2272 Fashion Ave

							Medi-Cal Suspended and Ineligible Provider List - August Update

ADDITIONS:

Physician (susp A)

Harris, Darryl Clarence    G88191-CA    Suspended
2625 W. Alameda Ave.       L3676-TX     indefinitely effective
Unit #412                  1982644415   7/15/2012
Burbank, CA
and
2126 S. La Brea
Unit #104
Los Angeles, CA

Schaller, Douglas Alvin,   G61159       Suspended
M.D.                       00G611590    indefinitely effective
1455 Crenshaw Blvd.        00G611591    2/29/2012
Ste. #110                  00G611592
Torrance, CA               00G611593
and
1437 Lomita Blvd.
Harbor City, CA
and
333 N. Prairie Ave.
Inglewood, CA
and
10044 Westminister Ave.
Garden Grove, CA
and
P.O. Box 1811
Tustin, CA


Psychologist (susp C)

Eibl, John F.              PSY15585     Suspended
P.O. Box 1215                           indefinitely effective
Paso Robles, CA                         6/1/2012

Martinez-Romero, Sergio    PSY15419     Suspended
11238 East Ave. R6                      indefinitely effective
Littlerock, CA                          9/17/2011

Thompson, Linda            PSY16656     Suspended
4540 Marloma Dr.                        indefinitely effective
Rolling Hills Estate, CA                10/12/2011


Sick Room Supply (susp F)

Audcon Group of            DME03370F    Suspended
Companies                  1144335589   indefinitely effective
Alex Uche – Owner                       7/15/2012
4703 Brooks St.
Montclair, CA


Dentist (susp G)

Omrani, Behdad             52443        Suspended
1271 Granville Ave.        D52443       indefinitely effective
Unit #202                  G87939-01    7/4/2012
Los Angeles, CA            1356526750


Acupuncturist (susp I)

Lam, Kam Man               AC329        Suspended
320 Yale Ave.              AC0003290    indefinitely effective
Claremont, CA              1437281722   4/19/2012
and
1528 Highpoint St.
Upland, CA
Chiropractor (susp J)

Bowser, Larry Kreig         11273        Suspended
aka: Larry K. Bowser        DC0112730    indefinitely effective
18333 Bear Valley Rd.                    5/11/2012
Hesperis, CA
and
P.O. Box 308
Apple Valley, CA

Klassy, Thomas Michael      23031        Suspended
295 Main St.                DC0230310    indefinitely effective
Weed, CA                    1245217884   5/30/2012

Simmons, Drew Phillip       DC25099      Suspended
650 Larkfield Center                     indefinitely effective
Ste. A-4                                 2/18/2012
Santa Rosa, CA


Laboratory Owner/Operator (susp M)

Adjian, Vahan                            Suspended
Community Labs Inc.                      indefinitely effective
18946 Granada Cir.                       7/4/2012
Porter Ranch, CA


Home Health Aide (susp P)

Bell, Taneshula             144993       Suspended
13572 Cheshire St.                       indefinitely effective
Victorville, CA                          2/28/2012

Ohringer, Sara H.           221711       Suspended
7319 Hazeltine Ave.                      indefinitely effective
Apt. #17                                 5/20/2012
Van Nuys, CA

Onofre, Rubi                219169       Suspended
P.O. Box 53                              indefinitely effective
Watsonville, CA                          5/20/2012


Certified Nurse Assistant (susp R)

Bell, Taneshula             472593       Suspended
13572 Cheshire St.                       indefinitely effective
Victorville, CA                          2/28/2012

Chavez, Monica              730393       Suspended
5420 E. Grove Ave.                       indefinitely effective
Fresno, CA                               5/20/2012

Ferguson, Karrie            655207       Suspended
560 N. 4th St.                           indefinitely effective
Portola, CA                              5/20/2012

Garcia, Ricardo             766286       Suspended
551 California St.                       indefinitely effective
Portola, CA                              5/20/2012

Ohringer, Sara H.           723668       Suspended
7319 Hazeltine Ave.                      indefinitely effective
Apt. #17                                 5/20/2012
Van Nuys, CA

Onofre, Rubi                677304       Suspended
P.O. Box 53                              indefinitely effective
Watsonville, CA                          5/20/2012


