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Gabriel, Fred 718785 Suspended - Medi-Cal Suspended and Ineligible Provider List 1


Gabriel, Fred 718785 Suspended



320 Shady Ln. indefinitely effective



Apt. #15 8/18/2011



El Cajon, CA





Gadsby, Vynola E. 238618 Suspended

aka: Gadsby, Eileen indefinitely effective

386 Carleton 4/6/2004

Claremont, CA

Gadson, Elizabeth Ann 420554 Suspended

3109 Seacrest Ave. indefinitely effective

Unit N1 12/22/2006

Marina, CA

Gaitan, Isabel Monterrosa Suspended

159 Tiffany Ave. indefinitely effective

Unit #3 10/23/1996

San Francisco, CA

Galbreath, Marsha Faye 525493 Suspended

622 Katella Ave. indefinitely effective

Apt. #152 1/19/2012

Stanton, CA

Gallaway, Mary Oliver 575397 Suspended

P.O. Box 1449 indefinitely effective

Choctaw, OK 4/1/201

Gallea, Michelle Ann 538074 Suspended

1440 Calhoun Ct. indefinitely effective

Ste. D 1/20/2003

Hemet, CA

Registered Nurse Provider

Numbers

Gamez, Robin Lynn RNE392162 Suspended

aka: Shackles, Robin indefinitely effective

Lynn 3/20/1998

1640 Don Pedro Rd.

Ceres, CA

Garcia, Charlotte Lynette 493242 Suspended

470 Rancho La Mirada indefinitely effective

Escondido, CA 2/27/2003

Garcia, Dolores 518294 Suspended

15734 E. Atglen St. indefinitely effective

Hacienda Heights, CA 10/2/2006

Garcia, Joselito B. 461597 Suspended

aka: Joselito Gracia indefinitely effective

aka: Joselito Jay 3/12/2008

aka: Joseph Belista

aka: Lilto Garcia

aka: Lito Garcia

aka: Joselito Belista Garcia

aka: Joselito Belista

aka: Jay Garcia

aka: Joseph Garcia

49 Capp St.

San Francisco, CA

Garcia, Kelli Sue 518281 Suspended



6450 Camino del Parque indefinitely effective



Carlsbad, CA 8/8/2011





Gardner, Janet Lynne 493255 Suspended

Bledsoe indefinitely effective

641 Cordelia Cir. 3/8/2001

Vacaville, CA

Gardner, Susan Diane 362064 Suspended

Mitch indefinitely effective

2502 Sawgrass St. 9/22/2011

El Cajon, CA

Garibaldi, Eugene 53460 Suspended

aka: Eugene Frank indefinitely effective

Garibaldi 1/27/2012

aka: Eugene Frank

Garibaldi Jr.

