MARY BOTHWELL (NPI# 1184058646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184058646 |
| Entity Type | Individual |
| Full Name | MARY BOTHWELL |
| Credential | C.S.B. |
| Practice Address |
2409 Honolulu Ave Ste 4 Montrose CA 91020-1871 |
| Mailing Address |
1710 Knollwood Dr Pasadena CA 91103-1908 |
| Practice Telephone | 6264492003 |
| Mailing Telephone | 6264492003 |
| Enumeration Date | 2013-09-02 |
| Last Update Date | 2013-09-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 374K00000X | Religious Nonmedical Practitioner | Nursing Service Related Providers |
| Street Address |
2409 HONOLULU AVE STE 4 |
| City | MONTROSE |
| State | CA |
| Zip Code | 91020-1871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265800866 | Amoret Kaufman | Marriage & Family Therapist | 2233 Honolulu Ave Ste 305, Montrose, CA 91020 | 2015-09-14 |
| 1114303161 | Vincent Hess Stack | Pathology | 2732 Piedmont Ave. #1, Montrose, CA 91020 | 2015-07-31 |
| 1013300920 | Miroslav Zofcik | Massage Therapist | 2331 Honolulu Ave #e, Montrose, CA 91020 | 2015-03-17 |
| 1528466257 | Luiza Andakyan | Behavioral Analyst | 2233 Honolulu Ave # 301, Montrose, CA 91020 | 2014-12-11 |
| 1437598570 | Clodiya Taroian | Registered Nurse | 2331 Montrose Avenue, 1, Montrose, CA 91020 | 2013-06-21 |
| 1740531284 | Stacey L Sherrell | Marriage & Family Therapist | 2550 Honolulu Ave Ste 201, Montrose, CA 91020 | 2012-09-24 |
| 1285926055 | Chul Jae Lee | Acupuncturist | 4420 Briggs Ave., Montrose, CA 91020 | 2011-05-11 |
| 1447444856 | Verdugo Valley Skilled Nursing & Wellness Centre, LLC | Skilled Nursing Facility | 2635 Honolulu Ave, Montrose, CA 91020 | 2007-08-29 |
| 1003034497 | Gonzalez Dental Corporation | Dentist | 3901 Ocean View Blvd, Montrose, CA 91020 | 2007-04-23 |
| 1275612715 | Susan Wooton Reyes | Counselor | 2039 1/2 Montrose Ave, Montrose, CA 91020 | 2006-11-03 |
| Find all providers in zip 91020 | ||||
| Taxonomy Code | 374K00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Religious Nonmedical Practitioner |
| A religious nonmedical practitioner offers spiritually-based care. Services may be rendered in an office, home, or care facility or by phone, email, or written correspondence. |
| Notes: Source: National Uniform Claim Committee , 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629696455 | Meir Sultan | Religious Nonmedical Practitioner | 5234 Vantage Ave Unit 101, Valley Village, CA 91607-2644 | 2020-07-08 |
| 1790318178 | Skye Kent Davis | Religious Nonmedical Practitioner | 8668 Oldwoods Way, Sacramento, CA 95828-5043 | 2020-02-13 |
| 1740781509 | Honest Citizens Network | Religious Nonmedical Practitioner | 1545 5th St, Clovis, CA 93611-1411 | 2018-02-26 |
| 1538593801 | Michael Morgan | Religious Nonmedical Practitioner | 4132 W Hood Ave, Burbank, CA 91505-4010 | 2013-08-22 |
| 1467703884 | Brian Douglas Talcott | Religious Nonmedical Practitioner | 1076 Siler Pl, Berkeley, CA 94705-1536 | 2012-09-25 |
| 1376892299 | Julio C Rivas | Religious Nonmedical Practitioner | 6800 Treasure Trail, Los Angeles, CA 90068 | 2012-09-06 |
| 1821599598 | Aaronjack Russell Perry IIi | Religious Nonmedical Practitioner | 1545 5th St, Clovis, CA 93611-1411 | 2018-02-27 |
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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.