PERFORMANCE REHAB WELLNESS CENTER (NPI# 1902210644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902210644 |
| Entity Type | Organization |
| Organization Name | PERFORMANCE REHAB WELLNESS CENTER |
| Practice Address |
12389 San Ysidro St Victorville CA 92392-6623 |
| Practice Telephone | 7604904524 |
| Practice Fax Number | 7609273268 |
| Mailing Telephone | 7604904524 |
| Mailing Fax Number | 7609273268 |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-06-19 |
| Authorized Official Name | MRS. HAZEL NIKKI MANGAOANG DAVID (PARTNER) |
| Authorized Official Telephone | 7604904524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
12389 SAN YSIDRO ST |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92392-6623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215568688 | Kristin Parris | Behavior Technician | 15490 Civic Drive, Victorville, CA 92392 | 2020-02-03 |
| 1366001604 | Pine Ridge Treatment Centers, Inc. | Substance Abuse Rehabilitation Facility | 15367 Bonanza Rd, Ste A, Victorville, CA 92392 | 2019-06-11 |
| 1851871289 | Betty A. Murphy, Lmft, Inc | Marriage & Family Therapist | 15437 Anacapa Rd. Ste 26, Victorville, CA 92392 | 2018-08-15 |
| 1104313402 | Jorge L Soler Iglesias | Nurse Practitioner | 12459 Cricket St., Victorville, CA 92392 | 2018-04-23 |
| 1689192049 | Jamesina Johns | Nurse Practitioner | 12127 Mall Blvd #148, Victorville, CA 92392 | 2017-09-06 |
| 1285151886 | Jasmin Sanchez | Behavioral Analyst | 13201 Eclipse Ave, Victorville, CA 92392 | 2017-08-24 |
| 1174049829 | Virginia Marshall | Behavioral Analyst | 13901 Amargosa Rd., Victorville, CA 92392 | 2017-08-15 |
| 1346781465 | San Bernardino Conty | Counselor | 15480 Ramona Ave., Victoville, CA 92392 | 2017-03-09 |
| 1841741279 | Lorinda Morreale | Marriage & Family Therapist | 15428 Civic Dr. Ste 200, Act Family Counseling, Victorville, CA 92392 | 2016-10-20 |
| 1235582404 | Greater Hope Foundation | Community/Behavioral Health | 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 | 2016-07-22 |
| Find all providers in zip 92392 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124460019 | Symmetry Physical Therapy Inc | Clinic/Center | 13890 Palmdale Rd, Victorville, CA 92392-9289 | 2013-07-22 |
| 1144409061 | A&g Health Services, Inc. | Clinic/Center | 17270 Bear Valley Rd Ste 105, Victorville, CA 92395-7751 | 2007-10-27 |
| 1104041144 | P and A Health Services | Clinic/Center | 14566 Seventh Street, Victorville, CA 92392 | 2007-04-16 |
| 1487967014 | Symmetry Physical Therapy | Clinic/Center | 12384 Palmdale Rd, Suite 202, Victorville, CA 92392-8506 | 2010-07-25 |
| 1881925600 | Team Therapy and Rehabilitation, Inc | Clinic/Center | 13024 Hesperia Rd, Suite 101, Victorville, CA 92395-8302 | 2010-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051839 | The Pelvic Model Physical Therapy, Inc. | Clinic/Center | 3761 Vinton Ave Apt 6, Los Angeles, CA 90034-5781 | 2020-10-18 |
| 1932707957 | Body In Motion Therapy, P.c | Clinic/Center | 1111 S Grand Ave Apt 708, Los Angeles, CA 90015-2169 | 2020-10-12 |
| 1992303275 | Vw Physical Therapy, Inc. | Clinic/Center | 100 Saybrook Ave, Vacaville, CA 95687-4129 | 2020-10-09 |
| 1730787094 | Movement System Institute Physiotherapy Inc | Clinic/Center | 508 Glenwood Rd Apt 102, Glendale, CA 91202-1572 | 2020-10-09 |
| 1538766530 | Sterling King Physical Therapy | Clinic/Center | 1820 Fullerton Ave Ste 280, Corona, CA 92881-3175 | 2020-10-03 |
| 1902403041 | Jha Geriatric Services, Inc | Clinic/Center | 12490 Fielding Circle, Suite 174, Playa Vista, CA 90094-3024 | 2020-10-01 |
| 1245847540 | Bespoke San Diego Physical Therapy PC | Clinic/Center | 2748 Ariane Dr, Unit 141, San Diego, CA 92117-3407 | 2020-09-30 |
| 1285241786 | Rapid Recovery Physical Therapy Inc | Clinic/Center | 39807 Paseo Padre Pkwy, Fremont, CA 94538-2974 | 2020-09-28 |
| 1053928697 | Bonnie Laine Lasher | Clinic/Center | 33772 Copper Lantern St Apt C, Dana Point, CA 92629-6427 | 2020-09-28 |
| 1295340792 | Naum Physical Therapy PC | Clinic/Center | 11405 Fulbourn Ct, Rancho Cucamonga, CA 91730-8341 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
| City | VICTORVILLE |
| Zip Code | 92392 |
Please comment or provide details below to improve the information on PERFORMANCE REHAB WELLNESS CENTER.
| 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.