323	Fee-for-Service	1326010547	1326010547	1	1	HUANG, WEI-CHI MD	7/1/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	36081	40	Pediatrics	0	In state provider	None	2650 JONES WAY	STE 11	SIMI VALLEY	CA	93065	1205	56	06111	34.28861251	-118.745991	Ventura County
204328	Fee-for-Service	1528271608	1528271608	1	1	HYON, SUNG MD	1/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145590	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
204368	Fee-for-Service	1407140726	1407140726	2	1	HANGER PROSTHETICS & ORTHOTI	5/18/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	1001 PARTRIDGE DR	SUITE 210	VENTURA	CA	93003	0716	56	06111	34.26809702	-119.2039993	Ventura County
204370	Fee-for-Service	1396726287	1396726287	1	1	HUBBARD, JEFFERY MICHAEL	9/15/1997	207R00000X	NA	Other	026	PHYSICIANS	62200	41	Internal Medicine	0	In state provider	None	275 W HERNDON AVE	None	CLOVIS	CA	93612	0204	10	06019	36.83766747	-119.715174	Fresno County
204371	Fee-for-Service	1790952943	1790952943	1	1	HARRINGTON, JEWETT J CNM	10/21/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
204392	Fee-for-Service	1073957080	1073957080	1	1	HOPKINS, JUSTIN N MD	11/24/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	132958	20	Orthopedic Surgery	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
204418	Fee-for-Service	1881040020	1881040020	1	1	HEWETT, LEE J	10/19/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	174967	None	None	0	In state provider	None	2975 SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
204460	Fee-for-Service	1063832400	1063832400	1	1	HOLDER, SEVELLE K MD	9/5/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	154693	15	Obstetrics (D.O. only)	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
204530	Fee-for-Service	1073565461	1073565461	1	2	HSU, MING-CHANG MD	11/26/1979	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	34714	None	None	0	In state provider	None	3318 DEL MAR AVE	APT 205E	ROSEMEAD	CA	91770	2373	19	06037	34.06859814	-118.0994741	Los Angeles County
204535	Fee-for-Service	1417241712	1417241712	1	1	HAUSER, MICHELLE E MD	1/5/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	131070	41	Internal Medicine	0	In state provider	None	2710 MIDDLEFIELD RD	None	REDWOOD CITY	CA	94063	3404	41	06081	37.47644946	-122.2110919	San Mateo County
204541	Fee-for-Service	1063497097	1063497097	1	1	HILL, HANK C MD	2/7/2020	208600000X	NA	General Surgery	026	PHYSICIANS	159418	02	General Surgery	0	In state provider	None	516 W ATEN RD	STE 1	IMPERIAL	CA	92251	9805	13	06025	32.82558069	-115.5814237	Imperial County
204543	Fee-for-Service	1912378324	1912378324	1	2	HUNTINGTON SPECIALIST &	5/4/2017	No Taxonomy Provided	NA	None	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	5353 G STREET	None	CHINO	CA	91710	5249	36	06071	34.00987149	-117.6880905	San Bernardino County
204547	Fee-for-Service	1528084027	1528084027	1	1	HERREROS, RODRIGO MD	8/7/2020	207L00000X	NA	Other	026	PHYSICIANS	160751	05	Anesthesiology	0	In state provider	None	1541 FLORIDA AVE	STE 200	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
204557	Fee-for-Service	1235113820	1235113820	1	1	HIRSHBURG, FREDERICK MD	5/8/1987	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	24863	40	Pediatrics	0	In state provider	None	6620 COYLE AVE	STE 21	CARMICHAEL	CA	95608	6333	34	06067	38.66751	-121.310028	Sacramento County
204558	Fee-for-Service	1780067124	1780067124	1	1	HAMMERLI, CHRISTIANE H LMFT	7/23/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	120 BONNIE BRAE	None	BONNY DOON	CA	95060	9107	44	06087	37.03818937	-122.1448873	Santa Cruz County
204588	Fee-for-Service	1740396175	1740396175	1	1	HUDSON, AMY J CRNA	6/1/2003	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	3555 CESAR CHAVEZ	None	SAN FRANCISCO	CA	94110	4403	38	06075	37.74802705	-122.4207367	San Francisco County
204593	Fee-for-Service	1376524843	1376524843	1	1	HACIENDA CARE CENTER	11/1/1984	311500000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	301 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3429	54	06107	36.06950036	-119.0234661	Tulare County
204624	Fee-for-Service	1366492241	1366492241	1	1	HEIDI J. BRAY, ARNP	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	413 LILLY RD NE	None	OLYMPIA	WA	98506	5133	00	None	47.052801	-122.847462	Thurston County
204635	Fee-for-Service	1992267546	1992267546	1	1	HJ LEE CHIROPRACTIC CORPORAT	6/30/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	ION	1201 S BEACH BLVD	#107	LA HABRA	CA	90631	6366	30	06059	33.9162211	-117.9688889	Orange County
204668	Fee-for-Service	1851493688	1851493688	1	1	HERNANDEZ, CECILIA M MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	77974	08	Family Practice	0	In state provider	None	3288 BELL RD	None	AUBURN	CA	95603	9243	31	06061	38.94193048	-121.1046075	Placer County
204721	Fee-for-Service	1326388026	1326388026	1	1	HSIH, JOHN Y MD	9/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	120283	05	Anesthesiology	0	In state provider	None	23625 HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
204743	Fee-for-Service	1548205560	1548205560	1	1	HENSON, TRAVIS W MD	7/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85711	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
204782	Fee-for-Service	1235280470	1235280470	1	1	HALLORAN, BRETT J MD	10/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131872	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
204824	Fee-for-Service	1790979540	1790979540	1	1	HILL, ASHLEY G PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2185 W GRANT LINE RD	None	TRACY	CA	95377	7309	39	06077	37.75425686	-121.4567805	San Joaquin County
204826	Fee-for-Service	1487615324	1487615324	1	1	HOLLYWOOD PATHOLOGY MED	10/1/1995	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	CARL P TRELING, MD	1300 N VERMONT AVE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
204869	Fee-for-Service	1609104579	1609104579	1	1	HERNANDEZ, ANDRES R	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
204886	Fee-for-Service	1770504862	1770504862	1	2	HAROLD KATZMAN M D INC	5/3/2024	152W00000X	NA	Other	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	LINIC INC	4403 VERMONT AVE	None	LOS ANGELES	CA	90037	2413	19	06037	34.00342736	-118.2915892	Los Angeles County
204909	Fee-for-Service	1104466796	1104466796	1	1	HARMONIA HOSPICE AND	4/6/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE, INC	6621 VAN NUYS BLVD	STE 117	VAN NUYS	CA	91405	4675	19	06037	34.19138471	-118.4487668	Los Angeles County
204911	Fee-for-Service	1487624284	1487624284	1	1	HWANG, STEVE S G MD	5/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	51555	22	Pathology (M.D. only)	0	In state provider	None	2215 TRUXTON AVENUE	None	BAKERSFIELD	CA	93301	3602	15	06029	35.37327448	-119.0278665	Kern County
204927	Fee-for-Service	1013175033	1013175033	1	1	HASHEMI, MARYAM MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113521	36	Psychiatry	0	In state provider	None	5016 CHESEBRO RD.	SUITE 200	AGOURA HILLS	CA	91301	2277	19	06037	34.14134802	-118.7392827	Los Angeles County
204956	Fee-for-Service	1265703847	1265703847	1	1	HASAN, MUFADDA J MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142787	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
204967	Fee-for-Service	1861713000	1861713000	1	1	HUFFAKER, STEPHEN J MD	9/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135749	20	Orthopedic Surgery	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
204972	Fee-for-Service	1306810072	1306810072	1	1	HARVEY, LEE A MD	5/31/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	35374	30	Radiology	0	In state provider	None	7930 FROST ST	STE 301	SAN DIEGO	CA	92123	2767	37	06073	32.80027001	-117.1532893	San Diego County
205007	Fee-for-Service	1568604221	1568604221	1	1	HAGEN, JOSIAH D DO	10/11/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12649	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
205046	Fee-for-Service	1386668507	1386668507	1	1	HUBERT, GARY D MD	6/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	55771	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
205048	Fee-for-Service	1134590243	1134590243	1	1	HOFFMAN, DAVID C M DO	9/12/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14262	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
205146	Fee-for-Service	1699353227	1699353227	1	1	HSU, STEPHEN	7/2/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4572 TELEPHONE RD	STE 903	VENTURA	CA	93003	5663	56	06111	34.25635267	-119.2348313	Ventura County
205174	Fee-for-Service	1770504862	1770504862	1	2	HAROLD KATZMAN M D INC	5/3/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	LINIC INC	4403 VERMONT AVE	None	LOS ANGELES	CA	90037	2413	19	06037	34.00342736	-118.2915892	Los Angeles County
205199	Fee-for-Service	1104466796	1104466796	1	1	HARMONIA HOSPICE AND	4/6/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE, INC	6621 VAN NUYS BLVD	STE 117	VAN NUYS	CA	91405	4675	19	06037	34.19138471	-118.4487668	Los Angeles County
205221	Fee-for-Service	1013240019	1013240019	1	1	HILDEBRANT, AMANDA J LCSW	12/12/2014	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	19	06037	33.94274917	-118.2461916	Los Angeles County
205239	Fee-for-Service	1982684924	1982684924	1	1	HERNAN MEDINA, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10229 N 92ND ST	I-103	SCOTTSDALE	AZ	85258	0000	00	None	33.579099	-111.878703	Maricopa County
205260	Fee-for-Service	1356418560	1356418560	1	1	HANNA, GUIRGUIS S MD	9/30/1987	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	39007	13	Neurology (M.D. only)	0	In state provider	None	2400 S WESTERN AVE	None	LOS ANGELES	CA	90018	2607	19	06037	34.034481	-118.3089535	Los Angeles County
205261	Fee-for-Service	1356491575	1356491575	1	1	HOBSON, STEVEN LMFT	4/10/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	3590 EL PORTAL DR.	7, 8, 9, 10, 15, 16, & 1	REDDING	CA	96002	3154	45	06089	40.55435123	-122.3565549	Shasta County
205274	Fee-for-Service	1689968224	1689968224	1	1	HANN, JOHN W MD	3/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125034	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
205326	Fee-for-Service	1578338786	1578338786	1	1	HOWARD, LANDON	9/20/2024	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
205363	Fee-for-Service	1922462167	1922462167	1	1	HOLWELL, EVE B MD	9/1/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	169437	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
205383	Fee-for-Service	1982144333	1982144333	1	1	HOGENBOOM, JEANETTE NP	9/25/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1420 N TRACY BLVD	None	TRACY	CA	95376	3451	39	06077	37.744011	-121.4349725	San Joaquin County
205386	Fee-for-Service	1275611964	1275611964	1	1	HO, MARK D MD	4/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68939	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
205445	Fee-for-Service	1215930813	1215930813	1	1	HUCKABEE, RIFE E MD	8/15/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	180383	30	Radiology	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
205485	Fee-for-Service	1881890200	1881890200	1	2	HONG, RAYMOND H MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86058	None	None	0	In state provider	None	10900 WARNER AVE	SUITE 101-B	FOUNTAIN VALLEY	CA	92708	3846	30	06059	33.71628153	-117.9388215	Orange County
205524	Fee-for-Service	1053325290	1053325290	1	1	HEYING, ROBERT H PHD	2/8/2015	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1220 LAUREL ST	None	NAPA	CA	94559	3829	28	06055	38.29212793	-122.2858688	Napa County
205533	Fee-for-Service	1457551038	1457551038	1	1	HOWARD, ZOE D MD	8/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115122	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94035	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
205548	Fee-for-Service	1578649067	1578649067	2	1	HALL, SUSAN P MD	6/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	76766	08	Family Practice	0	In state provider	None	432 W J ST	STE A	TEHACHAPI	CA	93561	1349	15	06029	35.13547731	-118.4538972	Kern County
205565	Fee-for-Service	1568996510	1568996510	1	1	HORNER, GWYNNETH K MD	1/3/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	179788	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
205723	Fee-for-Service	1598945537	1598945537	1	1	HEGEDUS, ERIC S MD	4/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98649	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVE	None	LONG BEACH	CA	90806	1937	19	06037	33.808185	-118.1850575	Los Angeles County
205752	Fee-for-Service	1306828744	1306828744	1	1	HODGES, JASON L MD	4/20/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	155727	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
205761	Fee-for-Service	1598794877	1598794877	1	1	HUSSAIN, MAHVEEN F MD	2/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71873	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
205776	Fee-for-Service	1285786582	1285786582	1	1	HACKETT, SHAWN D LCSW	3/23/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1660 E ROSEVILLE PKWY	None	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
205782	Fee-for-Service	1841207347	1841207347	1	1	HUYHN, VONG N MD	7/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85411	08	Family Practice	0	In state provider	None	2120 THIBODO RD	None	VISTA	CA	92081	7901	37	06073	33.16745345	-117.2180381	San Diego County
205797	Fee-for-Service	1255654174	1255654174	1	1	HOLLYWOOD HOSPITALIST MEDI	4/1/2010	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	CAL GROUP INC	1300 N VERMONT AVENUE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
205812	Fee-for-Service	1265790901	1265790901	1	1	HAN, PAUL H MD	9/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138715	01	General Practice	0	In state provider	None	211 13TH ST	None	RAMONA	CA	92065	2711	37	06073	33.04020023	-116.8739786	San Diego County
205823	Fee-for-Service	1588077788	1588077788	1	1	HODOBA, NATHANIEL MD	9/22/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	169325	13	Neurology (M.D. only)	0	In state provider	None	1625 STOCKTON BLVD	None	SACRAMENTO	CA	95816	7053	34	06067	38.56554	-121.4664615	Sacramento County
205892	Fee-for-Service	1710262571	1710262571	1	1	HUSSAIN, JAMAL MD INC	11/28/2011	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	52498	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3650 E SOUTH ST	STE 105	LAKEWOOD	CA	90712	1531	19	06037	33.8601747	-118.1494013	Los Angeles County
205910	Fee-for-Service	1144323064	1144323064	1	1	HSIEH, PIN-HUNG MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	62358	41	Internal Medicine	0	In state provider	None	13522 NEWPORT AVE	STE 102	TUSTIN	CA	92780	3707	30	06059	33.74329025	-117.8167455	Orange County
205916	Fee-for-Service	1730229675	1730229675	1	1	HARRIS, CARMEN J LCSW	12/20/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	88840	-	NOT APPLICABLE	0	In state provider	None	675 FIRST STREET	None	UPPER LAKE	CA	95485	9586	17	06033	39.16426454	-122.903172	Lake County
205917	Fee-for-Service	1306233515	1306233515	1	1	HIGGINBOTHAM, ALLISON DO	8/6/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	15957	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
205939	Fee-for-Service	1831256767	1831256767	1	1	HANKS, BILLY R CRNA	6/3/2004	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
205980	Fee-for-Service	1528060662	1528060662	2	1	HANGER PROSTHETICS & ORTHOTI	5/18/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	16520 HARBOR BLVD	SUITE G	FOUNTAIN VALLEY	CA	92708	1360	30	06059	33.7234142	-117.919744	Orange County
205988	Fee-for-Service	1518426352	1518426352	1	1	HUANG, SIU-YUAN L MD	3/13/2024	2086X0206X	NA	General Surgery	026	PHYSICIANS	182424	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
206000	Fee-for-Service	1679841001	1679841001	1	1	HONG, FORREST LCSW	11/6/2022	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
206004	Fee-for-Service	1790403186	1790403186	1	1	HEFLER, MADISON B	8/25/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	81 CERNON ST.	None	VACAVILLE	CA	95688	2803	48	06095	38.36102104	-121.9906107	Solano County
206022	Fee-for-Service	1174903918	1174903918	1	1	HARRIS, ELISE MD	7/1/2021	207R00000X	NA	Other	026	PHYSICIANS	164080	None	None	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
206029	Fee-for-Service	1730143561	1730143561	1	1	HAMBURG,CAROLE	6/3/2021	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	8268 164TH ST	None	JAMAICA	NY	11432	1121	00	None	40.717917	-73.804086	Queens County
206038	Fee-for-Service	1104200781	1104200781	2	1	HOGAN, MARIAN S LCSW	8/24/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2025 SOQUEL AVENUE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
206059	Fee-for-Service	1962619882	1962619882	1	1	HARDELL, MICHELLE A PSYD	3/8/2021	103T00000X	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
206060	Fee-for-Service	1417980798	1417980798	1	1	HAROON, A EBRAHIM MD	8/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	51046	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
206066	Fee-for-Service	1366536419	1366536419	1	1	HUANG, KENNETH Y MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	73683	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
206080	Fee-for-Service	1083460679	1083460679	1	1	HOTTOCARE	1/28/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	18 BARTOL ST	# 1325	SAN FRANCISCO	CA	94133	4501	38	06075	37.79790027	-122.4034215	San Francisco County
206082	Fee-for-Service	1043981699	1043981699	1	2	HELPING HANDS SENIOR TRANSPO	11/23/2021	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	RTATION	7219 RESEDA BLVD	B	RESEDA	CA	91335	3046	19	06037	34.201791	-118.5360655	Los Angeles County
206085	Fee-for-Service	1255654174	1255654174	1	1	HOLLYWOOD HOSPITALIST MEDI	4/1/2010	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CAL GROUP INC	1300 N VERMONT AVENUE	None	LOS ANGELES	CA	90027	6005	19	06037	34.0956033	-118.2916918	Los Angeles County
206089	Fee-for-Service	1275515256	1275515256	1	1	HALBERG, FRANCINE MD	6/30/1989	2085R0001X	NA	Other	026	PHYSICIANS	43500	01	General Practice	0	In state provider	None	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	21	06041	37.9469952	-122.5373892	Marin County
206103	Fee-for-Service	1912398629	1912398629	1	2	HARPER, NICOLE L LMFT	10/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
206113	Fee-for-Service	1063739027	1063739027	1	1	HUR, SEUNG H MD	11/15/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	174187	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
206175	Fee-for-Service	1467027870	1467027870	1	2	HM ACQUISITION LLC	6/29/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	14755 BUDWIN LANE	None	POWAY	CA	92064	3006	37	06073	32.98220193	-117.0319625	San Diego County
206198	Fee-for-Service	1144323064	1144323064	1	1	HSIEH, PIN-HUNG MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	62358	01	General Practice	0	In state provider	None	13522 NEWPORT AVE	STE 102	TUSTIN	CA	92780	3707	30	06059	33.74329025	-117.8167455	Orange County
206221	Fee-for-Service	1760656169	1760656169	1	1	HURE, MICHELLE C MD	7/28/2017	207ZD0900X	NA	Other	026	PHYSICIANS	112182	22	Pathology (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
206225	Fee-for-Service	1720209109	1720209109	1	1	HUANG, ANNE Y MD	5/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99549	22	Pathology (M.D. only)	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
206230	Fee-for-Service	1518951300	1518951300	1	44	HOAG MEMORIAL HOSPITAL	1/3/2023	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	500 SUPERIOR AVENUE	SUITE 100	NEWPORT BEACH	CA	92663	3660	30	06059	33.63017269	-117.929499	Orange County
206250	Fee-for-Service	1285746073	1285746073	1	1	HOLDY, KALMAN E MD INC	7/22/1977	No Taxonomy Provided	NA	None	026	PHYSICIANS	26103	41	Internal Medicine	0	In state provider	None	7920 FROST ST	STE 101	SAN DIEGO	CA	92123	2732	37	06073	32.80027449	-117.153846	San Diego County
206252	Fee-for-Service	1073787883	1073787883	1	1	HUSAIN, ADEEL MD	10/31/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	109351	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
206295	Fee-for-Service	1568106359	1568106359	1	1	HERRERA, ERIC A LMFT	6/20/2024	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
206301	Fee-for-Service	1821032822	1821032822	1	1	HEINZEN JIM, KATHERINE S. MD	6/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	640 ULUKAHIKI ST	None	KAILUA	HI	96734	4454	00	None	21.38090913	-157.758388	Honolulu County
206374	Fee-for-Service	1780050385	1780050385	1	1	HARDWICK, ALEXANDER B MD	4/26/2021	207R00000X	NA	Other	026	PHYSICIANS	149279	None	None	0	In state provider	None	2400 BATH	201	SANTA BARBARA	CA	93105	4351	42	06083	34.43168847	-119.7234694	Santa Barbara County
206392	Fee-for-Service	1427715515	1427715515	1	5	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7275 EAST SOUTHGATE DR	SUITE 106	SACRAMENTO	CA	95823	2161	34	06067	38.493576	-121.436559	Sacramento County
206410	Fee-for-Service	1417090341	1417090341	1	1	HEALTHRIGHT 360	8/4/2016	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1601 DONNER AVE	STE 3	SAN FRANCISCO	CA	94124	3277	38	06075	37.7243837	-122.3940496	San Francisco County
206434	Fee-for-Service	1417334186	1417334186	1	1	HERA HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	9029 RESEDA BLVD	SUITE 209	NORTHRIDGE	CA	91324	3932	19	06037	34.23452657	-118.536098	Los Angeles County
206442	Fee-for-Service	1427184761	1427184761	1	1	HERBSTMAN, CHARLES H MD	3/4/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	54673	05	Anesthesiology	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
206464	Fee-for-Service	1073910030	1073910030	1	1	HARDMAN, ANDREA LCSW	11/21/2024	251S00000X	NA	Other	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
206475	Fee-for-Service	1609907682	1609907682	1	1	HOYT, JEANA G MD	6/24/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95913	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94122	2722	38	06075	37.76332993	-122.4582988	San Francisco County
206487	Fee-for-Service	1588742738	1588742738	1	1	HERNRIED, JOHN D MD	6/27/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49671	08	Family Practice	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
206494	Fee-for-Service	1518951300	1518951300	1	26	HOAG MEMORIAL HOSPITAL	6/27/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16105 SAND CANYON AVE	SUITE 100	IRVINE	CA	92618	3704	30	06059	33.66320123	-117.7725531	Orange County
206548	Fee-for-Service	1073251872	1073251872	1	1	HOMETOWN MEDICAL SUPPLIES, L	4/4/2024	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	8226 W MINERAL KING AVE	None	VISALIA	CA	93291	7976	54	06107	36.328023	-119.382912	Tulare County
206585	Fee-for-Service	1225008733	1225008733	1	1	HOFMEISTER, ELIZABETH M MD	12/7/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	166728	None	None	0	In state provider	None	1955 CITRACADO PARKWAY	#301	ESCONDIDO	CA	92029	4113	37	06073	33.11301099	-117.1202081	San Diego County
206592	Fee-for-Service	1285608869	1285608869	1	1	HARVEY, SUSAN D DO	3/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	8920	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
206615	Fee-for-Service	1649382581	1649382581	1	1	HARPER, ROBERT 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	1101 26TH ST S	None	GREAT FALLS	MT	59405	5161	00	None	47.491965	-111.2617215	Cascade County
206683	Fee-for-Service	1427715515	1427715515	1	5	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	7275 EAST SOUTHGATE DR	SUITE 106	SACRAMENTO	CA	95823	2161	34	06067	38.493576	-121.436559	Sacramento County
206700	Fee-for-Service	1811965031	1811965031	1	1	HOWARD G DANIEL MD	5/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4300 W MEMORIAL RD	None	OKLAHOMA CITY	OK	73120	8304	00	None	35.606601	-97.6003605	Oklahoma County
206722	Fee-for-Service	1417334186	1417334186	1	1	HERA HOSPICE INC	5/8/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	9029 RESEDA BLVD	SUITE 209	NORTHRIDGE	CA	91324	3932	19	06037	34.23452657	-118.536098	Los Angeles County
206764	Fee-for-Service	1942350764	1942350764	1	1	HOANG, MICHELLE M OD	10/16/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
206782	Fee-for-Service	1407495344	1407495344	1	1	HANSON, GIOVANNA LCSW	12/11/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
206788	Fee-for-Service	1417995374	1417995374	1	1	HANSEN,RICK MD	8/4/2007	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	0000	00	None	43.6124738	-116.1926844	Ada County
206815	Fee-for-Service	1548239932	1548239932	1	1	HOPKINS, LEAH G MD	1/16/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	156195	41	Internal Medicine	0	In state provider	None	7117 BROCKTON AVE	None	RIVERSIDE	CA	92506	3912	33	06065	33.94354395	-117.394926	Riverside County
206823	Fee-for-Service	1912418492	1912418492	1	1	HSIAO, CHUNMING LAC	9/18/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	22706 ASPAN ST STE 300	None	LAKE FOREST	CA	92630	1603	30	06059	33.63302585	-117.7156522	Orange County
206858	Fee-for-Service	1023314192	1023314192	1	1	HOANG, CAM LINH T NP	12/13/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
206866	Fee-for-Service	1730618166	1730618166	1	1	HADLEY, HOLLY A LMFT	10/13/2023	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
206951	Fee-for-Service	1932187127	1932187127	1	1	HUGHES, TUDOR H MD	8/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83748	30	Radiology	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
206956	Fee-for-Service	1285963322	1285963322	1	1	HEPIE, A B MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119412	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
206958	Fee-for-Service	1629605779	1629605779	1	1	HUYNH, KEVIN MD	3/12/2024	207L00000X	NA	Other	026	PHYSICIANS	187923	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
206962	Fee-for-Service	1902974363	1902974363	1	1	HOFFER, MONROE M MD	9/20/2007	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	10463	20	Orthopedic Surgery	0	In state provider	None	2300 S FLOWER ST	STE 200	LOS ANGELES	CA	90007	2676	19	06037	34.0294397	-118.2734132	Los Angeles County
206978	Fee-for-Service	1124139167	1124139167	1	1	HSU, RAYMOND K MD	5/19/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108247	45	Nephrology (Renal-Kidney)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
207003	Fee-for-Service	1003399361	1003399361	1	1	HARRIS-MILLER, MICHELLE A CN	12/20/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	P	1340 MITCHELL RD	None	MODESTO	CA	95351	4923	50	06099	37.61159722	-120.9387211	Stanislaus County
207032	Fee-for-Service	1659409142	1659409142	1	1	HUYNH, CASEY C LMFT	10/15/2020	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
207059	Fee-for-Service	1134144801	1134144801	1	1	HENRY FORD HOSP	6/2/1995	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2799 W GRAND BLVD	None	DETROIT	MI	48202	2608	00	None	42.36645079	-83.08385497	Wayne County
207093	Fee-for-Service	1871710335	1871710335	1	1	HOLLAR-WILT, LAURA J MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141082	36	Psychiatry	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
207112	Fee-for-Service	1285993238	1285993238	1	1	HEGEDUS, MONICA M MD	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134659	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
207139	Fee-for-Service	1780039487	1780039487	1	1	HO, NHUHANG MD	4/8/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	08	Family Practice	0	In state provider	None	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
207170	Fee-for-Service	1902398506	1902398506	1	1	HUANG, LINGLING MD	5/30/2023	207W00000X	NA	Ophthalmology	026	PHYSICIANS	165218	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
207186	Fee-for-Service	1770864779	1770864779	1	1	HO, JENSINE MD	11/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133830	None	None	0	In state provider	None	3160 FOLSOM BLVD	STE 2500	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
207203	Fee-for-Service	1558738203	1558738203	1	1	HELPFUL HANDS HOME HEALTH CA	3/8/2018	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	2569 DAKIN DRIVE	None	CORONA	CA	92882	6195	33	06065	33.85296287	-117.5846727	Riverside County
207205	Fee-for-Service	1154516052	1154516052	1	1	HUMPHREYS, NICOLE LCSW	3/21/2024	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
207260	Fee-for-Service	1780755603	1780755603	1	1	HERNANDEZ, LOUIS A MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64954	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
207272	Fee-for-Service	1518983493	1518983493	1	1	HUI, JENNIFER I MD	1/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	115818	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	SUITE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
207302	Fee-for-Service	1174571731	1174571731	1	1	HOFFMAN, ROBERT A OD	9/26/1989	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2390 EAST BIDWELL	SUITE 400	FOLSOM	CA	95630	3873	34	06067	38.664882	-121.1381055	Sacramento County
207318	Fee-for-Service	1740325273	1740325273	1	1	HAJDENA-DAWSON, MONICA	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81767	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	505 PARNASSUS AVE	BOX 110	SAN FRANCISCO	CA	94143	0110	38	06075	37.7634502	-122.4579779	San Francisco County
207344	Fee-for-Service	1134144801	1134144801	1	1	HENRY FORD HOSP	4/28/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2799 W GRAND BLVD	None	DETROIT	MI	48202	2608	00	None	42.36645079	-83.08385497	Wayne County
207348	Fee-for-Service	1720250475	1720250475	1	1	HAJI-ABDOLLAHI, SARA MD	11/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	133198	18	Ophthalmology	0	In state provider	None	5400 BALBOA BLVD	SUITE 222	ENCINO	CA	91316	1502	19	06037	34.169283	-118.501072	Los Angeles County
207371	Fee-for-Service	1639730930	1639730930	1	1	HUNTOON, PERRY B	10/1/2024	104100000X	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
207372	Fee-for-Service	1952404808	1952404808	1	1	HERNANDEZ, ROBERT H MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	62147	08	Family Practice	0	In state provider	None	1140 MAIN ST	None	LIVINGSTON	CA	95334	1257	24	06047	37.37992056	-120.7234222	Merced County
207394	Fee-for-Service	1124263462	1124263462	1	1	HERRIN, KELLEY J LMFT	9/20/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6 S WASHINGTON ST	#1	SONORA	CA	95370	4752	55	06109	37.98523646	-120.3833545	Tuolumne County
207412	Fee-for-Service	1053991125	1053991125	1	1	HAWKINS, MAXIMILIAN MD	7/10/2024	207P00000X	NA	Other	026	PHYSICIANS	192008	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
207417	Fee-for-Service	1588604748	1588604748	1	1	HODGSON,PETER S MD	6/1/2001	207L00000X	NA	Other	026	PHYSICIANS	85721	05	Anesthesiology	0	In state provider	None	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
207468	Fee-for-Service	1841276730	1841276730	1	1	HELMY, MARWAH MD	6/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92371	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
207522	Fee-for-Service	1083632079	1083632079	1	1	HUNDAL, NIRBHAI S MD	2/1/2001	207R00000X	NA	Other	026	PHYSICIANS	67219	41	Internal Medicine	0	In state provider	None	1516 COLORADO AVE	None	TURLOCK	CA	95380	2711	50	06099	37.507041	-120.8352525	Stanislaus County
207568	Fee-for-Service	1326037599	1326037599	1	1	HINKLEY, BRUCE A OD	10/25/2009	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1019 16TH ST	STE A	MODESTO	CA	95354	1105	50	06099	37.645377	-120.9952958	Stanislaus County
207586	Fee-for-Service	1760619803	1760619803	1	1	HILL, MICHELLE L MD	7/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	115121	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
207604	Fee-for-Service	1740325273	1740325273	1	1	HAJDENA-DAWSON, MONICA	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	81767	40	Pediatrics	0	In state provider	None	505 PARNASSUS AVE	BOX 110	SAN FRANCISCO	CA	94143	0110	38	06075	37.7634502	-122.4579779	San Francisco County
207608	Fee-for-Service	1376975763	1376975763	1	1	HOFFMAN, KILEY M LCSW	8/4/2022	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
207628	Fee-for-Service	1063551000	1063551000	1	1	HUISA-GARATE, BRANKO N MD	1/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108574	13	Neurology (M.D. only)	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
207685	Fee-for-Service	1235438524	1235438524	1	1	HANY LOTFY YOUSSEF, 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	800 W MEETING STREET	None	LANCASTER	SC	29720	2202	00	None	34.71685822	-80.78743339	Lancaster County
207692	Fee-for-Service	1265913339	1265913339	1	1	HUSTON, ROSE T RCP	9/24/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
207710	Fee-for-Service	1235800715	1235800715	1	1	HOLGUIN, REBECCA LCSW	6/26/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
207723	Fee-for-Service	1184828444	1184828444	1	1	HSIEH, LANNY L MD	8/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74172	77	Infectious Disease	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
207745	Fee-for-Service	1659683258	1659683258	1	1	HOELSCHER, DEANN M MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137791	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
207767	Fee-for-Service	1477091288	1477091288	1	1	HI-DESERT MEDICAL PHARMACY I	12/27/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1002 E AVE J	E-1	LANCASTER	CA	93535	3870	19	06037	34.6894167	-118.1120423	Los Angeles County
207834	Fee-for-Service	1992969596	1992969596	1	1	HUSSAIN, SYED MD	3/26/2024	207R00000X	NA	Other	026	PHYSICIANS	128683	41	Internal Medicine	0	In state provider	None	185 E 7TH AVE	STE A	CHICO	CA	95926	3356	04	06007	39.74473059	-121.8488381	Butte County
207835	Fee-for-Service	1437170149	1437170149	1	1	HOFFMAN, WILLIAM G MD	12/21/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	26691	01	General Practice	0	In state provider	None	PO BOX 609	None	BROWNSVILLE	CA	95919	0609	58	06115	0	0	None
207841	Fee-for-Service	1699795997	1699795997	1	1	HAMAI, KIM YEE MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68699	40	Pediatrics	0	In state provider	None	11370 ANDERSON ST	STE B100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
207844	Fee-for-Service	1144513797	1144513797	1	1	HOUGHAM, AARON	6/18/2024	207P00000X	NA	Other	026	PHYSICIANS	123802	66	Emergency Medicine (Urgent Care)	0	In state provider	None	914 PINE STREET	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
207845	Fee-for-Service	1245899582	1245899582	1	1	HALL, JORDAN MD	3/20/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	179335	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
207873	Fee-for-Service	1225223043	1225223043	1	1	HADLEY, DAVID MD	8/24/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115120	None	None	0	In state provider	None	11370 ANDERSON ST	STE 1100	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
207907	Fee-for-Service	1184868093	1184868093	1	1	HOSSEINI, REZA V MD	4/22/2013	No Taxonomy Provided	NA	None	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
207929	Fee-for-Service	1154746295	1154746295	1	1	HOOSHMAND, FARNAZ MD	12/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138248	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
207970	Fee-for-Service	1386030013	1386030013	1	1	HUTCHINGS, DANIELLE A MD	6/25/2020	207ZP0102X	NA	Other	026	PHYSICIANS	165258	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	8700 BEVERLY BLVD	ROOM 3719	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
207987	Fee-for-Service	1730138561	1730138561	1	1	HOLCOMBE, TRAVIS C MD	2/6/2018	2086S0122X	NA	General Surgery	026	PHYSICIANS	53209	24	Plastic Surgery	0	In state provider	None	1260 S MAIN ST	STE 201	SALINAS	CA	93901	2292	27	06053	36.65656335	-121.6598928	Monterey County
208009	Fee-for-Service	1619129574	1619129574	1	2	HOME HEALTH PLUS SERVICES	6/4/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	900 S FIRST AVENUE	SUITE H	ARCADIA	CA	91006	7527	19	06037	34.13024371	-118.028126	Los Angeles County
208016	Fee-for-Service	1184828444	1184828444	1	1	HSIEH, LANNY L MD	8/22/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	74172	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
208031	Fee-for-Service	1356365753	1356365753	1	1	HAQ, AZHAR UL MD	3/16/1993	207RP1001X	NA	Pulmonology	026	PHYSICIANS	34693	41	Internal Medicine	0	In state provider	None	910 S SUNSET AVE	STE 2	WEST COVINA	CA	91790	3409	19	06037	34.064247	-117.9429166	Los Angeles County
208066	Fee-for-Service	1124406608	1124406608	1	1	HO, STEPHANIE MD	8/26/2019	390200000X	NA	Other	026	PHYSICIANS	144846	09	Gynecology (D.O. only)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
208111	Fee-for-Service	1184954992	1184954992	1	1	HALL, SHAMEA L LMFT	2/19/2020	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
208120	Fee-for-Service	1568463263	1568463263	1	1	HU, CHENGGANG MD	9/3/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82247	None	None	0	In state provider	None	332 S JUNIPER ST	STE 108	ESCONDIDO	CA	92025	4941	37	06073	33.12066536	-117.0770413	San Diego County
208140	Fee-for-Service	1629573894	1629573894	1	1	HUYNH NGUYEN, MELISSA V MD	8/31/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	164993	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
208176	Fee-for-Service	1447285028	1447285028	1	1	HAMADA, BRONSON W OD INC	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7192 EDINGER AVENUE	None	HUNTINGTON BEACH	CA	92647	3505	30	06059	33.73007951	-118.004607	Orange County
208205	Fee-for-Service	1316708944	1316708944	1	1	HILL, LINDA A BIRTH DOULA	2/9/2024	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
208211	Fee-for-Service	1164424289	1164424289	1	1	HEAP, LEAH A MD	8/18/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	58280	01	General Practice	0	In state provider	None	12660 RIVERSIDE DR	STE 320	NORTH HOLLYWOOD	CA	91607	3431	19	06037	34.1575795	-118.409499	Los Angeles County
208268	Fee-for-Service	1114339397	1114339397	1	1	HUGHES, STEPHEN M MD	10/26/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143547	41	Internal Medicine	0	In state provider	None	525 THIRD AVE	None	CHULA VISTA	CA	91910	5696	37	06073	32.63367609	-117.0769202	San Diego County
208299	Fee-for-Service	1366746893	1366746893	1	1	HOFFMAN, LINDSEY DO	6/26/2023	2080P0207X	NA	Hematology	026	PHYSICIANS	-	68	Hematology	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
208352	Fee-for-Service	1346820016	1346820016	1	1	HSU, ATHENA MD	3/20/2023	390200000X	NA	Other	026	PHYSICIANS	183575	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
208355	Fee-for-Service	1124406608	1124406608	1	1	HO, STEPHANIE MD	8/26/2019	390200000X	NA	Other	026	PHYSICIANS	144846	15	Obstetrics (D.O. only)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
208374	Fee-for-Service	1497857940	1497857940	1	1	HINDS MEDICAL GROUP APC	10/13/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2 JAMES WAY	STE 109	PISMO BEACH	CA	93349	4974	40	06079	35.13869436	-120.630734	San Luis Obispo County
208390	Fee-for-Service	1417549510	1417549510	1	1	HUNT, YLAN N LCSW	8/12/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
208400	Fee-for-Service	1730148941	1730148941	1	1	HARDWICK, WAYNE C 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
208403	Fee-for-Service	1669507836	1669507836	1	1	HANSEN, CAROL M LMFT	6/13/2019	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	L HANSEN M.F.T., PSY.D.	595 E COLORADO BLVD	506	PASADENA	CA	91101	2039	19	06037	34.14588202	-118.1380722	Los Angeles County
208408	Fee-for-Service	1730390725	1730390725	1	1	HANNA, MARY R MD	1/31/2018	207ZP0102X	NA	Other	026	PHYSICIANS	96209	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
208500	Fee-for-Service	1306919758	1306919758	1	1	HONG, JAMES S MD	6/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	89289	41	Internal Medicine	0	In state provider	None	1310 W STEWART DR	STE 410	ORANGE	CA	92868	3895	30	06059	33.78236048	-117.8664975	Orange County
208520	Fee-for-Service	1477036804	1477036804	1	1	HARRINGTON, MELANIE OT	8/2/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	3180 ARDEN WY	None	SACRAMENTO	CA	95825	3701	34	06067	38.595528	-121.3903395	Sacramento County
208607	Fee-for-Service	1780762674	1780762674	1	1	HTOON, AUNG A MD	9/8/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79964	41	Internal Medicine	0	In state provider	None	800 DOUGLAS RD	None	STOCKTON	CA	95207	3607	39	06077	38.00786919	-121.3210892	San Joaquin County
208625	Fee-for-Service	1679544472	1679544472	1	1	HALSEY,WILLIAM S MD	8/24/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	30707	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
208626	Fee-for-Service	1154053924	1154053924	1	1	HUGHES, LYNDSAY LCSW	1/15/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
208640	Fee-for-Service	1629761218	1629761218	1	1	HAYES, KRISTA D DOULA	7/21/2023	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	01	06001	0	0	None
208671	Fee-for-Service	1407950710	1407950710	1	1	HAFFNER, GARY B MD	11/8/2006	207R00000X	NA	Other	026	PHYSICIANS	39098	41	Internal Medicine	0	In state provider	None	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	04	06007	39.506454	-121.5412785	Butte County
208706	Fee-for-Service	1538165675	1538165675	1	1	HOFFMAN, DAVID MJ MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	55344	41	Internal Medicine	0	In state provider	None	8635 W 3RD ST	None	LOS ANGELES	CA	90048	6101	19	06037	34.07361928	-118.3803143	Los Angeles County
208715	Fee-for-Service	1588658397	1588658397	1	1	HOWELL, STEVEN L OD	1/1/1984	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	620 W YOSEMITE AVE	None	MADERA	CA	93637	4523	20	06039	36.95712331	-120.0665526	Madera County
208744	Fee-for-Service	1316386287	1316386287	1	1	HANNA, NICHOLAS M DO	7/8/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	13527	08	Family Practice	0	In state provider	None	1301 MISSION STREET	None	SANTA CRUZ	CA	95030	3528	44	06087	36.96817615	-122.0381947	Santa Cruz County
208746	Fee-for-Service	1790922896	1790922896	1	1	HOU, JACK C MD	8/18/2022	208800000X	NA	Other	026	PHYSICIANS	132236	None	None	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
208756	Fee-for-Service	1386955862	1386955862	1	1	HUANG, JINGBO MD	10/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125465	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
208787	Fee-for-Service	1891898797	1891898797	1	1	HUSSAIN, TANVIR MD	5/19/2014	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	87962	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
208789	Fee-for-Service	1730451238	1730451238	1	1	HUANG, JACKSON CNP	11/10/2021	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
208797	Fee-for-Service	1164594339	1164594339	1	2	HWANG, STANLEY MD PC	9/16/2010	174400000X	NA	Other	026	PHYSICIANS	58772	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	355 ABBOTT STREET	SUITE 100	SALINAS	CA	93901	4401	27	06053	36.66552031	-121.6439174	Monterey County
208854	Fee-for-Service	1982082129	1982082129	1	1	HONG, ALBERT MD	10/3/2019	207P00000X	NA	Other	026	PHYSICIANS	154521	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
208861	Fee-for-Service	1669423331	1669423331	1	1	HANDLER, STEPHEN MD	2/6/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	25116	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
208864	Fee-for-Service	1598837304	1598837304	1	1	HATTENDORF, BRANDY A MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89496	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
208866	Fee-for-Service	1356594816	1356594816	1	1	HOLAWAY, ROBERT M PHD	10/25/2010	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
208893	Fee-for-Service	1720026875	1720026875	1	1	HANDLY, NEAL B	2/8/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145124	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2700 DOLBEER STREET	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
208897	Fee-for-Service	1346467826	1346467826	1	1	HSU CLARA PEI-LING	12/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60894	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
208914	Fee-for-Service	1679544472	1679544472	1	1	HALSEY,WILLIAM S MD	8/24/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	30707	04	Otology, Laryngology, Rhinology	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
208933	Fee-for-Service	1609085745	1609085745	1	1	HUANG, YUNG L MD	8/3/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121437	02	General Surgery	0	In state provider	None	1541 FLORIDA AVE	None	MODESTO	CA	95350	4438	50	06099	37.666863	-120.9962775	Stanislaus County
208940	Fee-for-Service	1811006612	1811006612	1	1	HAKIM, SAEED MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	24238	02	General Surgery	0	In state provider	None	8930 S SEPULVEDA BLVD	STE 207	LOS ANGELES	CA	90045	3624	19	06037	33.955128	-118.3961915	Los Angeles County
208974	Fee-for-Service	1093893778	1093893778	1	1	HALL, ADRIENNE MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90679	36	Psychiatry	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
208979	Fee-for-Service	1104172634	1104172634	1	1	HERITAGE HEALTH CARE INC	8/20/2013	310400000X	NA	Other	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	OWNER/ ADMINISTRATOR	25271 BARTON RD	None	LOMA LINDA	CA	92354	3013	36	06071	34.04804454	-117.253044	San Bernardino County
209045	Fee-for-Service	1114489598	1114489598	1	1	HAMMOUD, NADINE M DO	7/5/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19668	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
209095	Fee-for-Service	1538252945	1538252945	1	1	HURWITZ, LAWRENCE M MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	43641	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
209110	Fee-for-Service	1447200449	1447200449	1	1	HIGUCHI, SHAWN K MD	5/1/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	83045	13	Neurology (M.D. only)	0	In state provider	None	11370 ANDERSON ST	STE 2400	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
209126	Fee-for-Service	1013366095	1013366095	1	1	HOANG, VICTOR C DO	9/11/2023	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	16097	None	None	0	In state provider	None	3000 Q STREET	4TH FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
209140	Fee-for-Service	1255992855	1255992855	1	1	HALLMARK, ANDREW K MD	8/1/2024	207L00000X	NA	Other	026	PHYSICIANS	192127	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
209155	Fee-for-Service	1598837304	1598837304	1	1	HATTENDORF, BRANDY A MD	8/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89496	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
209178	Fee-for-Service	1073690913	1073690913	1	1	HUANG, LYNN L MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	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
209253	Fee-for-Service	1528606076	1528606076	1	1	HERBERT, SUSAN A LMFT	6/10/2024	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
209256	Fee-for-Service	1003187535	1003187535	1	1	HERRING, CHARLES L MD APC	7/24/2013	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	84865	None	None	0	In state provider	None	6221 WILSHIRE BLVD	STE 620	LOS ANGELES	CA	90048	5215	19	06037	34.06329534	-118.3640031	Los Angeles County
209259	Fee-for-Service	1538180245	1538180245	1	1	HEALTH AND LIFE	3/27/2008	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	ORGANIZATION INC	2200 DEL PASO BLVD	None	SACRAMENTO	CA	95815	3102	34	06067	38.609991	-121.4506125	Sacramento County
209263	Fee-for-Service	1093893778	1093893778	1	1	HALL, ADRIENNE MD	7/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90679	26	Psychiatry (child)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
209331	Fee-for-Service	1336129451	1336129451	1	1	HICKS, STANELY MICHAEL MD	6/23/2008	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
209546	Fee-for-Service	1538180245	1538180245	1	1	HEALTH AND LIFE	3/27/2008	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	ORGANIZATION INC	2200 DEL PASO BLVD	None	SACRAMENTO	CA	95815	3102	34	06067	38.609991	-121.4506125	Sacramento County
209561	Fee-for-Service	1043487176	1043487176	1	1	HUSSAIN, ZAREENA MD	6/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111143	30	Radiology	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
209645	Fee-for-Service	1508918731	1508918731	1	1	HOLTZMAN, GILBERT MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	22197	36	Psychiatry	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
209683	Fee-for-Service	1942225511	1942225511	1	1	HLA, OMMAR T MD	7/3/2021	2085R0001X	NA	Other	026	PHYSICIANS	158948	None	None	0	In state provider	None	3555 ROUND BARN CIRCLE	None	SANTA ROSA	CA	95403	1757	49	06097	38.478717	-122.729715	Sonoma County
209708	Fee-for-Service	1801117700	1801117700	1	1	HAUFF, NIELS M MD	9/6/2022	207L00000X	NA	Other	026	PHYSICIANS	117803	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
209750	Fee-for-Service	1306379110	1306379110	1	1	HARPER, LAUREN M MD	7/1/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	162796	83	Rheumatology	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
209762	Fee-for-Service	1730577024	1730577024	1	1	HORNUNG, ABBEY R LMFT	7/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	468 MANZANITA AVE	STE 7	CHICO	CA	95926	1358	04	06007	39.75707298	-121.8433455	Butte County
209774	Fee-for-Service	1437614047	1437614047	1	1	HEALTHY DRAGON ACUPUNCTURE	3/4/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	320 RIVER ST	None	SANTA CRUZ	CA	95060	2723	44	06087	36.98095917	-122.028884	Santa Cruz County
209798	Fee-for-Service	1932499829	1932499829	1	1	HADLEY, BRETT G DO	2/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13114	None	None	0	In state provider	None	31700 TEMECULA WAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
209801	Fee-for-Service	1104321959	1104321959	1	33	HEALTH DIAGNOSTICS OF CALIFO	3/10/2025	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	LLEY	21030 REDWOOD RD	B	CASTRO VALLEY	CA	94546	5920	01	06001	37.69301044	-122.0736825	Alameda County
209825	Fee-for-Service	1952475253	1952475253	1	1	HIDALGO, LAUREN A MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	69316	None	None	0	In state provider	None	669 E CALAVERAS BLVD	None	MILPITAS	CA	95035	7705	43	06085	37.43330421	-121.8952653	Santa Clara County
209833	Fee-for-Service	1538180245	1538180245	1	1	HEALTH AND LIFE	11/30/2009	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	ORGANIZATION INC	2200 DEL PASO BLVD	None	SACRAMENTO	CA	95815	3102	34	06067	38.609991	-121.4506125	Sacramento County
209925	Fee-for-Service	1508842006	1508842006	1	1	HAGER, BRIAN C DO	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
209931	Fee-for-Service	1285997080	1285997080	1	1	HOO, NANCY M MD	6/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127461	40	Pediatrics	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
209979	Fee-for-Service	1518501527	1518501527	1	1	HARMONIC SOLUTIONS LLC	12/17/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1776 YGNACIO VALLEY ROAD	206	WALNUT CREEK	CA	94598	3190	07	06013	37.91657746	-122.0403263	Contra Costa County
210026	Fee-for-Service	1841598109	1841598109	1	1	HENDLER, ADI LMFT	8/16/2021	101YM0800X	NA	Other	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
210033	Fee-for-Service	1013022615	1013022615	1	1	HASSANKHANI, ALBORZ MD	1/12/2012	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	71799	None	None	0	In state provider	None	5525 GROSSMONT CTR DR	STE 609	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
210036	Fee-for-Service	1306379110	1306379110	1	1	HARPER, LAUREN M MD	7/1/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	162796	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
210042	Fee-for-Service	1811441975	1811441975	1	1	HORIEH, DEAN I CRNA	1/24/2017	No Taxonomy Provided	NA	None	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
210066	Fee-for-Service	1851443675	1851443675	1	1	HADDAD, ISSAC MD INC	5/1/2009	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	90074	40	Pediatrics	0	In state provider	None	2990 E COLORADO BLVD	STE 105C	PASADENA	CA	91107	4463	19	06037	34.1461666	-118.0884437	Los Angeles County
210084	Fee-for-Service	1104321959	1104321959	1	21	HEALTH DIAGNOSTICS OF CALIFO	4/21/2022	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	6185 PASEO DEL NORTE	STE 110	CARLSBAD	CA	92011	1152	37	06073	33.11651363	-117.316013	San Diego County
210117	Fee-for-Service	1518962083	1518962083	1	1	HOSPICE OF SAN JOAQUIN	11/7/1994	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3888 PACIFIC AVE	None	STOCKTON	CA	95204	1953	39	06077	37.9836276	-121.3093935	San Joaquin County
210142	Fee-for-Service	1497798730	1497798730	1	1	HASS, VICTOR N MD	2/4/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85219	None	None	0	In state provider	None	460 GREENFIELD AVE	STE 4	HANFORD	CA	93230	3500	16	06031	36.3296463	-119.6581535	Kings County
210161	Fee-for-Service	1689838641	1689838641	1	1	HAQUE, DILRUBA N MD	5/15/2014	207R00000X	NA	Other	026	PHYSICIANS	96156	None	None	0	In state provider	None	1441 EASTLAKE AVE	NOR8302E	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
210177	Fee-for-Service	1447411566	1447411566	1	1	HAMIDI, SANAZ MD	7/22/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114427	None	None	0	In state provider	None	3751 KATELLA AVENUE	None	LOS ALAMITOS	CA	90720	3113	30	06059	33.80318353	-118.0666665	Orange County
210246	Fee-for-Service	1730237645	1730237645	1	1	HAUSMAN, CHERYL J	12/24/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	732 N BROADWAY	None	ESCONDIDO	CA	92025	1870	37	06073	33.13001532	-117.0851623	San Diego County
210249	Fee-for-Service	1760410518	1760410518	1	1	HARDY, WILLIAM D MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40623	77	Infectious Disease	0	In state provider	None	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90095	0001	19	06037	34.07671715	-118.3799413	Los Angeles County
210302	Fee-for-Service	1871886135	1871886135	1	1	HAIR, VALERIE PT	3/17/2023	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
210303	Fee-for-Service	1104321959	1104321959	1	31	HEALTH DIAGNOSTICS OF CALIFO	3/11/2025	2085R0202X	NA	Mammography/MRI Provider	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	99 N LA CIENEGA BLVD	103	BEVERLY HILLS	CA	90211	2285	19	06037	34.06736471	-118.3763201	Los Angeles County
210306	Fee-for-Service	1558329623	1558329623	2	1	HAMEED, KHAN J MD	3/17/2021	2086S0129X	NA	General Surgery	026	PHYSICIANS	37664	None	None	0	In state provider	None	315 N 3RD AVE	SUITE 300	COVINA	CA	91723	9179	19	06037	34.08873786	-117.8923869	Los Angeles County
210350	Fee-for-Service	1336191386	1336191386	1	1	HSU, CHAI-LIN MD	5/1/1999	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	66913	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
210359	Fee-for-Service	1013088871	1013088871	1	1	HUANG, JEANNIE S MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61762	10	Gastroenterology (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
210377	Fee-for-Service	1104321959	1104321959	1	33	HEALTH DIAGNOSTICS OF CALIFO	1/13/2025	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	LLEY	21030 REDWOOD RD	B	CASTRO VALLEY	CA	94546	5920	01	06001	37.69301044	-122.0736825	Alameda County
210379	Fee-for-Service	1508574781	1508574781	1	1	HELPING HANDS MEDICAL TRANSP	4/25/2023	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ORTATION II, INC	2191 5TH ST	STE 201	NORCO	CA	92860	1965	33	06065	33.93162823	-117.5638152	Riverside County
210392	Fee-for-Service	1700414661	1700414661	1	1	HILL, JESSI C DO	9/26/2022	207P00000X	NA	Other	026	PHYSICIANS	19572	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
210405	Fee-for-Service	1518962083	1518962083	1	1	HOSPICE OF SAN JOAQUIN	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3888 PACIFIC AVE	None	STOCKTON	CA	95204	1953	39	06077	37.9836276	-121.3093935	San Joaquin County
210406	Fee-for-Service	1508931023	1508931023	1	1	HOVEIDA, KEVIN H MD	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46063	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVENUE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
210511	Fee-for-Service	1962882084	1962882084	1	1	HARRINGTON, TARA L DPM	1/10/2021	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	8220 WYMARK DRIVE	STE 200	ELK GROVE	CA	95757	6298	34	06067	38.406888	-121.4100495	Sacramento County
210513	Fee-for-Service	1689823486	1689823486	1	1	HANSAM CORP	12/11/2008	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	36919 COOK ST	#102	PALM DESERT	CA	92211	6069	33	06065	33.780348	-116.3580525	Riverside County
210532	Fee-for-Service	1003279951	1003279951	1	1	HARRIS, WILLIAM C MD	5/13/2021	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	172000	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
210540	Fee-for-Service	1114294212	1114294212	1	1	HUANG, MARGARET G MD	7/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118107	66	Emergency Medicine (Urgent Care)	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
210551	Fee-for-Service	1811051386	1811051386	1	1	HOOK, RENEE B DO	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	7526	08	Family Practice	0	In state provider	None	6344 TOPANGA CANYON BLVD	STE 2040	WOO0DLAND HILLS	CA	91367	2362	19	06037	34.18515	-118.605863	Los Angeles County
210561	Fee-for-Service	1144434200	1144434200	1	1	HAYES, MARY JEAN PHD	6/28/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	5862	-	NOT APPLICABLE	0	In state provider	None	2403 PROFESSIONAL DRIVE	SUITE 101	SANTA ROSA	CA	95403	3007	49	06097	38.463642	-122.7245175	Sonoma County
210570	Fee-for-Service	1568091528	1568091528	1	1	HANNA, ABANOUB PAUL MD	9/3/2023	207P00000X	NA	Other	026	PHYSICIANS	185993	None	None	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
210576	Fee-for-Service	1821110388	1821110388	1	1	HANLON, STACEY C MD	6/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76269	None	None	0	In state provider	None	995 BLANCO CIR	# A	SALINAS	CA	93901	4447	27	06053	36.65488958	-121.6372749	Monterey County
210591	Fee-for-Service	1942347851	1942347851	1	1	HERBERT, A JOSEPH MD	12/16/1988	207L00000X	NA	Other	026	PHYSICIANS	46241	05	Anesthesiology	0	In state provider	None	1946 SMOKEY RIDGE AVE	None	THOUSAND OAKS	CA	91362	5262	56	06111	34.19886943	-118.7858922	Ventura County
210595	Fee-for-Service	1104321959	1104321959	1	31	HEALTH DIAGNOSTICS OF CALIFO	12/6/2024	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	None	99 N LA CIENEGA BLVD	103	BEVERLY HILLS	CA	90211	2285	19	06037	34.06736471	-118.3763201	Los Angeles County
210609	Fee-for-Service	1467027870	1467027870	1	1	HM ACQUISITION LLC	6/29/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	14805 BUDWIN LN	None	POWAY	CA	92064	3006	37	06073	32.98261531	-117.0319796	San Diego County
210616	Fee-for-Service	1184766685	1184766685	1	1	HESSELTINE, ANDREW W MD INC	7/1/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	0	In state provider	None	1850 E WASHINGTON ST	None	COLTON	CA	92324	4621	36	06071	34.0483915	-117.295902	San Bernardino County
210631	Fee-for-Service	1528040508	1528040508	1	1	HOFFMAN, CHERYL MD	9/30/1986	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	60886	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
210646	Fee-for-Service	1013088871	1013088871	1	1	HUANG, JEANNIE S MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	61762	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
210694	Fee-for-Service	1508931023	1508931023	1	1	HOVEIDA, KEVIN H MD	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46063	45	Nephrology (Renal-Kidney)	0	In state provider	None	4077 FIFTH AVENUE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
210713	Fee-for-Service	1235367236	1235367236	1	1	HUMPHREY, CHRISTINE S MD	5/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135462	01	General Practice	0	In state provider	None	3201 DATA DRIVE	None	RANCHO CORDOVA	CA	95670	7374	34	06067	38.58561	-121.2838875	Sacramento County
210754	Fee-for-Service	1043548407	1043548407	1	1	HENDRICKSON, CAROLYN M MD	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111424	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
210757	Fee-for-Service	1225444235	1225444235	1	1	HEARING AID SPECIALISTS, INC	7/21/2020	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	9153 RESEDA BLVD	None	NORTHRIDGE	CA	91324	3031	19	06037	34.236792	-118.536108	Los Angeles County
210761	Fee-for-Service	1528556958	1528556958	1	1	HIGH CARE HOSPICE INC	1/29/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	74710 HIGHWAY 111	SUITE 102-223	PALM DESERT	CA	92260	3820	33	06065	33.72136847	-116.3616075	Riverside County
210771	Fee-for-Service	1013960756	1013960756	1	1	HUANG, GARY Y MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	65342	41	Internal Medicine	0	In state provider	None	555 E TACHEVAH DR	STE 3W103	PALM SPRINGS	CA	92262	5747	33	06065	33.83753681	-116.5424435	Riverside County
210786	Fee-for-Service	1801992490	1801992490	1	1	HONDA, MELVIN H OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1730 E 17TH ST	STE G	SANTA ANA	CA	92705	8624	30	06059	33.758649	-117.8430255	Orange County
210839	Fee-for-Service	1811051386	1811051386	1	1	HOOK, RENEE B DO	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	7526	01	General Practice	0	In state provider	None	6344 TOPANGA CANYON BLVD	STE 2040	WOO0DLAND HILLS	CA	91367	2362	19	06037	34.18515	-118.605863	Los Angeles County
210841	Fee-for-Service	1831119254	1831119254	1	1	HOLLIS, RICHARD K DO	8/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	5900 OLYMPIC BLVD	None	LOS ANGELES	CA	90036	4671	19	06037	34.05760692	-118.3604361	Los Angeles County
210849	Fee-for-Service	1306370465	1306370465	1	1	HURT, BRIAN MD	5/28/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	160271	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
210869	Fee-for-Service	1649255423	1649255423	1	1	HARDEV SINGH PARIHAR, MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	485 COLLIERS WAY	STE N	WEIRTON	WV	26062	5012	00	None	40.39559895	-80.52862491	Brooke County
210904	Fee-for-Service	1184766685	1184766685	1	1	HESSELTINE, ANDREW W MD INC	7/1/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1850 E WASHINGTON ST	None	COLTON	CA	92324	4621	36	06071	34.0483915	-117.295902	San Bernardino County
210910	Fee-for-Service	1750716114	1750716114	1	1	HARUTYUNYAN, ANI LCSW	3/2/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16530 VENTURA BLVD	400	ENCINO	CA	91436	4551	19	06037	34.15766626	-118.4934057	Los Angeles County
210920	Fee-for-Service	1053730788	1053730788	1	1	HAMILTON, SUZANNE C	8/16/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
210926	Fee-for-Service	1134573157	1134573157	1	1	HOFMANN, JEFFREY MD	6/11/2020	207ZP0101X	NA	Other	026	PHYSICIANS	153383	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
210942	Fee-for-Service	1558449306	1558449306	1	1	HOSANG, ROBERT A MD	9/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	40977	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
210968	Fee-for-Service	1114100443	1114100443	1	1	HOWARD, KIRK G MD INC	3/3/2008	207L00000X	NA	Other	026	PHYSICIANS	22748	05	Anesthesiology	0	In state provider	None	654 CAMINO DE LOS MARES	None	SAN CLEMENTE	CA	92673	2827	30	06059	33.45756029	-117.6497373	Orange County
210970	Fee-for-Service	1053624312	1053624312	1	1	HURWITZ, DANIELLE	12/29/2022	1041C0700X	NA	Mental Health Outpatient Services	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
210982	Fee-for-Service	1508931023	1508931023	1	1	HOVEIDA, KEVIN H MD	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46063	41	Internal Medicine	0	In state provider	None	4077 FIFTH AVENUE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
210996	Fee-for-Service	1720293277	1720293277	1	1	HENDRICKS, GLENMORE NP	2/16/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
211018	Fee-for-Service	1093823288	1093823288	1	1	HEMANT K SINHA	6/24/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1007 GOODYEAR AVE	None	GADSDEN	AL	35903	1195	00	None	34.00934587	-85.96782466	Etowah County
211028	Fee-for-Service	1225221864	1225221864	1	1	HOEG, TRACY B MD	12/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140275	25	Physical Medicine and Rehabilitation	0	In state provider	None	3421 VILLA LANE	STE 2B	NAPA	CA	94558	3060	28	06055	38.32459323	-122.2934714	Napa County
211041	Fee-for-Service	1043548407	1043548407	1	1	HENDRICKSON, CAROLYN M MD	7/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	111424	41	Internal Medicine	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
211048	Fee-for-Service	1528556958	1528556958	1	1	HIGH CARE HOSPICE INC	1/29/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	74710 HIGHWAY 111	SUITE 102-223	PALM DESERT	CA	92260	3820	33	06065	33.72136847	-116.3616075	Riverside County
211085	Fee-for-Service	1447462726	1447462726	1	1	HOLLAND, PAUL R MD	7/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108512	18	Ophthalmology	0	In state provider	None	2171 JUNIPERO SERRA BLVD	SUITE 100	DALY CITY	CA	94014	1987	41	06081	37.69836798	-122.4706688	San Mateo County
211087	Fee-for-Service	1912971300	1912971300	1	1	HSU, SHU-DEAN MD	5/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	33845	68	Hematology	0	In state provider	None	602 W WILLOW AVE	None	VISALIA	CA	93291	6102	54	06107	36.328473	-119.2979925	Tulare County
211089	Fee-for-Service	1851554687	1851554687	1	1	HONEGGER, JUDY ANN DO	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12288	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	250 SAN JOSE ST.	None	SALINAS	CA	93901	3901	27	06053	36.65817286	-121.6460674	Monterey County
211109	Fee-for-Service	1841341534	1841341534	1	1	HOOE, ERIC S PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1001 SNEATH LANE	STE 204	SAN BRUNO	CA	94066	2349	41	06081	37.63462925	-122.4259247	San Mateo County
211117	Fee-for-Service	1528040870	1528040870	1	1	HUMPHRIES, MISTY D MD	11/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	88686	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
211153	Fee-for-Service	1972757219	1972757219	1	1	HUTCHINSON, SU MD	7/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	137456	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
211171	Fee-for-Service	1982675427	1982675427	1	1	HANSER, ROBERT S DO	6/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13285	01	General Practice	0	In state provider	None	2110 N BELLFLOWER BLVD	None	LONG BEACH	CA	90815	3126	19	06037	33.795261	-118.125222	Los Angeles County
211190	Fee-for-Service	1831146034	1831146034	1	1	HALL, JEFFREY TIM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1055 N. CURTIS	None	BOISE	ID	83706	0000	00	None	43.61455048	-116.256231	Ada County
211200	Fee-for-Service	1649890401	1649890401	1	1	HERNANDEZ SAENZ, ANTONIO MD	4/17/2024	207P00000X	NA	Other	026	PHYSICIANS	186968	66	Emergency Medicine (Urgent Care)	0	In state provider	None	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	0000	19	06037	34.158213	-118.328112	Los Angeles County
211224	Fee-for-Service	1518951300	1518951300	1	25	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16105 SAND CANYON AVE	SUITE 150	IRVINE	CA	92618	3788	30	06059	33.66320123	-117.7725531	Orange County
211313	Fee-for-Service	1609950237	1609950237	1	6	HUNTINGTON FOUNDATION	8/15/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEDICAL GROUP	10 CONGRESS ST	STE 208	PASADENA	CA	91105	3023	19	06037	34.13396893	-118.1528162	Los Angeles County
211324	Fee-for-Service	1073660965	1073660965	1	1	HAGERMAN, HEATHER E MD	6/5/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102125	05	Anesthesiology	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
211345	Fee-for-Service	1417225616	1417225616	1	1	HAYES, COLLEEN R LMFT	7/20/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1430 EAST AVE	STE 2B	CHICO	CA	95926	1629	04	06007	39.76116577	-121.8188568	Butte County
211346	Fee-for-Service	1124401286	1124401286	1	1	HOLLIER, BRITTANI LCSW	7/24/2024	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
211355	Fee-for-Service	1740210707	1740210707	1	1	HOANG, KHANH T MD	9/30/1989	207L00000X	NA	Other	026	PHYSICIANS	66951	01	General Practice	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
211369	Fee-for-Service	1851521603	1851521603	1	1	HOLLAND, PAUL R MD INC	7/30/2009	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2171 JUNIPERO SERRA BLVD	STE 100	DALY CITY	CA	94014	1906	41	06081	37.69836798	-122.4706688	San Mateo County
211374	Fee-for-Service	1912971300	1912971300	1	1	HSU, SHU-DEAN MD	5/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	33845	78	Neoplastic Diseases/Oncology	0	In state provider	None	602 W WILLOW AVE	None	VISALIA	CA	93291	6102	54	06107	36.328473	-119.2979925	Tulare County
211380	Fee-for-Service	1669925343	1669925343	1	1	HASIBAR, JOAN M LMFT	7/17/2023	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
211381	Fee-for-Service	1720577125	1720577125	1	1	HAO, MENG MD	6/28/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184496	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
211384	Fee-for-Service	1528112083	1528112083	1	1	HSU, YAO W MD	10/12/2001	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	61296	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	FIRST COMMUNITY MED CLNC	2222 E 1ST ST	None	LOS ANGELES	CA	90033	3902	19	06037	34.04441482	-118.2116257	Los Angeles County
211426	Fee-for-Service	1508081571	1508081571	1	1	HARTMAN, DOUGLAS F MD	9/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	111317	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
211435	Fee-for-Service	1619907581	1619907581	1	1	HARRELL-BRUDER, BEVERLY	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	65023	66	Emergency Medicine (Urgent Care)	0	In state provider	None	435 H ST	None	CHULA VISTA	CA	91910	4307	37	06073	32.63282707	-117.0829101	San Diego County
211442	Fee-for-Service	1568857456	1568857456	1	1	HUPPERT, LAURA A MD	6/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	146809	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
211452	Fee-for-Service	1700978236	1700978236	1	1	HEMBD, DENNIS MD	2/2/2024	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	71249	None	None	0	In state provider	None	2801 K ST	SUITE 410	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
211474	Fee-for-Service	1538934823	1538934823	1	1	HEFFELFINGER, KRISTI L RCP	1/16/2024	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
211486	Fee-for-Service	1871504605	1871504605	1	1	HUNDAL, SARBJIT S MD	8/13/1992	207W00000X	NA	Ophthalmology	026	PHYSICIANS	34847	18	Ophthalmology	0	In state provider	None	39263 MISSION BLVD	None	FREMONT	CA	94539	3037	01	06001	37.56282031	-121.9592214	Alameda County
211491	Fee-for-Service	1477622660	1477622660	1	1	HU, RICHARD MD	5/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	81032	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
211501	Fee-for-Service	1750157517	1750157517	1	1	HWA ANN ACUPUNCTURE & HERBS	1/15/2024	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	INC	1433 W MERCED AVE	STE 309	WEST COVINA	CA	91790	3402	19	06037	34.06252177	-117.9477117	Los Angeles County
211516	Fee-for-Service	1518951300	1518951300	1	30	HOAG MEMORIAL HOSPITAL	10/14/2016	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	PRESBYTERIAN	16305 SAND CANYON AVE	SUITE 100	IRVINE	CA	92618	3783	30	06059	33.66201662	-117.7737316	Orange County
211519	Fee-for-Service	1871006361	1871006361	1	1	HAWAII LIFE FLIGHT, LLC	8/8/2018	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	4480 KUENE ST	None	LIHUE	HI	96766	1038	00	None	21.98648266	-159.3658178	Kauai County
211529	Fee-for-Service	1740504638	1740504638	1	1	HOLTZMAN, DANIEL J MD	9/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142055	20	Orthopedic Surgery	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2612	41	06081	37.48892015	-122.218747	San Mateo County
211542	Fee-for-Service	1174859383	1174859383	1	1	HEREDIA, PEDRO LCSW	11/27/2023	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
211566	Fee-for-Service	1053607549	1053607549	1	1	HARMON, LAURA A MD	11/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	89	Surgery-Traumatic	2	Out of state provider	None	13199 E MONTVIEW BLVD	None	AURORA	CO	80045	7201	00	None	39.748041	-104.834673	Adams County
211586	Fee-for-Service	1194761122	1194761122	1	1	HU, EUGENE W MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85852	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
211608	Fee-for-Service	1407869159	1407869159	1	1	HEAREY, RAYMOND D MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82000	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
211642	Fee-for-Service	1851927834	1851927834	1	1	HONG, WOO SUK MD	11/21/2023	207P00000X	NA	Other	026	PHYSICIANS	180579	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
211655	Fee-for-Service	1851521603	1851521603	1	1	HOLLAND, PAUL R MD INC	7/30/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	18	Ophthalmology	0	In state provider	None	2171 JUNIPERO SERRA BLVD	STE 100	DALY CITY	CA	94014	1906	41	06081	37.69836798	-122.4706688	San Mateo County
211662	Fee-for-Service	1851363386	1851363386	1	2	HORIZON HOME CARE INC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	SUITE 205	NORWALK	CA	90650	4387	19	06037	33.90523023	-118.0681168	Los Angeles County
211731	Fee-for-Service	1477545721	1477545721	1	1	HAN, WENCHIANG MD	10/2/2011	174400000X	NA	Other	026	PHYSICIANS	73066	13	Neurology (M.D. only)	0	In state provider	None	414 G ST	STE 112	MARYSVILLE	CA	95901	5663	58	06115	39.13913942	-121.5934649	Yuba County
211762	Fee-for-Service	1982755419	1982755419	1	1	HERFORD, ALAN S MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	72043	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
211768	Fee-for-Service	1366071441	1366071441	1	1	HENKE, JOSHUA NP	11/18/2024	363L00000X	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
211774	Fee-for-Service	1215022561	1215022561	2	1	HENRY, JEAN-CLAUDE MD	5/11/2010	208600000X	NA	General Surgery	026	PHYSICIANS	36648	02	General Surgery	0	In state provider	None	1401 S GRAND AVE	None	LOS ANGELES	CA	90015	3010	19	06037	34.03719097	-118.2654105	Los Angeles County
211795	Fee-for-Service	1902831092	1902831092	1	1	HOFFMAN, JEROME R MD	9/1/1995	207PE0004X	NA	Other	026	PHYSICIANS	29743	66	Emergency Medicine (Urgent Care)	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
211803	Fee-for-Service	1477563831	1477563831	1	1	HADDAD LANZEROTTI MALIN	1/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	AUBRY & GORES MDS	909 HYDE ST	STE 125	SAN FRANCISCO	CA	94109	4832	38	06075	37.78939387	-122.4170945	San Francisco County
211836	Fee-for-Service	1427397140	1427397140	1	1	HOLY CARE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	13758 VICTORY BLVD	SUITE 200	NORTH HOLLYWOOD	CA	91401	6723	19	06037	34.18664549	-118.4332815	Los Angeles County
211856	Fee-for-Service	1386638104	1386638104	1	1	HOMECARE SERVICE	1/1/1990	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	SPECIALIST INC.	328 N ORANGE ST	None	GLENDALE	CA	91203	2206	19	06037	34.151022	-118.2563805	Los Angeles County
211860	Fee-for-Service	1912929670	1912929670	1	1	HIATT, JONATHAN R MD	4/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	37809	02	General 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
211878	Fee-for-Service	1194812842	1194812842	1	1	HIPOLITO, RONALDO B MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	50691	40	Pediatrics	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	0000	39	06077	37.88652418	-121.2820956	San Joaquin County
211915	Fee-for-Service	1275780272	1275780272	1	1	HERNANDEZ, ADRIANA LMFT	1/27/2022	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
211925	Fee-for-Service	1831370899	1831370899	2	1	HIGHLAND HOME HEALTHCARE INC	1/18/2012	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	8671 WILSHIRE BLVD	STE 606	BEVERLY HILLS	CA	90211	2936	19	06037	34.06636104	-118.3807703	Los Angeles County
211958	Fee-for-Service	1265752380	1265752380	1	1	HUANG, JEAN MD	3/5/2018	207RE0101X	NA	Endocrinology	026	PHYSICIANS	118910	67	Endocrinology	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
211959	Fee-for-Service	1235473471	1235473471	1	1	HARRIS, TIANNA LCSW	3/28/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
211966	Fee-for-Service	1356778161	1356778161	1	1	HIRSH, KYLE	8/12/2024	207R00000X	NA	Other	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	101 CIVIC CENTER LANE	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
211990	Fee-for-Service	1154717858	1154717858	1	1	HAN, XIAO MD	9/27/2020	207P00000X	NA	Other	026	PHYSICIANS	160304	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
212051	Fee-for-Service	1326149329	1326149329	1	1	HERRICK, AMY E CRNA	1/25/2017	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
212057	Fee-for-Service	1508243825	1508243825	1	1	HAMBRECHT, AMANDA MD	8/9/2023	208600000X	NA	General Surgery	026	PHYSICIANS	175933	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
212078	Fee-for-Service	1720292949	1720292949	1	5	HEALTHY SMILES FOR KIDS	10/7/2016	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1002 W 2ND ST	None	SANTA ANA	CA	92703	3929	30	06059	33.74618758	-117.8777615	Orange County
212083	Fee-for-Service	1669415378	1669415378	1	1	HUANG, SHIHJWO MD	1/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72392	22	Pathology (M.D. only)	0	In state provider	None	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
212085	Fee-for-Service	1477563831	1477563831	1	1	HADDAD LANZEROTTI MALIN	1/1/1997	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	10	Gastroenterology (M.D. only)	0	In state provider	AUBRY & GORES MDS	909 HYDE ST	STE 125	SAN FRANCISCO	CA	94109	4832	38	06075	37.78939387	-122.4170945	San Francisco County
212096	Fee-for-Service	1205603917	1205603917	1	1	HAWK HEALTHCARE PC	6/17/2024	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	9464 9TH AVE	SUITE A	HESPERIA	CA	92345	3483	36	06071	34.42240692	-117.3208348	San Bernardino County
212103	Fee-for-Service	1497822217	1497822217	1	1	HUANG, JOSEPH MD	11/19/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	68163	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
212107	Fee-for-Service	1497034615	1497034615	1	1	HOANG, UYEN P DO	12/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13970	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
212121	Fee-for-Service	1346546363	1346546363	1	1	HOSPITALIST MEDICINE	3/1/2011	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PHYSICIANS OF SAN LUIS O	1100 LAS TABLAS RD	None	TEMPLETON	CA	93465	9704	40	06079	35.55442648	-120.719754	San Luis Obispo County
212124	Fee-for-Service	1427397140	1427397140	1	1	HOLY CARE HOSPICE INC	1/31/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	13758 VICTORY BLVD	SUITE 200	NORTH HOLLYWOOD	CA	91401	6723	19	06037	34.18664549	-118.4332815	Los Angeles County
212141	Fee-for-Service	1104296409	1104296409	1	1	HAGSTROM, ANALISE E NP	8/15/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
212211	Fee-for-Service	1104547272	1104547272	1	1	HERNANDEZ-SANCHEZ, MARISOL	11/3/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OD	500 S ATLANTIC BLVD	STE A	MONTEREY PARK	CA	91754	3872	19	06037	34.05627946	-118.1347926	Los Angeles County
212215	Fee-for-Service	1770844391	1770844391	1	1	HUYNH, AN N MD	5/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	130133	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	RM 1-340	LOS ANGELES	CA	90095	0001	19	06037	34.06482757	-118.4443441	Los Angeles County
212238	Fee-for-Service	1558453852	1558453852	1	1	HWANG, TYNG J MD	1/8/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	84502	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
212254	Fee-for-Service	1083119564	1083119564	1	1	HWANG, THOMAS MD	6/1/2023	208800000X	NA	Other	026	PHYSICIANS	186625	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
212262	Fee-for-Service	1720292949	1720292949	1	6	HEALTHY SMILES FOR KIDS	10/7/2016	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1626 E 4TH ST	None	SANTA ANA	CA	92701	5148	30	06059	33.7480891	-117.8458186	Orange County
212263	Fee-for-Service	1255569836	1255569836	1	1	HO, THOMAS H MD	10/17/2012	207L00000X	NA	Other	026	PHYSICIANS	121504	05	Anesthesiology	0	In state provider	None	2701 S BRISTOL ST	None	SANTA ANA	CA	92704	6201	30	06059	33.71114199	-117.8853958	Orange County
212269	Fee-for-Service	1437311123	1437311123	1	1	HOLLANDER, RACHEL F MD	6/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111226	08	Family Practice	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2201	34	06067	38.552211	-121.449429	Sacramento County
212270	Fee-for-Service	1518951300	1518951300	1	35	HOAG MEMORIAL HOSPITAL	6/7/2018	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	4870 BARRANCA PKWY	SUITE 110	IRVINE	CA	92604	4787	30	06059	33.67639712	-117.7961326	Orange County
212273	Fee-for-Service	1740819200	1740819200	1	1	HOSLEY, JOHN D PA	6/18/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1595 GRAND AVE	100	SAN MARCOS	CA	92078	2450	37	06073	33.14530488	-117.1982671	San Diego County
212330	Fee-for-Service	1346334687	1346334687	1	1	HASADSRI,L THANIT MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	37926	01	General Practice	0	In state provider	None	601 W MURRAY AVE	None	VISALIA	CA	93291	4859	54	06107	36.333612	-119.2986405	Tulare County
212340	Fee-for-Service	1144305814	1144305814	1	1	HULTIN, CATHY A MD	10/28/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89661	66	Emergency Medicine (Urgent Care)	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
212374	Fee-for-Service	1073638623	1073638623	1	1	HOLIDAY, ERIKA PSYD	4/27/2023	103T00000X	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
212377	Fee-for-Service	1871955732	1871955732	1	1	HEIN, MIN MD	12/13/2024	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	09	06017	38.91229842	-119.9978133	El Dorado County
212383	Fee-for-Service	1881989762	1881989762	1	1	HAH, RAYMOND J MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	116815	20	Orthopedic 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
212389	Fee-for-Service	1801873427	1801873427	1	1	HAUPTMAN, MARK MD	7/31/1985	207R00000X	NA	Other	026	PHYSICIANS	55356	41	Internal Medicine	0	In state provider	None	24411 HEALTH CENTER DR	STE 550	LAGUNA HILLS	CA	92653	3687	30	06059	33.6087201	-117.7076948	Orange County
212398	Fee-for-Service	1194715078	1194715078	1	1	HARLEY, GARTH H MD	11/30/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	68992	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
212407	Fee-for-Service	1649209743	1649209743	1	1	HOLLYWOOD CROSS MEDICAL	3/1/1980	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CLINIC INC	1110 N WESTERN AVE	STE 201	LOS ANGELES	CA	90029	1087	19	06037	34.091289	-118.3091505	Los Angeles County
212426	Fee-for-Service	1023554631	1023554631	1	1	HAN, SEMI	3/30/2022	208M00000X	NA	Other	026	PHYSICIANS	164518	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
212500	Fee-for-Service	1932530441	1932530441	2	1	HARTMANN, JERRY D CPO	1/13/2014	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2345 S BROADWAY	#E	SANTA MARIA	CA	93454	7840	42	06083	34.91787028	-120.4361185	Santa Barbara County
212549	Fee-for-Service	1619619061	1619619061	1	1	HEROD, KANDUS J	1/31/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	500 N STREET	UNIT 506	SACRAMENTO	CA	95814	4330	34	06067	38.57715	-121.5012285	Sacramento County
212557	Fee-for-Service	1518951300	1518951300	1	23	HOAG MEMORIAL HOSPITAL	4/3/2014	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	19582 BEACH BLVD	SUITE 180	HUNTINGTON BEACH	CA	92648	2996	30	06059	33.67831649	-117.9885198	Orange County
212621	Fee-for-Service	1184823916	1184823916	1	1	HERNANDEZ, APRIL K PSYD	8/7/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2801 4TH AVE	None	SAN DIEGO	CA	92103	6207	37	06073	32.73471	-117.1612005	San Diego County
212648	Fee-for-Service	1639706336	1639706336	1	1	HARTMAN, ALEXANDER J MD	8/9/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	183809	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
212696	Fee-for-Service	1487005260	1487005260	1	1	HOPKINS, HEATHER N LCSW	6/3/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	255 TERRACINA BLVD	SUITE 204	REDLANDS	CA	92373	4870	36	06071	34.03788441	-117.2055761	San Bernardino County
212710	Fee-for-Service	1922240258	1922240258	1	1	HERRMANN, ANGELA MD INC	4/27/2009	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	None	630 SOUTH GLASSELL AVE	SUITE 106A	ORANGE	CA	92866	3004	30	06059	33.77799	-117.8532285	Orange County
212775	Fee-for-Service	1669665436	1669665436	1	1	HAQ, ALINA MD	8/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116328	41	Internal Medicine	0	In state provider	None	2505 WEST HAMMER LANE	None	STOCKTON	CA	95209	2839	39	06077	38.02139448	-121.347738	San Joaquin County
212778	Fee-for-Service	1104102201	1104102201	1	1	HA, YEN K OD	11/10/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	500 S ATLANTIC BLVD	STE A	MONTEREY PARK	CA	91754	3872	19	06037	34.05627946	-118.1347926	Los Angeles County
212797	Fee-for-Service	1629497060	1629497060	1	1	HUGHES, EVERARD H MD	7/28/2014	261Q00000X	NA	Other	026	PHYSICIANS	32722	41	Internal Medicine	0	In state provider	PROFESSIONAL MEDICAL	3798 JANES RD	SUITE 10	ARCATA	CA	95521	4753	12	06023	40.89649119	-124.0930501	Humboldt County
212815	Fee-for-Service	1770619447	1770619447	1	3	HARRY M MILLER MD INC	1/18/2013	207L00000X	NA	Other	026	PHYSICIANS	60912	None	None	0	In state provider	None	2947 CHINO AVENUE	SUITE D2	CHINO HILLS	CA	91709	3585	36	06071	34.01062009	-117.7414058	San Bernardino County
212829	Fee-for-Service	1356319826	1356319826	1	1	HAN, THIN T MD	12/26/2007	207R00000X	NA	Other	026	PHYSICIANS	93507	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
212835	Fee-for-Service	1619619061	1619619061	1	1	HEROD, KANDUS J	1/31/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	500 N STREET	UNIT 506	SACRAMENTO	CA	95814	4330	34	06067	38.57715	-121.5012285	Sacramento County
212908	Fee-for-Service	1174580880	1174580880	1	1	HEER, JAGDIPAK MD	10/18/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55008	01	General Practice	0	In state provider	None	327 CHESTER AVE	None	BAKERSFIELD	CA	93301	5413	15	06029	35.36002269	-119.0189312	Kern County
212940	Fee-for-Service	1396775870	1396775870	1	1	HERBERT, JOHN L	3/1/2002	2084P0800X	NA	Psychiatry	026	PHYSICIANS	66335	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
212974	Fee-for-Service	1194105890	1194105890	1	1	HUANG, MING J DO	12/6/2019	207L00000X	NA	Other	026	PHYSICIANS	16363	05	Anesthesiology	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
212990	Fee-for-Service	1235834375	1235834375	1	1	HALACOGLU, CARI A DO	1/24/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	233309	30	Radiology	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
213009	Fee-for-Service	1265636534	1265636534	1	1	HAMMES GANGULY, DEANNE	1/10/2008	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	M	2100 W THIRD STREET	FL 5	LOS ANGELES	CA	90057	1922	19	06037	34.06308947	-118.2733326	Los Angeles County
213018	Fee-for-Service	1801878590	1801878590	1	1	HUDSON, JAMES H. 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 TYSON AVE	None	PARIS	TN	38242	4579	00	None	36.29530685	-88.31230934	Henry County
213067	Fee-for-Service	1427259308	1427259308	1	1	HSIEH, SHU-CHIENG MD	4/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67813	68	Hematology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
213078	Fee-for-Service	1629497060	1629497060	1	1	HUGHES, EVERARD H MD	7/28/2014	261Q00000X	NA	Other	026	PHYSICIANS	32722	78	Neoplastic Diseases/Oncology	0	In state provider	PROFESSIONAL MEDICAL	3798 JANES RD	SUITE 10	ARCATA	CA	95521	4753	12	06023	40.89649119	-124.0930501	Humboldt County
213128	Fee-for-Service	1083881858	1083881858	1	1	HEO, JOLINE W MD	6/3/2010	390200000X	NA	Other	026	PHYSICIANS	105705	41	Internal Medicine	0	In state provider	None	1120 SECOND ST	# A	BRENTWOOD	CA	94513	2234	07	06013	37.93716122	-121.6978484	Contra Costa County
213133	Fee-for-Service	1427029628	1427029628	1	1	HAIGHT, BRUCE T MD INC	1/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	41117	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5565 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
213134	Fee-for-Service	1023011459	1023011459	1	1	HOFFMAN, ANTHONY R	3/26/2004	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	461 W EATON AVE	None	TRACY	CA	95376	3420	39	06077	37.74338183	-121.4325934	San Joaquin County
213148	Fee-for-Service	1669850368	1669850368	1	1	HITCHNER, LILY MD	8/1/2018	207P00000X	NA	Other	026	PHYSICIANS	146646	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
213179	Fee-for-Service	1073856035	1073856035	1	1	HASHMI, ASRA MD	9/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147436	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
213195	Fee-for-Service	1174580880	1174580880	1	1	HEER, JAGDIPAK MD	10/18/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	55008	66	Emergency Medicine (Urgent Care)	0	In state provider	None	327 CHESTER AVE	None	BAKERSFIELD	CA	93301	5413	15	06029	35.36002269	-119.0189312	Kern County
213210	Fee-for-Service	1548781917	1548781917	1	1	HERNANDEZ, MIRANDA	5/22/2024	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
213216	Fee-for-Service	1174618169	1174618169	1	1	HELINET AVIATION SERVICE	12/1/1998	No Taxonomy Provided	NA	None	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	16303 WATERMAN DRIVE	None	VAN NUYS	CA	91406	1222	19	06037	34.21505972	-118.4884717	Los Angeles County
213223	Fee-for-Service	1750450680	1750450680	1	1	HARRIS, DAVID MD	8/8/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32359	01	General Practice	0	In state provider	None	336 S HALCYON RD	None	ARROYO GRANDE	CA	93420	3898	40	06079	35.113869	-120.591639	San Luis Obispo County
213248	Fee-for-Service	1972654499	1972654499	1	1	HESPERIA UNIFIED SD	9/13/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	15576 MAIN ST	None	HESPERIA	CA	92345	3482	36	06071	34.42464781	-117.322468	San Bernardino County
213274	Fee-for-Service	1235373473	1235373473	1	1	HARLAND, APINYA NP	6/30/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	21263 ERWIN ST	None	WOODLAND HILLS	CA	91367	3715	19	06037	34.18286951	-118.5949215	Los Angeles County
213282	Fee-for-Service	1235834375	1235834375	1	1	HALACOGLU, CARI A DO	1/24/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	233309	70	Clinic (mixed specialty)	0	In state provider	None	3161 L ST	None	SACRAMENTO	CA	95816	5234	34	06067	38.570958	-121.4642295	Sacramento County
213326	Fee-for-Service	1154856946	1154856946	1	1	HSU, SHARON	6/23/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
213329	Fee-for-Service	1386067486	1386067486	1	1	HUA, JENNIFER C OD	7/18/2016	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
213332	Fee-for-Service	1891037081	1891037081	1	1	HSIAO, PATRICIA L L MD	12/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143813	01	General Practice	0	In state provider	None	8001 MADISON AVE	None	CITRUS HEIGHTS	CA	95610	7901	34	06067	38.664486	-121.266099	Sacramento County
213353	Fee-for-Service	1427259308	1427259308	1	1	HSIEH, SHU-CHIENG MD	4/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	67813	78	Neoplastic Diseases/Oncology	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
213363	Fee-for-Service	1689607293	1689607293	1	1	HINIKA, GUDATA	12/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	63029	01	General Practice	0	In state provider	None	5141 CRENSHAW BLVD	None	LOS ANGELES	CA	90043	1853	19	06037	33.9955892	-118.331023	Los Angeles County
213366	Fee-for-Service	1619931466	1619931466	1	1	HARDIN MEMORIAL HOSP	8/22/2004	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	913 N DIXIE AVE	None	ELIZABETHTOWN	KY	42701	2599	00	None	37.71075973	-85.87544734	Hardin County
213376	Fee-for-Service	1316294754	1316294754	1	1	HALL, MELANIE M MD	7/20/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	127772	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
213386	Fee-for-Service	1801659321	1801659321	1	1	HINICH, JONATHAN PT	10/31/2024	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
213387	Fee-for-Service	1417381336	1417381336	1	1	HOSPICE OF ORANGE COUNTY INC	2/27/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1440 N HARBOR BLVD	SUITE 305A	FULLERTON	CA	92835	4149	30	06059	33.88513341	-117.926041	Orange County
213423	Fee-for-Service	1205903192	1205903192	1	1	HOLLAND, SWEND MD	2/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	83683	22	Pathology (M.D. only)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
213426	Fee-for-Service	1427029628	1427029628	1	1	HAIGHT, BRUCE T MD INC	1/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	41117	18	Ophthalmology	0	In state provider	None	5565 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
213474	Fee-for-Service	1285731976	1285731976	1	1	HULLANDER, ROBERT	6/11/1998	207L00000X	NA	Other	026	PHYSICIANS	68228	05	Anesthesiology	0	In state provider	None	5469 KEARNY VILLA RD	STE 302	SAN DIEGO	CA	92123	1159	37	06073	32.83298834	-117.1388725	San Diego County
213536	Fee-for-Service	1508390782	1508390782	1	1	HUNT-HEINZEN, ELYSE M MD	12/17/2022	207P00000X	NA	Other	026	PHYSICIANS	173182	None	None	0	In state provider	None	1420 S CENTRAL AVE	None	GLENDALE	CA	91204	2508	19	06037	34.12811155	-118.2577764	Los Angeles County
213546	Fee-for-Service	1790034320	1790034320	1	1	HSU, CRYSTAL S DPM	8/22/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	1510 FLORIDA AVE	STE B	MODESTO	CA	95350	4408	50	06099	37.666053	-120.996222	Stanislaus County
213548	Fee-for-Service	1477856680	1477856680	1	1	HENRY TSENG DPM A PODIATRIC	4/27/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	MEDICAL CORPORATION	2707 E VALLEY BLVD	STE 217	WEST COVINA	CA	91792	3197	19	06037	34.00296323	-117.8868537	Los Angeles County
213553	Fee-for-Service	1457678617	1457678617	1	1	HUGHES, CLIFFORD E CRNA	9/12/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
213567	Fee-for-Service	1770653305	1770653305	1	1	HUTCHINSON, WILLIAM B MD	9/4/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	25923	02	General Surgery	0	In state provider	None	2001 SANTA MONICA BLVD	STE 560W	SANTA MONICA	CA	90404	2182	19	06037	34.02891163	-118.4797466	Los Angeles County
213582	Fee-for-Service	1720102056	1720102056	1	1	HERNANDEZ, MARIA N MD	12/7/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	51414	-	NOT APPLICABLE	0	In state provider	None	1020 S ARROYO PKWY	SUITE 110	PASADENA	CA	91105	3911	19	06037	34.128351	-118.1471735	Los Angeles County
213654	Fee-for-Service	1619931466	1619931466	1	1	HARDIN MEMORIAL HOSP	12/29/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	913 N DIXIE AVE	None	ELIZABETHTOWN	KY	42701	2599	00	None	37.71075973	-85.87544734	Hardin County
213676	Fee-for-Service	1417381336	1417381336	1	1	HOSPICE OF ORANGE COUNTY INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1440 N HARBOR BLVD	SUITE 305A	FULLERTON	CA	92835	4149	30	06059	33.88513341	-117.926041	Orange County
213709	Fee-for-Service	1083690812	1083690812	1	1	HO, CHARLES P MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	56084	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
213743	Fee-for-Service	1982979019	1982979019	1	1	HORN, ADAM R MD	12/24/2020	2085R0001X	NA	Other	026	PHYSICIANS	126697	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
213746	Fee-for-Service	1538897269	1538897269	1	1	HARRIS, MAALIYAH LMFT	4/8/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4199 CAMPUS DR	SUITE 550, OFFICE 57	IRVINE	CA	92612	4684	30	06059	33.650775	-117.838296	Orange County
213803	Fee-for-Service	1295132934	1295132934	1	1	HOPE FOR HEALING COUNSELING	12/26/2014	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	INC	16415 S COLORADO AVE	SUITE 305	PARAMOUNT	CA	90723	5053	19	06037	33.8853075	-118.1614695	Los Angeles County
213807	Fee-for-Service	1073076808	1073076808	1	1	HOANG, MARTIN MD	8/1/2024	207RC0200X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	33	06065	33.90290859	-117.4941562	Riverside County
213844	Fee-for-Service	1659362903	1659362903	1	1	HALLARE, DOMINGO A MD	7/3/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84497	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
213861	Fee-for-Service	1013020619	1013020619	1	1	HILL, LUCIUS	6/11/1982	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	BASELINE FAMILY FOOT CEN	1481 W WATERMAN AVE	STE 108	SAN BERNARDINO	CA	92404	0000	36	06071	34.12637854	-117.2787591	San Bernardino County
213881	Fee-for-Service	1457935355	1457935355	1	1	HESLIN, MARK E MD	5/30/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
213892	Fee-for-Service	1134207202	1134207202	1	1	HOKANSON, JERROLD T MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	33941	40	Pediatrics	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
213928	Fee-for-Service	1770040065	1770040065	1	1	HART, ASHTON LMFT	3/25/2025	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
213952	Fee-for-Service	1942549290	1942549290	1	1	HANSON, KYRA Y CNP	12/8/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	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
213989	Fee-for-Service	1790732527	1790732527	1	1	HERNANDEZ, MICHAEL G MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	25368	05	Anesthesiology	0	In state provider	CPMC	3875 TELEGRAPH AVE	None	OAKLAND	CA	94609	2428	01	06001	37.82802619	-122.2647821	Alameda County
214012	Fee-for-Service	1093791170	1093791170	1	1	HOSPITAL DEVELOPMENT OF WES	4/19/2017	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	13677 W MCDOWELL ROAD	None	GOODYEAR	AZ	85395	2635	00	None	33.461982	-112.3535475	Maricopa County
214026	Fee-for-Service	1306189964	1306189964	1	1	HENDRICKS, LOUIE B MD	11/3/2018	208600000X	NA	General Surgery	026	PHYSICIANS	151513	02	General Surgery	0	In state provider	None	10880 WILSHIRE BLVD	1101	LOS ANGELES	CA	90024	4112	19	06037	34.05897499	-118.4431123	Los Angeles County
214028	Fee-for-Service	1114520780	1114520780	1	1	HEART TO HEART HOSPICE AND	1/18/2023	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	11336 CAMARILLO ST	SUITE 306	NORTH HOLLYWOOD	CA	91602	3501	19	06037	34.15762023	-118.3779131	Los Angeles County
214045	Fee-for-Service	1023628732	1023628732	1	1	HIKARI ADULT & OLDER ADULT P	10/15/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	SYCHOLOGICAL CARE INC.	2221 LINCOLN PARK AVE	None	LOS ANGELES	CA	90031	2920	19	06037	34.07105982	-118.202527	Los Angeles County
214056	Fee-for-Service	1790092823	1790092823	1	1	HAENER, DANIELLE R PHD	9/8/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
214088	Fee-for-Service	1730146184	1730146184	1	1	HOLIHAN, RICHARD C MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	31923	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
214092	Fee-for-Service	1295132934	1295132934	1	1	HOPE FOR HEALING COUNSELING	12/26/2014	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	INC	16415 S COLORADO AVE	SUITE 305	PARAMOUNT	CA	90723	5053	19	06037	33.8853075	-118.1614695	Los Angeles County
214133	Fee-for-Service	1104994185	1104994185	1	1	HEALTHRIGHT 360	4/14/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	6181 MISSION STREET	None	DALY CITY	CA	94014	2002	41	06081	37.70678453	-122.4584088	San Mateo County
214160	Fee-for-Service	1831178524	1831178524	1	1	HAMBY, JEFFREY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	ST EDWARD MED SVCS INC	7301 ROGERS AVE	None	FORT SMITH	AR	72903	0000	00	None	35.35551	-94.35276	Sebastian County
214166	Fee-for-Service	1184774788	1184774788	1	1	HONG, HELENE Y OD	7/31/1992	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
214167	Fee-for-Service	1831320720	1831320720	1	1	HINDIYEH, NADA	7/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	117487	13	Neurology (M.D. only)	0	In state provider	None	300 PASTEUR DR	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
214175	Fee-for-Service	1558420398	1558420398	1	1	HORWITZ, REED M MD	12/24/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	34833	30	Radiology	0	In state provider	VENTURA COUNTY MED CTR	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
214239	Fee-for-Service	1942462783	1942462783	1	1	HARFOUCH, CHAWKI MD	2/25/2019	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	95225	77	Infectious Disease	0	In state provider	None	28078 BAXTER RD	SUITE 320	MURRIETA	CA	92563	1402	33	06065	33.615	-117.1670265	Riverside County
214244	Fee-for-Service	1205238458	1205238458	1	1	HOFFMAN, CATHERINE M PSYD	10/8/2021	103T00000X	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
214245	Fee-for-Service	1578505095	1578505095	1	1	HOSPITAL DIST#1 CRAWFORD	9/14/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COUNTY	302 N HOSPITAL DRIVE	None	GIRARD	KS	66743	2000	00	None	37.51462395	-94.8583732	Crawford County
214252	Fee-for-Service	1205809647	1205809647	1	1	HOLLAND PAUL RO	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 SERRAMONTE CTR	None	DALY CITY	CA	94015	2345	41	06081	37.67355	-122.470938	San Mateo County
214300	Fee-for-Service	1093791170	1093791170	1	1	HOSPITAL DEVELOPMENT OF WES	4/19/2017	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	13677 W MCDOWELL ROAD	None	GOODYEAR	AZ	85395	2635	00	None	33.461982	-112.3535475	Maricopa County
214306	Fee-for-Service	1437512886	1437512886	1	1	HUANG, KEVIN DO	10/4/2021	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	18928	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
214315	Fee-for-Service	1114520780	1114520780	1	1	HEART TO HEART HOSPICE AND	1/18/2023	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	PALLIATIVE CARE INC	11336 CAMARILLO ST	SUITE 306	NORTH HOLLYWOOD	CA	91602	3501	19	06037	34.15762023	-118.3779131	Los Angeles County
214341	Fee-for-Service	1689695389	1689695389	1	1	HILGER, BRUCE L MD	5/3/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	23481	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	969 PLUMAS ST	None	YUBA CITY	CA	95991	4011	51	06101	39.14263634	-121.6176593	Sutter County
214406	Fee-for-Service	1396036463	1396036463	1	1	HOUSTON, COLE J MD	5/9/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148047	01	General Practice	0	In state provider	None	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1217	36	06071	34.131303	-117.3225325	San Bernardino County
214461	Fee-for-Service	1629413521	1629413521	1	1	HADDAD, RAMI M DO	7/16/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13996	01	General Practice	0	In state provider	None	25455 BURTON RD	None	LOMA LINDA	CA	92354	3130	36	06071	34.04805253	-117.249534	San Bernardino County
214463	Fee-for-Service	1699257907	1699257907	1	1	HANNA, LINDSAY D NP	7/19/2021	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
214491	Fee-for-Service	1356658314	1356658314	1	1	HASAN, NATALYA S MD	5/30/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	113327	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
214495	Fee-for-Service	1467489427	1467489427	1	1	HIRAOKA,TOSHI MD	6/29/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	75512	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1000 NUT TREE RD	None	VACAVILLE	CA	95687	4100	48	06095	38.35581953	-121.9530257	Solano County
214533	Fee-for-Service	1578505095	1578505095	1	1	HOSPITAL DIST#1 CRAWFORD	9/14/2009	282NC0060X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	COUNTY	302 N HOSPITAL DRIVE	None	GIRARD	KS	66743	2000	00	None	37.51462395	-94.8583732	Crawford County
214534	Fee-for-Service	1316208937	1316208937	1	1	HARA, HARNEET MD	8/1/2019	2080P0207X	NA	Hematology	026	PHYSICIANS	141826	40	Pediatrics	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
214538	Fee-for-Service	1376955773	1376955773	1	1	HINDLE-KATEL, WILLIAM J MD	9/22/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	172576	None	None	0	In state provider	None	1450 TREAT BLVD	STE 250B	WALNUT CREEK	CA	94597	2168	07	06013	37.92643968	-122.0521822	Contra Costa County
214585	Fee-for-Service	1982100798	1982100798	1	1	HOOTMAN, JONATHAN R MD	4/19/2024	207RC0200X	NA	Other	026	PHYSICIANS	163992	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
214609	Fee-for-Service	1346456142	1346456142	1	1	HAWORTH, CHERILYN R LCSW	10/4/2022	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
214683	Fee-for-Service	1184181828	1184181828	1	1	HUENERGARDT, KAYLA CCC-SLP	9/26/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	667 LIGHTHOUSE AVE	201	PACIFIC GROVE	CA	93950	2644	27	06053	36.62205802	-121.9200608	Monterey County
214715	Fee-for-Service	1871865592	1871865592	1	1	HODSON, SAMANTHA T G	1/21/2016	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	115 N LOMITA AVE	None	OJAI	CA	93023	2222	56	06111	34.44902497	-119.2761422	Ventura County
214729	Fee-for-Service	1982686580	1982686580	1	1	HOLLEY, MICHELE M MD	7/7/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7942	00	None	35.110926	-114.5552445	Mohave County
214739	Fee-for-Service	1427715515	1427715515	1	1	HEALTH AND LIFE ORGANIZATION	5/2/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	965 EL CAMINO AVE	None	SACRAMENTO	CA	95815	2530	34	06067	38.611638	-121.4444745	Sacramento County
214750	Fee-for-Service	1710068069	1710068069	1	1	HALLSTRAND, JANIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4500 SAND POINT WAY NE	STE 100	SEATTLE	WA	98105	3954	00	None	47.66165594	-122.2864502	King County
214826	Fee-for-Service	1427333731	1427333731	1	1	HULL, JONNA M	10/9/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	44630 MONTEREY AVE	SUITE 100	PALM DESERT	CA	92260	3326	33	06065	33.72415798	-116.3912386	Riverside County
214827	Fee-for-Service	1144392978	1144392978	1	1	HA, ANGELICA MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	61179	40	Pediatrics	0	In state provider	None	10725 INTERNATIONAL DR	None	RANCHO CORDOVA	CA	95670	7967	34	06067	38.576079	-121.2938325	Sacramento County
214873	Fee-for-Service	1679807465	1679807465	1	1	HOFFMAN, JENNIFER L LMFT	4/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	563 BRUNSWICK RD	STE 9	GRASS VALLEY	CA	95945	9544	29	06057	39.23435666	-121.0310084	Nevada County
214927	Fee-for-Service	1376825604	1376825604	1	1	HOOKS, BARBARA M A PSYD	7/24/2017	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
214929	Fee-for-Service	1265592547	1265592547	1	1	HARVEY, WILLIAMS S DO	11/19/2013	207L00000X	NA	Other	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	5330 S HWY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
214960	Fee-for-Service	1780214973	1780214973	1	1	HOFFMAN, HOLLY F PSYD	4/5/2020	103TC0700X	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
214975	Fee-for-Service	1780682401	1780682401	1	1	HWYNN, JULIE MD	1/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	66861	41	Internal Medicine	0	In state provider	None	12555 GARDEN GROVE BLVD	STE 301	GARDEN GROVE	CA	92843	1903	30	06059	33.77450946	-117.913041	Orange County
214987	Fee-for-Service	1578573416	1578573416	1	1	HEIDENREICH, PAUL A MD	11/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	69420	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
214991	Fee-for-Service	1790198158	1790198158	1	1	HAWKINS, KELLEY L MD	7/1/2018	207W00000X	NA	Ophthalmology	026	PHYSICIANS	143169	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	SUITE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
214993	Fee-for-Service	1003995499	1003995499	1	1	HAYES, DAWN M MD	9/1/1994	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	70038	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
214994	Fee-for-Service	1528589405	1528589405	1	1	HASHM, HASSAN DO	9/23/2024	207LC0200X	NA	Other	026	PHYSICIANS	22584	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	500 N GARFIELD AVE	STE 204	MONTEREY PARK	CA	91754	1242	19	06037	34.0674894	-118.1228646	Los Angeles County
215025	Fee-for-Service	1427715515	1427715515	1	1	HEALTH AND LIFE ORGANIZATION	5/2/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	AFFILIATE	965 EL CAMINO AVE	None	SACRAMENTO	CA	95815	2530	34	06067	38.611638	-121.4444745	Sacramento County
215040	Fee-for-Service	1508956889	1508956889	1	1	HARRY, WENDELL M MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	62779	08	Family Practice	0	In state provider	None	1330 NATIVIDAD RD	None	SALINAS	CA	93906	3101	27	06053	36.696996	-121.633173	Monterey County
215047	Fee-for-Service	1396940854	1396940854	1	1	HOWARD, JAMES P MD	9/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109689	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
215061	Fee-for-Service	1144856824	1144856824	1	1	HANNA, ARIA E LMFT	10/4/2024	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
215076	Fee-for-Service	1912183716	1912183716	1	1	HSIAO, WAYLAND MD	10/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126863	34	Urology and Urological Surgery	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
215095	Fee-for-Service	1063611762	1063611762	1	1	HARTSHORN, TAMARA G MD	10/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	108105	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	200 MEDICAL PLAZA	STE 430	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
215153	Fee-for-Service	1982068797	1982068797	1	1	HUYNH, DOUGLAS C MD	8/19/2021	390200000X	NA	Other	026	PHYSICIANS	171770	05	Anesthesiology	0	In state provider	None	1225 WILSHIRE BLVD	None	LOS ANGELES	CA	90017	1901	19	06037	34.05358988	-118.2661119	Los Angeles County
215169	Fee-for-Service	1538777487	1538777487	1	1	HOPSON, KYLE W PT	4/30/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
215247	Fee-for-Service	1821124884	1821124884	1	1	HEALTH CENTER #2	7/1/1994	261QP2300X	NA	Other	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 PIERCE ST	None	SAN FRANCISCO	CA	94115	4005	38	06075	37.78238106	-122.4359186	San Francisco County
215274	Fee-for-Service	1578573416	1578573416	1	1	HEIDENREICH, PAUL A MD	11/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	69420	06	Cardiovascular Disease (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
215326	Fee-for-Service	1790873230	1790873230	1	1	HOULE, NICOLE M NP	2/8/2015	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	25500 MEDICAL CENTER DR	None	MURRIETA	CA	92562	2237	33	06065	33.5580705	-117.1835458	Riverside County
215335	Fee-for-Service	1629576244	1629576244	1	1	HERRICK, KENNETH D NP	10/4/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	606 E MILL ST	None	SAN BERNARDINO	CA	92415	0620	36	06071	34.09217051	-117.271935	San Bernardino County
215369	Fee-for-Service	1316961386	1316961386	1	1	HERLING, JOHN MD	1/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	45233	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
215383	Fee-for-Service	1366755621	1366755621	1	1	HOCKETT, MARGARET M MD	11/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	119768	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
215393	Fee-for-Service	1760427702	1760427702	1	1	HUDSON, LISA A MD	7/22/1993	207R00000X	NA	Other	026	PHYSICIANS	77153	41	Internal Medicine	0	In state provider	None	2255 YGNACIO VALLEY RD	STE A	WALNUT CREEK	CA	94598	3349	07	06013	37.92242643	-122.0301696	Contra Costa County
215394	Fee-for-Service	1417187162	1417187162	1	1	HANNOUN, DONALD MD	7/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	108456	34	Urology and Urological Surgery	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
215397	Fee-for-Service	1851786453	1851786453	1	1	HELLFELD, MEGAN W MD	7/8/2020	390200000X	NA	Other	026	PHYSICIANS	149287	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
215441	Fee-for-Service	1629425590	1629425590	1	1	HUYNH, CHI T OD INC	10/17/2016	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9225 MIRA MESA BLVD	SUITE 108	SAN DIEGO	CA	92126	4810	37	06073	32.9170405	-117.125928	San Diego County
215445	Fee-for-Service	1275896284	1275896284	1	1	HORANI, TARIQ	9/30/2022	207R00000X	NA	Other	026	PHYSICIANS	177046	None	None	0	In state provider	None	1020 29TH STREET	SUITE 570	SACRAMENTO	CA	95816	5125	34	06067	38.572803	-121.4685	Sacramento County
215470	Fee-for-Service	1073005518	1073005518	1	1	HOHENBERGER, KATIE K MD	2/27/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	None	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
215516	Fee-for-Service	1275692840	1275692840	1	1	HOWELL, JEFFREY DIXON DO	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7889	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
215566	Fee-for-Service	1285925271	1285925271	1	1	HANSEN, KURT A MD	5/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	133946	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3330 LOMITA BLVD	None	TORRANCE	CA	90505	5002	19	06037	33.81253631	-118.3435557	Los Angeles County
215576	Fee-for-Service	1326443177	1326443177	1	1	HECKLAU, AUBREY LMFT	1/10/2022	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
215585	Fee-for-Service	1043425515	1043425515	1	1	HILTON, DANIEL P MD INC	12/21/2004	193400000X	NA	Other	026	PHYSICIANS	80187	41	Internal Medicine	0	In state provider	None	17822 BEACH BLVD	STE 430	HUNTINGTON BEACH	CA	92647	7508	30	06059	33.70331388	-117.9890471	Orange County
215631	Fee-for-Service	1316382849	1316382849	1	1	HERMIZ, DAVID J MD	9/3/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	133957	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	3415 S SEPULVEDA BLVD	STE 1100	LOS ANGELES	CA	90034	7090	19	06037	34.02086527	-118.4235306	Los Angeles County
215642	Fee-for-Service	1780169128	1780169128	1	1	HUUSFELDT, ANGELA M CNP	2/26/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
215680	Fee-for-Service	1861570590	1861570590	1	1	HALVORSEN, LEE O MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	58278	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2525 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
215681	Fee-for-Service	1639558836	1639558836	1	1	HOSSAIN, LUANA J MD	8/5/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	173019	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
215683	Fee-for-Service	1760467559	1760467559	1	1	HERNANDEZ, GERARDO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	81733	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	500 DOYLE PARK DR	STE G04	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
215765	Fee-for-Service	1174576953	1174576953	1	1	HOMES, STEPHEN 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	1301 PUNCHBOWL ST	None	HONOLULU	HI	96813	2402	00	None	21.30800017	-157.8550765	Honolulu County
215766	Fee-for-Service	1154670446	1154670446	1	1	HONG, JUNGRAK MD	7/27/2021	207R00000X	NA	Other	026	PHYSICIANS	171474	None	None	0	In state provider	None	1149 W 190TH ST	None	GARDENA	CA	90248	4321	19	06037	33.85834052	-118.2958065	Los Angeles County
215793	Fee-for-Service	1619961398	1619961398	1	1	HOLGER HENNIG	7/9/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	939 HARLOW RD	STE 110	SPRINGFIELD	OR	97477	1190	00	None	44.06977851	-123.0418746	Lane County
215806	Fee-for-Service	1275692840	1275692840	1	1	HOWELL, JEFFREY DIXON DO	5/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	7889	38	Geriatrics	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
215821	Fee-for-Service	1447202460	1447202460	1	1	HATTI, VIKRAM M MD	3/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	92712	30	Radiology	0	In state provider	None	3300 W COAST HIGHWAY	None	NEWPORT BEACH	CA	92663	4007	30	06059	33.62136043	-117.9274297	Orange County
215856	Fee-for-Service	1114984366	1114984366	1	1	HANBERG, FRANCINE B MD	6/20/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	53850	77	Infectious Disease	0	In state provider	None	2701 W ALAMEDA AVE	STE 300	BURBANK	CA	91505	4408	19	06037	34.15751343	-118.3303715	Los Angeles County
215862	Fee-for-Service	1801424502	1801424502	1	1	HALL, WILLIAM L MD	6/13/2023	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	185643	None	None	0	In state provider	None	500 40TH STREET	None	BAKERSFIELD	CA	93301	1224	15	06029	35.39619932	-119.0074457	Kern County
215904	Fee-for-Service	1215122346	1215122346	1	2	HEALTH LINK	5/19/2017	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	550 BRYANT ST	SUITE 2A	SAN FRANCISCO	CA	94107	1217	38	06075	37.78041094	-122.3970264	San Francisco County
215926	Fee-for-Service	1962889964	1962889964	1	1	HONG, CONNIE MD	9/1/2018	390200000X	NA	Other	026	PHYSICIANS	143944	40	Pediatrics	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90809	1701	19	06037	33.808185	-118.1850575	Los Angeles County
215935	Fee-for-Service	1710945357	1710945357	1	1	HAW, WELDON W MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60743	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
215947	Fee-for-Service	1528409919	1528409919	1	1	HUERTA, SALLY LMFT	12/7/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	306 CAPITOL STREET	205	SALINAS	CA	93901	2394	27	06053	36.67277221	-121.6600508	Monterey County
215967	Fee-for-Service	1710218367	1710218367	1	1	HOH, DAVID A OPTOMETRIST INC	1/1/1984	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	373 9TH STREET	SUITE 201	OAKLAND	CA	94607	6516	01	06001	37.80008607	-122.2714059	Alameda County
215976	Fee-for-Service	1376539411	1376539411	1	1	HAYWARD, JOHN A MD	2/8/2015	207RH0003X	NA	Oncology	026	PHYSICIANS	61995	78	Neoplastic Diseases/Oncology	0	In state provider	None	265 COHASSET RD	STE 150	CHICO	CA	95926	2273	04	06007	39.75090044	-121.8522609	Butte County
215982	Fee-for-Service	1609946003	1609946003	1	1	HOLISTIC APPROACH INC	10/21/1993	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	HEALTH CARE AGENCY	5250 CLAREMONT AVE	STE 248	STOCKTON	CA	95207	5700	39	06077	37.99861886	-121.3102123	San Joaquin County
216015	Fee-for-Service	1285687574	1285687574	1	3	HARRIS, BRIAN W MD	6/17/2019	207P00000X	NA	Other	086	MEDICAL DIRECTORS	70720	-	NOT APPLICABLE	0	In state provider	None	660 E LOS ANGELES AVE	SUITE B2	SIMI VALLEY	CA	93065	1844	56	06111	34.27162154	-118.7846685	Ventura County
216016	Fee-for-Service	1386926665	1386926665	1	1	HUNT, KATIE L NP	4/11/2016	No Taxonomy Provided	NA	None	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
216068	Fee-for-Service	1184682486	1184682486	1	1	HILL, ARTHUR CHARLES MD	6/30/1991	208G00000X	NA	General Surgery	026	PHYSICIANS	51770	02	General Surgery	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
216080	Fee-for-Service	1619041217	1619041217	1	1	HUA, JALING MD	8/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	61856	40	Pediatrics	0	In state provider	None	2415 W VINE ST	# 22	LODI	CA	95242	3731	39	06077	38.1228953	-121.3052826	San Joaquin County
216112	Fee-for-Service	1477620367	1477620367	1	1	HAGHI, BEHZAD MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67187	01	General Practice	0	In state provider	ATTN MGA OFFICE	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
216152	Fee-for-Service	1518951300	1518951300	1	4	HOAG MEMORIAL HOSPITAL	4/6/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	1 HOAG DR	None	NEWPORT BEACH	CA	92663	4162	30	06059	33.62421676	-117.9309656	Orange County
216197	Fee-for-Service	1164747218	1164747218	1	1	HUSSAIN, MEHBOOB A MD	8/15/2023	207RE0101X	NA	Endocrinology	026	PHYSICIANS	188640	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
216198	Fee-for-Service	1285663310	1285663310	1	1	HAGHIGHAT, SHAGHAYEGH MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70308	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
216213	Fee-for-Service	1912378324	1912378324	1	1	HUNTINGTON SPECIALIST &	5/4/2017	193400000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	NURSING CORPORATION	4619 ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	1478	19	06037	34.08871316	-118.073569	Los Angeles County
216234	Fee-for-Service	1417640897	1417640897	1	1	HOLDEN, PATRICK J	6/20/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1545 W 5TH ST	STE 100	OXNARD	CA	93030	6510	56	06111	34.19757729	-119.1961091	Ventura County
216241	Fee-for-Service	1588048995	1588048995	1	2	HERRERA, KIMBERLY O LMFT	9/14/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	306 E. LANSING WAY	None	FRESNO	CA	93704	4106	10	06019	36.78753774	-119.808263	Fresno County
216264	Fee-for-Service	1548469992	1548469992	1	1	HENGAMEH RASTEGAR-MURPHY, 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
216266	Fee-for-Service	1376539411	1376539411	1	1	HAYWARD, JOHN A MD	2/8/2015	207RH0003X	NA	Oncology	026	PHYSICIANS	61995	68	Hematology	0	In state provider	None	265 COHASSET RD	STE 150	CHICO	CA	95926	2273	04	06007	39.75090044	-121.8522609	Butte County
216279	Fee-for-Service	1184659062	1184659062	1	1	HOOK, ROBERT L III MD	6/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	45710	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
216289	Fee-for-Service	1932175296	1932175296	1	1	HUFFEY, DEBORAH L LCSW	5/24/2017	No Taxonomy Provided	NA	None	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
216311	Fee-for-Service	1508090655	1508090655	1	1	HACK, KATHRYN R LMFT	12/6/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 201	ENCINO	CA	91436	2921	19	06037	34.15524484	-118.4756687	Los Angeles County
216353	Fee-for-Service	1962566653	1962566653	1	1	HUANG, KUANG JEN MD	5/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	41756	36	Psychiatry	0	In state provider	None	850 S ATLANTIC BLVD	STE 304	MONTEREY PARK	CA	91754	4729	19	06037	34.05097684	-118.1379979	Los Angeles County
216379	Fee-for-Service	1376753400	1376753400	1	1	HAYS, JEANNINE M LMFT	5/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
216406	Fee-for-Service	1194747378	1194747378	1	1	HONG, AARON SOK-JOON MD	4/27/2006	207L00000X	NA	Other	026	PHYSICIANS	60006	01	General Practice	0	In state provider	None	6115 ORANGE AVE	None	LONG BEACH	CA	90805	3042	19	06037	33.86592	-118.1773685	Los Angeles County
216456	Fee-for-Service	1801020144	1801020144	1	1	HO, JENNIFER C MD	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107231	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
216465	Fee-for-Service	1245395060	1245395060	1	1	HOENIG, JONATHAN A MD	7/31/1993	207W00000X	NA	Ophthalmology	026	PHYSICIANS	78917	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	200 STEIN PLAZA RM 1-340	None	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
216470	Fee-for-Service	1760595847	1760595847	1	1	HEARD, GENE G MD	6/1/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	55696	30	Radiology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
216502	Fee-for-Service	1912378324	1912378324	1	1	HUNTINGTON SPECIALIST &	5/4/2017	193400000X	NA	Other	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	NURSING CORPORATION	4619 ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	1478	19	06037	34.08871316	-118.073569	Los Angeles County
216524	Fee-for-Service	1467743690	1467743690	1	1	HONG, JENNIFER MD	9/8/2023	208M00000X	NA	Other	026	PHYSICIANS	187174	None	None	0	In state provider	None	ONE MEDICAL PLAZA DR	None	ROSEVILLE	CA	95661	3037	31	06061	38.76553806	-121.2497067	Placer County
216529	Fee-for-Service	1679978688	1679978688	1	1	HUYNH, JACOB MD INC	8/31/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54539	01	General Practice	0	In state provider	None	7901 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4043	30	06059	33.75930046	-117.991053	Orange County
216553	Fee-for-Service	1497849004	1497849004	1	1	HARSCH, DIANE M	8/19/2013	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
216567	Fee-for-Service	1154409902	1154409902	1	1	HALL, JONATHAN D MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	50938	01	General Practice	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
216582	Fee-for-Service	1619015393	1619015393	1	1	HOSPICE OF HUMBOLDT INC	6/1/1989	251E00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3327 TIMBER FALL COURT	None	EUREKA	CA	95503	4894	12	06023	40.778478	-124.135642	Humboldt County
216690	Fee-for-Service	1487008264	1487008264	1	1	HSIA, WEI JUNG MD	8/1/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	152530	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
216694	Fee-for-Service	1194747378	1194747378	1	1	HONG, AARON SOK-JOON MD	4/27/2006	207L00000X	NA	Other	026	PHYSICIANS	60006	41	Internal Medicine	0	In state provider	None	6115 ORANGE AVE	None	LONG BEACH	CA	90805	3042	19	06037	33.86592	-118.1773685	Los Angeles County
216716	Fee-for-Service	1073168696	1073168696	1	1	HAMILTON, MEGAN PT	6/17/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
216789	Fee-for-Service	1912378324	1912378324	1	1	HUNTINGTON SPECIALIST &	5/4/2017	193400000X	NA	Other	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	NURSING CORPORATION	4619 ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	1478	19	06037	34.08871316	-118.073569	Los Angeles County
216817	Fee-for-Service	1154479186	1154479186	1	1	HOM, DENISE G MD	3/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	85019	08	Family Practice	0	In state provider	None	25825 VERMONT AVENUE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
216822	Fee-for-Service	1346744547	1346744547	1	1	HOMER, CHRISTINA M MD	7/26/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	165354	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
216832	Fee-for-Service	1215149240	1215149240	1	1	HEITZ, ANDREA D LCSW	12/26/2017	No Taxonomy Provided	NA	None	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
216868	Fee-for-Service	1619015393	1619015393	1	1	HOSPICE OF HUMBOLDT INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3327 TIMBER FALL COURT	None	EUREKA	CA	95503	4894	12	06023	40.778478	-124.135642	Humboldt County
216880	Fee-for-Service	1396889846	1396889846	1	1	HERNANDEZ, VICTOR LMFT	2/16/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	24520 HAWTHORNE BLVD	ST 220	TORRANCE	CA	90505	6848	19	06037	33.79879508	-118.3510187	Los Angeles County
216912	Fee-for-Service	1003365941	1003365941	1	1	HERNANDEZ, BRYAN E MD	8/7/2023	207R00000X	NA	Other	026	PHYSICIANS	163637	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
216930	Fee-for-Service	1013171834	1013171834	1	1	HO, MICHAEL G MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	108864	13	Neurology (M.D. only)	0	In state provider	None	11303 W WASHINGTON BLVD	STE 100	LOS ANGELES	CA	90066	6003	19	06037	34.00408212	-118.4147433	Los Angeles County
216976	Fee-for-Service	1922568864	1922568864	1	1	HALL, OLIVIA MD	8/11/2023	207P00000X	NA	Other	026	PHYSICIANS	180357	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
216981	Fee-for-Service	1194747378	1194747378	1	1	HONG, AARON SOK-JOON MD	4/27/2006	207L00000X	NA	Other	026	PHYSICIANS	60006	05	Anesthesiology	0	In state provider	None	6115 ORANGE AVE	None	LONG BEACH	CA	90805	3042	19	06037	33.86592	-118.1773685	Los Angeles County
217027	Fee-for-Service	1619449071	1619449071	1	1	HERBERT, DELAMAR C RCP	5/11/2020	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	97 SAN MARIN DR	None	NOVATO	CA	94945	1100	21	06041	38.12173729	-122.6048491	Marin County
217076	Fee-for-Service	1912378324	1912378324	1	1	HUNTINGTON SPECIALIST &	5/4/2017	193400000X	NA	Other	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	NURSING CORPORATION	4619 ROSEMEAD BLVD	None	ROSEMEAD	CA	91770	1478	19	06037	34.08871316	-118.073569	Los Angeles County
217078	Fee-for-Service	1114099918	1114099918	1	1	HEINERT, MAYA R MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85979	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
217093	Fee-for-Service	1528233509	1528233509	1	1	HSU, KATHY M	8/31/2022	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
217149	Fee-for-Service	1710098298	1710098298	1	1	HOOBERMAN, PETER A MD	1/25/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	25964	10	Gastroenterology (M.D. only)	0	In state provider	None	20101 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.69819004	-122.0873124	Alameda County
217206	Fee-for-Service	1013446996	1013446996	1	1	HECKER, JORDYN A LMFT	5/6/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7365 CARNELIAN ST	STE 202	RANCHO CUCAMONGA	CA	91730	1100	36	06071	34.12038413	-117.6160525	San Bernardino County
217230	Fee-for-Service	1295288348	1295288348	1	1	HEALTH ACCESS FOR ALL INC	5/17/2019	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	None	6208 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98382489	-118.2226198	Los Angeles County
217337	Fee-for-Service	1184735524	1184735524	1	1	HANSEL, DONNA E MD	8/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55982	22	Pathology (M.D. only)	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
217362	Fee-for-Service	1114099918	1114099918	1	1	HEINERT, MAYA R MD	2/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85979	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93638	8761	20	06039	36.88437894	-119.8003484	Madera County
217401	Fee-for-Service	1194998419	1194998419	1	1	HAZEN, JESSICA B DO	11/4/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11078	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
217418	Fee-for-Service	1952473779	1952473779	1	1	HICKMAN, ROBERT L MD	3/3/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	73026	08	Family Practice	0	In state provider	None	1625 E MAIN ST	STE 100	EL CAJON	CA	92021	5240	37	06073	32.80969963	-116.9203429	San Diego County
217428	Fee-for-Service	1942432497	1942432497	1	1	HERMOGENO, BRENDA J MD	7/16/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	117123	41	Internal Medicine	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
217452	Fee-for-Service	1407389547	1407389547	1	1	HIERMANDI, NAHID DO	8/20/2024	2080P0208X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	23042	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
217470	Fee-for-Service	1417320896	1417320896	1	1	HOLMGREN, SARAH S CNP	6/3/2019	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
217494	Fee-for-Service	1750461810	1750461810	1	1	HEYDT, JOHN A MD	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	64103	08	Family Practice	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
217509	Fee-for-Service	1659669901	1659669901	1	1	HENRY, JAMESON MD	7/1/2017	207R00000X	NA	Other	026	PHYSICIANS	142946	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
217518	Fee-for-Service	1295288348	1295288348	1	1	HEALTH ACCESS FOR ALL INC	5/1/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	6208 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98382489	-118.2226198	Los Angeles County
217525	Fee-for-Service	1093995870	1093995870	1	1	HAN, JEANNIE MD	8/20/2009	2085R0001X	NA	Other	026	PHYSICIANS	107123	78	Neoplastic Diseases/Oncology	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
217542	Fee-for-Service	1366512071	1366512071	1	1	HAWKINS, MYRT J DO	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	5827	08	Family Practice	0	In state provider	None	31 WINHAM ST	None	SALINAS	CA	93901	3314	27	06053	36.66992723	-121.6536728	Monterey County
217548	Fee-for-Service	1508991597	1508991597	1	1	HU, RONA J MD	7/1/1998	2084P0800X	NA	Psychiatry	026	PHYSICIANS	74426	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
217554	Fee-for-Service	1235596305	1235596305	1	1	HUMFLEET, GARY L PHD	3/21/2016	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
217569	Fee-for-Service	1528112083	1528112083	1	2	HSU, YAO W MD	10/1/1999	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	61296	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3755 BEVERLY BLVD	STE 301	LOS ANGELES	CA	90004	3540	19	06037	34.0763345	-118.29078	Los Angeles County
217603	Fee-for-Service	1932411543	1932411543	1	2	HEMANS, NICHOLE LCSW	12/18/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	60950	-	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
217610	Fee-for-Service	1851518872	1851518872	1	1	HUSSAIN, SYED F MD	9/18/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98692	41	Internal Medicine	0	In state provider	None	3628 E IMPERIAL HWY	STE 100	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
217638	Fee-for-Service	1619180601	1619180601	1	1	HARROD, VIRGINIA MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1301 BARBARA JORDAN BLVD	STE 401	AUSTIN	TX	78723	3078	00	None	30.30559533	-97.7069625	Travis County
217649	Fee-for-Service	1043316730	1043316730	1	1	HAMADA, JAMES S MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30470	20	Orthopedic Surgery	0	In state provider	None	21350 HAWTHORNE BLVD	STE 274	TORRANCE	CA	90503	5639	19	06037	33.8344453	-118.3529294	Los Angeles County
217652	Fee-for-Service	1134293889	1134293889	1	1	HUTSON, AMY 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	3-3420 KUHIO HIGHWAY	STE B	HONOLULU	HI	96766	1098	00	None	21.98560043	-159.3663628	Kauai County
217653	Fee-for-Service	1447469440	1447469440	1	1	HOLLANDER, SUSAN C NP	7/18/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	165 ROWLAND WAY	SUITE 201	NOVATO	CA	94945	5055	21	06041	38.09824386	-122.559872	Marin County
217666	Fee-for-Service	1215066881	1215066881	1	1	HAMRANG, KAMBIZ MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	42928	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2390 E FLORIDA AVE	STE 205	HEMET	CA	92544	4754	33	06065	33.7477405	-116.94681	Riverside County
217670	Fee-for-Service	1871170282	1871170282	1	1	HEWAPATHIRANA, UDANIE MD	8/8/2024	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
217680	Fee-for-Service	1770593162	1770593162	1	1	HOEFER, DANIEL R MD	10/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	72103	08	Family Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
217688	Fee-for-Service	1912953506	1912953506	1	1	HARRIS, PATRICIA F MD	2/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53546	None	None	0	In state provider	None	1520 SAN PABLO STREET	STE 1000	LOS ANGELES	CA	90033	4528	19	06037	34.06269295	-118.2030006	Los Angeles County
217690	Fee-for-Service	1063897445	1063897445	1	1	HORVATH, REBECCA N LMFT	5/6/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
217704	Fee-for-Service	1952473779	1952473779	1	1	HICKMAN, ROBERT L MD	3/3/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	73026	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1625 E MAIN ST	STE 100	EL CAJON	CA	92021	5240	37	06073	32.80969963	-116.9203429	San Diego County
217805	Fee-for-Service	1295288348	1295288348	1	1	HEALTH ACCESS FOR ALL INC	5/1/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	6208 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98382489	-118.2226198	Los Angeles County
217813	Fee-for-Service	1093995870	1093995870	1	1	HAN, JEANNIE MD	8/20/2009	2085R0001X	NA	Other	026	PHYSICIANS	107123	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
217816	Fee-for-Service	1730380734	1730380734	1	1	HUGHES, PAMELA M LMFT	10/31/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	660 CAMINO AGUAJITO	204	MONTEREY	CA	93940	3654	27	06053	36.59501721	-121.8823642	Monterey County
217869	Fee-for-Service	1780296392	1780296392	1	1	HARRISON, CHARLOTTE P CCC-SL	6/7/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	P	633 WEST FIFTH STREET	OFFICE #2876B	LOS ANGELES	CA	90071	2005	19	06037	34.05071143	-118.25466	Los Angeles County
217877	Fee-for-Service	1306075379	1306075379	1	1	HIEMENZ, MATTHEW C MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143394	22	Pathology (M.D. only)	0	In state provider	None	4650 SUNSET BLVD W	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
217878	Fee-for-Service	1316970866	1316970866	1	1	HADADZ, ALI MD	10/15/2008	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	69816	01	General Practice	0	In state provider	BEVERLY HILLS MED CORP	9301 WILSHIRE BLVD	STE 405	BEVERLY HILLS	CA	90210	6138	19	06037	34.06707307	-118.3946743	Los Angeles County
217879	Fee-for-Service	1588658249	1588658249	1	1	HAUSDORFER, GLENN S MD	3/28/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	49307	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
217887	Fee-for-Service	1982615159	1982615159	1	1	HOMAYOON,KAVEH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MARICOPA MEDICAL CENTER	2601 E ROOSEVELT ST	None	PHOENIX	AZ	85008	0000	00	None	33.457203	-112.0262625	Maricopa County
217888	Fee-for-Service	1003442096	1003442096	1	1	HUANG, YUN-HAN MD	7/2/2024	207RR0500X	NA	Other	026	PHYSICIANS	178471	83	Rheumatology	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
217892	Fee-for-Service	1548930258	1548930258	1	1	HUDSON, BRIAN JONATHAN PT	2/11/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	46-900 MONROE ST	BLDG C, SUITE 304	INDIO	CA	92201	4829	33	06065	33.70748774	-116.2338705	Riverside County
217894	Fee-for-Service	1447427091	1447427091	1	1	HO, HUONG M MD	11/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114971	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
217942	Fee-for-Service	1174804777	1174804777	1	1	HOLLAND, MATTHEW J PHD	4/24/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1761 BROADWAY STREET	None	VALLEJO	CA	94589	2226	48	06095	38.13049234	-122.2522422	Solano County
217993	Fee-for-Service	1538774708	1538774708	1	1	HIGH TECH HIGH CHARTER	7/1/2022	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	SCHOOLS	2861 WOMBLE RD	ATTN: SPECIAL EDUCATION	SAN DIEGO	CA	92106	6025	37	06073	32.73540151	-117.2169778	San Diego County
218044	Fee-for-Service	1497708762	1497708762	1	1	HANSINK, RAYMOND L PHD	8/1/2002	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	29222 RANCHO VIEJ0 RD	STE 208	SAN JUAN CAPISTRA	CA	92675	1045	30	06059	33.53905045	-117.6736364	Orange County
218092	Fee-for-Service	1295288348	1295288348	1	1	HEALTH ACCESS FOR ALL INC	12/18/2017	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	6208 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98382489	-118.2226198	Los Angeles County
218103	Fee-for-Service	1699455089	1699455089	1	1	HARBOR CARE HOMES LLC	4/15/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	24632 ARTEMIA AVENUE	None	MISSION VIEJO	CA	92691	4618	30	06059	33.60433895	-117.6835935	Orange County
218109	Fee-for-Service	1134806441	1134806441	1	1	HOOVER, BENJAMIN LMFT	8/8/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1430 BLUE OAKS BLVD	STE 120	ROSEVILLE	CA	95747	5156	31	06061	38.79556567	-121.3172774	Placer County
218117	Fee-for-Service	1407077126	1407077126	1	2	HOLY INFANT HOME CARE, INC.	5/5/2022	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	791 MARYLIND AVE	BLDG 3	CLAREMONT	CA	91711	3531	19	06037	34.108965	-117.699264	Los Angeles County
218136	Fee-for-Service	1083777569	1083777569	1	1	HELDT, GREGORY P MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	33254	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
218192	Fee-for-Service	1154565612	1154565612	1	1	HO, ALAN W MD	7/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123864	05	Anesthesiology	0	In state provider	None	11160 WARNER AVE	SUITE 417	FOUNTAIN VALLEY	CA	92708	8703	30	06059	33.71630854	-117.934317	Orange County
218196	Fee-for-Service	1134445596	1134445596	1	1	HAMRA, WILLIAM S MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120675	None	None	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
218218	Fee-for-Service	1689801821	1689801821	1	1	HANNA, DIANA L MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114393	78	Neoplastic Diseases/Oncology	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
218243	Fee-for-Service	1689879751	1689879751	1	1	HOLLY G MCNULTY, 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
218247	Fee-for-Service	1902948771	1902948771	1	1	HUNTINGTON BEACH INTERNA	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GROUP INC	17822 BEACH BLVD	STE 473	HUNTINGTON BEACH	CA	92647	7168	30	06059	33.70331388	-117.9890471	Orange County
218277	Fee-for-Service	1861998122	1861998122	1	1	HERMANN, CHRISTINE E MD	8/1/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	174096	None	None	0	In state provider	None	25828 REDLANDS BLVD	101	REDLANDS	CA	92373	8450	36	06071	34.06306846	-117.240957	San Bernardino County
218279	Fee-for-Service	1922537331	1922537331	1	1	HARTMAN, JENNIFER NP	2/27/2020	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
218307	Fee-for-Service	1922128255	1922128255	2	1	HANCOCK, CHRISTOPHER R MD	9/1/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	114746	30	Radiology	0	In state provider	None	1133 N PALM CANYON DR	STE B	PALM SPRINGS	CA	92262	4431	33	06065	33.838164	-116.546796	Riverside County
218318	Fee-for-Service	1760268312	1760268312	1	1	HAZZARD, ELIJAH PT	11/2/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	77622 COUNTRY CLUB DR	STE G	PALM DESERT	CA	92211	0447	33	06065	33.75833438	-116.3101957	Riverside County
218335	Fee-for-Service	1528523123	1528523123	1	1	HO, QUANG L	4/2/2020	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	14221 EUCLID ST	SUITE F	GARDEN GROVE	CA	92843	4991	30	06059	33.757191	-117.937638	Orange County
218356	Fee-for-Service	1013445667	1013445667	1	1	HSU, RUBY NP	2/20/2025	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
218374	Fee-for-Service	1316095391	1316095391	1	1	HSIAO, WARREN MD	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	55179	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
218379	Fee-for-Service	1952609190	1952609190	1	1	HOI, HELENE HAI LIN MD	3/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114945	40	Pediatrics	0	In state provider	None	701 E EL CAMINO REAL	None	MOUNTAIN VIEW	CA	94040	6203	43	06085	37.37715796	-122.0651926	Santa Clara County
218414	Fee-for-Service	1699169813	1699169813	1	1	HEIN, JULIE D MD	10/8/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	145900	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
218425	Fee-for-Service	1083777569	1083777569	1	1	HELDT, GREGORY P MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	33254	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
218437	Fee-for-Service	1396876306	1396876306	1	1	HOPPER, MARIE C LMFT	12/27/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
218441	Fee-for-Service	1932650223	1932650223	1	1	HO, LORENA PSYD	6/21/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5755 COTTLE RD	None	SAN JOSE	CA	95123	3640	43	06085	37.246896	-121.8040865	Santa Clara County
218452	Fee-for-Service	1396296737	1396296737	1	1	HWANG, RAY PSYD	6/17/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	41 E FOOTHILL BLVD	SUITE 102	ARCADIA	CA	91006	2361	19	06037	34.15102394	-118.0297543	Los Angeles County
218462	Fee-for-Service	1437420072	1437420072	1	1	HAGGIAGI, JEHAD M MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140556	45	Nephrology (Renal-Kidney)	0	In state provider	None	11550 INDIAN HILLS	371	MISSION HILLS	CA	91345	1252	19	06037	34.28024575	-118.4588775	Los Angeles County
218484	Fee-for-Service	1750523643	1750523643	1	1	HANKS, JASON D MD	7/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122814	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
218495	Fee-for-Service	1912324864	1912324864	1	1	HQ MEDICAL INC	6/27/2014	261QM1300X	NA	Other	026	PHYSICIANS	66690	45	Nephrology (Renal-Kidney)	0	In state provider	None	11028 LOWER AZUSA RD	STE C	EL MONTE	CA	91731	1440	19	06037	34.09193387	-118.0251713	Los Angeles County
218519	Fee-for-Service	1710952957	1710952957	1	1	HO, SAI-SUN MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	66825	41	Internal Medicine	0	In state provider	None	2858 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1511	38	06075	37.72566124	-122.4028218	San Francisco County
218526	Fee-for-Service	1346649480	1346649480	1	1	HACIENDA OUTPATIENT SURGERY	9/28/2018	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	CENTER LLC	4626 WILLOW RD	STE 100	PLEASANTON	CA	94588	8555	01	06001	37.69238686	-121.8983286	Alameda County
218566	Fee-for-Service	1477303824	1477303824	1	1	H DERMATOLOGY PC	10/6/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	None	07	Dermatology	0	In state provider	None	11900 SOUTH ST	SUITE 118	CERRITOS	CA	90703	6800	19	06037	33.85844949	-118.079559	Los Angeles County
218571	Fee-for-Service	1831255595	1831255595	1	1	HEAR CENTER	6/12/1979	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	301 E DEL MAR BLVD	None	PASADENA	CA	91101	2714	19	06037	34.14040752	-118.144026	Los Angeles County
218601	Fee-for-Service	1740354349	1740354349	1	1	HU, LI FANG MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79965	78	Neoplastic Diseases/Oncology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
218676	Fee-for-Service	1013024223	1013024223	1	1	HYGEIA LTC CORP	11/13/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	786 MONTEREY PASS RD	None	MONTEREY PARK	CA	91754	3607	19	06037	34.05200264	-118.1547086	Los Angeles County
218694	Fee-for-Service	1033545298	1033545298	1	1	HULL, ROBERT K PSYD	5/15/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2131 ELKS	104	SAN BERNARDINO	CA	92404	5544	36	06071	34.13470788	-117.262434	San Bernardino County
218711	Fee-for-Service	1578591715	1578591715	1	1	HOURANI, JAMEEL M INC	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	5417	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	8631 W 3RD ST	STE 735E	LOS ANGELES	CA	90048	5996	19	06037	34.07361928	-118.3803143	Los Angeles County
218719	Fee-for-Service	1336484096	1336484096	1	1	HIGHLY ARTISTIC SURGERY INC	9/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	105747	24	Plastic Surgery	0	In state provider	None	15725 POMERADO RD	STE 212	POWAY	CA	92064	5913	37	06073	33.00037882	-117.0580735	San Diego County
218746	Fee-for-Service	1427715515	1427715515	1	4	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4986 WATT AVENUE	SUITE D	NORTH HIGHLANDS	CA	95660	5182	34	06067	38.657412	-121.381722	Sacramento County
218773	Fee-for-Service	1902120439	1902120439	1	1	HANNA, MARK MD	8/16/2018	208C00000X	NA	General Surgery	026	PHYSICIANS	126440	02	General Surgery	0	In state provider	None	7777 MILLIKEN AVENUE	STE 110, 210, 330	RANCHO CUCAMONGA	CA	91730	6781	36	06071	34.10843256	-117.5570865	San Bernardino County
218782	Fee-for-Service	1912324864	1912324864	1	1	HQ MEDICAL INC	6/27/2014	261QM1300X	NA	Other	026	PHYSICIANS	66690	41	Internal Medicine	0	In state provider	None	11028 LOWER AZUSA RD	STE C	EL MONTE	CA	91731	1440	19	06037	34.09193387	-118.0251713	Los Angeles County
218784	Fee-for-Service	1902445513	1902445513	1	1	HESSLER, MARK CRNA	10/1/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
218810	Fee-for-Service	1710952957	1710952957	1	1	HO, SAI-SUN MD	11/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	66825	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2858 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1511	38	06075	37.72566124	-122.4028218	San Francisco County
218833	Fee-for-Service	1396824082	1396824082	1	1	HARDY HOOD, LESLIE S MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	85255	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	19845 LAKE CHABOT RD	STE 302	CASTRO VALLEY	CA	94546	4055	01	06001	37.69995352	-122.087795	Alameda County
218844	Fee-for-Service	1972105500	1972105500	1	1	HEART AT HOME HEALTHCARE INC	8/25/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6356 VAN NUYS BLVD	SUITE 212	VAN NUYS	CA	91401	2627	19	06037	34.185861	-118.4487045	Los Angeles County
218878	Fee-for-Service	1558666834	1558666834	1	1	HA, CHRISTINA H CNM	9/25/2014	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
218890	Fee-for-Service	1740354349	1740354349	1	1	HU, LI FANG MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79965	68	Hematology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
218918	Fee-for-Service	1518026210	1518026210	1	1	HUGHES, RANDY M CRNA	7/19/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
218919	Fee-for-Service	1043581085	1043581085	1	1	HERNANDEZ, JORGE R LCSW	11/4/2016	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1500 21ST ST	None	SACRAMENTO	CA	95811	5216	34	06067	38.570553	-121.481325	Sacramento County
218926	Fee-for-Service	1881765774	1881765774	1	1	HIRSCH, MARTIN D MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	44124	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
218937	Fee-for-Service	1629235510	1629235510	1	1	HWANG, JOHN C MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112582	18	Ophthalmology	0	In state provider	None	2010 EAST FIRST STREET	SUITE 140	SANTA ANA	CA	92705	4086	30	06059	33.74554507	-117.8387522	Orange County
218956	Fee-for-Service	1528227998	1528227998	1	1	HENDERSON, BLAIR P MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119767	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92120	2303	37	06073	32.72663119	-117.1611714	San Diego County
218988	Fee-for-Service	1073925251	1073925251	1	1	HUGHES, CHARLOTTE K MD	1/18/2023	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	180883	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
218999	Fee-for-Service	1578591715	1578591715	1	1	HOURANI, JAMEEL M INC	10/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	5417	41	Internal Medicine	0	In state provider	None	8631 W 3RD ST	STE 735E	LOS ANGELES	CA	90048	5996	19	06037	34.07361928	-118.3803143	Los Angeles County
219006	Fee-for-Service	1104237080	1104237080	1	1	HEALTHY CHOICE HOSPICE INC	10/16/2017	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	12001 VENTURA PLACE	STE 202	STUDIO CITY	CA	91604	2622	19	06037	34.14394491	-118.393247	Los Angeles County
219009	Fee-for-Service	1336484096	1336484096	1	1	HIGHLY ARTISTIC SURGERY INC	9/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	105747	78	Neoplastic Diseases/Oncology	0	In state provider	None	15725 POMERADO RD	STE 212	POWAY	CA	92064	5913	37	06073	33.00037882	-117.0580735	San Diego County
219016	Fee-for-Service	1831279991	1831279991	1	1	HO, DAN-PHUONG N MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76031	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
219019	Fee-for-Service	1457346066	1457346066	1	1	HAUCH, RICHARD D MD	6/21/2000	207L00000X	NA	Other	026	PHYSICIANS	27709	05	Anesthesiology	0	In state provider	None	4001 J ST	None	SACRAMENTO	CA	95819	3626	34	06067	38.570526	-121.4521695	Sacramento County
219036	Fee-for-Service	1427715515	1427715515	1	4	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	4986 WATT AVENUE	SUITE D	NORTH HIGHLANDS	CA	95660	5182	34	06067	38.657412	-121.381722	Sacramento County
219061	Fee-for-Service	1124400155	1124400155	1	1	HEALING STRIDES PSYCHOTHERAP	3/12/2019	103TC1900X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	Y, INC.	12755 WEST END ROAD	None	ARCATA	CA	95521	8956	12	06023	40.876308	-124.0156755	Humboldt County
219126	Fee-for-Service	1366450116	1366450116	1	1	HALE, MAURICE J MD	9/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84687	30	Radiology	0	In state provider	None	1220 S CENTRAL AVE	STE 201	GLENDALE	CA	91204	2504	19	06037	34.131447	-118.2577905	Los Angeles County
219131	Fee-for-Service	1972105500	1972105500	1	1	HEART AT HOME HEALTHCARE INC	8/25/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6356 VAN NUYS BLVD	SUITE 212	VAN NUYS	CA	91401	2627	19	06037	34.185861	-118.4487045	Los Angeles County
219135	Fee-for-Service	1215374046	1215374046	1	1	HIGGINS, JORDAN T MD	11/14/2021	207L00000X	NA	Other	026	PHYSICIANS	137370	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
219153	Fee-for-Service	1437635604	1437635604	1	1	HALE, MOLLY K AU	2/21/2023	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
219159	Fee-for-Service	1871812727	1871812727	1	1	HARGROVE, RACHEL A MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	119227	33	Thoracic Surgery	0	In state provider	None	2865 ATLANTIC AVE	STE 205	LONG BEACH	CA	90806	1745	19	06037	33.809418	-118.185058	Los Angeles County
219192	Fee-for-Service	1578140885	1578140885	1	1	HUA, JEFFREY T CRNA	7/16/2021	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
219202	Fee-for-Service	1750428538	1750428538	1	1	HUTTON, KARA M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	90565	40	Pediatrics	0	In state provider	None	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
219222	Fee-for-Service	1548455892	1548455892	1	1	HAUGEN, KIEL K MD	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97878	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
219229	Fee-for-Service	1356873301	1356873301	1	1	HOQUE, TASFIA DO	4/25/2023	207R00000X	NA	Other	026	PHYSICIANS	20440	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
219231	Fee-for-Service	1134477995	1134477995	1	1	HESSE, TRACY LMFT	9/20/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1606 MAIN STREET	SUITE 210	NAPA	CA	94559	2824	28	06055	38.30352566	-122.288961	Napa County
219249	Fee-for-Service	1083107577	1083107577	1	1	HESHMATZADEH BEHZADI, ASHKAN	9/22/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	MD	1510 E HERNDON AVE	110	FRESNO	CA	93720	3322	10	06019	36.83756048	-119.7609525	Fresno County
219290	Fee-for-Service	1104237080	1104237080	1	1	HEALTHY CHOICE HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	12001 VENTURA PLACE	STE 202	STUDIO CITY	CA	91604	2622	19	06037	34.14394491	-118.393247	Los Angeles County
219309	Fee-for-Service	1740384353	1740384353	1	1	HSU, SHIN-FU MD APC	12/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	34621	04	Otology, Laryngology, Rhinology	0	In state provider	None	1850 S AZUSA AVE	STE 207	HACIENDA HEIGHTS	CA	91745	6853	19	06037	33.98895597	-117.9322797	Los Angeles County
219351	Fee-for-Service	1255384640	1255384640	1	1	HULL, PETER V MD	7/31/1995	207P00000X	NA	Other	026	PHYSICIANS	83071	66	Emergency Medicine (Urgent Care)	0	In state provider	None	333 SUNRISE AVE	None	ROSEVILLE	CA	95661	3479	31	06061	38.740806	-121.272001	Placer County
219369	Fee-for-Service	1386204386	1386204386	1	1	HARMONAE PSYCHOLOGICAL SERVI	10/17/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	CES, INC.	130 S. EUCLID AVE	8	PASADENA	CA	91101	2446	19	06037	34.14339645	-118.1429134	Los Angeles County
219411	Fee-for-Service	1942709803	1942709803	1	1	HUMBOLDT RADIOLOGY MEDICAL	7/13/2018	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	3300 RENNER DR	None	FORTUNA	CA	95540	3120	12	06023	40.58243651	-124.135992	Humboldt County
219423	Fee-for-Service	1487970893	1487970893	1	1	HUANG, BENJAMIN J MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120211	68	Hematology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
219444	Fee-for-Service	1265695209	1265695209	1	1	HABER, JORDANA J MD	7/3/2015	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
219475	Fee-for-Service	1275873622	1275873622	1	1	HEALTHY LIVING AT HOME	8/2/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	FRESNO LLC	1322 EAST SHAW AVENUE	SUITE 430	FRESNO	CA	93710	7904	10	06019	36.8087145	-119.7644625	Fresno County
219478	Fee-for-Service	1639565088	1639565088	1	1	HDMC HOLDINGS, LLC	7/15/2015	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
219509	Fee-for-Service	1144391970	1144391970	1	1	HEINSHEIMER, JOAN G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	37147	None	None	0	In state provider	None	1152 SOLANO AVE	STE B	ALBANY	CA	94706	1638	01	06001	37.89033695	-122.2972592	Alameda County
219561	Fee-for-Service	1902866072	1902866072	1	1	HENSEL, TYLER D MD	5/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	94162	01	General Practice	0	In state provider	None	710 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
219580	Fee-for-Service	1467653303	1467653303	1	2	HILLSIDE HOUSE INC	8/16/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1235 VERONICA SPRINGS RD	None	SANTA BARBARA	CA	93105	4522	42	06083	34.41968532	-119.742279	Santa Barbara County
219584	Fee-for-Service	1457881690	1457881690	1	1	HOOVER, BENJAMIN J MD	10/20/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	177809	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
219622	Fee-for-Service	1659457166	1659457166	1	1	HALPERIN, HARVEY D MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	46754	18	Ophthalmology	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
219629	Fee-for-Service	1942251509	1942251509	1	1	HAAS, ROBERT G MD	9/30/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	5650	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
219642	Fee-for-Service	1194138347	1194138347	1	1	HEALTHRIGHT 360	6/1/2015	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	521 S GRAND VIEW ST	None	LOS ANGELES	CA	90057	3119	19	06037	34.06084646	-118.2767813	Los Angeles County
219653	Fee-for-Service	1629230149	1629230149	1	1	HAUSER, CHARLENE A MD	9/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	112965	08	Family Practice	0	In state provider	None	10058 WOLF ROAD	None	GRASS VALLEY	CA	95949	8194	29	06057	39.04265452	-121.0952182	Nevada County
219660	Fee-for-Service	1376193409	1376193409	1	1	HULTS, AMANDA LMFT	11/21/2024	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
219705	Fee-for-Service	1619194867	1619194867	1	1	HSU, LUKE	5/25/2011	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
219713	Fee-for-Service	1487970893	1487970893	1	1	HUANG, BENJAMIN J MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120211	78	Neoplastic Diseases/Oncology	0	In state provider	None	725 WELCH RD	None	PALO ALTO	CA	94304	1601	43	06085	37.43721275	-122.1744449	Santa Clara County
219733	Fee-for-Service	1073724399	1073724399	1	1	HODGSON, JEFFREY T	5/9/2017	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
219734	Fee-for-Service	1992195663	1992195663	1	1	HASE, KATHLEEN M CRNA	6/24/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
219790	Fee-for-Service	1851827661	1851827661	1	1	HAGHVERDIAN, BRANDON A MD	9/1/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185483	None	None	0	In state provider	None	280 SOUTH MAIN STREET	SUITE 200	ORANGE	CA	92868	3852	30	06059	33.784695	-117.867327	Orange County
219847	Fee-for-Service	1902866072	1902866072	1	1	HENSEL, TYLER D MD	5/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	94162	08	Family Practice	0	In state provider	None	710 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
219858	Fee-for-Service	1366520140	1366520140	1	1	HARRISON, CAMILLE M MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64900	18	Ophthalmology	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
219877	Fee-for-Service	1669543641	1669543641	1	1	HWANG, JANE Y MD	5/9/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	83038	13	Neurology (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
219896	Fee-for-Service	1780757856	1780757856	1	1	HILO HOSPITAL	10/20/2002	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1190 WAIANUENUE AVE	None	HILO	HI	96720	2020	00	None	19.71752563	-155.1129745	Hawaii County
219929	Fee-for-Service	1386711398	1386711398	1	1	HEINDL, LISA M MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64817	02	General Surgery	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
219940	Fee-for-Service	1801098421	1801098421	1	1	HACIENDA LA PUENTE USD	1/3/1993	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	PO BOX 60002	None	CITY OF INDUSTRY	CA	91716	0002	19	06037	0	0	None
219956	Fee-for-Service	1376957795	1376957795	1	1	HAHR, JENNIFER MD	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	139471	41	Internal Medicine	0	In state provider	None	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	30	06059	33.89343304	-117.9279349	Orange County
219977	Fee-for-Service	1619686961	1619686961	1	1	HAKIMEH, MARY	1/25/2023	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
219991	Fee-for-Service	1720248339	1720248339	1	1	HINGARH, NILESH H MD INC	4/23/2007	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	80963	77	Infectious Disease	0	In state provider	None	23861 MCBEAN PKWY	STE E26	VALENCIA	CA	91355	4457	19	06037	34.39567343	-118.5542698	Los Angeles County
220002	Fee-for-Service	1487970893	1487970893	1	1	HUANG, BENJAMIN J MD	7/12/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120211	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
220083	Fee-for-Service	1285786350	1285786350	1	1	HUMBOLDT RADIOLOGY MEDICAL	7/1/1985	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
220085	Fee-for-Service	1952324790	1952324790	1	1	HEYENDAL, RICHARD N MD	11/15/1990	207L00000X	NA	Other	026	PHYSICIANS	39446	05	Anesthesiology	0	In state provider	None	23201 LAKE CENTER DR	STE 320	EL TORO	CA	92630	6808	30	06059	33.6255281	-117.7160257	Orange County
220096	Fee-for-Service	1205003027	1205003027	1	1	HASHISH, SHAMEL A MD	4/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115082	25	Physical Medicine and Rehabilitation	0	In state provider	None	5001 COMMERCE DR	None	BAKERSFIELD	CA	93309	0648	15	06029	35.36784468	-119.0578744	Kern County
220114	Fee-for-Service	1265850762	1265850762	1	1	HOYOS GOMEZ, TATIANA MD	8/2/2021	2086S0127X	NA	General Surgery	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
220156	Fee-for-Service	1548670268	1548670268	1	1	HINDOYAN, KEVORK N MD	7/31/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	140145	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
220182	Fee-for-Service	1780757856	1780757856	1	1	HILO HOSPITAL	10/20/2002	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	1190 WAIANUENUE AVE	None	HILO	HI	96720	2020	00	None	19.71752563	-155.1129745	Hawaii County
220215	Fee-for-Service	1386711398	1386711398	1	1	HEINDL, LISA M MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	64817	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
220242	Fee-for-Service	1124407119	1124407119	1	1	HEKMATJOU, HESAM MD	7/31/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151253	01	General Practice	0	In state provider	None	191 S BUENA VISTA ST	STE 100	BURBANK	CA	91505	4554	19	06037	34.15872557	-118.3283863	Los Angeles County
220273	Fee-for-Service	1083781918	1083781918	1	1	HOTCHNER, BRADLEY MD	8/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	57455	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
220279	Fee-for-Service	1720248339	1720248339	1	1	HINGARH, NILESH H MD INC	4/23/2007	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	80963	41	Internal Medicine	0	In state provider	None	23861 MCBEAN PKWY	STE E26	VALENCIA	CA	91355	4457	19	06037	34.39567343	-118.5542698	Los Angeles County
220333	Fee-for-Service	1376512376	1376512376	1	1	HASHIM, RABAB F MD	3/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53105	02	General Surgery	0	In state provider	None	1515 NEWELL AVENUE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
220348	Fee-for-Service	1558636316	1558636316	1	1	HARIRI, OMID R MD	11/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	12369	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
220350	Fee-for-Service	1396861555	1396861555	1	1	HAMMILL, CAROL H 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
220383	Fee-for-Service	1982274544	1982274544	1	1	HEALY, MADISON R CCC-SLP	6/21/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
220401	Fee-for-Service	1588329403	1588329403	1	1	HAMPTON, TAYLOR A LCSW	2/8/2025	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2716 S VERMONT AVE	UNIT 9	LOS ANGELES	CA	90007	2671	19	06037	34.029891	-118.2915225	Los Angeles County
220440	Fee-for-Service	1801892542	1801892542	1	1	HOSEK, NANCY L NP	4/11/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7140 INDIANA AVENUE	None	RIVERSIDE	CA	92509	4624	33	06065	33.93890182	-117.3977958	Riverside County
220472	Fee-for-Service	1215245436	1215245436	1	1	HSIEN, DANIEL C PT	11/28/2012	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6670 ALTON PARKWAY	None	IRVINE	CA	92618	3734	30	06059	33.65837833	-117.7727118	Orange County
220507	Fee-for-Service	1164575536	1164575536	1	1	HRACH, BARBARA A MD	1/1/1995	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	54570	41	Internal Medicine	0	In state provider	None	888 S HILL RD	None	VENTURA	CA	93003	8400	56	06111	34.26903979	-119.2062923	Ventura County
220542	Fee-for-Service	1376075796	1376075796	1	1	HERNANDEZ, DANIEL O MD	9/3/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169531	None	None	0	In state provider	None	8501 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3150	19	06037	34.0653985	-118.3769177	Los Angeles County
220543	Fee-for-Service	1699817296	1699817296	1	1	HARTT, TERI LMFT	10/23/2018	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5923 KANAN RD	None	AGOURA	CA	91301	1688	19	06037	34.15745916	-118.7563357	Los Angeles County
220580	Fee-for-Service	1609950237	1609950237	1	5	HUNTINGTON FOUNDATION	8/15/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	MEDICAL GROUP	47 CONGRESS ST	None	PASADENA	CA	91105	3008	19	06037	34.1341053	-118.1513728	Los Angeles County
220581	Fee-for-Service	1891873501	1891873501	1	1	HALL, STEPHEN K MD	4/30/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	44504	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4747 ENGLE RD	None	CARMICHAEL	CA	95608	2223	34	06067	38.6320173	-121.3545928	Sacramento County
220593	Fee-for-Service	1700930294	1700930294	1	1	HUM, DANNY OD	1/31/1993	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
220596	Fee-for-Service	1154700516	1154700516	1	1	HOUSE, NINA R MD	12/18/2020	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
220603	Fee-for-Service	1033781646	1033781646	1	1	HARDINGER, JAN S CRNA	9/29/2022	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
220605	Fee-for-Service	1376968610	1376968610	1	1	HEALTH ATLAST WEST LA INC	1/16/2015	208100000X	NA	Physical Medicine and Rehabilitation	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3030 SAWTELLE BLVD	None	LOS ANGELES	CA	90066	1408	19	06037	34.02558195	-118.4308546	Los Angeles County
220606	Fee-for-Service	1699783993	1699783993	1	1	HOANG, TRANG D MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	69641	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
220619	Fee-for-Service	1578578266	1578578266	1	1	HEPFER, MICHAEL S MD	5/11/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	86432	40	Pediatrics	0	In state provider	None	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	37	06073	33.14066871	-117.156095	San Diego County
220702	Fee-for-Service	1710768411	1710768411	1	1	HUMBOLDT COUNSELING CONNECTI	7/10/2024	261QM0850X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	ON	123 F ST STE F	None	EUREKA	CA	95501	1048	12	06023	40.80503195	-124.1666813	Humboldt County
220733	Fee-for-Service	1942527023	1942527023	1	1	HARMONY HOMES INCORPORATED	11/10/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5288 W RAMONA AVENUE	None	FRESNO	CA	93722	7132	10	06019	36.78582791	-119.8854782	Fresno County
220736	Fee-for-Service	1861533812	1861533812	1	1	HALPER, JILL D MD	12/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76176	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
220743	Fee-for-Service	1063558476	1063558476	1	1	HU, BILLY MD	12/3/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	94763	13	Neurology (M.D. only)	0	In state provider	None	2800 L ST	None	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
220805	Fee-for-Service	1760502322	1760502322	1	1	HEMCHAND KOLLI, MD INC	4/11/2019	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	1278 E LATHAM AVE	None	HEMET	CA	92543	4445	33	06065	33.7494633	-116.9588968	Riverside County
220808	Fee-for-Service	1841437241	1841437241	1	8	H STREET CLINIC, INC.	3/29/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE CARE CLINIC 2	1329 NORTH H STREET	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
220815	Fee-for-Service	1699448092	1699448092	1	1	HAKELI PHARMACY GROUP, INC.	12/14/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3109 DEL MAR AVE	None	ROSEMEAD	CA	91770	2366	19	06037	34.06473987	-118.0995734	Los Angeles County
220821	Fee-for-Service	1821270240	1821270240	1	1	HUANG, KUN J MD	3/27/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98491	01	General Practice	0	In state provider	None	830 SCENIC DRIVE	None	MODESTO	CA	95350	6131	50	06099	37.64720049	-120.982338	Stanislaus County
220856	Fee-for-Service	1386272979	1386272979	1	1	HSIANG, ELAINE Y MD	4/9/2024	207P00000X	NA	Other	026	PHYSICIANS	189240	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
220896	Fee-for-Service	1376968610	1376968610	1	1	HEALTH ATLAST WEST LA INC	1/16/2015	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	25	Physical Medicine and Rehabilitation	0	In state provider	None	3030 SAWTELLE BLVD	None	LOS ANGELES	CA	90066	1408	19	06037	34.02558195	-118.4308546	Los Angeles County
220905	Fee-for-Service	1578578266	1578578266	1	1	HEPFER, MICHAEL S MD	5/11/2004	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	86432	41	Internal Medicine	0	In state provider	None	150 VALPREDA RD	None	SAN MARCOS	CA	92069	2973	37	06073	33.14066871	-117.156095	San Diego County
220939	Fee-for-Service	1881650240	1881650240	1	1	HILL, JENNIFER A MD	4/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65448	30	Radiology	0	In state provider	None	44105 15TH ST W	None	LANCASTER	CA	93534	4088	19	06037	34.684218	-118.1568465	Los Angeles County
220948	Fee-for-Service	1811387038	1811387038	1	1	HONG, KIMBERLY M CRNA	11/7/2016	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
220966	Fee-for-Service	1851433833	1851433833	1	1	HSU, THOMAS H MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78861	34	Urology and Urological Surgery	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
220992	Fee-for-Service	1205465747	1205465747	1	2	HEALING GROVE HEALTH CENTER	4/20/2020	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	226 W ALMA AVE	SUITE 10	SAN JOSE	CA	95110	3520	43	06085	37.31327869	-121.8783424	Santa Clara County
221039	Fee-for-Service	1558608331	1558608331	1	1	HARADA, MELISSA K MD	9/18/2020	2080P0006X	NA	Psychiatry	026	PHYSICIANS	141491	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
221069	Fee-for-Service	1003405960	1003405960	1	1	HOUSE OF GRACE LLC	3/11/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	618 RIDGEFIELD DR	None	CLAREMONT	CA	91711	2430	19	06037	34.11841458	-117.7393959	Los Angeles County
221089	Fee-for-Service	1134587553	1134587553	1	1	HASTON, MAUREEN NP	1/17/2022	363L00000X	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
221091	Fee-for-Service	1841437241	1841437241	1	8	H STREET CLINIC, INC.	3/29/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE CARE CLINIC 2	1329 NORTH H STREET	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
221092	Fee-for-Service	1346525656	1346525656	1	1	HEUER, LISA OD A	9/20/2012	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	316 WALNUT ST	None	WOODLAND	CA	95695	3141	57	06113	38.678337	-121.7781855	Yolo County
221101	Fee-for-Service	1285805028	1285805028	1	1	HSUEH, FRANK C MD INC	6/15/2010	207R00000X	NA	Other	026	PHYSICIANS	61761	41	Internal Medicine	0	In state provider	None	5601 NORRIS CANYON RD	#340	SAN RAMON	CA	94583	5407	07	06013	37.77772182	-121.9579459	Contra Costa County
221106	Fee-for-Service	1386688687	1386688687	1	1	HALLIS, RAOUF G M MD	2/23/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	30602	41	Internal Medicine	0	In state provider	None	1920 COLORADO BLVD	None	SANTA MONICA	CA	90404	3414	19	06037	34.02564555	-118.477319	Los Angeles County
221123	Fee-for-Service	1265749790	1265749790	1	1	HIMELSTEIN, SAMUEL P PHD	8/28/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1400 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2616	41	06081	37.48892015	-122.218747	San Mateo County
221148	Fee-for-Service	1649480542	1649480542	1	1	HAMPTON, MICHAEL S MD	12/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	138262	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
221180	Fee-for-Service	1073650834	1073650834	1	1	HUNTINGTON BEACH PHY	1/1/1999	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	THERAPY SPECIALISTS	18800 MAIN ST	STE 208	HUNTINGTON BEACH	CA	92648	1718	30	06059	33.68890364	-117.9949974	Orange County
221200	Fee-for-Service	1023724002	1023724002	1	1	HUERTA, ANDREA C OD	5/15/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7075 N SHARON AVE	None	FRESNO	CA	93720	3329	10	06019	36.83882737	-119.7590708	Fresno County
221232	Fee-for-Service	1407289218	1407289218	1	1	HART, TRINITY S LMFT	3/12/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	525 SOUTH MAIN STREET (B	SUITE C	UKIAH	CA	95482	3910	23	06045	39.14680016	-123.2057752	Mendocino County
221243	Fee-for-Service	1043752751	1043752751	1	1	HU, ALEXANDER DO MD	9/18/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15036	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
221280	Fee-for-Service	1710126388	1710126388	1	1	HAQ, MUHAMMAD S MD	9/9/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105789	41	Internal Medicine	0	In state provider	None	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	42	06083	34.444782	-119.7794675	Santa Barbara County
221281	Fee-for-Service	1205465747	1205465747	1	2	HEALING GROVE HEALTH CENTER	4/20/2020	261QP2300X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	226 W ALMA AVE	SUITE 10	SAN JOSE	CA	95110	3520	43	06085	37.31327869	-121.8783424	Santa Clara County
221292	Fee-for-Service	1679916878	1679916878	1	1	HUANG, CYNTHIA MD	8/1/2018	207RC0200X	NA	Other	026	PHYSICIANS	None	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	411 30TH STREET	STE 314	OAKLAND	CA	94609	3312	01	06001	37.81903474	-122.2649444	Alameda County
221300	Fee-for-Service	1033524178	1033524178	1	1	HUTCHISON, JUSTIN T DO	12/16/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	16514	15	Obstetrics (D.O. only)	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
221304	Fee-for-Service	1861994600	1861994600	2	1	HEALTHQUEST ESOTERICS INC	6/1/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	None	6 BENDIX	None	IRVINE	CA	92618	2006	30	06059	33.64883449	-117.7147372	Orange County
221305	Fee-for-Service	1598813305	1598813305	1	1	HSIEH, AMY K MD	8/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78033	18	Ophthalmology	0	In state provider	None	2617 E CHAPMAN AVE	STE 301	ORANGE	CA	92869	3234	30	06059	33.7878445	-117.8254845	Orange County
221315	Fee-for-Service	1447465448	1447465448	1	1	HOFFMAN, KATHLEEN D LMFT	2/14/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	427 A ST	STE 400	LINCOLN	CA	95648	1976	31	06061	38.89076065	-121.2851473	Placer County
221319	Fee-for-Service	1093730798	1093730798	1	1	HADDADIAN, ARTO H MD APC	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	74992	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
221340	Fee-for-Service	1558577106	1558577106	1	1	HARRIS, IAN S MD	12/5/2007	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	86662	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
221357	Fee-for-Service	1003206111	1003206111	1	1	HOME OF COMPASSION NO 2 INC	3/10/2016	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	13500 BORDEN AVENUE	None	SYLMAR	CA	91342	2646	19	06037	34.31752356	-118.4561797	Los Angeles County
221402	Fee-for-Service	1548774276	1548774276	1	1	HWANG, HOJUN LAC	1/13/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
221435	Fee-for-Service	1588606610	1588606610	1	1	HUBER, GLENN MD	4/3/2024	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	65106	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
221496	Fee-for-Service	1033164017	1033164017	1	1	HOUSECALL DOCTORS MEDICAL GR	8/20/2024	207QG0300X	NA	Adult Primary Care	010	GROUP CERTIFIED NURSE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	OUP INC	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
221520	Fee-for-Service	1881895431	1881895431	1	1	HOFER, CHRISTINA M MD	4/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97466	01	General Practice	0	In state provider	None	243 MARCH ST	None	SANTA PAULA	CA	93060	2511	56	06111	34.34932722	-119.0780965	Ventura County
221554	Fee-for-Service	1033235973	1033235973	1	1	HAZEL HAWKINS MEMORIAL	6/23/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HEALTH CLINIC	930 SUNSET DR	BUILDING 3	HOLLISTER	CA	95023	5620	35	06069	36.83510073	-121.385707	San Benito County
221608	Fee-for-Service	1407042070	1407042070	1	1	HERNANDEZ, ANGELA R LMFT	9/4/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7177 BROCKTON AVE	SUITE 333 A	RIVERSIDE	CA	92506	2635	33	06065	33.94289496	-117.3943941	Riverside County
221623	Fee-for-Service	1184269607	1184269607	1	1	HAAS, REBECCA	6/3/2020	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
221624	Fee-for-Service	1598184343	1598184343	1	1	HANDSCHIN, TOBIAS MD	7/18/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	139849	None	None	0	In state provider	None	2975 NORTH SYCAMORE DR	None	SIMI VALLEY	CA	93065	1201	56	06111	34.28924598	-118.7439214	Ventura County
221661	Fee-for-Service	1467884205	1467884205	1	1	HORIUCHI, SHOKO PHD	3/25/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
221700	Fee-for-Service	1275598831	1275598831	1	1	HILTON, KEVIN R MD	6/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	79838	02	General Surgery	0	In state provider	None	1235 W VINE ST	SUITE 22	LODI	CA	95240	5144	39	06077	38.12279179	-121.2879362	San Joaquin County
221719	Fee-for-Service	1023092855	1023092855	1	1	HESSL, DAVID R PHD	5/1/2002	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4900 BROADWAY	STE 2800	SACRAMENTO	CA	95820	1536	34	06067	38.546091	-121.447305	Sacramento County
221744	Fee-for-Service	1982730834	1982730834	1	1	HARTER, PHILLIP M MD	4/30/1989	207PE0004X	NA	Other	026	PHYSICIANS	52141	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
221747	Fee-for-Service	1972519890	1972519890	1	1	HOBAN, DAVID A MD	10/17/1987	207L00000X	NA	Other	026	PHYSICIANS	44418	05	Anesthesiology	0	In state provider	None	550 WASHINGTON ST	STE 331	SAN DIEGO	CA	92103	2227	37	06073	32.75003652	-117.1603431	San Diego County
221753	Fee-for-Service	1477645489	1477645489	1	1	HAID, JOAN M DO	3/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	7551	30	Radiology	0	In state provider	None	399 E 21ST	None	SAN BERNARDINO	CA	92404	4185	36	06071	34.13403047	-117.2767275	San Bernardino County
221783	Fee-for-Service	1033164017	1033164017	1	1	HOUSECALL DOCTORS MEDICAL GR	9/6/2019	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	OUP INC	23181 VERDUGO DR	STE 103A	LAGUNA HILLS	CA	92653	1313	30	06059	33.62609529	-117.7293191	Orange County
221786	Fee-for-Service	1902098940	1902098940	1	1	HAROUTUNIAN, HARRY L	11/23/2015	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	84257	-	NOT APPLICABLE	0	In state provider	None	82353 INDIO BLVD	None	INDIO	CA	92201	3116	33	06065	33.72671547	-116.2281125	Riverside County
221809	Fee-for-Service	1881895431	1881895431	1	1	HOFER, CHRISTINA M MD	4/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	97466	41	Internal Medicine	0	In state provider	None	243 MARCH ST	None	SANTA PAULA	CA	93060	2511	56	06111	34.34932722	-119.0780965	Ventura County
221843	Fee-for-Service	1033235973	1033235973	1	1	HAZEL HAWKINS MEMORIAL	1/4/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	HEALTH CLINIC	930 SUNSET DR	BUILDING 3	HOLLISTER	CA	95023	5620	35	06069	36.83510073	-121.385707	San Benito County
221891	Fee-for-Service	1386733418	1386733418	1	1	HASTINGS, CAROLINE A MD	1/1/1999	2080P0207X	NA	Hematology	026	PHYSICIANS	60797	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
221969	Fee-for-Service	1912085689	1912085689	1	1	HERR, DAMON N MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	64752	02	General Surgery	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
222000	Fee-for-Service	1437590197	1437590197	1	1	HUANG, YIN JIANG MD	4/5/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	133453	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
222005	Fee-for-Service	1992024715	1992024715	1	1	HENRY, JAMES R MD	8/3/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	118753	26	Psychiatry (child)	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
222014	Fee-for-Service	1942837984	1942837984	1	1	HTN HOSPICE INC	8/27/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8215 VAN NUYS BLVD	STE 314	PANORAMA CITY	CA	91402	4810	19	06037	34.22026244	-118.4488066	Los Angeles County
222027	Fee-for-Service	1548201858	1548201858	1	1	HERITAGE HOME HEALTH, INC	3/21/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	18645 SHERMAN WAY	STE 208	RESEDA	CA	91335	8621	19	06037	34.20120553	-118.54026	Los Angeles County
222049	Fee-for-Service	1821244229	1821244229	1	1	HSU, MELANIE V PHD	9/11/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6620 VIA DEL ORO	None	SAN JOSE	CA	95119	1451	43	06085	37.23418124	-121.7818366	Santa Clara County
222062	Fee-for-Service	1063939759	1063939759	1	1	HAMILTON, GRACE PSYD	6/23/2020	103G00000X	NA	Other	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
222066	Fee-for-Service	1780885624	1780885624	1	1	HUCKABY, SCOTT D PHD	11/18/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
222076	Fee-for-Service	1497792147	1497792147	1	1	HO, NATHANIEL D MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73933	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
222097	Fee-for-Service	1215044300	1215044300	1	1	HUR, CHUNG OK MD	12/11/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42674	41	Internal Medicine	0	In state provider	None	710 N EUCLID ST	# 301	ANAHEIM	CA	92801	4115	30	06059	33.8420837	-117.9415765	Orange County
222132	Fee-for-Service	1033235973	1033235973	1	1	HAZEL HAWKINS MEMORIAL	6/23/1995	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HEALTH CLINIC	930 SUNSET DR	BUILDING 3	HOLLISTER	CA	95023	5620	35	06069	36.83510073	-121.385707	San Benito County
222133	Fee-for-Service	1871585349	1871585349	1	1	HIRSCH, OREN N MD	8/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94112	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
222173	Fee-for-Service	1184708166	1184708166	1	1	HENSLEY, DONALD S MD	4/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39530	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
222175	Fee-for-Service	1194170894	1194170894	1	1	HWU, JOSEPHINE MD	11/4/2021	207RN0300X	NA	Nephrology	026	PHYSICIANS	154264	None	None	0	In state provider	None	120 E EMERSON AVENUE	None	MONTEREY PARK	CA	91755	1709	19	06037	34.06610653	-118.1219085	Los Angeles County
222188	Fee-for-Service	1659864080	1659864080	1	1	HANS, MADHUPREET K DO	12/22/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17787	None	None	0	In state provider	None	568 N SUNRISE AVE	STE 250	ROSEVILLE	CA	95661	3035	31	06061	38.7576732	-121.2534645	Placer County
222222	Fee-for-Service	1376550970	1376550970	1	1	HEALY, JOHN F MD	3/31/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	22588	30	Radiology	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
222251	Fee-for-Service	1023113511	1023113511	1	1	HERSH, ALAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	38047	01	General Practice	0	In state provider	None	2027 VILLAGE LN	STE 102	SOLVANG	CA	93463	2271	42	06083	34.60089846	-120.1274865	Santa Barbara County
222292	Fee-for-Service	1720315666	1720315666	1	1	HODA, ZAHID A MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	115663	89	Surgery-Traumatic	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
222293	Fee-for-Service	1437687720	1437687720	1	1	HERMIZ, CHRISTINE DO	1/13/2025	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	23013	08	Family Practice	0	In state provider	None	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	33	06065	33.49890392	-117.1612965	Riverside County
222300	Fee-for-Service	1982021481	1982021481	1	1	HUTTON, COURTNEY N LCSW	4/27/2020	1041C0700X	NA	Mental Health Outpatient Services	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
222303	Fee-for-Service	1942837984	1942837984	1	1	HTN HOSPICE INC	8/27/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8215 VAN NUYS BLVD	STE 314	PANORAMA CITY	CA	91402	4810	19	06037	34.22026244	-118.4488066	Los Angeles County
222322	Fee-for-Service	1952987398	1952987398	1	1	HANISCH, JONATHAN R MD	3/27/2024	207R00000X	NA	Other	026	PHYSICIANS	191829	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
222353	Fee-for-Service	1558577064	1558577064	1	1	HACK, KATHRYN E LMFT	7/22/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6 SOUTH WASHINGTON ST	SUITE #7	SONORA	CA	95370	4738	55	06109	37.98523646	-120.3833545	Tuolumne County
222356	Fee-for-Service	1457809535	1457809535	1	1	HANLEY, LAUREN LCSW	8/2/2023	1041C0700X	NA	Mental Health Outpatient Services	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
222422	Fee-for-Service	1508881228	1508881228	1	1	HUYNH, LINH T MD	11/9/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	155996	08	Family Practice	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
222423	Fee-for-Service	1902863194	1902863194	1	1	HENSZEL, ANGELA L MD	6/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102858	05	Anesthesiology	0	In state provider	None	460 PLUMAS BLVD	SUITE 202	YUBA CITY	CA	95991	5005	51	06101	39.13140416	-121.6141951	Sutter County
222432	Fee-for-Service	1437238839	1437238839	1	1	HALE, RONALD J MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	21297	01	General Practice	0	In state provider	None	1450 10TH ST	STE 202	SANTA MONICA	CA	90401	2831	19	06037	34.01992119	-118.4882747	Los Angeles County
222433	Fee-for-Service	1831770858	1831770858	1	1	HOWARD, KIMBERLEY L	11/3/2023	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
222434	Fee-for-Service	1720292949	1720292949	1	2	HEALTHY SMILES FOR KIDS	12/23/2014	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	10602 CHAPMAN AVE	SUITE 200	GARDEN GROVE	CA	92840	3147	30	06059	33.78861049	-117.9480735	Orange County
222441	Fee-for-Service	1952365272	1952365272	1	1	HIROSE, RYUTARO MD	1/31/1995	208600000X	NA	General Surgery	026	PHYSICIANS	71653	47	Miscellaneous	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
222446	Fee-for-Service	1568407013	1568407013	1	1	HERBOLD, KYLE MD	11/1/2023	207N00000X	NA	Dermatology	026	PHYSICIANS	68815	None	None	0	In state provider	None	200 COTTAGE AVE	STE 201	MANTECA	CA	95336	4935	39	06077	37.79956104	-121.1982472	San Joaquin County
222447	Fee-for-Service	1730935453	1730935453	1	1	HOUSTON-MCGEE, NICOLE DOULA	5/21/2024	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	33	06065	0	0	None
222450	Fee-for-Service	1760253918	1760253918	1	1	HEART THERAPY CENTER A PSYCH	2/28/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	OTHERAPY CORPORATION	545 OCEAN VIEW AVE	None	SANTA CRUZ	CA	95062	3363	44	06087	36.97603287	-122.0166335	Santa Cruz County
222478	Fee-for-Service	1992298822	1992298822	1	1	HENDRICKS, JOSHUA M DPM	5/5/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1038 E. CHAPMAN AVE	None	ORANGE	CA	92866	2111	30	06059	33.78782652	-117.84249	Orange County
222486	Fee-for-Service	1700818838	1700818838	1	1	HARCH, PAUL G MD	8/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	50045	66	Emergency Medicine (Urgent Care)	0	In state provider	None	914 PINE ST	None	MOUNT SHASTA	CA	96067	2143	47	06093	41.31798759	-122.3218165	Siskiyou County
222535	Fee-for-Service	1881031789	1881031789	1	1	HERRINGTON, NATHAN P DO	6/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	None	32.683167	-114.633459	Yuma County
222547	Fee-for-Service	1881091759	1881091759	1	1	HOANG, AI NHI MD	6/25/2020	207L00000X	NA	Other	026	PHYSICIANS	167370	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
222589	Fee-for-Service	1457809543	1457809543	1	1	HAGENAU, MARY JANE LMFT	8/31/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1350 CHERRY ST	None	SAN CARLOS	CA	94070	3008	41	06081	37.50406985	-122.2612475	San Mateo County
222592	Fee-for-Service	1376921767	1376921767	1	1	HARP, JORDAN MD	9/1/2018	207P00000X	NA	Other	026	PHYSICIANS	148082	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
222646	Fee-for-Service	1629170527	1629170527	1	1	HOSSEINION, WARREN MD	5/29/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69768	41	Internal Medicine	0	In state provider	None	5170 SANTA MONICA BLVD	None	LOS ANGELES	CA	90029	2428	19	06037	34.09078098	-118.3026895	Los Angeles County
222657	Fee-for-Service	1285040147	1285040147	1	1	HSIA, SOPHIA J OD	6/14/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	330 N BRAND BLVD	SUITE 110	GLENDALE	CA	91203	2308	19	06037	34.15116156	-118.2549512	Los Angeles County
222690	Fee-for-Service	1902246580	1902246580	1	1	HARDY, ALEX N DO	11/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	26357 MCBEAN PKWY	None	VALENCIA	CA	91355	4488	19	06037	34.41257644	-118.5597683	Los Angeles County
222713	Fee-for-Service	1649350703	1649350703	1	1	HOLLISTER, CHRISTINE LEE	11/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	78643	05	Anesthesiology	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
222716	Fee-for-Service	1013117977	1013117977	1	1	HORN, GEOFFREY W DO	11/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11701	30	Radiology	0	In state provider	None	10 WOODLAND RD	None	ST HELENA	CA	94574	9554	28	06055	38.54196972	-122.4751787	Napa County
222719	Fee-for-Service	1437238839	1437238839	1	1	HALE, RONALD J MD	2/8/2015	174400000X	NA	Other	026	PHYSICIANS	21297	07	Dermatology	0	In state provider	None	1450 10TH ST	STE 202	SANTA MONICA	CA	90401	2831	19	06037	34.01992119	-118.4882747	Los Angeles County
222729	Fee-for-Service	1952365272	1952365272	1	1	HIROSE, RYUTARO MD	1/31/1995	208600000X	NA	General Surgery	026	PHYSICIANS	71653	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
222733	Fee-for-Service	1487288874	1487288874	1	1	HEALTHRIGHT 360	10/30/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1750 S WHITE RD	None	SAN JOSE	CA	95127	4760	43	06085	37.347282	-121.8062115	Santa Clara County
222742	Fee-for-Service	1275607319	1275607319	1	1	HAMAN, SUSANNE LMFT	10/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	46470	-	NOT APPLICABLE	0	In state provider	None	4141 PACIFIC HIGHWAY	None	SAN DIEGO	CA	92110	2030	37	06073	32.7444541	-117.1921543	San Diego County
222836	Fee-for-Service	1326609256	1326609256	1	1	HOM, MELANIE A PHD	10/26/2021	103TC0700X	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
222837	Fee-for-Service	1184912248	1184912248	1	1	HORNE, VINCENT E MD	10/1/2021	2080P0205X	NA	Endocrinology	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
222839	Fee-for-Service	1457427056	1457427056	1	1	HUFF-FURGASON, FRANCES A	12/19/2016	No Taxonomy Provided	NA	None	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
222866	Fee-for-Service	1639657521	1639657521	1	1	HEATHER MCKENZIE	10/6/2019	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2177 W IRONWOOD CENTER D	None	COEUR D ALENE	ID	83814	2639	00	None	47.69675953	-116.7966345	Kootenai County
222876	Fee-for-Service	1114054954	1114054954	2	1	HEALTHCARE MEDICAL SUPPLIES	11/19/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1535 W MERCED AVE	STE 100	WEST COVINA	CA	91790	3404	19	06037	34.06295577	-117.9482872	Los Angeles County
222913	Fee-for-Service	1346569217	1346569217	1	1	HABIB, SHEHNAZ N MD APC	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	50211	None	None	0	In state provider	None	14860 ROSCOE BLVD	SUITE 300	VAN NUYS	CA	91402	7902	19	06037	34.2214515	-118.4573205	Los Angeles County
222919	Fee-for-Service	1417560863	1417560863	1	1	HABIB M.D. INC.	12/11/2020	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	NIC	612 WEST DUARTE RD	305	ARCADIA	CA	91007	7602	19	06037	34.12647805	-118.051994	Los Angeles County
222933	Fee-for-Service	1063400786	1063400786	1	1	HEROLD, JOSEPH 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	1901 N MACARTHUR BLVD	None	IRVING	TX	75061	2220	00	None	32.834691	-96.95924802	Dallas County
222949	Fee-for-Service	1821236126	1821236126	1	1	HEEMER, LISA K LCSW	8/10/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5479 E ABBEYFIELD ST	STE 3	LONG BEACH	CA	90815	3050	19	06037	33.79388819	-118.1261825	Los Angeles County
222961	Fee-for-Service	1003336967	1003336967	2	1	HUNDAL, JASMINE K MD	6/13/2023	207R00000X	NA	Other	026	PHYSICIANS	165442	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
222966	Fee-for-Service	1225092661	1225092661	1	1	HOME OF GUIDING HANDS	1/9/2001	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10436 REGINAS CT	None	SANTEE	CA	92071	2755	37	06073	32.85298352	-116.969841	San Diego County
222980	Fee-for-Service	1619480126	1619480126	1	1	HANNA, MINA S PT	5/8/2018	225100000X	NA	Physical Therapist	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
222990	Fee-for-Service	1407339716	1407339716	1	1	HELMAND, HUMA NP	8/31/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	43360 MISSION BLVD	SUITE 100	FREMONT	CA	94539	5829	01	06001	37.53249631	-121.9198141	Alameda County
223010	Fee-for-Service	1194846741	1194846741	1	1	HASHMI, SHAHID H MD	6/24/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93204	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
223034	Fee-for-Service	1154567527	1154567527	1	1	HANFORD JOINT UNION SD	5/20/2007	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	823 WEST LACEY BLVD	None	HANFORD	CA	93230	4328	16	06031	36.32802448	-119.657205	Kings County
223039	Fee-for-Service	1649413022	1649413022	1	2	HOVEROUND CORPORATION	7/5/2023	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	6415 ALONDRA BLVD	None	PARAMOUNT	CA	90723	3759	19	06037	33.88923537	-118.185049	Los Angeles County
223069	Fee-for-Service	1275665259	1275665259	1	1	HOLT, BRIAN R MD	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	76811	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDLOW RD	None	LONG BEACH	CA	90503	1727	19	06037	33.8188341	-118.1923297	Los Angeles County
223089	Fee-for-Service	1083259808	1083259808	1	1	HARDISON, JACQUELINE OT	1/28/2020	225X00000X	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
223110	Fee-for-Service	1437473840	1437473840	1	1	HLADIK, LISA L MD	9/17/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119285	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
223141	Fee-for-Service	1285703769	1285703769	1	1	HONIG, MARK I MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	24212	36	Psychiatry	0	In state provider	None	28640 GUNTER RD	None	RANCHO PALOS VERD	CA	90275	0880	19	06037	33.75706934	-118.3144701	Los Angeles County
223179	Fee-for-Service	1033290101	1033290101	1	1	HABIB MUNSHI	2/5/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	875 E STATE HIGHWAY 76	STE A	BRANSON	MO	65616	7511	00	None	36.64201061	-93.20548612	Taney County
223182	Fee-for-Service	1821109075	1821109075	1	2	HORNUNG-BANKSTON, JANET L LM	6/22/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	395 TAYLOR BLVD	#220	PLEASANT HILL	CA	94523	2290	07	06013	37.96119614	-122.070409	Contra Costa County
223200	Fee-for-Service	1164409165	1164409165	1	1	HAYS, RUSSELL B MD	4/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	54728	08	Family Practice	0	In state provider	None	447 W EATON AVE	None	TRACY	CA	95376	3420	39	06077	37.74338833	-121.432305	San Joaquin County
223211	Fee-for-Service	1669656500	1669656500	1	1	HAN, ALYSIA Y MD	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	101762	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
223229	Fee-for-Service	1346393386	1346393386	1	1	HOLT, ALLISON MD	11/8/2024	2084P0804X	NA	Psychiatry	026	PHYSICIANS	None	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
223270	Fee-for-Service	1235429507	1235429507	1	1	HESS, CLAYTON B MD	6/8/2021	2085R0001X	NA	Other	026	PHYSICIANS	123801	None	None	0	In state provider	None	155 GLASSON WAY # L20	None	GRASS VALLEY	CA	95945	5723	29	06057	39.22820863	-121.0465856	Nevada County
223274	Fee-for-Service	1316230907	1316230907	1	1	HEALTHRIGHT 360	12/20/2017	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	57 N WHITE RD	None	SAN JOSE	CA	95127	1933	43	06085	37.36742231	-121.829491	Santa Clara County
223324	Fee-for-Service	1457435448	1457435448	1	1	HAIMAN, MICHAEL J MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	82176	07	Dermatology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
223337	Fee-for-Service	1972522589	1972522589	1	1	HEBER, DAVID MD	1/1/1995	207RE0101X	NA	Endocrinology	026	PHYSICIANS	28371	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
223375	Fee-for-Service	1902836307	1902836307	1	1	HUTTON,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	ONE VANTAGE WAY	STE B #240	NASHVILLE	TN	37228	0000	00	None	36.19232503	-86.79194122	Davidson County
223426	Fee-for-Service	1285703769	1285703769	1	1	HONIG, MARK I MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	24212	01	General Practice	0	In state provider	None	28640 GUNTER RD	None	RANCHO PALOS VERD	CA	90275	0880	19	06037	33.75706934	-118.3144701	Los Angeles County
223433	Fee-for-Service	1912175340	1912175340	1	1	HSU, E-KAI MD	6/30/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103079	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
223436	Fee-for-Service	1861439465	1861439465	1	1	HOLZNER, CHARLES M MD	5/1/1995	207RE0101X	NA	Endocrinology	026	PHYSICIANS	45314	41	Internal Medicine	0	In state provider	None	6758 PASSONS BLVD	None	PICO RIVERA	CA	90660	3666	19	06037	33.97999121	-118.0894442	Los Angeles County
223452	Fee-for-Service	1770874919	1770874919	1	1	HO, VINCENT D INC	3/10/2015	193400000X	NA	Other	026	PHYSICIANS	84224	01	General Practice	0	In state provider	None	3927 BALDWIN AVE	None	EL MONTE	CA	91731	1703	19	06037	34.07984864	-118.0525757	Los Angeles County
223458	Fee-for-Service	1881716769	1881716769	1	1	HOHERTZ,BRAIN 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 STREET	SLOT 521	LITTLE ROCK	AR	72205	7101	00	None	34.749009	-92.320101	Pulaski County
223520	Fee-for-Service	1346393386	1346393386	1	1	HOLT, ALLISON MD	11/8/2024	2084P0804X	NA	Psychiatry	026	PHYSICIANS	None	26	Psychiatry (child)	0	In state provider	None	100 PINE ST	STE 1250	SAN FRANCISCO	CA	94111	5235	38	06075	37.79237874	-122.3989278	San Francisco County
223535	Fee-for-Service	1902967342	1902967342	1	1	HIPOLITO, ERNESTO B MD	7/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	56132	01	General Practice	0	In state provider	None	2647 E 14TH ST	None	OAKLAND	CA	94601	1537	01	06001	37.78099267	-122.2320006	Alameda County
223543	Fee-for-Service	1437560703	1437560703	1	1	HANSON, BRENT W MD	6/7/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	140881	01	General Practice	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
223561	Fee-for-Service	1326487505	1326487505	1	1	HSIEH, EMILY MD	8/30/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	172971	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
223584	Fee-for-Service	1871647362	1871647362	1	1	HSIA, RENEE Y MD	2/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	92161	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
223593	Fee-for-Service	1679221766	1679221766	1	1	HANLEY, KELSEY	10/6/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
223613	Fee-for-Service	1992795249	1992795249	1	1	HYNDMAN, MARK F MD	4/22/2013	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
223619	Fee-for-Service	1114401072	1114401072	1	1	HANDY, PAIGE O OT	4/9/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1855 E COCHRAN ST	#109	SIMI VALLEY	CA	93065	2265	56	06111	34.27906738	-118.7628635	Ventura County
223629	Fee-for-Service	1568617348	1568617348	1	1	HU, JASIA MD	12/4/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	105560	01	General Practice	0	In state provider	None	5977 E SPRING ST	None	LONG BEACH	CA	90808	3752	19	06037	33.81062147	-118.1154555	Los Angeles County
223644	Fee-for-Service	1659554095	1659554095	1	1	HOYLE, BRUCE R MD INC	8/24/2011	193400000X	NA	Other	026	PHYSICIANS	47710	08	Family Practice	0	In state provider	None	1120 W LA VETA AVENUE	SUITE 830	ORANGE	CA	92868	4232	30	06059	33.78029455	-117.864369	Orange County
223707	Fee-for-Service	1760648018	1760648018	1	1	HOOKER, MICHAEL A LMFT	4/28/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6809 INDIANA AVE	SUITE 181	RIVERSIDE	CA	92506	4221	33	06065	33.94312844	-117.3918196	Riverside County
223722	Fee-for-Service	1952489015	1952489015	1	1	HAHN, KIRK A MD	7/25/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63447	40	Pediatrics	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
223728	Fee-for-Service	1457771131	1457771131	1	1	HARTCOOPER, GEOFFREY D MD	9/15/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	138736	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
223731	Fee-for-Service	1154816684	1154816684	1	1	HUANG, AMY H LMFT	3/2/2021	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
223760	Fee-for-Service	1841357720	1841357720	1	1	HAGLUND, KIMBERLEY A MD	10/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80831	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
223764	Fee-for-Service	1710091475	1710091475	1	1	HABER, DANIELLE A MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	54925	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
223777	Fee-for-Service	1043322738	1043322738	1	1	HALL,STEVEN 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
223783	Fee-for-Service	1508008178	1508008178	1	1	HANFLIK, ANDREW M MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136847	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
223795	Fee-for-Service	1639243181	1639243181	1	1	HENG, ALLEN K MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	33201	05	Anesthesiology	0	In state provider	None	27300 IRIS AVE	None	MORENO VALLEY	CA	92555	4802	33	06065	33.89552551	-117.186021	Riverside County
223823	Fee-for-Service	1023032125	1023032125	1	1	HUNTER, ALICE D MD	7/31/1995	207P00000X	NA	Other	026	PHYSICIANS	34806	41	Internal Medicine	0	In state provider	None	1 HAIGHT ST	None	SAN FRANCISCO	CA	94102	5801	38	06075	37.77310252	-122.4224845	San Francisco County
223851	Fee-for-Service	1669753695	1669753695	1	1	HAAS, BRADLEY T MD	4/10/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118196	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
223856	Fee-for-Service	1518914316	1518914316	1	1	HOENSHELL, WESLEY L MD	10/16/1987	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	40469	08	Family Practice	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
223873	Fee-for-Service	1235526559	1235526559	1	1	HARITON, EDUARDO MD	7/30/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	160833	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
223906	Fee-for-Service	1962550814	1962550814	1	1	HUA, PAUL H DO	11/21/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	8022	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
223913	Fee-for-Service	1124187703	1124187703	1	1	HANANEL, JEFFREY MD	9/1/1998	207RP1001X	NA	Pulmonology	026	PHYSICIANS	None	29	Pulmonary Diseases (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
223940	Fee-for-Service	1992034433	1992034433	1	1	HO, KIN S PT	4/13/2010	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	101 SOUTH FIRST STREET	SUITE 1800	BURBANK	CA	91502	1959	19	06037	34.17942444	-118.3096895	Los Angeles County
223955	Fee-for-Service	1083737035	1083737035	1	1	HOLYBEE, VALERIE M LMFT	9/27/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
223959	Fee-for-Service	1215465927	1215465927	1	1	HA, JAMES MD	6/2/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17548	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
223975	Fee-for-Service	1689728388	1689728388	1	1	HOVLAND, IRENE E OD	7/27/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	49	06097	38.482839	-122.7357945	Sonoma County
223996	Fee-for-Service	1265856694	1265856694	1	1	HUPF, JESSICA L LMFT	2/25/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1800 BRIDGEGATE ST	STE 201	WESTLAKE VILLAGE	CA	91361	1462	56	06111	34.14780568	-118.843921	Ventura County
224024	Fee-for-Service	1013391572	1013391572	1	1	HARRIS, KIMBERLY A MSW LCSW	9/4/2024	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
224029	Fee-for-Service	1093886590	1093886590	1	1	HUTSON-THROM, MONICA J	4/28/2005	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	130 N BUTTE STREET	STE A	WILLOWS	CA	95988	2836	11	06021	39.52141639	-122.1953507	Glenn County
224042	Fee-for-Service	1730361403	1730361403	1	1	HERRERA, CHRISTIAN A MD	7/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103541	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	54	06107	36.327888	-119.294919	Tulare County
224046	Fee-for-Service	1619255106	1619255106	1	1	HOAG HOSPICE, LLC	7/11/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4041 MACARTHUR BLVD	SUITE 105	NEWPORT BEACH	CA	92660	2512	30	06059	33.66197804	-117.8635581	Orange County
224047	Fee-for-Service	1679587711	1679587711	1	2	HER, PO CHUA DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1610 N EL DORADO ST	STE 12	STOCKTON	CA	95204	5930	39	06077	37.96862394	-121.2942407	San Joaquin County
224050	Fee-for-Service	1942206560	1942206560	1	1	HANNON, ZIYAD J MD	1/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40187	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2645 OCEAN AVE	STE 309	SAN FRANCISCO	CA	94132	1647	38	06075	37.73199657	-122.4739936	San Francisco County
224166	Fee-for-Service	1508937582	1508937582	1	1	HALACKER, CARLA Z MD	11/30/1984	207LP3000X	NA	Other	026	PHYSICIANS	54595	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
224222	Fee-for-Service	1538219837	1538219837	1	1	HANSON, MARY K LMFT	8/10/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	211 W ALAMEDA AVE	STE 101	BURBANK	CA	91502	3025	19	06037	34.16890032	-118.3057575	Los Angeles County
224254	Fee-for-Service	1407951189	1407951189	1	1	HARDY, SAMUEL J MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	27532	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6501 MING AVE	None	BAKERSFIELD	CA	93309	6707	15	06029	35.33461152	-119.074059	Kern County
224258	Fee-for-Service	1639363260	1639363260	1	1	HAKIMI, AHMAD N MD	11/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95840	02	General Surgery	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
224275	Fee-for-Service	1063562882	1063562882	1	1	HUANG, HENRY W MD	10/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76732	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
224280	Fee-for-Service	1669949012	1669949012	1	1	HYDE, JESSICA R AU	6/12/2020	237600000X	NA	Other	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
224294	Fee-for-Service	1073698742	1073698742	1	1	HUANG, DELPHINE C MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74320	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
224328	Fee-for-Service	1003495755	1003495755	1	1	HUYNH, BAO MD	10/28/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182744	08	Family 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
224332	Fee-for-Service	1619255106	1619255106	1	1	HOAG HOSPICE, LLC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4041 MACARTHUR BLVD	SUITE 105	NEWPORT BEACH	CA	92660	2512	30	06059	33.66197804	-117.8635581	Orange County
224385	Fee-for-Service	1851354419	1851354419	1	1	HOFSTETTER, SETH M MD	5/24/1995	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
224389	Fee-for-Service	1720016850	1720016850	1	1	HEANEY, ANTHONY P MD	10/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92084	67	Endocrinology	0	In state provider	None	200 MED PLAZA	STE 530	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
224419	Fee-for-Service	1376045203	1376045203	1	1	HASSETT, RONALD	11/20/2018	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1850 DOUGLAS BLVD	STE 992	ROSEVILLE	CA	95661	3639	31	06061	38.74415734	-121.2570324	Placer County
224433	Fee-for-Service	1588033054	1588033054	1	1	HWANG, CAROLYN A R CNM	10/19/2018	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
224434	Fee-for-Service	1720599558	1720599558	1	1	HOWARD, DEIDRA D NP	10/24/2023	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
224444	Fee-for-Service	1801044862	1801044862	1	1	HALBEISEN, ANNA M DO	6/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12902	01	General Practice	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
224446	Fee-for-Service	1841538162	1841538162	1	1	HUMBOLDT MEDICAL AND	3/21/2013	193400000X	NA	Other	026	PHYSICIANS	43797	41	Internal Medicine	0	In state provider	None	2200 HARRISON AVENUE	None	EUREKA	CA	95501	3215	12	06023	40.7881047	-124.1397037	Humboldt County
224454	Fee-for-Service	1588995906	1588995906	1	1	HUGHES, JONATHAN A MD	3/13/2023	207ZP0102X	NA	Other	026	PHYSICIANS	110839	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
224521	Fee-for-Service	1619986999	1619986999	1	1	HENKEL, DANIELLE M MD	1/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	150701	41	Internal Medicine	0	In state provider	None	11234 ANDERSON STREET	STE 1617	SAN BERNARDINO	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino
224533	Fee-for-Service	1225002694	1225002694	1	1	HAVARD, ROBERT A JR MD	5/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54783	41	Internal Medicine	0	In state provider	None	602 W WILLOW AVE	None	VISALIA	CA	93291	6102	54	06107	36.328473	-119.2979925	Tulare County
224544	Fee-for-Service	1407951189	1407951189	1	1	HARDY, SAMUEL J MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	27532	01	General Practice	0	In state provider	None	6501 MING AVE	None	BAKERSFIELD	CA	93309	6707	15	06029	35.33461152	-119.074059	Kern County
224563	Fee-for-Service	1063562882	1063562882	1	1	HUANG, HENRY W MD	10/16/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	76732	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
224637	Fee-for-Service	1295883189	1295883189	1	1	HARRIES, BILL J	6/28/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	43112 N 15TH STREET W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
224656	Fee-for-Service	1508252032	1508252032	1	2	HANGER PROSTHETICS & ORTHOTI	5/1/2019	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1221 E SPRUCE AVE	STE 104	FRESNO	CA	93720	3374	10	06019	36.84197867	-119.761714	Fresno County
224659	Fee-for-Service	1649408790	1649408790	1	1	HEPOKOSKI, MARK L MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125984	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
224670	Fee-for-Service	1427715515	1427715515	1	6	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3301 FONG RANCH RD	None	SACRAMENTO	CA	95834	1719	34	06067	38.628351	-121.4946855	Sacramento County
224674	Fee-for-Service	1275161184	1275161184	1	1	HASHEMI, ALEX MD	8/11/2023	207R00000X	NA	Other	026	PHYSICIANS	183659	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
224681	Fee-for-Service	1265039994	1265039994	1	1	HOLTAN, LAURA CCC-SLP	5/6/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
224689	Fee-for-Service	1922163757	1922163757	1	1	HANFORD SURGERY CENTER	12/7/2000	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1360 BAILEY ST	None	HANFORD	CA	93230	5921	16	06031	36.3273344	-119.665596	Kings County
224729	Fee-for-Service	1205948544	1205948544	1	1	HUANG, LOUISE MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	78034	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
224733	Fee-for-Service	1841538162	1841538162	1	1	HUMBOLDT MEDICAL AND	3/21/2013	193400000X	NA	Other	026	PHYSICIANS	43797	13	Neurology (M.D. only)	0	In state provider	None	2200 HARRISON AVENUE	None	EUREKA	CA	95501	3215	12	06023	40.7881047	-124.1397037	Humboldt County
224809	Fee-for-Service	1619986999	1619986999	1	1	HENKEL, DANIELLE M MD	1/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	150701	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	11234 ANDERSON STREET	STE 1617	SAN BERNARDINO	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino
224814	Fee-for-Service	1477055630	1477055630	1	1	HUMANGOOD SOCAL	6/3/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	710 W 13TH AVE	None	ESCONDIDO	CA	92025	5511	37	06073	33.10602574	-117.0836678	San Diego County
224817	Fee-for-Service	1164581880	1164581880	1	1	HUGHES, KEITH E CRNA	9/1/2011	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
224822	Fee-for-Service	1225002694	1225002694	1	1	HAVARD, ROBERT A JR MD	5/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	54783	78	Neoplastic Diseases/Oncology	0	In state provider	None	602 W WILLOW AVE	None	VISALIA	CA	93291	6102	54	06107	36.328473	-119.2979925	Tulare County
224866	Fee-for-Service	1447292685	1447292685	1	1	HUYNH, ROSALIE D	7/1/2001	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	904 W TOWN AND COUNTRY R	None	ORANGE	CA	92868	4721	30	06059	33.77651249	-117.861444	Orange County
224882	Fee-for-Service	1689066961	1689066961	1	1	HALE, KAITLIN C NP	2/2/2021	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
224883	Fee-for-Service	1053874784	1053874784	1	1	HAWK, KATIE E MD	11/27/2022	207P00000X	NA	Other	026	PHYSICIANS	178958	66	Emergency Medicine (Urgent Care)	0	In state provider	None	16237 VENTURA BLVD	None	ENCINO	CA	91436	2201	19	06037	34.15686987	-118.4871369	Los Angeles County
224890	Fee-for-Service	1821073222	1821073222	1	1	HUNTINGTON, KEVIN G LCSW	4/22/2022	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
224906	Fee-for-Service	1932549789	1932549789	1	1	HORENSTEIN, JANET MD INC	7/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	35255	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1400 S GRAND AVE	#711	LOS ANGELES	CA	90015	3048	19	06037	34.03692236	-118.2655238	Los Angeles County
224926	Fee-for-Service	1215170717	1215170717	1	1	HINSHAW, PAUL W DO	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13379	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	488 E VALLEY PARKWAY	SUITE 310	ESCONDIDO	CA	92025	3373	37	06073	33.12523814	-117.0769715	San Diego County
224946	Fee-for-Service	1649408790	1649408790	1	1	HEPOKOSKI, MARK L MD	9/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	125984	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 WEST ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
224957	Fee-for-Service	1427715515	1427715515	1	6	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	3301 FONG RANCH RD	None	SACRAMENTO	CA	95834	1719	34	06067	38.628351	-121.4946855	Sacramento County
224964	Fee-for-Service	1811377062	1811377062	1	1	HOWARD, JOHN H MD	7/1/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	156404	45	Nephrology (Renal-Kidney)	0	In state provider	None	777 CAMPUS COMMONS RD	SUITE 120	SACRAMENTO	CA	95825	8343	34	06067	38.571021	-121.416786	Sacramento County
224976	Fee-for-Service	1427184712	1427184712	1	1	HOSPICE OF IMPERIAL VLY	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	137 S 8TH ST	None	EL CENTRO	CA	92243	2901	13	06025	32.79208173	-115.5613968	Imperial County
224987	Fee-for-Service	1629367859	1629367859	1	1	HUNTER, ASHLEY E L MD	8/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123682	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	STE 365 120 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
224992	Fee-for-Service	1407382773	1407382773	1	1	HARRISON, MONIQUE MD	3/16/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	157168	None	None	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1019	38	06075	37.7738933	-122.4544685	San Francisco County
225011	Fee-for-Service	1144586637	1144586637	1	1	HONG, JASON MD	8/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	135397	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
225107	Fee-for-Service	1164416764	1164416764	1	1	HOLST, DAVID MD	12/1/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76027	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	824 PINE ST	None	MOUNT SHASTA	CA	96067	2137	47	06093	41.31718861	-122.3207167	Siskiyou County
225117	Fee-for-Service	1881726131	1881726131	1	1	HONKA, THOMAS M DC	8/24/2009	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	380 N RESERVATION ROAD	None	PORTERVILLE	CA	93257	9673	54	06107	36.02996779	-118.7882551	Tulare County
225126	Fee-for-Service	1790006013	1790006013	1	1	HOUGHTON, CAITLIN C MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	121369	02	General 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
225145	Fee-for-Service	1497001465	1497001465	1	1	HOBSON, SUEJY A MD	3/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	124882	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1301 PINOLE VALLEY ROAD	None	PINOLE	CA	94564	1384	07	06013	37.9991883	-122.2867117	Contra Costa County
225157	Fee-for-Service	1477857290	1477857290	1	1	HINDOYAN, ANTREAS H MD	7/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110092	41	Internal Medicine	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
225198	Fee-for-Service	1598777146	1598777146	1	1	HART, KAREN E MD	9/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79820	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
225233	Fee-for-Service	1477152338	1477152338	1	1	HUGHES, TYRA L LCSW	11/10/2023	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
225235	Fee-for-Service	1841437241	1841437241	1	5	H STREET CLINIC, INC.	7/5/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	1329 NORTH H ST	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
225251	Fee-for-Service	1316124399	1316124399	1	1	HAJRA, SEMINA MD	10/28/2019	207R00000X	NA	Other	026	PHYSICIANS	96713	41	Internal Medicine	0	In state provider	None	7601 STONERIDGE	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
225253	Fee-for-Service	1083709927	1083709927	1	1	HANSEN, TIMOTHY W MD	5/31/1989	207L00000X	NA	Other	026	PHYSICIANS	68030	05	Anesthesiology	0	In state provider	None	3152 N MILLBROOK AVE	None	FRESNO	CA	93703	1400	10	06019	36.779166	-119.7634925	Fresno County
225258	Fee-for-Service	1427184712	1427184712	1	1	HOSPICE OF IMPERIAL VLY	3/21/1997	251G00000X	NA	Other	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	137 S 8TH ST	None	EL CENTRO	CA	92243	2901	13	06025	32.79208173	-115.5613968	Imperial County
225280	Fee-for-Service	1629367859	1629367859	1	1	HUNTER, ASHLEY E L MD	8/4/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	123682	40	Pediatrics	0	In state provider	None	200 MEDICAL PLAZA	STE 365 120 420	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
225297	Fee-for-Service	1245790674	1245790674	1	1	HEWLETT, MEGHAN MD	5/26/2023	207P00000X	NA	Other	026	PHYSICIANS	179325	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
225302	Fee-for-Service	1144865981	1144865981	1	1	HUANG, BRIAN PT	3/10/2020	2251X0800X	NA	Physical Therapist	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
225335	Fee-for-Service	1861668824	1861668824	1	1	HATAMIZADEH, PARTA MD	11/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	117204	41	Internal Medicine	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
225350	Fee-for-Service	1205837895	1205837895	1	1	HARE, JEFFREY L MD	11/16/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175192	None	None	0	In state provider	None	29101 HOSPITAL ROAD	None	LAKE ARROWHEAD	CA	92352	9706	36	06071	34.26577765	-117.1695461	San Bernardino County
225393	Fee-for-Service	1164416764	1164416764	1	1	HOLST, DAVID MD	12/1/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	76027	08	Family Practice	0	In state provider	None	824 PINE ST	None	MOUNT SHASTA	CA	96067	2137	47	06093	41.31718861	-122.3207167	Siskiyou County
225414	Fee-for-Service	1447273206	1447273206	1	1	HANSEN, ANNIKEN B MD	2/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92520	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
225440	Fee-for-Service	1104834605	1104834605	1	1	HYDER, DOUGLAS J MD	9/27/2017	2084N0402X	NA	Neurology	026	PHYSICIANS	83416	79	Neurology-Child	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
