medi-cal suspended and ineligible provider list (susp...

susp TMedi-Cal Suspended and Ineligible Provider List 1Employee Provider

Number

Acovera, Moime Suspended8988 Dalby Cove indefinitely effectiveSan Diego, California 8/20/2006.

Adamos, Nita Suspended1317 D Avenue, #815 indefinitely effectiveNational City, California 6/20/2006.

Adem, Sunday Joseph Suspended aka: Edemenang, Sunday indefinitely effective Joseph 11/19/02. Edem, Joseph Enfiok9277 Lincoln Boulevard, # 3273Los Angeles, California

Adkins, Jo Ann Suspended aka: Barnes, Jo Ann indefinitely effective Walker, Joann 8/14/2006. Moore, Joann611 North Van NessFresno, California

Affleje, Joaquin Suspended Crisostomo indefinitely effective631 East 8th Street 6/20/2006.National City, California

Afsharian, Payam M. Suspended631 Georgina Avenue indefinitely effectiveSanta Monica, California 8/18/05.

Afzal-Brown, Valencia Suspended aka: Cavalier, Mahogany indefinitely effective Cavalier, Valencia 6/26/2007.109 ProspectChula Vista, California

Agazarian, Martiros Suspended1088 East Magnolia Boulevard indefinitely effectiveBurbank, California 07/20/00.

Agcaoil, Sonia Maritess Suspended242 Atlantic Avenue #6 indefinitely effectiveLong Beach, California 11/16/00.

Agopian, Ovsanna Suspended aka: Agopian, Joanna indefinitely effective16015 Kingsbury Street 10/20/05.Granada Hills, California

Aguilar, Joel M. Suspended750 E. Third Street, Apartment N indefinitely effectivePomona, California 05/06/02.

Ahmed, Khalid Suspended319 Sandy Lane, Apartment E indefinitely effectiveSuisun City, California 06/20/01.

Ahmed, Saeed Suspended110 East 129th Street, #A8 indefinitely effectiveNew York City, New York 8/20/2003.

Ahmed, Saeed Suspended aka: Ashraf, Muhammad indefinitely effectiveCDC T80720 08/20/03Wasco State PrisonP.O. Box 5500Wasco, California

Employee ProviderNumber

Ahmed, Shahzad Suspended aka: Ahmed, Bilal Junior indefinitely effective Shazad, Muhammad 08/20/03. Ahmed, ShazadCDC T80718Wasco State PrisonP.O. Box 5500Wasco, California

Akopyan, Daniel Suspended2282 Gill Village Way, indefinitely effective#1205 06/20/00.San Diego, California

Alexander, Mary Suspended3828 Cypress Street indefinitely effectiveSacramento, California 02/04/03.

Allison, Keith Suspended aka: Allison, Lynn indefinitely effective3010 South Normandie 10/19/2006. Avenue, Apartment #1Los Angeles, California

Almazan, Abner Suspended4814 Castle Road indefinitely effectiveLa Canada, California 03/20/03.

Almazan, Maria Directo Suspended 4814 Castle Road indefinitely effectiveLa Canada, California 11/26/02.

Altman, Charlotte Ethel Suspended2400 San Dimas Canyon indefinitely effective Road, #136 8/30/2006.La Verne, California

Alvarenga, Maria Marta Suspended1319 Ingraham Street, #306 indefinitely effectiveLos Angeles, California 11/19/02.

Amirian, Amir Suspended5608 Hoback Glen Road indefinitely effectiveHidden Hills, California 9/20/05.

Anderson, Cathy Jean SuspendedNo. 10504-023 indefinitely effectiveFederal Prison Camp 06/18/04. Dublin5675 8th Street-Camp ParksDublin, California

Andrada, Maria Carmela Suspended2139 Sr. Augusta Lane indefinitely effectiveHawthorne, California 11/16/00.

Andrews, Patricia Gail Suspended aka: Goudeau, Patricia Gail indefinitely effective687 West 17th Street, Suite #3 4/25/06.San Bernardino, California

Arciaga, Recy C. Suspended7143 Kitty Hawk Street indefinitely effectiveFontana, California 05/12/04.

1 – Medi-Cal Suspended and Ineligible Provider ListJuly 2007

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Anzueto, Rosa Suspended aka: Baires, Rosa indefinitely effective9510 Karmont Avenue 08/04/04.South Gate, California

Armero, Juan Antonio Suspended136 S. Pasadena Avenue indefinitely effectiveAzusa, California 10/26/01.

Arreola, Stephanie Suspended2620 West Ball Road, indefinitely effectiveApt. 232 08/04/04.Anaheim, California

Arriola, Alicia Suspended5835 Priory Street indefinitely effectiveBell Gardens, California 12/18/03.

Artsrounian, Haik SuspendedTAFT CI indefinitely effectiveP.O. Box 7001 8/19/04.Taft, California

Asares, Angelina Suspended aka: Chang, Angelina indefinitely effective214 S. Westmoreland 4/30/2007. AvenueLos Angeles, California

Attikian, Armen SuspendedVictory Medical Supply indefinitely effective6908 Mammoth Avenue 06/24/04.Van Nuys, California

Augur, Carol Leann Suspended43800 Wilson Valley Road indefinitely effectiveHemet, California 10/24/2006.

Avetissian, Ashot Art Suspended13227 Van Owen Avenue, indefinitely effective#203 07/20/00.North Hollywood, California

Ayrapetyan, Tigran Suspended330 North Jackson Street, indefinitely effective#218 4/21/05.Glendale, California

Bahamon, Ramiro Suspended700 East Washington indefinitely effective Street, #206 08/20/02.Colton, California

Baird, Karin Lynn Suspended12431 Windsor Drive indefinitely effectiveYucaipa, California 04/20/03.

Baires, Douglas Arturo Suspended910 Karmont Avenue indefinitely effectiveSouth Gate, California 08/18/00.

Baker, Melvin Otis Suspended1211 Caminito Septimo indefinitely effectiveCardiff by the Sea, California 8/18/2005.

Banos, Ana Luz Suspended13729 East Penn indefinitely effective Street, #6 8/3/2006.Whittier, California


Baquedano-Estrada, Elsa Suspended318 North Hobart, #3 indefinitely effectiveLos Angeles, California 8/3/2006.

Barillas, Cesar A. Suspended8301 S. Vermont Avenue, indefinitely effectiveA, B & C 8/23/2007.Los Angeles, California

Barreto, Guillermo Jose Suspended5338 Riley Street indefinitely effectiveSan Diego, California 07/18/02.

Barton, Lupe Eva Suspended22135 Debra Street indefinitely effectiveLake Forest, California 08/20/02.

Bassey, Kristine A. Suspended3230 North Lincoln Avenue, indefinitely effective#220 05/02/03.Anaheim, California

Beauchamp, Lisa Marie Suspended509 Sheids Street indefinitely effectiveSan Francisco, California 04/09/03.

Beauford, Archie Suspended Edward, Sr. indefinitely effective aka: Beauford, James 4/19/2007. Edward Beuford, Archie1648 S. La Brea Avenue, #1Los Angeles, California

Bedford, Phillip M. Suspended623 18th Street indefinitely effectiveOakland, California 03/20/02.

Bedolla, Enrique Lemus Suspended4662 North Rosindo indefinitely effective Avenue 5/18/06.Fresno, California

Bedrosian, Yepram Suspended1436 Hermosa Drive indefinitely effectiveCorona, California 05/25/01.

Bellaire, Emily 296493 Suspended7740 Watt Avenue #105 indefinitely effectiveAntelope, California 01/11/02.

Bejanzadeh, Emil Suspended1168 East Alameda, #103 indefinitely effectiveGlendale, California 08/25/04.

Bello, Blasida Medel Suspended18000 Highway 12, #18 indefinitely effectiveBoyes Hot Springs, CA 04/13/04.

Bettencourt, Aubrie RN602412 Suspended Elizabeth indefinitely effective330 Birch Street 8/16/2006.Willows, California

1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007

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Bigornia, Susana Suspended Lorenzana indefinitely effective aka: Maldonado, Susana 01/19/05. Lorenzana Bigornia, Susan3611 Ashby Court Rowland Heights, California

Birt, Angela Suspended11530 Simms Avenue indefinitely effectiveInglewood, California 03/24/04.

Blankenship, Kenneth Joseph Suspended aka: Howe, Steve indefinitely effectiveInmate # 54652198 08/20/01.USP Lompoc SCP3901 Klein BoulevardLompoc, California

Blankenship, Ruth Suspended Christine Ely indefinitely effective aka: Cruz, Cris 08/20/01. Cruz, Maria970 Campo RoadSpring Valley, California

Blodger, Gary Darnell Suspended1623 E. 33rd Street indefinitely effectiveOakland, California 09/30/02.

Boettcher, William V. Suspended#05579-082 indefinitely effectiveFCI Sheridan 1/20/06.Federal Correctional InstitutionP.O. Box 5000Sheridan, Oregon

Bolding, Cynthia L. Suspended555 Matmor Road, #163 indefinitely effectiveWoodland, California 7/22/2007. and435 Aspen StreetWoodland, California

Borja, Cuaujtemoe Suspended aka: Borja, Peter indefinitely effective1814 Bluehaven Court 05/20/02.San Diego, California

Boughton, Lloyd Suspended Cornelius indefinitely effective aka: Broughton, Lloyd 10/19/2006.26080 Baseline Street,Apartment #V180San Bernardino, California

Bratcher, Louis Suspended3656 North Shirley indefinitely effectiveFresno, California 08/20/02.

Briggs, Pleashette Latoya Suspended210 North Beechwood indefinitely effective Avenue, #143 8/31/2006.Rialto, California

Brown, Marilyn Faye Suspended aka: Faye, Marilyn indefinitely effective Brandon, Marilyn 05/20/01.4418 2nd AvenueLos Angeles, California


Bruce, James Edward Suspended1925 College Avenue indefinitely effective and 1369 North Wall Street 01/08/03.San Bernardino, California

Buendia, Natalie C. Suspended aka: DeGuzman, Natalie indefinitely effective Buendia 4/5/2007.587 South Street, #6Glendale, California

Bukhari, Samad Suspended aka: Bukhari, Abdul indefinitely effective1519 East 1st Street, 11/20/01.Room 110Santa Ana, California

Bun, Sothary Ryan Suspended aka: Bun, Ryan Sothary indefinitely effective1683 East South Street 05/20/01.Long Beach, California

Burks, Louis Suspended aka: Johnson, Larry indefinitely effectiveCDC # P20467 08/20/02.Chuckawalla State PrisonP.O. Box 2349Blythe, California

Cabrera, Teresa Gomez Suspended730 W. 4th Street indefinitely effectiveLa Habra, California 11/19/02.

Calderon, Wendy Suspended3813 Locke Avenue indefinitely effectiveLos Angeles, California 5/18/2006.

Calimbas, Francis Suspended aka: Calimbas, Frank indefinitely effective615 Monterey Avenue, #F 09/11/03.Monrovia, California

Calinisan, Leonor Estepa Suspended11325 Miro Circle indefinitely effectiveSan Diego, California 8/31/2006.

Calpo, Epifania Directo Jacob Suspended4600 Rochelle Drive indefinitely effectiveUnion City, California 11/26/02.

Campos, Lucy B. Suspended6430 Stoneridge Mall Road, indefinitely effective#L213 05/20/02.Pleasanton, California

Campuzano, Mario Suspended Corrales indefinitely effective aka: Corrales, Mario 8/16/2006.547 West 5th StreetLong Beach, California

Cancio, Meneleo Cometa SuspendedUSM No. 13491-097 indefinitely effectiveLompoc Federal Prison Camp 08/20/03. (Satellite)3901 Kline BoulevardLompoc, California


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Canet, Francisco Suspended14515 Foothill Avenue indefinitely effectiveHawthorne, California 07/14/01.

Canta, Lenard Suspended6420 ½ Coldwater Canyon indefinitely effective Avenue 09/19/02.North Hollywood, California

Carrera, Mirna Amarillis Suspended11908 Deana Street, #3 indefinitely effectiveEl Monte, California 11/19/02.

Carter, Valerie Jayne Suspended aka: Carter Valarie Jayne indefinitely effective Dennis, Valarie 04/28/04. Jackson, Valarie601 Linden Avenue, #103Long Beach, California

Casiano, Rosario Suspended8035 East Hill Drive indefinitely effectiveRosemead, California 06/30/04.

Castaneda, Patricia Suspended18157 Canterburry Court indefinitely effectiveHowland Heights, California 08/04/04.

