MR. JUSTIN MICHAEL TEGERSTRAND (NPI# 1013417393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013417393 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN MICHAEL TEGERSTRAND |
| Credential | CPO |
| Practice Address |
2102 Civic Center Dr Redding CA 96001-2704 |
| Practice Telephone | 5302414040 |
| Practice Fax Number | 5302414092 |
| Mailing Telephone | 5302414040 |
| Mailing Fax Number | 5302414092 |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2019-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 206 Roelofs Ct Ste A, Mount Shasta, CA 960672765 | 5309260560 | 5309260560 |
| 574 Manzanita Ave Ste 11, Chico, CA 959261369 | 5309655164 | 5302414040 |
| Street Address |
2102 CIVIC CENTER DR |
| City | REDDING |
| State | CA |
| Zip Code | 96001-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437144797 | Donn & Doff Inc | Prosthetic/Orthotic Supplier | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2005-09-13 |
| 1942762109 | Daniel C Brown | Pedorthist | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2019-04-04 |
| 1144711045 | Dona Rebecca Tegerstrand | Mastectomy Fitter | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2018-05-25 |
| 1649770926 | John Morgan | Orthotist | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2018-02-13 |
| 1003316381 | Deanna Hansen | Orthotist | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2018-02-13 |
| 1528272069 | Allyson K Martin | Physician Assistant | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2007-05-10 |
| 1144262593 | Mohamed H Khan Md Inc | Internal Medicine | 2102 Civic Center Dr, Redding, CA 96001-2704 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| 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 |
|---|---|---|---|---|
| 1306315593 | Kirk Rose | Prosthetist | 1844 South St, Redding, CA 96001-1809 | 2018-11-16 |
| 1487842944 | Richard M O'sullivan | Prosthetist | 2147 Court St, Redding, CA 96001-2531 | 2007-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752942 | Elizabeth Olajide | Prosthetist | 43536 Gadsden Ave Apt 324, Lancaster, CA 93534-6036 | 2020-02-20 |
| 1831733948 | Shayla R Williams | Prosthetist | 11050 Strathmore Dr Apt 422, Los Angeles, CA 90024-2319 | 2019-10-31 |
| 1578111290 | Charmie Johnson | Prosthetist | 7309 University Ave Ste B, La Mesa, CA 91942-0525 | 2019-08-27 |
| 1790341915 | Gloria Tatiana Dixon | Prosthetist | 32366 Evening Primrose Trl, Campo, CA 91906-3162 | 2019-05-13 |
| 1629633219 | Duana Robinson | Prosthetist | 1430 Brandon Dewey Ln, Tracy, CA 95304-5981 | 2019-05-08 |
| 1366908741 | Alicia Lander | Prosthetist | 5252 Foothill Blvd, Oakland, CA 94601-5438 | 2019-02-11 |
| 1154895944 | Keyonia K Paramore | Prosthetist | 735 W Pacific Coast Hwy, Long Beach, CA 90806-5240 | 2019-01-15 |
| 1629544499 | Alexander Hetherington | Prosthetist | 1500 Owens St Ste 115, San Francisco, CA 94158-2338 | 2018-10-19 |
| 1255815155 | Mary Alice Swiney | Prosthetist | 3437 Stocker St Apt 4, Los Angeles, CA 90008-3730 | 2018-09-18 |
| 1285113951 | Janet Miller | Prosthetist | 6662 Charlene Ave, San Diego, CA 92114 | 2018-08-13 |
| 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.