225448	Fee-for-Service	1477857290	1477857290	1	1	HINDOYAN, ANTREAS H MD	7/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	110092	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
225456	Fee-for-Service	1891098281	1891098281	1	1	HAMMOND, JOHN M LMFT	4/6/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	909 15TH ST	SUITE 8	MODESTO	CA	95354	1130	50	06099	37.64355442	-120.9949898	Stanislaus County
225458	Fee-for-Service	1265841936	1265841936	1	1	HAKIMI HOME HEALTH INC	5/29/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	280 SOUTH LOS ROBLES	SUITE A	PASADENA	CA	91101	2872	19	06037	34.14065512	-118.14134	Los Angeles County
225477	Fee-for-Service	1306926985	1306926985	1	1	HUANG, ROBERT Y MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	62150	04	Otology, Laryngology, Rhinology	0	In state provider	None	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	43	06085	37.36797679	-122.0297112	Santa Clara County
225505	Fee-for-Service	1699735191	1699735191	1	1	HIROTA, DAVID M MD	4/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	65105	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
225523	Fee-for-Service	1841437241	1841437241	1	1	H STREET CLINIC, INC.	4/21/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1329 NORTH H ST	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
225538	Fee-for-Service	1396333878	1396333878	1	1	HEURING, JULIE J NP	4/21/2021	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
225567	Fee-for-Service	1679537229	1679537229	1	1	HOSOHAMA, BETTY M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63899	30	Radiology	0	In state provider	None	559 ABBOTT ST	None	SALINAS	CA	93901	4325	27	06053	36.66284132	-121.6420108	Monterey County
225569	Fee-for-Service	1558313916	1558313916	1	1	HATA, TISSA R MD	2/28/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63547	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
225577	Fee-for-Service	1649883075	1649883075	1	1	HAGEN, MICHELLE N LMFT	5/3/2021	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
225607	Fee-for-Service	1003270646	1003270646	1	1	HIRSCHBEIN, EVAN DPM	10/27/2022	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
225634	Fee-for-Service	1417969650	1417969650	1	1	HO, VIET H MD	1/11/2007	207W00000X	NA	Ophthalmology	026	PHYSICIANS	92798	18	Ophthalmology	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
225650	Fee-for-Service	1174983357	1174983357	1	1	HENDRICKS, JACOB S	4/4/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6640 ALTON PARKWAY	None	IRVINE	CA	92618	3734	30	06059	33.65911992	-117.7737909	Orange County
225656	Fee-for-Service	1932709177	1932709177	1	1	HEAL BEHAVIORAL HEALTH LLC	10/14/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	4660 EL CAJON BLVD	STE 105	SAN DIEGO	CA	92105	4639	37	06073	32.75587585	-117.093663	San Diego County
225685	Fee-for-Service	1841264272	1841264272	1	2	HAN, MICHAEL S MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54113	05	Anesthesiology	0	In state provider	None	400 N PEPPER AVE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
225686	Fee-for-Service	1487972048	1487972048	1	1	HAUCH, HEATHER C CCC-SLP	1/30/2025	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
225690	Fee-for-Service	1316025414	1316025414	1	1	HEAREY, CHARLES D JR MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	21352	40	Pediatrics	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
225691	Fee-for-Service	1740222314	1740222314	1	1	HEYMAN, MELVIN B MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	36232	10	Gastroenterology (M.D. only)	0	In state provider	UCSF MED CTR	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
225724	Fee-for-Service	1730576851	1730576851	1	1	HARTSTEIN, VANESSA C MD	9/11/2020	163WP0200X	NA	Other	026	PHYSICIANS	162350	40	Pediatrics	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
225727	Fee-for-Service	1104834605	1104834605	1	1	HYDER, DOUGLAS J MD	9/27/2017	2084N0402X	NA	Neurology	026	PHYSICIANS	83416	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
225766	Fee-for-Service	1346405644	1346405644	1	1	HANCHETT, MATTHEW P MD	10/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111418	41	Internal Medicine	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5427	19	06037	34.21980849	-118.4301135	Los Angeles County
225771	Fee-for-Service	1407906357	1407906357	1	1	HUYNH, TRACY N MD	6/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	97103	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	200 MEDICAL PLAZA	STE 365	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
225793	Fee-for-Service	1841233772	1841233772	1	1	HELLER, BARRY MD	7/31/1982	207P00000X	NA	Other	026	PHYSICIANS	39263	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
225810	Fee-for-Service	1841437241	1841437241	1	1	H STREET CLINIC, INC.	4/21/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1329 NORTH H ST	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
225818	Fee-for-Service	1912442740	1912442740	1	1	HUDA, NAUREEN S MD	7/15/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	180146	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
225838	Fee-for-Service	1982715843	1982715843	1	1	HOSSAIN, KAMAL R K MD	4/6/2015	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	40662	01	General Practice	0	In state provider	None	627 BROOKSIDE AVE	None	REDLANDS	CA	92373	4666	36	06071	34.05267102	-117.1904214	San Bernardino County
225844	Fee-for-Service	1700215456	1700215456	1	1	HERMANN, VALERIE	5/30/2017	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
225856	Fee-for-Service	1679537229	1679537229	1	1	HOSOHAMA, BETTY M MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	63899	02	General Surgery	0	In state provider	None	559 ABBOTT ST	None	SALINAS	CA	93901	4325	27	06053	36.66284132	-121.6420108	Monterey County
225858	Fee-for-Service	1962511162	1962511162	1	1	HOWALT, KRISTOPHER D MD	7/5/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	62030	-	NOT APPLICABLE	0	In state provider	None	111 E FESLER STREET	None	SANTA MARIA	CA	93454	4404	42	06083	34.9565163	-120.4353045	Santa Barbara County
225880	Fee-for-Service	1780982991	1780982991	1	1	HEU, TIFFANY G M DO	1/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13658	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
225898	Fee-for-Service	1174747570	1174747570	1	1	HEATH, AGIUA I MD	7/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	58616	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC:5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
225925	Fee-for-Service	1275883514	1275883514	1	1	HOSPITAL CIRCLE SURGERY CENT	4/16/2024	No Taxonomy Provided	NA	None	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	210 HOSPITAL CIR	SUITE D	WESTMINSTER	CA	92683	3900	30	06059	33.76238217	-117.9945685	Orange County
225948	Fee-for-Service	1982865705	1982865705	1	1	HENRY, DUNCAN M MD	6/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120250	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
225979	Fee-for-Service	1740222314	1740222314	1	1	HEYMAN, MELVIN B MD	1/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	36232	40	Pediatrics	0	In state provider	UCSF MED CTR	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
226014	Fee-for-Service	1154473387	1154473387	1	1	HODGSON, SHEILA M MD	12/11/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	72294	28	Proctology (colon and rectal)	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
226023	Fee-for-Service	1174625131	1174625131	1	1	HEFFERNON, JEFFREY MD	2/23/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35445	None	None	0	In state provider	None	3000 Q STREET	None	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
226061	Fee-for-Service	1184810236	1184810236	1	1	HAAG, CINDY L	6/2/2020	176B00000X	NA	Licensed Midwife	082	LICENSED MIDWIVES	-	-	NOT APPLICABLE	0	In state provider	None	3101 TELEGRAPH AVE	None	BERKELEY	CA	94705	1984	01	06001	37.85361291	-122.2600247	Alameda County
226097	Fee-for-Service	1841437241	1841437241	1	1	H STREET CLINIC, INC.	7/16/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1329 NORTH H ST	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
226103	Fee-for-Service	1265607303	1265607303	1	1	HAN, JUNG A MD	4/27/2020	207R00000X	NA	Other	026	PHYSICIANS	161341	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
226122	Fee-for-Service	1285839936	1285839936	1	1	HEMPRICH, ULF MD	8/24/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	86665	05	Anesthesiology	0	In state provider	None	250 HOSPITAL PKWAY	None	SAN JOSE	CA	95119	1103	43	06085	37.23948065	-121.8005798	Santa Clara County
226133	Fee-for-Service	1194873042	1194873042	1	1	HARPUR, CHARLES WILLIAM OD	1/17/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7060 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92111	1003	37	06073	32.83272447	-117.1648125	San Diego County
226143	Fee-for-Service	1861021909	1861021909	1	1	HANHAN, JABER MD	8/7/2024	207L00000X	NA	Other	026	PHYSICIANS	179086	05	Anesthesiology	0	In state provider	None	1100 VETERANS BLVD	None	REDWOOD CITY	CA	94603	2037	41	06081	37.48948529	-122.2232468	San Mateo County
226144	Fee-for-Service	1780047597	1780047597	1	1	HASAN, AWS K MD	6/27/2022	163WG0100X	NA	Other	026	PHYSICIANS	161409	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
226167	Fee-for-Service	1578652798	1578652798	1	1	HANNA, JEANNETTE MD	8/11/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	35746	None	None	0	In state provider	None	18682 BEACH BLVD	120	HUNTINGTON BEACH	CA	92648	2049	30	06059	33.69152695	-117.9887007	Orange County
226171	Fee-for-Service	1366481509	1366481509	1	1	HSU, ERIN A C MD	1/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89312	77	Infectious Disease	0	In state provider	None	2100 WEBSTER ST	STE 400	SAN FRANCISCO	CA	94115	2378	38	06075	37.7904826	-122.4324477	San Francisco County
226179	Fee-for-Service	1205153921	1205153921	1	1	HEALY, AARON H MD	9/26/2020	208G00000X	NA	General Surgery	026	PHYSICIANS	169309	None	None	0	In state provider	None	2800 L ST	STE 610	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
226220	Fee-for-Service	1144470667	1144470667	1	1	HSU, AMY K MD	12/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	120839	04	Otology, Laryngology, Rhinology	0	In state provider	None	3533 MOTOR AVE	None	LOS ANGELES	CA	90034	4806	19	06037	34.02588491	-118.4081613	Los Angeles County
226251	Fee-for-Service	1841296894	1841296894	1	1	HAWKINS, JOSEPH B MD	1/30/2023	174400000X	NA	Other	026	PHYSICIANS	51019	None	None	0	In state provider	None	7230 MILLBROOK AVE	None	FRESNO	CA	93720	3340	10	06019	36.84059039	-119.7656456	Fresno County
226305	Fee-for-Service	1437216744	1437216744	1	1	HAYWARD, ROBERT C MD	3/31/1988	2084P0800X	NA	Psychiatry	026	PHYSICIANS	57515	36	Psychiatry	0	In state provider	None	1350 WILLOW RD	STE 202	MENLO PARK	CA	94025	1516	41	06081	37.47713734	-122.1521704	San Mateo County
226360	Fee-for-Service	1881308062	1881308062	1	1	HENDERSON-BONILLA, MIAJANAY	1/11/2023	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	07	06013	0	0	None
226387	Fee-for-Service	1053727982	1053727982	1	1	HARVEY, FATIMAH Z CNP	12/11/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	29610 RANCHO CALIFORNIA	None	TEMECULA	CA	92591	5283	33	06065	33.50455159	-117.1462052	Riverside County
226417	Fee-for-Service	1609140524	1609140524	1	1	HERRERO, TIFFANY C MD	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	119846	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
226422	Fee-for-Service	1356578587	1356578587	1	1	HANSASUTA, AKE MD	6/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53672	13	Neurology (M.D. only)	0	In state provider	None	300 PASTUER DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
226425	Fee-for-Service	1467857920	1467857920	1	1	HANSEN, DIANNA C LMFT	3/5/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
226434	Fee-for-Service	1902140734	1902140734	1	1	HYGEIA II MEDICAL GROUP INC	4/20/2015	332BP3500X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	6241 YARROW DRIVE	SUITE A	CARLSBAD	CA	92011	1541	37	06073	33.12109082	-117.273774	San Diego County
226454	Fee-for-Service	1497779581	1497779581	1	1	HINES, OSCAR J MD	10/31/1995	208600000X	NA	General Surgery	026	PHYSICIANS	77151	20	Orthopedic Surgery	0	In state provider	None	200 MEDICAL PLAZA	STE 530	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
226460	Fee-for-Service	1366481509	1366481509	1	1	HSU, ERIN A C MD	1/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	89312	41	Internal Medicine	0	In state provider	None	2100 WEBSTER ST	STE 400	SAN FRANCISCO	CA	94115	2378	38	06075	37.7904826	-122.4324477	San Francisco County
226497	Fee-for-Service	CGP149715	None	1	1	HARLEY, JIM MD	12/1/2021	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	CHILDRENS HOSPITAL	3020 CHILDRENS WAY	# MC5088	SAN DIEGO	CA	92123	4223	37	06073	32.798691	-117.150829	San Diego County
226501	Fee-for-Service	1497788905	1497788905	1	1	HABIS, SABA MD	5/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	151769	41	Internal Medicine	0	In state provider	None	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
226532	Fee-for-Service	1205900172	1205900172	1	1	HANGER P & O WEST INC.	6/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	7700 IMPERIAL HWY	STE E2	DOWNEY	CA	90242	3466	19	06037	33.92670648	-118.1580043	Los Angeles County
226547	Fee-for-Service	1962900514	1962900514	1	1	HENSLEY, KAITLYN LMFT	7/18/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	325 E HILLCREST DR STE 1	None	THOUSAND OAKS	CA	91360	7782	56	06111	34.1812975	-118.8718187	Ventura County
226575	Fee-for-Service	1487621801	1487621801	1	1	HATANAKA, ROBERT T DPM	4/20/2011	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4137 VERDUGO RD	None	LOS ANGELES	CA	90065	3802	19	06037	34.1261475	-118.2319835	Los Angeles County
226589	Fee-for-Service	1285859397	1285859397	1	1	HOLLOWAY, ANNETTE PSYD	12/13/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	9 PEPPER WAY	None	SAN RAFAEL	CA	94901	1117	21	06041	37.98184289	-122.5383866	Marin County
226605	Fee-for-Service	1154746295	1154746295	1	2	HOOSHMAND, FARNAZ MD	10/24/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	138248	-	NOT APPLICABLE	0	In state provider	None	2001 THE ALAMEDA	None	SAN JOSE	CA	95126	1136	43	06085	37.34293689	-121.9270392	Santa Clara County
226614	Fee-for-Service	1932265170	1932265170	1	1	HARRIS-THOMAS, DUDLEASA	9/10/2007	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	S PHD	4715 VIEWRIDGE AVE	STE 230	SAN DIEGO	CA	92123	1680	37	06073	32.82422034	-117.1210743	San Diego County
226627	Fee-for-Service	1427033042	1427033042	1	1	HINTON, WALTER L MD	2/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	43373	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
226639	Fee-for-Service	1235237827	1235237827	1	1	HEALTH & MOBILITY, INC	5/22/2007	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	40414 CALIF OAKS RD	STE I	MURRIETA	CA	92562	5787	33	06065	33.57801366	-117.2004402	Riverside County
226707	Fee-for-Service	1164699658	1164699658	1	1	HORN, STUART A	5/14/2013	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	21311 MADRONA AVE	STE 100-A	TORRANCE	CA	90503	5970	19	06037	33.835599	-118.3450965	Los Angeles County
226717	Fee-for-Service	1265487649	1265487649	1	1	HAYATDAVOUDI, SAWSAWN MD	8/8/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84223	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DR	None	VALLEJO	CA	94589	2574	48	06095	38.13070051	-122.237307	Solano County
226730	Fee-for-Service	1336565977	1336565977	1	1	HILL, PATRICK S MD	8/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128479	20	Orthopedic Surgery	0	In state provider	None	4315 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759747	-118.359747	Los Angeles County
226769	Fee-for-Service	1235345067	1235345067	1	1	HICHOICE HEALTH CARE INC	10/26/2006	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	WELLCARE ADULT DAY HLTH	7626 VINELAND AVE	STE 110-150	SUN VALLEY	CA	91352	4535	19	06037	34.209144	-118.3703005	Los Angeles County
226785	Fee-for-Service	1417641929	1417641929	1	1	HN HEALTH INC	7/26/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2643 SENTER RD	STE. A	SAN JOSE	CA	95111	1184	43	06085	37.30242209	-121.8424654	Santa Clara County
226786	Fee-for-Service	1912410416	1912410416	1	1	HAWAII LIFE FLIGHT, LLC	10/9/2018	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	2	Out of state provider	None	73-990 KUKUINUI ST	None	KAILUA KONA	HI	96740	8580	00	None	19.72134803	-155.9962873	Hawaii County
226789	Fee-for-Service	1457884660	1457884660	1	1	HUANG, BRENDAN K MD	6/27/2022	207RP1001X	NA	Pulmonology	026	PHYSICIANS	161774	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
226816	Fee-for-Service	1124508296	1124508296	1	1	HARDISON MEDICAL CORPORATION	3/22/2019	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	2210 ENCINITAS BLVD	STE N	ENCINITAS	CA	92024	4376	37	06073	33.0379322	-117.2403774	San Diego County
226823	Fee-for-Service	1033758065	1033758065	1	1	HEALING ART CORPORATION	6/23/2020	261QM0801X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10653 RIVERSIDE DRIVE	None	NORTH HOLLYWOOD	CA	91602	2341	19	06037	34.15226042	-118.3632608	Los Angeles County
226855	Fee-for-Service	1619991635	1619991635	1	1	HILL, JAMES D JR MD	8/30/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	22346	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2510 WEBER ST	# 200	BERKELEY	CA	94705	0000	01	06001	0	0	None
226876	Fee-for-Service	1770097263	1770097263	1	1	HOWELL, SONYA LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
226899	Fee-for-Service	1154075356	1154075356	1	1	HONEY M.D. INC	5/17/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	None	None	0	In state provider	None	18321 CLARK ST	None	TARZANA	CA	91356	3501	19	06037	34.16979433	-118.5312303	Los Angeles County
226906	Fee-for-Service	1063705804	1063705804	1	1	HWANG, CALVIN E MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122153	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
226924	Fee-for-Service	1881624799	1881624799	1	1	HOUSE EAR CLINIC	1/1/1979	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	A MEDICAL GROUP, INC	2100 W 3RD ST	STE 111	LOS ANGELES	CA	90057	1944	19	06037	34.06308947	-118.2733326	Los Angeles County
226933	Fee-for-Service	1154466928	1154466928	1	3	HOPE HOUSE FOR THE MULTIPLE	7/29/1991	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HANDICAPPED INC	4317 CEDAR AVE	None	EL MONTE	CA	91732	1832	19	06037	34.08369724	-118.0235422	Los Angeles County
226987	Fee-for-Service	1093206633	1093206633	1	1	HUYNH, STEPHEN DO	6/30/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17815	None	None	0	In state provider	None	15425 LOS GATOS BLVD	120	LOS GATOS	CA	95032	2553	43	06085	37.24444696	-121.9589876	Santa Clara County
226994	Fee-for-Service	1053742767	1053742767	1	1	HAYDERZADEH, ZAHRA LMFT	8/23/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3711 LONG BEACH BLVD	601	LONG BEACH	CA	90807	3315	19	06037	33.824583	-118.1893785	Los Angeles County
227000	Fee-for-Service	1649966201	1649966201	1	1	HILLERMAN, RONA KAYE N	10/31/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1700 KEYSTONE PACIFIC PK	STE C2	PATTERSON	CA	95363	8874	50	06099	37.47600952	-121.160718	Stanislaus County
227004	Fee-for-Service	1699274233	1699274233	1	1	HOOD, KEREN-HAPPUCH K DO	7/11/2022	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	19479	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
227006	Fee-for-Service	1164557815	1164557815	1	1	HEALTH CENTER #3	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1525 SILVER AVE	None	SAN FRANCISCO	CA	94134	1229	38	06075	37.73224392	-122.4063707	San Francisco County
227018	Fee-for-Service	1336565977	1336565977	1	1	HILL, PATRICK S MD	8/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128479	02	General Surgery	0	In state provider	None	4315 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759747	-118.359747	Los Angeles County
227020	Fee-for-Service	1578722823	1578722823	1	1	HOMEWORKS PHYSICAL THERAPY	9/12/2013	261QP2000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	2012 PHILAROPE COURT	None	COSTA MESA	CA	92626	4734	30	06059	33.66936852	-117.9403807	Orange County
227033	Fee-for-Service	1194286179	1194286179	1	1	HUANG, JONATHAN J MD	12/16/2022	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	178416	None	None	0	In state provider	None	1000 FRANKLIN PARKWAY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
227042	Fee-for-Service	1578630331	1578630331	1	1	HAKIMIAN, SHAHBAZ MD	1/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86403	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
227075	Fee-for-Service	1972666501	1972666501	2	1	H.K. PHARMACY CORP.	5/25/2010	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	124 N WESTERN AVE	None	LOS ANGELES	CA	90004	4106	19	06037	34.07428954	-118.3091021	Los Angeles County
227099	Fee-for-Service	1730270489	1730270489	1	1	HAIGHT, MATTHEW J DO	8/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8215	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
227100	Fee-for-Service	1124140116	1124140116	1	1	HIESTAND AMY J. 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	101 W 8TH AVE	None	SPOKANE	WA	99204	2307	00	None	47.647989	-117.4112415	Spokane County
227103	Fee-for-Service	1124508296	1124508296	1	1	HARDISON MEDICAL CORPORATION	3/22/2019	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2210 ENCINITAS BLVD	STE N	ENCINITAS	CA	92024	4376	37	06073	33.0379322	-117.2403774	San Diego County
227112	Fee-for-Service	1609227453	1609227453	1	1	HARRIS HWANG, CAITLIN DO	10/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17379	08	Family Practice	0	In state provider	None	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	42	06083	34.44257521	-119.7584538	Santa Barbara County
227113	Fee-for-Service	1811011331	1811011331	1	1	HAIDER, HAMID T MD	11/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	6900 N DURANGO BLVD	None	LAS VEGAS	NV	89149	4409	00	None	36.28701289	-115.2877045	Clark County
227131	Fee-for-Service	1326460338	1326460338	1	1	HONG, DONNA NP	1/14/2020	363LF0000X	NA	Nurse Practitioner	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
227141	Fee-for-Service	1518974161	1518974161	1	1	HUNG, CHARLES MD	1/27/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53252	41	Internal Medicine	0	In state provider	None	11539 HAWTHORNE BLVD	6TH FLOOR	HAWTHORNE	CA	90502	2325	19	06037	33.929352	-118.352747	Los Angeles County
227170	Fee-for-Service	1073168696	1073168696	1	2	HAMILTON, MEGAN PT	3/19/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	29650 BRADLEY RD	None	MENIFEE	CA	92586	6521	33	06065	33.6899672	-117.1885767	Riverside County
227212	Fee-for-Service	1881624799	1881624799	1	1	HOUSE EAR CLINIC	1/1/1979	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	04	Otology, Laryngology, Rhinology	0	In state provider	A MEDICAL GROUP, INC	2100 W 3RD ST	STE 111	LOS ANGELES	CA	90057	1944	19	06037	34.06308947	-118.2733326	Los Angeles County
227214	Fee-for-Service	1154035095	1154035095	1	1	HUANG, SHIYING NP	2/27/2023	363L00000X	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
227215	Fee-for-Service	1174590574	1174590574	1	1	HOSPICE BY THE SEA	12/3/1994	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	312 S CEDROS AVE	STE 205	SOLANA BEACH	CA	92075	1979	37	06073	32.98888951	-117.2697968	San Diego County
227216	Fee-for-Service	1023554060	1023554060	1	1	HUNTINGTON, JULIET L CNM	7/10/2020	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	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
227300	Fee-for-Service	1427715515	1427715515	1	2	HEALTH AND LIFE ORGANIZATION	3/8/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE-KAJSIAB	7215 55TH STREET	None	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
227324	Fee-for-Service	1649480377	1649480377	1	1	HUMPHREY, TARA L DO	3/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10759	05	Anesthesiology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
227330	Fee-for-Service	1578630331	1578630331	1	1	HAKIMIAN, SHAHBAZ MD	1/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	86403	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
227346	Fee-for-Service	1225680846	1225680846	1	1	HORAN, JANEANE M CNP	11/23/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9730 MISSION GORGE RD	None	SANTEE	CA	92071	3808	37	06073	32.83879131	-116.9848056	San Diego County
227356	Fee-for-Service	1306680590	1306680590	1	1	HANSON-FINN, AKIRA CNP	9/30/2024	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
227383	Fee-for-Service	1609022938	1609022938	1	1	HALATI, ALIREZA MD	10/14/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	92433	40	Pediatrics	0	In state provider	None	455 S MAIN STREET	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
227394	Fee-for-Service	1629000815	1629000815	1	1	HAIMSON, ROBERT MD	9/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	64619	20	Orthopedic Surgery	0	In state provider	None	780 E WASHINGTON BLVD	STE 104	CRESCENT CITY	CA	95531	8359	08	06015	41.775246	-124.194447	Del Norte County
227408	Fee-for-Service	1306022694	1306022694	1	1	HB PODIATRY GROUP, INC.	7/31/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	17822 BEACH BLVD	SUITE 407	HUNTINGTON BEACH	CA	92647	7101	30	06059	33.70331388	-117.9890471	Orange County
227424	Fee-for-Service	1912977554	1912977554	1	1	HOWARD, ROBERT M OD	11/23/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	8022 CLAIREMONT MESA	None	SAN DIEGO	CA	92111	1615	37	06073	32.83286919	-117.1496765	San Diego County
227444	Fee-for-Service	1285049726	1285049726	1	1	HAMMAMI, MOHAMED M MD	8/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144038	41	Internal Medicine	0	In state provider	None	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	15	06029	35.382555	-118.970757	Kern County
227484	Fee-for-Service	1235126749	1235126749	1	1	HELTON, JAMES G MD	4/11/1988	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	62623	05	Anesthesiology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
227503	Fee-for-Service	1174590574	1174590574	1	1	HOSPICE BY THE SEA	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	312 S CEDROS AVE	STE 205	SOLANA BEACH	CA	92075	1979	37	06073	32.98888951	-117.2697968	San Diego County
227587	Fee-for-Service	1427715515	1427715515	1	2	HEALTH AND LIFE ORGANIZATION	3/8/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE-KAJSIAB	7215 55TH STREET	None	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
227602	Fee-for-Service	1346404456	1346404456	1	1	HERNANDEZ, SERGIO A MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109686	66	Emergency Medicine (Urgent Care)	0	In state provider	None	225 NORTH JACKSON AVE	None	SAN JOSE	CA	95116	1603	43	06085	37.36217918	-121.8472051	Santa Clara County
227643	Fee-for-Service	1780692533	1780692533	1	1	HARRIS, ROY M MD	5/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	63972	08	Family Practice	0	In state provider	None	3104 SUNSET BLVD	STE 2B	ROCKLIN	CA	95677	3093	31	06061	38.78632648	-121.2517479	Placer County
227648	Fee-for-Service	1871820779	1871820779	1	1	HOWERTON, MARK J LMFT	11/26/2019	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
227704	Fee-for-Service	1073584397	1073584397	1	1	HOLTEL, MICHAEL R MD	4/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	59182	04	Otology, Laryngology, Rhinology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2393	37	06073	32.72663119	-117.1611714	San Diego County
227763	Fee-for-Service	1760725550	1760725550	1	1	HSIEH, CALEB G MD	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134543	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
227773	Fee-for-Service	1235126749	1235126749	1	1	HELTON, JAMES G MD	4/11/1988	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	62623	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
227785	Fee-for-Service	1396265856	1396265856	1	1	HAROON, SAMIR A MD	8/8/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175726	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
227787	Fee-for-Service	1497833024	1497833024	1	1	HOWE, STEPHEN L MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	60286	41	Internal Medicine	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
227794	Fee-for-Service	1700838778	1700838778	1	1	HAYWARD, IVAN MD	7/31/1990	2085R0204X	NA	Other	026	PHYSICIANS	65385	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
227813	Fee-for-Service	1215514849	1215514849	1	1	HILK, KELLY MD	5/6/2024	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
227852	Fee-for-Service	1346417110	1346417110	1	1	HOANG, VUNGHI MD	6/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111879	None	None	0	In state provider	None	1000 GREENLEY RD	None	SONORA	CA	95370	5200	55	06109	37.97749352	-120.3700335	Tuolumne County
227887	Fee-for-Service	1306153382	1306153382	1	1	HESHMATI, SHAHLA MD INC	6/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	50416	40	Pediatrics	0	In state provider	None	15785 LAGUNA CANYON ROAD	SUITE 250	IRVINE	CA	92618	3179	30	06059	33.66542536	-117.7615537	Orange County
227902	Fee-for-Service	1326092834	1326092834	1	1	HOSSEINIAN, RASAM M MD	10/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54175	41	Internal Medicine	0	In state provider	None	47111 MONROE ST	None	INDIO	CA	92201	6739	33	06065	33.70620698	-116.2339008	Riverside County
227945	Fee-for-Service	1982005013	1982005013	1	1	HAMMER, LESLIE M LCSW	10/26/2023	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
227947	Fee-for-Service	1093810640	1093810640	1	1	HAIRSTON, DOJUANA D LMFT	9/14/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 MAGNOLIA AVE	STE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
227968	Fee-for-Service	1386828242	1386828242	1	1	HUNDAL, KANWALPREET K MD	6/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102246	None	None	0	In state provider	None	101 THE CITY DR SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
228000	Fee-for-Service	1902367469	1902367469	1	1	HOER, BRYCE A MD	7/15/2022	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	1550 W CRAIG RD	STE 100	LAS VEGAS	NV	89032	0329	00	None	36.2395135	-115.162875	Clark County
228005	Fee-for-Service	1720292949	1720292949	1	8	HEALTHY SMILES FOR KIDS	3/10/2021	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	10602 CHAPMAN AVE	SUITE 200	GARDEN GROVE	CA	92840	3146	30	06059	33.78861049	-117.9480735	Orange County
228051	Fee-for-Service	1124201140	1124201140	1	1	HAN, YING MD	5/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102086	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
228128	Fee-for-Service	1275106890	1275106890	1	1	HUTCHINS, MARISSA	11/22/2024	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1260 A ST	SUITE 100	HAYWARD	CA	94541	2961	01	06001	37.67705643	-122.0794392	Alameda County
228133	Fee-for-Service	1073591038	1073591038	1	1	HASS FREDERICKJM	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	27265	01	General Practice	0	In state provider	None	750 LAS GALLINAS AVE	None	SAN RAFAEL	CA	94903	3438	21	06041	38.00688138	-122.5463961	Marin County
228135	Fee-for-Service	1275607319	1275607319	1	2	HAMAN, SUSANNE LMFT	12/10/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4909 MURPHY CANYON RD	300	SAN DIEGO	CA	92123	4349	37	06073	32.8287682	-117.1197549	San Diego County
228145	Fee-for-Service	1720374333	1720374333	1	1	HILL, DONIECE M LCSW	5/18/2020	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
228173	Fee-for-Service	1598949430	1598949430	1	1	HSU, DAVID C MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111497	36	Psychiatry	0	In state provider	None	1792 TRIBUTE RD	STE 350	SACRAMENTO	CA	95815	4322	34	06067	38.598219	-121.445964	Sacramento County
228210	Fee-for-Service	1912058033	1912058033	1	1	HENRI, HEATHER COHEN MD	8/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76444	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
228237	Fee-for-Service	1497986285	1497986285	1	1	HELMI, JEHAN MD	8/12/2022	2084P0804X	NA	Psychiatry	026	PHYSICIANS	124839	None	None	0	In state provider	None	1707 EYE ST	100	BAKERSFIELD	CA	93301	5208	15	06029	35.37461686	-119.020062	Kern County
228272	Fee-for-Service	1578590097	1578590097	1	1	HAYNES-LEE, JOAN E MD	11/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51704	08	Family Practice	0	In state provider	None	25455 BARTON RD	STE 204B	LOMA LINDA	CA	92354	3172	36	06071	34.04805253	-117.249534	San Bernardino County
228275	Fee-for-Service	1467759233	1467759233	1	1	HENEVELD, TREVOR M MD	8/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	141385	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2825 CAPITOL AVE	None	SACRAMENTO	CA	95816	6039	34	06067	38.570805	-121.4696385	Sacramento County
228315	Fee-for-Service	1265749790	1265749790	1	2	HIMELSTEIN, SAMUEL	5/7/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	25229	-	NOT APPLICABLE	0	In state provider	None	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
228342	Fee-for-Service	1962501494	1962501494	1	1	HZOR MEDICAL SERVICES	2/14/2003	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	HMS ADHCC	740 E WASHINGTON BLVD	None	PASADENA	CA	91104	5007	19	06037	34.16893349	-118.135197	Los Angeles County
228347	Fee-for-Service	1568655462	1568655462	1	1	HUANG, WILLIS MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98053	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
228386	Fee-for-Service	1336180603	1336180603	1	1	HAYASHI, MICHAEL K OD	9/17/1980	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1111 E HERNDON AVE	STE 101	FRESNO	CA	93720	3100	10	06019	36.8371853	-119.7695056	Fresno County
228441	Fee-for-Service	1851848030	1851848030	1	1	HORIZON CHARTER SCHOOLS	7/1/2016	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	873 1ST STREET	None	LINCOLN	CA	95648	1764	31	06061	38.88653655	-121.295061	Placer County
228480	Fee-for-Service	1386693547	1386693547	1	1	HAMILTON, ROBERT C MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	48570	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5176 HILL RD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
228482	Fee-for-Service	1700194586	1700194586	1	1	HOSPITALIST MEDICINE	12/29/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PHYSICIANS OF SAN BERNAR	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
228543	Fee-for-Service	1578669545	1578669545	1	1	HOFFMANN,THOMAS J MD INC	12/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	55138	07	Dermatology	0	In state provider	ADVANCED DERMATOLOGY SUR	18095 HWY 18	STE D	APPLE VALLEY	CA	92307	0000	36	06071	34.54025876	-117.2693057	San Bernardino County
228572	Fee-for-Service	1003932963	1003932963	1	1	HO, JEFFREY H DO	5/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	10	Gastroenterology (M.D. only)	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
228581	Fee-for-Service	1043566318	1043566318	1	1	HASSAN, SURA OD	5/24/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
228648	Fee-for-Service	1790339216	1790339216	1	1	HOANG, KEVIN OD	4/5/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4029 43RD STREET	SUITE 300	SAN DIEGO	CA	92105	8537	37	06073	32.75012697	-117.1019424	San Diego County
228662	Fee-for-Service	1366070559	1366070559	1	1	HUYNH, TIEN-PHAT V MD	6/5/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	191630	13	Neurology (M.D. only)	0	In state provider	None	300 STEIN PLZ	420	LOS ANGELES	CA	90095	0001	19	06037	34.06482846	-118.4443432	Los Angeles County
228663	Fee-for-Service	1053412403	1053412403	1	1	HEAD, BOBBIE MD	3/1/1984	193200000X	NA	Other	026	PHYSICIANS	50943	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
228674	Fee-for-Service	1598737587	1598737587	1	1	HALE, BRADEN R MD	4/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	79430	77	Infectious Disease	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
228728	Fee-for-Service	1235287129	1235287129	1	1	HOKSBERGEN, KARLA S CRNA	3/22/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	10800 MAGNOLIA AVENUE	RMC M0B2	RIVERSIDE	CA	92505	3047	33	06065	33.904782	-117.469323	Riverside County
228738	Fee-for-Service	1982771887	1982771887	1	1	HARTER, CAROL A MD	1/1/1982	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	33895	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
228764	Fee-for-Service	1386693547	1386693547	1	1	HAMILTON, ROBERT C MD	7/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	48570	01	General Practice	0	In state provider	None	5176 HILL RD E	None	LAKEPORT	CA	95453	6300	17	06033	39.10557408	-122.9078316	Lake County
228770	Fee-for-Service	1700194586	1700194586	1	1	HOSPITALIST MEDICINE	12/29/2010	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	PHYSICIANS OF SAN BERNAR	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
228837	Fee-for-Service	1598043978	1598043978	1	1	HERMOSILLO, MONICA LMFT	10/28/2024	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
228860	Fee-for-Service	1578025219	1578025219	1	1	HERRERA, STEPHANIE LMFT	1/31/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	151782	-	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
228861	Fee-for-Service	1003932963	1003932963	1	1	HO, JEFFREY H DO	5/28/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3874	30	06059	33.78077578	-117.8673468	Orange County
228940	Fee-for-Service	1871139097	1871139097	1	1	HOOK DYE, MEGAN LCSW	3/24/2025	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
228952	Fee-for-Service	1558771808	1558771808	1	1	HOANG, VANNA OD INC	1/30/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1232 S MAGNOLIA AVE	None	ANAHEIM	CA	92804	5116	30	06059	33.8159493	-117.9757948	Orange County
228987	Fee-for-Service	1982870622	1982870622	1	1	HOU, LINDA A MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115160	10	Gastroenterology (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
228995	Fee-for-Service	1831437243	1831437243	1	1	HEDDERLY, CHRISTINA C W DO	2/11/2015	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
229008	Fee-for-Service	1962868182	1962868182	1	1	HAR, KIM H PHD	3/2/2020	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
229016	Fee-for-Service	1083802474	1083802474	1	1	HEINTZ, SHANNON S CRNA	7/2/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
229024	Fee-for-Service	1275634248	1275634248	1	1	HWU, JIM-JER MD	10/12/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	41098	45	Nephrology (Renal-Kidney)	0	In state provider	GOLDEN PACIFIC NEPHROLOG	228 N GARFIELD AVE	STE 201	MONTEREY PARK	CA	91754	1709	19	06037	34.06461848	-118.1228384	Los Angeles County
229048	Fee-for-Service	1437595154	1437595154	1	1	HAMBERGER, ERIC MD	6/5/2019	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	142808	40	Pediatrics	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
229051	Fee-for-Service	1659735769	1659735769	1	1	HAAS, MADELINE M MD	3/13/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	None	None	0	In state provider	None	11980 SAN VICENTE BLVD.	102	LOS ANGELES	CA	90049	5012	19	06037	34.05221538	-118.4721745	Los Angeles County
229073	Fee-for-Service	1326087925	1326087925	1	1	HENRY, CHRISTOPHER P MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	54616	None	None	0	In state provider	None	1415 ROSS AVE	None	EL CENTRO	CA	92243	4306	13	06025	32.78144947	-115.568541	Imperial County
229101	Fee-for-Service	1588432371	1588432371	1	1	HADDAD, SARAH BCO-BADO	12/18/2023	332B00000X	NA	Other	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	321 NORTH LARCHMONT BOUL	SUITE 711	LOS ANGELES	CA	90004	3049	19	06037	34.0769016	-118.323663	Los Angeles County
229118	Fee-for-Service	1366571275	1366571275	3	1	HRH PHARMACY INC	5/31/2012	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1900 MCHENRY AVE	#202	ESCALON	CA	95320	9473	39	06077	37.79237158	-120.9965343	San Joaquin County
229119	Fee-for-Service	1609294024	1609294024	1	1	HIGASHIYAMA, NICOLE S MD	3/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137723	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
229131	Fee-for-Service	1689698524	1689698524	1	1	HSIEH, GEORGE D MD	1/1/1999	207P00000X	NA	Other	026	PHYSICIANS	67417	41	Internal Medicine	0	In state provider	None	11111 W LA PALMA AVE	None	ANAHEIM	CA	92803	3005	30	06059	33.84704372	-117.9495093	Orange County
229232	Fee-for-Service	1528794559	1528794559	1	1	HAIDE UY	8/2/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1024 HALSTEAD WAY	None	HEMET	CA	92545	9043	33	06065	33.73066047	-117.0003789	Riverside County
229265	Fee-for-Service	1144573692	1144573692	1	1	HERRERA, MAESPERANZA S PT	2/9/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1535 RIVER PARK DR	STE 1000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
229269	Fee-for-Service	1578094421	1578094421	1	1	HILTON, KARIN L NP	1/6/2017	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
229272	Fee-for-Service	1073717963	1073717963	1	1	HILL, ADRIENNE A MD	12/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	93360	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
229274	Fee-for-Service	1083778765	1083778765	1	1	HOPKINS, KEITH A MD	7/25/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141874	01	General Practice	0	In state provider	None	5524 ASSEMBLY COURT	None	SACRAMENTO	CA	95823	2625	34	06067	38.493306	-121.4392995	Sacramento County
229278	Fee-for-Service	1982870622	1982870622	1	1	HOU, LINDA A MD	7/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115160	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
229305	Fee-for-Service	1417984279	1417984279	1	1	HELMER, JAMES J MD	6/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78270	38	Geriatrics	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
229318	Fee-for-Service	1023764792	1023764792	1	1	HAZLETT, KATRINA A CNP	5/27/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4934 VERDUGO	None	CAMARILLO	CA	93012	8631	56	06111	34.21594032	-119.0048014	Ventura County
229334	Fee-for-Service	1023031671	1023031671	1	1	HENDRICKS, LANCE P MD	10/26/1978	207L00000X	NA	Other	026	PHYSICIANS	14616	05	Anesthesiology	0	In state provider	MISSION BAY HOSP	3030 BUNKER HILL ST	None	SAN DIEGO	CA	92109	5754	37	06073	32.80346216	-117.2151829	San Diego County
229371	Fee-for-Service	1497828396	1497828396	1	1	HASSAN, MAGDA A MD INC	3/7/2008	207L00000X	NA	Other	026	PHYSICIANS	35725	05	Anesthesiology	0	In state provider	None	525 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	19	06037	34.06794352	-118.1229278	Los Angeles County
229403	Fee-for-Service	1891874582	1891874582	1	1	HUANG, RICK P MD	5/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87735	08	Family Practice	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
229406	Fee-for-Service	1508845322	1508845322	1	1	HUNTINGTON HOSPITAL	4/8/2010	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	270 PARK AVE	None	HUNTINGTON	NY	11743	2787	00	None	40.879431	-73.4160375	Suffolk County
229411	Fee-for-Service	1952535486	1952535486	1	1	HFL HARBOR GATEWAY HOMES	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1435 WEST 223RD STREET	None	TORRANCE	CA	90501	4125	19	06037	33.82455481	-118.3028771	Los Angeles County
229484	Fee-for-Service	1952459802	1952459802	1	1	HENDEE, FADI MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	41463	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
229486	Fee-for-Service	1821190711	1821190711	1	2	HOSPITALISTS OF MODESTO MEDI	4/1/2002	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	CAL GROUP INC	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
229502	Fee-for-Service	1649368259	1649368259	1	1	HATTER, DOUGLAS G MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70383	02	General Surgery	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
229506	Fee-for-Service	1639181977	1639181977	1	1	HERZOG, NICOLE S MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65861	40	Pediatrics	0	In state provider	None	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	19	06037	34.069509	-118.383743	Los Angeles County
229553	Fee-for-Service	1992761365	1992761365	2	1	HURST, PHILIP K MD	7/11/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	66293	66	Emergency Medicine (Urgent Care)	0	In state provider	None	751 S BASCOM AVENUE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
229559	Fee-for-Service	1447322771	1447322771	1	1	HUANG, JUN TA DO	9/14/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8641	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
229571	Fee-for-Service	1407191356	1407191356	1	4	HIGH DESERT PATHOLOGY MEDICA	9/8/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1217	36	06071	34.131303	-117.3225325	San Bernardino County
229590	Fee-for-Service	1669663803	1669663803	1	1	HA, CHI D MD FACS	2/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105747	None	None	0	In state provider	None	300 PASTEUR DRIVE	MC: 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
229593	Fee-for-Service	1417984279	1417984279	1	1	HELMER, JAMES J MD	6/2/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78270	08	Family Practice	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
229607	Fee-for-Service	1023486222	1023486222	1	1	HARTMAN, JAIMEE MFT	3/30/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	85368	-	NOT APPLICABLE	0	In state provider	None	2307 W 6TH STREET	None	LOS ANGELES	CA	90057	3119	19	06037	34.06056584	-118.2771007	Los Angeles County
229627	Fee-for-Service	1740473552	1740473552	1	1	HORON, ROBERT	3/8/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	10165 FOOTHILL BLVD	#3	RANCHO CUCAMONGA	CA	91730	0340	36	06071	34.10653497	-117.5834924	San Bernardino County
229628	Fee-for-Service	1710939152	1710939152	1	1	HILL, TANYA 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
229634	Fee-for-Service	1205985827	1205985827	1	1	HODGSON, DANNER T MD	11/19/2007	207P00000X	NA	Other	026	PHYSICIANS	97336	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
229637	Fee-for-Service	1841232337	1841232337	1	1	HALLER, STEFAN MD	10/19/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	51503	30	Radiology	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
229681	Fee-for-Service	1104860816	1104860816	1	1	HOFFMAN, MARK D MD	8/13/1984	207P00000X	NA	Other	026	PHYSICIANS	53435	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9400 E ROSECRANS BLVD	None	BELLFLOWER	CA	90706	0000	19	06037	33.9040752	-118.1328995	Los Angeles County
229686	Fee-for-Service	1144707423	1144707423	1	1	HADJ SMAINE, LINA DO	4/7/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	17813	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
229695	Fee-for-Service	1508845322	1508845322	1	1	HUNTINGTON HOSPITAL	8/16/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	270 PARK AVE	None	HUNTINGTON	NY	11743	2787	00	None	40.879431	-73.4160375	Suffolk County
229729	Fee-for-Service	1548411713	1548411713	1	1	HONG, DOROTHY C MD	10/27/2009	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	97554	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	207 S SANTA ANITA ST	STE 335	SAN GABRIEL	CA	91776	1160	19	06037	34.10072807	-118.1066296	Los Angeles County
229792	Fee-for-Service	1649368259	1649368259	1	1	HATTER, DOUGLAS G MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	70383	01	General Practice	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
229851	Fee-for-Service	1982693693	1982693693	2	1	HANCOCK, CRAIG E MD	5/8/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	182346	30	Radiology	0	In state provider	None	1150 INDIAN CANYON	None	PALM SPRINGS	CA	92262	4872	33	06065	33.838623	-116.542737	Riverside County
229856	Fee-for-Service	1043274236	1043274236	1	1	HUANG, YI-CHAO MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	79686	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
229864	Fee-for-Service	1245762152	1245762152	1	1	HO, BRIAN P MD	8/2/2019	207P00000X	NA	Other	026	PHYSICIANS	157905	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
229897	Fee-for-Service	1407392921	1407392921	1	1	HAMER, LARS E CRNA	1/2/2023	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
229946	Fee-for-Service	1689937393	1689937393	1	1	HUNTER, JEANNE DO	6/6/2020	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	16241	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
229980	Fee-for-Service	1306261078	1306261078	1	1	HORNAGE, NICOLE LMFT	10/17/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
229983	Fee-for-Service	1861422347	1861422347	1	1	HARBISON, JOHN D MD	11/23/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	70156	None	None	0	In state provider	None	1001 POTRERO AVE	RM 7M	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
230003	Fee-for-Service	1679049142	1679049142	1	1	HAUPERT, NICOLE C NP	12/11/2018	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
230008	Fee-for-Service	1174245104	1174245104	1	1	HEALING SOULS HOME HEALTH	11/1/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE	6501 FOOTHILL BLVD	STE 204A	TUJUNGA	CA	91042	2768	19	06037	34.24497265	-118.2734363	Los Angeles County
230012	Fee-for-Service	1225067465	1225067465	1	1	HAMOUI, NAHID MD	8/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	74889	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
230030	Fee-for-Service	1063967636	1063967636	1	1	HIGH FIVE HAND THERAPY AND R	11/10/2023	261QR0400X	NA	Physical Therapist	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	EHABILITATION	9828 GARDEN GROVE BLVD	STE 110	GARDEN GROVE	CA	92844	1655	30	06059	33.77397547	-117.960813	Orange County
230063	Fee-for-Service	1851424071	1851424071	1	1	HOANG, VANNA T MD	9/19/2009	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9567 BOLSA AVE	None	WESTMINSTER	CA	92683	5904	30	06059	33.74500952	-117.9617175	Orange County
230066	Fee-for-Service	1972812022	1972812022	1	1	HONG, DONNA M OD INC	9/29/2010	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5520 WHITTIER BLVD	None	COMMERCE	CA	90022	4104	19	06037	34.01904832	-118.1511878	Los Angeles County
230084	Fee-for-Service	1790864437	1790864437	1	1	HILL, BRADLEY BRUCE MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61409	02	General Surgery	0	In state provider	None	2680 HANOVER ST	STE 100	PALO ALTO	CA	94304	1117	43	06085	37.41744418	-122.1474815	Santa Clara County
230085	Fee-for-Service	1841437241	1841437241	1	3	H STREET CLINIC, INC.	5/1/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3750 ARLINGTON AVE	None	RIVERSIDE	CA	92506	2607	33	06065	33.94621715	-117.399167	Riverside County
230112	Fee-for-Service	1043774961	1043774961	1	1	HOANG, MARTHA RCP	2/24/2019	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
230118	Fee-for-Service	1295288348	1295288348	1	3	HEALTH ACCESS FOR ALL INC	2/6/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5800 KING AVENUE	None	MAYWOOD	CA	90270	2928	19	06037	33.98753616	-118.1832598	Los Angeles County
230131	Fee-for-Service	1750318945	1750318945	1	1	HALL, BRIAN E MD	2/3/2016	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
230176	Fee-for-Service	1265651632	1265651632	1	1	HOANG, JOHN V DO	9/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9427	41	Internal Medicine	0	In state provider	None	3628 E IMPERIAL HWY	STE 100	LYNWOOD	CA	90262	2600	19	06037	33.93070837	-118.2044557	Los Angeles County
230180	Fee-for-Service	1124482443	1124482443	1	1	HANS, HARLIV S MD	10/1/2019	208M00000X	NA	Other	026	PHYSICIANS	156087	41	Internal Medicine	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
230250	Fee-for-Service	1407842792	1407842792	1	1	HIGA, NOLAN T MD INC	8/4/2006	207L00000X	NA	Other	026	PHYSICIANS	33621	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
230255	Fee-for-Service	1700272549	1700272549	1	2	HUDKINS, MATTHEW R MD	6/21/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	144102	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
230263	Fee-for-Service	1265627277	1265627277	1	1	HUNTINGTON GERIATRIC MEDICAL	4/18/2014	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	38	Geriatrics	0	In state provider	GROUP	2100 E COLORADO BLVD	STE 1	PASADENA	CA	91107	5860	19	06037	34.14602354	-118.107063	Los Angeles County
230290	Fee-for-Service	1760437222	1760437222	1	1	HEIER,JEFFREY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SANFORD CLINIC HOSP	1305 W 18TH ST	None	SIOUX FALLS	SD	57117	5039	00	None	43.535484	-96.7428585	Minnehaha County
230341	Fee-for-Service	1851372239	1851372239	1	1	HORODYSKY, ANDRIJ W MD	2/28/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	50670	08	Family Practice	0	In state provider	None	1113 ALTA AVE	STE 120	UPLAND	CA	91786	2803	36	06071	34.10824455	-117.6322743	San Bernardino County
230368	Fee-for-Service	1770560013	1770560013	1	1	HU, CHARLENE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	79330	13	Neurology (M.D. only)	0	In state provider	CHARLENE HU NEUROLOGY	5725 W LAS POSITAS BLVD	STE 280	PLEASANTON	CA	94588	4059	01	06001	37.688107	-121.8861427	Alameda County
230370	Fee-for-Service	1790864437	1790864437	1	1	HILL, BRADLEY BRUCE MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61409	23	Peripheral Vascular Disease or Surgery (D.O. 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
230375	Fee-for-Service	1841437241	1841437241	1	3	H STREET CLINIC, INC.	5/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	3750 ARLINGTON AVE	None	RIVERSIDE	CA	92506	2607	33	06065	33.94621715	-117.399167	Riverside County
230389	Fee-for-Service	1962806042	1962806042	1	1	HU, GINA Y	10/17/2016	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6041 CADILLAC	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
230400	Fee-for-Service	1013357862	1013357862	1	1	HERD, TIFFANY LMFT	3/7/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4160 TEMESCAL CANYON RD	STE 401	CORONA	CA	92883	4625	33	06065	33.81915655	-117.5075503	Riverside County
230408	Fee-for-Service	1295288348	1295288348	1	3	HEALTH ACCESS FOR ALL INC	4/10/2024	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5800 KING AVENUE	None	MAYWOOD	CA	90270	2928	19	06037	33.98753616	-118.1832598	Los Angeles County
230411	Fee-for-Service	1326099151	1326099151	1	2	HINER, BRADLEY C MD	10/1/2021	2084N0400X	NA	Neurology	026	PHYSICIANS	52261	13	Neurology (M.D. only)	0	In state provider	None	1700 N ROSE AVE	STE 470	OXNARD	CA	93030	7659	56	06111	34.21746	-119.155545	Ventura County
230415	Fee-for-Service	1235496589	1235496589	1	1	HONARI, SAHAR MD	2/23/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	147954	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
230419	Fee-for-Service	1952440554	1952440554	1	1	HINNANT, CHRISTOPHER MD	3/11/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	53005	01	General Practice	0	In state provider	None	375 LAGUNA HONDA BLVD	None	SAN FRANCISCO	CA	94116	1411	38	06075	37.74791027	-122.4587116	San Francisco County
230428	Fee-for-Service	1780614602	1780614602	1	1	HART, JASON K MD	7/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55718	08	Family Practice	0	In state provider	None	15464 GOLDENWEST STREET	None	WESTMINSTER	CA	92683	6149	30	06059	33.73784708	-118.0068331	Orange County
230448	Fee-for-Service	1265562557	1265562557	1	1	HEMET UNIFIED SCHOOL	9/13/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	1791 WEST ACACIA AVE	None	HEMET	CA	92545	3797	33	06065	33.74376019	-116.9903284	Riverside County
230457	Fee-for-Service	1316170004	1316170004	1	1	HOLTROP, MARIA I PSYD	6/14/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	D	1672 W AVENUE J	207	LANCASTER	CA	93534	2861	19	06037	34.68938947	-118.1609775	Los Angeles County
230496	Fee-for-Service	1437766847	1437766847	1	1	HAYWARD, KATHERYN R LCSW	1/26/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	14500 ROSCOE BLVD.	400	PANORAMA CITY	CA	91402	4194	19	06037	34.2215055	-118.44918	Los Angeles County
230526	Fee-for-Service	1760470777	1760470777	1	1	HENDRICKSON, MARGO MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	85	Surgery-Pediatric	2	Out of state provider	None	3006 S MARYLAND PKWY	STE 770	LAS VEGAS	NV	89109	2246	00	None	36.135288	-115.1368705	Clark County
230546	Fee-for-Service	1730589441	1730589441	1	1	HADDAD, HANNAH	8/15/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1827 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.25641704	-119.2199387	Ventura County
230549	Fee-for-Service	1255089058	1255089058	1	1	HARRISON, LAUREN E PHD	7/29/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
230551	Fee-for-Service	1265627277	1265627277	1	1	HUNTINGTON GERIATRIC MEDICAL	4/18/2014	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP	2100 E COLORADO BLVD	STE 1	PASADENA	CA	91107	5860	19	06037	34.14602354	-118.107063	Los Angeles County
230584	Fee-for-Service	1104812585	1104812585	1	1	HASHIMOTO, HIROFUMI MD	2/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83463	41	Internal Medicine	0	In state provider	None	450 E ROMIE LN	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
230610	Fee-for-Service	1629039177	1629039177	1	1	HOMLER, HOWARD J MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	40470	41	Internal Medicine	0	In state provider	None	6660 COYLE AVE	STE 250	CARMICHAEL	CA	95608	6367	34	06067	38.667447	-121.3091505	Sacramento County
230631	Fee-for-Service	1205038502	1205038502	1	1	HASSAN, FATIMA M MD	12/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	95580	40	Pediatrics	0	In state provider	None	2417 CENTRAL AVE	None	ALAMEDA	CA	94501	4515	01	06001	37.76389996	-122.2420612	Alameda County
230675	Fee-for-Service	1831781756	1831781756	1	1	HELPLINE YOUTH COUNSELING	6/21/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	5400 E OLYMPIC BLVD	SUITE 225	COMMERCE	CA	90022	5147	19	06037	34.01564534	-118.1555473	Los Angeles County
230678	Fee-for-Service	1558756536	1558756536	1	1	HEALTHRIGHT 360	3/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	117 N SAN MATEO DR	SUITE 1	SAN MATEO	CA	94401	2708	41	06081	37.56866767	-122.3286434	San Mateo County
230694	Fee-for-Service	1295288348	1295288348	1	3	HEALTH ACCESS FOR ALL INC	2/6/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5800 KING AVENUE	None	MAYWOOD	CA	90270	2928	19	06037	33.98753616	-118.1832598	Los Angeles County
230736	Fee-for-Service	1902413842	1902413842	1	1	HELMIG, MADELINE E CCC-SLP	7/18/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
230798	Fee-for-Service	1861106254	1861106254	1	1	HIRSCHFELD, HAILEY M CNP	2/1/2023	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
230816	Fee-for-Service	1326433418	1326433418	1	1	HATAMI, NAZILA 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
230837	Fee-for-Service	1265627277	1265627277	1	1	HUNTINGTON GERIATRIC MEDICAL	4/18/2014	207QG0300X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	01	General Practice	0	In state provider	GROUP	2100 E COLORADO BLVD	STE 1	PASADENA	CA	91107	5860	19	06037	34.14602354	-118.107063	Los Angeles County
230858	Fee-for-Service	1437418951	1437418951	1	1	HWANG, CONNIE J MFT	10/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	92103	-	NOT APPLICABLE	0	In state provider	None	103 SHORELINE PKWY	SUITE 201, 101	SAN RAFAEL	CA	94901	5584	21	06041	37.9516451	-122.4933768	Marin County
230898	Fee-for-Service	1629039177	1629039177	1	1	HOMLER, HOWARD J MD	11/30/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	40470	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6660 COYLE AVE	STE 250	CARMICHAEL	CA	95608	6367	34	06067	38.667447	-121.3091505	Sacramento County
230920	Fee-for-Service	1841437241	1841437241	1	6	H STREET CLINIC, INC.	7/12/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	13132 STUDEBAKER RD	STE A	NORWALK	CA	90650	2573	19	06037	33.911874	-118.099151	Los Angeles County
230923	Fee-for-Service	1922155670	1922155670	1	1	HOLLAND, LAUREN M MD	12/17/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93009	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	710 LAWRENCE EXPWY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
230958	Fee-for-Service	1083766810	1083766810	2	1	HWANG, JESSIE Y OD	4/15/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	306 SPRUCE AVE	None	S SAN FRANCISCO	CA	94080	2741	41	06081	37.65669155	-122.4159146	San Mateo County
230969	Fee-for-Service	1558756536	1558756536	1	1	HEALTHRIGHT 360	3/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	117 N SAN MATEO DR	SUITE 1	SAN MATEO	CA	94401	2708	41	06081	37.56866767	-122.3286434	San Mateo County
230997	Fee-for-Service	1457589509	1457589509	1	1	HAQ, AAZAZ U MD	4/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124259	38	Geriatrics	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
231017	Fee-for-Service	1194186296	1194186296	1	2	HEISER, STEPHANIE	4/16/2024	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
231037	Fee-for-Service	1841904349	1841904349	1	1	HSU, PRISCILLA DOULA	2/6/2023	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
231039	Fee-for-Service	1588804934	1588804934	1	1	H L H AND ASSOCIATES INC	10/9/2014	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	44630 MONTEREY AVE	SUITE 100	PALM DESERT	CA	92260	3326	33	06065	33.72415798	-116.3912386	Riverside County
231046	Fee-for-Service	1740372887	1740372887	1	1	HYUK LEE MD AMC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	30417	None	None	0	In state provider	None	10230 ARTESIA BLVD	STE 111	BELLFLOWER	CA	90706	6768	19	06037	33.8728276	-118.1160403	Los Angeles County
231091	Fee-for-Service	1669700886	1669700886	1	1	HUSENI, SHEHLANOOR A MD	9/2/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	109237	40	Pediatrics	0	In state provider	None	4125 BANGS AVE	None	MODESTO	CA	95356	8713	50	06099	37.70451024	-121.0709696	Stanislaus County
231122	Fee-for-Service	1750326427	1750326427	1	1	HANJAN, TARA MD	4/5/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	81535	None	None	0	In state provider	None	35800 BOB HOPE DR	SUITE 150A	RANCHO MIRAGE	CA	92270	1739	33	06065	33.790527	-116.4058645	Riverside County
231183	Fee-for-Service	1508929001	1508929001	2	1	HURDLE, ALAIN M MD	9/15/2017	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	8584	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	117 W BUNNY AVE	None	SANTA MARIA	CA	93458	2805	42	06083	34.96327701	-120.4368111	Santa Barbara County
231189	Fee-for-Service	1841437241	1841437241	1	4	H STREET CLINIC, INC.	8/18/2021	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1490 1494 W SIXTH ST	None	COACHELLA	CA	92236	1712	33	06065	33.67864375	-116.1765864	Riverside County
231207	Fee-for-Service	1578881736	1578881736	1	1	HAZRATI, EHSAN MD	11/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126441	None	None	0	In state provider	None	975 S FAIRMONT AVE	None	LODI	CA	95242	3635	39	06077	38.12188356	-121.285872	San Joaquin County
231208	Fee-for-Service	1841437241	1841437241	1	6	H STREET CLINIC, INC.	7/12/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	13132 STUDEBAKER RD	STE A	NORWALK	CA	90650	2573	19	06037	33.911874	-118.099151	Los Angeles County
231231	Fee-for-Service	1043635394	1043635394	1	1	HATANO, YUI CNP	12/9/2024	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	511 N HOLLYWOOD WAY	None	BURBANK	CA	91505	3406	19	06037	34.15985598	-118.3431272	Los Angeles County
231258	Fee-for-Service	1598991366	1598991366	1	1	HOYAL, RACHEL A DPM	5/25/2010	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1041 FOURTH ST	STE B	SANTA ROSA	CA	95404	4329	49	06097	38.444229	-122.7061935	Sonoma County
231273	Fee-for-Service	1649384751	1649384751	1	1	HAUCK, BRIAN P MD	4/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50233	41	Internal Medicine	0	In state provider	None	2089 VALE RD	STE 33	SAN PABLO	CA	94806	3850	07	06013	37.95396781	-122.3375393	Contra Costa County
231285	Fee-for-Service	1457589509	1457589509	1	1	HAQ, AAZAZ U MD	4/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124259	36	Psychiatry	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
231292	Fee-for-Service	1497461321	1497461321	1	1	HUTCHINS, NATHANIEL P LCSW	3/21/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
231301	Fee-for-Service	1306158506	1306158506	1	1	HUO, KEUNHENG MD	3/22/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	117599	20	Orthopedic Surgery	0	In state provider	None	24331 EL TORO ROAD	SUITE 200	LAGUNA WOODS	CA	92637	3116	30	06059	33.60928782	-117.7295058	Orange County
231340	Fee-for-Service	1134408057	1134408057	1	1	HART, JAMES L MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121172	38	Geriatrics	0	In state provider	None	10666 N TORREY PINE RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
231342	Fee-for-Service	1578786448	1578786448	1	1	HELMY, MOHAMMAD MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84120	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
231347	Fee-for-Service	1891928560	1891928560	1	1	HUBER, MARY R MD	12/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	88314	41	Internal Medicine	0	In state provider	None	3285 CLAREMONT WAY	None	NAPA	CA	94558	3313	28	06055	38.32103673	-122.3025002	Napa County
231395	Fee-for-Service	1689801722	1689801722	1	1	HEITMANN, SONYA MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113757	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
231409	Fee-for-Service	1083470967	1083470967	1	1	HANCOCK, JENNIFER A LCSW	3/21/2024	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
231428	Fee-for-Service	1295780476	1295780476	1	1	HTI MEMORIAL HOSPITAL	1/3/2009	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	3441 DICKERSON PIKE	None	NASHVILLE	TN	37207	2539	00	None	36.245349	-86.74983	Davidson County
231442	Fee-for-Service	1740213362	1740213362	1	1	HANGER P & O WEST INC	6/6/2002	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1411 SECRET RAVINE PKWY	SUITE 100	ROSEVILLE	CA	95661	6042	31	06061	38.76424823	-121.2440842	Placer County
231477	Fee-for-Service	1841437241	1841437241	1	4	H STREET CLINIC, INC.	1/18/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1490 1494 W SIXTH ST	None	COACHELLA	CA	92236	1712	33	06065	33.67864375	-116.1765864	Riverside County
231478	Fee-for-Service	1437161247	1437161247	1	1	HAMILTON, CAROL V DC	7/31/1986	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	1241 7TH ST	None	WASCO	CA	93280	1820	15	06029	35.59421548	-119.340171	Kern County
231533	Fee-for-Service	1699355768	1699355768	1	1	HERNANDEZ, MAIRA M LMFT	5/7/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 E SHAW AVE	STE 230	FRESNO	CA	93710	7708	10	06019	36.80886739	-119.7731624	Fresno County
231536	Fee-for-Service	1942644307	1942644307	1	1	HUANG, GRACE P MD	7/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142809	41	Internal Medicine	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
231553	Fee-for-Service	1811926975	1811926975	1	1	HANKER, GREGORY J MD	3/31/1991	207XS0106X	NA	Orthopedic Surgery	026	PHYSICIANS	49306	20	Orthopedic Surgery	0	In state provider	None	6815 NOBLE AVE	FL 3	VAN NUYS	CA	91405	3796	19	06037	34.19440435	-118.461871	Los Angeles County
231555	Fee-for-Service	1518040799	1518040799	1	1	HERRON, GEORGE JR MD INC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	45	Nephrology (Renal-Kidney)	0	In state provider	None	1610 N EL DORADO ST	STE 17	STOCKTON	CA	95204	5930	39	06077	37.96862394	-121.2942407	San Joaquin County
231559	Fee-for-Service	1508966045	1508966045	1	1	HENRY, TERRI D MD	1/14/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	69585	08	Family Practice	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
231560	Fee-for-Service	1649384751	1649384751	1	1	HAUCK, BRIAN P MD	4/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	50233	10	Gastroenterology (M.D. only)	0	In state provider	None	2089 VALE RD	STE 33	SAN PABLO	CA	94806	3850	07	06013	37.95396781	-122.3375393	Contra Costa County
231583	Fee-for-Service	1124446307	1124446307	1	1	HARANDI, NIMA K MD	10/19/2021	2085R0001X	NA	Other	026	PHYSICIANS	152026	None	None	0	In state provider	None	504 GIBSON DR	None	ROSEVILLE	CA	95678	5791	31	06061	38.77842304	-121.274421	Placer County
231613	Fee-for-Service	1679890750	1679890750	1	1	HARMONY HOMES INCORPORATED	11/16/2010	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1034 WEST MESA AVE	None	FRESNO	CA	93711	2001	10	06019	36.82471205	-119.8093149	Fresno County
231614	Fee-for-Service	1992856587	1992856587	2	1	HK GALLERIA PHARMACY INC	6/5/2017	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	3250 W OLYMPIC BLVD	STE 101	LOS ANGELES	CA	90006	2368	19	06037	34.05263234	-118.3077799	Los Angeles County
231626	Fee-for-Service	1134408057	1134408057	1	1	HART, JAMES L MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121172	41	Internal Medicine	0	In state provider	None	10666 N TORREY PINE RD	None	LA JOLLA	CA	92037	1027	37	06073	32.89687721	-117.2418677	San Diego County
231637	Fee-for-Service	1134197080	1134197080	1	1	HITESH K MOVALIA	12/21/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SUN CITY IMAGING P.C	14502 W MEEKER BLVD	None	SUN CITY WEST	AZ	85375	0000	00	None	33.660657	-112.3736175	Maricopa County
231641	Fee-for-Service	1982769998	1982769998	1	1	HALLEE, JULIA A MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	74947	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
231666	Fee-for-Service	1629322201	1629322201	1	1	HUMPHREY, KESHIA D LMFT	5/21/2020	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
231699	Fee-for-Service	1205977444	1205977444	1	1	HARBOR MEDICAL ASSOCIATES	12/1/1998	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	36	Psychiatry	0	In state provider	INC	3 CORPORATE PLAZA DRIV	None	NEWPORT BEACH	CA	92660	7980	30	06059	33.607359	-117.876908	Orange County
231718	Fee-for-Service	1295780476	1295780476	1	1	HTI MEMORIAL HOSPITAL	1/3/2009	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	CORPORATION	3441 DICKERSON PIKE	None	NASHVILLE	TN	37207	2539	00	None	36.245349	-86.74983	Davidson County
231723	Fee-for-Service	1487137105	1487137105	1	1	HUANG, FLORA OD	3/22/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
231765	Fee-for-Service	1841437241	1841437241	1	4	H STREET CLINIC, INC.	6/24/2021	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1490 1494 W SIXTH ST	None	COACHELLA	CA	92236	1712	33	06065	33.67864375	-116.1765864	Riverside County
231796	Fee-for-Service	1700193018	1700193018	1	1	HARGROVE, RUSSELL A CRNA	3/25/2025	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
231807	Fee-for-Service	1912425851	1912425851	1	1	HOY, CHELSEA CRNA	10/31/2017	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
231840	Fee-for-Service	1518040799	1518040799	1	1	HERRON, GEORGE JR MD INC	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1610 N EL DORADO ST	STE 17	STOCKTON	CA	95204	5930	39	06077	37.96862394	-121.2942407	San Joaquin County
231841	Fee-for-Service	1922582832	1922582832	1	1	HADILAKSONO, ANNA J NP	3/3/2023	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1105 LAS TABLAS RD	STE D	TEMPLETON	CA	93465	9480	40	06079	35.55437047	-120.7191105	San Luis Obispo County
231863	Fee-for-Service	1437116142	1437116142	1	1	HOMAN, JOHN D	7/18/2013	207R00000X	NA	Other	026	PHYSICIANS	50213	None	None	0	In state provider	None	520 SUPERIOR AVE	SUITE 255	NEWPORT BEACH	CA	92663	3668	30	06059	33.628914	-117.9276525	Orange County
231883	Fee-for-Service	1730464132	1730464132	1	1	HOUSHANIAN, MALIHE	3/22/2013	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	22736 VANOWEN ST	STE 205	WEST HILLS	CA	91307	2655	19	06037	34.19369647	-118.622556	Los Angeles County
231885	Fee-for-Service	1558435644	1558435644	1	1	HAMMEL, NATHAN C MD	5/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139718	20	Orthopedic Surgery	0	In state provider	None	3030 CHILDRENS WAY	None	SAN DIEGO	CA	92123	4232	37	06073	32.798889	-117.150826	San Diego County
231888	Fee-for-Service	1255392213	1255392213	1	1	HOLLEY,SHAY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	5475 S 500 E	None	OGDEN	UT	84405	6905	00	None	41.16449014	-111.9686412	Weber County
231959	Fee-for-Service	1093140972	1093140972	1	1	HULLIBARGER, AMBER LMFT	3/28/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	279 BRANCH STREET	#I	SAN LUIS OBISPO	CA	93401	5026	40	06079	35.27018862	-120.6659631	San Luis Obispo County
231975	Fee-for-Service	1841226792	1841226792	1	1	HINES,BRUCE 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	ONE VANTAGE WAY	STE B240	NASHVILLE	TN	37228	0000	00	None	36.19232503	-86.79194122	Davidson County
231976	Fee-for-Service	1396838348	1396838348	1	1	HILTON, ELIZABETH MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	SACRED HEART MEDICAL CEN	3333 RIVERBEND DR	None	SPRINGFIELD	OR	97477	8800	00	None	44.08199228	-123.0283538	Lane County
231979	Fee-for-Service	1083858500	1083858500	1	1	HALE, CHRISTOPHER S MD	8/15/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123799	22	Pathology (M.D. only)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
232007	Fee-for-Service	1396816344	1396816344	1	1	HOANG, LYNN MD	6/28/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	60509	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
232052	Fee-for-Service	1841437241	1841437241	1	4	H STREET CLINIC, INC.	1/18/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1490 1494 W SIXTH ST	None	COACHELLA	CA	92236	1712	33	06065	33.67864375	-116.1765864	Riverside County
232069	Fee-for-Service	1912294703	1912294703	1	1	HUYNH, CHRISTY MD	7/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	143046	08	Family Practice	0	In state provider	None	3291 LOMA VISTA ROAD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
232076	Fee-for-Service	1295923613	1295923613	1	1	HUTCHINSON, DESIRAE MFT	9/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	770 MAGNOLIA AVE	STE 1F	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
232094	Fee-for-Service	1720136625	1720136625	1	1	HOWARD, ALISON OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3033 BUNKER HILL ST	None	SAN DIEGO	CA	92109	3705	37	06073	32.80361012	-117.2146946	San Diego County
232161	Fee-for-Service	1578548442	1578548442	2	1	HARRISON, BRAD V MD	12/10/2019	207P00000X	NA	Other	026	PHYSICIANS	-	None	None	2	Out of state provider	None	1400 S DOBSON RD	None	MESA	AZ	85202	4707	00	None	33.38982	-111.8760885	Maricopa County
232224	Fee-for-Service	1205846961	1205846961	1	1	HSIEH, LINDA OD	9/23/2019	207W00000X	NA	Ophthalmology	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
232226	Fee-for-Service	1912266461	1912266461	1	1	HAIK, NANCY B LMFT	6/17/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	105089	-	NOT APPLICABLE	0	In state provider	None	100 EAST WARDLOW ROAD	None	LONG BEACH	CA	90807	4417	19	06037	33.8188341	-118.1923297	Los Angeles County
232228	Fee-for-Service	1427025816	1427025816	1	1	HORIE, DAVID S OD	10/1/1994	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	951 S BEACH BLVD	None	LA HABRA	CA	90631	6418	30	06059	33.920172	-117.967889	Orange County
232231	Fee-for-Service	1497701734	1497701734	1	1	HAN, DONG SOO MD INC	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	25260	05	Anesthesiology	0	In state provider	None	17150 NEWHOPE ST	STE 507	FOUNTAIN VALLEY	CA	92708	4253	30	06059	33.71373	-117.9283535	Orange County
232243	Fee-for-Service	1396197075	1396197075	1	1	HOADLEY, SARA LMFT	9/8/2020	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
232255	Fee-for-Service	1669466868	1669466868	1	1	HACKETT, LEONARD THOMAS	10/1/1984	207RH0003X	NA	Oncology	026	PHYSICIANS	52529	68	Hematology	0	In state provider	None	4420 N 1ST ST	STE 116	FRESNO	CA	93726	2328	10	06019	36.798138	-119.772224	Fresno County
232272	Fee-for-Service	1982625349	1982625349	1	1	HASSOUN, ASSAD A MD	9/20/2007	204F00000X	NA	General Surgery	026	PHYSICIANS	67695	02	General Surgery	0	In state provider	None	2340 CLAY ST	STE 251	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
232306	Fee-for-Service	1538496187	1538496187	1	1	HARRIS, KERI R LCSW	6/16/2022	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
232315	Fee-for-Service	1801880729	1801880729	1	1	HAIDT, STERLING J MD INC	8/31/1985	207W00000X	NA	Ophthalmology	026	PHYSICIANS	24087	18	Ophthalmology	0	In state provider	None	50 S SAN MATEO DR	STE 125	SAN MATEO	CA	94401	3859	41	06081	37.56634141	-122.3261145	San Mateo County
232401	Fee-for-Service	1275742223	1275742223	1	1	HAWS, TERRILL K DO	1/13/2023	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	15606	None	None	0	In state provider	None	6766 PASSONS BLVD.	A&B	PICO RIVERA	CA	90660	3632	19	06037	33.97972571	-118.0896078	Los Angeles County
232435	Fee-for-Service	1679753461	1679753461	1	1	HUYNH, KELLY MD	10/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	107397	78	Neoplastic Diseases/Oncology	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
232454	Fee-for-Service	1457439051	1457439051	1	1	HUA, HONG T MD	8/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63755	06	Cardiovascular Disease (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
232514	Fee-for-Service	1558840561	1558840561	1	1	HOLMES, HAYLEY L CCC-A	12/22/2022	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 MOODY DRIVE	None	THOUSAND OAKS	CA	91360	6077	56	06111	34.17732532	-118.8654117	Ventura County
232541	Fee-for-Service	1811109077	1811109077	2	1	HEALDSBURG UNIFIED SCHOOL	1/10/2013	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	DISTRICT	1028 PRINCE AVE	None	HEALDSBURG	CA	95448	3449	49	06097	38.62287049	-122.8680553	Sonoma County
232550	Fee-for-Service	1578649554	1578649554	1	1	HOLTZ, GERALD B MD	6/16/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	171946	None	None	0	In state provider	None	FRESNO AND R ST	None	FRESNO	CA	93721	0000	10	06019	36.741663	-119.7841005	Fresno County
232594	Fee-for-Service	1104349943	1104349943	1	1	HOMEYER, HOLLY N LCSW	2/8/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
232613	Fee-for-Service	1720029135	1720029135	1	1	HOJJATI, MEHRNAZ MD	11/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131825	None	None	0	In state provider	None	1020 29TH ST	SUITE 270	SACRAMENTO	CA	95816	5173	34	06067	38.572803	-121.4685	Sacramento County
232626	Fee-for-Service	1164629515	1164629515	1	1	HERPICH, BYRON K MD	6/19/2023	207R00000X	NA	Other	026	PHYSICIANS	186165	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
232641	Fee-for-Service	1073047213	1073047213	1	1	HAN, ASHLEY A MD	7/1/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	163076	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
232664	Fee-for-Service	1114964970	1114964970	1	1	HALL, MYRON L DPM	2/13/2012	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6222 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90048	5193	19	06037	34.06325771	-118.3641574	Los Angeles County
232710	Fee-for-Service	1790777381	1790777381	1	1	HORWITZ, SANDRA G OD	4/18/1995	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	14714 HAWTHORNE BLVD	None	LAWNDALE	CA	90260	1523	19	06037	33.89778908	-118.3523295	Los Angeles County
232716	Fee-for-Service	1497780563	1497780563	1	1	HABERMAN, MARK MD	1/22/1997	207R00000X	NA	Other	026	PHYSICIANS	83540	40	Pediatrics	0	In state provider	None	13152 NEWPORT AVE	None	TUSTIN	CA	92780	3416	30	06059	33.74737358	-117.812672	Orange County
232725	Fee-for-Service	1194879783	1194879783	1	1	HUNT, SHARON A MD	6/21/2000	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	25739	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	770 WELCH RD	STE 380	PALO ALTO	CA	94304	1523	43	06085	37.43748087	-122.1759625	Santa Clara County
232742	Fee-for-Service	1457439051	1457439051	1	1	HUA, HONG T MD	8/22/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	63755	02	General Surgery	0	In state provider	None	2425 GEARY BLVD	None	SAN FRANCISCO	CA	94115	3358	38	06075	37.78272203	-122.4433297	San Francisco County
232780	Fee-for-Service	1346207651	1346207651	1	1	HUANG, SUSAN S MD	7/31/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100737	77	Infectious Disease	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
232799	Fee-for-Service	1952072027	1952072027	1	1	HEALI AI CORP	1/26/2023	174H00000X	NA	Other	102	DIABETES PREVENTION PROGRAM SUPPLIER	-	-	NOT APPLICABLE	0	In state provider	None	1431 OCEAN AVE	100	SANTA MONICA	CA	90401	2124	19	06037	34.01323125	-118.4970598	Los Angeles County
232821	Fee-for-Service	1184799603	1184799603	1	1	HUH, YONGCHUL MD INC	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	60977	41	Internal Medicine	0	In state provider	None	356 S WESTERN AVE	STE 200	LOS ANGELES	CA	90020	3815	19	06037	34.067412	-118.309084	Los Angeles County
232859	Fee-for-Service	1215975818	1215975818	1	1	HELBIG, HERBERT D MD	8/24/1973	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	34518	30	Radiology	0	In state provider	None	709 18TH ST	None	MODESTO	CA	95354	1210	50	06099	37.64364413	-120.9896383	Stanislaus County
232861	Fee-for-Service	1508136847	1508136847	1	1	HATA, CORY J DO	1/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12330	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
232866	Fee-for-Service	1528196060	1528196060	1	1	HUNT, CAMMAX I OD	10/15/1981	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	342 MORRISSEY BLVD	None	SANTA CRUZ	CA	95062	1256	44	06087	36.9856961	-122.004797	Santa Cruz County
232870	Fee-for-Service	1073359055	1073359055	1	1	HALIMI, AHMAD HAIRI MD	1/23/2025	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232882	Fee-for-Service	1588635692	1588635692	1	1	HUTCHINSON,JERRY H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4888 N STONE AVE	None	TUCSON	AZ	85704	5749	00	None	32.29425	-110.970225	Pima County
232907	Fee-for-Service	1093038135	1093038135	1	1	HSU, JOHN F DO	12/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	11134	24	Plastic Surgery	0	In state provider	None	415 S GARFIELD AVE	None	ALHAMBRA	CA	91801	3838	19	06037	34.09058841	-118.1236963	Los Angeles County
232908	Fee-for-Service	1265610513	1265610513	1	1	HORRICKS, JUSTIN E MD	12/9/2009	390200000X	NA	Other	026	PHYSICIANS	97914	05	Anesthesiology	0	In state provider	None	400 N PEPPER AVENUE	None	COLTON	CA	92324	1801	36	06071	34.073505	-117.3505995	San Bernardino County
232928	Fee-for-Service	1740704592	1740704592	1	1	HERGET, LAURA M PT	11/4/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	42	06083	34.42967671	-119.7228362	Santa Barbara County
232938	Fee-for-Service	1972097939	1972097939	1	1	HONG, THOMAS S MD	7/5/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	184818	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232941	Fee-for-Service	1689934465	1689934465	1	1	HU, KATIE Y MD	5/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127799	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
232942	Fee-for-Service	1366639445	1366639445	1	1	HAH, JENNIFER M MD	7/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	100279	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
232945	Fee-for-Service	1467819193	1467819193	1	1	HAYS, APRIL C CNM	6/13/2016	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
232956	Fee-for-Service	1508434200	1508434200	1	1	HUNTER, CHARLES DO	9/10/2024	207P00000X	NA	Other	026	PHYSICIANS	22920	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2000 MOWRY AVE	None	FREMONT	CA	94538	1716	01	06001	37.55769729	-121.9808861	Alameda County
232999	Fee-for-Service	1720292949	1720292949	1	10	HEALTHY SMILES FOR KIDS	4/17/2024	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1201 W. LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
233001	Fee-for-Service	1497780563	1497780563	1	1	HABERMAN, MARK MD	1/22/1997	207R00000X	NA	Other	026	PHYSICIANS	83540	41	Internal Medicine	0	In state provider	None	13152 NEWPORT AVE	None	TUSTIN	CA	92780	3416	30	06059	33.74737358	-117.812672	Orange County
233003	Fee-for-Service	1467884098	1467884098	1	1	HAMMETT, ERIN K DO	11/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	14025	41	Internal Medicine	0	In state provider	None	317 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4310	42	06083	34.42967671	-119.7228362	Santa Barbara County
233036	Fee-for-Service	1427715515	1427715515	1	7	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	5524 ASSEMBLY COURT	None	SACRAMENTO	CA	95823	2625	34	06067	38.493306	-121.4392995	Sacramento County
233083	Fee-for-Service	1770669202	1770669202	1	1	HAN, JENNIFER MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62012	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
233086	Fee-for-Service	1932457421	1932457421	1	1	HAMILTON, CHRISTINA L MD	2/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122150	08	Family Practice	0	In state provider	None	595 CENTER AVE	SUITE 300	MARTINEZ	CA	94553	4633	07	06013	37.99313048	-122.1189497	Contra Costa County
233101	Fee-for-Service	1881651248	1881651248	2	1	HELVIE, CHARLOTTE MD	3/24/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83738	40	Pediatrics	0	In state provider	None	152 PIONEER LANE	STE H	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
233148	Fee-for-Service	1497931299	1497931299	1	1	HERRADOR, ANA L LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
233153	Fee-for-Service	1801972955	1801972955	1	1	HAYES, ELIZABETH A MD	10/19/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84652	40	Pediatrics	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
233180	Fee-for-Service	1598381410	1598381410	1	1	HOSHIZAKI, VALERIE L OD	11/8/2022	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
233196	Fee-for-Service	1962493841	1962493841	1	1	HOLMES, ROBERT R MD	4/26/2018	207R00000X	NA	Other	026	PHYSICIANS	152909	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
233212	Fee-for-Service	1295795227	1295795227	1	1	HWANG, CHENDUEN MD	8/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68576	22	Pathology (M.D. only)	0	In state provider	None	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	19	06037	34.19395645	-118.463265	Los Angeles County
233214	Fee-for-Service	1841437241	1841437241	1	9	H STREET CLINIC, INC.	3/29/2023	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE CARE CLINIC 3	1329 NORTH H STREET	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
233216	Fee-for-Service	1821782129	1821782129	1	1	HAMPTON, MEGAN LINDSAY	6/14/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	12193 CUSTER ST	None	YUCAIPA	CA	92399	4485	36	06071	34.03227027	-117.0322462	San Bernardino County
233219	Fee-for-Service	1457882276	1457882276	1	1	HARALAMBOS DAMANAKIS	2/26/2023	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	506 LENOX AVE	None	NEW YORK	NY	10037	1802	00	None	40.814352	-73.94031	New York County
233251	Fee-for-Service	1508893934	1508893934	1	1	HIRAMATSU, MIKA MD	1/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	70483	40	Pediatrics	0	In state provider	None	20101B LAKE CHABOT ROAD	None	CASTRO VALLEY	CA	94546	5305	01	06001	37.69815357	-122.0873462	Alameda County
233272	Fee-for-Service	1689442477	1689442477	1	1	HADDAD, STEPHEN BCO-BADO	12/18/2023	332B00000X	NA	Other	012	DISPENSING OPTICIANS	-	-	NOT APPLICABLE	0	In state provider	None	321 NORTH LARCHMONT BOUL	SUITE 711	LOS ANGELES	CA	90004	3049	19	06037	34.0769016	-118.323663	Los Angeles County
233325	Fee-for-Service	1427715515	1427715515	1	7	HEALTH AND LIFE ORGANIZATION	9/1/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	5524 ASSEMBLY COURT	None	SACRAMENTO	CA	95823	2625	34	06067	38.493306	-121.4392995	Sacramento County
233326	Fee-for-Service	1164787081	1164787081	1	1	HUERTA-MINAKATA, AUGUSTO LM	10/11/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	1255 W COLTON AVE STE 58	None	REDLANDS	CA	92374	2861	36	06071	34.06285254	-117.20178	San Bernardino County
233346	Fee-for-Service	1629616412	1629616412	1	1	HULPA, MARCIE L NP	6/21/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2303	19	06037	34.02980528	-118.4786605	Los Angeles County
233426	Fee-for-Service	1336293331	1336293331	1	1	HINMON, TREON B PSYD	6/29/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4785 N FIRST STREET	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
233432	Fee-for-Service	1750801684	1750801684	1	2	HAJAL, NASTASSIA J PHD	10/23/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
233439	Fee-for-Service	1144691635	1144691635	1	1	HARRIS, SUSAN W LCSW	6/10/2024	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
233457	Fee-for-Service	1851942072	1851942072	1	1	HERNANDEZ MARRIAGE & FAMILY	1/20/2025	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICE	400 S FARRELL DR	STE B210	PALM SPRINGS	CA	92262	7933	33	06065	33.81787498	-116.5180068	Riverside County
233469	Fee-for-Service	1730728940	1730728940	1	1	HACKETT, SAFFRON R NP	9/13/2024	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
233471	Fee-for-Service	1568548089	1568548089	1	1	HUYNH, TUAN MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80292	40	Pediatrics	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
233502	Fee-for-Service	1841437241	1841437241	1	9	H STREET CLINIC, INC.	3/29/2023	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE CARE CLINIC 3	1329 NORTH H STREET	None	SAN BERNARDINO	CA	92405	5039	36	06071	34.123851	-117.300894	San Bernardino County
233504	Fee-for-Service	1821782129	1821782129	1	1	HAMPTON, MEGAN LINDSAY	6/14/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	12193 CUSTER ST	None	YUCAIPA	CA	92399	4485	36	06071	34.03227027	-117.0322462	San Bernardino County
233571	Fee-for-Service	1457076648	1457076648	1	1	HEALTH DIAGNOSTICS LABORATOR	6/17/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	IES INC	17835 VENTURA BLVD	STE 201	ENCINO	CA	91316	3669	19	06037	34.1633551	-118.5215171	Los Angeles County
233597	Fee-for-Service	1649701251	1649701251	1	2	HAGHNAZAR, HAMED	6/10/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	190140	-	NOT APPLICABLE	0	In state provider	None	2150 N VICTORIA AVE	None	OXNARD	CA	93036	7791	56	06111	34.22559401	-119.2209704	Ventura County
233676	Fee-for-Service	1164594339	1164594339	1	1	HWANG, STANLEY MD PC	1/31/1992	193400000X	NA	Other	026	PHYSICIANS	58772	44	Public Health	0	In state provider	None	909 BLANCO CIR	None	SALINAS	CA	93901	4401	27	06053	36.65354107	-121.6381985	Monterey County
233678	Fee-for-Service	1629103817	1629103817	1	1	HSIEH, STEPHANIE Y	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	10630 TOWN CENTER DR	SUITE 124	RANCHO CUCAMONGA	CA	91739	5123	36	06071	34.11112305	-117.5729644	San Bernardino County
233687	Fee-for-Service	1326244930	1326244930	1	1	HADLEY, SCOTT R MD	10/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131748	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
233706	Fee-for-Service	1477606424	1477606424	1	1	HEMET EKG INTERPRETATION	8/31/1994	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	MEDICAL GROUP INC	225 LAURSEN ST	None	HEMET	CA	92543	4437	33	06065	33.749955	-116.9608485	Riverside County
233710	Fee-for-Service	1083361869	1083361869	1	1	HOPKINS, RANIQUE LMFT	9/27/2024	101YM0800X	NA	Other	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
233718	Fee-for-Service	1205225174	1205225174	1	1	HADILAKSONO, MATTHEW G DO	7/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	15470	None	None	0	In state provider	None	801 E CHAPEL ST	STE 1	SANTA MARIA	CA	93454	4607	42	06083	34.9542915	-120.424455	Santa Barbara County
233738	Fee-for-Service	1457724189	1457724189	1	1	HOLGUIN, AMANDA K LCSW	11/4/2024	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2001 SANTA MONICA	370W, 380W, 860W, 1070	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
233744	Fee-for-Service	1851942072	1851942072	1	1	HERNANDEZ MARRIAGE & FAMILY	1/20/2025	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICE	400 S FARRELL DR	STE B210	PALM SPRINGS	CA	92262	7933	33	06065	33.81787498	-116.5180068	Riverside County
233769	Fee-for-Service	1104993120	1104993120	1	1	HERNANDEZ, SALVADOR MD	1/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	64901	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
233771	Fee-for-Service	1699923318	1699923318	1	1	HARASHEVSKY, MARK A DO	10/15/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	10936	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
233783	Fee-for-Service	1063589927	1063589927	1	1	HEIKOFF, LISA E. MD.	7/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	42782	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
233799	Fee-for-Service	1598072522	1598072522	1	1	HB ANESTHESIA APC	4/24/2018	207L00000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	11500 BROOKSHIRE AVE	None	DOWNEY	CA	90241	4917	19	06037	33.93500365	-118.1321119	Los Angeles County
233802	Fee-for-Service	1154333540	1154333540	1	1	HEARD, JONATHAN S MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	59961	08	Family Practice	0	In state provider	None	336 E HILLCREST BLVD	STE 505	INGLEWOOD	CA	90301	2400	19	06037	33.96022166	-118.3504526	Los Angeles County
233807	Fee-for-Service	1447975842	1447975842	1	1	HEALING PATHS THERAPY INC	8/2/2024	261QM0801X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	909 CALLE FRONDOSA	None	SAN DIMAS	CA	91773	1001	19	06037	34.08695141	-117.8238673	Los Angeles County
233858	Fee-for-Service	1205859683	1205859683	1	1	HAMBRICK, DIANE L MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	30415	08	Family Practice	0	In state provider	None	975 SEREO DR	None	VALLEJO	CA	94589	3003	48	06095	38.12828446	-122.24821	Solano County
233870	Fee-for-Service	1205126141	1205126141	1	1	HUYNH, LUCY H MD	2/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	116541	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
233886	Fee-for-Service	1316358971	1316358971	1	1	HENAO, MARTHA C MD	7/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139610	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	SUITE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
233909	Fee-for-Service	1649773227	1649773227	1	1	HENDERSON, ROBIN G NP	8/2/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	69780 STELLAR DR	SUITE A	RANCHO MIRAGE	CA	92270	2954	33	06065	33.76299197	-116.444597	Riverside County
233926	Fee-for-Service	1255377156	1255377156	1	1	HURD, RYAN C MD	11/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	105167	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
233932	Fee-for-Service	1053607887	1053607887	1	1	HUANG, HUI L MD	12/14/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	128748	01	General Practice	0	In state provider	None	767 N HILL ST	STE 200	LOS ANGELES	CA	90012	2365	19	06037	34.06255157	-118.2397077	Los Angeles County
233938	Fee-for-Service	1528265923	1528265923	2	1	HEALTHY LIFE HOME CARE INC	6/1/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	16661 VENTURA BLVD	SUITE 613	ENCINO	CA	91436	1985	19	06037	34.15820737	-118.496492	Los Angeles County
233959	Fee-for-Service	1255372447	1255372447	1	1	HOWARD B SCHAFF, M.D.	8/29/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1512 12TH AVE RD	None	NAMPA	ID	83686	6008	00	None	43.55346193	-116.5727785	Canyon County
233964	Fee-for-Service	1164594339	1164594339	1	1	HWANG, STANLEY MD PC	1/31/1992	193400000X	NA	Other	026	PHYSICIANS	58772	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	909 BLANCO CIR	None	SALINAS	CA	93901	4401	27	06053	36.65354107	-121.6381985	Monterey County
233967	Fee-for-Service	1548635451	1548635451	1	1	HOLTHAUS, AMY K PT	5/4/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	588 NORTH SUNRISE AVENUE	SUITE 100	ROSEVILLE	CA	95661	2843	31	06061	38.7585915	-121.2527015	Placer County
233978	Fee-for-Service	1427020932	1427020932	1	1	HOFFMAN, ANNA N NP	11/10/2021	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
233981	Fee-for-Service	1811223076	1811223076	1	1	HOLY ADDICTION CARE CENTER	12/27/2013	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	111 GLENDALE BOULEVARD	SUITE B	LOS ANGELES	CA	90026	5825	19	06037	34.06269932	-118.2597909	Los Angeles County
234000	Fee-for-Service	1780649442	1780649442	1	1	HUANG, JIMMY C DO	9/25/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6713	08	Family Practice	0	In state provider	None	3756 SANTA ROSALIA	STE 422	LOS ANGELES	CA	90008	3614	19	06037	34.00888336	-118.3389334	Los Angeles County
234014	Fee-for-Service	1275854226	1275854226	1	1	HUFF, MARY W	3/18/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	159951	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
234027	Fee-for-Service	1932162583	1932162583	1	1	HARRINGTON, WILLIAM Z MD	1/1/2002	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
234035	Fee-for-Service	1679507537	1679507537	1	1	HO, CHRISTOPHER T MD	8/15/1995	207N00000X	NA	Dermatology	026	PHYSICIANS	77152	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	STE 465	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
234049	Fee-for-Service	1003852682	1003852682	1	1	HALL, MICHAEL CRNA	7/19/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	18300 US HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
234051	Fee-for-Service	1386662922	1386662922	1	1	HUEY, DONALD MD	1/31/1986	207R00000X	NA	Other	026	PHYSICIANS	57604	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
234054	Fee-for-Service	1275943797	1275943797	1	1	HOEHNER-COOPER, CHRISTINE N	5/15/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	P	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
234058	Fee-for-Service	1992805246	1992805246	1	1	HOFSTRA, THOMAS C MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	74277	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
234089	Fee-for-Service	1154333540	1154333540	1	1	HEARD, JONATHAN S MD	4/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	59961	02	General Surgery	0	In state provider	None	336 E HILLCREST BLVD	STE 505	INGLEWOOD	CA	90301	2400	19	06037	33.96022166	-118.3504526	Los Angeles County
234104	Fee-for-Service	1003246240	1003246240	1	1	HAMMEL, MEGHAN C PHD	7/20/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
234113	Fee-for-Service	1225138829	1225138829	1	1	HORWITZ, KENNETH B MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	59007	41	Internal Medicine	0	In state provider	None	12062 VALLEY VIEW ST	STE 129	GARDEN GROVE	CA	92845	1741	30	06059	33.78720885	-118.028413	Orange County
234134	Fee-for-Service	1750407904	1750407904	1	1	HARARY, FRIEDA H CNM	10/18/2013	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	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
234139	Fee-for-Service	1538545272	1538545272	1	1	HARRIS, MILES S NP	6/17/2022	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
234141	Fee-for-Service	1043699382	1043699382	1	1	HU, STACY N OD FAAO	12/19/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	795 E SECOND ST	STE 2	POMONA	CA	91766	2020	19	06037	34.05845654	-117.7423951	Los Angeles County
234152	Fee-for-Service	1578042354	1578042354	1	1	HORI, YUSUKE MD	11/2/2024	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
234243	Fee-for-Service	1407898653	1407898653	1	2	HANNA, IBRAHIM I MD	6/1/1993	207R00000X	NA	Other	026	PHYSICIANS	50259	41	Internal Medicine	0	In state provider	None	9810 LAS TUNAS DR	None	TEMPLE CITY	CA	91780	2208	19	06037	34.10732672	-118.0561258	Los Angeles County
234291	Fee-for-Service	1306938998	1306938998	1	1	HWANG, EUN K MD	1/25/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	54454	40	Pediatrics	0	In state provider	None	15243 VANOWEN ST	SUITE 300	VAN NUYS	CA	91405	3605	19	06037	34.19394848	-118.4654115	Los Angeles County
234297	Fee-for-Service	1780649442	1780649442	1	1	HUANG, JIMMY C DO	9/25/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	6713	01	General Practice	0	In state provider	None	3756 SANTA ROSALIA	STE 422	LOS ANGELES	CA	90008	3614	19	06037	34.00888336	-118.3389334	Los Angeles County
234308	Fee-for-Service	1770054967	1770054967	1	1	HUTCHISON, KATELYNN A LMFT	5/20/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2068 ORANGE TREE LANE	216	REDLANDS	CA	92374	0109	36	06071	34.0679639	-117.2250148	San Bernardino County
234339	Fee-for-Service	1063690659	1063690659	1	1	HERNANDEZ-ARCE, ISRAEL J MD	8/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102532	41	Internal Medicine	0	In state provider	None	2212 E 4TH ST	None	SANTA ANA	CA	92705	3811	30	06059	33.746706	-117.835191	Orange County
234346	Fee-for-Service	1992805246	1992805246	1	1	HOFSTRA, THOMAS C MD	6/21/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	74277	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
234357	Fee-for-Service	1750743829	1750743829	1	1	HUTCHISON, BRENT CRNA	9/28/2022	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
234432	Fee-for-Service	1972683191	1972683191	1	1	HARVER, EDWARD K OD	1/1/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4502 BONITA RD	None	BONITA	CA	91902	1427	37	06073	32.66156684	-117.0306083	San Diego County
234446	Fee-for-Service	1487659272	1487659272	1	1	HUFFORD, KENT A	12/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	68948	08	Family Practice	0	In state provider	None	150 VERA AVE	None	RIPON	CA	95366	2343	39	06077	37.7389707	-121.133029	San Joaquin County
234465	Fee-for-Service	1710246848	1710246848	1	1	HAMADANI, SYEDA MD	5/17/2022	207K00000X	NA	Other	026	PHYSICIANS	129168	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
234483	Fee-for-Service	1679798425	1679798425	1	2	HEALTH CARE MEDICAL ASSOCIAT	4/24/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	09	Gynecology (D.O. only)	0	In state provider	ES INC	3200 WALFORD AVE	SUITE E	EUREKA	CA	95503	4828	12	06023	40.77887445	-124.1378239	Humboldt County
234501	Fee-for-Service	1235660721	1235660721	1	1	HERNANDEZ, ROSA M MD	9/18/2020	207R00000X	NA	Other	026	PHYSICIANS	160973	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
234526	Fee-for-Service	1265968028	1265968028	1	1	HOME HEALTH CARE	9/2/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	ORGANIZATION INC	644 W BROADWAY	STE 102	GLENDALE	CA	91204	1026	19	06037	34.14675811	-118.268636	Los Angeles County
234530	Fee-for-Service	1780276618	1780276618	1	1	HUMBLE HEARTS HOSPICE INC	11/16/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14622 VICTORY BLVD	STE 204	VAN NUYS	CA	91411	1669	19	06037	34.18663352	-118.451745	Los Angeles County
234536	Fee-for-Service	1235182577	1235182577	1	1	HATCHER, TIMOTHY A CRNA	3/13/2007	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
234610	Fee-for-Service	1841265147	1841265147	1	1	HILLER, KATHERINE 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
234612	Fee-for-Service	1619660149	1619660149	1	1	HOMETOWN MEDICAL SUPPLIES LL	5/15/2024	332BC3200X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	10700 JERSEY BLVD	STE 190	RANCHO CUCAMONGA	CA	91730	5116	36	06071	34.09465183	-117.5707193	San Bernardino County
234644	Fee-for-Service	1770151706	1770151706	1	1	HAMLIN, KRISTA L NP	8/1/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	3001 SAINT ROSE PKWY	None	HENDERSON	NV	89052	3839	00	None	36.00555274	-115.1163108	Clark County
234673	Fee-for-Service	1750467288	1750467288	1	1	HARIS, SONY S MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	51216	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
234699	Fee-for-Service	1881919199	1881919199	1	1	HINES, JONAS Z MD	5/2/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	117806	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
234701	Fee-for-Service	1447765359	1447765359	1	1	HOLDEN, SUZANNIA PSYD	5/27/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1307 W 6TH ST	212C	CORONA	CA	92882	1642	33	06065	33.87790309	-117.589666	Riverside County
234763	Fee-for-Service	1538107685	1538107685	1	1	HAMEED, TARIQ A MD	10/3/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	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
234768	Fee-for-Service	1457444531	1457444531	1	1	HERNANDEZ, ANGEL 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	801 7TH AVE	None	FORT WORTH	TX	76104	2733	00	None	32.73710364	-97.3419336	Tarrant County
234771	Fee-for-Service	1679798425	1679798425	1	2	HEALTH CARE MEDICAL ASSOCIAT	4/24/2025	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	15	Obstetrics (D.O. only)	0	In state provider	ES INC	3200 WALFORD AVE	SUITE E	EUREKA	CA	95503	4828	12	06023	40.77887445	-124.1378239	Humboldt County
234784	Fee-for-Service	1124589007	1124589007	1	1	HARP, ALANA MD	7/1/2023	2279E0002X	NA	Other	026	PHYSICIANS	180580	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
234785	Fee-for-Service	1114104411	1114104411	1	1	HORIZON SERVICES, INC	1/30/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1866 B STREET	STE 101	HAYWARD	CA	94541	3139	01	06001	37.68271803	-122.0657206	Alameda County
234816	Fee-for-Service	1780276618	1780276618	1	1	HUMBLE HEARTS HOSPICE INC	11/16/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14622 VICTORY BLVD	STE 204	VAN NUYS	CA	91411	1669	19	06037	34.18663352	-118.451745	Los Angeles County
234830	Fee-for-Service	1073565461	1073565461	1	1	HSU, MING-CHANG MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	34714	01	General Practice	0	In state provider	None	5520 SANTA MONICA BLVD	STE 112	LOS ANGELES	CA	90038	4089	19	06037	34.09074149	-118.310229	Los Angeles County
234831	Fee-for-Service	1972919736	1972919736	1	1	HUTCHINSON, NORA MD	9/28/2023	208M00000X	NA	Other	026	PHYSICIANS	188231	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
234835	Fee-for-Service	1174199038	1174199038	1	1	HELPING HANDS FAMILY THERAPY	6/24/2021	101YM0800X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	CENTER INC.	24405 CHESTNUT ST	205	NEWHALL	CA	91321	2852	19	06037	34.37967818	-118.531332	Los Angeles County
234861	Fee-for-Service	1841256989	1841256989	1	1	HRABKO, RANDALL P MD	8/24/2004	207N00000X	NA	Dermatology	026	PHYSICIANS	39326	07	Dermatology	0	In state provider	None	8540 S SEPULVEDA BLVD	STE 1206	LOS ANGELES	CA	90045	3819	19	06037	33.96022076	-118.3961982	Los Angeles County
234864	Fee-for-Service	1306961883	1306961883	3	1	HSYS MANAGEMENT INC	6/13/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	903 S. CRENSHAW BLVD.	102B	LOS ANGELES	CA	90019	1965	19	06037	34.05617593	-118.3221956	Los Angeles County
234890	Fee-for-Service	1326464660	1326464660	1	1	HOU, SAIYUN MD	3/9/2020	2081P2900X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	140529	25	Physical Medicine and Rehabilitation	0	In state provider	None	5348 CARROLL CANYON RD	SUITE 101	SAN DIEGO	CA	92121	1733	37	06073	32.89218932	-117.1918653	San Diego County
234894	Fee-for-Service	1184709842	1184709842	1	1	HEINRICH, BARBARA MD	7/31/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41982	01	General Practice	0	In state provider	None	46752 MISSION BLVD	None	FREMONT	CA	94539	7949	01	06001	37.49039813	-121.9286833	Alameda County
234929	Fee-for-Service	1780085449	1780085449	1	1	HODGE, LESLIE LMFT	7/29/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
234935	Fee-for-Service	1730108929	1730108929	1	1	HOLY MEDICAL CENTER, INC	12/18/2003	261QP2300X	NA	Other	026	PHYSICIANS	83140	01	General Practice	0	In state provider	HOLY MEDICAL CENTER	6330 LAUREL CANYON BLVD	STE B	NORTH HOLLYWOOD	CA	91306	3213	19	06037	34.185663	-118.396504	Los Angeles County
234949	Fee-for-Service	1497436968	1497436968	1	1	HEALTH TRANSPORTATION SOLUTI	1/10/2024	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	ONS INC	6742 VAN NUYS BLVD	201	VAN NUYS	CA	91405	4611	19	06037	34.19343344	-118.4487213	Los Angeles County
234950	Fee-for-Service	1255614442	1255614442	1	1	HAMAD, RITA MD	11/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	118507	08	Family Practice	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94552	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
234960	Fee-for-Service	1003912015	1003912015	1	1	HARRIS, JENNIFER I MD	11/14/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92120	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
234967	Fee-for-Service	1992734412	1992734412	1	1	HARDEN, WILLIAM S MD	10/31/1994	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	79976	01	General Practice	0	In state provider	None	3270 CHURN CREEK RD	None	REDDING	CA	96002	2504	45	06089	40.560021	-122.353087	Shasta County
234987	Fee-for-Service	1578601779	1578601779	1	1	HAY, LAURIE	11/12/2021	106H00000X	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
235094	Fee-for-Service	1225360498	1225360498	1	1	HAMISI, KHADIJA H NP	11/22/2023	363LP0808X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11801 PIERCE ST	STE 200	RIVERSIDE	CA	92505	5191	33	06065	33.90100297	-117.49363	Riverside County
235139	Fee-for-Service	1770537466	1770537466	1	1	HIGH DESERT PRIMARY CARE	3/11/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GRP A CA GEN PAR	12550 HESPERIA RD	None	VICTORVILLE	CA	92395	5873	36	06071	34.47928534	-117.2909553	San Bernardino County
235171	Fee-for-Service	1194776336	1194776336	1	1	HELVEY, JASON 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	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
235177	Fee-for-Service	1568411312	1568411312	1	1	HEETEN,DESAI 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	0000	00	None	32.175801	-110.9306925	Pima County
235237	Fee-for-Service	1861445892	1861445892	1	1	HOMETOWN HEALTH MANAGEMENT	12/22/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	1	Border provider	COMPANY	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
235248	Fee-for-Service	1821066457	1821066457	1	1	HO, CHRISTOPHER B MD	6/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	66691	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
235263	Fee-for-Service	1174084834	1174084834	1	1	HA, KEVIN T DO	7/1/2022	111NI0900X	NA	Other	026	PHYSICIANS	19570	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
235324	Fee-for-Service	1184244147	1184244147	1	1	HOWER, KIMBERLY DO	2/10/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	19503	None	None	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
235384	Fee-for-Service	1053485912	1053485912	1	1	HANGER P & O WEST INC	10/31/2002	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	1	Border provider	None	1355 RAMAR RD	STE 4B	BULLHEAD CITY	AZ	86442	7100	00	None	35.115705	-114.599817	Mohave County
235408	Fee-for-Service	1427810290	1427810290	1	1	HAN, LANAH	10/9/2024	363L00000X	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
235409	Fee-for-Service	1649256025	1649256025	1	1	HEDGES, BRENDA 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	2200 NE PROFESSIONAL CT	None	BEND	OR	97701	6063	00	None	44.06492445	-121.270761	Deschutes County
235427	Fee-for-Service	1770537466	1770537466	1	1	HIGH DESERT PRIMARY CARE	3/11/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	MEDICAL GRP A CA GEN PAR	12550 HESPERIA RD	None	VICTORVILLE	CA	92395	5873	36	06071	34.47928534	-117.2909553	San Bernardino County
235485	Fee-for-Service	1013232206	1013232206	1	1	HENN, DEBRA L PT	12/1/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	60 PENNY LANE	None	WATSONVILLE	CA	95076	3079	44	06087	36.93074806	-121.7788515	Santa Cruz County
235503	Fee-for-Service	1801850821	1801850821	1	1	HO, ANDY T MD	3/24/2022	207R00000X	NA	Other	026	PHYSICIANS	72198	None	None	0	In state provider	None	7631 WYOMING ST	STE 201	WESTMINSTER	CA	92683	3904	30	06059	33.7610165	-117.996174	Orange County
235513	Fee-for-Service	1174034698	1174034698	1	1	HAUSER, JENNIFER M PSYD	4/25/2022	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	750 B	2870	SAN DIEGO	CA	92101	8114	37	06073	32.71782447	-117.157905	San Diego County
235528	Fee-for-Service	1780641480	1780641480	1	1	HOGAN, J MARTIN MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26332	30	Radiology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
235539	Fee-for-Service	1306900717	1306900717	1	1	HONG, SHIRLEY L T OD	8/23/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1635 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
235546	Fee-for-Service	1669891263	1669891263	1	1	HURTADO, CAROLINA MD	5/8/2020	207R00000X	NA	Other	026	PHYSICIANS	154487	67	Endocrinology	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
235562	Fee-for-Service	1720449267	1720449267	1	1	HOT SPRINGS PHARMACY INC	8/24/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	13313 PALM DRIVE	UNIT A	DESERT HOT SPRING	CA	92240	5980	33	06065	33.951663	-116.501339	Riverside County
235619	Fee-for-Service	1902394166	1902394166	1	1	HEART CARE ASSOCIATES A	10/11/2018	193400000X	NA	Other	026	PHYSICIANS	103787	41	Internal Medicine	0	In state provider	MEDICAL CORPORATION	3230 WARING CT	STE O	OCEANSIDE	CA	92056	4509	37	06073	33.18776771	-117.2893136	San Diego County
235636	Fee-for-Service	1497219497	1497219497	1	1	HARBIN, AMY K RCP	2/5/2019	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
235650	Fee-for-Service	1124061411	1124061411	1	1	HUVAL, WILLIAM MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	MISSOULA SURGICAL	500 WEST BROADWAY,	5TH FLR	MISSOULA	MT	59807	0000	00	None	46.874889	-114.000444	Missoula County
235684	Fee-for-Service	1720292949	1720292949	1	7	HEALTHY SMILES FOR KIDS	2/8/2021	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	AFFILIATED	1800 W BALL RD	None	ANAHEIM	CA	92804	5516	30	06059	33.81787448	-117.9467235	Orange County
235697	Fee-for-Service	1952764888	1952764888	1	1	HICKS, KATHARINE LCSW	9/6/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1761 HOTEL CIR	SUITE 360	SAN DIEGO	CA	92108	3318	37	06073	32.75901493	-117.1790451	San Diego County
235705	Fee-for-Service	1568807873	1568807873	1	1	HENNESSAY, MEGAN E DO	2/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13635	01	General Practice	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
235717	Fee-for-Service	1770537466	1770537466	1	1	HIGH DESERT PRIMARY CARE	3/11/1996	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GRP A CA GEN PAR	12550 HESPERIA RD	None	VICTORVILLE	CA	92395	5873	36	06071	34.47928534	-117.2909553	San Bernardino County
235739	Fee-for-Service	1912969353	1912969353	1	1	HO, HECTOR W MD	7/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87832	01	General Practice	0	In state provider	None	1010 W LA VETA AVENUE	SUITE 710	ORANGE	CA	92868	4306	30	06059	33.78028244	-117.8635552	Orange County
235754	Fee-for-Service	1750048260	1750048260	1	1	HUEZO, TATIANA	2/12/2024	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
235768	Fee-for-Service	1376996363	1376996363	1	1	HEALING HEARTS COUNSELING CE	11/2/2023	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NTER	317 N EL CAMINO REAL	STE 306	ENCINITAS	CA	92024	2814	37	06073	33.05428107	-117.2615637	San Diego County
235779	Fee-for-Service	1316107675	1316107675	1	1	HAMMOND, CHRISTOPHER L DO	5/5/2023	207P00000X	NA	Other	026	PHYSICIANS	20649	None	None	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
235803	Fee-for-Service	1326623125	1326623125	1	1	HESEL, MARGOT G NP	6/15/2022	363LP2300X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5865 E NAPLES PLZ	None	LONG BEACH	CA	90803	5040	19	06037	33.75569352	-118.1195343	Los Angeles County
235833	Fee-for-Service	1669891263	1669891263	1	1	HURTADO, CAROLINA MD	5/8/2020	207R00000X	NA	Other	026	PHYSICIANS	154487	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
235869	Fee-for-Service	1376536193	1376536193	1	2	HORTAREAS, JOHN E MD	7/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11256	41	Internal Medicine	0	In state provider	None	2001 FOURTH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
235882	Fee-for-Service	1528181278	1528181278	1	1	HANDEL, LIANN N MD	11/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99629	34	Urology and Urological Surgery	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
235909	Fee-for-Service	1902394166	1902394166	1	1	HEART CARE ASSOCIATES A	10/11/2018	193400000X	NA	Other	026	PHYSICIANS	103787	06	Cardiovascular Disease (M.D. only)	0	In state provider	MEDICAL CORPORATION	3230 WARING CT	STE O	OCEANSIDE	CA	92056	4509	37	06073	33.18776771	-117.2893136	San Diego County
235928	Fee-for-Service	1043426208	1043426208	1	1	HEATH, LORE CRNA	10/22/2008	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
235930	Fee-for-Service	1639533474	1639533474	1	1	HALTERMAN, SONJA J MD	10/21/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	153525	08	Family Practice	0	In state provider	None	1020 29TH ST	STE 680	SACRAMENTO	CA	95816	5126	34	06067	38.572803	-121.4685	Sacramento County
235947	Fee-for-Service	1356371074	1356371074	1	1	HARVARD EYE ASSOCIATES	7/1/1996	207W00000X	NA	Ophthalmology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	ORANGE CTY MED GRP	665 CAMINO DE LOS MARES	STE 102	SAN CLEMENTE	CA	92673	2840	30	06059	33.45730192	-117.6483252	Orange County
236011	Fee-for-Service	1467843847	1467843847	1	1	HOSBEIN, SUSANNAH B LMFT	7/5/2020	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
236026	Fee-for-Service	1912969353	1912969353	1	1	HO, HECTOR W MD	7/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	87832	02	General Surgery	0	In state provider	None	1010 W LA VETA AVENUE	SUITE 710	ORANGE	CA	92868	4306	30	06059	33.78028244	-117.8635552	Orange County
236042	Fee-for-Service	1780678037	1780678037	1	1	HINES, DONNA L MD	7/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130260	40	Pediatrics	0	In state provider	None	1285 S STATE STREET	None	HEMET	CA	92543	7976	33	06065	33.727887	-116.971567	Riverside County
236119	Fee-for-Service	1619052396	1619052396	1	1	HENRY-TUCKER, SHARON MD	9/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	78125	40	Pediatrics	0	In state provider	None	652 W 11TH ST	STE 129	TRACY	CA	95376	3821	39	06077	37.73965047	-121.435452	San Joaquin County
236135	Fee-for-Service	1598096364	1598096364	1	1	HALUM, MARTIN G MD	8/8/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	103201	05	Anesthesiology	0	In state provider	None	2500 GRANT ROAD	None	MOUNTAIN VIEW	CA	94040	4378	43	06085	37.36893518	-122.0779448	Santa Clara County
236154	Fee-for-Service	1295794725	1295794725	1	1	HUIE, DANIEL A MD	4/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	75907	08	Family Practice	0	In state provider	None	1300 CRANE STREET	None	MENLO PARK	CA	94025	4260	41	06081	37.45264069	-122.1878743	San Mateo County
236161	Fee-for-Service	1891115572	1891115572	1	1	HOLLOWED, JOHN J MD	3/10/2021	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	142140	None	None	0	In state provider	None	2655 1ST STREET	360, 380	SIMI VALLEY	CA	93065	1581	56	06111	34.28400453	-118.778978	Ventura County
236182	Fee-for-Service	1699857169	1699857169	1	1	HUTTER, RALPH F OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4049 BALL RD	None	CYPRESS	CA	90630	3463	30	06059	33.8177013	-118.0607596	Orange County
236235	Fee-for-Service	1245439306	1245439306	1	1	HANCHETT, ROSS H MD	8/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116017	None	None	0	In state provider	None	771 BUSCHMANN RD	None	PARADISE	CA	95969	5869	04	06007	39.7485737	-121.6213589	Butte County
236241	Fee-for-Service	1942388608	1942388608	1	1	HAMMEL, ELIZABETH M MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64353	40	Pediatrics	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
236244	Fee-for-Service	1710474317	1710474317	1	1	HUYNH, MELISSA A NP	6/5/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
236248	Fee-for-Service	1508940305	1508940305	1	1	HERSHON, JAMES J MD	11/6/2000	207RC0200X	NA	Other	026	PHYSICIANS	34963	01	General Practice	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
236257	Fee-for-Service	1932550910	1932550910	1	1	HO, ANDREW M DO	10/5/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18006	08	Family Practice	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06343528	-117.9856963	Los Angeles County
236265	Fee-for-Service	1538426309	1538426309	1	1	HARDEE, STEVEN A MD	7/19/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154365	22	Pathology (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
236286	Fee-for-Service	1285807495	1285807495	1	1	HAFEZI, SETAREH MD	9/10/2019	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	101532	15	Obstetrics (D.O. only)	0	In state provider	None	27212 CALAROGA AVENUE	None	HAYWARD	CA	94545	4339	01	06001	37.63229023	-122.0896425	Alameda County
236309	Fee-for-Service	1770568867	1770568867	1	1	HEESTAND, GREGORY M MD	6/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92666	78	Neoplastic Diseases/Oncology	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
236416	Fee-for-Service	1740312149	1740312149	1	1	HIRATA, JEFFREY T MD	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	102941	30	Radiology	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
236418	Fee-for-Service	1861030322	1861030322	1	1	HOBART, MICHAEL CRNA	2/3/2020	367500000X	NA	Other	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
236446	Fee-for-Service	1831205145	1831205145	1	1	HALAT, KATHLEEN M DPM	2/8/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	10051 LAKE ST	SUITE 3	TRUCKEE	CA	96161	4870	29	06057	39.32550268	-120.2025066	Nevada County
236450	Fee-for-Service	1003443300	1003443300	1	1	HAN, MICHAEL M MD	7/13/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	184732	18	Ophthalmology	0	In state provider	None	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	19	06037	34.06238259	-118.2030986	Los Angeles County
236465	Fee-for-Service	1578599825	1578599825	1	1	HOVANESSIAN, HOORI C	12/31/1992	207P00000X	NA	Other	026	PHYSICIANS	72169	None	None	0	In state provider	None	1250 E ALMOND AVE	None	MADERA	CA	93637	5606	20	06039	36.94519024	-120.0420086	Madera County
236517	Fee-for-Service	1730273251	1730273251	1	1	HOWARD, JAMES D MD	5/1/1983	207L00000X	NA	Other	026	PHYSICIANS	43147	05	Anesthesiology	0	In state provider	PRESBYTERIAN INTERCOMM	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
236523	Fee-for-Service	1619499142	1619499142	1	1	HIRST, VICTORIA CNP	4/4/2019	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	19	06037	33.896799	-118.3959415	Los Angeles County
236535	Fee-for-Service	1508940305	1508940305	1	1	HERSHON, JAMES J MD	11/6/2000	207RC0200X	NA	Other	026	PHYSICIANS	34963	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2333 BUCHANAN ST	None	SAN FRANCISCO	CA	94115	1925	38	06075	37.79071145	-122.4308506	San Francisco County
236596	Fee-for-Service	1770568867	1770568867	1	1	HEESTAND, GREGORY M MD	6/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	92666	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
236668	Fee-for-Service	1871846592	1871846592	1	1	HO, SUSAN H LCSW	4/16/2019	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
236669	Fee-for-Service	1063135424	1063135424	1	1	HARPER, BRITTANY N OT	10/17/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8282 WHITE OAK AVE	107, 108, AND 111	RANCHO CUCAMONGA	CA	91730	7680	36	06071	34.10361339	-117.5644472	San Bernardino County
236789	Fee-for-Service	1417021395	1417021395	1	1	HANGER PROSTHETICS &	12/27/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	1	Border provider	ORTHOTICS WEST INC	961 MATLEY LANE	SUITE 100	RENO	NV	89502	2188	00	None	39.51613222	-119.7807033	Washoe County
236805	Fee-for-Service	1730273251	1730273251	1	1	HOWARD, JAMES D MD	5/1/1983	207L00000X	NA	Other	026	PHYSICIANS	43147	66	Emergency Medicine (Urgent Care)	0	In state provider	PRESBYTERIAN INTERCOMM	12401 WASHINGTON BLVD	None	WHITTIER	CA	90602	1006	19	06037	33.969141	-118.0489095	Los Angeles County
236813	Fee-for-Service	1891735007	1891735007	1	1	HUANG, VERNON W MD	9/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74349	05	Anesthesiology	0	In state provider	None	CLAY AND BUCHANAN ST	None	SAN FRANCISCO	CA	94120	0000	38	06075	37.791126	-122.4309105	San Francisco County
236821	Fee-for-Service	1669544102	1669544102	1	1	HURVITZ, CAROLE G MD	10/8/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	24167	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
236826	Fee-for-Service	1578260758	1578260758	1	1	HAMED, JACQUELYN NP	12/4/2023	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
236842	Fee-for-Service	1265499032	1265499032	1	1	HSU, SHEREE S MD	2/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84402	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
236856	Fee-for-Service	1659390003	1659390003	1	1	HOLLAND, ROMIE H MD	1/1/1982	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	36922	01	General Practice	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
236872	Fee-for-Service	1639426976	1639426976	1	1	HERSHBERGER, JULIE B	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
236896	Fee-for-Service	1174601074	1174601074	1	1	HANDS, RUSSELL D MD	3/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	49146	02	General Surgery	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
236917	Fee-for-Service	1609987577	1609987577	1	1	HUSAIN, SHABNAM MD	4/30/1992	207R00000X	NA	Other	026	PHYSICIANS	51911	41	Internal Medicine	0	In state provider	None	1625 THE ALAMEDA	STE 202	SAN JOSE	CA	95126	2223	43	06085	37.3357723	-121.9172682	Santa Clara County
236925	Fee-for-Service	1003945882	1003945882	1	1	HRISTOVA, DENITZA V PT	11/26/2012	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
236999	Fee-for-Service	1164982260	1164982260	1	1	HOLDAWAY, JESSICA MD	12/5/2024	207P00000X	NA	Other	026	PHYSICIANS	178151	66	Emergency Medicine (Urgent Care)	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
237015	Fee-for-Service	1275505653	1275505653	1	1	HARMON, BUFORD K III	10/24/2009	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1250 S SUNSET AVE	STE 204	WEST COVINA	CA	91790	3911	19	06037	34.0610671	-117.9463685	Los Angeles County
237070	Fee-for-Service	1790718211	1790718211	1	1	HASHEMI, LILLA A LCSW	6/13/1999	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	21143 SAN MIGUEL ST	None	WOODLAND HILLS	CA	91364	3347	19	06037	34.1599064	-118.5921642	Los Angeles County
237105	Fee-for-Service	1669544102	1669544102	1	1	HURVITZ, CAROLE G MD	10/8/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	24167	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
237107	Fee-for-Service	1881778686	1881778686	1	1	HENIG, NOREEN R MD	7/6/1999	207RC0200X	NA	Other	026	PHYSICIANS	79023	29	Pulmonary Diseases (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
237111	Fee-for-Service	1023551751	1023551751	1	1	HOANG-KELADA, OLIVIA MD	8/15/2019	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	153544	None	None	0	In state provider	None	2261 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3831	31	06061	38.74434897	-121.2413247	Placer County
237122	Fee-for-Service	1063437192	1063437192	1	1	HOLLY, LANGSTON MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62474	14	Neurological Surgery	0	In state provider	None	300 UCLA MEDICAL PLZ	STE 200	LOS ANGELES	CA	90095	8346	19	06037	34.06465655	-118.4461	Los Angeles County
237126	Fee-for-Service	1437198082	1437198082	1	1	HETTS, STEVEN W MD	7/9/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76558	30	Radiology	0	In state provider	None	20103 LAKE CHABOT RD	STE 103	CASTRO VALLEY	CA	94546	5305	01	06001	37.698264	-122.090112	Alameda County
237206	Fee-for-Service	1245395219	1245395219	1	1	HAND, CAROLYN S NP	11/19/2018	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
237218	Fee-for-Service	1366513178	1366513178	1	1	HEFFERNAN, MARK C PHD	11/29/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	79 AUGUSTA DR	None	RANCHO MIRAGE	CA	92270	1610	33	06065	33.79920507	-116.4063631	Riverside County
237252	Fee-for-Service	1124130620	1124130620	2	3	HARMONY HEALTH MEDICAL CLINI	11/10/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1930 N BEALE RD	None	MARYSVILLE	CA	95901	6915	58	06115	39.12785754	-121.5449204	Yuba County
237259	Fee-for-Service	1427318500	1427318500	2	2	H & E PHARMACY & MEDICAL SUP	1/28/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	430 W WILLOW ST	None	LONG BEACH	CA	90806	2804	19	06037	33.8042757	-118.196628	Los Angeles County
237291	Fee-for-Service	1225317951	1225317951	1	1	HUANG, DIANA	5/16/2011	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	46324 WARM SPRINGS BLVD	STE 747	FREMONT	CA	94539	8004	01	06001	37.49251571	-121.9309435	Alameda County
237324	Fee-for-Service	1588695597	1588695597	1	1	HEMMERICH, JASON J MD	12/4/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	95355	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
237350	Fee-for-Service	1508252032	1508252032	1	1	HANGER PROSTHETICS & ORTHOTI	2/16/2016	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	3520 E SHIELDS AVE	SUITE 102	FRESNO	CA	93726	6923	10	06019	36.77947947	-119.765781	Fresno County
237361	Fee-for-Service	1891734596	1891734596	1	1	HAMBLILNMD, 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	355 RIDGE AVE	None	EVANSTON	IL	60202	3328	00	None	42.02450175	-87.68519074	Cook County
237440	Fee-for-Service	1447206958	1447206958	1	1	HERR, ROBERT MD	3/25/2025	207R00000X	NA	Other	026	PHYSICIANS	64173	01	General Practice	0	In state provider	None	275 N EL CIELO RD	None	PALM SPRINGS	CA	92262	6972	33	06065	33.82736911	-116.5109632	Riverside County
237508	Fee-for-Service	1841437241	1841437241	1	2	H STREET CLINIC, INC.	4/7/2020	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	360 E 7TH ST	SUITE B	UPLAND	CA	91786	6701	36	06071	34.08880374	-117.6465151	San Bernardino County
237529	Fee-for-Service	1104474139	1104474139	1	1	HONEST PHARMACY LLC	9/2/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	210 N GARFIELD AVE	STE 101	MONTEREY PARK	CA	91754	1746	19	06037	34.064181	-118.122834	Los Angeles County
237541	Fee-for-Service	1124130620	1124130620	2	3	HARMONY HEALTH MEDICAL CLINI	11/10/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	1930 N BEALE RD	None	MARYSVILLE	CA	95901	6915	58	06115	39.12785754	-121.5449204	Yuba County
237562	Fee-for-Service	1689239972	1689239972	1	1	HA, JUNGHOON MD	4/19/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	186220	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
237671	Fee-for-Service	1528298890	1528298890	1	1	HEITMAN, DANIELLE L LMFT	9/21/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9495 MAIN ST	STE 6	UPPER LAKE	CA	95485	9603	17	06033	39.16447733	-122.9108418	Lake County
237672	Fee-for-Service	1700829926	1700829926	1	1	HUERTAS, PATRICIA L MD	8/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90029	66	Emergency Medicine (Urgent Care)	0	In state provider	None	770 MASON ST	None	VACAVILLE	CA	95688	4646	48	06095	38.35504697	-121.983852	Solano County
237674	Fee-for-Service	1073383097	1073383097	1	1	HSU, TIFFANY	1/25/2024	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8282 WHITE OAK AVE	107, 108, AND 111	RANCHO CUCAMONGA	CA	91730	7680	36	06071	34.10361339	-117.5644472	San Bernardino County
237685	Fee-for-Service	1558874719	1558874719	1	1	HAYES, JULIA V PT	5/2/2018	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	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
237703	Fee-for-Service	1891997466	1891997466	1	1	HEALTHNET HOME CARE SERVICES	3/20/2008	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2025 N GLENOAKS BLVD	STE 203	BURBANK	CA	91504	2809	19	06037	34.19736202	-118.3256874	Los Angeles County
237718	Fee-for-Service	1811153182	1811153182	1	1	HOVEY, CHERIE L	11/13/2008	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	191 W BURTON MESA BLVD	STE B	LOMPOC	CA	93436	1400	42	06083	34.70401649	-120.4647615	Santa Barbara County
237781	Fee-for-Service	1942386446	1942386446	1	1	HDEZ, MICHAEL J MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	48582	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	7520 ARROYO CIR	None	GILROY	CA	95020	7303	43	06085	37.01225317	-121.5604444	Santa Clara County
237787	Fee-for-Service	1457592230	1457592230	1	1	HAZANY, SAMAN MD	5/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	104684	13	Neurology (M.D. only)	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
237797	Fee-for-Service	1841437241	1841437241	1	2	H STREET CLINIC, INC.	4/7/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	360 E 7TH ST	SUITE B	UPLAND	CA	91786	6701	36	06071	34.08880374	-117.6465151	San Bernardino County
237827	Fee-for-Service	1760661110	1760661110	1	1	HERBOLD, THOMAS A MD APC	6/18/2007	193400000X	NA	Other	026	PHYSICIANS	72292	30	Radiology	0	In state provider	None	16661 VENTURA BLVD	STE 100	ENCINO	CA	91436	1922	19	06037	34.15820737	-118.496492	Los Angeles County
237849	Fee-for-Service	1528479383	1528479383	1	1	HARRIS, DOROTHY P MD	4/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	142739	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE B 200	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
237867	Fee-for-Service	1619316874	1619316874	1	1	HU, JIAMIN OD	11/9/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9333 E ROSECRANS AVE	None	BELLFLOWER	CA	90706	2141	19	06037	33.90413858	-118.1346616	Los Angeles County
237877	Fee-for-Service	1689872525	1689872525	1	1	HSU, ALICE MD	4/5/2019	207R00000X	NA	Other	026	PHYSICIANS	160451	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
237883	Fee-for-Service	1710026406	1710026406	1	1	HELSPER, LINDA P LCSW	8/28/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	34455 YUCAIPA BLVD	SUITE 206	YUCAIPA	CA	92399	2476	36	06071	34.0338117	-117.0525613	San Bernardino County
237946	Fee-for-Service	1093343550	1093343550	1	1	HUANG, WILSON MD	5/26/2023	207P00000X	NA	Other	026	PHYSICIANS	184870	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
237961	Fee-for-Service	1558455618	1558455618	1	1	HOFF, MARK L MD	6/30/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	31257	08	Family Practice	0	In state provider	None	999 S FAIRMONT AVE	STE 135	LODI	CA	95240	5141	39	06077	38.1206163	-121.2858323	San Joaquin County
237967	Fee-for-Service	1528118395	1528118395	1	1	HUNG, JENNIFER DO	1/22/2019	208M00000X	NA	Other	026	PHYSICIANS	8642	41	Internal Medicine	0	In state provider	None	26991 CROWN VALLEY PKWY	100	MISSION VIEJO	CA	92691	6528	30	06059	33.56210341	-117.6694207	Orange County
238027	Fee-for-Service	1114293420	1114293420	1	1	HITCHCOCK, MATTHEW M MD	11/6/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	136224	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
238028	Fee-for-Service	1396322962	1396322962	1	1	HAQ, MARIAM MD	10/21/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	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
238041	Fee-for-Service	1740864271	1740864271	1	1	HITCHCOCK, TAMARA J NP	6/20/2022	363L00000X	NA	Nurse Practitioner	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
238060	Fee-for-Service	1710364856	1710364856	1	1	HUANG, GUIQING MD	12/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	142422	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
238066	Fee-for-Service	1912007097	1912007097	1	2	HEALTHCARE CALIFORNIA	4/24/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6327 N FRESNO ST	104B	FRESNO	CA	93710	5236	10	06019	36.82875536	-119.781417	Fresno County
238074	Fee-for-Service	1457592230	1457592230	1	1	HAZANY, SAMAN MD	5/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	104684	30	Radiology	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
238102	Fee-for-Service	1790700094	1790700094	1	1	HEAD, CHRISTIAN S MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	54096	84	Surgery-Head and Neck	0	In state provider	None	200 MEDICAL PLAZA	STE 550	LOS ANGELES	CA	90024	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
238115	Fee-for-Service	1851595581	1851595581	1	1	HALL, SARAH C	3/18/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5860	19	06037	34.06343528	-117.9856963	Los Angeles County
238142	Fee-for-Service	1861835704	1861835704	1	1	HILL, KATHERINE B MD	6/22/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131900	40	Pediatrics	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
238193	Fee-for-Service	1053391326	1053391326	1	1	HARRINGTON,KAREN G MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60809	08	Family Practice	0	In state provider	None	3200 BELL RD	None	AUBURN	CA	95603	9244	31	06061	38.94193574	-121.103139	Placer County
238209	Fee-for-Service	1518102995	1518102995	1	1	HAMRICK, JENNIFER L MD	7/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	102931	05	Anesthesiology	0	In state provider	None	3636 RUFFIN RD	None	SAN DIEGO	CA	92123	1810	37	06073	32.80995479	-117.1193919	San Diego County
238210	Fee-for-Service	1851476113	1851476113	1	1	HIRSH LINDA J	7/24/2002	335E00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	ME AGAIN	2901 OCEAN PARK BLVD	STE 207	SANTA MONICA	CA	90405	2964	19	06037	34.01987882	-118.4542217	Los Angeles County
238242	Fee-for-Service	1033298963	1033298963	1	1	HUYNH, DAT T MD	10/22/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	50071	41	Internal Medicine	0	In state provider	None	1661 BURDETTE DR	STE N	SAN JOSE	CA	95121	1681	43	06085	37.32012377	-121.8254031	Santa Clara County
238256	Fee-for-Service	1902984651	1902984651	1	1	HEARN, EDWARD W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	19299	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
238259	Fee-for-Service	1407387467	1407387467	1	1	HUWYLER, CAMILLE M MD	11/14/2020	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	159157	None	None	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	5730	01	06001	37.8237837	-122.2590026	Alameda County
238292	Fee-for-Service	1467531251	1467531251	1	1	HSU, TE-CHUNG MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	62972	30	Radiology	0	In state provider	None	FRESNO & R STREET	None	FRESNO	CA	93701	0000	10	06019	36.741663	-119.7841005	Fresno County
238297	Fee-for-Service	1356415236	1356415236	1	1	HANGER P & O WEST INC.	3/1/1999	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1707 MCHENRY AVE	BUILDING B	MODESTO	CA	95350	4352	50	06099	37.669248	-120.9940175	Stanislaus County
238308	Fee-for-Service	1467730614	1467730614	1	1	HATCH, ZACHARY S MD	8/4/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	136570	36	Psychiatry	0	In state provider	None	147 N BRENT ST	None	VENTURA	CA	93007	2809	56	06111	34.2746295	-119.2573399	Ventura County
238337	Fee-for-Service	1053549410	1053549410	1	1	HINKLEY, DOROTHY OD	10/30/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	12100 WILSHIRE BLVD.	SUITE 1275	LOS ANGELES	CA	90025	7143	19	06037	34.04370122	-118.4678993	Los Angeles County
238350	Fee-for-Service	1265489413	1265489413	1	1	HERRERA, CARMEN MILTZA MD	10/12/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	73067	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
238353	Fee-for-Service	1912007097	1912007097	1	2	HEALTHCARE CALIFORNIA	4/24/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6327 N FRESNO ST	104B	FRESNO	CA	93710	5236	10	06019	36.82875536	-119.781417	Fresno County
238424	Fee-for-Service	1396767588	1396767588	1	1	HART, ELAINE A MD	6/22/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78387	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
238430	Fee-for-Service	1891752309	1891752309	1	1	HORVAL, ANDREW E MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70479	90	Pathology-Forensic	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
238450	Fee-for-Service	1538346911	1538346911	1	1	HAMMAN, MICHAEL S MD	5/7/2008	207P00000X	NA	Other	026	PHYSICIANS	97551	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
238456	Fee-for-Service	1063589885	1063589885	1	1	HOWARD, WARREN C MD	4/5/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	62357	77	Infectious Disease	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
238463	Fee-for-Service	1316337819	1316337819	1	1	HONG, BRIAN K DPM	9/2/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
238474	Fee-for-Service	1720314982	1720314982	2	1	HOME DIALYSIS CENTERS OF	10/25/2016	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	RANCHO CUCAMONGA LLC	8239 ROCHESTER AVENUE	SUITE 110	RANCHO CUCAMONGA	CA	91730	0721	36	06071	34.103961	-117.543177	San Bernardino County
238495	Fee-for-Service	1730634619	1730634619	1	1	HERNANDEZ, DANIEL O MD	6/29/2022	207P00000X	NA	Other	026	PHYSICIANS	164992	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
238510	Fee-for-Service	1669680260	1669680260	1	1	HUMPHREY, CHARLES R MD INC	4/22/2010	208600000X	NA	General Surgery	026	PHYSICIANS	23919	02	General Surgery	0	In state provider	None	1310 S IMPERIAL AVENUE	None	EL CENTRO	CA	92243	4201	13	06025	32.78078474	-115.5696892	Imperial County
238527	Fee-for-Service	1134500440	1134500440	1	1	HOME HEALTH PROFESSIONALS	12/20/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	14558 SYLVAN ST	STE 202	VAN NUYS	CA	91411	2324	19	06037	34.18462355	-118.4506785	Los Angeles County
238552	Fee-for-Service	1053757054	1053757054	1	1	HARTZLER, MOLLY A MD	9/27/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	162537	20	Orthopedic Surgery	0	In state provider	None	2510 AIRPARK DR	STE 301	REDDING	CA	96001	2462	45	06089	40.57119566	-122.4016582	Shasta County
238595	Fee-for-Service	1730834367	1730834367	1	1	HOME DIALYSIS THERAPIES OF	7/1/2022	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	SAN DIEGO	1948 VIA CENTRE	None	VISTA	CA	92081	6056	37	06073	33.18409519	-117.2831485	San Diego County
238599	Fee-for-Service	1679013049	1679013049	1	1	HORAN, TIMOTHY DO	10/18/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	19452	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
238606	Fee-for-Service	1346351574	1346351574	1	1	HANTMAN, JOSHUA D MD	3/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82102	41	Internal Medicine	0	In state provider	None	3288 BELL RD	None	AUBURN	CA	95603	9243	31	06061	38.94193048	-121.1046075	Placer County
238609	Fee-for-Service	1467988824	1467988824	1	1	HUGDAL, STEPHEN M MD	4/13/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	158386	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
238626	Fee-for-Service	1275868978	1275868978	1	1	HANSON, JEWEL	11/5/2009	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	4408 MELLO COURT	None	SACRAMENTO	CA	95820	3934	34	06067	38.5353	-121.45716	Sacramento County
238648	Fee-for-Service	1447485156	1447485156	1	1	HUMBOLDT PHYSICIANS SURGERY	1/4/2010	261QS0132X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	AND LASER CENTER LLC	3226 TIMBER FALL CRT	None	EUREKA	CA	95503	4870	12	06023	40.77919293	-124.1360422	Humboldt County
238676	Fee-for-Service	1578729356	1578729356	1	1	HARDY AND LUKES INC	11/29/2018	225X00000X	NA	Other	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	41769 ENTERPRISE CIR N	STE 104	TEMECULA	CA	92590	5626	33	06065	33.51823541	-117.1701538	Riverside County
238684	Fee-for-Service	1720292949	1720292949	1	9	HEALTHY SMILES FOR KIDS	4/17/2024	No Taxonomy Provided	NA	None	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	27042 TOWNE CENTER DR	STE 270	FOOTHILL RANCH	CA	92610	2811	30	06059	33.67305926	-117.6587661	Orange County
238688	Fee-for-Service	1275141582	1275141582	1	1	HEINTZ, ANGELA E PT	3/8/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	10255 LIVE OAK BLVD	None	LIVE OAK	CA	95953	2015	51	06101	39.28004385	-121.661271	Sutter County
238719	Fee-for-Service	1891752309	1891752309	1	1	HORVAL, ANDREW E MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70479	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
238724	Fee-for-Service	1902357155	1902357155	1	1	HOU, SAMUEL MD PHD INC	2/8/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	97972	30	Radiology	0	In state provider	None	1600 N ROSE AVE	None	OXNARD	CA	93030	3722	56	06111	34.21700406	-119.1582582	Ventura County
238758	Fee-for-Service	1801264189	1801264189	1	1	HERNANDEZ, AGARDINA LCSW	12/7/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
238852	Fee-for-Service	1346667193	1346667193	1	1	HOLLEY, ERIN PSYD	9/25/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	30423 CANWOOD ST	SUITE 138	AGOURA HILLS	CA	91301	4315	19	06037	34.14710182	-118.7842501	Los Angeles County
238858	Fee-for-Service	1720068984	1720068984	1	1	HOMESLEY, SUSAN D V OD	1/31/1981	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1516 MAIN ST	STE 102	RAMONA	CA	92065	5242	37	06073	33.03747003	-116.8767366	San Diego County
238916	Fee-for-Service	1518970037	1518970037	1	1	HERMAN, ANDREA M MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72721	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
238923	Fee-for-Service	1023486222	1023486222	1	2	HARTMAN, JAIMEE S PSYD	10/25/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	12021 S WILMINGTON AVE	BUILDING 18, SUITE 300	LOS ANGELES	CA	90059	3019	19	06037	33.922575	-118.2391785	Los Angeles
238963	Fee-for-Service	1578729356	1578729356	1	1	HARDY AND LUKES INC	11/29/2018	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
238966	Fee-for-Service	1942298153	1942298153	1	1	HAYWARD SISTERS HOSPITAL	12/1/1977	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4383	01	06001	37.63347961	-122.0897735	Alameda County
238995	Fee-for-Service	1235602996	1235602996	1	1	HMS PHARMACY INC	2/8/2019	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2795 W LINCOLN AVE	STE K	ANAHEIM	CA	92801	6334	30	06059	33.8322415	-117.984087	Orange County
238996	Fee-for-Service	1659330645	1659330645	1	1	HILINSKI, JOHN M MD	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	63027	04	Otology, Laryngology, Rhinology	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
239004	Fee-for-Service	1932411097	1932411097	1	1	HARLEY, ELIZA K PHD	7/9/2024	103TC2200X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
239042	Fee-for-Service	1194744557	1194744557	1	1	HWANG, YENJEAN S MD	4/1/1999	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	68164	41	Internal Medicine	0	In state provider	None	1 COUNTRY CLUB PLZ	None	ORINDA	CA	94563	2308	07	06013	37.88568592	-122.1926401	Contra Costa County
239057	Fee-for-Service	1124020417	1124020417	1	1	HAMSTRA, GERALD 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	12205 GUNSTOCK DR	None	COLO SPGS	CO	80921	3624	00	None	39.00789805	-104.7942504	El Paso County
239058	Fee-for-Service	1053548065	1053548065	1	1	HOPPE, ALLYSON MD	10/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114327	41	Internal Medicine	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	3663	30	06059	33.62421676	-117.9309656	Orange County
239064	Fee-for-Service	1891365821	1891365821	1	1	HARRINGTON, MELANIE PHD	5/15/2023	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
239088	Fee-for-Service	1528898772	1528898772	1	1	HUANG, HSIN YI PT	11/22/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4131 GEARY BLVD	None	SAN FRANCISCO	CA	94118	3101	38	06075	37.78096053	-122.4637512	San Francisco County
239091	Fee-for-Service	1447342902	1447342902	1	1	HANLIN, DOUGLAS E MD	6/13/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86099	36	Psychiatry	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
239128	Fee-for-Service	1831248756	1831248756	1	1	HAMMER, LAWRENCE MD	6/30/1983	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	31863	01	General Practice	0	In state provider	None	505 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
239140	Fee-for-Service	1265537831	1265537831	1	1	HEADRICK, CHARLES N MD	12/21/2009	208C00000X	NA	General Surgery	026	PHYSICIANS	48418	28	Proctology (colon and rectal)	0	In state provider	None	85 SIERRA PARK ROAD	None	MAMMOTH LAKES	CA	93546	0660	26	06051	37.64575895	-118.9638914	Mono County
239150	Fee-for-Service	1811934847	1811934847	1	1	HANSEN, JAMES G MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1200 WESTWOOD DR	None	HAMILTON	MT	59840	2345	00	None	46.248102	-114.1718175	Ravalli County
239167	Fee-for-Service	1649273459	1649273459	1	1	HISTOLOGY ASSOCIATES, INC	7/5/2022	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	22108 HARPER AVE	None	SAINT CLAIR SHORE	MI	48080	1830	00	None	42.45895324	-82.91088808	Macomb County
239175	Fee-for-Service	1205985447	1205985447	1	1	HSIAO, AMBER MD	8/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	103140	30	Radiology	0	In state provider	None	44725 TENTH ST	WEST STE 150	LANCASTER	CA	93534	3000	19	06037	34.695693	-118.1480965	Los Angeles County
239187	Fee-for-Service	1225059827	1225059827	1	1	HTAY, SOE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	82672	41	Internal Medicine	0	In state provider	None	4253 REDONDO BEACH BLVD	None	LAWNDALE	CA	90260	3341	19	06037	33.87517581	-118.3505148	Los Angeles County
239205	Fee-for-Service	1790088326	1790088326	1	1	HOFFER, LYNN L	1/3/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	8999 BALBOA BLVD	None	NORTHRIDGE	CA	91325	2608	19	06037	34.23447	-118.5025585	Los Angeles County
239231	Fee-for-Service	1811190606	1811190606	1	1	HSU, ANGELA C MD	4/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	132414	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
239253	Fee-for-Service	1942298153	1942298153	1	1	HAYWARD SISTERS HOSPITAL	12/1/1979	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	None	27200 CALAROGA AVE	None	HAYWARD	CA	94545	4383	01	06001	37.63347961	-122.0897735	Alameda County
239254	Fee-for-Service	1578729356	1578729356	1	1	HARDY AND LUKES INC	11/29/2018	225X00000X	NA	Other	037	SPEECH 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
239287	Fee-for-Service	1942226832	1942226832	1	1	HARRIS, CLIFFORD N MD	2/1/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	16005	41	Internal Medicine	0	In state provider	None	3435 WILSHIRE BLVD	RM 21	LOS ANGELES	CA	90010	1901	19	06037	34.06177941	-118.2985544	Los Angeles County
239311	Fee-for-Service	1285722876	1285722876	1	1	HARRIS CARE CENTERS, INC	9/30/2005	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1429 E LAMBDA PL	None	ANAHEIM	CA	92805	4829	30	06059	33.83111325	-117.895441	Orange County
239343	Fee-for-Service	1699981654	1699981654	1	1	HARABOR, BIANCA MD	8/8/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96762	41	Internal Medicine	0	In state provider	None	2801 K ST	STE 520	SACRAMENTO	CA	95816	5119	34	06067	38.572947	-121.46904	Sacramento County
239363	Fee-for-Service	1851556286	1851556286	1	1	HABIB, MUZZAMAL MD	1/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	113617	41	Internal Medicine	0	In state provider	None	THREE MEDICAL PLAZA	None	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
239416	Fee-for-Service	1831248756	1831248756	1	1	HAMMER, LAWRENCE MD	6/30/1983	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	31863	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
239507	Fee-for-Service	1780046482	1780046482	1	1	HINOJOSA, JESSICA	5/3/2024	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
239539	Fee-for-Service	1326399296	1326399296	1	1	HEALTHFLEX HOME HEALTH	12/24/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES	7677 OAKPORT ST	STE 930	OAKLAND	CA	94621	1929	01	06001	37.74725101	-122.2028137	Alameda County
239576	Fee-for-Service	1942226832	1942226832	1	1	HARRIS, CLIFFORD N MD	2/1/1984	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	16005	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	3435 WILSHIRE BLVD	RM 21	LOS ANGELES	CA	90010	1901	19	06037	34.06177941	-118.2985544	Los Angeles County
239579	Fee-for-Service	1023080355	1023080355	1	1	HUANG, CHARLES Q MD	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	88833	18	Ophthalmology	0	In state provider	None	7601 STONERIDGE DR	None	PLEASANTON	CA	94588	4501	01	06001	37.69013379	-121.9265243	Alameda County
239593	Fee-for-Service	1013012632	1013012632	1	1	HEEREN, MATHEW M MD	12/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82104	40	Pediatrics	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
239632	Fee-for-Service	1497868079	1497868079	1	1	HINTZ, BRACE L MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	12572	30	Radiology	0	In state provider	None	4867 W SUNSET BLVD	None	LOS ANGELES	CA	90027	5969	19	06037	34.0981755	-118.295055	Los Angeles County
239638	Fee-for-Service	1407968332	1407968332	1	1	HOLY CROSS APOTHECARY INC	8/1/1994	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	HOLY CROSS PHARMACY	11550 INDIAN HILLS RD	STE 130	MISSION HILLS	CA	91345	1201	19	06037	34.28024575	-118.4588775	Los Angeles County
239670	Fee-for-Service	1285092106	1285092106	1	1	HARVEST RETIREMENT CORP	10/27/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	9011 KNOTT AVE	None	BUENA PARK	CA	90620	4138	30	06059	33.831126	-118.010976	Orange County
239678	Fee-for-Service	1568620342	1568620342	1	1	HORN, TA'SHANNE W LCSW	9/2/2021	101YM0800X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	572 RIO LINDO AVE	STE 203	CHICO	CA	95926	1851	04	06007	39.75508407	-121.8487933	Butte County
239679	Fee-for-Service	1710236898	1710236898	1	1	HAO, JINGPING MD	12/26/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	500 SW RAMSEY AVE	None	GRANTS PASS	OR	97527	5543	00	None	42.4198785	-123.3432318	Josephine County
239722	Fee-for-Service	1407497183	1407497183	1	1	HARMONY LIFE HOSPICE INC	11/18/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	17042 DEVONSHIRE ST	SUITE 214	NORTHRIDGE	CA	91325	1691	19	06037	34.25750455	-118.503648	Los Angeles County
239733	Fee-for-Service	1508485046	1508485046	1	1	HOLLAND, LAUREN DO	10/29/2024	208M00000X	NA	Other	026	PHYSICIANS	22565	41	Internal Medicine	0	In state provider	None	11795 EDUCATION ST	STE 201	AUBURN	CA	95602	2469	31	06061	38.94433757	-121.098912	Placer County
239747	Fee-for-Service	1437604279	1437604279	1	1	HOANG, LESLIE PT	9/16/2019	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
239758	Fee-for-Service	1558985390	1558985390	1	1	HUNT, TYRELLE MD	12/7/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184592	None	None	0	In state provider	None	1701 E FLORIDA AVE	None	HEMET	CA	92544	4632	33	06065	33.74755247	-116.9539875	Riverside County
239761	Fee-for-Service	1467036954	1467036954	1	1	HUANG, LILI CNP	6/15/2021	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
239830	Fee-for-Service	1326081696	1326081696	1	1	HARRIS, TRAVIS M MD	7/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	53649	66	Emergency Medicine (Urgent Care)	0	In state provider	None	300 HOSPITAL DRIVE	None	VALLEJO	CA	94589	2517	48	06095	38.13070051	-122.237307	Solano County
239836	Fee-for-Service	1093114753	1093114753	1	1	HAWKINS, ALICE E MD	8/12/2024	207RH0002X	NA	Adult Primary Care	026	PHYSICIANS	186169	13	Neurology (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
239877	Fee-for-Service	1548455413	1548455413	1	1	HAYDEN, DARA PSYD	9/22/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2308 6TH ST	None	BERKELEY	CA	94710	2412	01	06001	37.86310677	-122.2961825	Alameda County
239938	Fee-for-Service	1679759161	1679759161	1	2	HALLSTROM, KRISTIN R	8/26/2022	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
239964	Fee-for-Service	1891332565	1891332565	1	1	HA DECISIONS HOSPICE INC	7/15/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	14845 MAGNOLIA BLVD	STE 202	SHERMAN OAKS	CA	91403	1397	19	06037	34.16487652	-118.4568435	Los Angeles County
239973	Fee-for-Service	1649419755	1649419755	1	1	HALL, LYNOUS W MD INC	11/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	35906	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1205 GARCES HWY	STE 300	DELANO	CA	93215	3659	15	06029	35.76144147	-119.2400687	Kern County
240009	Fee-for-Service	1407497183	1407497183	1	1	HARMONY LIFE HOSPICE INC	11/18/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	17042 DEVONSHIRE ST	SUITE 214	NORTHRIDGE	CA	91325	1691	19	06037	34.25750455	-118.503648	Los Angeles County
240039	Fee-for-Service	1649817974	1649817974	1	1	HOUTERMANS, MIA LCSW	5/11/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
240054	Fee-for-Service	1831186345	1831186345	1	1	HOLLENBECK HOME FOR AGED	3/1/1966	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	573 S BOYLE AVE	None	LOS ANGELES	CA	90033	3816	19	06037	34.04050892	-118.2197575	Los Angeles County
240065	Fee-for-Service	1942952130	1942952130	1	1	HALLOWAY, AMANDA J LMFT	12/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	5266 HOLLISTER AVE	STE 205	SANTA BARBARA	CA	93111	2037	42	06083	34.43497016	-119.8071895	Santa Barbara County
240098	Fee-for-Service	1326236183	1326236183	1	1	HONNER, SAMANTHA K MD	1/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	93611	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
240109	Fee-for-Service	1225126170	1225126170	1	1	HO, RACHEL J NP	3/9/2010	363LF0000X	NA	Nurse Practitioner	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
240116	Fee-for-Service	1528453180	1528453180	1	1	HILLMAN, DANIEL	5/9/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	-	30	Radiology	2	Out of state provider	None	3181 SW SAM JACKSON PARK	RD	PORTLAND	OR	97239	3011	00	None	45.49936609	-122.6856232	Multnomah County
240142	Fee-for-Service	1972769974	1972769974	1	1	HUO, EUGENE J MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	143706	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
240147	Fee-for-Service	1164830071	1164830071	1	1	HONG, ESTER MD	11/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148359	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
240182	Fee-for-Service	1871941401	1871941401	1	1	HOPPENFELD, MITA S MD	4/24/2020	207R00000X	NA	Other	026	PHYSICIANS	150613	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
240194	Fee-for-Service	1679061170	1679061170	1	1	HTUT, PHYU	7/25/2024	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
240235	Fee-for-Service	1649433954	1649433954	1	1	HAMILTON, DAWN C LMFT	1/13/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7365 CARNELIAN STREET	SUITE 132	RANCHO CUCAMONGA	CA	91730	1100	36	06071	34.12038413	-117.6160525	San Bernardino County
240249	Fee-for-Service	1891332565	1891332565	1	1	HA DECISIONS HOSPICE INC	7/15/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	14845 MAGNOLIA BLVD	STE 202	SHERMAN OAKS	CA	91403	1397	19	06037	34.16487652	-118.4568435	Los Angeles County
240256	Fee-for-Service	1477875680	1477875680	1	1	HOUSTON BAKER, KAMILA L LCSW	10/1/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	445 BELLEVUE AVE	SUITE 101-D	OAKLAND	CA	94610	4923	01	06001	37.80910261	-122.2526914	Alameda County
240311	Fee-for-Service	1396005740	1396005740	1	1	HSU, DAVID W MD	7/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	145953	04	Otology, Laryngology, Rhinology	0	In state provider	None	200 MEDICAL PLAZA	STE 550	LOS ANGELES	CA	90095	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
240324	Fee-for-Service	1659300986	1659300986	1	1	HOFFMAN, LANCE H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	600 S 42ND ST	None	OMAHA	NE	68198	1002	00	None	41.255128	-95.97577589	Douglas County
240354	Fee-for-Service	1487949863	1487949863	1	1	HAN, WENCHIANG MD INC	7/8/2011	174400000X	NA	Other	026	PHYSICIANS	73066	13	Neurology (M.D. only)	0	In state provider	None	870 SHASTA STREET	STE 400	YUBA CITY	CA	95991	4117	51	06101	39.14204	-121.6161711	Sutter County
240404	Fee-for-Service	1609073717	1609073717	1	1	HSU, JOE L MD	12/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85715	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
240405	Fee-for-Service	1033105523	1033105523	1	1	HARRIS AND KING HEALTH	2/8/2019	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	SERVICES INC	2486 PONDEROSA NORTH	SUITE D 106	CAMARILLO	CA	93010	2376	56	06111	34.24266768	-119.0228157	Ventura County
240409	Fee-for-Service	1750839338	1750839338	1	1	HURT, ALYSSIA N LCSW	8/7/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
240434	Fee-for-Service	1699164277	1699164277	1	1	HETREA, STEPHANIE L NP	11/28/2019	363LA2100X	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
240436	Fee-for-Service	1790244127	1790244127	1	1	HAGANS, TABITHA LPCC	11/21/2024	101YP2500X	NA	Other	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
240451	Fee-for-Service	1649701871	1649701871	1	1	HA, DANIEL MD	10/16/2020	207R00000X	NA	Other	026	PHYSICIANS	159464	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
240459	Fee-for-Service	1245688977	1245688977	1	1	HOJAT, SEYED AMIN MD	7/26/2024	207ZP0102X	NA	Other	026	PHYSICIANS	178100	22	Pathology (M.D. only)	0	In state provider	None	4301 NORTHSTAR WAY	None	MODESTO	CA	95356	9535	50	06099	0	0	None
240491	Fee-for-Service	1639699127	1639699127	1	1	HILL, EUGENE D MD	6/21/2022	207P00000X	NA	Other	026	PHYSICIANS	175091	None	None	0	In state provider	None	23625 HOLMAN HIGHWAY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
240499	Fee-for-Service	1972068625	1972068625	1	1	HOM, BETTY MD	8/11/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184494	None	None	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
240505	Fee-for-Service	1104109750	1104109750	1	1	HANCOCK, CHRISTOPHER S CNP	5/9/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	45	06089	40.57278686	-122.3958519	Shasta County
240541	Fee-for-Service	1962527085	1962527085	1	1	HEALTHRIGHT 360	1/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	SERVICES	1285 ESCUELA DRIVE	None	MILPITAS	CA	95035	3223	43	06085	37.44760411	-121.9000097	Santa Clara County
240603	Fee-for-Service	1205984150	1205984150	1	1	HAMILTON, KEITH A MD	11/10/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8960	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVENUE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
240623	Fee-for-Service	1902214778	1902214778	1	1	HARRISON, DARYA PSYD	3/17/2022	103T00000X	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
240633	Fee-for-Service	1538587852	1538587852	1	1	HAMILTON, ROSS MD	6/18/2024	2084N0400X	NA	Neurology	026	PHYSICIANS	167538	13	Neurology (M.D. only)	0	In state provider	None	6010 HIDDEN VALLEY RD	SUITE 200	CARLSBAD	CA	92011	4219	37	06073	33.12288368	-117.3058276	San Diego County
240662	Fee-for-Service	1457457384	1457457384	1	1	HERITAGE MANOR	1/11/1996	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HEALTHCARE LLC	610 N GARFIELD AVE	None	MONTEREY PARK	CA	91754	1103	19	06037	34.06881064	-118.1228976	Los Angeles County
240667	Fee-for-Service	1770112682	1770112682	1	1	HANIF, AISHA A DO	4/10/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	21385	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
240679	Fee-for-Service	1861440893	1861440893	2	1	HASSABALLA, HESHAM A MD	4/27/2023	207RC0200X	NA	Other	026	PHYSICIANS	167793	None	None	0	In state provider	None	1800 CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
240707	Fee-for-Service	1376800375	1376800375	1	1	HERRERA, SARAH K S MD	5/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128825	40	Pediatrics	0	In state provider	None	23521 PASEO DE VALENCIA	STE 200	LAGUNA HILLS	CA	92653	3101	30	06059	33.61113028	-117.7126684	Orange County
240723	Fee-for-Service	1821186867	1821186867	1	1	HUGHES, MICHAEL D MD	4/29/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55639	08	Family Practice	0	In state provider	None	555 TACHEVAH DR	3W105	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
240748	Fee-for-Service	1316706294	1316706294	1	1	HADDAD, LEANN CNM	7/1/2024	367A00000X	NA	Certified Nurse Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
240752	Fee-for-Service	1790972453	1790972453	1	1	HENSEN & PERLMAN ODS	9/5/1979	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	5385 WALNUT AVE	STE 2	CHINO	CA	91710	2605	36	06071	34.02627451	-117.6872175	San Bernardino County
240772	Fee-for-Service	1124102116	1124102116	1	1	HWANG, LINDA Y MD	10/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	60352	07	Dermatology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
240774	Fee-for-Service	1124130620	1124130620	2	1	HARMONY HEALTH MEDICAL CLINI	8/12/2015	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CLINIC & FAMILY RESOURCE	1908 N BEALE ROAD	SUITE E	MARYSVILLE	CA	95901	6937	58	06115	39.1278388	-121.5457994	Yuba County
240853	Fee-for-Service	1891770111	1891770111	1	1	HOFBAUER, JOHN D MD INC	7/30/1990	207W00000X	NA	Ophthalmology	026	PHYSICIANS	38645	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
240926	Fee-for-Service	1629844824	1629844824	1	1	HOBSON, COLE PT	1/23/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	7525 METROPOLITAN DR	STE 306	SAN DIEGO	CA	92108	4404	37	06073	32.77677653	-117.1592911	San Diego County
240988	Fee-for-Service	1376679688	1376679688	1	1	HERRERA, RENETTE M LMFT	3/24/2020	106H00000X	NA	Mental Health Outpatient Services	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
241000	Fee-for-Service	1285894949	1285894949	1	1	HWANG, LAWRENCE M MD	5/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104288	08	Family Practice	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
241045	Fee-for-Service	1891751939	1891751939	1	1	HARVEY, DAVID H CRNA	10/16/2013	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVENUE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
241061	Fee-for-Service	1124130620	1124130620	2	1	HARMONY HEALTH MEDICAL CLINI	8/12/2015	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CLINIC & FAMILY RESOURCE	1908 N BEALE ROAD	SUITE E	MARYSVILLE	CA	95901	6937	58	06115	39.1278388	-121.5457994	Yuba County
241070	Fee-for-Service	1992419626	1992419626	1	1	HAGAN, JENNICA NP	5/30/2024	363LN0000X	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
241095	Fee-for-Service	1457565152	1457565152	1	1	H-DN INDEPENDENT PRACTICE AS	12/20/2019	302R00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	E ASSOCIATION	2316 HARRISON AVE	None	EUREKA	CA	95501	3217	12	06023	40.786722	-124.139666	Humboldt County
241107	Fee-for-Service	1528135217	1528135217	1	1	HUEN, FLOYD MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	41373	41	Internal Medicine	0	In state provider	None	2181 BRAEMAR RD	None	OAKLAND	CA	94602	2003	01	06001	37.81304058	-122.2023918	Alameda County
241108	Fee-for-Service	1548285661	1548285661	1	1	HIMMEL, ALLISON M MD	7/10/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90150	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
241153	Fee-for-Service	1063435055	1063435055	1	1	HERSHEY, DANIEL W MD	7/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	82477	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
241204	Fee-for-Service	1497742852	1497742852	1	1	HANSON, JAMES H MD	7/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	53697	40	Pediatrics	0	In state provider	None	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	01	06001	37.8242017	-122.2578306	Alameda County
241217	Fee-for-Service	1629501754	1629501754	1	1	HENDRIX, ANGELA D	6/23/2017	No Taxonomy Provided	NA	None	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
241229	Fee-for-Service	1407805153	1407805153	1	1	HAKIMEH, IHSAN MD	6/1/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	44274	41	Internal Medicine	0	In state provider	None	1025 W OLYMPIC BLVD	None	LOS ANGELES	CA	90015	1329	19	06037	34.04624254	-118.267606	Los Angeles County
241243	Fee-for-Service	1679916654	1679916654	1	1	HUANG, HANS D MD	8/14/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	163407	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
241272	Fee-for-Service	1437198454	1437198454	1	1	HENSON, WILLIAM 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	176 S MAIN ST	None	PONTOTOC	MS	38863	3311	00	None	34.24263458	-88.99671322	Pontotoc County
241303	Fee-for-Service	1013029487	1013029487	1	1	HETTENA, AVI J MD	11/30/1984	207R00000X	NA	Other	026	PHYSICIANS	45263	01	General Practice	0	In state provider	None	2300 SUTTER ST	STE 301	SAN FRANCISCO	CA	94115	3029	38	06075	37.78546004	-122.4384038	San Francisco County
241320	Fee-for-Service	1154439669	1154439669	1	1	HARRIS, ANDREA L MD	12/31/1992	207P00000X	NA	Other	026	PHYSICIANS	78196	None	None	0	In state provider	None	6501 COYLE AVE	None	CARMICHAEL	CA	95608	0306	34	06067	38.669562	-121.31379	Sacramento County
241365	Fee-for-Service	1376113944	1376113944	1	1	HWANG, WINIFRED CRNA	12/1/2023	367500000X	NA	Other	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
241369	Fee-for-Service	1477627354	1477627354	1	1	HANGER PROSTHETICS &	5/24/2001	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	1	Border provider	None	1025 WEST 24TH ST	STE 17	YUMA	AZ	85364	8371	00	None	32.683824	-114.631668	Yuma County
241396	Fee-for-Service	1528135217	1528135217	1	1	HUEN, FLOYD MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	41373	08	Family Practice	0	In state provider	None	2181 BRAEMAR RD	None	OAKLAND	CA	94602	2003	01	06001	37.81304058	-122.2023918	Alameda County
241418	Fee-for-Service	1265590905	1265590905	1	1	HOANG, TUAN N MD	9/17/2020	208600000X	NA	General Surgery	026	PHYSICIANS	55303	02	General Surgery	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
241447	Fee-for-Service	1497371769	1497371769	1	1	HOMAYOUNI, ASAL MD	9/5/2024	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	180714	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	276 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.2402111	-121.8021684	Santa Clara County
241483	Fee-for-Service	1841694056	1841694056	1	1	HERNANDEZ, LORENA PSYD	4/24/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	177 BOVET RD	SUITE 300	SAN MATEO	CA	94402	3140	41	06081	37.5502646	-122.3169875	San Mateo County
241500	Fee-for-Service	1376548156	1376548156	1	1	HONEGGER, MARILYN M MD	11/29/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	53701	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
241511	Fee-for-Service	1134290190	1134290190	1	1	HUEBNER-CHAN, DAVID R MD	5/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73737	22	Pathology (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
241573	Fee-for-Service	1437291465	1437291465	1	1	HAMED, MIRUAIS S MD	9/1/2013	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
241583	Fee-for-Service	1447204672	1447204672	1	1	HEILBRUN, MARTA 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 DR	None	SLC	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
241588	Fee-for-Service	1013029487	1013029487	1	1	HETTENA, AVI J MD	11/30/1984	207R00000X	NA	Other	026	PHYSICIANS	45263	45	Nephrology (Renal-Kidney)	0	In state provider	None	2300 SUTTER ST	STE 301	SAN FRANCISCO	CA	94115	3029	38	06075	37.78546004	-122.4384038	San Francisco County
241591	Fee-for-Service	1740369404	1740369404	1	1	HO, PAUL MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69547	30	Radiology	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
241598	Fee-for-Service	1740379668	1740379668	1	1	HOM, PHILIP	1/31/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	51695	None	None	0	In state provider	None	201 S ALVARADO ST	STE 406	LOS ANGELES	CA	90057	2353	19	06037	34.06417777	-118.2719543	Los Angeles County
241674	Fee-for-Service	1558335372	1558335372	1	1	HARRISON, SCOTT 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	2000 HOSPITAL DR	None	SEDRO WOOLLEY	WA	98284	4327	00	None	48.49548051	-122.2760925	Skagit County
241740	Fee-for-Service	1386670495	1386670495	1	1	HANNAH, JAMES B MD	5/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	46098	22	Pathology (M.D. only)	0	In state provider	None	134 NELSON ST	None	ARROYO GRANDE	CA	93420	3386	40	06079	35.12233737	-120.576558	San Luis Obispo County
241761	Fee-for-Service	1316024508	1316024508	1	1	HYDER, SHAKIR A MD	10/31/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42593	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
241793	Fee-for-Service	1851472161	1851472161	1	1	HALES, MARTHA S MD	3/31/1995	207ZP0102X	NA	Other	026	PHYSICIANS	44502	22	Pathology (M.D. only)	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
241824	Fee-for-Service	1396804878	1396804878	1	1	HEDAYATI, NASIM MD	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99996	02	General Surgery	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
241830	Fee-for-Service	1659371482	1659371482	1	1	HASSEL, ALAN 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	350 N WILMOT RD	None	TUCSON	AZ	85711	2602	00	None	32.227209	-110.8556595	Pima County
241832	Fee-for-Service	1376511188	1376511188	1	1	HAMZEL, ALI R MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	62682	66	Emergency Medicine (Urgent Care)	0	In state provider	None	345 SANTA FE DR	None	ENCINITAS	CA	92024	5132	37	06073	33.03619096	-117.2847386	San Diego County
241852	Fee-for-Service	1659423192	1659423192	1	1	HOU, DAVID S DO	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	10207	05	Anesthesiology	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
241877	Fee-for-Service	1013029487	1013029487	1	1	HETTENA, AVI J MD	11/30/1984	207R00000X	NA	Other	026	PHYSICIANS	45263	41	Internal Medicine	0	In state provider	None	2300 SUTTER ST	STE 301	SAN FRANCISCO	CA	94115	3029	38	06075	37.78546004	-122.4384038	San Francisco County
241896	Fee-for-Service	1134646565	1134646565	1	1	HOFFMAN, SAVANNAH M LCSW	12/15/2023	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
241898	Fee-for-Service	1053584474	1053584474	1	1	HAIGHT, BRUCE T MD INC	8/31/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	41117	18	Ophthalmology	0	In state provider	None	5565 GROSSMONT CENTER DR	2-3	LA MESA	CA	91942	3020	37	06073	32.77978322	-117.0094766	San Diego County
241917	Fee-for-Service	1194723825	1194723825	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	7720 CARDINAL COURT	None	SAN DIEGO	CA	92123	3333	37	06073	32.79149637	-117.1577414	San Diego County
241933	Fee-for-Service	1700236924	1700236924	1	1	HERNANDEZ-SUTTON, OSCAR PHD	1/4/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2615 ASHBY AVE	None	BERKELEY	CA	94705	2200	01	06001	37.85685511	-122.2547897	Alameda County
241952	Fee-for-Service	1730499914	1730499914	1	1	HOUSE, KATHRYN R	3/29/2011	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
241970	Fee-for-Service	1225240518	1225240518	1	1	HOANGQUOCGIA, CLINT DO	9/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	13441	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
242006	Fee-for-Service	1366053423	1366053423	1	1	HOANG, DON D PT	7/21/2022	225100000X	NA	Physical Therapist	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
242022	Fee-for-Service	1235337908	1235337908	1	1	HENRY, JENNIFER L LAC	10/26/2007	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	133 E HALEY AT	None	SANTA BARBARA	CA	93102	2330	42	06083	34.41883725	-119.6933889	Santa Barbara County
242037	Fee-for-Service	1780003525	1780003525	1	1	HANNO, RAM MD	6/6/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	23625 WR HOLMAN HWY	None	MONTEREY	CA	93940	5902	27	06053	36.5785911	-121.9150013	Monterey County
242039	Fee-for-Service	1518952076	1518952076	1	1	HERVIEUX, ADRIENNE M MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	68650	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
242043	Fee-for-Service	1306888631	1306888631	2	1	HEALTH ENTERPRISES INC	5/31/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	22573 BARTON RD	SUITE B	GRAND TERRACE	CA	92313	5902	36	06071	34.03390452	-117.3119985	San Bernardino County
242045	Fee-for-Service	1356331136	1356331136	1	1	HUDKINS, MATTHEW G MD	10/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	97009	30	Radiology	0	In state provider	None	455 HICKEY BLVD	STE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
242064	Fee-for-Service	1205137148	1205137148	1	1	HENRIFARRY, JUDITH C LMFT	9/8/2015	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	41945 BIG BEAR BLVD	227	BIG BEAR LAKE	CA	92315	8980	36	06071	34.24334115	-116.8869688	San Bernardino County
242074	Fee-for-Service	1649667965	1649667965	1	1	HOANG, GARY MD	6/4/2021	390200000X	NA	Other	026	PHYSICIANS	168696	None	None	0	In state provider	None	1100 N TUSTIN AVE	UNIT A	SANTA ANA	CA	92705	3505	30	06059	33.754707	-117.8342455	Orange County
242075	Fee-for-Service	1326010620	1326010620	1	2	HUNT, JAMES MD	11/18/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	78304	-	NOT APPLICABLE	0	In state provider	None	1901 CLEVELAND AVE	SUITE B	SANTA ROSA	CA	95401	4298	49	06097	38.454633	-122.727042	Sonoma County
242094	Fee-for-Service	1003988585	1003988585	1	1	HO, TAYLOR MD	4/2/1999	208600000X	NA	General Surgery	026	PHYSICIANS	60101	02	General Surgery	0	In state provider	None	4500 BROCKTON AVE	STE 204	RIVERSIDE	CA	92501	4090	33	06065	33.97785263	-117.3836152	Riverside County
242119	Fee-for-Service	1376511188	1376511188	1	1	HAMZEL, ALI R MD	11/21/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	62682	41	Internal Medicine	0	In state provider	None	345 SANTA FE DR	None	ENCINITAS	CA	92024	5132	37	06073	33.03619096	-117.2847386	San Diego County
242125	Fee-for-Service	1578031597	1578031597	1	1	HIGHLAND OPTOMETRICS	4/12/2023	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	7291 BOULDER AVENUE SUIT	None	HIGHLAND	CA	92346	3389	36	06071	34.12169346	-117.1953693	San Bernardino County
242139	Fee-for-Service	1073773180	1073773180	1	1	HADEED, JOSEF G MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115941	46	Hand Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
242156	Fee-for-Service	1548298417	1548298417	1	1	HSU, FRANK P K MD	5/23/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86891	14	Neurological Surgery	0	In state provider	None	25455 BARTON RD	STE 108A	LOMA LINDA	CA	92354	3129	36	06071	34.04805253	-117.249534	San Bernardino County
242196	Fee-for-Service	1700996931	1700996931	1	1	HAUSER, STEPHEN L MD	12/14/1992	2084N0400X	NA	Neurology	026	PHYSICIANS	75715	13	Neurology (M.D. only)	0	In state provider	None	400 PARNASSUS AVE	# A887	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
242215	Fee-for-Service	1285933945	1285933945	1	1	HO, JACQUELINE R MD	1/24/2019	207VE0102X	NA	Obstetrics & Gynecology	026	PHYSICIANS	122858	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
242223	Fee-for-Service	1467438036	1467438036	1	1	HESSELTINE, ANDREW W MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	66517	05	Anesthesiology	0	In state provider	None	26520 CACTUS AVE	# F2027	MORENO VALLEY	CA	92555	3927	33	06065	33.912117	-117.195849	Riverside County
242234	Fee-for-Service	1730343757	1730343757	1	1	HORAN, BRIAN E DO	8/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	9406	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
242312	Fee-for-Service	1396371209	1396371209	1	1	HUANG, GING TANG DO	3/18/2025	2084N0400X	NA	Neurology	026	PHYSICIANS	None	13	Neurology (M.D. only)	0	In state provider	None	630 S RAYMOND AVE	STE 310	PASADENA	CA	91105	3278	19	06037	34.13505223	-118.1487761	Los Angeles County
242318	Fee-for-Service	1922539865	1922539865	1	1	HADLEY, MICHAEL D MD	1/22/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157438	08	Family Practice	0	In state provider	None	525 3RD AVE	None	CHULA VISTA	CA	91910	5696	37	06073	32.63367609	-117.0769202	San Diego County
242322	Fee-for-Service	1194819987	1194819987	1	1	HESS, JENNIFER A CNM	7/31/2017	No Taxonomy Provided	NA	None	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
242329	Fee-for-Service	1336153816	1336153816	1	1	HSU, HUGO Y MD	9/15/2010	207W00000X	NA	Ophthalmology	026	PHYSICIANS	74891	18	Ophthalmology	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
242382	Fee-for-Service	1558555078	1558555078	1	1	HARRIS, JULIE M CCC-SLP	6/23/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	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
242406	Fee-for-Service	1881769347	1881769347	1	1	HARTING, SONJA L LMFT	5/23/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1125 16TH ST	STE 207	ARCATA	CA	95521	5585	12	06023	40.87523499	-124.0878891	Humboldt County
242427	Fee-for-Service	1073773180	1073773180	1	1	HADEED, JOSEF G MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	115941	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
242450	Fee-for-Service	1568610913	1568610913	1	1	HOEHING, DOUGLAS E PHD	10/29/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2547 W SHAW AVE	STE 117	FRESNO	CA	93711	3321	10	06019	36.80804173	-119.8385565	Fresno County
242452	Fee-for-Service	1598994709	1598994709	1	1	HUNDAL, HARKAWAL S MD	9/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	107451	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
242518	Fee-for-Service	1861522609	1861522609	1	1	HUERTA, JUAN J LMFT	6/4/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1011 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	19	06037	34.06477215	-117.9845382	Los Angeles County
242551	Fee-for-Service	1033296090	1033296090	1	1	HUANG, JANE E MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69301	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
242561	Fee-for-Service	1134709421	1134709421	1	1	HAO, MICHELLE MD	9/9/2024	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	183272	08	Family Practice	0	In state provider	None	1301 PINOLE VALLEY RD	None	PINOLE	CA	94564	1384	07	06013	37.9991883	-122.2867117	Contra Costa County
242568	Fee-for-Service	1720044787	1720044787	1	1	HALVERSON, JAMES R MD	2/8/2015	193400000X	NA	Other	026	PHYSICIANS	51412	08	Family Practice	0	In state provider	None	1306 MARICOPA HWY	None	OJAI	CA	93023	3131	56	06111	34.44229705	-119.2645703	Ventura County
242595	Fee-for-Service	1477592087	1477592087	1	1	HUTCHISON, LAURA MD	1/10/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	154216	None	None	0	In state provider	None	7700 MORRO RD	None	ATASCADERO	CA	93422	4435	40	06079	35.47579542	-120.6678702	San Luis Obispo County
242609	Fee-for-Service	1598008443	1598008443	1	1	HOOD-MEDLAND, EVE A MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133572	41	Internal Medicine	0	In state provider	None	4600 BROADWAY	STE 100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
242617	Fee-for-Service	1447696448	1447696448	1	1	HUNTER, VANESSA A NP	8/9/2019	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
242629	Fee-for-Service	1346620978	1346620978	1	1	HU, SHIRLEY MD	12/30/2019	208M00000X	NA	Other	026	PHYSICIANS	145198	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
242643	Fee-for-Service	1386783082	1386783082	1	1	HEISLER, TRACY L MD	11/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	65570	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
242676	Fee-for-Service	1821002593	1821002593	1	1	HISEROTE, PATRICIA M MD	1/4/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	8380	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
242684	Fee-for-Service	1609980770	1609980770	1	1	HSU, CINDY C MD	2/7/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91658	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
242692	Fee-for-Service	1689869356	1689869356	1	1	HOFFMAN, GEORGE S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	38099	18	Ophthalmology	0	In state provider	None	1220 LA VENTA RD	STE 203	WESTLAKE VILLAGE	CA	91361	3751	56	06111	34.14891743	-118.8225621	Ventura County
242771	Fee-for-Service	1811412182	1811412182	1	1	HARDEY, KRISTINE K LMFT	7/25/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	8203 SIERRA COLLEGE BLVD	None	ROSEVILLE	CA	95661	9409	31	06061	38.74778102	-121.2264025	Placer County
242867	Fee-for-Service	1730123837	1730123837	1	1	HUI, JENNIFER S MD	8/7/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82977	13	Neurology (M.D. only)	0	In state provider	None	1510 SAN PABLO ST	STE 268	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
242881	Fee-for-Service	1750911228	1750911228	1	2	HHL CARE CORPORATION	5/21/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	23916 HIGHLAND VALLEY RD	None	DIAMOND BAR	CA	91765	1122	19	06037	34.03593464	-117.8003993	Los Angeles County
242893	Fee-for-Service	1083177042	1083177042	1	1	HASSAN, AMAL Y MD	9/23/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181949	None	None	0	In state provider	None	455 OCONNOR DR	SUITE 210	SAN JOSE	CA	95128	1633	43	06085	37.326654	-121.939897	Santa Clara County
242897	Fee-for-Service	1598008443	1598008443	1	1	HOOD-MEDLAND, EVE A MD	6/20/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133572	01	General Practice	0	In state provider	None	4600 BROADWAY	STE 100	SACRAMENTO	CA	95820	1527	34	06067	38.546127	-121.452669	Sacramento County
242957	Fee-for-Service	1528086550	1528086550	1	1	HO, JAMES N MD	6/30/1993	207ZP0102X	NA	Other	026	PHYSICIANS	68662	22	Pathology (M.D. only)	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
242976	Fee-for-Service	1578789046	1578789046	1	1	HICKS, PEARLMAN D MD INC	1/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	39324	None	None	0	In state provider	None	2360 LONG BEACH BLVD	None	LONG BEACH	CA	90806	3260	19	06037	33.80017044	-118.1892456	Los Angeles County
242982	Fee-for-Service	1184829160	1184829160	1	1	HARTMAN, KURT C	6/3/2011	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
243029	Fee-for-Service	1902928179	1902928179	1	1	HWANG, DENNIS MD	7/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83404	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
243069	Fee-for-Service	1225533722	1225533722	1	1	HIFKO, ALAN J MD	9/6/2024	390200000X	NA	Other	026	PHYSICIANS	None	05	Anesthesiology	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
243085	Fee-for-Service	1659680411	1659680411	1	1	HO, SANDRA A MD	9/14/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	113522	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
243099	Fee-for-Service	1225081102	1225081102	1	1	HINOHARA, TOMOAKI MD	7/31/1987	174400000X	NA	Other	026	PHYSICIANS	44971	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	770 WELCH RD	STE 100	PALO ALTO	CA	94304	1505	43	06085	37.43748087	-122.1759625	Santa Clara County
243101	Fee-for-Service	1396807202	1396807202	1	1	HI DESERT PET & NUCLEAR	8/27/2008	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	IMAGING CENTER INC	17260 BEAR VALLEY RD	STE 114	VICTORVILLE	CA	92595	7778	36	06071	34.47103651	-117.2855205	San Bernardino County
243108	Fee-for-Service	1467772756	1467772756	1	1	HAWTHORNE, HEATHER D MD	7/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135489	01	General Practice	0	In state provider	None	1433 N HOLLENBECK AVENUE	SUITE 200	COVINA	CA	91722	1558	19	06037	34.105518	-117.8989985	Los Angeles County
243114	Fee-for-Service	1255822672	1255822672	1	1	HOLLAI, VERONIKA E PSYD	10/25/2023	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	480B TESCONI CIR	None	SANTA ROSA	CA	95401	4691	49	06097	38.44950583	-122.7351601	Sonoma County
243149	Fee-for-Service	1639603475	1639603475	1	1	HALTEH, PIERRE B MD	6/9/2022	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	175928	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
243173	Fee-for-Service	1952740920	1952740920	1	1	HEMOND, MICHAEL S MD	8/28/2017	207W00000X	NA	Ophthalmology	026	PHYSICIANS	134903	18	Ophthalmology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
243176	Fee-for-Service	1003337122	1003337122	1	1	HARN, ABRAHAM DO	6/19/2020	390200000X	NA	Other	026	PHYSICIANS	17487	41	Internal Medicine	0	In state provider	None	1211 W LA PALMA AVE	STE 207	ANAHEIM	CA	92801	2139	30	06059	33.84718298	-117.933758	Orange County
243213	Fee-for-Service	1295193126	1295193126	1	1	HEUNG, SHARON S PT	1/25/2021	225100000X	NA	Physical Therapist	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
243229	Fee-for-Service	1053366344	1053366344	1	1	HARANATH, SAI P MD	4/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84840	41	Internal Medicine	0	In state provider	None	1505 S MAIN STREET	None	WALNUT CREEK	CA	94596	0000	07	06013	37.89003052	-122.0574583	Contra Costa County
243246	Fee-for-Service	1528086550	1528086550	1	1	HO, JAMES N MD	6/30/1993	207ZP0102X	NA	Other	026	PHYSICIANS	68662	01	General Practice	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
243262	Fee-for-Service	1851784672	1851784672	2	1	HANGER PROSTHETICS & ORTHOTI	5/19/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	14450 HOOVER ST	None	WESTMINSTER	CA	92683	5319	30	06059	33.75270953	-117.9983297	Orange County
243286	Fee-for-Service	1689061731	1689061731	1	1	HALABI, ANASHEH MD	4/13/2020	2084N0400X	NA	Neurology	026	PHYSICIANS	146808	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA # B200	None	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
243305	Fee-for-Service	1427410984	1427410984	1	1	HUSSEIN, TARIK A MD	12/27/2022	207R00000X	NA	Other	026	PHYSICIANS	160228	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
243308	Fee-for-Service	1487120374	1487120374	1	1	HORIZON FAMILY AND COMMUNITY	6/30/2024	106H00000X	NA	Mental Health Outpatient Services	104	LICENSED PROFESSIONAL CLINICAL COUNSELOR - GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3960 INDUSTRIAL BLVD	600	WEST SACRAMENTO	CA	95691	3496	57	06113	38.57029234	-121.5767941	Yolo County
243339	Fee-for-Service	1912179896	1912179896	1	1	HERDER, CLARE L LMFT	5/11/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	27186 NEWPORT RD	STE 2/B2	MENIFEE	CA	92584	7385	33	06065	33.68505447	-117.1854	Riverside County
243340	Fee-for-Service	1962715250	1962715250	1	1	HJORT, JAMES R LCSW	11/9/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11980 SAN VICENTE BLVD.	102	LOS ANGELES	CA	90049	5012	19	06037	34.05221538	-118.4721745	Los Angeles County
243372	Fee-for-Service	1306409677	1306409677	1	1	HIGGINBOTHAM, DEVAN MD	8/1/2024	390200000X	NA	Other	026	PHYSICIANS	None	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
243382	Fee-for-Service	1184003626	1184003626	1	1	HU, PEIFEN S MD	10/6/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	144723	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
243402	Fee-for-Service	1316121403	1316121403	1	1	HE, FENG YUN CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	5940 STOCKTON BLVD	None	SACRAMENTO	CA	95824	3039	34	06067	38.518101	-121.440708	Sacramento County
243443	Fee-for-Service	1548767494	1548767494	1	1	HENSON, PRISCILLA A MD	2/26/2021	207P00000X	NA	Other	026	PHYSICIANS	165181	None	None	0	In state provider	None	869 N CHERRY ST	None	TULARE	CA	93274	2207	54	06107	36.220932	-119.337698	Tulare County
243477	Fee-for-Service	1194058248	1194058248	1	1	HARARY, SAMUEL K PSYD	4/30/2015	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
243524	Fee-for-Service	1053366344	1053366344	1	1	HARANATH, SAI P MD	4/28/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84840	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1505 S MAIN STREET	None	WALNUT CREEK	CA	94596	0000	07	06013	37.89003052	-122.0574583	Contra Costa County
243551	Fee-for-Service	1801249370	1801249370	1	1	HANGER PROSTHETICS &	10/31/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	7700 IMPERIAL HWY	STE B2	DOWNEY	CA	90242	3469	19	06037	33.92670648	-118.1580043	Los Angeles County
243594	Fee-for-Service	1487120374	1487120374	1	1	HORIZON FAMILY AND COMMUNITY	10/6/2021	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	None	3960 INDUSTRIAL BLVD	600	WEST SACRAMENTO	CA	95691	3496	57	06113	38.57029234	-121.5767941	Yolo County
243628	Fee-for-Service	1396476388	1396476388	1	1	HORIZON CBAS INC	7/27/2023	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	1035 S. HARBISON AVE	None	NATIONAL CITY	CA	91950	3919	37	06073	32.68288448	-117.0743919	San Diego County
243687	Fee-for-Service	1376040667	1376040667	1	1	HUNG, JENNY L MD	4/30/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	165477	None	None	0	In state provider	None	1120 W LA VETA AVE	STE 125	ORANGE	CA	92868	4235	30	06059	33.78029455	-117.864369	Orange County
243695	Fee-for-Service	1952375958	1952375958	1	1	HO, ARTHUR C MD	7/22/2005	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
243704	Fee-for-Service	1528153244	1528153244	1	1	HUMAN TOUCH HOME HEALTH CARE	7/30/2010	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY INC	3629 N SEPULVEDA BLVD	STE 101	MANHATTAN BEACH	CA	90266	3632	19	06037	33.90129	-118.396299	Los Angeles County
243729	Fee-for-Service	1437547940	1437547940	1	1	HELD, MARK M PHD	5/14/2015	No Taxonomy Provided	NA	None	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
243757	Fee-for-Service	1194879718	1194879718	1	1	HUANG, JAMES H MD	9/30/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72870	08	Family Practice	0	In state provider	None	21840 NORMANDIE AVE	STE 100	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
243763	Fee-for-Service	1962426924	1962426924	1	1	HANNAMAN, ALEXANDER MD	4/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82788	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
243767	Fee-for-Service	1851812499	1851812499	1	1	HAYYAT, UMER MD	9/16/2020	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	169544	41	Internal Medicine	0	In state provider	None	465 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3320	54	06107	36.06953472	-119.0273379	Tulare County
243789	Fee-for-Service	1871785360	1871785360	1	1	HONG, DONNA M	9/21/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	10906 VALLEY MALL	None	EL MONTE	CA	91731	2616	19	06037	34.07569098	-118.0370272	Los Angeles County
243847	Fee-for-Service	1679109581	1679109581	1	1	HONIG, FRANS DO	8/12/2024	363LX0001X	NA	Nurse Practitioner	026	PHYSICIANS	22796	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
243854	Fee-for-Service	1285204537	1285204537	1	1	HOPPER, LAURYN E CRNA	8/1/2023	367500000X	NA	Other	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
243862	Fee-for-Service	1366550360	1366550360	2	1	HEMET VALLEY AMBULANCE	4/22/2016	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	208 E DEVONSHIRE AVE	None	HEMET	CA	92543	5416	33	06065	33.75119447	-116.9702325	Riverside County
243867	Fee-for-Service	1578897690	1578897690	1	1	HOSPITALIST MEDICINE PHYSICI	1/14/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	ANS OF IMPERIAL COUNTY I	207 W LEGION RD	None	BRAWLEY	CA	92227	7780	13	06025	32.95809	-115.5537045	Imperial County
243906	Fee-for-Service	1477558427	1477558427	1	1	HUSBAND, GEORGE G MD	8/10/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	21850	02	General Surgery	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
243930	Fee-for-Service	1699064378	1699064378	1	1	HARTER, MELISSA E LCSW	1/30/2024	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
243935	Fee-for-Service	1457488587	1457488587	1	1	HOLLOWAY. ROBERT P MD	2/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55346	26	Psychiatry (child)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
243969	Fee-for-Service	1003095696	1003095696	1	1	HALPIN, TIMOTHY L DO	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	10182	08	Family Practice	0	In state provider	None	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
243990	Fee-for-Service	1245498716	1245498716	1	1	HER, SOU	10/27/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	11874	None	None	0	In state provider	None	2800 N CALIFORNIA ST	SUITE 10	STOCKTON	CA	95204	3759	39	06077	37.97782434	-121.2919633	San Joaquin County
244018	Fee-for-Service	1114250362	1114250362	1	1	HARTMEISTER, MICHELLE R PT	7/14/2011	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
244024	Fee-for-Service	1104105535	1104105535	1	1	HABIB, MANAL MD	4/23/2021	2080P0205X	NA	Endocrinology	026	PHYSICIANS	130937	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
244043	Fee-for-Service	1699712844	1699712844	1	1	HATCH, GEORGE F III MD	2/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83116	20	Orthopedic Surgery	0	In state provider	None	1520 SAN PABLO STREET	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
244044	Fee-for-Service	1063561512	1063561512	1	1	HUYNH, TUAN K OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1105 N STATE COLLEGE BLV	None	ANAHEIM	CA	92806	2704	30	06059	33.848865	-117.889349	Orange County
244055	Fee-for-Service	1023149440	1023149440	1	1	HUMPHRIES, SIMON A MD	6/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	67109	41	Internal Medicine	0	In state provider	None	811 ALTOS OAKS DR	STE 2	LOS ALTOS	CA	94024	5427	43	06085	37.35937193	-122.0923298	Santa Clara County
244115	Fee-for-Service	1285722876	1285722876	1	6	HARRIS CARE CENTERS, INC	10/14/2008	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	2420 W GLENOAKS AVE	None	ANAHEIM	CA	92801	3225	30	06059	33.84319261	-117.9688626	Orange County
244117	Fee-for-Service	1134262942	1134262942	1	1	HOANG, ANNA DC	7/1/2001	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	THE NECK & BACK DOCTORS	567 SUMMERFIELD RD	STE C	SANTA ROSA	CA	95405	5285	49	06097	38.453157	-122.6716965	Sonoma County
244167	Fee-for-Service	1770946816	1770946816	1	1	HUYNH, THANH-AN N DO	6/14/2020	208M00000X	NA	Other	026	PHYSICIANS	16675	None	None	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
244181	Fee-for-Service	1528268158	1528268158	1	1	HEINZ, THOMAS R MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	32045	22	Pathology (M.D. only)	0	In state provider	None	280 S MAIN ST	None	ORANGE	CA	92868	3852	30	06059	33.784695	-117.867327	Orange County
244209	Fee-for-Service	1407191356	1407191356	1	2	HIGH DESERT PATHOLOGY MEDICA	1/11/2018	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	1025 S ANAHEIM BLVD	None	ANAHEIM	CA	92850	5806	30	06059	33.81994338	-117.9087416	Orange County
244224	Fee-for-Service	1457488587	1457488587	1	1	HOLLOWAY. ROBERT P MD	2/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55346	36	Psychiatry	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
244255	Fee-for-Service	1689751687	1689751687	1	1	HUMBOLDT CO HLTH DEPT	12/9/1987	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	LABORATORY	529 I ST	None	EUREKA	CA	95501	1116	12	06023	40.80213826	-124.162569	Humboldt County
244256	Fee-for-Service	1760473003	1760473003	1	1	HOANG,KIM 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	5656 S POWER RD	None	GILBERT	AZ	85295	0000	00	None	33.31386	-111.6877185	Maricopa County
244283	Fee-for-Service	1982873055	1982873055	1	1	HORN, HEATHER M	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
244312	Fee-for-Service	1669461208	1669461208	1	1	HUTH, MARK M MD	3/5/1996	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	-	06	Cardiovascular Disease (M.D. only)	2	Out of state provider	None	555 BLACK OAK DR	STE 200	MEDFORD	OR	97504	8491	00	None	42.318873	-122.835653	Jackson County
244315	Fee-for-Service	1912007097	1912007097	1	1	HEALTHCARE CALIFORNIA	3/30/2005	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	6327 N FRESNO ST	104	FRESNO	CA	93710	5236	10	06019	36.82875536	-119.781417	Fresno County
244355	Fee-for-Service	1710290382	1710290382	1	1	HWANG, DAYE OD	5/20/2011	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	833 S WESTERN AVE	STE 2	LOS ANGELES	CA	90005	3376	19	06037	34.057368	-118.309118	Los Angeles County
244398	Fee-for-Service	1780715557	1780715557	1	1	HRUSKA, KARIM M. MD	2/13/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1400 E BOULDER	None	COLORADO SPGS	CO	80909	5533	00	None	38.8388119	-104.7995065	El Paso County
244406	Fee-for-Service	1154077493	1154077493	1	1	HUYNH, MARY T	12/6/2022	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
244425	Fee-for-Service	1093787459	1093787459	1	1	HARDER, MARK H OD	4/25/2006	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	MARK HARDER OPTOMETRY	501 E ORANGEBURG AVE	STE B	MODESTO	CA	95350	5578	50	06099	37.66366051	-120.986838	Stanislaus County
244434	Fee-for-Service	1275896219	1275896219	1	1	HAYASE, JUSTIN H H MD	9/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	127730	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
244517	Fee-for-Service	1306093158	1306093158	1	1	HARLAN, SUSAN R MD	11/2/2010	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	109961	30	Radiology	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
244533	Fee-for-Service	1659991966	1659991966	1	2	HAMBARTZHUMIAN, RAPHI MD	5/8/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	183680	-	NOT APPLICABLE	0	In state provider	None	2101 E 1ST ST	None	SANTA ANA	CA	92705	4007	30	06059	33.74575646	-117.836901	Orange County
244568	Fee-for-Service	1093576894	1093576894	1	1	HUMBLED BY MOTHERHOOD INC.	7/13/2024	261QM1300X	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
244595	Fee-for-Service	1538233416	1538233416	1	1	HANGER P & O WEST INC	9/1/1997	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	88 ROWLAND WAY	SUITE 175	NOVATO	CA	94949	6231	21	06041	38.09521518	-122.5589697	Marin County
244617	Fee-for-Service	1881892685	1881892685	1	1	HELMS, ALLISON M MD	9/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8303	01	General Practice	0	In state provider	None	30 BRENNAN ST	None	WATSONVILLE	CA	95076	4303	44	06087	36.91346025	-121.7577455	Santa Cruz County
244631	Fee-for-Service	1154584738	1154584738	1	1	HABIBI, AHMAD	9/11/2015	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1635 E LINCOLN AVE	None	ORANGE	CA	92865	1929	30	06059	33.83499747	-117.8370225	Orange County
244650	Fee-for-Service	1578622544	1578622544	1	1	HEARING SOLUTIONS	9/1/1998	237600000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	175 N JACKSON AVE	STE 204	SAN JOSE	CA	95116	1909	43	06085	37.36217918	-121.8472051	Santa Clara County
244674	Fee-for-Service	1235536186	1235536186	1	1	HOLNESS, STEVEN R MD	7/1/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	139973	30	Radiology	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
244693	Fee-for-Service	1790120939	1790120939	1	1	HUSSAIN, MUNEEB S MD	4/5/2017	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	142980	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
244713	Fee-for-Service	1205416609	1205416609	1	1	HENDERSON, JAMES A LMFT	1/3/2022	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
244715	Fee-for-Service	1366640104	1366640104	1	1	HSU, LI-CHIN	4/5/2011	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
244746	Fee-for-Service	1497704548	1497704548	1	1	HEALTH-O-MED, INC	5/11/2009	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	7606 SANTA MONICA BLVD	None	LOS ANGELES	CA	90046	6409	19	06037	34.0907367	-118.3555779	Los Angeles County
244757	Fee-for-Service	1043384936	1043384936	1	1	HANGER PROSTHETICS &	6/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	69730 HIGHWAY 111	STE 107	RANCHO MIRAGE	CA	92270	2873	33	06065	33.7728798	-116.4474207	Riverside County
244795	Fee-for-Service	1811342751	1811342751	1	1	HANNA, HANAA MD INC	12/7/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52577	40	Pediatrics	0	In state provider	None	887 W 9TH ST	None	SAN PEDRO	CA	90731	3603	19	06037	33.73604049	-118.296558	Los Angeles County
244823	Fee-for-Service	1548602287	1548602287	1	1	HORIZONS PHARMACY SERVICES	8/11/2014	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	PC	15951 LOS GATOS BLVD	SUITE 12	LOS GATOS	CA	95032	3428	43	06085	37.23692447	-121.9625977	Santa Clara County
244826	Fee-for-Service	1053394676	1053394676	1	1	HOM, SOPHIA S MD	2/8/2015	208G00000X	NA	General Surgery	026	PHYSICIANS	70336	33	Thoracic Surgery	0	In state provider	None	1245 WILSHIRE BLVD	STE 804	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
244860	Fee-for-Service	1942518691	1942518691	1	1	HSU, LILLIAN Y MD	5/24/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119471	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
244877	Fee-for-Service	1477631018	1477631018	1	1	HUYNH, CURTIS C MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77558	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
244910	Fee-for-Service	1811239007	1811239007	1	1	HERRICK, MATTHEW P MD	9/14/2017	207P00000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2825 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	6039	34	06067	38.570805	-121.4696385	Sacramento County
244935	Fee-for-Service	1033725478	1033725478	1	1	HAPPY MED INC.	11/3/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	210 S GRAND AVE	STE 116	GLENDORA	CA	91741	4262	19	06037	34.133859	-117.872523	Los Angeles County
244946	Fee-for-Service	1447281878	1447281878	1	1	HOPKINS,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	0000	00	None	39.14105892	-84.50040782	Hamilton County
244963	Fee-for-Service	1124130620	1124130620	2	2	HARMONY HEALTH MEDICAL CLINI	8/12/2015	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1908 N BEALE ROAD	SUITE E	MARYSVILLE	CA	95901	6937	58	06115	39.1278388	-121.5457994	Yuba County
244967	Fee-for-Service	1316981640	1316981640	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	26440 LA ALAMEDA	#320	MISSION VIEJO	CA	92691	6304	30	06059	33.5636138	-117.6689254	Orange County
244972	Fee-for-Service	1881652394	1881652394	1	1	HUANG, BRYAN J MD	11/17/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87875	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
244979	Fee-for-Service	1417590555	1417590555	1	1	HORIZON VIEW HOSPICE INC	11/30/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	232 N LAKE AVE	SUITE 225	PASADENA	CA	91101	1862	19	06037	34.150005	-118.1323505	Los Angeles County
245020	Fee-for-Service	1124359369	1124359369	1	1	HEALTHCARE SERVICES, INC.	12/13/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1320, 1330, & 1340 WEST	None	ANAHEIM	CA	92801	5940	30	06059	33.81427746	-117.923991	Orange County
245031	Fee-for-Service	1124599444	1124599444	1	1	HELPLINE YOUTH COUNSELING	6/21/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	920 ATLANTIC AVENUE	101-102	LONG BEACH	CA	90813	4545	19	06037	33.778215	-118.185024	Los Angeles County
245032	Fee-for-Service	1902056732	1902056732	2	1	HEALTHMARK PHARMACY INC	3/8/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	222 WEST EULALIA ST	STE 212	GLENDALE	CA	91204	2851	19	06037	34.12653215	-118.257121	Los Angeles County
245067	Fee-for-Service	1376067280	1376067280	1	1	HAO, SELENA NP	10/20/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	43	06085	37.43378232	-121.8920598	Santa Clara County
245072	Fee-for-Service	1083673172	1083673172	1	1	HONGKHAM, ALEX S MD	6/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	94258	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
245089	Fee-for-Service	1437121142	1437121142	1	1	HUNTINGTON MEMORIAL HOSP	1/1/1995	273R00000X	NA	Other	072	MENTAL HEALTH INPATIENT SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3097	19	06037	34.133598	-118.1534895	Los Angeles County
245100	Fee-for-Service	1346698149	1346698149	1	1	HILOW, ELIZABETH MD	3/15/2024	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	-	10	Gastroenterology (M.D. only)	2	Out of state provider	None	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	None	33.478749	-112.0426515	Maricopa County
245103	Fee-for-Service	1750410353	1750410353	1	1	HOLMES, ANITA LCSW	1/11/2025	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
245106	Fee-for-Service	1750342242	1750342242	1	1	HENNESSEY, SEAN P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	41883	08	Family Practice	0	In state provider	None	220 HOSPITAL DR	None	VALLEJO	CA	94589	2517	48	06095	38.13109785	-122.238998	Solano County
245111	Fee-for-Service	1386809093	1386809093	1	1	HAN, HUI MD	2/19/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97913	25	Physical Medicine and Rehabilitation	0	In state provider	None	1721 W YOSEMITE AVE	None	MANTECA	CA	95337	5130	39	06077	37.79735353	-121.2443415	San Joaquin County
245115	Fee-for-Service	1053394676	1053394676	1	1	HOM, SOPHIA S MD	2/8/2015	208G00000X	NA	General Surgery	026	PHYSICIANS	70336	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1245 WILSHIRE BLVD	STE 804	LOS ANGELES	CA	90017	4808	19	06037	34.05362775	-118.2661889	Los Angeles County
245134	Fee-for-Service	1881285633	1881285633	2	1	HORNE, DANIELLE LPCC	4/15/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1460 MARIA LN	300	WALNUT CREEK	CA	94596	8802	07	06013	37.89249772	-122.0566087	Contra Costa County
245163	Fee-for-Service	1659339059	1659339059	1	1	HU, MARY Y MD	9/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	84011	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
245215	Fee-for-Service	1871513747	1871513747	1	1	HARBAUGH, ROBERT D	8/31/1988	2084N0400X	NA	Neurology	026	PHYSICIANS	48884	13	Neurology (M.D. only)	0	In state provider	None	219 NOGALES AVE	STE F	SANTA BARBARA	CA	93105	3848	42	06083	34.43171016	-119.7220176	Santa Barbara County
245219	Fee-for-Service	1164627832	1164627832	1	1	HIBBS, NICOLE M MD	10/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	106600	40	Pediatrics	0	In state provider	None	550 WASHINGTON ST	STE 300	SAN DIEGO	CA	92103	2227	37	06073	32.75003652	-117.1603431	San Diego County
245229	Fee-for-Service	1417663105	1417663105	1	1	HAYWARD SNF HEALTHCARE LLC	3/1/2023	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1628 B ST	None	HAYWARD	CA	94541	3020	01	06001	37.6795481	-122.0717846	Alameda County
245248	Fee-for-Service	1124130620	1124130620	2	2	HARMONY HEALTH MEDICAL CLINI	8/12/2015	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1908 N BEALE ROAD	SUITE E	MARYSVILLE	CA	95901	6937	58	06115	39.1278388	-121.5457994	Yuba County
245267	Fee-for-Service	1417590555	1417590555	1	1	HORIZON VIEW HOSPICE INC	11/30/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	232 N LAKE AVE	SUITE 225	PASADENA	CA	91101	1862	19	06037	34.150005	-118.1323505	Los Angeles County
245361	Fee-for-Service	1578509741	1578509741	1	1	HUGHES-WATKINS,ELISE M M	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80317	41	Internal Medicine	0	In state provider	None	106 LACASA VIA	#100	WALNUT CREEK	CA	94598	0000	07	06013	37.91266782	-122.042913	Contra Costa County
245376	Fee-for-Service	1437486891	1437486891	1	1	HANSRA, NINA MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111136	07	Dermatology	0	In state provider	None	2345 FAIR OAKS BLVD	None	SACRAMENTO	CA	95825	4708	34	06067	38.57535	-121.407633	Sacramento County
245422	Fee-for-Service	1467500686	1467500686	1	1	HALLISEY, JOHN W MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	25366	18	Ophthalmology	0	In state provider	None	1270 PEACH ST	STE 100	SAN LUIS OBISPO	CA	93401	2856	40	06079	35.28673322	-120.6595429	San Luis Obispo County
245430	Fee-for-Service	1205239332	1205239332	1	1	HARDING, STEPHEN A MD	1/1/2022	207P00000X	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
245440	Fee-for-Service	1689735888	1689735888	1	1	HIDALGO, VILMA L MD	9/5/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	91436	36	Psychiatry	0	In state provider	None	1423 N TRACY BLVD	None	TRACY	CA	95376	3445	39	06077	37.74413972	-121.435077	San Joaquin County
245494	Fee-for-Service	1033283916	1033283916	1	1	HANGER P & O WEST INC	9/1/1998	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	436 E YOSEMITE AVE	SUITE C	MERCED	CA	95340	8400	24	06047	37.33211553	-120.461976	Merced County
245506	Fee-for-Service	1134381577	1134381577	1	1	HIDAJI, LILLIE	6/20/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3196 S MARYLAND PKWY	None	LAS VEGAS	NV	89109	2305	00	None	36.13194	-115.136873	Clark County
245511	Fee-for-Service	1316062821	1316062821	1	1	HSU, JENNY C W MD	5/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	65454	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
245520	Fee-for-Service	1114203098	1114203098	1	1	HORMOZI, TANIA LMFT	4/1/2020	101YA0400X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	591 CAMINO DE LA REINA	SUITE 210	SAN DIEGO	CA	92108	3104	37	06073	32.76632791	-117.1616245	San Diego County
245539	Fee-for-Service	1760575849	1760575849	1	1	HOWREY,RICHARD P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	COOK CHILDREN'S PHYS	1500 COOPER ST	None	FORT WORTH	TX	76104	2710	00	None	32.73654147	-97.341327	Tarrant County
245553	Fee-for-Service	1134697816	1134697816	1	1	HIRANI, RIKESH PT	3/13/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1045 W REDONDO BEACH BLV	130	GARDENA	CA	90247	4129	19	06037	33.89247044	-118.2931941	Los Angeles County
245624	Fee-for-Service	1124106851	1124106851	1	1	HOEHN, THEODORE W MD	4/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	44013	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
245649	Fee-for-Service	1821259953	1821259953	1	1	HERNANDEZ, GERTRUDES A PHD	2/26/2015	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
245688	Fee-for-Service	1992806426	1992806426	1	1	HAMILTON, LUCILLE M LCSW	4/16/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
245697	Fee-for-Service	1184618548	1184618548	1	1	HOPKINS COUNTY MEMORIAL	1/14/2002	282NR1301X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	115 AIRPORT RD	None	SULPHUR SPGS	TX	75482	2105	00	None	33.15631021	-95.60008732	Hopkins County
245749	Fee-for-Service	1811056294	1811056294	1	1	HILL, WES LEE MD	2/27/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	118906	02	General Surgery	0	In state provider	None	300 W HUNTINGTON DR	None	ARCADIA	CA	91007	3402	19	06037	34.13489987	-118.0424069	Los Angeles County
245786	Fee-for-Service	1871056143	1871056143	1	1	HONG, HYO JUNG MD	6/12/2023	207L00000X	NA	Other	026	PHYSICIANS	181787	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
245877	Fee-for-Service	1326010620	1326010620	1	3	HUNT, JAMES MD	10/17/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	78304	18	Ophthalmology	0	In state provider	None	1255 TRAVIS BLVD	None	FAIRFIELD	CA	94533	4801	48	06095	38.25815459	-122.0487714	Solano County
245925	Fee-for-Service	1780047795	1780047795	1	1	HWANG, LINDSAY MD	9/9/2021	2085R0001X	NA	Other	026	PHYSICIANS	153492	None	None	0	In state provider	None	1520 SAN PABLO ST	STE 1000A	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
245929	Fee-for-Service	1750314167	1750314167	1	1	HUTNICK, LANA S DC	1/13/2021	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
245952	Fee-for-Service	1437771680	1437771680	1	1	HAMIDI, ZAHRA NP	12/1/2021	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2825 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	6039	34	06067	38.570805	-121.4696385	Sacramento County
245980	Fee-for-Service	1508067489	1508067489	1	1	HSIAI, TZUNG K MD	10/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	79671	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
245983	Fee-for-Service	1659673788	1659673788	1	1	HAGA HOSPICE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1403 W LOMITA BLVD	STE 303A	HARBOR CITY	CA	90710	2085	19	06037	33.79785936	-118.3016552	Los Angeles County
245985	Fee-for-Service	1184618548	1184618548	1	1	HOPKINS COUNTY MEMORIAL	1/14/2002	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	HOSPITAL	115 AIRPORT RD	None	SULPHUR SPGS	TX	75482	2105	00	None	33.15631021	-95.60008732	Hopkins County
245989	Fee-for-Service	1083781298	1083781298	1	1	HUANG, HAI-FENG MD	7/1/1995	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	79672	40	Pediatrics	0	In state provider	None	100 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3010	19	06037	34.133598	-118.1534895	Los Angeles County
245995	Fee-for-Service	1932626074	1932626074	1	1	HUEBER, PIERRE-ALAIN MD	9/28/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	151426	34	Urology and Urological Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0112	19	06037	34.06169385	-118.2044698	Los Angeles County
245997	Fee-for-Service	1447348461	1447348461	1	1	HEDDEN, LAURIE E MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45591	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 W I ST	STE A	LOS BANOS	CA	93635	3459	24	06047	37.06347448	-120.858102	Merced County
246002	Fee-for-Service	1326542291	1326542291	1	1	HOFFMAN, DANIEL B MD	3/2/2022	208600000X	NA	General Surgery	026	PHYSICIANS	164231	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
246014	Fee-for-Service	1700078680	1700078680	1	1	HOANG, NGHI V MD	8/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102276	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
246018	Fee-for-Service	1861570624	1861570624	1	1	HONG, MARY S MD	9/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	61806	41	Internal Medicine	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
246024	Fee-for-Service	1104138114	1104138114	1	1	HUEY, ROBYN E NP	8/1/2013	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
246066	Fee-for-Service	1992837181	1992837181	1	1	HUNTER, MARIDEE T PHD	3/12/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	340 VICTORIA STREET	None	COSTA MESA	CA	92327	1914	30	06059	33.65263167	-117.9138606	Orange County
246082	Fee-for-Service	1902165707	1902165707	1	1	HOY, VANESSA C MD	7/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149657	05	Anesthesiology	0	In state provider	None	505 PARNASSUS AVENUE	None	SAN FRANCISCO	CA	94143	2204	38	06075	37.7634502	-122.4579779	San Francisco County
246102	Fee-for-Service	1922035963	1922035963	1	1	HUSSAIN, SABA MD	10/31/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93649	08	Family Practice	0	In state provider	None	1207 FAIRCHILD CT	None	WOODLAND	CA	95695	4321	57	06113	38.6657551	-121.7922645	Yolo County
246162	Fee-for-Service	1336815703	1336815703	1	1	HANDY, PAULETTE LCSW	11/1/2024	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
246207	Fee-for-Service	1588759062	1588759062	2	1	HORENSTEIN, JANET M MD	8/24/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	35255	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1400 S GRAND AVE	#711	LOS ANGELES	CA	90015	3048	19	06037	34.03692236	-118.2655238	Los Angeles County
246209	Fee-for-Service	1063525897	1063525897	1	1	HURLEY, CATHERINE M MD	4/22/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	73864	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
246223	Fee-for-Service	1114022332	1114022332	1	1	HUNGS, MARCEL MD	7/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	84845	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
246238	Fee-for-Service	1851389878	1851389878	1	1	HAUPT, DAVID J DPM	8/22/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	400 NEWPORT CENTER DRIVE	SUITE 706	NEWPORT BEACH	CA	92660	7661	30	06059	33.6142606	-117.8726808	Orange County
246268	Fee-for-Service	1982131637	1982131637	1	1	HERRERA, LANDON J MD	7/1/2020	207P00000X	NA	Other	026	PHYSICIANS	161989	66	Emergency Medicine (Urgent Care)	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
246270	Fee-for-Service	1659673788	1659673788	1	1	HAGA HOSPICE INC	6/30/2012	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1403 W LOMITA BLVD	STE 303A	HARBOR CITY	CA	90710	2085	19	06037	33.79785936	-118.3016552	Los Angeles County
246340	Fee-for-Service	1326466426	1326466426	1	1	HUANG, ANDY MD	6/24/2020	390200000X	NA	Other	026	PHYSICIANS	139362	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
246354	Fee-for-Service	1699721498	1699721498	1	1	HAN, LIZ Y MD	11/16/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	112111	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
246370	Fee-for-Service	1831919729	1831919729	1	1	HUET, CATHLEEN LCSW	11/19/2024	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
246377	Fee-for-Service	1265170427	1265170427	1	1	HOFFMANN, ETHAN D PHD	12/9/2022	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
246390	Fee-for-Service	1215346382	1215346382	1	1	HORAN, TERRENCE R MD	9/2/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	140159	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
246412	Fee-for-Service	1437365590	1437365590	1	1	HONG, MIN LAC	5/5/2017	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	621 S VIRGIL AVE	STE 240	LOS ANGELES	CA	90005	4000	19	06037	34.06286314	-118.2870969	Los Angeles County
246448	Fee-for-Service	1861827685	1861827685	1	1	HWANG, KAREN PT	12/20/2018	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	855 N LARK ELLEN AVE	SUITE L	WEST COVINA	CA	91791	1099	19	06037	34.087707	-117.9166385	Los Angeles County
246508	Fee-for-Service	1992060693	1992060693	1	1	HENRY, MICHAEL M MD	12/9/2024	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
246511	Fee-for-Service	1689785024	1689785024	1	1	HERRON, DANIEL E MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	88946	30	Radiology	0	In state provider	None	6660 COYLE AVE	None	CARMICHAEL	CA	95608	6360	34	06067	38.667447	-121.3091505	Sacramento County
