SHANE RICHARD WURDEMAN (NPI# 1497911572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497911572 |
Entity Type | Individual |
Full Name | SHANE RICHARD WURDEMAN |
Credential | CP |
Practice Address |
11301 Wilshire Blvd Bldg 304 Los Angeles CA 90073-1003 |
Mailing Address |
1323 14th St Apt. E Santa Monica CA 90404-1744 |
Practice Telephone | 3104783711 |
Mailing Telephone | 3104783711 |
Enumeration Date | 2008-07-29 |
Last Update Date | 2008-07-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP003610 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
11301 WILSHIRE BLVD BLDG 304 |
City | LOS ANGELES |
State | CA |
Zip Code | 90073-1003 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295739043 | Mark S Horng | Internal Medicine | 11301 Wilshire Blvd, 10-c-1, Los Angeles, CA 90073-1003 | 2005-06-09 |
1720685944 | Sara Magdalin | Dietitian, Registered | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-10-01 |
1336750223 | Nathalie Esther Halajian | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-08-13 |
1811508344 | Hillary Xanthe Enclade | Speech-Language Pathologist | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-08-10 |
1356950919 | Maren Abromowitz | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-29 |
1285243030 | Alyson Prince Shittu | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-28 |
1124637087 | Soheil Kooraki | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-27 |
1376152371 | Ynez Sabio | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-24 |
1154949972 | Leah Effron | Registered Nurse | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-07-08 |
1972120988 | Justin Man Truong | Pharmacist | 11301 Wilshire Blvd, Los Angeles, CA 90073-1003 | 2020-06-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
1184285090 | Marcela Leticia Orellana Galvez | Podiatrist | 11301 Wilshire Blvd Bldg 500, Dept of Surgery, #10-h-2, Los Angeles, CA 90073 | 2019-06-23 |
1508310996 | Jennifer Maravola | Student in an Organized Health Care Education/Training Program | 11303 Wilshire Bl. Bdg 116, New Direction Inc., Los Angeles, CA 90073 | 2016-08-15 |
1861859480 | Michael Fisher | Student in an Organized Health Care Education/Training Program | 11303 Willshire Blv., V.a. Building 116, Los Angeles, CA 90073 | 2016-01-27 |
1629453295 | Christopher Denzel Lewis | Student in an Organized Health Care Education/Training Program | 11303 Wilshire Blvd., Va Bldg. 116, Los Angeles, CA 90073 | 2015-07-24 |
1689089179 | Rachel Stannus | Social Worker | 11303 Wilshire Blvd, Bldg116, Los Angeles, CA 90073 | 2014-06-24 |
1215355433 | Michael Francis Zito | Psychiatry & Neurology | 11301 Wilshire Blvd Bldg 210a, Los Angeles, CA 90073 | 2014-04-03 |
1831523901 | Sarah Arensman Miller | Psychologist | 11301 Wilshire Blvd. Bldg 256, Rm 106a, Va West Los Angeles (116b), Los Angeles, CA 90073 | 2013-08-26 |
1134447733 | Stuart Thomas Yee | Physical Medicine & Rehabilitation | 11301 Wilshire Blvd. Mail Code 117, Los Angeles, CA 90073 | 2010-05-07 |
1306177654 | Pete Petriashvili | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd, Building 500, Room 4455, Los Angeles, CA 90073 | 2010-01-27 |
Find all providers in zip 90073 |
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 |
---|---|---|---|---|
1831733948 | Shayla R Williams | Prosthetist | 11050 Strathmore Dr Apt 422, Los Angeles, CA 90024-2319 | 2019-10-31 |
1255815155 | Mary Alice Swiney | Prosthetist | 3437 Stocker St Apt 4, Los Angeles, CA 90008-3730 | 2018-09-18 |
1114013158 | Los Angeles Institute for Prosthetics and Orthotics Inc | Prosthetist | 443 1/2 So Atlantic Blvd, Los Angeles, CA 90022-2617 | 2006-10-05 |
1033736848 | Sue Sean | Prosthetist | 1830 W Olympic Blvd Ste 123, Los Angeles, CA 90006-3734 | 2020-06-26 |
1770082570 | Matthew Mills | Prosthetist | 6300 Wilshire Blvd, Los Angeles, CA 90048-5204 | 2018-02-07 |
1841744034 | David Craft | Prosthetist | 3160 Geneva St, Los Angeles, CA 90020-1117 | 2016-08-05 |
1316134802 | Suzanne Mary Eckhardt | Prosthetist | 637 Lucas Ave, Los Angeles, CA 90017-1912 | 2007-09-27 |
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1134752942 | Elizabeth Olajide | Prosthetist | 43536 Gadsden Ave Apt 324, Lancaster, CA 93534-6036 | 2020-02-20 |
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 |
1285113951 | Janet Miller | Prosthetist | 6662 Charlene Ave, San Diego, CA 92114 | 2018-08-13 |
1710482807 | John Vetter | Prosthetist | 5110 Whitsett Ave, Valley Village, CA 91607-3016 | 2018-03-29 |
1144728569 | Shiaw Wen Wu | Prosthetist | 1009 N Orange Ave, Azusa, CA 91702-1920 | 2018-01-31 |
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City | LOS ANGELES |
Zip Code | 90073 |
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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.