MANE OF YOUR DREAM (NPI# 1629603741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629603741 |
| Entity Type | Organization |
| Organization Name | MANE OF YOUR DREAM |
| Practice Address |
11553 Foothill Blvd Ste 101 Rancho Cucamonga CA 91730-0731 |
| Mailing Address |
10210 Baseline Rd Spc 267 Alta Loma CA 91701-6048 |
| Practice Telephone | 9099691833 |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | PATSY GALLIAN (BILLING/CRENDENTIALING) |
| Authorized Official Telephone | 2144372272 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
Other Service Providers | ||
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | COSMETOLOGY LICENSE | KK347413 | 01 |
| Street Address |
11553 FOOTHILL BLVD STE 101 |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91730-0731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572506 | Sandie Dubois | Counselor | 11553 Foothill Blvd Ste 101, Rancho Cucamonga, CA 91730-0731 | 2020-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722444 | Alliancerx Health Solutions, LLC. | Clinical Medical Laboratory | 9431 Haven Ave, Suite 100 #376, Rancho Cucamonga, CA 91730 | 2020-05-19 |
| 1346860194 | Wecare Dialysis Center | Clinic/Center | 8591 Grove Ave, Rancho Cucamonga, CA 91730 | 2020-04-22 |
| 1982235263 | Mel Latone Family Counseling, Inc. | Marriage & Family Therapist | 9033 Base Line Road, Suite M, Rancho Cucamonga, CA 91730 | 2020-01-27 |
| 1205471240 | Breena Nakamoto | Social Worker | 9645 Arrow Route, Building 5, Suite A, Rancho Cucamonga, CA 91730 | 2019-11-13 |
| 1497300180 | Laura Estela Le | Behavior Technician | 8350 Archilbald Ave Ste 110, Rancho Cucamonga, CA 91730 | 2019-08-08 |
| 1336792100 | Swan Psychological Services, Inc. | Psychologist | 8333 E. Foothill Blvd., Suite 109, Rancho Cucamonga, CA 91730 | 2019-07-22 |
| 1568023745 | Mariah Wright | Behavior Technician | 10532 Arcacia St, B-11, Rancho Cucamonga, CA 91730 | 2019-06-27 |
| 1770140378 | Amanda Ware | Clinic/Center | 9333 Fairway View Place Suite 101, Rancho Cucamonga, CA 91730 | 2019-05-20 |
| 1265995435 | Collaborative Autism Management Programs Inc. | Community/Behavioral Health | 9360 Santa Anita Ave Ste 104, Rancho Cucamonga, CA 91730 | 2019-04-12 |
| 1700361326 | Brittany Rhone | Behavioral Analyst | 933 Baseline Rd, Rancho Cucamonga, CA 91730 | 2018-09-28 |
| Find all providers in zip 91730 | ||||
| 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 |
|---|---|---|---|---|
| 1972929461 | My Wig Studio | Prosthetic/Orthotic Supplier | 12543 Winery Dr, Rancho Cucamonga, CA 91739-8834 | 2014-03-09 |
| 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 | ||||
| City | RANCHO CUCAMONGA |
| Zip Code | 91730 |
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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.