246512	Fee-for-Service	1366426694	1366426694	1	1	HSU, ANDREW A MD	3/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	36615	01	General Practice	0	In state provider	None	665 S KNICKERBOCKER DR	STE 8	SUNNYVALE	CA	94087	1059	43	06085	37.37243191	-122.0590527	Santa Clara County
246574	Fee-for-Service	1346930856	1346930856	1	1	HYGEIA APOTHECARY INC	1/26/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	21115 SHERMAN WAY	None	CANOGA PARK	CA	91303	1679	19	06037	34.20110949	-118.5934087	Los Angeles County
246608	Fee-for-Service	1275611857	1275611857	1	1	HJORTSVANG, ERICK W MD	11/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	79589	41	Internal Medicine	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
246626	Fee-for-Service	1326466426	1326466426	1	1	HUANG, ANDY MD	6/24/2020	390200000X	NA	Other	026	PHYSICIANS	139362	06	Cardiovascular Disease (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
246630	Fee-for-Service	1659960912	1659960912	1	1	HEMERA HOSPICE CARE LLC	6/21/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	3221 N SAN FERNANDO RD	STE H	LOS ANGELES	CA	90065	1414	19	06037	34.11630202	-118.2472203	Los Angeles County
246678	Fee-for-Service	1649434390	1649434390	2	1	HUYNH, CHAU Q MD	4/21/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	84403	30	Radiology	0	In state provider	None	101 EAST VALENCIA DR	None	FULLERTON	CA	92835	3809	30	06059	33.8662563	-117.9241995	Orange County
246685	Fee-for-Service	1619290459	1619290459	1	1	HEWITT, JILL A MFT	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	52017	-	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
246687	Fee-for-Service	1437450624	1437450624	1	1	HERNANDEZ, WILFREDO L MD INC	4/18/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	26402	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1513 S GRAND AVENUE	STE 400	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
246693	Fee-for-Service	1306292875	1306292875	1	1	HUNG, BETHANY M MD	6/29/2022	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	165556	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
246725	Fee-for-Service	1053388876	1053388876	1	1	HAMEDANINIA, AZAR MD	12/31/1992	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51456	40	Pediatrics	0	In state provider	None	1635 3RD AVE	STE J	CHULA VISTA	CA	91911	5867	37	06073	32.59663479	-117.064444	San Diego County
246732	Fee-for-Service	1942294285	1942294285	1	1	HORTA, ELISA E MD, MPH	5/25/2004	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	72518	None	None	0	In state provider	PROFESSIONAL MED CORP	2050 LYNDELL TERRACE	STE 150	DAVIS	CA	95616	6206	57	06113	38.56307228	-121.7693602	Yolo County
246753	Fee-for-Service	1861711756	1861711756	1	1	HANCOCK, JULIE M	11/2/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1687 ERRINGER ROAD	STE 109	SIMI VALLEY	CA	93065	3357	56	06111	34.268886	-118.761426	Ventura County
246781	Fee-for-Service	1386063790	1386063790	1	1	HU, JIANAN PHD	6/5/2020	103T00000X	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
246799	Fee-for-Service	1215122346	1215122346	1	3	HEALTH LINK	6/16/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	BRANCH	1280 CIVIC DR	SUITE 105	WALNUT CREEK	CA	94596	7233	07	06013	37.90426462	-122.0595246	Contra Costa County
246804	Fee-for-Service	1366426694	1366426694	1	1	HSU, ANDREW A MD	3/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	36615	13	Neurology (M.D. only)	0	In state provider	None	665 S KNICKERBOCKER DR	STE 8	SUNNYVALE	CA	94087	1059	43	06085	37.37243191	-122.0590527	Santa Clara County
246847	Fee-for-Service	1093821100	1093821100	1	1	HUYNH, CHINH V MD	3/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	44038	01	General Practice	0	In state provider	None	9411 BOLSA AVE	STE B	WESTMINSTER	CA	92683	5980	30	06059	33.7449829	-117.9639338	Orange County
246883	Fee-for-Service	1831288273	1831288273	1	1	HATCH, CHRISTOPHER G MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	72894	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
246901	Fee-for-Service	1093101586	1093101586	1	1	HANAWAY, TIMOTHY D MD	12/13/2022	207P00000X	NA	Other	026	PHYSICIANS	172707	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
246902	Fee-for-Service	1891727889	1891727889	1	1	HERNANDEZ, MICHAEL N PT	12/1/1999	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	260 COHASSET RD	STE 185	CHICO	CA	95926	2210	04	06007	39.754035	-121.851117	Butte County
246913	Fee-for-Service	1174503338	1174503338	1	1	HORSPOOL, JAMES C DO	1/1/1998	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	6948	40	Pediatrics	0	In state provider	None	525 3RD AVE	None	CHULA VISTA	CA	91910	5616	37	06073	32.63367609	-117.0769202	San Diego County
246920	Fee-for-Service	1659960912	1659960912	1	1	HEMERA HOSPICE CARE LLC	6/21/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	3221 N SAN FERNANDO RD	STE H	LOS ANGELES	CA	90065	1414	19	06037	34.11630202	-118.2472203	Los Angeles County
246926	Fee-for-Service	1396011870	1396011870	1	1	HEALTHY LIVING AT HOME-SAN D	5/13/2021	251E00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	IEGO, LLC.	334 VIA VERA CRUZ	SUITE 150	SAN MARCOS	CA	92078	2638	37	06073	33.13698477	-117.1888034	San Diego County
246972	Fee-for-Service	1770927949	1770927949	1	1	HYUN, SUZANNE MD	7/27/2018	207L00000X	NA	Other	026	PHYSICIANS	132481	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
246976	Fee-for-Service	1437450624	1437450624	1	1	HERNANDEZ, WILFREDO L MD INC	4/18/2012	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	26402	78	Neoplastic Diseases/Oncology	0	In state provider	None	1513 S GRAND AVENUE	STE 400	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
247015	Fee-for-Service	1821393059	1821393059	1	1	HORN, KRISTLE NP	4/13/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
247020	Fee-for-Service	1003014028	1003014028	1	1	HART, AMY D LMFT	6/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4405 W RIVERSIDE DR	STE 106	BURBANK	CA	91505	4050	19	06037	34.15222929	-118.3480509	Los Angeles County
247050	Fee-for-Service	1548201023	1548201023	1	1	HASKIN, LEE PT	11/14/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1421 RIVERSIDE AVE	None	PASO ROBLES	CA	93446	1730	40	06079	35.62945249	-120.6871524	San Luis Obispo County
247056	Fee-for-Service	1487674792	1487674792	1	1	HATHOUT, EBA H MD	8/31/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	48523	40	Pediatrics	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
247058	Fee-for-Service	1013956176	1013956176	1	1	HUNAG, BENSON Y MD	7/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	1710 E SAUNDERS	B290	LAREDO	TX	78041	5530	00	None	27.532485	-99.4780755	Webb County
247066	Fee-for-Service	1578141214	1578141214	1	1	HERZEL, BENJAMIN J MD	7/1/2024	207P00000X	NA	Other	026	PHYSICIANS	189183	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7500 HOSPITAL DRIVE	None	SACRAMENTO	CA	95823	5403	34	06067	38.463381	-121.416183	Sacramento County
247071	Fee-for-Service	1316533359	1316533359	1	1	HOUSTON, JANAE BIRTH DOULA	4/7/2024	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
247073	Fee-for-Service	1356824726	1356824726	1	1	HUGHES, ALICE M	8/6/2024	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1251 E DYER RD	SUITE 150	SANTA ANA	CA	92705	5662	30	06059	33.70870351	-117.8551005	Orange County
247077	Fee-for-Service	1386962868	1386962868	1	1	HARIHARAN, LUXME MD	10/14/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132669	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
247108	Fee-for-Service	1932117207	1932117207	1	1	HADDEN,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	1401 N 10TH AVE	None	STAYTON	OR	97383	0000	00	None	44.805159	-122.7841775	Marion County
247118	Fee-for-Service	1679691810	1679691810	1	1	HOLLYWOOD SUNSET FREE CL	2/7/1997	261QA0005X	NA	Other	040	FREE CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	3324 W SUNSET BLVD	None	LOS ANGELES	CA	90026	2190	19	06037	34.08714277	-118.2756967	Los Angeles County
247126	Fee-for-Service	1578638664	1578638664	1	1	HUME, CAROLYN L MD	12/17/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	84324	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
247141	Fee-for-Service	1285709048	1285709048	1	1	HAMMON, LISA LMFT	8/3/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
247146	Fee-for-Service	1952478778	1952478778	1	1	HERSH, EDWARD G MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34232	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
247307	Fee-for-Service	1881753499	1881753499	1	1	HOWARD, ADAM B MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73481	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4733 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
247317	Fee-for-Service	1144883075	1144883075	1	1	HASAN, JAAN MD	6/15/2023	207P00000X	NA	Other	026	PHYSICIANS	184752	None	None	0	In state provider	None	350 HAWTHORNE AVE	None	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
247318	Fee-for-Service	1184881401	1184881401	1	1	HOGREFE, CHRISTOPHER P MD	12/29/2021	207P00000X	NA	Other	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
247340	Fee-for-Service	1790856250	1790856250	1	1	HOLCOMB, JUDITH G OD	10/16/2012	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	910 MAPLE STREET	None	REDWOOD CITY	CA	94063	2034	41	06081	37.48867968	-122.2222351	San Mateo County
247346	Fee-for-Service	1487674792	1487674792	1	1	HATHOUT, EBA H MD	8/31/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	48523	67	Endocrinology	0	In state provider	None	9851 MAGNOLIA AVE	None	RIVERSIDE	CA	92503	3528	33	06065	33.918192	-117.4547295	Riverside County
247347	Fee-for-Service	1013956176	1013956176	1	1	HUNAG, BENSON Y MD	7/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	1710 E SAUNDERS	B290	LAREDO	TX	78041	5530	00	None	27.532485	-99.4780755	Webb County
247389	Fee-for-Service	1285630343	1285630343	1	1	HAMMASH, MUHANNAD M MD	10/31/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	55978	41	Internal Medicine	0	In state provider	None	8510 BALBOA BLVD	STE 150	NORTHRIDGE	CA	91325	5810	19	06037	34.224507	-118.5026015	Los Angeles County
247390	Fee-for-Service	1023439031	1023439031	1	1	HARRIS, MARIAM LMFT	2/5/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17111 BEACH BLVD	STE 205	HUNTINGTON BEACH	CA	92647	5947	30	06059	33.713937	-117.9892085	Orange County
247427	Fee-for-Service	1659397065	1659397065	1	1	HADDOCK, NATHANIELD MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3260 HOSPITAL DR	None	JUNEAU	AK	99801	7808	00	None	58.32940561	-134.4658793	City and Borough of Juneau
247442	Fee-for-Service	1003923772	1003923772	1	1	HIROSE, KENZO MD	7/14/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	74280	02	General Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
247456	Fee-for-Service	1578666491	1578666491	1	1	HALE, WILLIAM R MD INC	7/31/1984	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	26646	20	Orthopedic Surgery	0	In state provider	None	1800 N ORANGE GROVE AVE	None	POMONA	CA	91767	3006	19	06037	34.07659799	-117.7490974	Los Angeles County
247466	Fee-for-Service	1750439667	1750439667	1	1	HAWRIN, CRAIG J MD	4/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	48776	20	Orthopedic Surgery	0	In state provider	None	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
247473	Fee-for-Service	1992272413	1992272413	1	1	HEIDRICH, LORENA PT	4/1/2019	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
247481	Fee-for-Service	1609834720	1609834720	1	1	HOMER, TERRI D MD	8/31/1983	207L00000X	NA	Other	026	PHYSICIANS	43639	05	Anesthesiology	0	In state provider	None	1375 SUTTER ST	STE 311	SAN FRANCISCO	CA	94109	5466	38	06075	37.78738239	-122.4229066	San Francisco County
247488	Fee-for-Service	1417097783	1417097783	1	1	HEARING AID CTR NTH PARK	1/1/1979	193400000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	3952 30TH ST	None	SAN DIEGO	CA	92104	3005	37	06073	32.74942584	-117.1301817	San Diego County
247515	Fee-for-Service	1750348363	1750348363	1	1	HOANG, THAO Y DO	10/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	6854	08	Family Practice	0	In state provider	None	2600 REDONDO AVE	None	LONG BEACH	CA	90806	2325	19	06037	33.806097	-118.151378	Los Angeles County
247530	Fee-for-Service	1649318973	1649318973	1	1	HABIB-SEDRAK, SUZY G MD	6/3/2008	207R00000X	NA	Other	026	PHYSICIANS	85992	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
247554	Fee-for-Service	1508894486	1508894486	1	1	HSIA, THOMAS P MD	2/8/2015	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	60975	10	Gastroenterology (M.D. only)	0	In state provider	None	525 PLAZA DR	STE 307	SANTA MARIA	CA	93454	6955	42	06083	34.93735341	-120.4286548	Santa Barbara County
247558	Fee-for-Service	1811457435	1811457435	1	1	HUSBANDS, TAISHA S MD	9/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	181342	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
247562	Fee-for-Service	1588842637	1588842637	1	1	HYACINTH, OCTAVIA CNP	5/24/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	19	06037	33.896799	-118.3959415	Los Angeles County
247563	Fee-for-Service	1154896553	1154896553	1	1	HINSHAW, TREVOR MD	11/27/2023	207R00000X	NA	Other	026	PHYSICIANS	185719	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
247636	Fee-for-Service	1245205715	1245205715	1	1	HOWARD STERLING	3/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	7026 OLD KATY RD	STE 276	HOUSTON	TX	77024	2187	00	None	29.78388299	-95.44503208	Harris County
247684	Fee-for-Service	1285945196	1285945196	1	1	HAMDI, ABDULRAHMAN A MD	2/25/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	147337	01	General Practice	0	In state provider	None	1646 E HERNDON AVE	STE 106	FRESNO	CA	93720	3380	10	06019	36.8375595	-119.757339	Fresno County
247737	Fee-for-Service	1225100043	1225100043	1	1	HOLSCLAW, DOUGLAS S MD	8/1/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	78601	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
247743	Fee-for-Service	1578852471	1578852471	1	1	HIGGINSON, SARA M MD	9/9/2019	208600000X	NA	General Surgery	026	PHYSICIANS	123464	02	General 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
247768	Fee-for-Service	1720271604	1720271604	1	1	HAMIDUZZAMAN, NIDA MD	9/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110641	41	Internal Medicine	0	In state provider	None	1520 SAN PABLO	STE 1000	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
247799	Fee-for-Service	1467559401	1467559401	1	1	HINDMAN, DAVID W PHD	2/17/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8939 S SEPULVEDA BLVD	SUITE #200	LOS ANGELES	CA	90045	3631	19	06037	33.95485856	-118.3962461	Los Angeles County
247802	Fee-for-Service	1992552228	1992552228	1	1	HIGHWAY MILES TRANSPORT INC	6/18/2024	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1602 YORKTOWN CT	None	TURLOCK	CA	95382	0778	50	06099	37.51748649	-120.866229	Stanislaus County
247849	Fee-for-Service	1376162511	1376162511	1	1	HIRABAYASHI, KYLE	8/25/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	3772 HOWE ST	None	OAKLAND	CA	94611	5311	01	06001	37.8243542	-122.2566075	Alameda County
247890	Fee-for-Service	1104847532	1104847532	1	1	HARRIS, STEVEN T MD	4/7/2022	207RE0101X	NA	Endocrinology	026	PHYSICIANS	30282	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
247953	Fee-for-Service	1821753542	1821753542	1	1	HUGHES, CRISTEL ANN T CNP	5/5/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	19353 VICTORY BLVD	None	RESEDA	CA	91335	6302	19	06037	34.18659936	-118.5552114	Los Angeles County
247967	Fee-for-Service	1881187177	1881187177	1	1	HOLMES, MICHAEL E PT	5/16/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1335 COFFEE RD	STE 200	MODESTO	CA	95355	3188	50	06099	37.66291854	-120.9756994	Stanislaus County
247981	Fee-for-Service	1508365206	1508365206	1	2	HEAL MEDICAL GROUP	11/1/2021	163WC1500X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	4276 54TH	C	SAN DIEGO	CA	92115	6011	37	06073	32.75444691	-117.0788921	San Diego County
247994	Fee-for-Service	1992296792	1992296792	1	1	HALL, ASHLEY E MD	8/2/2022	207P00000X	NA	Other	026	PHYSICIANS	178278	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
247995	Fee-for-Service	1730104860	1730104860	1	1	HUTCHINS, TY W MD	2/4/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	70724	None	None	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
248038	Fee-for-Service	1831518406	1831518406	1	1	HUNT, STEPHEN M MD	6/27/2018	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	2306	00	None	36.132948	-115.136874	Clark County
248057	Fee-for-Service	1487117289	1487117289	1	1	HEALTH ACCESS FOR ALL INC	4/23/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6120 SEVILLE AVENUE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98438021	-118.2226279	Los Angeles County
248072	Fee-for-Service	1407191356	1407191356	1	6	HIGH DESERT PATHOLOGY MEDICA	3/23/2023	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	22	Pathology (M.D. only)	0	In state provider	None	6655 ALVARADO ROAD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
248086	Fee-for-Service	1275849663	1275849663	1	1	HILL, TIANA M	11/8/2010	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
248159	Fee-for-Service	1003559642	1003559642	1	1	HERRERA, JASON E PT	4/28/2022	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
248164	Fee-for-Service	1942478086	1942478086	1	1	HSU, JIACHIAHN S MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95434	41	Internal Medicine	0	In state provider	None	520 N PROSPECT AVENUE	STE 103	REDONDO BEACH	CA	90277	3033	19	06037	33.8529819	-118.3802954	Los Angeles County
248187	Fee-for-Service	1891348918	1891348918	1	1	HOSPICE OF NATION INC	12/21/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	11835 W OLYMPIC BLVD	STE 830E	LOS ANGELES	CA	90064	5123	19	06037	34.03273663	-118.4516927	Los Angeles County
248207	Fee-for-Service	1316989445	1316989445	1	1	HORN, BARRY R MD	7/14/1976	No Taxonomy Provided	NA	None	026	PHYSICIANS	20988	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	2001 DWIGHT WAY	None	BERKELEY	CA	94704	2608	01	06001	37.86379498	-122.2689084	Alameda County
248222	Fee-for-Service	1699851279	1699851279	1	1	HELLAN, MINIA MD	6/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96294	78	Neoplastic Diseases/Oncology	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
248304	Fee-for-Service	1699091793	1699091793	1	1	HAMPTON, ALLISON T MD	11/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126293	40	Pediatrics	0	In state provider	None	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	07	06013	38.00403417	-121.8422798	Contra Costa County
248312	Fee-for-Service	1609219781	1609219781	1	1	HOOPS, HEATHER E MD	1/11/2021	2086S0127X	NA	General Surgery	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
248344	Fee-for-Service	1487117289	1487117289	1	1	HEALTH ACCESS FOR ALL INC	4/23/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	6120 SEVILLE AVENUE	None	HUNTINGTON PARK	CA	90255	2913	19	06037	33.98438021	-118.2226279	Los Angeles County
248359	Fee-for-Service	1407191356	1407191356	1	6	HIGH DESERT PATHOLOGY MEDICA	3/23/2023	207ZP0102X	NA	Other	022	PHYSICIANS GROUP	-	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	6655 ALVARADO ROAD	None	SAN DIEGO	CA	92120	5208	37	06073	32.77718098	-117.0571332	San Diego County
248369	Fee-for-Service	1104904895	1104904895	1	1	HUSSA, GREGORY A MD	10/29/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40034	41	Internal Medicine	0	In state provider	None	193 WASHINGTON ST	None	COALINGA	CA	93210	1643	10	06019	36.14375252	-120.3653565	Fresno County
248451	Fee-for-Service	1942478086	1942478086	1	1	HSU, JIACHIAHN S MD	10/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95434	40	Pediatrics	0	In state provider	None	520 N PROSPECT AVENUE	STE 103	REDONDO BEACH	CA	90277	3033	19	06037	33.8529819	-118.3802954	Los Angeles County
248456	Fee-for-Service	1881673911	1881673911	1	1	HOFFINGER, SCOTT A MD	9/30/1987	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	63381	20	Orthopedic Surgery	0	In state provider	None	850 DEL GANADO ROAD	None	SAN RAFAEL	CA	94903	2310	21	06041	38.0175301	-122.5682383	Marin County
248476	Fee-for-Service	1891348918	1891348918	1	1	HOSPICE OF NATION INC	12/21/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	11835 W OLYMPIC BLVD	STE 830E	LOS ANGELES	CA	90064	5123	19	06037	34.03273663	-118.4516927	Los Angeles County
248509	Fee-for-Service	1699851279	1699851279	1	1	HELLAN, MINIA MD	6/25/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	96294	02	General Surgery	0	In state provider	None	1500 DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
248564	Fee-for-Service	1881987980	1881987980	1	1	HASTING, ALLISON	3/13/2025	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
248617	Fee-for-Service	1619471851	1619471851	1	1	HOWELL, KAITLEN MD	11/1/2021	207P00000X	NA	Other	026	PHYSICIANS	167395	None	None	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
248629	Fee-for-Service	1285211581	1285211581	1	1	HOSPODAR, ALEXANDRA R MD	4/30/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	184537	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
248635	Fee-for-Service	1851659213	1851659213	1	1	HAFEN, RYAN D MD	9/5/2017	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
248641	Fee-for-Service	1194370593	1194370593	1	1	HAMAD, MOHAMAD MD	8/22/2022	208M00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	2825 E BARNETT RD	None	MEDFORD	OR	97504	8332	00	None	42.31650147	-122.8306005	Jackson County
248656	Fee-for-Service	1093198392	1093198392	1	1	HUSAIN, ABDURRAHMAN A MD	3/23/2020	207RP1001X	NA	Pulmonology	026	PHYSICIANS	154096	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
248683	Fee-for-Service	1770722696	1770722696	2	1	HOANG, VIET MD	3/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	87487	None	None	0	In state provider	None	1720 CESAR E CHAVEZ AVE	None	LOS ANGELES	CA	90033	2414	19	06037	34.04925	-118.2177405	Los Angeles County
248693	Fee-for-Service	1417281700	1417281700	1	1	HUANG, JEFFREY MD	9/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	113441	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
248754	Fee-for-Service	1538695697	1538695697	1	1	HOLBERT, BRANDON C MD	7/5/2022	390200000X	NA	Other	026	PHYSICIANS	160589	None	None	0	In state provider	None	5525 GROSSMONT CENTER DR	None	LA MESA	CA	91942	3009	37	06073	32.781195	-117.0070695	San Diego County
248755	Fee-for-Service	1801377890	1801377890	1	1	HEDAYAT, MILAD S DPM	12/12/2019	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	12520 MAGNOLIA BLVD	#304	VALLEY VILLAGE	CA	91607	2355	19	06037	34.16485451	-118.406106	Los Angeles County
248786	Fee-for-Service	1316909336	1316909336	1	1	HOME OF GUIDING HANDS	4/14/1999	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	10474 STRATHMORE DR	None	SANTEE	CA	92071	1074	37	06073	32.86965514	-117.0033234	San Diego County
248790	Fee-for-Service	1730296484	1730296484	1	1	HUNT, PETER W MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70944	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
248807	Fee-for-Service	1265963953	1265963953	1	1	HONG, TIMOTHY MD	1/24/2022	207P00000X	NA	Other	026	PHYSICIANS	160819	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
248809	Fee-for-Service	1003841891	1003841891	1	1	HILLBORNE, LEE	1/31/1993	207ZP0102X	NA	Other	026	PHYSICIANS	50314	22	Pathology (M.D. only)	0	In state provider	None	4455 W 117TH ST	None	HAWTHORNE	CA	90250	2241	19	06037	33.92825048	-118.3539285	Los Angeles County
248817	Fee-for-Service	1740354620	1740354620	1	1	HANGER P & O WEST INC	2/5/2018	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	1247 EAST ALLUVIAL ST	SUITE 103	FRESNO	CA	93277	1591	10	06019	36.84470048	-119.7606195	Fresno County
248865	Fee-for-Service	1689831869	1689831869	1	1	HARWARD, BRADLEY J MD	6/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	108457	22	Pathology (M.D. only)	0	In state provider	None	555 EAST VALLEY PARKWAY	None	ESCONDIDO	CA	92025	3048	37	06073	33.12542915	-117.0764725	San Diego County
248914	Fee-for-Service	1649311234	1649311234	1	1	HARRIS, KATARENA LMFT	8/6/2024	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
248915	Fee-for-Service	1316039977	1316039977	1	1	HERING, JUSTIN W MD	9/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	131549	None	None	0	In state provider	None	9888 GENESEE AVENUE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
248932	Fee-for-Service	1285722876	1285722876	1	7	HARRIS CARE CENTERS, INC	4/5/2012	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	10271 ROBIN HOOD CIRCLE	None	VILLA PARK	CA	92861	4558	30	06059	33.81298376	-117.821367	Orange County
248937	Fee-for-Service	1881799161	1881799161	1	1	HADCOCK, WILLIAM E JR MD INC	9/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	41224	02	General Surgery	0	In state provider	None	1247 ALLUVIAL AVE	STE 101	FRESNO	CA	93720	2686	10	06019	36.84470048	-119.7606195	Fresno County
248955	Fee-for-Service	1518294511	1518294511	1	1	HAVILAND, ARLIE B OT	5/1/2023	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	835 N. HIGHLAND SPRINGS	SUITE 210	BEAUMONT	CA	92223	5770	33	06065	33.93245893	-116.9469871	Riverside County
249028	Fee-for-Service	1922172808	1922172808	1	1	HANGER PROSTHETICS & ORT	4/1/1995	332B00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1270 E GARVEY ST	STE 145	COVINA	CA	91724	3658	19	06037	34.07114462	-117.8638608	Los Angeles County
249041	Fee-for-Service	1225292253	1225292253	1	1	HUANG, KAREN E MD	10/21/2008	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	98205	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
249068	Fee-for-Service	1750370458	1750370458	1	1	HO, HUY T MD	8/22/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	82417	41	Internal Medicine	0	In state provider	None	825 DELBON AVE	None	TURLOCK	CA	95382	2016	50	06099	37.51052943	-120.8386573	Stanislaus County
249084	Fee-for-Service	1114944618	1114944618	1	1	HOPPE, DIANA E MD	8/27/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69638	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
249085	Fee-for-Service	1710051693	1710051693	1	1	HANGER P & O INC	4/1/1995	335E00000X	NA	Other	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
249101	Fee-for-Service	1205655792	1205655792	1	1	HUAMBACHANO, ESMERALDA PT	11/12/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1855 E COCHRAN ST	#109	SIMI VALLEY	CA	93065	2265	56	06111	34.27906738	-118.7628635	Ventura County
249105	Fee-for-Service	1740354620	1740354620	1	1	HANGER P & O WEST INC	12/1/1998	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1247 EAST ALLUVIAL ST	SUITE 103	FRESNO	CA	93277	1591	10	06019	36.84470048	-119.7606195	Fresno County
249119	Fee-for-Service	1598041162	1598041162	1	1	HO, COREY K MD	9/28/2017	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
249120	Fee-for-Service	1437688041	1437688041	1	1	HERNANDEZ CASTRO, ROSIBEL M	1/30/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	188407	None	None	0	In state provider	MD FACOG	1900 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2725	19	06037	33.9891357	-118.2389609	Los Angeles County
249132	Fee-for-Service	1780886804	1780886804	1	1	HO, CYNTHIA H MD	9/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	93437	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
249193	Fee-for-Service	1184659914	1184659914	1	1	HEIT, LOUIS W LCSW	3/5/2013	1041C0700X	NA	Mental Health Outpatient Services	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	2945 HARDING ST	STE 110	CARLSBAD	CA	92008	1818	37	06073	33.16250689	-117.345105	San Diego County
249199	Fee-for-Service	1386609105	1386609105	2	1	HOPKINS, MONEE NP	10/4/2006	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
249208	Fee-for-Service	1134503337	1134503337	1	1	HWANG, MICHELLE R MD	7/7/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	144799	45	Nephrology (Renal-Kidney)	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
249211	Fee-for-Service	1154952737	1154952737	1	1	HESTER, JOSHUA CRNA	6/16/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
249228	Fee-for-Service	1093760381	1093760381	1	1	HOWTON, MARCIA J MD	2/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	73343	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
249230	Fee-for-Service	1306308804	1306308804	1	1	HILLIARD, STARR MD	10/1/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	182049	None	None	0	In state provider	None	722 MEDICAL CENTER DR	STE 105	CLOVIS	CA	93611	6810	10	06019	36.84107334	-119.6587409	Fresno County
249249	Fee-for-Service	1649759044	1649759044	1	1	HOLBROOK, EDINIA S OT	1/27/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
249299	Fee-for-Service	1497810402	1497810402	1	1	HURVITZ, KIMBERLY U MD	3/16/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	72486	07	Dermatology	0	In state provider	None	2320 BATH ST	STE 205	SANTA BARBARA	CA	93105	5313	42	06083	34.43082689	-119.7223032	Santa Barbara County
249343	Fee-for-Service	1659813681	1659813681	1	1	HUNG, ANNA H PHD	3/25/2020	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
249368	Fee-for-Service	1962539189	1962539189	1	1	HILL, KIMBERLY R PH D	2/27/2004	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
249371	Fee-for-Service	1407440308	1407440308	1	1	HOPE & CARE HOSPICE	5/3/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	183 N HILL AVE	SUITE 204	PASADENA	CA	91106	1915	19	06037	34.149339	-118.1214055	Los Angeles County
249373	Fee-for-Service	1114944618	1114944618	1	1	HOPPE, DIANA E MD	8/27/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	69638	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
249394	Fee-for-Service	1194086322	1194086322	1	1	HEIDARI, SHIREEN N MD	6/21/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	127973	01	General Practice	0	In state provider	None	300 PASTEUR DRIVE	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
249420	Fee-for-Service	1235200213	1235200213	1	1	HUA, SUSAN Y MD	12/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78909	41	Internal Medicine	0	In state provider	None	420 W ROWLAND ST	None	COVINA	CA	91723	2943	19	06037	34.078949	-117.8963031	Los Angeles County
249422	Fee-for-Service	1780886804	1780886804	1	1	HO, CYNTHIA H MD	9/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	93437	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
249436	Fee-for-Service	1588868723	1588868723	1	1	HALVERSON-MUENZER, RICHARD J	11/1/2023	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
249448	Fee-for-Service	1760800973	1760800973	1	1	HOU, ZHE MD	2/19/2019	207N00000X	NA	Dermatology	026	PHYSICIANS	141906	07	Dermatology	0	In state provider	None	770 MAGNOLIA AVE	STE 1H	CORONA	CA	92879	3121	33	06065	33.85936872	-117.5534605	Riverside County
249490	Fee-for-Service	1063559060	1063559060	1	1	HALL, JOSHUA M MD	5/1/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	89840	36	Psychiatry	0	In state provider	None	11878 AVENUE OF INDUSTRY	None	SAN DIEGO	CA	92128	3423	37	06073	32.99058739	-117.0752486	San Diego County
249500	Fee-for-Service	1134503337	1134503337	1	1	HWANG, MICHELLE R MD	7/7/2020	207RN0300X	NA	Nephrology	026	PHYSICIANS	144799	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
249503	Fee-for-Service	1932337680	1932337680	1	1	HASTINGS, NOEL C MD	7/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114226	66	Emergency Medicine (Urgent Care)	0	In state provider	None	5151 F STREET	None	SACRAMENTO	CA	95819	3295	34	06067	38.571156	-121.4391555	Sacramento County
249508	Fee-for-Service	1063805836	1063805836	1	1	HO, QUOC-ANH MD	8/9/2022	2085R0001X	NA	Other	026	PHYSICIANS	179797	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
249523	Fee-for-Service	1295975878	1295975878	1	1	HSU, CARY MD	9/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	82006	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 MED PLAZA	#120	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
249580	Fee-for-Service	1689684003	1689684003	1	1	HUANG, STEPHEN OD	2/23/2006	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1400 E PALOMAR ST	None	CHULA VISTA	CA	91913	1800	37	06073	32.62382113	-116.9960539	San Diego County
249582	Fee-for-Service	1629179049	1629179049	1	1	HAACK, SUSAN MD	11/30/1991	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51031	40	Pediatrics	0	In state provider	None	1008 N CHERRY ST	None	TULARE	CA	93274	2212	54	06107	36.22217583	-119.3376171	Tulare County
249607	Fee-for-Service	1194854794	1194854794	1	1	HO, PAULINE MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	67636	77	Infectious Disease	0	In state provider	None	1275 N ROSE DR	STE 134	PLACENTIA	CA	92870	3919	30	06059	33.8868003	-117.8420447	Orange County
249614	Fee-for-Service	1841438827	1841438827	1	1	HALL, JANET A	3/2/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	855 N LARK ELLEN AVE	SUITE J	WEST COVINA	CA	91791	1099	19	06037	34.087707	-117.9166385	Los Angeles County
249640	Fee-for-Service	1144230707	1144230707	1	1	HOLDEN, BRADLEY J MD	7/26/1995	174400000X	NA	Other	026	PHYSICIANS	62352	40	Pediatrics	0	In state provider	None	450 STANYAN ST	None	SAN FRANCISCO	CA	94117	1079	38	06075	37.7738933	-122.4544685	San Francisco County
249642	Fee-for-Service	1598060568	1598060568	1	1	HUANG, CANDICE S OT	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
249652	Fee-for-Service	1225424187	1225424187	1	1	HUANG, DAVIS DO	11/1/2021	208M00000X	NA	Other	026	PHYSICIANS	17278	None	None	0	In state provider	None	1 HOAG DRIVE	None	NEWPORT BEACH	CA	92663	3663	30	06059	33.62421676	-117.9309656	Orange County
249659	Fee-for-Service	1407440308	1407440308	1	1	HOPE & CARE HOSPICE	5/3/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	183 N HILL AVE	SUITE 204	PASADENA	CA	91106	1915	19	06037	34.149339	-118.1214055	Los Angeles County
249681	Fee-for-Service	1689854432	1689854432	1	1	HUGH D. WHITE, M.D.	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4502 MEDICAL DR	None	SAN ANTONIO	TX	78229	4402	00	None	29.508012	-98.578683	Bexar County
249737	Fee-for-Service	1851705602	1851705602	1	1	HERNANDEZ, MANUEL J MD	9/1/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	170031	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
249746	Fee-for-Service	1386907038	1386907038	1	1	HE, YANGDONG MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	135621	41	Internal Medicine	0	In state provider	None	2101 N WATERMAN AVE	None	SAN BERNARDINO	CA	92404	4836	36	06071	34.13502	-117.2758635	San Bernardino County
249752	Fee-for-Service	1003938192	1003938192	1	1	HUYNH, HIEU MD	10/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85410	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
249754	Fee-for-Service	1427563402	1427563402	1	1	HOANG, JULIE D NP	2/21/2018	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
249773	Fee-for-Service	1740056175	1740056175	1	1	HAWLEY, LYNN M LCSW	1/27/2024	101Y00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	9324 W STOCKTON BLVD	None	ELK GROVE	CA	95758	8012	34	06067	38.418309	-121.3939665	Sacramento County
249819	Fee-for-Service	1295975878	1295975878	1	1	HSU, CARY MD	9/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	82006	02	General Surgery	0	In state provider	None	200 MED PLAZA	#120	LOS ANGELES	CA	90095	8344	19	06037	34.06527974	-118.4462792	Los Angeles County
249821	Fee-for-Service	1982007670	1982007670	1	1	HEALTH DIAGNOSTICS OF	2/7/2017	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	1180 POST STREET	None	SAN FRANCISCO	CA	94109	5505	38	06075	37.78672984	-122.4209381	San Francisco County
249828	Fee-for-Service	1124043526	1124043526	1	1	HATFIELD, ANN K	2/25/2009	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	None	1792 TRIBUTE ROAD	STE 350	SACRAMENTO	CA	95815	4322	34	06067	38.598219	-121.445964	Sacramento County
249860	Fee-for-Service	1073677837	1073677837	1	1	HOLMES-CANNON, ROBYN	1/24/2020	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST 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
249889	Fee-for-Service	1144308800	1144308800	1	1	HEFNER, JENNIFER L MD	7/26/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	51918	01	General Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
249921	Fee-for-Service	1851464606	1851464606	1	1	HO, MYLIEN V MD	10/31/1989	174400000X	NA	Other	026	PHYSICIANS	48215	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	5555 RESERVOIR DR	STE 205	SAN DIEGO	CA	92120	5148	37	06073	32.77628471	-117.0563688	San Diego County
249929	Fee-for-Service	1518087956	1518087956	1	1	HAZEM, MARIAM A MD	3/7/2025	208M00000X	NA	Other	026	PHYSICIANS	111423	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
249941	Fee-for-Service	1104835685	1104835685	1	1	HABIBI, ALI MD	2/8/2015	207L00000X	NA	Other	026	PHYSICIANS	54560	05	Anesthesiology	0	In state provider	None	2500 GRANT RD	None	MOUNTAIN VIEW	CA	94040	4302	43	06085	37.36893518	-122.0779448	Santa Clara County
249951	Fee-for-Service	1760610273	1760610273	1	1	HUANG, STELLA M DO	9/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12718	15	Obstetrics (D.O. only)	0	In state provider	None	100 HOSPITAL DR	STE 200	VALLEJO	CA	94589	2580	48	06095	38.13100118	-122.2403008	Solano County
249956	Fee-for-Service	1750011581	1750011581	1	1	HALBERT, FAITH P NP	9/24/2022	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
250021	Fee-for-Service	1780647313	1780647313	1	1	HABIB, MOKSEDUL MD	5/1/1999	174400000X	NA	Other	026	PHYSICIANS	64069	41	Internal Medicine	0	In state provider	None	5945 TRUXTUN EXTENSION	None	BAKERSFIELD	CA	93309	0610	15	06029	35.36322921	-119.0706029	Kern County
250066	Fee-for-Service	1730959537	1730959537	1	1	HAMMOND, JOSEPH SWANZY	3/6/2024	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	7468 HAYSTACK LOOP	None	RIVERSIDE	CA	92507	9600	33	06065	34.011486	-117.292338	Riverside County
250074	Fee-for-Service	1053685255	1053685255	1	1	HADRICKY, JULIA PSYD	9/11/2012	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
250087	Fee-for-Service	1922186774	1922186774	1	1	HU, PEARL Y MD	10/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	80104	20	Orthopedic Surgery	0	In state provider	None	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
250088	Fee-for-Service	1750598025	1750598025	1	1	HARTAS, GEORGIOS A MD	2/13/2019	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	145986	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	411 N CENTRAL AVE	250	GLENDALE	CA	91203	2081	19	06037	34.15248444	-118.2579448	Los Angeles County
250101	Fee-for-Service	1689316887	1689316887	1	1	HOVSEPYAN, SYUZANNA NP	8/24/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	24355 LYONS AVE	STE 211	SANTA CLARITA	CA	91321	2382	19	06037	34.37868281	-118.5605291	Los Angeles County
250102	Fee-for-Service	1295282986	1295282986	1	1	HURTADO FIEL, ROBERTO J MD	8/14/2022	207P00000X	NA	Other	026	PHYSICIANS	178481	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
250147	Fee-for-Service	1083012884	1083012884	1	1	HWANG, STEPHANIE W NP	6/19/2018	No Taxonomy Provided	NA	None	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
250148	Fee-for-Service	1831137413	1831137413	1	1	HESPERIA PHYSICAL THERAPY	9/14/2018	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	INC	15235 MAIN ST	None	HESPERIA	CA	92345	3326	36	06071	34.42696716	-117.3306656	San Bernardino County
250154	Fee-for-Service	1912968389	1912968389	1	1	HSU, BRADFORD T MD	10/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	86179	02	General Surgery	0	In state provider	None	480 4TH AVE	STE 404	CHULA VISTA	CA	91910	4413	37	06073	32.63411298	-117.0816772	San Diego County
250171	Fee-for-Service	1598716367	1598716367	1	1	HUEGE, STEVEN F MD	5/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141122	36	Psychiatry	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
250179	Fee-for-Service	1598962102	1598962102	1	1	HOFFLICH, HEATHER L DO	4/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	8966	41	Internal Medicine	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
250185	Fee-for-Service	1851072011	1851072011	1	1	HUANG ACUPUNCTURE & HERB INC	9/15/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	14351 RED HILL AVE	C	TUSTIN	CA	92780	6271	30	06059	33.72948962	-117.8194882	Orange County
250206	Fee-for-Service	1427053115	1427053115	1	1	HIDALGO, RICHARD M MD	8/27/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154162	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
250220	Fee-for-Service	1760007579	1760007579	1	1	HARRIS, CHRISTOPHER A PT	6/29/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	631 S HAM LN	STE B	LODI	CA	95242	3532	39	06077	38.12696729	-121.2882893	San Joaquin County
250222	Fee-for-Service	1346508827	1346508827	1	1	HAO, FRANK MD	6/23/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147584	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
250238	Fee-for-Service	1760610273	1760610273	1	1	HUANG, STELLA M DO	9/23/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	12718	09	Gynecology (D.O. only)	0	In state provider	None	100 HOSPITAL DR	STE 200	VALLEJO	CA	94589	2580	48	06095	38.13100118	-122.2403008	Solano County
250239	Fee-for-Service	1700490786	1700490786	1	1	HONEST HOME HEALTH CARE	1/26/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	4221 WILSHIRE BLVD	SUITE 170-16	LOS ANGELES	CA	90010	3519	19	06037	34.06177566	-118.320844	Los Angeles County
250246	Fee-for-Service	1427046879	1427046879	1	1	HENKES, DAVID MD.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	333 N SANTA ROSA AVE	None	SAN ANTONIO	TX	78207	3108	00	None	29.42763246	-98.49794799	Bexar County
250249	Fee-for-Service	1275547473	1275547473	1	1	HEIDERSBACH, ROBERT MD	3/1/1998	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	83682	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
250251	Fee-for-Service	1477920221	1477920221	1	1	HILLE, LESLIE LCSW	5/10/2022	103K00000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
250273	Fee-for-Service	1740542612	1740542612	1	1	HAQ, IRMINA S MD	2/28/2022	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	135666	None	None	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
250304	Fee-for-Service	1942514682	1942514682	1	1	HALEY, MICHELLE	11/13/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3825 HOPYARD	STE 140	PLEASANTON	CA	94588	8530	01	06001	37.683009	-121.9036935	Alameda County
250309	Fee-for-Service	1780647313	1780647313	1	1	HABIB, MOKSEDUL MD	5/1/1999	174400000X	NA	Other	026	PHYSICIANS	64069	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5945 TRUXTUN EXTENSION	None	BAKERSFIELD	CA	93309	0610	15	06029	35.36322921	-119.0706029	Kern County
250319	Fee-for-Service	1700073178	1700073178	1	1	HUBBARD, ERIKA M MD	7/5/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102768	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
250325	Fee-for-Service	1760740963	1760740963	1	1	HENDREY, DANIEL B MD	2/21/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122212	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
250356	Fee-for-Service	1730959537	1730959537	1	1	HAMMOND, JOSEPH SWANZY	3/6/2024	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	7468 HAYSTACK LOOP	None	RIVERSIDE	CA	92507	9600	33	06065	34.011486	-117.292338	Riverside County
250363	Fee-for-Service	1629369442	1629369442	1	1	HUYNH, RICHARD V MD	8/29/2022	207RH0003X	NA	Oncology	026	PHYSICIANS	125988	None	None	0	In state provider	None	540 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4230	42	06083	34.42739162	-119.7253175	Santa Barbara County
250366	Fee-for-Service	1316437130	1316437130	1	1	HRM HOME HEALTH INC	5/4/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	539 N GLENOAKS BLVD	SUITE 303	BURBANK	CA	91502	3209	19	06037	34.18652984	-118.310858	Los Angeles County
250434	Fee-for-Service	1629375431	1629375431	1	1	HO, LOUIS DO MD	3/1/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11585	08	Family Practice	0	In state provider	None	513 EAST LIME AVE	#201	MONROVIA	CA	91016	2983	19	06037	34.14819851	-117.993105	Los Angeles County
250437	Fee-for-Service	1942256094	1942256094	1	2	HUNTINGTON PARK CLINICA MEDI	7/27/2023	261QM1300X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	CA GENERAL MEDICAL CENTE	7400 PACIFIC BLVD	SUITE A&B	HUNTINGTON PARK	CA	90255	5954	19	06037	33.97222445	-118.2252072	Los Angeles County
250441	Fee-for-Service	1982707956	1982707956	1	1	HONSIK, KENNETH A MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71509	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
250492	Fee-for-Service	1417253808	1417253808	1	1	HAMMOND, WOODROW W PT	6/14/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	12217 SANTA MONICA BLVD	209	LOS ANGELES	CA	90025	2589	19	06037	34.03988283	-118.4648672	Los Angeles County
250507	Fee-for-Service	1730226663	1730226663	1	1	HUNT, THURMAN MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	70538	05	Anesthesiology	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
250517	Fee-for-Service	1144781964	1144781964	1	1	HERTZING, WILLIAM J MD	8/4/2022	208M00000X	NA	Other	026	PHYSICIANS	178132	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
250631	Fee-for-Service	1780927541	1780927541	1	1	HALBROOK S STOECKLEIN	12/12/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	50 N MEDICAL DR	None	SALT LAKE CTY	UT	84132	0001	00	None	40.77197161	-111.8352608	Salt Lake County
250676	Fee-for-Service	1770774341	1770774341	1	1	HSIEH, LOAN B MD	8/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82088	78	Neoplastic Diseases/Oncology	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
250717	Fee-for-Service	1588678791	1588678791	1	2	HELM, CRAIG J MD	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	46407	18	Ophthalmology	0	In state provider	None	27420 TOURNEY ROAD	SUITE 100	VALENCIA	CA	91355	5631	19	06037	34.42122797	-118.5787489	Los Angeles County
250740	Fee-for-Service	1467076240	1467076240	1	1	HOWARD, KATHY JEAN A	6/25/2020	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3086 PALOMINO WAY	None	HOLLISTER	CA	95023	9268	35	06069	36.82001381	-121.3876811	San Benito County
250778	Fee-for-Service	1285722876	1285722876	1	2	HARRIS CARE CENTERS, INC	2/8/1994	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	LENMAR HOME	11581 LENMAR ST	None	STANTON	CA	90680	3536	30	06059	33.79450726	-117.994399	Orange County
250797	Fee-for-Service	1497882948	1497882948	1	1	HELPER, STEPHEN D MD	9/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	37387	01	General Practice	0	In state provider	None	3838 SAN DIMAS STREET	SUITE A200	BAKERSFIELD	CA	93301	1115	15	06029	35.3946385	-119.008203	Kern County
250821	Fee-for-Service	1134207707	1134207707	1	1	HO, JOCELYN C MD	4/24/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	88811	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
250844	Fee-for-Service	1417256488	1417256488	1	1	HATCHER, DAVID M MD	7/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141990	34	Urology and Urological Surgery	0	In state provider	None	1441 EASTLAKE AVENUE	None	LOS ANGELES	CA	90089	0112	19	06037	34.06169385	-118.2044698	Los Angeles County
250910	Fee-for-Service	1306957584	1306957584	1	1	HANKINS, STEPHEN M MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90913	46	Hand Surgery	0	In state provider	None	3 MEDICAL PLAZA DR	STE 110	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
250913	Fee-for-Service	1356798276	1356798276	1	1	HUNTER, SAMANTHA A MD	10/2/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	142363	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
250920	Fee-for-Service	1336100379	1336100379	1	1	HAIDER, THOMAS T MD	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	61537	20	Orthopedic Surgery	0	In state provider	None	6276 RIVER CREST DRIVE	SUITE A	RIVERSIDE	CA	92507	0754	33	06065	33.93782112	-117.2922842	Riverside County
250963	Fee-for-Service	1770774341	1770774341	1	1	HSIEH, LOAN B MD	8/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82088	10	Gastroenterology (M.D. only)	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
250975	Fee-for-Service	1629018353	1629018353	1	1	HARDY, DAVID 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	8TH AVE + C ST	None	SALT LAKE CITY	UT	84143	0000	00	None	40.779063	-111.8805548	Salt Lake County
251000	Fee-for-Service	1578227070	1578227070	1	1	HEALTHY LIFE SERVICE INC	2/9/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	15921 LIGGET ST	None	NORTH HILLS	CA	91343	3143	19	06037	34.24012628	-118.4792278	Los Angeles County
251005	Fee-for-Service	1114954096	1114954096	1	1	HUDSON, CAROLYN E MD	11/30/1988	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	68844	40	Pediatrics	0	In state provider	None	27212 CALAROGA AVE	None	HAYWARD	CA	94545	4339	01	06001	37.63229023	-122.0896425	Alameda County
251019	Fee-for-Service	1598140568	1598140568	1	1	HUONG, ADDISON PT	10/28/2024	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
251031	Fee-for-Service	1467076240	1467076240	1	1	HOWARD, KATHY JEAN A	6/25/2020	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3086 PALOMINO WAY	None	HOLLISTER	CA	95023	9268	35	06069	36.82001381	-121.3876811	San Benito County
251055	Fee-for-Service	1750469847	1750469847	1	1	HASANAIN, LUBNA S MD	7/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	50934	40	Pediatrics	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
251094	Fee-for-Service	1003996844	1003996844	2	1	HAMZA, MOHSEN M MD	11/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	43543	13	Neurology (M.D. only)	0	In state provider	None	11600 WILSHIRE BLVD	SUITE 420	LOS ANGELES	CA	90025	1785	19	06037	34.05055194	-118.4594619	Los Angeles County
251119	Fee-for-Service	1518953298	1518953298	1	1	HEALTHCARE CROSSING CORP	7/26/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	39765 DATE ST	STE 102	MURRIETA	CA	92563	2005	33	06065	33.54593179	-117.1538761	Riverside County
251139	Fee-for-Service	1912556010	1912556010	1	1	HEALTH GIVERS HOMEHEALTH INC	8/22/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9029 RESEDA BLVD	STE 203	NORTHRIDGE	CA	91324	3932	19	06037	34.23452657	-118.536098	Los Angeles County
251194	Fee-for-Service	1306957584	1306957584	1	1	HANKINS, STEPHEN M MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90913	20	Orthopedic Surgery	0	In state provider	None	3 MEDICAL PLAZA DR	STE 110	ROSEVILLE	CA	95661	3088	31	06061	38.76566391	-121.2457432	Placer County
251251	Fee-for-Service	1770774341	1770774341	1	1	HSIEH, LOAN B MD	8/28/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	82088	68	Hematology	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
251283	Fee-for-Service	1922119809	1922119809	1	2	HINER, BRUCE G PSYD	1/28/2019	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	120 PLEASANT HILL AVE N	STE 370	SEBASTOPOL	CA	95472	3168	49	06097	38.39887847	-122.8397185	Sonoma County
251312	Fee-for-Service	1063423002	1063423002	1	1	HUERTA, FIDEL B MD	9/20/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	66490	08	Family Practice	0	In state provider	None	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
251336	Fee-for-Service	1316408214	1316408214	1	1	HAN, ALLISON M MD	10/31/2024	207NP0225X	NA	Dermatology	026	PHYSICIANS	182480	07	Dermatology	0	In state provider	None	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
251360	Fee-for-Service	1558404186	1558404186	1	1	HERRMANN, FAYE E LMFT	10/23/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1809 W. REDLANDS BLVD	# 234	REDLANDS	CA	92373	8054	36	06071	34.06288379	-117.2156673	San Bernardino County
251408	Fee-for-Service	1518953298	1518953298	1	1	HEALTHCARE CROSSING CORP	7/26/2010	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	39765 DATE ST	STE 102	MURRIETA	CA	92563	2005	33	06065	33.54593179	-117.1538761	Riverside County
251447	Fee-for-Service	1225786619	1225786619	1	1	HART, SHANNAE V LCSW	3/22/2024	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
251560	Fee-for-Service	1861423246	1861423246	1	1	HALBERG, DIANE F MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76175	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
251626	Fee-for-Service	1316408214	1316408214	1	1	HAN, ALLISON M MD	10/31/2024	207NP0225X	NA	Dermatology	026	PHYSICIANS	182480	40	Pediatrics	0	In state provider	None	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
251663	Fee-for-Service	1225167034	1225167034	1	1	HALSEY, HOLLY A LAC	1/21/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9449 BALBOA AVE	105	SAN DIEGO	CA	92123	4336	37	06073	32.8221995	-117.1264275	San Diego County
251669	Fee-for-Service	1407820509	1407820509	1	1	HALL, JURGEN M NP	6/9/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	1	Border provider	None	5330 SOUTH HIGHWAY 95	None	FORT MOHAVE	AZ	86426	9225	00	None	35.002656	-114.595893	Mohave County
251708	Fee-for-Service	1528564267	1528564267	1	1	HWANG, KRISTINE ANNE MD	4/7/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	175664	None	None	0	In state provider	None	1305 TOMMYDON	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
251709	Fee-for-Service	1952336232	1952336232	1	1	HOWARD, RENEE M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	56625	None	None	0	In state provider	None	599 SIR FRANCIS DRAKE BL	STE 305	GREENBRAE	CA	94904	1732	21	06041	37.95026531	-122.5332546	Marin County
251748	Fee-for-Service	1841253010	1841253010	1	1	HUGHES, DOUGLAS M MD	8/1/1993	2085R0204X	NA	Other	026	PHYSICIANS	71796	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
251766	Fee-for-Service	1184099335	1184099335	1	1	HIROFUJI, ERI NP	10/25/2024	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
251785	Fee-for-Service	1932182334	1932182334	1	1	HENRY-HOYT, SUSAN NP	4/8/2024	363L00000X	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
251797	Fee-for-Service	1528597309	1528597309	1	1	HAQ, ALI MD	6/10/2024	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
251801	Fee-for-Service	1154982510	1154982510	1	1	HADLEY, KENDRA P LPCC	12/15/2023	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
251832	Fee-for-Service	1598130569	1598130569	1	1	HORIZON MULTICARE GROUP INC	4/3/2018	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1600 W AVENUE J	None	LANCASTER	CA	93534	2814	19	06037	34.68938848	-118.158354	Los Angeles County
251868	Fee-for-Service	1003347816	1003347816	1	1	HUDSON, KATARZYNA A CNP	12/6/2018	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	921 PACIFIC COAST HWY	None	SEAL BEACH	CA	90740	6244	30	06059	33.74418902	-118.1018883	Orange County
251876	Fee-for-Service	1518167444	1518167444	1	1	HASTINGS, ALISON J DO	6/30/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	14171	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	8170 LAGUNA BLVD	SUITE 101	ELK GROVE	CA	95758	7902	34	06067	38.421054	-121.405365	Sacramento County
251890	Fee-for-Service	1881884609	1881884609	1	1	HTUN, LWIN MD	12/1/2003	207R00000X	NA	Other	026	PHYSICIANS	70893	41	Internal Medicine	0	In state provider	None	341 E MAIN ST	None	SAN JACINTO	CA	92583	4231	33	06065	33.78391437	-116.9562698	Riverside County
251936	Fee-for-Service	1629009964	1629009964	1	1	HUMILITY OF MARY HLTH	7/24/2007	No Taxonomy Provided	NA	None	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	667 EASTLAND AVE SE	None	WARREN	OH	44484	4503	00	None	41.23080722	-80.77832106	Trumbull County
251938	Fee-for-Service	1821534389	1821534389	1	1	HOGAN, KRYSTAL D LMFT	7/26/2022	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
251939	Fee-for-Service	1710279765	1710279765	1	1	HOSPITALIST MEDICINE	7/14/2011	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	PHYSICIANS OF MONTEREY	450 E ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
251988	Fee-for-Service	1801838776	1801838776	1	1	HERSCOITZ, ROBERTS 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	5216 DAWES AVE	None	ALEXANDRIA	VA	22311	1404	00	None	38.83997458	-77.1193102	Alexandria city
251990	Fee-for-Service	1457541559	1457541559	1	1	HUNG, JENNY	5/11/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3943 GRAND AVE	None	CHINO	CA	91710	5440	36	06071	33.995241	-117.7193205	San Bernardino County
251993	Fee-for-Service	1215002753	1215002753	1	1	HAJDUK, MICHAEL B MD	10/15/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84931	41	Internal Medicine	0	In state provider	None	1010 MURRAY STREET	None	SAN LUIS OBISPO	CA	93405	8800	40	06079	35.29101669	-120.6663647	San Luis Obispo County
251999	Fee-for-Service	1699842260	1699842260	1	1	HILLTOP FAMILY MEDICAL	9/5/2006	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP INC	130 E ROMIE LN	STE D	SALINAS	CA	93901	3160	27	06053	36.66175331	-121.6541075	Monterey County
252023	Fee-for-Service	1457996936	1457996936	1	1	HETZEL, NAOMI NP	11/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	3701 BROADWAY	None	OAKLAND	CA	94611	5613	01	06001	37.82533768	-122.258094	Alameda County
252024	Fee-for-Service	1558432633	1558432633	1	1	HORNSTEIN, BRUCE A	2/8/2015	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	236 N CENTRAL AVE	None	GLENDALE	CA	91203	2532	19	06037	34.1493982	-118.2578964	Los Angeles County
252030	Fee-for-Service	1528096294	1528096294	1	1	HORTON, LESLIE A MD	5/7/2009	2084P0800X	NA	Psychiatry	026	PHYSICIANS	70296	36	Psychiatry	0	In state provider	None	2900 E DEL MAR BLVD	None	PASADENA	CA	91107	4375	19	06037	34.14213253	-118.090593	Los Angeles County
252114	Fee-for-Service	1942591789	1942591789	1	1	HOWELL, MARILYN A MD	8/25/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	134197	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
252165	Fee-for-Service	1174730444	1174730444	1	1	HAENEBALCKE, ELINE MD	10/13/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116814	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
252216	Fee-for-Service	1962791061	1962791061	1	1	HWANG, DAVID W MD	4/7/2017	207R00000X	NA	Other	026	PHYSICIANS	116021	41	Internal Medicine	0	In state provider	None	3687 MT DIABLO BLVD	STE 200	LAFAYETTE	CA	94549	3717	07	06013	37.8898926	-122.1304235	Contra Costa County
252226	Fee-for-Service	1629009964	1629009964	1	1	HUMILITY OF MARY HLTH	7/24/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	667 EASTLAND AVE SE	None	WARREN	OH	44484	4503	00	None	41.23080722	-80.77832106	Trumbull County
252230	Fee-for-Service	1427408749	1427408749	1	1	HILLAWY, BAKER MD	10/2/2019	207R00000X	NA	Other	026	PHYSICIANS	160960	41	Internal Medicine	0	In state provider	None	3865 JACKSON ST	None	RIVERSIDE	CA	92503	3919	33	06065	33.92617009	-117.4404151	Riverside County
252233	Fee-for-Service	1558320515	1558320515	1	1	HOCKENBERRY, TIMOTHY W MD	1/9/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	130997	01	General Practice	0	In state provider	None	1375 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3382	49	06097	38.627145	-122.863779	Sonoma County
252241	Fee-for-Service	1326553926	1326553926	1	1	HEREDIA THERAPY GROUP INC	4/21/2021	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	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
252254	Fee-for-Service	1659418655	1659418655	1	1	HSIAO, VICTORIA C MD	11/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145561	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
252288	Fee-for-Service	1407084502	1407084502	1	1	HELMING, HEATHER DO	7/31/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	11800	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
252323	Fee-for-Service	1417167453	1417167453	1	1	HO, IMELDA Y MD	6/26/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	86668	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
252334	Fee-for-Service	1417017591	1417017591	1	1	HOFFMAN, ERCELL H	9/1/2004	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	4034 E ELIZABETH ST	None	COMPTON	CA	90221	4672	19	06037	33.88778752	-118.1987746	Los Angeles County
252335	Fee-for-Service	1770537466	1770537466	1	3	HIGH DESERT PRIMARY CARE	11/12/2008	193200000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL GRP A CA GEN PAR	19333 BEAR VALLEY RD	SUITE 101	APPLE VALLEY	CA	92308	5149	36	06071	34.47104148	-117.2413863	San Bernardino County
252342	Fee-for-Service	1578685517	1578685517	1	1	HUMAN TOUCH PALLIATIVE AND	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE INC	3629 N SEPULVEDA BLVD	SUITE 102	MANHATTAN BEACH	CA	90266	3832	19	06037	33.90129	-118.396299	Los Angeles County
252351	Fee-for-Service	1982226155	1982226155	1	1	HIEU DOAN OPTOMETRY INC	12/11/2024	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4210 HIGHLAND AVE	None	HIGHLAND	CA	92346	2742	36	06071	34.137684	-117.1947915	San Bernardino County
252406	Fee-for-Service	1326743535	1326743535	1	1	HEALTHTRACKRX INDIANA, INC	8/7/2024	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	2	Out of state provider	None	706 LEWIS AND CLARK PKWY	STE 11	CLARKSVILLE	IN	47129	2279	00	None	38.310309	-85.7641815	Clark County
252428	Fee-for-Service	1326322579	1326322579	1	1	HAIR, STEPHANIE C LCSW	4/17/2020	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	370 DISTEL CIRCLE	None	LOS ALTOS	CA	94022	1404	43	06085	37.39572142	-122.1051204	Santa Clara County
252431	Fee-for-Service	1629005749	1629005749	1	1	HATHAWAY, NICKOLINE M MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	47705	41	Internal Medicine	0	In state provider	None	152 PIONEER LN	None	BISHOP	CA	93514	2563	14	06027	37.36269	-118.407312	Inyo County
252479	Fee-for-Service	1508925124	1508925124	1	1	HO, TRAN T MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	71110	08	Family Practice	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
252480	Fee-for-Service	1679603344	1679603344	1	1	H RANDOLPH BROWN O D INC	7/24/2023	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	11226 GOLD EXPRESS DR.	STE 202	GOLD RIVER	CA	95670	4411	34	06067	38.622456	-121.264299	Sacramento County
252509	Fee-for-Service	1982232542	1982232542	1	1	HOYT, BRIGGS S MD	6/11/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
252527	Fee-for-Service	1841458296	1841458296	1	1	HAGEN, WENDY J DO	3/13/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9928	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
252532	Fee-for-Service	1326553926	1326553926	1	1	HEREDIA THERAPY GROUP INC	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
252547	Fee-for-Service	1356304224	1356304224	1	1	HIGA, KELVIN D MD	8/31/1989	208600000X	NA	General Surgery	026	PHYSICIANS	53771	02	General Surgery	0	In state provider	None	4785 N 1ST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
252554	Fee-for-Service	1407944952	1407944952	1	1	HOPE MEDICAL SUPPLY INC	5/5/2006	332B00000X	NA	Other	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	1410 3RD ST	STE 11	RIVERSIDE	CA	92507	3422	33	06065	33.98297949	-117.3436605	Riverside County
252556	Fee-for-Service	1194802744	1194802744	1	1	HEARTLAND CHILD AND FAMILY S	1/15/2025	163WP0807X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	ERVICES	811 GRAND AVE	SUITE D	SACRAMENTO	CA	95838	3466	34	06067	38.637621	-121.4470125	Sacramento County
252573	Fee-for-Service	1134234511	1134234511	1	1	HSU, BARBARA Y MD	1/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	62660	30	Radiology	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
252630	Fee-for-Service	1578685517	1578685517	1	1	HUMAN TOUCH PALLIATIVE AND	5/12/2011	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	HOSPICE CARE INC	3629 N SEPULVEDA BLVD	SUITE 102	MANHATTAN BEACH	CA	90266	3832	19	06037	33.90129	-118.396299	Los Angeles County
252635	Fee-for-Service	1003270463	1003270463	1	1	HOLT, HUNTER K MD	6/21/2019	390200000X	NA	Other	026	PHYSICIANS	160608	08	Family Practice	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
252641	Fee-for-Service	1477758050	1477758050	1	1	HILL, JACLYN MD	12/8/2023	207XP3100X	NA	Orthopedic Surgery	026	PHYSICIANS	192263	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
252686	Fee-for-Service	1891987970	1891987970	1	1	HUGHES, EVA MD	4/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	98821	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
252690	Fee-for-Service	1669534046	1669534046	1	1	HARRELL, MARY E	1/11/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1635 DIVISADERO STREET	None	SAN FRANCISCO	CA	94115	3036	38	06075	37.78487142	-122.4398095	San Francisco County
252710	Fee-for-Service	1346222734	1346222734	1	1	HILTY, DONALD M MD	11/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	75437	36	Psychiatry	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
252715	Fee-for-Service	1396037750	1396037750	1	1	HOWELL, NIKA C MD	10/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	132660	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
252736	Fee-for-Service	1285669226	1285669226	1	1	HONKANEN, ANITA MD	10/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86880	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
252786	Fee-for-Service	1841367679	1841367679	1	1	HSIANG, PAUL J MD	12/1/1997	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	62783	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
252818	Fee-for-Service	1386453355	1386453355	1	1	HATEEM SIDDIQUI MD PC	2/10/2025	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	1800 WESTERN AVE	STE 302	SAN BERNARDINO	CA	92411	1354	36	06071	34.1315778	-117.3182453	San Bernardino County
252820	Fee-for-Service	1326553926	1326553926	1	1	HEREDIA THERAPY GROUP INC	6/19/2018	No Taxonomy Provided	NA	None	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	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
252864	Fee-for-Service	1689616153	1689616153	1	1	HOVSEPIAN, PAUL G MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	41173	41	Internal Medicine	0	In state provider	None	103 N GARFIELD AVE	STE F	ALHAMBRA	CA	91801	3578	19	06037	34.0961716	-118.1275921	Los Angeles County
252871	Fee-for-Service	1407112923	1407112923	1	1	HORNER, DAVID J	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	141403	01	General Practice	0	In state provider	None	31700 TEMECULA PKWY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
252894	Fee-for-Service	1487120374	1487120374	1	2	HORIZON FAMILY AND COMMUNITY	1/10/2025	106H00000X	NA	Mental Health Outpatient Services	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	SERVICES	530 PLAZA DRIVE	130	FOLSOM	CA	95630	4781	34	06067	38.65716	-121.1729085	Sacramento County
252910	Fee-for-Service	1841437241	1841437241	1	7	H STREET CLINIC, INC.	5/14/2024	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1245 WILSHIRE BLVD	SUITE 715	LOS ANGELES	CA	90017	4807	19	06037	34.05362775	-118.2661889	Los Angeles County
252930	Fee-for-Service	1831869775	1831869775	1	1	HSS MEDICAL TRANS INC	9/16/2021	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	3764 S WALTON AVE	None	YUBA CITY	CA	95993	9229	51	06101	39.071835	-121.641588	Sutter County
252933	Fee-for-Service	1710472147	1710472147	1	1	HEY TAXI INC.	12/2/2021	343900000X	NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1091 SOUTH STATE ST	None	UKIAH	CA	95482	6411	23	06045	39.13657554	-123.2053206	Mendocino County
252962	Fee-for-Service	1992313084	1992313084	1	1	HAPPY RIDES LLC	12/29/2020	343900000X	Both NEMT & NMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	26577 N HIGHWAY 1	None	FORT BRAGG	CA	95437	9586	23	06045	39.516174	-123.7555305	Mendocino County
252989	Fee-for-Service	1073597852	1073597852	1	1	HENSLEY, EDWARD KIP MD	5/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	43201	24	Plastic Surgery	0	In state provider	None	411 W 20TH ST	None	MERCED	CA	95340	3713	24	06047	37.30404265	-120.4804769	Merced County
252997	Fee-for-Service	1346604733	1346604733	1	1	HAN, VY L MD	10/17/2019	207P00000X	NA	Other	026	PHYSICIANS	145975	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
253008	Fee-for-Service	1548295124	1548295124	1	1	HUANG, VICTOR H MD	1/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	85942	01	General Practice	0	In state provider	None	1035 SOUTH MAIN ST	None	FALLBROOK	CA	92028	3338	37	06073	33.373188	-117.2515065	San Diego County
253015	Fee-for-Service	1053734525	1053734525	1	1	HUFF, IVY J LMFT	10/24/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2501 W. SHAW AVE	STE 119	FRESNO	CA	93710	7510	10	06019	36.8064869	-119.8354798	Fresno County
253063	Fee-for-Service	1578656237	1578656237	1	1	HURWITZ, S ROBERT MD	1/1/1982	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	21143	30	Radiology	0	In state provider	None	355 PLACENTIA AVE	None	NEWPORT BEACH	CA	92663	3311	30	06059	33.62672719	-117.9312941	Orange County
253107	Fee-for-Service	1659356020	1659356020	1	1	HAGERMAN RANDI JM	1/18/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	32435	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
253110	Fee-for-Service	1326553926	1326553926	1	1	HEREDIA THERAPY GROUP INC	10/27/2021	1041C0700X	NA	Mental Health Outpatient Services	019	OCCUPATIONAL THERAPISTS	-	-	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
253143	Fee-for-Service	1003408642	1003408642	1	1	HSIEH, HSING-CHUN NP	6/9/2022	363LG0600X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	207 SANTA ANITA ST.	STE P05	SAN GABRIEL	CA	91776	1159	19	06037	34.10072807	-118.1066296	Los Angeles County
253153	Fee-for-Service	1689616153	1689616153	1	1	HOVSEPIAN, PAUL G MD	2/8/2015	207R00000X	NA	Other	026	PHYSICIANS	41173	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	103 N GARFIELD AVE	STE F	ALHAMBRA	CA	91801	3578	19	06037	34.0961716	-118.1275921	Los Angeles County
253159	Fee-for-Service	1972523876	1972523876	1	1	HALL, SUSAN L MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70213	41	Internal Medicine	0	In state provider	None	11370 ANDERSON ST	STE 3150	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
253201	Fee-for-Service	1841437241	1841437241	1	7	H STREET CLINIC, INC.	5/14/2024	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT CLINIC	1245 WILSHIRE BLVD	SUITE 715	LOS ANGELES	CA	90017	4807	19	06037	34.05362775	-118.2661889	Los Angeles County
253220	Fee-for-Service	1649681495	1649681495	1	1	HAMIDUZZAMAN, ANUM MD	12/29/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149418	None	None	0	In state provider	None	1680 E 120 ST	None	LOS ANGELES	CA	90059	3029	19	06037	33.92456051	-118.2417525	Los Angeles County
253234	Fee-for-Service	1811996697	1811996697	1	1	HUBANKS, JOHN R MD INC	2/8/2015	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	10884	04	Otology, Laryngology, Rhinology	0	In state provider	None	1510 S CENTRAL AVE	STE 550	GLENDALE	CA	91204	2539	19	06037	34.12709764	-118.2577911	Los Angeles County
253240	Fee-for-Service	1659399293	1659399293	1	1	HUDSON,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	1200 N BEAVER	None	FLAGSTAFF	AZ	86001	0000	00	None	35.208594	-111.645099	Coconino County
253279	Fee-for-Service	1245894633	1245894633	1	1	HARIRI, LEILA H MD	12/7/2022	390200000X	NA	Other	026	PHYSICIANS	182484	36	Psychiatry	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
253294	Fee-for-Service	1649358532	1649358532	1	1	HAYNES, HOWARD S MD	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	60254	05	Anesthesiology	0	In state provider	None	400 E MAIN ST	STE 200	STOCKTON	CA	95202	3000	39	06077	37.95344497	-121.2852303	San Joaquin County
253348	Fee-for-Service	1043321367	1043321367	1	1	HYLTON, GALE LYNETTE MD	11/30/1990	2084P0800X	NA	Psychiatry	026	PHYSICIANS	70760	36	Psychiatry	0	In state provider	None	300 HOMER AVE	None	PALO ALTO	CA	94301	2726	43	06085	37.44411082	-122.157252	Santa Clara County
253352	Fee-for-Service	1003294794	1003294794	1	1	HECKENLIVELY, LINDA M	11/21/2016	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
253373	Fee-for-Service	1205985249	1205985249	1	1	HO, MIKE MD	8/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	98130	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
253375	Fee-for-Service	1811420102	1811420102	1	1	HEISLER, KATHERINE M LCSW	11/13/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3400 INLAND EMPIRE BLVD	None	ONTARIO	CA	91764	5510	36	06071	34.071462	-117.5782005	San Bernardino County
253392	Fee-for-Service	1750301008	1750301008	1	1	HOUMAN, BRUCE MD	2/4/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	37896	34	Urology and Urological Surgery	0	In state provider	THE UROLOGY CNTR OF S CA	3900 SHERMAN DR	STE E	RIVERSIDE	CA	92503	4005	33	06065	33.92756479	-117.4375031	Riverside County
253393	Fee-for-Service	1326553926	1326553926	1	1	HEREDIA THERAPY GROUP INC	6/19/2018	No Taxonomy Provided	NA	None	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	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
253398	Fee-for-Service	1174543326	1174543326	1	1	HERRERA, HUMBERTO MD	10/31/1996	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	45967	25	Physical Medicine and Rehabilitation	0	In state provider	None	2955 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5836	19	06037	33.97333678	-118.2163277	Los Angeles County
253431	Fee-for-Service	1093907198	1093907198	1	1	HUSSAINI, NOREEN M MD	11/30/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102049	08	Family Practice	0	In state provider	None	441 NORTH LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
253448	Fee-for-Service	1659578110	1659578110	1	1	HEDAYATI-RAD, AMIR MD INC	2/4/2013	207RC0001X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	60239	41	Internal Medicine	0	In state provider	None	435 ARDEN AVENUE	SUITE 330	GLENDALE	CA	91203	4016	19	06037	34.15848148	-118.2628845	Los Angeles County
253449	Fee-for-Service	1568709939	1568709939	1	1	HALLAIAN, SEVINI S MD	7/9/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	148101	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
253515	Fee-for-Service	1699797753	1699797753	1	1	HALL, GLENN L MD	6/15/1994	174400000X	NA	Other	026	PHYSICIANS	20145	01	General Practice	0	In state provider	None	460 GREENFIELD AVE	STE 4	HANFORD	CA	93230	3500	16	06031	36.3296463	-119.6581535	Kings County
253522	Fee-for-Service	1396399200	1396399200	1	1	HERRERA-GARDEA, EZTLI M LMFT	9/6/2022	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
253529	Fee-for-Service	1083931869	1083931869	1	1	HAH, MINA MD	6/25/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	82972	36	Psychiatry	0	In state provider	None	2230 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1419	34	06067	38.555631	-121.459203	Sacramento County
253530	Fee-for-Service	1659933133	1659933133	1	1	HOUSTON-CROOK, SAMANTHA P LM	10/12/2022	101YP2500X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	FT	17772 IRVINE BLVD	SUITE 209	TUSTIN	CA	92780	3234	30	06059	33.74824746	-117.8220736	Orange County
253536	Fee-for-Service	1518228659	1518228659	1	1	HUEY, WYLIE LAC	1/17/2022	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	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
253541	Fee-for-Service	1700032547	1700032547	1	1	HERNANDEZ, VICENTE S LMFT	7/14/2022	106H00000X	NA	Mental Health Outpatient Services	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
253582	Fee-for-Service	1629039912	1629039912	1	1	HAUSER, MICHAEL E MD	10/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	54192	40	Pediatrics	0	In state provider	None	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	20	06039	36.88437894	-119.8003484	Madera County
253611	Fee-for-Service	1699842518	1699842518	1	1	HARUYAMA, ATSUKO Z MD	5/6/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	73168	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
253614	Fee-for-Service	1447737838	1447737838	1	1	HOTA, TAPASWINI MD	3/15/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	176784	None	None	0	In state provider	None	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	0000	54	06107	36.0663928	-119.01714	Tulare County
253620	Fee-for-Service	1811253214	1811253214	1	1	HOANG, LINDA P MD	8/18/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	153098	68	Hematology	0	In state provider	None	4501 X ST	None	SACRAMENTO	CA	95817	2229	34	06067	38.553822	-121.452822	Sacramento County
253685	Fee-for-Service	1174543326	1174543326	1	1	HERRERA, HUMBERTO MD	10/31/1996	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	45967	08	Family Practice	0	In state provider	None	2955 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5836	19	06037	33.97333678	-118.2163277	Los Angeles County
253698	Fee-for-Service	1083901961	1083901961	1	1	HAMRAZ, ALI MD	1/4/2022	207R00000X	NA	Other	026	PHYSICIANS	161681	None	None	0	In state provider	None	2637 SHADELANDS DR	None	WALNUT CREEK	CA	94598	2512	07	06013	37.925712	-122.021856	Contra Costa County
253717	Fee-for-Service	1801195334	1801195334	1	1	HARRIS, JAMILA MD	10/23/2019	2084P0800X	NA	Psychiatry	026	PHYSICIANS	156482	27	Psychiatry Neurology (D.O. 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
253720	Fee-for-Service	1023672425	1023672425	1	1	HEIMLER, GRAHAM MD	9/27/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	178396	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
253762	Fee-for-Service	1841709599	1841709599	1	1	HOUDEK, LAURA NP	11/20/2024	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
253780	Fee-for-Service	1023364692	1023364692	1	1	HONG, HANNA MD	9/10/2019	2080P0214X	NA	Pulmonology	026	PHYSICIANS	126707	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
253798	Fee-for-Service	1285662122	1285662122	1	1	HADEED, ADNAN J MD	1/31/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	33084	04	Otology, Laryngology, Rhinology	0	In state provider	None	607 GEORGIA ST	None	VALLEJO	CA	94590	6123	48	06095	38.1009957	-122.2529827	Solano County
253806	Fee-for-Service	1457459661	1457459661	1	1	HUSS, KAREN L LCSW	11/21/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	510 PLAZA DRIVE	STE 170	FOLSOM	CA	95630	4790	34	06067	38.65716	-121.1738175	Sacramento County
253844	Fee-for-Service	1568669042	1568669042	1	1	HARBOR ARTHRITIS &	4/15/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	MEDICAL CLINIC INC	13872 HARBOR BLVD	UNIT 1A	GARDEN GROVE	CA	92843	4000	30	06059	33.760971	-117.920161	Orange County
253859	Fee-for-Service	1679739288	1679739288	1	1	HAUGHEY, JOHN C MD	5/1/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110836	66	Emergency Medicine (Urgent Care)	0	In state provider	None	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	37	06073	32.7537975	-117.1658298	San Diego County
253886	Fee-for-Service	1215243522	1215243522	1	1	HING-HERNANDEZ, AMANDA L	10/26/2021	363LF0000X	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
253891	Fee-for-Service	1336198449	1336198449	1	1	HOMICZ, MARK MD	7/27/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70413	04	Otology, Laryngology, Rhinology	0	In state provider	None	2451 SUMMERFIELD RD	None	SANTA ROSA	CA	95405	7815	49	06097	38.441646	-122.6621475	Sonoma County
253899	Fee-for-Service	1780758839	1780758839	1	1	HANGER PROSTHETICS &	12/27/2016	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	1	Border provider	ORTHOTICS WEST INC	403 W NYE LANE	STE B	CARSON CITY	NV	89706	7917	00	None	39.186225	-119.769687	Consolidated Municipality of Carson City
253902	Fee-for-Service	1407855679	1407855679	1	1	HANDLEY, JOHANNA G MD	2/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	86532	08	Family Practice	0	In state provider	None	3800 DALE RD	None	MODESTO	CA	95356	8627	50	06099	37.69395556	-121.0499498	Stanislaus County
253911	Fee-for-Service	1659329225	1659329225	1	1	HARAN, PATRICK J MD	4/1/1995	207PE0004X	NA	Other	026	PHYSICIANS	80366	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
253927	Fee-for-Service	1396820064	1396820064	1	1	HSIA, ERIC C MD	6/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	62229	66	Emergency Medicine (Urgent Care)	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
253931	Fee-for-Service	1972680239	1972680239	1	1	HARDI, UMAR M MD	11/14/2023	207R00000X	NA	Other	026	PHYSICIANS	182805	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
253939	Fee-for-Service	1427495647	1427495647	1	1	HAUCK, CARLIN R MD	9/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154283	30	Radiology	0	In state provider	None	200 BELLA VISTA RD	None	VACAVILLE	CA	95687	5414	48	06095	38.34851794	-121.9884793	Solano County
253940	Fee-for-Service	1447201447	1447201447	1	1	HEFLIN, JOSEPH W JR MD	3/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	1600 MEDICAL PKWY	None	CARSON CITY	NV	89703	4625	00	None	39.202263	-119.7841095	Consolidated Municipality of Carson City
254000	Fee-for-Service	1689906406	1689906406	1	1	HIVES, FREDERICK II PHD	7/21/2017	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	4785 N FIRST ST	None	FRESNO	CA	93726	0513	10	06019	36.80478	-119.7724585	Fresno County
254016	Fee-for-Service	1043268014	1043268014	1	1	HOANG, TRI-DUNG G MD	8/19/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	79685	41	Internal Medicine	0	In state provider	None	6540 STOCKTON BLVD	STE 3A	SACRAMENTO	CA	95823	1635	34	06067	38.507094	-121.434858	Sacramento County
254048	Fee-for-Service	1902284144	1902284144	1	1	HAND REHAB PROS	8/13/2019	225XH1200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	23300 CINEMA DR	SUITE 240	VALENCIA	CA	91355	1775	19	06037	34.41921148	-118.542807	Los Angeles County
254053	Fee-for-Service	1598795130	1598795130	1	1	HAMILTON, CHRISTOPHER D MD	12/2/2021	207XX0005X	NA	Orthopedic Surgery	026	PHYSICIANS	76486	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
254069	Fee-for-Service	1205609401	1205609401	1	1	HOLLYWOOD EYE ASSOCIATES A P	2/28/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	3801 SAN DIMAS ST	SUITE A	BAKERSFIELD	CA	93301	1499	15	06029	35.39450879	-119.0082635	Kern County
254083	Fee-for-Service	1437497260	1437497260	1	1	HERCULES, YENI LMFT	11/26/2024	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
254113	Fee-for-Service	1134283591	1134283591	1	1	HOUSEMAN, JENNIFER C PHD	4/25/2014	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2001 JUNIPERO SERRA BLVD	SUITE 650	DALY CITY	CA	94104	3891	41	06081	37.70124814	-122.4706974	San Mateo County
254125	Fee-for-Service	1306899208	1306899208	1	1	HWONG, YU L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	47398	34	Urology and Urological Surgery	0	In state provider	None	25 N 14TH ST	STE 900	SAN JOSE	CA	95112	6216	43	06085	37.34293357	-121.8775187	Santa Clara County
254131	Fee-for-Service	1144547696	1144547696	1	1	HSU, STEVEN J MD	10/13/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120101	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
254132	Fee-for-Service	1568669042	1568669042	1	1	HARBOR ARTHRITIS &	4/15/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	83	Rheumatology	0	In state provider	MEDICAL CLINIC INC	13872 HARBOR BLVD	UNIT 1A	GARDEN GROVE	CA	92843	4000	30	06059	33.760971	-117.920161	Orange County
254134	Fee-for-Service	1194103358	1194103358	1	1	HENTZEN, COURTNEY J MD	6/27/2019	207P00000X	NA	Other	026	PHYSICIANS	159537	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
254135	Fee-for-Service	1366779977	1366779977	1	1	HAGGERTY, JENNIFER D MD	12/17/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	104935	08	Family Practice	0	In state provider	None	15425 LOS GATOS BLVD	120	LOS GATOS	CA	95032	2553	43	06085	37.24444696	-121.9589876	Santa Clara County
254150	Fee-for-Service	1649732454	1649732454	1	1	HILL, ELIANA NP	1/16/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
254156	Fee-for-Service	1205333853	1205333853	1	1	HEALD, JASON N MD	4/26/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	164529	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
254166	Fee-for-Service	1427133438	1427133438	1	1	HARRIS, EDMUND J JR MD	4/30/1992	2086S0129X	NA	General Surgery	026	PHYSICIANS	74792	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
254222	Fee-for-Service	1417930785	1417930785	1	1	HO, HUNG SY MD	5/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	65444	89	Surgery-Traumatic	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
254241	Fee-for-Service	1457764730	1457764730	1	1	HUBER-KEENER, KATHRYN MD	11/11/2021	207V00000X	NA	Obstetrics & Gynecology	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
254268	Fee-for-Service	1851586507	1851586507	1	1	HOTT, JASON M MD	8/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	102592	36	Psychiatry	0	In state provider	None	222 WEST 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
254273	Fee-for-Service	1295725190	1295725190	1	1	HATT, RUSSELL MD	4/30/1990	174400000X	NA	Other	026	PHYSICIANS	60974	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 E 4TH ST	None	NATIONAL CITY	CA	91950	1350	37	06073	32.68038513	-117.1040623	San Diego County
254311	Fee-for-Service	1528639838	1528639838	1	1	HAVANA HOME HEALTH INC	12/21/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13711 VAN NUYS BLVD	STE 3A	PACOIMA	CA	91331	3603	19	06037	34.25923536	-118.4315636	Los Angeles County
254314	Fee-for-Service	1801891551	1801891551	1	1	HEE, MICHAEL R MD	5/23/2006	207W00000X	NA	Ophthalmology	026	PHYSICIANS	71248	None	None	0	In state provider	None	1850 SULLIVAN AVE	STE 540	DALY CITY	CA	94015	2215	41	06081	37.68085904	-122.4728842	San Mateo County
254332	Fee-for-Service	1053680280	1053680280	1	1	HOLY CROSS HOSPICE INC.	5/6/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	28 N OAK AVENUE	STE 201	PASADENA	CA	91107	5870	19	06037	34.146387	-118.1075515	Los Angeles County
254337	Fee-for-Service	1699065342	1699065342	1	2	HUYNH, MICHAEL V MD	1/3/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	131349	-	NOT APPLICABLE	0	In state provider	None	86 SOUTH 14TH STREET	UNIT 1	SAN JOSE	CA	95112	2015	43	06085	37.34109735	-121.8760463	Santa Clara County
254342	Fee-for-Service	1609386572	1609386572	1	1	HIGGINS, MYSTY D LPCC	11/12/2023	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
254348	Fee-for-Service	1205838257	1205838257	1	1	HARNESS, JAY K MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	70155	02	General Surgery	0	In state provider	A MEDICAL CORP	1000 W LA VETA AVE	None	ORANGE	CA	92868	4304	30	06059	33.78028244	-117.8635552	Orange County
254373	Fee-for-Service	1326280074	1326280074	1	1	HE, XUE S MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	105396	13	Neurology (M.D. only)	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
254382	Fee-for-Service	1992150668	1992150668	1	1	HWANG, REGINA MD	9/24/2024	208600000X	NA	General Surgery	026	PHYSICIANS	179411	02	General Surgery	0	In state provider	None	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	19	06037	34.06169385	-118.2044698	Los Angeles County
254394	Fee-for-Service	1740505007	1740505007	1	1	HAFEZ, NAVID MD	5/1/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	183871	None	None	0	In state provider	None	11800 WILSHIRE BLVD	None	LOS ANGELES	CA	90025	6606	19	06037	34.0475456	-118.4632671	Los Angeles County
254433	Fee-for-Service	1083632582	1083632582	1	1	HERBSMAN, ODED MD	7/13/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53280	40	Pediatrics	0	In state provider	None	2340 CLAY ST	None	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
254442	Fee-for-Service	1689808115	1689808115	1	1	HFL HARBOR GATEWAY HOMES	4/20/2017	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	21218 MARIPOSA AVE	None	TORRANCE	CA	90502	1818	19	06037	33.83641549	-118.2981885	Los Angeles County
254529	Fee-for-Service	1568085686	1568085686	1	1	HH AND LL HOSPICE CARE INC	9/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1492 W COLORADO BLVD	SUITE 220	PASADENA	CA	91105	1465	19	06037	34.14086703	-118.1796369	Los Angeles County
254600	Fee-for-Service	1033641378	1033641378	1	1	HOLT, LUKAS L DO	12/28/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18207	None	None	0	In state provider	None	975 SERENO DR	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
254613	Fee-for-Service	1336195585	1336195585	1	1	HOGAN,ROBERT E MD	8/31/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1460 NE MEDICAL CTR DR	None	BEND	OR	97701	0000	00	None	44.064765	-121.2666635	Deschutes County
254620	Fee-for-Service	1083269864	1083269864	1	1	HUMANE HOME HEALTH INC	7/9/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 FRIAR ST	STE 158	VAN NUYS	CA	91411	2397	19	06037	34.18570347	-118.450386	Los Angeles County
254623	Fee-for-Service	1053680280	1053680280	1	1	HOLY CROSS HOSPICE INC.	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	28 N OAK AVENUE	STE 201	PASADENA	CA	91107	5870	19	06037	34.146387	-118.1075515	Los Angeles County
254633	Fee-for-Service	1073577979	1073577979	1	1	HUANG, HARRY S MD	6/20/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85073	40	Pediatrics	0	In state provider	None	1500 S CENTRAL AVE	STE 100	GLENDALE	CA	91204	2585	19	06037	34.12736888	-118.257777	Los Angeles County
254634	Fee-for-Service	1205838257	1205838257	1	1	HARNESS, JAY K MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	70155	67	Endocrinology	0	In state provider	A MEDICAL CORP	1000 W LA VETA AVE	None	ORANGE	CA	92868	4304	30	06059	33.78028244	-117.8635552	Orange County
254652	Fee-for-Service	1265545040	1265545040	1	1	HART, MATTHEW H MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	71211	05	Anesthesiology	0	In state provider	None	1901 COLLEGE AVENUE	None	SANTA ANA	CA	92706	2334	30	06059	33.76163312	-117.8918492	Orange County
254663	Fee-for-Service	1902024813	1902024813	1	1	HILLSON, CHRISTINA MARIE MD	12/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126168	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
254705	Fee-for-Service	1770537912	1770537912	1	1	HATHORN, ROBERT W MD	7/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	49051	34	Urology and Urological Surgery	0	In state provider	None	9834 GENESEE AVE	STE 421	LA JOLLA	CA	92037	1264	37	06073	32.884074	-117.225855	San Diego County
254718	Fee-for-Service	1083632582	1083632582	1	1	HERBSMAN, ODED MD	7/13/1994	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	53280	09	Gynecology (D.O. only)	0	In state provider	None	2340 CLAY ST	None	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
254739	Fee-for-Service	1477753614	1477753614	1	1	HAEFFELE, CHRISTIANE L MD	11/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120280	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
254743	Fee-for-Service	1609853142	1609853142	1	1	HERALDS HOME HEALTH	11/4/2003	251E00000X	NA	Other	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	13047 ARTESIA BLVD	SUITE C200 1/2	CERRITOS	CA	90703	5700	19	06037	33.87328747	-118.0544355	Los Angeles County
254763	Fee-for-Service	1164046827	1164046827	1	1	HSIEH, BENJAMIN MD	9/26/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189011	None	None	0	In state provider	None	700 17TH ST	None	MODESTO	CA	95354	1209	50	06099	37.64283069	-120.9903982	Stanislaus County
254774	Fee-for-Service	1427602036	1427602036	1	2	HEALTHCARE CLINICAL LABORATO	3/26/2021	291U00000X	NA	Other	009	CLINICAL LABORATORIES	-	-	NOT APPLICABLE	0	In state provider	RY, INC.	5744 SAN FERNANDO RD	UNIT 200	GLENDALE	CA	91202	2104	19	06037	34.15667442	-118.2773889	Los Angeles County
254789	Fee-for-Service	1538152707	1538152707	1	1	HENTELEFF, STEVEN R OD	6/18/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2867 AGOURA RD	None	WESTLAKE VILLAGE	CA	91361	3218	56	06111	34.1501976	-118.8244431	Ventura County
254796	Fee-for-Service	1427117373	1427117373	1	1	HOPPER, DOUGLAS J MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	21560	15	Obstetrics (D.O. only)	0	In state provider	None	2221 LINCOLN BLVD	STE 200	SANTA MONICA	CA	90405	1320	19	06037	34.00977424	-118.479803	Los Angeles County
254818	Fee-for-Service	1568085686	1568085686	1	1	HH AND LL HOSPICE CARE INC	9/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1492 W COLORADO BLVD	SUITE 220	PASADENA	CA	91105	1465	19	06037	34.14086703	-118.1796369	Los Angeles County
254842	Fee-for-Service	1487780284	1487780284	1	1	HONG LEI MD	1/13/2014	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
254845	Fee-for-Service	1538789151	1538789151	1	1	HARDY, KRISTIN K PHD	11/11/2022	103TC2200X	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
254870	Fee-for-Service	1043890254	1043890254	1	1	HARTNETT, ERIN	8/2/2024	207P00000X	NA	Other	026	PHYSICIANS	None	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
254890	Fee-for-Service	1639504269	1639504269	1	1	HOLLOWAY, RACHEL PSYD	4/20/2018	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
254910	Fee-for-Service	1427560812	1427560812	1	1	HOULSTON, MELISSA LCSW	5/16/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
254916	Fee-for-Service	1104873173	1104873173	1	1	HANNA NADY I MD	5/21/2007	2084P0800X	NA	Psychiatry	026	PHYSICIANS	50212	36	Psychiatry	0	In state provider	None	23845 MCBEAN PKWY	None	VALENCIA	CA	91355	2001	19	06037	34.39696803	-118.5525278	Los Angeles County
254923	Fee-for-Service	1205838257	1205838257	1	1	HARNESS, JAY K MD	9/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	70155	78	Neoplastic Diseases/Oncology	0	In state provider	A MEDICAL CORP	1000 W LA VETA AVE	None	ORANGE	CA	92868	4304	30	06059	33.78028244	-117.8635552	Orange County
254932	Fee-for-Service	1497886006	1497886006	1	1	HOUGHTON, CATHERINE M MFT	6/20/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	47044	-	NOT APPLICABLE	0	In state provider	None	43520 DIVISION STREET	None	LANCASTER	CA	93535	4089	19	06037	34.673445	-118.130143	Los Angeles County
254951	Fee-for-Service	1720406135	1720406135	1	1	HAQUE, NAJM S MD	6/12/2020	207P00000X	NA	Other	026	PHYSICIANS	156158	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
254965	Fee-for-Service	1588660401	1588660401	1	1	HAMNER, RICHARD T MD	5/22/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	66513	08	Family Practice	0	In state provider	None	1800 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	18	06035	40.43816059	-120.6279677	Lassen County
254998	Fee-for-Service	1447344692	1447344692	1	1	HASTINGS,LAURA A MD	3/15/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86027	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
255008	Fee-for-Service	1669812400	1669812400	1	1	HTET, NATALIE N MD	2/1/2018	207P00000X	NA	Other	026	PHYSICIANS	139728	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1411 EAST 31ST STREET	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
255027	Fee-for-Service	1477753614	1477753614	1	1	HAEFFELE, CHRISTIANE L MD	11/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120280	06	Cardiovascular Disease (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
255031	Fee-for-Service	1508171992	1508171992	1	1	HANSSEN, TORA M MD	6/27/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	42856	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DRIVE	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
255040	Fee-for-Service	1821259953	1821259953	1	2	HERNANDEZ, GERTRUDES A PHD	7/3/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	.	2815 MITCHELL DR	STE 119	WALNUT CREEK	CA	94598	1622	07	06013	37.93129027	-122.0204585	Contra Costa County
255046	Fee-for-Service	1447451372	1447451372	1	1	HAGERTY, DENNIS P LMFT	5/7/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	80448	-	NOT APPLICABLE	0	In state provider	None	43807 10TH ST W	D	LANCASTER	CA	93534	4805	19	06037	34.6788	-118.1479295	Los Angeles County
255057	Fee-for-Service	1598728891	1598728891	1	1	HOLT, PETER D MD	4/16/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	51879	30	Radiology	0	In state provider	None	18436 ROSCOE BLVD	None	NORTHRIDGE	CA	91325	4107	19	06037	34.22078873	-118.5351265	Los Angeles County
255133	Fee-for-Service	1962957720	1962957720	1	1	HEALING TOUCH HOME HEALTH	5/1/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	CARE INC	2893 SUNRISE BLVD	SUITE 209	RANCHO CORDOVA	CA	95742	6527	34	06067	38.598471	-121.2650595	Sacramento County
255138	Fee-for-Service	1457310500	1457310500	1	1	HOLCOMB, DIANA L OD	4/3/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	GRASS VLY EYE CARE OPT	670 SUTTON WAY	None	GRASS VALLEY	CA	95945	5392	29	06057	39.23319097	-121.0359874	Nevada County
255176	Fee-for-Service	1881154698	1881154698	1	1	HAN, STEVEN J MD	8/30/2024	208M00000X	NA	Other	026	PHYSICIANS	189815	41	Internal Medicine	0	In state provider	None	9353 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.9171603	-118.1288418	Los Angeles County
255213	Fee-for-Service	1225158157	1225158157	1	1	HANKINSON,JENNIFER MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2525 S DOWING	None	DENVER	CO	80210	0000	00	None	39.670326	-104.9735195	Denver County
255229	Fee-for-Service	1073285706	1073285706	1	1	HUGHELL, CYNTHIA	7/13/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1827 KNOLL DR	None	VENTURA	CA	93003	7321	56	06111	34.25641704	-119.2199387	Ventura County
255242	Fee-for-Service	1336659754	1336659754	1	1	HODGSON, MACGREGOR MD	5/23/2024	207L00000X	NA	Other	026	PHYSICIANS	182203	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
255257	Fee-for-Service	1265122741	1265122741	1	1	HOME OF PURPOSE LLC	6/14/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	37544 RIVER OATS LANE	None	MURRIETA	CA	92563	3571	33	06065	33.57500561	-117.1021191	Riverside County
255287	Fee-for-Service	1447344692	1447344692	1	1	HASTINGS,LAURA A MD	3/15/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86027	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
255297	Fee-for-Service	1669812400	1669812400	1	1	HTET, NATALIE N MD	2/1/2018	207P00000X	NA	Other	026	PHYSICIANS	139728	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
255308	Fee-for-Service	1518017672	1518017672	1	1	HSU, DI CCC-SLP	4/17/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
255369	Fee-for-Service	1316168875	1316168875	1	1	HONG, DANIEL K	10/18/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	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
255373	Fee-for-Service	1194815043	1194815043	1	1	HWANG, JOO H MD	12/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	152676	10	Gastroenterology (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
255376	Fee-for-Service	1699193425	1699193425	1	1	HOROWITZ, MAX P MD	10/19/2021	207VX0201X	NA	Obstetrics & Gynecology	026	PHYSICIANS	173735	None	None	0	In state provider	None	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
255401	Fee-for-Service	1285729848	1285729848	1	1	HWANG, ALBERT D MD	9/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	96879	25	Physical Medicine and Rehabilitation	0	In state provider	None	3160 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5219	34	06067	38.568393	-121.4658585	Sacramento County
255415	Fee-for-Service	1013078393	1013078393	1	1	HALEY, ROGER J MD	8/10/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	36061	41	Internal Medicine	0	In state provider	None	8665 GIBBS DR	STE 202	SAN DIEGO	CA	92123	1747	37	06073	32.81043091	-117.1419105	San Diego County
255448	Fee-for-Service	1669753778	1669753778	1	1	HOORNBEEK, DOREEN E LMFT	10/26/2023	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
255461	Fee-for-Service	1760582217	1760582217	1	1	HENDERSON, ELLEN L MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68158	66	Emergency Medicine (Urgent Care)	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
255471	Fee-for-Service	1033570122	1033570122	1	1	HOSSEINIPOUR, MOJGAN DO	8/13/2020	207N00000X	NA	Dermatology	026	PHYSICIANS	18195	07	Dermatology	0	In state provider	None	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	33	06065	33.90336622	-117.49394	Riverside County
255533	Fee-for-Service	1891259024	1891259024	1	1	HALPERN, STEPHANIE E NP	1/2/2024	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	95010921	-	NOT APPLICABLE	0	In state provider	None	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	19	06037	34.28133474	-118.4198166	Los Angeles County
255548	Fee-for-Service	1720263114	1720263114	2	1	HUNTINGTON CARE LLC	8/23/2013	No Taxonomy Provided	NA	None	093	CARE COORDINATOR AGENCIES (CCA)	-	-	NOT APPLICABLE	0	In state provider	None	3452 E FOOTHILL BLVD	130C	PASADENA	CA	91107	3162	19	06037	34.15010239	-118.0788233	Los Angeles County
255670	Fee-for-Service	1851533046	1851533046	1	1	HARLAN, ELIZABETH E MD	7/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	126077	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
255702	Fee-for-Service	1609978352	1609978352	1	1	HISATOMI, GEORGE Y MD	10/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	78734	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 300230	SACRAMENTO	CA	95816	5238	34	06067	38.570076	-121.4657145	Sacramento County
255731	Fee-for-Service	1285052498	1285052498	1	1	HAN, JAMES J MD	10/2/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	155459	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
255735	Fee-for-Service	1609295583	1609295583	1	1	HOMER, NATALIE A MD	8/19/2020	207WX0200X	NA	Ophthalmology	026	PHYSICIANS	169185	18	Ophthalmology	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
255738	Fee-for-Service	1588182117	1588182117	1	1	HARKHAM, SINAIA LCSW	3/25/2025	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	94697	-	NOT APPLICABLE	0	In state provider	None	1750 S LA CIENEGA BLVD	STE A, B, C, D	LOS ANGELES	CA	90035	4602	19	06037	34.04559008	-118.3765503	Los Angeles County
255746	Fee-for-Service	1760582217	1760582217	1	1	HENDERSON, ELLEN L MD	5/11/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	68158	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
255755	Fee-for-Service	1114346830	1114346830	1	1	HARRIS-NADDELL, MARITA M MD	6/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	146604	66	Emergency Medicine (Urgent Care)	0	In state provider	None	400 WEST PUEBLO STREET	None	SANTA BARBARA	CA	93105	4353	42	06083	34.42887662	-119.7237878	Santa Barbara County
255762	Fee-for-Service	1962004085	1962004085	1	1	HESSLER, WALTER CRNA	5/5/2021	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	975 SOUTH FAIRMONT AVE	None	LODI	CA	95240	5118	39	06077	38.12188356	-121.285872	San Joaquin County
255778	Fee-for-Service	1275584203	1275584203	1	1	HECHANOVA, DEMETRIO	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	40661	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1334 W COVINA BLVD	STE 205	SAN DIMAS	CA	91773	3211	19	06037	34.097067	-117.833751	Los Angeles County
255783	Fee-for-Service	1730634619	1730634619	1	2	HERNANDEZ, DANIEL MD	6/29/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	164992	-	NOT APPLICABLE	0	In state provider	None	2100 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	5721	34	06067	38.572722	-121.479849	Sacramento County
255813	Fee-for-Service	1407116007	1407116007	1	1	HAMILTON, JESSICA W MD	5/19/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123206	01	General Practice	0	In state provider	JESSICA HAMILTON	2500 ALHAMBRA AVE	None	MARTINEZ	CA	94553	3156	07	06013	38.00658519	-122.1309063	Contra Costa County
255827	Fee-for-Service	1801391537	1801391537	1	1	HUMPHREY, DANIELLE L 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
255849	Fee-for-Service	1376742726	1376742726	1	1	HOOD, NEDRA Y MD	8/3/2023	208800000X	NA	Other	026	PHYSICIANS	185520	None	None	0	In state provider	None	7300 N FRESNO	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
255868	Fee-for-Service	1942915863	1942915863	1	1	HENNING, DEMETRIUS PT	2/18/2025	No Taxonomy Provided	NA	None	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
255896	Fee-for-Service	1457063992	1457063992	1	1	HOVANESIAN, SOSEH PT	3/21/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1000 N CENTRAL AVE.	SUITE 110	GLENDALE	CA	91202	2957	19	06037	34.15992057	-118.2572221	Los Angeles County
255902	Fee-for-Service	1275629750	1275629750	1	1	HOOPAI, RODNEY	5/30/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	CE SERVICES	5053 LA MART DR	105	RIVERSIDE	CA	92507	0609	33	06065	33.95818206	-117.3320081	Riverside County
255907	Fee-for-Service	1912018219	1912018219	1	1	HONG, JOSEPH S MD	10/30/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	8140	13	Neurology (M.D. only)	0	In state provider	None	6699 ALVARADO RD	STE 2100	SAN DIEGO	CA	92120	5238	37	06073	32.77665383	-117.0540279	San Diego County
255947	Fee-for-Service	1881972719	1881972719	1	1	HOLLWIG, KATHLEEN E LMFT	12/19/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6615 E PACIFIC COAST HWY	SUITE 280	LONG BEACH	CA	90803	4231	19	06037	33.75463355	-118.1079597	Los Angeles County
255956	Fee-for-Service	1942663570	1942663570	1	1	HERR, NICOLE	12/26/2023	207P00000X	NA	Other	026	PHYSICIANS	192014	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
256030	Fee-for-Service	1497251367	1497251367	1	1	HSIEH, TERRY MD	6/15/2022	390200000X	NA	Other	026	PHYSICIANS	164534	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
256032	Fee-for-Service	1750574075	1750574075	1	1	HOANG-XUAN, TUAN A MD	2/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	7954	07	Dermatology	0	In state provider	PACIFIC COAST DERMATOLO	13768 ROSWELL AVENUE	STE 102	CHINO	CA	91710	1401	36	06071	34.0038	-117.7218555	San Bernardino County
256066	Fee-for-Service	1275584203	1275584203	1	1	HECHANOVA, DEMETRIO	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	40661	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1334 W COVINA BLVD	STE 205	SAN DIMAS	CA	91773	3211	19	06037	34.097067	-117.833751	Los Angeles County
256112	Fee-for-Service	1447480785	1447480785	1	1	HOME FOOT CARE, INC.	12/12/2019	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	12520 MAGNOLIA BLVD	#304	VALLEY VILLAGE	CA	91607	2355	19	06037	34.16485451	-118.406106	Los Angeles County
256142	Fee-for-Service	1619596111	1619596111	1	1	HILLS PHARMACY INC	8/16/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2906 1/2 FOOTHILL BLVD	None	LA CRESCENTA	CA	91214	3411	19	06037	34.2256325	-118.2423787	Los Angeles County
256166	Fee-for-Service	1730111923	1730111923	1	1	HOFFMAN, CHRISTOPHER MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	40982	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2110 PROFESSIONAL DR	STE 100	ROSEVILLE	CA	95661	3752	31	06061	38.74234873	-121.2521259	Placer County
256224	Fee-for-Service	1992862791	1992862791	1	1	HWANG, JENNY M INC	8/28/2014	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1701 CESAR CHAVEZ AVE	STE 305	LOS ANGELES	CA	90033	2488	19	06037	34.05112725	-118.2173921	Los Angeles County
256242	Fee-for-Service	1457370207	1457370207	1	1	HSIAO,AN-FU MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	69989	41	Internal Medicine	0	In state provider	None	200 MED PLAZA	STE 365	LOS ANGELES	CA	90055	0000	19	06037	34.06527974	-118.4462792	Los Angeles County
256259	Fee-for-Service	1407191356	1407191356	1	1	HIGH DESERT PATHOLOGY MEDICA	1/10/2013	193200000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	16850 BEAR VALLEY ROAD	None	VICTORVILLE	CA	92395	5794	36	06071	34.47092468	-117.2977236	San Bernardino County
256289	Fee-for-Service	1124552674	1124552674	1	1	HENKEL, CAROLYN MD	6/26/2019	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	159273	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
256302	Fee-for-Service	1689661225	1689661225	1	1	HANSEN, KEVIN P MD	8/26/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	70781	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
256322	Fee-for-Service	1033390273	1033390273	1	1	HERALD CHRISTIAN HEALTH	11/1/2013	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER	923 S SAN GABRIEL BLVD	None	SAN GABRIEL	CA	91776	2743	19	06037	34.09081108	-118.0909325	Los Angeles County
256346	Fee-for-Service	1780298745	1780298745	1	1	HORWITZ, LISANNE R PT	8/19/2022	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	795 EL CAMINO REAL	None	PALO ALTO	CA	94301	2302	43	06085	37.43920432	-122.162109	Santa Clara County
256351	Fee-for-Service	1477507622	1477507622	1	1	HASSAN, SAMMY J MD	9/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	79071	05	Anesthesiology	0	In state provider	None	1800 NORTH CALIFORNIA ST	None	STOCKTON	CA	95204	6019	39	06077	37.97026329	-121.2890849	San Joaquin County
256352	Fee-for-Service	1275584203	1275584203	1	1	HECHANOVA, DEMETRIO	12/11/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	40661	41	Internal Medicine	0	In state provider	None	1334 W COVINA BLVD	STE 205	SAN DIMAS	CA	91773	3211	19	06037	34.097067	-117.833751	Los Angeles County
256396	Fee-for-Service	1104831866	1104831866	1	1	HOBBS, LORI M MD	9/27/2021	302R00000X	NA	Other	026	PHYSICIANS	78354	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
256418	Fee-for-Service	1386120434	1386120434	1	1	HILL, TURIYA LAC	12/4/2018	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1908 N BEALE RD	STE E	MARYSVILLE	CA	95901	6937	58	06115	39.1278388	-121.5457994	Yuba County
256469	Fee-for-Service	1346313772	1346313772	1	1	HUNTER, KATHLYN B	6/22/2017	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
256516	Fee-for-Service	1770922122	1770922122	1	1	HEERBOTH, AARON P MD	7/1/2017	207P00000X	NA	Other	026	PHYSICIANS	124309	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
256570	Fee-for-Service	1891923173	1891923173	1	1	HUFFMAN, CHARLES S MD	2/6/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	113585	-	NOT APPLICABLE	0	In state provider	None	5 MAREBLU	STE 100, 200, 250	ALISO VIEJO	CA	92656	3014	30	06059	33.57250566	-117.7027366	Orange County
256575	Fee-for-Service	1891769105	1891769105	1	1	HAZEL, ALEXANDER DO	8/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	8379	36	Psychiatry	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
256579	Fee-for-Service	1790910677	1790910677	1	1	HOUGO, KAREN R MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	81882	41	Internal Medicine	0	In state provider	None	2115 S CENTERPOINTE PKWY	None	SANTA MARIA	CA	93455	1334	42	06083	34.92292048	-120.428709	Santa Barbara County
256585	Fee-for-Service	1205459716	1205459716	1	1	HEALTHRIGHT 360	8/12/2020	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	33440 ALVARADO NILES RD	None	UNION CITY	CA	94587	3110	01	06001	37.59181933	-122.0376576	Alameda County
256610	Fee-for-Service	1033390273	1033390273	1	1	HERALD CHRISTIAN HEALTH	11/1/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER	923 S SAN GABRIEL BLVD	None	SAN GABRIEL	CA	91776	2743	19	06037	34.09081108	-118.0909325	Los Angeles County
256628	Fee-for-Service	1538194436	1538194436	1	1	HONG, JOHNNY C MD	6/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86819	02	General 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
256694	Fee-for-Service	1407172463	1407172463	1	1	HESSLING, THOMAS A MD INC	6/11/2013	2084P0800X	NA	Psychiatry	026	PHYSICIANS	39433	None	None	0	In state provider	None	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	37	06073	32.79493052	-117.155268	San Diego County
256709	Fee-for-Service	1326028192	1326028192	1	1	HUEBNER, CHADLEY R MD	10/17/2019	2080P0006X	NA	Psychiatry	026	PHYSICIANS	109814	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
256735	Fee-for-Service	1578824512	1578824512	1	1	HA, EUNTAIK MD	6/7/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	128999	40	Pediatrics	0	In state provider	None	25845 BARTON RD	STE F	LOMA LINDA	CA	92354	3857	36	06071	34.04824949	-117.2401425	San Bernardino County
256778	Fee-for-Service	1124786660	1124786660	1	1	HOMEAID HOME HEALTH CARE INC	6/25/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3075 E THOUSAND OAKS BLV	STE 28	WESTLAKE VILLAGE	CA	91362	3402	56	06111	34.16931166	-118.8361901	Ventura County
256791	Fee-for-Service	1699853184	1699853184	1	1	HAMANN, KEVIN C MD	6/15/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	81437	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
256795	Fee-for-Service	1972115004	1972115004	1	1	HOME HEALTH INC	10/19/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2050 W CHAPMAN AVE	STE 200	ORANGE	CA	92868	2602	30	06059	33.78787054	-117.87498	Orange County
256840	Fee-for-Service	1760465157	1760465157	1	1	HANFORD REGIONAL MEDICAL	3/2/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	GROUP APC	1524 W LACEY BLVD	None	HANFORD	CA	93230	5965	16	06031	36.32816338	-119.6690189	Kings County
256858	Fee-for-Service	1780657577	1780657577	1	1	HARRINGTON,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	200 LOTHROP STREET	None	PITTSBURGH	PA	15213	0000	00	None	40.44188737	-79.96079711	Allegheny County
256865	Fee-for-Service	1790910677	1790910677	1	1	HOUGO, KAREN R MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	81882	01	General Practice	0	In state provider	None	2115 S CENTERPOINTE PKWY	None	SANTA MARIA	CA	93455	1334	42	06083	34.92292048	-120.428709	Santa Barbara County
256880	Fee-for-Service	1023166857	1023166857	1	1	HUM, PETER T MD	10/1/1999	207R00000X	NA	Other	026	PHYSICIANS	75718	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
256941	Fee-for-Service	1538146337	1538146337	1	1	HUSKEY, DANA E MD	9/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	99128	None	None	0	In state provider	None	8010 FROST ST	STE 301	SAN DIEGO	CA	92123	4237	37	06073	32.80026879	-117.1520059	San Diego County
256945	Fee-for-Service	1699849570	1699849570	1	1	HANGER P & O WEST INC.	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	23961 CALLE DE LA MAGDAL	STE 153	LAGUNA HILLS	CA	92653	3616	30	06059	33.60999658	-117.7126577	Orange County
256957	Fee-for-Service	1730336884	1730336884	1	1	HAAS, CLARE M MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124258	40	Pediatrics	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
256991	Fee-for-Service	1326824673	1326824673	1	1	HOELZEL, PATRICIA BIRTH DOU	11/2/2023	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	30	06059	0	0	None
257061	Fee-for-Service	1578516373	1578516373	1	1	HORN, JAN MD	7/31/1983	2086S0102X	NA	General Surgery	026	PHYSICIANS	48017	02	General Surgery	0	In state provider	WARD 3A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
257075	Fee-for-Service	1952604035	1952604035	1	1	HYUN, MYUNG H	3/26/2014	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1045 W REDONDO BEACH BLV	SUITE 110	GARDENA	CA	90247	4124	19	06037	33.89247044	-118.2931941	Los Angeles County
257076	Fee-for-Service	1386296101	1386296101	1	1	HURTS, JESSIKA R PSYD	11/30/2021	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
257100	Fee-for-Service	1033152624	1033152624	1	1	HSU, VINCENT OD	1/29/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1220 S GOLDEN WEST AVE	STE C	ARCADIA	CA	91007	7484	19	06037	34.12490283	-118.0600324	Los Angeles County
257128	Fee-for-Service	1760465157	1760465157	1	1	HANFORD REGIONAL MEDICAL	3/2/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	GROUP APC	1524 W LACEY BLVD	None	HANFORD	CA	93230	5965	16	06031	36.32816338	-119.6690189	Kings County
257135	Fee-for-Service	1689136616	1689136616	1	1	HOMEBOUNCE IN-HOME THERAPY S	7/1/2020	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	ERVICES INC.	22519 HAWTHORNE BLVD	SUITE F	TORRANCE	CA	90505	2509	19	06037	33.823503	-118.351227	Los Angeles County
257153	Fee-for-Service	1790910677	1790910677	1	1	HOUGO, KAREN R MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	81882	67	Endocrinology	0	In state provider	None	2115 S CENTERPOINTE PKWY	None	SANTA MARIA	CA	93455	1334	42	06083	34.92292048	-120.428709	Santa Barbara County
257157	Fee-for-Service	1568447860	1568447860	1	1	HA, THOMAS T MD, INC	2/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	43426	41	Internal Medicine	0	In state provider	None	320 S GARFIELD AVE	STE 110	ALHAMBRA	CA	91801	3887	19	06037	34.09184212	-118.1245127	Los Angeles County
257221	Fee-for-Service	1386693547	1386693547	1	2	HAMILTON, ROBERT MD	8/14/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	48570	-	NOT APPLICABLE	0	In state provider	None	1839 S EL DORADO STREET	None	STOCKTON	CA	95206	2025	39	06077	37.93316949	-121.2845192	San Joaquin County
257222	Fee-for-Service	1790924280	1790924280	1	1	HUANG, CATHERINE OD A	3/27/2009	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	PROFESSIONAL CORPORATION	1001 W WHITTIER BLVD	STE E	MONTEBELLO	CA	90640	4688	19	06037	34.01063931	-118.110997	Los Angeles County
257247	Fee-for-Service	1730336884	1730336884	1	1	HAAS, CLARE M MD	7/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	124258	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2801 ATLANTIC AVENUE	None	LONG BEACH	CA	90806	1701	19	06037	33.808185	-118.1850575	Los Angeles County
257251	Fee-for-Service	1609405992	1609405992	1	1	HELOU, MICHELINE CNP	7/13/2021	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	21091 RIDER ST	SUITE 218	PERRIS	CA	92570	8878	33	06065	33.8298049	-117.2941212	Riverside County
257257	Fee-for-Service	1306924196	1306924196	1	1	HUYNH, DENNIS S MD	1/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	45436	01	General Practice	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
257263	Fee-for-Service	1346231149	1346231149	1	1	HANDIN, RICHARD MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	39118	41	Internal Medicine	0	In state provider	None	7300 MEDICAL CENTER DR	None	CANOGA PARK	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
257271	Fee-for-Service	1760560247	1760560247	1	1	HSU, ALAN MD	11/7/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	82216	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
257295	Fee-for-Service	1912674755	1912674755	1	1	HUTAPEA, JOSHUA K PT	11/19/2021	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
257319	Fee-for-Service	1609495175	1609495175	1	1	HAMIDI, ROHAUM MD	9/25/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	186269	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
257358	Fee-for-Service	1508840786	1508840786	1	1	HUBBARD, ROBERT J MD	1/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	48779	22	Pathology (M.D. only)	0	In state provider	None	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1217	36	06071	34.131303	-117.3225325	San Bernardino County
257368	Fee-for-Service	1790392488	1790392488	1	1	HOBBS, ALICIA M MD	11/13/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	189720	08	Family Practice	0	In state provider	None	1900 DRESDEN	None	LINCOLN	CA	95648	8803	31	06061	38.85524393	-121.2946284	Placer County
257415	Fee-for-Service	1760465157	1760465157	1	1	HANFORD REGIONAL MEDICAL	3/2/2004	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	GROUP APC	1524 W LACEY BLVD	None	HANFORD	CA	93230	5965	16	06031	36.32816338	-119.6690189	Kings County
257416	Fee-for-Service	1760439681	1760439681	1	1	HABIS, JOSEPH A, MD	2/18/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	73451	41	Internal Medicine	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
257451	Fee-for-Service	1124524095	1124524095	1	1	HERNANDEZ, JENNIFER MD	12/7/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	191601	None	None	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
257467	Fee-for-Service	1902980147	1902980147	1	1	HOANG, JEAN K OD	1/6/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	936 S BROOKHURST ST	None	ANAHEIM	CA	92804	4305	30	06059	33.819075	-117.9589105	Orange County
257477	Fee-for-Service	1104950872	1104950872	1	1	HENG, SEAM T LMFT	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
257489	Fee-for-Service	1316382732	1316382732	1	1	HAN, XIAO MD	9/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149504	25	Physical Medicine and Rehabilitation	0	In state provider	None	10050 N WOLFE ROAD	None	CUPERTINO	CA	95014	2519	43	06085	37.323639	-122.014123	Santa Clara County
257505	Fee-for-Service	1649255290	1649255290	1	1	HANDLER, CURTIS R MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	34638	30	Radiology	0	In state provider	None	5470 JEFFERSON AVE	None	CHINO	CA	91710	3517	36	06071	34.02470949	-117.685854	San Bernardino County
257521	Fee-for-Service	1518957901	1518957901	1	1	HUANG, ERIC MD	8/30/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	75514	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
257528	Fee-for-Service	1275738254	1275738254	1	1	HARTMAN, SANDRA K	5/27/2010	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	400 CRAVEN ROAD	None	SAN MARCOS	CA	92078	4201	37	06073	33.12746646	-117.17028	San Diego County
257532	Fee-for-Service	1063901767	1063901767	1	2	HUMBOLDT MOBILE MASSAGE INC	4/9/2025	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	23	06045	0	0	None
257562	Fee-for-Service	1013901271	1013901271	1	1	HO, TIMOTHY C DPM	7/1/2003	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3150 ALMADEN EXPY	STE 231A	SAN JOSE	CA	95118	1250	43	06085	37.276537	-121.8777357	Santa Clara County
257574	Fee-for-Service	1558513101	1558513101	1	1	HU, JENNY C MD	3/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	108053	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	STE 450	LOS ANGELES	CA	90095	6957	19	06037	34.06527974	-118.4462792	Los Angeles County
257593	Fee-for-Service	1609851187	1609851187	2	1	HEKMAT, VAHID MD	3/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51341	40	Pediatrics	0	In state provider	None	23101 SHERMAN PL	STE 407	WEST HILLS	CA	91307	2032	19	06037	34.20099112	-118.6297991	Los Angeles County
257604	Fee-for-Service	1497130058	1497130058	1	1	HENNON, MONICA J PHD	9/9/2015	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
257624	Fee-for-Service	1689712515	1689712515	1	1	HOLT,RICHARD 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
257628	Fee-for-Service	1184155673	1184155673	1	1	HARRISON, CAMERON W MD	3/4/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	158091	08	Family Practice	0	In state provider	None	8110 WOODMAN AVE	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21850103	-118.4310944	Los Angeles County
257643	Fee-for-Service	1538406970	1538406970	1	1	HAYATDAVOUDI, SAMAN MD INC	4/19/2013	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
257652	Fee-for-Service	1841078912	1841078912	1	1	HAMON, TAMMY NP	3/3/2025	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7373 WEST LN	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
257811	Fee-for-Service	1053375931	1053375931	1	1	HEBSON, CATHLEEN A MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	63811	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
257838	Fee-for-Service	1447974605	1447974605	1	1	HERNANDEZ, EMMANUEL PT	5/23/2024	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	6850 BROCKTON AVE	STE 212	RIVERSIDE	CA	92506	3808	33	06065	33.9493261	-117.3967206	Riverside County
257848	Fee-for-Service	1699158022	1699158022	1	1	HOOPER, JASON K	5/3/2017	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
257850	Fee-for-Service	1164508628	1164508628	1	1	HUNG, RAYMOND K MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	80929	30	Radiology	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
257852	Fee-for-Service	1770810244	1770810244	1	1	HELTON, BETTY A MD	3/31/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	59766	05	Anesthesiology	0	In state provider	None	425 W JUNIPERO ST	None	SANTA BARBARA	CA	93105	4200	42	06083	34.42973253	-119.7249544	Santa Barbara County
257882	Fee-for-Service	1609851187	1609851187	2	1	HEKMAT, VAHID MD	3/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	51341	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	23101 SHERMAN PL	STE 407	WEST HILLS	CA	91307	2032	19	06037	34.20099112	-118.6297991	Los Angeles County
257883	Fee-for-Service	1316336779	1316336779	1	1	HARLAN, DENISE K LCSW	12/22/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER 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
257930	Fee-for-Service	1538406970	1538406970	1	1	HAYATDAVOUDI, SAMAN MD INC	4/19/2013	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
257934	Fee-for-Service	1508160086	1508160086	1	1	HALLIGAN, SOMMER CD	12/12/2023	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	12	06023	0	0	None
257975	Fee-for-Service	1902932726	1902932726	1	1	HORDSANDQUIST, KAREN L MD	4/4/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	86818	01	General Practice	0	In state provider	None	51 HITCHCOCK WAY	None	SANTA BARBARA	CA	93105	3101	42	06083	34.43833587	-119.7444336	Santa Barbara County
257985	Fee-for-Service	1477784668	1477784668	1	1	HOMER, MICHAEL V MD	6/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114947	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
258004	Fee-for-Service	1699909101	1699909101	1	1	HERNANDEZ, JAIME D MD	8/17/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110306	20	Orthopedic Surgery	0	In state provider	None	6815 NOBLE AVENUE	None	VAN NUYS	CA	91405	3730	19	06037	34.19440435	-118.461871	Los Angeles County
258034	Fee-for-Service	1710407499	1710407499	1	1	HERNANDEZ, NANCY K LCSW	11/2/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	101026	-	NOT APPLICABLE	0	In state provider	None	3250 WILSHIRE BLVD	300	LOS ANGELES	CA	90010	1577	19	06037	34.06176363	-118.2932622	Los Angeles County
258059	Fee-for-Service	1659459824	1659459824	1	1	HETHUMUNI, GAMINI D MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	33433	41	Internal Medicine	0	In state provider	None	416 W LAS TUNAS DR	STE 300	SAN GABRIEL	CA	91776	1236	19	06037	34.10243845	-118.1046106	Los Angeles County
258083	Fee-for-Service	1417641507	1417641507	1	1	HOLBERT, MATTHEW PT	6/21/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	4339 E MORADA LN STE 150	150	STOCKTON	CA	95212	1634	39	06077	38.039067	-121.259493	San Joaquin County
258101	Fee-for-Service	1366701864	1366701864	1	1	HOOGE, JOHN D MD	8/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128598	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
258108	Fee-for-Service	1114952850	1114952850	1	1	HAN, CAROLINE M MD	2/17/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85098	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2000 SUTTER PL	None	DAVIS	CA	95616	6201	57	06113	38.56289303	-121.7715238	Yolo County
258125	Fee-for-Service	1548816168	1548816168	1	1	HAMILTON, SARA B	11/19/2019	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	23018 TIMBER RIDGE CT	None	WILDOMAR	CA	92595	7783	33	06065	33.59724847	-117.2571975	Riverside County
258195	Fee-for-Service	1053792291	1053792291	1	1	HAYANO, TODD R DO	11/14/2020	207RS0010X	NA	Other	026	PHYSICIANS	18436	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
258201	Fee-for-Service	1992786529	1992786529	1	1	HOOVER, KEVIN B MD	5/26/2020	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161971	30	Radiology	0	In state provider	None	8670 WILSHIRE BOULEVARD	SUITE 101	BEVERLY HILLS	CA	90211	2930	19	06037	34.06629779	-118.3807407	Los Angeles County
258217	Fee-for-Service	1538406970	1538406970	1	1	HAYATDAVOUDI, SAMAN MD INC	4/19/2013	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1100 BUTTE STREET	None	REDDING	CA	96001	0852	45	06089	40.5853603	-122.3869865	Shasta County
258243	Fee-for-Service	1750460143	1750460143	1	1	HADI, SUHAD DPM	8/11/2005	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	6555 COYLE AVE	None	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
258258	Fee-for-Service	1073518353	1073518353	1	1	HALBRIDGE, NEIL J MD	1/1/1982	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	27529	20	Orthopedic Surgery	0	In state provider	None	6800 BROCKTON AVE	None	RIVERSIDE	CA	92506	3810	33	06065	33.9496766	-117.3967147	Riverside County
258269	Fee-for-Service	1942981188	1942981188	1	1	HOI, JOSIAH W CRNA	12/8/2023	163W00000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
258286	Fee-for-Service	1013309947	1013309947	1	1	HOROVITZ, DAVID MD	9/20/2018	208800000X	NA	Other	026	PHYSICIANS	148088	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
258287	Fee-for-Service	1679238745	1679238745	1	1	HYLTON, EMILY P	1/14/2022	163W00000X	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
258323	Fee-for-Service	1598080624	1598080624	1	1	HUFFMAN, ELIZABETH A MD	9/6/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118108	40	Pediatrics	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
258332	Fee-for-Service	1851332423	1851332423	1	1	HEPOLA, MARIE L	10/9/1995	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1801 W ROMNEYA DR	STE 205	ANAHEIM	CA	92801	1825	30	06059	33.8506615	-117.946413	Orange County
258365	Fee-for-Service	1306103783	1306103783	1	1	HATHUC, CHINHNAM DO	10/20/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12261	01	General Practice	0	In state provider	None	540 E ARTESIA BLVD	None	LONG BEACH	CA	90805	3809	19	06037	33.87435148	-118.186947	Los Angeles County
258370	Fee-for-Service	1932411543	1932411543	1	1	HEMANS, NICHOLE S LCSW	9/4/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18663 VENTURA BLVD	SUITE 232	TARZANA	CA	91356	6801	19	06037	34.17051848	-118.5402557	Los Angeles County
258389	Fee-for-Service	1831233493	1831233493	1	1	HINESLY, JAIME E LMFT	7/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	4045 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2021	15	06029	35.3540847	-119.0536548	Kern County
258415	Fee-for-Service	1548816168	1548816168	1	1	HAMILTON, SARA B	11/19/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	23018 TIMBER RIDGE CT	None	WILDOMAR	CA	92595	7783	33	06065	33.59724847	-117.2571975	Riverside County
258419	Fee-for-Service	1639568074	1639568074	1	1	HEALTH ESSENTIALS RESOURCE &	6/15/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	SERVICES INC	24301 SOUTHLAND DRIVE	SUITE 611	HAYWARD	CA	94545	1554	01	06001	37.65344508	-122.1045736	Alameda County
258452	Fee-for-Service	1366624926	1366624926	1	1	HILL, TOBY S	12/22/2009	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1196 BOULEVARD WAY	STE 1	WALNUT CREEK	CA	94595	1193	07	06013	37.89442153	-122.07461	Contra Costa County
258466	Fee-for-Service	1194784397	1194784397	1	1	HAERING, RICHARD S DO	10/8/2015	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
258477	Fee-for-Service	1356548341	1356548341	1	1	HSU, DIANA MD	10/24/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	123622	05	Anesthesiology	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
258478	Fee-for-Service	1346450418	1346450418	1	1	HARDY, ROBERT A MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	39841	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
258486	Fee-for-Service	1457553497	1457553497	1	1	HUY PHAM	3/5/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	PEACE HEALTH MEDICAL GRP	2901 SQUALICUM PRKWY	None	BELLINGHAM	WA	98225	1851	00	None	48.77211992	-122.473101	Whatcom County
258489	Fee-for-Service	1790711935	1790711935	1	1	HUBBARD, IONELA O CA	10/28/2003	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	11406 LOMA LINDA DR	STE 300	LOMA LINDA	CA	92354	3711	36	06071	34.04642588	-117.2480303	San Bernardino County
258503	Fee-for-Service	1033122114	1033122114	1	1	HARRIS, LINDA G DO	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	7573	01	General 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
258535	Fee-for-Service	1073611885	1073611885	1	1	HUYNH, ANTHONY A OD	9/20/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1601 ARDEN WAY	None	SACRAMENTO	CA	95815	4004	34	06067	38.602404	-121.429512	Sacramento County
258539	Fee-for-Service	1346347028	1346347028	1	1	HARMON, GREGORY S MD	9/13/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	79243	10	Gastroenterology (M.D. only)	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
258545	Fee-for-Service	1962177162	1962177162	1	1	HAPPY VENUE ADHC INC	8/5/2024	261QA0600X	NA	Other	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	5716 LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91601	1625	19	06037	34.17446002	-118.3803716	Los Angeles County
258549	Fee-for-Service	1417981507	1417981507	1	1	HUANG, WEI PT	7/8/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1208 S GARFIELD AVE	None	ALHAMBRA	CA	91801	5036	19	06037	34.0802917	-118.1230178	Los Angeles County
258559	Fee-for-Service	1184246308	1184246308	1	1	HEALING ANGELS HOSPICE CARE	10/5/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	11755 N VICTORY BLVD	SUITE 100-C	NORTH HOLLYWOOD	CA	91606	3457	19	06037	34.18670448	-118.389699	Los Angeles County
258566	Fee-for-Service	1508892860	1508892860	1	1	HERGESHEIMER, CHARLES E	8/31/1995	207R00000X	NA	Other	026	PHYSICIANS	76058	41	Internal Medicine	0	In state provider	None	2120 THIBODO CT	None	VISTA	CA	92081	7965	37	06073	33.16806475	-117.2174346	San Diego County
258615	Fee-for-Service	1992783765	1992783765	1	1	HOPE PROFESSIONAL SERVICES	7/19/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	11731 STERLING AVE	UNIT C	RIVERSIDE	CA	92503	4916	33	06065	33.89475166	-117.4878553	Riverside County
258650	Fee-for-Service	1467434811	1467434811	1	1	HILL, LINDA L MD	6/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	41532	08	Family Practice	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
258652	Fee-for-Service	1306975313	1306975313	1	1	HAIMOWITZ, RONALD T PHD	8/3/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	6741 SEBASTOPOL AVE	SUITE 230	SEBASTOPOL	CA	95472	3838	49	06097	38.40277333	-122.819659	Sonoma County
258653	Fee-for-Service	1265571202	1265571202	1	1	HANNA, REMA F MD	6/29/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108423	41	Internal Medicine	0	In state provider	None	200 MEDICAL PLAZA	#365	LOS ANGELES	CA	90024	7001	19	06037	34.06527974	-118.4462792	Los Angeles County
258678	Fee-for-Service	1033297932	1033297932	1	1	HANSROTE, SUN DUK MD	12/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77924	79	Neurology-Child	0	In state provider	None	1305 TOMMYDON ST	None	STOCKTON	CA	95210	3364	39	06077	38.01883046	-121.29624	San Joaquin County
258683	Fee-for-Service	1295741916	1295741916	1	1	HARDING, JAMES 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
258690	Fee-for-Service	1770501744	1770501744	2	1	HELIOS HEALTHCARE, LLC	7/1/2007	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1002 W FREMONT AVE	None	SUNNYVALE	CA	94087	3031	43	06085	37.35204451	-122.055822	Santa Clara County
258771	Fee-for-Service	1427580067	1427580067	1	1	HAN, JENNIFER MD	6/8/2021	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160263	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
258796	Fee-for-Service	1356751184	1356751184	1	1	HERMOSURA, JOAN R	3/28/2016	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
258849	Fee-for-Service	1184246308	1184246308	1	1	HEALING ANGELS HOSPICE CARE	10/5/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	11755 N VICTORY BLVD	SUITE 100-C	NORTH HOLLYWOOD	CA	91606	3457	19	06037	34.18670448	-118.389699	Los Angeles County
258871	Fee-for-Service	1700086329	1700086329	1	2	HARRIS-CARRIMAN, STACEY	12/1/2010	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	91115	25	Physical Medicine and Rehabilitation	0	In state provider	None	900 HYDE STREET	None	SAN FRANCISCO	CA	94109	4806	38	06075	37.78956486	-122.417072	San Francisco County
258915	Fee-for-Service	1780857573	1780857573	1	1	HADUONG, JOSEPHINE H MD	6/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99760	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
258956	Fee-for-Service	1386000248	1386000248	1	1	HERALD CHRISTIAN HEALTH	3/22/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTER	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	19	06037	34.06276591	-118.07587	Los Angeles County
258964	Fee-for-Service	1336533991	1336533991	1	1	HOVIS, KEEGAN K MD	5/17/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	172238	None	None	0	In state provider	None	180 ROWLAND WAY	None	NOVATO	CA	94945	5009	21	06041	38.09825699	-122.5598561	Marin County
259003	Fee-for-Service	1285722876	1285722876	1	4	HARRIS CARE CENTERS, INC	7/18/1989	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	MALBORO HOME	1327 W MALBORO AVE	None	ANAHEIM	CA	92801	2016	30	06059	33.85147468	-117.9370117	Orange County
259010	Fee-for-Service	1386646180	1386646180	1	1	HARWOOD, DANIEL W MD	6/1/1986	208600000X	NA	General Surgery	026	PHYSICIANS	57785	02	General Surgery	0	In state provider	None	106 GARDEN GULCH ST	None	WEAVERVILLE	CA	96093	2280	53	06105	40.73597863	-122.9406956	Trinity County
259048	Fee-for-Service	1376694893	1376694893	1	1	HOLTVILLE UNIFIED SD	5/6/1995	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	621 E 6TH ST	None	HOLTVILLE	CA	92250	1450	13	06025	32.8129388	-115.3728168	Imperial County
259061	Fee-for-Service	1912444944	1912444944	1	1	HAMMANG, LAUREL J OD	12/11/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2565 CEANOTHUS AVENUE	STE 155	CHICO	CA	95973	7615	04	06007	39.76285262	-121.8199996	Butte County
259144	Fee-for-Service	1760658629	1760658629	1	1	HYER, CHRISTOPHER CRNA	2/3/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
259155	Fee-for-Service	1295376028	1295376028	1	1	HIGHER GROUND FAMILY THERAPY	3/25/2020	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC	3 GOVERNORS LN	A	CHICO	CA	95926	5503	04	06007	39.75542195	-121.8587226	Butte County
259173	Fee-for-Service	1578657045	1578657045	1	1	HANDELSMAN, SARAH C MD	3/7/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	68465	40	Pediatrics	0	In state provider	None	5700 TELEGRAPH AVE	SUITE 100	OAKLAND	CA	94609	1710	01	06001	37.84323585	-122.2614659	Alameda County
259194	Fee-for-Service	1144391038	1144391038	1	1	HSIEH, SIULAN I NP	10/14/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	23781 MAQUINA AVE	None	MISSION VIEJO	CA	92690	2716	30	06059	33.61792093	-117.6778904	Orange County
259198	Fee-for-Service	1780857573	1780857573	1	1	HADUONG, JOSEPHINE H MD	6/3/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99760	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
259242	Fee-for-Service	1386000248	1386000248	1	1	HERALD CHRISTIAN HEALTH	3/22/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTER	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	19	06037	34.06276591	-118.07587	Los Angeles County
259279	Fee-for-Service	1831716307	1831716307	1	1	HYDE, CHRISTOPHER MD	4/4/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	189609	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
259280	Fee-for-Service	1265218309	1265218309	1	1	HWANG, MICHAEL PT	5/20/2024	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
259281	Fee-for-Service	1336188150	1336188150	1	1	HIGGINBOTHAM, MICHAEL 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	2221 ELM ST	None	RAWLINS	WY	82301	5108	00	None	41.78641963	-107.2617813	Carbon County
259296	Fee-for-Service	1629149505	1629149505	1	1	HUO, LICHUN MD	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70626	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
259350	Fee-for-Service	1023159100	1023159100	1	1	HUIZAR, FREDERICK A OD	2/20/2008	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1412 E WARDLOW RD	None	LONG BEACH	CA	90807	4836	19	06037	33.81888949	-118.1738475	Los Angeles County
259351	Fee-for-Service	1710138466	1710138466	1	1	HIFUMI, GLENN T MD	1/12/2010	208600000X	NA	General Surgery	026	PHYSICIANS	68228	02	General Surgery	0	In state provider	None	9604 ARTESIA BLVD	STE 200	BELLFLOWER	CA	90706	8044	19	06037	33.87472842	-118.1288599	Los Angeles County
259353	Fee-for-Service	1639188980	1639188980	1	1	HAMILTON, STEVEN P MD	2/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	70412	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
259371	Fee-for-Service	1679741540	1679741540	1	1	HARRIGAL, CHIVONNE L MD	8/18/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104593	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
259379	Fee-for-Service	1053834028	1053834028	1	1	HEALING PHARMACY INC	5/24/2018	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	7840 WESTMINSTER BLVD	None	WESTMINSTER	CA	92683	4043	30	06059	33.75919182	-117.9923118	Orange County
259396	Fee-for-Service	1336278431	1336278431	3	2	HEDAYATI, PEJMAN MD	6/18/2021	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	123863	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
259397	Fee-for-Service	1285712901	1285712901	1	1	HONEYCHURCH, DAVID B MD	11/16/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	75551	40	Pediatrics	0	In state provider	None	9201 BIG HORN BLVD	None	ELK GROVE	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento County
259443	Fee-for-Service	1295376028	1295376028	1	1	HIGHER GROUND FAMILY THERAPY	3/25/2020	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC	3 GOVERNORS LN	A	CHICO	CA	95926	5503	04	06007	39.75542195	-121.8587226	Butte County
259522	Fee-for-Service	1780975839	1780975839	1	1	HADIDCHI, SHIMA MD	9/4/2012	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	120144	08	Family Practice	0	In state provider	None	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	2206	36	06071	34.5406159	-117.2658221	San Bernardino County
259580	Fee-for-Service	1568166965	1568166965	1	1	HAMED, SAMIR M 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
259585	Fee-for-Service	1629149505	1629149505	1	1	HUO, LICHUN MD	3/19/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70626	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
259589	Fee-for-Service	1740763036	1740763036	1	1	HORNIA SILVA, ANISBEL	1/1/2024	208D00000X	NA	Adult Primary Care	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	15497 W SAND ST	None	VICTORVILLE	CA	92392	2910	36	06071	34.51312455	-117.325854	San Bernardino County
259610	Fee-for-Service	1265747786	1265747786	1	1	HARRIS, LISA D PT	8/1/2022	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
259629	Fee-for-Service	1770958886	1770958886	1	1	HECKEROTH, CHRISTIANE E	2/24/2016	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
259648	Fee-for-Service	1720208184	1720208184	1	1	HOSEIN, HAZEM H MD	6/3/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	91256	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
259666	Fee-for-Service	1790004638	1790004638	1	1	HARIHARAN, JAYRAM S MD	3/5/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	111419	08	Family Practice	0	In state provider	None	4601 DALE ROAD	None	MODESTO	CA	95356	9718	50	06099	37.706508	-121.052457	Stanislaus County
259701	Fee-for-Service	1396820866	1396820866	1	1	HARRINGTON, SCOTT M DO	12/1/2012	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
259707	Fee-for-Service	1407191356	1407191356	1	5	HIGH DESERT PATHOLOGY MEDICA	9/8/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	15248 11TH ST	None	VICTORVILLE	CA	92395	3704	36	06071	34.52825401	-117.2925587	San Bernardino County
259722	Fee-for-Service	1174563399	1174563399	1	1	HARRIS, ANDREW B MD	9/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	82334	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
259731	Fee-for-Service	1376020024	1376020024	1	1	HOCK, STEPHANIE OT	3/13/2019	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1902 ROYALTY DRIVE	SUITE 220	POMONA	CA	91767	3056	19	06037	34.07791925	-117.746146	Los Angeles County
259736	Fee-for-Service	1598231847	1598231847	1	1	HAI, PENG Y NP	11/14/2018	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
259739	Fee-for-Service	1861040511	1861040511	1	1	HONG, ALLISON AU	10/3/2019	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	1301 W PROVIDENCE AVE	None	ORANGE	CA	92868	3892	30	06059	33.78142951	-117.866583	Orange County
259757	Fee-for-Service	1215161807	1215161807	1	1	HUMPHERYS, CLINT G MD	1/28/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	05	Anesthesiology	1	Border provider	None	101 CIVIC CENTER LN	None	LAKE HAVASU CITY	AZ	86403	5607	00	None	34.480224	-114.3390555	Mohave County
259828	Fee-for-Service	1902097959	1902097959	1	1	HALL, MICHAEL P MD	9/24/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114015	20	Orthopedic Surgery	0	In state provider	None	4733 W SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6021	19	06037	34.09817553	-118.293237	Los Angeles County
259845	Fee-for-Service	1689455057	1689455057	1	1	HERR, MIKALA OD	12/18/2023	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3451 S DOGWOOD AVE	SUITE 1334	EL CENTRO	CA	92243	7906	13	06025	32.762997	-115.530678	Imperial County
259863	Fee-for-Service	1659991966	1659991966	1	1	HAMBARTZHUMIAN, RAPHI MD DO	8/1/2024	208M00000X	NA	Other	086	MEDICAL DIRECTORS	183680	-	NOT APPLICABLE	0	In state provider	None	40700 CALIFORNIA OAKS RD	# 201/202/203	MURRIETA	CA	92562	5789	33	06065	33.57067363	-117.2045035	Riverside County
259893	Fee-for-Service	1659990679	1659990679	1	1	HALBERT, TORREY B DO	8/5/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	23014	09	Gynecology (D.O. only)	0	In state provider	None	31001 RANCHO VIEJO RD	STE 200	SAN JUAN CAPISTRA	CA	92675	8703	30	06059	33.50974262	-117.6596065	Orange County
259956	Fee-for-Service	1205910205	1205910205	1	1	HAIMOWITZ, JULIA E MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	86131	07	Dermatology	0	In state provider	None	99 MONTECILLO RD	None	SAN RAFAEL	CA	94903	3308	21	06041	38.00450116	-122.5540001	Marin County
259974	Fee-for-Service	1326252230	1326252230	1	1	HUANG, FAITH R MD	6/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	125987	03	Allergy	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
259990	Fee-for-Service	1053701573	1053701573	1	1	HERMOSILLO, ADRIANA LMFT	8/30/2022	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
259995	Fee-for-Service	1023695699	1023695699	1	1	HUFFARD, ADRIAN L MD	7/3/2024	390200000X	NA	Other	026	PHYSICIANS	None	70	Clinic (mixed specialty)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
260003	Fee-for-Service	1629156781	1629156781	1	1	HUANG, ELIZABETH MD	10/31/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	91258	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
260028	Fee-for-Service	1891764205	1891764205	1	1	HA, LAC-LONG T MD	8/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	69293	41	Internal Medicine	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
260038	Fee-for-Service	1568853802	1568853802	1	1	HODGSON, JASON T LPCC	5/4/2021	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - 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
260056	Fee-for-Service	1558471474	1558471474	1	1	HOLLINGER, BARBARA E NP	4/15/2013	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
260057	Fee-for-Service	1942760087	1942760087	1	1	HO, TRUC V MD	8/9/2022	390200000X	NA	Other	026	PHYSICIANS	180761	None	None	0	In state provider	None	9888 GENESEE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
260058	Fee-for-Service	1376651067	1376651067	2	1	HARANO & HAW OPTOMETRIC	10/12/2007	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1377 MACARTHUR BLVD	None	SAN LEANDRO	CA	94577	3918	01	06001	37.72917298	-122.1387677	Alameda County
260059	Fee-for-Service	1417184649	1417184649	1	1	HOANG, LINH T MD	9/22/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	104939	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2417 CENTRAL AVE	None	ALAMEDA	CA	94501	4515	01	06001	37.76389996	-122.2420612	Alameda County
260061	Fee-for-Service	1891786919	1891786919	1	1	HUNTER, JILL V MD	11/1/2021	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
260071	Fee-for-Service	1962987594	1962987594	1	1	HALEY, GEORGE	3/4/2024	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
260122	Fee-for-Service	1801199039	1801199039	1	1	HUNTINGTON AMBULATORY	10/26/2011	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	SURGERY CENTER LLC	625 S FAIR OAKS AVE	SUITE 380	PASADENA	CA	91105	2074	19	06037	34.134894	-118.1504155	Los Angeles County
260140	Fee-for-Service	1104576271	1104576271	1	1	HALL, ANDREA NP	2/13/2024	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
260142	Fee-for-Service	1548744170	1548744170	1	1	HORIZON SERVICES INC	10/5/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1020 SERPENTINE LANE	STE 100, 102	PLEASANTON	CA	94566	4758	01	06001	37.67453047	-121.8661605	Alameda County
260153	Fee-for-Service	1447221239	1447221239	1	1	HUGHES, DALE E LCSW	3/7/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	25500 HAWTHORNE BLVD	STE 1152	TORRANCE	CA	90505	6834	19	06037	33.7949648	-118.3489484	Los Angeles County
260168	Fee-for-Service	1144336264	1144336264	1	1	HORSEMAN, ROBERT T MD	10/31/1996	207L00000X	NA	Other	026	PHYSICIANS	83955	05	Anesthesiology	0	In state provider	None	2200 HARRISON AVE	None	EUREKA	CA	95501	3215	12	06023	40.7881047	-124.1397037	Humboldt County
260177	Fee-for-Service	1659990679	1659990679	1	1	HALBERT, TORREY B DO	8/5/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	23014	15	Obstetrics (D.O. only)	0	In state provider	None	31001 RANCHO VIEJO RD	STE 200	SAN JUAN CAPISTRA	CA	92675	8703	30	06059	33.50974262	-117.6596065	Orange County
260186	Fee-for-Service	1063702520	1063702520	1	1	HOWARD, EVAN A MD	8/1/2017	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	146384	30	Radiology	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
260200	Fee-for-Service	1114938867	1114938867	1	1	HOLNESS, RONALD MD INC	6/18/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	55605	02	General Surgery	0	In state provider	None	3801 KATELLA AVE	STE 420	LOS ALAMITOS	CA	90720	6903	30	06059	33.80318951	-118.066068	Orange County
260215	Fee-for-Service	1659465193	1659465193	1	2	HENDERSON, MICHAEL LMFT	2/3/2025	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1158 CIRBY WAY	SUITE B	ROSEVILLE	CA	95661	4478	31	06061	38.72946937	-121.2742038	Placer County
260241	Fee-for-Service	1104922590	1104922590	1	1	HAHM, SUSAN JUNGHEE	10/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	97007	02	General Surgery	0	In state provider	None	751 W LEGION RD	STE 201	BRAWLEY	CA	92227	7732	13	06025	32.95996012	-115.5538196	Imperial County
260281	Fee-for-Service	1114105913	1114105913	1	1	HAINES, AMY E	12/17/2012	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	30250 RANCHO VIEJO RD	STE A	SAN JUAN CAPISTRA	CA	92675	1555	30	06059	33.52319034	-117.6657717	Orange County
260283	Fee-for-Service	1023695699	1023695699	1	1	HUFFARD, ADRIAN L MD	7/3/2024	390200000X	NA	Other	026	PHYSICIANS	None	66	Emergency Medicine (Urgent Care)	0	In state provider	None	975 S. FAIRMONT AVENUE	None	LODI	CA	95241	5118	39	06077	38.12188356	-121.285872	San Joaquin County
260301	Fee-for-Service	1043241524	1043241524	1	1	HERBST, ROBERT W MD	2/8/2015	207W00000X	NA	Ophthalmology	026	PHYSICIANS	29531	18	Ophthalmology	0	In state provider	None	15725 POMERADO RD	STE 102	POWAY	CA	92064	2057	37	06073	33.00037882	-117.0580735	San Diego County
260317	Fee-for-Service	1891764205	1891764205	1	1	HA, LAC-LONG T MD	8/30/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	69293	05	Anesthesiology	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
260345	Fee-for-Service	1376651067	1376651067	2	1	HARANO & HAW OPTOMETRIC	10/12/2007	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1377 MACARTHUR BLVD	None	SAN LEANDRO	CA	94577	3918	01	06001	37.72917298	-122.1387677	Alameda County
260365	Fee-for-Service	1275762833	1275762833	1	1	HOFFMAN, JAMIE M MD	8/20/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119363	40	Pediatrics	0	In state provider	None	9999 MIRA MESA BLVD	102	SAN DIEGO	CA	92131	1006	37	06073	32.91668328	-117.1118001	San Diego County
260407	Fee-for-Service	1508685124	1508685124	1	1	HAZEN, JULIA	2/28/2025	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	4211 B VALLEY VIEW AVE	None	NORCO	CA	92860	3502	33	06065	33.943446	-117.5498725	Riverside County
260410	Fee-for-Service	1538270707	1538270707	1	1	HAAS, ANN F MD	8/31/1990	207N00000X	NA	Dermatology	026	PHYSICIANS	55599	07	Dermatology	0	In state provider	None	2525 STOCKTON BLVD	# 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
260417	Fee-for-Service	1558658153	1558658153	1	1	HITTINGER, SCOTT A MD	7/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	150285	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
260457	Fee-for-Service	1710549878	1710549878	1	1	HAJIANNASAB, RASAM MD	8/1/2024	207ZP0102X	NA	Other	026	PHYSICIANS	None	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	20001 S RANCHO WAY	None	COMPTON	CA	90220	6318	19	06037	33.8498073	-118.2223737	Los Angeles County
260478	Fee-for-Service	1245661354	1245661354	1	1	HYGEIA HOME CARE INC	4/30/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14545 VICTORY BLVD	SUITE 606	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
260532	Fee-for-Service	1790245256	1790245256	1	1	HO, SOPHIA P DO	1/3/2023	207R00000X	NA	Other	026	PHYSICIANS	19502	None	None	0	In state provider	None	15615 POMERADO ROAD	None	POWAY	CA	92064	2405	37	06073	32.99706	-117.05544	San Diego County
260536	Fee-for-Service	1093058836	1093058836	1	1	HAMPTON, RENEE ELAINE	3/29/2014	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	3047 E VIA CORVINA	None	ONTARIO	CA	91764	7401	36	06071	34.071921	-117.5854905	San Bernardino County
260543	Fee-for-Service	1568492759	1568492759	1	1	HASHEMI, EMAD A MD	1/25/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	93435	None	None	0	In state provider	None	520 SUPERIOR AVE	STE 200	NEWPORT BEACH	CA	92663	3642	30	06059	33.628914	-117.9276525	Orange County
260557	Fee-for-Service	1629117668	1629117668	1	1	HALL, JENNIFER C MD	2/24/2023	207P00000X	NA	Other	026	PHYSICIANS	183397	None	None	0	In state provider	None	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	15	06029	35.38333823	-119.0188872	Kern County
260566	Fee-for-Service	1851462766	1851462766	1	1	HABBAL, SOUHEIL M MD	8/9/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38919	41	Internal Medicine	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
260606	Fee-for-Service	1326004037	1326004037	1	1	HEARD, MAURINE B MD	8/24/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	61177	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
260627	Fee-for-Service	1336692615	1336692615	1	1	HSU, KEVIN T MD	6/21/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	164533	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
260683	Fee-for-Service	1982371118	1982371118	1	1	H&H HARPER PHARMACY CORPORAT	10/10/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1850 SOUTH AZUSA AVENUE	101	HACIENDA HEIGHTS	CA	91745	6854	19	06037	33.98895597	-117.9322797	Los Angeles County
260704	Fee-for-Service	1831258409	1831258409	1	3	HURLEY, MARY E MD	7/1/2021	No Taxonomy Provided	NA	None	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	1451 E PENNSYLVANIA AVE	None	REDLANDS	CA	92374	4734	36	06071	34.07374879	-117.1539218	San Bernardino County
260735	Fee-for-Service	1396834354	1396834354	1	1	HOCHSTOEGER, GRACE NP	11/27/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	1033 3RD ST	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
260765	Fee-for-Service	1952573693	1952573693	1	1	HONORIS, LILY MD	1/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109812	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
260798	Fee-for-Service	1407090079	1407090079	1	1	HU, JENNIFER MD	11/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120605	18	Ophthalmology	0	In state provider	None	710 LAWRENCE EXPRESSWAY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33636857	-121.9958111	Santa Clara County
260800	Fee-for-Service	1396011557	1396011557	1	1	HONG, ARIA MD	6/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134775	29	Pulmonary Diseases (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
260823	Fee-for-Service	1386824043	1386824043	1	1	HERNANDEZ, CHRISTINA Y	2/1/2008	207R00000X	NA	Other	026	PHYSICIANS	101109	41	Internal Medicine	0	In state provider	MD	1180 E SHAW AVE	STE 101	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
260824	Fee-for-Service	1093058836	1093058836	1	1	HAMPTON, RENEE ELAINE	3/29/2014	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	3047 E VIA CORVINA	None	ONTARIO	CA	91764	7401	36	06071	34.071921	-117.5854905	San Bernardino County
260849	Fee-for-Service	1760543771	1760543771	1	1	HOWARD, CUSANDA LMFT	4/2/2025	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
260852	Fee-for-Service	1851462766	1851462766	1	1	HABBAL, SOUHEIL M MD	8/9/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38919	03	Allergy	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
260964	Fee-for-Service	1073120051	1073120051	1	1	HUSSNA WAKILY MD A PROFESSIO	1/14/2021	261Q00000X	NA	Other	026	PHYSICIANS	None	None	None	0	In state provider	NAL CORPORATION	3601 VISTA WAY	203	OCEANSIDE	CA	92056	4559	37	06073	33.18140858	-117.3093221	San Diego County
260970	Fee-for-Service	1851401988	1851401988	1	1	HASSAN, SHAHID MD	2/2/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93284	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
260983	Fee-for-Service	1790112019	1790112019	1	1	HEITLINGER, CLAIRE L CCC-SLP	5/6/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	801 TRAEGER AVE	STE 304	SAN BRUNO	CA	94066	3048	41	06081	37.62782298	-122.4223337	San Mateo County
260984	Fee-for-Service	1124545074	1124545074	1	1	HEAD AND NECK SURGERY SPECIA	3/7/2018	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	LISTS, A PROFESSIONAL CO	321 E ST	None	CHULA VISTA	CA	91910	2667	37	06073	32.64457385	-117.0820661	San Diego County
260992	Fee-for-Service	1689111668	1689111668	1	1	HUYNH, AMY LMFT	9/13/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	19772 MACARTHUR	None	IRVINE	CA	92612	2413	30	06059	33.65624304	-117.8623446	Orange County
260995	Fee-for-Service	1801307368	1801307368	1	5	HEALTH SERVICE ALLIANCE	12/15/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	9089 BASELINE ROAD	SUITE 200	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
261001	Fee-for-Service	1720085251	1720085251	1	1	HALL, BRUCE C MD	12/28/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	44503	None	None	0	In state provider	None	835 SEQUOIA AVE	None	LINDSAY	CA	93247	1424	54	06107	36.21351337	-119.0961199	Tulare County
261012	Fee-for-Service	1770678492	1770678492	1	1	HUGHES, JOSEPH M DPM	6/21/1984	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	10961 CHERRY ST	None	LOS ALAMITOS	CA	90720	2452	30	06059	33.80341067	-118.0679931	Orange County
261045	Fee-for-Service	1467493437	1467493437	1	1	HARDING, CLARKE T MD III	11/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	54892	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
261057	Fee-for-Service	1043605637	1043605637	1	1	HSU, TONY MD	11/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	146098	08	Family Practice	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
261065	Fee-for-Service	1679678288	1679678288	1	1	HOPKINS, SIOBHAN S MD	7/10/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	161563	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
261076	Fee-for-Service	1861758831	1861758831	1	1	HOANG, DAVID N DO	5/12/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	13241	01	General Practice	0	In state provider	None	13672 HAWTHORNE BLVD	None	HAWTHORNE	CA	90250	5810	19	06037	33.90763296	-118.3523964	Los Angeles County
261086	Fee-for-Service	1326065871	1326065871	1	1	HARRIS, CHARLES R III MD	7/16/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	74170	66	Emergency Medicine (Urgent Care)	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
261089	Fee-for-Service	1962011064	1962011064	1	1	HFM INC	9/14/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	750 MEDICAL CENTER CT	SUITE 8, UNIT A	CHULA VISTA	CA	91911	6634	37	06073	32.61830281	-117.0237339	San Diego County
261094	Fee-for-Service	1609878834	1609878834	1	1	HIGGINBOTHAM, ROBERT MD	1/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	28752	18	Ophthalmology	0	In state provider	None	628 CALIFORNIA BLVD	STE B	SAN LUIS OBISPO	CA	93401	2554	40	06079	35.28917428	-120.6578269	San Luis Obispo County
261108	Fee-for-Service	1114016458	1114016458	1	2	HERNANDEZ, RAUL MANUEL MD	12/6/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	50128	40	Pediatrics	0	In state provider	None	851 W FOOTHILL BLVD	STE 101	RIALTO	CA	92376	4731	36	06071	34.10672307	-117.3864948	San Bernardino County
261135	Fee-for-Service	1790881332	1790881332	1	1	HEIDMANN, JENNIFER A MD	10/24/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	73714	41	Internal Medicine	0	In state provider	None	2280 HARRISON AVE	None	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
261218	Fee-for-Service	1962631192	1962631192	1	1	HU, TINGFEI MD	12/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	122972	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
261250	Fee-for-Service	1003042235	1003042235	2	1	HEALTH DIAGNOSTICS OF	1/23/2012	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	8370 WILSHIRE BLVD	SUITE 110	BEVERLY HILLS	CA	90211	2334	19	06037	34.06453566	-118.373697	Los Angeles County
261274	Fee-for-Service	1609993682	1609993682	3	1	HOANG, NGOC-YEN T OD	10/15/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	3705 E SOUTH ST	None	LONG BEACH	CA	90805	4521	19	06037	33.86026343	-118.1478013	Los Angeles County
261279	Fee-for-Service	1942404629	1942404629	1	1	HINES, PAMELA D MD	12/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	48889	40	Pediatrics	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
261283	Fee-for-Service	1801307368	1801307368	1	5	HEALTH SERVICE ALLIANCE	12/15/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	9089 BASELINE ROAD	SUITE 200	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
261311	Fee-for-Service	1003868142	1003868142	1	1	HATTIS, RONALD P MD	1/1/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	23473	08	Family Practice	0	In state provider	None	780 E GILBERT ST	None	SAN BERNARDINO	CA	92415	1003	36	06071	34.1268333	-117.2705634	San Bernardino County
261357	Fee-for-Service	1003850553	1003850553	1	1	HASNAIN, IMRAN MD	6/9/2022	207R00000X	NA	Other	026	PHYSICIANS	73218	None	None	0	In state provider	None	720 RAMONA AVENUE	105	CORONA	CA	92879	2153	33	06065	33.87348563	-117.5654745	Riverside County
261370	Fee-for-Service	1922021757	1922021757	1	1	HOBERMAN, RICHARD MD INC	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	61122	05	Anesthesiology	0	In state provider	None	215 W JANSS RD	None	THOUSAND OAKS	CA	91360	1847	56	06111	34.2064445	-118.8824085	Ventura County
261375	Fee-for-Service	1528329414	1528329414	1	1	HOES, ARMIN MD	4/25/2023	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	133224	-	NOT APPLICABLE	0	In state provider	None	18646 OXNARD STREET	None	TARZANA	CA	91356	1411	19	06037	34.17993229	-118.5397265	Los Angeles County
261397	Fee-for-Service	1962575647	1962575647	1	1	HAHN, IN-HEI MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	154183	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
261411	Fee-for-Service	1790820876	1790820876	1	1	HOLMBLAD, BRUCE R MD	10/19/1990	207L00000X	NA	Other	026	PHYSICIANS	60416	05	Anesthesiology	0	In state provider	None	6969 BROCKTON AVE	None	RIVERSIDE	CA	92506	3813	33	06065	33.94701	-117.396786	Riverside County
261419	Fee-for-Service	1891149761	1891149761	1	1	HOME SWEET CARE HOMES INC	3/25/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	1584 DIANDA DR	None	CONCORD	CA	94521	1951	07	06013	37.96657146	-121.9854759	Contra Costa County
261455	Fee-for-Service	1124239330	1124239330	1	1	HEGDE, MANU MD	3/10/2010	2084N0400X	NA	Neurology	026	PHYSICIANS	99711	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
261490	Fee-for-Service	1295930527	1295930527	1	1	HSU, VICTORIA J Y MD	7/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97102	18	Ophthalmology	0	In state provider	None	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	07	06013	37.92699561	-122.0292732	Contra Costa County
261516	Fee-for-Service	1770850323	1770850323	1	1	HADEN, GEORGINA R MD	10/31/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	133139	41	Internal Medicine	0	In state provider	None	501 PETALUMA AVE	None	SEBASTOPOL	CA	95472	4215	49	06097	38.39674221	-122.8201502	Sonoma County
261517	Fee-for-Service	1578911459	1578911459	1	1	HOME HEALTH OF CALIFORNIA	12/6/2019	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	1145 N CALIFORNIA ST	STE 205	STOCKTON	CA	95202	1537	39	06077	37.96528462	-121.2878034	San Joaquin County
261581	Fee-for-Service	1649374109	1649374109	1	1	HORTON, CLAIRE K MD	1/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71387	41	Internal Medicine	0	In state provider	None	222 W 39TH AVE	None	SAN MATEO	CA	94403	4364	41	06081	37.53039072	-122.2987772	San Mateo County
261586	Fee-for-Service	1053677641	1053677641	1	1	HARP, GARRETT M MD	8/5/2022	207R00000X	NA	Other	026	PHYSICIANS	153990	None	None	0	In state provider	None	9888 GENESEE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
261607	Fee-for-Service	1396816203	1396816203	1	1	HANNAUER, DAVID J MD	12/5/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83115	13	Neurology (M.D. only)	0	In state provider	None	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	19	06037	33.78673844	-118.2965289	Los Angeles County
261644	Fee-for-Service	1053452664	1053452664	1	1	HIRST, KATHRYN P MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95063	08	Family 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
261681	Fee-for-Service	1710513726	1710513726	1	1	HALLETT, TRAVIS MD	9/1/2023	208M00000X	NA	Other	026	PHYSICIANS	185239	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
261684	Fee-for-Service	1639373590	1639373590	1	1	HELLER, JUSTIN B MD	10/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	111496	24	Plastic Surgery	0	In state provider	None	42135 10TH STREET WEST	STE 101	LANCASTER	CA	93534	7099	19	06037	34.648533	-118.1477975	Los Angeles County
261689	Fee-for-Service	1528395290	1528395290	1	2	HEALTH PLUS HOME HEALTH CARE	2/7/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	2251 SAN DIEGO AVE	SUITE A-235	SAN DIEGO	CA	92110	3003	37	06073	32.74884678	-117.1920392	San Diego County
261691	Fee-for-Service	1811900558	1811900558	1	1	HERRERA MATA, LYDIA M MD	8/30/2013	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	75245	08	Family Practice	0	In state provider	None	2505 E DIVISADERO ST	None	FRESNO	CA	93721	1401	10	06019	36.74334929	-119.7809344	Fresno County
261708	Fee-for-Service	1366570665	1366570665	1	1	HARBOR HEALTH CARE INC	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9904 ROSE ST	None	BELLFLOWER	CA	90706	6915	19	06037	33.8696067	-118.1224995	Los Angeles County
261714	Fee-for-Service	1851485627	1851485627	1	1	HICKS, DAVID A MD	4/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	26166	40	Pediatrics	0	In state provider	None	1201 W LA VETA AVE	STE 201	ORANGE	CA	92868	4207	30	06059	33.78034779	-117.8655767	Orange County
261735	Fee-for-Service	1053332619	1053332619	1	1	HOU, LILY X MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79148	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
261748	Fee-for-Service	1073585543	1073585543	1	1	HIRASUNA, RICHARD R MD	10/20/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	111464	05	Anesthesiology	0	In state provider	None	25405 HANCOCK AVENUE	SUITE 103	MURRIETA	CA	92562	5978	33	06065	33.5580833	-117.1850127	Riverside County
261832	Fee-for-Service	1538197082	1538197082	1	1	HONG, JAE Y MD INC	4/15/2008	174400000X	NA	Other	026	PHYSICIANS	31851	05	Anesthesiology	0	In state provider	None	44301 N LORIMER	None	LANCASTER	CA	93534	3700	19	06037	34.68798563	-118.1601762	Los Angeles County
261864	Fee-for-Service	1851801450	1851801450	1	1	HAMLIN, CAITLIN S PSYD	3/20/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
261899	Fee-for-Service	1841022530	1841022530	1	1	HARRELL, GAVIN	1/28/2025	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	85 HARTNELL AVE STE 300	None	REDDING	CA	96002	1888	45	06089	40.56995266	-122.3694812	Shasta County
261929	Fee-for-Service	1154776094	1154776094	1	1	HOWLETT, NATALIE MD	5/9/2019	207R00000X	NA	Other	026	PHYSICIANS	155075	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
261932	Fee-for-Service	1053452664	1053452664	1	1	HIRST, KATHRYN P MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	95063	36	Psychiatry	0	In state provider	None	200 WEST ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
261945	Fee-for-Service	1437108131	1437108131	1	1	HOOTMAN, KYRA K DO	9/9/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	10293	41	Internal Medicine	0	In state provider	None	1180 E SHAW	STE 125	FRESNO	CA	93710	7812	10	06019	36.80891142	-119.768244	Fresno County
261946	Fee-for-Service	1982046736	1982046736	1	1	HOOVER, JEFFERY C MD	7/15/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	160985	40	Pediatrics	0	In state provider	None	6555 COYLE AVENUE	SUITE 280	CARMICHAEL	CA	95608	0302	34	06067	38.66859	-121.3118055	Sacramento County
261969	Fee-for-Service	1801307368	1801307368	1	1	HEALTH SERVICE ALLIANCE	1/11/2022	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
261973	Fee-for-Service	1639373590	1639373590	1	1	HELLER, JUSTIN B MD	10/29/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	111496	20	Orthopedic Surgery	0	In state provider	None	42135 10TH STREET WEST	STE 101	LANCASTER	CA	93534	7099	19	06037	34.648533	-118.1477975	Los Angeles County
262011	Fee-for-Service	1003958661	1003958661	1	1	HELLER, LINDSAY PSYD	8/16/2018	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
262030	Fee-for-Service	1750577177	1750577177	1	1	HOLMES, JENNIFER M CRNA	6/30/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
262087	Fee-for-Service	1124416607	1124416607	1	1	HEKMAT, VAHID MD INC	9/30/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51341	40	Pediatrics	0	In state provider	None	23101 SHERMAN PLACE	STE 407	WEST HILLS	CA	91307	2032	19	06037	34.20099112	-118.6297991	Los Angeles County
262159	Fee-for-Service	1598098170	1598098170	1	1	HADER A MANSOUR, 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 ST	None	PITTSBURGH	PA	15213	2593	00	None	40.44350017	-79.95952606	Allegheny County
262192	Fee-for-Service	1548541717	1548541717	1	1	HADI, YULIE M MD	1/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128246	01	General Practice	0	In state provider	None	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8687	07	06013	37.94947636	-121.7752571	Contra Costa County
262193	Fee-for-Service	1932942232	1932942232	1	1	HILTON, DIANDRA PHD	2/22/2025	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
262240	Fee-for-Service	1811626401	1811626401	1	1	HS2, INC.	7/21/2022	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	12282 BEACH BLVD	None	STANTON	CA	90680	3970	30	06059	33.78418035	-117.9927632	Orange County
262254	Fee-for-Service	1801307368	1801307368	1	1	HEALTH SERVICE ALLIANCE	8/1/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
262325	Fee-for-Service	1134182058	1134182058	1	1	HODGES, SEAN D PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	HEALTH SOLUTIONS	3975 5TH AVE	STE 213	SAN DIEGO	CA	92103	3120	37	06073	32.749335	-117.160413	San Diego County
262371	Fee-for-Service	1124416607	1124416607	1	1	HEKMAT, VAHID MD INC	9/30/2014	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	51341	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	23101 SHERMAN PLACE	STE 407	WEST HILLS	CA	91307	2032	19	06037	34.20099112	-118.6297991	Los Angeles County
262393	Fee-for-Service	1558491761	1558491761	1	2	HELPLINE YOUTH COUNSELING, I	7/28/2016	251S00000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	12440 FIRESTONE BLVD	316	NORWALK	CA	90650	9319	19	06037	33.90523023	-118.0681168	Los Angeles County
262433	Fee-for-Service	1790892321	1790892321	1	1	HERNANDEZ, MATHEW R MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90684	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
262457	Fee-for-Service	1679852552	1679852552	1	1	HUNG, KENNETH EBOND CP	5/26/2011	No Taxonomy Provided	NA	None	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	2140 W CHAPMAN AVE	#121	ORANGE	CA	92868	2331	30	06059	33.78787403	-117.8757819	Orange County
262460	Fee-for-Service	1619292752	1619292752	1	1	HIGHAM, CHRISTINE S MD	6/26/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	149284	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
262463	Fee-for-Service	1053975821	1053975821	1	1	HOANG, CLINTON V DO	12/4/2024	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	4855 BLUE DIAMOND RD STE	None	LAS VEGAS	NV	89139	7602	00	None	36.03258913	-115.2074608	Clark County
262500	Fee-for-Service	1083145908	1083145908	1	1	HANLEY, KEVIN J MD	6/14/2021	207P00000X	NA	Other	026	PHYSICIANS	159918	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
262543	Fee-for-Service	1801307368	1801307368	1	1	HEALTH SERVICE ALLIANCE	8/1/2019	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	13193 CENTRAL AVE	SUITE 100	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
262568	Fee-for-Service	1144315839	1144315839	1	1	HONG, SEONGJIN MD	8/30/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	56255	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	160 E ARTESIA ST	STE 350	POMONA	CA	91767	2927	19	06037	34.07556833	-117.7507835	Los Angeles County
262614	Fee-for-Service	1043283997	1043283997	1	1	HALLOWS, KENNETH R MD	8/17/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	136632	45	Nephrology (Renal-Kidney)	0	In state provider	None	1520 SAN PABLO ST	None	LOS ANGELES	CA	90033	5310	19	06037	34.06269295	-118.2030006	Los Angeles County
262642	Fee-for-Service	1518109750	1518109750	1	1	HAKIMI, MICHAEL MD	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	113583	02	General Surgery	0	In state provider	None	4333 TORRANCE BLVD	None	TORRANCE	CA	90503	4401	19	06037	33.83759353	-118.360089	Los Angeles County
262697	Fee-for-Service	1952305294	1952305294	1	1	HILDEBRAND, STEVEN W MD	9/30/1991	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	46944	66	Emergency Medicine (Urgent Care)	0	In state provider	None	25333 BARTON RD	None	LOMA LINDA	CA	92354	3123	36	06071	34.04801656	-117.251334	San Bernardino County
262722	Fee-for-Service	1790892321	1790892321	1	1	HERNANDEZ, MATHEW R MD	8/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90684	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
262736	Fee-for-Service	1376537498	1376537498	1	1	HUMPHREYS, HAROLD K MD	2/28/1990	207L00000X	NA	Other	026	PHYSICIANS	63245	05	Anesthesiology	0	In state provider	None	3315 WATT AVE	None	SACRAMENTO	CA	95821	3600	34	06067	38.626056	-121.3834455	Sacramento County
262754	Fee-for-Service	1083063051	1083063051	1	1	HAASE, SARAH LPCC	7/26/2024	101YM0800X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	818 MOUNTAIN AVE	STE 203	UPLAND	CA	91786	4165	36	06071	34.10424442	-117.6701797	San Bernardino County
262785	Fee-for-Service	1518087998	1518087998	1	1	HURRELL, MARK L LMFT	5/31/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	18141 BEACH BLVD	STE 275	HUNTINGTON BEACH	CA	92648	8615	30	06059	33.699042	-117.9892265	Orange County
262790	Fee-for-Service	1588106579	1588106579	1	1	HOVATTER, JESSICA L NP	12/2/2016	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
262808	Fee-for-Service	1699814632	1699814632	1	1	HWYNN, NELSON H DO	4/15/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	10667	13	Neurology (M.D. 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
262821	Fee-for-Service	1679706386	1679706386	1	1	HAGOS, ELILTA M MD	12/19/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121648	08	Family Practice	0	In state provider	None	2330 WEST COVELL BLVD	None	WOODLAND	CA	95616	5658	57	06113	38.56097929	-121.7800614	Yolo County
262828	Fee-for-Service	1518183664	1518183664	1	1	HIRSHBERG, JAMES A MD	7/31/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104284	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
262851	Fee-for-Service	1053766790	1053766790	1	1	HUA, HUGO V MD	8/19/2020	208M00000X	NA	Other	026	PHYSICIANS	166118	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
262857	Fee-for-Service	1144315839	1144315839	1	1	HONG, SEONGJIN MD	8/30/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	56255	41	Internal Medicine	0	In state provider	None	160 E ARTESIA ST	STE 350	POMONA	CA	91767	2927	19	06037	34.07556833	-117.7507835	Los Angeles County
262901	Fee-for-Service	1700961471	1700961471	1	1	HSU, DANIEL T DO	2/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	7386	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
262915	Fee-for-Service	1518901016	1518901016	1	1	HONG, LINN OD	5/22/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
262999	Fee-for-Service	1689750820	1689750820	2	1	HANGER PROSTHETICS & ORTHOTI	5/18/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	3010 STATE ST	None	SANTA BARBARA	CA	93105	3304	42	06083	34.44039552	-119.7286695	Santa Barbara County
263066	Fee-for-Service	1619264645	1619264645	1	1	HASHEMI, NAFISEH MD	3/11/2016	207W00000X	NA	Ophthalmology	026	PHYSICIANS	136366	18	Ophthalmology	0	In state provider	None	5400 BALBOA STREET	STE 209	ENCINO	CA	91316	5218	19	06037	34.169283	-118.501072	Los Angeles County
263093	Fee-for-Service	1124233820	1124233820	1	1	HAMER, MERLIN J MD	9/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	105394	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
263134	Fee-for-Service	1508465113	1508465113	1	1	HO, PHILLIP NP	5/11/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2720 N HARBOR BLVD.	#200	FULLERTON	CA	92835	2626	30	06059	33.90126238	-117.9292154	Orange County
263156	Fee-for-Service	1588203988	1588203988	1	2	HIGH DESERT EYE SURGERY CENT	2/14/2024	261QA1903X	NA	Other	044	SURGICAL CLINIC	-	-	NOT APPLICABLE	0	In state provider	ER, LLC	16030 KAMANA RD.	None	APPLE VALLEY	CA	92307	1335	36	06071	34.5424198	-117.2718373	San Bernardino County
263182	Fee-for-Service	1447572409	1447572409	1	1	HUTH, NICOLE J	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
263207	Fee-for-Service	1750455630	1750455630	1	2	HANGER PROSTHETICS & ORTHOTI	11/7/2022	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	4849 LONE TREE WAY	SUITE A	ANTIOCH	CA	94531	8644	07	06013	37.96289777	-121.7679057	Contra Costa County
263235	Fee-for-Service	1760525695	1760525695	1	1	HENDERSON, VICTOR W MD	3/3/1982	2084N0400X	NA	Neurology	026	PHYSICIANS	39863	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
263240	Fee-for-Service	1528076411	1528076411	1	1	HOLLINGSWORTH, JASPER C MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	68730	26	Psychiatry (child)	0	In state provider	None	3558 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	1780	49	06097	38.47617	-122.7235455	Sonoma County
263260	Fee-for-Service	1487771432	1487771432	1	1	HESELTINE, PETER MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	29490	77	Infectious Disease	0	In state provider	UNIV OF SO CALIF	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
263323	Fee-for-Service	1730491432	1730491432	1	1	HOM, JASON L MD	8/16/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118477	41	Internal Medicine	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
263350	Fee-for-Service	1649701251	1649701251	1	1	HAGHNAZAR, HAMED MD	4/9/2024	390200000X	NA	Other	026	PHYSICIANS	190140	08	Family Practice	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
263357	Fee-for-Service	1548655020	1548655020	1	1	HENTSCHEL, OLIVER J P MD	10/1/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	152733	41	Internal Medicine	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
263408	Fee-for-Service	1659524544	1659524544	1	1	HOUSE, SEAN PHD	11/13/2012	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5333 MISSION CENTER RD	SUITE 100	SAN DIEGO	CA	92108	1347	37	06073	32.77178608	-117.1547851	San Diego County
263457	Fee-for-Service	1467711713	1467711713	1	1	HAYES, CHRISTOPHER B MD	8/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148378	20	Orthopedic Surgery	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
263458	Fee-for-Service	1164536579	1164536579	1	1	HUNTING, DANIEL B MD	8/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37178	66	Emergency Medicine (Urgent Care)	0	In state provider	GRPUP INC	450 4TH AVE	STE 303	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
263474	Fee-for-Service	1972706315	1972706315	1	1	HAMMAN, JEFF M MD	11/7/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	103138	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
263529	Fee-for-Service	1528076411	1528076411	1	1	HOLLINGSWORTH, JASPER C MD	9/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	68730	36	Psychiatry	0	In state provider	None	3558 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	1780	49	06097	38.47617	-122.7235455	Sonoma County
263532	Fee-for-Service	1831263714	1831263714	1	1	HANGER P & O WEST INC	3/1/1999	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	23451 MADISON ST	SKYPARK BLDG 7, #200	TORRANCE	CA	90505	4763	19	06037	33.81197627	-118.3478154	Los Angeles County
263536	Fee-for-Service	1730528555	1730528555	1	1	HANDY, KRYSTAL L LMFT	5/20/2020	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
263549	Fee-for-Service	1487771432	1487771432	1	1	HESELTINE, PETER MD	8/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	29490	41	Internal Medicine	0	In state provider	UNIV OF SO CALIF	1200 N STATE ST	None	LOS ANGELES	CA	90033	1029	19	06037	34.05855992	-118.209755	Los Angeles County
263557	Fee-for-Service	1841480019	1841480019	1	2	HERNANDEZ, GERI ANN	3/9/2019	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1566 HEATHER LN	None	RIVERSIDE	CA	92504	5517	33	06065	33.89769363	-117.3991527	Riverside County
263561	Fee-for-Service	1790868909	1790868909	1	1	HAGHIGHI, BIJAN MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	81258	90	Pathology-Forensic	0	In state provider	None	280 S MAIN ST	None	ORANGE	CA	92868	3852	30	06059	33.784695	-117.867327	Orange County
263565	Fee-for-Service	1043301674	1043301674	1	1	HARVEY W MEISLIN, 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
263591	Fee-for-Service	1013062439	1013062439	1	1	HAMLETT, FRANK B MD	9/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	39116	30	Radiology	0	In state provider	None	319 LAUREL ST	None	SAN DIEGO	CA	92101	1630	37	06073	32.73134788	-117.1617595	San Diego County
263626	Fee-for-Service	1902914468	1902914468	2	1	HARANO & HAW OPTOMETRIC	3/12/2008	152W00000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	35104 NEWARK BLVD	None	NEWARK	CA	94560	0054	01	06001	37.54981032	-122.0478142	Alameda County
263641	Fee-for-Service	1942653365	1942653365	1	1	HORN, CHARITY LMFT	8/23/2022	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
263642	Fee-for-Service	1518947506	1518947506	1	1	HILL, TODD DO	1/27/2025	2084P0800X	NA	Psychiatry	026	PHYSICIANS	16336	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1355 EAST ST	SUITE 200	REDDING	CA	96001	0801	45	06089	40.58628506	-122.3887911	Shasta County
263669	Fee-for-Service	1447699954	1447699954	1	1	HINSON, MICHAEL R DO	2/9/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12738	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
263746	Fee-for-Service	1164536579	1164536579	1	1	HUNTING, DANIEL B MD	8/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	37178	34	Urology and Urological Surgery	0	In state provider	GRPUP INC	450 4TH AVE	STE 303	CHULA VISTA	CA	91910	4429	37	06073	32.63513513	-117.0820663	San Diego County
263752	Fee-for-Service	1376623637	1376623637	1	1	HOLLIER, LARRY H MD	11/1/2021	2086S0122X	NA	General Surgery	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
263778	Fee-for-Service	1457770125	1457770125	1	1	HILL, RYAN W MD	6/3/2022	207L00000X	NA	Other	026	PHYSICIANS	139404	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
263823	Fee-for-Service	1073263349	1073263349	1	1	HUCKABY, DALTON	5/23/2024	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
263849	Fee-for-Service	1790868909	1790868909	1	1	HAGHIGHI, BIJAN MD	4/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	81258	22	Pathology (M.D. only)	0	In state provider	None	280 S MAIN ST	None	ORANGE	CA	92868	3852	30	06059	33.784695	-117.867327	Orange County
263866	Fee-for-Service	1720047699	1720047699	1	1	HOUCHIN, KENNETH MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	57897	41	Internal Medicine	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
263904	Fee-for-Service	1285746552	1285746552	1	2	HUYNH, ANTHONY MEDICAL GROUP	4/1/2012	207N00000X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	4231 HWY 86	STE 6	BRAWLEY	CA	92227	9648	13	06025	32.95825939	-115.551562	Imperial County
263962	Fee-for-Service	1861576837	1861576837	1	1	HOFFMANN, GARIMA S MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	30182	08	Family Practice	0	In state provider	None	421 E COTATI AVE	None	COTATI	CA	94931	4000	49	06097	38.32839218	-122.7000854	Sonoma County
263986	Fee-for-Service	1164497905	1164497905	2	1	HERITAGE VALLEY EYE CARE	8/3/2015	193200000X	NA	Other	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	OPTOMETRIC CENTER	400 E SANTA BARBARA ST	SUITE C	SANTA PAULA	CA	93060	2675	56	06111	34.35269772	-119.069955	Ventura County
264014	Fee-for-Service	1891149761	1891149761	1	3	HOME SWEET CARE HOMES INC	6/5/2024	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	280 ELSIE DR	None	DANVILLE	CA	94526	2517	07	06013	37.8276049	-122.0003402	Contra Costa County
264040	Fee-for-Service	1720088792	1720088792	1	1	HOLSTEIN III, LESTER S	9/15/1993	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	77560	08	Family Practice	0	In state provider	None	4455 W 117TH ST	None	HAWTHORNE	CA	90250	2241	19	06037	33.92825048	-118.3539285	Los Angeles County
264048	Fee-for-Service	1316474125	1316474125	1	1	HOU, GINA MD	8/16/2023	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	161207	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
264063	Fee-for-Service	1831801059	1831801059	1	1	HITENKUMAR R. PATEL, M.D., I	5/23/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	30	Radiology	0	In state provider	NC.	11735 FIRESTONE BLVD	SUITE 13	NORWALK	CA	90650	2808	19	06037	33.91353706	-118.0831749	Los Angeles County
264071	Fee-for-Service	1467959239	1467959239	1	1	HANAK, JENNIFER MD	4/15/2024	390200000X	NA	Other	026	PHYSICIANS	None	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
264151	Fee-for-Service	1720047699	1720047699	1	1	HOUCHIN, KENNETH MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	57897	66	Emergency Medicine (Urgent Care)	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
264172	Fee-for-Service	1871120006	1871120006	1	1	HARIRFOROOSH, SARAH MD	6/24/2024	207R00000X	NA	Other	026	PHYSICIANS	187082	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
264204	Fee-for-Service	1083749337	1083749337	1	1	HERNANDEZ, LIZBETH G	12/26/2014	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	16415 S COLORADO AVE	SUITE 305	PARAMOUNT	CA	90723	5053	19	06037	33.8853075	-118.1614695	Los Angeles County
264246	Fee-for-Service	1184884280	1184884280	1	1	HUGEN, CORY M MD	10/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137403	34	Urology and Urological Surgery	0	In state provider	None	1441 EASTLAKE AVENUE	None	LOS ANGELES	CA	90089	0112	19	06037	34.06169385	-118.2044698	Los Angeles County
264255	Fee-for-Service	1972677276	1972677276	1	1	HALL, VICTORIA M MD	3/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	65445	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
264279	Fee-for-Service	1568084747	1568084747	1	1	HIPKIN, COURTNEY L CRNA	7/7/2020	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	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
264382	Fee-for-Service	1518619014	1518619014	1	1	HANDS ON HANDS CONGREGATE	5/10/2023	No Taxonomy Provided	NA	None	059	HOME AND COMMUNITY BASED SERVICES NURSING FACILITY	-	-	NOT APPLICABLE	0	In state provider	LIVING LLC	13880 PROCTOR AVE	None	LA PUENTE	CA	91746	2529	19	06037	34.04020616	-117.9896376	Los Angeles County
264396	Fee-for-Service	1528001815	1528001815	1	1	HOLMES, WILLIAM B MD	6/1/1994	207R00000X	NA	Other	026	PHYSICIANS	32816	01	General Practice	0	In state provider	None	4770 W HERNDON AVE	None	FRESNO	CA	93722	8401	10	06019	36.83717984	-119.8778388	Fresno County
264418	Fee-for-Service	1518061266	1518061266	1	1	HAMELBERG, HEIDE PSYD	9/22/2009	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
264442	Fee-for-Service	1720047699	1720047699	1	1	HOUCHIN, KENNETH MD	4/30/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	57897	18	Ophthalmology	0	In state provider	None	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	33	06065	33.934059	-117.2789475	Riverside County
264454	Fee-for-Service	1982278933	1982278933	1	1	HICKS, MOLLY CRNA	8/7/2023	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
264480	Fee-for-Service	1487789194	1487789194	1	1	HARNEY, KIM MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	48240	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	11 BIRCH ST	None	REDWOOD CITY	CA	94062	1480	41	06081	37.48882891	-122.2411617	San Mateo County
264492	Fee-for-Service	1033449459	1033449459	1	1	HART DIALYSIS LLC	5/17/2011	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1821 W LINCOLN AVE	None	ANAHEIM	CA	92801	6731	30	06059	33.83259453	-117.946476	Orange County
264498	Fee-for-Service	1861445645	1861445645	1	1	HOLLIMAN, KENNETH E MD	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	39719	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1045 W REDONDO BEACH BLV	None	GARDENA	CA	90247	4128	19	06037	33.89247044	-118.2931941	Los Angeles County
264499	Fee-for-Service	1497056568	1497056568	1	1	HENDERSON, JAIME L LPCC	12/6/2023	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
264500	Fee-for-Service	1821204702	1821204702	1	1	HANDEL, NEAL MD	1/8/2020	2086S0122X	NA	General Surgery	026	PHYSICIANS	27530	24	Plastic Surgery	0	In state provider	None	23365 HAWTHORNE BLVD	SUITE 104	TORRANCE	CA	90505	3736	19	06037	33.814098	-118.3512385	Los Angeles County
264514	Fee-for-Service	1659387629	1659387629	1	1	HERNANDEZ, ROGELIO M MD	1/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	49249	40	Pediatrics	0	In state provider	MADERA CHILDREN'S MED CL	1130 COUNTRY CLUB DR	STE E	MADERA	CA	93638	1582	20	06039	36.97610274	-120.0742439	Madera County
264517	Fee-for-Service	1093787491	1093787491	1	1	HUMAN, DONALD A MD	8/1/2016	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
264682	Fee-for-Service	1508123696	1508123696	1	1	HAMILTON, BARBARA MD	3/1/2022	208600000X	NA	General Surgery	026	PHYSICIANS	128218	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
264686	Fee-for-Service	1578501714	1578501714	2	1	HO, HAREL A MD	2/26/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	60917	08	Family Practice	0	In state provider	None	880 S ATLANTIC BLVD	STE 302	MONTEREY PARK	CA	91754	4758	19	06037	34.05038485	-118.1383456	Los Angeles County
264739	Fee-for-Service	1689838708	1689838708	1	1	HOANG, QUYNH B MD	10/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	103880	35	Pediatric Cardiology (M.D. only)	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
264807	Fee-for-Service	1689156168	1689156168	1	1	HERNANDEZ SCHULTE, MAYRA A M	8/11/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	167202	None	None	0	In state provider	D	555 TECHEVAH DRIVE	None	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
264814	Fee-for-Service	1487063673	1487063673	1	1	HYNES, JOHN LMFT	4/16/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	100528	-	NOT APPLICABLE	0	In state provider	None	1100 NORTH D ST	None	SAN BERNARDINO	CA	92410	3425	36	06071	34.119711	-117.291936	San Bernardino County
264815	Fee-for-Service	1598752883	1598752883	1	1	HOM, PERRY S	3/31/1993	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	364 E ROWLAND ST	None	COVINA	CA	91723	3154	19	06037	34.0788207	-117.883851	Los Angeles County
264841	Fee-for-Service	1932542537	1932542537	1	1	HASAN, ASMA MD	1/14/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	133517	41	Internal Medicine	0	In state provider	None	15725 E WHITTIER BLVD	None	WHITTIER	CA	90603	3102	19	06037	33.94435533	-117.9931159	Los Angeles County
264861	Fee-for-Service	1861571812	1861571812	1	1	HNAT, DAWN MD	6/30/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	49658	83	Rheumatology	0	In state provider	None	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	19	06037	33.809751	-118.1079275	Los Angeles County
264873	Fee-for-Service	1124130620	1124130620	2	5	HARMONY HEALTH MEDICAL CLINI	9/18/2024	No Taxonomy Provided	NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	C AND FAMILY RESOURCE	1908 BEALE RD	E	MARYSVILLE	CA	95901	6937	58	06115	39.1278388	-121.5457994	Yuba County
264882	Fee-for-Service	1972891679	1972891679	1	1	HASSAS, AZITA R MD	7/21/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	108511	08	Family Practice	0	In state provider	None	5153 HOLT BLVD	SUITE B1	MONTCLAIR	CA	91763	2432	36	06071	34.0631015	-117.692694	San Bernardino County
264910	Fee-for-Service	1871112870	1871112870	1	1	HANNA, KAMIL MD	5/7/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	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
264919	Fee-for-Service	1154548006	1154548006	2	1	HEALTH DIAGNOSTICS OF	1/23/2012	No Taxonomy Provided	NA	None	045	CLINIC EXEMP FROM LICENSURE	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	325 SACRAMENTO STREET	None	SAN FRANCISCO	CA	94111	3601	38	06075	37.79424305	-122.3994352	San Francisco County
264935	Fee-for-Service	1992922561	1992922561	1	1	HENDRICKSON, CANDICE M MFT	8/14/2017	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	49672	-	NOT APPLICABLE	0	In state provider	None	1385 NORTH JOHNSON AVE	SUITE 102 & 103	EL CAJON	CA	92020	1660	37	06073	32.813847	-116.970981	San Diego County
264939	Fee-for-Service	1508897752	1508897752	1	1	HO, GLENN M MD	12/31/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	38922	01	General Practice	0	In state provider	None	1505 S BALDWIN AVE	None	ARCADIA	CA	91007	7925	19	06037	34.1219725	-118.055215	Los Angeles County
265003	Fee-for-Service	1114380581	1114380581	1	1	HOANG, ANH DO	6/18/2019	207R00000X	NA	Other	026	PHYSICIANS	16321	41	Internal Medicine	0	In state provider	None	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
265011	Fee-for-Service	1902287352	1902287352	1	2	HARKINS, AUBREY E NP	6/10/2020	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	42	06083	34.44509477	-119.7186392	Santa Barbara County
265036	Fee-for-Service	1316494107	1316494107	1	1	HO, JENNIFER T	7/15/2022	390200000X	NA	Other	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
265045	Fee-for-Service	1952407983	1952407983	1	1	HEIDARI-FOROUSHANI,	7/14/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	81842	None	None	0	In state provider	ARASH MD	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	15	06029	35.3818329	-118.9710228	Kern County
265068	Fee-for-Service	1861495020	1861495020	1	1	HEALY, MICHAEL H MD	1/1/1982	207RN0300X	NA	Nephrology	026	PHYSICIANS	27842	41	Internal Medicine	0	In state provider	None	2212 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3603	15	06029	35.37346298	-119.0276324	Kern County
265079	Fee-for-Service	1033747217	1033747217	1	1	HUI, MICHAEL MD	10/18/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	189719	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
265137	Fee-for-Service	1972710895	1972710895	1	2	HARTT, GREGORY T MD	8/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	None	None	0	In state provider	None	726 4TH STREET	None	MARYSVILLE	CA	95901	5656	58	06115	39.13872267	-121.5944372	Yuba County
265143	Fee-for-Service	1225871015	1225871015	1	1	HUANG, YI HSUAN LMFT	6/27/2024	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
265146	Fee-for-Service	1225023922	1225023922	1	1	HOME WELLNESS INC	6/16/2006	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	2	Out of state provider	HOME WELLNESS INC	1450 TAYLORS LN	STE A	CINNAMINSON	NJ	08077	2512	00	None	40.01425028	-74.97673055	Burlington County
265149	Fee-for-Service	1407191356	1407191356	1	3	HIGH DESERT PATHOLOGY MEDICA	1/11/2018	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICAL GROUP	1001 N TUSTIN AVE	None	SANTA ANA	CA	92705	3502	30	06059	33.75363187	-117.8341886	Orange County
265231	Fee-for-Service	1053720797	1053720797	1	1	HWANG, GRACE S MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	125505	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
265251	Fee-for-Service	1447208731	1447208731	1	1	HSIEH, KOU-YING MD	2/24/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86471	41	Internal Medicine	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
265320	Fee-for-Service	1417016122	1417016122	1	1	HUGHES, MARY J CRNA	2/28/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
265322	Fee-for-Service	1295814705	1295814705	1	1	HATEM, CARLO M MD	12/13/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	4305 N. MESA SUITE A	None	EL PASO	TX	79902	0000	00	None	31.79736	-106.511277	El Paso County
265325	Fee-for-Service	1124187737	1124187737	1	1	HIRSCH, KAREN M MD	9/30/1985	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	55358	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
265344	Fee-for-Service	1053470633	1053470633	1	1	HORITA, TIMOTHY J MD	2/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	66626	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
265355	Fee-for-Service	1467615633	1467615633	1	1	HARTIS, JASON N MD	3/26/2019	207P00000X	NA	Other	026	PHYSICIANS	157802	66	Emergency Medicine (Urgent Care)	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
265364	Fee-for-Service	1124259940	1124259940	1	1	HAYTON, RYAN A MD	10/28/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120421	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
265369	Fee-for-Service	1912347246	1912347246	1	1	HOPKINS, MICHAEL J CRNA	2/21/2014	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	300 CANAL ST	None	KING CITY	CA	93930	3431	27	06053	36.20653258	-121.1319345	Monterey County
265380	Fee-for-Service	1174187710	1174187710	1	1	HARDESTY, WALTER MD	10/18/2022	207R00000X	NA	Other	026	PHYSICIANS	181350	None	None	0	In state provider	None	12669 ENCINITAS AVE	None	SYLMAR	CA	91342	3635	19	06037	34.29981583	-118.473722	Los Angeles County
265391	Fee-for-Service	1710153598	1710153598	1	1	HURLEY, CATHERINE E MD	6/11/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	109706	01	General Practice	0	In state provider	None	1033 3RD STREET	None	SAN RAFAEL	CA	94901	3107	21	06041	37.97209412	-122.5280013	Marin County
265419	Fee-for-Service	1194788489	1194788489	1	1	HEIKKILA, DIANNA M CRNA	12/14/2012	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
265445	Fee-for-Service	1851586507	1851586507	1	2	HOTT, JASON M MD	8/3/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	102592	-	NOT APPLICABLE	0	In state provider	None	590 RIO LINDO AVENUE	None	CHICO	CA	95926	1817	04	06007	39.75427022	-121.8482553	Butte County
265446	Fee-for-Service	1366470452	1366470452	1	1	HARLE, MARK 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	4242 MEDICAL DR	None	SAN ANTONIO	TX	78229	5640	00	None	29.51345208	-98.56843947	Bexar County
265469	Fee-for-Service	1992879878	1992879878	1	1	HANGER P & O WEST INC.	4/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1215 PLUMAS ST	STE 1000	YUBA CITY	CA	95991	3456	51	06101	39.14709336	-121.6175316	Sutter County
265472	Fee-for-Service	1922119809	1922119809	1	1	HINER, BRUCE G PSYD	3/5/2009	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	300 CHERRY CREEK ROAD	None	CLOVERDALE	CA	95425	3811	49	06097	38.79480942	-123.0245421	Sonoma County
265478	Fee-for-Service	1063173896	1063173896	1	1	HILLSIDE SENIOR LIVING LLC	8/4/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4162 ISABELLA CIR	None	LAKE ELSINORE	CA	92530	2033	33	06065	33.70618785	-117.3826918	Riverside County
265557	Fee-for-Service	1134707847	1134707847	1	1	HIGASHIYA, KORI MD	4/4/2024	390200000X	NA	Other	026	PHYSICIANS	181015	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
265574	Fee-for-Service	1962474650	1962474650	1	1	HIRSCHBERG, JOEL MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	40006	41	Internal Medicine	0	In state provider	None	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	33	06065	33.763572	-116.4056895	Riverside County
265582	Fee-for-Service	1730214503	1730214503	1	1	HIURA, GLENN W OD	2/8/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	38433 20TH ST E	None	PALMDALE	CA	93550	4034	19	06037	34.58083527	-118.0941939	Los Angeles County
265584	Fee-for-Service	1699021428	1699021428	1	1	HYKE, TRAVIS D PHD	2/5/2025	103T00000X	NA	Mental Health Outpatient Services	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
265655	Fee-for-Service	1174688303	1174688303	1	1	HANLON, MICHAEL E A PHD	2/11/2013	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1660 E ROSEVILLE PARKWAY	BUILDING C	ROSEVILLE	CA	95661	3988	31	06061	38.74827146	-121.2397281	Placer County
265674	Fee-for-Service	1285722876	1285722876	1	5	HARRIS CARE CENTERS, INC	7/15/1994	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HARRIET HOME	9802 HARRIET LN	None	ANAHEIM	CA	92804	5631	30	06059	33.8118737	-117.9621252	Orange County
265711	Fee-for-Service	1154085991	1154085991	1	1	HERNANDEZ, DENISE CNP	1/19/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5623 KANAN RD	None	AGOURA HILLS	CA	91301	3358	19	06037	34.15237396	-118.757941	Los Angeles County
265724	Fee-for-Service	1760508022	1760508022	1	1	HUTCHINSON, BRIAN K MD	9/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99550	20	Orthopedic Surgery	0	In state provider	None	6041 CADILLAC AVE	None	LOS ANGELES	CA	90034	1702	19	06037	34.03781261	-118.3755101	Los Angeles County
265763	Fee-for-Service	1255918066	1255918066	1	1	HELPFUL HOSPICE SERVICES INC	12/16/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 202	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
265780	Fee-for-Service	1982674438	1982674438	1	1	HAUSER, BRIAN P	10/25/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	136227	None	None	0	In state provider	None	26991 CROWN VALLEY PKWY	None	MISSION VIEJO	CA	92691	6528	30	06059	33.56210341	-117.6694207	Orange County
265799	Fee-for-Service	1336471416	1336471416	1	1	HSU, CHRISTOPHER P MD	8/11/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	99740	None	None	0	In state provider	None	44725 10TH ST W	STE 150	LANCASTER	CA	93535	3000	19	06037	34.695693	-118.1480965	Los Angeles County
265800	Fee-for-Service	1295376028	1295376028	1	2	HIGHER GROUND FAMILY THERAPY	3/27/2020	251S00000X	NA	Other	078	MARRIAGE AND FAMILY THERAPIST GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC	2400 WASHINGTON AVE	STE 401	REDDING	CA	96001	2827	45	06089	40.577499	-122.371478	Shasta County
265806	Fee-for-Service	1255409314	1255409314	1	1	HEALTHRIGHT360	1/29/2014	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1340 TULLY ROAD	301 AND 304	SAN JOSE	CA	95122	3055	43	06085	37.31710924	-121.8334186	Santa Clara County
265819	Fee-for-Service	1750455630	1750455630	1	1	HANGER PROSTHETICS & ORTHOTI	8/27/2008	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	4849 LONETREE WAY	SUITE A & B	ANTIOCH	CA	94531	8644	07	06013	37.96289777	-121.7679057	Contra Costa County
265830	Fee-for-Service	1376584573	1376584573	1	1	HENDRICKSON, MATTHEW S	8/9/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	77309	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
265855	Fee-for-Service	1700516218	1700516218	1	1	HERNANDEZ, STEVE B DC	10/4/2022	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3 COURT ST	None	WOODLAND	CA	95695	3111	57	06113	38.67888652	-121.783788	Yolo County
265875	Fee-for-Service	1558419473	1558419473	1	1	HWANG, JAMES S MD	2/1/1995	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	6559	66	Emergency Medicine (Urgent Care)	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
265877	Fee-for-Service	1386255248	1386255248	1	1	HONG, HELEN H CNP	8/15/2022	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
265906	Fee-for-Service	1649471798	1649471798	1	1	HERSHEY, DOUGLAS W MD	4/30/1991	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	18962	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1111 EXPOSITION BLVD	STE 200	SACRAMENTO	CA	95815	4324	34	06067	38.598876	-121.4502885	Sacramento County
265926	Fee-for-Service	1609045954	1609045954	1	1	HAMIDI, SARA B MD	6/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111686	38	Geriatrics	0	In state provider	None	2121 COLORADO AVE	SUITE C	TURLOCK	CA	95382	2012	50	06099	37.5117454	-120.8353096	Stanislaus County
265938	Fee-for-Service	1952849663	1952849663	1	1	HAILLE INC	4/13/2017	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	7484 UNIVERSITY AVE #340	None	LA MESA	CA	91942	6030	37	06073	32.75856212	-117.0361153	San Diego County
265949	Fee-for-Service	1750527669	1750527669	1	1	HUDA, AMINA A 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
265963	Fee-for-Service	1477866549	1477866549	1	1	HABIB, MISHA MD	6/12/2020	207R00000X	NA	Other	026	PHYSICIANS	157931	41	Internal Medicine	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
266004	Fee-for-Service	1780636167	1780636167	1	1	HAFEZ, MOHAMED A I MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	48947	41	Internal Medicine	0	In state provider	None	9918 KATELLA AVE	SUITE C	ANAHEIM	CA	92804	6465	30	06059	33.80307047	-117.959688	Orange County
266010	Fee-for-Service	1215978911	1215978911	1	1	HECK, CHRISTIANNE N MD	1/1/1995	2084N0400X	NA	Neurology	026	PHYSICIANS	77022	13	Neurology (M.D. only)	0	In state provider	None	1510 SAN PABLO ST	STE 268	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
266021	Fee-for-Service	1609397165	1609397165	1	1	HELP & CARE LLC	4/13/2023	No Taxonomy Provided	NA	None	066	PERSONAL CARE AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	14417 BIG BASIN WAY	SUITE B	SARATOGA	CA	95070	6181	43	06085	37.25886901	-122.0326021	Santa Clara County
266049	Fee-for-Service	1255918066	1255918066	1	1	HELPFUL HOSPICE SERVICES INC	12/16/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 202	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
266063	Fee-for-Service	1235142738	1235142738	1	1	HENDRIX, JEFFERSON C MD	2/8/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	32571	01	General Practice	0	In state provider	None	17542 IRVINE BLVD	STE D	TUSTIN	CA	92780	3155	30	06059	33.74823156	-117.8262234	Orange County
266083	Fee-for-Service	1982860268	1982860268	1	1	HOFFMAN, KRISTIN MD	10/22/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	110473	40	Pediatrics	0	In state provider	None	1600 EUREKA RD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
266086	Fee-for-Service	1295376028	1295376028	1	2	HIGHER GROUND FAMILY THERAPY	3/27/2020	251S00000X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	, INC	2400 WASHINGTON AVE	STE 401	REDDING	CA	96001	2827	45	06089	40.577499	-122.371478	Shasta County
266090	Fee-for-Service	1780880807	1780880807	1	1	HERRELL, RENATA L LMFT	8/24/2018	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
266091	Fee-for-Service	1750700720	1750700720	1	1	HONG, PAMELA DPM	9/15/2017	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	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
266159	Fee-for-Service	1053452664	1053452664	1	2	HIRST, KATHRYN P MD	5/11/2020	2084P0800X	NA	Psychiatry	086	MEDICAL DIRECTORS	95063	-	NOT APPLICABLE	0	In state provider	None	3594 FOURTH AVE	None	SAN DIEGO	CA	92103	4940	37	06073	32.74318084	-117.1615865	San Diego County
266168	Fee-for-Service	1073284857	1073284857	1	1	HOM, BRIANNA M OT	5/11/2022	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 S INDIAN HILL BLVD S	None	CLAREMONT	CA	91711	5461	19	06037	34.084494	-117.7191945	Los Angeles County
266172	Fee-for-Service	1831349935	1831349935	1	1	HARARI, AVITAL MD	4/22/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	107125	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
266212	Fee-for-Service	1609045954	1609045954	1	1	HAMIDI, SARA B MD	6/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111686	08	Family Practice	0	In state provider	None	2121 COLORADO AVE	SUITE C	TURLOCK	CA	95382	2012	50	06099	37.5117454	-120.8353096	Stanislaus County
266222	Fee-for-Service	1265957682	1265957682	1	1	HUANG, HERMAN PT	3/27/2023	2251X0800X	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
266241	Fee-for-Service	1780046987	1780046987	1	1	HELLER, KRISTINA K DO	11/12/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16146	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
266242	Fee-for-Service	1831640119	1831640119	1	1	HOLEY, ALEXANDRA W CNM	1/2/2023	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
266265	Fee-for-Service	1265752935	1265752935	1	1	HY, MARIA MD	1/16/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	09	Gynecology (D.O. only)	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
266281	Fee-for-Service	1235122805	1235122805	1	1	HEATON, JASON O MD	9/27/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	162695	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
266289	Fee-for-Service	1780636167	1780636167	1	1	HAFEZ, MOHAMED A I MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	48947	01	General Practice	0	In state provider	None	9918 KATELLA AVE	SUITE C	ANAHEIM	CA	92804	6465	30	06059	33.80307047	-117.959688	Orange County
266309	Fee-for-Service	1710513700	1710513700	1	1	HUEBNER, EMMA R MD	2/21/2024	207L00000X	NA	Other	026	PHYSICIANS	190478	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
266341	Fee-for-Service	1457662868	1457662868	1	1	HARVEY, SCOTT A MD	4/14/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	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
266345	Fee-for-Service	1255958054	1255958054	1	1	HOBBS INDUSTRIES, INC	10/19/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	1	Border provider	None	1155 W 4TH ST	SUITE 225, EXECUTIVE SUI	RENO	NV	89503	5172	00	None	39.52595285	-119.8289757	Washoe County
266362	Fee-for-Service	1477872976	1477872976	1	1	HOM, APRIL A MD	9/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	128106	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
266365	Fee-for-Service	1457531352	1457531352	1	1	HARTFORD & HARTFORD ODS	9/15/1982	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	27875 BERWICK DR	STE B	CARMEL	CA	93923	8678	27	06053	36.52204244	-121.8087006	Monterey County
266484	Fee-for-Service	1952414328	1952414328	1	1	HO, STEVEN S MD	11/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77099	41	Internal Medicine	0	In state provider	MEDIPRO MEDICAL GRP INC	2105 BEVERLY BLVD	STE 201	LOS ANGELES	CA	90057	2216	19	06037	34.06682861	-118.2706286	Los Angeles County
266489	Fee-for-Service	1720492648	1720492648	1	1	HILLARD, GRACE NP	4/10/2020	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16420 PERRIS	STE Q	MORENO VALLEY	CA	92551	1135	33	06065	33.8815293	-117.2260941	Riverside County
266491	Fee-for-Service	1629399019	1629399019	1	1	HOY, ZACHARY D MD	7/1/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112830	None	None	0	In state provider	None	455 S MAIN ST	None	ORANGE	CA	92868	3835	30	06059	33.78077578	-117.8673468	Orange County
266533	Fee-for-Service	1568854743	1568854743	1	1	HUDSON-CRIM, ABIGAIL LCSW	1/20/2025	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	ORAZON COMMUNITY COUNSEL	537 G ST	204	EUREKA	CA	95501	1043	12	06023	40.80153993	-124.1647136	Humboldt County
266549	Fee-for-Service	1356737936	1356737936	1	1	HSU, JAMES C 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
266552	Fee-for-Service	1265752935	1265752935	1	1	HY, MARIA MD	1/16/2025	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	None	15	Obstetrics (D.O. only)	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
266565	Fee-for-Service	1588931455	1588931455	1	1	HERRERA, ULYSSES MD	2/19/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128572	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
266596	Fee-for-Service	1467490185	1467490185	1	1	HULGUIST,MATTHEW MD	8/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	9850 W ST LUKES DR	None	NAMPA	ID	83687	0000	00	None	43.618383	-116.5904145	Canyon County
266695	Fee-for-Service	1386771715	1386771715	1	1	HAYES, SEAN W MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	83076	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	123 S ALVARADO ST	None	LOS ANGELES	CA	90057	2201	19	06037	34.06593048	-118.2708351	Los Angeles County
266707	Fee-for-Service	1306956123	1306956123	1	1	HALCOMB, JAMES L MD	4/17/2000	207L00000X	NA	Other	026	PHYSICIANS	85412	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
266717	Fee-for-Service	1912024126	1912024126	1	1	HASELRIG, TRINA 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
266744	Fee-for-Service	1548336183	1548336183	1	2	HAWAII ANESTHESIA GROUP INC	3/19/2017	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	05	Anesthesiology	2	Out of state provider	None	1319 PUNAHOU STREET	None	HONOLULU	HI	96826	1028	00	None	21.30030321	-157.8342762	Honolulu County
266770	Fee-for-Service	1952414328	1952414328	1	1	HO, STEVEN S MD	11/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	77099	45	Nephrology (Renal-Kidney)	0	In state provider	MEDIPRO MEDICAL GRP INC	2105 BEVERLY BLVD	STE 201	LOS ANGELES	CA	90057	2216	19	06037	34.06682861	-118.2706286	Los Angeles County
266780	Fee-for-Service	1598750721	1598750721	1	1	HUNT MEMORIAL HOSPITAL DISTR	6/8/2020	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4215 JOE RAMSEY BLVD	None	GREENVILLE	TX	75401	7852	00	None	33.1234432	-96.12339239	Hunt County
266826	Fee-for-Service	1891793980	1891793980	1	1	HOPKINS, BRIAN D MD	2/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	54799	34	Urology and Urological Surgery	0	In state provider	None	2222 EAST ST	STE 250	CONCORD	CA	94520	2096	07	06013	37.98125538	-122.0329375	Contra Costa County
266833	Fee-for-Service	1528146024	1528146024	1	1	HASSANEIN, MUHAMMAD H MD	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	92854	41	Internal Medicine	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
266882	Fee-for-Service	1932486636	1932486636	1	1	HOLDEN, RYAN J	12/11/2012	No Taxonomy Provided	NA	None	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1150 W ORANGEBURG AVE	None	MODESTO	CA	95350	4042	50	06099	37.66396236	-121.0095829	Stanislaus County
266924	Fee-for-Service	1700250941	1700250941	1	1	HAYES, KARALEE	7/6/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3162 LOS FELIZ BLVD	None	LOS ANGELES	CA	90039	1507	19	06037	34.12384092	-118.2678157	Los Angeles County
266928	Fee-for-Service	1316387715	1316387715	1	1	HUH, MARC H MD	8/10/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137535	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
266942	Fee-for-Service	1790562072	1790562072	1	1	HEALTHCARE SERVICES, INC.	1/17/2024	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1340 W PEARL ST	None	ANAHEIM	CA	92801	5943	30	06059	33.834132	-117.9318025	Orange County
266944	Fee-for-Service	1184806325	1184806325	1	1	HWA, MICHAEL MD	7/18/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	96767	41	Internal Medicine	0	In state provider	DR. A BANUELOS JR CMO	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
266951	Fee-for-Service	1336483718	1336483718	1	1	HARDIMAN, KEVIN J DO	5/18/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	12516	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23845 MCBEAN PARKWAY	None	VALENCIA	CA	91355	2083	19	06037	34.39696803	-118.5525278	Los Angeles County
266966	Fee-for-Service	1194186296	1194186296	1	1	HEISER, STEPHANIE	9/1/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	123562	-	NOT APPLICABLE	0	In state provider	None	265 S ANITA DR	202	ORANGE	CA	92868	3346	30	06059	33.78499409	-117.8811837	Orange County
266982	Fee-for-Service	1386771715	1386771715	1	1	HAYES, SEAN W MD	1/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	83076	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	123 S ALVARADO ST	None	LOS ANGELES	CA	90057	2201	19	06037	34.06593048	-118.2708351	Los Angeles County
266997	Fee-for-Service	1871660738	1871660738	1	1	HUBBARD, ANDREW M MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	47877	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
267000	Fee-for-Service	1760783963	1760783963	1	1	HO, VINH H PA	10/6/2015	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	21279	-	NOT APPLICABLE	0	In state provider	None	1322 N AVALON BLVD	None	WILMINGTON	CA	90744	2639	19	06037	33.78953748	-118.263169	Los Angeles County
267009	Fee-for-Service	1174969463	1174969463	1	1	HEINZEROTH, JASON CP	5/28/2013	224P00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1011 CASS ST	#112	MONTEREY	CA	93940	4542	27	06053	36.59201772	-121.8966282	Monterey County
267016	Fee-for-Service	1518013317	1518013317	1	1	HERSEVOORT, SHAWN B MD	9/13/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88489	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
267025	Fee-for-Service	1962065946	1962065946	1	1	HAWKINS, TARA	4/20/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5016 CHESEBRO RD	STE 200	AGOURA HILLS	CA	91301	2277	19	06037	34.14134802	-118.7392827	Los Angeles County
267058	Fee-for-Service	1639347099	1639347099	1	1	HEYERMAN, WILLIAM B MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	34070	None	None	0	In state provider	A MEDICAL CORPORATION	2160 COURT ST	None	REDDING	CA	96001	2530	45	06089	40.57698594	-122.3931348	Shasta County
267059	Fee-for-Service	1992092357	1992092357	1	1	HAN, JUNG H DO	12/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12460	38	Geriatrics	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
267062	Fee-for-Service	1598750721	1598750721	1	1	HUNT MEMORIAL HOSPITAL DISTR	6/8/2020	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	4215 JOE RAMSEY BLVD	None	GREENVILLE	TX	75401	7852	00	None	33.1234432	-96.12339239	Hunt County
267097	Fee-for-Service	1508834946	1508834946	1	1	HERBEI, LAVINIA MD	5/13/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	88890	41	Internal Medicine	0	In state provider	None	1220 ROSSMOOR PKWY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
267101	Fee-for-Service	1871976878	1871976878	1	1	HANDA, RICHA	6/7/2024	207R00000X	NA	Other	026	PHYSICIANS	170978	41	Internal Medicine	0	In state provider	None	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
267129	Fee-for-Service	1427564566	1427564566	1	1	HOWELLS, LAURA G	3/8/2025	174N00000X	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
267211	Fee-for-Service	1649296385	1649296385	1	1	HARRISON, STEVEN A MD	4/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63736	01	General Practice	0	In state provider	INC	1299 NEWELL HILL PL	STE 103	WALNUT CREEK	CA	94596	5230	07	06013	37.89387272	-122.0539301	Contra Costa County
267231	Fee-for-Service	1134377021	1134377021	1	1	HILLSEGEMO, DEBORAH K LMFT	2/18/2019	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
267249	Fee-for-Service	1376947978	1376947978	1	1	HAYES B. GLADSTONE, MD, PC.	1/29/2021	207ND0101X	NA	Dermatology	022	PHYSICIANS GROUP	-	07	Dermatology	0	In state provider	None	101 PARK PL	SUITE 200	SAN RAMON	CA	94583	1761	07	06013	37.7730841	-121.9883297	Contra Costa County
267272	Fee-for-Service	1427478510	1427478510	1	1	HICKS, CHRISTOPHER R MD	5/1/2021	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	170615	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
267282	Fee-for-Service	1871660738	1871660738	1	1	HUBBARD, ANDREW M MD	1/31/1983	No Taxonomy Provided	NA	None	026	PHYSICIANS	47877	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
267288	Fee-for-Service	1417286279	1417286279	1	1	HERRERA-ESPINOZA, HAYDEE NP	6/5/2017	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	19	06037	34.21980849	-118.4301135	Los Angeles County
267304	Fee-for-Service	1538620802	1538620802	1	1	HWANG, ERIC S MD	4/15/2023	390200000X	NA	Other	026	PHYSICIANS	184627	None	None	0	In state provider	None	266 S HARVARD BLVD	SUITE 500	LOS ANGELES	CA	90004	4372	19	06037	34.069221	-118.3041245	Los Angeles County