30225 River Rd.

Cloverdale, CA
Registered Nurse Provider

Numbers

Garley, Jacquelyn Marie 260393 Suspended

aka: Wegienka, indefinitely effective

Jacquelyn Marie 4/22/2000

aka: Wegienka Garley,

Jacquelyn Marie

32743 Jean Dr.

Union City, CA

Garlock, Clark Steven RN271142 Suspended

P.O. Box 1023 indefinitely effective

Fortuna, CA 6/17/1999

Garlock, Clark Steven 271142 Suspended

General Delivery indefinitely effective

Fortuna, CA 5/20/1999

Garner, Charmaine CA570834 Suspended

McCoy RN108798 indefinitely effective

8840 Bazemore Rd. TN108798 3/20/2008

Cordova, TN

Garner, Jeanette Katherine Suspended

aka: Bender, Jeanette K. indefinitely effective

1609 N. Wilson Way 4/20/1998

Stockton, CA

Garrett, Virginia Ila 543848 Suspended

249 Magellan Dr. indefinitely effective

Sarasota, FL 1/27/2012
Garza, Kimberly Ann 560568 Suspended

12888 Valley Crest Dr. indefinitely effective

Oakdale, CA 6/18/2011

Gasparini, Cheryl Ann 476749 Suspended

aka: Cheryl Ann Mitchener indefinitely effective

215 E. Haven Ave. 5/20/2012

Arcadia, CA
Gassner, Terry Lee 202926 Suspended

aka: Terry Lee Payseno indefinitely effective

aka: Terry Lee Gross 12/28/2011

6349 Wine Ct.

Alta Loma, CA
Gates, Cynthia Dora 481898 Suspended

12208 410th St. Ct. E. indefinitely effective

Eatonville, WA 7/24/2006

Registered Nurse Provider

Numbers

Gatten, Anne Marie CA633770 Suspended

523 Meadowvale Dr. AZRN115949 indefinitely effective

Orlando, FL 4/21/2008

Gaule, John Francis 383146 Suspended



aka: Richard Brother indefinitely effective



Gaule 9/14/2011



1232 Carlsbad Pl.



Ventura, CA



Gauthier, Rochelle Lee 588424 Suspended

aka: Gauthier, Rochelle indefinitely effective

Williams 1/5/2006

4051 Bayou Rapides Rd.

Apt. #906

Alexandria, LA

Gearhart, Diana Rae RN471092 Suspended

87091 Wakefield Ave. indefinitely effective

Panorama, CA 4/20/1999

Gentner-Gonzalez, 608158 Suspended

Barbara indefinitely effective

aka: Barbara Ann Gentner 11/10/2011

Gonzalez

3131 S.W. Isaac Ave.

Pendelton, OR

George, Anne Marie 550709 Suspended

6717 B. CA Ave. S.W. indefinitely effective

Seattle, WA 11/15/2004

George, Diane 481913 Suspended

Elizabeth indefinitely effective

aka: Diane Elizabeth 12/23/2008

Oliverson

809 W. Lincoln Ave.

Woodland, CA

Gerbino, Laurie Suspended

aka: Gerbinoduldulao, indefinitely effective

Laurie 5/5/1997

1011 Shenencodk Way

Roseville, CA

Registered Nurse Provider

Numbers

Geronilla, Candace Lynn 590777 Suspended

aka: Candace Johnson indefinitely effective

aka: Candace Ramirez 11/4/2011

aka: Candace Muriel

8000 W. Spring Mountain Rd.

Unit #1025

Las Vegas, NV

etzen, Rita Jane 413012 Suspended

P.O. Box 814 indefinitely effective

Geyserville, CA 10/7/2004

Ghoush, Manal Saleem 574590 Suspended

Abu indefinitely effective

2860 W. Ball Rd. 4/19/2008

Unit G-3

Anaheim, CA

Gibbs, Laurie 698440 Suspended

aka: Laurie Ruth indefinitely effective

Strickland 7/6/2010

aka: Laurie Jennings

13465 Camino Canada

Ste. #106

PMB #217

El Cajon, CA

Giesbrecht, Nathan David 613855 Suspended

10582 French Meadows indefinitely effective

Way 12/2/2011

Reno, NV
Gilbert, Claudia 581306 Suspended

631 Ramona Ave. indefinitely effective

Apt. C 12/21/2010

Laguna Beach, CA

Gilich, Renee Michelle 660274 Suspended