Licensed Vocational Nurse (susp R)

Thomas, Larry Charles Jr.   219271       Suspended
1841 Brookside Ct.                       indefinitely effective
Yuba City, CA                            7/22/2012
Nurse Practitioner (susp R)

O'Brien, Laura May          6263           Suspended
aka: Laura O'Brien          NP Furnisher   indefinitely effective
aka: Laura Roa                             1/12/2012
aka: Laura May Cannon
P.O. Box 684
Oregon House, CA


Public Health Nurse (susp R)

Bischel, Maureen Ann        55725          Suspended
1556 W. Herndon                            indefinitely effective
Apt. #105                                  3/5/2012
Fresno, CA

O'Donnell, Stacie Noel     76241           Suspended
aka: Stacie Noel McConnell                 indefinitely effective
15356 Carfax Ave.                          12/30/2011
Bellflower, CA


Registered Nurse (susp R)

Addair, Michael Scott       656199         Suspended
Rte. 1 Box 235A                            indefinitely effective
Honaker, VA                                10/19/2011

Anderson, Janine M.         289444         Suspended
aka: Janine Marie Ross                     indefinitely effective
3200 W. Brenda Loop                        10/20/2011
Flagstaff, AZ

Anderson, Sharon Gail       760193         Suspended
7635 69th St. N.E.                         indefinitely effective
Marysville, WA                             12/16/2011

Austin, Judith Lynn         525173         Suspended
aka: Judith Lynn Zawacki                   indefinitely effective
25108 Marguerite Pkwy.                     10/11/2011
Unit A353
Mission Viejo, CA

Barry, Lisa Alice           698752         Suspended
aka: Lisa Alice Lombard                    indefinitely effective
aka: Lisa Alice Holbrook                   12/16/2011
315 Gay Rd.
Griffin, GA

Bartlett, Pamela Recene   559129           Suspended
aka: Pamela Recene Melzer                  indefinitely effective
11335 Pagosi Rd.                           4/10/2012
Apple Valley, CA

Bischel, Maureen Ann        519783         Suspended
1556 W. Herndon                            indefinitely effective
Apt. #105                                  3/5/2012
Fresno, CA

Biscocho, Glenda            628971         Suspended
Deguzman                                   indefinitely effective
P.O. Box 934                               5/20/2012
Depue, IL

Bradford, Melissa Renae     626642         Suspended
828 High St.                               indefinitely effective
Aberdeen, OH                               12/16/2011

Brooks, Roy Gregory         376716         Suspended
1303 S. Acacia St.                         indefinitely effective
Compton, CA                                7/14/2011

Bruus, Ann Elisabeth        582649         Suspended
aka: Ann Elisabeth                         indefinitely effective
Ledbetter                                  12/21/2011
513 Airel Ave.
Foley, AL
Registered Nurse (susp R) . . . (continued)

Byoune, Christina           549551            Suspended
Antoinette                                    indefinitely effective
aka: Christina Antoinette                     1/27/2012
Logan
aka: Christina Antoinette
Burton
7795 Antelope Rd.
Unit #5
Citrus Heights, CA

Caporuscio, Elizabeth       511906            Suspended
Lynn                                          indefinitely effective
3101 Peninsula Rd.                            11/23/2011
Unit #214
Oxnard, CA

Casper, Diann               372313            Suspended
aka: Diann Lynn Casper                        indefinitely effective
1772 E. Palm Beach Dr                         10/28/2011
Chandler, AZ

Cathey, Beverly Dianne     677505             Suspended
aka: Beverly Bailey Cathey                    indefinitely effective
3614 Tonkins St.                              9/16/2011
Greensboro, NC
and
360 E. Erna Ave.
Apt. J
La Habra, CA

Celvi, Lynn Marie           668561            Suspended
aka: Lynn Marie Thomas                        indefinitely effective
13210 Uvas Rd.                                9/16/2011
Lot #20
Morgan Hill, CA

Chornomud, Barbara Lynn     389323            Suspended
9631 Innsbruck Dr                             indefinitely effective
Huntington Beach, CA                          11/23/2011

Christian, Brenda Gail      636067            Suspended
2530 Carriage Ln.                             indefinitely effective
Apt. #1A                                      11/4/2011
Fredericksburg, VA