267315	Fee-for-Service	1639629181	1639629181	1	1	HANNA, MORA	12/20/2023	2251P0200X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	8265 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	7671	36	06071	34.10330723	-117.5642502	San Bernardino County
267344	Fee-for-Service	1992092357	1992092357	1	1	HAN, JUNG H DO	12/29/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	12460	01	General Practice	0	In state provider	None	11420 WARNER AVE	None	FOUNTAIN VALLEY	CA	92708	2529	30	06059	33.71633952	-117.929061	Orange County
267377	Fee-for-Service	1245617489	1245617489	1	1	HIETALATI, SAMANTHA M MD	8/1/2022	2080N0001X	NA	Pediatric Primary Care	026	PHYSICIANS	162427	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
267385	Fee-for-Service	1679935944	1679935944	1	1	HSIUE, PETER P MD	9/5/2024	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	151110	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
267389	Fee-for-Service	1073558953	1073558953	2	1	HANGER PROSTHETICS & ORTHOTI	1/7/2013	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	CS WEST, INC.	4150 REGENTS PARK ROW	#265	LA JOLLA	CA	92037	1417	37	06073	32.87272099	-117.2175656	San Diego County
267423	Fee-for-Service	1245529775	1245529775	1	1	HUYNH, LISA MD	8/11/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	130034	20	Orthopedic Surgery	0	In state provider	None	300 PASTEUR DRIVE	MC 5548	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
267493	Fee-for-Service	1649296385	1649296385	1	1	HARRISON, STEVEN A MD	4/21/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	63736	18	Ophthalmology	0	In state provider	INC	1299 NEWELL HILL PL	STE 103	WALNUT CREEK	CA	94596	5230	07	06013	37.89387272	-122.0539301	Contra Costa County
267550	Fee-for-Service	1215945514	1215945514	1	1	HANGER P & O WEST INC	9/19/2001	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	3155 KEARNEY ST	#130	FREMONT	CA	94538	2268	01	06001	37.5490951	-121.974815	Alameda County
267556	Fee-for-Service	1174613772	1174613772	1	1	HORWITZ, DANIEL S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	20	Orthopedic Surgery	2	Out of state provider	None	590 WAKARA WAY	None	SALT LAKE CITY	UT	84108	1200	00	None	40.7559267	-111.8324577	Salt Lake County
267582	Fee-for-Service	1558342048	1558342048	1	1	HO, BENJAMIN T MD	6/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	72142	05	Anesthesiology	0	In state provider	None	17101 ARMSTRONG AVE	STE 201	IRVINE	CA	92614	5742	30	06059	33.69524989	-117.8444582	Orange County
267608	Fee-for-Service	1750689733	1750689733	1	1	HEATHER LYNN MCCONNELL NP	12/1/2014	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	700 CHILDRENS DR	None	COLUMBUS	OH	43205	2664	00	None	39.95288635	-82.98152375	Franklin County
267683	Fee-for-Service	1609004191	1609004191	1	1	HANSON, COURTNEY C MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	114225	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
267769	Fee-for-Service	1598108847	1598108847	1	1	HOMETOWN LTC PHARMACY INC	5/30/2013	3336L0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1450 W MCCOY LANE	UNIT B	SANTA MARIA	CA	93455	1059	42	06083	34.91594453	-120.4629165	Santa Barbara County
267771	Fee-for-Service	1215452826	1215452826	1	1	HINTZSCHE, KRISTINA L CRNA	8/24/2017	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVENUE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
267847	Fee-for-Service	1013023274	1013023274	1	1	HUANG, FRANK T JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52167	41	Internal Medicine	0	In state provider	None	999 S FAIRMONT AVE	STE 135	LODI	CA	95240	5141	39	06077	38.1206163	-121.2858323	San Joaquin County
267871	Fee-for-Service	1356877641	1356877641	1	1	HASELMAN, CYRUS H MD	11/30/2020	207P00000X	NA	Other	026	PHYSICIANS	157425	None	None	0	In state provider	None	333 MERCY AVENUE	None	MERCED	CA	95340	8319	24	06047	37.33875148	-120.467457	Merced County
267925	Fee-for-Service	1205849825	1205849825	1	1	HORSLEY, DEBRA L LCSW	6/20/2018	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	332 S JUNIPER ST	None	ESCONDIDO	CA	92025	4940	37	06073	33.12066536	-117.0770413	San Diego County
267934	Fee-for-Service	1003316381	1003316381	1	1	HANSEN, DEANNA J	10/23/2017	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	None	2102 CIVIC CENTER DRIVE	None	REDDING	CA	96001	2704	45	06089	40.57610996	-122.3804753	Shasta County
267935	Fee-for-Service	1386626182	1386626182	1	1	HILL, ANGELIA G CRNA	5/20/2020	367500000X	NA	Other	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
267942	Fee-for-Service	1386419521	1386419521	1	1	HEAD & HEART FAMILY THERAPY,	1/10/2024	261QM0850X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	790 INDIGO CT	STE C	POMONA	CA	91767	2272	19	06037	34.09299247	-117.7371765	Los Angeles County
268000	Fee-for-Service	1083077739	1083077739	1	1	HUYNH, ERIC MD	1/26/2022	207R00000X	NA	Other	026	PHYSICIANS	-	None	None	1	Border provider	None	657 NORTH TOWN CENTER DR	None	LAS VEGAS	NV	89144	6367	00	None	36.180999	-115.3174815	Clark County
268011	Fee-for-Service	1164137337	1164137337	1	1	HEALTHRIGHT 360	9/19/2023	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	265 SOUTH ANITA DRIVE	SUITES 202, 301, 302	ORANGE	CA	92868	3355	30	06059	33.78499409	-117.8811837	Orange County
268012	Fee-for-Service	1952561284	1952561284	1	1	HOU, RANDY MD	8/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	104191	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
268015	Fee-for-Service	1710382189	1710382189	1	1	HAMI, ANOOSHIRAVEN MD CORP	3/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	67031	41	Internal Medicine	0	In state provider	None	3400 W BALL ROAD	STE 207	ANAHEIM	CA	92804	3102	30	06059	33.81724472	-118.0083216	Orange County
268030	Fee-for-Service	1215294871	1215294871	1	1	HANKS, KARLA M LCSW	7/29/2020	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6820 LA TIJERA BLVD	SUITE 115	LOS ANGELES	CA	90045	1908	19	06037	33.97691336	-118.3722427	Los Angeles County
268033	Fee-for-Service	1568620896	1568620896	1	1	HONG LEE, DEBORAH H MD	12/5/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	106016	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
268047	Fee-for-Service	1073692570	1073692570	1	1	HOWARD, KIRK G MD	3/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	22748	05	Anesthesiology	0	In state provider	None	11234 ANDERSON STREET	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
268089	Fee-for-Service	1093876831	1093876831	1	1	HELMAN, JEROME P MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	28388	10	Gastroenterology (M.D. only)	0	In state provider	None	2001 SANTA MONICA BLVD	STE 470-W	SANTA MONICA	CA	90404	2102	19	06037	34.02891163	-118.4797466	Los Angeles County
268096	Fee-for-Service	1992475594	1992475594	1	1	HERNANDEZ, LAURA M LCSW	5/23/2024	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
268099	Fee-for-Service	1861871337	1861871337	1	1	HILL, ROBERT B MD	8/18/2020	207LP3000X	NA	Other	026	PHYSICIANS	169625	05	Anesthesiology	0	In state provider	None	6235 N FRESNO ST	STE 103	FRESNO	CA	93710	5269	10	06019	36.82733123	-119.7814229	Fresno County
268130	Fee-for-Service	1013023274	1013023274	1	1	HUANG, FRANK T JR MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	52167	67	Endocrinology	0	In state provider	None	999 S FAIRMONT AVE	STE 135	LODI	CA	95240	5141	39	06077	38.1206163	-121.2858323	San Joaquin County
268152	Fee-for-Service	1851875322	1851875322	1	1	HONECK, NOEL PSYD	2/16/2024	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2373 COLORADO BLVD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
268153	Fee-for-Service	1851678916	1851678916	1	1	HOSPICE OF ST CLARE INC	11/7/2014	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	144 N GLENDALE AVE	SUITE 222	GLENDALE	CA	91206	4903	19	06037	34.14799289	-118.2464845	Los Angeles County
268156	Fee-for-Service	1366589558	1366589558	1	1	HILK, SUSAN S CNP	5/15/2019	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
268172	Fee-for-Service	1689778987	1689778987	1	1	HERBER, STEVEN C MD	2/8/2015	2086S0122X	NA	General Surgery	026	PHYSICIANS	61120	02	General Surgery	0	In state provider	None	1030 MAIN ST	STE 206	SAINT HELENA	CA	94574	2056	28	06055	38.50265028	-122.4659168	Napa County
268174	Fee-for-Service	1891746541	1891746541	1	1	HARDERS, GREGORY	6/9/2024	207P00000X	NA	Other	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2400 S AVENUE A	None	YUMA	AZ	85364	7124	00	None	32.683167	-114.633459	Yuma County
268190	Fee-for-Service	1356554679	1356554679	1	1	HSU, LYDIA MD	8/11/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108514	18	Ophthalmology	0	In state provider	None	300 PASTEUR DRIVE	MC 5500	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
268207	Fee-for-Service	1093886053	1093886053	1	1	HWANG, TONY K MD	11/30/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	50948	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
268230	Fee-for-Service	1396786406	1396786406	1	1	HESS, JASON R MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104343	46	Hand Surgery	0	In state provider	None	12021 WILSHIRE BLVD	STE 745	LOS ANGELES	CA	90025	1206	19	06037	34.04543773	-118.4658404	Los Angeles County
268231	Fee-for-Service	1700220407	1700220407	1	1	HARMONY HEALTH MEDICAL CLNC	5/1/2014	No Taxonomy Provided	NA	None	052	ALTERNATIVE BIRTH CENTERS - SPECIALTY CLINIC	-	-	NOT APPLICABLE	0	In state provider	AND FAMILY RESOURCE CTR	1908 N BEALE RD	STE C	MARYSVILLE	CA	95901	6837	58	06115	39.1278388	-121.5457994	Yuba County
268278	Fee-for-Service	1639129901	1639129901	1	1	HEAL, GEORGINA M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85249	66	Emergency Medicine (Urgent Care)	0	In state provider	None	23845 HOLMAN HWY	STE 220	MONTEREY	CA	93940	5901	27	06053	36.57594044	-121.9132944	Monterey County
268281	Fee-for-Service	1992243364	1992243364	1	1	HANSRA, SHAN MD	4/22/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	180494	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
268286	Fee-for-Service	1508142068	1508142068	1	1	HARTMAYER, LISA M 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
268300	Fee-for-Service	1710382189	1710382189	1	1	HAMI, ANOOSHIRAVEN MD CORP	3/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	67031	66	Emergency Medicine (Urgent Care)	0	In state provider	None	3400 W BALL ROAD	STE 207	ANAHEIM	CA	92804	3102	30	06059	33.81724472	-118.0083216	Orange County
268311	Fee-for-Service	1194767582	1194767582	1	1	HOMER, SUZANNE Y MD	12/15/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	73381	30	Radiology	0	In state provider	None	1441 FLORIDA AVE	None	MODESTO	CA	95350	4405	50	06099	37.66508443	-120.9962589	Stanislaus County
268330	Fee-for-Service	1750735304	1750735304	1	1	HEDGCOCK, MICHELLE PT	2/18/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1100 N VENTURA RD	STE 103	OXNARD	CA	93030	3841	56	06111	34.212771	-119.1944035	Ventura County
268335	Fee-for-Service	1831622760	1831622760	1	1	HUNTER, GRACE E MD	7/30/2020	207R00000X	NA	Other	026	PHYSICIANS	159887	41	Internal Medicine	0	In state provider	None	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
268338	Fee-for-Service	1285830877	1285830877	1	1	HAUGER, PAMELA J	3/22/2011	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
268409	Fee-for-Service	1902040009	1902040009	1	1	HAFTBARADARAN-MOHAMMADI	3/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118197	45	Nephrology (Renal-Kidney)	0	In state provider	AFSANEH MD	11180 WARNER AVE	SUITE 463	FOUNTAIN VALLEY	CA	92708	7505	30	06059	33.71632048	-117.9334575	Orange County
268435	Fee-for-Service	1851678916	1851678916	1	1	HOSPICE OF ST CLARE INC	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	144 N GLENDALE AVE	SUITE 222	GLENDALE	CA	91206	4903	19	06037	34.14799289	-118.2464845	Los Angeles County
268456	Fee-for-Service	1770518391	1770518391	1	1	HUNG, GUO-LONG MD	2/28/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	43074	01	General Practice	0	In state provider	None	1624 W OLIVE AVE	STE F	BURBANK	CA	91506	2459	19	06037	34.1673422	-118.3229985	Los Angeles County
268477	Fee-for-Service	1619900115	1619900115	1	1	HINKIN, CHARLES H PHD	5/22/1998	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8353	19	06037	34.07067	-118.4432445	Los Angeles County
268519	Fee-for-Service	1285722876	1285722876	1	3	HARRIS CARE CENTERS, INC	12/11/1996	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	ANCONA HOME	22682 ANCONA	None	LAGUNA HILLS	CA	92653	1905	30	06059	33.62035589	-117.7341332	Orange County
268523	Fee-for-Service	1275794935	1275794935	1	1	HARRIS, TYLER J MD	6/11/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	119515	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
268532	Fee-for-Service	1396786406	1396786406	1	1	HESS, JASON R MD	10/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104343	24	Plastic Surgery	0	In state provider	None	12021 WILSHIRE BLVD	STE 745	LOS ANGELES	CA	90025	1206	19	06037	34.04543773	-118.4658404	Los Angeles County
268559	Fee-for-Service	1487919155	1487919155	1	1	HUBBARD, TRENTON R MD	2/26/2020	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	167536	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
268560	Fee-for-Service	1639129901	1639129901	1	1	HEAL, GEORGINA M MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85249	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	23845 HOLMAN HWY	STE 220	MONTEREY	CA	93940	5901	27	06053	36.57594044	-121.9132944	Monterey County
268585	Fee-for-Service	1710382189	1710382189	1	1	HAMI, ANOOSHIRAVEN MD CORP	3/10/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	67031	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	3400 W BALL ROAD	STE 207	ANAHEIM	CA	92804	3102	30	06059	33.81724472	-118.0083216	Orange County
268611	Fee-for-Service	1962848432	1962848432	1	1	HUANG, JEANNIE K DO	11/30/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13923	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
268627	Fee-for-Service	1447208962	1447208962	1	1	HO, HELEN H MD	7/12/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	85408	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2450 ASHBY AVE	None	BERKELEY	CA	94705	2067	01	06001	37.85646136	-122.2573894	Alameda County
268633	Fee-for-Service	1336182757	1336182757	1	1	HOROWITZ, ALFRED L MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	22171	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
268634	Fee-for-Service	1982856969	1982856969	1	1	HUMPHREYS, LORI O	2/22/2013	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
268636	Fee-for-Service	1912622689	1912622689	1	1	HOLCOMBE, JOHN C PT	3/13/2023	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3760 CONVOY STREET	100	SAN DIEGO	CA	92111	3743	37	06073	32.81197521	-117.1531278	San Diego County
268654	Fee-for-Service	1205216728	1205216728	1	1	HOLDER, WILLIAM G	3/20/2023	207P00000X	NA	Other	026	PHYSICIANS	183944	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
268669	Fee-for-Service	1841480019	1841480019	1	1	HERNANDEZ, GERI ANN	10/6/2005	163W00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1566 HEATHER LN	None	RIVERSIDE	CA	92504	5517	33	06065	33.89769363	-117.3991527	Riverside County
268673	Fee-for-Service	1124080502	1124080502	1	1	HESS, THEA H NP	3/9/2020	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
268688	Fee-for-Service	1902040009	1902040009	1	1	HAFTBARADARAN-MOHAMMADI	3/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	118197	41	Internal Medicine	0	In state provider	AFSANEH MD	11180 WARNER AVE	SUITE 463	FOUNTAIN VALLEY	CA	92708	7505	30	06059	33.71632048	-117.9334575	Orange County
268709	Fee-for-Service	1629166673	1629166673	1	1	HARDIN, STEVEN B MD	8/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	58481	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
268754	Fee-for-Service	1376660498	1376660498	1	1	HU, YINGCHUAN	2/22/2018	207ZP0101X	NA	Other	026	PHYSICIANS	113024	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	2625 COFFEE RD	STE S	MODESTO	CA	95355	2050	50	06099	37.67888506	-120.9759048	Stanislaus County
268796	Fee-for-Service	1184934010	1184934010	1	1	HALL, TRACY E LCSW	3/27/2023	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
268812	Fee-for-Service	1982636486	1982636486	1	1	HERTZBERG, LINDA B MD	1/31/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	46102	05	Anesthesiology	0	In state provider	None	1303 E HERNDON AVE	None	FRESNO	CA	93720	3309	10	06019	36.83626596	-119.7674879	Fresno County
268826	Fee-for-Service	1528010998	1528010998	1	1	HASAN, SYED A MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	68482	41	Internal Medicine	0	In state provider	None	1535 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	2667	15	06029	35.6489946	-117.6698641	Kern County
268901	Fee-for-Service	1003906785	1003906785	1	1	HOLLISTER,ROGER 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	PO BOX 111719	AURORA	CO	80042	1719	00	None	39.748041	-104.834673	Adams County
268941	Fee-for-Service	1821146200	1821146200	1	1	HARA, PATRICIA A	2/22/2013	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	34	06067	38.594898	-121.3884765	Sacramento County
268989	Fee-for-Service	1629166673	1629166673	1	1	HARDIN, STEVEN B MD	8/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	58481	68	Hematology	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
269058	Fee-for-Service	1831273812	1831273812	1	1	HERTZ, BRIAN D MD	10/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	86565	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
269066	Fee-for-Service	1184756884	1184756884	1	1	HATCH, ILENE E MD	9/17/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	71146	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	101 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3298	30	06059	33.78674051	-117.8888713	Orange County
269084	Fee-for-Service	1659327013	1659327013	1	1	HCA HEALTHCARE LLC MED	7/22/2001	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER OF AURORA	1501 S POTOMAC ST	None	AURORA	CO	80012	5411	00	None	39.689343	-104.832198	Arapahoe County
269123	Fee-for-Service	1164984381	1164984381	1	1	HAYWARD HEALTH CENTER LLC	11/24/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	718 BARTLETT AVE	None	HAYWARD	CA	94541	3698	01	06001	37.66946085	-122.1181444	Alameda County
269125	Fee-for-Service	1265509723	1265509723	1	1	HUYNH, CHAU MINH MD	11/25/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	42298	41	Internal Medicine	0	In state provider	None	1865 ALUM ROCK AVE	STE B	SAN JOSE	CA	95116	1396	43	06085	37.35430746	-121.8524581	Santa Clara County
269127	Fee-for-Service	1023196839	1023196839	1	1	HARNOOR, ANJANA V MD	3/16/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	80107	67	Endocrinology	0	In state provider	None	3553 WHIPPLE ROAD	None	UNION CITY	CA	94587	1507	01	06001	37.60573981	-122.0835989	Alameda County
269161	Fee-for-Service	1740397074	1740397074	1	1	HUA, JENNY MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	80515	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
269181	Fee-for-Service	1992967590	1992967590	1	1	HAN, CHARLES M DPM	4/16/2015	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	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
269186	Fee-for-Service	1164610630	1164610630	1	1	HILL-STEGALL, KISHA	2/5/2007	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	38239 MULLIGAN DR	None	BEAUMONT	CA	92223	0937	33	06065	33.95030429	-117.0115968	Riverside County
269207	Fee-for-Service	1356401442	1356401442	1	1	HART, MARQUIS E MD	10/31/1989	208600000X	NA	General Surgery	026	PHYSICIANS	42694	02	General Surgery	0	In state provider	None	225 DICKINSON ST	None	SAN DIEGO	CA	92103	1910	37	06073	32.75514083	-117.1655414	San Diego County
269215	Fee-for-Service	1841558004	1841558004	1	1	HASHEMI SANAZ MD	8/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	122925	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
269234	Fee-for-Service	1528153244	1528153244	1	2	HUMAN TOUCH HOME HEALTH CARE	9/18/2013	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY INC	1122 WEST AVE L12	SUITE 103	LANCASTER	CA	93534	7051	19	06037	34.64937595	-118.1509885	Los Angeles County
269253	Fee-for-Service	1053828590	1053828590	1	1	HWANG, JIMIN LAC	5/24/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	22481 EL TORO RD	STE D	LAKE FOREST	CA	92630	5052	30	06059	33.63542935	-117.6822042	Orange County
269270	Fee-for-Service	1629166673	1629166673	1	1	HARDIN, STEVEN B MD	8/31/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	58481	78	Neoplastic Diseases/Oncology	0	In state provider	None	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
269274	Fee-for-Service	1356467112	1356467112	1	1	HOUSHAN, WESAM G MD	8/13/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	107848	41	Internal Medicine	0	In state provider	None	16162 BEACH BLVD	STE 100	HUNTINGTON BEACH	CA	92647	3807	30	06059	33.728148	-117.9891345	Orange County
269335	Fee-for-Service	1093161192	1093161192	1	1	HENRY ARTHUR DUARTI	5/10/2016	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	6935 LAGOON COURT	None	JURUPA VALLEY	CA	91752	2783	33	06065	33.96217195	-117.5425376	Riverside County
269362	Fee-for-Service	1659327013	1659327013	1	1	HCA HEALTHCARE LLC MED	7/22/2001	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	MEDICAL CENTER OF AURORA	1501 S POTOMAC ST	None	AURORA	CO	80012	5411	00	None	39.689343	-104.832198	Arapahoe County
269374	Fee-for-Service	1194504233	1194504233	1	1	HARRIS, ALISE JENE	11/1/2023	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	14858 FLATBUSH AVE	None	NORWALK	CA	90650	5318	19	06037	33.894954	-118.106503	Los Angeles County
269423	Fee-for-Service	1316473200	1316473200	1	1	HANDCOX, JORDAN E MD	4/13/2023	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	185320	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
269443	Fee-for-Service	1831333566	1831333566	1	1	HARSH PATEL	2/19/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10501 E 91ST ST SOUTH	None	TULSA	OK	74133	5790	00	None	36.0319983	-95.85685015	Tulsa County
269466	Fee-for-Service	1164610630	1164610630	1	1	HILL-STEGALL, KISHA	2/5/2007	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	38239 MULLIGAN DR	None	BEAUMONT	CA	92223	0937	33	06065	33.95030429	-117.0115968	Riverside County
269496	Fee-for-Service	1073932224	1073932224	2	1	HARRIS, BRITTNEY L MD	8/16/2023	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	174966	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
269497	Fee-for-Service	1366019010	1366019010	1	1	HEANEY, SAMUEL D PT	7/9/2021	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
269506	Fee-for-Service	1780655621	1780655621	1	1	HANSEN, JOHN CARL	4/30/1989	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	68382	40	Pediatrics	0	In state provider	None	3939 IOWA ST	None	SAN DIEGO	CA	92104	3008	37	06073	32.749398	-117.1264015	San Diego County
269515	Fee-for-Service	1548523046	1548523046	1	1	HSIAO, VICTORIA F DO	7/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12289	08	Family Practice	0	In state provider	None	9089 BASELINE ROAD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
269567	Fee-for-Service	1164616306	1164616306	1	1	HOU, ANTHONY C MD	8/1/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90502	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
269577	Fee-for-Service	1831258409	1831258409	1	1	HURLEY, MARY E MD	12/2/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	74202	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
269582	Fee-for-Service	1972180073	1972180073	1	1	HANAFY, OMAR F MD	8/5/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	None	40	Pediatrics	0	In state provider	None	2335 E KASHIAN LANE	SUITE 280	FRESNO	CA	93701	2211	10	06019	36.74333844	-119.7831874	Fresno County
269595	Fee-for-Service	1932401684	1932401684	1	1	HUBERMAN CARBONE, SARA B MD	5/7/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	114540	None	None	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
269602	Fee-for-Service	1710186085	1710186085	1	1	HERZLINGER, DAVID C MD	1/8/1975	No Taxonomy Provided	NA	None	026	PHYSICIANS	26306	07	Dermatology	0	In state provider	A PROFESSIONAL CORP	1441 AVOCADO AVE	STE 409	NEWPORT BEACH	CA	92660	7705	30	06059	33.61338536	-117.8693961	Orange County
269607	Fee-for-Service	1710676291	1710676291	1	1	HILL, CARLEE LCSW	2/6/2024	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
269613	Fee-for-Service	1093161192	1093161192	1	1	HENRY ARTHUR DUARTI	5/23/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	6935 LAGOON COURT	None	JURUPA VALLEY	CA	91752	2783	33	06065	33.96217195	-117.5425376	Riverside County
269621	Fee-for-Service	1922287507	1922287507	1	1	HONG, RAYMOND	7/11/2014	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	9007 TELEGRAPH RD	None	PICO RIVERA	CA	90660	5422	19	06037	33.96035999	-118.1091362	Los Angeles County
269642	Fee-for-Service	1639505175	1639505175	1	1	HILL, CYNTHIA A MD	2/21/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	127386	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
269653	Fee-for-Service	1194504233	1194504233	1	1	HARRIS, ALISE JENE	11/1/2023	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	14858 FLATBUSH AVE	None	NORWALK	CA	90650	5318	19	06037	33.894954	-118.106503	Los Angeles County
269659	Fee-for-Service	1245284280	1245284280	1	1	HORST, DENNIS 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	401 S BALLENGER HWY	None	FLINT	MI	48532	3638	00	None	43.01432039	-83.73359605	Genesee County
269688	Fee-for-Service	1205847126	1205847126	1	1	HANGER PROSTHETICS AND	1/11/2007	No Taxonomy Provided	NA	None	021	ORTHOTISTS	-	-	NOT APPLICABLE	0	In state provider	ORTHOTICS WEST INC	1073 ROSS AVE	STE A	EL CENTRO	CA	92243	4371	13	06025	32.78146253	-115.5644505	Imperial County
269718	Fee-for-Service	1225238835	1225238835	1	1	HUBER, RYAN T MD	5/18/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147548	30	Radiology	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
269749	Fee-for-Service	1518034537	1518034537	1	1	HUANG, IDA E MD	11/10/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83684	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
269758	Fee-for-Service	1205099918	1205099918	1	1	HUBBELL, FRANK W LCSW	7/12/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1765 SHAFFER RD	None	ATWATER	CA	95341	6250	24	06047	37.34916194	-120.5959871	Merced County
269799	Fee-for-Service	1548523046	1548523046	1	1	HSIAO, VICTORIA F DO	7/31/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	12289	01	General Practice	0	In state provider	None	9089 BASELINE ROAD	STE 100	RANCHO CUCAMONGA	CA	91730	1295	36	06071	34.12151248	-117.6074505	San Bernardino County
269802	Fee-for-Service	1598795247	1598795247	1	1	HELMY, IBRAHIM MD INC	1/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46891	66	Emergency Medicine (Urgent Care)	0	In state provider	None	575 E HARDY ST	STE 305	INGLEWOOD	CA	90301	4083	19	06037	33.94909392	-118.3477665	Los Angeles County
269821	Fee-for-Service	1609954593	1609954593	1	1	HAO, HUIWEN MD	1/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78444	36	Psychiatry	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
269855	Fee-for-Service	1902083827	1902083827	1	1	HARDER, SHERI L MD	4/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76123	30	Radiology	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
269865	Fee-for-Service	1629527429	1629527429	1	1	HANFORDIDENCE OPCO LLC	1/1/2017	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1007 W LACEY BLVD	None	HANFORD	CA	93230	4331	16	06031	36.3279745	-119.659923	Kings County
269873	Fee-for-Service	1831183805	1831183805	1	1	HERRON, STEVEN J MD	8/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	55433	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1111 LAS TABLAS RD	STE N	TEMPLETON	CA	93465	9732	40	06079	35.55437154	-120.7191015	San Luis Obispo County
269878	Fee-for-Service	1851349195	1851349195	1	1	HUDSON, HENRY L MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	76091	41	Internal Medicine	0	In state provider	None	7695 CARDINAL COURT	SUITE 100	SAN DIEGO	CA	92123	3357	37	06073	32.79146985	-117.1578472	San Diego County
269921	Fee-for-Service	1275921223	1275921223	1	1	HOANG, VON NP	9/21/2022	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
269936	Fee-for-Service	1740611912	1740611912	1	1	HANSON, HEATHER E	7/22/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	941 SPRING ST STE 5	None	PLACERVILLE	CA	95667	4546	09	06017	38.73242101	-120.8011963	El Dorado County
269947	Fee-for-Service	1952564114	1952564114	1	2	HUANG, WENDY W MD	6/23/2022	207WX0110X	NA	Ophthalmology	026	PHYSICIANS	121436	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
269952	Fee-for-Service	1619037496	1619037496	1	1	HUDDELSTON, JAMES I MD	9/7/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	90915	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
270035	Fee-for-Service	1598709313	1598709313	1	1	HIRABAYASHI, DEAN R MD	1/1/1979	No Taxonomy Provided	NA	None	026	PHYSICIANS	29742	18	Ophthalmology	0	In state provider	None	291 GEARY ST	STE 700	SAN FRANCISCO	CA	94102	1810	38	06075	37.78736144	-122.40797	San Francisco County
270062	Fee-for-Service	1629241260	1629241260	1	1	HANNA, STEPHANIE C MD	10/10/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	110191	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
270080	Fee-for-Service	1598795247	1598795247	1	1	HELMY, IBRAHIM MD INC	1/1/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	46891	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	575 E HARDY ST	STE 305	INGLEWOOD	CA	90301	4083	19	06037	33.94909392	-118.3477665	Los Angeles County
270092	Fee-for-Service	1124130620	1124130620	2	4	HARMONY HEALTH MEDICAL CLINI	11/5/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	MOBILE	1976 N BEALE ROAD	None	MARYSVILLE	CA	95901	6921	58	06115	39.12791353	-121.5432514	Yuba County
270105	Fee-for-Service	1427130319	1427130319	1	1	HUYNH, VU T DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	93 DEVINE STREET	#A	SAN JOSE	CA	95110	2484	43	06085	37.33926698	-121.8945415	Santa Clara County
270111	Fee-for-Service	1194083105	1194083105	1	1	HOSSEINI, MERSEDEH B MD	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	137503	13	Neurology (M.D. only)	0	In state provider	None	300 MEDICAL PLAZA	STE B200	LOS ANGELES	CA	90095	8346	19	06037	34.06473399	-118.445865	Los Angeles County
270255	Fee-for-Service	1801307368	1801307368	1	3	HEALTH SERVICE ALLIANCE	7/1/2021	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	9804 FOOTHILL BLVD	None	RANCHO CUCAMONGA	CA	91730	3616	36	06071	34.10669649	-117.5911245	San Bernardino County
270291	Fee-for-Service	1487133997	1487133997	1	1	HUANG, JOANNE AU	3/25/2020	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
270306	Fee-for-Service	1497773287	1497773287	1	1	HOUSHAN, IYAD G MD	8/14/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	84297	41	Internal Medicine	0	In state provider	None	3401 W SUNFLOWER AVE	SUITE 250	SANTA ANA	CA	92704	6948	30	06059	33.69575566	-117.9144503	Orange County
270310	Fee-for-Service	1548313067	1548313067	1	1	HO, LILY L.M.	12/1/1995	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	855 STOCKTON ST	STE B	SAN FRANCISCO	CA	94108	2175	38	06075	37.79367743	-122.4078132	San Francisco County
270366	Fee-for-Service	1124130620	1124130620	2	4	HARMONY HEALTH MEDICAL CLINI	11/5/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	MOBILE	1976 N BEALE ROAD	None	MARYSVILLE	CA	95901	6921	58	06115	39.12791353	-121.5432514	Yuba County
270498	Fee-for-Service	1801989371	1801989371	1	1	HERZBERG, LAURA J MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76085	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
270530	Fee-for-Service	1447343413	1447343413	1	1	HENDEL, JEFFREY L MD	7/1/2000	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	57286	None	None	0	In state provider	GY	1300 N VERMONT AVENUE	SUITE 505	LOS ANGELES	CA	90027	9005	19	06037	34.0956033	-118.2916918	Los Angeles County
270536	Fee-for-Service	1801307368	1801307368	1	3	HEALTH SERVICE ALLIANCE	7/1/2021	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	9804 FOOTHILL BLVD	None	RANCHO CUCAMONGA	CA	91730	3616	36	06071	34.10669649	-117.5911245	San Bernardino County
270567	Fee-for-Service	1871033639	1871033639	1	1	HILL, KARLA L CNM	10/16/2017	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
270575	Fee-for-Service	1962883025	1962883025	1	1	HOU, KIRK MD	3/6/2019	No Taxonomy Provided	NA	None	026	PHYSICIANS	143728	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA	STE 1-340	LOS ANGELES	CA	90095	7001	19	06037	34.06482757	-118.4443441	Los Angeles County
270604	Fee-for-Service	1548483662	1548483662	1	1	HEKMAT, KIUMARS R MD	12/26/1996	174400000X	NA	Other	026	PHYSICIANS	37811	34	Urology and Urological Surgery	0	In state provider	None	2801 K ST	STE 220	SACRAMENTO	CA	95816	5118	34	06067	38.572947	-121.46904	Sacramento County
270610	Fee-for-Service	1285296525	1285296525	1	1	HELPLINE YOUTH COUNSELING	6/21/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	INC	14181 TELEGRAPH ROAD	None	WHITTIER	CA	90604	2832	19	06037	33.92892082	-118.0299538	Los Angeles County
270614	Fee-for-Service	1770841140	1770841140	1	1	HUANG, MARIA Z MD	8/10/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	137270	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
270666	Fee-for-Service	1003439035	1003439035	1	1	HEART OF ANGEL HOSPICE	10/31/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	& PALLIATIVE INC	405 S SAN GABRIEL BLVD	STE A	SAN GABRIEL	CA	91776	1968	19	06037	34.097607	-118.090978	Los Angeles County
270686	Fee-for-Service	1851587067	1851587067	1	1	HANDMAN, DAVID E MD	3/4/2008	2086S0102X	NA	General Surgery	026	PHYSICIANS	101444	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
270688	Fee-for-Service	1831517390	1831517390	1	1	HUSTON, KRISTOPHER A MD	8/10/2020	207R00000X	NA	Other	026	PHYSICIANS	140669	41	Internal Medicine	0	In state provider	None	3501 S HARBOR BLVD	None	SANTA ANA	CA	92704	6919	30	06059	33.69981147	-117.9194272	Orange County
270694	Fee-for-Service	1124642889	1124642889	1	1	HAILE, DAWIT MD	12/20/2024	208M00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
270698	Fee-for-Service	1760580971	1760580971	1	1	HAWKINS, RANDY W MD	9/30/1986	207R00000X	NA	Other	026	PHYSICIANS	49354	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	644 E REGENT ST	STE 200	INGLEWOOD	CA	90301	1444	19	06037	33.96448447	-118.345059	Los Angeles County
270709	Fee-for-Service	1225449796	1225449796	1	1	HITT, BRIAN D MD	8/24/2021	390200000X	NA	Other	026	PHYSICIANS	173018	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
270752	Fee-for-Service	1710652243	1710652243	1	1	HEALTH ALLIES CLINIC INC	10/25/2021	2086S0127X	NA	General Surgery	022	PHYSICIANS GROUP	-	89	Surgery-Traumatic	0	In state provider	None	5395 RUFFIN RD	STE 102	SAN DIEGO	CA	92123	1338	37	06073	32.832387	-117.1266225	San Diego County
270758	Fee-for-Service	1386098804	1386098804	1	1	HUSAINI, SYED S MD	8/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	171716	None	None	0	In state provider	None	2825 J ST	None	SACRAMENTO	CA	95816	4300	34	06067	38.573757	-121.468248	Sacramento County
270768	Fee-for-Service	1942398847	1942398847	1	1	HENDERSON, LORRE T MD	12/11/2002	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	41977	04	Otology, Laryngology, Rhinology	0	In state provider	None	2580 PARK AVE	STE 4	CONCORD	CA	94520	1903	07	06013	37.98453787	-122.0338976	Contra Costa County
270771	Fee-for-Service	1528066560	1528066560	1	2	HELLER, ANDREAS E MD	8/5/2013	207R00000X	NA	Other	026	PHYSICIANS	84414	41	Internal Medicine	0	In state provider	None	6327 N FRESNO ST	STE 104	FRESNO	CA	93710	5236	10	06019	36.82875536	-119.781417	Fresno County
270773	Fee-for-Service	1952540213	1952540213	1	1	HOYT, LESLIE A PHD	8/11/2016	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	13209	-	NOT APPLICABLE	0	In state provider	None	10535 RD 35	None	MADERA	CA	93636	8487	20	06039	36.90376264	-119.9101802	Madera County
270790	Fee-for-Service	1184783508	1184783508	1	1	HECHT, MATTHEW L MD	1/9/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	64034	18	Ophthalmology	0	In state provider	None	4223 E REDONDO BEACH	None	LAWNDALE	CA	90260	3341	19	06037	33.8754741	-118.3496149	Los Angeles County
270792	Fee-for-Service	1861710840	1861710840	1	1	HASHMI, JAVAD T MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	131603	66	Emergency Medicine (Urgent Care)	0	In state provider	None	13855 EAST 14TH STREET	None	SAN LEANDRO	CA	94578	2611	01	06001	37.712385	-122.143428	Alameda County
270836	Fee-for-Service	1851669386	1851669386	1	1	HORVATH, HELEN R NP	5/30/2017	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
270903	Fee-for-Service	1811353469	1811353469	1	1	HIGHLAND COMMUNITY PHARMACY	3/18/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	INC	1689 E HIGHLAND AVE	STE B	SAN BERNARDINO	CA	92404	4615	36	06071	34.1357997	-117.2500093	San Bernardino County
270914	Fee-for-Service	1861423600	1861423600	1	1	HALL, JOHN L MD	12/6/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	50025	41	Internal Medicine	0	In state provider	None	CASTRO & DUBOCE STREETS	LEVEL A, STE 160 & 175	SAN FRANCISCO	CA	94114	0000	38	06075	37.769049	-122.43582	San Francisco County
270939	Fee-for-Service	1558923946	1558923946	1	1	HART, SARAH LCSW	2/18/2025	390200000X	NA	Other	070	LICENSED CLINICAL SOCIAL WORKER 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
270942	Fee-for-Service	1003439035	1003439035	1	1	HEART OF ANGEL HOSPICE	10/31/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	& PALLIATIVE INC	405 S SAN GABRIEL BLVD	STE A	SAN GABRIEL	CA	91776	1968	19	06037	34.097607	-118.090978	Los Angeles County
270990	Fee-for-Service	1700908985	1700908985	1	1	HOVIS, KRISTIN	5/21/2023	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	2262 N. 1ST ST	None	SAN JOSE	CA	95131	2022	43	06085	37.37772646	-121.921374	Santa Clara County
270994	Fee-for-Service	1942388012	1942388012	1	1	HEGG, MARGARET E MD	1/1/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	26055	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
271048	Fee-for-Service	1861095614	1861095614	1	1	HONEST HOME CARE INC	6/28/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4119 W BURBANK BLVD	STE 163	BURBANK	CA	91505	2122	19	06037	34.1730175	-118.3553514	Los Angeles County
271064	Fee-for-Service	1225116825	1225116825	1	1	HENG, YAO Y MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64935	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
271067	Fee-for-Service	1467611467	1467611467	2	1	HEALTH DIAGNOSTICS OF	2/7/2017	No Taxonomy Provided	NA	None	084	INDEPENDENT DIAGNOSTIC TESTING FACILITY XOVER PROV ONLY	-	-	NOT APPLICABLE	0	In state provider	CALIFORNIA LLC	455 HICKEY BOULEVARD	SUITE 200	DALY CITY	CA	94015	2630	41	06081	37.66383747	-122.4671404	San Mateo County
271078	Fee-for-Service	1720585847	1720585847	1	1	HUYNH, ALAN D MD	4/18/2023	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	184580	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
271102	Fee-for-Service	1164985156	1164985156	1	1	HARRIS, LAUREN MD	11/27/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	191596	None	None	0	In state provider	None	1515 NEWELL	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
271149	Fee-for-Service	1134200629	1134200629	1	1	HAGELE, JOHN E MD	3/31/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	81026	18	Ophthalmology	0	In state provider	None	409 JOERSCHKE DR	None	GRASS VALLEY	CA	95945	5288	29	06057	39.22979447	-121.0431019	Nevada County
271234	Fee-for-Service	1356438170	1356438170	1	1	HAYNES, ALVIN S JR MD	8/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	55106	41	Internal Medicine	0	In state provider	None	450 EAST ROMIE LANE	None	SALINAS	CA	93901	4029	27	06053	36.65983988	-121.6458041	Monterey County
271241	Fee-for-Service	1801232095	1801232095	1	1	HOFF, COLIN C MD	8/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132866	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
271244	Fee-for-Service	1275692907	1275692907	1	1	HOM, JILL C 0D	12/24/2013	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	9333 IMPERIAL HWY	None	DOWNEY	CA	90242	2812	19	06037	33.918975	-118.1291985	Los Angeles County
271306	Fee-for-Service	1760740971	1760740971	1	1	HAN, MICHELLE J MD	5/20/2020	207L00000X	NA	Other	026	PHYSICIANS	129825	05	Anesthesiology	0	In state provider	None	1100 W STEWART DR	None	ORANGE	CA	92868	3849	30	06059	33.78236558	-117.8648414	Orange County
271316	Fee-for-Service	1205199411	1205199411	1	1	HUTCHASON, CELESTE G LCSW	4/18/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	82229	-	NOT APPLICABLE	0	In state provider	None	5850 S MAIN ST	RM 1078,2010, 2017	LOS ANGELES	CA	90003	1215	19	06037	33.988536	-118.2739135	Los Angeles County
271341	Fee-for-Service	1225116825	1225116825	1	1	HENG, YAO Y MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64935	10	Gastroenterology (M.D. only)	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
271349	Fee-for-Service	1679691497	1679691497	1	1	HARGADON, ANNEMARIE P MD	3/18/2019	207R00000X	NA	Other	026	PHYSICIANS	71986	70	Clinic (mixed specialty)	0	In state provider	None	4860 Y ST	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
271359	Fee-for-Service	1700356813	1700356813	1	1	HEALTH AND HOPE HOME HEALTH	2/5/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	9837 FOLSOM BLVD	STE D	SACRAMENTO	CA	95827	1356	34	06067	38.575764	-121.330647	Sacramento County
271394	Fee-for-Service	1144753039	1144753039	1	1	HUANG, ANDREW DO	2/5/2022	207P00000X	NA	Other	026	PHYSICIANS	18116	None	None	0	In state provider	None	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	36	06071	34.03717616	-117.2046115	San Bernardino County
271409	Fee-for-Service	1881081065	1881081065	1	1	HANS, DANIEL	10/8/2018	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	15095	08	Family Practice	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
271577	Fee-for-Service	1104239144	1104239144	1	1	HOVASAPIAN, NANAR OD	1/17/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	43112 N 15TH WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
271580	Fee-for-Service	1275142960	1275142960	1	1	HOWER, MARIA V	6/27/2024	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
271587	Fee-for-Service	1700128519	1700128519	1	1	HARLESS, LUCAS D MD	5/2/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	132603	04	Otology, Laryngology, Rhinology	0	In state provider	None	3600 BROADWAY	None	OAKLAND	CA	94611	0000	01	06001	37.8237837	-122.2590026	Alameda County
271663	Fee-for-Service	1386234243	1386234243	1	1	HEALTH MAX HOME HEALTH INC	7/1/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1903 N GLENOAKS BLVD	STE C	BURBANK	CA	91504	3826	19	06037	34.19634567	-118.3246279	Los Angeles County
271686	Fee-for-Service	1437439742	1437439742	1	1	HELEN HUANG O.D. INC	12/28/2018	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	17251 FOOTHILL BLVD	None	FONTANA	CA	92335	9044	36	06071	34.10656453	-117.428166	San Bernardino County
271715	Fee-for-Service	1194738906	1194738906	1	1	HELLINGS, CAROLINE MD	6/30/1988	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	65025	08	Family Practice	0	In state provider	None	500 DOYLE PARK DR	STE 200	SANTA ROSA	CA	95405	4559	49	06097	38.44332	-122.6985255	Sonoma County
271815	Fee-for-Service	1205916368	1205916368	1	1	HERMAN, JUNE M MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	74424	42	Nuclear Medicine	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
271848	Fee-for-Service	1700129541	1700129541	1	1	HUNG, KIN W MD	7/24/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	134570	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
271860	Fee-for-Service	1861410029	1861410029	2	1	HEDAYATI-RAD, AMIR MD	11/9/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	60239	41	Internal Medicine	0	In state provider	None	435 ARDEN AVENUE	SUITE 330	GLENDALE	CA	91203	4016	19	06037	34.15848148	-118.2628845	Los Angeles County
271896	Fee-for-Service	1346433687	1346433687	1	1	HASHEM, SHAMEL M MD	3/2/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	102087	01	General Practice	0	In state provider	None	975 SERENO DRIVE	None	VALLEJO	CA	94589	2441	48	06095	38.12828446	-122.24821	Solano County
271907	Fee-for-Service	1245630045	1245630045	1	1	HENDERSON, JENNIFER L LAC	5/3/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	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
271948	Fee-for-Service	1821893322	1821893322	1	1	HALE, WYNTER S OT	2/19/2025	225X00000X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	8282 WHITE OAK AVE	107, 108, AND 111	RANCHO CUCAMONGA	CA	91730	7680	36	06071	34.10361339	-117.5644472	San Bernardino County
271954	Fee-for-Service	1316144017	1316144017	1	1	HILLTOP MEDICAL TRANSPORT	6/1/2007	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	INC	315 CALLE LA QUINTA	None	CHULA VISTA	CA	91914	4423	37	06073	32.671016	-116.971576	San Diego County
272024	Fee-for-Service	1952877011	1952877011	1	1	HOWE, LISA C LCSW	5/12/2020	1041C0700X	NA	Mental Health Outpatient Services	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
272029	Fee-for-Service	1851847214	1851847214	1	1	HOGAN, JESSICA L PSYD	7/19/2021	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	8300 UTICA AVE	STE 245	RANCHO CUCAMONGA	CA	91730	3852	36	06071	34.10227306	-117.5715643	San Bernardino County
272039	Fee-for-Service	1891181103	1891181103	1	1	HALL, MARK E MD	9/21/2020	207RR0500X	NA	Other	026	PHYSICIANS	167921	41	Internal Medicine	0	In state provider	None	1250 LA VENTA DRIVE	100, 101A, 105, 207, 211	WESTLAKE VILLAGE	CA	91361	3774	19	06037	34.14827603	-118.8227637	Ventura County
272041	Fee-for-Service	1932156221	1932156221	1	1	HER, MICHAEL J H MD	6/8/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	55223	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
272084	Fee-for-Service	1205916368	1205916368	1	1	HERMAN, JUNE M MD	7/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	74424	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
272253	Fee-for-Service	1154494565	1154494565	1	1	HALL, ANDREW MD	12/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	62891	41	Internal Medicine	0	In state provider	None	2562 STATE ST	STE D	CARLSBAD	CA	92008	1663	37	06073	33.1643004	-117.3525361	San Diego County
272254	Fee-for-Service	1750919189	1750919189	1	1	HIRJI, SITARA MD	6/26/2024	207W00000X	NA	Ophthalmology	026	PHYSICIANS	None	18	Ophthalmology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
272261	Fee-for-Service	1881258390	1881258390	1	1	HOSPICE OF PEACE INC	2/16/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2461 E ORANGETHORPE AVE	STE 209	FULLERTON	CA	92831	5302	30	06059	33.85968746	-117.886599	Orange County
272270	Fee-for-Service	1508953563	1508953563	1	1	HEIFETS, RAISA MD	11/1/1983	208D00000X	NA	Adult Primary Care	026	PHYSICIANS	40429	01	General Practice	0	In state provider	YORK MEDICAL GROUP	6027 YORK BLVD	None	LOS ANGELES	CA	90042	3503	19	06037	34.11793708	-118.188309	Los Angeles County
272282	Fee-for-Service	1316586258	1316586258	1	1	HUNTER, JACLYN S LMFT	2/15/2021	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
272297	Fee-for-Service	1760760623	1760760623	1	1	HOJAT-KHOSHNIYAT, MAHSA LCS	6/13/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	12433 LAMBERT RD	None	WHITTIER	CA	90606	2700	19	06037	33.96634621	-118.0474099	Los Angeles County
272312	Fee-for-Service	1891181103	1891181103	1	1	HALL, MARK E MD	9/21/2020	207RR0500X	NA	Other	026	PHYSICIANS	167921	83	Rheumatology	0	In state provider	None	1250 LA VENTA DRIVE	100, 101A, 105, 207, 211	WESTLAKE VILLAGE	CA	91361	3774	19	06037	34.14827603	-118.8227637	Ventura County
272339	Fee-for-Service	1255413332	1255413332	1	1	HIMELMAN, RONALD B	3/31/1990	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54463	None	None	0	In state provider	None	555 E TACHEVAH DR	# 202	PALM SPRINGS	CA	92262	5750	33	06065	33.83753681	-116.5424435	Riverside County
272366	Fee-for-Service	1073958245	1073958245	1	1	HUMPHREY, TYLER M MD	4/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	136177	None	None	0	In state provider	None	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	56	06111	34.27623479	-119.2520218	Ventura County
272374	Fee-for-Service	1649468661	1649468661	1	1	HAYNES, CLAUDIA M MD	10/3/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	97008	22	Pathology (M.D. only)	0	In state provider	None	700 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	43	06085	37.33578	-121.999329	Santa Clara County
272400	Fee-for-Service	1992149843	1992149843	1	1	HILAL, TARIQ I DO	3/7/2018	2083X0100X	NA	Adult Primary Care	026	PHYSICIANS	15622	39	Preventive (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
272415	Fee-for-Service	1134258957	1134258957	1	1	HAVRANEK, JOYCE M MD	10/27/2021	207R00000X	NA	Other	026	PHYSICIANS	95060	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
272432	Fee-for-Service	1972268035	1972268035	1	1	HARMAN, JACY E PT	11/11/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	30141 ANTELOPE RD.	STE A	MENIFEE	CA	92584	7001	33	06065	33.68176015	-117.1680307	Riverside County
272452	Fee-for-Service	1932538014	1932538014	1	1	HENDRICKS, KATRINA E LMFT	5/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
272466	Fee-for-Service	1346720851	1346720851	1	1	HEBBLETHWAITE, ANDREW A RCP	8/27/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
272478	Fee-for-Service	1023049756	1023049756	1	1	HAWES, KRISTA V	10/12/2008	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	3065 PORTER ST	STE 105	SOQUEL	CA	95073	2231	44	06087	36.989559	-121.957318	Santa Cruz County
272533	Fee-for-Service	1881258390	1881258390	1	1	HOSPICE OF PEACE INC	2/16/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2461 E ORANGETHORPE AVE	STE 209	FULLERTON	CA	92831	5302	30	06059	33.85968746	-117.886599	Orange County
272534	Fee-for-Service	1104016336	1104016336	1	1	HIBA ABDEL AZIZ	7/20/2020	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	16601 N 40TH ST	STE 227	PHOENIX	AZ	85032	3345	00	None	33.637356	-111.995514	Maricopa County
272565	Fee-for-Service	1548447865	1548447865	1	1	HARIHARAN, RADHIKA S MD	8/13/2019	174400000X	NA	Other	026	PHYSICIANS	138247	67	Endocrinology	0	In state provider	None	625 W CITRACADO PKWY	108	ESCONDIDO	CA	92025	6428	37	06073	33.09166731	-117.0784699	San Diego County
272592	Fee-for-Service	1649590969	1649590969	1	1	HOLEMON, SCOTT K MD	11/10/2018	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	138419	None	None	0	In state provider	None	10111 HOLE AVENUE	None	RIVERSIDE	CA	92503	3441	33	06065	33.91431544	-117.4585034	Riverside County
272641	Fee-for-Service	1134125321	1134125321	1	1	HOGGARTH, CURTIS C OD	4/25/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	43839 15TH ST W	None	LANCASTER	CA	92354	4756	19	06037	34.678791	-118.156867	Los Angeles County
272647	Fee-for-Service	1285764266	1285764266	1	1	HERD, VALORIE D S PSYD	12/16/2016	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
272659	Fee-for-Service	1033347125	1033347125	1	1	HANRAHAN, DAVID M MD	2/21/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	169060	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
272662	Fee-for-Service	1275621104	1275621104	1	1	HAMMERSTEDT, HEATHER S MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	146668	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
272667	Fee-for-Service	1245851815	1245851815	1	3	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	550 MONTEREY AVE	None	ONTARIO	CA	91764	3318	36	06071	34.069239	-117.642987	San Bernardino County
272671	Fee-for-Service	1043244007	1043244007	1	1	HANNA, NADINE B MD	8/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	68399	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	112 LA CASA VIA	STE 200	WALNUT CREEK	CA	94598	3011	07	06013	37.91229899	-122.0423696	Contra Costa County
272683	Fee-for-Service	1720114010	1720114010	1	1	HOME DIALYSIS THERAPIES	7/13/2005	261QE0700X	NA	Other	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	OF SAN DIEGO INC	2060 OTAY LAKES RD	SUITE 120	CHULA VISTA	CA	91915	1364	37	06073	32.64467094	-116.9735956	San Diego County
272690	Fee-for-Service	1598062705	1598062705	1	1	HARTLEY, MARIA W LCSW	11/7/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	69875	-	NOT APPLICABLE	0	In state provider	None	1303 WEST WALNUT PARKWAY	None	COMPTON	CA	90220	5030	19	06037	33.87724562	-118.2446904	Los Angeles County
272699	Fee-for-Service	1417342106	1417342106	1	1	HEDRICK, JONATHAN	8/12/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	157270	None	None	0	In state provider	None	3100 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3866	31	06061	38.74399612	-121.2349547	Placer County
272720	Fee-for-Service	1598458887	1598458887	1	1	HARIKRISHNA PHARMACY INC	7/31/2023	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1237 & 1243 E FLORIDA AV	None	HEMET	CA	92543	4513	33	06065	33.7475037	-116.9591465	Riverside County
272741	Fee-for-Service	1336122217	1336122217	1	1	HELLER, VIRGINIA R MD	5/25/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	162575	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	2240 MERCURY WAY	None	SANTA ROSA	CA	95407	5413	49	06097	38.421135	-122.752008	Sonoma County
272756	Fee-for-Service	1073612065	1073612065	1	1	HAYES, JIM W MD	1/1/2002	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
272838	Fee-for-Service	1588647861	1588647861	1	1	HOGAN, LAURA A MD	12/10/2019	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	161421	30	Radiology	0	In state provider	None	1150 N INDIAN CANYON DR	None	PALM SPRINGS	CA	92255	4267	33	06065	33.838623	-116.542737	Riverside County
272839	Fee-for-Service	1922043074	1922043074	1	1	HESSLER, JILL L MD	6/8/2010	207YS0123X	NA	ENT/Otolaryngology	026	PHYSICIANS	103879	04	Otology, Laryngology, Rhinology	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
272886	Fee-for-Service	1134296940	1134296940	1	1	HAJIANPOUR, BATOOL MD	3/25/1985	No Taxonomy Provided	NA	None	026	PHYSICIANS	41781	05	Anesthesiology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
272899	Fee-for-Service	1922012780	1922012780	1	1	HAYES,AMY MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2127 E HARMONY RD	STE 125	FORT COLLINS	CO	80528	8052	00	None	40.52313048	-105.036552	Larimer County
272937	Fee-for-Service	1245851815	1245851815	1	3	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	550 MONTEREY AVE	None	ONTARIO	CA	91764	3318	36	06071	34.069239	-117.642987	San Bernardino County
272940	Fee-for-Service	1134642788	1134642788	1	1	HERATSI HOME HEALTH CARE INC	10/6/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	14621 TITUS ST	STE 128	VAN NUYS	CA	91402	4909	19	06037	34.21972652	-118.451799	Los Angeles County
272955	Fee-for-Service	1306111901	1306111901	1	1	HELENIUM HOME HEALTH INC	3/24/2016	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	1590 OAKLAND RD	STE B113	SAN JOSE	CA	95131	2442	43	06085	37.38046042	-121.8952819	Santa Clara County
272956	Fee-for-Service	1760770747	1760770747	1	1	HOAG URGENT CARE-HUNTINGTON	9/13/2012	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	HARBOUR INC	5355 WARNER AVE	STE 102	HUNTINGTON BEACH	CA	92649	6030	30	06059	33.71544849	-118.0362015	Orange County
272957	Fee-for-Service	1063748911	1063748911	1	1	HEATON, CHASE M MD	5/8/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	115084	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
272959	Fee-for-Service	1588980023	1588980023	1	1	HAN, SEUNG G MD	7/18/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	119665	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
272981	Fee-for-Service	1437772233	1437772233	1	1	HAO, CELESTI OD	1/7/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2103 REDWOOD ST	STE 100	VALLEJO	CA	94590	3608	48	06095	38.12221962	-122.2372664	Solano County
272987	Fee-for-Service	1740294834	1740294834	1	1	HSU, JOYCE J MD	4/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74603	40	Pediatrics	0	In state provider	None	3565 DEL AMO BLVD	None	TORRANCE	CA	90503	1637	19	06037	33.84861872	-118.3488958	Los Angeles County
273027	Fee-for-Service	1689808438	1689808438	1	1	HUANG, LYNN L MD	6/16/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	120191	18	Ophthalmology	0	In state provider	None	11370 ANDERSON ST	SUITE 1800	LOMA LINDA	CA	92354	3450	36	06071	34.047153	-117.2611485	San Bernardino County
273031	Fee-for-Service	1154419406	1154419406	1	1	HONER, DENISE A MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	71222	41	Internal Medicine	0	In state provider	INC	5111 GARFIELD ST	STE A	LA MESA	CA	91941	5103	37	06073	32.77192525	-117.0059214	San Diego County
273042	Fee-for-Service	1750919627	1750919627	1	1	HAN, DANIEL DO	11/3/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	20990	None	None	0	In state provider	None	1000 FRANKLIN PARKWAY	None	SAN MATEO	CA	94403	1922	41	06081	37.54350476	-122.2913782	San Mateo County
273052	Fee-for-Service	1689622078	1689622078	1	1	HILL-SAKURAI, LAURA E MD	8/2/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72293	08	Family Practice	0	In state provider	None	350 PARNASSUS AVE	None	SAN FRANCISCO	CA	94117	3608	38	06075	37.76403932	-122.4561371	San Francisco County
273066	Fee-for-Service	1417484569	1417484569	1	1	HAN, NATHAN	5/22/2024	207T00000X	NA	General Surgery	026	PHYSICIANS	None	14	Neurological Surgery	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
273075	Fee-for-Service	1437345964	1437345964	1	1	HANCOCK, GEORGE R MD INC	6/30/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	32642	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	790 W ORANGE AVE	STE C	EL CENTRO	CA	92243	3274	13	06025	32.7888123	-115.5609792	Imperial County
273083	Fee-for-Service	1225450430	1225450430	1	1	HOLLMANN, SARA CRNA	9/13/2017	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
273104	Fee-for-Service	1215133798	1215133798	1	1	HSIAO, JULIA DO	3/4/2025	2084N0400X	NA	Neurology	026	PHYSICIANS	11680	13	Neurology (M.D. only)	0	In state provider	None	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	31	06061	38.74390969	-121.2319271	Placer County
273109	Fee-for-Service	1922043074	1922043074	1	1	HESSLER, JILL L MD	6/8/2010	207YS0123X	NA	ENT/Otolaryngology	026	PHYSICIANS	103879	24	Plastic Surgery	0	In state provider	None	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	43	06085	37.313433	-121.9318385	Santa Clara County
273110	Fee-for-Service	1578866323	1578866323	1	2	HILLTOP RECOVERY SERVICES	1/26/2022	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	14725 CATHOLIC CHURCH RD	None	CLEARLAKE OAKS	CA	95423	9601	17	06033	39.01117309	-122.633198	Lake County
273112	Fee-for-Service	1689723744	1689723744	1	1	HOWLEY, JOAN E MD	10/31/1994	207L00000X	NA	Other	026	PHYSICIANS	75333	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
273154	Fee-for-Service	1801133277	1801133277	1	1	HANSEN, KAREN L LMFT	6/30/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
273223	Fee-for-Service	1871247957	1871247957	1	1	HOME HEALTH OF VENTURA INC	1/8/2024	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	484 E LOS ANGELES AVE	STE 226	MOORPARK	CA	93021	1968	56	06111	34.27891154	-118.8753975	Ventura County
273278	Fee-for-Service	1609228600	1609228600	1	1	HUNTER, CAMILLE MD	5/25/2021	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	154513	None	None	0	In state provider	None	1919 STATE ST	301	SANTA BARBARA	CA	93101	8443	42	06083	34.4306401	-119.7144766	Santa Barbara County
273289	Fee-for-Service	1649526518	1649526518	1	1	HANH M. BUI, MD, APMC	5/19/2020	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	2067 W VISTA WAY	SUITE 225	VISTA	CA	92083	5523	37	06073	33.18505594	-117.285958	San Diego County
273292	Fee-for-Service	1609473735	1609473735	1	1	HUFFMAN, ETHAN G NP	4/2/2024	363LP0808X	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
273307	Fee-for-Service	1972948164	1972948164	1	1	HSUEH, WILLIAM MD	8/28/2019	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	163191	10	Gastroenterology (M.D. only)	0	In state provider	None	938 N CHERRY ST	None	VISALIA	CA	93274	2210	54	06107	36.221211	-119.337643	Tulare County
273318	Fee-for-Service	1952408122	1952408122	1	1	HOWARD, JOHN MD	12/1/1997	207QS0010X	NA	Adult Primary Care	026	PHYSICIANS	60637	41	Internal Medicine	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
273360	Fee-for-Service	1053306688	1053306688	1	1	HAMBLEY, RICHARD M MD	2/8/2015	207ND0101X	NA	Dermatology	026	PHYSICIANS	47873	07	Dermatology	0	In state provider	None	977 PACIFIC ST	None	MONTEREY	CA	93940	4400	27	06053	36.59105417	-121.898995	Monterey County
273380	Fee-for-Service	1851679336	1851679336	1	1	HOGAN, TIFFANY A MD	10/7/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	114750	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
273397	Fee-for-Service	1124285796	1124285796	1	1	HEALTHRIGHT 360	7/20/2016	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2150 N VICTORIA AVE	None	OXNARD	CA	93036	7791	56	06111	34.22559401	-119.2209704	Ventura County
273411	Fee-for-Service	1952732018	1952732018	1	1	HAWORTH, HEATHER L PT	7/16/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	3760 CONVOY STREET	100	SAN DIEGO	CA	92111	3743	37	06073	32.81197521	-117.1531278	San Diego County
273431	Fee-for-Service	1891703229	1891703229	1	1	HAND, HAROLD E MD	12/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	28963	18	Ophthalmology	0	In state provider	None	1801 E MARCH LN	STE C350	STOCKTON	CA	95210	6674	39	06077	38.00315652	-121.2868715	San Joaquin County
273455	Fee-for-Service	1649565417	1649565417	1	1	HOFFMAN, MICAH T MD	9/19/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	123103	None	None	0	In state provider	None	15400 FOOTHILL BLVD	None	SAN LEANDRO	CA	94578	1009	01	06001	37.7069698	-122.1191104	Alameda County
273496	Fee-for-Service	1740584549	1740584549	1	1	HUMBOLDT WOMENS HEALTH INC	3/8/2011	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	39526	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	3798 JANES RD	STE 10	ARCATA	CA	95521	4745	12	06023	40.89649119	-124.0930501	Humboldt County
273519	Fee-for-Service	1922392349	1922392349	1	1	HUDSON, KRISTEN A MD	12/28/2017	2084N0400X	NA	Neurology	026	PHYSICIANS	149147	27	Psychiatry Neurology (D.O. only)	0	In state provider	None	1115 S SUNSET AVE	None	WEST COVINA	CA	91790	3940	19	06037	34.062852	-117.9446658	Los Angeles County
273532	Fee-for-Service	1639523228	1639523228	1	1	HAI, FAIZI MD	8/24/2023	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	159324	None	None	0	In state provider	None	4060 4TH AVE	STE 240	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
273547	Fee-for-Service	1457811697	1457811697	1	1	HULL, JOCELYN V MD	9/1/2022	207R00000X	NA	Other	026	PHYSICIANS	180991	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
273552	Fee-for-Service	1699340125	1699340125	1	1	HOKE, CARLY	10/18/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
273559	Fee-for-Service	1447232764	1447232764	1	1	HALES, ROBERT E MD	3/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	36993	36	Psychiatry	0	In state provider	None	2525 STOCKTON BLVD	STE 2008	SACRAMENTO	CA	95817	2207	34	06067	38.551311	-121.454433	Sacramento County
273562	Fee-for-Service	1043345366	1043345366	1	1	HAUGEN, PERRY A MD	8/3/2000	207W00000X	NA	Ophthalmology	026	PHYSICIANS	85829	18	Ophthalmology	0	In state provider	None	595 STANISLAUS AVE	STE A	ANGELS CAMP	CA	95222	5969	05	06009	38.07602766	-120.5503016	Calaveras County
273613	Fee-for-Service	1912133646	1912133646	1	1	HUBLIKAR, SIDDHARTH R MD	7/2/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	129113	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
273617	Fee-for-Service	1083032544	1083032544	1	1	HOLMER, ARIELA MD	8/7/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	149594	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
273645	Fee-for-Service	1801307368	1801307368	1	2	HEALTH SERVICE ALLIANCE	1/1/2020	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5050 SAN BERNARDINO ST	None	MONTCLAIR	CA	91763	2326	36	06071	34.0776775	-117.694521	San Bernardino County
273651	Fee-for-Service	1235767401	1235767401	1	1	HICKEY, COLLIN DO	7/1/2023	390200000X	NA	Other	026	PHYSICIANS	20855	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
273673	Fee-for-Service	1457541393	1457541393	1	1	HILGENBERG, SARAH L MD	8/4/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	116398	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
273692	Fee-for-Service	1225101090	1225101090	1	1	HUANG TIEN-HO, THERESA	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
273716	Fee-for-Service	1184843039	1184843039	1	1	HERRON, ANGELA LCSW	12/21/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
273741	Fee-for-Service	1023175866	1023175866	1	1	HWANG, JULIE M OD	5/1/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	26415 CARL BOYER DR	None	SANTA CLARITA	CA	91350	5824	19	06037	34.41292326	-118.5035939	Los Angeles County
273750	Fee-for-Service	1588699383	1588699383	1	1	HUNTLEY, DAVID T	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	45718	None	None	0	In state provider	None	3855 VIA NONA MARIE	STE #302	CARMEL	CA	93923	8642	27	06053	36.539028	-121.905982	Monterey County
273774	Fee-for-Service	1598822413	1598822413	1	1	HOPPER, BONNA CRNA	4/6/2005	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
273841	Fee-for-Service	1811122450	1811122450	1	1	HOSSEINI, ASHRAF LMFT	7/31/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2790 SKYPARK DRIVE	STE 205	TORRANCE	CA	90505	5345	19	06037	33.80456075	-118.3357569	Los Angeles County
273845	Fee-for-Service	1487725206	1487725206	1	1	HUI, THOMAS T L MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62576	02	General Surgery	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
273847	Fee-for-Service	1215297031	1215297031	1	1	HOVANESIAN, PAUL NARMAN T PH	1/3/2018	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	760 WESTWOOD PLAZA	None	LOS ANGELES	CA	90095	6968	19	06037	34.07067	-118.4432445	Los Angeles County
273859	Fee-for-Service	1053636985	1053636985	1	1	HU, JINWEI MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124204	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
273868	Fee-for-Service	1619924685	1619924685	1	1	HOFFMAN, ANDREW	7/31/1984	207RE0101X	NA	Endocrinology	026	PHYSICIANS	47300	01	General Practice	0	In state provider	None	300 PASTEUR DR	# A333	PALO ALTO	CA	94304	2203	43	06085	37.43304542	-122.1759654	Santa Clara County
273877	Fee-for-Service	1245427913	1245427913	1	1	HENRIQUEZ, KATYA X LMFT	5/6/2020	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
273882	Fee-for-Service	1144385386	1144385386	1	1	HORST, KATHLEEN C MD	10/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	72961	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
273893	Fee-for-Service	1326087065	1326087065	1	1	HOCKETT, PATRICIA K MD	3/14/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	77035	08	Family 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
273900	Fee-for-Service	1902933641	1902933641	1	1	HUSAINI, SAMINA S MD	4/27/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	48967	40	Pediatrics	0	In state provider	None	1000 FREMONT AVE	None	LOS ALTOS	CA	94024	6093	43	06085	37.3523425	-122.086026	Santa Clara County
273913	Fee-for-Service	1801307368	1801307368	1	2	HEALTH SERVICE ALLIANCE	12/23/2019	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	5050 SAN BERNARDINO ST	None	MONTCLAIR	CA	91763	2326	36	06071	34.0776775	-117.694521	San Bernardino County
273927	Fee-for-Service	1801667266	1801667266	1	1	HENDERSON, KELLY RCP	3/1/2024	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
273942	Fee-for-Service	1689094856	1689094856	1	1	HELLER, LISA M	8/17/2017	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	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
273947	Fee-for-Service	1427076272	1427076272	1	1	HOUSHIAR, ALLEN DO	4/26/2011	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	8012	08	Family Practice	0	In state provider	None	56480 HWY 371	STE 120	ANZA	CA	92539	1700	33	06065	33.5551195	-116.6749785	Riverside County
273949	Fee-for-Service	1952335994	1952335994	1	1	HOSPITAL PHYSICIANS MED	10/1/1983	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	70	Clinic (mixed specialty)	0	In state provider	GRP INC	1500 E CHEVY CHASE DR	STE 104	GLENDALE	CA	91206	4106	19	06037	34.15201194	-118.2322051	Los Angeles County
273991	Fee-for-Service	1790797736	1790797736	1	1	HAMID, SYED A	4/1/1998	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	53544	43	Pediatric Allergy	0	In state provider	None	1111 W 4TH ST	None	MADERA	CA	93637	4474	20	06039	36.95563823	-120.0735861	Madera County
273993	Fee-for-Service	1821509555	1821509555	1	1	HARVARD HOME HEALTH LLC	7/1/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	511 E HARVARD ST	STE 6	GLENDALE	CA	91205	1184	19	06037	34.14449793	-118.2495946	Los Angeles County
273996	Fee-for-Service	1548248511	1548248511	1	1	HUYNH, HUNG H MD	5/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	69990	66	Emergency Medicine (Urgent Care)	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
274000	Fee-for-Service	1780188136	1780188136	1	1	HSU, EDMUND D MD	7/30/2021	390200000X	NA	Other	026	PHYSICIANS	173644	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
274014	Fee-for-Service	1902937972	1902937972	1	1	HERRERA, OBDULIA LMFT	12/21/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	44615 10TH ST W	None	LANCASTER	CA	93534	3013	19	06037	34.69401	-118.1480995	Los Angeles County
274017	Fee-for-Service	1205076536	1205076536	1	1	HAZEL HAWKINS MEMORIAL	6/1/2012	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	321 1ST STREET	None	HOLLISTER	CA	95023	3712	35	06069	36.85563094	-121.4025629	San Benito County
274067	Fee-for-Service	1245441856	1245441856	1	1	HENRICH, MELANIE M LMFT	3/15/2019	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	831 ALAMO DRIVE	SUITE 6C	VACAVILLE	CA	95688	5343	48	06095	38.34840279	-121.9987874	Solano County
274082	Fee-for-Service	1891783437	1891783437	1	1	HUANG, RAYMOND I MD	8/10/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	70992	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	2505 SAMARITAN DR	STE 309	SAN JOSE	CA	95124	4011	43	06085	37.25111447	-121.9483395	Santa Clara County
274083	Fee-for-Service	1023002151	1023002151	1	1	HOUSE, MARIA W DO MD	2/5/2019	208C00000X	NA	General Surgery	026	PHYSICIANS	148178	None	None	0	In state provider	None	2800 L STREET	200	SACRAMENTO	CA	95816	5616	34	06067	38.571237	-121.469958	Sacramento County
274110	Fee-for-Service	1487725206	1487725206	1	1	HUI, THOMAS T L MD	10/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	62576	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
274111	Fee-for-Service	1245387166	1245387166	1	1	HONG, DAVID K MD	6/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	79880	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
274124	Fee-for-Service	1053636985	1053636985	1	1	HU, JINWEI MD	7/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124204	04	Otology, Laryngology, Rhinology	0	In state provider	None	9961 SIERRA AVE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
274142	Fee-for-Service	1871883215	1871883215	1	1	HASIBUAN, FRANKY P MD	9/12/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	122762	01	General Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
274148	Fee-for-Service	1508813072	1508813072	1	1	HABRA, HENRY M MD	7/31/1995	207L00000X	NA	Other	026	PHYSICIANS	83681	05	Anesthesiology	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
274160	Fee-for-Service	1750510293	1750510293	1	1	HOTHI, JASPAL S MD	8/16/2021	2080P0201X	NA	Neurology	026	PHYSICIANS	172970	None	None	0	In state provider	None	250 E CAROLINE ST	STE J	SAN BERNARDINO	CA	92408	3758	36	06071	34.0615203	-117.2793274	San Bernardino County
274200	Fee-for-Service	1124274998	1124274998	1	1	HUANG, JEFFREY Y DO	4/15/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	11984	18	Ophthalmology	0	In state provider	None	207 S SANTA ANITA ST	SUITE P 25	SAN GABRIEL	CA	91776	1146	19	06037	34.10072807	-118.1066296	Los Angeles County
274242	Fee-for-Service	1841521242	1841521242	1	1	HAWKINS, JOHNATHON S CRNA	8/31/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1441 CONSTITUTION BLVD	None	SALINAS	CA	93906	3100	27	06053	36.696987	-121.633164	Monterey County
274255	Fee-for-Service	1790797736	1790797736	1	1	HAMID, SYED A	4/1/1998	2080P0206X	NA	Gastroenterology	026	PHYSICIANS	53544	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1111 W 4TH ST	None	MADERA	CA	93637	4474	20	06039	36.95563823	-120.0735861	Madera County
274277	Fee-for-Service	1154882082	1154882082	1	1	HEALTHY COMMUNITY FORUM FOR	10/7/2024	172V00000X	NA	Other	108	COMMUNITY BASED ORGANIZATIONS	-	-	NOT APPLICABLE	0	In state provider	None	2029 H STREET	None	SACRAMENTO	CA	95811	3109	34	06067	38.578797	-121.477878	Sacramento County
274283	Fee-for-Service	1205076536	1205076536	1	1	HAZEL HAWKINS MEMORIAL	6/1/2012	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	HOSPITAL	321 1ST STREET	None	HOLLISTER	CA	95023	3712	35	06069	36.85563094	-121.4025629	San Benito County
274293	Fee-for-Service	1548224736	1548224736	1	1	HOFT, RICHARD H MD	7/19/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	50212	18	Ophthalmology	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
274302	Fee-for-Service	1912969742	1912969742	1	1	HABIB, JILL C OD	9/1/2002	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1360 E HERNDON AVE	STE 401	FRESNO	CA	93720	3326	10	06019	36.83744648	-119.7646425	Fresno County
274313	Fee-for-Service	1194055293	1194055293	1	1	HATCHER, PRINCESS A DPM	3/25/2020	213ES0103X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	22110 ROSCOE BLVD	STE 201	CANOGA PARK	CA	91304	3861	19	06037	34.21957849	-118.6082685	Los Angeles County
274317	Fee-for-Service	1487219523	1487219523	1	1	HO, VICTORIA MD	9/26/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	179248	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
274331	Fee-for-Service	1942548953	1942548953	1	1	HUMAN TOUCH BEHAVIORAL HEALT	3/9/2022	2084P0800X	NA	Psychiatry	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	H INC	1610 EXECUTIVE CT	None	SACRAMENTO	CA	95864	2608	34	06067	38.594628	-121.393557	Sacramento County
274332	Fee-for-Service	1487944658	1487944658	1	1	HAYTON, MICHELLE L	1/30/2018	No Taxonomy Provided	NA	None	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	270 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	43	06085	37.24047903	-121.7998157	Santa Clara County
274363	Fee-for-Service	1326130543	1326130543	1	1	HIRK, JACQUELINE LMFT	4/25/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1400 QUAIL ST	STE 150	NEWPORT BEACH	CA	92660	2759	30	06059	33.66063101	-117.868116	Orange County
274364	Fee-for-Service	1043284771	1043284771	1	1	HO, WINSTON P MD	1/27/2023	208000000X	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
274382	Fee-for-Service	1457531352	1457531352	1	2	HARTFORD & HARTFORD ODS	12/31/1984	No Taxonomy Provided	NA	None	023	GROUP OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	167 MAIN ST	STE D	SOLEDAD	CA	93960	3075	27	06053	36.42762288	-121.3285187	Monterey County
274401	Fee-for-Service	1760626352	1760626352	1	1	HORENSTEIN, MARIA S MD	8/22/2013	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	87618	None	None	0	In state provider	None	1415 ROSS AVENUE	None	EL CENTRO	CA	92243	4398	13	06025	32.78144947	-115.568541	Imperial County
274426	Fee-for-Service	1063435741	1063435741	1	1	HOFFMAN, THOMAS E MD	7/15/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	20623	70	Clinic (mixed specialty)	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
274447	Fee-for-Service	1295794782	1295794782	1	1	HARPER, GODFREY M MD	4/25/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	87646	38	Geriatrics	0	In state provider	None	400 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
274463	Fee-for-Service	1568995694	1568995694	1	1	HACHOLSKI, MARK A MD	2/5/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169591	None	None	0	In state provider	None	525 3RD AVE	None	CHULA VISTA	CA	91910	5696	37	06073	32.63367609	-117.0769202	San Diego County
274474	Fee-for-Service	1992312243	1992312243	1	1	HEALING HANDS HEALTH CARE	3/8/2024	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	1905 E 17TH STREET	STE 312	SANTA ANA	CA	92705	8671	30	06059	33.76000749	-117.8405775	Orange County
274522	Fee-for-Service	1568579878	1568579878	1	1	HILL, RICHARD C JR MD	3/31/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	53358	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
274523	Fee-for-Service	1104244268	1104244268	1	1	HUANG, JAMES MD	11/24/2019	207RS0010X	NA	Other	026	PHYSICIANS	150083	41	Internal Medicine	0	In state provider	None	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
274558	Fee-for-Service	1548224736	1548224736	1	1	HOFT, RICHARD H MD	7/19/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	50212	02	General Surgery	0	In state provider	None	21840 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	19	06037	33.82982744	-118.2991395	Los Angeles County
274561	Fee-for-Service	1154479087	1154479087	1	1	HURWITZ, HOLLY B CNM	8/8/2014	No Taxonomy Provided	NA	None	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	732 N BROADWAY	None	ESCONDIDO	CA	92025	1870	37	06073	33.13001532	-117.0851623	San Diego County
274597	Fee-for-Service	1326099151	1326099151	1	1	HINER, BRADLEY C MD	12/18/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	52261	13	Neurology (M.D. only)	0	In state provider	None	1700 N ROSE AVE	STE 220	OXNARD	CA	93030	7640	56	06111	34.21746	-119.155545	Ventura County
274635	Fee-for-Service	1740431444	1740431444	1	1	HAYES, SANDRA M MD	9/22/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	123250	41	Internal Medicine	0	In state provider	None	9300 CAMPUS POINT DR	None	LA JOLLA	CA	92037	1300	37	06073	32.877999	-117.225891	San Diego County
274648	Fee-for-Service	1588725352	1588725352	1	1	HEBREW HOME FOR THE AGED	9/16/1987	314000000X	NA	Skilled Nursing Facility	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	DISABLED	302 SILVER AVE	None	SAN FRANCISCO	CA	94112	1510	38	06075	37.72851602	-122.4296638	San Francisco County
274672	Fee-for-Service	1780639161	1780639161	1	1	HAND, SAMUEL MD	2/8/2015	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
274692	Fee-for-Service	1063435741	1063435741	1	1	HOFFMAN, THOMAS E MD	7/15/2024	207N00000X	NA	Dermatology	026	PHYSICIANS	20623	07	Dermatology	0	In state provider	None	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	01	06001	37.54866156	-121.9750739	Alameda County
274727	Fee-for-Service	1356438741	1356438741	1	1	HUSAIN, ASGHAR MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	77027	20	Orthopedic Surgery	0	In state provider	None	400 N MOUNTAIN AVE	STE 310	UPLAND	CA	91786	5182	36	06071	34.098489	-117.670074	San Bernardino County
274731	Fee-for-Service	1750390746	1750390746	1	1	HARTMAN, GREGORY D DPM	5/7/2009	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	4000 STOCKDALE HIGHWAY	SUITE C	BAKERSFIELD	CA	93309	2056	15	06029	35.35429352	-119.0531115	Kern County
274738	Fee-for-Service	1992312243	1992312243	1	1	HEALING HANDS HEALTH CARE	3/8/2024	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1905 E 17TH STREET	STE 312	SANTA ANA	CA	92705	8671	30	06059	33.76000749	-117.8405775	Orange County
274784	Fee-for-Service	1861015000	1861015000	1	1	HOSSEINI NAVID, SEYED NASROL	3/10/2024	2084P0800X	NA	Psychiatry	026	PHYSICIANS	182961	None	None	0	In state provider	LAH MD	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	56	06111	34.27771547	-119.2540344	Ventura County
274800	Fee-for-Service	1215475710	1215475710	1	1	HUYNH, KIMBERLY NP	3/19/2024	363LA2200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	5602 UNIVERSITY AVE	None	SAN DIEGO	CA	92105	2308	37	06073	32.7481088	-117.0743149	San Diego County
274835	Fee-for-Service	1023203882	1023203882	1	1	HIGH DESERT WOMENS	9/18/2007	174400000X	NA	Other	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	MEMORIAL MEDICAL CTR APC	2680 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	4708	19	06037	33.97394914	-118.2229166	Los Angeles County
274865	Fee-for-Service	1477174340	1477174340	1	1	HUSSEIN, GHASSAN RCP	9/3/2024	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
274889	Fee-for-Service	1023356706	1023356706	1	1	HAYIM TOVIM 2	6/13/2013	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	None	1061 S FAIRFAX AVE	None	LOS ANGELES	CA	90019	1742	19	06037	34.05640958	-118.3647012	Los Angeles County
274898	Fee-for-Service	1073631545	1073631545	1	1	HANES, BEVERLY LMFT APC	10/4/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6809 INDIANA AVE	STE 140	RIVERSIDE	CA	92506	4221	33	06065	33.94312844	-117.3918196	Riverside County
274951	Fee-for-Service	1023152378	1023152378	1	1	HWANG, IVAN P MD	5/7/1999	207W00000X	NA	Ophthalmology	026	PHYSICIANS	68304	18	Ophthalmology	0	In state provider	None	3747 SUNSET LN	None	ANTIOCH	CA	94509	6101	07	06013	37.98340082	-121.8048051	Contra Costa County
275047	Fee-for-Service	1275703019	1275703019	1	1	HEUR, JUN-MIN M MD	9/19/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	104468	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
275061	Fee-for-Service	1396815130	1396815130	1	1	HALLER, BARBARA L MD	9/25/2019	207ZP0105X	NA	Other	026	PHYSICIANS	85865	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	1001 POTRERO AVE	RM 2M14	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
275073	Fee-for-Service	1508927385	1508927385	1	1	HYUNG, KIM S MD	1/4/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	81497	25	Physical Medicine and Rehabilitation	0	In state provider	None	239 S LA CIENEGA BLVD	STE 200	BEVERLY HILLS	CA	90211	3319	19	06037	34.0639648	-118.3762121	Los Angeles County
275076	Fee-for-Service	1548604960	1548604960	1	1	HASAN, ZAIN DO	8/4/2023	207L00000X	NA	Other	026	PHYSICIANS	21338	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
275087	Fee-for-Service	1710418280	1710418280	1	1	HERRADOR, DANIEL A MD	6/29/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	169976	None	None	0	In state provider	None	8110 LAGUNA BLVD	None	ELK GROVE	CA	95758	7904	34	06067	38.421306	-121.408173	Sacramento County
275097	Fee-for-Service	1023203882	1023203882	1	1	HIGH DESERT WOMENS	9/18/2007	174400000X	NA	Other	022	PHYSICIANS GROUP	-	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	MEMORIAL MEDICAL CTR APC	2680 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	4708	19	06037	33.97394914	-118.2229166	Los Angeles County
275101	Fee-for-Service	1164476750	1164476750	1	1	HEAPS, NATHAN D MD	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
275133	Fee-for-Service	1730167933	1730167933	1	1	HAMID, NADEEM A MD	6/11/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78269	None	None	0	In state provider	None	8700 BEVERLY BLVD	STE 8211	LOS ANGELES	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
275182	Fee-for-Service	1265875629	1265875629	1	1	HILT, GARRETT S CRNA	5/16/2016	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2635 G STREET	None	BAKERSFIELD	CA	93301	2813	15	06029	35.38360448	-119.0223416	Kern County
275198	Fee-for-Service	1750802195	1750802195	1	1	HAN, SUL KI OD	9/17/2019	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	207 S SANTA ANITA ST	SUITE P-25	SAN GABRIEL	CA	91776	1145	19	06037	34.10072807	-118.1066296	Los Angeles County
275212	Fee-for-Service	1023152378	1023152378	1	1	HWANG, IVAN P MD	5/7/1999	207W00000X	NA	Ophthalmology	026	PHYSICIANS	68304	17	Ophthalmology, Otolaryngology, Rhinology (D.O.only)	0	In state provider	None	3747 SUNSET LN	None	ANTIOCH	CA	94509	6101	07	06013	37.98340082	-121.8048051	Contra Costa County
275234	Fee-for-Service	1710280409	1710280409	1	1	HAYNES, RACHEL	1/10/2024	363LP0200X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	7700 MORRO RD	None	ATASCADERO	CA	93422	4435	40	06079	35.47579542	-120.6678702	San Luis Obispo County
275236	Fee-for-Service	1649350836	1649350836	1	1	HOLLIMAN, RENATA G	2/18/2022	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2825 CAPITOL AVENUE	None	SACRAMENTO	CA	95816	6039	34	06067	38.570805	-121.4696385	Sacramento County
275285	Fee-for-Service	1811302284	1811302284	1	1	HALL, CHARLES J DO	5/26/2017	207P00000X	NA	Other	026	PHYSICIANS	15431	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
275324	Fee-for-Service	1982234027	1982234027	1	1	HORNFELD, COURTNEY A NP	12/27/2022	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
275352	Fee-for-Service	1376771469	1376771469	1	1	HOTTINGER, COURTNEY L LMFT	12/27/2022	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
275430	Fee-for-Service	1265895817	1265895817	1	1	HOSOYA, HITOMI MD	3/30/2023	207RH0003X	NA	Oncology	026	PHYSICIANS	163013	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
275440	Fee-for-Service	1891738720	1891738720	1	1	HENRIQUEZ, FIDEL H. MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	10796 PINES BLVD	STE 103	PEMBROKE PNES	FL	33026	3919	00	None	26.00779493	-80.29099709	Broward County
275472	Fee-for-Service	1447287347	1447287347	1	1	HUMBOLDT FAMILY CARE	5/1/2010	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	None	1733 CENTRAL AVE	None	MCKINLEYVILLE	CA	95519	3601	12	06023	40.93684932	-124.1008968	Humboldt County
275517	Fee-for-Service	1750503348	1750503348	2	1	HUMBOLDT SENIOR RESOURCE	4/13/2020	No Taxonomy Provided	NA	None	001	ADULT DAY HEALTH CARE CENTERS	-	-	NOT APPLICABLE	0	In state provider	CENTER/FORTUNA ADHC	3200 NEWBURG ROAD	None	FORTUNA	CA	95540	0000	12	06023	40.59521047	-124.1331741	Humboldt County
275523	Fee-for-Service	1154367704	1154367704	1	1	HERNANDEZ, GERMAN T MD	7/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	70267	41	Internal Medicine	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
275596	Fee-for-Service	1629178884	1629178884	1	1	HUNT, WILLIAM E LMFT	5/7/2018	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	780 ROOSEVELT	STE 126	IRVINE	CA	92620	3660	30	06059	33.69276	-117.7691085	Orange County
275616	Fee-for-Service	1942473749	1942473749	1	1	HALL, RANDON T MD	2/18/2022	2080S0010X	NA	Orthopedic Surgery	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
275622	Fee-for-Service	1720222771	1720222771	1	1	HARTLEY, DEBRA C MD	3/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	08	Family Practice	1	Border provider	None	3000 BRYANT WILLIAMS DR	None	KLAMATH FALLS	OR	97601	1139	00	None	42.25179653	-121.7822714	Klamath County
275651	Fee-for-Service	1578506952	1578506952	1	1	HASHIMOTO, HARVEY J MD	9/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	55355	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
275654	Fee-for-Service	1467888164	1467888164	1	1	HIBBARD, ALLISON N LMFT	2/7/2024	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
275680	Fee-for-Service	1083905194	1083905194	1	1	HANSON, BEVERLY A LMFT	2/11/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	106338	-	NOT APPLICABLE	0	In state provider	None	1420 WILLOW PASS RD	STE 140	CONCORD	CA	94520	5823	07	06013	37.96956948	-122.0507563	Contra Costa County
275691	Fee-for-Service	1942527361	1942527361	1	1	HAMID, ELIZABETH C MD	6/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129503	13	Neurology (M.D. only)	0	In state provider	None	1515 NEWELL AVE	None	WALNUT CREEK	CA	94596	5120	07	06013	37.89281357	-122.0598728	Contra Costa County
275724	Fee-for-Service	1891750170	1891750170	1	1	HOME OF GUIDING HANDS	2/8/2006	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1543 PENASCO RD	None	EL CAJON	CA	92019	3702	37	06073	32.77025453	-116.926407	San Diego County
275732	Fee-for-Service	1447287347	1447287347	1	1	HUMBOLDT FAMILY CARE	11/1/1994	261QR1300X	NA	Rural Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	None	1733 CENTRAL AVE	None	MCKINLEYVILLE	CA	95519	3601	12	06023	40.93684932	-124.1008968	Humboldt County
275782	Fee-for-Service	1245799212	1245799212	1	1	HUYNH, JAMIE MD	10/9/2023	207L00000X	NA	Other	026	PHYSICIANS	179996	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
275791	Fee-for-Service	1821078544	1821078544	1	1	HOM, LUN W MD	5/31/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	20593	02	General Surgery	0	In state provider	None	2865 ATLANTIC AVE	STE 108	LONG BEACH	CA	90806	7409	19	06037	33.809418	-118.185058	Los Angeles County
275795	Fee-for-Service	1629653720	1629653720	1	1	HAVEN POST ACUTE, LLC	5/1/2021	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	1311 E DATE ST	None	SAN BERNARDINO	CA	92404	4233	36	06071	34.14124247	-117.2585115	San Bernardino County
275809	Fee-for-Service	1336806256	1336806256	1	1	HILL, VICTORIA L CNM	4/18/2022	176B00000X	NA	Licensed Midwife	005	CERTIFIED NURSE MIDWIFE	-	None	None	0	In state provider	None	500 W HOSPITAL ROAD	None	FRENCH CAMP	CA	95231	9693	39	06077	37.88652418	-121.2820956	San Joaquin County
275821	Fee-for-Service	1477689230	1477689230	1	1	HAMILTON, NICOLE A LMFT	3/1/2019	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
275824	Fee-for-Service	1861747396	1861747396	1	1	HOLDEN, MARC M MD	7/30/2019	208800000X	NA	Other	026	PHYSICIANS	129770	34	Urology and Urological Surgery	0	In state provider	None	4060 FOURTH AVE	SUITE 310	SAN DIEGO	CA	92103	2120	37	06073	32.75053673	-117.1616539	San Diego County
275825	Fee-for-Service	1003053307	1003053307	1	1	HAVILL, DIANA L	3/18/2020	2084P0800X	NA	Psychiatry	026	PHYSICIANS	167486	36	Psychiatry	0	In state provider	None	5016 CHESEBRO RD	STE 200	AGOURA HILLS	CA	91301	2277	19	06037	34.14134802	-118.7392827	Los Angeles County
275832	Fee-for-Service	1457344350	1457344350	2	1	HOUSTON, RENDEL R MD	12/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	14956	34	Urology and Urological Surgery	0	In state provider	None	1500 E DUARTE RD	None	DUARTE	CA	91010	3012	19	06037	34.129683	-117.970857	Los Angeles County
275860	Fee-for-Service	1811042468	1811042468	1	1	HUMMEL, CHRISTOPHER B.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	67391	66	Emergency Medicine (Urgent Care)	0	In state provider	None	185 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.643877	-118.963932	Mono County
275873	Fee-for-Service	1245418433	1245418433	1	1	HASHEMI, LEILA MD	12/22/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106251	41	Internal Medicine	0	In state provider	None	1510 SAN PABLO ST	None	LOS ANGELES	CA	90033	5320	19	06037	34.06287152	-118.2029433	Los Angeles County
275907	Fee-for-Service	1679190110	1679190110	1	1	HUYNH-TRAN, THANH-LIEM MD	2/20/2024	207WX0109X	NA	Ophthalmology	026	PHYSICIANS	179074	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
275911	Fee-for-Service	1154409803	1154409803	1	1	HERTZ, GABOR H MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85756	22	Pathology (M.D. only)	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
275938	Fee-for-Service	1225575863	1225575863	1	1	HONNAKORE, SWAPNAJA M	9/24/2018	No Taxonomy Provided	NA	None	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	706 N DIAMOND BAR BLVD	STE B	DIAMOND BAR	CA	91765	1059	19	06037	34.03167081	-117.8089198	Los Angeles County
275945	Fee-for-Service	1689939670	1689939670	2	1	HIRSCH, COREY LCSW	10/15/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3625 E THOUSAND OAKS BLV	151	WESTLAKE VILLAGE	CA	91362	3558	56	06111	34.16480359	-118.8299997	Ventura County
275952	Fee-for-Service	1659789212	1659789212	2	1	HUGHEY, JENNIFER M LMFT	6/3/2022	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3763 ARLINGTON AVE	204	RIVERSIDE	CA	92506	2680	33	06065	33.94626774	-117.3994379	Riverside County
275984	Fee-for-Service	1447287347	1447287347	1	1	HUMBOLDT FAMILY CARE	11/1/1994	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	None	1733 CENTRAL AVE	None	MCKINLEYVILLE	CA	95519	3601	12	06023	40.93684932	-124.1008968	Humboldt County
276008	Fee-for-Service	1427186725	1427186725	1	1	HARBOR HEALTH CARE	1/4/2000	315P00000X	NA	Intermediate Care Faciltiy	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	GABLE DIVISION	13640 CLARK AVE	None	BELLFLOWER	CA	90706	2203	19	06037	33.90650564	-118.13403	Los Angeles County
276020	Fee-for-Service	1568475135	1568475135	1	1	HESSAMI, ESMAIL MD	5/1/1983	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	34841	10	Gastroenterology (M.D. only)	0	In state provider	None	500 E OLIVE AVE	STE 660	BURBANK	CA	91501	2132	19	06037	34.1845331	-118.3048131	Los Angeles County
276028	Fee-for-Service	1790282903	1790282903	1	1	HERNANDEZ, MICHAEL E DO	7/21/2021	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	18072	None	None	0	In state provider	None	12942 HARBOR BLVD	None	GARDEN GROVE	CA	92840	5809	30	06059	33.77554119	-117.9178077	Orange County
276048	Fee-for-Service	1952515959	1952515959	1	1	HAM, DAVID A MD	8/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	94899	08	Family Practice	0	In state provider	None	7000 BOULDER AVE	None	HIGHLAND	CA	92346	3348	36	06071	34.12632952	-117.1956652	San Bernardino County
276085	Fee-for-Service	1265799654	1265799654	1	1	HOLMES, GEMMA R LMFT	9/12/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	28991 OLD TOWN FRONT ST	102	TEMECULA	CA	92590	5803	33	06065	33.48435441	-117.1437755	Riverside County
276116	Fee-for-Service	1811042468	1811042468	1	1	HUMMEL, CHRISTOPHER B.	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	67391	47	Miscellaneous	0	In state provider	None	185 SIERRA PARK RD	None	MAMMOTH LAKES	CA	93546	0000	26	06051	37.643877	-118.963932	Mono County
276139	Fee-for-Service	1205030459	1205030459	1	1	HAN, LIWEN MD	8/17/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	100283	41	Internal Medicine	0	In state provider	None	9041 MAGNOLIA AVE	STE 107	RIVERSIDE	CA	92503	3942	33	06065	33.92541585	-117.4378266	Riverside County
276173	Fee-for-Service	1801473384	1801473384	1	1	HILLCREST EAR NOSE & THROAT	8/17/2021	207Y00000X	NA	ENT/Otolaryngology	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	4033 3RD AVE STE 104	None	SAN DIEGO	CA	92103	2136	37	06073	32.75053781	-117.1627168	San Diego County
276175	Fee-for-Service	1780901413	1780901413	1	1	HANNA, LOUISA MD	7/29/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110260	08	Family Practice	0	In state provider	None	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6720	36	06071	34.072245	-117.4319685	San Bernardino County
276178	Fee-for-Service	1093893539	1093893539	1	1	HOM, BRYANT DO	12/26/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	9215	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
276190	Fee-for-Service	1336259670	1336259670	1	1	HERAGU, NARAKESARI P MD	6/8/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	51536	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
276203	Fee-for-Service	1609923523	1609923523	1	1	HAUSER, RHONDA L LCSW	3/4/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	20700 VENTURA BLVD	228	WOODLAND HILLS	CA	91364	6269	19	06037	34.16687239	-118.5840442	Los Angeles County
276216	Fee-for-Service	1467400226	1467400226	1	1	HAWES, JOHN R JR DO	12/31/1986	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	4986	08	Family Practice	0	In state provider	None	16017 TUSCOLA RD	None	APPLE VALLEY	CA	92307	1317	36	06071	34.542252	-117.2692645	San Bernardino County
276223	Fee-for-Service	1255638706	1255638706	1	1	HEIDI MARIE GIBSON	1/11/2011	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	36262 AVENUE E	None	YUCAIPA	CA	92399	4934	36	06071	34.02395441	-117.0140879	San Bernardino County
276239	Fee-for-Service	1699712430	1699712430	1	1	HONDA, GORDON D MD	1/1/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	48027	22	Pathology (M.D. only)	0	In state provider	None	2111 E DAKOTA AVE	None	FRESNO	CA	93726	4805	10	06019	36.78683711	-119.785712	Fresno County
276253	Fee-for-Service	1831463330	1831463330	1	1	H & A MEDICAL TRANSPORTATION	3/29/2012	343900000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	INC	2471 DEAUVILLE CIR	None	CLOVIS	CA	93619	2828	10	06019	36.86473617	-119.6674637	Fresno County
276266	Fee-for-Service	1538449194	1538449194	1	1	HIDALGO, MARCO A PHD	3/13/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	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
276278	Fee-for-Service	1467539460	1467539460	1	1	HAIMAN, AMANDA K MD	5/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	66013	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
276279	Fee-for-Service	1669468757	1669468757	1	1	HAN, JAY B MD	8/22/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	80255	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
276287	Fee-for-Service	1033304894	1033304894	1	1	HIGH DESERT WOMENS MEMORIAL	9/18/2007	174400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	K	625 WEST COLLEGE STREET	105	LOS ANGELES	CA	90012	1675	19	06037	34.06520183	-118.240809	Los Angeles County
276354	Fee-for-Service	1093755159	1093755159	1	1	HYDE, GILBERT L MD	12/8/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	51007	20	Orthopedic Surgery	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
276360	Fee-for-Service	1275501488	1275501488	1	1	HARTUNG, BETH A MD	6/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	67188	41	Internal Medicine	0	In state provider	None	350 HAWTHORNE AVE	STE 2320	OAKLAND	CA	94609	3108	01	06001	37.819368	-122.263902	Alameda County
276390	Fee-for-Service	1437646460	1437646460	1	1	HUNTINGTON HOME HEALTH	3/4/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	AGENCY	171 N ALTADENA DR	SUITE 255	PASADENA	CA	91107	7352	19	06037	34.14902931	-118.0986299	Los Angeles County
276427	Fee-for-Service	1770562506	1770562506	1	1	HANSEN, ERIC R DO	8/3/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	8138	None	None	0	In state provider	None	15888 MAIN ST	STE 112B	HESPERIA	CA	92345	3467	36	06071	34.42375898	-117.3163823	San Bernardino County
276454	Fee-for-Service	1548300437	1548300437	1	1	HUGHES, BEVERLY J MD	1/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	2	Out of state provider	None	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	None	36.1590063	-115.1674415	Clark County
276469	Fee-for-Service	1285746552	1285746552	1	1	HUYNH, ANTHONY MEDICAL GROUP	11/18/2011	193400000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	INC	1334 N IMPERIAL AVE	None	EL CENTRO	CA	92243	1313	13	06025	32.80514274	-115.570218	Imperial County
276472	Fee-for-Service	1255638706	1255638706	1	1	HEIDI MARIE GIBSON	1/11/2011	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	36262 AVENUE E	None	YUCAIPA	CA	92399	4934	36	06071	34.02395441	-117.0140879	San Bernardino County
276489	Fee-for-Service	1588918148	1588918148	1	1	HARRING, KENDRA B	2/9/2015	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
276495	Fee-for-Service	1780180778	1780180778	1	1	HALKET, DOUGLAS B MD	6/3/2021	207R00000X	NA	Other	026	PHYSICIANS	163581	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
276509	Fee-for-Service	1043398761	1043398761	1	1	HAJAR, HAYSSAM E MD	11/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72586	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
276512	Fee-for-Service	1578866323	1578866323	1	1	HILLTOP RECOVERY SERVICES	9/18/2018	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	14715 EAST HIGHWAY 20	None	CLEARLAKE OAKS	CA	95423	0366	17	06033	39.01323418	-122.6330714	Lake County
276517	Fee-for-Service	1114998390	1114998390	1	1	HOUTS, ROBERT L MD	12/31/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	21723	30	Radiology	0	In state provider	None	681 MAIN ST	STE 105	PLACERVILLE	CA	95667	5747	09	06017	38.72992279	-120.7927701	El Dorado County
276535	Fee-for-Service	1881801157	1881801157	1	1	HSU, GEORGE DO	12/8/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	11211	04	Otology, Laryngology, Rhinology	0	In state provider	None	1351 E SPRUCE	None	FRESNO	CA	93720	3342	10	06019	36.84136088	-119.7588077	Fresno County
276537	Fee-for-Service	1831583111	1831583111	1	1	HUNTER, RYAN B MD	12/10/2023	2080P0203X	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
276545	Fee-for-Service	1033649843	1033649843	1	1	HAMMAMI, SUMAYA MD	12/29/2022	207R00000X	NA	Other	026	PHYSICIANS	183208	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
276554	Fee-for-Service	1720583339	1720583339	1	1	HSU, SARAH C MD	11/18/2024	207RH0003X	NA	Oncology	026	PHYSICIANS	166809	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
276580	Fee-for-Service	1598271892	1598271892	1	1	HERTEL, LORELEI-ANNE B OT	8/7/2019	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
276586	Fee-for-Service	1659383719	1659383719	1	1	HALL AMBULANCE SERVICE INC	12/11/2001	No Taxonomy Provided	NA	None	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	1001 21ST ST	None	BAKERSFIELD	CA	93301	4792	15	06029	35.37808032	-119.0132246	Kern County
276587	Fee-for-Service	1629149695	1629149695	1	1	HU, GRACE C MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78644	41	Internal Medicine	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
276664	Fee-for-Service	1023192192	1023192192	1	1	HOLVE, RICHARD L	5/31/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	43929	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
276705	Fee-for-Service	1063031094	1063031094	1	1	HUSSERL, CONNIE OD	9/15/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	34420 FREMONT BLVD	SUITE E	FREMONT	CA	94555	3323	01	06001	37.57486959	-122.040298	Alameda County
276724	Fee-for-Service	1649445800	1649445800	1	1	HUNT, RASELETTE A MD	8/14/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147477	01	General Practice	0	In state provider	None	9201 BIG HORN BLVD	None	SACRAMENTO	CA	95758	1240	34	06067	38.425365	-121.4068185	Sacramento
276738	Fee-for-Service	1841493723	1841493723	1	1	HABERMAN, CARLA L LMFT	9/11/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3160 TELEGRAPH RD	STE 200	VENTURA	CA	93003	3250	56	06111	34.27228149	-119.2529119	Ventura County
276749	Fee-for-Service	1881742856	1881742856	1	1	HSU, MARJORIE C MD	11/29/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83123	40	Pediatrics	0	In state provider	None	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	30	06059	33.85429563	-117.8166478	Orange County
276758	Fee-for-Service	1508507849	1508507849	1	1	HITTLE, RODNEY R CRNA	8/17/2022	367500000X	NA	Other	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
276761	Fee-for-Service	1902859028	1902859028	1	1	HOMANSKY, EDWIN P MD	11/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	41	Internal Medicine	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
276788	Fee-for-Service	1104866748	1104866748	1	1	HUSSAIN, FARABI M MD	7/25/1996	208600000X	NA	General Surgery	026	PHYSICIANS	60613	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
276808	Fee-for-Service	1922605815	1922605815	1	1	H & A DEDICATED HOME HEALTH	12/30/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	INC	10999 RIVERSIDE DR	SUITE 100	STUDIO CITY	CA	91602	2239	19	06037	34.15230395	-118.3693888	Los Angeles County
276815	Fee-for-Service	1548334543	1548334543	1	1	HUYNH, JACK S MD	1/18/1988	207R00000X	NA	Other	026	PHYSICIANS	41781	41	Internal Medicine	0	In state provider	None	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	38	06075	37.79989786	-122.4090369	San Francisco County
276835	Fee-for-Service	1659383719	1659383719	1	1	HALL AMBULANCE SERVICE INC	1/2/1979	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	1001 21ST ST	None	BAKERSFIELD	CA	93301	4792	15	06029	35.37808032	-119.0132246	Kern County
276841	Fee-for-Service	1457371171	1457371171	1	1	HILL, RONALD 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	555 S 70TH ST	None	LINCOLN	NE	68510	2462	00	None	40.808151	-96.62516802	Lancaster County
276892	Fee-for-Service	1558977215	1558977215	1	1	HELPING HANDS HOME HEALTH	1/12/2022	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	BEST CARE INC	14545 VICTORY BLVD	STE 407	VAN NUYS	CA	91411	1620	19	06037	34.18668846	-118.450152	Los Angeles County
276923	Fee-for-Service	1720145642	1720145642	1	1	HELWIG, MARY M	12/19/2016	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	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
276938	Fee-for-Service	1972573228	1972573228	1	1	HAZARD, JAMES 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	9205 SW BARNES RD	None	PORTLAND	OR	97225	6603	00	None	45.51093	-122.771907	Washington County
276954	Fee-for-Service	1023270345	1023270345	1	1	HUYNH, EMILY T OD	8/26/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	1689 ARDEN WAY	None	SACRAMENTO	CA	95815	4029	34	06067	38.601549	-121.4274825	Sacramento County
276967	Fee-for-Service	1821310236	1821310236	1	1	HSU, HUA-WEN NP	3/9/2020	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
276979	Fee-for-Service	1952307894	1952307894	1	1	HANANOUCHI, GLENN I MD	10/31/1991	261QR0200X	NA	Mammography/MRI Provider	026	PHYSICIANS	57893	None	None	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
276984	Fee-for-Service	1053529818	1053529818	1	1	HOHL, JOSEPH C MD	7/1/2004	207X00000X	NA	Orthopedic Surgery	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	MTU CONSULTANT	1042 N MOUNTAIN AVE	B BOX 444	UPLAND	CA	91786	3695	36	06071	34.1083747	-117.6702125	San Bernardino County
276985	Fee-for-Service	1740602945	1740602945	1	2	HARVEST HEALTH CLINIC FOR AC	9/12/2023	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	UPUNCTURE, INC.	801 N. TUSTIN AVE.	305	SANTA ANA	CA	92705	3612	30	06059	33.752286	-117.8341735	Orange County
277002	Fee-for-Service	1033102959	1033102959	1	1	HOOD, RODNEY D MD	5/25/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	27791	41	Internal Medicine	0	In state provider	None	292 EUCLID AVE	STE 210	SAN DIEGO	CA	92114	3613	37	06073	32.70706919	-117.0850896	San Diego County
277036	Fee-for-Service	1043463854	1043463854	1	1	HUANG, MARJORIE LCSW	12/27/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
277082	Fee-for-Service	1972764207	1972764207	1	1	HERRERA, GABRIELA LMFT	11/25/2019	106H00000X	NA	Mental Health Outpatient Services	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
277085	Fee-for-Service	1619010238	1619010238	1	1	HONG, JAN K LMFT	9/20/2024	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
277109	Fee-for-Service	1770650640	1770650640	1	1	HAN, VINCENT M	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	83085	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
277112	Fee-for-Service	1558764761	1558764761	1	1	HORIE, MARIKO LAC	5/8/2019	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	101 CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
277136	Fee-for-Service	1235301524	1235301524	1	1	HEALTHY COMMUNITIES INC	3/2/2009	261Q00000X	NA	Other	041	COMMUNITY CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	2580 SAN PABLO AVE	None	OAKLAND	CA	94612	1160	01	06001	37.81671329	-122.2751725	Alameda County
277167	Fee-for-Service	1508937400	1508937400	1	1	HAYTON, WILLIAM C MD	1/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	36424	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
277191	Fee-for-Service	1952413627	1952413627	1	1	HAILU, TEGEST F MD	6/4/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60221	77	Infectious Disease	0	In state provider	None	7011 N HOWARD ST	STE 202	FRESNO	CA	93720	2955	10	06019	36.8382219	-119.783793	Fresno County
277277	Fee-for-Service	1225076417	1225076417	1	1	HERMAN, LEONARD Y MD	6/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	85589	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
277327	Fee-for-Service	1184757080	1184757080	1	1	HARRIS, ISIAH D MD	12/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121028	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1263 E ARQUES AVE	None	SUNNYVALE	CA	94085	4701	43	06085	37.38060846	-121.9896672	Santa Clara County
277335	Fee-for-Service	1457697211	1457697211	1	1	HAHN, KATHERINE MD	10/4/2022	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	180073	None	None	0	In state provider	None	8536 WILSHIRE BLVD	None	BEVERLY HILLS	CA	90211	3103	19	06037	34.06550726	-118.3775199	Los Angeles County
277413	Fee-for-Service	1922186568	1922186568	1	1	HO, BETTY MD	12/1/1998	No Taxonomy Provided	NA	None	026	PHYSICIANS	54729	41	Internal Medicine	0	In state provider	None	1150 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	41	06081	37.48948529	-122.2232468	San Mateo County
277436	Fee-for-Service	1952413627	1952413627	1	1	HAILU, TEGEST F MD	6/4/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60221	01	General Practice	0	In state provider	None	7011 N HOWARD ST	STE 202	FRESNO	CA	93720	2955	10	06019	36.8382219	-119.783793	Fresno County
277455	Fee-for-Service	1538160338	1538160338	1	1	HABBE,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	2805 5TH ST	STE 210	RAPID CITY	SD	57701	7330	00	None	44.05797219	-103.2271947	Pennington County
277458	Fee-for-Service	1790947356	1790947356	1	1	HUNG, JENNY MD	9/8/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	112521	40	Pediatrics	0	In state provider	None	9400 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2246	19	06037	33.9040752	-118.1328995	Los Angeles County
277486	Fee-for-Service	1801307368	1801307368	1	4	HEALTH SERVICE ALLIANCE	9/1/2022	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	41990 COOK ST	SUITE F-2002	PALM DESERT	CA	92211	6100	33	06065	33.748371	-116.356173	Riverside County
277572	Fee-for-Service	1902284771	1902284771	1	1	HER, CHEE LCSW	2/22/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2401 MERCED ST	None	SAN LEANDRO	CA	94577	4228	01	06001	37.70670062	-122.1696327	Alameda County
277573	Fee-for-Service	1457550956	1457550956	1	1	HOFFMAN, IAN MD	10/2/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	101932	01	General Practice	0	In state provider	None	2200 OFARRELL ST	None	SAN FRANCISCO	CA	94115	3357	38	06075	37.78224789	-122.4412946	San Francisco County
277603	Fee-for-Service	1538469929	1538469929	1	2	HARMONY HEALTHCARE LLC	2/9/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	2350 MISSION COLLEGE BLV	SUITE 875	SANTA CLARA	CA	95054	1532	43	06085	37.38877529	-121.966646	Santa Clara County
277611	Fee-for-Service	1831556471	1831556471	1	1	HOME HEALTH BAY AREA INC	8/22/2018	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	901 CAMPUS DR	SUITE 301	DALY CITY	CA	94015	4930	41	06081	37.66535778	-122.4763793	San Mateo County
277629	Fee-for-Service	1164552568	1164552568	1	1	HOUSTON, MARJORIE DBA	3/25/2009	No Taxonomy Provided	NA	None	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	HOUSTON'S HSE HRG INSTRU	130 N FIG ST	None	ESCONDIDO	CA	92025	3415	37	06073	33.12518563	-117.0729256	San Diego County
277635	Fee-for-Service	1356357560	1356357560	1	1	HWANG, HLA MYINT MAUNG S MD	10/1/2000	207RN0300X	NA	Nephrology	026	PHYSICIANS	55844	None	None	0	In state provider	None	27400 HESPERIAN BLVD	None	HAYWARD	CA	94545	4235	01	06001	37.63011596	-122.0960694	Alameda County
277654	Fee-for-Service	1407934581	1407934581	1	1	HUI, STEVEN W MD	7/1/1984	No Taxonomy Provided	NA	None	026	PHYSICIANS	30183	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2000 VALE RD	None	SAN PABLO	CA	94806	3808	07	06013	37.95393251	-122.3375029	Contra Costa County
277657	Fee-for-Service	1760058960	1760058960	1	2	HEART AMBULANCE CORPORATION	11/5/2021	341600000X	NEMT Provider	Other	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	11629 CLARK ST	SUITE 201	ARCADIA	CA	91006	6030	19	06037	34.10188841	-118.0066278	Los Angeles County
277658	Fee-for-Service	1710183868	1710183868	1	1	HARIANAWALA, SALIM S MD	3/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	56050	41	Internal Medicine	0	In state provider	None	1275 E LATHAM	SUITE C	HEMET	CA	92543	4424	33	06065	33.74938248	-116.9589555	Riverside County
277674	Fee-for-Service	1891923686	1891923686	1	1	HARRISON, BRIDGET M MD	8/26/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	104342	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
277680	Fee-for-Service	1952413627	1952413627	1	1	HAILU, TEGEST F MD	6/4/2008	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	60221	08	Family Practice	0	In state provider	None	7011 N HOWARD ST	STE 202	FRESNO	CA	93720	2955	10	06019	36.8382219	-119.783793	Fresno County
277690	Fee-for-Service	1578503793	1578503793	1	1	HOGUE, DARA E MD	11/1/1997	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	80103	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
277702	Fee-for-Service	1174757405	1174757405	1	1	HENRY, KIMBERLY A MD INC	5/19/2010	193400000X	NA	Other	026	PHYSICIANS	74346	24	Plastic Surgery	0	In state provider	None	350 BON AIR RD	STE 1	GREENBRAE	CA	94904	1752	21	06041	37.94974377	-122.5342016	Marin County
277713	Fee-for-Service	1841271988	1841271988	1	1	HACK, TERRACE A MD	8/24/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	76422	05	Anesthesiology	0	In state provider	None	2776 PACIFIC AVE	None	LONG BEACH	CA	90806	2613	19	06037	33.80692698	-118.1936915	Los Angeles County
277733	Fee-for-Service	1801307368	1801307368	1	4	HEALTH SERVICE ALLIANCE	9/1/2022	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INTERMITTENT	41990 COOK ST	SUITE F-2002	PALM DESERT	CA	92211	6100	33	06065	33.748371	-116.356173	Riverside County
277736	Fee-for-Service	1891006375	1891006375	1	1	HUEZO, RAFAEL MD	7/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	121288	01	General Practice	0	In state provider	None	3733 SAN DIMAS ST	SUITE 104	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
277753	Fee-for-Service	1609289917	1609289917	1	1	HSU, GEOFFREY OD	5/9/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4423 REDONDO BEACH BLVD	None	LAWNDALE	CA	90260	3465	19	06037	33.87395013	-118.3532371	Los Angeles County
277767	Fee-for-Service	1518446103	1518446103	1	1	HILL, JACQUELINE RCP	10/5/2018	227800000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	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
277787	Fee-for-Service	1073525978	1073525978	1	1	HABIBIAN, ALEXANDER S MD	9/30/1992	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	66573	30	Radiology	0	In state provider	None	36485 INLAND VALLEY DR	None	WILDOMAR	CA	92595	9681	33	06065	33.591699	-117.2368285	Riverside County
277828	Fee-for-Service	1811272206	1811272206	1	1	HERNANDEZ, CHRISTINE CNP	8/16/2024	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
277872	Fee-for-Service	1487989315	1487989315	1	1	HUNG, AMY A MD	9/30/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	109625	08	Family Practice	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
277879	Fee-for-Service	1649341603	1649341603	1	1	HWANG, MICHAEL M MD	1/1/1999	207W00000X	NA	Ophthalmology	026	PHYSICIANS	60430	18	Ophthalmology	0	In state provider	None	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	37	06073	32.79293009	-117.0952438	San Diego County
277897	Fee-for-Service	1790949972	1790949972	1	1	HAYS, TOBIAS G MD	4/20/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97503	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
277898	Fee-for-Service	1437475183	1437475183	1	1	HABALUYAS, DONNA C MD	8/8/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	125502	08	Family Practice	0	In state provider	None	43112 15TH ST WEST	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
277899	Fee-for-Service	1710183868	1710183868	1	1	HARIANAWALA, SALIM S MD	3/18/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	56050	29	Pulmonary Diseases (M.D. only)	0	In state provider	None	1275 E LATHAM	SUITE C	HEMET	CA	92543	4424	33	06065	33.74938248	-116.9589555	Riverside County
277926	Fee-for-Service	1124151303	1124151303	1	1	HUANG, DONNY P MD	5/5/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	72296	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
278004	Fee-for-Service	1477731867	1477731867	1	1	HO, WAYNE T	7/29/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99958	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
278023	Fee-for-Service	1215363189	1215363189	1	1	HUERTA, KIMBERLY	7/9/2024	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	30200 AGOURA RD	SUITE 190	AGOURA HILLS	CA	91301	5434	19	06037	34.14513267	-118.7821377	Los Angeles County
278031	Fee-for-Service	1649848631	1649848631	1	1	HARCROW, FLETCHER LPCC	2/14/2025	101YP2500X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	140 COMMONWEALTH AVE	SUITE 208	FULLERTON	CA	92832	1905	30	06059	33.87034048	-117.922437	Orange County
278102	Fee-for-Service	1801186036	1801186036	1	1	HEDGES-DOMENICUCCI, MARION	5/7/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	3160 TELEGRAPH ROAD	STE 200	VENTURA	CA	93003	3250	56	06111	34.27228149	-119.2529119	Ventura County
278143	Fee-for-Service	1568077634	1568077634	1	1	HOSPICE OF GENTLE CARE INC	8/24/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	7311 VAN NUYS BLVD	UNIT 14	VAN NUYS	CA	91405	1958	19	06037	34.203393	-118.4487795	Los Angeles County
278170	Fee-for-Service	1043749427	1043749427	1	1	HARGROVE, MI K LCSW	12/18/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	23504 LYONS AVE	SUITE 402	SANTA CLARITA	CA	91321	5136	19	06037	34.37942345	-118.5452006	Los Angeles County
278185	Fee-for-Service	1588651350	1588651350	1	1	HYE PAHRMACY INC	3/24/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1200 S CENTRAL AVE	None	GLENDALE	CA	91204	2504	19	06037	34.13205	-118.257791	Los Angeles County
278193	Fee-for-Service	1255435533	1255435533	1	1	HUMBOLDT OPEN DOOR CLIN	1/1/1995	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	CENTERS	1150 FOSTER AVE	None	ARCATA	CA	95521	5986	12	06023	40.87939413	-124.0890805	Humboldt County
278196	Fee-for-Service	1598167967	1598167967	1	1	HANAGAMI, CORI MD	6/24/2022	2084P0800X	NA	Psychiatry	026	PHYSICIANS	147481	None	None	0	In state provider	None	5931 STANLEY AVE	# 1	CARMICHAEL	CA	95608	3846	34	06067	38.622978	-121.326966	Sacramento County
278259	Fee-for-Service	1629059779	1629059779	1	1	HOAGLAND, PETER M MD	7/1/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54598	06	Cardiovascular Disease (M.D. only)	0	In state provider	PO BOX 2369	4343 YAQUI PASS ROAD	None	BORREGO SPRINGS	CA	92004	0000	37	06073	33.19398291	-116.330373	San Diego County
278283	Fee-for-Service	1619995255	1619995255	1	1	HOVSEPIAN, DAVID M MD	9/10/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88032	30	Radiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
278308	Fee-for-Service	1962425611	1962425611	1	1	HOLY CROSS HOSPITAL	3/18/2007	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2701 W 68TH ST	None	CHICAGO	IL	60629	1813	00	None	41.7699994	-87.69097987	Cook County
278321	Fee-for-Service	1215232376	1215232376	1	1	HORTON, CELENA LCSW	11/15/2021	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	11799 SEBASTIAN WAY	103	RANCHO CUCAMONGA	CA	91730	0708	36	06071	34.10415255	-117.5480055	San Bernardino County
278324	Fee-for-Service	1437375268	1437375268	1	1	HERRERA, SUSANA MD	10/21/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	97626	08	Family Practice	0	In state provider	None	1294 W 6TH ST	None	SAN PEDRO	CA	90731	2987	19	06037	33.73885348	-118.3056165	Los Angeles County
278384	Fee-for-Service	1568077634	1568077634	1	1	HOSPICE OF GENTLE CARE INC	8/24/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	7311 VAN NUYS BLVD	UNIT 14	VAN NUYS	CA	91405	1958	19	06037	34.203393	-118.4487795	Los Angeles County
278402	Fee-for-Service	1558998542	1558998542	1	1	HALIM, MARK M MD	6/14/2022	1835P1300X	NA	Other	026	PHYSICIANS	177063	None	None	0	In state provider	None	13993 PARK AVE	None	VICTORVILLE	CA	92392	2485	36	06071	34.50503628	-117.3265137	San Bernardino County
278412	Fee-for-Service	1134103807	1134103807	2	1	HOOMALU, WILLIAM JR PT	6/1/2000	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1165 S DORA STREET	SUITE A	UKIAH	CA	94582	6353	23	06045	39.13602308	-123.2095502	Mendocino County
278416	Fee-for-Service	1477701654	1477701654	1	1	HO, ADA M MD	8/3/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	103564	40	Pediatrics	0	In state provider	None	20 ALLEN STREET	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
278428	Fee-for-Service	1255435533	1255435533	1	1	HUMBOLDT OPEN DOOR CLIN	3/1/1997	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	CENTERS	1150 FOSTER AVE	None	ARCATA	CA	95521	5986	12	06023	40.87939413	-124.0890805	Humboldt County
278431	Fee-for-Service	1427518869	1427518869	1	1	HA, CHRISTOPHER T DO	10/13/2023	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	20798	None	None	0	In state provider	None	3421 VILLA LANE	SUITE 2B	NAPA	CA	94558	3060	28	06055	38.32459323	-122.2934714	Napa County
278452	Fee-for-Service	1427088293	1427088293	1	1	HERMER, ALAN J MD	4/27/1973	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	13545	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	5220 CLARK AVE	None	LAKEWOOD	CA	90712	2618	19	06037	33.8527092	-118.1337623	Los Angeles County
278476	Fee-for-Service	1710013966	1710013966	1	1	HLATKY, MARK A	6/30/1988	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	38785	06	Cardiovascular Disease (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
278479	Fee-for-Service	1487749461	1487749461	1	1	HARING, KRISTEN E MD	3/1/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	64751	41	Internal Medicine	0	In state provider	None	2020 GENESEE AVE	None	SAN DIEGO	CA	92123	4219	37	06073	32.7921973	-117.1571251	San Diego County
278498	Fee-for-Service	1629059779	1629059779	1	1	HOAGLAND, PETER M MD	7/1/1985	207RC0000X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	54598	41	Internal Medicine	0	In state provider	PO BOX 2369	4343 YAQUI PASS ROAD	None	BORREGO SPRINGS	CA	92004	0000	37	06073	33.19398291	-116.330373	San Diego County
278501	Fee-for-Service	1215025275	1215025275	1	1	HIYAMA, LAUREN S	3/21/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84500	41	Internal Medicine	0	In state provider	None	8700 BEVERLY BLVD	None	WEST HOLLYWOOD	CA	90048	1804	19	06037	34.07671715	-118.3799413	Los Angeles County
278535	Fee-for-Service	1326296880	1326296880	1	1	HARDING, PHILLIP R MD	11/26/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	24876	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	101 E BEVERLY BLVD	STE 407	MONTEBELLO	CA	90640	4317	19	06037	34.01556395	-118.0983878	Los Angeles County
278551	Fee-for-Service	1962425611	1962425611	1	1	HOLY CROSS HOSPITAL	12/9/2001	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	2701 W 68TH ST	None	CHICAGO	IL	60629	1813	00	None	41.7699994	-87.69097987	Cook County
278575	Fee-for-Service	1801068713	1801068713	1	1	HILDERBRAND, KELLY R MD	3/30/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	134308	40	Pediatrics	0	In state provider	None	10243 GENETIC CENTER DR	None	SAN DIEGO	CA	92121	6310	37	06073	32.90618683	-117.1814064	San Diego County
278608	Fee-for-Service	1619995891	1619995891	1	1	HARRISON, VIRGINIA H	4/9/2007	No Taxonomy Provided	NA	None	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	LCSW	4283 PIEDMONT AVE	STE E8	OAKLAND	CA	94611	4764	01	06001	37.82859706	-122.2495723	Alameda County
278645	Fee-for-Service	1649520701	1649520701	1	1	HSIEH, DENNIS T MD	8/1/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	129373	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1441 FLORIDA AVENUE	None	MODESTO	CA	95350	4418	50	06099	37.66508443	-120.9962589	Stanislaus County
278665	Fee-for-Service	1255435533	1255435533	1	1	HUMBOLDT OPEN DOOR CLIN	1/1/1995	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CENTERS	1150 FOSTER AVE	None	ARCATA	CA	95521	5986	12	06023	40.87939413	-124.0890805	Humboldt County
278697	Fee-for-Service	1932634805	1932634805	1	1	HENNINGER, AMELIA L MD	10/20/2020	207R00000X	NA	Other	026	PHYSICIANS	166597	66	Emergency Medicine (Urgent Care)	0	In state provider	None	31700 TEMECULA PARKWAY	None	TEMECULA	CA	92592	5896	33	06065	33.481134	-117.1060515	Riverside County
278721	Fee-for-Service	1538451877	1538451877	1	1	HADDAD, NADIA E MD	7/27/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	122486	36	Psychiatry	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
278724	Fee-for-Service	1124040696	1124040696	1	1	HONG, DERRICK M MD	5/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78389	66	Emergency Medicine (Urgent Care)	0	In state provider	None	4077 FIFTH AVE	None	SAN DIEGO	CA	92103	2105	37	06073	32.75034388	-117.161023	San Diego County
278781	Fee-for-Service	1538271556	1538271556	1	1	HARRIS & HENDEL CARDI-	5/26/1993	207RC0000X	NA	Cardiology/Interventional Cardiology	022	PHYSICIANS GROUP	-	06	Cardiovascular Disease (M.D. only)	0	In state provider	OLOGY MEDICAL GROUP INC	201 S ALVARADO ST	STE 515	LOS ANGELES	CA	90057	2385	19	06037	34.06417777	-118.2719543	Los Angeles County
278783	Fee-for-Service	1558468397	1558468397	2	1	HS PHARMACY INC	9/5/2007	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4248 MACARTHUR BLVD	None	OAKLAND	CA	94619	1908	01	06001	37.78781136	-122.1951647	Alameda County
278786	Fee-for-Service	1578709127	1578709127	1	1	HARRIS, LUZ M	2/1/2009	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	21951 BIRCHWOOD	None	MISSION VIEJO	CA	92692	4226	30	06059	33.64357101	-117.6374302	Orange County
278843	Fee-for-Service	1740501022	1740501022	1	1	HUMBOLDT PHYSICAL THERAPY	4/29/2013	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1551 GIUNTOLI LANE	None	ARCATA	CA	95521	4495	12	06023	40.90501349	-124.081893	Humboldt County
278858	Fee-for-Service	1487721833	1487721833	1	1	HERNANDEZ, RAUL A MD	1/1/1994	208800000X	NA	Other	026	PHYSICIANS	67342	34	Urology and Urological Surgery	0	In state provider	None	1800 SULLIVAN AVE	STE 1047	DALY CITY	CA	94015	2228	41	06081	37.68077723	-122.4728941	San Mateo County
278889	Fee-for-Service	1760680250	1760680250	1	1	HORTON, DARLENE P MD	6/30/1990	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	67667	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
278900	Fee-for-Service	1255435533	1255435533	1	1	HUMBOLDT OPEN DOOR CLIN	1/1/1995	261QF0400X	NA	Federally Qualified Health Center	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CENTERS	1150 FOSTER AVE	None	ARCATA	CA	95521	5986	12	06023	40.87939413	-124.0890805	Humboldt County
278918	Fee-for-Service	1285784017	1285784017	1	2	HO, ALICE Y MD	2/24/2025	2085R0001X	NA	Other	026	PHYSICIANS	143389	30	Radiology	0	In state provider	None	9730 SUMMERS RIDGE RD	None	SAN DIEGO	CA	92121	3101	37	06073	32.89408843	-117.1706972	San Diego County
278959	Fee-for-Service	1124040696	1124040696	1	1	HONG, DERRICK M MD	5/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	78389	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
278964	Fee-for-Service	1538574744	1538574744	1	1	HU, JINGJING MD	9/30/2019	207ZP0102X	NA	Other	026	PHYSICIANS	146830	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
278969	Fee-for-Service	1316471964	1316471964	1	1	HSIAO, HENRY C MD	8/20/2021	208M00000X	NA	Other	026	PHYSICIANS	165941	None	None	0	In state provider	None	3000 Q STREET	3RD FLOOR	SACRAMENTO	CA	95816	7058	34	06067	38.564991	-121.4696565	Sacramento County
278989	Fee-for-Service	1629234109	1629234109	1	1	HUSAIN, HATIM MD	1/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	99267	68	Hematology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
279006	Fee-for-Service	1356568661	1356568661	1	1	HANSON, NICHOLAS P MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	98416	30	Radiology	0	In state provider	None	2320 BATH ST	STE 113	SANTA BARBARA	CA	93105	3805	42	06083	34.43082689	-119.7223032	Santa Barbara County
279018	Fee-for-Service	1033434881	1033434881	1	1	HONG, GENEWOO J MD	8/4/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	118719	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
279019	Fee-for-Service	1578709127	1578709127	1	1	HARRIS, LUZ M	2/1/2009	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	21951 BIRCHWOOD	None	MISSION VIEJO	CA	92692	4226	30	06059	33.64357101	-117.6374302	Orange County
279054	Fee-for-Service	1225392145	1225392145	1	1	HOFFARCAND, LEA V MD	3/3/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	128574	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
279057	Fee-for-Service	1659478121	1659478121	1	1	HUANG, YIHUNG MD	3/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147122	41	Internal Medicine	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
279076	Fee-for-Service	1639197726	1639197726	1	1	HUSS, JERRY MD	3/1/2022	207P00000X	NA	Other	026	PHYSICIANS	174965	None	None	0	In state provider	None	2400 EAST 4TH STREET	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
279086	Fee-for-Service	1194035261	1194035261	1	1	HEALING LODGE OF THE SEVEN	9/6/2013	324500000X	NA	Other	075	INDIAN HEALTH SERVICES/MEMORANDUM OF AGREEMENT	-	-	NOT APPLICABLE	2	Out of state provider	NATIONS	5600 E 8TH AVE	None	SPOKANE VALLEY	WA	99212	0220	00	None	47.646432	-117.328806	Spokane County
279088	Fee-for-Service	1275667222	1275667222	1	1	HARDISTY, KATHLEEN O LCSW	6/11/2015	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
279175	Fee-for-Service	1477660074	1477660074	1	1	HART, ROBERT R MD	4/20/2016	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	38923	-	NOT APPLICABLE	0	In state provider	None	620 N AURORA ST	SUITE 1, 3, 3A, S2-9	STOCKTON	CA	95202	2276	39	06077	37.96104648	-121.2811438	San Joaquin County
279178	Fee-for-Service	1477633287	1477633287	1	1	HSIAO, JACK Y MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	83383	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4282 GENESEE AVE	STE 201	SAN DIEGO	CA	92117	4964	37	06073	32.82092667	-117.1828683	San Diego County
279189	Fee-for-Service	1164833406	1164833406	1	1	HECKMANN, NATHANAEL D MD	9/6/2019	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	137295	20	Orthopedic 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
279204	Fee-for-Service	1063997948	1063997948	1	1	HERRERA, PRISCILLA S	11/6/2018	No Taxonomy Provided	NA	None	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	2212 GATEWAY OAKS	APT 201	SACRAMENTO	CA	95833	4215	34	06067	38.607336	-121.5143505	Sacramento County
279223	Fee-for-Service	1629234109	1629234109	1	1	HUSAIN, HATIM MD	1/25/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	99267	78	Neoplastic Diseases/Oncology	0	In state provider	None	200 W ARBOR DRIVE	None	SAN DIEGO	CA	92103	9001	37	06073	32.7537975	-117.1658298	San Diego County
279265	Fee-for-Service	1124025960	1124025960	1	1	HIRANO, PAUL S OD	5/1/2001	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	2130 REDONDO BEACH BLVD	STE G	TORRANCE	CA	90504	1680	19	06037	33.88598821	-118.3168669	Los Angeles County
279291	Fee-for-Service	1659478121	1659478121	1	1	HUANG, YIHUNG MD	3/1/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147122	45	Nephrology (Renal-Kidney)	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
279311	Fee-for-Service	1770669293	1770669293	1	1	HICKOX, DONNA M MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	49943	01	General Practice	0	In state provider	None	596 CARROLL ST	None	SUNNYVALE	CA	94086	6207	43	06085	37.36853041	-122.0305901	Santa Clara County
279322	Fee-for-Service	1194035261	1194035261	1	1	HEALING LODGE OF THE SEVEN	9/6/2013	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	2	Out of state provider	NATIONS	5600 E 8TH AVE	None	SPOKANE VALLEY	WA	99212	0220	00	None	47.646432	-117.328806	Spokane County
279339	Fee-for-Service	1932141165	1932141165	1	1	HICKS, CRAIG A MD	8/25/2020	207P00000X	NA	Other	026	PHYSICIANS	169242	None	None	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
279403	Fee-for-Service	1467993667	1467993667	1	1	HILL, ALEXANDRA M MD	8/25/2021	390200000X	NA	Other	026	PHYSICIANS	162095	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
279423	Fee-for-Service	1154466928	1154466928	1	2	HOPE HOUSE FOR THE MULTIPLE	11/1/1990	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	HANDICAPPED INC	11338 RANCHITO ST	None	EL MONTE	CA	91732	1335	19	06037	34.08997481	-118.0204543	Los Angeles County
279433	Fee-for-Service	1063997948	1063997948	1	1	HERRERA, PRISCILLA S	11/6/2018	No Taxonomy Provided	NA	None	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	2212 GATEWAY OAKS	APT 201	SACRAMENTO	CA	95833	4215	34	06067	38.607336	-121.5143505	Sacramento County
279446	Fee-for-Service	1760722755	1760722755	1	1	HOSPITALISTS OF THE PENINSUL	9/6/2024	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A, A PROFESSIONAL CORPOR	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	41	06081	37.592811	-122.382351	San Mateo County
279522	Fee-for-Service	1205339280	1205339280	1	1	HOERTER, JACOB	7/22/2024	207Y00000X	NA	ENT/Otolaryngology	026	PHYSICIANS	187951	84	Surgery-Head and Neck	0	In state provider	None	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
279542	Fee-for-Service	1770669293	1770669293	1	1	HICKOX, DONNA M MD	7/31/1986	No Taxonomy Provided	NA	None	026	PHYSICIANS	49943	08	Family Practice	0	In state provider	None	596 CARROLL ST	None	SUNNYVALE	CA	94086	6207	43	06085	37.36853041	-122.0305901	Santa Clara County
279556	Fee-for-Service	1770803538	1770803538	1	1	HUFFMAN, LYNNE C MD	6/23/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	53858	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
279567	Fee-for-Service	1770538514	1770538514	1	1	HILVERS, ROBERT 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
279573	Fee-for-Service	1023094760	1023094760	1	1	HALL, WYATT J. MD	3/17/2009	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
279581	Fee-for-Service	1366576886	1366576886	1	1	HANSEN, JULIE LCSW	4/27/2019	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2373 COLORADO BOULEVARD	None	LOS ANGELES	CA	90041	1157	19	06037	34.13990611	-118.2182985	Los Angeles County
279652	Fee-for-Service	1972689545	1972689545	1	1	HSU, FRANK J Y MD	8/30/1999	No Taxonomy Provided	NA	None	026	PHYSICIANS	33036	41	Internal Medicine	0	In state provider	None	160 E ARTESIA ST	STE 350	POMONA	CA	91767	2927	19	06037	34.07556833	-117.7507835	Los Angeles County
279662	Fee-for-Service	1851616056	1851616056	1	1	HAAS, KELLY B MD	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120042	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
279666	Fee-for-Service	1750567384	1750567384	1	1	HAYAT, JABEEN MD	3/18/2019	No Taxonomy Provided	NA	None	086	MEDICAL DIRECTORS	102741	-	NOT APPLICABLE	0	In state provider	None	10877 CONDUCTOR BLVD	STE 300	SUTTER CREEK	CA	95685	9682	03	06005	38.36440771	-120.8174749	Amador County
279695	Fee-for-Service	1720152556	1720152556	1	1	HISHIYA, YUKIKO LMFT	3/4/2019	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	1340 TULLY ROAD	STE 301 AND 304	SAN JOSE	CA	95122	3055	43	06085	37.31710924	-121.8334186	Santa Clara County
279731	Fee-for-Service	1104860626	1104860626	1	1	HARIRI, ALI MD	3/27/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	84352	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
279752	Fee-for-Service	1487625133	1487625133	1	1	HERSH, DANIEL R MD	1/31/1995	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	75069	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
279772	Fee-for-Service	1285689703	1285689703	1	1	HRISTEA, IONUT N MD	4/25/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	76768	41	Internal Medicine	0	In state provider	None	5901 W OLYMPIC BLVD	STE 305	LOS ANGELES	CA	90036	4664	19	06037	34.05764121	-118.3603115	Los Angeles County
279776	Fee-for-Service	1649708611	1649708611	1	1	HI-DESERT MEMORIAL HEALTH	8/7/2017	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	58383 29 PALMS HWY	SUITE 101	YUCCA VALLEY	CA	92284	5891	36	06071	34.13159539	-116.3901072	San Bernardino County
279812	Fee-for-Service	1508899253	1508899253	1	1	HONSBERG, ANGELICA E MD	2/2/2016	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
279839	Fee-for-Service	1801826086	1801826086	1	1	HOVANESSIAN, ARMEN A MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LANE	SUITE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
279866	Fee-for-Service	1467652834	1467652834	1	1	HOUCK, EVAN A DO	9/23/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	9392	08	Family Practice	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
279873	Fee-for-Service	1649950924	1649950924	1	1	HUANG, EMILY	8/29/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	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
279878	Fee-for-Service	1356348015	1356348015	1	1	HOLLAND, ROBERT 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	170 FORD RD	None	JOHN DAY	OR	97845	2009	00	None	44.41742189	-118.9584121	Grant County
279880	Fee-for-Service	1891750824	1891750824	1	1	HANKS, DEBRA A MD	9/20/2007	207ZC0500X	NA	Other	026	PHYSICIANS	68197	22	Pathology (M.D. only)	0	In state provider	None	263 PEARSON DR	STE 102	PORTERVILLE	CA	93257	3333	54	06107	36.07050297	-119.0277645	Tulare County
279895	Fee-for-Service	1851616056	1851616056	1	1	HAAS, KELLY B MD	5/9/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	120042	10	Gastroenterology (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
279900	Fee-for-Service	1801235106	1801235106	1	1	HENRY, JANIEL PSYD	4/23/2020	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
279949	Fee-for-Service	1346881356	1346881356	1	1	HIGGINS, SARAH G LCSW	4/30/2024	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
279961	Fee-for-Service	1912193137	1912193137	1	1	HAKIMI, MICHAEL N DO	3/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	13147	41	Internal Medicine	0	In state provider	None	16119 VANOWEN STREET	None	VAN NUYS	CA	91406	4822	19	06037	34.19394152	-118.484424	Los Angeles County
279968	Fee-for-Service	1275695843	1275695843	1	1	HSU, KEN-YAO MD	4/30/1985	207XS0117X	NA	Orthopedic Surgery	026	PHYSICIANS	35379	20	Orthopedic Surgery	0	In state provider	None	2235 HAYES ST	FL 4	SAN FRANCISCO	CA	94117	1012	38	06075	37.77302045	-122.4529717	San Francisco County
280005	Fee-for-Service	1649708611	1649708611	1	1	HI-DESERT MEMORIAL HEALTH	8/7/2017	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	CARE DISTRICT	58383 29 PALMS HWY	SUITE 101	YUCCA VALLEY	CA	92284	5891	36	06071	34.13159539	-116.3901072	San Bernardino County
280038	Fee-for-Service	1013087311	1013087311	1	1	HUANG, SHERRY MD	1/29/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	97555	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
280074	Fee-for-Service	1417356916	1417356916	1	1	HERNANDEZ, GERARDO D MD	5/24/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	154073	None	None	0	In state provider	None	8627 ATLANTIC AVE	None	SOUTH GATE	CA	90280	3501	19	06037	33.95462085	-118.1838426	Los Angeles County
280135	Fee-for-Service	1477752293	1477752293	1	1	HARRIS, JO ANN LMFT	5/29/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
280139	Fee-for-Service	1255751608	1255751608	1	1	HOWLETT, KRISTIE L NP	10/11/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	6600 BRUCEVILLE RD	None	SACRAMENTO	CA	95823	4671	34	06067	38.470392	-121.4223975	Sacramento County
280165	Fee-for-Service	1700967213	1700967213	1	1	HUMANGOOD NORCAL	3/29/2011	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	0	In state provider	OF THE WEST INC	1401 NEW STINE RD	None	BAKERSFIELD	CA	93309	3530	15	06029	35.341929	-119.0612555	Kern County
280187	Fee-for-Service	1144711995	1144711995	1	1	HUBBARD, ASHLEY R DO	6/30/2021	390200000X	NA	Other	026	PHYSICIANS	18007	None	None	0	In state provider	None	1411 E 31ST ST	None	OAKLAND	CA	94602	1018	01	06001	37.79926205	-122.2314248	Alameda County
280205	Fee-for-Service	1134168750	1134168750	1	1	HO, BETTY M MD	2/28/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	68661	10	Gastroenterology (M.D. only)	0	In state provider	None	11 BIRCH ST	None	REDWOOD CITY	CA	94062	1480	41	06081	37.48882891	-122.2411617	San Mateo County
280211	Fee-for-Service	1306901335	1306901335	1	1	HONE, CHONG S MD	4/1/1991	No Taxonomy Provided	NA	None	026	PHYSICIANS	49271	08	Family Practice	0	In state provider	None	17883 COLIMA RD	None	LA PUENTE	CA	91748	1729	19	06037	33.99009562	-117.9139303	Los Angeles County
280212	Fee-for-Service	1902923147	1902923147	1	1	HINKSON, ROGER S MD	6/11/2019	2083P0500X	NA	Adult Primary Care	026	PHYSICIANS	76810	39	Preventive (M.D. only)	0	In state provider	None	3828 SCHAUFELE AVENUE	SUITE 200	LONG BEACH	CA	90808	1793	19	06037	33.8283	-118.1479725	Los Angeles County
280217	Fee-for-Service	1679642243	1679642243	1	1	HALL, ANSELM P	9/15/2008	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4618 FOUNTAIN AVE	None	LOS ANGELES	CA	90029	1977	19	06037	34.095582	-118.290195	Los Angeles County
280225	Fee-for-Service	1215974316	1215974316	2	1	HAYS, RICHARD L MD	10/1/2023	207L00000X	NA	Other	026	PHYSICIANS	55603	None	None	0	In state provider	None	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	41	06081	37.67984327	-122.4730264	San Mateo County
280294	Fee-for-Service	1679872238	1679872238	1	1	HAYNES, BRANDON M MD	6/13/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	147715	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
280302	Fee-for-Service	1124209036	1124209036	1	1	HEMPHILL, BILLY JOE CCC-SLP	3/25/2021	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1180 W. OLIVE AVE	SUITE I	MERCED	CA	95348	1900	24	06047	37.31910454	-120.4885665	Merced County
280306	Fee-for-Service	1225188709	1225188709	1	1	HARRIS, JEFFREY N MD	12/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	620 SHADOW LN	None	LAS VEGAS	NV	89106	4119	00	None	36.163269	-115.1654465	Clark County
280339	Fee-for-Service	1669407888	1669407888	1	1	HAYCOCK, KORBIN H MD	2/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	76627	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	# A108	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
280369	Fee-for-Service	1619994456	1619994456	1	1	HEAGNEY, MICHAEL C MD	9/6/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	46099	30	Radiology	0	In state provider	None	2 W FERN AVE	None	REDLANDS	CA	92373	5916	36	06071	34.05016907	-117.1793443	San Bernardino County
280392	Fee-for-Service	1700967213	1700967213	1	1	HUMANGOOD NORCAL	7/9/1979	314000000X	NA	Skilled Nursing Facility	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	OF THE WEST INC	1401 NEW STINE RD	None	BAKERSFIELD	CA	93309	3530	15	06029	35.341929	-119.0612555	Kern County
280401	Fee-for-Service	1023145869	1023145869	2	1	HAUGENS IDEAL PHARMACY	5/31/2017	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	1155 N CENTRAL AVE	STE 106	GLENDALE	CA	91202	2562	19	06037	34.16347353	-118.2569192	Los Angeles County
280422	Fee-for-Service	1679282891	1679282891	1	1	HOPE HOUSE LLC	3/23/2023	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	4239 S HARVARD BLVD	None	LOS ANGELES	CA	90062	1737	19	06037	34.0062359	-118.3067834	Los Angeles County
280450	Fee-for-Service	1578668240	1578668240	1	1	HENRY, CHERIESSE PT	4/21/2020	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	200 MUIR RD	None	MARTINEZ	CA	94553	4614	07	06013	37.99430233	-122.1107194	Contra Costa County
280466	Fee-for-Service	1669514634	1669514634	1	1	HOEFT, CRAIG W OD	9/1/2002	No Taxonomy Provided	NA	None	023	GROUP 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
280469	Fee-for-Service	1982022521	1982022521	1	1	HELDT, JONATHAN P MD	5/7/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	140093	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
280486	Fee-for-Service	1164469417	1164469417	1	1	HADAYA, KINAN DC	9/25/2018	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	CENTER	615 WEST AVE Q	SUITE E	PALMDALE	CA	93551	3887	19	06037	34.58716061	-118.1417509	Los Angeles County
280497	Fee-for-Service	1063075448	1063075448	1	1	HRABIA, JOANNA MD	10/20/2023	207R00000X	NA	Other	026	PHYSICIANS	185693	None	None	0	In state provider	None	1531 ESPLANADE	None	CHICO	CA	95926	3310	04	06007	39.74248474	-121.8493369	Butte County
280551	Fee-for-Service	1609338391	1609338391	1	1	HEALING INDIVIDUAL AND FAMIL	10/11/2022	261QM0801X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	Y COUNSELING, INC.	15545 DEVONSHIRE ST	208	MISSION HILLS	CA	91345	2655	19	06037	34.25734153	-118.4710734	Los Angeles County
280559	Fee-for-Service	1437225208	1437225208	1	1	HYZIN, SOPHIA M PHD	2/4/2019	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	1651 E FOURTH ST	SUITE 230	SANTA ANA	CA	92701	5164	30	06059	33.74814742	-117.8454019	Orange County
280570	Fee-for-Service	1952460552	1952460552	1	1	HACOPIAN, BEATRIS T MD	4/12/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87840	None	None	0	In state provider	None	2661 E WASHINGTON BLVD	None	PASADENA	CA	91107	1412	19	06037	34.16910574	-118.0955603	Los Angeles County
280728	Fee-for-Service	1124317615	1124317615	1	2	HOSPITALIST CORPORATION OF I	8/19/2022	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	1880 N ORANGE GROVE AVE	None	POMONA	CA	91767	3006	19	06037	34.07803211	-117.74833	Los Angeles County
280762	Fee-for-Service	1396885455	1396885455	1	1	HAMMER, GREGORY B MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	51413	40	Pediatrics	0	In state provider	PACIFIC PRESBYT MED CNTR	2340 CLAY ST	# 303	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
280806	Fee-for-Service	1104942119	1104942119	1	1	HASAN, SHAMIM M MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	54451	36	Psychiatry	0	In state provider	None	17507 JEFFREY AVE	None	CERRITOS	CA	90703	8609	19	06037	33.87178162	-118.0545458	Los Angeles County
280821	Fee-for-Service	1124200811	1124200811	1	1	HOM, CHRISTY L PHD	8/18/2008	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	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
280832	Fee-for-Service	1699833152	1699833152	1	1	HAMILL, GARY OD	1/4/2020	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	TOMETRY	117 N SAN MATEO DR	2	SAN MATEO	CA	94401	2794	41	06081	37.56866767	-122.3286434	San Mateo County
280834	Fee-for-Service	1356567572	1356567572	1	1	HSU, EDWARD MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	90100	05	Anesthesiology	0	In state provider	None	16300 SAND CANYON AVE	#506	IRVINE	CA	92618	3705	30	06059	33.66115075	-117.7742405	Orange County
280880	Fee-for-Service	1831560077	1831560077	1	1	HOLTEN DIALYSIS LLC	4/18/2018	No Taxonomy Provided	NA	None	042	CHRONIC DIALYSIS CLINIC	-	-	NOT APPLICABLE	0	In state provider	None	1800 MEDICAL CENTER DR	SUITE 150	SAN BERNARDINO	CA	92411	1218	36	06071	34.131816	-117.322587	San Bernardino County
280889	Fee-for-Service	1164059465	1164059465	1	1	HERNANDEZ, SEBASTIAN MD	7/1/2023	390200000X	NA	Other	026	PHYSICIANS	183951	None	None	0	In state provider	None	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	34	06067	38.555181	-121.4566785	Sacramento County
280892	Fee-for-Service	1023206067	1023206067	1	1	HART, BRENDA PHD	5/28/2021	103T00000X	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
280928	Fee-for-Service	1962535419	1962535419	1	1	HETRICK, LARRY K MD	7/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	78733	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
280950	Fee-for-Service	1245418201	1245418201	1	1	HAAS, SALLY J MD	5/25/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	83214	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1201 W LA VETA AVE	None	ORANGE	CA	92868	4203	30	06059	33.78034779	-117.8655767	Orange County
280982	Fee-for-Service	1881075935	1881075935	1	1	HARTSHORN, CARLA J LMFT	7/2/2021	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	15720 VENTURA BLVD	SUITE 420	ENCINO	CA	91436	1000	19	06037	34.15524484	-118.4756687	Los Angeles County
280983	Fee-for-Service	1396885455	1396885455	1	1	HAMMER, GREGORY B MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	51413	66	Emergency Medicine (Urgent Care)	0	In state provider	PACIFIC PRESBYT MED CNTR	2340 CLAY ST	# 303	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
281036	Fee-for-Service	1659496156	1659496156	1	1	HOANG, THAO P CRNA	4/6/2011	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	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
281070	Fee-for-Service	1194764738	1194764738	1	1	HA, CHRISTOPHER H MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	60428	07	Dermatology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
281072	Fee-for-Service	1730469735	1730469735	1	1	HOLGUIN, GLORIA T LCSW	8/17/2018	No Taxonomy Provided	NA	None	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
281086	Fee-for-Service	1922382407	1922382407	1	1	HSU, YU NAN DO	8/21/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	11894	41	Internal Medicine	0	In state provider	None	24411 HEALTH CENTER DR	STE 680	LAGUNA HILLS	CA	92653	3692	30	06059	33.6087201	-117.7076948	Orange County
281181	Fee-for-Service	1912762733	1912762733	1	1	HOLLINGSHEAD, ALETHEA LPCC	3/17/2025	101Y00000X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	6904 VILLAGE PARKWAY	None	DUBLIN	CA	94568	2406	01	06001	37.70726135	-121.9248393	Alameda County
281203	Fee-for-Service	1396885455	1396885455	1	1	HAMMER, GREGORY B MD	12/11/2002	207L00000X	NA	Other	026	PHYSICIANS	51413	05	Anesthesiology	0	In state provider	PACIFIC PRESBYT MED CNTR	2340 CLAY ST	# 303	SAN FRANCISCO	CA	94115	1932	38	06075	37.79101969	-122.43208	San Francisco County
281218	Fee-for-Service	1962065946	1962065946	1	2	HAWKINS, TARA	8/1/2020	103T00000X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	260 NEWPORT CENTER DR	SUITE 208	NEWPORT BEACH	CA	92660	7520	30	06059	33.610986	-117.873171	Orange County
281228	Fee-for-Service	1134250913	1134250913	1	1	HEALTHRIGHT 360	4/14/2015	No Taxonomy Provided	NA	None	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	1115 MISSION ROAD	None	S SAN FRANCISCO	CA	94080	1302	41	06081	37.66051555	-122.4378449	San Mateo County
281259	Fee-for-Service	1104313097	1104313097	1	1	HICKEY, SEAN T MD	8/11/2021	207P00000X	NA	Other	026	PHYSICIANS	173691	None	None	0	In state provider	None	2700 DOLBEER ST	None	EUREKA	CA	95501	4736	12	06023	40.78355148	-124.1420294	Humboldt County
281285	Fee-for-Service	1144291899	1144291899	1	1	HOWARD COUNTY GENERAL	11/3/2002	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5755 CEDAR LN	None	COLUMBIA	MD	21044	2912	00	None	39.21414128	-76.88716277	Howard County
281379	Fee-for-Service	1669829032	1669829032	1	2	HAJAL, ALAA MD	11/7/2022	207R00000X	NA	Other	026	PHYSICIANS	166325	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
281388	Fee-for-Service	1679001564	1679001564	1	1	HASSAN, MOHAMMED K DPM	9/10/2020	390200000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	15141 WHITTIER BLVD	SUITE 330	WHITTIER	CA	90603	2168	19	06037	33.94810044	-118.0039419	Los Angeles County
281416	Fee-for-Service	1518316199	1518316199	1	1	HOEHN, CASEY MD	8/13/2019	207P00000X	NA	Other	026	PHYSICIANS	160165	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
281421	Fee-for-Service	1982995809	1982995809	1	1	HEYMAN, BENJAMIN M MD	10/15/2018	207RH0003X	NA	Oncology	026	PHYSICIANS	157684	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
281430	Fee-for-Service	1457382335	1457382335	1	1	HICKS, TOMMY L MD INC	11/12/2015	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	48888	None	None	0	In state provider	None	23521 PASEO DE VALENCIA	STE 108	LAGUNA HILLS	CA	92653	3137	30	06059	33.61113028	-117.7126684	Orange County
281488	Fee-for-Service	1700327988	1700327988	1	1	HUANG, JIA XIN MD	5/8/2020	390200000X	NA	Other	026	PHYSICIANS	158076	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
281499	Fee-for-Service	1144291899	1144291899	1	1	HOWARD COUNTY GENERAL	6/1/1998	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	5755 CEDAR LN	None	COLUMBIA	MD	21044	2912	00	None	39.21414128	-76.88716277	Howard County
281532	Fee-for-Service	1396108932	1396108932	1	1	HU, TONY DO	7/8/2020	207L00000X	NA	Other	026	PHYSICIANS	16277	05	Anesthesiology	0	In state provider	None	603 E LATHAM AVE	None	HEMET	CA	92543	4342	33	06065	33.74933852	-116.96598	Riverside County
281554	Fee-for-Service	1336776541	1336776541	1	1	HOLLAND, LEVI C MD	4/4/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	None	34	Urology and Urological Surgery	0	In state provider	None	1260 15TH STREET	1024	SANTA MONICA	CA	90404	1145	19	06037	34.02648965	-118.4867439	Los Angeles County
281616	Fee-for-Service	1447889365	1447889365	1	1	HUGHES, KINNAH M CRNA	10/19/2021	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
281619	Fee-for-Service	1316187602	1316187602	1	1	HURRICANE FAMILY PHARMACY IN	4/9/2021	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	2	Out of state provider	C	25 N 2000 W	None	HURRICANE	UT	84737	4111	00	None	37.17698414	-113.3255546	Washington County
281626	Fee-for-Service	1699937383	1699937383	1	1	HOWARD, LAURA A MD	7/28/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	111270	08	Family Practice	0	In state provider	None	11000 OLSON DR	STE 100	RANCHO CORDOVA	CA	95670	5606	34	06067	38.595123	-121.2820155	Sacramento County
281663	Fee-for-Service	1144760943	1144760943	1	1	HURTT FAMILY HEALTH CLINIC,	5/21/2018	No Taxonomy Provided	NA	None	058	HEALTH ACCESS PROGRAM	-	-	NOT APPLICABLE	0	In state provider	INC	947 S ANAHEIM BLVD	SUITE 260	ANAHEIM	CA	92805	5582	30	06059	33.82164135	-117.909385	Orange County
281673	Fee-for-Service	1073338117	1073338117	1	1	HATZFELD, KALEN PT	1/17/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	9900 INDIANA AVE	8	RIVERSIDE	CA	92503	5498	33	06065	33.90939848	-117.4496843	Riverside County
281700	Fee-for-Service	1275351512	1275351512	1	1	HARO, ANDRES PT	1/7/2025	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1520 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	2379	19	06037	34.01926577	-118.1154058	Los Angeles County
281705	Fee-for-Service	1437148707	1437148707	1	1	HUANG, RONG MD	6/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	67591	41	Internal Medicine	0	In state provider	None	400 EVELYN AVE	None	ALBANY	CA	94706	1312	01	06001	37.89873243	-122.2971602	Alameda County
281706	Fee-for-Service	1972655058	1972655058	1	1	HUMBOLDT RADIOLOGY MEDICAL	12/1/1997	2085R0202X	NA	Mammography/MRI Provider	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	2200 HARRIS ST	None	EUREKA	CA	95503	4747	12	06023	40.78035514	-124.1443756	Humboldt County
281732	Fee-for-Service	1467785535	1467785535	1	1	HAMILTON, RACHEL E LCSW	12/13/2023	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
281770	Fee-for-Service	1891719282	1891719282	1	1	HUSTON, KENNETH G JR MD	2/28/1993	207L00000X	NA	Other	026	PHYSICIANS	46892	05	Anesthesiology	0	In state provider	None	12440 FIRESTONE BLVD	STE 101	NORWALK	CA	90650	4328	19	06037	33.90523023	-118.0681168	Los Angeles County
281775	Fee-for-Service	1902017502	1902017502	1	1	HONG, JUNG MD	4/15/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	93019	05	Anesthesiology	0	In state provider	None	2420 CAMINO RAMON	STE 270	SAN RAMON	CA	94583	4319	07	06013	37.77229042	-121.9634581	Contra Costa County
281784	Fee-for-Service	1568090801	1568090801	1	1	HOPEFUL HEARTS HOSPICE INC	2/18/2021	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	20246 SATICOY ST	203	WINNETKA	CA	91306	4433	19	06037	34.20831848	-118.574766	Los Angeles County
281798	Fee-for-Service	1912352303	1912352303	1	1	HAILE TEKLEZGHI, AMAHA CRNA	1/18/2019	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	2755 HERNDON AVE	None	CLOVIS	CA	93611	6800	10	06019	36.83745149	-119.6604315	Fresno County
281833	Fee-for-Service	1891996302	1891996302	1	1	HALEM, MONICA L MD	2/20/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	99422	07	Dermatology	0	In state provider	None	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	49	06097	38.471625	-122.7259935	Sonoma County
281860	Fee-for-Service	1891167912	1891167912	1	1	HABILITATIVE HOMES RESIDENT	4/1/2016	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	RESIDENTIAL CARE FACILI	11775 WALNUT RD	None	LAKESIDE	CA	92040	5624	37	06073	32.83280844	-116.9377438	San Diego County
281877	Fee-for-Service	1144760943	1144760943	1	1	HURTT FAMILY HEALTH CLINIC,	3/6/2018	No Taxonomy Provided	NA	None	035	RURAL HEALTH CLINICS/FEDERALLY QUALIFIED HEALTH CENTER	-	-	NOT APPLICABLE	0	In state provider	INC	947 S ANAHEIM BLVD	SUITE 260	ANAHEIM	CA	92805	5582	30	06059	33.82164135	-117.909385	Orange County
281922	Fee-for-Service	1235251851	1235251851	1	1	HAGHIGHI, PARICHER B PT	6/8/2010	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	21263 ERWIN STREET	None	WOODLAND HILLS	CA	91367	3715	19	06037	34.18286951	-118.5949215	Los Angeles County
281942	Fee-for-Service	1124694708	1124694708	1	1	HOANG, KIMBERLY T NP	4/24/2023	363LA2100X	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
281951	Fee-for-Service	1154774099	1154774099	1	1	HTWE, THAN A MD	8/27/2019	207R00000X	NA	Other	026	PHYSICIANS	162681	41	Internal Medicine	0	In state provider	None	2823 FRESNO STREET	None	FRESNO	CA	93721	1324	10	06019	36.7423511	-119.7834688	Fresno County
281992	Fee-for-Service	1568090801	1568090801	1	1	HOPEFUL HEARTS HOSPICE INC	2/18/2021	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	20246 SATICOY ST	203	WINNETKA	CA	91306	4433	19	06037	34.20831848	-118.574766	Los Angeles County
282004	Fee-for-Service	1346760709	1346760709	1	1	HARDER, MICHELLE C	7/19/2017	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	11100 COLOMA RD	None	RANCHO CORDOVA	CA	95670	2804	34	06067	38.616606	-121.271949	Sacramento County
282032	Fee-for-Service	1326382516	1326382516	1	1	HINES, ANNA L NP	6/11/2022	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
282083	Fee-for-Service	1831378298	1831378298	1	1	HAAS, CYNTHIA Y LCSW	7/25/2018	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	17418 CHATSWORTH ST	STE 201 B	GRANADA HILLS	CA	91344	5972	19	06037	34.26482277	-118.5138395	Los Angeles County
282085	Fee-for-Service	1144760943	1144760943	1	1	HURTT FAMILY HEALTH CLINIC,	3/6/2018	No Taxonomy Provided	NA	None	053	EVERY WOMAN COUNTS	-	-	NOT APPLICABLE	0	In state provider	INC	947 S ANAHEIM BLVD	SUITE 260	ANAHEIM	CA	92805	5582	30	06059	33.82164135	-117.909385	Orange County
282087	Fee-for-Service	1770747552	1770747552	1	1	HEARWELL HEARING AID CTR	8/19/2008	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	DEBRA L MILLER	6150 EL CAJON BLVD	STE D	SAN DIEGO	CA	92115	3928	37	06073	32.76274752	-117.0649196	San Diego County
282121	Fee-for-Service	1154554657	1154554657	1	1	HO, NANCY MD	11/16/2020	207RG0100X	NA	Gastroenterology	026	PHYSICIANS	168605	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
282128	Fee-for-Service	1285927095	1285927095	1	1	HARRIOT, JOAN	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	3015 3RD AVE SE	None	ABERDEEN	SD	57401	1846	00	None	45.46218051	-98.444655	Brown County
282166	Fee-for-Service	1891800538	1891800538	1	2	HENSLEY, ALLISON C MD	7/1/2004	208000000X	NA	Pediatric Primary Care	080	CA CHILDRENS SERVICES/GENETICALLY HANDICAPPED PERSONS PROGRAM NON- INSTITUTIONAL	-	-	NOT APPLICABLE	0	In state provider	None	11175 CAMPUS ST	None	LOMA LINDA	CA	92350	1700	36	06071	34.049547	-117.2656245	San Bernardino County
282174	Fee-for-Service	1194934109	1194934109	1	1	HOWARD, LAURA L MD	1/4/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	110196	18	Ophthalmology	0	In state provider	None	1395 W LACEY BLVD	None	HANFORD	CA	93230	5904	16	06031	36.32798439	-119.6660001	Kings County
282187	Fee-for-Service	1528170552	1528170552	1	1	HOGEN, ERIK T MD	1/31/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	72380	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
282194	Fee-for-Service	1538496781	1538496781	1	1	HEALTH CARE 21 FAMILY LP	12/14/2010	No Taxonomy Provided	NA	None	002	ASSISTIVE DEVICE AND SICK ROOM SUPPLY DEALERS	-	-	NOT APPLICABLE	0	In state provider	None	846 W VALLEY BLVD	SUITE A-B	ALHAMBRA	CA	91803	3233	19	06037	34.0779567	-118.1326804	Los Angeles County
282196	Fee-for-Service	1356329536	1356329536	1	1	HOUSER, MELISSA MD	1/1/1997	No Taxonomy Provided	NA	None	026	PHYSICIANS	51883	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
282262	Fee-for-Service	1740269174	1740269174	1	1	HOT SPRINGS MEDICAL SURGICAL	10/28/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	20	Orthopedic Surgery	0	In state provider	None	2323 DE LA VINA ST	STE 201	SANTA BARBARA	CA	93105	3879	42	06083	34.43202913	-119.7212339	Santa Barbara County
282265	Fee-for-Service	1447305438	1447305438	1	1	HUBBARD, BRYAN D MD	9/30/2014	208600000X	NA	General Surgery	026	PHYSICIANS	79530	02	General Surgery	0	In state provider	None	1513 S GRAND AVE	SUITE 300	LOS ANGELES	CA	90015	3075	19	06037	34.03596303	-118.266212	Los Angeles County
282290	Fee-for-Service	1144760943	1144760943	1	1	HURTT FAMILY HEALTH CLINIC,	3/6/2018	No Taxonomy Provided	NA	None	200	DEVELOPMENTAL SCREENING AND TRAUMA	-	-	NOT APPLICABLE	0	In state provider	INC	947 S ANAHEIM BLVD	SUITE 260	ANAHEIM	CA	92805	5582	30	06059	33.82164135	-117.909385	Orange County
282297	Fee-for-Service	1992013197	1992013197	1	1	HUNT, RYAN B MD	8/1/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	119329	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
282323	Fee-for-Service	1336185560	1336185560	1	1	HOGAN, CHRISTOPER D MD	10/1/1998	207P00000X	NA	Other	026	PHYSICIANS	43310	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1081 N CHINA LAKE BLVD	None	RIDGECREST	CA	93555	3130	15	06029	35.640783	-117.6698475	Kern County
282327	Fee-for-Service	1912003252	1912003252	1	1	HILLCREST INTERNAL	1/20/2000	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	None	None	0	In state provider	MEDICINE, A MED CORP	4060 4TH AVE	STE 505	SAN DIEGO	CA	92103	2121	37	06073	32.75053673	-117.1616539	San Diego County
282347	Fee-for-Service	1689707416	1689707416	1	1	HUGHES, JAYDEE LMFT	1/2/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	150 W FOOTHILL BLVD	A	SAN DIMAS	CA	91773	1103	19	06037	34.12480006	-117.8083927	Los Angeles County
282349	Fee-for-Service	1760915573	1760915573	1	1	HSIAO, WENDY MD	8/16/2023	2080P0210X	NA	Nephrology	026	PHYSICIANS	160615	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
282359	Fee-for-Service	1679201222	1679201222	1	1	HOWSE, AARON PT	10/4/2022	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
282388	Fee-for-Service	1891897609	1891897609	1	1	HAWKINS, DANA E MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	77106	08	Family Practice	0	In state provider	None	1201 ALHAMBRA BLVD	STE 335	SACRAMENTO	CA	95816	5242	34	06067	38.570076	-121.4657145	Sacramento County
282417	Fee-for-Service	1295151561	1295151561	1	1	HELPING HANDS HOME HEALTH CA	9/18/2019	251G00000X	NA	Other	034	MEDICARE CROSSOVER PROVIDER ONLY	-	-	NOT APPLICABLE	0	In state provider	RE & HOSPICE, INC	1710 S AMPHLETT BLVD	SUITE 112	SAN MATEO	CA	94402	2703	41	06081	37.55823076	-122.3014602	San Mateo County
282454	Fee-for-Service	1194977454	1194977454	1	1	HAWKINS, ALFREDA A PT	10/19/2010	No Taxonomy Provided	NA	None	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
282469	Fee-for-Service	1740269174	1740269174	1	1	HOT SPRINGS MEDICAL SURGICAL	10/28/2003	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	46	Hand Surgery	0	In state provider	None	2323 DE LA VINA ST	STE 201	SANTA BARBARA	CA	93105	3879	42	06083	34.43202913	-119.7212339	Santa Barbara County
282499	Fee-for-Service	1063869196	1063869196	1	1	HARLOW, JOHN B MD	9/24/2018	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	150082	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
282511	Fee-for-Service	1891280665	1891280665	1	1	HUBBARD, CHANDLER P DPM	7/7/2021	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	299 W FOOTHILL BLVD	124	UPLAND	CA	91786	3854	36	06071	34.10706753	-117.6550335	San Bernardino County
282520	Fee-for-Service	1730571878	1730571878	1	1	HUNTER, JAMES G	6/4/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	15775 LAGUNA CANYON RD	STE 110	IRVINE	CA	92618	3192	30	06059	33.6663745	-117.760682	Orange County
282549	Fee-for-Service	1891921458	1891921458	1	1	HSU, KEITH C MD	6/17/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	110787	41	Internal Medicine	0	In state provider	None	26800 CROWN VALLEY PKWY	#100	MISSION VIEJO	CA	92691	6389	30	06059	33.56286021	-117.6673449	Orange County
282632	Fee-for-Service	1518638287	1518638287	1	1	HAMOUIE, JUDY OD	10/6/2021	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	100 E CALIFORNIA BLVD	None	PASADENA	CA	91105	3205	19	06037	34.1357725	-118.148301	Los Angeles County
282670	Fee-for-Service	1922628684	1922628684	1	1	HSU, SARAH DO	12/13/2024	207P00000X	NA	Other	026	PHYSICIANS	20767	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9455 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1297	37	06073	32.83133206	-117.1252363	San Diego County
282678	Fee-for-Service	1992883078	1992883078	1	1	HASSLER, DOROTHY L MD	2/28/1987	No Taxonomy Provided	NA	None	026	PHYSICIANS	40565	40	Pediatrics	0	In state provider	None	1425 S MAIN ST	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
282711	Fee-for-Service	1952362758	1952362758	1	1	HOME OF GUIDING HANDS	4/1/1984	320600000X	NA	Other	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	CORPORATION	1243 BERMUDA LN	None	EL CAJON	CA	92021	3725	37	06073	32.81211121	-116.9141678	San Diego County
282720	Fee-for-Service	1497743850	1497743850	1	1	HIGLEY, MICHELLE A MD	11/1/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78349	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
282732	Fee-for-Service	1366859647	1366859647	1	1	HAJKAZEMSHIRAZI, LEILA OD	6/15/2015	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	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
282762	Fee-for-Service	1437353562	1437353562	1	1	HEALEY, CHRISTINE J MD	3/6/1989	No Taxonomy Provided	NA	None	026	PHYSICIANS	45834	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
282801	Fee-for-Service	1831381664	1831381664	1	1	HAN, WILLIAM I MD INC	4/5/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	38218	None	None	0	In state provider	None	17150 EUCLID ST	STE 220	FOUNTAIN VLY	CA	92708	4055	30	06059	33.714171	-117.9369905	Orange County
282852	Fee-for-Service	1104053743	1104053743	1	1	HERRO, ELISE M MD	7/13/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	114480	07	Dermatology	0	In state provider	None	200 MEDICAL PLAZA	STE 450,465	LOS ANGELES	CA	90095	0001	19	06037	34.06527974	-118.4462792	Los Angeles County
282891	Fee-for-Service	1134231384	1134231384	1	1	HIRAI, THOMAS MD FACS	7/23/2018	208600000X	NA	General Surgery	026	PHYSICIANS	84170	02	General Surgery	0	In state provider	None	200 JOSE FIGUERES AVE	450	SAN JOSE	CA	95116	1500	43	06085	37.36122014	-121.8505998	Santa Clara County
282916	Fee-for-Service	1750412102	1750412102	1	1	HOLDING, ANNE B LMFT	2/10/2021	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	None	-	NOT APPLICABLE	0	In state provider	None	441 N MAIN ST	None	ALTURAS	CA	96101	3457	25	06049	41.48803571	-120.542554	Modoc County
282959	Fee-for-Service	1306330535	1306330535	1	1	HARRISON, BRENDAN J MD	2/22/2025	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	None	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
282978	Fee-for-Service	1679883979	1679883979	1	1	HOULAHAN, MATTHEW G MD	10/18/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118798	08	Family Practice	0	In state provider	None	115 LOCUST STREET	None	SANTA CRUZ	CA	95060	3907	44	06087	36.97519309	-122.027024	Santa Cruz County
283037	Fee-for-Service	1912103326	1912103326	1	1	HEARING AID SYSTEMS INC	3/12/2020	332S00000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	41800 ENTERPRISE CIR S	SUITE A	TEMECULA	CA	92590	4831	33	06065	33.51615781	-117.1673842	Riverside County
283087	Fee-for-Service	1679844518	1679844518	1	1	HILMAR UNIFIED SD	1/24/2002	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	7807 N LANDER AVE	None	HILMAR	CA	95324	9398	24	06047	37.40139596	-120.8502103	Merced County
283090	Fee-for-Service	1427306869	1427306869	1	1	HEPP, MALLORY D LCSW	9/12/2017	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER 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
283124	Fee-for-Service	1801011085	1801011085	1	1	HOVANESYAN, ARSEN MD	1/18/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	99380	41	Internal Medicine	0	In state provider	None	435 ARDEN AVE #410	None	GLENDALE	CA	91203	4020	19	06037	34.15848148	-118.2628845	Los Angeles County
283129	Fee-for-Service	1053434043	1053434043	1	1	HARRIS, SERINA A LMFT	5/18/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
283154	Fee-for-Service	1417035247	1417035247	1	1	HLAING, SAW K MD	3/3/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	93102	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
283203	Fee-for-Service	1518987585	1518987585	1	1	HOLSTEIN, CLYDE D MD	10/21/2019	2084N0400X	NA	Neurology	026	PHYSICIANS	32277	13	Neurology (M.D. only)	0	In state provider	None	1211 W LA PALMA AVE	710	ANAHEIM	CA	92801	2814	30	06059	33.84718298	-117.933758	Orange County
283246	Fee-for-Service	1063081412	1063081412	1	1	HILL, KAYLINN M OT	6/24/2021	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
283248	Fee-for-Service	1063853398	1063853398	1	1	HEALTHY LIVING AT HOME	3/21/2014	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	REDDING LLC	2150 CHURN CREEK ROAD	SUITE 100	REDDING	CA	96002	0727	45	06089	40.57693482	-122.3531706	Shasta County
283250	Fee-for-Service	1154823599	1154823599	1	1	HEALTHNOW HOSPICE INC	4/28/2020	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	23591 FOLEY ST	None	HAYWARD	CA	94545	1676	01	06001	37.640439	-122.131387	Alameda County
283281	Fee-for-Service	1760722755	1760722755	1	2	HOSPITALISTS OF THE PENINSUL	9/6/2024	208M00000X	NA	Other	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	A, A PROFESSIONAL CORPOR	33 MATEO AVE	None	MILLBRAE	CA	94030	2037	41	06081	37.60514265	-122.3940598	San Mateo County
283283	Fee-for-Service	1619095973	1619095973	1	1	HRYMOC, ELHAM M MD	7/30/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	97930	36	Psychiatry	0	In state provider	None	4650 SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
283298	Fee-for-Service	1073807152	1073807152	1	1	HORN, REBECCA G V MD	4/21/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	124386	36	Psychiatry	0	In state provider	None	760 WESTWOOD BLVD	None	LOS ANGELES	CA	90095	8631	19	06037	34.07067	-118.4432445	Los Angeles County
283315	Fee-for-Service	1194308924	1194308924	1	1	HELIOS HOME HEALTH INC	4/19/2023	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	4 EAST HOLLY ST	STE 207	PASADENA	CA	91103	3900	19	06037	34.14762319	-118.150039	Los Angeles County
283318	Fee-for-Service	1952567042	1952567042	1	1	HOLMES, MIATA K LCSW	3/20/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3505 BROADWAY	None	OAKLAND	CA	94611	5714	01	06001	37.82263926	-122.2597946	Alameda County
283351	Fee-for-Service	1780010033	1780010033	1	1	HAN, MIN MD	9/3/2019	207ZP0102X	NA	Other	026	PHYSICIANS	158088	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	None	101 THE CITY DR S	None	ORANGE	CA	92868	3201	30	06059	33.78674051	-117.8888713	Orange County
283407	Fee-for-Service	1699134676	1699134676	1	1	HULL, BARBARA ANNE MD	8/8/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52507	01	General Practice	0	In state provider	None	7215 55TH STREET	None	SACRAMENTO	CA	95823	2601	34	06067	38.495196	-121.440681	Sacramento County
283425	Fee-for-Service	1053375188	1053375188	1	1	HILLIARD, DENISE M MD	8/31/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72959	41	Internal Medicine	0	In state provider	None	765 W COVELL BLVD	None	DAVIS	CA	95616	5916	57	06113	38.56090449	-121.759776	Yolo County
283441	Fee-for-Service	1154823599	1154823599	1	1	HEALTHNOW HOSPICE INC	4/28/2020	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	23591 FOLEY ST	None	HAYWARD	CA	94545	1676	01	06001	37.640439	-122.131387	Alameda County
283442	Fee-for-Service	1487805362	1487805362	1	1	HONG, RICHARD MD	6/12/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108108	30	Radiology	0	In state provider	None	400 PARNASSUS AVE	BOX 0648	SAN FRANCISCO	CA	94143	2202	38	06075	37.76344756	-122.4581992	San Francisco County
283461	Fee-for-Service	1861404758	1861404758	2	1	HILBIG, CLARKE A MD	3/17/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	69639	10	Gastroenterology (M.D. only)	0	In state provider	None	1200 B GALE WILSON BLVD	None	FAIRFIELD	CA	94533	3552	48	06095	38.26109552	-122.0470245	Solano County
283468	Fee-for-Service	1518925494	1518925494	1	1	HERRICK, MAIE K MD	4/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	33058	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
283471	Fee-for-Service	1750777371	1750777371	1	1	HSU, WILLIAM W DO	11/13/2018	390200000X	NA	Other	026	PHYSICIANS	15479	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
283480	Fee-for-Service	1124018262	1124018262	1	1	HURWITZ, JOHN P DO	11/6/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	6856	41	Internal Medicine	0	In state provider	None	1165 MONTGOMERY DRIVE	None	SANTA ROSA	CA	95405	4801	49	06097	38.443806	-122.701374	Sonoma County
283533	Fee-for-Service	1659413789	1659413789	1	1	HYDE, SUSAN L LMFT	1/21/2019	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
283564	Fee-for-Service	1053359729	1053359729	1	1	HARBORVIEW MEDICAL CTR	10/1/1996	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	325 9TH AVE	None	SEATTLE	WA	98104	2499	00	None	47.60414369	-122.3235136	King County
283630	Fee-for-Service	1699398032	1699398032	1	1	HOWENSTEIN, BRIANA M	3/7/2023	235Z00000X	NA	Other	037	SPEECH 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
283644	Fee-for-Service	1649295023	1649295023	1	1	HSU, DAVID H MD	4/1/2000	207L00000X	NA	Other	026	PHYSICIANS	33953	05	Anesthesiology	0	In state provider	None	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	19	06037	33.93112671	-118.2035532	Los Angeles County
283651	Fee-for-Service	1306216916	1306216916	1	1	HAYES, JUSTIN PSYD	11/9/2021	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	710 S BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
283731	Fee-for-Service	1811395965	1811395965	1	1	HTAY. ZAY YAR S MD	8/28/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	139764	01	General Practice	0	In state provider	None	1880 N ORANGE GROVE AVE	None	POMONA	CA	91767	3006	19	06037	34.07803211	-117.74833	Los Angeles County
283746	Fee-for-Service	1053359729	1053359729	1	1	HARBORVIEW MEDICAL CTR	10/2/1996	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	325 9TH AVE	None	SEATTLE	WA	98104	2499	00	None	47.60414369	-122.3235136	King County
283770	Fee-for-Service	1235577933	1235577933	1	1	HILL, DANIKA L LMFT	3/14/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3554 ROUNDBARN BLVD	None	SANTA ROSA	CA	95403	0929	49	06097	38.47599	-122.725557	Sonoma County
283804	Fee-for-Service	1528042520	1528042520	1	1	HIGHSMITH, MARIA J DPM	12/1/1994	213E00000X	NA	Other	027	PODIATRISTS	-	None	None	0	In state provider	None	1001 NUT TREE RD	STE 220	VACAVILLE	CA	95687	4166	48	06095	38.3564252	-121.9532031	Solano County
283853	Fee-for-Service	1346690153	1346690153	1	1	HOSPICE CARE OF THE COAST	12/17/2018	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	INC	215 S HICKORY ST	SUITE 104	ESCONDIDO	CA	92025	4361	37	06073	33.12335985	-117.0753842	San Diego County
283854	Fee-for-Service	1366655359	1366655359	1	1	HERRMANN, PAUL C MD	9/16/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	95062	22	Pathology (M.D. only)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	36	06071	34.049547	-117.264078	San Bernardino County
283880	Fee-for-Service	1659456325	1659456325	1	1	HENDLER, PETER L MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	36769	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
283901	Fee-for-Service	1952853053	1952853053	1	1	HESTER, NICHOLA M CRNA	11/14/2016	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
283925	Fee-for-Service	1134193469	1134193469	1	1	HIGGINS, MARK EDWARD MD	11/1/1997	207R00000X	NA	Other	026	PHYSICIANS	60868	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
283944	Fee-for-Service	1477668945	1477668945	1	1	HERNANDEZ, ADA A MD	10/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	84970	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
283964	Fee-for-Service	1215014428	1215014428	1	1	HARDER, ELMER W MD	4/20/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	38000	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
283997	Fee-for-Service	1871938118	1871938118	1	1	HEALTHRIGHT 360	3/30/2016	324500000X	NA	Other	076	DRUG MEDI-CAL	-	-	NOT APPLICABLE	0	In state provider	None	2307 WEST 6TH STREET	None	LOS ANGELES	CA	90057	3119	19	06037	34.06056584	-118.2771007	Los Angeles County
284007	Fee-for-Service	1073585410	1073585410	2	1	HOLDEN OPTICAL INC	7/12/2017	237700000X	NA	Other	013	HEARING AID DISPENSERS	-	-	NOT APPLICABLE	0	In state provider	None	1150 W ORANGEBURG AVE	None	MODESTO	CA	95350	4042	50	06099	37.66396236	-121.0095829	Stanislaus County
284035	Fee-for-Service	1649590464	1649590464	1	1	HOFFMAN, NATALIE J MD	8/26/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	118106	08	Family Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
284037	Fee-for-Service	1346690153	1346690153	1	1	HOSPICE CARE OF THE COAST	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	INC	215 S HICKORY ST	SUITE 104	ESCONDIDO	CA	92025	4361	37	06073	33.12335985	-117.0753842	San Diego County
284062	Fee-for-Service	1659456325	1659456325	1	1	HENDLER, PETER L MD	2/28/1990	No Taxonomy Provided	NA	None	026	PHYSICIANS	36769	83	Rheumatology	0	In state provider	None	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	01	06001	37.55102172	-121.9759026	Alameda County
284071	Fee-for-Service	1679505242	1679505242	1	1	HOOD, DOUGLAS B MD	9/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	66574	02	General Surgery	0	In state provider	None	7601 IMPERIAL HWY	None	DOWNEY	CA	90242	3456	19	06037	33.929829	-118.157607	Los Angeles County
284074	Fee-for-Service	1174202238	1174202238	1	1	HADLEY HOUSE COUNSELING LICE	1/7/2024	261QM0801X	NA	Other	071	LICENSED CLINICAL SOCIAL WORKER GROUP	-	-	NOT APPLICABLE	0	In state provider	None	13112 HADLEY ST	108	WHITTIER	CA	90601	4529	19	06037	33.98268303	-118.0358304	Los Angeles County
284103	Fee-for-Service	1518987965	1518987965	1	1	HUANG, JIAOTI MD	9/23/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	53385	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
284106	Fee-for-Service	1528073269	1528073269	1	1	HASHMY, ARSHIA MD	5/31/1982	No Taxonomy Provided	NA	None	026	PHYSICIANS	35078	40	Pediatrics	0	In state provider	None	10234 ROSECRANS AVE	None	BELLFLOWER	CA	90706	2602	19	06037	33.90197379	-118.1144208	Los Angeles County
284135	Fee-for-Service	1831232982	1831232982	1	1	HUERTA, YESENIA LMFT	7/4/2020	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
284145	Fee-for-Service	1215014428	1215014428	1	1	HARDER, ELMER W MD	4/20/1995	No Taxonomy Provided	NA	None	026	PHYSICIANS	38000	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	2400 E 4TH ST	None	NATIONAL CITY	CA	91950	2026	37	06073	32.68637926	-117.0828839	San Diego County
284189	Fee-for-Service	1073563714	1073563714	1	1	HIRST, JEREMY M MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	85801	26	Psychiatry (child)	0	In state provider	None	4311 3RD AVE	None	SAN DIEGO	CA	92103	1407	37	06073	32.758578	-117.1637685	San Diego County
284201	Fee-for-Service	1013442466	1013442466	1	1	HAMES, REBECCA LMFT	9/27/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	471 E TAHQUITZ CANYON WA	207	PALM SPRINGS	CA	92262	6620	33	06065	33.8230047	-116.543381	Riverside County
284204	Fee-for-Service	1821371329	1821371329	1	1	HODSON, MEGAN M LCSW	4/25/2023	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	7300 WYNDHAM	None	SACRAMENTO	CA	95823	4913	34	06067	38.467854	-121.4188155	Sacramento County
284211	Fee-for-Service	1811661085	1811661085	1	1	HANSEN, ROWAN A LAC	3/21/2023	305S00000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	624 FREDERICK ST	None	SANTA CRUZ	CA	95062	2203	44	06087	36.98007098	-122.0043791	Santa Cruz County
284218	Fee-for-Service	1851807978	1851807978	1	1	HERNANDEZ, ANGELA M LMFT	1/21/2023	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	471 E TAHQUITZ CANYON WA	201	PALM SPRINGS	CA	92262	6620	33	06065	33.8230047	-116.543381	Riverside County
284249	Fee-for-Service	1407878796	1407878796	2	1	HERMAN, KRISTIN C MD	2/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	76209	38	Geriatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
284294	Fee-for-Service	1750758884	1750758884	1	1	HALE, JUSTINA LCSW	10/16/2024	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1742 OREGON STREET	None	REDDING	CA	96001	1717	45	06089	40.5808265	-122.3932989	Shasta County
284308	Fee-for-Service	1972603371	1972603371	1	1	HIGHTOWER, STEPHEN A MD	3/1/1999	208800000X	NA	Other	026	PHYSICIANS	84688	34	Urology and Urological Surgery	0	In state provider	None	3791 KATELLA AVE	STE 106	LOS ALAMITOS	CA	90720	2000	30	06059	33.80318449	-118.0672965	Orange County
284335	Fee-for-Service	1033971924	1033971924	1	1	HENDERSON, CLAIRE BIRTH DOU	3/20/2024	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	12	06023	0	0	None
284356	Fee-for-Service	1538329271	1538329271	1	1	HENRY, MARGARET E MD	5/17/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	120335	36	Psychiatry	0	In state provider	None	250 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1788	19	06037	34.0696407	-118.3836988	Los Angeles County
284359	Fee-for-Service	1073563714	1073563714	1	1	HIRST, JEREMY M MD	2/8/2015	2084P0800X	NA	Psychiatry	026	PHYSICIANS	85801	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
284378	Fee-for-Service	1669977591	1669977591	1	1	HUNTER-ADAMSON, LYNDSEY MD	8/20/2024	2080P0202X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	166552	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
284423	Fee-for-Service	1407878796	1407878796	2	1	HERMAN, KRISTIN C MD	2/28/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	76209	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
284438	Fee-for-Service	1558310581	1558310581	1	1	HEJJA, PAUL MD	5/12/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	51066	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
284503	Fee-for-Service	1952362634	1952362634	1	1	HENDRIX, MAXWELL P MD	10/12/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90148	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
284515	Fee-for-Service	1922624998	1922624998	1	1	HUANG, VINCENT J MD	8/2/2024	207R00000X	NA	Other	026	PHYSICIANS	None	41	Internal Medicine	0	In state provider	None	2025 MORSE AVE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
284569	Fee-for-Service	1609886605	1609886605	1	1	HACKETT, LAURA A MD	10/16/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	69866	08	Family Practice	0	In state provider	None	2001 4TH AVE	None	SAN DIEGO	CA	92101	2303	37	06073	32.72663119	-117.1611714	San Diego County
284591	Fee-for-Service	1194007906	1194007906	1	1	HI DESERT EMERGENCY	1/1/2012	207P00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	PHYSICIANS INC	6601 WHITE FEATHER RD	None	JOSHUA TREE	CA	92252	6607	36	06071	34.13189479	-116.2767026	San Bernardino County
284617	Fee-for-Service	1447896519	1447896519	1	1	HOME HEALTH 101 INC	11/13/2020	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	3357 CAHUENGA BLVD	SUITE 26	LOS ANGELES	CA	90068	1327	19	06037	34.13130457	-118.3515446	Los Angeles County
284621	Fee-for-Service	1972703213	1972703213	1	2	HAR, DELEE K MD	5/16/2017	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	109516	40	Pediatrics	0	In state provider	None	13425 SOUSA LANE	None	SARATOGA	CA	95070	4637	43	06085	37.27266037	-121.9961313	Santa Clara County
284636	Fee-for-Service	1508918574	1508918574	1	1	HUYNH, THAILAI T MD	12/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	95111	38	Geriatrics	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
284653	Fee-for-Service	1487692679	1487692679	1	1	HSU, CAROL MD	9/30/1990	207P00000X	NA	Other	026	PHYSICIANS	70097	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	19	06037	34.02861627	-118.273964	Los Angeles County
284657	Fee-for-Service	1821165630	1821165630	1	1	HAN, MYAT M MD	9/9/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	81999	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
284682	Fee-for-Service	1578513610	1578513610	1	1	HAGOPIAN-DRESSER, LAURIE MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	6977	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
284684	Fee-for-Service	1275037202	1275037202	1	1	HUANG, TIFFANY L MD	5/31/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	178790	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
284802	Fee-for-Service	1558400051	1558400051	1	1	HARGROVE, JENNY R MD	6/6/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	87959	66	Emergency Medicine (Urgent Care)	0	In state provider	None	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	36	06071	34.049547	-117.264078	San Bernardino County
284804	Fee-for-Service	1508918574	1508918574	1	1	HUYNH, THAILAI T MD	12/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	95111	41	Internal Medicine	0	In state provider	None	7373 WEST LANE	None	STOCKTON	CA	95210	3377	39	06077	38.017701	-121.297869	San Joaquin County
284840	Fee-for-Service	1205271335	1205271335	1	1	HUYNH, UYEN-CHI N MD	8/15/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	138368	41	Internal Medicine	0	In state provider	None	1220 ROSSMOOR PARKWAY	None	WALNUT CREEK	CA	94595	2501	07	06013	37.87825259	-122.0703705	Contra Costa County
284892	Fee-for-Service	1831209394	1831209394	1	1	HYSELL, STEVEN E MD	8/24/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	72897	14	Neurological Surgery	0	In state provider	None	445 S CEDAR AVE	None	FRESNO	CA	93702	2907	10	06019	36.7382512	-119.7543688	Fresno County
284975	Fee-for-Service	1285413641	1285413641	1	1	HEAVENLY PATH INC.	4/4/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	110 MONTCLAIR ST	206	BAKERSFIELD	CA	93309	3100	15	06029	35.35373011	-119.0546591	Kern County
284993	Fee-for-Service	1528321650	1528321650	1	1	HUDSON, JESSICA L MD	10/18/2023	208G00000X	NA	General Surgery	026	PHYSICIANS	191268	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
285008	Fee-for-Service	1285782151	1285782151	1	1	HERNANDEZ, RALPH C MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42207	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
285047	Fee-for-Service	1710308655	1710308655	1	1	HOSPICE OF THE SOUTH COAST	11/19/2015	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	LLC	5675 RUFFIN ROAD	STE 130	SAN DIEGO	CA	92123	1362	37	06073	32.83743314	-117.1267383	San Diego County
285087	Fee-for-Service	1104822758	1104822758	1	1	HOLLANDER, JOHN D DPM	5/6/2010	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	990 SONOMA AVE	STE 18	SANTA ROSA	CA	95404	4813	49	06097	38.439729	-122.701545	Sonoma County
285129	Fee-for-Service	1366755662	1366755662	1	1	HADAVI, REZA	2/5/2019	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	190 SIERRA COURT	SUITE C4	PALMDALE	CA	93550	7607	19	06037	34.64013337	-118.1280539	Los Angeles County
285155	Fee-for-Service	1861636763	1861636763	1	1	HSU, ALAN J MD	1/26/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133160	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
285170	Fee-for-Service	1285782151	1285782151	1	1	HERNANDEZ, RALPH C MD	12/1/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	42207	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
285171	Fee-for-Service	1841398005	1841398005	1	1	HOMANS, JAMES D MD	11/1/1994	No Taxonomy Provided	NA	None	026	PHYSICIANS	46434	01	General Practice	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
285193	Fee-for-Service	1568578482	1568578482	1	1	HAWKYNS, STEPHEN F MD	5/6/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	2735 SILVER CREEK RD	None	BULLHEAD CITY	AZ	86442	7942	00	None	35.110926	-114.5552445	Mohave County
285196	Fee-for-Service	1285097915	1285097915	1	1	HAROUN, PISHOY MD	9/15/2022	207RI0200X	NA	HIV/AIDS/Infectious Disease	026	PHYSICIANS	152706	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
285210	Fee-for-Service	1710308655	1710308655	1	1	HOSPICE OF THE SOUTH COAST	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	LLC	5675 RUFFIN ROAD	STE 130	SAN DIEGO	CA	92123	1362	37	06073	32.83743314	-117.1267383	San Diego County
285213	Fee-for-Service	1932260254	1932260254	1	1	HANNAH, TERRI M RN	6/26/2007	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	874 W MARTIN LUTHER KING	None	LOS ANGELES	CA	90037	1205	19	06037	34.01092167	-118.2898462	Los Angeles County
285240	Fee-for-Service	1043268857	1043268857	1	1	HARNER, BETTINA P MD	6/8/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	71995	13	Neurology (M.D. only)	0	In state provider	None	600 COFFEE RD	None	MODESTO	CA	95355	4201	50	06099	37.653219	-120.975542	Stanislaus County
285266	Fee-for-Service	1235168576	1235168576	1	1	HSIEH, SUSAN MD	7/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	74710	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
285286	Fee-for-Service	1891992319	1891992319	1	1	HUI, CHRISTINA MOW-KAY MD	10/11/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	101410	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
285288	Fee-for-Service	1487690194	1487690194	1	1	HARRISON, WILLIAM	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	987400 NEBRASKA MED CTR	None	OMAHA	NE	68198	0001	00	None	0	0	None
285312	Fee-for-Service	1699216010	1699216010	1	1	HENNEIN, LAUREN M MD	9/23/2022	207W00000X	NA	Ophthalmology	026	PHYSICIANS	157975	None	None	0	In state provider	None	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	37	06073	32.80027449	-117.153846	San Diego County
285355	Fee-for-Service	1235345760	1235345760	1	1	HASAN, ZEENAT R MD	11/21/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	121972	None	None	0	In state provider	None	863 N DOUGLAS STREET	#100	EL SEGUNDO	CA	90245	2081	19	06037	33.92830583	-118.3831669	Los Angeles County
285386	Fee-for-Service	1821063439	1821063439	1	1	HERZOG, JOSHUA P MD	11/28/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	128025	20	Orthopedic Surgery	0	In state provider	None	200 MISSION BLVD	None	JACKSON	CA	95642	2564	03	06005	38.35007723	-120.7659932	Amador County
285425	Fee-for-Service	1467473330	1467473330	1	1	HARAN, PANCHAPAKESAN P	3/3/2021	207L00000X	NA	Other	026	PHYSICIANS	170830	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
285522	Fee-for-Service	1073576765	1073576765	1	1	HIRMENDI, MAHWASH MD	6/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	77107	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
285668	Fee-for-Service	1164893038	1164893038	1	1	HERNANDEZ, RAYMOND	1/20/2025	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	400 S FARRELL DR	STE B210	PALM SPRINGS	CA	92262	7933	33	06065	33.81787498	-116.5180068	Riverside County
285671	Fee-for-Service	1740585520	1740585520	1	1	HAAS, ALEXANDRA P MFT	2/23/2018	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	103861	-	NOT APPLICABLE	0	In state provider	None	1001 POTRERO AVE	WARD 93/95	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
285734	Fee-for-Service	1831179704	1831179704	1	1	HANSMAN, MATTHEW F MD	12/1/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	83396	02	General Surgery	0	In state provider	None	2025 SOQUEL AVE	None	SANTA CRUZ	CA	95062	1323	44	06087	36.98191238	-121.9975767	Santa Cruz County
285739	Fee-for-Service	1861841801	1861841801	1	1	HOLMES, AUSTIN MD	12/1/2023	2086S0129X	NA	General Surgery	026	PHYSICIANS	164773	None	None	0	In state provider	None	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	34	06067	38.556288	-121.458474	Sacramento County
285780	Fee-for-Service	1164594909	1164594909	1	1	HSIEH, FRANK T MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85688	68	Hematology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
285782	Fee-for-Service	1912392291	1912392291	1	1	HOLLAND, DANIELLE L MD	7/27/2021	207L00000X	NA	Other	026	PHYSICIANS	146495	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
285807	Fee-for-Service	1396107249	1396107249	1	1	HEALTH CARE PIONEERS	4/19/2016	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	72780 COUNTRY CLUB DR	STE 403	RANCHO MIRAGE	CA	92270	4149	33	06065	33.75795596	-116.392246	Riverside County
285815	Fee-for-Service	1568490548	1568490548	1	1	HOWENSTINE,SABRINA V. MD	4/28/2006	No Taxonomy Provided	NA	None	026	PHYSICIANS	90099	40	Pediatrics	0	In state provider	None	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	19	06037	34.06373445	-118.443537	Los Angeles County
285824	Fee-for-Service	1750911228	1750911228	1	3	HHL CARE CORPORATION	11/10/2022	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	22935 HAPPY HOLLOW RD	None	DIAMOND BAR	CA	91765	1018	19	06037	34.03088425	-117.8137264	Los Angeles County
285831	Fee-for-Service	1710389549	1710389549	1	1	HIGGINS, JOEL S CRNA	1/13/2015	No Taxonomy Provided	NA	None	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	450 GREENFIELD AVE	None	HANFORD	CA	93230	3513	16	06031	36.328968	-119.6582195	Kings County
285837	Fee-for-Service	1417577446	1417577446	1	1	HSU, CHAO-JUNG PT	6/22/2021	225100000X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1359 PARK AVE	None	ALAMEDA	CA	94501	4511	01	06001	37.76329307	-122.2420565	Alameda County
285859	Fee-for-Service	1235512757	1235512757	1	1	HUI, BING H MD	3/29/2022	207P00000X	NA	Other	026	PHYSICIANS	167626	None	None	0	In state provider	None	3751 KATELLA AVE	None	LOS ALAMITOS	CA	90720	3113	30	06059	33.80318353	-118.0666665	Orange County
285880	Fee-for-Service	1669976270	1669976270	1	1	HILDEBRANDT, ERIN M NP	12/27/2024	363LP0200X	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
285933	Fee-for-Service	1164594909	1164594909	1	1	HSIEH, FRANK T MD	8/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	85688	78	Neoplastic Diseases/Oncology	0	In state provider	None	1001 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	31	06061	38.72845186	-121.2904134	Placer County
285938	Fee-for-Service	1366099186	1366099186	2	1	HEALTHY CARE RX INC	9/12/2024	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	6405 VAN NUYS BLVD	None	VAN NUYS	CA	91401	1437	19	06037	34.186905	-118.448767	Los Angeles County
285941	Fee-for-Service	1568728996	1568728996	1	1	HARTMAN, GAVIN H MD	10/19/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	126555	05	Anesthesiology	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
285954	Fee-for-Service	1679527386	1679527386	1	1	HAYAKAWA, BRENDA N MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63803	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
285968	Fee-for-Service	1326154196	1326154196	1	1	HUMBOLDT RADIOLOGY MEDICAL	1/1/1979	No Taxonomy Provided	NA	None	022	PHYSICIANS GROUP	-	30	Radiology	0	In state provider	GROUP INC	2330 BUHNE ST	None	EUREKA	CA	95501	3237	12	06023	40.78589338	-124.1424621	Humboldt County
285984	Fee-for-Service	1164614715	1164614715	1	1	HILL, BRUCE RICHARD	9/4/2007	164X00000X	NA	Other	057	EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT SUPPLEMENTAL SERVICES PROVIDER	-	None	None	0	In state provider	None	1229 PALOMINO RD	None	FALLBROOK	CA	92028	4243	37	06073	33.36539874	-117.2333745	San Diego County
285996	Fee-for-Service	1255408092	1255408092	1	1	HICKMAN, GAYLE D NP	12/2/2013	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	11911 CENTRAL AVE	None	CHINO	CA	91710	1906	36	06071	34.03704117	-117.6893971	San Bernardino County
286001	Fee-for-Service	1225633167	1225633167	1	1	HUIZAR, ESMERALDA M LCSW	7/20/2021	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
286003	Fee-for-Service	1164765046	1164765046	1	1	HERNANDEZ, CRISTINA T MD	9/19/2019	207P00000X	NA	Other	026	PHYSICIANS	161241	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
286015	Fee-for-Service	1912386210	1912386210	1	1	HAJIZADEH BARFJANI, SANAZ M	5/25/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	151355	08	Family Practice	0	In state provider	D	1650 RESPONSE ROAD	None	SACRAMENTO	CA	95815	4807	34	06067	38.596581	-121.4303535	Sacramento County
286035	Fee-for-Service	1114580156	1114580156	1	1	HOYT, NATHAN M MD	7/1/2023	2084P0800X	NA	Psychiatry	026	PHYSICIANS	177852	None	None	0	In state provider	None	1686 BARTON ROAD	None	REDLANDS	CA	92373	7761	36	06071	34.04833901	-117.2120103	San Bernardino County
286041	Fee-for-Service	1427527845	1427527845	1	1	HU, JIONG CCC-A	12/22/2021	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	NOT APPLICABLE	0	In state provider	None	155 5TH STREET	SUITE 250	SAN FRANCISCO	CA	94103	2919	38	06075	37.78207387	-122.405581	San Francisco County
286073	Fee-for-Service	1528440708	1528440708	1	1	HOYT-AUSTIN, ADRIENNE DO	7/15/2019	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	17113	40	Pediatrics	0	In state provider	None	2521 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2207	34	06067	38.55204	-121.455387	Sacramento County
286081	Fee-for-Service	1063406080	1063406080	1	1	HODGENS, DAVID W MD	2/28/1982	174400000X	NA	Other	026	PHYSICIANS	38589	66	Emergency Medicine (Urgent Care)	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
286086	Fee-for-Service	1275682650	1275682650	1	1	HUANG, EDWARD S MD	1/22/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	94260	10	Gastroenterology (M.D. only)	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
286087	Fee-for-Service	1871214726	1871214726	1	1	HARDY, GHISLAIN MD	1/31/2025	207VM0101X	NA	Obstetrics & Gynecology	026	PHYSICIANS	183128	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1524 MCHENRY AVE	SUITES 550, 570	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
286091	Fee-for-Service	1609910959	1609910959	1	1	HANJARI, SHAHRAM Z MD	10/4/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	105774	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
286108	Fee-for-Service	1679527386	1679527386	1	1	HAYAKAWA, BRENDA N MD	8/31/1988	No Taxonomy Provided	NA	None	026	PHYSICIANS	63803	66	Emergency Medicine (Urgent Care)	0	In state provider	None	250 S GRAND AVE	None	GLENDORA	CA	91741	4218	19	06037	34.132842	-117.872523	Los Angeles County
286112	Fee-for-Service	1043881444	1043881444	1	1	HEIDEN, JENNIFER CRNA	2/7/2025	367500000X	NA	Other	018	NURSE ANESTHETISTS	-	None	None	0	In state provider	None	1100 MAGELLAN DR.	None	TEHACHAPI	CA	93561	1380	15	06029	35.14690796	-118.4506925	Kern County
286125	Fee-for-Service	1750629218	1750629218	1	1	HIRSCH, EMILY T LCSW	12/18/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	710 SOUTH BROADWAY	None	WALNUT CREEK	CA	94596	5294	07	06013	37.89702115	-122.0569066	Contra Costa County
286136	Fee-for-Service	1164614715	1164614715	1	1	HILL, BRUCE RICHARD	9/4/2007	164X00000X	NA	Other	067	RVNS INDIVIDUAL NURSE PROVIDERS	-	-	NOT APPLICABLE	0	In state provider	None	1229 PALOMINO RD	None	FALLBROOK	CA	92028	4243	37	06073	33.36539874	-117.2333745	San Diego County
286138	Fee-for-Service	1336670538	1336670538	1	1	HAMILTON, CAMILLE E MD	7/30/2024	2251P0200X	NA	Physical Therapist	026	PHYSICIANS	160337	40	Pediatrics	0	In state provider	None	200 UCLA MEDICAL PLAZA	None	LOS ANGELES	CA	90095	8344	19	06037	34.065126	-118.446237	Los Angeles County
286190	Fee-for-Service	1316964844	1316964844	1	1	HUANG,FRANK F MD	12/1/2000	No Taxonomy Provided	NA	None	026	PHYSICIANS	30640	08	Family Practice	0	In state provider	None	50 E MAIN AVE	STE A	MORGAN HILL	CA	95037	3661	43	06085	37.13087009	-121.6537977	Santa Clara County
286208	Fee-for-Service	1508150913	1508150913	1	1	HOWES, TIMOTHY R MD	7/1/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	66	Emergency Medicine (Urgent Care)	1	Border provider	None	832 WILLOW ST	None	RENO	NV	89434	9641	00	None	39.52468616	-119.8016173	Washoe County
286227	Fee-for-Service	1023591286	1023591286	1	1	HOOGS, HANS K CRNA	1/24/2023	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
286228	Fee-for-Service	1689965980	1689965980	1	1	HEKMAT, DIANA H MD	7/29/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	137258	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
286233	Fee-for-Service	1063406080	1063406080	1	1	HODGENS, DAVID W MD	2/28/1982	174400000X	NA	Other	026	PHYSICIANS	38589	30	Radiology	0	In state provider	None	9888 GENESEE AVE	None	LA JOLLA	CA	92037	1205	37	06073	32.8865608	-117.2250386	San Diego County
286287	Fee-for-Service	1750733655	1750733655	1	1	HEALTHY POINT INC	6/1/2018	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	9200 KEWEN STREET	None	SUN VALLEY	CA	91352	3648	19	06037	34.2367046	-118.3999942	Los Angeles County
286314	Fee-for-Service	1558561043	1558561043	1	1	HOLMES, DENISE E LCSW	1/12/2022	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
286426	Fee-for-Service	1558655472	1558655472	1	1	HAQ, HAROON MD	2/2/2024	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
286490	Fee-for-Service	1134633274	1134633274	1	1	HUBBART, JASON PT	9/10/2019	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
286556	Fee-for-Service	1598305526	1598305526	1	1	HEMMINGS, DONNA A NP	2/8/2025	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
286557	Fee-for-Service	1215193198	1215193198	1	1	HUSTON, RONALD G PHD	8/7/2018	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	13193 CENTRAL AVENUE	SUITE 200	CHINO	CA	91710	4179	36	06071	34.01406506	-117.6891684	San Bernardino County
286597	Fee-for-Service	1669555447	1669555447	1	1	HUDSON, RYAN K DO	10/2/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	9299	08	Family Practice	0	In state provider	None	1111 COLUMBUS ST	STE 1100	BAKERSFIELD	CA	93305	1936	15	06029	35.39744148	-118.9822815	Kern County
286618	Fee-for-Service	1891372462	1891372462	1	1	HARTMAN, ETHAN N MD	9/5/2023	207P00000X	NA	Other	026	PHYSICIANS	186274	None	None	0	In state provider	None	115 MALL DRIVE	None	HANFORD	CA	93230	5786	16	06031	36.32396253	-119.6688834	Kings County
286633	Fee-for-Service	1285291658	1285291658	1	1	HEALTH PATH HOME CARE INC	1/31/2021	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	None	9003 RESEDA BLVD	SUITE 210	NORTHRIDGE	CA	91324	3951	19	06037	34.233885	-118.5360995	Los Angeles County
286649	Fee-for-Service	1114030244	1114030244	1	1	HARKER, SUSAN LEIANN PHD	2/8/2015	103TC0700X	NA	Mental Health Outpatient Services	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5300 ORANGE AVE	STE 226	CYPRESS	CA	90630	2972	30	06059	33.82428852	-118.0396755	Orange County
286672	Fee-for-Service	1881420628	1881420628	1	1	HELLO ORANGE COUNTY INC	9/29/2024	No Taxonomy Provided	NMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	None	236 OAK GLN	236	IRVINE	CA	92618	4703	30	06059	33.66407215	-117.7757833	Orange County
286700	Fee-for-Service	1659452399	1659452399	1	1	HAWLEY, MITCHELL L DPM	10/31/1991	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	2005 COURT ST	STE C	REDDING	CA	96001	1807	45	06089	40.57842204	-122.3936969	Shasta County
286742	Fee-for-Service	1164430773	1164430773	1	1	HOANG, THU-ANH	10/31/1989	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	44972	30	Radiology	0	In state provider	None	3531 FASHION WAY	None	TORRANCE	CA	90503	4807	19	06037	33.8352235	-118.348254	Los Angeles County
286753	Fee-for-Service	1043278179	1043278179	1	1	HUANG, ALISON J MD	7/18/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	86355	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
286929	Fee-for-Service	1083916191	1083916191	1	1	HOAG URGENT CARE-ORANGE INC	7/24/2012	261QU0200X	NA	Other	022	PHYSICIANS GROUP	-	66	Emergency Medicine (Urgent Care)	0	In state provider	None	7630 E CHAPMAN AVE	SUITE B	ORANGE	CA	92869	8534	30	06059	33.79509767	-117.7717717	Orange County
286954	Fee-for-Service	1164849063	1164849063	1	1	HAN, ETHAN Q MD	4/1/2022	207P00000X	NA	Other	026	PHYSICIANS	174843	None	None	0	In state provider	None	7300 MEDICAL CENTER DR.	None	WEST HILLS	CA	91307	1902	19	06037	34.20289797	-118.6294006	Los Angeles County
286982	Fee-for-Service	1063962694	1063962694	1	1	HARVELL, CHRISTINE E R LMFT	9/5/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	245 E OLIVE AVE	STE 400	BURBANK	CA	91502	1214	19	06037	34.18145335	-118.3081834	Los Angeles County
286988	Fee-for-Service	1376257428	1376257428	1	1	HARRIS, BRYANT LCSW	8/12/2024	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
287018	Fee-for-Service	1659778496	1659778496	1	1	HUANG, HSIN YI GRACE MD INC	3/11/2015	207RI0011X	NA	Cardiology/Interventional Cardiology	026	PHYSICIANS	104119	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	207 S SANTA ANITA ST	STE P15	SAN GABRIEL	CA	91776	1165	19	06037	34.10072807	-118.1066296	Los Angeles County
287022	Fee-for-Service	1831182591	1831182591	1	1	HOWELL, SCOTT C DO	1/2/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	9700	01	General 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
287025	Fee-for-Service	1053498147	1053498147	1	1	HORWICH, PERRY J MD	8/16/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	30	Radiology	1	Border provider	None	2020 PALOMINO LN	STE 100	LAS VEGAS	NV	89106	4894	00	None	36.16257648	-115.170696	Clark County
287041	Fee-for-Service	1659706489	1659706489	1	1	HARKRUIZ, ROXANNE	10/11/2023	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	3686 EDINGTON DR	None	RANCHO CORDOVA	CA	95742	7827	34	06067	38.56671	-121.1995575	Sacramento County
287062	Fee-for-Service	1235588351	1235588351	1	1	HARRISON, JON M MD	7/17/2023	208600000X	NA	General Surgery	026	PHYSICIANS	186315	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
287067	Fee-for-Service	1689898363	1689898363	1	2	HANSON, LARA B LCSW	6/11/2018	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1139 N BRAND BLVD	STE A	GLENDALE	CA	91202	3012	19	06037	34.162839	-118.2550895	Los Angeles County
287134	Fee-for-Service	1629312632	1629312632	1	1	HERNANDEZ, HEIDI LMFT	12/6/2024	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
287137	Fee-for-Service	1811173123	1811173123	1	1	HALL CRTCL CARE TRANSPRT	4/8/2008	3416A0800X	NA	Other	038	AIR AMBULANCE TRANSPORTATION SERVICES	-	-	NOT APPLICABLE	0	In state provider	SERVICE INC	1001 21ST ST	None	BAKERSFIELD	CA	93301	4708	15	06029	35.37808032	-119.0132246	Kern County
287155	Fee-for-Service	1245212695	1245212695	1	1	HUGHES, TIMNA L L INC	11/29/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70258	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1000 FOWLER WAY	STE 1B	PLACERVILLE	CA	95667	5738	09	06017	38.72679661	-120.7923668	El Dorado County
287174	Fee-for-Service	1740316355	1740316355	1	1	HALL, REBECCA A 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
287211	Fee-for-Service	1659578706	1659578706	1	1	HAZARD, FLORETTE K MD	8/15/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	86052	None	None	0	In state provider	None	300 PASTEUR DR	None	STANFORD	CA	94305	2200	43	06085	37.43304542	-122.1759654	Santa Clara County
287247	Fee-for-Service	1932737996	1932737996	1	1	HOSTETTER, ISAURE MD	8/12/2023	207R00000X	NA	Other	026	PHYSICIANS	187606	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
287303	Fee-for-Service	1528213782	1528213782	1	1	HERB'S UNITED DRUGS INC	2/3/2009	No Taxonomy Provided	NA	None	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	4948 W PICO BOULEVARD	UNIT B	LOS ANGELES	CA	90019	4228	19	06037	34.04790155	-118.3443429	Los Angeles County
287355	Fee-for-Service	1790182145	1790182145	1	1	HEEREN, NICOLE K LMFT	1/29/2020	101Y00000X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	2940 SUMMIT ST	2D	OAKLAND	CA	94609	3416	01	06001	37.81849213	-122.2647718	Alameda County
287371	Fee-for-Service	1538327713	1538327713	1	1	HOLDEN, AMANDA J MD	4/26/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	109561	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
287382	Fee-for-Service	1154811636	1154811636	1	1	HEDMAN, TERI-LEE LCSW	10/3/2023	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
287485	Fee-for-Service	1063477701	1063477701	1	1	HERMANNS, DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	2301 HOLMES ST	None	KANSAS CITY	MO	64108	2640	00	None	39.08455286	-94.57578107	Jackson County
287557	Fee-for-Service	1497512792	1497512792	1	1	HADIPOUR, REIHANEH PCD	3/4/2024	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	30	06059	0	0	None
287576	Fee-for-Service	1902890957	1902890957	1	1	HABEGGER, JANET D MD	12/12/1981	No Taxonomy Provided	NA	None	026	PHYSICIANS	39656	01	General Practice	0	In state provider	None	1471 N ACACIA AVE	None	REEDLEY	CA	93654	2102	10	06019	36.60940406	-119.4510445	Fresno County
287594	Fee-for-Service	1114248358	1114248358	1	1	HAN, MARIA A MD	2/3/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	124753	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
287595	Fee-for-Service	1366976078	1366976078	1	1	HUERTA, ALISA LMFT	6/12/2023	101YM0800X	NA	Other	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	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
287618	Fee-for-Service	1407240245	1407240245	1	1	HAMILTON, HANNAH L	3/27/2015	No Taxonomy Provided	NA	None	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	2835 CHILDRESS DRIVE	None	ANDERSON	CA	96007	3563	45	06089	40.45498247	-122.2907255	Shasta County
287625	Fee-for-Service	1609915388	1609915388	1	1	HESSELLUND WARNER, KARIN	2/8/2015	225XP0200X	NA	Other	019	OCCUPATIONAL THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	1615 S RANCHO SANTA FE R	STE A	SAN MARCOS	CA	92078	5194	37	06073	33.10654333	-117.225348	San Diego County
287644	Fee-for-Service	1851384218	1851384218	1	1	HETLAND, MARTIN OD	1/4/2024	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	628 CALIFORNIA BLVD	STE B	SAN LUIS OBISPO	CA	93401	2554	40	06079	35.28917428	-120.6578269	San Luis Obispo County
287685	Fee-for-Service	1598118325	1598118325	1	1	HAN DUONG OPTOMETRY INC	4/8/2017	152W00000X	NA	Other	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	630 BLOSSOM HILL RD	20	SAN JOSE	CA	95123	3056	43	06085	37.25049949	-121.84425	Santa Clara County
287721	Fee-for-Service	1134287352	1134287352	1	1	HUDLER, ELIZABETH R MD	11/14/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	78721	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
287738	Fee-for-Service	1447264239	1447264239	1	1	HEMANT D PATEL MD INC	8/12/2011	No Taxonomy Provided	NA	None	026	PHYSICIANS	41383	41	Internal Medicine	0	In state provider	None	2287 MOWRY AVE	STE I	FREMONT	CA	94538	1622	01	06001	37.55664244	-121.9818434	Alameda County
287780	Fee-for-Service	1609235043	1609235043	1	1	HUA, NANCY N L OD	5/9/2016	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	4423 REDONDO BEACH BLVD	None	LAWNDALE	CA	90260	3465	19	06037	33.87395013	-118.3532371	Los Angeles County
287789	Fee-for-Service	1538245329	1538245329	1	1	HOPPE, CAROLYN C MD	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	76000	40	Pediatrics	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
287899	Fee-for-Service	1538245329	1538245329	1	1	HOPPE, CAROLYN C MD	7/1/1996	No Taxonomy Provided	NA	None	026	PHYSICIANS	76000	68	Hematology	0	In state provider	None	747 52ND ST	None	OAKLAND	CA	94609	1809	01	06001	37.83734639	-122.2672128	Alameda County
287940	Fee-for-Service	1225270903	1225270903	1	1	HULBERT, KATHERINE R MD	8/1/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	113586	36	Psychiatry	0	In state provider	None	2060 FAIRMONT DR	None	SAN LEANDRO	CA	94578	1001	01	06001	37.71083326	-122.1208841	Alameda County
288011	Fee-for-Service	1750443438	1750443438	1	1	HAJIAN, HOVSEP	8/31/1994	No Taxonomy Provided	NEMT Provider	None	030	GROUND MEDICAL TRANSPORTATION	-	-	NOT APPLICABLE	0	In state provider	HYE TRANS NON EMERGENCY	269 W ALAMEDA AVE	STE B	BURBANK	CA	91502	2597	19	06037	34.16723083	-118.3075057	Los Angeles County
288045	Fee-for-Service	1417485087	1417485087	1	1	HATAMIYA, NICOLAS S DO	10/26/2020	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	16777	08	Family Practice	0	In state provider	None	1225 15TH ST	2100	SANTA MONICA	CA	90404	1101	19	06037	34.02683888	-118.4870127	Los Angeles County
288056	Fee-for-Service	1962525279	1962525279	1	1	HOPP,LAWRENCE M MD	2/22/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	76028	18	Ophthalmology	0	In state provider	None	8641 WILSHIRE BLVD	STE 312	BEVERLY HILLS	CA	90211	2921	19	06037	34.06614972	-118.3798912	Los Angeles County
288077	Fee-for-Service	1003954942	1003954942	2	1	HANNA, HANAA N MD	5/23/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	52577	40	Pediatrics	0	In state provider	None	887 W 9TH ST	None	SAN PEDRO	CA	90731	3600	19	06037	33.73604049	-118.296558	Los Angeles County
288094	Fee-for-Service	1821016031	1821016031	1	1	HOLDER, MICHAEL G JR MD	4/11/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	40	Pediatrics	1	Border provider	None	3186 SOUTH MARYLAND PKWY	None	LAS VEGAS	NV	89109	2317	00	None	36.132948	-115.136874	Clark County
288151	Fee-for-Service	1871043778	1871043778	1	1	HEIDARI-TROWBRIDGE, NEILOUFA	12/12/2022	101YM0800X	NA	Other	031	PSYCHOLOGISTS	-	None	None	0	In state provider	R F	3900 BROADWAY	None	OAKLAND	CA	94611	5616	01	06001	37.82664697	-122.25721	Alameda County
288157	Fee-for-Service	1235859992	1235859992	1	1	HELLORX PHARMACY CORPORATION	3/7/2023	333600000X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2268 SENTER RD	202	SAN JOSE	CA	95112	2623	43	06085	37.31042313	-121.8500899	Santa Clara County
288176	Fee-for-Service	1417432964	1417432964	1	1	HAYHOE, MEGHAN LMFT	6/22/2020	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	119241	-	NOT APPLICABLE	0	In state provider	None	1200 NORTH MAIN ST	STE 100B, 301, 500	SANTA ANA	CA	92701	3640	30	06059	33.755175	-117.8676195	Orange County
288217	Fee-for-Service	1427636372	1427636372	1	1	HASHMI, FARHAD A MD	7/10/2024	207R00000X	NA	Other	026	PHYSICIANS	None	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
288223	Fee-for-Service	1114969680	1114969680	1	1	HSUE, PRISCILLA Y MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64756	06	Cardiovascular Disease (M.D. only)	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
288232	Fee-for-Service	1245851815	1245851815	1	5	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	845 LARK ELLEN AVE	None	WEST COVINA	CA	91791	1069	19	06037	34.0869951	-117.9166283	Los Angeles County
288312	Fee-for-Service	1437519790	1437519790	1	1	HONEST HEALTH CARE INC	2/18/2019	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	8622 RESEDA BLVD	SUITE 218	NORTHRIDGE	CA	91324	4085	19	06037	34.22719786	-118.5360442	Los Angeles County
288337	Fee-for-Service	1114969680	1114969680	1	1	HSUE, PRISCILLA Y MD	5/1/2002	No Taxonomy Provided	NA	None	026	PHYSICIANS	64756	41	Internal Medicine	0	In state provider	None	1001 POTRERO AVE	RM 5H22	SAN FRANCISCO	CA	94110	3518	38	06075	37.75548534	-122.4065362	San Francisco County
288346	Fee-for-Service	1245851815	1245851815	1	5	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	845 LARK ELLEN AVE	None	WEST COVINA	CA	91791	1069	19	06037	34.0869951	-117.9166283	Los Angeles County
288385	Fee-for-Service	1851952030	1851952030	1	1	HUYNH, KEVIN NP	7/30/2021	363LA2100X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
288427	Fee-for-Service	1437519790	1437519790	1	1	HONEST HEALTH CARE INC	2/18/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	8622 RESEDA BLVD	SUITE 218	NORTHRIDGE	CA	91324	4085	19	06037	34.22719786	-118.5360442	Los Angeles County
288532	Fee-for-Service	1427189232	1427189232	1	2	HESSELBROCK, CHRISTINA	8/6/2022	No Taxonomy Provided	NA	None	087	LICENSED PROFESSIONALS	24680	-	NOT APPLICABLE	0	In state provider	None	320 E PALMDALE BLVD	None	PALMDALE	CA	93550	4598	19	06037	34.57983613	-118.1240079	Los Angeles County
288538	Fee-for-Service	1013346246	1013346246	1	1	HUNG, ALEX W LAC	10/24/2018	171100000X	NA	Other	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	18369 COLIMA RD	None	ROWLAND HEIGHTS	CA	91748	2762	19	06037	33.98851142	-117.9049538	Los Angeles County
288557	Fee-for-Service	1437782398	1437782398	1	1	HA SON NGUYEN MD	5/5/2020	207T00000X	NA	General Surgery	026	PHYSICIANS	None	None	None	0	In state provider	None	227 W JANSS RD	125	THOUSAND OAKS	CA	91360	1856	56	06111	34.20611691	-118.883861	Ventura County
288568	Fee-for-Service	1538630165	1538630165	1	1	HAWLEY, ALEXANDER P RCP	10/28/2022	227900000X	NA	Other	056	RESPIRATORY CARE PRACTITIONER	-	-	NOT APPLICABLE	0	In state provider	None	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
288644	Fee-for-Service	1205038171	1205038171	1	1	HOUSEMAN, BENJAMIN T MD	8/23/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	88968	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
288737	Fee-for-Service	1093981714	1093981714	1	1	HUANG, THOMAS T-I MD	8/18/2009	No Taxonomy Provided	NA	None	026	PHYSICIANS	108460	10	Gastroenterology (M.D. only)	0	In state provider	None	1600 EUREKA ROAD	None	ROSEVILLE	CA	95661	3027	31	06061	38.746836	-121.250529	Placer County
288738	Fee-for-Service	1851322010	1851322010	1	1	HIGH DESERT VALLEY PED	11/12/1985	208000000X	NA	Pediatric Primary Care	022	PHYSICIANS GROUP	-	40	Pediatrics	0	In state provider	MEDICAL GROUP, INC	18270 SISKIYOU RD	STE B	APPLE VALLEY	CA	92307	1413	36	06071	34.54450348	-117.265221	San Bernardino County
288766	Fee-for-Service	1316301807	1316301807	1	1	HULTMAN, LUCAS DPM	1/14/2022	213ES0103X	NA	Other	027	PODIATRISTS	-	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
288803	Fee-for-Service	1245250976	1245250976	1	1	HAGEN, JENNIFER M MD FAAP	2/24/2021	207RG0300X	NA	Adult Primary Care	026	PHYSICIANS	-	None	None	1	Border provider	None	1155 MILL ST	None	RENO	NV	89502	1576	00	None	39.52483792	-119.7968314	Washoe County
288867	Fee-for-Service	1023473709	1023473709	1	1	HEINEN, GREGORY T MD INC	5/2/2016	207X00000X	NA	Orthopedic Surgery	026	PHYSICIANS	81061	None	None	0	In state provider	None	301 W HUNTINGTON DR	SUITE 617	ARCADIA	CA	91007	3462	19	06037	34.13481053	-118.0425638	Los Angeles County
288869	Fee-for-Service	1114006665	1114006665	2	1	HEADLEY, MARY P NP	2/17/2016	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	16412 LOS GATOS BLVD	None	LOS GATOS	CA	95030	5525	43	06085	37.23046706	-121.9654506	Santa Clara County
288964	Fee-for-Service	1104910744	1104910744	1	1	HERRERA, MICHAEL A	11/30/1993	No Taxonomy Provided	NA	None	026	PHYSICIANS	6617	66	Emergency Medicine (Urgent Care)	0	In state provider	None	500 W HOSPITAL RD	None	FRENCH CAMP	CA	95231	0000	39	06077	37.88652418	-121.2820956	San Joaquin County
288974	Fee-for-Service	1932123965	1932123965	1	1	HOLLAND, GARY MD	7/31/1992	207W00000X	NA	Ophthalmology	026	PHYSICIANS	43637	18	Ophthalmology	0	In state provider	None	200 STEIN PLAZA RM 1-340	None	LOS ANGELES	CA	90024	0000	19	06037	34.06482757	-118.4443441	Los Angeles County
288986	Fee-for-Service	1396486320	1396486320	1	1	HAGENS, THEODORE MD	10/11/2024	2085R0202X	NA	Mammography/MRI Provider	026	PHYSICIANS	190927	30	Radiology	0	In state provider	None	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	19	06037	34.09813032	-118.2901794	Los Angeles County
289001	Fee-for-Service	1154680593	1154680593	1	1	HARMON, LIV K MD	1/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	149975	02	General Surgery	0	In state provider	None	280 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	43	06085	37.23931375	-121.8014189	Santa Clara County
