Randy S Vallembois, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

Practice address

2039 N Fine Ave
Fresno, CA 93727-1512

Phone

(559) 251-5557

Fax

(559) 251-5559

NPI assigned

Oct 10, 2019

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Orthotic & Prosthetic LLC

  • Prosthetic/Orthotic Supplier
  • Fresno, CA
  • NPI 1760119168

  Orthotist

  NPD Authorized official
• Tammy L Dirksen

  dba Central Orthotic & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Fresno, CA
  • NPI 1558559484
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1215579230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 N FINE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271512",
            "telephone_number": "559-251-5557",
            "fax_number": "559-251-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 N FINE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271512",
            "telephone_number": "559-251-5557",
            "fax_number": "559-251-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEMBOIS",
        "first_name": "RANDY",
        "middle_name": "S",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-10",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XC0197370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priscilla A Valle, LCSW
• Sandra Elizabeth Valle
• Anthony M Vallejo I
• Patricia Vallejo
• Joseph Vallejos, BCBA
• Francisco Javier Valles
• Stephanie Valleser, NP
• Lydia Marie Vallesillas, PA-C
• Valley Adult Day Health Care Center
• Valley Cardiac Surgery Medical Group

• Prosthetist in Fresno, CA
• Providers in Fresno, CA by specialty
• Prosthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.