ALPHA ISCANDARI SANUSI (NPI# 1710534821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710534821 |
| Entity Type | Individual |
| Full Name | ALPHA ISCANDARI SANUSI |
| Credential | BOCPO |
| Practice Address |
1760 Chicago Ave Ste L21 Riverside CA 92507-2326 |
| Practice Telephone | 6266223359 |
| Mailing Telephone | 6266223359 |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | C51502 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 224P00000X | Prosthetist | C51502 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ORTHOTIST/PROSTHETIST CREDENTIAL | C51502 | 01 |
| Street Address |
1760 CHICAGO AVE STE L21 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92507-2326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110508 | Cameron Stewart | Specialist | 1760 Chicago Ave Ste L21, Riverside, CA 92507-2326 | 2019-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448917 | Rachel Nielson | Counselor | 1450 Spruce St, Suite A, Riverside, CA 92507 | 2020-08-24 |
| 1437769742 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 2862 Unit B Canyon Springs Parkway, Riverside, CA 92507 | 2020-08-03 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1164067567 | Audrey Gruen | Social Worker | Canyon Crest Mental Health, 5225 Canyon Crest Drive #100, Riverside, CA 92507 | 2019-11-10 |
| 1518432962 | Antonio Mixon | Specialist | 1405 Spruce Street, Suite A, Riverside, CA 92507 | 2018-10-11 |
| 1811479793 | New Day Counseling Services | Counselor | 20363 Harvard Way, Riverside, CA 92507 | 2018-09-06 |
| 1780176875 | Miriam Martinez | Case Manager/Care Coordinator | 2085 Rustin Ave., Riverside, CA 92507 | 2018-06-04 |
| 1518478874 | Lisa Manuel | Counselor | 2058 Rustin Ave, Riverside, CA 92507 | 2017-10-13 |
| 1497272942 | Yajaira Placensia | Behavioral Analyst | 1486 Everton Place, Riverside, CA 92507 | 2017-08-25 |
| 1841717691 | Stephanie Teuchert | Behavioral Analyst | 1080 Spruce Street Apartment 7c, Riverside, CA 92507 | 2017-08-23 |
| Find all providers in zip 92507 | ||||
| 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 |
|---|---|---|---|---|
| 1588022131 | Leshi Barnes | Prosthetist | 10580 Magnolia Ave, Riverside, CA 92505-6904 | 2016-02-10 |
| 1619100930 | Dean E Rabbitt | Prosthetist | 8170 Janis St, Riverside, CA 92504-3112 | 2009-09-02 |
| 1326534363 | Tracie Radford | Prosthetist | 6086 Brockton Ave, Riverside, CA 92506-2227 | 2018-07-02 |
| 1417145988 | Cyrus G Price | Prosthetist | 6377 Riverside Ave Ste B100, Riverside, CA 92506-3133 | 2007-10-10 |
| 1811182082 | Phillip Conley | Prosthetist | 6377 Riverside Ave Ste B100, Riverside, CA 92506-3133 | 2007-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752942 | Elizabeth Olajide | Prosthetist | 43536 Gadsden Ave Apt 324, Lancaster, CA 93534-6036 | 2020-02-20 |
| 1831733948 | Shayla R Williams | Prosthetist | 11050 Strathmore Dr Apt 422, Los Angeles, CA 90024-2319 | 2019-10-31 |
| 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 |
| 1255815155 | Mary Alice Swiney | Prosthetist | 3437 Stocker St Apt 4, Los Angeles, CA 90008-3730 | 2018-09-18 |
| 1285113951 | Janet Miller | Prosthetist | 6662 Charlene Ave, San Diego, CA 92114 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
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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.