289004	Fee-for-Service	1285023341	1285023341	1	1	HALLAM, KURTIS PT	2/9/2021	2251X0800X	NA	Physical Therapist	025	PHYSICAL THERAPISTS	-	None	None	0	In state provider	None	1535 RIVER PARK DR	STE 1000	SACRAMENTO	CA	95815	4601	34	06067	38.600334	-121.4361675	Sacramento County
289026	Fee-for-Service	1235714338	1235714338	1	1	HAYES, MARY L CMF	2/22/2022	224900000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	S	1130 W MURRAY AVE	None	VISALIA	CA	93291	4718	54	06107	36.333954	-119.304036	Tulare County
289047	Fee-for-Service	1982088993	1982088993	1	1	HUH, JIN Y NP	11/6/2018	No Taxonomy Provided	NA	None	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	39500 LIBERTY STREET	None	FREMONT	CA	94538	2211	01	06001	37.54845774	-121.9773463	Alameda County
289080	Fee-for-Service	1639335110	1639335110	1	1	HAN, SUKGU M MD	10/6/2008	No Taxonomy Provided	NA	None	026	PHYSICIANS	98415	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
289085	Fee-for-Service	1568427656	1568427656	1	1	HAYES, DON	6/8/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	-	29	Pulmonary Diseases (M.D. only)	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
289096	Fee-for-Service	1326295452	1326295452	1	1	HADADIAN, SEDI MD	1/25/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	102620	15	Obstetrics (D.O. only)	0	In state provider	None	191 SOUTH BUENA VISTA ST	STE 475	BURBANK	CA	91505	4554	19	06037	34.15872557	-118.3283863	Los Angeles County
289103	Fee-for-Service	1558642736	1558642736	1	1	HARRISON, ADAM T LCSW	11/21/2016	No Taxonomy Provided	NA	None	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
289104	Fee-for-Service	1376959775	1376959775	1	1	HEALTHY LIVING AT HOME	10/24/2015	No Taxonomy Provided	NA	None	014	HOME HEALTH AGENCIES	-	-	NOT APPLICABLE	0	In state provider	MODESTO LLC	3600 SISK RD	STE C	MODESTO	CA	95356	0585	50	06099	37.69033236	-121.0612655	Stanislaus County
289139	Fee-for-Service	1841214244	1841214244	1	1	HORNEY, DEBRA A MD	9/1/1984	207N00000X	NA	Dermatology	026	PHYSICIANS	41545	07	Dermatology	0	In state provider	None	2601 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2210	34	06067	38.551311	-121.454433	Sacramento County
289142	Fee-for-Service	1023109873	1023109873	3	1	HALL, LYNOUS W MD	1/27/2020	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	35906	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	301 BRUNDAGE LN	None	BAKERSFIELD	CA	93304	3248	15	06029	35.35386839	-119.0055269	Kern County
289186	Fee-for-Service	1568427656	1568427656	1	1	HAYES, DON	6/8/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	-	41	Internal Medicine	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
289193	Fee-for-Service	1902907041	1902907041	1	1	HOPE HOSPICE	9/20/1994	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	6377 CLARK AVE	SUITE 100	DUBLIN	CA	94568	3024	01	06001	37.70390357	-121.9209435	Alameda County
289208	Fee-for-Service	1013449065	1013449065	1	1	HUMPHREYS, CAROLINE H MD	3/19/2021	207P00000X	NA	Other	026	PHYSICIANS	160956	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
289214	Fee-for-Service	1770946089	1770946089	1	1	HUO, MAE X MD	2/1/2024	208000000X	NA	Pediatric Primary Care	026	PHYSICIANS	None	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
289226	Fee-for-Service	1801381447	1801381447	1	1	HOLDREN, AMBER PHD	2/24/2025	103T00000X	NA	Mental Health Outpatient Services	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
289238	Fee-for-Service	1003103805	1003103805	1	1	HAJAR, RABAB E MD	11/23/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	133570	None	None	0	In state provider	None	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	34	06067	38.602089	-121.3925895	Sacramento County
289278	Fee-for-Service	1710995972	1710995972	1	1	HEENEY,DAVID MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	None	None	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	221 MAHALANI STREET	None	HONOLULU	HI	96793	0000	00	None	20.88554026	-156.4902142	Maui County
289283	Fee-for-Service	1568427656	1568427656	1	1	HAYES, DON	6/8/2023	2080P0214X	NA	Pulmonology	026	PHYSICIANS	-	40	Pediatrics	2	Out of state provider	None	3333 BURNET AVENUE	None	CINCINNATI	OH	45229	3039	00	None	39.14105892	-84.50040782	Hamilton County
289291	Fee-for-Service	1902907041	1902907041	1	1	HOPE HOSPICE	1/1/2019	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	6377 CLARK AVE	SUITE 100	DUBLIN	CA	94568	3024	01	06001	37.70390357	-121.9209435	Alameda County
289296	Fee-for-Service	1144343112	1144343112	1	1	HOOK, ESTEE M PT	3/22/2011	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
289336	Fee-for-Service	1013748938	1013748938	1	1	HOWARD, JANISHA DOULA	11/25/2024	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	33	06065	0	0	None
289360	Fee-for-Service	1427143270	1427143270	1	1	HERRERA, ALICIA MD	5/1/2007	No Taxonomy Provided	NA	None	026	PHYSICIANS	79328	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
289390	Fee-for-Service	1306858204	1306858204	1	1	HILCHEY, SEAN D MD	7/13/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	78388	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
289402	Fee-for-Service	1750911228	1750911228	1	1	HHL CARE CORPORATION	2/3/2020	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	None	23801 SAPPHIRE CANYON RD	None	DIAMOND BAR	CA	91765	1139	19	06037	34.0356599	-117.802	Los Angeles County
289411	Fee-for-Service	1023444379	1023444379	1	1	HOSSEINI, CHEYENNE R LCSW	1/31/2022	1041C0700X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1492 W 6TH ST	J	CORONA	CA	92882	6529	33	06065	33.87831466	-117.593974	Riverside County
289480	Fee-for-Service	1134122880	1134122880	1	1	HAGAN, JAMES M DPM	5/30/2012	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	175 PARK ST	None	LAKEPORT	CA	95453	4803	17	06033	39.04282879	-122.9140827	Lake County
289487	Fee-for-Service	1689645004	1689645004	1	1	HOSPITAL OF MORRISTOWN INC	12/29/2015	282N00000X	NA	Hospitals	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	726 MACFARLAND STREET	None	MORRISTOWN	TN	37814	3989	00	None	36.21458574	-83.30427311	Hamblen County
289539	Fee-for-Service	1376924910	1376924910	1	1	HERRERA, SOFIA LCSW	10/6/2023	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
289541	Fee-for-Service	1235691767	1235691767	1	1	HUBBARD PHARMACY INC	4/29/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	None	2012 GLENOAKS BLVD	None	SAN FERNANDO	CA	91340	1625	19	06037	34.29818276	-118.4378281	Los Angeles County
289567	Fee-for-Service	1952861494	1952861494	1	1	HARDIN, JEREMY R MD	6/7/2022	207P00000X	NA	Other	026	PHYSICIANS	176958	None	None	0	In state provider	None	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	37	06073	33.02257788	-117.0856332	San Diego County
289571	Fee-for-Service	1689645004	1689645004	1	1	HOSPITAL OF MORRISTOWN INC	12/29/2015	282N00000X	NA	Hospitals	016	COMMUNITY INPATIENT HOSPITAL	-	-	NOT APPLICABLE	2	Out of state provider	None	726 MACFARLAND STREET	None	MORRISTOWN	TN	37814	3989	00	None	36.21458574	-83.30427311	Hamblen County
289581	Fee-for-Service	1548373202	1548373202	1	1	HOOD, DREW D MD	6/30/1992	No Taxonomy Provided	NA	None	026	PHYSICIANS	57791	66	Emergency Medicine (Urgent Care)	0	In state provider	None	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	52	06103	40.14847323	-122.2180997	Tehama County
289586	Fee-for-Service	1164423851	1164423851	1	1	HUANG, ROBERT CHEN MD	7/21/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	83818	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
289605	Fee-for-Service	1083995856	1083995856	1	1	HAN, HOPE PT	1/17/2022	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
289607	Fee-for-Service	1932721487	1932721487	1	1	HILLMAN, GRETCHEN M CNP	11/13/2023	363L00000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	2280 HARRISON AVE	STE K	EUREKA	CA	95501	3200	12	06023	40.78745765	-124.1396643	Humboldt County
289624	Fee-for-Service	1255920773	1255920773	1	1	HEARTFUL HOSPICE CARE, INC	1/13/2022	No Taxonomy Provided	NA	None	039	CERTIFIED HOSPICE	-	-	NOT APPLICABLE	0	In state provider	None	2500 E FOOTHILL BLVD	STE 206	PASADENA	CA	91107	3460	19	06037	34.14979547	-118.097982	Los Angeles County
289703	Fee-for-Service	1255920773	1255920773	1	1	HEARTFUL HOSPICE CARE, INC	1/13/2022	No Taxonomy Provided	NA	None	105	HOSPICE PROVIDERS FOR PALLIATIVE CARE SERVICES	-	-	NOT APPLICABLE	0	In state provider	None	2500 E FOOTHILL BLVD	STE 206	PASADENA	CA	91107	3460	19	06037	34.14979547	-118.097982	Los Angeles County
289715	Fee-for-Service	1871712737	1871712737	1	1	HAMILTON AVE MED GRP INC	1/1/1979	207R00000X	NA	Other	022	PHYSICIANS GROUP	-	None	None	0	In state provider	None	295 OCONNOR DR	None	SAN JOSE	CA	95128	1624	43	06085	37.32556245	-121.9398958	Santa Clara County
289800	Fee-for-Service	1194749549	1194749549	2	1	HOME RELATED SERVICES INC	2/27/2012	No Taxonomy Provided	NA	None	028	PORTABLE X-RAY	-	-	NOT APPLICABLE	0	In state provider	None	914 N GLENDALE AVE	None	GLENDALE	CA	91206	2129	19	06037	34.15930258	-118.2393182	Los Angeles County
289810	Fee-for-Service	1275974552	1275974552	1	1	HADDAD, FADI A DO	5/22/2018	No Taxonomy Provided	NA	None	026	PHYSICIANS	15567	05	Anesthesiology	0	In state provider	None	147 N BRENT STREET	None	VENTURA	CA	93003	2809	56	06111	34.2746295	-119.2573399	Ventura County
289914	Fee-for-Service	1154466928	1154466928	1	1	HOPE HOUSE FOR THE MULTIPLE	4/13/1992	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	5121 BUFFINGTON RD	None	EL MONTE	CA	91732	1431	19	06037	34.09443755	-118.0081442	Los Angeles County
289919	Fee-for-Service	1811171382	1811171382	1	1	HOH, DANIEL K MD	7/10/2008	207P00000X	NA	Other	026	PHYSICIANS	99870	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1191 PHELPS AVE	None	COALINGA	CA	93210	9609	10	06019	36.15152163	-120.340676	Fresno County
289939	Fee-for-Service	1427189232	1427189232	1	1	HESSELBROCK, CHRISTINA L	3/16/2015	No Taxonomy Provided	NA	None	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	LCSW	28245 AVENUE CROCKER	SUITE 220	VALENCIA	CA	91355	1201	19	06037	34.43823766	-118.588305	Los Angeles County
290003	Fee-for-Service	1073639761	1073639761	1	1	HOVENIC, THOMAS A MD	11/27/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	-	77	Infectious Disease	1	Border provider	None	75 PRINGLE WAY	STE 705	RENO	NV	89502	1472	00	None	39.52621891	-119.7944075	Washoe County
290011	Fee-for-Service	1649282849	1649282849	1	1	HEINLE, ERIN C MD	8/15/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	89841	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
290037	Fee-for-Service	1245851815	1245851815	1	6	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	14148 FRANCISQUITO AVE	None	BALDWIN PARK	CA	91706	6120	19	06037	34.06339562	-117.9671298	Los Angeles County
290099	Fee-for-Service	1245851815	1245851815	1	6	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	14148 FRANCISQUITO AVE	None	BALDWIN PARK	CA	91706	6120	19	06037	34.06339562	-117.9671298	Los Angeles County
290162	Fee-for-Service	1003890773	1003890773	1	1	HELLER, BEATE DC	7/13/2020	111N00000X	NA	Other	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	LTH	8840 WARNER AVE	SUITE 100	FOUNTAIN VALLEY	CA	92708	3232	30	06059	33.71570241	-117.9745591	Orange County
290170	Fee-for-Service	1821417791	1821417791	1	1	HADAYA, IMAN A MD	1/8/2019	207L00000X	NA	Other	026	PHYSICIANS	132438	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
290181	Fee-for-Service	1497833305	1497833305	1	1	HARDIMAN, ROBIN C MD	9/18/2003	No Taxonomy Provided	NA	None	026	PHYSICIANS	86904	24	Plastic Surgery	0	In state provider	None	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	10	06019	36.84133078	-119.7824983	Fresno County
290184	Fee-for-Service	1851737738	1851737738	1	1	HARUTUNIAN, GRIGOR M MD INC	11/12/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	111421	13	Neurology (M.D. only)	0	In state provider	None	1215 S CENTRAL AVE	None	GLENDALE	CA	91204	2503	19	06037	34.131618	-118.2578475	Los Angeles County
290189	Fee-for-Service	1154471092	1154471092	1	1	HOU, MELODY Y MD	8/1/2012	No Taxonomy Provided	NA	None	026	PHYSICIANS	120768	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	4860 Y STREET	None	SACRAMENTO	CA	95817	2307	34	06067	38.552211	-121.449429	Sacramento County
290207	Fee-for-Service	1316973316	1316973316	1	1	HATCH, KATHERINE A PHD	2/8/2015	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	2955 SHATTUCK AVE	STE 7	BERKELEY	CA	94705	1808	01	06001	37.85574785	-122.2665517	Alameda County
290231	Fee-for-Service	1881022754	1881022754	1	1	HASSARD, LORNA LCSW	2/26/2019	104100000X	NA	Mental Health Outpatient Services	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	1524 MCHENRY AVE	SUITE 370	MODESTO	CA	95350	4500	50	06099	37.666233	-120.993933	Stanislaus County
290236	Fee-for-Service	1134798267	1134798267	1	1	HAFTEVANI SOGOMONIAN, EMMA	10/31/2024	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	None	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
290269	Fee-for-Service	1184895989	1184895989	1	1	HUYNH, WALLY C MD	4/6/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	106097	41	Internal Medicine	0	In state provider	None	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6237	54	06107	36.327888	-119.294919	Tulare County
290287	Fee-for-Service	1831199785	1831199785	1	1	HUNTER, DAVID E MD	11/1/2000	207P00000X	NA	Other	026	PHYSICIANS	78447	66	Emergency Medicine (Urgent Care)	0	In state provider	None	350 MINERS TRL	None	GRASS VALLEY	CA	95945	7320	29	06057	39.21015325	-121.0572838	Nevada County
290296	Fee-for-Service	1831120559	1831120559	1	1	HOANG, DIEMHA T MD	2/8/2015	No Taxonomy Provided	NA	None	026	PHYSICIANS	62572	25	Physical Medicine and Rehabilitation	0	In state provider	None	3545 LONG BEACH BLVD	STE 105	LONG BEACH	CA	90807	3964	19	06037	33.82086796	-118.18938	Los Angeles County
290345	Fee-for-Service	1407468150	1407468150	1	1	HEALTHY MIND PSYCHIATRY INC	8/6/2021	2084P0800X	NA	Psychiatry	026	PHYSICIANS	None	None	None	0	In state provider	None	27201 TOURNEY RD	204	SANTA CLARITA	CA	91355	1804	19	06037	34.41741018	-118.5770409	Los Angeles County
290382	Fee-for-Service	1073562096	1073562096	1	1	HELLER, MEREDITH R MD	5/23/2005	No Taxonomy Provided	NA	None	026	PHYSICIANS	85851	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
290384	Fee-for-Service	1104990084	1104990084	1	1	HANGER P & O WEST INC	6/1/1995	335E00000X	NA	Other	029	PROSTHETISTS	-	-	NOT APPLICABLE	0	In state provider	None	1035 S FAIR OAKS AVE	STE 102	PASADENA	CA	91105	2654	19	06037	34.128	-118.1503455	Los Angeles County
290386	Fee-for-Service	1114066230	1114066230	1	1	HU, LUCY G CA	2/8/2015	No Taxonomy Provided	NA	None	032	CERTIFIED ACUPUNCTURIST	-	-	NOT APPLICABLE	0	In state provider	None	1900 LAFAYETTE ST	STE 110	SANTA CLARA	CA	95050	3994	43	06085	37.35959362	-121.9478856	Santa Clara County
290405	Fee-for-Service	1497101794	1497101794	1	1	HAN, PETER S MD	7/1/2021	163WX0601X	NA	Other	026	PHYSICIANS	151704	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
290414	Fee-for-Service	1962587709	1962587709	1	1	HURD, JULIE K OD	1/22/2014	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	20940 BURBANK BLVD	None	WOODLAND HILLS	CA	91365	6701	19	06037	34.1719401	-118.5881418	Los Angeles County
290427	Fee-for-Service	1104052661	1104052661	1	1	HOLMBLAD, KRISTEL B MD	10/17/2016	No Taxonomy Provided	NA	None	026	PHYSICIANS	145173	40	Pediatrics	0	In state provider	None	1524 MCHENRY AVE	STE 570	MODESTO	CA	95350	4574	50	06099	37.666233	-120.993933	Stanislaus County
290442	Fee-for-Service	1083701775	1083701775	1	1	HOLGUIN, FERNANDO MD	10/6/2020	207RC0200X	NA	Other	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
290448	Fee-for-Service	1740784248	1740784248	1	1	HONG, SUK-JOON MD	4/29/2025	No Taxonomy Provided	NA	None	026	PHYSICIANS	166847	40	Pediatrics	0	In state provider	None	3601 S HARBOR BLVD	SUITE 100	SANTA ANA	CA	92704	6924	30	06059	33.698367	-117.9194115	Orange County
290475	Fee-for-Service	1831113836	1831113836	1	1	HUTCHINSON, JOEL L MD	8/1/2001	No Taxonomy Provided	NA	None	026	PHYSICIANS	67551	05	Anesthesiology	0	In state provider	None	999 SAN BERNARDINO RD	None	UPLAND	CA	91786	4920	36	06071	34.1010559	-117.6369445	San Bernardino County
290531	Fee-for-Service	1861561888	1861561888	1	1	HUNNICUTT, ANNA LMFT	11/26/2024	106H00000X	NA	Mental Health Outpatient Services	077	MARRIAGE AND FAMILY THERAPIST 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
290569	Fee-for-Service	1447350566	1447350566	1	1	HORN, ALLAN J MD	8/26/1993	207L00000X	NA	Other	026	PHYSICIANS	47574	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
290590	Fee-for-Service	1720147234	1720147234	1	1	HERRING, PHYLLIS N	3/7/2013	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
290621	Fee-for-Service	1215073259	1215073259	2	1	HALLER'S PHARMACY AND MEDICA	3/1/2020	3336C0003X	NA	Pharmacies	024	PHARMACIES/PHARMACISTS	-	-	NOT APPLICABLE	0	In state provider	L SUPPLY	37323 FREMONT BLVD	None	FREMONT	CA	94536	3702	01	06001	37.55820562	-122.0070406	Alameda County
290638	Fee-for-Service	1720465032	1720465032	1	1	HEFFNER, AARON C DO	11/14/2018	2084P0800X	NA	Psychiatry	026	PHYSICIANS	15107	36	Psychiatry	0	In state provider	None	10800 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3043	33	06065	33.904782	-117.469323	Riverside County
290688	Fee-for-Service	1649807769	1649807769	1	1	HADAEGH, MIAD DO	4/1/2024	208100000X	NA	Physical Medicine and Rehabilitation	026	PHYSICIANS	20890	None	None	0	In state provider	None	1250 16TH STREET	None	SANTA MONICA	CA	90404	1249	19	06037	34.02749142	-118.486063	Los Angeles County
290689	Fee-for-Service	1992845457	1992845457	1	1	HUMBOLDT CO OFC OF EDU	4/8/1996	No Taxonomy Provided	NA	None	055	LOCAL EDUCATION AGENCY	-	-	NOT APPLICABLE	0	In state provider	None	901 MYRTLE AVE	None	EUREKA	CA	95501	1219	12	06023	40.80088276	-124.1502005	Humboldt County
290699	Fee-for-Service	1477820033	1477820033	1	1	HALE, LISA P NP	11/2/2021	363L00000X	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
290720	Fee-for-Service	1992845457	1992845457	1	1	HUMBOLDT CO OFC OF EDU	3/11/2025	No Taxonomy Provided	NA	None	112	CYBHI FEE SCHEDULE	-	-	NOT APPLICABLE	0	In state provider	None	901 MYRTLE AVE	None	EUREKA	CA	95501	1219	12	06023	40.80088276	-124.1502005	Humboldt County
290721	Fee-for-Service	1598338725	1598338725	1	1	HAWTHORNE TERRACE CARE HOME	9/23/2021	No Taxonomy Provided	NA	None	092	RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)	-	-	NOT APPLICABLE	0	In state provider	LLC	4760 W 123RD STREET	None	HAWTHORNE	CA	90250	3606	19	06037	33.92140653	-118.3604175	Los Angeles County
290731	Fee-for-Service	1184947277	1184947277	1	1	HERNANDEZ, MARTHA MD	9/14/2010	No Taxonomy Provided	NA	None	026	PHYSICIANS	107930	40	Pediatrics	0	In state provider	None	901 NEVIN AVENUE	None	RICHMOND	CA	94801	3143	07	06013	37.93684848	-122.361345	Contra Costa County
290748	Fee-for-Service	1215966809	1215966809	2	1	HICKS, PEARLMAN D MD	4/5/2013	No Taxonomy Provided	NA	None	026	PHYSICIANS	39324	24	Plastic Surgery	0	In state provider	None	2360 LONG BEACH BLVD	None	LONG BEACH	CA	90806	3260	19	06037	33.80017044	-118.1892456	Los Angeles County
290749	Fee-for-Service	1245851815	1245851815	1	4	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	08	Family Practice	0	In state provider	None	10841 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	3811	36	06071	34.10467596	-117.5661881	San Bernardino County
290779	Fee-for-Service	1245851815	1245851815	1	4	HASSAN CHAHINE MD INC	2/13/2025	207Q00000X	NA	Adult Primary Care	022	PHYSICIANS GROUP	-	41	Internal Medicine	0	In state provider	None	10841 WHITE OAK AVE	None	RANCHO CUCAMONGA	CA	91730	3811	36	06071	34.10467596	-117.5661881	San Bernardino County
290785	Fee-for-Service	1235543638	1235543638	1	1	HARISH KUMAR, CHINTAN MD	6/23/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	168947	None	None	0	In state provider	None	17762 BEACH BLVD.	220	HUNTINGTON BEACH	CA	92647	6860	30	06059	33.70404013	-117.9890603	Orange County
290821	Fee-for-Service	1861832255	1861832255	1	1	HANSEN, SPENCER MD	7/20/2020	208600000X	NA	General Surgery	026	PHYSICIANS	167495	02	General Surgery	0	In state provider	None	77 CASA ST	STE 103	SAN LUIS OBISPO	CA	93405	5804	40	06079	35.29306786	-120.6650709	San Luis Obispo County
290851	Fee-for-Service	1962587550	1962587550	1	1	HOLLAND, TERRY F DC	2/8/2015	No Taxonomy Provided	NA	None	006	CHIROPRACTORS	-	-	NOT APPLICABLE	0	In state provider	None	37 BRYSON DR	None	SUTTER CREEK	CA	95685	4119	03	06005	38.38265037	-120.8046969	Amador County
290881	Fee-for-Service	1417331182	1417331182	1	1	HO, MELISSA M AU	9/25/2024	231H00000X	NA	Other	003	AUDIOLOGISTS	-	-	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
290905	Fee-for-Service	1912015124	1912015124	1	1	HAIMOWITZ, CARLA E PHD	1/11/2005	No Taxonomy Provided	NA	None	031	PSYCHOLOGISTS	-	None	None	0	In state provider	None	5108 MANILA AVE	None	OAKLAND	CA	94618	1020	01	06001	37.83619091	-122.2549661	Alameda County
290914	Fee-for-Service	1881601177	1881601177	1	1	HALPERIN, GABRIEL J DPM	3/1/2001	No Taxonomy Provided	NA	None	027	PODIATRISTS	-	None	None	0	In state provider	None	3616 E 1ST ST	None	LOS ANGELES	CA	90063	2326	19	06037	34.03597969	-118.1884647	Los Angeles County
290977	Fee-for-Service	1750081840	1750081840	1	1	HEAVENSTONE COUNSELING: LICE	4/3/2023	261QM0850X	NA	Other	103	LICENSED PROFESSIONAL CLINICAL COUNSELOR - INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	NSED PROFESSIONAL CLINIC	1490 N CLAREMONT BLVD	STE 204	CLAREMONT	CA	91711	3519	19	06037	34.11108358	-117.7019894	Los Angeles County
290978	Fee-for-Service	1336679661	1336679661	1	1	HARTUNG, CLAIRE MD	8/10/2018	390200000X	NA	Other	026	PHYSICIANS	157215	None	None	0	In state provider	None	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	07	06013	38.00771973	-122.1331484	Contra Costa County
290985	Fee-for-Service	1952691222	1952691222	1	1	HONG, TINA MD	3/20/2023	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	168242	None	None	0	In state provider	None	2500 MERCED STREET	None	SAN LEANDRO	CA	94577	4201	01	06001	37.706364	-122.165163	Alameda County
291054	Fee-for-Service	1043873185	1043873185	1	1	HAGAN, ANJANI G MD	10/25/2022	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	182248	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
291064	Fee-for-Service	1396011755	1396011755	1	1	HARDING-JACKSON, NICHOLAS M	1/24/2018	207ZP0102X	NA	Other	026	PHYSICIANS	146271	21	Pathologic Anatomy: Clinical Pathology (D.O. only)	0	In state provider	MD	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	19	06037	33.83760674	-118.3572569	Los Angeles County
291069	Fee-for-Service	1497223226	1497223226	1	1	HANALEI HOLDINGS LLC	7/7/2019	No Taxonomy Provided	NA	None	017	LONG TERM CARE FACILITY	-	-	NOT APPLICABLE	0	In state provider	None	521 LOREL WAY	None	YUBA CITY	CA	95991	1913	51	06101	39.15512984	-121.6206491	Sutter County
291088	Fee-for-Service	1215384532	1215384532	1	1	HUA, JENNIFER OD	6/13/2017	No Taxonomy Provided	NA	None	020	OPTOMETRISTS	-	-	NOT APPLICABLE	0	In state provider	None	425 W CENTRAL AVE	STE 102	LOMPOC	CA	93436	2806	42	06083	34.66085568	-120.4617943	Santa Barbara County
291093	Fee-for-Service	1972803666	1972803666	1	1	HU, WANDA D MD	8/25/2014	No Taxonomy Provided	NA	None	026	PHYSICIANS	114751	18	Ophthalmology	0	In state provider	None	3085 LOMA VISTA ROAD	None	VENTURA	CA	93003	2916	56	06111	34.2757721	-119.2550726	Ventura County
291126	Fee-for-Service	1952714222	1952714222	1	1	HANNA, MARIAM G MD	5/20/2024	207V00000X	NA	Obstetrics & Gynecology	026	PHYSICIANS	161441	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
291160	Fee-for-Service	1104021385	1104021385	1	1	HARRIS, CYNTHIA J MFT	8/21/2018	No Taxonomy Provided	NA	None	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	-	-	NOT APPLICABLE	0	In state provider	None	43112 15TH ST W	None	LANCASTER	CA	93534	6219	19	06037	34.66467	-118.1567445	Los Angeles County
291189	Fee-for-Service	1831132133	1831132133	1	1	HACKLEY HOSPITAL	9/17/2007	No Taxonomy Provided	NA	None	015	COMMUNITY OUTPATIENT HOSPITAL	-	-	NOT APPLICABLE	4	Out of state provider - CA-MMIS Fiscal Intermediary (FI)	None	1700 CLINTON ST	None	MUSKEGON	MI	49442	5502	00	None	43.222263	-86.24303973	Muskegon County
291209	Fee-for-Service	1265167241	1265167241	1	1	HOLLAND, ZAKARY J NP	9/30/2022	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	None	None	0	In state provider	None	840 S AKERS ST	None	VISALIA	CA	93277	8309	54	06107	36.322398	-119.3484285	Tulare County
291223	Fee-for-Service	1871856393	1871856393	1	1	HE, LILY CCC-SLP	8/10/2020	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	None	301 9TH STREET	219	REDLANDS	CA	92374	4412	36	06071	34.05825	-117.177229	San Bernardino County
291228	Fee-for-Service	1841876208	1841876208	1	1	HESSELL, BRITTANY DO	9/30/2024	207R00000X	NA	Other	026	PHYSICIANS	20670	41	Internal Medicine	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
291265	Fee-for-Service	1770903320	1770903320	1	1	HE, BO MD	6/25/2019	207XX0801X	NA	Orthopedic Surgery	026	PHYSICIANS	138765	20	Orthopedic Surgery	0	In state provider	None	6620 COYLE AVE	STE 212	CARMICHAEL	CA	95608	6337	34	06067	38.66751	-121.310028	Sacramento County
291313	Fee-for-Service	1588264360	1588264360	1	1	HO, JOCELYN J NP	4/17/2023	363LF0000X	NA	Nurse Practitioner	007	CERTIFIED NURSE PRACTIONER	-	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
291318	Fee-for-Service	1326368572	1326368572	1	1	HANIF, NOAMAN	2/23/2023	207Q00000X	NA	Adult Primary Care	026	PHYSICIANS	111544	None	None	0	In state provider	None	289 WEST HUNTINGTON DRIV	204	ARCADIA	CA	91007	3495	19	06037	34.13549119	-118.0419175	Los Angeles County
291325	Fee-for-Service	1235287053	1235287053	1	1	HARRIS-BUCKNER, LESLIE A	4/20/2004	No Taxonomy Provided	NA	None	026	PHYSICIANS	70266	08	Family Practice	0	In state provider	MD	3733 SAN DIMAS ST	None	BAKERSFIELD	CA	93301	1407	15	06029	35.393499	-119.008257	Kern County
291389	Fee-for-Service	1912089939	1912089939	1	1	HONG, TU-HI MD	1/31/1985	208800000X	NA	Other	026	PHYSICIANS	45761	34	Urology and Urological Surgery	0	In state provider	None	919 E MERRITT AVE	None	TULARE	CA	93274	2221	54	06107	36.2219798	-119.3341671	Tulare County
291417	Fee-for-Service	1417374638	1417374638	1	1	HSU, CHRISTINA G MD	10/31/2017	No Taxonomy Provided	NA	None	026	PHYSICIANS	148189	66	Emergency Medicine (Urgent Care)	0	In state provider	None	1425 S MAIN STREET	None	WALNUT CREEK	CA	94596	5318	07	06013	37.89189148	-122.057999	Contra Costa County
291472	Fee-for-Service	1376187039	1376187039	1	1	HENNESSEY BRUCE, SHANNON K C	10/28/2022	235Z00000X	NA	Other	037	SPEECH THERAPISTS	-	-	NOT APPLICABLE	0	In state provider	CC-SLP	1 QUALITY DRIVE	None	VACAVILLE	CA	95688	9494	48	06095	38.38851772	-121.9382798	Solano County
291475	Fee-for-Service	1801838917	1801838917	1	1	HENRY, DAVID S MD	9/30/1980	No Taxonomy Provided	NA	None	026	PHYSICIANS	39593	16	Obstetrics-Gynecology (M.D. Only) Neonatal	0	In state provider	None	1444 COFFEE RD	None	MODESTO	CA	95355	3105	50	06099	37.66517547	-120.975681	Stanislaus County
291511	Non-Physician Medical Practitioner	None	1184210429	0	0	HAASE, SARAH B PA	8/1/2023	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
291514	Non-Physician Medical Practitioner	None	1215040977	0	0	HERING, FREDERICK J	10/31/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	734 PINE RIDGE AVE	None	MOUNT SHASTA	CA	96067	2024	00	06000	41.32137793	-122.3078385	Siskiyou County
291599	Non-Physician Medical Practitioner	None	1497018220	0	0	HERNANDEZ, LAUREN E PA	6/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	00	06000	34.44509477	-119.7186392	Santa Barbara County
291606	Non-Physician Medical Practitioner	None	1639843212	0	0	HERRERA, JORGE D NP	1/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1680 EAST 120TH ST	None	LOS ANGELES	CA	90059	3026	00	06000	33.92456051	-118.2417525	Los Angeles County
291627	Non-Physician Medical Practitioner	None	1407525140	0	0	HEAPS, SUSAN	11/23/2024	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
291646	Non-Physician Medical Practitioner	None	1083694517	0	0	HAYES-BARTLETT, CHERYL FRANCES	2/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2575 E BIDWELL ST	SUITE 100	FOLSOM	CA	95630	6444	00	06000	38.658888	-121.1303835	Sacramento County
291658	Non-Physician Medical Practitioner	None	1821549569	0	0	HUNTSMAN, CHRISTOPHER J	7/14/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1775 GRAND AVE	None	SANTA BARBARA	CA	93103	0000	00	06000	34.43576696	-119.7045448	Santa Barbara County
291773	Non-Physician Medical Practitioner	None	1013641919	0	0	HWANG, TIFFANY J PA-C	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	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
291797	Non-Physician Medical Practitioner	None	1528450343	0	0	HOOK, KATHRYN B	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	57 TAHOE COURT	APT 7	WALNUT CREEK	CA	94596	4954	00	06000	37.90041339	-122.0525199	Contra Costa County
291804	Non-Physician Medical Practitioner	None	1487600896	0	0	HAVERDINK, BRIAN L	4/1/2011	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
291872	Non-Physician Medical Practitioner	None	1730842980	0	0	HIRA, GAGANDEEP K	5/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	440 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	00	06000	39.13140416	-121.6141951	Sutter County
291958	Non-Physician Medical Practitioner	None	1699970863	0	0	HABER, RAQUEL B	11/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6154 MINES RD	None	LIVERMORE	CA	94550	9182	00	06000	37.63422235	-121.7105641	Alameda County
291993	Non-Physician Medical Practitioner	None	1659902625	0	0	HAYWARD, OLIVIA G PA	10/29/2021	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
292000	Non-Physician Medical Practitioner	None	1699170100	0	0	HAAKENSON, ANNA C 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
292037	Non-Physician Medical Practitioner	None	1487189791	0	0	HARRIS, FELICITY A V	11/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2600 SAN LEANDRO BLVD	1702	SAN LEANDRO	CA	94578	5060	00	06000	37.71314654	-122.1463845	Alameda County
292070	Non-Physician Medical Practitioner	None	1851843288	0	0	HAMAJIMA, YUKO NP	12/31/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	139 MAGNOLIA AVE	None	MILLBRAE	CA	94030	2524	00	06000	37.59877057	-122.3906001	San Mateo County
292077	Non-Physician Medical Practitioner	None	1568763043	0	0	HANNA, LISA MARGARET	10/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	251 IMPERIAL HWY	SUITE 460	FULLERTON	CA	92835	1057	00	06000	33.919812	-117.929763	Orange County
292080	Non-Physician Medical Practitioner	None	1497427835	0	0	HOPKINS, FRANCES NP	10/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1111 EXPOSITION BLVD. BL	STE 102	SACRAMENTO	CA	95815	4300	00	06000	38.598876	-121.4502885	Sacramento County
292100	Non-Physician Medical Practitioner	None	1962563460	0	0	HONG-AUYOUNG, JANET S	8/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	275 HOSPITAL PKWY	SUITE 310	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
292151	Non-Physician Medical Practitioner	None	1952866451	0	0	HULTIN, MICHAEL P NP	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	805 W ACEQUIA AVE	1B	VISALIA	CA	93291	6162	00	06000	36.32895	-119.30031	Tulare County
292159	Non-Physician Medical Practitioner	None	1609279207	0	0	HANDEL, DUSTIN C PA-C	1/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29100 PORTOLA PKWY	SUITE B	LAKE FOREST	CA	92630	8712	00	06000	33.66214655	-117.6532809	Orange County
292161	Non-Physician Medical Practitioner	None	1477610855	0	0	HOLT, MARIETTA C NP	10/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	201 E HOBSON WAY	None	BLYTHE	CA	92225	1651	00	06000	33.6105213	-114.5949917	Riverside County
292170	Non-Physician Medical Practitioner	None	1851728422	0	0	HUA, EMILY T	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	16326 BAMBOO ST	None	LA PUENTE	CA	91744	5509	00	06000	34.01726734	-117.9425973	Los Angeles County
292176	Non-Physician Medical Practitioner	None	1356486021	0	0	HOMER, RANDALL SCOTT	6/18/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3941 J ST	SUITE 354	SACRAMENTO	CA	95819	3624	00	06000	38.570652	-121.4535465	Sacramento County
292179	Non-Physician Medical Practitioner	None	1053010744	0	0	HORTON, SAVANNAH A PA	5/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	00	06000	33.80432955	-118.1594295	Los Angeles County
292181	Non-Physician Medical Practitioner	None	1457002685	0	0	HERRERA, EUNICE C NP	3/10/2022	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
292182	Non-Physician Medical Practitioner	None	1093203838	0	0	HUYNH, LONG B NP	1/25/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17100 EUCLID ST	None	FOUNTAIN VALLEY	CA	92708	4004	00	06000	33.715035	-117.936993	Orange County
292198	Non-Physician Medical Practitioner	None	1023723384	0	0	HOLLOWAY, JASMINE PA-C	3/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13010 HESPERIA ROAD	SUITE 200	VICTORVILLE	CA	92395	8315	00	06000	34.48843676	-117.2909745	San Bernardino County
292204	Non-Physician Medical Practitioner	None	1912540592	0	0	HOLIWELL, JUSTIN P PA-C	11/2/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	400 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
292209	Non-Physician Medical Practitioner	None	1871297234	0	0	HAYS, LAUREN R NP	8/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14500 ROSCOE BLVD	FLOOR 4 OFFICE 58	PANORAMA CITY	CA	91402	4194	00	06000	34.2215055	-118.44918	Los Angeles County
292229	Non-Physician Medical Practitioner	None	1265192892	0	0	HAGA, BRIDGET A NP	3/3/2022	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
292240	Non-Physician Medical Practitioner	None	1013445667	0	0	HSU, RUBY NP	8/15/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	180 OTTAWA AVENUE	None	SAN FRANCISCO	CA	94112	3640	00	06000	37.71606961	-122.446765	San Francisco County
292254	Non-Physician Medical Practitioner	None	1215209770	0	0	HOWELL, SHELLEY N NP	11/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2513 ANABAS AVE	None	SAN PEDEO	CA	90732	4619	00	06000	33.72382266	-118.3159694	Los Angeles County
292265	Non-Physician Medical Practitioner	None	1427563402	0	0	HOANG, JULIE D NP	3/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6026 PLUMAS ST	C	RENO	NV	89519	6015	00	06000	39.475521	-119.8087335	Washoe County
292274	Non-Physician Medical Practitioner	None	1992461834	0	0	HUYNH, ALICE PA	12/5/2022	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
292276	Non-Physician Medical Practitioner	None	1841840014	0	0	HERNANDEZ, MARIA E NP	1/11/2022	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
292281	Non-Physician Medical Practitioner	None	1467006148	0	0	HODGE, AMYE L NP	10/6/2020	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
292296	Non-Physician Medical Practitioner	None	1386858272	0	0	HUDSON, BEVERLY KAY	9/18/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11175 CAMPUS ST	#11120	LOMA LINDA	CA	92350	1700	00	06000	34.049547	-117.2656245	San Bernardino County
292306	Non-Physician Medical Practitioner	None	1902315799	0	0	HSU, MARGARET L NP	4/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	00	06000	37.592811	-122.382351	San Mateo County
292321	Non-Physician Medical Practitioner	None	1952176018	0	0	HO, RYAN PA-C	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	500 WEST HOSPITAL RD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
292328	Non-Physician Medical Practitioner	None	1790402634	0	0	HENRICH, CAITLIN M NP	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	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	00	06000	37.36797679	-122.0297112	Santa Clara County
292337	Non-Physician Medical Practitioner	None	1457557043	0	0	HONG, JILL O	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	17940 SANTA MARIANA ST	None	FOUNTAIN VALLEY	CA	92708	5026	00	06000	33.70216249	-117.9765163	Orange County
292362	Non-Physician Medical Practitioner	None	1134365950	0	0	HALLGREN, KIMBERLY L NP	12/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
292366	Non-Physician Medical Practitioner	None	1770138950	0	0	HOUSTON, JENSEN T PA-C	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	15107 VANOWEN ST	None	VAN NUYS	CA	91405	4542	00	06000	34.19395645	-118.463265	Los Angeles County
292408	Non-Physician Medical Practitioner	None	1164812293	0	0	HAMID, WAHIDA CNP	9/5/2019	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
292423	Non-Physician Medical Practitioner	None	1962433474	0	0	HENRY, CHRISTINE NATALIE RENEE	12/7/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25333 BARTON RD	None	LOMA LINDA	CA	92354	3123	00	06000	34.04801656	-117.251334	San Bernardino County
292460	Non-Physician Medical Practitioner	None	1962810739	0	0	HUNTER, NERISSA A NP	6/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	886 HAMPTON ST	None	VACAVILLE	CA	95687	8235	00	06000	38.32460828	-121.949456	Solano County
292464	Non-Physician Medical Practitioner	None	1043988207	0	0	HURTADO, ROXANA LEONOR NP	9/2/2023	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
292465	Non-Physician Medical Practitioner	None	1114591658	0	0	HANSON, ANGELA M PA	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	11370 ANDERSON ST	STE B-100	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
292486	Non-Physician Medical Practitioner	None	1578135679	0	0	HUGHES, SAMANTHA M NP	8/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1162 MONTGOMERY DR	SUITE 200 & 300	SANTA ROSA	CA	95405	4802	00	06000	38.442978	-122.6999565	Sonoma County
292517	Non-Physician Medical Practitioner	None	1154334373	0	0	HAYEK, CORTNEY A	3/20/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2942 HUMESTON AVENUE	None	TUSTIN	CA	92782	3339	00	06000	33.74861971	-117.7690541	Orange County
292556	Non-Physician Medical Practitioner	None	1124474358	0	0	HOGG-DUNCAN, BRANDY 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	317 WEST PUEBLO ST	None	SANTA BARBARA	CA	93105	4365	00	06000	34.42967671	-119.7228362	Santa Barbara County
292577	Non-Physician Medical Practitioner	None	1063741205	0	0	HOANG, HENRY NP	4/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1439 18TH STREET	APT 4	SANTA MONICA	CA	90404	2827	00	06000	34.02636308	-118.4809585	Los Angeles County
292590	Non-Physician Medical Practitioner	None	1427482363	0	0	HEALTH MOBILE	2/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1659 SCOTT BLVD STE 4	None	SANTA CLARA	CA	95050	4137	00	06000	37.35434281	-121.9594982	Santa Clara County
292594	Non-Physician Medical Practitioner	None	1245353309	0	0	HYPPOLITE, MARIE T	8/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20427 SPRING ST	None	RIVERSIDE	CA	92507	0127	00	06000	34.01194734	-117.3062895	Riverside County
292629	Non-Physician Medical Practitioner	None	1639416142	0	0	HEBRON, RONALD H M NP	12/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1087 TANLAND DR	STE 105	PALO ALTO	CA	94303	3746	00	06000	37.44441596	-122.1208663	Santa Clara County
292689	Non-Physician Medical Practitioner	None	1780605980	0	0	HALLINAN, KAREN A 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	5501 LOS ROBLES DR	None	CARLSBAD	CA	92008	4425	00	06000	33.1270954	-117.3305952	San Diego County
292709	Non-Physician Medical Practitioner	None	1972829521	0	0	HUMPHREY, KIMBERLY NP	9/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	00	06000	38.00771973	-122.1331484	Contra Costa County
292714	Non-Physician Medical Practitioner	None	1881730240	0	0	HUGUEZ, MARIA G	9/12/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1045 N LAKE AVE	None	PASADENA	CA	91104	4521	00	06000	34.16394511	-118.1324885	Los Angeles County
292716	Non-Physician Medical Practitioner	None	1780223024	0	0	HARFORD, EMILY PA-C	4/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1180 N INDIAN CANYON DR	SUITE 200	PALM SPRINGS	CA	92262	4800	00	06000	33.839505	-116.5455735	Riverside County
292718	Non-Physician Medical Practitioner	None	1205295631	0	0	HANHAN, MARSELLA	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	5006 VINE CIRCLE	None	ROCKLIN	CA	95765	4739	00	06000	38.80782764	-121.2762743	Placer County
292754	Non-Physician Medical Practitioner	None	1912179334	0	0	HAMIDI, DAOUD	2/12/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6801 SOUTH MARIPOSA LN	None	DUBLIN	CA	94568	4207	00	06000	37.713852	-121.9110025	Alameda County
292758	Non-Physician Medical Practitioner	None	1932504990	0	0	HERNANDEZ, FRANCISCO L NP	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	2228 WHITE OAK DR	None	DELANO	CA	93215	4768	00	06000	35.78799877	-119.2263146	Kern County
292763	Non-Physician Medical Practitioner	None	1992439798	0	0	HENSLER, CAROLYN PA-C	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
292769	Non-Physician Medical Practitioner	None	1306839352	0	0	HOLIDAY, BRENDA L	3/21/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1307 N COMMERCE ST	None	STOCKTON	CA	95202	1012	00	06000	37.96535383	-121.2959608	San Joaquin County
292773	Non-Physician Medical Practitioner	None	1619495124	0	0	HERNANDEZ, STEVEN A PA	10/5/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41050 18TH ST WEST	None	PALMDALE	CA	93551	2229	00	06000	34.62900141	-118.1630878	Los Angeles County
292786	Non-Physician Medical Practitioner	None	1982488250	0	0	HUA, ALEX	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	5725 S SOTO ST	None	HUNTINGTON PARK	CA	90255	9993	00	06000	33.990444	-118.2193965	Los Angeles County
292794	Non-Physician Medical Practitioner	None	1669874103	0	0	HORVATH, CHLOE E PA	8/13/2021	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
292802	Non-Physician Medical Practitioner	None	1225360498	0	0	HAMISI, KHADIJA H NP	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	2372 STERLING AVE	None	SAN BERNARDINO	CA	92404	4624	00	06000	34.13682	-117.243687	San Bernardino County
292812	Non-Physician Medical Practitioner	None	1417320896	0	0	HOLMGREN, SARAH S 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	2811 COOLIDGE AVE	None	OAKLAND	CA	94601	2719	00	06000	37.7900142	-122.2161466	Alameda County
292835	Non-Physician Medical Practitioner	None	1902015076	0	0	HUK, BOTH S	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	1919 W CHERRY DR	None	ORANGE	CA	92868	2026	00	06000	33.79376548	-117.8731215	Orange County
292875	Non-Physician Medical Practitioner	None	1235182577	0	0	HATCHER, TIMOTHY A	2/14/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1711 W TEMPLE ST	None	LOS ANGELES	CA	90026	5421	00	06000	34.06891181	-118.2638033	Los Angeles County
292889	Non-Physician Medical Practitioner	None	1861742843	0	0	HUSAIN, JENNIFER N PA-C	3/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5120 VIA SAMUEL	None	YORBA LINDA	CA	92886	4527	00	06000	33.8876642	-117.7798277	Orange County
292925	Non-Physician Medical Practitioner	None	1306471560	0	0	HERNANDEZ, ERNIE PA-C	1/22/2021	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
292956	Non-Physician Medical Practitioner	None	1588239560	0	0	HOLGUIN, MARIELA S PA	12/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
292980	Non-Physician Medical Practitioner	None	1487252425	0	0	HERNANDEZ, KRISTINA M NP	1/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4860 Y ST	None	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
293001	Non-Physician Medical Practitioner	None	1467883504	0	0	HAYES, PEDRO L NP	3/5/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29604 PLEASANT PASEO CV	None	MENIFEE	CA	92585	9271	00	06000	33.71278084	-117.1434421	Riverside County
293003	Non-Physician Medical Practitioner	None	1497239719	0	0	HAIGLER, HEATHER M PA	5/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4002 VISTA WAY	None	OCEANSIDE	CA	92056	4506	00	06000	33.1857	-117.290538	San Diego County
293007	Non-Physician Medical Practitioner	None	1174309157	0	0	HERNANDEZ, EJ STERRIN B NP	9/28/2023	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
293024	Non-Physician Medical Practitioner	None	1740661586	0	0	HECHANOVA, RACHEL L	7/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2058 N MILLS AVE	SUITE 202	CLAREMONT	CA	91711	2812	00	06000	34.12087209	-117.7070923	Los Angeles County
293034	Non-Physician Medical Practitioner	None	1477692192	0	0	HUNT, SUSAN M	4/25/2007	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	MAILSTOP #12	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
293050	Non-Physician Medical Practitioner	None	1538631239	0	0	HURTADO CORTES, SERGIO A	8/6/2019	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
293051	Non-Physician Medical Practitioner	None	1881454726	0	0	HOUSTON, AUTUMN NP	7/11/2024	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
293065	Non-Physician Medical Practitioner	None	1093291379	0	0	HAILE, RAHWA NP	6/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	6386	00	06000	37.36797679	-122.0297112	Santa Clara County
293068	Non-Physician Medical Practitioner	None	1255343505	0	0	HOVLAND, TIMOTHY O	1/25/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2418 WALNUT GROVE	None	SAN JOSE	CA	95128	1129	00	06000	37.33338548	-121.947714	Santa Clara County
293110	Non-Physician Medical Practitioner	None	1295236560	0	0	HOBSON, TAMARA L NP	4/18/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	34816 ELMWOOD LN	None	YUCAIPA	CA	92399	6203	00	06000	34.04705453	-117.0450405	San Bernardino County
293137	Non-Physician Medical Practitioner	None	1043655483	0	0	HASTINGS, MELISSA E	7/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	450 BROADWAY ST	PAVILION A, MC 6110	REDWOOD CITY	CA	94063	3132	00	06000	37.48523183	-122.2025998	San Mateo County
293205	Non-Physician Medical Practitioner	None	1023332731	0	0	HIRSCH, ELISA MARIE	11/24/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2925 PALO VERDE AVE	None	LONG BEACH	CA	90815	1552	00	06000	33.809751	-118.1079275	Los Angeles County
293222	Non-Physician Medical Practitioner	None	1447660873	0	0	HAYDER, AGHA NP	9/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	328 S 1ST ST	STE E	ALHAMBRA	CA	91801	3707	00	06000	34.09104553	-118.1252904	Los Angeles County
293229	Non-Physician Medical Practitioner	None	1316582695	0	0	HUNTER, LAUREN A PA	7/5/2020	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
293249	Non-Physician Medical Practitioner	None	1932687696	0	0	HALL, RASHONDA N CNP	1/19/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27200 CALAROGA	None	HAYWARD	CA	94545	4339	00	06000	37.63347961	-122.0897735	Alameda County
293267	Non-Physician Medical Practitioner	None	1285136507	0	0	HIGGINBOTHAM, JESSICA L	11/29/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1650 E SHEPHERD AVE	APT 134	FRESNO	CA	93720	5604	00	06000	36.86661641	-119.7521719	Fresno County
293271	Non-Physician Medical Practitioner	None	1316225873	0	0	HSU, SHENG	10/20/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	380 90TH ST	None	DALY CITY	CA	94015	1807	00	06000	37.69110985	-122.4742036	San Mateo County
293287	Non-Physician Medical Practitioner	None	1881323442	0	0	HAUG, HAILEY NP	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	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
293291	Non-Physician Medical Practitioner	None	1932431376	0	0	HELENIUS, KEVIN N PA	4/2/2020	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
293302	Non-Physician Medical Practitioner	None	1194975995	0	0	HINTON, ANNE C PA-C	8/11/2022	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
293314	Non-Physician Medical Practitioner	None	1619201191	0	0	HERRMANN, MICHELE C	6/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10354 CAMINITO GOMA	None	SAN DIEGO	CA	92131	1628	00	06000	32.90489049	-117.104733	San Diego County
293359	Non-Physician Medical Practitioner	None	1902546922	0	0	HOTTA, JOHNATHAN M PA	7/22/2022	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
293400	Non-Physician Medical Practitioner	None	1497166144	0	0	HEU, CHIA-YU	5/29/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	121 BADEN STREET	None	SAN FRANCISCO	CA	94131	3217	00	06000	37.73106344	-122.4397452	San Francisco County
293405	Non-Physician Medical Practitioner	None	1215440094	0	0	HUANG, HUNTER PA	2/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVENUE	None	REDDING	CA	96001	2549	00	06000	40.57278686	-122.3958519	Shasta County
293419	Non-Physician Medical Practitioner	None	1821623208	0	0	HOWELL, JESSICA	2/27/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	06000	32.683167	-114.633459	Yuma County
293435	Non-Physician Medical Practitioner	None	1780869487	0	0	HARTMAN, LESLIE A	9/23/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9520 MONTE MAR DRIVE	None	LOS ANGELES	CA	90035	4014	00	06000	34.04933574	-118.3961528	Los Angeles County
293437	Non-Physician Medical Practitioner	None	1508396557	0	0	HERNANDEZ, RAYMOND S NP	8/8/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2432 PAULINE ST	None	WEST COVINA	CA	91792	2612	00	06000	34.01843203	-117.8942199	Los Angeles County
293462	Non-Physician Medical Practitioner	None	1245802040	0	0	HARP, ERNEST L NP	9/11/2024	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
293465	Non-Physician Medical Practitioner	None	1043417587	0	0	HABTEWOLD, GETNET T	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	12021 WILMINGTON AVE	None	LOS ANGELES	CA	90059	3019	00	06000	33.922863	-118.2431655	Los Angeles County
293484	Non-Physician Medical Practitioner	None	1467028027	0	0	HARTING, JON PA-C	4/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	301 W BASTANCHURY RD	220	FULLERTON	CA	92835	3424	00	06000	33.89397383	-117.9316737	Orange County
293508	Non-Physician Medical Practitioner	None	1184017519	0	0	HOYME, CHERYL A NP	9/3/2019	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	BLDG 53	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
293547	Non-Physician Medical Practitioner	None	1730598400	0	0	HA, REGINA 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
293631	Non-Physician Medical Practitioner	None	1508511452	0	0	HERNANDEZ, AMANDA P 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	3801 KATELLA AVE	STE 330	LOS ALAMITOS	CA	90720	6900	00	06000	33.80318951	-118.066068	Orange County
293659	Non-Physician Medical Practitioner	None	1679105654	0	0	HAN, MIYA 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	8700 BEVERLY BLVD	ROOM 3719	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
293668	Non-Physician Medical Practitioner	None	1912198003	0	0	HIGUCHI, MONA EIKO	9/17/2009	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	GROUND FLOOR	SAN FRANCISCO	CA	94115	3358	00	06000	37.78272203	-122.4433297	San Francisco County
293671	Non-Physician Medical Practitioner	None	1235708165	0	0	HICHAR, JENNIFER NP	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	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
293714	Non-Physician Medical Practitioner	None	1568850295	0	0	HOLMES, WHITNEY M NP	3/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	6208 GREENFIELD WAY	None	DAYTON	OH	45424	1323	00	06000	39.87307271	-84.12491775	Montgomery County
293723	Non-Physician Medical Practitioner	None	1851403075	0	0	HARTLAND, GARY A	5/12/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2662 EDITH AVE	None	REDDING	CA	96001	0000	00	06000	40.57071892	-122.3974077	Shasta County
293744	Non-Physician Medical Practitioner	None	1124652805	0	0	HOBSON, ERICA NP	9/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8135 S PAINTER AVENUE	SUITE 103	WHITTIER	CA	90602	3171	00	06000	33.965829	-118.032738	Los Angeles County
293787	Non-Physician Medical Practitioner	None	1396342366	0	0	HALLFORD-REESE, CHELSEA B NP	9/3/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1508 ALHAMBRA	200	SACRAMENTO	CA	95816	6510	00	06000	38.567007	-121.468068	Sacramento County
293800	Non-Physician Medical Practitioner	None	1477601490	0	0	HONG, THOMAS S	6/3/2009	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 RD	None	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
293823	Non-Physician Medical Practitioner	None	1013079557	0	0	HATIA, NISHA E NP	8/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18133 VENTURA BLVD	200 2ND FLOOR	TARZANA	CA	91356	3616	00	06000	34.1657808	-118.5283188	Los Angeles County
293827	Non-Physician Medical Practitioner	None	1255870739	0	0	HILL, VANNESSA M	7/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3364 RAINBOW LN	None	HIGHLAND	CA	92346	2580	00	06000	34.13273892	-117.2139684	San Bernardino County
293843	Non-Physician Medical Practitioner	None	1629000591	0	0	HUBER, ALAN DAVID	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	27700 MEDICAL CENTER RD	None	MISSION VIEJO	CA	92691	6426	00	06000	33.56008604	-117.6657795	Orange County
293857	Non-Physician Medical Practitioner	None	1922198399	0	0	HAMMOND, BEATRIZ	11/13/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13105 BAY MEADOW CT	None	CHINO	CA	91710	5960	00	06000	34.0148389	-117.7042215	San Bernardino County
293876	Non-Physician Medical Practitioner	None	1962587717	0	0	HENDRICKS, KYLA J PA	11/20/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	00	06000	34.27680789	-119.2480851	Ventura County
293880	Non-Physician Medical Practitioner	None	1841326790	0	0	HOPKINS, ELENA M NP	12/7/2022	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
293882	Non-Physician Medical Practitioner	None	1487045621	0	0	HELSTON, BRENDON P NP	4/2/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2700 BANK STREET	None	BAKERSFIELD	CA	93304	2629	00	06000	35.35800853	-119.033037	Kern County
293884	Non-Physician Medical Practitioner	None	1902946007	0	0	HUDSON, LILLIE E PA-C	1/17/2025	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
293890	Non-Physician Medical Practitioner	None	1144624958	0	0	HUISO, CELSO Q NP	8/8/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	46 W JULIAN PLACE	APT 324	SAN JOSE	CA	95110	2474	00	06000	37.34009254	-121.8947447	Santa Clara County
293892	Non-Physician Medical Practitioner	None	1023526498	0	0	HAMEL, STEVEN R	8/14/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1756 BEECHNUT AVE	None	HENDERSON	NV	89074	0953	00	06000	36.03855247	-115.0631807	Clark County
293894	Non-Physician Medical Practitioner	None	1649053141	0	0	HERNANDEZ, MIRANDA PA	11/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2000 OUTLET CENTER DR	SUITE 225	OXNARD	CA	93036	0607	00	06000	34.220935	-119.1483716	Ventura County
293926	Non-Physician Medical Practitioner	None	1760727606	0	0	HALIT, SAMANTHA S PA	3/17/2020	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
293932	Non-Physician Medical Practitioner	None	1124534904	0	0	HANNA, RANIA B NP	5/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	191 E ALESSANDRO BLVD	9A	RIVERSIDE	CA	92508	5095	00	06000	33.91628074	-117.3284633	Riverside County
293937	Non-Physician Medical Practitioner	None	1922649649	0	0	HELMS, MADISON L PA	3/22/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3809	00	06000	33.89356031	-117.9271656	Orange County
293957	Non-Physician Medical Practitioner	None	1154523504	0	0	HIRSCH, BETH A F NP	2/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5915 W MADOC	None	VISALIA	CA	93291	8527	00	06000	36.352656	-119.3569605	Tulare County
294025	Non-Physician Medical Practitioner	None	1629616412	0	0	HULPA, MARCIE L NP	8/19/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5825 KANAN RD	B	AGOURA HILLS	CA	91301	1651	00	06000	34.15592291	-118.7563824	Los Angeles County
294029	Non-Physician Medical Practitioner	None	1457373219	0	0	HAMMIG, MEREDITH S CNM	9/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1125 LIVE OAK AVE	None	SANTA CRUZ	CA	95062	2516	00	06000	36.97176939	-121.9916122	Santa Cruz County
294041	Non-Physician Medical Practitioner	None	1306220629	0	0	HOUSER, DALE D PA	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	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
294102	Non-Physician Medical Practitioner	None	1982487021	0	0	HOFFMAN, ZACHARY B PA-C	2/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1730 PRAIRIE CITY ROAD	SUITE 120	FOLSOM	CA	95630	9594	00	06000	38.651472	-121.167387	Sacramento County
294125	Non-Physician Medical Practitioner	None	1104530401	0	0	HARRINGTON, KERIANNE PA	9/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2067 W VISTA WAY	250	VISTA	CA	92083	6034	00	06000	33.18505594	-117.285958	San Diego County
294189	Non-Physician Medical Practitioner	None	1992842538	0	0	HARRISON, REGINA SURICE	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	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	00	06000	37.8242017	-122.2578306	Alameda County
294197	Non-Physician Medical Practitioner	None	1508465113	0	0	HO, PHILLIP NP	9/21/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15975 HARBOR BOULEVARD	None	FOUNTAIN VALLEY	CA	92708	1303	00	06000	33.73140379	-117.9200162	Orange County
294212	Non-Physician Medical Practitioner	None	1023314192	0	0	HOANG, CAM LING T NP	4/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 SOUTHHAMPTON RD	APT 23	BENICIA	CA	94510	1737	00	06000	38.07030182	-122.1769985	Solano County
294213	Non-Physician Medical Practitioner	None	1558447417	0	0	HUERTA, RAMONA LAMBERT	7/29/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4601 DALE ROAD, 3RD FLOO	None	MODESTO	CA	95356	9459	00	06000	37.706508	-121.052457	Stanislaus County
294236	Non-Physician Medical Practitioner	None	1376537589	0	0	HANSON, ALLISON	5/2/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	320 LENNON LN	None	WALNUT CREEK	CA	94598	2419	00	06000	37.92699561	-122.0292732	Contra Costa County
294238	Non-Physician Medical Practitioner	None	1659037273	0	0	HUNKELE, CHRISTINA M NP	3/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 S CENTRAL AVE	STE 200	GLENDALE	CA	91204	2851	00	06000	34.12736888	-118.257777	Los Angeles County
294278	Non-Physician Medical Practitioner	None	1861168585	0	0	HUANG, WOYAN PA-C	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	1310 EL CAMINO REAL	STE J	SAN BRUNO	CA	94066	1310	00	06000	37.63997826	-122.4230745	San Mateo County
294283	Non-Physician Medical Practitioner	None	1700849205	0	0	HOULEHAN, MARGARET	11/6/2023	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
294294	Non-Physician Medical Practitioner	None	1205480639	0	0	HALLER-BAKER, SHANNON M PA	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	1531 ESPLANADE	None	CHICO	CA	95926	3310	00	06000	39.74248474	-121.8493369	Butte County
294314	Non-Physician Medical Practitioner	None	1124130620	0	0	HARMONY HEALTH MEDICAL CLINIC AND FAMILY RESOURCE	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	1908 N BEALE RD STE E	None	MARYSVILLE	CA	95901	6937	00	06000	39.1278388	-121.5457994	Yuba County
294326	Non-Physician Medical Practitioner	None	1720244478	0	0	HEIN, MARJORIE J	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	1309 HIGHLAND AVE	APT 1324	DUARTE	CA	91010	3803	00	06000	34.13814636	-117.9667007	Los Angeles County
294332	Non-Physician Medical Practitioner	None	1558836510	0	0	HALDERMAN, STACY NP	12/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 TOWN AND COUNTRY DR	SUITE 104	NORCO	CA	92860	3611	00	06000	33.92721419	-117.561448	Riverside County
294334	Non-Physician Medical Practitioner	None	1033533666	0	0	HOLDEN, AMBER A	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	41770 MARGARITA RD	2097	TEMECULA	CA	92591	1979	00	06000	33.51468128	-117.1487219	Riverside County
294386	Non-Physician Medical Practitioner	None	1194449413	0	0	HAWES, ALISA J NP	12/12/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4700 SOQUEL DR	None	SOQUEL	CA	95073	2427	00	06000	36.98815433	-121.9571695	Santa Cruz County
294448	Non-Physician Medical Practitioner	None	1215428990	0	0	HSU, PETER J NP	6/30/2018	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
294454	Non-Physician Medical Practitioner	None	1891430559	0	0	HOANG, MARGARET V PA-C	3/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39141 CIVIC CENTER DR	STE 335	FREMONT	CA	94538	5831	00	06000	37.55436307	-121.9764708	Alameda County
294481	Non-Physician Medical Practitioner	None	1659506368	0	0	HILL, JULIE L NP	3/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5458 BROCKTON AVE	None	RIVERSIDE	CA	92506	1801	00	06000	33.96736507	-117.3924476	Riverside County
294507	Non-Physician Medical Practitioner	None	1922556893	0	0	HALL, REBECCA A	11/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	176 VIERRA CIRCLE	None	FOLSOM	CA	95630	5435	00	06000	38.665026	-121.164129	Sacramento County
294527	Non-Physician Medical Practitioner	None	1770624462	0	0	HYATT, SHERI K	1/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	512 WEST PRESCOTT AVE	None	CLOVIS	CA	93619	0423	00	06000	36.86460551	-119.722896	Fresno County
294529	Non-Physician Medical Practitioner	None	1154331189	0	0	HARVEY, MARK C PA	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	771 CRESTVIEW DR	None	DIAMOND BAR	CA	91765	6105	00	06000	34.01072051	-117.8051203	Los Angeles County
294540	Non-Physician Medical Practitioner	None	1821080060	0	0	HALL, ANNE V	3/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	721 RIVER DR	None	FORT BRAGG	CA	95437	5403	00	06000	39.43204627	-123.801581	Mendocino County
294541	Non-Physician Medical Practitioner	None	1194818757	0	0	HARRIS, DEBORAH G NP	7/1/1996	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5752 CAPESWOOD DRIVE	None	RANCHO PLS VRD	CA	90275	1726	00	06000	33.79109003	-118.3803291	Los Angeles County
294560	Non-Physician Medical Practitioner	None	1659848950	0	0	HSIEH, SUE-JEAN NP	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	125 SAN ANSELMO AVE	None	SAN FRANCISCO	CA	94127	1513	00	06000	37.73646314	-122.4656209	San Francisco County
294573	Non-Physician Medical Practitioner	None	1891143830	0	0	HORI, COURTNEY N	5/18/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7671 DEL OAK WAY	None	SACRAMENTO	CA	95831	4403	00	06000	38.47842	-121.5140175	Sacramento County
294588	Non-Physician Medical Practitioner	None	1306471669	0	0	HINER, KATHERINE L CNM	11/1/2021	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
294611	Non-Physician Medical Practitioner	None	1518216266	0	0	HEHN, PHILIP V	9/15/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3825 E SEEGER AVE	None	VISALIA	CA	93292	1396	00	06000	36.310401	-119.2496625	Tulare County
294640	Non-Physician Medical Practitioner	None	1376532010	0	0	HARRIS, DEVIN C NP	12/3/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4092 CLAYMORE COURT	None	SHINGLE SPRINGS	CA	95682	7696	00	06000	38.68711768	-120.9731388	El Dorado County
294655	Non-Physician Medical Practitioner	None	1689226508	0	0	HOERRES, LYNN 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	8851 CENTER DR	STE 505	LA MESA	CA	91942	3032	00	06000	32.78189749	-117.0075062	San Diego County
294674	Non-Physician Medical Practitioner	None	1497032452	0	0	HUBBARD, ROBYN ANNE	11/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	115 MALL DR	None	HANFORD	CA	93230	5786	00	06000	36.32396253	-119.6688834	Kings County
294676	Non-Physician Medical Practitioner	None	1689958159	0	0	HAUSWIRTH, STEVEN L	10/23/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7204 RAMONA WAY	None	FRESNO	CA	93737	9212	00	06000	36.7862263	-119.6601065	Fresno County
294677	Non-Physician Medical Practitioner	None	1487655023	0	0	HART, KRISTINA Y	5/25/2005	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	ENCINITAS	ENCINITAS	CA	92024	5142	00	06000	33.03623896	-117.2837308	San Diego County
294725	Non-Physician Medical Practitioner	None	1164992285	0	0	HANNA, LUCY K PA-C	10/12/2022	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
294802	Non-Physician Medical Practitioner	None	1801576350	0	0	HERNANDEZ, YESENIA PA-C	11/28/2023	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
294844	Non-Physician Medical Practitioner	None	1295066223	0	0	HEROLD, HEATHER	4/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	508 SOUTH ALVY ST	None	ANAHEIM	CA	92802	1206	00	06000	33.82575394	-117.9405752	Orange County
294851	Non-Physician Medical Practitioner	None	1629746003	0	0	HENDERSON, DAVID R NP	10/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1131 WILSHIRE BLVD	100	SANTA MONICA	CA	90401	2072	00	06000	34.02509887	-118.4909994	Los Angeles County
294890	Non-Physician Medical Practitioner	None	1083776033	0	0	HORTON, NEREYDA M NP	10/22/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2103 WELLINGTON ROAD	None	LOS ANGELES	CA	90016	1826	00	06000	34.03735048	-118.3352326	Los Angeles County
294894	Non-Physician Medical Practitioner	None	1699405456	0	0	HILLER, ASHLEY E PA-C	2/3/2023	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
294924	Non-Physician Medical Practitioner	None	1457891848	0	0	HESLOP, MILDRED H NP	8/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2663 MABRY DR	None	SACRAMENTO	CA	95835	1502	00	06000	38.676681	-121.526127	Sacramento County
294938	Non-Physician Medical Practitioner	None	1790896967	0	0	HALL, MARLA D	5/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5301 F ST	#220	SACRAMENTO	CA	95819	3226	00	06000	38.571354	-121.4368695	Sacramento County
294985	Non-Physician Medical Practitioner	None	1659350361	0	0	HOLLINGSWORTH, DOROTHY M	3/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5360 RESERVOIR DR	None	SAN DIEGO	CA	92115	1509	00	06000	32.77313084	-117.0558813	San Diego County
295022	Non-Physician Medical Practitioner	None	1124692256	0	0	HOBEL, VICTORIA L PA	8/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	584 N. SUNRISE AVE	100	ROSEVILLE	CA	95661	2862	00	06000	38.75842021	-121.2528302	Placer County
295043	Non-Physician Medical Practitioner	None	1710031158	0	0	HENDERSON, BONNIE L NP	5/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1335 OAK KNOLL RD	None	UKIAH	CA	95482	6836	00	06000	39.11509433	-123.2148216	Mendocino County
295048	Non-Physician Medical Practitioner	None	1952469371	0	0	HOUSEMAN, HILLARY K	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	31737 CALLE REDONDELA	None	TEMECULA	CA	92592	3917	00	06000	33.49065141	-117.1085665	Riverside County
295054	Non-Physician Medical Practitioner	None	1831852698	0	0	HELLER, LAUREN R PA-C	7/1/2024	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
295058	Non-Physician Medical Practitioner	None	1164190914	0	0	HOWARD, SHELBY PA	7/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2010 EAST CARSON STREET	None	LONG BEACH	CA	90807	3040	00	06000	33.83242453	-118.16721	Los Angeles County
295063	Non-Physician Medical Practitioner	None	1033528757	0	0	HIDAY, MARK A NP	2/13/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26 E HIGHLAND AVE	None	REDLANDS	CA	92373	6818	00	06000	34.04179102	-117.170807	San Bernardino County
295080	Non-Physician Medical Practitioner	None	1659438000	0	0	HOLTZ, RAMONA T NP	10/5/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	104 E JASPER RD	None	HEBER	CA	92249	0001	00	06000	32.70880942	-115.4982922	Imperial County
295102	Non-Physician Medical Practitioner	None	1780394304	0	0	HANEY, KIMBERLY PA	4/4/2024	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
295164	Non-Physician Medical Practitioner	None	1972111292	0	0	HO, SHANNON M	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	1973 FOOTHILL PKWY	104	CORONA	CA	92881	4110	00	06000	33.83172462	-117.530378	Riverside County
295175	Non-Physician Medical Practitioner	None	1184099335	0	0	HIROFUJI, ERI NP	10/18/2023	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
295183	Non-Physician Medical Practitioner	None	1174999015	0	0	HAGOPIAN, KRISTINA R NP	8/28/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26800 CROWN VALLEY PKWY	STE 305, 315, 325, 330	MISSION VIEJO	CA	92691	8033	00	06000	33.56286021	-117.6673449	Orange County
295184	Non-Physician Medical Practitioner	None	1508933342	0	0	HOM, RICHARD	3/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	792 VIA LOS ANDES STREET	None	CLAREMONT	CA	91711	1566	00	06000	34.13425661	-117.7309926	Los Angeles County
295189	Non-Physician Medical Practitioner	None	1518364769	0	0	HASHEMIESFAHANI, MARYAM NP	9/1/2019	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	3201	00	06000	33.78674051	-117.8888713	Orange County
295230	Non-Physician Medical Practitioner	None	1982953329	0	0	HARRIS, LILLIAN 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	6815 MOORE DRIVE	None	PIEDMONT	CA	94611	1554	00	06000	37.83379195	-122.1905921	Alameda County
295251	Non-Physician Medical Practitioner	None	1023480126	0	0	HATCHIMONJI, RACHEL L 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	2022 EASTERN AVE	None	ARCATA	CA	95521	5320	00	06000	40.87982577	-124.0899702	Humboldt County
295289	Non-Physician Medical Practitioner	None	1104367465	0	0	HICKS-WILLIAMS, ANYTA M NP	12/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1220 PLUMAS ST	None	YUBA CITY	CA	95991	3411	00	06000	39.14626814	-121.6176162	Sutter County
295310	Non-Physician Medical Practitioner	None	1295249225	0	0	HENRY, TRACY NP	4/17/2024	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
295326	Non-Physician Medical Practitioner	None	1063687523	0	0	HOWARD, PATRICIA CLAIRE	6/2/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5701 S HOOVER ST	None	LOS ANGELES	CA	90037	4045	00	06000	33.9903	-118.2871595	Los Angeles County
295331	Non-Physician Medical Practitioner	None	1043595788	0	0	HICKSON, RUBI A NP	11/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1420 MIDDLEBROOK WAY	None	ROHNERT PARK	CA	94928	3622	00	06000	38.33224187	-122.6806445	Sonoma County
295341	Non-Physician Medical Practitioner	None	1447385679	0	0	HINDS, WILLIAM H PA	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	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	00	06000	33.763572	-116.4056895	Riverside County
295358	Non-Physician Medical Practitioner	None	1225689318	0	0	HARDING, KATELYN A PA	3/17/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
295370	Non-Physician Medical Practitioner	None	1992347298	0	0	HASTINGS, MICHELLE L	3/19/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13024 HESPERIA ROAD	STE 103	VICTORVILLE	CA	92395	8303	00	06000	34.48893153	-117.29123	San Bernardino County
295378	Non-Physician Medical Practitioner	None	1578934014	0	0	HANSEN, ANNE N	3/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2368 REDWOOD DR	None	APTOS	CA	95003	2518	00	06000	37.00613601	-121.902537	Santa Cruz County
295381	Non-Physician Medical Practitioner	None	1922251735	0	0	HOLLOWAY, TREVOR M	10/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15492 VERMONT STREET	None	WESTMINSTER	CA	92683	6141	00	06000	33.73785192	-118.0000342	Orange County
295426	Non-Physician Medical Practitioner	None	1679266266	0	0	HAUN, ELIZABETH 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	152 PIONEER LANE	A-H	BISHOP	CA	93514	2563	00	06000	37.36269	-118.407312	Inyo County
295430	Non-Physician Medical Practitioner	None	1346361201	0	0	HARMON-COBB, CALISHA	10/5/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
295446	Non-Physician Medical Practitioner	None	1619940806	0	0	HAZLETON, BARBARA	3/22/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	KAISER HOSPITAL	1425 SOUTH MAIN ST	WALNUT CREEK	CA	94596	0000	00	06000	37.8836235	-122.04612	Contra Costa County
295449	Non-Physician Medical Practitioner	None	1376887935	0	0	HASHEMI, LADAN P	4/23/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4093 ARENZANO WAY	None	EL DORADO HILLS	CA	95702	5427	00	06000	38.67782318	-121.0504778	El Dorado County
295460	Non-Physician Medical Practitioner	None	1740215912	0	0	HRUSCHKA, CAROLYN CRANE	7/18/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	585 W COLLEGE AVE	None	SANTA ROSA	CA	95401	5000	00	06000	38.445903	-122.735601	Sonoma County
295464	Non-Physician Medical Practitioner	None	1184143299	0	0	HANSON, TINNEKE NP	12/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7130 N MILLBROOK AVE	SUITE 100	FRESNO	CA	93720	3347	00	06000	36.83832032	-119.7632391	Fresno County
295491	Non-Physician Medical Practitioner	None	1164602793	0	0	HALL, AMITY	6/25/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	875 BLAKE WILBUR	None	STANFORD	CA	94305	5820	00	06000	37.43562782	-122.1766097	Santa Clara County
295506	Non-Physician Medical Practitioner	None	1538577697	0	0	HARMON, AMBER E	4/7/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5601 COFFEE ROAD	APT 728	BAKERSFIELD	CA	93308	9465	00	06000	35.410266	-119.092327	Kern County
295513	Non-Physician Medical Practitioner	None	1497953053	0	0	HAHN, NICOLE	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	360 SAN MIGUEL DR	STE 309	NEWPORT BEACH	CA	92660	7836	00	06000	33.61321911	-117.8722084	Orange County
295533	Non-Physician Medical Practitioner	None	1952636524	0	0	HALTER, BERTHOLD F PA-C	7/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 TOWN AND COUNTRY DR	SUITE 104	NORCO	CA	92860	3611	00	06000	33.92721419	-117.561448	Riverside County
295536	Non-Physician Medical Practitioner	None	1972849693	0	0	HERNANDEZ, ROSANA PA-C	7/31/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3529 FIRESTONE BLVD	None	SOUTH GATE	CA	90280	3031	00	06000	33.95422949	-118.2050894	Los Angeles County
295560	Non-Physician Medical Practitioner	None	1215008412	0	0	HAKIMI, SIMON	5/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9793 NORTH GRANVILLE AVE	None	FRESNO	CA	93720	4253	00	06000	36.87857757	-119.7556313	Fresno County
295564	Non-Physician Medical Practitioner	None	1396815866	0	0	HETTIG, JUDITH L	5/10/2011	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
295613	Non-Physician Medical Practitioner	None	1427067495	0	0	HICKS, NICOLE A	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	145 MISSION RANCH BLVD	SUITE 110	CHICO	CA	95926	0000	00	06000	39.75331457	-121.8608378	Butte County
295628	Non-Physician Medical Practitioner	None	1730813205	0	0	HSIAO, JOSEPH W 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	2826 HARRIS ST	None	EUREKA	CA	95503	4809	00	06000	40.78047614	-124.1355056	Humboldt County
295633	Non-Physician Medical Practitioner	None	1184954547	0	0	HARO, SABRINA	4/8/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9300 VALLEY CHILDRENS PL	None	MADERA	CA	93636	8761	00	06000	36.88437894	-119.8003484	Madera County
295651	Non-Physician Medical Practitioner	None	1558006288	0	0	HULSE, KRISTINA C NP	7/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1120 WEST AVENUE M-4	None	PALMDALE	CA	93551	1432	00	06000	34.6457071	-118.155831	Los Angeles County
295659	Non-Physician Medical Practitioner	None	1144995697	0	0	HEYDENBURG, KYRIE PA-C	10/26/2021	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	STE 220	FRESNO	CA	93701	2234	00	06000	36.74333844	-119.7831874	Fresno County
295675	Non-Physician Medical Practitioner	None	1619565363	0	0	HERNANDEZ, JOSE M PA	9/13/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11795 EDUCATION ST	STE 100	AUBURN	CA	95602	2469	00	06000	38.94433757	-121.098912	Placer County
295682	Non-Physician Medical Practitioner	None	1922050392	0	0	HOLLIMAN, NATASHA W	11/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31234 PALOS VERDES DR W	None	RANCHO PALOS VERD	CA	90275	5361	00	06000	33.74903636	-118.4074404	Los Angeles County
295705	Non-Physician Medical Practitioner	None	1790952943	0	0	HARRINGTON, JEWETT JACQUES	6/10/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2005 WILSHIRE BLVD	None	LOS ANGELES	CA	90057	3503	00	06000	34.05752693	-118.2749902	Los Angeles County
295718	Non-Physician Medical Practitioner	None	1942809009	0	0	HORNING, JESSICA M PA-C	2/15/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	705 W. LA VETA AVE	SUITE 111	ORANGE	CA	92868	4447	00	06000	33.78062272	-117.8600738	Orange County
295793	Non-Physician Medical Practitioner	None	1538351705	0	0	HOFFMAN, TAWNYA IRENE	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	16911 WILLOW GLEN ROAD	None	BROWNSVILLE	CA	95919	0609	00	06000	39.46025309	-121.2838218	Yuba County
295807	Non-Physician Medical Practitioner	None	1245580273	0	0	HO, COLEMAN	2/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	516 W CENTRAL AVE	None	SAN GABRIEL	CA	91776	2923	00	06000	34.0879285	-118.1072925	Los Angeles County
295814	Non-Physician Medical Practitioner	None	1316268238	0	0	HARRIS, LYNNE C NP	3/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13327 MCKINLEY AVE	None	LOS ANGELES	CA	90059	3321	00	06000	33.910209	-118.261518	Los Angeles County
295836	Non-Physician Medical Practitioner	None	1386639649	0	0	HARTBERG, MARSHA L	10/6/2009	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	STATION A OB/GYN CLINIC	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
295849	Non-Physician Medical Practitioner	None	1053772889	0	0	HOANG, PHUONG B NP	12/4/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CITY DR S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
295856	Non-Physician Medical Practitioner	None	1740449073	0	0	HARTER, GINA ANDREA	6/4/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6408 VIA COLINITA	None	RANCHO PALOS VERD	CA	90275	6458	00	06000	33.74179013	-118.3226188	Los Angeles County
295895	Non-Physician Medical Practitioner	None	1598366577	0	0	HAKANSON, BETHANIE D NP	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	1401 SPANOS COURT	SUITE 108	MODESTO	CA	95355	2812	00	06000	37.66975543	-120.9724048	Stanislaus County
295934	Non-Physician Medical Practitioner	None	1659752699	0	0	HUNGERFORD, CHASE A	8/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3813 SEBREN AVE	None	LONG BEACH	CA	90808	2043	00	06000	33.82809907	-118.1218505	Los Angeles County
295966	Non-Physician Medical Practitioner	None	1407194087	0	0	HINOHARA, ANNA NP	4/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 UCLA MEDICAL PLZ	None	LOS ANGELES	CA	90095	8346	00	06000	34.06465655	-118.4461	Los Angeles County
295993	Non-Physician Medical Practitioner	None	1629372297	0	0	HENN, RACHEL N	1/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2775 MESA VERDE DR E	APT E104	COSTA MESA	CA	92626	4957	00	06000	33.67262594	-117.9252731	Orange County
296043	Non-Physician Medical Practitioner	None	1295961100	0	0	HAMILTON, JASON	7/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29738 RANCHO CALIFORNIA	SUITE B	TEMECULA	CA	92591	5322	00	06000	33.50612116	-117.1438774	Riverside County
296093	Non-Physician Medical Practitioner	None	1265553853	0	0	HAMILTON, DEIRDRE M PA-C	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	2 UPPER RAGSDALE	STE B230	MONTEREY	CA	93940	7836	00	06000	36.57940327	-121.8142876	Monterey County
296121	Non-Physician Medical Practitioner	None	1326827171	0	0	HYUN, JUNG HWAN	8/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	480B TESCONI CIR	None	SANTA ROSA	CA	95401	4691	00	06000	38.44950583	-122.7351601	Sonoma County
296125	Non-Physician Medical Practitioner	None	1710414875	0	0	HAVIG, JEFFERY NP	12/11/2024	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
296131	Non-Physician Medical Practitioner	None	1699794081	0	0	HALL, ANNE K	2/21/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2879 PALMER DR	None	GLASSELL	CA	90065	5235	00	06000	34.13268948	-118.2279761	Los Angeles County
296157	Non-Physician Medical Practitioner	None	1770938664	0	0	HAYS, ANNA K NP	1/27/2022	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
296177	Non-Physician Medical Practitioner	None	1154928885	0	0	HIJAZ, ROKAYA N PA-C	11/1/2021	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
296178	Non-Physician Medical Practitioner	None	1073711644	0	0	HUGHES, MARIAH D	5/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	96 BRIARWOOD CT	None	VACAVILLE	CA	95688	2004	00	06000	38.36976364	-122.0060218	Solano County
296206	Non-Physician Medical Practitioner	None	1457902645	0	0	HORNBROOK, CARINA A PA	2/14/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	BUENA VISTA & ALAMEDA ST	None	BURBANK	CA	91505	0000	00	06000	34.158213	-118.328112	Los Angeles County
296240	Non-Physician Medical Practitioner	None	1760521330	0	0	HALLINAN, ALLISON E	5/11/2007	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
296274	Non-Physician Medical Practitioner	None	1396034534	0	0	HOLMAN, SAMIA 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	8331 LAMBERT DRIVE	None	HUNTINGTON BEACH	CA	92647	9510	00	06000	33.72012178	-117.9830227	Orange County
296287	Non-Physician Medical Practitioner	None	1336809771	0	0	HARRIS, MONIKA NP	10/27/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15611 POMERADO RD	STE 400	POWAY	CA	92064	2437	00	06000	32.99706	-117.05544	San Diego County
296304	Non-Physician Medical Practitioner	None	1447789391	0	0	HINDOYAN, NATALINE A	7/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1021 WILLARD AVE	None	GLENDALE	CA	91201	2216	00	06000	34.1637876	-118.2837593	Los Angeles County
296313	Non-Physician Medical Practitioner	None	1982117024	0	0	HOSTETLER, ROBERT J PA-C	4/11/2020	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
296319	Non-Physician Medical Practitioner	None	1467813162	0	0	HERNANDEZ, JOEL	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	6654 AQUEDUCT AVE	None	VAN NUYS	CA	91406	6205	00	06000	34.19201817	-118.473808	Los Angeles County
296345	Non-Physician Medical Practitioner	None	1144047796	0	0	HERNANDEZ SHUR, BLANCA 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	3975 JACKSON STREET	STE 207	RIVERSIDE	CA	92503	3948	00	06000	33.92729721	-117.4413503	Riverside County
296374	Non-Physician Medical Practitioner	None	1922415769	0	0	HAN, ESTERA NP	6/29/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16047 SIERRA PASS WAY	None	HACIENDA HEIGHTS	CA	91745	6541	00	06000	33.98017778	-117.96297	Los Angeles County
296382	Non-Physician Medical Practitioner	None	1346736089	0	0	HARTSOCK, EUNICE PAULA D NP	10/28/2019	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
296383	Non-Physician Medical Practitioner	None	1558930297	0	0	HONG, IRENE L PA-C	8/19/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1509 WILSON TERRACE	None	GLENDALE	CA	91206	4007	00	06000	34.14950866	-118.2311155	Los Angeles County
296398	Non-Physician Medical Practitioner	None	1780345629	0	0	HONG, AMANDA PA	8/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14443 CULVER DR	14443-A	IRVINE	CA	92604	0343	00	06000	33.70541708	-117.7871432	Orange County
296404	Non-Physician Medical Practitioner	None	1619365384	0	0	HSU, SHIRLEY I 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	750 REDWOOD HWY	SUITE 1204	MILL VALLEY	CA	94941	2483	00	06000	37.89525674	-122.5158838	Marin County
296414	Non-Physician Medical Practitioner	None	1568453801	0	0	HICKS, LARRY CHARLES	6/28/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA	None	MODESTO	CA	95352	0000	00	06000	37.66508443	-120.9962589	Stanislaus County
296486	Non-Physician Medical Practitioner	None	1336784446	0	0	HEFNER, HEATHER CNP	2/19/2020	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
296501	Non-Physician Medical Practitioner	None	1780087163	0	0	HILL, WENDY M NP	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	616 E LADERA ST	None	PASADENA	CA	91104	2250	00	06000	34.17118899	-118.1379743	Los Angeles County
296526	Non-Physician Medical Practitioner	None	1225706088	0	0	HOWLETT, EMILY PA	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	16506 LAKEWOOD BLVD	STE 200	BELLFLOWER	CA	90706	5165	00	06000	33.88470916	-118.1424401	Los Angeles County
296563	Non-Physician Medical Practitioner	None	1235801960	0	0	HENRY, JOYCE B NP	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	1355 EAST ST	SUITE 200	REDDING	CA	96001	0801	00	06000	40.58628506	-122.3887911	Shasta County
296568	Non-Physician Medical Practitioner	None	1700568979	0	0	HOANG, MYLOAN NP	11/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	530 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3723	00	06000	34.02866849	-118.2597481	Los Angeles County
296588	Non-Physician Medical Practitioner	None	1902287352	0	0	HARKINS, AUBREY E NP	6/7/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7111 FRESNO ST	STE 200	FRESNO	CA	93720	2965	00	06000	36.83951763	-119.7815709	Fresno County
296592	Non-Physician Medical Practitioner	None	1720394000	0	0	HAMILTON, MARIE N	2/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11914 KLING ST	STE 21	VALLEY VILLAGE	CA	91607	4059	00	06000	34.15578513	-118.3927511	Los Angeles County
296593	Non-Physician Medical Practitioner	None	1396730602	0	0	HOUSE, KAREN KAY	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	KAISER PERMANENTE OB/GYN	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
296604	Non-Physician Medical Practitioner	None	1295990364	0	0	HOTARI, CARISA D PA-C	2/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	313 BISHOP AVENUE	None	PACIFIC GROVE	CA	93950	5203	00	06000	36.60410286	-121.9178605	Monterey County
296611	Non-Physician Medical Practitioner	None	1528572856	0	0	HOLT, ALLISON A NP	12/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2600 L ST	None	SACRAMENTO	CA	95816	5612	00	06000	38.571921	-121.472541	Sacramento County
296638	Non-Physician Medical Practitioner	None	1841612082	0	0	HI-DESERT MEMORIAL HEALTH CARE DISTRICT	10/29/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	58375 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	5890	00	06000	34.13141256	-116.3904357	San Bernardino County
296660	Non-Physician Medical Practitioner	None	1114237104	0	0	HARRISON, MARITZA NP	5/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1820 FULLERTON AVE	230	CORONA	CA	92881	3147	00	06000	33.858756	-117.5503465	Riverside County
296726	Non-Physician Medical Practitioner	None	1447360979	0	0	HARRIS, CATHERINE C	12/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1845 E POPLAR ST	None	STOCKTON	CA	95205	4211	00	06000	37.96565152	-121.2692198	San Joaquin County
296752	Non-Physician Medical Practitioner	None	1558784645	0	0	HENDERSON, SOFIA	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	15850 LASSELLE STREET	UNIT C	MORENO VALLEY	CA	92551	4766	00	06000	33.88976056	-117.2062853	Riverside County
296753	Non-Physician Medical Practitioner	None	1972768489	0	0	HENEFELD, JEFFREY J PA-C	1/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3427 ROBIN LANE	STE 100	CAMERON PARK	CA	95682	7255	00	06000	38.65580389	-120.9675841	El Dorado County
296769	Non-Physician Medical Practitioner	None	1609588979	0	0	HAYLOCK, CHANAE JOI NP	4/11/2023	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
296771	Non-Physician Medical Practitioner	None	1730651167	0	0	HILDEBRANDT, KARA NP	4/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	06000	33.478749	-112.0426515	Maricopa County
296777	Non-Physician Medical Practitioner	None	1114649464	0	0	HYNES, THOMAS W PA-C	12/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
296788	Non-Physician Medical Practitioner	None	1083308340	0	0	HSIAO, JESSE 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	5860 OWENS DR	None	PLEASANTON	CA	94588	3900	00	06000	37.69979047	-121.8991292	Alameda County
296827	Non-Physician Medical Practitioner	None	1043277916	0	0	HILL, SALLIE P CNM	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	4637 APRIL COURT	None	VALLEJO	CA	94591	6379	00	06000	38.13330965	-122.2042467	Solano County
296836	Non-Physician Medical Practitioner	None	1568788669	0	0	HABELL, BARBARA E NP	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	5799 CARELL AVE	None	AGOURA HILLS	CA	91301	2128	00	06000	34.156467	-118.7515185	Los Angeles County
296857	Non-Physician Medical Practitioner	None	1881064988	0	0	HO, TIM N	12/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4621 FROST DRIVE	None	OXNARD	CA	93033	7247	00	06000	34.15819234	-119.1680743	Ventura County
296875	Non-Physician Medical Practitioner	None	1649784208	0	0	HAINLEY, ANNE K NP	1/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	580 E MILANO ST	None	PLACENTIA	CA	92870	3244	00	06000	33.8870662	-117.8552768	Orange County
296881	Non-Physician Medical Practitioner	None	1669690517	0	0	HINCHMAN, ELIZABETH A NP	2/5/2020	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
296887	Non-Physician Medical Practitioner	None	1194451864	0	0	HERMES, ERIN E NP	9/7/2022	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
296909	Non-Physician Medical Practitioner	None	1730519778	0	0	HORNER, ROBERT E	3/4/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8241 E HILLSDALE DR	None	ORANGE	CA	92869	2440	00	06000	33.79831683	-117.7653798	Orange County
296944	Non-Physician Medical Practitioner	None	1457085763	0	0	HSIEH, WINSTON PA-C	9/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	160 E ARTESIA STREET	SUITE 310	POMONA	CA	91767	2922	00	06000	34.07556833	-117.7507835	Los Angeles County
296971	Non-Physician Medical Practitioner	None	1053989475	0	0	HACOBIAN, DAVID S PA-C	11/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	00	06000	33.912117	-117.195849	Riverside County
297041	Non-Physician Medical Practitioner	None	1841546165	0	0	HANTER, HERBERT H NP	12/14/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8525 TOBIAS AVE	127	PANORAMA CITY	CA	91402	2903	00	06000	34.225605	-118.4517075	Los Angeles County
297049	Non-Physician Medical Practitioner	None	1679871172	0	0	HARE, KRISTI DORN	3/5/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1215 E CHAPMAN AVE	None	ORANGE	CA	92866	2237	00	06000	33.78786853	-117.840456	Orange County
297080	Non-Physician Medical Practitioner	None	1619228954	0	0	HOLMES, SARAH K	8/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3709 S PORT DRIVE	STE 38	SACRAMENTO	CA	95826	5111	00	06000	38.545335	-121.360788	Sacramento County
297085	Non-Physician Medical Practitioner	None	1518998111	0	0	HARRIS, MICHELLE S	11/16/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 SIERRA COLLEGE DR	SUITE 270	GRASS VALLEY	CA	95945	5082	00	06000	39.23625806	-121.054471	Nevada County
297104	Non-Physician Medical Practitioner	None	1609154426	0	0	HILL, VICKI L 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	21 GREENVALE	None	RANCHO SANTA MARG	CA	92688	5516	00	06000	33.59664318	-117.6229633	Orange County
297121	Non-Physician Medical Practitioner	None	1104000595	0	0	HARPER MILFORT, MIRANDA D	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	1736 W 65TH STREET	None	LOS ANGELES	CA	90047	1911	00	06000	33.98056853	-118.308072	Los Angeles County
297130	Non-Physician Medical Practitioner	None	1144600248	0	0	HEALTH AND LIFE ORGANIZATION, INC	10/20/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3030 EXPLORER DR	None	SACRAMENTO	CA	95827	2728	00	06000	38.563362	-121.332429	Sacramento County
297154	Non-Physician Medical Practitioner	None	1952974107	0	0	HOVAN, NATALIA G NP	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	1336 NATIVIDAD RD	None	SALINAS	CA	93906	3101	00	06000	36.69908763	-121.6352503	Monterey County
297163	Non-Physician Medical Practitioner	None	1861981417	0	0	HO, NANCY PA	9/1/2018	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
297177	Non-Physician Medical Practitioner	None	1083040794	0	0	HYDERI, ALEYA F	1/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12887 CLEMSON DR	None	CORONA	CA	92880	3370	00	06000	33.9522751	-117.5643647	Riverside County
297186	Non-Physician Medical Practitioner	None	1508522426	0	0	HU, XINYUAN	1/10/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18433 ROSCOE BLVD	SUITE 104	NORTHRIDGE	CA	91325	4108	00	06000	34.22076747	-118.534725	Los Angeles County
297196	Non-Physician Medical Practitioner	None	1760981948	0	0	HSU, ANGELA	4/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12866 EASTERN SHORE DR	None	CORONA	CA	92880	3455	00	06000	33.95675315	-117.5640182	Riverside County
297219	Non-Physician Medical Practitioner	None	1548635840	0	0	HONG, DORIS H NP	1/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1615 NEW BRUNSWICK AVE	None	SUNNYVALE	CA	94087	4261	00	06000	37.340694	-122.043209	Santa Clara County
297234	Non-Physician Medical Practitioner	None	1861022469	0	0	HINES, CASEY PA	2/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1800 W CHARLESTON BLVD	None	LAS VEGAS	NV	89102	2329	00	06000	36.1590063	-115.1674415	Clark County
297244	Non-Physician Medical Practitioner	None	1053535724	0	0	HORWITZ, MICHELE L NP	1/10/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3291 LOMA VISTA RD	None	VENTURA	CA	93003	3099	00	06000	34.27623479	-119.2520218	Ventura County
297245	Non-Physician Medical Practitioner	None	1205334273	0	0	HOANG, ANNIE NP	12/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11180 WARNER AVE	353	FOUNTAIN VALLEY	CA	92708	7501	00	06000	33.71632048	-117.9334575	Orange County
297249	Non-Physician Medical Practitioner	None	1003484650	0	0	HIROSE, ERICSON M PA	11/7/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
297271	Non-Physician Medical Practitioner	None	1215304860	0	0	HACINAS, REYNALDO O NP	12/10/2020	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
297287	Non-Physician Medical Practitioner	None	1558756536	0	0	HEALTHRIGHT 360	10/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	117 N SAN MATEO DR	None	SAN MATEO	CA	94401	2708	00	06000	37.56866767	-122.3286434	San Mateo County
297293	Non-Physician Medical Practitioner	None	1518543818	0	0	HAMILTON, TINA NP	8/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1704 WEST MANCHESTER AVE	SUITE 106	LOS ANGELES	CA	90047	3056	00	06000	33.9599425	-118.307079	Los Angeles County
297301	Non-Physician Medical Practitioner	None	1619315231	0	0	HA, THANH NP	1/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	646 MARLOWE COURT	None	STOCKTON	CA	95210	4430	00	06000	38.03072305	-121.3057477	San Joaquin County
297305	Non-Physician Medical Practitioner	None	1467602920	0	0	HANSON, STEPHANIE THERESA	4/16/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	11460 N PHILBIN RD	None	POCATELLO	ID	83202	5306	00	06000	42.92742181	-112.4960853	Bannock County
297312	Non-Physician Medical Practitioner	None	1679974919	0	0	HENDRIX, JOSEPH A	6/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4355 FARMDALE AVE	None	STUDIO CITY	CA	91604	2737	00	06000	34.14899591	-118.3812166	Los Angeles County
297332	Non-Physician Medical Practitioner	None	1558899278	0	0	HAMMOND, DESSIE M P	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	1824 23RD ST	None	SAN FRANCISCO	CA	94107	3300	00	06000	37.75483529	-122.3980876	San Francisco County
297336	Non-Physician Medical Practitioner	None	1407175532	0	0	HARTMAN, M EVELYN	6/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	800 PELHAM RD	None	GREENVILLE	SC	29615	3300	00	06000	34.8568841	-82.32449878	Greenville County
297346	Non-Physician Medical Practitioner	None	1023118411	0	0	HUEBNER, JOHN A	5/2/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	145 N BRENT ST	SUITE 102	VENTURA	CA	93003	2816	00	06000	34.27394582	-119.2571887	Ventura County
297361	Non-Physician Medical Practitioner	None	1861993867	0	0	HOFFMEISTER, JOHN PA	4/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1600 ESPLANADE	SUITE C	CHICO	CA	95926	3369	00	06000	39.74352822	-121.8495394	Butte County
297438	Non-Physician Medical Practitioner	None	1013217298	0	0	HUYNH, ANNIE P H NP	2/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6206 SKI SLOPE DRIVE	None	BAKERSFIELD	CA	93313	6098	00	06000	35.29861252	-119.0615672	Kern County
297442	Non-Physician Medical Practitioner	None	1437658259	0	0	HAMPTON-MIELKE, SHAYNA L 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	3130 DEL MONTE BLVD	None	MARINA	CA	93933	3047	00	06000	36.68590557	-121.8010492	Monterey County
297458	Non-Physician Medical Practitioner	None	1740618008	0	0	HARRIS, KURT A	1/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 BARTON RD	APT 2503	REDLANDS	CA	92373	5442	00	06000	34.049079	-117.205767	San Bernardino County
297461	Non-Physician Medical Practitioner	None	1649326349	0	0	HILL, JEREMY ADAM	6/28/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	374 WEST OLIVE AVENUE	SUITE A	MERCED	CA	95348	3137	00	06000	37.31914092	-120.4749911	Merced County
297500	Non-Physician Medical Practitioner	None	1629557764	0	0	HUOTH, ALLISON P PA	5/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5601 DE SOTO AVE	None	WOODLAND HILLS	CA	91367	6701	00	06000	34.17030266	-118.5881699	Los Angeles County
297510	Non-Physician Medical Practitioner	None	1063761237	0	0	HOPKINS, DENISE K PA-C	12/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10670 WHITE ROCK RD	STE 100	RANCHO CORDOVA	CA	95670	6146	00	06000	38.586177	-121.291812	Sacramento County
297518	Non-Physician Medical Practitioner	None	1114382421	0	0	HOPE COMMUNITY CARE CLINIC	7/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11273 LAUREL CANYON BLVD	SUITE 2	SAN FERNANDO	CA	91340	4349	00	06000	34.27498293	-118.4494282	Los Angeles County
297580	Non-Physician Medical Practitioner	None	1174553168	0	0	HEATH, KELLY L	10/4/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 ROYAL PALM AVE	None	HALF MOON BAY	CA	94019	4217	00	06000	37.5132798	-122.4859529	San Mateo County
297591	Non-Physician Medical Practitioner	None	1295862126	0	0	HARVATIN, TERESA M	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	2085 CLEMENTINE ST	None	REDLANDS	CA	92374	1631	00	06000	34.08607427	-117.1884977	San Bernardino County
297600	Non-Physician Medical Practitioner	None	1104597277	0	0	HAN, SANGWOOK PA-C	2/18/2025	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
297632	Non-Physician Medical Practitioner	None	1811630148	0	0	HILL, TAYLOR D PA-C	9/6/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	729 SUNRISE AVE	SUITE 602	ROSEVILLE	CA	95661	4542	00	06000	38.73444822	-121.2720033	Placer County
297637	Non-Physician Medical Practitioner	None	1366770927	0	0	HELLER, AMY	7/26/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2285 TREEHOUSE LN APT 10	None	CORONA	CA	92879	8024	00	06000	33.8926861	-117.5199774	Riverside County
297649	Non-Physician Medical Practitioner	None	1205323607	0	0	HULTGREN, ANDREW R NP	10/8/2020	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
297657	Non-Physician Medical Practitioner	None	1477974822	0	0	HOWARD, SARA S	12/16/2021	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 AVENUE,	SUITE 501	LOS ANGELES	CA	90027	6098	00	06000	34.0956033	-118.2916918	Los Angeles County
297704	Non-Physician Medical Practitioner	None	1831330240	0	0	HUANG, ZAN	5/19/2011	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
297706	Non-Physician Medical Practitioner	None	1346600681	0	0	HUANG, JACKIE NP	1/15/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	00	06000	34.05362775	-118.2661889	Los Angeles County
297739	Non-Physician Medical Practitioner	None	1962568865	0	0	HUDDLESTON, JENNIFER	6/29/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15500 MARILLA ST	None	NORTH HILLS	CA	91343	2127	00	06000	34.24726349	-118.4699925	Los Angeles County
297743	Non-Physician Medical Practitioner	None	1780394114	0	0	HEATH, YOLANDA R CNM	5/16/2023	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
297753	Non-Physician Medical Practitioner	None	1497308936	0	0	HICKS, KATELYN NP	11/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4101 TORRANCE BLVD	None	TORRANCE	CA	90503	4607	00	06000	33.83760674	-118.3572569	Los Angeles County
297784	Non-Physician Medical Practitioner	None	1104146836	0	0	HAINOR, MARA A	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	1529 TRICIA LANE	None	SANTA CRUZ	CA	95062	3100	00	06000	36.97402671	-121.9796204	Santa Cruz County
297857	Non-Physician Medical Practitioner	None	1699278978	0	0	HE, JIANHONG NP	4/3/2020	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
297860	Non-Physician Medical Practitioner	None	1164998803	0	0	HUYNH, THANH-TAM T PA	5/31/2022	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 2A	CORONA	CA	92879	3122	00	06000	33.85936872	-117.5534605	Riverside County
297924	Non-Physician Medical Practitioner	None	1003126129	0	0	HASSELMAN, SHELLEY R NP	9/27/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27640 EUCALYPTUS AVE	None	MORENO VALLEY	CA	92555	4557	00	06000	33.93749258	-117.1807371	Riverside County
297944	Non-Physician Medical Practitioner	None	1346849742	0	0	HAN, GINA PA-C	2/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	850 S ATLANTIC BLVD	305	MONTEREY PARK	CA	91754	6714	00	06000	34.05097684	-118.1379979	Los Angeles County
298020	Non-Physician Medical Practitioner	None	1528269412	0	0	HALBERT, RUSHTON E III	2/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25333 MCCOY AVE	None	HARBOR CITY	CA	90710	3151	00	06000	33.79380873	-118.2899393	Los Angeles County
298038	Non-Physician Medical Practitioner	None	1215697370	0	0	HAQ, RAHILA	11/14/2024	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
298058	Non-Physician Medical Practitioner	None	1659043016	0	0	HOLLAND JR, MELVIN L NP	10/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3828 DELMAS	None	CULVER CITY	CA	90232	2713	00	06000	34.02308948	-118.3972101	Los Angeles County
298081	Non-Physician Medical Practitioner	None	1942514062	0	0	HWANG, TIFFANY B NP	5/26/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	901 BUSH ST	APT 602	SAN FRANCISCO	CA	94109	6356	00	06000	37.78970354	-122.412317	San Francisco County
298102	Non-Physician Medical Practitioner	None	1447673967	0	0	HERRERA, SILVA NP	11/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3970 COVE CIRCLE	None	BLYTHE	CA	92225	3029	00	06000	33.65990101	-114.5233487	Riverside County
298105	Non-Physician Medical Practitioner	None	1962446740	0	0	HUSSON, SUNITHA VODUR	3/15/2003	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 1300	LOS ANGELES	CA	90033	5310	00	06000	34.06269295	-118.2030006	Los Angeles County
298113	Non-Physician Medical Practitioner	None	1750955746	0	0	HUYNH, PETER T PA	12/1/2023	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
298149	Non-Physician Medical Practitioner	None	1124608856	0	0	HUGHES, HAYLEY L PA-C	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	350 TERRACINA BLVD	None	REDLANDS	CA	92373	4850	00	06000	34.03717616	-117.2046115	San Bernardino County
298155	Non-Physician Medical Practitioner	None	1558387936	0	0	HABETS, MICHELLE L	5/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8067 HIDDEN VIEW CIRCLE	None	FAIR OAKS	CA	95628	5965	00	06000	38.647467	-121.26681	Sacramento County
298161	Non-Physician Medical Practitioner	None	1366767535	0	0	HERNANDEZ, CORINA P NP	9/6/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5628 WISH AVENUE	None	ENCINO	CA	91316	1408	00	06000	34.17324403	-118.5058872	Los Angeles County
298169	Non-Physician Medical Practitioner	None	1609118074	0	0	HUNTER, JENNIFER L	9/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3033 LA SELVA ST	APT 300	SAN MATEO	CA	94403	2138	00	06000	37.54409177	-122.2841859	San Mateo County
298172	Non-Physician Medical Practitioner	None	1144549981	0	0	HOFF, KATHLEEN MARIE	10/9/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	725 W TOWN AND COUNTRY R	SUITE 130	ORANGE	CA	92868	4703	00	06000	33.77669152	-117.8601975	Orange County
298190	Non-Physician Medical Practitioner	None	1093253437	0	0	HAZANY, SARAH PA-C	4/25/2022	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
298208	Non-Physician Medical Practitioner	None	1982144333	0	0	HOGENBOOM, JEANETTE 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	111 ALIEN COURT	None	MORAGA	CA	94556	2701	00	06000	37.84743474	-122.1059869	Contra Costa County
298216	Non-Physician Medical Practitioner	None	1013558089	0	0	HOBURN, MONETTE C NP	2/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
298226	Non-Physician Medical Practitioner	None	1255751608	0	0	HOWLETT, KRISTIE L NP	8/27/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2056 DORRINGTON DR	None	ROSEVILLE	CA	95661	4084	00	06000	38.76260819	-121.2291171	Placer County
298235	Non-Physician Medical Practitioner	None	1376946285	0	0	HAMEL, KELLY D NP	11/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1057 LOYOLA AVE	None	CLOVIS	CA	93619	7554	00	06000	36.86252652	-119.6979705	Fresno County
298236	Non-Physician Medical Practitioner	None	1457540197	0	0	HARDY, JENNIFER L	11/10/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	34155 CAMELINA ST	None	LAKE ELSINORE	CA	92532	2946	00	06000	33.66009519	-117.2391441	Riverside County
298244	Non-Physician Medical Practitioner	None	1366986069	0	0	HENDRICKS, SYDNEY NP	11/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	685 N 13TH AVE	STE 7,8,9	UPLAND	CA	91786	4963	00	06000	34.10202219	-117.6339091	San Bernardino County
298256	Non-Physician Medical Practitioner	None	1558451690	0	0	HUTTER, HOLLY A	3/1/2003	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
298279	Non-Physician Medical Practitioner	None	1730585324	0	0	HERAVI, JESSICA	7/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1414 S SALTAIR AVE	STE 302	LOS ANGELES	CA	90025	8108	00	06000	34.04240103	-118.4635258	Los Angeles County
298299	Non-Physician Medical Practitioner	None	1134630684	0	0	HUBBELL, SARAH 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	18 ROSS VALLEY DR	None	SAN RAFAEL	CA	94901	2654	00	06000	37.97554062	-122.5505033	Marin County
298313	Non-Physician Medical Practitioner	None	1437669397	0	0	HE, HUAJUN	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	203B PALMETTO DRIVE	None	ALHAMBRA	CA	91801	4369	00	06000	34.08739228	-118.125331	Los Angeles County
298324	Non-Physician Medical Practitioner	None	1831740448	0	0	HUGHES, JENNIFER PA-C	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	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	00	06000	33.90290859	-117.4941562	Riverside County
298340	Non-Physician Medical Practitioner	None	1528126604	0	0	HEETEBRY, IRENE ANN	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	7300 N FRESNO ST	None	FRESNO	CA	93720	2941	00	06000	36.84133078	-119.7824983	Fresno County
298341	Non-Physician Medical Practitioner	None	1568982569	0	0	HONG, SHIAN NP	5/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3200 KEARNEY ST	None	FREMONT	CA	94538	2299	00	06000	37.54866156	-121.9750739	Alameda County
298364	Non-Physician Medical Practitioner	None	1811986672	0	0	HAGSTROM, LIV S G	9/23/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	714 STRAND ST	None	SANTA MONICA	CA	90405	2424	00	06000	34.00939265	-118.4805726	Los Angeles County
298400	Non-Physician Medical Practitioner	None	1417372350	0	0	HELMHOUT, LACI N PA	11/13/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10670 WEXFORD ST	None	SAN DIEGO	CA	92131	3940	00	06000	32.93893186	-117.0982186	San Diego County
298405	Non-Physician Medical Practitioner	None	1568806131	0	0	HARO, MANUEL H	2/17/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8313 DINSDALE ST	None	DOWNEY	CA	90240	3902	00	06000	33.95218163	-118.1245217	Los Angeles County
298437	Non-Physician Medical Practitioner	None	1407890049	0	0	HURTADO, WALTER S PA	5/9/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1377 E HERNDON AVE	SUITE 104	FRESNO	CA	93720	3022	00	06000	36.83704387	-119.7641113	Fresno County
298444	Non-Physician Medical Practitioner	None	1235270398	0	0	HIGGINS, ANGELA C NP	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	5700 WESTFIELD ST	None	YORBA LINDA	CA	92887	3731	00	06000	33.87965963	-117.7525292	Orange County
298445	Non-Physician Medical Practitioner	None	1326671124	0	0	HERNANDEZ, KATHRINE A NP	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	12746 W JEFFERSON BLVD	FL 2-4	LOS ANGELES	CA	90094	2885	00	06000	33.97751255	-118.417598	Los Angeles County
298449	Non-Physician Medical Practitioner	None	1447229232	0	0	HEBERT, LAUREEN MARIE	9/6/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	KAISER PERMANENTE SAN MA	400 CRAVEN ROAD	SAN MARCOS	CA	92078	0000	00	06000	0	0	None
298456	Non-Physician Medical Practitioner	None	1508451949	0	0	HINKLE, CORINNE C PA	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	16950 VIA TAZON	None	SAN DIEGO	CA	92127	1607	00	06000	33.02257788	-117.0856332	San Diego County
298501	Non-Physician Medical Practitioner	None	1013661248	0	0	HUYNH, AMANDA P PA	6/22/2022	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
298504	Non-Physician Medical Practitioner	None	1598160343	0	0	HERMANSON, KATHLEEN H	10/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1565 CHERT DR	None	SAN MACOS	CA	92078	2827	00	06000	33.10328772	-117.1855168	San Diego County
298505	Non-Physician Medical Practitioner	None	1770619009	0	0	HANKERSON, TONY L PA	6/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1225 WILSHIRE BOULEVARD	None	LOS ANGELES	CA	90017	1901	00	06000	34.05358988	-118.2661119	Los Angeles County
298524	Non-Physician Medical Practitioner	None	1609331719	0	0	HOER, JULIA PA-C	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	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	00	06000	40.14847323	-122.2180997	Tehama County
298533	Non-Physician Medical Practitioner	None	1487126421	0	0	HUGHES, ELIZA	6/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1310 LAS TABLAS RD	STE 202	TEMPLETON	CA	93465	9737	00	06000	35.55442349	-120.722643	San Luis Obispo County
298554	Non-Physician Medical Practitioner	None	1609590959	0	0	HOOGEVEEN, CASSIDY M PA-C	3/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7101 MAGNOLIA AVE	A	RIVERSIDE	CA	92504	3843	00	06000	33.94582085	-117.4021968	Riverside County
298562	Non-Physician Medical Practitioner	None	1619526118	0	0	HURLEY, TERESA M NP	6/15/2020	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
298583	Non-Physician Medical Practitioner	None	1669151817	0	0	HEITER, HEATHER	7/16/2024	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
298605	Non-Physician Medical Practitioner	None	1598005720	0	0	HERRERA, SARAH J PA	2/22/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	449 45TH ST	None	OAKLAND	CA	94609	2135	00	06000	37.83322581	-122.2609804	Alameda County
298609	Non-Physician Medical Practitioner	None	1750712568	0	0	HENSARLING, JENNIFER M NP	4/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12163 CAMINITO MIRA DEL	None	SAN DIEGO	CA	92130	2302	00	06000	32.94082801	-117.235176	San Diego County
298648	Non-Physician Medical Practitioner	None	1346735735	0	0	HOBSON, HALEY B	10/18/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	57141 CRESTVIEW DR	None	YUCCA VALLEY	CA	92284	2711	00	06000	34.12968135	-116.4172551	San Bernardino County
298662	Non-Physician Medical Practitioner	None	1588012124	0	0	HESHAM EL MOKADEM, M.D., INC.	7/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	760 WASHBURN AVE STE 3A	None	CORONA	CA	92882	3303	00	06000	33.87374585	-117.5678741	Riverside County
298677	Non-Physician Medical Practitioner	None	1932985314	0	0	HAYS, EMILY PA	10/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1798 N GAREY AVE	None	POMONA	CA	91767	2918	00	06000	34.076894	-117.7522688	Los Angeles County
298686	Non-Physician Medical Practitioner	None	1730451238	0	0	HUANG, JACKSON NP	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	26 RANCHO DEL MAR	None	APTOS	CA	95003	3973	00	06000	36.97832273	-121.9080422	Santa Cruz County
298724	Non-Physician Medical Practitioner	None	1679796866	0	0	HAFEZI, MARJAN NP	3/6/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	515 DARTMOUTH AVE	None	SAN CARLOS	CA	94070	1704	00	06000	37.50881397	-122.2813298	San Mateo County
298736	Non-Physician Medical Practitioner	None	1841232576	0	0	HALES, JENNIFER L W	12/5/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2564 MANZANITA AVE	None	EUREKA	CA	95503	5699	00	06000	40.77585165	-124.1389467	Humboldt County
298741	Non-Physician Medical Practitioner	None	1588893838	0	0	HUSSAINI, ASMA	7/31/2009	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	WEST HOLLYWOOD	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
298746	Non-Physician Medical Practitioner	None	1689253676	0	0	HENDON, BLAINE PA-C	8/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1255 LIBERTY STREET	None	REDDING	CA	96001	0814	00	06000	40.58769807	-122.3879041	Shasta County
298749	Non-Physician Medical Practitioner	None	1770864746	0	0	HALL, PATRICIA NP	4/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 CORPORATE POINTE	STE 465	CULVER CITY	CA	90230	8706	00	06000	33.98867148	-118.3837334	Los Angeles County
298794	Non-Physician Medical Practitioner	None	1194731018	0	0	HARRINGTON-HOWARD, SUSAN E	11/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3041 W SILVERHILL LANE	None	FRESNO	CA	93711	1176	00	06000	36.83693145	-119.8454015	Fresno County
298799	Non-Physician Medical Practitioner	None	1689004327	0	0	HANSELMAN, CAROL J NP	11/14/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	40144 VILLAGE RD	# 1536	TEMECULA	CA	92591	3527	00	06000	33.53872757	-117.1540012	Riverside County
298817	Non-Physician Medical Practitioner	None	1225674765	0	0	HERBERGER, ANNA C PA	11/9/2021	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
298897	Non-Physician Medical Practitioner	None	1417298753	0	0	HOUBEIN, PIERRE T	12/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	990 DEL REY AVE	None	PASADENA	CA	91107	4618	00	06000	34.16329942	-118.0972011	Los Angeles County
298905	Non-Physician Medical Practitioner	None	1962957944	0	0	HACKER, PAUL R	1/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	601 TAMMI WAY	None	TURLOCK	CA	95382	1236	00	06000	37.5178805	-120.8420775	Stanislaus County
298910	Non-Physician Medical Practitioner	None	1831406990	0	0	HOOD, LISA	6/30/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1510 HERNDON	210 AND 230	FRESNO	CA	93720	3303	00	06000	36.83756048	-119.7609525	Fresno County
298945	Non-Physician Medical Practitioner	None	1427393297	0	0	HILLIS, VALERIE ANN	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	2010 E 1ST ST STE 100	None	SANTA ANA	CA	92705	4086	00	06000	33.74554507	-117.8387522	Orange County
298955	Non-Physician Medical Practitioner	None	1770766842	0	0	HAPKE, ELIZABETH	12/3/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1133 S STREET	None	FRESNO	CA	93721	1408	00	06000	36.7419804	-119.7827004	Fresno County
298956	Non-Physician Medical Practitioner	None	1447532320	0	0	HINOJOS, STEVEN M	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	341 MAGNOLIA AVE STE 101	None	CORONA	CA	92879	3331	00	06000	33.85291106	-117.566479	Riverside County
298969	Non-Physician Medical Practitioner	None	1750340246	0	0	HANISS-YOUSSEF, NIRMEEN PA	9/9/2021	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
299020	Non-Physician Medical Practitioner	None	1598235756	0	0	HATIN, ABBEY M NP	10/23/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2970 HILLTOP MALL RD.	304	RICHMOND	CA	94806	5274	00	06000	37.97819764	-122.329244	Contra Costa County
299040	Non-Physician Medical Practitioner	None	1659317295	0	0	HI CARE MEDICAL CENTER	11/19/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2001 ZINFANDEL DR	SUITE B-3	RANCHO CORDOVA	CA	95670	4265	00	06000	38.611782	-121.271499	Sacramento County
299042	Non-Physician Medical Practitioner	None	1588839393	0	0	HAMM, JOE B PA-C	12/10/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
299105	Non-Physician Medical Practitioner	None	1275983843	0	0	HAGGENJOS, SHAWNA L PA	4/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	47111 MONROE ST	None	INDIO	CA	92201	6739	00	06000	33.70620698	-116.2339008	Riverside County
299114	Non-Physician Medical Practitioner	None	1720094592	0	0	HYATT, EVE M NP	4/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1515 EAST OCEAN AVE.	None	LOMPOC	CA	93436	7092	00	06000	34.63941491	-120.4393023	Santa Barbara County
299127	Non-Physician Medical Practitioner	None	1417378621	0	0	HUNTLEY, CHRISTOPHER PA	10/19/2021	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
299162	Non-Physician Medical Practitioner	None	1902463862	0	0	HELMS, EMMA PA-C	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	2151 HARBOR BLVD	STE 3100	FULLERTON	CA	92835	3820	00	06000	33.89443025	-117.9288328	Orange County
299173	Non-Physician Medical Practitioner	None	1801513742	0	0	HOWDEN, THANH NP	8/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5801 S FIGUEROA STREET	None	LOS ANGELES	CA	90003	1016	00	06000	33.98958	-118.2827085	Los Angeles County
299180	Non-Physician Medical Practitioner	None	1538539002	0	0	HOSTY, ERIN E NP	11/30/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2076 WESTWOOD CT	APT 58	LANCASTER	CA	92536	7270	00	06000	34.69741297	-118.1680942	Los Angeles County
299193	Non-Physician Medical Practitioner	None	1609943455	0	0	HAAGER, AMY 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	13861 WOODHILL LANE	None	CHINO HILLS	CA	91709	4434	00	06000	34.00197095	-117.7556993	San Bernardino County
299241	Non-Physician Medical Practitioner	None	1902074230	0	0	HUTTON PARROTT, AMANDA A NP	6/6/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	276 FUNSTON AVE	None	SAN FRANCISCO	CA	94118	2105	00	06000	37.78310468	-122.4719277	San Francisco County
299246	Non-Physician Medical Practitioner	None	1588641617	0	0	HADLEY, LYDIA GUADALUPE	3/1/2000	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2823 FRESNO ST	None	FRESNO	CA	93721	1324	00	06000	36.7423511	-119.7834688	Fresno County
299248	Non-Physician Medical Practitioner	None	1720292949	0	0	HEALTHY SMILES FOR KIDS OF ORANGE COUNTY	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	10602 CHAPMAN AVE	SUITE 200	GARDEN GROVE	CA	92840	3103	00	06000	33.78861049	-117.9480735	Orange County
299307	Non-Physician Medical Practitioner	None	1699078923	0	0	HEAD, KRISTIN N NP	7/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28831 TUPELO RD	None	MENIFEE	CA	92584	7483	00	06000	33.6597811	-117.1570847	Riverside County
299314	Non-Physician Medical Practitioner	None	1508529561	0	0	HEYING, BROOKE V PA	11/8/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8330 RED OAK ST	STE 201	RANCHO CUCAMONGA	CA	91730	0602	00	06000	34.10217525	-117.5693231	San Bernardino County
299320	Non-Physician Medical Practitioner	None	1780143164	0	0	HUSSEY, JULIE J NP	1/1/2022	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
299331	Non-Physician Medical Practitioner	None	1295343887	0	0	HOLLOWAY, CARRIE	8/26/2024	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
299342	Non-Physician Medical Practitioner	None	1225659006	0	0	HERNANDEZ, THOMAS R PA	1/8/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2 BON AIR RD	SUITE 120	LARKSPUR	CA	94939	1141	00	06000	37.94364568	-122.5396483	Marin County
299386	Non-Physician Medical Practitioner	None	1902463003	0	0	HIGGINSON, JONATHAN T NP	4/20/2022	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
299395	Non-Physician Medical Practitioner	None	1578045902	0	0	HULES, MICHELLE A NP	9/25/2021	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
299444	Non-Physician Medical Practitioner	None	1780835033	0	0	HICKS, THEODORE PA-C	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	400 MCDOWELL BLVD	None	PETALUMA	CA	94954	2339	00	06000	38.25477	-122.63175	Sonoma County
299468	Non-Physician Medical Practitioner	None	1710640313	0	0	HUOT, JEFFERSON NP	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	221 ELMO HWY	300	MC FARLAND	CA	93250	9528	00	06000	35.68880285	-119.2321901	Kern County
299512	Non-Physician Medical Practitioner	None	1154035095	0	0	HUANG, SHIYING NP	10/27/2023	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
299525	Non-Physician Medical Practitioner	None	1902043458	0	0	HEALY, NATHAN	2/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2139 E BEECHWOOD AVE	None	FRESNO	CA	93720	0340	00	06000	36.8383165	-119.7441	Fresno County
299533	Non-Physician Medical Practitioner	None	1417196098	0	0	HOLT, MARTIN C	6/22/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	901 W ORANGETHORPE AVE	None	FULLERTON	CA	92832	2826	00	06000	33.85940147	-117.939735	Orange County
299544	Non-Physician Medical Practitioner	None	1063752772	0	0	HAU, CHEN C NP	4/14/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2532 DOREEN AVE	None	S EL MONTE	CA	91733	2140	00	06000	34.058259	-118.0447315	Los Angeles County
299573	Non-Physician Medical Practitioner	None	1093147712	0	0	HUYNH, CRYSTAL PA	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	2141 N HARBOR BLVD	STE 25000	FULLERTON	CA	92835	3830	00	06000	33.89443025	-117.9288328	Orange County
299581	Non-Physician Medical Practitioner	None	1790964336	0	0	HEGDAL, JULIET KAREN	8/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 WEST COAST RD.	None	REDWAY	CA	95560	0769	00	06000	40.11704433	-123.8133408	Humboldt County
299585	Non-Physician Medical Practitioner	None	1629529540	0	0	HURD, CHARLES W PA-C	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	3933 HARLAN RANCH BLVD	None	CLOVIS	CA	93619	5061	00	06000	36.86156181	-119.6370518	Fresno County
299613	Non-Physician Medical Practitioner	None	1801501861	0	0	HERMENEGILDO, IRIDIANA PA	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	115 MALL DRIVE	None	HANFORD	CA	93230	5786	00	06000	36.32396253	-119.6688834	Kings County
299633	Non-Physician Medical Practitioner	None	1356951057	0	0	HINTON, SYLVIA K PA	11/1/2020	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
299659	Non-Physician Medical Practitioner	None	1013465202	0	0	HURLEY, SHAWN 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	4445 MAGNOLIA AVE	None	RIVERSIDE	CA	92501	4135	00	06000	33.9760587	-117.3800672	Riverside County
299670	Non-Physician Medical Practitioner	None	1871987685	0	0	HOUDA, NIKI J 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	22332 COLONNA	None	LAGUNA HILLS	CA	92653	1829	00	06000	33.61872851	-117.7396361	Orange County
299678	Non-Physician Medical Practitioner	None	1235519042	0	0	HEWETT, LAUREN P	11/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	120 SCHINDLER CRT	APT 255	EAST RUTHERFORD	NJ	07073	1362	00	06000	40.80870836	-74.08331495	Bergen County
299679	Non-Physician Medical Practitioner	None	1861624181	0	0	HIGGINS, JOSHUA B	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	2469 FALLBROOK PL	None	ESCONDIDO	CA	92027	6726	00	06000	33.11468371	-117.0116026	San Diego County
299703	Non-Physician Medical Practitioner	None	1154849800	0	0	HAINES, JESSILYN E NP	4/24/2019	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	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
299704	Non-Physician Medical Practitioner	None	1629635511	0	0	HALE, MEGHAN 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	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
299711	Non-Physician Medical Practitioner	None	1003065897	0	0	HANLEY, JENNIFER L PA-C	2/15/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8860 CENTER DRIVE	None	LA MESA	CA	91942	7001	00	06000	32.78189749	-117.0075062	San Diego County
299717	Non-Physician Medical Practitioner	None	1003494097	0	0	HOYOS, PAULA A PA-C	9/27/2022	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
299761	Non-Physician Medical Practitioner	None	1225076763	0	0	HIGBEE, CARLA ADINA	9/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9080 COLIMA RD	None	WHITTIER	CA	90605	1600	00	06000	33.95062799	-118.0051627	Los Angeles County
299771	Non-Physician Medical Practitioner	None	1629242839	0	0	HAN, ANGELA D NP	6/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5162 FIOLI LOOP	None	SAN RAMON	CA	94582	5976	00	06000	37.77129457	-121.9012107	Contra Costa County
299777	Non-Physician Medical Practitioner	None	1023267028	0	0	HEALY, SUSAN K NP	2/9/2018	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	200	SALINAS	CA	93901	4483	00	06000	36.66552031	-121.6439174	Monterey County
299804	Non-Physician Medical Practitioner	None	1598736498	0	0	HARRIS, CONSTANCE A M NP	5/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9119 EAST MESA AVE	None	CLOVIS	CA	93619	9035	00	06000	36.82451752	-119.6256505	Fresno County
299839	Non-Physician Medical Practitioner	None	1568864858	0	0	HUGHLOCK, KATHRYN NP	7/27/2019	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
299846	Non-Physician Medical Practitioner	None	1326582875	0	0	HENKEL, KATIE T	1/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1350 KELSO DUNES AVE	APT 522	HENDERSON	NV	89014	7844	00	06000	36.05264458	-115.0442726	Clark County
299888	Non-Physician Medical Practitioner	None	1700551066	0	0	HORNING, NATALIE D NP	6/27/2023	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
299895	Non-Physician Medical Practitioner	None	1235664517	0	0	HO, KOKCHEUNG NP	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	1841 NORTH LANGLEY AVE	None	CLOVIS	CA	93619	0507	00	06000	36.86410913	-119.6364019	Fresno County
299901	Non-Physician Medical Practitioner	None	1174057558	0	0	HERNANDEZ, ELIZABETH A	6/21/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9252 SHAMOUTI DR	None	RIVERSIDE	CA	92508	6456	00	06000	33.88217325	-117.3194094	Riverside County
299907	Non-Physician Medical Practitioner	None	1508160086	0	0	HALLIGAN, SOMMER A CNM	9/26/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2505 LUCAS STREET	SUITE B	EUREKA	CA	95501	4436	00	06000	40.79130448	-124.139304	Humboldt County
299931	Non-Physician Medical Practitioner	None	1144409699	0	0	HANSEN, ERIN R NP	1/6/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2508 53RD STREET	None	SACRAMENTO	CA	95817	1628	00	06000	38.552265	-121.4439615	Sacramento County
299947	Non-Physician Medical Practitioner	None	1063062982	0	0	HWANG, CATHERINE I NP	12/15/2021	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
299974	Non-Physician Medical Practitioner	None	1184293615	0	0	HO, BRYANT PA-C	8/21/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2160 APPIAN WAY	SUITE 200	PINOLE	CA	94564	2565	00	06000	37.99585174	-122.3021549	Contra Costa County
299992	Non-Physician Medical Practitioner	None	1134135924	0	0	HAYRE-KWAN, SURANI NP	2/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3242 COBBLESTONE DR	None	SANTA ROSA	CA	95404	1738	00	06000	38.474109	-122.708745	Sonoma County
300033	Non-Physician Medical Practitioner	None	1396891263	0	0	HARTHRONG, ROGER L	9/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	925 LOTUS CIR	None	SAN DIMAS	CA	91773	1559	00	06000	34.118244	-117.798731	Los Angeles County
300100	Non-Physician Medical Practitioner	None	1649780784	0	0	HO, VIVIAN Y NP	6/9/2021	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
300105	Non-Physician Medical Practitioner	None	1972756161	0	0	HARDWICK, ALISA B	12/10/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5301 F ST	SUITE 308	SACRAMENTO	CA	95819	3226	00	06000	38.571354	-121.4368695	Sacramento County
300147	Non-Physician Medical Practitioner	None	1053367193	0	0	HARRISON, TEENA NP	3/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 ADOBE ST	None	CONCORD	CA	94520	2313	00	06000	37.97700068	-122.0381159	Contra Costa County
300163	Non-Physician Medical Practitioner	None	1770857930	0	0	HOPKINS, PATRICK ROY	3/15/2012	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	4404	00	06000	37.66508443	-120.9962589	Stanislaus County
300164	Non-Physician Medical Practitioner	None	1164015764	0	0	HYRY, JULIA PA-C	9/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2175 ROSALINE AVE	None	REDDING	CA	96001	2549	00	06000	40.57278686	-122.3958519	Shasta County
300166	Non-Physician Medical Practitioner	None	1336728195	0	0	HARRISON, MARIAN	12/10/2024	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
300167	Non-Physician Medical Practitioner	None	1184904013	0	0	HILL, CAITLIN A NP	9/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	615 HEALDSBURG	323	SANTA ROSA	CA	95401	5169	00	06000	38.444337	-122.718015	Sonoma County
300185	Non-Physician Medical Practitioner	None	1306122288	0	0	HOANG, TRICIA L NP	6/28/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8868 SYCAMORE AVE	None	WESTMINSTER	CA	92683	5497	00	06000	33.7486762	-117.9735538	Orange County
300189	Non-Physician Medical Practitioner	None	1427700780	0	0	HO, QUANG	9/12/2024	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
300218	Non-Physician Medical Practitioner	None	1154053841	0	0	HOLMES, KALEY PA	8/16/2022	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
300230	Non-Physician Medical Practitioner	None	1538884762	0	0	HILTON, ANA D NP	10/20/2022	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
300231	Non-Physician Medical Practitioner	None	1497283618	0	0	HERNANDEZ, NYCHELE	2/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	297 N STATE COLLEGE BLVD	APT 3087	ORANGE	CA	92868	1787	00	06000	33.79353006	-117.8893343	Orange County
300233	Non-Physician Medical Practitioner	None	1609244714	0	0	HEITMAN, RYAN J	7/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1311 SPRINGFIELD ST	None	UPLAND	CA	91786	7511	00	06000	34.1082933	-117.6746053	San Bernardino County
300296	Non-Physician Medical Practitioner	None	1881183713	0	0	HSIEH, JUDY PA-C	9/24/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	31720 S TEMECULA PARKWAY	203	TEMECULA	CA	92592	2034	00	06000	33.4799323	-117.1033702	Riverside County
300317	Non-Physician Medical Practitioner	None	1376055277	0	0	HENAULT, EMERALD MD	2/1/2018	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
300346	Non-Physician Medical Practitioner	None	1215531033	0	0	HE, MAYBO PA-C	11/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	455 HICKEY DRIVE	SUITE 200	DALY CITY	CA	94015	2630	00	06000	37.66383747	-122.4671404	San Mateo County
300356	Non-Physician Medical Practitioner	None	1033280235	0	0	HANSEN, CAROLINE L	8/31/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4673 N WISHON	None	FRESNO	CA	93704	3142	00	06000	36.80256474	-119.8023219	Fresno County
300386	Non-Physician Medical Practitioner	None	1063597219	0	0	HANSEN, LYNN C CNM	2/24/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	53 HILLRISE	None	DOVE CANYON	CA	92679	3504	00	06000	33.63963209	-117.5656526	Orange County
300387	Non-Physician Medical Practitioner	None	1922386416	0	0	HAUSER, ESTELA	4/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7853 LILAC LANE	None	SIMI VALLEY	CA	93063	4917	00	06000	34.26306431	-118.6336323	Ventura County
300419	Non-Physician Medical Practitioner	None	1306311196	0	0	HAZZARD, KARI L	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	2725 CAPITOL AVE	None	SACRAMENTO	CA	95816	6004	00	06000	38.571084	-121.471074	Sacramento County
300426	Non-Physician Medical Practitioner	None	1912345711	0	0	HUBBERT, TAMARA L	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	115 S MICHIGAN ST	None	REDLANDS	CA	92373	5156	00	06000	34.05112105	-117.1881456	San Bernardino County
300466	Non-Physician Medical Practitioner	None	1174920805	0	0	HAGEN, HILARY 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
300478	Non-Physician Medical Practitioner	None	1306365622	0	0	HOLLINGHURST, CHRISTOPHER S	12/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7471 SILVERSPORT ROAD	None	RIVERSIDE	CA	92507	0132	00	06000	34.01334461	-117.3044942	Riverside County
300480	Non-Physician Medical Practitioner	None	1003048620	0	0	HECK, TINA LISA	2/27/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	77 CASA ST STE 201	None	SAN LUIS OBISPO	CA	93405	5806	00	06000	35.29306786	-120.6650709	San Luis Obispo County
300492	Non-Physician Medical Practitioner	None	1568675593	0	0	HANNAH, STEPHANIE M	10/17/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3155 W LOS ALTOS AVE	None	FRESNO	CA	93711	1035	00	06000	36.83437553	-119.8479105	Fresno County
300495	Non-Physician Medical Practitioner	None	1952803462	0	0	HAMILTON, LAURA B NP	1/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2996 KILANIE DRIVE	None	SIMI VALLEY	CA	93063	2174	00	06000	34.28963414	-118.7280456	Ventura County
300500	Non-Physician Medical Practitioner	None	1578910287	0	0	HSU, LI CHEN J PA	6/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1055 EAST COLORADO BLVD	None	PASADENA	CA	91188	2375	00	06000	34.14595648	-118.1287575	Los Angeles County
300506	Non-Physician Medical Practitioner	None	1922119734	0	0	HAKIM, MARGRETTE F	3/3/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8902 WOODMAN AVE	None	ARLETA	CA	91331	6401	00	06000	34.23141203	-118.4374526	Los Angeles County
300509	Non-Physician Medical Practitioner	None	1881008639	0	0	HUFTON, TAMMY NP	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	4001 J STREET	None	SACRAMENTO	CA	95819	3626	00	06000	38.570526	-121.4521695	Sacramento County
300533	Non-Physician Medical Practitioner	None	1912450081	0	0	HERRICK, REBEKAH E F	12/30/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	135 ANCHORAGE AVE	None	SANTA CRUZ	CA	95062	5416	00	06000	36.9564156	-121.9740643	Santa Cruz County
300540	Non-Physician Medical Practitioner	None	1841561487	0	0	HENDERSON, JENNIFER A PA	4/18/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	00	06000	34.049547	-117.264078	San Bernardino County
300543	Non-Physician Medical Practitioner	None	1568713006	0	0	HOSPICE OF THE VALLEY	7/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	455 OCONNOR DR	SUITE 300	SAN JOSE	CA	95128	1633	00	06000	37.326654	-121.939897	Santa Clara County
300582	Non-Physician Medical Practitioner	None	1144870767	0	0	HUNT, NICOLE M NP	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
300617	Non-Physician Medical Practitioner	None	1740798487	0	0	HUNTER, LUCIA M PA-C	5/17/2019	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 201	CORONA	CA	92879	3332	00	06000	33.85291987	-117.5664344	Riverside County
300637	Non-Physician Medical Practitioner	None	1528054475	0	0	HARRIS, APRIL A NP	8/29/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1025 OLIVE STREET	None	PASO ROBLES	CA	93446	2538	00	06000	35.62489199	-120.695075	San Luis Obispo County
300654	Non-Physician Medical Practitioner	None	1720613300	0	0	HUMPHREY, ANDREA K CNM	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	1505 SOQUEL DR	STE 1	SANTA CRUZ	CA	95065	1716	00	06000	36.98803429	-121.9848045	Santa Cruz County
300663	Non-Physician Medical Practitioner	None	1215032982	0	0	HARDIN, JOHN L	4/1/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7253 ORCHARD CIRCLE	None	PENRYN	CA	95663	9316	00	06000	38.83271356	-121.1726366	Placer County
300677	Non-Physician Medical Practitioner	None	1801892542	0	0	HOSEK, NANCY L NP	11/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25784 SUNRISE WAY	None	LOMA LINDA	CA	92354	3844	00	06000	34.0461148	-117.2419058	San Bernardino County
300690	Non-Physician Medical Practitioner	None	1306198296	0	0	HEALTH AND LIFE ORGANIZATION, INC	10/4/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2138 DEL PASO BLVD	None	SACRAMENTO	CA	95815	3002	00	06000	38.609811	-121.4510265	Sacramento County
300696	Non-Physician Medical Practitioner	None	1245792555	0	0	HERNANDEZ, JOSE R NP	7/9/2019	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
300714	Non-Physician Medical Practitioner	None	1710989439	0	0	HALL, KELLY R	3/16/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 N ROSE AVE	STE 210	OXNARD	CA	93030	7639	00	06000	34.21746	-119.155545	Ventura County
300716	Non-Physician Medical Practitioner	None	1568058683	0	0	HANNA, PAUL PA	11/1/2021	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 B-100	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
300733	Non-Physician Medical Practitioner	None	1538285788	0	0	HUDSON, KIMBERLY B	10/2/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27889 TWILIGHT COURT	None	MURRIETA	CA	92563	5063	00	06000	33.58133829	-117.1740147	Riverside County
300745	Non-Physician Medical Practitioner	None	1528518073	0	0	HERMANSEN, MICHAEL S	2/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9201 SUNSET BLVD	STE M 155	WEST HOLLYWOOD	CA	90069	3701	00	06000	34.09054375	-118.392295	Los Angeles County
300748	Non-Physician Medical Practitioner	None	1396193868	0	0	HUSSAIN, BASHARAT PA-C	11/20/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41880 KALMIA ST	SUITE 100	MURRIETA	CA	92562	8835	00	06000	33.55740114	-117.2157733	Riverside County
300750	Non-Physician Medical Practitioner	None	1043908866	0	0	HOSSEINI, HADEIAH	11/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18200 YORBA LINDA BLVD	SUITE 250	YORBA LINDA	CA	92886	4044	00	06000	33.88842824	-117.8154698	Orange County
300752	Non-Physician Medical Practitioner	None	1538629712	0	0	HUNTER, JACQUELINE S PA-C	3/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2900 WHIPPLE AVE	SUITE 225	REDWOOD CITY	CA	94065	2851	00	06000	37.4783072	-122.2551089	San Mateo County
300768	Non-Physician Medical Practitioner	None	1063517761	0	0	HANEFFANT, MARIA-DOLORES CERQUEIRA	3/2/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3100 DOUGLAS BLVD	None	ROSEVILLE	CA	95661	3866	00	06000	38.74399612	-121.2349547	Placer County
300777	Non-Physician Medical Practitioner	None	1831496116	0	0	HOPPER, KRISTIN D	7/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5049 CHARDONNAY CT	None	VISALIA	CA	93291	9095	00	06000	36.346671	-119.3479605	Tulare County
300823	Non-Physician Medical Practitioner	None	1295820199	0	0	HAWKINS, ROBERT MATTHEW	7/24/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	12605 E 16TH AVE	None	AURORA	CO	80045	2545	00	06000	39.742182	-104.8408515	Adams County
300825	Non-Physician Medical Practitioner	None	1295185585	0	0	HART, STEPHANIE L NP	5/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5771 MISSION CENTER ROAD	APT 301	SAN DIEGO	CA	92108	4368	00	06000	32.77996615	-117.1539131	San Diego County
300833	Non-Physician Medical Practitioner	None	1649586058	0	0	HELGERSON, JUDY A NP	11/5/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3509 FRIGATEBIRD LN	None	NORTH LAS VEGAS	NV	89084	2323	00	06000	36.29222362	-115.1871674	Clark County
300878	Non-Physician Medical Practitioner	None	1134647449	0	0	HOANG, KAREN NP	11/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1941 JOHNSON AVE	STE 101	SAN LUIS OBISPO	CA	93401	4154	00	06000	35.27804785	-120.649711	San Luis Obispo County
300932	Non-Physician Medical Practitioner	None	1922550821	0	0	HUSTREI, CARLY J PA	5/12/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3814 AUBURN BLVD	SUITE 72	SACRAMENTO	CA	95821	2123	00	06000	38.639034	-121.375305	Sacramento County
300951	Non-Physician Medical Practitioner	None	1992932974	0	0	HONG, SHIRLEY T NP	2/26/2024	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
300974	Non-Physician Medical Practitioner	None	1083489983	0	0	HAWKINS, VANESSA A NP	4/18/2024	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
300976	Non-Physician Medical Practitioner	None	1568144822	0	0	HADDY, MEGAN	10/4/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	444 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	00	06000	39.13178911	-121.6141048	Sutter County
300984	Non-Physician Medical Practitioner	None	1053668046	0	0	HODGES, KARISSA LYNN	12/1/2012	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	MS #102	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
301007	Non-Physician Medical Practitioner	None	1952753626	0	0	HOUTROUW, CYNTHIA R	12/7/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	360 S LOLA LN	None	PAHRUMP	NV	89048	0884	00	06000	36.214524	-116.025615	Nye County
301010	Non-Physician Medical Practitioner	None	1336575976	0	0	HENDERSON, SAMANTHA M NP	11/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3504 N TENAYA WAY	None	LAS VEGAS	NV	89129	6258	00	06000	36.22426932	-115.2514022	Clark County
301018	Non-Physician Medical Practitioner	None	1326658642	0	0	HUMMEL, SHAZA H NP	12/17/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1920 COLORADO AVE	None	SANTA MONICA	CA	90404	3414	00	06000	34.02564555	-118.477319	Los Angeles County
301021	Non-Physician Medical Practitioner	None	1558315515	0	0	HENDERSON, DEBORAH L	7/27/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13519 JENNIFER LANE	None	YUCAIPA	CA	92399	6309	00	06000	34.00785327	-117.0203172	San Bernardino County
301023	Non-Physician Medical Practitioner	None	1790250603	0	0	HUNG, CHRISTOPHER PA	12/23/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1014 BALDWIN PARK BLVD	None	BALDWIN PARK	CA	91706	5806	00	06000	34.06343528	-117.9856963	Los Angeles County
301024	Non-Physician Medical Practitioner	None	1174887368	0	0	HINKLE, DAWN 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	760 OTAY LAKES RD	None	CHULA VISTA	CA	91910	6915	00	06000	32.64603447	-117.0015068	San Diego County
301061	Non-Physician Medical Practitioner	None	1033212691	0	0	HEREDIA, ROSA ELENA	3/9/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	244 N JACKSON AVE	STE 209	SAN JOSE	CA	95116	1604	00	06000	37.36405837	-121.8488656	Santa Clara County
301062	Non-Physician Medical Practitioner	None	1760666226	0	0	HUTCHINGS, ANN E NP	2/13/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3629 ROCKCREST CT	None	BAKERSFIELD	CA	93311	2211	00	06000	35.32167708	-119.1125232	Kern County
301114	Non-Physician Medical Practitioner	None	1134144876	0	0	HARRIS, MARCUS E	12/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15134 OAKWOOD LANE	None	CHINO HILLS	CA	91709	2628	00	06000	33.97846669	-117.7167654	San Bernardino County
301116	Non-Physician Medical Practitioner	None	1801293642	0	0	HARDIN, CHRISTINA M PA	9/26/2022	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
301125	Non-Physician Medical Practitioner	None	1164672275	0	0	HALE, JULIA L	7/28/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	809 LYNNHAVEN LN	None	LA CANADA	CA	91001	2420	00	06000	34.21157342	-118.1960845	Los Angeles County
301139	Non-Physician Medical Practitioner	None	1831138478	0	0	HARDY-PETERSON, MARCELLA L 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	4990 ARLINGTON AVE	STE D	RIVERSIDE	CA	92504	2757	00	06000	33.94604554	-117.4117995	Riverside County
301152	Non-Physician Medical Practitioner	None	1124475280	0	0	HEVERLY, STEVEN J	11/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5801 CHIQUITA LANE	None	SAN BERNARDINO	CA	92404	3207	00	06000	34.14856232	-117.2488796	San Bernardino County
301190	Non-Physician Medical Practitioner	None	1376094144	0	0	HUYNH, KIMBERLY T NP	5/2/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5837 BRINTWOOD WAY	None	SAN DIEGO	CA	92117	3320	00	06000	32.82740044	-117.1727346	San Diego County
301217	Non-Physician Medical Practitioner	None	1205072816	0	0	HALLIDAY, RHODA A NP	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	1936 ELEANOR AVE	None	SANTA ROSA	CA	95404	3111	00	06000	38.453688	-122.693679	Sonoma County
301246	Non-Physician Medical Practitioner	None	1699145862	0	0	HANES, NATALIE A NP	6/18/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1060 W SIERRA AVE	STE 105	FRESNO	CA	93711	2063	00	06000	36.83009575	-119.8099386	Fresno County
301250	Non-Physician Medical Practitioner	None	1124290093	0	0	HIGHSMITH, AARON S	5/1/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5965 MALTON AVE	None	SIMI VALLEY	CA	93063	3684	00	06000	34.2768975	-118.675107	Ventura County
301274	Non-Physician Medical Practitioner	None	1619501103	0	0	HERNANDEZ, FRANCISCO PA-C	10/20/2020	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	STE 1300	LOS ANGELES	CA	90033	5312	00	06000	34.06269295	-118.2030006	Los Angeles County
301282	Non-Physician Medical Practitioner	None	1750860870	0	0	HEBERT, BIANCA E PA-C	2/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	266 S EL MOLINO AVE	APT 11	PASADENA	CA	91101	2946	00	06000	34.14120789	-118.1368317	Los Angeles County
301305	Non-Physician Medical Practitioner	None	1760736292	0	0	HORWOOD, KRISTIN LINDSAY	6/17/2013	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	SUITE 3416	LOS ANGELES	CA	90033	0000	00	06000	34.060806	-118.20636	Los Angeles County
301330	Non-Physician Medical Practitioner	None	1194819987	0	0	HESS, JENNIFER A	8/31/2005	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
301331	Non-Physician Medical Practitioner	None	1386358612	0	0	HEALY, MACKENZIE M PA	2/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2550 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	00	06000	40.14847323	-122.2180997	Tehama County
301336	Non-Physician Medical Practitioner	None	1750416665	0	0	HORTON, CARRINGTON DAEVON	9/6/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4130 HALLMARK PKWY	SUITE C	SAN BERNARDINO	CA	92407	1877	00	06000	34.16543706	-117.3376443	San Bernardino County
301339	Non-Physician Medical Practitioner	None	1700019353	0	0	HILTON, DOUGLAS M	3/20/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10409 GRIZZLY STREET	None	BAKERSFIELD	CA	93311	9532	00	06000	35.30645654	-119.118195	Kern County
301342	Non-Physician Medical Practitioner	None	1942619325	0	0	HERNANDEZ, JOSE A	9/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35 GRACE TERRACE	None	PASADENA	CA	91105	3436	00	06000	34.12670102	-118.1512797	Los Angeles County
301344	Non-Physician Medical Practitioner	None	1033697172	0	0	HILLER, ERIKA R PA	1/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4234 RIVERWALK PKWY	SUITE 230	RIVERSIDE	CA	92505	3312	00	06000	33.90290859	-117.4941562	Riverside County
301354	Non-Physician Medical Practitioner	None	1093047078	0	0	HAMILTON, BETH	2/7/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	3000 ERICSSON DR	SUITE 100	WARRENDALE	PA	15086	6501	00	06000	40.6586921	-80.10305404	Allegheny County
301381	Non-Physician Medical Practitioner	None	1831221167	0	0	HOFF, KURT ALAN	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	271N L ST	None	DINUBA	CA	93618	2107	00	06000	36.54248431	-119.3921496	Tulare County
301391	Non-Physician Medical Practitioner	None	1710902242	0	0	HUERTA, GLORIA M NP	11/14/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 TOWN AND COUNTRY DR	SUITE 104	NORCO	CA	92860	3611	00	06000	33.92721419	-117.561448	Riverside County
301393	Non-Physician Medical Practitioner	None	1861839425	0	0	HATTON, KIMBERLY L NP	5/4/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14035 ROSEDALE HWY	SP 115	BAKERSFIELD	CA	93314	9682	00	06000	35.38348354	-119.1586995	Kern County
301412	Non-Physician Medical Practitioner	None	1447022827	0	0	HIRSCH, KYLE	10/29/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	360 SAN MIGUEL DR	STE 309	NEWPORT BEACH	CA	92660	7836	00	06000	33.61321911	-117.8722084	Orange County
301438	Non-Physician Medical Practitioner	None	1871279471	0	0	HARRIS, TYLER G PA	4/11/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1950 SUNNYCREST DR	None	FULLERTON	CA	92835	3644	00	06000	33.89240507	-117.9313904	Orange County
301442	Non-Physician Medical Practitioner	None	1255753307	0	0	HOLDREGE, KAREN J NP	12/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7606 HOLLISTER AVE	UNIT 311	GOLETA	CA	93117	2711	00	06000	34.42978532	-119.8933584	Santa Barbara County
301447	Non-Physician Medical Practitioner	None	1194035501	0	0	HUYNH, HOAI-HUONG	11/18/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9350 CAMPUS POINT DR	None	LA JOLLA	CA	92037	1300	00	06000	32.877999	-117.225891	San Diego County
301454	Non-Physician Medical Practitioner	None	1871935882	0	0	HARRIS, KRISTIN	8/16/2013	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	SUITE 150	BEVERLY HILLS	CA	90211	3150	00	06000	34.0653985	-118.3769177	Los Angeles County
301456	Non-Physician Medical Practitioner	None	1467813345	0	0	HERNANDEZ, CARISA L NP	9/10/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7265 PARKSIDE PL	None	RANCHO CUCAMONGA	CA	91701	6321	00	06000	34.12233337	-117.5710276	San Bernardino County
301461	Non-Physician Medical Practitioner	None	1114709821	0	0	HUGHES, KRISTEN NP	2/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	627 W AVENUE Q	STE D	PALMDALE	CA	93551	3891	00	06000	34.58715647	-118.1417372	Los Angeles County
301492	Non-Physician Medical Practitioner	None	1912579889	0	0	HUYNH, LINH T	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	1501 SKYLINE DR	None	MONTEREY	CA	93940	4110	00	06000	36.59323606	-121.9166669	Monterey County
301519	Non-Physician Medical Practitioner	None	1104581537	0	0	HARKER, KAMLYN PA-C	3/18/2025	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
301535	Non-Physician Medical Practitioner	None	1740381896	0	0	HOWARTH, MARGARET	1/19/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11250 PENANOVA ST	None	SAN DIEGO	CA	92129	1027	00	06000	32.99433482	-117.0944943	San Diego County
301609	Non-Physician Medical Practitioner	None	1376965012	0	0	HANSON, CATHERINE M 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	33488 CORTE MANGARINO	None	TEMECULA	CA	92592	9948	00	06000	33.49368831	-117.0754302	Riverside County
301611	Non-Physician Medical Practitioner	None	1710420252	0	0	HA, MAI X NP	4/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CITY DR S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
301615	Non-Physician Medical Practitioner	None	1194138347	0	0	HEALTHRIGHT 360	6/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	521 SOUTH GRAND VIEW STR	None	LOS ANGELES	CA	90057	0000	00	06000	34.06084646	-118.2767813	Los Angeles County
301634	Non-Physician Medical Practitioner	None	1386762268	0	0	HIGASHI, DIANE	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	1600 DIVISADERO ST # 166	None	SAN FRANCISCO	CA	94115	3010	00	06000	37.78475261	-122.43973	San Francisco County
301674	Non-Physician Medical Practitioner	None	1548075898	0	0	HANIF, UZMA NP	4/2/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	71-511 HIGHWAY 111	STE H	RANCHO MIRAGE	CA	92270	4465	00	06000	33.7750795	-116.4496953	Riverside County
301706	Non-Physician Medical Practitioner	None	1295160588	0	0	HOLDEN, SERENITY J	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	3629 W DELTA AVENUE	None	VISALIA	CA	93291	0021	00	06000	36.342207	-119.331	Tulare County
301713	Non-Physician Medical Practitioner	None	1164937884	0	0	HAYS, ERIN S PA	8/22/2018	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
301720	Non-Physician Medical Practitioner	None	1538348560	0	0	HUNT-BRADLYN, PATRICIA D 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	13881 BEAR VALLEY TRAIL	None	REDDING	CA	96003	9139	00	06000	40.69083458	-122.2431979	Shasta County
301721	Non-Physician Medical Practitioner	None	1902975311	0	0	HUNT, WILLIE OLLIE	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	280 W MACARTHUR BLVD	None	OAKLAND	CA	94611	5642	00	06000	37.8242017	-122.2578306	Alameda County
301757	Non-Physician Medical Practitioner	None	1609588847	0	0	HERNANDEZ, ANDRES PA-C	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	2900 WHIPPLE	STE 132	REDWOOD CITY	CA	94062	2843	00	06000	37.4783072	-122.2551089	San Mateo County
301779	Non-Physician Medical Practitioner	None	1992011225	0	0	HOUSER, SARAH WOLFE	3/19/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8170 LAGUNA BLVD	SUITE 220	ELK GROVE	CA	95758	7902	00	06000	38.421054	-121.405365	Sacramento County
301783	Non-Physician Medical Practitioner	None	1356163406	0	0	HENG, JENNIFER	1/20/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 S RAYMOND AVE	None	ALHAMBRA	CA	91801	3166	00	06000	34.09027878	-118.1450083	Los Angeles County
301784	Non-Physician Medical Practitioner	None	1548653108	0	0	HUSSMAN, RYAN D	5/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4664 49TH STREET	None	SAN DIEGO	CA	92115	3239	00	06000	32.76209457	-117.0889144	San Diego County
301807	Non-Physician Medical Practitioner	None	1598361321	0	0	HENRY, KENDALL L PA	4/26/2022	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
301814	Non-Physician Medical Practitioner	None	1437536562	0	0	HUDSON, LINDA PA	10/28/2019	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
301840	Non-Physician Medical Practitioner	None	1679916738	0	0	HARRIS, ELLEN D NP	1/24/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	725 MIDDLE BRIDGE DR	APT 16	FAYETVILLE	NC	28303	0820	00	06000	35.093097	-78.97095	Cumberland County
301844	Non-Physician Medical Practitioner	None	1417594318	0	0	HARTIGAN, JANE E PA-C	7/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	416 AVIATION BLVD	SUITE B	SANTA ROSA	CA	95403	1032	00	06000	38.51406287	-122.7847603	Sonoma County
301847	Non-Physician Medical Practitioner	None	1477924132	0	0	HOANG, JOHN L	10/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12552 WALNUT AVE	None	GARDEN GROVE	CA	92840	5235	00	06000	33.78053566	-117.9397008	Orange County
301862	Non-Physician Medical Practitioner	None	1497216824	0	0	HALL, MEGAN R PA-C	11/23/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	425 DIAMOND DRIVE	SUITE 104-105	LAKE ELSINORE	CA	92530	4495	00	06000	33.65802263	-117.3002985	Riverside County
301880	Non-Physician Medical Practitioner	None	1508634403	0	0	HANDAL, KARINA PA-C	8/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26357 MCBEAN PARKWAY	STE 255	VALENCIA	CA	91355	5504	00	06000	34.41257644	-118.5597683	Los Angeles County
301887	Non-Physician Medical Practitioner	None	1386470755	0	0	HARTWIG, HEATHER PA	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	111 RALEY BLVD	SUITE 100	CHICO	CA	95928	8351	00	06000	39.71601447	-121.790817	Butte County
301905	Non-Physician Medical Practitioner	None	1710226139	0	0	HUYNH, XUYEN KIM	7/26/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14221 EUCLID ST	SUITE H	GARDEN GROVE	CA	92843	4991	00	06000	33.757191	-117.937638	Orange County
301909	Non-Physician Medical Practitioner	None	1942704374	0	0	HENRIKSEN, CAGNE PA-C	5/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2309 ANTONIO AVE	None	CAMARILLO	CA	93010	1414	00	06000	34.24435917	-119.0191975	Ventura County
301964	Non-Physician Medical Practitioner	None	1881424059	0	0	HAILE, ALULA NP	8/29/2024	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
301967	Non-Physician Medical Practitioner	None	1871102590	0	0	HURD, SARAH H NP	5/10/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	57463 29 PALMS HWY	201	YUCCA VALLEY	CA	92284	2925	00	06000	34.12447835	-116.4106891	San Bernardino County
301972	Non-Physician Medical Practitioner	None	1275723660	0	0	HOFFERT, DAISY CHRISTINA	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	1800 W CHARLESTON BLVD	ADMINISTRATION BLDG RM 5	LAS VEGAS	NV	89102	2329	00	06000	36.1590063	-115.1674415	Clark County
301983	Non-Physician Medical Practitioner	None	1255836904	0	0	HAGHNAZARIAN, SHAKEH NP	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	2131 WEST THIRD STREET	None	LOS ANGELES	CA	90057	7992	00	06000	34.06324759	-118.2737045	Los Angeles County
301984	Non-Physician Medical Practitioner	None	1588991822	0	0	HENSON, BRANDY R	6/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18300 HIGHWAY 18	None	APPLE VALLEY	CA	92307	0000	00	06000	34.5406159	-117.2658221	San Bernardino County
302013	Non-Physician Medical Practitioner	None	1538860507	0	0	HARRISON, ZACHARIAH PA-C	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	3110 CHINO AVE	SUITE 150	CHINO HILLS	CA	91709	1211	00	06000	34.01077341	-117.738406	San Bernardino County
302017	Non-Physician Medical Practitioner	None	1033644703	0	0	HAUER-LAURENCIN, KELLY Y PA-C	2/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	450 E ROMIE LN	None	SALINAS	CA	93901	4029	00	06000	36.65983988	-121.6458041	Monterey County
302077	Non-Physician Medical Practitioner	None	1386278547	0	0	HUYNH, MARY ISABELLE COLENE D PA-C	4/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1197 E ARQUES AVE	None	SUNNYVALE	CA	94085	3904	00	06000	37.38051652	-121.9964175	Santa Clara County
302092	Non-Physician Medical Practitioner	None	1407223944	0	0	HECK, HEATHER R	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	4060 RICE ROAD	None	RIVERSIDE	CA	92506	0142	00	06000	33.97468977	-117.3868167	Riverside County
302107	Non-Physician Medical Practitioner	None	1932585361	0	0	HEARN, KEVIN E PA-C	9/10/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	411 YUCCA ROAD	None	FALLBROOK	CA	92028	2649	00	06000	33.382872	-117.1910205	San Diego County
302111	Non-Physician Medical Practitioner	None	1245402130	0	0	HIRSCH, HEATHER L	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	77 MAHOGANY LANE	None	SIMI VALLEY	CA	93065	6922	00	06000	34.25473954	-118.8006965	Ventura County
302114	Non-Physician Medical Practitioner	None	1023157542	0	0	HUTCHINSON, LINDSAY B PA-C	1/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3816 WOODRUFF AVE	STE 412	LONG BEACH	CA	90808	2146	00	06000	33.828102	-118.1165525	Los Angeles County
302144	Non-Physician Medical Practitioner	None	1912566209	0	0	HOM, RYAN M PA-C	8/9/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18300 ROSCOE BLVD	None	NORTHRIGE	CA	91325	4105	00	06000	34.22073847	-118.532988	Los Angeles County
302162	Non-Physician Medical Practitioner	None	1619951654	0	0	HORTON, CHRISTOPHER JAMES	5/15/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1210 E ALMOND AVE	None	MADERA	CA	93637	5606	00	06000	36.94540933	-120.0458266	Madera County
302163	Non-Physician Medical Practitioner	None	1053720359	0	0	HANSON, LEAH M	3/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16602 SELL CIRCLE	APT 49	HUNTINGTON BEACH	CA	92649	3243	00	06000	33.72125075	-118.0490463	Orange County
302177	Non-Physician Medical Practitioner	None	1740813252	0	0	HOWARTH, ELIZABETH M PA-C	6/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 FIVEPOINT	None	IRVINE	CA	92618	2377	00	06000	33.65251244	-117.7317885	Orange County
302187	Non-Physician Medical Practitioner	None	1285062901	0	0	HUYNH, XUAN U	8/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4214 SAN ONOFRE CT	None	CHINO	CA	91710	4930	00	06000	34.00580354	-117.7128638	San Bernardino County
302223	Non-Physician Medical Practitioner	None	1679255327	0	0	HLAVAC, SANDRA	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	31625 DE PORTOLA RD	SUITE 101	TEMECULA	CA	92592	2770	00	06000	33.48359715	-117.1048345	Riverside County
302235	Non-Physician Medical Practitioner	None	1003994278	0	0	HA, MAI M	2/17/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26 LUPARI	None	IRVINE	CA	92618	0116	00	06000	33.64589332	-117.7606963	Orange County
302252	Non-Physician Medical Practitioner	None	1861720328	0	0	HANNAH, SADIE	4/22/2010	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	BOX 0106	SAN FRANCISCO	CA	94143	2204	00	06000	37.7634502	-122.4579779	San Francisco County
302309	Non-Physician Medical Practitioner	None	1609228915	0	0	HAN, HANS P	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	407 FAIRMOUNT AVE	APT 304	OAKLAND	CA	94611	5589	00	06000	37.81911831	-122.2564181	Alameda County
302315	Non-Physician Medical Practitioner	None	1679318711	0	0	HADA, ALEXIS A PA	8/9/2024	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
302353	Non-Physician Medical Practitioner	None	1669067252	0	0	HUANG, ERIKA S 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	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	00	06000	37.70554251	-121.873005	Alameda County
302376	Non-Physician Medical Practitioner	None	1558131573	0	0	HOLLOWAY, LEAH PA-C	8/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
302382	Non-Physician Medical Practitioner	None	1700318979	0	0	HUYNH, YEN N	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	2718 RIVERRUN DRIVE	None	SAN JOSE	CA	95127	1880	00	06000	37.36868653	-121.8406581	Santa Clara County
302391	Non-Physician Medical Practitioner	None	1285922070	0	0	HOLYBEE, RACHEL F	2/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16640 ANGELICA COURT	None	RIVERSIDE	CA	92503	0565	00	06000	33.87776326	-117.4834464	Riverside County
302393	Non-Physician Medical Practitioner	None	1508019167	0	0	HESS, MANUELA A	11/7/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3115 E RUTH PLACE	None	ORANGE	CA	92869	4727	00	06000	33.78144624	-117.8201876	Orange County
302404	Non-Physician Medical Practitioner	None	1447279310	0	0	HEALTHRIGHT 360	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	330 ELLIS ST	None	SAN FRANCISCO	CA	94102	2735	00	06000	37.7850612	-122.4116525	San Francisco County
302408	Non-Physician Medical Practitioner	None	1740914092	0	0	HSIN, JAMIE PA-C	7/11/2024	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
302422	Non-Physician Medical Practitioner	None	1487266292	0	0	HUDSON, MOLLIE S NP	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	3100 SUMMIT ST	2ND FLOOR	OAKLAND	CA	94609	3410	00	06000	37.82018974	-122.2643221	Alameda County
302425	Non-Physician Medical Practitioner	None	1912123811	0	0	HOEFT, JENA N	2/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	00	06000	38.26876442	-122.6598332	Sonoma County
302465	Non-Physician Medical Practitioner	None	1427828052	0	0	HAMAMOTO, KELLY A PA	4/16/2024	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
302481	Non-Physician Medical Practitioner	None	1932471141	0	0	HUANG, HUI-CHIA NP	10/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1259 OAK ST	SUITE 4	SAN FRANCISCO	CA	94117	2268	00	06000	37.77276493	-122.4400088	San Francisco County
302487	Non-Physician Medical Practitioner	None	1780117390	0	0	HERRERA, KRISZTINA	6/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12400 VENTURA BLVD	UNIT 282	STUDIO CITY	CA	91604	5616	00	06000	34.14282973	-118.4031882	Los Angeles County
302496	Non-Physician Medical Practitioner	None	1962987198	0	0	HATHAWAY, LILLIAN J PA-C	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	1798 N GAREY AVE	None	POMONA	CA	91767	2918	00	06000	34.076894	-117.7522688	Los Angeles County
302566	Non-Physician Medical Practitioner	None	1912967498	0	0	HEAL, HEIDI I	3/21/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	79 SAINT RAMON CT	None	DANVILLE	CA	94526	3037	00	06000	37.787501	-121.9793619	Contra Costa County
302571	Non-Physician Medical Practitioner	None	1174651913	0	0	HOFFMAN, AMBER E NP	6/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2725 MYRTLE AVE	None	EUREKA	CA	95501	3425	00	06000	40.78318056	-124.1260558	Humboldt County
302579	Non-Physician Medical Practitioner	None	1902465453	0	0	HAMMERS, AULORA E NP	7/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	47111 MONROE ST	None	INDIO	CA	92201	6739	00	06000	33.70620698	-116.2339008	Riverside County
302586	Non-Physician Medical Practitioner	None	1184221798	0	0	HANSEN, LARAE NP	4/22/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2601 E. MAIN STREET	SUITE 200	VENTURA	CA	93003	0000	00	06000	34.27443821	-119.2609368	Ventura County
302589	Non-Physician Medical Practitioner	None	1760023360	0	0	HEESEN, ISAAC G NP	10/4/2022	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	WEST HOLLYWOOD	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
302603	Non-Physician Medical Practitioner	None	1144594367	0	0	HERNANDEZ, MIRIAM Z PA-C	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	9710 BRIMHALL ROAD	None	BAKERSFIELD	CA	93312	2779	00	06000	35.3687456	-119.1106561	Kern County
302617	Non-Physician Medical Practitioner	None	1144939323	0	0	HULING, JASON PA-C	10/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17271 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	3701	00	06000	33.71228787	-117.9545597	Orange County
302675	Non-Physician Medical Practitioner	None	1336176908	0	0	HARDY, BILLIANA NMI	11/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1002 WALES DR	SUITE 8	KILLEEN	TX	76549	1136	00	06000	31.11284342	-97.76361616	Bell County
302677	Non-Physician Medical Practitioner	None	1134958382	0	0	HAYES, SHANNON NP	1/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9090 WILSHIRE BLVD	STE 200	BEVERLY HILLS	CA	90211	1850	00	06000	34.06702873	-118.3894057	Los Angeles County
302689	Non-Physician Medical Practitioner	None	1396811378	0	0	HEYL, MARY M	10/24/2006	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 AVENUE	None	COLTON	CA	92324	1817	00	06000	34.073505	-117.3505995	San Bernardino County
302692	Non-Physician Medical Practitioner	None	1538790209	0	0	HARBAUGH, ALYSSA NP	2/2/2022	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
302744	Non-Physician Medical Practitioner	None	1487290789	0	0	HOANG, BRITTANY R NP	2/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39141 CIVIC CENTER DR	STE 335	FREMONT	CA	94538	5831	00	06000	37.55436307	-121.9764708	Alameda County
302774	Non-Physician Medical Practitioner	None	1205127651	0	0	HUNTER, JACQUELINE A	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	2210 N THOMAS CT	None	VISALIA	CA	93292	2180	00	06000	36.350091	-119.286945	Tulare County
302782	Non-Physician Medical Practitioner	None	1780897603	0	0	HOLDRIDGE, MARIA SOLIDUM	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	1410 S LA BRUCHERIE RD	None	EL CENTRO	CA	92243	9676	00	06000	32.78048827	-115.578488	Imperial County
302784	Non-Physician Medical Practitioner	None	1982089215	0	0	HARRISON, DYANNA M NP	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
302820	Non-Physician Medical Practitioner	None	1285063362	0	0	HOLM, SETH M NP	12/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17265 TABLE MOUNTAIN RD	None	JAMESTOWN	CA	95327	9708	00	06000	37.9361744	-120.4509824	Tuolumne County
302823	Non-Physician Medical Practitioner	None	1821493230	0	0	HUYNH, JEAN PA-C	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	11370 ANDERSON ST	None	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
302839	Non-Physician Medical Practitioner	None	1689280331	0	0	HEALT, NICHOLAS R PA	6/9/2022	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
302846	Non-Physician Medical Practitioner	None	1093592024	0	0	HWANG, JIM B PA-C	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	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
302862	Non-Physician Medical Practitioner	None	1689304024	0	0	HOREJSI, LOGAN PA-C	8/25/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3095 OLD CONEJO RD	SUITE 200	NEWBURY PARK	CA	91320	2130	00	06000	34.18969088	-118.9412876	Ventura County
302883	Non-Physician Medical Practitioner	None	1215929765	0	0	HAND, RITA RAE	6/26/2009	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	WEST HOLLYWOOD	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
302909	Non-Physician Medical Practitioner	None	1447696448	0	0	HUNTER, VANESSA A NP	2/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	833 ROLAND LANE	None	APPLEGATE	CA	95703	0546	00	06000	38.98644986	-120.9884772	Placer County
302912	Non-Physician Medical Practitioner	None	1295909232	0	0	HYDOCK, CHRISTOPHER M PA	7/24/2019	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
302923	Non-Physician Medical Practitioner	None	1891494936	0	0	HURTADO SALINAS, MARICELA NP	5/23/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	00	06000	34.44257521	-119.7584538	Santa Barbara County
302927	Non-Physician Medical Practitioner	None	1013482231	0	0	HINES, MORGAN PA	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	2800 L ST	STE 10	SACRAMENTO	CA	95816	5616	00	06000	38.571237	-121.469958	Sacramento County
302982	Non-Physician Medical Practitioner	None	1487146213	0	0	HUMBERT, COLEMAN A NP	8/2/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3441 MARYSVILLE BLVD	None	SACRAMENTO	CA	95838	4512	00	06000	38.631231	-121.431402	Sacramento County
303025	Non-Physician Medical Practitioner	None	1215627195	0	0	HERNANDEZ MENDOZA, SILVESTRE NP	9/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16455 MAIN ST	STE 1	HESPERIA	CA	92345	3500	00	06000	34.42186386	-117.3038021	San Bernardino County
303038	Non-Physician Medical Practitioner	None	1255117594	0	0	HORTIZUELA, KAHREENA NP	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	1235 W VINE ST	None	LODI	CA	95240	5144	00	06000	38.12279179	-121.2879362	San Joaquin County
303057	Non-Physician Medical Practitioner	None	1134525728	0	0	HINZ, THERESE NP	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	785 MEDICAL CENTER	203	CLOVIS	CA	93611	6878	00	06000	36.84377271	-119.6609536	Fresno County
303083	Non-Physician Medical Practitioner	None	1962723643	0	0	HUMMEL, DEBRA L NP	1/9/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	274 DURAND WAY	None	PALO ALTO	CA	94304	2382	00	06000	37.43788302	-122.1785928	Santa Clara County
303181	Non-Physician Medical Practitioner	None	1417531104	0	0	HENSON, KEVIN CNP	5/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3814 AUBURN BLVD	SUITE 72	SACRAMENTO	CA	95821	2123	00	06000	38.639034	-121.375305	Sacramento County
303186	Non-Physician Medical Practitioner	None	1447850367	0	0	HUYNH, JENNY M NP	1/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2615 CHESTER AVE	None	BAKERSFIELD	CA	93301	2014	00	06000	35.38333823	-119.0188872	Kern County
303188	Non-Physician Medical Practitioner	None	1699164277	0	0	HETREA, STEPHANIE L NP	11/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4860 Y ST	None	SACRAMENTO	CA	95817	2307	00	06000	38.552211	-121.449429	Sacramento County
303222	Non-Physician Medical Practitioner	None	1053733527	0	0	HI-DESERT MEMORIAL HEALTH CARE DISTRICT	10/29/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	72724 29 PALMS HWY	SUITE 103	TWENTYNINE PALMS	CA	92277	2459	00	06000	34.13547448	-116.076159	San Bernardino County
303232	Non-Physician Medical Practitioner	None	1386913663	0	0	HUMPHRIES, LINDA D NP	6/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1141 W REDONDO BEACH BLV	STE 402	GARDENA	CA	90247	3582	00	06000	33.89247036	-118.2941482	Los Angeles County
303234	Non-Physician Medical Practitioner	None	1346337672	0	0	HEINRICH, KRISTY L PA	8/22/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	00	06000	38.38851772	-121.9382798	Solano County
303270	Non-Physician Medical Practitioner	None	1740987247	0	0	HUTCHINSON, MICHELE NP	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	11180 WARNER AVENUE	380	FOUNTAIN VALLEY	CA	92708	7501	00	06000	33.71632048	-117.9334575	Orange County
303289	Non-Physician Medical Practitioner	None	1972037943	0	0	HOLDGRAFER, TAYLOR PA-C	1/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6955 EL CAMINO REAL	STE 101	ATASCADERO	CA	93422	4216	00	06000	35.48656009	-120.6652493	San Luis Obispo County
303291	Non-Physician Medical Practitioner	None	1275105942	0	0	HEARONS, DOMINGA B NP	3/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9508 STOCKDALE HWY	SUITE 150	BAKERSFIELD	CA	93311	3622	00	06000	35.35453237	-119.1086014	Kern County
303301	Non-Physician Medical Practitioner	None	1588295810	0	0	HEATH, ANGELA M PA	10/11/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	847 W CHILDS AVE	None	MERCED	CA	95341	6805	00	06000	37.28825369	-120.4963159	Merced County
303307	Non-Physician Medical Practitioner	None	1427033216	0	0	HARE, PATRICK M	12/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	SUITE 100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
303337	Non-Physician Medical Practitioner	None	1770223976	0	0	HOFFMAN, JANEEN NP	7/6/2022	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
303349	Non-Physician Medical Practitioner	None	1457115701	0	0	HEIDUK, JILLIAN M PA	4/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
303372	Non-Physician Medical Practitioner	None	1346830817	0	0	HE, JESSICA Y NP	6/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1018 CALLOWAY	None	BAKERSFIELD	CA	93312	6337	00	06000	35.36734178	-119.1115596	Kern County
303418	Non-Physician Medical Practitioner	None	1134328925	0	0	HERRERA, MARLO A	2/11/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5823 YORK BLVD	#1	LOS ANGELES	CA	90042	2634	00	06000	34.11850913	-118.1915335	Los Angeles County
303462	Non-Physician Medical Practitioner	None	1508236993	0	0	HEAD, NICOLETTE NP	12/28/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11100 WARNER AVE	STE 158	FOUNTAIN VALLEY	CA	92708	7510	00	06000	33.716291	-117.9355051	Orange County
303465	Non-Physician Medical Practitioner	None	1104014562	0	0	HILLMAN, CHRISTOPHER J	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	1315 CHENNAULT	None	CLOVIS	CA	93611	0354	00	06000	36.8428876	-119.694678	Fresno County
303487	Non-Physician Medical Practitioner	None	1831108612	0	0	HASHEMI, SAEED AKBAR S	4/7/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7000 COLLEGE AVE	194	BAKERSFIELD	CA	93306	7541	00	06000	35.38338015	-118.9263859	Kern County
303489	Non-Physician Medical Practitioner	None	1780962035	0	0	HOFFMAN, CARLY NICOLE	10/11/2011	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
303490	Non-Physician Medical Practitioner	None	1003457565	0	0	HURTADO, TATIANA PA-C	12/12/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3301 C ST	None	SACRAMENTO	CA	95816	3300	00	06000	38.579877	-121.456143	Sacramento County
303494	Non-Physician Medical Practitioner	None	1255430773	0	0	HUANG, ARCH Z PA	7/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2727 N PECK RD	None	EL MONTE	CA	91733	2434	00	06000	34.060311	-118.0306097	Los Angeles County
303504	Non-Physician Medical Practitioner	None	1285643213	0	0	HUDOCK, MARCUS W	3/15/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	169 COSTELLO COURT	None	FOLSOM	CA	95630	8407	00	06000	38.647296	-121.133727	Sacramento County
303507	Non-Physician Medical Practitioner	None	1760673115	0	0	HARLAN, MICHAEL S	10/20/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1729 TERRACE WAY	None	EUREKA	CA	95501	1564	00	06000	40.79289008	-124.1327329	Humboldt County
303512	Non-Physician Medical Practitioner	None	1982226205	0	0	HOLTZ, MADISON K PA	10/4/2020	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
303528	Non-Physician Medical Practitioner	None	1649419482	0	0	HARRIS, ANDREW ALFRED	12/21/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5475 WALNUT AVE	None	CHINO	CA	91710	2609	00	06000	34.02627053	-117.684846	San Bernardino County
303544	Non-Physician Medical Practitioner	None	1932258431	0	0	HAMILTON, DEBRA S NP	12/14/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	740 N BUBBLING WELL DR	None	GLENDORA	CA	91741	2052	00	06000	34.14835691	-117.8691994	Los Angeles County
303567	Non-Physician Medical Practitioner	None	1740731066	0	0	HOFFMAN, ALEXANDER E	1/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2133 SANTA CLARA AVENUE	APT 207	ALAMEDA	CA	94501	2879	00	06000	37.76790039	-122.2476838	Alameda County
303574	Non-Physician Medical Practitioner	None	1538730429	0	0	HO, JESSICA W PA-C	10/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2900 WHIPPLE AVE	STE 230	REDWOOD CITY	CA	94062	2852	00	06000	37.4783072	-122.2551089	San Mateo County
303622	Non-Physician Medical Practitioner	None	1437714037	0	0	HILTON, MARGARET L PA	8/6/2020	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
303643	Non-Physician Medical Practitioner	None	1629662358	0	0	HERNANDEZ, DIANA NP	2/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	391 N SAN JACINTO ST	None	HEMET	CA	92543	3118	00	06000	33.752565	-116.958687	Riverside County
303653	Non-Physician Medical Practitioner	None	1578193702	0	0	HASHEM, OMAR M NP	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	11234 ANDERSON ST	STE 1617	LOMA LINDA	CA	92354	2804	00	06000	34.049547	-117.264078	San Bernardino County
303668	Non-Physician Medical Practitioner	None	1265836506	0	0	HOSSEINIAN, FAKHRIALSADAT NP	10/24/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14255 ESTHER DR	None	SAN JOSE	CA	95124	2715	00	06000	37.26148617	-121.9355542	Santa Clara County
303672	Non-Physician Medical Practitioner	None	1003300179	0	0	HOWELL, DOUGLAS T	8/3/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6539 N LAUREEN	None	FRESNO	CA	93710	4914	00	06000	36.83087326	-119.7333527	Fresno County
303701	Non-Physician Medical Practitioner	None	1538530738	0	0	HENSHAW, KIMBERLY	2/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28092 CHAMPIONSHIP DR	None	MORENO VALLEY	CA	92555	6411	00	06000	33.89865837	-117.1722838	Riverside County
303709	Non-Physician Medical Practitioner	None	1326420738	0	0	HUETTNER, LAURA A	8/25/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3254 WOODBINE STREET	None	LOS ANGELES	CA	90064	4830	00	06000	34.03289356	-118.4045747	Los Angeles County
303735	Non-Physician Medical Practitioner	None	1649732454	0	0	HILL, ELIANA NP	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	530 E WASHINGTON BLVD	None	LOS ANGELES	CA	90015	3723	00	06000	34.02866849	-118.2597481	Los Angeles County
303738	Non-Physician Medical Practitioner	None	1548023609	0	0	HAKOOPIAN, ROOBINA NP	8/5/2024	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
303748	Non-Physician Medical Practitioner	None	1598927501	0	0	HOORFAR, BIJAN	6/19/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16952 VENTURA BLVD	None	ENCINO	CA	91316	4197	00	06000	34.1596646	-118.5030016	Los Angeles County
303753	Non-Physician Medical Practitioner	None	1235842535	0	0	HOOKS, SHANNON NP	7/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	790 E FOOTHILL BLVD # D	None	RIALTO	CA	92376	5269	00	06000	34.10679349	-117.3556395	San Bernardino County
303766	Non-Physician Medical Practitioner	None	1093016735	0	0	HU, CHARLOTTE LING CHIEN	2/11/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8510 BALBOA BLVD STE 150	None	NORTHRIDGE	CA	91325	5810	00	06000	34.224507	-118.5026015	Los Angeles County
303773	Non-Physician Medical Practitioner	None	1538255914	0	0	HIU, ROSE	8/1/2002	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	0000	00	06000	34.129683	-117.970857	Los Angeles County
303784	Non-Physician Medical Practitioner	None	1891407508	0	0	HA, GISELLE C NP	2/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	00	06000	33.80432955	-118.1594295	Los Angeles County
303789	Non-Physician Medical Practitioner	None	1538567912	0	0	HASDORFF, CHARISE P PA-C	1/1/2022	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	EMERGENCY DEPARTMENT	SAN JOSE	CA	95116	1603	00	06000	37.36217918	-121.8472051	Santa Clara County
303828	Non-Physician Medical Practitioner	None	1851696595	0	0	HWANG, DIANA ESTHER	12/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4318 MAINE AVE	SUITE B	BALDWIN PARK	CA	91706	3324	00	06000	34.090929	-117.9604215	Los Angeles County
303832	Non-Physician Medical Practitioner	None	1831411453	0	0	HARDIN, MEGAN JOHNSTONE	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	1479 YGNACIO VALLEY RD	SUITE 209	WALNUT CREEK	CA	94598	2986	00	06000	37.91301169	-122.0438513	Contra Costa County
303863	Non-Physician Medical Practitioner	None	1821444944	0	0	HANG, KATIE PA-C	7/1/2020	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
303881	Non-Physician Medical Practitioner	None	1396151213	0	0	HUANG, LUCILLE NP	4/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1421 WAYLAND STREET	None	SAN FRANCISCO	CA	94134	1633	00	06000	37.72296516	-122.4162863	San Francisco County
303926	Non-Physician Medical Practitioner	None	1134359359	0	0	HOWES, KAREN I NP	7/25/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1540 DUNFORD WAY	None	ROSEVILLE	CA	95747	6021	00	06000	38.75962858	-121.3237656	Placer County
303953	Non-Physician Medical Practitioner	None	1104173418	0	0	HOOPES, MICHELLE L PA	6/13/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1124 10TH ST	None	EUREKA	CA	95501	1938	00	06000	40.79883286	-124.1578308	Humboldt County
303956	Non-Physician Medical Practitioner	None	1053487231	0	0	HENRY, LORI A NP	6/7/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16044 GRAMERCY DRIVE	None	SAN LEANDRO	CA	94578	1111	00	06000	37.70632426	-122.1103436	Alameda County
304011	Non-Physician Medical Practitioner	None	1962748681	0	0	HURST, MELINDA B CNM	9/3/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18530 HATTERAS ST	UNIT 340	TARZANA	CA	91356	1922	00	06000	34.17743974	-118.5370002	Los Angeles County
304035	Non-Physician Medical Practitioner	None	1942601018	0	0	HESLOP, BRETT PA-C	2/12/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1135 S SUNSET AVE	STE 200	WEST COVINA	CA	91790	3937	00	06000	34.06215064	-117.9453997	Los Angeles County
304055	Non-Physician Medical Practitioner	None	1942676663	0	0	HOLMAN, JENNIFER C	11/14/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13425 APRICOT TREE LANE	None	EASTVILLE	CA	92880	8990	00	06000	33.97342251	-117.5765787	Riverside County
304061	Non-Physician Medical Practitioner	None	1174890263	0	0	HUANG, YUJEN I NP	2/21/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23893 S OLIVE AVE	None	RIPON	CA	95366	9518	00	06000	37.74089563	-121.1559301	San Joaquin County
304067	Non-Physician Medical Practitioner	None	1043533888	0	0	HUBBARD, TIARA R	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	11686 RED DOG ROAD	None	NEVADA CITY	CA	95959	9509	00	06000	39.26260031	-120.9866181	Nevada County
304110	Non-Physician Medical Practitioner	None	1164053880	0	0	HABIB, AHMAD F NP	9/5/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8191 TIMBERLAKE WAY	SUITE 400	SACRAMENTO	CA	95823	5418	00	06000	38.460222	-121.4131365	Sacramento County
304113	Non-Physician Medical Practitioner	None	1487820155	0	0	HERNANDEZ, STEPHANIE A NP	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	8263 LOST RIVER RD	None	CORONA	CA	92880	3916	00	06000	33.93824373	-117.6007116	Riverside County
304155	Non-Physician Medical Practitioner	None	1366435869	0	0	HOCHULI, BRENDA L PA	4/6/2023	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
304161	Non-Physician Medical Practitioner	None	1063012060	0	0	HOEFKE, ANGELA NP	3/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9850 GENESEE AVENUE	SUITE 820	LA JOLLA	CA	92037	1219	00	06000	32.882913	-117.226341	San Diego County
304173	Non-Physician Medical Practitioner	None	1528566742	0	0	HORMAZDI, MEGAN NP	10/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	28081 VIA LUIS	None	LAGUNA NIGUEL	CA	92677	7546	00	06000	33.55496593	-117.6944582	Orange County
304244	Non-Physician Medical Practitioner	None	1881024222	0	0	HAMMOND, NATALIE A PA	12/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 CESAR E CHAVEZ AVE	STE 2200	LOS ANGELES	CA	90033	2476	00	06000	34.05101259	-118.217259	Los Angeles County
304254	Non-Physician Medical Practitioner	None	1104196120	0	0	HESS, JAMIE M NP	11/15/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6398 E CAMINO GRANDE	None	ANAHEIM	CA	92807	4825	00	06000	33.83475944	-117.7677524	Orange County
304260	Non-Physician Medical Practitioner	None	1003830639	0	0	HAHM, EDWARD S	2/20/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	407 DEVONSHIRE BLVD	None	SAN CARLOS	CA	94070	1632	00	06000	37.49627094	-122.2885697	San Mateo County
304278	Non-Physician Medical Practitioner	None	1861120172	0	0	HWANG, DASOL CNP	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	72780 COUNTRY CLUB DR	STE C300	RANCHO MIRAGE	CA	92270	4150	00	06000	33.75795596	-116.392246	Riverside County
304298	Non-Physician Medical Practitioner	None	1063879633	0	0	HOEWING, BONNIE NP	11/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	FIVE MEDICAL PLAZA	STE 190	ROSEVILLE	CA	95661	2865	00	06000	38.76523677	-121.2493453	Placer County
304308	Non-Physician Medical Practitioner	None	1518546068	0	0	HENNESY, MEGAN L PA-C	10/26/2021	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	STE 220	FRESNO	CA	93701	2234	00	06000	36.74333844	-119.7831874	Fresno County
304324	Non-Physician Medical Practitioner	None	1063550713	0	0	HUSER, SUSAN M CNM	7/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	421 EL MEDIO AVE	None	PACIFIC PALISADES	CA	90272	4220	00	06000	34.0407199	-118.5356021	Los Angeles County
304348	Non-Physician Medical Practitioner	None	1013634823	0	0	HAMILTON, ANNETTE G NP	10/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14860 ROSCOE BLVD	#200	PANORAMA CITY	CA	91402	4683	00	06000	34.2214515	-118.4573205	Los Angeles County
304377	Non-Physician Medical Practitioner	None	1265714521	0	0	HUEY, MEGAN R PA	2/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	00	06000	33.85429563	-117.8166478	Orange County
304380	Non-Physician Medical Practitioner	None	1720399843	0	0	HERRERA, RAFAEL JR	7/6/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	642 N JAMES PL	None	ANAHEIM	CA	92801	4710	00	06000	33.83881363	-117.9356934	Orange County
304387	Non-Physician Medical Practitioner	None	1437573516	0	0	HEIRICH, DANA O NP	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	914 CELIA DRIVE	None	PALO ALTO	CA	94303	3508	00	06000	37.44066398	-122.126065	Santa Clara County
304447	Non-Physician Medical Practitioner	None	1003112525	0	0	HEISE, AMINA MICHELLE	2/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8110 BIRMINGHAM WAY BLDG	2ND FLOOR	SAN DIEGO	CA	92123	2758	00	06000	32.79648424	-117.1521397	San Diego County
304460	Non-Physician Medical Practitioner	None	1225746282	0	0	HANSEN, STEPHANIE P CNM	5/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	00	06000	35.39052148	-119.0070765	Kern County
304490	Non-Physician Medical Practitioner	None	1336358217	0	0	HOFFMANN, LINDSEY M	3/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8326 EDGEWOOD ST	None	CHINO	CA	91708	9325	00	06000	33.96801558	-117.6227606	San Bernardino County
304493	Non-Physician Medical Practitioner	None	1114274339	0	0	HOEKMAN, SHAN-YU CNM	9/8/2022	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	100	OAKLAND	CA	94609	3422	00	06000	37.81892183	-122.2640154	Alameda County
304525	Non-Physician Medical Practitioner	None	1821508284	0	0	HARKEMA, ALEXA N PA-C	12/7/2023	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
304529	Non-Physician Medical Practitioner	None	1285674960	0	0	HUNTSINGER, MARY ENG	11/24/2013	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
304534	Non-Physician Medical Practitioner	None	1922191774	0	0	HAKES, ANNE FS	8/6/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2203 W 20TH ST	None	LOS ANGELES	CA	90018	1409	00	06000	34.03884226	-118.3120146	Los Angeles County
304547	Non-Physician Medical Practitioner	None	1710021134	0	0	HOLMES, JENOA L PA-C	1/2/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13010 HESPERIA ROAD	SUITE 200	VICTORVILLE	CA	92395	8315	00	06000	34.48843676	-117.2909745	San Bernardino County
304552	Non-Physician Medical Practitioner	None	1861239477	0	0	HAO, JIMMY NP	12/4/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10538 MISSION GORGE RD	100	SANTEE	CA	92071	3154	00	06000	32.8384953	-116.9677746	San Diego County
304590	Non-Physician Medical Practitioner	None	1750765988	0	0	HAPAK, ASHLEY M NP	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	3949 M STREET	APT A	SACRAMENTO	CA	95819	4056	00	06000	38.567106	-121.454442	Sacramento County
304597	Non-Physician Medical Practitioner	None	1548811193	0	0	HART, ROCHELLE K PA-C	3/12/2020	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
304607	Non-Physician Medical Practitioner	None	1588108526	0	0	HAVEA REGAN, ROSE PA	12/31/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 N CALIFORNIA ST	None	STOCKTON	CA	95204	6019	00	06000	37.97026329	-121.2890849	San Joaquin County
304625	Non-Physician Medical Practitioner	None	1578808192	0	0	HENSLEY, TAMMIE D NP	4/2/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	93 BUNDREN ST	None	OAKVIEW	CA	93022	9401	00	06000	34.40051282	-119.3002988	Ventura County
304643	Non-Physician Medical Practitioner	None	1104368869	0	0	HARAGUNI, MIKI NP	4/6/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12 SHERWOOD DR	None	WESTLAKE VILLAGE	CA	91361	4810	00	06000	34.13172727	-118.820212	Los Angeles County
304659	Non-Physician Medical Practitioner	None	1154303543	0	0	HASS, VIRGINIA M NP	2/1/1999	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2681 7TH AVENUE	None	SACRAMENTO	CA	95818	3901	00	06000	38.545524	-121.4777835	Sacramento County
304674	Non-Physician Medical Practitioner	None	1285874172	0	0	HORNBECK, TRACI	5/20/2009	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	A301	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
304675	Non-Physician Medical Practitioner	None	1316175532	0	0	HEMMERLIN, STACI L NP	3/1/2018	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	STE 270	NAPA	CA	94558	2908	00	06000	38.32316569	-122.2981938	Napa County
304684	Non-Physician Medical Practitioner	None	1548805427	0	0	HOCKADAY, JAZMINE D PA	7/16/2024	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
304685	Non-Physician Medical Practitioner	None	1841844040	0	0	HERRERA, ISHEEN DIZON D PA	11/26/2019	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
304690	Non-Physician Medical Practitioner	None	1730728940	0	0	HACKETT, SAFFRON R NP	7/31/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5841 JAMESON CT	STE 1	CARMICHAEL	CA	95608	0820	00	06000	38.6514	-121.328586	Sacramento County
304700	Non-Physician Medical Practitioner	None	1083482137	0	0	HWANG, LILIAN PA-C	6/18/2024	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
304704	Non-Physician Medical Practitioner	None	1265726426	0	0	HU, AIHUA NP	8/30/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	119 FAIR OAKS AVENUE	None	MOUNTAIN VIEW	CA	94040	1514	00	06000	37.40261045	-122.0988293	Santa Clara County
304725	Non-Physician Medical Practitioner	None	1619517745	0	0	HUBBARD, BENJAMIN PA	1/27/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	00	06000	38.38851772	-121.9382798	Solano County
304746	Non-Physician Medical Practitioner	None	1225410913	0	0	HUANG, LEE-MAY NP	5/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1532 150TH AVE	None	SAN LEANDRO	CA	94578	1823	00	06000	37.70718429	-122.1274288	Alameda County
304810	Non-Physician Medical Practitioner	None	1821320185	0	0	HERBSTCOLLINS, ELIZABETH A	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	4 RANCHVIEW ROAD	None	ROLLING HILLS EST	CA	90274	2434	00	06000	33.78370071	-118.3551986	Los Angeles County
304823	Non-Physician Medical Practitioner	None	1740212109	0	0	HOYT, KAREN SUE	9/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1300 W 7TH ST	None	SAN PEDRO	CA	90732	3505	00	06000	33.73793948	-118.3036095	Los Angeles County
304885	Non-Physician Medical Practitioner	None	1164893681	0	0	HAGEMAN, HANNAH K	1/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	637 E CALIFORNIA BLVD	None	PASADENA	CA	91106	3813	00	06000	34.13589952	-118.137177	Los Angeles County
304888	Non-Physician Medical Practitioner	None	1053081455	0	0	HOANG, BRIAN PA-C	5/3/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19950 RINALDI ST	SUITES 100 103 200	PORTER RANCH	CA	91326	4141	00	06000	34.27560199	-118.5696701	Los Angeles County
304891	Non-Physician Medical Practitioner	None	1821102328	0	0	HAMILTON, KAREN P	4/22/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	249 RIVER RIDGE	None	FOLSOM	CA	95630	1861	00	06000	38.696697	-121.188312	Sacramento County
304910	Non-Physician Medical Practitioner	None	1134839053	0	0	HAKOPIAN, ARMINE NP	7/27/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 S RAYMOND AVE	None	ALHAMBRA	CA	91801	3166	00	06000	34.09027878	-118.1450083	Los Angeles County
304957	Non-Physician Medical Practitioner	None	1356851869	0	0	HOM, ALEXANDRA K PA	10/19/2021	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
304960	Non-Physician Medical Practitioner	None	1710427901	0	0	HATHAWAY, LINDSEY K NP	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	969 RENFRO RD	None	BAKERSFIELD	CA	93314	8926	00	06000	35.36654681	-119.1632926	Kern County
304975	Non-Physician Medical Practitioner	None	1770981888	0	0	HENNIGAN, MATTHEW T PA	6/15/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2830 GLENDESSARY LANE	None	SANTA BARBARA	CA	93105	2960	00	06000	34.44509477	-119.7186392	Santa Barbara County
304994	Non-Physician Medical Practitioner	None	1063147957	0	0	HALL, MADELINE PA	10/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2704 E WILLOW ST	None	SIGNAL HILL	CA	90755	2217	00	06000	33.80432955	-118.1594295	Los Angeles County
305002	Non-Physician Medical Practitioner	None	1588094452	0	0	HOANG, PHU T PA-C	10/8/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3604 N DANEHURST AVE	None	COVINA	CA	91724	3405	00	06000	34.081344	-117.8652105	Los Angeles County
305060	Non-Physician Medical Practitioner	None	1083788541	0	0	HILL, BESTY A NP	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	3030 W SAN GABRIEL AVE	None	FRESNO	CA	93722	4035	00	06000	36.80353866	-119.8450777	Fresno County
305071	Non-Physician Medical Practitioner	None	1023326923	0	0	HARN, DUSTIN J	10/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1002 CAMPUS AVE	None	REDLANDS	CA	92374	3617	00	06000	34.06518555	-117.1692435	San Bernardino County
305075	Non-Physician Medical Practitioner	None	1457374571	0	0	HULTMAN, DANIEL	8/4/1998	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1400 S HARBOR BLVD STE A	None	LA HABRA	CA	90631	7577	00	06000	33.91429299	-117.9326786	Orange County
305089	Non-Physician Medical Practitioner	None	1972629137	0	0	HUYNH, KIET T	3/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16911 SILVER CREST DR	None	SAN DIEGO	CA	92127	2816	00	06000	33.02321429	-117.1160667	San Diego County
305092	Non-Physician Medical Practitioner	None	1225518533	0	0	HONG, JUDY S NP	2/13/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1179 N MCDOWELL BLVD	None	PETALUMA	CA	94954	6559	00	06000	38.26876442	-122.6598332	Sonoma County
305136	Non-Physician Medical Practitioner	None	1568800662	0	0	HEDGES, LINDA M NP	4/18/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3000 Q STREET	2ND FLOOR	SACRAMENTO	CA	95816	7058	00	06000	38.564991	-121.4696565	Sacramento County
305149	Non-Physician Medical Practitioner	None	1437836145	0	0	HALE, JEFFREY 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	5600 CALIFORNIA AVE	STE 101	BAKERSFIELD	CA	93309	1614	00	06000	35.356203	-119.0612695	Kern County
305179	Non-Physician Medical Practitioner	None	1215333406	0	0	HAYES, CARRIE M PA	7/15/2020	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
305209	Non-Physician Medical Practitioner	None	1417394784	0	0	HASKINS, HEIDI D NP	2/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1222 S ALTA VISTA AVE	APARTMENT B	MONROVIA	CA	91016	4086	00	06000	34.13832571	-118.0073509	Los Angeles County
305212	Non-Physician Medical Practitioner	None	1275786709	0	0	HANNAN, JOSHUA D	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	1117 FERN AVE	None	BREA	CA	92821	5218	00	06000	33.91229966	-117.9149009	Orange County
305271	Non-Physician Medical Practitioner	None	1316331838	0	0	HENG, YI L NP	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	13360 CARDINAL RIDGE RD	UNIT D	CHINO HILLS	CA	91709	1251	00	06000	34.01045417	-117.7442545	San Bernardino County
305318	Non-Physician Medical Practitioner	None	1891209219	0	0	HONG, KRISTINA S	2/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7129 LA SARRA DRIVE	None	LANCASTER	CA	93536	8444	00	06000	34.6578452	-118.2570544	Los Angeles County
305348	Non-Physician Medical Practitioner	None	1659773224	0	0	HARTWIG, CHELSEA PA	7/23/2019	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
305357	Non-Physician Medical Practitioner	None	1013658525	0	0	HERNANDEZ, STEVEN J NP	12/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	81812 DOCTOR CARREON BLV	None	INDIO	CA	92201	0607	00	06000	33.70742848	-116.236728	Riverside County
305380	Non-Physician Medical Practitioner	None	1821211806	0	0	HEMMATKHANI ROBERTS, MERCEDES	4/16/2009	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
305395	Non-Physician Medical Practitioner	None	1639711070	0	0	HUNTER, ASHLEY V NP	8/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4050 DUBLIN BLVD	None	DUBLIN	CA	94568	3112	00	06000	37.70554251	-121.873005	Alameda County
305416	Non-Physician Medical Practitioner	None	1427544238	0	0	HAYES, RACHEL NP	4/4/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9508 STOCKDALE HWY	SUITE 150	BAKERSFIELD	CA	93311	3622	00	06000	35.35453237	-119.1086014	Kern County
305420	Non-Physician Medical Practitioner	None	1053985176	0	0	HANSON, ASHLEY T PA-C	11/6/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2880 ATLANTIC AVE	SUITE 170	LONG BEACH	CA	90806	1715	00	06000	33.809382	-118.185001	Los Angeles County
305431	Non-Physician Medical Practitioner	None	1740276419	0	0	HASH, JUDY MELAIE	2/22/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2801 K STREET	SUITE 520	SACRAMENTO	CA	95816	5119	00	06000	38.572947	-121.46904	Sacramento County
305432	Non-Physician Medical Practitioner	None	1316682701	0	0	HE, LAN 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	525 NORTH GARFIELD AVE	None	MONTEREY PARK	CA	91754	1202	00	06000	34.06794352	-118.1229278	Los Angeles County
305454	Non-Physician Medical Practitioner	None	1124187851	0	0	HENDRY, WILL P	5/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14152 MILAN ST	None	WESTMINSTER	CA	92683	4130	00	06000	33.75703487	-118.0334469	Orange County
305463	Non-Physician Medical Practitioner	None	1366797995	0	0	HIRSIG, KATRINA C NP	3/3/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	425 WOODLAND DR	None	LOS OSOS	CA	93402	3733	00	06000	35.31182124	-120.847231	San Luis Obispo County
305470	Non-Physician Medical Practitioner	None	1205440005	0	0	HASEN, ALEXANDRA L PA	5/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	00	06000	33.912117	-117.195849	Riverside County
305514	Non-Physician Medical Practitioner	None	1790710655	0	0	HANSON, STEPHEN H	1/1/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13500 SPRING MOUNTAIN AV	None	BAKERSFIELD	CA	93314	9015	00	06000	35.39501143	-119.1523606	Kern County
305537	Non-Physician Medical Practitioner	None	1891005112	0	0	HOOPER, TAMARA	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	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
305571	Non-Physician Medical Practitioner	None	1285865253	0	0	HANDRON, CHRISTOPHER	10/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 WASHINGTON ST	SUITE 705	SAN DIEGO	CA	92103	2231	00	06000	32.74986289	-117.1599343	San Diego County
305603	Non-Physician Medical Practitioner	None	1669540712	0	0	HALL, MARY ANNE	10/14/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9940 TALBERT AVE	#100	FOUNTAIN VALLEY	CA	92708	5153	00	06000	33.70166347	-117.955494	Orange County
305608	Non-Physician Medical Practitioner	None	1932832912	0	0	HERNANDEZ, ANASTACIA M PA-C	9/20/2024	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
305630	Non-Physician Medical Practitioner	None	1134613201	0	0	HARDIMAN, EARNEST NP	2/14/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 SAN PABLO ST	None	LOS ANGELES	CA	90033	5313	00	06000	34.06238259	-118.2030986	Los Angeles County
305648	Non-Physician Medical Practitioner	None	1073120382	0	0	HUBER, BRANDON PA-C	10/1/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 DELBON AVE	None	TURLOCK	CA	95382	2016	00	06000	37.51052943	-120.8386573	Stanislaus County
305678	Non-Physician Medical Practitioner	None	1336863422	0	0	HOBBS, ROXANNE S NP	12/30/2022	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	None	PALMDALE	CA	93551	4483	00	06000	34.58364037	-118.1441012	Los Angeles County
305690	Non-Physician Medical Practitioner	None	1326529769	0	0	HOWARD, HARRISON PA	10/27/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6699 ALVARADO RD	STE 2200	SAN DIEGO	CA	92120	5253	00	06000	32.77665383	-117.0540279	San Diego County
305704	Non-Physician Medical Practitioner	None	1568995546	0	0	HODGES, BEVERLY NP	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	1524 MCHENRY AVE	SUITE 370	MODESTO	CA	95350	4500	00	06000	37.666233	-120.993933	Stanislaus County
305718	Non-Physician Medical Practitioner	None	1285344283	0	0	HOLE, MARINA PA	1/31/2025	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
305742	Non-Physician Medical Practitioner	None	1184789695	0	0	HIRSCH, JODI PA	4/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
305758	Non-Physician Medical Practitioner	None	1497121545	0	0	HERNANDEZ, JONATHAN PA	3/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 ADOBE ST	None	CONCORD	CA	94520	2313	00	06000	37.97700068	-122.0381159	Contra Costa County
305772	Non-Physician Medical Practitioner	None	1457559726	0	0	HOANG, NAM T	8/17/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	510 S HEWITT	UNIT 403	LOS ANGELES	CA	90013	1659	00	06000	34.04158288	-118.2350401	Los Angeles County
305786	Non-Physician Medical Practitioner	None	1679012033	0	0	HECHANOVA, MARJORIE C NP	5/9/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1812 VERDUGO BLVD	None	GLENDALE	CA	91208	1407	00	06000	34.20560177	-118.216054	Los Angeles County
305793	Non-Physician Medical Practitioner	None	1083929541	0	0	HENNICK, JENNIFER LOUISE	1/18/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	575 N THOMPSON RD	None	TIPTON	CA	93272	9756	00	06000	36.06399345	-119.3122406	Tulare County
305797	Non-Physician Medical Practitioner	None	1710309851	0	0	HUA-FENG, LIEN T P NP	2/8/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17032 VAN NESS AVENUE	None	TORRANCE	CA	90504	2220	00	06000	33.87560241	-118.3178358	Los Angeles County
305831	Non-Physician Medical Practitioner	None	1841350709	0	0	HILL, MARGARET R	1/27/1992	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	144 STONY POINT RD	None	SANTA ROSA	CA	95401	4122	00	06000	38.440494	-122.74353	Sonoma County
305840	Non-Physician Medical Practitioner	None	1417446717	0	0	HAUER-LAURENCIN, JORDAN	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	504 SPRING ST	None	SANTA CRUZ	CA	95060	2028	00	06000	36.98129479	-122.0447515	Santa Cruz County
305851	Non-Physician Medical Practitioner	None	1659776607	0	0	HANCOCK, KIMBERLY M	1/30/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	10167 N ENCORE ST	None	CASA GRANDE	AZ	85122	9853	00	06000	32.97152769	-111.7769527	Pinal County
305858	Non-Physician Medical Practitioner	None	1548994148	0	0	HARRIS, TINA L PA-C	9/4/2024	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
305870	Non-Physician Medical Practitioner	None	1922732049	0	0	HLUDZINSKI, SARAH 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	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
305901	Non-Physician Medical Practitioner	None	1558739052	0	0	HANKS, KATHRYN L	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	8893 N CHANCE AVE	None	FRESNO	CA	93720	1941	00	06000	36.8651927	-119.7531917	Fresno County
305913	Non-Physician Medical Practitioner	None	1144769886	0	0	HAVILAND, NALANI C	8/13/2019	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
305916	Non-Physician Medical Practitioner	None	1205482601	0	0	HIGGINS, RYAN	12/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	333 MERCY AVE	None	MERCED	CA	95340	8319	00	06000	37.33875148	-120.467457	Merced County
305920	Non-Physician Medical Practitioner	None	1871908905	0	0	HARTSHORN, MICHELLE L NP	11/29/2018	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
305921	Non-Physician Medical Practitioner	None	1891123550	0	0	HAMBLIN, NATHAN PA-C	7/21/2020	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
305935	Non-Physician Medical Practitioner	None	1275109639	0	0	HANNA, JULIANNA PA-C	1/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2303	00	06000	34.02980528	-118.4786605	Los Angeles County
305938	Non-Physician Medical Practitioner	None	1003364084	0	0	HILTON, KATHLEEN C NP	11/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13350 BIG BASIN WAY	None	BOULDER CREEK	CA	95006	9237	00	06000	37.12492123	-122.1245364	Santa Cruz County
305939	Non-Physician Medical Practitioner	None	1659102564	0	0	HOBBS, CALLIE NP	12/12/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3883 AIRWAY DR	SUITE 320	SANTA ROSA	CA	95403	1670	00	06000	38.483226	-122.739705	Sonoma County
305944	Non-Physician Medical Practitioner	None	1801253869	0	0	HEALTH AND HUMAN SERVICES AG	5/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3851 ROSECRANS ST	None	SAN DIEGO	CA	92100	3115	00	06000	32.75343795	-117.2028528	San Diego County
305952	Non-Physician Medical Practitioner	None	1306847686	0	0	HENSON, ELAINE R NP	5/20/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8851 CENTER DR	STE 500	LA MESA	CA	91942	3033	00	06000	32.78189749	-117.0075062	San Diego County
305959	Non-Physician Medical Practitioner	None	1184348617	0	0	HAN, THOMAS NP	8/24/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3801 KATELLA AVE	STE 330	LOS ALAMITOS	CA	90720	6900	00	06000	33.80318951	-118.066068	Orange County
305962	Non-Physician Medical Practitioner	None	1326521501	0	0	HAN, DAE K NP	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	1701 SANTA ANITA AVE	None	EL MONTE	CA	91733	3411	00	06000	34.04810648	-118.0424794	Los Angeles County
305988	Non-Physician Medical Practitioner	None	1700913175	0	0	HAYHURST, SUMMER L	3/21/2013	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
305991	Non-Physician Medical Practitioner	None	1326175902	0	0	HANSEN, STEPHANIE LYNN	9/7/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2664 E WATERFORD AVE	SUITE 102	FRESNO	CA	93720	4642	00	06000	36.87625101	-119.7354977	Fresno County
306013	Non-Physician Medical Practitioner	None	1427232651	0	0	HANLY, JENNIFER MICHELLE	12/27/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6430 W SUNSET BLVD STE 6	None	LOS ANGELES	CA	90028	7909	00	06000	34.09797681	-118.3299393	Los Angeles County
306037	Non-Physician Medical Practitioner	None	1427161272	0	0	HERNANDEZ, ALEJANDRO PA	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	1313 W 8TH ST	STE 100	LOS ANGELES	CA	90017	4420	00	06000	34.05048998	-118.269586	Los Angeles County
306058	Non-Physician Medical Practitioner	None	1295993442	0	0	HERRERA, NIDFEL N PA-C	4/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	19042 SOLEDAD CANYON RD	A	SANTA CLARITA	CA	91351	3362	00	06000	34.4156522	-118.46848	Los Angeles County
306086	Non-Physician Medical Practitioner	None	1457829970	0	0	HOANG, JIMMY M PA	3/29/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2121 E COAST HWY	150	CORONA DEL MAR	CA	92625	1931	00	06000	33.60580088	-117.876276	Orange County
306090	Non-Physician Medical Practitioner	None	1548343510	0	0	HORNBECK, SHANA A	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	905 CRESTA WAY	APT 3	SAN RAFAEL	CA	94903	2629	00	06000	38.02214552	-122.5364286	Marin County
306091	Non-Physician Medical Practitioner	None	1295345486	0	0	HOHENBRINK, LESLIE P PA-C	9/8/2020	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
306097	Non-Physician Medical Practitioner	None	1083351423	0	0	HOPSON, MONICA NP	6/22/2022	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
306123	Non-Physician Medical Practitioner	None	1982460622	0	0	HE, XIAOHUA NP	5/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1705 28TH ST	None	BAKERSFIELD	CA	93301	1902	00	06000	35.38477999	-119.0215335	Kern County
306133	Non-Physician Medical Practitioner	None	1124131883	0	0	HERING, KELLY J	10/31/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3184 CHURN CREEK RD	None	REDDING	CA	96002	2122	00	06000	40.56138796	-122.3531253	Shasta County
306147	Non-Physician Medical Practitioner	None	1588092431	0	0	HYUN, JUNG AH	2/5/2014	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 STE 863	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
306180	Non-Physician Medical Practitioner	None	1922432129	0	0	HANDY, JENNIFER K 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	16675 STATE DRIVE	114	CHINO HILLS	CA	91709	7402	00	06000	33.96453294	-117.6896115	San Bernardino County
306199	Non-Physician Medical Practitioner	None	1538455605	0	0	HARGER, KAROLINA M NP	1/28/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2340 CLAY STREET	SUITE 106	SAN FRANCISCO	CA	94115	1932	00	06000	37.79101969	-122.43208	San Francisco County
306213	Non-Physician Medical Practitioner	None	1770884371	0	0	HEFFELFINGER, DANIEL J	4/29/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	670 ALBERT WAY	None	CAMPBELL	CA	95008	3912	00	06000	37.28080279	-121.9616963	Santa Clara County
306235	Non-Physician Medical Practitioner	None	1164962924	0	0	HOM, DIANA	12/26/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	633 N CENTRAL AVE	APT 229	GLENDALE	CA	91203	1815	00	06000	34.155054	-118.2579675	Los Angeles County
306272	Non-Physician Medical Practitioner	None	1811713357	0	0	HARSHMAN, JUSTIN PA	4/14/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 E CESAR E CHAVEZ AV	SUITE 2500	LOS ANGELES	CA	90033	2434	00	06000	34.05101259	-118.217259	Los Angeles County
306313	Non-Physician Medical Practitioner	None	1801077961	0	0	HASTING, LAURA J NP	8/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12615 BEECHFIELD DR	None	BAKERSFIELD	CA	93312	5817	00	06000	35.35919189	-119.1432154	Kern County
306315	Non-Physician Medical Practitioner	None	1902193501	0	0	HEWITT, AMBER J	2/21/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3710 TICE CREEK WAY	None	SACRAMENTO	CA	95833	4441	00	06000	38.626866	-121.519809	Sacramento County
306333	Non-Physician Medical Practitioner	None	1619433117	0	0	HARTMANN, AELI C CNP	11/1/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	700 W 19TH ST	None	COSTA MESA	CA	92627	3517	00	06000	33.64342564	-117.9280911	Orange County
306347	Non-Physician Medical Practitioner	None	1740405810	0	0	HOWARD, ALAN MICHAEL	10/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4645 SAN SEBASTIAN AVE	None	OAKLAND	CA	94602	1442	00	06000	37.81124917	-122.218461	Alameda County
306356	Non-Physician Medical Practitioner	None	1003469693	0	0	HARRIS, JANAE M NP	10/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1601 N MONTE VISTA AVE	#100	CLAREMONT	CA	91711	6601	00	06000	34.112259	-117.698539	Los Angeles County
306399	Non-Physician Medical Practitioner	None	1174606800	0	0	HERNANDEZ, DELIA Y PA-C	5/9/2011	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
306400	Non-Physician Medical Practitioner	None	1699811158	0	0	HANSON, IRENE NP	3/11/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1458 AVENUE E	None	KINGSBURG	CA	93631	2684	00	06000	36.51329395	-119.5715773	Fresno County
306406	Non-Physician Medical Practitioner	None	1568856292	0	0	HINKLE, VIRGINIA L NP	2/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	21671 BAHAMA LANE	None	HUNTINGTON BEACH	CA	92646	7809	00	06000	33.64790274	-117.9681798	Orange County
306412	Non-Physician Medical Practitioner	None	1255781340	0	0	HALL, LAURA E NP	7/11/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2280 HARRISON AVE	STE K	EUREKA	CA	95501	3200	00	06000	40.78745765	-124.1396643	Humboldt County
306431	Non-Physician Medical Practitioner	None	1235118993	0	0	HEDGPETH, NICOLANN L 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	1000 FIVEPOINT	None	IRVINE	CA	92618	2377	00	06000	33.65251244	-117.7317885	Orange County
306458	Non-Physician Medical Practitioner	None	1306220587	0	0	HUMMEL, RAYMOND F 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	750 N KINGS RD	APT 318	WEST HOLLYWOOD	CA	90069	5909	00	06000	34.08466098	-118.3717314	Los Angeles County
306463	Non-Physician Medical Practitioner	None	1811093826	0	0	HERD, APRIL S	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	897 E CROMWELL AVE	None	FRESNO	CA	93720	2518	00	06000	36.84685965	-119.768083	Fresno County
306468	Non-Physician Medical Practitioner	None	1427838234	0	0	HUI, CRYSTAL PA-C	1/30/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	888 S BREA CANYON RD	STE 330	DIAMOND BAR	CA	91789	3059	00	06000	34.00137763	-117.8453859	Los Angeles County
306492	Non-Physician Medical Practitioner	None	1437212727	0	0	HACK, HEATHER	7/21/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1024 CENTRAL PARK DR	None	STEAMBOAT SPRINGS	CO	80487	8813	00	06000	40.46266355	-106.8139862	Routt County
306535	Non-Physician Medical Practitioner	None	1891034328	0	0	HANLAN, MARGO E NP	4/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5 BON AIR ROAD	STE 105	LARKSPUR	CA	94939	1137	00	06000	37.9438204	-122.5395357	Marin County
306536	Non-Physician Medical Practitioner	None	1033774385	0	0	HEATON, BRIAN K 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	400 N PEPPER AVE	None	COLTON	CA	92324	1801	00	06000	34.073505	-117.3505995	San Bernardino County
306537	Non-Physician Medical Practitioner	None	1972310761	0	0	HERNANDEZ, LIBERTY	4/3/2025	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
306563	Non-Physician Medical Practitioner	None	1255730438	0	0	HUMANN ZACHARIAS, DOROTHEA J CNM	7/23/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3838 CALIFORNIA ST .	SUITE 805	SAN FRANCISCO	CA	94118	1510	00	06000	37.78591809	-122.4575439	San Francisco County
306564	Non-Physician Medical Practitioner	None	1548260227	0	0	HOLMES, GINA D PA	9/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1370 TRANCAS ST	BX 406	NAPA	CA	94558	2912	00	06000	38.32254751	-122.301659	Napa County
306591	Non-Physician Medical Practitioner	None	1285162412	0	0	HUNT, RANDY W JR	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	1819 S ST	UNIT 201	SACRAMENTO	CA	95811	6742	00	06000	38.567565	-121.48587	Sacramento County
306607	Non-Physician Medical Practitioner	None	1255881298	0	0	HENNESSEY, BRENNA PA	7/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23621 MAIN ST	None	CARSON	CA	90745	5745	00	06000	33.810615	-118.2757055	Los Angeles County
306633	Non-Physician Medical Practitioner	None	1972597151	0	0	HOLBROOK, HELENE M	9/17/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2151 CENTURY LANE	None	JOHNSON CITY	TN	37604	4469	00	06000	36.308268	-82.3892625	Washington County
306679	Non-Physician Medical Practitioner	None	1629045984	0	0	HEITTER, DAVID ORVILLE	6/28/2007	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	0000	00	06000	41.77272521	-124.1940494	Del Norte County
306686	Non-Physician Medical Practitioner	None	1841276409	0	0	HIXON, ERIC O	9/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2638 GREENWOOD AVENUE	None	MORRO BAY	CA	93442	1547	00	06000	35.39019054	-120.8554262	San Luis Obispo County
306695	Non-Physician Medical Practitioner	None	1194582197	0	0	HESTER, STEPHANIE D NP	10/2/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2656 EDITH AVE	None	REDDING	CA	96001	3030	00	06000	40.57073094	-122.3974088	Shasta County
306700	Non-Physician Medical Practitioner	None	1639681513	0	0	HWANG, TAMMY S NP	8/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15400 LOS GATOS BLVD	None	LOS GATOS	CA	95032	2502	00	06000	37.24572659	-121.957997	Santa Clara County
306739	Non-Physician Medical Practitioner	None	1538248018	0	0	HANKS, KIMBERLY L	6/25/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	881 1ST AVE	None	TRINIDAD	CA	95570	9719	00	06000	41.03243549	-124.1033895	Humboldt County
306780	Non-Physician Medical Practitioner	None	1548643166	0	0	HODGE, CHERYL R	10/31/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	999 RIO SAN DIEGO DR	None	SAN DIEGO	CA	92108	5629	00	06000	32.7755297	-117.1419348	San Diego County
306800	Non-Physician Medical Practitioner	None	1760621890	0	0	HUGHES, BRIAN K PA	5/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	160 E ARTESIA ST	220	POMONA	CA	91767	2921	00	06000	34.07556833	-117.7507835	Los Angeles County
306802	Non-Physician Medical Practitioner	None	1871867259	0	0	HAMILTON, RONETE PELTZ	5/23/2012	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
306804	Non-Physician Medical Practitioner	None	1114459765	0	0	HUNTER, JACOB A	11/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1908 CALIFORNIA ST	UNIT 6	BERKELEY	CA	91703	1272	00	06000	37.87188428	-122.2799174	Alameda County
306808	Non-Physician Medical Practitioner	None	1558475699	0	0	HALEY, MARK MASON	3/30/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	ONE GRAND AVE	None	SAN LUIS OBISPO	CA	93407	0210	00	06000	35.30048884	-120.6580985	San Luis Obispo County
306813	Non-Physician Medical Practitioner	None	1154701399	0	0	HUTCHINSON, MONIQUE PA-C	2/1/2024	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
306817	Non-Physician Medical Practitioner	None	1982383238	0	0	HAKIMIANPOUR, CELINE A 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	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
306834	Non-Physician Medical Practitioner	None	1184900276	0	0	HU, KAI J	4/29/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20925 GLENBROOK DRIVE	None	WALNUT	CA	91789	3846	00	06000	33.99566109	-117.8469987	Los Angeles County
306851	Non-Physician Medical Practitioner	None	1871085662	0	0	HARDIN, KATHERINE NP	7/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4700 HOEN AVE	None	SANTA ROSA	CA	95405	7824	00	06000	38.440899	-122.6643975	Sonoma County
306865	Non-Physician Medical Practitioner	None	1619431269	0	0	HICKS, ELENA NP	11/25/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4153 24TH STREET	4	SAN FRANCISCO	CA	94114	3614	00	06000	37.75120501	-122.4352246	San Francisco County
306873	Non-Physician Medical Practitioner	None	1124701685	0	0	HUYNH, STEPHANIE NP	1/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	235 E BADILLO ST	None	COVINA	CA	91723	1917	00	06000	34.08632446	-117.88677	Los Angeles County
306905	Non-Physician Medical Practitioner	None	1790836302	0	0	HAHM, CHRISTINE SETO	4/9/2012	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
306918	Non-Physician Medical Practitioner	None	1154478311	0	0	HILGEMANN, MARGARET MARY	1/10/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	19840 WATERFORD PLACE	None	SHOREWOOD	MN	55331	0000	00	06000	44.90289069	-93.53091095	Hennepin County
306921	Non-Physician Medical Practitioner	None	1891929907	0	0	HWANG, SARAH	6/6/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3711 BALBOA TERRACE	UNIT C	SAN DIEGO	CA	92117	5432	00	06000	32.80985166	-117.2084365	San Diego County
306925	Non-Physician Medical Practitioner	None	1528270303	0	0	HARUTYUNYAN, LUSINE	6/23/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3834 S WESTERN AVE	None	LOS ANGELES	CA	90062	1104	00	06000	34.016157	-118.3088825	Los Angeles County
306956	Non-Physician Medical Practitioner	None	1205889326	0	0	HALL, WILLIAM C A PA	1/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	749 N VICEROY AVE	None	COVINA	CA	91723	1108	00	06000	34.0936745	-117.8911418	Los Angeles County
306963	Non-Physician Medical Practitioner	None	1700324423	0	0	HOLMES, AMANDA J NP	5/24/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	800 SOUTH MAIN ST	None	CORONA	CA	92882	3420	00	06000	33.872958	-117.568359	Riverside County
306971	Non-Physician Medical Practitioner	None	1740223452	0	0	HARVEY, MICHAEL E	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	16671 VINCENNES ST	None	NORTHRIDGE	CA	91343	2709	00	06000	34.24159276	-118.4962203	Los Angeles County
306999	Non-Physician Medical Practitioner	None	1225698962	0	0	HASEGAWA, CHRIS PA	11/25/2019	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
307009	Non-Physician Medical Practitioner	None	1730822875	0	0	HILLERY, EBONY N NP	5/8/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41880 KALMIA ST	SUITE 100	MURRIETA	CA	92562	8835	00	06000	33.55740114	-117.2157733	Riverside County
307027	Non-Physician Medical Practitioner	None	1437662459	0	0	HUSTEDT, MICHELLE M 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
307028	Non-Physician Medical Practitioner	None	1740677814	0	0	HWANG, EUNAH NP	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	835 W HARNEY LANE	APT 123	LODI	CA	95242	7039	00	06000	38.1011793	-121.3272962	San Joaquin County
307055	Non-Physician Medical Practitioner	None	1821024746	0	0	HAZELTON, TRACY M PA	1/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5092 LARKSPUR WAY	None	KELSEYVILLE	CA	95451	8732	00	06000	38.95290548	-122.7242398	Lake County
307091	Non-Physician Medical Practitioner	None	1003457474	0	0	HALE, AYLA N PA	10/25/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 TOWN AND COUNTRY DR	SUITE 104	NORCO	CA	92860	3611	00	06000	33.92721419	-117.561448	Riverside County