Castaneto, Orlando Suspended22723 Neptune Avenue indefinitely effectiveCarson, California 06/30/04.

Castro, Alfredo P. Suspended2804 East Plaza Boulevard indefinitely effectiveNational City, California 6/20/2006.

Castro, Amparo Santa Rita Suspended2804 East Plaza Boulevard indefinitely effectiveNational City, California 6/20/2006.

Cazares-Martinez, SuspendedMark Anthony indefinitely effective32090 Rancho Vista, #A 1/20/2006.Cathedral City, California

Centeno, Theresa Suspended3336 West Beran Way indefinitely effectiveFresno, California 4/26/2007.

Cerda, Eduardo Suspended1109 Verde Court indefinitely effectivePomona, California 05/20/03.

Cerda, Lourdes Suspended aka: Cerda, Lourdes C. indefinitely effective Martinez, Lourdes 8/18/2005. Cuevas Martinez, Delourdes Cuevas16821 Shinnecock LaneFontana, California

Chan, Tha Suspended1683 East South Street indefinitely effectiveLong Beach, California 5/20/01.

Chand, Puran SuspendedP.O. Box 613 indefinitely effectiveStanton, California 08/04/04.


Chavez, Linda Martinez Suspended1791 Neil Armstrong Street, #207 indefinitely effectiveMontebello, California 05/20/03.

Chavira, Armida Suspended1805 Newcastle Lane Indefinitely effectiveSan Dimas, California 07/29/04.

Che, Chanthy Suspended7188 Wake Court indefinitely effectiveFontana, California 05/11/04.

Chelzinger, Micha Suspended aka: Moshe indefinitely effective18729 Miranda Street 08/20/03.Tarzana, California

Chem, Phalla Suspended1051 Gladys Avenue, #6 indefinitely effectiveLong Beach, California 05/02/03.

Chen, Syng-Fu F. Suspended aka: Chen, Frank S. indefinitely effectiveP.O. Box 2084 02/19/04.Palos Verdes Peninsula, California

Chyorny, Anne Suspended3158 Hutton Drive indefinitely effectiveBeverly Hills, California 11/19/02.

Ciraolo, Constanza Rosario Suspended aka: Ramirez, Constanza indefinitely effective Del Rosario 06/23/04. Lujan, Constanza Del Rosario Vasquez, Constanza Rosario Lujan, Constanza Rosario1447 West Toscanini DriveRancho Palos Verdes, California

Clauzel, Nicole Suspended12650 Lakeshore Drive, indefinitely effective#149 4/10/2007.Lakeside, California

Cole, Wilhermina Omolara Suspended1210 Evergreen Court indefinitely effectiveCarson, California 06/23/03.

Coleman, Carol Ann Suspended aka: Daugherty, Carol indefinitely effective Davis, Carol Ann 9/4/2006. Bozeman, Carol Ann Miller, Carol Ann1096 Columbus Avenue, Apartment #AChico, California

Colyer, Gerald Ray Suspended4096 45th Avenue indefinitely effective North East 07/20/04.Salem, Oregon

Cone, Alan C. Suspended (Owner DME Company) indefinitely effectiveInmate #53540198 08/20/01.USP Lompoc3901 Klein BoulevardLompoc, California

1 – Medi-Cal Suspended and Ineligible Provider ListAugust 2007

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Cook, Marie Suspended6336 Spar Way indefinitely effectiveMagalia, California 6/3/2007.

Cook, Turhan Andrea SuspendedP.O. Box 2175 indefinitely effectiveRosamond, California 7/29/2007.

Cooke, Leonata Collene Suspended1340 North Northstar indefinitely effectiveColton, California 08/04/04.

Coquia, Sergio M. Suspended8035 Paradise Valley indefinitely effective Road, #19 6/20/2006.San Diego, California

Coquia, Tarcela Feliciano Suspended8035 Paradise Valley indefinitely effective Road, #19 4/20/2006.San Diego, California

Cortez, Ivan-Silva Suspended841 Lakeville Circle indefinitely effectivePetaluma, California 8/16/2006.

Cortez, Josie Lopez Suspended229 North Olive Street, indefinitely effectiveApartment 1 04/09/03.Alhambra, California

Costales, Philip Suspended1028 Chestnut Avenue, #4 indefinitely effectiveLong Beach, California 12/20/04.

Craine, Tamika Suspended11895 Morning Star Road indefinitely effectiveApple Valley, California 8/23/2006.

Creer, Michelle A. Suspended153 Donahue Street, #31 indefinitely effectiveSausalito, California 7/29/2007.

Cristobal, Lisa Borja Suspended2644 Daisy Avenue indefinitely effectiveLos Angeles, California 11/16/00.

Cuchez, Maria Suspended8045 Eastern Avenue indefinitely effectiveBell Gardens, California 09/30/00.

Curtis, Lorraine Suspended18507 9th Street indefinitely effectiveBoomingdale, California 09/15/00.

Dagdagan, Myrna Parilla Suspended aka: Collado, Myrna indefinitely effective Dagdagan 7/20/2006.323 Coronado PlaceDelano, California

Dallarte, Majella Molarte Suspended1630 N. Brighton Street indefinitely effectiveBurbank, California 8/7/2007.

Davis, Lydia Caldwell Suspended10506 S Van Ness indefinitely effectiveLos Angeles, California 03/20/02.


Davis, Virgil Jr. Suspended2031 East 122nd Street, indefinitely effective Apartment 216 04/20/03.Compton, California

Day, April Marie Suspended aka: Walls, Rashanda indefinitely effective3904 Stevely Avenue, #8 06/30/04.Los Angeles, California

De Los Santos, Lydia L. Suspended1317 D Avenue, #814 indefinitely effectiveNational City, California 6/20/2006.

Dealba, Carlos Suspended(Address not available) indefinitely effective

4/3/2006.

DeGuzman, Maria Nenita Suspended11723 Bellflower Boulevard indefinitely effectiveDowney, California 9/7/05.

De Jesus, Lorna Suspended aka: Munoz, Lorna indefinitely effective25399 The Old Road, 10/15/03.Apartment 16-308Stevenson Ranch, California

Delgado, Edwin 388383 Suspended3660 W. 58th Place indefinitely effectiveLos Angeles, California 1/16/02.

Delgado, Josue E. Suspended3215 Baldwin Park indefinitely effective Boulevard 8/17/2006.Baldwin Park, California

Delgado, Luis Suspended aka: Delgado, Luis Lopez indefinitely effective210 E. 23rd Street 8/2/2007.Los Angeles, California

DelMonte, Digna Junsay Suspended821 Kempton Street indefinitely effectiveSpring Valley, California 6/20/2006.

Denis, Alfonso Suspended11110 Dodson Street indefinitely effectiveEl Monte, California 09/30/00.

Der Gregorian, Alain A. Suspended3157 Charing Cross Place indefinitely effectiveGlendale, California 5/6/02.

DeRouen, Tamara 504962 Suspended7006 E. Parkway, #4 indefinitely effectiveSacramento, California 3/12/02.

Dilakyan, Geganush Suspended12300 Roscoe Boulevard indefinitely effectiveSun Valley, California 6/12/03.

Dino, Jerico SuspendedU.S. Marshall #21560-038 indefinitely effectiveTaft Correctional Institute 4/18/02.P.O. Box 7001Taft, California


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Dino, Magdalena Suspended1020 S. 6th Avenue indefinitely effectiveArcadia, California 3/20/02.

Dioso, Marites R. Suspended626 24th Street, #5 indefinitely effectiveNational City, California 8/7/2007.

Directo, Elizabeth Suspended5152 La Roda Avenue indefinitely effectiveLos Angeles, California 5/6/02.

Directo, Jon Edwin Suspended5521 Via Marisol indefinitely effectiveLos Angeles, California 11/26/02.

Diremsizyan, Minas Suspended5313 Virginia Avenue indefinitely effectiveLos Angeles, California 11/21/00.

Domantay, Adelaida Suspended3171 Carlyle Street indefinitely effectiveLos Angeles, California 4/20/04.

Domantay, Brumeo Suspended3171 Carlyle Street indefinitely effectiveLos Angeles, California 4/20/04.

Dominguez, Ramon Mario Suspended925 Reno Ridge Lane indefinitely effectiveDiamond Bar, California 09/09/00.

Drabkin, Marina Suspended aka: Andreve, Marina indefinitely effective Slusker, Marina 11/19/02.1045 N. Kings Road, #203West Hollywood, California

Du, Danny M. SuspendedCDC #V36751 indefinitely effectiveWasco State Prison 10/20/2005.P.O. Box 5500Wasco, California

Duenas, Adelioda Tobar Suspended aka: Tobar, Adelioda indefinitely effective1536 West University Avenue 8/04/04.Fresno, California

Duenas, Feralina Louise Suspended aka: Coronado, Feralina indefinitely effective603 West Fountain Way 10/20/05.Fresno, California

Duong, Truc Suspended aka: Vo, Truc indefinitely effective Truc, Co 4/19/2007.13361 Redbird StreetGarden Grove, California

Durand, Devin Brian Suspended1812 Cottage Grove Drive 06/20/00Encinitas, California for 5 years.

Durkee, Susan E. Suspended1003 Tanzania Drive indefinitely effectiveRoseville, California 5/28/03.


Earaft, Glennetta Suspended463 Jessica Avenue indefinitely effectiveSacramento, California 8/17/2006.

Edmonds, Quehemiah Z. Suspended7049 Chandler Drive indefinitely effectiveSacramento, California 9/24/02.

Edukere, Godwin Sunday Suspended aka: Edukere, Goddy Sunny indefinitely effective Sunday, Edukere G. 05/05/04.35 Hunter Point RoadPhillips Ranch, California

Edwards, Carmen CNA190364 Suspended1115 W. 4th Street, #4 HHA45113 indefinitely effectiveAntioch, California 3/25/02.

Ehumadu, Adolphus Kelechi Suspended aka: Ehumadu, Kelechi indefinitely effective Ehumadu, K.C. 09/19/03. Kelechi, E.A.21489 Cold Spring LaneDiamond Bar, California

Ekizyan, Oganes Suspended6038 Buffalo Avenue indefinitely effectiveVan Nuys, California 06/20/00.

Espinoza, Carlos Antonio Suspended13415 S. Berendo Avenue indefinitely effectiveGardena, California 5/20/02.

Espinoza, Maria Aura Suspended9933 Walnut Avenue indefinitely effectiveSouthgate, California 09/15/00.

Espinoza, Thelma Auziliador Suspended8157 Chestnut Avenue indefinitely effectiveSouthgate, California 09/15/00.

Esqueda, Rosalinda Suspended aka: Arenas, Rosalinda indefinitely effective1165 Hays Street 6/3/2007.Bannin, California and964 Rialto Avenue, #1San Bernardino, California

Estrella, Nestor Jorge Suspended9229 Sepulveda indefinitely effective Boulevard, #424 6/20/2006.North Hills, California

Eugencio, Prudencio Suspended Corpuz, Sr. indefinitely effective912 Olive Avenue 6/20/2006.National City, California

Evangelista, Nancy Garcia Suspended1632 1/2 South Lake Street indefinitely effectiveGlendale, California 8/13/2007.

Farinas, Marcelo Tomas Suspended2663 South Bayport Drive indefinitely effectiveTorrance, California 07/28/04.


susp T7


Farrell, Sheldon Charles Suspended aka: Farrell, Sheldon indefinitely effective2599 West Lake Van Ness 8/31/2006. CircleFresno, California

Fattouh, Rouba Suspended1303 Cinco Street, indefinitely effectiveApartment #124 4/26/2007.Austin, Texas

Favela, Oscar Suspended550 Larch Avenue indefinitely effectiveRialto, California 09/15/00.

Favela, Ricardo Suspended6535 Pickering Avenue indefinitely effectiveWhittier, California 09/15/00.

Felekian, Hrach Suspended8151 Allott Avenue indefinitely effectiveVan Nuys, California 11/21/00.

Ferrer, Annilie Arcangel SuspendedCDC #W83859 indefinitely effectiveCentral California Women’s 5/20/02. FacilityP.O. Box 1508Chowchilla, California

Festa, David L. Suspended7430 Batista Street indefinitely effectiveSan Diego, California 4/30/2007.

Flores, Jose Suspended1733 W. Adams Boulevard indefinitely effectiveLos Angeles, California 4/29/02.

