MRS. CECELIA ROSE GREENE/PENDZICH


Address: 7760 Fay Ave, Suite M., La Jolla, CA 92037
Phone: 8582302340

MRS. CECELIA ROSE GREENE/PENDZICH (NPI# 1700357936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700357936
Entity Type Individual
Full Name MRS. CECELIA ROSE GREENE/PENDZICH
Credential CERTIFIED PERMANENT
Practice Address 7760 Fay Ave, Suite M.
La Jolla
CA 92037
Practice Telephone 8582302340
Mailing Telephone 8582302340
Enumeration Date 2018-12-16
Last Update Date 2018-12-16
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 224900000X Mastectomy Fitter Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 7760 FAY AVE, SUITE M.
City LA JOLLA
State CA
Zip Code 92037

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1982221768 Equip Health Medical, PC Clinic/Center 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 2020-06-29
1134745474 Brenda Kay Wiederhold Psychologist Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 2020-06-23
1316581598 Kathleen M Blechertas Physical Therapist 9888 Genesee, Lj19, La Jolla, CA 92037 2019-10-31
1316592876 Kevin Yanyan Li Student in an Organized Health Care Education/Training Program 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 2019-08-01
1407400542 Juan J Salmeron Dentist Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 2019-07-26
1609428598 Nicole Whitney Mark Physician Assistant 8103 Caminito Sonoma, La Jolla, CA 92037 2019-07-11
1740765890 Jeenal Ankit Gordhandas Student in an Organized Health Care Education/Training Program East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 2018-09-25
1306325220 Lisa Beth Perlov Marks Marriage & Family Therapist 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 2018-08-10
1023596731 Uc San Diego, Pathology Dept Pathology East Campus Office Building, Medical Center Dr, San Diego, CA 92037 2018-08-03
1891288197 Maria Bernadette Facun Nurse Practitioner 10666 N. Torrey Pines Road, N203, La Jolla, CA 92037 2018-06-11
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Taxonomy Information

Taxonomy Code 224900000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Mastectomy Fitter

Taxonomy Definition

An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1053944827 Abigail's Medical Supply Inc Mastectomy Fitter 2020 Camino Del Rio N Ste 105, San Diego, CA 92108-1542 2020-02-19
1679106926 Dana Walker Mastectomy Fitter 9033 Baseline Rd Ste C, Rancho Cucamonga, CA 91730-1214 2020-02-14
1053832923 Bras and Honey Lingerie Limited Mastectomy Fitter 4242 Camino Del Rio N Ste 9, San Diego, CA 92108-2612 2017-06-30
1477810646 Sasha Merritt Mastectomy Fitter 760 Market St Ste 854, San Francisco, CA 94102-2309 2012-04-12
1477834315 Nancy A. Pavsek Mastectomy Fitter 1338 W Winton Ave, Hayward, CA 94545-1408 2011-09-06
1851461123 Enhance By Linda Reib Inc. Mastectomy Fitter 4811 Chippendale Dr, Suite 208, Sacramento, CA 95841-2555 2006-11-08
1386277002 Cinderella's Closet Your Specialty Lingerie Boutique Mastectomy Fitter 9033 Baseline Rd Ste C, Rancho Cucamonga, CA 91730-1214 2020-02-20
1891257499 Haley Trivoli Mastectomy Fitter 232 N Brand Blvd, Glendale, CA 91203-2610 2019-04-02
1629547963 Elizabeth L. Garcia-flynn Mastectomy Fitter 660 E Regent St, Inglewood, CA 90301-1415 2018-11-15
1144711045 Dona Rebecca Tegerstrand Mastectomy Fitter 2102 Civic Center Dr, Redding, CA 96001-2704 2018-05-25
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Competitor

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City LA JOLLA
Zip Code 92037

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Dataset Information

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.

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