307100	Non-Physician Medical Practitioner	None	1427096643	0	0	HEINEN, JOHN P PA	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	386 CERRO ST	None	ENCINITAS	CA	92024	4806	00	06000	33.03889784	-117.2531892	San Diego County
307105	Non-Physician Medical Practitioner	None	1083349849	0	0	HART, SAMANTHA PA	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	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
307118	Non-Physician Medical Practitioner	None	1508571324	0	0	HO, BENJAMIN N PA-C	4/28/2023	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	STE 220	FRESNO	CA	93701	2234	00	06000	36.74333844	-119.7831874	Fresno County
307139	Non-Physician Medical Practitioner	None	1407053515	0	0	HURD, SARAH B NP	5/21/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1260 S MAIN ST	STE 201	SALINAS	CA	93901	2292	00	06000	36.65656335	-121.6598928	Monterey County
307142	Non-Physician Medical Practitioner	None	1730814401	0	0	HAIRABEDIAN, ERIC D PA-C	11/30/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10 CONGRESS	320	PASADENA	CA	91105	3020	00	06000	34.13396893	-118.1528162	Los Angeles County
307150	Non-Physician Medical Practitioner	None	1639450414	0	0	HUONG-SCHLEIF, SHU TZE	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	115 MALL DR	None	HANFORD	CA	93230	5786	00	06000	36.32396253	-119.6688834	Kings County
307156	Non-Physician Medical Practitioner	None	1720293277	0	0	HENDRICKS, GLENMORE	7/21/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6405 DAY ST	None	RIVERSIDE	CA	92507	0901	00	06000	33.934059	-117.2789475	Riverside County
307178	Non-Physician Medical Practitioner	None	1326599192	0	0	HORVATH, MARIAH B	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	12255 FERNANDO CT	None	SAN DIEGO	CA	92128	1216	00	06000	33.04211495	-117.068582	San Diego County
307199	Non-Physician Medical Practitioner	None	1457996936	0	0	HETZEL, NAOMI A NP	11/22/2019	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
307222	Non-Physician Medical Practitioner	None	1710369434	0	0	HERMAN, RENEE Y PA	10/27/2017	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
307243	Non-Physician Medical Practitioner	None	1477675825	0	0	HERNANDEZ, GENARO 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	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
307251	Non-Physician Medical Practitioner	None	1376641787	0	0	HO, IRENE M	10/27/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	8910 VERNON RD	None	LAKE STEVENS	WA	98258	2400	00	06000	48.00218408	-122.1107815	Snohomish County
307254	Non-Physician Medical Practitioner	None	1174924112	0	0	HARTOGH, RYAN J	2/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20411 HEMMINGWAY STREET	None	WINNETKA	CA	91306	2248	00	06000	34.21392458	-118.5773354	Los Angeles County
307287	Non-Physician Medical Practitioner	None	1821436734	0	0	HAVEN, MARK PA	8/26/2022	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
307292	Non-Physician Medical Practitioner	None	1730462102	0	0	HENRIE, KRISTEN M NP	2/22/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	29936 SHERWOOD AVE	None	MCFARLAND	CA	93250	9512	00	06000	35.67428351	-119.2991573	Kern County
307337	Non-Physician Medical Practitioner	None	1578127114	0	0	HAWKINS, MATTHEW J PA-C	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	726 4TH ST	None	MARYSVILLE	CA	95901	5656	00	06000	39.13872267	-121.5944372	Yuba County
307338	Non-Physician Medical Practitioner	None	1811326838	0	0	HONG, PEARL K NP	1/26/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1780 MOSS CREEK CIRCLE	None	CORONA	CA	92882	5695	00	06000	33.85421485	-117.610984	Riverside County
307351	Non-Physician Medical Practitioner	None	1538986914	0	0	HADWEH, ELIAS PA-C	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	38600 MEDICAL CENTER DR	None	PALMDALE	CA	93551	4483	00	06000	34.58364037	-118.1441012	Los Angeles County
307353	Non-Physician Medical Practitioner	None	1477200954	0	0	HARRIS, SCARLETT E CNM	4/22/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	35 CASA ST	STE 220	SAN LUIS OBISPO	CA	93405	1890	00	06000	35.29359615	-120.6654304	San Luis Obispo County
307395	Non-Physician Medical Practitioner	None	1700425170	0	0	HEDGES, MEGAN L NP	3/7/2022	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
307419	Non-Physician Medical Practitioner	None	1134118573	0	0	HYDORN, TRACY HELEN	9/1/1998	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4 SW OF OCEAN AVE ON MON	None	CARMEL	CA	93921	2393	00	06000	36.55526011	-121.9144573	Monterey County
307449	Non-Physician Medical Practitioner	None	1609100163	0	0	HOPKINS, BARBIE ANNE	3/7/2011	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
307462	Non-Physician Medical Practitioner	None	1952808206	0	0	HUANG, STEPHANIE A	4/17/2020	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
307468	Non-Physician Medical Practitioner	None	1982750212	0	0	HOLOYDA, HANG N	7/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1220 NORTH RD	None	BELMONT	CA	94002	1947	00	06000	37.52572321	-122.2889094	San Mateo County
307477	Non-Physician Medical Practitioner	None	1285028977	0	0	HERNANDEZ, ANANTY Y	10/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12020 BURGESS AVE	None	WHITTIER	CA	90604	3006	00	06000	33.920568	-118.0239045	Los Angeles County
307508	Non-Physician Medical Practitioner	None	1669875266	0	0	HUEY, ALEXANDRA B PA	7/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	40461 MURRIETA HOT SPRIN	# J-01	MURRIETA	CA	92563	0001	00	06000	33.55643046	-117.1786329	Riverside County
307521	Non-Physician Medical Practitioner	None	1073091062	0	0	HELM, ADAM NP	8/3/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7111 FRESNO ST	STE 200	FRESNO	CA	93720	2965	00	06000	36.83951763	-119.7815709	Fresno County
307531	Non-Physician Medical Practitioner	None	1588843874	0	0	HUNT, SHALECHIA A M	12/9/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13485 BRAMBLE LANE	None	VICTORVILLE	CA	92394	9545	00	06000	34.52555877	-117.3685392	San Bernardino County
307556	Non-Physician Medical Practitioner	None	1639777105	0	0	HOOPER, FORREST G NP	11/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8881 FLETCHER PKWY	STE 205	LA MESA	CA	91942	3187	00	06000	32.78442148	-117.0073814	San Diego County
307626	Non-Physician Medical Practitioner	None	1427557305	0	0	HA, STEPHANIE Y NP	8/6/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23517 MAIN ST	SUITE 103	CARSON	CA	90745	5234	00	06000	33.81129174	-118.2756933	Los Angeles County
307630	Non-Physician Medical Practitioner	None	1346268901	0	0	HUFFSTUTTER, SUSAN U M	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	5450 KIRKWOOD DRIVE	#J3	CONCORD	CA	94521	1665	00	06000	37.95813711	-121.9462313	Contra Costa County
307644	Non-Physician Medical Practitioner	None	1346529823	0	0	HOBBS, KEYNAN 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	5565 GROSSMONT CENTER DR	#357	LA MESA	CA	91942	3027	00	06000	32.77978322	-117.0094766	San Diego County
307665	Non-Physician Medical Practitioner	None	1306481973	0	0	HEINMAN, OLGA NP	10/14/2022	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
307670	Non-Physician Medical Practitioner	None	1003696634	0	0	HERSE, ERIN D NP	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	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
307682	Non-Physician Medical Practitioner	None	1104374024	0	0	HAWLEY, SANDY E NP	10/22/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12735 VENICE BLVD	UNIT 1	LOS ANGELES	CA	90066	3710	00	06000	34.00096861	-118.4392245	Los Angeles County
307690	Non-Physician Medical Practitioner	None	1821062878	0	0	HOOPER, BONNIE J NP	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	4244 RIVERWALK PKWY	170	RIVERSIDE	CA	92505	8509	00	06000	33.90336622	-117.49394	Riverside County
307707	Non-Physician Medical Practitioner	None	1699522243	0	0	HARRIS, SYDNEY	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	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
307735	Non-Physician Medical Practitioner	None	1689370405	0	0	HENSON, JACOB L NP	6/2/2023	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
307771	Non-Physician Medical Practitioner	None	1548964562	0	0	HARRELL, KAYLA N PA-C	3/5/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1805 MEDICAL CENTER DR	None	SAN BERNARDINO	CA	92411	1214	00	06000	34.131303	-117.3225325	San Bernardino County
307779	Non-Physician Medical Practitioner	None	1235272345	0	0	HOLLAND, TOSHIKO K	2/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
307797	Non-Physician Medical Practitioner	None	1992739833	0	0	HILLS, DONALD E PA	9/16/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 W LUGONIA AVE	STE 120	REDLANDS	CA	92374	9704	00	06000	34.07027851	-117.218421	San Bernardino County
307836	Non-Physician Medical Practitioner	None	1023764792	0	0	HAZLETT, KATRINA A NP	4/13/2022	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
307915	Non-Physician Medical Practitioner	None	1346558251	0	0	HEADLEE, CAREY A PA	8/31/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7920 FROST STREET	SUITE 200	SAN DIEGO	CA	92123	4289	00	06000	32.80027449	-117.153846	San Diego County
307945	Non-Physician Medical Practitioner	None	1811215999	0	0	HILL-ARNAIZ, MAKAYLA RAE	3/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	380 STEVENS AVE # SB100	None	SOLANA BEACH	CA	92075	2063	00	06000	32.99328265	-117.2619437	San Diego County
307961	Non-Physician Medical Practitioner	None	1932717592	0	0	HATCH, MATTHEW D PA-C	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	600 N HIGHLAND SPRINGS A	None	BANNING	CA	92220	3046	00	06000	33.9316595	-116.9468639	Riverside County
307963	Non-Physician Medical Practitioner	None	1124743836	0	0	HONNOLL, TAYLOR R PA-C	12/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1205 E NORTH STREET	None	MANTECA	CA	95336	4932	00	06000	37.80110374	-121.1974853	San Joaquin County
307969	Non-Physician Medical Practitioner	None	1053580670	0	0	HERNANDEZ, HETZABEL PA-C	4/20/2022	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
307983	Non-Physician Medical Practitioner	None	1245374008	0	0	HILL, MELISSA E PA-C	8/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27109 EASTVALE RD	None	PALOS VERDES PENI	CA	90274	4012	00	06000	33.7762917	-118.3546585	Los Angeles County
307994	Non-Physician Medical Practitioner	None	1609398650	0	0	HALEY, THERESA A	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	2200 COFFEE RD	APT 34	MODESTO	CA	95355	2334	00	06000	37.674855	-120.975744	Stanislaus County
307995	Non-Physician Medical Practitioner	None	1902315427	0	0	HERNANDEZ, NICOLE E PA-C	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	1520 SAN PABLO ST	STE 1300	LOS ANGELES	CA	90033	5312	00	06000	34.06269295	-118.2030006	Los Angeles County
307998	Non-Physician Medical Practitioner	None	1306425715	0	0	HUFFMAN, GREGORY R PA-C	7/30/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1910 OUTLET CENTER DRIVE	None	OXNARD	CA	93036	0677	00	06000	34.2202663	-119.1484221	Ventura County
308024	Non-Physician Medical Practitioner	None	1235301524	0	0	HEALTHY COMMUNITIES, INCORPORATED	3/2/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2580 SAN PABLO AVE	None	OAKLAND	CA	94612	1160	00	06000	37.81671329	-122.2751725	Alameda County
308047	Non-Physician Medical Practitioner	None	1932109204	0	0	HUCKABY, BONNIE	12/10/2024	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
308076	Non-Physician Medical Practitioner	None	1265043004	0	0	HADDOCK, BENJAMIN N PA-C	1/19/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	00	06000	33.763572	-116.4056895	Riverside County
308086	Non-Physician Medical Practitioner	None	1437882883	0	0	HUI, ANNE KLARRYSE	10/25/2024	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
308103	Non-Physician Medical Practitioner	None	1821310236	0	0	HSU, HUA-WEN	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	3535 EL PORTAL DRIVE	APT C304	EL SOBRANTE	CA	94803	2740	00	06000	37.96538217	-122.3189987	Contra Costa County
308104	Non-Physician Medical Practitioner	None	1649503921	0	0	HUANG, ELAINA C 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	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
308105	Non-Physician Medical Practitioner	None	1851989602	0	0	HWANG, YUN NP	3/29/2024	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
308116	Non-Physician Medical Practitioner	None	1235239278	0	0	HEALEY, CHERYL M.	3/22/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4033 3RD AVE STE 210	None	SAN DIEGO	CA	92103	2137	00	06000	32.75053781	-117.1627168	San Diego County
308125	Non-Physician Medical Practitioner	None	1568166965	0	0	HAMED, SAMIR MONEER NAWAF NP	9/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	41670 IVY ST	SUITE C	MURRIETA	CA	92562	4392	00	06000	33.55420371	-117.207013	Riverside County
308195	Non-Physician Medical Practitioner	None	1083713515	0	0	HOOVER, DENISE ANN	5/2/2011	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
308211	Non-Physician Medical Practitioner	None	1700461639	0	0	HONGSERMEIER, LEVI PA-C	11/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1742 OREGON STREET	None	REDDING	CA	96001	1717	00	06000	40.5808265	-122.3932989	Shasta County
308217	Non-Physician Medical Practitioner	None	1164086948	0	0	HARTMAN, MATTHEW PA-C	7/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 COFFEE RD	None	MODESTO	CA	95355	2803	00	06000	37.668645	-120.9756715	Stanislaus County
308234	Non-Physician Medical Practitioner	None	1073983243	0	0	HAWKINS, KIMBERLY NP	5/5/2017	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
308239	Non-Physician Medical Practitioner	None	1043330657	0	0	HSU, JULIEANN A NP	4/27/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	26032 HINCKLEY ST	None	LOMA LINDA	CA	92354	3946	00	06000	34.04297287	-117.2364765	San Bernardino County
308245	Non-Physician Medical Practitioner	None	1508069386	0	0	HEIN, AVA C	4/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8471 NEW WINDSOR	None	RIVERSIDE	CA	92508	6166	00	06000	33.89703635	-117.3173766	Riverside County
308253	Non-Physician Medical Practitioner	None	1225278138	0	0	HA, NIKKI NP	4/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20 ALLEN ST	None	MARTINEZ	CA	94553	2681	00	06000	38.00771973	-122.1331484	Contra Costa County
308300	Non-Physician Medical Practitioner	None	1497159495	0	0	HALDEMAN, SHYLAH M NP	4/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1868 CATALINA BLVD	None	SAN DIEGO	CA	92107	2641	00	06000	32.73783823	-117.2376516	San Diego County
308306	Non-Physician Medical Practitioner	None	1336729623	0	0	HOANG, TIFFANY PA	7/15/2021	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
308327	Non-Physician Medical Practitioner	None	1447528104	0	0	HART, BRITTON R NP	6/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1500 N CALIFORNIA BLVD	APT 235	WALNUT CREEK	CA	94596	7429	00	06000	37.8995574	-122.0635211	Contra Costa County
308356	Non-Physician Medical Practitioner	None	1700221751	0	0	HILL, KISH L PA	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	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
308368	Non-Physician Medical Practitioner	None	1730275629	0	0	HALEY, GLORIA D	3/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5405 ALTON PARKWAY	5-A-300	IRVINE	CA	92604	3718	00	06000	33.67010684	-117.7888898	Orange County
308373	Non-Physician Medical Practitioner	None	1376958173	0	0	HILL, JANET A	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	209 E MAIN STREET	None	WINTERS	CA	95694	2131	00	06000	38.52519981	-121.962982	Yolo County
308395	Non-Physician Medical Practitioner	None	1841527942	0	0	HOANG, TIM P PA-C	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	1850 E WASHINGTON ST	None	COLTON	CA	92324	4621	00	06000	34.0483915	-117.295902	San Bernardino County
308407	Non-Physician Medical Practitioner	None	1548367527	0	0	HOLLINGSWORTH, JOHN M	8/10/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6386 ALVARADO CT	SUITE 210	SAN DIEGO	CA	92120	4905	00	06000	32.77666838	-117.0614255	San Diego County
308411	Non-Physician Medical Practitioner	None	1821556762	0	0	HISASHIMA, ELIZABETH W NP	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	100 S. SAN MATEO DR.	None	SAN MATEO	CA	94401	3805	00	06000	37.5656736	-122.3254527	San Mateo County
308420	Non-Physician Medical Practitioner	None	1417400649	0	0	HASSMAN, SARAH E	2/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	612 OLD SAN FRANCISCO RD	None	SUNNYVALE	CA	94086	7960	00	06000	37.36715633	-122.0223445	Santa Clara County
308430	Non-Physician Medical Practitioner	None	1497142608	0	0	HAMILTON, SABRINA J NP	9/23/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2730 E CONNELLY AVE	None	VISALIA	CA	93292	8031	00	06000	36.339939	-119.2626585	Tulare County
308435	Non-Physician Medical Practitioner	None	1114351814	0	0	HAGMAN, TEAH C	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	5030 YORKSHIRE DRIVE	None	CYPRESS	CA	90630	3607	00	06000	33.82088927	-118.0449987	Orange County
308465	Non-Physician Medical Practitioner	None	1548427941	0	0	HALL, TRACY DENISE	5/10/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5 MEDICAL PLAZA DRIVE	SUITE 120	ROSEVILLE	CA	95661	0000	00	06000	38.76604411	-121.2466761	Placer County
308467	Non-Physician Medical Practitioner	None	1730157868	0	0	HANSEN, ANDREW C PA	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	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
308480	Non-Physician Medical Practitioner	None	1407192438	0	0	HOLM, AMY J NP	11/15/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1634 HYDE ST	None	SAN FRANCISCO	CA	94109	2638	00	06000	37.7959421	-122.4183727	San Francisco County
308482	Non-Physician Medical Practitioner	None	1669178232	0	0	HUBER, ALEXANDRA NP	7/21/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	18200 YORBA LINDA BLVD	SUITE 250	YORBA LINDA	CA	92886	4044	00	06000	33.88842824	-117.8154698	Orange County
308493	Non-Physician Medical Practitioner	None	1538390687	0	0	HALL, JANET M NP	4/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3464 ISLE ROYAL CT	None	PLEASANTON	CA	94588	5215	00	06000	37.67615174	-121.9041573	Alameda County
308496	Non-Physician Medical Practitioner	None	1174262596	0	0	HARLESS, DAVID	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	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
308512	Non-Physician Medical Practitioner	None	1821872045	0	0	HENRY, BRITTANY M 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	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
308513	Non-Physician Medical Practitioner	None	1902092786	0	0	HALE, CYNTHIA M	11/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1375 DELTA WAY	None	PARADISE	CA	95969	4269	00	06000	39.76727188	-121.5968169	Butte County
308524	Non-Physician Medical Practitioner	None	1245325315	0	0	HAPAK, SHARON ANNE	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	1600 EUREKA RD	MUSKULOSKLELETAL SERVICE	ROSEVILLE	CA	95661	3027	00	06000	38.746836	-121.250529	Placer County
308546	Non-Physician Medical Practitioner	None	1902201429	0	0	HAAKENSON, STEVEN B 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
308603	Non-Physician Medical Practitioner	None	1174048607	0	0	HARPER, ALINA R	11/7/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8544 HAZEL CREST CT	None	ELK GROVE	CA	95624	2803	00	06000	38.420928	-121.3873605	Sacramento County
308607	Non-Physician Medical Practitioner	None	1205465945	0	0	HUGHES, JONATHAN NP	12/8/2024	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
308609	Non-Physician Medical Practitioner	None	1427827203	0	0	HOLLINGER, TREVOR T PA-C	1/15/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1798 N GAREY AVE	None	POMONA	CA	91767	2918	00	06000	34.076894	-117.7522688	Los Angeles County
308617	Non-Physician Medical Practitioner	None	1821860826	0	0	HAN, HANNAH S NP	11/3/2023	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
308648	Non-Physician Medical Practitioner	None	1851310379	0	0	HOUSTON, REBECCA LYNN	6/2/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	500 N RAINBOW BLVD	#203	LAS VEGAS	NV	89107	1082	00	06000	36.17824166	-115.2421974	Clark County
308667	Non-Physician Medical Practitioner	None	1760890354	0	0	HEALEY, ERIN	7/29/2024	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
308687	Non-Physician Medical Practitioner	None	1598410946	0	0	HERNANDEZ, ANGELA G 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	5565 GROSSMONT CENTER DR	#357	LA MESA	CA	91942	3027	00	06000	32.77978322	-117.0094766	San Diego County
308694	Non-Physician Medical Practitioner	None	1912523978	0	0	HENIGMAN, HANNAH	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	210 N TUSTIN AVE	None	SANTA ANA	CA	92705	3807	00	06000	33.746805	-117.834147	Orange County
308716	Non-Physician Medical Practitioner	None	1811207632	0	0	HAIMANOT, BEKELE T	11/19/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9528 LOS COCHES COURT	None	RIVERSIDE	CA	92508	0000	00	06000	33.878016	-117.3219745	Riverside County
308752	Non-Physician Medical Practitioner	None	1215329396	0	0	HYSTAD, BERNADETTE M	7/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2145 SANTA CLARA AVE	APT B	ALAMEDA	CA	94501	2871	00	06000	37.76769387	-122.2472157	Alameda County
308792	Non-Physician Medical Practitioner	None	1356958425	0	0	HELMUTH, ALYSSA M PA	11/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	250 SOUTH GRAND AVE	None	GLENDORA	CA	91741	4218	00	06000	34.132842	-117.872523	Los Angeles County
308800	Non-Physician Medical Practitioner	None	1346599073	0	0	HARRINGTON, KRISTEN C	10/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	865 PARK VIEW TERRACE	None	GLENDORA	CA	91741	2442	00	06000	34.13908192	-117.8796962	Los Angeles County
308831	Non-Physician Medical Practitioner	None	1134547599	0	0	HENDERSON, KYLE A	1/30/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7296 BRIZA LOOP	None	SAN RAMON	CA	94582	5070	00	06000	37.77715751	-121.9287943	Contra Costa County
308868	Non-Physician Medical Practitioner	None	1851701502	0	0	HAMMOND, HILARY C	8/15/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1354 CHESTNUT ST	None	SAN FRANCISCO	CA	94123	3164	00	06000	37.80218179	-122.4256539	San Francisco County
308872	Non-Physician Medical Practitioner	None	1124009915	0	0	HERING, LETA S NP	4/2/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	528 W RIO VIEW CIRCLE	None	FRESNO	CA	93711	6960	00	06000	36.85474975	-119.80325	Fresno County
308893	Non-Physician Medical Practitioner	None	1487119103	0	0	HUANG, XIAOQIONG NP	1/13/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	316 E LAS TUNAS DR	STE 102	SAN GABRIEL	CA	91776	1535	00	06000	34.10314065	-118.096387	Los Angeles County
308905	Non-Physician Medical Practitioner	None	1780352328	0	0	HAZAMA, KELSEY A PA-C	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	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	00	06000	36.327888	-119.294919	Tulare County
308907	Non-Physician Medical Practitioner	None	1295226231	0	0	HUA, DENISE NP	6/28/2018	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
308910	Non-Physician Medical Practitioner	None	1053764704	0	0	HOANG, TANYA NP	10/9/2020	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
308915	Non-Physician Medical Practitioner	None	1245548874	0	0	HOANG, CYNTHIA	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	107 N MCKINLEY ST	None	CORONA	CA	92879	6561	00	06000	33.88230027	-117.5145319	Riverside County
308919	Non-Physician Medical Practitioner	None	1891210324	0	0	HINSON, SAWYER J PA-C	9/20/2022	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
308938	Non-Physician Medical Practitioner	None	1417778564	0	0	HETTEMA, AMANDA CNM	2/5/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1405 MAGNOLIA AVE	STE A	CHICO	CA	95926	3226	00	06000	39.74046859	-121.8497839	Butte County
308957	Non-Physician Medical Practitioner	None	1730235383	0	0	HALEY, KEVIN DAVID	7/11/2006	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5405 ALTON PKWY	SUITE 5-A-300	IRVINE	CA	92604	3717	00	06000	33.67010684	-117.7888898	Orange County
308971	Non-Physician Medical Practitioner	None	1508142068	0	0	HARTMAYER, LISA MICHELE	11/21/2011	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	SUITE A701	SAN FRANCISCO	CA	94143	2202	00	06000	37.76344756	-122.4581992	San Francisco County
308973	Non-Physician Medical Practitioner	None	1104942762	0	0	HYMAN, KENNETH M PA-C	4/11/2022	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
308991	Non-Physician Medical Practitioner	None	1013516996	0	0	HARMIS, NATASHA PA	7/19/2021	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
309052	Non-Physician Medical Practitioner	None	1902870835	0	0	HOLWEGER, AMY K	5/1/2001	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2640 BIEHN STREET	SUITE 1	KLAMATH FALLS	OR	97601	1801	00	06000	42.2454811	-121.7916325	Klamath County
309060	Non-Physician Medical Practitioner	None	1629372305	0	0	HENRY, LEAH B NP	11/16/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	7681 LETHBRIDGE AVENUE	None	LAS VEGAS	NV	89131	1106	00	06000	36.31977862	-115.2615031	Clark County
309070	Non-Physician Medical Practitioner	None	1619321858	0	0	HWANG, LILIAN PA	10/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2888 LONG BEACH BLVD	SUITE 210	LONG BEACH	CA	90806	1530	00	06000	33.809706	-118.189343	Los Angeles County
309075	Non-Physician Medical Practitioner	None	1386670776	0	0	HERMAN, CLAUDE PA-C	10/24/2022	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
309098	Non-Physician Medical Practitioner	None	1134887029	0	0	HERNANDEZ, JED P PA-C	7/20/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3630 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2609	00	06000	33.93112671	-118.2035532	Los Angeles County
309111	Non-Physician Medical Practitioner	None	1093706558	0	0	HALL, CORY T	10/21/2005	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
309139	Non-Physician Medical Practitioner	None	1669738423	0	0	HEILIG-ADAMS, ANNA R	5/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3905 LINDEN AVE	None	LONG BEACH	CA	90807	2714	00	06000	33.82927125	-118.1865153	Los Angeles County
309142	Non-Physician Medical Practitioner	None	1124751953	0	0	HOANG, LISA X PA	11/28/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	39000 BOB HOPE DR	None	RANCHO MIRAGE	CA	92270	3221	00	06000	33.763572	-116.4056895	Riverside County
309146	Non-Physician Medical Practitioner	None	1558085787	0	0	HUTCHINS, JUSTIN	9/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2400 S AVENUE A	None	YUMA	AZ	85364	7127	00	06000	32.683167	-114.633459	Yuma County
309160	Non-Physician Medical Practitioner	None	1053097857	0	0	HOANG, WHITNEY T NP	11/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2571 PARK AVE	None	CONCORD	CA	94520	1901	00	06000	37.98410885	-122.0337521	Contra Costa County
309166	Non-Physician Medical Practitioner	None	1134750474	0	0	HERRICK, BENJAMIN A NP	11/4/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12550 HESPERIA RD	SUITE 100	VICTORVILLE	CA	92395	5873	00	06000	34.47928534	-117.2909553	San Bernardino County
309173	Non-Physician Medical Practitioner	None	1558861997	0	0	HERNANDEZ, CYNTHIA T NP	8/17/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	255 N GILBERT ST	BLDG B, STE A	HEMET	CA	92543	4066	00	06000	33.75067797	-116.976072	Riverside County
309174	Non-Physician Medical Practitioner	None	1053801670	0	0	HO, KIMBERLY PA-C	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	1135 S SUNSET BLVD	SUITE 301	WEST COVINA	CA	91790	3707	00	06000	34.06215064	-117.9453997	Los Angeles County
309194	Non-Physician Medical Practitioner	None	1124090162	0	0	HALLORAN, JASMINE M	1/15/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	377 SANTA CLARA AVE	APT 307	OAKLAND	CA	94610	2660	00	06000	37.8132922	-122.2483855	Alameda County
309198	Non-Physician Medical Practitioner	None	1598720732	0	0	HONDA, LINDA M NP	6/12/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5821 JAMESON CT	None	CARMICHAEL	CA	95608	0820	00	06000	38.651409	-121.3290945	Sacramento County
309207	Non-Physician Medical Practitioner	None	1427531490	0	0	HARUTYUNYAN, IZABELA NP	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	4342 WHITSETT AVE	APT 5	STUDIO CITY	CA	91604	1693	00	06000	34.14980449	-118.4052188	Los Angeles County
309231	Non-Physician Medical Practitioner	None	1922875947	0	0	HUGHES, CYNTHIA B NP	3/4/2024	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
309236	Non-Physician Medical Practitioner	None	1932260254	0	0	HANNAH, TERRI MARIE	4/1/1998	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	874 W MARTIN LUTHER KING	None	LOS ANGELES	CA	90037	1205	00	06000	34.01092167	-118.2898462	Los Angeles County
309241	Non-Physician Medical Practitioner	None	1942315965	0	0	HI-DESERT MEMORIAL HEALTH CARE DISTRICT	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	58375 29 PALMS HWY	SUITE B	YUCCA VALLEY	CA	92284	5813	00	06000	34.13141256	-116.3904357	San Bernardino County
309251	Non-Physician Medical Practitioner	None	1962854034	0	0	HERNANDEZ, JENNIFER L NP	6/7/2018	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
309259	Non-Physician Medical Practitioner	None	1891388641	0	0	HEDVAT, SHANA NP	3/20/2024	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
309294	Non-Physician Medical Practitioner	None	1912620808	0	0	HAMILTON, DEIDRE PA-C	5/13/2024	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
309325	Non-Physician Medical Practitioner	None	1760805444	0	0	HARPER, LAURA PA-C	9/13/2022	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
309344	Non-Physician Medical Practitioner	None	1053745059	0	0	HALTER, KENNETH N PA	5/8/2018	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
309364	Non-Physician Medical Practitioner	None	1730803438	0	0	HAPUARACHCHI, RUCHITTRANI R PA-C	6/5/2024	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
309366	Non-Physician Medical Practitioner	None	1518154277	0	0	HALL, EUNICE E NP	2/9/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3349 G STREET	SUITE F	MERCED	CA	95340	0978	00	06000	37.32432497	-120.4693064	Merced County
309381	Non-Physician Medical Practitioner	None	1477137172	0	0	HENLINE, THOMAS J PA-C	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	2175 ROSALINE AVE	None	REDDING	CA	96001	2509	00	06000	40.57278686	-122.3958519	Shasta County
309391	Non-Physician Medical Practitioner	None	1427504190	0	0	HERMOSILLO, JESUS G	2/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5034 SNOW DR	None	SAN JOSE	CA	95111	2731	00	06000	37.27138729	-121.804225	Santa Clara County
309405	Non-Physician Medical Practitioner	None	1912925967	0	0	HUCHTING, JEANNE MARIE	2/1/2006	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	365,530,420,120	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
309414	Non-Physician Medical Practitioner	None	1801386149	0	0	HABEEB, GINA 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	23080 ALESSANDRO BLVD	#202	MORENO VALLEY	CA	92553	9674	00	06000	33.91731429	-117.2599095	Riverside County
309418	Non-Physician Medical Practitioner	None	1194495440	0	0	HAMPTON, MARIE ANTOINETTE NP	3/24/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	57463 29 PALMS HWY	201	YUCCA VALLEY	CA	92284	2925	00	06000	34.12447835	-116.4106891	San Bernardino County
309448	Non-Physician Medical Practitioner	None	1679784185	0	0	HERFERT, LOU ANN TABOR	8/18/2010	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
309474	Non-Physician Medical Practitioner	None	1831800564	0	0	HECOMOVICH, EMILY PA	12/1/2023	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
309484	Non-Physician Medical Practitioner	None	1649225871	0	0	HOWARD, NANCY ANN	7/16/2004	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1441 FLORIDA AVENUE	None	MODESTO	CA	95350	0000	00	06000	37.66508443	-120.9962589	Stanislaus County
309486	Non-Physician Medical Practitioner	None	1326553710	0	0	HALPERN, DAVID L NP	6/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8260 MIRA MESA BLVD	SUITE A	SAN DIEGO	CA	92126	2662	00	06000	32.91277002	-117.1459433	San Diego County
309569	Non-Physician Medical Practitioner	None	1467791301	0	0	HOLBROOK, JOHN P	2/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	100 PARK VISTA DR	APT 3088	LAS VEGAS	NV	89138	3041	00	06000	36.17824986	-115.3449524	Clark County
309572	Non-Physician Medical Practitioner	None	1922460914	0	0	HUIZAR, DIANA C NP	4/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	550 SAUBER CT	None	LIVINGSTON	CA	95334	9109	00	06000	37.38750957	-120.7018192	Merced County
309574	Non-Physician Medical Practitioner	None	1770027724	0	0	HANCOCK, SUSAN K NP	3/2/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1550 MIDNIGHT COWBOY CT	None	LAS VEGAS	NV	89110	5918	00	06000	36.18797651	-115.0261988	Clark County
309611	Non-Physician Medical Practitioner	None	1770033995	0	0	HARBAN, MICHELLE R 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	782 MEDICAL CENTER DRIVE	STE 212	CLOVIS	CA	93611	6889	00	06000	36.84379626	-119.6609117	Fresno County
309615	Non-Physician Medical Practitioner	None	1699335026	0	0	HALL, NICOLE S PA	7/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4501 SAND CREEK ROAD	None	ANTIOCH	CA	94531	8577	00	06000	37.94947636	-121.7752571	Contra Costa County
309616	Non-Physician Medical Practitioner	None	1104016104	0	0	HERNANDEZ, MAYRA MARLEN	8/3/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3831 HUGHES AVE	SUITE 604	CULVER CITY	CA	90232	2751	00	06000	34.02243278	-118.3981492	Los Angeles County
309623	Non-Physician Medical Practitioner	None	1942740774	0	0	HAMLER, NANCY PA	2/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1650 CREEKSIDE DRIVE	None	FOLSOM	CA	95630	3400	00	06000	38.67021	-121.145382	Sacramento County
309624	Non-Physician Medical Practitioner	None	1588229991	0	0	HUYNH, HA T PA	11/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CITY DR S	BLDG 25	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
309643	Non-Physician Medical Practitioner	None	1982234027	0	0	HORNFELD, COURTNEY A NP	2/16/2021	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
309667	Non-Physician Medical Practitioner	None	1558847129	0	0	HAMILTON, ANNE M 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	2581 SAMARITAN DR	None	SAN JOSE	CA	95124	4112	00	06000	37.25305684	-121.9507351	Santa Clara County
309680	Non-Physician Medical Practitioner	None	1174916753	0	0	HIZON, ANA	11/21/2022	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
309699	Non-Physician Medical Practitioner	None	1326740952	0	0	HELT, ALAINA M NP	9/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	802 W COLTON AVENUE	SUITE E	REDLANDS	CA	92374	2905	00	06000	34.06290649	-117.1918845	San Bernardino County
309715	Non-Physician Medical Practitioner	None	1568199578	0	0	HAMMONDS, ALEXANDER M PA-C	12/6/2022	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
309727	Non-Physician Medical Practitioner	None	1356786123	0	0	HOUSER, MELANIE N	4/12/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4372 PASADERA WAY	None	TURLOCK	CA	95382	8636	00	06000	37.53393121	-120.8629648	Stanislaus County
309768	Non-Physician Medical Practitioner	None	1477893915	0	0	HORISONS UNLIMITED	8/28/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5320 HIGHWAY 49 N	None	MARIPOSA	CA	95338	9588	00	06000	37.49881243	-119.9844614	Mariposa County
309814	Non-Physician Medical Practitioner	None	1124893193	0	0	HERNANDEZ, CHRISTINA R NP	6/10/2024	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
309832	Non-Physician Medical Practitioner	None	1861430050	0	0	HAMM, GARY K	6/9/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13400 DRY CREEK RD	None	AUBURN	CA	95602	8427	00	06000	38.96057261	-121.074782	Placer County
309836	Non-Physician Medical Practitioner	None	1285241919	0	0	HWANG, JANNISEN NP	7/23/2021	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
309855	Non-Physician Medical Practitioner	None	1477818672	0	0	HARRIS, KATHRYN B	2/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1304 BAYSIDE CIRCLE	None	OXNARD	CA	93035	2148	00	06000	34.1883683	-119.2317369	Ventura County
309890	Non-Physician Medical Practitioner	None	1740653807	0	0	HENRY, KATHLEEN C	1/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5873 ELMHURST AVENUE	None	RANCHO CUCAMONGA	CA	91737	2911	00	06000	34.14660644	-117.5855187	San Bernardino County
309894	Non-Physician Medical Practitioner	None	1427373208	0	0	HARRIS, JILL RENEE	8/13/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2240 N. HARBOR BLVD	SUITE 200	FULLERTON	CA	92835	0000	00	06000	33.89764434	-117.929218	Orange County
309908	Non-Physician Medical Practitioner	None	1457300923	0	0	HONG, DAVID D	8/18/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	00	06000	34.28200485	-118.4030797	Los Angeles County
309910	Non-Physician Medical Practitioner	None	1063797363	0	0	HEISE, CHRISTINE KAY	10/22/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	1919 E THOMAS RD	None	PHOENIX	AZ	85016	7710	00	06000	33.478749	-112.0426515	Maricopa County
309929	Non-Physician Medical Practitioner	None	1912984113	0	0	HASTINGS, RYAN D PA-C	3/7/2013	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
309958	Non-Physician Medical Practitioner	None	1851075865	0	0	HERRERA, MARIA D NP	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	26800 CROWN VALLEY PKWY	STE 305, 315, 325, 330	MISSION VIEJO	CA	92691	8033	00	06000	33.56286021	-117.6673449	Orange County
309971	Non-Physician Medical Practitioner	None	1861164733	0	0	HAGADONE, YUKIKO I NP	5/30/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	191 S BUENA VISTA STREET	SUITE 200-240	BURBANK	CA	91505	4542	00	06000	34.15872557	-118.3283863	Los Angeles County
309975	Non-Physician Medical Practitioner	None	1407890320	0	0	HERNANDEZ, LUZ M NP	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	1621 W IMOLA AVE	None	NAPA	CA	94559	4721	00	06000	38.28190003	-122.2926629	Napa County
309992	Non-Physician Medical Practitioner	None	1598235764	0	0	HAN, CHRISTINE N NP	8/29/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8590 RIO SAN DIEGO DR	SUITE 111	SAN DIEGO	CA	92108	5507	00	06000	32.77472926	-117.1448295	San Diego County
310007	Non-Physician Medical Practitioner	None	1407232754	0	0	HENDRICKSON, EMILY J PA	12/4/2019	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	WEST HOLLYWOOD	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
310041	Non-Physician Medical Practitioner	None	1891856654	0	0	HARTLEY, DANIEL J NP	11/5/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	136 CHAFFEY COURT	None	VACAVILLE	CA	95687	4619	00	06000	38.35818206	-121.9502571	Solano County
310048	Non-Physician Medical Practitioner	None	1679752315	0	0	HAGEN, SCOTT W	6/16/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	381 E NEES AVE	UNIT 105	FRESNO	CA	93720	2023	00	06000	36.85185049	-119.7800055	Fresno County
310055	Non-Physician Medical Practitioner	None	1477922045	0	0	HERNANDEZ, HUGO PA-C	10/11/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 E HERNDON AVE	None	FRESNO	CA	93720	3235	00	06000	36.83626267	-119.7674845	Fresno County
310064	Non-Physician Medical Practitioner	None	1093234882	0	0	HALL, SACHA B PA-C	4/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2280 HARRISON AVE	SUITE B	EUREKA	CA	95501	3200	00	06000	40.78745765	-124.1396643	Humboldt County
310077	Non-Physician Medical Practitioner	None	1043375785	0	0	HINEMAN, LISA D NP	1/3/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1245 WILSHIRE BLVD	STE 303	LOS ANGELES	CA	90017	4803	00	06000	34.05362775	-118.2661889	Los Angeles County
310079	Non-Physician Medical Practitioner	None	1154801140	0	0	HARRIS, PAULYN G NP	9/29/2021	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
310105	Non-Physician Medical Practitioner	None	1275254419	0	0	HEATON, MARGARET E NP	12/9/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	00	06000	34.069509	-118.383743	Los Angeles County
310140	Non-Physician Medical Practitioner	None	1730753815	0	0	HUANG, HELEN X PA-C	9/23/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	00	06000	34.069509	-118.383743	Los Angeles County
310145	Non-Physician Medical Practitioner	None	1467639138	0	0	HUYNH, IRVING H	7/19/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	10415 HOYT PARK PLACE	None	EL MONTE	CA	91733	2325	00	06000	34.06592448	-118.0447065	Los Angeles County
310151	Non-Physician Medical Practitioner	None	1568556363	0	0	HEALTHRIGHT 360	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	1748 MARKET ST	SUITE 201	SAN FRANCISCO	CA	94102	5800	00	06000	37.77238427	-122.4228556	San Francisco County
310171	Non-Physician Medical Practitioner	None	1003221078	0	0	HAMILTON, JAMES N PA	5/20/2021	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
310182	Non-Physician Medical Practitioner	None	1225588130	0	0	HAASS, ADRIANNA M	11/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1587 GLENCREST DR	None	SAN MARCOS	CA	92078	1024	00	06000	33.10679075	-117.2064554	San Diego County
310194	Non-Physician Medical Practitioner	None	1063692366	0	0	HIGGINS, KENDRA 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	2860 TERRAZA PL	None	FULLERTON	CA	92835	2409	00	06000	33.90350411	-117.936588	Orange County
310229	Non-Physician Medical Practitioner	None	1245439488	0	0	HILTON, GENELL D NP	5/27/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7232 ELLEN LANE	None	FORESTVILLE	CA	95436	9291	00	06000	38.46878904	-122.8973959	Sonoma County
310235	Non-Physician Medical Practitioner	None	1376254797	0	0	HWANG, SIMON PA	1/18/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	2375 E PRATER WAY	None	SPARKS	NV	89434	9641	00	06000	39.54247495	-119.6975356	Washoe County
310259	Non-Physician Medical Practitioner	None	1386255248	0	0	HONG, HELEN H NP	8/6/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11180 WARNER AVENUE	380	FOUNTAIN VALLEY	CA	92708	7501	00	06000	33.71632048	-117.9334575	Orange County
310298	Non-Physician Medical Practitioner	None	1083093975	0	0	HIERSCHE, JOYALENE O L N 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	9974 N CANYON CREEK LN	None	FRESNO	CA	93730	1242	00	06000	36.88024197	-119.769644	Fresno County
310299	Non-Physician Medical Practitioner	None	1487106464	0	0	HUANG, YUZHEN NP	4/27/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12143 NAVAJO RD	None	APPLE VALLEY	CA	92308	7250	00	06000	34.472412	-117.190084	San Bernardino County
310300	Non-Physician Medical Practitioner	None	1700288222	0	0	HERMANN, LINDA	12/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	950 SANTA HELENA PARK CT	None	SOLANA BEACH	CA	92075	1543	00	06000	32.99829093	-117.2539293	San Diego County
310315	Non-Physician Medical Practitioner	None	1073670923	0	0	HERRERA, YVETTE K NP	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	19217 KENYA STREET	None	PORTER RANCH	CA	91326	4042	00	06000	34.27142323	-118.5516243	Los Angeles County
310324	Non-Physician Medical Practitioner	None	1154520971	0	0	HEAL HOPLEY, LETICIA REBECCA	2/27/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1535 S WESTERN AVE	SUITE G	LOS ANGELES	CA	90006	4200	00	06000	34.04428113	-118.3090633	Los Angeles County
310327	Non-Physician Medical Practitioner	None	1972995157	0	0	HSIEH, JUI-MAN NP	5/18/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3042 CENTER STREET	None	ARCADIA	CA	91006	5856	00	06000	34.10839147	-118.0145859	Los Angeles County
310336	Non-Physician Medical Practitioner	None	1992980742	0	0	HUNTER, MERCY G NP	6/12/2019	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
310366	Non-Physician Medical Practitioner	None	1902908817	0	0	HAMILTON, ANGELA M	9/11/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	215 PESETAS LN	None	SANTA BARBARA	CA	93110	1416	00	06000	34.44257521	-119.7584538	Santa Barbara County
310387	Non-Physician Medical Practitioner	None	1902275639	0	0	HILL, JAMES E	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	1033 N CUSTER STREET	None	SANTA ANA	CA	92780	6407	00	06000	33.75495	-117.858004	Orange County
310432	Non-Physician Medical Practitioner	None	1578758736	0	0	HERNANDEZ DOMINGUEZ, CINTHYA	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	1425 HAVASU DR	None	MODESTO	CA	95355	3690	00	06000	37.665	-120.9256565	Stanislaus County
310446	Non-Physician Medical Practitioner	None	1902151269	0	0	HARRAH, ASHLEE KRISTINE	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	2725 CAPITOL AVE	SUITE 302	SACRAMENTO	CA	95816	6004	00	06000	38.571084	-121.471074	Sacramento County
310452	Non-Physician Medical Practitioner	None	1932860731	0	0	HENRY, DANIELLE L PA	4/1/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 DELBON AVE	None	TURLOCK	CA	95382	2016	00	06000	37.51052943	-120.8386573	Stanislaus County
310464	Non-Physician Medical Practitioner	None	1487479119	0	0	HARRINGTON, KELLIE A PA	3/17/2025	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
310474	Non-Physician Medical Practitioner	None	1235770595	0	0	HERNANDEZ, ASCENCION M NP	11/16/2021	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	3201	00	06000	33.78674051	-117.8888713	Orange County
310517	Non-Physician Medical Practitioner	None	1942292404	0	0	HILL, DAVID A PA	6/21/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1180 N INDIAN CANYON DR	SUITE W201	PALM SPRINGS	CA	92262	4876	00	06000	33.839505	-116.5455735	Riverside County
310550	Non-Physician Medical Practitioner	None	1902032311	0	0	HAQ, RODICA	7/3/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2501 MCHENRY AVE	SUITE F	MODESTO	CA	95350	3259	00	06000	37.677753	-120.9941595	Stanislaus County
310579	Non-Physician Medical Practitioner	None	1215176227	0	0	HOLLIS, CHRISTY M NP	3/1/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2940 HILLSDALE DR	None	PLEASANT HILL	CA	94523	4551	00	06000	37.92751066	-122.0830552	Contra Costa County
310584	Non-Physician Medical Practitioner	None	1073819801	0	0	HILL, SARAH E PA-C	11/26/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	345 CAMINO DEL REMEDIO	None	SANTA BARBARA	CA	93110	1332	00	06000	34.444782	-119.7794675	Santa Barbara County
310589	Non-Physician Medical Practitioner	None	1558080572	0	0	HILLER, DEVIN O 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	300 PASTEUR DR	None	STANFORD	CA	94305	2200	00	06000	37.43304542	-122.1759654	Santa Clara County
310617	Non-Physician Medical Practitioner	None	1114341930	0	0	HAN, JANET E	3/13/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7568 OWENS STREET	None	TUJUNGA	CA	91042	1630	00	06000	34.26409837	-118.2975855	Los Angeles County
310646	Non-Physician Medical Practitioner	None	1902630288	0	0	HURD, HANNAH S PA-C	9/17/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24331 EL TORO ROAD	SUITE 200	LAGUNA WOODS	CA	92637	3116	00	06000	33.60928782	-117.7295058	Orange County
310679	Non-Physician Medical Practitioner	None	1366151375	0	0	HUYNH, TIFFANY P PA-C	5/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	00	06000	37.9469952	-122.5373892	Marin County
310688	Non-Physician Medical Practitioner	None	1003357955	0	0	HOMAYONI, SEPIDEH	7/11/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1477 INDIAN TRAIL	None	SAN BERNARDINO	CA	92407	2841	00	06000	34.17218665	-117.32041	San Bernardino County
310693	Non-Physician Medical Practitioner	None	1558312652	0	0	HUNTINGTON, JOHN A	7/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3409 MONDRAIN DR	None	MODESTO	CA	95356	2449	00	06000	37.69490773	-121.0378565	Stanislaus County
310709	Non-Physician Medical Practitioner	None	1760926059	0	0	HAN, BRENDA H NP	3/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5958 CALVIN AVENUE	None	TARZANA	CA	91356	1113	00	06000	34.17909233	-118.5556419	Los Angeles County
310734	Non-Physician Medical Practitioner	None	1144849415	0	0	HAKIMJAVADI, LADAN	6/7/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16119 VANOWEN STREET	None	VAN NUYS	CA	94106	4822	00	06000	34.19394152	-118.484424	Los Angeles County
310737	Non-Physician Medical Practitioner	None	1093371981	0	0	HUANG, MICHELLE M 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	3030 CHILDREN'S WAY	None	SAN DIEGO	CA	92123	4232	00	06000	32.798889	-117.150826	San Diego County
310738	Non-Physician Medical Practitioner	None	1770849671	0	0	HOLMAN, KEVIN J	7/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7100 REDWOOD BLVD	STE 200	NOVATO	CA	94945	4100	00	06000	38.10057107	-122.5678339	Marin County
310834	Non-Physician Medical Practitioner	None	1982392460	0	0	HESTER, SARAH 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	4139 BALL RD	None	CYPRESS	CA	90630	3465	00	06000	33.81766548	-118.060362	Orange County
310836	Non-Physician Medical Practitioner	None	1114945029	0	0	HATCHETT, JOANNE	3/1/2007	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
310849	Non-Physician Medical Practitioner	None	1821372871	0	0	HORAN, AMY K	7/1/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1248 BELMONT ST	None	SAN CARLOS	CA	94070	5127	00	06000	37.49669109	-122.2500551	San Mateo County
310855	Non-Physician Medical Practitioner	None	1366872459	0	0	HENSCHEL, KELSEY M	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	124 N LINDSAY ST	None	VISALIA	CA	93291	9661	00	06000	36.329607	-119.3636115	Tulare County
310861	Non-Physician Medical Practitioner	None	1992227805	0	0	HO, JOHANNA C	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	2727 38TH AVE	None	SAN FRANCISCO	CA	94116	2859	00	06000	37.73600038	-122.4956445	San Francisco County
310862	Non-Physician Medical Practitioner	None	1124489117	0	0	HALAVI, DELARAM	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	433 N PALM DRIVE	201	BEVERLY HILLS	CA	90210	3907	00	06000	34.07787545	-118.3923116	Los Angeles County
310876	Non-Physician Medical Practitioner	None	1164608675	0	0	HORTON, LAURA A NP	4/7/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	408 5TH STREET	None	CORONADO	CA	92118	1603	00	06000	32.69616087	-117.1831856	San Diego County
310900	Non-Physician Medical Practitioner	None	1669011409	0	0	HALAHARVI, HARINI PA-C	8/8/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1662 DOMINICAN WAY	None	SANTA CRUZ	CA	95065	1816	00	06000	36.99033079	-121.9816507	Santa Cruz County
310924	Non-Physician Medical Practitioner	None	1134477185	0	0	HUYNH, LAN H PA-C	10/1/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1071 BLOSSOM HILL RD	None	SAN JOSE	CA	95123	1103	00	06000	37.2509447	-121.8743507	Santa Clara County
310954	Non-Physician Medical Practitioner	None	1427681535	0	0	HUMPHREY, ANNIE C PA-C	7/23/2020	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
310974	Non-Physician Medical Practitioner	None	1356501415	0	0	HUTCHINS, KENNETH ALBERT	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	1830 FLOWER ST	None	BAKERSFIELD	CA	93305	4144	00	06000	35.3818329	-118.9710228	Kern County
310992	Non-Physician Medical Practitioner	None	1285869966	0	0	HADFIELD, GREGORY SEAN	10/1/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5144 HILL RD E	None	LAKEPORT	CA	95453	6300	00	06000	39.10419823	-122.9089591	Lake County
311074	Non-Physician Medical Practitioner	None	1447988092	0	0	HIPWELL, EMILY G PA	2/13/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1950 SUNNYCREST DR	None	FULLERTON	CA	92835	3644	00	06000	33.89240507	-117.9313904	Orange County
311083	Non-Physician Medical Practitioner	None	1336248822	0	0	HART, ANNE H	1/1/1999	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2725 CAPITOL AVE	SUITE 304	SACRAMENTO	CA	95816	6004	00	06000	38.571084	-121.471074	Sacramento County
311099	Non-Physician Medical Practitioner	None	1114557154	0	0	HO, JANELLE NP	1/24/2020	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
311121	Non-Physician Medical Practitioner	None	1326478041	0	0	HUDSON, MARY C	3/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1944 N LAROSE LANE	None	CLOVIS	CA	93619	7692	00	06000	36.865197	-119.701548	Fresno County
311158	Non-Physician Medical Practitioner	None	1649798422	0	0	HIROKANE, SHANNON PA-C	7/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3800 HOMESTEAD RD	None	SANTA CLARA	CA	95051	4542	00	06000	37.3377485	-122.001453	Santa Clara County
311160	Non-Physician Medical Practitioner	None	1598907255	0	0	HENDRIX, HALEY M NP	8/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	921 SIERRA AVE	None	CLOVIS	CA	93612	1259	00	06000	36.83037495	-119.697429	Fresno County
311188	Non-Physician Medical Practitioner	None	1891083408	0	0	HELLER-BENSON, MARIEL P	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	5266 CAMPUS DRIVE	None	DUBLIN	CA	94568	7129	00	06000	37.7048674	-121.8959165	Alameda County
311209	Non-Physician Medical Practitioner	None	1861989873	0	0	HAMLETT, LAUREN E PA	7/17/2020	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
311292	Non-Physician Medical Practitioner	None	1508105719	0	0	HOLMES, MARY ALICE	5/20/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2030 SUTTER PL STE 2200	None	DAVIS	CA	95616	6214	00	06000	38.56292466	-121.7715423	Yolo County
311340	Non-Physician Medical Practitioner	None	1760048318	0	0	HAMEED, SAMIRA 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	400 W MINERAL KING AVE	None	VISALIA	CA	93291	6263	00	06000	36.327888	-119.294919	Tulare County
311344	Non-Physician Medical Practitioner	None	1700403409	0	0	HARO, LYDIA NP	10/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4136 BACHMAN PLACE	None	SAN DIEGO	CA	92103	2028	00	06000	32.75258794	-117.1632586	San Diego County
311360	Non-Physician Medical Practitioner	None	1891144952	0	0	HUSTED, SEAN M PA-C	10/7/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3525 LOMA VISTA ROAD	SUITE A	VENTURA	CA	93003	3165	00	06000	34.27680789	-119.2480851	Ventura County
311369	Non-Physician Medical Practitioner	None	1578795647	0	0	HARMON, ASHLEY S NP	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	6851 REALTY RD	None	LODI	CA	95240	9339	00	06000	38.12681749	-121.2326722	San Joaquin County
311387	Non-Physician Medical Practitioner	None	1952467433	0	0	HUANG, LIAN EN	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	1900 SULLIVAN AVE	None	DALY CITY	CA	94015	2200	00	06000	37.67984327	-122.4730264	San Mateo County
311402	Non-Physician Medical Practitioner	None	1093252926	0	0	HOWLAND, CATALINA J NP	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	885 KIMBERLY CT	None	UPLAND	CA	91784	1208	00	06000	34.14062649	-117.6629176	San Bernardino County
311409	Non-Physician Medical Practitioner	None	1699191643	0	0	HERICO, JANE T NP	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	1557 E AMAR RD STE F	None	WEST COVINA	CA	91792	1678	00	06000	34.03023504	-117.9121024	Los Angeles County
311433	Non-Physician Medical Practitioner	None	1053975904	0	0	HOZHABRZADEH, LEILA PA	9/18/2019	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
311434	Non-Physician Medical Practitioner	None	1215563796	0	0	HONG, ROBIN S PA	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	1441 EASTLAKE AVE	None	LOS ANGELES	CA	90089	0177	00	06000	34.06169385	-118.2044698	Los Angeles County
311437	Non-Physician Medical Practitioner	None	1487831491	0	0	HAYS, OLENA N	3/21/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4418 STOCKBRIDGE AVE	None	SACRAMENTO	CA	95842	3347	00	06000	38.666628	-121.3606575	Sacramento County
311448	Non-Physician Medical Practitioner	None	1104092667	0	0	HA, JUNG OK NP	11/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	291 W MONTECITO AVE	APT B	SIERRA MODE	CA	91024	1834	00	06000	34.16307655	-118.0590178	Los Angeles County
311454	Non-Physician Medical Practitioner	None	1548343668	0	0	HAAS, KATHLEEN A	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	3925 OLD REDWOOD HWY	None	SANTA ROSA	CA	95403	1719	00	06000	38.482839	-122.7357945	Sonoma County
311463	Non-Physician Medical Practitioner	None	1285872267	0	0	HERNANDEZ, KELLI NP	7/26/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	75 N. SANTA ANITA AVE	206	ARCADIA	CA	91006	3112	00	06000	34.14122978	-118.0316312	Los Angeles County
311465	Non-Physician Medical Practitioner	None	1235957234	0	0	HUMPHRIES, PATRICK NP	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	7901 FROST ST	None	SAN DIEGO	CA	92123	2701	00	06000	32.8002375	-117.1546269	San Diego County
311476	Non-Physician Medical Practitioner	None	1770639593	0	0	HE, HONGXIN 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	7909 LAS CRUSES AVE	None	BAKERSFIELD	CA	93309	2220	00	06000	35.35369879	-119.0908799	Kern County
311493	Non-Physician Medical Practitioner	None	1790873230	0	0	HOULE, NICOLE MARIE	10/5/2010	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
311550	Non-Physician Medical Practitioner	None	1013633791	0	0	HURST, TIMOTHY CNP	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	28780 SINGLE OAK DRIVE	SUITE 160	TEMECULA	CA	92590	5528	00	06000	33.49890392	-117.1612965	Riverside County
311560	Non-Physician Medical Practitioner	None	1194132837	0	0	HUNTER, JAY M NP	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	2221 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1418	00	06000	38.556288	-121.458474	Sacramento County
311563	Non-Physician Medical Practitioner	None	1205445715	0	0	HOLTHAUS, MCKINSEY PA-C	11/3/2020	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
311588	Non-Physician Medical Practitioner	None	1225574833	0	0	HESTER, ANGELA B NP	1/4/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7546 CREEKSIDE MOBILE	#103	SHINGLETOWN	CA	96088	9358	00	06000	40.50417832	-121.8399565	Shasta County
311591	Non-Physician Medical Practitioner	None	1629591938	0	0	HARVEY, EBONY NP	6/13/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3325 PALO VERDE AVENUE,	SUITE 201	LONG BEACH	CA	90808	4132	00	06000	33.81701249	-118.1078791	Los Angeles County
311597	Non-Physician Medical Practitioner	None	1508395229	0	0	HEISER, SYLVIA P NP	6/23/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1651 N HACIENDA BLVD	None	LA PUENTE	CA	91744	1137	00	06000	34.0491962	-117.9454467	Los Angeles County
311601	Non-Physician Medical Practitioner	None	1437691946	0	0	HERNANDEZ, KAYLA MONIQUE S NP	10/4/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4663 SCOTTS VALLEY DR	None	SCOTTS VALLEY	CA	95066	3943	00	06000	37.04973619	-122.0157773	Santa Cruz County
311624	Non-Physician Medical Practitioner	None	1154512416	0	0	HEFNER, DONNA M PA	11/20/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	126 AVOCADO AVE	102	PERRIS	CA	92571	2605	00	06000	33.8102395	-117.2244465	Riverside County
311625	Non-Physician Medical Practitioner	None	1275117632	0	0	HOVSEPIAN, JORA NP	3/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	501 S BUENA VISTA ST	None	BURBANK	CA	91505	4809	00	06000	34.15729818	-118.3277073	Los Angeles County
311641	Non-Physician Medical Practitioner	None	1720169345	0	0	HARRIS, HILARIE SUZANNE	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	1200 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	3208	00	06000	37.65894608	-122.440161	San Mateo County
311662	Non-Physician Medical Practitioner	None	1710975602	0	0	HO, ANNA	11/20/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	328 W LINDEN DR	None	ORANGE	CA	92865	5000	00	06000	33.83718949	-117.8535324	Orange County
311690	Non-Physician Medical Practitioner	None	1871910950	0	0	HUERTA, CARMEN NP	3/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	40280 CALLE REAL	None	MURIETA	CA	92563	5903	00	06000	33.55056325	-117.1713344	Riverside County
311709	Non-Physician Medical Practitioner	None	1639640675	0	0	HONDA, STEPHANIE A CNM	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	1735 CREEKSIDE	None	FOLSOM	CA	95630	3914	00	06000	38.672028	-121.140198	Sacramento County
311711	Non-Physician Medical Practitioner	None	1508516162	0	0	HUANG, ANGIE J PA-C	1/20/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11333 SEPULVEDA BLVD	None	MISSION HILLS	CA	91345	1116	00	06000	34.27684353	-118.4684024	Los Angeles County
311712	Non-Physician Medical Practitioner	None	1649992371	0	0	HWANG, DANIEL J PA-C	11/8/2022	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
311746	Non-Physician Medical Practitioner	None	1568930402	0	0	HOANG, QUYNH-CHAU T PA-C	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	3525 LOMA VISTA RD	STE A	VENTURA	CA	93003	3101	00	06000	34.27680789	-119.2480851	Ventura County
311750	Non-Physician Medical Practitioner	None	1437629474	0	0	HAKHPANDYAN, HRACHUHI L NP	6/25/2020	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
311758	Non-Physician Medical Practitioner	None	1366129587	0	0	HARROD, SARAH N 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	1310 W STEWART DR	STE 306	ORANGE	CA	92868	3838	00	06000	33.78236048	-117.8664975	Orange County
311785	Non-Physician Medical Practitioner	None	1174553259	0	0	HEYING, GOOLD L	11/21/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1809 NATIONAL AVENUE	LOGAN HEIGHTS FAMILY HEA	SAN DIEGO	CA	92113	2196	00	06000	32.70162897	-117.1465065	San Diego County
311792	Non-Physician Medical Practitioner	None	1588192256	0	0	HALBER, ANDREW PA	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	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
311841	Non-Physician Medical Practitioner	None	1386000248	0	0	HERALD CHRISTIAN HEALTH CENT	2/12/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	00	06000	34.06276591	-118.07587	Los Angeles County
311847	Non-Physician Medical Practitioner	None	1851585988	0	0	HAINES, MARIANNE	9/6/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	100 W CALIFORNIA BLVD	HUNTINGTON MEMORIAL HOSP	PASADENA	CA	91105	3010	00	06000	34.133598	-118.1534895	Los Angeles County
311853	Non-Physician Medical Practitioner	None	1467800508	0	0	HA, JEANETTE N NP	6/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	878 N WHITTIER AVE	None	CLOVIS	CA	93611	6655	00	06000	36.84650108	-119.6820335	Fresno County
311857	Non-Physician Medical Practitioner	None	1639476971	0	0	HEYWOOD, JILLIAN L PA	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	15435 JOSEPH PHELPS AVE	None	BAKERSFIELD	CA	93314	5300	00	06000	35.37471562	-119.1738114	Kern County
311872	Non-Physician Medical Practitioner	None	1841437241	0	0	H STREET CLINIC	12/9/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1329 N H ST	None	SAN BERNARDINO	CA	92405	5039	00	06000	34.123851	-117.300894	San Bernardino County
311879	Non-Physician Medical Practitioner	None	1740693894	0	0	HOUSEKEEPER, KARLA L	9/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5657 SUMMIT DR	None	ROCKLIN	CA	95765	1750	00	06000	38.80354437	-121.2562549	Placer County
311945	Non-Physician Medical Practitioner	None	1083242952	0	0	HURTADO, JULIA A PA	12/4/2020	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
312010	Non-Physician Medical Practitioner	None	1427450477	0	0	HARTMAN, STEPHANIE L	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	3186 MAJESTIC OAK CIRCLE	None	COTTONWOOD	CA	96022	9567	00	06000	40.37983842	-122.3568858	Shasta County
312035	Non-Physician Medical Practitioner	None	1649664079	0	0	HAYHURST, JENNIFER D	9/1/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	305 S BUENA VISTA ST	None	REDLANDS	CA	92373	5130	00	06000	34.04913814	-117.1847963	San Bernardino County
312086	Non-Physician Medical Practitioner	None	1407376940	0	0	HEROLD, JESSICA C PA-C	9/22/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	360 SAN MIGUEL DR	STE 309	NEWPORT BEACH	CA	92660	7836	00	06000	33.61321911	-117.8722084	Orange County
312092	Non-Physician Medical Practitioner	None	1336204163	0	0	HALSTEAD, RICKI R NP	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	1374 E ALLUVIAL AVE	None	FRESNO	CA	93720	2608	00	06000	36.84475352	-119.758806	Fresno County
312116	Non-Physician Medical Practitioner	None	1205852555	0	0	HARLAMOFF, LAUREL J	8/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3500 MAPLETHORPE LANE	None	SOQUEL	CA	95073	2921	00	06000	36.99343725	-121.9372633	Santa Cruz County
312121	Non-Physician Medical Practitioner	None	1275509473	0	0	HUSTOSKY, DAVID AARON	4/8/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15611 POMERADO RD	None	POWAY	CA	92064	2437	00	06000	32.99706	-117.05544	San Diego County
312129	Non-Physician Medical Practitioner	None	1386705853	0	0	HOLLEMAN, ANN NP	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	3701 BROADWAY	None	OAKLAND	CA	94611	5613	00	06000	37.82533768	-122.258094	Alameda County
312132	Non-Physician Medical Practitioner	None	1306322045	0	0	HENINGER, STEPHANIE K PA	7/31/2020	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
312191	Non-Physician Medical Practitioner	None	1689278087	0	0	HENDRICKS, JESSICA A 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	601 S WESTMORELAND AVE	None	LOS ANGELES	CA	90005	3999	00	06000	34.06348495	-118.28845	Los Angeles County
312221	Non-Physician Medical Practitioner	None	1962633180	0	0	HUGHES, MARY B PA	6/26/2019	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
312263	Non-Physician Medical Practitioner	None	1003338500	0	0	HODGSON, STEPHANIE NP	4/25/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1020 16TH ST	APT 41	SACRAMENTO	CA	95814	4001	00	06000	38.577393	-121.485789	Sacramento County
312269	Non-Physician Medical Practitioner	None	1710919857	0	0	HUNTER, SHARON A	11/15/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	45081 LITTLE LAKE ST	None	MENDOCINO	CA	95460	0000	00	06000	39.30723036	-123.8001505	Mendocino County
312317	Non-Physician Medical Practitioner	None	1548921729	0	0	HENBERGER, MEGAN PA	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	19742 MACARTHUR BLVD	SUITE 100	IRVINE	CA	92612	2408	00	06000	33.65738766	-117.8625556	Orange County
312320	Non-Physician Medical Practitioner	None	1588347892	0	0	HENNING, JACLYN A NP	8/23/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	901 CAMPUS DR.	None	DALY CITY	CA	94015	4900	00	06000	37.66535778	-122.4763793	San Mateo County
312331	Non-Physician Medical Practitioner	None	1114196425	0	0	HILL, MELISA M NP	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	118 8TH STREET	APT 1	SEAL BEACH	CA	90740	6337	00	06000	33.74093092	-118.1063695	Orange County
312356	Non-Physician Medical Practitioner	None	1265440861	0	0	HIBBARD, KAREN J	2/18/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	115 CUMBERLAND ROAD	None	BURLINGTON	VT	05408	2473	00	06000	44.50825663	-73.26508596	Chittenden County
312369	Non-Physician Medical Practitioner	None	1093176307	0	0	HUYNH, TUAN D	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	125 W OLIVE AVENUE	APT 303	MONROVIA	CA	91016	3402	00	06000	34.14481361	-118.0023167	Los Angeles County
312376	Non-Physician Medical Practitioner	None	1588762777	0	0	HANDLEY, RICHARD TODD	4/15/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	23929 MCBEAN PKWY STE 10	None	VALENCIA	CA	91355	4467	00	06000	34.39588575	-118.5538975	Los Angeles County
312401	Non-Physician Medical Practitioner	None	1164941415	0	0	HUMPHREY, DARIUS T RN PNP	5/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7111 FRESNO ST	STE 200	FRESNO	CA	93720	2965	00	06000	36.83951763	-119.7815709	Fresno County
312406	Non-Physician Medical Practitioner	None	1669517991	0	0	HANNEMA VANNIX, ROSEMARY A	10/23/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	75 W SUNSET DR	None	REDLANDS	CA	92373	7237	00	06000	34.02094974	-117.1544701	San Bernardino County
312446	Non-Physician Medical Practitioner	None	1669991014	0	0	HAMDJA, CRISTINA NP	5/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 N HARBOR BLVD	None	ANAHEIM	CA	92805	1810	00	06000	33.84310811	-117.92254	Orange County
312449	Non-Physician Medical Practitioner	None	1114069358	0	0	HANSON, MARIJO PA-C	7/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1310 CHURN CREEK RD	STE E5	REDDING	CA	96003	4004	00	06000	40.58819665	-122.3510235	Shasta County
312456	Non-Physician Medical Practitioner	None	1700665536	0	0	HENDERSON, CHARLES J PA-C	12/16/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4968 BOOTH	106	IRVINE	CA	92604	3360	00	06000	33.68590715	-117.7855253	Orange County
312457	Non-Physician Medical Practitioner	None	1821226598	0	0	HAMILTON, JOSEPH JOHN	5/1/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11303 SUMMIT POINT CT	None	BAKERSFIELD	CA	93312	6466	00	06000	35.41914932	-119.1284763	Kern County
312465	Non-Physician Medical Practitioner	None	1154459709	0	0	HENRY, ISAAC NATHANIEL	9/25/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1001 S STATE ST	None	HEMET	CA	92543	7186	00	06000	33.731505	-116.971599	Riverside County
312492	Non-Physician Medical Practitioner	None	1417592890	0	0	HEAD, NELSON PA-C	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	4650 W SUNSET BLVD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
312497	Non-Physician Medical Practitioner	None	1710132642	0	0	HEADRICK, SHARON PA-C	11/24/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	27640 EUCALYPTUS AVE	None	MORENO VALLEY	CA	92555	4557	00	06000	33.93749258	-117.1807371	Riverside County
312565	Non-Physician Medical Practitioner	None	1982938262	0	0	HAYES, DANIEL T NP	8/26/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	9 LORNE RD	None	ARLINGTON	MA	02476	5711	00	06000	42.423516	-71.1883125	Middlesex County
312589	Non-Physician Medical Practitioner	None	1992126965	0	0	HATA, ANDREA L NP	8/2/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1479 YGNACIO VALLEY RD	None	WALNUT CREEK	CA	94598	2986	00	06000	37.91301169	-122.0438513	Contra Costa County
312617	Non-Physician Medical Practitioner	None	1093721540	0	0	HUDSON, KESHA K	2/2/2003	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2144 FIRETHORN GLEN	None	ESCONDIDO	CA	92027	1151	00	06000	33.1582861	-117.0647839	San Diego County
312668	Non-Physician Medical Practitioner	None	1700417243	0	0	HAYES, MATTHEW PA	3/27/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	444 PLUMAS BLVD	None	YUBA CITY	CA	95991	5071	00	06000	39.13178911	-121.6141048	Sutter County
312714	Non-Physician Medical Practitioner	None	1144973298	0	0	HELMANDI, HABIB PA	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	19042 SOLEDAD CANYON RD	A	SANTA CLARITA	CA	91351	3362	00	06000	34.4156522	-118.46848	Los Angeles County
312722	Non-Physician Medical Practitioner	None	1871165696	0	0	HURLEY, MORGAN PA	9/6/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1415 BADGER FLAT RD	A	LOS BANOS	CA	93635	8600	00	06000	37.05576382	-120.8782498	Merced County
312777	Non-Physician Medical Practitioner	None	1427286004	0	0	HARRINGTON, MEGAN L NP	8/1/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8663 COUNTRY CREEK DRIVE	None	ORANGEVALE	CA	95662	2135	00	06000	38.712726	-121.2360165	Sacramento County
312780	Non-Physician Medical Practitioner	None	1063835213	0	0	HERALD CHRISTIAN HEALTH CENTER	8/20/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1661 HANOVER RD STE 103	None	CITY OF INDUSTRY	CA	91748	1796	00	06000	33.99109665	-117.920988	Los Angeles County
312802	Non-Physician Medical Practitioner	None	1235623851	0	0	HINES-STELLISCH, KELLY Y NP	9/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	300 HILLMONT AVE	None	VENTURA	CA	93003	3099	00	06000	34.27771547	-119.2540344	Ventura County
312819	Non-Physician Medical Practitioner	None	1922387307	0	0	HUMPHREY, DAVEIN R NP	6/1/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5356 GOLD CREEK CIRCLE	None	DISCOVERY BAY	CA	94505	2618	00	06000	37.9211666	-121.6198456	Contra Costa County
312846	Non-Physician Medical Practitioner	None	1306149612	0	0	HANSEN, CATHERINE NADYNE	5/13/2013	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
312872	Non-Physician Medical Practitioner	None	1033621834	0	0	HA, TIFFANY A PA-C	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	26520 CACTUS AVE	None	MORENO VALLEY	CA	92555	3927	00	06000	33.912117	-117.195849	Riverside County
312877	Non-Physician Medical Practitioner	None	1730878554	0	0	HUANG, JULIE K PA-C	1/15/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12456 WASHINGTON BLVD	None	WHITTIER	CA	90602	1005	00	06000	33.96757592	-118.046351	Los Angeles County
312883	Non-Physician Medical Practitioner	None	1437454220	0	0	HOUSTON, PETER D	4/11/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3340 BONITA MESA ROAD	None	BONITA	CA	91902	1021	00	06000	32.65590167	-117.0548376	San Diego County
312920	Non-Physician Medical Practitioner	None	1710632435	0	0	HILL, GENIELYN NP	4/16/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	296 H ST	303	CHULA VISTA	CA	91910	4779	00	06000	32.63445985	-117.0769184	San Diego County
312933	Non-Physician Medical Practitioner	None	1932571759	0	0	HARMS, AMYLOU G NP	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	14591 NEWPORT AVE.	100	TUSTIN	CA	92780	6026	00	06000	33.7317307	-117.8285651	Orange County
312952	Non-Physician Medical Practitioner	None	1336606367	0	0	HENSLEY, JENNIFER M 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	5504 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4104	00	06000	34.01907641	-118.1513095	Los Angeles County
312993	Non-Physician Medical Practitioner	None	1952850604	0	0	HOOSIER, MICHAEL A	8/6/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3592 SANTA CLARA TRL	None	FRAZIER PARK	CA	93225	0000	00	06000	34.82641318	-118.9448793	Kern County
313019	Non-Physician Medical Practitioner	None	1073826210	0	0	HUANG, STEPHANIE K	10/9/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2576 PARK RIDGE DRIVE	None	ESCONDIDO	CA	92025	7775	00	06000	33.0910154	-117.0448643	San Diego County
313047	Non-Physician Medical Practitioner	None	1134560915	0	0	HUNT, NICOLE C CNM	7/16/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	14124 BURBANK BLVD	STE 2006	SHERMAN OAKS	CA	91401	4951	00	06000	34.17208254	-118.440927	Los Angeles County
313102	Non-Physician Medical Practitioner	None	1063524429	0	0	H, MURGUIA K	2/4/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	550 W CYPRESS AVE	None	REEDLEY	CA	93654	2096	00	06000	36.60787518	-119.4523704	Fresno County
313127	Non-Physician Medical Practitioner	None	1457544876	0	0	HO, KATIE C NP	12/12/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1330 ROBERT COURT	None	BREA	CA	92821	2100	00	06000	33.93975989	-117.9047951	Orange County
313159	Non-Physician Medical Practitioner	None	1912474768	0	0	HOFFMAN, JESSICA F 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	44014 FERN AVE	None	LANCASTER	CA	93534	4433	00	06000	34.68268557	-118.1425105	Los Angeles County
313171	Non-Physician Medical Practitioner	None	1649352865	0	0	HEUSER, LORI S	7/16/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 FOWLER	None	PLACERVILLE	CA	95667	4511	00	06000	38.72679661	-120.7923668	El Dorado County
313175	Non-Physician Medical Practitioner	None	1336875061	0	0	HAM, SONNY NP	12/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4081 E OLYMPIC BLVD	None	LOS ANGELES	CA	90023	3330	00	06000	34.01891346	-118.186614	Los Angeles County
313192	Non-Physician Medical Practitioner	None	1255717211	0	0	HENDERSON, JASMINE P PA	6/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
313202	Non-Physician Medical Practitioner	None	1023470226	0	0	HUA, THUY X PA-C	6/25/2020	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
313214	Non-Physician Medical Practitioner	None	1629243993	0	0	HENRY, KRISTINE M NP	7/27/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5125 NEWANGA AVE	None	SANTA ROSA	CA	95405	7424	00	06000	38.446308	-122.657238	Sonoma County
313235	Non-Physician Medical Practitioner	None	1497451413	0	0	HARRIS, JACQUELINE L 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	8700 BEVERLY BLVD	None	LOS ANGELES	CA	90048	1804	00	06000	34.07671715	-118.3799413	Los Angeles County
313246	Non-Physician Medical Practitioner	None	1205076536	0	0	HAZEL HAWKINS MEMORIAL HOSPITAL	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	321 1ST ST	None	HOLLISTER	CA	95023	3729	00	06000	36.85563094	-121.4025629	San Benito County
313289	Non-Physician Medical Practitioner	None	1326798851	0	0	HERNANDEZ, JASON J PA	11/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1205 E NORTH STREET	None	MANTECA	CA	95336	4932	00	06000	37.80110374	-121.1974853	San Joaquin County
313298	Non-Physician Medical Practitioner	None	1932580362	0	0	HACKBUSCH, MAREN E PA	7/10/2020	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
313308	Non-Physician Medical Practitioner	None	1639540743	0	0	HARO, CHRISTINA M NP	7/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	158 TALMONT	None	ROSEVILLE	CA	95678	6059	00	06000	38.78519276	-121.2908702	Placer County
313323	Non-Physician Medical Practitioner	None	1720053846	0	0	HARRIS, CHRISTINA V PA	3/27/2018	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
313324	Non-Physician Medical Practitioner	None	1528392743	0	0	HEWITT, SUZANNE H	6/4/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	5201 HARRY HINES BLVD	OBSERVATION UNIT 2 SS	DALLAS	TX	75235	7708	00	06000	32.81161328	-96.83715929	Dallas County
313327	Non-Physician Medical Practitioner	None	1245645027	0	0	HAYES, ANNA D	4/20/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25 YARNALL PLACE	None	REDWOOD CITY	CA	94063	4326	00	06000	37.4837808	-122.1913944	San Mateo County
313341	Non-Physician Medical Practitioner	None	1275874828	0	0	HYDEN, RACHEL K	3/9/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	9635 JIMZEL ROAD	None	LA MESA	CA	91942	4041	00	06000	32.79382492	-116.9896569	San Diego County
313346	Non-Physician Medical Practitioner	None	1215465968	0	0	HAROUT, CHOULJIAN T	1/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	230 N BEACON ST	None	WATERTOWN	MA	02472	2749	00	06000	42.363288	-71.172027	Middlesex County
313356	Non-Physician Medical Practitioner	None	1952608010	0	0	HORISONS UNLIMITED	11/16/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 N FRONT ST STE ABAND	None	CHOWCHILLA	CA	93610	2916	00	06000	37.12503251	-120.2591627	Madera County
313391	Non-Physician Medical Practitioner	None	1952839508	0	0	HOFFMAN, LAUREN B	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	540 NORTH CROFT AVENUE	#5	WEST HOLLYWOOD	CA	90048	2545	00	06000	34.081326	-118.3742025	Los Angeles County
313400	Non-Physician Medical Practitioner	None	1609978410	0	0	HARRIS, TRACY ANN	7/16/2009	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1000 FOWLER WAY	SUITE 7	PLACERVILLE	CA	95667	5738	00	06000	38.72679661	-120.7923668	El Dorado County
313451	Non-Physician Medical Practitioner	None	1104284975	0	0	HARNED, BERNADETTE E NP	6/15/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	17772 BEACH BLVD	None	HUNTINGTON BEACH	CA	92647	6819	00	06000	33.703677	-117.9865035	Orange County
313458	Non-Physician Medical Practitioner	None	1366589558	0	0	HILK, SUSAN SWEENY	11/18/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	747 52ND ST.	CHILDREN'S HOSPITAL OAKL	OAKLAND	CA	94609	0000	00	06000	37.83734639	-122.2672128	Alameda County
313493	Non-Physician Medical Practitioner	None	1558601955	0	0	HO, DREW NP	12/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	535 27TH ST	None	SAN FRANCISCO	CA	94131	1909	00	06000	37.74658913	-122.4322277	San Francisco County
313512	Non-Physician Medical Practitioner	None	1780713487	0	0	HARVEY-LEONARD, GERALDINE	1/25/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	9050 CENTRE POINTE DR	SUITE 400	WEST CHESTER	OH	45069	4874	00	06000	39.32693678	-84.42262792	Butler County
313530	Non-Physician Medical Practitioner	None	1821332156	0	0	HWANG, RUTH T	4/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	653 CLOVER CT	None	BREA	CA	92821	3421	00	06000	33.9278282	-117.893812	Orange County
313543	Non-Physician Medical Practitioner	None	1639689805	0	0	HERNANDEZ, JONATHAN NP	4/13/2020	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
313546	Non-Physician Medical Practitioner	None	1528343555	0	0	HUYNH, CONSTANCE D PA-C	11/28/2022	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
313551	Non-Physician Medical Practitioner	None	1265524755	0	0	HAYNES, GWENDOLYN E	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
313554	Non-Physician Medical Practitioner	None	1790334696	0	0	HARRISON, KEENA N CNP	6/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	40700 CALIFORNIA OAKS RD	SUITE 208	MURRIETA	CA	92562	5789	00	06000	33.57067363	-117.2045035	Riverside County
313568	Non-Physician Medical Practitioner	None	1952944241	0	0	HARRIS, SAVANNAH J NP	10/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 N ROSE AVE	STE 350	OXNARD	CA	93030	7627	00	06000	34.21746	-119.155545	Ventura County
313597	Non-Physician Medical Practitioner	None	1659405728	0	0	HASKETT, JOHN TIM	11/4/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4410 CHAFFIN RD	None	MCKINLEYVILLE	CA	95519	8029	00	06000	40.98542062	-124.0957133	Humboldt County
313672	Non-Physician Medical Practitioner	None	1073918215	0	0	HARRISON, STEVEN V III MD	12/5/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4200 HOMEWOOD CT	None	RIVERSIDE	CA	92506	0136	00	06000	33.97417461	-117.3892325	Riverside County
313743	Non-Physician Medical Practitioner	None	1265888333	0	0	HAZAN, ALISON B PA-C	8/11/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	8260 MIRA MESA BLVD	SUITE A	SAN DIEGO	CA	92126	2662	00	06000	32.91277002	-117.1459433	San Diego County
313744	Non-Physician Medical Practitioner	None	1265041651	0	0	HADFIELD, ANNIE NP	10/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1175 E ARROWY HWY	UNIT M	UPLAND	CA	91786	5525	00	06000	34.09981647	-117.636003	San Bernardino County
313749	Non-Physician Medical Practitioner	None	1760861827	0	0	HUTCHINS, MOLLY C PA	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	3553 WHIPPLE RD	None	UNION CITY	CA	94587	1507	00	06000	37.60573981	-122.0835989	Alameda County
313754	Non-Physician Medical Practitioner	None	1669710984	0	0	HENDERSON, WHITNEY A 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	35800 BOB HOPE DRIVE	#240	RANCHO MIRAGE	CA	92270	1740	00	06000	33.790527	-116.4058645	Riverside County
313816	Non-Physician Medical Practitioner	None	1467185447	0	0	HOOVER, MATTHEW R PA-C	11/16/2023	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
313819	Non-Physician Medical Practitioner	None	1801567946	0	0	HARMON, ERIKA K NP	9/20/2022	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
313825	Non-Physician Medical Practitioner	None	1144677956	0	0	HE, XIAOJING J	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	1388 GAZDAR CT	None	SANTA CLARA	CA	95051	3202	00	06000	37.34980832	-122.0001209	Santa Clara County
313900	Non-Physician Medical Practitioner	None	1235811225	0	0	HO, ARCEL ANNABELLE	9/13/2023	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
313937	Non-Physician Medical Practitioner	None	1629645635	0	0	HETENIAK, VERONIKA M PA	2/25/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12660 RIVERSIDE DRIVE	SUITE 225	NORTH HOLLYWOOD	CA	91201	3000	00	06000	34.1575795	-118.409499	Los Angeles County
313941	Non-Physician Medical Practitioner	None	1265586275	0	0	HAN, SUZETTE H S 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	17 AMBER COURT	None	HERCULES	CA	94547	1710	00	06000	38.00779002	-122.2748273	Contra Costa County
313974	Non-Physician Medical Practitioner	None	1982247045	0	0	HAWLEY, SHANNON R NP	5/16/2023	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
313981	Non-Physician Medical Practitioner	None	1154165777	0	0	HERRERA, MEGAN M NP	1/8/2025	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
314038	Non-Physician Medical Practitioner	None	1679283790	0	0	HARBER, SARAH C RN CPNP	1/5/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	627 W AVENUE Q	STE D	PALMDALE	CA	93551	3891	00	06000	34.58715647	-118.1417372	Los Angeles County
314065	Non-Physician Medical Practitioner	None	1508949736	0	0	HEIN, LANCE D	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	912 COLE ST	STE 167	SAN FRANCISCO	CA	94117	4316	00	06000	37.76555061	-122.4498948	San Francisco County
314074	Non-Physician Medical Practitioner	None	1518517481	0	0	HUMASON, JULIANNE M NP	2/2/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4940 VAN NUYS BLVD.	SUITE 302	SHERMAN OAKS	CA	91403	1743	00	06000	34.160589	-118.4486715	Los Angeles County
314080	Non-Physician Medical Practitioner	None	1710441977	0	0	HINDI, DANIELLE N PA-C	5/17/2019	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 B-100	LOMA LINDA	CA	92354	3450	00	06000	34.047153	-117.2611485	San Bernardino County
314081	Non-Physician Medical Practitioner	None	1750892501	0	0	HITTER, KATHRYNE D	3/7/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7089 NORTH MARKS AVE	None	FRESNO	CA	93711	0267	00	06000	36.83907954	-119.8475632	Fresno County
314122	Non-Physician Medical Practitioner	None	1376669515	0	0	HANEY, MELISSA A	2/18/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1174 KNOTTINGHAM	None	SIMI VALLEY	CA	93065	5107	00	06000	34.26052898	-118.73962	Ventura County
314144	Non-Physician Medical Practitioner	None	1407181423	0	0	HAWKINS, MEGAN S PA	7/1/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	2	Out of state provider	n/a	8109 MYSTIC DESERT AVE	None	LAS VEGAS	NV	89131	1424	00	06000	36.3111284	-115.2702904	Clark County
314165	Non-Physician Medical Practitioner	None	1376054650	0	0	HUME, JOHN G	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	2908 WEALD WAY	APT 323	SACRAMENTO	CA	95833	4313	00	06000	38.617965	-121.5195255	Sacramento County
314234	Non-Physician Medical Practitioner	None	1659590974	0	0	HAMILTON, DAVID W	5/9/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4150 V ST STE 3500	GASTROENTEROLOGY DIVISIO	SACRAMENTO	CA	95817	1460	00	06000	38.556081	-121.4570475	Sacramento County
314236	Non-Physician Medical Practitioner	None	1134814809	0	0	HANNA, CRAIG 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	5311 HOPYARD RD	None	PLEASANTON	CA	94588	3307	00	06000	37.69896849	-121.9046448	Alameda County
314240	Non-Physician Medical Practitioner	None	1255087102	0	0	HOLBROOK, EMMA PA	9/5/2023	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
314241	Non-Physician Medical Practitioner	None	1306014626	0	0	HEFFINGTON, ROYCE L PA	7/12/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	611 ABBOTT ST	SUITE 101	SALINAS	CA	93901	4391	00	06000	36.66192801	-121.6413283	Monterey County
314253	Non-Physician Medical Practitioner	None	1013251396	0	0	HONG, TERESA D NP	3/21/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7633 EISENHOWER ST	None	VENTURA	CA	93003	2480	00	06000	34.27673446	-119.1925464	Ventura County
314294	Non-Physician Medical Practitioner	None	1811004591	0	0	HARVEY, SARAH JOSEPHINE	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	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
314325	Non-Physician Medical Practitioner	None	1851642243	0	0	HUIPIO, JESSICA L	2/24/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2773 E PLYMOUTH WAY	None	FRESNO	CA	93720	5429	00	06000	36.87811797	-119.7337279	Fresno County
314341	Non-Physician Medical Practitioner	None	1376180505	0	0	HARTWELL, AMY E PA	7/13/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2623 E SLAUSON AVE	None	HUNTINGTON PARK	CA	90255	2926	00	06000	33.98921547	-118.2242565	Los Angeles County
314396	Non-Physician Medical Practitioner	None	1912300021	0	0	HERZ, JENNIFER N NP	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	3660 COOLHEIGHTS DRIVE	None	RANCHO PALOS VERD	CA	90275	6233	00	06000	33.73804264	-118.3416552	Los Angeles County
314413	Non-Physician Medical Practitioner	None	1720248230	0	0	HARMANN, KATHERINE BAKER	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	770 WELCH RD STE 100	None	PALO ALTO	CA	94304	1505	00	06000	37.43748087	-122.1759625	Santa Clara County
314414	Non-Physician Medical Practitioner	None	1205941853	0	0	HUNTER, LAMONT P	3/24/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	350 RISHELL DR	None	OAKLAND	CA	94619	2336	00	06000	37.79891856	-122.1725909	Alameda County
314469	Non-Physician Medical Practitioner	None	1407473044	0	0	HARTMANN, ERICA L PA	10/11/2022	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
314522	Non-Physician Medical Practitioner	None	1487613519	0	0	HAWKS, MELISSA S	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	17101 SPRINGDALE ST	#226	HUNTINGTON BEACH	CA	92649	4686	00	06000	33.71384917	-118.0239623	Orange County
314533	Non-Physician Medical Practitioner	None	1194982694	0	0	HARB-SAFADY, MARIA N NP	2/8/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5577 LAKEVIEW CANYON	None	WESTLAKE VILLAGE	CA	91362	5520	00	06000	34.18583034	-118.791562	Ventura County
314537	Non-Physician Medical Practitioner	None	1942719273	0	0	HYNES, JENNA E	1/22/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	13644 MESA SOL DRIVE	None	YUCAIPA	CA	92399	9691	00	06000	34.0053329	-116.984918	San Bernardino County
314572	Non-Physician Medical Practitioner	None	1003250093	0	0	HURTT FAMILY HEALTH CLINIC, INC.	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	1100B NORTH TUSTIN AVE.	SUITES A,B,D	SANTA ANA	CA	92705	3531	00	06000	33.7548117	-117.8342879	Orange County
314591	Non-Physician Medical Practitioner	None	1962787838	0	0	HASTIN, JULIE B	12/5/2011	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 3	None	FULLERTON	CA	92835	3831	00	06000	33.89443025	-117.9288328	Orange County
314606	Non-Physician Medical Practitioner	None	1376534792	0	0	HINRICHSEN, BRIAN CURTIS	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	3010 COLBY ST	None	BERKELEY	CA	94705	2091	00	06000	37.85492078	-122.2576101	Alameda County
314613	Non-Physician Medical Practitioner	None	1699360057	0	0	HIX, LEA R PA-C	9/13/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2900 WHIPPLE	STE 132	REDWOOD CITY	CA	94062	2843	00	06000	37.4783072	-122.2551089	San Mateo County
314619	Non-Physician Medical Practitioner	None	1699540880	0	0	HUYNH, ANN NP	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	4049 BROCKTON AVE	None	RIVERSIDE	CA	92501	3440	00	06000	33.98177617	-117.3807605	Riverside County
314629	Non-Physician Medical Practitioner	None	1245534056	0	0	HERRERA, JENNIFER M	10/19/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	22903 ESTORIL DRIVE	NUMBER 1	DIAMOND BAR	CA	91765	4483	00	06000	33.99968612	-117.8175523	Los Angeles County
314642	Non-Physician Medical Practitioner	None	1265007033	0	0	HART, VALERIE	12/17/2024	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
314674	Non-Physician Medical Practitioner	None	1982337317	0	0	HARRISON, REAGAN PA-C	8/9/2024	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
314675	Non-Physician Medical Practitioner	None	1407254162	0	0	HEIBY, COLLEEN E PA-C	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	3151 S STREET	#229	SACRAMENTO	CA	95816	7072	00	06000	38.562894	-121.4684415	Sacramento County
314681	Non-Physician Medical Practitioner	None	1659687499	0	0	HULL, DERRICK NP	5/1/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12980 FREDERICK ST	STE I	MORENO VALLEY	CA	92553	5263	00	06000	33.931872	-117.2613835	Riverside County
314685	Non-Physician Medical Practitioner	None	1326005646	0	0	HENKE, JONATHAN P	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
314700	Non-Physician Medical Practitioner	None	1821554106	0	0	HAMILTON, AMY M PA	9/21/2019	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 PARKWAY	None	LAS VEGAS	NV	89109	2317	00	06000	36.132948	-115.136874	Clark County
314708	Non-Physician Medical Practitioner	None	1649350836	0	0	HOLLIMAN, RENATA G	4/1/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5151 F ST	None	SACRAMENTO	CA	95819	3223	00	06000	38.571156	-121.4391555	Sacramento County
314739	Non-Physician Medical Practitioner	None	1215586870	0	0	HERNANDEZ, MARISSA 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	420 34TH ST	None	BAKERSFIELD	CA	93301	2237	00	06000	35.39052148	-119.0070765	Kern County
314748	Non-Physician Medical Practitioner	None	1942764386	0	0	HWANG, CONNIE J PA	9/26/2022	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
314749	Non-Physician Medical Practitioner	None	1144828112	0	0	HAMILTON, JULIE M NP	11/10/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12677 HESPERIA ROAD	SUITE 130	VICTORVILLE	CA	92395	7735	00	06000	34.48148078	-117.2906175	San Bernardino County
314756	Non-Physician Medical Practitioner	None	1780199349	0	0	HEINZE, LAUREN C PA	4/7/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	441 N LAKEVIEW AVE	None	ANAHEIM	CA	92807	3028	00	06000	33.85429563	-117.8166478	Orange County
314761	Non-Physician Medical Practitioner	None	1629374426	0	0	HEIL, KARI A NP	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	5569 E EDGEMAR AVE	None	ANAHEIM HILLS	CA	92807	3105	00	06000	33.85278481	-117.7922614	Orange County
314765	Non-Physician Medical Practitioner	None	1255381901	0	0	HSIEH, LISA L NP	3/21/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	315 S ALHAMBRA AVE	None	MONTEREY PARK	CA	91755	3401	00	06000	34.05927136	-118.1168062	Los Angeles County
314783	Non-Physician Medical Practitioner	None	1417064916	0	0	HI-DESERT MEMORIAL HEALTH CARE DISTRICT	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	72724 29 PALMS HWY	SUITE 103	TWENTYNINE PALMS	CA	92277	2459	00	06000	34.13547448	-116.076159	San Bernardino County
314786	Non-Physician Medical Practitioner	None	1992869739	0	0	HALEY, KATHLEEN M NP	5/15/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6188 CAMINTO DEL OESTE	None	SAN DIEGO	CA	92111	6819	00	06000	32.77942897	-117.1818393	San Diego County
314819	Non-Physician Medical Practitioner	None	1851924427	0	0	HAYMAN, MALKA M NP	11/9/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1260 15TH STREET	1501, 1502	SANTA MONICA	CA	90404	1150	00	06000	34.02648965	-118.4867439	Los Angeles County
314834	Non-Physician Medical Practitioner	None	1861884132	0	0	HERNANDEZ SILERIO, GLORIA NP	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	584 E ST	None	CHULA VISTA	CA	91910	2348	00	06000	32.64149715	-117.0926857	San Diego County
314849	Non-Physician Medical Practitioner	None	1750916433	0	0	HAWKINS, CASSONDRA NP	3/19/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1800 ADOBE ST	None	CONCORD	CA	94520	2313	00	06000	37.97700068	-122.0381159	Contra Costa County
314850	Non-Physician Medical Practitioner	None	1861865321	0	0	HOSANG CELESTIN, RHEA M NP	3/24/2022	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
314857	Non-Physician Medical Practitioner	None	1629402482	0	0	HOFSTETTER, CAMERON L NP	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	140 CENTENNIAL WAY	None	TUSTIN	CA	92780	3711	00	06000	33.74496	-117.818857	Orange County
314863	Non-Physician Medical Practitioner	None	1053649483	0	0	HILOW, SAMVADA MANUELA	1/5/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	540 W PUEBLO ST	None	SANTA BARBARA	CA	93105	4230	00	06000	34.42739162	-119.7253175	Santa Barbara County
314864	Non-Physician Medical Practitioner	None	1891213039	0	0	HOUSE, MATTHEW NP	9/5/2023	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
314873	Non-Physician Medical Practitioner	None	1972064913	0	0	HICKMAN, GLENN J NP	6/21/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	825 DELBON AVE	None	TURLOCK	CA	95382	2016	00	06000	37.51052943	-120.8386573	Stanislaus County
314876	Non-Physician Medical Practitioner	None	1003591108	0	0	HARTLEY, SYDNEY NP	8/31/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2929 HEALTH CENTER DR	None	SAN DIEGO	CA	92123	2762	00	06000	32.79692047	-117.1567137	San Diego County
314879	Non-Physician Medical Practitioner	None	1033536594	0	0	HARTMAN, ELIZABETH M	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	5410 WEST 134TH ST	None	HAWTHORNE	CA	90250	5063	00	06000	33.91083354	-118.37484	Los Angeles County
314904	Non-Physician Medical Practitioner	None	1184076333	0	0	HARRIS, ELIZABETH A	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	12722 MILLENNIUM DRIVE	UNIT B407	PLAYA VISTA	CA	90094	2899	00	06000	33.97615231	-118.4158533	Los Angeles County
314912	Non-Physician Medical Practitioner	None	1275911075	0	0	HUYNH, TRACY NP	9/9/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16026 CARLETON ST	None	FOUNTAIN VALLEY	CA	92708	1319	00	06000	33.73064368	-117.917879	Orange County
314915	Non-Physician Medical Practitioner	None	1649289943	0	0	HEWITT, RHONDA L	1/18/2008	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
314943	Non-Physician Medical Practitioner	None	1164537023	0	0	HARPER, TAMMY	8/1/2006	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
314950	Non-Physician Medical Practitioner	None	1619932464	0	0	HUBBS, MEGAN K MD	12/3/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4151 FOOTHILL ROAD	None	SANTA BARBARA	CA	93110	1110	00	06000	34.45144647	-119.7604485	Santa Barbara County
314956	Non-Physician Medical Practitioner	None	1023166964	0	0	HORTILLOSA, JOSEPH	11/13/2007	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4647 ZION AVE	None	SAN DIEGO	CA	92120	2507	00	06000	32.79293009	-117.0952438	San Diego County
314959	Non-Physician Medical Practitioner	None	1417635392	0	0	HERNANDEZ, GABRIELA S PA	2/1/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	7920 FROST STREET	SUITE 200	SAN DIEGO	CA	92123	4289	00	06000	32.80027449	-117.153846	San Diego County
314962	Non-Physician Medical Practitioner	None	1215547484	0	0	HA, EUN H	7/28/2022	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3747 WORSHAM AVENUE	#100	LONG BEACH	CA	90808	1774	00	06000	33.82647568	-118.1462742	Los Angeles County
314997	Non-Physician Medical Practitioner	None	1831506443	0	0	HE, HUI	10/30/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	151 CALDERON AVE	286	MOUNTAIN VIEW	CA	94041	1451	00	06000	37.39134094	-122.0718038	Santa Clara County
315031	Non-Physician Medical Practitioner	None	1215522461	0	0	HAYCRAFT, LAURICE E NP	4/24/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	854 MAGNOLIA AVE	STE 201	CORONA	CA	92879	3109	00	06000	33.8605591	-117.5513844	Riverside County
315040	Non-Physician Medical Practitioner	None	1437537388	0	0	HOIER, SHARON A 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	13 HELMCREST	None	ALISO VIEJO	CA	92656	1926	00	06000	33.59037082	-117.7408228	Orange County
315051	Non-Physician Medical Practitioner	None	1104109750	0	0	HANCOCK, CHRISTOPHER S	7/16/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	310 HARTNELL AVE	None	REDDING	CA	96002	1800	00	06000	40.56670901	-122.3688887	Shasta County
315057	Non-Physician Medical Practitioner	None	1093291288	0	0	HAGADORN, MELISSA NP	4/17/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	101 CITY DR S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
315126	Non-Physician Medical Practitioner	None	1609454883	0	0	HANEY, COLLEEN 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	29826 HAUN	300	MENIFEE	CA	92586	6546	00	06000	33.68719818	-117.1748757	Riverside County
315157	Non-Physician Medical Practitioner	None	1689166787	0	0	HO NGO, LENNIE T	8/28/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	650 LIBERATION WAY	None	FULLERTON	CA	92832	2649	00	06000	33.86418183	-117.9405732	Orange County
315174	Non-Physician Medical Practitioner	None	1366217028	0	0	HOLGUIN, ARMANDO PA-C	4/3/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6926 BROCKTON AVE	SUITE 6	RIVERSIDE	CA	92506	3804	00	06000	33.947919	-117.3967225	Riverside County
315175	Non-Physician Medical Practitioner	None	1487278040	0	0	HUANG, VIVIAN NP	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	301 INDUSTRIAL ROAD	None	SAN CARLOS	CA	94070	2603	00	06000	37.51438187	-122.2607682	San Mateo County
315178	Non-Physician Medical Practitioner	None	1740886654	0	0	HASSER, RYAN PA-C	10/5/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	24331 EL TORO ROAD	SUITE 200	LAGUNA WOODS	CA	92637	3116	00	06000	33.60928782	-117.7295058	Orange County
315189	Non-Physician Medical Practitioner	None	1235252529	0	0	HILLYER, KIMBERLY L NP	8/30/2013	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11234 ANDERSON ST	None	LOMA LINDA	CA	92354	2804	00	06000	34.049547	-117.264078	San Bernardino County
315202	Non-Physician Medical Practitioner	None	1386049310	0	0	HART, DONALD R NP	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	1501 TROUSDALE DR	None	BURLINGAME	CA	94010	4506	00	06000	37.592811	-122.382351	San Mateo County
315203	Non-Physician Medical Practitioner	None	1326399924	0	0	HORTON, LAUREN M NP	2/22/2022	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
315244	Non-Physician Medical Practitioner	None	1841966280	0	0	HARSKAMP, CAMERON J NP	9/16/2021	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
315279	Non-Physician Medical Practitioner	None	1326590761	0	0	HER, PANG C PA-C	6/17/2021	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
315296	Non-Physician Medical Practitioner	None	1669535167	0	0	HIGUCHI, ANGELA S NP	10/21/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2101 SHORELINE DRIVE	229	ALAMEDA	CA	94501	6252	00	06000	37.7564281	-122.2557969	Alameda County
315333	Non-Physician Medical Practitioner	None	1447616958	0	0	HALAK, JENIECE N	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	1245 CALLE CECILIA	None	SAN DIMAS	CA	91773	4435	00	06000	34.07459324	-117.8314096	Los Angeles County
315353	Non-Physician Medical Practitioner	None	1457084675	0	0	HERTEL, EMMA PA	10/9/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4929 VAN NUYS BLVD	ATTN: EMERGENCY DEPT	SHERMAN OAKS	CA	91403	1702	00	06000	34.1602022	-118.4487313	Los Angeles County
315361	Non-Physician Medical Practitioner	None	1568819530	0	0	HADZIABDULAHOVIC, SABINA NP	10/13/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11514 ROCHESTER AVE	APT 101	LOS ANGELES	CA	90025	2340	00	06000	34.04807066	-118.4548535	Los Angeles County
315362	Non-Physician Medical Practitioner	None	1437570066	0	0	HUBBARD, ELIZABETH M PA	11/8/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	901 NEVIN AVE	None	RICHMOND	CA	94801	3143	00	06000	37.93684848	-122.361345	Contra Costa County
315377	Non-Physician Medical Practitioner	None	1346015054	0	0	HANSCOM, DARREN PA-C	3/6/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11103 VENICE BLVD	None	LOS ANGELES	CA	90034	6914	00	06000	34.01379685	-118.4159354	Los Angeles County
315379	Non-Physician Medical Practitioner	None	1003878950	0	0	HAUSER, CHRISTIAN C	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	469 W SKYLINE DRIVE	None	LA HABRA HEIGHTS	CA	90631	7774	00	06000	33.97192056	-117.9710455	Los Angeles County
315386	Non-Physician Medical Practitioner	None	1750007431	0	0	HAZELTINE, AMANDA M NP	7/23/2024	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	200 N ROBERTSON BLVD	None	BEVERLY HILLS	CA	90211	1769	00	06000	34.069509	-118.383743	Los Angeles County
315388	Non-Physician Medical Practitioner	None	1942686837	0	0	HASTINGS, BRANDON E 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	4343 3RD ST	204	SAN FRANCISCO	CA	94124	2193	00	06000	37.73810939	-122.3894236	San Francisco County
315391	Non-Physician Medical Practitioner	None	1255753158	0	0	HERMAN, ERIN L NP	3/2/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1940 WARD ST	None	BERKELEY	CA	94703	2219	00	06000	37.85905073	-122.2696623	Alameda County
315405	Non-Physician Medical Practitioner	None	1376097519	0	0	HARRINGTON, MATTHEW T	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	16131 PITMAN LANE	None	HUNTINGTON BEACH	CA	92647	3434	00	06000	33.72805177	-118.0110185	Orange County
315418	Non-Physician Medical Practitioner	None	1477595379	0	0	HALPERN, REBEKAH E	12/20/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	16361 ROSEWOOD ST	None	FOUNTAIN VALLEY	CA	92708	1957	00	06000	33.72526168	-117.9652486	Orange County
315424	Non-Physician Medical Practitioner	None	1649804972	0	0	HALL, VANESSA M NP	7/10/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3710 E CESAR CHAVEZ AVE	None	LOS ANGELES	CA	90063	2219	00	06000	34.04048853	-118.1854845	Los Angeles County
315436	Non-Physician Medical Practitioner	None	1639402399	0	0	HOMOTOFF, KERRY A	1/14/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	625 AVENUE B	None	REDONDO BEACH	CA	90277	4830	00	06000	33.82651634	-118.382826	Los Angeles County
315462	Non-Physician Medical Practitioner	None	1992910541	0	0	HULL, SHERRI NP	1/30/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4990 ARLINGTON AVE	STE D	RIVERSIDE	CA	92504	2757	00	06000	33.94604554	-117.4117995	Riverside County
315465	Non-Physician Medical Practitioner	None	1891155743	0	0	HRIB, LOREDANA M NP	9/4/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	210 S 33RD ST	None	SAN DIEGO	CA	92113	0645	00	06000	32.70419268	-117.122644	San Diego County
315474	Non-Physician Medical Practitioner	None	1790852564	0	0	HEMBREE, JENNIFER L	2/24/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	25117 CINERIA WY	None	LAKE FOREST	CA	92630	3308	00	06000	33.63865166	-117.6918006	Orange County
315482	Non-Physician Medical Practitioner	None	1942513841	0	0	HOOD, JULIE K NP	6/16/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3644 SHENANDOAH CT	None	PLEASANTON	CA	94588	5221	00	06000	37.67304787	-121.9092722	Alameda County
315488	Non-Physician Medical Practitioner	None	1871293779	0	0	HERNANDEZ, JACQUELINE M NP	8/15/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	15398 MAIN STREET	SUITE A	HESPERIA	CA	92345	3391	00	06000	34.42611361	-117.3274904	San Bernardino County
315525	Non-Physician Medical Practitioner	None	1598061665	0	0	HALL, MONIQUE F	5/15/2011	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2888 GRAYBARK AVE	None	CLOVIS	CA	93619	3923	00	06000	36.79965623	-119.6488106	Fresno County
315541	Non-Physician Medical Practitioner	None	1588115141	0	0	HUYNH, SON K PA	2/10/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12610 BRIARGLEN LOOP	UNIT G	STANTON	CA	90680	4168	00	06000	33.77863406	-117.9969524	Orange County
315549	Non-Physician Medical Practitioner	None	1841841079	0	0	HONG, AMANDA R PA-C	10/4/2021	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
315578	Non-Physician Medical Practitioner	None	1831510353	0	0	HUNT, LAUREN S NP	6/19/2019	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1906 COMMERCENTER E	STE 100	SAN BERNARDINO	CA	92408	3423	00	06000	34.066692	-117.282329	San Bernardino County
315595	Non-Physician Medical Practitioner	None	1356977607	0	0	HEYDARI, SHIRIN PA	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	100 E VALENCIA MESA DR	None	FULLERTON	CA	92835	3813	00	06000	33.89343304	-117.9279349	Orange County
315598	Non-Physician Medical Practitioner	None	1326127820	0	0	HASSANZADEH, HAMID	5/9/2012	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	873 LAKE TERRACE CIRCLE	None	DAVIS	CA	95616	2747	00	06000	38.55053088	-121.7882734	Yolo County
315638	Non-Physician Medical Practitioner	None	1366929887	0	0	HOLVERSON, ALEXIS S	9/24/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1422 W STONERIDGE CT	None	ONTARIO	CA	91762	2822	00	06000	34.064955	-117.677646	San Bernardino County
315674	Non-Physician Medical Practitioner	None	1235534108	0	0	HOLT, MEGAN C	1/5/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	30133 FRONTERA DEL SUR	None	HIGHLAND	CA	92324	5936	00	06000	34.11412628	-117.1470377	San Bernardino County
315680	Non-Physician Medical Practitioner	None	1619499142	0	0	HIRST, VICTORIA	3/1/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	2900 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2730	00	06000	33.896799	-118.3959415	Los Angeles County
315733	Non-Physician Medical Practitioner	None	1912488123	0	0	HEWITT, JANET M NP	12/19/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1981 MATZEN RANCH CIRCLE	None	PETALUMA	CA	94954	8596	00	06000	38.26740035	-122.6283164	Sonoma County
315751	Non-Physician Medical Practitioner	None	1285036319	0	0	HORNUNG, KIMBERLY L	12/10/2014	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	4626 MARITIME LOOP	None	UNION CITY	CA	94587	6007	00	06000	37.58737864	-122.0842517	Alameda County
315752	Non-Physician Medical Practitioner	None	1861100653	0	0	HUSTON, HEATHER NP	4/2/2025	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1100 BUTTE ST	None	REDDING	CA	96001	0852	00	06000	40.5853603	-122.3869865	Shasta County
315791	Non-Physician Medical Practitioner	None	1992945430	0	0	HARRIS, WALTER C	11/3/2015	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	3125 CORAL AVE	None	COSTA MESA	CA	92626	2473	00	06000	33.683904	-117.9249785	Orange County
315852	Non-Physician Medical Practitioner	None	1679850374	0	0	HUDSON, BOBBIE D NP	4/13/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	121 BLEDSOE CT	None	OROVILLE	CA	95966	8251	00	06000	39.41978831	-121.5180616	Butte County
315860	Non-Physician Medical Practitioner	None	1093570251	0	0	HAND, SKYLER N PA	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	7910 FROST ST	None	SAN DIEGO	CA	92123	2771	00	06000	32.80027449	-117.153846	San Diego County
315889	Non-Physician Medical Practitioner	None	1851473623	0	0	HINESLEY, CHELA M	4/19/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	645 W N BEAR CREEK DR	None	MERCED	CA	95348	2507	00	06000	37.31370984	-120.4799613	Merced County
315916	Non-Physician Medical Practitioner	None	1073023420	0	0	HALL, AMANDA J 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	101 THE CITY DR S	None	ORANGE	CA	92868	3298	00	06000	33.78674051	-117.8888713	Orange County
315923	Non-Physician Medical Practitioner	None	1891776357	0	0	HWANGBO, HAILEY H NP	6/28/2016	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12823 OAKWOOD LANE	None	LA MIRADA	CA	90638	2301	00	06000	33.9147907	-118.0097244	Los Angeles County
315924	Non-Physician Medical Practitioner	None	1871031245	0	0	HAWXHURST, CHRISTINE PA-C	5/4/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	12260 FOOTHILL BLVD	None	SYLMAR	CA	91342	6001	00	06000	34.28200485	-118.4030797	Los Angeles County
315948	Non-Physician Medical Practitioner	None	1164605093	0	0	HUN, EMILY DAVI	1/29/2008	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	6505 COYOTE ST	None	CHINO HILLS	CA	91709	3933	00	06000	33.92502418	-117.6629937	San Bernardino County
315952	Non-Physician Medical Practitioner	None	1679895015	0	0	HAN, SABRINA H Y	4/26/2010	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	801 E ATHERTON DRIVE	APT 264	MANTECA	CA	95337	7967	00	06000	37.78169673	-121.2028368	San Joaquin County
315966	Non-Physician Medical Practitioner	None	1881675619	0	0	HAGEMANN, DAVID SHANE	7/1/2002	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	20103 LAKE CHABOT RD	None	CASTRO VALLEY	CA	94546	5341	00	06000	37.698264	-122.090112	Alameda County
315977	Non-Physician Medical Practitioner	None	1790285526	0	0	HUGHES, THOMAS D NP	6/16/2018	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	605 REDONDO AVE	UNIT 305	LONG BEACH	CA	90814	5064	00	06000	33.773814	-118.152446	Los Angeles County
315984	Non-Physician Medical Practitioner	None	1336899319	0	0	HARRIS, ALEXANDRA PA	5/17/2023	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5030 J ST	301	SACRAMENTO	CA	95819	3800	00	06000	38.566359	-121.442094	Sacramento County
315985	Non-Physician Medical Practitioner	None	1720090434	0	0	HAWKINS, GARY R PA-C	10/26/2020	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1700 N ROSE AVE	STE 350	OXNARD	CA	93030	7627	00	06000	34.21746	-119.155545	Ventura County
315992	Non-Physician Medical Practitioner	None	1255055752	0	0	HERRINGTON, NASIM PA	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	100 UCLA MEDICAL PLZ	755	LOS ANGELES	CA	90024	6990	00	06000	34.06544724	-118.4459249	Los Angeles County
316008	Non-Physician Medical Practitioner	None	1164486296	0	0	HOANG, RICHARD THAO	1/11/2005	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	11160 WARNER AVE	SUITE 421	FOUNTAIN VALLEY	CA	92708	4008	00	06000	33.71630854	-117.934317	Orange County
316035	Non-Physician Medical Practitioner	None	1669118253	0	0	HAGEN, SARAH M PA	5/31/2024	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
316043	Non-Physician Medical Practitioner	None	1821190653	0	0	HESS, LAURALEE S NP	2/13/2017	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	5406 MINX WAY	None	CARMICHAEL	CA	95608	5731	00	06000	38.597895	-121.3379055	Sacramento County
316047	Non-Physician Medical Practitioner	None	1558550343	0	0	HINOJOSA, FEDERICO PA-C	3/1/1993	Taxonomy not applicable	NA	n/a	n/a	n/a	n/a	n/a	n/a	0	In state provider	n/a	1901 W BADILLO ST	None	WEST COVINA	CA	91790	1133	00	06000	34.08730047	-117.9444827	Los Angeles County
316102	Ordering, Referring, Prescribing	N/A	1003122623	0	0	HASHIMOTO, KAMI M PHARMD	6/1/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH64224	N/A	N/A	N/A	N/A	N/A	2110 TRUXTUN AVE	SUITE 400	BAKERSFIELD	CA	93301	3703	00	06000	35.37344851	-119.0261655	Kern County
316125	Ordering, Referring, Prescribing	N/A	1003150442	0	0	HERZ, SHAWN A LMFT	2/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT32242	N/A	N/A	N/A	N/A	N/A	3600 WILSHIRE BLVD	2200	LOS ANGELES	CA	90010	2632	00	06000	34.0617065	-118.3036455	Los Angeles County
316177	Ordering, Referring, Prescribing	N/A	1003222803	0	0	HAWK, BRANDI PHD	11/16/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28862	N/A	N/A	N/A	N/A	N/A	3671 BUSINESS DR	SUITE 100	SACRAMENTO	CA	95820	2165	00	06000	38.54133	-121.41891	Sacramento County
316195	Ordering, Referring, Prescribing	N/A	1003242454	0	0	HE, JOYCE PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69394	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
316196	Ordering, Referring, Prescribing	N/A	1003240839	0	0	HAN, LINDA	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69280	N/A	N/A	N/A	N/A	N/A	1841 S WATSON ST	None	LA HABRA	CA	90631	9515	00	06000	33.90922393	-117.9600608	Orange County
316222	Ordering, Referring, Prescribing	N/A	1003279209	0	0	HENKEL, ANDREA G	8/17/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151537	N/A	N/A	N/A	N/A	N/A	1691 THE ALAMEDA	None	SAN JOSE	CA	95126	2203	00	06000	37.3373761	-121.9192532	Santa Clara County
316233	Ordering, Referring, Prescribing	N/A	1003291436	0	0	HAWSON, EVELYN PHARMD	12/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH61885	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
316234	Ordering, Referring, Prescribing	N/A	1003296039	0	0	HERZOG-KABISCH, CHRISTINA M LCSW	3/8/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79804	N/A	N/A	N/A	N/A	N/A	180 VIA VERDE	STE. 200	SAN DIMAS	CA	91773	3993	00	06000	34.07767801	-117.8150295	Los Angeles County
316242	Ordering, Referring, Prescribing	N/A	1003297805	0	0	HUYNH, ANGELA PHARMD	8/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH72654	N/A	N/A	N/A	N/A	N/A	2810 S TRACY BLVD	None	TRACY	CA	95377	8127	00	06000	37.707805	-121.4344886	San Joaquin County
316266	Ordering, Referring, Prescribing	N/A	1003347840	0	0	HILL, ZACHARY R MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157265	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
316293	Ordering, Referring, Prescribing	N/A	1003370453	0	0	HUGHES, BRIANNE LMFT	2/19/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133234	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
316296	Ordering, Referring, Prescribing	N/A	1003380452	0	0	HERNANDEZ, STEPHANIE D NP	1/16/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010896	N/A	N/A	N/A	N/A	N/A	9235 E BROADWAY STREET	None	PLANADA	CA	95365	8088	00	06000	37.29049953	-120.3207705	Merced County
316316	Ordering, Referring, Prescribing	N/A	1003399932	0	0	HAVAEI, MARYAM PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78712	N/A	N/A	N/A	N/A	N/A	227 SHORELINE HWY	None	MILL VALLEY	CA	94941	3678	00	06000	37.88055641	-122.5240059	Marin County
316317	Ordering, Referring, Prescribing	N/A	1003408642	0	0	HSIEH, HSING-CHUN NP	1/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016540	N/A	N/A	N/A	N/A	N/A	880 S ATLANTIC BLVD	208	MONTEREY PARK	CA	91754	4775	00	06000	34.05038485	-118.1383456	Los Angeles County
316333	Ordering, Referring, Prescribing	N/A	1003434804	0	0	HO, TIFFANY PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82735	N/A	N/A	N/A	N/A	N/A	3400 DELTA FAIR BLVD	None	ANTIOCH	CA	94509	4004	00	06000	38.00403417	-121.8422798	Contra Costa County
316334	Ordering, Referring, Prescribing	N/A	1003435942	0	0	HUSSAIN, LAILA S DO	11/12/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20795	N/A	N/A	N/A	N/A	N/A	21810 NORMANDIE AVE	None	TORRANCE	CA	90502	2047	00	06000	33.829803	-118.29474	Los Angeles County
316355	Ordering, Referring, Prescribing	N/A	1003457565	0	0	HURTADO, TATIANA M PA	10/7/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57318	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
316379	Ordering, Referring, Prescribing	N/A	1003495755	0	0	HUYNH, BAO T MD	4/10/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182744	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
316407	Ordering, Referring, Prescribing	N/A	1003586504	0	0	HWANG, KELLEY M PHARMD	9/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85151	N/A	N/A	N/A	N/A	N/A	20319 EAST YALE DRIVE	None	WALNUT	CA	91789	1244	00	06000	34.0401575	-117.8564516	Los Angeles County
316424	Ordering, Referring, Prescribing	N/A	1003674847	0	0	HOULE, STEPHANIE NP	12/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028465	N/A	N/A	N/A	N/A	N/A	28477 LIZARD ROCKS RD	None	VALLEY CENTER	CA	92082	6652	00	06000	33.23082596	-117.0218035	San Diego County
316428	Ordering, Referring, Prescribing	N/A	1003854571	0	0	HOPE, BRADLEY MD	5/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A61390	N/A	N/A	N/A	N/A	N/A	4141 STATE STREET	SUITE B3	SANTA BARBARA	CA	93110	1814	00	06000	34.4404695	-119.7612045	Santa Barbara County
316438	Ordering, Referring, Prescribing	N/A	1003931080	0	0	HOFFMAN, STEPHANIE OT	1/22/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT1003	N/A	N/A	N/A	N/A	N/A	19401 S VERMONT AVENUE	L102	TORRANCE	CA	90502	1029	00	06000	33.85486409	-118.2905603	Los Angeles County
316490	Ordering, Referring, Prescribing	N/A	1013015197	0	0	HIRST, NANCY K LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT37345	N/A	N/A	N/A	N/A	N/A	11951 HESPERIA RD	None	HESPERIA	CA	92345	1855	00	06000	34.46842866	-117.2924286	San Bernardino County
316493	Ordering, Referring, Prescribing	N/A	1013021484	0	0	HUGHES, WILLIAM H MD	5/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A53892	N/A	N/A	N/A	N/A	N/A	3301 37TH AVE	None	SACRAMENTO	CA	95824	2418	00	06000	38.519739	-121.471992	Sacramento County
316507	Ordering, Referring, Prescribing	N/A	1013049105	0	0	HANIN, GENINE I	6/9/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY13568	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
316511	Ordering, Referring, Prescribing	N/A	1013049642	0	0	HERNANDEZ, ANGELA D LCSW	1/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99644	N/A	N/A	N/A	N/A	N/A	1300 17TH. ST.	None	BAKERSFIELD	CA	93301	4504	00	06000	35.37476047	-119.016774	Kern County
316520	Ordering, Referring, Prescribing	N/A	1013071570	0	0	HOGUE, LIZBETH LMFT	8/23/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108768	N/A	N/A	N/A	N/A	N/A	1610 N E STREET	None	SAN BERNARDINO	CA	92405	0010	00	06000	34.12864763	-117.2942387	San Bernardino County
316534	Ordering, Referring, Prescribing	N/A	1013099019	0	0	HOM, KENNETH E PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	49155	N/A	N/A	N/A	N/A	N/A	13652 CANTARA STREET	None	PANORAMA CITY	CA	91402	5423	00	06000	34.21980849	-118.4301135	Los Angeles County
316561	Ordering, Referring, Prescribing	N/A	1013162080	0	0	HUIZAR, JOSE M LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53822	N/A	N/A	N/A	N/A	N/A	401 E OCEAN AVE	None	LOMPOC	CA	93436	6828	00	06000	34.6389765	-120.4537095	Santa Barbara County
316576	Ordering, Referring, Prescribing	N/A	1013175033	0	0	HASHEMI, MARYAM MD	1/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A113521	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
316579	Ordering, Referring, Prescribing	N/A	1013179431	0	0	HAWS, STEPHEN LMFT	7/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43592	N/A	N/A	N/A	N/A	N/A	2951 FULTON	None	SACRAMENTO	CA	95821	4909	00	06000	38.618991	-121.402692	Sacramento County
316602	Ordering, Referring, Prescribing	N/A	1013217298	0	0	HUYNH, ANNIE P NP	4/7/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN519767	N/A	N/A	N/A	N/A	N/A	1700 MT VERNON AVE	None	BAKERSFIELD	CA	93306	4018	00	06000	35.382555	-118.970757	Kern County
316626	Ordering, Referring, Prescribing	N/A	1013261908	0	0	HOHN, ERIC A MD	2/6/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124203	N/A	N/A	N/A	N/A	N/A	4140 JADE ST	STE 100	CAPITOLA	CA	95010	3037	00	06000	36.97026148	-121.9638195	Santa Cruz County
316681	Ordering, Referring, Prescribing	N/A	1013344324	0	0	HANSEN, KRISTINE LPCC	1/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	6589	N/A	N/A	N/A	N/A	N/A	411 E LAKE AVE	None	WATSONVILLE	CA	95076	4424	00	06000	36.91720138	-121.7507888	Santa Cruz County
316693	Ordering, Referring, Prescribing	N/A	1013357862	0	0	HERD, TIFFANY LMFT	5/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111351	N/A	N/A	N/A	N/A	N/A	2813 S MAIN STREET	None	CORONA	CA	92882	5942	00	06000	33.84741266	-117.570694	Riverside County
316749	Ordering, Referring, Prescribing	N/A	1013446996	0	0	HECKER, JORDYN A LMFT	2/28/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131421	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
316759	Ordering, Referring, Prescribing	N/A	1013460021	0	0	HEGEMAN, JOEL PT	1/6/2025	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT307459	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
316783	Ordering, Referring, Prescribing	N/A	1013499896	0	0	HERRERA, JESSICA N LCSW	2/23/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107052	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
316789	Ordering, Referring, Prescribing	N/A	1013516855	0	0	HANLON, CHRISTOPHER J LCSW	5/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	122637	N/A	N/A	N/A	N/A	N/A	333 S. FARRELL DRIVE	None	PALM SPRINGS	CA	92234	7257	00	06000	33.8189007	-116.51811	Riverside County
316793	Ordering, Referring, Prescribing	N/A	1013525682	0	0	HARDT, OLIVIA R LMFT	12/7/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143482	N/A	N/A	N/A	N/A	N/A	900 E MAIN ST	None	GRASS VALLEY	CA	95945	5853	00	06000	39.22827201	-121.0517684	Nevada County
316799	Ordering, Referring, Prescribing	N/A	1013541333	0	0	HU, IVY Y LAC	8/4/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	18821	N/A	N/A	N/A	N/A	N/A	728 PACIFIC AVE	503	SAN FRANCISCO	CA	94133	4457	00	06000	37.79687859	-122.4074282	San Francisco County
316810	Ordering, Referring, Prescribing	N/A	1013558089	0	0	HOBURN, MONETTE C CNP	10/21/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95013424	N/A	N/A	N/A	N/A	N/A	625 34TH ST	STE 100 & 200	BAKERSFIELD	CA	93301	2305	00	06000	35.39046051	-119.0092725	Kern County
316814	Ordering, Referring, Prescribing	N/A	1013573666	0	0	HANNA, VERONIA	1/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76439	N/A	N/A	N/A	N/A	N/A	1125 SECOND STREET	None	BRENTWOOD	CA	94513	2211	00	06000	37.93711772	-121.6982025	Contra Costa County
316839	Ordering, Referring, Prescribing	N/A	1013689546	0	0	HUYNH, BA V PHARMD	8/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55924	N/A	N/A	N/A	N/A	N/A	3098 G STREET	None	MERCED	CA	95340	2137	00	06000	37.31800248	-120.4692105	Merced County
316842	Ordering, Referring, Prescribing	N/A	1013692631	0	0	HERNANDEZ NAVARRO, BEVERLY K PA-C	12/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63777	N/A	N/A	N/A	N/A	N/A	6119 AGRA ST	None	BELL GARDENS	CA	90201	1705	00	06000	33.97562016	-118.1541987	Los Angeles County
316854	Ordering, Referring, Prescribing	N/A	1013900653	0	0	HORTA, ELISA E MD	2/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72518	N/A	N/A	N/A	N/A	N/A	417 MACE BLVD STE J-285	STE. 150	DAVIS	CA	95618	6053	00	06000	38.54974227	-121.694506	Yolo County
316864	Ordering, Referring, Prescribing	N/A	1013966423	0	0	HENDERSON, MELINDA S MD	4/14/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C157290	N/A	N/A	N/A	N/A	N/A	5800 S EASTERN AVE	None	COMMERCE	CA	90040	4016	00	06000	33.98534547	-118.1620372	Los Angeles County
316872	Ordering, Referring, Prescribing	N/A	1023005774	0	0	HIGGINS, KAREN F MD	5/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C50133	N/A	N/A	N/A	N/A	N/A	560 COHASSET RD	175	CHICO	CA	95926	2281	00	06000	39.7519137	-121.8477606	Butte County
316894	Ordering, Referring, Prescribing	N/A	1023127941	0	0	HOLLIDAY, JOHN L LCSW	4/14/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29817	N/A	N/A	N/A	N/A	N/A	109 PARMAC RD	1, 2A	CHICO	CA	95926	2294	00	06000	39.75358764	-121.8505893	Butte County
316917	Ordering, Referring, Prescribing	N/A	1023150265	0	0	HOGREBE, JAMES N MD	12/16/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G27646	N/A	N/A	N/A	N/A	N/A	5150 PACIFIC COAST HWY.	100	LONG BEACH	CA	90804	3312	00	06000	33.7831762	-118.1333125	Los Angeles County
316944	Ordering, Referring, Prescribing	N/A	1023208683	0	0	HAWTHORNE, KINJI L MD	11/26/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A64097	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
316994	Ordering, Referring, Prescribing	N/A	1023314192	0	0	HOANG, CAMLINH	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0746432	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
317002	Ordering, Referring, Prescribing	N/A	1023349198	0	0	HERNANDEZ, CRISTINA F LMFT	3/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115932	N/A	N/A	N/A	N/A	N/A	109 PARMAC RD	1, 2A	CHICO	CA	95926	2294	00	06000	39.75358764	-121.8505893	Butte County
317007	Ordering, Referring, Prescribing	N/A	1023361672	0	0	HSU, LUCIANA LCSW	2/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82068	N/A	N/A	N/A	N/A	N/A	13800 HEACOCK ST	STE D111	MORENO VALLEY	CA	92553	3340	00	06000	33.91968997	-117.2437139	Riverside County
317018	Ordering, Referring, Prescribing	N/A	1023386497	0	0	HUYNH, LUONG T PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	54850	N/A	N/A	N/A	N/A	N/A	1600 EXPO PKWY	None	SACRAMENTO	CA	95815	4228	00	06000	38.597148	-121.4520705	Sacramento County
317026	Ordering, Referring, Prescribing	N/A	1023392909	0	0	HERNANDEZ, JONATAN LMFT	12/3/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84910	N/A	N/A	N/A	N/A	N/A	1509 W CAMERON AVE	STE 230	WEST COVINA	CA	91790	2725	00	06000	34.06870559	-117.9422297	Los Angeles County
317028	Ordering, Referring, Prescribing	N/A	1023391562	0	0	HERROZ, ARACELI G LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT114909	N/A	N/A	N/A	N/A	N/A	18623 GALE AVE	None	CITY OF INDUSTRY	CA	91748	1342	00	06000	33.9945603	-117.8965305	Los Angeles County
317033	Ordering, Referring, Prescribing	N/A	1023401296	0	0	HUR, DAVID PHARMD	9/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62156	N/A	N/A	N/A	N/A	N/A	6570 LONE TREE WAY	None	BRENTWOOD	CA	94513	5257	00	06000	37.96174626	-121.7318398	Contra Costa County
317058	Ordering, Referring, Prescribing	N/A	1023439031	0	0	HARRIS, MARIAM PHD	9/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78002	N/A	N/A	N/A	N/A	N/A	9713 SANTA MONICA BLVD.	201	BEVERLY HILLS	CA	90210	4236	00	06000	34.06835061	-118.4076858	Los Angeles County
317070	Ordering, Referring, Prescribing	N/A	1023456746	0	0	HANKEY, ASHLYN L	4/19/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151026	N/A	N/A	N/A	N/A	N/A	50 W MAIN STREET	110	WOODLAND	CA	95695	3083	00	06000	38.67757843	-121.7858144	Yolo County
317095	Ordering, Referring, Prescribing	N/A	1023492089	0	0	HAMILTON, MICHELLE F NP	6/28/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015982	N/A	N/A	N/A	N/A	N/A	1752 S VICTORIA AVE	SUITE 250	VENTURA	CA	93003	6152	00	06000	34.25916679	-119.2090522	Ventura County
317117	Ordering, Referring, Prescribing	N/A	1023526936	0	0	HUDSON, DANIELLE LCSW	1/27/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106669	N/A	N/A	N/A	N/A	N/A	1600 W CAMPBELL AVE	201	CAMPBELL	CA	95008	1526	00	06000	37.28599733	-121.9780835	Santa Clara County
317130	Ordering, Referring, Prescribing	N/A	1023554060	0	0	HUNTINGTON, JULIET L CNM	6/5/2017	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	NMW235824	N/A	N/A	N/A	N/A	N/A	9 COMMERCIAL BLVD	200	NOVATO	CA	94949	6118	00	06000	38.06858293	-122.5329327	Marin County
317169	Ordering, Referring, Prescribing	N/A	1023613056	0	0	HAINJE, JESSICA C NP	11/12/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95015887	N/A	N/A	N/A	N/A	N/A	2020 SANTA MONICA BLVD	SUITE 600	SANTA MONICA	CA	90404	2131	00	06000	34.02901811	-118.4795396	Los Angeles County
317170	Ordering, Referring, Prescribing	N/A	1023632023	0	0	HUDSON, SANDRA C RN BS	3/21/2020	Taxonomy not applicable	NA	n/a	000	Unknown	399426	N/A	N/A	N/A	N/A	N/A	2111 MISSION AVE	None	OCEANSIDE	CA	92058	2326	00	06000	33.20572898	-117.3626661	San Diego County
317180	Ordering, Referring, Prescribing	N/A	1023647039	0	0	HAJI DATOO, ASMA MD	11/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A184446	N/A	N/A	N/A	N/A	N/A	15451 SAN FERNANDO MISSI	200	MISSION HILLS	CA	91345	1368	00	06000	34.27201722	-118.4684783	Los Angeles County
317181	Ordering, Referring, Prescribing	N/A	1023651494	0	0	HADDAD, MONIQUE S PHARMD	3/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82820	N/A	N/A	N/A	N/A	N/A	7 NIGHT BLOOM	None	IRVINE	CA	92602	2472	00	06000	33.71424761	-117.7792258	Orange County
317213	Ordering, Referring, Prescribing	N/A	1023754835	0	0	HOLOD, MONIQUE MD	7/22/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PTL14944	N/A	N/A	N/A	N/A	N/A	455 OCONNOR DR	SUITE 200	SAN JOSE	CA	95128	1633	00	06000	37.326654	-121.939897	Santa Clara County
317242	Ordering, Referring, Prescribing	N/A	1023898855	0	0	HALSEY, MELISSA NP	8/22/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026566	N/A	N/A	N/A	N/A	N/A	575 W PUTNAM AVE	None	PORTERVILLE	CA	93257	3270	00	06000	36.06956695	-119.0296813	Tulare County
317262	Ordering, Referring, Prescribing	N/A	1033149968	0	0	HASKINS, BRIAN F DO	5/18/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A5772	N/A	N/A	N/A	N/A	N/A	28000 MARGUERITE PARKWAY	None	MISSION VIEJO	CA	92692	3636	00	06000	33.551397	-117.6653385	Orange County
317305	Ordering, Referring, Prescribing	N/A	1033269675	0	0	HUTCHINS, KENNETH PHD	6/22/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY15486	N/A	N/A	N/A	N/A	N/A	13191 CENTRAL AVE	100	CHINO	CA	91710	4179	00	06000	34.01396733	-117.6891262	San Bernardino County
317313	Ordering, Referring, Prescribing	N/A	1033283874	0	0	HO, PHUONG N PHARMD	4/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	56095	N/A	N/A	N/A	N/A	N/A	9961 SIERRA AVENUE	None	FONTANA	CA	92335	6794	00	06000	34.072245	-117.4319685	San Bernardino County
317398	Ordering, Referring, Prescribing	N/A	1033436704	0	0	HISCOCKS, EMMA J MD	2/11/2015	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A120585	N/A	N/A	N/A	N/A	N/A	1421 EAST 17TH STREET	None	SANTA ANA	CA	92705	8505	00	06000	33.75994564	-117.847815	Orange County
317409	Ordering, Referring, Prescribing	N/A	1033442983	0	0	HERNANDEZ, MAYRA A LMFT	5/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102416	N/A	N/A	N/A	N/A	N/A	9890 COUNTY FARM RD	BUILDING 1	RIVERSIDE	CA	92503	3678	00	06000	33.92009951	-117.4574475	Riverside County
317433	Ordering, Referring, Prescribing	N/A	1033475678	0	0	HARVEY, JACK A DPM	12/3/2018	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5204	N/A	N/A	N/A	N/A	N/A	1234 E NORTH ST	STE 106	MANTECA	CA	95336	4961	00	06000	37.80105524	-121.1968581	San Joaquin County
317446	Ordering, Referring, Prescribing	N/A	1033495734	0	0	HO, CHI PHARMD	3/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	63718	N/A	N/A	N/A	N/A	N/A	401 N GARFIELD AVE	SUITE #101	MONTEREY PARK	CA	91754	0000	00	06000	34.066305	-118.122906	Los Angeles County
317462	Ordering, Referring, Prescribing	N/A	1033510839	0	0	HER, GAO N LCSW	6/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84936	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA STREET	260A	SAN JOSE	CA	95112	5865	00	06000	37.32582868	-121.8777868	Santa Clara County
317466	Ordering, Referring, Prescribing	N/A	1033514518	0	0	HELLMAN, SARAH M LMFT	4/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102622	N/A	N/A	N/A	N/A	N/A	3800 COOLIDGE AVE	None	OAKLAND	CA	94602	3399	00	06000	37.8007257	-122.2064578	Alameda County
317478	Ordering, Referring, Prescribing	N/A	1033521745	0	0	HADGU, ABEBA G PHARMD	1/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH70278	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
317484	Ordering, Referring, Prescribing	N/A	1033542162	0	0	HILDRETH, LINDA C LMFT	3/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	101312	N/A	N/A	N/A	N/A	N/A	375 89TH ST	None	DALY CITY	CA	94015	1802	00	06000	37.69175212	-122.474006	San Mateo County
317506	Ordering, Referring, Prescribing	N/A	1033582143	0	0	HADDADIN, SHADI A PHARMD	1/23/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74040	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	STE P1	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
317523	Ordering, Referring, Prescribing	N/A	1033592738	0	0	HSU, HANA K	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67285	N/A	N/A	N/A	N/A	N/A	1800 HARRISON ST 13TH FL	None	OAKLAND	CA	94612	3429	00	06000	37.80593773	-122.2656714	Alameda County
317557	Ordering, Referring, Prescribing	N/A	1033655436	0	0	HULSEY, KRISTI L LPCC	9/27/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC9989	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2656	00	06000	35.35413152	-119.058471	Kern County
317584	Ordering, Referring, Prescribing	N/A	1033693650	0	0	HERNANDEZ, JULIE A LCSW	6/14/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106524	N/A	N/A	N/A	N/A	N/A	1000 EUCLID AVE # B	None	NATIONAL CITY	CA	91950	0000	00	06000	32.68067201	-117.0804893	San Diego County
317687	Ordering, Referring, Prescribing	N/A	1043300114	0	0	HAN, WILLIAM I MD	7/23/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A38218	N/A	N/A	N/A	N/A	N/A	17150 EUCLID ST	220	FOUNTAIN VALLEY	CA	92708	4092	00	06000	33.714171	-117.9369905	Orange County
317715	Ordering, Referring, Prescribing	N/A	1043374994	0	0	HALL, TRACIE L LCSW	10/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26120	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
317722	Ordering, Referring, Prescribing	N/A	1043376668	0	0	HAKAKZADEH, NEDA PHARMD	4/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57717	N/A	N/A	N/A	N/A	N/A	2013 MIDVALE AVE	None	LOS ANGELES	CA	90025	5729	00	06000	34.04579286	-118.4348137	Los Angeles County
317743	Ordering, Referring, Prescribing	N/A	1043416738	0	0	HUGHES, LAURA	12/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	14135	N/A	N/A	N/A	N/A	N/A	3585 MAPLE ST	252	VENTURA	CA	93003	3504	00	06000	34.26916737	-119.2456769	Ventura County
317765	Ordering, Referring, Prescribing	N/A	1043467376	0	0	HARRIS, NARISSA L LMFT	1/16/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT79076	N/A	N/A	N/A	N/A	N/A	1611 SYCAMORE AVE	5741	HERCULES	CA	94547	1768	00	06000	38.00932439	-122.2693314	Contra Costa County
317794	Ordering, Referring, Prescribing	N/A	1043522261	0	0	HAN, SOOJUNG LCSW	3/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28607	N/A	N/A	N/A	N/A	N/A	1430 WILLOW PASS RD	SUITE 100	CONCORD	CA	94520	7928	00	06000	37.97055112	-122.0492933	Contra Costa County
317814	Ordering, Referring, Prescribing	N/A	1043570708	0	0	HELLER, CASSANDRA J DO	8/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	20A15448	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY ST	None	HEALDSBURG	CA	95448	3314	00	06000	38.62729851	-122.8637785	Sonoma County
317832	Ordering, Referring, Prescribing	N/A	1043601503	0	0	HO-NG, KAYIN L LMFT	12/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	101102	N/A	N/A	N/A	N/A	N/A	867 N FAIR OAKS AVE	None	PASADENA	CA	91103	3050	00	06000	34.160877	-118.1506375	Los Angeles County
317860	Ordering, Referring, Prescribing	N/A	1043635394	0	0	HATANO, YUI CNP	5/18/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000363	N/A	N/A	N/A	N/A	N/A	333 S. TWIN OAKS VALLEY	None	SAN MARCOS	CA	92096	0001	00	06000	33.12741952	-117.1651625	San Diego County
317862	Ordering, Referring, Prescribing	N/A	1043643539	0	0	HUTTEN, BURTON M LCSW	2/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW93640	N/A	N/A	N/A	N/A	N/A	3133 LAUREL STREET	None	NAPA	CA	94558	0000	00	06000	38.29817081	-122.3146643	Napa County
317901	Ordering, Referring, Prescribing	N/A	1043697089	0	0	HOLGUIN, MARIA E LMFT	5/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125910	N/A	N/A	N/A	N/A	N/A	1330 W RAMSEY ST	None	BANNING	CA	92220	4477	00	06000	33.92538854	-116.8912035	Riverside County
317904	Ordering, Referring, Prescribing	N/A	1043701170	0	0	HAN, SEUNG H PA-C	8/29/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA63222	N/A	N/A	N/A	N/A	N/A	5504 MONTEREY HWY	None	SAN JOSE	CA	95138	1529	00	06000	37.2546727	-121.8004013	Santa Clara County
317908	Ordering, Referring, Prescribing	N/A	1043715618	0	0	HENDRY, ALISHA B LMFT	12/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	136316	N/A	N/A	N/A	N/A	N/A	17830 ARROW BLVD	MAIL CODE 0460	FONTANA	CA	92335	4037	00	06000	34.09947748	-117.4151205	San Bernardino County
317923	Ordering, Referring, Prescribing	N/A	1043728884	0	0	HUYNH, JULIE PA	8/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54927	N/A	N/A	N/A	N/A	N/A	700 S TUSTIN ST	None	ORANGE	CA	92866	3425	00	06000	33.77685748	-117.8357804	Orange County
317929	Ordering, Referring, Prescribing	N/A	1043739584	0	0	HERSHFIELD, AVIS P NP	2/19/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007424	N/A	N/A	N/A	N/A	N/A	1463 SOUTH 4TH STREET	None	EL CENTRO	CA	92243	4556	00	06000	32.78037178	-115.5523224	Imperial County
317930	Ordering, Referring, Prescribing	N/A	1043740939	0	0	HLUCHAN, CHRISTINE M MD	9/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174964	N/A	N/A	N/A	N/A	N/A	4760 SUNSET BOULEVARD	FIRST FLOOR	LOS ANGELES	CA	90027	6063	00	06000	34.09811852	-118.293408	Los Angeles County
317931	Ordering, Referring, Prescribing	N/A	1043742455	0	0	HANNA, MAMDOUH MD	1/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157174	N/A	N/A	N/A	N/A	N/A	14677 MERRILL AVE	None	FONTANA	CA	92335	4219	00	06000	34.09195549	-117.484956	San Bernardino County
317937	Ordering, Referring, Prescribing	N/A	1043745052	0	0	HERNANDEZ, BRIAN MD	11/10/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159274	N/A	N/A	N/A	N/A	N/A	1190 OLIVEWOOD DRIVE	STE A	MERCED	CA	95348	1256	00	06000	37.31824467	-120.49032	Merced County
317943	Ordering, Referring, Prescribing	N/A	1043746563	0	0	HILTON, DORIAN LCSW	9/20/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108408	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
317956	Ordering, Referring, Prescribing	N/A	1043779119	0	0	HE, CYNTHIA X MD	6/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL236	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
317999	Ordering, Referring, Prescribing	N/A	1043850944	0	0	HERNANDEZ, VIVIANA D LMFT	5/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125925	N/A	N/A	N/A	N/A	N/A	566 SOUTH BRAND BOULEVAR	None	SAN FERNANDO	CA	91340	1002	00	06000	34.27861303	-118.4437412	Los Angeles County
318007	Ordering, Referring, Prescribing	N/A	1043871288	0	0	HAGHNAZARIAN, EDITH MD	4/22/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178017	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
318020	Ordering, Referring, Prescribing	N/A	1043898497	0	0	HUANG, CRYSTAL X MD	10/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A183903	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVENUE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
318027	Ordering, Referring, Prescribing	N/A	1043934482	0	0	HEINRICH, LEAH S NP	9/23/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022781	N/A	N/A	N/A	N/A	N/A	652 PETALUMA AVE	H	SEBASTOPOL	CA	95472	4256	00	06000	38.39662494	-122.8201368	Sonoma County
318048	Ordering, Referring, Prescribing	N/A	1053028449	0	0	HWANG, JENNIFER S PHARMD	11/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87246	N/A	N/A	N/A	N/A	N/A	4605 MORENA BLVD	None	SAN DIEGO	CA	92117	3650	00	06000	32.82186082	-117.2264619	San Diego County
318054	Ordering, Referring, Prescribing	N/A	1053039065	0	0	HERRERA-MALDONADO, VINCENT A NP	12/18/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033361	N/A	N/A	N/A	N/A	N/A	1855 N FAIR OAKS AVE	200	PASADENA	CA	91103	1620	00	06000	34.177806	-118.1507985	Los Angeles County
318056	Ordering, Referring, Prescribing	N/A	1043998776	0	0	HO, DAISY OD	8/30/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35463	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
318062	Ordering, Referring, Prescribing	N/A	1053067843	0	0	HOFER, LESLIE NP	2/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95020129	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
318076	Ordering, Referring, Prescribing	N/A	1053141952	0	0	HAILE, WINTA NP	7/31/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031417	N/A	N/A	N/A	N/A	N/A	1300 N DUTTON AVENUE	None	SANTA ROSA	CA	95401	7112	00	06000	38.449791	-122.733027	Sonoma County
318079	Ordering, Referring, Prescribing	N/A	1053175604	0	0	HORWITZ, JULIETTE LMFT	11/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143206	N/A	N/A	N/A	N/A	N/A	13634 CORDARY AVE	None	HAWTHORNE	CA	90250	7409	00	06000	33.907257	-118.3416915	Los Angeles County
318132	Ordering, Referring, Prescribing	N/A	1053453597	0	0	HILLBLOM, KATHERINE L PHARMD	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	30912	N/A	N/A	N/A	N/A	N/A	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	00	06000	38.594898	-121.3884765	Sacramento County
318198	Ordering, Referring, Prescribing	N/A	1053555029	0	0	HOWELL, JEAN G MD	1/24/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A123548	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
318202	Ordering, Referring, Prescribing	N/A	1053560060	0	0	HANNANT, MICHAEL P MSW LCSW	11/19/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	70167	N/A	N/A	N/A	N/A	N/A	330 E LIVE OAK AVE	None	ARCADIA	CA	91006	5617	00	06000	34.10850998	-118.0219204	Los Angeles County
318231	Ordering, Referring, Prescribing	N/A	1053624312	0	0	HURWITZ, DANIELLE LMSW	2/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	65734	N/A	N/A	N/A	N/A	N/A	2750 EAST WASHINGTON BOU	SUITE 240	PASADENA	CA	91107	1448	00	06000	34.1680038	-118.0943955	Los Angeles County
318243	Ordering, Referring, Prescribing	N/A	1053642991	0	0	HEMANI, HEENA LMFT	4/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	83024	N/A	N/A	N/A	N/A	N/A	2813 S MAIN ST	None	CORONA	CA	92882	5942	00	06000	33.84741266	-117.570694	Riverside County
318251	Ordering, Referring, Prescribing	N/A	1053667139	0	0	HERNANDEZ-MORIN, JUANITA L PSYD	5/28/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSYD31633	N/A	N/A	N/A	N/A	N/A	1900 LAKE TAHOE BLVD.	None	SOUTH LAKE TAHOE	CA	96150	0000	00	06000	38.91165546	-120.0083802	El Dorado County
318277	Ordering, Referring, Prescribing	N/A	1053701573	0	0	HERMOSILLO, ADRIANA LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT117313	N/A	N/A	N/A	N/A	N/A	16552 SUNHILL DR	None	VICTORVILLE	CA	92395	4518	00	06000	34.5068043	-117.2986245	San Bernardino County
318301	Ordering, Referring, Prescribing	N/A	1053722892	0	0	HANSEN, DANIEL MD	7/10/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C186214	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
318310	Ordering, Referring, Prescribing	N/A	1053734525	0	0	HUFF, IVY LMFT	9/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105106	N/A	N/A	N/A	N/A	N/A	1303 E. HERDON	None	FRESNO	CA	93729	3303	00	06000	36.83626596	-119.7674879	Fresno County
318344	Ordering, Referring, Prescribing	N/A	1053776328	0	0	HUIE, VINCENT PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52621	N/A	N/A	N/A	N/A	N/A	300 PULLMAN ST	BUILDING B	LIVERMORE	CA	94551	9756	00	06000	37.70755227	-121.7149933	Alameda County
318349	Ordering, Referring, Prescribing	N/A	1053781633	0	0	HUANG, CECILIA MD	4/29/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178215	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
318362	Ordering, Referring, Prescribing	N/A	1053792978	0	0	HERRERA, CECILIA LCSW	6/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW82336	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
318369	Ordering, Referring, Prescribing	N/A	1053803411	0	0	HUANG, MAN LI NP	4/10/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008660	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
318371	Ordering, Referring, Prescribing	N/A	1053807446	0	0	HAMIDI, GYVE L	3/11/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	103745	N/A	N/A	N/A	N/A	N/A	321 VAN DUZEN RD	None	MAD RIVER	CA	95526	9508	00	06000	40.46004463	-123.5301743	Trinity County
318406	Ordering, Referring, Prescribing	N/A	1053870634	0	0	HUNTER, YOLOXOCHITL S LMFT	4/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT35247	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
318440	Ordering, Referring, Prescribing	N/A	1053955286	0	0	HERNANDEZ, FERNANDO LCSW	7/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW109314	N/A	N/A	N/A	N/A	N/A	355 DOVER PKWY	None	DELANO	CA	93215	3440	00	06000	35.7610493	-119.2523273	Kern County
318450	Ordering, Referring, Prescribing	N/A	1053970285	0	0	HA, CAITLIN X	9/18/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	104828	N/A	N/A	N/A	N/A	N/A	250 E HANFORD ARMONA RD	None	LEMOORE	CA	93245	2141	00	06000	36.31347649	-119.7771345	Kings County
318465	Ordering, Referring, Prescribing	N/A	1053975821	0	0	HOANG, CLINTON DO	2/13/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	DO3607	N/A	N/A	N/A	N/A	N/A	9405 VALENCIA CANYON DRI	None	LAS VEGAS	NV	89117	7131	00	06000	36.15505723	-115.2997283	Clark County
318468	Ordering, Referring, Prescribing	N/A	1063018141	0	0	HELTON, HAILY N PA-C	2/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA59186	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	STE 100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
318486	Ordering, Referring, Prescribing	N/A	1063063774	0	0	HAN, KYOUNG WON DDS	5/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	104272	N/A	N/A	N/A	N/A	N/A	1033 CLEMENT ST	None	SAN FRANCISCO	CA	94118	2112	00	06000	37.78261628	-122.470294	San Francisco County
318492	Ordering, Referring, Prescribing	N/A	1063081974	0	0	HARRIS, CLAUDINE NP	1/22/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017594	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
318496	Ordering, Referring, Prescribing	N/A	1063068443	0	0	HURTADO, ALYSSA K LCSW	5/29/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115546	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
318502	Ordering, Referring, Prescribing	N/A	1063128932	0	0	HELMI, MUSTAFA DDS	3/17/2024	Taxonomy not applicable	NA	n/a	000	Unknown	108516	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
318515	Ordering, Referring, Prescribing	N/A	1063171676	0	0	HERNANDEZ, LEA V LCSW	12/14/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104626	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
318528	Ordering, Referring, Prescribing	N/A	1063401594	0	0	HOOPINGARNER, BRADLEY R MD	4/25/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C178064	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
318540	Ordering, Referring, Prescribing	N/A	1063438687	0	0	HOLLAND, TANYA PSYD	7/30/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	22330	N/A	N/A	N/A	N/A	N/A	3331 POWER INN RD	None	SACRAMENTO	CA	95826	3889	00	06000	38.543391	-121.4077095	Sacramento County
318543	Ordering, Referring, Prescribing	N/A	1063463727	0	0	HERNANDEZ, PAMELA	4/23/2017	Taxonomy not applicable	NA	n/a	000	Unknown	15761	N/A	N/A	N/A	N/A	N/A	444 WEST EL MONTE WAY	None	DINUBA	CA	93618	1500	00	06000	36.54592542	-119.39921	Tulare County
318553	Ordering, Referring, Prescribing	N/A	1063497097	0	0	HILL, HANK C MD	7/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C159418	N/A	N/A	N/A	N/A	N/A	1345 A PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3159	00	06000	40.43531297	-120.6557201	Lassen County
318565	Ordering, Referring, Prescribing	N/A	1063523363	0	0	HENSEL, MELISSA M LCSW	11/11/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW23919	N/A	N/A	N/A	N/A	N/A	2308 J STREET	SUITE D	SACRAMENTO	CA	95816	4718	00	06000	38.575188	-121.475565	Sacramento County
318576	Ordering, Referring, Prescribing	N/A	1063539633	0	0	HOWELL, MICHELLE K LCSW	2/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26189	N/A	N/A	N/A	N/A	N/A	1925 E DAKOTA AVE	107	FRESNO	CA	93726	4821	00	06000	36.78683208	-119.7876584	Fresno County
318603	Ordering, Referring, Prescribing	N/A	1063550713	0	0	HUSER, SUSAN M	4/4/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0292682	N/A	N/A	N/A	N/A	N/A	200 MEDICAL PLZ	STE 430	LOS ANGELES	CA	90095	0001	00	06000	34.06527974	-118.4462792	Los Angeles County
318630	Ordering, Referring, Prescribing	N/A	1063605483	0	0	HUANG, RYAN	12/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	56071	N/A	N/A	N/A	N/A	N/A	4415 S CENTRAL AVE	None	LOS ANGELES	CA	90011	3629	00	06000	34.003413	-118.256519	Los Angeles County
318652	Ordering, Referring, Prescribing	N/A	1063666550	0	0	HILTON, ADAM S LMFT	2/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52499	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
318670	Ordering, Referring, Prescribing	N/A	1063700326	0	0	HUANG, URSULA M LMFT	2/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT108602	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
318704	Ordering, Referring, Prescribing	N/A	1063756997	0	0	HUFFNER, CHRISTINE M NP	3/2/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	578291	N/A	N/A	N/A	N/A	N/A	1030 INTERNATIONAL AVE	None	OAKLAND	CA	94606	3730	00	06000	37.7917365	-122.2492617	Alameda County
318720	Ordering, Referring, Prescribing	N/A	1063781375	0	0	HOANG, DELIA PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60935	N/A	N/A	N/A	N/A	N/A	1376 KOOSER RD	None	SAN JOSE	CA	95118	3813	00	06000	37.24617512	-121.8903909	Santa Clara County
318729	Ordering, Referring, Prescribing	N/A	1063793909	0	0	HAGANS, LAQEISHIA S PHD	6/25/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32704	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	SUITE 220	MISSION VIEJO	CA	92691	6441	00	06000	33.56536541	-117.670334	Orange County
318732	Ordering, Referring, Prescribing	N/A	1063793404	0	0	HOANG, JACQUELINE PHARMD	7/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54866	N/A	N/A	N/A	N/A	N/A	2605 MIDDLEFIELD ROAD	None	PALO ALTO	CA	94306	2516	00	06000	37.43410933	-122.1303843	Santa Clara County
318749	Ordering, Referring, Prescribing	N/A	1063797199	0	0	HAN, LILY P	9/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	63053	N/A	N/A	N/A	N/A	N/A	3461 W 3RD ST	None	LOS ANGELES	CA	90020	1604	00	06000	34.06908046	-118.290924	Los Angeles County
318781	Ordering, Referring, Prescribing	N/A	1063847523	0	0	HOM, STEPHEN T PHARMD	8/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69603	N/A	N/A	N/A	N/A	N/A	351 HOSPITAL RD	SUITE 211	NEWPORT BEACH	CA	92663	3503	00	06000	33.62579141	-117.9299554	Orange County
318801	Ordering, Referring, Prescribing	N/A	1063876829	0	0	HARANDI, SHAHEEN J MD MPH	1/25/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A156220	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
318810	Ordering, Referring, Prescribing	N/A	1063889566	0	0	HARKRUIZ, SYDNEY LCSW	10/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW115369	N/A	N/A	N/A	N/A	N/A	3840 ROSIN COURT	SUITE 240	SACRAMENTO	CA	95834	1639	00	06000	38.637567	-121.473306	Sacramento County
318841	Ordering, Referring, Prescribing	N/A	1063935880	0	0	HOVAKEMIAN, ANNIE OD	6/12/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT33686	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	225	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
318873	Ordering, Referring, Prescribing	N/A	1063988350	0	0	HONDA, JARED PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78672	N/A	N/A	N/A	N/A	N/A	6600 BRUCEVILLE ROAD	None	SACRAMENTO	CA	95823	4671	00	06000	38.470392	-121.4223975	Sacramento County
318885	Ordering, Referring, Prescribing	N/A	1073011409	0	0	HOPWOOD, KEVIN W NP	6/12/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95007195	N/A	N/A	N/A	N/A	N/A	1035 PLACER STREET	None	REDDING	CA	96001	1125	00	06000	40.58349378	-122.3853903	Shasta County
318895	Ordering, Referring, Prescribing	N/A	1073026977	0	0	HALLADAY, JOIE LMFT	1/25/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	93474	N/A	N/A	N/A	N/A	N/A	124 MAIN ST	None	ROSEVILLE	CA	95678	2232	00	06000	38.75196548	-121.2861465	Placer County
318919	Ordering, Referring, Prescribing	N/A	1073069746	0	0	HERVEY, NICOLE LMFT	11/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129419	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
318931	Ordering, Referring, Prescribing	N/A	1073080131	0	0	HOPPER, TAMARIND	9/7/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235979	N/A	N/A	N/A	N/A	N/A	1530 S. OLIVE STREET	None	LOS ANGELES	CA	90015	0000	00	06000	34.03542552	-118.2652073	Los Angeles County
318936	Ordering, Referring, Prescribing	N/A	1073088225	0	0	HERNANDEZ, WALTER E	8/24/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009823	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
318951	Ordering, Referring, Prescribing	N/A	1073120382	0	0	HUBER, BRANDON M PA-C	11/24/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58890	N/A	N/A	N/A	N/A	N/A	857 W. CHILDS AVE.	None	MERCED	CA	95341	6862	00	06000	37.2882813	-120.497688	Merced County
318991	Ordering, Referring, Prescribing	N/A	1073258430	0	0	HUSSEIN, TEEBA J	8/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	85969	N/A	N/A	N/A	N/A	N/A	1070 E CYPRESS AVE	None	REDDING	CA	96002	1114	00	06000	40.57107349	-122.3512425	Shasta County
319017	Ordering, Referring, Prescribing	N/A	1073389557	0	0	HARTZELL, MAKENNA OD	9/28/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT35598	N/A	N/A	N/A	N/A	N/A	8829 SHELDON RD	SUITE 150	ELK GROVE	CA	95624	5043	00	06000	38.438883	-121.372974	Sacramento County
319025	Ordering, Referring, Prescribing	N/A	1073531414	0	0	HUGHES, SUZANNE M	4/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	35321	N/A	N/A	N/A	N/A	N/A	1033 LAUREL ST	None	SAN CARLOS	CA	94070	0001	00	06000	37.50079437	-122.2542324	San Mateo County
319028	Ordering, Referring, Prescribing	N/A	1073555678	0	0	HENDRICKS, LAURA E NP	2/16/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95016706	N/A	N/A	N/A	N/A	N/A	831 E. ARROW HWY	None	POMONA	CA	91767	0000	00	06000	34.09030767	-117.7353578	Los Angeles County
319029	Ordering, Referring, Prescribing	N/A	1073596938	0	0	HARRIS, EMILY S MD	4/12/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G53980	N/A	N/A	N/A	N/A	N/A	555 HOSPITAL LN	None	SUSANVILLE	CA	96130	4808	00	06000	40.40857373	-120.666989	Lassen County
319057	Ordering, Referring, Prescribing	N/A	1073660411	0	0	HAN, LINDA P	1/7/2020	Taxonomy not applicable	NA	n/a	000	Unknown	43817	N/A	N/A	N/A	N/A	N/A	1855 W KATELLA AVE	None	ORANGE	CA	92867	3451	00	06000	33.8061655	-117.872442	Orange County
319068	Ordering, Referring, Prescribing	N/A	1073665758	0	0	HUEZO, VIRGINIA MSW LCSW	2/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25778	N/A	N/A	N/A	N/A	N/A	2751 NAPA VALLEY CORPORA	None	NAPA	CA	94558	7751	00	06000	38.24829023	-122.2745626	Napa County
319104	Ordering, Referring, Prescribing	N/A	1073778767	0	0	HUFF, TINA M NP	9/16/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011228	N/A	N/A	N/A	N/A	N/A	58375 29 PALMS HWY	None	YUCCA VALLEY	CA	92284	5813	00	06000	34.13141256	-116.3904357	San Bernardino County
319140	Ordering, Referring, Prescribing	N/A	1073859542	0	0	HARVEY, CHRISTOPHER B LCSW	9/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96644	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
319143	Ordering, Referring, Prescribing	N/A	1073858775	0	0	HERRINGTON, JESSICA L LMFT	12/9/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129785	N/A	N/A	N/A	N/A	N/A	3360 NORTH HWY 59	K	MERCED	CA	95348	9405	00	06000	37.32547941	-120.5047136	Merced County
319154	Ordering, Referring, Prescribing	N/A	1073885430	0	0	HARRER, THOMAS E LMFT	11/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	82188	N/A	N/A	N/A	N/A	N/A	6060 SUNRISE VISTA DR #2	None	CITRUS HEIGHTS	CA	95610	7068	00	06000	38.676861	-121.263903	Sacramento County
319187	Ordering, Referring, Prescribing	N/A	1073940680	0	0	HAYNES, ADAM L	11/20/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74673	N/A	N/A	N/A	N/A	N/A	867 N FAIR OAKS AVE	None	PASADENA	CA	91103	3050	00	06000	34.160877	-118.1506375	Los Angeles County
319195	Ordering, Referring, Prescribing	N/A	1073964169	0	0	HALOTE, VICTORIA L LCSW	12/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW98966	N/A	N/A	N/A	N/A	N/A	2502 E HUNTINGTON DR.	None	DUARTE	CA	91010	2221	00	06000	34.13967149	-117.9511686	Los Angeles County
319196	Ordering, Referring, Prescribing	N/A	1073965638	0	0	HAMBRO, JENNIFER LMFT	12/27/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT136806	N/A	N/A	N/A	N/A	N/A	921 WEST AVENUE J	SUITE C	LANCASTER	CA	93534	3443	00	06000	34.6895043	-118.1463998	Los Angeles County
319199	Ordering, Referring, Prescribing	N/A	1073968624	0	0	HEINLA, CHERYL LMFT	5/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90412	N/A	N/A	N/A	N/A	N/A	2425 BISSO LN	200	CONCORD	CA	94520	4897	00	06000	37.98393807	-122.0466953	Contra Costa County
319229	Ordering, Referring, Prescribing	N/A	1083001689	0	0	HU, JONATHAN PHARMD	3/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71307	N/A	N/A	N/A	N/A	N/A	1800 HARRISON ST	None	OAKLAND	CA	94612	3466	00	06000	37.80593773	-122.2656714	Alameda County
319246	Ordering, Referring, Prescribing	N/A	1083023329	0	0	HOUSTON, LIVIA LCSW	12/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99164	N/A	N/A	N/A	N/A	N/A	233 S QUINTANA DR	BLDG H	ANAHEIM	CA	92807	4029	00	06000	33.85230249	-117.7739305	Orange County
319253	Ordering, Referring, Prescribing	N/A	1083026843	0	0	HAREWOOD, MEREDITH E MD	11/30/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A129253	N/A	N/A	N/A	N/A	N/A	4760 S SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4820	00	06000	34.00134941	-118.4039837	Los Angeles County
319264	Ordering, Referring, Prescribing	N/A	1083039614	0	0	HOANG, DUC K PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69968	N/A	N/A	N/A	N/A	N/A	100 N IMPERIAL AVE	None	EL CENTRO	CA	92243	2809	00	06000	32.79344238	-115.5699452	Imperial County
319282	Ordering, Referring, Prescribing	N/A	1083069330	0	0	HSU, I-HSUAN PHARMD	3/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73374	N/A	N/A	N/A	N/A	N/A	3902 WASHINGTON BLVD	None	FREMONT	CA	94538	4954	00	06000	37.53267585	-121.9573339	Alameda County
319289	Ordering, Referring, Prescribing	N/A	1083082465	0	0	HASSENBERG, AMY PHARMD	3/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72922	N/A	N/A	N/A	N/A	N/A	3551 WHIPPLE RD	None	HAYWARD	CA	94540	0000	00	06000	37.6057383	-122.0834562	Alameda County
319321	Ordering, Referring, Prescribing	N/A	1083130132	0	0	HATFIELD, KEZIA A LMFT	8/25/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT100698	N/A	N/A	N/A	N/A	N/A	12 NEVADA STREET	SUITE B	REDLANDS	CA	92373	4222	00	06000	34.04940822	-117.2174557	San Bernardino County
319342	Ordering, Referring, Prescribing	N/A	1083163604	0	0	HERNANDEZ, ARTHUR NP	8/19/2019	Taxonomy not applicable	NA	n/a	000	Unknown	95004665	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
319346	Ordering, Referring, Prescribing	N/A	1083164636	0	0	HUANG, KUAN-LIN PHARMD	1/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75017	N/A	N/A	N/A	N/A	N/A	3970 RIVERMARK PLZ	None	SANTA CLARA	CA	95054	4155	00	06000	37.39481183	-121.9460207	Santa Clara County
319354	Ordering, Referring, Prescribing	N/A	1083177042	0	0	HASSAN, AMAL Y MD	4/12/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL2743	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
319361	Ordering, Referring, Prescribing	N/A	1083192116	0	0	HONG, SANGHEE NP	5/14/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007410	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
319371	Ordering, Referring, Prescribing	N/A	1083213748	0	0	HAYDEN, AMANDA M LMFT	4/1/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138925	N/A	N/A	N/A	N/A	N/A	464 S PALM AVE	None	HEMET	CA	92543	4808	00	06000	33.740703	-116.980311	Riverside County
319393	Ordering, Referring, Prescribing	N/A	1083259360	0	0	HARRISON, LINDA E NP	8/18/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013712	N/A	N/A	N/A	N/A	N/A	6950 BROCKTON AVE	5	RIVERSIDE	CA	92506	3831	00	06000	33.9474392	-117.3967287	Riverside County
319443	Ordering, Referring, Prescribing	N/A	1083438915	0	0	HOOD, ABIGAIL NP	9/4/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95032022	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
319467	Ordering, Referring, Prescribing	N/A	1083681498	0	0	HAYES, JOSEPH L DO	4/4/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16344	N/A	N/A	N/A	N/A	N/A	210 N CHESTER AVE	None	BAKERSFIELD	CA	93308	4841	00	06000	35.407179	-119.0208925	Kern County
319486	Ordering, Referring, Prescribing	N/A	1083737035	0	0	HOLYBEE, VALERIE M	3/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	35121	N/A	N/A	N/A	N/A	N/A	1563 MISSION STREET	SUITE A	SAN FRANCISCO	CA	94103	2543	00	06000	37.77327874	-122.4183559	San Francisco County
319501	Ordering, Referring, Prescribing	N/A	1083764484	0	0	HALEY, STEVEN DC	7/20/2022	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	25697	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
319508	Ordering, Referring, Prescribing	N/A	1083777312	0	0	HENSON, DAWN M LMFT	4/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40037	N/A	N/A	N/A	N/A	N/A	124 RIVER RD	None	SALINAS	CA	93908	9601	00	06000	36.61705976	-121.6608103	Monterey County
319550	Ordering, Referring, Prescribing	N/A	1083876981	0	0	HAUPRICHT, BRADLEY J MD	3/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C171767	N/A	N/A	N/A	N/A	N/A	330 N BRAND BLVD	700	GLENDALE	CA	91203	2308	00	06000	34.15116156	-118.2549512	Los Angeles County
319612	Ordering, Referring, Prescribing	N/A	1083969695	0	0	HERNANDEZ, JAVIER A CNP	3/30/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP22038	N/A	N/A	N/A	N/A	N/A	815 DR. MARTIN LUTHER KI	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
319644	Ordering, Referring, Prescribing	N/A	1093027724	0	0	HUNG, PETER MD	11/25/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A118199	N/A	N/A	N/A	N/A	N/A	1 HOPE DR	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
319683	Ordering, Referring, Prescribing	N/A	1093104309	0	0	HARGIS, ERIC M DO	12/9/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A13690	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
319696	Ordering, Referring, Prescribing	N/A	1093130510	0	0	HILBURN, MATTHEW C LMFT	8/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	120767	N/A	N/A	N/A	N/A	N/A	15339 SATICOY ST.	None	VAN NUYS	CA	91406	3345	00	06000	34.2084865	-118.4678505	Los Angeles County
319715	Ordering, Referring, Prescribing	N/A	1093160459	0	0	HEYRANA, KATRINA MD	7/19/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A168712	N/A	N/A	N/A	N/A	N/A	825 N SAN VICENTE BLVD	None	WEST HOLLYWOOD	CA	90069	4505	00	06000	34.0855723	-118.3845783	Los Angeles County
319749	Ordering, Referring, Prescribing	N/A	1093199176	0	0	HRISTEVA, NADYA Y	2/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	72779	N/A	N/A	N/A	N/A	N/A	1110 N DUTTON AVE	None	SANTA ROSA	CA	95401	4671	00	06000	38.446731	-122.729859	Sonoma County
319752	Ordering, Referring, Prescribing	N/A	1093177073	0	0	HIDIRSAH, AREK MD	1/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162777	N/A	N/A	N/A	N/A	N/A	5000 W SUNSET BLVD BLDG	None	LOS ANGELES	CA	90027	5861	00	06000	34.0981066	-118.2986382	Los Angeles County
319764	Ordering, Referring, Prescribing	N/A	1093212029	0	0	HALIBURTON RUDY, DAWN D LCSW	4/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87354	N/A	N/A	N/A	N/A	N/A	3301 E 12TH ST	None	OAKLAND	CA	94601	2940	00	06000	37.77617499	-122.2247899	Alameda County
319813	Ordering, Referring, Prescribing	N/A	1093286460	0	0	HONG, JENNIFER LMFT	10/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128727	N/A	N/A	N/A	N/A	N/A	19401 S VERMONT AVENUE	L102	TORRANCE	CA	90502	1029	00	06000	33.85486409	-118.2905603	Los Angeles County
319819	Ordering, Referring, Prescribing	N/A	1093317760	0	0	HARRIS, TODD PA-C	2/27/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62427	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
319863	Ordering, Referring, Prescribing	N/A	1093434045	0	0	HER, MAI Z	10/13/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	107880	N/A	N/A	N/A	N/A	N/A	1830 COMMERCIAL WAY	None	SANTA CRUZ	CA	95065	1819	00	06000	36.98837145	-121.9802206	Santa Cruz County
319867	Ordering, Referring, Prescribing	N/A	1093465668	0	0	HUANG, TINA MD	3/7/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188245	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
319886	Ordering, Referring, Prescribing	N/A	1093574816	0	0	HOFFMAN, JULIANA OT	3/8/2024	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	26165	N/A	N/A	N/A	N/A	N/A	10431 COMMERCE ST	SUITE A	REDLANDS	CA	92374	0110	00	06000	34.06427678	-117.2416506	San Bernardino County
319902	Ordering, Referring, Prescribing	N/A	1093755977	0	0	HAN, DAVID S MD	10/18/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A92286	N/A	N/A	N/A	N/A	N/A	1901 BROADVIEW DR	None	GLENDALE	CA	91208	1201	00	06000	34.20399715	-118.2268778	Los Angeles County
319944	Ordering, Referring, Prescribing	N/A	1093866998	0	0	HUDSON, KARIN F PSYD	8/14/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY24844	N/A	N/A	N/A	N/A	N/A	5335 LAKESHORE BLVD	None	LAKEPORT	CA	95453	6123	00	06000	39.1058965	-122.9032986	Lake County
319952	Ordering, Referring, Prescribing	N/A	1093887143	0	0	HARRIS, ANNE C LMFT	5/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47479	N/A	N/A	N/A	N/A	N/A	1086 E GRAND AVE	None	ARROYO GRANDE	CA	93420	2505	00	06000	35.11933967	-120.5958538	San Luis Obispo County
319960	Ordering, Referring, Prescribing	N/A	1093897423	0	0	HSIAO, LUNG SHENG LAC	4/12/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC6582	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
319968	Ordering, Referring, Prescribing	N/A	1093903411	0	0	HER, SANDY LCSW	7/7/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	116298	N/A	N/A	N/A	N/A	N/A	2719 N. AIR FRESNO DRIVE	None	FRESNO	CA	93727	1547	00	06000	36.77448139	-119.7281325	Fresno County
320010	Ordering, Referring, Prescribing	N/A	1093987901	0	0	HERNANDEZ, ELIZABETH P	1/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48543	N/A	N/A	N/A	N/A	N/A	1100 LINCOLN AVE	108	NAPA	CA	94558	4900	00	06000	38.3085749	-122.2949243	Napa County
320018	Ordering, Referring, Prescribing	N/A	1093992869	0	0	HELDT, RHONDA A PSYD	6/8/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	18160	N/A	N/A	N/A	N/A	N/A	2225 CHALLENGER WAY	None	SANTA ROSA	CA	95407	0000	00	06000	38.425482	-122.75262	Sonoma County
320031	Ordering, Referring, Prescribing	N/A	1104034941	0	0	HERRERA, RAFAEL LCSW	7/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW6085	N/A	N/A	N/A	N/A	N/A	4025 TERRA GRANADA DRIVE	None	WALNUT CREEK	CA	94595	4348	00	06000	37.85203057	-122.0624719	Contra Costa County
320040	Ordering, Referring, Prescribing	N/A	1104052380	0	0	HENKEL, CHRISTINA LMFT	10/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43895	N/A	N/A	N/A	N/A	N/A	1202 MORENA BLVD	None	SAN DIEGO	CA	92110	4711	00	06000	32.77025942	-117.2017196	San Diego County
320042	Ordering, Referring, Prescribing	N/A	1104054717	0	0	HANSON-LOPEZ, GABRIELA LCSW	2/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW72138	N/A	N/A	N/A	N/A	N/A	1236 CHAPALA STREET	None	SANTA BARBARA	CA	93101	0408	00	06000	34.42310529	-119.7066629	Santa Barbara County
320056	Ordering, Referring, Prescribing	N/A	1104093921	0	0	HORN, CARRIE A PSYD	8/14/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	26201	N/A	N/A	N/A	N/A	N/A	1605 HOPE ST.	#335	SOUTH PASADENA	CA	91030	5840	00	06000	34.11679363	-118.150088	Los Angeles County
320058	Ordering, Referring, Prescribing	N/A	1104095918	0	0	HAMASAKI, SUZANNE R LMFT	3/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50982	N/A	N/A	N/A	N/A	N/A	2801 BRISTOL ST	2ND FLOOR	COSTA MESA	CA	92626	5996	00	06000	33.67474907	-117.889122	Orange County
320062	Ordering, Referring, Prescribing	N/A	1104104249	0	0	HERNANDEZ, HUMBERTO R PHD	1/15/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26563	N/A	N/A	N/A	N/A	N/A	11110 ALONDRA BLVD.	STUDENT HEALTH SERVICES	NORWALK	CA	90650	6203	00	06000	33.885675	-118.097631	Los Angeles County
320072	Ordering, Referring, Prescribing	N/A	1104112549	0	0	HORSTMAN, HIROKO PHARMD	3/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	45270	N/A	N/A	N/A	N/A	N/A	13463 WASHINGTON BLVD	None	MARINA DEL REY	CA	90292	5658	00	06000	33.993054	-118.4472405	Los Angeles County
320081	Ordering, Referring, Prescribing	N/A	1104134188	0	0	HWANG, SUNG HEA LCSW	1/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	82920	N/A	N/A	N/A	N/A	N/A	600 ST PAUL AVE	STE 101	LOS ANGELES	CA	90017	5660	00	06000	34.05324991	-118.2609994	Los Angeles County
320108	Ordering, Referring, Prescribing	N/A	1104191832	0	0	HIPPEN, KELSEY A PSYD	5/16/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34211	N/A	N/A	N/A	N/A	N/A	1563 MISSION ST	None	SAN FRANCISCO	CA	94103	2543	00	06000	37.77327874	-122.4183559	San Francisco County
320116	Ordering, Referring, Prescribing	N/A	1104195908	0	0	HO, BOSCO LMFT	5/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106506	N/A	N/A	N/A	N/A	N/A	1968 W ADAMS BLVD	STE 106	LOS ANGELES	CA	90018	3515	00	06000	34.03266053	-118.3081635	Los Angeles County
320117	Ordering, Referring, Prescribing	N/A	1104199785	0	0	HSIA, TING TING LAC	7/20/2022	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	14593	N/A	N/A	N/A	N/A	N/A	2633 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1597	00	06000	37.72840413	-122.4039067	San Francisco County
320120	Ordering, Referring, Prescribing	N/A	1104206473	0	0	HO, NGOCDIEP T PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57983	N/A	N/A	N/A	N/A	N/A	8920 FLETCHER PKWY	None	LA MESA	CA	91942	3231	00	06000	32.78544347	-117.0051058	San Diego County
320121	Ordering, Referring, Prescribing	N/A	1104203108	0	0	HALL, ELIZABETH A LMFT	4/2/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132114	N/A	N/A	N/A	N/A	N/A	2261 S WATNEY WAY	None	FAIRFIELD	CA	94533	6757	00	06000	38.23596282	-122.0705195	Solano County
320122	Ordering, Referring, Prescribing	N/A	1104203454	0	0	HOXMEIER, KRYSTA M PA-C	2/26/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA58505	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
320130	Ordering, Referring, Prescribing	N/A	1104213958	0	0	HITZ, SAMUEL MD	6/17/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146380	N/A	N/A	N/A	N/A	N/A	1359 N GRAND AVE	None	COVINA	CA	91724	1016	00	06000	34.104681	-117.872706	Los Angeles County
320132	Ordering, Referring, Prescribing	N/A	1104226141	0	0	HOLZUM, DAMON LCSW	2/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81327	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE	None	LOS ANGELES	CA	90001	9304	00	06000	33.9664185	-118.2477481	Los Angeles County
320136	Ordering, Referring, Prescribing	N/A	1104226448	0	0	HERNANDEZ, BENIGNA E LCSW	4/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94727	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
320151	Ordering, Referring, Prescribing	N/A	1104250190	0	0	HARDISON, STEPHANIE M LCSW	9/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96929	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	165	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
320159	Ordering, Referring, Prescribing	N/A	1104258268	0	0	HENDERSON, ASHLEY L NP	6/20/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP23312	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO ST	698	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
320210	Ordering, Referring, Prescribing	N/A	1104348838	0	0	HERNANDEZ, MARIA LCSW	11/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127422	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
320217	Ordering, Referring, Prescribing	N/A	1104349943	0	0	HOMEYER, HOLLY N LCSW	2/25/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100275	N/A	N/A	N/A	N/A	N/A	650 N. OAKLAND AVE	None	PASADENA	CA	91101	1160	00	06000	34.15697849	-118.1399781	Los Angeles County
320244	Ordering, Referring, Prescribing	N/A	1104384957	0	0	HARRY, JUNE M NP	2/12/2019	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	NP95011147	N/A	N/A	N/A	N/A	N/A	750 E WALKER ST	None	ORLAND	CA	95963	2222	00	06000	39.74723653	-122.1722213	Glenn County
320246	Ordering, Referring, Prescribing	N/A	1104368869	0	0	HARAGUNI, MIKI NP	9/11/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	684260	N/A	N/A	N/A	N/A	N/A	200 MEDICAL PLAZA	None	LOS ANGELES	CA	90095	7403	00	06000	34.06527974	-118.4462792	Los Angeles County
320271	Ordering, Referring, Prescribing	N/A	1104458017	0	0	HEI, SIMY S NP	2/8/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015147	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
320286	Ordering, Referring, Prescribing	N/A	1104478148	0	0	HOON, MARY E LMFT	4/1/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132104	N/A	N/A	N/A	N/A	N/A	9445 FAIRWAY VIEW PL	100	RANCHO CUCAMONGA	CA	91730	0929	00	06000	34.08193054	-117.5597308	San Bernardino County
320296	Ordering, Referring, Prescribing	N/A	1104524891	0	0	HAZENBERG, BROOKLYNE PA-C	3/22/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62332	N/A	N/A	N/A	N/A	N/A	905 CALLE AMANECER	SUITE 115	SAN CLEMENTE	CA	92673	6226	00	06000	33.44951265	-117.6075825	Orange County
320311	Ordering, Referring, Prescribing	N/A	1104646611	0	0	HONG, MUNG GI PA-C	10/14/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA65236	N/A	N/A	N/A	N/A	N/A	2680 SATURN AVE	None	HUNTINGTON PARK	CA	90255	4377	00	06000	33.9768845	-118.222884	Los Angeles County
320317	Ordering, Referring, Prescribing	N/A	1104678077	0	0	HWANG, IN SANG PHARMD	2/21/2024	Taxonomy not applicable	NA	n/a	000	Unknown	89240	N/A	N/A	N/A	N/A	N/A	6405 DAY STREET	None	RIVERSIDE	CA	92507	0901	00	06000	33.934059	-117.2789475	Riverside County
320320	Ordering, Referring, Prescribing	N/A	1104681410	0	0	HOY, MARIA MARISSA RN PHN	6/7/2023	Taxonomy not applicable	NA	n/a	000	Unknown	696240	N/A	N/A	N/A	N/A	N/A	150 DISTRICT CENTER DR	None	PALM SPRINGS	CA	92264	3626	00	06000	33.82485354	-116.4955129	Riverside County
320331	Ordering, Referring, Prescribing	N/A	1104854843	0	0	HASPEL, THOMAS W MD	1/11/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G79756	N/A	N/A	N/A	N/A	N/A	1055 W HENDERSON	STE 2	PORTERVILLE	CA	93257	0906	00	06000	36.08036906	-119.0410926	Tulare County
320332	Ordering, Referring, Prescribing	N/A	1104859982	0	0	HARMON, SHIRLEY M PSYD	2/22/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY20198	N/A	N/A	N/A	N/A	N/A	200 W SANTA ANA BLVD	801	SANTA ANA	CA	92701	4134	00	06000	33.74970951	-117.8691975	Orange County
320338	Ordering, Referring, Prescribing	N/A	1104866748	0	0	HUSSAIN, FARABI MD DO	8/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A60613	N/A	N/A	N/A	N/A	N/A	1873 COMMERCENTER W	None	SAN BERNARDINO	CA	92408	3303	00	06000	34.067781	-117.286122	San Bernardino County
320344	Ordering, Referring, Prescribing	N/A	1104916808	0	0	HOFFMAN-WINBERRY, KAREN S LMFT	7/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT35628	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	None	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
320355	Ordering, Referring, Prescribing	N/A	1104948652	0	0	HONG, KATHY T PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54956	N/A	N/A	N/A	N/A	N/A	16201 HARBOR BLVD.	None	FOUNTAIN VALLEY	CA	92708	1371	00	06000	33.728085	-117.9215595	Orange County
320373	Ordering, Referring, Prescribing	N/A	1104967256	0	0	HAMMETT, JENNIE E LAC	11/3/2020	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	7570	N/A	N/A	N/A	N/A	N/A	101 WEST COAST ROAD	None	REDWAY	CA	95560	0769	00	06000	40.11704433	-123.8133408	Humboldt County
320377	Ordering, Referring, Prescribing	N/A	1104979202	0	0	HYDE, TARA PSYD	10/29/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26452	N/A	N/A	N/A	N/A	N/A	2600 REDONDO AVE.	None	LONG BEACH	CA	90806	2325	00	06000	33.806097	-118.151378	Los Angeles County
320379	Ordering, Referring, Prescribing	N/A	1104980556	0	0	HALCON, ANTHONY LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	44910	N/A	N/A	N/A	N/A	N/A	200 BROADWAY ST.	88	KING CITY	CA	93930	2862	00	06000	36.2133658	-121.1256124	Monterey County
320413	Ordering, Referring, Prescribing	N/A	1114052487	0	0	HEDGLIN, LITA S MD	12/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G78032	N/A	N/A	N/A	N/A	N/A	9101 WHIITTIER BLVD	None	PICO RIVERA	CA	90660	2405	00	06000	34.00074139	-118.0822944	Los Angeles County
320441	Ordering, Referring, Prescribing	N/A	1114116886	0	0	HARRIS, SHELIALANNA L LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51623	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
320459	Ordering, Referring, Prescribing	N/A	1114130358	0	0	HASHOUSH, MARIAM K	1/29/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D54931	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
320464	Ordering, Referring, Prescribing	N/A	1114141173	0	0	HERRINGTON, RANDOLPH G	6/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48970	N/A	N/A	N/A	N/A	N/A	1212 N. CALIFORNIA STREE	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
320470	Ordering, Referring, Prescribing	N/A	1114157252	0	0	HORST, ORAPIN V	9/4/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D60971	N/A	N/A	N/A	N/A	N/A	1830 COMMERCIAL WAY	None	SANTA CRUZ	CA	95065	1819	00	06000	36.98837145	-121.9802206	Santa Cruz County
320475	Ordering, Referring, Prescribing	N/A	1114173325	0	0	HUANG, HSIN YI GRACE MD	2/25/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A104119	N/A	N/A	N/A	N/A	N/A	51 N 5TH AVE	#303	ARCADIA	CA	91006	3711	00	06000	34.1412293	-118.0205477	Los Angeles County
320497	Ordering, Referring, Prescribing	N/A	1114209582	0	0	HERNANDEZ, GEMILA E LCSW	3/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	76777	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD	None	CERRITOS	CA	90703	2640	00	06000	33.87008991	-118.0991298	Los Angeles County
320542	Ordering, Referring, Prescribing	N/A	1114300829	0	0	HENRY, CAROLINE L PA	8/30/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA64992	N/A	N/A	N/A	N/A	N/A	325 EAST 7TH STREET	None	LOS ANGELES	CA	90014	0000	00	06000	34.04209386	-118.2486813	Los Angeles County
320550	Ordering, Referring, Prescribing	N/A	1114316387	0	0	HABASHY, GINA LMFT	8/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113247	N/A	N/A	N/A	N/A	N/A	1950 MARKET ST	None	CITY IS NOT LISTE	CA	92501	1720	00	06000	34.00316496	-117.3767967	Riverside County
320562	Ordering, Referring, Prescribing	N/A	1114325917	0	0	HARVEY, RACHAEL A LMFT	7/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113127	N/A	N/A	N/A	N/A	N/A	1908 N BEALE RD	E	MARYSVILLE	CA	95901	6937	00	06000	39.1278388	-121.5457994	Yuba County
320574	Ordering, Referring, Prescribing	N/A	1114340106	0	0	HERNANDEZ, MARA E LCSW	7/24/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW116792	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	200	ANAHEIM	CA	92806	5159	00	06000	33.81812448	-117.8880075	Orange County
320586	Ordering, Referring, Prescribing	N/A	1114359429	0	0	HERNANDEZ, RUBICELI CNP	12/9/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	20225	N/A	N/A	N/A	N/A	N/A	18785 BROOKHURST ST	101	FOUNTAIN VALLEY	CA	92708	6749	00	06000	33.68987636	-117.9542321	Orange County
320594	Ordering, Referring, Prescribing	N/A	1114380581	0	0	HOANG, ANH K DO	4/29/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16321	N/A	N/A	N/A	N/A	N/A	1165 MONTGOMERY DR	None	SANTA ROSA	CA	95405	0000	00	06000	38.443806	-122.701374	Sonoma County
320603	Ordering, Referring, Prescribing	N/A	1114391935	0	0	HOSSEINI, SOHEILA PSYD	10/29/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29987	N/A	N/A	N/A	N/A	N/A	520 S. SEPULVEDA BLVD.	SUITE 406	LOS ANGELES	CA	90049	3547	00	06000	34.06573968	-118.4598268	Los Angeles County
320612	Ordering, Referring, Prescribing	N/A	1114409232	0	0	HAILE, CANDICE	8/13/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125126	N/A	N/A	N/A	N/A	N/A	9837 FOLSOM BLVD	F	SACRAMENTO	CA	95827	1356	00	06000	38.575764	-121.330647	Sacramento County
320622	Ordering, Referring, Prescribing	N/A	1114423076	0	0	HARUNO, JULIA F MD	7/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164685	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
320630	Ordering, Referring, Prescribing	N/A	1114434917	0	0	HARITOPOULOS, MARIA LMFT	12/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123837	N/A	N/A	N/A	N/A	N/A	1300 W FLORIDA AVE STE B	STE B	HEMET	CA	92543	4628	00	06000	33.74755149	-116.98533	Riverside County
320636	Ordering, Referring, Prescribing	N/A	1114443264	0	0	HUCKABAY, CAROLYN G LCSW	6/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76937	N/A	N/A	N/A	N/A	N/A	301 VICTORIA ST	None	COSTA MESA	CA	92627	1995	00	06000	33.65258952	-117.9121545	Orange County
320641	Ordering, Referring, Prescribing	N/A	1114455839	0	0	HSU, DULCE R LMFT	4/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125684	N/A	N/A	N/A	N/A	N/A	3301 E. 12TH ST.	SUITE 259	OAKLAND	CA	94601	2940	00	06000	37.77617499	-122.2247899	Alameda County
320672	Ordering, Referring, Prescribing	N/A	1114448875	0	0	HOANG, THUY PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74880	N/A	N/A	N/A	N/A	N/A	8010 PARKWAY DR	None	LA MESA	CA	91942	2104	00	06000	32.7749024	-117.0246371	San Diego County
320704	Ordering, Referring, Prescribing	N/A	1114587797	0	0	HORTON, CRYSTAL D LCSW	3/29/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW114085	N/A	N/A	N/A	N/A	N/A	2130 NATIONAL AVE	None	SAN DIEGO	CA	92113	2209	00	06000	32.69800063	-117.1411927	San Diego County
320725	Ordering, Referring, Prescribing	N/A	1114651890	0	0	HAMIDEH, SHADIA PA-C	6/6/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA62832	N/A	N/A	N/A	N/A	N/A	123 S ALVARADO ST	None	LOS ANGELES	CA	90057	2201	00	06000	34.06593048	-118.2708351	Los Angeles County
320771	Ordering, Referring, Prescribing	N/A	1124006408	0	0	HARTNETT, TIMOTHY V LMFT	9/20/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	27228	N/A	N/A	N/A	N/A	N/A	700 FREDERICK STREET	STE. 103	SANTA CRUZ	CA	95062	2239	00	06000	36.98031434	-122.004438	Santa Cruz County
320778	Ordering, Referring, Prescribing	N/A	1114960937	0	0	HOU, PEN MD	5/22/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C172450	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
320785	Ordering, Referring, Prescribing	N/A	1124089685	0	0	HUANG, STEPHEN MD	8/31/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C54719	N/A	N/A	N/A	N/A	N/A	700 RIVER DRIVE	None	FORT BRAGG	CA	95437	5403	00	06000	39.43163763	-123.8007631	Mendocino County
320803	Ordering, Referring, Prescribing	N/A	1124116660	0	0	HAGELE, MARK J	9/26/1991	Taxonomy not applicable	NA	n/a	099	DENTIST	D39410	N/A	N/A	N/A	N/A	N/A	4941 OLIVEHURST AVE	None	OLIVEHURST	CA	95961	4225	00	06000	39.09746115	-121.5514942	Yuba County
320806	Ordering, Referring, Prescribing	N/A	1124122551	0	0	HUANG, JEFF C MD	6/4/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A61014	N/A	N/A	N/A	N/A	N/A	18663 BROOKHURST ST	None	FOUNTAIN VALLEY	CA	92708	6709	00	06000	33.69170358	-117.9543032	Orange County
320817	Ordering, Referring, Prescribing	N/A	1124149257	0	0	HUNTER SUDDRETH, JEAN MARIE LMFT	12/31/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	41229	N/A	N/A	N/A	N/A	N/A	867 N FAIR OAKS AVE	None	PASADENA	CA	91103	3050	00	06000	34.160877	-118.1506375	Los Angeles County
320860	Ordering, Referring, Prescribing	N/A	1124215686	0	0	HWANG, ALENA S PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60202	N/A	N/A	N/A	N/A	N/A	6041 CADILLAC AVE	PHARMACY OPERATIONS, SUI	LOS ANGELES	CA	90034	1702	00	06000	34.03781261	-118.3755101	Los Angeles County
320870	Ordering, Referring, Prescribing	N/A	1124237383	0	0	HUNT, LINDA A	4/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS18407	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE.	SUITE 125C	OAKLAND	CA	94605	2408	00	06000	37.768221	-122.17608	Alameda County
320901	Ordering, Referring, Prescribing	N/A	1124309380	0	0	HILL, CATHERINE J PHARMD	9/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61781	N/A	N/A	N/A	N/A	N/A	2220 MOORPARK AVE	None	SAN JOSE	CA	95128	2613	00	06000	37.31607058	-121.932335	Santa Clara County
320902	Ordering, Referring, Prescribing	N/A	1124302815	0	0	HAROIAN, NAIRI C	6/8/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D60873	N/A	N/A	N/A	N/A	N/A	801 S CHEVY CHASE DR	STE 250	GLENDALE	CA	91205	4433	00	06000	34.136757	-118.2396195	Los Angeles County
320903	Ordering, Referring, Prescribing	N/A	1124307632	0	0	HERRERA, SONIA LMFT	12/15/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110397	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
320948	Ordering, Referring, Prescribing	N/A	1124386875	0	0	HARRIS, ARI L MD	7/29/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174168	N/A	N/A	N/A	N/A	N/A	2180 HARVARD ST.	STE 210	SACRAMENTO	CA	95815	3318	00	06000	38.60568	-121.4345385	Sacramento County
320953	Ordering, Referring, Prescribing	N/A	1124366380	0	0	HASSANZADEH, FARANAK PHARMD	3/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	68585	N/A	N/A	N/A	N/A	N/A	4211 SOUTH AVALON BLVD	None	LOS ANGELES	CA	90011	5622	00	06000	34.007238	-118.2653065	Los Angeles County
320958	Ordering, Referring, Prescribing	N/A	1124404025	0	0	HERRERA, CLARA A LMFT	4/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116585	N/A	N/A	N/A	N/A	N/A	500 CITY PKWY W	SUITE 200	ORANGE	CA	92868	2941	00	06000	33.78299346	-117.895788	Orange County
321007	Ordering, Referring, Prescribing	N/A	1124474358	0	0	HOGG-DUNCAN, BRANDY CNP	5/6/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95014534	N/A	N/A	N/A	N/A	N/A	400 W PUEBLO STREET	None	SANTA BARBARA	CA	93105	4353	00	06000	34.42887662	-119.7237878	Santa Barbara County
321033	Ordering, Referring, Prescribing	N/A	1124508064	0	0	HOANG, AMY PHARMD	8/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78253	N/A	N/A	N/A	N/A	N/A	15480 MAIN ST	None	HESPERIA	CA	92345	3318	00	06000	34.42530462	-117.3256052	San Bernardino County
321037	Ordering, Referring, Prescribing	N/A	1124512330	0	0	HAMILTON, KACEY M MD	5/16/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A175995	N/A	N/A	N/A	N/A	N/A	1316 3RD STREET PROMENAD	201	SANTA MONICA	CA	90401	1328	00	06000	34.01670895	-118.497462	Los Angeles County
321042	Ordering, Referring, Prescribing	N/A	1124532007	0	0	HAYWARD, AUDREY E LCSW	9/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	102284	N/A	N/A	N/A	N/A	N/A	2130 STOCKTON BLVD	300	SACRAMENTO	CA	95817	1337	00	06000	38.557593	-121.4616735	Sacramento County
321054	Ordering, Referring, Prescribing	N/A	1124547351	0	0	HERRERA, ABEL LCSW	1/4/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW120238	N/A	N/A	N/A	N/A	N/A	6244 EL CAJON BLVD	SUITE 14	SAN DIEGO	CA	92115	3918	00	06000	32.76342577	-117.0636924	San Diego County
321110	Ordering, Referring, Prescribing	N/A	1124642889	0	0	HAILE, DAWIT T MD	4/9/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A195369	N/A	N/A	N/A	N/A	N/A	1700 COFFEE ROAD	None	MODESTO	CA	95355	8405	00	06000	37.668645	-120.9756715	Stanislaus County
321158	Ordering, Referring, Prescribing	N/A	1124799283	0	0	HUA, ZACHARY	9/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85341	N/A	N/A	N/A	N/A	N/A	5055 TELEGRAPH AVE	None	OAKLAND	CA	94609	2040	00	06000	37.8368777	-122.2624355	Alameda County
321160	Ordering, Referring, Prescribing	N/A	1124805270	0	0	HUSSEN, SAFIA NP	11/7/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95027983	N/A	N/A	N/A	N/A	N/A	1532 SAN BERNARDINO AVE	B7	POMONA	CA	91767	3559	00	06000	34.0758525	-117.7200855	Los Angeles County
321168	Ordering, Referring, Prescribing	N/A	1134106362	0	0	HSU, CHRISTENSEN S	9/16/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	D44362	N/A	N/A	N/A	N/A	N/A	1127 WILSHIRE BLVD	STE 1504	LOS ANGELES	CA	90017	4006	00	06000	34.05270508	-118.2641005	Los Angeles County
321174	Ordering, Referring, Prescribing	N/A	1134132897	0	0	HATCH, LANETTE A PA-C	7/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA16721	N/A	N/A	N/A	N/A	N/A	1040 FLYNN ROAD	None	VENTURA	CA	93012	5092	00	06000	34.22803589	-119.0182161	Ventura
321195	Ordering, Referring, Prescribing	N/A	1134224314	0	0	HSU, CHUN-HSIU LMFT	2/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43077	N/A	N/A	N/A	N/A	N/A	2719 N AIR FRESNO DR	None	FRESNO	CA	93727	1547	00	06000	36.77448139	-119.7281325	Fresno County
321220	Ordering, Referring, Prescribing	N/A	1134255755	0	0	HENNICK, JASON D LCSW	10/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28047	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS ST	K-08	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
321242	Ordering, Referring, Prescribing	N/A	1134294820	0	0	HURSH, KEVIN D	12/10/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D49113	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY AVE	None	HEALDSBURG	CA	95448	3314	00	06000	38.62757555	-122.8638141	Sonoma County
321249	Ordering, Referring, Prescribing	N/A	1134300627	0	0	HAMILTON, SILVIA D PSYD	8/31/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	31862	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
321282	Ordering, Referring, Prescribing	N/A	1134400849	0	0	HECKER, LISA LCSW	2/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19842	N/A	N/A	N/A	N/A	N/A	14677 MERRILL AVE	None	FONTANA	CA	92335	4219	00	06000	34.09195549	-117.484956	San Bernardino County
321314	Ordering, Referring, Prescribing	N/A	1134468796	0	0	HEGR, ADRIENNE D LMFT	8/26/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102088	N/A	N/A	N/A	N/A	N/A	1100 MELODY LN	SUITE 224	ROSEVILLE	CA	95678	5208	00	06000	38.72518759	-121.2912717	Placer County
321318	Ordering, Referring, Prescribing	N/A	1134478886	0	0	HOANG, JULIE A PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68033	N/A	N/A	N/A	N/A	N/A	17284 SLOVER AVE	PALM COURT II, SUITE 204	FONTANA	CA	92337	7584	00	06000	34.065396	-117.4277475	San Bernardino County
321363	Ordering, Referring, Prescribing	N/A	1134535479	0	0	HOOVER, ANNIE C LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85404	N/A	N/A	N/A	N/A	N/A	1830 SIERRA GARDENS DR	10	ROSEVILLE	CA	95661	2942	00	06000	38.7469982	-121.2600775	Placer County
321367	Ordering, Referring, Prescribing	N/A	1134536964	0	0	HURLEY, JOHN LMFT	3/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99315	N/A	N/A	N/A	N/A	N/A	2801 HOP RANCH RD	None	UNION CITY	CA	94587	5708	00	06000	37.5908715	-122.0473803	Alameda County
321384	Ordering, Referring, Prescribing	N/A	1134573041	0	0	HUONG, BAOVI PHARMD	3/15/2022	Taxonomy not applicable	NA	n/a	000	Unknown	70454	N/A	N/A	N/A	N/A	N/A	2530 GLENDALE BLVD	None	LOS ANGELES	CA	90039	3220	00	06000	34.10317638	-118.2591943	Los Angeles County
321434	Ordering, Referring, Prescribing	N/A	1134652803	0	0	HARWELL, CLARISSA E LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	92663	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
321440	Ordering, Referring, Prescribing	N/A	1134655590	0	0	HOSSAIN, SAIF MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A171715	N/A	N/A	N/A	N/A	N/A	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	00	06000	34.06750236	-117.925203	Los Angeles County
321446	Ordering, Referring, Prescribing	N/A	1134657398	0	0	HEITMEYER, MARISOL LMFT	9/15/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134743	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
321478	Ordering, Referring, Prescribing	N/A	1134722648	0	0	HUANG, JACKIE	3/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83657	N/A	N/A	N/A	N/A	N/A	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	00	06000	38.594898	-121.3884765	Sacramento County
321480	Ordering, Referring, Prescribing	N/A	1134731318	0	0	HUANG, JIMMY A PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82831	N/A	N/A	N/A	N/A	N/A	260 INTERNATIONAL CIR	None	SAN JOSE	CA	95119	1130	00	06000	37.24047903	-121.7998157	Santa Clara County
321486	Ordering, Referring, Prescribing	N/A	1134750474	0	0	HERRICK, BENJAMIN NP	1/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013738	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
321564	Ordering, Referring, Prescribing	N/A	1144300690	0	0	HOOPER, JEDEDIAH M MD	4/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A93285	N/A	N/A	N/A	N/A	N/A	2415 UNIVERSITY AVE	3RD FLOOR	EAST PALO ALTO	CA	94303	1164	00	06000	37.47232529	-122.139568	San Mateo County
321595	Ordering, Referring, Prescribing	N/A	1144359118	0	0	HAREWOOD, CASSANDRA E MD	12/14/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A66120	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
321610	Ordering, Referring, Prescribing	N/A	1144380940	0	0	HOFFMAN, HOLLI M NP	11/21/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	14724	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
321631	Ordering, Referring, Prescribing	N/A	1144451972	0	0	HEINZELMANN, VERONICA B LCSW	2/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25761	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
321634	Ordering, Referring, Prescribing	N/A	1144450982	0	0	HUGON, SHANNON LCSW	12/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88256	N/A	N/A	N/A	N/A	N/A	1451 28TH AVE	None	OAKLAND	CA	94601	1632	00	06000	37.78066946	-122.2292246	Alameda County
321644	Ordering, Referring, Prescribing	N/A	1144482852	0	0	HUERTA, REGINA LMFT	12/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123637	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
321650	Ordering, Referring, Prescribing	N/A	1144489857	0	0	HURTADO, MARIA G MSW LCSW	6/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89153	N/A	N/A	N/A	N/A	N/A	828 W VENTURA ST	None	FILLMORE	CA	93015	1876	00	06000	34.39581413	-118.9207744	Ventura County
321664	Ordering, Referring, Prescribing	N/A	1144519257	0	0	HEDLIN, CHRYSTAL A LCSW	6/6/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	62418	N/A	N/A	N/A	N/A	N/A	650 ZEDIKER AVE	None	PARLIER	CA	93648	2666	00	06000	36.60500164	-119.5210273	Fresno County
321681	Ordering, Referring, Prescribing	N/A	1144563107	0	0	HENDRICKS, CHERYL MD	8/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133159	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVE	None	LOS ANGELES	CA	90018	1336	00	06000	34.037415	-118.3176815	Los Angeles County
321706	Ordering, Referring, Prescribing	N/A	1144609819	0	0	HEDGES, ZACHARY LMFT	1/14/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124016	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
321711	Ordering, Referring, Prescribing	N/A	1144603606	0	0	HSU, JENNIFER	2/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147335	N/A	N/A	N/A	N/A	N/A	3505 LONE TREE WAY SUITE	None	ANTIOCH	CA	94509	6067	00	06000	37.98725411	-121.8065036	Contra Costa County
321736	Ordering, Referring, Prescribing	N/A	1144641911	0	0	HONRADA, TIMOTHY N PHARMD	3/30/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH70307	N/A	N/A	N/A	N/A	N/A	8011 UNIVERSITY AVE	None	LA MESA	CA	91942	5520	00	06000	32.76600931	-117.02485	San Diego County
321742	Ordering, Referring, Prescribing	N/A	1144650573	0	0	HUANG, DENNY H LCSW	12/29/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW77554	N/A	N/A	N/A	N/A	N/A	1373 CENTER COURT DRIVE	None	COVINA	CA	91724	3663	00	06000	34.07244497	-117.8619565	Los Angeles County
321770	Ordering, Referring, Prescribing	N/A	1144686312	0	0	HEUKLOM, SHANNON NP	11/3/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003581	N/A	N/A	N/A	N/A	N/A	730 POLK ST	4TH FL	SAN FRANCISCO	CA	94109	7813	00	06000	37.78379532	-122.4192766	San Francisco County
321776	Ordering, Referring, Prescribing	N/A	1144690660	0	0	HUNDAL, DILRAJ K PHARMD	4/1/2018	Taxonomy not applicable	NA	n/a	000	Unknown	73066	N/A	N/A	N/A	N/A	N/A	9831 CAMPO RD	None	SPRING VALLEY	CA	91977	1418	00	06000	32.74794448	-116.98407	San Diego County
321778	Ordering, Referring, Prescribing	N/A	1144697723	0	0	HUH, DANIEL J	4/6/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	101146	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
321788	Ordering, Referring, Prescribing	N/A	1144714122	0	0	HUNTER, CAROLYN	6/18/2018	Taxonomy not applicable	NA	n/a	000	Unknown	LEP3453	N/A	N/A	N/A	N/A	N/A	15151 TEMPLE ST.	None	WESTMINSTER	CA	92683	4499	00	06000	33.74205945	-117.9966812	Orange County
321842	Ordering, Referring, Prescribing	N/A	1144780859	0	0	HAKAMI, MUSTAFA MD	9/30/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182601	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
321853	Ordering, Referring, Prescribing	N/A	1144792193	0	0	HIDALGO, ALONZO R OT	8/18/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	19402	N/A	N/A	N/A	N/A	N/A	909 S. FAIR OAKS AVE.	None	PASADENA	CA	91105	2625	00	06000	34.13056002	-118.1503751	Los Angeles County
321856	Ordering, Referring, Prescribing	N/A	1144795899	0	0	HERABID-SIRAKI, SELIN	11/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	56217	N/A	N/A	N/A	N/A	N/A	544 N GLENDALE AVE	None	GLENDALE	CA	91206	3311	00	06000	34.15454904	-118.2429872	Los Angeles County
321870	Ordering, Referring, Prescribing	N/A	1144811761	0	0	HUYNH, HANG T PA-C	3/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA59310	N/A	N/A	N/A	N/A	N/A	1919 S SAN PEDRO ST	None	LOS ANGELES	CA	90011	1121	00	06000	34.02704017	-118.2578387	Los Angeles County
321900	Ordering, Referring, Prescribing	N/A	1144856824	0	0	HANNA, ARIA E LMFT	4/16/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT146424	N/A	N/A	N/A	N/A	N/A	3545 LONG BEACH BOULEVAR	None	LONG BEACH	CA	90807	3941	00	06000	33.82086796	-118.18938	Los Angeles County
321913	Ordering, Referring, Prescribing	N/A	1144899824	0	0	HUYNH, ESTHER PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82559	N/A	N/A	N/A	N/A	N/A	1190 VETERANS BLVD	None	REDWOOD CITY	CA	94063	2037	00	06000	37.48941956	-122.2227204	San Mateo County
321919	Ordering, Referring, Prescribing	N/A	1144936998	0	0	HYUN, HENRY Y PHARMD	12/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87499	N/A	N/A	N/A	N/A	N/A	1520 BRUNDAGE LN	None	BAKERSFIELD	CA	93304	2949	00	06000	35.355456	-119.0196225	Kern County
321981	Ordering, Referring, Prescribing	N/A	1154302875	0	0	HOFFMAN, GRANT D DC	8/30/2018	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	25543	N/A	N/A	N/A	N/A	N/A	2101 7TH ST	None	WASCO	CA	93280	1502	00	06000	35.59426049	-119.3498955	Kern County
322000	Ordering, Referring, Prescribing	N/A	1154390839	0	0	HOLLAND, BRIAN C OD	11/9/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	11425	N/A	N/A	N/A	N/A	N/A	250 WEST 5TH ST	None	HANFORD	CA	93230	8823	00	06000	36.32439821	-119.6472235	Kings County
322001	Ordering, Referring, Prescribing	N/A	1154403780	0	0	HUYNH, LANG Q MD	4/2/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A53893	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
322068	Ordering, Referring, Prescribing	N/A	1154527109	0	0	HOFFMAN, AIMEE PA-C	9/15/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA19113	N/A	N/A	N/A	N/A	N/A	1551 BISHOP ST STE 430	STE 430	SAN LUIS OBISPO	CA	93401	4663	00	06000	35.27498647	-120.6450304	San Luis Obispo County
322069	Ordering, Referring, Prescribing	N/A	1154533602	0	0	HO, GRACE SHUN YAO PSYD	9/23/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY20942	N/A	N/A	N/A	N/A	N/A	3775 BEACON AVE	STE 208	FREMONT	CA	94538	1411	00	06000	37.54785737	-121.9830193	Alameda County
322092	Ordering, Referring, Prescribing	N/A	1154579829	0	0	HOWARD, SHELBY J LMFT	5/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51525	N/A	N/A	N/A	N/A	N/A	8750 MOUNTAIN BLVD	None	OAKLAND	CA	94605	4500	00	06000	37.76618305	-122.1517347	Alameda County
322113	Ordering, Referring, Prescribing	N/A	1154609477	0	0	HOFFMAN, CHRISTINE LMFT	2/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52273	N/A	N/A	N/A	N/A	N/A	1086 E. GRANDE AVE	None	ARROYO GRANDE	CA	93420	2505	00	06000	35.11933967	-120.5958538	San Luis Obispo County
322176	Ordering, Referring, Prescribing	N/A	1154725521	0	0	HERNANDEZ SALDIVAR, MIRNA V LCSW	10/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97601	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
322195	Ordering, Referring, Prescribing	N/A	1154742831	0	0	HASSANPOUR, MARYAM DO	11/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6615	N/A	N/A	N/A	N/A	N/A	1642 E. CAPITOL EXPRESSW	None	SAN JOSE	CA	95121	0001	00	06000	37.3061289	-121.8119182	Santa Clara County
322206	Ordering, Referring, Prescribing	N/A	1154774230	0	0	HEUER, LIESL LCSW	8/11/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	125028	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
322260	Ordering, Referring, Prescribing	N/A	1154858694	0	0	HWANG, ANDREW Y MD	1/27/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164933	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
322270	Ordering, Referring, Prescribing	N/A	1154867513	0	0	HERMIS, NATASHA PHARMD	9/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55348	N/A	N/A	N/A	N/A	N/A	840 OAKDALE RD	None	MODESTO	CA	95355	4509	00	06000	37.654353	-120.957403	Stanislaus County
322275	Ordering, Referring, Prescribing	N/A	1154870517	0	0	HOFF, SYDNEY N OT	4/20/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	15719	N/A	N/A	N/A	N/A	N/A	1108 S. EL CAMINO REAL	None	SAN MATEO	CA	94402	2804	00	06000	37.55635875	-122.3187345	San Mateo County
322289	Ordering, Referring, Prescribing	N/A	1154869519	0	0	HANSEN, IAN R LMFT	10/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121960	N/A	N/A	N/A	N/A	N/A	180 EAST VIA VERDE AVENU	200	SAN DIMAS	CA	91773	3993	00	06000	34.07773175	-117.814739	Los Angeles County
322355	Ordering, Referring, Prescribing	N/A	1164038436	0	0	HASSANZADEH, AZEEN A PHARMD	7/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83175	N/A	N/A	N/A	N/A	N/A	5005 BALL ROAD	None	CYPRESS	CA	90630	3643	00	06000	33.81701014	-118.0450115	Orange County
322357	Ordering, Referring, Prescribing	N/A	1164046827	0	0	HSIEH, BENJAMIN MD	8/19/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A189011	N/A	N/A	N/A	N/A	N/A	12619 BENTLEY ST	None	WATERFORD	CA	95386	9011	00	06000	37.64073442	-120.7613165	Stanislaus County
322358	Ordering, Referring, Prescribing	N/A	1164051207	0	0	HOUR, MICHELLE LCSW	8/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93135	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	401	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
322406	Ordering, Referring, Prescribing	N/A	1164180220	0	0	HERVEY, PATIENCE A LMFT	6/29/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT106363	N/A	N/A	N/A	N/A	N/A	1870 BIRD STREET	None	OROVILLE	CA	95965	4854	00	06000	39.51265355	-121.5566432	Butte County
322415	Ordering, Referring, Prescribing	N/A	1164203261	0	0	HERNANDEZ, ASHLEY A NP	4/1/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025821	N/A	N/A	N/A	N/A	N/A	808 W. 58TH STREET	None	LOS ANGELES	CA	90037	3632	00	06000	33.98965917	-118.287673	Los Angeles County
322454	Ordering, Referring, Prescribing	N/A	1164540027	0	0	HELTON, ALISON R LMFT	11/17/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48152	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
322461	Ordering, Referring, Prescribing	N/A	1164541538	0	0	HESS, SOLEDAD N LCSW	2/27/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100303	N/A	N/A	N/A	N/A	N/A	380 ENCINAL ST.	200	SANTA CRUZ	CA	95060	2178	00	06000	36.98747083	-122.0380148	Santa Cruz County
322466	Ordering, Referring, Prescribing	N/A	1164555306	0	0	HAZLEWOOD, KENNETH M LMFT	10/20/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT83241	N/A	N/A	N/A	N/A	N/A	36977 PARK AVENUE	None	BURNEY	CA	96013	4067	00	06000	40.87640189	-121.6730441	Shasta County
322486	Ordering, Referring, Prescribing	N/A	1164573879	0	0	HERRERA, LISE P	6/12/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D36377	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
322495	Ordering, Referring, Prescribing	N/A	1164597282	0	0	HOFMANN, NINAH	7/6/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	10115	N/A	N/A	N/A	N/A	N/A	2403 KEITH ST	None	SAN FRANCISCO	CA	94124	3231	00	06000	37.7261274	-122.3922206	San Francisco County
322503	Ordering, Referring, Prescribing	N/A	1164606828	0	0	HUGHES, KELLY A	4/17/2019	Taxonomy not applicable	NA	n/a	000	Unknown	17085	N/A	N/A	N/A	N/A	N/A	161 N. MILL ST	None	TEHACHAPI	CA	93561	2523	00	06000	35.13410412	-118.4520157	Kern County
322504	Ordering, Referring, Prescribing	N/A	1164614525	0	0	HARRIS, DANA L MD	2/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A100456	N/A	N/A	N/A	N/A	N/A	1328 SECOND STREET	None	SANTA MONICA	CA	90401	1123	00	06000	34.01557114	-118.497924	Los Angeles County
322527	Ordering, Referring, Prescribing	N/A	1164663670	0	0	HAYWOOD, MONIQUE N LCSW	5/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86669	N/A	N/A	N/A	N/A	N/A	370 W CRENSHAW BLVD	E-100	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
322533	Ordering, Referring, Prescribing	N/A	1164673828	0	0	HERRERA, AMANDA K LCSW	3/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW64877	N/A	N/A	N/A	N/A	N/A	21455 BIRCH ST	201	HAYWARD	CA	94541	2165	00	06000	37.68159734	-122.0935159	Alameda County
322534	Ordering, Referring, Prescribing	N/A	1164686937	0	0	HUNN, JULIE M	8/14/2017	Taxonomy not applicable	NA	n/a	000	Unknown	54518	N/A	N/A	N/A	N/A	N/A	729 SUNRISE AVE	STE 900	ROSEVILLE	CA	95661	4565	00	06000	38.73444822	-121.2720033	Placer County
322541	Ordering, Referring, Prescribing	N/A	1164704094	0	0	HOURSHENAS, LILY PHARMD	7/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64630	N/A	N/A	N/A	N/A	N/A	28311 MARGUERITE PKWY	B1	MISSION VIEJO	CA	92692	3700	00	06000	33.55177913	-117.6709579	Orange County
322543	Ordering, Referring, Prescribing	N/A	1164702700	0	0	HO, MERCEDES PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46240	N/A	N/A	N/A	N/A	N/A	456 MISSION ST	None	SAN FRANCISCO	CA	94105	2907	00	06000	37.79028395	-122.3973981	San Francisco County
322554	Ordering, Referring, Prescribing	N/A	1164711578	0	0	HOANG, ANDREW N PHARMD	4/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63566	N/A	N/A	N/A	N/A	N/A	1540 FROOM RANCH WAY	None	SAN LUIS OBISPO	CA	93405	7211	00	06000	35.25089426	-120.6906169	San Luis Obispo County
322569	Ordering, Referring, Prescribing	N/A	1164741047	0	0	HUR, SARAH PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58823	N/A	N/A	N/A	N/A	N/A	11080 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	00	06000	33.90402176	-117.4750005	Riverside County
322585	Ordering, Referring, Prescribing	N/A	1164765566	0	0	HAYNIE, JONATHAN G	11/19/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D62780	N/A	N/A	N/A	N/A	N/A	6616 MISSION GORGE RD	None	SAN DIEGO	CA	92120	2309	00	06000	32.79330682	-117.0975234	San Diego County
322606	Ordering, Referring, Prescribing	N/A	1164807384	0	0	HA, CINDY A	6/10/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D64319	N/A	N/A	N/A	N/A	N/A	4815 WATT AVE	None	NORTH HIGHLANDS	CA	95660	5108	00	06000	38.653245	-121.3836075	Sacramento County
322627	Ordering, Referring, Prescribing	N/A	1164840724	0	0	HASNAIN, ABBAS S MD	11/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144151	N/A	N/A	N/A	N/A	N/A	1500 6TH AVENUE	None	DELANO	CA	93215	3011	00	06000	35.76504054	-119.236779	Kern County
322628	Ordering, Referring, Prescribing	N/A	1164840898	0	0	HANJRAA, LOVELEEN MD	4/23/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146040	N/A	N/A	N/A	N/A	N/A	1524 W LACEY BLVD	SUITE 201A	HANFORD	CA	93230	5965	00	06000	36.32816338	-119.6690189	Kings County
322647	Ordering, Referring, Prescribing	N/A	1164885224	0	0	HALL, JAMES A MD	3/23/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151313	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
322661	Ordering, Referring, Prescribing	N/A	1164906624	0	0	HARVEY, KAREN L LMFT	3/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124956	N/A	N/A	N/A	N/A	N/A	5400 E OLYMPIC BLVD	FIRST FLOOR	COMMERCE	CA	90022	5147	00	06000	34.01564534	-118.1555473	Los Angeles County
322668	Ordering, Referring, Prescribing	N/A	1164916029	0	0	HARRIS, EBONY A LMFT	7/21/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140568	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
322669	Ordering, Referring, Prescribing	N/A	1164919072	0	0	HY, CARLEEN	9/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	78362	N/A	N/A	N/A	N/A	N/A	1025 ALHAMBRA BLVD	None	SACRAMENTO	CA	95816	5212	00	06000	38.571894	-121.4649	Sacramento County
322682	Ordering, Referring, Prescribing	N/A	1164928354	0	0	HAWKINS, CHRISTINA M CCC-SLP	4/29/2019	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	13764	N/A	N/A	N/A	N/A	N/A	1015 SEVENTH ST	None	NOVATO	CA	94945	2205	00	06000	38.10958513	-122.5781795	Marin County
322688	Ordering, Referring, Prescribing	N/A	1164947354	0	0	HOWELL, DANIELLE	11/8/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34662	N/A	N/A	N/A	N/A	N/A	2940 SUMMIT STREET	SUITE 2D	OAKLAND	CA	94609	3416	00	06000	37.81849213	-122.2647718	Alameda County
322693	Ordering, Referring, Prescribing	N/A	1164953162	0	0	HRDINA SCHOEN, ROBIN R DO	10/22/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17405	N/A	N/A	N/A	N/A	N/A	24910 LAS BRISAS RD	SUITE 105	MURRIETA	CA	92562	2072	00	06000	33.57522424	-117.1828078	Riverside County
322704	Ordering, Referring, Prescribing	N/A	1164982260	0	0	HOLDAWAY, JESSICA MD	8/8/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178151	N/A	N/A	N/A	N/A	N/A	333 H ST	2080	CHULA VISTA	CA	91910	5555	00	06000	32.63411233	-117.0783636	San Diego County
322707	Ordering, Referring, Prescribing	N/A	1164980876	0	0	HOLTY, JULIE A RN	7/17/2018	Taxonomy not applicable	NA	n/a	000	Unknown	496193	N/A	N/A	N/A	N/A	N/A	7311 ROSEDALE HWY	None	BAKERSFIELD	CA	93308	5738	00	06000	35.38329551	-119.083689	Kern County
322732	Ordering, Referring, Prescribing	N/A	1174003040	0	0	HASNAIN, AMIR NP	12/20/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95009530	N/A	N/A	N/A	N/A	N/A	58471 29 PALMS HWY	102	YUCCA VALLEY	CA	92284	5818	00	06000	34.13270029	-116.3881647	San Bernardino County
322734	Ordering, Referring, Prescribing	N/A	1174019228	0	0	HALTERMAN, LAURA M CNP	6/8/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009211	N/A	N/A	N/A	N/A	N/A	405 E. BUENAVISTA STREET	None	BARSTOW	CA	92311	2815	00	06000	34.89563451	-117.0233145	San Bernardino County
322737	Ordering, Referring, Prescribing	N/A	1174032643	0	0	HANSON, AMANDA G LAC	12/10/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	15917	N/A	N/A	N/A	N/A	N/A	3260 KERNER BLVD	None	SAN RAFAEL	CA	94901	4840	00	06000	37.96081282	-122.501833	Marin County
322741	Ordering, Referring, Prescribing	N/A	1174033328	0	0	HAYES, RYAN R LCSW	4/8/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101039	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
322743	Ordering, Referring, Prescribing	N/A	1174029326	0	0	HUI, BRIAN K	8/19/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	100218	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
322746	Ordering, Referring, Prescribing	N/A	1174041420	0	0	HOWARD, MONIKA F LPCC	6/4/2019	Taxonomy not applicable	NA	n/a	000	Unknown	740	N/A	N/A	N/A	N/A	N/A	6147 SUTTER AVE	None	CARMICHAEL	CA	95608	2738	00	06000	38.63325214	-121.3236304	Sacramento County
322748	Ordering, Referring, Prescribing	N/A	1174045447	0	0	HOPKINS, KYLE DPM	5/6/2019	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5557	N/A	N/A	N/A	N/A	N/A	1672 W AVENUE J	STE. 201	LANCASTER	CA	93534	2861	00	06000	34.68938947	-118.1609775	Los Angeles County
322763	Ordering, Referring, Prescribing	N/A	1174077556	0	0	HOUSTON, SHAUNA	4/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74847	N/A	N/A	N/A	N/A	N/A	17284 SLOVER AVE	SUITE 204	FONTANA	CA	92337	7584	00	06000	34.065396	-117.4277475	San Bernardino County
322776	Ordering, Referring, Prescribing	N/A	1174099808	0	0	HANLY, MORIAH PA-C	8/23/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57119	N/A	N/A	N/A	N/A	N/A	7350 CHURCH ST.	None	YUCCA VALLEY	CA	92284	3246	00	06000	34.11914526	-116.4365977	San Bernardino County
322777	Ordering, Referring, Prescribing	N/A	1174091425	0	0	HAMDAN, AMAL I CNP	11/7/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009938	N/A	N/A	N/A	N/A	N/A	731 S HIGHLAND AVE	None	FULLERTON	CA	92832	2753	00	06000	33.863598	-117.928718	Orange County
322780	Ordering, Referring, Prescribing	N/A	1174105969	0	0	HAYDIS, MARIA L LMFT	7/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	140483	N/A	N/A	N/A	N/A	N/A	26137 LA PAZ RD STE 230	STE 230	MISSION VIEJO	CA	92691	5337	00	06000	33.60038172	-117.6735855	Orange County
322793	Ordering, Referring, Prescribing	N/A	1174127054	0	0	HERMAN, BRITNEY NP	6/2/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95017143	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
322795	Ordering, Referring, Prescribing	N/A	1174127765	0	0	HURTADO, JACQUELINE NP	2/16/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013955	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
322808	Ordering, Referring, Prescribing	N/A	1174151120	0	0	HANULIK, ISABELLA M MD	6/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A187081	N/A	N/A	N/A	N/A	N/A	3514 30TH ST	None	SAN DIEGO	CA	92104	4120	00	06000	32.74247286	-117.1301067	San Diego County
322869	Ordering, Referring, Prescribing	N/A	1174505721	0	0	HERTER, AMY L LMFT	8/12/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39199	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
322874	Ordering, Referring, Prescribing	N/A	1174543326	0	0	HERRERA, HUMBERTO MD	8/23/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A45967	N/A	N/A	N/A	N/A	N/A	2955 E FLORENCE AVE	None	HUNTINGTON PARK	CA	90255	5836	00	06000	33.97333678	-118.2163277	Los Angeles County
322880	Ordering, Referring, Prescribing	N/A	1174548267	0	0	HILL, JANE A LCSW	11/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW17908	N/A	N/A	N/A	N/A	N/A	676 N. 12TH ST	21	GROVER BEACH	CA	93433	1104	00	06000	35.12791646	-120.6162709	San Luis Obispo County
322902	Ordering, Referring, Prescribing	N/A	1174646608	0	0	HENRY-BERRY, NATALIE E LCSW	3/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28572	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
322935	Ordering, Referring, Prescribing	N/A	1174698765	0	0	HAUCK, MICHELLE S LCSW	6/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28464	N/A	N/A	N/A	N/A	N/A	828 S BASCOM AVE	180	SAN JOSE	CA	95128	2651	00	06000	37.31225204	-121.9317854	Santa Clara County
322998	Ordering, Referring, Prescribing	N/A	1174818249	0	0	HIGGINS, KEVIN PSYD	7/15/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29234	N/A	N/A	N/A	N/A	N/A	1066 S WHITE RD	None	SAN JOSE	CA	95127	3812	00	06000	37.35676387	-121.8196933	Santa Clara County
323007	Ordering, Referring, Prescribing	N/A	1174851760	0	0	HAZARD, LESLIE J NP	8/11/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	18999	N/A	N/A	N/A	N/A	N/A	5555 GROSSMONT CENTER DR	None	LA MESA	CA	91942	0000	00	06000	32.781483	-117.007182	San Diego County
323032	Ordering, Referring, Prescribing	N/A	1174871990	0	0	HOOVER, SHAWNESHIA L LMFT	3/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116036	N/A	N/A	N/A	N/A	N/A	3450 3RD ST, #1C	None	SAN FRANCISCO	CA	94124	1444	00	06000	37.74535239	-122.387252	San Francisco County
323038	Ordering, Referring, Prescribing	N/A	1174892004	0	0	HUANG, SUZANNA PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54358	N/A	N/A	N/A	N/A	N/A	930 E HUNTINGTON DR	None	MONROVIA	CA	91016	0000	00	06000	34.13941599	-117.986405	Los Angeles County
323068	Ordering, Referring, Prescribing	N/A	1174922132	0	0	HAN, KENNETH LMFT	3/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111577	N/A	N/A	N/A	N/A	N/A	2523 W 7TH ST	None	LOS ANGELES	CA	90057	3801	00	06000	34.05889258	-118.2821556	Los Angeles County
323083	Ordering, Referring, Prescribing	N/A	1174944623	0	0	HERRERA, SULMA J MD	5/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A148951	N/A	N/A	N/A	N/A	N/A	1359 N GRAND AVE	None	COVINA	CA	91724	1016	00	06000	34.104681	-117.872706	Los Angeles County
323107	Ordering, Referring, Prescribing	N/A	1174977987	0	0	HUYNH, JIMMY MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A170535	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
323137	Ordering, Referring, Prescribing	N/A	1184006165	0	0	HERNANDEZ, MARLENA LCSW	8/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96243	N/A	N/A	N/A	N/A	N/A	3625 14TH STREET	None	RIVERSIDE	CA	92501	3815	00	06000	33.97584034	-117.3775789	Riverside County
323167	Ordering, Referring, Prescribing	N/A	1184043432	0	0	HOM, JENNIFER J	10/27/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D64905	N/A	N/A	N/A	N/A	N/A	16928 11TH ST	# 790	HURON	CA	93234	0790	00	06000	36.20532278	-120.1027083	Fresno County
323168	Ordering, Referring, Prescribing	N/A	1184046823	0	0	HOWARD, PEGGY LCSW	3/31/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21342	N/A	N/A	N/A	N/A	N/A	250 BON AIR RD	UNIT B	GREENBRAE	CA	94904	1702	00	06000	37.9469952	-122.5373892	Marin County
323178	Ordering, Referring, Prescribing	N/A	1184052805	0	0	HANNA, JUMANA B PHARMD	4/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	45842	N/A	N/A	N/A	N/A	N/A	17900 NEWHOPE ST	None	FOUNTAIN VALLEY	CA	92708	5422	00	06000	33.70347	-117.9311985	Orange County
323186	Ordering, Referring, Prescribing	N/A	1184076333	0	0	HARRIS, ELIZABETH A PA-C	6/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53846	N/A	N/A	N/A	N/A	N/A	698	400 W PUEBLO STREET	SANTA BARBARA	CA	93105	4353	00	06000	0	0	None
323187	Ordering, Referring, Prescribing	N/A	1184062960	0	0	HERNANDEZ, EMILIO LMFT	4/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT105537	N/A	N/A	N/A	N/A	N/A	144 S L ST	None	DINUBA	CA	93618	2323	00	06000	36.54033313	-119.389607	Tulare County
323193	Ordering, Referring, Prescribing	N/A	1184087645	0	0	HANDLER, TED A MD	3/23/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151495	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
323229	Ordering, Referring, Prescribing	N/A	1184099335	0	0	HIROFUJI, ERI NP	9/10/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	643400	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLZA	STE B 790 A	LOS ANGELES	CA	90065	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
323244	Ordering, Referring, Prescribing	N/A	1184151052	0	0	HADI, RICHARD S DO	10/7/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17812	N/A	N/A	N/A	N/A	N/A	41002 COUNTY CENTER DR	320	TEMECULA	CA	92591	6051	00	06000	33.52762603	-117.1615428	Riverside County
323259	Ordering, Referring, Prescribing	N/A	1184171969	0	0	HASHEMI, LEILA LCSW	3/2/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107161	N/A	N/A	N/A	N/A	N/A	3055 W. ORANGE AVE	105	ANAHEIM	CA	92804	3152	00	06000	33.8247435	-117.99621	Orange County