8278 Station Village Ln. indefinitely effective

Unit #2903 1/6/2012

San Diego, CA
Gill, Scott Allen 577979 Suspended

390 Milroy Rd. indefinitely effective

New Columbia, PA 9/29/2010

Registered Nurse Provider

Numbers

Gill, Virginia Rose 334566 Suspended

13 Niguel Pointe Dr. indefinitely effective

Laguna Niguel, CA 12/20/1998

Gillespie, Darlene 190869 Suspended

aka: Franschilla, Darlene indefinitely effective

aka: Gammon, Darlene 8/4/2001

4815 Oceanaire St.

Oxnard, CA

Gillespie, Laurie Ann 541832 Suspended

aka: Laurie Ann Mohoney indefinitely effective

23745 San Estaban Dr. 12/24/2009

Mission Viejo, CA

Gilmore, Ricky Jay 497631 Suspended

6421 Tulagi St. indefinitely effective

Cypress, CA 2/4/2011

Ginnetti, John Michael 432799 Suspended

136 Oliver Rd. indefinitely effective

New Haven, CT 1/16/2002

Giovacchini, Michael Gino 283400 Suspended

618 Silver Rd. indefinitely effective

Valley Springs, CA 10/8/2000

Gish, Aerika Kohara Frye 556204 Suspended

aka: Gish, Aerika indefinitely effective

aka: Frye, Aerika 9/20/2006

aka: Kohara, Aerika

144 Hollywood Ave.

Oxnard, CA

Glanfield, David Edward 648518-CA Suspended

aka: David E. Glanfield 177363-CO indefinitely effective

1630 G St. 3/20/2012

Apt. B

Sacramento, CA

Registered Nurse Provider

Numbers

Glenn, Jennifer Nell 524331 Suspended

351 S. Monte Vista St. indefinitely effective

Unit #11 12/28/2011

La Harbra, CA
Gloria, Donna Marie 682003 Suspended

841 S. Center St. indefinitely effective

Pedro, CA 6/6/2011
Glover, Jessica Nadine 737348 Suspended

826 4th Terrace W. indefinitely effective

Birmingham, AL 5/12/2011

Glover, Marion Ethel RN108344 Suspended

aka: Glover, Marion E. indefinitely effective

P.O. Box 33 8/20/1998

Grizzly Flats, CA

Gluzman, Alexander 512189 Suspended

16425 Napa St. indefinitely effective

North Hills, CA 10/7/2004

Godsey, Robert Denver 573719 Suspended

619 N. Gale Hill indefinitely effective

Lindsay, CA 7/14/2004
Goebel, Laure Marie Y326400 Suspended

585 Hollyburne Ln. indefinitely effective

Thousand Oaks, CA 2/9/2002

Goff Bartlett, Susan B. 384324 Suspended

aka: Goff, Susan B. indefinitely effective

aka: Bartlett, Susan A. 9/20/2000

149 Castle Rock

Apt. #1

Woodlake, CA

Registered Nurse Provider

Numbers

Goldgruber, Gail Louise 365273 Suspended

aka: Arnold, Gail Louis indefinitely effective

801 Alvarez Ave. 5/20/1998

Unit #13-1

Pinole, CA

Gill, Virginia Rose 334566 Suspended

13 Niguel Pointe Dr. indefinitely effective

Laguna Niguel, CA 12/20/1998

Glynn, Maree Agnes L. 456655 Suspended

aka: Maree Glynn indefinitely effective

1221 Mills Ave. 1/27/2012

Modesto, CA
Godfrey, Robert Lee 419399 Suspended

11763 Canton Pl. indefinitely effective

Studio City, CA 1/26/2012
Goller, Christine Elaine 341986 Suspended

5249 Colodny Dr. indefinitely effective

Unit #4 7/7/2005

Agoura Hills, CA

Gomez, Eugene Dizon 683900 Suspended

17914 Los Pesos Cir. indefinitely effective

Fountain Valley, CA 1/3/2010

Gomez, Lorena Vallejo not provided Suspended

aka: Lorena Vallejo Llanos indefinitely effective

613 S. La Verne Ave. 1/19/2012

Unit #12

Los Angeles, CA

Gonano Lovell Hunt, 358970 Suspended

Kimberly Elizabeth indefinitely effective

aka: Hunt, Kimberly Elizabeth 10/22/2004

aka: Rates, Kimberly Elizabeth