Flores, Serafin C. Mira Suspended aka: Flores, Flores Serafin indefinitely effective Mira 07/28/04. Miraflores, Serafin Flores, S.M. Flores, Santino Montelebano Flores, Essie1839 Stevely AvenueLong Beach, California

Forthoffer, Gloria Bess Suspended3680 Spruce, Apartment #5 indefinitely effectiveSouth Lake Tahoe, 8/23/2006.California

Fortunato, Jose 416547 Suspended600 Echo Summit Road indefinitely effectiveVallejo, California 2/4/02.

Fraga, Luz Maria Suspended2266 Marshall Avenue indefinitely effectiveSimi Valley, California 7/10/2007.

Freeman, Deborah Kay Suspended33472 Waldo Road indefinitely effectiveHemet, California 09/02/00.

Freeman, Kenneth Dale Suspended33472 Waldo Road indefinitely effectiveHemet, California 09/02/00.


Frid, Boris Suspended aka: Boris Fred indefinitely effective4425 Ensenada Drive 12/20/2005.Woodland Hills, California

Fusillo, Ana Marie Suspended aka: Katherine Barrera 04/20/993779 Blackford Avenue, for 10 years.Apartment 28San Jose, California

Gabriel, Gabriel San Juan Suspended17152 Samgerry Drive indefinitely effectiveValinda, California 11/19/02.

Gallardo, Amanda Suspended504 South Petaluma indefinitely effective Boulevard 07/14/04.Petaluma, California

Gallego, Raynaldo Suspended6545 Green Valley Circle, indefinitely effective#303 7/20/04.Culver City, California

Gallego, Robert Balite Suspended3128 Crescent Avenue, indefinitely effectiveApartment #49 8/19/04.Marina, California

Galvez, Gladdys Suspended7125 Stafford Avenue, #7 indefinitely effectiveHuntington Park, California 07/28/04.

Garcia, Benedict Jonathon Suspended Vargas indefinitely effective aka: JoJo Garcia 09/15/00.57 AustinIrvine, California

Garcia, Eduardo Suspended aka: Warner, Clarence indefinitely effective Emanuel, Jr. 11/19/02.1714 New England StreetLos Angeles, California

Garcia, Maria Remedios Rillo Suspended aka: Medette Garcia indefinitely effective57 Austin 09/09/00.Irvine, California

Gardner, Darrell Suspended Dewayne Jr. indefinitely effective4011 Crosswinds Way 8/20/02.Bakersfield, California

Geddes, Jan Suspended1096 Corino Real Court indefinitely effectiveChico, California 9/4/2006.

Gellis, Richard Barry Suspended2218 Cambridge Street indefinitely effectiveLos Angeles, California 5/15/03.

Gevorkyan, Arman Suspended7705 Ben Avenue indefinitely effectiveNorth Hollywood, California 9/14/01.


susp T8


Gezvkarayan, Khachik Suspended5276 Los Francisco Way indefinitely effectiveLos Angeles, California 05/12/04.

Gil, Frederick B. Suspended35 Amar Street indefinitely effectiveWest Covina, California 6/18/03.

Godoy, Maria Suspended aka: Maria Villatoro indefinitely effective20718 Brana Road 09/15/00.Riverside, California

Godzhoyan, Sarkis Suspended715 East Elk Avenue, #B indefinitely effectiveGlendale, California 08/28/00.

Gomez, Carmencita Suspended1750 Bramblewood Court indefinitely effectiveChula Vista, California 7/15/2007.

Gomez, Francisco Javier Suspended aka: Gomez, Francisco indefinitely effective35230 Pashal Place 2/20/02.Wildomar, California

Gonzalez, Daniel Suspended119 Belmont Avenue, indefinitely effectiveSuite #107 4/9/2007.Los Angeles, California

Gonzalez, Elia Cespedes Suspended7814 Hershey Street indefinitely effectiveRosemead, California 5/27/2007.

Gonzalez, Jairo Emilio Suspended121 Sinclair Avenue, #240 indefinitely effectiveGlendale, California 8/21/2007.

Gonzalez, Luisa Estela Suspended aka: Ciraolo, Luisa Estela indefinitely effective Gonzalez, Luisa E. 07/29/04. Lombardi, Luisa Estela Lombardi, Luisa15123 Florwood AvenueLawndale, California

Gonzalez, Sandra Suspended25911 Hinckley Street indefinitely effectiveLoma Linda, California 6/20/02.

Gorodetsky, George Suspended aka: Yuri Gorodetsky indefinitely effective15523-112 10/19/00.Metropolitan Detention CenterP.O. Box 1500Los Angeles, California

Grady, John Lewis Suspended27432 Portsmouth Avenue indefinitely effectiveHayward, California 11/19/04.

Gravich, Gersha Suspended2515 Apollo Drive indefinitely effectiveLos Angeles, California 9/10/01.


Gray, Amos Dale Suspended1066 East Poplar indefinitely effectivePorterville, California 8/13/2007.

Gray, David M. Suspended359 Byxbee Street indefinitely effectiveSan Francisco, California 01/20/04.

Griffin, David L. Suspended6521 North Walnut indefinitely effectiveLong Beach, California 5/6/02.

Grimble, Gervis Jerome Suspended aka: Leake, Jeally indefinitely effective158 West 51st Street 04/20/03.Los Angeles, California

Grubb, Travis Esten Suspended 102 Sweetwood Court indefinitely effectiveMoreno Valley, California 11/19/02.

Guerra, Carmen Suspended1067 Holiday Avenue indefinitely effectiveWest Covina, California 10/20/04.

Guerrero, Leticia Marie Suspended1494 and 1496 Jones Lane indefinitely effectiveParadise, California 8/31/2006.

Guiterrez, Raymond M. Suspended1105 Melia Place indefinitely effectivePlacentia, California 8/23/2007.

Gutierrez, Eugene Gomez Suspended aka: De La Cruz, Juan indefinitely effective3220 W. 71st Street 1/29/03. and5727 W. Jefferson BoulevardLos Angeles, California

Gutierrez, Orlando Suspended9933 Walnut Avenue indefinitely effectiveSouth Gate, California 10/10/01.

Gutierrez, Raymond Suspended c/o Fineline Marketing indefinitely effective1743 East Taylor 07/28/04.Placentia, California

Gyulnazaryan, Svetlana Suspended Mishayevna indefinitely effective4924 N. Greenwood Avenue 1/29/03.Sanger, California

Habib, Yakoob Suspended aka: Kalia, Yakoob Habib indefinitely effective8081 8th Street, 7/11/2006.Apartment #101Buena Park, California

Haggood, Elizabeth Marie Suspended26833 Hillview, #2 indefinitely effectiveHighland, California 8/13/2007.


susp T9


Haines, Amby Suspended19816 Blythe Street indefinitely effectiveWinnetka, California 9/30/02.

Hall, Sandra Renita Suspended1422 9th Street, indefinitely effectiveApartment G40 10/20/02.San Bernardino, California

Hann, Malina Lynn Suspended2021 East Dalton indefinitely effectiveSpokane, Washington 7/18/02.

Haqq, Kassandra Suspended3396 West Shields Avenue, indefinitely effectiveApt. #202 6/4/01.Fresno, California

Harper, Tara J. Suspended922 South Lake Street, indefinitely effectiveApartment 207 4/9/02.Los Angeles, California

Harris, Ronald Pierre Suspended1245 East 223rd Street indefinitely effectiveCarson, California 6/4/01.

Harrison, Mark Anthony Suspended aka: Grigsby, Mark Anthony indefinitely effective2072 North Marks, #146 9/7/05.Fresno, California

Hayes, Lisa A. Suspended aka: Hayes, Lisa Ann indefinitely effective Pacheco, Lynda Joye 10/4/04. Pacheco, Lynda Pacheco, Lynda Joyce Pacheco, Lynda J. Stanton, Jayne4607 Foothill Boulevard,Apartment AOakland, California

Haynes, Larry Oscar Suspended3811 Charlesworth Drive indefinitely effectiveCathedral City, California 4/30/2007.

Heravi, Behrooz Suspended11455 Thurston Circle indefinitely effectiveLos Angeles, California 4/29/02.

Heravi, Behzad Suspended18566 Gilmore Street indefinitely effectiveReseda, California 09/09/00.

Hernancez, Rolando Arias Suspended332 West Mangolia Avenue indefinitely effectiveInglewood, California 7/14/01.

Hernandez, Veronica Suspended6334 Cedar Street indefinitely effectiveHuntington Park, California 1/29/03.


Herrington, Tommy L. Suspended2190 North Schnoor indefinitely effective Street, Apartment #233 1/30/2007.Madera, California

Hidlago, Alma Yaneth Suspended105 Nesbit Ridge indefinitely effectiveRoswell, Georgia 6/20/2006.

Hill, Jacqueline Suspended11307 South Stanford Avenue indefinitely effectiveLos Angeles, California 5/18/06.

Hing, Van Dan Suspended1619 East 4th Street indefinitely effectiveLong Beach, California 09/30/00.

Hinojosa, Jorge Alfonso Suspended3160 Bonita Road indefinitely effectiveSan Diego, California 09/15/00.

Ho, Jason Suspended aka: Ho, Quan Manh indefinitely effective19411 Valerio Street 9/19/02.Reseda, California

Holland, Monica Suspended aka: Holland, Monique indefinitely effective Renee 9/20/2005. Brown, Monique Renee Holland, Moni Holland, Monica380 North Linden Avenue, Apartment #2606Rialto, California

Holmes, Dwayne Antwain Suspended2072 North Marks, #137 indefinitely effectiveFresno, California 3/26/2007.

Holy Family Medical Clinic Suspended Gabriel, Gabriel San Juan indefinitely effective (Co-Owner) 11/19/02.2500 W. 8th Street #203Los Angeles, California

Hovsapyan, Sarkis Suspended1448 Wesley Avenue indefinitely effectivePasadena, California 11/21/00.

Huaitan, Bernardino Alejandro Suspended7316 Beach Street indefinitely effectiveLos Angeles, California 7/11/2006.

Hudson, Paul E. Suspended10 Coral Lane indefinitely effectiveSacramento, California 5/6/02.

Hudson, Phillip Michael SuspendedP.O. Box 194 indefinitely effectiveTorrance, California 8/29/2007.

Huidor, Alicia Suspended2407 Flower Street indefinitely effectiveHuntington Park, 7/4/2007.California


susp T10


Hutcheson, William Suspended Edward indefinitely effective101 Misty Court 2/20/2007.Vallejo, California

I, Chea Suspended1365 St. Louis Avenue indefinitely effectiveLong Beach, California 9/24/02.

Imperial, Norman Suspended2155 East La Palma, #233 indefinitely effectiveAnaheim, California 11/16/00.

Iqbal, Imran Mohammad Suspended5600 River Way East indefinitely effectiveBuena Park, California 8/3/2006.

Isaacson, Joseph SuspendedCDC # P75878 indefinitely effectiveCommunity Correctional 09/09/00. Facility - Desert View10450 Rancho RoadAdelanto, California

Isaguirre, Frederico A., Jr. Suspended532 East 223rd Street indefinitely effectiveCarson, California 5/17/2007.

Jackson, Linda Varnell Suspended1916 West 131st Street indefinitely effectiveCompton, California 7/17/2006.

Jackson, Mildred Suspended aka: Harlan, Mildred indefinitely effective8416 Turbo Court 9/30/02.Sacramento, California

Jackson, Monique LaJoy Suspended1300 S. Pearl Avenue indefinitely effectiveCompton, California 4/13/02.

Jakubowicz, Leeor Suspended584 Europa Court indefinitely effectiveWalnut Creek, California 1/20/06.

Jalallian, Chariya Suspended4360 Linden Avenue indefinitely effectiveLong Beach, California 6/22/01.

Jamora, Jr., Tirso David Suspended aka: Jamora, Jun indefinitely effective201 East Chapman Avneue, 4/18/02.#22MPlacentia, California

Janazyan, Harutun Harry Suspended aka: Dzhanazyan, indefinitely effective Harutun 8/2/2006. Djanazian, Haroutioun Haroutioun, Janazian11128 Sheldon StreetSun Valley, California


Jari, Steve SuspendedCDC #28234-112 indefinitely effectiveTaft Correctional Institution 1/20/2006. aka: Reyes, Michael Reyes, Michael Percey Chan, Ching-Chin Jaari, Steve Jaari, Zvi Schlomo Jaari, Zui SchlomoP.O. Box 7001Taft, California

Jensen, Tonya D. Suspended aka: Jensen, Tonya indefinitely effective Dejonette 8/31/2006. Christian, Tonya Dejonette4049 Howe Avenue,#156San Diego, California

Jin, Kyo Hyun Suspended aka: Jin, John indefinitely effective249 South Lafayette Park 8/18/05. Place, #309Los Angeles, California

Jin, Kyo Sung 42553 SuspendedCDC #V40206 indefinitely effectiveCalifornia State Prison 9/20/05.P.O. Box 5002Calipatria, California

Johnson, JR. Gadson Suspended5544 Corning Avenue indefinitely effectiveLos Angeles, California 3/20/05. and4102 Degnan BoulevardLos Angeles, California

Johnson, Michelle 456588 Suspended4560 N. F Street indefinitely effectiveSan Bernardino, California 1/2/02.

