JUSTIN WYNHOFF (NPI# 1336640978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336640978 |
| Entity Type | Individual |
| Full Name | JUSTIN WYNHOFF |
| Credential | CPED |
| Practice Address |
1844 South St Redding CA 96001-1809 |
| Practice Telephone | 5302434500 |
| Practice Fax Number | 5302434554 |
| Mailing Telephone | 5302434500 |
| Mailing Fax Number | 5302434554 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224L00000X | Pedorthist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CA | PG0073849001 | 01 |
| CA | GFC000180 | 05 |
| Street Address |
1844 SOUTH ST |
| City | REDDING |
| State | CA |
| Zip Code | 96001-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639173537 | Spectrum Prosthetics & Orthotics of Redding Inc | Prosthetic/Orthotic Supplier | 1844 South St, Redding, CA 96001-1809 | 2005-06-08 |
| 1750988051 | Kathryn Anderson | Orthotist | 1844 South St, Redding, CA 96001-1809 | 2020-10-08 |
| 1306315593 | Kirk Rose | Prosthetist | 1844 South St, Redding, CA 96001-1809 | 2018-11-16 |
| 1639671290 | Matt Hoffer | Orthotic Fitter | 1844 South St, Redding, CA 96001-1809 | 2018-02-28 |
| 1285136846 | Justin Clark | Orthotist | 1844 South St, Redding, CA 96001-1809 | 2018-02-28 |
| 1952802597 | Tina Zeller | Mastectomy Fitter | 1844 South St, Redding, CA 96001-1809 | 2018-02-27 |
| 1225539869 | Heather Bletcher | Mastectomy Fitter | 1844 South St, Redding, CA 96001-1809 | 2018-02-27 |
| 1538660170 | Jeff Zeller | Orthotist | 1844 South St, Redding, CA 96001-1809 | 2018-02-27 |
| 1346741980 | Tyler Rowley | Orthotist | 1844 South St, Redding, CA 96001-1809 | 2018-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| Taxonomy Code | 224L00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Pedorthist |
| An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] 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 |
|---|---|---|---|---|
| 1659701993 | Harold Peters | Pedorthist | 685 Mary St, Redding, CA 96001-0310 | 2013-11-23 |
| 1942762109 | Daniel C Brown | Pedorthist | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2019-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750993572 | Rachel Olivares | Pedorthist | 13193 Lavonda St, Eastvale, CA 92880-0789 | 2020-08-21 |
| 1871130781 | Matthew Maltezos | Pedorthist | 6536 E Spring St, Long Beach, CA 90815-1554 | 2019-12-10 |
| 1295378891 | Jennifer Faria | Pedorthist | 301 Georgia St Ste 322, Vallejo, CA 94590-5945 | 2019-10-26 |
| 1134689607 | Jesse Bittle | Pedorthist | 1830 Hacienda Dr Ste 5, Vista, CA 92081-4544 | 2019-03-21 |
| 1467929307 | Jennifer Faria | Pedorthist | 438 Annette Ave, Vallejo, CA 94591-6574 | 2018-10-29 |
| 1730600222 | Chris Bonsall Sr. | Pedorthist | 1350 Grant Rd Ste 14b, Mountain View, CA 94040-3248 | 2017-07-05 |
| 1245750140 | Judy Burke Morabito | Pedorthist | 801 Dolliver Street, Pismo Beach, CA 93449 | 2017-06-21 |
| 1548701675 | Gill L Majko | Pedorthist | 4941 E Walnut St # 7, Soquel, CA 95073-2433 | 2017-03-08 |
| 1740655448 | Michael Wells | Pedorthist | 1835 Chicago Ave, Unit A, Riverside, CA 92507-2378 | 2015-12-07 |
| 1508420589 | Argishti Madatyan | Pedorthist | 10639 Burbank Blvd, North Hollywood, CA 91601-2512 | 2019-04-25 |
| Find all providers with the same taxonomy | ||||
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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.