aka: Gonano, Kimberly Elizabeth

aka: Lovely, Kimberly Elizabeth

2441 El Cajon Way

Oxnard, CA

Registered Nurse Provider

Numbers

Gongora, Guadalupe 332860 Suspended

13905 Walnut Way indefinitely effective

Clearlake Way, CA 3/23/2006

Gonsalves, Natalia RN379013 Suspended

543 34th Ave. indefinitely effective

San Francisco, CA 3/20/1999

Gonzales, Pedro Roy L 647781 Suspended

242 E. 14th St. indefinitely effective

Chicago, IL 6/13/2011
Gonzalez, Kathleen 443873 Suspended

5462 N. Fresno St. indefinitely effective

Unit #105 11/23/2008

Fresno, CA

Gonzalez, Lillian 600501-CA Suspended

613 Coastal Dreams Ave. 40812-NV indefinitely effective

Las Vegas, CA 11/12/2010

Gonzalez, Maria Amalia 622233 Suspended

aka: Yasmin Beltran indefinitely effective

aka: Maria Amalia Alcala 12/3/2009

845 E. Arrow Hwy.

Pomona, CA

and

43935 2nd St. E.

Lancaster, CA

Registered Nurse Provider

Numbers

Gooch, Russell Lee 588556 Suspended

2269 Chestnut St. indefinitely effective

Unit #154 6/26/2007

San Francisco, CA

Goodwin, Sandra Louise Suspended

aka: Read, Sandra Louise indefinitely effective

Burley, Sandra Louise 10/16/1997

6089 Evelyn Ave.

Rohnert Park, CA

Gordon, Marie 528270 Suspended

3203 N. Marengo Ave. indefinitely effective

Altadena, CA 11/5/2009

Gosnell-Chambers, 566102 Suspended

Gabrielle indefinitely effective

3942 Regatta Dr. 9/17/2010

Discovery Bay, CA

Goss, James Jefferson 505653 Suspended

1933 E. Vassar Ave. indefinitely effective

Visalia, CA 10/20/2011
Goss, Janice Faith 604660-CA Suspended

aka: Janice Faith Farris 516843-TX indefinitely effective

P.O. Box 435 5/19/2011

Sulphur Springs, TX

Gotelli, Christine Anne 411619 Suspended

aka: Bussey, Christine 44323 indefinitely effective

P.O. Box 207 8/22/2003

Orinda, CA

Gott, Bianca Leigh 557989 Suspended

aka: Bianca Leigh Shockley indefinitely effective

6322 N. Marina Pacifica Dr. 3/21/2008

Long Beach, CA

Registered Nurse Provider

Numbers

Goulette, Billy Jean 493374 Suspended

609 Terry Lynn Pl. indefinitely effective

Long Beach, CA 9/14/2005

Graham, Janie Louise 547233 Suspended

aka: Janie Louise Wood indefinitely effective

Graham 12/7/2011

465 Transom Ln.

Foster City, CA
Graham, Shelby Jean 399412 Suspended

8207 Sawyer Brown Rd. indefinitely effective

Unit N-1 5/20/00

Nashville, TN

Graves, Jeffrey Scott 592399 Suspended

4084 Summer Gate Ave. indefinitely effective

Vallejo, CA 6/17/2006

Graves, Rhonda Lynn 592398 Suspended

aka: Brown, Rhonda indefinitely effective

Lynn 6/17/2006

4084 Summer Gate Ave.

Vallejo, CA

Gray, Dana Sue RN334143 Suspended

aka: Armbrust, Dana Sue indefinitely effective

c/o Office of the Public 3/19/1999

Defender

4200 Orange St.

Riverside, CA

Greco, Rose M. 505594 Suspended

aka: Rose Marie Gecco indefinitely effective

aka: Rose Marie Wilson 7/8/2010

2010 Country Club Ln.

Unit #65

Oceanside, CA

Registered Nurse Provider

Numbers

Green, Syndi Ann RN443903 Suspended

aka: Baker, Cynthia Anne indefinitely effective

327 W. Wilson 4/1/1999

Unit #26

Costa Mesa, CA

Greene, Kenneth 727582 Suspended

Wayne Jr. indefinitely effective

1120 E. Twiggs St. 2/2/2011

Unit #322

Tampa, FL

Greenwood, Karen 612909 Suspended

Calvina indefinitely effective

aka: Karen Calvina Elliott 12/20/2011

936 9th St.