Jones, Loretta Ann Suspended aka: Gardner, Loretta Ann indefinitely effective Jones, Loretta Anita 11/19/02.3217 Cerritos AvenueSignal Hill, California

Jovovich, Momchilo Suspended2200 Colorado Avenue, indefinitely effective#703 8/29/2007.Santa Monica, California

Kain, Darrall Suspended2701 Prindle Road, indefinitely effectiveApartment #1 4/16/2007.Belmont, California

KNJ Group, Inc. SuspendedP.O. Box 8692 indefinitely effectiveCalabasas, California 4/20/05.

Kaladzhyan, Oganes Suspended1233 North Artmore, No. 7 indefinitely effectiveLos Angeles, California 6/17/03.

Kampuryan, Gevork Suspended aka: Kampuryan, George indefinitely effective6713 Vantage Avenue 06/30/04.North Hollywood, California


susp T11


Kascius, Lauren Suspended2020 Third Street indefinitely effectiveJulian, California 10/19/00.

Kashishyan, Edik Suspended582 Palm Drive, #2 indefinitely effectiveGlendale, California 4/2/03.

Kaur, Milanjit Suspended28945 Shadow Valley Lane indefinitely effectiveSaugus, California 4/5/2007.

Kazaryan, Gayane Suspended aka: Kazaryan, Karina indefinitely effective5950 Whitsett Avenue, 2/20/2007.Apartment #106Valley Village, California

Keo, Channy Suspended1140 East 17th Street, #A indefinitely effectiveLong Beach, California 7/14/01.

Keophikoun, Keooudone Suspended Stacy indefinitely effective8805 Bridalsmith Drive 4/17/2007.Sacramento, California

Ketsoyan, Tigran Suspended1355 Hastings Ranch Drive indefinitely effectivePasadena, California 6/4/01.

Khachatrian, Sarkis SuspendedLOMPOC USP indefinitely effective3901 Klein Boulevard 8/19/04.Lompoc, California

Kim, Peter Suspended709 South Arizona Avenue indefinitely effectiveLos Angeles, California 4/19/2007.

Killings, Curtis Earl Suspended1520 West 8th Street, indefinitely effectiveApartment 109 04/20/03.Los Angeles, California

Kinard, Lottie Luzell Suspended aka: Blue, Lottie Luzell indefinitely effective2417 6th Street 07/29/04.Berkeley, California

Kirpichyan, Hakop “Jack” Suspended10409 Wilsey Avenue indefinitely effectiveTujunga, California 03/08/04.

Koeut, Jannyka Sovanny Suspended3702 Euclid Avenue indefinitely effectiveSan Diego, California 8/14/01.

Koeut, Larry Chen Suspended4335 50th Street indefinitely effectiveSan Diego, California 8/14/01.


Kopilevich, Mikhail Suspended aka: Misha indefinitely effective21901 Burbank 11/30/01.Boulevard, #203Woodland Hills, California

Koshkaryan, Oganes Suspended1336 North Kingsley Drive, #12 indefinitely effectiveLos Angeles, California 04/02/03.

Ku, Jay Suspended5970 Elm Avenue indefinitely effectiveLong Beach, California 01/31/05.

Kush Family Pain Center Suspended101 N. La Brea Avenue, indefinitely effectiveSuite 300 03/20/02.Inglewood, California

Lach, Hong Suspended dba: Star Medical Clinic indefinitely effective6084 Cerritos Avenue 11/21/00.Long Beach, California

Lamar, Magaline Eddings Suspended5625 East Balch, #208 indefinitely effectiveFresno, California 09/02/00.

Layon, Warrie Suspended10336 Beach Boulevard indefinitely effectiveStanton, California 9/2/2007. and26344 Antonio CircleLoma Linda, California

Ledesma-Sittman, SuspendedVictoria H. indefinitely effective4875 Manzanita Avenue, 7/20/2005.#38Carmichael, California

Lee, Francine Suspended aka: Kendrick, Francine indefinitely effective Hughes, Tanya 3/1/06.8165 Port Royale WaySacramento, California

Lee, Marvin Suspended368 West 1st Avenue indefinitely effectiveChico, California 9/4/2006.

Lemos, Adolph Suspended7525 Sherman Hoyt indefinitely effective Avenue 7/1/2007.Twenty-Nine Palms, California

Lemus, Maria Ibette Suspended3910 West 118th Place indefinitely effectiveHawthorne, California 11/9/2006.

Leniu, Grace F. Suspended44474 Cayenne Trail indefinitely effectiveTemecula, California 11/20/01.

Leon, Vanessa Norma De Suspended37824 17th Street East indefinitely effectivePalmdale, California 11/19/04.


susp T12


Leonardo, Alicia M. Suspended411 Cardiff Street indefinitely effectiveSan Diego, California 6/6/2007.

Lewandowski, Jennifer Ann Suspended3316 East Wilton Street, #3 indefinitely effectiveLong Beach, California 05/23/03.

Lewandowski, Suspended Rebecca Lynn indefinitely effective2795 Anderson Avenue 05/02/03.Klamath Falls, Oregon

Lewandowski, Mark Suspended733 Calle De Arboles indefinitely effectiveRedondo Beach, California 02/19/04.

Lewis, Robert Nathaniel Suspended5678 West 63rd Street indefinitely effectiveLos Angeles, California 04/03/02.

Lewis, Terry Suspended125 #B East Morgan Street indefinitely effectiveRialto, California 09/15/00.

Leyba, Sherry 498320 Suspended1884 Drendel Circle indefinitely effectiveParadise, California 01/04/02.

Lim, John Suyat, Jr. Suspended526 South Ardmore, #120 indefinitely effectiveLos Angeles, California 3/1/2006.

Link, Liza Ma Suspended727 Dillion Street indefinitely effectiveLos Angeles, California 04/02/03.

Littlefield, Susan Suspended22110 Gilmore Street indefinitely effectiveCanoga Park, California 09/24/02.

Loba, Cristeta 533408 Suspended1585 W. El Camino Real, #5 indefinitely effectiveMountain View, California 03/21/02.

Long, Narin Suspended536 Rose Avenue indefinitely effectiveLong Beach, California 6/22/01.

Long, Vandy Y. Suspended525 East Esther Street, indefinitely effectiveApartment 3 04/09/03.Long Beach, California

Lopez, Bernabe Suspended805 Lakeville Circle indefinitely effectivePetaluma, California 08/04/04.

Lopez, Carlos 474445 Suspended1629 Del Mar Avenue, #3 indefinitely effectiveRosemead, California 03/28/02.

Lopez, Carole Ann Suspended2814 S. Bedford Street indefinitely effectiveLos Angeles, California 11/19/02.

Lopez, Jaime Antonio Mart Suspended aka: Lopez, Jaime indefinitely effective Antonio Martinez 10/20/02.7025 Crofton AvenueBell, California


Lopez, Jose Refugio Suspended626 S. Record Avenue indefinitely effectiveLos Angeles, California 12/16/02.

Lopez, Myrna Ramos Suspended216 South Occidental indefinitely effective Boulevard, #2 10/01/03.Los Angeles, CaliforniaLuna, Javier Suspended1561 Pera Street indefinitely effectiveCorona, California 8/20/02.

Macabuhay, Dennis Suspended Ordonez indefinitely effective1558 San Fernando Drive 05/12/04.Corona, California

Maddock, Michael Suspended24128 Censor Avenue indefinitely effectiveHarbor City, California 5/11/04.

Magsino, Rene Diola Suspended3163 Helms Avenue indefinitely effectiveLos Angeles, California 06/24/04.

Makseredzhyan, Hakop Suspended1613½ Winona Boulevard indefinitely effectiveLos Angeles, California 08/04/04.

Manukian, Gagik Suspended207 West Lomita Avenue, indefinitely effectiveApt. 313 06/24/04.Glendale, California

McKinnon, Laurie J. Suspended aka: McKinnon, Laura Jo indefinitely effective Adams, Laurie J. 01/20/04.25 Greenwood AvenueSan Francisco, California

Marayelle, Judith P. LP2727 Suspended101 Oceana Avenue, indefinitely effectiveApartment #14 04/20/00.Santa Barbara, CaliforniaMarquez, Francisco Suspended11511 Sunnybrook Lane indefinitely effectiveWhittier, California 07/14/04.

Martin, Deo Victor Suspended aka: Martin Deo P. indefinitely effective2645 Market Street, #102 8/10/01.San Francisco, California

Martinez, Ana Cristina Suspended aka: Martinez, Anna indefinitely effective Martinez, Ana C. 04/19/04. Martinez, Ana Zaldana, Ana Cristina Zaldana, Ana Zaldanamartinez, Ana C.622 Marshall RoadVacaville, California

Martinez, Joe Suspended947 Graybar Avenue indefinitely effectiveLa Puente, California 05/20/03.


susp T13


Martinez, Rebecca Suspended443½ North Virgil Avenue indefinitely effectiveLos Angeles, California 4/18/02.

Martinez, Sylvia Calayca Suspended631 East 8th Street indefinitely effectiveNational City, California 6/20/2006.

Martinez, Sylvia D. Suspended aka: Martinez, Silvia indefinitely effective Pineda, Lura 12/16/02.1711 South Highland AvenueLos Angeles, California

Matthews, Hazel 13386 Suspended805 Pennsylvania Street indefinitely effectiveVallejo, California 3/25/02.

Maxwell, Kendra Suspended1639 East G Street indefinitely effectiveSan Bernardino, California 4/13/02.

McCallum, Ronald D. Suspended355 North Wolf Road indefinitely effectiveSunnyvale, California 3/19/04.

McClarty, Timothy W. Suspended6725 Medford Court indefinitely effectiveChino, California 3/29/02.

McCoy, Jimmy Dean Suspended2330 South Lotus indefinitely effectiveFresno, California 3/20/05.

McCready, Robert Oliver Suspended24555 Treasure Drive indefinitely effectiveMoreno Valley, California 4/28/02.

McGann, Jon D. Suspended1340 Via Terrassa indefinitely effectiveEncinitas, California 12/19/02.

McGuffin, Devere Suspended Warrington, II indefinitely effective401 Meadowgrove Street 8/7/2007.La Canada, California

McIntosh, Delores Harris Suspended376 Spinnaker Way indefinitely effective6000 S. Land Park Drive, #218 10/20/02.Sacramento, California

Meckstroth, Charles Suspended3811 Charlesworth Drive indefinitely effectiveCathedral City, California 4/26/2007.

Medillin, Sarah Jo Suspended758 Braun Avenue indefinitely effectiveSan Diego, California 4/16/2007.

Medina, Cathy SuspendedP.O. Box 962 indefinitely effectiveChino, California 8/7/2007.

Medina, George Suspended24710 Morning Glory Drive indefinitely effectiveMoreno Valley, California 7/22/2007.


Mejia, Yasmin Marlene Suspended8027 Teesdale Avenue indefinitely effectiveNorth Hollywood, 4/10/2007.California

Melkonyan, Arsen Suspended6339 Morse Avenue #306 indefinitely effectiveNorth Hollywood, California 11/21/00.

Mena, Daisy Marlene Suspended7240 South Bright indefinitely effective Avenue, #A 8/3/2006.Whittier, California

Mendez, Agueda Yaneth Suspended6 Quiet Hills Circle indefinitely effectivePomona, California 3/27/2007.

Mendoza, Henry Suspended15724 Marlin Place indefinitely effectiveVan Nuys, California 8/5/2007.

Mestetsky, Illya G. Suspended12411 Magnolia Boulevard, indefinitely effective #408 10/18/01.Valley Village, California

Mikayelyan, Rafik Suspended12775 Stagg Street indefinitely effectiveNorth Hollywood, California 6/12/03.

