WENDY M CROOMES (NPI# 1609378876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609378876 |
| Entity Type | Individual |
| Full Name | WENDY M CROOMES |
| Practice Address |
11905 S Central Ave Ste 303 Los Angeles CA 90059-2897 |
| Mailing Address |
9808 Venice Blvd Ste 700 Culver City CA 90232-6824 |
| Practice Telephone | 3232002550 |
| Mailing Telephone | 3109453350 |
| Mailing Fax Number | 3109453356 |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2019-04-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | 87510 | CA | Behavioral Health & Social Service Providers |
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | C2144497 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 470 E 3rd St, Los Angeles, CA 900131629 | 2136266411 |
| Street Address |
11905 S CENTRAL AVE STE 303 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059-2897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235304809 | Mental Health America of Los Angeles | Community/Behavioral Health | 11905 S Central Ave Ste 303, Los Angeles, CA 90059-2836 | 2008-04-24 |
| 1437704806 | Exodus Recovery, Inc. | Community/Behavioral Health | 11905 S Central Ave Ste 303, Los Angeles, CA 90059-2897 | 2019-08-02 |
| 1528478112 | John Trieu | Nurse Practitioner | 11905 S Central Ave Ste 303, Los Angeles, CA 90059-2897 | 2014-05-05 |
| 1790113801 | Liza Beth Anulao | Counselor | 11905 S Central Ave Ste 303, Los Angeles, CA 90059-2897 | 2013-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| 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 |
|---|---|---|---|---|
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1063046795 | Leanne Margaret Cremin | Rehabilitation Practitioner | 2285 Westwood Blvd, Los Angeles, CA 90064-2017 | 2020-03-03 |
| 1720610421 | Ronmoe Inc | Rehabilitation Practitioner | 2025 Westwood Blvd, Los Angeles, CA 90025-6328 | 2020-02-10 |
| 1104390723 | Joana Rodriguez | Rehabilitation Practitioner | 3731 Stocker St., Suite 105, Los Angeles, CA 90008 | 2019-01-16 |
| 1376055145 | Gentle F Carcamo | Rehabilitation Practitioner | 3731 Stoker Street, Ste. 105, Los Angeles, CA 90008 | 2017-11-01 |
| 1114445848 | Claudia Melgar | Rehabilitation Practitioner | 1540 Alcazar St # St133, Los Angeles, CA 90089-0080 | 2017-09-01 |
| 1134646516 | Maria Salas | Rehabilitation Practitioner | 333 S Beaudry Ave., Los Angeles, CA 90017 | 2017-08-25 |
| 1295257111 | Freddy Pablo | Rehabilitation Practitioner | 3580 Wilshire Blvd., Ste. 800, Los Angeles, CA 90010 | 2017-07-12 |
| 1356893796 | Rosemary Marroquin | Rehabilitation Practitioner | 511 N Harvard Blvd, Los Angeles, CA 90004-1906 | 2016-11-02 |
| 1902356520 | Aida Kimberly Escobar | Rehabilitation Practitioner | 2715 E 5th St, Los Angeles, CA 90033-4422 | 2016-10-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
Please comment or provide details below to improve the information on WENDY M CROOMES.
| 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.