Orange Cove, CA

Griddine, William Erwin 462978 Suspended

13961 Oxnard Blvd. indefinitely effective

Unit #37 3/1/2002

Van Nuys, CA

Grieco, Michelle 541908 Suspended

aka: Michelle McConnell indefinitely effective

403 E. Sussex Way 4/7/2011

Fresno, CA

Griffin, Beverly S. 402983 Suspended

25849 Delphinium Ave. indefinitely effective

Moreno Valley, CA 4/15/2009

Registered Nurse Provider

Numbers

Griffin, John Joseph 475739 Suspended

6575 Paseo Frontera indefinitely effective

Apt. F 1/25/2010

Carlsbad, CA

Griffis, Julie Lynn 518995 Suspended

aka: Julie Lynn Hartman indefinitely effective

30206 Hillside Ter. 12/7/2010

San Juan Capistrano, CA

Grillet, Kendra 495924 Suspended

aka: Kendra Lynna indefinitely effective

Holloway 10/18/2010

aka: Kendra Lynna

Tunison

587 Calle Sequoia

Thousand Oaks, CA

Grimes, Stacy Lou 416052 Suspended

9700 Park Terrace Dr. indefinitely effective

Unit #47 2/1/2008

Santee, CA

Grimm, Artith Loann 41139 Suspended

aka: Davidson, Artith RN351915 indefinitely effective

LoAnn 351915 10/28/1999 (old date)

2405 Riedal Way 4/20/2000 (new date date)

Modesto, CA

and

65 Eastmoor Ave.

Apt. #2

Daly City, CA

Registered Nurse Provider

Numbers

Grimm, Glenn Christian 559879 Suspended

273 Plains Ct. indefinitely effective

Galt, CA 7/18/2007

Groendyke, Diana Lynne 706017 Suspended

232 Shadow Mountain Cir. indefinitely effective

Gardnerville, NV 7/30/2011
Groover, Lena R. 551520 Suspended

aka: Lena Remay indefinitely effective

Groover 7/2/2010

aka: Lena Ramay

Groover

25690 Crenshaw Blvd.

Torrance, CA

Grube, Stephanie Ann 503907 Suspended

16625 Quinnault Rd. indefinitely effective

Apple Valley, CA 5/6/2005

Grudus, Edward Michael 501563 Suspended

213 Noe St. indefinitely effective

San Francisco, CA 2/23/2007

Grupp, Judith Ann 206261 Suspended

aka: Judith Ann Silver indefinitely effective

316 S. 19th St. 11/28/2011

San Jose, CA
Guardi, Krista Marie 677276 Suspended

3912 Laurel Canyon Blvd. indefinitely effective

Apt. #105 2/2/2011

Studio City, CA
Guaydacan, Farrah 590398 Suspended

Suzzanne indefinitely effective

aka: Farrah Guaydacan 3/13/2009

aka: Farrah Lewis

3368 E. Hampton Way

Fresno, CA

Gufler, Christina 562102 Suspended

Margaret indefinitely effective

756 Mimosa Blvd. 9/22/2010

Apt. A8

Roswell, GA

Registered Nurse Provider

Numbers

Guill, Deborah Smith 664265 Suspended

4147 Whitmell School Rd. indefinitely effective

Dry Fork, VA 11/15/2011

Gultia, Jesse Sumalde 631276 Suspended

aka: Jesusito Sumalde indefinitely effective

Gultia 12/29/2011

2991 Crestmoor Dr.

San Bruno, CA
Gunkel, George Frederick 436255 Suspended

179 Flood Ave. indefinitely effective

San Francisco, CA 7/8/2000

Gunter, Alric Victor 593457 Suspended

820 County Rd. indefinitely effective

Unit #1578 7/7/2005

Baileytown, AL

Gunthner, Maureen 527476 Suspended

Kathryn indefinitely effective

13981 Azalea Ave. 12/21/2006

Poway, CA

Gurrola, Arthur 159381 Suspended

4670 E. Illinois Ave. indefinitely effective

Fresno, CA 7/8/2004

Gustafson, Debra Jean 482058 Suspended

1426 Meadow Lark Way indefinitely effective

Yuba City, CA 3/7/2004
2014-07-19 18:44
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