COLLEEN WENDTLAND (NPI# 1801244389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801244389 |
| Entity Type | Individual |
| Full Name | COLLEEN WENDTLAND |
| Credential | CPED, CFOM |
| Practice Address |
1468 Pepper Ln Banning CA 92220-1469 |
| Practice Telephone | 9095530646 |
| Mailing Telephone | 9095530646 |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225000000X | Orthotic Fitter | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 224900000X | Mastectomy Fitter | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 224L00000X | Pedorthist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1468 PEPPER LN |
| City | BANNING |
| State | CA |
| Zip Code | 92220-1469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962056523 | Golden View Guest Home, Inc. | Assisted Living Facility | 5466 West Wilson, Banning, CA 92220 | 2019-07-31 |
| 1780246157 | Fjs Hearing Professionals | Hearing Instrument Specialist | 3559 W Ramsey Ave Suit C-2, Banning, CA 92220 | 2019-07-05 |
| 1790237832 | Jennifer De Geus | Counselor | 1627 Hargrave St., Banning, CA 92220 | 2016-10-25 |
| 1427447507 | Dalonna Blackwell | Counselor | 2781 W. Ramsey St., Banning, CA 92220 | 2015-01-13 |
| 1639575962 | Eunjung J. Jung Choi | Dentist | 300 S Highland Springs Ave Ste 2l, Banning, CA 92220 | 2014-11-13 |
| 1861810244 | Genevra Diana Glenn | Counselor | 2781 W Ramsey, Suite 1, Banning, CA 92220 | 2014-04-02 |
| 1841617420 | Kristen Lew | Internal Medicine | 6109 W.ramsey Street, Banning, CA 92220 | 2014-03-21 |
| 1588917884 | Jamison William Murphy | Military Health Care Provider | Uss Howard Ddg 83, Fpo, AP 92220 | 2012-10-24 |
| 1972871390 | John Hong | Pharmacist | 60 N Highlandsprings, Beaumont, CA 92220 | 2011-12-13 |
| 1679855936 | Lydia Session | Marriage & Family Therapist | 1627 S. Hargrave, Banning, CA 92220 | 2011-09-13 |
| Find all providers in zip 92220 | ||||
| Taxonomy Code | 224L00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Pedorthist |
| An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750993572 | Rachel Olivares | Pedorthist | 13193 Lavonda St, Eastvale, CA 92880-0789 | 2020-08-21 |
| 1871130781 | Matthew Maltezos | Pedorthist | 6536 E Spring St, Long Beach, CA 90815-1554 | 2019-12-10 |
| 1295378891 | Jennifer Faria | Pedorthist | 301 Georgia St Ste 322, Vallejo, CA 94590-5945 | 2019-10-26 |
| 1134689607 | Jesse Bittle | Pedorthist | 1830 Hacienda Dr Ste 5, Vista, CA 92081-4544 | 2019-03-21 |
| 1467929307 | Jennifer Faria | Pedorthist | 438 Annette Ave, Vallejo, CA 94591-6574 | 2018-10-29 |
| 1730600222 | Chris Bonsall Sr. | Pedorthist | 1350 Grant Rd Ste 14b, Mountain View, CA 94040-3248 | 2017-07-05 |
| 1245750140 | Judy Burke Morabito | Pedorthist | 801 Dolliver Street, Pismo Beach, CA 93449 | 2017-06-21 |
| 1548701675 | Gill L Majko | Pedorthist | 4941 E Walnut St # 7, Soquel, CA 95073-2433 | 2017-03-08 |
| 1740655448 | Michael Wells | Pedorthist | 1835 Chicago Ave, Unit A, Riverside, CA 92507-2378 | 2015-12-07 |
| 1659701993 | Harold Peters | Pedorthist | 685 Mary St, Redding, CA 96001-0310 | 2013-11-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COLLEEN WENDTLAND.
| 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.