IMPACT REHABILITATION CENTER INC (NPI# 1801817739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801817739 |
| Entity Type | Organization |
| Organization Name | IMPACT REHABILITATION CENTER INC |
| Practice Address |
255 N Tustin St Orange CA 92867-7772 |
| Mailing Address |
Po Box 5986 Orange CA 92863-5986 |
| Practice Telephone | 7142889125 |
| Practice Fax Number | 7142889129 |
| Mailing Telephone | 7142889125 |
| Mailing Fax Number | 7142889129 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-03-30 |
| NPI Deactivation Date | 07/13/2018 |
| NPI Reactivation Date | 2018-08-08 |
| Authorized Official Name | WILLIS MARK SUTCLIFF (PRESIDENT) |
| Authorized Official Telephone | 7142889125 |
| Authorized Official Credential | MPT, ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PT26858 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GPT001400 | 05 |
| Street Address |
255 N TUSTIN ST |
| City | ORANGE |
| State | CA |
| Zip Code | 92867-7772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467942714 | Jeremy Reed | Physical Therapist | 255 N Tustin St, Orange, CA 92867-7718 | 2018-05-12 |
| 1174774244 | Devon Christopher Clark | Physical Therapy Assistant | 255 N Tustin St, Orange, CA 92867-7772 | 2008-10-07 |
| 1578587457 | Diana Finn Sutcliff | Physical Therapist | 255 N Tustin St, Orange, CA 92867-7772 | 2006-07-26 |
| 1073534905 | Willis Mark Sutcliff | Physical Therapist | 255 N Tustin St, Orange, CA 92867-7772 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770197618 | Family First Healthcare | Home Health | 2712 E Blueridge Ave, Orange, CA 92867 | 2020-09-08 |
| 1568924793 | Denise Giovanazzi Weinberg | Nurse Practitioner | 3215 East Abbey Lane, Orange, CA 92867 | 2019-04-05 |
| 1629536701 | Cindy Diaz | Behavioral Analyst | 410 E. Katella, Orange, CA 92867 | 2019-03-07 |
| 1992206940 | Oc Healthy Heart LLC | Internal Medicine | 438 E Katella Ave Suite B, Orange, CA 92867 | 2018-02-26 |
| 1083139059 | Randy Hope | Counselor | 1855 W Katella Ave #150, Orange, CA 92867 | 2017-08-10 |
| 1801319595 | Danielle Collett | Registered Nurse | 1855 N. Katella, 150, Orange, CA 92867 | 2017-07-25 |
| 1023538931 | Mala Leao | Social Worker | 2440 E. Vanowen Ave., Orange, CA 92867 | 2017-06-21 |
| 1184096257 | Renew Acupuncture Clinic | Health Maintenance Organization | 1132 E Katella Avenue Ste. A14, Orange, CA 92867 | 2015-10-28 |
| 1942604913 | Seon Song | Acupuncturist | 1327 E Katella Ave, Orange, CA 92867 | 2014-10-20 |
| 1700298965 | Nazanin Minouei | Physical Therapy Assistant | 1045 N. Tustin Ave, Orange, CA 92867 | 2014-05-22 |
| Find all providers in zip 92867 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053702738 | Natasha Shaffer | Specialist | 3207 E Almond Ave, Orange, CA 92869-3728 | 2015-02-16 |
| 1124427075 | Nancy Ceja | Specialist | 200 S Esplanade St, Orange, CA 92869-3962 | 2014-08-16 |
| 1750723078 | Sarah Linda Maze | Specialist | 686 N Lemon Hill Trl, Orange, CA 92869-2403 | 2013-07-29 |
| 1508209362 | Bruce D. Burtoff | Specialist | 108 Railroad Ave, Orange, VA 22960 | 2013-04-11 |
| 1346581402 | National Medical Physicians Services Group LLC | Specialist | 308 W Chapman Ave Unit 1936, Orange, CA 92856-7079 | 2013-03-13 |
| 1881956266 | Arthur H Salibian Md A Professional Corporation | Specialist | 1310 W Stewart Dr Ste 211, Orange, CA 92868-3837 | 2012-06-12 |
| 1992969018 | Samir Sobhy Kamel Ebeade | Specialist | 3009 Macarthur Dr, Orange, TX 77630-4707 | 2008-07-17 |
| 1366613259 | Marc A Zepeda M D A Professional Corporation | Specialist | 805 W La Veta Ave Ste 107, Orange, CA 92868-3928 | 2008-03-18 |
| 1831370220 | Guohua Zhao | Specialist | 101 The City Dr, S, Rm 101, Building 10, Orange, CA 92868 | 2007-11-14 |
| 1154516623 | Santa Ruth Saucedo | Specialist | 8209 E Hillsdale Dr, Orange, CA 92869-2440 | 2007-09-07 |
| Find all providers in ORANGE | ||||
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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.