Cruz, Reynaldo D. Dela      648036            Suspended
1215 W. Resecrans Ave.                        indefinitely effective
Unit #26                                      1/27/2012
Gardena, CA

Culver, Brenda Suzanne      498605            Suspended
P.O. Box 437                                  indefinitely effective
Moorpark, CA                                  12/28/2011

Dailey, Nadine Evelyn       443433            Suspended
aka: Nadine Combs                             indefinitely effective
855 Hartzell Ave.                             1/27/2012
Redlands, CA

Daoang, Joycelynn           370420            Suspended
Geronimo                                      indefinitely effective
aka: Joycelynn Daoang                         12/28/2011
Geronimo
aka: Joycelynn Josephine
Geronimo Daoang
aka: Josephine Daoang
P.O. Box 5344
Carson, CA

Dell'Amico, Mary Lynn       691877            Suspended
7 Judson Dr.                                  indefinitely effective
Montpelier, VT                                12/2/2011

Dillon, Charles Clyde       380405            Suspended
1301 N. Chester Ave.                          indefinitely effective
Pasadena, CA                                  7/13/2011
Registered Nurse (susp R) . . . (continued)

Dunn, Laura Mechelle          666693          Suspended
aka: Laura M Daughtry                         indefinitely effective
Dunn                                          12/16/2011
42 Pioneer Dr.
Seale, AL

Fabian, Maryann               531816          Suspended
aka: Mary Ann Fabian                          indefinitely effective
39 Park Ave.                                  12/21/2011
Binghamton, NY

Gassner, Terry Lee            202926          Suspended
aka: Terry Lee Payseno                        indefinitely effective
aka: Terry Lee Gross                          12/28/2011
6349 Wine Ct.
Alta Loma, CA

Giesbrecht, Nathan David      613855          Suspended
10582 French Meadows                          indefinitely effective
Way                                           12/2/2011
Reno, NV

Hall, Jennifer Ellen         not provided     Suspended
aka: Jennifer Ellen Maschke                   indefinitely effective
aka: Jennifer Ellen Phillips                  5/20/2012
911 Madalyn Ave.
Tulare, CA

Hauser, Marjorie              691373          Suspended
aka: Marjorie Bush                            indefinitely effective
aka: Marjorie Clarice                         1/27/2012
P.O. Box 41352
Santa Barbara, CA

Helms, Marilyn Jayne        291225            Suspended
aka: Marilyn Jayne Fawley                     indefinitely effective
aka: Marilyn Jayne Helminiak                  1/27/2012
aka: Marilyn Jayne Klobertanz
2906 N. Cardell Cir.
Tucson, AZ

Henry, April                  639278          Suspended
aka: April Michelle Darnell                   indefinitely effective
40409 Jacob Way                               12/23/2011
Murrieta, CA

Holcomb, Deborah Sue          723367          Suspended
3 Trentwood Pl.                               indefinitely effective
Rome, GA                                      10/15/2011

Imouokhome, Juliet            620507          Suspended
aka: Juliet Aliletu                           indefinitely effective
Imouokhome                                    11/7/2011
aka: Juliet Alilety Yakubu
26043 Galena Stone Ln.
Katy, TX

James, Roberta           526029               Suspended
aka: Roberta Lynn Tinnea                      indefinitely effective
1205 Alamo Creek Terrace                      12/30/2011
Apt. #4
Paso Robles, CA

Jasin, Martha A.              672481          Suspended
3101 Pasadena Ave.                            indefinitely effective
Long Beach, CA                                2/16/2012

Jorgensen, Laurel Anne        668160          Suspended
aka: Laurel Anne Harvey                       indefinitely effective
P.O. Box 360985                               1/27/2012
Milpitas, CA

Lange, Cheryl A.              586009          Suspended
1164 Cota St.                                 indefinitely effective
Santa Ynez, CA                                1/27/2012
Registered Nurse (susp R) . . . (continued)

Lim, Mariya Vadinovna       667889            Suspended
aka: Marya Lim                                indefinitely effective
20615 Mayall St.                              12/16/2011
Chatsworth, CA