Min, Chanphirun Meanowuth Suspended aka: Min, Christopher indefinitely effective Meanowuth 05/20/03. Kikma, Min Min, KokmaP.O. Box 5000Delano, California

Minasyan, Nshan Suspended4363½ Clayton Avenue indefinitely effectiveLos Angeles, California 08/28/00.

Misuraca, Betsy Ann Suspended aka: Christman, Betsy indefinitely effective Ann 5/18/2006.6100 Michigan Bluff Road,#389Foresthill, California

Mohammed, Idris G. Suspended7629 Franklin Boulevard, indefinitely effective #18 8/20/02.Sacramento, California

Molina, Esperanza Suspended Elizabeth Rivas indefinitely effective5246 Florence 04/20/03. Avenue, #12Bell, California

Monroy, Lorraine 485115 Suspended44208 Hermosa Lane, #16 indefinitely effectivePalm Desert, California 3/19/02.

Montoya, Nilda Suspended12960 Dronfield Avenue, indefinitely effective#106 8/5/2007.Sylmar, California


susp T14


Moore, Emery E. 5938 Suspended5023 5th Street indefinitely effectiveFallbrook, California 03/21/03.

Morales, Almario 536322 Suspended121 Maher Court indefinitely effectiveVallejo, California 3/26/02.

Morales, Ana Suspended734 South Bernardo indefinitely effective Street, #305 8/16/2006.Los Angeles, California

Morales, Mary Magdalene Suspended2017 North Dern Avenue indefinitely effectiveLos Angeles, California 10/17/2006.

Moore, Merlyn Suspended6101 Geremander Avenue indefinitely effectiveRialto, California 12/20/05.

Moreno, Mauricio Javier Suspended174 Chambers Street, #6 indefinitely effectiveEl Cajon, California 09/15/00.

Muhamed, Munir A. Suspended254 Delfino Way indefinitely effectiveHenderson, Nevada 11/20/01.

Munn, Vincent Edward Suspended3861 B Street, indefinitely effectiveApartment O 01/5/05.San Bernardino, California

Murphy, Loatha Dennyce Suspended aka: Reed, Loatha indefinitely effective Reed, Loatha Dennyce 8/17/2006.28 East Lemon AvenueFresno, California

Muy, Nong Suspended5700 Walnut Avenue indefinitely effectiveLong Beach, California 5/25/01.

Najaryan, Vigen Suspended420 West Windsor Road, #21 indefinitely effectiveGlendale, California 9/9/2007.

Navarro, Lourdes MTA39059 SuspendedP.O. Box 10104 indefinitely effectiveGlendale, California 3/22/02.

Nazaryan, Mina Suspended8875 Costa Verde indefinitely effective Boulevard, 3/20/2007.Apartment #608San Diego, California

Ndemba, Jackson N. Suspended3718 Clarington Avenue, #4 indefinitely effectiveLos Angeles, California 4/29/02.

Needles, Francine Diane Suspended12040 Eastman Street indefinitely effectiveCerritos, California 4/18/02.

Nguyen, Dat Tat Suspended7538 Clear Sky Road indefinitely effectiveSan Diego, California 8/14/01.


Nguyen, Doi Thanh Suspended4355 Menlo, #3 indefinitely effectiveSan Diego, California 09/15/00.

Nguyen, Due Huu Suspended4343 Menlo Avenue indefinitely effectiveSan Diego, California 9/14/01.

Nguyen, Hoang Mau Suspended7538 Clear Sky Road indefinitely effectiveSan Diego, California 8/14/01.

Nguyen, Ly Quang Suspended576 Shadywood Drive indefinitely effectiveEl Cajon, California 09/09/00.

Nickerson, Annie Neal Suspended5518 North Dairy Avenue indefinitely effectiveLong Beach, California 09/30/00.

Niknia, David Suspended1314 Laurel Way indefinitely effectiveBeverly Hills, California 7/22/2007.

Novikov, Leonid Suspended2303 Weybridge Lane indefinitely effectiveLos Angeles, California 5/7/03.

Nugiel, Dale Joseph 48421 Suspended2718 Colby Avenue indefinitely effectiveLos Angeles, California 6/5/2005.

Nwabuzoh, Joseph Onuorah Suspended aka: Onuorah, Joseph indefinitely effective Nwabuzoh 11/19/02. Onwuka, Joseph Nwabuzoh22257 Welby WayWoodland Hills, California

Nwakwo, Raymond Suspended aka: Nwankwo, Raymond indefinitely effective5750 Cerritos Avenue, #1 09/19/03.Long Beach, California

O’Campo, Emma Suspended8113 Cypress Avenue, indefinitely effectiveApartment B 01/5/05.South Gate, California

Odesskaya, Yana Suspended5301 Balboa Boulevard, indefinitely effectiveApartment #G-6 3/1/2006.Encino, California

Ojeda, Alberta Suspended aka: Ojeda, Berti indefinitely effective3627 Puente Avenue 12/16/02.Baldwin Park, California

Orozco, Consuelo Suspended125 1/2 Mountain View Street indefinitely effectiveOak View, California 3/2/06.

Osoria, Karla Suspended369 S. Columbia Avenue, indefinitely effective#421 11/19/02.Los Angeles, California

1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007

susp T15


Otterbeck, Benjamin L. Suspended11387 Vela Drive indefinitely effectiveSan Diego, California 3/20/02.

Osoria, Karla SuspendedOudin, James Charles indefinitely effective2291 Aurora Court 10/26/01.El Centro, California

Oudin, Madelyn Alexis Suspended Norrington indefinitely effective2291 Aurora Court 09/09/00.El Centro, California

Ovasapyan, Razmik Suspended451 West Hawthorne Street, #301 indefinitely effectiveGlendale, California 08/28/00.

Ozaeta, Sean 499447 Suspended6414 Indio Avenue indefinitely effectiveYucca Valley, California 3/1/02.

Packard, Christy Michelle Suspended aka: Packard, Christy indefinitely effective Nichelle 12/6/2006.2717 South Bardell AvenueFresno, California

Padrigo, Rafael Ignacio Suspended6915 Simi Place indefinitely effectiveSan Diego, California 6/20/2006.

Palezyan, Richard Suspended445 East Magnolia indefinitely effective Boulevard, #104 06/20/00.Burbank, California

Panshi, Surinder Singh Suspended215 North Wyoming Avenue indefinitely effectiveSouth Orange, California 08/04/04.

Parks, Michelle Earlena Suspended3611 South Barcelona, #A indefinitely effectiveSpring Valley, California 8/16/2006.

Patterson, William Sanvurn Suspended467 Saratoga Avenue #603 indefinitely effectiveSan Jose, California 11/06/00.

Paz, Elida Suspended12343 Darnell Street indefinitely effectiveGardena Grove, California 9/2/2007.

Pearsall, Tonya Suspended1616 Neal Dow Avenue, indefinitely effectiveApartment #4 9/4/2006.Chico, California

Peaslee, Geraldine Suspended Elizabeth indefinitely effective7367 Central, 10/20/02.Apartment 274Highland, California

Pena, Irma Yolanda Suspended4620 Coliseum Street, #3102 indefinitely effectiveLos Angeles, California 06/30/04.


Penniman, Vernanell Gibson Suspended540 Hidden Valley Drive indefinitely effectiveAzusa, California 10/01/03.

Pham, Michael Suspended aka: Pham, Hoang indefinitely effective1009 Stanley Avenue 5/20/02.Long Beach, California

Pina, Carmen Mary Suspended aka: Lara, Carmen Mary indefinitely effective Delgado, Carmen Mary 07/14/04. Vasquez, Carmen2279 East WhiteFresno, California

Pinkney, Brandi Raquel Suspended17800 East Colima Road, #402 indefinitely effectiveRowland Heights, California 09/15/00.

Pok, Malacca Suspended aka: Tony indefinitely effectiveCDC#T34095 6/20/02.Shafter CCF1150 E. Ash AvenueShafter, California

Polishchuk, Vladimir Suspended18745 Hatteras Street, #44 indefinitely effectiveTarzana, California 3/20/2006.

Ponce, Ingrid Belen Suspended aka: Lopez, Ingrid Belen indefinitely effective326 South Avenue 57, 08/25/04.Apt. 105Los Angeles, California

Potts, Elena Theresa Suspended73-600 Siesta Trail indefinitely effectivePalm Desert, California 09/09/00.

Provo, Benjamin Earl Jr. Suspended12017 Carlisle Avenue indefinitely effectiveChino, California 4/9/03.

Pulfer, Jeffery A. Suspended645 Garfield Street indefinitely effectiveCedarville, California 9/6/2007.

Pulfer, Kathleen Suspended645 Garfield Street indefinitely effectiveCedarville, California 9/6/2007.

Puma, Yoon Suspended4810 E. Sphinx Way, #1094 indefinitely effectiveLas Vegas, Nevada 10/20/02.

Puquiz, Rodrigo Casipit Suspended804 Rachael Avenue indefinitely effectiveNational City, California 6/20/2006.

Ramirez, Jorge Antonio Suspended1920 North Fair Oaks Drive indefinitely effectiveLong Beach, California 5/29/2007.

Ramirez, Maria Elena Suspended aka: Ramirez, Maria Diaz indefinitely effective Ramirez, Maria Helen 9/7/05.11041½ Louise AvenueLynwood, California


susp T16


Ramirez-Merlos, Javier SuspendedPMB 1154 indefinitely effective416 W San Ysidro 09/20/00. Boulevard–LSan Ysidro, California

Ramirez, Ruperta Sunas Suspended1379 Vado Way indefinitely effectiveSan Diego, California 6/20/2006.

Ramos, Bernadito Caneja Suspended aka: Ramos, Bernie indefinitely effective5081 College View Avenue, #4 4/18/02.Los Angeles, California

Ray, Suzanna 181633 Suspended2150 Oxford Street, #77B 42612 indefinitely effectiveBerkeley, California 2/1/02.

Recaido, Alves Bert Allen Suspended aka: Allen, Recaido Bert indefinitely effective Allen 08/04/04.22214 Catskill AvenueCarson, California

Recaido, Evelyn B. Suspended aka: Devera, Bongato indefinitely effective Evelyn 08/04/04.22214 Catskill AvenueCarson, California

Recinos, Maria Carolina Suspended aka: Parra, Maria Carolina indefinitely effective11112 Penn Street 8/2/2006.Lynwood, California

Reed, Loatha Suspended aka: Reed, Loatha Dennyce indefinitely effective28 East Lemon Avenue 4/20/2006.Fresno, California

Requilam, Carolina SuspendedCastaneto, Carolina indefinitely effective22723 Neptune Avenue 12/20/04.Carson, California

Resendiz, Rolan 505551 Suspended701 Chestnut Street, indefinitely effectiveApartment 3 2/25/02.Turlock, California

Revelli, Carmen Suspended aka: Del Toro, Carmen indefinitely effective Diane 07/14/04. Valer, Carmen De Revelli, Carmen Diane Valer5309 Fidler AvenueLakewood, California

Reyes, Aristeo 454397 Suspended304 N. Laurel, #A indefinitely effectiveSanta Ana, California 3/5/02.

Reyes, Jorge Benitez Suspended aka: Rodriguez, Julian indefinitely effective Floy 8/23/2006.918 East Hoffman Street, #4Long Beach, California


Reyes, Rosa Maria Suspended6442 Desert Queen indefinitely effective Avenue, #5 8/31/2006.Twentynine Palms, California

Reymundo, Rosa Maria Suspended Olmedo Reyes indefinitely effective1611 Cabarita Court 02/25/04.Upland, California

Ricci, Charlene SuspendedP.O. Box 373 indefinitely effectiveSolvang, California 9/4/2006.

Richard, Jessie Charles Suspended 632 Capitol Street, #B indefinitely effectiveVallejo, California 10/20/05.

Rivera, Vanessa 483206 SuspendedP.O. Box 928 indefinitely effectiveCathedral City, California 2/4/02.

Roberts, Diana M. Suspended1845 Business Center indefinitely effective Drive, #105 9/2/2007.San Bernardino, California

Roblas, Esterhilda Suspended aka: Robles, Estherhilda indefinitely effective438 Zachary Drive 04/19/04.Vacaville, California

Rodgers, Mae Suspended3113 S. Rita Way indefinitely effectiveSanta Ana, California 11/19/02.

Roedel, Marlisa Suspended2701 Gramercy Avenue, #7 indefinitely effectiveTorrance, California 05/23/03.

