MRS. CECELIA ROSE GREENE/PENDZICH (NPI# 1700357936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700357936 |
| Entity Type | Individual |
| Full Name | MRS. CECELIA ROSE GREENE/PENDZICH |
| Credential | CERTIFIED PERMANENT |
| Practice Address |
7760 Fay Ave, Suite M. La Jolla CA 92037 |
| Practice Telephone | 8582302340 |
| Mailing Telephone | 8582302340 |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224900000X | Mastectomy Fitter | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
7760 FAY AVE, SUITE M. |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| 1891288197 | Maria Bernadette Facun | Nurse Practitioner | 10666 N. Torrey Pines Road, N203, La Jolla, CA 92037 | 2018-06-11 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 224900000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Mastectomy Fitter |
| An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services. |
| 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 |
|---|---|---|---|---|
| 1053944827 | Abigail's Medical Supply Inc | Mastectomy Fitter | 2020 Camino Del Rio N Ste 105, San Diego, CA 92108-1542 | 2020-02-19 |
| 1679106926 | Dana Walker | Mastectomy Fitter | 9033 Baseline Rd Ste C, Rancho Cucamonga, CA 91730-1214 | 2020-02-14 |
| 1053832923 | Bras and Honey Lingerie Limited | Mastectomy Fitter | 4242 Camino Del Rio N Ste 9, San Diego, CA 92108-2612 | 2017-06-30 |
| 1477810646 | Sasha Merritt | Mastectomy Fitter | 760 Market St Ste 854, San Francisco, CA 94102-2309 | 2012-04-12 |
| 1477834315 | Nancy A. Pavsek | Mastectomy Fitter | 1338 W Winton Ave, Hayward, CA 94545-1408 | 2011-09-06 |
| 1851461123 | Enhance By Linda Reib Inc. | Mastectomy Fitter | 4811 Chippendale Dr, Suite 208, Sacramento, CA 95841-2555 | 2006-11-08 |
| 1386277002 | Cinderella's Closet Your Specialty Lingerie Boutique | Mastectomy Fitter | 9033 Baseline Rd Ste C, Rancho Cucamonga, CA 91730-1214 | 2020-02-20 |
| 1891257499 | Haley Trivoli | Mastectomy Fitter | 232 N Brand Blvd, Glendale, CA 91203-2610 | 2019-04-02 |
| 1629547963 | Elizabeth L. Garcia-flynn | Mastectomy Fitter | 660 E Regent St, Inglewood, CA 90301-1415 | 2018-11-15 |
| 1144711045 | Dona Rebecca Tegerstrand | Mastectomy Fitter | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2018-05-25 |
| 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.