323269	Ordering, Referring, Prescribing	N/A	1184190332	0	0	HAIKEN, SALLY LCSW	2/19/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100117	N/A	N/A	N/A	N/A	N/A	2440 6TH ST.	None	EUREKA	CA	95501	0788	00	06000	40.80368802	-124.1456878	Humboldt County
323289	Ordering, Referring, Prescribing	N/A	1184235236	0	0	HERZOG, KATHERINE V	2/19/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95011521	N/A	N/A	N/A	N/A	N/A	6900 BROCKTON AVE	200	RIVERSIDE	CA	92506	3819	00	06000	33.94872	-117.3967215	Riverside County
323363	Ordering, Referring, Prescribing	N/A	1184460081	0	0	HUYNH, CHELSEA DMD	6/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110225	N/A	N/A	N/A	N/A	N/A	3590 E IMPERIAL HWY	None	LYNWOOD	CA	90262	2655	00	06000	33.93042906	-118.2056035	Los Angeles County
323431	Ordering, Referring, Prescribing	N/A	1184787855	0	0	HOLLAND, DOUGLAS MD	9/4/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20636	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
323462	Ordering, Referring, Prescribing	N/A	1184846834	0	0	HARRINGTON, LEIGH E MD	5/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A90076	N/A	N/A	N/A	N/A	N/A	137 N COTTONWOOD SUITE 1	None	WOODLAND	CA	95695	6646	00	06000	38.68538399	-121.7933582	Yolo County
323467	Ordering, Referring, Prescribing	N/A	1184858698	0	0	HERNANDEZ, VANESSA LMFT	1/28/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52166	N/A	N/A	N/A	N/A	N/A	661 W 1ST STREET	SUITE A-C	TUSTIN	CA	92780	2939	00	06000	33.74578153	-117.831231	Orange County
323520	Ordering, Referring, Prescribing	N/A	1184948382	0	0	HUYNH, HALI N PHARMD	6/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63960	N/A	N/A	N/A	N/A	N/A	837 E ANAHEIM ST	None	LONG BEACH	CA	90813	3550	00	06000	33.78263447	-118.1827035	Los Angeles County
323564	Ordering, Referring, Prescribing	N/A	1194025478	0	0	HSIEH, MARY C	3/25/2018	Taxonomy not applicable	NA	n/a	000	Unknown	44073	N/A	N/A	N/A	N/A	N/A	3901 PORTOLA PARKWAY	None	IRVINE	CA	92602	0833	00	06000	33.73347357	-117.7615894	Orange County
323634	Ordering, Referring, Prescribing	N/A	1194154146	0	0	HARRIS, SUMMYR LPCC	4/2/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16097	N/A	N/A	N/A	N/A	N/A	7171 BOWLING DR	300	SACRAMENTO	CA	95823	2034	00	06000	38.497527	-121.455297	Sacramento County
323639	Ordering, Referring, Prescribing	N/A	1194159384	0	0	HUDSON, KATE C LCSW	5/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83712	N/A	N/A	N/A	N/A	N/A	1963 4TH AVE	None	SAN DIEGO	CA	92101	2394	00	06000	32.72572745	-117.1608615	San Diego County
323652	Ordering, Referring, Prescribing	N/A	1194186601	0	0	HEALY, MICHELLE ANNE PHARMD	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73194	N/A	N/A	N/A	N/A	N/A	30116 EIGENBRODT WAY	None	UNION CITY	CA	94587	1225	00	06000	37.60846354	-122.0715526	Alameda County
323656	Ordering, Referring, Prescribing	N/A	1194186296	0	0	HEISER, STEPHANIE E LMFT	12/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123562	N/A	N/A	N/A	N/A	N/A	615 W CIVIC CENTER DR	SUITE 200	SANTA ANA	CA	92701	4006	00	06000	33.75157048	-117.8744355	Orange County
323674	Ordering, Referring, Prescribing	N/A	1194215731	0	0	HUNT, SEAN R CNP	2/10/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007328	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
323697	Ordering, Referring, Prescribing	N/A	1194254391	0	0	HEARE, MICHELLE R MD	3/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158580	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
323703	Ordering, Referring, Prescribing	N/A	1194257816	0	0	HANDY, NICKETTI M MD	7/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188123	N/A	N/A	N/A	N/A	N/A	2121 SANTA MONICA BLVD	None	SANTA MONICA	CA	90404	2303	00	06000	34.02980528	-118.4786605	Los Angeles County
323708	Ordering, Referring, Prescribing	N/A	1194271643	0	0	HSU, SABRINA LCSW	8/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW108176	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
323729	Ordering, Referring, Prescribing	N/A	1194286179	0	0	HUANG, JONATHAN J MD	3/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL2223	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
323742	Ordering, Referring, Prescribing	N/A	1194347708	0	0	HAMMEL, KRISTINA K LMFT	3/4/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT131574	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
323753	Ordering, Referring, Prescribing	N/A	1194382523	0	0	HAMID, SHAHEER MD	5/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178813	N/A	N/A	N/A	N/A	N/A	311 WEST I STREET	None	LOS BANOS	CA	93635	3479	00	06000	37.06343055	-120.8570545	Merced County
323777	Ordering, Referring, Prescribing	N/A	1194471284	0	0	HIGGINS, JULIA DMD	11/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	108900	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
323791	Ordering, Referring, Prescribing	N/A	1194592774	0	0	HALE, CHARITY	2/2/2023	Taxonomy not applicable	NA	n/a	000	Unknown	71801	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
323809	Ordering, Referring, Prescribing	N/A	1194781294	0	0	HENRY, GERRIT V DO	2/1/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A12356	N/A	N/A	N/A	N/A	N/A	9781 BLUE LARKSPUR LANE	None	MONTEREY	CA	93940	6509	00	06000	36.57152408	-121.8037459	Monterey County
323835	Ordering, Referring, Prescribing	N/A	1194854174	0	0	HESSAM, TAHEREH LMFT	12/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77399	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
323845	Ordering, Referring, Prescribing	N/A	1194863068	0	0	HERNANDEZ, CYNTHIA R LMFT	3/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77267	N/A	N/A	N/A	N/A	N/A	631 S. ORCHARD AVE	None	UKIAH	CA	95482	5011	00	06000	39.14619517	-123.1986323	Mendocino County
323893	Ordering, Referring, Prescribing	N/A	1194944736	0	0	HALAMANDARIS, PHILL V MD	4/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G66098	N/A	N/A	N/A	N/A	N/A	47-825 OASIS ST.	None	INDIO	CA	92201	6950	00	06000	33.72305277	-116.220673	Riverside County
323894	Ordering, Referring, Prescribing	N/A	1194952051	0	0	HANNAN, MEREDITH A MD	11/10/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A115789	N/A	N/A	N/A	N/A	N/A	19231 VICTORY BLVD	SUITE 110	RESEDA	CA	91335	6321	00	06000	34.18659852	-118.552221	Los Angeles County
323914	Ordering, Referring, Prescribing	N/A	1194993139	0	0	HATA, MICAH PHARMD	10/25/2018	Taxonomy not applicable	NA	n/a	000	Unknown	60744	N/A	N/A	N/A	N/A	N/A	795 E. SECOND ST.	1	POMONA	CA	91766	2007	00	06000	34.05845654	-117.7423951	Los Angeles County
323953	Ordering, Referring, Prescribing	N/A	1205099918	0	0	HUBBELL, FRANK W JR LCSW	7/18/2017	Taxonomy not applicable	NA	n/a	000	Unknown	6966	N/A	N/A	N/A	N/A	N/A	3605 HOSPITAL RD	None	ATWATER	CA	95301	5173	00	06000	37.36678073	-120.576731	Merced County
323960	Ordering, Referring, Prescribing	N/A	1205108610	0	0	HADDOCK, ALYSHA LCS	6/17/2013	Taxonomy not applicable	NA	n/a	034	MEDICARE CROSSOVER PROVIDER ONLY	CSW027271	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
323976	Ordering, Referring, Prescribing	N/A	1205123254	0	0	HARRIMAN, SOMMER R LCSW	8/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108245	N/A	N/A	N/A	N/A	N/A	3540 HOWARD WAY	SUITE 150	COSTA MESA	CA	92626	1465	00	06000	33.69823787	-117.9273979	Orange County
323983	Ordering, Referring, Prescribing	N/A	1205129822	0	0	HOANG, THINH T	11/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH64976	N/A	N/A	N/A	N/A	N/A	1814 19TH ST	None	SACRAMENTO	CA	95811	6713	00	06000	38.567871	-121.485915	Sacramento County
324002	Ordering, Referring, Prescribing	N/A	1205164530	0	0	HERNANDEZ, OSVALDO R DDS	12/1/2009	Taxonomy not applicable	NA	n/a	099	DENTIST	D59009	N/A	N/A	N/A	N/A	N/A	1617 MAIN ST	None	LIVINGSTON	CA	95334	1250	00	06000	37.37645459	-120.7233764	Merced County
324007	Ordering, Referring, Prescribing	N/A	1205178373	0	0	HUMPHRIES, PARIS S MD	4/6/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A134677	N/A	N/A	N/A	N/A	N/A	58383 29 PALMS HWY	101	YUCCA VALLEY	CA	92284	5891	00	06000	34.13159539	-116.3901072	San Bernardino County
324021	Ordering, Referring, Prescribing	N/A	1205211760	0	0	HOFFMAN, TIFFANY M LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107492	N/A	N/A	N/A	N/A	N/A	101 CIRBY HILLS DR	None	ROSEVILLE	CA	95678	4360	00	06000	38.7303989	-121.2872592	Placer County
324043	Ordering, Referring, Prescribing	N/A	1205254331	0	0	HERMAN, DAVID J MD	5/27/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140451	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
324054	Ordering, Referring, Prescribing	N/A	1205282647	0	0	HALFMAN, MARIE PT	5/10/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	41737	N/A	N/A	N/A	N/A	N/A	1840 WEST DR	None	VISTA	CA	92083	6115	00	06000	33.1901697	-117.2808305	San Diego County
324076	Ordering, Referring, Prescribing	N/A	1205303229	0	0	HAEDRICH, ERICA M PA	1/21/2019	Taxonomy not applicable	NA	n/a	000	Unknown	56202	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
324108	Ordering, Referring, Prescribing	N/A	1205356201	0	0	HERNANDEZ, LILYBETH LCSW	7/29/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112308	N/A	N/A	N/A	N/A	N/A	2040 CAMFIELD AVE	None	LOS ANGELES	CA	90040	1502	00	06000	34.00861575	-118.1559052	Los Angeles County
324110	Ordering, Referring, Prescribing	N/A	1205350386	0	0	HUNTER, RAEISHA L LMFT	8/9/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT127364	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2656	00	06000	35.35413152	-119.058471	Kern County
324173	Ordering, Referring, Prescribing	N/A	1205480639	0	0	HALLER-BAKER, SHANNON PA	4/17/2023	Taxonomy not applicable	NA	n/a	000	Unknown	57519	N/A	N/A	N/A	N/A	N/A	2526 SISTER MARY COLUMBA	None	RED BLUFF	CA	96080	4327	00	06000	40.14934389	-122.2195713	Tehama County
324174	Ordering, Referring, Prescribing	N/A	1205482601	0	0	HIGGINS, RYAN S PA-C	6/17/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58213	N/A	N/A	N/A	N/A	N/A	847 W. CHILDS AVE.	C	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
324176	Ordering, Referring, Prescribing	N/A	1205488210	0	0	HERRERA MARTINEZ, WENDY LMFT	1/4/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135523	N/A	N/A	N/A	N/A	N/A	1625 W OLYMPIC BLVD	600	LOS ANGELES	CA	90015	3809	00	06000	34.04957404	-118.2750068	Los Angeles County
324177	Ordering, Referring, Prescribing	N/A	1205475811	0	0	HOH, RYAN M PHARMD	3/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81584	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PARKWAY	None	SAN JOSE	CA	95019	1102	00	06000	37.23951066	-121.8013511	Santa Clara County
324179	Ordering, Referring, Prescribing	N/A	1205492683	0	0	HASEEB, RAHEMA B	10/27/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	107083	N/A	N/A	N/A	N/A	N/A	198 N. G STREET	None	EMPIRE	CA	95319	5132	00	06000	37.64084134	-120.9011164	Stanislaus County
324205	Ordering, Referring, Prescribing	N/A	1205602596	0	0	HAZEL, ERIN PA-C	1/27/2025	Taxonomy not applicable	NA	n/a	000	Unknown	65767	N/A	N/A	N/A	N/A	N/A	728 E VALLEY PKWY	None	ESCONDIDO	CA	92025	3052	00	06000	33.12769389	-117.0730873	San Diego County
324222	Ordering, Referring, Prescribing	N/A	1205808763	0	0	HEBERT-BROWN, JEAN L LMSW	8/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW9682	N/A	N/A	N/A	N/A	N/A	215 W MISSION ST	None	SANTA BARBARA	CA	93101	2820	00	06000	34.42816282	-119.7173341	Santa Barbara County
324227	Ordering, Referring, Prescribing	N/A	1205846961	0	0	HSIEH, LINDA OD	10/30/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	9462	N/A	N/A	N/A	N/A	N/A	1206 E 17TH ST	None	SANTA ANA	CA	92701	2641	00	06000	33.75983651	-117.8539425	Orange County
324285	Ordering, Referring, Prescribing	N/A	1215007810	0	0	HAN, CURTIS DC	2/20/2018	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	25879	N/A	N/A	N/A	N/A	N/A	15230 LAKESHORE DR	None	CLEARLAKE	CA	95422	8107	00	06000	38.95005226	-122.6264492	Lake County
324333	Ordering, Referring, Prescribing	N/A	1215089719	0	0	HENRY, LINDSAY E LCSW	12/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23693	N/A	N/A	N/A	N/A	N/A	124 MAIN ST	None	ROSEVILLE	CA	95678	2232	00	06000	38.75196548	-121.2861465	Placer County
324357	Ordering, Referring, Prescribing	N/A	1215136957	0	0	HARWICK, DONALD T PA	10/1/2017	Taxonomy not applicable	NA	n/a	000	Unknown	13177	N/A	N/A	N/A	N/A	N/A	9350 NORTH LOOP BLVD	None	CALIFORNIA CITY	CA	93505	2269	00	06000	35.13319573	-117.9617515	Kern County
324362	Ordering, Referring, Prescribing	N/A	1215136700	0	0	HERNANDEZ, ANGELICA LMFT	4/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113111	N/A	N/A	N/A	N/A	N/A	120 S STATE COLLEGE BLVD	150	BREA	CA	92821	5834	00	06000	33.92111797	-117.8828786	Orange County
324372	Ordering, Referring, Prescribing	N/A	1215193198	0	0	HUSTON, RONALD G PHD	5/31/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	10341	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
324402	Ordering, Referring, Prescribing	N/A	1215232376	0	0	HORTON, CELENA LCSW	7/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88212	N/A	N/A	N/A	N/A	N/A	11799 SEBASTIAN WAY	103	RANCHO CUCAMONGA	CA	91730	0708	00	06000	34.10415255	-117.5480055	San Bernardino County
324412	Ordering, Referring, Prescribing	N/A	1215243019	0	0	HAMILLHARDER, JEANINE PHARMD	3/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	44526	N/A	N/A	N/A	N/A	N/A	22633 SAVI RANCH PKWY	None	YORBA LINDA	CA	92887	4647	00	06000	33.87492883	-117.7432851	Orange County
324424	Ordering, Referring, Prescribing	N/A	1215263348	0	0	HENG, MALY PHARMD	9/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	50689	N/A	N/A	N/A	N/A	N/A	10635 FOLSOM BLVD	None	FOLSOM	CA	95630	4848	00	06000	38.67515783	-121.1808388	Sacramento County
324427	Ordering, Referring, Prescribing	N/A	1215276696	0	0	HEREDIA, HOLLY MSW LCSW	2/5/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	128539	N/A	N/A	N/A	N/A	N/A	1445 VETERANS MEMORIAL C	SUITE B	YUBA CITY	CA	95993	3011	00	06000	39.14469836	-121.6380819	Sutter County
324440	Ordering, Referring, Prescribing	N/A	1215301197	0	0	HENDERSON, MICHAEL D	4/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	73786	N/A	N/A	N/A	N/A	N/A	4805 BECHELLI LN	None	REDDING	CA	96002	3556	00	06000	40.54014957	-122.3548634	Shasta County
324504	Ordering, Referring, Prescribing	N/A	1215385885	0	0	HERNANDEZ, VANESSA E LMFT	1/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT117291	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
324544	Ordering, Referring, Prescribing	N/A	1215469556	0	0	HOLLAND, CHRISTOPHER T MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157252	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BOULEVARD	None	SACRAMENTO	CA	95817	2201	00	06000	38.555181	-121.4566785	Sacramento County
324556	Ordering, Referring, Prescribing	N/A	1215483607	0	0	HALANSKI, NATALIE PHARMD	9/22/2023	Taxonomy not applicable	NA	n/a	000	Unknown	71160	N/A	N/A	N/A	N/A	N/A	200 W ARBOR DR	None	SAN DIEGO	CA	92103	1911	00	06000	32.7537975	-117.1658298	San Diego County
324577	Ordering, Referring, Prescribing	N/A	1215501861	0	0	HANSEN, HEATHER LCSW	9/8/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW117950	N/A	N/A	N/A	N/A	N/A	1420 WILLOW PASS RD	SUITE 200	CONCORD	CA	94520	5223	00	06000	37.96956948	-122.0507563	Contra Costa County
324578	Ordering, Referring, Prescribing	N/A	1215513437	0	0	HASKELL, ABIGAIL N PA	2/8/2023	Taxonomy not applicable	NA	n/a	000	Unknown	1181341	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
324628	Ordering, Referring, Prescribing	N/A	1215614862	0	0	HILL, PAUL OD	6/1/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35488	N/A	N/A	N/A	N/A	N/A	1625 E 4TH ST	None	LOS ANGELES	CA	90033	4201	00	06000	34.04297786	-118.2220181	Los Angeles County
324669	Ordering, Referring, Prescribing	N/A	1225010705	0	0	HOUGHTALING, JACK S PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54643	N/A	N/A	N/A	N/A	N/A	621 I ST	None	CHULA VISTA	CA	91910	5110	00	06000	32.62736031	-117.0886342	San Diego County
324691	Ordering, Referring, Prescribing	N/A	1225102098	0	0	HAWKSWORTH, LAUREN F LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52294	N/A	N/A	N/A	N/A	N/A	315 W HALEY ST	102	SANTA BARBARA	CA	93101	3471	00	06000	34.41320534	-119.6993554	Santa Barbara County
324703	Ordering, Referring, Prescribing	N/A	1225150543	0	0	HUANG, MICHAEL M	3/21/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D54151	N/A	N/A	N/A	N/A	N/A	5205 MELROSE AVE	None	LOS ANGELES	CA	90038	3144	00	06000	34.08354051	-118.314009	Los Angeles County
324708	Ordering, Referring, Prescribing	N/A	1225151285	0	0	HUNTER, AYESHA C LMFT	5/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48508	N/A	N/A	N/A	N/A	N/A	480 EAST 13TH STREET	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
324731	Ordering, Referring, Prescribing	N/A	1225172489	0	0	HUDSON, DANA L LMFT	3/27/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	82994	N/A	N/A	N/A	N/A	N/A	1212 N. CALIFORNIA STREE	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
324755	Ordering, Referring, Prescribing	N/A	1225220080	0	0	HADAR, REBECCA PSYD	6/23/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25380	N/A	N/A	N/A	N/A	N/A	10833 WASHINGTON BLVD.	#4	CULVER CITY	CA	90232	3618	00	06000	34.01466556	-118.4079433	Los Angeles County
324757	Ordering, Referring, Prescribing	N/A	1225222334	0	0	HARRIS, RACHEL K LPCC	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC9340	N/A	N/A	N/A	N/A	N/A	507 NATOMA ST	None	FOLSOM	CA	95630	2523	00	06000	38.676294	-121.1718825	Sacramento County
324763	Ordering, Referring, Prescribing	N/A	1225233992	0	0	HEREDIA, MARIA LCSW	9/28/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101622	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
324779	Ordering, Referring, Prescribing	N/A	1225270903	0	0	HULBERT, KATHERINE R MD	6/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A113586	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	110	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
324818	Ordering, Referring, Prescribing	N/A	1225355290	0	0	HENLEY, ROBERT R PHD	4/8/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	15291	N/A	N/A	N/A	N/A	N/A	2630	FIRST AVE	SAN DIEGO	CA	92103	6599	00	06000	0	0	None
324819	Ordering, Referring, Prescribing	N/A	1225349889	0	0	HOANG, TRAM K PHARMD	5/20/2018	Taxonomy not applicable	NA	n/a	000	Unknown	61697	N/A	N/A	N/A	N/A	N/A	2010 E. 1ST ST., STE 120	None	SANTA ANA	CA	92705	4086	00	06000	33.74554507	-117.8387522	Orange County
324821	Ordering, Referring, Prescribing	N/A	1225360498	0	0	HAMISI, KHADIJA H CNP	2/3/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	20560	N/A	N/A	N/A	N/A	N/A	3210 LONG BEACH BLVD	None	LONG BEACH	CA	90807	0001	00	06000	33.815637	-118.1892215	Los Angeles County
324838	Ordering, Referring, Prescribing	N/A	1225396062	0	0	HELFER, MONIQUE L NP	5/16/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP21712	N/A	N/A	N/A	N/A	N/A	1500 FLORIDA AVE	None	MODESTO	CA	95350	4408	00	06000	37.665738	-120.9962205	Stanislaus County
324865	Ordering, Referring, Prescribing	N/A	1225424823	0	0	HALL, JOSEPH R MD	8/31/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154749	N/A	N/A	N/A	N/A	N/A	525 E MAIN ST	None	EL CAJON	CA	92020	4007	00	06000	32.79492347	-116.955981	San Diego County
324882	Ordering, Referring, Prescribing	N/A	1225462161	0	0	HOCKADAY, BRANDON C PHARMD	1/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67640	N/A	N/A	N/A	N/A	N/A	3560 W CENTURY BLVD	None	INGLEWOOD	CA	90303	1201	00	06000	33.942825	-118.333431	Los Angeles County
324928	Ordering, Referring, Prescribing	N/A	1225516537	0	0	HERMANT, JESSIE K NP	2/26/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016806	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
324954	Ordering, Referring, Prescribing	N/A	1225554686	0	0	HOUCHIN, LOUISE Z LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113358	N/A	N/A	N/A	N/A	N/A	170 SOUTH SPRUCE AVE	STE. 200	SOUTH SAN FRANCIS	CA	94080	0000	00	06000	37.64883531	-122.4187311	San Mateo County
324972	Ordering, Referring, Prescribing	N/A	1225573454	0	0	HO, BETTINA A PA	3/1/2022	Taxonomy not applicable	NA	n/a	000	Unknown	54136	N/A	N/A	N/A	N/A	N/A	2690 PACIFIC AVE	370	LONG BEACH	CA	90806	2657	00	06000	33.805854	-118.1936805	Los Angeles County
324985	Ordering, Referring, Prescribing	N/A	1225599293	0	0	HOFF, TRAM L MD	1/27/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176133	N/A	N/A	N/A	N/A	N/A	1035 PLACER STREET	None	REDDING	CA	96001	6001	00	06000	40.58349378	-122.3853903	Shasta County
325001	Ordering, Referring, Prescribing	N/A	1225653785	0	0	HASOLKAR, MEERA PHARMD	4/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61295	N/A	N/A	N/A	N/A	N/A	14359 PIONEER BLVD	B	NORWALK	CA	90650	4850	00	06000	33.90057	-118.0826075	Los Angeles County
325004	Ordering, Referring, Prescribing	N/A	1225654197	0	0	HUIZAR, DIANA	10/6/2020	Taxonomy not applicable	NA	n/a	000	Unknown	3716	N/A	N/A	N/A	N/A	N/A	11200 TELECHRON AVE.	None	WHITTIER	CA	90605	3799	00	06000	33.92908443	-118.0394246	Los Angeles County
325017	Ordering, Referring, Prescribing	N/A	1225680572	0	0	HABBOUSH, RANA PA-C	2/12/2024	Taxonomy not applicable	NA	n/a	000	Unknown	PA58839	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
325020	Ordering, Referring, Prescribing	N/A	1225684269	0	0	HOANG, UYEN P PHARMD	3/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH50306	N/A	N/A	N/A	N/A	N/A	1601 COLEMAN AVE	None	SANTA CLARA	CA	95050	3122	00	06000	37.35814451	-121.93908	Santa Clara County
325032	Ordering, Referring, Prescribing	N/A	1225700461	0	0	HUANG, SHIHUI	9/11/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC00019216	N/A	N/A	N/A	N/A	N/A	767 N. HILL ST.	200	LOS ANGELES	CA	90012	2343	00	06000	34.06255157	-118.2397077	Los Angeles County
325051	Ordering, Referring, Prescribing	N/A	1235145590	0	0	HAGAN, MOWBRAY P MD	4/22/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A29431	N/A	N/A	N/A	N/A	N/A	482 CORONA MALL	None	CORONA	CA	92879	1418	00	06000	33.87658954	-117.5663302	Riverside County
325077	Ordering, Referring, Prescribing	N/A	1235224205	0	0	HERNANDEZ, LETICIA PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	40481	N/A	N/A	N/A	N/A	N/A	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	5423	00	06000	34.21980849	-118.4301135	Los Angeles County
325107	Ordering, Referring, Prescribing	N/A	1235276726	0	0	HOANG, NAM X	5/26/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D53797	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
325113	Ordering, Referring, Prescribing	N/A	1235294141	0	0	HAYES-HERNANDEZ, ELIZABETH J LMFT	10/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49173	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	None	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
325116	Ordering, Referring, Prescribing	N/A	1235299892	0	0	HARNEY, CHRISTINA E LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53982	N/A	N/A	N/A	N/A	N/A	117 W TUNNELL ST	None	SANTA MARIA	CA	93458	4096	00	06000	34.95752999	-120.4366316	Santa Barbara County
325170	Ordering, Referring, Prescribing	N/A	1235407362	0	0	HAMMEL, CARL J PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58891	N/A	N/A	N/A	N/A	N/A	7929 LOWER SACRAMENTO RD	None	STOCKTON	CA	95210	3723	00	06000	38.021913	-121.3230885	San Joaquin County
325201	Ordering, Referring, Prescribing	N/A	1235457581	0	0	HEMENIUK, JENNIFER L	1/9/2017	Taxonomy not applicable	NA	n/a	024	PHARMACIES/PHARMACISTS	72718	N/A	N/A	N/A	N/A	N/A	1100 W ARTESIA BLVD	None	COMPTON	CA	90220	5108	00	06000	33.87310855	-118.2410909	Los Angeles County
325206	Ordering, Referring, Prescribing	N/A	1235466590	0	0	HIBBS, LINDA L LCSW	10/8/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	18604	N/A	N/A	N/A	N/A	N/A	8710 MONROE CT	STE 150	RANCHO CUCAMONGA	CA	91730	4883	00	06000	34.09544496	-117.5747968	San Bernardino County
325244	Ordering, Referring, Prescribing	N/A	1235524778	0	0	HO, NICHOLAS	1/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	74940	N/A	N/A	N/A	N/A	N/A	43621 PACIFIC COMMONS BL	None	FREMONT	CA	94538	3809	00	06000	37.50266787	-121.9716761	Alameda County
325256	Ordering, Referring, Prescribing	N/A	1235545609	0	0	HUERTA, ARACELI	7/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025783	N/A	N/A	N/A	N/A	N/A	500 E ALMOND AVE	1	MADERA	CA	93637	5600	00	06000	36.94548547	-120.0518941	Madera County
325266	Ordering, Referring, Prescribing	N/A	1235559477	0	0	HOLGUIN, NICHOLE C LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113079	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR.	SUITE 210	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
325278	Ordering, Referring, Prescribing	N/A	1235576059	0	0	HAMILTON, LISA M DO	2/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14772	N/A	N/A	N/A	N/A	N/A	128 N BROADWAY	None	ESCONDIDO	CA	92025	2714	00	06000	33.12249406	-117.0818384	San Diego County
325281	Ordering, Referring, Prescribing	N/A	1235573072	0	0	HELGESON, CARRIE J LCSW	8/5/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25210	N/A	N/A	N/A	N/A	N/A	3303 N BROADWAY	4TH FLOOR	LOS ANGELES	CA	90031	2803	00	06000	34.07380397	-118.20586	Los Angeles County
325285	Ordering, Referring, Prescribing	N/A	1235580978	0	0	HAUPERT, JOHN NP	4/17/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011629	N/A	N/A	N/A	N/A	N/A	630 DRAKE AVE	None	SAUSALITO	CA	94965	1107	00	06000	37.87340883	-122.515085	Marin County
325308	Ordering, Referring, Prescribing	N/A	1235622077	0	0	HIRASHIMA, CARLA J	12/3/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008826	N/A	N/A	N/A	N/A	N/A	1520 NUTMEG PL	None	COSTA MESA	CA	92626	2501	00	06000	33.68196448	-117.920322	Orange County
325318	Ordering, Referring, Prescribing	N/A	1235640988	0	0	HUNT, MELANIE N LCSW	6/14/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115879	N/A	N/A	N/A	N/A	N/A	2204 NATIONAL AVE	None	SAN DIEGO	CA	92113	3615	00	06000	32.69715769	-117.1399272	San Diego County
325323	Ordering, Referring, Prescribing	N/A	1235648171	0	0	HARRINGTON, ASHLEY R NP	1/15/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016442	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
325337	Ordering, Referring, Prescribing	N/A	1235664517	0	0	HO, KOKCHEUNG NP	3/6/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	722308	N/A	N/A	N/A	N/A	N/A	355 CAMPUS DR	STE E	HANFORD	CA	93230	4376	00	06000	36.3271295	-119.6633596	Kings County
325372	Ordering, Referring, Prescribing	N/A	1235750191	0	0	HUYNH, LINDSEY P PHARMD	6/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	81866	N/A	N/A	N/A	N/A	N/A	14501 MAGNOLIA ST	STE 104	WESTMINSTER	CA	92683	1306	00	06000	33.75188963	-117.9723601	Orange County
325376	Ordering, Referring, Prescribing	N/A	1235766536	0	0	HU, REBECCA MD	10/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL4199	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
325396	Ordering, Referring, Prescribing	N/A	1235806621	0	0	HAM, LAWRENCE PA	6/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61234	N/A	N/A	N/A	N/A	N/A	1999 MOWRY AVE	None	FREMONT	CA	94538	1738	00	06000	37.55783419	-121.9808484	Alameda County
325411	Ordering, Referring, Prescribing	N/A	1235866013	0	0	HAKOBYAN, ANAHIT NP	6/8/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021207	N/A	N/A	N/A	N/A	N/A	8337 LAUREL CANYON BLVD	None	SUN VALLEY	CA	91352	4322	00	06000	34.22306683	-118.3964783	Los Angeles County
325415	Ordering, Referring, Prescribing	N/A	1235896044	0	0	HOBSON, PAUL PHD	11/3/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33771	N/A	N/A	N/A	N/A	N/A	6386 ALVARADO CT	SUITE 310	SAN DIEGO	CA	92120	4905	00	06000	32.77666838	-117.0614255	San Diego County
325435	Ordering, Referring, Prescribing	N/A	1245095074	0	0	HUERTA, MARCOS LCSW	2/7/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120944	N/A	N/A	N/A	N/A	N/A	2425 BISSO LN	STE 200	CONCORD	CA	94520	4886	00	06000	37.98393807	-122.0466953	Contra Costa County
325477	Ordering, Referring, Prescribing	N/A	1245353432	0	0	HALL, JULIE A LMFT	10/20/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51897	N/A	N/A	N/A	N/A	N/A	891 MOUNTAIN RANCH RD	None	SAN ANDREAS	CA	95249	9601	00	06000	38.19035603	-120.6679939	Calaveras County
325602	Ordering, Referring, Prescribing	N/A	1245570019	0	0	HOLGUIN, SARAH E LCSW	3/4/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW121379	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2656	00	06000	35.35413152	-119.058471	Kern County
325641	Ordering, Referring, Prescribing	N/A	1245619824	0	0	HONGKHAM, JINNIE S PHARMD	3/19/2018	Taxonomy not applicable	NA	n/a	000	Unknown	61660	N/A	N/A	N/A	N/A	N/A	41000 CALIFORNIA OAKS RD	None	MURRIETA	CA	92562	5749	00	06000	33.566922	-117.203733	Riverside County
325655	Ordering, Referring, Prescribing	N/A	1245647619	0	0	HAWKINS, HERMINIA H NP	7/12/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	572257	N/A	N/A	N/A	N/A	N/A	9416 ROAD 238	None	TERRA BELLA	CA	93270	9416	00	06000	35.96072962	-119.0399481	Tulare County
325671	Ordering, Referring, Prescribing	N/A	1245667351	0	0	HERNANDEZ, WILLIAM L NP	2/17/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	722246	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
325683	Ordering, Referring, Prescribing	N/A	1245692490	0	0	HUYNH, DEREK H	3/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	67472	N/A	N/A	N/A	N/A	N/A	8200 LONG BEACH BLVD	D2	SOUTH GATE	CA	90280	2057	00	06000	33.96384898	-118.2251501	Los Angeles County
325743	Ordering, Referring, Prescribing	N/A	1245769298	0	0	HUNT, FELICIA L CNP	10/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95007035	N/A	N/A	N/A	N/A	N/A	7301 STATE ST.	None	HUNTINGTON PARK	CA	90255	8523	00	06000	33.97149395	-118.2097278	Los Angeles County
325760	Ordering, Referring, Prescribing	N/A	1245789395	0	0	HOGAN, ALEX H PHARMD	2/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75154	N/A	N/A	N/A	N/A	N/A	10161 BOLSA AVE	STE 105B	WESTMINSTER	CA	92683	6770	00	06000	33.74508538	-117.9521356	Orange County
325761	Ordering, Referring, Prescribing	N/A	1245790674	0	0	HEWLETT, MEGHAN MD	6/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179325	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
325774	Ordering, Referring, Prescribing	N/A	1245822550	0	0	HUDSPETH, CASSONDRA LMFT	3/4/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	145527	N/A	N/A	N/A	N/A	N/A	327 S K STREET	None	TULARE	CA	93274	5416	00	06000	36.20476387	-119.3454489	Tulare County
325799	Ordering, Referring, Prescribing	N/A	1245867613	0	0	HO, DANIEL MD	2/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176545	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2282	00	06000	38.555181	-121.4566785	Sacramento County
325822	Ordering, Referring, Prescribing	N/A	1245913441	0	0	HUSSAIN, MOHAMMAD I NP	11/25/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025749	N/A	N/A	N/A	N/A	N/A	1335 3/4 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5911	00	06000	34.0965	-118.2961655	Los Angeles County
325830	Ordering, Referring, Prescribing	N/A	1245948421	0	0	HORSBURGH, ELIZABETH J RDH	11/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RDH28052	N/A	N/A	N/A	N/A	N/A	242 E AIRPORT DR	None	SAN BERNARDINO	CA	92408	3432	00	06000	34.06745358	-117.2828436	San Bernardino County
325878	Ordering, Referring, Prescribing	N/A	1255117594	0	0	HORTIZUELA, KAHREENA A CNP	6/5/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025463	N/A	N/A	N/A	N/A	N/A	780 ATLANTIC AVE	None	LONG BEACH	CA	90813	4565	00	06000	33.776325	-118.1850235	Los Angeles County
325902	Ordering, Referring, Prescribing	N/A	1255403168	0	0	HOOKER, MICHELLE D LCSW	12/15/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74851	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
325905	Ordering, Referring, Prescribing	N/A	1255419867	0	0	HUANG, ERIC PHARMD	3/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH57791	N/A	N/A	N/A	N/A	N/A	8392 REMBRANDT DR	None	HUNTINGTON BEACH	CA	92647	6021	00	06000	33.71384167	-117.9819699	Orange County
325915	Ordering, Referring, Prescribing	N/A	1255430773	0	0	HUANG, ARCH Z PA-C	5/18/2017	Taxonomy not applicable	NA	n/a	000	Unknown	PA14078	N/A	N/A	N/A	N/A	N/A	2727 N. PECK ROAD	None	EL MONTE	CA	91733	2434	00	06000	34.060311	-118.0306097	Los Angeles County
325960	Ordering, Referring, Prescribing	N/A	1255520029	0	0	HAMMOND, JAMIE A LCSW	6/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21015	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
325977	Ordering, Referring, Prescribing	N/A	1255543872	0	0	HOLTHAUS, STEPHANIE PHD	8/15/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21589	N/A	N/A	N/A	N/A	N/A	90 VIA JUANA RD	None	SANTA YNEZ	CA	93460	9679	00	06000	34.60546842	-120.0931812	Santa Barbara County
325989	Ordering, Referring, Prescribing	N/A	1255593174	0	0	HAN, CHRISTINA S MD	1/22/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A95748	N/A	N/A	N/A	N/A	N/A	7100 VAN NUYS BLVD	#108	VAN NUYS	CA	91405	3063	00	06000	34.19957761	-118.4487663	Los Angeles County
325991	Ordering, Referring, Prescribing	N/A	1255571238	0	0	HANSEN, KIM M NP	5/10/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	12070	N/A	N/A	N/A	N/A	N/A	711 STONY POINT RD	SUITE 17	SANTA ROSA	CA	95407	6802	00	06000	38.428848	-122.7420045	Sonoma County
326023	Ordering, Referring, Prescribing	N/A	1255636270	0	0	HE, JIE PHARMD	3/15/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH61109	N/A	N/A	N/A	N/A	N/A	12874 E FLORENCE AVE	None	SANTA FE SPRINGS	CA	90670	4540	00	06000	33.93512767	-118.0576379	Los Angeles County
326042	Ordering, Referring, Prescribing	N/A	1255682860	0	0	HERNANDEZ, DANIELA V LMFT	8/26/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	95049	N/A	N/A	N/A	N/A	N/A	444 SOUTH 8TH STREET	SUITE B3	EL CENTRO	CA	92243	3236	00	06000	32.789268	-115.5614175	Imperial County
326045	Ordering, Referring, Prescribing	N/A	1255681326	0	0	HO, NIKKI PHARMD	5/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67789	N/A	N/A	N/A	N/A	N/A	358 S INDIAN HILL BLVD	None	CLAREMONT	CA	91711	5223	00	06000	34.08920856	-117.7191627	Los Angeles County
326076	Ordering, Referring, Prescribing	N/A	1255730362	0	0	HERNANDEZ MORENO, CINDY LMFT	2/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102283	N/A	N/A	N/A	N/A	N/A	520 E TULARE AVE	None	VISALIA	CA	93292	3629	00	06000	36.320679	-119.2870845	Tulare County
326083	Ordering, Referring, Prescribing	N/A	1255745105	0	0	HODGE, HAYLEY	5/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT93510	N/A	N/A	N/A	N/A	N/A	5740 RALSTON ST.	SUITE 201	VENTURA	CA	93003	6571	00	06000	34.26070802	-119.213699	Ventura County
326093	Ordering, Referring, Prescribing	N/A	1255751764	0	0	HANZAL, TIFFANY A LMFT	4/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106094	N/A	N/A	N/A	N/A	N/A	1401 L ST	None	BAKERSFIELD	CA	93301	4522	00	06000	35.37071435	-119.0164657	Kern County
326097	Ordering, Referring, Prescribing	N/A	1255764627	0	0	HEIDENBERG, BRADLEY T LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98495	N/A	N/A	N/A	N/A	N/A	480 E 13TH ST	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
326116	Ordering, Referring, Prescribing	N/A	1255806568	0	0	HURD, MELISSA	2/25/2018	Taxonomy not applicable	NA	n/a	000	Unknown	LEP3489	N/A	N/A	N/A	N/A	N/A	17200 PINEHURST LN	None	HUNTINGTON BEACH	CA	92647	5569	00	06000	33.71147558	-118.0215746	Orange County
326121	Ordering, Referring, Prescribing	N/A	1255815502	0	0	HART, LINDA LPCC	11/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	13452	N/A	N/A	N/A	N/A	N/A	1170 INDUSTRIAL STREET	None	REDDING	CA	96002	0734	00	06000	40.57474549	-122.3503065	Shasta County
326130	Ordering, Referring, Prescribing	N/A	1255828869	0	0	HABIYAREMYE, GAKWAYA MD	11/21/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A200068	N/A	N/A	N/A	N/A	N/A	475 BRUCE ST	SUITE 900	YREKA	CA	96097	3474	00	06000	41.71860037	-122.6467317	Siskiyou County
326157	Ordering, Referring, Prescribing	N/A	1255866570	0	0	HERMOSILLO, ROSALBA LCSW	7/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW91030	N/A	N/A	N/A	N/A	N/A	2200 W ORANGEWOOD AVE	212	ORANGE	CA	92868	1945	00	06000	33.79576054	-117.875655	Orange County
326195	Ordering, Referring, Prescribing	N/A	1255914875	0	0	HERRERA, KELSEY R DO	4/8/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A22594	N/A	N/A	N/A	N/A	N/A	1809 NATIONAL AVE	None	SAN DIEGO	CA	92113	2113	00	06000	32.70162897	-117.1465065	San Diego County
326196	Ordering, Referring, Prescribing	N/A	1255913612	0	0	HUANG, ZUYUAN DO	6/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21155	N/A	N/A	N/A	N/A	N/A	211 EASTMOOR AVE	None	DALY CITY	CA	94015	2036	00	06000	37.6847337	-122.4787562	San Mateo County
326202	Ordering, Referring, Prescribing	N/A	1255921052	0	0	HENDRICKS, ANNA C LCSW	3/8/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100418	N/A	N/A	N/A	N/A	N/A	333 LAWS AVENUE	None	UKIAH	CA	95482	6540	00	06000	39.12772164	-123.2111168	Mendocino County
326214	Ordering, Referring, Prescribing	N/A	1255955985	0	0	HARRIS, JADE LPCC	3/23/2025	Taxonomy not applicable	NA	n/a	000	Unknown	18995	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
326219	Ordering, Referring, Prescribing	N/A	1255968939	0	0	HILT, AUSTIN J MD MPH	4/30/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179780	N/A	N/A	N/A	N/A	N/A	7415 HENRIETTA DR	None	SACRAMENTO	CA	95822	5142	00	06000	38.487969	-121.496031	Sacramento County
326225	Ordering, Referring, Prescribing	N/A	1255986394	0	0	HAGEN, KAITLIN L LMFT	11/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123087	N/A	N/A	N/A	N/A	N/A	1436 GOODRICH BLVD	None	COMMERCE	CA	90022	5111	00	06000	34.01117577	-118.1585527	Los Angeles County
326240	Ordering, Referring, Prescribing	N/A	1265000251	0	0	HEYN, DANIEL MD	7/15/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197739	N/A	N/A	N/A	N/A	N/A	3302 RENNER DRIVE	None	FORTUNA	CA	95540	3120	00	06000	40.5823206	-124.1359965	Humboldt County
326254	Ordering, Referring, Prescribing	N/A	1265039226	0	0	HENSLEY, ZACHARY LMFT	11/30/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143253	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
326260	Ordering, Referring, Prescribing	N/A	1265047310	0	0	HAMMON, PAMELA LCSW	5/31/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115567	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
326292	Ordering, Referring, Prescribing	N/A	1265140404	0	0	HERNANDEZ, YESSICA NP	1/31/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021303	N/A	N/A	N/A	N/A	N/A	2040 CAMFIELD AVE.	None	COMMERCE	CA	90040	1501	00	06000	34.00861575	-118.1559052	Los Angeles County
326313	Ordering, Referring, Prescribing	N/A	1265197032	0	0	HILLMAN, BENJAMIN J PA-C	11/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60347	N/A	N/A	N/A	N/A	N/A	1850 SPRING RIDGE DRIVE	None	SUSANVILLE	CA	96130	6100	00	06000	40.43814074	-120.6259249	Lassen County
326322	Ordering, Referring, Prescribing	N/A	1265291256	0	0	HASAN, MARIUM DDS	2/15/2024	Taxonomy not applicable	NA	n/a	000	Unknown	109874	N/A	N/A	N/A	N/A	N/A	5925 W LAS POSITAS BLVD	STE 100	PLEASANTON	CA	94588	8537	00	06000	37.68360997	-121.8990082	Alameda County
326345	Ordering, Referring, Prescribing	N/A	1265498539	0	0	HOPKINS, STEPHEN J MD	5/13/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A50509	N/A	N/A	N/A	N/A	N/A	1345 A PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3159	00	06000	40.43531297	-120.6557201	Lassen County
326347	Ordering, Referring, Prescribing	N/A	1265506943	0	0	HYUN, JOHN S PHARMD	4/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	41888	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
326356	Ordering, Referring, Prescribing	N/A	1265521348	0	0	HEINEMANN, SHIRLEY S PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48368	N/A	N/A	N/A	N/A	N/A	3900 LAKEVILLE HWY	None	PETALUMA	CA	94954	5698	00	06000	38.2304311	-122.5827918	Sonoma County
326358	Ordering, Referring, Prescribing	N/A	1265521256	0	0	HAYDEN, ERIKA M LMFT	3/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50967	N/A	N/A	N/A	N/A	N/A	120 S STATE COLLEGE BLVD	STE 150	BREA	CA	92821	5837	00	06000	33.92111797	-117.8828786	Orange County
326404	Ordering, Referring, Prescribing	N/A	1265641823	0	0	HOM, CYNTHIA DDS	5/29/2023	Taxonomy not applicable	NA	n/a	000	Unknown	43346	N/A	N/A	N/A	N/A	N/A	1110 N DUTTON AVENUE	None	SANTA ROSA	CA	95401	4606	00	06000	38.446731	-122.729859	Sonoma County
326441	Ordering, Referring, Prescribing	N/A	1265711584	0	0	HERRERA, ROCIO	2/11/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88553	N/A	N/A	N/A	N/A	N/A	14181 TELEGRAPH RD.	None	WHITTIER	CA	90604	2554	00	06000	33.92892082	-118.0299538	Los Angeles County
326473	Ordering, Referring, Prescribing	N/A	1265747398	0	0	HERRERA, MARIA T LMFT	1/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113242	N/A	N/A	N/A	N/A	N/A	13001 RAMONA BLVD ST	SUITE A	IRWINDALE	CA	91706	3752	00	06000	34.07969659	-117.9895641	Los Angeles County
326476	Ordering, Referring, Prescribing	N/A	1265749709	0	0	HUTTON, LYNNE E LCSW	7/10/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71701	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
326480	Ordering, Referring, Prescribing	N/A	1265759906	0	0	HORSTMANN, ELIZABETH A MD	11/23/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A129888	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
326503	Ordering, Referring, Prescribing	N/A	1265795306	0	0	HOLMES, LAURA C MD	7/1/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146493	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
326534	Ordering, Referring, Prescribing	N/A	1265852719	0	0	HUA, DUONG T MD	7/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A137650	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
326568	Ordering, Referring, Prescribing	N/A	1265900252	0	0	HANG, DIANA L PHARMD	12/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	77387	N/A	N/A	N/A	N/A	N/A	2110 TRUXTUN AVE	400	BAKERSFIELD	CA	93301	3703	00	06000	35.37344851	-119.0261655	Kern County
326611	Ordering, Referring, Prescribing	N/A	1265979322	0	0	HASSAN, DUAA	10/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62473	N/A	N/A	N/A	N/A	N/A	31960 TEMECULA PKWY	None	TEMECULA	CA	92592	5897	00	06000	33.48082892	-117.0999334	Riverside County
326612	Ordering, Referring, Prescribing	N/A	1265978662	0	0	HWANG, KUANGHENG LMFT	9/6/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	149562	N/A	N/A	N/A	N/A	N/A	1310 WILSHIRE BLVD.	None	LOS ANGELES	CA	90017	1705	00	06000	34.0539383	-118.267018	Los Angeles County
326617	Ordering, Referring, Prescribing	N/A	1265985980	0	0	HERNANDEZ, CHANTALL LMFT	3/5/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	124729	N/A	N/A	N/A	N/A	N/A	5100 S EASTERN AVE	SUITE 110	COMMERCE	CA	90040	2950	00	06000	33.98882955	-118.1615175	Los Angeles County
326628	Ordering, Referring, Prescribing	N/A	1275013013	0	0	HUSTEAD, JERICA LMFT	4/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103065	N/A	N/A	N/A	N/A	N/A	1789 W YOSEMITE AVE	SIERRA BUILDING	MANTECA	CA	95337	5130	00	06000	37.79964	-121.246425	San Joaquin County
326630	Ordering, Referring, Prescribing	N/A	1275013179	0	0	HUM, JUSTINE L	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77030	N/A	N/A	N/A	N/A	N/A	2262 MARKET STREET	None	SAN FRANCISCO	CA	94114	1508	00	06000	37.76498914	-122.4322587	San Francisco County
326637	Ordering, Referring, Prescribing	N/A	1275033540	0	0	HARBUCK, DANA L CNP	2/20/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008589	N/A	N/A	N/A	N/A	N/A	1355 EAST ST. STE 200	None	REDDING	CA	96001	0000	00	06000	40.58628506	-122.3887911	Shasta County
326643	Ordering, Referring, Prescribing	N/A	1275047037	0	0	HEER, ALEXANDER L	6/21/2020	Taxonomy not applicable	NA	n/a	000	Unknown	ASW92131	N/A	N/A	N/A	N/A	N/A	815 HYDE ST	None	SAN FRANCISCO	CA	94109	5998	00	06000	37.78855	-122.416917	San Francisco County
326675	Ordering, Referring, Prescribing	N/A	1275091944	0	0	HENSON, LAUREN LPCC	4/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC13449	N/A	N/A	N/A	N/A	N/A	780 E GILBERT ST	None	SAN BERNARDINO	CA	92415	1003	00	06000	34.1268333	-117.2705634	San Bernardino County
326683	Ordering, Referring, Prescribing	N/A	1275113110	0	0	HOANG, VY PHARMD	4/6/2022	Taxonomy not applicable	NA	n/a	000	Unknown	50675	N/A	N/A	N/A	N/A	N/A	1800 CAVITT DR	None	FOLSOM	CA	95630	6235	00	06000	38.645388	-121.1097645	Sacramento County
326708	Ordering, Referring, Prescribing	N/A	1275161267	0	0	HO, PRESTON E PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82146	N/A	N/A	N/A	N/A	N/A	191 EAST 3RD AVE.	None	SAN MATEO	CA	94401	4012	00	06000	37.56505473	-122.3231627	San Mateo County
326732	Ordering, Referring, Prescribing	N/A	1275211617	0	0	HAO, YUE MD	8/2/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL11519	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
326765	Ordering, Referring, Prescribing	N/A	1275570699	0	0	HILLMAN, SHONA M MD	12/5/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C146051	N/A	N/A	N/A	N/A	N/A	1680 PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3133	00	06000	40.42141164	-120.6468171	Lassen County
326767	Ordering, Referring, Prescribing	N/A	1275542193	0	0	HALVORSON, PAULA DC	1/19/2022	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC19679	N/A	N/A	N/A	N/A	N/A	1309 S MISSION RD	None	FALLBROOK	CA	92028	4167	00	06000	33.36938909	-117.2510954	San Diego County
326784	Ordering, Referring, Prescribing	N/A	1275611857	0	0	HJORTSVANG, ERICK W MD	6/9/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79589	N/A	N/A	N/A	N/A	N/A	584 CAMINO MERCADO	None	ARROYO GRANDE	CA	93420	1816	00	06000	35.13009097	-120.599303	San Luis Obispo County
326788	Ordering, Referring, Prescribing	N/A	1275615833	0	0	HOHL, JOSEPH C	5/30/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G10358	N/A	N/A	N/A	N/A	N/A	150 EAST HOLT BLVD	3RD FLOOR	ONTARIO	CA	91761	3695	00	06000	34.063164	-117.6502275	San Bernardino County
326801	Ordering, Referring, Prescribing	N/A	1275653743	0	0	HENRIE, PATRICK M	10/13/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D20020	N/A	N/A	N/A	N/A	N/A	333 LAWS AVE	None	UKIAH	CA	95482	6540	00	06000	39.12772164	-123.2111168	Mendocino County
326811	Ordering, Referring, Prescribing	N/A	1275663767	0	0	HERNANDEZ-LARA, YOLANDA LCSW	12/22/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24832	N/A	N/A	N/A	N/A	N/A	4701 E CESAR E CHAVEZ AV	FLOOR 2	LOS ANGELES	CA	90022	1209	00	06000	34.04062547	-118.1643975	Los Angeles County
326815	Ordering, Referring, Prescribing	N/A	1275665259	0	0	HOLT, BRIAN R MD	11/12/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A76811	N/A	N/A	N/A	N/A	N/A	1303 W WALNUT PKWY	None	COMPTON	CA	90220	5030	00	06000	33.87724562	-118.2446904	Los Angeles County
326835	Ordering, Referring, Prescribing	N/A	1275708588	0	0	HUANG, JENNIFER V DO	1/23/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A9516	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
326866	Ordering, Referring, Prescribing	N/A	1275784233	0	0	HARGETT, STEPHEN W MD	4/26/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A33434	N/A	N/A	N/A	N/A	N/A	650 ZEDIKER AVE	None	PARLIER	CA	93648	2666	00	06000	36.60500164	-119.5210273	Fresno County
326867	Ordering, Referring, Prescribing	N/A	1275780272	0	0	HERNANDEZ, ADRIANA LMFT	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT103788	N/A	N/A	N/A	N/A	N/A	5800 S EASTERN AVE	None	COMMERCE	CA	90040	4016	00	06000	33.98534547	-118.1620372	Los Angeles County
326895	Ordering, Referring, Prescribing	N/A	1275837460	0	0	HYAMS, LAURA LMFT	9/15/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48769	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
326940	Ordering, Referring, Prescribing	N/A	1275906836	0	0	HINATA, SATOMI DMD	11/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65179	N/A	N/A	N/A	N/A	N/A	1000 VALE TERRACE DR	None	VISTA	CA	92084	5218	00	06000	33.20904502	-117.2286439	San Diego County
326968	Ordering, Referring, Prescribing	N/A	1275943672	0	0	HA, TRACY E	6/6/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D63236	N/A	N/A	N/A	N/A	N/A	8841 GARVEY AVE	None	ROSEMEAD	CA	91770	3358	00	06000	34.06276591	-118.07587	Los Angeles County
326982	Ordering, Referring, Prescribing	N/A	1275968869	0	0	HERNANDEZ, JENNIFER LCSW	12/18/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81891	N/A	N/A	N/A	N/A	N/A	510 S VERMONT AVE	None	LOS ANGELES	CA	90020	1912	00	06000	34.065	-118.291631	Los Angeles County
327056	Ordering, Referring, Prescribing	N/A	1285063362	0	0	HOLM, SETH NP	8/16/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000059	N/A	N/A	N/A	N/A	N/A	311 WEST I STREET	None	LOS BANOS	CA	93635	3479	00	06000	37.06343055	-120.8570545	Merced County
327057	Ordering, Referring, Prescribing	N/A	1285064824	0	0	HOMAN, JASON DPM	2/3/2024	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	5234	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
327073	Ordering, Referring, Prescribing	N/A	1285083121	0	0	HSIEH-WONG, JACQUELINE H MD	4/18/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A177855	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
327102	Ordering, Referring, Prescribing	N/A	1285129866	0	0	HAMRANG, NASIM N LMFT	3/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132724	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
327115	Ordering, Referring, Prescribing	N/A	1285152553	0	0	HUANG, EVA LCSW	10/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97173	N/A	N/A	N/A	N/A	N/A	720 SACRAMENTO ST.	None	SAN FRANCISCO	CA	94108	2535	00	06000	37.79355846	-122.4050846	San Francisco County
327129	Ordering, Referring, Prescribing	N/A	1285182881	0	0	HAROUNPOUR, SHIVA PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH73578	N/A	N/A	N/A	N/A	N/A	1911 LINCOLN BLVD	None	SANTA MONICA	CA	90405	1314	00	06000	34.01192219	-118.482444	Los Angeles County
327157	Ordering, Referring, Prescribing	N/A	1285226969	0	0	HERMOSURA, JAMIE J	5/17/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015511	N/A	N/A	N/A	N/A	N/A	14623 HAWTHORNE BLVD	300	LAWNDALE	CA	90260	1581	00	06000	33.898572	-118.3527775	Los Angeles County
327196	Ordering, Referring, Prescribing	N/A	1285284752	0	0	HERNANDEZ BUCIO, GUADALUPE I LMFT	8/2/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127271	N/A	N/A	N/A	N/A	N/A	1000 S MAIN ST	105	SALINAS	CA	93901	2352	00	06000	36.66226091	-121.6578913	Monterey County
327206	Ordering, Referring, Prescribing	N/A	1285331470	0	0	HILL, FAITH NP	10/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	95024211	N/A	N/A	N/A	N/A	N/A	344 E 6TH ST	None	MADERA	CA	93638	3631	00	06000	36.96288964	-120.0556279	Madera County
327209	Ordering, Referring, Prescribing	N/A	1285342642	0	0	HERNANDEZ-CRUZ, ANA J CNP	11/17/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023357	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
327269	Ordering, Referring, Prescribing	N/A	1285713206	0	0	HARRIS, ZOADA PHD	10/2/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	17725	N/A	N/A	N/A	N/A	N/A	1933 S BROADWAY	None	LOS ANGELES	CA	90007	4501	00	06000	34.03102377	-118.2660738	Los Angeles County
327332	Ordering, Referring, Prescribing	N/A	1285856609	0	0	HO, JOSEPH MD	11/29/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C144558	N/A	N/A	N/A	N/A	N/A	150 LAGUNA RD	SUITE A	FULLERTON	CA	92835	3614	00	06000	33.89367364	-117.9302191	Orange County
327338	Ordering, Referring, Prescribing	N/A	1285867333	0	0	HARRIS, ARTHUR L LMFT	5/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78354	N/A	N/A	N/A	N/A	N/A	3000 PARKER ROAD	None	RICHMOND	CA	94806	2741	00	06000	37.9690797	-122.3241653	Contra Costa County
327371	Ordering, Referring, Prescribing	N/A	1285923961	0	0	HORNUNG, KRISTEN G LPCC	5/12/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC2071	N/A	N/A	N/A	N/A	N/A	1260 MORENA BLVD	STE 200	SAN DIEGO	CA	92110	3889	00	06000	32.77077343	-117.2018542	San Diego County
327385	Ordering, Referring, Prescribing	N/A	1285940916	0	0	HERRERA, ANDREA S LMFT	7/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT119933	N/A	N/A	N/A	N/A	N/A	1750 W WALNUT AVE	STE B	VISALIA	CA	93277	6233	00	06000	36.313335	-119.3114205	Tulare County
327394	Ordering, Referring, Prescribing	N/A	1285945196	0	0	HAMDI, ABDULRAHMAN A MD	4/27/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A147337	N/A	N/A	N/A	N/A	N/A	811 E ELEVENTH ST	None	REEDLEY	CA	93654	2527	00	06000	36.60347345	-119.4404912	Fresno County
327404	Ordering, Referring, Prescribing	N/A	1285973305	0	0	HAMMAD, CHIREEN	10/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	78703	N/A	N/A	N/A	N/A	N/A	10301 VISTA DRIVE	None	CUPERTINO	CA	95014	2040	00	06000	37.32655045	-122.0276	Santa Clara County
327412	Ordering, Referring, Prescribing	N/A	1285989996	0	0	HARRIS, MATTHEW W	11/12/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D61530	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
327422	Ordering, Referring, Prescribing	N/A	1295001923	0	0	HARTZLER, ALEX A MD	11/29/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A119883	N/A	N/A	N/A	N/A	N/A	655 REDWOOD HIGHWAY FRON	304	MILL VALLEY	CA	94941	3057	00	06000	37.8918372	-122.5169699	Marin County
327443	Ordering, Referring, Prescribing	N/A	1295066223	0	0	HEROLD, HEATHER C PA	7/15/2020	Taxonomy not applicable	NA	n/a	000	Unknown	20599	N/A	N/A	N/A	N/A	N/A	303 W LINCOLN AVE	None	ANAHEIM	CA	92805	2936	00	06000	33.83508976	-117.9177981	Orange County
327526	Ordering, Referring, Prescribing	N/A	1295218097	0	0	HUMPHREY, KELLEY F PA	8/6/2018	Taxonomy not applicable	NA	n/a	000	Unknown	55838	N/A	N/A	N/A	N/A	N/A	1119 PACIFIC AVE	STE 200	SANTA CRUZ	CA	95060	4464	00	06000	36.9722444	-122.0256836	Santa Cruz County
327527	Ordering, Referring, Prescribing	N/A	1295216331	0	0	HAYES, AIESHA LCSW	1/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120530	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
327574	Ordering, Referring, Prescribing	N/A	1295277457	0	0	HERNANDEZ, SONIA E LMFT	3/31/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138919	N/A	N/A	N/A	N/A	N/A	800 S BROADWAY	208	SANTA MARIA	CA	93454	6623	00	06000	34.9442448	-120.4359479	Santa Barbara County
327580	Ordering, Referring, Prescribing	N/A	1295286946	0	0	HA, JUDY PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75130	N/A	N/A	N/A	N/A	N/A	14555 VALLEY CENTER DR	None	VICTORVILLE	CA	92395	4216	00	06000	34.51554423	-117.3195841	San Bernardino County
327592	Ordering, Referring, Prescribing	N/A	1295316172	0	0	HEGDE, SALONI MD	9/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL7510	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
327599	Ordering, Referring, Prescribing	N/A	1295325520	0	0	HUYNH, LONG T PHARMD	1/9/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84007	N/A	N/A	N/A	N/A	N/A	160 1ST ST	None	LOS ALTOS	CA	94022	2705	00	06000	37.37917164	-122.118817	Santa Clara County
327609	Ordering, Referring, Prescribing	N/A	1295346377	0	0	HE, SHUNING PHARMD	9/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76547	N/A	N/A	N/A	N/A	N/A	1640 R ST	None	MERCED	CA	95340	4527	00	06000	37.30406774	-120.4927895	Merced County
327616	Ordering, Referring, Prescribing	N/A	1295362549	0	0	HOUK-SYAU, SHARON	5/31/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179950	N/A	N/A	N/A	N/A	N/A	301 THE CITY DRIVE SOUTH	None	ORANGE	CA	92868	3205	00	06000	33.78547994	-117.8888036	Orange County
327684	Ordering, Referring, Prescribing	N/A	1295787166	0	0	HUANG, WILLIAM MD	6/20/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A84462	N/A	N/A	N/A	N/A	N/A	8841 GRAVEY AVE	None	ROSEMEAD	CA	91770	3558	00	06000	34.06276591	-118.07587	Los Angeles County
327685	Ordering, Referring, Prescribing	N/A	1295783710	0	0	HO, ANH-DAO T OD	6/16/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	11062	N/A	N/A	N/A	N/A	N/A	12795 MAIN ST	None	HESPERIA	CA	92345	0101	00	06000	34.424496	-117.383643	San Bernardino County
327705	Ordering, Referring, Prescribing	N/A	1295859635	0	0	HAN, MEEHEE MSW LCSW	12/4/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28025	N/A	N/A	N/A	N/A	N/A	11100 ARTESIA BLVD	STE. A	CERRITOS	CA	90703	2547	00	06000	33.87288108	-118.097253	Los Angeles County
327746	Ordering, Referring, Prescribing	N/A	1295949550	0	0	HU, XIAOHONG	12/10/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C162502	N/A	N/A	N/A	N/A	N/A	2323 E PALMDALE BLVD	SUITE A	PALMDALE	CA	93550	6502	00	06000	34.58021347	-118.0857516	Los Angeles County
327755	Ordering, Referring, Prescribing	N/A	1295975100	0	0	HUYNH, HONG-AN PHARMD	2/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61590	N/A	N/A	N/A	N/A	N/A	4175 E LA PALMA AVE	None	ANAHEIM	CA	92807	1842	00	06000	33.85947346	-117.8265479	Orange County
327756	Ordering, Referring, Prescribing	N/A	1295957041	0	0	HURST, PAULETTE M LMFT	2/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53429	N/A	N/A	N/A	N/A	N/A	7001 EAST PARKWAY	800	SACRAMENTO	CA	95823	2501	00	06000	38.497293	-121.4504235	Sacramento County
327759	Ordering, Referring, Prescribing	N/A	1295981942	0	0	HONG, SUK YOUNG E	5/7/2023	Taxonomy not applicable	NA	n/a	000	Unknown	52030	N/A	N/A	N/A	N/A	N/A	1600 SAN FERNANDO RD	None	SAN FERNANDO	CA	91340	3115	00	06000	34.28899399	-118.4481394	Los Angeles County
327813	Ordering, Referring, Prescribing	N/A	1306086392	0	0	HAUPTMAN, LISA NP	7/10/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	7376	N/A	N/A	N/A	N/A	N/A	711 STONY POINT RD	SUITE 17	SANTA ROSA	CA	95407	6802	00	06000	38.428848	-122.7420045	Sonoma County
327816	Ordering, Referring, Prescribing	N/A	1306096714	0	0	HODGE, ROGER G PSYD	6/5/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	26148	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
327825	Ordering, Referring, Prescribing	N/A	1306116868	0	0	HO, DAVID K PHARMD	9/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60054	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
327829	Ordering, Referring, Prescribing	N/A	1306121827	0	0	HOUN, ALLEN PHARMD	4/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	63246	N/A	N/A	N/A	N/A	N/A	12700 DAY ST.	None	MORENO VALLEY	CA	92553	7521	00	06000	33.935724	-117.275922	Riverside County
327849	Ordering, Referring, Prescribing	N/A	1306148770	0	0	HOANG, BICH-LOAN PHARMD	3/20/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH49258	N/A	N/A	N/A	N/A	N/A	150 E EL CAMINO REAL	None	SUNNYVALE	CA	94087	1936	00	06000	37.36500202	-122.0290606	Santa Clara County
327859	Ordering, Referring, Prescribing	N/A	1306161161	0	0	HOPPIS, ALEXANDRA M LMFT	3/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51307	N/A	N/A	N/A	N/A	N/A	222 PAUL SCANNELL DR	BHRS	SAN MATEO	CA	94402	4061	00	06000	37.51168342	-122.3375282	San Mateo County
327871	Ordering, Referring, Prescribing	N/A	1306179262	0	0	HAMBERLIN, DARREN M LMFT	12/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111525	N/A	N/A	N/A	N/A	N/A	988 MCCOURTNEY RD	STE 102	GRASS VALLEY	CA	95949	7400	00	06000	39.2089732	-121.0729043	Nevada County
327895	Ordering, Referring, Prescribing	N/A	1306220629	0	0	HOUSER, DALE D PA-C	12/8/2017	Taxonomy not applicable	NA	n/a	000	Unknown	54002	N/A	N/A	N/A	N/A	N/A	4405 VANDEVER AVENUE	None	SAN DIEGO	CA	92120	3315	00	06000	32.78765609	-117.09908	San Diego County
327897	Ordering, Referring, Prescribing	N/A	1306221783	0	0	HOANG, LANA T	9/8/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D64793	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
327916	Ordering, Referring, Prescribing	N/A	1306236518	0	0	HSIH, KATE MD	8/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A169941	N/A	N/A	N/A	N/A	N/A	2828 FORD ST	THE HUB	OAKLAND	CA	94601	2114	00	06000	37.77357837	-122.2352589	Alameda County
327937	Ordering, Referring, Prescribing	N/A	1306285242	0	0	HALL, MATTHEW L	6/10/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D62490	N/A	N/A	N/A	N/A	N/A	791 EL DORADO WAY	None	SACRAMENTO	CA	95819	3214	00	06000	38.568294	-121.436595	Sacramento County
327939	Ordering, Referring, Prescribing	N/A	1306291299	0	0	HONG, JOY MD	9/26/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151905	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
327941	Ordering, Referring, Prescribing	N/A	1306295944	0	0	HABIB, SAMY	10/27/2017	Taxonomy not applicable	NA	n/a	000	Unknown	72751	N/A	N/A	N/A	N/A	N/A	9901 PARAMOUNT BLVD	110	DOWNEY	CA	90240	3843	00	06000	33.95539219	-118.128812	Los Angeles County
327947	Ordering, Referring, Prescribing	N/A	1306300686	0	0	HERNANDEZ, BRENDA LMFT	2/6/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	144835	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
327986	Ordering, Referring, Prescribing	N/A	1306366125	0	0	HAGER, DANIELLE K LCSW	2/24/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100231	N/A	N/A	N/A	N/A	N/A	100 W WALNUT ST	STE 375	PASADENA	CA	91124	0001	00	06000	34.14963648	-118.1522925	Los Angeles County
328017	Ordering, Referring, Prescribing	N/A	1306452776	0	0	HERNANDEZ PANUCO, OMAR PHARMD	4/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83207	N/A	N/A	N/A	N/A	N/A	447 HILL AVE	None	FOWLER	CA	93625	2002	00	06000	36.623052	-119.6873535	Fresno County
328027	Ordering, Referring, Prescribing	N/A	1306481973	0	0	HEINMAN, OLGA CNP	11/5/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013169	N/A	N/A	N/A	N/A	N/A	100 UCLA MEDICAL PLZ	660	LOS ANGELES	CA	90024	6970	00	06000	34.06544724	-118.4459249	Los Angeles County
328056	Ordering, Referring, Prescribing	N/A	1306529896	0	0	HORAN, OLIVIA NP	8/22/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95025859	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
328092	Ordering, Referring, Prescribing	N/A	1306840657	0	0	HARDMAN, NORMAN G PT	10/15/2019	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	25540	N/A	N/A	N/A	N/A	N/A	1071 BROADWAY	None	EL CAJON	CA	92021	4804	00	06000	32.8076427	-116.9450865	San Diego County
328110	Ordering, Referring, Prescribing	N/A	1306900279	0	0	HARMS, BRADLEY L LMFT	5/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	41115	N/A	N/A	N/A	N/A	N/A	3801 3RD STREET	400	SAN FRANCISCO	CA	94124	0001	00	06000	37.74208019	-122.3880422	San Francisco County
328117	Ordering, Referring, Prescribing	N/A	1306916994	0	0	HOURIHAN, KEITH DC	1/29/2024	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC25211	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
328143	Ordering, Referring, Prescribing	N/A	1306971148	0	0	HOLSCHER, DONNA A MD	11/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G59568	N/A	N/A	N/A	N/A	N/A	29632 E HIGHWAY 299	None	ROUND MOUNTAIN	CA	96084	8000	00	06000	40.80385331	-121.9397745	Shasta County
328166	Ordering, Referring, Prescribing	N/A	1316023609	0	0	HECKMAN, JENNIFER N	2/15/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	D47293	N/A	N/A	N/A	N/A	N/A	954 N VERMONT AVE	None	LOS ANGELES	CA	90029	3529	00	06000	34.08896256	-118.2917211	Los Angeles County
328175	Ordering, Referring, Prescribing	N/A	1316026487	0	0	HANTON, STEPHANIE PHARMD	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46576	N/A	N/A	N/A	N/A	N/A	100 SMITH RANCH RD	2ND FLOOR	SAN RAFAEL	CA	94903	1900	00	06000	38.01968283	-122.5339655	Marin County
328192	Ordering, Referring, Prescribing	N/A	1316067564	0	0	HOOSHMAND, HASSAN A PA	12/20/2017	Taxonomy not applicable	NA	n/a	000	Unknown	13300	N/A	N/A	N/A	N/A	N/A	6907 SEVILLE AVE.	None	HUNTINGTON PARK	CA	90255	4901	00	06000	33.97664362	-118.2225466	Los Angeles County
328205	Ordering, Referring, Prescribing	N/A	1316087422	0	0	HARASZTI, JOSEPH S MD	2/3/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G37865	N/A	N/A	N/A	N/A	N/A	5900 SOUTH EASTERN AVENU	SUITE 138	COMMERCE	CA	90040	4018	00	06000	33.98421287	-118.162224	Los Angeles County
328223	Ordering, Referring, Prescribing	N/A	1316149545	0	0	HOWLETT, STEVE P	7/29/2013	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT012105	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
328253	Ordering, Referring, Prescribing	N/A	1316220874	0	0	HODGKINS, ZILLAH J PSYD	12/23/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33907	N/A	N/A	N/A	N/A	N/A	1025 E OCEAN AVE	B	LOMPOC	CA	93436	7088	00	06000	34.6389048	-120.4454929	Santa Barbara County
328280	Ordering, Referring, Prescribing	N/A	1316252141	0	0	HAJIAGHAMOHSENI, LAELA M MD	3/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A121863	N/A	N/A	N/A	N/A	N/A	307 PLACENTIA AVE.	SUITE 107	NEWPORT BEACH	CA	92663	3307	00	06000	33.62631386	-117.9310576	Orange County
328291	Ordering, Referring, Prescribing	N/A	1316281686	0	0	HAMILTON, PATRICE A LCSW	9/27/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115306	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
328292	Ordering, Referring, Prescribing	N/A	1316291404	0	0	HERNANDEZ, LAURA LMFT	1/29/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152562	N/A	N/A	N/A	N/A	N/A	602 ANACAPA ST	SECOND FLOOR	SANTA BARBARA	CA	93101	1615	00	06000	34.41898237	-119.6956812	Santa Barbara County
328295	Ordering, Referring, Prescribing	N/A	1316296445	0	0	HAGEL, KATRIN MARGRIT LMFT	6/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105747	N/A	N/A	N/A	N/A	N/A	2235 CHALLENGER WAY	101	SANTA ROSA	CA	95407	0000	00	06000	38.425491	-122.7519	Sonoma County
328303	Ordering, Referring, Prescribing	N/A	1316313125	0	0	HOLMES, MICHAEL A DMD	4/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	103317	N/A	N/A	N/A	N/A	N/A	923 N MILPAS ST	None	SANTA BARBARA	CA	93103	2331	00	06000	34.43047465	-119.6910698	Santa Barbara County
328309	Ordering, Referring, Prescribing	N/A	1316316920	0	0	HEITZ, SARAH L LCSW	2/12/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99981	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
328311	Ordering, Referring, Prescribing	N/A	1316316946	0	0	HORINOUCHI, LAUREN	5/9/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	745202	N/A	N/A	N/A	N/A	N/A	16465 SIERRA LAKES PKWY	None	FONTANA	CA	92336	1242	00	06000	34.13805177	-117.4457839	San Bernardino County
328318	Ordering, Referring, Prescribing	N/A	1316322399	0	0	HOANG, DOROTHY PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71950	N/A	N/A	N/A	N/A	N/A	275 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1106	00	06000	37.23951066	-121.8013511	Santa Clara County
328319	Ordering, Referring, Prescribing	N/A	1316320013	0	0	HUTTON, SOPHIA E LMFT	8/22/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141052	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
328340	Ordering, Referring, Prescribing	N/A	1316347578	0	0	HERNANDEZ-RAMIREZ, NORMA D	9/29/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022851	N/A	N/A	N/A	N/A	N/A	731 S. HIGHLAND AVE	None	FULLERTON	CA	92832	0000	00	06000	33.863598	-117.928718	Orange County
328371	Ordering, Referring, Prescribing	N/A	1316397078	0	0	HUNSAKER-GRIMES, ASHLEY D LMFT	8/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112948	N/A	N/A	N/A	N/A	N/A	9343 TECH CENTER DR	None	SACRAMENTO	CA	95826	2563	00	06000	38.564091	-121.3509285	Sacramento County
328375	Ordering, Referring, Prescribing	N/A	1316398217	0	0	HERNANDEZ, SALVADOR LCSW	6/15/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW101951	N/A	N/A	N/A	N/A	N/A	8787 HALL RD	None	LAMONT	CA	93241	1953	00	06000	35.25969451	-118.908099	Kern County
328394	Ordering, Referring, Prescribing	N/A	1316431935	0	0	HUERTA GALINDO, JUAN C MD	7/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188292	N/A	N/A	N/A	N/A	N/A	625 34TH ST	STE 100	BAKERSFIELD	CA	93301	2307	00	06000	35.39046051	-119.0092725	Kern County
328401	Ordering, Referring, Prescribing	N/A	1316443757	0	0	HEICHMAN, SHARON MD	12/13/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163788	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
328405	Ordering, Referring, Prescribing	N/A	1316451099	0	0	HAN, MI-HYUN S NP	1/29/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011785	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVE	A	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
328407	Ordering, Referring, Prescribing	N/A	1316454200	0	0	HER, KAU N PT	8/6/2019	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	294104	N/A	N/A	N/A	N/A	N/A	1133 W. SYCAMORE ST.	None	WILLOWS	CA	95988	2601	00	06000	39.5205105	-122.2082775	Glenn County
328412	Ordering, Referring, Prescribing	N/A	1316462252	0	0	HUANG, JIEWEN LCSW	11/23/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW102579	N/A	N/A	N/A	N/A	N/A	2140 SUTTER ST	2	SAN FRANCISCO	CA	94115	3120	00	06000	37.78581888	-122.4356608	San Francisco County
328418	Ordering, Referring, Prescribing	N/A	1316466527	0	0	HOWLAND, ELIZABETH L NP	2/21/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007854	N/A	N/A	N/A	N/A	N/A	2017 FIRST AVENUE	100	SAN DIEGO	CA	92101	9001	00	06000	32.72646147	-117.1638767	San Diego County
328424	Ordering, Referring, Prescribing	N/A	1316474125	0	0	HOU, GINA	7/6/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A161207	N/A	N/A	N/A	N/A	N/A	26600 CACTUS AVE	SUITE 300	MORENO VALLEY	CA	92555	3901	00	06000	33.91013953	-117.193383	Riverside County
328425	Ordering, Referring, Prescribing	N/A	1316472608	0	0	HAN, STEPHANIE Y MD	10/25/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158328	N/A	N/A	N/A	N/A	N/A	500 CITY PKWY W	STE. 200	ORANGE	CA	92868	2941	00	06000	33.78299346	-117.895788	Orange County
328432	Ordering, Referring, Prescribing	N/A	1316484074	0	0	HENDERSON, LATESHIA M NP	3/12/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005819	N/A	N/A	N/A	N/A	N/A	11888 BARTLETT AVE	None	ADELANTO	CA	92301	1709	00	06000	34.57927736	-117.4068692	San Bernardino County
328474	Ordering, Referring, Prescribing	N/A	1316558026	0	0	HEARD, ANTOINE LCSW	10/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	97959	N/A	N/A	N/A	N/A	N/A	3576 ARLINGTON AVE.	SUITE 100	RIVERSIDE	CA	92506	0000	00	06000	33.94625192	-117.3913739	Riverside County
328475	Ordering, Referring, Prescribing	N/A	1316554306	0	0	HARRAR, HAVILYN M BSN PHN	9/15/2020	Taxonomy not applicable	NA	n/a	000	Unknown	95015443	N/A	N/A	N/A	N/A	N/A	1908 N BEALE RD	E	MARYSVILLE	CA	95901	6937	00	06000	39.1278388	-121.5457994	Yuba County
328478	Ordering, Referring, Prescribing	N/A	1316565799	0	0	HOANG, CELIA PHARMD	6/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84485	N/A	N/A	N/A	N/A	N/A	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23948065	-121.8005798	Santa Clara County
328479	Ordering, Referring, Prescribing	N/A	1316565526	0	0	HIRSCH, ISABEL NP	2/2/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024124	N/A	N/A	N/A	N/A	N/A	3225 TIMBER FALL CT	STE B	EUREKA	CA	95503	4892	00	06000	40.778955	-124.1356445	Humboldt County
328507	Ordering, Referring, Prescribing	N/A	1316626344	0	0	HART, BECKY NP	6/23/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025699	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
328550	Ordering, Referring, Prescribing	N/A	1316979396	0	0	HESS, VICKI L LCSW	9/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	95063	N/A	N/A	N/A	N/A	N/A	1850 SPRING RIDGE DR	None	SUSANVILLE	CA	96130	6100	00	06000	40.43814074	-120.6259249	Lassen County
328566	Ordering, Referring, Prescribing	N/A	1326038647	0	0	HARRIS, JEFFREY	7/22/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G156585	N/A	N/A	N/A	N/A	N/A	1530 S. OLIVE STREET	None	LOS ANGELES	CA	90015	0000	00	06000	34.03542552	-118.2652073	Los Angeles County
328575	Ordering, Referring, Prescribing	N/A	1326104944	0	0	HUI, CHEE HO S	6/8/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D40447	N/A	N/A	N/A	N/A	N/A	925 BEVINS CT	None	LAKEPORT	CA	95453	8778	00	06000	39.03772106	-122.9223338	Lake County
328602	Ordering, Referring, Prescribing	N/A	1326137332	0	0	HARVEY-SMITH, SHABREN LCSW	3/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW26344	N/A	N/A	N/A	N/A	N/A	3700 DELTA FAIR BLVD	SUITE 210	ANTIOCH	CA	94509	4075	00	06000	38.0038852	-121.8448833	Contra Costa County
328610	Ordering, Referring, Prescribing	N/A	1326161886	0	0	HOLZMAN, JESSICA	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0598903	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
328673	Ordering, Referring, Prescribing	N/A	1326262999	0	0	HEARTSILL, ROBERT K	10/10/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	21999	N/A	N/A	N/A	N/A	N/A	161 N MILL ST	None	TEHACHAPI	CA	93309	7081	00	06000	35.13410412	-118.4520157	Kern County
328685	Ordering, Referring, Prescribing	N/A	1326296393	0	0	HOIT, JENNIFER L LMFT	3/12/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53571	N/A	N/A	N/A	N/A	N/A	1452 26TH STREET	SUITE 102	SANTA MONICA	CA	90404	3042	00	06000	34.03218119	-118.4730364	Los Angeles County
328693	Ordering, Referring, Prescribing	N/A	1326301227	0	0	HERNANDEZ, HERMINIA PSYD	5/21/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28690	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
328710	Ordering, Referring, Prescribing	N/A	1326317116	0	0	HUNDAL, MANDEEP	8/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55376	N/A	N/A	N/A	N/A	N/A	1334 SARATOGA AVE	None	SAN JOSE	CA	95129	4336	00	06000	37.30015404	-121.982283	Santa Clara County
328716	Ordering, Referring, Prescribing	N/A	1326320748	0	0	HERNANDEZ, ROSIE L LCSW	2/3/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	80820	N/A	N/A	N/A	N/A	N/A	1830 S CENTRAL ST	None	VISALIA	CA	93277	4418	00	06000	36.314271	-119.311362	Tulare County
328743	Ordering, Referring, Prescribing	N/A	1326353657	0	0	HORROCKS, AMANDA J NP	4/17/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	19985	N/A	N/A	N/A	N/A	N/A	9280 WEST STOCKTON BLVD	230	ELK GROVE	CA	95758	8078	00	06000	38.420235	-121.394961	Sacramento County
328754	Ordering, Referring, Prescribing	N/A	1326368572	0	0	HANIF, NOAMAN MD	4/16/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A111544	N/A	N/A	N/A	N/A	N/A	1161 HUNTINGTON DR	None	DUARTE	CA	91010	1314	00	06000	34.13973294	-117.9791926	Los Angeles County
328801	Ordering, Referring, Prescribing	N/A	1326443177	0	0	HECKLAU, AUBREY LMFT	3/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT97502	N/A	N/A	N/A	N/A	N/A	3002 ARMSTRONG ST	None	SAN DIEGO	CA	92111	5702	00	06000	32.80043242	-117.165431	San Diego County
328825	Ordering, Referring, Prescribing	N/A	1326475039	0	0	HOWELL, MIKO L LMFT	8/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86798	N/A	N/A	N/A	N/A	N/A	425 E SANTA CLARA ST	None	SAN JOSE	CA	95113	1936	00	06000	37.34052905	-121.8814851	Santa Clara County
328844	Ordering, Referring, Prescribing	N/A	1326510157	0	0	HAMMONS, MARTHA L LCSW	12/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88084	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	MS5-120	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
328845	Ordering, Referring, Prescribing	N/A	1326508623	0	0	HUTH, MEGAN E	5/14/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86169	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
328847	Ordering, Referring, Prescribing	N/A	1326517244	0	0	HUANG, CANMING PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79659	N/A	N/A	N/A	N/A	N/A	1189 POTRERO AVE	None	SAN FRANCISCO	CA	94110	3520	00	06000	37.75329906	-122.4063227	San Francisco County
328862	Ordering, Referring, Prescribing	N/A	1326544248	0	0	HARRIZ, ROB MD	1/2/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174261	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
328873	Ordering, Referring, Prescribing	N/A	1326568064	0	0	HARLAND, JESSICA PHARMD	8/18/2022	Taxonomy not applicable	NA	n/a	000	Unknown	76372	N/A	N/A	N/A	N/A	N/A	4145 30TH ST	None	SAN DIEGO	CA	92104	1905	00	06000	32.753079	-117.130173	San Diego County
328887	Ordering, Referring, Prescribing	N/A	1326591389	0	0	HERNANDEZ INFAN, ILIANA J	8/8/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	100545	N/A	N/A	N/A	N/A	N/A	9001 S H ST	None	BAKERSFIELD	CA	93307	5948	00	06000	35.27289	-119.0212895	Kern County
328959	Ordering, Referring, Prescribing	N/A	1326740952	0	0	HELT, ALAINA CNP	2/23/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95024409	N/A	N/A	N/A	N/A	N/A	11985 4TH ST	102	YUCAIPA	CA	92399	2727	00	06000	34.035525	-117.0518615	San Bernardino County
328994	Ordering, Referring, Prescribing	N/A	1336176908	0	0	HARDY, BILLIANA N PA-C	2/14/2019	Taxonomy not applicable	NA	n/a	000	Unknown	16289	N/A	N/A	N/A	N/A	N/A	324 N VERMONT AVE	None	DINUBA	CA	93618	1631	00	06000	36.54780049	-119.3894155	Tulare County
329002	Ordering, Referring, Prescribing	N/A	1336207257	0	0	HANSON, HEIDI A LMFT	2/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115474	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE	STE. 101-180	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
329028	Ordering, Referring, Prescribing	N/A	1336266238	0	0	HIROYASU, STUART K OD	3/28/2017	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	10203	N/A	N/A	N/A	N/A	N/A	250 SEE VEE LANE	None	BISHOP	CA	93514	8130	00	06000	37.365066	-118.410912	Inyo County
329060	Ordering, Referring, Prescribing	N/A	1336330273	0	0	HAZBOUN, VIVECA A MD	2/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G34403	N/A	N/A	N/A	N/A	N/A	1224 VINE STREET	None	LOS ANGELES	CA	90038	1612	00	06000	34.093332	-118.326603	Los Angeles County
329069	Ordering, Referring, Prescribing	N/A	1336350768	0	0	HART, MAYA O LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49619	N/A	N/A	N/A	N/A	N/A	1727 MLK JR. WAY	#109	OAKLAND	CA	94612	1358	00	06000	37.80868384	-122.2744362	Alameda County
329073	Ordering, Referring, Prescribing	N/A	1336362680	0	0	HANS, HARBANS S MD	3/2/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	5553A	N/A	N/A	N/A	N/A	N/A	2521 E 15TH STREET	None	CASPER	WY	82609	4126	00	06000	42.834753	-106.2938295	Natrona County
329075	Ordering, Referring, Prescribing	N/A	1336364736	0	0	HARRE, ALISON H LMFT	9/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52375	N/A	N/A	N/A	N/A	N/A	550 WATER STREET	BUILDING L, SUITE 2	SANTA CRUZ	CA	95060	4133	00	06000	36.98046158	-122.018718	Santa Cruz County
329114	Ordering, Referring, Prescribing	N/A	1336428838	0	0	HALL, TAMI S LMFT	1/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT98547	N/A	N/A	N/A	N/A	N/A	2821 H ST	None	BAKERSFIELD	CA	93301	1913	00	06000	35.38560771	-119.0211608	Kern County
329127	Ordering, Referring, Prescribing	N/A	1336459080	0	0	HASHIMOTO, JONATHAN M PHARMD	10/22/2018	Taxonomy not applicable	NA	n/a	000	Unknown	61793	N/A	N/A	N/A	N/A	N/A	2251 W. ROSECRANS AVE	18-21	COMPTON	CA	90222	3858	00	06000	33.90273823	-118.2557598	Los Angeles County
329143	Ordering, Referring, Prescribing	N/A	1336494251	0	0	HY, MONICA C LMFT	8/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90710	N/A	N/A	N/A	N/A	N/A	815 COLORADO BLVD	300	LOS ANGELES	CA	90041	1744	00	06000	34.14042861	-118.1836207	Los Angeles County
329177	Ordering, Referring, Prescribing	N/A	1336532365	0	0	HERRERA, CINDY LMFT	6/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105007	N/A	N/A	N/A	N/A	N/A	1885 LUNDY AVE	233	SAN JOSE	CA	95131	1887	00	06000	37.39329538	-121.8907367	Santa Clara County
329229	Ordering, Referring, Prescribing	N/A	1336595206	0	0	HARALSON, CATHERINE A LCSW	3/6/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19669	N/A	N/A	N/A	N/A	N/A	1465 30TH ST	SUITE K	SAN DIEGO	CA	92154	3497	00	06000	32.72113554	-117.1302118	San Diego County
329235	Ordering, Referring, Prescribing	N/A	1336606250	0	0	HAMLIN, PONEVA V LMFT	8/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121362	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
329246	Ordering, Referring, Prescribing	N/A	1336628577	0	0	HENNING, LINDSEY C OT	5/17/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	18892	N/A	N/A	N/A	N/A	N/A	10431 COMMERCE ST	SUITE A	REDLANDS	CA	92374	0110	00	06000	34.06427678	-117.2416506	San Bernardino County
329253	Ordering, Referring, Prescribing	N/A	1336643667	0	0	HENG, SANDY T PHARMD	11/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78310	N/A	N/A	N/A	N/A	N/A	3550 FRUITVALE AVE	None	OAKLAND	CA	94602	2327	00	06000	37.80135941	-122.2157258	Alameda County
329265	Ordering, Referring, Prescribing	N/A	1336659754	0	0	HODGSON, MACGREGOR J MD	5/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182203	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	1111	00	06000	37.75548534	-122.4065362	San Francisco County
329273	Ordering, Referring, Prescribing	N/A	1336665587	0	0	HO, ELAINE S DO	7/3/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15869	N/A	N/A	N/A	N/A	N/A	570 SOUTH MT. VERNON AVE	#G	SAN BERNARDINO	CA	92410	2737	00	06000	34.090776	-117.3138565	San Bernardino County
329311	Ordering, Referring, Prescribing	N/A	1336736693	0	0	HA, JEFFERSON	7/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH79359	N/A	N/A	N/A	N/A	N/A	1538 E CHAPMAN AVE	None	ORANGE	CA	92866	2231	00	06000	33.78779155	-117.8367795	Orange County
329325	Ordering, Referring, Prescribing	N/A	1336769744	0	0	HUYNH, HIEN E PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81374	N/A	N/A	N/A	N/A	N/A	2025 MORSE AVENUE	None	SACRAMENTO	CA	95825	2115	00	06000	38.602089	-121.3925895	Sacramento County
329335	Ordering, Referring, Prescribing	N/A	1336786367	0	0	HUYNH, MICHELLE PHARMD	12/6/2019	Taxonomy not applicable	NA	n/a	000	Unknown	81589	N/A	N/A	N/A	N/A	N/A	2980 E CAPITOL EXPY	None	SAN JOSE	CA	95148	4247	00	06000	37.33024428	-121.8119226	Santa Clara County
329338	Ordering, Referring, Prescribing	N/A	1336792795	0	0	HINKLE, FRANCES I NP	6/26/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012014	N/A	N/A	N/A	N/A	N/A	347 W MISSION AVE	None	ESCONDIDO	CA	92025	1729	00	06000	33.12861918	-117.0906689	San Diego County
329353	Ordering, Referring, Prescribing	N/A	1336860568	0	0	HUYNH, KRISTY T PHARMD	7/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86282	N/A	N/A	N/A	N/A	N/A	2345 FENTON PKWY	None	SAN DIEGO	CA	92108	4743	00	06000	32.782482	-117.1285875	San Diego County
329364	Ordering, Referring, Prescribing	N/A	1336923580	0	0	HAW, ZULEIKA OT	4/15/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	10286	N/A	N/A	N/A	N/A	N/A	3364 BEYER BLVD	SUITE 102-193	SAN YSIDRO	CA	92173	1322	00	06000	32.56624454	-117.0611925	San Diego County
329365	Ordering, Referring, Prescribing	N/A	1336899376	0	0	HARIS, NATASHA	5/9/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A190938	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
329366	Ordering, Referring, Prescribing	N/A	1336926039	0	0	HIGGINBOTHAM, KAREN RN MA	10/4/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RN95076519	N/A	N/A	N/A	N/A	N/A	12220 ROAD 36	None	MADERA	CA	93636	8405	00	06000	36.926154	-119.8991745	Madera County
329381	Ordering, Referring, Prescribing	N/A	1346054350	0	0	HUANG, HSIN CHENG LAC	10/23/2024	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC20209	N/A	N/A	N/A	N/A	N/A	229 7TH ST	None	SAN FRANCISCO	CA	94103	4003	00	06000	37.77745513	-122.4086852	San Francisco County
329390	Ordering, Referring, Prescribing	N/A	1346222734	0	0	HILTY, DONALD M MD	11/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G75437	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
329396	Ordering, Referring, Prescribing	N/A	1346262672	0	0	HUNTINGTON, ALISA LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT36959	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
329459	Ordering, Referring, Prescribing	N/A	1346383304	0	0	HARRIS, TODD A LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT41677	N/A	N/A	N/A	N/A	N/A	556 COHASSET RD	None	CHICO	CA	95926	2212	00	06000	39.75165002	-121.8485826	Butte County
329471	Ordering, Referring, Prescribing	N/A	1346406824	0	0	HALL, JANE P	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT50808	N/A	N/A	N/A	N/A	N/A	1212 N. CALIFORNIA STREE	None	STOCKTON	CA	95202	0000	00	06000	37.96681769	-121.2881382	San Joaquin County
329514	Ordering, Referring, Prescribing	N/A	1346515566	0	0	HESS, MARY H LMFT	1/10/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139879	N/A	N/A	N/A	N/A	N/A	365 KUCK LN	None	PETALUMA	CA	94952	9606	00	06000	38.25757751	-122.7132072	Sonoma County
329532	Ordering, Referring, Prescribing	N/A	1346540135	0	0	HASHEMIAN, SHADI PHARMD	8/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	48925	N/A	N/A	N/A	N/A	N/A	21181 NEWPORT COAST DR	None	NEWPORT BEACH	CA	92657	1123	00	06000	33.60637856	-117.8269899	Orange County
329600	Ordering, Referring, Prescribing	N/A	1346641149	0	0	HO, DAVID M LCSW	12/4/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW87260	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
329603	Ordering, Referring, Prescribing	N/A	1346648458	0	0	HERNANDEZ, JUAN M LMFT	8/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121271	N/A	N/A	N/A	N/A	N/A	2719 N AIR FRESNO DR	None	FRESNO	CA	93727	1547	00	06000	36.77448139	-119.7281325	Fresno County
329623	Ordering, Referring, Prescribing	N/A	1346667193	0	0	HOLLEY, ERIN E PSYD	12/14/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29161	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
329641	Ordering, Referring, Prescribing	N/A	1346702503	0	0	HORN, MEGAN F NP	2/2/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011483	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
329648	Ordering, Referring, Prescribing	N/A	1346716966	0	0	HODGSON, HILLARY LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52966	N/A	N/A	N/A	N/A	N/A	867 N FAIR OAKS AVE	None	PASADENA	CA	91103	3050	00	06000	34.160877	-118.1506375	Los Angeles County
329661	Ordering, Referring, Prescribing	N/A	1346732328	0	0	HOANG, DEBBIE PA-C	7/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59767	N/A	N/A	N/A	N/A	N/A	201 E LAKEVIEW AVE	None	WOODLAKE	CA	93286	1301	00	06000	36.4172997	-119.0975768	Tulare County
329667	Ordering, Referring, Prescribing	N/A	1346736089	0	0	HARTSOCK, EUNICE P NP	7/3/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009376	N/A	N/A	N/A	N/A	N/A	210 N CHESTER AVE	None	BAKERSFIELD	CA	93308	4841	00	06000	35.407179	-119.0208925	Kern County
329675	Ordering, Referring, Prescribing	N/A	1346758604	0	0	HOANG, TRINH T PHARMD	3/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	78069	N/A	N/A	N/A	N/A	N/A	247 E 18TH ST	None	OAKLAND	CA	94606	1728	00	06000	37.80002661	-122.2529701	Alameda County
329697	Ordering, Referring, Prescribing	N/A	1346793361	0	0	HEBERT, MARY A LCSW	1/27/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW106668	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
329701	Ordering, Referring, Prescribing	N/A	1346801479	0	0	HABERMAN, PAIGE V AU	7/2/2019	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	AU3424	N/A	N/A	N/A	N/A	N/A	2415 HIGH SCHOOL AVE	#300	CONCORD	CA	94520	1800	00	06000	37.98481374	-122.0347555	Contra Costa County
329716	Ordering, Referring, Prescribing	N/A	1346832896	0	0	HOM, KEVIN PHARMD	4/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	87917	N/A	N/A	N/A	N/A	N/A	2203 MISSION ST	None	SANTA CRUZ	CA	95060	5221	00	06000	36.9619042	-122.0454945	Santa Cruz County
329718	Ordering, Referring, Prescribing	N/A	1346849007	0	0	HAWARA, JANESSA J PA-C	10/5/2020	Taxonomy not applicable	NA	n/a	000	Unknown	58619	N/A	N/A	N/A	N/A	N/A	12100 VALLEY BLVD ST	109A	EL MONTE	CA	91732	3161	00	06000	34.06130355	-118.0164048	Los Angeles County
329722	Ordering, Referring, Prescribing	N/A	1346837143	0	0	HERRERA, MARGARITA LPCC	7/20/2024	Taxonomy not applicable	NA	n/a	000	Unknown	17009	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
329738	Ordering, Referring, Prescribing	N/A	1346891314	0	0	HO, JEFF PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80858	N/A	N/A	N/A	N/A	N/A	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	0000	00	06000	37.23948065	-121.8005798	Santa Clara County
329742	Ordering, Referring, Prescribing	N/A	1346904935	0	0	HOANG, KATHY T OD	10/11/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT35047	N/A	N/A	N/A	N/A	N/A	25982 PALA	SUITE 270	MISSION VIEJO	CA	92691	4106	00	06000	33.61983904	-117.6772494	Orange County
329751	Ordering, Referring, Prescribing	N/A	1346912441	0	0	HOANG, PATRICK	8/30/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84572	N/A	N/A	N/A	N/A	N/A	2811 MIDDLEFIELD RD	None	PALO ALTO	CA	94306	2522	00	06000	37.43244792	-122.1277424	Santa Clara County
329752	Ordering, Referring, Prescribing	N/A	1346924172	0	0	HOWARD, FELIX	8/3/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026476	N/A	N/A	N/A	N/A	N/A	5385 FRANKLIN BLVD	None	SACRAMENTO	CA	95820	4756	00	06000	38.526282	-121.471398	Sacramento County
329807	Ordering, Referring, Prescribing	N/A	1356170112	0	0	HAMANN, CLAIRE NP	7/29/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031380	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
329809	Ordering, Referring, Prescribing	N/A	1356171474	0	0	HILL, ASHLEY NP	7/31/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95031411	N/A	N/A	N/A	N/A	N/A	1035 PLACER ST	STE 110	REDDING	CA	96001	1171	00	06000	40.58349378	-122.3853903	Shasta County
329828	Ordering, Referring, Prescribing	N/A	1356385124	0	0	HAYDEN, LYNN E CNM	9/26/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	7589	N/A	N/A	N/A	N/A	N/A	1700 W HILLSDALE BLVD	None	SAN MATEO	CA	94402	3757	00	06000	37.53183837	-122.3352514	San Mateo County
329837	Ordering, Referring, Prescribing	N/A	1356409668	0	0	HODGENS, CRISELDA T	4/11/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D43169	N/A	N/A	N/A	N/A	N/A	204 E BEACH ST	None	WATSONVILLE	CA	95076	4809	00	06000	36.91224802	-121.7541363	Santa Cruz County
329854	Ordering, Referring, Prescribing	N/A	1356458616	0	0	HLA, NI NI MD	11/21/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A94426	N/A	N/A	N/A	N/A	N/A	2180 HARVARD STREET	210	SACRAMENTO	CA	95815	3318	00	06000	38.60568	-121.4345385	Sacramento County
329857	Ordering, Referring, Prescribing	N/A	1356457550	0	0	HURLEY, ADRIENNE PA	5/24/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA16117	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
329878	Ordering, Referring, Prescribing	N/A	1356511653	0	0	HEISLER, CHERYL B LMFT	4/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77369	N/A	N/A	N/A	N/A	N/A	802 BREWSTER AVE	None	REDWOOD CITY	CA	94063	1510	00	06000	37.48873991	-122.2339433	San Mateo County
329881	Ordering, Referring, Prescribing	N/A	1356520019	0	0	HUSAINI, ZAHA MD	11/25/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A101411	N/A	N/A	N/A	N/A	N/A	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	0001	00	06000	37.30176	-121.9136465	Santa Clara County
329891	Ordering, Referring, Prescribing	N/A	1356550453	0	0	HEATH, ROBERT J LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47413	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
329908	Ordering, Referring, Prescribing	N/A	1356582431	0	0	HAWKINS, SHAVON L PA	6/13/2023	Taxonomy not applicable	NA	n/a	000	Unknown	14585	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
329952	Ordering, Referring, Prescribing	N/A	1356649545	0	0	HALVERSEN, LAURIE K LCSW	7/30/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26339	N/A	N/A	N/A	N/A	N/A	15230 LAKESHORE DR	None	CLEARLAKE	CA	95422	8107	00	06000	38.95005226	-122.6264492	Lake County
329959	Ordering, Referring, Prescribing	N/A	1356665178	0	0	HERRERA, PERLA E LMFT	3/16/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT92042	N/A	N/A	N/A	N/A	N/A	84 E J ST	None	CHULA VISTA	CA	91910	6115	00	06000	32.6320024	-117.0582826	San Diego County
330037	Ordering, Referring, Prescribing	N/A	1356781017	0	0	HOLMES, LOUIS S MD	5/5/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146082	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL, SUITE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
330067	Ordering, Referring, Prescribing	N/A	1356822365	0	0	HOANG, AMBER R LCSW	12/1/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	105877	N/A	N/A	N/A	N/A	N/A	679 S NEW HAMPSHIRE AVE	SUITE 400	LOS ANGELES	CA	90005	1355	00	06000	34.06107902	-118.2929191	Los Angeles County
330073	Ordering, Referring, Prescribing	N/A	1356833412	0	0	HUGHES, MICHELE L LPCC	3/20/2023	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC13453	N/A	N/A	N/A	N/A	N/A	500 CROWN POINT CIR	STE 120	GRASS VALLEY	CA	95945	9561	00	06000	39.22028885	-121.0316663	Nevada County
330088	Ordering, Referring, Prescribing	N/A	1356877377	0	0	HSIEH, AN CHIH MD	1/17/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A171316	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
330090	Ordering, Referring, Prescribing	N/A	1356872824	0	0	HICKMAN, NORVAL PHD	1/6/2024	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY24866	N/A	N/A	N/A	N/A	N/A	175 E PROSPECT AVE	SUITE 210A	DANVILLE	CA	94526	3867	00	06000	37.82236229	-121.9988311	Contra Costa County
330151	Ordering, Referring, Prescribing	N/A	1356986574	0	0	HARDY, ALAYA M NP	1/28/2025	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95033738	N/A	N/A	N/A	N/A	N/A	201 29TH ST	SUITE B	SACRAMENTO	CA	95816	3482	00	06000	38.581875	-121.463802	Sacramento County
330170	Ordering, Referring, Prescribing	N/A	1366029951	0	0	HERNANDEZ SANTIAGO, LAURA MD	3/19/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A194802	N/A	N/A	N/A	N/A	N/A	335 EAST AVENUE I	None	LANCASTER	CA	93535	0000	00	06000	34.7041113	-118.1247548	Los Angeles County
330181	Ordering, Referring, Prescribing	N/A	1366058836	0	0	HALIM, RAMSEY G PHARMD	9/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83173	N/A	N/A	N/A	N/A	N/A	4333 SOUTH ST	None	LAKEWOOD	CA	90712	1184	00	06000	33.86046642	-118.1410856	Los Angeles County
330209	Ordering, Referring, Prescribing	N/A	1366117426	0	0	HUANG, KAREN NP	12/18/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014239	N/A	N/A	N/A	N/A	N/A	2574 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1505	00	06000	37.72907852	-122.4042585	San Francisco County
330211	Ordering, Referring, Prescribing	N/A	1366104275	0	0	HILLMAN, JORDAN R LCSW	1/21/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	128226	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
330217	Ordering, Referring, Prescribing	N/A	1366168031	0	0	HOWARD, NATHANIEL C NP	10/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022999	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
330254	Ordering, Referring, Prescribing	N/A	1366452146	0	0	HARTNETT, JOHN M MD	9/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72166	N/A	N/A	N/A	N/A	N/A	925 S ELISEO DR	None	GREENBRAE	CA	94904	2142	00	06000	37.94347832	-122.5327745	Marin County
330285	Ordering, Referring, Prescribing	N/A	1366571184	0	0	HUEZO-MESHACK, SHERYL D LCSW	11/13/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88015	N/A	N/A	N/A	N/A	N/A	13130 BURBANK BLVD.	None	VAN NUYS	CA	91401	6037	00	06000	34.17210778	-118.4192552	Los Angeles County
330289	Ordering, Referring, Prescribing	N/A	1366579138	0	0	HALLIWELL, MEHERA MD	12/21/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A90555	N/A	N/A	N/A	N/A	N/A	66 HURLBUT ST	None	PASADENA	CA	91105	4025	00	06000	34.12993251	-118.1516625	Los Angeles County
330299	Ordering, Referring, Prescribing	N/A	1366601742	0	0	HENRY, MARITZA G LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT38496	N/A	N/A	N/A	N/A	N/A	375 CAMBRIDGE AVE	None	PALO ALTO	CA	94306	1603	00	06000	37.42750116	-122.1451628	Santa Clara County
330327	Ordering, Referring, Prescribing	N/A	1366659625	0	0	HAYATSHAHI, ALIREZA PHARMD	9/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH70611	N/A	N/A	N/A	N/A	N/A	11234 ANDERSON ST	6300	LOMA LINDA	CA	92354	2804	00	06000	34.049547	-117.264078	San Bernardino County
330343	Ordering, Referring, Prescribing	N/A	1366707721	0	0	HAN, SILVIA OD FAAO	10/14/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	14569	N/A	N/A	N/A	N/A	N/A	5460 E. LA PALMA AVE	None	ANAHEIM	CA	92807	2023	00	06000	33.85983003	-117.7966383	Orange County
330373	Ordering, Referring, Prescribing	N/A	1366755001	0	0	HWANG, ALEXIS DDS	6/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60726	N/A	N/A	N/A	N/A	N/A	1625 E 4TH ST	None	LOS ANGELES	CA	90033	4201	00	06000	34.04297786	-118.2220181	Los Angeles County
330379	Ordering, Referring, Prescribing	N/A	1366779183	0	0	HONMA, KRISTEN J LCSW	6/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29708	N/A	N/A	N/A	N/A	N/A	1309 EVANS AVE	None	SAN FRANCISCO	CA	94124	1705	00	06000	37.74005234	-122.3834106	San Francisco County
330393	Ordering, Referring, Prescribing	N/A	1366798530	0	0	HATLAVONGSA, KONGSAB L	10/28/2015	Taxonomy not applicable	NA	n/a	099	DENTIST	D61581	N/A	N/A	N/A	N/A	N/A	445 11TH ST	None	ORANGE COVE	CA	93646	2211	00	06000	36.62723052	-119.319103	Fresno County
330416	Ordering, Referring, Prescribing	N/A	1366832032	0	0	HSI, ANDY MD	3/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149487	N/A	N/A	N/A	N/A	N/A	2420 SAMARITAN DRIVE	None	SAN JOSE	CA	95124	3907	00	06000	37.25107191	-121.946105	Santa Clara County
330423	Ordering, Referring, Prescribing	N/A	1366843849	0	0	HILL-GAUER, SHANTI	11/21/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74070	N/A	N/A	N/A	N/A	N/A	3696 BURNSIDE ROAD	None	SEBASTOPOL	CA	95472	9141	00	06000	38.35973254	-122.8745703	Sonoma County
330433	Ordering, Referring, Prescribing	N/A	1366849085	0	0	HERNANDEZ, DEVANNE A LMFT	3/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98249	N/A	N/A	N/A	N/A	N/A	1500 S. OLIVE ST	None	LOS ANGELES	CA	90015	3023	00	06000	34.03568676	-118.2649769	Los Angeles County
330439	Ordering, Referring, Prescribing	N/A	1366866816	0	0	HSIEH, ANNIE PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70172	N/A	N/A	N/A	N/A	N/A	11121 SIERRA AVE	None	FONTANA	CA	92337	9310	00	06000	34.05159204	-117.4353952	San Bernardino County
330442	Ordering, Referring, Prescribing	N/A	1366861692	0	0	HANZO, JESSICA K LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116100	N/A	N/A	N/A	N/A	N/A	1266 14TH ST	None	OAKLAND	CA	94607	2247	00	06000	37.81022696	-122.2887619	Alameda County
330493	Ordering, Referring, Prescribing	N/A	1366951105	0	0	HAYDEN-WADE, HELEN A PHD	2/2/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY19313	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
330525	Ordering, Referring, Prescribing	N/A	1376000646	0	0	HAYNES, SYDNEY D LCSW	9/16/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW104076	N/A	N/A	N/A	N/A	N/A	77 WALNUT WAY	None	WILLOW CREEK	CA	95573	0724	00	06000	40.93992144	-123.6272255	Humboldt County
330543	Ordering, Referring, Prescribing	N/A	1376034512	0	0	HUYNH, CATHY PHARMD	10/2/2018	Taxonomy not applicable	NA	n/a	000	Unknown	64251	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	None	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
330605	Ordering, Referring, Prescribing	N/A	1376162651	0	0	HUA, JEFFREY C PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82830	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	None	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
330617	Ordering, Referring, Prescribing	N/A	1376176487	0	0	HERNANDEZ, DIANA MSW LCSW	3/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94380	N/A	N/A	N/A	N/A	N/A	1436 GOODRICH BLVD	None	COMMERCE	CA	90022	5111	00	06000	34.01117577	-118.1585527	Los Angeles County
330626	Ordering, Referring, Prescribing	N/A	1376193409	0	0	HULTS, AMANDA	2/3/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130972	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
330640	Ordering, Referring, Prescribing	N/A	1376262873	0	0	HEIKALI, DONNA PHARMD	8/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86487	N/A	N/A	N/A	N/A	N/A	795 E. 2ND ST	SUITE 1 AND 5	POMONA	CA	91766	1854	00	06000	34.05845654	-117.7423951	Los Angeles County
330642	Ordering, Referring, Prescribing	N/A	1376178715	0	0	HUNDESSA, JODDI LCSW	6/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95046	N/A	N/A	N/A	N/A	N/A	3870 CRENSHAW BLVD	212	LOS ANGELES	CA	90008	1837	00	06000	34.0152336	-118.3348463	Los Angeles County
330657	Ordering, Referring, Prescribing	N/A	1376389452	0	0	HUDSON, HALEY NP	6/28/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030833	N/A	N/A	N/A	N/A	N/A	6500 MORRO RD # D, ATASC	None	ATASCADERO	CA	93422	2401	00	06000	35.48339222	-120.6656707	San Luis Obispo County
330681	Ordering, Referring, Prescribing	N/A	1376620187	0	0	HERNANDEZ, JENNIFER B LCSW	4/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24097	N/A	N/A	N/A	N/A	N/A	2311 EL SEGUNDO BLVD	None	HAWTHORNE	CA	90250	0000	00	06000	33.91647947	-118.3189815	Los Angeles County
330754	Ordering, Referring, Prescribing	N/A	1376771469	0	0	HOTTINGER, COURTNEY L LMFT	3/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	81802	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
330769	Ordering, Referring, Prescribing	N/A	1376800391	0	0	HANSEN, NATHAN M	1/17/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D62370	N/A	N/A	N/A	N/A	N/A	3701 J ST	STE 201	SACRAMENTO	CA	95816	5542	00	06000	38.571237	-121.4566245	Sacramento County
330778	Ordering, Referring, Prescribing	N/A	1376823906	0	0	HOFFMAN, AI PHARMD	8/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63475	N/A	N/A	N/A	N/A	N/A	331 N PACIFIC COAST HWY	None	EL SEGUNDO	CA	90245	4444	00	06000	33.92058735	-118.39638	Los Angeles County
330780	Ordering, Referring, Prescribing	N/A	1376824128	0	0	HERNANDEZ-MIRANDA, OSCAR	5/2/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88857	N/A	N/A	N/A	N/A	N/A	204 E BEACH ST	None	WATSONVILLE	CA	95076	4809	00	06000	36.91224802	-121.7541363	Santa Cruz County
330812	Ordering, Referring, Prescribing	N/A	1376880716	0	0	HERNANDEZ, LEONEL LMFT	5/30/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102621	N/A	N/A	N/A	N/A	N/A	560 S ST LOUIS ST	None	LOS ANGELES	CA	90033	4320	00	06000	34.03924138	-118.2172475	Los Angeles County
330838	Ordering, Referring, Prescribing	N/A	1376924027	0	0	HAWS, REBEKAH LCSW	11/30/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127513	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
330841	Ordering, Referring, Prescribing	N/A	1376925479	0	0	HEARNS-RIVAS, MARIA M PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72546	N/A	N/A	N/A	N/A	N/A	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
330873	Ordering, Referring, Prescribing	N/A	1376944751	0	0	HU, VERA PHARMD	1/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	71092	N/A	N/A	N/A	N/A	N/A	130 W FOOTHILL BLVD	None	MONROVIA	CA	91016	2607	00	06000	34.1512797	-118.0022275	Los Angeles County
330876	Ordering, Referring, Prescribing	N/A	1376976944	0	0	HARRISON, LAWRENCE V MD	10/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A23034	N/A	N/A	N/A	N/A	N/A	40925 COUNTY CENTER DR	200	TEMECULA	CA	92591	6054	00	06000	33.52802214	-117.1605544	Riverside County
330898	Ordering, Referring, Prescribing	N/A	1386001188	0	0	HUYNH, MARY C PHARMD	10/1/2018	Taxonomy not applicable	NA	n/a	000	Unknown	62699	N/A	N/A	N/A	N/A	N/A	751 S BASCOM AVE	None	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
330930	Ordering, Referring, Prescribing	N/A	1386052686	0	0	HILP, LESLEY LMFT	6/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115706	N/A	N/A	N/A	N/A	N/A	1450 CIVIC CT	SUITE 200	CONCORD	CA	94520	5295	00	06000	37.9718675	-122.0496338	Contra Costa County
330935	Ordering, Referring, Prescribing	N/A	1386053999	0	0	HOSSEINI, HOUTAN A DDS	1/2/2024	Taxonomy not applicable	NA	n/a	000	Unknown	DDS41923	N/A	N/A	N/A	N/A	N/A	625 34TH ST	STE 100 & 200	BAKERSFIELD	CA	93301	2307	00	06000	35.39046051	-119.0092725	Kern County
330942	Ordering, Referring, Prescribing	N/A	1386062248	0	0	HA, LOAN T NP	5/21/2017	Taxonomy not applicable	NA	n/a	000	Unknown	95000268	N/A	N/A	N/A	N/A	N/A	1 HOPE DRIVE	None	TUSTIN	CA	92782	0221	00	06000	33.71470753	-117.8323965	Orange County
330965	Ordering, Referring, Prescribing	N/A	1386098804	0	0	HUSAINI, SYED S	3/18/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A171716	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
330968	Ordering, Referring, Prescribing	N/A	1386108090	0	0	HUNT, BRYAN M PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	80201	N/A	N/A	N/A	N/A	N/A	4129 18TH ST	None	SAN FRANCISCO	CA	94114	2407	00	06000	37.7608252	-122.4356669	San Francisco County
330981	Ordering, Referring, Prescribing	N/A	1386129690	0	0	HORMOZIAN, MICHELLE PHARMD	1/20/2019	Taxonomy not applicable	NA	n/a	000	Unknown	79358	N/A	N/A	N/A	N/A	N/A	1510 SAN PABLO ST	STE. 144	LOS ANGELES	CA	90033	5320	00	06000	34.06287152	-118.2029433	Los Angeles County
331010	Ordering, Referring, Prescribing	N/A	1386171106	0	0	HWANG, BOHYE S MD	9/16/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158825	N/A	N/A	N/A	N/A	N/A	308 NORTH LA CADENA DRIV	None	COLTON	CA	92324	2946	00	06000	34.06815282	-117.3240225	San Bernardino County
331013	Ordering, Referring, Prescribing	N/A	1386170637	0	0	HER, YOU LCSW	2/23/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113826	N/A	N/A	N/A	N/A	N/A	480 E 13TH ST	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
331017	Ordering, Referring, Prescribing	N/A	1386175941	0	0	HONG, CHRISTOPHER J DO	7/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18408	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	#53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
331093	Ordering, Referring, Prescribing	N/A	1386321172	0	0	HERRERA GUZMAN, VIVIANA	1/28/2024	Taxonomy not applicable	NA	n/a	000	Unknown	729555	N/A	N/A	N/A	N/A	N/A	2635 ZANKER RD	None	SAN JOSE	CA	95134	2107	00	06000	37.38911415	-121.9253145	Santa Clara County
331099	Ordering, Referring, Prescribing	N/A	1386365856	0	0	HUYNH, ANA PHARMD	8/19/2022	Taxonomy not applicable	NA	n/a	000	Unknown	86553	N/A	N/A	N/A	N/A	N/A	155 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3005	00	06000	34.13579917	-118.1534676	Los Angeles County
331142	Ordering, Referring, Prescribing	N/A	1386637643	0	0	HERSHEY-WEBER, JEANNE K NP	4/29/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	394917	N/A	N/A	N/A	N/A	N/A	3743 S. LA BREA AVE.	None	LOS ANGELES	CA	90016	5309	00	06000	34.01991	-118.355626	Los Angeles County
331157	Ordering, Referring, Prescribing	N/A	1386706927	0	0	HARRISON, ARI J MD	5/27/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A69637	N/A	N/A	N/A	N/A	N/A	2235 CHALLENGER WAY	None	SANTA ROSA	CA	95407	5458	00	06000	38.425491	-122.7519	Sonoma County
331188	Ordering, Referring, Prescribing	N/A	1386772473	0	0	HUNTER, JANICE S LMFT	4/11/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133145	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
331272	Ordering, Referring, Prescribing	N/A	1386940807	0	0	HAMMER, KAITLYN T LMFT	1/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	80217	N/A	N/A	N/A	N/A	N/A	10929 SOUTH STREET	SUITE 208 B	CERRITOS	CA	90703	5368	00	06000	33.85836353	-118.101204	Los Angeles County
331298	Ordering, Referring, Prescribing	N/A	1386991669	0	0	HIRSCHBERG, AMANDA O LMFT	12/7/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51811	N/A	N/A	N/A	N/A	N/A	15305 RAYEN ST	None	NORTH HILLS	CA	91343	5117	00	06000	34.23191048	-118.4657625	Los Angeles County
331324	Ordering, Referring, Prescribing	N/A	1396026035	0	0	HABRE, MICHEL E LMFT	3/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113215	N/A	N/A	N/A	N/A	N/A	4545 N WEST AVE	None	FRESNO	CA	93705	0946	00	06000	36.799623	-119.8264355	Fresno County
331346	Ordering, Referring, Prescribing	N/A	1396056651	0	0	HOANG, ANTON L	12/6/2021	Taxonomy not applicable	NA	n/a	099	DENTIST	106873	N/A	N/A	N/A	N/A	N/A	355 CENTRAL AVE	None	FILLMORE	CA	93015	1920	00	06000	34.40028802	-118.9137057	Ventura County
331356	Ordering, Referring, Prescribing	N/A	1396093852	0	0	HUNT, JOSIE A PA-C	1/23/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA52607	N/A	N/A	N/A	N/A	N/A	2201 COURAGE DR	None	FAIRFIELD	CA	94533	6733	00	06000	38.23727106	-122.0692856	Solano County
331392	Ordering, Referring, Prescribing	N/A	1396154217	0	0	HALL, ELIZABETH M LCSW	3/16/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89166	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
331401	Ordering, Referring, Prescribing	N/A	1396162335	0	0	HENRY, JANELLE NP	7/18/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95006414	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
331409	Ordering, Referring, Prescribing	N/A	1396170759	0	0	HURLEY-KIM, KERI K PHARMD	11/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69396	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
331422	Ordering, Referring, Prescribing	N/A	1396185955	0	0	HIGGINS, AMY M LCSW	11/19/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	72284	N/A	N/A	N/A	N/A	N/A	11565 LAUREL CANYON BLVD	116	SAN FERNANDO	CA	91340	4168	00	06000	34.28018218	-118.4549135	Los Angeles County
331440	Ordering, Referring, Prescribing	N/A	1396206819	0	0	HSIEH, HOWARD PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77140	N/A	N/A	N/A	N/A	N/A	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
331460	Ordering, Referring, Prescribing	N/A	1396249371	0	0	HA, BARBARA MD	5/5/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163935	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
331468	Ordering, Referring, Prescribing	N/A	1396254777	0	0	HWANG, IRENE PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77034	N/A	N/A	N/A	N/A	N/A	3555 WHIPPLE RD	None	UNION CITY	CA	94587	1507	00	06000	37.60574038	-122.0836254	Alameda County
331543	Ordering, Referring, Prescribing	N/A	1396382313	0	0	HICKMAN, RUTH E NP	2/20/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	7055	N/A	N/A	N/A	N/A	N/A	3364 BEYER BLVD	SUITE 102-103	SAN YSIDRO	CA	92173	1322	00	06000	32.56624454	-117.0611925	San Diego County
331547	Ordering, Referring, Prescribing	N/A	1396382487	0	0	HUYNH, QUYNH THU T PHARMD	11/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81071	N/A	N/A	N/A	N/A	N/A	6951 EL CAMINO REAL	None	CARLSBAD	CA	92009	4146	00	06000	33.10361009	-117.2668384	San Diego County
331564	Ordering, Referring, Prescribing	N/A	1396430278	0	0	HUI, KINGSLEY K PA-C	4/4/2023	Taxonomy not applicable	NA	n/a	000	Unknown	62584	N/A	N/A	N/A	N/A	N/A	117 N SAN MATEO DR	NO. 1	SAN MATEO	CA	94401	2793	00	06000	37.56866767	-122.3286434	San Mateo County
331569	Ordering, Referring, Prescribing	N/A	1396435335	0	0	HAJI RASOOLI, MOHAMMAD CNP	5/11/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025153	N/A	N/A	N/A	N/A	N/A	1045 R ST	None	FRESNO	CA	93721	1312	00	06000	36.74038639	-119.7827527	Fresno County
331571	Ordering, Referring, Prescribing	N/A	1396464921	0	0	HOLLIDAY, SHELBY A	3/24/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024714	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
331605	Ordering, Referring, Prescribing	N/A	1396749230	0	0	HALCZAK, ROXANNE LCSW	8/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20799	N/A	N/A	N/A	N/A	N/A	720 WOOD ST	None	EUREKA	CA	95501	0714	00	06000	40.78118068	-124.1607622	Humboldt County
331610	Ordering, Referring, Prescribing	N/A	1396762936	0	0	HAMMER, HALI	12/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A55867	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL ST	None	SAN FRANCISCO	CA	94110	1390	00	06000	37.76460716	-122.416335	San Francisco County
331616	Ordering, Referring, Prescribing	N/A	1396796058	0	0	HOUPT, WAYNE E MD	6/17/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A45153	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
331626	Ordering, Referring, Prescribing	N/A	1396819686	0	0	HERZMARK, NICHOLAS	9/27/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	31852	N/A	N/A	N/A	N/A	N/A	227 MARIN ST	None	SAN RAFAEL	CA	94901	3713	00	06000	37.96962972	-122.5348832	Marin County
331628	Ordering, Referring, Prescribing	N/A	1396827671	0	0	HOWARD, DOUGLAS A DC	9/18/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC30296	N/A	N/A	N/A	N/A	N/A	6100 REDWOOD BLVD	None	NOVATO	CA	94945	4501	00	06000	38.09578333	-122.5627508	Marin County
331635	Ordering, Referring, Prescribing	N/A	1396835161	0	0	HUANG, BEATRICE Y	2/9/1999	Taxonomy not applicable	NA	n/a	099	DENTIST	D42055	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
331642	Ordering, Referring, Prescribing	N/A	1396855540	0	0	HOSKINS, DAVID PSYD	6/17/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27403	N/A	N/A	N/A	N/A	N/A	380 MARTIN LUTHER KING J	None	OAKLAND	CA	94607	3572	00	06000	37.79912588	-122.2802959	Alameda County
331654	Ordering, Referring, Prescribing	N/A	1396863676	0	0	HERNANDEZ, NANCY LCSW	3/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	85203	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
331677	Ordering, Referring, Prescribing	N/A	1396889846	0	0	HERNANDEZ, VICTOR LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51129	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
331710	Ordering, Referring, Prescribing	N/A	1396977278	0	0	HOYE, AUBREY J DO	7/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A15751	N/A	N/A	N/A	N/A	N/A	2170 SOUTH AVE	None	SOUTH LAKE TAHOE	CA	96150	7026	00	06000	38.91229842	-119.9978133	El Dorado County
331726	Ordering, Referring, Prescribing	N/A	1407002157	0	0	HSYEH, HSIANGFENG LMFT	2/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53246	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
331755	Ordering, Referring, Prescribing	N/A	1407084502	0	0	HELMING, HEATHER L DO	1/22/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A11800	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
331770	Ordering, Referring, Prescribing	N/A	1407116007	0	0	HAMILTON, JESSICA W	12/31/2013	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A00123206	N/A	N/A	N/A	N/A	N/A	8480 ENTERPRISE WAY	None	OAKLAND	CA	94621	0000	00	06000	37.74207882	-122.1925503	Alameda County
331787	Ordering, Referring, Prescribing	N/A	1407156896	0	0	HO, NHA K PHARMD	4/5/2018	Taxonomy not applicable	NA	n/a	000	Unknown	52277	N/A	N/A	N/A	N/A	N/A	1221 SOUTH GAFFEY ST	None	SAN PEDRO	CA	90731	4014	00	06000	33.732882	-118.292398	Los Angeles County
331790	Ordering, Referring, Prescribing	N/A	1407156037	0	0	HAAS, GREGORY S PHARMD	3/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH61951	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
331803	Ordering, Referring, Prescribing	N/A	1407193782	0	0	HARPER, CINNAMON LCSW	12/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99113	N/A	N/A	N/A	N/A	N/A	333 H ST	SUITE 3010	CHULA VISTA	CA	91910	5555	00	06000	32.63411233	-117.0783636	San Diego County
331829	Ordering, Referring, Prescribing	N/A	1407237498	0	0	HERRERA, NATALIE K PA-C	5/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA52564	N/A	N/A	N/A	N/A	N/A	16465 SIERRA LAKES PKWY	300	FONTANA	CA	92336	1242	00	06000	34.13805177	-117.4457839	San Bernardino County
331845	Ordering, Referring, Prescribing	N/A	1407262876	0	0	HUANG, CHYUN Y MD	3/8/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176780	N/A	N/A	N/A	N/A	N/A	1345 A PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3159	00	06000	40.43531297	-120.6557201	Lassen County
331847	Ordering, Referring, Prescribing	N/A	1407272388	0	0	HASSAN, DEENA M MD	11/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A137857	N/A	N/A	N/A	N/A	N/A	529 S. MAPLE AVE	None	LOS ANGELES	CA	90013	1511	00	06000	34.04465262	-118.2472846	Los Angeles County
331863	Ordering, Referring, Prescribing	N/A	1407296619	0	0	HOOVER, NATALIE LCSW	12/13/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112591	N/A	N/A	N/A	N/A	N/A	265 SAN JACINTO RIVER RD	None	LAKE ELSINORE	CA	92530	4419	00	06000	33.66201142	-117.3001906	Riverside County
331867	Ordering, Referring, Prescribing	N/A	1407301690	0	0	HAJJA, SHATHA MD	11/27/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159695	N/A	N/A	N/A	N/A	N/A	821 TEXAS AVE	None	LOS BANOS	CA	93635	3453	00	06000	37.06376226	-120.860675	Merced County
331872	Ordering, Referring, Prescribing	N/A	1407303175	0	0	HOFFMAN, DANIEL S	3/6/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	100577	N/A	N/A	N/A	N/A	N/A	480 1ST AVE	None	PORTOLA	CA	96122	9405	00	06000	39.80603471	-120.463888	Plumas County
331885	Ordering, Referring, Prescribing	N/A	1407326168	0	0	HERNANDEZ, VICTORIA LMFT	7/6/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT133574	N/A	N/A	N/A	N/A	N/A	680 LANGSDORF DR	SUITE 200	FULLERTON	CA	92831	3702	00	06000	33.87673088	-117.8824577	Orange County
331897	Ordering, Referring, Prescribing	N/A	1407337314	0	0	HADDAD, ROBERT PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73787	N/A	N/A	N/A	N/A	N/A	200 WILMOT RD	None	DEERFIELD	IL	60015	4620	00	06000	42.156882	-87.870654	Lake County
331898	Ordering, Referring, Prescribing	N/A	1407339716	0	0	HELMAND, HUMA	5/15/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009076	N/A	N/A	N/A	N/A	N/A	1441 N TRACY BLVD	None	TRACY	CA	95376	3445	00	06000	37.744731	-121.4350375	San Joaquin County
331908	Ordering, Referring, Prescribing	N/A	1407347271	0	0	HARTMAN, LILLIAN F NP	5/8/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009020	N/A	N/A	N/A	N/A	N/A	1125 10TH ST	None	SACRAMENTO	CA	95814	3503	00	06000	38.57890563	-121.4939739	Sacramento County
331920	Ordering, Referring, Prescribing	N/A	1407357254	0	0	HAN, JAE W PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77784	N/A	N/A	N/A	N/A	N/A	2840 W AVE L	None	LANCASTER	CA	93536	0000	00	06000	34.6602533	-118.1827153	Los Angeles County
331934	Ordering, Referring, Prescribing	N/A	1407387467	0	0	HUWYLER, CAMILLE M MD	10/24/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159157	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FLOOR SUITE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
331965	Ordering, Referring, Prescribing	N/A	1407487200	0	0	HARRISON, LECIA LCSW	4/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86799	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
331968	Ordering, Referring, Prescribing	N/A	1407495344	0	0	HANSON, GIOVANNA F LCSW	4/19/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93398	N/A	N/A	N/A	N/A	N/A	16250 VENTURA BLVD	SUITE 465	ENCINO	CA	91436	4620	00	06000	34.15682212	-118.4871886	Los Angeles County
331995	Ordering, Referring, Prescribing	N/A	1407578024	0	0	HINOJOS, SUSAN L LMFT	2/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133097	N/A	N/A	N/A	N/A	N/A	10755 APPLE VALLEY RD	None	APPLE VALLEY	CA	92308	9358	00	06000	34.444179	-117.2316915	San Bernardino County
332027	Ordering, Referring, Prescribing	N/A	1407890320	0	0	HERNANDEZ, LUZ M NP	4/11/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN507057	N/A	N/A	N/A	N/A	N/A	243 GEORGIA STREET	None	VALLEJO	CA	94590	5904	00	06000	38.10111026	-122.2588175	Solano County
332047	Ordering, Referring, Prescribing	N/A	1407927650	0	0	HOWARD, STEPHANIE L LCSW	10/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27501	N/A	N/A	N/A	N/A	N/A	2415 SAN PABLO DAM RD	106-267	SAN PABLO	CA	94806	3919	00	06000	37.95418238	-122.3316516	Contra Costa County
332051	Ordering, Referring, Prescribing	N/A	1407936685	0	0	HARGITT, KATHERINE F PSYD	6/17/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26539	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
332081	Ordering, Referring, Prescribing	N/A	1407995897	0	0	HOLLAND, MAUREEN A PSYD	11/4/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23469	N/A	N/A	N/A	N/A	N/A	19231 VICTORY BLVD., SUI	None	RESEDA	CA	91335	6300	00	06000	34.18659852	-118.552221	Los Angeles County
332088	Ordering, Referring, Prescribing	N/A	1417018896	0	0	HWANG, STACY PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH57695	N/A	N/A	N/A	N/A	N/A	770 E CALAVERAS BLVD	None	MILPITAS	CA	95035	5491	00	06000	37.43378232	-121.8920598	Santa Clara County
332109	Ordering, Referring, Prescribing	N/A	1417060203	0	0	HENRY, MOSS	10/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	29073	N/A	N/A	N/A	N/A	N/A	659 CHERRY ST	204	SANTA ROSA	CA	95404	4280	00	06000	38.444841	-122.7151035	Sonoma County
332114	Ordering, Referring, Prescribing	N/A	1417075714	0	0	HESS, TRACEY PHD	10/15/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27154	N/A	N/A	N/A	N/A	N/A	701 E SANTA CLARA ST	STE 14C	VENTURA	CA	93001	5972	00	06000	34.27957166	-119.289727	Ventura County
332119	Ordering, Referring, Prescribing	N/A	1417081175	0	0	HERNANDEZCHAVEZ, BLANCA E LMFT	9/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49752	N/A	N/A	N/A	N/A	N/A	762 CYPRESS ST	None	SAN DIMAS	CA	91773	3505	00	06000	34.09577399	-117.8223776	Los Angeles County
332142	Ordering, Referring, Prescribing	N/A	1417103383	0	0	HERON, SARA MD	6/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A112236	N/A	N/A	N/A	N/A	N/A	2828 FORD STREET	None	OAKLAND	CA	94601	2114	00	06000	37.77357837	-122.2352589	Alameda County
332147	Ordering, Referring, Prescribing	N/A	1417113770	0	0	HOLCOMBE, SEAN C LMFT	7/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT52147	N/A	N/A	N/A	N/A	N/A	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	00	06000	37.9469952	-122.5373892	Marin County
332156	Ordering, Referring, Prescribing	N/A	1417137993	0	0	HANSEN-STAYER, DELRAE LMFT	11/30/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52780	N/A	N/A	N/A	N/A	N/A	2608 VICTOR AVE	STE A	REDDING	CA	96002	1447	00	06000	40.56937246	-122.3391096	Shasta County
332173	Ordering, Referring, Prescribing	N/A	1417171786	0	0	HAMILTON, HEATHER M LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT46528	N/A	N/A	N/A	N/A	N/A	1290 COMMODORE WEST DRIV	None	SAN BRUNO	CA	94066	0601	00	06000	37.63134914	-122.4260472	San Mateo County
332178	Ordering, Referring, Prescribing	N/A	1417184847	0	0	HIGA, MELANIE R CCC-SLP	6/1/2020	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	16241	N/A	N/A	N/A	N/A	N/A	1901 N RICE AVE	170-180	OXNARD	CA	93030	7912	00	06000	34.21960355	-119.1421345	Ventura County
332185	Ordering, Referring, Prescribing	N/A	1417196098	0	0	HOLT, MARTIN C PA-C	6/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA13479	N/A	N/A	N/A	N/A	N/A	1182 N EUCLID ST	None	ANAHEIM	CA	92801	0901	00	06000	33.849909	-117.9416115	Orange County
332197	Ordering, Referring, Prescribing	N/A	1417226119	0	0	HUYNH, TUNG D PHARMD	8/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60250	N/A	N/A	N/A	N/A	N/A	8917 TRAUTWEIN RD	None	RIVERSIDE	CA	92508	9473	00	06000	33.88900767	-117.3244103	Riverside County
332210	Ordering, Referring, Prescribing	N/A	1417253147	0	0	HUANG, KENNY K	11/1/2018	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	4929	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
332217	Ordering, Referring, Prescribing	N/A	1417264326	0	0	HARANIN, EMILY C PHD	3/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY24491	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
332219	Ordering, Referring, Prescribing	N/A	1417268079	0	0	HAHN-SMITH, ANNE M PHD	12/1/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23376	N/A	N/A	N/A	N/A	N/A	140 MAYHEW WAY	SUITE 300	PLEASANT HILL	CA	94523	4328	00	06000	37.93664097	-122.0572179	Contra Costa County
332222	Ordering, Referring, Prescribing	N/A	1417272618	0	0	HULSEY, TIMOTHY S DC	5/21/2015	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	31614	N/A	N/A	N/A	N/A	N/A	293 TORREY PINES LANE	None	BAKERSFIELD	CA	93308	4653	00	06000	35.40668849	-119.0359935	Kern County
332267	Ordering, Referring, Prescribing	N/A	1417338484	0	0	HAYES, BRENDAN	6/12/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	57548	N/A	N/A	N/A	N/A	N/A	2333 MCALLIE AVE	None	CHATTANOOGA	TN	37404	0000	00	06000	35.03359275	-85.26838574	Hamilton County
332271	Ordering, Referring, Prescribing	N/A	1417342106	0	0	HEDRICK, JONATHAN S MD	7/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A157270	N/A	N/A	N/A	N/A	N/A	10956 DONNER PASS RD	110	TRUCKEE	CA	96161	4861	00	06000	39.32625521	-120.2012059	Nevada County
332286	Ordering, Referring, Prescribing	N/A	1417372673	0	0	HUNDAL, PARVINDER PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68477	N/A	N/A	N/A	N/A	N/A	3098 G ST	None	MERCED	CA	95340	2137	00	06000	37.31800248	-120.4692105	Merced County
332291	Ordering, Referring, Prescribing	N/A	1417381468	0	0	HALIM, GEHAN R LCSW	7/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW92675	N/A	N/A	N/A	N/A	N/A	2933 UNIVERSITY AVE	None	RIVERSIDE	CA	92507	4243	00	06000	33.97760919	-117.3651828	Riverside County
332322	Ordering, Referring, Prescribing	N/A	1417434507	0	0	HO, SON D PHARMD	10/10/2018	Taxonomy not applicable	NA	n/a	000	Unknown	77618	N/A	N/A	N/A	N/A	N/A	46848 MISSION BLVD	None	FREMONT	CA	94539	7943	00	06000	37.49001935	-121.9292205	Alameda County
332334	Ordering, Referring, Prescribing	N/A	1417452343	0	0	HINES, ELIZABETH C LMFT	1/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123963	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
332335	Ordering, Referring, Prescribing	N/A	1417449992	0	0	HUTFLES, GERALD J MD	7/16/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A18959	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
332338	Ordering, Referring, Prescribing	N/A	1417456021	0	0	HESS, KRISTEN C LCSW	2/2/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99862	N/A	N/A	N/A	N/A	N/A	1737 CHORRO ST	STE 234F	SAN LUIS OBISPO	CA	93401	4408	00	06000	35.27466763	-120.6582841	San Luis Obispo County
332339	Ordering, Referring, Prescribing	N/A	1417463589	0	0	HARDING, DEBRAH K	2/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	977	N/A	N/A	N/A	N/A	N/A	4110 SORRENTO VALLEY BLV	None	SAN DIEGO	CA	92121	1407	00	06000	32.90375674	-117.2170258	San Diego County
332378	Ordering, Referring, Prescribing	N/A	1417522145	0	0	HAYWARD, GLEN R NP	5/11/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017322	N/A	N/A	N/A	N/A	N/A	1441 LIBERTY STREET	None	REDDING	CA	96001	0000	00	06000	40.5857177	-122.3870781	Shasta County
332401	Ordering, Referring, Prescribing	N/A	1417575903	0	0	HENDERSON, GENA B NP	6/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95016589	N/A	N/A	N/A	N/A	N/A	661 E UNIVERSITY DR	None	CARSON	CA	90746	1966	00	06000	33.85832615	-118.2640232	Los Angeles County
332417	Ordering, Referring, Prescribing	N/A	1417590886	0	0	HENDRIX, JASMINE L PSYD	9/2/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY32820	N/A	N/A	N/A	N/A	N/A	8300 S VERMONT AVE	1ST FLR	LOS ANGELES	CA	90044	3493	00	06000	33.963021	-118.291474	Los Angeles County
332442	Ordering, Referring, Prescribing	N/A	1417675620	0	0	HUANG CHEN, LUISITO	7/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	107685	N/A	N/A	N/A	N/A	N/A	8627 ATLANTIC AVE	None	SOUTH GATE	CA	90280	3501	00	06000	33.95462085	-118.1838426	Los Angeles County
332465	Ordering, Referring, Prescribing	N/A	1417782970	0	0	HAMID, SAHAR DDS	9/3/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110715	N/A	N/A	N/A	N/A	N/A	4415 S. CENTRAL AVENUE	None	LOS ANGELES	CA	90011	3629	00	06000	34.003413	-118.256519	Los Angeles County
332499	Ordering, Referring, Prescribing	N/A	1427110709	0	0	HUYNH, DANH MD	3/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A51656	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
332501	Ordering, Referring, Prescribing	N/A	1427110386	0	0	HONG, DAVIS J	12/11/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D50066	N/A	N/A	N/A	N/A	N/A	3727 W 6TH ST	210	LOS ANGELES	CA	90020	5105	00	06000	34.06358655	-118.3037656	Los Angeles County
332529	Ordering, Referring, Prescribing	N/A	1427154848	0	0	HAGY-LOPEZ, TAMARA L LMFT	8/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50147	N/A	N/A	N/A	N/A	N/A	47-950 DUNE PALMS RD	BUILDING C	LA QUINTA	CA	92253	4000	00	06000	33.71421874	-116.2774852	Riverside County
332587	Ordering, Referring, Prescribing	N/A	1427295682	0	0	HAGLUND, KAYEE	5/19/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	20675	N/A	N/A	N/A	N/A	N/A	1057 KINGSTON AVE	None	LOS ANGELES	CA	90033	1310	00	06000	34.05708747	-118.209555	Los Angeles County
332620	Ordering, Referring, Prescribing	N/A	1427359421	0	0	HO, LUCY	1/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH52923	N/A	N/A	N/A	N/A	N/A	4550 ATLANTIC AVE.	None	LONG BEACH	CA	90807	1513	00	06000	33.84102335	-118.183932	Los Angeles County
332623	Ordering, Referring, Prescribing	N/A	1427358191	0	0	HASTINGS, DANIEL L	3/19/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH 51175	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
332697	Ordering, Referring, Prescribing	N/A	1427483940	0	0	HUI, KATUNG PHARMD	2/7/2024	Taxonomy not applicable	NA	n/a	000	Unknown	68311	N/A	N/A	N/A	N/A	N/A	2031 6TH STREET	None	BERKELEY	CA	94710	2006	00	06000	37.86709575	-122.2973759	Alameda County
332705	Ordering, Referring, Prescribing	N/A	1427466226	0	0	HERRERA PEREA, GUADALUPE LCSW	10/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	97410	N/A	N/A	N/A	N/A	N/A	1224 N. VINE ST	None	LOS ANGELES	CA	90038	1612	00	06000	34.093332	-118.326603	Los Angeles County
332706	Ordering, Referring, Prescribing	N/A	1427499821	0	0	HEIL, KARSTEN M MD	9/4/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A150963	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
332737	Ordering, Referring, Prescribing	N/A	1427545698	0	0	HERNANDEZ, ROBERT NP	11/11/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008801	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
332778	Ordering, Referring, Prescribing	N/A	1427580067	0	0	HAN, JENNIFER MD MPH	2/21/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160263	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD, MS #53	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
332799	Ordering, Referring, Prescribing	N/A	1427650506	0	0	HANNA, CAROLINE	12/20/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	143838	N/A	N/A	N/A	N/A	N/A	5 MAREBLU	100	ALISO VIEJO	CA	92656	3014	00	06000	33.57250566	-117.7027366	Orange County
332803	Ordering, Referring, Prescribing	N/A	1427658202	0	0	HALL, REBECCA OT	12/21/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	21353	N/A	N/A	N/A	N/A	N/A	10431 COMMERCE ST	STE A	REDLANDS	CA	92374	0110	00	06000	34.06427678	-117.2416506	San Bernardino County
332838	Ordering, Referring, Prescribing	N/A	1427775972	0	0	HAYES, LINDA J LCSW	9/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	15914	N/A	N/A	N/A	N/A	N/A	801 S GRAND AVENUE	475	LOS ANGELES	CA	90017	4622	00	06000	34.04532806	-118.258462	Los Angeles County
332846	Ordering, Referring, Prescribing	N/A	1427797943	0	0	HOWELL, AMANDA NP	6/25/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95020894	N/A	N/A	N/A	N/A	N/A	1625 E 4TH ST	None	LOS ANGELES	CA	90033	4201	00	06000	34.04297786	-118.2220181	Los Angeles County
332850	Ordering, Referring, Prescribing	N/A	1427832526	0	0	HADIASHAR, NASIM DDS	8/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	DDS109040	N/A	N/A	N/A	N/A	N/A	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5212	00	06000	37.30176	-121.9136465	Santa Clara County
332883	Ordering, Referring, Prescribing	N/A	1437233509	0	0	HEDIN, ANDREA L MD	7/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G46755	N/A	N/A	N/A	N/A	N/A	615B STREET	SUITE 1A	SAN RAFAEL	CA	94901	3884	00	06000	37.9699095	-122.5300109	Marin County
332904	Ordering, Referring, Prescribing	N/A	1437275526	0	0	HAYES, CATHERINE M LMFT	2/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT38275	N/A	N/A	N/A	N/A	N/A	211 W 5TH ST	None	ONTARIO	CA	91762	1653	00	06000	34.08148232	-117.6538183	San Bernardino County
332909	Ordering, Referring, Prescribing	N/A	1437281813	0	0	HAO, TOM W LMFT	11/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49662	N/A	N/A	N/A	N/A	N/A	5100 S EASTERN AVE	STE 110	COMMERCE	CA	90040	2964	00	06000	33.98882955	-118.1615175	Los Angeles County
332923	Ordering, Referring, Prescribing	N/A	1437289246	0	0	HSIA, CECILIA L MD	2/25/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A76124	N/A	N/A	N/A	N/A	N/A	160 S 7TH AVE	None	LA PUENTE	CA	91746	3211	00	06000	34.0335863	-117.9760093	Los Angeles County
332927	Ordering, Referring, Prescribing	N/A	1437282282	0	0	HALL, GRADY S MD	4/1/2020	Taxonomy not applicable	NA	n/a	000	Unknown	G22935	N/A	N/A	N/A	N/A	N/A	72-630 FRED WARING DR.	STE. 101	PALM DESERT	CA	92260	5004	00	06000	33.728697	-116.4008512	Riverside County
332941	Ordering, Referring, Prescribing	N/A	1437327897	0	0	HOOKER, DARSHAWN LMFT	3/6/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	97775	N/A	N/A	N/A	N/A	N/A	3680 E IMPERIAL HWY	200	LYNWOOD	CA	90262	2659	00	06000	33.93211641	-118.2011728	Los Angeles County
332944	Ordering, Referring, Prescribing	N/A	1437330248	0	0	HERNANDEZ, LAMONT LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	48211	N/A	N/A	N/A	N/A	N/A	1730 DIVISADERO ST	None	SAN FRANCISCO	CA	94115	3012	00	06000	37.78568783	-122.4399247	San Francisco County
332972	Ordering, Referring, Prescribing	N/A	1437371671	0	0	HANDY, JEREMY A MD	3/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A125259	N/A	N/A	N/A	N/A	N/A	47915 OASIS ST	None	INDIO	CA	92201	6950	00	06000	33.701508	-116.220908	Riverside County
333014	Ordering, Referring, Prescribing	N/A	1437445616	0	0	HUSTON, CARRIE D PHARMD	4/22/2022	Taxonomy not applicable	NA	n/a	000	Unknown	59231	N/A	N/A	N/A	N/A	N/A	1755 HACIENDA DR	None	VISTA	CA	92081	4546	00	06000	33.18744941	-117.2759225	San Diego County
333023	Ordering, Referring, Prescribing	N/A	1437464179	0	0	HALL, VICTORIA L LMFT	11/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT91065	N/A	N/A	N/A	N/A	N/A	480 EAST 13TH STREET	None	MERCED	CA	95341	6214	00	06000	37.29194565	-120.4717887	Merced County
333028	Ordering, Referring, Prescribing	N/A	1437464419	0	0	HOLT, NICHOLAS V LCSW	12/30/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	67195	N/A	N/A	N/A	N/A	N/A	11303 W WASHINGTON BLVD	200	LOS ANGELES	CA	90066	6003	00	06000	34.00408212	-118.4147433	Los Angeles County
333042	Ordering, Referring, Prescribing	N/A	1437472784	0	0	HAYNES, KARLA A RN CPNP	3/31/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	17074	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD. MS #96	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
333048	Ordering, Referring, Prescribing	N/A	1437503505	0	0	HARRIS, MONIQUE N	1/19/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121565	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	UNIT 201	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
333065	Ordering, Referring, Prescribing	N/A	1437533411	0	0	HOANG, TIFFANY T PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH72728	N/A	N/A	N/A	N/A	N/A	25011 ALESSANDRO BLVD	None	MORENO VALLEY	CA	92553	4312	00	06000	33.91720845	-117.2256545	Riverside County
333069	Ordering, Referring, Prescribing	N/A	1437536562	0	0	HUDSON, LINDA M	6/2/2015	Taxonomy not applicable	NA	n/a	000	Unknown	52444	N/A	N/A	N/A	N/A	N/A	755 N SEQUOIA AVE	STE B	LINDSAY	CA	93247	1422	00	06000	36.21173551	-119.0961155	Tulare County
333078	Ordering, Referring, Prescribing	N/A	1437548088	0	0	HARDY, SHANNON LCSW	12/30/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW127917	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
333083	Ordering, Referring, Prescribing	N/A	1437560703	0	0	HANSON, BRENT MD	6/12/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140881	N/A	N/A	N/A	N/A	N/A	500B JEFFERSON BLVD	180	WEST SACRAMENTO	CA	95617	2394	00	06000	38.58811316	-121.5270471	Yolo County
333089	Ordering, Referring, Prescribing	N/A	1437564457	0	0	HUCKINS, KELSEY A NP	10/7/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030055	N/A	N/A	N/A	N/A	N/A	1431 MCHENRY	SUITE 100	MODESTO	CA	95350	4534	00	06000	37.664811	-120.993969	Stanislaus County
333142	Ordering, Referring, Prescribing	N/A	1437631082	0	0	HA, RENEE L LMFT	8/23/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127699	N/A	N/A	N/A	N/A	N/A	9353 VALLEY BLVD	STE C	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
333198	Ordering, Referring, Prescribing	N/A	1437714565	0	0	HILL, JEFFREY C PHARMD	12/22/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RPH36981	N/A	N/A	N/A	N/A	N/A	330 E 13TH STREET	None	MERCED	CA	95341	6212	00	06000	37.29253231	-120.4733513	Merced County
333211	Ordering, Referring, Prescribing	N/A	1437739000	0	0	HU, ANGELA MD	5/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A183972	N/A	N/A	N/A	N/A	N/A	2035 E BALL RD	100C	ANAHEIM	CA	92806	0101	00	06000	33.81812448	-117.8880075	Orange County
333236	Ordering, Referring, Prescribing	N/A	1437801339	0	0	HEARNE, MADISON LCSW	11/19/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127093	N/A	N/A	N/A	N/A	N/A	3200 MOTOR AVENUE	None	LOS ANGELES	CA	90034	3710	00	06000	34.03321301	-118.4109122	Los Angeles County
333242	Ordering, Referring, Prescribing	N/A	1437811056	0	0	HOMAIZAD, JESSICA LCSW	7/3/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	123821	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
333259	Ordering, Referring, Prescribing	N/A	1437850203	0	0	HUYNH, YOLANDE N	2/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH87712	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
333261	Ordering, Referring, Prescribing	N/A	1437852118	0	0	HA, MIRYAM DO	8/13/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A23291	N/A	N/A	N/A	N/A	N/A	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
333265	Ordering, Referring, Prescribing	N/A	1437872827	0	0	HUR, YUN OD	6/22/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT35549	N/A	N/A	N/A	N/A	N/A	1532 SAN BERNARDINO AVE	B7	POMONA	CA	91767	3559	00	06000	34.0758525	-117.7200855	Los Angeles County
333329	Ordering, Referring, Prescribing	N/A	1447337589	0	0	HEARN, REGINA A LCSW	12/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26806	N/A	N/A	N/A	N/A	N/A	23501 CINEMA DR STE 200	STE 210	VALENCIA	CA	91355	5430	00	06000	34.42039699	-118.5463513	Los Angeles County
333342	Ordering, Referring, Prescribing	N/A	1447360979	0	0	HARRIS, CATHERINE C PA-C	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	19280	N/A	N/A	N/A	N/A	N/A	16233 KING STREET	None	DELHI	CA	95315	9460	00	06000	37.43319758	-120.7809931	Merced County
333351	Ordering, Referring, Prescribing	N/A	1447373824	0	0	HICKS, MICHAEL D LMFT	9/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122188	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DR	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
333356	Ordering, Referring, Prescribing	N/A	1447377353	0	0	HOVE, GAYLE L	10/1/2018	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	14347	N/A	N/A	N/A	N/A	N/A	3800 JANES ROAD	None	ARCATA	CA	95521	4742	00	06000	40.89645172	-124.0930637	Humboldt County
333361	Ordering, Referring, Prescribing	N/A	1447398243	0	0	HOBZA, CHRISTY PSYD	1/20/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23548	N/A	N/A	N/A	N/A	N/A	1550 TREAT AVE.	None	SAN FRANCISCO	CA	94110	5234	00	06000	37.74592266	-122.4125043	San Francisco County
333363	Ordering, Referring, Prescribing	N/A	1447407457	0	0	HILL, CHRISTOPHER M LMFT	10/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT28479	N/A	N/A	N/A	N/A	N/A	140 GREGORY LN	250	PLEASANT HILL	CA	94523	3360	00	06000	37.94794183	-122.0649162	Contra Costa County
333364	Ordering, Referring, Prescribing	N/A	1447408067	0	0	HERNANDEZ, OCTAVIO LCSW	4/28/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW85206	N/A	N/A	N/A	N/A	N/A	1900 ROYALTY DR.	None	POMONA	CA	91767	3046	00	06000	34.07754346	-117.7463466	Los Angeles County
333371	Ordering, Referring, Prescribing	N/A	1447418934	0	0	HORNER, PAULETTE M LCSW	12/11/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	27210	N/A	N/A	N/A	N/A	N/A	11716 ENTERPRISE DR	None	AUBURN	CA	95603	3732	00	06000	38.90720197	-121.0838099	Placer County
333380	Ordering, Referring, Prescribing	N/A	1447451372	0	0	HAGERTY, DENNIS P LMFT	12/11/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT80448	N/A	N/A	N/A	N/A	N/A	43807 10TH STREET WEST	D	LANCASTER	CA	93534	4805	00	06000	34.6788	-118.1479295	Los Angeles County
333398	Ordering, Referring, Prescribing	N/A	1447496336	0	0	HUERTA, IVETTE M LMFT	3/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	44611	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
333405	Ordering, Referring, Prescribing	N/A	1447505136	0	0	HERNANDEZ, KARINA LPCC	4/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC5194	N/A	N/A	N/A	N/A	N/A	40 E MINARETS AVE	None	PINEDALE	CA	93650	1239	00	06000	36.84269447	-119.7897525	Fresno County
333409	Ordering, Referring, Prescribing	N/A	1447514971	0	0	HANSON, CHRISTOPHER MD	7/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	036136586	N/A	N/A	N/A	N/A	N/A	3525 N UNIVERSITY ST	None	PEORIA	IL	61604	1324	00	06000	40.73117243	-89.61273306	Peoria County
333413	Ordering, Referring, Prescribing	N/A	1447516166	0	0	HALL, CHRISTINA M LMFT	6/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT118914	N/A	N/A	N/A	N/A	N/A	3631 S HARBOR BLVD STE 2	300	SANTA ANA	CA	92704	7936	00	06000	33.6988425	-117.919374	Orange County
333419	Ordering, Referring, Prescribing	N/A	1447533096	0	0	HUANG, DORCAS D PHARMD	7/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50323	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
333423	Ordering, Referring, Prescribing	N/A	1447529383	0	0	HOUSE, DARLENE M PHARMD	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	66685	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
333441	Ordering, Referring, Prescribing	N/A	1447585047	0	0	HERNANDEZ, ELIZABETH LCSW	12/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99120	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
333460	Ordering, Referring, Prescribing	N/A	1447616503	0	0	HERNANDEZ, ESPERANZA S LMFT	10/25/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125793	N/A	N/A	N/A	N/A	N/A	1990 CONCORD AVE	None	CHICO	CA	95928	9518	00	06000	39.72768476	-121.7912855	Butte County
333498	Ordering, Referring, Prescribing	N/A	1447678834	0	0	HENDERSON, PHILIP L MD	2/1/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A140324	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
333510	Ordering, Referring, Prescribing	N/A	1447686399	0	0	HAMBLET, SARAH J LCSW	11/20/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	73392	N/A	N/A	N/A	N/A	N/A	509 E ROSECRANS AVE	None	COMPTON	CA	90221	2056	00	06000	33.90345595	-118.2182212	Los Angeles County
333518	Ordering, Referring, Prescribing	N/A	1447698402	0	0	HEATON, MICHAEL J OT	10/30/2019	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	13488	N/A	N/A	N/A	N/A	N/A	130 W VICTORIA ST	None	GARDENA	CA	90248	3523	00	06000	33.86469393	-118.2771267	Los Angeles County
333546	Ordering, Referring, Prescribing	N/A	1447736269	0	0	HOWITT, JOSHUA LCSW	5/18/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101548	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
333553	Ordering, Referring, Prescribing	N/A	1447761572	0	0	HUANG, SIN-YI PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63511	N/A	N/A	N/A	N/A	N/A	198 PLAZA DR	None	VALLEJO	CA	94591	3702	00	06000	38.133234	-122.213403	Solano County
333575	Ordering, Referring, Prescribing	N/A	1447789201	0	0	HENDERSON, LAQUASHA LMFT	3/27/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138855	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
333596	Ordering, Referring, Prescribing	N/A	1447848155	0	0	HOE, JACKIE	8/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59679	N/A	N/A	N/A	N/A	N/A	1691 THE ALAMEDA	None	SAN JOSE	CA	95126	0000	00	06000	37.3373761	-121.9192532	Santa Clara County
333606	Ordering, Referring, Prescribing	N/A	1447872668	0	0	HARRIS, JENNIFER L LMFT	10/31/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT142514	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
333624	Ordering, Referring, Prescribing	N/A	1447905310	0	0	HERNANDEZ, KELSEY LMFT	1/27/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT152849	N/A	N/A	N/A	N/A	N/A	201 N. K STREET	None	TULARE	CA	93274	4005	00	06000	36.20957262	-119.3464875	Tulare County
333653	Ordering, Referring, Prescribing	N/A	1457029548	0	0	HONG, EUN JI	11/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84999	N/A	N/A	N/A	N/A	N/A	67 LINCOLN BLVD	None	LINCOLN	CA	95648	9389	00	06000	38.87853574	-121.2956801	Placer County
333668	Ordering, Referring, Prescribing	N/A	1457093791	0	0	HILL, CHERISHA M NP	12/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	95018815	N/A	N/A	N/A	N/A	N/A	1550 N GAREY AVE	None	POMONA	CA	91767	3826	00	06000	34.07356342	-117.7522392	Los Angeles County
333673	Ordering, Referring, Prescribing	N/A	1457111940	0	0	HERSANT, HALEY	8/23/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL15923	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
333675	Ordering, Referring, Prescribing	N/A	1457126732	0	0	HERMAN, JOY NP	11/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028045	N/A	N/A	N/A	N/A	N/A	6368 HOLLYWOOD BLVD	None	LOS ANGELES	CA	90028	6320	00	06000	34.1015865	-118.328976	Los Angeles County
333682	Ordering, Referring, Prescribing	N/A	1457188559	0	0	HUANG, CHIEN-HSUN LAC	7/3/2024	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	20124	N/A	N/A	N/A	N/A	N/A	728 PACIFIC AVE	303	SAN FRANCISCO	CA	94133	4457	00	06000	37.79687859	-122.4074282	San Francisco County
333735	Ordering, Referring, Prescribing	N/A	1457488587	0	0	HOLLOWAY, ROBERT P MD	3/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A55346	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
333744	Ordering, Referring, Prescribing	N/A	1457497398	0	0	HARRINGTON, NANCY E LMFT	6/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT40270	N/A	N/A	N/A	N/A	N/A	1266 14TH STREET	None	OAKLAND	CA	94607	2247	00	06000	37.81022696	-122.2887619	Alameda County
333780	Ordering, Referring, Prescribing	N/A	1457571978	0	0	HORNER, DENISE LMFT	9/12/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47296	N/A	N/A	N/A	N/A	N/A	19375 HWY 116	None	MONTE RIO	CA	95462	0519	00	06000	38.47790938	-122.9980793	Sonoma County
333787	Ordering, Referring, Prescribing	N/A	1457586984	0	0	HERNANDEZ, LISA M LMFT	1/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT79612	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
333798	Ordering, Referring, Prescribing	N/A	1457608697	0	0	HELLENDER, STACEY C LCSW	7/14/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101774	N/A	N/A	N/A	N/A	N/A	3301 E 12TH ST	259	OAKLAND	CA	94601	3424	00	06000	37.77617499	-122.2247899	Alameda County
333815	Ordering, Referring, Prescribing	N/A	1457643512	0	0	HARTMANN, JOHN S MD	6/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A122006	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
333816	Ordering, Referring, Prescribing	N/A	1457651507	0	0	HUANG, SE-NE PHD	12/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58163	N/A	N/A	N/A	N/A	N/A	1530 HAMILTON AVE	None	SAN JOSE	CA	95125	4539	00	06000	37.29440152	-121.911003	Santa Clara County
333827	Ordering, Referring, Prescribing	N/A	1457651523	0	0	HING, HIU PHARMD	10/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	50165	N/A	N/A	N/A	N/A	N/A	2300 16TH STREET	203	SAN FRANCISCO	CA	94013	4805	00	06000	37.76569327	-122.4091306	San Francisco County
333831	Ordering, Referring, Prescribing	N/A	1457665705	0	0	HA, DUONG A	2/14/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	D59400	N/A	N/A	N/A	N/A	N/A	1129 W 4TH ST	None	ONTARIO	CA	91762	1703	00	06000	34.077636	-117.6713055	San Bernardino County
333860	Ordering, Referring, Prescribing	N/A	1457727166	0	0	HUANG, XIUQI CNP	11/14/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93702	N/A	N/A	N/A	N/A	N/A	701 S ATLANTIC BLVD	100	MONTEREY PARK	CA	91754	0000	00	06000	34.05382447	-118.1363489	Los Angeles County
333884	Ordering, Referring, Prescribing	N/A	1457769333	0	0	HANNA-HADDAD, WEGDAN PHD	10/19/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	26481	N/A	N/A	N/A	N/A	N/A	950 S EUCLID AVE	None	SAN DIEGO	CA	92114	6201	00	06000	32.696181	-117.085139	San Diego County
333891	Ordering, Referring, Prescribing	N/A	1457773624	0	0	HIRSCH CORDEIRO, LISA LPCC	1/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC11031	N/A	N/A	N/A	N/A	N/A	338 ENGLISH STREET	UNIT A	PETALUMA	CA	94952	2531	00	06000	38.22964851	-122.6479456	Sonoma County
333895	Ordering, Referring, Prescribing	N/A	1457770745	0	0	HUFF, STEPHANIE Q LPCC	3/29/2020	Taxonomy not applicable	NA	n/a	000	Unknown	5454	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
333914	Ordering, Referring, Prescribing	N/A	1457802084	0	0	HERNANDEZ HUFFMAN, ANGELA J LCSW	2/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	91331	N/A	N/A	N/A	N/A	N/A	210 E. ENOS DR.	A	SANTA MARIA	CA	93454	7215	00	06000	34.9340215	-120.4343968	Santa Barbara County
333920	Ordering, Referring, Prescribing	N/A	1457809535	0	0	HANLEY, LAUREN M LCSW	5/31/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW81076	N/A	N/A	N/A	N/A	N/A	2213 BUCHANAN RD STE	103	ANTIOCH	CA	94509	4265	00	06000	37.99879828	-121.8360576	Contra Costa County
333953	Ordering, Referring, Prescribing	N/A	1457856379	0	0	HASSAN, ABD-ELRAHMAN S MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164921	N/A	N/A	N/A	N/A	N/A	2314 STOCKTON BLVD	None	SACRAMENTO	CA	95817	2201	00	06000	38.55420878	-121.4574806	Sacramento County
333956	Ordering, Referring, Prescribing	N/A	1457857047	0	0	HSIAO, LAUREN MD	7/26/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174078	N/A	N/A	N/A	N/A	N/A	313 W SHAW AVE	None	CLOVIS	CA	93612	3685	00	06000	36.8085986	-119.7162883	Fresno County
333988	Ordering, Referring, Prescribing	N/A	1457895674	0	0	HO, TINA PHARMD	3/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	75342	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
333992	Ordering, Referring, Prescribing	N/A	1457903700	0	0	HERNANDEZ, MIRIAM PA	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58953	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
333993	Ordering, Referring, Prescribing	N/A	1457901035	0	0	HAINES, PENDRY M LCSW	12/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99188	N/A	N/A	N/A	N/A	N/A	631 S. ORCHARD	None	UKIAH	CA	95482	5011	00	06000	39.14619517	-123.1986323	Mendocino County
333997	Ordering, Referring, Prescribing	N/A	1457907677	0	0	HSIEH, WEI-YUN LMFT	1/12/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT130594	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	None	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
334044	Ordering, Referring, Prescribing	N/A	1457999823	0	0	HARO, JANIS LMFT	1/17/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152734	N/A	N/A	N/A	N/A	N/A	1280 E GIBSON RD	None	WOODLAND	CA	95776	6315	00	06000	38.660391	-121.761837	Yolo County
334095	Ordering, Referring, Prescribing	N/A	1467120931	0	0	HERNANDEZ, DENNIS J PT	9/9/2021	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	300889	N/A	N/A	N/A	N/A	N/A	1600 WEEOT WAY	None	ARCATA	CA	95521	4734	00	06000	40.89808837	-124.0923819	Humboldt County
334099	Ordering, Referring, Prescribing	N/A	1467124248	0	0	HERNANDEZ, VICTORIA LCSW	4/11/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW122016	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
334126	Ordering, Referring, Prescribing	N/A	1467270504	0	0	HANEY, DEVAN PA	9/26/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65115	N/A	N/A	N/A	N/A	N/A	29632 HIGHWAY 299 EAST	None	ROUND MOUNTAIN	CA	96084	0000	00	06000	40.80385331	-121.9397745	Shasta County
334127	Ordering, Referring, Prescribing	N/A	1467290429	0	0	HERNANDEZ, DENISE E NP	7/9/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030975	N/A	N/A	N/A	N/A	N/A	6601 RUGBY AVE	300	HUNTINGTON PARK	CA	90255	4040	00	06000	33.979113	-118.2265595	Los Angeles County
334132	Ordering, Referring, Prescribing	N/A	1467447714	0	0	HAMWI, GERALD R MD	1/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A65266	N/A	N/A	N/A	N/A	N/A	4940 VAN NUYS BLVD	SUITE 200	SHERMAN OAKS	CA	91403	1741	00	06000	34.160589	-118.4486715	Los Angeles County
334136	Ordering, Referring, Prescribing	N/A	1467451609	0	0	HILTON, BRET D PA-C	5/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	1068671206	N/A	N/A	N/A	N/A	N/A	410 N 100 E	None	KOOSHAREM	UT	84744	7700	00	06000	38.51295462	-111.8791899	Sevier County
334162	Ordering, Referring, Prescribing	N/A	1467546150	0	0	HOLOHAN, JENNIFER PA	1/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	17523	N/A	N/A	N/A	N/A	N/A	2800 RIVERSIDE AVE	None	PASO ROBLES	CA	93446	1311	00	06000	35.64351546	-120.6888699	San Luis Obispo County
334170	Ordering, Referring, Prescribing	N/A	1467576603	0	0	HOITSMA, ERICA M LMFT	7/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47635	N/A	N/A	N/A	N/A	N/A	851 N. OAKLAND AVE.	None	PASADENA	CA	91104	4343	00	06000	34.16031813	-118.1403347	Los Angeles County
334176	Ordering, Referring, Prescribing	N/A	1467586693	0	0	HERNANDEZ, FABIAN E DO	11/6/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A12331	N/A	N/A	N/A	N/A	N/A	11080 W OLYMPIC BLVD	None	LOS ANGELES	CA	90064	1937	00	06000	34.04036814	-118.4376056	Los Angeles County
334196	Ordering, Referring, Prescribing	N/A	1467637835	0	0	HO, WAN MING LCSW	3/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29396	N/A	N/A	N/A	N/A	N/A	729 FILBERT STREET	None	SAN FRANCISCO	CA	94133	2760	00	06000	37.80103613	-122.4119083	San Francisco County
334203	Ordering, Referring, Prescribing	N/A	1467647172	0	0	HERNANDEZ, JEANNET LMFT	2/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53800	N/A	N/A	N/A	N/A	N/A	820 E GILBERT ST	None	SAN BERNARDINO	CA	92415	0928	00	06000	34.1268333	-117.2687417	San Bernardino County
334235	Ordering, Referring, Prescribing	N/A	1467704189	0	0	HARPER, AMY E LMFT	8/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110473	N/A	N/A	N/A	N/A	N/A	5079 HWY 140	None	MARIPOSA	CA	95338	0062	00	06000	37.48746975	-119.9681179	Mariposa County
334253	Ordering, Referring, Prescribing	N/A	1467737825	0	0	HO, FRANCIS V PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH43177	N/A	N/A	N/A	N/A	N/A	600 LONG BEACH BLVD	None	LONG BEACH	CA	90802	0000	00	06000	33.774372	-118.189284	Los Angeles County
334289	Ordering, Referring, Prescribing	N/A	1467794990	0	0	HYATT, ADIL LMFT	12/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123476	N/A	N/A	N/A	N/A	N/A	230 N MORRISON AVE	None	SAN JOSE	CA	95126	2741	00	06000	37.33307626	-121.9084647	Santa Clara County
334291	Ordering, Referring, Prescribing	N/A	1467796318	0	0	HAHN, RACHEL LCSW	8/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96440	N/A	N/A	N/A	N/A	N/A	1266 14TH ST	None	OAKLAND	CA	94607	2247	00	06000	37.81022696	-122.2887619	Alameda County
334299	Ordering, Referring, Prescribing	N/A	1467815217	0	0	HUZYK, THEODORE N MD	6/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144285	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	None	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
334306	Ordering, Referring, Prescribing	N/A	1467823567	0	0	HENG, XEE M NP	6/8/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	794150	N/A	N/A	N/A	N/A	N/A	1041 ROSE AVE	None	SELMA	CA	93662	3240	00	06000	36.56879252	-119.596257	Fresno County
334318	Ordering, Referring, Prescribing	N/A	1467832071	0	0	HERRERA, TERESA LMFT	6/21/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	147584	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY STE.	STE. 207	SANTA ROSA	CA	95407	5486	00	06000	38.425266	-122.749875	Sonoma County
334321	Ordering, Referring, Prescribing	N/A	1467835009	0	0	HENG, HOUN PHARMD	10/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH48019	N/A	N/A	N/A	N/A	N/A	3255 GRAND AVE	None	CHINO HILLS	CA	91709	1488	00	06000	34.00187992	-117.7347038	San Bernardino County
334355	Ordering, Referring, Prescribing	N/A	1467887505	0	0	HAGAN, BREANA N MSW LCSW	6/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94923	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
334356	Ordering, Referring, Prescribing	N/A	1467888164	0	0	HIBBARD, ALLISON LMFT	1/6/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123915	N/A	N/A	N/A	N/A	N/A	1693 NADOWA	None	MINDEN	CA	96150	2303	00	06000	38.88720256	-119.9847941	El Dorado County
334360	Ordering, Referring, Prescribing	N/A	1467884098	0	0	HAMMETT, ERIN DO	3/14/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14025	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
334378	Ordering, Referring, Prescribing	N/A	1467913954	0	0	HASSID, BRANDON V MD	3/3/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A176691	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
334397	Ordering, Referring, Prescribing	N/A	1467945253	0	0	HOLLAND, JAMES LCSW	4/28/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101299	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
334403	Ordering, Referring, Prescribing	N/A	1467949149	0	0	HARRIS, JACQUELLIN LCSW	10/3/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110809	N/A	N/A	N/A	N/A	N/A	3756 SANTA ROSALIA DR	SUITE 628	LOS ANGELES	CA	90008	3606	00	06000	34.00888336	-118.3389334	Los Angeles County
334418	Ordering, Referring, Prescribing	N/A	1467971317	0	0	HASKELL, BRITTANY M LPCC	10/12/2020	Taxonomy not applicable	NA	n/a	000	Unknown	8278	N/A	N/A	N/A	N/A	N/A	8745 BENNINGTON ST	None	SAN DIEGO	CA	92126	3221	00	06000	32.91054584	-117.1359577	San Diego County
334429	Ordering, Referring, Prescribing	N/A	1467986992	0	0	HARMON, MATTHEW D	6/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173111	N/A	N/A	N/A	N/A	N/A	4001 J STREET	None	SACRAMENTO	CA	95819	3626	00	06000	38.570526	-121.4521695	Sacramento County
334438	Ordering, Referring, Prescribing	N/A	1467996272	0	0	HODGE MATTHEWS, SHARDEL J LMFT	10/11/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	135160	N/A	N/A	N/A	N/A	N/A	5900 S EASTERN AVE	138	COMMERCE	CA	90040	4017	00	06000	33.98421287	-118.162224	Los Angeles County
334468	Ordering, Referring, Prescribing	N/A	1477052991	0	0	HOBAYAN, NICOLE D PHARMD	9/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77969	N/A	N/A	N/A	N/A	N/A	1830 W 11TH ST	None	TRACY	CA	95376	4920	00	06000	37.73923552	-121.4505495	San Joaquin County
334488	Ordering, Referring, Prescribing	N/A	1477093805	0	0	HUYNH, TUAN V PHARMD	11/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76180	N/A	N/A	N/A	N/A	N/A	1120 E CLARK AVE	None	ORCUTT	CA	93455	5123	00	06000	34.86500248	-120.417299	Santa Barbara County
334491	Ordering, Referring, Prescribing	N/A	1477096022	0	0	HOLLARMAN, AMBER R LMFT	2/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96963	N/A	N/A	N/A	N/A	N/A	9008 SAN GABRIEL RD	None	ATASCADERO	CA	93422	5472	00	06000	35.46185955	-120.6537097	San Luis Obispo County
334494	Ordering, Referring, Prescribing	N/A	1477091494	0	0	HOANG, DIANA E PHARMD	8/3/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75428	N/A	N/A	N/A	N/A	N/A	101 THE CITY DRIVE S	None	ORANGE	CA	92868	3201	00	06000	33.78674051	-117.8888713	Orange County
334499	Ordering, Referring, Prescribing	N/A	1477112928	0	0	HUYNH, KRISTIE H PHARMD	1/1/2024	Taxonomy not applicable	NA	n/a	000	Unknown	RPH76047	N/A	N/A	N/A	N/A	N/A	1405 W CAMERON AVE	None	VISALIA	CA	93277	9527	00	06000	36.292698	-119.306538	Tulare County
334513	Ordering, Referring, Prescribing	N/A	1477152338	0	0	HUGHES, TYRA LCSW	8/4/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75659	N/A	N/A	N/A	N/A	N/A	6923 LANGMUIR LN	None	DUBLIN	CA	94568	1710	00	06000	37.71903831	-121.9217644	Alameda County
334515	Ordering, Referring, Prescribing	N/A	1477163004	0	0	HOSSEPIAN, DERIK PSYD	9/27/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	34310	N/A	N/A	N/A	N/A	N/A	4605 LANKERSHIM BLVD	STE 545	NORTH HOLLYWOOD	CA	91602	1892	00	06000	34.15389329	-118.3679999	Los Angeles County
334522	Ordering, Referring, Prescribing	N/A	1477173581	0	0	HADLEY, SIERRA M	1/27/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014420	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
334531	Ordering, Referring, Prescribing	N/A	1477180305	0	0	HOFMANN, JENNIFER A	9/11/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	105197	N/A	N/A	N/A	N/A	N/A	7777 SUNRISE BLVD	STE 2500	CITRUS HEIGHTS	CA	95610	2372	00	06000	38.706561	-121.2731145	Sacramento County
334565	Ordering, Referring, Prescribing	N/A	1477291425	0	0	HILL, TAMMY JO LCSW	7/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27986	N/A	N/A	N/A	N/A	N/A	2035 E. BALL ROAD	SUITE 100	ANAHEIM	CA	92806	5158	00	06000	33.81812448	-117.8880075	Orange County
334626	Ordering, Referring, Prescribing	N/A	1477634707	0	0	HE, FLORA F PHARMD	3/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54997	N/A	N/A	N/A	N/A	N/A	1761 BROADWAY ST	101	AMERICAN CANYON	CA	94589	2226	00	06000	38.13049234	-122.2522422	Solano County
334638	Ordering, Referring, Prescribing	N/A	1477660074	0	0	HART, ROBERT R	4/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C38923	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
334663	Ordering, Referring, Prescribing	N/A	1477703890	0	0	HAMILTON, TAMIEKA LCSW	1/31/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61767	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
334673	Ordering, Referring, Prescribing	N/A	1477746816	0	0	HERNANDEZ, VIRGINIA MD	9/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C174953	N/A	N/A	N/A	N/A	N/A	1500 21ST ST	MIDTOWN	SACRAMENTO	CA	95811	5216	00	06000	38.570553	-121.481325	Sacramento County
334674	Ordering, Referring, Prescribing	N/A	1477747392	0	0	HARBOUR, CYNTHIA A LCSW	11/9/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21123	N/A	N/A	N/A	N/A	N/A	43520 DIVISION STREET W	None	LANCASTER	CA	93535	4089	00	06000	34.673445	-118.130143	Los Angeles County
334681	Ordering, Referring, Prescribing	N/A	1477752772	0	0	HALL, HEATHER J PHD	5/5/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25816	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD.	MS #53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
334730	Ordering, Referring, Prescribing	N/A	1477839942	0	0	HUYNH, THUY PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	52336	N/A	N/A	N/A	N/A	N/A	5301 ALMADEN EXPRESSWAY	None	SAN JOSE	CA	95118	3603	00	06000	37.253214	-121.880196	Santa Clara County
334749	Ordering, Referring, Prescribing	N/A	1477866531	0	0	HUYNH, JESSICA T OD	1/14/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	14380	N/A	N/A	N/A	N/A	N/A	2401 15TH ST	None	SACRAMENTO	CA	95818	2238	00	06000	38.562687	-121.4931195	Sacramento County
334759	Ordering, Referring, Prescribing	N/A	1477903086	0	0	HEARD, JASON MD FACS	5/3/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A172506	N/A	N/A	N/A	N/A	N/A	2425 STOCKTON BOULEVARD	None	SACRAMENTO	CA	95817	1495	00	06000	38.553012	-121.45545	Sacramento County
334777	Ordering, Referring, Prescribing	N/A	1477922045	0	0	HERNANDEZ, HUGO PA-C	12/27/2023	Taxonomy not applicable	NA	n/a	000	Unknown	52860	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
334789	Ordering, Referring, Prescribing	N/A	1477942779	0	0	HAKL, CHRISTINA	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70052	N/A	N/A	N/A	N/A	N/A	100 W WALNUT AVE	None	VISALIA	CA	93277	5367	00	06000	36.313209	-119.292516	Tulare County
334792	Ordering, Referring, Prescribing	N/A	1477944841	0	0	HSU, DEREK Y MD	5/10/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A172646	N/A	N/A	N/A	N/A	N/A	1125 E 17TH ST	W248	SANTA ANA	CA	92701	2217	00	06000	33.76004145	-117.854838	Orange County
334796	Ordering, Referring, Prescribing	N/A	1477951028	0	0	HOANG, KIM MD	11/17/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A161022	N/A	N/A	N/A	N/A	N/A	515 COLUMBIA AVE	STE 200	LOS ANGELES	CA	90017	1007	00	06000	34.05683109	-118.265995	Los Angeles County
334802	Ordering, Referring, Prescribing	N/A	1477959104	0	0	HARANO, DENISE M	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH71962	N/A	N/A	N/A	N/A	N/A	1800 HARRISON ST	13TH FLOOR	OAKLAND	CA	94612	3466	00	06000	37.80593773	-122.2656714	Alameda County
334829	Ordering, Referring, Prescribing	N/A	1487005104	0	0	HUANG, ERICA PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73590	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
334830	Ordering, Referring, Prescribing	N/A	1487005260	0	0	HOPKINS, HEATHER N LCSW	11/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW98623	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
334832	Ordering, Referring, Prescribing	N/A	1487005450	0	0	HSU, TIFFANY W PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73077	N/A	N/A	N/A	N/A	N/A	7568 BARNHART PLACE	None	CUPERTINO	CA	95014	5238	00	06000	37.29440352	-122.0377307	Santa Clara County
334860	Ordering, Referring, Prescribing	N/A	1487039541	0	0	HOOMAN, FARANAK	4/19/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	86519	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE	None	SAN JOSE	CA	95128	2631	00	06000	37.3160785	-121.937121	Santa Clara County
334866	Ordering, Referring, Prescribing	N/A	1487041067	0	0	HERNANDEZ, ROSELY D LMFT	12/1/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108112	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
334901	Ordering, Referring, Prescribing	N/A	1487089801	0	0	HERNANDEZ, ESDRAS N LCSW	12/30/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW91858	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
334913	Ordering, Referring, Prescribing	N/A	1487112041	0	0	HOANG, ANDY PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH79039	N/A	N/A	N/A	N/A	N/A	903 E HUNTINGTON DR	None	MONROVIA	CA	91016	3715	00	06000	34.13964081	-117.9858194	Los Angeles County
334914	Ordering, Referring, Prescribing	N/A	1487111456	0	0	HENDRICKS MARQUEZ, JENNIFER M LMFT	11/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT135993	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
334932	Ordering, Referring, Prescribing	N/A	1487137105	0	0	HUANG, FLORA OD	10/12/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34082	N/A	N/A	N/A	N/A	N/A	7090 PARKWAY DRIVE	UNIT A	LA MESA	CA	91942	1596	00	06000	32.77342457	-117.043671	San Diego County
334968	Ordering, Referring, Prescribing	N/A	1487192530	0	0	HIYKEL, JACOB A LMFT	6/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT126399	N/A	N/A	N/A	N/A	N/A	100 POPLAR AVE	None	MODESTO	CA	95354	0510	00	06000	37.64602395	-121.000188	Stanislaus County
335023	Ordering, Referring, Prescribing	N/A	1487278040	0	0	HUANG, VIVIAN	1/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013744	N/A	N/A	N/A	N/A	N/A	29 BAYWOOD AVE	None	SAN MATEO	CA	94402	0000	00	06000	37.56478204	-122.3289243	San Mateo County
335029	Ordering, Referring, Prescribing	N/A	1487274825	0	0	HOEFFER, TATIANA MD	11/26/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A191499	N/A	N/A	N/A	N/A	N/A	264 N HIGHLAND SPRINGS S	D	BANNING	CA	92220	3082	00	06000	33.93063	-116.946864	Riverside County
335079	Ordering, Referring, Prescribing	N/A	1487642492	0	0	HYMAN, MICHAEL J MD	2/28/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79203	N/A	N/A	N/A	N/A	N/A	16311 VENTURA BLVD	800	ENCINO	CA	91436	7431	00	06000	34.15706864	-118.4885978	Los Angeles County
335088	Ordering, Referring, Prescribing	N/A	1487684965	0	0	HARRISON, GEORGE H MD	4/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G72867	N/A	N/A	N/A	N/A	N/A	1930 MARKET STREET	None	SAN FRANCISCO	CA	94102	6228	00	06000	37.77037155	-122.4255051	San Francisco County
335093	Ordering, Referring, Prescribing	N/A	1487713061	0	0	HUANG, YING H MD	7/30/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A90077	N/A	N/A	N/A	N/A	N/A	416 W LAS TUNAS DR	304	SAN GABRIEL	CA	91776	1236	00	06000	34.10243845	-118.1046106	Los Angeles County
335137	Ordering, Referring, Prescribing	N/A	1487781332	0	0	HARVEY, LISA LMFT	10/22/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38973	N/A	N/A	N/A	N/A	N/A	849 E. 6TH STREET	None	LOS ANGELES	CA	90021	1026	00	06000	34.03994957	-118.2414778	Los Angeles County
335170	Ordering, Referring, Prescribing	N/A	1487847349	0	0	HUI, JENNY PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58530	N/A	N/A	N/A	N/A	N/A	1200 EL CAMINO REAL	None	SOUTH SAN FRANCIS	CA	94080	7433	00	06000	37.65894608	-122.440161	San Mateo County
335201	Ordering, Referring, Prescribing	N/A	1487934709	0	0	HUNT, DYLAN K LCSW	3/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81516	N/A	N/A	N/A	N/A	N/A	1255 KENDALL ROAD	None	SAN LUIS OBISPO	CA	93401	8750	00	06000	35.2372881	-120.6292313	San Luis Obispo County
335223	Ordering, Referring, Prescribing	N/A	1487962965	0	0	HARRISON, DIANE L LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW74458	N/A	N/A	N/A	N/A	N/A	26137 LA PAZ RD	230	MISSION VIEJO	CA	92691	5319	00	06000	33.60038172	-117.6735855	Orange County
335236	Ordering, Referring, Prescribing	N/A	1487989273	0	0	HOOKSTRA, FRANCES LMFT	3/18/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122247	N/A	N/A	N/A	N/A	N/A	25115 AVE STANFORD	A-103	VALENCIA	CA	91355	4794	00	06000	34.43652793	-118.5753255	Los Angeles County
335259	Ordering, Referring, Prescribing	N/A	1497021646	0	0	HARRIS, ALLISON	12/5/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0820262	N/A	N/A	N/A	N/A	N/A	71777 SAN JACINTO DR	SUITE 202	RANCHO MIRAGE	CA	92270	4457	00	06000	33.74394755	-116.4124572	Riverside County
335278	Ordering, Referring, Prescribing	N/A	1497051189	0	0	HOFER, BRIAN PHARMD	7/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	49561	N/A	N/A	N/A	N/A	N/A	1405 W CAMERON AVE	None	VISALIA	CA	93277	9527	00	06000	36.292698	-119.306538	Tulare County
335351	Ordering, Referring, Prescribing	N/A	1497166144	0	0	HSU, CHIA-YU I NP	4/19/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95000249	N/A	N/A	N/A	N/A	N/A	211 EASTMOOR AVE	None	DALY CITY	CA	94015	2036	00	06000	37.6847337	-122.4787562	San Mateo County
335369	Ordering, Referring, Prescribing	N/A	1497199939	0	0	HEGDE, NANDITA LCSW	7/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28283	N/A	N/A	N/A	N/A	N/A	39155 LIBERTY STREET	G710	FREMONT	CA	94538	1513	00	06000	37.55123907	-121.9828956	Alameda County
335394	Ordering, Referring, Prescribing	N/A	1497235725	0	0	HO, CUONG Q PHARMD	6/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54638	N/A	N/A	N/A	N/A	N/A	9550 BOLSA AVE	109	WESTMINSTER	CA	92683	5944	00	06000	33.7447587	-117.9625358	Orange County
335400	Ordering, Referring, Prescribing	N/A	1497247373	0	0	HONG, JEONG IM LAC	12/27/2018	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	18020	N/A	N/A	N/A	N/A	N/A	7212 ORANGETHORPE AVE	9A	BUENA PARK	CA	90621	3341	00	06000	33.85890953	-118.007244	Orange County
335411	Ordering, Referring, Prescribing	N/A	1497257927	0	0	HARVEY, TAKIRA LCSW	10/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104864	N/A	N/A	N/A	N/A	N/A	8300 S VERMONT AVE	None	LOS ANGELES	CA	90044	3493	00	06000	33.963021	-118.291474	Los Angeles County
335418	Ordering, Referring, Prescribing	N/A	1497273650	0	0	HERRMANN, BRIDGETTE R LMFT	4/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113420	N/A	N/A	N/A	N/A	N/A	1692 EL CAMINO REAL	None	SAN CARLOS	CA	94070	5208	00	06000	37.49476947	-122.2457929	San Mateo County
335420	Ordering, Referring, Prescribing	N/A	1497266357	0	0	HASSANSHAHI, NAUZ OD	4/10/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	33841TLG	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
335424	Ordering, Referring, Prescribing	N/A	1497282883	0	0	HERNANDEZ, ALEXANDRA M LMFT	3/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT111037	N/A	N/A	N/A	N/A	N/A	2180 JOHNSON AVE	None	SAN LUIS OBISPO	CA	93401	4558	00	06000	35.27488974	-120.6468257	San Luis Obispo County
335439	Ordering, Referring, Prescribing	N/A	1497313654	0	0	HALVERSON, ASHLEY M LCSW	1/26/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	99739	N/A	N/A	N/A	N/A	N/A	8910 CLAIREMONT MESA BLV	None	SAN DIEGO	CA	92123	1104	00	06000	32.83150953	-117.136431	San Diego County
335455	Ordering, Referring, Prescribing	N/A	1497345771	0	0	HAJOU, TATIANA K NP	12/11/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016137	N/A	N/A	N/A	N/A	N/A	28137 LA PAZ ROAD	200	MISSION VIEJO	CA	92691	5321	00	06000	33.6026339	-117.6385618	Orange County
335465	Ordering, Referring, Prescribing	N/A	1497380992	0	0	HICKOK, KRISTEN NP	10/14/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013946	N/A	N/A	N/A	N/A	N/A	36101 BOB HOPE DRIVE	SUITE A1	RANCHO MIRAGE	CA	92270	2002	00	06000	33.786126	-116.406086	Riverside County
335567	Ordering, Referring, Prescribing	N/A	1497879936	0	0	HUH, YOUNGA L LCSW	1/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28203	N/A	N/A	N/A	N/A	N/A	515 COLUMBIA AVE	200	LOS ANGELES	CA	90017	1209	00	06000	34.05683109	-118.265995	Los Angeles County
335570	Ordering, Referring, Prescribing	N/A	1497881726	0	0	HOPPER, STEVEN D LMFT	9/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104894	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
335574	Ordering, Referring, Prescribing	N/A	1497884332	0	0	HODES, MARTIN J	2/4/1992	Taxonomy not applicable	NA	n/a	099	DENTIST	D37189	N/A	N/A	N/A	N/A	N/A	203 EAST BROADWAY	None	VISTA	CA	92084	0000	00	06000	33.20121106	-117.2417422	San Diego County
335575	Ordering, Referring, Prescribing	N/A	1497886006	0	0	HOUGHTON, CATHERINE M LMFT	12/23/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47044	N/A	N/A	N/A	N/A	N/A	43520 DIVISION ST	None	LANCASTER	CA	93535	4089	00	06000	34.673445	-118.130143	Los Angeles County
335593	Ordering, Referring, Prescribing	N/A	1497921324	0	0	HATHUC, KHOIVIET DO	1/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A11093	N/A	N/A	N/A	N/A	N/A	1855 W KATELLA AVE	None	ORANGE	CA	92867	3451	00	06000	33.8061655	-117.872442	Orange County
335617	Ordering, Referring, Prescribing	N/A	1497977110	0	0	HAYS, SHEILA B PHD	5/30/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	19426	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	SUITE 100	MONTCLAIR	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
335625	Ordering, Referring, Prescribing	N/A	1497986285	0	0	HELMI, JEHAN F MD	8/12/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A124839	N/A	N/A	N/A	N/A	N/A	101 THE CITY DRIVE, BLDG	None	ORANGE	CA	92868	9286	00	06000	33.78674051	-117.8888713	Orange County
335635	Ordering, Referring, Prescribing	N/A	1508031485	0	0	HONG, SOOBOK L PHD	3/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH47911	N/A	N/A	N/A	N/A	N/A	33601 DEL OBISPO ST	None	DANA POINT	CA	92629	2103	00	06000	33.47511226	-117.6850201	Orange County
335657	Ordering, Referring, Prescribing	N/A	1508080250	0	0	HARA, BELINDA A MD	11/16/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A97426	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
335737	Ordering, Referring, Prescribing	N/A	1508218280	0	0	HARRIS, AJILA LCSW	1/8/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71802	N/A	N/A	N/A	N/A	N/A	11100 SEPULVEDA BLVD	8-291	MISSION HILLS	CA	91345	2113	00	06000	34.27255732	-118.4675155	Los Angeles County
335741	Ordering, Referring, Prescribing	N/A	1508232000	0	0	HILL, SAMANTHA LCSW	10/9/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86206	N/A	N/A	N/A	N/A	N/A	4151 MEXICALI DRIVE	None	BAKERSFIELD	CA	93313	2065	00	06000	35.317233	-119.081649	Kern County
335750	Ordering, Referring, Prescribing	N/A	1508239948	0	0	HENDRICKSON, CHERI L LMFT	7/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT115235	N/A	N/A	N/A	N/A	N/A	137 N. COTTONWOOD ST.	STE 1500	WOODLAND	CA	95695	6646	00	06000	38.68538399	-121.7933582	Yolo County
335781	Ordering, Referring, Prescribing	N/A	1508266727	0	0	HAMMETT, GREGORY DO	12/20/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A14761	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
335790	Ordering, Referring, Prescribing	N/A	1508306366	0	0	HENSLEY, MICHAEL T LCSW	5/1/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75570	N/A	N/A	N/A	N/A	N/A	2145 5TH AVE	None	OROVILLE	CA	95965	5870	00	06000	39.50368243	-121.5646958	Butte County
335801	Ordering, Referring, Prescribing	N/A	1508326026	0	0	HE, YU TING MD	4/27/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178174	N/A	N/A	N/A	N/A	N/A	2574 SAN BRUNO AVE	None	SAN FRANCISCO	CA	94134	1505	00	06000	37.72907852	-122.4042585	San Francisco County
335811	Ordering, Referring, Prescribing	N/A	1508336983	0	0	HAN, SAMANTHA NP	11/19/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009556	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
335822	Ordering, Referring, Prescribing	N/A	1508349663	0	0	HUINQUEZ, CASSANDRA LCSW	5/25/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101652	N/A	N/A	N/A	N/A	N/A	3665 KEARNY VILLA ROAD	SUITE 101	SAN DIEGO	CA	92123	1953	00	06000	32.80816826	-117.1510112	San Diego County
335885	Ordering, Referring, Prescribing	N/A	1508476490	0	0	HUANG, JIANGSHAN PHARMD	2/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82658	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
335940	Ordering, Referring, Prescribing	N/A	1508686064	0	0	HORSLEY, ALLISON NP	6/21/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95030677	N/A	N/A	N/A	N/A	N/A	151 E WEBSTER ST	STE B	COLUSA	CA	95932	2970	00	06000	39.20745427	-122.0008341	Colusa County
335953	Ordering, Referring, Prescribing	N/A	1508840265	0	0	HAMANN, CHRISTOPHER MD	1/11/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C183803	N/A	N/A	N/A	N/A	N/A	400 CONCAR DR	None	SAN MATEO	CA	94402	2681	00	06000	37.55338259	-122.3076528	San Mateo County
335960	Ordering, Referring, Prescribing	N/A	1508865023	0	0	HERNANDEZ, MICHAEL MD	6/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A43165	N/A	N/A	N/A	N/A	N/A	1720 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90033	2414	00	06000	34.04925	-118.2177405	Los Angeles County
335977	Ordering, Referring, Prescribing	N/A	1508920380	0	0	HUYNH, TRUC L	4/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	51440	N/A	N/A	N/A	N/A	N/A	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	00	06000	38.594898	-121.3884765	Sacramento County
336001	Ordering, Referring, Prescribing	N/A	1508982612	0	0	HABERZURITA, DEBRA M LCSW	4/3/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW15515	N/A	N/A	N/A	N/A	N/A	399 TAYLOR BLVD	210	PLEASANT HILL	CA	94523	2287	00	06000	37.96117359	-122.0721927	Contra Costa County
336002	Ordering, Referring, Prescribing	N/A	1508983685	0	0	HUNTLEY, KENNETH R LMFT	9/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	37511	N/A	N/A	N/A	N/A	N/A	800 SCENIC DR	None	MODESTO	CA	95350	6131	00	06000	37.64722447	-120.9836925	Stanislaus County
336021	Ordering, Referring, Prescribing	N/A	1518008697	0	0	HEINDSELMAN, TRACY L PHD	1/21/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	20744	N/A	N/A	N/A	N/A	N/A	1908 BUSINESS CENTER DRI	220	SAN BERNARDINO	CA	92408	3468	00	06000	34.06732096	-117.2801085	San Bernardino County
336038	Ordering, Referring, Prescribing	N/A	1518045384	0	0	HU, GENA MD	3/14/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79006	N/A	N/A	N/A	N/A	N/A	1885 LUNDY AVE	223	SAN JOSE	CA	95131	1887	00	06000	37.39329538	-121.8907367	Santa Clara County
336047	Ordering, Referring, Prescribing	N/A	1518071679	0	0	HANSON, KARI A LMFT	11/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123228	N/A	N/A	N/A	N/A	N/A	8912 VOLUNTEER LN	None	SACRAMENTO	CA	95826	3221	00	06000	38.55438	-121.3756965	Sacramento County
336050	Ordering, Referring, Prescribing	N/A	1518080506	0	0	HANNAH, KATHY L LMFT	4/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43976	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
336083	Ordering, Referring, Prescribing	N/A	1518130830	0	0	HUYNH, BACHYEN T	2/4/2018	Taxonomy not applicable	NA	n/a	000	Unknown	18618	N/A	N/A	N/A	N/A	N/A	2101 TENAYA DRIVE	None	MODESTO	CA	95354	3930	00	06000	37.6324545	-120.956463	Stanislaus County
336113	Ordering, Referring, Prescribing	N/A	1518191659	0	0	HERRICK, KARA M LMFT	5/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT43283	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
336124	Ordering, Referring, Prescribing	N/A	1518222488	0	0	HANNON, SUSAN M LCSW	8/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	20199	N/A	N/A	N/A	N/A	N/A	81812 DR CARREON BLVD	D	INDIO	CA	92201	5594	00	06000	33.70742848	-116.236728	Riverside County
336169	Ordering, Referring, Prescribing	N/A	1518307164	0	0	HUDDLESTON, SHANNON M PSYD	3/10/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29981	N/A	N/A	N/A	N/A	N/A	2325 CLEMENT AVE.	SUITE A	ALAMEDA	CA	94501	7061	00	06000	37.77017367	-122.2389726	Alameda County
336198	Ordering, Referring, Prescribing	N/A	1518348846	0	0	HEINS, MICHELLE L NP	10/31/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	837115	N/A	N/A	N/A	N/A	N/A	201 29TH ST	STE B	SACRAMENTO	CA	95816	3271	00	06000	38.581875	-121.463802	Sacramento County
336251	Ordering, Referring, Prescribing	N/A	1518426352	0	0	HUANG, SIU-YUAN L MD	7/31/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182424	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
336269	Ordering, Referring, Prescribing	N/A	1518453166	0	0	HERRERA, LUIS M MSW LCSW	9/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW110641	N/A	N/A	N/A	N/A	N/A	11731 TELEGRAPH RD	G	SANTA FE SPRINGS	CA	90670	3675	00	06000	33.94630253	-118.0832082	Los Angeles County
336273	Ordering, Referring, Prescribing	N/A	1518450758	0	0	HEFFINGTON, VANESSA	10/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128851	N/A	N/A	N/A	N/A	N/A	5960 S LAND PARK DR	769	SACRAMENTO	CA	95822	3313	00	06000	38.51919	-121.513455	Sacramento County
336304	Ordering, Referring, Prescribing	N/A	1518527746	0	0	HAGOS, AMANDA R LCSW	2/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83636	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
336316	Ordering, Referring, Prescribing	N/A	1518570852	0	0	HAUGEN, KIRK J	10/27/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	105334	N/A	N/A	N/A	N/A	N/A	940 SYLVA LN	STE K2	SONORA	CA	95370	5969	00	06000	37.98764779	-120.3681842	Tuolumne County
336326	Ordering, Referring, Prescribing	N/A	1518595008	0	0	HUESO, IRIS V LMFT	7/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140484	N/A	N/A	N/A	N/A	N/A	2130 NATIONAL AVE	None	SAN DIEGO	CA	92113	2209	00	06000	32.69800063	-117.1411927	San Diego County
336376	Ordering, Referring, Prescribing	N/A	1528010998	0	0	HASAN, SYED MD	5/20/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A68482	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
336385	Ordering, Referring, Prescribing	N/A	1528054475	0	0	HARRIS, APRIL A NP	1/21/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	492918	N/A	N/A	N/A	N/A	N/A	723 WALNUT DR	None	PASO ROBLES	CA	93446	2315	00	06000	35.6288215	-120.6724095	San Luis Obispo County
336396	Ordering, Referring, Prescribing	N/A	1528096294	0	0	HORTON, LESLIE A MD	7/1/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G70296	N/A	N/A	N/A	N/A	N/A	200 HILLMONT AVE	None	VENTURA	CA	93003	1651	00	06000	34.2764461	-119.253765	Ventura County
336423	Ordering, Referring, Prescribing	N/A	1528152295	0	0	HOLLINS, VIOLA R MD	4/5/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G166997	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
336432	Ordering, Referring, Prescribing	N/A	1528190725	0	0	HUDSON, MARK LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	78609	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
336437	Ordering, Referring, Prescribing	N/A	1528195047	0	0	HSU, HSIANG LING PSYD	11/24/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	21532	N/A	N/A	N/A	N/A	N/A	11050 E ARTESIA BLVD	SUITE - F	CERRITOS	CA	90703	2542	00	06000	33.8728535	-118.097847	Los Angeles County
336454	Ordering, Referring, Prescribing	N/A	1528242070	0	0	HAYNES, JARON D LMFT	3/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88574	N/A	N/A	N/A	N/A	N/A	1000 BROADWAY	None	EL CAJON	CA	92021	7417	00	06000	32.80772549	-116.94771	San Diego County
336460	Ordering, Referring, Prescribing	N/A	1528253168	0	0	HOLLAND, JANEL I LMFT	2/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	91153	N/A	N/A	N/A	N/A	N/A	2712 MISSION	ALTERNATIVES/MISSION ICM	SF CA	CA	94110	3104	00	06000	37.75336705	-122.4185922	San Francisco County
336498	Ordering, Referring, Prescribing	N/A	1528331378	0	0	HERNANDEZ, ADOLFO M LMFT	8/2/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126948	N/A	N/A	N/A	N/A	N/A	1661 NORTH E STREET	None	SAN BERNARDINO	CA	92405	4405	00	06000	34.1297697	-117.2941003	San Bernardino County
336502	Ordering, Referring, Prescribing	N/A	1528332111	0	0	HATTICK, ALEXANDRA S LCSW	5/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW94498	N/A	N/A	N/A	N/A	N/A	370 S. CRENSHAW BOULEVAR	STE E 100	TORRANCE	CA	90503	1727	00	06000	33.84549	-118.3287415	Los Angeles County
336508	Ordering, Referring, Prescribing	N/A	1528340817	0	0	HERNANDEZ, KARINA LCSW	6/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79023	N/A	N/A	N/A	N/A	N/A	649 E ALBERTONI ST	100	CARSON	CA	90746	1538	00	06000	33.87194399	-118.2643054	Los Angeles County
336530	Ordering, Referring, Prescribing	N/A	1528372042	0	0	HEIL, MICHELLE L LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90950	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
336591	Ordering, Referring, Prescribing	N/A	1528460144	0	0	HERRON, JOHANNA N LMFT	5/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	101175	N/A	N/A	N/A	N/A	N/A	2245 CHALENGER WAY	None	SANTA ROSA	CA	95407	5418	00	06000	38.42559	-122.751243	Sonoma County
336596	Ordering, Referring, Prescribing	N/A	1528471216	0	0	HAGARMAN, RYAN LCSW	4/24/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101063	N/A	N/A	N/A	N/A	N/A	5580 CALLE REAL	None	GOLETA	CA	93111	1646	00	06000	34.44131559	-119.8184752	Santa Barbara County
336622	Ordering, Referring, Prescribing	N/A	1528531225	0	0	HERNANDEZ, JACINTO LMFT	7/12/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT126906	N/A	N/A	N/A	N/A	N/A	4000 W METROPOLITAN DR	None	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
336636	Ordering, Referring, Prescribing	N/A	1528540465	0	0	HENNINGFIELD, JENNIFER A LCSW	12/7/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	16000	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
336649	Ordering, Referring, Prescribing	N/A	1528570231	0	0	HO, THIEN KIM K PHARMD	1/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77863	N/A	N/A	N/A	N/A	N/A	645 SAN ANTONIO RD	None	MOUNTAIN VIEW	CA	94040	1303	00	06000	37.40220238	-122.1130454	Santa Clara County
336676	Ordering, Referring, Prescribing	N/A	1528606076	0	0	HERBERT, SUSAN A LMFT	5/24/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	139714	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
336706	Ordering, Referring, Prescribing	N/A	1528650801	0	0	HERNANDEZ, AMANDA LMFT	11/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT143213	N/A	N/A	N/A	N/A	N/A	21545 CENTRE POINTE PKWY	None	SANTA CLARITA	CA	91350	2947	00	06000	34.413021	-118.514534	Los Angeles County
336727	Ordering, Referring, Prescribing	N/A	1528699337	0	0	HUI, CALVIN PHARMD	7/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	81372	N/A	N/A	N/A	N/A	N/A	2550 OCEAN AVE	None	SAN FRANCISCO	CA	94112	1718	00	06000	37.73153503	-122.4728702	San Francisco County
336768	Ordering, Referring, Prescribing	N/A	1538160353	0	0	HAWKES, ELIZABETH K MD	9/30/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G85127	N/A	N/A	N/A	N/A	N/A	3861 SEPULVEDA BLVD	None	CULVER CITY	CA	90230	4605	00	06000	34.01133074	-118.4159833	Los Angeles County
336792	Ordering, Referring, Prescribing	N/A	1538213152	0	0	HOLT, ALBERT MD	5/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A90946	N/A	N/A	N/A	N/A	N/A	1301 PIERCE ST	None	SAN FRANCISCO	CA	94115	4005	00	06000	37.78238106	-122.4359186	San Francisco County
336795	Ordering, Referring, Prescribing	N/A	1538208814	0	0	HURDLE, CONNIE M LMFT	4/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34265	N/A	N/A	N/A	N/A	N/A	1414 S MILLER ST	D	SANTA MARIA	CA	93454	6923	00	06000	34.937433	-120.431561	Santa Barbara County
336801	Ordering, Referring, Prescribing	N/A	1538226824	0	0	HANAWAY, SHARLENE M LMFT	7/31/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT27221	N/A	N/A	N/A	N/A	N/A	445 BELLLEVUE AVE	SUITE 203	OAKLAND	CA	94610	4923	00	06000	37.80910261	-122.2526914	Alameda County
336830	Ordering, Referring, Prescribing	N/A	1538292032	0	0	HANNA, RAGAA R LMFT	12/7/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42956	N/A	N/A	N/A	N/A	N/A	530 W BADILLO ST	None	COVINA	CA	91722	3787	00	06000	34.08625283	-117.8999625	Los Angeles County
336843	Ordering, Referring, Prescribing	N/A	1538319645	0	0	HENLEY, MEARA E NP	2/10/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002545	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
336866	Ordering, Referring, Prescribing	N/A	1538369806	0	0	HUNTSMAN, MARY ANN H PHARMD	8/28/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH37998	N/A	N/A	N/A	N/A	N/A	1550 SUPERIOR AVE	None	COSTA MESA	CA	92627	3653	00	06000	33.63305341	-117.9266303	Orange County
336878	Ordering, Referring, Prescribing	N/A	1538390760	0	0	HAN, JENNIFER A PHARMD	4/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	62567	N/A	N/A	N/A	N/A	N/A	11080 MAGNOLIA AVE	None	RIVERSIDE	CA	92505	3047	00	06000	33.90402176	-117.4750005	Riverside County
336884	Ordering, Referring, Prescribing	N/A	1538408877	0	0	HOWARD-YARBER, VICTORIA OT	10/5/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT2263	N/A	N/A	N/A	N/A	N/A	391 TAYLOR BLVD.	100	PLEASANT HILL	CA	94523	2289	00	06000	37.96119614	-122.070409	Contra Costa County
336889	Ordering, Referring, Prescribing	N/A	1538417449	0	0	HER, GE LCSW	11/17/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW105627	N/A	N/A	N/A	N/A	N/A	1925 E DAKOTA AVE	None	FRESNO	CA	93726	4821	00	06000	36.78683208	-119.7876584	Fresno County
336891	Ordering, Referring, Prescribing	N/A	1538418892	0	0	HON, VIRGINIA C PHARMD	3/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67493	N/A	N/A	N/A	N/A	N/A	975 SERENO DRIVE	None	VALLEJO	CA	94589	2489	00	06000	38.12828446	-122.24821	Solano County
336897	Ordering, Referring, Prescribing	N/A	1538429741	0	0	HUGHES, ANNE E LMFT	7/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102270	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	220	MISSION VIEJO	CA	92691	6441	00	06000	33.56536541	-117.670334	Orange County
336904	Ordering, Referring, Prescribing	N/A	1538427729	0	0	HILDEBRANDT, ERICA J LCSW	5/27/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	C008854	N/A	N/A	N/A	N/A	N/A	33100 COUNTY ROAD 31	None	DAVIS	CA	95616	9523	00	06000	38.562426	-121.893282	Yolo County
336915	Ordering, Referring, Prescribing	N/A	1538447230	0	0	HWANG, HENRY LAC	3/24/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC10180	N/A	N/A	N/A	N/A	N/A	16200 AMBER VALLEY DRIVE	None	WHITTIER	CA	90604	4051	00	06000	33.92458653	-117.9826605	Los Angeles County
336921	Ordering, Referring, Prescribing	N/A	1538459011	0	0	HASSAMAL, SAMEER K MD	3/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A133740	N/A	N/A	N/A	N/A	N/A	11721 TELEGRAPH RD	None	SANTA FE SPRINGS	CA	90670	3674	00	06000	33.94629336	-118.0832752	Los Angeles County
336928	Ordering, Referring, Prescribing	N/A	1538478318	0	0	HOLT, MATTHEW LCSW	4/11/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96472	N/A	N/A	N/A	N/A	N/A	22245 MAIN STREET	SUITE 200	HAYWARD	CA	94541	4028	00	06000	37.67674766	-122.0863181	Alameda County
336954	Ordering, Referring, Prescribing	N/A	1538518030	0	0	HTAIK, YIN PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH72479	N/A	N/A	N/A	N/A	N/A	1175 COLUMBUS AVE	None	SAN FRANCISCO	CA	94133	1729	00	06000	37.80490869	-122.4168359	San Francisco County
336969	Ordering, Referring, Prescribing	N/A	1538540919	0	0	HEIB, SANDRA LCSW	7/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95387	N/A	N/A	N/A	N/A	N/A	108 W. VICTORIA	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
336976	Ordering, Referring, Prescribing	N/A	1538545272	0	0	HARRIS, MILES NP	1/10/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009050	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
336983	Ordering, Referring, Prescribing	N/A	1538558721	0	0	HURTADO, SANDRA E LMFT	1/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105664	N/A	N/A	N/A	N/A	N/A	209 E 7TH ST	None	MADERA	CA	93638	3780	00	06000	36.96069768	-120.0559841	Madera County
336995	Ordering, Referring, Prescribing	N/A	1538569694	0	0	HY, ALICE K PHARMD	1/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67562	N/A	N/A	N/A	N/A	N/A	900 S HARBOR BLVD	None	FULLERTON	CA	92832	3025	00	06000	33.862491	-117.921951	Orange County
337004	Ordering, Referring, Prescribing	N/A	1538587852	0	0	HAMILTON, ROSS M MD	8/4/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A167538	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
337009	Ordering, Referring, Prescribing	N/A	1538591003	0	0	HASAN, KAYCEE I LCSW	7/22/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	109368	N/A	N/A	N/A	N/A	N/A	8755 FONTAINE ST	None	OAKLAND	CA	94605	4141	00	06000	37.76227212	-122.1514142	Alameda County
337039	Ordering, Referring, Prescribing	N/A	1538648688	0	0	HWANG, MATTHEW RCP	10/15/2017	Taxonomy not applicable	NA	n/a	000	Unknown	30723	N/A	N/A	N/A	N/A	N/A	25825 VERMONT AVE	None	HARBOR CITY	CA	90710	3518	00	06000	33.78673844	-118.2965289	Los Angeles County
337050	Ordering, Referring, Prescribing	N/A	1538663513	0	0	HORTON, JOHN MD	11/25/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166834	N/A	N/A	N/A	N/A	N/A	11080 W OLYMPIC BLVD	None	LOS ANGELES	CA	90064	1937	00	06000	34.04036814	-118.4376056	Los Angeles County
337057	Ordering, Referring, Prescribing	N/A	1538673850	0	0	HOLBDY, PHILLIP L PHD	11/21/2017	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	29676	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
337079	Ordering, Referring, Prescribing	N/A	1538711809	0	0	HOTHI, NAVEEN PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79158	N/A	N/A	N/A	N/A	N/A	1011 RIVERSIDE AVE	None	ROSEVILLE	CA	95678	5134	00	06000	38.72827776	-121.2904066	Placer County
337101	Ordering, Referring, Prescribing	N/A	1538754825	0	0	HUEZO, MARJANI LCSW	10/10/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	126686	N/A	N/A	N/A	N/A	N/A	1151 E WALNUT ST	None	ONTARIO	CA	91761	6155	00	06000	34.026975	-117.6303375	San Bernardino County
337165	Ordering, Referring, Prescribing	N/A	1548080377	0	0	HUANG, KRISTY PHARMD	9/23/2024	Taxonomy not applicable	NA	n/a	000	Unknown	90249	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
337170	Ordering, Referring, Prescribing	N/A	1548207152	0	0	HUTHSTEINER, CONNY D MD	10/8/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C53158	N/A	N/A	N/A	N/A	N/A	100 E. THOUSAND OAKS BLV	139	THOUSAND OAKS	CA	91360	8129	00	06000	34.17902886	-118.8749335	Ventura County
337184	Ordering, Referring, Prescribing	N/A	1548262975	0	0	HOLIWELL, ROSIE B PA-C	3/25/2020	Taxonomy not applicable	NA	n/a	000	Unknown	15781	N/A	N/A	N/A	N/A	N/A	6001-A TRUXTUN AVE	160	BAKERSFIELD	CA	93309	0693	00	06000	35.36252236	-119.072932	Kern County
337229	Ordering, Referring, Prescribing	N/A	1548388903	0	0	HITCHCOCK-CHAPPELLE, DIERDRE S LMFT	6/20/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38753	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
337235	Ordering, Referring, Prescribing	N/A	1548396328	0	0	HOYLE, LINDA J LMFT	7/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT17875	N/A	N/A	N/A	N/A	N/A	3628 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2153	00	06000	35.35426453	-119.045007	Kern County
337281	Ordering, Referring, Prescribing	N/A	1548509961	0	0	HARRISON, KATHLEEN Y LCSW	6/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25364	N/A	N/A	N/A	N/A	N/A	828 S. BASCOM AVE.	180	SAN JOSE	CA	95128	2600	00	06000	37.31225204	-121.9317854	Santa Clara County
337284	Ordering, Referring, Prescribing	N/A	1548497373	0	0	HSIN, OLIVIA PHD	4/1/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	26035	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD MS#53	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
337288	Ordering, Referring, Prescribing	N/A	1548525215	0	0	HAYS, ALYSIA M LCSW	6/18/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	69387	N/A	N/A	N/A	N/A	N/A	38883 HWY 299	None	WILLOW CREEK	CA	95573	0726	00	06000	40.93997425	-123.6336606	Humboldt County
337309	Ordering, Referring, Prescribing	N/A	1548561251	0	0	HEIN, SYLVIA	3/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63276	N/A	N/A	N/A	N/A	N/A	7544 GIRARD AVE	None	LA JOLLA	CA	92037	5101	00	06000	32.84185671	-117.2729557	San Diego County
337336	Ordering, Referring, Prescribing	N/A	1548615719	0	0	HINOJOSA, ELIZABETH D PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78753	N/A	N/A	N/A	N/A	N/A	4351 E IMPERIAL HWY	None	LYNWOOD	CA	90202	2318	00	06000	33.93079627	-118.1842645	Los Angeles County
337338	Ordering, Referring, Prescribing	N/A	1548623937	0	0	HARRIS, BREJON NP	2/14/2023	Taxonomy not applicable	NA	n/a	000	Unknown	NP95024280	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
337347	Ordering, Referring, Prescribing	N/A	1548633407	0	0	HUYNH, BAOANH	4/1/2018	Taxonomy not applicable	NA	n/a	000	Unknown	73843	N/A	N/A	N/A	N/A	N/A	14200 PALM DR	None	DESERT HOT SPRING	CA	92240	6873	00	06000	33.94538937	-116.5012248	Riverside County
337357	Ordering, Referring, Prescribing	N/A	1548643521	0	0	HSIN, HONG-YUAN J	6/28/2020	Taxonomy not applicable	NA	n/a	099	DENTIST	101215	N/A	N/A	N/A	N/A	N/A	1855 N FAIR OAKS AVE	None	PASADENA	CA	91103	1620	00	06000	34.177806	-118.1507985	Los Angeles County
337372	Ordering, Referring, Prescribing	N/A	1548683238	0	0	HOSEIN, RAMI J MD	3/23/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151495	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FL STE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
337374	Ordering, Referring, Prescribing	N/A	1548679335	0	0	HEITZIG, ASHLEY D PSYD	3/22/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	29926	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
337381	Ordering, Referring, Prescribing	N/A	1548693302	0	0	HO, QUYEN V PHARMD	8/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66125	N/A	N/A	N/A	N/A	N/A	24382 MUIRLANDS BLVD, LA	None	LAKE FOREST	CA	92630	3679	00	06000	33.62847787	-117.7048119	Orange County
337393	Ordering, Referring, Prescribing	N/A	1548717507	0	0	HORTON, TANIESHA LCSW	9/18/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98261	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
337400	Ordering, Referring, Prescribing	N/A	1548723091	0	0	HEAD, SHAUGHN M MD	8/3/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A188415	N/A	N/A	N/A	N/A	N/A	155 15TH ST	SUITE A	WEST SACRAMENTO	CA	95691	3737	00	06000	38.57104661	-121.5260133	Yolo County
337431	Ordering, Referring, Prescribing	N/A	1548772940	0	0	HOU, KAROLYN S PHARMD	3/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68274	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	None	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
337436	Ordering, Referring, Prescribing	N/A	1548781917	0	0	HERNANDEZ, MIRANDA L LMFT	5/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118276	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
337438	Ordering, Referring, Prescribing	N/A	1548782105	0	0	HARRINGTON, ELLEN R LCSW	12/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99331	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN STREET	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
337477	Ordering, Referring, Prescribing	N/A	1548897077	0	0	HARE, EMMA DO	6/28/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19839	N/A	N/A	N/A	N/A	N/A	3440 VIKING DR	None	SACRAMENTO	CA	95827	2844	00	06000	38.562795	-121.33143	Sacramento County
337522	Ordering, Referring, Prescribing	N/A	1558051748	0	0	HOLTAN, DAWN C LMFT	1/14/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152671	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
337529	Ordering, Referring, Prescribing	N/A	1558065672	0	0	HINDS, NICOLE	7/1/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197353	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
337530	Ordering, Referring, Prescribing	N/A	1558083121	0	0	HOANG, MARVIN NP	5/26/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021083	N/A	N/A	N/A	N/A	N/A	2418 SAN GABRIEL BLVD	A	ROSEMEAD	CA	91770	3674	00	06000	34.0558524	-118.0905163	Los Angeles County
337539	Ordering, Referring, Prescribing	N/A	1558125914	0	0	HONG, CAYLA OD	2/7/2024	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35637TLG	N/A	N/A	N/A	N/A	N/A	1182 N EUCLID ST	None	ANAHEIM	CA	92801	1900	00	06000	33.849909	-117.9416115	Orange County
337563	Ordering, Referring, Prescribing	N/A	1558373506	0	0	HOWARD, KEITH PHD	7/7/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY20187	N/A	N/A	N/A	N/A	N/A	800 N ECKHOFF ST	None	ORANGE	CA	92868	1008	00	06000	33.79960624	-117.8741126	Orange County
337571	Ordering, Referring, Prescribing	N/A	1558375022	0	0	HARTWICK, ELSA M MD	3/10/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A65743	N/A	N/A	N/A	N/A	N/A	1414 S GRAND AVE	380	LOS ANGELES	CA	90015	3067	00	06000	34.03661142	-118.2657227	Los Angeles County
337588	Ordering, Referring, Prescribing	N/A	1558457457	0	0	HEDGEMON, MELANIE G PA-C	3/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	11497	N/A	N/A	N/A	N/A	N/A	400 WEST 30TH STREET	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
337615	Ordering, Referring, Prescribing	N/A	1558516898	0	0	HENRY, BRIANA LMFT	2/11/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT104847	N/A	N/A	N/A	N/A	N/A	1791 W ACACIA AVE	None	HEMET	CA	92545	3797	00	06000	33.74376019	-116.9903284	Riverside County
337683	Ordering, Referring, Prescribing	N/A	1558662817	0	0	HUA, LINH Y PHARMD	5/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	51830	N/A	N/A	N/A	N/A	N/A	32401 CAMINO CAPISTRANP	None	SAN JUAN CAPISTRA	CA	92675	4517	00	06000	33.49262774	-117.6627855	Orange County
337688	Ordering, Referring, Prescribing	N/A	1558686501	0	0	HASKELL, ROBERT J MD	1/4/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A125983	N/A	N/A	N/A	N/A	N/A	3200 MOTOR AVENUE	None	LOS ANGELES	CA	90034	3710	00	06000	34.03321301	-118.4109122	Los Angeles County
337694	Ordering, Referring, Prescribing	N/A	1558692574	0	0	HARREL, NICHOLAS D MD	9/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C163141	N/A	N/A	N/A	N/A	N/A	1680 PAUL BUNYAN RD	None	SUSANVILLE	CA	96130	3133	00	06000	40.42141164	-120.6468171	Lassen County
337731	Ordering, Referring, Prescribing	N/A	1558718403	0	0	HUGHES, ANDREW T LCSW	6/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113012	N/A	N/A	N/A	N/A	N/A	631 S. MAPLE AVE	UNIT A	LOS ANGELES	CA	90014	2211	00	06000	34.04323075	-118.2485358	Los Angeles County
337743	Ordering, Referring, Prescribing	N/A	1558781245	0	0	HARRIS, DESIREE I LPCC	6/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC11676	N/A	N/A	N/A	N/A	N/A	600 N. ARROWHEAD AVENUE	SUITE 300	SAN BERNARDINO	CA	92401	0000	00	06000	34.110486	-117.2896755	San Bernardino County
337747	Ordering, Referring, Prescribing	N/A	1558783274	0	0	HASBROUCK, ALETHEA LCSW	11/16/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	89698	N/A	N/A	N/A	N/A	N/A	466 8TH AVE	None	SANTA CRUZ	CA	95062	0000	00	06000	36.96733408	-121.9972043	Santa Cruz County
337748	Ordering, Referring, Prescribing	N/A	1558785360	0	0	HELU, MARYANA M LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96711	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS STE 22	SUITE 220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
337765	Ordering, Referring, Prescribing	N/A	1558805242	0	0	HERBERT, THERESA M OT	3/8/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	4458	N/A	N/A	N/A	N/A	N/A	686 E MILL ST	None	SAN BERNARDINO	CA	92408	1610	00	06000	34.09216669	-117.2710544	San Bernardino County
337783	Ordering, Referring, Prescribing	N/A	1558844977	0	0	HOFFMAN, RACHEL L NP	9/11/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010001	N/A	N/A	N/A	N/A	N/A	1030 E BROCKTON AVE	None	REDLANDS	CA	92374	3611	00	06000	34.06636048	-117.168048	San Bernardino County
337786	Ordering, Referring, Prescribing	N/A	1558845412	0	0	HOANG, VIVIAN T PA	6/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA55925	N/A	N/A	N/A	N/A	N/A	2032 MARENGO ST	None	LOS ANGELES	CA	90033	1319	00	06000	34.0566188	-118.2074593	Los Angeles County
337787	Ordering, Referring, Prescribing	N/A	1558845263	0	0	HARPST, SARAH M NP	1/17/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009421	N/A	N/A	N/A	N/A	N/A	4321 COLLINGTON RD	None	BOWIE	MD	20716	2259	00	06000	38.947581	-76.733703	Prince George's County
337817	Ordering, Referring, Prescribing	N/A	1558889444	0	0	HABIB, SHADDI M PHARMD	1/25/2019	Taxonomy not applicable	NA	n/a	000	Unknown	76737	N/A	N/A	N/A	N/A	N/A	845 COLLEGE BLVD	None	OCEANSIDE	CA	92057	6258	00	06000	33.240771	-117.294741	San Diego County
337821	Ordering, Referring, Prescribing	N/A	1558889006	0	0	HENNING, JESSICA PT	11/22/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT294277	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
337828	Ordering, Referring, Prescribing	N/A	1558914531	0	0	HANEY, KARA LCSW	1/23/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	120617	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
337832	Ordering, Referring, Prescribing	N/A	1558920801	0	0	HYMES, RACHEL M	7/30/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	103823	N/A	N/A	N/A	N/A	N/A	355 CENTRAL AVE	None	FILLMORE	CA	93015	1920	00	06000	34.40028802	-118.9137057	Ventura County
337852	Ordering, Referring, Prescribing	N/A	1558971945	0	0	HASHIM, USOF PHARMD	7/23/2020	Taxonomy not applicable	NA	n/a	000	Unknown	82655	N/A	N/A	N/A	N/A	N/A	5713 N PERSHING AVE	A3	STOCKTON	CA	95207	4942	00	06000	38.00011235	-121.3261426	San Joaquin County
337854	Ordering, Referring, Prescribing	N/A	1558972018	0	0	HOGAN, KATHLEEN LCSW	12/11/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127718	N/A	N/A	N/A	N/A	N/A	1371 DETROIT AVE	None	CONCORD	CA	94520	3521	00	06000	37.96606732	-122.0390313	Contra Costa County
337867	Ordering, Referring, Prescribing	N/A	1568008225	0	0	HUYNH, KATHERINE T NP	3/8/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	F07191522	N/A	N/A	N/A	N/A	N/A	368 FELL ST	None	SAN FRANCISCO	CA	94102	5144	00	06000	37.77587758	-122.4234278	San Francisco County
337922	Ordering, Referring, Prescribing	N/A	1568144871	0	0	HARLOW, HEIDI J NP	7/28/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026353	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
337941	Ordering, Referring, Prescribing	N/A	1568184745	0	0	HOURANI, DINA LMFT	7/11/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	147995	N/A	N/A	N/A	N/A	N/A	18350 MT. LANGLEY ST.	220	FOUNTAIN VALLEY	CA	92798	6900	00	06000	33.69633523	-117.9420534	Orange County
337948	Ordering, Referring, Prescribing	N/A	1568245355	0	0	HERNANDEZ, ALEXANDRA PA	1/27/2024	Taxonomy not applicable	NA	n/a	000	Unknown	63983	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
337971	Ordering, Referring, Prescribing	N/A	1568491363	0	0	HURT, CARLA PA-C	1/5/2023	Taxonomy not applicable	NA	n/a	000	Unknown	17951	N/A	N/A	N/A	N/A	N/A	4723 W MAIN ST	SUITE H	GUADALUPE	CA	93434	1787	00	06000	34.9576413	-120.5778803	Santa Barbara County
338014	Ordering, Referring, Prescribing	N/A	1568584076	0	0	HEIRENDT, ROBERT L LCSW	12/11/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23165	N/A	N/A	N/A	N/A	N/A	988 MCCOURTNEY RD	STE. 102	GRASS VALLEY	CA	95949	7400	00	06000	39.2089732	-121.0729043	Nevada County
338030	Ordering, Referring, Prescribing	N/A	1568612034	0	0	HADAYA, ZAKI S	1/18/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH60981	N/A	N/A	N/A	N/A	N/A	276 W COLLEGE ST	None	COVINA	CA	91723	1902	00	06000	34.08747441	-117.8941951	Los Angeles County
338037	Ordering, Referring, Prescribing	N/A	1568651495	0	0	HAMLING-BALL, DEBORAH J NP	9/4/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	270009	N/A	N/A	N/A	N/A	N/A	5500 CAMPANILE DR	None	SAN DIEGO	CA	92182	4701	00	06000	32.77590585	-117.0722922	San Diego County
338040	Ordering, Referring, Prescribing	N/A	1568651032	0	0	HAIR, TERRY	1/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH37815	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
338060	Ordering, Referring, Prescribing	N/A	1568678605	0	0	HONG, JEANNE MD	5/13/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A95624	N/A	N/A	N/A	N/A	N/A	2226 N 1ST ST	None	SAN JOSE	CA	95131	2007	00	06000	37.3776967	-121.9213514	Santa Clara County
338068	Ordering, Referring, Prescribing	N/A	1568707487	0	0	HAYES, KRISTINE S LPCC	2/23/2020	Taxonomy not applicable	NA	n/a	000	Unknown	4006	N/A	N/A	N/A	N/A	N/A	365 S RANCHO SANTA FE RD	100	SAN MARCOS	CA	92078	2303	00	06000	33.14154576	-117.2025301	San Diego County
338084	Ordering, Referring, Prescribing	N/A	1568731818	0	0	HODGE, MAUREEN P LCSW	8/1/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW20390	N/A	N/A	N/A	N/A	N/A	120 N ASHWOOD AVE	None	VENTURA	CA	93003	1810	00	06000	34.27632403	-119.239551	Ventura County
338117	Ordering, Referring, Prescribing	N/A	1568779833	0	0	HONG, PAULIN H PHARMD	3/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	64166	N/A	N/A	N/A	N/A	N/A	10815 LINDBLADE ST	None	CULVER CITY	CA	90230	3741	00	06000	34.0105077	-118.4030053	Los Angeles County
338123	Ordering, Referring, Prescribing	N/A	1568788669	0	0	HABELL, BARBARA	3/18/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0640642	N/A	N/A	N/A	N/A	N/A	2400 S FLOWER ST	None	LOS ANGELES	CA	90007	2629	00	06000	34.02861627	-118.273964	Los Angeles County
338137	Ordering, Referring, Prescribing	N/A	1568805208	0	0	HOANG, VY A	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH70553	N/A	N/A	N/A	N/A	N/A	5300 3RD ST	None	SAN FRANCISCO	CA	94124	2604	00	06000	37.72884002	-122.3929237	San Francisco County
338138	Ordering, Referring, Prescribing	N/A	1568811347	0	0	HLAING, HTAR S MD	12/27/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A160089	N/A	N/A	N/A	N/A	N/A	954 NORTH VERMONT AVENUE	None	LOS ANGELES	CA	90029	3529	00	06000	34.08896256	-118.2917211	Los Angeles County
338148	Ordering, Referring, Prescribing	N/A	1568824860	0	0	HENDOW, CHELSEA J MD	6/3/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A179264	N/A	N/A	N/A	N/A	N/A	4140 JADE ST	SUITE 100	CAPITOLA	CA	95010	3956	00	06000	36.97026148	-121.9638195	Santa Cruz County
338166	Ordering, Referring, Prescribing	N/A	1568823664	0	0	HO, VICTORIA MD	9/25/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149664	N/A	N/A	N/A	N/A	N/A	300 MEDICAL PLAZA	# B200	LOS ANGELES	CA	90095	8346	00	06000	34.06473399	-118.445865	Los Angeles County
338171	Ordering, Referring, Prescribing	N/A	1568853794	0	0	HURLESS, VANESSA R NP	8/16/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001826	N/A	N/A	N/A	N/A	N/A	1295 BROADWAY	STE 201	CHULA VISTA	CA	91911	2975	00	06000	32.60364599	-117.0786521	San Diego County
338172	Ordering, Referring, Prescribing	N/A	1568854743	0	0	HUDSON-CRIM, ABIGAIL B LCSW	2/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	79262	N/A	N/A	N/A	N/A	N/A	2440 6TH STREET	None	EUREKA	CA	95501	0788	00	06000	40.80368802	-124.1456878	Humboldt County
338191	Ordering, Referring, Prescribing	N/A	1568874410	0	0	HAWKINS, MARSHA	8/14/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131690	N/A	N/A	N/A	N/A	N/A	6051 N FRESNO ST	201	FRESNO	CA	93710	5280	00	06000	36.823905	-119.781436	Fresno County
338209	Ordering, Referring, Prescribing	N/A	1568896082	0	0	HSU, CARISSA M LMFT	1/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT96487	N/A	N/A	N/A	N/A	N/A	19401 S VERMONT AVENUE	L102	TORRANCE	CA	90502	1029	00	06000	33.85486409	-118.2905603	Los Angeles County
338224	Ordering, Referring, Prescribing	N/A	1568923449	0	0	HUANG, CECILIA H MD	8/15/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A181270	N/A	N/A	N/A	N/A	N/A	303 W LINCOLN AVE	#105	ANAHEIM	CA	92805	2936	00	06000	33.83508976	-117.9177981	Orange County
338229	Ordering, Referring, Prescribing	N/A	1568939924	0	0	HENDERSON, COURTNEY LCSW	2/20/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86614	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
338232	Ordering, Referring, Prescribing	N/A	1568941847	0	0	HAMAMA, ALEXIS LCSW	7/19/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW116652	N/A	N/A	N/A	N/A	N/A	474 W VERMONT AVE	SUITE 103	ESCONDIDO	CA	92025	6584	00	06000	33.10046604	-117.0729623	San Diego County
338255	Ordering, Referring, Prescribing	N/A	1568983971	0	0	HWANG, AMY PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75232	N/A	N/A	N/A	N/A	N/A	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	00	06000	37.70755227	-121.7149933	Alameda County
338265	Ordering, Referring, Prescribing	N/A	1568995546	0	0	HODGES, BEVERLY NP	8/5/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005869	N/A	N/A	N/A	N/A	N/A	1140 MAIN STREET	None	LIVINGSTON	CA	95334	1257	00	06000	37.37992056	-120.7234222	Merced County
338273	Ordering, Referring, Prescribing	N/A	1568995694	0	0	HACHOLSKI, MARK A MD	3/13/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A169591	N/A	N/A	N/A	N/A	N/A	3544 30TH ST	None	SAN DIEGO	CA	92104	4120	00	06000	32.742936	-117.130118	San Diego County
338274	Ordering, Referring, Prescribing	N/A	1578005237	0	0	HUCKLE, ERICKA PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75305	N/A	N/A	N/A	N/A	N/A	14808 HIGHTOP ST	None	MOORPARK	CA	93021	5089	00	06000	34.30693514	-118.8711516	Ventura County
338285	Ordering, Referring, Prescribing	N/A	1578030540	0	0	HONG, YOOJIN PHARMD	3/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	79590	N/A	N/A	N/A	N/A	N/A	5030 HAMNER AVE	None	EASTVALE	CA	91752	1009	00	06000	33.996744	-117.555534	Riverside County
338292	Ordering, Referring, Prescribing	N/A	1578043808	0	0	HERNANDEZ, VANESSA E LCSW	5/5/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115125	N/A	N/A	N/A	N/A	N/A	649 E ALBERTONI ST	100	CARSON	CA	90746	1538	00	06000	33.87194399	-118.2643054	Los Angeles County
338311	Ordering, Referring, Prescribing	N/A	1578073763	0	0	HUANG, KARIN LMFT	7/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120305	N/A	N/A	N/A	N/A	N/A	2151 COLLEGE AVE	None	BAKERSFIELD	CA	93305	4113	00	06000	35.3830369	-118.9680991	Kern County
338344	Ordering, Referring, Prescribing	N/A	1578116547	0	0	HYUN, GRACE E PHARMD	7/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH79898	N/A	N/A	N/A	N/A	N/A	20901 DEVONSHIRE ST	None	CHATSWORTH	CA	91311	2313	00	06000	34.25728053	-118.589265	Los Angeles County
338377	Ordering, Referring, Prescribing	N/A	1578174348	0	0	HERNANDEZ, JESSICA S LCSW	2/15/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW113712	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
338389	Ordering, Referring, Prescribing	N/A	1578228722	0	0	HO, THAO L	1/26/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018921	N/A	N/A	N/A	N/A	N/A	11180 WARNER AVE	353	FOUNTAIN VALLEY	CA	92708	7501	00	06000	33.71632048	-117.9334575	Orange County
338397	Ordering, Referring, Prescribing	N/A	1578260758	0	0	HAMED, JACQUELYN NP	12/9/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023584	N/A	N/A	N/A	N/A	N/A	1328 S MISSION RD	None	FALLBROOK	CA	92028	4006	00	06000	33.36868654	-117.2507699	San Diego County
338399	Ordering, Referring, Prescribing	N/A	1578271631	0	0	HO, STEVEN	10/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH87194	N/A	N/A	N/A	N/A	N/A	13255 BLACK MOUNTAIN RD	None	SAN DIEGO	CA	92129	2658	00	06000	32.95881607	-117.1266381	San Diego County
338431	Ordering, Referring, Prescribing	N/A	1578540340	0	0	HATMAKER, DAVID L MD	1/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	50556	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
338510	Ordering, Referring, Prescribing	N/A	1578743233	0	0	HARLAN, STACEY LMFT	8/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	32664	N/A	N/A	N/A	N/A	N/A	555 HOSPITAL LN	None	SUSANVILLE	CA	96130	4808	00	06000	40.40857373	-120.666989	Lassen County
338522	Ordering, Referring, Prescribing	N/A	1578748562	0	0	HERNANDEZ, MARIA I LMFT	4/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104855	N/A	N/A	N/A	N/A	N/A	2000 ALAMEDA DE LAS PULG	200	SAN MATEO	CA	94403	1293	00	06000	37.54524373	-122.3205511	San Mateo County
338546	Ordering, Referring, Prescribing	N/A	1578792057	0	0	HELVIE, MONICA P LMFT	12/21/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84305	N/A	N/A	N/A	N/A	N/A	28581 OLD TOWN DR FRNT	SUITE 103	TEMECULA	CA	92590	2724	00	06000	33.49421281	-117.149836	Riverside County
338548	Ordering, Referring, Prescribing	N/A	1578788105	0	0	HAYNES, AMY D PSYD	4/28/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY21297	N/A	N/A	N/A	N/A	N/A	768 PLEASANT VALLEY RD.	SUITE 201	PLACERVILLE	CA	95619	9260	00	06000	38.69498433	-120.8070771	El Dorado County
338574	Ordering, Referring, Prescribing	N/A	1578842944	0	0	HERNANDEZ, ELIZABETH C NP	2/21/2018	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	620759	N/A	N/A	N/A	N/A	N/A	317 LAKE BLVD	STE A	REDDING	CA	96003	2504	00	06000	40.61143873	-122.3817637	Shasta County
338588	Ordering, Referring, Prescribing	N/A	1578863247	0	0	HA, JANE Y PHARMD	3/29/2018	Taxonomy not applicable	NA	n/a	000	Unknown	56562	N/A	N/A	N/A	N/A	N/A	3850 VALLEY CENTRE DR	None	SAN DIEGO	CA	92130	2331	00	06000	32.93777252	-117.2318423	San Diego County
338641	Ordering, Referring, Prescribing	N/A	1578923488	0	0	HUDSON, JESSICA LMFT	6/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	111593	N/A	N/A	N/A	N/A	N/A	1660 HOTEL CIRCLE NORTH	SUITE 101	SAN DIEGO	CA	92108	2807	00	06000	32.75964178	-117.1791442	San Diego County
338709	Ordering, Referring, Prescribing	N/A	1588006787	0	0	HAWKES, NATHANIEL LCSW	3/4/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW100378	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
338727	Ordering, Referring, Prescribing	N/A	1588036438	0	0	HADDAD, DAVID MD	11/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G60412	N/A	N/A	N/A	N/A	N/A	7208 CAMINO LAS RAMBLAS	None	CAMARILLO	CA	93012	9207	00	06000	34.24302074	-118.9674403	Ventura County
338729	Ordering, Referring, Prescribing	N/A	1588034920	0	0	HEU, NDZEU PA-C	4/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52876	N/A	N/A	N/A	N/A	N/A	344 E 6TH ST	None	MADERA	CA	93638	3631	00	06000	36.96288964	-120.0556279	Madera County
338778	Ordering, Referring, Prescribing	N/A	1588092415	0	0	HAIL, SARAH K LMFT	4/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	96600	N/A	N/A	N/A	N/A	N/A	9837 FOLSOM BLVD	F	SACRAMENTO	CA	95827	1356	00	06000	38.575764	-121.330647	Sacramento County
338782	Ordering, Referring, Prescribing	N/A	1588097059	0	0	HOANG, LINH PHARMD	7/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54698	N/A	N/A	N/A	N/A	N/A	480 N MCKINLEY ST	None	CORONA	CA	92879	1291	00	06000	33.886881	-117.5245245	Riverside County
338812	Ordering, Referring, Prescribing	N/A	1588137095	0	0	HUCHIM, JENNIFER LCSW	6/8/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108412	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
338828	Ordering, Referring, Prescribing	N/A	1588173025	0	0	HYATT, JENNIFER LMFT	2/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	99355	N/A	N/A	N/A	N/A	N/A	31772 CASINO DR	B	LAKE ELSINORE	CA	92530	4502	00	06000	33.65728153	-117.2958688	Riverside County
338834	Ordering, Referring, Prescribing	N/A	1588176036	0	0	HAYRAPETIAN, JAKLIN LMFT	10/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122498	N/A	N/A	N/A	N/A	N/A	237 N CENTRAL AVE	C	GLENDALE	CA	91203	3526	00	06000	34.14943423	-118.2579487	Los Angeles County
338855	Ordering, Referring, Prescribing	N/A	1588218663	0	0	HEYWARD, CHARLISA NP	9/13/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012553	N/A	N/A	N/A	N/A	N/A	17450 MAIN ST	D-E-F	HESPERIA	CA	92345	6298	00	06000	34.41871211	-117.2821748	San Bernardino County
338857	Ordering, Referring, Prescribing	N/A	1588207351	0	0	HOY, MEGAN NP	8/30/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014350	N/A	N/A	N/A	N/A	N/A	554-580 MEDICAL CENTER D	None	BIEBER	CA	96009	0277	00	06000	0	0	None
338874	Ordering, Referring, Prescribing	N/A	1588272603	0	0	HO, VINH PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82482	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
338894	Ordering, Referring, Prescribing	N/A	1588329403	0	0	HAMPTON, TAYLOR	1/3/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	128009	N/A	N/A	N/A	N/A	N/A	233 S QUINTANA DR	None	ANAHEIM	CA	92807	4029	00	06000	33.85230249	-117.7739305	Orange County
338914	Ordering, Referring, Prescribing	N/A	1588417380	0	0	HORTON, KATELYN	9/19/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	16474	N/A	N/A	N/A	N/A	N/A	1000 W CARSON ST	None	TORRANCE	CA	90502	2059	00	06000	33.83155851	-118.2920625	Los Angeles County
