DEODRA BROADNAX (NPI# 1548879489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548879489 |
Entity Type | Individual |
Full Name | DEODRA BROADNAX |
Practice Address |
1451 Marine Ave Apt D Gardena CA 90247-3331 |
Mailing Address |
7857 Florence Ave # 112 Downey CA 90240-3700 |
Practice Telephone | 3109910023 |
Mailing Telephone | 3109910023 |
Enumeration Date | 2020-07-27 |
Last Update Date | 2020-07-27 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
Street Address |
1451 MARINE AVE APT D |
City | GARDENA |
State | CA |
Zip Code | 90247-3331 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982204707 | Melissa Reyes | Home Health Aide | 835 N Rosecrans Ave Apt 125, Gardena, CA 90247 | 2020-10-30 |
1538645569 | Christopher Jabarie Markham | Case Manager/Care Coordinator | 12817 S Hoover St Apt 14, Gardena, CA 90247 | 2018-07-12 |
1013404243 | Sunshine Community Resource Organization Center | Counselor | 1202 W 135th Street, Gardena, CA 90247 | 2018-04-13 |
1124537261 | Nina Vu | Pharmacist | 14416 Plum Lane, Unit 3, Gardena, CA 90247 | 2017-09-20 |
1356871008 | Delaram Moshfegh | Pharmacist | 1735 Artesia Blvd, Gardena, CA 90247 | 2017-06-15 |
1497290522 | Better Vision Optical | Eyewear Supplier (Equipment, not the service) | 1121 W Gardena Blvd Ste A, Gardena, CA 90247 | 2016-12-28 |
1013394832 | Lydia Gonzalez | Case Management | 13605 S Vermont Ave Apt 16, Gardena, CA 90247 | 2015-04-30 |
1396147682 | Daniel Medical Group, Inc. | Acupuncturist | 2015 W Redondo Beach Blvd., Ste F, Gardena, CA 90247 | 2014-09-18 |
1386913663 | Linda Doreen Humphries | Nurse Practitioner | 1141 W. Redondo Beach Blvd., Suite 402, Gardena, CA 90247 | 2011-12-15 |
1215229547 | Everett D Wong | Social Worker | 1045 W Redondo Beach Blvd Ste 150, Gardena, CA 90247 | 2011-05-04 |
Find all providers in zip 90247 |
Taxonomy Code | 251C00000X |
Grouping | Agencies |
Classification | Day Training, Developmentally Disabled Services |
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932718871 | Michelle Wright | Day Training, Developmentally Disabled Services | 105 W Walnut St, Gardena, CA 90248-3103 | 2020-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194335430 | Creative Alternative for Learning & Living, Inc. | Day Training, Developmentally Disabled Services | 11700 Viejo Camino, Atascadero, CA 93422-6023 | 2020-08-02 |
1487262259 | Loving Hands Home Care LLC | Day Training, Developmentally Disabled Services | 12414 Gila River Dr, Bakersfield, CA 93312-5740 | 2020-07-17 |
1366061301 | Jannic Health Services, LLC | Day Training, Developmentally Disabled Services | 26970 Hayward Blvd Apt 206, Hayward, CA 94542-2088 | 2020-04-09 |
1427681063 | Guardians | Day Training, Developmentally Disabled Services | 1512 California St Apt 3, San Francisco, CA 94109-4753 | 2020-02-21 |
1629619705 | Aura Behavioral Health | Day Training, Developmentally Disabled Services | 2656 El Prado Way, Sacramento, CA 95825-0304 | 2019-09-30 |
1235791492 | A Veteran's Objective | Day Training, Developmentally Disabled Services | 4612 Abbotswood Cir # 1619, Irvine, CA 92604-2319 | 2019-07-08 |
1780242404 | Sprye Person With Unique Disability Inc | Day Training, Developmentally Disabled Services | 4130 W 161st St, Lawndale, CA 90260-2731 | 2019-05-29 |
1962067629 | Taneeka Hearns | Day Training, Developmentally Disabled Services | 13484 Cora Pl, Moreno Valley, CA 92553-3820 | 2019-05-07 |
1053976811 | Octavia Antoinette Askew | Day Training, Developmentally Disabled Services | 5412 S Broadway, Los Angeles, CA 90037-4126 | 2019-05-07 |
1831752781 | Nexus Therapies LLC | Day Training, Developmentally Disabled Services | 2401 Waterman Blvd Ste A4-230, Fairfield, CA 94534-1800 | 2019-04-17 |
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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.