JACKRABBIT SHOES AND ORTHOTICS, INC. (NPI# 1982903720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982903720 |
| Entity Type | Organization |
| Organization Name | JACKRABBIT SHOES AND ORTHOTICS, INC. |
| Practice Address |
4576 E 2nd St H Benicia CA 94510-1046 |
| Practice Telephone | 7077511630 |
| Practice Fax Number | 9252263184 |
| Mailing Telephone | 7077511630 |
| Mailing Fax Number | 9252263184 |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |
| Authorized Official Name | MR. DALE SOVAK (OWNER) |
| Authorized Official Telephone | 7077511630 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | CPED 2916 | CA | Suppliers |
| Street Address |
4576 E 2ND ST H |
| City | BENICIA |
| State | CA |
| Zip Code | 94510-1046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518003243 | Dale Sovak | Podiatrist | 4576 E 2nd St, H, Benicia, CA 94510-1046 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578114690 | Stacie Coveleski | Psychologist | 701 Southhampton Road, Suite 102, Benicia, CA 94510 | 2019-09-20 |
| 1962065227 | Susan Samuelsz | Marriage & Family Therapist | 1350 Hayes St. Suite A33, Benicia, CA 94510 | 2019-04-22 |
| 1982150546 | Christine Torres | Health Educator | 777 West H Street, Benicia, CA 94510 | 2016-09-01 |
| 1548654692 | Paul Villamizar | Pharmacist | 900 Cambridge Drive Unit 11, Benicia, CA 94510 | 2015-03-26 |
| 1457768079 | Gail Frizzell | Social Worker | 865 West I Street, Benicia, CA 94510 | 2014-07-15 |
| 1093150740 | Mjq Family Dentistry | Dentist | 125 East N Street, Benicia, CA 94510 | 2013-05-08 |
| 1528328283 | Julie Laura Rose | Acupuncturist | 555 First St., Suite 200, Benicia, CA 94510 | 2012-05-29 |
| 1720379175 | Gary Archie Plaskett | Counselor | 591 Capitol Dr, Benicia, CA 94510 | 2011-04-20 |
| 1104062405 | Dan Gary Wertheimer | Social Worker | 1901 Shoreline Drive, Apt 303, Alameda, CA 94510 | 2008-12-17 |
| 1023266053 | Mark David Levine Md Vallejo Professional Corporation | Psychiatry & Neurology | 1021 First St Ste 5, Benicia, CA 94510 | 2008-09-03 |
| Find all providers in zip 94510 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] 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 |
|---|---|---|---|---|
| 1821696592 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 3031 W March Ln Ste 216w, Stockton, CA 95219-6500 | 2020-10-14 |
| 1871191742 | Alcam Medical Inc. | Prosthetic/Orthotic Supplier | 1244 N Mariposa St Ste 10, Fresno, CA 93703-3929 | 2020-10-13 |
| 1740887462 | A-z Consulting O & P Services | Prosthetic/Orthotic Supplier | 1133 Smith Ln Ste 5, Roseville, CA 95661-4131 | 2020-10-06 |
| 1255938452 | Sheek Hair Boutique | Prosthetic/Orthotic Supplier | 1432 N Cedar Ave Apt 107, Fresno, CA 93703-5303 | 2020-10-01 |
| 1922615368 | Inland Artificial Limb & Brace | Prosthetic/Orthotic Supplier | 1101 Bryan Ave Ste C, Tustin, CA 92780-4401 | 2020-09-29 |
| 1043823461 | Crystal Johnson | Prosthetic/Orthotic Supplier | 812 S Flower St Apt 4, Inglewood, CA 90301-7913 | 2020-08-25 |
| 1225640220 | Christopher Holloway | Prosthetic/Orthotic Supplier | 4517 Market St Ste 4, Ventura, CA 93003-7841 | 2020-08-20 |
| 1407468416 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 488 E Valley Pkwy Ste 207, Escondido, CA 92025-3368 | 2020-08-20 |
| 1801406269 | Restore Medical Inc | Prosthetic/Orthotic Supplier | 1505 Soquel Dr Ste 4, Santa Cruz, CA 95065-1716 | 2020-07-31 |
| 1801404199 | Covering With Care | Prosthetic/Orthotic Supplier | 21350 Avalon Blvd Unit 5039, Carson, CA 90749-7032 | 2020-07-22 |
| 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.