Jessica Nicole Vanderkallen, P.A-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21848 Issued in CA

Practice address

7777 Milliken Ave
Rancho Cucamonga, CA 91730-6780

Phone

(909) 948-8050

NPI assigned

Oct 5, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jessica.vanderkallen@ran.eclinicaldirectplus.com

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1861776049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 MILLIKEN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306780",
            "telephone_number": "909-948-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 MILLIKEN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306780",
            "telephone_number": "909-948-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKALLEN",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geraldine Valmonte, FNP-C
• Chloe Alexandria Valmore, MSW
• Ilyanna Van Essen
• Kimberly Anne Van Genderen
• Addison Breann Vandegrift
• Vanessa Peterson, DDS, Ms, PC
• Christopher J Vansuch, O.D.
• Vanura Homehealth Services, Inc.
• Vivica Victorio Vaquilar
• Vanessa Mary Vardayou, FNP

• Physician Assistant in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.