DARYL JOHN KALLENBACH (NPI# 1619213576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619213576 |
| Entity Type | Individual |
| Full Name | DARYL JOHN KALLENBACH |
| Credential | CNA |
| Practice Address |
3465 Thunderbird Ln Lake Havasu City AZ 86406-5556 |
| Mailing Address |
1345 Beefeater Dr Lake Havasu City AZ 86404-1953 |
| Practice Telephone | 9287065851 |
| Mailing Telephone | 9287065851 |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2012-12-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 374U00000X | Home Health Aide | CNA1000021924 | AZ | Nursing Service Related Providers |
| Street Address |
3465 THUNDERBIRD LN |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86406-5556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924070 | James Richard Fisher | Durable Medical Equipment & Medical Supplies | 2540 Viejo Dr, Lake Havasu City, AZ 86406 | 2008-02-27 |
| 1265657969 | Eugene Vitvitsky Md | Surgery | 2046 Burke Lane, Lake Havasu City, AZ 86406 | 2007-04-16 |
| 1659497105 | Assisted Living Concepts Inc | Assisted Living Facility | 3076 Shoshone Drive, Lake Havasu, AZ 86406 | 2007-03-22 |
| 1164546750 | Charles Reese Mead | Dentist | 101 Riveria Dr, Lake Havasu, AZ 86406 | 2007-03-19 |
| 1427172550 | Jesdeen Lynn Nunez | Registered Nurse | 12033 Agency Road, Parker, AZ 86406 | 2007-03-16 |
| 1285797993 | Karen Ann Powell | Podiatrist | Oro Grande Elementary 1250 Pawnee Drive, Lake Havasu City, AZ 86406 | 2006-12-18 |
| 1215978606 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2800 Sweetwater Ave, Lake Havasu City, AZ 86406 | 2006-06-09 |
| 1467519512 | Catherine Evelyn Sondrol | Occupational Therapist | 3588 Tarpon Dr, Lake Havasu City, AZ 86406-4223 | 2007-01-01 |
| 1346477593 | Steven Bertovich | Registered Nurse | 3499 Tarpon Dr, Lake Havasu City, AZ 86406-4246 | 2009-06-15 |
| 1093975310 | Serenity Assisted Living | Assisted Living Facility | 3677 Blue Colt Dr, Lake Havasu City, AZ 86406-4273 | 2008-06-10 |
| Find all providers in zip 86406 | ||||
| Taxonomy Code | 374U00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Home Health Aide |
| A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174013155 | Tyler Wright | Home Health Aide | 2858 Sweetwater Ave Ste 102, Lake Havasu City, AZ 86406-9199 | 2018-05-15 |
| 1558987958 | Wright Care LLC | Home Health Aide | 2858 Sweetwater Ave Ste 102, Lake Havasu City, AZ 86406-9199 | 2020-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346557 | Prince Terrence C Woods | Home Health Aide | 15620 N 25th Ave Apt K209, Phoenix, AZ 85023-6514 | 2020-11-04 |
| 1174121396 | Comonique Russell | Home Health Aide | 2151 E Southern Ave Apt 1082, Mesa, AZ 85204-5358 | 2020-10-09 |
| 1083211288 | Kindred Hearts Assisted Living LLC | Home Health Aide | 530 E Mariposa St Apt 26, Phoenix, AZ 85012-1636 | 2020-10-01 |
| 1518570506 | Ideal Care LLC | Home Health Aide | 4135 N 108th Ave Ste 102, Phoenix, AZ 85037-5462 | 2020-08-28 |
| 1518578566 | Lakeisha Elem | Home Health Aide | 855 N Dobson Rd Apt 1045, Chandler, AZ 85224-6904 | 2020-08-13 |
| 1821612375 | Annie Mayson | Home Health Aide | 8517 W Chickasaw St, Tolleson, AZ 85353-8939 | 2020-06-01 |
| 1427670207 | James Verdieu | Home Health Aide | 2785 W Goldmine Mountain Dr, San Tan Valley, AZ 85142-4752 | 2020-05-14 |
| 1104452903 | People That Care, LLC. | Home Health Aide | 7034 W Peck Dr, Glendale, AZ 85303-4431 | 2020-03-13 |
| 1932734803 | Shane Amour Fulton | Home Health Aide | 2314 W Thomas Rd Apt 261, Phoenix, AZ 85015-5911 | 2020-03-11 |
| 1598397739 | Nasir Adam Ibrahim | Home Health Aide | 4009 S 12th Ave, Tucson, AZ 85714-1452 | 2020-02-05 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86406 |
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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.