Ann Kathleen Jamgochian, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP10575 Issued in CA

Practice address

205 South St
Fort Bragg, CA 95437-5540

Phone

(707) 964-1251

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redwood Empire Dermatology Inc

  • Specialist
  • Santa Rosa, CA
  • NPI 1154496248
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1295873941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-964-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-964-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMGOCHIAN",
        "first_name": "ANN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP10575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CA147118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Ben Housel III, MD
• Huckleberry Transportation, LLC
• Integrated Care Management Solutions
• Mei Lin M Jackson
• Linda K James, M.D.
• Jason D Moore
• Richard William Jaulus, LCSW
• Charles C Jenkins, MD
• John a. Kermen, D.O.
• Marty Christine Johnson, L.M.F.T. CA.

• Family Nurse Practitioner in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.