Rogers, Julie Ann Suspended4830 Virginia Avenue indefinitely effectiveOroville, California 9/4/2006.

Rohar, Lynette Mae Suspended5523 Acacia Street indefinitely effectiveSan Bernardino, California 8/20/02.

Romo, Julio Javier Suspended11118 Daneswood Drive indefinitely effectiveArcadia, California 09/24/03.

Rosales, Marisela Lopez Suspended5338 Miller Avenue indefinitely effectiveStockton, California 6/6/2007.

Rosario, Ma Theresa del Suspended aka: Ma Theresa Samson indefinitely effective del Rosario 08/20/00. Tess Samson del Rosario Tiessie Samson del Rosario Terecita Samson del Rosario5017 Gardenia AvenueLong Beach, California


susp T17


Ross, Adam Suspended4430 Noble Avenue, #203 indefinitely effectiveSherman Oaks, California 8/31/05.

Ross, Chom Che Suspended940 Gaviota Avenue, Apt. A indefinitely effectiveLong Beach, California 06/16/03.

Ross, Vanareth Suspended940 Gaviota Avenue, Apt. A indefinitely effectiveLong Beach, California 05/21/03.

Rowan, Victoria Suspended380 N. Linden Avenue indefinitely effectiveSan Bernardino, California 4/13/02.

Roxas, Felipe Posadas Suspended912 Olive Avenue indefinitely effectiveNational City, California 6/20/2006.

Rozenberg, Arkady Suspended2309 Apollo Drive indefinitely effectiveLos Angeles, California 4/18/02.

Rubenich, Ervand Doganian Suspended425 East Cedar, Apartment A indefinitely effectiveBurbank, California 09/09/00.

Ruff, Maria Delrosario Suspended1011 Donner Avenue indefinitely effectiveSimi Valley, California 7/10/2007.

Ruiz, Reyna Isabel Suspended aka: Ruiz, Reyna Isabelle indefinitely effective8168 Cypress Avenue, #B 5/20/02.South Gate, California

Ruiz, Rolando Jose Suspended8168 Cypress Avenue, #B indefinitely effectiveSouthgate, California 08/28/00.

Saguin, Khalila Cruz Suspended11901 East 176th Street indefinitely effectiveArtesia, California 10/17/2006.

Salazar-Villar, Ciro Alcides Suspended aka: Salazar, Ciro indefinitely effective101 S. Spruce Street, 2/20/02.Apartment 121Escondido, California

Saludo, Eduardo Dy Suspended256 S. La Fayette Park indefinitely effectivePlace, #301 2/20/02.Los Angeles, California

Sanchez, Bernardo Suspended7723 Eastern Avenue indefinitely effectiveBell Gardens, California 10/13/04.

Sanchez, Donald Albert Suspended15790 Washoan Road indefinitely effectiveApple Valley, California 10/20/03.


Sanchez, Laura Sue Suspended aka: Rasp, Laura Sue indefinitely effective15790 Washoan Road 4/13/02.Apple Valley, California

San Joaquin Valley Suspended Community Support indefinitely effective Services 8/30/2006. dba: Fresno Co. Community Group Home4705 North Sonora Avenue,Suite #109Fresno, California

Schexnayder, Ernest Suspended John, Jr. indefinitely effective5751 North Katy Lane 4/20/2005.Fresno, California

Schluter, Kathleen H. Suspended261 Manuella Lane indefinitely effectiveSonoma, California 4/20/04.

Schneider, Jerome Suspended8355 Rednock Lane indefinitely effectiveMiami Lakes, Florida 4/18/02.

Schneider-Rucinski, Noreen Suspended3344 N. Mountain indefinitely effective View Drive 2/20/02.San Diego, California

Schwartz, Elizabeth Anne Suspended12437 Damasco Court indefinitely effectiveSan Diego, California 7/23/2007.

Scott, Erika Deanna Suspended3118 East Pine Avenue indefinitely effectiveFresno, California 4/9/03.

Scura, Richard J. Suspended340 N. Huntley Drive indefinitely effectiveLos Angeles, California 8/20/01.

Sebastian, Elizabeth Suspended aka: Sebastian, Mary indefinitely effective415 South Occidental 06/30/04. Boulevard, #105Los Angeles, California

Sehl, Barbara Yvonne Suspended32 West Johnson Drive indefinitely effectiveSequim, Washington 9/2/2007.

Sey, Savon Suspended aka: Steven Sey indefinitely effective Peter Song 6/4/01. Phillip Gomez1748 East 54th Street, #293Los Angeles, California

Shackman, Stephen J. Suspended7803 S E 119th Court indefinitely effectivePortland, Oregon 3/20/02.


susp T18


Shams, Irman Suspended aka: Shah, Sam indefinitely effective Khan, Sam Mohammad 8/19/04.17682 Cameron Street, #FHuntington Beach, California

Sheikh, Asif SuspendedIntercare/Westcare indefinitely effective Transport Inc. (Owner) 9/30/02.11849 Pradera RoadCamarillo, California

Shiery, Julie A. Suspended21400 Burbank Boulevard, indefinitely effectiveApartment #108 12/20/04.Woodland Hills, California

Shoaib, Mohammad Suspended aka: Mohammad, Shoaib indefinitely effective1832 Commonwealth 8/3/2006. Avenue, B-125Fullerton, California

Shorrock, Gerald J. Suspended516 Canal Street, #1 indefinitely effectiveSan Rafael, California 9/2/2007.

Shpirt, Jenny Suspended119 Belmont Avenue indefinitely effectiveLos Angeles, California 2/1/2007.

Shpolyansky, Eddy Suspended24300 Gilmore Street indefinitely effectiveWest Hills, California 3/5/2007.

Simmons, Sandra Denise Suspended17142 Coronado Avenue indefinitely effectiveFontana, California 01/20/04.

Sims, Richard Carlton Suspended#3130668 indefinitely effectiveCorcoran State Prison 8/5/2007.P.O. Box 8800Corcoran, California

Sinibaldi, Jose Luis Suspended539 West Buckthorn Avenue indefinitely effectiveInglewood, California 7/14/01.

Skyllingstad, Ryann L. Suspended1791 N. Sycamore Avenue, indefinitely effective#312 8/2/2007.Hollywood, California

Smallen, Iana Michina Suspended aka: Michina, Iana indefinitely effective Smallen, Jana 5/29/2007.73 Rue du ChateauAliso Viejo, California

Smettler, Kim 206718 Suspended27432 Portsmouth Avenue indefinitely effectiveHayward, California 3/15/02.


Smith, Sybil Agatha Suspended aka: Farrell, Sybil Agatha indefinitely effective2599 W. Lake Van Ness 8/7/2007. CircleFresno, California

Smoots, Olivia Suspended 8120 Power Inn Road, indefinitely effectiveApartment #102 10/20/02.Sacramento, California

Speer, Evelyn Ladessa Suspended4535 Inez Avenue indefinitely effectiveYucca Valley, California 7/22/2007.

Spencer, Denis Edward Suspended1201 Walnut Avenue indefinitely effectiveTustin, California 09/28/99.

Srey, Thavy Suspended2299 Rose Avenue, #5 indefinitely effectiveSignal Hill, California 1/29/03.

Stack, Sophia Dao Suspended876 South Harbor Boulevard indefinitely effectiveAnaheim, California 1/20/03.

Stafford, Debbie D. Suspended4754 Santa Margarita indefinitely effective Lake Road 9/4/2006.Santa Margarita, California

Stepanyan, Arthur Suspended320 South Adams, #E indefinitely effectiveGlendale, California 08/28/00.

Steppuhn, Jorge H. Suspended3719 Elma Road, indefinitely effectiveApartment #A 8/18/05.Pasadena, California

Stevens, Anthony Suspended aka: Brace, Michael indefinitely effective5902 Landis Avenue 10/5/01.Carmichael, California

Stevens, Nick Suspended aka: Brace, Mathew indefinitely effective5902 Landis Avenue 7/4/01.Carmichael, California

Stewart, Marcus Douglas Suspended2115 E. Cole Avenue indefinitely effectiveFresno, California 5/20/2007.

Strusz, Robert Suspended#14656-097 indefinitely effectivec/o Cornell Corrections 7/20/05.205 Mac Arthur BoulevardOakland, California

Sumblin, Delisa Antoinette Suspended aka: Delisa Antoinette Cole indefinitely effective7720 Robinette Road 09/02/00.Sacramento, California


susp T19


Tabibian, Fazlollah Suspended4576 Martson Drive indefinitely effectiveEncino, California 2/19/2007.

Tacanga, Carolina Elvira Suspended14040 Foothill, Suite #334 indefinitely effectiveMission Hills, California 8/7/2006.

Tagumasi, Abner Suspended22124 Newkirk Avenue indefinitely effectiveCarson, California 11/21/00.

Taheri, Mahshid Alami-Rad Suspended4430 Milano Way indefinitely effectiveOceanside, California 4/18/02.

Taheri, Seyed Ali Asghar Suspended7136 Tangier Drive indefinitely effectiveCarlsbad, California 09/15/00.

Takos-Brooks, Althea Suspended2641 Foothill Drive indefinitely effectiveCarmichael, California 8/23/2006.

Tarango-Wilhoite, Rosa M. 41804 Suspended aka: Tarango, Rosa M. indefinitely effectiveP.O. Box 183 10/18/01.Downey, California

Tatoian, Grigor Suspended15515 Lemac Street indefinitely effectiveVan Nuys, California 6/4/01.

Taylor, Gary Wayne Suspended8230 Hollywood Boulevard indefinitely effectiveLos Angeles, California 10/01/03.

Tecson, Ronaldo C. Suspended20518 Londelius Street indefinitely effectiveWinnetka, California 07/28/04.

Thomas, Archie Melvin Suspended aka: Washington, Melvin Louis indefinitely effective10701 Wilmington Avenue 04/20/03.Los Angeles, California

Thomason, Ronnie Modoc Suspended506 East 12th Street, indefinitely effectiveApartment #36 4/30/2007.Alturas, California

Torossian, Marine Mary Suspended2312 Peyton Avenue indefinitely effectiveBurbank, California 8/3/2006.

Townsend, Bernard Suspended #28245-112 indefinitely effective aka: B.J. 1/20/06. Townsend, Bernard Besyt Townsend, Bernard Bias Townsend, Bernard B.CI Taft Correctional InstitutionP.O. Box 7001Taft, California


Tran, Quy Quoc Suspended aka: Tran, Quincy indefinitely effective9988 Silver Meadow Way 8/18/05.Sacramento, California

Triche, Mitchell Ray Sr. Suspended aka: Brooks, Mitchell Ray Indefinitely effective6509 South Main Street, Apt. 1 04/20/03.Los Angeles, California

Turknett, Leroy Suspended2300 Morell Street Rear indefinitely effectiveSacramento, California 8/7/2006.

Ty, Huynh Van Suspended2715 West Foothill indefinitely effective Boulevard,Suite 5 05/20/03.Rialto, California

Umansky, Olga Suspended11808 Dorothy Street, indefinitely effectiveUnit 302 08/06/04.Los Angeles, California

Universal Placement, Inc. Suspended3345 Wilshire Boulevard, indefinitely effectiveSuite #407 11/18/04.Los Angeles, California

Upshaw, Robinlene Suspended4695 East Belgravia Avenue indefinitely effectiveFresno, California 09/20/00.

Urin, Alexander Suspended8163 Redlands Street, #12 indefinitely effectivePlaya Del Rey, California 10/13/04.

Vann, Hoeuth Liz Suspended3213 Magnolia Avenue indefinitely effectiveLong Beach, California 06/30/04.

Vann, Sinnaro Suspended10 West 47th Street indefinitely effectiveLong Beach, California 06/30/04.

Vega, Salvador Suspended747 Florida Street #D indefinitely effectiveImperial Beach, California 09/20/00.

Velazquez, Graciela Suspended1141 North Alma Avenue indefinitely effectiveLos Angeles, California 8/7/2006.

Ventura, Silvia Del Carmen Suspended6608 South Main Street indefinitely effectiveLos Angeles, California 8/15/2006.

Villamizar, Carlos Suspended c/o Specialized Medical indefinitely effective Clinic 12/31/03.10811 South Grevillea AvenueLennox, California


susp T20


Villanueva, Graciela 246779 Suspended1445 N. Pecan indefinitely effectiveReedley, California 3/19/02.Villariza, Beatrice Burrola Suspended2261 Aurora Court indefinitely effectivePalm Desert, California 09/09/00.

