Alliance Mobile Nursing Practitioner Inc

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

ALLIANCE MOBILE NURSING PRACTITIONER INC

Practice address

4579 Maple Ave Ste 1
La Mesa, CA 91941-3154

Phone

(760) 481-9946

Fax

(760) 560-2369

NPI assigned

Dec 26, 2023

Last updated

May 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jackie Van DO

Title

Ceo/Owner

Phone

(858) 380-6983

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jackie Van DO, FNP

  • Family Nurse Practitioner
  • San Marcos, CA
  • NPI 1356925283
  Medicare reassignment NPD

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1629847140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PALMAC ST",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691315",
            "telephone_number": "760-481-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 MAPLE AVE STE 1",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413154",
            "telephone_number": "760-481-9946",
            "fax_number": "760-560-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE MOBILE NURSING PRACTITIONER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-26",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "VAN DO",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "858-380-6983"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Allen
• David Ryan Allen, MA, BCBA
• Forrest B. Allen, MD
• Sharronda Allen, BCBA
• Alliance Home Health-Inc
• Alliance Retina Consultants, Inc
• Elizabeth Carol Allman, M.A., BCBA
• Ziad Allos, M.D.
• Ronda Alpatty
• Lindsey Stroben Alper, PHD

• Primary Care Nurse Practitioner in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.