Love, Joni Denise            280917           Suspended
aka: Joni Denise Hull                         indefinitely effective
aka: Joni Denise Dudley Hull                  12/30/2011
35309 U.S. Hwy. 285
Ojo Caliente, NM

Maiorana, Denise Ann        561918            Suspended
4359 Buckingham Ct.                           indefinitely effective
Vadnias Heights, MN                           1/27/2012

Maristela, Alfon C.         520468            Suspended
4387 Santa Rita Rd.                           indefinitely effective
El Sobrante, CA                               1/27/2012

Matthews, Kimberly Lynn     633940            Suspended
P.O. Box 518                                  indefinitely effective
Fultondale, AL                                1/13/2012

Meadows, Elizabeth          698746            Suspended
Ashley                                        indefinitely effective
928 Pheasant Run                              12/21/2011
Williamsburg, VA

Meehleib, Marsha            627696            Suspended
Slosarova                                     indefinitely effective
2567 Old Quarry Rd.                           1/13/2012
Apt. #2435
San Diego, CA

Morgan, Therese             727875            Suspended
19932 Sweetgum Cir.                           indefinitely effective
Unit #12                                      1/20/2012
Germantown, MD

Morrison, Katrina           460799            Suspended
807 One Oak Chase                             indefinitely effective
Rosharon, TX                                  12/21/2011

Nekola, Kelly               714939            Suspended
aka: Kelly Jolee Nekola                       indefinitely effective
7735 Erin Ct.                                 12/2/2011
Lincoln, NE

Newman, Ann Barbara        480167             Suspended
aka: Ann Barbara Parks                        indefinitely effective
aka: Ann Barbara Donaldson                    11/4/2011
aka: Ann Barbara Pearce
46 N. Hayes Rd.
Lapeer, MI

Nieto, Ignacio Jr.          653690            Suspended
1347 Aquarius Ct.                             indefinitely effective
Bakersfield, CA                               12/14/2011

O'Brien, Laura May          421367            Suspended
aka: Laura O'Brien                            indefinitely effective
aka: Laura Roa                                1/12/2012
aka: Laura May Cannon
P.O. Box 684
Oregon House, CA

Ocampo, Adelaida Dizon      511194            Suspended
27808 Gainesville Ave.                        indefinitely effective
Hayward, CA                                   4/15/2011

O'Donnell, Stacie Noel     561536             Suspended
aka: Stacie Noel McConnell                    indefinitely effective
15356 Carfax Ave.                             12/30/2011
Bellflower, CA

Parker, Barry David         727397            Suspended
8019 E. Sundew Dr.                            indefinitely effective
Tucson, AZ                                    12/16/2011
Registered Nurse (susp R) . . . (continued)

Raskin, Karen H.           321817             Suspended
aka: Karen Hope Raskin                        indefinitely effective
aka: Karen Wintroub Raskin                    1/12/2012
aka: Karen Hope Wintroub
6211 W. Winchcomb Dr.
Scottsdale, AZ

Ray, Eileen Teresa           468301           Suspended
aka: Eileen Teresa Fee                        indefinitely effective
121 Greenbriar Dr.                            1/26/2012
Simpsonville, SC

Robinson, Elizabeth Alicia   613715           Suspended
336 Saclan Terrace                            indefinitely effective
Clayton, CA                                   8/23/2011

Rogers, Jenay Lynn           546340           Suspended
aka: Jenay Lynn Venuti                        indefinitely effective
106 Parkwind Ct.                              12/30/2011
Cary, NC

Short, Lisa Himes            698808           Suspended
1358 47th Ave.                                indefinitely effective
San Francisco, CA                             10/3/2011

Sibulo, Lemuel Bathan        538749           Suspended
P.O. Box 4838                                 indefinitely effective
Downey, CA                                    1/20/2012

Siveley, Jonathon W.         514247           Suspended
aka: Robert Mose Freyta                       indefinitely effective
1130 Arcadia Ave.                             12/30/2011
Unit E
Arcadia, CA

Tebo, Carolyn H.          330440              Suspended
aka: Carolyn Harpole Tebo                     indefinitely effective
P.O. Box 2002                                 1/20/2012
Monterey, CA

Thompson, Lea Whitehead 658428                Suspended
7729 San Gabriel St.                          indefinitely effective
Raleigh, NC                                   1/27/2012