338957	Ordering, Referring, Prescribing	N/A	1588718571	0	0	HUANG, RAYMOND S	12/21/1985	Taxonomy not applicable	NA	n/a	099	DENTIST	D30221	N/A	N/A	N/A	N/A	N/A	25 N 14TH ST	SUITE 860	SAN JOSE	CA	95112	6204	00	06000	37.34293357	-121.8775187	Santa Clara County
338968	Ordering, Referring, Prescribing	N/A	1588759534	0	0	HETLER-WOOLEVER, TAMARA PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50735	N/A	N/A	N/A	N/A	N/A	1761 BROADWAY ST	209	VALLEJO	CA	94589	2226	00	06000	38.13049234	-122.2522422	Solano County
338970	Ordering, Referring, Prescribing	N/A	1588757561	0	0	HAYKAL, MOHAMAD Y PHARMD	12/21/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH63694	N/A	N/A	N/A	N/A	N/A	9902 BRIMHALL RD #100	None	BAKERSFIELD	CA	93312	2801	00	06000	35.36882344	-119.1124447	Kern County
338979	Ordering, Referring, Prescribing	N/A	1588783161	0	0	HALL, CATHERINE H LMFT	8/11/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT34405	N/A	N/A	N/A	N/A	N/A	2910 CAMINO DIABLO	#200	WALNUT CREEK	CA	94597	3997	00	06000	37.8984265	-122.083701	Contra Costa County
338985	Ordering, Referring, Prescribing	N/A	1588792618	0	0	HARVEY, AMY E LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT36273	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
338986	Ordering, Referring, Prescribing	N/A	1588792105	0	0	HA, LINH N	11/14/2000	Taxonomy not applicable	NA	n/a	099	DENTIST	D47900	N/A	N/A	N/A	N/A	N/A	7761 GARDEN GROVE BLVD	None	GARDEN GROVE	CA	92841	4200	00	06000	33.77387145	-117.9966555	Orange County
338992	Ordering, Referring, Prescribing	N/A	1588796817	0	0	HORNIBROOK, HEATHER A LMFT	2/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49067	N/A	N/A	N/A	N/A	N/A	5121 STOCKDALE HWY	None	BAKERSFIELD	CA	93305	4113	00	06000	35.35413152	-119.058471	Kern County
338999	Ordering, Referring, Prescribing	N/A	1588822530	0	0	HAROON, FARNAZ G	2/28/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	D49107	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
339013	Ordering, Referring, Prescribing	N/A	1588851653	0	0	HOGAN, NELLNI S	5/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84295	N/A	N/A	N/A	N/A	N/A	21455 BIRCH ST	#201	HAYWARD	CA	94541	2165	00	06000	37.68159734	-122.0935159	Alameda County
339019	Ordering, Referring, Prescribing	N/A	1588850457	0	0	HO, QUAN U PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60141	N/A	N/A	N/A	N/A	N/A	10820 E. 183RD ST.	None	CERRITOS	CA	90703	8013	00	06000	33.86553349	-118.1027115	Los Angeles County
339024	Ordering, Referring, Prescribing	N/A	1588873871	0	0	HEINEMAN, FUKIKO M LCSW	5/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26915	N/A	N/A	N/A	N/A	N/A	1000 BROADWAY	210	EL CAJON	CA	92021	7417	00	06000	32.80772549	-116.94771	San Diego County
339026	Ordering, Referring, Prescribing	N/A	1588868723	0	0	HALVERSON-MUENZER, RICHARD J LMFT	3/21/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102852	N/A	N/A	N/A	N/A	N/A	780 S DORA ST	None	UKIAH	CA	95482	5348	00	06000	39.14258789	-123.2107888	Mendocino County
339039	Ordering, Referring, Prescribing	N/A	1588913537	0	0	HEFNER, ANNA M CNP	1/9/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	5512	N/A	N/A	N/A	N/A	N/A	10737 CAMINO RUIZ	235	SAN DIEGO	CA	92126	2359	00	06000	32.91416051	-117.1437943	San Diego County
339088	Ordering, Referring, Prescribing	N/A	1588974497	0	0	HERNANDEZ, CINDY G PA-C	7/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA21264	N/A	N/A	N/A	N/A	N/A	200 S WELLS RD	100	VENTURA	CA	93004	1377	00	06000	34.29321532	-119.1597424	Ventura County
339143	Ordering, Referring, Prescribing	N/A	1598043978	0	0	HERMOSILLO, MONICA LMFT	11/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT112484	N/A	N/A	N/A	N/A	N/A	409 CAMINO DEL RIO S	None	SAN DIEGO	CA	92108	3504	00	06000	32.76105674	-117.1609032	San Diego County
339148	Ordering, Referring, Prescribing	N/A	1598062705	0	0	HARTLEY, MARIA LCSW	4/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW69875	N/A	N/A	N/A	N/A	N/A	1303 W WALNUT PKWY	None	COMPTON	CA	90220	5030	00	06000	33.87724562	-118.2446904	Los Angeles County
339168	Ordering, Referring, Prescribing	N/A	1598099202	0	0	HUI, SANDRA J LCSW	7/8/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	64242	N/A	N/A	N/A	N/A	N/A	5731 W SLAUSON AVE	SUITE 220	CULVER CITY	CA	90230	6537	00	06000	33.98898953	-118.3818077	Los Angeles County
339176	Ordering, Referring, Prescribing	N/A	1598106213	0	0	HAKIM, MINA MD	7/31/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144604	N/A	N/A	N/A	N/A	N/A	4415 S CENTRAL AVE	None	LOS ANGELES	CA	90011	3629	00	06000	34.003413	-118.256519	Los Angeles County
339229	Ordering, Referring, Prescribing	N/A	1598184343	0	0	HANDSCHIN, TOBIAS MD	4/30/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139849	N/A	N/A	N/A	N/A	N/A	2767 OLIVE HWY	None	OROVILLE	CA	95966	6118	00	06000	39.506454	-121.5412785	Butte County
339239	Ordering, Referring, Prescribing	N/A	1598197154	0	0	HUYNH, TONY D PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68983	N/A	N/A	N/A	N/A	N/A	3533 PERADA DR	None	WALNUT CREEK	CA	94598	2709	00	06000	37.93085294	-122.0059297	Contra Costa County
339246	Ordering, Referring, Prescribing	N/A	1598200776	0	0	HODGES, OLISHA LCSW	9/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	75026	N/A	N/A	N/A	N/A	N/A	31 TOWER RD	None	SAN MATEO	CA	94402	4000	00	06000	37.51232162	-122.3333429	San Mateo County
339250	Ordering, Referring, Prescribing	N/A	1598215725	0	0	HO, KATHERINE T LMFT	8/31/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT	N/A	N/A	N/A	N/A	N/A	2933 N. EL NIDO DR.	None	ALTADENA	CA	91001	1400	00	06000	34.19549106	-118.1655134	Los Angeles County
339254	Ordering, Referring, Prescribing	N/A	1598221624	0	0	HAM, HYEWON PHARMD	2/5/2023	Taxonomy not applicable	NA	n/a	000	Unknown	78133	N/A	N/A	N/A	N/A	N/A	3027 RANCHO VISTA BLVD	None	PALMDALE	CA	93551	3582	00	06000	34.60188906	-118.1846656	Los Angeles County
339255	Ordering, Referring, Prescribing	N/A	1598228066	0	0	HAN, STEPHANIE PHARMD	4/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH65108	N/A	N/A	N/A	N/A	N/A	4150 REGENTS PARK ROW	155	LA JOLLA	CA	92037	9179	00	06000	32.87272099	-117.2175656	San Diego County
339270	Ordering, Referring, Prescribing	N/A	1598262370	0	0	HAN, SANG HUN MD	1/29/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173424	N/A	N/A	N/A	N/A	N/A	625 34TH STREET	STE 100 & 200	BAKERSFIELD	CA	93301	2305	00	06000	35.39046051	-119.0092725	Kern County
339272	Ordering, Referring, Prescribing	N/A	1598265647	0	0	HINES, TAYTE C DC	5/3/2022	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	34116	N/A	N/A	N/A	N/A	N/A	903 E DEVONSHIRE AVE	STE D	HEMET	CA	92543	3097	00	06000	33.75116958	-116.9627485	Riverside County
339291	Ordering, Referring, Prescribing	N/A	1598305245	0	0	HERMOSILLO, ROSITA D MSW LCSW	9/11/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	118015	N/A	N/A	N/A	N/A	N/A	555 N PERRIS BLVD	None	PERRIS	CA	92571	2811	00	06000	33.79131	-117.226053	Riverside County
339323	Ordering, Referring, Prescribing	N/A	1598367146	0	0	HU, DEVIN D PHARMD	3/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83603	N/A	N/A	N/A	N/A	N/A	3800 DALE ROAD	None	MODESTO	CA	95356	8627	00	06000	37.69395556	-121.0499498	Stanislaus County
339385	Ordering, Referring, Prescribing	N/A	1598738742	0	0	HAINES, SHANNON N	9/20/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0797874	N/A	N/A	N/A	N/A	N/A	303 W LINCOLN AVE	#105	ANAHEIM	CA	92805	2928	00	06000	33.83508976	-117.9177981	Orange County
339423	Ordering, Referring, Prescribing	N/A	1598867459	0	0	HASKINS, DAWN R LMFT	1/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	50946	N/A	N/A	N/A	N/A	N/A	855 CANYON RD	None	REDDING	CA	96001	5544	00	06000	40.48978049	-122.3926387	Shasta County
339513	Ordering, Referring, Prescribing	N/A	1609062801	0	0	HUYNH, PHUONG-KIEU T	1/27/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D56342	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
339538	Ordering, Referring, Prescribing	N/A	1609125285	0	0	HAYTER DE LOPEZ, APRIL J LCSW	7/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW14777	N/A	N/A	N/A	N/A	N/A	10717 CAMINO RUIZ	STE 207	SAN DIEGO	CA	92126	2360	00	06000	32.91373261	-117.1437822	San Diego County
339549	Ordering, Referring, Prescribing	N/A	1609144922	0	0	HOM, EVELYN C PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50176	N/A	N/A	N/A	N/A	N/A	5055 TELEGRAPH AVE	None	OAKLAND	CA	94609	2040	00	06000	37.8368777	-122.2624355	Alameda County
339571	Ordering, Referring, Prescribing	N/A	1609159540	0	0	HA, DAVID D PHARMD	10/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH62279	N/A	N/A	N/A	N/A	N/A	602 EUCIID AVE	None	SAN DIEGO	CA	92114	2207	00	06000	32.711796	-117.0850785	San Diego County
339581	Ordering, Referring, Prescribing	N/A	1609178011	0	0	HSU, ANNIE Y PHARMD	4/8/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58359	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	MS SEC2-B	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
339603	Ordering, Referring, Prescribing	N/A	1609222090	0	0	HAMIDI, AFSHIN MD	3/21/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A162227	N/A	N/A	N/A	N/A	N/A	33 RISERO DR	None	MISSION VIEJO	CA	92692	5123	00	06000	33.59597848	-117.6484148	Orange County
339606	Ordering, Referring, Prescribing	N/A	1609226182	0	0	HERNANDEZ, ANGELA P LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT107621	N/A	N/A	N/A	N/A	N/A	3855 N WEST AVE	110	FRESNO	CA	93705	2759	00	06000	36.78782638	-119.8265069	Fresno County
339613	Ordering, Referring, Prescribing	N/A	1609238898	0	0	HONG, JANE L NP	9/15/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	791738	N/A	N/A	N/A	N/A	N/A	7212 ORANGETHORPE AVE	STE 9A	BUENA PARK	CA	90621	4667	00	06000	33.85890953	-118.007244	Orange County
339620	Ordering, Referring, Prescribing	N/A	1609255850	0	0	HAGBOM, ROBERT	11/15/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A156494	N/A	N/A	N/A	N/A	N/A	184 BIMINI PL	None	LOS ANGELES	CA	90004	5903	00	06000	34.07060546	-118.290517	Los Angeles County
339706	Ordering, Referring, Prescribing	N/A	1609384239	0	0	HANSEN, BERND P LCSW	1/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113214	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
339720	Ordering, Referring, Prescribing	N/A	1609405992	0	0	HELOU, MICHELINE CNP	1/28/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013802	N/A	N/A	N/A	N/A	N/A	63532 29 PALMS HWY	SUITE C	JOSHUA TREE	CA	92252	0000	00	06000	34.13510347	-116.277102	San Bernardino County
339722	Ordering, Referring, Prescribing	N/A	1609403906	0	0	HORAN, ALLISON R MD	12/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	5236	N/A	N/A	N/A	N/A	N/A	401 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2211	00	06000	37.76376114	-122.4567626	San Francisco County
339745	Ordering, Referring, Prescribing	N/A	1609458132	0	0	HONG, JENNIFER MD	9/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A182145	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
339759	Ordering, Referring, Prescribing	N/A	1609487529	0	0	HASHEMI-TOROGHI, ORIANA NP	12/21/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95019027	N/A	N/A	N/A	N/A	N/A	995 GATEWAY CENTER WAY	106	SAN DIEGO	CA	92102	4544	00	06000	32.71405516	-117.1158459	San Diego County
339826	Ordering, Referring, Prescribing	N/A	1609924083	0	0	HOCHMAN, STEPHANIE L LCSW	10/19/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW16300	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
339875	Ordering, Referring, Prescribing	N/A	1619010238	0	0	HONG, JAN K LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42018	N/A	N/A	N/A	N/A	N/A	790 E BONITA AVE	None	POMONA	CA	91767	1906	00	06000	34.09621447	-117.737406	Los Angeles County
339895	Ordering, Referring, Prescribing	N/A	1619040896	0	0	HUNT, LILY A LCSW	11/29/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	28791	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
339929	Ordering, Referring, Prescribing	N/A	1619109519	0	0	HENDERSON, GREGORY P MD	8/24/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A125261	N/A	N/A	N/A	N/A	N/A	1127 WILSHIRE BLVD	STE 600	LOS ANGELES	CA	90017	3907	00	06000	34.05270508	-118.2641005	Los Angeles County
339940	Ordering, Referring, Prescribing	N/A	1619152113	0	0	HERNANDEZ, LUIS MD	12/7/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G42433	N/A	N/A	N/A	N/A	N/A	1817 W BEVERLY BLVD	None	MONTEBELLO	CA	90640	3969	00	06000	34.01983077	-118.1189072	Los Angeles County
339945	Ordering, Referring, Prescribing	N/A	1619155280	0	0	HARRIS-MUCHELL, CAROLYN D NP	2/7/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95001644	N/A	N/A	N/A	N/A	N/A	2620 26TH STREET	None	OAKLAND	CA	94601	1907	00	06000	37.79088756	-122.2231716	Alameda County
339975	Ordering, Referring, Prescribing	N/A	1619194586	0	0	HOLLIS, CAROL J CNP	12/5/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0388433	N/A	N/A	N/A	N/A	N/A	333 S. TWIN OAKS VALLEY	STE 100	SAN MARCOS	CA	92096	0001	00	06000	33.12741952	-117.1651625	San Diego County
339983	Ordering, Referring, Prescribing	N/A	1619224854	0	0	HEIGHTS, SHOCKA N LCSW	1/14/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113175	N/A	N/A	N/A	N/A	N/A	8945 GOLF LINKS ROAD	None	OAKLAND	CA	94605	4142	00	06000	37.76047483	-122.157608	Alameda County
340043	Ordering, Referring, Prescribing	N/A	1619333457	0	0	HAM, STEPHANIE R PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73573	N/A	N/A	N/A	N/A	N/A	300 PULLMAN ST	None	LIVERMORE	CA	94551	9756	00	06000	37.70755227	-121.7149933	Alameda County
340054	Ordering, Referring, Prescribing	N/A	1619335643	0	0	HERNANDEZ, NICHOLETTE LMFT	8/8/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125740	N/A	N/A	N/A	N/A	N/A	1510 S CENTRAL AVE	STE 600	GLENDALE	CA	91204	2548	00	06000	34.12709764	-118.2577911	Los Angeles County
340089	Ordering, Referring, Prescribing	N/A	1619382504	0	0	HENNIG, PAUL D MD	4/24/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A139035	N/A	N/A	N/A	N/A	N/A	4141 STATE STREET	SUITE B3	SANTA BARBARA	CA	93110	1810	00	06000	34.4404695	-119.7612045	Santa Barbara County
340090	Ordering, Referring, Prescribing	N/A	1619382140	0	0	HODEL, RACHELLE S LCSW	5/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81191	N/A	N/A	N/A	N/A	N/A	1000 S. MAIN ST	STE. 105	SALINAS	CA	93901	3250	00	06000	36.66226091	-121.6578913	Monterey County
340094	Ordering, Referring, Prescribing	N/A	1619391174	0	0	HARPER, REBECCA PHARMD	9/30/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54586	N/A	N/A	N/A	N/A	N/A	1212 N. CALIFORNIA	None	STOCKTON	CA	95202	1552	00	06000	37.96681769	-121.2881382	San Joaquin County
340114	Ordering, Referring, Prescribing	N/A	1619427127	0	0	HERNANDEZ, JOSE A LCSW	8/29/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96618	N/A	N/A	N/A	N/A	N/A	155 N OCCIDENTAL BLVD	None	LOS ANGELES	CA	90026	4641	00	06000	34.07178779	-118.2787879	Los Angeles County
340117	Ordering, Referring, Prescribing	N/A	1619431269	0	0	HICKS, ELENA M NP	10/19/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010134	N/A	N/A	N/A	N/A	N/A	50 BELLEFONTAINE ST	205	PASADENA	CA	91105	3132	00	06000	34.13155953	-118.1517525	Los Angeles County
340122	Ordering, Referring, Prescribing	N/A	1619433117	0	0	HARTMANN, AELI CNP	5/18/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95013705	N/A	N/A	N/A	N/A	N/A	1708 S VICTORIA AVE D,	None	VENTURA	CA	93003	0203	00	06000	34.25957804	-119.2110778	Ventura County
340150	Ordering, Referring, Prescribing	N/A	1619476132	0	0	HOCH, LAURA S LPCC	3/13/2024	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC16029	N/A	N/A	N/A	N/A	N/A	222 S HILL ST	None	LOS ANGELES	CA	90012	3506	00	06000	34.0525918	-118.2482081	Los Angeles County
340158	Ordering, Referring, Prescribing	N/A	1619510500	0	0	HILOU, HANEEN S LMFT	8/15/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT140920	N/A	N/A	N/A	N/A	N/A	7601 CANBY AVE	SUITE 3	RESEDA	CA	91335	2953	00	06000	34.20872085	-118.5347527	Los Angeles County
340214	Ordering, Referring, Prescribing	N/A	1619647625	0	0	HARRIS, CAMILLE PA-C	8/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA61451	N/A	N/A	N/A	N/A	N/A	9699 SIERRA AVE	None	FONTANA	CA	92335	5716	00	06000	34.077834	-117.4356515	San Bernardino County
340223	Ordering, Referring, Prescribing	N/A	1619711793	0	0	HANNA, SOSSANA DDS	6/12/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110172	N/A	N/A	N/A	N/A	N/A	17185 ARROW BLVD	None	FONTANA	CA	92335	3972	00	06000	34.09922149	-117.429642	San Bernardino County
340226	Ordering, Referring, Prescribing	N/A	1619718848	0	0	HOANG, MICHELLE OD	5/30/2024	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35719	N/A	N/A	N/A	N/A	N/A	5460 E LA PALMA AVE.	None	ANAHEIM	CA	92807	2023	00	06000	33.85983003	-117.7966383	Orange County
340230	Ordering, Referring, Prescribing	N/A	1619742046	0	0	HOSHMAND, MEENA PA	2/7/2024	Taxonomy not applicable	NA	n/a	000	Unknown	64043	N/A	N/A	N/A	N/A	N/A	420 S GLENDORA AVE	None	WEST COVINA	CA	91790	3001	00	06000	34.06750236	-117.925203	Los Angeles County
340233	Ordering, Referring, Prescribing	N/A	1619777547	0	0	HYDE, NICHOLAS DC	3/19/2024	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	33744	N/A	N/A	N/A	N/A	N/A	545 FREDERICK ST	None	SANTA CRUZ	CA	95062	2635	00	06000	36.978709	-122.0041784	Santa Cruz County
340236	Ordering, Referring, Prescribing	N/A	1619931698	0	0	HEFFELFINGER, JAMES D MD	4/6/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G76725	N/A	N/A	N/A	N/A	N/A	6100 REDWOOD BLVD	None	NOVATO	CA	94945	4501	00	06000	38.09578333	-122.5627508	Marin County
340251	Ordering, Referring, Prescribing	N/A	1629028873	0	0	HORTON, RICHARD MD	5/5/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G154945	N/A	N/A	N/A	N/A	N/A	444 GEORGIA ST	None	VALLEJO	CA	94590	6005	00	06000	38.10111363	-122.2552224	Solano County
340259	Ordering, Referring, Prescribing	N/A	1629060157	0	0	HWANG, VILAYPHONE T	3/21/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0689202	N/A	N/A	N/A	N/A	N/A	10833 LE CONTE AVE	None	LOS ANGELES	CA	90095	3075	00	06000	34.06373445	-118.443537	Los Angeles County
340274	Ordering, Referring, Prescribing	N/A	1629098884	0	0	HARRISON, DANIEL MD	6/28/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G81812	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
340327	Ordering, Referring, Prescribing	N/A	1629207485	0	0	HONG, SEPTIMA B PHARMD	4/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60342	N/A	N/A	N/A	N/A	N/A	401 BICENTENNIAL WAY	None	SANTA ROSA	CA	95403	2149	00	06000	38.471625	-122.7259935	Sonoma County
340352	Ordering, Referring, Prescribing	N/A	1629273396	0	0	HUNKOFF, IGOR MD	12/24/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A42609	N/A	N/A	N/A	N/A	N/A	1328 SECOND ST, CA	None	SANTA MONICA	CA	90401	1122	00	06000	34.01557114	-118.497924	Los Angeles County
340371	Ordering, Referring, Prescribing	N/A	1629322201	0	0	HUMPHREY, KESHIA D LMFT	2/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	113750	N/A	N/A	N/A	N/A	N/A	45111 FERN AVE	None	LANCASTER	CA	93534	2301	00	06000	34.70150394	-118.1452081	Los Angeles County
340380	Ordering, Referring, Prescribing	N/A	1629324140	0	0	HOSSEINI, ALIREZA MD	6/17/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A142579	N/A	N/A	N/A	N/A	N/A	16305 SAND CANYON AVE, S	140	IRVINE	CA	92618	0000	00	06000	33.66201662	-117.7737316	Orange County
340384	Ordering, Referring, Prescribing	N/A	1629341953	0	0	HINO-BOURASSA, CAROLYN E	5/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	37122	N/A	N/A	N/A	N/A	N/A	1006 W WABASH AVE	None	EUREKA	CA	95501	2121	00	06000	40.79158228	-124.1830134	Humboldt County
340395	Ordering, Referring, Prescribing	N/A	1629347125	0	0	HOWARD, CYNTHIA S	12/1/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	104759	N/A	N/A	N/A	N/A	N/A	5201 GREAT AMERICAY PKWY	STE 320	SANTA CLARA	CA	95054	1140	00	06000	37.406304	-121.9776535	Santa Clara County
340434	Ordering, Referring, Prescribing	N/A	1629414529	0	0	HOLT, SUSAN LMFT	1/24/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	54015	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
340442	Ordering, Referring, Prescribing	N/A	1629425269	0	0	HAN, BECKY	4/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74379	N/A	N/A	N/A	N/A	N/A	1001 METRO CENTER BLVD	None	FOSTER CITY	CA	94404	2177	00	06000	37.56120852	-122.2739553	San Mateo County
340464	Ordering, Referring, Prescribing	N/A	1629477435	0	0	HERNANDEZ, GUY LMFT	7/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	102205	N/A	N/A	N/A	N/A	N/A	300 MONTGOMERY AVE	204	SAN FRANCISCO	CA	94101	0000	00	06000	37.7923269	-122.4026145	San Francisco County
340486	Ordering, Referring, Prescribing	N/A	1629507868	0	0	HOGAN, HALLIE J MD	8/30/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158581	N/A	N/A	N/A	N/A	N/A	250 BON AIR RD	None	GREENBRAE	CA	94904	1702	00	06000	37.9469952	-122.5373892	Marin County
340493	Ordering, Referring, Prescribing	N/A	1629520507	0	0	HECK, PETER LCSW	11/13/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86760	N/A	N/A	N/A	N/A	N/A	321 VAN DUZEN ROAD	None	BRIDGEVILLE	CA	95526	0004	00	06000	40.46004463	-123.5301743	Trinity County
340514	Ordering, Referring, Prescribing	N/A	1629557525	0	0	HWANG, JACKIE W LMFT	5/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125918	N/A	N/A	N/A	N/A	N/A	18623 GALE AVE	None	CITY OF INDUSTRY	CA	91748	1342	00	06000	33.9945603	-117.8965305	Los Angeles County
340557	Ordering, Referring, Prescribing	N/A	1629615893	0	0	HERNANDEZ, CHRISTINE A LCSW	6/11/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW108463	N/A	N/A	N/A	N/A	N/A	658 E. BRIER DR.,	STE. 200	SAN BERNARDINO	CA	92408	2875	00	06000	34.07137738	-117.2702805	San Bernardino County
340570	Ordering, Referring, Prescribing	N/A	1629634100	0	0	HUYNH, ANGIE T DO	11/2/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19861	N/A	N/A	N/A	N/A	N/A	2040 CAMFIELD AVE	None	COMMERCE	CA	90040	1502	00	06000	34.00861575	-118.1559052	Los Angeles County
340625	Ordering, Referring, Prescribing	N/A	1629763081	0	0	HALFORD, SANDRA J LMFT	1/30/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133940	N/A	N/A	N/A	N/A	N/A	350 ATLANTIC ST	None	ROSEVILLE	CA	95678	1849	00	06000	38.75308479	-121.2798922	Placer County
340632	Ordering, Referring, Prescribing	N/A	1629808548	0	0	HERNANDEZ, CHRISTINE LCSW	11/6/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29045	N/A	N/A	N/A	N/A	N/A	23228 MADERO	None	MISSION VIEJO	CA	92691	2706	00	06000	33.62548354	-117.6804077	Orange County
340645	Ordering, Referring, Prescribing	N/A	1639166978	0	0	HETSKO, MICHAEL L DDS	2/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	58077	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
340677	Ordering, Referring, Prescribing	N/A	1639245814	0	0	HARRIS MILLMAN, PHOEBE K LCSW	6/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24526	N/A	N/A	N/A	N/A	N/A	51 MARINA BOULEVARD	SUITE D	PITTSBURG	CA	94565	2068	00	06000	38.0354387	-121.8837345	Contra Costa County
340714	Ordering, Referring, Prescribing	N/A	1639344567	0	0	HALL, CHANTEE PSYD	5/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51569	N/A	N/A	N/A	N/A	N/A	1303 W WALNUT PKWY	None	COMPTON	CA	90220	5030	00	06000	33.87724562	-118.2446904	Los Angeles County
340726	Ordering, Referring, Prescribing	N/A	1639377443	0	0	HANSEN, KATHRYN J LCSW	3/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	66632	N/A	N/A	N/A	N/A	N/A	2178 JOHNSON AVENUE	None	SAN LUIS OBISPO	CA	93401	4535	00	06000	35.27488974	-120.6468257	San Luis Obispo County
340804	Ordering, Referring, Prescribing	N/A	1639489727	0	0	HERNANDEZ, KELLI K PA-C	3/15/2021	Taxonomy not applicable	NA	n/a	000	Unknown	21159	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
340815	Ordering, Referring, Prescribing	N/A	1639513849	0	0	HIGGINS, ARTHUR MD	2/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151550	N/A	N/A	N/A	N/A	N/A	7512 MORRO RD	None	ATASCADERO	CA	93422	4404	00	06000	35.47716258	-120.6674786	San Luis Obispo County
340821	Ordering, Referring, Prescribing	N/A	1639510225	0	0	HU, XIAOMING LCSW	4/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW86746	N/A	N/A	N/A	N/A	N/A	1930 MARKET STREET	None	SAN FRANCISCO	CA	94102	6228	00	06000	37.77037155	-122.4255051	San Francisco County
340826	Ordering, Referring, Prescribing	N/A	1639523228	0	0	HAI, FAIZI M MD	2/8/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159324	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
340850	Ordering, Referring, Prescribing	N/A	1639555725	0	0	HOSSEINI, SAMIRA LCSW	11/5/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88018	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
340879	Ordering, Referring, Prescribing	N/A	1639598600	0	0	HART, ILANA F LCSW	2/12/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW99666	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
340883	Ordering, Referring, Prescribing	N/A	1639599236	0	0	HORN, AARON L LMFT	6/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114998	N/A	N/A	N/A	N/A	N/A	1266 14TH ST	None	OAKLAND	CA	94607	2247	00	06000	37.81022696	-122.2887619	Alameda County
340935	Ordering, Referring, Prescribing	N/A	1639681513	0	0	HWANG, TAMMY NP	12/16/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007792	N/A	N/A	N/A	N/A	N/A	1333 MERIDIAN AVE	None	SAN JOSE	CA	95125	5212	00	06000	37.30176	-121.9136465	Santa Clara County
340967	Ordering, Referring, Prescribing	N/A	1639747074	0	0	HALE, JESSICA LMFT	11/4/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126436	N/A	N/A	N/A	N/A	N/A	4867 SUNSET BLVD,	None	LOS ANGELES	CA	90027	5969	00	06000	34.0981755	-118.295055	Los Angeles County
340986	Ordering, Referring, Prescribing	N/A	1639796204	0	0	HANNA, MONICA K DC	4/28/2021	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	34772	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
341017	Ordering, Referring, Prescribing	N/A	1639904048	0	0	HERB, CANDACE	8/27/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95031901	N/A	N/A	N/A	N/A	N/A	29 BAYWOOD AVE	None	SAN MATEO	CA	94402	0000	00	06000	37.56478204	-122.3289243	San Mateo County
341020	Ordering, Referring, Prescribing	N/A	1639937568	0	0	HARRIS, AMBER DC	2/10/2024	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	36861	N/A	N/A	N/A	N/A	N/A	8530 FIRESTONE BLVD	None	DOWNEY	CA	90241	4926	00	06000	33.93782301	-118.1288691	Los Angeles County
341067	Ordering, Referring, Prescribing	N/A	1649311010	0	0	HUGHES, KRISTINE M LMFT	1/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	43467	N/A	N/A	N/A	N/A	N/A	1965 LIVE OAK BLVD	None	YUBA CITY	CA	95991	8850	00	06000	39.15563037	-121.620091	Sutter County
341130	Ordering, Referring, Prescribing	N/A	1649445800	0	0	HUNT, RASELETTE A MD	4/11/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C147477	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
341166	Ordering, Referring, Prescribing	N/A	1649513821	0	0	HOFFMAN, LINDSAY R CNM	7/20/2015	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235655	N/A	N/A	N/A	N/A	N/A	3131 ALUM ROCK AVE	None	SAN JOSE	CA	95121	1664	00	06000	37.36639819	-121.8272112	Santa Clara County
341179	Ordering, Referring, Prescribing	N/A	1649545781	0	0	HERNANDEZ, JOANNA LCSW	3/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81625	N/A	N/A	N/A	N/A	N/A	550 S VERMONT AVE	3	LOS ANGELES	CA	90020	1912	00	06000	34.064091	-118.2916225	Los Angeles County
341205	Ordering, Referring, Prescribing	N/A	1649590951	0	0	HOLMAN, ALLYSON PA	9/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	21023	N/A	N/A	N/A	N/A	N/A	877 OAK PARK BLVD	None	PISMO BEACH	CA	93449	3292	00	06000	35.13294806	-120.6057266	San Luis Obispo County
341215	Ordering, Referring, Prescribing	N/A	1649601717	0	0	HUA, WILLIAM PHD	3/25/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY26416	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
341259	Ordering, Referring, Prescribing	N/A	1649656299	0	0	HAN, PAMELA ZUNG F	3/2/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D64739	N/A	N/A	N/A	N/A	N/A	1031 WATERLOO RD	None	STOCKTON	CA	95205	4256	00	06000	37.96732496	-121.2723543	San Joaquin County
341264	Ordering, Referring, Prescribing	N/A	1649674912	0	0	HUTHSING, JAMIE L LMFT	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84361	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
341275	Ordering, Referring, Prescribing	N/A	1649683723	0	0	HANNABERRY, JOHN LCSW	7/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95620	N/A	N/A	N/A	N/A	N/A	1411 N GRAND AVE	None	COVINA	CA	91724	1001	00	06000	34.105149	-117.87435	Los Angeles County
341284	Ordering, Referring, Prescribing	N/A	1649701871	0	0	HA, DANIEL MD	11/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A159464	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY	4TH FLOOR SUITE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
341299	Ordering, Referring, Prescribing	N/A	1649728569	0	0	HERME, ALYSON C PHD	3/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29571	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	MS #170	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
341314	Ordering, Referring, Prescribing	N/A	1649760901	0	0	HURLEY, ERIN M PA	10/12/2018	Taxonomy not applicable	NA	n/a	000	Unknown	56141	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
341320	Ordering, Referring, Prescribing	N/A	1649770017	0	0	HARRIS, MICHELLE LCSW	6/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	108456	N/A	N/A	N/A	N/A	N/A	4000 METROPOLITAN DRIVE	401	ORANGE	CA	92686	3504	00	06000	33.78016046	-117.8956101	Orange County
341340	Ordering, Referring, Prescribing	N/A	1649804972	0	0	HALL, VANESSA M NP	2/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95014022	N/A	N/A	N/A	N/A	N/A	3710 E CESAR E CHAVEZ AV	None	LOS ANGELES	CA	90063	2219	00	06000	34.04048853	-118.1854845	Los Angeles County
341366	Ordering, Referring, Prescribing	N/A	1649848631	0	0	HARCROW, FLETCHER LPCC	1/22/2025	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC18499	N/A	N/A	N/A	N/A	N/A	27200 TOURNEY RD STE 175	STE 175	VALENCIA	CA	91355	4986	00	06000	34.41656755	-118.5763161	Los Angeles County
341378	Ordering, Referring, Prescribing	N/A	1649867532	0	0	HERNANDEZ, ERNESTO PT	4/14/2022	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	299591	N/A	N/A	N/A	N/A	N/A	500 SAN FERNANDO MISSION	100	SAN FERNANDO	CA	91340	4061	00	06000	34.28208951	-118.4457662	Los Angeles County
341384	Ordering, Referring, Prescribing	N/A	1649881616	0	0	HUANG, SHARON PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	82462	N/A	N/A	N/A	N/A	N/A	2875 MAIN ST	None	SUSANVILLE	CA	96130	4739	00	06000	40.41007292	-120.6355924	Lassen County
341392	Ordering, Referring, Prescribing	N/A	1649916925	0	0	HASAN, SARI S PHARMD	4/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85450	N/A	N/A	N/A	N/A	N/A	4805 BECHELLI LN	None	REDDING	CA	96002	3556	00	06000	40.54014957	-122.3548634	Shasta County
341412	Ordering, Referring, Prescribing	N/A	1649936964	0	0	HA, DAYE LCSW	12/20/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90553	N/A	N/A	N/A	N/A	N/A	5105 W GOLDLEAF CIR	200	LOS ANGELES	CA	90056	1269	00	06000	33.9878918	-118.3672336	Los Angeles County
341487	Ordering, Referring, Prescribing	N/A	1659405728	0	0	HASKETT, JOHN T CNP	8/4/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	6064	N/A	N/A	N/A	N/A	N/A	720 WOOD ST.	None	EUREKA	CA	95591	4413	00	06000	40.78118068	-124.1607622	Humboldt County
341512	Ordering, Referring, Prescribing	N/A	1659464212	0	0	HUEY, ALEXANDER Y PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	47350	N/A	N/A	N/A	N/A	N/A	1800 HARRISON ST	None	OAKLAND	CA	94612	3466	00	06000	37.80593773	-122.2656714	Alameda County
341515	Ordering, Referring, Prescribing	N/A	1659465193	0	0	HENDERSON, MICHAEL T LMFT	1/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	42250	N/A	N/A	N/A	N/A	N/A	101 CIRBY HILLS DR	None	ROSEVILLE	CA	95678	4360	00	06000	38.7303989	-121.2872592	Placer County
341534	Ordering, Referring, Prescribing	N/A	1659503597	0	0	HERNANDEZ, MONICA LCSW	3/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29515	N/A	N/A	N/A	N/A	N/A	695 S VERMONT AVE	FLOOR 8	LOS ANGELES	CA	90005	1349	00	06000	34.06078495	-118.2916863	Los Angeles County
341538	Ordering, Referring, Prescribing	N/A	1659512069	0	0	HUBER, MICHELLE LCSW	2/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24773	N/A	N/A	N/A	N/A	N/A	6651 BALBOA BLVD	None	VAN NUYS	CA	91406	5529	00	06000	34.191468	-118.5011883	Los Angeles County
341542	Ordering, Referring, Prescribing	N/A	1659519601	0	0	HENRY-JOHNSON, ALYSHA E PA-C	10/10/2021	Taxonomy not applicable	NA	n/a	000	Unknown	58959	N/A	N/A	N/A	N/A	N/A	1971 E 4TH ST	200	SANTA ANA	CA	92705	3917	00	06000	33.7482685	-117.83934	Orange County
341557	Ordering, Referring, Prescribing	N/A	1659549830	0	0	HASHIM, ZULFIQAR A MD	11/9/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C175464	N/A	N/A	N/A	N/A	N/A	1350 S ORANGE AVE	None	FRESNO	CA	93702	3463	00	06000	36.728883	-119.763677	Fresno County
341593	Ordering, Referring, Prescribing	N/A	1659629285	0	0	HERRON, RITA LMFT	2/22/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	117262	N/A	N/A	N/A	N/A	N/A	620 N. AURORA ST.	None	STOCKTON	CA	95202	1000	00	06000	37.96104648	-121.2811438	San Joaquin County
341639	Ordering, Referring, Prescribing	N/A	1659689446	0	0	HIGHLY, KATHLEEN A PHD	2/22/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY16402	N/A	N/A	N/A	N/A	N/A	200 S WELLS ROAD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
341651	Ordering, Referring, Prescribing	N/A	1659724359	0	0	HERNANDEZ, JEANET LCSW	11/21/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112226	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
341738	Ordering, Referring, Prescribing	N/A	1659848059	0	0	HART, ALEXAH E LCSW	10/22/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW126873	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	210	OXNARD	CA	93036	0617	00	06000	34.219566	-119.1539365	Ventura County
341745	Ordering, Referring, Prescribing	N/A	1659855823	0	0	HART, MICHELE LPCC	3/7/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC5296	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVE	100	GILROY	CA	95020	3673	00	06000	37.03080985	-121.5741639	Santa Clara County
341789	Ordering, Referring, Prescribing	N/A	1659932606	0	0	HASAN, EEMAN PA-C	7/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA56972	N/A	N/A	N/A	N/A	N/A	200 S WELLS ROAD	100	VENTURA	CA	93004	1302	00	06000	34.29321532	-119.1597424	Ventura County
341806	Ordering, Referring, Prescribing	N/A	1659977114	0	0	HASSAN-MOHAMMED, SADIYA I LMFT	6/21/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133349	N/A	N/A	N/A	N/A	N/A	12966 EUCLID ST	None	GARDEN GROVE	CA	92840	5200	00	06000	33.77455935	-117.9378298	Orange County
341831	Ordering, Referring, Prescribing	N/A	1669033908	0	0	HERNANDEZ, ULISSES DO	4/7/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20036	N/A	N/A	N/A	N/A	N/A	2101 7TH ST	None	WASCO	CA	93280	1502	00	06000	35.59426049	-119.3498955	Kern County
341835	Ordering, Referring, Prescribing	N/A	1669056040	0	0	HUYNH, ANDREA TRAM ANH Q MD	9/27/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A199303	N/A	N/A	N/A	N/A	N/A	57 N 13TH STREET	None	SAN JOSE	CA	95112	3439	00	06000	37.34278534	-121.8786963	Santa Clara County
341836	Ordering, Referring, Prescribing	N/A	1669060117	0	0	HOWELL, SHIVA LMFT	12/15/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129944	N/A	N/A	N/A	N/A	N/A	226 W OJAI AVE	None	OJAI	CA	93023	3277	00	06000	34.44760276	-119.2488095	Ventura County
341840	Ordering, Referring, Prescribing	N/A	1669067252	0	0	HUANG, ERIKA S NP	2/18/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95016721	N/A	N/A	N/A	N/A	N/A	39500 LIBERTY ST	None	FREMONT	CA	94538	2211	00	06000	37.54845774	-121.9773463	Alameda County
341844	Ordering, Referring, Prescribing	N/A	1669088258	0	0	HEU, CHONG M NP	10/1/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015989	N/A	N/A	N/A	N/A	N/A	2042 KERN ST	None	FRESNO	CA	93721	2008	00	06000	36.73339969	-119.7882967	Fresno County
341860	Ordering, Referring, Prescribing	N/A	1669141891	0	0	HOBBS, NATHAN L LCSW	9/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28563	N/A	N/A	N/A	N/A	N/A	2227 CAPRICORN WAY	210	SANTA ROSA	CA	95407	5478	00	06000	38.425266	-122.749875	Sonoma County
341913	Ordering, Referring, Prescribing	N/A	1669501300	0	0	HALL, JEBEDIAH M LMFT	6/7/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112513	N/A	N/A	N/A	N/A	N/A	2701 PARK MARINA DR	None	REDDING	CA	96001	0101	00	06000	40.57469468	-122.372817	Shasta County
341938	Ordering, Referring, Prescribing	N/A	1669545521	0	0	HOLLRAH, SUZANNE L LMFT	8/5/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127342	N/A	N/A	N/A	N/A	N/A	901 OLIVE ST	None	SANTA BARBARA	CA	93101	1406	00	06000	34.42588414	-119.6949769	Santa Barbara County
341941	Ordering, Referring, Prescribing	N/A	1669572764	0	0	HAFTER, DAVID N LMFT	1/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	24935	N/A	N/A	N/A	N/A	N/A	3050 BEACON BLVD	None	WEST SACRAMENTO	CA	95691	3467	00	06000	38.57221637	-121.5512902	Yolo County
341945	Ordering, Referring, Prescribing	N/A	1669579330	0	0	HUMES, ROXAN C	8/15/1993	Taxonomy not applicable	NA	n/a	099	DENTIST	D41092	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVENUE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
341979	Ordering, Referring, Prescribing	N/A	1669656393	0	0	HIDALGO-BARNES, MIGUEL K PSYD	2/9/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY24974	N/A	N/A	N/A	N/A	N/A	3001 INTERNATIONAL BLVD	None	OAKLAND	CA	94601	2203	00	06000	37.77859396	-122.2279493	Alameda County
341997	Ordering, Referring, Prescribing	N/A	1669721858	0	0	HAN, PHRAEOPHAN PHARMD	5/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67965	N/A	N/A	N/A	N/A	N/A	13640 ROSCOE BLVD BLDG 3	RM 1301	PANORAMA CITY	CA	91402	3904	00	06000	34.22164249	-118.4299965	Los Angeles County
342002	Ordering, Referring, Prescribing	N/A	1669726337	0	0	HO, SAMUEL C PHARMD	8/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH68273	N/A	N/A	N/A	N/A	N/A	5809 FOOTHILL BLVD	None	OAKLAND	CA	94605	1305	00	06000	37.77174338	-122.1917257	Alameda County
342005	Ordering, Referring, Prescribing	N/A	1669738886	0	0	HUN, WINT T MD	6/4/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A134814	N/A	N/A	N/A	N/A	N/A	1509 WILSON TERRACE	None	GLENDALE	CA	91206	1000	00	06000	34.14950866	-118.2311155	Los Angeles County
342013	Ordering, Referring, Prescribing	N/A	1669753778	0	0	HOORNBEEK, DOREEN E LMFT	6/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	108016	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	None	MISSION VIEJO	CA	92691	6441	00	06000	33.56536541	-117.670334	Orange County
342021	Ordering, Referring, Prescribing	N/A	1669760740	0	0	HAMILTON, MONIQUE M LCSW	5/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86360	N/A	N/A	N/A	N/A	N/A	1500 FRANKLIN ST FLOOR 2	None	SAN FRANCISCO	CA	94109	4523	00	06000	37.78847503	-122.4235955	San Francisco County
342024	Ordering, Referring, Prescribing	N/A	1669772166	0	0	HUGHES, ADRIANE R LCSW	4/20/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW29280	N/A	N/A	N/A	N/A	N/A	1499 HUNTINGTON DRIVE	101	PASADENA	CA	91030	5445	00	06000	34.10404853	-118.150551	Los Angeles County
342032	Ordering, Referring, Prescribing	N/A	1669781498	0	0	HOGAN, EVA C LCSW	5/21/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	106549	N/A	N/A	N/A	N/A	N/A	725 W LA VETA AVE	SUITGE 260	ORANGE	CA	92868	3833	00	06000	33.78063949	-117.8603285	Orange County
342069	Ordering, Referring, Prescribing	N/A	1669854741	0	0	HU, AILLIE Y	1/9/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	100766	N/A	N/A	N/A	N/A	N/A	355 CENTRAL AVE	None	FILLMORE	CA	93015	1920	00	06000	34.40028802	-118.9137057	Ventura County
342079	Ordering, Referring, Prescribing	N/A	1669875266	0	0	HUEY, ALEXANDRA PA-C	1/5/2021	Taxonomy not applicable	NA	n/a	000	Unknown	51968	N/A	N/A	N/A	N/A	N/A	905 CALLE AMANECER	SUITE 115	SAN CLEMENTE	CA	92673	6226	00	06000	33.44951265	-117.6075825	Orange County
342083	Ordering, Referring, Prescribing	N/A	1669893459	0	0	HSIEH, JIA-YANN T PHARMD	4/5/2022	Taxonomy not applicable	NA	n/a	000	Unknown	40854	N/A	N/A	N/A	N/A	N/A	28505 HESPERIAN BLVD	None	HAYWARD	CA	94545	5008	00	06000	37.61653109	-122.0880046	Alameda County
342086	Ordering, Referring, Prescribing	N/A	1669893764	0	0	HELSBY, SHERRI LCSW	6/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29248	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
342112	Ordering, Referring, Prescribing	N/A	1669925343	0	0	HASIBAR, JOAN M LMFT	7/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT110956	N/A	N/A	N/A	N/A	N/A	650 N OAKLAND AVE	None	PASADENA	CA	91101	1160	00	06000	34.15697849	-118.1399781	Los Angeles County
342148	Ordering, Referring, Prescribing	N/A	1669991014	0	0	HAMDJA, CRISTINA	5/19/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007418	N/A	N/A	N/A	N/A	N/A	1725 W 17TH ST	102F	SANTA ANA	CA	92706	2316	00	06000	33.75999552	-117.892593	Orange County
342157	Ordering, Referring, Prescribing	N/A	1679006811	0	0	HAMMAMI, SAFA MD	1/22/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164911	N/A	N/A	N/A	N/A	N/A	1441 LIBERTY STREET	None	REDDING	CA	96001	1441	00	06000	40.5857177	-122.3870781	Shasta County
342160	Ordering, Referring, Prescribing	N/A	1679013866	0	0	HAGHSHENAS, BAHAREH PHARMD	7/20/2021	Taxonomy not applicable	NA	n/a	000	Unknown	74688	N/A	N/A	N/A	N/A	N/A	2261 W ESPLANADE AVE	None	SAN JACINTO	CA	92582	4704	00	06000	33.77281146	-117.005976	Riverside County
342166	Ordering, Referring, Prescribing	N/A	1679028716	0	0	HOOEY, TIMOTHY LMFT	8/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106771	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
342174	Ordering, Referring, Prescribing	N/A	1679032569	0	0	HSU, LIH-CHIAO MD	4/28/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178196	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
342177	Ordering, Referring, Prescribing	N/A	1679041008	0	0	HTET, SOE M	9/18/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	104290	N/A	N/A	N/A	N/A	N/A	767 N HILL ST	STE 200	LOS ANGELES	CA	90012	2365	00	06000	34.06255157	-118.2397077	Los Angeles County
342246	Ordering, Referring, Prescribing	N/A	1679137004	0	0	HUTCHINSON, APRIL LMFT	11/25/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141664	N/A	N/A	N/A	N/A	N/A	27699 JEFFERSON AVE	SUITE 111	TEMECULA	CA	92590	2697	00	06000	33.51449799	-117.1593524	Riverside County
342269	Ordering, Referring, Prescribing	N/A	1679199632	0	0	HAYDEN, ERIN E LCSW	12/12/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	112563	N/A	N/A	N/A	N/A	N/A	66 HURLBUT ST.	None	PASADENA	CA	91105	4025	00	06000	34.12993251	-118.1516625	Los Angeles County
342277	Ordering, Referring, Prescribing	N/A	1679224786	0	0	HSIEH, KEL-ANN NP	2/13/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016834	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
342300	Ordering, Referring, Prescribing	N/A	1679358113	0	0	HUANG, LISA PHARMD	8/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88335	N/A	N/A	N/A	N/A	N/A	155 W CALIFORNIA BLVD	None	PASADENA	CA	91105	3005	00	06000	34.13579917	-118.1534676	Los Angeles County
342310	Ordering, Referring, Prescribing	N/A	1679547897	0	0	HALAPPA, ARUNDATI MD	1/14/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A84222	N/A	N/A	N/A	N/A	N/A	4150 PATTERSON RD	None	RIVERBANK	CA	95367	9536	00	06000	37.73262081	-120.9200969	Stanislaus County
342315	Ordering, Referring, Prescribing	N/A	1679574495	0	0	HARDY, GRACE S	3/19/2004	Taxonomy not applicable	NA	n/a	099	DENTIST	D51696	N/A	N/A	N/A	N/A	N/A	18533 SOLEDAD CANYON RD	None	CANYON COUNTRY	CA	91351	3722	00	06000	34.41652146	-118.45647	Los Angeles County
342339	Ordering, Referring, Prescribing	N/A	1679648158	0	0	HARRIS, DIANE C MD	3/25/2020	Taxonomy not applicable	NA	n/a	000	Unknown	G84412	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
342353	Ordering, Referring, Prescribing	N/A	1679664247	0	0	HSIEH, YEU-SHAN PHARMD	4/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH49905	N/A	N/A	N/A	N/A	N/A	4175 E LA PALMA AVE	SUITE 240	ANAHEIM	CA	92807	1842	00	06000	33.85947346	-117.8265479	Orange County
342356	Ordering, Referring, Prescribing	N/A	1679691497	0	0	HARGADON, ANNEMARIE P MD	11/1/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G71986	N/A	N/A	N/A	N/A	N/A	1909 GALILEO CT	SUITE A	DAVIS	CA	95618	4890	00	06000	38.54211572	-121.7285954	Yolo County
342409	Ordering, Referring, Prescribing	N/A	1679786677	0	0	HERNANDEZ, MARCO A DC	11/8/2022	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC27239	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
342413	Ordering, Referring, Prescribing	N/A	1679804645	0	0	HOOVER, GERALD C DO	12/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A6186	N/A	N/A	N/A	N/A	N/A	31180 ROAD 72	None	GOSHEN	CA	93227	9997	00	06000	36.35594779	-119.4124242	Tulare County
342421	Ordering, Referring, Prescribing	N/A	1679806558	0	0	HOLMAN, ALEA R PHD	6/6/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27787	N/A	N/A	N/A	N/A	N/A	3301 E 12TH ST	SUITE 259	OAKLAND	CA	94601	3424	00	06000	37.77617499	-122.2247899	Alameda County
342436	Ordering, Referring, Prescribing	N/A	1679831515	0	0	HOW, POH CHOO MD	3/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A127698	N/A	N/A	N/A	N/A	N/A	2150 STOCKTON BLVD	None	SACRAMENTO	CA	96817	1337	00	06000	38.557287	-121.461444	Sacramento County
342448	Ordering, Referring, Prescribing	N/A	1679857353	0	0	HUYNH, TIFFANY T PHARMD	7/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	51990	N/A	N/A	N/A	N/A	N/A	1800 E IMPERIAL HWY STE	SUITE 150	BREA	CA	92821	6015	00	06000	33.91089547	-117.8759707	Orange County
342462	Ordering, Referring, Prescribing	N/A	1679905830	0	0	HIPPLE, WENDY LMFT	6/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105344	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	165	OXNARD	CA	93036	0673	00	06000	34.219566	-119.1539365	Ventura County
342463	Ordering, Referring, Prescribing	N/A	1679886279	0	0	HICKENBOTTOM, ANGELA N LMFT	6/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102595	N/A	N/A	N/A	N/A	N/A	1215 1ST ST	None	GILROY	CA	95020	4733	00	06000	37.01355551	-121.5947655	Santa Clara County
342495	Ordering, Referring, Prescribing	N/A	1679958094	0	0	HIGGINS, TAYLOR L LPCC	6/28/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC7465	N/A	N/A	N/A	N/A	N/A	27261 LAS RAMBLAS	STE 220	MISSION VIEJO	CA	92691	6468	00	06000	33.56536541	-117.670334	Orange County
342521	Ordering, Referring, Prescribing	N/A	1679989487	0	0	HUNTER, ALLISON F LMFT	1/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	98995	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
342539	Ordering, Referring, Prescribing	N/A	1689022477	0	0	HARIRI, LADAN MD	12/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A141688	N/A	N/A	N/A	N/A	N/A	30262 CROWN VALLEY PKWY	None	LAGUNA NIGUEL	CA	92677	2364	00	06000	33.52292298	-117.7155152	Orange County
342571	Ordering, Referring, Prescribing	N/A	1689069759	0	0	HARDIN, KAITLYN A MD	10/18/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A146675	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
342620	Ordering, Referring, Prescribing	N/A	1689152555	0	0	HARRISON, CHRISTINA L LCSW	10/25/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101035	N/A	N/A	N/A	N/A	N/A	845 W EAST AVE	None	CHICO	CA	95926	2002	00	06000	39.74764347	-121.8765412	Butte County
342625	Ordering, Referring, Prescribing	N/A	1689156168	0	0	HERNANDEZ SCHULTE, MAYRA A MD	10/11/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A167202	N/A	N/A	N/A	N/A	N/A	26137 LA PAZ RD	SUITE 200	MISSION VIEJO	CA	92691	5319	00	06000	33.60038172	-117.6735855	Orange County
342642	Ordering, Referring, Prescribing	N/A	1689172421	0	0	HOUDE, NICOLE R PA-C	5/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	54674	N/A	N/A	N/A	N/A	N/A	3415 MARTIN LUTHER KING	None	SACRAMENTO	CA	95817	3468	00	06000	38.54376	-121.4644095	Sacramento County
342673	Ordering, Referring, Prescribing	N/A	1689237174	0	0	HUBBARD, DAVID MD	8/12/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A181256	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
342676	Ordering, Referring, Prescribing	N/A	1689242380	0	0	HIRTHLER, GARY L LMFT	9/6/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	149483	N/A	N/A	N/A	N/A	N/A	380 ENCINAL	200	SANTA CRUZ	CA	95060	2178	00	06000	36.98747083	-122.0380148	Santa Cruz County
342706	Ordering, Referring, Prescribing	N/A	1689298432	0	0	HORNER, GRANT LCSW	11/13/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	119191	N/A	N/A	N/A	N/A	N/A	23461 S POINTE DRIVE,	SUITE 100	LAGUNA HILLS	CA	92653	1523	00	06000	33.62535142	-117.7206568	Orange County
342724	Ordering, Referring, Prescribing	N/A	1689392250	0	0	HAYES, CHERIE F	4/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	4225	N/A	N/A	N/A	N/A	N/A	6885 ORANGETHORPE AVE.	None	BUENA PARK	CA	90620	1398	00	06000	33.85891414	-118.0139031	Orange County
342725	Ordering, Referring, Prescribing	N/A	1689393118	0	0	HE, DI PA	8/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA61493	N/A	N/A	N/A	N/A	N/A	1870 LUNDY AVE	None	SAN JOSE	CA	95131	1826	00	06000	37.39271022	-121.8903238	Santa Clara County
342742	Ordering, Referring, Prescribing	N/A	1689605206	0	0	HICKS, ROGER G MD	7/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G32049	N/A	N/A	N/A	N/A	N/A	1908 N. BEALE ROAD	SUITE E	MARSYVILLE	CA	95901	6937	00	06000	39.1278388	-121.5457994	Yuba County
342750	Ordering, Referring, Prescribing	N/A	1689679045	0	0	HARDY, DANIEL MD	5/6/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G77650	N/A	N/A	N/A	N/A	N/A	311 W I ST	None	LOS BANOS	CA	93635	3479	00	06000	37.06343055	-120.8570545	Merced County
342767	Ordering, Referring, Prescribing	N/A	1689717159	0	0	HARRISON, TRACY J LCSW	1/24/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	64677	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
342768	Ordering, Referring, Prescribing	N/A	1689723546	0	0	HAGHNAZARI, PARICHEHR S PHARMD	3/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH51984	N/A	N/A	N/A	N/A	N/A	13651 WILLARD ST	None	PANORAMA CITY	CA	91402	5423	00	06000	34.2177693	-118.4298601	Los Angeles County
342775	Ordering, Referring, Prescribing	N/A	1689736571	0	0	HITCHCOCK, MARGARET P LMFT	4/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	45279	N/A	N/A	N/A	N/A	N/A	1486 HUNTINGTON AVE	100	SOUTH SAN FRANCIS	CA	94080	5971	00	06000	37.64441633	-122.4219331	San Mateo County
342779	Ordering, Referring, Prescribing	N/A	1689745267	0	0	HUEY, VICKY M LMFT	2/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47521	N/A	N/A	N/A	N/A	N/A	1400 SOUTH GRAND AVENUE	SUITE 600	LOS ANGELES	CA	90015	2881	00	06000	34.03692236	-118.2655238	Los Angeles County
342796	Ordering, Referring, Prescribing	N/A	1689802373	0	0	HWANG, KELLY LMFT	3/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	52974	N/A	N/A	N/A	N/A	N/A	509 E ROSECRANS AVE	None	COMPTON	CA	90221	2056	00	06000	33.90345595	-118.2182212	Los Angeles County
342853	Ordering, Referring, Prescribing	N/A	1689920944	0	0	HALL, ALISON	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0729823	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
342865	Ordering, Referring, Prescribing	N/A	1689941064	0	0	HUSON, JENNIFER M NP	2/1/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	15382	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
342870	Ordering, Referring, Prescribing	N/A	1689942443	0	0	HUNTER, SCOTT R	10/29/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A123174	N/A	N/A	N/A	N/A	N/A	1605 EASTLAKE AVE	None	LOS ANGELES	CA	90033	1009	00	06000	34.06300636	-118.2054784	Los Angeles County
342914	Ordering, Referring, Prescribing	N/A	1699039743	0	0	HOTTA, CHISATO F LMFT	2/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT98939	N/A	N/A	N/A	N/A	N/A	18350 MOUNT LANGLEY ST	200	FOUNTAIN VALLEY	CA	92708	6900	00	06000	33.69633523	-117.9420534	Orange County
342916	Ordering, Referring, Prescribing	N/A	1699044883	0	0	HERRERA, ALICIA S PHARMD	7/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	46486	N/A	N/A	N/A	N/A	N/A	12490 CENTRAL AVE	None	CHINO	CA	91710	2603	00	06000	34.026831	-117.6895075	San Bernardino County
342937	Ordering, Referring, Prescribing	N/A	1699065342	0	0	HUYNH, MICHAEL V MD	5/19/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A131349	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
342955	Ordering, Referring, Prescribing	N/A	1699090175	0	0	HAIDER, JANELLE	11/7/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A100455	N/A	N/A	N/A	N/A	N/A	10736 JEFFERSON BLVD	#614	CULVER CITY	CA	90230	0000	00	06000	34.00259978	-118.3941387	Los Angeles County
342962	Ordering, Referring, Prescribing	N/A	1699101386	0	0	HORKY, ALLISON H LCSW	5/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	73562	N/A	N/A	N/A	N/A	N/A	1380 HOWARD ST	423	SAN FRANCISCO	CA	94103	2638	00	06000	37.77424669	-122.4141502	San Francisco County
342965	Ordering, Referring, Prescribing	N/A	1699102194	0	0	HANRATTY, KAYLA J	10/21/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0788756	N/A	N/A	N/A	N/A	N/A	533 E PALMDALE BLVD	STE A1	PALMDALE	CA	93550	2375	00	06000	34.5796702	-118.1198284	Los Angeles County
342976	Ordering, Referring, Prescribing	N/A	1699112755	0	0	HEREDIA, MONICA Y LMFT	4/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	110642	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
342978	Ordering, Referring, Prescribing	N/A	1699124396	0	0	HO, KELVIN	10/7/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT136214	N/A	N/A	N/A	N/A	N/A	240 EDMONDS RD	None	REDWOOD CITY	CA	94062	0000	00	06000	37.47334689	-122.2854712	San Mateo County
342993	Ordering, Referring, Prescribing	N/A	1699155911	0	0	HAMPAPUR, PREMA DPM	2/12/2023	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	5529	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
342996	Ordering, Referring, Prescribing	N/A	1699157602	0	0	HURNG, JONATHAN M	8/23/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	103677	N/A	N/A	N/A	N/A	N/A	1807 BAY RD	None	EAST PALO ALTO	CA	94303	1312	00	06000	37.47199121	-122.1344629	San Mateo County
342999	Ordering, Referring, Prescribing	N/A	1699164053	0	0	HERMOSILLA, ESTEFANIA LCSW	3/31/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107492	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
343022	Ordering, Referring, Prescribing	N/A	1699210146	0	0	HONG, KEVIN J PHARMD	4/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH75959	N/A	N/A	N/A	N/A	N/A	2381 E DUDLEY ST	None	PASADENA	CA	91104	3418	00	06000	34.16249636	-118.1013604	Los Angeles County
343071	Ordering, Referring, Prescribing	N/A	1699298315	0	0	HAKOPIAN, NEKTAR N PHARMD	2/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75147	N/A	N/A	N/A	N/A	N/A	4950 W SUNSET BLVD	187	LOS ANGELES	CA	90027	5822	00	06000	34.09812092	-118.2980246	Los Angeles County
343073	Ordering, Referring, Prescribing	N/A	1699298349	0	0	HUEZO, GRICELDA LMFT	4/26/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132510	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
343098	Ordering, Referring, Prescribing	N/A	1699357434	0	0	HALL, CHRISTOPHER B NP	6/1/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95014605	N/A	N/A	N/A	N/A	N/A	5959 GREENBACK LN	STE 500	CITRUS HEIGHTS	CA	95621	4700	00	06000	38.681397	-121.322682	Sacramento County
343123	Ordering, Referring, Prescribing	N/A	1699398032	0	0	HOWENSTEIN, BRIANA CCC-SLP	1/30/2024	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	31788	N/A	N/A	N/A	N/A	N/A	10431 COMMERCE ST	None	REDLANDS	CA	92374	0110	00	06000	34.06427678	-117.2416506	San Bernardino County
343133	Ordering, Referring, Prescribing	N/A	1699422048	0	0	HOVHANNISYAN, TATEVIK NP	10/7/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018767	N/A	N/A	N/A	N/A	N/A	3861 SEPULVEDA BLVD.	None	CULVER CITY	CA	90230	4605	00	06000	34.01133074	-118.4159833	Los Angeles County
343135	Ordering, Referring, Prescribing	N/A	1699424952	0	0	HIPOLITO, ROSELA M NP	3/23/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	16162	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
343172	Ordering, Referring, Prescribing	N/A	1699715243	0	0	HARRIS, JEANETTE M DC	12/18/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	24140	N/A	N/A	N/A	N/A	N/A	2502 E JENSEN AVE	None	SANGER	CA	93657	2447	00	06000	36.70680549	-119.572011	Fresno County
343189	Ordering, Referring, Prescribing	N/A	1699798868	0	0	HAGELIS, JOHN P PHD	7/22/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	4704	N/A	N/A	N/A	N/A	N/A	313 KENDAL ST	None	VACAVILLE	CA	95688	3960	00	06000	38.35754372	-121.9893443	Solano County
343191	Ordering, Referring, Prescribing	N/A	1699800086	0	0	HAUS, KELLY LMFT	2/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	37870	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
343206	Ordering, Referring, Prescribing	N/A	1699811158	0	0	HANSON, IRENE NP	2/2/2020	Taxonomy not applicable	NA	n/a	000	Unknown	16077	N/A	N/A	N/A	N/A	N/A	3505 E SHIELDS AVE	None	FRESNO	CA	93726	6910	00	06000	36.77977313	-119.7661846	Fresno County
343219	Ordering, Referring, Prescribing	N/A	1699838680	0	0	HUYNH, CANG T PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	51784	N/A	N/A	N/A	N/A	N/A	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	00	06000	38.594898	-121.3884765	Sacramento County
343244	Ordering, Referring, Prescribing	N/A	1699885608	0	0	HEYART, GREGORY R DC	9/18/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	16121	N/A	N/A	N/A	N/A	N/A	161 N MILL ST	None	TEHACHAPI	CA	93561	2523	00	06000	35.13410412	-118.4520157	Kern County
343282	Ordering, Referring, Prescribing	N/A	1699974485	0	0	HOLSTEN, MARGARITA MD	11/12/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C163126	N/A	N/A	N/A	N/A	N/A	490 POST ST	939	SAN FRANCISCO	CA	94102	1401	00	06000	37.78812774	-122.4096884	San Francisco County
343291	Ordering, Referring, Prescribing	N/A	1700032547	0	0	HERNANDEZ, VICENTE S LMFT	2/17/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131249	N/A	N/A	N/A	N/A	N/A	5300 ANGELES VISTA BLVD	None	VIEW PARK	CA	90043	1648	00	06000	33.99473949	-118.34271	Los Angeles County
343314	Ordering, Referring, Prescribing	N/A	1700087467	0	0	HEIN, CLAUDIA M LCSW	5/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29220	N/A	N/A	N/A	N/A	N/A	6333 TELEGRAPH AVE	102	OAKLAND	CA	94609	0060	00	06000	37.84914135	-122.260702	Alameda County
343329	Ordering, Referring, Prescribing	N/A	1700101821	0	0	HODGE, DERON R	1/27/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47146	N/A	N/A	N/A	N/A	N/A	12970 3RD ST	None	CHINO	CA	91710	3464	00	06000	34.01815857	-117.695635	San Bernardino County
343335	Ordering, Referring, Prescribing	N/A	1700125705	0	0	HALE, MELISSA D LCSW	9/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	69098	N/A	N/A	N/A	N/A	N/A	1904 RICHLAND AVE	BLDG F	CERES	CA	95307	4562	00	06000	37.60031128	-120.9658226	Stanislaus County
343341	Ordering, Referring, Prescribing	N/A	1700128519	0	0	HARLESS, LUCAS D MD	7/19/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132603	N/A	N/A	N/A	N/A	N/A	3600 BROADWAY 4TH FLOOR	SUITE 43	OAKLAND	CA	94611	5730	00	06000	37.8237837	-122.2590026	Alameda County
343352	Ordering, Referring, Prescribing	N/A	1700137098	0	0	HANSEN-WEAVER, JESSICA LCSW	8/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96436	N/A	N/A	N/A	N/A	N/A	PAYROLL OFFICE - UCSF BO	None	SAN FRANCISCO	CA	94143	0815	00	06000	0	0	None
343356	Ordering, Referring, Prescribing	N/A	1700155751	0	0	HOWARD, MOLLY LCSW	10/12/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW118588	N/A	N/A	N/A	N/A	N/A	8912 VOLUNTEER LN	None	SACRAMENTO	CA	95826	3221	00	06000	38.55438	-121.3756965	Sacramento County
343359	Ordering, Referring, Prescribing	N/A	1700150034	0	0	HILDEBRAND, CANDICE M LMFT	6/23/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	90673	N/A	N/A	N/A	N/A	N/A	19-531 MCLANE STREET	B	PALM SPRINGS	CA	92262	0001	00	06000	33.90844677	-116.5523877	Riverside County
343396	Ordering, Referring, Prescribing	N/A	1700200433	0	0	HUA, HUNG PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	68275	N/A	N/A	N/A	N/A	N/A	30251 MURRIETA RD	None	MENIFEE	CA	92584	8385	00	06000	33.684399	-117.2060495	Riverside County
343471	Ordering, Referring, Prescribing	N/A	1700323425	0	0	HAFFNER, MAX R MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163694	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
343475	Ordering, Referring, Prescribing	N/A	1700324167	0	0	HOLLEY, MELANIE NP	8/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95006129	N/A	N/A	N/A	N/A	N/A	135 SPRUCE ST	None	GRIDLEY	CA	95948	2239	00	06000	39.36695252	-121.6888785	Butte County
343498	Ordering, Referring, Prescribing	N/A	1700364015	0	0	HAMPTON, JULIE M NP	7/18/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95009517	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
343510	Ordering, Referring, Prescribing	N/A	1700369659	0	0	HENDRICKS, KATHRYN T LMFT	6/10/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126400	N/A	N/A	N/A	N/A	N/A	777 N. 1ST STREET	SUITE 444	SAN JOSE	CA	95112	6339	00	06000	37.35064564	-121.9015633	Santa Clara County
343524	Ordering, Referring, Prescribing	N/A	1700382389	0	0	HASROUNI, EDY A MD	7/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A174111	N/A	N/A	N/A	N/A	N/A	26926 CHERRY HILLS BLVD	STE B & C	MENIFEE	CA	92586	2500	00	06000	33.71084821	-117.1899782	Riverside County
343526	Ordering, Referring, Prescribing	N/A	1700390705	0	0	HERNANDEZ, RACHAEL	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77498	N/A	N/A	N/A	N/A	N/A	710 LAWRENCE EXPY	DEPT 362	SANTA CLARA	CA	95051	5173	00	06000	37.33636857	-121.9958111	Santa Clara County
343581	Ordering, Referring, Prescribing	N/A	1700510328	0	0	HEFLIN, BRENDA A LCSW	7/29/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93466	N/A	N/A	N/A	N/A	N/A	7290 EL CAJON BLVD	None	SAN DIEGO	CA	92115	1829	00	06000	32.76884635	-117.0406752	San Diego County
343649	Ordering, Referring, Prescribing	N/A	1700918893	0	0	HERNANDEZ, GRISELDA LMFT	6/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT48147	N/A	N/A	N/A	N/A	N/A	625 CITRACADO PKWY	102	ESCONDIDO	CA	92025	6428	00	06000	33.09177699	-117.078913	San Diego County
343657	Ordering, Referring, Prescribing	N/A	1700936655	0	0	HALL, DEBRA G	5/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0392643	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
343688	Ordering, Referring, Prescribing	N/A	1710004205	0	0	HONG, LINH T LCSW	9/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	21108	N/A	N/A	N/A	N/A	N/A	871 ENBORG CT	100	SAN JOSE	CA	95128	2645	00	06000	37.311489	-121.933817	Santa Clara County
343701	Ordering, Referring, Prescribing	N/A	1710019989	0	0	HERNANDEZ, EMMA S LMFT	12/5/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT91643	N/A	N/A	N/A	N/A	N/A	3939 ATLANTIC AVE.	103	LONG BEACH	CA	90807	3529	00	06000	33.830073	-118.1851065	Los Angeles County
343703	Ordering, Referring, Prescribing	N/A	1710024591	0	0	HOHENGARTEN, DONN P LMFT	10/15/2017	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	18917	N/A	N/A	N/A	N/A	N/A	950 SOUTH WASHINGTON STR	None	SONORA	CA	95370	5158	00	06000	37.97262182	-120.3791509	Tuolumne County
343710	Ordering, Referring, Prescribing	N/A	1710037338	0	0	HERRIMAN, KIMBERLY S PSYD	7/7/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY34336	N/A	N/A	N/A	N/A	N/A	2034 DE LA VINA	None	SANTA BARBARA	CA	93101	3814	00	06000	34.42872207	-119.7168624	Santa Barbara County
343719	Ordering, Referring, Prescribing	N/A	1710066642	0	0	HUYNH, NHI Y MD	6/22/2020	Taxonomy not applicable	NA	n/a	000	Unknown	A49296	N/A	N/A	N/A	N/A	N/A	160 E. VIRGINIA ST,	SUITE 280	SAN JOSE	CA	95112	5848	00	06000	37.32582868	-121.8777868	Santa Clara County
343729	Ordering, Referring, Prescribing	N/A	1710090717	0	0	HASSLER, MONIKA	2/5/2014	Taxonomy not applicable	NA	n/a	000	Unknown	PA11395	N/A	N/A	N/A	N/A	N/A	390 7TH STREET	None	HOLLISTER	CA	95023	3820	00	06000	36.8494215	-121.4036781	San Benito County
343734	Ordering, Referring, Prescribing	N/A	1710119474	0	0	HUYNH, KEVAN Q	11/7/2014	Taxonomy not applicable	NA	n/a	000	Unknown	187	N/A	N/A	N/A	N/A	N/A	2100 CURTNER AVE	STE G	SAN JOSE	CA	95124	1330	00	06000	37.27251154	-121.934295	Santa Clara County
343738	Ordering, Referring, Prescribing	N/A	1710118583	0	0	HALL, MELANIE J LCSW	4/2/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	25183	N/A	N/A	N/A	N/A	N/A	695 S VERMONT AVE	None	LOS ANGELES	CA	90005	1349	00	06000	34.06078495	-118.2916863	Los Angeles County
343751	Ordering, Referring, Prescribing	N/A	1710165386	0	0	HAHN, JIM PHARMD	3/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53785	N/A	N/A	N/A	N/A	N/A	1745 EASTLAKE PKWY	104	CHULA VISTA	CA	91915	2033	00	06000	32.61933394	-116.9619239	San Diego County
343759	Ordering, Referring, Prescribing	N/A	1710174032	0	0	HERRERA, ERICA L LMFT	4/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT79295	N/A	N/A	N/A	N/A	N/A	3125 MYERS STREET	BUILDING 3	RIVERSIDE	CA	92503	5527	00	06000	33.90932558	-117.4428095	Riverside County
343765	Ordering, Referring, Prescribing	N/A	1710185400	0	0	HUGHES, STEPHEN A MD	5/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A114493	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DR	SUITE 160	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
343773	Ordering, Referring, Prescribing	N/A	1710214978	0	0	HEER, PARMINDER LCSW	2/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW75168	N/A	N/A	N/A	N/A	N/A	1965 LIVE OAK BLVD	None	YUBA CITY	CA	95991	8850	00	06000	39.15563037	-121.620091	Sutter County
343790	Ordering, Referring, Prescribing	N/A	1710236005	0	0	HARMS, MARIANA LMFT	2/10/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	84908	N/A	N/A	N/A	N/A	N/A	1236 CHAPALA ST	None	SANTA BARBARA	CA	93101	3116	00	06000	34.42310529	-119.7066629	Santa Barbara County
343830	Ordering, Referring, Prescribing	N/A	1710294996	0	0	HSU, EMILY PHD	6/4/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27308	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
343836	Ordering, Referring, Prescribing	N/A	1710301387	0	0	HSIEH, YVONNE Y PHARMD	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	70270	N/A	N/A	N/A	N/A	N/A	401 N AZUSA AVE	None	COVINA	CA	91722	3609	00	06000	34.08845439	-117.9079036	Los Angeles County
343837	Ordering, Referring, Prescribing	N/A	1710303094	0	0	HARTWIG, JENNIFER LMFT	10/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	87583	N/A	N/A	N/A	N/A	N/A	315 CAMINO DEL REMEDIO	B	SANTA BARBARA	CA	93110	1332	00	06000	34.444881	-119.7793725	Santa Barbara County
343844	Ordering, Referring, Prescribing	N/A	1710309851	0	0	HUA-FENG, LIEN NP	2/20/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	23742	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
343847	Ordering, Referring, Prescribing	N/A	1710316674	0	0	HARTMAN, ELIZABETH LCSW	6/5/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	113468	N/A	N/A	N/A	N/A	N/A	18144 SECO ST	None	JAMESTOWN	CA	95327	9498	00	06000	37.95208073	-120.4216785	Tuolumne County
343851	Ordering, Referring, Prescribing	N/A	1710319538	0	0	HERNANDEZ, DIEGO LMFT	5/17/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106789	N/A	N/A	N/A	N/A	N/A	1030 W. WARNER AVE., SAN	None	SANTA ANA	CA	92707	3147	00	06000	33.71597598	-117.8819134	Orange County
343859	Ordering, Referring, Prescribing	N/A	1710342514	0	0	HERNANDEZ, ERIKA M LPCC	3/19/2020	Taxonomy not applicable	NA	n/a	000	Unknown	7724	N/A	N/A	N/A	N/A	N/A	1126 N GRAND AVE	D	COVINA	CA	91724	1551	00	06000	34.100082	-117.8724825	Los Angeles County
343934	Ordering, Referring, Prescribing	N/A	1710449053	0	0	HONTS, MELENY LMFT	5/11/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT125943	N/A	N/A	N/A	N/A	N/A	1555 PARKMOOR AVENUE	None	SAN JOSE	CA	91528	2407	00	06000	37.31712017	-121.9185451	Santa Clara County
343945	Ordering, Referring, Prescribing	N/A	1710474317	0	0	HUYNH, MELISSA A NP	1/4/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95008293	N/A	N/A	N/A	N/A	N/A	1901 W KETTLEMAN LN	STE 200	LODI	CA	95242	4337	00	06000	38.11558533	-121.2964501	San Joaquin County
343946	Ordering, Referring, Prescribing	N/A	1710473608	0	0	HUANG, JENNY DDS	5/15/2023	Taxonomy not applicable	NA	n/a	000	Unknown	103485	N/A	N/A	N/A	N/A	N/A	50100 GOLSH ROAD	None	VALLEY CENTER	CA	92082	5338	00	06000	33.27715948	-116.9618201	San Diego County
343959	Ordering, Referring, Prescribing	N/A	1710499199	0	0	HAITSUKA, SCOTT LCSW	2/9/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW75745	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
344009	Ordering, Referring, Prescribing	N/A	1710632435	0	0	HILL, GENIELYN M NP	2/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95020046	N/A	N/A	N/A	N/A	N/A	9995 CARMEL MOUNTAIN RD	B10-11	SAN DIEGO	CA	92129	2889	00	06000	32.96073738	-117.1119913	San Diego County
344047	Ordering, Referring, Prescribing	N/A	1710976055	0	0	HENDRICKS, JAMES G MD	4/24/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G84825	N/A	N/A	N/A	N/A	N/A	1225 E LATHAM AVE	B	HEMET	CA	92543	4423	00	06000	33.74937952	-116.959626	Riverside County
344063	Ordering, Referring, Prescribing	N/A	1720057128	0	0	HESS, KARL M PHARMD	1/9/2019	Taxonomy not applicable	NA	n/a	000	Unknown	57627	N/A	N/A	N/A	N/A	N/A	1801 W ROMNEYA DR	108	ANAHEIM	CA	92801	1830	00	06000	33.8506615	-117.946413	Orange County
344064	Ordering, Referring, Prescribing	N/A	1720037864	0	0	HAXTON, RONALD S MD	9/16/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A22838	N/A	N/A	N/A	N/A	N/A	27800 MEDICAL CENTER RD	SUITE 204	MISSION VIEJO	CA	92691	6408	00	06000	33.55952733	-117.6645199	Orange County
344118	Ordering, Referring, Prescribing	N/A	1720176746	0	0	HADDEN, ANDREW L PSYD	3/25/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY17222	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
344148	Ordering, Referring, Prescribing	N/A	1720250236	0	0	HUTTON, ASHLEY S LCSW	3/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	72956	N/A	N/A	N/A	N/A	N/A	4000 W. METROPOLITAN DRI	SUITE 401	ORANGE	CA	92868	3504	00	06000	33.78016046	-117.8956101	Orange County
344163	Ordering, Referring, Prescribing	N/A	1720293962	0	0	HARWOOD, DANNIELLE O MD	8/24/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A98775	N/A	N/A	N/A	N/A	N/A	702 MANGROVE AVE	345	CHICO	CA	95926	3948	00	06000	39.73601922	-121.8356645	Butte County
344174	Ordering, Referring, Prescribing	N/A	1720310592	0	0	HERNANDEZ, ALEX Y MD	3/5/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C153842	N/A	N/A	N/A	N/A	N/A	2505 MERCED ST	None	FRESNO	CA	93721	1811	00	06000	36.74081939	-119.7879808	Fresno County
344179	Ordering, Referring, Prescribing	N/A	1720316490	0	0	HATANAKA, YUKIKO LMFT	3/13/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	112486	N/A	N/A	N/A	N/A	N/A	46 RACE ST	None	SAN JOSE	CA	95126	3130	00	06000	37.33026222	-121.9118718	Santa Clara County
344181	Ordering, Referring, Prescribing	N/A	1720322183	0	0	HOANG, SIMON T PHARMD	11/23/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH67382	N/A	N/A	N/A	N/A	N/A	4605 MORENA BLVD	None	SAN DIEGO	CA	92117	3650	00	06000	32.82186082	-117.2264619	San Diego County
344211	Ordering, Referring, Prescribing	N/A	1720361702	0	0	HSIA, MELINDA J PHARMD	4/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	35764	N/A	N/A	N/A	N/A	N/A	2207 W COMMONWEALTH AVE	None	ALHAMBRA	CA	91803	1302	00	06000	34.08785952	-118.1488918	Los Angeles County
344240	Ordering, Referring, Prescribing	N/A	1720403892	0	0	HONGO, TRANG PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53937	N/A	N/A	N/A	N/A	N/A	10407 SANTA MONICA BLVD	None	LOS ANGELES	CA	90025	2691	00	06000	34.05735528	-118.4244855	Los Angeles County
344246	Ordering, Referring, Prescribing	N/A	1720403454	0	0	HENRIQUEZ, KEVIN A	3/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129317	N/A	N/A	N/A	N/A	N/A	1245 E SANTA CLARA ST	None	SAN JOSE	CA	95116	2337	00	06000	37.34780368	-121.8662009	Santa Clara County
344253	Ordering, Referring, Prescribing	N/A	1720408644	0	0	HEATH, EDWARD DDS	6/20/2022	Taxonomy not applicable	NA	n/a	000	Unknown	100555	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
344287	Ordering, Referring, Prescribing	N/A	1720453061	0	0	HANS, ANDREA E LMFT	5/28/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100609	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
344346	Ordering, Referring, Prescribing	N/A	1720535438	0	0	HUGHES, THOMAS MD	9/1/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145945	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
344347	Ordering, Referring, Prescribing	N/A	1720537160	0	0	HEBRON, LIBERTY P LPCC	7/1/2020	Taxonomy not applicable	NA	n/a	000	Unknown	6032	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
344386	Ordering, Referring, Prescribing	N/A	1720590904	0	0	HORNEY, KRISTAN NP	5/11/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007712	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
344437	Ordering, Referring, Prescribing	N/A	1720692999	0	0	HODGKINS, DANIELLE N PHARMD	4/3/2022	Taxonomy not applicable	NA	n/a	000	Unknown	84232	N/A	N/A	N/A	N/A	N/A	801 TIOGA AVENUE	None	SEASIDE	CA	93955	3050	00	06000	36.61641241	-121.845767	Monterey County
344439	Ordering, Referring, Prescribing	N/A	1720684392	0	0	HOLLOWAY, AARON S PA	3/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59374	N/A	N/A	N/A	N/A	N/A	31660 STATE HIGHWAY 3	None	WEAVERVILLE	CA	96093	0000	00	06000	40.73956736	-122.9266898	Trinity County
344440	Ordering, Referring, Prescribing	N/A	1720691355	0	0	HUANG, HENRY A PHARMD	8/17/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH83066	N/A	N/A	N/A	N/A	N/A	2424 MISSION STREET	None	SAN FRANCISCO	CA	94112	2415	00	06000	37.75816928	-122.4190376	San Francisco County
344456	Ordering, Referring, Prescribing	N/A	1720735731	0	0	HERRERA, JAIME L NP	11/15/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95019147	N/A	N/A	N/A	N/A	N/A	2130 E 4TH ST	None	SANTA ANA	CA	92705	3818	00	06000	33.74808392	-117.836143	Orange County
344482	Ordering, Referring, Prescribing	N/A	1720868045	0	0	HSIEH, STEPHANIE	9/9/2023	Taxonomy not applicable	NA	n/a	000	Unknown	63007	N/A	N/A	N/A	N/A	N/A	1016 OUTER RD	None	SAN DIEGO	CA	92154	1351	00	06000	32.57795659	-117.0825179	San Diego County
344492	Ordering, Referring, Prescribing	N/A	1730156936	0	0	HAIDER, ABDULLAH T MD	3/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A64435	N/A	N/A	N/A	N/A	N/A	220 ROTANZI ST	None	RAMONA	CA	92065	2583	00	06000	33.02892485	-116.889131	San Diego County
344493	Ordering, Referring, Prescribing	N/A	1730166638	0	0	HO, JENNIFER C PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	52247	N/A	N/A	N/A	N/A	N/A	1 QUALITY DR	None	VACAVILLE	CA	95688	9494	00	06000	38.38851772	-121.9382798	Solano County
344502	Ordering, Referring, Prescribing	N/A	1730201203	0	0	HARMON, JAMIE G LCSW	3/3/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW27460	N/A	N/A	N/A	N/A	N/A	12966 EUCLID ST	135	CITY IS NOT LISTE	CA	92840	5200	00	06000	33.77455935	-117.9378298	Orange County
344507	Ordering, Referring, Prescribing	N/A	1730206087	0	0	HUNT, DEBORAH L LCSW	2/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	24398	N/A	N/A	N/A	N/A	N/A	287 RIO LINDO AVE	None	CHICO	CA	95926	1973	00	06000	39.75438707	-121.8542235	Butte County
344533	Ordering, Referring, Prescribing	N/A	1730239914	0	0	HEBERLEIN, PAUL PHD	9/20/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	11450	N/A	N/A	N/A	N/A	N/A	602 E. SANTA CLARA ST	SUITE 200	SAN JOSE	CA	95112	0001	00	06000	37.34219766	-121.8778507	Santa Clara County
344553	Ordering, Referring, Prescribing	N/A	1730268053	0	0	HALBRIDGE, BRUCE MD	7/5/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G36230	N/A	N/A	N/A	N/A	N/A	2237 W BALL RD	None	ANAHEIM	CA	92804	5314	00	06000	33.817798	-117.9610599	Orange County
344577	Ordering, Referring, Prescribing	N/A	1730333105	0	0	HURTADO, ADRIANA DDS	9/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	57445	N/A	N/A	N/A	N/A	N/A	116H ST	None	BAKERSFIELD	CA	93304	2910	00	06000	35.35574568	-119.0141841	Kern County
344578	Ordering, Referring, Prescribing	N/A	1730354119	0	0	HEMELA, KATHERINE MD	3/2/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A42074	N/A	N/A	N/A	N/A	N/A	520 E. TULARE AVE	None	VISALIA	CA	93292	3629	00	06000	36.320679	-119.2870845	Tulare County
344583	Ordering, Referring, Prescribing	N/A	1730364969	0	0	HAMZEH, RABIH K MD	9/29/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A83298	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
344667	Ordering, Referring, Prescribing	N/A	1730514431	0	0	HAYNES, MICHAEL E LMFT	6/7/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT94657	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
344708	Ordering, Referring, Prescribing	N/A	1730593682	0	0	HUNG, HENRY C MD	2/19/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A145914	N/A	N/A	N/A	N/A	N/A	607 S ATLANTIC BLVD	None	LOS ANGELES	CA	90022	3211	00	06000	34.02477432	-118.1560364	Los Angeles County
344720	Ordering, Referring, Prescribing	N/A	1730608233	0	0	HAIG, HAIG V PHARMD	3/16/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77041	N/A	N/A	N/A	N/A	N/A	615 W AVE L	None	LANCASTER	CA	93534	7211	00	06000	34.6603515	-118.1419695	Los Angeles County
344724	Ordering, Referring, Prescribing	N/A	1730613985	0	0	HERNANDEZ, AUDREY LMFT	11/8/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121803	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
344742	Ordering, Referring, Prescribing	N/A	1730648510	0	0	HAYOSTEK, OLIVIA MD	4/27/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178148	N/A	N/A	N/A	N/A	N/A	67 EVANS ROAD	None	WOFFORD HEAIGHTS	CA	93285	9640	00	06000	35.70661847	-118.4580008	Kern County
344776	Ordering, Referring, Prescribing	N/A	1730698283	0	0	HOLTSKI, GABRIEL	9/27/2018	Taxonomy not applicable	NA	n/a	000	Unknown	ND1014	N/A	N/A	N/A	N/A	N/A	427 F ST	SUITE #205	EUREKA	CA	95501	1008	00	06000	40.80253539	-124.1660942	Humboldt County
344793	Ordering, Referring, Prescribing	N/A	1730732918	0	0	HOOPER, JOSIAH W LMFT	7/17/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT148121	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
344816	Ordering, Referring, Prescribing	N/A	1730777467	0	0	HACOPIAN, ELMA NP	12/21/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016298	N/A	N/A	N/A	N/A	N/A	303 S GLENOAKS BLVD	STE 9	BURBANK	CA	91502	1190	00	06000	34.18156737	-118.3040137	Los Angeles County
344835	Ordering, Referring, Prescribing	N/A	1730842980	0	0	HIRA, GAGANDEEP K NP	8/31/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018262	N/A	N/A	N/A	N/A	N/A	460 PLUMAS BLVD	None	YUBA CITY	CA	95991	5005	00	06000	39.13140416	-121.6141951	Sutter County
344849	Ordering, Referring, Prescribing	N/A	1730873175	0	0	HARO, MAYRA A RN	6/8/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95121160	N/A	N/A	N/A	N/A	N/A	3041 W AVENUE K	None	LANCASTER	CA	93536	5402	00	06000	34.677999	-118.1869785	Los Angeles County
344866	Ordering, Referring, Prescribing	N/A	1740013424	0	0	HASHIMOTO-RAJU, LANI NP	2/27/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95027921	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
344882	Ordering, Referring, Prescribing	N/A	1740242254	0	0	HELFER, JOANNE M NP	1/4/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	12691	N/A	N/A	N/A	N/A	N/A	1500 FLORIDA AVE	None	MODESTO	CA	95242	4337	00	06000	37.665738	-120.9962205	Stanislaus County
344885	Ordering, Referring, Prescribing	N/A	1740263359	0	0	HEATON JR, KENNETH G	8/27/2013	Taxonomy not applicable	NA	n/a	099	DENTIST	D41731	N/A	N/A	N/A	N/A	N/A	16233 KING ST	None	DELHI	CA	95315	9460	00	06000	37.43319758	-120.7809931	Merced County
344941	Ordering, Referring, Prescribing	N/A	1740405026	0	0	HEGARTY, ELIZABETH MD	7/18/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A97427	N/A	N/A	N/A	N/A	N/A	751 LOMBARDI CT	None	SANTA ROSA	CA	95407	6798	00	06000	38.427804	-122.7493035	Sonoma County
344969	Ordering, Referring, Prescribing	N/A	1740474436	0	0	HOLM, VANESSA D LMFT	2/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47518	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
345010	Ordering, Referring, Prescribing	N/A	1740562859	0	0	HO, UYEN NHI PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH53078	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
345015	Ordering, Referring, Prescribing	N/A	1740566157	0	0	HUFFMAN, CHRISTINA PHARMD	7/27/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50204	N/A	N/A	N/A	N/A	N/A	101 W. IMPERIAL HWY.	None	LA HABRA	CA	90631	7261	00	06000	33.91736753	-117.946566	Orange County
345036	Ordering, Referring, Prescribing	N/A	1740614288	0	0	HAYS, HEATHER I	10/26/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83327	N/A	N/A	N/A	N/A	N/A	2243 N MOUNTAIN AVE.	None	CLAREMONT	CA	91711	1586	00	06000	34.124265	-117.729017	Los Angeles County
345072	Ordering, Referring, Prescribing	N/A	1740665025	0	0	HOLDEN, THOMAS	6/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	123768	N/A	N/A	N/A	N/A	N/A	320 10TH ST	None	SANTA ROSA	CA	95401	5291	00	06000	38.443572	-122.719698	Sonoma County
345076	Ordering, Referring, Prescribing	N/A	1740672237	0	0	HILOT, CHRISTINE PHARMD	1/7/2020	Taxonomy not applicable	NA	n/a	000	Unknown	RPH66655	N/A	N/A	N/A	N/A	N/A	3400 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	00	06000	34.02767826	-118.2008037	Los Angeles County
345127	Ordering, Referring, Prescribing	N/A	1740739499	0	0	HUANG, JIN YI LCSW	8/6/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	96027	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON STREET	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
345149	Ordering, Referring, Prescribing	N/A	1740772516	0	0	HUYNH, DIEN PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78467	N/A	N/A	N/A	N/A	N/A	1810 FREEDOM BLVD	None	WATSONVILLE	CA	95076	1234	00	06000	36.93442012	-121.7726139	Santa Cruz County
345157	Ordering, Referring, Prescribing	N/A	1740784248	0	0	HONG, SUK-JOON MD	7/24/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A166847	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
345163	Ordering, Referring, Prescribing	N/A	1740791649	0	0	HEPWORTH, TYLDESLEY A T LCSW	11/19/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	70991	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
345165	Ordering, Referring, Prescribing	N/A	1740798487	0	0	HUNTER, LUCIA M PA	8/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	54721	N/A	N/A	N/A	N/A	N/A	4575 COLLEGE AVE	None	SAN DIEGO	CA	92115	4011	00	06000	32.76023438	-117.0667611	San Diego County
345167	Ordering, Referring, Prescribing	N/A	1740793751	0	0	HATFIELD, JENNIFER A LCSW	10/30/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98689	N/A	N/A	N/A	N/A	N/A	18350 MOUNT LANGLEY ST	None	FOUNTAIN VALLEY	CA	92708	6900	00	06000	33.69633523	-117.9420534	Orange County
345199	Ordering, Referring, Prescribing	N/A	1740855147	0	0	HARRIS, VALERIE OT	5/26/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	746	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
345218	Ordering, Referring, Prescribing	N/A	1740915586	0	0	HERNANDEZ, FERNANDO PA-C	5/3/2023	Taxonomy not applicable	NA	n/a	000	Unknown	PA62674	N/A	N/A	N/A	N/A	N/A	65 S HOCKETT ST	None	PORTERVILLE	CA	93257	4728	00	06000	36.06415362	-119.0171608	Tulare County
345231	Ordering, Referring, Prescribing	N/A	1740957497	0	0	HUYNH, JENNIFER OD	8/27/2021	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	34932	N/A	N/A	N/A	N/A	N/A	9741 BOLSA AVE	STE 115	WESTMINSTER	CA	92683	6683	00	06000	33.74502448	-117.9595626	Orange County
345234	Ordering, Referring, Prescribing	N/A	1740958206	0	0	HEFNER, BRENNAN	11/23/2023	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	3360	N/A	N/A	N/A	N/A	N/A	2799 GATEWAY DR.	None	RIVERSIDE	CA	92507	0003	00	06000	33.93469569	-117.2818008	Riverside County
345251	Ordering, Referring, Prescribing	N/A	1750024931	0	0	HAO, MAY S DDS	6/8/2023	Taxonomy not applicable	NA	n/a	000	Unknown	108849	N/A	N/A	N/A	N/A	N/A	1563 MISSION ST	5TH FLOOR	SAN FRANCISCO	CA	94103	2543	00	06000	37.77327874	-122.4183559	San Francisco County
345252	Ordering, Referring, Prescribing	N/A	1750039699	0	0	HOANG, DIANA	9/11/2024	Taxonomy not applicable	NA	n/a	000	Unknown	65033	N/A	N/A	N/A	N/A	N/A	201 29TH ST	B	SACRAMENTO	CA	95816	3482	00	06000	38.581875	-121.463802	Sacramento County
345280	Ordering, Referring, Prescribing	N/A	1750166393	0	0	HERRERA DE SALVATIERRA, ELEISKA Y DDS	8/27/2023	Taxonomy not applicable	NA	n/a	000	Unknown	109227	N/A	N/A	N/A	N/A	N/A	240 SHOTWELL ST	None	SAN FRANCISCO	CA	94110	1323	00	06000	37.76460716	-122.416335	San Francisco County
345335	Ordering, Referring, Prescribing	N/A	1750453353	0	0	HIRSA, ALIREZA DC	7/27/2022	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	DC28957	N/A	N/A	N/A	N/A	N/A	1685 EAST HOME AVE	None	FRESNO	CA	93728	2027	00	06000	36.76325049	-119.7908582	Fresno County
345352	Ordering, Referring, Prescribing	N/A	1750504775	0	0	HUGHES, KIMBERLY LCSW	5/27/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	19274	N/A	N/A	N/A	N/A	N/A	4250 FOWLER LANE	SUITE 204	DIAMOND SPRING	CA	95619	1987	00	06000	38.69331583	-120.8130299	El Dorado County
345361	Ordering, Referring, Prescribing	N/A	1750514709	0	0	HENRY, CHRISTINE J LMFT	1/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT85347	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
345376	Ordering, Referring, Prescribing	N/A	1750567384	0	0	HAYAT, JABEEN MD	11/30/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A102741	N/A	N/A	N/A	N/A	N/A	10877 CONDUCTOR BLVD	SUITE 300	SUTTER CREEK	CA	95685	9688	00	06000	38.36440771	-120.8174749	Amador County
345401	Ordering, Referring, Prescribing	N/A	1750640975	0	0	HENNESSEY, CELINA M LMFT	5/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	94347	N/A	N/A	N/A	N/A	N/A	1500 MISSION ST	None	SAN FRANCISCO	CA	94103	2513	00	06000	37.7740462	-122.4174849	San Francisco County
345411	Ordering, Referring, Prescribing	N/A	1750661732	0	0	HILDINGER, JULIE F LMFT	12/10/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT102425	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
345447	Ordering, Referring, Prescribing	N/A	1750716114	0	0	HARUTYUNYAN, ANI LCSW	12/23/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	77522	N/A	N/A	N/A	N/A	N/A	10605 BALBOA BLVD	100	GRANADA HILLS	CA	91344	0000	00	06000	34.263378	-118.5022965	Los Angeles County
345461	Ordering, Referring, Prescribing	N/A	1750736807	0	0	HERNANDEZ RODRIGUEZ, ADAM LMFT	9/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	122149	N/A	N/A	N/A	N/A	N/A	13585 SAN PABLO AVE	None	SAN PABLO	CA	94806	3804	00	06000	37.95651393	-122.3371491	Contra Costa County
345464	Ordering, Referring, Prescribing	N/A	1750739975	0	0	HICKS, HAILEY N PSYD	3/22/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	31396	N/A	N/A	N/A	N/A	N/A	3300 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3137	00	06000	35.37353416	-119.0392409	Kern County
345476	Ordering, Referring, Prescribing	N/A	1750746939	0	0	HENNESSEE, ELLE LMFT	5/20/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	126090	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
345477	Ordering, Referring, Prescribing	N/A	1750756391	0	0	HUBER, CHRISTOPHER PHARMD	8/7/2019	Taxonomy not applicable	NA	n/a	000	Unknown	52956	N/A	N/A	N/A	N/A	N/A	2110 TRUXTUN AVE	None	BAKERSFIELD	CA	93301	3703	00	06000	35.37344851	-119.0261655	Kern County
345493	Ordering, Referring, Prescribing	N/A	1750767554	0	0	HENDERSON, TAYLER C LCSW	12/14/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	87081	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE	None	LOS ANGELES	CA	90001	9999	00	06000	33.9664185	-118.2477481	Los Angeles County
345499	Ordering, Referring, Prescribing	N/A	1750769352	0	0	HARPER, ELIZA CLAIRE M NP	12/20/2021	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	236225	N/A	N/A	N/A	N/A	N/A	2970 HILLTOP MALL RD	307	RICHMOND	CA	94806	5274	00	06000	37.97819764	-122.329244	Contra Costa County
345513	Ordering, Referring, Prescribing	N/A	1750802468	0	0	HIDIRSAH, SELIN A LMFT	7/26/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	127146	N/A	N/A	N/A	N/A	N/A	14600 SHERMAN WAY.	SUITE 200	VAN NUYS	CA	91405	5850	00	06000	34.20025916	-118.4500763	Los Angeles County
345516	Ordering, Referring, Prescribing	N/A	1750807731	0	0	HURN, SARA J	8/18/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT134298	N/A	N/A	N/A	N/A	N/A	855 CANYON RD.	None	REDDING	CA	96001	5544	00	06000	40.48978049	-122.3926387	Shasta County
345530	Ordering, Referring, Prescribing	N/A	1750829115	0	0	HERNANDEZ, DIANA LMFT	1/27/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	130834	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
345547	Ordering, Referring, Prescribing	N/A	1750858742	0	0	HASHEMI, SAMAN PHARMD	10/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH79809	N/A	N/A	N/A	N/A	N/A	3383 BASS LAKE RD	None	EL DORADO HILLS	CA	95762	6623	00	06000	38.67607992	-121.0295773	El Dorado County
345626	Ordering, Referring, Prescribing	N/A	1760019806	0	0	HARSIMRAT KAUR, FNU NP	2/26/2020	Taxonomy not applicable	NA	n/a	000	Unknown	95014068	N/A	N/A	N/A	N/A	N/A	4011 N MARKS AVE	None	FRESNO	CA	93722	4555	00	06000	36.794691	-119.8443365	Fresno County
345695	Ordering, Referring, Prescribing	N/A	1760402234	0	0	HOLLINGSHEAD, DAVID S NP	1/27/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	2132164405	N/A	N/A	N/A	N/A	N/A	730 SPRING DRIVE	None	TOQUERVILLE	UT	84774	0000	00	06000	37.26971712	-113.2766861	Washington County
345708	Ordering, Referring, Prescribing	N/A	1760457808	0	0	HAN, THEIN H MD	12/15/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A82881	N/A	N/A	N/A	N/A	N/A	11741 E TELEGRAPH RD	A	SANTA FE SPRINGS	CA	90670	3681	00	06000	33.9462235	-118.0830161	Los Angeles County
345753	Ordering, Referring, Prescribing	N/A	1760563183	0	0	HSIAO, LUNG CHENG LAC	4/11/2021	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC6803	N/A	N/A	N/A	N/A	N/A	16200 AMBER VALLEY DRIVE	None	WHITTIER	CA	90604	4051	00	06000	33.92458653	-117.9826605	Los Angeles County
345768	Ordering, Referring, Prescribing	N/A	1760615348	0	0	HOANG, HANNAH H LCSW	1/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW95198	N/A	N/A	N/A	N/A	N/A	2292 FARADAY AVE STE 110	STE 110	CARLSBAD	CA	92008	7239	00	06000	33.13490794	-117.2765569	San Diego County
345776	Ordering, Referring, Prescribing	N/A	1760648018	0	0	HOOKER, MICHAEL A LMFT	4/28/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92564	N/A	N/A	N/A	N/A	N/A	6809 INDIANA AVE	181	RIVERSIDE	CA	92506	0104	00	06000	33.94312844	-117.3918196	Riverside County
345780	Ordering, Referring, Prescribing	N/A	1760659759	0	0	HO, NANCY	10/31/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51469	N/A	N/A	N/A	N/A	N/A	767 N HILL ST.	STE 400B	LOS ANGELES	CA	90012	2381	00	06000	34.06255157	-118.2397077	Los Angeles County
345786	Ordering, Referring, Prescribing	N/A	1760576839	0	0	HUDSON, BRADLEY O PSYD	1/13/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY13124	N/A	N/A	N/A	N/A	N/A	3250 WILSHIRE	SUITE 500	LOS ANGELES	CA	90010	1427	00	06000	34.06176363	-118.2932622	Los Angeles County
345787	Ordering, Referring, Prescribing	N/A	1760671655	0	0	HALE, DARIN L MD	9/11/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	42724	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
345814	Ordering, Referring, Prescribing	N/A	1760713622	0	0	HERNANDEZ, TANYA R LMFT	3/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT100132	N/A	N/A	N/A	N/A	N/A	820 E GILBERT ST	None	SAN BERNARDINO	CA	92415	0928	00	06000	34.1268333	-117.2687417	San Bernardino County
345829	Ordering, Referring, Prescribing	N/A	1760740765	0	0	HORVATH, JAMES A PHARMD	12/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58650	N/A	N/A	N/A	N/A	N/A	1130 BROADWAY	None	CHULA VISTA	CA	91911	2707	00	06000	32.60853	-117.083862	San Diego County
345865	Ordering, Referring, Prescribing	N/A	1760805444	0	0	HARPER, LAURA PA-C	8/17/2022	Taxonomy not applicable	NA	n/a	000	Unknown	51401	N/A	N/A	N/A	N/A	N/A	730 N I ST	202	MADERA	CA	93637	3077	00	06000	36.96528452	-120.0693616	Madera County
345917	Ordering, Referring, Prescribing	N/A	1760866412	0	0	HAASE, GINA LCSW	12/28/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	70539	N/A	N/A	N/A	N/A	N/A	600 COMMONWEALTH AVE	600	LOS ANGELES	CA	90005	0000	00	06000	34.06328086	-118.2856343	Los Angeles County
345931	Ordering, Referring, Prescribing	N/A	1760871065	0	0	HENNEN, CHELSEA A NP	9/15/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026118	N/A	N/A	N/A	N/A	N/A	400 WEST 30TH ST	None	LOS ANGELES	CA	90007	3320	00	06000	34.0239409	-118.2755606	Los Angeles County
345965	Ordering, Referring, Prescribing	N/A	1760933915	0	0	HOWARD, SARAH F LCSW	9/9/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	103887	N/A	N/A	N/A	N/A	N/A	3576 ARLINGTON AVE	106	RIVERSIDE	CA	92506	3907	00	06000	33.94625192	-117.3913739	Riverside County
346017	Ordering, Referring, Prescribing	N/A	1770033995	0	0	HARBAN, MICHELLE R	6/6/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95011897	N/A	N/A	N/A	N/A	N/A	847 W CHILDS AVE	A	MERCED	CA	95341	6862	00	06000	37.28825369	-120.4963159	Merced County
346047	Ordering, Referring, Prescribing	N/A	1770075608	0	0	HABERMAN, NORIKA J	9/19/2022	Taxonomy not applicable	NA	n/a	099	DENTIST	106559	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
346060	Ordering, Referring, Prescribing	N/A	1770118572	0	0	HANSEN, JUDY	1/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	LEP3571	N/A	N/A	N/A	N/A	N/A	2240 OLD RIVER RD	None	UKIAH	CA	95482	6103	00	06000	39.1293897	-123.1645436	Mendocino County
346082	Ordering, Referring, Prescribing	N/A	1770148447	0	0	HWANG, KIMBERLY PHARMD	8/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73243	N/A	N/A	N/A	N/A	N/A	12001 EUCLID ST	None	GARDEN GROVE	CA	92840	3332	00	06000	33.78758768	-117.941271	Orange County
346103	Ordering, Referring, Prescribing	N/A	1770222184	0	0	HARTMAN, JULIE S NP	6/1/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021134	N/A	N/A	N/A	N/A	N/A	25240 HANCOCK AVE	STE 120	MURRIETA	CA	92562	5991	00	06000	33.56227729	-117.1831012	Riverside County
346105	Ordering, Referring, Prescribing	N/A	1770209819	0	0	HO, DUONG PHARMD	10/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	87088	N/A	N/A	N/A	N/A	N/A	15549 UNION AVE	None	LOS GATOS	CA	95032	3904	00	06000	37.24258308	-121.9312446	Santa Clara County
346143	Ordering, Referring, Prescribing	N/A	1770582231	0	0	HARRISON, CYNTHIA A NP	5/19/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	530675	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
346160	Ordering, Referring, Prescribing	N/A	1770615643	0	0	HENRY, JULIANNE LCSW	5/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23586	N/A	N/A	N/A	N/A	N/A	120 N AUBURN ST	SUITE 215	GRASS VALLEY	CA	95945	6277	00	06000	39.21970186	-121.0622716	Nevada County
346182	Ordering, Referring, Prescribing	N/A	1770669244	0	0	HATAKEYAMA, JASON LCSW	12/16/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84528	N/A	N/A	N/A	N/A	N/A	532 E COLORADO BLVD	None	PASADENA	CA	91101	2044	00	06000	34.14582052	-118.139274	Los Angeles County
346185	Ordering, Referring, Prescribing	N/A	1770672453	0	0	HO, MARIA M LMFT	12/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49363	N/A	N/A	N/A	N/A	N/A	1359 N GRAND AVE	2ND FLOOR	COVINA	CA	91724	1016	00	06000	34.104681	-117.872706	Los Angeles County
346197	Ordering, Referring, Prescribing	N/A	1770710501	0	0	HURLEY, BRIAN MD	11/4/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A130543	N/A	N/A	N/A	N/A	N/A	3751 STOCKER ST	None	LOS ANGELES	CA	90008	5101	00	06000	34.00616017	-118.3385751	Los Angeles County
346199	Ordering, Referring, Prescribing	N/A	1770714164	0	0	HERNANDEZ, CECELIA D LCSW	5/18/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW80426	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
346206	Ordering, Referring, Prescribing	N/A	1770742843	0	0	HILLS, AMANDA J LCSW	3/31/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	22627	N/A	N/A	N/A	N/A	N/A	23772 NEWHALL AVE	None	NEWHALL	CA	91321	3125	00	06000	34.37160007	-118.5160227	Los Angeles County
346219	Ordering, Referring, Prescribing	N/A	1770750788	0	0	HOOL, FERNANDO PA-C	10/14/2018	Taxonomy not applicable	NA	n/a	000	Unknown	17103	N/A	N/A	N/A	N/A	N/A	2237 W BALL RD	None	ANAHEIM	CA	92804	5314	00	06000	33.817798	-117.9610599	Orange County
346244	Ordering, Referring, Prescribing	N/A	1770831299	0	0	HERNANDEZ, CYNTHIA LMFT	2/9/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT86703	N/A	N/A	N/A	N/A	N/A	520 E. TULARE AVE.	None	VISALIA	CA	93292	3629	00	06000	36.320679	-119.2870845	Tulare County
346255	Ordering, Referring, Prescribing	N/A	1770845364	0	0	HARPER, CAMESHA M LCSW	7/24/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	81545	N/A	N/A	N/A	N/A	N/A	1114 YUBA ST.	RM 144	MARYSVILLE	CA	95901	4838	00	06000	39.14834653	-121.5840927	Yuba County
346271	Ordering, Referring, Prescribing	N/A	1770866931	0	0	HUA, STACEY N PHARMD	7/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58731	N/A	N/A	N/A	N/A	N/A	24081 EL TORO RD	None	LAGUNA HILLS	CA	92653	3103	00	06000	33.61279466	-117.7127914	Orange County
346312	Ordering, Referring, Prescribing	N/A	1770926016	0	0	HEATHERLY, GIANNA F LMFT	7/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT113603	N/A	N/A	N/A	N/A	N/A	3628 STOCKDALE HWY	None	BAKERSFIELD	CA	93309	2153	00	06000	35.35426453	-119.045007	Kern County
346315	Ordering, Referring, Prescribing	N/A	1770942690	0	0	HERNANDEZ, KATHRYN LCSW	3/14/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107298	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
346324	Ordering, Referring, Prescribing	N/A	1770950040	0	0	HILL, TABITHA S CCC-SLP	5/31/2023	Taxonomy not applicable	NA	n/a	037	SPEECH THERAPISTS	35207	N/A	N/A	N/A	N/A	N/A	8600 MARTELL RD	None	HICKMAN	NE	68372	9789	00	06000	40.641993	-96.6051675	Lancaster County
346346	Ordering, Referring, Prescribing	N/A	1770980500	0	0	HAN, JOHN PHARMD	4/24/2018	Taxonomy not applicable	NA	n/a	000	Unknown	RPH64847	N/A	N/A	N/A	N/A	N/A	4150 REGENTS PARK ROW	155	LA JOLLA	CA	92037	9179	00	06000	32.87272099	-117.2175656	San Diego County
346358	Ordering, Referring, Prescribing	N/A	1770996548	0	0	HUANG, RITA S	3/14/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D63354	N/A	N/A	N/A	N/A	N/A	3081 TEAGARDEN ST	None	SAN LEANDRO	CA	94577	5720	00	06000	37.70519163	-122.1536391	Alameda County
346377	Ordering, Referring, Prescribing	N/A	1780035931	0	0	HARTMAN, RAYNA LMFT	9/21/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	134817	N/A	N/A	N/A	N/A	N/A	1910 OLYMPIC BLVD	SUITE 365	WALNUT CREEK	CA	94596	5096	00	06000	37.89453628	-122.0662326	Contra Costa County
346384	Ordering, Referring, Prescribing	N/A	1780046482	0	0	HINOJOSA, JESSICA LMFT	9/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT121817	N/A	N/A	N/A	N/A	N/A	1515 W. CAMERON AVE	350	WEST COVINA	CA	91790	1000	00	06000	34.06871052	-117.9422359	Los Angeles County
346387	Ordering, Referring, Prescribing	N/A	1780050385	0	0	HARDWICK, ALEXANDER B MD	2/1/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A149279	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
346420	Ordering, Referring, Prescribing	N/A	1780102434	0	0	HENRIQUEZ, RACHELLE H LMFT	11/16/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129286	N/A	N/A	N/A	N/A	N/A	7038 OWENSMOUTH AVE	None	CANOGA PARK	CA	91303	3198	00	06000	34.19850365	-118.6015289	Los Angeles County
346469	Ordering, Referring, Prescribing	N/A	1780177147	0	0	HARPEL, SHERYL E NP	11/15/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95009329	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
346536	Ordering, Referring, Prescribing	N/A	1780354159	0	0	HAN, JUSTINE PHARMD	9/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85102	N/A	N/A	N/A	N/A	N/A	500 PARNASSUS AVE	None	SAN FRANCISCO	CA	94143	2203	00	06000	37.76351054	-122.4579681	San Francisco County
346537	Ordering, Referring, Prescribing	N/A	1780355859	0	0	HOK, SE BUNNY PHARMD	9/17/2021	Taxonomy not applicable	NA	n/a	000	Unknown	85269	N/A	N/A	N/A	N/A	N/A	1500 E GAGE AVE	None	LOS ANGELES	CA	90001	1724	00	06000	33.98202771	-118.2473747	Los Angeles County
346556	Ordering, Referring, Prescribing	N/A	1780439836	0	0	HER, SONNY NP	3/29/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029632	N/A	N/A	N/A	N/A	N/A	4929 E. KINGS CANYON ROA	None	FRESNO	CA	93727	3812	00	06000	36.73603152	-119.730573	Fresno County
346567	Ordering, Referring, Prescribing	N/A	1780654616	0	0	HAN, ERIN S OD	2/12/2018	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT8482	N/A	N/A	N/A	N/A	N/A	3359 WILSHIRE BLVD	None	LOS ANGELES	CA	90010	1803	00	06000	34.0618263	-118.296969	Los Angeles County
346579	Ordering, Referring, Prescribing	N/A	1780696567	0	0	HUSSAIN, ASIMA MD	12/24/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C200517	N/A	N/A	N/A	N/A	N/A	1560 MESA RD	STE 100	NIPOMO	CA	93444	0001	00	06000	35.02977199	-120.5498922	San Luis Obispo County
346655	Ordering, Referring, Prescribing	N/A	1780848648	0	0	HOELTER, DANIELLE CNM	1/25/2023	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	235672	N/A	N/A	N/A	N/A	N/A	2970 HILLTOP MALL RD	307	RICHMOND	CA	94806	5274	00	06000	37.97819764	-122.329244	Contra Costa County
346667	Ordering, Referring, Prescribing	N/A	1780889113	0	0	HARTLEY, SARAH E MD	4/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	4301083981	N/A	N/A	N/A	N/A	N/A	1500 E MEDICAL CENTER DR	None	ANN ARBOR	MI	48109	5000	00	06000	42.28391347	-83.72716554	Washtenaw County
346694	Ordering, Referring, Prescribing	N/A	1780934414	0	0	HARLAND, ANTHONY	9/19/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	149921	N/A	N/A	N/A	N/A	N/A	500 JEFFERSON BLVD	100	WEST SACRAMENTO	CA	95691	2173	00	06000	38.58758543	-121.5270475	Yolo County
346704	Ordering, Referring, Prescribing	N/A	1780955450	0	0	HEDRICK-HARWELL, STEPHANIE E LMFT	4/13/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105671	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
346733	Ordering, Referring, Prescribing	N/A	1790002509	0	0	HEISER, MARC A MD	11/18/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A120147	N/A	N/A	N/A	N/A	N/A	21730 S VERMONT AVE	SUITE 122	TORRANCE	CA	90502	0000	00	06000	33.830658	-118.290203	Los Angeles County
346808	Ordering, Referring, Prescribing	N/A	1790073187	0	0	HUTTON, JESSLYN L NP	2/1/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0810497	N/A	N/A	N/A	N/A	N/A	11722 S WILMINGTON AVE	None	LOS ANGELES	CA	90059	2543	00	06000	33.9267675	-118.2390104	Los Angeles County
346813	Ordering, Referring, Prescribing	N/A	1790117489	0	0	HEINZ, ANNA E CNM	12/5/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0739608	N/A	N/A	N/A	N/A	N/A	1820 MARRON ROAD	SUITE 110	CARLSBAD	CA	92008	1177	00	06000	33.17711559	-117.3396763	San Diego County
346848	Ordering, Referring, Prescribing	N/A	1790165785	0	0	HASANUDDIN, HARRISON DO	3/10/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16309	N/A	N/A	N/A	N/A	N/A	420 NORTH GARFIELD AVENU	203	MONTEREY PARK	CA	91754	1206	00	06000	34.0670077	-118.1228585	Los Angeles County
346860	Ordering, Referring, Prescribing	N/A	1790177301	0	0	HAWKINS, LURA LMFT	5/20/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105665	N/A	N/A	N/A	N/A	N/A	5350 OLD REDWOOD HIGHWAY	STE. 600	PETALUMA	CA	94954	3406	00	06000	38.27834611	-122.6686269	Sonoma County
346873	Ordering, Referring, Prescribing	N/A	1790207017	0	0	HOLT, KACIE L LCSW	10/5/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110855	N/A	N/A	N/A	N/A	N/A	1859 BIRD ST	None	OROVILLE	CA	95965	4854	00	06000	39.51259228	-121.5566418	Butte County
346878	Ordering, Referring, Prescribing	N/A	1790215408	0	0	HOLLAND, ANA-NAOMI R MD	11/16/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158582	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
346879	Ordering, Referring, Prescribing	N/A	1790207512	0	0	HILL, ASHLEY E LMFT	3/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	118634	N/A	N/A	N/A	N/A	N/A	2940 INLAND EMPIRE BLVD	None	ONTARIO	CA	91761	0108	00	06000	34.069788	-117.5884605	San Bernardino County
346894	Ordering, Referring, Prescribing	N/A	1790233567	0	0	HSIEH, JOHANNA D DDS	8/20/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	100706	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
346896	Ordering, Referring, Prescribing	N/A	1790232791	0	0	HAFEZ, FADY	9/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72647	N/A	N/A	N/A	N/A	N/A	12384 PALMDALE RD. #105	None	VICTORVILLE	CA	92392	0000	00	06000	34.50675814	-117.3929237	San Bernardino County
346930	Ordering, Referring, Prescribing	N/A	1790293389	0	0	HO, NGA T PHARMD	1/6/2020	Taxonomy not applicable	NA	n/a	000	Unknown	77948	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
346938	Ordering, Referring, Prescribing	N/A	1790300754	0	0	HUFFAKER, KRISTA PA	11/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	60433	N/A	N/A	N/A	N/A	N/A	65 N HOCKETT ST	None	PORTERVILLE	CA	93257	0000	00	06000	36.0663928	-119.01714	Tulare County
346944	Ordering, Referring, Prescribing	N/A	1790312098	0	0	HAGGE, LANDIN P DO	12/28/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A20528	N/A	N/A	N/A	N/A	N/A	1035 PLACER ST	None	REDDING	CA	96001	1171	00	06000	40.58349378	-122.3853903	Shasta County
346954	Ordering, Referring, Prescribing	N/A	1790323111	0	0	HWANG, NINA PHARMD	3/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	81591	N/A	N/A	N/A	N/A	N/A	2901 LOS FELIZ BLVD	None	LOS ANGELES	CA	90039	1502	00	06000	34.129008	-118.263933	Los Angeles County
346959	Ordering, Referring, Prescribing	N/A	1790334696	0	0	HARRISON, KEENA NP	7/24/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013139	N/A	N/A	N/A	N/A	N/A	2933 UNIVERSITY AVE	None	RIVERSIDE	CA	92507	4243	00	06000	33.97760919	-117.3651828	Riverside County
346963	Ordering, Referring, Prescribing	N/A	1790339596	0	0	HUIPIO, DENISE LCSW	4/20/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107753	N/A	N/A	N/A	N/A	N/A	4590 ALLSTATE DR	None	RIVERSIDE	CA	92501	1702	00	06000	34.00399445	-117.3768474	Riverside County
347008	Ordering, Referring, Prescribing	N/A	1790468288	0	0	HANSEN, BENTE	5/29/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	34936	N/A	N/A	N/A	N/A	N/A	300 TAMAL PLZ	None	CORTE MADERA	CA	94925	1129	00	06000	37.93527968	-122.5198702	Marin County
347029	Ordering, Referring, Prescribing	N/A	1790705556	0	0	HERSHOFF-LOOPER, ISA LMFT	1/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38688	N/A	N/A	N/A	N/A	N/A	1701 OCEAN AVE	None	SAN FRANCISCO	CA	94112	1111	00	06000	37.72476918	-122.4604495	San Francisco County
347034	Ordering, Referring, Prescribing	N/A	1790737179	0	0	HUQ, FIRDOUSE A MD	12/15/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A76272	N/A	N/A	N/A	N/A	N/A	355 TUOLUMNE ST	None	VALLEJO	CA	94590	5700	00	06000	38.10261225	-122.2382555	Solano County
347068	Ordering, Referring, Prescribing	N/A	1790838860	0	0	HUFBAUER, ELLEN A MD	5/1/2013	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A00072145	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
347072	Ordering, Referring, Prescribing	N/A	1790847853	0	0	HUANG, YEA-LIAN PHARMD	3/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH49063	N/A	N/A	N/A	N/A	N/A	39400 PASEO PADRE PKWY	None	FREMONT	CA	94538	2310	00	06000	37.55102172	-121.9759026	Alameda County
347083	Ordering, Referring, Prescribing	N/A	1790860039	0	0	HOWARD, ROBERT R LCSW	6/6/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW83110	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
347089	Ordering, Referring, Prescribing	N/A	1790869097	0	0	HEFFERNAN, NANCY J NP	2/18/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN658516	N/A	N/A	N/A	N/A	N/A	4555 PRECISSI LANE	None	STOCKTON	CA	95207	6239	00	06000	37.98919284	-121.3152121	San Joaquin County
347136	Ordering, Referring, Prescribing	N/A	1790978245	0	0	HUNTER, CANDICE J MD	1/13/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C165709	N/A	N/A	N/A	N/A	N/A	160 E VIRGINIA ST STE 28	STE 280	SAN JOSE	CA	95112	5817	00	06000	37.32582868	-121.8777868	Santa Clara County
347143	Ordering, Referring, Prescribing	N/A	1790998318	0	0	HUNT, MARGARET G	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	38380	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
347163	Ordering, Referring, Prescribing	N/A	1801037635	0	0	HOLLY, TSIONE M	3/18/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0524876	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLAZA	STE 3325	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
347165	Ordering, Referring, Prescribing	N/A	1801043625	0	0	HEISEN, LINDA LMFT	8/9/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	33023	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
347187	Ordering, Referring, Prescribing	N/A	1801085816	0	0	HERSHFIELD, JENNIFER A PHD	2/12/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29624	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BOULEVARD	None	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
347203	Ordering, Referring, Prescribing	N/A	1801124938	0	0	HOURANY, JOHANNA J LMFT	8/24/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	81855	N/A	N/A	N/A	N/A	N/A	140 MAYHEW WAY	606	PLEASANT HILL	CA	94523	4328	00	06000	37.93664097	-122.0572179	Contra Costa County
347208	Ordering, Referring, Prescribing	N/A	1801133277	0	0	HANSEN, KAREN L LMFT	6/28/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107241	N/A	N/A	N/A	N/A	N/A	1340 ARNOLD DRIVE	225	MARTINEZ	CA	94553	4189	00	06000	37.99250264	-122.0983907	Contra Costa County
347213	Ordering, Referring, Prescribing	N/A	1801143037	0	0	HODGES, CHRISTIAN R LMFT	8/12/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT120458	N/A	N/A	N/A	N/A	N/A	3132 JEFFERSON ST	None	SAN DIEGO	CA	92110	4421	00	06000	32.75567499	-117.203517	San Diego County
347293	Ordering, Referring, Prescribing	N/A	1801245063	0	0	HUSSAIN, MOHAMMAD AHRAZ MD	2/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163153	N/A	N/A	N/A	N/A	N/A	757 WESTWOOD PLZ	None	LOS ANGELES	CA	90095	8358	00	06000	34.06633051	-118.4452686	Los Angeles County
347295	Ordering, Referring, Prescribing	N/A	1801257712	0	0	HOERGER, JOSHUA L	4/4/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A154233	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
347306	Ordering, Referring, Prescribing	N/A	1801271143	0	0	HAMOVITCH, RACHEL LCSW	12/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110410	N/A	N/A	N/A	N/A	N/A	9295 FARNHAM ST	200	SAN DIEGO	CA	92123	1254	00	06000	32.83285255	-117.1299735	San Diego County
347315	Ordering, Referring, Prescribing	N/A	1801277116	0	0	HARRISON, KATRIN LCSW	12/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84670	N/A	N/A	N/A	N/A	N/A	11080 W OLYMPIC BLVD	None	LOS ANGELES	CA	90064	1937	00	06000	34.04036814	-118.4376056	Los Angeles County
347320	Ordering, Referring, Prescribing	N/A	1801277199	0	0	HERNANDEZ, ELIZABETH LCSW	10/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97353	N/A	N/A	N/A	N/A	N/A	3625 14TH ST	None	RIVERSIDE	CA	92501	3815	00	06000	33.97584034	-117.3775789	Riverside County
347358	Ordering, Referring, Prescribing	N/A	1801338587	0	0	HAMAMI, STEFANIE LMFT	9/25/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT122148	N/A	N/A	N/A	N/A	N/A	66 HURLBUT ST	None	PASADENA	CA	91105	4205	00	06000	34.12993251	-118.1516625	Los Angeles County
347359	Ordering, Referring, Prescribing	N/A	1801338645	0	0	HARTMAN, KAITLIN D NP	7/12/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	825610	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
347361	Ordering, Referring, Prescribing	N/A	1801340047	0	0	HUIZAR HERRERA, SANDRA NP	4/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	NPF95004625	N/A	N/A	N/A	N/A	N/A	705 W PECAN AVE	None	MADERA	CA	93637	6254	00	06000	36.941103	-120.06729	Madera County
347390	Ordering, Referring, Prescribing	N/A	1801390810	0	0	HSU, ERIKA MD	3/7/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164519	N/A	N/A	N/A	N/A	N/A	2116 ARLINGTON AVENUE	SUITE 100	LOS ANGELES	CA	90018	1353	00	06000	34.037415	-118.3176815	Los Angeles County
347413	Ordering, Referring, Prescribing	N/A	1801443486	0	0	HERNANDEZ, MAYRA LPCC	4/24/2024	Taxonomy not applicable	NA	n/a	000	Unknown	16359	N/A	N/A	N/A	N/A	N/A	707 14TH ST.	None	MODESTO	CA	95354	2506	00	06000	37.64072107	-120.9933527	Stanislaus County
347424	Ordering, Referring, Prescribing	N/A	1801472733	0	0	HAPONYUK, ANASTASIYA MD	7/7/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A181326	N/A	N/A	N/A	N/A	N/A	2315 STOCKTON BLVD	None	SACRAMENTO	CA	95817	1460	00	06000	38.555181	-121.4566785	Sacramento County
347431	Ordering, Referring, Prescribing	N/A	1801487434	0	0	HAYRAPETIAN, ARBI PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	55974	N/A	N/A	N/A	N/A	N/A	1436 W GLENOAKS BLVD	A	GLENDALE	CA	91201	1984	00	06000	34.16809811	-118.2857303	Los Angeles County
347449	Ordering, Referring, Prescribing	N/A	1801530795	0	0	HARRIS, DEANNA S	9/6/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95020276	N/A	N/A	N/A	N/A	N/A	9742 RASPBERRY ICE LN	None	LA MESA	CA	91941	6878	00	06000	32.75698541	-116.9868681	San Diego County
347463	Ordering, Referring, Prescribing	N/A	1801590831	0	0	HAKAKIAN, BENJAMIN MD	7/1/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197348	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
347494	Ordering, Referring, Prescribing	N/A	1801911581	0	0	HOANG, TRANG LCSW	9/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCW17197	N/A	N/A	N/A	N/A	N/A	4601 S BROADWAY	1ST FLOOR	LOS ANGELES	CA	90037	2729	00	06000	34.001775	-118.2783785	Los Angeles County
347514	Ordering, Referring, Prescribing	N/A	1801948187	0	0	HECKMAN, KELEY L LCSW	3/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	68697	N/A	N/A	N/A	N/A	N/A	3132 JEFFERSON ST	None	SAN DIEGO	CA	92110	4421	00	06000	32.75567499	-117.203517	San Diego County
347519	Ordering, Referring, Prescribing	N/A	1801957105	0	0	HOWARD, MYRA T	7/26/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0306265	N/A	N/A	N/A	N/A	N/A	195 W HWY 246	None	BUELLTON	CA	93427	9459	00	06000	34.61514868	-120.1976747	Santa Barbara County
347526	Ordering, Referring, Prescribing	N/A	1801996970	0	0	HAN, JIN S	5/10/1989	Taxonomy not applicable	NA	n/a	099	DENTIST	D35726	N/A	N/A	N/A	N/A	N/A	6331 HAVEN AVE	SUITE 17	RANCHO CUCAMONGA	CA	91737	6941	00	06000	34.139313	-117.575753	San Bernardino County
347539	Ordering, Referring, Prescribing	N/A	1811021496	0	0	HOWARD, MARCIA D LMSW	6/15/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23049	N/A	N/A	N/A	N/A	N/A	30 E SAN JOAQUIN ST	102	SALINAS	CA	93901	2945	00	06000	36.65855693	-121.6578301	Monterey County
347565	Ordering, Referring, Prescribing	N/A	1811058696	0	0	HALPIN, DANIELLE LMFT	12/8/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT45742	N/A	N/A	N/A	N/A	N/A	275 BECK AVE	None	FAIRFIELD	CA	94533	6804	00	06000	38.23532718	-122.0663968	Solano County
347578	Ordering, Referring, Prescribing	N/A	1811081524	0	0	HOYT, LISA M	1/4/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	10169	N/A	N/A	N/A	N/A	N/A	1 HARPST ST	None	ARCATA	CA	95521	8222	00	06000	40.87420204	-124.0791833	Humboldt County
347586	Ordering, Referring, Prescribing	N/A	1811087646	0	0	HORN, JENNIFER PHD	6/23/2022	Taxonomy not applicable	NA	n/a	003	AUDIOLOGISTS	AU2641	N/A	N/A	N/A	N/A	N/A	3418 LOMA VISTA RD.	SUITE 5A	VENTURA	CA	93003	3039	00	06000	34.27643562	-119.2503132	Ventura County
347594	Ordering, Referring, Prescribing	N/A	1811127343	0	0	HADDAD, RIHAM K LCSW	5/1/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	115026	N/A	N/A	N/A	N/A	N/A	11601 S WESTERN AVE	None	LOS ANGELES	CA	90047	5006	00	06000	33.92826552	-118.3092091	Los Angeles County
347621	Ordering, Referring, Prescribing	N/A	1811158728	0	0	HARTONIAN, IVET MD	5/13/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A112893	N/A	N/A	N/A	N/A	N/A	1828 E. CESAR E,. CHAVEZ	#5000	LOS ANGELES	CA	90033	2487	00	06000	34.05023174	-118.2154927	Los Angeles County
347624	Ordering, Referring, Prescribing	N/A	1811205438	0	0	HANSEN, PAUL M	7/1/2020	Taxonomy not applicable	NA	n/a	000	Unknown	1845	N/A	N/A	N/A	N/A	N/A	1682 NOVATO BLVD	SUITE 105	NOVATO	CA	94947	7000	00	06000	38.10598003	-122.5782662	Marin County
347625	Ordering, Referring, Prescribing	N/A	1811205222	0	0	HONG, ROBIN T PSYD	4/2/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30177	N/A	N/A	N/A	N/A	N/A	800 N ECKHOFF ST	BLDG #124	ORANGE	CA	92868	1008	00	06000	33.79960624	-117.8741126	Orange County
347627	Ordering, Referring, Prescribing	N/A	1811209448	0	0	HERNANDEZ, DESIREE	8/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74698	N/A	N/A	N/A	N/A	N/A	11800 CENTRAL AVE	225	CHINO	CA	91710	7200	00	06000	34.0388092	-117.689654	San Bernardino County
347639	Ordering, Referring, Prescribing	N/A	1811231798	0	0	HALBERT, LEANNE I LMFT	5/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119160	N/A	N/A	N/A	N/A	N/A	1940 E DEERE AVE	100	SANTA ANA	CA	92705	5718	00	06000	33.70430421	-117.8482556	Orange County
347654	Ordering, Referring, Prescribing	N/A	1811252505	0	0	HARA, PETER A	2/8/2019	Taxonomy not applicable	NA	n/a	099	DENTIST	100960	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
347681	Ordering, Referring, Prescribing	N/A	1811285711	0	0	HAZDOVAC, MARY C LMFT	6/30/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84276	N/A	N/A	N/A	N/A	N/A	1117 PIEDMONT AVE	None	PACIFIC GROVE	CA	93950	5422	00	06000	36.60394658	-121.9285129	Monterey County
347715	Ordering, Referring, Prescribing	N/A	1811360357	0	0	HSU, TRINH PHARMD	11/1/2023	Taxonomy not applicable	NA	n/a	000	Unknown	73209	N/A	N/A	N/A	N/A	N/A	2341 WINCHESTER BLVD	None	CAMPBELL	CA	95008	4001	00	06000	37.279971	-121.949816	Santa Clara County
347720	Ordering, Referring, Prescribing	N/A	1811365521	0	0	HESLOP, JALIE A NP	1/19/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	415771	N/A	N/A	N/A	N/A	N/A	10050 GEARY AVE	STE 111	EL MONTE	CA	91733	2088	00	06000	0	0	None
347778	Ordering, Referring, Prescribing	N/A	1811445992	0	0	HENRY, MARLENA L LMFT	3/1/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT124652	N/A	N/A	N/A	N/A	N/A	100 WEST WALNUT STREET	375	PASADENA	CA	91124	0001	00	06000	34.14963648	-118.1522925	Los Angeles County
347786	Ordering, Referring, Prescribing	N/A	1811448095	0	0	HA, LIEN PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59989	N/A	N/A	N/A	N/A	N/A	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
347791	Ordering, Referring, Prescribing	N/A	1811457799	0	0	HUA, PHOEBE	11/27/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A178090	N/A	N/A	N/A	N/A	N/A	9353 VALLEY BLVD	None	ROSEMEAD	CA	91770	1923	00	06000	34.08115618	-118.0651957	Los Angeles County
347823	Ordering, Referring, Prescribing	N/A	1811509292	0	0	HUTSELL, STEPHANIE Q PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72838	N/A	N/A	N/A	N/A	N/A	725 WELCH RD	None	PALO ALTO	CA	94304	1601	00	06000	37.43721275	-122.1744449	Santa Clara County
347826	Ordering, Referring, Prescribing	N/A	1811507452	0	0	HERNANDEZ, YENLING Y PA-C	10/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA60261	N/A	N/A	N/A	N/A	N/A	330 S GARFIELD AVE	300	ALHAMBRA	CA	91801	3892	00	06000	34.09137167	-118.1241735	Los Angeles County
347829	Ordering, Referring, Prescribing	N/A	1811526114	0	0	HUDSON, SELENA NP	12/27/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95013611	N/A	N/A	N/A	N/A	N/A	1080 EMELINE AVE	None	SANTA CRUZ	CA	95060	1966	00	06000	36.99191102	-122.0176744	Santa Cruz County
347841	Ordering, Referring, Prescribing	N/A	1811550072	0	0	HEILBRONN, JACKSON DO	6/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A19729	N/A	N/A	N/A	N/A	N/A	26600 CACTUS AVE	300	MORENO VALLEY	CA	92555	3901	00	06000	33.91013953	-117.193383	Riverside County
347844	Ordering, Referring, Prescribing	N/A	1811523780	0	0	HILL, BIANCA S MD	3/30/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A185245	N/A	N/A	N/A	N/A	N/A	7821 S. AVALON BLVD	None	LOS ANGELES	CA	90003	2358	00	06000	33.969393	-118.265197	Los Angeles County
347849	Ordering, Referring, Prescribing	N/A	1811565310	0	0	HUYNH, HANNA T NP	6/10/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017528	N/A	N/A	N/A	N/A	N/A	1421 E 17TH ST	None	SANTA ANA	CA	92705	8505	00	06000	33.75994564	-117.847815	Orange County
347874	Ordering, Referring, Prescribing	N/A	1811654288	0	0	HEARNDON, JOSEPHINE	12/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	ND1283	N/A	N/A	N/A	N/A	N/A	5305 N FRESNO ST	103	FRESNO	CA	93710	6845	00	06000	36.814059	-119.781387	Fresno County
347879	Ordering, Referring, Prescribing	N/A	1811666209	0	0	HUM, JENNIE L PHARMD	9/7/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85104	N/A	N/A	N/A	N/A	N/A	3801 HOWE ST	None	OAKLAND	CA	94611	5312	00	06000	37.8242732	-122.2568561	Alameda County
347898	Ordering, Referring, Prescribing	N/A	1811763147	0	0	HOCANSON, JAIME K LCSW	12/7/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW105171	N/A	N/A	N/A	N/A	N/A	4750 DATE AVE	None	LA MESA	CA	91942	9214	00	06000	32.76528367	-117.0222905	San Diego County
347924	Ordering, Referring, Prescribing	N/A	1821024746	0	0	HAZELTON, TRACY PA	3/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	13690	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
347925	Ordering, Referring, Prescribing	N/A	1821026766	0	0	HSU, DORA DAH-JIE V	12/17/1998	Taxonomy not applicable	NA	n/a	099	DENTIST	D44896	N/A	N/A	N/A	N/A	N/A	9024 SNIKTAW LN	None	FORT JONES	CA	96032	9408	00	06000	41.59983924	-122.9748122	Siskiyou County
347929	Ordering, Referring, Prescribing	N/A	1821001371	0	0	HIGGINS, ALLISON M LMFT	3/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT51320	N/A	N/A	N/A	N/A	N/A	505 N EUCLID ST	SUITE 300	ANAHEIM	CA	92801	5506	00	06000	33.8379454	-117.9416147	Orange County
347945	Ordering, Referring, Prescribing	N/A	1821114232	0	0	HERNANDEZ, DAVID J LCSW	3/10/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW107235	N/A	N/A	N/A	N/A	N/A	1849 SAWTELLE BLVD	610	LOS ANGELES	CA	90025	7013	00	06000	34.04266851	-118.4451527	Los Angeles County
347985	Ordering, Referring, Prescribing	N/A	1821176421	0	0	HERREMAN, KAREN K OT	3/31/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	OT318	N/A	N/A	N/A	N/A	N/A	195 E SAN FERNANDO ST	None	SAN JOSE	CA	95112	3503	00	06000	37.33620916	-121.8852264	Santa Clara County
347998	Ordering, Referring, Prescribing	N/A	1821207457	0	0	HOLMES, SHANNON OT	9/25/2022	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	7736	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
348013	Ordering, Referring, Prescribing	N/A	1821238692	0	0	HOUSER, LINDA S NP	3/8/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0414771	N/A	N/A	N/A	N/A	N/A	100 UCLA MEDICAL PLZ	STE 630	LOS ANGELES	CA	90024	6997	00	06000	34.06544724	-118.4459249	Los Angeles County
348015	Ordering, Referring, Prescribing	N/A	1821244229	0	0	HSU, MELANIE V PHD	6/4/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY23914	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
348018	Ordering, Referring, Prescribing	N/A	1821251109	0	0	HOLMES, JOAN E NP	6/22/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	560735	N/A	N/A	N/A	N/A	N/A	1901 VICTOR AVE	None	REDDING	CA	96002	0412	00	06000	40.578561	-122.338664	Shasta County
348044	Ordering, Referring, Prescribing	N/A	1821305731	0	0	HERNANDEZ, AMERICA F LCSW	11/27/2018	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	86924	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
348082	Ordering, Referring, Prescribing	N/A	1821375577	0	0	HY, AMY Y	1/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	59722	N/A	N/A	N/A	N/A	N/A	12700 DAY ST	None	MORENO VALLEY	CA	92553	7521	00	06000	33.935724	-117.275922	Riverside County
348113	Ordering, Referring, Prescribing	N/A	1821429101	0	0	HERNANDEZ, CELIA LCSW	7/23/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	85694	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	MAILSTOP 53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
348151	Ordering, Referring, Prescribing	N/A	1821476110	0	0	HAMILTON, ELVENA J LMFT	2/23/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT145312	N/A	N/A	N/A	N/A	N/A	101 CIRBY HILLS DR.	None	ROSEVILLE	CA	95678	4360	00	06000	38.7303989	-121.2872592	Placer County
348156	Ordering, Referring, Prescribing	N/A	1821494337	0	0	HO, LYSA DO	3/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A17507	N/A	N/A	N/A	N/A	N/A	220 ROTANZI ST	None	RAMONA	CA	92065	2583	00	06000	33.02892485	-116.889131	San Diego County
348160	Ordering, Referring, Prescribing	N/A	1821498486	0	0	HERMANN, MITZI LCSW	9/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96945	N/A	N/A	N/A	N/A	N/A	18350 MT LANGLEY ST	220	FOUNTAIN VALLEY	CA	92708	6912	00	06000	33.69633523	-117.9420534	Orange County
348163	Ordering, Referring, Prescribing	N/A	1821508029	0	0	HUYNH, KHANH N PHARMD	5/31/2023	Taxonomy not applicable	NA	n/a	000	Unknown	76645	N/A	N/A	N/A	N/A	N/A	3851 ROSECRANS ST	RM G35	SAN DIEGO	CA	92110	3115	00	06000	32.75343795	-117.2028528	San Diego County
348185	Ordering, Referring, Prescribing	N/A	1821530338	0	0	HORNS, STEPHANIE L MSW LCSW	8/15/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100322	N/A	N/A	N/A	N/A	N/A	47915 OASIS ST	None	INDIO	CA	92201	6950	00	06000	33.701508	-116.220908	Riverside County
348191	Ordering, Referring, Prescribing	N/A	1821534389	0	0	HOGAN, KRYSTAL D LMFT	3/1/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131495	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
348206	Ordering, Referring, Prescribing	N/A	1821573049	0	0	HERMANN, JESSICA LCSW	3/6/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100642	N/A	N/A	N/A	N/A	N/A	1441 LIBERTY STREET	None	REDDING	CA	96001	1441	00	06000	40.5857177	-122.3870781	Shasta County
348249	Ordering, Referring, Prescribing	N/A	1821642778	0	0	HOM, ALLISON R PHARMD	7/11/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH84205	N/A	N/A	N/A	N/A	N/A	2200 ARDEN WAY	None	SACRAMENTO	CA	95825	3302	00	06000	38.595852	-121.414806	Sacramento County
348283	Ordering, Referring, Prescribing	N/A	1821733577	0	0	HEJAZI, MINASADAT PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH86013	N/A	N/A	N/A	N/A	N/A	1285 S MISSION RD	None	FALLBROOK	CA	92028	4005	00	06000	33.37002334	-117.251391	San Diego County
348292	Ordering, Referring, Prescribing	N/A	1821775099	0	0	HOY, AUSTIN OD	8/6/2023	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	35565	N/A	N/A	N/A	N/A	N/A	1300 W OCEAN AVE	None	LOMPOC	CA	93436	5678	00	06000	34.63907053	-120.473361	Santa Barbara County
348306	Ordering, Referring, Prescribing	N/A	1831114297	0	0	HOUSTON, MICHAEL J DC	4/20/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	27335	N/A	N/A	N/A	N/A	N/A	3567 W MT WHITNEY AVE	None	RIVERDALE	CA	93656	0000	00	06000	36.43078218	-119.8620732	Fresno County
348307	Ordering, Referring, Prescribing	N/A	1831116425	0	0	HAUSER, CARL MD	2/4/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G40233	N/A	N/A	N/A	N/A	N/A	193 FAIRVIEW LN	C	SONORA	CA	95370	4828	00	06000	37.97880957	-120.3912459	Tuolumne County
348337	Ordering, Referring, Prescribing	N/A	1831221167	0	0	HOFF, KURT A NP	5/29/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	368935	N/A	N/A	N/A	N/A	N/A	11899 SHAW PL	None	HANFORD	CA	93230	6644	00	06000	36.30003132	-119.6312291	Kings County
348341	Ordering, Referring, Prescribing	N/A	1831225390	0	0	HOSIER HARDCASTLE, ANN A NP	5/29/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	231475	N/A	N/A	N/A	N/A	N/A	11899 SHAW PL	None	HANFORD	CA	93230	6644	00	06000	36.30003132	-119.6312291	Kings County
348349	Ordering, Referring, Prescribing	N/A	1831231927	0	0	HERRING, CHARLES L MD	11/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G84865	N/A	N/A	N/A	N/A	N/A	1680 E 120TH STREET	None	LOS ANGELES	CA	90059	3026	00	06000	33.92456051	-118.2417525	Los Angeles County
348356	Ordering, Referring, Prescribing	N/A	1831247766	0	0	HANNA, IMAN N MD	7/9/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A55259	N/A	N/A	N/A	N/A	N/A	316 E E ST	None	ONTARIO	CA	91764	3712	00	06000	34.067898	-117.6477975	San Bernardino County
348392	Ordering, Referring, Prescribing	N/A	1831343227	0	0	HABBOUSH, SARMAD J	3/9/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D50061	N/A	N/A	N/A	N/A	N/A	165 S 1ST ST	None	EL CAJON	CA	92019	4795	00	06000	32.794002	-116.944563	San Diego County
348421	Ordering, Referring, Prescribing	N/A	1831431287	0	0	HA, RICHARD D DO	6/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A16584	N/A	N/A	N/A	N/A	N/A	1911 WILLIAMS DRIVE	210	OXNARD	CA	93036	2612	00	06000	34.219566	-119.1539365	Ventura County
348438	Ordering, Referring, Prescribing	N/A	1831467083	0	0	HUA, LE PHARMD	7/6/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53990	N/A	N/A	N/A	N/A	N/A	310 SYCAMORE AVENUE	None	VISTA	CA	92083	7702	00	06000	33.16952438	-117.2127924	San Diego County
348446	Ordering, Referring, Prescribing	N/A	1831468388	0	0	HIDAKA, MIO	6/21/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29789	N/A	N/A	N/A	N/A	N/A	2400 MOORPARK AVE. SUITE	AACI	SAN JOSE	CA	95128	1005	00	06000	37.3160785	-121.937121	Santa Clara County
348464	Ordering, Referring, Prescribing	N/A	1831497890	0	0	HUYNH, TUNG T PHARMD	7/12/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH58409	N/A	N/A	N/A	N/A	N/A	4718 W 1ST ST	101	SANTA ANA	CA	92703	5131	00	06000	33.74505053	-117.932085	Orange County
348468	Ordering, Referring, Prescribing	N/A	1831510353	0	0	HUNT, LAUREN S NP	11/5/2014	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	725625	N/A	N/A	N/A	N/A	N/A	6926 BROCKTON AVE	SUITE 6	RIVERSIDE	CA	92506	3804	00	06000	33.947919	-117.3967225	Riverside County
348499	Ordering, Referring, Prescribing	N/A	1831553544	0	0	HATLEN, SARA MD	6/30/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A152502	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
348506	Ordering, Referring, Prescribing	N/A	1831568427	0	0	HARBOUR, JARROD PA-C	7/1/2018	Taxonomy not applicable	NA	n/a	000	Unknown	52871	N/A	N/A	N/A	N/A	N/A	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	00	06000	36.05128153	-119.0422344	Tulare County
348516	Ordering, Referring, Prescribing	N/A	1831569748	0	0	HERNANDEZ, IZEL L LMFT	4/19/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	115783	N/A	N/A	N/A	N/A	N/A	1830 S. CENTRAL STREET	None	VISALIA	CA	93277	4418	00	06000	36.314271	-119.311362	Tulare County
348537	Ordering, Referring, Prescribing	N/A	1831613959	0	0	HSU, JASON LCSW	8/26/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW110181	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
348569	Ordering, Referring, Prescribing	N/A	1831654508	0	0	HAN, KRYSTAL L PHARMD	4/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79719	N/A	N/A	N/A	N/A	N/A	12462 PUTNAM ST	STE 105	WHITTIER	CA	90602	1048	00	06000	33.9709236	-118.0460596	Los Angeles County
348610	Ordering, Referring, Prescribing	N/A	1831702943	0	0	HUYNH, HOA T PHARMD	8/24/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH80315	N/A	N/A	N/A	N/A	N/A	23335 SOBOBA RD	None	SAN JACINTO	CA	92583	2701	00	06000	33.78252219	-116.9187403	Riverside County
348621	Ordering, Referring, Prescribing	N/A	1831716307	0	0	HYDE, CHRISTOPHER MD	3/18/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A189609	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
348631	Ordering, Referring, Prescribing	N/A	1831739937	0	0	HERNANDEZ, IVAN D LCSW	3/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW88699	N/A	N/A	N/A	N/A	N/A	18 W BEACH ST	None	WATSONVILLE	CA	95076	4504	00	06000	36.90958826	-121.7578621	Santa Cruz County
348645	Ordering, Referring, Prescribing	N/A	1831754282	0	0	HO, ALEXANDER Y PHARMD	4/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	77522	N/A	N/A	N/A	N/A	N/A	1979 PEABODY RD	None	VACAVILLE	CA	95687	6288	00	06000	38.33641553	-121.9703994	Solano County
348656	Ordering, Referring, Prescribing	N/A	1831786896	0	0	HAKOPYAN, ARMINE NP	6/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95021500	N/A	N/A	N/A	N/A	N/A	801 S GRAND AVENUE	475	LOS ANGELES	CA	90017	0449	00	06000	34.04532806	-118.258462	Los Angeles County
348681	Ordering, Referring, Prescribing	N/A	1831891068	0	0	HOLLIDAY, JORDAN MD	7/26/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A197996	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
348686	Ordering, Referring, Prescribing	N/A	1831899608	0	0	HAN, KATE K NP	12/15/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95023645	N/A	N/A	N/A	N/A	N/A	3255 WILSHIRE BLVD	120	LOS ANGELES	CA	90010	1404	00	06000	34.0618166	-118.2932612	Los Angeles County
348691	Ordering, Referring, Prescribing	N/A	1831929868	0	0	HINE, CASSIDY DDS	9/9/2024	Taxonomy not applicable	NA	n/a	000	Unknown	110744	N/A	N/A	N/A	N/A	N/A	1381 UNIVERSITY AVE	None	HEALDSBURG	CA	95448	3314	00	06000	38.62757555	-122.8638141	Sonoma County
348712	Ordering, Referring, Prescribing	N/A	1841068137	0	0	HICKERSON, BRITNEY LCSW	9/25/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	114957	N/A	N/A	N/A	N/A	N/A	1202 MORENA BLVD	None	SAN DIEGO	CA	92110	4711	00	06000	32.77025942	-117.2017196	San Diego County
348714	Ordering, Referring, Prescribing	N/A	1841072055	0	0	HUA, AMBER DDS	9/26/2023	Taxonomy not applicable	NA	n/a	000	Unknown	109530	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
348722	Ordering, Referring, Prescribing	N/A	1841220845	0	0	HO, NATHAN H DO	10/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A9528	N/A	N/A	N/A	N/A	N/A	85 SIERRA PARK RD.	None	MAMMOTH LAKES	CA	93546	0085	00	06000	37.64575895	-118.9638914	Mono County
348760	Ordering, Referring, Prescribing	N/A	1841341773	0	0	HOLMAN, GINGER M LCSW	5/17/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	17626	N/A	N/A	N/A	N/A	N/A	1197 VALENCIA STREET	None	SAN FRANCISCO	CA	94110	3026	00	06000	37.75452673	-122.4208621	San Francisco County
348772	Ordering, Referring, Prescribing	N/A	1841375458	0	0	HIGH, ANEITA MD	10/11/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A79981	N/A	N/A	N/A	N/A	N/A	555 W REDONDO BEACH BLVD	204	GARDENA	CA	90248	1612	00	06000	33.89270304	-118.2843009	Los Angeles County
348785	Ordering, Referring, Prescribing	N/A	1841387685	0	0	HOANG, JENNIFER N PHARMD	3/25/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57665	N/A	N/A	N/A	N/A	N/A	220 E HACIENDA AVE	None	CAMPBELL	CA	95008	6617	00	06000	37.26914953	-121.9566285	Santa Clara County
348797	Ordering, Referring, Prescribing	N/A	1841406154	0	0	HALL, STEPHANIE MD	12/18/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G163367	N/A	N/A	N/A	N/A	N/A	209 E 7TH ST	None	MADERA	CA	93638	3780	00	06000	36.96069768	-120.0559841	Madera County
348799	Ordering, Referring, Prescribing	N/A	1841413226	0	0	HAFFNER, CHEREE A LCSW	5/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	17553	N/A	N/A	N/A	N/A	N/A	4250 FOWLER WAY	None	DIAMOND SPRINGS	CA	95619	9781	00	06000	38.69331583	-120.8130299	El Dorado County
348820	Ordering, Referring, Prescribing	N/A	1841454352	0	0	HENDERSON, BONNIE LCSW	5/2/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW69922	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL ROAD	SUITE# C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
348852	Ordering, Referring, Prescribing	N/A	1841517166	0	0	HANSEN, DEBORAH S LMFT	10/26/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT77890	N/A	N/A	N/A	N/A	N/A	335 E AVE I	AREA 12	LANCASTER	CA	93535	1916	00	06000	34.7041113	-118.1247548	Los Angeles County
348870	Ordering, Referring, Prescribing	N/A	1841547668	0	0	HARUTYUNYAN, HAYK PHARMD	11/3/2021	Taxonomy not applicable	NA	n/a	000	Unknown	67438	N/A	N/A	N/A	N/A	N/A	18250 ROSCOE BLVD	104	NORTHRIDGE	CA	91325	4226	00	06000	34.22076142	-118.5313223	Los Angeles County
348877	Ordering, Referring, Prescribing	N/A	1841551611	0	0	HUMES, DAPHNE W LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106485	N/A	N/A	N/A	N/A	N/A	1757 WALLER ST	None	SAN FRANCISCO	CA	94117	2727	00	06000	37.76828967	-122.4526241	San Francisco County
348882	Ordering, Referring, Prescribing	N/A	1841553203	0	0	HUNTER, MELANIE P LMFT	12/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	87413	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
348894	Ordering, Referring, Prescribing	N/A	1841573235	0	0	HUNT, THOMAS D PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	36694	N/A	N/A	N/A	N/A	N/A	27951 BASELINE ST	None	HIGHLAND	CA	92346	3346	00	06000	34.12120447	-117.194688	San Bernardino County
348918	Ordering, Referring, Prescribing	N/A	1841601507	0	0	HUIZAR, JAEL LMFT	9/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	121894	N/A	N/A	N/A	N/A	N/A	265 SAN JACINTO RIVER RD	107	LAKE ELSINORE	CA	92530	4419	00	06000	33.66201142	-117.3001906	Riverside County
348978	Ordering, Referring, Prescribing	N/A	1841708401	0	0	HERNANDEZ, AMANDA LCSW	11/4/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW127134	N/A	N/A	N/A	N/A	N/A	1215 W WEST COVINA PKWY	None	WEST COVINA	CA	91790	2815	00	06000	34.06877078	-117.9349578	Los Angeles County
348979	Ordering, Referring, Prescribing	N/A	1841709599	0	0	HOUDEK, LAURA NP	8/23/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95022329	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
348980	Ordering, Referring, Prescribing	N/A	1841712502	0	0	HSIAO, PHILIP MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A153381	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
349015	Ordering, Referring, Prescribing	N/A	1841758489	0	0	HUANG, CHUNG-YING PHARMD	3/24/2022	Taxonomy not applicable	NA	n/a	000	Unknown	63977	N/A	N/A	N/A	N/A	N/A	6100 SEPULVEDA BLVD	None	VAN NUYS	CA	91411	2503	00	06000	34.181325	-118.463634	Los Angeles County
349053	Ordering, Referring, Prescribing	N/A	1841824976	0	0	HAWN, DANIEL A LMFT	10/16/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT150688	N/A	N/A	N/A	N/A	N/A	8530 LA MESA BLVD	#306	LA MESA	CA	91942	0966	00	06000	32.76873337	-117.0134248	San Diego County
349061	Ordering, Referring, Prescribing	N/A	1841840014	0	0	HERNANDEZ, MARIA NP	9/3/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95012651	N/A	N/A	N/A	N/A	N/A	1107 W POPLAR AVE	None	PORTERVILLE	CA	93257	5839	00	06000	36.05128153	-119.0422344	Tulare County
349087	Ordering, Referring, Prescribing	N/A	1841915097	0	0	HEWITSON, HAILEY R PHARMD	10/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH87110	N/A	N/A	N/A	N/A	N/A	3752 MISSION AVE	None	OCEANSIDE	CA	92058	1417	00	06000	33.22514029	-117.3318383	San Diego County
349104	Ordering, Referring, Prescribing	N/A	1841956810	0	0	HUYNH, ANNY PHARMD	8/16/2022	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85001	N/A	N/A	N/A	N/A	N/A	770 1ST ST	None	GILROY	CA	95020	4972	00	06000	37.01344257	-121.5843817	Santa Clara County
349134	Ordering, Referring, Prescribing	N/A	1851063051	0	0	HADDAD, WILLIAM H LMFT	6/8/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	133140	N/A	N/A	N/A	N/A	N/A	1509 CAMERON AVE	SUITE 230	WEST COVINA	CA	91790	2725	00	06000	34.06870559	-117.9422297	Los Angeles County
349135	Ordering, Referring, Prescribing	N/A	1851063580	0	0	HURTADO, MEGAN N LCSW	9/13/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110459	N/A	N/A	N/A	N/A	N/A	1774 ZONAL AVE	BUILDING E	LOS ANGELES	CA	90033	1063	00	06000	34.06160288	-118.2099956	Los Angeles County
349180	Ordering, Referring, Prescribing	N/A	1851423537	0	0	HALE, LAUREN M LMFT	11/25/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT38382	N/A	N/A	N/A	N/A	N/A	21000 PLUMMER STREET	None	CHATSWORTH	CA	91311	4903	00	06000	34.24271597	-118.5915861	Los Angeles County
349186	Ordering, Referring, Prescribing	N/A	1851425391	0	0	HILL, MARTHA L LMFT	3/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	53857	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
349194	Ordering, Referring, Prescribing	N/A	1851435424	0	0	HABIBI, SHADMAN	4/2/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0556186	N/A	N/A	N/A	N/A	N/A	200 UCLA MEDICAL PLAZA	STE 430	LOS ANGELES	CA	90095	6928	00	06000	34.065126	-118.446237	Los Angeles County
349210	Ordering, Referring, Prescribing	N/A	1851463855	0	0	HARPER, MARJORIE G LCSW	3/31/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	23854	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
349230	Ordering, Referring, Prescribing	N/A	1851518443	0	0	HUANG, BARRY DDS	4/15/2023	Taxonomy not applicable	NA	n/a	000	Unknown	43972	N/A	N/A	N/A	N/A	N/A	3401 AERO JET AVE	None	EL MONTE	CA	91731	2801	00	06000	34.070031	-118.068778	Los Angeles County
349235	Ordering, Referring, Prescribing	N/A	1851522304	0	0	HERRERA, JOSEFINA LMFT	3/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	109375	N/A	N/A	N/A	N/A	N/A	6051 N FRESNO ST	201	FRESNO	CA	93710	5280	00	06000	36.823905	-119.781436	Fresno County
349289	Ordering, Referring, Prescribing	N/A	1851640668	0	0	HARVEY, GRACE A LMFT	9/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT84335	N/A	N/A	N/A	N/A	N/A	1819 CLIFF DRIVE	SUITE F	SANTA BARBARA	CA	93109	0000	00	06000	34.40137954	-119.7214154	Santa Barbara County
349306	Ordering, Referring, Prescribing	N/A	1851658348	0	0	HARMON, HEIDI L LCSW	5/19/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71283	N/A	N/A	N/A	N/A	N/A	1330 LAS TABLAS RD	None	TEMPLETON	CA	93465	9758	00	06000	35.55442548	-120.723759	San Luis Obispo County
349309	Ordering, Referring, Prescribing	N/A	1851668933	0	0	HARIDAS, DEEPA PHARMD	8/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57723	N/A	N/A	N/A	N/A	N/A	444 W F ST	None	OAKDALE	CA	95361	3837	00	06000	37.76415497	-120.8530102	Stanislaus County
349312	Ordering, Referring, Prescribing	N/A	1851671986	0	0	HOANG, MYSHA PHARMD	4/7/2022	Taxonomy not applicable	NA	n/a	000	Unknown	48904	N/A	N/A	N/A	N/A	N/A	150 LAWRENCE STATION RD	None	SUNNYVALE	CA	94086	5309	00	06000	37.371906	-121.9959845	Santa Clara County
349353	Ordering, Referring, Prescribing	N/A	1851727416	0	0	HARKLESS, SUZANNE	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW84529	N/A	N/A	N/A	N/A	N/A	200 24TH STREET	None	RICHMOND	CA	94804	1804	00	06000	37.93439778	-122.3465322	Contra Costa County
349358	Ordering, Referring, Prescribing	N/A	1851730584	0	0	HERRERA-MALDONADO, BRENDA E CNP	1/16/2018	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	22134	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
349367	Ordering, Referring, Prescribing	N/A	1851739650	0	0	HAKIMI, DEHNAD PSYD	8/2/2018	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY29116	N/A	N/A	N/A	N/A	N/A	16661 VENTURA BLVD.	SUITE 400J	ENCINO	CA	91436	1925	00	06000	34.15820737	-118.496492	Los Angeles County
349386	Ordering, Referring, Prescribing	N/A	1851771182	0	0	HUYNH, JOANNA PHARMD	3/17/2018	Taxonomy not applicable	NA	n/a	000	Unknown	51917	N/A	N/A	N/A	N/A	N/A	550 E BASELINE RD	None	CLAREMONT	CA	91711	2236	00	06000	34.12158852	-117.7059825	Los Angeles County
349392	Ordering, Referring, Prescribing	N/A	1851777908	0	0	HANNA, ANDRE	3/25/2024	Taxonomy not applicable	NA	n/a	000	Unknown	70774	N/A	N/A	N/A	N/A	N/A	1703 TERMINO AVE	101	LONG BEACH	CA	90804	2126	00	06000	33.7883073	-118.1459488	Los Angeles County
349397	Ordering, Referring, Prescribing	N/A	1851779821	0	0	HARLESS, LAUREN LMFT	3/2/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	100688	N/A	N/A	N/A	N/A	N/A	365 S RANCHO SANTA FE RD	None	SAN MARCOS	CA	92078	2338	00	06000	33.14154576	-117.2025301	San Diego County
349410	Ordering, Referring, Prescribing	N/A	1851791941	0	0	HERRERA, JESSICA LCSW	6/7/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	101896	N/A	N/A	N/A	N/A	N/A	1700 KEYSTONE PACIFIC PK	B	PATTERSON	CA	95363	8874	00	06000	37.47600952	-121.160718	Stanislaus County
349441	Ordering, Referring, Prescribing	N/A	1851856371	0	0	HUGHEY, LAUREN	7/10/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	129783	N/A	N/A	N/A	N/A	N/A	9400 RUFFIN CT	STE A	SAN DIEGO	CA	92123	5300	00	06000	32.830713	-117.1230525	San Diego County
349489	Ordering, Referring, Prescribing	N/A	1851939714	0	0	HUANG, ROBIN PHARMD	3/28/2023	Taxonomy not applicable	NA	n/a	000	Unknown	81369	N/A	N/A	N/A	N/A	N/A	250 HOSPITAL PKWY	None	SAN JOSE	CA	95119	1103	00	06000	37.23948065	-121.8005798	Santa Clara County
349548	Ordering, Referring, Prescribing	N/A	1861083149	0	0	HOMAN, BRENDA M CNP	12/2/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016153	N/A	N/A	N/A	N/A	N/A	2433 MARCONI AVE	None	SACRAMENTO	CA	95821	4807	00	06000	38.619405	-121.4045595	Sacramento County
349557	Ordering, Referring, Prescribing	N/A	1861098725	0	0	HICKS BONAM, JAZZMIN T PSYD	11/24/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32243	N/A	N/A	N/A	N/A	N/A	320 N E ST	None	SAN BERNARDINO	CA	92401	1540	00	06000	34.10485752	-117.294163	San Bernardino County
349574	Ordering, Referring, Prescribing	N/A	1861168585	0	0	HUANG, WOYAN PA-C	10/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59948	N/A	N/A	N/A	N/A	N/A	6120 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2911	00	06000	33.98438021	-118.2226279	Los Angeles County
349577	Ordering, Referring, Prescribing	N/A	1861168916	0	0	HUANG, AI-GEN LAC	9/8/2023	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC19099	N/A	N/A	N/A	N/A	N/A	330 S GARFIELD AVE	STE 208	ALHAMBRA	CA	91801	3893	00	06000	34.09137167	-118.1241735	Los Angeles County
349587	Ordering, Referring, Prescribing	N/A	1861422347	0	0	HARBISON, JOHN D MD	5/28/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G70156	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
349599	Ordering, Referring, Prescribing	N/A	1861470197	0	0	HARTMAN, BONNIE J MD	11/22/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C175390	N/A	N/A	N/A	N/A	N/A	2235 CHALLENGER WAY	None	SANTA ROSA	CA	95407	5418	00	06000	38.425491	-122.7519	Sonoma County
349605	Ordering, Referring, Prescribing	N/A	1861492910	0	0	HASHIMOTO, HELEN T	1/17/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0632868	N/A	N/A	N/A	N/A	N/A	14372 BEACH BLVD	None	WESTMINSTER	CA	92683	4578	00	06000	33.75341465	-117.989413	Orange County
349626	Ordering, Referring, Prescribing	N/A	1861540957	0	0	HALL, MAXINE	10/7/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40190	N/A	N/A	N/A	N/A	N/A	1260 N. DUTTON AVE	230	SANTA ROSA	CA	95401	7161	00	06000	38.449197	-122.7320775	Sonoma County
349637	Ordering, Referring, Prescribing	N/A	1861562241	0	0	HAUN, ALLYSON LMFT	9/19/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT149938	N/A	N/A	N/A	N/A	N/A	499 LOMA ALTA AVENUE	None	LOS GATOS	CA	95030	4315	00	06000	37.21747493	-121.9662128	Santa Clara County
349647	Ordering, Referring, Prescribing	N/A	1861575052	0	0	HAMILTON, ROBERT P DC	7/13/2017	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	26552	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
349671	Ordering, Referring, Prescribing	N/A	1861648461	0	0	HASTANAN, CAROL L MD	2/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A110192	N/A	N/A	N/A	N/A	N/A	1111 W CHASE AVE	None	EL CAJON	CA	92020	5710	00	06000	32.78161035	-116.9764603	San Diego County
349680	Ordering, Referring, Prescribing	N/A	1861676587	0	0	HENNESSEY, NUBIA LMFT	1/29/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53896	N/A	N/A	N/A	N/A	N/A	511 N BROOKHURST ST	None	ANAHEIM	CA	92801	5231	00	06000	33.839253	-117.959068	Orange County
349686	Ordering, Referring, Prescribing	N/A	1861684664	0	0	HUGHES, STEVEN A LMFT	4/11/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	89902	N/A	N/A	N/A	N/A	N/A	2275 S MAIN STREET CORON	SUITE 201	CORONA	CA	92882	7058	00	06000	33.85511663	-117.5694892	Riverside County
349690	Ordering, Referring, Prescribing	N/A	1861694424	0	0	HOANG, LONG N	1/4/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	P5079	N/A	N/A	N/A	N/A	N/A	1315 S ADAMS ST	None	FORT WORTH	TX	76104	4404	00	06000	32.72994159	-97.33672572	Tarrant County
349696	Ordering, Referring, Prescribing	N/A	1861693343	0	0	HARRISON, BONNIE L LCSW	5/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCS25885	N/A	N/A	N/A	N/A	N/A	3450 3RD ST. 1C	None	SAN FRANCISCO	CA	94124	1402	00	06000	37.74535239	-122.387252	San Francisco County
349719	Ordering, Referring, Prescribing	N/A	1861747156	0	0	HERRERA, CARLA LCSW	3/4/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	100389	N/A	N/A	N/A	N/A	N/A	5256 MISSION BLVD	None	JURUPA VALLEY	CA	92509	4624	00	06000	33.99261717	-117.3987262	Riverside County
349728	Ordering, Referring, Prescribing	N/A	1861770364	0	0	HASIN, FAHMINA PSYD	10/27/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	27760	N/A	N/A	N/A	N/A	N/A	1 CIVIC PLAZA DR	None	CARSON	CA	90745	2243	00	06000	33.8328256	-118.2592958	Los Angeles County
349743	Ordering, Referring, Prescribing	N/A	1861777427	0	0	HUA-REYES, MICHELLE LCSW	5/28/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79573	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
349744	Ordering, Referring, Prescribing	N/A	1861780645	0	0	HILBERT, KATE L LMFT	5/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	107452	N/A	N/A	N/A	N/A	N/A	4250 FOWLER LANE	UNIT 204	PLACERVILLE	CA	95619	1987	00	06000	38.69331583	-120.8130299	El Dorado County
349805	Ordering, Referring, Prescribing	N/A	1861869653	0	0	HUNT, AUGUSTA LCSW	3/11/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	26442	N/A	N/A	N/A	N/A	N/A	7001-A EAST PARKWAY	SUITE 300	SACRAMENTO	CA	95823	2501	00	06000	38.497689	-121.4498385	Sacramento County
349906	Ordering, Referring, Prescribing	N/A	1871032888	0	0	HADI, AYMAN	7/29/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH68532	N/A	N/A	N/A	N/A	N/A	885 EUCLID AVE	None	NATIONAL CITY	CA	91950	0000	00	06000	32.68129235	-117.0810306	San Diego County
349946	Ordering, Referring, Prescribing	N/A	1871085076	0	0	HERNANDEZ, JENNIFER M LCSW	12/10/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	117117	N/A	N/A	N/A	N/A	N/A	23311 DRACAEA AVE	None	MORENO VALLEY	CA	92553	3201	00	06000	33.92807348	-117.258489	Riverside County
349947	Ordering, Referring, Prescribing	N/A	1871081513	0	0	HAYDEN, NAMIKO C LCSW	9/20/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	105624	N/A	N/A	N/A	N/A	N/A	231 E. THIRD ST.	G-106	LOS ANGELES	CA	90013	1493	00	06000	34.04804033	-118.2438699	Los Angeles County
349948	Ordering, Referring, Prescribing	N/A	1871085985	0	0	HUR, EMILY LMFT	6/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT119596	N/A	N/A	N/A	N/A	N/A	9015 MURRAY AVENUE #100	None	GILROY	CA	95020	3617	00	06000	37.03080985	-121.5741639	Santa Clara County
349956	Ordering, Referring, Prescribing	N/A	1871097956	0	0	HU, JONATHAN C MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163970	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
349962	Ordering, Referring, Prescribing	N/A	1871102590	0	0	HURD, SARAH H NP	7/29/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015063	N/A	N/A	N/A	N/A	N/A	71777 SAN JACINTO DRIVE	202	RANCHO MIRAGE	CA	92270	0000	00	06000	33.74394755	-116.4124572	Riverside County
349979	Ordering, Referring, Prescribing	N/A	1871144402	0	0	HOPPER, ALICIA RDH	4/25/2023	Taxonomy not applicable	NA	n/a	000	Unknown	RDH33000	N/A	N/A	N/A	N/A	N/A	1400 MARKET ST STE 8103	STE 8103	REDDING	CA	96001	1050	00	06000	40.58499451	-122.3911682	Shasta County
349981	Ordering, Referring, Prescribing	N/A	1871139097	0	0	HOOK DYE, MEGAN B LCSW	11/24/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127467	N/A	N/A	N/A	N/A	N/A	5445 LAUREL HILLS DR	None	SACRAMENTO	CA	95841	3105	00	06000	38.662227	-121.3378965	Sacramento County
349990	Ordering, Referring, Prescribing	N/A	1871165696	0	0	HURLEY, MORGAN PA-C	12/31/2023	Taxonomy not applicable	NA	n/a	000	Unknown	59735	N/A	N/A	N/A	N/A	N/A	760 E ALMOND AVE	None	MADERA	CA	93637	5617	00	06000	36.94546284	-120.04872	Madera County
350013	Ordering, Referring, Prescribing	N/A	1871204362	0	0	HUSTED, SARAH NP	7/15/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95021785	N/A	N/A	N/A	N/A	N/A	4341 GOLDEN CENTER DR	BUILDING A	PLACERVILLE	CA	95667	4341	00	06000	38.70594583	-120.8270239	El Dorado County
350023	Ordering, Referring, Prescribing	N/A	1871243154	0	0	HEINDEL, LEAH MD	11/14/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A190409	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
350102	Ordering, Referring, Prescribing	N/A	1871642082	0	0	HORST, THOMAS E	5/15/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	51196	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
350103	Ordering, Referring, Prescribing	N/A	1871648139	0	0	HUANG, KELIN CA	8/20/2018	Taxonomy not applicable	NA	n/a	032	CERTIFIED ACUPUNCTURIST	AC4278	N/A	N/A	N/A	N/A	N/A	3373 MISSION ST	None	SAN FRANCISCO	CA	94110	5027	00	06000	37.74270391	-122.4217542	San Francisco County
350109	Ordering, Referring, Prescribing	N/A	1871667568	0	0	HIDROBO, JENNIFER S LCSW	7/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW64874	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
350145	Ordering, Referring, Prescribing	N/A	1871752923	0	0	HOY, LACRESHIA L	8/16/2013	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	RN0555510	N/A	N/A	N/A	N/A	N/A	10300 COMPTON AVE	None	LOS ANGELES	CA	90002	3628	00	06000	33.94274917	-118.2461916	Los Angeles County
350153	Ordering, Referring, Prescribing	N/A	1871757922	0	0	HOFFMAN, THOMAS E MD	10/29/2019	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A103596	N/A	N/A	N/A	N/A	N/A	529 S. MAPLE AVE	None	LOS ANGELES	CA	90013	1511	00	06000	34.04465262	-118.2472846	Los Angeles County
350155	Ordering, Referring, Prescribing	N/A	1871760744	0	0	HARDY, JENNIFER K LMFT	3/17/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	49475	N/A	N/A	N/A	N/A	N/A	1430 WILLOW PASS ROAD	None	CONCORD	CA	94520	7946	00	06000	37.97055112	-122.0492933	Contra Costa County
350204	Ordering, Referring, Prescribing	N/A	1871841361	0	0	HOWARD, MAE MADGE MERETTE M LCSW	5/4/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	74977	N/A	N/A	N/A	N/A	N/A	3665 KEARNY VILLA RD	STE 165	SAN DIEGO	CA	92123	1953	00	06000	32.80816826	-117.1510112	San Diego County
350236	Ordering, Referring, Prescribing	N/A	1871875765	0	0	HO, MARGARET	7/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH54526	N/A	N/A	N/A	N/A	N/A	4170 EL CAMINO REAL	None	PALO ALTO	CA	94306	4008	00	06000	37.41148135	-122.1243315	Santa Clara County
350238	Ordering, Referring, Prescribing	N/A	1871892331	0	0	HEIKENS, MARC J MD	7/10/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A138136	N/A	N/A	N/A	N/A	N/A	8996 MIRAMAR RD	STE 301	SAN DIEGO	CA	92126	4463	00	06000	32.8938195	-117.131463	San Diego County
350248	Ordering, Referring, Prescribing	N/A	1871911297	0	0	HANN, MICHAEL E	2/9/2018	Taxonomy not applicable	NA	n/a	099	DENTIST	D63295	N/A	N/A	N/A	N/A	N/A	30195 FRASER DR	None	LAKE ELSINORE	CA	92530	7006	00	06000	33.68444711	-117.3679692	Riverside County
350263	Ordering, Referring, Prescribing	N/A	1871926972	0	0	HART, MARY A LMFT	8/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	34934	N/A	N/A	N/A	N/A	N/A	527 WOODMONT AVE	None	BERKELEY	CA	94708	1231	00	06000	37.90341266	-122.2676933	Alameda County
350278	Ordering, Referring, Prescribing	N/A	1871946582	0	0	HAUSSER, RONA S NP	9/15/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018429	N/A	N/A	N/A	N/A	N/A	5348 UNIVERSITY AVE	STE 108	SAN DIEGO	CA	92105	8025	00	06000	32.74909257	-117.0811685	San Diego County
350299	Ordering, Referring, Prescribing	N/A	1871976878	0	0	HANDA, RICHA MD	2/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A170978	N/A	N/A	N/A	N/A	N/A	500 WEST HOSPITAL RD	SUITE A,B & C	FRENCH CAMP	CA	95231	9693	00	06000	37.88652418	-121.2820956	San Joaquin County
350315	Ordering, Referring, Prescribing	N/A	1881008639	0	0	HUFTON, TAMMY L NP	6/6/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95006867	N/A	N/A	N/A	N/A	N/A	8665 SALMON AVENUE	None	KINGS BEACH	CA	96143	2167	00	06000	39.23616552	-120.021381	Placer County
350325	Ordering, Referring, Prescribing	N/A	1881018778	0	0	HUERTA JR, WILLIAM E	3/23/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	D63262	N/A	N/A	N/A	N/A	N/A	620 E ALVIN DR	STE G	SALINAS	CA	93906	3054	00	06000	36.70361129	-121.6321051	Monterey County
350326	Ordering, Referring, Prescribing	N/A	1881018174	0	0	HALL, ERIKA LMFT	1/22/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT39438	N/A	N/A	N/A	N/A	N/A	19401 S VERMONT AVENUE	L102	TORRANCE	CA	90502	1029	00	06000	33.85486409	-118.2905603	Los Angeles County
350338	Ordering, Referring, Prescribing	N/A	1881046555	0	0	HARDING, KATHERINE M LMFT	6/22/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	116391	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
350340	Ordering, Referring, Prescribing	N/A	1881046829	0	0	HENRIKSON, CANDACE LMFT	10/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	141798	N/A	N/A	N/A	N/A	N/A	160 WIKIUP DR	None	SANTA ROSA	CA	95403	7775	00	06000	38.50827407	-122.758229	Sonoma County
350354	Ordering, Referring, Prescribing	N/A	1881060473	0	0	HERNANDEZ, ELSIE C LCSW	11/13/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	98493	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
350361	Ordering, Referring, Prescribing	N/A	1881052777	0	0	HARRISON, MIA DMD MSD	3/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	DDS100681	N/A	N/A	N/A	N/A	N/A	2707 S CENTRAL LOS ANGEL	None	LOS ANGELES	CA	90011	5527	00	06000	34.01754879	-118.2555246	Los Angeles County
350391	Ordering, Referring, Prescribing	N/A	1881101624	0	0	HO DAC, TINA	10/5/2018	Taxonomy not applicable	NA	n/a	000	Unknown	75210	N/A	N/A	N/A	N/A	N/A	70 WEST HEDDING	None	SAN JOSE	CA	95110	1705	00	06000	37.35249294	-121.9050815	Santa Clara County
350405	Ordering, Referring, Prescribing	N/A	1881126266	0	0	HU, YVONNE PHARMD	2/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	50368	N/A	N/A	N/A	N/A	N/A	1380 HOWARD STREET	None	SAN FRANCISCO	CA	94103	2638	00	06000	37.77424669	-122.4141502	San Francisco County
350411	Ordering, Referring, Prescribing	N/A	1881135705	0	0	HEO, YUNKYUNG NP	9/18/2017	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005973	N/A	N/A	N/A	N/A	N/A	1045 5TH ST	None	LOS BANOS	CA	93635	4204	00	06000	37.05986807	-120.8505485	Merced County
350425	Ordering, Referring, Prescribing	N/A	1881154540	0	0	HO, NATALIE PHARMD	7/18/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84396	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD. M	None	BOISE	ID	83706	3999	00	06000	43.59860438	-116.1806635	Ada County
350513	Ordering, Referring, Prescribing	N/A	1881343077	0	0	HILL, ALANA OT	4/3/2023	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	23470	N/A	N/A	N/A	N/A	N/A	880 3RD AVE	A	CHULA VISTA	CA	91911	1305	00	06000	32.62153846	-117.0722021	San Diego County
350528	Ordering, Referring, Prescribing	N/A	1881454726	0	0	HOUSTON, AUTUMN NP	4/15/2024	Taxonomy not applicable	NA	n/a	000	Unknown	95027181	N/A	N/A	N/A	N/A	N/A	4060 FAIRMOUNT AVE	None	SAN DIEGO	CA	92105	1608	00	06000	32.750523	-117.100927	San Diego County
350563	Ordering, Referring, Prescribing	N/A	1881719581	0	0	HUH, CATHERINE C LCSW	12/21/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29290	N/A	N/A	N/A	N/A	N/A	2510 MAIN ST	SUITE 201	SANTA MONICA	CA	90405	3535	00	06000	34.00312088	-118.4847822	Los Angeles County
350564	Ordering, Referring, Prescribing	N/A	1881722007	0	0	HSIEH, HSING-HSIANG M LMFT	3/8/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT35826	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
350580	Ordering, Referring, Prescribing	N/A	1881725596	0	0	HALL, CASSANDRA LMFT	10/18/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT45639	N/A	N/A	N/A	N/A	N/A	42455 10TH ST WEST SUITE	None	LANCASTER	CA	93534	7060	00	06000	34.65438079	-118.1478341	Los Angeles County
350623	Ordering, Referring, Prescribing	N/A	1881847788	0	0	HEREDIA, JUDITH A LMFT	4/1/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT87420	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
350660	Ordering, Referring, Prescribing	N/A	1881944528	0	0	HIDALGO, SHERI S	4/17/2023	Taxonomy not applicable	NA	n/a	000	Unknown	68027	N/A	N/A	N/A	N/A	N/A	5417 WHITTIER BLVD	None	LOS ANGELES	CA	90022	4101	00	06000	34.01967692	-118.1536948	Los Angeles County
350670	Ordering, Referring, Prescribing	N/A	1881956431	0	0	HAMMONDS, BETZABE LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	87277	N/A	N/A	N/A	N/A	N/A	1 CIVIC PLAZA DR	None	CARSON	CA	90745	2243	00	06000	33.8328256	-118.2592958	Los Angeles County
350673	Ordering, Referring, Prescribing	N/A	1881956480	0	0	HUNDAL, JASKIRAN K MD	3/2/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A132595	N/A	N/A	N/A	N/A	N/A	1209 WOODROW AVENUE	SUITE B	MODESTO	CA	95350	1273	00	06000	37.68575206	-121.0112235	Stanislaus County
350690	Ordering, Referring, Prescribing	N/A	1881982650	0	0	HELLENGA, KATE LP	6/20/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	25117	N/A	N/A	N/A	N/A	N/A	1197 VALENCIA STREET	1	SAN FRANCISCO	CA	94110	3026	00	06000	37.75452673	-122.4208621	San Francisco County
350691	Ordering, Referring, Prescribing	N/A	1881981843	0	0	HAMMOND, AMY B LCSW	8/29/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW67043	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
350708	Ordering, Referring, Prescribing	N/A	1891024519	0	0	HUFFMAN, BENJAMIN C LMFT	5/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	92390	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
350731	Ordering, Referring, Prescribing	N/A	1891062832	0	0	HOYNES, AMANDA L PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76334	N/A	N/A	N/A	N/A	N/A	2271 BALFOUR RD	None	BRENTWOOD	CA	94513	4923	00	06000	37.92541953	-121.7373165	Contra Costa County
350732	Ordering, Referring, Prescribing	N/A	1891059796	0	0	HA, KWANG H PHD	7/16/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33013	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
350759	Ordering, Referring, Prescribing	N/A	1891099677	0	0	HUNG, LOK KA DORIS LMFT	1/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	88203	N/A	N/A	N/A	N/A	N/A	729 FILBERT STREET	None	SAN FRANCISCO	CA	94133	2760	00	06000	37.80103613	-122.4119083	San Francisco County
350768	Ordering, Referring, Prescribing	N/A	1891115572	0	0	HOLLOWED, JOHN J MD	8/15/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A142140	N/A	N/A	N/A	N/A	N/A	13651 WILLARD ST	None	PANORAMA CITY	CA	91402	6214	00	06000	34.2177693	-118.4298601	Los Angeles County
350788	Ordering, Referring, Prescribing	N/A	1891141073	0	0	HALL, STEPHANIE M LMFT	4/3/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	138949	N/A	N/A	N/A	N/A	N/A	1221 EAST DYER ROAD	220	SANTA ANA	CA	92705	5632	00	06000	33.70872153	-117.857052	Orange County
350798	Ordering, Referring, Prescribing	N/A	1891157657	0	0	HUANG, CHARITY A MD	1/19/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A158660	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
350812	Ordering, Referring, Prescribing	N/A	1891176020	0	0	HUYNH, LONGTRI PHARMD	3/14/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72538	N/A	N/A	N/A	N/A	N/A	3240 ARDEN WAY	None	SACRAMENTO	CA	95825	2015	00	06000	38.594898	-121.3884765	Sacramento County
350836	Ordering, Referring, Prescribing	N/A	1891213039	0	0	HOUSE, MATTHEW NP	7/2/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95007966	N/A	N/A	N/A	N/A	N/A	123 ATLANTIC AVE	None	LONG BEACH	CA	90802	5121	00	06000	33.7685184	-118.1850803	Los Angeles County
350851	Ordering, Referring, Prescribing	N/A	1891241998	0	0	HEANG, LINDA LCSW	9/14/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW96871	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
350870	Ordering, Referring, Prescribing	N/A	1891259024	0	0	HALPERN, STEPHANIE E NP	11/30/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95010921	N/A	N/A	N/A	N/A	N/A	11643 GLENOAKS BLVD	None	PACOIMA	CA	91331	1050	00	06000	34.28133474	-118.4198166	Los Angeles County
350878	Ordering, Referring, Prescribing	N/A	1891285987	0	0	HARDIN, CAROLINE J	3/23/2020	Taxonomy not applicable	NA	n/a	019	OCCUPATIONAL THERAPISTS	19346	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD.	MS 53	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
350886	Ordering, Referring, Prescribing	N/A	1891304291	0	0	HO, ALEX PHARMD	2/9/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83418	N/A	N/A	N/A	N/A	N/A	250 E PARKCENTER BLVD	MS SEC2-B	BOISE	ID	83706	3940	00	06000	43.59860438	-116.1806635	Ada County
350936	Ordering, Referring, Prescribing	N/A	1891431276	0	0	HICKS THOMPSON, STUART R DO	4/30/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21821	N/A	N/A	N/A	N/A	N/A	26600 CACTUS AVE	SUITE #300	MORENO VALLEY	CA	92555	3901	00	06000	33.91013953	-117.193383	Riverside County
350951	Ordering, Referring, Prescribing	N/A	1891462040	0	0	HOLLAHAN, RILEY N LMFT	1/31/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152943	N/A	N/A	N/A	N/A	N/A	3478 BUSKIRK AVE	SUITE 260	PLEASANT HILL	CA	94523	4344	00	06000	37.93963113	-122.0591644	Contra Costa County
350958	Ordering, Referring, Prescribing	N/A	1891486502	0	0	HONG, CINDY NP	4/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95024910	N/A	N/A	N/A	N/A	N/A	9862 CHAPMAN AVE	None	GARDEN GROVE	CA	92841	2711	00	06000	33.78849558	-117.9607338	Orange County
350991	Ordering, Referring, Prescribing	N/A	1891816369	0	0	HOLT, EDWARD W MD	3/9/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A108342	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
351007	Ordering, Referring, Prescribing	N/A	1891831996	0	0	HARTER, RETHANA C LMFT	4/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	82562	N/A	N/A	N/A	N/A	N/A	1887 MONTEREY HWY	205	SAN JOSE	CA	95112	6192	00	06000	37.30869336	-121.8664126	Santa Clara County
351016	Ordering, Referring, Prescribing	N/A	1891836003	0	0	HERSH, RICHARD J MD	10/12/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G31122	N/A	N/A	N/A	N/A	N/A	11793 GREEN VALLEY RD	None	SEBASTOPOL	CA	95472	9331	00	06000	38.439711	-122.9180265	Sonoma County
351027	Ordering, Referring, Prescribing	N/A	1891861324	0	0	HUGHES, JOAN L NP	2/19/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NPF95016741	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
351039	Ordering, Referring, Prescribing	N/A	1891927828	0	0	HOANG, ADRIAN M PA	5/9/2017	Taxonomy not applicable	NA	n/a	000	Unknown	20445	N/A	N/A	N/A	N/A	N/A	12116 BEACH BLVD	None	STANTON	CA	90680	3704	00	06000	33.78629892	-117.9927526	Orange County
351091	Ordering, Referring, Prescribing	N/A	1902024813	0	0	HILLSON, CHRISTINA	7/1/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A126168	N/A	N/A	N/A	N/A	N/A	1530 S OLIVE STREET	None	LOS ANGELES	CA	90015	0000	00	06000	34.03542552	-118.2652073	Los Angeles County
351126	Ordering, Referring, Prescribing	N/A	1902106545	0	0	HAMMER, JERROLD E PHARMD	3/20/2018	Taxonomy not applicable	NA	n/a	000	Unknown	31899	N/A	N/A	N/A	N/A	N/A	522 ORANGE ST	None	REDLANDS	CA	92374	3208	00	06000	34.060041	-117.182552	San Bernardino County
351175	Ordering, Referring, Prescribing	N/A	1902175763	0	0	HUA, TINALOAN K PHARMD	3/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65656	N/A	N/A	N/A	N/A	N/A	1761 BROADWAY ST	None	AMERICAN CANYON	CA	94589	2226	00	06000	38.13049234	-122.2522422	Solano County
351178	Ordering, Referring, Prescribing	N/A	1902181639	0	0	HUDSPETH, JENNIFER PHARMD	9/1/2021	Taxonomy not applicable	NA	n/a	000	Unknown	61212	N/A	N/A	N/A	N/A	N/A	5328 W CYPRESS AVE	None	VISALIA	CA	93277	8337	00	06000	36.324882	-119.3503545	Tulare County
351188	Ordering, Referring, Prescribing	N/A	1902193501	0	0	HEWITT, AMBER PA	11/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	21911	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
351195	Ordering, Referring, Prescribing	N/A	1902206410	0	0	HERNANDEZ, PAOLA A LCSW	1/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	88753	N/A	N/A	N/A	N/A	N/A	3576 ARLINGTON AVE	106	RIVERSIDE	CA	92506	3907	00	06000	33.94625192	-117.3913739	Riverside County
351211	Ordering, Referring, Prescribing	N/A	1902225816	0	0	HARIK, DANIELLE E DO	7/15/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	18396	N/A	N/A	N/A	N/A	N/A	6095 N 1ST STREET	None	FRESNO	CA	93710	5444	00	06000	36.82524765	-119.7723922	Fresno County
351227	Ordering, Referring, Prescribing	N/A	1902273782	0	0	HALEY, THEODORE B	1/26/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D64807	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
351228	Ordering, Referring, Prescribing	N/A	1902275639	0	0	HILL, JAMES E	10/5/2017	Taxonomy not applicable	NA	n/a	000	Unknown	52868	N/A	N/A	N/A	N/A	N/A	121 BARBOZA STREET	None	MENDOTA	CA	93640	1901	00	06000	36.76619136	-120.3839072	Fresno County
351236	Ordering, Referring, Prescribing	N/A	1902284771	0	0	HER, CHEE LCSW	10/15/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW97705	N/A	N/A	N/A	N/A	N/A	3001 INTERNATIONAL BLVD	None	OAKLAND	CA	94601	2203	00	06000	37.77859396	-122.2279493	Alameda County
351238	Ordering, Referring, Prescribing	N/A	1902287352	0	0	HARKINS, AUBREY E NP	6/23/2015	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	680658	N/A	N/A	N/A	N/A	N/A	21001 SHERMAN WAY	9	CANOGA PARK	CA	91303	3683	00	06000	34.20113553	-118.5912126	Los Angeles County
351241	Ordering, Referring, Prescribing	N/A	1902285570	0	0	HANNON, RACHEL NP	7/18/2020	Taxonomy not applicable	NA	n/a	000	Unknown	95001931	N/A	N/A	N/A	N/A	N/A	26357 MCBEAN PARKWAY	None	VALENCIA	CA	91355	0803	00	06000	34.41257644	-118.5597683	Los Angeles County
351259	Ordering, Referring, Prescribing	N/A	1902315427	0	0	HERNANDEZ, NICOLE PA	12/7/2020	Taxonomy not applicable	NA	n/a	000	Unknown	PA58000	N/A	N/A	N/A	N/A	N/A	2252 BEVERLY BLVD	STE 103	LOS ANGELES	CA	90057	2246	00	06000	34.06771646	-118.2728448	Los Angeles County
351282	Ordering, Referring, Prescribing	N/A	1902342769	0	0	HORIBE, MAKI LCSW	5/9/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW122456	N/A	N/A	N/A	N/A	N/A	540 N 1ST	None	SAN JOSE	CA	95112	5319	00	06000	37.34571835	-121.8975601	Santa Clara County
351335	Ordering, Referring, Prescribing	N/A	1902492168	0	0	HOU, CHANGE NP	5/7/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95016017	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
351352	Ordering, Referring, Prescribing	N/A	1902576812	0	0	HYRNE, SHARON NP	9/1/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95018279	N/A	N/A	N/A	N/A	N/A	50 PENNY LANE	None	WATSONVILLE	CA	95076	3079	00	06000	36.93039162	-121.7785632	Santa Cruz County
351399	Ordering, Referring, Prescribing	N/A	1902925209	0	0	HARLEY-BISHARA, CHRISTINA L LMFT	11/30/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	47290	N/A	N/A	N/A	N/A	N/A	225 W BROADWAY	None	GLENDALE	CA	91204	1331	00	06000	34.14673469	-118.257145	Los Angeles County
351400	Ordering, Referring, Prescribing	N/A	1902926231	0	0	HILL, PATRICIA M LMFT	4/26/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT23764	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
351431	Ordering, Referring, Prescribing	N/A	1902959513	0	0	HUTCHINS, ELWIN R	12/19/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D28867	N/A	N/A	N/A	N/A	N/A	101 N PALM ST	None	WOODLAKE	CA	93286	1422	00	06000	36.414099	-119.100159	Tulare County
351461	Ordering, Referring, Prescribing	N/A	1912033465	0	0	HSZIEH, KEVIN CHIH W	9/15/2006	Taxonomy not applicable	NA	n/a	099	DENTIST	D45270	N/A	N/A	N/A	N/A	N/A	1206 E 17TH ST	STE 101	SANTA ANA	CA	92701	2641	00	06000	33.75983651	-117.8539425	Orange County
351475	Ordering, Referring, Prescribing	N/A	1912057340	0	0	HICKS, CLIFTON PHD	6/10/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	94109	N/A	N/A	N/A	N/A	N/A	100 BLANKEN AVE	None	SAN FRANCISCO	CA	94134	2407	00	06000	37.7119479	-122.4006456	San Francisco County
351492	Ordering, Referring, Prescribing	N/A	1912089418	0	0	HF, TRUST MD	2/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A72484	N/A	N/A	N/A	N/A	N/A	680 LANGSDORF DR STE 200	STE 200	FULLERTON	CA	92831	3702	00	06000	33.87673088	-117.8824577	Orange County
351496	Ordering, Referring, Prescribing	N/A	1912088980	0	0	HU, JUDY C	3/15/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A94384	N/A	N/A	N/A	N/A	N/A	11731 TELEGRAPH RD	None	SANTA FE SPRINGS	CA	90670	3675	00	06000	33.94630253	-118.0832082	Los Angeles County
351565	Ordering, Referring, Prescribing	N/A	1912256918	0	0	HALLETT, JOSEPH C LCSW	3/1/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW79656	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
351572	Ordering, Referring, Prescribing	N/A	1912266461	0	0	HAIK, NANCY B LMFT	11/16/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105089	N/A	N/A	N/A	N/A	N/A	1303 W WALNUT PKWY	None	COMPTON	CA	90220	5030	00	06000	33.87724562	-118.2446904	Los Angeles County
351618	Ordering, Referring, Prescribing	N/A	1912317132	0	0	HUSSAINI, JAVERIA DPM	12/16/2023	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	E5635	N/A	N/A	N/A	N/A	N/A	1885 BAY ROAD	None	EAST PALO ALTO	CA	94303	1312	00	06000	37.47281405	-122.1323377	San Mateo County
351650	Ordering, Referring, Prescribing	N/A	1912369497	0	0	HUYNH, JASMINE MD	3/14/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A151540	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
351652	Ordering, Referring, Prescribing	N/A	1912367673	0	0	HUA, SPENCER S	12/12/2017	Taxonomy not applicable	NA	n/a	099	DENTIST	102176	N/A	N/A	N/A	N/A	N/A	355 CENTRAL AVE	None	FILLMORE	CA	93015	1920	00	06000	34.40028802	-118.9137057	Ventura County
351669	Ordering, Referring, Prescribing	N/A	1912389875	0	0	HERRON, ROBYNNE R LMFT	11/29/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT129518	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
351675	Ordering, Referring, Prescribing	N/A	1912396615	0	0	HELLENDAG, MADELINE G MD	7/3/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A144061	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
351679	Ordering, Referring, Prescribing	N/A	1912402496	0	0	HOLLIDAY, WILLIAM B MD	1/25/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A164022	N/A	N/A	N/A	N/A	N/A	1000 WEST CARSON	498	TORRANCE	CA	90509	2910	00	06000	33.83155851	-118.2920625	Los Angeles County
351714	Ordering, Referring, Prescribing	N/A	1912453747	0	0	HWANG, JACOB C ND	8/28/2017	Taxonomy not applicable	NA	n/a	000	Unknown	845	N/A	N/A	N/A	N/A	N/A	4110 SORRENTO VALLEY	None	SAN DIEGO	CA	92121	1407	00	06000	32.90375674	-117.2170258	San Diego County
351716	Ordering, Referring, Prescribing	N/A	1912461153	0	0	HIXSON, CHASE D	1/17/2019	Taxonomy not applicable	NA	n/a	000	Unknown	56479	N/A	N/A	N/A	N/A	N/A	31180 ROAD 72	None	GOSHEN	CA	93291	9672	00	06000	36.35594779	-119.4124242	Tulare County
351739	Ordering, Referring, Prescribing	N/A	1912490541	0	0	HUYNH, DENNIS PHARMD	6/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	69702	N/A	N/A	N/A	N/A	N/A	751 S BASCOM AVE	SUITE 150	SAN JOSE	CA	95128	2604	00	06000	37.313433	-121.9318385	Santa Clara County
351740	Ordering, Referring, Prescribing	N/A	1912487448	0	0	HALL, ALEXANDRA RCP	7/25/2018	Taxonomy not applicable	NA	n/a	000	Unknown	29342	N/A	N/A	N/A	N/A	N/A	1505 N EDGEMONT ST	None	LOS ANGELES	CA	90027	5209	00	06000	34.098408	-118.296167	Los Angeles County
351761	Ordering, Referring, Prescribing	N/A	1912534249	0	0	HONG, SUZIE S DO	7/22/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20A21111	N/A	N/A	N/A	N/A	N/A	2204 NATIONAL AVE	None	SAN DIEGO	CA	92113	3615	00	06000	32.69715769	-117.1399272	San Diego County
351762	Ordering, Referring, Prescribing	N/A	1912523978	0	0	HENIGMAN, HANNAH PA-C	10/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	59200	N/A	N/A	N/A	N/A	N/A	1971 E 4TH ST	200	SANTA ANA	CA	92705	3917	00	06000	33.7482685	-117.83934	Orange County
351780	Ordering, Referring, Prescribing	N/A	1912564279	0	0	HERNANDEZ, ROSA PSYD	8/2/2023	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY33371	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
351791	Ordering, Referring, Prescribing	N/A	1912611625	0	0	HASSAN, SUCDI M CNP	7/17/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	NP95031155	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
351800	Ordering, Referring, Prescribing	N/A	1912644733	0	0	HERNANDEZ, BERNARD MD	7/31/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A198089	N/A	N/A	N/A	N/A	N/A	2040 CAMFIELD AVE	None	LOS ANGELES	CA	90040	1501	00	06000	34.00861575	-118.1559052	Los Angeles County
351830	Ordering, Referring, Prescribing	N/A	1912764358	0	0	HERRERA, MICHELLE T	4/3/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95029673	N/A	N/A	N/A	N/A	N/A	6120 SEVILLE AVE	None	HUNTINGTON PARK	CA	90255	2911	00	06000	33.98438021	-118.2226279	Los Angeles County
351859	Ordering, Referring, Prescribing	N/A	1922108448	0	0	HALEY, ELEANOR Z	5/17/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	D39804	N/A	N/A	N/A	N/A	N/A	1300 BANCROFT AVE	#202	SAN LEANDRO	CA	94577	5147	00	06000	37.72690979	-122.1477291	Alameda County
351867	Ordering, Referring, Prescribing	N/A	1922119734	0	0	HAKIM, MARGRETTE F PA	6/4/2018	Taxonomy not applicable	NA	n/a	000	Unknown	PA16819	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
351900	Ordering, Referring, Prescribing	N/A	1922198399	0	0	HAMMOND, BEATRIZ	4/23/2017	Taxonomy not applicable	NA	n/a	000	Unknown	15430	N/A	N/A	N/A	N/A	N/A	901 W ORANGETHORPE AVE	None	FULLERTON	CA	92832	2826	00	06000	33.85940147	-117.939735	Orange County
351911	Ordering, Referring, Prescribing	N/A	1922195700	0	0	HANRAHAN, JEFFERY D MD	9/17/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A80476	N/A	N/A	N/A	N/A	N/A	815 DR MARTIN LUTHER KIN	None	BAKERSFIELD	CA	93307	1365	00	06000	35.3655	-118.985202	Kern County
351928	Ordering, Referring, Prescribing	N/A	1922272707	0	0	HOWELL, THOMAS MD	2/16/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A109350	N/A	N/A	N/A	N/A	N/A	9727 ELK GROVE FLORIN RD	None	ELK GROVE	CA	95624	2264	00	06000	38.404503	-121.370994	Sacramento County
351994	Ordering, Referring, Prescribing	N/A	1922397959	0	0	HOM, JEFFREY MD MPH	3/21/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A123865	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
351997	Ordering, Referring, Prescribing	N/A	1922398320	0	0	HACKETT, LAUREN K MD	5/27/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A114224	N/A	N/A	N/A	N/A	N/A	23521 PASEO DE VALENCIA	STE 200	LAGUNA HILLS	CA	92653	3101	00	06000	33.61113028	-117.7126684	Orange County
352034	Ordering, Referring, Prescribing	N/A	1922456862	0	0	HOLT, TAWNY L LMFT	9/9/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	128160	N/A	N/A	N/A	N/A	N/A	1266 14TH ST	None	OAKLAND	CA	94607	2247	00	06000	37.81022696	-122.2887619	Alameda County
352035	Ordering, Referring, Prescribing	N/A	1922459684	0	0	HALE, CARLOS R LMFT	2/14/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	131173	N/A	N/A	N/A	N/A	N/A	2500 E FOOTHILL BLVD	STE 300	PASADENA	CA	91107	7102	00	06000	34.14979547	-118.097982	Los Angeles County
352043	Ordering, Referring, Prescribing	N/A	1922450568	0	0	HUITZIL, JEANNINE MSW LCSW	12/16/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW89017	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
352058	Ordering, Referring, Prescribing	N/A	1922487776	0	0	HERTZBERG, ARIELLE M LMFT	6/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	109465	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
352090	Ordering, Referring, Prescribing	N/A	1922523182	0	0	HERRERA, KARLA M NP	6/6/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95005457	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
352092	Ordering, Referring, Prescribing	N/A	1922533850	0	0	HERNANDEZ, ABIGAIL K LCSW	12/9/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW106046	N/A	N/A	N/A	N/A	N/A	10 INDEPENDENCE CIR	None	CHICO	CA	95973	0381	00	06000	39.77093631	-121.8750587	Butte County
352094	Ordering, Referring, Prescribing	N/A	1922534007	0	0	HOMEN, ABBEY E LMFT	3/22/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	125044	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
352105	Ordering, Referring, Prescribing	N/A	1922543479	0	0	HAKHVERDYAN, ANI	1/7/2025	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	152531	N/A	N/A	N/A	N/A	N/A	15339 SATICOY ST	None	VAN NUYS	CA	91406	3345	00	06000	34.2084865	-118.4678505	Los Angeles County
352122	Ordering, Referring, Prescribing	N/A	1922569276	0	0	HENDRA, KALEN MD	3/28/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL741	N/A	N/A	N/A	N/A	N/A	747 52ND ST	None	OAKLAND	CA	94609	1809	00	06000	37.83734639	-122.2672128	Alameda County
352128	Ordering, Referring, Prescribing	N/A	1922583467	0	0	HERNANDEZ, MARLENE LCSW	10/1/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	29624	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
352129	Ordering, Referring, Prescribing	N/A	1922582832	0	0	HADILAKSONO, ANNA J NP	2/26/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010045	N/A	N/A	N/A	N/A	N/A	3596 SKYWAY DR	None	SANTA MARIA	CA	93455	2502	00	06000	34.89460852	-120.437766	Santa Barbara County
352130	Ordering, Referring, Prescribing	N/A	1922583814	0	0	HAKIM, DALIA	2/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	76848	N/A	N/A	N/A	N/A	N/A	3400 CALLOWAY DR	SUITE 302 EXPRESS PHARM.	BAKERSFIELD	CA	93312	2513	00	06000	35.39110123	-119.1097878	Kern County
352144	Ordering, Referring, Prescribing	N/A	1922614056	0	0	HORN, TRACEY CNP	9/4/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95015368	N/A	N/A	N/A	N/A	N/A	14550 HAYNES ST	None	VAN NUYS	CA	91411	1613	00	06000	34.18967817	-118.4506446	Los Angeles County
352145	Ordering, Referring, Prescribing	N/A	1922619881	0	0	HANLEY, OLIVIA P LCSW	1/2/2025	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW127975	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
352167	Ordering, Referring, Prescribing	N/A	1922680032	0	0	HAYMAN, CHELSEA	3/11/2025	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A201641	N/A	N/A	N/A	N/A	N/A	1001 POTRERO AVE	None	SAN FRANCISCO	CA	94110	0000	00	06000	37.75548534	-122.4065362	San Francisco County
352178	Ordering, Referring, Prescribing	N/A	1922713932	0	0	HASAN, ASHJAN DDS	2/29/2024	Taxonomy not applicable	NA	n/a	000	Unknown	109919	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
352208	Ordering, Referring, Prescribing	N/A	1922869254	0	0	HERBOLD, LILY A NP	1/10/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95028652	N/A	N/A	N/A	N/A	N/A	616 16TH ST	None	OAKLAND	CA	94612	1205	00	06000	37.80726295	-122.2743035	Alameda County
352212	Ordering, Referring, Prescribing	N/A	1932112190	0	0	HO, HAORAN MD	1/23/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A51701	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
352213	Ordering, Referring, Prescribing	N/A	1922883289	0	0	HUIZENGA, SARAH LCSW	6/17/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	110303	N/A	N/A	N/A	N/A	N/A	224 E 6TH ST	None	LOS ANGELES	CA	90014	2119	00	06000	34.04431784	-118.2485849	Los Angeles County
352216	Ordering, Referring, Prescribing	N/A	1932109204	0	0	HUCKABY, BONNIE S PA-C	8/2/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA61444	N/A	N/A	N/A	N/A	N/A	1971 E 4TH ST	200	SANTA ANA	CA	92705	3917	00	06000	33.7482685	-117.83934	Orange County
352228	Ordering, Referring, Prescribing	N/A	1932182334	0	0	HENRY-HOYT, SUSAN M NP	1/3/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	12717	N/A	N/A	N/A	N/A	N/A	1920 MEMORIAL DRIVE	None	CERES	CA	95307	1827	00	06000	37.600146	-120.961042	Stanislaus County
352232	Ordering, Referring, Prescribing	N/A	1932187457	0	0	HOLUM, ROBERT J LMFT	4/28/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	40503	N/A	N/A	N/A	N/A	N/A	1035 MARKET ST	STE 400	SAN FRANCISCO	CA	94103	1600	00	06000	37.78152549	-122.4111668	San Francisco County
352284	Ordering, Referring, Prescribing	N/A	1932310109	0	0	HOPKINS, JEFFREY C PHARMD	11/21/2018	Taxonomy not applicable	NA	n/a	000	Unknown	APH10422	N/A	N/A	N/A	N/A	N/A	3257 FOLSOM BLVD	None	SACRAMENTO	CA	95816	5220	00	06000	38.567835	-121.4643735	Sacramento County
352286	Ordering, Referring, Prescribing	N/A	1932318185	0	0	HUERTA, AMELIA M MSW LCSW	6/22/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW17630	N/A	N/A	N/A	N/A	N/A	7200 BANCROFT AVE	SUITE 125D	OAKLAND	CA	94605	2410	00	06000	37.768221	-122.17608	Alameda County
352292	Ordering, Referring, Prescribing	N/A	1932347739	0	0	HIGUERA, HILDA T LMFT	2/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	114911	N/A	N/A	N/A	N/A	N/A	4444 CALLE REAL	None	SANTA BARBARA	CA	93110	1002	00	06000	34.44240122	-119.7765542	Santa Barbara County
352310	Ordering, Referring, Prescribing	N/A	1932392206	0	0	HERBERGER, RICHARD W NP	5/26/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	591226	N/A	N/A	N/A	N/A	N/A	811 W TELEGRAPH RD	None	SANTA PAULA	CA	93060	3009	00	06000	34.33991633	-119.08577	Ventura County
352313	Ordering, Referring, Prescribing	N/A	1932398864	0	0	HIKIDA, PATRICIA M LMFT	6/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT42225	N/A	N/A	N/A	N/A	N/A	401 W CIVIC CENTER DR	STE # 100	SANTA ANA	CA	92701	4515	00	06000	33.75157353	-117.870921	Orange County
352321	Ordering, Referring, Prescribing	N/A	1932411097	0	0	HARLEY, ELIZA K PHD	4/1/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY25209	N/A	N/A	N/A	N/A	N/A	4650 SUNSET BLVD	MS 150	LOS ANGELES	CA	90027	6062	00	06000	34.09813032	-118.2901794	Los Angeles County
352326	Ordering, Referring, Prescribing	N/A	1932417722	0	0	HER, TXONG PA-C	4/4/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA21115	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
352365	Ordering, Referring, Prescribing	N/A	1932493699	0	0	HERNANDEZ, ERWIN C PA	8/10/2022	Taxonomy not applicable	NA	n/a	000	Unknown	PA21379	N/A	N/A	N/A	N/A	N/A	13193 CENTRAL AVE	100	CHINO	CA	91710	4179	00	06000	34.01406506	-117.6891684	San Bernardino County
352381	Ordering, Referring, Prescribing	N/A	1932523503	0	0	HERRERA RAMIREZ, JOSEFINA LMFT	4/5/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	146220	N/A	N/A	N/A	N/A	N/A	9412 BIG HORN BLVD	None	ELK GROVE	CA	95758	1101	00	06000	38.415861	-121.407957	Sacramento County
352423	Ordering, Referring, Prescribing	N/A	1932577426	0	0	HANG, JANNETTE N OD	6/8/2019	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT33387	N/A	N/A	N/A	N/A	N/A	13197 CENTRAL AVE.	101	CHINO	CA	91710	4178	00	06000	34.013781	-117.689161	San Bernardino County
352427	Ordering, Referring, Prescribing	N/A	1932583101	0	0	HONARBAKHT, HENGAMEH PHARMD	5/21/2019	Taxonomy not applicable	NA	n/a	000	Unknown	RPH68238	N/A	N/A	N/A	N/A	N/A	19307 SATICOY ST	None	RESEDA	CA	91335	0000	00	06000	34.20838149	-118.5542325	Los Angeles County
352446	Ordering, Referring, Prescribing	N/A	1932609054	0	0	HAYTOGLU, TAHIR MD	9/22/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A72482	N/A	N/A	N/A	N/A	N/A	3400 DOUGLAS BLVD	STE 225	ROSEVILLE	CA	95661	4283	00	06000	38.74390969	-121.2319271	Placer County
352450	Ordering, Referring, Prescribing	N/A	1932611183	0	0	HOANG, VAN ANH Q PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH80596	N/A	N/A	N/A	N/A	N/A	600 LONG BEACH BLVD	None	LONG BEACH	CA	90802	1321	00	06000	33.774372	-118.189284	Los Angeles County
352454	Ordering, Referring, Prescribing	N/A	1932621901	0	0	HORVATH, ANGELA LCSW	2/23/2022	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	107057	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
352458	Ordering, Referring, Prescribing	N/A	1932625928	0	0	HOOLIHAN, ERIN C PSYD	10/21/2021	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	32938	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
352561	Ordering, Referring, Prescribing	N/A	1932797560	0	0	HUYNH, JESSICA PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	83967	N/A	N/A	N/A	N/A	N/A	1430 EASTLAKE PKWY	None	CHULA VISTA	CA	91915	1926	00	06000	32.62994867	-116.9650465	San Diego County
352564	Ordering, Referring, Prescribing	N/A	1932809084	0	0	HOAC, DONNA RN BS	9/25/2022	Taxonomy not applicable	NA	n/a	000	Unknown	764900	N/A	N/A	N/A	N/A	N/A	880 S LEMON AVE	None	WALNUT	CA	91789	2931	00	06000	33.9999117	-117.8550964	Los Angeles County
352577	Ordering, Referring, Prescribing	N/A	1932871514	0	0	HUANG, ZHANHUANG PHARMD	8/31/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH85000	N/A	N/A	N/A	N/A	N/A	2690 MISSION ST	None	SAN FRANCISCO	CA	94110	3102	00	06000	37.75405301	-122.4186463	San Francisco County
352579	Ordering, Referring, Prescribing	N/A	1932891124	0	0	HENRY, KYLE NP	5/19/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95025257	N/A	N/A	N/A	N/A	N/A	14550 HAYNES ST	None	VAN NUYS	CA	91411	4116	00	06000	34.18967817	-118.4506446	Los Angeles County
352615	Ordering, Referring, Prescribing	N/A	1942287180	0	0	HAYES, CARL E MD	5/26/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G66485	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
352641	Ordering, Referring, Prescribing	N/A	1942342019	0	0	HUNTER, JENNIFER E LMFT	4/14/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51112	N/A	N/A	N/A	N/A	N/A	1330 W RAMSEY ST	None	BANNING	CA	92220	4477	00	06000	33.92538854	-116.8912035	Riverside County
352642	Ordering, Referring, Prescribing	N/A	1942348255	0	0	HANNA, LAILA MD	12/15/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A52175	N/A	N/A	N/A	N/A	N/A	1911 W GLENOAKS BLVD STE	None	GLENDALE	CA	91201	4746	00	06000	34.17434179	-118.2939072	Los Angeles County
352663	Ordering, Referring, Prescribing	N/A	1942375340	0	0	HINOKI, KEIKO I	2/5/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49869	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
352697	Ordering, Referring, Prescribing	N/A	1942464243	0	0	HERNANDEZ-PAZ, ARMANDO LMFT	12/31/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77377	N/A	N/A	N/A	N/A	N/A	17707 STUDEBAKER RD	202	CERRITOS	CA	90703	2640	00	06000	33.87008991	-118.0991298	Los Angeles County
352711	Ordering, Referring, Prescribing	N/A	1942499702	0	0	HULL, DAWN L LMFT	5/11/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT47856	N/A	N/A	N/A	N/A	N/A	12625 HEACOCK ST	None	MORENO VALLEY	CA	92553	0538	00	06000	33.936957	-117.2438195	Riverside County
352728	Ordering, Referring, Prescribing	N/A	1942542816	0	0	HACKETT, EMMA MD	2/25/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A143573	N/A	N/A	N/A	N/A	N/A	3429 RENNER DR	None	FORTUNA	CA	95540	3429	00	06000	40.58254803	-124.1353014	Humboldt County
352787	Ordering, Referring, Prescribing	N/A	1942634092	0	0	HURTADO, ITZURI A LMFT	4/6/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT116055	N/A	N/A	N/A	N/A	N/A	2415 UNIVERSITY AVE	300	EAST PALO ALTO	CA	94303	1164	00	06000	37.47232529	-122.139568	San Mateo County
352788	Ordering, Referring, Prescribing	N/A	1942634159	0	0	HILARIO, DODJIE S NP	6/22/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	644612	N/A	N/A	N/A	N/A	N/A	1330 W RAMSEY ST	None	BANNING	CA	92220	4477	00	06000	33.92538854	-116.8912035	Riverside County
352795	Ordering, Referring, Prescribing	N/A	1942643655	0	0	HYOUN, SARA MD	8/12/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A135684	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
352822	Ordering, Referring, Prescribing	N/A	1942686407	0	0	HER, JIEUN PHARMD	7/19/2021	Taxonomy not applicable	NA	n/a	000	Unknown	79808	N/A	N/A	N/A	N/A	N/A	3339 E ANAHEIM ST	None	LONG BEACH	CA	90804	4032	00	06000	33.78262848	-118.15317	Los Angeles County
352825	Ordering, Referring, Prescribing	N/A	1942689823	0	0	HARO, BRENDA LCSW	1/5/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW120062	N/A	N/A	N/A	N/A	N/A	1303 SAN CARLOS AVE	None	SAN CARLOS	CA	94070	0320	00	06000	37.50572931	-122.2621879	San Mateo County
352839	Ordering, Referring, Prescribing	N/A	1942713854	0	0	HUYNH, THIEN THU PHARMD	8/30/2021	Taxonomy not applicable	NA	n/a	000	Unknown	72667	N/A	N/A	N/A	N/A	N/A	918 E. FOOTHILL BLVD	None	RIALTO	CA	92313	3636	00	06000	34.10679947	-117.352134	San Bernardino County
352851	Ordering, Referring, Prescribing	N/A	1942724224	0	0	HUL-GALASEK, LARISSA LMFT	5/19/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT126063	N/A	N/A	N/A	N/A	N/A	2440 6TH ST	None	EUREKA	CA	95501	0788	00	06000	40.80368802	-124.1456878	Humboldt County
352874	Ordering, Referring, Prescribing	N/A	1942759261	0	0	HWANG, YUNAH NP	3/5/2019	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95002964	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
352896	Ordering, Referring, Prescribing	N/A	1942796586	0	0	HUSSEN, NEBAT N MD	3/7/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A173394	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
352943	Ordering, Referring, Prescribing	N/A	1942932447	0	0	HUANG, STEVEN DDS	8/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	107761	N/A	N/A	N/A	N/A	N/A	1520 STOCKTON ST	None	SAN FRANCISCO	CA	94133	3354	00	06000	37.79989786	-122.4090369	San Francisco County
352949	Ordering, Referring, Prescribing	N/A	1942937990	0	0	HARRAH, DIANA C RN	1/12/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95131626	N/A	N/A	N/A	N/A	N/A	11115 C ST	None	ARMONA	CA	93202	7730	00	06000	36.312084	-119.7070005	Kings County
352951	Ordering, Referring, Prescribing	N/A	1942942875	0	0	HEDGES, JAELYN D LCSW	12/2/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	127532	N/A	N/A	N/A	N/A	N/A	8019 COMPTON AVE	None	LOS ANGELES	CA	90001	3409	00	06000	33.9664185	-118.2477481	Los Angeles County
352963	Ordering, Referring, Prescribing	N/A	1942982426	0	0	HIATT, JOSEPH NP	7/21/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026252	N/A	N/A	N/A	N/A	N/A	1276 HALYARD DR	None	WEST SACRAMENTO	CA	95691	3412	00	06000	38.573118	-121.5501275	Yolo County
352978	Ordering, Referring, Prescribing	N/A	1952036568	0	0	HALL, MAURA L	10/14/2022	Taxonomy not applicable	NA	n/a	000	Unknown	61797	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
353012	Ordering, Referring, Prescribing	N/A	1952320418	0	0	HARVEY, CAROL A LMFT	9/13/2023	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	27229	N/A	N/A	N/A	N/A	N/A	120 4TH ST	None	PETALUMA	CA	94953	8800	00	06000	38.23193608	-122.6376314	Sonoma County
353021	Ordering, Referring, Prescribing	N/A	1952343139	0	0	HITCHCOCK, ROBERT J MD	3/5/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	174605	N/A	N/A	N/A	N/A	N/A	1315 S ADAMS ST	None	FORT WORTH	TX	76104	4444	00	06000	32.72994159	-97.33672572	Tarrant County
353037	Ordering, Referring, Prescribing	N/A	1952431751	0	0	HOICHI, MAKIKO MSW LCSW	11/6/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24300	N/A	N/A	N/A	N/A	N/A	108 WEST VICTORIA STREET	None	GARDENA	CA	90248	3523	00	06000	33.86509452	-118.2762279	Los Angeles County
353052	Ordering, Referring, Prescribing	N/A	1952453789	0	0	HADDAD, ISSAC M	9/20/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A90074	N/A	N/A	N/A	N/A	N/A	2990 E. COLORADO BLVD	105C	PASADENA	CA	91107	4463	00	06000	34.1461666	-118.0884437	Los Angeles County
353076	Ordering, Referring, Prescribing	N/A	1952477796	0	0	HARRIS, JUDY L NP	7/1/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	395081	N/A	N/A	N/A	N/A	N/A	1140 WEST MISSION RD	None	SAN MARCOS	CA	92069	1415	00	06000	33.151851	-117.178731	San Diego County
353079	Ordering, Referring, Prescribing	N/A	1952520066	0	0	HUDDLESTON, DEANA R LMFT	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	MFT40675	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
353080	Ordering, Referring, Prescribing	N/A	1952527319	0	0	HODARI, KAFELE T MD	6/26/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A104470	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
353082	Ordering, Referring, Prescribing	N/A	1952515959	0	0	HAM, DAVID A MD	9/2/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A94899	N/A	N/A	N/A	N/A	N/A	72-630 FRED WARING DR	SUITE 101	PALM DESERT	CA	92260	5004	00	06000	33.728697	-116.4008512	Riverside County
353083	Ordering, Referring, Prescribing	N/A	1952532624	0	0	HERNANDEZ, LILIANA PSYD	11/17/2019	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY27002	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
353085	Ordering, Referring, Prescribing	N/A	1952540213	0	0	HOYT, LESLIE A PHD	1/13/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY13209	N/A	N/A	N/A	N/A	N/A	10535 ROAD 35	None	MADERA	CA	93636	8487	00	06000	36.90376264	-119.9101802	Madera County
353102	Ordering, Referring, Prescribing	N/A	1952578007	0	0	HANNI, LORNA J LMFT	12/2/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT53191	N/A	N/A	N/A	N/A	N/A	11512 B AVE	None	AUBURN	CA	95603	2605	00	06000	38.93969517	-121.1046397	Placer County
353140	Ordering, Referring, Prescribing	N/A	1952654477	0	0	HICKS, JENNIFER L LMFT	4/15/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	104006	N/A	N/A	N/A	N/A	N/A	2434 MILVIA ST	OFFICE B	BERKELEY	CA	94704	1918	00	06000	37.86415096	-122.2699204	Alameda County
353150	Ordering, Referring, Prescribing	N/A	1952675712	0	0	HEDWALL, VAN LMFT	6/4/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49868	N/A	N/A	N/A	N/A	N/A	1005 ATLANTIC AVE.	None	ALAMEDA	CA	94501	1148	00	06000	37.78080326	-122.2676078	Alameda County
353199	Ordering, Referring, Prescribing	N/A	1952752792	0	0	HERNANDEZ, BRENDA LCSW	10/16/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW118675	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
353223	Ordering, Referring, Prescribing	N/A	1952790016	0	0	HILLER, ALDEN M LCSW	5/23/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW115442	N/A	N/A	N/A	N/A	N/A	600 G ST	None	UNION CITY	CA	94587	2400	00	06000	37.59996226	-122.0201927	Alameda County
353258	Ordering, Referring, Prescribing	N/A	1952841173	0	0	HARRELL, AAMBER LMFT	6/21/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	119555	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
353261	Ordering, Referring, Prescribing	N/A	1952851065	0	0	HARA, KYLE LPCC	8/20/2020	Taxonomy not applicable	NA	n/a	000	Unknown	LPCC5158	N/A	N/A	N/A	N/A	N/A	13 PETER BEHR DR	None	SAN RAFAEL	CA	94903	5216	00	06000	37.99870164	-122.5339219	Marin County
353270	Ordering, Referring, Prescribing	N/A	1952857633	0	0	HUNT, ROBERT M PHARMD	3/22/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH74935	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
353287	Ordering, Referring, Prescribing	N/A	1952881088	0	0	HALL, MICHELLE LCSW	1/3/2023	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW112947	N/A	N/A	N/A	N/A	N/A	661 ROBERTS LN	None	BAKERSFIELD	CA	93308	4723	00	06000	35.40859551	-119.033532	Kern County
353290	Ordering, Referring, Prescribing	N/A	1952889537	0	0	HATANAKA, FRANK H PHARMD	2/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	25725	N/A	N/A	N/A	N/A	N/A	916 E CYPRESS AVE	None	REDDING	CA	96002	1033	00	06000	40.57107148	-122.3550405	Shasta County
353301	Ordering, Referring, Prescribing	N/A	1952915779	0	0	HONG, ELLEN PHARMD	7/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH69853	N/A	N/A	N/A	N/A	N/A	495 E HOLT AVE	None	POMONA	CA	91767	5539	00	06000	34.06259846	-117.7425045	Los Angeles County
353319	Ordering, Referring, Prescribing	N/A	1952950776	0	0	HASHEM, SHIVA DC	10/2/2018	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	26269	N/A	N/A	N/A	N/A	N/A	1121 E WASHINGTON AVE	None	ESCONDIDO	CA	92025	2214	00	06000	33.13236227	-117.0691443	San Diego County
353327	Ordering, Referring, Prescribing	N/A	1952960452	0	0	HENRY, TANYA B PHARMD	7/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	53201	N/A	N/A	N/A	N/A	N/A	2400 N SEPULVEDA BLVD	None	MANHATTAN BEACH	CA	90266	2914	00	06000	33.89386589	-118.3959255	Los Angeles County
353387	Ordering, Referring, Prescribing	N/A	1962088724	0	0	HELFAND, ELANA DO	1/22/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL2027	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
353401	Ordering, Referring, Prescribing	N/A	1962145359	0	0	HANG, SAMBO A DPM	2/12/2024	Taxonomy not applicable	NA	n/a	027	PODIATRISTS	7043	N/A	N/A	N/A	N/A	N/A	975 SERENO DR	None	VALLEJO	CA	94589	2441	00	06000	38.12828446	-122.24821	Solano County
353406	Ordering, Referring, Prescribing	N/A	1962167213	0	0	HWANG, AMY Y PHARMD	1/31/2022	Taxonomy not applicable	NA	n/a	000	Unknown	85485	N/A	N/A	N/A	N/A	N/A	2781 W OLYMPIC BLVD	None	LOS ANGELES	CA	90006	2632	00	06000	34.05269749	-118.294083	Los Angeles County
353422	Ordering, Referring, Prescribing	N/A	1962262204	0	0	HOBBS, BROOKE MD	9/20/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	PTL16504	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
353464	Ordering, Referring, Prescribing	N/A	1962534594	0	0	HOLCOMB BRACKIN, TRACY A LMFT	11/18/2019	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT49212	N/A	N/A	N/A	N/A	N/A	4900 SERRANIA AVE	None	WOODLAND HILLS	CA	91364	3301	00	06000	34.15843077	-118.5882436	Los Angeles County
353519	Ordering, Referring, Prescribing	N/A	1962652131	0	0	HENNEMAN-LOW, JANE NP	3/28/2016	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	288127	N/A	N/A	N/A	N/A	N/A	1850 SPRING RIDGE DRIVE	None	SUSANVILLE	CA	96130	6100	00	06000	40.43814074	-120.6259249	Lassen County
353527	Ordering, Referring, Prescribing	N/A	1962656348	0	0	HOLLIS, NILA NP	6/26/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95003349	N/A	N/A	N/A	N/A	N/A	5776 STONERIDGE MALL RD	SUITE 300	PLEASANTON	CA	94588	2832	00	06000	37.69272221	-121.9305836	Alameda County
353528	Ordering, Referring, Prescribing	N/A	1962673780	0	0	HARRIS, ALICIA LCSW	2/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW24849	N/A	N/A	N/A	N/A	N/A	12625 HESPERIA RD	None	VICTORVILLE	CA	92395	7720	00	06000	34.48058899	-117.2907353	San Bernardino County
353537	Ordering, Referring, Prescribing	N/A	1962695320	0	0	HORSTMANN, MELANIE A LCSW	1/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW64379	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
353555	Ordering, Referring, Prescribing	N/A	1962732313	0	0	HOBBS, RICK A LMFT	6/3/2018	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT87589	N/A	N/A	N/A	N/A	N/A	1801 PANORAMA DR	None	BAKERSFIELD	CA	93305	1219	00	06000	35.407539	-118.972026	Kern County
353560	Ordering, Referring, Prescribing	N/A	1962743245	0	0	HOLTON, LAKISHA M NP	11/18/2020	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95010235	N/A	N/A	N/A	N/A	N/A	7000 MICHAEL CANLIS WAY	None	FRENCH CAMP	CA	95231	9781	00	06000	37.8826497	-121.2974852	San Joaquin County
353586	Ordering, Referring, Prescribing	N/A	1962770560	0	0	HUANG, SHERRY W PHARMD	3/8/2021	Taxonomy not applicable	NA	n/a	000	Unknown	65977	N/A	N/A	N/A	N/A	N/A	13652 CANTARA ST	None	PANORAMA CITY	CA	91402	0000	00	06000	34.21980849	-118.4301135	Los Angeles County
353587	Ordering, Referring, Prescribing	N/A	1962748681	0	0	HURST, MELINDA B	5/29/2013	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN0833201	N/A	N/A	N/A	N/A	N/A	11722 S WILMINGTON AVE	None	LOS ANGELES	CA	90059	2543	00	06000	33.9267675	-118.2390104	Los Angeles County
353588	Ordering, Referring, Prescribing	N/A	1962776302	0	0	HAYS, JENNIFER LMFT	3/16/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	106527	N/A	N/A	N/A	N/A	N/A	11175 SAN PABLO AVE	EL CERRITO CA 94530	EL CERRITO	CA	94530	2157	00	06000	37.91926262	-122.31424	Contra Costa County
353598	Ordering, Referring, Prescribing	N/A	1962777813	0	0	HOANG, EVELYN-ANH T PHARMD	4/11/2022	Taxonomy not applicable	NA	n/a	000	Unknown	46679	N/A	N/A	N/A	N/A	N/A	1099 E HOSPITALITY LN	None	SAN BERNARDINO	CA	92408	2813	00	06000	34.06887134	-117.2625206	San Bernardino County
353607	Ordering, Referring, Prescribing	N/A	1962784074	0	0	HA, THO PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	57779	N/A	N/A	N/A	N/A	N/A	128 S STATE COLLEGE BLVD	None	ANAHEIM	CA	92806	2921	00	06000	33.840252	-117.889103	Orange County
353672	Ordering, Referring, Prescribing	N/A	1962866335	0	0	HARUTYUNYAN, ARTAK PHARMD	2/23/2023	Taxonomy not applicable	NA	n/a	000	Unknown	74264	N/A	N/A	N/A	N/A	N/A	621 E. GLENOAKS BLVD	STE C	GLENDALE	CA	91207	1775	00	06000	34.1583091	-118.2483405	Los Angeles County
353718	Ordering, Referring, Prescribing	N/A	1962951681	0	0	HUME, RICHARD K DC	7/31/2023	Taxonomy not applicable	NA	n/a	006	CHIROPRACTORS	20632	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
353719	Ordering, Referring, Prescribing	N/A	1962954925	0	0	HERNANDEZ, ZULEMA PHARMD	8/28/2021	Taxonomy not applicable	NA	n/a	000	Unknown	75332	N/A	N/A	N/A	N/A	N/A	1760 STORY RD	None	SAN JOSE	CA	95122	1921	00	06000	37.34121313	-121.8410221	Santa Clara County
353734	Ordering, Referring, Prescribing	N/A	1962987594	0	0	HALEY, GEORGE F	4/7/2022	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	132141	N/A	N/A	N/A	N/A	N/A	2247 COTTONWOOD CT	None	HANFORD	CA	93230	7252	00	06000	36.35328279	-119.6314792	Kings County
353824	Ordering, Referring, Prescribing	N/A	1972137057	0	0	HSU, KRISTY K PHARMD	3/29/2022	Taxonomy not applicable	NA	n/a	000	Unknown	82145	N/A	N/A	N/A	N/A	N/A	2700 PARK AVE	None	TUSTIN	CA	92782	1391	00	06000	33.69923603	-117.821646	Orange County
353840	Ordering, Referring, Prescribing	N/A	1972185445	0	0	HUANG, DAVID PHARMD	5/21/2021	Taxonomy not applicable	NA	n/a	000	Unknown	84369	N/A	N/A	N/A	N/A	N/A	12110 INDUSTRIAL BLVD	None	JACKSON	CA	95642	0000	00	06000	0	0	None
353861	Ordering, Referring, Prescribing	N/A	1972243061	0	0	HUSSAIN, KHADIJAH T MD	9/17/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A189142	N/A	N/A	N/A	N/A	N/A	4094 4TH AVENUE	None	SAN DIEGO	CA	92103	2143	00	06000	32.75153771	-117.161688	San Diego County
353877	Ordering, Referring, Prescribing	N/A	1972285864	0	0	HAN-KHAMPRASEUTH, SHERINA NP	7/20/2023	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95026242	N/A	N/A	N/A	N/A	N/A	2740 S. ELM AVENUE	None	FRESNO	CA	93706	5435	00	06000	36.70101129	-119.7908643	Fresno County
353921	Ordering, Referring, Prescribing	N/A	1972635902	0	0	HERRERA, LYNDA C LMFT	2/17/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	77478	N/A	N/A	N/A	N/A	N/A	205 PASADENA AVENUE	None	SOUTH PASADENA	CA	91030	2919	00	06000	34.11219143	-118.1709685	Los Angeles County
353938	Ordering, Referring, Prescribing	N/A	1972659191	0	0	HESSLING, THOMAS A MD	1/31/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G39433	N/A	N/A	N/A	N/A	N/A	7850 VISTA HILL AVE	None	SAN DIEGO	CA	92123	2717	00	06000	32.79493052	-117.155268	San Diego County
353944	Ordering, Referring, Prescribing	N/A	1972670826	0	0	HOWITT, LORETTA Y MD	7/27/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	G60887	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
353961	Ordering, Referring, Prescribing	N/A	1972713808	0	0	HWANG, CHIH-WEI DDS	7/31/2023	Taxonomy not applicable	NA	n/a	000	Unknown	53603	N/A	N/A	N/A	N/A	N/A	9123 SLAUSON AVE	None	PICO RIVERA	CA	90660	0660	00	06000	33.97019868	-118.1020891	Los Angeles County
353983	Ordering, Referring, Prescribing	N/A	1972761211	0	0	HELBIG, GREGORY M MD	5/16/2018	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A114866	N/A	N/A	N/A	N/A	N/A	4016 DALE ROAD	None	MODESTO	CA	95356	9268	00	06000	37.69723812	-121.049967	Stanislaus County
353985	Ordering, Referring, Prescribing	N/A	1972763365	0	0	HOBSON, CONNIE D LCSW	6/3/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	72954	N/A	N/A	N/A	N/A	N/A	2625 ZANKER RD	None	SAN JOSE	CA	95134	2130	00	06000	37.38865356	-121.9250552	Santa Clara County
354001	Ordering, Referring, Prescribing	N/A	1972798239	0	0	HATCH, MEREDITH J LCSW	11/18/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW28183	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
354067	Ordering, Referring, Prescribing	N/A	1972891679	0	0	HASSAS, AZITA R MD	7/8/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A108511	N/A	N/A	N/A	N/A	N/A	661 W 1ST STREET	G	TUSTIN	CA	92780	2939	00	06000	33.74578153	-117.831231	Orange County
354073	Ordering, Referring, Prescribing	N/A	1972909133	0	0	HARWOOD, MIRANDA P LCSW	3/30/2019	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	83132	N/A	N/A	N/A	N/A	N/A	604 ROSE AVE	None	VENICE	CA	90291	2767	00	06000	33.99891527	-118.4714129	Los Angeles County
354084	Ordering, Referring, Prescribing	N/A	1972925873	0	0	HONEYMAN, CHRISTENA M PHARMD	7/26/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH44584	N/A	N/A	N/A	N/A	N/A	8005 EL CAMINO REAL	None	ATASCADERO	CA	93422	5211	00	06000	35.47712859	-120.6559822	San Luis Obispo County
354094	Ordering, Referring, Prescribing	N/A	1972931475	0	0	HOPSICKER, RACHEL PHD	2/16/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY28487	N/A	N/A	N/A	N/A	N/A	1236 CHAPALA STREET	None	SANTA BARBARA	CA	93101	3116	00	06000	34.42310529	-119.7066629	Santa Barbara County
354098	Ordering, Referring, Prescribing	N/A	1972938579	0	0	HERNANDEZ, PRISCILLA L LCSW	2/26/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90762	N/A	N/A	N/A	N/A	N/A	1160 S GRAND AVE	None	GLENDORA	CA	91740	5000	00	06000	34.11736533	-117.8725213	Los Angeles County
354107	Ordering, Referring, Prescribing	N/A	1972946564	0	0	HUNG, LI-CHI V MD	7/19/2016	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A134077	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
354121	Ordering, Referring, Prescribing	N/A	1972964559	0	0	HAMZEH, RAZAN Z DDS	7/25/2016	Taxonomy not applicable	NA	n/a	099	DENTIST	100361	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
354154	Ordering, Referring, Prescribing	N/A	1982005898	0	0	HAMILTON, KRISTY L LCSW	5/1/2017	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	61600	N/A	N/A	N/A	N/A	N/A	7451 N LANKERSHIM BLVD	None	NORTH HOLLYWOOD	CA	91605	2803	00	06000	34.20616081	-118.3878161	Los Angeles County
354186	Ordering, Referring, Prescribing	N/A	1982064218	0	0	HOUSE, CATHERINE LMFT	6/30/2021	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT31259	N/A	N/A	N/A	N/A	N/A	5266 HOLLISTER AVE	211	GOLETA	CA	93111	2037	00	06000	34.43497016	-119.8071895	Santa Barbara County
354193	Ordering, Referring, Prescribing	N/A	1982070355	0	0	HUERTA, ELISE LCSW	4/12/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW90328	N/A	N/A	N/A	N/A	N/A	11080 W OLYMPIC BLVD	None	LOS ANGELES	CA	90064	1937	00	06000	34.04036814	-118.4376056	Los Angeles County
354198	Ordering, Referring, Prescribing	N/A	1982074480	0	0	HERNANDEZ, SAMANTHA M LCSW	6/4/2024	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW122962	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
354213	Ordering, Referring, Prescribing	N/A	1982108635	0	0	HART, TRAVIS P MD	3/20/2021	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A163741	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
354240	Ordering, Referring, Prescribing	N/A	1982153060	0	0	HA, THANH LMFT	1/15/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	105813	N/A	N/A	N/A	N/A	N/A	3282 ADELINE ST	None	BERKELEY	CA	94703	2439	00	06000	37.84898491	-122.2715711	Alameda County
354243	Ordering, Referring, Prescribing	N/A	1982157301	0	0	HOSMAN, REBEKAH PA	4/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	PA59417	N/A	N/A	N/A	N/A	N/A	5400 RALSTON ST	None	VENTURA	CA	93003	0000	00	06000	34.25974984	-119.2179337	Ventura County
354249	Ordering, Referring, Prescribing	N/A	1982167375	0	0	HOROWITZ, ISAAC DO	9/9/2023	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	20038	N/A	N/A	N/A	N/A	N/A	441 E YOSEMITE AVE	None	MADERA	CA	93638	3631	00	06000	36.96460804	-120.055598	Madera County
354250	Ordering, Referring, Prescribing	N/A	1982169348	0	0	HUFFMAN, CHERYL A PT	7/24/2019	Taxonomy not applicable	NA	n/a	025	PHYSICAL THERAPISTS	PT26223	N/A	N/A	N/A	N/A	N/A	1133 W SYCAMORE ST	None	WILLOWS	CA	95988	2601	00	06000	39.5205105	-122.2082775	Glenn County
354266	Ordering, Referring, Prescribing	N/A	1982191433	0	0	HUANG, SHENG HSIANG PHARMD	11/2/2021	Taxonomy not applicable	NA	n/a	000	Unknown	RPH78113	N/A	N/A	N/A	N/A	N/A	6521 VAN NUYS BLVD	None	VAN NUYS	CA	91401	1425	00	06000	34.189497	-118.448759	Los Angeles County
354316	Ordering, Referring, Prescribing	N/A	1982270401	0	0	HSU, ETHAN W MD	4/15/2024	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A193086	N/A	N/A	N/A	N/A	N/A	335 E AVENUE I	None	LANCASTER	CA	93535	1916	00	06000	34.7041113	-118.1247548	Los Angeles County
354324	Ordering, Referring, Prescribing	N/A	1982311015	0	0	HENRY, ALAINA NP	10/28/2022	Taxonomy not applicable	NA	n/a	000	Unknown	95023152	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
354364	Ordering, Referring, Prescribing	N/A	1982659082	0	0	HANSA, SAHAPHUN MD	4/23/2018	Taxonomy not applicable	NA	n/a	000	Unknown	G70534	N/A	N/A	N/A	N/A	N/A	3838 SAN DIMAS ST	BUILDING A, SUITE 250	BAKERSFIELD	CA	93301	2284	00	06000	35.3946385	-119.008203	Kern County
354398	Ordering, Referring, Prescribing	N/A	1982737201	0	0	HUTSON, ELIZABETH W LMFT	2/3/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	LMFT45220	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
354419	Ordering, Referring, Prescribing	N/A	1982785507	0	0	HARRIS, ROBERT LCSW	8/25/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW76920	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
354424	Ordering, Referring, Prescribing	N/A	1982795589	0	0	HSIEH, CHIA-WEN PSYD	3/3/2020	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	21314	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
354432	Ordering, Referring, Prescribing	N/A	1982821179	0	0	HERNANDEZ, SILVIA LMFT	2/18/2020	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51787	N/A	N/A	N/A	N/A	N/A	3025 BEYER BLVD	E-101	SAN DIEGO	CA	92154	3432	00	06000	32.57279741	-117.0656603	San Diego County
354486	Ordering, Referring, Prescribing	N/A	1982925582	0	0	HANNA, CHRISTINE M PHARMD	4/13/2022	Taxonomy not applicable	NA	n/a	000	Unknown	57305	N/A	N/A	N/A	N/A	N/A	3560 W CENTURY BLVD	None	INGLEWOOD	CA	90303	1201	00	06000	33.942825	-118.333431	Los Angeles County
354538	Ordering, Referring, Prescribing	N/A	1992005219	0	0	HASSAN, RANDA	4/26/2022	Taxonomy not applicable	NA	n/a	000	Unknown	60952	N/A	N/A	N/A	N/A	N/A	1700 S BRADLEY RD	None	SANTA MARIA	CA	93454	8001	00	06000	34.92801184	-120.4200671	Santa Barbara County
354549	Ordering, Referring, Prescribing	N/A	1992032627	0	0	HOFFMANN, KIMBERLY A PHARMD	3/30/2020	Taxonomy not applicable	NA	n/a	000	Unknown	42635	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
354574	Ordering, Referring, Prescribing	N/A	1992064893	0	0	HENDERSON, BLAKE T MD	10/31/2014	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A128571	N/A	N/A	N/A	N/A	N/A	2525 GEARY BLVD	M160	SAN FRANCISCO	CA	94117	3358	00	06000	37.78246242	-122.4448129	San Francisco County
354589	Ordering, Referring, Prescribing	N/A	1992086243	0	0	HERNANDEZ, AMANDA E LCSW	6/24/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	93384	N/A	N/A	N/A	N/A	N/A	1650-K LAS PLUMAS AVE	None	SAN JOSE	CA	95133	1657	00	06000	37.36163624	-121.8663794	Santa Clara County
354626	Ordering, Referring, Prescribing	N/A	1992139166	0	0	HALPERIN, TAMARA PSYD	11/23/2022	Taxonomy not applicable	NA	n/a	031	PSYCHOLOGISTS	PSY30575	N/A	N/A	N/A	N/A	N/A	3002 ARMSTRONG ST	None	SAN DIEGO	CA	92111	5702	00	06000	32.80043242	-117.165431	San Diego County
354637	Ordering, Referring, Prescribing	N/A	1992158513	0	0	HIROSE, TAD PHARMD	11/10/2019	Taxonomy not applicable	NA	n/a	000	Unknown	44051	N/A	N/A	N/A	N/A	N/A	3400 WHITTIER BLVD	None	LOS ANGELES	CA	90023	1708	00	06000	34.02767826	-118.2008037	Los Angeles County
354663	Ordering, Referring, Prescribing	N/A	1992206015	0	0	HAWKES, TREVOR C NP	3/6/2024	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95019157	N/A	N/A	N/A	N/A	N/A	47915 OASIS ST	None	INDIO	CA	92201	6950	00	06000	33.701508	-116.220908	Riverside County
354692	Ordering, Referring, Prescribing	N/A	1992254544	0	0	HOVSEPIAN, MARIE D PHARMD	4/13/2021	Taxonomy not applicable	NA	n/a	000	Unknown	73859	N/A	N/A	N/A	N/A	N/A	43112 15TH ST W	None	LANCASTER	CA	93534	6219	00	06000	34.66467	-118.1567445	Los Angeles County
354699	Ordering, Referring, Prescribing	N/A	1992278949	0	0	HAGHNEGAHDAR, MARYAM	7/12/2022	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A180416	N/A	N/A	N/A	N/A	N/A	501 S IDAHO ST	100	LA HABRA	CA	90631	6047	00	06000	33.927525	-117.959216	Orange County
354706	Ordering, Referring, Prescribing	N/A	1992287486	0	0	HERNANDEZ, VALERIE RN	9/24/2017	Taxonomy not applicable	NA	n/a	000	Unknown	801981	N/A	N/A	N/A	N/A	N/A	3100 ACTIS RD	None	BAKERSFIELD	CA	93309	5911	00	06000	35.326998	-119.052223	Kern County
354707	Ordering, Referring, Prescribing	N/A	1992290779	0	0	HUR, CHRISTINE OD	2/27/2022	Taxonomy not applicable	NA	n/a	020	OPTOMETRISTS	OPT33982	N/A	N/A	N/A	N/A	N/A	3255 WILSHIRE BLVD	STE 100	LOS ANGELES	CA	90010	1404	00	06000	34.0618166	-118.2932612	Los Angeles County
354753	Ordering, Referring, Prescribing	N/A	1992380810	0	0	HAMILTON, AMY M LMFT	1/8/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	144263	N/A	N/A	N/A	N/A	N/A	28 W ARRELLAGA ST	None	SANTA BARBARA	CA	93101	6514	00	06000	34.42634973	-119.7103983	Santa Barbara County
354754	Ordering, Referring, Prescribing	N/A	1992376636	0	0	HUONG, CRYSTAL	6/30/2021	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	95017700	N/A	N/A	N/A	N/A	N/A	2705 S DIAMOND BAR BLVD	STE 100	DIAMOND BAR	CA	91765	3557	00	06000	33.97580639	-117.8361676	Los Angeles County
354802	Ordering, Referring, Prescribing	N/A	1992587018	0	0	HILLO, BRIANA E PHARMD	10/12/2023	Taxonomy not applicable	NA	n/a	000	Unknown	88750	N/A	N/A	N/A	N/A	N/A	1110 W ALAMEDA AVE	None	BURBANK	CA	91506	2806	00	06000	34.16282395	-118.3142996	Los Angeles County
354817	Ordering, Referring, Prescribing	N/A	1992776207	0	0	HENSCHEL, MARGARET A CNM	2/11/2014	Taxonomy not applicable	NA	n/a	005	CERTIFIED NURSE MIDWIFE	RN693807	N/A	N/A	N/A	N/A	N/A	316 NORTH MAIN STREET	None	SALINAS	CA	93901	2855	00	06000	36.682749	-121.6533777	Monterey County
354841	Ordering, Referring, Prescribing	N/A	1992837421	0	0	HAGER, CYNTHIA L LCSW	6/30/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	15516	N/A	N/A	N/A	N/A	N/A	3333 E. AMERICAN AVE	None	FRESNO	CA	93725	9247	00	06000	36.66341855	-119.7304116	Fresno County
354844	Ordering, Referring, Prescribing	N/A	1992838569	0	0	HERNANDEZ, MARIA T LCSW	7/7/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW19928	N/A	N/A	N/A	N/A	N/A	800 SCENIC DR	None	MODESTO	CA	95350	6131	00	06000	37.64722447	-120.9836925	Stanislaus County
354856	Ordering, Referring, Prescribing	N/A	1992852305	0	0	HARRY, JONATHAN MD MPH	9/2/2020	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	A69582	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
354878	Ordering, Referring, Prescribing	N/A	1992879399	0	0	HOFFMAN, RICHARD L MD	7/19/2017	Taxonomy not applicable	NA	n/a	026	PHYSICIANS	C28338	N/A	N/A	N/A	N/A	N/A	201 S ALVARADO ST	828	LOS ANGELES	CA	90057	2320	00	06000	34.06417777	-118.2719543	Los Angeles County
354909	Ordering, Referring, Prescribing	N/A	1992961726	0	0	HERRERA, JUDITH P LMFT	2/12/2024	Taxonomy not applicable	NA	n/a	077	MARRIAGE AND FAMILY THERAPIST INDIVIDUAL	51610	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
354910	Ordering, Referring, Prescribing	N/A	1992955207	0	0	HANDLEY, RENEE LCSW	4/5/2020	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	71389	N/A	N/A	N/A	N/A	N/A	1830 S CENTRAL ST	None	VISALIA	CA	93277	4418	00	06000	36.314271	-119.311362	Tulare County
354915	Ordering, Referring, Prescribing	N/A	1992962385	0	0	HERNANDEZ, LORENA LCSW	7/28/2021	Taxonomy not applicable	NA	n/a	070	LICENSED CLINICAL SOCIAL WORKER INDIVIDUAL	LCSW22441	N/A	N/A	N/A	N/A	N/A	10400 FRICOT CITY RD	None	SAN ANDREAS	CA	95249	9642	00	06000	38.17354088	-120.5345257	Calaveras County
354925	Ordering, Referring, Prescribing	N/A	1992990782	0	0	HANNAH, SHIRLEY E NP	11/1/2022	Taxonomy not applicable	NA	n/a	007	CERTIFIED NURSE PRACTIONER	16128	N/A	N/A	N/A	N/A	N/A	15301 TYLER FOOTE RD	None	NEVADA CITY	CA	95959	9318	00	06000	39.36622661	-121.0368658	Nevada County