TIM SHRIDE (NPI# 1043833619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043833619 |
| Entity Type | Individual |
| Full Name | TIM SHRIDE |
| Practice Address |
3800 Watt Ave Ste 151 Sacramento CA 95821-2688 |
| Mailing Address |
10717 126th Pl Ne Kirkland WA 98033-4756 |
| Practice Telephone | 9164821535 |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3800 WATT AVE STE 151 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-2688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780964999 | Richard Lyman Wilcox | Prosthetist | 2425 Stockton Blvd, Suite 236, Sacramento, CA 95817-2215 | 2011-08-18 |
| 1164718235 | George Villarruel | Prosthetist | 3001 L St, Sacramento, CA 95816-5225 | 2011-06-27 |
| 1932349883 | Eric J Smith | Prosthetist | 3001 P St, Suite B, Sacramento, CA 95816-6546 | 2009-03-04 |
| 1245492701 | Clint Jonutz | Prosthetist | 3838 Watt Ave Ste A110, Sacramento, CA 95821-2689 | 2008-06-26 |
| 1295924041 | Ann Theobald | Prosthetist | 1248 32nd St, Sacramento, CA 95816-5210 | 2007-10-17 |
| 1760671515 | Christine A Meyer | Prosthetist | 1248 32nd St, Sacramento, CA 95816-5210 | 2007-10-17 |
| 1720276025 | Bryan Hayes | Prosthetist | 1248 32nd St, Sacramento, CA 95816-5210 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752942 | Elizabeth Olajide | Prosthetist | 43536 Gadsden Ave Apt 324, Lancaster, CA 93534-6036 | 2020-02-20 |
| 1831733948 | Shayla R Williams | Prosthetist | 11050 Strathmore Dr Apt 422, Los Angeles, CA 90024-2319 | 2019-10-31 |
| 1578111290 | Charmie Johnson | Prosthetist | 7309 University Ave Ste B, La Mesa, CA 91942-0525 | 2019-08-27 |
| 1790341915 | Gloria Tatiana Dixon | Prosthetist | 32366 Evening Primrose Trl, Campo, CA 91906-3162 | 2019-05-13 |
| 1629633219 | Duana Robinson | Prosthetist | 1430 Brandon Dewey Ln, Tracy, CA 95304-5981 | 2019-05-08 |
| 1366908741 | Alicia Lander | Prosthetist | 5252 Foothill Blvd, Oakland, CA 94601-5438 | 2019-02-11 |
| 1154895944 | Keyonia K Paramore | Prosthetist | 735 W Pacific Coast Hwy, Long Beach, CA 90806-5240 | 2019-01-15 |
| 1629544499 | Alexander Hetherington | Prosthetist | 1500 Owens St Ste 115, San Francisco, CA 94158-2338 | 2018-10-19 |
| 1255815155 | Mary Alice Swiney | Prosthetist | 3437 Stocker St Apt 4, Los Angeles, CA 90008-3730 | 2018-09-18 |
| 1285113951 | Janet Miller | Prosthetist | 6662 Charlene Ave, San Diego, CA 92114 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.