Torti, Mark Anthony          548395           Suspended
5555 Rancho La Loma                           indefinitely effective
Linda                                         12/30/2011
Paso Robles, CA

Valdez, Teresita Cadelina 229391              Suspended
3122 Penitencia Creek Rd.                     indefinitely effective
San Jose, CA                                  6/24/2011

Vankham, Sourith             734928           Suspended
8745 Prospect Ave.                            indefinitely effective
Santee, CA                                    12/30/2011

Vaughan, Marybeth            550145           Suspended
aka: Marybeth Alexander                       indefinitely effective
Vaughan                                       1/27/2012
5215 Pavo Rd.
Thomasville, GA

Webster, Fe Isaac            609021           Suspended
533 Moss St.                                  indefinitely effective
Unit E-2                                      3/21/2012
Chula Vista, CA

Weeks, Robert McMillan       607145           Suspended
1300 Winding Ridge Ln.                        indefinitely effective
Unit D6                                       1/6/2012
Valparaiso, IN
Registered Nurse (susp R) . . . (continued)

Wilcox, Preston Walter Jr. 402022             Suspended
aka: Preston Walter Murphy                    indefinitely effective
aka: Preston Walter Larry                     3/29/2012
Wilcox
1700 Garth Ave.
Los Angeles, CA

Wood, Shanda Rae            724533            Suspended
76000 Frank Sinatra Dr.                       indefinitely effective
Palm Desert, CA                               1/13/2012

Woods, Michael J. Jr.       496257            Suspended
698 E. Browning Ave.                          indefinitely effective
Fresno, CA                                    12/16/2011


Respiratory Care Practitioner (susp S)

Capranica, Rick Alan        26701             Suspended
1931 S. 174th Ln.                             indefinitely effective
Goodyear, AZ                                  2/2/2012

Hillman, Steven Walter      17867             Suspended
30876 Epiplaniea Way                          indefinitely effective
Winchester, CA                                9/11/2011


Business Manager (susp T)

Marroquin, Aura Mariz                         Suspended
aka: Aura Maria Soto                          indefinitely effective
3800 W. 27th St.                              5/20/2012
Apt. #333
Los Angeles, CA


Business Owner (susp T)

Uche, Alex                  DME03370F         Suspended
Audcon Group of             1144335589        indefinitely effective
Companies                                     7/15/2012
4703 Brooks St.
Montclair, CA


Employees (susp T)

Giron, Concepcion Pinco                       Suspended
aka: Connie Pinco Giron                       indefinitely effective
3400 Richmond Pkwy.                           7/22/2012
Apt. #1902
San Pablo, CA

Gomez, Francisco Saucedo                      Suspended
8749 Tobias Ave.                              indefinitely effective
Apt. #14                                      5/20/2012
Panorama City, CA


Ground Transportation (susp T)

Aghajanyan, Roman           MTN01203F         Suspended
aka: Mike                   1629112065        indefinitely effective
Aghajanyan, Roland                            7/4/2012
aka: George
A & R Medical Transport
5300 Santa Monica Blvd.
Ste. #216
Los Angeles, CA
Marketer (susp T)

Banares, Elizabeth                       Suspended
aka: Elizabeth Uniza                     indefinitely effective
Banares                                  5/20/2012
aka: Elizabeth Cruz Uniza
FCI Victorville Medium II
Unit #56920-112
P.O. Box 5300
Adelanto, CA

Matinenzo, Crisencia T.                  Suspended
aka: Crisencia Tumambing                 indefinitely effective
Matienzo                                 5/20/2012
aka: Crisencia Tumanbing
Ising
CCM Long Beach
Unit #49063-112
1299 Seaside Ave.
San Pedro, CA


Private Citizen (susp T)

Hoskins, Peggy Lee                       Suspended
aka: Peggy Lee Sumner                    indefinitely effective
559 Wayland Ct.                          5/20/2012
Claremont, CA

Zaragoza, Claudia                        Suspended
aka: Claudia Zargoza                     indefinitely effective
aka: Claudia Castillo                    5/20/2012
18145 10th St.
Bloomington, CA


Recipient (susp T)