Villar, Fe Rodriguera Suspended3591 Ruffin Road, #128 indefinitely effectiveSan Diego, California 8/2/2006.

Vogel, Mary Ann Suspended13602 Cedar Creek Court indefinitely effectiveLa Mirada, California 6/20/01.

Volk, Maya Suspended aka: Fayngold, Maya indefinitely effective Solk, Maya 11/19/02. Vock, Maya8733 Double Eagle DriveLas Vegas, Nevada

Vong, Sokanha Suspended6975 Elmwood Road indefinitely effectiveSan Bernardino, California 7/14/01.

Vue, Ker Suspended2117 Hanford Drive indefinitely effectiveSan Diego, California 08/28/00.

Wade, Shanisha Suspended330 West Almond Street indefinitely effectiveCompton, California 09/09/00.

Wainwright, Wayne T. Suspended1385 Deveron Place indefinitely effectivePomona, California 8/18/05.

Walker, Evelyn State Suspended aka: Akers, Charlotte A. indefinitely effective Walker, Evelyn Jean 10/13/04. Fischer, Evelyn Jean Summer, Evelyn Jean Day, Evelyn Jean Hendrickson, Evelyn Jean Smith, Evelyn Hernandez, Evelyn972 West McKinleyFresno, California

Wallace, Donna L. Suspended aka: Richart, Donna indefinitely effective Hiltibran, Donna 8/20/2006.49272 Hibiscus Drive, Unit #BMorongo Valley, California

Wathen, Steven W. Suspended542 Covina Boulevard indefinitely effectiveSan Dimas, California 7/27/02.

West, Sharon Suspended aka: Ware, Sharon indefinitely effective4025 West 111th Street, Apt. 4 09/19/03.Inglewood, California


White-Ballard, Carletta Suspended aka: Ballard, Carletta indefinitely effective Percillian 8/26/2007.2521 S. Holmes PlaceOntario, California

White, Leroy Sydney Suspended1700 West Reeve Street indefinitely effectiveCompton, California 04/20/03.

White, Vance King Suspended691 South Irolo, #2010 indefinitely effectiveLos Angeles, California 10/01/03.

Wick, Carmen SuspendedInmate #17677112 indefinitely effectiveFederal Correctional 10/19/00. Facility–Camp Park5701 8th StreetDublin, California

Williams, Sandra Lynette Suspended603 Grove indefinitely effectiveOntario, California 05/20/04.

Woods, Brenda J. Suspended4113 Gaddi Drive, indefinitely effectiveApartment 3 4/29/02.Sacramento, California

Wyatt, Jeanette Suspended aka: Wilkerson, Jeanette indefinitely effective Johnson, Jeanette 10/13/04.1628 East Eighth StreetStockton, California

Yanes, Kimberly Ann Suspended2616 North Brunswick indefinitely effectiveFresno, California 9/20/2005.

Yasin, Muhammad Suspended aka: Massey, Charles indefinitely effective30 Telegraph Lane 08/04/04.Sayreville, New Jersey

Young, Olga Iris Suspended510 F Street indefinitely effectiveChula Vista, California 11/19/02.

Zherebnyuk, Nikolay Suspended1000 Rio Lane, #11 indefinitely effectiveSacramento, California 9/24/02.

Yancey, George Anthony Suspended aka: Yancy, George indefinitely effective Anthony 8/20/2006.2121 North Winery Avenue,Apartment CFresno, California

Yuzhelevsky, Anatoly Suspended aka: Levsky, indefinitely effective Anatoly “Tony” 10/13/04.7913 Vulcan DriveLos Angeles, California


susp T21

Administrator ProviderNumber

Woods, Gene Michael SuspendedInmate 91603-012 indefinitely effectiveFederal Correctional Prison Camp 06/20/00.P.O. Box 89Elkton, Ohio

Administrator/Owner (Unlicensed Residential Facility)

Chung, Pauline M. Suspended56925 Yucca Trail, Apartment 154 indefinitely effectiveYucca Valley, California 1/1/02.

Billing Manager

Casson, Ronald J., Jr. Suspended8050 Calico Street indefinitely effectiveSan Diego, California 9/20/01.

Bookkeeper

Dupre, Deborah Lynn Suspended2928 Villa Avenue 9/20/99Clovis, California for 15 years.

Corporation

Armenta, Lourdes H. Suspended and/or indefinitely effectiveRegroup Medical Billing & 01/20/04. Supplies, Inc. and/orRegroup Billing Services10562 Desser LaneAnaheim, California

Bagdasaryan, Emin Suspended c/o New Century Eyeglasses indefinitely effective3171 Los Feliz Boulevard, 07/07/04.Suite 302Los Angeles, California and115 East Palmer Avenue,Suite AGlendale, California

Classic Comfort, Inc. Suspended18566 Gilmore Street indefinitely effectiveReseda, California 03/20/03.

Gutierrez, Raymond Suspended c/o Fineline Marketing indefinitely effective1743 East Taylor 7/28/04.Placentia, California

Corporation ProviderNumber

Gutierrez, Raymond Suspended c/o Orange Management, Inc. indefinitely effective747 West Katella Avenue, 06/23/04.Suite 203Orange, California

L & M Diamond Suspended Jewelry Optical indefinitely effective and/or 07/07/04.Sigal, David and Mila7901 Santa Monica Boulevard,Suite 106Los Angeles, California

Morales, Jose Alfredo Suspended aka: Morales, indefinitely effective Jose Refugio Andrade 05/20/04. and/orLa Guadalupana Clinic1716 New England StreetLos Angeles, California

Norby, Scott Suspended3820 County Trails Lane indefinitely effectiveBonita, California 05/20/03. and/orPrinciple Medical Management, Inc.6424 West Sunset Boulevard,#850Hollywood, California

Nutcracker Business Services, Inc Suspended c/o Batis, Dennis Lynn indefinitely effective (Owner) 8/20/01.3936 Massachusetts AvenueLa Mesa, California

1 – Medi-Cal Suspended and Ineligible Provider ListJune 2007

susp T22

Corporation ProviderNumber

Orozco, Raquel Suspended41845 Carleton Way indefinitely effectiveTemecula, California 09/22/03.

R. M. Advance Suspended Instrumentation, Inc. indefinitely effective1040 North Grove 08/04/04.Anaheim, CaliforniaSafe Harbor Counseling Suspended4537 East 300 N indefinitely effectiveRigby, Idaho 06/18/04.

Sigal, David Suspended c/o L & M Diamond indefinitely effective Jewelry Optical 07/29/04.23020 Lita PlaceWoodland Hills, California

Udi, Joseph Effiong Suspended and/or indefinitely effective Mainland Consulting Group 10/20/03.P.O. Box 781243Los Angeles, California

Ground Transportation

Karunaratne, Nehil Mendis Suspended aka: Nehil, Karunaratn indefinitely effective Mendis 11/10/04. Karunaratne, M. Nehil Karunaratne, Nehic295 Pacini AvenuePittsburgh, California

Sales, George Suspended213 Longford Drive indefinitely effectiveSouth San Francisco, California 4/20/2005.

Group Home Employee

Farias, Manual Suspended29753 Niguel Road, Apt. C 8/20/98Laguna Niguel, California for 5 years.

House Parent

Rios, Robert Rogelio SuspendedCDC T75527 indefinitely effectivePleasant Valley 4/20/04. State PrisonP.O. Box 8501Coalinga, California

Licensed Practitioner ProviderNumber

Soares, John Allen 18011 Suspended2317 East Freemont indefinitely effectiveFresno, California 2/18/99.

Marketer

Bender, Cynthia Suspended330E Riverdale Avenue 4/20/99Orange, California for 5 years.

Bova, Sofia Suspended5225 White Oak Avenue, indefinitely effectiveApartment #4 7/20/2006.Encino, California

Grigoryan, Konstantin Suspended726 West Millard Canyon indefinitely effective Road 7/20/2005.Altadena, California

Starks, Edward Howard Suspended aka: Shaheed indefinitely effective9525 South 11th Avenue 7/20/2005.Inglewood, California

Stuardo, Carol Marie Suspended3735 Palo Court indefinitely effectiveBonita, California 09/30/00.

Stuardo, Luis Artemio Suspended3735 Palo Court indefinitely effectiveBonita, California 09/30/00.

Treynker, Aleksandr Suspended aka: Treynker, Alex indefinitely effective20258 Hamlin Street 7/20/2005.Canoga Park, California


susp T23

Medical Assistant ProviderNumber

Di, Map Suspended931 E. New York Street indefinitely effectiveLong Beach, California 5/14/99.

Di, Mealea Suspended11530 Hayford Street indefinitely effectiveNorwark, California 5/14/99.

Haro, Alba Patricia Suspended1515 Pleasant Avenue, #3 indefinitely effectiveLos Angeles, California 2/12/2007.

Mean, Rong R. Suspended1337 East Wesley Drive, #B indefinitely effectiveSignal Hill, California 9/16/99.

Preap, Dennisa Thida Suspended1389 Junipero, #4 9/20/99Long Beach, California for 10 years.

Valle, Luis Suspended343 West Acacia Avenue, indefinitely effectiveApartment #A 12/20/2005.Glendale, California

Medical Center

Ayman, Tooraj Torres SuspendedP.O. Box 486 indefinitely effectiveVista, California 1/19/04.

Body Care Center Suspended2576 Newport indefinitely effective Boulevard, #C 08/20/03.Costa Mesa, California

Central Community Services, SuspendedInc. indefinitely effective aka: Central ADHC 5/23/05. Asian Tower Health Center1825 Beverly BoulevardLos Angeles, California and 709 North Hill StreetLos Angeles, California

Dadyan, Gegam Suspended c/o Long Beach CCM indefinitely effective501 West Ocean Boulevard, 2/20/05.Suite #3260Long Beach, California

ElSayed, Sayad Mostafa Kamal Suspended aka: ElSayed, Sayed indefinitely effective Mostafa Kamal 12/19/02.11520 Washington PlaceLos Angeles, California

Medical Center ProviderNumber

Evergreen Medical Suspended Group, Inc. indefinitely effective15929 Youngwood Drive 5/20/03.Whittier, California

Haya Medical Group Inc. Suspended16701 Valley Boulevard, indefinitely effectiveSuite #F 10/20/04.Fontana, California

Heller, Eri Suspended803 San Vicente Boulevard indefinitely effectiveSanta Monica, California 08/19/02.

Highland Park Healthcare Center Suspended5676 York Boulevard indefinitely effectiveLos Angeles, California 01/20/04.

Karapetyan, Margarita Suspended aka: Karapetyan, indefinitely effective Margarett 6/20/2005. Kapapetyan, Margarita1413 North Kenmore Avenue, #3Los Angeles, California

La Mesa Medical Associates, Inc Suspended8851 Center Drive, indefinitely effectiveSuite 404 7/18/02.La Mesa, California

Medical Center of Norwalk SuspendedAguiluz, Amable D., Jr. indefinitely effective13330 Bloomfield Avenue, 10/23/05.Suite #111Norwalk, California

Memorial Medical Center Suspended465 McKenna Drive indefinitely effectiveMountain Home, Idaho 6/20/02.

Petersdorf, Michael Hans Suspended c/o Montecito Medical indefinitely effective4193 Carpinteria Avenue, 07/07/04.Suite 1Carpinteria, California


susp T24

Medical Center ProviderNumber

Seaton, Guy Roland Suspended and/or indefinitely effective St. Lukes Extended Care 08/25/04. St. Lukes Subacute Hospital and Nursing Center27253 Greenhaven RoadHayward, California and1652 Mono AvenueSan Leandro, California

St. Luke’s Subacute Suspended Hospital indefinitely effective and Nursing Centre, Inc. 1/19/05.Guy Seaton1652 Mono AvenueSan Leandro, California

Southern California Cardiology Suspended931 Buena Vista, #101 indefinitely effectiveDuarte, California 08/19/04.

Medical Clinic Admi nistrator

Darnell, Eloise Vergeire Suspended aka: Eloise S. Vergeire indefinitely effective Eloise Santos Vergeire 08/20/00. Eloise Vergeirecornillez Eloise Vergeire Cornillez5017 Gardenia AvenueLong Beach, California

Reed, Beverly Ann Suspended aka: Reed-Carson, 8/20/98 Beverly Ann for 5 years. Windbush, Beverly Ann 6709 La Tiujera Boulevard, #201Los Angeles, California

Tum, Wichniya Suspended3100 E. 105th Street, #4 5/20/99.Long Beach, California for 10 years.

