111 Fashion Lane LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

111 FASHION LANE LLC

Practice address

111 Fashion LN
Tustin, CA 92780-3306

Phone

(714) 619-8636

Fax

(866) 646-1488

NPI assigned

May 14, 2021

Organization subpart

No

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

Authorized official

Name

Agnes Yen Sinclair

Title

Manager

Phone

(626) 429-9290

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1265006258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FASHION LN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803306",
            "telephone_number": "714-619-8636",
            "fax_number": "866-646-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FASHION LN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803306",
            "telephone_number": "714-619-8636",
            "fax_number": "866-646-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "111 FASHION LANE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "YEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "626-429-9290"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 10 Acre Ranch
• 17TH Street Optometry Apc
• 20-20 Eyecare Center Optometry Inc
• A Touch of Care Senior Home LLC
• Trinytei Aaron
• Lea Dominique Maturan Abadies, PA

• All providers in Tustin, CA
• Adult Day Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.