Slade, Tamra Lee                         Suspended
aka: Tamra Lee                           indefinitely effective
Slade-Hayes                              5/20/2012
5 Natoma Ct.
Chico, CA


Unlicensed Caregiver (susp T)

Narisco, Ma Socorro                      Suspended
aka: Ma Socorro Patag                    indefinitely effective
Narcisso                                 5/20/2012
aka: Masocorro P. Narciso
FDC SEATAC
Unit #56460-112
P.O. Box 13900
Seattle, WA


In-Home Support Services Provider (susp U)

Alverson, Cynthia Louise                 Suspended
2272 Fashion Ave.                        indefinitely effective
Long Beach, CA                           7/15/2012

David, Dante Alviz                       Suspended
7642 14th St.                            indefinitely effective
Apt. #2                                  7/15/2012
Westminster, CA

Dixon, Debra Delorose                    Suspended
476 E. Ave.                              indefinitely effective
Chico, CA                                5/20/2012

Garsuta, Clarita Bayaoa                  Suspended
2436 43rd Ave.                           indefinitely effective
Sacramento, CA                           5/20/2012

Hardy, Betty Joyce                       Suspended
1319 S. Manhattan Pl.                    indefinitely effective
Los Angeles, CA                          7/22/2012
In-Home Support Services Provider (susp U) . . . (continued)

Lichtenauer, Elizabeth                      Suspended
aka: Elizabeth Gloria                       indefinitely effective
Martinez                                    5/20/2012
aka: Elizabeth Gloria
Lichtenhauer
290 Farrell Ave.
Gilroy, CA

Mansi, Marilyn Quintanilla                  Suspended
4408 Aragon Dr.                             indefinitely effective
San Diego, CA                               5/20/2012

McKenzie, Leonard                           Suspended
3836 Dry Creek Rd.                          indefinitely effective
Sacramento, CA                              5/20/2012

Ogle, Connie Lynn                           Suspended
2476 Streamside Ct.                         indefinitely effective
Chico, CA                                   5/20/2012

Pryor, Angela Elizabeth                     Suspended
7320 Willowwick Way                         indefinitely effective
Sacramento, CA                              5/20/2012

Schuetz, Deborah Jayne                      Suspended
711 West East Ave.                          indefinitely effective
Unit #13                                    5/20/2012
Chico, CA

Smith, Samona Sheniqua                      Suspended
4934 Ferigo Ln.                             indefinitely effective
Sacramento, CA                              5/20/2012

Strawn, Dianna Lyn                          Suspended
aka: Diana Lyn Strawn                       indefinitely effective
3176 Cherokee Rd.                           5/20/2012
Oroville, CA

Vang, Lisa Xia                              Suspended
12455 Alabama Rd.                           indefinitely effective
Herald, CA                                  5/20/2012

Waller, Eric Lidale                         Suspended
7200 Jacino Ave.                            indefinitely effective
Unit #4302                                  5/20/2012
Sacramento, CA


REINSTATEMENTS:

Physician (susp A)

Gray, Jeffrey T., M.D.       G56251         6/25/2012                (removed from pg. 36)
354 Cernon St.               00G562510
Vacaville, CA                00G562511
and                          00G562512
660 Sanitarium Rd.
Deer Park, CA
and
3449 Valle Verde Dr.
Ste. C
Napa, CA
and
2443 Fair Oaks Blvd..
Unit #358
Sacramento, CA

Hernandez-Rivera, Jose       A80166         6/25/2012                (removed from pg. 41)
1637 3rd Ave.                00A801660
Ste. H                       1487702379
Chula Vista, CA

Strub, Daniel                A25554         7/13/12                  (removed from pg. 96)
aka: Strub, Danny
12620 Monte Vista Rd.
Ste. E
Poway, CA
Licensed Vocational Nurse (susp R)

Balley, Raymond E.        VN160739       6/25/2012      (removed from pg. 164)
1258 Galen St.
Duarte, CA


CORRECTIONS:

Respiratory Care Practitioner (susp S)

Leo, Harold Reith         4770           Suspended      (address added on pg. 11)
38964 Mesquite Rd.                       indefinitely
Palmdale, CA                             11/21/2000
and
8209 Clemens Ave.
Canoga Park, CA