IMANI NICOLE GLENN (NPI# 1477041580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477041580 |
| Entity Type | Individual |
| Full Name | IMANI NICOLE GLENN |
| Credential | OTR/L |
| Practice Address |
1575 E Washington Blvd Pasadena CA 91104-2675 |
| Mailing Address |
20219 Harlan Ave Carson CA 90746-2549 |
| Practice Telephone | 6267687764 |
| Mailing Telephone | 3105975846 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1575 E WASHINGTON BLVD |
| City | PASADENA |
| State | CA |
| Zip Code | 91104-2675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881225324 | Camille Renee Matute | Speech-Language Pathologist | 1575 E Washington Blvd, Pasadena, CA 91104-2675 | 2020-02-03 |
| 1245896455 | Khededra Renee Lewis | Speech-Language Pathologist | 1575 E Washington Blvd, Pasadena, CA 91104-2675 | 2019-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284382 | Jack Lee Johnson II | Counselor | 1680 North Fair Oaks, Pasadena, CA 91104 | 2018-11-16 |
| 1699257055 | Aqueelah Russell | Lactation Consultant, Non-RN | 855 N. Catalina Ave, Pasadena, CA 91104 | 2018-09-02 |
| 1053893529 | Jordann Ashley Stewart | Case Manager/Care Coordinator | 691 East Washington Blvd, Pasadena, CA 91104 | 2018-08-31 |
| 1942789706 | Elmer Caballero | Case Manager/Care Coordinator | 691 E Washington Blvd, Pasadena, CA 91104 | 2018-08-12 |
| 1649759648 | Orlando Javier Sava Jr. | Case Manager/Care Coordinator | 1395 E. Orange Grove Blvd, Pasadena, CA 91104 | 2018-08-09 |
| 1669923611 | Grandview Foundation, Inc. | Substance Abuse Rehabilitation Facility | 225 Grandview Street, Pasadena, CA 91104 | 2016-10-14 |
| 1255734166 | Linhua Wang-kim | Massage Therapist | 1028 N. Lake Ave., Suite 108c, Pasadena, CA 91104 | 2014-10-06 |
| 1477893782 | Med Tec Diagnostic Inc. | Clinic/Center | 1310 N. Mar Vista Unit 3, Pasadena, CA 91104 | 2013-02-22 |
| 1750631321 | Gordon Sheldall | Marriage & Family Therapist | 1495 N Lake Avenue, Pasadena, CA 91104 | 2012-09-11 |
| 1699024521 | Sherry Lynn Wait | Marriage & Family Therapist | 1495 N. Lake Ave., Pasadena, CA 91104 | 2012-09-06 |
| Find all providers in zip 91104 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1548805344 | Aimee Isabelle Rodriguez | Rehabilitation Practitioner | 100 W Walnut St Ste 375110, Pasadena, CA 91103-3697 | 2019-11-15 |
| 1518427830 | Samantha Jo Elvira Haun | Rehabilitation Practitioner | 867 N Fair Oaks Ave # 867, Pasadena, CA 91103-3050 | 2019-03-22 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1366821613 | Claudia Boileu-flores | Rehabilitation Practitioner | 940 Avenue, 64, Pasadena, CA 91105 | 2015-05-20 |
| 1497161756 | Marine Bambakyan | Rehabilitation Practitioner | 66 Hurlbut St Fl 2, Pasadena, CA 91105-4026 | 2014-07-08 |
| 1922449107 | Marco Antonio Garcia Casas | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 10, Pasadena, CA 91105-2048 | 2013-07-16 |
| Find all providers in PASADENA | ||||
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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.