Medical Clinic ProviderOffice Manager Number

Ventura, Gilberto Suspended c/o Pleasant Care indefinitely effective Convalescent Hospital 06/30/04.523 Hayes LanePetaluma, California

Villamizar, Carlos Suspended c/o Specialized Medical Clinic indefinitely effective10811 South Grevillea Avenue 12/31/03.Lennox, California

Medical Clinic Owner

Dura, Narin I.D. K73969 Suspended c/o California Rehabilitation 5/20/99 Center at Norco for 25 years.#210, Bed 82Norco, California

Hy, Setha Suspended3609 E. 14th Street 10/20/99Long Beach, California for 25 years.

Medical Technologist

‘Makarem, Anis Hussein MTA8304/ Suspended31551 Saddletree Drive DRH24 7/20/99Westlake Village, California for 5 years.

Malik, Anil MTA26621 Suspended8502 Day Street 4/20/99Sunland, California for 5 years.


susp T25

Non-Licensed Care ProviderProvider Number

Cox, Carla Susan Suspended31671 Islay Way 3/20/00Shingletown, California for 5 years.

Martin, Allen J. 00A167150 Suspended2025 Soquel Avenue indefinitely effectiveSanta Cruz, California 10/20/98.

Rosenberg, Alan David 00G101180 Suspended aka: Alan D. Roseberg indefinitely effective2000 Vale Road 3/20/00.San Pablo, California

Waite, Verner S. 000G34430 Suspended5243 Vista Del Sol indefinitely effectiveCypress, California 4/20/00.

Business Manager

Hidalgo, Alma Yaneth Suspended aka: Hidalgo, Janet indefinitely effective105 Nesbit Ridge 6/20/2006.Roswell, Georgia

Yeghishian, Norik Suspended1124 San Rafael Street, indefinitely effectiveApartment #1 6/14/2006.Glendale, California

Business Owner

Abolahrar, Mohammad Suspended dba: Roxbury Pharmacy, indefinitely effective Inc. 6/26/2007.9821 West Pico BoulevardLos Angeles, California

Abolahrar, Reza Suspended dba: Bayview Pharmacy, indefinitely effective Inc. 6/6/2007.500 Torrance BoulevardRedondo Beach, California

Ali, Shahida Ather Suspended688 Featherwood Drive indefinitely effectiveDiamond Bar, California 4/17/2007. and1175 North Lake AvenuePasadena, California

Anis, Inas Suspended dba: Women's Healthcare indefinitely effective Connection Medical 4/5/2007. Corporation1130 Ninth Street,Apartment #10Santa Monica, California and7111 Winnetka Avenue, #6Canoga Park, California

Business Owner ProviderNumber

Ather, Ali Suspendedc/o: Ahluwalia, Jasdeep S. indefinitely effective Attorney at Law 4/17/2007.12 S. Raymond Avenue, FPasadena, California

Benison Medical Supply, SuspendedInc. indefinitely effective4250 Pacific Highway, 3/28/2007.#119ASan Diego, California

Cacal, Roque Galiza Suspended aka: Cacal, Roy G. indefinitely effective1237 North Alexandria 10/19/2006. AvenueLos Angeles, California and1101 East Broadway, Suite #109Glendale, California

Cacal, Rosa Y. Suspended aka: Cacal, Rose Y. indefinitely effective1237 North Alexandria 10/19/2006. AvenueLos Angeles, California

Corral, Edmond Ruben Suspended1456 Hepner Avenue indefinitely effectiveLos Angeles, California 4/20/05.

Cote, Gary Armand Suspended dba: South Bay indefinitely effective Hearing & Balance 8/13/2007.4510 Campus Avenue, #5San Diego, California

Coulson, Andrea Gabriela Suspended aka: Arguello-Coulson, indefinitely effective Andrea G. 10/19/2006 Arguello, Andrea Argellodecoulso, Andrea Gab3123 East Marywood DriveOrange, California

Deguzman, Abraham Suspended Calantas indefinitely effective655 Corwin Avenue 8/7/2007.Glendale, California

Gazarov, Georgi A. Suspended620 North Louise Street, #207 indefinitely effectiveGlendale, California 5/18/06.

Greathouse, Betty SuspendedRR1 Box 138 indefinitely effectiveLarved, Kansas 2/20/0101.


susp T26


Guerra, Alfonso Eric Suspended1067 Holiday Drive indefinitely effectiveWest Covina, California 8/2/2007.

Hart, Rose V. Suspended14520 Dickens, indefinitely effectiveApartment #111 9/20/2006.Sherman Oaks, California

Johnson, Melvin Van, Sr. Suspended4032 Rosemont Avenue indefinitely effectiveMontrose, California 12/22/2006.

Kalunta, Cosmas Ibeabuchi SuspendedImmuno Lab indefinitely effective2383 Creekside Run 2/20/06.Chino Hills, California and5300 Santa Monica Boulevard,Suite #309Los Angeles, California

Kazanchian, Ovsep Suspended9324 Garvey Avenue, Suite #K indefinitely effectiveSouth El Monte, California 3/20/2006.

Klang, David Anthony Suspended attn: Scan In A Van indefinitely effectiveP.O. Box 12102 7/20/2005.Palm Desert, California

Kroytor, Yuly Suspended aka: Kroytor, Yuly J. indefinitely effective7210 Pacific Boulevard 4/19/2007.Walnut Park, California and11477 Dona Pegita DriveStudio City, California

Kun, Eric 3108 Suspended aka: Chieh Min Kun indefinitely effective8254 Youngdale Street 7/20/2006.San Gabriel, California and1 West Hellman Avenue, #3 Alhambra, California and302 North Garfield Avenue,Suite #1Monterey, California

Lash, Jeffery David A61336 Suspended306 W. El Norte Parkway, S indefinitely effectiveEscondido, California 5/1/2007. andP.O. Box 500513San Diego, California


Lovelace, Kenneth Suspended aka: Ringo Pharmacy indefinitely effective403 South Long Beach 1/17/2007. BoulevardCompton, California and2000 Marengo Street, Suite ELos Angeles, California and1341 East 4th Street, Suite AOntario, California

Mary Hope Care Home, SuspendedLLC indefinitely effective99 Airport Boulevard 5/20/2006. (old date)Freedom, California

Mary Hope Care Home, SuspendedLLC indefinitely effective99 Airport Boulevard 5/20/2007. (new date)Freedom, California

Mastikian, Serpoui Susie Suspended1933 Erringer Road indefinitely effectiveSimi Valley, California 8/30/2006.

Mission Garden's Skilled Suspended Care indefinitely effective1428 West North Avenue 7/1/2007.Lompoc, California

Mr. J's Liquor, Inc. Suspended1005 West Century indefinitely effective Boulevard 12/20/2005.Los Angeles, California

Muradyan, Vahe SuspendedID #26688-112 indefinitely effective c/o USP Florence, ADMAX 3/20/2006.U.S. PenitentiaryP.O. Box 8500Florence, Colorado

Nashikyan, Susanna Suspended aka: Nashikyan, Susan indefinitely effective1725 North Talmadge Street, 7/20/2005.Suite #4Los Angeles, California


susp T27


Newton, Jerome Suspended4816 Cimarron Street indefinitely effectiveLos Angeles, California 2/20/2007.

Okorn, Atim Suspended aka: Atim, Okorn indefinitely effective823 East Sitka Avenue, 4/20/2006.Apartment #90Spokane, Washington

Olie, Robert Suspended dba: Angel indefinitely effective OrthopedicTech 7/8/2007.3820 Del Amo Boulevard, #321Torrance, California

Pakdelan, Mohammad Suspended6509 Verde Ridge Road indefinitely effectiveVerded, California 9/20/2006. and7004 Reseda BlvdReseda, California

Paulin, Renato Bernardo Suspended931 Palencia Place indefinitely effectiveChula Vista, California 3/28/2007.

Perea, Gerard P. Suspended dba: DME Billing indefinitely effective Management 8/5/2007.3522 Cotter Rim LaneDiamond Bar, California and13801 Roswell AvenueChino, California

Rowe, William Joseph SuspendedID #31259-112 indefinitely effective c/o Lompoc USP 5/20/2007.3901 Klein BoulevardLompoc, California

Roy, Robert W. Suspended dba: Western Care indefinitely effective Management 8/26/2007. Corporation8896 BrookdaleMillville, California


Sargsian, Aroutioun Suspended ID #26671-112 indefinitely effective c/o CI TAFT 7/20/2006. Correctional InstitutionP.O. Box 7001Taft, California

Shandize, Michael I. Suspended15322 Longbow Drive indefinitely effectiveSherman Oaks, California 9/20/2006.

Thaxton, Barry S. Suspended24475 Malvista Way indefinitely effectiveLaguna Niguel, California 4/22/2007.

Urgiles, Mario Valentin Suspended2725 Lanfanco Street, #1 indefinitely effectiveLos Angeles, California 5/20/2004.

Yamalyan, Hagop Suspended and indefinitely effectiveTemple Medical Supply 8/21/2007.2739 W. Temple StreetLos Angeles, California


susp T28

Sales Representative Provider Number

Frid, Boris Suspended4425 Ensenada Drive indefinitely effectiveWoodland Hills, California 12/20/05.

Larin, Lupe Ornelas Suspended aka: Ornelas, Lupe Guadalup indefinitely effective9426 Sandusky Avenue 7/20/05.Arleta, California

Tang, Sareth Suspended728 Orizaba Avenue 11/20/97Long Beach, California for 5 years.

Owner/Operator

Ederaine, Edward Suspended3141 Rainier Street indefinitely effectiveCorona, California 6/15/2006.

Stambulyan, Karapet SuspendedID#26035-112 indefinitely effective c/o FCI Lompoc 7/20/2006. Federal Correctional Institution3600 Guard RoadLompoc, California

Verian, Richard Suspended dba: Acme Medical Supply indefinitely effective18658 Kenya Street 2/24/00.Northridge, California

Uko, Ebong SuspendedUSM #15628-097 indefinitely effective c/o CI Taft 3/20/2006.Correctional InstitutionP.O. Box 7001Taft, California

Secretary/Treasurer and Chief/Financial

Nelson, Catherine Siu Mun Suspended aka: Choi, Catherine Siu Mun indefinitely effective4750 Lincoln Boulevard, 6/20/2006.Apartment #390Marina Del Rey, California

Surgery Center

Alter, Suzi Suspended3903 Stone Canyon Avenue indefinitely effectiveSherman Oaks, California 05/20/03.

Cosmetic Surgery and Suspended Laser Institute indefinitely effective1101 Bryan Avenue, #G 12/20/01.Tustin, California

Chief Financial Officer

Javier, Elarde Suspended855 Canis Lane indefinitely effectiveFoster City, California 7/8/2003.

Transportation ProviderProvider Number

Castaneda, Patricia Suspended1580 Crusado Lane, #319 indefinitely effectiveLos Angeles, California 3/20/2006.

Duong, Khanh Minh Suspended aka: Duong, Minh Khanh indefinitely effective13361 Redbird Street 3/20/2007.Garden Grove, California

Masterson, Mark MTE00718f Suspended1029 Gloria Drive indefinitely effectiveSanta Rosa, California 06/20/00.

Risher, Robert Suspended Raymond, Jr. indefinitely effective dba: Emergency 7/26/2006. Services, Inc.8724 Millergrove DriveSanta Fe Springs, California

Shpirt, Boris SuspendedGreybor Medical indefinitely effective Transportation, Inc. 1/9/2007.119 Belmont Avenue, Building #1, Suite #107Los Angeles, California

Valdez, Julio Cesar Suspended aka: Valdez-Fernandes, indefinitely effective Julio Cesar 2/20/2007.8027 Teesdale AvenueNorth Hollywood, California

Private Citizen

Missakian, Hratch Suspended345 Pioneer Drive, for 5 yearsApartment 1603 5/20/98.Glendale, California

Unlicensed Caregiver

Arriaza, Ana Suspended Elizabeth Camey indefinitely effective1311 Peck Street, #5 06/24/04.Compton, California

Diaz-Arango, Lucio 00513175 Suspended707 Greenbriar Circle indefinitely effectivePetaluma, California 08/04/04.

Billing Clerk

Boughton, Darla Jean Suspended690 North McDonald Court indefinitely effectivePost Falls, Idaho 10/19/2006.

Peterson, Ralph Suspended29581 Bright Spot Road indefinitely effectiveHighland, California 3/20/2006.


medi-cal suspended and ineligible provider list (susp...

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